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Comparison between audio-only and audiovisual biofeedback for regulating patients' respiration during four-dimensional radiotherapy

  • Yu, Jesang (Department of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine) ;
  • Choi, Ji Hoon (Department of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine) ;
  • Ma, Sun Young (Department of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine) ;
  • Jeung, Tae Sig (Department of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine) ;
  • Lim, Sangwook (Department of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine)
  • Received : 2015.08.24
  • Accepted : 2015.09.11
  • Published : 2015.09.30

Abstract

Purpose: To compare audio-only biofeedback to conventional audiovisual biofeedback for regulating patients' respiration during four-dimensional radiotherapy, limiting damage to healthy surrounding tissues caused by organ movement. Materials and Methods: Six healthy volunteers were assisted by audiovisual or audio-only biofeedback systems to regulate their respirations. Volunteers breathed through a mask developed for this study by following computer-generated guiding curves displayed on a screen, combined with instructional sounds. They then performed breathing following instructional sounds only. The guiding signals and the volunteers' respiratory signals were logged at 20 samples per second. Results: The standard deviations between the guiding and respiratory curves for the audiovisual and audio-only biofeedback systems were 21.55% and 23.19%, respectively; the average correlation coefficients were 0.9778 and 0.9756, respectively. The regularities between audiovisual and audio-only biofeedback for six volunteers' respirations were same statistically from the paired t-test. Conclusion: The difference between the audiovisual and audio-only biofeedback methods was not significant. Audio-only biofeedback has many advantages, as patients do not require a mask and can quickly adapt to this method in the clinic.

Keywords

References

  1. Keall PJ, Mageras GS, Balter JM, et al. The management of respiratory motion in radiation oncology report of AAPM Task Group 76. Med Phys 2006;33:3874-900. https://doi.org/10.1118/1.2349696
  2. Wilson EM, Williams FJ, Lyn BE, Wong JW, Aird EG. Validation of active breathing control in patients with non-small-cell lung cancer to be treated with CHARTWEL. Int J Radiat Oncol Biol Phys 2003;57:864-74. https://doi.org/10.1016/S0360-3016(03)00712-0
  3. Stromberg JS, Sharpe MB, Kim LH, et al. Active breathing control (ABC) for Hodgkin's disease: reduction in normal tissue irradiation with deep inspiration and implications for treatment. Int J Radiat Oncol Biol Phys 2000;48:797-806. https://doi.org/10.1016/S0360-3016(00)00681-7
  4. Mah D, Hanley J, Rosenzweig KE, et al. Technical aspects of the deep inspiration breath-hold technique in the treatment of thoracic cancer. Int J Radiat Oncol Biol Phys 2000;48:1175-85. https://doi.org/10.1016/S0360-3016(00)00747-1
  5. Rosenzweig KE, Hanley J, Mah D, et al. The deep inspiration breath-hold technique in the treatment of inoperable non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2000;48:81-7. https://doi.org/10.1016/S0360-3016(00)00583-6
  6. Barnes EA, Murray BR, Robinson DM, Underwood LJ, Hanson J, Roa WH. Dosimetric evaluation of lung tumor immobilization using breath hold at deep inspiration. Int J Radiat Oncol Biol Phys 2001;50:1091-8. https://doi.org/10.1016/S0360-3016(01)01592-9
  7. Kubo HD, Hill BC. Respiration gated radiotherapy treatment: a technical study. Phys Med Biol 1996;41:83-91. https://doi.org/10.1088/0031-9155/41/1/007
  8. Ramsey CR, Scaperoth D, Arwood D, Oliver AL. Clinical efficacy of respiratory gated conformal radiation therapy. Med Dosim 1999;24:115-9. https://doi.org/10.1016/S0958-3947(99)00006-0
  9. 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 2001;51:304-10.
  10. Keall PJ, Kini VR, Vedam SS, Mohan R. Motion adaptive x-ray therapy: a feasibility study. Phys Med Biol 2001;46:1-10. https://doi.org/10.1088/0031-9155/46/1/301
  11. Schweikard A, Shiomi H, Adler J. Respiration tracking in radiosurgery. Med Phys 2004;31:2738-41. https://doi.org/10.1118/1.1774132
  12. D'Souza WD, Naqvi SA, Yu CX. Real-time intra-fraction-motion tracking using the treatment couch: a feasibility study. Phys Med Biol 2005;50:4021-33. https://doi.org/10.1088/0031-9155/50/17/007
  13. Suh Y, Yi B, Ahn S, et al. Aperture maneuver with compelled breath (AMC) for moving tumors: a feasibility study with a moving phantom. Med Phys 2004;31:760-6. https://doi.org/10.1118/1.1650565
  14. He P, Li Q, Liu X, et al. Respiratory motion management using audio-visual biofeedback for respiratory-gated radiotherapy of synchrotron-based pulsed heavy-ion beam delivery. Med Phys 2014;41:111708. https://doi.org/10.1118/1.4897391
  15. Pollock S, Lee D, Keall P, Kim T. Audiovisual biofeedback improves motion prediction accuracy. Med Phys 2013;40:041705. https://doi.org/10.1118/1.4794497
  16. Masselli GM, Silvestri S, Ramella S, Trodella L. Design and evaluation of a methodology to perform personalized visual biofeedback for reducing respiratory amplitude in radiation treatment. Med Phys 2009;36:1467-72. https://doi.org/10.1118/1.3098942
  17. Lim S, Park SH, Ahn SD, et al. Guiding curve based on the normal breathing as monitored by thermocouple for regular breathing. Med Phys 2007;34:4514-8. https://doi.org/10.1118/1.2795829
  18. Lim S, Ahn SD, Park SH, et al. Study of respiration simulating phantom using thermocouple-based respiration monitoring mask. J Korean Soc Ther Radiol Oncol 2005;23:217-22.
  19. Lim S, Jeung TS, Park SH, Ahn SD, Lee S, Kim CY. Determination of target motion by using a respiration monitoring mask for 4-D radiotherapy. J Korean Phys Soc 2008;53:845-50. https://doi.org/10.3938/jkps.53.845
  20. Ahn YC, Shimizu S, Shirato H, et al. Application of real-time tumor-tracking and gated radiotherapy system for unresectable pancreatic cancer. Yonsei Med J 2004;45:584-90. https://doi.org/10.3349/ymj.2004.45.4.584
  21. 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 2000;46:1127-33. https://doi.org/10.1016/S0360-3016(99)00352-1
  22. Balter JM, Ten Haken RK, Lawrence TS, Lam KL, Robertson JM. Uncertainties in CT-based radiation therapy treatment planning associated with patient breathing. Int J Radiat Oncol Biol Phys 1996;36:167-74.

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