Real-Time External Respiratory Motion Measuring Technique Using an RGB-D Camera and Principal Component Analysis

Exploring the feasibility of millimeter-wave sensors for non-invasive respiratory motion visualization in diagnostic imaging and therapy

BACKGROUND

Management of respiratory motion during radiation therapy is essential for accurate dose delivery and minimizing the risk to organs. In diagnostic imaging, respiratory monitoring is required for confirmation of breath-hold and four-dimensional computed tomography (CT) reconstruction. Although respiratory monitoring systems are widely used in radiation therapy, they are not often used for diagnostic imaging, where they could improve image quality.

PURPOSE

The purpose of this study was to use a millimeter-wave sensor (MWS) to noninvasively visualize respiratory motion, confirm breath-holding, and explore the potential for clinical implementation of an MWS in diagnostic x-ray imaging, CT, and radiation therapy.

METHODS

A 24 GHz microMWS was used in this study. The MWS directionality was determined using a radio-wave dark-box system. An antenna directionality test evaluated the effective azimuthal and elevational beamwidths. Respiratory waveforms were detected by optimizing the fast Fourier transform threshold and the cutoff frequencies of the bandpass filter. To confirm the reproducibility of the MWS, the detected waveforms were compared with those of a respiratory motion phantom (QUASAR), the amplitude of motion of which could be controlled. The time from valley to peak of the waveforms obtained by normalized MWS and the QUASAR were compared. The MWS was used to acquire respiratory waveforms of 20 healthy volunteers (including an infant and a child) in geometries adopted during chest CT (supine position; anteroposterior view; source-to-surface distance, 400 mm) and chest x-ray imaging (standing position; posteroanterior view; source-to-surface distance, 1800 mm).

RESULTS

The effective azimuthal and elevational beamwidths of the MWS were approximately ± 20° and ± 40°, respectively. By optimizing the acquisition parameters (high-sensitivity setting; with noise cancelling; frequency range, 10-20 min-1), the waveforms detected using the MWS approximately matched those of the respiratory motion phantom at all amplitudes. The MWS was also used to confirm breath-holding in 18 volunteers in both supine (anteroposterior view) and standing (posteroanterior view) positions. In addition, for an infant and a child who were unable to follow the instruction to stop breathing, a visual count of their inhalations matched the number of respiratory cycles measured using the MWS.

CONCLUSION

The 24 GHz MWS successfully monitored respiratory motion and breath-holding during radiographic and CT imaging. With effective directionality and stability, this system holds promise for clinical management of respiratory motion during diagnostic imaging and radiation therapy.

For a clinical application of optical triangulation to assess respiratory rate using an RGB camera and a line laser

This paper presents a non-contact and unrestrained respiration monitoring system based on the optical triangulation technique. The proposed system consists of a red-green-blue (RGB) camera and a line laser installed to face the frontal thorax of a human body. The underlying idea of the work is that the camera and line laser are mounted in opposite directions, unlike other research. By applying the proposed image processing algorithm to the camera image, laser coordinates are extracted and converted to world coordinates using the optical triangulation method. These converted world coordinates represent the height of the thorax of a person. The respiratory rate is measured by analyzing changes of the thorax surface depth. To verify system performance, the camera and the line laser are installed on the head and foot sides of a bed, respectively, facing toward the center of the bed. Twenty healthy volunteers were enrolled and underwent measurement for 100s. Evaluation results show that the optical triangulation-based image processing method demonstrates non-inferior performance to a commercial patient monitoring system with a root-mean-squared error of 0.30rpm and a maximum error of 1rpm ( p > 0.05 ), which implies the proposed non-contact system can be a useful alternative to the conventional healthcare method.

Review of robotic systems for thoracoabdominal puncture interventional surgery

Cancer, with high morbidity and high mortality, is one of the major burdens threatening human health globally. Intervention procedures via percutaneous puncture have been widely used by physicians due to its minimally invasive surgical approach. However, traditional manual puncture intervention depends on personal experience and faces challenges in terms of precisely puncture, learning-curve, safety and efficacy. The development of puncture interventional surgery robotic (PISR) systems could alleviate the aforementioned problems to a certain extent. This paper attempts to review the current status and prospective of PISR systems for thoracic and abdominal application. In this review, the key technologies related to the robotics, including spatial registration, positioning navigation, puncture guidance feedback, respiratory motion compensation, and motion control, are discussed in detail.

Current Research Status of Respiratory Motion for Thorax and Abdominal Treatment: A Systematic Review

Malignant tumors have become one of the serious public health problems in human safety and health, among which the chest and abdomen diseases account for the largest proportion. Early diagnosis and treatment can effectively improve the survival rate of patients. However, respiratory motion in the chest and abdomen can lead to uncertainty in the shape, volume, and location of the tumor, making treatment of the chest and abdomen difficult. Therefore, compensation for respiratory motion is very important in clinical treatment. The purpose of this review was to discuss the research and development of respiratory movement monitoring and prediction in thoracic and abdominal surgery, as well as introduce the current research status. The integration of modern respiratory motion compensation technology with advanced sensor detection technology, medical-image-guided therapy, and artificial intelligence technology is discussed and analyzed. The future research direction of intraoperative thoracic and abdominal respiratory motion compensation should be non-invasive, non-contact, use a low dose, and involve intelligent development. The complexity of the surgical environment, the constraints on the accuracy of existing image guidance devices, and the latency of data transmission are all present technical challenges.

Analysis of emerging trends and hot spots in respiratory biomechanics from 2003 to 2022 based on CiteSpace

Introduction: With the global prevalence of coronavirus disease 2019 (COVID-19), an increasing number of people are experiencing respiratory discomfort. Respiratory biomechanics can monitor breathing patterns and respiratory movements and it is easier to prevent, diagnose, treat or rehabilitate. However, there is still a lack of global knowledge structure in the field of respiratory biomechanics. With the help of CiteSpace software, we aim to help researchers identify potential collaborators and collaborating institutions, hotspots and research frontiers in respiratory biomechanics. Methods: Articles on respiratory biomechanics from 2003 to 2022 were retrieved from the Web of Science Core Collection by using a specific strategy, resulting a total of 2,850 publications. We used CiteSpace 6.1.R6 to analyze the year of publication, journal/journals cited, country, institution, author/authors cited, references, keywords and research trends. Co-citation maps were created to visually observe research hot spots and knowledge structures. Results and discussion: The number of annual publications gradually increased over the past 20 years. Medical Physics published the most articles and had the most citations in this study. The United States was the most influential country, with the highest number and centrality of publications. The most productive and influential institution was Harvard University in the United States. Keall PJ was the most productive author and MCCLELLAND JR was the most cited authors The article by Keall PJ (2006) article (cocitation counts: 55) and the article by McClelland JR (2013) were the most representative and symbolic references, with the highest cocitation number and centrality, respectively. The top keywords were "radiotherapy", "volume", and "ventilation". The top Frontier keywords were "organ motion," "deep inspiration," and "deep learning". The keywords were clustered to form seven labels. Currently, the main area of research in respiratory biomechanics is respiratory motion related to imaging techniques. Future research may focus on respiratory assistance techniques and respiratory detection techniques. At the same time, in the future, we will pay attention to personalized medicine and precision medicine, so that people can monitor their health status anytime and anywhere.

Face-Free Chest Detection Using Convolutional Neural Networks for Non-Contact Respiration Monitoring

Non-contact methods for monitoring respiration face limitations when it comes to selecting the chest region of interest. The semi-automatic method, which requires the user to select the chest region in the first frame, is not suitable for real-time applications. The automatic method, which tracks the face first and then detects the chest region based on the face's position, can be inaccurate if the face is not visible or is rotated. Moreover, using the face region to track the chest region can under-utilize camera pixels since the face is not essential for monitoring respiration. This approach may adversely affect the quality of the respiration signal being measured. To address these issues, we propose a face-free chest detection model based on Convolutional Neural Networks. Our model enhances the measured non-contact respiration signal quality and utilizes more pixels for the chest region alone. In our quantitative study, we demonstrate that our method outperforms traditional methods that require the presence of the face. This approach offers potential benefits for real-time, non-contact respiration monitoring applicationsClinical relevance- This work enhances the performance of non-contact respiration monitoring techniques by precisely detecting the chest region without the need of face in it through a CNN-based model. The use of the CNN-based chest detection model also enhances the real-time monitoring capabilities of non-contact respiration monitoring techniques.

Machine Learning Radiomics Model for External and Internal Respiratory Motion Correlation Prediction in Lung Tumor

Objectives: The complexity and specificity of lung tumor motion render it necessary to determine the external and internal correlation individually before applying indirect tumor tracking. However, the correlation cannot be determined from patient respiratory and tumor clinical characteristics before treatment. The purpose of this study is to present a machine learning model for an external/internal correlation prediction that is based on computed tomography (CT) radiomic features. Methods: 4-dimensional computed tomography (4DCT) images of 67 patients were collected retrospectively, and the external/internal correlation of lung tumor was calculated based on Spearman's rank correlation coefficient. Radiomic features were extracted from average intensity projection and the light gradient boosting machine (LightGBM)-based cross-validation (the recursive elimination method) was used for feature selection. The LightGBM framework forecasting models with classification thresholds 0.7, 0.8, and 0.9 are established using stratified 5-fold cross-validation. Model performance was assessed using receiver operating characteristics, sensitivity, and specificity. Results: There were 16, 18, and 13 features selected for models 0.7, 0.8, and 0.9, respectively. Texture features are of great importance in external/internal correlation prediction compared to other features in all models. The sensitivities of the predictions in models 0.7, 0.8, and 0.9 were 0.800 ± 0.126, 0.829 ± 0.140, and 0.864 ± 0.086, respectively. The specificities were 0.771 ± 0.114, 0.936 ± 0.0581, and 0.839 ± 0.101, whereas the area under the curve (AUC) was 0.837, 0.946, and 0.877, respectively. Conclusions: Our findings indicate that radiomics is an effective tool for respiratory motion correlation prediction, which can extract tumor motion characteristics. We proposed a machine learning framework for correlation prediction in the motion management strategy for lung tumor patients.

Breathing In-Depth: A Parametrization Study on RGB-D Respiration Extraction Methods

As depth cameras have gotten smaller, more affordable, and more precise, they have also emerged as a promising sensor in ubiquitous systems, particularly for detecting objects, scenes, and persons. This article sets out to systematically evaluate how suitable depth data can be for picking up users’ respiration, from small distance changes across the torso over time. We contribute a large public dataset of depth data over time from 19 persons taken in a large variety of circumstances. On this data, we evaluate and compare different state-of-the-art methods and show that their individual performance significantly depends on a range of conditions and parameters. We investigate the influence of the observed torso region (e.g., the chest), the user posture and activity, the distance to the depth camera, the respiratory rate, the gender, and user specific peculiarities. Best results hereby are obtained from the chest whereas the abdomen is least suited for detecting the user’s breathing. In terms of accuracy and signal quality, the largest differences are observed on different user postures and activities. All methods can maintain a mean accuracy of above 92% when users are sitting, but half of the observed methods only achieve a mean accuracy of 51% while standing. When users are standing and additionally move their arms in front of their upper body, mean accuracy values between the worst and best performing methods range from 21 to 87%. Increasing the distance to the depth camera furthermore results in lower signal quality and decreased accuracy on all methods. Optimal results can be obtained at distances of 1–2 m. Different users have been found to deliver varying qualities of breathing signals. Causes range from clothing, over long hair, to movement. Other parameters have shown to play a minor role in the detection of users’ breathing.

Noninvasive Tidal Volume Measurements, Using a Time-of-Flight Camera, Under High-Flow Nasal Cannula-A Physiological Evaluation, in Healthy Volunteers

OBJECTIVES

The mechanisms of high-flow nasal cannula are still debated but may be mediated by the generation of low positive end-expiratory pressure and a washout of the airway dead space. The aims of this study were to assess the effects of high-flow nasal cannula on tidal volume using a noninvasive method using a time-of-flight camera, under various conditions.

DESIGN

A physiologic evaluation in healthy volunteers.

SETTING

An university hospital ICU.

SUBJECTS

Ten healthy volunteers were included in a physiologic study (CamOpt study, ClinicalTrials.gov identifier: NCT04096183).

INTERVENTIONS

All volunteers were submitted to 12 different conditions (i.e., gas flow [baseline = 0; 30-60 L/min]; mouth [open/closed]; respiratory rate [baseline; baseline + 10 breaths/min]). Tidal volume measurements were performed every minute, during a 6-minute recording period. In all combinations, reference respiratory rate was measured by using chronometric evaluation, over a 30-second period (RRREF), and by using the time-of-flight camera (RRTOF).

MEASUREMENTS AND MAIN RESULTS

Tidal volume increased while increasing gas flow whatever the respiratory rate and mouth condition (p < 0.001). Similar results were observed whatever the experimental conditions (p < 0.01), except one (baseline respiratory rate + 10 breaths/min and mouth closed). Tidal volume increased while decreasing respiratory rate (p < 0.001) and mouth closing (p < 0.05). Proportion of tidal volume greater than 10, 15, and 20 mL/kg changed while increasing the flow. RRTOF was in agreement with RRREF (intraclass correlation coefficient, 0.96), with a low mean bias (0.55 breaths/min) and acceptable deviation.

CONCLUSIONS

Time-of-flight enables to detect tidal volume changes under various conditions of high-flow nasal cannula application. Tidal volume increased significantly while increasing gas flow and mouth closing. Such technique might be useful to monitor the risk of patient self-inflicted lung injury or under assistance.

A real-time camera-based adaptive breathing monitoring system

Breathing is one of the vital signs used to assess the physical health of a subject. Non-contact-based measurements of both breathing rate and changes in breathing rate help monitor health condition of subjects more flexibly. In this paper, we present an improved real-time camera-based adaptive breathing monitoring system, which includes real time (1) adaptive breathing motion detection, (2) adaptive region of interest detection to eliminate environmental noise, (3) breathing and body movement classification, (4) respiration rate estimation, (5) monitor change in respiration rate to examine overall health of an individual, and (6) online adaptation to lighting. The proposed system does not pose any positional and postural constraint. For evaluation, 30 videos of 15 animals are tested with drugs to simulate various medical conditions and breathing patterns, and the results from the proposed system are compared with the outputs of an existing FDA-approved invasive medical system for patient monitoring. The results show that the proposed method performs significantly correlated RR results to the reference medical device with the correlation coefficient equal to 0.92 and p-value less than 0.001, and more importantly the proposed video-based method is demonstrated to produce alarms 10 to 20 s earlier than the benchmark medical device. Graphical abstract The proposed system flowchart to extract the respiratory pattern from video.

Automated Non-Contact Respiratory Rate Monitoring of Neonates Based on Synchronous Evaluation of a 3D Time-of-Flight Camera and a Microwave Interferometric Radar Sensor

This paper introduces an automatic non-contact monitoring method based on the synchronous evaluation of a 3D time-of-flight (ToF) camera and a microwave interferometric radar sensor for measuring the respiratory rate of neonates. The current monitoring on the Neonatal Intensive Care Unit (NICU) has several issues which can cause pressure marks, skin irritations and eczema. To minimize these risks, a non-contact system made up of a 3D time-of-flight camera and a microwave interferometric radar sensor is presented. The 3D time-of-flight camera delivers 3D point clouds which can be used to calculate the change in distance of the moving chest and from it the respiratory rate. The disadvantage of the ToF camera is that the heartbeat cannot be determined. The microwave interferometric radar sensor determines the change in displacement caused by the respiration and is even capable of measuring the small superimposed movements due to the heartbeat. The radar sensor is very sensitive towards movement artifacts due to, e.g., the baby moving its arms. To allow a robust vital parameter detection the data of both sensors was evaluated synchronously. In this publication, we focus on the first step: determining the respiratory rate. After all processing steps, the respiratory rate determined by the radar sensor was compared to the value received from the 3D time-of-flight camera. The method was validated against our gold standard: a self-developed neonatal simulation system which can simulate different breathing patterns. In this paper, we show that we are the first to determine the respiratory rate by evaluating the data of an interferometric microwave radar sensor and a ToF camera synchronously. Our system delivers very precise breaths per minute (BPM) values within the norm range of 20–60 BPM with a maximum difference of 3 BPM (for the ToF camera itself at 30 BPM in normal mode). Especially in lower respiratory rate regions, i.e., 5 and 10 BPM, the synchronous evaluation is required to compensate the drawbacks of the ToF camera. In the norm range, the ToF camera performs slightly better than the radar sensor.

Noncontact Respiratory Monitoring Using Depth Sensing Cameras: A Review of Current Literature

There is considerable interest in the noncontact monitoring of patients as it allows for reduced restriction of patients, the avoidance of single-use consumables and less patient-clinician contact and hence the reduction of the spread of disease. A technology that has come to the fore for noncontact respiratory monitoring is that based on depth sensing camera systems. This has great potential for the monitoring of a range of respiratory information including the provision of a respiratory waveform, the calculation of respiratory rate and tidal volume (and hence minute volume). Respiratory patterns and apneas can also be observed in the signal. Here we review the ability of this method to provide accurate and clinically useful respiratory information.

Advancements in Methods and Camera-Based Sensors for the Quantification of Respiration

Assessment of respiratory function allows early detection of potential disorders in the respiratory system and provides useful information for medical management. There is a wide range of applications for breathing assessment, from measurement systems in a clinical environment to applications involving athletes. Many studies on pulmonary function testing systems and breath monitoring have been conducted over the past few decades, and their results have the potential to broadly impact clinical practice. However, most of these works require physical contact with the patient to produce accurate and reliable measures of the respiratory function. There is still a significant shortcoming of non-contact measuring systems in their ability to fit into the clinical environment. The purpose of this paper is to provide a review of the current advances and systems in respiratory function assessment, particularly camera-based systems. A classification of the applicable research works is presented according to their techniques and recorded/quantified respiration parameters. In addition, the current solutions are discussed with regards to their direct applicability in different settings, such as clinical or home settings, highlighting their specific strengths and limitations in the different environments.

Correlated Skin Surface and Tumor Motion Modeling for Treatment Planning in Robotic Radiosurgery

In robotic radiosurgery, motion tracking is crucial for accurate treatment planning of tumor inside the thoracic or abdominal cavity. Currently, motion characterization for respiration tracking mainly focuses on markers that are placed on the surface of human chest. Nevertheless, limited markers are not capable of expressing the comprehensive motion feature of the human chest and abdomen. In this paper, we proposed a method of respiratory motion characterization based on the voxel modeling of the thoracoabdominal torso. Point cloud data from depth cameras were used to achieve three-dimensional modeling of the chest and abdomen surface during respiration, and a dimensionality reduction algorithm was proposed to extract respiratory features from the established voxel model. Finally, experimental results including the accuracy of voxel model and correlation coefficient were compared to validate the feasibility of the proposed method, which provides enhanced accuracy of target motion correlation than traditional methods that utilized external markers.

Automatic non-contact monitoring of the respiratory rate of neonates using a structured light camera

This paper introduces an automatic non-contact monitoring method for measuring the respiratory rate of neonates using a structured light camera. The current monitoring bears several issues causing pressure marks, skin irritations and eczema. A structured light camera provides distance data. Our non-contact approach detects the thorax area automatically using a plane segmentation and calculates the respiratory rate from the movement of the thorax. Our method was tested and validated using the baby simulator SimBaby by Laerdal. We used different breathing rates corresponding to preterm neonates, mature neonates and babies aged up to nine months as well as two different breathing modes with differing breathing strokes. Furthermore, measurements were taken of two positions: the baby lying on its back and on its stomach.

Towards Breathing as a Sensing Modality in Depth-Based Activity Recognition

Depth imaging has, through recent technological advances, become ubiquitous as products become smaller, more affordable, and more precise. Depth cameras have also emerged as a promising modality for activity recognition as they allow detection of users' body joints and postures. Increased resolutions have now enabled a novel use of depth cameras that facilitate more fine-grained activity descriptors: The remote detection of a person's breathing by picking up the small distance changes from the user's chest over time. We propose in this work a novel method to model chest elevation to robustly monitor a user's respiration, whenever users are sitting or standing, and facing the camera. The method is robust to users occasionally blocking their torso region and is able to provide meaningful breathing features to allow classification in activity recognition tasks. We illustrate that with this method, with specific activities such as paced-breathing meditating, performing breathing exercises, or post-exercise recovery, our model delivers a breathing accuracy that matches that of a commercial respiration chest monitor belt. Results show that the breathing rate can be detected with our method at an accuracy of 92 to 97% from a distance of two metres, outperforming state-of-the-art depth imagining methods especially for non-sedentary persons, and allowing separation of activities in respiration-derived features space.

respiTrack: Patient-specific real-time respiratory tumor motion prediction using magnetic tracking

Purpose

An intraoperative real-time respiratory tumor motion prediction system with magnetic tracking technology is presented. Based on respiratory movements in different body regions, it provides patient and single/multiple tumor-specific prediction that facilitates the guiding of treatments.

Methods

A custom-built phantom patient model replicates the respiratory cycles similar to a human body, while the custom-built sensor holder concept is applied on the patient’s surface to find optimum sensor number and their best possible placement locations to use in real-time surgical navigation and motion prediction of internal tumors. Automatic marker localization applied to patient’s 4D-CT data, feature selection and Gaussian process regression algorithms enable off-line prediction in the preoperative phase to increase the accuracy of real-time prediction.

Results

Two evaluation methods with three different registration patterns (at fully/half inhaled and fully exhaled positions) were used quantitatively at all internal target positions in phantom: The statical method evaluates the accuracy by stopping simulated breathing and dynamic with continued breathing patterns. The overall root mean square error (RMS) for both methods was between \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$0.32\pm 0.06~\hbox {mm}$$\end{document}0.32±0.06mm and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$3.71\pm 0.79~\hbox {mm}$$\end{document}3.71±0.79mm. The overall registration RMS error was \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$0.6\pm 0.4~\hbox {mm}$$\end{document}0.6±0.4mm. The best prediction errors were observed by registrations at half inhaled positions with minimum \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$0.27\pm 0.02~\hbox {mm}$$\end{document}0.27±0.02mm, maximum \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$2.90\pm 0.72~\hbox {mm}$$\end{document}2.90±0.72mm. The resulting accuracy satisfies most radiotherapy treatments or surgeries, e.g., for lung, liver, prostate and spine.

Conclusion

The built system is proposed to predict respiratory motions of internal structures in the body while the patient is breathing freely during treatment. The custom-built sensor holders are compatible with magnetic tracking. Our presented approach reduces known technological and human limitations of commonly used methods for physicians and patients.

Physiological Validation of an Airborne Ultrasound Based Surface Motion Camera for a Contactless Characterization of Breathing Pattern in Humans

Characterizing the breathing pattern in naturally breathing humans brings important information on respiratory mechanics, respiratory muscle, and breathing control. However, measuring breathing modifies breathing (observer effect) through the effects of instrumentation and awareness: measuring human breathing under true ecological conditions is currently impossible. This study tested the hypothesis that non-contact vibrometry using airborne ultrasound (SONAR) could measure breathing movements in a contactless and invisible manner. Thus, first, we evaluated the validity of SONAR measurements by testing their interchangeability with pneumotachograph (PNT) measurements obtained at the same time. We also aimed at evaluating the observer effect by comparing breathing variability obtained by SONAR versus SONAR-PNT measurements. Twenty-three healthy subjects (12 men and 11 women; mean age 33 years - range: 20-54) were studied during resting breathing while sitting on a chair. Breathing activity was described in terms of ventilatory flow measured using a PNT and, either simultaneously or sequentially, with a SONAR device measuring the velocity of the surface motion of the chest wall. SONAR was focused either anteriorly on the xiphoid process or posteriorly on the lower part of the costal margin. Discrete ventilatory temporal and volume variables and their coefficients of variability were calculated from the flow signal (PNT) and the velocity signal (SONAR) and tested for interchangeability (Passing-Bablok regression). Tidal volume (VT) and displacement were linearly related. Breathing frequency (BF), total cycle time (TT), inspiratory time (TI), and expiratory time (TE) met interchangeability criteria. Their coefficients of variation were not statistically significantly different with PNT and SONAR-only. This was true for both the anterior and the posterior SONAR measurements. Non-contact vibrometry using airborne ultrasound is a valid tool for measuring resting breathing pattern.

3-D Microvascular Imaging Using High Frame Rate Ultrasound and ASAP Without Contrast Agents: Development and Initial In Vivo Evaluation on Nontumor and Tumor Models

Three-dimensional imaging is valuable to noninvasively assess angiogenesis given the complex 3-D architecture of vascular networks. The emergence of high frame rate (HFR) ultrasound, which can produce thousands of images per second, has inspired novel signal processing techniques and their applications in structural and functional imaging of blood vessels. Although highly sensitive vascular mapping has been demonstrated using ultrafast Doppler, the detectability of microvasculature from the background noise may be hindered by the low signal-to-noise ratio (SNR) particularly in the deeper region and without the use of contrast agents. We have recently demonstrated a coherence-based technique, acoustic subaperture imaging (ASAP), for super-contrast vascular imaging and illustrated the contrast improvement using HFR contrast-enhanced ultrasound. In this work, we provide a feasibility study for microvascular imaging using ASAP without contrast agents, and extend its capability from 2-D to volumetric vascular mapping. Using an ultrasound research system and a preclinical probe, we demonstrated the improved visibility of microvascular mapping using ASAP in comparison to ultrafast power Doppler (PD) on a mouse kidney, liver, and tumor without contrast agent injection. The SNR of ASAP images improves in average by 10 dB when compared to PD. In addition, directional velocity mappings were also demonstrated by combining ASAP with the phase information extracted from lag-1 autocorrelation. The 3-D vascular and velocity mapping of the mouse kidney, liver, and tumor were demonstrated by stacking the ASAP images acquired using 2-D ultrasound imaging and a trigger-controlled linear translation stage. The 3-D results depicted clear microvasculature morphologies and functional information in terms of flow direction and velocity in two nontumor models and a tumor model. In conclusion, we have demonstrated a new 3-D in vivo ultrasound microvascular imaging technique with significantly improved SNR over existing ultrafast Doppler.

Development of a robust and cost-effective 3D respiratory motion monitoring system using the kinect device: Accuracy comparison with the conventional stereovision navigation system

BACKGROUND AND OBJECTIVE

To develop and validate a robust and cost-effective 3D respiratory monitoring system based on a Kinect device with a custom-made simple marker.

METHODS

A 3D respiratory monitoring system comprising the simple marker and the Microsoft Kinect v2 device was developed. The marker was designed for simple and robust detection, and the tracking algorithm was developed using the depth, RGB, and infra-red images acquired from the Kinect sensor. A Kalman filter was used to suppress movement noises. The major movements of the marker attached to the four different locations of body surface were determined from the initially collected tracking points of the marker while breathing. The signal level of respiratory motion with the tracking point was estimated along the major direction vector. The accuracy of the results was evaluated through a comparison with those of the conventional stereovision navigation system (NDI Polaris Spectra).

RESULTS

Sixteen normal volunteers were enrolled to evaluate the accuracy of this system. The correlation coefficients between the respiratory motion signal from the Kinect device and conventional navigation system ranged from 0.970 to 0.999 and from 0.837 to 0.995 at the abdominal and thoracic surfaces, respectively. The respiratory motion signal from this system was obtained at 27-30 frames/s.

CONCLUSIONS

This system with the Kinect v2 device and simple marker could be used for cost-effective, robust and accurate 3D respiratory motion monitoring. In addition, this system is as reliable for respiratory motion signal generation and as practically useful as the conventional stereovision navigation system and is less sensitive to patient posture.

[Development of Monitoring Method of Respiratory Waveform in Thoracicoabdominal Part Using Web Camera]

Countermeasures against respiratory movement are important for tumors of thorax and abdomen in stereotactic body radiation therapy. In the present paper, a web-camera-based-respiratory monitoring method without contact with patient's body was proposed for respiratory study. Thoracic and abdominal motion images were taken by a web camera, and were analyzed using simple image-processing techniques for obtaining respiratory waveforms. Four motion images with different respiration rate were obtained from resusci anne simulator. Respiration waveforms were estimated from the moving images by the proposed method, and were compared with respiration waveforms obtained by the conventional respiratory monitoring device. That was found to have a strong correlation. In addition, the two waveforms were similar in Bland-Altman method comparison. The proposed method can provide non-contact, non-invasive, simple, and realistic respiratory monitoring system for radiotherapy.