ArticlePhysics and imaging in radiation oncology2021
Quantifying inter-fraction cardiac substructure displacement during radiotherapy via magnetic resonance imaging guidance.
Article in Physics and imaging in radiation oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Deducing cardiorespiratory motion of cardiac substructures using a novel 5D-MRI workflow for radiotherapy.Physics in medicine and biology · 2026Article
- Cardiac substructure delineation in radiation therapy - A state-of-the-art review.Journal of medical imaging and radiation oncology · 2024Review
- Cardiac motion and its dosimetric impact during radioablation for refractory ventricular tachycardia.Journal of applied clinical medical physics · 2023Article
- On the feasibility of cardiac substructure sparing in magnetic resonance imaging guided stereotactic lung radiotherapy.Medical physics · 2023Article
- Validation of an established deep learning auto-segmentation tool for cardiac substructures in 4D radiotherapy planning scans.Physics and imaging in radiation oncology · 2022Article
- Proof-of-concept for x-ray based real-time image guidance during cardiac radioablation.Physics in medicine and biology · 2021Article
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Authors and funding
6 authors.
Funding
Abstract
purposeEmerging evidence suggests cardiac substructures are highly radiosensitive during radiation therapy for cancer treatment. However, variability in substructure position after tumor localization has not been well characterized. This study quantifies inter-fraction displacement and planning organ at risk volumes (PRVs) of substructures by leveraging the excellent soft tissue contrast of magnetic resonance imaging (MRI).
methodsEighteen retrospectively evaluated patients underwent radiotherapy for intrathoracic tumors with a 0.35 T MRI-guided linear accelerator. Imaging was acquired at a 17-25 s breath-hold (resolution 1.5 × 1.5 × 3 mm
resultsAcross substructures, inter-fraction displacements for 14% in the left-right, 18% in the anterior-posterior, and 21% of fractions in the superior-inferior were > 5 mm. Due to lack of breath-hold compliance, ~4% of all structures shifted > 10 mm in any axis. For the chambers, median displacements were 1.8, 1.9, and 2.2 mm in the left-right, anterior-posterior, and superior-inferior axis, respectively. Great vessels demonstrated larger displacements (> 3 mm) in the superior-inferior axis (43% of shifts) and were only 25% (left-right) and 29% (anterior-posterior) elsewhere. PRVs from 3 to 5 mm were determined as anisotropic substructure-specific margins.
conclusionsThis exploratory work derived substructure-specific safety margins to ensure highly effective cardiac sparing. Findings require validation in a larger cohort for robust margin derivation and for applications in prospective clinical trials.
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