Purpose: We developed an offline based organ motion verification system using cine EPID images and evaluated its accuracy and availability through phantom study. Methods: The system was designed for import of cine EPID images, which are obtained sequentially during treatment through a DICOM format and reconstructed into a live image. For verification of organ motion, a pattern matching algorithm using an internal surrogate was employed in the self-developed analysis software. For the system performance test, we developed a linear motion phantom, which consists of a human body shaped phantom with a fake tumor in the lung and linear motion cart with control software. The phantom was operated with a motion of 2 cm at 4 sec per cycle and cine EPID images were obtained at a rate of 3.3 frames/sec with 1024 × 768 pixel counts in a linear accelerator (10 MVX). Organ motion of the target was tracked using self-developed analysis software and compared with data from the RPM system (Varian, USA). For quantitative analysis, we analyzed correlation between two data sets in terms of average cycle, amplitude, and pattern (root mean square, RSM) of motion. Results: Averages for the cycle of motion from cine EPID and RPM system were 3.95±0.02 and 3.98±0.11 sec, respectively, and showed good agreement on real value (4 sec). Average of the amplitude of motion tracked by our system (1.71 ±0.02 cm) showed a slightly different value, compared with the actual value (2 cm), due to time resolution for image acquisition. The value of the RMS from the cine EPID image (0.379) grew slightly, by 3.8%, compared with data from the RPM (0.365). Conclusions: Our system showed good representation of its motion in a preliminary phantom study. The system can be implemented for clinical purposes, which include organ motion verification and its feedback for accurate dose delivery to the moving target.
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