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Open Access 01-12-2007 | Research

4D treatment planning for scanned ion beams

Authors: Christoph Bert, Eike Rietzel

Published in: Radiation Oncology | Issue 1/2007

Abstract

At Gesellschaft für Schwerionenforschung (GSI) more than 330 patients have been treated with scanned carbon ion beams in a pilot project. To date, only stationary tumors have been treated. In the presence of motion, scanned ion beam therapy is not yet possible because of interplay effects between scanned beam and target motion which can cause severe mis-dosage. We have started a project to treat tumors that are subject to respiratory motion. A prototype beam application system for target tracking with the scanned pencil beam has been developed and commissioned.

To facilitate treatment planning for tumors that are subject to organ motion, we have extended our standard treatment planning system TRiP to full 4D functionality. The 4D version of TRiP allows to calculate dose distributions in the presence of motion. Furthermore, for motion mitigation techniques tracking, gating, rescanning, and internal margins optimization of treatment parameters has been implemented. 4D calculations are based on 4D computed tomography data, deformable registration maps, organ motion traces, and beam scanning parameters.

We describe the methods of our 4D treatment planning approach and demonstrate functionality of the system for phantom as well as patient data.

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Chui CS, Yorke E, Hong L: The effects of intra-fraction organ motion on the delivery of intensity-modulated field with a multileaf collimator. Med Phys. 2003, 30: 1736-1746. 10.1118/1.1578771.PubMedCrossRef

Webb S: Limitations of a simple technique for movement compensation via movement-modified fluence profiles. Phys Med Biol. 2005, 50: 155-10.1088/0031-9155/50/14/N02.CrossRef

Bortfeld T, Jiang SB, Rietzel E: Effects of motion on the total dose distribution. Semin Radiat Oncol. 2004, 14: 41-51. 10.1053/j.semradonc.2003.10.011.PubMedCrossRef

Duan J, Shen S, Fiveash JB, Popple R, Brezovich IA: Dosimetric and radiobiological impact of dose fractionation on respiratory motion induced IMRT delivery errors: a volumetric dose measurement study. Med Phys. 2006, 33: 1380-1387. 10.1118/1.2192908.PubMedCrossRef

George R, Keall PJ, Kini VR, Vedam SS, Siebers JV, Wu Q, et al: Quantifying the effect of intrafraction motion during breast IMRT planning and dose delivery. Med Phys. 2003, 30: 552-562. 10.1118/1.1543151.PubMedCrossRef

Jiang SB, Pope C, Jarrah KMA, Kung JH, Bortfeld T, Chen GTY: An experimental investigation on intra-fractional organ motion effects in lung IMRT treatments. Phys Med Biol. 2003, 48: 1773-1784. 10.1088/0031-9155/48/12/307.PubMedCrossRef

Pemler P, Besserer J, Lombriser N, Pescia R, Schneider U: Influence of respiration-induced organ motion on dose distributions in treatments using enhanced dynamic wedges. Med Phys. 2001, 28: 2234-2240. 10.1118/1.1410121.PubMedCrossRef

Schaefer M, Münter MW, Thilmann C, Sterzing F, Haering P, Combs SE, Debus J, et al: Influence of intra-fractional breathing movement in step-and-shoot IMRT. Phys Med Biol. 2004, 49 (0031-9155): N175-10.1088/0031-9155/49/12/N03.PubMedCrossRef

Verellen D, Tournel K, Van De Steene SJ, Linthout N, Wauters T, Vinh-Hung V, Storme G, et al: Breathing-synchronized irradiation using stereoscopic kV-imaging to limit influence of interplay between leaf motion and organ motion in 3D-CRT and IMRT: Dosimetric verification and first clinical experience. International Journal of Radiation Oncology, Biology, Physics. 2006, 66: S108-S119. 10.1016/j.ijrobp.2005.11.032.CrossRef

10.

Yu CX, Jaffray DA, Wong JW: The effects of intra-fraction organ motion on the delivery of dynamic intensity modulation. Phys Med Biol. 1998, 43: 91-104. 10.1088/0031-9155/43/1/006.PubMedCrossRef

11.

Minohara S, Kanai T, Endo M, Noda K, Kanazawa M: Respiratory gated irradiation system for heavy-ion radiotherapy. Int J Radiat Oncol. 2000, 47: 1097-1103. 10.1016/S0360-3016(00)00524-1.CrossRef

12.

Lu HM, Safai S, Schneider R, Adams JA, Chen YL, Wolfgang JA, et al: Respiratory-gated Proton therapy treatment. PTCOG 44, Zurich, Switzerland. 2006

13.

Pedroni E, Bearpark R, Böhringer T, Coray A: The PSI Gantry 2: a second generation proton scanning gantry. Z Med Phys. 2004, 14: 25-34.PubMedCrossRef

14.

Phillips MH, Pedroni E, Blattmann H, Boehringer T, Coray A, Scheib S: Effects of respiratory motion on dose uniformity with a charged particle scanning method. Phys Med Biol. 1992, 37: 223-233. 10.1088/0031-9155/37/1/016.PubMedCrossRef

15.

Grozinger SO, Rietzel E, Li Q, Bert C, Haberer T, Kraft G: Simulations to design an online motion compensation system for scanned particle beams. Phys Med Biol. 2006, 51: 3517-3531. 10.1088/0031-9155/51/14/016.PubMedCrossRef

16.

Keall PJ, Kini VR, Vedam SS, Mohan R: Motion adaptive x-ray therapy: a feasibility study. Phys Med Biol. 2001, 46: 1-10. 10.1088/0031-9155/46/1/301.PubMedCrossRef

17.

Li Q, Grözinger SO, Haberer T, Kraft G: Online compensation of target motion with scanned particle beams: simulation environment. Phys Med Biol. 2004, 49: 3029-3046. 10.1088/0031-9155/49/14/001.PubMedCrossRef

18.

ICRU Report 62: Prescribing, Recording and Reporting Photon Beam Therapy. International Commission on Radiation Units and Measurements. 1999, 63:

19.

Engelsman M, Kooy HM: Target volume dose considerations in proton beam treatment planning for lung tumors. Med Phys. 2005, 32: 3549-3557. 10.1118/1.2126187.PubMedCrossRef

20.

Minohara S, Endo M, Kanai T, Kato H, Tsujii H: Estimating uncertainties of the geometrical range of particle radiotherapy during respiration. Int J Radiat Oncol. 2003, 56: 121-125. 10.1016/S0360-3016(03)00092-0.CrossRef

21.

Engelsman M, Rietzel E, Kooy HM: Four-dimensional proton treatment planning for lung tumors. Int J Radiat Oncol Biol Phys. 2006, 64: 1589-1595. 10.1016/j.ijrobp.2005.12.026.PubMedCrossRef

22.

Ford EC, Mageras GS, Yorke E, Ling CC: Respiration-correlated spiral CT: A method of measuring respiratory-induced anatomic motion for radiation treatment planning. Med Phys. 2003, 30: 88-97. 10.1118/1.1531177.PubMedCrossRef

23.

Vedam SS, Keall PJ, Kini VR, Mostafavi H, Shukla HP, Mohan R: Acquiring a four-dimensional computed tomography dataset using an external respiratory signal. Phys Med Biol. 2003, 48: 45-62. 10.1088/0031-9155/48/1/304.PubMedCrossRef

24.

Low DA, Nystrom M, Kalinin E, Parikh P, Dempsey JF, Bradley JD, et al: A method for the reconstruction of four-dimensional synchronized CT scans acquired during free breathing. Med Phys. 2003, 30: 1254-1263. 10.1118/1.1576230.PubMedCrossRef

25.

Keall PJ, Starkschall G, Shukla H, Forster KM, Ortiz V, Stevens CW, et al: Acquiring 4D thoracic CT scans using a multislice helical method. Phys Med Biol. 2004, 49: 2053-2067. 10.1088/0031-9155/49/10/015.PubMedCrossRef

26.

Rietzel E, Pan T, Chen GTY: Four-dimensional computed tomography: Image formation and clinical protocol. Med Phys. 2005, 32: 874-889. 10.1118/1.1869852.PubMedCrossRef

27.

Zimmermann H, Umathum R, Plathow C, Semmler W, Nitz W, Bock M: Messungen der Stembewegung mit schneller Magnetresonanztomographie und induktiv gekoppelten Markerspulen. Z Med Phys. 2005, 15: 38-44.PubMedCrossRef

28.

Hanley J, Debois MM, Mah D, Mageras GS, Raben A, Rosenzweig K, et al: Deep inspiration breath-hold technique for lung tumors: the potential value of target immobilization and reduced lung density in dose escalation. Int J Radiat Oncol. 1999, 45: 603-611. 10.1016/S0360-3016(99)00154-6.CrossRef

29.

Wong JW, Sharpe MB, Jaffray DA, Kini VR, Robertson JM, Stromberg JS, et al: The use of active breathing control (ABC) to reduce margin for breathing motion. Int J Radiat Oncol. 1999, 44: 911-919. 10.1016/S0360-3016(99)00056-5.CrossRef

30.

Kuechler S, Hoinkis C, Thierfelder C, Becker B, Zahn P, Geyer P, et al: Respiratory motion – first investigations on the optimization of gating parameters. Int J Radiat Oncol. 2004, 60: 579-10.1016/j.ijrobp.2004.07.570.CrossRef

31.

Keall PJ: 4-dimensional computed tomography imaging and treatment planning. Semin Radiat Oncol. 2004, 14: 81-90. 10.1053/j.semradonc.2003.10.006.PubMedCrossRef

32.

Keall PJ, Joshi S, Vedam SS, Siebers JV, Kini VR, Mohan R: Four-dimensional radiotherapy planning for DMLC-based respiratory motion tracking. Med Phys. 2005, 32: 942-951. 10.1118/1.1879152.PubMedCrossRef

33.

Rietzel E, Chen GTY, Choi NC, Willet CG: Four-dimensional image-based treatment planning: Target volume segmentation and dose calculation in the presence of respiratory motion. Int J Radiat Oncol. 2005, 61: 1535-1550. 10.1016/j.ijrobp.2004.11.037.CrossRef

34.

Schlaefer A, Fisseler J, Dieterich S, Shiomi H, Cleary K, Schweikard A: Feasibility of four-dimensional conformal planning for robotic radiosurgery. Med Phys. 2005, 32: 3786-3792. 10.1118/1.2122607.PubMedCrossRef

35.

Kraft G: Tumor Therapy with Heavy Charged Particles. Prog Part Nucl Phys. 2000, 45: 473-10.1016/S0146-6410(00)00112-5.CrossRef

36.

Schulz-Ertner D, Nikoghosyan A, Thilmann C, Haberer T, Jäkel O, Karger C, et al: Results of carbon ion radiotherapy in 152 patients. Int J Radiat Oncol. 2004, 58: 631-640. 10.1016/j.ijrobp.2003.09.041.CrossRef

37.

Grözinger SO: Volume Conformal Irradiation of Moving Target Volumes with Scanned Ion Beams. 2004, TU Darmstadt; PhD-Thesis

38.

Bert C: Bestrahlungsplanung für bewegte Zielvolumina in der Tumortherapie mit gescanntem Kohlenstoffstrahl. 2006, TU Darmstadt; PhD-Thesis

39.

Haberer T, Becher W, Schardt D, Kraft G: Magnetic scanning system for heavy ion therapy. Nucl Instrum Meth A. 1993, 330: 296-305. 10.1016/0168-9002(93)91335-K.CrossRef

40.

Krämer M, Jäkel O, Haberer T, Kraft G, Schardt D, Weber U: Treatment planning for heavy-ion radiotherapy: physical beam model and dose optimization. Phys Med Biol. 2000, 45: 3299-3317. 10.1088/0031-9155/45/11/313.PubMedCrossRef

41.

Krämer M, Scholz M: Treatment planning for heavy-ion radiotherapy: calculation and optimization of biologically effective dose. Phys Med Biol. 2000, 45: 3319-3330. 10.1088/0031-9155/45/11/314.PubMedCrossRef

42.

Jäkel O, Jacob C, Schardt D, Karger CP, Hartmann GH: Relation between carbon ion ranges and x-ray CT numbers. Med Phys. 2001, 28: 701-703. 10.1118/1.1357455.PubMedCrossRef

43.

Weber U, Becher W, Kraft G: Depth scanning for a conformal ion beam treatment of deep seated tumours. Phys Med Biol. 2000, 45: 3627-3641. 10.1088/0031-9155/45/12/309.PubMedCrossRef

44.

Hartkens T: Measuring, analysing, and visualizing brain deformation using non-rigid registration. 1993, King's College London, UK; PhD-Thesis

45.

Rietzel E, Chen GTY: Deformable registration of 4D computed tomography data. Med Phys. 2006, 33: 4423-4430. 10.1118/1.2361077.PubMedCrossRef

46.

Lujan AE, Larsen EW, Balter JM, Haken RKT: A method for incorporating organ motion due to breathing into 3D dose calculations. Med Phys. 1999, 26: 715-720. 10.1118/1.598577.PubMedCrossRef

47.

Heeg P, Eickhoff H, Haberer T: Conception of heavy ion beam therapy at Heidelberg University (HICAT). Z Med Phys. 2004, 14: 17-24.PubMedCrossRef

48.

Noda K, Kanazawa M, Itano A, Takada E, Torikoshi M, Araki N, et al: Slow beam extraction by a transverse RF field with AM and FM. Nucl Instrum Meth A. 1996, 374: 269-277. 10.1016/0168-9002(96)00096-4.CrossRef

49.

Weiss E, Wijesooriya K, Dill SV, Keall PJ: Tumor and normal tissue motion in the thorax during respiration: analysis of volumetric and positional variations using 4D CT. Int J Radiat Oncol Biol Phys. 2007, 67: 296-307.PubMedCrossRef

50.

Fitzpatrick MJ, Starkschall G, Antolak JA, Fu J, Shukla H, Keall PJ, et al: Displacement-based binning of time-dependent computed tomography image data sets. Med Phys. 2006, 33: 235-246. 10.1118/1.2044427.PubMedCrossRef

51.

Rietzel E, Chen GT: Improving retrospective sorting of 4D computed tomography data. Med Phys. 2006, 33: 377-379. 10.1118/1.2150780.PubMedCrossRef

52.

Kleshneva T, Muzik J, Alber M: An algorithm for automatic determination of the respiratory phases in four-dimensional computed tomography. Phys Med Biol. 2006, 51: N269-N276. 10.1088/0031-9155/51/16/N01.PubMedCrossRef

53.

Shimizu S, Shirato H, Kitamura K, Shinohara N, Harabayashi T, Tsukamoto T, et al: Use of an implanted marker and real-time tracking of the marker for the positioning of prostate and bladder cancers. Int J Radiat Oncol. 2000, 48: 1591-1597. 10.1016/S0360-3016(00)00809-9.CrossRef

54.

Shirato H, Shimizu S, Kunieda T, Kitamura K, Kagei K, Nishioka T, et al: Physical aspects of a real-time tumor-tracking system for gated radiotherapy. Int J Radiat Oncol. 2000, 48: 1187-1195. 10.1016/S0360-3016(00)00748-3.CrossRef

Title: 4D treatment planning for scanned ion beams
Authors: Christoph Bert
Eike Rietzel
Publication date: 01-12-2007
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2007
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-2-24

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4D treatment planning for scanned ion beams

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