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This study was to analyze quantitatively movement of planning target volume (PTV) and change of PTV volume through movement of diaphragm according to breathing phase. The purpose of present study was to investigate optimized respiration phase for radiation therapy of lung cancer. Simulated breathing training was performed in order to minimize systematic errors which is caused non-specific or irregular breathing. We performed 4-dimensional computed tomography (4DCTi) in accordance with each respiratory phase in the normalized respiratory gated radiation therapy procedures, then not only defined PTVi in 0 ~ 90%, 30 ~ 70% and 40 ~ 60% in the reconstructed 4DCTi images but analyzed quantitatively movement and changes of volume in PTVi. As a results, average respiratory cycle was seconds by simulated breathing training. R2-value which is expressed as concordance between clinically induced expected value and actual measured value, was almost 1. There was a statistically significant. And also movement of PTVi according to each respiration phase 0 ~ 90%, 30 ~ 70% and 40 ~ 60% were , and respectively. Change of volume in PTVi of respiration phase 30 ~ 70% was decreased by and 40 ~ 60% was decreased by . In conclusion, PTVi movement and volume change was reduced, when we apply a short breathing phase (40 ~ 60%: 30% duty cycle) range. Furthermore, PTVi margin considered respiration was not only within 4mm but able to get uniformity of dose.

The Optimum of Respiratory Phase Using the Motion Range of the Diaphragm: Focus on Respiratory Gated Radiotherapy of Lung Cancer