Systematic evaluation of four‐dimensional hybrid depth scanning for carbon‐ion lung therapy

Mori, Shinichiro; Furukawa, Takuji; Inaniwa, Taku; Zenklusen, Silvan; Nakao, Minoru; Shirai, Tomoyuki; Noda, K.

doi:10.1118/1.4792295

Cited by 43 publications

(43 citation statements)

References 56 publications

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“…Such a solution is not yet feasible due to the complexity of the problem. Another solution could also be phase-controlled rescanning with greatly reduced uncertainty in the mitigation outcome [Mori et al, 2013, Takahashi et al, 2014. However, it requires motion monitoring and complicates the treatment delivery.…”

Section: Treating Non-small Cell Lung Cancer With Particle Therapymentioning

confidence: 99%

“…Recent studies suggest that some patients require phase-controlled layer or volumetric rescanning for sufficiently robust target coverage [Mori et al, 2013, Takahashi et al, 2014. The advantage of simple slice-by-slice rescanning is that no motion monitoring or assumptions on the breathing frequency are necessary [Bert and Durante, 2011], but the higher required number of rescans might increase treatment times due to reduced beam intensities.…”

Section: Range Margins and Motion Mitigationmentioning

confidence: 99%

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In silico comparison of photons versus carbon ions in single fraction therapy of lung cancer

et al. 2016

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Stereotactic body image guided radiation therapy (SBRT) shows excellent results for the local control of early stage lung cancer. However, not all patients are eligible for SBRT, and advanced stage treatment is less successful and often associated with severe side effects. Scanned carbon ion therapy (PT) can deliver more conformal dose likely benefiting these patient groups.Therefore an in silico trial was conducted on early and advanced stage patients to identify potential advantages of PT. The patients were treated with SBRT at Champalimaud Center for the Unknown, Lisbon (Portugal). PT plans were simulated on 4DCTs, and rescanning was investigated for motion mitigation in 4D-dose calculations. A dedicated strategy for 4D intensity modulated particle therapy (IMPT) was developed and applied for advanced stage patients with multiple lesions. For clinically valid and reliable results the deformable image registrationnecessary for 4D-dose calculation -a quality assurance tool was developed and applied in the study.The results showed that target coverage was comparable in SBRT and PT, while PT delivered significantly lower doses to most critical structures, especially the heart, lungs, and esophagus.A highly complex case of advanced stage lung cancer could be treated in a single fraction of 24 Gy with PT, while SBRT could not deliver the full ablative dose treatment due to an excessive heart dose. The mean heart dose was reduced from 10 Gy to 0.8 Gy with PT for this specific patient.

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Section: Treating Non-small Cell Lung Cancer With Particle Therapymentioning

confidence: 99%

Section: Range Margins and Motion Mitigationmentioning

confidence: 99%

In silico comparison of photons versus carbon ions in single fraction therapy of lung cancer

et al. 2016

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“…In 2011, clinical trials were completed at NIRS using the PBS method, demonstrating improved dose distribution and reinforcing the results of international centers (4,5). Initial usage was limited to static sites, as development to compensate for respiratory motion and consequential interplay effects continued (6,7).…”

Section: Introductionmentioning

confidence: 99%

Respiration-gated fast-rescanning carbon-ion radiotherapy

Ebner

Tsuji

Yasuda

et al. 2016

Jpn. J. Clin. Oncol.

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Phase-controlled rescanning of the carbon-ion beam offers fast and precise dose application with decreased irradiation of normal tissue. However, organ movement with respiration remains a unique challenge. Technological development has enabled the simultaneous application of beamenergy-modulated markerless phase-controlled rescanning with respiration gating, allowing scanning treatment of respiration-mobile tumors with carbon. A total of 10 patients with tumors in the liver or lung were treated in a feasibility study at our facility using this combination. At a median of 10.5 months, follow-up examination including computed tomography/magnetic resonance imaging revealed no grade 2+ acute adverse effects with this new therapy. Two patients with complex disease experienced local recurrence, which may be improved with increased dose delivery. One patient died of unrelated causes. All other patients are alive with good control at the time of writing. Though long-term observation is pending, these are promising initial results for use of the carbon-beam phase-controlled rescanning method in respiration-mobile disease.

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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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Systematic evaluation of four‐dimensional hybrid depth scanning for carbon‐ion lung therapy

Cited by 43 publications

References 56 publications

In silico comparison of photons versus carbon ions in single fraction therapy of lung cancer

In silico comparison of photons versus carbon ions in single fraction therapy of lung cancer

Respiration-gated fast-rescanning carbon-ion radiotherapy

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

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