Shimizu Yasuhiro, Takamatsu Shigeyuki, Yamamoto Kazutaka, Maeda Yoshikazu, Sasaki Makoto, Tamamura Hiroyasu, Bou Sayuri, Kumano Tomoyasu, Gabata Toshifumi
Department of Radiology, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa, 920-8640, Japan.
Proton Therapy Center, Fukui Prefectural Hospital, Fukui, 910-8526, Japan.
Jpn J Radiol. 2018 Aug;36(8):511-518. doi: 10.1007/s11604-018-0750-3. Epub 2018 Jun 20.
The purpose of this study was to analyze the respiratory motion of each segment of the liver in patients with or without a history of abdominal surgery using four-dimensional computed tomography.
In total, 57 patients treated for abdominal tumors using proton beam therapy were enrolled. Eighteen patients had a history of abdominal surgery and 39 did not. The positions of clearly demarcated, high-density regions in the liver were measured as evaluation points with which to quantify the motion of each liver segment according to the Couinaud classification.
In total, 218 evaluation points were analyzed. Comparison of differences in the motion of individual liver segments showed that among patients without a history of surgery, the maximum was 29.0 (7.2-42.1) mm in S6 and the minimum was 15.1 (10.6-19.3) mm in S4. Among patients with a history of surgery, the maximum was 28.0 (9.0-37.4) mm in S7 and the minimum was 6.3 (4.1-9.3) mm in S3.
The distances and directions of respiratory motion differed for each liver segment, and a history of abdominal surgery reduced the respiratory motion of the liver. It is necessary to selectively use the internal margin setting.
本研究旨在使用四维计算机断层扫描分析有或无腹部手术史患者肝脏各节段的呼吸运动。
共纳入57例接受质子束治疗腹部肿瘤的患者。18例有腹部手术史，39例无腹部手术史。测量肝脏中清晰界定的高密度区域的位置作为评估点，以根据Couinaud分类量化每个肝段的运动。
共分析218个评估点。各肝段运动差异比较显示，无手术史患者中，S6段最大运动为29.0（7.2 - 42.1）mm，S4段最小运动为15.1（10.6 - 19.3）mm。有手术史患者中，S7段最大运动为28.0（9.0 - 37.4）mm，S3段最小运动为6.3（4.1 - 9.3）mm。
各肝段呼吸运动的距离和方向不同，腹部手术史会降低肝脏的呼吸运动。有必要选择性地使用内边界设置。
