{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:43:57Z","timestamp":1781628237187,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T00:00:00Z","timestamp":1670025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5R01CA206100"],"award-info":[{"award-number":["5R01CA206100"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To manage intra\u2010fractional motions, recent developments in tomotherapy enable a unique capability of adjusting MLC\/jaw to track the moving target based on the intra\u2010fractional motions detected by sequential monoscopic imaging. In this study, we evaluated the effectiveness of motion compensation with a realistic imaging rate for prostate stereotactic body radiotherapy (SBRT). The obtained results will guide optimizing treatment parameters and image\u2010guided radiation therapy (IGRT) in tomotherapy using this approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten retrospective prostate cases with actual prostate motion curves previously recorded through the Calypso system were used in this study. Based on the recorded peak\u2010to\u2010peak motion, these cases represented either large\u00a0(&gt;\u00a05\u00a0mm) or median (\u2264 5\u00a0mm) intra\u2010fractional prostate motions. All the cases were re\u2010planned on tomotherapy using 35\u00a0Gy\/5 fractions SBRT regimen and three different jaw settings of 1\u00a0cm static, 2.5\u00a0cm static, and 2.5\u00a0cm dynamic jaw. Two motion compensation methods were evaluated: a complete compensation that adjusted the jaw and MLC every 0.1 s (the same rate as the Calypso motion trace), and a realistic compensation that adjusted the jaw and MLC at an average imaging interval of 6 s from sequential monoscopic images. An in\u2010house 4D dose calculation software was then applied to calculate the dosimetric outcomes from the original motion\u2010free plan, the motion\u2010contaminated plan, and the two abovementioned motion\u2010compensated plans. During the process, various imaging rates were also simulated in one case with unusually large motions to quantify the impact of the KV\u2010imaging rate on the effectiveness of motion compensation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The effectiveness of motion compensation was evaluated based on the PTV coverage and OAR sparing. Without any motion\u2010compensation, the PTV coverage (PTV V100%) of patients with large prostate motions decreased remarkably to 55%\u201382% when planning with the 1\u00a0cm jaw but to a less level of 67\u201394% with the 2.5\u00a0cm jaw. In contrast, motion compensation improved the PTV coverage\u00a0(&gt;92%) when combined with the 2.5\u00a0cm jaw, but less effective, around 75%\u201394%, with the 1\u00a0cm jaw. For OAR sparing, the bladder D1cc, bladder D10cc, and rectum D1cc all increased in the motion\u2010contaminated plans. Motion compensation improved OAR sparing to the equivalent level of the original motion\u2010free plans. For patients with median prostate motion, motion\u2010induced degradation in PTV coverage was only observed when planning with the 1\u00a0cm jaw. After motion compensation, the PTV coverage improved to better than 94% for all three jaw settings. Additionally, the effectiveness of motion compensation depends on the imaging rate. Motion compensation with a typical rate of two KV images per gantry rotation effectively reduces motion\u2010induced dosimetric uncertainties. However, a higher imaging rate is recommended when planning with a 1\u00a0cm jaw for patients with large motions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results demonstrated that the performance of sequential monoscopic imaging\u2010guided motion compensation on tomotherapy depends on the amplitude of intra\u2010fractional prostate motion, the plan parameter settings, especially jaw setting, gantry rotation, and the imaging rate for motion compensation. Creating a patient\u2010specific imaging guidance protocol is essential to balance the effectiveness of motion compensation and achievable imaging rate for intra\u2010fractional motion tracking.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16112","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T05:53:36Z","timestamp":1668750816000},"page":"518-528","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sequential monoscopic image\u2010guided motion compensation in tomotherapy stereotactic body radiotherapy (SBRT) for prostate cancer"],"prefix":"10.1002","volume":"50","author":[{"given":"Lan","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Chao","sequence":"additional","affiliation":[{"name":"Accuray Incorporated 1310 Chesapeake 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