ArticleMedical physics2025
Shoot-through layers in upright proton arcs unlock advantages in plan quality and range verification.
Article in Medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Neural Representation Learning for Compact and Efficient Modeling of Monte Carlo Phase Space Data.International journal of particle therapy · 2026Article
- Particle Arc Therapy in Cancer Radiotherapy: A Scoping Review of Feasibility and Dosimetric Evidence.Cancers · 2026Review
- Machine Learning-Based Beam Delivery Time Model for Mevion S250i With Hyperscan Technology.International journal of particle therapy · 2026Article
- Towards ultra-fast treatments: large energy acceptance beam delivery systems and opportunities for proton beam therapy.Frontiers in oncology · 2026Review
- Upright positioning enhances beam angle optimization and organ sparing in head and neck carbon-ion radiotherapy with fixed-beam systems.Radiation oncology (London, England) · 2025Article
- Shoot-through layers in upright proton arcs unlock advantages in plan quality and range verification.Medical physics · 2025Article
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5 authors.
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Abstract
backgroundUpright proton therapy with compact delivery systems has the potential to reduce costs for treatments but could also lead to broadening of the beam penumbra due to energy selection close to the patient. PURPOSE: This study aims at combining upright static proton arcs with additional layers of shoot-through (ST) protons to sharpen the beam penumbra and improve plan quality for such systems. An additional advantage of the method is that it provides a straightforward approach for range verification with a fixed range detector opposite the fixed proton nozzle.
methodsWe examined various treatment plans for a virtual phantom: 3-beam IMPT, static arc (Arc) with/without ST (Arc+ST), and with/without collimation (+Coll). In the virtual phantom three different targets were utilized to study the effect on conformity index (CI), homogeneity index (HI), robustness and mean dose to the phantom volume. The phantom study was complemented with a head-and-neck (H&N) patient case with a similar set of plans. The delivery time for all plans was estimated using a combined model of the upright patient positioner and the proton nozzle. A range verification concept that determines residual ranges of the ST protons was studied in simulated scenarios for the H&N case.
resultsIn the phantom study, the Arc+ST plans show superior CI, HI and target robustness compared to the Arc+Coll plans. For the Arc plans without ST, the collimated plans perform better than the uncollimated plans. On the other hand, for Arc+ST, collimation has little impact on CI, HI and robustness. However, a small increase in the mean dose to the phantom volume is seen without collimation. For the H&N case, similar improvements for Arc+ST can be seen with only a marginal increase of the mean dose to the patient volume when no collimation is used. These results imply that no aperture is needed when combining arcs with ST, which in turn substantially reduces treatment times: for the H&N case the delivery time for Arc+ST is estimated to 5.4 min and for Arc+Coll to 6.5 min. The range verification simulation shows that the method is sensitive to detect systematic stopping power ratio errors, setup errors and changes in the patient anatomy.
conclusionsCombining proton arcs and ST layers can enhance compact upright proton solutions by improving plan quality at the same time as delivery time is reduced. The concept is also tailored for the inclusion of a fast and straightforward residual range verification method.
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