Dose-guided patient positioning in proton radiotherapy using multicriteria-optimization.

Dose-guided patient positioning in proton radiotherapy using multicriteria-optimization. Z Med Phys. 2018 Nov 05;: Authors: Kurz C, Süss P, Arnsmeyer C, Haehnle J, Teichert K, Landry G, Hofmaier J, Exner F, Hille L, Kamp F, Thieke C, Ganswindt U, Valentini C, Hölscher T, Troost E, Krause M, Belka C, Küfer KH, Parodi K, Richter C Abstract Proton radiotherapy (PT) requires accurate target alignment before each treatment fraction, ideally utilizing 3D in-room X-ray computed tomography (CT) imaging. Typically, the optimal patient position is determined based on anatomical landmarks or implanted markers. In the presence of non-rigid anatomical changes, however, the planning scenario cannot be exactly reproduced and positioning should rather aim at finding the optimal position in terms of the actually applied dose. In this work, dose-guided patient alignment, implemented as multicriterial optimization (MCO) problem, was investigated in the scope of intensity-modulated and double-scattered PT (IMPT and DSPT) for the first time. A method for automatically determining the optimal patient position with respect to pre-defined clinical goals was implemented. Linear dose interpolation was used to access a continuous space of potential patient shifts. Fourteen head and neck (H&N) and eight prostate cancer patients with up to five repeated CTs were included. Dose interpolation accuracy was evaluated and the potential dosimetric advantages of...
Source: Zeitschrift fur Medizinische Physik - Category: Radiology Authors: Tags: Z Med Phys Source Type: research