Journal of the Korean Society of Radiology (한국방사선학회논문지)

The Korean Society of Radiology (한국방사선학회)
권호 표지
DOI QR코드

DOI QR Code

Statistical Study on Respiratory Signal Analysis according to Patient Position and Device in Radiation Therapy

방사선치료 시 자세와 device에 따른 호흡신호의 분석

  • Seo, Jeong-Min (Department of Radiation Oncology, Samsung Medical Center) ;
  • Park, Myung-Hwan (Department of Radiation Oncology, Samsung Medical Center) ;
  • Shim, Jae-Koo (Department of Radiation Oncology, Samsung Medical Center) ;
  • Kim, Chan-Hyeong (Department of Nuclear Engineering, Hanyang University) ;
  • Park, Cheol-Soo (Department of Radiological Science, Hanlym College) ;
  • Kim, Kyung-Keun (Department of Radiological Science, Daegu Polytechnic University College) ;
  • Cho, Jae-Hwan (Department of Radiological Science, Gyeongsan University College)
  • 서정민 (삼성서울병원 방사선종양학과) ;
  • 박명환 (삼성서울병원 방사선종양학과) ;
  • 심재구 (삼성서울병원 방사선종양학과) ;
  • 김찬형 (한양대학교 원자력공학과) ;
  • 박철수 (한림성심대학 방사선과) ;
  • 김경근 (대구산업정보대학 방사선과) ;
  • 조재환 (경산1대학 방사선과)
  • Received : 2011.05.09
  • Accepted : 2011.08.22
  • Published : 2011.08.30
Download PDF
⟨ Previous Next ⟩

Abstract

This study statistically analyzed the difference of the stability of maintaining a respiratory period shown according to position and use of a device to search the tendency and usefulness of a device. The supine position showed better maintaining respiratory cycles than the prone position. The 85% of subjects who showed bad maintenance pattern of a respiratory cycle were significantly different pattern with using belly board. It could be said that there was a significant correlation between the maintenance of a respiratory cycle and relative index of respirational stability(p=0.044, kappa=0.607). The movement due to respiration was one of important considerations in the radiation therapy on chest, abdomen, and even pelvis. This study could contribute to the high quality radiation therapy by statistic analysis of respiratory signals and its application.

방사선 치료에서 일정한 호흡주기의 유지가 필요한 흉부 및 복부를 치료할 때 환자의 자세와 belly board device의 사용 여부에 따라 다르게 나타나는 호흡신호의 차이를 통계적으로 분석하여 임상적용에 관한 유용성을 검정하였다. 호흡주기유지는 supine 자세에서 비교적 양호하게 나타났으며, prone 자세에서 호흡주기 유지가 양호하지 않은 경우에 belly board를 적용하여 85%가 유의하게 다른 패턴의 호흡주기를 보였고, 57%는 호흡주기 유지가 양호하게 변화한 것으로 나타났다. 각 피험자의 비만도와 체중에 따른 호흡주기유지 안정성의 차이는 보이지 않았으며, 안정성의 상대적 비교지수로 분석한 시간의 흐름에 따른 호흡의 안정성 유지는 supine 자세에서 비교적 안정적이었으며, 호흡주기 유지의 검정통계결과와 일치하였다(p=0.044, kappa=0.607). 흉부 및 복부 심지어 골반의 방사선치료에서도 호흡에 의한 환자의 움직임은 중요한 고려사항 중 하나이다. 환자의 치료부위와 target의 위치, 예상되는 plan의 beam arrangement에 따라, 환자의 자세 및 device의 여부가 결정되지만, 본 연구와 같이 호흡신호의 통계적 분석과 이의 적용을 통해, 호흡유지에 최적의 자세, belly board와 같은 device 사용여부를 결정하여, 호흡주기의 유지 및 호흡의 안정도 유지에 기여할 수 있을 것으로 사료된다.

Keywords

References

  1. Rietzel E, Chen GTY, "Improving retrospective sorting of 4D computed tomography data", Med Phys, Vol. 33, No. 2, pp.377-379, 2006. https://doi.org/10.1118/1.2150780
  2. Mutaf YD, Antolak JA, Brinkmann DH, "The impact of temporal inaccuracies on 4DCT image quality", Med Phys, Vol. 34, No. 5, pp.1615-1622, 2007. https://doi.org/10.1118/1.2717404
  3. Ross CS, Hussey DH, Pennington EC, et al., "Analysis of movement of intrathoracic neoplasms using ultrafast computerized tomography", Int J Radiat Oncol Biol Phys, Vol. 1, No. 8, pp.671-677,1990.
  4. Hanley J, Debois MM, Mah D, et al., "Deep inspiration breathhold technique for lung tumors: The potential value of target immobilization and reduced lung density in dose escalation", Int J Radiat Oncol Biol Phys, Vol. 45, pp.603- 611, 1999. https://doi.org/10.1016/S0360-3016(99)00154-6
  5. Shimizu S, Shirato H, Kagei K, et al., "Impact of respiratory movement on the computed tomographic images of small lung tumors in three-dimensional (3D) radiotherapy", Int J Radiat Oncol Biol Phys, Vol. 46, pp.1127-1133, 2000. https://doi.org/10.1016/S0360-3016(99)00352-1
  6. Sixel KE, Ruschin M, Tirona R, et al., "Digital fluoroscopy to quantify lung tumor motion: Potential for patient-specific planning target volumes", Int J Radiat Oncol Biol Phys, Vol. 57, pp.717-723, 2003. https://doi.org/10.1016/S0360-3016(03)00713-2
  7. Stevens CW, Munden RF, Forster KM, et al., "Respiratorydriven lung tumor motion is independent of tumor size, tumor location, and pulmonary function", Int J Radiat Oncol Biol Phys, Vol. 51, pp.62- 68, 2001.
  8. Grills IS, Yan D, Martinez AA, et al., "Potential for reduced toxicity and dose escalation in the treatment of inoperable non-small-cell lung cancer: A comparison of intensity-mod-ulated radiation therapy (IMRT), 3D conformal radiation, and elective nodal irradiation", Int J Radiat Oncol Biol Phys, Vol. 57, pp.875-890, 2003. https://doi.org/10.1016/S0360-3016(03)00743-0
  9. Ekberg L, Holmberg O, Wittgren L, et al., "What margins should be added to the clinical target volume in radiotherapy treatment planning for lung cancer?", Radiother Oncol, Vol. 48, pp.71-77, 1998. https://doi.org/10.1016/S0167-8140(98)00046-2
  10. Murphy MJ, Adler JR Jr, Bodduluri M, et al., "Image-guided radiosurgery for the spine and pancreas", Comput Aided Surg, Vol. 5, pp.278-288,2000. https://doi.org/10.3109/10929080009148895
  11. Chen QS, Weinhous MS, Deibel FC, et al., "Fluoroscopic study of tumor motion due to breathing: Facilitating precise radiation therapy for lung cancer patients", Med Phys Vol. 28, pp.1850-1856, 2001. https://doi.org/10.1118/1.1398037
  12. Barnes EA, Murray BR, Robinson DM, et al., "Dosimetric evaluation of lung tumor immobilization using breath hold at deep inspiration", Int J Radiat Oncol Biol Phys, Vol. 50, pp.1091-1098, 2001. https://doi.org/10.1016/S0360-3016(01)01592-9
  13. Engelsman M, Damen EM, De Jaeger K, et al., "The effect of breathing and set-up errors on the cumulative dose to a lung tumor", Radiother Oncol Vol. 60, pp.95-105, 2001. https://doi.org/10.1016/S0167-8140(01)00349-8
  14. Shimizu S, Shirato H, Ogura S, et al., "Detection of lung tumor movement in real-time tumor-tracking radiotherapy", Int J Radiat Oncol Biol Phys, Vol. 51, pp.304-310, 2001.
  15. Seppenwoolde Y, Shirato H, Kitamura K, et al., "Precise and real-time measurement of 3D tumor motion in lung due to breathing and heartbeat, measured during radiotherapy", Int J Radiat Oncol Biol Phys, Vol. 53, pp.822-834, 2002. https://doi.org/10.1016/S0360-3016(02)02803-1
  16. Erridge SC, Seppenwoolde Y, Muller SH, et al., "Portal imaging to assess set-up errors, tumor motion and tumor shrinkage during conformal radiotherapy of non-small cell lung cancer", Radiother Oncol, Vol. 66, pp.75-85, 2003 https://doi.org/10.1016/S0167-8140(02)00287-6

Cited by

  1. CT and MRI Image Fusion Reproducibility and Dose Assessment on Treatment Planning System vol.24, pp.6, 2014, https://doi.org/10.4283/JKMS.2014.24.6.191
  2. Accuracy Evaluation of Respiratory Air Flow Transducer for Artificial Ventilation vol.9, pp.7, 2015, https://doi.org/10.7742/jksr.2015.9.7.425