This study analyzed the liver motion characteristics of 20 patients undergoing SBRT. A large variation in motion was observed, interfractionally and intrafractionally, and that as the distance between the markers increased, the difference in the absolute range of motion also increased. This suggests that marker(s) in closest proximity to the target be used.
The GateCT™ system revealed its consistency in temporal/phase tracking but had limitations in accurately tracking the absolute abdominal positions, thus suggesting its appropriateness for phase-sorting of 4DCT rather than amplitude-sorting. In contrast, the RPM™ system demonstrated stable respiratory signal tracking in all ranges and accurately both in phase and amplitude, and is a robust system to use for both phase-sorting and amplitude-sorting techniques. The impact of the observed mean-position drift in the GateCT™ system on the resulting 4DCT image quality, in amplitude-sorting, needs further investigation.
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