title: A fluence convolution method to account for respiratory motion in three-dimensional dose calculations of the liver: a Monte Carlo study.
abstract: We describe the implementation of a fluence convolution method to account for the influence of superior-inferior (SI) respiratory induced motion on a Monte Carlo-based dose calculation of a tumor located in the liver. This method involves convolving the static fluence map with a function describing the SI motion of the liver-the motion function has been previously derived from measurements of diaphragm movement observed under fluoroscopy. Significant differences are noted between fluence-convolved and static dose distributions in an example clinical treatment plan; hot and cold spots (on the order of 25%) are observed in the fluence-convolved plan at the superior and inferior borders of the liver, respectively. This study illustrates that the fluence convolution method can be incorporated into Monte Carlo dose calculation algorithms to account for some of the effects of patient breathing during radiotherapy treatment planning, thus leading to more accurate dose calculations.
authors.affiliation: Department of Radiation Oncology, The University of Michigan, Ann Arbor, Michigan 48109-0010, USA. indrin@med.umich.edu
authors.forename: Indrin J
authors.initials: IJ
authors.lastname: Chetty
authors.forename: Mihaela
authors.initials: M
authors.lastname: Rosu
authors.forename: Neelam
authors.initials: N
authors.lastname: Tyagi
authors.forename: Lon H
authors.initials: LH
authors.lastname: Marsh
authors.forename: Daniel L
authors.initials: DL
authors.lastname: McShan
authors.forename: James M
authors.initials: JM
authors.lastname: Balter
authors.forename: Benedick A
authors.initials: BA
authors.lastname: Fraass
authors.forename: Randall K
authors.initials: RK
authors.lastname: Ten Haken
mesh_terms: D000465:Algorithms; D016477:Artifacts; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000503:physiopathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000532:radiotherapy*; D008954:Models, Biological; D015233:Models, Statistical; D009010:Monte Carlo Method; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D011874:Radiometry / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods