ArticlePrecision radiation oncology2025
Impact of Intra-fractional respiratory motion on dose distribution in lattice radiotherapy for liver tumors.
Article in Precision radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Dosimetric comparison of pipe-joint versus conventional VMAT for lattice radiotherapy in bulky tumors: a retrospective planning study.Radiation oncology (London, England) · 2026Article
- A multicenter study identifies an immune inflammatory and nutritional prognostic signature in intrahepatic cholangiocarcinoma.Discover oncology · 2026Article
- Impact of Intra-fractional respiratory motion on dose distribution in lattice radiotherapy for liver tumors.Precision radiation oncology · 2025Article
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6 authors.
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Abstract
Purpose: To quantify the detrimental impact of respiratory motion on the critical "peak-and-valley" dose distribution in lattice radiotherapy (LRT) for liver tumors, to thereby evaluate the necessity of motion management. Methods: This study assessed the data of 24 patients with liver cancer who underwent free-breathing 4D-CT simulation, for which a 2×2×2 vertices LRT tree was constructed. Volumetric Modulated Arc Therapy (VMAT) plans were generated based on the results of free-breathing CT. The delivered dose distribution under respiratory motion was then simulated by dividing the planned dose into 10 equal subcomponents, applying phase-specific isocenter shifts derived from 4D-CT displacement measurements, and summing the deformed doses. The metrics analyzed included the vertex dose deviation, valley-to-peak dose ratio (VPDR), and low-dose bath volumes. Results: The analysis revealed a mean 3D respiratory motion error of 8.59 mm, with predominant displacement in the superior-inferior (SI) direction (6.78±3.15 mm). Respiratory motion significantly degraded the LRT dose distributions; specifically, the vertices mean dose (D Conclusion: Respiratory motion severely degrades essential spatial fractionation during liver LRT, particularly when exceeding 8 mm and occurring predominantly in the SI direction. This motion reduces peak vertex doses, increases the VPDR (homogenizing the dose distribution), and disrupts the low-dose bath volumes critical for normal tissue sparing and the bystander effect.
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