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SU-E-J-16: Prostate Bed Motion during Post-Prostatectomy Radiotherapy.

Z Xu1, T Li1, W Lee1

  • 1Duke University Medical Center, Durham, NC.

Medical Physics
|May 19, 2017
PubMed
Summary
This summary is machine-generated.

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Prostate bed motion during radiotherapy is small. Bladder wall motion may help predict prostate bed motion, but rectal wall motion correlation is weak.

Area of Science:

  • Radiation Oncology
  • Medical Imaging
  • Anatomy

Background:

  • Post-prostatectomy radiotherapy requires accurate targeting of the prostate bed.
  • Understanding inter-fractional motion is crucial for optimizing treatment margins.
  • Cone-beam CT (CBCT) is used for image-guided radiotherapy.

Purpose of the Study:

  • To quantify inter-fractional prostate bed motion (PBM) during post-prostatectomy radiotherapy using CBCT.
  • To investigate correlations between PBM and shifts in the anterior rectal wall and posterior bladder wall.

Main Methods:

  • Retrospective analysis of 70 CBCT and 8 planning CT scans from 8 patients.
  • Image registration using surgical clips and pelvic bony anatomy to determine PBM.
  • Comparison of rectal and bladder contours on CT and CBCT to assess organ wall motion.
Keywords:
AnatomyComputed tomographyCone beam computed tomographyImage registrationMedical image artifactsMedical image contrastMedical imagingRadiation therapyTherapeutics

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Main Results:

  • Prostate bed motion was small: 0.1±0.9mm (LR), 0.9±1.6mm (AP), -0.4±1.9mm (SI).
  • Derived planning target volume (PTV) to clinical target volume (CTV) margins were 3mm (LR), 5mm (AP), and 6mm (SI).
  • Correlation coefficients: PBM vs. rectal wall shifts (0.43-0.47), PBM vs. bladder wall shifts (0.67).

Conclusions:

  • Inter-fractional prostate bed motion is minimal relative to bony anatomy.
  • Rectal wall motion shows weak-to-moderate correlation with PBM, potentially due to contouring inconsistencies.
  • Posterior bladder wall motion demonstrates a significant correlation with PBM, suggesting its utility as a surrogate in the AP direction.