Motion management with phase-adapted 4D-optimization

Omid Nohadani*, Joao Seco, Thomas Bortfeld

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Cancer treatment with ionizing radiation is often compromised by organ motion, in particular for lung cases. Motion uncertainties can significantly degrade an otherwise optimized treatment plan. We present a spatiotemporal optimization method, which takes into account all phases of breathing via the corresponding 4D-CTs and provides a 4D-optimal plan that can be delivered throughout all breathing phases. Monte Carlo dose calculations are employed to warrant for highest dosimetric accuracy, as pertinent to study motion effects in lung. We demonstrate the performance of this optimization method with clinical lung cancer cases and compare the outcomes to conventional gating techniques. We report significant improvements in target coverage and in healthy tissue sparing at a comparable computational expense. Furthermore, we show that the phase-adapted 4D-optimized plans are robust against irregular breathing, as opposed to gating. This technique has the potential to yield a higher delivery efficiency and a decisively shorter delivery time.

Original languageEnglish (US)
Pages (from-to)5189-5202
Number of pages14
JournalPhysics in Medicine and Biology
Volume55
Issue number17
DOIs
StatePublished - Sep 7 2010

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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