title: Novel spirometry based on optical surface imaging.
abstract: OBJECTIVE
  To evaluate the feasibility of using optical surface imaging (OSI) to measure the dynamic tidal volume (TV) of the human torso during free breathing.
  
  
  METHODS
  We performed experiments to measure volume or volume change in geometric and deformable phantoms as well as human subjects using OSI. To assess the accuracy of OSI in volume determination, we performed experiments using five geometric phantoms and two deformable body phantoms and compared the values with those derived from geometric calculations and computed tomography (CT) measurements, respectively. To apply this technique to human subjects, an institutional review board protocol was established and three healthy volunteers were studied. In the human experiment, a high-speed image capture mode of OSI was applied to acquire torso images at 4-5 frames per second, which was synchronized with conventional spirometric measurements at 5 Hz. An in-house matlab program was developed to interactively define the volume of interest (VOI), separate the thorax and abdomen, and automatically calculate the thoracic and abdominal volumes within the VOIs. The torso volume change (TV C = ΔVtorso = ΔVthorax + ΔVabdomen) was automatically calculated using full-exhalation phase as the reference. The volumetric breathing pattern (BPv = ΔVthorax/ΔVtorso) quantifying thoracic and abdominal volume variations was also calculated. Under quiet breathing, TVC should equal the tidal volume measured concurrently by a spirometer with a conversion factor (1.08) accounting for internal and external differences of temperature and moisture. Another matlab program was implemented to control the conventional spirometer that was used as the standard.
  
  
  RESULTS
  The volumes measured from the OSI imaging of geometric phantoms agreed with the calculated volumes with a discrepancy of 0.0% ± 1.6% (range -1.9% to 2.5%). In measurements from the deformable torso/thorax phantoms, the volume differences measured using OSI imaging and CT imaging were 1.2% ± 2.1% (range -0.5% to 3.6%), with a linear regression fitting (slope = 1.02 and R(2) = 0.999). In volunteers, the relative error in OSI tidal volume measurement was -2.2% ± 4.9% (range -9.2% to 4.8%) and a correlation of r = 0.98 was found with spirometric measurement. The breathing pattern values of the three volunteers were substantially different from each other (BPv = 0.15, 0.45, and 0.32).
  
  
  CONCLUSIONS
  This study demonstrates the feasibility of using OSI to measure breathing tidal volumes and breathing patterns with adequate accuracy. This is the first time that dynamic breathing tidal volume as well as breathing patterns is measured using optical surface imaging. The OSI-observed movement of the entire torso could serve as a new respiratory surrogate in the treatment room during radiation therapy.
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York 10065.
authors.forename: Guang
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York 10065.
authors.forename: Hailiang
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Computer Science, City College of New York, New York, New York 10031.
authors.forename: Jie
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York 10065.
authors.forename: Diana G
authors.initials: DG
authors.lastname: Li
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York 10065.
authors.forename: Qing
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York 10065.
authors.forename: Carl P
authors.initials: CP
authors.lastname: Gaebler
authors.affiliation: Pulmonary Laboratories, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 10065.
authors.forename: James
authors.initials: J
authors.lastname: Sullivan
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York 10065.
authors.forename: Joan
authors.initials: J
authors.lastname: Zatcky
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York 10065.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rimner
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York 10065.
authors.forename: James
authors.initials: J
authors.lastname: Mechalakos
mesh_terms: D000005:Abdomen / Q000502:physiology; D005240:Feasibility Studies; D006801:Humans; D008954:Models, Biological; D061848:Optical Imaging / Q000295:instrumentation / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods; D019047:Phantoms, Imaging; D012119:Respiration; D012984:Software; D013147:Spirometry / Q000295:instrumentation / Q000379:methods*; D013909:Thorax / Q000502:physiology; D013990:Tidal Volume; D014057:Tomography, X-Ray Computed
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