Using Respiratory MotionSim

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Home > Loading Data for Analysis > Using Respiratory MotionSim

Using Respiratory MotionSim

Respiratory MotionSim is an optional module for 3DVH in the version 3.0 or higher software.
Respiratory MotionSim will allow for quantitative estimation of the potential impact resulting from
the interplay between moving tumors and/or other structures and dynamically delivered external
beam radiotherapy. It cannot be used with TomoTherapy plans.
Note: Respiratory MotionSim requires a separate license. See Options for more
information.
Refer to the following publication for more information about the algorithm details and accuracy of
Respiratory MotionSim. This publication can be downloaded from the 3DVH product page on the
Sun Nuclear Corporation web site: Motion as a perturbation: Measurement-guided dose estimates to
moving patient voxels during modulated arc deliveries1
The option to calculate Respiratory MotionSim will be enabled if 3DVH is licensed for Respiratory
MotionSim for the ArcCHECK device serial number specified in an *.acml file loaded as the
comparison dose.
The option to calculate Respiratory MotionSim will be disabled in the following scenarios:
3DVH is not licensed for Respiratory MotionSim.
3DVH is licensed for Respiratory MotionSim, but the ArcCHECK device serial number specified
in the *.acml file is not licensed for Respiratory MotionSim.
1. Vladimir Feygelman, Cassandra Stambaugh, Geoffrey Zhang, Dylan Hunt, Daniel Opp,
Theresa K. Wolf, and Benjamin E. Nelms; Motion as a perturbation: Measurement-guided dose
estimates to moving patient voxels during modulated arc deliveries, Med. Phys. 40, 021708 (2013).

2016, Sun Nuclear Corporation. All rights reserved.

Home > Loading Data for Analysis > Using Respiratory MotionSim > Load Files and Define
Trajectory

Load Files and Define Trajectory

Reference data required (minimum reference data required to enable Respiratory MotionSim): RT
Plan, RT Dose, Structure Set.
Comparison data required: Non-DICOM ArcCHECK movie file (*.acml) that was saved in the SNC

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Patient software. RT Plan and RT Dose must be calculated on the ArcCHECK phantom.
1

Load reference data and comparison data (if you will be simulating dose to moving target).

For instructions to load comparison data for an AC-PDP reconstruction, see Loading Comparison
Data for AC-PDP.
2 Enable the Save MotionSim 4D Doses check box. Note that the Save MotionSim 4D
Doses check box is only available if the loaded ArcCHECK movie lite measurement (*.acml) has a
valid MotionSim license.
Note: When Save MotionSim 4D Doses is selected, the 4D dose files will be saved in a
folder, 4D_AC_Doses_HighSens. The 4D_AC_Doses folder will be in the same directory
path as the ArcCHECK movie lite (*.acml) file.

If you save the calculated AC-PDP (FILE > Save AC-PDP Dose as DICOM RT Dose), the
MotionSim analysis can be performed at a later time by reloading the saved data.
3

Click Calculate.

4 After loading the reference and comparison data in the 3DVH main window, perform a
conventional analysis if desired.
5 Select the 4D Workspace tab and click the MotionSim toolbar button to open the MotionSim
module.
6 On the left side of the screen, click Define Anatomical Motion to open the Define Motion
Trajectory dialog box. Use the tools across the top of the dialog box to customize the motion.
a. Motion ROI drop-down list select the moving target from the current ROI structure set.
b.

Margin (mm) enter the margin for the motion; the default motion margin is 20 mm.

c. External ROI (required) select an external ROI from the current structure set. This defines the
three-dimensional envelope of voxels around the Motion ROI that will move in the same fashion as
the Motion ROI. This is used by the AC-PDP calculation and must be specified.
d. Guide ROI select a guide ROI from the currently selected motion ROI (for example, the
planning target volume or internal target volume). This structure provides a static visual guide to
help verify that the motion of the selected motion ROI is correct.

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e. Repeating (Periodic) disable the check box for a one-time motion, rather than cyclical motion.
This can be useful, for example, for motion that is not cyclical, such as organ movement due to
peristalsis.
f.

Phase Shift (sec) when simulating a single fraction, enter a value for the motion trajectory.

g. Center-of-Motion (mm) the center-of-motion computed by 3DVH based upon the entered
motion trajectory.

7 Specify the motion trajectory. At a minimum, a trajectory row must consist of a time (sec),
spatial offsets dX, dY, and dZ (mm), and rotational roll, yaw (IEC rotation), and pitch (degrees). If
any cells are blank, the blank cells will be set to 0.00 (mm or degrees) when you save or build a
motion trajectory.
Use one of the following options to define the trajectory.
Option 1: Set spatial offsets (dX, dY, and dZ) automatically by selecting a 4D structure created
by the planning system using a 4DCT
a. In the first Set by ROI column of the Trajectory table, select a structure corresponding to the first
phase of motion. The positional change values, dX, dY, and dZ, are automatically populated based
on 3DVH's computation of the center-of-mass for that phase. Repeat this process for each phase,
making sure the phases are sequentially ordered. Finally, select the same structure for the final row
as was selected for the first row to signify a return to the original position. For example, if the
trajectory starts with GTV0, it should also end at GTV0.
b. In the Time column, enter the times for each phase of the motion trajectory. For example, if you
have 10 phases in the period, each phase will be 1/10 of the period.
c. To save the trajectory file, click the Save Trajectory button on the toolbar. By default, the
trajectory file is saved in the main directory of the dataset. Enter a descriptive name and click Save.
The file is saved with a .traj extension and can be imported for reuse.
Option 2: Set spatial offsets manually

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A motion trajectory row will consist minimally of a time (sec), spatial offsets dX, dY, and dZ (mm),
and rotational roll, yaw, and pitch (degrees). If any of these columns are left blank, the blank cells
will be set to 0.00 (mm or degrees) when the trajectory is built or saved,
a. In the Trajectory table, enter the Time (sec) for the first row, usually 0 for the first row.
b. Enter the spatial offsets dX (mm), dY (mm), and dZ (mm) for the first row. If the Time is 0, the
value for each column is 0, 0, 0.
c. Repeat the step b for additional rows to complete the trajectory. If necessary, click the Add New
Row button on the toolbar to add additional rows to the table.
d. After defining the motion trajectory, you can save the file to use again. Click the Save
Trajectory button on the toolbar. By default, the trajectory file is saved in the main directory of the
dataset. Enter a descriptive name and click Save. The file is saved with a .traj extension and can be
imported for reuse.
e. To clear data in all cells of the Trajectory table, drag the mouse across the rows and press delete.
To delete rows within the table, click the Delete button on the toolbar. Any empty rows will be
removed from the table when the trajectory is built or the trajectory is saved.
Option 3: Import a Saved Trajectory File
If you have previously built a trajectory file and saved it, you can import the file (see option 1
above).
a. Click the Load Trajectory from Saved Text File button on the toolbar.
b.

Navigate to the location of the saved file, select it, and then click Open.

c. Use the file as is or make changes if required. If the motion trajectory is changed, the file can be
resaved, or saved with a different file name.
8 Use the tools in the movie panel to view the motion trajectory. Make adjustments to the
trajectory if required.

9 To simulate gating, select the Gated Delivery check box and specify a small phase where the
beam is on. Enter the values for the gating window in the text boxes that are visible when Gated
Delivery is enabled. This gating window will be taken into account during the dynamic DVH
binning process central to the MotionSim process.
10 Click Load to load the motion kernel and return to the MotionSim main window.

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Home > Loading Data for Analysis > Using Respiratory MotionSim > Load 4D Dose Data and
Preview Motion with Dose Delivery

Load 4D Dose Data and Preview Motion with Dose Delivery

1 After defining the motion trajectory and loading the motion kernel (see Load Files and Define
Trajectory), in the left panel of the MotionSim main window, click Load 4D Doses (ACPDP-toArcCHECK) and load the 4D ArcCHECK dose directory that was saved during the calculation for
the AC-PDP reconstruction.
The software searches for a directory of 4D doses under the main directory for the dataset, and if
found, this will be the default data directory. If multiple 4D data directories exist, the default will be
the first one found but you can navigate to and select a different directory if necessary.
Select a directory not a file. All 4D dose grids in the selected directory will be loaded.
2 After the 4D doses are loaded, the MotionSim focus changes to the DVH Analysis tab. Use the
movie tools below the axial and coronal plane images to review the 4D dose-to-phantom through the
isocenter of the ArcCHECK phantom.
For simulation options, see Simulate Dose-To-Moving-Target.

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Home > Loading Data for Analysis > Using Respiratory MotionSim > Simulate Dose-To-MovingTarget

Simulate Dose-To-Moving-Target
After loading the 4D doses for Respiratory MotionSim, three options are available in the left panel
below Simulate Dose-to-Moving Target: Motion-Simulated Dose (1 Fx 1 Phase); Motion-Simulated
Dose (N Fx Random Phases); and Motion-Simulated Dose (Statistical Mean).
WARNING: Deformation of anatomical structures is not considered in the Respiratory
MotionSim module. All translations and rotations are handled as rigid body motions.

Motion-Simulated Dose (1 Fx 1 Phase)

Use this option to simulate the effects of the motion on the selected ROI for a single fraction.
1 In the MotionSim module, load the reference and comparison data, then define and load the
motion trajectory. See Load Files and Define Trajectory.
2 Click Motion-Simulated Dose (1 Fx, 1 Phase). In the Fraction Simulator dialog box, the
Number of Fractions selection is set to 1 and cannot be changed.
The Number of Fractions Yielding Current Dose-to-Perturb group box displays the total number of
fractions in the composite plan. For a single fraction, the software will perturb a fraction of the total.
For example, if the number of fractions is 5, the software will perturb one-fifth of the composite
dose.
3

Click OK.

4 If a reference dose and a comparison dose are loaded, a dialog box opens, prompting you to
select which dose to use as a basis for the motion simulation. Select Reference Dose or Comparison

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Dose to continue.
The progress of the calculation displays at the bottom of the window.
5 When the simulation is complete, the focus changes to the DVH Analysis tab where the DVHs
can be analyzed.
When the single fraction simulation is complete, if you wish, you can save the single fractions
dose. In the Simulate Dose-to-Moving Target group in the left panel, click Save Motion-Simulated
Dose. By default, the file is saved in the plans Measured directory.
To view the effects on other structures, click Select ROI(s) below the DVH image panel and
toggle the ROIs on or off, depending on what you want to analyze.
To generate active Quick Stat parameters for the moving and static ROI DVHs, click Quick Stats
below the DVH image panel.

Motion-Simulated Dose (N Fx, Random Phases)

Use this option to simulate the full course of treatment.
1 In the MotionSim module, load the reference and comparison data, then define and load the
motion trajectory. See Load Files and Define Trajectory.
2 Click Motion-Simulated Dose (N Fx, Random Phases). In the Fraction Simulator dialog box,
the Number of Fractions selection is set to the number of fractions in the plan.
The Number of Fractions Yielding Current Dose-to-Perturb group box displays the total number of
fractions in the composite plan. To simulate the full course of treatment, accept the total number of

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fractions.
3

Click OK.

4 If a reference dose and a comparison dose are loaded, a dialog box opens, prompting you to
select which dose to perturb. Select Reference Dose or Comparison Dose to continue.
The 3DVH software will perturb all fractions with random phases. The progress of the calculation
displays at the bottom of the window.
5 When the simulation is complete, the MotionSim focus changes to the DVH Analysis tab
where the DVHs can be analyzed.

Motion-Simulated Dose (Statistical Mean)

Use this option to calculate a number of simulations and average them out.
1 In the MotionSim module, load the reference and comparison data, then define and load the
motion trajectory. See Load Files and Define Trajectory.
2 Click Motion-Simulated Dose (Statistical Mean). The Sampling Density dialog box opens.
Enter the number of sampling bins for the simulation. The default is 10. This was empirically
determined as the number of fractions needed to average out the impact of motion for a VMAT case
and is consistent with the literature.
3

Click OK.

4 If a reference dose and a comparison dose are loaded, a dialog box opens, prompting you to
select which dose to perturb. Select Reference Dose or Comparison Dose to continue.
The 3DVH software will perturb all fractions with random phases. The progress of the calculation
displays at the bottom of the window.
5 When the simulation is complete, the MotionSim focus changes to the DVH Analysis tab
where the DVHs can be analyzed.

2016, Sun Nuclear Corporation. All rights reserved.

Home > Loading Data for Analysis > Using Respiratory MotionSim > Extract Dose versus Time

Extract Dose versus Time

MotionSim allows you to extract a single voxel or multiple voxels from a simulation for analysis.
This can be useful, for example, to focus on the impact of the motion on a single point.
1 In the MotionSim module, load the reference and comparison data, then define and load the
motion trajectory. See Load Files and Define Trajectory.

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In the table, Extraction Points, in the left panel, enter the coordinates of the voxel to follow:

For a single voxel, enter the X, Y, and Z coordinates in the first row of the table.
For multiple voxels, enter the X, Y, and Z coordinates for each set of points.
3

To view the cumulative dose or differential dose versus time:

a. In the drop-down list below Extract Dose vs. Time, select Cumulative Dose vs. Time or
Differential Dose vs. Time.
b. Select Extract Point Dose(s) vs. Time. The Number of Fractions To Deliver Current Dose
dialog box open.
c. Change the number of fractions if desired and click OK.
d. When prompted, select the dose to simulate (reference or comparison). The progress of the dose
extraction displays at the bottom of the window.
When complete, the MotionSim focus changes to the Point Dose vs. Time (Patient) tab and a graph
of the moving target versus the static point displays, showing the points inside the moving target. If
comparing multiple voxels, each set of lines or bars on the graph are color-coded.
e. To save the dose comparison, click Save Dose vs.Time Data in the left panel. The file is saved
with a .csv extension which can be imported into a spreadsheet application.
4

To view the cumulative dose or differential dose versus time:

a. In the drop-down list below Extract Dose vs. Time, select, Cumulative Dose vs. Time or
Differential Dose vs. Time.
b. Click Extract Volume-Averaged Dose(s) vs. Time. The Number of Fractions To Deliver
Current Dose dialog box open.
c. Change the number of fractions if desired and click OK.
d.

When prompted, select the dose to simulate (Reference or Comparison).

e. The Volume Average dialog box opens. Enter the volume to average and click OK. The default
value is 0.125.
The progress of the dose point extraction displays at the bottom of the window. When complete, the
MotionSim focus changes to the Point Dose vs. Time tab and a graph of dose average displays,
showing the points inside the moving target. If comparing multiple points, each set of lines or bars
on the graph are color-coded.
f. To save the comparison, click Save Dose vs.Time Data in the left panel. The file is saved with
a .csv extension which can be imported into a spreadsheet application. If comparing multiple voxels,
each set of lines on the graph are color-coded.

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