Tumor-tracking radiotherapy of moving targets; verification using 3D polymer gel, 2D ion-chamber array and biplanar diode array

Ceberg, Sofie; Falk, Marianne; Rosenschöld, Per Munck af; Cattell, H.; Gustafsson, H.; Keall, Paul J.; Korreman, S.; Medin, Joakim; Nordström, Fredrik; Persson, Gitte Fredberg; Sawant, Amit; Svatos, M; Zimmerman, Jens; Bäck, Sven

doi:10.1088/1742-6596/250/1/012051

Cited by 9 publications

(10 citation statements)

References 10 publications

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“…Real‐time dynamic multi leaf collimator (DMLC) tumor‐tracking radiation delivery uses the DMLC to continuously align and reshape the treatment machine apertures to follow the target motion in real time. This allows for tighter margins to be applied and for adapting the dose delivery to the target motion . Keall et al have used real‐time 3D DMLC tumor tracking with Volumetric Modulated Arc Therapy (VMAT) .…”

Section: Methods Of Addressing Motionmentioning

confidence: 99%

“…This allows for tighter margins to be applied and for adapting the dose delivery to the target motion. 98 Keall et al have used real-time 3D DMLC tumor tracking with Volumetric Modulated Arc Therapy (VMAT). 99,100 The tumor position was measured electromagnetically, and new leaf positions were created to conform to the shape and location of the moving target at each instant.…”

Section: E Tumor Trackingmentioning

confidence: 99%

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Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: A review from NRG oncology

et al. 2017

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The efficacy of stereotactic body radiotherapy (SBRT) has been well demonstrated. However, it presents unique challenges for accurate planning and delivery especially in the lungs and upper abdomen where respiratory motion can be significantly confounding accurate targeting and avoidance of normal tissues. In this paper we review the current literature on SBRT for lung and upper abdominal tumors with particular emphasis on addressing respiratory motion and its affects. We provide recommendations on strategies to manage motion for different, patient specific situations. Some of the recommendations will potentially be adopted to guide clinical trial protocols.

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Section: Methods Of Addressing Motionmentioning

confidence: 99%

Section: E Tumor Trackingmentioning

confidence: 99%

Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: A review from NRG oncology

et al. 2017

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“…Also, special care should be taken before using VMAT treatment for patients experiencing target motions with large amplitude and long period time. Other methods presented in the literature shown to mitigate interplay effects are the use of respiratory gating in combination with VMAT (Nicolini et al 2010, Qian et al 2011, Riley et al 2014, Viel et al 2015, tracking (Ceberg et al 2010, Keall et al 2014, and the use of conformal arcs (Dickey et al 2015).…”

Section: Mitigation Of Interplay Effectsmentioning

confidence: 99%

“…However, increased margins are not sufficient to adequately account for the interplay effects. Different approaches to quantify interplay effects for IMRT and VMAT have been proposed, including statistical analysis (Bortfeld et al 2002), simulations (Court et al 2008, Poulsen et al 2012, and measurements (Jiang et al 2003, Duan et al 2006, Court et al 2008, 2010, Ong et al 2011, Rao et al 2012, Ceberg et al 2013. Using these different methods, it has been shown that extensive interplay effects may occur and that the extent depends on patient-and machine specific parameters, such as breathing pattern (Court et al 2008, 2010, Ong et al 2011, dose level (Rao et al 2012), dose rate (Jiang et al 2003, Court et al 2008, Ong et al 2013, collimator angle (Court et al 2008), and the complexity of the treatment plan (Court et al 2010, Ong et al 2011.…”

mentioning

confidence: 99%

Motion induced interplay effects for VMAT radiotherapy

et al. 2018

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The purpose of this study was to develop a method to simulate breathing motion induced interplay effects for volumetric modulated arc therapy (VMAT), to verify the proposed method with measurements, and to use the method to investigate how interplay effects vary with different patient- and machine specific parameters. VMAT treatment plans were created on a virtual phantom in a treatment planning system (TPS). Interplay effects were simulated by dividing each plan into smaller sub-arcs using an in-house developed software and shifting the isocenter for each sub-arc to simulate a sin breathing motion in the superior-inferior direction. The simulations were performed for both flattening-filter (FF) and flattening-filter free (FFF) plans and for different breathing amplitudes, period times, initial breathing phases, dose levels, plan complexities, CTV sizes, and collimator angles. The resulting sub-arcs were calculated in the TPS, generating a dose distribution including the effects of motion. The interplay effects were separated from dose blurring and the relative dose differences to 2% and 98% of the CTV volume (ΔD and ΔD) were calculated. To verify the simulation method, measurements were carried out, both static and during motion, using a quasi-3D phantom and a motion platform. The results of the verification measurements during motion were comparable to the results of the static measurements. Considerable interplay effects were observed for individual fractions, with the minimum ΔD and maximum ΔD being -16.7% and 16.2%, respectively. The extent of interplay effects was larger for FFF compared to FF and generally increased for higher breathing amplitudes, larger period times, lower dose levels, and more complex treatment plans. Also, the interplay effects varied considerably with the initial breathing phase, and larger variations were observed for smaller CTV sizes. In conclusion, a method to simulate motion induced interplay effects was developed and verified with measurements, which allowed for a large number of treatment scenarios to be investigated. The simulations showed large interplay effects for individual fractions and that the extent of interplay effects varied with the breathing pattern, FFF/FF, dose level, CTV size, collimator angle, and the complexity of the treatment plan.

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“…The dosimetric accuracy of these techniques has been investigated extensively through dynamic phantoms measurements, often using detector arrays mounted on a motion stage to apply intrafraction translations [23][24][25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Dosimetric impact of intrafraction prostate rotation and accuracy of gating, multi-leaf collimator tracking and couch tracking to manage rotation: An end-to-end validation using volumetric film measurements

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Hansen

Crijns

et al. 2021

Radiotherapy and Oncology

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Tumor-tracking radiotherapy of moving targets; verification using 3D polymer gel, 2D ion-chamber array and biplanar diode array

Cited by 9 publications

References 10 publications

Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: A review from NRG oncology

Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: A review from NRG oncology

Motion induced interplay effects for VMAT radiotherapy

Dosimetric impact of intrafraction prostate rotation and accuracy of gating, multi-leaf collimator tracking and couch tracking to manage rotation: An end-to-end validation using volumetric film measurements

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