Magnet-Free Proton Therapy with 4D Pencil Beam Delivery Optimisation
无磁铁质子治疗与四维笔形束递送优化
Nair N von Muehlenen, Florentin Bieder, Ye Zhang, Philippe C Cattin
AI总结 提出一种四维笔形束递送策略,通过将呼吸运动纳入动态治疗计划,在无磁铁和无机架配置下实现移动肿瘤的质子治疗,并评估其剂量适形性和治疗效率。
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目的. 运动管理是移动肿瘤质子治疗中的关键挑战。本研究旨在开发并评估一种新颖的四维(4D)笔形束递送策略,该策略将呼吸运动纳入动态治疗计划,以提高剂量适形性和治疗效率。方法. 为评估此4D笔形束递送策略,使用了移动体模。生成的4D治疗计划在各种扫描仪配置下进行评估,包括无机架和无磁铁扫描头。对于每种设置,量化了治疗时间、剂量适形性以及对不规则呼吸模式的鲁棒性。评估了扫描头设计和患者特异性运动不规则性对整体计划质量的影响。主要结果. 4D规划工具生成的计划在所有配置下均实现了临床可接受的剂量分布。在无磁铁配置中,静态束流操作显著增加了治疗时间并降低了剂量适形性。相比之下,使用单个扫描磁铁且无机架的配置在可接受的治疗时间内保持了适形性。意义. 所提出的4D递送策略展示了使用简化的无机架和无磁铁扫描头设计治疗移动目标的可行性。通过将患者呼吸与4D递送同步,可进一步改善不规则或中断呼吸期间的剂量准确性。通过降低系统复杂性同时保持剂量学性能,该方法为运动影响肿瘤的质子治疗提供了一条更易获得且成本效益更高的途径。
Objective. Motion management is a critical challenge in proton therapy for mobile tumours. This study aims to develop and evaluate a novel four-dimensional (4D) pencil beam delivery strategy that incorporates respiratory motion into a dynamic treatment plan to improve dose conformity and treatment efficiency. Approach. To assess this 4D pencil beam delivery strategy, a mobile phantom was used. The generated 4D treatment plans were assessed with various scanner configurations, including gantry-free and magnet-free scanner heads. For each setup, the treatment time, dose conformity, and robustness against irregular breathing patterns were quantified. The influence of scanner head design and patient-specific motion irregularities on overall plan quality was evaluated. Main Results. The 4D planning tool generated treatment plans that achieved clinically acceptable dose distributions across all configurations. In magnet-free configurations, static beam operation substantially increased treatment time and reduced dose conformity. In contrast, configurations using a single scanner magnet, without a gantry, maintained acceptable conformity within practical treatment times. Significance. The proposed 4D delivery strategy demonstrates feasibility for treating mobile targets with simplified, gantry-free and magnet-free scanner designs. Further improvements could be achieved by synchronising the patient's breathing with 4D delivery, which may enhance dose accuracy during irregular or interrupted breathing. By reducing system complexity while preserving dosimetric performance, this approach offers a pathway toward more accessible and cost-effective proton beam therapy for motion-affected tumours.