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Toward Dynamically Collimated Proton Arc Therapy: Foundational Tools for Treatment Planning and Delivery Efficiency
Toward Dynamically Collimated Proton Arc Therapy: Foundational Tools for Treatment Plannin...
Toward Dynamically Collimated Proton Arc Therapy: Foundational Tools for Treatment Planning and Delivery Efficiency

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자료유형  
 학위논문 서양
최종처리일시  
20260202105128
ISBN  
9798291553640
DDC  
530
저자명  
Wake, Karsten K.
서명/저자  
Toward Dynamically Collimated Proton Arc Therapy: Foundational Tools for Treatment Planning and Delivery Efficiency
발행사항  
[Sl] : The University of Wisconsin - Madison, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
160 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-02, Section: A.
주기사항  
Advisor: Culberson, Wesley S.;Hill, Patrick M.
학위논문주기  
Thesis (Ph.D.)--The University of Wisconsin - Madison, 2025.
초록/해제  
요약Proton therapy offers significant dosimetric advantages over conventional photon radiotherapy due to the characteristic Bragg peak, enabling precise dose deposition to tumors while minimizing irradiation of surrounding healthy tissues. Pencil Beam Scanning (PBS) and Intensity Modulated Proton Therapy (IMPT) have further enhanced this precision. However, challenges remain in optimizing lateral dose fall-off and improving treatment efficiency. Dynamically Collimated Proton Arc Therapy (DC-PAT) emerges as a promising modality, aiming to combine the advantages of spot-specific dynamic collimation with those of an arc delivery to achieve superior dose conformity and organ sparing. Despite its potential, DC-PAT faces substantial hurdles related to treatment planning complexity, delivery efficiency, system integration, and quality assurance (QA). This dissertation focuses on developing and evaluating foundational tools and methodologies to address these challenges, specifically utilizing the Dynamic Collimation System (DCS) prototype, to advance DC-PAT towards clinical feasibility.The research presented herein encompasses three principal areas of investigation. Firstly, to address treatment planning and delivery efficiency, a novel post-processing "Cut-Sort-Group" (CSG) algorithm was developed and evaluated for DC-PAT plans. The CSG algorithm incorporates three components: (1) "Cut," which eliminates low-weight control points; (2) "Sort," which employs a novel Sliding-Window Energy Layer Sorting (SWELS) algorithm to minimize time-consuming low-to-high energy transitions; and (3) "Group," which utilizes ant colony optimization to group collimated spots into shared trimmer configurations, thereby reducing trimmer motion time. Applied to DC-PAT plans for three cranial cases, the CSG algorithm, with optimized parameters (SWELS window size of 25°, mean spot group size between 6 and 10), demonstrated a substantial reduction in expected beam delivery times by up to 65%, achieving clinically feasible total treatment times of approximately 10 to 13 minutes. Crucially, these significant efficiency gains were achieved while preserving essential dosimetric plan quality (target coverage, homogeneity, conformity) and without substantially compromising plan robustness under simulated delivery uncertainties.Secondly, this work developed critical tools and procedures for the accurate delivery and dosimetric verification of DC-PAT. A systematic investigation of gantry angle-dependent isocenter drift for the DCS-equipped nozzle was conducted using kV imaging. This resulted in the development and validation of a corrective look-up table (LUT) that successfully reduced DCS-radiation field misalignment to within 0.5 mm for X trimmers and 0.1 mm for Y trimmers, essential for accurate collimation during arc deliveries. The feasibility of using n-type silicon diodes (specifically, Sun Nuclear EDGETM diodes, similar to those in the ArcCHECK® device) for patient-specific QA in the plateau region of proton arc beams was assessed. These diodes exhibited high short-term precision, dose linearity up to 10 Gy, and minimal energy or dose-rate dependence (2%) in the plateau region. While significant sensitivity degradation with accumulated proton dose (5-9% per 100 Gy) was observed, the estimated per-fraction damage for typical arc QA was found to be potentially manageable with appropriate recalibration schedules. Furthermore, a novel cylindrical acrylic phantom for GafchromicTM EBT3 film dosimetry was designed and constructed, with Monte Carlo simulations verifying its suitability for high-resolution 2D dose verification in the plateau region of DC-PAT treatment beams, thereby avoiding LET-dependent film under-response.Thirdly, a comprehensive MATLAB-based log analysis toolkit was developed to facilitate detailed understanding and modeling of DCS performance during treatment delivery. This toolkit automates the parsing of complex machine log files, enabling rapid quantification of delivery accuracy, including spot positional errors (typically 0.2 mm), delivered monitor units, and DCS-specific parameters like trimmer positioning precision (mean error generally 0.04 mm across various motor jerk settings). A key output of this work is a novel empirical sigmoid model accurately describing DCS trimmer motion dynamics during slew times, derived from over 14,300 logged trimmer movements. This model, which predicts trimmer trajectories based on displacement and motor jerk (mean RMSE 0.99 for normal motion), led to a more accurate method for calculating Trimmer Displacement Time (TDT). This improved TDT calculation demonstrated the potential to reduce previously estimated DCS delivery times by 30-50% compared to simplistic kinematic models and provided a means to identify anomalous trimmer behaviors. The toolkit also supports the generation of log-based Proton Layer Definition (PLD) files, enabling dose reconstruction for supplementary QA.In conclusion, this dissertation provides significant advancements in treatment planning algorithms, delivery correction mechanisms, novel QA tools, and sophisticated system modeling for DC-PAT. The CSG algorithm offers a pathway to clinically efficient plan delivery. The developed isocenter correction, diode characterization, and film phantom design contribute to robust and accurate treatment verification. The log-based trimmer motion model and analysis toolkit enhance understanding of the DCS, improve delivery time predictions, and provide powerful tools for post-delivery analysis and QA. Collectively, these contributions address key challenges in DC-PAT, advancing this innovative modality closer to clinical implementation and offering the potential for more precise and effective cancer radiotherapy.
일반주제명  
Physics
일반주제명  
Biomedical engineering
일반주제명  
Oncology
일반주제명  
Health sciences
일반주제명  
Therapy
키워드  
Intensity Modulated Proton Therapy
키워드  
Pencil Beam Scanning
키워드  
Dynamically Collimated Proton Arc Therapy
키워드  
Dynamic Collimation System
키워드  
Cancer radiotherapy
기타저자  
The University of Wisconsin - Madison Medical Physics
기본자료저록  
Dissertations Abstracts International. 87-02A.
전자적 위치 및 접속  
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MARC

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■1001  ▼aWake,  Karsten  K.
■24510▼aToward  Dynamically  Collimated  Proton  Arc  Therapy:  Foundational  Tools  for  Treatment  Planning  and  Delivery  Efficiency
■260    ▼a[Sl]▼bThe  University  of  Wisconsin  -  Madison▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a160  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-02,  Section:  A.
■500    ▼aAdvisor:  Culberson,  Wesley  S.;Hill,  Patrick  M.
■5021  ▼aThesis  (Ph.D.)--The  University  of  Wisconsin  -  Madison,  2025.
■520    ▼aProton  therapy  offers  significant  dosimetric  advantages  over  conventional  photon  radiotherapy  due  to  the  characteristic  Bragg  peak,  enabling  precise  dose  deposition  to  tumors  while  minimizing  irradiation  of  surrounding  healthy  tissues.  Pencil  Beam  Scanning  (PBS)  and  Intensity  Modulated  Proton  Therapy  (IMPT)  have  further  enhanced  this  precision.  However,  challenges  remain  in  optimizing  lateral  dose  fall-off  and  improving  treatment  efficiency.  Dynamically  Collimated  Proton  Arc  Therapy  (DC-PAT)  emerges  as  a  promising  modality,  aiming  to  combine  the  advantages  of  spot-specific  dynamic  collimation  with  those  of  an  arc  delivery  to  achieve  superior  dose  conformity  and  organ  sparing.  Despite  its  potential,  DC-PAT  faces  substantial  hurdles  related  to  treatment  planning  complexity,  delivery  efficiency,  system  integration,  and  quality  assurance  (QA).  This  dissertation  focuses  on  developing  and  evaluating  foundational  tools  and  methodologies  to  address  these  challenges,  specifically  utilizing  the  Dynamic  Collimation  System  (DCS)  prototype,  to  advance  DC-PAT  towards  clinical  feasibility.The  research  presented  herein  encompasses  three  principal  areas  of  investigation.  Firstly,  to  address  treatment  planning  and  delivery  efficiency,  a  novel  post-processing  "Cut-Sort-Group"  (CSG)  algorithm  was  developed  and  evaluated  for  DC-PAT  plans.  The  CSG  algorithm  incorporates  three  components:  (1)  "Cut,"  which  eliminates  low-weight  control  points;  (2)  "Sort,"  which  employs  a  novel  Sliding-Window  Energy  Layer  Sorting  (SWELS)  algorithm  to  minimize  time-consuming  low-to-high  energy  transitions;  and  (3)  "Group,"  which  utilizes  ant  colony  optimization  to  group  collimated  spots  into  shared  trimmer  configurations,  thereby  reducing  trimmer  motion  time.  Applied  to  DC-PAT  plans  for  three  cranial  cases,  the  CSG  algorithm,  with  optimized  parameters  (SWELS  window  size  of  25°,  mean  spot  group  size  between  6  and  10),  demonstrated  a  substantial  reduction  in  expected  beam  delivery  times  by up  to  65%,  achieving  clinically  feasible  total  treatment  times  of  approximately  10  to  13  minutes.  Crucially,  these  significant  efficiency  gains  were  achieved  while  preserving  essential  dosimetric  plan  quality  (target  coverage,  homogeneity,  conformity)  and  without  substantially  compromising  plan  robustness  under  simulated  delivery  uncertainties.Secondly,  this  work  developed  critical  tools  and  procedures  for  the  accurate  delivery  and  dosimetric  verification  of  DC-PAT.  A  systematic  investigation  of  gantry  angle-dependent  isocenter  drift  for  the  DCS-equipped  nozzle  was  conducted  using  kV  imaging.  This  resulted  in  the  development  and  validation  of  a  corrective  look-up  table  (LUT)  that  successfully  reduced  DCS-radiation  field  misalignment  to  within  0.5  mm  for  X  trimmers  and  0.1  mm  for  Y  trimmers,  essential  for  accurate  collimation  during  arc  deliveries.  The  feasibility  of  using  n-type  silicon  diodes  (specifically,  Sun  Nuclear  EDGETM  diodes,  similar  to  those  in  the  ArcCHECK®  device)  for  patient-specific  QA  in  the  plateau  region  of  proton  arc  beams  was  assessed.  These  diodes  exhibited  high  short-term  precision,  dose  linearity  up  to  10  Gy,  and  minimal  energy  or  dose-rate  dependence  (2%)  in  the  plateau  region.  While  significant  sensitivity  degradation  with  accumulated  proton  dose  (5-9%  per  100  Gy)  was  observed,  the  estimated  per-fraction  damage  for  typical  arc  QA  was  found  to  be  potentially  manageable  with  appropriate  recalibration  schedules.  Furthermore,  a  novel  cylindrical  acrylic  phantom  for  GafchromicTM  EBT3  film  dosimetry  was  designed  and  constructed,  with  Monte  Carlo  simulations  verifying  its  suitability  for  high-resolution  2D  dose  verification  in  the  plateau  region  of  DC-PAT  treatment  beams,  thereby  avoiding  LET-dependent  film  under-response.Thirdly,  a  comprehensive  MATLAB-based  log  analysis  toolkit  was  developed  to  facilitate  detailed  understanding  and  modeling  of  DCS  performance  during  treatment  delivery.  This  toolkit  automates  the  parsing  of  complex  machine  log  files,  enabling  rapid  quantification  of  delivery  accuracy,  including  spot  positional  errors  (typically  0.2  mm),  delivered  monitor  units,  and  DCS-specific  parameters  like  trimmer  positioning  precision  (mean  error  generally 0.04  mm  across  various  motor  jerk  settings).  A  key  output  of  this  work  is  a  novel  empirical  sigmoid  model  accurately  describing  DCS  trimmer  motion  dynamics  during  slew  times,  derived  from  over  14,300  logged  trimmer  movements.  This  model,  which  predicts  trimmer  trajectories  based  on  displacement  and  motor  jerk  (mean  RMSE    0.99  for  normal  motion),  led  to  a  more  accurate  method  for  calculating  Trimmer  Displacement  Time  (TDT).  This  improved  TDT  calculation  demonstrated  the  potential  to  reduce  previously  estimated  DCS  delivery  times  by  30-50%  compared  to  simplistic  kinematic  models  and  provided  a  means  to  identify  anomalous  trimmer  behaviors.  The  toolkit  also  supports  the  generation  of  log-based  Proton  Layer  Definition  (PLD)  files,  enabling  dose  reconstruction  for  supplementary  QA.In  conclusion,  this  dissertation  provides  significant  advancements  in  treatment  planning  algorithms,  delivery  correction  mechanisms,  novel  QA  tools,  and  sophisticated  system  modeling  for  DC-PAT.  The  CSG  algorithm  offers  a  pathway  to  clinically  efficient  plan  delivery.  The  developed  isocenter  correction,  diode  characterization,  and  film  phantom  design  contribute  to  robust  and  accurate  treatment  verification.  The  log-based  trimmer  motion  model  and  analysis  toolkit  enhance  understanding  of  the  DCS,  improve  delivery  time  predictions,  and  provide  powerful  tools  for  post-delivery  analysis  and  QA.  Collectively,  these  contributions  address  key  challenges  in  DC-PAT,  advancing  this  innovative  modality  closer  to  clinical  implementation  and  offering  the  potential  for  more  precise  and  effective  cancer  radiotherapy.
■590    ▼aSchool  code:  0262.
■650  4▼aPhysics
■650  4▼aBiomedical  engineering
■650  4▼aOncology
■650  4▼aHealth  sciences
■650  4▼aTherapy
■653    ▼aIntensity  Modulated  Proton  Therapy  
■653    ▼aPencil  Beam  Scanning
■653    ▼aDynamically  Collimated  Proton  Arc  Therapy  
■653    ▼aDynamic  Collimation  System
■653    ▼aCancer  radiotherapy
■690    ▼a0605
■690    ▼a0566
■690    ▼a0992
■690    ▼a0541
■690    ▼a0212
■71020▼aThe  University  of  Wisconsin  -  Madison▼bMedical  Physics.
■7730  ▼tDissertations  Abstracts  International▼g87-02A.
■790    ▼a0262
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17359502▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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