Range uncertainties in proton therapy and the role of Monte Carlo simulations
By Harald Paganetti. Physics in Medicine and Biology, 2012
1,201 citations recorded by the source corpus.
The main advantages of proton therapy are the reduced total energy deposited in the patient as compared to photon techniques and the finite range of the proton beam. The latter adds an additional degree of freedom to treatment planning. The range in tissue is associated with considerable uncertainties caused by imaging, patient setup, beam delivery and dose calculation. Reducing the uncertainties would allow a reduction of the treatment volume and thus allow a better utilization of the advantages of protons. This paper summarizes the role of Monte Carlo simulations when aiming at a reduction of range uncertainties in proton therapy. Differences in dose calculation when comparing Monte Carlo with analytical algorithms are analyzed as well as range uncertainties due to material constants and CT conversion. Range uncertainties due to biological effects and the role of Monte Carlo for in vivo range verification are discussed. Furthermore, the current range uncertainty recipes used at several proton therapy facilities are revisited. We conclude that a significant impact of Monte Carlo dose calculation can be expected in complex geometries where local range uncertainties due to multiple Coulomb scattering will reduce the accuracy of analytical algorithms. In these cases Monte Carlo techniques might reduce the range uncertainty by several mm.
Subfields: Pulmonary and Respiratory Medicine, Radiation
View Paper: https://www.semanticscholar.org/paper/63ae0bea9dd15d76aa56750589e281ad5970b686
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Citations in the corpus
- Relative biological effectiveness (RBE) values for proton beam therapy. Variations as a function of biological endpoint, dose, and linear energy transfer (2014, background): “(f) Delivery uncertainties in proton therapy are being reduced based on research in many areas, potentially leading to a reduction in margins, which in turn might expose RBE variations (Paganetti 2012, Carabe et al 2012, Schuemann et al 2014).”