ArticleJournal of applied clinical medical physics2021
Implementation of free breathing respiratory amplitude-gated treatments.
Article in Journal of applied clinical medical physics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- A glimpse into the CyberKnife robotic radiosurgery system: technical specifications and developments during thirty years.Frontiers in oncology · 2026Review
- Dosimetric and treatment efficiency comparison of lung SBRT using three different motion management strategies.Clinical and translational radiation oncology · 2026Article
- Impact of different respiratory gating methods on target delineation and a radiotherapy plan for solitary pulmonary tumors.Cancer medicine · 2024Article
- Explicitly encoding the cyclic nature of breathing signal allows for accurate breathing motion prediction in radiotherapy with minimal training data.Physics and imaging in radiation oncology · 2024Article
- Accuracy of four models and update strategies to estimate liver tumor motion from external respiratory motion.Frontiers in oncology · 2024Article
- Adoption of respiratory motion management in radiation therapy.Physics and imaging in radiation oncology · 2022Article
- A standardized workflow for respiratory-gated motion management decision-making.Journal of applied clinical medical physics · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to provide guidance in developing and implementing a process for the accurate delivery of free breathing respiratory amplitude-gated treatments.
methodsA phase-based 4DCT scan is acquired at time of simulation and motion is evaluated to determine the exhale phases that minimize respiratory motion to an acceptable level. A phase subset average CT is then generated for treatment planning and a tracking structure is contoured to indicate the location of the target or a suitable surrogate over the planning phases. Prior to treatment delivery, a 4DCBCT is acquired and a phase subset average is created to coincide with the planning phases for an initial match to the planning CT. Fluoroscopic imaging is then used to set amplitude gate thresholds corresponding to when the target or surrogate is in the tracking structure. The final imaging prior to treatment is an amplitude-gated CBCT to verify both the amplitude gate thresholds and patient positioning. An amplitude-gated treatment is then delivered. This technique was commissioned using an in-house lung motion phantom and film measurements of a simple two-field 3D plan.
resultsThe accuracy of 4DCBCT motion and target position measurements were validated relative to 4DCT imaging. End to end testing showed strong agreement between planned and film measured dose distributions. Robustness to interuser variability and changes in respiratory motion were demonstrated through film measurements.
conclusionsThe developed workflow utilizes 4DCBCT, respiratory-correlated fluoroscopy, and gated CBCT imaging in an efficient and sequential process to ensure the accurate delivery of free breathing respiratory-gated treatments.
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