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Session: Respiratory Motion Management Systems [Return to Session]

Respiratory Motion Management Systems

C Peeler1*, K Kvasnica2*, S Mutic3*, P Barry4*, B Waghorn5*, B Lu6*, (1) UT MD Anderson Cancer Center, Houston, TX, (2) Accuray, (3) Varian Medical Systems, Creve Coeur, MO, (4) Elekta, Inc., Atlanta, GA, (5) Vision RT Ltd, Alpharetta, GA, (6) University of Florida, Gainesville, FL


MO-PinS-INV1-0 (Monday, 7/11/2022) 1:45 PM - 3:45 PM [Eastern Time (GMT-4)]

Innovation Room 1

A key factor that must be considered for the accurate delivery of radiation therapy is the motion of target volumes and organs at risk (OAR) due to respiration. This motion must be accounted for during all components of the radiation therapy process, including simulation, treatment planning, and treatment delivery, in order to ensure that the planned dose is ultimately translated into delivered dose. A great number of tools and techniques have been developed for the purpose of quantifying respiratory motion.

At treatment simulation, respiratory motion can be quantified with techniques such as 4D computed tomography or minimized using breath-hold techniques. The motion management decisions made during simulation then determine the strategies used during treatment planning for target and OAR delineation and margin selection. Daily patient alignment at treatment will further depend on the motion management decisions made earlier in the process with treatment delivered under free-breathing or breath hold techniques.

Modern systems for quantifying respiratory motion employ a variety of technologies which often rely on the tracking of markers or surrogates. Tracking systems may be based on external infrared markers, internal fiducials, internal radiofrequency beacons, and optical surface guidance among other technologies. Many of these techniques can find use in both free-breathing and breath-hold simulation and treatment strategies. All systems have inherent advantages and disadvantages and the best solution will be different for each clinic.

This lecture will highlight the impact of respiratory motion on the delivery of radiation therapy and the need for mitigation strategies to allow for accurate treatment delivery. It will furthermore provide an overview of the technologies that are employed clinically for the delivery of radiation therapy in the presence of respiratory motion.

Learning Objectives:
1. Understand the impact of respiratory motion on radiation treatment planning and delivery
2. Understand the different tools and techniques available to manage respiratory motion in radiation therapy
3. Understand how respiratory motion management tools are implemented in the clinic



Target Localization, Respiration, Organ Motion


TH- RT Interfraction Motion Management: General (most aspects)

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