A location-mixture autoregressive model for online forecasting of lung tumor motion

Lung tumor tracking for radiotherapy requires real-time, multiple-step ahead forecasting of a quasi-periodic time series recording instantaneous tumor locations. We introduce a location-mixture autoregressive (LMAR) process that admits multimodal conditional distributions, fast approximate inference using the EM algorithm and accurate multiple-step ahead predictive distributions. LMAR outperforms several commonly used methods in terms of out-of-sample prediction accuracy using clinical data from lung tumor patients. With its superior predictive performance and real-time computation, the LMAR model could be effectively implemented for use in current tumor tracking systems.