MRI-based tumor motion characterization and gating schemes for radiation therapy of pancreatic cancer  Hanne D. Heerkens, Marco van Vulpen, Cornelis A.T. van den Berg, Rob H.N. Tijssen, Sjoerd P.M. Crijns, Izaak Q. Molenaar, Hjalmar C. van Santvoort, Onne Reerink, Gert J. Meijer  Radiotherapy and Oncology  Volume 111, Issue 2, Pages 252-257 (May 2014) DOI: 10.1016/j.radonc.2014.03.002 Copyright © 2014 Elsevier Ireland Ltd Terms and Conditions

Fig. 1 Angulation of the coronal scan plan in the principal motion direction of the pancreas. Radiotherapy and Oncology 2014 111, 252-257DOI: (10.1016/j.radonc.2014.03.002) Copyright © 2014 Elsevier Ireland Ltd Terms and Conditions

Fig. 2 Single frame of a mixed T1/T2 weighted cine MRI series of a pancreatic cancer patient. The tumor is contoured in white. Tracking was performed at one point at the inferior edge of the tumor, indicated with the X, and at one point at the superior edge (not shown in this image). Radiotherapy and Oncology 2014 111, 252-257DOI: (10.1016/j.radonc.2014.03.002) Copyright © 2014 Elsevier Ireland Ltd Terms and Conditions

Fig. 3A Typical example of craniocaudal tumor motion over time (patient 9). The peak-to-peak amplitude here is 14mm. The end-exhale position (upper part) is more reproducable than the end-inhale position (lower part). Radiotherapy and Oncology 2014 111, 252-257DOI: (10.1016/j.radonc.2014.03.002) Copyright © 2014 Elsevier Ireland Ltd Terms and Conditions

Fig. 3B Tumor motion in three directions. All dots represent individual patients. For each patient, the M100% and M95% are shown in craniocaudal (CC), anteroposterior (AP) and left–right (LR) direction. Radiotherapy and Oncology 2014 111, 252-257DOI: (10.1016/j.radonc.2014.03.002) Copyright © 2014 Elsevier Ireland Ltd Terms and Conditions

Fig. 4 Extent of IGTV in relation to the beam-on time. As shown, at 50% beam-on time, the required GTV-to-IGTV margin decreases to one quarter of the total breathing amplitude. Radiotherapy and Oncology 2014 111, 252-257DOI: (10.1016/j.radonc.2014.03.002) Copyright © 2014 Elsevier Ireland Ltd Terms and Conditions

Fig. 5 Duty cycles shown for different margins. Each dot represents an individual patient. Radiotherapy and Oncology 2014 111, 252-257DOI: (10.1016/j.radonc.2014.03.002) Copyright © 2014 Elsevier Ireland Ltd Terms and Conditions

Supplementary Fig. A Agreement between different motion analysis algorithms, i.e. MOSSE filter, Optical Flow and Elastix. Radiotherapy and Oncology 2014 111, 252-257DOI: (10.1016/j.radonc.2014.03.002) Copyright © 2014 Elsevier Ireland Ltd Terms and Conditions

Supplementary Fig. B Tumor motion patterns in craniocaudal direction for all individual patients, as measured on sagittal cine MRIs. Radiotherapy and Oncology 2014 111, 252-257DOI: (10.1016/j.radonc.2014.03.002) Copyright © 2014 Elsevier Ireland Ltd Terms and Conditions

Supplementary Fig. C 2D tumor trajectory in craniocaudal and anteroposterior direction for all patients. Each graph represents individual patients and their tumor trajectory. The thick black lines correspond to the linear regression line of the motion, e.g. the angulation of the trajectory. Radiotherapy and Oncology 2014 111, 252-257DOI: (10.1016/j.radonc.2014.03.002) Copyright © 2014 Elsevier Ireland Ltd Terms and Conditions