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Quantitative Mapping of Specific Ventilation in the Human Lung using Proton Magnetic Resonance Imaging and Oxygen as a Contrast Agent

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Published on: June 5, 2019

Breathing interplay effects during proton beam scanning: simulation and statistical analysis.

Joao Seco¹, Daniel Robertson, Alexei Trofimov

¹Department of Radiation Oncology, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA.

Physics in Medicine and Biology

|June 25, 2009

Summary

This summary is machine-generated.

Proton therapy repainting strategies minimize interplay effects from tumor motion. Breath sampling is most effective, requiring 5-10 repaints per field to keep dose errors below 5%.

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Area of Science:

Medical Physics
Radiation Oncology
Biomedical Engineering

Background:

Active beam scanning in proton therapy faces interplay effects due to simultaneous beam and tumor motion.
Fractionation may not sufficiently blur interplay effects, necessitating strategies like repainting.
Investigating repainting effectiveness is crucial for accurate proton radiation therapy delivery.

Purpose of the Study:

To evaluate the efficacy of various repainting strategies in mitigating interplay effects during proton beam scanning.
To assess the dosimetric impact of tumor motion and breathing patterns on dose delivery.
To identify optimal repainting parameters for minimizing dose errors in proton therapy.

Main Methods:

Simulations were conducted analyzing tumor motion amplitude, breathing period, and delivery system parameters.
Asymmetric sine functions modeled breathing motion (10-30 mm amplitude) perpendicular to the beam.
Five repainting strategies were compared, including 'breath sampling', for their vulnerability to dose errors.

Main Results:

Tumor motion narrowed the high-dose profile and widened the penumbra, significantly reducing the 90% isodose area with large amplitudes.
Breathing asymmetry caused a caudal dose shift of 1-5 mm.
'Breath sampling' demonstrated the highest effectiveness in reducing dose errors with minimal treatment time increase.

Conclusions:

Breath sampling, with 5-10 repaints per field, is recommended to maintain dose delivery errors below 5% for a 8.5 x 8.5 x 10 cm³ tumor volume.
Fewer repaints suffice for larger tumors, while smaller tumors may require more.
This strategy balances dose accuracy and treatment efficiency in proton radiation therapy.