{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T13:17:30Z","timestamp":1782739050481,"version":"3.54.5"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"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":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The Xsight lung tracking system (XLTS) utilizes an advanced image processing algorithm to precisely identify the position of a tumor and determine its location in orthogonal x\u2010ray images, instead of finding fiducials, thereby minimizing the risk of fiducial insertion\u2010related side effects. To assess and gauge the effectiveness of CyberKnife Synchrony in treating liver tumors located in close proximity to or within the diaphragm, we employed the Xsight diaphragm tracking system (XDTS), which was based on the XLTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We looked back at the treatment logs of 11 patients (8\/11 [XDTS], 3\/11 [Fiducial\u2010based Target Tracking System\u2010FTTS]) who had liver tumors in close proximity to or within the diaphragm. And the results are compared with the patients who undergo the treatment of FTTS. The breathing data information was calculated as a rolling average to reduce the effect of irregular breathing. We tested the tracking accuracy with a dynamic phantom (18023\u2010A) on the basis of patient\u2010specific respiratory curve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average values for the XDTS and FTTS correlation errors were 1.38\u00a0\u00b1\u00a00.65\u00a0 versus 1.50\u00a0\u00b1\u00a00.26\u00a0mm (superior\u2010inferior), 1.28\u00a0\u00b1\u00a00.48\u00a0 versus 0.40\u00a0\u00b1\u00a00.09\u00a0mm (left\u2010right), and 0.96\u00a0\u00b1\u00a00.32\u00a0 versus 0.47\u00a0\u00b1\u00a00.10\u00a0mm(anterior\u2010posterior), respectively. The prediction errors for two methods of 0.65\u00a0\u00b1\u00a00.16\u00a0 versus 5.48\u00a0\u00b1\u00a03.33\u00a0mm in the S\u2010I direction, 0.34\u00a0\u00b1\u00a00.10\u00a0 versus 1.41\u00a0\u00b1\u00a00.76\u00a0mm in the A\u2010P direction, and 0.22\u00a0\u00b1\u00a00.072\u00a0 versus 1.22\u00a0\u00b1\u00a00.48\u00a0mm in the L\u2010R direction. The coverage rate of FTTS slightly less than that of XDTS, such as 96.53\u00a0\u00b1\u00a08.19% (FTTS) versus 98.03\u00a0\u00b1\u00a01.54 (XDTS). The prediction error, the motion amplitude, and the variation of the respiratory center phase were strongly related to each other. Especially, the higher the amplitude and the variation, the higher the prediction error.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The diaphragm has the potential to serve as an alternative to gold fiducial markers for detecting liver tumors in close proximity or within it. We also found that we needed to reduce the motion amplitude and train the respiration of the patients during liver radiotherapy, as well as control and evaluate their breathing.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.14341","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T05:44:37Z","timestamp":1713246277000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Novel utilization and quantification of Xsight diaphragm tracking for respiratory motion compensation in Cyberknife Synchrony treatment of liver tumors"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5586-7600","authenticated-orcid":false,"given":"Jianping","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Fujian Medical University Union Hospital  Fuzhou China"},{"name":"Fujian Medical University Union Clinical Medicine College Fujian 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