Four-Dimensional Computed Tomography Based Respiratory-Gated Radiotherapy with Respiratory Guidance System: Analysis of Respiratory Signals and Dosimetric Comparison

Jung Ae Lee, Chul Yong Kim, Dae-Sik Yang, Won Sup Yoon, Young Je Park, Suk Lee, Young Bum Kim

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Purpose. To investigate the effectiveness of respiratory guidance system in 4-dimensional computed tomography (4DCT) based respiratory-gated radiation therapy (RGRT) by comparing respiratory signals and dosimetric analysis of treatment plans. Methods. The respiratory amplitude and period of the free, the audio device-guided, and the complex system-guided breathing were evaluated in eleven patients with lung or liver cancers. The dosimetric parameters were assessed by comparing free breathing CT plan and 4DCT-based 30-70% maximal intensity projection (MIP) plan. Results. The use of complex system-guided breathing showed significantly less variation in respiratory amplitude and period compared to the free or audio-guided breathing regarding the root mean square errors (RMSE) of full inspiration (P=0.031), full expiration (P=0.007), and period (P=0.007). The dosimetric parameters including V5 Gy, V10 Gy, V20 Gy, V30 Gy, V40 Gy, and V50 Gy of normal liver or lung in 4DCT MIP plan were superior over free breathing CT plan. Conclusions. The reproducibility and regularity of respiratory amplitude and period were significantly improved with the complex system-guided breathing compared to the free or the audio-guided breathing. In addition, the treatment plan based on the 4D CT-based MIP images acquired with the complex system guided breathing showed better normal tissue sparing than that on the free breathing CT.

Original languageEnglish
Article number306021
JournalBioMed Research International
Publication statusPublished - 2014


ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Medicine(all)

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