West Kimberley, Russo Majella, Brown Elizabeth, Barry Tamara, Hargrave Cathy, Pryor David
Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
J Med Imaging Radiat Oncol. 2018 Feb;62(1):128-132. doi: 10.1111/1754-9485.12681. Epub 2017 Oct 9.
The optimal delivery of stereotactic radiotherapy for kidney tumours requires an effective motion management strategy. This study assessed the effectiveness of a pneumatic abdominal compression belt in reducing kidney motion during free breathing.
Thirteen patients, with four-dimensional computed tomography (4DCT) of the abdomen in free breathing with and without a pneumatic abdominal compression belt, were retrospectively reviewed. Points of Interest (POI) were placed on each kidney to determine the greatest magnitude of displacement in all directions.
Without compression, all patients had >5.0 mm motion in the craniocaudal (CC) direction in at least one kidney. Median CC excursion of the left superior pole was reduced with compression from 8.0 mm (range 2.0 mm-18.0 mm) to 4.0 mm (range 2.0 mm-10.0 mm, P = 0.047) and right superior pole from 10.0 mm (range 4.0 mm-16.0 mm) to 6.0 mm (range 2.0 mm-10.0 mm, P=value 0.051). A benefit was less evident for the left and right inferior poles with median CC excursion of 6.0 mm versus 4.0 mm and 5.0 mm versus 4.0 mm without and with compression, respectively. Median displacement in the anteroposterior direction (≤3.2 mm) and lateral directions (≤1.3 mm) was similar for left and right kidneys and not significantly altered by compression. Overall, seven patients had kidney motion reduced by >5.0 mm with two reduced by 10.0 mm.
A pneumatic abdominal compression belt reduced kidney motion by >5.0 mm in seven of thirteen patients. The relative benefit is patient and location specific and should be assessed on an individual basis.
肾肿瘤立体定向放射治疗的最佳实施需要有效的运动管理策略。本研究评估了气动腹部压迫带在自由呼吸期间减少肾脏运动的有效性。
回顾性分析了13例患者，这些患者在自由呼吸状态下有带和不带气动腹部压迫带的腹部四维计算机断层扫描（4DCT）图像。在每个肾脏上放置感兴趣点（POI），以确定各个方向上的最大位移幅度。
在未进行压迫时，所有患者至少有一个肾脏在头脚（CC）方向上的运动>5.0 mm。压迫后，左肾上极的CC中位偏移量从8.0 mm（范围2.0 mm - 18.0 mm）降至4.0 mm（范围2.0 mm - 10.0 mm，P = 0.047），右肾上极从10.0 mm（范围4.0 mm - 16.0 mm）降至6.0 mm（范围2.0 mm - 10.0 mm，P值 = 0.051）。对于左、右下极，压迫的益处不太明显，未压迫和压迫时CC中位偏移量分别为6.0 mm对4.0 mm和5.0 mm对4.0 mm。左、右肾在前后方向（≤3.2 mm）和侧向方向（≤1.3 mm）的中位位移相似，且压迫后无显著变化。总体而言，7例患者的肾脏运动减少>5.0 mm，其中2例减少了10.0 mm。
气动腹部压迫带使13例患者中的7例肾脏运动减少>5.0 mm。相对益处因患者和位置而异，应根据个体情况进行评估。
