title: Comparison of visual biofeedback system with a guiding waveform and abdomen-chest motion self-control system for respiratory motion management.
abstract: Irregular breathing can influence the outcome of 4D computed tomography imaging and cause artifacts. Visual biofeedback systems associated with a patient-specific guiding waveform are known to reduce respiratory irregularities. In Japan, abdomen and chest motion self-control devices (Abches) (representing simpler visual coaching techniques without a guiding waveform) are used instead; however, no studies have compared these two systems to date. Here, we evaluate the effectiveness of respiratory coaching in reducing respiratory irregularities by comparing two respiratory management systems. We collected data from 11 healthy volunteers. Bar and wave models were used as visual biofeedback systems. Abches consisted of a respiratory indicator indicating the end of each expiration and inspiration motion. Respiratory variations were quantified as root mean squared error (RMSE) of displacement and period of breathing cycles. All coaching techniques improved respiratory variation, compared with free-breathing. Displacement RMSEs were 1.43 ± 0.84, 1.22 ± 1.13, 1.21 ± 0.86 and 0.98 ± 0.47 mm for free-breathing, Abches, bar model and wave model, respectively. Period RMSEs were 0.48 ± 0.42, 0.33 ± 0.31, 0.23 ± 0.18 and 0.17 ± 0.05 s for free-breathing, Abches, bar model and wave model, respectively. The average reduction in displacement and period RMSE compared with the wave model were 27% and 47%, respectively. For variation in both displacement and period, wave model was superior to the other techniques. Our results showed that visual biofeedback combined with a wave model could potentially provide clinical benefits in respiratory management, although all techniques were able to reduce respiratory irregularities.
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Nakajima
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan kadoya.n@rad.med.tohoku.ac.jp.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Kadoya
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kanai
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Radiological Technology, Health Sciences, Tohoku University, Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Dobashi
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Takaya
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Ishikawa
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Matsushita
authors.affiliation: Department of Radiological Technology, Health Sciences, Tohoku University, Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Jingu
mesh_terms: D000005:Abdomen / Q000502:physiology*; D000328:Adult; D001676:Biofeedback, Psychology; D056228:Feedback, Sensory; D064368:Healthy Volunteers; D006801:Humans; D009038:Motion; D012119:Respiration; D000068356:Self-Control; D013909:Thorax / Q000502:physiology*; D058067:Wavelet Analysis; D055815:Young Adult
keywords: breathing guidance; four-dimensional CT; radiotherapy; respiratory motion management; visual biofeedback