A Simple Respiratory Indicator for Irradiation during Voluntary Breath Holding: A One-Touch Device without Electronic Materials

Oda, Hiroshi; Kawakami, Hideyuki; Marino, Kan; Komiyama, Takafumi; Kuriyama, Kinya; Araya, Masayuki; Saito, Ryo; Aoki, Shin; Araki, Tsutomu

doi:10.1148/radiol.10090890

Cited by 48 publications

(65 citation statements)

References 16 publications

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“…We have been using an integrated CT-linac irradiation system which connects a CT scanner and a linac via a common treatment coach. The patient on the treatment couch was placed supine with a respiration-synchronizing device on the patient's chest and abdomen to control internal motion of the target [3]. In order to use the respiration-synchronizing device most effectively, non-invasive patient fixation with a comparably loose vacuum pillow is essential.…”

Section: Discussionmentioning

confidence: 99%

“…In order to control internal organ motion, an FDA-approved respiration-synchronizing device [3], was used in all cases. This device has two sensors (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…Most of them provide quality assurance, shorten treatment time, and increase safety and consistency [2–3]. With the respiration-synchronizing device, controlling target movement during irradiation is achieved by breath-holding.…”

Section: Introductionmentioning

confidence: 99%

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Intrafractional setup errors in patients undergoing non-invasive fixation using an immobilization system during hypofractionated stereotactic radiotherapy for lung tumors

Watanabe

Oda

Kuriyama

et al. 2013

Journal of Radiation Research

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Intrafractional setup errors during hypofractionated stereotactic radiotherapy (SRT) were investigated on the patient under voluntary breath-holding conditions with non-invasive immobilization on the CT-linac treatment table. A total of 30 patients with primary and metastatic lung tumors were treated with the hypofractionated SRT with a total dose of 48–60 Gy with four treatment fractions. The patient was placed supine and stabilized on the table with non-invasive patient fixation. Intrafractional setup errors in Right/Left (R.L.), Posterior/Anterior (P.A.), and Inferior/Superior (I.S.) dimensions were analyzed with pre- and post-irradiation CT images. The means and one standard deviation of the intrafractional errors were 0.9 ± 0.7mm (R.L.), 0.9 ± 0.7mm (P.A.) and 0.5 ± 1.0 mm (I.S.). Setup errors in each session of the treatment demonstrated no statistically significant difference in the mean value between any two sessions. The frequency within 3mm displacement was 98% in R.L., 98% in P.A. and 97% in I.S. directions. SRT under the non-invasive patient fixation immobilization system with a comparatively loose vacuum pillow demonstrated satisfactory reproducibility of minimal setup errors with voluntary breath-holding conditions that required a small internal margin.

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Section: Discussionmentioning

confidence: 99%

“…In order to control internal organ motion, an FDA-approved respiration-synchronizing device [3], was used in all cases. This device has two sensors (Fig.…”

Section: Methodsmentioning

confidence: 99%

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Intrafractional setup errors in patients undergoing non-invasive fixation using an immobilization system during hypofractionated stereotactic radiotherapy for lung tumors

Watanabe

Oda

Kuriyama

et al. 2013

Journal of Radiation Research

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“…He showed a very positive and cheerful demeanor. During the SBRT planning sessions, the patient was trained in voluntary breath-holding during the inspiration phase using a respiratory indicator [26] to minimize the adrenal respiratory motions during irradiation [27]. Planning target volume (PTV) was determined as the gross tumor volume (GTV) of the right adrenal mass plus the personal internal margin, with an additional margin of 2 mm to compensate for intrasession reproducibility and to provide a safety margin.…”

Section: Clinical Casementioning

confidence: 99%

Stereotactic Body Radiotherapy for Metachronous Multisite Oligo-Recurrence: A Long-Surviving Case with Sequential Oligo-Recurrence in Four Different Organs Treated Using Locally Radical Radiotherapy and a Review of the Literature

Oda¹,

Ozaki

Kuriyama³

et al. 2012

Pulmonary Medicine

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Stereotactic body radiotherapy (SBRT) for oligometastases represents a recent trend in radiation oncology. While abundant data are available regarding the use of SBRT for the treatment of lung or liver oligometastases from various retrospective series and prospective trials, relatively little information has been accumulated for the treatment of oligometastases at sites other than the lungs and liver, particularly for sequential oligometastases in multiple organs. Oligometastases with primary lesions controlled is called “oligo-recurrence.” We describe herein the case of a lung cancer patient who developed repeated oligo-recurrence at multiple sites that were each controlled by radical radiotherapy and achieved long-term survival and discuss the merits of locally aggressive radiotherapy for this type of disease condition with reviewing the literature. Although further investigation should be undertaken to clarify the benefits, objectives, and methods of SBRT for the treatment of oligometastases, we believe utilization of SBRT may be worthwhile for patients with remote metastases who hope for treatment to acquire better local control and possible longer survival.

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“…Another approach was to maintain the distance between surface reference marks and room lasers, or the distance between light field borders and the pre-marked field borders on the surface of a breast cancer patient [3]. Still another method was to employ a breath-hold monitor, which had two fulcrums each being placed on the abdomen and on the chest of a patient, and a pointer was mechanically connected to the two fulcrums thereby detecting breathing of a patient [4].…”

Section: Introductionmentioning

confidence: 99%

A Half-Arc Multiple Deep-Inspiration Breath-Hold Volumetric Modulated Arc Therapy for a Lung Tumor with 10 MV Flattening-Filter-Free Beams and an Image Sensor Measuring a Distance Map to Thorax Surface: An Initial Clinical Experience

Nakagawa¹,

Nawa²,

Hashimoto³

et al. 2017

IJMPCERO

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A technique for multiple deep-inspiration breath-hold (DIBH) volumetric modulated arc therapy (VMAT) for a lung tumor has been proposed with 10 MV flattening-filter-free beams and an image sensor measuring a distance map to thorax surface. Planning CT images were acquired under a DIBH condition and a clinical target volume (CTV) was contoured. This procedure was repeated five times and an internal target volume (ITV) among the multiple DIBHs was created by integrating the five CTVs. A planning target volume (PTV) was defined by adding an isotropic margin of 5 mm to the ITV. Immediately before treatment, a 30-second half-arc cone-beam computer tomography (CBCT) imaging was performed under another DIBH condition, and the couch was repositioned so that tumor may be located inside the PTV contours. An infrared distance measurement device having laser diodes and an image sensor was attached to the couch, and a distance map to the patient thorax surface was recorded as a reference during still another DIBH condition. A half-arc segmented VMAT beams with two beam interrupts were delivered to the patient under multiple DIBHs, where the delivery time of each of the three segmented beams was 30 seconds. During the beam delivery, the distance map was monitored in real time to confirm that the distance to the thorax surface remained unchanged. In-treatment CBCT images suggested that the tumor position at the time of tumor registration was accurately reHow to cite this

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A Simple Respiratory Indicator for Irradiation during Voluntary Breath Holding: A One-Touch Device without Electronic Materials

Abstract: The device demonstrates satisfactory reproducibility of voluntary patient breath holding easily and inexpensively and may offer a convenient device for easy use during irradiation with voluntary breath-holding conditions that require a small internal margin.

Cited by 48 publications

References 16 publications

Intrafractional setup errors in patients undergoing non-invasive fixation using an immobilization system during hypofractionated stereotactic radiotherapy for lung tumors

Intrafractional setup errors in patients undergoing non-invasive fixation using an immobilization system during hypofractionated stereotactic radiotherapy for lung tumors

Stereotactic Body Radiotherapy for Metachronous Multisite Oligo-Recurrence: A Long-Surviving Case with Sequential Oligo-Recurrence in Four Different Organs Treated Using Locally Radical Radiotherapy and a Review of the Literature

A Half-Arc Multiple Deep-Inspiration Breath-Hold Volumetric Modulated Arc Therapy for a Lung Tumor with 10 MV Flattening-Filter-Free Beams and an Image Sensor Measuring a Distance Map to Thorax Surface: An Initial Clinical Experience

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