Quantification of the Variability of Diaphragm Motion and Implications for Treatment Margin Construction

The respiratory motion is more irregular during the fractions than between the fractions. The PDF of the respiratory motion is asymmetrically distributed. Both the intra-acquisition variability and the PDF asymmetry have a limited impact on dose distributions and inferred margins. The use of a margin recipe to account for respiratory motion with an estimate of the average motion amplitude was adequate in almost all patients.