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Strahlentherapie und Onkologie

, Volume 187, Issue 7, pp 426–432 | Cite as

Respiratory-Induced Prostate Motion

Characterization and Quantification in Dynamic MRI
  • Julien DinkelEmail author
  • Christian Thieke
  • Christian Plathow
  • Patrick Zamecnik
  • Hermann Prüm
  • Peter E. Huber
  • Hans-Ulrich Kauczor
  • Heinz-Peter Schlemmer
  • Christian M. Zechmann
Original Article

Background and Purpose:

To investigate prostate movement during deep breathing and contraction of abdominal musculature by means of dynamic MRI and analyze implications for image-guided radiotherapy of prostate cancer.

Patients and Methods:

A total of 43 patients and 8 healthy volunteers were examined with MRI. Images during deep respiration and during contraction of abdominal musculature (via a coughing maneuver) were obtained with dynamic two-dimensional (2D) balanced SSFP; 3 frames/s were obtained over an acquisition time of 15 s. Images were acquired in sagittal orientation to evaluate motion along both the craniocaudal (cc)-axis and anteroposterior (ap)-axis. Prostate motion was quantified semi-automatically using dedicated software tools.

Results:

Respiratory induced mean cc-axis displacement of the prostate was 2.7 ± 1.9 (SD) mm (range, 0.5–10.6 mm) and mean ap-axis displacement 1.8 ± 1.0 (SD) mm (range, 0.3–10 mm). In 69% of the subjects, breathing-related prostate movements were found to be negligible (< 3 mm). The prostate displacement for abdominal contraction was significantly higher: mean cc-axis displacement was max. 8.4 ± 6.7 (SD) mm (range, 0.6–27 mm); mean anteroposterior movement was 8.3 ± 7.7 (SD) mm (range, 0.7–26 mm).

Conclusion:

Dynamic MRI is an excellent tool for noninvasive real-time imaging of prostate movement. Further investigations regarding possible applications in image-guided radiotherapy, e.g., for individualized planning and in integrated linac/MRI systems, are warranted.

Key Words

Dynamic MRI Organ motion Prostate 

Ateminduzierte Bewegung der Prostata: Charakterisierung und Quantifizierung mittels dynamischer MRT

Zielsetzung:

Ziel dieser Studie war die nicht-invasive Analyse der ateminduzierten Prostatabewegung mittels dynamischer MRT-Bildgebung im Hinblick auf die Auswirkungen für die bildgestützte Radiotherapie beim Prostatakarzinom.

Methoden:

43 Patienten und 8 Probanden wurden mittels MRT untersucht. Aufnahmen unter Echtzeit-Bedingungen während der Atmung und während der Kontraktion der abdominalen Muskulatur (Hustenversuch) erfolgten mit einer 2D-cine-balanced-SSFP-Sequenz. 3 Bilder/s wurden während 15 s Aufnahmezeit produziert. Die Bewegung der Prostata in der kraniokaudalen und anteroposterioren Richtung wurde in einer sagittalen Orientierung erfasst. Die atemabhängige und muskelkontraktionsabhängige Prostatabewegung wurde semiautomatisch mit dedizierter Software analysiert.

Ergebnisse:

Die Prostata bewegte sich synchron mit der Zwerchfellbewegung. Die kraniokaudale atembedingte Prostatabewegung betrug 2,7 ± 1,9 (SD) mm (Range 0,5–10,6 mm), während die anteroposteriore Bewegung bei 1,8 ± 1 (SD) mm (Range 0,3–10 mm) lag. 69 % der Prostatabewegungen waren kleiner als 3 mm. Bei maximaler abdominaler Muskelkontraktion bewegte sich die Prostata signifikant mehr als allein aufgrund der Atmung. Die Muskelkontraktion verursachte eine kraniokaudale Prostatabewegung von max. 8,4 ± 6,7 (SD) mm (Range 0,6–27 mm). Die AP-Bewegung betrug 8,3 ± 7,7 (SD) mm (Range 0,7–26 mm).

Schlussfolgerung:

Die dynamische MRT ermöglicht die nichtinvasive Analyse der Prostatabewegung. Weitere Studien bezüglich möglicher Anwendungen in der bildgestützten Radiotherapie, z. B. zur individuellen Planung und Integration in MRT-/Linac-Systeme, sind erforderlich.

Schlüsselwörter

Dynamische MRT Organbewegung Prostata 

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Copyright information

© Urban & Vogel 2011

Authors and Affiliations

  • Julien Dinkel
    • 1
    • 8
    Email author
  • Christian Thieke
    • 2
    • 3
  • Christian Plathow
    • 1
    • 4
  • Patrick Zamecnik
    • 1
  • Hermann Prüm
    • 5
  • Peter E. Huber
    • 2
  • Hans-Ulrich Kauczor
    • 1
    • 6
  • Heinz-Peter Schlemmer
    • 1
  • Christian M. Zechmann
    • 1
    • 7
  1. 1.Department of RadiologyGerman Cancer Research CenterHeidelbergGermany
  2. 2.Clinical Cooperation Unit Radiation OncologyGerman Cancer Research CenterHeidelbergGermany
  3. 3.Department of Radiation OncologyUniversity Clinic HeidelbergHeidelbergGermany
  4. 4.Radiology Baden-BadenBaden-BadenGermany
  5. 5.Software Development for Integrated Diagnostics and Therapy GroupGerman Cancer Research CenterHeidelbergGermany
  6. 6.Department of RadiologyUniversity Clinic HeidelbergHeidelbergGermany
  7. 7.Department of Nuclear medicineUniversity Clinic HeidelbergHeidelbergGermany
  8. 8.Department of RadiologyGerman Cancer Research CenterHeidelbergGermany

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