ArticleThe British journal of radiology2023
Clinical benefit of range uncertainty reduction in proton treatment planning based on dual-energy CT for neuro-oncological patients.
Article in The British journal of radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Proton therapy range uncertainty reduction using vendor-agnostic tissue characterization on a virtual photon-counting CT head scan.Medical physics · 2026Article
- Photon-counting computed tomography for stopping power ratio prediction in proton therapy.Medical physics · 2025Article
- Practical considerations for handling implants in proton therapy.Journal of applied clinical medical physics · 2025Article
- Comparison of two dual-energy CT-based methods for proton stopping-power ratio estimation in brain cancer patients with metal implants.Acta oncologica (Stockholm, Sweden) · 2025Article
- Instantaneous in vivo distal edge verification in intensity-modulated proton therapy by means of PET imaging.Medical physics · 2025Article
- Investigating LETd optimization strategies in carbon ion radiotherapy for pancreatic cancer: a dosimetric study using an anthropomorphic phantom.Medical physics · 2025Article
- Feasibility study for proton dose calculation of esophageal squamous cell carcinoma based on stopping power ratio directly derived from dual energy CT.Frontiers in oncology · 2025Article
- Deep learning estimation of proton stopping power with photon-counting computed tomography: a virtual study.Journal of medical imaging (Bellingham, Wash.) · 2024Article
- Benefit of range uncertainty reduction in robust optimisation for proton therapy of brain, head-and-neck and breast cancer patients.Physics and imaging in radiation oncology · 2024Article
- Virtual unenhanced dual-energy computed tomography for photon radiotherapy: The effect on dose distribution and cone-beam computed tomography based position verification.Physics and imaging in radiation oncology · 2024Article
- From computed tomography innovation to routine clinical application in radiation oncology - A joint initiative of close collaboration.Physics and imaging in radiation oncology · 2024Article
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16 authors.
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Abstract
objectiveSeveral studies have shown that dual-energy CT (DECT) can lead to improved accuracy for proton range estimation. This study investigated the clinical benefit of reduced range uncertainty, enabled by DECT, in robust optimisation for neuro-oncological patients.
methodsDECT scans for 27 neuro-oncological patients were included. Commercial software was applied to create stopping-power ratio (SPR) maps based on the DECT scan. Two plans were robustly optimised on the SPR map, keeping the beam and plan settings identical to the clinical plan. One plan was robustly optimised and evaluated with a range uncertainty of 3% (as used clinically; denoted 3%-plan); the second plan applied a range uncertainty of 2% (2%-plan). Both plans were clinical acceptable and optimal. The dose-volume histogram parameters were compared between the two plans. Two experienced neuro-radiation oncologists determined the relevant dose difference for each organ-at-risk (OAR). Moreover, the OAR toxicity levels were assessed.
resultsFor 24 patients, a dose reduction >0.5/1 Gy (relevant dose difference depending on the OAR) was seen in one or more OARs for the 2%-plan;
conclusionRobust optimisation with reduced range uncertainty allows for reduction of OAR toxicity, providing a rationale for clinical implementation. Based on these results, we have clinically introduced DECT-based proton treatment planning for neuro-oncological patients, accompanied with a reduced range uncertainty of 2%. ADVANCES IN KNOWLEDGE: This study shows the clinical benefit of range uncertainty reduction from 3% to 2% in robustly optimised proton plans. A dose reduction to one or more OARs was seen for 89% of the patients, and 44% of the patients had an expected toxicity level decrease.
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