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A Novel Volumetric Respiratory Surrogate Using Optical Surface Imaging

G Li

G Li1*, J Wei2 , A Rimner1 , J Mechalakos1 , (1) Memorial Sloan Kettering Cancer Center, New York, NY, (2) City College of New York, New York, NY


TH-C-17A-10 Thursday 10:15AM - 12:15PM Room: 17A

Purpose: Respiration induces motion of the entire torso because the semi-fluid internal organs are movable driven primarily by the diaphragm within the connected body cavities: thoracic, abdominal and pelvis. Therefore, surface motion of the entire torso represents all respiration-induced external motion and could serve as a more informative respiratory surrogate.

Methods: Four-dimensional optical surface (4DOS) imaging was used to monitor the entire torso as a volumetric respiratory surrogate. High speed image capture yields high spatial-resolution images at 5 frames per second using 3 ceiling-mounted stereoscopic cameras, capturing all moving surface of the torso. 4DOS images were retrospectively reconstructed. An in-house MATLAB program was designed to automatically process the surface images with 1x1mm² grid and calculate torso volume variation as a function of time with a common volume of interest defined by the torso surface, a posterior cut-plane (PCP), and 2 vertical cut-planes at superior-inferior borders. Torso volume variation during quiet breathing (<±3mmHg) represents time-resolved tidal volume (TV) since the tissues and reserved body air within the torso conserve. The spatial distribution of TV in the torso is quantified as breathing pattern (BP=ΔVthorax/TV) using the rib cage as the thorax. Two volunteers were examined performing 4 different breathing patterns, including fake breathing during breath hold.

Results: Using different PCPs at or below sagittal midline of the torso, 4DOS produces same TV (<±2%) in free-/chest-/belly-breathing, suggesting that posterior body motion is negligible. Fake breathing during breath hold shows large BP variations (e.g., -ΔVthorax=ΔVabdomen≤750cm³) but small TV changes (-6±39cm³), depicting volume conservation. Surface motion is location-dependent, suggesting intrinsic uncertainties and limited usefulness of point-fiducial surrogates.

Conclusion: The 4DOS-based respiratory surrogate produces dynamic TV and BP values, which are potentially useful in developing a more reliable tumor motion surrogate. Further study of this tidal-volume surrogate with more volunteers is on-going under an IRB-approved protocol.

Funding Support, Disclosures, and Conflict of Interest: This research is in part supported by NIH (U54CA137788/132378).

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