Exhale fluctuation in respiratory-gated radiotherapy of the lung: A pitfall of respiratory gating shown in a synchronized internal/external marker recording study

Nishioka, Seiko; Nishioka, Takeshi; Kawahara, Masaki; Tanaka, Shigeru; Hiromura, Tadao; Tomita, Kazuo; Shirato, Hiroki

doi:10.1016/j.radonc.2007.11.014

Cited by 35 publications

(35 citation statements)

References 20 publications

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“…( 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: 57%

“…There have been few, small sample sized studies that have investigated respiratory motion parameters for external respiratory surrogates. ( 7 , 8 , 9 ) I n order to fully describe this respiratory motion, a large population study is needed. To complete the picture of respiratory motion, not only do the basic extent of motion parameters, such as peak‐to‐peak amplitude, period, and end exhale phase need to be described, but also the variability of respiratory motion including inter‐ and intrafraction motion and baseline drift.…”

Section: Introductionmentioning

confidence: 99%

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External respiratory motion analysis and statistics for patients and volunteers

Quirk

Becker

Smith

2013

J Applied Clin Med Phys

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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

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Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

External respiratory motion analysis and statistics for patients and volunteers

Quirk

Becker

Smith

2013

J Applied Clin Med Phys

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“…1 In brief, in our system radiation beams are turned on when a respiratory monitor detects an end-exhale signal from the external anatomy, the mid to upper abdomen. However, the position of a tumor can vary among end-exhales, depending on the tumor site, patient's condition, and the treatment session.…”

Section: Introductionmentioning

confidence: 99%

Synchronous monitoring of external/internal respiratory motion: validity of respiration-gated radiotherapy for liver tumors

Nishioka

Nishioka²,

Kawahara

et al. 2009

Jap J Radiol

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“…The respiratory synchronized techniques that intend to either gate the dose delivery at a certain tumor position or track the tumor in real-time are appealing since they minimize the tumor motion contribution in the safety margin calculation (26)(27)(28)(29). However, these approaches remain complex to implement, require sophisticated and time-consuming inroom verification procedures, and are technically unfeasible with helical tomotherapy machine.…”

Section: Treatment Planning Strategiesmentioning

confidence: 99%

4D PET-CT guided radiation therapy

Geets¹

2013

Journal of the Belgian Society of Radiology

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Exhale fluctuation in respiratory-gated radiotherapy of the lung: A pitfall of respiratory gating shown in a synchronized internal/external marker recording study

Cited by 35 publications

References 20 publications

External respiratory motion analysis and statistics for patients and volunteers

External respiratory motion analysis and statistics for patients and volunteers

Synchronous monitoring of external/internal respiratory motion: validity of respiration-gated radiotherapy for liver tumors

4D PET-CT guided radiation therapy

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