Ultrasound (US) imaging, in contrast to other image guidance techniques, offers the distinct advantage of providing volumetric image data in real-time (4D) without using ionizing radiation. The goal of this study was to perform the first quantitative comparison of three different 4D US systems with fast matrix array probes and real-time data streaming regarding their target tracking accuracy and system latency. Sinusoidal motion of varying amplitudes and frequencies was used to simulate breathing motion with a robotic arm and a static US phantom. US volumes and robot positions were acquired online and stored for retrospective analysis. A template matching approach was used for target localization in the US data. Target motion measured in US was compared to the reference trajectory performed by the robot to determine localization accuracy and system latency. Using the robotic setup, all investigated 4D US systems could detect a moving target with sub-millimeter accuracy. However, especially high system latency increased tracking errors substantially and should be compensated with prediction algorithms for respiratory motion compensation.

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