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Title: SU-E-J-235: Audiovisual Biofeedback Improves the Correlation Between Internal and External Respiratory Motion

Abstract

Purpose: External respiratory surrogates are often used to predict internal lung tumor motion for beam gating but the assumption of correlation between external and internal surrogates is not always verified resulting in amplitude mismatch and time shift. To test the hypothesis that audiovisual (AV) biofeedback improves the correlation between internal and external respiratory motion, in order to improve the accuracy of respiratory-gated treatments for lung cancer radiotherapy. Methods: In nine lung cancer patients, 2D coronal and sagittal cine-MR images were acquired across two MRI sessions (pre- and mid-treatment) with (1) free breathing (FB) and (2) AV biofeedback. External anterior-posterior (AP) respiratory motions of (a) chest and (b) abdomen were simultaneously acquired with physiological measurement unit (PMU, 3T Skyra, Siemens Healthcare Erlangen, Germany) and real-time position management (RPM) system (Varian, Palo Alto, USA), respectively. Internal superior-inferior (SI) respiratory motions of (c) lung tumor (i.e. centroid of auto-segmented lung tumor) and (d) diaphragm (i.e. upper liver dome) were measured from individual cine-MR images across 32 dataset. The four respiratory motions were then synchronized with the cine-MR image acquisition time. Correlation coefficients were calculated in the time variation of two nominated respiratory motions: (1) chest-abdomen, (2) abdomen-diaphragm and (3) diaphragm-lung tumor. The threemore » combinations were compared between FB and AV biofeedback. Results: Compared to FB, AV biofeedback improved chest-abdomen correlation by 17% (p=0.005) from 0.75±0.23 to 0.90±0.05 and abdomen-diaphragm correlation by 4% (p=0.058) from 0.91±0.11 to 0.95±0.05. Compared to FB, AV biofeedback improved diaphragm-lung tumor correlation by 12% (p=0.023) from 0.65±0.21 to 0.74±0.16. Conclusions: Our results demonstrated that AV biofeedback significantly improved the correlation of internal and external respiratory motion, thus suggesting the need of AV biofeedback in respiratory-gated treatments.« less

Authors:
; ;  [1];  [2];  [3];  [4];  [5];  [1];  [6]
  1. Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, NSW (Australia)
  2. School of Mathematical and Physical Sciences, The University of Newcastle, Newcastle, NSW (Australia)
  3. (Australia)
  4. Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW (Australia)
  5. Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano (Italy)
  6. (United States)
Publication Date:
OSTI Identifier:
22499337
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 42; Journal Issue: 6; Other Information: (c) 2015 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; ABDOMEN; ACCURACY; AMPLITUDES; CHEST; DATASETS; DIAPHRAGM; IMAGES; LIVER; LUNGS; NEOPLASMS; NMR IMAGING; PATIENTS; RADIOTHERAPY

Citation Formats

Lee, D, Pollock, S, Keall, P, Greer, P, Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW, Ludbrook, J, Paganelli, C, Kim, T, and Department of Radiation Oncology, University of Virginia Health System, Charlottesville, NC. SU-E-J-235: Audiovisual Biofeedback Improves the Correlation Between Internal and External Respiratory Motion. United States: N. p., 2015. Web. doi:10.1118/1.4924321.
Lee, D, Pollock, S, Keall, P, Greer, P, Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW, Ludbrook, J, Paganelli, C, Kim, T, & Department of Radiation Oncology, University of Virginia Health System, Charlottesville, NC. SU-E-J-235: Audiovisual Biofeedback Improves the Correlation Between Internal and External Respiratory Motion. United States. doi:10.1118/1.4924321.
Lee, D, Pollock, S, Keall, P, Greer, P, Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW, Ludbrook, J, Paganelli, C, Kim, T, and Department of Radiation Oncology, University of Virginia Health System, Charlottesville, NC. Mon . "SU-E-J-235: Audiovisual Biofeedback Improves the Correlation Between Internal and External Respiratory Motion". United States. doi:10.1118/1.4924321.
@article{osti_22499337,
title = {SU-E-J-235: Audiovisual Biofeedback Improves the Correlation Between Internal and External Respiratory Motion},
author = {Lee, D and Pollock, S and Keall, P and Greer, P and Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW and Ludbrook, J and Paganelli, C and Kim, T and Department of Radiation Oncology, University of Virginia Health System, Charlottesville, NC},
abstractNote = {Purpose: External respiratory surrogates are often used to predict internal lung tumor motion for beam gating but the assumption of correlation between external and internal surrogates is not always verified resulting in amplitude mismatch and time shift. To test the hypothesis that audiovisual (AV) biofeedback improves the correlation between internal and external respiratory motion, in order to improve the accuracy of respiratory-gated treatments for lung cancer radiotherapy. Methods: In nine lung cancer patients, 2D coronal and sagittal cine-MR images were acquired across two MRI sessions (pre- and mid-treatment) with (1) free breathing (FB) and (2) AV biofeedback. External anterior-posterior (AP) respiratory motions of (a) chest and (b) abdomen were simultaneously acquired with physiological measurement unit (PMU, 3T Skyra, Siemens Healthcare Erlangen, Germany) and real-time position management (RPM) system (Varian, Palo Alto, USA), respectively. Internal superior-inferior (SI) respiratory motions of (c) lung tumor (i.e. centroid of auto-segmented lung tumor) and (d) diaphragm (i.e. upper liver dome) were measured from individual cine-MR images across 32 dataset. The four respiratory motions were then synchronized with the cine-MR image acquisition time. Correlation coefficients were calculated in the time variation of two nominated respiratory motions: (1) chest-abdomen, (2) abdomen-diaphragm and (3) diaphragm-lung tumor. The three combinations were compared between FB and AV biofeedback. Results: Compared to FB, AV biofeedback improved chest-abdomen correlation by 17% (p=0.005) from 0.75±0.23 to 0.90±0.05 and abdomen-diaphragm correlation by 4% (p=0.058) from 0.91±0.11 to 0.95±0.05. Compared to FB, AV biofeedback improved diaphragm-lung tumor correlation by 12% (p=0.023) from 0.65±0.21 to 0.74±0.16. Conclusions: Our results demonstrated that AV biofeedback significantly improved the correlation of internal and external respiratory motion, thus suggesting the need of AV biofeedback in respiratory-gated treatments.},
doi = {10.1118/1.4924321},
journal = {Medical Physics},
number = 6,
volume = 42,
place = {United States},
year = {Mon Jun 15 00:00:00 EDT 2015},
month = {Mon Jun 15 00:00:00 EDT 2015}
}