Development of a Real-Time Internal and External Marker Based Gating System for Proton Therapy

Junsang Cho; Wonjoong Cheon; Sanghee Ahn; Moonhee Lee; Hee Chul Park; Youngyih Han

doi:10.14316/pmp.2017.28.3.92

Journal List > Prog Med Phys > v.28(3) > 1098595

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Cho, Cheon, Ahn, Lee, Park, and Han: Development of a Real-Time Internal and External Marker Based Gating System for Proton Therapy

Original Article

Progress in Medical Physics 2017;28(3):92-99.

Published online: 17 September 2017

DOI: https://doi.org/10.14316/pmp.2017.28.3.92

Development of a Real-Time Internal and External Marker Based Gating System for Proton Therapy

Junsang Cho^∗, Wonjoong Cheon^†, Sanghee Ahn^†, Moonhee Lee^†, Hee Chul Park^∗, Youngyih Han^∗,

^∗Department of Radiation Oncology, Samsung Medical Center, SAIHST, Sungkyunkwan University School of Medicine, Seoul, Korea

^†Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea

Corresponding author Youngyih Han (youngyih@skku.edu) Tel: 82-2-3410-2604 Fax: 82-2-3410-2619

Received 24 August 201727 September 2017 Accepted 28 September 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In respiratory-induced proton therapy, the accuracy of tracking system and beam controlling is more important than photon therapy. Therefore, a high accuracy motion tracking system that can track internal marker and external surrogate is needed. In this research, our team has installed internal and external marker tracking system at our institution's proton therapy system, and tested the scanning with gating according to the position of marker. The results demonstrate that the developed in-house external/internal marker based gating system can be clinically used for proton therapy system for moving tumor treatment.

Keywords: Proton therapy, Respiratory gating, Internal/external fiducials, Marker tracking

REFERENCES

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Fig. 1.

The flat panel detectors (FPD) at the gantry of our institution.

Fig. 2.

The concept of finding the 3D coordinates of marker in biplane images (The two blue rectangles represent FPD's biplane images).

Fig. 3.

The Bonita 10 camera (left) and the Nexus software (right).

Fig. 4.

The real time output status of the ‘Co-registration Algorithm’. The boxes on the left side of the monitor show the coordinates of the three external markers, and the box on the right shows the 3D coordinates of the internal marker in millimeter scale.

Fig. 5.

Current proton therapy system at our institution.

Fig. 6.

Modified proton therapy system which is able to gate the beam based on external/internal marker's position.

Fig. 7.

A sliding motion phantom was placed on a couch for phantom simulation.

Fig. 8.

The gamma analysis result for case 1 with the anzai external respiratory gating.

Fig. 9.

The gamma analysis result for case 1 with the modified system's respiratory gating.

Fig. 10.

The gamma analysis result for case 2 with the anzai external respiratory gating.

Fig. 11.

The gamma analysis result for case 2 with the modified system's respiratory gating.

Table 1.

The gamma analysis comparison table

Gating method	Passing rate	Absolute difference (arithmetic mean)
Plan 1
Anzai gating	89.0%	0.056 Gy
Gating with proposed system	93.8%	0.047 Gy
Plan 2
Anzai gating	96.0%	0.044 Gy
Gating with proposed system	90.7%	0.045 Gy

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