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Inter-fraction movements of the prostate and pelvic lymph nodes during IGRT
Umeå University, Faculty of Medicine, Department of Radiation Sciences.ORCID iD: 0000-0003-4132-6915
Umeå University, Faculty of Medicine, Department of Radiation Sciences.
Umeå University, Faculty of Medicine, Department of Radiation Sciences.
Umeå University, Faculty of Medicine, Department of Radiation Sciences.
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2018 (English)In: Journal of radiation oncology, ISSN 1948-7894, Vol. 7, no 4, p. 357-366Article in journal (Refereed) Published
Abstract [en]

Objectivities: The aim of this study was to evaluate inter-fraction movements of lymph node regions that are commonly included in the pelvic clinical target volume (CTV) for high-risk prostate cancer patients. We also aimed to evaluate if the movements affect the planning target volumes. Methods: Ten prostate cancer patients were included. The patients underwent six MRI scans, from treatment planning to near end of treatment. The CTV movements were analyzed with deformable registration technique with the CTV divided into sections. The validity of the deformable registration was assessed by comparing the results for individual lymph nodes that were possible to identify in all scans. Results: Using repetitive MRI, measurements showed that areas inside the CTV (lymph nodes) in some extreme cases were as mobile as the prostate and not fixed to the bones. The lymph node volumes closest to the prostate did not tend to follow the prostate motion. The more cranial lymph node volumes moved less, but still independently, and they were not necessarily fixed to the pelvic bones. In 95% of the cases, the lymph node motion in the R-L direction was 2-4mm, in the A-P direction 2-7mm, and in the C-C direction 2-5mm depending on the CTV section. Conclusion: Lymph nodes and prostate were most mobile in the A-P direction, followed by the C-C and R-L directions. This movement should be taken into account when deciding the margins for the planning target volumes (PTV).

Place, publisher, year, edition, pages
Springer, 2018. Vol. 7, no 4, p. 357-366
Keywords [en]
Prostate, Lymph nodes, CTV, Movements
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:umu:diva-154896DOI: 10.1007/s13566-018-0366-3ISI: 000452890500007PubMedID: 30595810OAI: oai:DiVA.org:umu-154896DiVA, id: diva2:1275626
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07Bibliographically approved

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Björeland, UlrikaJonsson, JoakimAlm, MagnusBeckman, LarsNyholm, TufveThellenberg-Karlsson, Camilla

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Björeland, UlrikaJonsson, JoakimAlm, MagnusBeckman, LarsNyholm, TufveThellenberg-Karlsson, Camilla
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