Respiration gated radiotherapy treatment: a technical study

TLDR

Upper‑torso radiotherapy targets move substantially due to respiration. The study seeks to optimize external‑beam conformal radiotherapy by minimizing patient movement through respiration‑gated beam delivery. The authors evaluated several respiration sensors, measured organ displacement with fluoroscopic playback, and assessed dose, symmetry, and uniformity on a Varian 2100C linear accelerator to determine gating effects.

Abstract

In order to optimize external-beam conformal radiotherapy, patient movement during treatment must be minimized. For treatment on the upper torso, the target organs are known to move substantially due to patient respiration. This paper deals with the technical aspects of gating the radiotherapy beam synchronously with respiration: the optimal respiration monitoring system, measurements of organ displacement and linear accelerator gating. Several respiration sensors including a thermistor, a thermocouple, a strain gauge and a pneumotachograph were examined to find the optimal sensor. The magnitude of breast, chest wall and lung motion were determined using playback of fluoroscopic x-ray images recorded on a VCR during routine radiotherapy simulation. Total dose, beam symmetry and beam uniformity were examined to determine any effects on the Varian 2100C linear accelerator due to gating.