A new way of adapting IMRT delivery fraction-by-fraction to cater for variable intrafraction motion

Physics in Medicine and Biology
S Webb, Thomas Bortfeld

Abstract

In this paper a technique is presented for adaptive therapy to compensate for variable intrafraction tissue motion. So long as the motion can be measured or deduced for each fraction the technique modifies the fluence profile for the subsequent fractions in a repeatable cyclic way. The fluence modification is based on projecting the dose discrepancies between the cumulative delivered dose after each fraction and the expected planned dose at the same stage. It was shown that, in general, it is best to adapt the fluence profile to moving leaves that also have been modified to 'breathe' according to some regular default motion. However, it is important to point out that, if this regular default motion were to differ too much from the variable motion at each fraction, then the result can be worse than adapting to non-breathing leaves in a dynamic MLC technique. Furthermore, in general it should always be possible to improve results by starting the adaptation process with a constrained deconvolution of the regular default motion.

References

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Aug 8, 2002·Physics in Medicine and Biology·Thomas BortfeldSteve B Jiang
Feb 22, 2005·Medical Physics·Lech Papiez, Dharanipathy Rangaraj
Jun 3, 2005·Physics in Medicine and Biology·Alexei TrofimovThomas Bortfeld
Jun 23, 2006·Physics in Medicine and Biology·S Webb
Aug 11, 2006·Medical Physics·Dan RuanJan-Jakob Sonke
Mar 1, 2007·Physics in Medicine and Biology·M von SiebenthalPh Cattin

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Citations

Jan 22, 2010·Physics in Medicine and Biology·M LameyB G Fallone
Jul 6, 2010·Physics in Medicine and Biology·Yankhua Fan, Ravinder Nath
Feb 15, 2012·Physics in Medicine and Biology·Jagdish RamakrishnanJohn N Tsitsiklis
Apr 23, 2009·Physics in Medicine and Biology·Christian VrancićThomas Bortfeld

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