A comparison of the respiratory signals acquired by different respiratory monitoring systems used in respiratory gated radiotherapy

Otani, Yuki; Fukuda, Ichirou; Tsukamoto, Nobuhiro; Kumazaki, Yu; Shinmoto, Hiroshi; Imabayashi, Etsuko; Kawaguchi, Osamu; Nose, Takayuki; Teshima, Tadashi; Dokiya, Takushi

doi:10.1118/1.3512798

Cited by 47 publications

(49 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…( 7 , 8 , 9 , 18 ) Our results for mean (SD) for amplitude, 1.0 (0.5) cm, and period, 3.7 (1.0) s, fall into the range of motion found for external motion range of amplitudes of 3 mm to 3 cm ( 8 , 9 ) and a range of period of 4.8 (1.2) s. ( 18 ) …”

Section: Discussionsupporting

confidence: 54%

External respiratory motion analysis and statistics for patients and volunteers

Quirk

Becker

Smith

2013

J Applied Clin Med Phys

View full text Add to dashboard Cite

We analyzed a large patient and volunteer study of external respiratory motion in order to develop a population database of respiratory information. We analyzed 120 lung, liver, and abdominal patients and 25 volunteers without lung disease to determine the extent of motion using the Varian Real‐Time Position Management system. The volunteer respiratory motion was measured for both abdominal and thoracic placement of the RPM box. Evaluation of a subset of 55 patients demonstrates inter‐ and intrafraction variation over treatment. We also calculated baseline drift and duty cycle for patients and volunteers. The mean peak‐to‐peak amplitude (SD) for the patients was 1.0 (0.5) cm, and for the volunteers it was abdomen 0.8 (0.3) cm and thoracic 0.2 (0.2) cm. The mean period (SD) was 3.6 (1.0) s, 4.2 (1.1) s, and 4.1 (0.8) s, and the mean end exhale position (SD) was 60% (6), 58% (7), and 56% (7) for patient, volunteer abdomen, and volunteer thoracic, respectively. Baseline drift was greater than 0.5 cm for 40% of patients. We found statistically significant differences between the patient and volunteer groups. Peak‐to‐peak amplitude was significantly larger for patients than the volunteer abdominal measurement and the volunteer abdominal measurement is significantly larger than the volunteer thoracic measurement. The patient group also exhibited significantly larger baseline drift than the volunteer group. We also found that peak‐to‐peak amplitude was the most variable parameter for both intra‐ and interfraction motion. This database compilation can be used as a resource for expected motion when using external surrogates in radiotherapy applications.PACS number: 87.19.Wx, 87.55.Km

show abstract

Section: Discussionsupporting

confidence: 54%

External respiratory motion analysis and statistics for patients and volunteers

Quirk

Becker

Smith

2013

J Applied Clin Med Phys

View full text Add to dashboard Cite

show abstract

“…De Groote17 proposed a model showing that if there exists asynchrony between motions along the dorsoventral and lateral directions with respiration, there will be a phase shift between the anterior–posterior movement (as measured as the RPM signal) and the change in abdominal perimeter (as measured as the ANZAI belt signal). In addition, in previous studies comparing different external surrogates,13, 16, 18 shape distortion can be observed between the respiratory traces in patients, which has not been investigated in those studies.…”

Section: Introductionmentioning

confidence: 93%

Evaluation of the combined use of two different respiratory monitoring systems for 4D CT simulation and gated treatment

Liu

Lin

Fan

et al. 2018

J Applied Clin Med Phys

View full text Add to dashboard Cite

PurposeTwo different respiratory monitoring systems (Varian's Real‐Time Position Management (RPM) System and Siemens’ ANZAI belt Respiratory Gating System) are compared in the context of respiratory signals and 4D CT images that are accordingly reconstructed. This study aims to evaluate the feasibility of combined use of RPM and ANZAI systems for 4DCT simulation and gated radiotherapy treatment, respectively.MethodsThe RPM infrared reflecting marker and the ANZAI belt pressure sensor were both placed on the patient's abdomen during 4DCT scans. The respiratory signal collected by the two systems was synchronized. Fifteen patients were enrolled for respiratory signal collection and analysis. The discrepancies between the RPM and ANZAI traces can be characterized by phase shift and shape distortion. To reveal the impact of the changes in respiratory signals on 4D images, two sets of 4D images based on the same patient's raw data were reconstructed using the RPM and ANZAI data for phase sorting, respectively. The volume of whole lung and the position of diaphragm apex were measured and compared for each respiratory phase.ResultsThe mean phase shift was measured as 0.2 ± 0.1 s averaged over 15 patients. The shape of the breathing trace was found to be in disagreement. For all the patients, the ANZAI trace had a steeper falloff in exhalation than RPM. The inhalation curve, however, was matched for nine patients, steeper in ANZAI for five patients and steeper in RPM for one patient. For 4D image comparison, the difference in whole‐lung volume was about −4% to +4% and the difference in diaphragm position was about −5 mm to +4 mm, compared in each individual phase and averaged over seven patients.ConclusionsCombined use of one system for 4D CT simulation and the other for gated treatment should be avoided as the resultant gating window would not fully match with each other due to the remarkable discrepancy in breathing traces acquired by the two different surrogate systems.

show abstract

“…Different synchronization tools are offered by manufacturers; the main tools include the Real Time Position Management™ system from Varian Medical Systems (Palo Alto, CA), the pressure sensor AZ-733V from Anzai Medical (Tokyo, Japan) 7 or a deformable belt proposed by Medspira IBC System (Minneapolis, MN).…”

Section: Introductionmentioning

confidence: 99%

Clinical respiratory motion correction software (reconstruct, register and averaged—RRA), for 18F-FDG-PET-CT: phantom validation, practical implications and patient evaluation

Bouyeure-Petit¹,

Chastan²,

Edet-Sanson³

et al. 2017

The British Journal of Radiology

View full text Add to dashboard Cite

Objective: On fluorine-18 fludeoxyglucose ( 18 F-FDG) positron emission tomography (PET) CT of pulmonary or hepatic lesions, standard uptake value (SUV) is often underestimated due to patient breathing. The aim of this study is to validate, on phantom and patient data, a motion correction algorithm [reconstruct, register and averaged (RRA)] implemented on a PET-CT system. Methods: Three phantoms containing five spheres filled with 18 F-FDG and suspended in a water or Styrofoam® 18 F-FDG-filled tank to create different contrasts and attenuation environment were acquired on a Discovery GE710. The spheres were animated with a 2-cm longitudinal respiratory-based movement. Respiratory-gated (RRA) and ungated PET images were compared with static reference images (without movement). The optimal acquisition time, number of phases and the best phase within the respiratory cycle were investigated. The impact of irregular motion was also investigated. Quantification impact was computed on each sphere. Quantification improvement on 28 lung lesions was also investigated. Results: Phantoms: 4 min was required to obtain a stable quantification with the RRA method. The reference phase and the number of phases used for RRA did not affect the quantification which was similar on static acquisitions but different on ungated images. The results showed that the maximum standard uptake value (SUV max ) restoration is majored for the smallest spheres (#2.1 ml). Patients: SUV max on RRA and ungated acquisitions were statistically different to the SUV max on whole-body images (p 5 0.05) but not different from each other (mean SUV max : 7.0 6 7.8 vs 6.9 6 7.8, p 5 0.23 on RRA and ungated images, respectively). We observed a statistically significant correlation between SUV restoration and lesion displacement, with a real SUV quantitation improvement for lesion with movement .1.2 mm. Conclusion: According to the results obtained using phantoms, RRA method is promising, showing a real impact on the lesion quantification on phantom data. With regard to the patient study, our results showed a trend towards an increase in the SUVs and a decrease in the volume between the ungated and RRA data. We also noticed a statistically significant correlation between the quantitative restoration obtained with RRA compared with ungated data and lesion displacement, indicating that the RRA approach should be reserved to patients with small lesions or nodes moving with a displacement larger than 1.2 cm. Advances in knowledge: This article investigates the performances of motion correction software recently introduced in PET. The conclusion revealed that such respiratory motion correction approach shows a real impact on the lesion quantification but must be reserved to the patient for whom lesion displacement was confirmed and high enough to clearly impact lesion evaluation.

show abstract

A comparison of the respiratory signals acquired by different respiratory monitoring systems used in respiratory gated radiotherapy

Abstract: The estimation of the position of the tumor centroid and tumor shape may vary with the use of different respiratory monitoring systems. This implies that it is preferable to use the same respiratory monitoring system with 4DCT, 4DPET-CT, and linac.

Cited by 47 publications

References 31 publications

External respiratory motion analysis and statistics for patients and volunteers

External respiratory motion analysis and statistics for patients and volunteers

Evaluation of the combined use of two different respiratory monitoring systems for 4D CT simulation and gated treatment

Clinical respiratory motion correction software (reconstruct, register and averaged—RRA), for 18F-FDG-PET-CT: phantom validation, practical implications and patient evaluation

Contact Info

Product

Resources

About