Gating delays for two respiratory motion sensors in scanned particle radiation therapy

Gating is one option for radiotherapy of tumours that move intrafractionally due to respiration. Delays of the motion monitoring system can lead to a shift of the gating window and thus slightly shifted dose distributions. We studied the delay of two motion monitoring systems which use the motion of the chest wall as surrogate for tumour motion. Delays and their dosimetric influence were determined against a precise motion acquisition system in a phantom study. The measurement data were supplemented by dedicated simulations of the experimental setup. Finally, the dosimetric influence for patient treatments was estimated for a lung tumour case using the extreme situation of a radiosurgery setting with a single field. We determined delays of 132 ± 18 ms and 103 ± 22 ms for the two systems. There was no significant difference between beam start and beam stop delay. Even for delays of 200 ms the dosimetric influence in a single-field radiosurgery setting is moderate (V95 = 96.5%, V107 = 8.5%, D5-D95 = 13%). We conclude, that the delay of the motion monitoring system should be part of the commissioning process for gated treatments. The dosimetric impact should be studied in detail prior treatments with a scanned ion beam.