Carbon-ion scanning lung treatment planning with respiratory-gated phase-controlled rescanning: simulation study using 4-dimensional CT data

Radiation Oncology

Tadashi Kamada²  Keiichi Nakagawa¹  Koji Noda²  Toshiyuki Shirai²  Takuji Furukawa²  Taku Inaniwa²  Naoyoshi Yamamoto²  Mio Nakajima²  Shinichiro Mori²  Wataru Takahashi¹ 

[1] Department of Radiology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan;Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1, Anagawa, Inage-ku, Chiba-shi 263-8555, Chiba, Japan

关键词: Scanning beam;    Respiratory motion;    Lung cancer;    CT;    Four-dimensional;    Carbon-ion beam;   

Others  :  1228543
DOI  :  10.1186/s13014-014-0238-y

 received in 2014-07-14, accepted in 2014-10-15,  发布年份 2014

【 摘 要 】

Background

To moving lung tumors, we applied a respiratory-gated strategy to carbon-ion pencil beam scanning with multiple phase-controlled rescanning (PCR). In this simulation study, we quantitatively evaluated dose distributions based on 4-dimensional CT (4DCT) treatment planning.

Methods

Volumetric 4DCTs were acquired for 14 patients with lung tumors. Gross tumor volume, clinical target volume (CTV) and organs at risk (OARs) were delineated. Field-specific target volumes (FTVs) were calculated, and 48Gy(RBE) in a single fraction was prescribed to the FTVs delivered from four beam angles. The dose assessment metrics were quantified by changing the number of PCR and the results for the ungated and gated scenarios were then compared.

Results

For the ungated strategy, the mean dose delivered to 95% of the volume of the CTV (CTV-D95) was in average 45.3?±?0.9 Gy(RBE) even with a single rescanning (1?×?PCR). Using 4?×?PCR or more achieved adequate target coverage (CTV-D95?=?46.6?±?0.3 Gy(RBE) for ungated 4?×?PCR) and excellent dose homogeneity (homogeneity index =1.0?±?0.2% for ungated 4?×?PCR). Applying respiratory gating, percentage of lung receiving at least 20 Gy(RBE) (lung-V20) and heart maximal dose, averaged over all patients, significantly decreased by 12% (p?p?

Conclusions

Four or more PCR during PBS-CIRT improved dose conformation to moving lung tumors without gating. The use of a respiratory-gated strategy in combination with PCR reduced excessive doses to OARs.

【 授权许可】

   
2014 Takahashi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Mori S, Shibayama K, Tanimoto K, Kumagai M, Matsuzaki Y, Furukawa T, Inaniwa T, Shirai T, Noda K, Tsuji H, Kamada T: First clinical experience in carbon ion scanning beam therapy: retrospective analysis of patient positional accuracy. J Radiat Res 2012, 53(5):760-768.
• [2]Furukawa T, Inaniwa T, Sato S, Shirai T, Mori S, Takeshita E, Mizushima K, Himukai T, Noda K: Moving target irradiation with fast rescanning and gating in particle therapy. Med Phys 2010, 37(9):4874-4879.
• [3]Mori S, Furukawa T, Inaniwa T, Zenklusen S, Nakao M, Shirai T, Noda K: Systematic evaluation of four-dimensional hybrid depth scanning for carbon-ion lung therapy. Med Phys 2013, 40(3):031720.
• [4]Mori S, Endo M, Tsunoo T, Kandatsu S, Tanada S, Aradate H, Saito Y, Miyazaki H, Satoh K, Matsushita S, Kusakabe M: Physical performance evaluation of a 256-slice CT-scanner for four-dimensional imaging. Med Phys 2004, 31:1348-1356.
• [5]Shackleford JA, Kandasamy N, Sharp GC: On developing B-spline registration algorithms for multi-core processors. Phys Med Biol 2010, 7(55(21)):6329-6351.
• [6]Graeff C, Durante M, Bert C: Motion mitigation in intensity modulated particle therapy by internal target volumes covering range changes. Med Phys 2012, 39(10):6004-6013.
• [7]Takahashi W, Nakajima M, Yamamoto N, Tsuji H, Kamada T, Tsujii H: Carbon ion radiotherapy in a hypofractionation regimen for stage I non-small-cell lung cancer. J Radiat Res 2014, 55(Suppl 1):i26-i27.
• [8]Kanai T, Endo M, Minohara S, Miyahara N, Koyama-ito H, Tomura H, Matsufuji N, Futami Y, Fukumura A, Hiraoka T, Furusawa Y, Ando K, Suzuki M, Soga F, Kawachi K: Biophysical characteristics of HIMAC clinical irradiation system for heavy-ion radiation therapy. Int J Radiat Oncol Biol Phys 1999, 44:201-210.
• [9]Furukawa T, Inaniwa T, Sato S, Tomitani T, Minohara S, Noda K, Kanai T: Design study of a raster scanning system for moving target irradiation in heavy-ion radiotherapy. Med Phys 2007, 34(3):1085-1097.
• [10]Mori S, Chen GT: Quantification and visualization of charged particle range variations. Int J Radiat Oncol Biol Phys 2008, 72:268-277.
• [11]Knopf AC, Hong TS, Lomax A: Scanned proton radiotherapy for mobile targets-the effectiveness of re-scanning in the context of different treatment planning approaches and for different motion characteristics. Phys Med Biol 2011, 21(56(22)):7257-7271.
• [12]Bert C, Grözinger SO, Rietzel E: Quantification of interplay effects of scanned particle beams and moving targets. Phys Med Biol 2008, 7(53(9)):2253-2265.
• [13]Kang Y, Zhang X, Chang JY, Wang H, Wei X, Liao Z, Komaki R, Cox JD, Balter PA, Liu H, Zhu XR, Mohan R, Dong L: 4D Proton treatment planning strategy for mobile lung tumors. Int J Radiat Oncol Biol Phys 2007, 1(67(3)):906-914.
• [14]Mori S, Inaniwa T, Furukawa T, Takahashi W, Nakajima M, Shirai T, Noda K, Yasuda S, Yamamoto N: Amplitude-based gated phase-controlled rescanning in carbon-ion scanning beam treatment planning under irregular breathing conditions using lung and liver 4DCTs. J Radiat Res 2014, 55(5):948-958.