Magnetic Resonance Imaging Assessment of Spinal Cord and Cauda Equina Motion in Supine Patients With Spinal Metastases Planned for Spine Stereotactic Body Radiation Therapy
Purpose To assess motion of the spinal cord and cauda equina, which are critical neural tissues (CNT), which is important when evaluating the planning organ-at-risk margin required for stereotactic body radiation therapy. Methods and Materials We analyzed CNT motion in 65 patients with spinal metast...
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| creator | Tseng, Chia-Lin, MD Sussman, Marshall S., PhD Atenafu, Eshetu G., MSc Letourneau, Daniel, PhD Ma, Lijun, PhD Soliman, Hany, MD Thibault, Isabelle, MD Cho, B. C. John, MD, PhD Simeonov, Anna, MSc, MRT Yu, Eugene, MD Fehlings, Michael G., MD, PhD Sahgal, Arjun, MD |
| description | Purpose To assess motion of the spinal cord and cauda equina, which are critical neural tissues (CNT), which is important when evaluating the planning organ-at-risk margin required for stereotactic body radiation therapy. Methods and Materials We analyzed CNT motion in 65 patients with spinal metastases (11 cervical, 39 thoracic, and 24 lumbar spinal segments) in the supine position using dynamic axial and sagittal magnetic resonance imaging (dMRI, 3T Verio, Siemens) over a 137-second interval. Motion was segregated according to physiologic cardiorespiratory oscillatory motion (characterized by the average root mean square deviation) and random bulk shifts associated with gross patient motion (characterized by the range). Displacement was evaluated in the anteroposterior (AP), lateral (LR), and superior-inferior (SI) directions by use of a correlation coefficient template matching algorithm, with quantification of random motion measure error over 3 separate trials. Statistical significance was defined according to P |
| doi_str_mv | 10.1016/j.ijrobp.2014.12.037 |
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C. John, MD, PhD ; Simeonov, Anna, MSc, MRT ; Yu, Eugene, MD ; Fehlings, Michael G., MD, PhD ; Sahgal, Arjun, MD</creator><creatorcontrib>Tseng, Chia-Lin, MD ; Sussman, Marshall S., PhD ; Atenafu, Eshetu G., MSc ; Letourneau, Daniel, PhD ; Ma, Lijun, PhD ; Soliman, Hany, MD ; Thibault, Isabelle, MD ; Cho, B. C. John, MD, PhD ; Simeonov, Anna, MSc, MRT ; Yu, Eugene, MD ; Fehlings, Michael G., MD, PhD ; Sahgal, Arjun, MD</creatorcontrib><description>Purpose To assess motion of the spinal cord and cauda equina, which are critical neural tissues (CNT), which is important when evaluating the planning organ-at-risk margin required for stereotactic body radiation therapy. Methods and Materials We analyzed CNT motion in 65 patients with spinal metastases (11 cervical, 39 thoracic, and 24 lumbar spinal segments) in the supine position using dynamic axial and sagittal magnetic resonance imaging (dMRI, 3T Verio, Siemens) over a 137-second interval. Motion was segregated according to physiologic cardiorespiratory oscillatory motion (characterized by the average root mean square deviation) and random bulk shifts associated with gross patient motion (characterized by the range). Displacement was evaluated in the anteroposterior (AP), lateral (LR), and superior-inferior (SI) directions by use of a correlation coefficient template matching algorithm, with quantification of random motion measure error over 3 separate trials. Statistical significance was defined according to P <.05. Results In the AP, LR, and SI directions, significant oscillatory motion was observed in 39.2%, 35.1%, and 10.8% of spinal segments, respectively, and significant bulk motions in all cases. The median oscillatory CNT motions in the AP, LR, and SI directions were 0.16 mm, 0.17 mm, and 0.44 mm, respectively, and the maximal statistically significant oscillatory motions were 0.39 mm, 0.41 mm, and 0.77 mm, respectively. The median bulk displacements in the AP, LR, and SI directions were 0.51 mm, 0.59 mm, and 0.66 mm, and the maximal statistically significant displacements were 2.21 mm, 2.87 mm, and 3.90 mm, respectively. In the AP, LR, and SI directions, bulk displacements were greater than 1.5 mm in 5.4%, 9.0%, and 14.9% of spinal segments, respectively. No significant differences in axial motion were observed according to cord level or cauda equina. Conclusions Oscillatory CNT motion was observed to be relatively minor. Our results support the importance of controlling bulk patient motion and the practice of applying a planning organ-at-risk margin.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2014.12.037</identifier><identifier>PMID: 25832691</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>ALGORITHMS ; Cauda Equina - physiology ; Cerebrospinal Fluid - physiology ; CORRELATIONS ; ERRORS ; Hematology, Oncology and Palliative Medicine ; Humans ; Magnetic Resonance Imaging - methods ; METASTASES ; Movement - physiology ; NMR IMAGING ; Organs at Risk - physiology ; Patient Positioning ; PATIENTS ; PLANNING ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; Radiosurgery - methods ; RADIOTHERAPY ; RANDOMNESS ; Respiration ; SPINAL CORD ; Spinal Cord - physiology ; Spinal Neoplasms - secondary ; Spinal Neoplasms - surgery ; Supine Position - physiology ; VERTEBRAE</subject><ispartof>International journal of radiation oncology, biology, physics, 2015-04, Vol.91 (5), p.995-1002</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-7a8339314fff4861d4c15ffe70177dbb6233cf81e6f575facfd51cb84c526ae33</citedby><cites>FETCH-LOGICAL-c445t-7a8339314fff4861d4c15ffe70177dbb6233cf81e6f575facfd51cb84c526ae33</cites><orcidid>0000-0002-4398-9651</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2014.12.037$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,315,781,785,886,3551,27928,27929,45999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25832691$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22458673$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Tseng, Chia-Lin, MD</creatorcontrib><creatorcontrib>Sussman, Marshall S., PhD</creatorcontrib><creatorcontrib>Atenafu, Eshetu G., MSc</creatorcontrib><creatorcontrib>Letourneau, Daniel, PhD</creatorcontrib><creatorcontrib>Ma, Lijun, PhD</creatorcontrib><creatorcontrib>Soliman, Hany, MD</creatorcontrib><creatorcontrib>Thibault, Isabelle, MD</creatorcontrib><creatorcontrib>Cho, B. C. John, MD, PhD</creatorcontrib><creatorcontrib>Simeonov, Anna, MSc, MRT</creatorcontrib><creatorcontrib>Yu, Eugene, MD</creatorcontrib><creatorcontrib>Fehlings, Michael G., MD, PhD</creatorcontrib><creatorcontrib>Sahgal, Arjun, MD</creatorcontrib><title>Magnetic Resonance Imaging Assessment of Spinal Cord and Cauda Equina Motion in Supine Patients With Spinal Metastases Planned for Spine Stereotactic Body Radiation Therapy</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose To assess motion of the spinal cord and cauda equina, which are critical neural tissues (CNT), which is important when evaluating the planning organ-at-risk margin required for stereotactic body radiation therapy. Methods and Materials We analyzed CNT motion in 65 patients with spinal metastases (11 cervical, 39 thoracic, and 24 lumbar spinal segments) in the supine position using dynamic axial and sagittal magnetic resonance imaging (dMRI, 3T Verio, Siemens) over a 137-second interval. Motion was segregated according to physiologic cardiorespiratory oscillatory motion (characterized by the average root mean square deviation) and random bulk shifts associated with gross patient motion (characterized by the range). Displacement was evaluated in the anteroposterior (AP), lateral (LR), and superior-inferior (SI) directions by use of a correlation coefficient template matching algorithm, with quantification of random motion measure error over 3 separate trials. Statistical significance was defined according to P <.05. Results In the AP, LR, and SI directions, significant oscillatory motion was observed in 39.2%, 35.1%, and 10.8% of spinal segments, respectively, and significant bulk motions in all cases. The median oscillatory CNT motions in the AP, LR, and SI directions were 0.16 mm, 0.17 mm, and 0.44 mm, respectively, and the maximal statistically significant oscillatory motions were 0.39 mm, 0.41 mm, and 0.77 mm, respectively. The median bulk displacements in the AP, LR, and SI directions were 0.51 mm, 0.59 mm, and 0.66 mm, and the maximal statistically significant displacements were 2.21 mm, 2.87 mm, and 3.90 mm, respectively. In the AP, LR, and SI directions, bulk displacements were greater than 1.5 mm in 5.4%, 9.0%, and 14.9% of spinal segments, respectively. No significant differences in axial motion were observed according to cord level or cauda equina. Conclusions Oscillatory CNT motion was observed to be relatively minor. Our results support the importance of controlling bulk patient motion and the practice of applying a planning organ-at-risk margin.</description><subject>ALGORITHMS</subject><subject>Cauda Equina - physiology</subject><subject>Cerebrospinal Fluid - physiology</subject><subject>CORRELATIONS</subject><subject>ERRORS</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>METASTASES</subject><subject>Movement - physiology</subject><subject>NMR IMAGING</subject><subject>Organs at Risk - physiology</subject><subject>Patient Positioning</subject><subject>PATIENTS</subject><subject>PLANNING</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Radiosurgery - methods</subject><subject>RADIOTHERAPY</subject><subject>RANDOMNESS</subject><subject>Respiration</subject><subject>SPINAL CORD</subject><subject>Spinal Cord - physiology</subject><subject>Spinal Neoplasms - secondary</subject><subject>Spinal Neoplasms - surgery</subject><subject>Supine Position - physiology</subject><subject>VERTEBRAE</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFktFqFDEUhgdR7Lb6BiIBb7zZMZkkM7M3Ql2qFrpYuhW9C9nkZDfrbDJNMsK-Ux_STKf1whshEEi-_5z_5E9RvCG4JJjUH_al3Qe_6csKE1aSqsS0eVbMSNss5pTzn8-LGaY1ntMMnxSnMe4xxoQ07GVxUvGWVvWCzIr7ldw6SFahG4jeSacAXR7k1rotOo8RYjyAS8gbtO6tkx1a-qCRdBot5aAlurgb8jFa-WS9Q9ah9ZA5QNcy2SyM6IdNuyftCpKMeUFE1510DjQyPjzcAlonCOCTVKOZT14f0Y3UVj7Uvd1BkP3xVfHCyC7C68f9rPj--eJ2-XV-9e3L5fL8aq4Y42neyJbSBSXMGMPammimCDcGGkyaRm82dUWpMi2B2vCGG6mM5kRtWqZ4VUug9Kx4N9X1MVkRlU2gdspnwyqJqmK8rZuRej9RffB3A8QkDjYq6PJk4IcoSF0vWkb4AmeUTagKPsYARvTBHmQ4CoLFmKbYiylNMaYpSCVymln29rHDsDmA_it6ii8DHycA8mv8thBGs5Az1DaMXrW3_-vwbwHVWWeV7H7BEeLeDyEHl2cRMQvEevxR44ciDDNOG0b_AMfjyag</recordid><startdate>20150401</startdate><enddate>20150401</enddate><creator>Tseng, Chia-Lin, MD</creator><creator>Sussman, Marshall S., PhD</creator><creator>Atenafu, Eshetu G., MSc</creator><creator>Letourneau, Daniel, PhD</creator><creator>Ma, Lijun, PhD</creator><creator>Soliman, Hany, MD</creator><creator>Thibault, Isabelle, MD</creator><creator>Cho, B. C. John, MD, PhD</creator><creator>Simeonov, Anna, MSc, MRT</creator><creator>Yu, Eugene, MD</creator><creator>Fehlings, Michael G., MD, PhD</creator><creator>Sahgal, Arjun, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope><orcidid>https://orcid.org/0000-0002-4398-9651</orcidid></search><sort><creationdate>20150401</creationdate><title>Magnetic Resonance Imaging Assessment of Spinal Cord and Cauda Equina Motion in Supine Patients With Spinal Metastases Planned for Spine Stereotactic Body Radiation Therapy</title><author>Tseng, Chia-Lin, MD ; Sussman, Marshall S., PhD ; Atenafu, Eshetu G., MSc ; Letourneau, Daniel, PhD ; Ma, Lijun, PhD ; Soliman, Hany, MD ; Thibault, Isabelle, MD ; Cho, B. C. John, MD, PhD ; Simeonov, Anna, MSc, MRT ; Yu, Eugene, MD ; Fehlings, Michael G., MD, PhD ; Sahgal, Arjun, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-7a8339314fff4861d4c15ffe70177dbb6233cf81e6f575facfd51cb84c526ae33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>ALGORITHMS</topic><topic>Cauda Equina - physiology</topic><topic>Cerebrospinal Fluid - physiology</topic><topic>CORRELATIONS</topic><topic>ERRORS</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>METASTASES</topic><topic>Movement - physiology</topic><topic>NMR IMAGING</topic><topic>Organs at Risk - physiology</topic><topic>Patient Positioning</topic><topic>PATIENTS</topic><topic>PLANNING</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Radiosurgery - methods</topic><topic>RADIOTHERAPY</topic><topic>RANDOMNESS</topic><topic>Respiration</topic><topic>SPINAL CORD</topic><topic>Spinal Cord - physiology</topic><topic>Spinal Neoplasms - secondary</topic><topic>Spinal Neoplasms - surgery</topic><topic>Supine Position - physiology</topic><topic>VERTEBRAE</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tseng, Chia-Lin, MD</creatorcontrib><creatorcontrib>Sussman, Marshall S., PhD</creatorcontrib><creatorcontrib>Atenafu, Eshetu G., MSc</creatorcontrib><creatorcontrib>Letourneau, Daniel, PhD</creatorcontrib><creatorcontrib>Ma, Lijun, PhD</creatorcontrib><creatorcontrib>Soliman, Hany, MD</creatorcontrib><creatorcontrib>Thibault, Isabelle, MD</creatorcontrib><creatorcontrib>Cho, B. C. John, MD, PhD</creatorcontrib><creatorcontrib>Simeonov, Anna, MSc, MRT</creatorcontrib><creatorcontrib>Yu, Eugene, MD</creatorcontrib><creatorcontrib>Fehlings, Michael G., MD, PhD</creatorcontrib><creatorcontrib>Sahgal, Arjun, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tseng, Chia-Lin, MD</au><au>Sussman, Marshall S., PhD</au><au>Atenafu, Eshetu G., MSc</au><au>Letourneau, Daniel, PhD</au><au>Ma, Lijun, PhD</au><au>Soliman, Hany, MD</au><au>Thibault, Isabelle, MD</au><au>Cho, B. C. John, MD, PhD</au><au>Simeonov, Anna, MSc, MRT</au><au>Yu, Eugene, MD</au><au>Fehlings, Michael G., MD, PhD</au><au>Sahgal, Arjun, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Magnetic Resonance Imaging Assessment of Spinal Cord and Cauda Equina Motion in Supine Patients With Spinal Metastases Planned for Spine Stereotactic Body Radiation Therapy</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2015-04-01</date><risdate>2015</risdate><volume>91</volume><issue>5</issue><spage>995</spage><epage>1002</epage><pages>995-1002</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>Purpose To assess motion of the spinal cord and cauda equina, which are critical neural tissues (CNT), which is important when evaluating the planning organ-at-risk margin required for stereotactic body radiation therapy. Methods and Materials We analyzed CNT motion in 65 patients with spinal metastases (11 cervical, 39 thoracic, and 24 lumbar spinal segments) in the supine position using dynamic axial and sagittal magnetic resonance imaging (dMRI, 3T Verio, Siemens) over a 137-second interval. Motion was segregated according to physiologic cardiorespiratory oscillatory motion (characterized by the average root mean square deviation) and random bulk shifts associated with gross patient motion (characterized by the range). Displacement was evaluated in the anteroposterior (AP), lateral (LR), and superior-inferior (SI) directions by use of a correlation coefficient template matching algorithm, with quantification of random motion measure error over 3 separate trials. Statistical significance was defined according to P <.05. Results In the AP, LR, and SI directions, significant oscillatory motion was observed in 39.2%, 35.1%, and 10.8% of spinal segments, respectively, and significant bulk motions in all cases. The median oscillatory CNT motions in the AP, LR, and SI directions were 0.16 mm, 0.17 mm, and 0.44 mm, respectively, and the maximal statistically significant oscillatory motions were 0.39 mm, 0.41 mm, and 0.77 mm, respectively. The median bulk displacements in the AP, LR, and SI directions were 0.51 mm, 0.59 mm, and 0.66 mm, and the maximal statistically significant displacements were 2.21 mm, 2.87 mm, and 3.90 mm, respectively. In the AP, LR, and SI directions, bulk displacements were greater than 1.5 mm in 5.4%, 9.0%, and 14.9% of spinal segments, respectively. No significant differences in axial motion were observed according to cord level or cauda equina. Conclusions Oscillatory CNT motion was observed to be relatively minor. Our results support the importance of controlling bulk patient motion and the practice of applying a planning organ-at-risk margin.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25832691</pmid><doi>10.1016/j.ijrobp.2014.12.037</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-4398-9651</orcidid></addata></record> |
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| ispartof | International journal of radiation oncology, biology, physics, 2015-04, Vol.91 (5), p.995-1002 |
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| subjects | ALGORITHMS Cauda Equina - physiology Cerebrospinal Fluid - physiology CORRELATIONS ERRORS Hematology, Oncology and Palliative Medicine Humans Magnetic Resonance Imaging - methods METASTASES Movement - physiology NMR IMAGING Organs at Risk - physiology Patient Positioning PATIENTS PLANNING Radiology RADIOLOGY AND NUCLEAR MEDICINE Radiosurgery - methods RADIOTHERAPY RANDOMNESS Respiration SPINAL CORD Spinal Cord - physiology Spinal Neoplasms - secondary Spinal Neoplasms - surgery Supine Position - physiology VERTEBRAE |
| title | Magnetic Resonance Imaging Assessment of Spinal Cord and Cauda Equina Motion in Supine Patients With Spinal Metastases Planned for Spine Stereotactic Body Radiation Therapy |
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