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Planning CT Identifies Patients at Risk of High Prostate Intrafraction Motion

SIMPLE SUMMARY: Motion of the prostate may adversely affect the outcome of radiotherapy. Online tracking of the prostate during irradiation is technologically feasible but only available at select institutions. It would be beneficial to be able to identify patients at risk of particularly high prost...

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Autores principales: Ballhausen, Hendrik, Li, Minglun, Lombardo, Elia, Landry, Guillaume, Belka, Claus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452220/
https://www.ncbi.nlm.nih.gov/pubmed/37627131
http://dx.doi.org/10.3390/cancers15164103
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author Ballhausen, Hendrik
Li, Minglun
Lombardo, Elia
Landry, Guillaume
Belka, Claus
author_facet Ballhausen, Hendrik
Li, Minglun
Lombardo, Elia
Landry, Guillaume
Belka, Claus
author_sort Ballhausen, Hendrik
collection PubMed
description SIMPLE SUMMARY: Motion of the prostate may adversely affect the outcome of radiotherapy. Online tracking of the prostate during irradiation is technologically feasible but only available at select institutions. It would be beneficial to be able to identify patients at risk of particularly high prostate intrafraction motion with simpler technology. In this paper, we present a larger inner diameter of the lesser pelvis as an anatomical predictor for high prostate intrafraction motion. It can be measured with a single planning CT, which should always be available. Risk patients identified in this way could then be selected for more rigorous online motion management or benefit from increased safety margins. ABSTRACT: Prostate motion (standard deviation, range of motion, and diffusion coefficient) was calculated from 4D ultrasound data of 1791 fractions of radiation therapy in N = 100 patients. The inner diameter of the lesser pelvis was obtained from transversal slices through the pubic symphysis in planning CTs. On the lateral and craniocaudal axes, motility increases significantly (t-test, p < 0.005) with the inner diameter of the lesser pelvis. A diameter of >106 mm (ca. 6th decile) is a good predictor for high prostate intrafraction motion (ca. 9th decile). The corresponding area under the receiver operator curve (AUROC) is 80% in the lateral direction, 68% to 80% in the craniocaudal direction, and 62% to 70% in the vertical direction. On the lateral x-axis, the proposed test is 100% sensitive and has a 100% negative predictive value for all three characteristics (standard deviation, range of motion, and diffusion coefficient). On the craniocaudal z-axis, the proposed test is 79% to 100% sensitive and reaches 95% to 100% negative predictive value. On the vertical axis, the proposed test still delivers 98% negative predictive value but is not particularly sensitive. Overall, the proposed predictor is able to help identify patients at risk of high prostate motion based on a single planning CT.
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spelling pubmed-104522202023-08-26 Planning CT Identifies Patients at Risk of High Prostate Intrafraction Motion Ballhausen, Hendrik Li, Minglun Lombardo, Elia Landry, Guillaume Belka, Claus Cancers (Basel) Article SIMPLE SUMMARY: Motion of the prostate may adversely affect the outcome of radiotherapy. Online tracking of the prostate during irradiation is technologically feasible but only available at select institutions. It would be beneficial to be able to identify patients at risk of particularly high prostate intrafraction motion with simpler technology. In this paper, we present a larger inner diameter of the lesser pelvis as an anatomical predictor for high prostate intrafraction motion. It can be measured with a single planning CT, which should always be available. Risk patients identified in this way could then be selected for more rigorous online motion management or benefit from increased safety margins. ABSTRACT: Prostate motion (standard deviation, range of motion, and diffusion coefficient) was calculated from 4D ultrasound data of 1791 fractions of radiation therapy in N = 100 patients. The inner diameter of the lesser pelvis was obtained from transversal slices through the pubic symphysis in planning CTs. On the lateral and craniocaudal axes, motility increases significantly (t-test, p < 0.005) with the inner diameter of the lesser pelvis. A diameter of >106 mm (ca. 6th decile) is a good predictor for high prostate intrafraction motion (ca. 9th decile). The corresponding area under the receiver operator curve (AUROC) is 80% in the lateral direction, 68% to 80% in the craniocaudal direction, and 62% to 70% in the vertical direction. On the lateral x-axis, the proposed test is 100% sensitive and has a 100% negative predictive value for all three characteristics (standard deviation, range of motion, and diffusion coefficient). On the craniocaudal z-axis, the proposed test is 79% to 100% sensitive and reaches 95% to 100% negative predictive value. On the vertical axis, the proposed test still delivers 98% negative predictive value but is not particularly sensitive. Overall, the proposed predictor is able to help identify patients at risk of high prostate motion based on a single planning CT. MDPI 2023-08-15 /pmc/articles/PMC10452220/ /pubmed/37627131 http://dx.doi.org/10.3390/cancers15164103 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ballhausen, Hendrik
Li, Minglun
Lombardo, Elia
Landry, Guillaume
Belka, Claus
Planning CT Identifies Patients at Risk of High Prostate Intrafraction Motion
title Planning CT Identifies Patients at Risk of High Prostate Intrafraction Motion
title_full Planning CT Identifies Patients at Risk of High Prostate Intrafraction Motion
title_fullStr Planning CT Identifies Patients at Risk of High Prostate Intrafraction Motion
title_full_unstemmed Planning CT Identifies Patients at Risk of High Prostate Intrafraction Motion
title_short Planning CT Identifies Patients at Risk of High Prostate Intrafraction Motion
title_sort planning ct identifies patients at risk of high prostate intrafraction motion
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452220/
https://www.ncbi.nlm.nih.gov/pubmed/37627131
http://dx.doi.org/10.3390/cancers15164103
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