Abstract

Background and purposeTo assess the influence of tumor diameter on tumor mobility and motion of the tumor bearing hemithorax during the whole breathing cycle in patients with stage I non-small-cell lung cancer (NSCLC) using dynamic MRI. Patients and methodsBreathing cycles of thirty-nine patients with solitary NSCLCs were examined using a trueFISP sequence (three images per second). Patients were divided into three groups according to the maximal tumor diameter in the transverse plane (<3, 3–5 and >5cm). Continuous time–distance curves and deep inspiratory and expiratory positions of the chest wall, the diaphragm and the tumor were measured in three planes. Motion of tumor-bearing and corresponding contralateral non-tumor bearing regions was compared. ResultsPatients with a tumor >3cm showed a significantly lower diaphragmatic motion of the tumor bearing compared with the non-tumor bearing hemithorax in the craniocaudal (CC) directions (tumors 3–5cm: 23.4±1.2 vs 21.1±1.5cm (P<0.05); tumors >5cm: 23.4±1.2 vs 20.1±1.6cm (P<0.01). Tumors >5cm in the lower lung region showed a significantly lower mobility compared with tumors <3cm (1.8±1.0 vs 3.8±0.7cm, P<0.01) in the CC directions. ConclusionsDynamic MRI is a simple non-invasive method to differentiate mobility of tumors with different diameters and its influence on the surrounding tissue. Tumor diameter has a significant influence on tumor mobility and this might be taken into account in future radiotherapy planning.

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