Feasibility of 4DCBCT-based proton dose calculation: An ex vivo porcine lung phantom study

Niepel, Katharina; Kamp, Florian; Kurz, Christopher; Hansen, David C.; Rit, Simon; Neppl, S.; Hofmaier, Jan; Bondesson, David; Thieke, Christian; Dinkel, Julien; Belka, Claus; Parodi, Katia; Landry, Guillaume

doi:10.1016/j.zemedi.2018.10.005

Cited by 19 publications

(34 citation statements)

References 38 publications

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“…For more advanced applications, as for example 4DCBCT-based proton dose calculations, further improvements will be required to warrant sufficient image quality. 17 The finite range of protons and their sensitivity to changes in water equivalent thickness make it important to monitor variations in motion of the tumor and surrounding tissue. Especially when variations occur in the beam paths, at the distal edge or the lateral Medical Physics, 0 (0), xxxx penumbra regions.…”

Section: Discussionmentioning

confidence: 99%

“…MA‐ROOSTER reconstructed 4DCBCTs were found suitable in our opinion in the context of tumor motion assessment. For more advanced applications, as for example 4DCBCT‐based proton dose calculations, further improvements will be required to warrant sufficient image quality 17 . The finite range of protons and their sensitivity to changes in water equivalent thickness make it important to monitor variations in motion of the tumor and surrounding tissue.…”

Section: Discussionmentioning

confidence: 99%

“…16 Only one published study investigated the potential of using (sparse-view) 4DCBCTs for proton therapy treatments specifically. 17 This was done using phantom CBCT data acquired at a medical linear accelerator that was reconstructed using an iterative reconstruction method based on total variation regularization. 17 This technical note reports on the potential of using the advanced reconstruction method MA-ROOSTER for creating 4DCBCTs from sparse-view clinical CBCT data.…”

Section: Introductionmentioning

confidence: 99%

“…17 This was done using phantom CBCT data acquired at a medical linear accelerator that was reconstructed using an iterative reconstruction method based on total variation regularization. 17 This technical note reports on the potential of using the advanced reconstruction method MA-ROOSTER for creating 4DCBCTs from sparse-view clinical CBCT data. This was done for a representative proton therapy data set of (non-) small cell lung cancer ([N]SCLC) patients.…”

Section: Introductionmentioning

confidence: 99%

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Technical Note: 4D cone‐beam CT reconstruction from sparse‐view CBCT data for daily motion assessment in pencil beam scanned proton therapy (PBS‐PT)

et al. 2020

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The number of pencil beam scanned proton therapy (PBS-PT) facilities equipped with cone-beam computed tomography (CBCT) imaging treating thoracic indications is constantly rising. To enable daily internal motion monitoring during PBS-PT treatments of thoracic tumors, we assess the performance of Motion-Aware RecOnstructiOn method using Spatial and Temporal Regularization (MA-ROOSTER) four-dimensional CBCT (4DCBCT) reconstruction for sparse-view CBCT data and a realistic data set of patients treated with proton therapy. Methods: Daily CBCT projection data for nine non-small cell lung cancer (NSCLC) patients and one SCLC patient were acquired at a proton gantry system (IBA Proteus ® One). Four-dimensional CBCT images were reconstructed applying the MA-ROOSTER and the conventional phase-correlated Feldkamp-Davis-Kress (PC-FDK) method. Image quality was assessed by visual inspection, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and the structural similarity index measure (SSIM). Furthermore, gross tumor volume (GTV) centroid motion amplitudes were evaluated. Results: Image quality for the 4DCBCT reconstructions using MA-ROOSTER was superior to the PC-FDK reconstructions and close to FDK images (median CNR: 1.23 [PC-FDK], 1.98 [MA-ROOS-TER], and 1.98 [FDK]; median SNR: 2.56 [PC-FDK], 4.76 [MA-ROOSTER], and 5.02 [FDK]; median SSIM: 0.18 [PC-FDK vs FDK], 0.31 [MA-ROOSTER vs FDK]). The improved image quality of MA-ROOSTER facilitated GTV contour warping and realistic motion monitoring for most of the reconstructions. Conclusion: MA-ROOSTER based 4DCBCTs performed well in terms of image quality and appear to be promising for daily internal motion monitoring in PBS-PT treatments of (N)SCLC patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Technical Note: 4D cone‐beam CT reconstruction from sparse‐view CBCT data for daily motion assessment in pencil beam scanned proton therapy (PBS‐PT)

et al. 2020

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“…In the future, this limitation might be overcome by introducing post-processed synthetic 4DCTs based on daily CBCTs suitable for proton dose calculations. There are multiple examples for developments towards introduction of 4DCBCTs [17] and synthetic CTs [18] which do have improved CT number accuracy that might make synthetic 4DCTs suitable for proton dose calculation. The initial investigations on the Table 3 CTV dose statistics based on reconstructed fraction doses and accumulated course dose.…”

Section: Limitationsmentioning

confidence: 99%

Evaluation of interplay and organ motion effects by means of 4D dose reconstruction and accumulation

Meijers

Knopf

Crijns

et al. 2020

Radiotherapy and Oncology

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Pencil beam scanned proton therapy (PBS-PT) treatment quality might be compromised by interplay and motion effects. Via fraction-wise reconstruction of 4D dose distributions and dose accumulation, we assess the clinical relevance of motion related target dose degradation in thoracic cancer patients. Methods and materials: For the ten thoracic patients (Hodgkin lymphoma and non-small cell lung cancer) treated at our proton therapy facility, daily breathing pattern records, treatment delivery log-files and weekly repeated 4DCTs were collected. Patients exhibited point-max target motion of up to 20 mm. They received robustly optimized treatment plans, delivered with five-times rescanning in fractionated regimen. Treatment delivery records were used to reconstruct 4D dose distributions and the accumulated treatment course dose per patient. Fraction-wise target dose degradations were analyzed and the accumulated treatment course dose, representing an estimation of the delivered dose, was compared with the prescribed dose. Results: No clinically relevant loss of target dose homogeneity was found in the fraction-wise reconstructed 4D dose distributions. Overall, in 97% of all reconstructed fraction doses, D98 remained within 5% from the prescription dose. The V95 of accumulated treatment course doses was higher than 99.7% for all ten patients. Conclusions: 4D dose reconstruction and accumulation enables the clinical estimation of actual exhibited interplay and motion effects. In the patients considered here, the loss of homogeneity caused by interplay and organ motion did not show systematic pattern and smeared out throughout the course of fractionated PBS-PT treatment. Dose degradation due to anatomical changes showed to be more severe and triggered treatment adaptations for five patients.

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Impact of different respiratory gating methods on target delineation and a radiotherapy plan for solitary pulmonary tumors

Shang,

Duan,

Yin

et al. 2024

Cancer Medicine

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Background and PurposeRespiratory movement has an important impact on the radiotherapy for lung tumor. Respiratory gating technology is helpful to improve the accuracy of target delineation. This study investigated the value of prospective and retrospective respiratory gating simulations in target delineation and radiotherapy plan design for solitary pulmonary tumors (SPTs) in radiotherapy.MethodsThe enrolled patients underwent CT simulation with three‐dimensional (3D) CT non gating, prospective respiratory gating, and retrospective respiratory gating simulation. The target volumes were delineated on three sets of CT images, and radiotherapy plans were prepared accordingly. Tumor displacements and movement information obtained using the two respiratory gating approaches, as well as the target volumes and dosimetry parameters in the radiotherapy plan were compared.ResultsNo significant difference was observed in tumor displacement measured using the two gating methods (p > 0.05). However, the internal gross tumor volumes (IGTVs), internal target volumes (ITVs), and planning target volumes (PTVs) based on the retrospective respiratory gating simulation were larger than those obtained using prospective gating (group A: pIGTV = 0.041, pITV = 0.003, pPTV = 0.008; group B: pIGTV = 0.025, pITV = 0.039, pPTV = 0.004). The two‐gating PTVs were both smaller than those delineated on 3D non gating images (p < 0.001). V5Gy, V10Gy, V20Gy, V30Gy, and mean lung dose in the two gated radiotherapy plans were lower than those in the 3D non gating plan (p < 0.001); however, no significant difference was observed between the two gating plans (p > 0.05).ConclusionsThe application of respiratory gating could reduce the target volume and the radiation dose that the normal lung tissue received. Compared to prospective respiratory gating, the retrospective gating provides more information about tumor movement in PTV.

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Feasibility of 4DCBCT-based proton dose calculation: An ex vivo porcine lung phantom study

Cited by 19 publications

References 38 publications

Technical Note: 4D cone‐beam CT reconstruction from sparse‐view CBCT data for daily motion assessment in pencil beam scanned proton therapy (PBS‐PT)

Technical Note: 4D cone‐beam CT reconstruction from sparse‐view CBCT data for daily motion assessment in pencil beam scanned proton therapy (PBS‐PT)

Evaluation of interplay and organ motion effects by means of 4D dose reconstruction and accumulation

Impact of different respiratory gating methods on target delineation and a radiotherapy plan for solitary pulmonary tumors

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