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Published on: April 7, 2023
Four-dimensional CT analysis of vocal cords mobility for highly focused single vocal cord irradiation
Sarah O S Osman1, Hans C J de Boer, Ben J M Heijmen
1Department of Radiation Oncology, Erasmus MC - Daniel den Hoed Cancer Center, Rotterdam, The Netherlands. s.osman@erasmusmc.nl
Background And Purpose:
To quantify respiratory motion of the vocal cords during normal respiration using 4D-CT. The final goal is to develop a technique for single vocal cord irradiation (SVCI) in early glottic carcinoma. Sparing the non-involved cord and surrounding structures has the potential to preserve voice quality and allow re-irradiation of recurrent and second primary tumors.
Material And Methods:
Four-dimensional CTs of 1mm slice thickness from 10 early glottic carcinoma patients were acquired. The lateral dimensions of the air gap separating the vocal cords were measured anteriorly, at mid-level and posteriorly at each phase of the 4D-CTs. The corresponding anterior-posterior gaps were similarly measured. Cranio-caudal vocal cords movements during breathing were derived from the shifts of the arythenoids.
Results:
The population-averaged mean gap size+/-the corresponding standard deviation due to breathing (SD(B)) for the lateral gaps was 5.8+/-0.7mm anteriorly, 8.7+/-0.9mm at mid-level, and 11.0+/-1.3mm posteriorly. Anterior-posterior gap values were 21.7+/-0.7mm, while cranio-caudal shift SD(B) was 0.8mm.
Conclusion:
Vocal cords breathing motions were found to be small relative to their separation. Hence, breathing motion does not seem to be a limiting factor for SVCI.
