{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:07:46Z","timestamp":1788365266032,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,2,25]],"date-time":"2023-02-25T00:00:00Z","timestamp":1677283200000},"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":["P30CA008748"],"award-info":[{"award-number":["P30CA008748"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P41EB028744"],"award-info":[{"award-number":["P41EB028744"]}],"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":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Gastrointestinal (GI) tract motility is one of the main sources for intra\/inter\u2010fraction variability and uncertainty in radiation therapy for abdominal targets. Models for GI motility can improve the assessment of delivered dose and contribute to the development, testing, and validation of deformable image registration (DIR) and dose\u2010accumulation algorithms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To implement GI tract motion in the 4D extended cardiac\u2010torso (XCAT) digital phantom of human anatomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Motility modes that exhibit large amplitude changes in the diameter of the GI tract and may persist over timescales comparable to online adaptive planning and radiotherapy delivery were identified based on literature research. Search criteria included amplitude changes larger than planning risk volume expansions and durations of the order of tens of minutes. The following modes were identified: peristalsis, rhythmic segmentation, high amplitude propagating contractions (HAPCs), and tonic contractions. Peristalsis and rhythmic segmentations were modeled by traveling and standing sinusoidal waves. HAPCs and tonic contractions were modeled by traveling and stationary Gaussian waves. Wave dispersion in the temporal and spatial domain was implemented by linear, exponential, and inverse power law functions. Modeling functions were applied to the control points of the nonuniform rational B\u2010spline surfaces defined in the reference XCAT library. GI motility was combined with the cardiac and respiratory motions available in the standard 4D\u2010XCAT phantom. Default model parameters were estimated based on the analysis of cine MRI acquisitions in 10 patients treated in a 1.5T MR\u2010linac.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We demonstrate the ability to generate realistic 4D multimodal images that simulate GI motility combined with respiratory and cardiac motion. All modes of motility, except tonic contractions, were observed in the analysis of our cine MRI acquisitions. Peristalsis was the most common. Default parameters estimated from cine MRI were used as initial values for simulation experiments. It is shown that in patients undergoing stereotactic body radiotherapy for abdominal targets, the effects of GI motility can be comparable or larger than the effects of respiratory motion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The digital phantom provides realistic models to aid in medical imaging and radiation therapy research. The addition of GI motility will further contribute to the development, testing, and validation of DIR and dose accumulation algorithms for MR\u2010guided radiotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16305","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T04:11:49Z","timestamp":1676952709000},"page":"3066-3075","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A model for gastrointestinal tract motility in a 4D imaging phantom of human anatomy"],"prefix":"10.1002","volume":"50","author":[{"given":"Ergys","family":"Subashi","sequence":"first","affiliation":[{"name":"Department of Medical Physics Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Segars","sequence":"additional","affiliation":[{"name":"Department of Radiology Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harini","family":"Veeraraghavan","sequence":"additional","affiliation":[{"name":"Department of Medical Physics Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Deasy","sequence":"additional","affiliation":[{"name":"Department of Medical Physics Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelam","family":"Tyagi","sequence":"additional","affiliation":[{"name":"Department of Medical Physics Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2349696"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2014.02.009"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2014.02.008"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2014.02.015"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2014.02.011"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-019-1309-x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2017.10.020"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2017.02.003"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2017.11.032"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13418"},{"key":"e_1_2_8_12_1","doi-asserted-by":"crossref","DOI":"10.1002\/acm2.13586","article-title":"Longitudinal assessment of quality assurance measurements in a 1.5 T MR\u2010linac: Part II\u2014Magnetic resonance imaging","author":"Subashi E","year":"2022","journal-title":"J Appl Clin Med Phys"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205917"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/abef42"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/abd66e"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.1996.tb00267.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(98)70155-6"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e31816b444d"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2008.01230.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-018-0030-9"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-019-0167-1"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12019"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1109\/23.775570"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00411-003-0221-8"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3480985"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/61\/2\/974"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/57\/9\/2441"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1109\/JPROC.2009.2032855"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/56\/13\/002"},{"key":"e_1_2_8_30_1","doi-asserted-by":"crossref","unstructured":"EhrleinHJ KeinkeO SchemannM.Studies on the Process of Gastric Emptying. 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