Evaluation of a non-metallic dual-port expander for intensity modulated proton therapy

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics Pub Date : 2024-09-23 DOI:10.1002/acm2.14512

Kristen McConnell, Zachary Fellows, James Kraus, Mauricio Acosta, Joseph Panoff, Eduardo Pons, Alonso Gutierrez, Andrew Wroe

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Abstract

Purpose

To provide a methodology for characterization of the technical properties of a newly developed non-metallic tissue expander for intensity modulated proton therapy.

Methods

Three tissue expanders (AlloX2-Pro: plastic-dual port, AlloX2: metal-dual port, and Dermaspan: metal-single port) were deconstructed, CT-scanned, and modeled in RayStation12A. A 165 MeV single spot was used to create RayStation dose planes, and the integrated depth dose profiles were calculated and the DR90 extracted to predict water equivalent thickness (WET). These predictions were compared to measurements taken with an IBA Giraffe MLIC. Native, water, and fully modelled overrides were compared for the AlloX2 Pro to quantify differences in override choices. Geometric considerations between expanders were compared using a ray-tracing technique to contour the “no-fly” zone around metallic components using a clinical, three beam arrangement. Lastly, a planning and evaluation framework was provided using a single plan as an illustration.

Results

The measured AlloX2-Pro WET values were within 0.22 cm of RayStation predictions while metallic values ranged from 0.08 to 0.46 cm. Using natively scanned density values for the AlloX2 Pro improved the discrepancy in WET between predicted and measured from −0.22 to −0.09 cm (drain) and from −0.17 to −0.12 cm (injection). The “no-fly” zone volume of all three beams reduced 95% between the AlloX2-Pro and Dermaspan, which geometrically allowed more uniform coverage behind the port and reduced need for beam modulation.

Conclusion

The beam perturbation of the AlloX2-Pro is well modeled, but improved agreement with measured WET values was observed when utilizing native densities in calculations. The AlloX2 Pro can support beam arrangements that traverse the ports, which can enable simpler beam geometry and a reduction in dose modulation around the port to promote improved robustness and treatment delivery quality.

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评估用于强度调制质子疗法的非金属双端口扩张器。

目的：提供一种用于强度调制质子疗法的新开发非金属组织扩张器技术特性的表征方法：对三种组织扩张器（AlloX2-Pro：塑料双端口、AlloX2：金属双端口和 Dermaspan：金属单端口）进行解构、CT 扫描并在 RayStation12A 中建模。使用 165 MeV 单光斑创建 RayStation 剂量平面，计算综合深度剂量曲线并提取 DR90 以预测水当量厚度 (WET)。这些预测结果与使用 IBA 长颈鹿 MLIC 进行的测量结果进行了比较。对 AlloX2 Pro 的原生、水和完全模拟覆盖进行了比较，以量化覆盖选择的差异。使用光线追踪技术，对扩张器之间的几何因素进行了比较，该技术使用临床三光束排列，对金属部件周围的 "禁飞 "区进行了轮廓分析。最后，以单个计划为例，提供了一个计划和评估框架：测量的 AlloX2-Pro WET 值与 RayStation 预测值相差 0.22 厘米，而金属值则在 0.08 至 0.46 厘米之间。使用 AlloX2 Pro 的原始扫描密度值，可将预测值与测量值之间的 WET 差异从 -0.22 厘米减小到 -0.09 厘米（排水），从 -0.17 厘米减小到 -0.12 厘米（注水）。AlloX2-Pro 与 Dermaspan 相比，三种光束的 "禁飞 "区体积减少了 95%，从几何角度看，这使得端口后的覆盖范围更加均匀，减少了对光束调制的需求：结论：AlloX2-Pro 的光束扰动建模良好，但在计算中使用本机密度时，与 WET 测量值的一致性有所提高。AlloX2 Pro 可支持横穿端口的射束排列，从而简化射束几何形状，减少端口周围的剂量调制，提高稳健性和治疗质量。

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来源期刊

Journal of Applied Clinical Medical Physics 医学-核医学

CiteScore

3.60

自引率

19.00%

发文量

331

审稿时长

3 months

期刊介绍： Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission. JACMP will publish: -Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500. -Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed. -Technical Notes: These should be no longer than 3000 words, including key references. -Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents. -Book Reviews: The editorial office solicits Book Reviews. -Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics. -Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic