Intra- and interfraction breathing variations during curative radiotherapy for lung cancer

Nøttrup, Trine Jakobi; Korreman, S.; Pedersen, Anders N.; Aarup, Lasse Rye; Nyström, Håkan; Olsen, Mikael; Specht, Lena

doi:10.1016/j.radonc.2007.05.026

Cited by 83 publications

(59 citation statements)

References 22 publications

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“…We found that on average, the interfraction variability was larger than the intrafraction variability. This is consistent with results for end exhale phase by Juhler‐Nottrup et al ( 25 ) that showed the interfraction variation was significantly larger than the intrafraction variation.…”

Section: Discussionsupporting

confidence: 93%

External respiratory motion analysis and statistics for patients and volunteers

Quirk

Becker

Smith

2013

J Applied Clin Med Phys

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We analyzed a large patient and volunteer study of external respiratory motion in order to develop a population database of respiratory information. We analyzed 120 lung, liver, and abdominal patients and 25 volunteers without lung disease to determine the extent of motion using the Varian Real‐Time Position Management system. The volunteer respiratory motion was measured for both abdominal and thoracic placement of the RPM box. Evaluation of a subset of 55 patients demonstrates inter‐ and intrafraction variation over treatment. We also calculated baseline drift and duty cycle for patients and volunteers. The mean peak‐to‐peak amplitude (SD) for the patients was 1.0 (0.5) cm, and for the volunteers it was abdomen 0.8 (0.3) cm and thoracic 0.2 (0.2) cm. The mean period (SD) was 3.6 (1.0) s, 4.2 (1.1) s, and 4.1 (0.8) s, and the mean end exhale position (SD) was 60% (6), 58% (7), and 56% (7) for patient, volunteer abdomen, and volunteer thoracic, respectively. Baseline drift was greater than 0.5 cm for 40% of patients. We found statistically significant differences between the patient and volunteer groups. Peak‐to‐peak amplitude was significantly larger for patients than the volunteer abdominal measurement and the volunteer abdominal measurement is significantly larger than the volunteer thoracic measurement. The patient group also exhibited significantly larger baseline drift than the volunteer group. We also found that peak‐to‐peak amplitude was the most variable parameter for both intra‐ and interfraction motion. This database compilation can be used as a resource for expected motion when using external surrogates in radiotherapy applications.PACS number: 87.19.Wx, 87.55.Km

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Section: Discussionsupporting

confidence: 93%

External respiratory motion analysis and statistics for patients and volunteers

Quirk

Becker

Smith

2013

J Applied Clin Med Phys

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“…For the majority of the volunteers it was not possible to reproduce the breathing cycle amplitude and its variation the following days based on the breathing in the reference session irrespective of coaching or free breathing. There is no reason to believe that this will be different for lung cancer patients [8]. This interfraction motion variation in breathing cycle amplitude indicates the presence of a significant interfraction variation in tumour motion, which has to be taken into account when designing appropriate margins for lung cancer radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…The breathing cycle amplitude was defined as the distance between the inhale and the exhale point. This method is previously described by Juhler-Nøttrup et al [8]. To ensure that the sizes of the amplitudes in the sequences were normally distributed a KolmogorovSmirnov test for continuous variables (WinSTAT statistics) was performed.…”

Section: Discussionmentioning

confidence: 99%

Can audio coached 4D CT emulate free breathing during the treatment course?

et al. 2008

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“…. Such detectors are placed on external contours of patients, but it is known that external displacements can differ from internal tumour displacements up to approximately 2 cm [5] [6].…”

Section: Introductionmentioning

confidence: 99%