A comparison framework for breathing motion estimation methods from 4-D imaging

Motion estimation is an important issue in radiation therapy of moving organs. In particular, motion estimates from 4-D imaging can be used to compute the distribution of an absorbed dose during the therapeutic irradiation. We propose a strategy and criteria incorporating spatiotemporal information to evaluate the accuracy of model-based methods capturing breathing motion from 4-D CT images. This evaluation relies on the identification and tracking of landmarks on the 4-D CT images by medical experts. Three different experts selected more than 500 landmarks within 4-D CT images of lungs for three patients. Landmark tracking was performed at four instants of the expiration phase. Two metrics are proposed to evaluate the tracking performance of motion-estimation models. The first metric cumulates over the four instants the errors on landmark location. The second metric integrates the error over a time interval according to an a priori breathing model for the landmark spatiotemporal trajectory. This latter metric better takes into account the dynamics of the motion. A second aim of this paper is to estimate the impact of considering several phases of the respiratory cycle as compared to using only the extreme phases (end-inspiration and end-expiration). The accuracy of three motion estimation models (two image registration-based methods and a biomechanical method) is compared through the proposed metrics and statistical tools. This paper points out the interest of taking into account more frames for reliably tracking the respiratory motion.