TY - JOUR
T1 - Liquid fiducial marker applicability in proton therapy of locally advanced lung cancer
AU - Scherman Rydhög, Jonas
AU - Perrin, Rosalind
AU - Jølck, Rasmus Irming
AU - Gagnon-Moisan, Francis
AU - Larsen, Klaus Richter
AU - Clementsen, Paul
AU - Riisgaard de Blanck, Steen
AU - Fredberg Persson, Gitte
AU - Weber, Damien Charles
AU - Lomax, Tony
AU - Andresen, Thomas Lars
AU - Munck Af Rosenschold, Per
N1 - Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - BACKGROUND AND PURPOSE: We investigated the clinical applicability of a novel liquid fiducial marker (LFM) for image-guided pencil beam scanned (PBS) proton therapy (PBSPT) of locally advanced lung cancer (LALC).MATERIALS AND METHODS: The relative proton stopping power (RSP) of the LFM was calculated and measured. Dose perturbations of the LFM and three solid markers, in a phantom, were measured. PBSPT treatment planning on computer tomography scans of five patients with LALC with the LFM implanted was performed with 1-3 fields.RESULTS: The RSP was experimentally determined to be 1.164 for the LFM. Phantom measurements revealed a maximum relative deviation in dose of 4.8% for the LFM in the spread-out Bragg Peak, compared to 12-67% for the solid markers. Using the experimentally determined RSP, the maximum proton range error introduced by the LFM is about 1mm. If the marker was displaced at PBSPT, the maximum dosimetric error was limited to 2 percentage points for 3-field plans.CONCLUSION: The dose perturbations introduced by the LFM were considerably smaller than the solid markers investigated. The RSP of the fiducial marker should be corrected in the treatment planning system to avoid errors. The investigated LFM introduced clinically acceptable dose perturbations for image-guided PBSPT of LALC.
AB - BACKGROUND AND PURPOSE: We investigated the clinical applicability of a novel liquid fiducial marker (LFM) for image-guided pencil beam scanned (PBS) proton therapy (PBSPT) of locally advanced lung cancer (LALC).MATERIALS AND METHODS: The relative proton stopping power (RSP) of the LFM was calculated and measured. Dose perturbations of the LFM and three solid markers, in a phantom, were measured. PBSPT treatment planning on computer tomography scans of five patients with LALC with the LFM implanted was performed with 1-3 fields.RESULTS: The RSP was experimentally determined to be 1.164 for the LFM. Phantom measurements revealed a maximum relative deviation in dose of 4.8% for the LFM in the spread-out Bragg Peak, compared to 12-67% for the solid markers. Using the experimentally determined RSP, the maximum proton range error introduced by the LFM is about 1mm. If the marker was displaced at PBSPT, the maximum dosimetric error was limited to 2 percentage points for 3-field plans.CONCLUSION: The dose perturbations introduced by the LFM were considerably smaller than the solid markers investigated. The RSP of the fiducial marker should be corrected in the treatment planning system to avoid errors. The investigated LFM introduced clinically acceptable dose perturbations for image-guided PBSPT of LALC.
KW - Fiducial Markers
KW - Humans
KW - Lung Neoplasms
KW - Phantoms, Imaging
KW - Proton Therapy
KW - Radiotherapy Dosage
KW - Radiotherapy Planning, Computer-Assisted
KW - Tomography, X-Ray Computed
KW - Journal Article
U2 - 10.1016/j.radonc.2016.12.027
DO - 10.1016/j.radonc.2016.12.027
M3 - Journal article
C2 - 28104299
SN - 0167-8140
VL - 122
SP - 393
EP - 399
JO - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
JF - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
IS - 3
ER -
