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Effect of respiratory guidance on internal/external respiratory motion correlation for synchrotron-based pulsed heavy-ion radiotherapy

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Abstract

Having implemented an audio–visual biofeedback (BFB) method for respiratory-gated radiotherapy of synchrotron-based pulsed heavy-ion beam delivery with tracking of external abdominal wall motion, this study evaluated the feasibility of the respiratory guidance method on thoracic and abdominal cancer patients, and the internal/external respiratory motion consistency under respiratory guidance maneuvers due to its interactive intervention in free breathing (FB). A total of 42 breathing traces from seven lung and breast cancer patients and corresponding fluoroscopy movies under FB, standard breath hold (stBH) and representative breath hold (reBH) guidance maneuvers were analyzed. Diaphragm motions were measured manually on a frame-by-frame basis. Mean absolute deviation (MAD) values of the measured external motion curves were calculated for the FB and guidance maneuvers, and the internal/external motion consistencies were compared with a linear fit. Compared with FB, the MAD values were reduced significantly with respiratory guidance maneuvers. The mean internal/external correlations of the first treatment fraction were determined to be 0.96 ± 0.03, 0.97 ± 0.02, and 0.97 ± 0.03 for the FB, stBH and reBH guidance maneuvers, respectively, and were 0.95 ± 0.03, 0.97 ± 0.03, and 0.98 ± 0.02 for the second treatment fraction. No phase shift between the two breathing signals was observed, and good reproducibility of consistency of breathing guidance between the two fractions was achieved. These results demonstrated that treatment precision could be improved for cancer patients with audio–visual BFB, and a strong correlation between diaphragm motion and abdominal wall motion was obtained. The use of audio–visual BFB improved the regularity of both internal and external motions, allowing confident use of the audio–visual BFB method by tracking of the external abdominal wall motion to synchrotron-based heavy-ion radiotherapy.

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Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 11705247); the National Key Research and Development Program of the Ministry of Science and Technology of China (Grant No. 2017YFC0107500); the CAS ‘Light of West China’ Program (Grant No. 29Y662020); the Gansu Natural Science Foundation (Grant No. 1606RJZA056); the National Key Technology Support Program of the Ministry of Science and Technology of China (Grant No. 2015BAI01B11).

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Authors and Affiliations

  1. Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, 730000, China

    Pengbo He, Qiang Li & Guoqing Xiao

  2. Key Laboratory of Heavy Ion Radiation Biology and Medicine of Chinese Academy of Sciences, Lanzhou, 730000, China

    Pengbo He & Qiang Li

  3. Key Laboratory of Basic Research on Heavy Ion Radiation Application in Medicine, Lanzhou, 730000, Gansu, China

    Pengbo He & Qiang Li

  4. Gansu Tumor Hospital, Lanzhou, 730050, China

    Xiaohu Wang, Shuigen Ouyang & Ruifeng Liu

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  1. Pengbo He
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  2. Qiang Li
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  3. Guoqing Xiao
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  4. Xiaohu Wang
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  5. Shuigen Ouyang
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  6. Ruifeng Liu
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Correspondence to Qiang Li.

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The authors declare that there is no conflict of interest regarding the publication of this paper.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institute of Modern Physics, Chinese Academy of Sciences and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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He, P., Li, Q., Xiao, G. et al. Effect of respiratory guidance on internal/external respiratory motion correlation for synchrotron-based pulsed heavy-ion radiotherapy. Australas Phys Eng Sci Med 41, 713–720 (2018). https://doi.org/10.1007/s13246-018-0667-2

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  • DOI: https://doi.org/10.1007/s13246-018-0667-2

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