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. 2013 Jul 8;14(4):4087.
doi: 10.1120/jacmp.v14i4.4087.

Deep inspiration breath-hold technique guided by an opto- electronic system for extracranial stereotactic treatments

Cristina Garibaldi  1 , Gianpiero Catalano, Guido Baroni, Barbara Tagaste, Marco Riboldi, Maria Francesca Spadea, Mario Ciocca, Raffaella Cambria, Flavia Serafini, Roberto Orecchia
Affiliations

Deep inspiration breath-hold technique guided by an opto- electronic system for extracranial stereotactic treatments

Cristina Garibaldi et al. J Appl Clin Med Phys. .

Abstract

The purpose of this work was to evaluate the intrapatient tumor position reproducibility in a deep inspiration breath-hold (DIBH) technique based on two infrared optical tracking systems, ExacTrac and ELITETM, in stereotactic treatment of lung and liver lesions. After a feasibility study, the technique was applied to 15 patients. Each patient, provided with a real-time visual feedback of external optical marker displacements, underwent a full DIBH, a free-breathing (FB), and three consecutive DIBH CT-scans centered on the lesion to evaluate the tumor position reproducibility. The mean reproducibility of tumor position during repeated DIBH was 0.5 ± 0.3 mm in laterolateral (LL), 1.0 ± 0.9 mm in anteroposterior (AP), and 1.4 ± 0.9 mm in craniocaudal (CC) direction for lung lesions, and 1.0 ± 0.6 mm in LL, 1.1 ± 0.5 mm in AP, and 1.2 ± 0.4 mm in CC direction for liver lesions. Intra- and interbreath-hold reproducibility during treatment, as determined by optical markers displacements, was below 1 mm and 3 mm, respectively, in all directions for all patients. Optically-guided DIBH technique provides a simple noninvasive method to minimize breathing motion for collaborative patients. For each patient, it is important to ensure that the tumor position is reproducible with respect to the external markers configuration.

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Figures

Figure 1
Figure 1
Patient with passive markers and eyewear viewer (a) showing in real‐time marker displacements in LL, CC, and AP directions (with respect to a reference configuration (b)).
Figure 2
Figure 2
Reproducibility of tumor position during repeated DIBH CT scans fused on the FB CT scan (shown in pink).
Figure 3
Figure 3
Displacement of GTV and passive markers between FB and DIBH in all directions for lung lesions.
Figure 4
Figure 4
Displacement of GTV and passive markers between FB and DIBH in all directions for liver lesions.
See this image and copyright information in PMC

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