Clinical evaluation of 4D PET motion compensation strategies for treatment verification in ion beam therapy

Gianoli, Chiara; Kurz, Christopher; Riboldi, Marco; Bauer, J.; Fontana, Giulia; Baroni, Guido; Debus, Jürgen; Parodi, Katia

doi:10.1088/0031-9155/61/11/4141

Cited by 7 publications

(3 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To contain 95% of the IBTV volume, an expansion of about 13 mm was necessary for ITV or BTV. This is similar to the results of Callahan Jason [ 17 ]. To contain 97% of ITV derived from 4D PET-CT MIP images, they suggested a 15 mm margin expansion from GTV to the planning target volume (PTV).…”

Section: Discussionsupporting

confidence: 92%

Comparison of biological target volume metrics based on FDG PET-CT and 4DCT for primary non-small-cell lung cancer

Zhang

Duan³

et al. 2017

Oncotarget

View full text Add to dashboard Cite

Fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) and four-dimensional CT (4DCT) are used in several methods for defining the biological target volume (BTV) in primary non-small cell lung cancer (NSCLC). Disagreements between the assessments using these methodologies make the use of BTV for radiotherapy planning controversial. In this study, we compared existing methods with our proposed internal biological target volume (IBTV) metric, derived by combining internal target volume (ITV) and BTV metrics. We defined the IBTV from ITV (IBTVi) or BTV (IBTVb) based on ITV or BTV with symmetrical margin expansion. We detected large differences between IBTV, IBTVi and IBTVb (p < 0.001), but no difference between ITV and BTV. A margin expansion of about 13 mm was necessary for ITV or BTV to encompass > 95% IBTV. The conformity index correlated negatively with IBTV/ITV, IBTV/BTV, IBTVi/ITV, and IBTVb/BTV volume ratios (p < 0.05). VR also increased the margins of IBTVi and IBTVb. Indeed, IBTV was much smaller than IBTVi or IBTVb, suggesting that using IBTV for radiotherapy planning could improve treatment by minimizing the radiation exposure of healthy tissue and organs surrounding tumors.

show abstract

Section: Discussionsupporting

confidence: 92%

Comparison of biological target volume metrics based on FDG PET-CT and 4DCT for primary non-small-cell lung cancer

Zhang

Duan³

et al. 2017

Oncotarget

View full text Add to dashboard Cite

show abstract

“…10 and 11. Despite also being an iterative MLEM reconstruction code, it is optimized for the scanner model's actual FOV, with Fourier rebinning and intra-reconstruction smoothing [54,55].…”

Section: Applications To Particle Therapymentioning

confidence: 99%

An overview of recent developments in FLUKA PET tools

et al. 2018

View full text Add to dashboard Cite

The new developments of the FLUKA Positron-Emission-Tomography (PET) tools are detailed. FLUKA is a fully integrated Monte Carlo (MC) particle transport code, used for an extended range of applications, including Medical Physics. Recently, it provided the medical community with dedicated simulation tools for clinical applications, including the PET simulation package. PET is a well-established imaging technique in nuclear medicine, and a promising method for clinical in vivo treatment verification in hadrontherapy. The application of clinically established PET scanners to new irradiation environments such as hadrontherapy requires further experimental and theoretical research to which MC simulations could be applied. The FLUKA PET tools, besides featuring PET scanner models in its library, allow the configuration of new PET prototypes via the FLUKA Graphical User Interface (GUI) Flair. Both the beam time structure and scan time can be specified by the user, reproducing PET acquisitions in time, in a particle therapy scenario. Furthermore, different scoring routines allow the analysis of single and coincident events, and identification of parent isotopes generating annihilation events. Two reconstruction codes are currently supported: the Filtered Back-Projection (FBP) and Maximum-Likelihood Expectation Maximization (MLEM), the latter embedded in the tools. Compatibility with other reconstruction frameworks is also possible. The FLUKA PET tools package has been successfully tested for different detectors and scenarios, including conventional functional PET applications and in beam PET, either using radioactive sources, or simulating hadron beam irradiations. The results obtained so far confirm the FLUKA PET tools suitability to perform PET simulations in R&D environment.

show abstract

“…PET can be used for 4D‐dose verification, but might be too slow for single fraction irradiations. In contrast to prompt emission methods, the fragmented nuclei are deposited in the irradiated tissue, though biological washout plays a major role especially in the heart.…”

Section: Requirements For a Clinical Applicationmentioning

confidence: 99%

Noninvasive cardiac arrhythmia ablation with particle beams

Graeff

Bert

2018

Medical Physics

View full text Add to dashboard Cite

Cardiac arrhythmias are a major health burden, associated with reduced quality of life and substantial morbidity and mortality. Current therapy includes moderately effective medication and catheter‐based ablation of arrhythmogenic substrates in the heart. Catheter interventions frequently have to be repeated due to recurrent arrhythmia, can have rare but severe side‐effects and are less suited especially for potentially lethal left ventricular tachycardia. Noninvasive alternatives are therefore warranted. Photon and ion beam radiotherapy has been studied in animal models and first patient cases have been reported using photons. Ion beams might offer the possibility to greatly reduce dose to surrounding healthy tissue, including critical cardiac substructures. Based on a recently conducted animal study, we report advantages and disadvantages of 4D‐ion beam therapy, and strategies necessary for a clinical transition. Motion management of both respiration and heartbeat are discussed, as well as range uncertainty resulting from both regular motion and interfractional anatomic changes. Image guidance both in 3D and 4D has to be employed for a safe irradiation, but also population‐based data on motion variability and time behavior of interfractional changes are necessary. Range verification could play a crucial role at least during development of clinical protocols. For clinical realization, it appears necessary to suppress or conformally mitigate the large respiratory motion to avoid normal tissue complications. Cardiac motion has to be incorporated into treatment planning, either through adequate range‐considering internal margins or through more conformal strategies such as ECG‐based gating or even 4D‐optimization. The latter strategies would necessitate online 4D image guidance.

show abstract

Clinical evaluation of 4D PET motion compensation strategies for treatment verification in ion beam therapy

Cited by 7 publications

References 41 publications

Comparison of biological target volume metrics based on FDG PET-CT and 4DCT for primary non-small-cell lung cancer

Comparison of biological target volume metrics based on FDG PET-CT and 4DCT for primary non-small-cell lung cancer

An overview of recent developments in FLUKA PET tools

Noninvasive cardiac arrhythmia ablation with particle beams

Contact Info

Product

Resources

About