Enrico Bautista

Enrico Bautista

Dose Calculation Errors in Lung Cancer Patients Receiving Proton Therapy


Enrico Bautista, Walter O'Dell


Dr. Walter O'Dell


College of Medicine


We are computing the error in dose calculation between a conventional average CT scan and breathing phase images and relating this dose error to predicted tissue damage for tissue surrounding the tumor/target in lung cancer patients receiving proton therapy. This would have future implications for treatment planning. In lung tumor treatment using proton therapy, the patient is free breathing. For treatment planning, a 4D CT scan is acquired, capturing multiple breathing cycles. After all the image data is collected, the scanner then bins the data based on the breathing phase to generate a stack of images at each of 10 breathing phases through the entire cycle. For planning, an ‘average’ of all 10 phase-image sets is created where the tumor and body structures are blurred. The edges of the blurred tumor represent the farthest motions of the tumor. The clinical target volume is defined as the smallest contour that encompasses the entirety of the tumor over all breathing phases. Our hypothesis is that the dose distribution in the lung that is computed using the ‘average’ CT scan is not equal to the dose that would be computed if the treatment beam protocol is applied individually to each of the 10 breathing-phase CTs. This difference would occur because the chest wall and internal anatomy is different between the average scan and each of the phase scans, and that will change the path of the protons to the tissue near the target in a non-trivial manner.


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