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The dosimetric effect of residual breath-hold motion in pencil beam scanned proton therapy – An experimental study

Gorgisyan, Jenny LU ; Lomax, Antony J. ; Rosenschold, Per Munck af LU orcid ; Persson, Gitte F. ; Krieger, Miriam ; Colvill, Emma ; Scherman, Jonas ; Gagnon-Moisan, Francis ; Egloff, Martina and Fattori, Giovanni , et al. (2019) In Radiotherapy and Oncology 134. p.135-142
Abstract

Background and purpose: Motion management in the treatment of lung cancer is necessary to assure highest quality of the delivered radiation therapy. In this study, the breath-hold technique is experimentally investigated for pencil beam scanned (PBS) proton therapy, with respect to the dosimetric effect of residual breath-hold motion. Material and methods: Three-dimensional (3D)-printed tumours extracted from CT scans of three patients were inserted into a dynamic anthropomorphic breathing phantom. The target was set up to move with the individual patient's tumour motion during breath-hold as previously assessed on fluoroscopy. Target dose was measured with radio-chromic film, and both single field uniform dose (SFUD) and... (More)

Background and purpose: Motion management in the treatment of lung cancer is necessary to assure highest quality of the delivered radiation therapy. In this study, the breath-hold technique is experimentally investigated for pencil beam scanned (PBS) proton therapy, with respect to the dosimetric effect of residual breath-hold motion. Material and methods: Three-dimensional (3D)-printed tumours extracted from CT scans of three patients were inserted into a dynamic anthropomorphic breathing phantom. The target was set up to move with the individual patient's tumour motion during breath-hold as previously assessed on fluoroscopy. Target dose was measured with radio-chromic film, and both single field uniform dose (SFUD) and intensity-modulated proton therapy (IMPT) plans were delivered. Experiments were repeated for each patient without any motion, to compute the relative dose deviation between static and breath-hold cases. Results: SFUD plans showed small dose deviations between static and breath-hold cases, as evidenced by the gamma pass rate (3%, 3 mm) of 85% or higher. Dose deviation was more evident for IMPT plans, with gamma pass rate reduced to 50–70%. Conclusions: The breath-hold technique is robust to residual intra-breath-hold motion for SFUD treatment plans, based on our experimental study. IMPT was less robust with larger detected dose deviations.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
4D phantom, Breath-hold, Lung tumours, PBS proton therapy
in
Radiotherapy and Oncology
volume
134
pages
135 - 142
publisher
Elsevier
external identifiers
  • pmid:31005207
  • scopus:85061425719
ISSN
0167-8140
DOI
10.1016/j.radonc.2019.01.033
language
English
LU publication?
no
additional info
Funding Information: The authors would like to thank the Danish Society for Clinical Oncology ( DSKO ) for funding. The authors would further like to thank Viktor Eggspuehler for the 3D printing. Publisher Copyright: © 2019 Elsevier B.V.
id
96d24523-c2a1-4d7b-baf9-b21a4d5221bb
date added to LUP
2023-07-07 08:05:05
date last changed
2024-02-19 21:15:14
@article{96d24523-c2a1-4d7b-baf9-b21a4d5221bb,
  abstract     = {{<p>Background and purpose: Motion management in the treatment of lung cancer is necessary to assure highest quality of the delivered radiation therapy. In this study, the breath-hold technique is experimentally investigated for pencil beam scanned (PBS) proton therapy, with respect to the dosimetric effect of residual breath-hold motion. Material and methods: Three-dimensional (3D)-printed tumours extracted from CT scans of three patients were inserted into a dynamic anthropomorphic breathing phantom. The target was set up to move with the individual patient's tumour motion during breath-hold as previously assessed on fluoroscopy. Target dose was measured with radio-chromic film, and both single field uniform dose (SFUD) and intensity-modulated proton therapy (IMPT) plans were delivered. Experiments were repeated for each patient without any motion, to compute the relative dose deviation between static and breath-hold cases. Results: SFUD plans showed small dose deviations between static and breath-hold cases, as evidenced by the gamma pass rate (3%, 3 mm) of 85% or higher. Dose deviation was more evident for IMPT plans, with gamma pass rate reduced to 50–70%. Conclusions: The breath-hold technique is robust to residual intra-breath-hold motion for SFUD treatment plans, based on our experimental study. IMPT was less robust with larger detected dose deviations.</p>}},
  author       = {{Gorgisyan, Jenny and Lomax, Antony J. and Rosenschold, Per Munck af and Persson, Gitte F. and Krieger, Miriam and Colvill, Emma and Scherman, Jonas and Gagnon-Moisan, Francis and Egloff, Martina and Fattori, Giovanni and Engelholm, Svend Aage and Weber, Damien C. and Perrin, Rosalind}},
  issn         = {{0167-8140}},
  keywords     = {{4D phantom; Breath-hold; Lung tumours; PBS proton therapy}},
  language     = {{eng}},
  month        = {{02}},
  pages        = {{135--142}},
  publisher    = {{Elsevier}},
  series       = {{Radiotherapy and Oncology}},
  title        = {{The dosimetric effect of residual breath-hold motion in pencil beam scanned proton therapy – An experimental study}},
  url          = {{http://dx.doi.org/10.1016/j.radonc.2019.01.033}},
  doi          = {{10.1016/j.radonc.2019.01.033}},
  volume       = {{134}},
  year         = {{2019}},
}