Richard Amos (UCH)

46 Pages·2014·3.21 MB·English

by  Richard Amos

Clinical delivery of state-of-the-art
proton therapy for moving targets

Richard A. Amos,
MSc, FIPEM

Operational Lead for Proton Beam Therapy Physics
Dept. of Radiotherapy Physics, UCLH

Honorary Senior Lecturer
Dept. of Medical Physics & Biomedical Engineering, UCL

4D Treatment Planning Workshop
November 28th, 2014
Why Proton Beam Radiotherapy ?
2

Range probe / proton radiography
•Possible prior, during and after field delivery
•pCT only possible pre- or post-delivery

Prompt gamma
•Prompt γ emission within nanoseconds
•Only applicable for on-line range verification

PET
•Possible on-line, or short time after irradiation
•Biological wash-out can be an issue

MRI
•Retrospective range verification as a function
of tissue change.
FY'12 Proton NTS Through May
PBT patient mix (2012)
32, 5%
47, 7%
Other 142, 22%
HN
5%
7% FY’12
PED/CNS
Annualized
22%
PEDI/CNS 191
GU 311
THORACIC 261
THORACIC
195, 30% 30% HN 63
OTHER 32
GU
TOTAL 857
36%
242, 36%
PEDI/CNS GU THOR HN Other
Passive Scatter Proton Dose with
Tumor Motion
(Yoshikazu Tsunashima)
Thoracic
Obtain 4D-CT data
Avg, MIP, and breathing phase data sets transferred to
Eclipse TPS, and all registered to the Avg. CT.
MedTec: Knee-and-Feet LokTM
Avg. CT
Contouring
Physician contours the iGTV one
of two ways:
• draw the iGTV on the MIP image
• draw the GTV on both end
inspiration (T ) and end expiration
0
(T ), and use the union of these
50
to create the iGTV
•PET fusion used also

Contouring on the MIP when the
GTV is adjacent to dense objects
is avoided

iGTV copied to average CT
dataset
Verify that the iGTV contour encompasses the GTV on all 10 phases of the
breathing cycle, and edit contour as necessary
T T T T T
0 10 20 30 40
T T T T T
50 60 70 80 90