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Assessment of bladder motion for clinical radiotherapy practice using cine–magnetic resonance imaging

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McBain, Catherine A., Khoo, Vincent S., Buckley, David L., Sykes, Jonathan S., Green, Melanie M., Cowan, Richard A., Hutchinson, Charles, Moore, Christopher J. and Price, Patricia M.. (2009) Assessment of bladder motion for clinical radiotherapy practice using cine–magnetic resonance imaging. International Journal of Radiation Oncology*Biology*Physics, Vol.75 (No.3). pp. 664-671. ISSN 0360-3016

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Official URL: http://dx.doi.org/10.1016/j.ijrobp.2008.11.040

Abstract

Organ motion is recognized as the principal source of inaccuracy in bladder radiotherapy (RT), but there is currently little information on intrafraction bladder motion. Methods and Materials We used cine–magnetic resonance imaging (cine-MRI) to study bladder motion relevant to intrafraction RT delivery. On two occasions, a 28 minute cine-MRI sequence was acquired from 10 bladder cancer patients and 5 control participants immediately after bladder emptying, after abstinence from drinking for the preceding hour. From the resulting cine sequences, bladder motion was subjectively assessed. To quantify bladder motion, the bladder was contoured in imaging volume sets at 0, 14, and 28 min to measure changes to bladder volumes, wall displacements, and center of gravity (COG) over time. Results The dominant source of bladder motion during imaging was bladder filling (up to 101% volume increase); rectal and small bowel movements were transient, with minimal impact. Bladder volume changes were similar for all participants. However for bladder cancer patients, wall displacements were larger (up to 58 mm), less symmetrical, and more variable compared with nondiseased control bladders. Conclusions Significant and individualized intrafraction bladder wall displacements may occur during bladder RT delivery. This important source of inaccuracy should be incorporated into treatment planning and verification. Author Keywords Bladder cancer; Radiotherapy; Intrafraction motion; Cine-MRI

Item Type: Journal Article
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
Journal or Publication Title: International Journal of Radiation Oncology*Biology*Physics
Publisher: Elsevier
ISSN: 0360-3016
Date: 2009
Volume: Vol.75
Number: No.3
Page Range: pp. 664-671
Identification Number: 10.1016/j.ijrobp.2008.11.040
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
URI: http://wrap.warwick.ac.uk/id/eprint/44015

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