4D-MRI analysis of lung tumor motion in patients with hemidiaphragmatic paralysis.
Radiother Oncol
; 91(3): 449-54, 2009 Jun.
Article
in En
| MEDLINE
| ID: mdl-19394712
ABSTRACT
PURPOSE:
To investigate the complex breathing patterns in patients with hemidiaphragmatic paralysis due to malignant infiltration using four-dimensional magnetic resonance imaging (4D-MRI). PATIENTS ANDMETHODS:
Seven patients with bronchial carcinoma infiltrating the phrenic nerve were examined using 1.5 T MRI. The motion of the tumor and of both hemi-diaphragms were measured on dynamic 2D TrueFISP and 4D FLASH MRI sequences.RESULTS:
For each patient, 3-6 breathing cycles were recorded. The respiratory-induced mean cranio-caudal displacement of the tumor was 6.6 mm (+/-2.8 SD). The mean displacement anterior-posterior was 7.4 mm (+/-2.6), while right-left movement was about 7.4 mm (+/-4.5). The mediastinum moved sidewards during inspiration, realizing a "mediastinal shift". The paralyzed hemidiaphragm and the tumor showed a paradox motion during respiration in five patients. In two patients, the affected hemidiaphragm had a regular, however minimal and asynchronous motion during respiration. Respiratory variability of both tumor and diaphragm motions was about 20% although patients were instructed to breath normally. The findings showed significant differences compared to breathing patterns of patients without diaphragm dysfunction.CONCLUSION:
4D-MRI is a promising tool to analyze complex breathing patterns in patients with lung tumors. It should be considered for use in planning of radiotherapy to account for individual tumor motion.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Phrenic Nerve
/
Bronchial Neoplasms
/
Diaphragm
/
Image Enhancement
/
Respiratory Mechanics
/
Lung Neoplasms
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Radiother Oncol
Year:
2009
Document type:
Article
Affiliation country:
Germany