Respiration-induced movement of the upper abdominal organs: a pitfall for the three-dimensional conformal radiation treatment of pancreatic cancer

Respiration-induced movement of the upper abdominal organs (pancreas, liver and kidneys) was assessed in 12 subjects using dynamic magnetic resonance imaging. The movement of each organ in the crania-caudal, the lateral and the anterior-posterior direction was deduced front the movement of the center of gravity on two-dimensional images. This center of gravity was computed from the volume delineated on sequential 8-mm slices of both sagittal and coronal dynamic series. The largest movements were noticed in the crania-caudal direction for pancreas and liver (23.7 +/- 15.9 mm and 24.4 +/- 16.4 mm). The kidneys showed smaller movements in the crania-caudal direction (left kidney 16.9 +/- 6.7 mm and right kidney 16.1 +/- 7.9 mm). The movements of the different organs in the anterior-posterior and lateral directions were less pronounced. It is of the Greatest importance to be aware of these movements in the planning of a conformal radiation treatment for pancreatic cancer. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.