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Online MR evaluation of inter- and intra-fraction uterus motions and bladder volume changes during cervical cancer external beam radiotherapy
The purpose of the study was to assess the uterus motions and bladder volume changes of fractional movements in cervical sites throughout the external beam radiotherapy (EBRT) treatment. A prospective online MR imaging tracking study was conducted in EBRT 43 patients with at least 4 scans during eac...
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| Published in: | Radiation oncology (London, England) England), 2021-09, Vol.16 (1), p.179-179, Article 179 |
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| creator | Li, Xu Wang, Lizhen Cui, Zhen Li, Yukun Liu, Pei Wang, Yungang Zhu, Jinhong Zhu, Jianmin Yin, Yong Li, Zhenjiang |
| description | The purpose of the study was to assess the uterus motions and bladder volume changes of fractional movements in cervical sites throughout the external beam radiotherapy (EBRT) treatment.
A prospective online MR imaging tracking study was conducted in EBRT 43 patients with at least 4 scans during each treatment (before: ultrasound scan, MRI scan, CBCT scan, after: MRI scan) were included. In order to improve the treatment repeatability, each patient was instructed to empty the bladder and drink 500 ml water 1 h before CT simulation and each treatment. If the ultrasound scan result reached the CT simulation volume of bladder, the treatment began. Bladder was outlined on the T2 weighted axial sequence and CBCT image by the two observers to avoid the influence of contouring. The data of bladder volume and scanning time were accurately recorded. The bladder volumes, filling rates and uterus motion were retrospectively analyzed by MIM software.
Inter-fraction variation of the bladder volume was significant (p |
| doi_str_mv | 10.1186/s13014-021-01907-1 |
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A prospective online MR imaging tracking study was conducted in EBRT 43 patients with at least 4 scans during each treatment (before: ultrasound scan, MRI scan, CBCT scan, after: MRI scan) were included. In order to improve the treatment repeatability, each patient was instructed to empty the bladder and drink 500 ml water 1 h before CT simulation and each treatment. If the ultrasound scan result reached the CT simulation volume of bladder, the treatment began. Bladder was outlined on the T2 weighted axial sequence and CBCT image by the two observers to avoid the influence of contouring. The data of bladder volume and scanning time were accurately recorded. The bladder volumes, filling rates and uterus motion were retrospectively analyzed by MIM software.
Inter-fraction variation of the bladder volume was significant (p < 0.0001). Intra-fraction mean increase of the bladder volume was modest (30 cc) but significant (p < 0.001). Both inter- and intra-fraction of the uterus motion were significant. The average time between the pre-and post-fraction MRI scans was 27.82 ± 7.12 min (range 10-55 min) for IMRT plans and 24.14 ± 5.86 min (range7-38 min) for VMAT plan. Average bladder filling rate was 3.43 ml/min. The bladder filling rate did not change significantly with the course of treatment, but the bladder was more intolerant.
This is the most detailed assessment of intra-fraction and inter-fraction motion during EBRT for cervical cancer. Finally, this study will inform appropriate treatment margins for online adaptive radiotherapy. We suggest that at least one image scan is needed before the EBRT. The portable US scanner provides a quick but unreliable measurement of the bladder volume. There is a significant statistical difference between the results of ultrasonic scanning and that of image scanning.</description><identifier>ISSN: 1748-717X</identifier><identifier>EISSN: 1748-717X</identifier><identifier>DOI: 10.1186/s13014-021-01907-1</identifier><identifier>PMID: 34535161</identifier><language>eng</language><publisher>England: BioMed Central</publisher><subject>Adult ; Aged ; Bladder ; Bladder filling ; Cancer ; Cancer therapies ; Cervical cancer ; Cervix ; Computed tomography ; Cone-Beam Computed Tomography ; Contouring ; EBRT ; Female ; Humans ; Inter-fractional and Intra-fractional bladder motion ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Medical imaging ; Middle Aged ; Movement ; Online MRI ; Patients ; Planning ; Prospective Studies ; Radiation therapy ; Radiotherapy, Image-Guided - methods ; Scanners ; Scanning ; Simulation ; Statistical analysis ; Ultrasonic imaging ; Ultrasound ; Urinary Bladder - diagnostic imaging ; Uterine cancer ; Uterine Cervical Neoplasms - diagnostic imaging ; Uterine Cervical Neoplasms - radiotherapy ; Uterus ; Uterus - diagnostic imaging</subject><ispartof>Radiation oncology (London, England), 2021-09, Vol.16 (1), p.179-179, Article 179</ispartof><rights>2021. The Author(s).</rights><rights>2021. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2021, corrected publication 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c496t-17c8ffd9b42b7e16c9565676524c759bd3410d5deb9f55a05dd122da3beb0e573</citedby><cites>FETCH-LOGICAL-c496t-17c8ffd9b42b7e16c9565676524c759bd3410d5deb9f55a05dd122da3beb0e573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8447532/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2574655487?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34535161$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Xu</creatorcontrib><creatorcontrib>Wang, Lizhen</creatorcontrib><creatorcontrib>Cui, Zhen</creatorcontrib><creatorcontrib>Li, Yukun</creatorcontrib><creatorcontrib>Liu, Pei</creatorcontrib><creatorcontrib>Wang, Yungang</creatorcontrib><creatorcontrib>Zhu, Jinhong</creatorcontrib><creatorcontrib>Zhu, Jianmin</creatorcontrib><creatorcontrib>Yin, Yong</creatorcontrib><creatorcontrib>Li, Zhenjiang</creatorcontrib><title>Online MR evaluation of inter- and intra-fraction uterus motions and bladder volume changes during cervical cancer external beam radiotherapy</title><title>Radiation oncology (London, England)</title><addtitle>Radiat Oncol</addtitle><description>The purpose of the study was to assess the uterus motions and bladder volume changes of fractional movements in cervical sites throughout the external beam radiotherapy (EBRT) treatment.
A prospective online MR imaging tracking study was conducted in EBRT 43 patients with at least 4 scans during each treatment (before: ultrasound scan, MRI scan, CBCT scan, after: MRI scan) were included. In order to improve the treatment repeatability, each patient was instructed to empty the bladder and drink 500 ml water 1 h before CT simulation and each treatment. If the ultrasound scan result reached the CT simulation volume of bladder, the treatment began. Bladder was outlined on the T2 weighted axial sequence and CBCT image by the two observers to avoid the influence of contouring. The data of bladder volume and scanning time were accurately recorded. The bladder volumes, filling rates and uterus motion were retrospectively analyzed by MIM software.
Inter-fraction variation of the bladder volume was significant (p < 0.0001). Intra-fraction mean increase of the bladder volume was modest (30 cc) but significant (p < 0.001). Both inter- and intra-fraction of the uterus motion were significant. The average time between the pre-and post-fraction MRI scans was 27.82 ± 7.12 min (range 10-55 min) for IMRT plans and 24.14 ± 5.86 min (range7-38 min) for VMAT plan. Average bladder filling rate was 3.43 ml/min. The bladder filling rate did not change significantly with the course of treatment, but the bladder was more intolerant.
This is the most detailed assessment of intra-fraction and inter-fraction motion during EBRT for cervical cancer. Finally, this study will inform appropriate treatment margins for online adaptive radiotherapy. We suggest that at least one image scan is needed before the EBRT. The portable US scanner provides a quick but unreliable measurement of the bladder volume. There is a significant statistical difference between the results of ultrasonic scanning and that of image scanning.</description><subject>Adult</subject><subject>Aged</subject><subject>Bladder</subject><subject>Bladder filling</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Cervical cancer</subject><subject>Cervix</subject><subject>Computed tomography</subject><subject>Cone-Beam Computed Tomography</subject><subject>Contouring</subject><subject>EBRT</subject><subject>Female</subject><subject>Humans</subject><subject>Inter-fractional and Intra-fractional bladder motion</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Movement</subject><subject>Online MRI</subject><subject>Patients</subject><subject>Planning</subject><subject>Prospective Studies</subject><subject>Radiation therapy</subject><subject>Radiotherapy, Image-Guided - methods</subject><subject>Scanners</subject><subject>Scanning</subject><subject>Simulation</subject><subject>Statistical analysis</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><subject>Urinary Bladder - diagnostic imaging</subject><subject>Uterine cancer</subject><subject>Uterine Cervical Neoplasms - diagnostic imaging</subject><subject>Uterine Cervical Neoplasms - radiotherapy</subject><subject>Uterus</subject><subject>Uterus - diagnostic imaging</subject><issn>1748-717X</issn><issn>1748-717X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNpdksFu1DAQhiMEoqXwAhyQJS5cAnZsx8kFCVUUKhVVQiBxsyb2ZNerxF7sZEUfgneusylVy8ljzz-fZ0Z_Ubxm9D1jTf0hMU6ZKGnFSspaqkr2pDhlSjSlYurX0wfxSfEipR2lQnLaPi9OeA4kq9lp8ffaD84j-fad4AGGGSYXPAk9cX7CWBLwdgkjlH0Ec0zOOTEnMobllo6KbgBrMZJDGOYRidmC32Aido7Ob4jBeHAGBmLA55jgn0zw-d4hjCSCdWHaYoT9zcviWQ9Dwld351nx8-Lzj_Ov5dX1l8vzT1elEW09lUyZpu9t24mqU8hq08pa1qqWlTBKtp3lglErLXZtLyVQaS2rKgu8w46iVPysuFy5NsBO76MbId7oAE4fH0LcaIiTMwNqwVFBBkiZ18cstIxbamj-HJuq4wvr48raz92I1uCyreER9HHGu63ehINuhFCSVxnw7g4Qw-8Z06RHlwwOA3gMc9KVVIK3Io-YpW__k-7CvKxyVdVSimbpqFpVJoaUIvb3zTCqF-fo1Tk6O0cfnaNZLnrzcIz7kn9W4bepDsH0</recordid><startdate>20210917</startdate><enddate>20210917</enddate><creator>Li, Xu</creator><creator>Wang, Lizhen</creator><creator>Cui, Zhen</creator><creator>Li, Yukun</creator><creator>Liu, Pei</creator><creator>Wang, Yungang</creator><creator>Zhu, Jinhong</creator><creator>Zhu, Jianmin</creator><creator>Yin, Yong</creator><creator>Li, Zhenjiang</creator><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20210917</creationdate><title>Online MR evaluation of inter- and intra-fraction uterus motions and bladder volume changes during cervical cancer external beam radiotherapy</title><author>Li, Xu ; Wang, Lizhen ; Cui, Zhen ; Li, Yukun ; Liu, Pei ; Wang, Yungang ; Zhu, Jinhong ; Zhu, Jianmin ; Yin, Yong ; Li, Zhenjiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c496t-17c8ffd9b42b7e16c9565676524c759bd3410d5deb9f55a05dd122da3beb0e573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Bladder</topic><topic>Bladder filling</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Cervical cancer</topic><topic>Cervix</topic><topic>Computed tomography</topic><topic>Cone-Beam Computed Tomography</topic><topic>Contouring</topic><topic>EBRT</topic><topic>Female</topic><topic>Humans</topic><topic>Inter-fractional and Intra-fractional bladder motion</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Medical imaging</topic><topic>Middle Aged</topic><topic>Movement</topic><topic>Online MRI</topic><topic>Patients</topic><topic>Planning</topic><topic>Prospective Studies</topic><topic>Radiation therapy</topic><topic>Radiotherapy, Image-Guided - methods</topic><topic>Scanners</topic><topic>Scanning</topic><topic>Simulation</topic><topic>Statistical analysis</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><topic>Urinary Bladder - diagnostic imaging</topic><topic>Uterine cancer</topic><topic>Uterine Cervical Neoplasms - diagnostic imaging</topic><topic>Uterine Cervical Neoplasms - radiotherapy</topic><topic>Uterus</topic><topic>Uterus - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Xu</creatorcontrib><creatorcontrib>Wang, Lizhen</creatorcontrib><creatorcontrib>Cui, Zhen</creatorcontrib><creatorcontrib>Li, Yukun</creatorcontrib><creatorcontrib>Liu, Pei</creatorcontrib><creatorcontrib>Wang, Yungang</creatorcontrib><creatorcontrib>Zhu, Jinhong</creatorcontrib><creatorcontrib>Zhu, Jianmin</creatorcontrib><creatorcontrib>Yin, Yong</creatorcontrib><creatorcontrib>Li, Zhenjiang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Radiation oncology (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Xu</au><au>Wang, Lizhen</au><au>Cui, Zhen</au><au>Li, Yukun</au><au>Liu, Pei</au><au>Wang, Yungang</au><au>Zhu, Jinhong</au><au>Zhu, Jianmin</au><au>Yin, Yong</au><au>Li, Zhenjiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Online MR evaluation of inter- and intra-fraction uterus motions and bladder volume changes during cervical cancer external beam radiotherapy</atitle><jtitle>Radiation oncology (London, England)</jtitle><addtitle>Radiat Oncol</addtitle><date>2021-09-17</date><risdate>2021</risdate><volume>16</volume><issue>1</issue><spage>179</spage><epage>179</epage><pages>179-179</pages><artnum>179</artnum><issn>1748-717X</issn><eissn>1748-717X</eissn><abstract>The purpose of the study was to assess the uterus motions and bladder volume changes of fractional movements in cervical sites throughout the external beam radiotherapy (EBRT) treatment.
A prospective online MR imaging tracking study was conducted in EBRT 43 patients with at least 4 scans during each treatment (before: ultrasound scan, MRI scan, CBCT scan, after: MRI scan) were included. In order to improve the treatment repeatability, each patient was instructed to empty the bladder and drink 500 ml water 1 h before CT simulation and each treatment. If the ultrasound scan result reached the CT simulation volume of bladder, the treatment began. Bladder was outlined on the T2 weighted axial sequence and CBCT image by the two observers to avoid the influence of contouring. The data of bladder volume and scanning time were accurately recorded. The bladder volumes, filling rates and uterus motion were retrospectively analyzed by MIM software.
Inter-fraction variation of the bladder volume was significant (p < 0.0001). Intra-fraction mean increase of the bladder volume was modest (30 cc) but significant (p < 0.001). Both inter- and intra-fraction of the uterus motion were significant. The average time between the pre-and post-fraction MRI scans was 27.82 ± 7.12 min (range 10-55 min) for IMRT plans and 24.14 ± 5.86 min (range7-38 min) for VMAT plan. Average bladder filling rate was 3.43 ml/min. The bladder filling rate did not change significantly with the course of treatment, but the bladder was more intolerant.
This is the most detailed assessment of intra-fraction and inter-fraction motion during EBRT for cervical cancer. Finally, this study will inform appropriate treatment margins for online adaptive radiotherapy. We suggest that at least one image scan is needed before the EBRT. The portable US scanner provides a quick but unreliable measurement of the bladder volume. There is a significant statistical difference between the results of ultrasonic scanning and that of image scanning.</abstract><cop>England</cop><pub>BioMed Central</pub><pmid>34535161</pmid><doi>10.1186/s13014-021-01907-1</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Bladder Bladder filling Cancer Cancer therapies Cervical cancer Cervix Computed tomography Cone-Beam Computed Tomography Contouring EBRT Female Humans Inter-fractional and Intra-fractional bladder motion Magnetic resonance imaging Magnetic Resonance Imaging - methods Medical imaging Middle Aged Movement Online MRI Patients Planning Prospective Studies Radiation therapy Radiotherapy, Image-Guided - methods Scanners Scanning Simulation Statistical analysis Ultrasonic imaging Ultrasound Urinary Bladder - diagnostic imaging Uterine cancer Uterine Cervical Neoplasms - diagnostic imaging Uterine Cervical Neoplasms - radiotherapy Uterus Uterus - diagnostic imaging |
| title | Online MR evaluation of inter- and intra-fraction uterus motions and bladder volume changes during cervical cancer external beam radiotherapy |
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