Abstract

This study assessed abdominal organ motion induced by gastroduodenal motilities in volunteers during fasting and postprandial states, using cine magnetic resonance imaging (cine-MRI). Thirty-five volunteers underwent cine-MRI while holding their breath in the fasting and postprandial states. Gastric motility was quantified by the amplitude and velocity of antral peristaltic waves. Duodenal motility was evaluated as the change of duodenal diameter. Abdominal organ motion was measured in the liver, pancreas and kidneys. Motion was quantified by calculating maximal organ displacement in the left–right, antero–posterior and caudal–cranial directions. Median antral amplitude and velocity in the fasting and postprandial states were 7.7 and 15.1 mm (P < 0.01), and 1.3 and 2.5 mm/s (P < 0.01), respectively. Duodenal motility did not change. Median displacement for all organs ranged from 0.9 to 2.9 mm in the fasting state and from 1.0 to 2.9 mm in the postprandial state. Significant increases in abdominal organ displacement in the postprandial state were observed in the right lobe of the liver, pancreatic head and both kidneys. Differences in the median displacement of these organs between the two states were all <1 mm. Although the motion of several abdominal organs increased in the postprandial state, the difference between the two states was quite small. Thus, our study suggests that treatment planning and irradiation need not include strict management of gastric conditions, nor the addition of excess margins to compensate for differences in the intra-fractional abdominal organ motion under different gastric motilities in the fasting and postprandial states.

Highlights

  • High-precision radiotherapy, such as stereotactic body radiation therapy or intensity modulated radiation therapy, has become available to treat abdominal tumors

  • High-precision radiotherapy requires an accurate understanding of the intra-fractional motions of abdominal tumors and organs

  • Significant increases in organ motion in the postprandial state were observed within the following organs

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Summary

Introduction

High-precision radiotherapy, such as stereotactic body radiation therapy or intensity modulated radiation therapy, has become available to treat abdominal tumors. High-precision radiotherapy requires an accurate understanding of the intra-fractional motions of abdominal tumors and organs. Respiration contributes greatly to overall abdominal organ motion. Abdominal organ motion induced by respiration has been previously studied [1–3], and unreliable tumor dose and normal tissue volume due to respiration on treatment planning computed tomography has been reported [4, 5]. Cine magnetic resonance imaging (cine-MRI) has been proposed to monitor gastric or 837.

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