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      Development and clinical evaluation of a simple optical method to detect and measure patient external motion

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          Abstract

          A simple and independent system to detect and measure the position of a number of points in space was devised and implemented. Its application aimed to detect patient motion during radiotherapy treatments, alert of out‐of‐tolerances motion, and record the trajectories for subsequent studies. The system obtains the 3D position of points in space, through its projections in 2D images recorded by two cameras. It tracks black dots on a white sticker placed on the surface of the moving object. The system was tested with linear displacements of a phantom, circular trajectories of a rotating disk, oscillations of an in‐house phantom, and oscillations of a 4D phantom. It was also used to track 461 trajectories of points on the surface of patients during their radiotherapy treatments. Trajectories of several points were reproduced with accuracy better than 0.3 mm in the three spatial directions. The system was able to follow periodic motion with amplitudes lower than 0.5 mm, to follow trajectories of rotating points at speeds up to 11.5 cm/s, and to track accurately the motion of a respiratory phantom. The technique has been used to track the motion of patients during radiotherapy and to analyze that motion. The method is flexible. Its installation and calibration are simple and quick. It is easy to use and can be implemented at a very affordable price. Data collection does not involve any discomfort to the patient and does not delay the treatment, so the system can be used routinely in all treatments. It has an accuracy similar to that of other, more sophisticated, commercially available systems. It is suitable to implement a gating system or any other application requiring motion detection, such as 4D CT, MRI or PET.

          PACS numbers: 87.55.N, 87.56.Da

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          Most cited references40

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          A versatile camera calibration technique for high-accuracy 3D machine vision metrology using off-the-shelf TV cameras and lenses

          R Tsai (1987)
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            Organ motion and its management.

            To compile and review data on the topic of organ motion and its management. Data were classified into three categories: (a) patient position-related organ motion, (b) interfraction organ motion, and (c) intrafraction organ motion. Data on interfraction motion of gynecological tumors, the prostate, bladder, and rectum are reviewed. Literature pertaining to the intrafraction movement of the liver, diaphragm, kidneys, pancreas, lung tumors, and prostate is compiled. Methods for managing interfraction and intrafraction organ motion in radiation therapy are also reviewed.
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              Effects of intra-fraction motion on IMRT dose delivery: statistical analysis and simulation.

              There has been some concern that organ motion, especially intra-fraction organ motion due to breathing, can negate the potential merit of intensity-modulated radiotherapy (IMRT). We wanted to find out whether this concern is justified. Specifically, we wanted to investigate whether IMRT delivery techniques with moving parts, e.g., with a multileaf collimator (MLC), are particularly sensitive to organ motion due to the interplay between organ motion and leaf motion. We also wanted to know if, and by how much, fractionation of the treatment can reduce the effects. We performed a statistical analysis and calculated the expected dose values and dose variances for volume elements of organs that move during the delivery of the IMRT. We looked at the overall influence of organ motion during the course of a fractionated treatment. A linear-quadratic model was used to consider fractionation effects. Furthermore, we developed software to simulate motion effects for IMRT delivery with an MLC, with compensators, and with a scanning beam. For the simulation we assumed a sinusoidal motion in an isocentric plane. We found that the expected dose value is independent of the treatment technique. It is just a weighted average over the path of motion of the dose distribution without motion. If the treatment is delivered in several fractions, the distribution of the dose around the expected value is close to a Gaussian. For a typical treatment with 30 fractions, the standard deviation is generally within 1% of the expected value for MLC delivery if one assumes a typical motion amplitude of 5 mm (1 cm peak to peak). The standard deviation is generally even smaller for the compensator but bigger for scanning beam delivery. For the latter it can be reduced through multiple deliveries ('paintings') of the same field. In conclusion, the main effect of organ motion in IMRT is an averaging of the dose distribution without motion over the path of the motion. This is the same as for treatments with conventional beams. Additional effects that are specific to the IMRT delivery technique appear to be relatively small, except for the scanning beam.
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                Author and article information

                Contributors
                bbarbes@unav.es
                Journal
                J Appl Clin Med Phys
                J Appl Clin Med Phys
                10.1002/(ISSN)1526-9914
                ACM2
                Journal of Applied Clinical Medical Physics
                John Wiley and Sons Inc. (Hoboken )
                1526-9914
                08 September 2015
                September 2015
                : 16
                : 5 ( doiID: 10.1002/acm2.2015.16.issue-5 )
                : 306-321
                Affiliations
                [ 1 ] Servicio de Radiofísica Clínica Universidad de Navarra Pamplona Spain
                [ 2 ] IdiSNA (Instituto de Investigación Sanitaria de Navarra) Recinto de Complejo Hospitalario de Navarra c/Irunlarrea Pamplona Spain
                [ 3 ] Tecnun Universidad de Navarra San Sebastián Spain
                [ 4 ] Departamento de Física y Matemática Aplicada Facultad de Ciencias, Universidad de Navarra Pamplona Spain
                Author notes
                [*] [* ] a Corresponding author: Benigno Barbés, Servicio de Radiofísica, Clínica Universidad de Navarra, Avda. Pío XII 36, E31008 Pamplona, Spain; phone: (+34) 948 255 400; fax: (+34) 948 296 500; email: bbarbes@ 123456unav.es

                Article
                ACM20306
                10.1120/jacmp.v16i5.5524
                5690156
                26699313
                43188f77-5580-47cb-8774-a466f4e0edc8
                © 2015 The Authors.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 March 2015
                : 22 April 2015
                Page count
                Figures: 9, Tables: 1, References: 43, Pages: 16, Words: 6722
                Categories
                Radiation Oncology Physics
                Radiation Oncology Physics
                Custom metadata
                2.0
                acm20306
                September 2015
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.2.5 mode:remove_FC converted:16.11.2017

                radiotherapy,motion,optical,gating
                radiotherapy, motion, optical, gating

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