Comparison of 3D and 4D robustly optimized proton treatment plans for non-small cell lung cancer patients with tumour motion amplitudes larger than 5 mm

Review and recommendations on deformable image registration uncertainties for radiotherapy applications

“…A commonly proposed use of dose accumulation is for 4D treatment planning or the dose reconstruction of the dose in a moving area. Both, 4D optimisation (Graeff et al 2013 , Engwall et al 2018 , Spautz et al 2023 ) and 4D dose evaluation (Zhang et al 2019 , Meijers et al 2020 ) require DIR and therefore show DIR-related uncertainties. Both are mostly applied in anatomical areas affected by breathing motion, registering all phases of a 4D CT or 4D MRI scan into a reference phase or average image (Rosu and Hugo 2012 , Engwall et al 2018 , Meijers et al 2020 ).…”

Comparing different boost concepts and beam configurations for proton therapy of pancreatic cancer

“…However, there is no consensus on the optimal beam arrangement in proton therapy for pancreatic cancer even using three beams showed to achieve a homogenous dose distribution in the target [16] . To identify suitable beam arrangements robustness evaluation is essential as recently demonstrated [17] , [18] . The simultaneous integrated boost (SIB) technique is more commonly used to deliver higher doses to targets.…”

A review of the clinical introduction of 4D particle therapy research concepts

“…In clinical practice, the three-dimensional (3D) robust optimisation is well established for static tumour regions prone to interfractional variations. Also, it has been shown that the intrafractional motion might be sufficiently compensated by the internal target volume (ITV) concept, overcoming the necessity of 4D robust optimisation [17] , [18] . However, the final decision depends on the individual case and the centres’ technical capabilities.…”

“…However, the feasibility of adaptation depends not only on the time but also on the indication, treatment modality and strategy [20] , [21] , [22] as well as online imaging capabilities. Especially in particle therapy shortcomings in automatic re-planning and auto-contouring have resulted in a lack of online adaptive strategies [16] , [17] , [18] , [23] .…”