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In-vivo range verification analysis with in-beam PET data for patients treated with proton therapy at CNAO

Authors :
Martina Moglioni
Aafke Christine Kraan
Guido Baroni
Giuseppe Battistoni
Nicola Belcari
Andrea Berti
Pietro Carra
Piergiorgio Cerello
Mario Ciocca
Angelica De Gregorio
Micol De Simoni
Damiano Del Sarto
Marco Donetti
Yunsheng Dong
Alessia Embriaco
Maria Evelina Fantacci
Veronica Ferrero
Elisa Fiorina
Marta Fischetti
Gaia Franciosini
Giuseppe Giraudo
Francesco Laruina
Davide Maestri
Marco Magi
Giuseppe Magro
Etesam Malekzadeh
Michela Marafini
Ilaria Mattei
Enrico Mazzoni
Paolo Mereu
Alfredo Mirandola
Matteo Morrocchi
Silvia Muraro
Ester Orlandi
Vincenzo Patera
Francesco Pennazio
Marco Pullia
Alessandra Retico
Angelo Rivetti
Manuel Dionisio Da Rocha Rolo
Valeria Rosso
Alessio Sarti
Angelo Schiavi
Adalberto Sciubba
Giancarlo Sportelli
Sara Tampellini
Marco Toppi
Giacomo Traini
Antonio Trigilio
Serena Marta Valle
Francesca Valvo
Barbara Vischioni
Viviana Vitolo
Richard Wheadon
Maria Giuseppina Bisogni
Source :
Frontiers in oncology (2022). doi:10.3389/fonc.2022.929949
Publication Year :
2022
Publisher :
Frontiers Editorial Office, Lausanne , Svizzera, 2022.

Abstract

Morphological changes that may arise through a treatment course are probably one of the most significant sources of range uncertainty in proton therapy. Non-invasive in-vivo treatment monitoring is useful to increase treatment quality. The INSIDE in-beam Positron Emission Tomography (PET) scanner performs in-vivo range monitoring in proton and carbon therapy treatments at the National Center of Oncological Hadrontherapy (CNAO). It is currently in a clinical trial (ID: NCT03662373) and has acquired in-beam PET data during the treatment of various patients. In this work we analyze the in-beam PET (IB-PET) data of eight patients treated with proton therapy at CNAO. The goal of the analysis is twofold. First, we assess the level of experimental fluctuations in inter-fractional range differences (sensitivity) of the INSIDE PET system by studying patients without morphological changes. Second, we use the obtained results to see whether we can observe anomalously large range variations in patients where morphological changes have occurred. The sensitivity of the INSIDE IB-PET scanner was quantified as the standard deviation of the range difference distributions observed for six patients that did not show morphological changes. Inter-fractional range variations with respect to a reference distribution were estimated using the Most-Likely-Shift (MLS) method. To establish the efficacy of this method, we made a comparison with the Beam’s Eye View (BEV) method. For patients showing no morphological changes in the control CT the average range variation standard deviation was found to be 2.5 mm with the MLS method and 2.3 mm with the BEV method. On the other hand, for patients where some small anatomical changes occurred, we found larger standard deviation values. In these patients we evaluated where anomalous range differences were found and compared them with the CT. We found that the identified regions were mostly in agreement with the morphological changes seen in the CT scan.

Details

Language :
English
ISSN :
03662373
Database :
OpenAIRE
Journal :
Frontiers in oncology (2022). doi:10.3389/fonc.2022.929949
Accession number :
edsair.doi.dedup.....32bb0a199932816c6aaf34ccc103e2f9
Full Text :
https://doi.org/10.3389/fonc.2022.929949