First clinical experience in carbon ion scanning beam therapy: retrospective analysis of patient positional accuracy

Mori, Shinichiro; Shibayama, Kouichi; Tanimoto, Katsuyuki; Kumagai, Motoki; Matsuzaki, Y; Furukawa, Takuji; Inaniwa, Taku; Shirai, Tomoyuki; Noda, K.; Tsuji, Hiroshi; Kamada, Tadashi

doi:10.1093/jrr/rrs017

Cited by 41 publications

(36 citation statements)

References 13 publications

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“…9b). (20) We found five cases over 30 min patient setup process during the clinical trials, this is because patients moved during patient setup process.…”

Section: Resultsmentioning

confidence: 91%

“…It is extendable in response to changes in treatment workflow. Several PTHAs are installed, including a DRR application, (19) patient position verification application (landmark‐based manual registration, GPU‐based 2D/3D auto‐registration), (20) quality assurance application, 4D tool (image registration, and 4D dose calculation by exchange of data with the treatment planning system). These applications were custom designed for the new facility for use with any treatment workflow.…”

Section: Methodsmentioning

confidence: 99%

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Patient handling system for carbon ion beam scanning therapy

Mori¹,

Shirai²,

Takei³

et al. 2012

J Applied Clin Med Phys

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Our institution established a new treatment facility for carbon ion beam scanning therapy in 2010. The major advantages of scanning beam treatment compared to the passive beam treatment are the following: high dose conformation with less excessive dose to the normal tissues, no bolus compensator and patient collimator/ multi‐leaf collimator, better dose efficiency by reducing the number of scatters. The new facility was designed to solve several problems encountered in the existing facility, at which several thousand patients were treated over more than 15 years. Here, we introduce the patient handling system in the new treatment facility. The new facility incorporates three main systems, a scanning irradiation system (S‐IR), treatment planning system (TPS), and patient handling system (PTH). The PTH covers a wide range of functions including imaging, geometrical/position accuracy including motion management (immobilization, robotic arm treatment bed), layout of the treatment room, treatment workflow, software, and others. The first clinical trials without respiratory gating have been successfully started. The PTH allows a reduction in patient stay in the treatment room to as few as 7 min. The PTH plays an important role in carbon ion beam scanning therapy at the new institution, particularly in the management of patient handling, application of image‐guided therapy, and improvement of treatment workflow, and thereby allows substantially better treatment at minimum cost.PACS numbers: 87.56.‐v; 87.57.‐s; 87.55.‐x

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“…9b). (20) We found five cases over 30 min patient setup process during the clinical trials, this is because patients moved during patient setup process.…”

Section: Resultsmentioning

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Patient handling system for carbon ion beam scanning therapy

Mori¹,

Shirai²,

Takei³

et al. 2012

J Applied Clin Med Phys

View full text Add to dashboard Cite

show abstract

“…Yaw (rotation along the vertical axis) and pitch (rotation along the lateral axis) are the frontal image rotation and lateral image rotation, respectively. However, because roll (rotation along the longitudinal axis) cannot be determined from the frontal and lateral DRs, a 2D–3D registration method 4 , 5 , 6 , 7 , 8 , 9 , 10 is needed. In this evaluation of patient positioning error, it is assumed that the rotation error is negligible and can be almost ignored because the measurements take place after the patient positioning has been completed, and the pointing technique is also used for evaluation only regarding the translation errors.…”

Section: Discussionmentioning

confidence: 99%

“…For patient positioning research, CT–CT registration methods have been proposed using CT images or cone beam CT images, 1 , 2 , 3 2D–3D registration methods have been proposed using two‐directional X‐ray images, 4 , 5 , 6 , 7 , 8 , 9 , 10 and patient positioning systems that are fast and highly accurate are widely used. For patient positioning in particle therapy, the prescribed dose is not deposited to the target when the water‐equivalent path length (WEL) to the target changes, even if the target is positioned to the correct irradiation position using CT images 11 , 12 , 13 .…”

Section: Introductionmentioning

confidence: 99%

Development of an automatic evaluation method for patient positioning error

Kubota

Tashiro

Shinohara

et al. 2015

J Applied Clin Med Phys

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Highly accurate radiotherapy needs highly accurate patient positioning. At our facility, patient positioning is manually performed by radiology technicians. After the positioning, positioning error is measured by manually comparing some positions on a digital radiography image (DR) to the corresponding positions on a digitally reconstructed radiography image (DRR). This method is prone to error and can be time‐consuming because of its manual nature. Therefore, we propose an automated measuring method for positioning error to improve patient throughput and achieve higher reliability. The error between a position on the DR and a position on the DRR was calculated to determine the best matched position using the block‐matching method. The zero‐mean normalized cross‐correlation was used as our evaluation function, and the Gaussian weight function was used to increase importance as the pixel position approached the isocenter. The accuracy of the calculation method was evaluated using pelvic phantom images, and the method's effectiveness was evaluated on images of prostate cancer patients before the positioning, comparing them with the results of radiology technicians' measurements. The root mean square error (RMSE) of the calculation method for the pelvic phantom was 0.23±0.05 mm. The coefficients between the calculation method and the measurement results of the technicians were 0.989 for the phantom images and 0.980 for the patient images. The RMSE of the total evaluation results of positioning for prostate cancer patients using the calculation method was 0.32±0.18 mm. Using the proposed method, we successfully measured residual positioning errors. The accuracy and effectiveness of the method was evaluated for pelvic phantom images and images of prostate cancer patients. In the future, positioning for cancer patients at other sites will be evaluated using the calculation method. Consequently, we expect an improvement in treatment throughput for these other sites.PACS number: 87

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“…Carbon-ion scanning beam treatment without respiratory gating was successfully implemented in 2011. 1,2 To extend treatment anatomical sites, we are now preparing to introduce carbon-ion scanning treatment for the thoracic and abdominal regions. One of our goals is to increase capacity to meet the increasing numbers of patients, while maintaining high treatment accuracy and patient comfort.…”

mentioning

confidence: 99%

Implementation of a target volume design function for intrafractional range variation in a particle beam treatment planning system

Mori¹,

Inaniwa²,

Miki³

et al. 2014

BJR

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Objective: Treatment planning for charged particle therapy in the thoracic and abdominal regions should take account of range uncertainty due to intrafractional motion. Here, we developed a design tool (4Dtool) for the target volume [field-specific target volume (FTV)], which accounts for this uncertainty using four-dimensional CT (4DCT). Methods: Target and normal tissue contours were input manually into a treatment planning system (TPS). These data were transferred to the 4Dtool via the picture archiving and communication system (PACS). Contours at the reference phase were propagated to other phases by deformable image registration. FTV was calculated using 4DCT on the 4Dtool. The TPS displays FTV contours using digital imaging and communications in medicine files imported from the PACS. These treatment parameters on the CT image at the reference phase were then used for dose calculation on the TPS. The tool was tested in single clinical case randomly selected from patients treated at our centre for lung cancer. Results: In this clinical case, calculation of dose distribution with the 4Dtool resulted in the successful delivery of carbon-ion beam at the reference phase of 95% of the prescribed dose to the clinical target volume (CTV). Application to the other phases also provided sufficient dose to the CTV. Conclusion: The 4Dtool software allows the design of the target volume with consideration to intrafractional range variation and is now in routine clinical use at our institution. Advances in knowledge: Our alternative technique represents a practical approach to four-dimensional treatment planning within the current state of charged particle therapy.Our centre treats .700 patients per year by passive carbonion beam irradiation therapy, conducted over 4 days per week. Carbon-ion scanning beam treatment without respiratory gating was successfully implemented in 2011.

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First clinical experience in carbon ion scanning beam therapy: retrospective analysis of patient positional accuracy

Cited by 41 publications

References 13 publications

Patient handling system for carbon ion beam scanning therapy

Patient handling system for carbon ion beam scanning therapy

Development of an automatic evaluation method for patient positioning error

Implementation of a target volume design function for intrafractional range variation in a particle beam treatment planning system

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