Physica Medica-European Journal of Medical Physics最新文献

{"title":"The application of radiomics in cancer imaging with a focus on lung cancer, renal cell carcinoma, gastrointestinal cancer, and head and neck cancer: A systematic review","authors":"Roberta Fusco ,&nbsp;Vincenza Granata ,&nbsp;Sergio Venanzio Setola ,&nbsp;Piero Trovato ,&nbsp;Roberta Galdiero ,&nbsp;Mauro Mattace Raso ,&nbsp;Francesca Maio ,&nbsp;Annamaria Porto ,&nbsp;Paolo Pariante ,&nbsp;Vincenzo Cerciello ,&nbsp;Eugenio Sorgente ,&nbsp;Biagio Pecori ,&nbsp;Mimma Castaldo ,&nbsp;Francesco Izzo ,&nbsp;Antonella Petrillo","doi":"10.1016/j.ejmp.2025.104891","DOIUrl":"10.1016/j.ejmp.2025.104891","url":null,"abstract":"<div><h3>Purpose</h3><div>To study the application of radiomics in cancer imaging with a focus on lung cancer, renal cell carcinoma, gastrointestinal cancer, and head and neck cancer.</div></div><div><h3>Methods</h3><div>Different electronic databases were considered. Articles published in the last five years were analyzed (January 2019 and December 2023). Papers were selected by two investigators with over 15 years of experience in Radiomics analysis in cancer imaging. The methodological quality of each radiomics study was performed using the Radiomic Quality Score (RQS) by two different readers in consensus and then by a third operator to solve disagreements between the two readers.</div></div><div><h3>Results</h3><div>19 articles are included in the review. Among the analyzed studies, only one study achieved an RQS of 18 reporting multivariable analyzes with also non-radiomics features and using the validation phase considering two datasets from two distinct institutes and open science and data domain.</div></div><div><h3>Conclusion</h3><div>This informative review has brought attention to the increasingly consolidated potential of Radiomics, although there are still several aspects to be evaluated before the transition to routine clinical practice. There are several challenges to address, including the need for standardization at all stages of the workflow and the potential for cross-site validation using heterogeneous real-world datasets. It will be necessary to establish and promote an imaging data acquisition protocol, conduct multicenter prospective quality control studies, add scanner differences and vendor-dependent characteristics; to collect images of individuals at additional time points, to report calibration statistics.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"130 ","pages":"Article 104891"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Configuration of Timepix3 read-out parameters for spectral measurements in proton therapy applications","authors":"Paulina Stasica-Dudek ,&nbsp;Cristina Oancea ,&nbsp;Carlos Granja ,&nbsp;Konrad Guguła ,&nbsp;Jan Jakubek ,&nbsp;Renata Kopeć ,&nbsp;Dawid Krzempek ,&nbsp;Michal Matous ,&nbsp;Antoni Rucinski ,&nbsp;Marzena Rydygier ,&nbsp;Jan Gajewski","doi":"10.1016/j.ejmp.2024.104885","DOIUrl":"10.1016/j.ejmp.2024.104885","url":null,"abstract":"<div><h3>Purpose:</h3><div>With the increasing use of proton therapy, there is a growing emphasis on including radiation quality, often quantified by linear energy transfer, as a treatment plan optimization factor. The Timepix detectors offer energy-sensitive particle tracking useful for the characterization of proton linear energy transfer. To improve the detector’s performance in mixed radiation fields produced in proton therapy, we customized the detector settings and performed the per-pixel energy calibration.</div></div><div><h3>Methods:</h3><div>The detection threshold and per-pixel signal shaping time (I<span><math><msub><mrow></mrow><mrow><mi>K</mi><mi>r</mi><mi>u</mi><mi>m</mi></mrow></msub></math></span> current) were customized, and energy calibration was performed for MiniPIX Timepix3. The detector calibration was verified using <span><math><mi>α</mi></math></span> source and clinical proton beams, as well as Monte Carlo simulations. The effects on the detector’s performance, in terms of spectral saturation and pixel occupancy, were evaluated.</div></div><div><h3>Results:</h3><div>Measurements with proton beams showed a good agreement with simulations. With the customized settings, the measurable energy range in the detector data-driven mode was extended, and the signal duration time was reduced by 80%, while the yield of pixel time occupancy reduction depends on the number of occupied pixels. For performed measurements with proton beams, the number of occupied pixels was further reduced up to 40% due to the increased threshold.</div></div><div><h3>Conclusions:</h3><div>Customized detector configuration of the Timepix3 detector allowed for reduced pixel occupancy and mitigation of signal saturation in a data-driven mode without significantly interfering with the energy deposition measurement. The presented approach enables the extension of the operational range, including higher intensities and mixed-radiation fields in particle radiotherapy environments.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"130 ","pages":"Article 104885"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A gender breakdown of unexpected benefits generated by work from home in STEM fields − A qualitative analysis of the WiMPBME Task Group survey","authors":"Eva Bezak ,&nbsp;Kelsey J. Sharrad ,&nbsp;Loredana G. Marcu ,&nbsp;Magdalena Stoeva ,&nbsp;Lenka Lhotska ,&nbsp;Gilda Barabino ,&nbsp;Fatimah Ibrahim ,&nbsp;Sierin Lim ,&nbsp;Eleni Kaldoudi ,&nbsp;Ana Maria Marques da Silva ,&nbsp;Peck Ha Tan ,&nbsp;Virginia Tsapaki ,&nbsp;Monique Frize","doi":"10.1016/j.ejmp.2025.104897","DOIUrl":"10.1016/j.ejmp.2025.104897","url":null,"abstract":"<div><h3>Background</h3><div>Working from home during the Covid-19 pandemic was perceived differently by men and women working in STEM fields. The aim of this paper is to highlight the unexpected benefits generated by working from home during the pandemic.</div></div><div><h3>Methods</h3><div>Qualitative methodology was used to analyze data, collected via survey. The survey designed and conducted by WiMPBME targeted both males and females working in medical-related STEM fields (physics and engineering) and was answered by 921 individuals from 76 countries across all continents. This report analysed the responses to one open-ended question of the survey, namely: “What is the one positive that you have learnt/experienced as a result of working from home during this pandemic?”.</div></div><div><h3>Results</h3><div>594 responded to the question of interest. Access to home office was reported by 72.2% of survey participants. Males were more likely than females to report no positives of working from home (62.9%). Females were more likely to cite quality time, physical and mental health as positive factors than males, and to mention children in their responses. The most commonly coded thematic unit for males was remote working, with many males reporting the feasibility of working from home. Increased work productivity, better time management and work organisation were other common themes highlighted by responders irrespective of gender.</div></div><div><h3>Conclusion</h3><div>The findings of the survey show the diversity of perceptions about remote working in STEM fields, while highlighting the importance of considering family dynamics, individual circumstances as well as gender when evaluating varied experiences of STEM professionals.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"130 ","pages":"Article 104897"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of the HollandPTC R&D proton beamline for physics and radiobiology studies","authors":"M. Rovituso ,&nbsp;C.F. Groenendijk ,&nbsp;E. van der Wal ,&nbsp;W. van Burik ,&nbsp;A. Ibrahimi ,&nbsp;H. Rituerto Prieto ,&nbsp;J.M.C. Brown ,&nbsp;U. Weber ,&nbsp;Y. Simeonov ,&nbsp;M. Fontana ,&nbsp;D. Lathouwers ,&nbsp;M. van Vulpen ,&nbsp;M. Hoogeman","doi":"10.1016/j.ejmp.2024.104883","DOIUrl":"10.1016/j.ejmp.2024.104883","url":null,"abstract":"<div><div>HollandPTC is an independent outpatient center for proton therapy, scientific research, and education. Patients with different types of cancer are treated with Intensity Modulated Proton Therapy (IMPT). Additionally, the HollandPTC R&amp;D consortium conducts scientific research into the added value and improvements of proton therapy. To this end, HollandPTC created clinical and pre-clinical research facilities including a versatile R&amp;D proton beamline for various types of biologically and technologically oriented research. In this work, we present the characterization of the R&amp;D proton beamline of HollandPTC. Its pencil beam mimics the one used for clinical IMPT, with energy ranging from 70 up to 240 MeV, which has been characterized in terms of shape, size, and intensity. For experiments that need a uniform field in depth and lateral directions, a dual ring passive scattering system has been designed, built, and characterized. With this system, field sizes between 2 × 2 cm² and 20 × 20 cm² with 98 % uniformity are produced with dose rates ranging from 0.5 Gy/min up to 9 Gy/min. The unique and customized support of the dual ring system allows switching between a pencil beam and a large field in a very simple and fast way, making the HollandPTC R&amp;D proton beam able to support a wide range of different applications.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"130 ","pages":"Article 104883"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-time dose measurement in minibeam radiotherapy using radioluminescence imaging","authors":"Francesca Marson ,&nbsp;Stefano Pizzardi ,&nbsp;Lisa Alborghetti ,&nbsp;Federica Vurro ,&nbsp;Maria Assunta Lacavalla ,&nbsp;Claudio Fiorino ,&nbsp;Antonello E. Spinelli","doi":"10.1016/j.ejmp.2025.104894","DOIUrl":"10.1016/j.ejmp.2025.104894","url":null,"abstract":"<div><h3>Purpose:</h3><div>Minibeam radiotherapy (MBRT) uses small parallel beams of radiation to create a highly modulated dose pattern. The aim of this study is to develop an optical radioluminescence imaging (RLI) approach to perform real-time dose measurement for MBRT.</div></div><div><h3>Methods:</h3><div>MBRT was delivered using an image-guided small animal irradiator equipped with a custom collimator. Five slabs of plastic scintillators with a thicknesses of 0.5, 1, 2, 3 and 10 mm were placed on top of a mouse phantom, to localize and measure the delivered dose. A thin radioluminescence film (<span><math><mrow><mi>G</mi><msub><mrow><mi>d</mi></mrow><mrow><mn>2</mn></mrow></msub><msub><mrow><mi>O</mi></mrow><mrow><mn>2</mn></mrow></msub><mi>S</mi><mo>:</mo><mi>T</mi><mi>b</mi></mrow></math></span>) was used to obtain the mini beam dose profile that was compared against GafChromic (GC) films measurements. The RLI signal was detected with a CMOS camera placed at 90 deg with respect to the beam axis. Monte Carlo (MC) simulations were also performed using TOPAS for comparison with the experimental results.</div></div><div><h3>Results:</h3><div>The measured peak to valley dose ratio (PVDR) obtained with RLI was 16.7 in line with GC films measurements. The differences between peak and valley dimension were less that 3% with respect to GC measurements. Using RLI performed with the scintillator slabs, it was possible to localize and measure in real-time MBRT delivery on the mouse phantom.</div></div><div><h3>Conclusions:</h3><div>We proposed a novel method for MBRT dose localization and measurement in real-time based on RLI. The results we obtained are in good agreement with GC film measurements.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"130 ","pages":"Article 104894"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of the most appropriate radionuclide for knee radiosynovectomy: Assessment of radiation dose, radiation-induced cancer risk, and post-treatment imaging feasibility","authors":"Roghiyeh Bodaghi ,&nbsp;Babak Mahmoudian ,&nbsp;Hadi Rezaei ,&nbsp;Asra Sadat Talebi","doi":"10.1016/j.ejmp.2025.104903","DOIUrl":"10.1016/j.ejmp.2025.104903","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to systematically evaluate all radionuclides used in knee RSV to date and identify the most suitable radionuclide for knee RSV.</div></div><div><h3>Methods</h3><div>To compare knee RSV with Y-90, P-32, Ho-166, Re-188, Au-198, Lu-177, Sm-153, and Re-186, we measured the radiation dose to non-target organs and the inducing of secondary malignancies in knee RSV patient, the radiation dose to family member and medical staff from the knee RSV patients, and the quality of post-treatment images.</div></div><div><h3>Results</h3><div>The Lifetime Attributable Risks of cancer incidence and mortality and the Relative Risks of solid cancer incidence and mortality are significantly higher for Y-90 and P-32 in both adult and pediatric patients compared to other radionuclides used in knee RSV. Knee RSV with Re-188, Ho-166, Au-198, and Sm-153 induces a negligible risk of secondary malignancies. The average absorbed dose for medical staff and family members exposed to patients treated with Y-90 is also significantly greater than for those exposed to RSV patients treated with other radionuclides. In contrast, the absorbed dose for medical staff and family members exposed to RSV patients treated with Sm-153, Ho-166, and Au-198 is negligible. Sm-153, Ho-166, and Re-188 offer high-quality images in post-RSV planar imaging.</div></div><div><h3>Conclusion</h3><div>Based on the findings of this study and the therapeutic range of the radionuclides, Re-188 has been identified as a suitable alternative to Y-90 for knee RSV in adults. At the same time, Sm-153 and Ho-166 have been recognized as the most appropriate radionuclides for pediatric knee RSV.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"130 ","pages":"Article 104903"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic base-dose planning for a robust field junction in total marrow irradiation","authors":"Nicola Lambri ,&nbsp;Damiano Dei ,&nbsp;Ricardo Coimbra Brioso ,&nbsp;Leonardo Crespi ,&nbsp;Daniele Loiacono ,&nbsp;Marta Scorsetti ,&nbsp;Pietro Mancosu","doi":"10.1016/j.ejmp.2025.104898","DOIUrl":"10.1016/j.ejmp.2025.104898","url":null,"abstract":"<div><h3>Purpose</h3><div>Total marrow (lymph-node) irradiation (TMI/TMLI) is a radiotherapy technique irradiating the whole body of a patient. The limited couch travel range in modern linacs (130–150 cm) forces to split the TMI/TMLI delivery into two plans with opposite orientation. A dedicated field junction is necessary to achieve satisfactory target coverage in the overlapping region of the two plans. In a recent study, we implemented an automatic tool (AT) using the Eclipse Scripting API for the creation of a field junction and optimization of TMI/TMLI. In this work, we improved the AT by developing an automatic base-dose planning approach.</div></div><div><h3>Methods</h3><div>Ten patients were selected to compare the manual procedure, original automatic planning approach, and new base-dose approach. Treatment plans were evaluated with the D98%, D_mean, and D2% for the planning target volume at the junction (PTV_J), while D_mean and D2% were considered for the PTV without the junction (PTVNoJ) and healthy tissues.</div></div><div><h3>Results</h3><div>Base-dose planning significantly improved the PTV_J coverage compared with the manual approach, with unaltered D_mean, consistently lower D2% (2.24 Gy vs. 2.30 Gy) and higher D98% (1.98 Gy vs. 1.89 Gy). Moreover, it significantly reduced the hotspots in healthy tissues (2.02 Gy vs. 2.15 Gy). No significant differences for PTVNoJ dose statistics were observed among the procedures, demonstrating that the automatic approaches produced a target coverage similar to the one obtained manually.</div></div><div><h3>Conclusions</h3><div>Base-dose planning improved the field junction optimization of TMI/TMLI. Automatic planning tools can incrementally improve procedures that would be challenging or error-prone to achieve manually.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"130 ","pages":"Article 104898"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Task transfer function measurement of monoenergetic CT in energy-integrated detector CT and photon-counting detector CT, based on tasks using iodinated rod and wire phantoms","authors":"Kazuya Ohashi ,&nbsp;Katsuhiro Ichikawa ,&nbsp;Nobuo Kitera ,&nbsp;Seita Watanabe ,&nbsp;Hiroki Kawashima ,&nbsp;Tatsuya Kawai ,&nbsp;Akio Hiwatashi","doi":"10.1016/j.ejmp.2025.104920","DOIUrl":"10.1016/j.ejmp.2025.104920","url":null,"abstract":"<div><h3>Purpose</h3><div>When evaluating the task transfer function (TTF) of monoenergetic (MonoE) CT applying energy-domain noise reduction (EDNR), special caution should be exercised on the task size because of the low-pass filtering (LPF) process involved. The purpose of this study was to evaluate TTFs at MonoE at 40 keV compared with those at polyenergy (PolyE) at 120 kV.</div></div><div><h3>Methods</h3><div>A rod (diameter: 30 mm) or wire (diameter: 1 mm) phantom made of a material equivalent to 12-mg/ml diluted iodine (IROD or IW, respectively) was placed in a 210-mm water phantom and scanned at a radiation dose corresponding to a head CT angiography protocol, using an energy-integrated detector CT (EID-CT) system and a photon-counting detector CT (PCD-CT) system. TTFs for IROD and IW were measured using the circular edge (CE) method and a method typically used with the traditional wire method (IW method), respectively.</div></div><div><h3>Results</h3><div>For EID-CT, TTF by the CE method was lower (25 % for 50 %TTF) for MonoE than for PolyE, whereas, by the IW method, the difference was minimal. The ratio of MonoE’s CT number to PolyE’s was, however, markedly lower with IW than with IROD, reflecting the CT number manipulation in EDNR. For PCD-CT, both the differences in TTF and in CT number were negligible between MonoE and PolyE.</div></div><div><h3>Conclusions</h3><div>With EDNR, PCD-CT was better than EID-CT because it avoids reduction in CT number at MonoE for small objects. When measuring TTF with EID-CT, the CT number reduction in low energy MonoE should be taken into consideration.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"130 ","pages":"Article 104920"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143161470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aims & Scope & Editorial Board","authors":"","doi":"10.1016/S1120-1797(25)00036-5","DOIUrl":"10.1016/S1120-1797(25)00036-5","url":null,"abstract":"","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"130 ","pages":"Article 104926"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143308459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton therapy of lung cancer patients – Treatment strategies and clinical experience from a medical physicist’s perspective","authors":"Vicki Trier Taasti,&nbsp;Esther Kneepkens,&nbsp;Judith van der Stoep,&nbsp;Marije Velders,&nbsp;Maud Cobben,&nbsp;Anouk Vullings,&nbsp;Janou Buck,&nbsp;Femke Visser,&nbsp;Maud van den Bosch,&nbsp;Djoya Hattu,&nbsp;Jolein Mannens,&nbsp;Lieke in ’t Ven,&nbsp;Dirk de Ruysscher,&nbsp;Judith van Loon,&nbsp;Stephanie Peeters,&nbsp;Mirko Unipan,&nbsp;Ilaria Rinaldi","doi":"10.1016/j.ejmp.2024.104890","DOIUrl":"10.1016/j.ejmp.2024.104890","url":null,"abstract":"<div><h3>Purpose</h3><div>Proton therapy of moving targets is considered a challenge. At Maastro, we started treating lung cancer patients with proton therapy in October 2019. In this work, we summarise the developed treatment strategies and gained clinical experience from a physics point of view.</div></div><div><h3>Methods</h3><div>We report on our clinical approaches to treat lung cancer patients with the Mevion Hyperscan S250i proton machine. We classify lung cancer patients as small movers (tumour movement ≤ 5 mm) or large movers (tumour movement &gt; 5 mm). The preferred beam configuration has evolved over the years of clinical treatment, and currently mostly two or three beam directions are used. All patients are treated with robustly optimised plans (5 mm setup and 3% range uncertainty). Small movers are planned based on a clinical target volume (CTV) with a 3 mm isotropic margin expansion to account for motion, while large movers are planned based on an internal target volume (ITV). All patients are treated in free-breathing.</div></div><div><h3>Results</h3><div>Between October 2019 and December 2023, 379 lung cancer patients have been treated, of which 130 were large movers. The adaptation rate was 28%. The median treatment time has been reduced from 30 to 23 min. The mean dose to the heart, oesophagus, and lungs was on average 4.3, 15.4, and 11.0 Gy, respectively.</div></div><div><h3>Conclusions</h3><div>Several treatment planning and workflow improvements have been introduced over the years, resulting in an increase of treatment quality and number of treated patients, as well as reduction of planning and treatment time.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"130 ","pages":"Article 104890"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}