Towards real-time PGS range monitoring in proton therapy of prostate cancer

Abstract Proton therapy of prostate cancer (PCPT) was linked with increased levels of gastrointestinal toxicity in its early use compared to intensity-modulated radiation therapy (IMRT). The higher radiation dose to the rectum by proton beams is mainly due to anatomical variations. Here, we demonstr...

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Autores principales:	Paulo Magalhaes Martins, Hugo Freitas, Thomas Tessonnier, Benjamin Ackermann, Stephan Brons, Joao Seco
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/44b7d6fa510d498d98e1503894e69b7d
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spelling	oai:doaj.org-article:44b7d6fa510d498d98e1503894e69b7d2021-12-02T18:46:57ZTowards real-time PGS range monitoring in proton therapy of prostate cancer10.1038/s41598-021-93612-y2045-2322https://doaj.org/article/44b7d6fa510d498d98e1503894e69b7d2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93612-yhttps://doaj.org/toc/2045-2322Abstract Proton therapy of prostate cancer (PCPT) was linked with increased levels of gastrointestinal toxicity in its early use compared to intensity-modulated radiation therapy (IMRT). The higher radiation dose to the rectum by proton beams is mainly due to anatomical variations. Here, we demonstrate an approach to monitor rectal radiation exposure in PCPT based on prompt gamma spectroscopy (PGS). Endorectal balloons (ERBs) are used to stabilize prostate movement during radiotherapy. These ERBs are usually filled with water. However, other water solutions containing elements with higher atomic numbers, such as silicon, may enable the use of PGS to monitor the radiation exposure of the rectum. Protons hitting silicon atoms emit prompt gamma rays with a specific energy of 1.78 MeV, which can be used to monitor whether the ERB is being hit. In a binary approach, we search the silicon energy peaks for every irradiated prostate region. We demonstrate this technique for both single-spot irradiation and real treatment plans. Real-time feedback based on the ERB being hit column-wise is feasible and would allow clinicians to decide whether to adapt or continue treatment. This technique may be extended to other cancer types and organs at risk, such as the oesophagus.Paulo Magalhaes MartinsHugo FreitasThomas TessonnierBenjamin AckermannStephan BronsJoao SecoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Paulo Magalhaes Martins Hugo Freitas Thomas Tessonnier Benjamin Ackermann Stephan Brons Joao Seco Towards real-time PGS range monitoring in proton therapy of prostate cancer
description	Abstract Proton therapy of prostate cancer (PCPT) was linked with increased levels of gastrointestinal toxicity in its early use compared to intensity-modulated radiation therapy (IMRT). The higher radiation dose to the rectum by proton beams is mainly due to anatomical variations. Here, we demonstrate an approach to monitor rectal radiation exposure in PCPT based on prompt gamma spectroscopy (PGS). Endorectal balloons (ERBs) are used to stabilize prostate movement during radiotherapy. These ERBs are usually filled with water. However, other water solutions containing elements with higher atomic numbers, such as silicon, may enable the use of PGS to monitor the radiation exposure of the rectum. Protons hitting silicon atoms emit prompt gamma rays with a specific energy of 1.78 MeV, which can be used to monitor whether the ERB is being hit. In a binary approach, we search the silicon energy peaks for every irradiated prostate region. We demonstrate this technique for both single-spot irradiation and real treatment plans. Real-time feedback based on the ERB being hit column-wise is feasible and would allow clinicians to decide whether to adapt or continue treatment. This technique may be extended to other cancer types and organs at risk, such as the oesophagus.
format	article
author	Paulo Magalhaes Martins Hugo Freitas Thomas Tessonnier Benjamin Ackermann Stephan Brons Joao Seco
author_facet	Paulo Magalhaes Martins Hugo Freitas Thomas Tessonnier Benjamin Ackermann Stephan Brons Joao Seco
author_sort	Paulo Magalhaes Martins
title	Towards real-time PGS range monitoring in proton therapy of prostate cancer
title_short	Towards real-time PGS range monitoring in proton therapy of prostate cancer
title_full	Towards real-time PGS range monitoring in proton therapy of prostate cancer
title_fullStr	Towards real-time PGS range monitoring in proton therapy of prostate cancer
title_full_unstemmed	Towards real-time PGS range monitoring in proton therapy of prostate cancer
title_sort	towards real-time pgs range monitoring in proton therapy of prostate cancer
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/44b7d6fa510d498d98e1503894e69b7d
work_keys_str_mv	AT paulomagalhaesmartins towardsrealtimepgsrangemonitoringinprotontherapyofprostatecancer AT hugofreitas towardsrealtimepgsrangemonitoringinprotontherapyofprostatecancer AT thomastessonnier towardsrealtimepgsrangemonitoringinprotontherapyofprostatecancer AT benjaminackermann towardsrealtimepgsrangemonitoringinprotontherapyofprostatecancer AT stephanbrons towardsrealtimepgsrangemonitoringinprotontherapyofprostatecancer AT joaoseco towardsrealtimepgsrangemonitoringinprotontherapyofprostatecancer
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Towards real-time PGS range monitoring in proton therapy of prostate cancer

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