• Progress in Medical Physics
• /
• v.26 no.3
• /
• pp.119-126
• /
• 2015

The purpose of this study is to analyze motion-induced dose error generated by each tumor motion parameters of irregular tumor motion in helical tomotherapy. To understand the effect of the irregular tumor motion, a simple analytical model was simulated. Moving cases that has tumor motion were divided into a slightly irregular tumor motion case, a large irregular tumor motion case and a patient case. The slightly irregular tumor motion case was simulated with a variability of 10% in the tumor motion parameters of amplitude (amplitude case), period (period case), and baseline (baseline case), while the large irregular tumor motion case was simulated with a variability of 40%. In the phase case, the initial phase of the tumor motion was divided into end inhale, mid exhale, end exhale, and mid inhale; the simulated dose profiles for each case were compared. The patient case was also investigated to verify the motion-induced dose error in 'clinical-like' conditions. According to the simulation process, the dose profile was calculated. The moving case was compared with the static case that has no tumor motion. In the amplitude, period, baseline cases, the results show that the motion-induced dose error in the large irregular tumor motion case was larger than that in the slightly irregular tumor motion case or regular tumor motion case. Because the offset effect was inversely proportion to irregularity of tumor motion, offset effect was smaller in the large irregular tumor motion case than the slightly irregular tumor motion case or regular tumor motion case. In the phase case, the larger dose discrepancy was observed in the irregular tumor motion case than regular tumor motion case. A larger motion-induced dose error was also observed in the patient case than in the regular tumor motion case. This study analyzed motion-induced dose error as a function of each tumor motion parameters of irregular tumor motion during helical tomotherapy. The analysis showed that variability control of irregular tumor motion is important. We believe that the variability of irregular tumor motion can be reduced by using abdominal compression and respiratory training.

• Radiation Oncology Journal
• /
• v.29 no.3
• /
• pp.206-213
• /
• 2011

Purpose: Intensity modulated radiation therapy (IMRT) is a high precision therapy technique that can achieve a conformal dose distribution on a given target. However, organ motion induced by respiration can result in significant dosimetric error. Therefore, this study explores the dosimetric error that result from various patterns of respiration. Materials and Methods: Experiments were designed to deliver a treatment plan made for a real patient to an in-house developed motion phantom. The motion pattern; the amplitude and period as well as inhale-exhale period, could be controlled by in-house developed software. Dose distribution was measured using EDR2 film and analysis was performed by RIT113 software. Three respiratory patterns were generated for the purpose of this study; first the 'even inhale-exhale pattern', second the slightly long exhale pattern (0.35 seconds longer than inhale period) named 'general signal pattern', and third a 'long exhale pattern' (0.7 seconds longer than inhale period). One dimensional dose profile comparisons and gamma index analysis on 2 dimensions were performed. Results: In one-dimensional dose profile comparisons, 5% in the target and 30% dose difference at the boundary were observed in the long exhale pattern. The center of high dose region in the profile was shifted 1 mm to inhale (caudal) direction for the 'even inhale-exhale pattern', 2 mm and 5 mm shifts to exhale (cranial) direction were observed for 'slightly long exhale pattern' and 'long exhale pattern', respectively. The areas of gamma index >1 were 11.88 %, 15.11%, and 24.33% for 'even inhale-exhale pattern', 'general pattern', and 'long exhale pattern', respectively. The long exhale pattern showed largest errors. Conclusion: To reduce the dosimetric error due to respiratory motions, controlling patient's breathing to be closer to even inhaleexhale period is helpful with minimizing the motion amplitude.

• Journal of the Korean Society of Radiology
• /
• v.7 no.2
• /
• pp.157-163
• /
• 2013

This study was to analyze quantitatively movement of planning target volume (PTV) and change of PTV volume through movement of diaphragm according to breathing phase. The purpose of present study was to investigate optimized respiration phase for radiation therapy of lung cancer. Simulated breathing training was performed in order to minimize systematic errors which is caused non-specific or irregular breathing. We performed 4-dimensional computed tomography (4DCTi) in accordance with each respiratory phase in the normalized respiratory gated radiation therapy procedures, then not only defined PTVi in 0 ~ 90%, 30 ~ 70% and 40 ~ 60% in the reconstructed 4DCTi images but analyzed quantitatively movement and changes of volume in PTVi. As a results, average respiratory cycle was $3.4{\pm}0.5$ seconds by simulated breathing training. R2-value which is expressed as concordance between clinically induced expected value and actual measured value, was almost 1. There was a statistically significant. And also movement of PTVi according to each respiration phase 0 ~ 90%, 30 ~ 70% and 40 ~ 60% were $13.4{\pm}6.4mm$, $6.1{\pm}2.9mm$ and $4.0{\pm}2.1mm$ respectively. Change of volume in PTVi of respiration phase 30 ~ 70% was decreased by $32.6{\pm}8.7%$ and 40 ~ 60% was decreased by $41.6{\pm}6.2%$. In conclusion, PTVi movement and volume change was reduced, when we apply a short breathing phase (40 ~ 60%: 30% duty cycle) range. Furthermore, PTVi margin considered respiration was not only within 4mm but able to get uniformity of dose.