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Cited 3 time in webofscience Cited 3 time in scopus
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Interfractional diaphragmatic position variation according to stomach volume change during respiratory-gated radiotherapy for hepatocellular carcinoma

Authors
Kim, Tae GyuKang, Ki MunPark, ByungdoPark, JeehoonSong, Yun GyuKim, Kwang MinShim, SanggoonYu, Kil JongLee, Hyoun Wook
Issue Date
Sep-2021
Publisher
American Association of Physicists in Medicine
Keywords
baseline shifts; hepatocellular carcinoma; respiratory-gated radiotherapy; stomach
Citation
Medical Physics, v.48, no.9, pp 5531 - 5539
Pages
9
Indexed
SCIE
SCOPUS
Journal Title
Medical Physics
Volume
48
Number
9
Start Page
5531
End Page
5539
URI
https://scholarworks.gnu.ac.kr/handle/sw.gnu/3290
DOI
10.1002/mp.15055
ISSN
0094-2405
2473-4209
Abstract
Purpose We evaluated the correlation between stomach volume change and interfractional baseline shifts of the diaphragm in image-guided radiotherapy (IGRT) for hepatocellular carcinoma (HCC). Materials and methods Twenty-four patients with HCC underwent ten fractions of IGRT, and a total of 240 cone beam computed tomography (CBCT) and on-board imager (OBI) kV image sets were acquired. These image sets were retrospectively analyzed. Baseline shifts of the diaphragm relative to bone and stomach volume change ratios were evaluated using four-dimensional simulation CT, kV image, and CBCT images. Associations between baseline shifts and patient physiologic factors were investigated. Results The average baseline shift of the diaphragm in the superior-inferior (SI) direction was 1.5 mm (standard deviation 4.6 mm), which was higher than the shift in other directions (0.7, 2.0 mm and 0.9, 2.6 mm in right-left (RL) and anterior-posterior (AP) directions, respectively). Interfractional baseline shifts of the diaphragm in the SI and AP directions were positively correlated with the stomach volume change ratio (Pearson's r: 0.416 and 0.302, p-value: <0.001 and <0.001, respectively). Conclusions The interfractional baseline shifts of the diaphragm in the SI and AP directions correlated well with stomach volume changes. Efforts to maintain a constant stomach volume before the simulation and each treatment, such as fasting, may reduce interfractional baseline shifts of liver tumors.
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