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Extracranial radiosurgery: immobilizing liver motion in dogs using high-frequency jet ventilation and total intravenous anesthesia.

Publication ,  Journal Article
Yin, F; Kim, JG; Haughton, C; Brown, SL; Ajlouni, M; Stronati, M; Pamukov, N; Kim, JH
Published in: Int J Radiat Oncol Biol Phys
January 1, 2001

PURPOSE: Extracranial radiosurgery requires control of organ motion. The purpose of this study is to quantitatively determine the extent of liver motion in anesthetized dogs with continuous i.v. propofol infusion with or without muscle relaxants and high-frequency jet ventilation. METHODS AND MATERIALS: Five dogs were used in the experiment. Each dog was restrained while anesthetized in the supine position using an alpha cradle. Surgical metal clips were implanted around the liver periphery so that its motion could be visualized using a fluoroscopic imaging device in a conventional simulator. Initially, two orthogonal simulation films were taken to correlate locations of implanted clips. Two orthogonal views of fluoroscopic images for each anesthetized dog were recorded on a magnetic tape and analyzed from the post-imaging data. Liver motion was documented under the following three conditions: 1) ventilated with a conventional mechanical ventilator, 2) ventilated with a high-frequency jet ventilator, and 3) ventilated with a high-frequency jet ventilator and total muscle paralysis (with vecuronium injection). The maximum liver motion for each dog was analyzed in three orthogonal directions: the inferior-to-superior direction, the anterior-to-posterior direction, and the right-to-left direction. RESULTS: When the anesthetized dogs were ventilated with a conventional mechanical ventilator, the average liver motions were 1.2 cm in the inferior-to-superior direction, 0.4 cm in the anterior-to-posterior direction, and 0.2 cm in the right-to-left direction, respectively. After the introduction of high-frequency jet ventilation, the average liver motions were reduced to 0.2 cm in the inferior-to-superior direction, 0.2 cm in the anterior-to-posterior direction, and 0.1 cm in the right-to-left direction. The maximum liver motion was dependent on ventilator settings. There was no additional measurable motion reduction with the addition of the muscle relaxant. CONCLUSION: The liver motion in each anesthetized dog was controlled under 3.0 mm in all directions with the use of high-frequency jet ventilation. No detectable advantage was identified by the injection of muscle relaxant in terms of further reducing the liver motion. The preclinical animal study indicated that the use of high-frequency jet ventilation (HFJV) would be able to limit the liver motion to an extent acceptable for the application of extracranial radiosurgery in humans. Radiosurgery for localized liver tumors warrants further investigation.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

January 1, 2001

Volume

49

Issue

1

Start / End Page

211 / 216

Location

United States

Related Subject Headings

  • Respiration, Artificial
  • Radiosurgery
  • Radiography
  • Propofol
  • Pilot Projects
  • Oncology & Carcinogenesis
  • Movement
  • Liver
  • High-Frequency Jet Ventilation
  • Dogs
 

Citation

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Yin, F., Kim, J. G., Haughton, C., Brown, S. L., Ajlouni, M., Stronati, M., … Kim, J. H. (2001). Extracranial radiosurgery: immobilizing liver motion in dogs using high-frequency jet ventilation and total intravenous anesthesia. Int J Radiat Oncol Biol Phys, 49(1), 211–216. https://doi.org/10.1016/s0360-3016(00)01370-5
Yin, F., J. G. Kim, C. Haughton, S. L. Brown, M. Ajlouni, M. Stronati, N. Pamukov, and J. H. Kim. “Extracranial radiosurgery: immobilizing liver motion in dogs using high-frequency jet ventilation and total intravenous anesthesia.Int J Radiat Oncol Biol Phys 49, no. 1 (January 1, 2001): 211–16. https://doi.org/10.1016/s0360-3016(00)01370-5.
Yin F, Kim JG, Haughton C, Brown SL, Ajlouni M, Stronati M, et al. Extracranial radiosurgery: immobilizing liver motion in dogs using high-frequency jet ventilation and total intravenous anesthesia. Int J Radiat Oncol Biol Phys. 2001 Jan 1;49(1):211–6.
Yin, F., et al. “Extracranial radiosurgery: immobilizing liver motion in dogs using high-frequency jet ventilation and total intravenous anesthesia.Int J Radiat Oncol Biol Phys, vol. 49, no. 1, Jan. 2001, pp. 211–16. Pubmed, doi:10.1016/s0360-3016(00)01370-5.
Yin F, Kim JG, Haughton C, Brown SL, Ajlouni M, Stronati M, Pamukov N, Kim JH. Extracranial radiosurgery: immobilizing liver motion in dogs using high-frequency jet ventilation and total intravenous anesthesia. Int J Radiat Oncol Biol Phys. 2001 Jan 1;49(1):211–216.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

January 1, 2001

Volume

49

Issue

1

Start / End Page

211 / 216

Location

United States

Related Subject Headings

  • Respiration, Artificial
  • Radiosurgery
  • Radiography
  • Propofol
  • Pilot Projects
  • Oncology & Carcinogenesis
  • Movement
  • Liver
  • High-Frequency Jet Ventilation
  • Dogs