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A novel dose-based positioning method for CT image-guided proton therapy
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Image of FIG. 1.
FIG. 1.

Planned dose distribution and beam angles for patient 1.

Image of FIG. 2.
FIG. 2.

Workflow diagram for the dose-based alignment method compared to the current IGRT workflow.

Image of FIG. 3.
FIG. 3.

Scatter plot and histogram of vector magnitude differences of the isocenter shifts comparing the dose-based alignments with the bony alignment and iGTV alignment.

Image of FIG. 4.
FIG. 4.

DVHs for the target (left) and ipsilateral lung (right) for patient 13. The anatomy-based and dose-based alignment DVHs are shown by the solid and dashed lines, respectively. The DVH bands show the extent of all of the dose calculations in the search space, with the lighter gray band corresponding to the calculated DVHs that did not meet the target coverage constraint and the darker gray bands showing the DVHs that did meet the constraint.

Image of FIG. 5.
FIG. 5.

An objective plot of the solution space of mean ipsilateral lung dose versus target . Calculated solutions are shown in the dots, with the doses for anatomy-based and optimized single-isocenter dose-based alignments shown in the red (lower) and green (upper) stars, respectively. The target coverage constraint is shown by the green dashed line (above the line is meeting the constraint), and the Pareto frontier (nondominated solutions) is shown by the solid red lines.

Image of FIG. 6.
FIG. 6.

Dose distributions for patient 13 for the (a) plan and the last weekly CT based on (b) bony-alignment, and (c) dose-alignment. The dose clouds between 95% and 110% prescription dose levels for the bony-alignment and dose-alignment methods are also presented in axial, coronal, sagittal viewing planes to illustrate target coverage and locations of underdosage.


Generic image for table

Tumor characteristics.

Generic image for table

Target (ITV) coverage requirement and mean ipsilateral lung dose.


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752b84549af89a08dbdd7fdb8b9568b5 journal.articlezxybnytfddd
Scitation: A novel dose-based positioning method for CT image-guided proton therapy