This study applied an ultrasound image tracking algorithm (UITA) for tracking respiration and developed a 2D dose distribution simulation program (DDSP) for simulating a dose distribution map. We evaluated the feasibility of a 2D respiratory motion simulation system combined with the UITA during radiotherapy for tracking respiration. The recorded respiration signals were input to the DDSP to generate a simulated dose distribution map and verify the effectiveness of the Gafchromic Film EBT3 (EBT3 film) as a measured dose distribution map (MDDM), to validate the DDSP. A radiation dose was delivered to EBT3 film and the film response was quantified using the isodose area rate (IAR), average dose rate within the field (ADFR), conformity index rate (CIR), and gamma passing rate. The tracking performance was evaluated by calculating the root mean squared error (RMSE). The calculated RMSEs were 1.67–5.34 and 0.42–2.53 mm in superior–inferior and right–left directions, respectively. The ADFR was 0.93–1.21 and the IARs at 20, 50, 70, and 80% were 0.87–1.29, 0.84–1.16, 0.79–1.61, and 0.48–6.64, respectively. The CIRs at 50, 70, and 80% were 0.87–1.23, 0.84–1.29, and 0.81–4.40, respectively. The human respiration patterns exhibited a 3%/3 mm gamma passing rate of 76.56–96.94%. This study successfully used an ultrasound imaging system to capture human respiration signals and transmit them to the DDSP for simulating radiation dose distributions, thus demonstrating the feasibility of the system.
Ultrasound imaging Respiration compensating system Dose distribution simulation Real-time tracking Gafchromic EBT3 film
This is a preview of subscription content, log in to check access.
This research was supported by the Taipei Medical University Hospital under Contract USTP-NTUT-TMU-104-03. The authors express their appreciation to the Taipei Medical University Hospital, Taipei, Taiwan, for providing the financial support and facilities for this study.
Compliance with Ethical Standards
Conflict of interest
There are no conflicts of interest to be disclosed.
Purdy, J. (2004). Current ICRU definitions of volumes: limitations and future directions. Seminars in Radiation Oncology,14(1), 27–40.MathSciNetCrossRefGoogle Scholar
Shiinoki, T., Kawamura, S., Uehara, T., et al. (2016). Evaluation of a combined respiratory-gating system comprising the TrueBeam linear accelerator and a new real-time tumor-tracking radiotherapy system: A preliminary study. Journal of Applied Clinical Medical Physics,17(4), 202–213.CrossRefGoogle Scholar
Poppe, B., Djouguela, A., Blechschmidt, A., et al. (2007). Spatial resolution of 2D ionization chamber arrays for IMRT dose verification: single-detector size and sampling step width. Physics in Medicine & Biology,52(10), 2921–2935.CrossRefGoogle Scholar
Olko, P. (2010). Advantages and disadvantages of luminescence dosimetry. Radiation Measurements,45, 506–511.CrossRefGoogle Scholar
Baldock, C., De, Deene Y., Doran, S., et al. (2010). Topical review: Polymer gel dosimetry. Physics in Medicine & Biology,55(5), R1–R63.CrossRefGoogle Scholar
Sorriaux, J., Kacperek, A., Rossomme, S., et al. (2013). Evaluation of Gafchromic® EBT3 films characteristics in therapy photon, electron and proton beams. Physica Medica,29(6), 599–606.CrossRefGoogle Scholar
Wen, Ning, Siming, Lu, Kim, Jinkoo, et al. (2016). Precise film dosimetry for stereotactic radiosurgery and stereotactic body radiotherapy quality assurance using Gafchromic™ EBT3 films. Radiotherapy and Oncology,11(1), 132.CrossRefGoogle Scholar
Low, D. A., Harms, W. B., Mutic, S., & Purdy, J. A. (1998). Purdy. A technique for the quantitative evaluation of dose distributions. Medical Physics,25(5), 656–661.CrossRefGoogle Scholar
Kyriakou, E., & McKenzie, D. R. (2011). Dynamic modeling of lung tumor motion during respiration. Physics in Medicine & Biology,56(10), 2999–3013.CrossRefGoogle Scholar
Gendrin, Christelle, Furtado, Hugo, Weber, Christoph, et al. (2012). Monitoring tumor motion by real time 2D/3D registration during radiotherapy. Radiotherapy and Oncology,102–142(2), 274–280.CrossRefGoogle Scholar
Yang, J., Cai, J., Wang, H., et al. (2014). Is diaphragm motion a good surrogate for liver tumor motion? International Journal of Radiation Oncology Biology Physics,90(4), 952–958.CrossRefGoogle Scholar
Kuo, C. C., Chuang, H. C., Teng, K. T., et al. (2016). An autotuning respiration compensation system based on ultrasound image tracking. Journal of X-ray Science and Technology,24(6), 875–892.CrossRefGoogle Scholar
Cheung, Y., & Sawant, A. (2015). An externally and internally deformable, programmable lung motion phantom. Medical Physics,42(5), 2585–2593.CrossRefGoogle Scholar
Chuang, H. C., Chiou, C. Y., Tien, D. C., et al. (2012). A compensating system of respiratory motion for tumor tracking: Design and verification. Journal of X-ray Science and Technology,20(2), 161–174.Google Scholar
Chuang, H. C., Huang, D. Y., Tien, D. C., Wu, R. H., & Hsu, C. H. (2014). A respiratory compensating system: design and performance evaluation. Journal of Applied Clinical Medical Physics,15(3), 307–322.CrossRefGoogle Scholar
Fattori, G., Seregni, M., Pella, A., et al. (2016). Real-time optical tracking for motion compensated irradiation with scanned particle beams at CNAO. Nuclear Instruments and Methods in Physics Research Section A,827, 39–45.CrossRefGoogle Scholar
Chung, Jin-Beom, Kang, Sang-Won, Eom, Keun-Yong, et al. (2016). Comparison of dosimetric performance among commercial qualitey assurance systems for verifying pretreatment plans of stereotactic body radiotherapy using flattening-filter-free beams. Journal of Korean Medical Science,31(11), 1742–1748.CrossRefGoogle Scholar
Girard, F., Bouchard, H., & Lacroix, F. (2012). Reference dosimetry using radiochromic film. Journal of Applied Clinical Medical Physics,13, 3994.CrossRefGoogle Scholar
Miura, H., Ozawa, S., Hosono, F., et al. (2016). Gafchromic EBT-XD film: dosimetry characterization in high-dose, volumetric-modulated arc therapy. Journal of Applied Clinical Medical Physics,17(6), 312–322.CrossRefGoogle Scholar
Colvill, E., Booth, J., Nill, S., et al. (2016). A dosimetric comparison of real-time adaptive and non-adaptive radiotherapy: a multi-institutional study encompassing robotic, gimbaled, multileaf collimator and couch tracking. Radiotherapy and Oncology,119(1), 159–165.CrossRefGoogle Scholar
Ma, L., Herrmann, C., & Schilling, K. (2007). Modeling and prediction of lung tumor motion for robotic assisted radiotherapy. IEEE, pp. 189–194.Google Scholar
Underberg, R. W., Lagerwaard, F. J., Cuijpers, J. P., et al. (2004). Four-dimensional CT scans for treatment planning in stereotactic radiotherapy for stage I lung cancer. International Journal of Radiation Oncology Biology Physics,60(4), 1283–1290.CrossRefGoogle Scholar
Keall, P. J., Sawant, A., Cho, B., et al. (2011). Electromagnetic-Guided Dynamic Multileaf Collimator Tracking Enables Motion Management for Intensity-Modulated Arc Therapy. International Journal of Radiation Oncology Biology Physics,79(1), 312–320.CrossRefGoogle Scholar
Lens, E., Gurney-Champion, O. J., Tekelenburg, D. R., et al. (2016). Abdominal organ motion during inhalation and exhalation breath-holds: pancreatic motion at different lung volumes compared. Radiotherapy and Oncology,121(2), 268–275.CrossRefGoogle Scholar