Danny Lee1, Peter B Greer2, Joanna Ludbrook3, Jameen Arm3, Perry Hunter3, Sean Pollock1, Kuldeep Makhija1, Ricky T O'brien1, Taeho Kim4, Paul Keall5. 1. Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, Sidney, NSW, Australia. 2. School of Mathematical and Physical Sciences, The University of Newcastle, Newcastle, NSW, Australia; Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW, Australia. 3. Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW, Australia. 4. Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, Sidney, NSW, Australia; Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia. 5. Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, Sidney, NSW, Australia. Electronic address: paul.keall@sydney.edu.au.
Abstract
PURPOSE: To assess the impact of an audiovisual (AV) biofeedback on intra- and interfraction tumor motion for lung cancer patients. METHODS AND MATERIALS: Lung tumor motion was investigated in 9 lung cancer patients who underwent a breathing training session with AV biofeedback before 2 3T magnetic resonance imaging (MRI) sessions. The breathing training session was performed to allow patients to become familiar with AV biofeedback, which uses a guiding wave customized for each patient according to a reference breathing pattern. In the first MRI session (pretreatment), 2-dimensional cine-MR images with (1) free breathing (FB) and (2) AV biofeedback were obtained, and the second MRI session was repeated within 3-6 weeks (mid-treatment). Lung tumors were directly measured from cine-MR images using an auto-segmentation technique; the centroid and outlier motions of the lung tumors were measured from the segmented tumors. Free breathing and AV biofeedback were compared using several metrics: intra- and interfraction tumor motion consistency in displacement and period, and the outlier motion ratio. RESULTS: Compared with FB, AV biofeedback improved intrafraction tumor motion consistency by 34% in displacement (P=.019) and by 73% in period (P<.001). Compared with FB, AV biofeedback improved interfraction tumor motion consistency by 42% in displacement (P<.046) and by 74% in period (P=.005). Compared with FB, AV biofeedback reduced the outlier motion ratio by 21% (P<.001). CONCLUSIONS: These results demonstrated that AV biofeedback significantly improved intra- and interfraction lung tumor motion consistency for lung cancer patients. These results demonstrate that AV biofeedback can facilitate consistent tumor motion, which is advantageous toward achieving more accurate medical imaging and radiation therapy procedures.
PURPOSE: To assess the impact of an audiovisual (AV) biofeedback on intra- and interfraction tumor motion for lung cancerpatients. METHODS AND MATERIALS: Lung tumor motion was investigated in 9 lung cancerpatients who underwent a breathing training session with AV biofeedback before 2 3T magnetic resonance imaging (MRI) sessions. The breathing training session was performed to allow patients to become familiar with AV biofeedback, which uses a guiding wave customized for each patient according to a reference breathing pattern. In the first MRI session (pretreatment), 2-dimensional cine-MR images with (1) free breathing (FB) and (2) AV biofeedback were obtained, and the second MRI session was repeated within 3-6 weeks (mid-treatment). Lung tumors were directly measured from cine-MR images using an auto-segmentation technique; the centroid and outlier motions of the lung tumors were measured from the segmented tumors. Free breathing and AV biofeedback were compared using several metrics: intra- and interfraction tumor motion consistency in displacement and period, and the outlier motion ratio. RESULTS: Compared with FB, AV biofeedback improved intrafraction tumor motion consistency by 34% in displacement (P=.019) and by 73% in period (P<.001). Compared with FB, AV biofeedback improved interfraction tumor motion consistency by 42% in displacement (P<.046) and by 74% in period (P=.005). Compared with FB, AV biofeedback reduced the outlier motion ratio by 21% (P<.001). CONCLUSIONS: These results demonstrated that AV biofeedback significantly improved intra- and interfraction lung tumor motion consistency for lung cancerpatients. These results demonstrate that AV biofeedback can facilitate consistent tumor motion, which is advantageous toward achieving more accurate medical imaging and radiation therapy procedures.
Authors: Seyoun Park; Rana Farah; Steven M Shea; Erik Tryggestad; Russell Hales; Junghoon Lee Journal: Phys Med Biol Date: 2018-01-11 Impact factor: 3.609
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