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Title: WE-E-BRF-01: The ESTRO-AAPM Joint Symposium On Imaging for Proton Treatment Planning and Guidance

Abstract

In this first inaugural joint ESTRO-AAPM session we will attempt to provide some answers to the problems encountered in the clinical application of particle therapy. Indeed the main advantage is that the physical properties of ion beams offer high ballistic accuracy for tightly conformal irradiation of the tumour volume, with excellent sparing of surrounding healthy tissue and critical organs, This also its Achilles' heel calling for an increasing role of imaging to ensure safe application of the intended dose to the targeted area during the entire course of fractionated therapy. We have three distinguished speakers addressing possible solutions. Katia Parodi (Ludwig Maximilians University, Munich, Germany) To date, Positron Emission Tomography (PET) is the only technique which has been already clinically investigated for in-vivo visualization of the beam range during or shortly after ion beam delivery. The method exploits the transient amount of β{sup 2}-activity induced in nuclear interactions between the primary beam and the irradiated tissue, depending on the ion beam species, the tissue elemental composition and physiological properties (in terms of biological clearance), as well as the time course of irradiation and imaging. This contribution will review initial results, ongoing methodological developments and remaining challenges related to the clinicalmore » usage of viable but often suboptimal instrumentation and workflows of PET-based treatment verification. Moreover, it will present and discuss promising new detector developments towards next-generation dedicated PET scanners relying on full-ring or dual-head designs for in-beam quasi real-time imaging. Denis Dauvergne (Institut de Physique Nucleaire de Lyon, Lyon, France) Prompt gamma radiation monitoring of hadron therapy presents the advantage of real time capability to measure the ion range. Both simulations and experiments show that millimetric verification of the range can be achieved at the pencil beam scale for active proton beam delivery in homogenous targets. The development of gamma cameras, that has been studied by several groups worldwide over the last years, now reaches - for some of them - the stage of being applicable in clinical conditions, with real size prototypes and count rate capability matching the therapeutic beam intensities. We will review the different concepts of gamma cameras, the advantages and limitations of this method, and the main challenges that should still be overcome before the widespread of prompt gamma quality assurance for proton and hadrontherapy. Jon Kruse (Mayo Clinic, Rochester, MN, USA) Treatment simulation images for proton therapy are used to determine proton stopping power and range in the patient. This talk will discuss the careful control of CT numbers and conversion of CT number to stopping power required in proton therapy. Imaging for treatment guidance of proton therapy also presents unique challenges which will be addressed. Among them are the enhanced relationship between internal anatomy changes and dosimetry, the need for imaging to support adaptive planning protocols, and high operational efficiency. Learning Objectives: To learn about the possibilities of using activation products to determine the range of particle beams in a patient treatment setting To be informed on an alternative methodology using prompt gamma detectors To understand the impact of the accuracy of the knowledge of the patient information with respect to the delivered treatment.« less

Authors:
 [1];  [2];  [3]
  1. Ludwig-Maximilians-University Munich, Garching, Bavaria (Germany)
  2. Institut de Physique Nucleaire de Lyon, Lyon (France)
  3. Mayo Clinic, Rochester, MN (United States)
Publication Date:
OSTI Identifier:
22409716
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
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; 60 APPLIED LIFE SCIENCES; ACCURACY; ANATOMY; CRITICAL ORGANS; GAMMA CAMERAS; PATIENTS; PLANNING; POSITRON COMPUTED TOMOGRAPHY; PROMPT GAMMA RADIATION; PROTON BEAMS; RADIOTHERAPY; STOPPING POWER

Citation Formats

Parodi, K, Dauvergne, D, and Kruse, J. WE-E-BRF-01: The ESTRO-AAPM Joint Symposium On Imaging for Proton Treatment Planning and Guidance. United States: N. p., 2014. Web. doi:10.1118/1.4889442.
Parodi, K, Dauvergne, D, & Kruse, J. WE-E-BRF-01: The ESTRO-AAPM Joint Symposium On Imaging for Proton Treatment Planning and Guidance. United States. doi:10.1118/1.4889442.
Parodi, K, Dauvergne, D, and Kruse, J. Sun . "WE-E-BRF-01: The ESTRO-AAPM Joint Symposium On Imaging for Proton Treatment Planning and Guidance". United States. doi:10.1118/1.4889442.
@article{osti_22409716,
title = {WE-E-BRF-01: The ESTRO-AAPM Joint Symposium On Imaging for Proton Treatment Planning and Guidance},
author = {Parodi, K and Dauvergne, D and Kruse, J},
abstractNote = {In this first inaugural joint ESTRO-AAPM session we will attempt to provide some answers to the problems encountered in the clinical application of particle therapy. Indeed the main advantage is that the physical properties of ion beams offer high ballistic accuracy for tightly conformal irradiation of the tumour volume, with excellent sparing of surrounding healthy tissue and critical organs, This also its Achilles' heel calling for an increasing role of imaging to ensure safe application of the intended dose to the targeted area during the entire course of fractionated therapy. We have three distinguished speakers addressing possible solutions. Katia Parodi (Ludwig Maximilians University, Munich, Germany) To date, Positron Emission Tomography (PET) is the only technique which has been already clinically investigated for in-vivo visualization of the beam range during or shortly after ion beam delivery. The method exploits the transient amount of β{sup 2}-activity induced in nuclear interactions between the primary beam and the irradiated tissue, depending on the ion beam species, the tissue elemental composition and physiological properties (in terms of biological clearance), as well as the time course of irradiation and imaging. This contribution will review initial results, ongoing methodological developments and remaining challenges related to the clinical usage of viable but often suboptimal instrumentation and workflows of PET-based treatment verification. Moreover, it will present and discuss promising new detector developments towards next-generation dedicated PET scanners relying on full-ring or dual-head designs for in-beam quasi real-time imaging. Denis Dauvergne (Institut de Physique Nucleaire de Lyon, Lyon, France) Prompt gamma radiation monitoring of hadron therapy presents the advantage of real time capability to measure the ion range. Both simulations and experiments show that millimetric verification of the range can be achieved at the pencil beam scale for active proton beam delivery in homogenous targets. The development of gamma cameras, that has been studied by several groups worldwide over the last years, now reaches - for some of them - the stage of being applicable in clinical conditions, with real size prototypes and count rate capability matching the therapeutic beam intensities. We will review the different concepts of gamma cameras, the advantages and limitations of this method, and the main challenges that should still be overcome before the widespread of prompt gamma quality assurance for proton and hadrontherapy. Jon Kruse (Mayo Clinic, Rochester, MN, USA) Treatment simulation images for proton therapy are used to determine proton stopping power and range in the patient. This talk will discuss the careful control of CT numbers and conversion of CT number to stopping power required in proton therapy. Imaging for treatment guidance of proton therapy also presents unique challenges which will be addressed. Among them are the enhanced relationship between internal anatomy changes and dosimetry, the need for imaging to support adaptive planning protocols, and high operational efficiency. Learning Objectives: To learn about the possibilities of using activation products to determine the range of particle beams in a patient treatment setting To be informed on an alternative methodology using prompt gamma detectors To understand the impact of the accuracy of the knowledge of the patient information with respect to the delivered treatment.},
doi = {10.1118/1.4889442},
journal = {Medical Physics},
number = 6,
volume = 41,
place = {United States},
year = {Sun Jun 15 00:00:00 EDT 2014},
month = {Sun Jun 15 00:00:00 EDT 2014}
}
  • Experimental research in medical physics has expanded the limits of our knowledge and provided novel imaging and therapy technologies for patients around the world. However, experimental efforts are challenging due to constraints in funding, space, time and other forms of institutional support. In this joint ESTRO-AAPM symposium, four exciting experimental projects from four different countries are highlighted. Each project is focused on a different aspect of radiation therapy. From the USA, we will hear about a new linear accelerator concept for more compact and efficient therapy devices. From Canada, we will learn about novel linear accelerator target design and themore » implications for imaging and therapy. From France, we will discover a mature translational effort to incorporate theranostic nanoparticles in MR-guided radiation therapy. From Germany, we will find out about a novel in-treatment imaging modality for particle therapy. These examples of high impact, experimental medical physics research are representative of the diversity of such efforts that are on-going around the globe. J. Robar, Research is supported through collaboration with Varian Medical Systems and Brainlab AGD. Westerly, This work is supported by the Department of Radiation Oncology at the University of Colorado School of Medicine. COI: NONEK. Parodi, Part of the presented work is supported by the DFG (German Research Foundation) Cluster of Excellence MAP (Munich-Centre for Advanced Photonics) and has been carried out in collaboration with IBA.« less
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  • The United States' healthcare delivery model is undergoing significant change. Insurance and reimbursement models are rapidly evolving, federal allocations are shifting from specialty services to preventive and generalpractice services, and Accountable Care Organizations are gaining in prominence. One area of focus is on the perceived over-utilization of expensive services such as advanced imaging and, in some cases, radiation therapy. Reimbursement incentives are increasingly aimed at quality metrics, leading to an increased interest in the core concepts of High Reliability Organizations. With the shift in federal resources away from specialty services and the increasing prominence of Accountable Care Organizations, we willmore » likely be challenged to re-assess our traditional model for delivering medical physics services. Medical physicists have a unique combination of education and training in physics principles, radiation physics applications in medicine, human anatomy, as well as safety analysis and quality control methods. An effective medical physicist recognizes that to advance the institution's mission, the medical physicist must join other professional leaders within the institution to provide clear direction and perspective for the entire team. To do that, we must first recognize the macro changes in our healthcare delivery system and candidly assess how the medical physics practice model can evolve in a prudent way to support the institution's objectives while maintaining the traditionally high level of quality and safety. This year's Professional Council Symposium will explore the many facets of the changing healthcare system and its potential impact on medical physics. Dr. Shine will provide an overview of the developing healthcare delivery and reimbursement models, with a focus on how the physician community has adapted to the changing objectives. Mr. White will describe recent changes in the reimbursement patterns for both imaging and radiation therapy services, the underlying imperatives that will influence additional changes in the near-term future, and the broader changes in the medical physics workforce that may arise due to many (often conflicting) directives and incentives both internal and external to the profession. Maintaining the integrity of the medical physics profession and the high quality of medical physics services will require a shared understanding of the changing practice environment and a firm commitment to protecting the key priorities of clinical medical physics as the healthcare system transitions to a new and very different model. To be effective as medical physicists, we must learn how to provide leadership in our respective institutions. Learning Objectives: Understand the macro changes occurring in the US healthcare delivery system. Understand the likely near-term, and possible longer-term, impact on the medical physics profession. Understand some strategies for providing leadership during this period of significant change.« less
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