Streamlined pin‐ridge‐filter design for single‐energy proton FLASH planning

Background FLASH radiotherapy (FLASH‐RT) with ultra‐high dose rate has yielded promising results in reducing normal tissue toxicity while maintaining tumor control. Planning with single‐energy proton beams modulated by ridge filters (RFs) has been demonstrated feasible for FLASH‐RT. Purpose This stu...

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Published in:Medical physics (Lancaster) 2024-04, Vol.51 (4), p.2955-2966
Main Authors: Ma, Chaoqiong, Zhou, Jun, Chang, Chih‐Wei, Wang, Yinan, Patel, Pretesh R., Yu, David S., Tian, Sibo, Yang, Xiaofeng
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proton FLASH
single‐energy planning
streamlined ridge filter
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container_title Medical physics (Lancaster)
container_volume 51
creator Ma, Chaoqiong
Zhou, Jun
Chang, Chih‐Wei
Wang, Yinan
Patel, Pretesh R.
Yu, David S.
Tian, Sibo
Yang, Xiaofeng
description Background FLASH radiotherapy (FLASH‐RT) with ultra‐high dose rate has yielded promising results in reducing normal tissue toxicity while maintaining tumor control. Planning with single‐energy proton beams modulated by ridge filters (RFs) has been demonstrated feasible for FLASH‐RT. Purpose This study explored the feasibility of a streamlined pin‐shaped RF (pin‐RF) design, characterized by coarse resolution and sparsely distributed ridge pins, for single‐energy proton FLASH planning. Methods An inverse planning framework integrated within a treatment planning system was established to design streamlined pin RFs for single‐energy FLASH planning. The framework involves generating a multi‐energy proton beam plan using intensity‐modulated proton therapy (IMPT) planning based on downstream energy modulation strategy (IMPT‐DS), followed by a nested pencil‐beam‐direction‐based (PBD‐based) spot reduction process to iteratively reduce the total number of PBDs and energy layers along each PBD for the IMPT‐DS plan. The IMPT‐DS plan is then translated into the pin‐RFs and the single‐energy beam configurations for IMPT planning with pin‐RFs (IMPT‐RF). This framework was validated on three lung cases, quantifying the FLASH dose of the IMPT‐RF plan using the FLASH effectiveness model. The FLASH dose was then compared to the reference dose of a conventional IMPT plan to measure the clinical benefit of the FLASH planning technique. Results The IMPT‐RF plans closely matched the corresponding IMPT‐DS plans in high dose conformity (conformity index of
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Planning with single‐energy proton beams modulated by ridge filters (RFs) has been demonstrated feasible for FLASH‐RT. Purpose This study explored the feasibility of a streamlined pin‐shaped RF (pin‐RF) design, characterized by coarse resolution and sparsely distributed ridge pins, for single‐energy proton FLASH planning. Methods An inverse planning framework integrated within a treatment planning system was established to design streamlined pin RFs for single‐energy FLASH planning. The framework involves generating a multi‐energy proton beam plan using intensity‐modulated proton therapy (IMPT) planning based on downstream energy modulation strategy (IMPT‐DS), followed by a nested pencil‐beam‐direction‐based (PBD‐based) spot reduction process to iteratively reduce the total number of PBDs and energy layers along each PBD for the IMPT‐DS plan. The IMPT‐DS plan is then translated into the pin‐RFs and the single‐energy beam configurations for IMPT planning with pin‐RFs (IMPT‐RF). This framework was validated on three lung cases, quantifying the FLASH dose of the IMPT‐RF plan using the FLASH effectiveness model. The FLASH dose was then compared to the reference dose of a conventional IMPT plan to measure the clinical benefit of the FLASH planning technique. Results The IMPT‐RF plans closely matched the corresponding IMPT‐DS plans in high dose conformity (conformity index of &lt;1.2), with minimal changes in V7Gy and V7.4 Gy for the lung (&lt;3%) and small increases in maximum doses (Dmax) for other normal structures (&lt;3.4 Gy). Comparing the FLASH doses to the doses of corresponding IMPT‐RF plans, drastic reductions of up to nearly 33% were observed in Dmax for the normal structures situated in the high‐to‐moderate‐dose regions, while negligible changes were found in Dmax for normal structures in low‐dose regions. Positive clinical benefits were seen in comparing the FLASH doses to the reference doses, with notable reductions of 21.4%–33.0% in Dmax for healthy tissues in the high‐dose regions. However, in the moderate‐to‐low‐dose regions, only marginal positive or even negative clinical benefit for normal tissues were observed, such as increased lung V7Gy and V7.4 Gy (up to 17.6%). Conclusions A streamlined pin‐RF design was developed and its effectiveness for single‐energy proton FLASH planning was validated, revealing positive clinical benefits for the normal tissues in the high dose regions. The coarsened design of the pin‐RF demonstrates potential advantages, including cost efficiency and ease of adjustability, making it a promising option for efficient production.</description><identifier>ISSN: 0094-2405</identifier><identifier>EISSN: 2473-4209</identifier><identifier>DOI: 10.1002/mp.16939</identifier><identifier>PMID: 38214381</identifier><language>eng</language><publisher>United States</publisher><subject>proton FLASH ; single‐energy planning ; streamlined ridge filter</subject><ispartof>Medical physics (Lancaster), 2024-04, Vol.51 (4), p.2955-2966</ispartof><rights>2024 American Association of Physicists in Medicine.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3219-e758d9cf601765309b0648def13a2e1166e7a6a09aa72aca184ca883b3b2cd6e3</citedby><cites>FETCH-LOGICAL-c3219-e758d9cf601765309b0648def13a2e1166e7a6a09aa72aca184ca883b3b2cd6e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38214381$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ma, Chaoqiong</creatorcontrib><creatorcontrib>Zhou, Jun</creatorcontrib><creatorcontrib>Chang, Chih‐Wei</creatorcontrib><creatorcontrib>Wang, Yinan</creatorcontrib><creatorcontrib>Patel, Pretesh R.</creatorcontrib><creatorcontrib>Yu, David S.</creatorcontrib><creatorcontrib>Tian, Sibo</creatorcontrib><creatorcontrib>Yang, Xiaofeng</creatorcontrib><title>Streamlined pin‐ridge‐filter design for single‐energy proton FLASH planning</title><title>Medical physics (Lancaster)</title><addtitle>Med Phys</addtitle><description>Background FLASH radiotherapy (FLASH‐RT) with ultra‐high dose rate has yielded promising results in reducing normal tissue toxicity while maintaining tumor control. Planning with single‐energy proton beams modulated by ridge filters (RFs) has been demonstrated feasible for FLASH‐RT. Purpose This study explored the feasibility of a streamlined pin‐shaped RF (pin‐RF) design, characterized by coarse resolution and sparsely distributed ridge pins, for single‐energy proton FLASH planning. Methods An inverse planning framework integrated within a treatment planning system was established to design streamlined pin RFs for single‐energy FLASH planning. The framework involves generating a multi‐energy proton beam plan using intensity‐modulated proton therapy (IMPT) planning based on downstream energy modulation strategy (IMPT‐DS), followed by a nested pencil‐beam‐direction‐based (PBD‐based) spot reduction process to iteratively reduce the total number of PBDs and energy layers along each PBD for the IMPT‐DS plan. The IMPT‐DS plan is then translated into the pin‐RFs and the single‐energy beam configurations for IMPT planning with pin‐RFs (IMPT‐RF). This framework was validated on three lung cases, quantifying the FLASH dose of the IMPT‐RF plan using the FLASH effectiveness model. The FLASH dose was then compared to the reference dose of a conventional IMPT plan to measure the clinical benefit of the FLASH planning technique. Results The IMPT‐RF plans closely matched the corresponding IMPT‐DS plans in high dose conformity (conformity index of &lt;1.2), with minimal changes in V7Gy and V7.4 Gy for the lung (&lt;3%) and small increases in maximum doses (Dmax) for other normal structures (&lt;3.4 Gy). Comparing the FLASH doses to the doses of corresponding IMPT‐RF plans, drastic reductions of up to nearly 33% were observed in Dmax for the normal structures situated in the high‐to‐moderate‐dose regions, while negligible changes were found in Dmax for normal structures in low‐dose regions. Positive clinical benefits were seen in comparing the FLASH doses to the reference doses, with notable reductions of 21.4%–33.0% in Dmax for healthy tissues in the high‐dose regions. However, in the moderate‐to‐low‐dose regions, only marginal positive or even negative clinical benefit for normal tissues were observed, such as increased lung V7Gy and V7.4 Gy (up to 17.6%). Conclusions A streamlined pin‐RF design was developed and its effectiveness for single‐energy proton FLASH planning was validated, revealing positive clinical benefits for the normal tissues in the high dose regions. 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Planning with single‐energy proton beams modulated by ridge filters (RFs) has been demonstrated feasible for FLASH‐RT. Purpose This study explored the feasibility of a streamlined pin‐shaped RF (pin‐RF) design, characterized by coarse resolution and sparsely distributed ridge pins, for single‐energy proton FLASH planning. Methods An inverse planning framework integrated within a treatment planning system was established to design streamlined pin RFs for single‐energy FLASH planning. The framework involves generating a multi‐energy proton beam plan using intensity‐modulated proton therapy (IMPT) planning based on downstream energy modulation strategy (IMPT‐DS), followed by a nested pencil‐beam‐direction‐based (PBD‐based) spot reduction process to iteratively reduce the total number of PBDs and energy layers along each PBD for the IMPT‐DS plan. The IMPT‐DS plan is then translated into the pin‐RFs and the single‐energy beam configurations for IMPT planning with pin‐RFs (IMPT‐RF). This framework was validated on three lung cases, quantifying the FLASH dose of the IMPT‐RF plan using the FLASH effectiveness model. The FLASH dose was then compared to the reference dose of a conventional IMPT plan to measure the clinical benefit of the FLASH planning technique. Results The IMPT‐RF plans closely matched the corresponding IMPT‐DS plans in high dose conformity (conformity index of &lt;1.2), with minimal changes in V7Gy and V7.4 Gy for the lung (&lt;3%) and small increases in maximum doses (Dmax) for other normal structures (&lt;3.4 Gy). Comparing the FLASH doses to the doses of corresponding IMPT‐RF plans, drastic reductions of up to nearly 33% were observed in Dmax for the normal structures situated in the high‐to‐moderate‐dose regions, while negligible changes were found in Dmax for normal structures in low‐dose regions. Positive clinical benefits were seen in comparing the FLASH doses to the reference doses, with notable reductions of 21.4%–33.0% in Dmax for healthy tissues in the high‐dose regions. However, in the moderate‐to‐low‐dose regions, only marginal positive or even negative clinical benefit for normal tissues were observed, such as increased lung V7Gy and V7.4 Gy (up to 17.6%). Conclusions A streamlined pin‐RF design was developed and its effectiveness for single‐energy proton FLASH planning was validated, revealing positive clinical benefits for the normal tissues in the high dose regions. The coarsened design of the pin‐RF demonstrates potential advantages, including cost efficiency and ease of adjustability, making it a promising option for efficient production.</abstract><cop>United States</cop><pmid>38214381</pmid><doi>10.1002/mp.16939</doi><tpages>12</tpages></addata></record>
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subjects proton FLASH
single‐energy planning
streamlined ridge filter
title Streamlined pin‐ridge‐filter design for single‐energy proton FLASH planning
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