Initial clinical evaluation of a respiratory gating radiotherapy system Conference Paper
| Authors: | Mageras, G.; Yorke, E.; Rosenzweig, K.; Fontenla, F.; Keatley, E.; Ling, C. |
| Editor: | Enderle, J. D. |
| Title: | Initial clinical evaluation of a respiratory gating radiotherapy system |
| Conference Title: | 22nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society |
| Abstract: | We report on initial patient studies at this Center to evaluate the performance of a commercial respiratory gating radiotherapy system. The system uses a breathing monitor, consisting of an infrared video camera and passive reflective markers placed on the patient's abdomen, to synchronize radiation from a linear accelerator with the patient's breathing cycle. Patients receiving treatment for lung cancer participated in a study of system characteristics during treatment simulation with fluoroscopy, port film acquisition, and treatment. Breathing synchronized fluoroscopy was performed initially without instruction, followed by fluoroscopy with recorded verbal instruction (i.e., when to inhale and exhale) with the tempo matched to the patient's normal breathing period. Patients tended to inhale more deeply and consistently when given instruction, as assessed by external marker movement. This resulted in smaller variation in expiration and inspiration marker positions relative to total excursion, thereby permitting more precise gating tolerances at those parts of the breathing cycle. Verbal instruction also improved the correlation between diaphragm position and external marker position, as observed with fluoroscopy as well as in comparison of gated simulation and portal film; furthermore, a factor 2-4 reduction in diaphragm movement was achievable by gating on 30-50% of the breathing cycle at expiration. Patients expressed no difficulty with following instruction, and gated treatment procedures required little additional time. We conclude that verbal breathing instruction can improve reproducibility in breathing, and in turn improve the consistency of gated treatments with this system. |
| Keywords: | radiotherapy; respiration; respiratory mechanics; fluoroscopy; infrared radiation; breathing; respiratory system; linear accelerators; gating; noninvasive medical procedures; light emitting diodes; charge coupled devices; video cameras; breathing monitor; infrared video camera; passive reflective markers; respiratory gating radiotherapy system |
| Journal Title | IEEE Engineering in Medicine and Biology Society. Annual International Conference. Proceedings |
| Volume: | 3 |
| Conference Dates: | 2000 Jul 23-28 |
| Conference Location: | Chicago, IL |
| ISBN: | 1094-687X |
| Publisher: | IEEE |
| Location: | Chicago, IL |
| Date Published: | 2000-01-01 |
| Start Page: | 2124 |
| End Page: | 2127 |
| Language: | English |
| PROVIDER: | scopus |
| DOI: | 10.1109/IEMBS.2000.900549 |
| DOI/URL: | |
| Notes: | Annu Int Conf IEEE Eng Med Biol Proc -- Conference code: 58180 -- Cited By :2 -- Export Date: 18 November 2015 -- CODEN: CEMBA -- 23 July 2000 through 28 July 2000 -- Source: Scopus |
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