Towards online adaptive proton therapy: first report of plan-library-based plan-of-the-day approach

Troost, Esther G.C.; Menkel, Stefan; Tschiche, Maria; Thiele, Julian; Jaster, M; Haak, D; Kunath, Daniela

doi:10.1080/0284186x.2021.1994154

Cited by 8 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Currently, online daily radiotherapy solutions are commercially available only for photon therapy with dedicated platforms using MR guidance [42] or AI-guided CBCT-based systems [125] . However, also the field of PT shows broad interest in implementing more online or hybrid approaches, especially including daily replanning and employing plan libraries [8] , [22] , [126] , [127] , [128] . Recently, several key players in the field of real-time adaptive PT joined forces [129] to tackle the remaining challenges and pave the way towards online adaptation in PT [130] , [131] , [132] , [133] , [134] , [135] , [136] .…”

Section: Technological Capabilities For Motion Managementmentioning

confidence: 99%

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

Knäusl,

Belotti,

Bertholet

et al. 2024

Physics and Imaging in Radiation Oncology

View full text Add to dashboard Cite

Section: Technological Capabilities For Motion Managementmentioning

confidence: 99%

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

Knäusl,

Belotti,

Bertholet

et al. 2024

Physics and Imaging in Radiation Oncology

View full text Add to dashboard Cite

“…By recalculating the treatment plan on the verification CT and performing a robustness evaluation, appropriate measures are taken to ensure treatment quality. Adaptive therapy for particle treatment is also an active research subject aiming at more frequent and active intervention by utilizing the daily setup imaging data (CBCT or in-room CT) [51][52][53][54][55][56].…”

Section: Patient Setup and Monitoring Of Anatomical Changesmentioning

confidence: 99%

Beam range uncertainty and its clinical management in particle therapy

Wang,

2024

Vis Cancer Med

View full text Add to dashboard Cite

The full theoretical advantages of particle beams in external beam radiotherapy have not been fully exploited, in large part due to uncertainties of the beam range in the patient. For this reason, efforts are underway, either for more precise in-vivo detection of Bragg peak positions or for further reduction of beam range computation errors in treatment planning. Meanwhile, management of the range uncertainty issues with mitigation techniques based on existing technology is critical in providing safe and effective treatments in clinical practice. This paper briefly reviews the definition and causes of particle range uncertainty, the uncertainty estimates currently used in clinical practice, and the corresponding mitigation techniques. It is intended to provide references for clinical practices at new and existing particle therapy centers.

show abstract

“…However, it is challenging and still unavailable in proton clinics due to the lack of a high‐quality onboard 3D imaging system and the long time required for a complex and labor‐intensive workflow. 8 Although multiple groups 9 , 10 , 11 , 12 have been endeavoring to overcome these challenges to enable online APT, there is also a concern in the RT community about the necessity of online APT. For instance, it is possible that the dosimetric disadvantages of the current offline APT shown in specific treatment fractions might be smeared due to the daily setup variations and hence counteracted in the cumulative dose over the entire treatment course, which might dampen the need for devoting significant efforts to develop the online APT technology.…”

Section: Introductionmentioning

confidence: 99%

A retrospective study on the investigation of potential dosimetric benefits of online adaptive proton therapy for head and neck cancer

Chang,

Bohannon,

Tian

et al. 2024

J Applied Clin Med Phys

View full text Add to dashboard Cite

PurposeProton therapy is sensitive to anatomical changes, often occurring in head‐and‐neck (HN) cancer patients. Although multiple studies have proposed online adaptive proton therapy (APT), there is still a concern in the radiotherapy community about the necessity of online APT. We have performed a retrospective study to investigate the potential dosimetric benefits of online APT for HN patients relative to the current offline APT.MethodsOur retrospective study has a patient cohort of 10 cases. To mimic online APT, we re‐evaluated the dose of the in‐use treatment plan on patients’ actual treatment anatomy captured by cone‐beam CT (CBCT) for each fraction and performed a templated‐based automatic replanning if needed, assuming that these were performed online before treatment delivery. Cumulative dose of the simulated online APT course was calculated and compared with that of the actual offline APT course and the designed plan dose of the initial treatment plan (referred to as nominal plan). The ProKnow scoring system was employed and adapted for our study to quantify the actual quality of both courses against our planning goals.ResultsThe average score of the nominal plans over the 10 cases is 41.0, while those of the actual offline APT course and our simulated online course is 25.8 and 37.5, respectively. Compared to the offline APT course, our online course improved dose quality for all cases, with the score improvement ranging from 0.4 to 26.9 and an average improvement of 11.7.ConclusionThe results of our retrospective study have demonstrated that online APT can better address anatomical changes for HN cancer patients than the current offline replanning practice. The advanced artificial intelligence based automatic replanning technology presents a promising avenue for extending potential benefits of online APT.

show abstract

Towards online adaptive proton therapy: first report of plan-library-based plan-of-the-day approach

Cited by 8 publications

References 17 publications

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

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

Beam range uncertainty and its clinical management in particle therapy

A retrospective study on the investigation of potential dosimetric benefits of online adaptive proton therapy for head and neck cancer

Contact Info

Product

Resources

About