Advances in 4D Treatment Planning for Scanned Particle Beam Therapy — Report of Dedicated Workshops

We report on recent progress in the field of mobile tumor treatment with scanned particle beams, as discussed in the latest editions of the 4D treatment planning workshop. The workshop series started in 2009, with about 20 people from 4 research institutes involved, all actively working on particle therapy delivery and development. The first workshop resulted in a summary of recommendations for the treatment of mobile targets, along with a list of requirements to apply these guidelines clinically. The increased interest in the treatment of mobile tumors led to a continuously growing number of attendees: the 2012 edition counted more than 60 participants from 20 institutions and commercial vendors. The focus of research discussions among workshop participants progressively moved from 4D treatment planning to complete 4D treatments, aiming at effective and safe treatment delivery. Current research perspectives on 4D treatments include all critical aspects of time resolved delivery, such as in-room imaging, motion detection, beam application, and quality assurance techniques. This was motivated by the start of first clinical treatments of hepato cellular tumors with a scanned particle beam, relying on gating or abdominal compression for motion mitigation. Up to date research activities emphasize significant efforts in investigating advanced motion mitigation techniques, with a specific interest in the development of dedicated tools for experimental validation. Potential improvements will be made possible in the near future through 4D optimized treatment plans that require upgrades of the currently established therapy control systems for time resolved delivery. But since also these novel optimization techniques rely on the validity of the 4DCT, research focusing on alternative 4D imaging technique, such as MRI based 4DCT generation will continue.

[1]  H. Tsujii,et al.  Local control and recurrence of stage I non-small cell lung cancer after carbon ion radiotherapy. , 2004, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[2]  George T. Y. Chen,et al.  Four-dimensional image-based treatment planning: Target volume segmentation and dose calculation in the presence of respiratory motion. , 2005, International journal of radiation oncology, biology, physics.

[3]  H. Laborit,et al.  [Experimental study]. , 1958, Bulletin mensuel - Societe de medecine militaire francaise.

[4]  Marco Riboldi,et al.  Scale Invariant Feature Transform as feature tracking method in 4D imaging: A feasibility study , 2012, 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[5]  Antje Knopf,et al.  Mapping motion from 4D-MRI to 3D-CT for use in 4D dose calculations: A technical feasibility study. , 2013, Medical physics.

[6]  Evon M. O. Abu-Taieh,et al.  Comparative Study , 2020, Definitions.

[7]  J. Dueck.  Robustness of the voluntary breath-hold approach for the treatment of early stage lung cancer with spot scanned proton therapy , 2013 .

[8]  Patrick A Kupelian,et al.  Real-time tumor tracking in the lung using an electromagnetic tracking system. , 2013, International journal of radiation oncology, biology, physics.

[9]  S Minohara,et al.  Respiratory gated irradiation system for heavy-ion radiotherapy. , 2000, International journal of radiation oncology, biology, physics.

[10]  Y. Istefanopulos,et al.  IEEE Engineering in Medicine and Biology Society , 2019, IEEE Transactions on Biomedical Engineering.

[11]  T. Delaney,et al.  Prescribing, Recording, and Reporting Proton-Beam Therapy , 2009 .

[12]  G Baroni,et al.  Robustness of external/internal correlation models for real-time tumor tracking to breathing motion variations , 2012, Physics in medicine and biology.

[13]  Pietro Cerveri,et al.  Tumor tracking based on correlation models in scanned ion beam therapy: an experimental study , 2013, Physics in medicine and biology.

[14]  Marco Riboldi,et al.  The Role of Regularization in Deformable Image Registration for Head and Neck Adaptive Radiotherapy , 2013, Technology in cancer research & treatment.

[15]  M. Durante,et al.  Assessment of uncertainties in treatment planning for scanned ion beam therapy of moving tumors. , 2013, International journal of radiation oncology, biology, physics.

[16]  Hiroki Shirato,et al.  Feasibility of synchronization of real-time tumor-tracking radiotherapy and intensity-modulated radiotherapy from viewpoint of excessive dose from fluoroscopy. , 2004, International journal of radiation oncology, biology, physics.

[17]  Christoph Bert,et al.  4D optimization of scanned ion beam tracking therapy for moving tumors , 2014, Physics in medicine and biology.

[18]  Geoffrey D. Hugo,et al.  Advances in 4D radiation therapy for managing respiration: part I - 4D imaging. , 2012, Zeitschrift fur medizinische Physik.

[19]  Marco Riboldi,et al.  Targeting Accuracy in Real-time Tumor Tracking via External Surrogates: A Comparative Study , 2010, Technology in cancer research & treatment.

[20]  Christoph Bert,et al.  Quantification of interplay effects of scanned particle beams and moving targets , 2008, Physics in medicine and biology.

[21]  Marco Riboldi,et al.  An adaptive fuzzy prediction model for real time tumor tracking in radiotherapy via external surrogates , 2013, Journal of applied clinical medical physics.

[22]  Marco Durante,et al.  Speed and accuracy of a beam tracking system for treatment of moving targets with scanned ion beams , 2009, Physics in medicine and biology.

[23]  J. Affeldt,et al.  The feasibility study , 2019, The Information System Consultant’s Handbook.

[24]  Oliver Jäkel,et al.  Quantitative carbon ion beam radiography and tomography with a flat-panel detector , 2012, Physics in medicine and biology.

[25]  S Dowdell,et al.  Interplay effects in proton scanning for lung: a 4D Monte Carlo study assessing the impact of tumor and beam delivery parameters , 2013, Physics in medicine and biology.

[26]  C Bert,et al.  4D particle therapy PET simulation for moving targets irradiated with scanned ion beams , 2013, Physics in medicine and biology.

[27]  Gregory C Sharp,et al.  Scale invariant feature transform in adaptive radiation therapy: a tool for deformable image registration assessment and re-planning indication , 2013, Physics in medicine and biology.

[28]  A. Koehler,et al.  Proton Radiographic Detection of Strokes , 1973, Nature.

[29]  S. Marnitz,et al.  Current therapy of patients with endometrial carcinoma , 2011, Strahlentherapie und Onkologie.

[30]  Steve B. Jiang,et al.  Temporo-spatial IMRT optimization: concepts, implementation and initial results , 2005, Physics in medicine and biology.

[31]  Eike Rietzel,et al.  Four-dimensional proton treatment planning for lung tumors. , 2006, International journal of radiation oncology, biology, physics.

[32]  E Pedroni,et al.  Proton radiography as a tool for quality control in proton therapy. , 1995, Medical physics.

[33]  Dirk Boye,et al.  Adequate margin definition for scanned particle therapy in the incidence of intrafractional motion. , 2013, Physics in medicine and biology.

[34]  D. Richter.  Treatment planning for tumors with residual motion in scanned ion beam therapy , 2012 .

[35]  M. Phillips,et al.  Effects of respiratory motion on dose uniformity with a charged particle scanning method. , 1992, Physics in medicine and biology.

[36]  M. Riboldi,et al.  A multiple points method for 4D CT image sorting. , 2011, Medical physics.

[37]  Tohru Okada,et al.  Carbon ion radiotherapy: clinical experiences at National Institute of Radiological Science (NIRS). , 2010, Journal of radiation research.

[38]  Christoph Bert,et al.  Target motion tracking with a scanned particle beam. , 2007, Medical physics.

[39]  D Meer,et al.  A study on repainting strategies for treating moderately moving targets with proton pencil beam scanning at the new Gantry 2 at PSI , 2010, Physics in medicine and biology.

[40]  Marco Riboldi,et al.  Real-time tumour tracking in particle therapy: technological developments and future perspectives. , 2012, The Lancet. Oncology.

[41]  E Heath,et al.  Dosimetric consequences of tumour motion due to respiration for a scanned proton beam , 2011, Physics in medicine and biology.

[42]  Joao Seco,et al.  Breathing interplay effects during proton beam scanning: simulation and statistical analysis , 2009, Physics in medicine and biology.

[43]  C Bert,et al.  Motion in radiotherapy: particle therapy , 2011, Physics in medicine and biology.

[44]  G. Sharp,et al.  Uncertainties in Lung Motion Prediction Relying on External Surrogate: A 4DCT Study in Regular vs. Irregular Breathers , 2010, Technology in cancer research & treatment.

[45]  K Parodi,et al.  Ion beam tracking using ultrasound motion detection. , 2014, Medical physics.

[46]  T Haberer,et al.  Gating delays for two respiratory motion sensors in scanned particle radiation therapy , 2013, Physics in medicine and biology.

[47]  K Parodi,et al.  Experimental verification of a 4D MLEM reconstruction algorithm used for in-beam PET measurements in particle therapy , 2013, Physics in medicine and biology.

[48]  Yoshiyuki Iwata,et al.  Performance of the NIRS fast scanning system for heavy-ion radiotherapy. , 2010, Medical physics.

[49]  Christoph Bert,et al.  Simulations to design an online motion compensation system for scanned particle beams , 2006, Physics in medicine and biology.

[50]  M. V. van Herk,et al.  Respiratory correlated cone beam CT. , 2005, Medical physics.

[51]  Marco Durante,et al.  Dosimetric precision of an ion beam tracking system , 2010, Radiation oncology.

[52]  J. Debus,et al.  The application of PET to quality assurance of heavy-ion tumor therapy , 1999, Strahlentherapie und Onkologie.

[53]  Julia Bauer,et al.  Hypofractionated carbon ion therapy delivered with scanned ion beams for patients with hepatocellular carcinoma – feasibility and clinical response , 2013, Radiation Oncology.

[54]  John T. Wei,et al.  Target localization and real-time tracking using the Calypso 4D localization system in patients with localized prostate cancer. , 2006, International journal of radiation oncology, biology, physics.

[55]  P. Evans.  Anatomical imaging for radiotherapy , 2008, Physics in medicine and biology.

[56]  Geoffrey D. Hugo,et al.  Advances in 4D radiation therapy for managing respiration: part II - 4D treatment planning. , 2012, Zeitschrift fur medizinische Physik.

[57]  David Sarrut,et al.  Multi-dimensional respiratory motion tracking from markerless optical surface imaging based on deformable mesh registration , 2012, Physics in medicine and biology.

[58]  Antje Knopf,et al.  Mapping motion from 4D-MRI to 3D-CT for use in 4D dose calculations: a technical feasibility study. , 2013, Medical physics.

[59]  M. V. van Herk,et al.  Precise and real-time measurement of 3D tumor motion in lung due to breathing and heartbeat, measured during radiotherapy. , 2002, International journal of radiation oncology, biology, physics.

[60]  P. Keall,et al.  Four-dimensional IMRT treatment planning using a DMLC motion-tracking algorithm , 2009, Physics in medicine and biology.

[61]  H. Tsujii,et al.  ICRU Report No. 78, Prescribing, recording, and reporting proton-beam therapy. , 2007 .

[62]  C Bert,et al.  A breathing thorax phantom with independently programmable 6D tumour motion for dosimetric measurements in radiation therapy , 2012, Physics in medicine and biology.

[63]  P. Keall,et al.  Estimation of effective imaging dose for kilovoltage intratreatment monitoring of the prostate position during cancer radiotherapy , 2013, Physics in medicine and biology.

[64]  Christoph Bert,et al.  Motion compensation with a scanned ion beam: a technical feasibility study , 2008, Radiation oncology.

[65]  M. Moerland,et al.  A conformation number to quantify the degree of conformality in brachytherapy and external beam irradiation: application to the prostate. , 1997, International journal of radiation oncology, biology, physics.

[66]  M. Durante,et al.  Development and performance evaluation of a dynamic phantom for biological dosimetry of moving targets , 2010, Physics in medicine and biology.

[67]  A. Trofimov,et al.  4D Monte Carlo simulation of proton beam scanning: modelling of variations in time and space to study the interplay between scanning pattern and time-dependent patient geometry , 2005, Physics in medicine and biology.

[68]  Marco Durante,et al.  Four-dimensional patient dose reconstruction for scanned ion beam therapy of moving liver tumors. , 2014, International journal of radiation oncology, biology, physics.

[69]  Christopher Kurz,et al.  129 FIRST STEPS TOWARDS 4D OFFLINE PET-BASED TREATMENT VERIFICATION AT THE HEIDELBERG ION BEAM THERAPY CENTER , 2012 .

[70]  Marco Durante,et al.  Experimental verification of a real-time compensation functionality for dose changes due to target motion in scanned particle therapy. , 2011, Medical physics.

[71]  A J Lomax,et al.  Deformable motion reconstruction for scanned proton beam therapy using on-line x-ray imaging , 2013, Physics in medicine and biology.

[72]  M. Durante,et al.  Calculation and experimental verification of the RBE-weighted dose for scanned ion beams in the presence of target motion , 2011, Physics in medicine and biology.

[73]  M. Josipovic,et al.  Robustness of the voluntary breath-hold approach for the treatment of early stage lung cancer with spot scanned proton therapy , 2013 .

[74]  George Starkschall,et al.  Assessment of gross tumor volume regression and motion changes during radiotherapy for non-small-cell lung cancer as measured by four-dimensional computed tomography. , 2007, International journal of radiation oncology, biology, physics.

[75]  Steve B. Jiang,et al.  Effects of intra-fraction motion on IMRT dose delivery: statistical analysis and simulation. , 2002, Physics in medicine and biology.

[76]  Satyapal Rathee,et al.  First demonstration of intrafractional tumor-tracked irradiation using 2D phantom MR images on a prototype linac-MR. , 2013, Medical physics.

[77]  A J Lomax,et al.  Comparative study of layered and volumetric rescanning for different scanning speeds of proton beam in liver patients , 2013, Physics in medicine and biology.

[78]  S. Korreman.  Motion in radiotherapy: photon therapy , 2012, Physics in medicine and biology.

[79]  S Green,et al.  Particle therapy. , 2011, The British journal of radiology.

[80]  K. Brock.  Results of a multi-institution deformable registration accuracy study (MIDRAS). , 2010, International journal of radiation oncology, biology, physics.

[81]  P. Steidl.  Gating for scanned ion beam therapy , 2011 .

[82]  Marco Durante,et al.  Motion mitigation in intensity modulated particle therapy by internal target volumes covering range changes. , 2012, Medical physics.

[83]  P. Keall,et al.  A deliverable four-dimensional intensity-modulated radiation therapy-planning method for dynamic multileaf collimator tumor tracking delivery. , 2008, International journal of radiation oncology, biology, physics.

[84]  Antje-Christin Knopf,et al.  Scanned proton radiotherapy for mobile targets—the effectiveness of re-scanning in the context of different treatment planning approaches and for different motion characteristics , 2011, Physics in medicine and biology.

[85]  Melvin L. Griem,et al.  Prescribing, Recording, and Reporting Photon Beam Therapy , 1994 .

[86]  O Jäkel,et al.  Upgrade and benchmarking of a 4D treatment planning system for scanned ion beam therapy. , 2013, Medical physics.

[87]  Christoph Bert,et al.  Gated irradiation with scanned particle beams. , 2009, International journal of radiation oncology, biology, physics.

[88]  I Rinaldi,et al.  Experimental characterization of a prototype detector system for carbon ion radiography and tomography , 2013, Physics in medicine and biology.

[89]  Christoph Bert,et al.  4D treatment planning for scanned ion beams , 2007, Radiation oncology.

[90]  Jan-Jakob Sonke,et al.  Variability of four-dimensional computed tomography patient models. , 2008, International journal of radiation oncology, biology, physics.

[91]  Robert Lüchtenborg,et al.  Real-time dose compensation methods for scanned ion beam therapy of moving tumors , 2012 .

[92]  S. Mori,et al.  Current status and future prospects of multi-dimensional image-guided particle therapy , 2013, Radiological Physics and Technology.

[93]  S Nill,et al.  The comparative performance of four respiratory motion predictors for real-time tumour tracking , 2011, Physics in medicine and biology.

[94]  A J Lomax,et al.  Respiratory liver motion estimation and its effect on scanned proton beam therapy , 2012, Physics in medicine and biology.

[95]  Daniel Richter,et al.  Special report: Workshop on 4D-treatment planning in actively scanned particle therapy-Recommendations, technical challenges, and future research directions. , 2010, Medical physics.

[96]  S van de Water,et al.  Tumour tracking with scanned proton beams: assessing the accuracy and practicalities , 2009, Physics in medicine and biology.

[97]  Christoph Bert,et al.  Respiratory motion management in particle therapy. , 2010, Medical physics.