An accurate method to quantify breathing-induced prostate motion for patients implanted with electromagnetic transponders



To validate and apply a method for the quantification of breathing-induced prostate motion (BIPM) for patients treated with radiotherapy and implanted with electromagnetic transponders for prostate localization and tracking.


For the analysis of electromagnetic transponder signal, dedicated software was developed and validated with a programmable breathing simulator phantom. The software was then applied to 1,132 radiotherapy fractions of 30 patients treated in supine position, and to a further 61 fractions of 2 patients treated in prone position.


Application of the software in phantom demonstrated reliability of the developed method in determining simulated breathing frequencies and amplitudes. For supine patients, the in vivo analysis of BIPM resulted in median (maximum) amplitudes of 0.10 mm (0.35 mm), 0.24 mm (0.66 mm), and 0.17 mm (0.61 mm) in the left-right (LR), cranio-caudal (CC), and anterior-posterior (AP) directions, respectively. Breathing frequency ranged between 7.73 and 29.43 breaths per minute. For prone patients, the ranges of the BIPM amplitudes were 0.1-0.5 mm, 0.5-1.3 mm, and 0.7-1.7 mm in the LR, CC, and AP directions, respectively.


The developed method was able to detect the BIPM with sub-millimeter accuracy. While for patients treated in supine position the BIPM represents a reduced source of treatment uncertainty, for patients treated in prone position, it can be higher than 3 mm.

Tumori 2017; 103(2): 136 - 142




Tommaso Giandini, Costanza M.V. Panaino, Barbara Avuzzi, Sara Morlino, Sergio Villa, Nice Bedini, Gabriele Carabelli, Sarah C. Frasca, Anna Romanyukha, Anatoly Rosenfeld, Emanuele Pignoli, Riccardo Valdagni, Mauro Carrara

Article History


Financial support: This work was partially funded by Associazione Italiana per la Ricerca sul Cancro AIRC IG-14300.
Conflict of interest: None of the authors has conflict of interest with this submission.

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  • Medical Physics Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • Prostate Program Unit, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • Medical Physics Unit, Department of Radiotherapy, Istituto Europeo di Oncologia, Milan - Italy
  • Radiation Oncology 1 Unit, Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW - Australia
  • Current address: Cancer Research UK Manchester Institute, The University of Manchester, Manchester - UK
  • Current address: Medical Physics Unit, Ente Ospedaliero Cantonale, Bellinzona - Switzerland

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