Fifty-eighth annual meeting of the american association of physicists in medicine
SU-G-TeP1-12: Random Repainting as Mitigation for Scanned Ion Beam Interplay Effects
Interference of dose application in scanned beam particle therapy and organ motion may lead to interplay effects with distorted dose to target volumes. Interplay effects depend on the speed and direction of the scanning beam, leading to fringed field edges (scanning parallel to organ motion direction) or over- and under-dosed regions (both directions are orthogonal). Current repainting methods can mitigate interplay effects, but are susceptible to artefacts when only a limited number of repaints are applied. In this study a random layered-repainting strategy was investigated.
Mono-energetic proton beams were irradiated to a 10 ×10 cm2 scanned field at a Varian ProBeam facility. Applied dose was measured with a 2D amorphous silicon detector mounted on a motion platform (CIRS dynamic platform). Motion was considered with different cycles, directions and translations up to ±8 mm. Dose distributions were measured for a static case, regular repainting (repeated meander-like path) and random repainting. Latter was realized by randomly distributing single spot locations during irradiation for a given number of repaints. Efficiency of repainting was analyzed by comparison to the static case. A simulation tool based on treatment logs and motion information was developed to compare measurement results to expected dose distributions.
Regular repainting could reduce motion artefacts, but dose distortion was strongly dependent on motion direction. Random repainting with same number of repaints (N=4) showed superior results, independent of target movement direction, while introducing slight penalty on delivery times, caused by an increase of overall scanning travel distance. The simulation tool showed good agreement to measured results.
The results demonstrate significant improvement in terms of dose conformity when layered repainting is applied in a randomized fashion. This allows for reduced target margins during treatment planning and limited number of repaints. A combination with e.g. respiratory gating is straight-forward.
Authors are employees of Varian Medical Systems Particle Therapy GmbH