목 적: 호흡동조방사선치료(Respiratory Gating Radiation Therapy, RGRT)에서 호흡의 안정성은 매우 중요한 인자이다. 이러한 호흡의 안정을 위해 본인의 호흡주기를 직접 확인할 수 있도록 시청각시스템을 이용한 호흡유도시스템을 개발하였고 이의 유용성을 평가하고자 하였다. 대상 및 방법: 2011년 6월부터 2012년 4월까지 본원에서 호흡동조방사선치료를 받은 7명의 환자를 대상으로 시청각시스템을 이용하지 않는 자유호흡을 먼저 측정하고 자체개발한 호흡유도시스템을 이용한 호흡을 측정하였다. 시청각시스템을 이용한 호흡연습 후에는 치료실내에서의 자가호흡과 시청각시스템을 이용한 호흡을 각각 측정하였다. 측정된 데이터는 호흡주기, 호흡함수의 면적을 구하여 표준편차를 구하였으며, 이를 분석하여 치료전후의 호흡변화를 알아 보았다. 결 과: 자유호흡과 오디오 유도시스템, 시청각 유도시스템의 표준편차는 PTP (peak to peak)가 각각 0.343, 0.148, 0.078이다. 호흡주기는 각각 0.645, 0.345, 0.171이며, 호흡함수의 면적은 각각 2.591, 1.008, 0.877로 나타났다. 전체 환자의 CT실과 치료실에서의 차이를 평균한 값은 PTP가 0.425, 호흡주기가 1.566, 호흡면적이 3.671로 측정되었다. 호흡유도시스템 적용전후의 표준편자는 PTP가 0.265, 호흡주기가 0.474, 호흡면적이 1.714의 차이를 나타내었다. 자유호흡과 시청각유도시스템 적용전후의 값을 T-검정한 결과에서는 PTP, 주기, 호흡함수면적에서 각각 P-value 0.035, 0.009, 0.010의 값을 나타냈다. 결 론: 호흡동조방사선치료에서 호흡조절은 치료의 성패를 좌우할 만큼 중요한 인자이다. 자유호흡이나 청각에 의존한 호흡주기 획득에 비해 시청각 호흡유도 시스템을 이용한 경우에 보다 안정적인 호흡을 얻을 수 있었다. 특히, 치료실에서도 같은 시스템을 이용하여 호흡을 조절함으로써 호흡주기의 재현성이 뛰어났다. 이러한 시스템은 호흡불안정에 의한 치료시간의 지연을 줄이고 좀 더 정확하고 정밀한 치료가 가능하게 되었다.
목 적: 호흡동조방사선치료(Respiratory Gating Radiation Therapy, RGRT)에서 호흡의 안정성은 매우 중요한 인자이다. 이러한 호흡의 안정을 위해 본인의 호흡주기를 직접 확인할 수 있도록 시청각시스템을 이용한 호흡유도시스템을 개발하였고 이의 유용성을 평가하고자 하였다. 대상 및 방법: 2011년 6월부터 2012년 4월까지 본원에서 호흡동조방사선치료를 받은 7명의 환자를 대상으로 시청각시스템을 이용하지 않는 자유호흡을 먼저 측정하고 자체개발한 호흡유도시스템을 이용한 호흡을 측정하였다. 시청각시스템을 이용한 호흡연습 후에는 치료실내에서의 자가호흡과 시청각시스템을 이용한 호흡을 각각 측정하였다. 측정된 데이터는 호흡주기, 호흡함수의 면적을 구하여 표준편차를 구하였으며, 이를 분석하여 치료전후의 호흡변화를 알아 보았다. 결 과: 자유호흡과 오디오 유도시스템, 시청각 유도시스템의 표준편차는 PTP (peak to peak)가 각각 0.343, 0.148, 0.078이다. 호흡주기는 각각 0.645, 0.345, 0.171이며, 호흡함수의 면적은 각각 2.591, 1.008, 0.877로 나타났다. 전체 환자의 CT실과 치료실에서의 차이를 평균한 값은 PTP가 0.425, 호흡주기가 1.566, 호흡면적이 3.671로 측정되었다. 호흡유도시스템 적용전후의 표준편자는 PTP가 0.265, 호흡주기가 0.474, 호흡면적이 1.714의 차이를 나타내었다. 자유호흡과 시청각유도시스템 적용전후의 값을 T-검정한 결과에서는 PTP, 주기, 호흡함수면적에서 각각 P-value 0.035, 0.009, 0.010의 값을 나타냈다. 결 론: 호흡동조방사선치료에서 호흡조절은 치료의 성패를 좌우할 만큼 중요한 인자이다. 자유호흡이나 청각에 의존한 호흡주기 획득에 비해 시청각 호흡유도 시스템을 이용한 경우에 보다 안정적인 호흡을 얻을 수 있었다. 특히, 치료실에서도 같은 시스템을 이용하여 호흡을 조절함으로써 호흡주기의 재현성이 뛰어났다. 이러한 시스템은 호흡불안정에 의한 치료시간의 지연을 줄이고 좀 더 정확하고 정밀한 치료가 가능하게 되었다.
Purpose: The respiration is one of the most important factors in respiratory gating radiation therapy (RGRT). We have developed an unique respiratory guidance system using an audio-visual system in order to support and stabilize individual patient's respiration and evaluated the usefulness of this s...
Purpose: The respiration is one of the most important factors in respiratory gating radiation therapy (RGRT). We have developed an unique respiratory guidance system using an audio-visual system in order to support and stabilize individual patient's respiration and evaluated the usefulness of this system. Materials and Methods: Seven patients received the RGRT at our clinic from June 2011 to April 2012. After breathing exercise with the audio-visual system, we measured their spontaneous respiration and their respiration with the audio-visual system respectively. With the measured data, we yielded standard deviations by the superficial contents of respiratory cycles and functions, and analyzed them to examine changes in their breathing before and after the therapy. Results: The PTP (peak to peak) of the standard deviations of the free breathing, the audio guidance system, and the respiratory guidance system were 0.343, 0.148, and 0.078 respectively. The respiratory cycles were 0.645, 0.345, and 0.171 respectively and the superficial contents of the respiratory functions were 2.591, 1.008, and 0.877 respectively. The average values of the differences in the standard deviations among the whole patients at the CT room and therapy room were 0.425 for the PTP, 1.566 for the respiratory cycles, and 3.671 for the respiratory superficial contents. As for the standard deviations before and after the application of the PTP respiratory guidance system, that of the PTP was 0.265, that of the respiratory cycles was 0.474, and that of the respiratory superficial contents. The results of t-test of the values before and after free breathing and the audio-visual guidance system showed that the P-value of the PTP was 0.035, that of the cycles 0.009, and that of the respiratory superficial contents 0.010. Conclusion: The respiratory control could be one of the most important factors in the RGRT which determines the success or failure of a treatment. We were able to get more stable breathing with the audio-visual respiratory guidance system than free breathing or breathing with auditory guidance alone. In particular, the above system was excellent at the reproduction of respiratory cycles in care units. Such a system enables to reduce time due to unstable breathing and to perform more precise and detailed treatment.
Purpose: The respiration is one of the most important factors in respiratory gating radiation therapy (RGRT). We have developed an unique respiratory guidance system using an audio-visual system in order to support and stabilize individual patient's respiration and evaluated the usefulness of this system. Materials and Methods: Seven patients received the RGRT at our clinic from June 2011 to April 2012. After breathing exercise with the audio-visual system, we measured their spontaneous respiration and their respiration with the audio-visual system respectively. With the measured data, we yielded standard deviations by the superficial contents of respiratory cycles and functions, and analyzed them to examine changes in their breathing before and after the therapy. Results: The PTP (peak to peak) of the standard deviations of the free breathing, the audio guidance system, and the respiratory guidance system were 0.343, 0.148, and 0.078 respectively. The respiratory cycles were 0.645, 0.345, and 0.171 respectively and the superficial contents of the respiratory functions were 2.591, 1.008, and 0.877 respectively. The average values of the differences in the standard deviations among the whole patients at the CT room and therapy room were 0.425 for the PTP, 1.566 for the respiratory cycles, and 3.671 for the respiratory superficial contents. As for the standard deviations before and after the application of the PTP respiratory guidance system, that of the PTP was 0.265, that of the respiratory cycles was 0.474, and that of the respiratory superficial contents. The results of t-test of the values before and after free breathing and the audio-visual guidance system showed that the P-value of the PTP was 0.035, that of the cycles 0.009, and that of the respiratory superficial contents 0.010. Conclusion: The respiratory control could be one of the most important factors in the RGRT which determines the success or failure of a treatment. We were able to get more stable breathing with the audio-visual respiratory guidance system than free breathing or breathing with auditory guidance alone. In particular, the above system was excellent at the reproduction of respiratory cycles in care units. Such a system enables to reduce time due to unstable breathing and to perform more precise and detailed treatment.
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제안 방법
Also, in order to investigate the reproducibility of breathing in actual care units before the application of the audio-visual guidance system, we measured the averages of the PTP of free breathing, respiratory cycles, and the changes in the superficial contents of respiratory functions in the CT room and the care units respectively. As for the measured average values, the PTP value was 0.
Developing our own respiratory guidance system for maintaining stable and regular breathing among patients in the course from the CT scan to radiation treatment, this study has compared free breathing and audio-based breathing with voice files, and measured and quantitatively analyzed respiratory signals via the comparison with our own developed voice and image based respiratory system. In doing this, we would like to evaluate the usefulness of our institution’s own developed respiratory guidance system in the course of the respiratory gating radiation therapy.
In order to compare respiratory data from each system, we respectively obtained data from free breathing without any application of the systems, from the application of the auditory guidance system, and from the simultaneous visual and auditory system of respiratory stability developed by our institution. For the purpose of the evaluation of the usefulness of the respiratory guidance system in the course of treatment, we obtained data by measuring respiratory signals with or without the application of the respiratory guidance system for 5 minutes a day over a 5 day period 3days after the attainment of the signals.
The first part is a 17” LCD monitor (Multisync LCD 1770NX, NEC) put in a cassette holder for those who have bad vision or are abhorrent of watching a screen closely, while the second is a 8” LED monitor (WINDOM, CT-M080B LED) put in a monitor arm with 6 joints with which CT scans are possible without collision with the bore by adjusting the angle after putting on a table.
The respiratory signal obtaining system used in this study consists of the Ream-Time Position Management System (RPM, Varian) using infrared cameras and reflectors and the interface (RPM Computer, Varian) showing signals real time. As seen in Fig.
By means of the subjects’ respiratory data obtained in this way, we yielded the PTP (peak to peak) of each respiratory cycle, and the superficial contents of the respiratory cycles and functions. Then, we yielded the standard deviations of these items and examined the changes in respiratory cycles and the similarities among respiratory volumes. Also, we evaluated the usefulness of the respiratory guidance system via t-test of the standard deviations.
대상 데이터
2, the system puts the infrared reflectors on a certain abdomen site and then visualizes time and position information. The CT simulator used in the experiment is BrightSpeed Elite (GE) and the linear accelerator is Trilogy (Varian, USA).
1). This study took as its subjects 7 patents who underwent the respiratory gating radiation therapy from June 2011 to April 2012.
This study took as its subjects 7 patients who received the respiratory gating radiation therapy from June 2011 to April 2012 in order to examine the inspiratory with the use of our own developed respiratory guidance equipment. Of the subjects, 4 had lung cancer and 3 liver cancer.
데이터처리
Then, we yielded the standard deviations of these items and examined the changes in respiratory cycles and the similarities among respiratory volumes. Also, we evaluated the usefulness of the respiratory guidance system via t-test of the standard deviations.
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