Potential Use of Ultrasound Speckle Tracking for Motion Management During Radiotherapy

We prospectively evaluated real‐time ultrasound speckle tracking for monitoring soft tissue motion for image‐guided radiotherapy. Two human volunteers and 1 patient with a proven hepatocellular carcinoma, who was being prepared for radiation therapy treatment, were scanned using a clinical ultrasound scanner modified to acquire and store radiofrequency signals. Scans were performed of the liver in the volunteers and the patient. In the patient, the speckle‐tracking results were compared to those measured on a treatment‐planning 4‐dimensional computed tomogram with tumors contoured manually in each phase and with estimates made by hand on gray scale ultrasound images. The surface of the right lung and the prostate were scanned in a volunteer. The liver and lung surface were scanned during respiration. To simulate prostate motion, the ultrasound probe was rocked in an anterior‐posterior direction. The correlation coefficients of all motion measurements were significantly correlated at all sites (P < .00001 for all sites) with 0 time delays. Ultrasound speckle‐tracking motion estimates of tumor motion were within 2 mm of estimates made by hand tracking on gray scale ultrasound images and the 4‐dimensional computed tomogram. The total tumor motion was greater than 20 mm. The angular displacement of the prostate was within 0.02 radians (1.1°) with displacements measured by hand. Speckle tracking could be used to monitor organ motion during radiotherapy.