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Title: SU-E-T-552: Minimum Monitor Unit Effects On Plan Quality for Multi-Field Optimized Spot Scanning Proton Therapy

Purpose: To investigate the influence of the minimum monitor unit (MU) on the quality of clinical treatment plans for scanned proton therapy. Methods: Delivery system characteristics limit the minimum number of protons that can be delivered per spot, resulting in a min-MU limit. Plan quality can be impacted by the min-MU limit. Two sites were used to investigate the impact of min-MU on treatment plans: pediatric brain tumor at a depth of 5-10 cm; a head and neck tumor at a depth of 1-20 cm. Three field intensity modulated spot scanning proton plans were created for each site with the following parameter variations: min-MU limit range of 0.0000-0.0060; and spot spacing range of 0.5-2.0σ of the nominal spot size at isocenter in water (σ=4mm in this work). Comparisons were based on target homogeneity and normal tissue sparing. Results: The increase of the min-MU with a fixed spot spacing decreases plan quality both in homogeneous target coverage and in the avoidance of critical structures. Both head and neck and pediatric brain plans show a 20% increase in relative dose for the hot spot in the CTV and 10% increase in key critical structures when comparing min-MU limits of 0.0000 and 0.0060more » with a fixed spot spacing of 1σ. The DVHs of CTVs show min-MU limits of 0.0000 and 0.0010 produce similar plan quality and quality decreases as the min-MU limit increases beyond 0.0020. As spot spacing approaches 2σ, degradation in plan quality is observed when no min-MU limit is imposed. Conclusion: Given a fixed spot spacing of ≤ 1σ of the spot size in water, plan quality decreases as min- MU increases greater than 0.0020. The effect of min-MU should be taken into consideration while planning spot scanning proton therapy treatments to realize its full potential.« less
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  1. Mayo Clinic, Rochester, MN (United States)
Publication Date:
OSTI Identifier:
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 41; Journal Issue: 6; Other Information: (c) 2014 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States