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• W2078491071 abstract "This study aims to investigate the pattern of internal lung tumor breathing motion during respiratory gating based on external chest-wall motion monitoring. As part of an IRB approved study, patients underwent placement of gold fiducial markers directly into the tumor under CT-guidance. The RPM system (Varian Medical Systems, Palo Alto CA) was used to record several consecutive orthogonal fluoroscopic movies of internal fiducial movement during breathing, synchronously with the movement of an external marker placed on the chest-wall. All measurements were performed during audio breathing instructions customized to a comfortable breathing pattern for each patient. To date, seven patients have been included in this study. Gating thresholds were retrospectively superposed on the external marker breathing traces, and the internal movement of the gold fiducials within those gating intervals was analyzed along all three axis of motion. Amplitude and phase approaches to assignment of gating thresholds was compared. Gating thresholds were applied to both inspiration and expiration points of the breathing cycle, respectively. Breathing motion range was quantified as limited by the 5% and the 95% fractiles of the total breathing motion. In general, very high correlation was observed between external and internal respiration traces (cross-correlation coefficients larger than 0.8). The patients ability to comply with breathing instructions was not a limiting factor for high internal-external motion correlation. Correspondingly, the reduction of internal movement by gating was mimicked well by the chosen gating reduction in external movement. For all cases, amplitude and/or phase gating gave a relative reduction in internal breathing motion of close to the same magnitude as the relative reduction in external breathing motion. Deviations between external and internal motion reductions were smaller than 25 percent points. For patients exhibiting regular breathing, phase gating provided the largest potential for internal motion reduction, especially when there was a phase shift between external and internal motion. Within gating thresholds corresponding to 40% dutycycles, phase gating motion reductions were up to twice as large as amplitude gating reductions. In cases of irregular breathing, amplitude gating still gave a stable limitation of internal movement. Examples of amplitude gating and phase gating for two cases of regular and irregular breathing, respectively, are shown in the figures. The figures represent scatter plots of external anterior-posterior motion versus internal superior-inferior motion. The horizontal lines indicate the ranges of internal breathing motion within gating intervals corresponding to a dutycycle of 40%. Respiratory gating using external marker monitoring provides consistent reduction of internal (intra-session) lung tumor breathing motion. The choice between phase and amplitude gating approaches should be based on patients individual breathing patterns." @default.
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• W2078491071 date "2004-09-01" @default.
• W2078491071 modified "2023-10-01" @default.
• W2078491071 title "Fluoroscopic characterization of lung tumor breathing motion during respiratory gating" @default.
• W2078491071 doi "https://doi.org/10.1016/j.ijrobp.2004.07.081" @default.
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