ArticleRadiation oncology (London, England)2019
4DMRI-based investigation on the interplay effect for pencil beam scanning proton therapy of pancreatic cancer patients.
Article in Radiation oncology (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Impact of daily volumetric imaging on target tracking without fiducial markers during robotic treatment of pancreas.Physics in medicine and biology · 2026Article
- Comparative evaluation of static and dynamic 4D dose recalculations in pencil beam scanning proton therapy for oesophageal cancer.Physics and imaging in radiation oncology · 2026Article
- Interplay Effect of Splenic Motion for Total Lymphoid Irradiation in Pediatric Proton Therapy.Cancers · 2023Article
- Analysis of the cost-effectiveness of proton beam therapy for unresectable pancreatic cancer in Japan.Cancer medicine · 2023Article
- Accelerating 4D image reconstruction for magnetic resonance-guided radiotherapy.Physics and imaging in radiation oncology · 2023Article
- Evaluating motion of pancreatic tumors and anatomical surrogates using cine MRI in 0.35T MRgRT under free breathing conditions.Journal of applied clinical medical physics · 2023Article
- Intrafraction tumor motion monitoring and dose reconstruction for liver pencil beam scanning proton therapy.Frontiers in oncology · 2023Article
- Proton Therapy in the Management of Pancreatic Cancer.Cancers · 2022Review
- Synthetic 4DCT(MRI) lung phantom generation for 4D radiotherapy and image guidance investigations.Medical physics · 2022Article
- Management of Motion and Anatomical Variations in Charged Particle Therapy: Past, Present, and Into the Future.Frontiers in oncology · 2022Review
- An adaptive planning strategy in carbon ion therapy of pancreatic cancer involving beam angle selection.Physics and imaging in radiation oncology · 2022Article
- Intensity-modulated proton therapy (IMPT) interplay effect evaluation of asymmetric breathing with simultaneous uncertainty considerations in patients with non-small cell lung cancer.Medical physics · 2020Article
- Three discipline collaborative radiation therapy (3DCRT) special debate: The United States needs at least one carbon ion facility.Journal of applied clinical medical physics · 2019Article
- Comparison of pancreatic respiratory motion management with three abdominal corsets for particle radiation therapy: Case study.Journal of applied clinical medical physics · 2019Article
- Respiratory-Correlated (RC) vs. Time-Resolved (TR) Four-Dimensional Magnetic Resonance Imaging (4DMRI) for Radiotherapy of Thoracic and Abdominal Cancer.Frontiers in oncology · 2019Review
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10 authors.
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Abstract
backgroundTime-resolved volumetric magnetic resonance imaging (4DMRI) offers the potential to analyze 3D motion with high soft-tissue contrast without additional imaging dose. We use 4DMRI to investigate the interplay effect for pencil beam scanning (PBS) proton therapy of pancreatic cancer and to quantify the dependency of residual interplay effects on the number of treatment fractions.
methodsBased on repeated 4DMRI datasets for nine pancreatic cancer patients, synthetic 4DCTs were generated by warping static 3DCTs with 4DMRI deformation vector fields. 4D dose calculations for scanned proton therapy were performed to quantify the interplay effect by CTV coverage (v95) and dose homogeneity (d5/d95) for incrementally up to 28 fractions. The interplay effect was further correlated to CTV motion characteristics. For quality assurance, volume and mass conservation were evaluated by Jacobian determinants and volume-density comparisons.
resultsFor the underlying patient cohort with CTV motion amplitudes < 15 mm, we observed significant correlations between CTV motion amplitudes and both the length of breathing cycles and the interplay effect. For individual fractions, tumor underdosage down to v95 = 70% was observed with pronounced dose heterogeneity (d5/d95 = 1.3). For full × 28 fractionated treatments, we observed a mitigation of the interplay effect with increasing fraction numbers. On average, after seven fractions, a CTV coverage with 95-107% of the prescribed dose was reached with sufficient dose homogeneity. For organs at risk, no significant differences were found between the static and accumulated dose plans for 28 fractions.
conclusionIntrafractional organ motion exhibits a large interplay effect for PBS proton therapy of pancreatic cancer. The interplay effect correlates with CTV motion, but can be mitigated efficiently by fractionation, mainly due to different breathing starting phases in fractionated treatments. For hypofractionated treatments, a further restriction of motion may be required. Repeated 4DMRI measurements are a viable tool for pre- and post-treatment evaluations of the interplay effect.
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