{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T05:50:57Z","timestamp":1774158657502,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Effective motion management is essential for accurate treatment planning, target localization and dose delivery in lung stereotactic body radiotherapy (SBRT). Lung tumors typically move 5\u201330\u00a0mm in superior\u2010inferior (SI) direction. The internal target volume (ITV) may be expanded up to 5\u00a0mm for day\u2010to\u2010day setup variations. Four\u2010dimensional cone beam computed tomography (4DCBCT), with a rotation scan time of 120 seconds, has the potential to improve on\u2010line target localization; however, its accuracy in target motion and volume measurements should be compared to four\u2010dimensional computed tomography (4DCT) with a scan time of\u00a0&lt;\u00a060 seconds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare the accuracy of 4DCT and 4DCBCT in measuring target motion and volume in a phantom programmed with both regular and patient\u2010derived irregular respiratory waveforms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A thorax phantom with a known target was imaged using 4DCT and 4DCBCT under controlled sinusoidal and irregular breathing patterns. 4DCBCT images were reconstructed using both Basic (i.e. FDK) and Advance (i.e. modified Mckinnon\u2010Bates) algorithms where the Advance algorithm subtracts re\u2010projection of\n                      <jats:italic>prior<\/jats:italic>\n                      image (using the entire un\u2010binned projections) from phase sorted projections to reduce streak artifacts. Motion amplitudes were calculated from target centroids across respiratory phases, as well as from 3DCBCT\u2010based motion blur profiles. Target volumes were assessed in average intensity projection (AIP) and maximum intensity projection (MIP), and in the reconstructed phases. Measured amplitudes were compared against programmed values, while the target volumes were compared in AIP, MIP and the phases between 4DCT and 4DCBCT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For regular motion, 4DCT demonstrated the smallest deviations from the programmed amplitudes (SI, Left\u2010right (LR) and Anterior\u2010posterior (AP) 95% confidence intervals (CI): \u22120.8 to 0.1\u00a0mm, \u22120.3 to 0.2\u00a0mm and \u22120.5 to 1.1\u00a0mm respectively). In regular motion, 4DCBCT Advance algorithm slightly underestimated the SI motion by 1\u00a0mm (SI CI: \u22121.5 to \u22120.4\u00a0mm, LR CI \u22121.4 to 1.2\u00a0mm, AP CI \u22121.2 to 0.6\u00a0mm) while the Basic algorithm provided slightly larger variability (SI CI: \u22121.1 to 0.7\u00a0mm, LR CI \u22121.1 to 0.6\u00a0mm, AP CI \u22120.9 to 1.3\u00a0mm). 3DCBCT\u2010based estimates showed higher variability across all motion directions (SI CI \u22121.7 to 1.6\u00a0mm, LR CI \u22121.9 to 1.6\u00a0mm, AP CI \u22121.6 to 1.0\u00a0mm). For irregular motion, both 4DCT and 4DCBCT Advance yielded differences from average programmed amplitude with no consistent superiority. The measured target volume showed strong agreement between 4DCT and 4DCBCT. The target volume expansion due to within\u2010phase blurring showed a very similar trend between 4DCT and 4DCBCT Advance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>4DCBCT within clinical workflow provides comparable motion and volume measurement accuracy to 4DCT. 3DCBCT estimated motion amplitude showed large differences from the programmed amplitude. 4DCBCT offers explicit and confident motion resolution, and phase\u2010dependent target volume at the time of treatment. These findings support the feasibility of integration of 4DCBCT, pending clinical validation, for image guidance in lung SBRT, especially where motion consistency between simulation and treatment is uncertain. Patient studies are needed to capture the influence of patient\u2010specific breathing irregularities such as hysteresis, baseline drift or anatomical deformation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70489","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:21:37Z","timestamp":1773012097000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative evaluation of 4DCT and 4DCBCT for motion and volume measurement accuracy in a dynamic phantom"],"prefix":"10.1002","volume":"27","author":[{"given":"Bhumika","family":"Handa","sequence":"first","affiliation":[{"name":"Medical Physics Division Department of Oncology University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2742-8432","authenticated-orcid":false,"given":"Satyapal","family":"Rathee","sequence":"additional","affiliation":[{"name":"Medical Physics Division Department of Oncology University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010016\u20100693\u20108"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20190524"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00622"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2008.02.010"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.01.155"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1531177"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1855013"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2022.06.007"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2024.100584"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.70054"},{"key":"e_1_2_9_12_1","unstructured":"Varian Medical Systems.TrueBeam Technical Reference Guide\u2014Volume 2: Imaging."},{"key":"e_1_2_9_13_1","unstructured":"Philips Healthcare.Respiratory Motion Management for CT. 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