The diaphragm as an anatomic surrogate for lung tumor motion

Laura I. Cervĩo, Alvin K Y Chao, Ajay Sandhu, Steve B. Jiang

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Lung tumor motion due to respiration poses a challenge in the application of modern three-dimensional conformal radiotherapy. Direct tracking of the lung tumor during radiation therapy is very difficult without implanted fiducial markers. Indirect tracking relies on the correlation of the tumor's motion and the surrogate's motion. The present paper presents an analysis of the correlation between tumor motion and diaphragm motion in order to evaluate the potential use of diaphragm as a surrogate for tumor motion. We have analyzed the correlation between diaphragm motion and superior-inferior lung tumor motion in 32 fluoroscopic image sequences from ten lung cancer patients. A simple linear model and a more complex linear model that accounts for phase delays between the two motions have been used. Results show that the diaphragm is a good surrogate for tumor motion prediction for most patients, resulting in an average correlation factor of 0.94 and 0.98 with each model respectively. The model that accounts for delays leads to an average localization prediction error of 0.8 mm and an error at the 95% confidence level of 2.1 mm. However, for one patient studied, the correlation is much weaker compared to other patients. This indicates that, before using diaphragm for lung tumor prediction, the correlation should be examined on a patient-by-patient basis.

Original languageEnglish (US)
Pages (from-to)3529-3541
Number of pages13
JournalPhysics in Medicine and Biology
Volume54
Issue number11
DOIs
StatePublished - 2009

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Diaphragm
Lung
Neoplasms
Linear Models
Fiducial Markers
Conformal Radiotherapy
Lung Neoplasms
Respiration
Radiotherapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

The diaphragm as an anatomic surrogate for lung tumor motion. / Cervĩo, Laura I.; Chao, Alvin K Y; Sandhu, Ajay; Jiang, Steve B.

In: Physics in Medicine and Biology, Vol. 54, No. 11, 2009, p. 3529-3541.

Research output: Contribution to journalArticle

Cervĩo, Laura I. ; Chao, Alvin K Y ; Sandhu, Ajay ; Jiang, Steve B. / The diaphragm as an anatomic surrogate for lung tumor motion. In: Physics in Medicine and Biology. 2009 ; Vol. 54, No. 11. pp. 3529-3541.
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