Rectal volume is correlated with interfractional positional shifts of the prostate gland in dogs receiving radiation therapy

Vet Radiol Ultrasound. 2024 May 12. doi: 10.1111/vru.13381. Online ahead of print.

Abstract

Variability in prostate gland positioning during RT for prostate tumors is a recognized challenge in both human and veterinary oncology. This retrospective study investigates the interfractional variability in prostate gland positioning in relation to rectal and bladder volumes in dogs undergoing radiation therapy (RT) for prostate tumors. The study tracked 10 dogs undergoing five RT sessions from February 2016 to November 2021, delivering a total of 25 Gy each. Each dog underwent CT scans for treatment simulation, and cone-beam CT (CBCT) images were acquired before each RT. The focus was to analyze the positional shifts of the prostate gland concerning the volumes of the rectum and urinary bladder. The pelvic bones were used as the point of reference. The rectal and bladder volumes were measured before each RT, and shifts in the prostate gland position were calculated by comparing coordinates from planning CT and treatment session images. Findings revealed significant correlations between prostate positional shifts in the dorsal-ventral (repeated measures correlation coefficient of -0.58 [range 00.75-00.33]; P < .001) and cranial-caudal directions (repeated measures correlation coefficient [95%CI] 0.56 [range 0.31-0.74]; P < .001) and rectal volume, while no significant relationship was observed with bladder volume. Shifts in the lateral direction were not correlated with either organ's volume. This study highlights the importance of considering rectal volume in canine prostate tumor RT to minimize positional uncertainties. Maintaining consistent rectal volume may enhance the precision of prostate targeting, potentially influencing the safety of RT.

Keywords: prostate gland; radiation therapy; rectum.