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Fast Monte Carlo log-based framework for robust 4D dose evaluation in proton therapy.

Agnieszka Wochnik1, Damian Borys2,3, Gabriela Foltyńska1

  • 1Institute of Nuclear Physics Polish Academy of Sciences, Radzikowskiego 152, 31-342 Krakow, Poland.

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Summary

This study introduces a fast 4D Monte Carlo (MC) dose evaluation tool for proton therapy. It accounts for organ motion and delivery timing, revealing significant reductions in target coverage during worst-case scenarios.

Keywords:
LYMPHOMA cancerMonte Carlomoving targetsproton therapyrobust 4D dose evaluation

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Computational Imaging

Background:

  • Proton therapy for moving targets, especially in the mediastinum, requires advanced dosimetric evaluation.
  • Current methods may not fully capture the complexities of organ motion during free-breathing treatments.

Purpose of the Study:

  • To develop and validate a robust 4D Monte Carlo (MC) dose evaluation (4DDE) methodology for proton therapy.
  • To integrate temporal information of both pencil beam delivery and organ motion for accurate dose assessment.
  • To evaluate the impact of respiratory motion on treatment plan robustness.

Main Methods:

  • Developed a specialized tool combining GPU-accelerated FRED MC code with temporal patient and delivery data.
  • Implemented standard 3D dose evaluation, plan recalculation across respiratory phases, and robust 4DDE.
  • Validated the approach using 4D CT scans from a Hodgkin lymphoma patient, employing deformable image registration.

Main Results:

  • Robust 4DDE revealed wider dose ranges compared to 3D analysis, indicating the importance of temporal data.
  • Voxel-wise worst-case dose distribution showed significant reductions in target coverage (47.4% for 95% isodose, 20.8% for 90% isodose) due to respiratory motion.
  • Gamma index analysis demonstrated differences between 3D and 4D evaluations.

Conclusions:

  • The developed tool provides a fast and versatile method for 4DDE in proton radiotherapy.
  • Accounting for dynamic anatomical changes is crucial for ensuring robust treatment plan evaluations.
  • This methodology enhances the accuracy of proton therapy for moving targets.