Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Optimizing choice of skin surrogates for surface guided stereotactic body radiotherapy of lung lesions using four-dimensional computed tomography

Vanda Leipold
* ORCID logo ,
Ivana Alerić
,
Mihaela Mlinarić
ORCID logo ,
Domagoj Kosmina
,
Fran Stanić
,
Mladen Kasabašić
ORCID logo ,
Damir Štimac
,
Hrvoje Kaučić
ORCID logo ,
Giovanni Ursi
,
Karla Schwarz
ORCID logo ,
Igor Nikolić
,
Denis Klapan
,
Dragan Schwarz
Version 1 : Received: 11 June 2024 / Approved: 12 June 2024 / Online: 13 June 2024 (13:07:59 CEST)

How to cite: Leipold, V.; Alerić, I.; Mlinarić, M.; Kosmina, D.; Stanić, F.; Kasabašić, M.; Štimac, D.; Kaučić, H.; Ursi, G.; Schwarz, K.; Nikolić, I.; Klapan, D.; Schwarz, D. Optimizing choice of skin surrogates for surface guided stereotactic body radiotherapy of lung lesions using four-dimensional computed tomography. Preprints 2024, 2024060941. https://doi.org/10.20944/preprints202406.0941.v1 Leipold, V.; Alerić, I.; Mlinarić, M.; Kosmina, D.; Stanić, F.; Kasabašić, M.; Štimac, D.; Kaučić, H.; Ursi, G.; Schwarz, K.; Nikolić, I.; Klapan, D.; Schwarz, D. Optimizing choice of skin surrogates for surface guided stereotactic body radiotherapy of lung lesions using four-dimensional computed tomography. Preprints 2024, 2024060941. https://doi.org/10.20944/preprints202406.0941.v1

Abstract

Image-guided radiotherapy supported by surface guidance can help track lower lung lesion respiratory motion while reducing a patient’s exposure to ionizing radiation. However, it is not always clear how skin respiratory motion magnitudes and correlations with lung lesion respiratory motion vary between different skin regions of interest (ROI). Four-dimensional Computed Tomography (4DCT) images provide information on both skin and lung respiratory motion and are routinely acquired for the purpose of treatment planning in our institution. Analysis of 4DCT images for 57 patients treated in our institution has been conducted to provide information on respiratory motion magnitudes of nine skin ROIs of the torso, a tracking structure (TS) representing lower lung lobe lesion, as well as respiratory motion correlations between nine ROIs and TS. The effects of gender and adipose tissue volume and distribution on these correlations and magnitudes have been analyzed. Significant differences between ROIs in both respiratory motion magnitudes and correlations to TS have been detected. An overall negative correlation between ROI respiratory magnitudes and the adipose tissue has been detected for ROIs with rib cage support. A weak to moderate negative correlation between adipose tissue volume and ROI-to-TS respiratory correlations has been detected for upper thorax ROIs. Respiratory magnitudes in regions without rib support tended to be larger for men than for women, but no differences in ROI-to-TS correlation between sexes have been detected. Described findings should be considered when choosing skin surrogates for lower lung lesion motion management.

Keywords

surface guided radiation therapy; image guided radiation therapy; stereotactic ablative radiation therapy

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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