The feasibility of the auto tuning respiratory compensation system with ultrasonic image tracking technique
Authors: Chuang Ho-Chiao , Hsu Hsiao-Yu , Nieh Shu-Kan , Tien Der-Chi 
Published: July 2015

The purpose of this study is to assess the feasibility of using the analytical technique of ultrasound images in combination with an auto tumor localization system. During respiration, the activity of breathing in and out causes organs displacement at the lower lobe of the lung, and the maximum displacement range happens in the Superior-Inferior (SI) direction. Therefore, in this study all the tumor positioning is in SI direction under respiratory compensation, in which the compensations are carried out to the organs at the lower lobe and adjacent to the lower lobe of lung.

In this research, due to the processes of ultrasound imaging generation, image analysis and signal transmission, when the captured respiratory signals are sent to auto tumor localization system, there was a signal time delay. The total delay time of the entire signal transmission process was 0.254 ± 0.023 seconds (with the lowest standard deviation) after implementing a series of analyses. To compensate for this signal delay time (0.254 ± 0.023 sec), a phase lead compensator (PLC) was designed and built into the auto tumor localization system. By analyzing the impact of the delay time and the respiratory waveforms under different frequencies on the phase lead compensator, an overall system delay time can be configured. Results showed as the respiratory frequency increased, variable value ``a'' and the subsequent gain ``k'' in the controller becomes larger. Moreover, value ``a'' and ``k'' increased as the system delay time increased when the respiratory frequency was fixed. The relationship of value ``a'' and ``k'' to the respiratory frequency can be obtained by using the curve fitting method to compensate for the respiratory motion for tumor localization. Through the comparison of the uncompensated signal and the compensated signal performed by the auto tumor localization system on the simulated respiratory signal, the feasibility of using ultrasound image analysis technology combined with the developed auto tumor localization system can be evaluated. The results show that the simulated respiratory signals under different frequencies of 0.5, 0.333, 0.25, 0.2 and 0.167 Hz with phase lead compensators were improved and stabilized. The compensation rate increased to the range of 7.04$∼ $18.82%, and the final compensation rate is about 97%. Therefore the auto tumor localization system combined with the ultrasound image analysis techniques is feasible.

In this study, the developed ultrasound image analysis techniques combined into the auto tumor localization system has the following four advantages: (1) It is a non-invasive way (ultrasonic images) to monitor the entire compensating process of the active respiration instead of using a C-arm (invasive) to observe the organs motion. (2) During radiation therapy, the whole treatment process can be continuous, which can save the overall treatment time. (3) It is an independent system, which can be mounted onto any treatment couch. (4) Users can operate this system easily without the need of prior complicated training process.