Multivariate respiratory motion prediction

In extracranial robotic radiotherapy, tumour motion is compensated by tracking external and internal surrogates. To compensate system specific time delays, time series prediction of the external optical surrogates is used. We investigate whether the prediction accuracy can be increased by expanding the current clinical setup by an accelerometer, a strain belt and a flow sensor. Four previously published prediction algorithms are adapted to multivariate inputs-normalized least mean squares (nLMS), wavelet-based least mean squares (wLMS), support vector regression (SVR) and relevance vector machines (RVM)-and evaluated for three different prediction horizons. The measurement involves 18 subjects and consists of two phases, focusing on long term trends (M1) and breathing artefacts (M2). To select the most relevant and least redundant sensors, a sequential forward selection (SFS) method is proposed. Using a multivariate setting, the results show that the clinically used nLMS algorithm is susceptible to large outliers. In the case of irregular breathing (M2), the mean root mean square error (RMSE) of a univariate nLMS algorithm is 0.66 mm and can be decreased to 0.46 mm by a multivariate RVM model (best algorithm on average). To investigate the full potential of this approach, the optimal sensor combination was also estimated on the complete test set. The results indicate that a further decrease in RMSE is possible for RVM (to 0.42 mm). This motivates further research about sensor selection methods. Besides the optical surrogates, the sensors most frequently selected by the algorithms are the accelerometer and the strain belt. These sensors could be easily integrated in the current clinical setup and would allow a more precise motion compensation.