Feasibility and robustness of dose painting by numbers in proton therapy with contour-driven plan optimization.
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| Title: | Feasibility and robustness of dose painting by numbers in proton therapy with contour-driven plan optimization. |
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| Authors: | Barragán, A. M.1, Differding, S.1, Janssens, G.2, Lee, J. A.1, Sterpin, E.1 |
| Source: | Medical Physics. Apr2015, Vol. 42 Issue 4, p2006-2017. 12p. |
| Subjects: | Proton therapy, Radiation doses, Drug prescribing, Radiotherapy treatment planning, Process optimization |
| Abstract: | Purpose: To prove the ability of protons to reproduce a dose gradient that matches a dose painting by numbers (DPBN) prescription in the presence of setup and range errors, by using contours and structure-based optimization in a commercial treatment planning system. Methods: For two patients with head and neck cancer, voxel-by-voxel prescription to the target volume (GTVPET) was calculated from 18FDG-PET images and approximated with several discrete prescription subcontours. Treatments were planned with proton pencil beam scanning. In order to determine the optimal plan parameters to approach the DPBN prescription, the effects of the scanning pattern, number of fields, number of subcontours, and use of range shifter were separately tested on each patient. Different constant scanning grids (i.e., spot spacing = Δx = Δy = 3.5, 4, and 5 mm) and uniform energy layer separation [4 and 5 mm WED (water equivalent distance)] were analyzed versus a dynamic and automatic selection of the spots grid. The number of subcontours was increased from 3 to 11 while the number of beams was set to 3, 5, or 7. Conventional PTV-based and robust clinical target volumes (CTV)-based optimization strategies were considered and their robustness against range and setup errors assessed. Because of the nonuniform prescription, ensuring robustness for coverage of GTVPET inevitably leads to overdosing, which was compared for both optimization schemes. Results: The optimal number of subcontours ranged from 5 to 7 for both patients. All considered scanning grids achieved accurate dose painting (1% average difference between the prescribed and planned doses). PTV-based plans led to nonrobust target coverage while robust-optimized plans improved it considerably (differences between worst-case CTV dose and the clinical constraint was up to 3 Gy for PTV-based plans and did not exceed 1 Gy for robust CTV-based plans). Also, only 15% of the points in the GTV PET (worst case) were above 5% of DPBN prescription for robust-optimized plans, while they were more than 50% for PTV plans. Low dose to organs at risk (OARs) could be achieved for both PTV and robust-optimized plans. Conclusions: DPBN in proton therapy is feasible with the use of a sufficient number subcontours, automatically generated scanning patterns, and no more than three beams are needed. Robust optimization ensured the required target coverage and minimal overdosing, while PTV-approach led to nonrobust plans with excessive overdose. Low dose to OARs can be achieved even in the presence of a high-dose escalation as in DPBN. [ABSTRACT FROM AUTHOR] |
| Copyright of Medical Physics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Header | DbId: egs DbLabel: Engineering Source An: 101903557 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Feasibility and robustness of dose painting by numbers in proton therapy with contour-driven plan optimization. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Barragán%2C+A%2E+M%2E%22">Barragán, A. M.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Differding%2C+S%2E%22">Differding, S.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Janssens%2C+G%2E%22">Janssens, G.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Lee%2C+J%2E+A%2E%22">Lee, J. A.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Sterpin%2C+E%2E%22">Sterpin, E.</searchLink><relatesTo>1</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Medical+Physics%22">Medical Physics</searchLink>. Apr2015, Vol. 42 Issue 4, p2006-2017. 12p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Proton+therapy%22">Proton therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Radiation+doses%22">Radiation doses</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+prescribing%22">Drug prescribing</searchLink><br /><searchLink fieldCode="DE" term="%22Radiotherapy+treatment+planning%22">Radiotherapy treatment planning</searchLink><br /><searchLink fieldCode="DE" term="%22Process+optimization%22">Process optimization</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Purpose: To prove the ability of protons to reproduce a dose gradient that matches a dose painting by numbers (DPBN) prescription in the presence of setup and range errors, by using contours and structure-based optimization in a commercial treatment planning system. Methods: For two patients with head and neck cancer, voxel-by-voxel prescription to the target volume (GTVPET) was calculated from 18FDG-PET images and approximated with several discrete prescription subcontours. Treatments were planned with proton pencil beam scanning. In order to determine the optimal plan parameters to approach the DPBN prescription, the effects of the scanning pattern, number of fields, number of subcontours, and use of range shifter were separately tested on each patient. Different constant scanning grids (i.e., spot spacing = Δx = Δy = 3.5, 4, and 5 mm) and uniform energy layer separation [4 and 5 mm WED (water equivalent distance)] were analyzed versus a dynamic and automatic selection of the spots grid. The number of subcontours was increased from 3 to 11 while the number of beams was set to 3, 5, or 7. Conventional PTV-based and robust clinical target volumes (CTV)-based optimization strategies were considered and their robustness against range and setup errors assessed. Because of the nonuniform prescription, ensuring robustness for coverage of GTVPET inevitably leads to overdosing, which was compared for both optimization schemes. Results: The optimal number of subcontours ranged from 5 to 7 for both patients. All considered scanning grids achieved accurate dose painting (1% average difference between the prescribed and planned doses). PTV-based plans led to nonrobust target coverage while robust-optimized plans improved it considerably (differences between worst-case CTV dose and the clinical constraint was up to 3 Gy for PTV-based plans and did not exceed 1 Gy for robust CTV-based plans). Also, only 15% of the points in the GTV PET (worst case) were above 5% of DPBN prescription for robust-optimized plans, while they were more than 50% for PTV plans. Low dose to organs at risk (OARs) could be achieved for both PTV and robust-optimized plans. Conclusions: DPBN in proton therapy is feasible with the use of a sufficient number subcontours, automatically generated scanning patterns, and no more than three beams are needed. Robust optimization ensured the required target coverage and minimal overdosing, while PTV-approach led to nonrobust plans with excessive overdose. Low dose to OARs can be achieved even in the presence of a high-dose escalation as in DPBN. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Medical Physics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1118/1.4915082 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 12 StartPage: 2006 Subjects: – SubjectFull: Proton therapy Type: general – SubjectFull: Radiation doses Type: general – SubjectFull: Drug prescribing Type: general – SubjectFull: Radiotherapy treatment planning Type: general – SubjectFull: Process optimization Type: general Titles: – TitleFull: Feasibility and robustness of dose painting by numbers in proton therapy with contour-driven plan optimization. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Barragán, A. M. – PersonEntity: Name: NameFull: Differding, S. – PersonEntity: Name: NameFull: Janssens, G. – PersonEntity: Name: NameFull: Lee, J. A. – PersonEntity: Name: NameFull: Sterpin, E. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: Apr2015 Type: published Y: 2015 Identifiers: – Type: issn-print Value: 00942405 Numbering: – Type: volume Value: 42 – Type: issue Value: 4 Titles: – TitleFull: Medical Physics Type: main |
| ResultId | 1 |
