Session Item

Saturday
August 28
14:15 - 15:30
N101-102
Guidelines
Anna Kirby, United Kingdom;
Claus Belka, Germany
0330
Symposium
Interdisciplinary
16:53 - 17:01
Time-resolved dosimetry for validation of 4D dose calculation in PBS proton beam radiotherapy
PH-0239

Abstract

Time-resolved dosimetry for validation of 4D dose calculation in PBS proton beam radiotherapy
Authors: Kostiukhina|, Natalia(1)*[natalya.kostyukhina@gmail.com];Palmans|, Hugo(2);Stock|, Markus(2);Georg|, Dietmar(1);Knäusl|, Barbara(1);
(1)Medical University of Vienna, Department of Radiation Oncology, Vienna, Austria;(2)EBG MedAustron GmbH, Medical Physics, Wiener Neustadt, Austria;
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Purpose or Objective

Validation of 4D dose calculations (4D-DC) is an essential step in the evaluation of motion mitigation techniques in pencil beam scanned (PBS) particle therapy. In this study, the distortion of dose distributions due to the interplay between beam and organ motion was simulated and validated using a recently proposed 4D dosimetry approach [1].

Material and Methods

PBS pulsed proton beams and a dynamic lung phantom were employed for the dosimetry. A treatment was planned on a CT with a static phantom (TPS RayStation6.99, MC4.1) and modified into different delivery scenarios: with varied prescribed physical dose (2 & 4Gy), and particle fluence degraded to 10, 20, and 50% of the nominal beam transmission. All plans were delivered to the static and moving (2cm cranio-caudal target motion) phantom. The start of phantom motion was synchronized with the beam-on signal. The dose was measured inside and outside of the target using 5 pinpoint IC (TM30013,PTW) PP1…PP5. Time-resolved values with 0.5s step were recorded by communicating with an electrometer via RS232 serial port using an in-house written Python script.
Retrospective 4D-DC was enabled by a scripting interface integrated in the TPS. Input data included beam delivery details (logfiles) and 4D-CT reflected the target motion. Each proton spot was reassigned to a certain breathing phase and the single phase sub-doses were transferred to and summed up on the planning CT. Absolute dose differences (DD) between measurements and 4D calculations were analyzed for 15 time points ti of each irradiation (fig.1a). At each ti dose gradients were calculated in a sphere of 3mm radius around each PP measurement point.

Results

For the point of interest outside the target (PP4) the DD were below 0.1Gy for both static and moving deliveries over the full irradiation time. At the end of the plan delivery, the DD for the target PPs summed up to 0.1Gy for static scenarios and to 0.3Gy -for moving scenarios. These DD of static and moving cases increased over irradiation time until a certain moment, after which they stabilized at a plateau (fig.2). A strong correlation between DD and corresponding dose gradients was observed. The peaks of static DD were associated with certain proton energies and, therefore, with dose gradients due to the beam scanning in depth (fig.1b). In the moving phantom steep dose gradients occurred additionally in the direction of target motion. Measurement points of PP2 and PP3 moving in-and-out of high dose area were most affected by this interplay process, while PP1 and PP5 stayed either in or out of the irradiation volume. Neither the dose per fraction nor the beam intensity had an influence on the DD.

Conclusion

The agreement between 4D dose measurements in the moving phantom and retrospective 4D-DC was found to be comparable to the static DD for all delivery scenarios. For both, static and moving, cases accurate measurements were challenging at steep dose gradients originating from the beam scanning and tumor motion.

[1] ESTRO38 PO-977

Figure 1 - (a) exemplary results of 4D dose measurements and 4D-DC for scenario: prescribed dose - 2 Gy, particle fluence degraded to 20%; delivered to the moving phantom. (b) dose distributions, obtained by 4D-DC, demonstrate dose gradient originated from the depth beam scanning only (top) and target motion additionally (bottom) at the time points t8 and t11

Figure 2 - dose difference between measurements and 4D calculations (DD), along with dose gradient presented for 15 time points ti over irradiation. Both parameters are shown for PP3 and PP5, which measured dose inside the target. PP3 measurements were affected by the dose gradient more than PP5