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Title: Active breathing control (ABC): Determination and reduction of breathing-induced organ motion in the chest

Abstract

Purpose: Extensive radiotherapy volumes for tumors of the chest are partly caused by interfractional organ motion. We evaluated the feasibility of respiratory observation tools using the active breathing control (ABC) system and the effect on breathing cycle regularity and reproducibility. Methods and Materials: Thirty-six patients with unresectable tumors of the chest were selected for evaluation of the ABC system. Computed tomography scans were performed at various respiratory phases starting at the same couch position without patient movement. Threshold levels were set at minimum and maximum volume during normal breathing cycles and at a volume defined as shallow breathing, reflecting the subjective maximal tolerable reduction of breath volume. To evaluate the extent of organ movement, 13 landmarks were considering using commercial software for image coregistration. In 4 patients, second examinations were performed during therapy. Results: Investigating the differences in a normal breathing cycle versus shallow breathing, a statistically significant reduction of respiratory motion in the upper, middle, and lower regions of the chest could be detected, representing potential movement reduction achieved through reduced breath volume. Evaluating interfraction reproducibility, the mean displacement ranged between 0.24 mm (chest wall/tracheal bifurcation) to 3.5 mm (diaphragm) for expiration and shallow breathing and 0.24 mm (chestmore » wall) to 5.25 mm (diaphragm) for normal inspiration. Conclusions: By modifying regularity of the respiratory cycle through reduction of breath volume, a significant and reproducible reduction of chest and diaphragm motion is possible, enabling reduction of treatment planning margins.« less

Authors:
 [1];  [2];  [2];  [2];  [2];  [3];  [4];  [2];  [2];  [2];  [5];  [2]
  1. Department of Radiotherapy, RWTH Aachen University, Aachen (Germany). E-mail: BGagel@UKAachen.de
  2. Department of Radiotherapy, RWTH Aachen University, Aachen (Germany)
  3. Institute of Medical Statistics, RWTH Aachen University, Aachen (Germany)
  4. Department of Internal Medicine, RWTH Aachen University, Aachen (Germany)
  5. Department of Diagnostic Radiology, RWTH Aachen University, Aachen (Germany)
Publication Date:
OSTI Identifier:
20944724
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2006.09.052; PII: S0360-3016(06)03235-4; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BREATH; CHEST; COMPUTERIZED TOMOGRAPHY; DIAPHRAGM; IMAGES; NEOPLASMS; PATIENTS; RADIOTHERAPY; RESPIRATION

Citation Formats

Gagel, Bernd, Demirel, Cengiz M.P., Kientopf, Aline, Pinkawa, Michael, Piroth, Marc, Stanzel, Sven, Breuer, Christian, Asadpour, Branka, Jansen, Thomas, Holy, Richard, Wildberger, Joachim E., and Eble, Michael J.. Active breathing control (ABC): Determination and reduction of breathing-induced organ motion in the chest. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.09.052.
Gagel, Bernd, Demirel, Cengiz M.P., Kientopf, Aline, Pinkawa, Michael, Piroth, Marc, Stanzel, Sven, Breuer, Christian, Asadpour, Branka, Jansen, Thomas, Holy, Richard, Wildberger, Joachim E., & Eble, Michael J.. Active breathing control (ABC): Determination and reduction of breathing-induced organ motion in the chest. United States. doi:10.1016/j.ijrobp.2006.09.052.
Gagel, Bernd, Demirel, Cengiz M.P., Kientopf, Aline, Pinkawa, Michael, Piroth, Marc, Stanzel, Sven, Breuer, Christian, Asadpour, Branka, Jansen, Thomas, Holy, Richard, Wildberger, Joachim E., and Eble, Michael J.. Thu . "Active breathing control (ABC): Determination and reduction of breathing-induced organ motion in the chest". United States. doi:10.1016/j.ijrobp.2006.09.052.
@article{osti_20944724,
title = {Active breathing control (ABC): Determination and reduction of breathing-induced organ motion in the chest},
author = {Gagel, Bernd and Demirel, Cengiz M.P. and Kientopf, Aline and Pinkawa, Michael and Piroth, Marc and Stanzel, Sven and Breuer, Christian and Asadpour, Branka and Jansen, Thomas and Holy, Richard and Wildberger, Joachim E. and Eble, Michael J.},
abstractNote = {Purpose: Extensive radiotherapy volumes for tumors of the chest are partly caused by interfractional organ motion. We evaluated the feasibility of respiratory observation tools using the active breathing control (ABC) system and the effect on breathing cycle regularity and reproducibility. Methods and Materials: Thirty-six patients with unresectable tumors of the chest were selected for evaluation of the ABC system. Computed tomography scans were performed at various respiratory phases starting at the same couch position without patient movement. Threshold levels were set at minimum and maximum volume during normal breathing cycles and at a volume defined as shallow breathing, reflecting the subjective maximal tolerable reduction of breath volume. To evaluate the extent of organ movement, 13 landmarks were considering using commercial software for image coregistration. In 4 patients, second examinations were performed during therapy. Results: Investigating the differences in a normal breathing cycle versus shallow breathing, a statistically significant reduction of respiratory motion in the upper, middle, and lower regions of the chest could be detected, representing potential movement reduction achieved through reduced breath volume. Evaluating interfraction reproducibility, the mean displacement ranged between 0.24 mm (chest wall/tracheal bifurcation) to 3.5 mm (diaphragm) for expiration and shallow breathing and 0.24 mm (chest wall) to 5.25 mm (diaphragm) for normal inspiration. Conclusions: By modifying regularity of the respiratory cycle through reduction of breath volume, a significant and reproducible reduction of chest and diaphragm motion is possible, enabling reduction of treatment planning margins.},
doi = {10.1016/j.ijrobp.2006.09.052},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 3,
volume = 67,
place = {United States},
year = {Thu Mar 01 00:00:00 EST 2007},
month = {Thu Mar 01 00:00:00 EST 2007}
}