Jonas Scherman Rydhög1, Rosalind Perrin2, Rasmus Irming Jølck3, Francis Gagnon-Moisan2, Klaus Richter Larsen4, Paul Clementsen5, Steen Riisgaard de Blanck6, Gitte Fredberg Persson6, Damien Charles Weber2, Tony Lomax2, Thomas Lars Andresen7, Per Munck Af Rosenschold8. 1. Department of Oncology, Section of Radiotherapy, 3994, Rigshospitalet, Copenhagen, Denmark; Niels Bohr Institute, University of Copenhagen, Denmark. Electronic address: per.jonas.scherman.rydhoeg@regionh.dk. 2. Paul Scherrer Institut, Center for Proton Therapy, Switzerland. 3. DTU Nanotech, Department of Micro- and Nanotechnology, Center for Nanomedicine and Theranostics, Technical University of Denmark, Kgs. Lyngby, Denmark; Nanovi Radiotherapy A/S, Kgs. Lyngby, Denmark. 4. Department of Clinical Medicine, Bispebjerg Hospital, København, Denmark. 5. Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet, Copenhagen, Denmark; Department of Internal Medicine, Zealand University Hospital, Roskilde, Denmark. 6. Department of Oncology, Section of Radiotherapy, 3994, Rigshospitalet, Copenhagen, Denmark. 7. DTU Nanotech, Department of Micro- and Nanotechnology, Center for Nanomedicine and Theranostics, Technical University of Denmark, Kgs. Lyngby, Denmark. 8. Department of Oncology, Section of Radiotherapy, 3994, Rigshospitalet, Copenhagen, Denmark; Niels Bohr Institute, University of Copenhagen, Denmark.
Abstract
BACKGROUND AND PURPOSE: We investigated the clinical applicability of a novel liquid fiducial marker (LFM) for image-guided pencil beam scanned (PBS) proton therapy (PBSPT) of locally advanced lung cancer (LALC). MATERIALS AND METHODS: The relative proton stopping power (RSP) of the LFM was calculated and measured. Dose perturbations of the LFM and three solid markers, in a phantom, were measured. PBSPT treatment planning on computer tomography scans of five patients with LALC with the LFM implanted was performed with 1-3 fields. RESULTS: The RSP was experimentally determined to be 1.164 for the LFM. Phantom measurements revealed a maximum relative deviation in dose of 4.8% for the LFM in the spread-out Bragg Peak, compared to 12-67% for the solid markers. Using the experimentally determined RSP, the maximum proton range error introduced by the LFM is about 1mm. If the marker was displaced at PBSPT, the maximum dosimetric error was limited to 2 percentage points for 3-field plans. CONCLUSION: The dose perturbations introduced by the LFM were considerably smaller than the solid markers investigated. The RSP of the fiducial marker should be corrected in the treatment planning system to avoid errors. The investigated LFM introduced clinically acceptable dose perturbations for image-guided PBSPT of LALC.
BACKGROUND AND PURPOSE: We investigated the clinical applicability of a novel liquid fiducial marker (LFM) for image-guided pencil beam scanned (PBS) proton therapy (PBSPT) of locally advanced lung cancer (LALC). MATERIALS AND METHODS: The relative proton stopping power (RSP) of the LFM was calculated and measured. Dose perturbations of the LFM and three solid markers, in a phantom, were measured. PBSPT treatment planning on computer tomography scans of five patients with LALC with the LFM implanted was performed with 1-3 fields. RESULTS: The RSP was experimentally determined to be 1.164 for the LFM. Phantom measurements revealed a maximum relative deviation in dose of 4.8% for the LFM in the spread-out Bragg Peak, compared to 12-67% for the solid markers. Using the experimentally determined RSP, the maximum proton range error introduced by the LFM is about 1mm. If the marker was displaced at PBSPT, the maximum dosimetric error was limited to 2 percentage points for 3-field plans. CONCLUSION: The dose perturbations introduced by the LFM were considerably smaller than the solid markers investigated. The RSP of the fiducial marker should be corrected in the treatment planning system to avoid errors. The investigated LFM introduced clinically acceptable dose perturbations for image-guided PBSPT of LALC.
Authors: Anders E Hansen; Jonas R Henriksen; Rasmus I Jølck; Frederikke P Fliedner; Linda M Bruun; Jonas Scherman; Andreas I Jensen; Per Munck Af Rosenschöld; Lilah Moorman; Sorel Kurbegovic; Steen R de Blanck; Klaus R Larsen; Paul F Clementsen; Anders N Christensen; Mads H Clausen; Wenbo Wang; Paul Kempen; Merete Christensen; Niels-Erik Viby; Gitte Persson; Rasmus Larsen; Knut Conradsen; Fintan J McEvoy; Andreas Kjaer; Thomas Eriksen; Thomas L Andresen Journal: Sci Adv Date: 2020-08-19 Impact factor: 14.136
Authors: Kathryn H Brown; Mihaela Ghita; Giuseppe Schettino; Kevin M Prise; Karl T Butterworth Journal: Cancers (Basel) Date: 2020-05-18 Impact factor: 6.639
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