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Respiratory-induced prostate motion: quantification and characterization.

S Malone1, J M Crook, W S Kendal

  • 1Department of Radiation Oncology, Ottawa Regional Cancer Centre, Ontario, Ottawa, Canada. smalone@cancercare.on.ca

International Journal of Radiation Oncology, Biology, Physics
|August 5, 2000
PubMed
Summary
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Respiratory motion significantly impacts prostate localization during radiotherapy. Immobilization shells can worsen this movement, necessitating careful attention to patient positioning and potential motion management strategies.

Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Anatomy

Background:

  • Accurate prostate localization is crucial for effective dose-escalated conformal radiotherapy.
  • Respiratory-induced movement is a potential source of error in prostate positioning.

Purpose of the Study:

  • To identify and characterize respiratory-induced prostate movement.
  • To evaluate the impact of immobilization techniques on prostate motion.

Main Methods:

  • Fluoroscopic measurement of prostate movement using implanted gold fiducial markers.
  • Evaluation of patients with prostate carcinoma in prone and supine positions, with and without thermoplastic shells.

Main Results:

  • Prostate movement synchronized with respiration when patients were immobilized prone in thermoplastic shells.

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  • Mean prostate displacement was 3.3 mm, with 23% of movements exceeding 4 mm.
  • Respiratory motion decreased significantly when shells were removed.

    • Conclusions:

    • Respiration induces significant prostate movement, potentially exacerbated by thermoplastic immobilization shells.
    • Transmitted intra-abdominal pressure likely contributes to this movement.
    • Careful immobilization and awareness of respiratory motion are vital for precise prostate radiotherapy.