TH-CD-209-07: Preliminary Experimental Comparison of Spot- and Continuous Line Scanning with Or Without Rescanning for Gated Proton Therapy

Authors


Abstract

Purpose:

We aim to compare the performance of discrete spot- or continuous line scanning combined with rescanning in mitigating residual organ motion during gated proton therapy treatments.

Methods:

The Quasar respiratory phantom was used to move a 2D scintillation detector on a linear trajectory with sinusoidal motion pattern (sin4), 20 mm peak-to-peak amplitude and 5 sec period. Its motion was monitored using a customized solution based on optical tracking technology. We compared spot and line scanning plans for a monoenergetic 150 MeV circular field, 50.4 mm radius at isocenter. Transverse dose distributions at 13 cm depth in PMMA (15.47 mm water equivalent) were measured to compare three options for motion mitigation: rescanning (10× factor), gating and their combination. The gating window was centered in the trajectory plateau to simulate end-exhale gated treatment in presence of 2 mm and 4 mm residual motion, parallel or perpendicular to the primary scanning direction.

Results:

When the target moves perpendicular to the primary scanning direction, large dose deviations are measured (γ3%/3mm=47%) without mitigation techniques. Beam gating combined with rescanning restores target coverage (γ3%/3mm=91%). For parallel target motion, observed dose distortions in the non-compensated irradiation are smaller (γ3%/3mm=77%). Beam gating alone recovers the 100% gamma pass-rate at 3%/3mm. Continuous line scanning reduces delivery time by up to 60% with respect to discrete spot scanning in presence of motion mitigation, and improves homogeneity when rescanning is applied (up to 20%, perpendicular motion, 4 mm residual motion).

Conclusion:

The direction of motion has a large impact on the target dose coverage. Nevertheless, even in the worst case scenario, gating combined with rescanning could mitigate the impact of motion on dose deposition. Moreover, continuous line rescanning improves the robustness against residual motion in the gating window.

This study has received funding from the European Community's Seventh Framework Programme (FP7/2007–2013) under grant agreement n.290605 (PSI-FELLOW/COFUND) and ‘Giuliana and Giorgio Stefanini Foundation’

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