2017_SBRT_Course Book

Uncertainty in Motion

▪ A single pre-treatment 4DCT is often not representative for the magnitude of motion during the treatment delivery ▪ Substantial tumor motion during breath-holding

• Jiajia Ge at al., Int J Radiation Oncol Biol Phys, Vol. 85, No. 4, pp. 999e1005, 2013 • Lens E, van der Horst A, Versteijne E, Bel A, van Tienhoven G. Considerable pancreatic tumor motion during breath-holding. Acta Oncol. 2016 Nov;55(11):1360-1368. • Lens E, van der Horst A, Kroon PS, van Hooft JE, Dávila Fajardo R, Fockens P, van Tienhoven G, Bel A. Differences in respiratory-induced pancreatic tumor motion between 4D treatment planning CT and daily cone beam CT, measured using intratumoral fiducials. Acta Oncol. 2014 Sep;53(9):1257-64.