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Evaluation of 4DCT Images with Correlation of RPM Signals to Tumor Motion for Respiratory-Gated Radiotherapy

T Lee

TK Lee*, A Ewald, T Schultz, SY Park, McLaren Cancer Institute, Flint, MI


SU-E-J-253 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose:The amplitudes of lung tumor target motion and RPM signals are different from each other. Also, RPM system does not have in-depth RPM signal analysis tool. We have developed an algorithm that analyzes RPM signals for its stability as well as correlativity to the tumor motion.

Methods:We used a Philips Big Bore CT scanner with a Varian Real-Time Position Managementâ„¢ (RPM) system attached. 4DCT images were reviewed and tumor motion amplitudes of full breathing in superior-inferior, anterior-posterior, and left-right directions were measured. RPM signals were analyzed with the algorithm developed with Matlab. Average signal period, amplitude and statistical stability of the full breathing pattern as well as the pattern around full expiration were calculated. RPM signal amplitudes were normalized to measured tumor motion amplitudes so that selected gating phases (30%-70% or 40%-60%) allow tumor motion under 5.0mm.

Results:Twelve patient cases were analyzed in this study with GTV sizes ranged from 1.0cm to 3.0cm diameter. The periods and amplitudes of RPM signal ranged from 3.1seconds to 6.5seconds and from 0.2cm to 1.7cm, respectively. RPM signals were most stable at full expiration. The standard deviation of the RPM signal peaks at full expiration was <0.11cm, and that of gated amplitudes was <0.25cm. Tumor motion amplitudes were primary in superior-inferior direction and minor (<=0.2cm) in other directions on all analyzed cases, ranged from 0.2cm to 2.5cm. The amplitudes increases with the tumor located toward the diaphragm. The gated phases were selected so that the average gated tumor motion amplitude as well as that plus deviation became under 0.5cm in superior-inferior direction.

Conclusion:We were able to determine the respiratory-gated phases in RPM signals employing measured tumor motion amplitudes as well as developed RPM signal analyzer through correlation process. The RPM signal amplitudes do not represent tumor motion because of its location.

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