Based on the results obtained from the four groups of women in our study, the "50-50" breast is not a representative model of the breast composition.

A finite element model has been developed to investigate the effect of contact surfaces and hyperelastic material properties on the mechanical behavior of human lungs of one lung cancer patient. The three-dimensional model consists of four parts, namely the left lung, right lung, tumor in the left lung and chest wall. The interaction between the lungs and chest wall was modeled using frictionless surface-based contact. Hyperelastic material properties of the lungs are used in the model. The effect of the two parameters is investigated by tracking the tumor movement, and by comparing the analytical results to the patient bifurcation points: 45 points in each lung and 18 points around the tumor. The accuracy of the model is improved by including the contact surface and hyperelastic material properties. The average error and the standard deviation (SD) in modeling the displacement in the SI direction are reduced from 0.68 (SD = 0.34) cm in the elastic model to 0.09 (0.21) cm in the contact-hyperelastic model. Similarly, the average error (SD) of tumor location decreases from 0.71 (0.21) cm in the elastic material without contact to -0.03 (0.24) cm in the hyperelastic material with contact model.

The optimum biomechanical model with the smallest registration error is when frictionless contact model and 0.4 Poisson's ratio are applied. The overall accuracies of all bifurcation points in all 16 patients including tumor points are 1.0 +/- 0.7, 1.2 +/- 1.0, and 1.7 +/- 1.4 mm in the LR, AP, and SI directions, respectively.

This study has proposed a novel technique to manufacture deformable volumetric gel dosimeters. By comparing the doses accumulated in MORFEUS and the doses measured with the dosimeters under the condition of deformation, the study has also demonstrated the potential of using deformable gel dosimetry to experimentally validate algorithms that include deformations into dose computation. Since dose less than 200 cGy was not evaluated in this study, future investigations will focus more on low dose regions by either using bigger gel dosimeters or prescribing a lower dose to provide a more complete experimental validation of MORFEUS across a wider dose range.