Feasibility of using a fully immersive virtual reality system for kinematic data collection

Commercially-available Virtual Reality (VR) systems have the potential to be effective tools for simultaneous visual manipulation and kinematic data collection. Previously, these systems have been integrated with research-grade motion capture systems to provide both functionalities; however, they are yet to be used as stand-alone systems for kinematic data collection. The present study aimed to validate the HTC VIVE VR system for kinematic data collection by evaluating the accuracy of its position and orientation signals. The VIVE controller and tracker were each compared to a Polhemus Liberty magnetic tracking system sensor for angular and translational measurement error and signal drift. A sensor from each system was mounted to opposite ends of a rigid segment which was driven through fifty rotations and fifty translations. Mean angular errors for both the VIVE tracker and controller were below 0.4°. Mean translational error for both sensors was below 3 mm. Drift in the Liberty signal components was consistently lower than drift in VIVE components. However, all mean rotational drift measures were below 0.1° and all mean translational measures were below 0.35 mm. These data indicate that the HTC VIVE system has the potential to be a valid and reliable means of kinematic data collection. However, further investigation is necessary to determine the VIVE’s suitability for capturing extremely minute or high-volume movements.     

Head mounted displays for capturing head kinematics in postural tasks

Tracking head motion in a simple, portable and accurate manner during performance of postural tasks in a virtual reality environment could have important implications for investigating normal and pathological head kinematics. We investigated concurrent validity of head tracking of two Head Mounted Displays (HMDs), Oculus Rift and HTC Vive, vs. a gold-standard motion capture system (Qualisys). Head kinematics of N = 20 healthy young adults was quantified during static and dynamic postural tasks. While wearing the Oculus Rift or HTC Vive, participants observed moving stars (static tasks) or a flying ball (dynamic task). Head kinematics were recorded simultaneously by the Rift or Vive and Qualisys camera system. We calculated head directional path, acceleration in 6 directions and volume of translation movement. Intra-Class Correlations (ICC) and 95% Limits of agreement were calculated. Most ICC values were around 0.9 with several at 0.99 indicating excellent agreement between the HMDs and Qualisys. Weaker agreement was observed for vertical displacement during a static task and moderate agreement was observed pitch and yaw displacement during a dynamic task. A negative bias of a small magnitude (indicating more movement in VR) was observed for most variables in static tasks, while a positive bias was observed for most variables in the dynamic task (indicating less movement in VR). Our results generally support the concurrent validity of Oculus Rift and HTC Vive head tracking during static and dynamic standing tasks in healthy young adults. Specific task- and direction-dependent differences should be considered when planning measurement studies using these novel tools.     

Journey to the centre of the cell: Virtual reality immersion into scientific data

Visualization of scientific data is crucial not only for scientific discovery but also to communicate science and medicine to both experts and a general audience. Until recently, we have been limited to visualizing the three‐dimensional (3D) world of biology in 2 dimensions. Renderings of 3D cells are still traditionally displayed using two‐dimensional (2D) media, such as on a computer screen or paper. However, the advent of consumer grade virtual reality (VR) headsets such as Oculus Rift and HTC Vive means it is now possible to visualize and interact with scientific data in a 3D virtual world. In addition, new microscopic methods provide an unprecedented opportunity to obtain new 3D data sets. In this perspective article, we highlight how we have used cutting edge imaging techniques to build a 3D virtual model of a cell from serial block‐face scanning electron microscope (SBEM) imaging data. This model allows scientists, students and members of the public to explore and interact with a “real” cell. Early testing of this immersive environment indicates a significant improvement in students’ understanding of cellular processes and points to a new future of learning and public engagement. In addition, we speculate that VR can become a new tool for researchers studying cellular architecture and processes by populating VR models with molecular data.      

Directional bias of soft-tissue artifacts on the acromion during recording of 3D scapular kinematics

Scapular kinematics during sports performances can be recorded using skin-mounted trackers attached to the skin overlying the acromion for continuous data collection without restricting natural motions of the subject relative to medical imaging analyses limiting its use for wide-range or high-speed motions. This study aimed to describe the existence of a directional bias in the translational and rotational errors of skin-mounted trackers using a 3D magnetic resonance imaging (3D-MRI) protocol. 3D-MRI scans of the healthy right shoulders of 19 males were acquired in 12 arm positions. The relative transformation of the scapular configuration determined to be the measurement error, as recorded by the configuration of the small cuboid imitating a skin-mounted tracker relative to the actual scapular configuration measured by the voxel-based registration. These measurement errors were expressed with either positive or negative values to describe the bias. Overall translational errors in the lateral, anterior, and superior directions were 3.7 ± 8.4 mm, 9.5 ± 6.4 mm, and 6.2 ± 4.6 mm, respectively. Overall rotational errors in protraction, upward rotation, and posterior tilt were 7.8 ± 8.4°, 0.2 ± 7.4°, and − 4.0 ± 7.5°, respectively. The skin-mounted tracker displayed a high probability of displacement in antero-superior (93% and 91%) directions and rotates in a protracting manner (82%) relative to the position of the underlying bone with the gradual nature of its change. The existence of the directional bias with its gradual change suggests a statistical predictability in measurement errors, which can be used to predict accurate scapular translation and rotation.     

微型种植体支抗在口腔正畸治疗中的临床研究

目的:探讨微型种植体支抗在口腔正畸治疗中的效果。方法:将80例需口腔正畸治疗的患者随机分为两组,对照组给予传统正畸治疗,观察组给予微型种植体支抗治疗,观察和比较两组的手术成功率、治疗结果及随访2周期间不良反应的发生情况。结果:观察组手术成功率(92.5%)显著高于对照组(70.0%,P0.05)。治疗后,观察组上中切牙凸距差为(4.54±1.21)mm(增加80.9%)、上中切牙倾角为(27.27±4.45)mm(增加132.3%)、下齿槽座角为(1.49±0.53)mm(增加81.7%)、尖牙间宽度为(1.73±0.69)mm(增加143.7%)、磨牙移位为(3.25±0.73)mm(降低37.1%)、上齿槽座角为(-1.81±0.46)mm(降低147.9%),与对照组相比,均有显著性差异(P0.05)。随访2周内,与对照组相比,观察组口腔炎症、口腔感染、不适感降低以及软组织轻度浮肿等不良反应的发生率(10%)显著低于对照组(30%,P0.05)。结论:微型种植体支抗在口腔正畸治疗中能发挥理想的矫治效果,稳定性好,手术成功率和安全性均较高。     

Assessment of intra-fraction motion during automated linac-based SRS treatment delivery with an open face mask system

Purpose/objectiveTo evaluate intra-fraction target shift during automated mono-isocentric linac-based stereotactic radiosurgery with open-face mask system and optical real-time tracking.Materials/methodsNinety-five patients were treated using automated linac-based stereotactic radiosurgery in 1–5 fractions with single isocenter for a total of 195 fractions. During treatment, patient positioning was tracked real-time with optical surface guidance and immobilized with a rigid open-face mask. Patients were re-positioned if optical surface guidance error exceeded 1 mm magnitude or 1°. Translational and rotational intra-fractional changes were determined by post-treatment CBCT matched to the planning CT. Target specific error was calculated by translation and rotation matrices applied to isocenter and target spatial coordinates.ResultsFor 132 fractions with isocenter within a single target, the median shift magnitude was 0.40 mm with a maximum shift of 1.17 mm. A total of 398 targets treated for plans having multiple or single targets that lied outside isocenter, resulted in a median shift magnitude of 0.46 mm, with median translational shifts of 0.20 mm and 0.20° rotational shifts. A 1 mm PTV margin was insufficient in 18% of targets at a distance greater than 6 cm away from isocenter, but sufficient for 96% of targets within 6 cm.ConclusionsThe findings of this study support 1 mm PTV expansion due to intra-fraction motion to ensure target coverage for plans with isocenter placement less than 6 cm away from the targets.     

Dependence of joint stiffness on the conditions of visual control in upright undisturbed stance in humans

We recorded the sagittal and frontal components of the stabilogram of healthy humans in upright undisturbed stance under five conditions of visual control: (i) open eyes (OE); (ii) closed eyes (CE); (iii) visual inversion (VI); (iv) central vision (CV), and (v) diffused light (DL). Through a low-pass filter of trajectories of the center of pressure of feet (CPF), the vertical projection of the center of gravity (CG) and, consequently, the difference CPF-CG were estimated. The former represents the controlled variable, while the latter is proportional to the horizontal acceleration and assumed to express the resultant joint stiffness (mostly in the ankle joints). The stiffness was characterized through a method based on spectral analysis of the CPF-CG variable and subsequent calculations of the median frequency (MF) and the root mean square (RMS) of the spectra. The median frequencies of the spectra of the CPF-CG variable changed slightly under various visual conditions. At standing on a rigid support, they varied from 0.97 to 0.99 Hz and from 0.93 to 0.97 Hz for the CPF-CG, calculated from the sagittal and frontal components of the stabilogram, respectively. Under conditions of a pliable support, the corresponding frequencies varied within the limits of 0.79–0.83 Hz and 0.74–0.78 Hz. In contrast to the median frequencies, the RMSs demonstrated greater variability depending on different visual conditions. At standing on a rigid support, paired comparisons showed significant differences between the RMSs of the spectra of the CPF-CG variable of the sagittal direction under CE and OE conditions (0.14 ± 0.030 and 0.09 ± 0.020 mm, respectively) and under DL and OE conditions (0.130 ± ± 0.025 and 0.090 ± 0.020 mm, respectively). The RMS of the CPF-CG variable calculated for the frontal stabilogram differed significantly from each other for the VI and OE conditions (0.115 ± 0.020 and 0.075 ± ± 0.015 mm, respectively). In case of standing on a pliable support, a greater variability of visual influences on the CPF-CG variable was found. The RMS for its sagittal motion was the greatest under CE conditions (0.19 ± 0.03 mm); it was significantly greater than the respective values under OE, CV, and DL conditions (0.097 ± ± 0.020, 0.110 ± 0.020, and 0.140 ± 0.030 mm, respectively). The means of RMSs of the spectra of the frontal CPF-CG was also the greatest under CE conditions (0.20 ± 0.03 mm) and the smallest under OE conditions (0.095 ± 0.020 mm). In addition, the value of the RMS fluctuations under CE conditions (0.150 ± 0.025 mm) differed significantly from the respective values under OE conditions (0.095 ± 0.020 mm) and CV conditions (0.110 ± 0.020 mm). Thus, our findings support the statement that the influence of visual conditions on the maintenance of vertical stance is mediated (at least partially) by the mechanisms controlling the ankle joint stiffness. This regulation is mostly manifested in changes of a single parameter, the amplitude of fluctuations of the CPF-CG variable. We also found that the joint stiffness can be modulated by both nonspecific visual influences (which, in particular, reflect the perception of illumination) and specific visual influences, related to information on the position of the body and on its movements with respect to external objects. Neirofiziologiya/Neurophysiology, Vol. 38, No. 2, pp. 157–166, March–April, 2006.     

Perturbation analysis of 4D dose distribution for scanned carbon-ion beam radiotherapy

PurposeTo evaluate the patients’ set-up error-induced perturbation effects on 4D dose distributions (4DDD) of range-adapted internal target volume-based (raITV) treatment plan using lung and liver 4DCT data sets.MethodsWe enrolled 20 patients with lung and liver cancer treated with respiratory-gated carbon-ion beam scanning therapy. PTVs were generated by adding a 2 mm range-adapted set-up margin on the raITVs. Set-up errors were simulated by shifting the beam isocenter in three translational directions of ±2 mm, ±4 mm, and ±6 mm. 4DDDs were calculated for both nominal and isocenter-shifted situations. Dose metrics of CTV dose coverage (D95) and normal tissue sparing were evaluated. Statistical significance with p < 0.01 was considered by Wilcoxon signed rank test.ResultsThe CTV dose coverage was more sensitive to set-up errors for lung cases than for liver cases, and more serious in superior-inferior direction. The sufficient CTV-D95 > 98% could be achieved with set-up errors less than ±2 mm in all shift directions both for lung and liver cases. With the increase of set-up error, the CTV dose coverage decreased gradually. The clinical criterial of CTV-D95 > 95% could not be fulfilled with set-up error reached to ±4 mm for lung cases, and ±6 mm for liver cases. OAR doses did not have a significant difference with each set-up error for both lung and liver cases.ConclusionsThe range-adapted set-up margin successfully prevented dose degradation of 4DDDs in the presence of the same magnitude of set-up error for raITV-based carbon-ion beam scanning therapy.     

Validating a low-cost,consumer force-measuring platform as an accessible alternative for measuring postural sway

The Zibrio SmartScale is a low-cost, portable force platform designed to perform an objective assessment of postural stability. The purpose of the present study was to validate the center of pressure (COP) measurements in the Zibrio SmartScale. Simultaneous COP data was collected by a Zibrio SmartScale and a laboratory-grade force platform (LFP) under the dynamic motion of an inverted pendulum device intended to mimic the sway of a standing human. The inverted pendulum was placed on the Zibrio SmartScale which was placed on the LFP. The pendulum was then displaced to angles of 3° and 5° in both the anterior-posterior (AP) and medial–lateral (ML) directions. The findings of this study show low mean average error (MAE) among the measures taken simultaneously upon the LFP and Zibrio SmartScale with no appreciable difference in error in either AP or ML COP directions. Averaged over repeated trials, the MAE did not surpass 0.5 mm. This represented 0.4% of the total range (±50 to 60 mm in 5° displacement trials) of simulated COP. The results of this study strongly indicate that the Zibrio SmartScale can perform adequately as a light-weight and low-cost alternative method of COP measurement in comparison to a traditional LFP.     

Night-time behavior of stabled and pastured peri-parturient ponies

Pregnant and lactating pony mares were observed in two environments, stable and pasture. Twenty-six pony mares were observed on pasture for 2 weeks before and after parturition. The behavior of each mare was recorded every 30 min from 18.00 to 06.00 h. The mutually exclusive behaviors were standing (either standing alert or standing at rest with a hindlimb flexed), grazing (prehending or masticating grass), walking, lying in sternal recumbency and lying in lateral recumbency. The total time-budget for prepartum mares on pasture was 55.3 ± 4.1% grazing, 32.9 ± 3.3% standing, 6.0 ± 1.5% lying in sternal recumbency, 2.7 ± 0.7% walking and 1.4 ± 0.6% lying in lateral recumbency. Grazing and standing occurred at all times, but grazing was most common from 18.00 to 21.00 h and after 05.00 h. Lying was most common between 01.00 and 04.00. Lying in lateral recumbency occurred only after dark, in pre-partum mares. The total time-budget for post-partum mares on pasture was 68.6 ± 4.0% grazing, 22.5 ± 3.0% standing, 4.7 ± 1.0% walking, 4.2 ± 1.2% lying in sternal recumbency and 0.2 ± 0.2% lying in lateral recumbency. Lying in lateral recumbency was seen only at 18.00 h. Lying in sternal recumbency occurred between 21.00 and 04.30 h. More time was spent grazing by the post-partum mares than by the pre-partum mares.The same behaviors were recorded for stabled pony mares except that eating hay rather than grazing constituted the ingestive behavior quantified. The total time-budget for pregnant stabled ponies was 71 ± 3% standing, 15 ± 3% eating, 0.5 ± 0% lying in lateral recumbency, 0.5 ± 0.2% walking and 12.1 ± 2.3% lying in sternal recumbency. Eating decreased and standing increased during the night. Most lying was seen between 01.30 and 05.00 h. Lying in lateral recumbency occurred between 19.30 and 03.30 h. The total nocturnal time-budget of post-partum stalled ponies was 67 ± 3% eating, 19 ± 3% standing and 13.0 ± 2.3% lying in sternal recumbency. Post-partum mares were not observed to walk or to lie in lateral recumbency.The change in behavior after parturition may reflect: (1) nutritional demands of lactation; (2) maternal protective behavior; (3) response to seasonal changes in the environment.     

An external dosimetry audit programme to credential static and rotational IMRT delivery for clinical trials quality assurance

PurposeExternal dosimetry audits give confidence in the safe and accurate delivery of radiotherapy. The RTTQA group have performed an on-site audit programme for trial recruiting centres, who have recently implemented static or rotational IMRT, and those with major changes to planning or delivery systems.MethodsMeasurements of reference beam output were performed by the host centre, and by the auditor using independent equipment. Verification of clinical plans was performed using the ArcCheck helical diode array.ResultsA total of 54 measurement sessions were performed between May 2014 and June 2016 at 28 UK institutions, reflecting the different combinations of planning and delivery systems used at each institution. Average ratio of measured output between auditor and host was 1.002 ± 0.006. Average point dose agreement for clinical plans was −0.3 ± 1.8%. Average (and 95% lower confidence intervals) of gamma pass rates at 2%/2 mm, 3%/2 mm and 3%/3 mm respectively were: 92% (80%), 96% (90%) and 98% (94%). Moderately significant differences were seen between fixed gantry angle and rotational IMRT, and between combination of planning systems and linac manufacturer, but not between anatomical treatment site or beam energy.ConclusionAn external audit programme has been implemented for universal and efficient credentialing of IMRT treatments in clinical trials. Good agreement was found between measured and expected doses, with few outliers, leading to a simple table of optimal and mandatory tolerances for approval of dosimetry audit results. Feedback was given to some centres leading to improved clinical practice.     

Crystal structure of Turkey egg-white lysozyme: Results of the molecular replacement method at 5 Å resolution

Turkey egg-white lysozyme differs from hen egg-white lysozyme in its primary structure in 7 of the 129 residues. We have determined the rotational and translational parameters relating the known co-ordinates of hen egg-white lysozyme molecule to the turkey lysozyme. The rotational parameters were determined using the rotation function, the translational parameters were determined by placing the properly rotated molecule systematically at all positions within the unit cell and searching for those positions producing few intermolecular contacts between the α-carbon atoms of one molecule and all its neighbors. These parameters were refined by minimizing the conventional R factor between observed and calculated structure amplitudes. The final rotational and translational parameters give an R value of 46.7% for reflections with d spacings between 6 Å and 12 Å and have 7 intermolecular contacts closer than 5 Å between the a carbon atoms of one molecule and all its neighbors. An electron density map has been calculated at 5 Å resolution; the packing of the molecules in this form appears to present the entire length of the active cleft in the vicinity of the crystallographic 6-fold axis and does not appear to be blocked by neighboring molecules.     

Accuracy of interface pressure measurement systems

Interface pressure measurement is needed to assess beds designed to prevent pressure sores, so it is therefore important to establish the accuracy of interface pressure measuring systems. In this study, the Talley SA500 pressure evaluator (with 28 mm and 100 mm sensor pads), the DIPE (with 100 mm sensor pad), and a water-filled bladder system (with 0.1 ml and 0.3 ml water) were assessed. Measurement errors were evaluated using a loading system with pressures up to 7.4 kPa (55 mm Hg) in steps of 0.9 kPa (6.9 mm Hg). All systems tested over-measured interface pressure, the error being approximately linearly proportional to the loading pressure. The repeatability for a given system was approximately constant. The mean error (± SD) (%) and repeatability (kPa) for the systems were: 28 mm Talley 12 ± 1%, ± 0.07 kPa; 100 mm Talley 15 ± 1%, ± 0.07 kPa; DIPE 27 ± 3%, ± 0.12 kPa; 0.1 ml water bladder 17 ± 1%, ± 0.13 kPa; 0.3 ml water bladder 26 ± 3%, ± 0.07 kPa. Different interfaces affected accuracy markedly, and repeatability was affected when an inhomogeneous interface was used. The study shows that the errors associated with interface pressure measurement systems can be substantial, and can vary from one system to another.     

Analysis of forearm rotational motion using biplane fluoroscopic intensity-based 2D–3D matching

Measuring three-dimensional (3D) forearm rotational motion is difficult. We aimed to develop and validate a new method for analyzing 3D forearm rotational motion. We proposed biplane fluoroscopic intensity-based 2D–3D matching, which employs automatic registration processing using the evolutionary optimization strategy. Biplane fluoroscopy was conducted for forearm rotation at 12.5 frames per second along with computed tomography (CT) at one static position. An arm phantom was embedded with eight stainless steel spheres (diameter, 1.5 mm), and forearm rotational motion measurements using the proposed method were compared with those using radiostereometric analysis, which is considered the ground truth. As for the time resolution analysis, we measured radiohumeral joint motion in a patient with posterolateral rotatory instability and compared the 2D–3D matching method with the simulated multiple CT method, which uses CTs at multiple positions and interpolates between the positions. Rotation errors of the radius and ulna between these two methods were 0.31 ± 0.35° and 0.32 ± 0.33°, respectively, translation errors were 0.43 ± 0.35 mm and 0.29 ± 0.25 mm, respectively. Although the 2D–3D method could detect joint dislocation, the multiple CT method could not detect quick motion during joint dislocation. The proposed method enabled high temporal- and spatial-resolution motion analyses with low radiation exposure. Moreover, it enabled the detection of a sudden motion, such as joint dislocation, and may contribute to 3D motion analysis, including joint dislocation, which currently cannot be analyzed using conventional methods.     

Measuring the sensitivity of total knee replacement kinematics and laxity to soft tissue imbalances

Ligament balancing during total knee replacement (TKR) is receiving increased attention due to its influence on resulting joint kinematics and laxity. We employed a novel in vitro technique to measure the kinematics and laxity of TKR implants during gait, and measured how these characteristics are influenced by implant shape and soft tissue balancing, simulated using virtual ligaments. Compared with virtual ligaments that were equally balanced in flexion and extension, the largest changes in stance-phase tibiofemoral AP and IE kinematics occurred when the virtual ligaments were simulated to be tighter in extension (tibia offset 1.0 ± 0.1 mm posterior and 3.6 ± 0.1° externally rotated). Virtual ligaments which were tight in flexion caused the largest swing-phase changes in AP kinematics (tibia offset 2.3 ± 0.2 mm), whereas ligaments which were tight in extension caused the largest swing-phase changes in IE kinematics (4.2 ± 0.1° externally rotated). When AP and IE loads were superimposed upon normal gait loads, incremental changes in AP and IE kinematics occurred (similar to laxity testing); and these incremental changes were smallest for joints with virtual ligaments that were tight in extension (in both the stance and swing phases). Two different implant designs (symmetric versus medially congruent) exhibited different kinematics and sensitivities to superimposed loads, but demonstrated similar responses to changes in ligament balancing. Our results demonstrate the potential for pre-clinical testing of implants using joint motion simulators with virtual soft tissues to better understand how ligament balancing affects implant motion.     

Cognitive Loading Affects Motor Awareness and Movement Kinematics but Not Locomotor Trajectories during Goal-Directed Walking in a Virtual Reality Environment

The primary purpose of this study was to investigate the effects of cognitive loading on movement kinematics and trajectory formation during goal-directed walking in a virtual reality (VR) environment. The secondary objective was to measure how participants corrected their trajectories for perturbed feedback and how participants'' awareness of such perturbations changed under cognitive loading. We asked 14 healthy young adults to walk towards four different target locations in a VR environment while their movements were tracked and played back in real-time on a large projection screen. In 75% of all trials we introduced angular deviations of ±5° to ±30° between the veridical walking trajectory and the visual feedback. Participants performed a second experimental block under cognitive load (serial-7 subtraction, counter-balanced across participants). We measured walking kinematics (joint-angles, velocity profiles) and motor performance (end-point-compensation, trajectory-deviations). Motor awareness was determined by asking participants to rate the veracity of the feedback after every trial. In-line with previous findings in natural settings, participants displayed stereotypical walking trajectories in a VR environment. Our results extend these findings as they demonstrate that taxing cognitive resources did not affect trajectory formation and deviations although it interfered with the participants'' movement kinematics, in particular walking velocity. Additionally, we report that motor awareness was selectively impaired by the secondary task in trials with high perceptual uncertainty. Compared with data on eye and arm movements our findings lend support to the hypothesis that the central nervous system (CNS) uses common mechanisms to govern goal-directed movements, including locomotion. We discuss our results with respect to the use of VR methods in gait control and rehabilitation.     

Analysis of the Setup Uncertainty and Margin of the Daily ExacTrac 6D Image Guide System for Patients with Brain Tumors

This study evaluated the setup uncertainties for brain sites when using BrainLAB’s ExacTrac X-ray 6D system for daily pretreatment to determine the optimal planning target volume (PTV) margin. Between August 2012 and April 2015, 28 patients with brain tumors were treated by daily image-guided radiotherapy using the BrainLAB ExacTrac 6D image guidance system of the Novalis-Tx linear accelerator. DUON^TM (Orfit Industries, Wijnegem, Belgium) masks were used to fix the head. The radiotherapy was fractionated into 27–33 treatments. In total, 844 image verifications were performed for 28 patients and used for the analysis. The setup corrections along with the systematic and random errors were analyzed for six degrees of freedom in the translational (lateral, longitudinal, and vertical) and rotational (pitch, roll, and yaw) dimensions. Optimal PTV margins were calculated based on van Herk et al.’s [margin recipe = 2.5∑ + 0.7σ - 3 mm] and Stroom et al.’s [margin recipe = 2∑ + 0.7σ] formulas. The systematic errors (∑) were 0.72, 1.57, and 0.97 mm in the lateral, longitudinal, and vertical translational dimensions, respectively, and 0.72°, 0.87°, and 0.83° in the pitch, roll, and yaw rotational dimensions, respectively. The random errors (σ) were 0.31, 0.46, and 0.54 mm in the lateral, longitudinal, and vertical rotational dimensions, respectively, and 0.28°, 0.24°, and 0.31° in the pitch, roll, and yaw rotational dimensions, respectively. According to van Herk et al.’s and Stroom et al.’s recipes, the recommended lateral PTV margins were 0.97 and 1.66 mm, respectively; the longitudinal margins were 1.26 and 3.47 mm, respectively; and the vertical margins were 0.21 and 2.31 mm, respectively. Therefore, daily setup verifications using the BrainLAB ExacTrac 6D image guide system are very useful for evaluating the setup uncertainties and determining the setup margin.     

Real patient data based cross verification of kilovoltage and megavoltage CT calibration for proton therapy

PurposeWe propose a methodology to evaluate the stoichiometric calibration method on MVCT against the corresponding kVCT calibration using patient data.MethodsStoichiometric calibrations were conducted for a MVCT and a kVCT scanner, respectively. We retrospectively analyzed kVCT and MVCT images of 21 patients by picking small tissue volumes in kVCT images and performing image registration to locate the tissue volumes in corresponding MVCT images. We computed the difference between the mean proton stopping power derived through kVCT and MVCT calibration, taking into account the uncertainties in calibration, imaging, and image registration.ResultskVCT and MVCT calibration curves were in good agreement for soft tissues such as muscle and brain, but showed statistically significant difference (p < 0.05) in stopping power of adipose (2.4 ± 1.7%) and bony structures such as spongiosa, and cranium (−3.2 ± 1.4 and −3.1 ± 2.1%, respectively).ConclusionThe MVCT calibration might not agree with the corresponding kVCT calibration for some tissues.     

Visual position stabilization in the hummingbird hawk moth, Macroglossum stellatarum L. I. Behavioural analysis

Optomotor responses of freely flying hawk moths, Macroglossum stellatarum, were characterized while the animals were hovering in front of and feeding on a dummy flower. Compensatory translational and rotational movements of the hawk moth were elicited by vertical grating patterns moving horizontally, mimicking imposed rotational and translational displacements of the animal in the horizontal plane. Oscillatory translational and rotational pattern motion leads to compensatory responses that peak in the frequency range between 2 Hz and 4 Hz. The control systems mediating the translational and rotational components of the optomotor response do not seem to influence each other. The system mediating translational responses is more sensitive in the fronto-lateral part of the visual field than in the lateral part; the opposite is true for the rotational system. The sensitivity of the translational system does not change along the vertical, whereas the rotational system is much more sensitive to motion in the dorsal than in the ventral part of the visual field. These sensitivity gradients may reflect an adaptation to the specific requirements of position stabilization in front of flowers during feeding. Accepted: 13 August 1997     

Evaluation of intrafractional head motion for intracranial stereotactic radiosurgery with a thermoplastic frameless mask and ceiling-floor-mounted image guidance device

PurposeTo evaluate intrafractional head motion (IFM) in patients who underwent intracranial stereotactic radiosurgery with the ExacTrac X-ray system (ETX) and a frameless mask.MethodsA total of 143 patients who completed a pre-treatment examination for IFM were eligible for this study. The frameless mask type B R408 (Klarity Medical & Equipment Co., Ltd., Guangzhou, China), which covers the back of the head, and the entire face, was used for patient immobilization. After the initial 6D correction and first X-ray verification (IFM₁), X-ray verification was performed every 3 min for a duration of 15 min. The IFM_p (2 ≤ p ≤ 6) was calculated as the positional difference from IFM₁. In addition, the inter-phase IFM (IP-IFM) and IFM_m were calculated. The IP-IFM was defined as |IFM_p − IFM_p-1|, and IFM_m as the difference between the values after all patients were asked to move their heads intentionally with the frameless mask on.ResultsBoth translational IFM_p and IP-IFM exceeded 1 mm for a single patient, whereas, for all patients, the translational IFM_m values were kept to within 1 mm in all directions. The proportions of the rotational IFM_p, IP-IFM, and IFM_m values within 0.5° were greater than 94.4%, 98.6%, and 90.2% for all of the rotational axes, respectively.ConclusionsA frameless mask achieved highly accurate patient positioning in combination with ETX and a 6°-of-freedom robotic couch; however, a deviation over 1 mm and 0.5° was observed with low frequency. Therefore, X-ray verification and correction are required during treatment.