Proton Treatment Planning

The differences between planning proton-beam therapy and photon-beam therapy derive from the differences in the physics of protons and photons, namely [1]: That protons have a finite and controllable (through choice of energy) penetration in depth with vi

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Proton Treatment Planning Chuan Zeng, Richard A. Amos, Brian Winey, Chris Beltran, Ziad Saleh, Zelig Tochner, Hanne Kooy, and Stefan Both

Contents 3.1  D  ifferences Between Photon and Proton Treatment Planning....................................... 46 3.1.1  Physics................................................................................................................ 48 3.1.2  Geometric Uncertainties, Range Uncertainty, and the PTV Concept................. 49 3.1.3  Particularities of the Delivery System Proton Versus Photon............................. 52

C. Zeng Procure Proton Therapy Center, Sumerset, NJ, USA e-mail: [email protected] R.A. Amos University College London, London, UK e-mail: [email protected] B. Winey • H. Kooy Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA e-mail: [email protected]; [email protected] C. Beltran Mayo Clinic, Rochester, MI, USA e-mail: [email protected] Z. Saleh Memorial Sloan-Kettering Cancer Center, New York, NY, USA e-mail: [email protected] S. Both (*) Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands e-mail: [email protected] Z. Tochner University of Pennsylvania, Philadelphia, PA, USA e-mail: [email protected] © Springer International Publishing Switzerland 2018 N. Lee et al. (eds.), Target Volume Delineation and Treatment Planning for Particle Therapy, Practical Guides in Radiation Oncology, https://doi.org/10.1007/978-3-319-42478-1_3

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3.2  P  roton-Specific Treatment Simulation and Immobilization Principles.......................... 53 3.2.1  CT Protocol, 4D CT, DIBH, DECT, and Contrast/Non-contrast CT.................. 53 3.2.2  Materials and Positioning in the Beam............................................................... 58 3.2.3  PET/MR Imaging................................................................................................ 61 3.2.4  Image Registration and Fusion........................................................................... 61 3.3  Anatomy Modeling, Overrides, CT, Average CT, and MIP........................................... 65 3.3.1  Artifact Reduction............................................................................................... 65 3.3.2  Delineation and CT Number Override................................................................ 66 3.4  Anatomy Modeling......................................................................................................... 67 3.4.1  4D CT.................................................................................................................. 67 3.5  Beam Design Characteristics.......................................................................................... 70 3.5.1  Passive Scattering................................................................................................ 70 3.5.2  Pencil-Beam Scanning.......................................................................................