Highly efficient and sensitive patient-specific quality assurance for spot-scanned proton therapy

Autor: Chris Beltran, Keith M. Furutani, Michael G. Herman, H. Wan Chan Tseung, Thomas J. Whitaker, Jon J. Kruse, Jedediah E. Johnson, Daniel W. Mundy
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Patient-Specific Modeling
Statistical methods
Quality Assurance
Health Care
Computer science
medicine.medical_treatment
Systems Engineering
Monte Carlo method
Cancer Treatment
030218 nuclear medicine & medical imaging
0302 clinical medicine
Planned Dose
Neoplasms
Medicine and Health Sciences
Proton Therapy
Radiation treatment planning
Multidisciplinary
Pharmaceutics
Physics
Applied Mathematics
Simulation and Modeling
Statistics
Radiotherapy Dosage
Oncology
030220 oncology & carcinogenesis
Physical Sciences
Engineering and Technology
Medicine
Protons
Algorithms
Elementary Particles
Research Article
Clinical Oncology
Science
Radiation Therapy
Research and Analysis Methods
Imaging phantom
03 medical and health sciences
DICOM
Dose Prediction Methods
Histogram
medicine
Humans
Engines
Particle Physics
Proton therapy
Simulation
Nuclear Physics
Nucleons
Retrospective Studies
Photons
business.industry
Mechanical Engineering
Radiotherapy Planning
Computer-Assisted
Data set
Radiation therapy
Mathematical and statistical techniques
Clinical Medicine
business
Quality Assurance
Quality assurance
Mathematics
Zdroj: PLoS ONE, Vol 14, Iss 2, p e0212412 (2019)
PLoS ONE
ISSN: 1932-6203
Popis: The purpose of this work was to develop an end-to-end patient-specific quality assurance (QA) technique for spot-scanned proton therapy that is more sensitive and efficient than traditional approaches. The patient-specific methodology relies on independently verifying the accuracy of the delivered proton fluence and the dose calculation in the heterogeneous patient volume. A Monte Carlo dose calculation engine, which was developed in-house, recalculates a planned dose distribution on the patient CT data set to verify the dose distribution represented by the treatment planning system. The plan is then delivered in a pre-treatment setting and logs of spot position and dose monitors, which are integrated into the treatment nozzle, are recorded. A computational routine compares the delivery log to the DICOM spot map used by the Monte Carlo calculation to ensure that the delivered parameters at the machine match the calculated plan. Measurements of dose planes using independent detector arrays, which historically are the standard approach to patient-specific QA, are not performed for every patient. The nozzle-integrated detectors are rigorously validated using independent detectors in regular QA intervals. The measured data are compared to the expected delivery patterns. The dose monitor reading deviations are reported in a histogram, while the spot position discrepancies are plotted vs. spot number to facilitate independent analysis of both random and systematic deviations. Action thresholds are linked to accuracy of the commissioned delivery system. Even when plan delivery is acceptable, the Monte Carlo second check system has identified dose calculation issues which would not have been illuminated using traditional, phantom-based measurement techniques. The efficiency and sensitivity of our patient-specific QA program has been improved by implementing a procedure which independently verifies patient dose calculation accuracy and plan delivery fidelity. Such an approach to QA requires holistic integration and maintenance of patient-specific and patient-independent QA.
Databáze: OpenAIRE
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