Monitoring Respiratory Motion during VMAT Treatment Delivery Using Ultra-Wideband Radar.

The goal of this paper is to evaluate the potential of a low-cost, ultra-wideband radar system for detecting and monitoring respiratory motion during radiation therapy treatment delivery. Radar signals from breathing motion patterns simulated using a respiratory motion phantom were captured during volumetric modulated arc therapy (VMAT) delivery. Gantry motion causes strong interference affecting the quality of the extracted respiration motion signal. We developed an artificial neural network (ANN) model for recovering the breathing motion patterns. Next, automated classification into four classes of breathing amplitudes is performed, including no breathing, breath hold, free breathing and deep inspiration. Breathing motion patterns extracted from the radar signal are in excellent agreement with the reference data recorded by the respiratory motion phantom. The classification accuracy of simulated deep inspiration breath hold breathing was 94% under the worst case interference from gantry motion and linac operation. Ultra-wideband radar systems can achieve accurate breathing rate estimation in real-time during dynamic radiation delivery. This technology serves as a viable alternative to motion detection and respiratory gating systems based on surface detection, and is well-suited to dynamic radiation treatment techniques. Novelties of this work include detection of the breathing signal using radar during strong interference from simultaneous gantry motion, and using ANN to perform adaptive signal processing to recover breathing signal from large interference signals in real time.