Four-dimensional CT analysis of vocal cords mobility for highly focused single vocal cord irradiation

S. O S Osman*, H. C J de Boer, B. J M Heijmen, Peter C. Levendag

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


Background and Purpose: To quantify respiratory motion of the vocal cords during normal respiration using 4D-CT. The final goal is to develop a technique for single vocal cord irradiation (SVCI) in early glottic carcinoma. Sparing the non-involved cord and surrounding structures has the potential to preserve voice quality and allow re-irradiation of recurrent and second primary tumors. Material and methods: Four-dimensional CTs of 1 mm slice thickness from 10 early glottic carcinoma patients were acquired. The lateral dimensions of the air gap separating the vocal cords were measured anteriorly, at mid-level and posteriorly at each phase of the 4D-CTs. The corresponding anterior-posterior gaps were similarly measured. Cranio-caudal vocal cords movements during breathing were derived from the shifts of the arythenoids. Results: The population-averaged mean gap size ± the corresponding standard deviation due to breathing (SDB) for the lateral gaps was 5.8 ± 0.7 mm anteriorly, 8.7 ± 0.9 mm at mid-level, and 11.0 ± 1.3 mm posteriorly. Anterior-posterior gap values were 21.7 ± 0.7 mm, while cranio-caudal shift SDB was 0.8 mm. Conclusion: Vocal cords breathing motions were found to be small relative to their separation. Hence, breathing motion does not seem to be a limiting factor for SVCI.

Original languageEnglish
Pages (from-to)19-27
Number of pages9
JournalRadiotherapy and Oncology
Issue number1
Publication statusPublished - 01 Oct 2008


  • 4D-CT
  • Early glottic carcinoma
  • IGRT
  • Vocal cords
  • Voice quality

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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