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Performance evaluation of a visual guidance patient-controlled respiratory gating system for respiratory-gated magnetic-resonance image-guided radiation therapy

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Abstract

The performance of a visual guidance patient-controlled (VG-PC) respiratory gating system for magnetic-resonance (MR) image-guided radiation therapy (MR-IGRT) was evaluated through a clinical trial of patients with either lung or liver cancer. Patients can voluntarily control their respiration utilizing the VG-PC respiratory gating system. The system enables patients to view near-real-time cine planar MR images projected inside the bore of MR-IGRT systems or an external screen. Twenty patients who had received stereotactic ablative radiotherapy (SABR) for lung or liver cancer were prospectively selected for this study. Before the first treatment, comprehensive instruction on the VG-PC respiratory gating system was provided to the patients. Respiratory-gated MR-IGRT was performed for each patient with it in the first fraction and then without it in the second fraction. For both the fractions, the total treatment time, beam-off time owing to the respiratory gating, and number of beam-off events were analyzed. The average total treatment time, beam-off time, and number of beam-off events with the system were 1507.3 s, 679.5 s, and 185, respectively, and those without the system were 2023.7 s (p < 0.001), 1195.0 s (p < 0.001), and 380 times (p < 0.001), respectively. The VG-PC respiratory gating system improved treatment efficiency through a reduction in the beam-off time, the number of beam-off events, and consequently the total treatment time when performing respiratory-gated MR-IGRT for lung and liver SABR.

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Funding

This work was supported by the Radiation Technology R&D program through the National Research Foundation of Korea funded by the Ministry of Science and ICT (2019M2A2B4095126 and 2019M2A2B4096540).

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Authors and Affiliations

  1. Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, Korea

    Hyung Jin Choun & Jong Min Park

  2. Department of Radiation Oncology , Seoul National University Hospital, Seoul, Korea

    Jung-in Kim, Chang Heon Choi, Seongmoon Jung, Hyeongmin Jin, Hong-Gyun Wu, Eui Kyu Chie & Jong Min Park

  3. Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea

    Hyung Jin Choun, Jung-in Kim, Chang Heon Choi, Seongmoon Jung, Hyeongmin Jin, Hong-Gyun Wu, Eui Kyu Chie & Jong Min Park

  4. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea

    Jung-in Kim, Chang Heon Choi, Hong-Gyun Wu, Eui Kyu Chie & Jong Min Park

  5. Department of Radiation Oncology , Seoul National University College of Medicine, Seoul, Korea

    Hong-Gyun Wu, Eui Kyu Chie & Jong Min Park

  6. Robotics Research Laboratory for Extreme Environments, Advanced Institutes of Convergence Technology, Suwon, Korea

    Jong Min Park

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  1. Hyung Jin Choun
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  8. Jong Min Park
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Contributions

Hyung Jin Choun and Jong Min Park conceived the study concept, analyzed the data, drafted the manuscript, and participated in all aspects of the study. Jung-in Kim, Chang Heon Choi, Seongmoon Jung, and Hyeongmin Jin gathered and processed the data. Hong Gyun Wu and Eui Kyu Chie performed the clinical trial and evaluated the VG-PC respiratory gating system performance. Hyung Jin Choun, Jong Min Park, Jung-in Kim, and Chang Heon Choi performed discussions to improve the significance of this study. Jong Min Park oversaw and verified the completion of the study. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Jong Min Park.

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The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of Seoul National University Hospital (IRB No. 1908-133-1057).

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

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Choun, H., Kim, Ji., Choi, C. et al. Performance evaluation of a visual guidance patient-controlled respiratory gating system for respiratory-gated magnetic-resonance image-guided radiation therapy. Phys Eng Sci Med 45, 809–816 (2022). https://doi.org/10.1007/s13246-022-01144-0

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  • DOI: https://doi.org/10.1007/s13246-022-01144-0

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