title: Effect of audio coaching on correlation of abdominal displacement with lung tumor motion.
abstract: OBJECTIVE
  To assess the effect of audio coaching on the time-dependent behavior of the correlation between abdominal motion and lung tumor motion and the corresponding lung tumor position mismatches.
  
  
  METHODS
  Six patients who had a lung tumor with a motion range >8 mm were enrolled in the present study. Breathing-synchronized fluoroscopy was performed initially without audio coaching, followed by fluoroscopy with recorded audio coaching for multiple days. Two different measurements, anteroposterior abdominal displacement using the real-time positioning management system and superoinferior (SI) lung tumor motion by X-ray fluoroscopy, were performed simultaneously. Their sequential images were recorded using one display system. The lung tumor position was automatically detected with a template matching technique. The relationship between the abdominal and lung tumor motion was analyzed with and without audio coaching.
  
  
  RESULTS
  The mean SI tumor displacement was 10.4 mm without audio coaching and increased to 23.0 mm with audio coaching (p < .01). The correlation coefficients ranged from 0.89 to 0.97 with free breathing. Applying audio coaching, the correlation coefficients improved significantly (range, 0.93-0.99; p < .01), and the SI lung tumor position mismatches became larger in 75% of all sessions.
  
  
  CONCLUSIONS
  Audio coaching served to increase the degree of correlation and make it more reproducible. In addition, the phase shifts between tumor motion and abdominal displacement were improved; however, all patients breathed more deeply, and the SI lung tumor position mismatches became slightly larger with audio coaching than without audio coaching.
authors.affiliation: Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan. m_nkmr@kuhp.kyoto-u.ac.jp
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Nakamura
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Narita
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Masaru
authors.initials: M
authors.lastname: Narabayashi
authors.forename: Manabu
authors.initials: M
authors.lastname: Nakata
authors.forename: Akira
authors.initials: A
authors.lastname: Sawada
authors.forename: Takashi
authors.initials: T
authors.lastname: Mizowaki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nagata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hiraoka
mesh_terms: D000005:Abdomen; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009068:Movement; D010353:Patient Education as Topic / Q000379:methods*; D011832:Radiation Injuries / Q000517:prevention & control; D011859:Radiography; D011878:Radiotherapy / Q000379:methods; D012119:Respiration; D012984:Software