Department of Radiation Oncology, Yamanashi University, 1110 Shimokato, Chuo-city, Yamanashi, Japan.
Radiology. 2010 Jun;255(3):917-23. doi: 10.1148/radiol.10090890.
To evaluate the use, structural principles, operation, and acquired reproducibility of a respiratory monitoring device to be used for voluntary patient breath holding.
Evaluation was performed of a respiratory monitoring device that enables determination of the respiratory level in a patient by measuring the movement of two contacts on the abdomen and chest wall. Neither metallic nor electronic materials are used in the mechanics for this device. The initial study group comprised 21 consecutive patients (15 men, six women; mean age, 75 years; range, 56-92 years) with lung or abdominal tumors who underwent examination with the device and computed tomography (CT) for three-dimensional reproducibility of lung base position during voluntary breath holding with or without use of the device.
One patient with mild dementia was excluded; in most of the remaining 20 patients, high reproducibility of the breath-holding position was achieved in a short time with the device. In these 20 patients who were able to adapt to use of the device, three-dimensional mean maximum differences in lung base position during three random voluntary breath holds were 2.0 mm along the cranial-caudal axis, 1.5 mm along the anterior-posterior axis, and 1.2 mm along the right-left axis. The differences in all axes were significantly smaller with use of the respiratory monitoring device than without the device.
The device demonstrates satisfactory reproducibility of voluntary patient breath holding easily and inexpensively and may offer a convenient device for easy use during irradiation with voluntary breath-holding conditions that require a small internal margin.
评估一种用于患者自主屏气呼吸监测的设备的使用方法、结构原理、操作方法和可重复性。
评估一种呼吸监测设备,该设备通过测量腹部和胸壁上的两个触点的运动来确定患者的呼吸水平。该设备的机械结构中不使用金属或电子材料。初始研究组包括 21 例连续接受检查的患者(15 例男性,6 例女性;平均年龄 75 岁;年龄范围 56-92 岁),这些患者患有肺部或腹部肿瘤,他们在使用或不使用该设备的情况下进行了自主屏气呼吸检查,并进行了 CT 三维重建,以评估在屏气呼吸时肺底位置的可重复性。
一名轻度痴呆的患者被排除在外;在其余的 20 名患者中,大多数患者在短时间内就能很好地适应该设备的使用,从而实现了呼吸暂停位置的高度可重复性。在这 20 名能够适应使用该设备的患者中,在三次随机自主屏气呼吸中,肺底位置的三维最大差异分别为沿颅尾轴方向 2.0 毫米,沿前后轴方向 1.5 毫米,沿左右轴方向 1.2 毫米。与不使用设备相比,所有轴上的差异均明显较小。
该设备能够简便、经济地实现患者自主屏气呼吸的高度可重复性,并且在需要小内边界的情况下,作为一种方便易用的设备,为在自主屏气条件下进行照射提供了便利。