Future technological developments in proton therapy – A predicted technological breakthrough

Vidal, M.; Moignier, Cyril; Patriarca, Annalisa; Sotiropoulos, Marios; Schneider, Tim; Marzi, Ludovic De

doi:10.1016/j.canrad.2021.06.017

Cited by 4 publications

(8 citation statements)

References 97 publications

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“…[ 26 ], which reported changes in the second week (n = 3/11) or third week (8/11). Other previous studies conducted verifications scans after two weeks [ 37 ], or after three weeks [ 38 ]. Ref.…”

Section: Discussionmentioning

confidence: 99%

Adaptive Proton Therapy of Pediatric Head and Neck Cases Using MRI-Based Synthetic CTs: Initial Experience of the Prospective KiAPT Study

Bäumer

Frakulli

Kohl

et al. 2022

Cancers

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Background and Purpose: Interfractional anatomical changes might affect the outcome of proton therapy (PT). We aimed to prospectively evaluate the role of Magnetic Resonance Imaging (MRI) based adaptive PT for children with tumors of the head and neck and base of skull. Methods: MRI verification images were acquired at half of the treatment course. A synthetic computed tomography (CT) image was created using this MRI and a deformable image registration (DIR) to the reference MRI. The methodology was verified with in-silico phantoms and validated using a clinical case with a shrinking cystic hygroma on the basis of dosimetric quantities of contoured structures. The dose distributions on the verification X-ray CT and on the synthetic CT were compared with a gamma-index test using global 2 mm/2% criteria. Results: Regarding the clinical validation case, the gamma-index pass rate was 98.3%. Eleven patients were included in the clinical study. The most common diagnosis was rhabdomyosarcoma (73%). Craniofacial tumor site was predominant in 64% of patients, followed by base of skull (18%). For one individual case the synthetic CT showed an increase in the median D2 and Dmax dose on the spinal cord from 20.5 GyRBE to 24.8 GyRBE and 14.7 GyRBE to 25.1 GyRBE, respectively. Otherwise, doses received by OARs remained relatively stable. Similarly, the target volume coverage seen by D95% and V95% remained unchanged. Conclusions: The method of transferring anatomical changes from MRIs to a synthetic CTs was successfully implemented and validated with simple, commonly available tools. In the frame of our early results on a small cohort, no clinical relevant deterioration for neither PTV coverage nor an increased dose burden to OARs occurred. However, the study will be continued to identify a pediatric patient cohort, which benefits from adaptive treatment planning.

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Section: Discussionmentioning

confidence: 99%

Adaptive Proton Therapy of Pediatric Head and Neck Cases Using MRI-Based Synthetic CTs: Initial Experience of the Prospective KiAPT Study

Bäumer

Frakulli

Kohl

et al. 2022

Cancers

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“…Various recent detailed reviews about particle therapy hardware technologies are available [3][4][5][6], as well as overviews of radiobiological advances [7][8][9], Monte Carlo simulations [10,11], treatment planning [12,13], treatment verification techniques [14], and applications of artificial intelligence in particle therapy [15]. Future directions in proton and particle therapy are discussed by Mohan [16] and Graeff et al [17], respectively.…”

Section: Introductionmentioning

confidence: 99%

“…The rationale was that most of these topics are interconnected. For some aspects we only present the basic concepts that are necessary to comprehend particle therapy technology and refer to the cited references for a more complete description [3][4][5][6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Technological Developments and Future Perspectives in Particle Therapy: A Topical Review

Kraan,

Del Guerra

2024

IEEE Trans. Radiat. Plasma Med. Sci.

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In the last decades, important technological progress has been made to enhance the quality and efficiency of particle therapy treatments. Continuous improvements in dose delivery, treatment planning and verification techniques have lead to higher dose conformity and better sparing of healthy tissue. At the same time, particle therapy treatments are complex and much more expensive than conventional radiotherapy, and only highly specialized facilities can offer these treatments. Cost reduction is thus a strong drive behind technological developments in the field. The number of treatment facilities offering proton and carbon therapy has strongly grown in the last decades, and the amount of research efforts and innovations have increased continuously.From a technological perspective, advances in hardware are often accompanied by innovations in software and computation, and vice versa. In this review we will present a basic overview of technological advances in particle therapy hardware (accelerators, gantries, applications of superconductivity, treatment verification techniques), software (Monte Carlo simulations, treatment planning calculations), and studies towards clinical applications. By combining a broad selection of topics into a single review and by covering both proton and carbon therapy, we aim at providing the reader a unique overview of the evolution of various technologies developed for particle therapy.

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“…Nonetheless, scientific programs at the National Insti-tute of Radiological Sciences (NIRS, Chiba, Japan) are investigating pre-clinical beams like oxygen and neon ions for the purpose of multi-ion therapy (MIT) regimes and/or hypofractionated treatments. [9][10][11] Despite the current clinical rationale of using stationary gantry angles and/or treatment table positions during delivery, interest in particle arc techniques is growing 5,12 with several institutions providing unique optimization and delivery approaches for proton arc techniques, for example, spot-scanning proton arc (SPArc) and proton monoenergetic arc therapy (PMAT). [13][14][15][16] Similarly, spot-scanning hadron arc (SHArc) therapy proposes an optimization technique for both light and heavy ions using proton, helium, or carbon ions.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the current clinical rationale of using stationary gantry angles and/or treatment table positions during delivery, interest in particle arc techniques is growing 5,12 with several institutions providing unique optimization and delivery approaches for proton arc techniques, for example, spot‐scanning proton arc (SPArc) and proton monoenergetic arc therapy (PMAT) 13–16 . Similarly, spot‐scanning hadron arc (SHArc) therapy proposes an optimization technique for both light and heavy ions using proton, helium, or carbon ions 17 .…”

Section: Introductionmentioning

confidence: 99%

Spot‐scanning hadron arc (SHArc) therapy: A proof of concept using single‐ and multi‐ion strategies with helium, carbon, oxygen, and neon ions

et al. 2022

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Purpose To present particle arc therapy treatments using single and multi‐ion therapy optimization strategies with helium (4He), carbon (12C), oxygen (16O), and neon (20Ne) ion beams. Methods and materials An optimization procedure and workflow were devised for spot‐scanning hadron arc therapy (SHArc) treatment planning in the PRECISE (PaRticle thErapy using single and Combined Ion optimization StratEgies) treatment planning system (TPS). Physical and biological beam models were developed for helium, carbon, oxygen, and neon ions via FLUKA MC simulation. SHArc treatments were optimized using both single‐ion (12C, 16O, or 20Ne) and multi‐ion therapy (16O+4He or 20Ne+4He) applying variable relative biological effectiveness (RBE) modeling using a modified microdosimetric kinetic model (mMKM) with (α/β)x values of 2, 5, and 3.1 Gy, respectively, for glioblastoma, pancreatic adenocarcinoma, and prostate adenocarcinoma patient cases. Dose, effective dose, linear energy transfer (LET), and RBE were computed with the GPU‐accelerated dose engine FRoG and dosimetric/biophysical attributes were evaluated in the context of conventional particle and photon‐based therapies (e.g., volumetric modulated arc therapy [VMAT]). Results All SHArc plans met the target optimization goals (3GyRBE) and demonstrated increased target conformity and substantially lower low‐dose bath to surrounding normal tissues than VMAT. SHArc plans using a singleion species (12C, 16O, or 20Ne) exhibited favorable LET distributions with the highest‐LET components centralized in the target volume, with values ranging from ∼80–170 keV/μm, ∼130–220 keV/μm, and ∼180–350 keV/μm for 12C, 16O, or 20Ne, respectively, exceeding mean target LET of conventional particle therapy (12C:∼55, 16O:∼75 20Ne:∼95 keV/μm). Multi‐ion therapy with SHArc delivery (SHArcMIT) provided a similar level of target LET enhancement as SHArc compared to conventional planning, however, with additional benefits of homogenous physical dose and RBE distributions. Conclusion Here, we demonstrate that arc delivery of light and heavy ion beams, using either a single‐ion species (12C, 16O, or 20Ne) or combining two ions in a single fraction (16O+4He or 20Ne+4He) affords enhanced physical and biological distributions (e.g., LET) compared with conventional delivery with photons or particle beams. SHArc marks the first single‐ and multi‐ion arc therapy treatment optimization approach using light and heavy ions.

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Future technological developments in proton therapy – A predicted technological breakthrough

Cited by 4 publications

References 97 publications

Adaptive Proton Therapy of Pediatric Head and Neck Cases Using MRI-Based Synthetic CTs: Initial Experience of the Prospective KiAPT Study

Adaptive Proton Therapy of Pediatric Head and Neck Cases Using MRI-Based Synthetic CTs: Initial Experience of the Prospective KiAPT Study

Technological Developments and Future Perspectives in Particle Therapy: A Topical Review

Spot‐scanning hadron arc (SHArc) therapy: A proof of concept using single‐ and multi‐ion strategies with helium, carbon, oxygen, and neon ions

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