Leipold Vanda, Alerić Ivana, Mlinarić Mihaela, Kosmina Domagoj, Stanić Fran, Kasabašić Mladen, Štimac Damir, Kaučić Hrvoje, Ursi Giovanni, Schwarz Karla, Nikolić Igor, Klapan Denis, Schwarz Dragan
Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
Specialty Hospital Radiochirurgia Zagreb, 10431 Sveta Nedelja, Croatia.
Cancers (Basel). 2024 Jun 27;16(13):2358. doi: 10.3390/cancers16132358.
Image-guided radiotherapy supported by surface guidance can help to track lower lung lesions' respiratory motion while reducing a patient's exposure to ionizing radiation. However, it is not always clear how the skin's respiratory motion magnitude and its correlation with the lung lesion's respiratory motion vary between different skin regions of interest (ROI). Four-dimensional computed tomography (4DCT) images provide information on both the skin and lung respiratory motion and are routinely acquired for the purpose of treatment planning in our institution. An analysis of 4DCT images for 57 patients treated in our institution has been conducted to provide information on the respiratory motion magnitudes of nine skin ROIs of the torso, a tracking structure (TS) representing a lower lung lobe lesion, as well as the respiratory motion correlations between the nine ROIs and the TS. The effects of gender and the adipose tissue volume and distribution on these correlations and magnitudes have been analyzed. Significant differences between the ROIs in both the respiratory motion magnitudes and their correlations with the TS have been detected. An overall negative correlation between the ROI respiratory magnitudes and the adipose tissue has been detected for ROIs with rib cage support. A weak to moderate negative correlation between the adipose tissue volume and ROI-to-TS respiratory correlations has been detected for upper thorax ROIs. The respiratory magnitudes in regions without rib support tend to be larger for men than for women, but no differences in the ROI-to-TS correlation between sexes have been detected. The described findings should be considered when choosing skin surrogates for lower lung lesion motion management.
由表面引导支持的图像引导放射治疗有助于跟踪下肺病变的呼吸运动，同时减少患者对电离辐射的暴露。然而，在不同的皮肤感兴趣区域（ROI）之间，皮肤的呼吸运动幅度及其与肺病变呼吸运动的相关性如何变化并不总是清楚。四维计算机断层扫描（4DCT）图像提供了皮肤和肺呼吸运动的信息，并且在我们机构中为治疗计划的目的而常规获取。对在我们机构接受治疗的57例患者的4DCT图像进行了分析，以提供有关躯干九个皮肤ROI、代表下肺叶病变的跟踪结构（TS）的呼吸运动幅度，以及九个ROI与TS之间的呼吸运动相关性的信息。分析了性别以及脂肪组织体积和分布对这些相关性和幅度的影响。已检测到ROI在呼吸运动幅度及其与TS的相关性方面存在显著差异。对于有肋骨支撑的ROI，已检测到ROI呼吸幅度与脂肪组织之间总体呈负相关。对于上胸部ROI，已检测到脂肪组织体积与ROI到TS的呼吸相关性之间存在弱至中度的负相关。没有肋骨支撑的区域中男性的呼吸幅度往往比女性大，但未检测到性别之间ROI到TS相关性的差异。在为下肺病变运动管理选择皮肤替代物时应考虑上述发现。
