Tridimensional dose evaluation of the respiratory motion influence on breast radiotherapy treatments using conformal radiotherapy,forward IMRT,and inverse IMRT planning techniques

PurposeTo evaluate the respiratory motion influence on the tridimensional (3D) dose delivery to breast-shaped phantoms using conformal radiotherapy (3D-RT), Field-in Field (FiF), and IMRT planning techniques.MethodsThis study used breast-shaped phantoms filled with MAGIC-f gel dosimeter to simulate the breast, and an oscillation platform to simulate the respiratory motion. The platform allowed motion in the anterior-posterior direction with oscillation amplitudes of 0.34 cm, 0.88 cm, and 1.22 cm. CT images of the static phantom were used for the 3D-RT, FiF, and IMRT treatment planning. Five phantoms were prepared and irradiated for each planning technique evaluated. Phantom 1 was irradiated static, phantoms 2–4 were irradiated moving with the three different motion amplitudes, and phantom 5 was used as a reference. The 3D dose distributions were obtained by relaxometry of magnetic resonance imaging, and the respiratory motion influence in the doses distribution was accessed by gamma evaluations (3%/3mm/15% threshold) comparing the measurements of the phantoms irradiated under movement with the static ones.ResultsThe mean gamma approvals for three oscillatory amplitudes were 96.44%, 93.23%, and 91.65%; 98.42%, 95.66%, and 94.31%; and 94.49%, 93.51%, and 86.62% respectively for 3D-RT, FiF and IMRT treatments. A gamma results profile per slice along the phantom showed that for FiF and IMRT irradiations, most of the failures occurred in the central region of the phantom.ConclusionsBy increasing the respiratory motion movement, the dose distribution variations for the three planning techniques were more pronounced, being the FiF technique variations the smallest one.     

Ultrasound-driven cardiac MRI

PurposeOne of the challenges of cardiac MR imaging is the compensation of respiratory motion, which causes the heart and the surrounding tissues to move. Commonly-used methods to overcome this effect, breath-holding and MR navigation, present shortcomings in terms of available acquisition time or need to periodically interrupt the acquisition, respectively. In this work, an implementation of respiratory motion compensation that obtains information from abdominal ultrasound and continuously adapts the imaged slice position in real time is presented.MethodsA custom workflow was developed, comprising an MR-compatible ultrasound acquisition system, a feature-motion-tracking system with polynomial predictive capability, and a custom MR sequence that continuously adapts the position of the acquired slice according to the tracked position. The system was evaluated on a moving phantom by comparing sharpness and image blurring between static and moving conditions, and in vivo by tracking the motion of the blood vessels of the liver to estimate the cardiac motion. Cine images of the heart were acquired during free breathing.ResultsIn vitro, the predictive motion correction yielded significantly better results than non-predictive or non-corrected acquisitions (p ≪ 0.01). In vivo, the predictive correction resulted in an image quality very similar to the breath-hold acquisition, whereas the uncorrected images show noticeable blurring artifacts.ConclusionIn this work, the possibility of using ultrasound navigation with tracking for the real-time adaptation of MR imaging slices was demonstrated. The implemented technique enabled efficient imaging of the heart with resolutions that would not be feasible in a single breath-hold.     

Validation of 4D Monte Carlo dose calculations using a programmable deformable lung phantom

PurposeTo validate the accuracy of 4D Monte Carlo (4DMC) simulations to calculate dose deliveries to a deforming anatomy in the presence of realistic respiratory motion traces. A previously developed deformable lung phantom comprising an elastic tumor was modified to enable programming of arbitrary motion profiles. 4D simulations of the dose delivered to the phantom were compared with the measurements.MethodsThe deformable lung phantom moving with irregular breathing patterns was irradiated using static and VMAT beam deliveries. Using the RADPOS 4D dosimetry system, point doses were measured inside and outside the tumor. Dose profiles were acquired using films along the motion path of the tumor (S-I). In addition to dose measurements, RADPOS was used to record the motion of the tumor during dose deliveries. Dose measurements were then compared against 4DMC simulations with EGSnrc/4DdefDOSXYZnrc using the recorded tumor motion.ResultsThe agreements between dose profiles from measurements and simulations were determined to be within 2%/2 mm. Point dose agreements were within 2σ of experimental and/or positional/dose reading uncertainties. 4DMC simulations were shown to accurately predict the sensitivity of delivered dose to the starting phase of breathing motions. We have demonstrated that our 4DMC method, combined with RADPOS, can accurately simulate realistic dose deliveries to a deforming anatomy moving with realistic breathing traces. This 4DMC tool has the potential to be used as a quality assurance tool to verify treatments involving respiratory motion. Adaptive treatment delivery is another area that may benefit from the potential of this 4DMC tool.     

Dose delivery accuracy on helical tomotherapy for 4-dimensional tumor motion — a phantom study

BackgroundThe advances in image guidance and capability of highly conformal dose deliveries made possible the use of helical tomotherapy (HT) for lung cancer treatment. To determine the effect of respiratory motion on the delivered dose in HT, film dosimetry using a dynamic phantom was performed. This was a phantom study to determine the effect of motion on the delivered dose in HT.Materials and methods4D computed tomography (4DCT) was acquired for various target motions of CIRS dynamic phantom (CIRS Inc., Norfolk, USA) with 2.5cm diameter spherical target of volume 8.2 cc moving in the COS⁴ motion pattern. AveIP images and treatment plans were generated in the HT planning system. Target excursions during treatment delivery were changed in the superior-inferior, anteroposterior and lateral directions. The breathing cycle time was varied from 4 to 5 sec. and also the delivery interruptions were introduced. A film was exposed for each delivery and gamma analysis was performed.ResultsThe gamma pass rate (GPR) with 3%, 2 mm criteria for the target motion in the S-I direction showed a significant reduction from 97.5% to 54.4% as the motion increased from 3 mm to 8 mm (p = 0.03). For the target motion in S-I = 8 mm, L-R = A-P = 3 mm, the percentage decrease in the GPR was 74% (p = 0.001) for three interruptions.ConclusionThe ITV based approach in HT is ideal for a shallow breathing situation when the tumor excursions were confined to 5 mm in the S-I and 3 mm in L-R and A-P directions.     

A modular dose delivery system for treating moving targets with scanned ion beams: Performance and safety characteristics,and preliminary tests

PurposeThe purpose of this study was to develop a modular dose-delivery system (DDS) for scanned-ion radiotherapy that mitigates against organ motion artifacts by synchronizing the motion of the beam with that of the moving anatomy.MethodsWe integrated a new motion synchronization system and an existing DDS into two centers. The modular approach to integration utilized an adaptive layer of software and hardware interfaces. The method of synchronization comprised three major tasks, namely, the creation of 3D treatment plans (each representing one phase of respiratory motion and together comprising a 4D plan), monitoring anatomic motion during treatment, and synchronization of the beam to anatomic motion. The synchronization was accomplished in real time by repeatedly selecting and delivering a 3D plan, i.e., the one that most closely corresponded to the current anatomic state, until all plans were delivered. The performance characteristics of the motion mitigation system were tested by delivering 4D treatment plans to a moving phantom and comparing planned and measured dose distributions. Dosimetric performance was considered acceptable when the gamma-index pass rate was >90%, homogeneity-index value was >95%, and conformity-index value was >60%. Selected safety characteristics were tested by introducing errors during treatment and testing DDS response.ResultsAcceptable dosimetric performance and safety characteristics were observed for all treatment plans.ConclusionsWe demonstrated, for the first time, that a modular prototype system, synchronizing scanned ion beams with moving targets can deliver conformal, motion-compensated dose distributions. The prototype system was implemented and characterized at GSI and CNAO.     

Development of a deformable phantom for experimental verification of 4D Monte Carlo simulations in a deforming anatomy

PurposeTo verify the accuracy of 4D Monte Carlo (MC) simulations, using the 4DdefDOSXYZnrc user code, in a deforming anatomy. We developed a tissue-equivalent and reproducible deformable lung phantom and evaluated 4D simulations of delivered dose to the phantom by comparing calculations against measurements.MethodsA novel deformable phantom consisting of flexible foam, emulating lung tissue, inside a Lucite external body was constructed. A removable plug, containing an elastic tumor that can hold film and other dosimeters, was inserted in the phantom. Point dose and position measurements were performed inside and outside the tumor using RADPOS 4D dosimetry system. The phantom was irradiated on an Elekta Infinity linac in both stationary and moving states. The dose delivery was simulated using delivery log files and the phantom motion recorded with RADPOS.ResultsReproducibility of the phantom motion was determined to be within 1 mm. The phantom motion presented realistic features like hysteresis. MC calculations and measurements agreed within 2% at the center of tumor. Outside the tumor agreements were better than 5% which were within the positional/dose reading uncertainties at the measurement points. More than 94% of dose points from MC simulations agreed within 2%/2 mm compared to film measurements.ConclusionThe deformable lung phantom presented realistic and reproducible motion characteristics and its use for verification of 4D dose calculations was demonstrated. Our 4DMC method is capable of accurate calculations of the realistic dose delivered to a moving and deforming anatomy during static and dynamic beam delivery techniques.     

Real-time tumor tracking with an artificial neural networks-based method: A feasibility study

The purpose of this study was to develop and assess the performance of a tumor tracking method designed for application in radiation therapy. This motion compensation strategy is currently applied clinically only in conventional photon radiotherapy but not in particle therapy, as greater accuracy in dose delivery is required.We proposed a tracking method that exploits artificial neural networks to estimate the internal tumor trajectory as a function of external surrogate signals. The developed algorithm was tested by means of a retrospective clinical data analysis in 20 patients, who were treated with state of the art infra-red motion tracking for photon radiotherapy, which is used as a benchmark. Integration into a hardware platform for motion tracking in particle therapy was performed and then tested on a moving phantom, specifically developed for this purpose.Clinical data show that a median tracking error reduction up to 0.7 mm can be achieved with respect to state of the art technologies. The phantom study demonstrates that a real-time tumor position estimation is feasible when the external signals are acquired at 60 Hz.The results of this work show that neural networks can be considered a valuable tool for the implementation of high accuracy real-time tumor tracking methodologies.     

Adaptive movement compensation for in vivo imaging of fast cellular dynamics within a moving tissue

In vivo non-linear optical microscopy has been essential to advance our knowledge of how intact biological systems work. It has been particularly enabling to decipher fast spatiotemporal cellular dynamics in neural networks. The power of the technique stems from its optical sectioning capability that in turn also limits its application to essentially immobile tissue. Only tissue not affected by movement or in which movement can be physically constrained can be imaged fast enough to conduct functional studies at high temporal resolution. Here, we show dynamic two-photon Ca(2+) imaging in the spinal cord of a living rat at millisecond time scale, free of motion artifacts using an optical stabilization system. We describe a fast, non-contact adaptive movement compensation approach, applicable to rough and weakly reflective surfaces, allowing real-time functional imaging from intrinsically moving tissue in live animals. The strategy involves enslaving the position of the microscope objective to that of the tissue surface in real-time through optical monitoring and a closed feedback loop. The performance of the system allows for efficient image locking even in conditions of random or irregular movements.     

Optimised motion tracking for positron emission tomography studies of brain function in awake rats

Positron emission tomography (PET) is a non-invasive molecular imaging technique using positron-emitting radioisotopes to study functional processes within the body. High resolution PET scanners designed for imaging rodents and non-human primates are now commonplace in preclinical research. Brain imaging in this context, with motion compensation, can potentially enhance the usefulness of PET by avoiding confounds due to anaesthetic drugs and enabling freely moving animals to be imaged during normal and evoked behaviours. Due to the frequent and rapid motion exhibited by alert, awake animals, optimal motion correction requires frequently sampled pose information and precise synchronisation of these data with events in the PET coincidence data stream. Motion measurements should also be as accurate as possible to avoid degrading the excellent spatial resolution provided by state-of-the-art scanners. Here we describe and validate methods for optimised motion tracking suited to the correction of motion in awake rats. A hardware based synchronisation approach is used to achieve temporal alignment of tracker and scanner data to within 10 ms. We explored the impact of motion tracker synchronisation error, pose sampling rate, rate of motion, and marker size on motion correction accuracy. With accurate synchronisation (<100 ms error), a sampling rate of >20 Hz, and a small head marker suitable for awake animal studies, excellent motion correction results were obtained in phantom studies with a variety of continuous motion patterns, including realistic rat motion (<5% bias in mean concentration). Feasibility of the approach was also demonstrated in an awake rat study. We conclude that motion tracking parameters needed for effective motion correction in preclinical brain imaging of awake rats are achievable in the laboratory setting. This could broaden the scope of animal experiments currently possible with PET.     

基于直线电机连续-步进运动的快速光声显微成像系统

报道了一种利用直线电机连续-步进的扫描方式进行光声显微成像的系统,该系统在运动时走弓字型路线,其中直线电机在X轴方向上连续运动,在Y轴方向上以步进的方式运动,采集卡只在X轴电机运动的过程中连续采集。该成像系统较之前振镜扫描的方式扫描的范围更大,可达到厘米尺度范围内的生物组织光声成像;较之前的步进电机逐点扫描的方式扫描速度明显提高。同时本文采用电机带动光和超声换能器一同扫描的方式,较光和超声换能器不动电机带动样品扫描的方式更灵活。另外利用包埋碳丝的模拟样品和在体小鼠耳朵血管来验证系统的成像能力。实验结果表明,这种快速光声显微成像方法及其系统可以实现在体组织的高分辨率成像,有望成为一种无创、实时的光声显微镜应用于生物医学当中。     

Evaluation of the target dose coverage of stereotactic body radiotherapy for lung cancer using helical tomotherapy: A dynamic phantom study

AimTo evaluate the target dose coverage for lung stereotactic body radiotherapy (SBRT) using helical tomotherapy (HT) with the internal tumor volume (ITV) margin settings adjusted according to the degree of tumor motion.BackgroundLung SBRT with HT may cause a dosimetric error when the target motion is large.Materials and methodsTwo lung SBRT plans were created using a tomotherapy planning station. Using these original plans, five plans with different ITV margins (4.0–20.0 mm for superior-inferior [SI] dimension) were generated. To evaluate the effects of respiratory motion on HT, an original dynamic motion phantom was developed. The respiratory wave of a healthy volunteer was used for dynamic motion as the typical tumor respiratory motion. Five patterns of motion amplitude that corresponded to five ITV margin sizes and three breathing cycles of 7, 14, and 28 breaths per minute were used. We evaluated the target dose change between a static delivery and a dynamic delivery with each motion pattern.ResultsThe target dose difference increased as the tumor size decreased and as the tumor motion increased. Although a target dose difference of <5 % was observed at ≤10 mm of tumor motion for each condition, a maximum difference of -9.94 % ± 7.10 % was observed in cases of small tumors with 20 mm of tumor motion under slow respiration.ConclusionsMinimizing respiratory movement is recommended as much as possible for lung SBRT with HT, especially for cases involving small tumors.     

Cuttlefish camouflage: context-dependent body pattern use during motion

It is virtually impossible to camouflage a moving target against a non-uniform background, but strategies have been proposed to reduce detection and targeting of movement. Best known is the idea that high contrast markings produce ‘motion dazzle’, which impairs judgement of speed and trajectory. The ability of the cuttlefish Sepia officinalis to change its visual appearance allows us to compare the animal''s choice of patterns during movement to the predictions of models of motion camouflage. We compare cuttlefish body patterns used during movement with those expressed when static on two background types; one of which promotes low-contrast mottle patterns and the other promotes high-contrast disruptive patterns. We find that the body pattern used during motion is context-specific and that high-contrast body pattern components are significantly reduced during movement. Thus, in our experimental conditions, cuttlefish do not use high contrast motion dazzle. It may be that, in addition to being inherently conspicuous during movement, moving high-contrast patterns will attract attention because moving particles in coastal waters tend to be of small size and of low relative contrast.     

Validation of a single camera three-dimensional motion tracking system

The ability to analyze human movement is an essential tool of biomechanical analysis for both sport and clinical applications. Traditional 3D motion capture technology limits the feasibility of large scale data collections and therefore the ability to address clinical questions. Ideally, the measurement system/protocol should be non-invasive, mobile, generate nearly instantaneous feedback to the clinician and athlete, and be relatively inexpensive. The retro-grate reflector (RGR) is a new technology that allows for three-dimensional motion capture using a single camera. Previous studies have shown that orientation and position information recorded by the RGR system has high measurement precision and is strongly correlated with a traditional multi-camera system across a series of static poses. The technology has since been refined to record moving pose information from multiple RGR targets at sampling rates adequate for assessment of athletic movements. The purpose of this study was to compare motion data for a standard athletic movement recorded simultaneously with the RGR and multi-camera (Motion Analysis Eagle) systems. Nine subjects performed three single-leg land-and-cut maneuvers. Thigh and shank three-dimensional kinematics were collected with the RGR and Eagle camera systems simultaneously at 100 Hz. Results showed a strong agreement between the two systems in all three planes, which demonstrates the ability of the RGR system to record moving pose information from multiple RGR targets at a sampling rate adequate for assessment of human movement and supports the ability to use the RGR technology as a valid 3D motion capture system.     

Non-invasive NIR spectroscopy of human brain function during exercise

The assessment of physiological changes associated with brain activity has become possible by optical methods, such as near-infrared spectroscopy (NIRS). NIRS is a useful neuroimaging technique based on haemodynamic principles for the non-invasive investigation of brain in motion. Due to its properties, the near-infrared light can penetrate biological tissue reasonably well to assess brain activity and two types of measurements are possible according to the number of channels used: dynamic changes in a localized brain region or functional brain imaging. The theoretical and technological advances of the past 10–15 years have opened the door to a range of applications in the human movement sciences, including some that involve imaging of the adult brain during motor and cognitive tasks, which for many years had been inaccessible to NIRS. This article examines the perturbation methods for measuring cerebral haemodynamic responses within resting and exercise conditions in humans and how NIRS can be used to image the moving brain. Methodological challenges of NIRS technique are presented, while the advantages and pitfalls of NIRS compared to other neuroimaging methods are discussed. Actual and future uses for NIRS in the field of sport sciences are outlined for a better understanding of brain processes during movement.     

Time Multiplexing Super Resolving Technique for Imaging from a Moving Platform

We propose a method for increasing the resolution of an object and overcoming the diffraction limit of an optical system installed on top of a moving imaging system, such as an airborne platform or satellite. The resolution improvement is obtained in a two-step process. First, three low resolution differently defocused images are being captured and the optical phase is retrieved using an improved iterative Gerchberg-Saxton based algorithm. The phase retrieval allows to numerically back propagate the field to the aperture plane. Second, the imaging system is shifted and the first step is repeated. The obtained optical fields at the aperture plane are combined and a synthetically increased lens aperture is generated along the direction of movement, yielding higher imaging resolution. The method resembles a well-known approach from the microwave regime called the Synthetic Aperture Radar (SAR) in which the antenna size is synthetically increased along the platform propagation direction. The proposed method is demonstrated through laboratory experiment.     

Streptococcus pneumoniae induced c-Jun-N-terminal kinase- and AP-1 -dependent IL-8 release by lung epithelial BEAS-2B cells

Background

Chronic lung diseases are a major issue in public health. A serial pulmonary assessment using imaging techniques free of ionizing radiation and which provides early information on local function impairment would therefore be a considerably important development. Magnetic resonance imaging (MRI) is a powerful tool for the static and dynamic imaging of many organs. Its application in lung imaging however, has been limited due to the low water content of the lung and the artefacts evident at air-tissue interfaces. Many attempts have been made to visualize local ventilation using the inhalation of hyperpolarized gases or gadolinium aerosol responding to MRI. None of these methods are applicable for broad clinical use as they require specific equipment.

Methods

We have shown previously that low-field MRI can be used for static imaging of the lung. Here we show that mathematical processing of data derived from serial MRI scans during the respiratory cycle produces good quality images of local ventilation without any contrast agent. A phantom study and investigations in 85 patients were performed.

Results

The phantom study proved our theoretical considerations. In 99 patient investigations good correlation (r = 0.8; p ≤ 0.001) was seen for pulmonary function tests and MR ventilation measurements. Small ventilation defects were visualized.

Conclusion

With this method, ventilation defects can be diagnosed long before any imaging or pulmonary function test will indicate disease. This surprisingly simple approach could easily be incorporated in clinical routine and may be a breakthrough for lung imaging and functional assessment.     

Development of a 4D numerical chest phantom with customizable breathing

Respiratory movement information is useful for radiation therapy, and is generally obtained using 4D scanners (4DCT). In the interest of patient safety, reducing the use of 4DCT could be a significant step in reducing radiation exposure, the effects of which are not well documented. The authors propose a customized 4D numerical phantom representing the organ contours. Firstly, breathing movement can be simulated and customized according to the patient’s anthroporadiametric data. Using learning sets constituted by 4D scanners, artificial neural networks can be trained to interpolate the lung contours corresponding to an unknown patient, and then to simulate its respiration. Lung movement during the breathing cycle is modeled by predicting the lung contours at any respiratory phases. The interpolation is validated comparing the obtained lung contours with 4DCT via Dice coefficient. Secondly, a preliminary study of cardiac and œsophageal motion is also presented to demonstrate the flexibility of this approach. The application may simulate the position and volume of the lungs, the œsophagus and the heart at every phase of the respiratory cycle with a good accuracy: the validation of the lung modeling gives a Dice index greater than 0.93 with 4DCT over a breath cycle.     

A novel tool for assessing the correlation of internal/external markers during SGRT guided stereotactic ablative radiotherapy treatments

IntroductionAn in-house developed tool was implemented and validated to investigate the skin surface, hepatic dome, and target displacement for stereotactic ablative radiotherapy (SABR) of thoracic/abdominal lesions using a Surface Guided Radiation Therapy (SGRT) system combined with 4D- images.Materials and methodsFourteen consecutive patients with tumors near the hepatic dome undergoing SABR treatments were analyzed. For each patient, a planning 4D-CT and five 4D-CBCT images were acquired. The C-RAD technology was also used to register/monitor the position of the skin reference point (SRP) as an external marker representative of patient breathing. The 4D images were imported in the developed tool, and the absolute maximum height (P_max,dome) of the hepatic dome on the ten respiratory phases was semi-automatically detected. Similarly, the contour of the skin surface was extracted in correspondence with the SRP position. The tool has been validated using an ad hoc modified moving phantom with pre-selected amplitudes and numbers of cycles. The Pearson correlation coefficients and Bland-Altman plots were calculated.ResultsThere was a strong correlation between the skin motion amplitude based on 4D-CBCT and the C-RAD in all the patients (0.90 ± 0.08). Similarly, the mean ± SD of Pearson correlation coefficients of skin and P_max,dome movements registered by 4D-CT and 4D-CBCT were 0.90 ± 0.05 and 0.94 ± 0.05, respectively. The mean ± SD of Pearson correlation coefficients comparing the skin and P_max,dome displacements within each imaging modality were 0.88 ± 0.05 and 0.90 ± 0.05 for 4D-CT and 4D-CBCT, respectively. The SRP displacement during the set-up imaging and the treatment delivery were similar in all the investigated patients. Similar results were obtained for the ad hoc modified phantom in the preliminary validation phase.ConclusionThe strong correlation between the tumor/ hepatic dome and skin displacements confirms that the SGRT approach can be considered appropriate for intra- and inter-fraction motion management in SABR therapy.     

In vivo tests of an improved method for functional location of the subtalar joint axis

The subtalar joint is important in frontal plane movement and posture of the hindfoot. Abnormal subtalar joint moments caused by muscle forces and the ground reaction force acting on the foot are thought to play a role in various foot deformities. Calculating joint moments typically requires knowledge of the location of the joint axis; however, location of the subtalar axis from measured movement is difficult because the talus cannot be tracked using skin-mounted markers. The accuracy of a novel technique for locating the subtalar axis was assessed in vivo using magnetic resonance imaging. The method was also tested with skin-mounted markers and video motion analysis. The technique involves applying forces to the foot that cause pure subtalar joint motion (with negligible talocrural joint motion), and then using helical axis decomposition of the resulting tibiocalcaneal motion. The resulting subtalar axis estimates differed by 6° on average from the true best-fit subtalar axes in the MRI tests. Motion was found to have been applied primarily about the subtalar joint with an average of only 3° of talocrural joint motion. The proposed method provides a potential means for obtaining subject-specific subtalar axis estimates which can then be used in inverse dynamic analyses and subject-specific musculoskeletal models.     

Correction de mouvement respiratoire en TEP/TDM

Respiratory motion reduces overall qualitative and quantitative accuracy in emission tomography imaging. The impact of respiratory motion has been further highlighted in the use of multi-modality imaging devices, where differences in respiratory conditions between the acquisition of anatomical and functional datasets can lead to significant artefacts. Current state of the art in accounting for such effects is the use of respiratory-gated acquisitions. Although such acquisitions may lead to a certain reduction in respiratory motion effects, the improvement is reduced as a result of using only part of the available data to reconstruct the individual gated frames. Approaches to correct the differences in the respiratory motion between the individual gated frames, in order to allow their combination, can be divided in two categories, namely, image or raw data based. The image-based approaches make use of registration algorithms to realign the gated images and, subsequently, sum them together; while the raw data approaches, based on the incorporation of transformations, account for differences in the respiratory motion between individual frames, either prior or during the reconstruction of all of the acquired data. Previous research in this field has demonstrated that a non-rigid local-based model leads to better results compared with an affine model in accounting for respiratory motion between gated frames. In addition, a superior image contrast can be obtained by incorporating the necessary transformation in the reconstruction process in comparison to an image-based approach.