Clinical experience using respiratory gated radiation therapy: comparison of free-breathing and breath-hold techniques

Int J Radiat Oncol Biol Phys. 2004 Oct 1;60(2):419-26. doi: 10.1016/j.ijrobp.2004.03.037.


Purpose: To investigate the clinical use of a commercially available gating system for minimizing respiratory-induced anatomic motion over a range of treatment sites.

Methods and materials: The gating system consists of a reflective marker placed on the patient's anterior surface. The motion of the marker is tracked using a camera interfaced to a computer. Gated intervals were defined that limited the motion of the diaphragm to less than 1 cm during free breathing. Patients underwent a computed tomography virtual simulation using a breath-hold technique. At the time of treatment, verification of patient position and gating interval were performed using electronic portal imaging.

Results: Between September 2000 and January 2002, 136 patients were simulated with respiratory gating. Of these, 108 patients were treated to 110 sites for a total of 2301 treatment sessions. Ninety-seven percent of patients completed their entire course of therapy with gated treatment delivery.

Conclusions: Respiratory gating is a practical and achievable solution for minimizing respiratory-induced target motion during both simulation and treatment. With proper patient selection and training, it can be successfully implemented in a clinical radiation therapy department.

Publication types

  • Evaluation Study

MeSH terms

  • Abdominal Neoplasms / diagnostic imaging
  • Abdominal Neoplasms / radiotherapy*
  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / radiotherapy*
  • Feasibility Studies
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / radiotherapy*
  • Middle Aged
  • Movement*
  • Radiography
  • Radiotherapy, Computer-Assisted / methods*
  • Reproducibility of Results
  • Respiration*
  • Retrospective Studies