title: A simple respiratory indicator for irradiation during voluntary breath holding: a one-touch device without electronic materials.
abstract: OBJECTIVE
  To evaluate the use, structural principles, operation, and acquired reproducibility of a respiratory monitoring device to be used for voluntary patient breath holding.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiation Oncology, Yamanashi University, 1110 Shimokato, Chuo-city, Yamanashi, Japan. honishi@yamanashi.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onishi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kawakami
authors.forename: Kan
authors.initials: K
authors.lastname: Marino
authors.forename: Takafumi
authors.initials: T
authors.lastname: Komiyama
authors.forename: Kengo
authors.initials: K
authors.lastname: Kuriyama
authors.forename: Masayuki
authors.initials: M
authors.lastname: Araya
authors.forename: Ryo
authors.initials: R
authors.lastname: Saito
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aoki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Araki
mesh_terms: D000005:Abdomen / Q000502:physiology; D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D009068:Movement; D011187:Posture / Q000502:physiology; D015203:Reproducibility of Results; D012119:Respiration; D035441:Thoracic Wall / Q000502:physiology; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging