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Huang P, Yin Z, Bian T, Hou S, Guan F, An S, Wang Y, Zhang T, Ji L, Wen L, Mu X. Design of the offline test electronics for the nozzle system of proton therapy. Sci Rep 2024; 14:12092. [PMID: 38802428 PMCID: PMC11130219 DOI: 10.1038/s41598-024-62515-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 05/17/2024] [Indexed: 05/29/2024] Open
Abstract
A set of nozzle equipment for proton therapy is currently under development at China Institute of Atomic Energy (CIAE). To facilitate the off-line commissioning of the whole equipment, a set of ionization chamber signal generation system, known as the test electronics, was designed. The results showed that the system can simulate the beam position, beam fluence (which exhibits a positive correlation with the dose), and other related analog signals generated by the proton beam when it traverses the ionization chamber. Moreover, the accuracy of the simulated beam position is within ± 0.33 mm, and the accuracy of the simulated beam fluence signal is within ± 1%. The test electronics can output analog signals representing environmental parameters. The test electronics meets the design requirements, which can be used for the commissioning of the nozzle system as well as the treatment control system without the presence of the proton beam.
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Affiliation(s)
- Peng Huang
- China Institute of Atomic Energy, Beijing, 102413, China.
| | - Zhiguo Yin
- China Institute of Atomic Energy, Beijing, 102413, China
| | - Tianjian Bian
- China Institute of Atomic Energy, Beijing, 102413, China
| | - Shigang Hou
- China Institute of Atomic Energy, Beijing, 102413, China
| | - Fengping Guan
- China Institute of Atomic Energy, Beijing, 102413, China
| | - Shizhong An
- China Institute of Atomic Energy, Beijing, 102413, China
| | - Yang Wang
- China Institute of Atomic Energy, Beijing, 102413, China
| | - Tianjue Zhang
- China Institute of Atomic Energy, Beijing, 102413, China
| | - Luyu Ji
- China Institute of Atomic Energy, Beijing, 102413, China
| | - Lipeng Wen
- China Institute of Atomic Energy, Beijing, 102413, China
| | - Xueer Mu
- China Institute of Atomic Energy, Beijing, 102413, China
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2
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Tominaga Y, Suga M, Takeda M, Yamamoto Y, Akagi T, Kato T, Tokumaru S, Yamamoto M, Oita M. Dose-volume comparisons of proton therapy for pencil beam scanning with and without multi-leaf collimator and passive scattering in patients with lung cancer. Med Dosim 2023; 49:13-18. [PMID: 37940436 DOI: 10.1016/j.meddos.2023.10.006] [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: 05/26/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 11/10/2023]
Abstract
This study evaluated the dose distributions of proton pencil beam scanning (PBS) with/without a multileaf collimator (MLC) compared to passive scattering (PS) for stage I/II lung cancers. Collimated/uncollimated (PBS+/PBS-) and PS plans were created for 20 patients. Internal-clinical-target-volumes (ICTVs) and planning-target-volumes (PTVs) with a 5 mm margin were defined on the gated CTs. Organs-at-risk (OARs) are defined as the normal lungs, spinal cord, esophagus, and heart. The prescribed dose was 66 Gy relative-biological-effectiveness (RBE) in 10 fractions at the isocenter and 50% volume of the ICTVs for the PS and PBS, respectively. We compared the target and OAR dose statistics from the dose volume histograms. The PBS+ group had a significantly better mean PTV conformity index than the PBS- and PS groups. The mean dose sparing for PBS+ was better than those for PBS- and PS. Only the normal lung doses of PBS- were worse than those of PS. The overall performance of the OAR sparing was in the order of PBS+, PBS-, and PS. The PBS+ plan showed significantly better target homogeneity and OAR sparing than the PBS- and PS plans. PBS requires collimating systems to treat lung cancers with the most OAR sparing while maintaining the target coverage.
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Affiliation(s)
- Yuki Tominaga
- Medical Co. Hakuhokai, Osaka Proton Therapy Clinic, Konohana-ku, Osaka 554-0022, Japan.
| | - Masaki Suga
- Hyogo Ion Beam Medical Center, Tatsuno, Hyogo 679-5165, Japan
| | - Mikuni Takeda
- Hyogo Ion Beam Medical Center, Tatsuno, Hyogo 679-5165, Japan
| | - Yuki Yamamoto
- Hyogo Ion Beam Medical Center, Tatsuno, Hyogo 679-5165, Japan
| | - Takashi Akagi
- Hyogo Ion Beam Medical Center, Tatsuno, Hyogo 679-5165, Japan
| | - Takahiro Kato
- Depertment of Radiological Sciences, School of Health Sciences, Fukushima, Medical University, Fukushima 960-1295, Japan; Depertment of Radiation Physics and Technology, Southern Tohoku Proton Therapy Center, Koriyama, Fukushima 963-8052, Japan
| | - Sunao Tokumaru
- Hyogo Ion Beam Medical Center, Tatsuno, Hyogo 679-5165, Japan
| | - Michinori Yamamoto
- Medical Co. Hakuhokai, Osaka Proton Therapy Clinic, Konohana-ku, Osaka 554-0022, Japan
| | - Masataka Oita
- Faculty of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama 700-8558, Japan
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Asadi A, Akhavanallaf A, Hosseini SA, Vosoughi N, Zaidi H. Development and validation of an optimal GATE model for proton pencil-beam scanning delivery. Z Med Phys 2023; 33:591-600. [PMID: 36424313 PMCID: PMC10751712 DOI: 10.1016/j.zemedi.2022.10.008] [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: 12/10/2021] [Revised: 10/14/2022] [Accepted: 10/14/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To develop and validate a versatile Monte Carlo (MC)-based dose calculation engine to support MC-based dose verification of treatment planning systems (TPSs) and quality assurance (QA) workflows in proton therapy. METHODS The GATE MC toolkit was used to simulate a fixed horizontal active scan-based proton beam delivery (SIEMENS IONTRIS). Within the nozzle, two primary and secondary dose monitors have been designed to enable the comparison of the accuracy of dose estimation from MC simulations with respect to physical QA measurements. The developed beam model was validated against a series of commissioning measurements using pinpoint chambers and 2D array ionization chambers (IC) in terms of lateral profiles and depth dose distributions. Furthermore, beam delivery module and treatment planning has been validated against the literature deploying various clinical test cases of the AAPM TG-119 (c-shape phantom) and a prostate patient. RESULTS MC simulations showed excellent agreement with measurements in the lateral depth-dose parameters and spread-out Bragg peak (SOBP) characteristics within a maximum relative error of 0.95 mm in range, 1.83% in entrance to peak ratio, 0.27% in mean point-to-point dose difference, and 0.32% in peak location. The mean relative absolute difference between MC simulations and measurements in terms of absorbed dose in the SOBP region was 0.93% ± 0.88%. Clinical phantom studies showed a good agreement compared to research TPS (relative error for TG-119 planning target volume PTV-D95 ∼ 1.8%; and for prostate PTV-D95 ∼ -0.6%). CONCLUSION We successfully developed a MC model for the pencil beam scanning system, which appears reliable for dose verification of the TPS in combination with QA information, prior to patient treatment.
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Affiliation(s)
- Ali Asadi
- Department of Energy Engineering, Sharif University of Technology, Tehran, Iran
| | - Azadeh Akhavanallaf
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | | | - Naser Vosoughi
- Department of Energy Engineering, Sharif University of Technology, Tehran, Iran
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland; Geneva University Neurocenter, Geneva University, Geneva, Switzerland; Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark.
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Saini J, Maes D, Regmi R, Fung A, Bloch C, Schwarz M, Stacey A, Chen J, Rengan R, Halasz L. Improved lateral penumbra for proton ocular treatments on a general-purpose spot scanning beamline. Phys Med 2023; 107:102551. [PMID: 36867911 DOI: 10.1016/j.ejmp.2023.102551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 01/31/2023] [Accepted: 02/18/2023] [Indexed: 03/05/2023] Open
Abstract
PURPOSE An ocular applicator that fits a commercial proton snout with an upstream range shifter to allow for treatments with sharp lateral penumbra is described. MATERIALS AND METHODS The validation of the ocular applicator consisted of a comparison of range, depth doses (Bragg peaks and spread out Bragg peaks), point doses, and 2-D lateral profiles. Measurements were made for three field sizes, 1.5, 2, and 3 cm, resulting in 15 beams. Distal and lateral penumbras were simulated in the treatment planning system for seven range-modulation combinations for beams typical of ocular treatments and a field size of 1.5 cm, and penumbra values were compared to published literature. RESULTS All the range errors were within 0.5 mm. The maximum averaged local dose differences for Bragg peaks and SOBPs were 2.6% and 1.1%, respectively. All the 30 measured point doses were within +/-3% of the calculated. The measured lateral profiles, analyzed through gamma index analysis and compared to the simulated, had pass rates greater than 96% for all the planes. The lateral penumbra increased linearly with depth, from 1.4 mm at 1 cm depth to 2.5 mm at 4 cm depth. The distal penumbra ranged from 3.6 to 4.4 mm and increased linearly with the range. The treatment time for a single 10 Gy (RBE) fractional dose ranged from 30 to 120 s, depending on the shape and size of the target. CONCLUSIONS The ocular applicator's modified design allows lateral penumbra similar to dedicated ocular beamlines while enabling planners to use modern treatment tools such as Monte Carlo and full CT-based planning with increased flexibility in beam placement.
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Affiliation(s)
- Jatinder Saini
- Department of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St., Seattle, WA 98195, USA; Fred Hutchinson Cancer Center, 1570 N 115th St., Seattle, WA 98133, USA.
| | - Dominic Maes
- Department of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St., Seattle, WA 98195, USA; Fred Hutchinson Cancer Center, 1570 N 115th St., Seattle, WA 98133, USA
| | - Rajesh Regmi
- Department of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St., Seattle, WA 98195, USA; Fred Hutchinson Cancer Center, 1570 N 115th St., Seattle, WA 98133, USA
| | - Angela Fung
- Fred Hutchinson Cancer Center, 1570 N 115th St., Seattle, WA 98133, USA
| | - Charles Bloch
- Department of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St., Seattle, WA 98195, USA; Fred Hutchinson Cancer Center, 1570 N 115th St., Seattle, WA 98133, USA
| | - Marco Schwarz
- Department of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St., Seattle, WA 98195, USA; Fred Hutchinson Cancer Center, 1570 N 115th St., Seattle, WA 98133, USA
| | - Andrew Stacey
- Department of Ophthalmology, University of Washington School of Medicine, 750 Republican St, Seattle, WA 98109, USA
| | - Jonathan Chen
- Department of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St., Seattle, WA 98195, USA; Fred Hutchinson Cancer Center, 1570 N 115th St., Seattle, WA 98133, USA
| | - Ramesh Rengan
- Department of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St., Seattle, WA 98195, USA; Fred Hutchinson Cancer Center, 1570 N 115th St., Seattle, WA 98133, USA
| | - Lia Halasz
- Department of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St., Seattle, WA 98195, USA; Fred Hutchinson Cancer Center, 1570 N 115th St., Seattle, WA 98133, USA
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Azcona JD, Aguilar B, Perales Á, Polo R, Zucca D, Irazola L, Viñals A, Cabello P, Delgado JM, Pedrero D, Bermúdez R, Fayos-Solá R, Huesa-Berral C, Burguete J. Commissioning of a synchrotron-based proton beam therapy system for use with a Monte Carlo treatment planning system. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Tominaga Y, Sakurai Y, Miyata J, Harada S, Akagi T, Oita M. Validation of pencil beam scanning proton therapy with multi-leaf collimator calculated by a commercial Monte Carlo dose engine. J Appl Clin Med Phys 2022; 23:e13817. [PMID: 36420959 PMCID: PMC9797166 DOI: 10.1002/acm2.13817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 08/10/2022] [Accepted: 10/01/2022] [Indexed: 11/25/2022] Open
Abstract
This study aimed to evaluate the clinical beam commissioning results and lateral penumbra characteristics of our new pencil beam scanning (PBS) proton therapy using a multi-leaf collimator (MLC) calculated by use of a commercial Monte Carlo dose engine. Eighteen collimated uniform dose plans for cubic targets were optimized by the RayStation 9A treatment planning system (TPS), varying scan area, modulation widths, measurement depths, and collimator angles. To test the patient-specific measurements, we also created and verified five clinically realistic PBS plans with the MLC, such as the liver, prostate, base-of-skull, C-shape, and head-and-neck. The verification measurements consist of the depth dose (DD), lateral profile (LP), and absolute dose (AD). We compared the LPs and ADs between the calculation and measurements. For the cubic plans, the gamma index pass rates (γ-passing) were on average 96.5% ± 4.0% at 3%/3 mm for the DD and 95.2% ± 7.6% at 2%/2 mm for the LP. In several LP measurements less than 75 mm depths, the γ-passing deteriorated (increased the measured doses) by less than 90% with the scattering such as the MLC edge and range shifter. The deteriorated γ-passing was satisfied by more than 90% at 2%/2 mm using uncollimated beams instead of collimated beams except for three planes. The AD differences and the lateral penumbra width (80%-20% distance) were within ±1.9% and ± 1.1 mm, respectively. For the clinical plan measurements, the γ-passing of LP at 2%/2 mm and the AD differences were 97.7% ± 4.2% on average and within ±1.8%, respectively. The measurements were in good agreement with the calculations of both the cubic and clinical plans inserted in the MLC except for LPs less than 75 mm regions of some cubic and clinical plans. The calculation errors in collimated beams can be mitigated by substituting uncollimated beams.
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Affiliation(s)
- Yuki Tominaga
- Department of Radiotherapy, Medical Co. HakuhokaiOsaka Proton Therapy ClinicOsakaJapan,Division of Radiological TechnologyGraduate School of Interdisciplinary Science and Engineering in Health SystemsOkayama UniversityOkayamaJapan
| | - Yusuke Sakurai
- Department of Radiotherapy, Medical Co. HakuhokaiOsaka Proton Therapy ClinicOsakaJapan
| | - Junya Miyata
- Division of Radiological TechnologyGraduate School of Interdisciplinary Science and Engineering in Health SystemsOkayama UniversityOkayamaJapan,Department of Radiological technologyKurashiki Central HospitalOkayamaJapan
| | | | | | - Masataka Oita
- Division of Radiological TechnologyGraduate School of Interdisciplinary Science and Engineering in Health SystemsOkayama UniversityOkayamaJapan
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Technical aspects of proton minibeam radiation therapy: Minibeam generation and delivery. Phys Med 2022; 100:64-71. [PMID: 35750002 DOI: 10.1016/j.ejmp.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/02/2022] [Accepted: 06/13/2022] [Indexed: 11/23/2022] Open
Abstract
Proton minibeam radiation therapy (pMBRT) is a novel therapeutic strategy that combines the normal tissue sparing of sub-millimetric, spatially fractionated beams with the improved ballistics of protons. This may allow a safe dose escalation in the tumour and has already proven to provide a remarkable increase of the therapeutic index for high-grade gliomas in animal experiments. One of the main challenges in pMBRT concerns the generation of minibeams and the implementation in a clinical environment. This article reviews the different approaches for generating minibeams, using mechanical collimators and focussing magnets, and discusses the technical aspects of the implementation and delivery of pMBRT.
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8
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Thasasi P, Ruangchan S, Oonsiri P, Oonsiri S. Determination of Integral Depth Dose in Proton Pencil Beam Using Plane-parallel Ionization Chambers. Int J Part Ther 2022; 9:1-9. [PMID: 36060414 PMCID: PMC9415752 DOI: 10.14338/ijpt-22-00006.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/25/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose This study aimed to determine the integral depth-dose curves and assess the geometric collection efficiency of different detector diameters in proton pencil beam scanning. Materials and Methods The Varian ProBeam Compact spot scanning system was used for this study. The integral depth-dose curves with a proton energy range of 130 to 220 MeV were acquired with 2 types of Bragg peak chambers: 34070 with 8-cm diameter and 34089 with 15-cm diameter (PTW), multi-layer ionization chamber with 12-cm diameter (Giraffe, IBA Dosimetry), and PeakFinder with 8-cm diameter (PTW). To assess geometric collection efficiency, the integral depth-dose curves of 8- and 12-cm chamber diameters were compared to a 15-cm chamber diameter as the largest detector. Results At intermediate depths of 130, 150, 190, and 220 MeV, PTW Bragg peak chamber type 34089 provided the highest integral depth-dose curves followed by IBA Giraffe, PTW Bragg peak chamber type 34070, and PTW PeakFinder. Moreover, PTW Bragg peak chamber type 34089 had increased geometric collection efficiency up to 3.8%, 6.1%, and 3.1% when compared to PTW Bragg peak chamber type 34070, PTW PeakFinder, and IBA Giraffe, respectively. Conclusion A larger plane-parallel ionization chamber could increase the geometric collection efficiency of the detector, especially at intermediate depths and high-energy proton beams.
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Affiliation(s)
- Phatthraporn Thasasi
- 1 Medical Physics Program, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- 2 Division of Radiation Oncology, Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Sirinya Ruangchan
- 2 Division of Radiation Oncology, Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Puntiwa Oonsiri
- 2 Division of Radiation Oncology, Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Sornjarod Oonsiri
- 2 Division of Radiation Oncology, Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Decomposition of the weight fractions for modelling ridge filters in a proton wobbling nozzle. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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ur Rehman M, Zeidan OA, Willoughby T, Meeks SL, Kelly P, Erhart K. Dosimetric Comparison of Various Spot Placement Techniques in Proton Pencil Beam Scanning. Int J Part Ther 2022; 9:54-63. [PMID: 35774494 PMCID: PMC9238129 DOI: 10.14338/ijpt-21-00022.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose To present quantitative dosimetric evaluations of five proton pencil beam spot placement techniques. Materials and Methods The spot placement techniques that were investigated include two grid-based (rectilinear grid and hexagonal grid, both commonly available in commercial planning systems) and three boundary-contoured (concentric contours, hybrid, and optimized) techniques. Treatment plans were created for two different target volumes, one spherical and one conical. An optimal set of planning parameters was defined for all treatment plans and the impact of spot placement techniques on the plan quality was evaluated in terms of lateral/distal dose falloff, normal tissue sparing, conformity and homogeneity of dose distributions, as well as total number of spots used. Results The results of this work highlight that for grid-based spot placement techniques, the dose conformity is dependent on target cross-sectional shape perpendicular to beam direction, which changes for each energy layer. This variable conformity problem is mitigated by using boundary contoured spot placement techniques. However, in the case of concentric contours, the conformity is improved but at the cost of decreased homogeneity inside the target. Hybrid and optimized spot placement techniques, which use contoured spots at the boundary and gridlike interior spot patterns, provide more uniform dose distributions inside the target volume while maintaining the improved dose conformity. The optimized spot placement technique improved target coverage, homogeneity of dose, and minimal number of spots. The dependence of these results on spot size is also presented for both target shapes. Conclusion This work illustrates that boundary-contoured spot placement techniques offer marked improvement in dosimetry metrics when compared to commercially available grid-based techniques for a range of proton scanned beam spot sizes.
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Huang YH, Fang C, Yang T, Cao L, Zhang G, Qu B, Zhang Y, Wang Z, Xu S. A systematic study of independently-tuned room-specific PBS beam model in a beam-matched multiroom proton therapy system. Radiat Oncol 2021; 16:206. [PMID: 34715894 PMCID: PMC8555324 DOI: 10.1186/s13014-021-01932-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background In the existing application of beam-matched multiroom proton therapy system, the model based on the commissioning data from the leading treatment room was used as the shared model. The purpose of this study is to investigate the ability of independently-tuned room-specific beam models of beam-matched gantries to reproduce the agreement between gantries’ performance when considering the errors introduced by the modeling process. Methods Raw measurements of two gantries’ dosimetric characteristics were quantitatively compared to ensure their agreement after initially beam-matched. Two gantries’ beam model parameters, as well as the model-based computed dosimetric characteristics, were analyzed to study the introduced errors and gantries’ post-modeling consistency. We forced two gantries to share the same beam model. The model-sharing patient-specific quality assurance (QA) tasks were retrospectively performed with 36 cancer patients to study the clinical impact of beam model discrepancies. Results Intra-gantry comparisons demonstrate that the modeling process introduced the errors to a certain extent indeed, which made the model-based reproduced results deviate from the raw measurements. Among them, the deviation introduced to the IDD curves was generally larger than that to the beam spots during modeling. Cross-gantry comparisons show that, from the beam model perspective, the introduced deviations deteriorated the high agreement of the dosimetric characteristics originally shown between two beam-matched gantries, but the cross-gantry discrepancy was still within the clinically acceptable tolerance. In model-sharing patient-specific QA, for the particular gantry, the beam model usage for intensity-modulated proton therapy (IMPT) QA plan generation had no significant effect on the actual delivering performance. All reached a high level of 95.0% passing rate with a 3 mm/3% criterion. Conclusions It was preliminary recognized that among beam-matched gantries, the independently-tuned room-specific beam model from any gantry is reasonable to be chosen as the shared beam model without affecting the treatment efficacy.
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Affiliation(s)
- Yu-Hua Huang
- Department of Radiation Oncology, The First Medical Center of PLA General Hospital, Beijing, 100853, China.,Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,Department of Radiation Oncology, Hebei Yizhou Cancer Hospital, Zhuozhou, 072750, China.,School of Physics, Beihang University, Beijing, 100191, China
| | - Chunfeng Fang
- Department of Radiation Oncology, Hebei Yizhou Cancer Hospital, Zhuozhou, 072750, China
| | - Tao Yang
- Department of Radiation Oncology, The First Medical Center of PLA General Hospital, Beijing, 100853, China.,Department of Radiation Oncology, Hebei Yizhou Cancer Hospital, Zhuozhou, 072750, China
| | - Lin Cao
- Department of Radiation Oncology, Hebei Yizhou Cancer Hospital, Zhuozhou, 072750, China
| | - Gaolong Zhang
- School of Physics, Beihang University, Beijing, 100191, China
| | - Baolin Qu
- Department of Radiation Oncology, The First Medical Center of PLA General Hospital, Beijing, 100853, China
| | - Yihang Zhang
- School of Physics, Beihang University, Beijing, 100191, China
| | - Zishen Wang
- Department of Radiation Oncology, Hebei Yizhou Cancer Hospital, Zhuozhou, 072750, China
| | - Shouping Xu
- Department of Radiation Oncology, The First Medical Center of PLA General Hospital, Beijing, 100853, China. .,Department of Radiation Oncology, Hebei Yizhou Cancer Hospital, Zhuozhou, 072750, China.
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Dosimetric study of the interplay effect using three-dimensional motion phantom in proton pencil beam scanning treatment of moving thoracic tumours. JOURNAL OF RADIOTHERAPY IN PRACTICE 2021. [DOI: 10.1017/s1460396921000479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Aim:
The dosimetric and clinical advantages offered by implementation of pencil beam scanning (PBS) proton therapy for moving thoracic tumours is hindered by interplay effect. The purpose of this study is to evaluate the impact of large proton beam spot size along with adaptive aperture (AA) and various motion mitigation techniques on the interplay effect for a range of motion amplitudes in a three-dimensional (3D) respiratory motion phantom.
Materials and Methods:
Point doses using ionisation chamber (IC) and planner dose distributions with radiochromic film were compared against the corresponding treatment planning system (TPS) information. A 3D respiratory motion phantom was scanned either for static or 4D computed tomographic (CT) technique for 6-, 10- and 14-mm motion amplitudes in SI direction. For free breathing (FB) treatment, a tumour was contoured on maximum intensity projection scan and an average scan was used for treatment planning. Each FB treatment was delivered with one, three and five volumetric repaintings (VRs). Three phases (CT40–60%) were extracted from the 4D-CT scans of each motion amplitude for the respiratory-gated treatment and were used for the treatment planning and delivery. All treatment plans were made using AA and robustly optimised with 5-mm set-up and 3·5% density uncertainty. A total of 26 treatment plans were delivered to IC and film using static, dynamic and respiratory-gated treatments combinations. A percent dose difference between IC and TPS for the point dose and gamma indices for film–TPS planner dose comparison was used.
Results:
The dose profile of film and TPS for the static phantom matched well, and percent dose difference between IC and TPS was 0·4%. The percent dose difference for all the gated treatments were below 3·0% except 14-mm motion amplitude-gated treatment. The gamma passing rate was more than 95% for film–TPS comparison for all gated treatment for the investigated gamma acceptance criteria. For FB treatments, the percent dose difference for 6-, 10- and 14-mm motion amplitude was 1·4%, −2·7% and −4·1%, respectively. As the number of VR increased, the percent difference between measured and calculated values decreased. The gamma passing rate met the required tolerance for different acceptance criteria except for the 14-mm motion amplitude FB treatment.
Conclusion:
The PBS technique for the FB thoracic treatments up to 10-mm motion amplitude can be implemented with an acceptable accuracy using large proton beam spot size, AA and robust optimisation. The impact of the interplay effect can be reduced with VR and respiratory-gated treatment and extend the treatable tumour motion amplitude.
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Conceptual Design of a Novel Nozzle Combined with a Clinical Proton Linac for Magnetically Focussed Minibeams. Cancers (Basel) 2021; 13:cancers13184657. [PMID: 34572884 PMCID: PMC8467416 DOI: 10.3390/cancers13184657] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/09/2021] [Accepted: 09/14/2021] [Indexed: 11/23/2022] Open
Abstract
Simple Summary Proton minibeam radiation therapy (pMBRT) is a novel therapeutic strategy that combines the tissue sparing potential of submillimetric, spatially fractionated beams (minibeams) with the improved ballistics of protons to enhance the tolerance of normal tissue and allow a dose escalation in the tumour. This approach could allow a more effective treatment of radioresistant tumours and has already shown excellent results for rat gliomas. To exploit the full potential of pMBRT, it should be delivered using magnetically focussed and scanned minibeams. However, such an implementation has not yet been demonstrated at clinically relevant beam energies. In this work, we therefore present a new design combining our recently developed minibeam nozzle with the first clinical proton linear accelerator. We show the suitability of this combination for the generation of magnetically focussed and scanned minibeams with clinically relevant parameters as well as for the delivery of conventional pencil beam scanning techniques. Abstract (1) Background: Proton minibeam radiation therapy (pMBRT) is a novel therapeutic approach with the potential to significantly increase normal tissue sparing while providing tumour control equivalent or superior to standard proton therapy. For reasons of efficiency, flexibility and minibeam quality, the optimal implementation of pMBRT should use magnetically focussed minibeams which, however, could not yet be generated in a clinical environment. In this study, we evaluated our recently proposed minibeam nozzle together with a new clinical proton linac as a potential implementation. (2) Methods: Monte Carlo simulations were performed to determine under which conditions minibeams can be generated and to evaluate the robustness against focussing magnet errors. Moreover, an example of conventional pencil beam scanning irradiation was simulated. (3) Results: Excellent minibeam sizes between 0.6 and 0.9 mm full width at half maximum could be obtained and a good tolerance to errors was observed. Furthermore, the delivery of a 10 cm × 10 cm field with pencil beams was demonstrated. (4) Conclusion: The combination of the new proton linac and minibeam nozzle could represent an optimal implementation of pMBRT by allowing the generation of magnetically focussed minibeams with clinically relevant parameters. It could furthermore be used for conventional pencil beam scanning.
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Aljabab S, Rana S, Maes S, O'Ryan-Blair A, Castro J, Zheng J, Halasz LM, Taddei PJ. The Advantage of Proton Therapy in Hypothalamic-Pituitary Axis and Hippocampus Avoidance for Children with Medulloblastoma. Int J Part Ther 2021; 8:43-54. [PMID: 35127975 PMCID: PMC8768900 DOI: 10.14338/ijpt-21-00001.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose Craniospinal irradiation (CSI) improves clinical outcomes at the cost of long-term neuroendocrine and cognitive sequelae. The purpose of this pilot study was to determine whether hypothalamic-pituitary axis (HPA) and hippocampus avoidance (HPA-HA) with intensity-modulated proton therapy (IMPT) can potentially reduce this morbidity compared with standard x-ray CSI. Materials and Methods We retrospectively evaluated 10 patients with medulloblastoma (mean, 7 years; range, 4-14 years). Target volumes and organs at risk were delineated as per our local protocol and the ACNS0331 atlas. An experienced neuroradiologist verified the HPA and hippocampus contours. The primary objective was CSI and boost clinical target volume (CTV) covering 95% of the volume (D95) > 99% coverage with robustness. Described proton therapy doses in grays are prescribed using a biological effectiveness relative to photon therapy of 1.1. The combined prescribed dose in the boost target was 54 Gy. Secondary objectives included the HPA and hippocampus composite average dose (Dmean ≤ 18 Gy). For each patient, volumetric modulated arc radiotherapy (VMAT) and tomotherapy (TOMO) plans existed previously, and a new plan was generated with 3 cranial and 1 or 2 spinal beams for pencil-beam scanning delivery. Statistical comparison was performed with 1-way analysis of variance. Results Compared with standard CSI, HPA-HA CSI had statistically significant decreases in the composite doses received by the HPA (32.2 versus 17.9 Gy; P < .001) and hippocampi (39.8 versus 22.8 Gy; P < .001). The composite HPA Dmean was lower in IMPT plans (17.9 Gy) compared with that of VMAT (21.8 Gy) and TOMO (21.2 Gy) plans (P = .05). Hippocampi composite Dmean was also lower in IMPT plans (21 Gy) compared with that of VMAT (27.5 Gy) and TOMO (27.2 Gy) plans (P = .02). The IMPT CTV D95 coverage was lower in IMPT plans (52.8 Gy) compared with that of VMAT (54.6 Gy) and TOMO (54.6 Gy) plans (P < .001) The spared mean volume was only 1.35% (19.8 cm3) of the whole-brain CTV volume (1476 cm3). Conclusion We found that IMPT has the strong potential to reduce the dose to the HPA and hippocampus, compared with standard x-ray CSI while maintaining target coverage. A prospective clinical trial is required to establish the safety, efficacy, and toxicity of this novel CSI approach.
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Affiliation(s)
- Saif Aljabab
- Radiation Oncology Department, King Saud University, Riyadh, Saudi Arabia
| | - Shushan Rana
- Radiation Oncology Department, University of Washington School of Medicine, Seattle, WA, USA
| | - Shadonna Maes
- Seattle Cancer Care Alliance Proton Therapy Center, Seattle, WA, USA
| | | | - Jackie Castro
- Seattle Cancer Care Alliance Proton Therapy Center, Seattle, WA, USA
| | - Jack Zheng
- Radiation Medicine Program, the Ottawa Hospital Cancer Centre, Ottawa, ON, Canada
| | - Lia M. Halasz
- Radiation Oncology Department, University of Washington School of Medicine, Seattle, WA, USA
| | - Phillip J. Taddei
- Radiation Oncology Department, University of Washington School of Medicine, Seattle, WA, USA
- Seattle Cancer Care Alliance Proton Therapy Center, Seattle, WA, USA
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
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Vidal M, Moignier C, Patriarca A, Sotiropoulos M, Schneider T, De Marzi L. Future technological developments in proton therapy - A predicted technological breakthrough. Cancer Radiother 2021; 25:554-564. [PMID: 34272182 DOI: 10.1016/j.canrad.2021.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/18/2021] [Indexed: 12/13/2022]
Abstract
In the current spectrum of cancer treatments, despite high costs, a lack of robust evidence based on clinical outcomes or technical and radiobiological uncertainties, particle therapy and in particular proton therapy (PT) is rapidly growing. Despite proton therapy being more than fifty years old (first proposed by Wilson in 1946) and more than 220,000 patients having been treated with in 2020, many technological challenges remain and numerous new technical developments that must be integrated into existing systems. This article presents an overview of on-going technical developments and innovations that we felt were most important today, as well as those that have the potential to significantly shape the future of proton therapy. Indeed, efforts have been done continuously to improve the efficiency of a PT system, in terms of cost, technology and delivery technics, and a number of different developments pursued in the accelerator field will first be presented. Significant developments are also underway in terms of transport and spatial resolution achievable with pencil beam scanning, or conformation of the dose to the target: we will therefore discuss beam focusing and collimation issues which are important parameters for the development of these techniques, as well as proton arc therapy. State of the art and alternative approaches to adaptive PT and the future of adaptive PT will finally be reviewed. Through these overviews, we will finally see how advances in these different areas will allow the potential for robust dose shaping in proton therapy to be maximised, probably foreshadowing a future era of maturity for the PT technique.
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Affiliation(s)
- M Vidal
- Centre Antoine-Lacassagne, Fédération Claude Lalanne, 227, avenue de la Lanterne, 06200 Nice, France
| | - C Moignier
- Centre François Baclesse, Department of Medical Physics, Centre de protonthérapie de Normandie, 14000 Caen, France
| | - A Patriarca
- Institut Curie, PSL Research University, Radiation oncology department, Centre de protonthérapie d'Orsay, Campus universitaire, bâtiment 101, 91898 Orsay, France
| | - M Sotiropoulos
- Institut Curie, Université PSL, CNRS UMR3347, Inserm U1021, Signalisation radiobiologie et cancer, 91400 Orsay, France
| | - T Schneider
- Institut Curie, Université PSL, CNRS UMR3347, Inserm U1021, Signalisation radiobiologie et cancer, 91400 Orsay, France
| | - L De Marzi
- Institut Curie, PSL Research University, Radiation oncology department, Centre de protonthérapie d'Orsay, Campus universitaire, bâtiment 101, 91898 Orsay, France; Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, Campus universitaire, 91898 Orsay, France.
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16
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Grewal HS, Ahmad S, Jin H. Characterization of penumbra sharpening and scattering by adaptive aperture for a compact pencil beam scanning proton therapy system. Med Phys 2021; 48:1508-1519. [PMID: 33580550 DOI: 10.1002/mp.14771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 12/12/2020] [Accepted: 02/08/2021] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To quantitatively access penumbra sharpening and scattering by adaptive aperture (AA) under various beam conditions and clinical cases for a Mevion S250i compact pencil beam scanning proton therapy system. METHODS First, in-air measurements were performed using a scintillation detector for single spot profile and lateral penumbra for five square field sizes (3 × 3 to 18 × 18 cm2 ), three energies (33.04, 147.36, and 227.16 MeV), and three snout positions (5, 15, and 33.6 cm) with Open and AA field. Second, treatment plans were generated in RayStation treatment planning system (TPS) for various combination of target size (3- and 10-cm cube), target depth (5, 10, and 15 cm) and air gap (5-20 cm) for both Open and AA field. These plans were delivered to EDR2 films in the solid water and penumbra reduction by AA was quantified. Third, the effect of the AA scattered protons on the surface dose was studied at 5 mm depth by EDR2 film and the RayStation TPS computation. Finally, dosimetric advantage of AA over Open field was studied for five brain and five prostate cases using the TPS simulation. RESULTS The spot size changed dramatically from 3.8 mm at proton beam energy of 227.15 MeV to 29.4 mm at energy 33.04 MeV. In-air measurements showed that AA substantially reduced the lateral penumbra by 30% to 60%. The EDR2 film measurements in solid water presented the maximum penumbra reduction of 10 to 14 mm depending on the target size. The maximum increase of 25% in field edge dose at 5 mm depth as compared to central axis was observed. The substantial penumbra reduction by AA produced less dose to critical structures for all the prostate and brain cases. CONCLUSIONS Adaptive aperture sharpens the penumbra by factor of two to three depending upon the beam condition. The absolute penumbra reduction with AA was more noticeable for shallower target, smaller target, and larger air gap. The AA-scattered protons contributed to increase in surface dose. Clinically, AA reduced the doses to critical structures.
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Affiliation(s)
- Hardev S Grewal
- Department of Radiation Oncology, University of Oklahoma Health Sciences Center, 800 NE 10th street SCC L100, Oklahoma City, OK, 73104, USA.,Oklahoma Proton Center, 5901 W Memorial Rd, Oklahoma City, OK, 73142, USA
| | - Salahuddin Ahmad
- Department of Radiation Oncology, University of Oklahoma Health Sciences Center, 800 NE 10th street SCC L100, Oklahoma City, OK, 73104, USA
| | - Hosang Jin
- Department of Radiation Oncology, University of Oklahoma Health Sciences Center, 800 NE 10th street SCC L100, Oklahoma City, OK, 73104, USA
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17
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Ribeiro CO, Terpstra J, Janssens G, Langendijk JA, Both S, Muijs CT, Wijsman R, Knopf A, Meijers A. Evaluation of continuous beam rescanning versus pulsed beam in pencil beam scanned proton therapy for lung tumours. Phys Med Biol 2020; 65:23NT01. [PMID: 33120367 DOI: 10.1088/1361-6560/abc5c8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The treatment of moving targets with pencil beam scanned proton therapy (PBS-PT) may rely on rescanning strategies to smooth out motion induced dosimetric disturbances. PBS-PT machines, such as Proteus®Plus (PPlus) and Proteus®One (POne), deliver a continuous or a pulsed beam, respectively. In PPlus, scaled (or no) rescanning can be applied, while POne implies intrinsic 'rescanning' due to its pulsed delivery. We investigated the efficacy of these PBS-PT delivery types for the treatment of lung tumours. In general, clinically acceptable plans were achieved, and PPlus and POne showed similar effectiveness.
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Affiliation(s)
- Cássia O Ribeiro
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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18
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Grewal HS, Ahmad S, Jin H. Performance evaluation of adaptive aperture's static and dynamic collimation in a compact pencil beam scanning proton therapy system: A dosimetric comparison study for multiple disease sites. Med Dosim 2020; 46:179-187. [PMID: 33279369 DOI: 10.1016/j.meddos.2020.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/15/2020] [Accepted: 11/12/2020] [Indexed: 11/18/2022]
Abstract
A compact pencil beam scanning (PBS) proton therapy system, Mevion S250i with Hyperscan, is equipped with adaptive aperture (AA) to collimate the beam with 2 different techniques: Static aperture (SA) and dynamic aperture (DA). SA (single aperture) collimates the outermost contour of the target and DA (multi-layer aperture) collimates each energy layer of the proton beam. This study evaluates dosimetric performance of SA and DA for different disease sites. This study includes 5 disease sites (brain, head and neck (HN), partial breast, lung, and prostate), and 8 patients for each. A total of 80 patient treatment plans (5 sites × 8 patients per site × 2 collimation techniques) were created using 2 to 4 proton beams. Both SA and DA plans were made using the same plan and optimization parameters calculated by a Monte Carlo dose algorithm. Multi-field optimization (MFO) was used for HN treatment plans, whereas treatment plans for the other sites were made with single-field optimization (SFO). All plans were robustly optimized with 3 mm (brain and HN) or 5 mm (breast, lung, and prostate) position uncertainty along with 3.5% range uncertainty. Treatment plans were normalized such that 99% of the clinical target volume (CTV) received 100% of the prescribed dose. Dose volume histogram (DVH) parameters were evaluated for CTV and organs at risk (OARs). The CTV was also evaluated for dose homogeneity, dose conformity, and dose gradient. In general, the DA plan made CTV hotter, while it saved OARs better. DA produced better conformity with sharper dose falloff around CTV, while SA generated better homogenous target coverage. DA decreased Dmax to brainstem (1.2% = [(SA-DA)/DA × 100%]) for brain, Dmax to the spinal cord (137.3%) for HN, D1% of the ipsilateral lung (50.5%) for breast, and Dmax to the spinal cord (74.0%) for lung. The dose reduction in bladder and rectum for prostate plans with DA was less than 2.5%. The DA plans reduced the dose to OARs for all disease sites but escalated the target maximum dose for the same target coverage than the SA plans. The OAR saving and dose escalation depended on CTV size, proximity of the OARs to CTV, and the plan complexity.
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Affiliation(s)
- Hardev S Grewal
- Department of Radiation Oncology, University Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; Oklahoma Proton Center, Oklahoma City, OK 73142, USA
| | - Salahuddin Ahmad
- Department of Radiation Oncology, University Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Hosang Jin
- Department of Radiation Oncology, University Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
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19
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Farr JB, Moyers MF, Allgower CE, Bues M, Hsi WC, Jin H, Mihailidis DN, Lu HM, Newhauser WD, Sahoo N, Slopsema R, Yeung D, Zhu XR. Clinical commissioning of intensity-modulated proton therapy systems: Report of AAPM Task Group 185. Med Phys 2020; 48:e1-e30. [PMID: 33078858 DOI: 10.1002/mp.14546] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023] Open
Abstract
Proton therapy is an expanding radiotherapy modality in the United States and worldwide. With the number of proton therapy centers treating patients increasing, so does the need for consistent, high-quality clinical commissioning practices. Clinical commissioning encompasses the entire proton therapy system's multiple components, including the treatment delivery system, the patient positioning system, and the image-guided radiotherapy components. Also included in the commissioning process are the x-ray computed tomography scanner calibration for proton stopping power, the radiotherapy treatment planning system, and corresponding portions of the treatment management system. This commissioning report focuses exclusively on intensity-modulated scanning systems, presenting details of how to perform the commissioning of the proton therapy and ancillary systems, including the required proton beam measurements, treatment planning system dose modeling, and the equipment needed.
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Affiliation(s)
- Jonathan B Farr
- Department of Medical Physics, Applications of Detectors and Accelerators to Medicine, Meyrin, 1217, Switzerland
| | | | - Chris E Allgower
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, 46202, USA
| | - Martin Bues
- Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, 85259, USA
| | - Wen-Chien Hsi
- University of Florida Proton Therapy Institute, University of Florida, Jacksonville, FL, 32206, USA
| | - Hosang Jin
- Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Dimitris N Mihailidis
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Hsiao-Ming Lu
- Department of Radiation Oncology, Hefei Ion Medical Center, 1700 Changning Avenue, Gaoxin District, Hefei, Anhui, 230088, China
| | - Wayne D Newhauser
- Department of Physics & Astronomy, Louisiana State University, Baton Rouge, LA, 70803, USA.,Mary Bird Perkins Cancer Center, Baton Rouge, LA, 70809, USA
| | - Narayan Sahoo
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Roelf Slopsema
- Department of Radiation Oncology, Emory Proton Therapy Center, Emory University, Atlanta, GA, 30322, USA
| | - Daniel Yeung
- Saudi Proton Therapy Center, King Fahad Medical City, Riyadh, Riyadh Province, 11525, Saudi Arabia
| | - X Ronald Zhu
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
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20
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Rana S, Bennouna J. Investigating beam matching for multi-room pencil beam scanning proton therapy. Phys Eng Sci Med 2020; 43:1241-1251. [PMID: 33025387 DOI: 10.1007/s13246-020-00927-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 09/10/2020] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to investigate the proton beam matching for a multi-room ProteusPLUS pencil beam scanning (PBS) proton therapy system and quantify the agreement among three beam-matched treatment rooms (GTR1, GTR2, and GTR3). In-air spot size measurements were acquired using a 2D scintillation detector at various gantry angles. Range and absolute dose measurements were performed in water at gantry angle 0°. Patient-specific quality assurance (QA) plans of four different disease sites (brain, mediastinum, sacrum, and prostate) and machine QA fields with uniform dose were delivered for various beam conditions. The results from GTR1 were considered as reference values. The average difference in spot sizes between GTR2 and GTR1 was - 0.3% ± 2.2% (range, - 5.9 to 5.8%). For GTR3 vs. GTR1, the average difference in spot sizes was 0.6% ± 1.7% (range, - 4.8 to 4.6%). The spot symmetry was found to be ≤ 4.4%. For proton range, the difference among three rooms was within ± 0.5 mm. On average, the difference in absolute dose was - 0.1 ± 0.7% (range, - 1.3 to 2.1%) for GTR2 vs. GTR1 and 0.7 ± 0.6% (range, - 0.1 to 2.1%) for GTR3 vs. GTR1. The average gamma passing rate of patient-specific QA measurements (n = 29) was ≥ 98.6%. The average gamma passing rate of machine QA fields was 99.9%. In conclusion, proton beam matching was quantified for three beam-matched rooms of an IBA ProteusPLUS system with a PBS dedicated nozzle. It is feasible to match the spot size and absolute dose within ± 5% and ± 2%, respectively. Proton range can be matched within ± 0.5 mm.
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Affiliation(s)
- Suresh Rana
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, 8900 N Kendall Drive, Miami, FL, 33176, USA. .,Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA. .,Department of Physics, School of Advanced Sciences, VIT University, Vellore, Tamil Nadu, India.
| | - Jaafar Bennouna
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, 8900 N Kendall Drive, Miami, FL, 33176, USA.,Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
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21
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Shang C, Evans G, Rahman M, Lin L. Beam characteristics of the first clinical 360° rotational single gantry room scanning pencil beam proton treatment system and comparisons against a multi‐room system. J Appl Clin Med Phys 2020; 21:266-271. [PMID: 32790244 PMCID: PMC7497910 DOI: 10.1002/acm2.12984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/21/2020] [Accepted: 06/23/2020] [Indexed: 11/07/2022] Open
Affiliation(s)
- Charles Shang
- South Florida Proton Therapy Institute Delray Beach FL USA
| | - Grant Evans
- South Florida Proton Therapy Institute Delray Beach FL USA
| | | | - Liyong Lin
- Emory Proton Therapy Center Atlanta GA USA
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22
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Rahman M, Brůža P, Langen KM, Gladstone DJ, Cao X, Pogue BW, Zhang R. Characterization of a new scintillation imaging system for proton pencil beam dose rate measurements. Phys Med Biol 2020; 65:165014. [PMID: 32428888 DOI: 10.1088/1361-6560/ab9452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The goal of this work was to create a technique that could measure all possible spatial and temporal delivery rates used in pencil-beam scanning (PBS) proton therapy. The proposed system used a fast scintillation screen for full-field imaging to resolve temporal and spatial patterns as it was delivered. A fast intensified CMOS camera used continuous mode with 10 ms temporal frame rate and 1 × 1 mm2 spatial resolution, imaging a scintillation screen during clinical proton PBS delivery. PBS plans with varying dose, dose rate, energy, field size, and spot-spacing were generated, delivered and imaged. The captured images were post processed to provide dose and dose rate values after background subtraction, perspective transformation, uniformity correction for the camera and the scintillation screen, and calibration into dose. The linearity in scintillation response with respect to varying dose rate, dose, and field size was within 2%. The quenching corrected response with varying energy was also within 2%. Large spatio-temporal variations in dose rate were observed, even for plans delivered with similar dose distributions. Dose and dose rate histograms and maximum dose rate maps were generated for quantitative evaluations. With the fastest PBS delivery on a clinical system, dose rates up to 26.0 Gy s-1 were resolved. The scintillation imaging technique was able to quantify proton PBS dose rate profiles with spot weight as low as 2 MU, with spot-spacing of 2.5 mm, having a 1 × 1 mm2 spatial resolution. These dose rate temporal profiles, spatial maps, and cumulative dose rate histograms provide useful metrics for the potential evaluation and optimization of dose rate in treatment plans.
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Affiliation(s)
- Mahbubur Rahman
- Thayer School of Engineering, Dartmouth College, Hanover, NH, United States of America
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23
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Kang M, Pang D. Commissioning and beam characterization of the first gantry-mounted accelerator pencil beam scanning proton system. Med Phys 2020; 47:3496-3510. [PMID: 31840264 DOI: 10.1002/mp.13972] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 10/29/2019] [Accepted: 12/05/2019] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To present and discuss beam characteristics and commissioning process of the first gantry-mounted accelerator single room pencil beam scanning (PBS) proton system. METHODS The Mevion HYPERSCAN employs a design configuration with a synchrocyclotron mounted on the gantry to eliminate the traditional beamline and a nozzle that contains the dosimetry monitoring chambers, the energy modulator (Energy Selector (ES)), and an Adaptive Aperture (AA). To characterize the beam, we measured the integrated depth dose (IDDs) for 12 energies, from highest energy of 227 MeV down to 28 MeV with a range difference ~ 2 cm between the adjacent energies, using a large radius Bragg peak chamber; single-spot profiles in air at five locations along the beam central axis using radiochromic EBT3 film and cross compared with a scintillation detector; and determined the output using a densely packed spot map. To access the performance of AA, we measured interleaf leakage and the penumbra reduction effect. Monte Carlo simulation using TOPAS was performed to study spot size variation along the beam path, beam divergence, and energy spectrum. RESULTS This proton system is calibrated to deliver 1 Gy dose at 5 cm depth in water using the highest beam energy by delivering 1 MU/spot to a 10 × 10 cm2 map with a 2.5 mm spot spacing. The spot size in air varies from 4 mm to 26 mm from 227 MeV to 28 MeV at the isocenter plane with the nozzle retracted 23.6 cm from isocenter. The beam divergence of 28 MeV beam is ~ 52.7 mrad, which is nearly 22 times that of 227 MeV proton beam. The binary design of the ES has resulted in shifts of the effective SSD toward the isocenter as the energy is modulated lower. The peaks of IDD curves have a constant 80%-80% width of 8.4 mm at all energies. The interleaf leakage of the AA is less than 1.5% at the highest energy; and the AA can reduce the penumbra by 2 mm to 13 mm for the 227 and 28 MeV energies at isocenter plane in air. CONCLUSIONS The unique design of the HYPERSCAN proton system has yielded beam characteristics significantly different from that of other proton systems in terms of the Bragg peak shapes, spot sizes, and the penumbra sharpening effect of the AA. The combination of the ES and AA has made PBS implementation possible without using beam transport line and range shifter devices. Different considerations may be required in treatment planning optimization to account for different design and beam characteristics.
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Affiliation(s)
- M Kang
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, USA
| | - D Pang
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, USA
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24
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Tseng YD, Maes SM, Kicska G, Sponsellor P, Traneus E, Wong T, Stewart RD, Saini J. Comparative photon and proton dosimetry for patients with mediastinal lymphoma in the era of Monte Carlo treatment planning and variable relative biological effectiveness. Radiat Oncol 2019; 14:243. [PMID: 31888769 PMCID: PMC6937683 DOI: 10.1186/s13014-019-1432-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 11/27/2019] [Indexed: 12/25/2022] Open
Abstract
Background Existing pencil beam analytical (PBA) algorithms for proton therapy treatment planning are not ideal for sites with heterogeneous tissue density and do not account for the spatial variations in proton relative biological effectiveness (vRBE). Using a commercially available Monte Carlo (MC) treatment planning system, we compared various dosimetric endpoints between proton PBA, proton MC, and photon treatment plans among patients with mediastinal lymphoma. Methods Eight mediastinal lymphoma patients with both free breathing (FB) and deep inspiration breath hold (DIBH) CT simulation scans were analyzed. The original PBA plans were re-calculated with MC. New proton plans that used MC for both optimization and dose calculation with equivalent CTV/ITV coverage were also created. A vRBE model, which uses a published model for DNA double strand break (DSB) induction, was applied on MC plans to study the potential impact of vRBE on cardiac doses. Comparative photon plans were generated on the DIBH scan. Results Re-calculation of FB PBA plans with MC demonstrated significant under coverage of the ITV V99 and V95. Target coverage was recovered by re-optimizing the PT plan with MC with minimal change to OAR doses. Compared to photons with DIBH, MC-optimized FB and DIBH proton plans had significantly lower dose to the mean lung, lung V5, breast tissue, and spinal cord for similar target coverage. Even with application of vRBE in the proton plans, the putative increase in RBE at the end of range did not decrease the dosimetric advantages of proton therapy in cardiac substructures. Conclusions MC should be used for PT treatment planning of mediastinal lymphoma to ensure adequate coverage of target volumes. Our preliminary data suggests that MC-optimized PT plans have better sparing of the lung and breast tissue compared to photons. Also, the potential for end of range RBE effects are unlikely to be large enough to offset the dosimetric advantages of proton therapy in cardiac substructures for mediastinal targets, although these dosimetric findings require validation with late toxicity data.
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Affiliation(s)
- Yolanda D Tseng
- Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, Box 356043, Seattle, WA, 98195, USA. .,Seattle Cancer Care Alliance Proton Therapy Center, Seattle, WA, USA.
| | - Shadonna M Maes
- Seattle Cancer Care Alliance Proton Therapy Center, Seattle, WA, USA
| | - Gregory Kicska
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Patricia Sponsellor
- Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, Box 356043, Seattle, WA, 98195, USA
| | | | - Tony Wong
- Seattle Cancer Care Alliance Proton Therapy Center, Seattle, WA, USA
| | - Robert D Stewart
- Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, Box 356043, Seattle, WA, 98195, USA
| | - Jatinder Saini
- Seattle Cancer Care Alliance Proton Therapy Center, Seattle, WA, USA
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Harms J, Chang CW, Zhang R, Lin L. Nuclear halo measurements for accurate prediction of field size factor in a Varian ProBeam proton PBS system. J Appl Clin Med Phys 2019; 21:197-204. [PMID: 31793202 PMCID: PMC6964762 DOI: 10.1002/acm2.12783] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/15/2019] [Accepted: 10/29/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose For pencil‐beam scanning proton therapy systems, in‐air non‐Gaussian halo can significantly impact output at small field sizes and low energies. Since the low‐intensity tail of spot profile (halo) is not necessarily modeled in treatment planning systems (TPSs), this can potentially lead to significant differences in patient dose distribution. In this work, we report such impact for a Varian ProBeam system. Methods We use a pair magnification technique to measure two‐dimensional (2D) spot profiles of protons from 70 to 242 MeV at the treatment isocenter and 30 cm upstream of the isocenter. Measurements are made with both Gafchromic film and a scintillator detector coupled to a CCD camera (IBA Lynx). Spot profiles are measured down to 0.01% of their maximum intensity. Field size factors (FSFs) are compared among calculation using measured 2D profiles, calculation using a clinical treatment planning algorithm (Raystation 8A clinical Monte Carlo), and a CC04 small‐volume ion chamber. FSFs were measured for square fields of proton energies ranging from 70 to 242 MeV. Results All film and Lynx measurements agree within 1 mm for full width at half maximum beam intensity. The measured radial spot profiles disagree with simple Gaussian approximations, which are used for modeling in the TPS. FSF measurements show the magnitude of disagreements between beam output in reality and in the TPS without modeling halo. We found that the clinical TPS overestimated output by as much as 6% for small field sizes of 2 cm at the lowest energy of 70 MeV while the film and Lynx measurements agreed within 4% and 1%, respectively, for this FSF. Conclusions If the in‐air halo for low‐energy proton beams is not fully modeled by the TPS, this could potentially lead to under‐dosing small, shallow treatment volumes in PBS treatment plans.
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Affiliation(s)
- Joseph Harms
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - Chih-Wei Chang
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - Rongxiao Zhang
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA.,Department of Radiation Oncology, Dartmouth University, Hanover, NH, USA
| | - Liyong Lin
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
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Schreuder AN, Bridges DS, Rigsby L, Blakey M, Janson M, Hedrick SG, Wilkinson JB. Validation of the RayStation Monte Carlo dose calculation algorithm using realistic animal tissue phantoms. J Appl Clin Med Phys 2019; 20:160-171. [PMID: 31541536 PMCID: PMC6806482 DOI: 10.1002/acm2.12733] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 07/29/2019] [Accepted: 08/12/2019] [Indexed: 01/23/2023] Open
Abstract
PURPOSE The aim of this study is to validate the RayStation Monte Carlo (MC) dose algorithm using animal tissue neck phantoms and a water breast phantom. METHODS Three anthropomorphic phantoms were used in a clinical setting to test the RayStation MC dose algorithm. We used two real animal necks that were cut to a workable shape while frozen and then thawed before being CT scanned. Secondly, we made a patient breast phantom using a breast prosthesis filled with water and placed on a flat surface. Dose distributions in the animal and breast phantoms were measured using the MatriXX PT device. RESULTS The measured doses to the neck and breast phantoms compared exceptionally well with doses calculated by the analytical pencil beam (APB) and MC algorithms. The comparisons between APB and MC dose calculations and MatriXX PT measurements yielded an average depth difference for best gamma agreement of <1 mm for the neck phantoms. For the breast phantom better average gamma pass rates between measured and calculated dose distributions were observed for the MC than for the APB algorithms. CONCLUSIONS The MC dose calculations are more accurate than the APB calculations for the static phantoms conditions we evaluated, especially in areas where significant inhomogeneous interfaces are traversed by the beam.
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Affiliation(s)
| | | | - Lauren Rigsby
- Provision Center for Proton Therapy – KnoxvilleKnoxvilleTNUSA
| | - Marc Blakey
- Provision Center for Proton Therapy – KnoxvilleKnoxvilleTNUSA
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Rana S, Samuel EJJ. Feasibility study of utilizing XRV-124 scintillation detector for quality assurance of spot profile in pencil beam scanning proton therapy. Phys Med 2019; 66:15-20. [DOI: 10.1016/j.ejmp.2019.09.078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/21/2019] [Accepted: 09/11/2019] [Indexed: 01/05/2023] Open
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Carlino A, Böhlen T, Vatnitsky S, Grevillot L, Osorio J, Dreindl R, Palmans H, Stock M, Kragl G. Commissioning of pencil beam and Monte Carlo dose engines for non-isocentric treatments in scanned proton beam therapy. ACTA ACUST UNITED AC 2019; 64:17NT01. [DOI: 10.1088/1361-6560/ab3557] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Nystrom H, Jensen MF, Nystrom PW. Treatment planning for proton therapy: what is needed in the next 10 years? Br J Radiol 2019; 93:20190304. [PMID: 31356107 DOI: 10.1259/bjr.20190304] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Treatment planning is the process where the prescription of the radiation oncologist is translated into a deliverable treatment. With the complexity of contemporary radiotherapy, treatment planning cannot be performed without a computerized treatment planning system. Proton therapy (PT) enables highly conformal treatment plans with a minimum of dose to tissues outside the target volume, but to obtain the most optimal plan for the treatment, there are a multitude of parameters that need to be addressed. In this review areas of ongoing improvements and research in the field of PT treatment planning are identified and discussed. The main focus is on issues of immediate clinical and practical relevance to the PT community highlighting the needs for the near future but also in a longer perspective. We anticipate that the manual tasks performed by treatment planners in the future will involve a high degree of computational thinking, as many issues can be solved much better by e.g. scripting. More accurate and faster dose calculation algorithms are needed, automation for contouring and planning is required and practical tools to handle the variable biological efficiency in PT is urgently demanded just to mention a few of the expected improvements over the coming 10 years.
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Affiliation(s)
- Hakan Nystrom
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark.,Skandionkliniken, Uppsala, Sweden
| | | | - Petra Witt Nystrom
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark.,Skandionkliniken, Uppsala, Sweden
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Rana S, Samuel EJJ. Measurements of in-air spot size of pencil proton beam for various air gaps in conjunction with a range shifter on a ProteusPLUS PBS dedicated machine and comparison to the proton dose calculation algorithms. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2019; 42:853-862. [PMID: 31222565 DOI: 10.1007/s13246-019-00772-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 06/13/2019] [Indexed: 10/26/2022]
Abstract
The purpose of this study is to (i) investigate the impact of various air gaps in conjunction with a range shifter of 7.5 cm water-equivalent-thickness (WET) on in-air spot size of a pencil proton beam at the isocenter and off-axis points, and (ii) compare the treatment planning system (TPS) calculated spot sizes against the measured spot sizes. A scintillation detector has been utilized to measure the in-air spot sizes at the isocenter. The air gap was varied from 0 to 35 cm at an increment of 5 cm. For each air gap, a single spot pencil proton beam of various energies (110-225 MeV) was delivered to the scintillation detector. By mimicking the experimental setup in RayStation TPS, proton dose calculations were performed using pencil beam (RS-PB) and Monte Carlo (RS-MC) dose calculation algorithms. The calculated spot sizes (RS-PB and RS-MC) were then compared against the measured spot sizes. For a comparative purpose, the spot sizes of each measured energy for different air gaps of (5-35 cm) were compared against that of 0 cm air gap. The results of the 5 cm air gap showed an increase in spot size by ≤ 0.6 mm for all energies. For the largest air gap (35 cm) in the current study, the spot size increased by 3.0 mm for the highest energy (225 MeV) and by 9.2 mm for the lowest energy (110 MeV). For the 0 cm air gap, the agreement between the TPS-calculated (RS-PB and RS-MC) and measured spot sizes were within ± 0.1 mm. For the 35 cm air gap, the RS-PB overpredicted spot sizes by 0.3-0.8 mm, whereas the RS-MC computed spot sizes were within ± 0.3 mm of measured spot sizes. In conclusion, spot size increment is dependent on the energy and air gap. The increase in spot size was more pronounced at lower energies ( < 150 MeV) for all air gaps. The comparison between the TPS calculated and measured spot sizes showed that the RS-MC is more accurate (within ± 0.3 mm), whereas the RS-PB overpredicted (up to 0.8 mm) the spot sizes when a range shifter (7.5 cm WET) and large air gaps are encountered in the proton beam path.
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Affiliation(s)
- Suresh Rana
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, 8900 N Kendall Drive, Miami, FL, 33176, USA. .,Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA. .,Department of Physics, School of Advanced Sciences, Vellore Institute of Technology (VIT) University, Vellore, Tamil Nadu, India.
| | - E James Jebaseelan Samuel
- Department of Physics, School of Advanced Sciences, Vellore Institute of Technology (VIT) University, Vellore, Tamil Nadu, India
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Molinelli S, Russo S, Magro G, Maestri D, Mairani A, Mastella E, Mirandola A, Vai A, Vischioni B, Valvo F, Ciocca M. Impact of TPS calculation algorithms on dose delivered to the patient in proton therapy treatments. ACTA ACUST UNITED AC 2019; 64:075016. [DOI: 10.1088/1361-6560/ab0a4d] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Schimke G, Syh J, Wu HT. A Model for Secondary Monitor Unit Calculations of PBS Proton Therapy Treatment Plans. Int J Part Ther 2019; 5:5-10. [PMID: 31788503 PMCID: PMC6874183 DOI: 10.14338/ijpt-18-00031.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 11/19/2018] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This article summarizes a volume-based method by which secondary monitor unit (MU) calculations may be performed for pencil beam scanning, single field uniform dose (SFUD) proton therapy treatment plans. MATERIALS AND METHODS Treatment planning system (TPS) simulations were performed by using the local beam model to define relationships between planning target volume (PTV) characteristics and the MUs required to deliver a uniform dose for a given beam orientation. Relevant target attributes included volume, depth (ie, beam range), range-shifter air gap, and the projected area of the target volume in the beam's eye view (BEV). The proposed model approximates the PTV as a simplified cuboid region of interest as defined by its volume and BEV projected area. Output factors (cGy/MU) were then tabulated for the idealized geometry through TPS simulations using region of interests with a range of dimensions expected to be seen clinically. Correction factors were applied that account for differences between the PTV and the idealized conditions, and MUs for each beam were then scaled according to the measured spread out Bragg peak (SOBP) dose in water. RESULTS Our model was applied to various treatment sites, including pelvis, brain, lung, and head and neck. Monitor units prescribed by the TPS were compared to those predicted by using the model for 78 treatment beams. The total mean percentage difference for all beams was -0.2% ± 3.8%. CONCLUSION This work demonstrates the potential for reasonably accurate secondary verification of MUs in pencil beam scanning proton therapy for SFUD treatment plans with the proposed method. Required inputs are few, and are readily accessible, facilitating automation and clinical application. Further investigation will expand the current model to accommodate a broader range of potential optimization problems, and intensity-modulated proton therapy treatment plans.
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Affiliation(s)
- Greg Schimke
- Radiation Oncology, Willis-Knighton Cancer Center, 2600 Kings Hwy, Shreveport LA, USA
| | - Joseph Syh
- Radiation Oncology, Willis-Knighton Cancer Center, 2600 Kings Hwy, Shreveport LA, USA
| | - Hsinshun Terry Wu
- Radiation Oncology, Willis-Knighton Cancer Center, 2600 Kings Hwy, Shreveport LA, USA
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Maes D, Regmi R, Taddei P, Bloch C, Bowen S, Nevitt A, Leuro E, Wong T, Rosenfeld A, Saini J. Parametric characterization of penumbra reduction for aperture-collimated pencil beam scanning (PBS) proton therapy. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab0953] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tesfamicael B, Athar B, Bejarano Buele A, Kozlyuk V, Nichiporov D, Watts DA, Arjomandy B. Technical Note: Use of commercial multilayer Faraday cup for offline daily beam range verification at the McLaren Proton Therapy Center. Med Phys 2019; 46:1049-1053. [DOI: 10.1002/mp.13348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 11/08/2018] [Accepted: 12/03/2018] [Indexed: 11/07/2022] Open
Affiliation(s)
| | - Basit Athar
- Karmanos Cancer Institute McLaren Proton Therapy Center Flint MI USA
| | | | - Valeri Kozlyuk
- Karmanos Cancer Institute McLaren Proton Therapy Center Flint MI USA
| | - Dmitri Nichiporov
- Karmanos Cancer Institute McLaren Proton Therapy Center Flint MI USA
| | | | - Bijan Arjomandy
- Karmanos Cancer Institute McLaren Proton Therapy Center Flint MI USA
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Giordanengo S, Palmans H. Dose detectors, sensors, and their applications. Med Phys 2018; 45:e1051-e1072. [DOI: 10.1002/mp.13089] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- Simona Giordanengo
- Istituto Nazionale di Fisica Nucleare, Section of Torino Via Giuria 1 10125 Torino Italy
| | - Hugo Palmans
- National Physical Laboratory Medical Radiation Science Hampton Road Teddington Middlesex TW11 0LW UK
- EBG MedAustron GmbH Marie‐Curiestraße 5 A‐2700 Wiener Neustadt Austria
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Pidikiti R, Patel BC, Maynard MR, Dugas JP, Syh J, Sahoo N, Wu HT, Rosen LR. Commissioning of the world's first compact pencil-beam scanning proton therapy system. J Appl Clin Med Phys 2018; 19:94-105. [PMID: 29152838 PMCID: PMC5768001 DOI: 10.1002/acm2.12225] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 09/06/2017] [Accepted: 10/12/2017] [Indexed: 12/27/2022] Open
Abstract
This paper summarizes clinical commissioning of the world's first commercial, clinically utilized installation of a compact, image-guided, pencil-beam scanning, intensity-modulated proton therapy system, the IBA Proteus® ONE, at the Willis-Knighton Cancer Center (WKCC) in Shreveport, LA. The Proteus® ONE is a single-room, compact-gantry system employing a cyclotron-generated proton beam with image guidance via cone-beam CT as well as stereoscopic orthogonal and oblique planar kV imaging. Coupling 220° of gantry rotation with a 6D robotic couch capable of in plane patient rotations of over 180° degrees allows for 360° of treatment access. Along with general machine characterization, system commissioning required: (a) characterization and calibration of the proton beam, (b) treatment planning system commissioning including CT-to-density curve determination, (c) image guidance system commissioning, and (d) safety verification (interlocks and radiation survey). System readiness for patient treatment was validated by irradiating calibration TLDs as well as prostate, head, and lung phantoms from the Imaging and Radiation Oncology Core (IROC), Houston. These results confirmed safe and accurate machine functionality suitable for patient treatment. WKCC also successfully completed an on-site dosimetry review by an independent team of IROC physicists that corroborated accurate Proteus® ONE dosimetry.
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Affiliation(s)
| | | | | | - Joseph P. Dugas
- Radiation OncologyWillis‐Knighton Cancer CenterShreveportLAUSA
| | - Joseph Syh
- Radiation OncologyWillis‐Knighton Cancer CenterShreveportLAUSA
| | - Narayan Sahoo
- Division of Radiation OncologyDepartment of Radiation PhysicsThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | | | - Lane R. Rosen
- Radiation OncologyWillis‐Knighton Cancer CenterShreveportLAUSA
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Giordanengo S, Manganaro L, Vignati A. Review of technologies and procedures of clinical dosimetry for scanned ion beam radiotherapy. Phys Med 2017; 43:79-99. [DOI: 10.1016/j.ejmp.2017.10.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 09/23/2017] [Accepted: 10/18/2017] [Indexed: 12/17/2022] Open
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Bäumer C, Geismar D, Koska B, Kramer PH, Lambert J, Lemke M, Plaude S, Pschichholz L, Qamhiyeh S, Schiemann A, Timmermann B, Vermeren X. Comprehensive clinical commissioning and validation of the RayStation treatment planning system for proton therapy with active scanning and passive treatment techniques. Phys Med 2017; 43:15-24. [PMID: 29195558 DOI: 10.1016/j.ejmp.2017.09.136] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/07/2017] [Accepted: 09/25/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To commission the treatment planning system (TPS) RayStation for proton therapy including beam models for spot scanning and for uniform scanning. METHODS Tests consist of procedures from ESTRO booklet number 7, the German DIN for constancy checks of TPSs, and extra tests checking the dose perturbation function. The dose distributions within patients were verified in silico by a comparison of 65 clinical treatment plans with the TPS XiO. Dose-volume parameters, dose differences, and three-dimensional gamma-indices serve as measures of similarity. The monthly constancy checks of Raystation have been automatized with a script. RESULTS The basic functionality of the software complies with ESTRO booklet number 7. For a few features minor enhancements are suggested. The dose distribution in RayStation agrees with the calculation in XiO. This is supported by a gamma-index (3mm/3%) pass rate of >98.9% (median over 59 plans) for the volume within the 20% isodose line and a difference of <0.3% of V95 of the PTV (median over 59 plans). If spot scanning is used together with a range shifter, the dose level calculated by RayStation can be off by a few percent. CONCLUSIONS RayStation can be used for the creation of clinical proton treatment plans. Compared to XiO RayStation has an improved modelling of the lateral dose fall-off in passively delivered fields. For spot scanning fields with range shifter blocks an empirical adjustment of monitor units is required. The computation of perturbed doses also allows the evaluation of the robustness of a treatment plan.
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Affiliation(s)
- C Bäumer
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany.
| | - D Geismar
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany
| | - B Koska
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany
| | - P H Kramer
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany
| | - J Lambert
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany
| | - M Lemke
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany
| | - S Plaude
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany
| | - L Pschichholz
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany; Hochschule Hamm-Lippstadt, Department Hamm 1, Marker Allee 76, Hamm, Germany
| | - S Qamhiyeh
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany
| | - A Schiemann
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany; Technische Universität Ilmenau, Institut für Biomedizinische Technik und Informatik, Gustav-Kirchhoff Str. 2, Ilmenau, Germany
| | - B Timmermann
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany; Clinic for Particle Therapy, University Hospital Essen, West German Cancer Center (WTZ), Hufelandstr. 55, Essen, Germany
| | - X Vermeren
- Westdeutsches Protonentherapiezentrum Essen, Hufelandstr. 55, Essen, Germany
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Saini J, Maes D, Egan A, Bowen SR, St James S, Janson M, Wong T, Bloch C. Dosimetric evaluation of a commercial proton spot scanning Monte-Carlo dose algorithm: comparisons against measurements and simulations. ACTA ACUST UNITED AC 2017; 62:7659-7681. [DOI: 10.1088/1361-6560/aa82a5] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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