{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:04:34Z","timestamp":1753884274095,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"1099","license":[{"start":{"date-parts":[[2019,5,22]],"date-time":"2019-05-22T00:00:00Z","timestamp":1558483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>Avoidance of radiation-induced optic neuropathy (RION) from stereotactic radiosurgery (SRS) requires precise anatomical localization; however, no prior studies have characterized the physiologic motion of the optic chiasm. We measured the extent of chiasm motion and its impact on SRS dose.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>In this cross-sectional study, serial MRI was performed in multiple planes in 11 human subjects without optic pathway abnormalities to determine chiasm motion across time. Subsequently, the measured displacement was applied to the hypothetical chiasm dose received in 11 patients treated with SRS to a perichiasmatic lesion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>On sagittal images, the average anteroposterior chiasm displacement was 0.51\u2009mm [95% confidence interval (CI) 0.27 \u2013 0.75\u2009mm], and the average superior-inferior displacement was 0.48\u2009mm (95%\u2009CI 0.22 \u2013 0.74\u2009mm). On coronal images, the average superior\u2013inferior displacement was 0.42\u2009mm (95%\u2009CI 0.13 \u2013 0.71\u2009mm), and the average lateral displacement was 0.75\u2009mm (95%\u2009CI 0.42 \u2013 1.08\u2009mm). In 11 patients who underwent SRS to a perichiasmatic lesion, the average displacements increased the maximum chiasm dose (Dmax) by a mean of 14 % (range 6\u201323 %; p &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>Average motion of the optic chiasm was approximately 0.50\u20130.75\u2009mm, which increased chiasm Dmax by a mean of 14%. In the occasional patient with higher-than-average chiasm motion in a region of steep dose gradient, the increase in chiasm Dmax and risk of RION could be even larger. Similarly, previously reported chiasm dose constraints may underestimate the true dose received during radiosurgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>To limit the risk of RION, clinicians may consider adding a 0.50\u20130.75\u2009mm expansion to the chiasm avoidance structure.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20190170","type":"journal-article","created":{"date-parts":[[2019,5,8]],"date-time":"2019-05-08T18:11:12Z","timestamp":1557339072000},"source":"Crossref","is-referenced-by-count":5,"title":["Physiological motion of the optic chiasm and its impact on stereotactic radiosurgery dose"],"prefix":"10.1093","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0170-9321","authenticated-orcid":false,"given":"Michael","family":"Xiang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Stanford University , Stanford, CA , United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Neuroradiology, Stanford University , Stanford, CA , United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Stanford University , Stanford, CA , United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khushboo","family":"Jani","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Stanford University , Stanford, CA , United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha J.","family":"Holdsworth","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Neuroradiology, Stanford University , Stanford, CA , United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Iv","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Neuroradiology, Stanford University , Stanford, CA , United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erqi L.","family":"Pollom","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Stanford University , Stanford, CA , United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott G.","family":"Soltys","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Stanford University , Stanford, CA , United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,5,22]]},"reference":[{"key":"2024050214465936400_b1","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1016\/j.ijrobp.2009.07.1753","article-title":"Radiation Dose\u2013Volume effects of optic nerves and chiasm","volume":"76","author":"Mayo","year":"2010","journal-title":"Int J Radiat Oncol"},{"key":"2024050214465936400_b2","article-title":"Single- and Multi-Fraction stereotactic radiosurgery dose tolerances of the optic pathways","author":"Milano","year":"2018","journal-title":"Int JRadiat Oncol Biol Phys"},{"key":"2024050214465936400_b3","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.semradonc.2015.11.008","article-title":"Dose-response modeling of the visual pathway tolerance to Single-Fraction and Hypofractionated stereotactic radiosurgery","volume":"26","author":"Hiniker","year":"2016","journal-title":"Semin Radiat Oncol"},{"key":"2024050214465936400_b4","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/WNO.0000000000000511","article-title":"Advanced MRI of the optic nerve","volume":"37","author":"Hoch","year":"2017","journal-title":"J Neuroophthalmol"},{"key":"2024050214465936400_b5","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.radonc.2007.06.008","article-title":"Evaluation of thoracic spinal cord motion using dynamic MRI","volume":"84","author":"Cai","year":"2007","journal-title":"Radiother Oncol"},{"key":"2024050214465936400_b6","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1002\/mrm.21260","article-title":"Investigation of human cervical and upper thoracic spinal cord motion: implications for imaging spinal cord structure and function","volume":"58","author":"Figley","year":"2007","journal-title":"Magn Reson Med"},{"key":"2024050214465936400_b7","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1109\/TSMC.1979.4310076","article-title":"A threshold selection method from Gray-Level histograms","volume":"9","author":"Otsu","year":"1979","journal-title":"IEEE Trans Syst Man Cybern"},{"key":"2024050214465936400_b8","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1002\/acm2.12022","article-title":"Single fraction radiosurgery\/stereotactic body radiation therapy (SBRT) for spine metastasis: a dosimetric comparison of multiple delivery platforms","volume":"18","author":"Nalichowski","year":"2017","journal-title":"J Appl Clin Med Phys"},{"key":"2024050214465936400_b9","doi-asserted-by":"crossref","first-page":"4078","DOI":"10.1118\/1.3438081","article-title":"Stereotactic body radiation therapy: the report of AAPM task group 101","volume":"37","author":"Benedict","year":"2010","journal-title":"Med Phys"},{"key":"2024050214465936400_b10","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.ijrobp.2012.05.007","article-title":"Probabilities of radiation myelopathy specific to stereotactic body radiation therapy to guide safe practice","volume":"85","author":"Sahgal","year":"2013","journal-title":"Int J Radiat Oncol"},{"key":"2024050214465936400_b11","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3171\/2016.8.SPINE16121","article-title":"Consensus guidelines for postoperative stereotactic body radiation therapy for spinal metastases: results of an international survey","volume":"26","author":"Redmond","year":"2017","journal-title":"J Neurosurg Spine"}],"container-title":["The British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/92\/1099\/20190170\/57378527\/bjr.20190170.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/92\/1099\/20190170\/57378527\/bjr.20190170.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T15:03:09Z","timestamp":1714662189000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/doi\/10.1259\/bjr.20190170\/7448882"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,22]]},"references-count":11,"journal-issue":{"issue":"1099","published-online":{"date-parts":[[2019,5,22]]},"published-print":{"date-parts":[[2019,7,1]]}},"URL":"https:\/\/doi.org\/10.1259\/bjr.20190170","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"type":"print","value":"0007-1285"},{"type":"electronic","value":"1748-880X"}],"subject":[],"published-other":{"date-parts":[[2019,7,1]]},"published":{"date-parts":[[2019,5,22]]},"article-number":"20190170"}}