4D modeling in a gimbaled linear accelerator by using gold anchor markers

Purpose

The purpose of this study was to verify whether the dynamic tumor tracking (DTT) feature of a Vero4DRT system performs with 10-mm-long and 0.28 mm diameter gold anchor markers.

Comparison of CT artifacts and image recognition of various fiducial markers including two types of thinner fiducial markers for CyberKnife treatment

AimThe aim of the study was to evaluate computed tomography (CT) artifacts and image recognition of the CyberKnife system. Regarding fiducial markers, VISICOIL of 0.5 mm × 5.0 mm and 0.75 mm × 5.0 mm, ball-shaped Gold Anchor (GA) of 0.28 mm × 10 mm and 0.28 mm × 20 mm, were compared with the standard cylinder marker of 0.9 mm × 3.0 mm (ACCULOC).BackgroundRecently, various kinds of commercial fiducial markers have been available in CyberKnife treatment.Materials and methodsThe CT images of a water equivalent gel with each fiducial marker were acquired for the evaluation of CT artifacts. The evaluation was performed using the standard deviation of Hounsfield Unit (HU) value for a rectangle region near the fiducial marker. Then, to evaluate the image recognition, each fiducial marker was located to overlap in the target locating system (TLS) for the two sites; the vertebral bone and the pubic bone.ResultsFor CT artifacts, the standard deviations of the VISICOIL of 0.5 mm × 5.0 mm was the smallest. The image recognition of four fiducial markers had a value close to the standard cylinder marker and was feasible for common use, but was slightly poorer when using GA of 0.28 mm × 10 mm in the dynamic conditions.ConclusionOur results indicated that VISICOIL 0.5 × 5.0 mm and the GAs can be used nearly always for CyberKnife treatment in spite of their much thinner needles than those of cylinder types.     

Retrospective assessment of a single fiducial marker tracking regimen with robotic stereotactic body radiation therapy for liver tumours

AimTo investigate tumour motion tracking uncertainties in the CyberKnife Synchrony system with single fiducial marker in liver tumours.BackgroundIn the fiducial-based CyberKnife real-time tumour motion tracking system, multiple fiducial markers are generally used to enable translation and rotation corrections during tracking. However, sometimes a single fiducial marker is employed when rotation corrections are not estimated during treatment.Materials and methodsData were analysed for 32 patients with liver tumours where one fiducial marker was implanted. Four-dimensional computed tomography (CT) scans were performed to determine the internal target volume (ITV). Before the first treatment fraction, the CT scans were repeated and the marker migration was determined. Log files generated by the Synchrony system were obtained after each treatment and the correlation model errors were calculated. Intra-fractional spine rotations were examined on the spine alignment images before and after each treatment.ResultsThe mean (standard deviation) ITV margin was 4.1 (2.3) mm, which correlated weakly with the distance between the fiducial marker and the tumour. The mean migration distance of the marker was 1.5 (0.7) mm. The overall mean correlation model error was 1.03 (0.37) mm in the radial direction. The overall mean spine rotations were 0.27° (0.31), 0.25° (0.22), and 0.23° (0.26) for roll, pitch, and yaw, respectively. The treatment time was moderately associated with the correlation model errors and weakly related to spine rotation in the roll and yaw planes.ConclusionsMore caution and an additional safety margins are required when tracking a single fiducial marker.     

Partial permeabilisation and depolarization of Salmonella enterica Typhimurium cells after treatment with pulsed electric fields and high pressure carbon dioxide

The aim of the present study is to investigate the efficiency of the combined pulsed electric fields and high pressure carbon dioxide (PEF + HPCD) treatment on the Gram-negative pathogen Salmonella Typhimurium in a liquid medium, by means of both plate count technique and flow cytometry (FCM). PEF was applied at two conditions: (1) 1 single pulse of 1 ms length at 30 kV/cm and (2) 12 pulses of 4 ms length at 30 kV/cm, while HPCD at 12 MPa, 22 °C and 35 °C for different treating times (0–45 min). At both temperatures, the application of PEF as HPCD pre-treatment was demonstrated to enhance the inactivation kinetics and to decrease the treatment time to inactivate S. Typhimurium if compared to HPCD alone. Further, the approach based on FCM permitted to investigate the functional status of bacterial cells after PEF and HPCD treatments distinguishing among viable bacteria (considered as intact cells), permeabilised cells and depolarised cells simultaneously. It has been demonstrated that the synergistic effect is due to the electroporation effect of PEF which lead to changes in the cell membrane potential but also in a partial structural damage, favoring the subsequent CO₂ penetration into the cells and increasing the inactivation kinetics, thus improving the efficiency of the entire process.     

Torque-onset determination: Unintended consequences of the threshold method

Background: Compared with visual torque-onset-detection (TOD), threshold-based TOD produces onset bias, which increases with lower torques or rates of torque development (RTD). Purpose: To compare the effects of differential TOD-bias on common contractile parameters in two torque-disparate groups. Methods: Fifteen boys and 12 men performed maximal, explosive, isometric knee-extensions. Torque and EMG were recorded for each contraction. Best contractions were selected by peak torque (MVC) and peak RTD. Visual-TOD-based torque-time traces, electromechanical delays (EMD), and times to peak RTD (tRTD) were compared with corresponding data derived from fixed 4-N m- and relative 5%MVC-thresholds. Results: The 5%MVC TOD-biases were similar for boys and men, but the corresponding 4-N m-based biases were markedly different (40.3 ± 14.1 vs. 18.4 ± 7.1 ms, respectively; p < 0.001). Boys–men EMD differences were most affected, increasing from 5.0 ms (visual) to 26.9 ms (4 N m; p < 0.01). Men’s visually-based torque kinetics tended to be faster than the boys’ (NS), but the 4-N m-based kinetics erroneously depicted the boys as being much faster to any given %MVC (p < 0.001). Conclusions: When comparing contractile properties of dissimilar groups, e.g., children vs. adults, threshold-based TOD methods can misrepresent reality and lead to erroneous conclusions. Relative-thresholds (e.g., 5% MVC) still introduce error, but group-comparisons are not confounded.     

Protective effect of combined therapy with dithiothreitol,zinc and selenium protects acute mercury induced oxidative injury in rats

The present study was undertaken to establish mode of action, comparative therapeutic efficacy and safety evaluation of dithiothreitol (DTT) supplemented with Zn and Se against dimethylmercury in rats. Adult male albino rats of Sprague-Dawley strain (150 ± 10 g, n = 6 per group) were exposed a bolus dose of dimethylmercury (10 mg/kg, p.o.) for once only followed by DTT (15.4 mg/kg, i.p.) along with the combination of antioxidants Zn and Se (2 mmol/kg and 0.5 mg/kg, p.o.) after 72 h of toxicant administration for three days. The results showed a significant (P ≤ 0.05) increase in the activities of AST, ALT, alkaline phosphatase, lactate dehydrogenase, in serum after toxicant administration. This was accompanied by histopathological observations. A significant rise was observed in lipid peroxidation level and mercury ion concentration however reduced glutathione content decreased in liver, kidney and brain. A significant (P ≤ 0.05) decrease in the activity of acetyl cholinesterase was also seen in different regions of brain. Combined treatment of DTT along with Zn and Se significantly (P ≤ 0.05) recouped the alterations in the enzymatic activities of serum and reversed the tissue biochemical and histopathological changes of liver, kidney and brain. Our results demonstrate that combined treatment of thiol chelator (DTT) along with antioxidants (Zn and Se) plays an important role against dimethylmercury induced tissue damage and hepatic, nephro and neurotoxicity.     

Experimental assessment of the influence of beam hardening filters on image quality and patient dose in volumetric 64-slice X-ray CT scanners

Beam hardening filters have long been employed in X-ray Computed Tomography (CT) to preferentially absorb soft and low-energy X-rays having no or little contribution to image formation, thus allowing the reduction of patient dose and beam hardening artefacts. In this work, we studied the influence of additional copper (Cu) and aluminium (Al) flat filters on patient dose and image quality and seek an optimum filter thickness for the GE LightSpeed VCT 64-slice CT scanner using experimental phantom measurements. Different thicknesses of Cu and Al filters (0.5–1.6 mm Cu, 0.5–4 mm Al) were installed on the scanner’s collimator. A planar phantom consisting of 13 slabs of Cu having different thicknesses was designed and scanned to assess the impact of beam filtration on contrast in the intensity domain (CT detector’s output). To assess image contrast and image noise, a cylindrical phantom consisting of a polyethylene cylinder having 16 holes filled with different concentrations of K₂HPO₄ solution mimicking different tissue types was used. The GE performance and the standard head CT dose index (CTDI) phantoms were also used to assess image resolution characterized by the modulation transfer function (MTF) and patient dose defined by the weighted CTDI. A 100 mm pencil ionization chamber was used for CTDI measurement. Finally, an optimum filter thickness was determined from an objective figure of merit (FOM) metric. The results show that the contrast is somewhat compromised with filter thickness in both the planar and cylindrical phantoms. The contrast of the K₂HPO₄ solutions in the cylindrical phantom was degraded by up to 10% for a 0.68 mm Cu filter and 6% for a 4.14 mm Al filter. It was shown that additional filters increase image noise which impaired the detectability of low density K₂HPO₄ solutions. It was found that with a 0.48 mm Cu filter the 50% MTF value is shifted by about 0.77 lp/cm compared to the case where the filter is not used. An added Cu filter with approximately 0.5 mm thickness accounts for 50% reduction in radiation-absorbed dose as measured by the weighted CTDI. The FOM results indicate that with an additional filter of 0.5 mm Cu or minimum 4 mm Al, a good compromise between image quality and patient dose is achieved for CT images acquired at tube voltages of 120 and 140 kVp. The results seem to indicate that an optimum filter for high kVp acquisitions, routinely used in cardiovascular imaging, should be 0.5 mm copper or 4 mm aluminium minimum.     

Surface electromyography reveals males have a slower patellar reflex than females

In humans the cross sectional area of spinal motor neurons at L3 is larger in males than in females. Since these contribute to the control of the quadriceps femoris muscle group and are involved in the patellar reflex (PR), gender differences in the PR are expected. We have investigated this possibility using a group of 28 young subjects (14 male and 14 female) aged 20–22 years. The PR was quantified by the muscle compound action potential (MCAP) from the surface electromyogram (sEMG) of the vastus lateralis muscle. We found that the PR latency in females (17 ± 0.19 ms), was significantly (p < 0.001) faster than in males (21 ± 0.37 ms). This 4 ms difference in latency could not be ascribed to differences in stature or thigh length. In conclusion, for the age range tested females posses a significantly faster patellar reflex than males. We suggest that the slower PR latency of male subjects may arise in part from their larger α-motorneurons: such that longer integration times are required for the summation of postsynaptic excitation to be sufficient to excite α-motorneurons.     

Multiple nanosecond electric pulses increase the number but not the size of long-lived nanopores in the cell membrane

Exposure to intense, nanosecond-duration electric pulses (nsEP) opens small but long-lived pores in the plasma membrane. We quantified the cell uptake of two membrane integrity marker dyes, YO-PRO-1 (YP) and propidium (Pr) in order to test whether the pore size is affected by the number of nsEP. The fluorescence of the dyes was calibrated against their concentrations by confocal imaging of stained homogenates of the cells. The calibrations revealed a two-phase dependence of Pr emission on the concentration (with a slower rise at < 4 μM) and a linear dependence for YP. CHO cells were exposed to nsEP trains (1 to 100 pulses, 60 ns, 13.2 kV/cm, 10 Hz) with Pr and YP in the medium, and the uptake of the dyes was monitored by time-lapse imaging for 3 min. Even a single nsEP triggered a modest but detectable entry of both dyes, which increased linearly when more pulses were applied. The influx of Pr per pulse was constant and independent of the pulse number. The influx of YP per pulse was highest with 1- and 2-pulse exposures, decreasing to about twice the Pr level for trains from 5 to 100 pulses. The constant YP/Pr influx ratio for trains of 5 to 100 pulses suggests that increasing the number of pulses permeabilizes cells to a greater extent by increasing the pore number and not the pore diameter.     

Seizure prevention by the naturally occurring phenols,carvacrol and thymol in a partial seizure-psychomotor model

The natural compounds carvacrol and thymol completely prevented seizures in the 6 Hz, 32 mA partial seizure model. Carvacrol and thymol, both exhibited an ED₅₀ = 35.8 mg/kg, ip and yielded protective indices of 5.3 and 3.4, respectively. At 44 mA current intensity, carvacrol and thymol exhibited ED₅₀s of 88.82 mg/kg (PI = 2.15) and 73.0 mg/kg (PI = 1.65), respectively. Thymol, but not carvacrol showed partial inhibitory activity in the maximal electroshock (MES), sc Metrazol (scMET) and Corneal-kindled models. These results suggest that carvacrol and thymol are more efficacious anticonvulsants than suggested by their lower efficacies in the conventional MES and scMET tests.     

Intérêt potentiel des images paramétriques des temps d’éjection et de relaxation en tomoscintigraphie des cavités cardiaques dans l’évaluation des cardiopathies asynchrones

Intraleft dyssynchrony is strongly correlated to contractile dysfunction associated to severe heart failure. Dyssynchrony is also a predictive marker for cardiac resynchronization therapy response. We measured dyssynchrony values for both ventricles from gated blood pool SPECT images.Material and methodsThree groups of patients were sampled from normal patients (n = 7), mild heart failure patients (n = 24) and severe heart failure patients (n = 9). Time-derivative parametric images were obtained from 24-time bins gated blood pool SPECT data. We measured intraleft and interventricular contractile and relaxing dyssynchrony values from these images.ResultsIntraleft dispersions values linked to ventricular peak emptying rate were 107 ± 21 ms, 141 ± 58 ms and 515 ± 104 ms for each of the three groups. The values linked to left ventricular peak filling rate were 122 ± 62 ms, 219 ± 117 ms and 603 ± 164 ms respectively. Statistical significant differences (p < 0.01) were observed both for contractile and relaxing phases for severe heart failure patients. Mild heart failure patients had isolated statistical significant (p < 0.01) alterations of the ventricular relaxing phase. Correlation between isotopic dyssynchrony values and left ejection fraction led to a R square coefficient of 0.71 and 0.64 for time to peak emptying and to peak filling respectively. Correlation to QRS width values led to a R square coefficient of 0.76 and 0.62 respectively.ConclusionVentricular dyssynchrony correlated to the importance of the ventricular mechanical dysfunctions is a robust predictor of heart failure. Separate analysis of contractile and relaxing dyssynchrony may lead to a better understanding and characterization of the mechanical dysfunctions involved in heart failure.     

Process intensification for an enhanced replication of a newly adapted RM-65 sheep pox virus strain in Vero cells grown in stirred bioreactor

Sheep pox virus initially adapted to replicate in primary lamb kidney cells was adapted to Vero cells by serial passages in monolayer cultures. After nine passages the virus was able to correctly replicate in Vero cells, virus titer achieved was 10^5.875 TCID₅₀ (median tissue culture infective dose) ml⁻¹.To optimize the production process, the effects of MOI (multiplicity of infection), TOI (time of infection) and the culture medium were investigated. Cell infection at a MOI of 0.005 concurrently with cell seeding showed the best results in terms of specific virus productivity. The effect of MEM enrichment with several components was investigated using the experimental design approach. 67 experiments were performed in 6-well plates to select the best combination. The highest titer was achieved when MEM was supplemented with 5 mM glucose, 5 mM fructose and 25 mM sucrose. Spinner culture confirms these data; virus titer was 10^7.375 TCID₅₀ ml⁻¹.In addition Vero cells were cultivated in a 7-l bioreactor in batch mode on 3 g l⁻¹ Cytodex1, and infected at cell seeding at a MOI of 0.005. Maximal virus titer was 10^7.275 TCID₅₀ ml⁻¹. This corresponds to 44-fold factor enhancement compared to spinner cultures conducted in MEM + 2% FCS.     

Algorithmic detection of the beginning and end of bipolar electrograms: Implications for novel methods to assess local activation time during atrial tachycardia

Activation mapping is required to effectively ablate atrial tachycardia (AT). Conventional tools to assess local activation time (LAT) are based upon the peak of the bipolar electrogram (B-EGM, LAT_Peak) and the maximal negative slope of the unipolar electrogram (U-EGM, LAT_Slope). Bipolar electrograms are influenced by wavefront direction, bipole orientation, and inter-electrode spacing causing ambiguity in peak detection, whereas unipolar electrograms are disturbed by the presence of far-field signals. We developed a new algorithm to detect the beginning and end of bipolar electrograms (t_begin and t_end). Then, we introduced new LAT methods related to the onset of B-EGMs (LAT_Onset), the center of mass of B-EGMs (LAT_CoM), and the slope of U-EGMs within a pre-defined window (LAT_Slope-hybrid).In total 3752 recordings from 31 AT patients were retrospectively analyzed. The signal-to-noise ratio (SNR) for B-EGMs was calculated to differentiate algorithmically high from low quality electrograms (HQ and LQ). In a subset of 328 B-EGMs, five experts validated the t_begin as determined by the algorithm by visual rating. The newly developed LAT methods were compared to the conventional LAT methods and to one another (Bland–Altman plots) in both HQ (n = 3003) and LQ EGMs (n = 749).The t_begin algorithm was accurate (deviation < ±10 ms) in 96 ± 4% of HQ and 91 ± 8% of LQ B-EGMs. BA plots revealed the following difference (bias) and variation in HQ and LQ EGMs respectively: (1) LAT_Onset vs. LAT_Peak: 27 ± 30 ms and 24 ± 62 ms; (2) LAT_CoM vs. LAT_Peak: 0 ± 16 ms and 2 ± 38 ms; (3) LAT_Slope-hybrid vs. LAT_Slope: 1 ± 32 ms and 15 ± 110 ms; (4) LAT_Onset vs. LAT_CoM: 22 ± 24 ms and 18 ± 22 ms; (5) LAT_Onset vs. LAT_Slope-hybrid: 16 ± 18 ms and 13 ± 22 ms; and (6) LAT_CoM vs. LAT_Slope-hybrid: 5 ± 20 ms and 4 ± 18 ms.In the present study, we introduced three new methods to assess local activation time in AT, based upon an algorithm detecting accurately the beginning and end of the B-EGM complex. BA analysis of the new methods showed similar variation in high and low quality EGMs, suggesting that they introduce less ambiguity than the conventional peak method. LAT_Onset consistently yielded an earlier activation moment. LAT_Slope-hybrid – by blanking far-field potentials – seems to be the optimal method for detection of the maximal negative slope in U-EGMs. Interestingly, LAT_CoM in B-EGMs coincided with the maximal negative slope in U-EGMs, suggesting its physiological sense and future use. The new LAT methods can be implemented in real-time mapping applications.     

Effect of verification imaging on in vivo dosimetry results using Gafchromic EBT3 film

In this work, the apparent treatment dose that kV planar or CBCT imaging contributes to Gafchromic EBT3 film used for in vivo dosimetry, was investigated. Gafchromic EBT3 film pieces were attached to a variety of phantoms and irradiated using the linear accelerator’s built-in kV imaging system, in both kV planar mode and CBCT mode. To evaluate the sensitivity of the film in the clinical scenario where dose contributions are received from both imaging and treatment, additional pieces of film were irradiated using base doses of 50 cGy and then irradiated using selected kV planar and CBCT techniques. For kV planar imaging, apparent treatment doses of up to 3.4 cGy per image pair were seen. For CBCT, apparent treatment doses ranged from 0.22 cGy to 3.78 cGy. These apparent doses were reproducible with and without the inclusion of the 50 cGy base dose. The contribution of apparent treatment dose from both planar kV as well as CBCT imaging can be detected, even in conjunction with an actual treatment dose. The magnitude of the apparent dose was found to be dependent on patient geometry, scanning protocol, and measurement location. It was found that the apparent treatment dose from the imaging could add up to 8% of additional uncertainty to the in vivo dosimetry result, if not taken into account. It is possible for this apparent treatment dose to be accounted for by subtraction of the experimentally determined apparent doses from in vivo measurements, as demonstrated in this work.     

Variable angle stereo imaging for rapid patient position correction in an in-house real-time position monitoring system

PurposeTo develop and validate a variable angle stereo image based position correction methodology in an X-ray based in-house online position monitoring system.Materials and methodsA stereo imaging module that enables 3D position determination and couch correction of the patient based on images acquired at any arbitrary angle and arbitrary angular separation was developed and incorporated to the in-house SeedTracker real-time position monitoring system. The accuracy of the developed system was studied by imaging an anthropomorphic phantom implanted with radiopaque markers set to known offset positions from its reference position in an Elekta linear accelerator (LA) and associated XVI imaging system. The accuracy of the system was further validated using CBCT data set from 10 prostate SBRT patients. The time gains achieved with the stereo image based position correction was compared with the manual matching of seed positions in Digitally Reconstructed Radiographs (DRRs) and kV images in the Mosaiq record and verify system.ResultsBased on phantom and patient CBCT dataset study stereo imaging module implemented in the SeedTracker shown to have an accuracy of 0.1(σ = 0.5) mm in detecting the 3D position offset. The time comparison study showed that stereo image based methodology implemented in SeedTracker was a minimum of 80(4) s faster than the manual method implemented in Mosaiq R&V system with a maximum time saving of 146(6) s.ConclusionThe variable angle stereo image based position correction method was shown to be accurate and faster than the standard manual DRR–kV image based correction approach, leading to more efficient treatment.     

Unweighted state as a sidestep preparation improve the initiation and reaching performance for basketball players

The preparatory motion of a defensive motion in contact sport such as basketball should be small and involve landing on both feet for strict time and motion constraints. We thus proposed the movement creating a unweighted state. Ten basketball players performed a choice reaction sidestepping task with and without the voluntary, continuous vertical fluctuation movement. The results indicated that the preparatory movement shortened the time of their sidestep initiation (301 vs. 314 ms, p = 0.011) and reaching performance (883 vs. 910 ms, p = 0.018) but did not increase their peak ground reaction force or movement velocity. The mechanism of the improvement was estimated to be the following: in the preparation phase, the vertical body fluctuation created the force fluctuation; after the direction signal, the unweighted state can shorten the time required to initiate the sidestepping (unweighted: 279 ms; weighted: 322 ms, p = 0.002); around the initiation phase, the dropping down of the body and weighted state can contribute to the reaching performance. We conducted additional experiment investigating muscle–tendon-complex dynamics and muscle activity using ultrasound device and electromyography. The result suggests that the building up of active state of muscle might explain the improvement of sidestepping performance.     

Effect of a change in step direction from a forward to a lateral target in response to a sensory perturbation

The aim of the current study was to investigate the response of healthy older and young adults to a change in step direction from a forward to a lateral target in response to a sensory perturbation. Nine healthy older (75.1 ± 6.7 years; age range, 65–81 years) and nine young adults (27 ± 3.6 years; age range, 23–31 years) participated in the study. The sensory perturbation was a visual cue presented at random times while subjects stepped over an obstacle from quiet stance. For both young and elderly subjects there was an abrupt change in the slope of both shear ground reaction forces (GRFs) of the stance limb following the perturbation. The slope and peak of the change in GRFs was greater for the young subjects and the onset significantly earlier (205 ms compared to 271 ms). Changes in the GRFs were accompanied by an increase in bilateral gluteus medius and stance limb soleus activity. A late visual cue resulted in a delayed response for elderly subjects. These data show that a stepping response to a sensory perturbation was both delayed and of less magnitude for older adults which has implications for fall risk.     

Accuracy map of an optical motion capture system with 42 or 21 cameras in a large measurement volume

Optical motion capture is commonly used in biomechanics to measure human kinematics. However, no studies have yet examined the accuracy of optical motion capture in a large capture volume (>100 m³), or how accuracy varies from the center to the extreme edges of the capture volume. This study measured the dynamic 3D errors of an optical motion capture system composed of 42 OptiTrack Prime 41 cameras (capture volume of 135 m³) by comparing the motion of a single marker to the motion reported by a ThorLabs linear motion stage. After spline interpolating the data, it was found that 97% of the capture area had error below 200 μm. When the same analysis was performed using only half (21) of the cameras, 91% of the capture area was below 200 μm of error. The only locations that exceeded this threshold were at the extreme edges of the capture area, and no location had a mean error exceeding 1 mm. When measuring human kinematics with skin-mounted markers, uncertainty of marker placement relative to underlying skeletal features and soft tissue artifact produce errors that are orders of magnitude larger than the errors attributed to the camera system itself. Therefore, the accuracy of this OptiTrack optical motion capture system was found to be more than sufficient for measuring full-body human kinematics with skin-mounted markers in a large capture volume (>100 m³).     

Rotator cuff tendinopathy alters the muscle activity onset and kinematics of scapula

Athletes with rotator cuff (RC) tendinopathy demonstrate an aberrant pattern of scapular motion which might relate to deficits in the scapular muscles. This study aimed to determine whether alteration in scapular kinematics is associated with deficits in the activity onset of scapular muscles. Forty-three male volleyball players (17 asymptomatic and 26 with RC tendinopathy) joined the study. Three-dimensional scapular kinematics was quantified using an acromial marker cluster method. The activity onset of the upper (UT), middle (MT), and lower trapezius (LT), and serratus anterior (SA) during arm abduction was assessed with electromyography. Athletes with RC tendinopathy demonstrated less scapular upward rotation (6.6 ± 2.3 vs. 8.2 ± 1.1°, p = 0.021) in the early phase of shoulder abduction from 0° to 30° when compared to asymptomatic athletes. The tendinopathy group had delayed activity onset of LT (14.1 ± 31.4 ms vs. 74.4 ± 45.1 ms, p < 0.001) and SA (−44.9 ± 26.0 ms vs. 23.0 ± 25.2 ms, p < 0.001) relative to UT when compared to the asymptomatic group. In asymptomatic athletes, earlier activity onset of MT and LT relative to UT was associated with more scapular upward rotation during 0–30° of abduction (r = 0.665, p = 0.021) and 30–60° of abduction (r = 0.680, p = 0.015), respectively. Our findings showed the control of the scapular upward rotation is related to the activity onset of the scapular muscles in athletes.