1
|
Miyasaka Y, Kawashiro S, Lee SH, Souda H, Ichikawa M, Chai H, Ishizawa M, Ono T, Sato H, Iwai T. Evaluation of the availability of single-position treatment with a rotating gantry and the validity of deformable image registration dose assessment for pancreatic cancer carbon-ion radiotherapy. J Appl Clin Med Phys 2024; 25:e14330. [PMID: 38478368 PMCID: PMC11163482 DOI: 10.1002/acm2.14330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/23/2024] [Accepted: 02/22/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the clinical acceptability of rotational gantry-based single-position carbon-ion radiotherapy (CIRT) to reduce the gastrointestinal (GI) dose in pancreatic cancer. We also evaluated the usefulness of the deformable image registration (DIR)-based dosimetry method for CIRT. MATERIAL AND METHODS Fifteen patients with pancreatic cancer were analyzed. The treatment plans were developed for four beam angles in the supine (SP plan) and prone (PR plan) positions. In the case of using multiple positions, the treatment plan was created with two angles for each of the supine and prone position (SP + PR plan). Dose evaluation for multiple positions was performed in two ways: by directly adding the values of the DVH parameters for each position treatment plan (DVH sum), and by calculating the DVH parameters from the accumulative dose distribution created using DIR (DIR sum). The D2cc and D6cc of the stomach and duodenum were recorded for each treatment plan and dosimetry method and compared. RESULTS There were no significant differences among any of the treatment planning and dosimetry methods (p > 0.05). The DVH parameters for the stomach and duodenum were higher in the PR plan and SP plan, respectively, and DVH sum tended to be between the SP and PR plans. DVH sum and DIR sum, DVH sum tended to be higher for D2cc and DIR sum tended to be higher for D6cc. CONCLUSION There were no significant differences in the GI dose, which suggests that treatment with a simple workflow performed in one position should be clinically acceptable. In CIRT, DIR-based dosimetry should be carefully considered because of the potential for increased uncertainty due to the steep dose distributions.
Collapse
Affiliation(s)
- Yuya Miyasaka
- Department of Heavy Particle Medical ScienceYamagata University Graduate School of Medical ScienceYamagataJapan
| | - Shohei Kawashiro
- Department of Radiation OncologyKanagawa Cancer CenterYokohamaJapan
| | - Sung Hyun Lee
- Department of Heavy Particle Medical ScienceYamagata University Graduate School of Medical ScienceYamagataJapan
| | - Hikaru Souda
- Department of Heavy Particle Medical ScienceYamagata University Graduate School of Medical ScienceYamagataJapan
| | - Mayumi Ichikawa
- Department of RadiologyYamagata University Faculty of MedicineYamagataJapan
| | - Hongbo Chai
- Department of Heavy Particle Medical ScienceYamagata University Graduate School of Medical ScienceYamagataJapan
| | - Miyu Ishizawa
- Department of Heavy Particle Medical ScienceYamagata University Graduate School of Medical ScienceYamagataJapan
| | - Takuya Ono
- Department of Heavy Particle Medical ScienceYamagata University Graduate School of Medical ScienceYamagataJapan
| | - Hiraku Sato
- Department of RadiologyYamagata University Faculty of MedicineYamagataJapan
| | - Takeo Iwai
- Department of Heavy Particle Medical ScienceYamagata University Graduate School of Medical ScienceYamagataJapan
| |
Collapse
|
2
|
Tsubouchi T, Beltran CJ, Yagi M, Hamatani N, Takashina M, Shimizu S, Kanai T, Furutani KM. Beam delivery characteristics of the Hitachi carbon ion scanning system at Osaka Heavy Ion Medical Accelerator in Kansai (HIMAK). Med Phys 2024; 51:2239-2250. [PMID: 37877590 DOI: 10.1002/mp.16791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 09/15/2023] [Accepted: 09/28/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Using the pencil beam raster scanning method employed at most carbon beam treatment facilities, spots can be moved without interrupting the beam, allowing for the delivery of a dose between spots (move dose). This technique is also known as Dose-Driven-Continuous-Scanning (DDCS). To minimize its impact on HIMAK patient dosimetry, there's an upper limit to the move dose. Spots within a layer are grouped into sets, or "break points," allowing continuous irradiation. The beam is turned off when transitioning between sets or at the end of a treatment layer or spill. The control system beam-off is accomplished by turning off the RF Knockout (RFKO) extraction and after a brief delay the High Speed Steering Magnet (HSST) redirects the beam transport away from isocenter to a beam dump. PURPOSE The influence of the move dose and beam on/off control on the dose distribution and irradiation time was evaluated by measurements never before reported and modelled for Hitachi Carbon DDCS. METHOD We conducted fixed-point and scanning irradiation experiments at three different energies, both with and without breakpoints. For fixed-point irradiation, we utilized a 2D array detector and an oscilloscope to measure beam intensity over time. The oscilloscope data enabled us to confirm beam-off and beam-on timing due to breakpoints, as well as the relative timing of the RFKO signal, HSST signal, and dose monitor (DM) signals. From these measurements, we analyzed and modelled the temporal characteristics of the beam intensity. We also developed a model for the spot shape and amplitude at isocenter occurring after the beam-off signal which we called flap dose and its dependence on beam intensity. In the case of scanning irradiation, we measured move doses using the 2D array detector and compared these measurements with our model. RESULT We observed that the most dominant time variation of the beam intensity was at 1 kHz and its harmonic frequencies. Our findings revealed that the derived beam intensity cannot reach the preset beam intensity when each spot belongs to different breakpoints. The beam-off time due to breakpoints was approximately 100 ms, while the beam rise time and fall time (tdecay ) were remarkably fast, about 10 ms and 0.2 ms, respectively. Moreover, we measured the time lag (tdelay ) of approximately 0.2 ms between the RFKO and HSST signals. Since tdelay ≈ tdecay at HIMAK then the HSST is activated after the residual beam intensity, resulting in essentially zero flap dose at isocenter from the HSST. Our measurements of the move dose demonstrated excellent agreement with the modelled move dose. CONCLUSION We conducted the first move dose measurement for a Hitachi Carbon synchrotron, and our findings, considering beam on/off control details, indicate that Hitachi's carbon synchrotron provides a stable beam at HIMAK. Our work suggests that measuring both move dose and flap dose should be part of the commissioning process and possibly using our model in the Treatment Planning System (TPS) for new facilities with treatment delivery control systems with higher beam intensities and faster beam-off control.
Collapse
Affiliation(s)
- Toshiro Tsubouchi
- Department of Medical Physics, Osaka Heavy Ion Therapy Center, Osaka, Japan
| | - Chris J Beltran
- Department of Carbon Ion Radiotherapy, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Radiation Oncology, Division of Medical Physics, Mayo Clinic, Jacksonville, Florida, USA
| | - Masashi Yagi
- Department of Medical Physics, Osaka Heavy Ion Therapy Center, Osaka, Japan
- Department of Carbon Ion Radiotherapy, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Noriaki Hamatani
- Department of Medical Physics, Osaka Heavy Ion Therapy Center, Osaka, Japan
| | - Masaaki Takashina
- Department of Medical Physics, Osaka Heavy Ion Therapy Center, Osaka, Japan
| | - Shinichi Shimizu
- Department of Carbon Ion Radiotherapy, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tatsuaki Kanai
- Department of Carbon Ion Radiotherapy, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Keith M Furutani
- Department of Carbon Ion Radiotherapy, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Radiation Oncology, Division of Medical Physics, Mayo Clinic, Jacksonville, Florida, USA
| |
Collapse
|
3
|
Gut P, Krieger M, Lomax T, Weber DC, Hrbacek J. Combining rescanning and gating for a time-efficient treatment of mobile tumors using pencil beam scanning proton therapy. Radiother Oncol 2021; 160:82-89. [PMID: 33839206 DOI: 10.1016/j.radonc.2021.03.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/04/2021] [Accepted: 03/31/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE Respiratory motion during proton therapy can severely degrade dose distributions, particularly due to interplay effects when using pencil beam scanning. Combined rescanning and gating treatments for moving tumors mitigates dose degradation, but at the cost of increased treatment delivery time. The objective of this study was to identify the time efficiency of these dose degradation-motion mitigation strategies for different range of motions. MATERIALS AND METHODS Seventeen patients with thoracic or abdominal tumors were studied. Tumor motion amplitudes ranged from 2-30 mm. Deliveries using different combinations of rescanning and gating were simulated with a dense dose spot grid (4 × 4 × 2.5 mm3) for all patients and a sparse dose spot grid (8 × 8 × 5 mm3) for six patients with larger tumor movements (>8 mm). The resulting plans were evaluated in terms of CTV coverage and time efficiency. RESULTS Based on the studied patient cohort, it has been shown that for amplitudes up to 5 mm, no motion mitigation is required with a dense spot grid. For amplitudes between 5 and 10 mm, volumetric rescanning should be applied while maintaining a 100% duty cycle when using a dense spot grid. Although gating could be envisaged to reduce the target volume for intermediate motion, it has been shown that the dose to normal tissues would only be reduced marginally. Moreover, the treatment time would increase. Finally, for larger motion amplitudes, both volumetric rescanning and respiratory gating should be applied with both spot grids. In addition, it has been shown that a dense spot grid delivers better CTV dose coverage than a sparse dose grid. CONCLUSION Volumetric rescanning and/or respiratory gating can be used in order to effectively and efficiently mitigate dose degradation due to tumor movement.
Collapse
Affiliation(s)
- Pauline Gut
- Department of Physics, ETH Zurich, Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland
| | - Miriam Krieger
- Department of Physics, ETH Zurich, Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland
| | - Tony Lomax
- Department of Physics, ETH Zurich, Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland
| | - Damien C Weber
- Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland; Department of Radiation Oncology, University Hospital of Zurich, Zurich, Switzerland; Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Jan Hrbacek
- Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland.
| |
Collapse
|
4
|
Gated carbon-ion scanning treatment for pancreatic tumour with field specific target volume and organs at risk. Phys Med 2016; 32:1521-1528. [DOI: 10.1016/j.ejmp.2016.11.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/25/2016] [Accepted: 11/09/2016] [Indexed: 01/04/2023] Open
|
5
|
Miki K, Mori S, Hasegawa A, Naganawa K, Koto M. Single-energy metal artefact reduction with CT for carbon-ion radiation therapy treatment planning. Br J Radiol 2016; 89:20150988. [PMID: 26942839 DOI: 10.1259/bjr.20150988] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE One approach to improving image quality of CT is to use metal artefact reduction image processing, such as single-energy metal artefact reduction (SEMAR). To quantify the impact of image correction on the quality of carbon-ion dose distribution, treatment planning using SEMAR was evaluated. METHODS Using a head phantom into which metal screws could be inserted, we acquired standard planning CT images. We calculated dose distributions using phantom images with and without metal added, and with and without SEMAR. Hounsfield unit (HU) and dose distribution variation of these images with and without SEMAR were measured using metal-free image subtraction. We similarly analysed the image data sets of two patients with head and neck cancer who had dental implants. RESULTS HU difference between metal-containing images and metal-free images without and with SEMAR were -79.5 ± 97.2 HU and -1.4 ± 19.5 HU on severe artefact area, respectively. The range of dose distribution difference from the prescribed dose between uncorrected and SEMAR-corrected images varied from -19.5% to -3.4% within planning target volume (PTV). PTV-D95 (%) for uncorrected and SEMAR-corrected image data were 82.4% and 95.4%, respectively. For data in patients with metal dental work, PTV-D95 (%) for uncorrected and SEMAR-corrected data were 92.2% and 92.5% (Patient 1), and 90.9% and 95.7% (Patient 2), respectively. CONCLUSION SEMAR algorithm shows promise in improving CT image quality and in ensuring an accurate representation of dose distribution. ADVANCES IN KNOWLEDGE SEMAR may improve treatment accuracy without the need for dental implant extraction in patients with head and neck cancer.
Collapse
Affiliation(s)
- Kentaro Miki
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | - Shinichiro Mori
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | - Azusa Hasegawa
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | - Kensuke Naganawa
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | - Masashi Koto
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| |
Collapse
|
6
|
Dias MF, Riboldi M, Seco J, Castelhano I, Pella A, Mirandola A, Peralta L, Ciocca M, Orecchia R, Baroni G. Scan path optimization with/without clustering for active beam delivery in charged particle therapy. Phys Med 2015; 31:130-6. [DOI: 10.1016/j.ejmp.2015.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 01/02/2015] [Accepted: 01/03/2015] [Indexed: 12/29/2022] Open
|
7
|
Inaniwa T, Kanematsu N, Hara Y, Furukawa T. Nuclear-interaction correction of integrated depth dose in carbon-ion radiotherapy treatment planning. Phys Med Biol 2014; 60:421-35. [DOI: 10.1088/0031-9155/60/1/421] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
8
|
Hara Y, Furukawa T, Inaniwa T, Mizushima K, Shirai T, Noda K. A novel method for experimental characterization of large-angle scattered particles in scanned carbon-ion therapy. Med Phys 2014; 41:021706. [PMID: 24506597 DOI: 10.1118/1.4860256] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE It is essential to consider large-angle scattered particles in dose calculation models for therapeutic carbon-ion beams. However, it is difficult to measure the small dose contribution from large-angle scattered particles. In this paper, the authors present a novel method to derive the parameters describing large-angle scattered particles from the measured results. METHODS The authors developed a new parallel-plate ionization chamber consisting of concentric electrodes. Since the sensitive volume of each channel is increased linearly with this type, it is possible to efficiently and easily detect small contributions from the large-angle scattered particles. The parameters describing the large-angle scattered particles were derived from pencil beam dose distribution in water measured with the new ionization chamber. To evaluate the validity of this method, the correction for the field-size dependence of the doses, "predicted-dose scaling factor," was calculated with the new parameters. RESULTS The predicted-dose scaling factor calculated with the new parameters was compared with the existing one. The difference between the new correction factor and the existing one was 1.3%. For target volumes of different sizes, the calculated dose distribution with the new parameters was in good agreement with the measured one. CONCLUSIONS Parameters describing the large-angle scattered particles can be efficiently and rapidly determined using the new ionization chamber. The authors confirmed that the field-size dependence of the doses could be compensated for by the new parameters. This method makes it possible to easily derive the parameters describing the large-angle scattered particles, while maintaining the dose calculation accuracy.
Collapse
Affiliation(s)
- Yousuke Hara
- Medical Physics Research Group, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Takuji Furukawa
- Medical Physics Research Group, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Taku Inaniwa
- Medical Physics Research Group, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Kota Mizushima
- Medical Physics Research Group, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Toshiyuki Shirai
- Medical Physics Research Group, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Koji Noda
- Medical Physics Research Group, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| |
Collapse
|
9
|
Schätti A, Meer D, Lomax AJ. First experimental results of motion mitigation by continuous line scanning of protons. Phys Med Biol 2014; 59:5707-23. [DOI: 10.1088/0031-9155/59/19/5707] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
10
|
Mori S, Inaniwa T, Miki K, Shirai T, Noda K. Implementation of a target volume design function for intrafractional range variation in a particle beam treatment planning system. Br J Radiol 2014; 87:20140233. [PMID: 25168286 DOI: 10.1259/bjr.20140233] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Treatment planning for charged particle therapy in the thoracic and abdominal regions should take account of range uncertainty due to intrafractional motion. Here, we developed a design tool (4Dtool) for the target volume [field-specific target volume (FTV)], which accounts for this uncertainty using four-dimensional CT (4DCT). METHODS Target and normal tissue contours were input manually into a treatment planning system (TPS). These data were transferred to the 4Dtool via the picture archiving and communication system (PACS). Contours at the reference phase were propagated to other phases by deformable image registration. FTV was calculated using 4DCT on the 4Dtool. The TPS displays FTV contours using digital imaging and communications in medicine files imported from the PACS. These treatment parameters on the CT image at the reference phase were then used for dose calculation on the TPS. The tool was tested in single clinical case randomly selected from patients treated at our centre for lung cancer. RESULTS In this clinical case, calculation of dose distribution with the 4Dtool resulted in the successful delivery of carbon-ion beam at the reference phase of 95% of the prescribed dose to the clinical target volume (CTV). Application to the other phases also provided sufficient dose to the CTV. CONCLUSION The 4Dtool software allows the design of the target volume with consideration to intrafractional range variation and is now in routine clinical use at our institution. ADVANCES IN KNOWLEDGE Our alternative technique represents a practical approach to four-dimensional treatment planning within the current state of charged particle therapy.
Collapse
Affiliation(s)
- S Mori
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | | | | | | | | |
Collapse
|
11
|
Inaniwa T, Kanematsu N, Hara Y, Furukawa T, Fukahori M, Nakao M, Shirai T. Implementation of a triple Gaussian beam model with subdivision and redefinition against density heterogeneities in treatment planning for scanned carbon-ion radiotherapy. Phys Med Biol 2014; 59:5361-86. [DOI: 10.1088/0031-9155/59/18/5361] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
12
|
Furukawa T, Inaniwa T, Hara Y, Mizushima K, Shirai T, Noda K. Patient-specific QA and delivery verification of scanned ion beam at NIRS-HIMAC. Med Phys 2013; 40:121707. [DOI: 10.1118/1.4828845] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
|
13
|
Inaniwa T, Suzuki M, Furukawa T, Kase Y, Kanematsu N, Shirai T, Hawkins RB. Effects of Dose-Delivery Time Structure on Biological Effectiveness for Therapeutic Carbon-Ion Beams Evaluated with Microdosimetric Kinetic Model. Radiat Res 2013; 180:44-59. [DOI: 10.1667/rr3178.1] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
14
|
Mori S, Shirai T, Takei Y, Furukawa T, Inaniwa T, Matsuzaki Y, Kumagai M, Murakami T, Noda K. Patient handling system for carbon ion beam scanning therapy. J Appl Clin Med Phys 2012; 13:3926. [PMID: 23149784 PMCID: PMC5718542 DOI: 10.1120/jacmp.v13i6.3926] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 07/25/2012] [Accepted: 07/26/2012] [Indexed: 11/23/2022] Open
Abstract
Our institution established a new treatment facility for carbon ion beam scanning therapy in 2010. The major advantages of scanning beam treatment compared to the passive beam treatment are the following: high dose conformation with less excessive dose to the normal tissues, no bolus compensator and patient collimator/ multi‐leaf collimator, better dose efficiency by reducing the number of scatters. The new facility was designed to solve several problems encountered in the existing facility, at which several thousand patients were treated over more than 15 years. Here, we introduce the patient handling system in the new treatment facility. The new facility incorporates three main systems, a scanning irradiation system (S‐IR), treatment planning system (TPS), and patient handling system (PTH). The PTH covers a wide range of functions including imaging, geometrical/position accuracy including motion management (immobilization, robotic arm treatment bed), layout of the treatment room, treatment workflow, software, and others. The first clinical trials without respiratory gating have been successfully started. The PTH allows a reduction in patient stay in the treatment room to as few as 7 min. The PTH plays an important role in carbon ion beam scanning therapy at the new institution, particularly in the management of patient handling, application of image‐guided therapy, and improvement of treatment workflow, and thereby allows substantially better treatment at minimum cost. PACS numbers: 87.56.‐v; 87.57.‐s; 87.55.‐x
Collapse
Affiliation(s)
- Shinichiro Mori
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Inage-ku, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Inaniwa T, Furukawa T, Kanematsu N, Mori S, Mizushima K, Sato S, Toshito T, Shirai T, Noda K. Evaluation of hybrid depth scanning for carbon-ion radiotherapy. Med Phys 2012; 39:2820-5. [DOI: 10.1118/1.4705357] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
16
|
Inaniwa T, Kanematsu N, Furukawa T, Hasegawa A. A robust algorithm of intensity modulated proton therapy for critical tissue sparing and target coverage. Phys Med Biol 2011; 56:4749-70. [DOI: 10.1088/0031-9155/56/15/008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
17
|
Inaniwa T, Kanematsu N, Furukawa T, Noda K. Optimization algorithm for overlapping-field plans of scanned ion beam therapy with reduced sensitivity to range and setup uncertainties. Phys Med Biol 2011; 56:1653-69. [DOI: 10.1088/0031-9155/56/6/009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
18
|
Inaniwa T, Furukawa T, Kase Y, Matsufuji N, Toshito T, Matsumoto Y, Furusawa Y, Noda K. Treatment planning for a scanned carbon beam with a modified microdosimetric kinetic model. Phys Med Biol 2010; 55:6721-37. [DOI: 10.1088/0031-9155/55/22/008] [Citation(s) in RCA: 186] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
19
|
Furukawa T, Inaniwa T, Sato S, Shirai T, Takei Y, Takeshita E, Mizushima K, Iwata Y, Himukai T, Mori S, Fukuda S, Minohara S, Takada E, Murakami T, Noda K. Performance of the NIRS fast scanning system for heavy-ion radiotherapy. Med Phys 2010; 37:5672-82. [DOI: 10.1118/1.3501313] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
20
|
Furukawa T, Inaniwa T, Sato S, Shirai T, Mori S, Takeshita E, Mizushima K, Himukai T, Noda K. Moving target irradiation with fast rescanning and gating in particle therapy. Med Phys 2010; 37:4874-9. [DOI: 10.1118/1.3481512] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
21
|
Zenklusen SM, Pedroni E, Meer D. A study on repainting strategies for treating moderately moving targets with proton pencil beam scanning at the new Gantry 2 at PSI. Phys Med Biol 2010; 55:5103-21. [PMID: 20702927 DOI: 10.1088/0031-9155/55/17/014] [Citation(s) in RCA: 131] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Treating moving targets using a scanning gantry for proton therapy is a promising but very challenging, not yet clinically demonstrated treatment modality. The interference of organ motion with the sequence of the beam delivery produces uncontrolled dose inhomogeneities within the target. One promising approach to overcome this difficulty is to increase the speed of scanning in order to apply the dose repeatedly (so-called repainting). To obtain sufficiently high scanning speeds a new, technologically improved gantry-Gantry 2-has been designed and is currently under construction at PSI. As there are many possible repainting strategies, the way repainting will be implemented on Gantry 2 will depend on the result of a careful analysis of the various treatment delivery strategies available. To achieve this aim, and prior to the start of experimental work with Gantry 2, simulations of dose distribution errors due to organ motion under various beam delivery strategies were investigated. The effects of motion on the dose distribution were studied for moderate motion amplitudes (5 mm) for spherical target volumes in a homogeneous medium and with homogeneous dose. In total over 200,000 dose distributions have been simulated and analyzed and selected results are discussed. From the obtained results we are confident to be able to treat moderately moving targets on Gantry 2 using repainted pencil-beam spot scanning. Continuous line scanning seems to be the most elegant solution; it provides higher repainting rates and produces superior results but is probably more difficult to realize. For larger motion amplitudes, continuous line scanning still shows good results, but we plan anyways to use a gating system for these cases, not only to reduce the inhomogeneity within the target volume but also to reduce safety margins.
Collapse
Affiliation(s)
- S M Zenklusen
- Paul Scherrer Institut, 5232 Villligen, Switzerland.
| | | | | |
Collapse
|
22
|
Abstract
Clinical outcomes of charged particle therapy are very promising. Currently, several dedicated centers that use scanning beam technology are either close to clinical use or under construction. Since scanned beam treatments of targets that move with respiration most likely result in marked local over- and underdosage due to interplay of target motion and dynamic beam application, dedicated motion mitigation techniques have to be employed. To date, the motion mitigation techniques, rescanning, beam gating, and beam tracking, have been proposed and tested in experimental studies. Rescanning relies on repeated irradiations of the target with the number of particles reduced accordingly per scan to statistically average local misdosage. Specific developments to prohibit temporal correlation between beam scanning and target motion will be required to guarantee adequate averaging. For beam gating, residual target motion within gating windows has to be mitigated in order to avoid local misdosage. Possibly the most promising strategy is to increase the overlap of adjacent particle pencil beams laterally as well as longitudinally to effectively reduce the sensitivity against small residual target motion. The most conformal and potentially most precise motion mitigation technique is beam tracking. Individual particle pencil beams have to be adapted laterally as well as longitudinally according to the target motion. Within the next several years, it can be anticipated that rescanning as well as beam gating will be ready for clinical use. For rescanning, treatment planning margins that incorporate the full extent of target motion as well as motion induced density variations in the beam paths will result in reduced target conformity of the applied dose distributions. Due to the limited precision of motion monitoring devices, it seems likely that beam gating will be used initially to mitigate interplay effects only but not to considerably decrease treatment planning margins. Then, in the next step, beam gating, based on more accurate motion monitoring systems, provides the possibility to restore target conformity as well as steep dose gradients due to reduced treatment planning margins. Accurate motion monitoring systems will be required for beam tracking. Even though beam tracking has already been successfully tested experimentally, full clinical implementation requires direct feedback of the actual target position in quasireal time to the treatment control system and can be anticipated to be several more years ahead.
Collapse
Affiliation(s)
- Eike Rietzel
- Abteilung Biophysik, GSI Helmholtzzentrum für Schwerionenforschung, Planckstrasse 1, 64291 Darmstadt, Germany.
| | | |
Collapse
|
23
|
Minohara S, Fukuda S, Kanematsu N, Takei Y, Furukawa T, Inaniwa T, Matsufuji N, Mori S, Noda K. Recent innovations in carbon-ion radiotherapy. JOURNAL OF RADIATION RESEARCH 2010; 51:385-392. [PMID: 20679740 DOI: 10.1269/jrr.10028] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In the last few years, hospital-based facilities for carbon-ion radiotherapy are being constructed and proposed in Europe and Asia. During the next few years, several new facilities will be opened for carbon-ion radiotherapy in the world. These facilities in operation or under construction are categorized in two types by the beam shaping method used. One is the passive beam shaping method that is mainly improved and systematized for routine clinical use at HIMAC, Japan. The other method is active beam shaping which is also known as beam scanning adopted at GSI/HIT, Germany. In this paper an overview of some technical aspects for beam shaping is reported. The technique of passive beam shaping is established for stable clinical application and has clinical result of over 4000 patients in HIMAC. In contrast, clinical experience of active beam shaping is about 400 patients, and there is no clinical experience to respiratory moving target. A great advantage of the active beam shaping method is patient-specific collimator-less and compensator-less treatment. This may be an interesting potential for adaptive radiotherapy.
Collapse
Affiliation(s)
- Shinichi Minohara
- Department of Accelerator and Medical Physics, Research Center for Particle Therapy, National Institute of Radiological Sciences, Inage, Chiba, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Inaniwa T, Furukawa T, Nagano A, Sato S, Saotome N, Noda K, Kanai T. Field-size effect of physical doses in carbon-ion scanning using range shifter plates. Med Phys 2009; 36:2889-97. [PMID: 19673188 DOI: 10.1118/1.3140586] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A field-size effect of physical doses was studied in scanning irradiation with carbon ions. For the target volumes of 60 x 60 x 80, 40 x 40 x 80, and 20 x 20 x 80 mm3, the doses along the beam axis within the spread-out Bragg peaks reduced to 99.4%, 98.2%, and 96.0% of the dose for the target of 80 x 80 x 80 mm3, respectively. The present study revealed that the observed reductions can be compensated for by adopting the three-Gaussian form of lateral dose distributions for the pencil beam model used in the treatment planning system. The parameters describing the form were determined through the irradiation experiments making flat concentric squared frames with a scanned carbon beam. Since utilizing the three-Gaussian model in the dose optimization loop is at present time consuming, the correction for the field-size effect should be implemented as a "predicted-dose scaling factor." The validity of this correction method was confirmed through the irradiation of a target of 20 x 20 x 80 mm3.
Collapse
Affiliation(s)
- Taku Inaniwa
- Medical Physics Research Group, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage-ku, Chiba 263-8555, Japan.
| | | | | | | | | | | | | |
Collapse
|
25
|
Pardo J, Donetti M, Bourhaleb F, Ansarinejad A, Attili A, Cirio R, Garella MA, Giordanengo S, Givehchi N, La Rosa A, Marchetto F, Monaco V, Pecka A, Peroni C, Russo G, Sacchi R. Heuristic optimization of the scanning path of particle therapy beams. Med Phys 2009; 36:2043-51. [DOI: 10.1118/1.3121506] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
26
|
Furukawa T, Saotome N, Inaniwa T, Sato S, Noda K, Kanai T. Delivery verification using 3D dose reconstruction based on fluorescence measurement in a carbon beam scanning irradiation system. Med Phys 2008; 35:2235-42. [PMID: 18649453 DOI: 10.1118/1.2911868] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The authors have developed a method to reconstruct the 3D dose distribution in a particle beam scanning irradiation system. In this scheme, 3D dose distribution is reconstructed by using the measured images of fluence distribution, which are taken for each iso-energy slice (i.e., the unit of the depth scanning). A fluorescent screen with a CCD camera is used to measure the fluence distribution. This system was installed at the HIMAC experimental port and tested by using carbon ion beams. Since a maximum difference between the reconstructed dose and the ionization chamber measurement was around 5% in the target volume, this system can be useful for quick verification of 3D dose distribution.
Collapse
Affiliation(s)
- Takuji Furukawa
- Medical Physics Research Group, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan.
| | | | | | | | | | | |
Collapse
|