Patient Breathing Motion and Delivery Specifics Influencing the Robustness of a Proton Pancreas Irradiation
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Data, Imaging and Treatment Workflow
2.2. 4D Dose Tracking Framework
- Distribute spots over different phases of the 4DCT for each fraction employing
- -
- A treatment record log file;
- -
- A breathing signal;
- -
- A map between breathing amplitude to phase;
- -
- Deformable image registration (DIR) between the different phases of the 4DCT and the planning CT.
- Compute dose on the different phases based on the determined spot distribution.
- Map doses to the reference phase, i.e., planning CT through DIR and accumulate the mapped doses
- Accumulate the 4DDT dose of each fraction to get the full treatment course dose
2.3. Rescanning
2.4. Evaluation and Statistics
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
[Gy(RBE)] | [Gy(RBE)] | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
CTV | PTV | Liver | Kidney | Spinal Cord | |||||||||
Contra | Ipsi | ||||||||||||
Patients | Plans | Static | 4DDT | Static | 4DDT | Static | 4DDT | Static | 4DDT | Static | 4DDT | Static | 4DDT |
pan2 | 1 (s) | 14.6 | 13.8 | 14.5 | 13.6 | 1.2 | 1.3 | 0.1 | 0.1 | 14.0 | 14.1 | 9.28 | 9.3 |
2 (r) | 9.8 | 9.8 | 9.6 | 9.6 | 5.6 | 5.5 | 3.8 | 3.8 | 10.0 | 10.1 | 2.2 | 2.2 | |
pan3 | 1 (s) | 24.8 | 24.6 | 24.4 | 24.3 | 12.4 | 12.2 | 5.8 | 6.2 | 13.8 | 13.2 | 12.2 | 12.2 |
pan4 | 1 (s) | 14.9 | 14.8 | 9.9 | 10.0 | 8.3 | 8.3 | 0.2 | 0.1 | 6.9 | 7.0 | 10.1 | 10.0 |
2 (r) | 9.8 | 9.8 | 8.1 | 8.1 | 0.4 | 0.4 | 2.8 | 2.8 | 6.4 | 6.4 | 6.6 | 6.5 | |
pan6 | 1 (s) | 23.3 | 23.2 | 15.9 | 15.8 | 14.7 | 14.8 | 0.1 | 0.1 | 3.2 | 3.2 | 0.0 | 0.0 |
pan7 | 1 (s) | 14.3 | 14.6 | 8.5 | 8.8 | 0.2 | 0.2 | 8.3 | 8.0 | 15.0 | 15.0 | 11.7 | 11.7 |
2 (r) | 9.3 | 8.78 | 2.3 | 2.6 | 0.5 | 0.4 | 0.9 | 1.4 | 10.2 | 10.0 | 11.5 | 11.9 | |
pan8 | 1 (s) | 25.1 | 25.1 | 24.4 | 24.2 | 29.8 | 30.6 | 22.1 | 21.7 | 24.3 | 23.5 | 13.8 | 13.8 |
pan10 | 1 (s) | 24.9 | 24.8 | 21.6 | 22.7 | 16.1 | 16.1 | 5.6 | 5.7 | 17.8 | 17.6 | 12.1 | 12.3 |
pan11 | 1 (r) | 25.3 | 24.6 | 18.8 | 18.8 | 25.3 | 25.1 | 8.2 | 7.8 | 15.2 | 15.8 | 13.6 | 13.7 |
pan12 | 1 (s) | 9.8 | 9.7 | 9.6 | 9.3 | 5.5 | 5.2 | 4.2 | 4.0 | 8.0 | 8.2 | 5.6 | 5.6 |
2 (r) | 14.7 | 14.7 | 13.9 | 13.9 | 9.8 | 9.7 | 4.2 | 4.1 | 4.9 | 4.9 | 11.1 | 11.1 | |
pan13 | 1 (s) | 15.1 | 15.1 | 13.4 | 13.8 | 21.5 | 21.2 | 3.8 | 3.8 | 21.6 | 21.6 | 5.7 | 5.7 |
2 (r) | 10.0 | 8.6 | 7.7 | 5.0 | 13.4 | 13.5 | 0.4 | 0.4 | 12.5 | 11.3 | 0.0 | 0.0 | |
pan15 | 1 (s) | 24.5 | 24.2 | 19.6 | 20.2 | 24.6 | 24.5 | 6.2 | 6.2 | 14.5 | 14.8 | 10.7 | 11.2 |
pan16 | 2 (s) | 15.0 | 15.0 | 13.8 | 12.9 | 21.8 | 21.4 | 0.0 | 0.0 | 9.8 | 9.0 | 10.8 | 11.2 |
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Patients | Plans | No. of | Dose/ | Breathing Pattern | DR | Rescanning | Simulated |
---|---|---|---|---|---|---|---|
(s/r) | Fractions | Fraction | Extracted | [GNP/s] | Applied | Non-Rescanned | |
(Days) | [Gy(RBE)] | from | (Mean ± Std) | Fractions | |||
pan2 | 1 (s) | 6 (3) | 4.0 | 4DCT | 0.52 ± 0.08 | yes | 3 |
2 (r) | 4 (2) | 4DCT | 0.67 ± 0.06 | yes | 2 | ||
pan3 | 1 (s) | 10 (5) | 3.75 | 4DCT | 0.60 ± 0.04 | yes | 5 |
pan4 | 1 (s) | 6 (3) | 3.75 | 4DCT | 0.54 ± 0.05 | yes | 3 |
2 (r) | 4 (2) | 4DCT | 0.54 ± 0.06 | yes | 2 | ||
pan6 | 1 (s) | 10 (5) | 3.75 | 4DCT | 0.60 ± 0.03 | yes | 5 |
pan7 | 1 (s) | 3 (3) | 7.5 | 4DCT | 0.47 ± 0.02 | no | - |
2 (r) | 4 (2) | 3.75 | 4DCT | 0.46 ± 0.03 | yes | 2 | |
pan8 | 1 (s) | 10 (5) | 4.0 | 4DCT | 0.52 ± 0.02 | yes | 5 |
pan10 | 1 (s) | 5 (5) | 7.5 | 4DCT | 0.51 ± 0.02 | no | - |
pan11 | 1 (r) | 5 (5) | 8.0 | 4DCT | 0.82 ± 0.04 | no | - |
pan12 | 1 (s) | 4 (2) | 3.5 | surface scanner | 0.96 ± 0.10 | yes | - |
2 (r) | 6 (3) | 4DCT | 0.93 ± 0.10 | yes | - | ||
pan13 | 1 (s) | 3 (3) | 7.5 | 4DCT | 0.98 ± 0.03 | no | - |
2 (r) | 4 (2) | 3.75 | surface scanner | 1.15 ± 0.01 | yes | - | |
pan15 | 1 (s) | 5 (5) | 7.5 | surface scanner | 0.80 ± 0.03 | no | - |
pan16 | 1 (r) * | 4 (2) | 4.0 | surface scanner | 0.80 ± 0.05 | yes | - |
2 (s) | 6 (3) | 4.0 | 4DCT | 0.75 ± 0.03 | yes | - |
Patient | Plan | 20% | PTV | Breathing | Breathing |
---|---|---|---|---|---|
(Orientation) | Isodose | Only | Amplitude [mm] | Period [s] | |
pan2 | 1 (s) | 79.9 | 77.4 | 3.3 | 4.3 |
2 (r) | 87.1 | 91.1 | 0.4 | 4.3 | |
pan3 | 1 (s) | 88.7 | 81.4 | 2.6 | 4.0 |
pan4 | 1 (s) | 93.1 | 94.6 | 0.5 | 3.4 |
2 (r) | 98.8 | 98.5 | 0.3 | 3.4 | |
pan6 | 1 (s) | 96.0 | 95.0 | 0.3 | 4.2 |
pan7 | 1 (r) | 93.2 | 95.0 | 0.8 | 4.6 |
2 (s) | 76.0 | 74.0 | 1.7 | 4.5 | |
pan8 | 1 (s) | 95.4 | 96.2 | 1.6 | 3.8 |
pan10 | 1 (s) | 95.3 | 90.8 | 2.3 | 4.4 |
pan11 | 1 (r) | 88.7 | 89.9 | 0.4 | 2.6 |
pan12 | 1 (r) | 75.2 | 74.4 | 0.6 | 4.2 |
2 (s) | 97.6 | 99.6 | 0.7 | 3.4 | |
pan13 | 1 (s) | 88.5 | 93.1 | 1.3 | 3.9 |
2 (r) | 71.6 | 76.8 | 1.5 | 3.9 | |
pan15 | 1 (s) | 91.0 | 93.1 | 0.6 | 4.5 |
pan16 | 2 (s) | 79.8 | 88.1 | 3.7 | 5.3 |
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Knäusl, B.; Lebbink, F.; Fossati, P.; Engwall, E.; Georg, D.; Stock, M. Patient Breathing Motion and Delivery Specifics Influencing the Robustness of a Proton Pancreas Irradiation. Cancers 2023, 15, 2550. https://doi.org/10.3390/cancers15092550
Knäusl B, Lebbink F, Fossati P, Engwall E, Georg D, Stock M. Patient Breathing Motion and Delivery Specifics Influencing the Robustness of a Proton Pancreas Irradiation. Cancers. 2023; 15(9):2550. https://doi.org/10.3390/cancers15092550
Chicago/Turabian StyleKnäusl, Barbara, Franciska Lebbink, Piero Fossati, Erik Engwall, Dietmar Georg, and Markus Stock. 2023. "Patient Breathing Motion and Delivery Specifics Influencing the Robustness of a Proton Pancreas Irradiation" Cancers 15, no. 9: 2550. https://doi.org/10.3390/cancers15092550