SU‐E‐T‐358: Double‐Ends Quasi‐Breath‐Hold (DE‐QBH) Technique for Respiratory Motion Management

Kim, S; Park, Y; Lee, J; Choi, Kyoo Wan; Ye, S

doi:10.1118/1.4814792

Cited by 2 publications

(3 citation statements)

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“…In a recent report, the pilot project of this study, six different DQBH biofeedback maneuvers (2-2, 3-3, 4-4, 5-5, 7-5, and 9-5 s for EOE-EOI combination) based on moderate deep breathing with three human subjects have been tested (Kim et al 2013). Compared to the previous study, we have evaluated three different maneuvers (2-2, 4-4 and 6-6 s) based on full deep breathing with four human subjects prior to the full study.…”

Section: Discussionmentioning

confidence: 99%

“…Before the main feasibility study, a maneuver assessment study was performed. Based on the findings from the previous pilot study (Kim et al 2013), three different DQBH maneuvers (2-2, 4-4 and 6-6 s QBH combinations at EOI-EOE) have been tested with four volunteer human subjects. The subject-specific guiding wave (basic wave) obtained under deep-breathing condition was manipulated by adding dual breath-hold moments at EOI and 90% EOE (EOE 90% ).…”

Section: Maneuver Assessmentmentioning

confidence: 99%

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Motion management within two respiratory-gating windows: feasibility study of dual quasi-breath-hold technique in gated medical procedures

Kim

Park

et al. 2014

Phys. Med. Biol.

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A dual quasi-breath-hold (DQBH) technique is proposed for respiratory motion management (a hybrid technique combining breathing-guidance with breath-hold task in the middle). The aim of this study is to test a hypothesis that the DQBH biofeedback system improves both the capability of motion management and delivery efficiency. Fifteen healthy human subjects were recruited for two respiratory motion measurements (free breathing and DQBH biofeedback breathing for 15 min). In this study, the DQBH biofeedback system utilized the abdominal position obtained using an real-time position management (RPM) system (Varian Medical Systems, Palo Alto, USA) to audio-visually guide a human subject for 4 s breath-hold at EOI and 90% EOE (EOE90%) to improve delivery efficiency. We investigated the residual respiratory motion and the delivery efficiency (duty-cycle) of abdominal displacement within the gating window. The improvement of the abdominal motion reproducibility was evaluated in terms of cycle-to-cycle displacement variability, respiratory period and baseline drift. The DQBH biofeedback system improved the abdominal motion management capability compared to that with free breathing. With a phase based gating (mean ± std: 55 ± 5%), the averaged root mean square error (RMSE) of the abdominal displacement in the dual-gating windows decreased from 2.26 mm of free breathing to 1.16 mm of DQBH biofeedback (p-value = 0.007). The averaged RMSE of abdominal displacement over the entire respiratory cycles reduced from 2.23 mm of free breathing to 1.39 mm of DQBH biofeedback breathing in the dual-gating windows (p-value = 0.028). The averaged baseline drift dropped from 0.9 mm min(-1) with free breathing to 0.09 mm min(-1) with DQBH biofeedback (p-value = 0.048). The averaged duty-cycle with an 1 mm width of displacement bound increased from 15% of free breathing to 26% of DQBH biofeedback (p-value = 0.003). The study demonstrated that the DQBH biofeedback system has the potential to significantly reduce the residual respiratory motion with the improved duty cycle during the respiratory gating procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Maneuver Assessmentmentioning

confidence: 99%

Motion management within two respiratory-gating windows: feasibility study of dual quasi-breath-hold technique in gated medical procedures

Kim

Park

et al. 2014

Phys. Med. Biol.

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“…If not properly managed during radiotherapy, it can result in insufficient dose delivery to the target and/or unnecessary irradiation of surrounding healthy tissues (2) . A number of diverse motion management techniques for brain/H&N (head and neck) immobilization have been proposed such as the simple face mask, bite block, and more aggressive head frame, (3‐5) but most of the systems are intolerable for claustrophobic patients. For example, only a few immobilization systems such as open‐face mask and head mold with a bite plate are available for the claustrophobic patient, (4,6) but they are mainly mask‐based and make the patients passive recipients of care with a certain degree of discomfort.…”

Section: Introductionmentioning

confidence: 99%

Development of a novel remote‐controlled and self‐contained audiovisual‐aided interactive system for immobilizing claustrophobic patients

Kim

Read

et al. 2015

J Applied Clin Med Phys

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In radiotherapy, only a few immobilization systems, such as open‐face mask and head mold with a bite plate, are available for claustrophobic patients with a certain degree of discomfort. The purpose of this study was to develop a remote‐controlled and self‐contained audiovisual (AV)‐aided interactive system with the iPad mini with Retina display for intrafractional motion management in brain/H&N (head and neck) radiotherapy for claustrophobic patients. The self‐contained, AV‐aided interactive system utilized two tablet computers: one for AV‐aided interactive guidance for the subject and the other for remote control by an operator. The tablet for audiovisual guidance traced the motion of a colored marker using the built‐in front‐facing camera, and the remote control tablet at the control room used infrastructure Wi‐Fi networks for real‐time communication with the other tablet. In the evaluation, a programmed QUASAR motion phantom was used to test the temporal and positional accuracy and resolution. Position data were also obtained from ten healthy volunteers with and without guidance to evaluate the reduction of intrafractional head motion in simulations of a claustrophobic brain or H&N case. In the phantom study, the temporal and positional resolution was 24 Hz and 0.2 mm. In the volunteer study, the average superior–inferior and right–left displacement was reduced from 1.9 mm to 0.3 mm and from 2.2 mm to 0.2 mm with AV‐aided interactive guidance, respectively. The superior–inferior and right–left positional drift was reduced from 0.5 mm/min to 0.1 mm/min and from 0.4 mm/min to 0.04 mm/min with audiovisual‐aided interactive guidance. This study demonstrated a reduction in intrafractional head motion using a remote‐controlled and self‐contained AV‐aided interactive system of iPad minis with Retina display, easily obtainable and cost‐effective tablet computers. This approach can potentially streamline clinical flow for claustrophobic patients without a head mask and also allows patients to practice self‐motion management before radiation treatment delivery.PACS number: 87.55.Gh

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SU‐E‐T‐358: Double‐Ends Quasi‐Breath‐Hold (DE‐QBH) Technique for Respiratory Motion Management

Cited by 2 publications

References 0 publications

Motion management within two respiratory-gating windows: feasibility study of dual quasi-breath-hold technique in gated medical procedures

Motion management within two respiratory-gating windows: feasibility study of dual quasi-breath-hold technique in gated medical procedures

Development of a novel remote‐controlled and self‐contained audiovisual‐aided interactive system for immobilizing claustrophobic patients

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