Relationship between Stomach Volume and Tumor Location in Radiation Treatment for Hepatic Tumors

간 종양의 방사선치료에서 위내용적과 종양 위치 간의 관계

  • Jeon, Mi-Jin (Department of Radiation Oncology, Gangnam Severance Hospital) ;
  • Lee, Chang-Geol (Department of Radiation Oncology, Gangnam Severance Hospital) ;
  • Lee, Ik-Jae (Department of Radiation Oncology, Gangnam Severance Hospital) ;
  • Choi, Won-Hoon (Department of Radiation Oncology, Gangnam Severance Hospital) ;
  • Choi, Yun-Sun (Department of Radiation Oncology, Gangnam Severance Hospital) ;
  • Shin, Dong-Bong (Department of Radiation Oncology, Gangnam Severance Hospital) ;
  • Kim, Jong-Dae (Department of Radiation Oncology, Gangnam Severance Hospital) ;
  • Kim, Sei-Joon (Department of Radiation Oncology, Gangnam Severance Hospital) ;
  • Ha, Jin-Suk (Department of Radiation Oncology, Gangnam Severance Hospital) ;
  • Cho, Yoon-Jin (Department of Radiation Oncology, Gangnam Severance Hospital)
  • 전미진 (강남세브란스병원 방사선종양학과) ;
  • 이창걸 (강남세브란스병원 방사선종양학과) ;
  • 이익재 (강남세브란스병원 방사선종양학과) ;
  • 최원훈 (강남세브란스병원 방사선종양학과) ;
  • 최윤선 (강남세브란스병원 방사선종양학과) ;
  • 신동봉 (강남세브란스병원 방사선종양학과) ;
  • 김종대 (강남세브란스병원 방사선종양학과) ;
  • 김세준 (강남세브란스병원 방사선종양학과) ;
  • 하진숙 (강남세브란스병원 방사선종양학과) ;
  • 조윤진 (강남세브란스병원 방사선종양학과)
  • Received : 2010.05.12
  • Accepted : 2010.07.02
  • Published : 2010.09.30

Abstract

Purpose: It aims to evaluate the location change and tendency of hepatic and intrahepatic tumors according to gastric volume and change of location. Materials and Methods: It studied 9 patients with hepatic tumors who visited Gangnam Severance Hospital from March 2009 to April 2010 and who underwent CT or PET (Positron Emission Tomography) within 2 weeks before CT-simulation. The patients fasted for 6 hours before CT-simulation and drank 240~250 cc of water just before CT or PET for image fusion. Those two types of images were fused to RTP (Radiation Treatment Planning, Pinnacle 8.0h) focusing on bone structure of individual patients. Results: They drank 240~260 cc of water but their stomach volume after drinking water varied from 259.3 cc to 495.4 cc. Even though individual differences existed in the change of stomach volume before and after drinking water, the volume was increased by 130 cc (174%) on average. The change in absolute distance between the centers of tumors ranged from 0.52 cm to 3.04 cm (1.52 cm on average); from 0.1 cm to 1.35 cm (0.44 cm on average) in cranial-caudal direction; from 0.05 cm to 2.75 cm (1.22 cm on average) in left-right direction; and from 0.05 cm to 1.85 cm (0.33 cm on average) in ventral-dorsal direction. Conclusion: It is hard to predict the movement of tumors by observing stomach movement, due to great individual differences; however, it was observed that the location of hepatic tumors was right-sided as the stomach was filled with water. Thus, it is recommended to maintain the fastened state to secure the accuracy of hepatic tumor treatment. If it cannot maintain the fastened state, it is recommended to measure stomach volumes and movement in the patient to consider the movement of hepatic tumors before radiation treatment.