A comparison of patient position displacements from body surface laser scanning and cone beam CT bone registrations for radiotherapy of pelvic targets, Acta Oncologica, 53:2, 268-277,
Irregular breathing may compromise the treated volume for free-breathing lung cancer patients during radiotherapy. We try to find a measure based on a breathing amplitude surrogate that can be used to select the patients who need further investigation of tumour motion to ensure that the Internal Target Volume (ITV) provides reliant coverage of the tumour. Material and methods Fourteen patients were scanned with four-dimensional computed tomography (4DCT) during freebreathing. The breathing motion was detected by a pneumatic bellows device used as a breathing amplitude surrogate. In addition to the 4DCT, a breath-hold (BH) scan and three cine CT imaging sessions were acquired. The cine images were taken at randomised intervals at a rate of 12 per minute for eight minutes to allow tumour motion determination during a typical hypo-fractionated treatment scenario. A clinical target volume (CTV) was segmented in the BH CT and propagated over all cine images and 4DCT bins. The centre-of-volume of the translated CTV (CTV COV) in the ten 4DCT bins were interconnected to define the 4DCT determined tumour trajectory (4DCT-TT). The volume of CTV inside ITV for all cine CTs was calculated and reported at the 10 th percentile (V CTV10%). The deviations between CTV COV in the cine CTs and the 4DCT-TT were calculated and reported at its 90 th percentile (d 90%). The standard deviation of the bellows amplitude peaks (SDP) and the ratio between large and normal inspirations, κ rel , were tested as surrogates for V CTV10% and d 90% .
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