4D robust optimization including uncertainties in time structures can reduce the interplay effect in proton pencil beam scanning radiation therapy

Medical Physics
E EngwallL Glimelius

Abstract

Interplay effects in proton radiotherapy can create large distortions in the dose distribution and severely degrade the plan quality. Standard methods to mitigate these effects include abdominal compression, gating, and rescanning. We propose a new method to include the time structures of the delivery and organ motion in the framework of four-dimensional (4D) robust optimization to generate plans that are robust against interplay effects. The method considers multiple scenarios reflecting the uncertainties in the delivery and in the organ motion. In each scenario, the pencil beam scanning spots are distributed to different phases of the breathing cycle according to each individual spot time stamp, and a partial beam dose is calculated for each phase. The partial beam doses are accumulated on a reference phase through deformable image registrations. Minimax optimization is performed to take all scenarios into account simultaneously. For simplicity, the uncertainties in this proof of concept study are limited to variations in the breathing pattern. The method is evaluated for three different nonsmall cell lung cancer patients and compared to plans using conventional 4D robust optimization both with and without rescanning. We asse...Continue Reading

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Citations

Nov 13, 2018·Physics in Medicine and Biology·Jan UnkelbachHuijun Xu
Aug 21, 2019·The British Journal of Radiology·Ann RaldowTheodore Hong
Jan 11, 2020·Radiation Oncology Journal·Youngyih Han
Dec 22, 2020·Physics in Medicine and Biology·Albin FredrikssonBjörn Andersson
Feb 6, 2021·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Cássia O RibeiroAntje Knopf
Nov 24, 2020·Physics in Medicine and Biology·Harald PaganettiTony Lomax
Mar 31, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Edoardo MastellaMario Ciocca
Oct 16, 2020·Journal of Applied Clinical Medical Physics·Hongying FengWei Liu
May 14, 2021·Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB)·Edoardo MastellaMario Ciocca
May 25, 2021·Biomedical Physics & Engineering Express·Suresh Rana, Anatoly B Rosenfeld
Oct 29, 2021·Physics in Medicine and Biology·Harald PaganettiBrian Winey
Nov 11, 2021·Physics in Medicine and Biology·Oscar Pastor-SerranoZoltán Perkó
Jan 7, 2022·Journal of Applied Clinical Medical Physics·Suresh Rana, Anatoly B Rosenfeld

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