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

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: Volume...

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Autores principales: Takahashi, Wataru, Mori, Shinichiro, Nakajima, Mio, Yamamoto, Naoyoshi, Inaniwa, Taku, Furukawa, Takuji, Shirai, Toshiyuki, Noda, Koji, Nakagawa, Keiichi, Kamada, Tadashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230758/
https://www.ncbi.nlm.nih.gov/pubmed/25384996
http://dx.doi.org/10.1186/s13014-014-0238-y
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author Takahashi, Wataru
Mori, Shinichiro
Nakajima, Mio
Yamamoto, Naoyoshi
Inaniwa, Taku
Furukawa, Takuji
Shirai, Toshiyuki
Noda, Koji
Nakagawa, Keiichi
Kamada, Tadashi
author_facet Takahashi, Wataru
Mori, Shinichiro
Nakajima, Mio
Yamamoto, Naoyoshi
Inaniwa, Taku
Furukawa, Takuji
Shirai, Toshiyuki
Noda, Koji
Nakagawa, Keiichi
Kamada, Tadashi
author_sort Takahashi, Wataru
collection PubMed
description 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 < 0.05) and 13% (p < 0.05), respectively. 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.
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spelling pubmed-42307582014-11-14 Carbon-ion scanning lung treatment planning with respiratory-gated phase-controlled rescanning: simulation study using 4-dimensional CT data Takahashi, Wataru Mori, Shinichiro Nakajima, Mio Yamamoto, Naoyoshi Inaniwa, Taku Furukawa, Takuji Shirai, Toshiyuki Noda, Koji Nakagawa, Keiichi Kamada, Tadashi Radiat Oncol Research 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 < 0.05) and 13% (p < 0.05), respectively. 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. BioMed Central 2014-11-11 /pmc/articles/PMC4230758/ /pubmed/25384996 http://dx.doi.org/10.1186/s13014-014-0238-y Text en © Takahashi et al.; licensee BioMed Central Ltd. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Takahashi, Wataru
Mori, Shinichiro
Nakajima, Mio
Yamamoto, Naoyoshi
Inaniwa, Taku
Furukawa, Takuji
Shirai, Toshiyuki
Noda, Koji
Nakagawa, Keiichi
Kamada, Tadashi
Carbon-ion scanning lung treatment planning with respiratory-gated phase-controlled rescanning: simulation study using 4-dimensional CT data
title Carbon-ion scanning lung treatment planning with respiratory-gated phase-controlled rescanning: simulation study using 4-dimensional CT data
title_full Carbon-ion scanning lung treatment planning with respiratory-gated phase-controlled rescanning: simulation study using 4-dimensional CT data
title_fullStr Carbon-ion scanning lung treatment planning with respiratory-gated phase-controlled rescanning: simulation study using 4-dimensional CT data
title_full_unstemmed Carbon-ion scanning lung treatment planning with respiratory-gated phase-controlled rescanning: simulation study using 4-dimensional CT data
title_short Carbon-ion scanning lung treatment planning with respiratory-gated phase-controlled rescanning: simulation study using 4-dimensional CT data
title_sort carbon-ion scanning lung treatment planning with respiratory-gated phase-controlled rescanning: simulation study using 4-dimensional ct data
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230758/
https://www.ncbi.nlm.nih.gov/pubmed/25384996
http://dx.doi.org/10.1186/s13014-014-0238-y
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