Evaluation of residual abdominal tumour motion in carbon ion gated treatments through respiratory motion modelling |
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| Institution: | 1. Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Pizza Leonardo da Vinci 32, I-20133 Milano, Italy;2. Centro Nazionale di Adroterapia Oncologica, Strada privata Campeggi 53, I-27100 Pavia, Italy;3. Istituto Europeo di Oncologia, via Ripamonti 435, I-20100 Milano, Italy;1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas;2. Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas;3. Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas;4. Department of Radiation Oncology, University of Southern California Keck School of Medicine, Los Angeles, California;1. Division of Imaging Sciences and Biomedical Engineering, King’s College London, London, UK;2. Centre for Medical Image Computing, University College London, London, UK;3. Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, UK;1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas;2. Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas;3. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas;4. Department of Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas;1. Department of Radiation Oncology, St Jude Children''s Research Hospital, Memphis, Tennessee;2. Department of Biostatistics, St Jude Children''s Research Hospital, Memphis, Tennessee;1. Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy;2. National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy;3. Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy |
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| Abstract: | At the Italian National Centre for Oncologic Hadrontherapy (CNAO) patients with upper-abdominal tumours are being treated with carbon ion therapy, adopting the respiratory gating technique in combination with layered rescanning and abdominal compression to mitigate organ motion. Since online imaging of the irradiated volume is not feasible, this study proposes a modelling approach for the estimation of residual motion of the target within the gating window. The model extracts a priori respiratory motion information from the planning 4DCT using deformable image registration (DIR), then combines such information with the external surrogate signal recorded during dose delivery. This provides estimation of a CT volume corresponding to any given respiratory phase measured during treatment. The method was applied for the retrospective estimation of tumour residual motion during irradiation, considering 16 patients treated at CNAO with the respiratory gating protocol. The estimated tumour displacement, calculated with respect to the reference end-exhale position, was always limited (average displacement is 0.32 ± 0.65 mm over all patients) and below the maximum motion defined in the treatment plan. This supports the hypothesis of target position reproducibility, which is the crucial assumption in the gating approach. We also demonstrated the use of the model as a simulation tool to establish a patient-specific relationship between residual motion and the width of the gating window. In conclusion, the implemented method yields an estimation of the repeatability of the internal anatomy configuration during gated treatments, which can be used for further studies concerning the dosimetric impact of the estimated residual organ motion. |
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| Keywords: | Motion modelling 4DCT Deformable image registration Gating Particle therapy |
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