Organs at risk proximity in central lung stereotactic ablative radiotherapy: A comparison of four-dimensional computed tomography and magnetic resonance-guided breath-hold delivery techniques

Nicolas Giraud; Hilâl Tekatli; Famke L. Schneiders; John R. van Sornsen de Koste; Marco Marzo; Miguel A. Palacios; Suresh Senan

doi:10.1016/j.phro.2025.100761

Organs at risk proximity in central lung stereotactic ablative radiotherapy: A comparison of four-dimensional computed tomography and magnetic resonance-guided breath-hold delivery techniques

Nicolas Giraud^*, Hilâl Tekatli, Famke L. Schneiders, John R. van Sornsen de Koste, Marco Marzo, Miguel A. Palacios, Suresh Senan

^*Corresponding author for this work

Department of Radiotherapy

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Higher toxicity rates are associated with stereotactic ablative radiotherapy (SABR) to central lung tumors. Breath-hold (BH) magnetic resonance-guided SABR (MR-SABR) can reduce doses to organs at risk (OAR). We quantified the planning target volumes (PTV) to OAR distance in 45 lesions treated using MR-SABR and generated a corresponding four-dimensional computed tomography (4D-CT) based PTV (motion-encompassing internal target volume plus 5 mm). For lesions located ≦3 cm from airways, BH MR-SABR increased the median PTV distance to OAR by 3.7 mm. For lesions ≦3 cm from pericardium, median PTV-OAR separation increased by 2.0 mm with BH. These findings highlight the advantage of BH SABR for central lung tumors.

Original language	English
Article number	100761
Number of pages	4
Journal	Physics and Imaging in Radiation Oncology
Volume	34
DOIs	https://doi.org/10.1016/j.phro.2025.100761
Publication status	Published - Apr 2025

Keywords

IGRT
Lung
MR-guided radiotherapy
SABR

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Organs at risk proximity in central lung stereotactic ablative radiotherapy: A comparison of four-dimensional computed tomography and magnetic resonance-guided breath-hold delivery techniquesFinal published version, 1.33 MBLicence: CC BY

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Giraud, N., Tekatli, H., Schneiders, F. L., van Sornsen de Koste, J. R., Marzo, M., Palacios, M. A., & Senan, S. (2025). Organs at risk proximity in central lung stereotactic ablative radiotherapy: A comparison of four-dimensional computed tomography and magnetic resonance-guided breath-hold delivery techniques. Physics and Imaging in Radiation Oncology, 34, Article 100761. https://doi.org/10.1016/j.phro.2025.100761

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title = "Organs at risk proximity in central lung stereotactic ablative radiotherapy: A comparison of four-dimensional computed tomography and magnetic resonance-guided breath-hold delivery techniques",

abstract = "Higher toxicity rates are associated with stereotactic ablative radiotherapy (SABR) to central lung tumors. Breath-hold (BH) magnetic resonance-guided SABR (MR-SABR) can reduce doses to organs at risk (OAR). We quantified the planning target volumes (PTV) to OAR distance in 45 lesions treated using MR-SABR and generated a corresponding four-dimensional computed tomography (4D-CT) based PTV (motion-encompassing internal target volume plus 5 mm). For lesions located ≦3 cm from airways, BH MR-SABR increased the median PTV distance to OAR by 3.7 mm. For lesions ≦3 cm from pericardium, median PTV-OAR separation increased by 2.0 mm with BH. These findings highlight the advantage of BH SABR for central lung tumors.",

keywords = "IGRT, Lung, MR-guided radiotherapy, SABR",

author = "Nicolas Giraud and Hil{\^a}l Tekatli and Schneiders, {Famke L.} and {van Sornsen de Koste}, {John R.} and Marco Marzo and Palacios, {Miguel A.} and Suresh Senan",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s)",

year = "2025",

month = apr,

doi = "10.1016/j.phro.2025.100761",

language = "English",

volume = "34",

journal = "Physics and Imaging in Radiation Oncology",

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Giraud, N, Tekatli, H, Schneiders, FL, van Sornsen de Koste, JR, Marzo, M, Palacios, MA & Senan, S 2025, 'Organs at risk proximity in central lung stereotactic ablative radiotherapy: A comparison of four-dimensional computed tomography and magnetic resonance-guided breath-hold delivery techniques', Physics and Imaging in Radiation Oncology, vol. 34, 100761. https://doi.org/10.1016/j.phro.2025.100761

Organs at risk proximity in central lung stereotactic ablative radiotherapy: A comparison of four-dimensional computed tomography and magnetic resonance-guided breath-hold delivery techniques. / Giraud, Nicolas; Tekatli, Hilâl; Schneiders, Famke L. et al.
In: Physics and Imaging in Radiation Oncology, Vol. 34, 100761, 04.2025.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Organs at risk proximity in central lung stereotactic ablative radiotherapy

T2 - A comparison of four-dimensional computed tomography and magnetic resonance-guided breath-hold delivery techniques

AU - Giraud, Nicolas

AU - Tekatli, Hilâl

AU - Schneiders, Famke L.

AU - van Sornsen de Koste, John R.

AU - Marzo, Marco

AU - Palacios, Miguel A.

AU - Senan, Suresh

PY - 2025/4

Y1 - 2025/4

N2 - Higher toxicity rates are associated with stereotactic ablative radiotherapy (SABR) to central lung tumors. Breath-hold (BH) magnetic resonance-guided SABR (MR-SABR) can reduce doses to organs at risk (OAR). We quantified the planning target volumes (PTV) to OAR distance in 45 lesions treated using MR-SABR and generated a corresponding four-dimensional computed tomography (4D-CT) based PTV (motion-encompassing internal target volume plus 5 mm). For lesions located ≦3 cm from airways, BH MR-SABR increased the median PTV distance to OAR by 3.7 mm. For lesions ≦3 cm from pericardium, median PTV-OAR separation increased by 2.0 mm with BH. These findings highlight the advantage of BH SABR for central lung tumors.

AB - Higher toxicity rates are associated with stereotactic ablative radiotherapy (SABR) to central lung tumors. Breath-hold (BH) magnetic resonance-guided SABR (MR-SABR) can reduce doses to organs at risk (OAR). We quantified the planning target volumes (PTV) to OAR distance in 45 lesions treated using MR-SABR and generated a corresponding four-dimensional computed tomography (4D-CT) based PTV (motion-encompassing internal target volume plus 5 mm). For lesions located ≦3 cm from airways, BH MR-SABR increased the median PTV distance to OAR by 3.7 mm. For lesions ≦3 cm from pericardium, median PTV-OAR separation increased by 2.0 mm with BH. These findings highlight the advantage of BH SABR for central lung tumors.

KW - IGRT

KW - Lung

KW - MR-guided radiotherapy

KW - SABR

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DO - 10.1016/j.phro.2025.100761

M3 - Article

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SN - 2405-6316

VL - 34

JO - Physics and Imaging in Radiation Oncology

JF - Physics and Imaging in Radiation Oncology

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Giraud N, Tekatli H, Schneiders FL, van Sornsen de Koste JR, Marzo M, Palacios MA et al. Organs at risk proximity in central lung stereotactic ablative radiotherapy: A comparison of four-dimensional computed tomography and magnetic resonance-guided breath-hold delivery techniques. Physics and Imaging in Radiation Oncology. 2025 Apr;34:100761. doi: 10.1016/j.phro.2025.100761

Organs at risk proximity in central lung stereotactic ablative radiotherapy: A comparison of four-dimensional computed tomography and magnetic resonance-guided breath-hold delivery techniques

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