title: Effect of mid-scan breathing changes on quality of 4DCT using a commercial phase-based sorting algorithm.
abstract: OBJECTIVE
  Though it is known that irregular breathing can introduce artifacts in commercial 4DCT, this has not been systematically explored. The purpose of this study is to investigate the effect of variations in basic parameters of the breathing wave on 4DCT imaging quality.
  
  
  METHODS
  A four-dimensional motion platform holding an acrylic sphere was scanned while moving in a trajectory modeled from a lung cancer patient. A bellows device was used as a respiratory surrogate, and the images were sorted by a commercial phase-based sorting algorithm. Motion during the first half of the scan was produced at a baseline trajectory with a consistent frequency and amplitude of 15 breaths per minute and 1 cm, peak to peak. The two parameters were then varied mid-scan to new frequency and amplitude values, with frequencies ranging from 7.5 to 22 bpm and amplitudes ranging from 0.5 to 1.5 cm. Image sets representing four respiratory phases were contoured. Each set was analyzed to compare centroid displacement, density homogeneity, and volumetric and geometric distortions of the imaged sphere. Undercoverage of the target ITV and overcoverage of healthy tissue was also evaluated.
  
  
  RESULTS
  Changes in amplitude of 25% or more, with or without changes in frequency, consistently caused measurable distortions in shape, position, and density of the imaged sphere. Frequency changes over 50% showed a similar trend.
  
  
  CONCLUSIONS
  This study suggests that basic breathing statistics can be used to quickly assess the quality of a 4DCT scan prior to image reconstruction. Such information can help give indication of the proper course of action when irregular breathing patterns are observed during CT scanning.
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
authors.forename: Camille E
authors.initials: CE
authors.lastname: Noel
authors.forename: Parag J
authors.initials: PJ
authors.lastname: Parikh
mesh_terms: D000465:Algorithms; D016477:Artifacts; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D009038:Motion; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*