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Title: SU-F-T-185: Study of the Robustness of a Proton Arc Technique Based On PBS Beams

Abstract

Purpose: One potential technique to realize proton arc is through using PBS beams from many directions to form overlaid Bragg peak (OBP) spots and placing these OBP spots throughout the target volume to achieve desired dose distribution. In this study, we analyzed the robustness of this proton arc technique. Methods: We used a cylindrical water phantom of 20 cm in radius in our robustness analysis. To study the range uncertainty effect, we changed the density of the phantom by ±3%. To study the setup uncertainty effect, we shifted the phantom by 3 & 5 mm. We also combined the range and setup uncertainties (3mm/±3%). For each test plan, we performed dose calculation for the nominal and 6 disturbed scenarios. Two test plans were used, one with single OBP spot and the other consisting of 121 OBP spots covering a 10×10cm{sup 2} area. We compared the dose profiles between the nominal and disturbed scenarios to estimate the impact of the uncertainties. Dose calculation was performed with Gate/GEANT based Monte Carlo software in cloud computing environment. Results: For each of the 7 scenarios, we simulated 100k & 10M events for plans consisting of single OBP spot and 121 OBP spots respectively. Formore » single OBP spot, the setup uncertainty had minimum impact on the spot’s dose profile while range uncertainty had significant impact on the dose profile. For plan consisting of 121 OBP spots, similar effect was observed but the extent of disturbance was much less compared to single OBP spot. Conclusion: For PBS arc technique, range uncertainty has significantly more impact than setup uncertainty. Although single OBP spot can be severely disturbed by the range uncertainty, the overall effect is much less when a large number of OBP spots are used. Robustness optimization for PBS arc technique should consider range uncertainty with priority.« less

Authors:
 [1];  [2]
  1. Reading Hospital, West Reading, PA (United States)
  2. Procure Proton Therapy Center, Oklahoma City, OK (United States)
Publication Date:
OSTI Identifier:
22648802
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; BEAMS; COMPUTER CODES; MONTE CARLO METHOD; PHANTOMS; RADIATION DOSE DISTRIBUTIONS

Citation Formats

Wang, Z, and Zheng, Y. SU-F-T-185: Study of the Robustness of a Proton Arc Technique Based On PBS Beams. United States: N. p., 2016. Web. doi:10.1118/1.4956322.
Wang, Z, & Zheng, Y. SU-F-T-185: Study of the Robustness of a Proton Arc Technique Based On PBS Beams. United States. doi:10.1118/1.4956322.
Wang, Z, and Zheng, Y. 2016. "SU-F-T-185: Study of the Robustness of a Proton Arc Technique Based On PBS Beams". United States. doi:10.1118/1.4956322.
@article{osti_22648802,
title = {SU-F-T-185: Study of the Robustness of a Proton Arc Technique Based On PBS Beams},
author = {Wang, Z and Zheng, Y},
abstractNote = {Purpose: One potential technique to realize proton arc is through using PBS beams from many directions to form overlaid Bragg peak (OBP) spots and placing these OBP spots throughout the target volume to achieve desired dose distribution. In this study, we analyzed the robustness of this proton arc technique. Methods: We used a cylindrical water phantom of 20 cm in radius in our robustness analysis. To study the range uncertainty effect, we changed the density of the phantom by ±3%. To study the setup uncertainty effect, we shifted the phantom by 3 & 5 mm. We also combined the range and setup uncertainties (3mm/±3%). For each test plan, we performed dose calculation for the nominal and 6 disturbed scenarios. Two test plans were used, one with single OBP spot and the other consisting of 121 OBP spots covering a 10×10cm{sup 2} area. We compared the dose profiles between the nominal and disturbed scenarios to estimate the impact of the uncertainties. Dose calculation was performed with Gate/GEANT based Monte Carlo software in cloud computing environment. Results: For each of the 7 scenarios, we simulated 100k & 10M events for plans consisting of single OBP spot and 121 OBP spots respectively. For single OBP spot, the setup uncertainty had minimum impact on the spot’s dose profile while range uncertainty had significant impact on the dose profile. For plan consisting of 121 OBP spots, similar effect was observed but the extent of disturbance was much less compared to single OBP spot. Conclusion: For PBS arc technique, range uncertainty has significantly more impact than setup uncertainty. Although single OBP spot can be severely disturbed by the range uncertainty, the overall effect is much less when a large number of OBP spots are used. Robustness optimization for PBS arc technique should consider range uncertainty with priority.},
doi = {10.1118/1.4956322},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: Plan robustness of the passive-scattering proton therapy treatment of lung tumors has been studied previously using combined uncertainties of 3.5% in CT number and 3 mm geometric shifts. In this study, we investigate whether this method is sufficient to predict proton plan robustness by comparing to plans performed on weekly verification CT scans. Methods: Ten lung cancer patients treated with passive-scattering proton therapy were randomly selected. All plans were prescribed 6660cGy in 37 fractions. Each initial plan was calculated using +/− 3.5% range and +/− 0.3cm setup uncertainty in x, y and z directions in Eclipse TPS(Method-A). Throughout themore » treatment course, patients received weekly verification CT scans to assess the daily treatment variation(Method-B). After contours and imaging registrations are verified by the physician, the initial plan with the same beamline and compensator was mapped into the verification CT. Dose volume histograms (DVH) were evaluated for robustness study. Results: Differences are observed between method A and B in terms of iCTV coverage and lung dose. Method-A shows all the iCTV D95 are within +/− 1% difference, while 20% of cases fall outside +/−1% range in Method-B. In the worst case scenario(WCS), the iCTV D95 is reduced by 2.5%. All lung V5 and V20 are within +/−5% in Method-A while 15% of V5 and 10% of V20 fall outside of +/−5% in Method-B. In the WCS, Lung V5 increased by 15% and V20 increased by 9%. Method A and B show good agreement with regard to cord maximum and Esophagus mean dose. Conclusion: This study suggests that using range and setup uncertainty calculation (+/−3.5% and +/−3mm) may not be sufficient to predict the WCS. In the absence of regular verification scans, expanding the conventional uncertainty parameters(e.g., to +/−3.5% and +/−4mm) may be needed to better reflect plan actual robustness.« less
  • Purpose: To investigate the robustness and safety of craniospinal irradiation (CSI) planned with a proton pencil beam scanning (PBS) technique which overcomes the complexity of the planning associated with feathering match lines. Methods: Six CSI patients were planned with gradient-dose matching using PBS technique. Uniform dose coverage to the entire target volumes was achieved with averaged junction lengths of 6.9±0.3 cm. Robustness of the plans was evaluated by shifting the isocenter of each treatment field by ±3 mm in longitudinal direction and compared with the original non-shifted plan with metrics of conformity number (CN) and homogeneity index (HI). An anthropomorphicmore » phantom study using film measurements was also carried out on a plan with 5 cm junction length. Results: For a given junction length, the dose errors were directly proportional to the setup errors. Setup errors of 3 mm from each field caused on average 3.5% lower CN and 2.1% higher HI. Minimal D95% to PTV and D98% to CTV were reduced by 2.2%±1.5% and 2.8%±1.7% respectively. A drop of maximal 6.8%±5.5% on the minimal dose to the cribriform plate was also observed. When the junction length was 5cm or longer, these 3mm setup errors from each field resulted in up to 12% dose errors. Consistent results were reached between film measurements and planned dose profiles in the junction area. Due to near-zero exit doses beyond the target volume, sparing of anterior organs such as heart, liver, lung and kidney were observed. Conclusions: Longitudinal setup errors directly reduce the dosimetric accuracy of the CSI treatment with matched proton fields. The reported technique creates a slow dose gradient in the junction area, which makes the treatment more robust and safe to longitudinal setup errors compared to conventional feathering methods.« less
  • Purpose: To investigate the robustness of the proton treatment plans in the presence of rotational setup error when patient is aligned with implanted fiducials. Methods: Five Stage I invasive breast cancer patients treated with the APBP protocol (PCG BRE007-12) were studied. The rotational setup errors were simulated by rotating the original CT images around the body center clockwise and counterclockwise 5 degrees (5CW and 5CCW). Manual translational registration was then performed to match the implanted fiducials on the rotated images to the original dataset. Patient contours were copied to the newly created CT set. The original treatment plan was appliedmore » to the new CT dataset with the beam isocenter placed at the geometrical center of PTV. The dose distribution was recalculated for dosimetric parameters comparison. Results: CTV and PTV (D95 and V95) coverages were not significantly different between the two simulated plans (5CW and 5CCW) and the original plan. PTV D95 and CTV D95 absolute difference among the three plans were relatively small, with maximum changes of 0.28 CGE and 0.15 CGE, respectively. PTV V95 and CTV V95 absolute differences were 0.79% and 0.48%. The dosage to the thyroid, heart, contralateral breast and lung remained zero for all three plans. The Dmax and Dmean to the volume of ipsilateral breast excluding CTV were compared, with maximum difference values of 1.02 CGE for Dmax and 3.56 CGE for Dmean. Ipsilateral lung Dmean maintained no significant changes through the three plan comparison, with the largest value 0.32 CGE. Ipsilateral lung Dmax was the most sensitive parameter to this simulation study, with a maximum difference at 20.2 CGE. Conclusion: Our study suggests that fiducial-based Accelerated Partial Breast Proton Therapy is robust with respect to +/− 5 degree patient setup rotational errors, as long as the internal fiducial markers are used for patient alignment.« less
  • Purpose: Different particle scanning beam delivery systems have different delivery accuracies. This study was performed to determine, for our particle treatment system, an appropriate composition (n=FWHM/GS) of spot size(FWHM) and grid size (GS), which can provide homogenous delivered dose distributions for both proton and heavy ion scanning beam radiotherapy. Methods: We analyzed the delivery errors of our beam delivery system using log files from the treatment of 28 patients. We used a homemade program to simulate square fields for different n values with and without considering the delivery errors and analyzed the homogeneity. All spots were located on a rectilinearmore » grid with equal spacing in the × and y directions. After that, we selected 7 energy levels for both proton and carbon ions. For each energy level, we made 6 square field plans with different n values (1, 1.5, 2, 2.5, 3, 3.5). Then we delivered those plans and used films to measure the homogeneity of each field. Results: For program simulation without delivery errors, when n≥1.1 the homogeneity can be within ±3%. For both proton and carbon program simulations with delivery errors and film measurements, the homogeneity can be within ±3% when n≥2.5. Conclusion: For our facility with system errors, the n≥2.5 is appropriate for maintaining homogeneity within ±3%.« less
  • As critical dimensions shrink, line edge and width roughness (LER and LWR) become of increasing concern. Crucial to the goal of reducing LER is its accurate characterization. LER has traditionally been represented as a single rms value. More recently the use of power spectral density (PSD), height-height correlation (HHCF), and {sigma} versus length plots has been proposed in order to extract the additional spatial descriptors of correlation length and roughness exponent. Here we perform a modeling-based noise-sensitivity study on the extraction of spatial descriptors from line-edge data as well as an experimental study of the robustness of these various descriptorsmore » using a large dataset of recent extreme-ultraviolet exposure data. The results show that in the presence of noise and in the large dataset limit, the PSD method provides higher accuracy in the extraction of the roughness exponent, whereas the HHCF method provides higher accuracy for the correlation length. On the other hand, when considering precision, the HHCF method is superior for both metrics.« less