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Introduce a rotational robust optimization framework for spot-scanning proton arc (SPArc) therapy.
Physics in medicine and biology
  • Sheng Chang, Beaumont Health
  • Gang Liu, Beaumont Health
  • Lewei Zhao, Beaumont Health
  • Weili Zheng, Beaumont Health
  • Di Yan, Beaumont Health
  • Peter Chen, Beaumont Health
  • Xiangpan Li
  • Rohan Deraniyagala, Beaumont Health
  • Craig Stevens, Beaumont Health
  • Inga Grills, Beaumont Health
  • Prakash Chinnaiyan, Beaumont Health
  • Xiaoqiang Li, Beaumont Health
  • Xuanfeng Ding, Beaumont Health
Document Type
Article
Publication Date
12-22-2022
Disciplines
Abstract

Objective. Proton dosimetric uncertainties resulting from the patient's daily setup errors in rotational directions exist even with advanced image-guided radiotherapy techniques. Thus, we developed a new rotational robust optimization SPArc algorithm (SPArcrot) to mitigate the dosimetric impact of the rotational setup error in Raystation ver. 6.02 (RaySearch Laboratory AB, Stockholm, Sweden).Approach.The initial planning CT was rotated ±5° simulating the worst-case setup error in the roll direction. The SPArcrotuses a multi-CT robust optimization framework by taking into account of such rotational setup errors. Five cases representing different disease sites were evaluated. Both SPArcoriginaland SPArcrotplans were generated using the same translational robust optimized parameters. To quantitatively investigate the mitigation effect from the rotational setup errors, all plans were recalculated using a series of pseudo-CT with rotational setup error (±1°/±2°/±3°/±5°). Dosimetric metrics such as D98% of CTV, and 3D gamma analysis were used to assess the dose distribution changes in the target and OARs.Main results.The magnitudes of dosimetric changes in the targets due to rotational setup error were significantly reduced by the SPArcrotcompared to SPArc in all cases. The uncertainties of the max dose to the OARs, such as brainstem, spinal cord and esophagus were significantly reduced using SPArcrot. The uncertainties of the mean dose to the OARs such as liver and oral cavity, parotid were comparable between the two planning techniques. The gamma passing rate (3%/3 mm) was significantly improved for CTV of all tumor sites through SPArcrot.Significance.Rotational setup error is one of the major issues which could lead to significant dose perturbations. SPArcrotplanning approach can consider such rotational error from patient setup or gantry rotation error by effectively mitigating the dose uncertainties to the target and in the adjunct series OARs.

DOI
10.1088/1361-6560/aca874
PubMed ID
36546347
Citation Information
Chang S, Liu G, Zhao L, Zheng W, Yan D, Chen P, et al. [Deraniyagala R, Stevens C, Grills I, Chinnaiyan P, Li X, Ding X] Introduce a rotational robust optimization framework for spot-scanning proton arc (SPArc) therapy. Phys Med Biol. 2022 Dec 22;68(1). doi: 10.1088/1361-6560/aca874. PMID: 36546347.