{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:28:38Z","timestamp":1769992118796,"version":"3.49.0"},"reference-count":36,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Image-guided radiotherapy supported by surface guidance can help to track lower lung lesions\u2019 respiratory motion while reducing a patient\u2019s exposure to ionizing radiation. However, it is not always clear how the skin\u2019s respiratory motion magnitude and its correlation with the lung lesion\u2019s respiratory motion vary between different skin regions of interest (ROI). Four-dimensional computed tomography (4DCT) images provide information on both the skin and lung respiratory motion and are routinely acquired for the purpose of treatment planning in our institution. An analysis of 4DCT images for 57 patients treated in our institution has been conducted to provide information on the respiratory motion magnitudes of nine skin ROIs of the torso, a tracking structure (TS) representing a lower lung lobe lesion, as well as the respiratory motion correlations between the nine ROIs and the TS. The effects of gender and the adipose tissue volume and distribution on these correlations and magnitudes have been analyzed. Significant differences between the ROIs in both the respiratory motion magnitudes and their correlations with the TS have been detected. An overall negative correlation between the ROI respiratory magnitudes and the adipose tissue has been detected for ROIs with rib cage support. A weak to moderate negative correlation between the adipose tissue volume and ROI-to-TS respiratory correlations has been detected for upper thorax ROIs. The respiratory magnitudes in regions without rib support tend to be larger for men than for women, but no differences in the ROI-to-TS correlation between sexes have been detected. The described findings should be considered when choosing skin surrogates for lower lung lesion motion management.<\/jats:p>","DOI":"10.3390\/cancers16132358","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T08:57:50Z","timestamp":1719478670000},"page":"2358","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Optimizing Choice of Skin Surrogates for Surface-Guided Stereotactic Body Radiotherapy of Lung Lesions Using Four-Dimensional Computed Tomography"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2338-8119","authenticated-orcid":false,"given":"Vanda","family":"Leipold","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"Specialty Hospital Radiochirurgia Zagreb, 10431 Sveta Nedelja, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana","family":"Aleri\u0107","sequence":"additional","affiliation":[{"name":"Specialty Hospital Radiochirurgia Zagreb, 10431 Sveta Nedelja, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6362-473X","authenticated-orcid":false,"given":"Mihaela","family":"Mlinari\u0107","sequence":"additional","affiliation":[{"name":"Specialty Hospital Radiochirurgia Zagreb, 10431 Sveta Nedelja, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domagoj","family":"Kosmina","sequence":"additional","affiliation":[{"name":"Specialty Hospital Radiochirurgia Zagreb, 10431 Sveta Nedelja, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran","family":"Stani\u0107","sequence":"additional","affiliation":[{"name":"Bitwise Solutions d.o.o., 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6707-4317","authenticated-orcid":false,"given":"Mladen","family":"Kasaba\u0161i\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damir","family":"\u0160timac","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9451-1762","authenticated-orcid":false,"given":"Hrvoje","family":"Kau\u010di\u0107","sequence":"additional","affiliation":[{"name":"Specialty Hospital Radiochirurgia Zagreb, 10431 Sveta Nedelja, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Ursi","sequence":"additional","affiliation":[{"name":"Specialty Hospital Radiochirurgia Zagreb, 10431 Sveta Nedelja, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla","family":"Schwarz","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Nikoli\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"Specialty Hospital Radiochirurgia Zagreb, 10431 Sveta Nedelja, Croatia"},{"name":"School of Medicine, University of Mostar, 88000 Mostar, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Klapan","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine and Health Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragan","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"Specialty Hospital Radiochirurgia Zagreb, 10431 Sveta Nedelja, Croatia"},{"name":"Faculty of Medicine, Juraj Dobrila University of Pula, 52100 Pula, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1001\/jamaoncol.2023.3495","article-title":"Individualized Stereotactic Ablative Radiotherapy for Lung Tumors the iSABR Phase 2 Nonrandomized Controlled Trial","volume":"9","author":"Gensheimer","year":"2023","journal-title":"JAMA Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3035","DOI":"10.3892\/ol.2017.6511","article-title":"Lung Cancer Requires Multidisciplinary Treatment to Improve Patient Survival: A Case Report","volume":"14","author":"Pezzuto","year":"2017","journal-title":"Oncol. 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