The deep inspiration breath-hold technique in the treatment of inoperable non–small-cell lung cancer

Rosenzweig, Kenneth E.; Hanley, Joseph; Mah, Dennis; Mageras, G.; Hunt, Margie; Toner, Sean; Burman, Chandra; Ling, C. Clifton; Mychalczak, Borys; Fuks, Zvi; Leibel, Steven A.

doi:10.1016/s0360-3016(00)00583-6

Cited by 366 publications

(188 citation statements)

References 23 publications

Supporting

Mentioning

181

Contrasting

Unclassified

Order By: Relevance

“…If no significant improvements in survival have yet been reported using these techniques, several studies have highlighted better dose conformity and a reduction in dose to organs at risk (OARs). ( 6 – 10 ) …”

Section: Introductionmentioning

confidence: 99%

“…Generally, these new techniques that manage the patient's respiratory motion during treatment are separated into two groups: breath‐hold techniques ( 6 , 11 ) and gating techniques (12) . In the breath‐hold technique, the patient is imaged and treated during a monitored breath‐hold.…”

Section: Introductionmentioning

confidence: 99%

“…This approach prevents motion of the tumor and the OARs. Moreover, if breath‐hold is achieved at deep inspiration, dosimetric benefits have also been observed for lung (6) . In the gating technique, the patient is treated at a particular phase of free breathing, generally by placing an external marker on the patient's chest and synchronizing beam delivery with the motion of the marker.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Initial evaluation of a four‐dimensional computed tomography system, using a programmable motor

Simon

Giraud

Servois

et al. 2006

J Applied Clin Med Phys

View full text Add to dashboard Cite

A dynamic lung tumor phantom was used to investigate the geometric reconstruction accuracy of a commercial four‐dimensional computed tomography (4D‐CT) system. A ball filled with resin, embedded in a cork cube, was placed on a moving platform. Various realistic antero‐posterior (AP) motions were programmed to reproduce the respiratory motion of a lung tumor. Several three‐dimensional (3D) CT and 4D‐CT images of this moving object were acquired and compared using different acquisition parameters. Apparent volume and diameter of the ball were measured and compared to the real values. The position of two points (the AP limits of the ball) during the motion in the coordinate system of the CT scanner were also compared with the expected values. Volume error was shown to increase with object speed. However, although the volume error was associated with intraslice artifacts, it did not reflect large interslice inconstancies in object position and should not be used as an indicator of image accuracy. The 3D‐CT gave a random position of the tumor along the phantom excursion; accuracy in the assessment of position by 4D‐CT ranged from 0.4 mm to 2.6 mm during extreme phases of breathing. We used average projection (AVE) and maximum intensity projection (MIP) algorithms available on the commercial software to create internal target volumes (ITVs) by merging gross tumor volume (GTV) images at various respiratory phases. The ITVs were compared to a theoretical value computed from the programmed ball excursion. The ITVs created from the MIP algorithm were closer to the theoretical value (within 12%) than were those created from the AVE algorithm (within 40%).PACS numbers: 87.53.Xd, 87.56.Mp, 87.57.Ce, 87.59.Fm

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Initial evaluation of a four‐dimensional computed tomography system, using a programmable motor

Simon

Giraud

Servois

et al. 2006

J Applied Clin Med Phys

View full text Add to dashboard Cite

show abstract

“…Note the clear improvement in the tumor delineation with the gated image, and the lack of a clear boundary between the tumor, lung and liver in the nongated image, as well as, in this case, a larger tumor volume. One method to reduce image artifacts due to motion, and also reduce the radiotherapy beam margins without compromising the treatment is to use respiration-gated such as breath-hold techniques [19][20][21][22][23][24] and active breathing control (ABC) 25 . Respiration gating is investigated here, as it is a non-interventional technique, and thus the most comfortable for the patient.…”

Section: Introductionmentioning

confidence: 99%

Potential radiotherapy improvements with respiratory gating

Keall

Kini

Vedam

et al. 2002

Australas. Phys. Eng. Sci. Med.

148

View full text Add to dashboard Cite

Gating is a relatively new and potentially useful therapeutic addition to external beam radiotherapy applied to regions affected by intra-fraction motion. The impact was of gating on treatment margins, image artifacts, and volume and positional accuracy was investigated by CT imaging of sinusoidally moving spheres. The motion of the spheres simulates target motion. During the CT imaging of dynamically moving spheres, gating reproduced the static volume to within 1%, whereas errors of over 20% were observed where gating was not used. Using a theoretical analysis of margins, gating alone or in combination with an electronic portal imaging device may allow a 2-11 mm reduction in the CTV to PTV margin, and thus less healthy tissue need be irradiated. Gating may allow a reduction of treatment margins, an improvement in image quality, and an improvement in positional and volumetric accuracy of the gross tumor volume.

show abstract

“…Methods employed to reduce radiotherapy errors due to respiratory motion include breath holding during CT image acquisition [16][17][18] , active patient control of breathing 19,20 , and modeling of tumor motion based upon external markers of respiration 1, 2, 21-23 . While respiratory control techniques can reduce treatment planning errors 16, 17, 24 , many lung cancer patients are unable to precisely manipulate their breathing.…”

Section: Introductionmentioning

confidence: 99%

Effect of Novel Amplitude/Phase Binning Algorithm on Commercial Four-Dimensional Computed Tomography Quality

Olsen

Hubenschmidt

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Purpose-Respiratory motion is a significant source of anatomic uncertainty in radiotherapy treatment planning, and may result in errors of portal size and subsequent radiation dose. While 4DCT allows for more accurate analysis of the respiratory cycle, breathing irregularities during data acquisition may cause considerable image distortions. The aim of this study was to examine the impact of respiratory irregularities on 4DCT imaging, and to evaluate a novel image reconstruction algorithm based upon percentile-based tagging of the respiratory cycle.Materials/Methods-Respiratory correlated helical CT was acquired on 11 consecutive patients. Inspiration and expiration datasets were reconstructed using the default phase based method as well as a novel respiration percentile based method using patient specific metrics to define ranges of the reconstruction. Image output was analyzed in a blinded fashion for both the phase and percentile based reconstructions to determine the prevalence and severity of image artifacts.Results-The percentile-based algorithm resulted in a significant reduction in artifact severity compared to the phase-based algorithm, although overall artifact prevalence did not differ between the two algorithms. The magnitude of differences in respiratory tag placement between the phase and percentile based algorithms was correlated with the presence of image artifacts.Conclusions-We conclude that our novel 4DCT reconstruction method may be useful to detect clinically relevant image distortions that may otherwise go unnoticed, and to reduce image distortion associated with some respiratory irregularities. Further work is necessary to assess the clinical impact on areas of possible irregular breathing.

show abstract

The deep inspiration breath-hold technique in the treatment of inoperable non–small-cell lung cancer

Cited by 366 publications

References 23 publications

Initial evaluation of a four‐dimensional computed tomography system, using a programmable motor

Initial evaluation of a four‐dimensional computed tomography system, using a programmable motor

Potential radiotherapy improvements with respiratory gating

Effect of Novel Amplitude/Phase Binning Algorithm on Commercial Four-Dimensional Computed Tomography Quality

Contact Info

Product

Resources

About