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Stability and Reliability of Enhanced External-Internal Motion Correlation via Dynamic Phase-Shift Corrections Over 30-min Timeframe for Respiratory-Gated Radiotherapy
To assess the stability of patient-specific phase shifts between external- and internal-respiratory motion waveforms, the reliability of enhanced external–internal correlation with phase-shift correction, and the feasibility of guiding respiratory-gated radiotherapy (RGRT) over 30 min. In this clini...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9340341/ https://www.ncbi.nlm.nih.gov/pubmed/35880289 http://dx.doi.org/10.1177/15330338221111592 |
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author | Milewski, Andrew Li, Guang |
author_facet | Milewski, Andrew Li, Guang |
author_sort | Milewski, Andrew |
collection | PubMed |
description | To assess the stability of patient-specific phase shifts between external- and internal-respiratory motion waveforms, the reliability of enhanced external–internal correlation with phase-shift correction, and the feasibility of guiding respiratory-gated radiotherapy (RGRT) over 30 min. In this clinical feasibility investigation, external bellows and internal-navigator waveforms were simultaneously and prospectively acquired along with two four-dimensional magnetic resonance imaging (4DMRI) scans (6–15 m each) with 15–20 m intervals in 10 volunteers. A bellows was placed 5 cm inferior to the xiphoid to monitor abdominal motion, and an MR navigator was used to track the diaphragmatic motion. The mean phase-domain (MPD) method was applied, which combines three individual phase-calculating methods: phase-space oval fitting, principal component analysis, and analytic signal analysis, weighted by the reciprocal of their residual errors (RE) excluding outliers (RE >2σ). The time-domain cross-correlation (TCC) analysis was applied for comparison. Dynamic phase-shift correction was performed based on the phase shift detected on the fly within two 10 s moving datasets. Simulating bellows-triggered gating, the median and 95% confidence interval for the navigator's position at beam-on/beam-off and %harm (percentage of beam-on time outside the safety margin) were calculated. Averaged across all subjects, the mean phase shifts are found indistinguishable (p > .05) between scan 1 (55˚ ± 9˚) and scan 2 (59˚ ± 11˚). Using the MPD method the averaged correlation increases from 0.56 ± 0.22 to 0.85 ± 0.11 for scan 1 and from 0.47 ± 0.30 to 0.84 ± 0.08 for scan 2. The TCC correction results in similar results. After phase-shift correction, the number of cases that were suitable for amplitude gating (with <10%harm) increased from 2 to 17 out of 20 cases. A patient-specific, stable phase-shift between the external and internal motions was observed and corrected using the MPD and TCC methods, producing long-lasting enhanced motion correlation over 30m. Phase-shift correction offers a feasible strategy for improving the accuracy of tumor-motion prediction during RGRT. |
format | Online Article Text |
id | pubmed-9340341 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-93403412022-08-02 Stability and Reliability of Enhanced External-Internal Motion Correlation via Dynamic Phase-Shift Corrections Over 30-min Timeframe for Respiratory-Gated Radiotherapy Milewski, Andrew Li, Guang Technol Cancer Res Treat Original Article To assess the stability of patient-specific phase shifts between external- and internal-respiratory motion waveforms, the reliability of enhanced external–internal correlation with phase-shift correction, and the feasibility of guiding respiratory-gated radiotherapy (RGRT) over 30 min. In this clinical feasibility investigation, external bellows and internal-navigator waveforms were simultaneously and prospectively acquired along with two four-dimensional magnetic resonance imaging (4DMRI) scans (6–15 m each) with 15–20 m intervals in 10 volunteers. A bellows was placed 5 cm inferior to the xiphoid to monitor abdominal motion, and an MR navigator was used to track the diaphragmatic motion. The mean phase-domain (MPD) method was applied, which combines three individual phase-calculating methods: phase-space oval fitting, principal component analysis, and analytic signal analysis, weighted by the reciprocal of their residual errors (RE) excluding outliers (RE >2σ). The time-domain cross-correlation (TCC) analysis was applied for comparison. Dynamic phase-shift correction was performed based on the phase shift detected on the fly within two 10 s moving datasets. Simulating bellows-triggered gating, the median and 95% confidence interval for the navigator's position at beam-on/beam-off and %harm (percentage of beam-on time outside the safety margin) were calculated. Averaged across all subjects, the mean phase shifts are found indistinguishable (p > .05) between scan 1 (55˚ ± 9˚) and scan 2 (59˚ ± 11˚). Using the MPD method the averaged correlation increases from 0.56 ± 0.22 to 0.85 ± 0.11 for scan 1 and from 0.47 ± 0.30 to 0.84 ± 0.08 for scan 2. The TCC correction results in similar results. After phase-shift correction, the number of cases that were suitable for amplitude gating (with <10%harm) increased from 2 to 17 out of 20 cases. A patient-specific, stable phase-shift between the external and internal motions was observed and corrected using the MPD and TCC methods, producing long-lasting enhanced motion correlation over 30m. Phase-shift correction offers a feasible strategy for improving the accuracy of tumor-motion prediction during RGRT. SAGE Publications 2022-07-25 /pmc/articles/PMC9340341/ /pubmed/35880289 http://dx.doi.org/10.1177/15330338221111592 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Article Milewski, Andrew Li, Guang Stability and Reliability of Enhanced External-Internal Motion Correlation via Dynamic Phase-Shift Corrections Over 30-min Timeframe for Respiratory-Gated Radiotherapy |
title | Stability and Reliability of Enhanced External-Internal Motion
Correlation via Dynamic Phase-Shift Corrections Over 30-min Timeframe for
Respiratory-Gated Radiotherapy |
title_full | Stability and Reliability of Enhanced External-Internal Motion
Correlation via Dynamic Phase-Shift Corrections Over 30-min Timeframe for
Respiratory-Gated Radiotherapy |
title_fullStr | Stability and Reliability of Enhanced External-Internal Motion
Correlation via Dynamic Phase-Shift Corrections Over 30-min Timeframe for
Respiratory-Gated Radiotherapy |
title_full_unstemmed | Stability and Reliability of Enhanced External-Internal Motion
Correlation via Dynamic Phase-Shift Corrections Over 30-min Timeframe for
Respiratory-Gated Radiotherapy |
title_short | Stability and Reliability of Enhanced External-Internal Motion
Correlation via Dynamic Phase-Shift Corrections Over 30-min Timeframe for
Respiratory-Gated Radiotherapy |
title_sort | stability and reliability of enhanced external-internal motion
correlation via dynamic phase-shift corrections over 30-min timeframe for
respiratory-gated radiotherapy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9340341/ https://www.ncbi.nlm.nih.gov/pubmed/35880289 http://dx.doi.org/10.1177/15330338221111592 |
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