ArticleInternational journal of radiation oncology, biology, physics2018
Impact of Spot Size and Spacing on the Quality of Robustly Optimized Intensity Modulated Proton Therapy Plans for Lung Cancer.
Article in International journal of radiation oncology, biology, physics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers.
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Who cites it
40 citing papers in PubMed.
- AI in Proton Therapy Treatment Planning: A Narrative Review.International journal of particle therapy · 2026Article
- A feasibility study on a machine-learning-based quality assurance tool for spot-scanning proton therapy using delivery log files and treatment plans.Physics and imaging in radiation oncology · 2026Article
- Noisy probing dose facilitated dose prediction for pencil beam scanning proton therapy: Physics enhances generalizability.Medical physics · 2026Article
- Article
- Comparison of protons and very high-energy electrons transmission pencil-beam-scanning for FLASH radiotherapy.Physics and imaging in radiation oncology · 2025Article
- Diffusion Transformer-based Universal Dose Denoising for Pencil Beam Scanning Proton Therapy.ArXiv · 2025Article
- Robust Optimization for Spot-Scanning Proton Therapy based on Dose-Linear-Energy-Transfer Volume Constraints.International journal of radiation oncology, biology, physics · 2025Article
- Quantification of beam size impact on intensity-modulated proton therapy with robust optimization in head and neck cancer-comparison with intensity-modulated radiation therapy.Journal of radiation research · 2025Article
- Enabling clinical use of linear energy transfer in proton therapy for head and neck cancer - A review of implications for treatment planning and adverse events study.Visualized cancer medicine · 2025Article
- Time structures of proton pencil beam scanning delivery on a microsecond scale measured with a pixelated semiconductor detector Timepix3.Journal of applied clinical medical physics · 2024Article
- NRG Oncology and Particle Therapy Co-Operative Group Patterns of Practice Survey and Consensus Recommendations on Pencil-Beam Scanning Proton Stereotactic Body Radiation Therapy and Hypofractionated Radiation Therapy for Thoracic Malignancies.International journal of radiation oncology, biology, physics · 2024Review
- Clinical Viability of an Active Spot Scanning Beam Delivery System With a Newly Developed Carbon-Ion Treatment Planning System.Advances in radiation oncology · 2024Article
- Impact of proton PBS machine operating parameters on the effectiveness of layer rescanning for interplay effect mitigation in lung SBRT treatment.Journal of applied clinical medical physics · 2024Article
- Mixed-size spot scanning with a compact large momentum acceptance superconducting (LMA-SC) gantry beamline for proton therapy.Physics in medicine and biology · 2024Article
- Quantifying dose uncertainties resulting from cardiorespiratory motion in intensity-modulated proton therapy for cardiac stereotactic body radiotherapy.Frontiers in oncology · 2024Article
- Artificial general intelligence for radiation oncology.Meta-radiology · 2023Article
- Deep-learning based fast and accurate 3D CT deformable image registration in lung cancer.Medical physics · 2023Article
- Comparison of 3D and 4D robustly optimized proton treatment plans for non-small cell lung cancer patients with tumour motion amplitudes larger than 5 mm.Physics and imaging in radiation oncology · 2023Article
- Article
- Deep-Learning-based Fast and Accurate 3D CT Deformable Image Registration in Lung Cancer.ArXiv · 2023Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
purposeTo investigate how spot size and spacing affect plan quality, robustness, and interplay effects of robustly optimized intensity modulated proton therapy (IMPT) for lung cancer. METHODS AND MATERIALS: Two robustly optimized IMPT plans were created for 10 lung cancer patients: first by a large-spot machine with in-air energy-dependent large spot size at isocenter (σ: 6-15 mm) and spacing (1.3 σ), and second by a small-spot machine with in-air energy-dependent small spot size (σ: 2-6 mm) and spacing (5 mm). Both plans were generated by optimizing radiation dose to internal target volume on averaged 4-dimensional computed tomography scans using an in-house-developed IMPT planning system. The dose-volume histograms band method was used to evaluate plan robustness. Dose evaluation software was developed to model time-dependent spot delivery to incorporate interplay effects with randomized starting phases for each field per fraction. Patient anatomy voxels were mapped phase-to-phase via deformable image registration, and doses were scored using in-house-developed software. Dose-volume histogram indices, including internal target volume dose coverage, homogeneity, and organs at risk (OARs) sparing, were compared using the Wilcoxon signed-rank test.
resultsCompared with the large-spot machine, the small-spot machine resulted in significantly lower heart and esophagus mean doses, with comparable target dose coverage, homogeneity, and protection of other OARs. Plan robustness was comparable for targets and most OARs. With interplay effects considered, significantly lower heart and esophagus mean doses with comparable target dose coverage and homogeneity were observed using smaller spots.
conclusionsRobust optimization with a small spot-machine significantly improves heart and esophagus sparing, with comparable plan robustness and interplay effects compared with robust optimization with a large-spot machine. A small-spot machine uses a larger number of spots to cover the same tumors compared with a large-spot machine, which gives the planning system more freedom to compensate for the higher sensitivity to uncertainties and interplay effects for lung cancer treatments.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.