{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:18:43Z","timestamp":1786976323855,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the feasibility of using the diaphragm as a surrogate for liver targets during MDTT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Diaphragm as surrogate for markers: a dome\u2010shaped phantom with implanted markers was fabricated and underwent dual\u2010orthogonal fluoroscopy sequences on the Vero4DRT linac. Ten patients participated in an IRB\u2010approved, feasibility study to assess the MDTT workflow. All images were analyzed using an in\u2010house program to back\u2010project the diaphragm\/markers position to the isocenter plane. ExacTrac imager log files were analyzed. Diaphragm as tracking structure for MDTT: The phantom \u201cdiaphragm\u201d was contoured as a markerless tracking structure (MTS) and exported to Vero4DRT\/ExacTrac. A single field plan was delivered to the phantom film plane under static and MDTT conditions. In the patient study, the diaphragm tracking structure was contoured on CT breath\u2010hold\u2010exhale datasets. The MDTT workflow was applied until just prior to MV beam\u2010on.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Diaphragm as surrogate for markers: phantom data confirmed the in\u2010house 3D back\u2010projection program was functioning as intended. In patients, the diaphragm\/marker relative positions had a mean\u00a0\u00b1\u00a0RMS difference of 0.70\u00a0\u00b1\u00a00.89, 1.08\u00a0\u00b1\u00a01.26, and 0.96\u00a0\u00b1\u00a01.06\u00a0mm in ML, SI, and AP directions. Diaphragm as tracking structure for MDTT: Building a respiratory\u2010correlation model using the diaphragm as surrogate for the implanted markers was successful in phantom\/patients. During the tracking verification imaging step, the phantom mean\u00a0\u00b1\u00a0SD difference between the image\u2010detected and predicted \u201cdiaphragm\u201d position was 0.52\u00a0\u00b1\u00a00.18\u00a0mm. The 2D film gamma (2%\/2\u00a0mm) comparison (static to MDTT deliveries) was 98.2%. In patients, the mean difference between the image\u2010detected and predicted diaphragm position was 2.02\u00a0\u00b1\u00a00.92\u00a0mm. The planning target margin contribution from MDTT diaphragm tracking is 2.2, 5.0, and 4.7\u00a0mm in the ML, SI, and AP directions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In phantom\/patients, the diaphragm motion correlated well with markers\u2019 motion and could be used as a surrogate. MDTT workflows using the diaphragm as the MTS is feasible using the Vero4DRT linac and could replace the need for implanted markers for liver radiotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.14161","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T05:05:26Z","timestamp":1696395926000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Markerless dynamic tumor tracking (MDTT) radiotherapy using diaphragm as a surrogate for liver targets"],"prefix":"10.1002","volume":"25","author":[{"given":"Maryam","family":"Rostamzadeh","sequence":"first","affiliation":[{"name":"Department of Physics and Astronomy University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Thomas","sequence":"additional","affiliation":[{"name":"Medical Physics Department BC Cancer\u2010Vancouver  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Laure","family":"Camborde","sequence":"additional","affiliation":[{"name":"Medical Physics Department BC Cancer\u2010Vancouver  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Karan","sequence":"additional","affiliation":[{"name":"Medical Physics Department BC Cancer\u2010Vancouver  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Liu","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department BC Cancer\u2010Vancouver  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Ma","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department BC Cancer\u2010Vancouver  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ante","family":"Mestrovic","sequence":"additional","affiliation":[{"name":"Medical Physics Department BC Cancer\u2010Vancouver  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradford","family":"Gill","sequence":"additional","affiliation":[{"name":"Medical Physics Department BC Cancer\u2010Vancouver  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Tai","sequence":"additional","affiliation":[{"name":"Radiation Therapy Department BC Cancer\u2010Vancouver  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alanah","family":"Bergman","sequence":"additional","affiliation":[{"name":"Medical Physics Department BC Cancer\u2010Vancouver  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/jmp.JMP_22_17"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2349696"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2014.07.028"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0167\u20108140(19)33182\u20102"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12292"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3020593"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2018.10.021"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2020.09.008"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.12.041"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.08.031"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.04.044"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.07.289"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.05.017"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.08.003"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12978"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1088\/2057\u20101976\/ac1fa5"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.04.038"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2905355"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.10.036"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/56\/17\/001"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/13645706.2019.1663217"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13194838"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.7785\/tcrt.2012.500378"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.12.026"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2007.04.001"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u2010717X\u20107\u2010102"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2021.01.010"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.zemedi.2019.10.003"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010057135"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15418"},{"key":"e_1_2_9_32_1","first-page":"4661","article-title":"Markerless dynamic tumour tracking: assessing soft\u2010tissue anatomical surrogates for liver cancer on the Vero4DRT radiotherapy linear accelerator","author":"Rostamzadeh M","year":"2021","journal-title":"MedPhys"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.930139"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2016.06.2191"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13566-018-0358-3"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13738"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010018\u20101180\u20101"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2012.12.015"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4794506"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2723878"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2009.07.011"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4754592"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360\u20103016(01)02805\u2010X"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4817236"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2011.01.015"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.598248"},{"issue":"879","key":"e_1_2_9_47_1","first-page":"294","article-title":"ICRU Report 62: Prescribing, Recording and Reporting Photon Beam Therapy","volume":"74","author":"Wambersie ALT","year":"2001","journal-title":"Br J Radiol"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360\u20103016(00)00518\u20106"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semradonc.2003.10.003"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2020.02.001"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(19)33288-8"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.14161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T08:51:37Z","timestamp":1707727897000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.14161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,3]]},"references-count":50,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/acm2.14161"],"URL":"https:\/\/doi.org\/10.1002\/acm2.14161","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,3]]},"assertion":[{"value":"2023-02-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14161"}}