Estimating soft tissue thickness from light-tissue interactions––a simulation study

Immobilization and marker-based motion tracking in radiation therapy often cause decreased patient comfort. However, the more comfortable alternative of optical surface tracking is highly inaccurate due to missing point-to-point correspondences between subsequent point clouds as well as elastic deformation of soft tissue. In this study, we present a proof of concept for measuring subcutaneous features with a laser scanner setup focusing on the skin thickness as additional input for high accuracy optical surface tracking. Using Monte-Carlo simulations for multi-layered tissue, we show that informative features can be extracted from the simulated tissue reflection by integrating intensities within concentric ROIs around the laser spot center. Training a regression model with a simulated data set identifies patterns that allow for predicting skin thickness with a root mean square error of down to 18 µm. Different approaches to compensate for varying observation angles were shown to yield errors still below 90 µm. Finally, this initial study provides a very promising proof of concept and encourages research towards a practical prototype.