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Assessment of tumor motion reproducibility with audio-visual coaching through successive 4D CT sessions

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Goossens, Samuel [UCL] Senny, Frédéric Lee, John Aldo [UCL] Janssens, Guillaume [UCL] Geets, Xavier [UCL]

This study aimed to compare combined audio-visual coaching with audio coaching alone and assess their respective impact on the reproducibility of external breathing motion and, one step further, on the internal lung tumor motion itself, through successive sessions. Thirteen patients with NSCLC were enrolled in this study. The tumor motion was assessed by three to four successive 4D CT sessions, while the breathing signal was measured from magnetic sensors positioned on the epigastric region. For all sessions, the breathing was regularized with either audio coaching alone (AC, n = 5) or combined with a real-time visual feedback (A/VC, n = 8) when tolerated by the patients. Peak-to-peak amplitude, period and signal shape of both breathing and tumor motions were first measured. Then, the correlation between the respiratory signal and internal tumor motion over time was evaluated, as well as the residual tumor motion for a gated strategy. Although breathing and tumor motions were comparable between AC and AV/C groups, A/VC approach achieved better reproducibility through sessions than AC alone (mean tumor motion of 7.2 mm ± 1 vs. 8.6 mm ± 1.8 mm, and mean breathing motion of 14.9 mm ± 1.2 mm vs. 13.3mm ± 3.7 mm, respectively). High internal/external correlation reproducibility was achieved in the superior-inferior tumor motion direction for all patients. For the anterior posterior tumor motion direction, better correlation reproducibility has been observed when visual feedback has been used. For a displacement-based gating approach, A/VC might also be recommended, since it led to smaller residual tumor motion within clinically relevant duty cycles. This study suggests that combining real-time visual feedback with audio coaching might improve the reproducibility of key characteristics of the breathing pattern, and might thus be considered in the implementation of lung tumor radiotherapy.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2014
Language Anglais
Journal information "Journal of Applied Clinical Medical Physics" - Vol. 15, no. 1, p. 47-56 (2014)
Peer reviewed yes
Publisher American College of Medical Physics ((United States) Reston, VA)
e-issn 1526-9914
Publication status Publié
Affiliations UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie
UCL - SST/ICTM/ELEN - Pôle en ingénierie électrique
UCL - (SLuc) Service de radiothérapie oncologique
MESH Subject Aged ; Lung Neoplasms ; Male ; Middle Aged ; Monte Carlo Method ; Movement ; Patient Education as Topic ; Prognosis ; Radiation Injuries ; Radiotherapy Dosage ; Respiration ; Aged, 80 and over ; Tomography, X-Ray Computed ; Algorithms ; Audiovisual Aids ; Carcinoma, Non-Small-Cell Lung ; Female ; Follow-Up Studies ; Four-Dimensional Computed Tomography ; Humans
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Bibliographic reference Goossens, Samuel ; Senny, Frédéric ; Lee, John Aldo ; Janssens, Guillaume ; Geets, Xavier. Assessment of tumor motion reproducibility with audio-visual coaching through successive 4D CT sessions. In: Journal of Applied Clinical Medical Physics, Vol. 15, no. 1, p. 47-56 (2014)
Permanent URL http://hdl.handle.net/2078.1/156134