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• W1480361857 abstract "Respiratory gating enables breathing synchronised activation of CT image acquisition and linear accelerator radiation output. Two commercially available respiratory gating systems used for planning and treatment of thoracic and abdominal cancer are investigated. The strain gauged AZ-733V respiratory gating system (Anzai Medical Systems, Tokyo, Japan) was used concurrently with the infrared Real-time Position Management system (Varian Medical Systems, Palo Alto, CA) to measure the respiratory cycle of 15 volunteers. Correlation between systems was measured in six locations and the optimum position of the external surrogates determined based on signal amplitude, reproducibility of breathing waveforms and the coefficient of determination between Anzai and RPM signals. The mean value of R 2 between the two systems was found to be 0.611, 0.788 and 0.925 when both markers were positioned at the xiphoid, midway between the xiphoid process and umbilicus, and at the umbilicus respectively. When positioned in separate locations results were varied, R 2 values ranging from 0.345-0.965. Results highlighted the importance of external surrogate position to the respiratory signal obtained, and indicated that the external marker position on the chest wall needs to be reproducible between 4D CT scanning and treatment. Recommendations are made that external surrogates must always be positioned at the umbilicus for the most clinically useful scans. Image distortion and artifacts were studied using the Anzai AZ-733V respiratory gating system in combination with the Siemens Sensation Open CT scanner. A moving respiratory phantom was constructed and the volumetric accuracy of retrospectively reconstructed 4D CT images for three moving test objects, across five frequencies and four amplitudes of movement was compared. Volumetric accuracy was found to be within 10% for retrospectively reconstructed gated objects moving with a period of 4 s, amplitude 1 cm. Large deviations of 19.4-51.6% from the static volume of the objects were observed in gated images for periods of 3 s or less. Significant distortion and under sampling was observed in gated images of the objects moving with a period of 10 s. Artifacts were related to the partial projection effect and data sufficiency conditions outlined in literature (Keall 2004, Pan 2004, Dinkel 2007). GLOSSARY AND ABBREVIATIONS 3DCRT: Three-dimensional conformal radiation therapy 4D CT: Four-dimensional computed tomography ABC: Active Breathing Control ACPSEM: Australasian College of Physical Scientists and Engineers in Medicine AP: Anterior-Posterior CCD: Charge coupled device CTV: Clinical Target Volume DIBH: Deep Inspiration Breath Hold DICOM: Digital Imaging and Communications in Medicine. DRR: Digitally Reconstructed Radiograph Duty cycle: Ratio of the beam on time to the total treatment time. EPID: Electronic Portal Imaging Device EOE: End of Exhale EOI: End of Inhale External surrogate: Traceable reference point exterior to the patient Exhalation: Resting expiratory level (Keall 2006) Fiducials: Reference points located within the patient Gating window: Range of the surrogate signal to which image acquisition or treatment is restricted. GTV: Gross Tumour Volume Hysteresis: The lagging of an effect behind its cause ICCC: Illawarra Cancer Care Centre Interfraction motion: Motion which occurs between fractions Intrafraction motion: Motion which occurs during a fraction (treatment session). IGRT: Image-guided radiation therapy IMRT: Intensity Modulated Radiation Therapy MLC: Multi-leaf collimator Phase sorting: The phase angle specifies a percentage of the period of the breathing cycle Pitch: The ratio of distance that the table moves during one complete rotation of the xray tube to slice thickness. PTV: Planning Target Volume Prospective 4DCT gating: Data acquisition is triggered by events in the respiratory signal Range of motion: Displacement between inhalation and exhalation (Keall 2006) Respiratory gated: The synchronisation of image acquisition and treatment with respiration such that the image is acquired/radiation delivered only during a specified portion of the breathing cycle (Keall 2006). Retrospective 4DCT gating: CT and respiratory signal are acquired simultaneously. Post scan, CT images are sorted into respiratory phases based on phase or amplitude of the respiratory trace. RPM system: Real-time Position Management respiratory gating system (Varian Medical Systems, Palo Alto, Ca) rpm: Respirations per minute SI: Superior-Inferior Spirometer: A device measuring the volume of air entering and leaving the lungs. Tumour residual motion: Tumour motion when the surrogate signal is in the gating window." @default.
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• W1480361857 date "2008-01-01" @default.
• W1480361857 modified "2023-09-27" @default.
• W1480361857 title "Investigation of two respiratory monitoring systems used for 4D CT and respiratory gating" @default.
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