Moving target irradiation with fast rescanning and gating in particle therapy

Furukawa, Takuji; Inaniwa, Taku; Sato, Shinji; Shirai, Tomoyuki; Mori, Shinichiro; Takeshita, Eri; Mizushima, Kota; Himukai, Takeshi; Noda, K.

doi:10.1118/1.3481512

Cited by 118 publications

(109 citation statements)

References 17 publications

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“…These uncertainties are highlighted in lung cancers (101)(102)(103)(104). In particular, several studies have demonstrated the heightened sensitivity of IMPT to changes in heterogeneity and motion interplay effects as compared with PS-PT (105)(106)(107)(108)(109).…”

Section: Modalitiesmentioning

confidence: 99%

Advances in radiotherapy techniques and delivery for non-small cell lung cancer: benefits of intensity-modulated radiation therapy, proton therapy, and stereotactic body radiation therapy

Diwanji¹,

Mohindra²,

Vyfhuis³

et al. 2017

Transl. Lung Cancer Res.

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Abstract:The 21st century has seen several paradigm shifts in the treatment of non-small cell lung cancer (NSCLC) in early-stage inoperable disease, definitive locally advanced disease, and the postoperative setting.A key driver in improvement of local disease control has been the significant evolution of radiation therapy techniques in the last three decades, allowing for delivery of definitive radiation doses while limiting exposure of normal tissues. For patients with locally-advanced NSCLC, the advent of volumetric imaging techniques has allowed a shift from 2-dimensional approaches to 3-dimensional conformal radiation therapy (3DCRT).The next generation of 3DCRT, intensity-modulated radiation therapy and volumetric-modulated arc therapy (VMAT), have enabled even more conformal radiation delivery. Clinical evidence has shown that this can improve the quality of life for patients undergoing definitive management of lung cancer. In the earlystage setting, conventional fractionation led to poor outcomes. Evaluation of altered dose fractionation with the previously noted technology advances led to advent of stereotactic body radiation therapy (SBRT). This technique has dramatically improved local control and expanded treatment options for inoperable, earlystage patients. The recent development of proton therapy has opened new avenues for improving conformity and the therapeutic ratio. Evolution of newer proton therapy techniques, such as pencil-beam scanning (PBS), could improve tolerability and possibly allow reexamination of dose escalation. These new progresses, along with significant advances in systemic therapies, have improved survival for lung cancer patients across the spectrum of non-metastatic disease. They have also brought to light new challenges and avenues for further research and improvement.

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Section: Modalitiesmentioning

confidence: 99%

Advances in radiotherapy techniques and delivery for non-small cell lung cancer: benefits of intensity-modulated radiation therapy, proton therapy, and stereotactic body radiation therapy

Diwanji¹,

Mohindra²,

Vyfhuis³

et al. 2017

Transl. Lung Cancer Res.

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“…The treatment time varies in the width of the gating window and the patient's respiratory cycle (25) . When the authors assume image acquisition conditions of 80 kV, 20 mA, 4 ms and 15 fps for thoracic regions, the effective dose and maximal skin dose are 0.…”

Section: Discussionmentioning

confidence: 99%

Estimation of organ doses and effective doses in image-guided respiration-gated radiotherapy

Nakao

Obara

Nabatame³

et al. 2015

Radiat Prot Dosimetry

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Dose conformity in thoracic and abdominal ion-beam radiotherapy is degraded by respiratory motion. To improve conformity, an image-guided respiration-gated system can be used in the treatment room. The purpose of this study was to estimate the organ doses and effective doses to patients from an image-guided respiration-gated system. Glass dosemeters were inserted into an adult anthropomorphic phantom and were attached to the surface on the phantom. The phantom was placed on the treatment couch, and the imaging dose from fluoroscopy was evaluated. In addition to the organ doses, the effective doses were also estimated according to the ICRP Publication 103. The irradiation time is over 3-5 min per beam angle. When image acquisition conditions were assumed for thoracic treatment, the effective doses and maximal skin doses were 0.48-0.79 mSv and 5.9-9.9 mGy, respectively. The estimated doses can be the base data for considering radiological protection in the radiotherapy.

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“…We do this on the basis of our previous studies, which showed that four or more phase-controlled rescans with FTV should substantially improve the accuracy of dose delivery, and it is indeed close to that calculated by our present approach. [20][21][22] In the present study, we introduced an alternative approach to four dimensions. This approach does not calculate 4D accumulated dose distribution using DIR, for the following reason.…”

Section: Discussionmentioning

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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Moving target irradiation with fast rescanning and gating in particle therapy

Cited by 118 publications

References 17 publications

Advances in radiotherapy techniques and delivery for non-small cell lung cancer: benefits of intensity-modulated radiation therapy, proton therapy, and stereotactic body radiation therapy

Advances in radiotherapy techniques and delivery for non-small cell lung cancer: benefits of intensity-modulated radiation therapy, proton therapy, and stereotactic body radiation therapy

Estimation of organ doses and effective doses in image-guided respiration-gated radiotherapy

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

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