title: An accurate method to quantify breathing-induced prostate motion for patients implanted with electromagnetic transponders.
abstract: OBJECTIVE
  To validate and apply a method for the quantification of breathing-induced prostate motion (BIPM) for patients treated with radiotherapy and implanted with electromagnetic transponders for prostate localization and tracking.
  
  
  METHODS
  For the analysis of electromagnetic transponder signal, dedicated software was developed and validated with a programmable breathing simulator phantom. The software was then applied to 1,132 radiotherapy fractions of 30 patients treated in supine position, and to a further 61 fractions of 2 patients treated in prone position.
  
  
  RESULTS
  Application of the software in phantom demonstrated reliability of the developed method in determining simulated breathing frequencies and amplitudes. For supine patients, the in vivo analysis of BIPM resulted in median (maximum) amplitudes of 0.10 mm (0.35 mm), 0.24 mm (0.66 mm), and 0.17 mm (0.61 mm) in the left-right (LR), cranio-caudal (CC), and anterior-posterior (AP) directions, respectively. Breathing frequency ranged between 7.73 and 29.43 breaths per minute. For prone patients, the ranges of the BIPM amplitudes were 0.1-0.5 mm, 0.5-1.3 mm, and 0.7-1.7 mm in the LR, CC, and AP directions, respectively.
  
  
  CONCLUSIONS
  The developed method was able to detect the BIPM with sub-millimeter accuracy. While for patients treated in supine position the BIPM represents a reduced source of treatment uncertainty, for patients treated in prone position, it can be higher than 3 mm.
authors.affiliation: Medical Physics Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.|Prostate Program Unit, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Giandini
authors.affiliation: Medical Physics Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.|Medical Physics Unit, Department of Radiotherapy, Istituto Europeo di Oncologia, Milan - Italy.|Current address: Cancer Research UK Manchester Institute, The University of Manchester, Manchester - UK.
authors.forename: Costanza M V
authors.initials: CM
authors.lastname: Panaino
authors.affiliation: Prostate Program Unit, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.|Radiation Oncology 1 Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Avuzzi
authors.affiliation: Prostate Program Unit, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.|Radiation Oncology 1 Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Morlino
authors.affiliation: Prostate Program Unit, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.|Radiation Oncology 1 Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Villa
authors.affiliation: Prostate Program Unit, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.|Radiation Oncology 1 Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Nice
authors.initials: N
authors.lastname: Bedini
authors.affiliation: Radiation Oncology 1 Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Carabelli
authors.affiliation: Radiation Oncology 1 Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Frasca
authors.affiliation: Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW - Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Romanyukha
authors.affiliation: Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW - Australia.
authors.forename: Anatoly
authors.initials: A
authors.lastname: Rosenfeld
authors.affiliation: Medical Physics Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.|Prostate Program Unit, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Pignoli
authors.affiliation: Prostate Program Unit, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.|Radiation Oncology 1 Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Valdagni
authors.affiliation: Medical Physics Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.|Prostate Program Unit, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.|Current address: Medical Physics Unit, Ente Ospedaliero Cantonale, Bellinzona - Switzerland.
authors.forename: Mauro
authors.initials: M
authors.lastname: Carrara
mesh_terms: D055590:Electromagnetic Phenomena; D006801:Humans; D008297:Male; D009038:Motion; D019047:Phantoms, Imaging; D016684:Prone Position / Q000502:physiology; D011467:Prostate / Q000503:physiopathology*; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D015203:Reproducibility of Results; D012119:Respiration