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Article ; Online: Simulation and pre-planning omitted radiotherapy (SPORT): a feasibility study for prostate cancer.

Zhuang, Tingliang / Parsons, David / Desai, Neil / Gibbard, Grant / Keilty, Dana / Lin, Mu-Han / Cai, Bin / Nguyen, Dan / Chiu, Tsuicheng / Godley, Andrew / Pompos, Arnold / Jiang, Steve

Biomedical physics & engineering express

2024 Volume 10, Issue 2

Abstract: This study explored the feasibility of on-couch intensity modulated radiotherapy (IMRT) planning for prostate cancer (PCa) on a cone-beam CT (CBCT)-based online adaptive RT platform without an individualized pre-treatment plan and contours. Ten patients ... ...

Abstract	This study explored the feasibility of on-couch intensity modulated radiotherapy (IMRT) planning for prostate cancer (PCa) on a cone-beam CT (CBCT)-based online adaptive RT platform without an individualized pre-treatment plan and contours. Ten patients with PCa previously treated with image-guided IMRT (60 Gy/20 fractions) were selected. In contrast to the routine online adaptive RT workflow, a novel approach was employed in which the same preplan that was optimized on one reference patient was adapted to generate individual on-couch/initial plans for the other nine test patients using Ethos emulator. Simulation CTs of the test patients were used as simulated online CBCT (sCBCT) for emulation. Quality assessments were conducted on synthetic CTs (sCT). Dosimetric comparisons were performed between on-couch plans, on-couch plans recomputed on the sCBCT and individually optimized plans for test patients. The median value of mean absolute difference between sCT and sCBCT was 74.7 HU (range 69.5-91.5 HU). The average CTV/PTV coverage by prescription dose was 100.0%/94.7%, and normal tissue constraints were met for the nine test patients in on-couch plans on sCT. Recalculating on-couch plans on the sCBCT showed about 0.7% reduction of PTV coverage and a 0.6% increasing of hotspot, and the dose difference of the OARs was negligible (<0.5 Gy). Hence, initial IMRT plans for new patients can be generated by adapting a reference patient's preplan with online contours, which had similar qualities to the conventional approach of individually optimized plan on the simulation CT. Further study is needed to identify selection criteria for patient anatomy most amenable to this workflow.
MeSH term(s)	Male ; Humans ; Feasibility Studies ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/radiotherapy ; Radiotherapy, Image-Guided
Language	English
Publishing date	2024-02-01
Publishing country	England
Document type	Journal Article
ISSN	2057-1976
ISSN (online)	2057-1976
DOI	10.1088/2057-1976/ad20aa
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Article: National Effort to Re-Establish Heavy Ion Cancer Therapy in the United States.

Pompos, Arnold / Foote, Robert L / Koong, Albert C / Le, Quynh Thu / Mohan, Radhe / Paganetti, Harald / Choy, Hak

Frontiers in oncology

2022 Volume 12, Page(s) 880712

Abstract: In this review, we attempt to make a case for the establishment of a limited number of heavy ion cancer research and treatment facilities in the United States. Based on the basic physics and biology research, conducted largely in Japan and Germany, and ... ...

Abstract	In this review, we attempt to make a case for the establishment of a limited number of heavy ion cancer research and treatment facilities in the United States. Based on the basic physics and biology research, conducted largely in Japan and Germany, and early phase clinical trials involving a relatively small number of patients, we believe that heavy ions have a considerably greater potential to enhance the therapeutic ratio for many cancer types compared to conventional X-ray and proton radiotherapy. Moreover, with ongoing technological developments and with research in physical, biological, immunological, and clinical aspects, it is quite plausible that cost effectiveness of radiotherapy with heavier ions can be substantially improved.
Language	English
Publishing date	2022-06-14
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.880712
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Article ; Online: Heavy Ions in Cancer Therapy.

Pompos, Arnold / Durante, Marco / Choy, Hak

JAMA oncology

2016 Volume 2, Issue 12, Page(s) 1539–1540

MeSH term(s)	Dose-Response Relationship, Radiation ; Heavy Ions/therapeutic use ; Humans ; Metals, Heavy/therapeutic use ; Neoplasms/pathology ; Neoplasms/radiotherapy ; Protons/therapeutic use
Chemical Substances	Metals, Heavy ; Protons
Language	English
Publishing date	2016-12-01
Publishing country	United States
Document type	Journal Article
ISSN	2374-2445
ISSN (online)	2374-2445
DOI	10.1001/jamaoncol.2016.2646
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Article: On the value of carbon-ion therapy.

Story, Michael / Pompos, Arnold / Timmerman, Robert

Physics today

2016 Volume 69, Issue 11, Page(s) 14–16

Language	English
Publishing date	2016-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2031187-4
ISSN	0031-9228
ISSN	0031-9228
DOI	10.1063/PT.3.3348
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Article ; Online: ART2Dose: A comprehensive dose verification platform for online adaptive radiotherapy.

Lin, Jingying / Chen, Mingli / Lai, Youfang / Trivedi, Zipalkumar / Wu, Junjie / Foo, Tim / Gonzalez, Yesenia / Reynolds, Robert / Park, Chunjoo / Yan, Yulong / Godley, Andrew / Jiang, Steve / Jia, Xun / Lin, Mu-Han / Pompos, Arnold / Lu, Weiguo

Medical physics

2023 Volume 51, Issue 1, Page(s) 18–30

Abstract: Background: Online adaptive radiotherapy (ART) involves the development of adaptable treatment plans that consider patient anatomical data obtained right prior to treatment administration, facilitated by cone-beam computed tomography guided adaptive ... ...

Abstract	Background: Online adaptive radiotherapy (ART) involves the development of adaptable treatment plans that consider patient anatomical data obtained right prior to treatment administration, facilitated by cone-beam computed tomography guided adaptive radiotherapy (CTgART) and magnetic resonance image-guided adaptive radiotherapy (MRgART). To ensure accuracy of these adaptive plans, it is crucial to conduct calculation-based checks and independent verification of volumetric dose distribution, as measurement-based checks are not practical within online workflows. However, the absence of comprehensive, efficient, and highly integrated commercial software for secondary dose verification can impede the time-sensitive nature of online ART procedures. Purpose: The main aim of this study is to introduce an efficient online quality assurance (QA) platform for online ART, and subsequently evaluate it on Ethos and Unity treatment delivery systems in our clinic. Methods: To enhance efficiency and ensure compliance with safety standards in online ART, ART2Dose, a secondary dose verification software, has been developed and integrated into our online QA workflow. This implementation spans all online ART treatments at our institution. The ART2Dose infrastructure comprises four key components: an SQLite database, a dose calculation server, a report generator, and a web portal. Through this infrastructure, file transfer, dose calculation, report generation, and report approval/archival are seamlessly managed, minimizing the need for user input when exporting RT DICOM files and approving the generated QA report. ART2Dose was compared with Mobius3D in pre-clinical evaluations on secondary dose verification for 40 adaptive plans. Additionally, a retrospective investigation was conducted utilizing 1302 CTgART fractions from ten treatment sites and 1278 MRgART fractions from seven treatment sites to evaluate the practical accuracy and efficiency of ART2Dose in routine clinical use. Results: With dedicated infrastructure and an integrated workflow, ART2Dose achieved gamma passing rates that were comparable to or higher than those of Mobius3D. Additionally, it significantly reduced the time required to complete pre-treatment checks by 3-4 min for each plan. In the retrospective analysis of clinical CTgART and MRgART fractions, ART2Dose demonstrated average gamma passing rates of 99.61 ± 0.83% and 97.75 ± 2.54%, respectively, using the 3%/2 mm criteria for region greater than 10% of prescription dose. The average calculation times for CTgART and MRgART were approximately 1 and 2 min, respectively. Conclusion: Overall, the streamlined implementation of ART2Dose notably enhances the online ART workflow, offering reliable and efficient online QA while reducing time pressure in the clinic and minimizing labor-intensive work.
MeSH term(s)	Humans ; Radiotherapy Planning, Computer-Assisted/methods ; Retrospective Studies ; Software ; Radiotherapy, Intensity-Modulated/methods ; Tomography, X-Ray Computed ; Radiotherapy Dosage
Language	English
Publishing date	2023-10-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	188780-4
ISSN	2473-4209 ; 0094-2405
ISSN (online)	2473-4209
ISSN	0094-2405
DOI	10.1002/mp.16806
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Article ; Online: Evaluation of fan-beam kilovoltage computed tomography image quality on a novel biological-guided radiotherapy platform.

Zhuang, Tingliang / Gibbard, Grant / Duan, Xinhui / Tan, Jun / Park, Yang / Lin, Mu-Han / Sun, Zhihui / Oderinde, Oluwaseyi M / Lu, Weiguo / Reynolds, Robert / Godley, Andrew / Pompos, Arnold / Dan, Tu / Garant, Aurelie / Iyengar, Puneeth / Timmerman, Robert / Jiang, Steve / Cai, Bin

Physics and imaging in radiation oncology

2023 Volume 26, Page(s) 100438

Abstract: Background and purpose: A recently developed biology-guided radiotherapy platform, equipped with positron emission tomography (PET) and computed tomography (CT), provides both anatomical and functional image guidance for radiotherapy. This study aimed ... ...

Abstract	Background and purpose: A recently developed biology-guided radiotherapy platform, equipped with positron emission tomography (PET) and computed tomography (CT), provides both anatomical and functional image guidance for radiotherapy. This study aimed to characterize performance of the kilovoltage CT (kVCT) system on this platform using standard quality metrics measured on phantom and patient images, using CT simulator images as reference. Materials and methods: Image quality metrics, including spatial resolution/modular transfer function (MTF), slice sensitivity profile (SSP), noise performance and image uniformity, contrast-noise ratio (CNR) and low-contrast resolution, geometric accuracy, and CT number (HU) accuracy, were evaluated on phantom images. Patient images were evaluated mainly qualitatively. Results: On phantom images the MTF Conclusions: Major image quality metrics of the PET/CT Linac kVCT were within vendor-recommended tolerances. Better spatial resolution but higher noise and better/comparable low contrast visibility were observed as compared to a CT simulator when images were acquired with clinical protocols.
Language	English
Publishing date	2023-04-10
Publishing country	Netherlands
Document type	Journal Article
ISSN	2405-6316
ISSN (online)	2405-6316
DOI	10.1016/j.phro.2023.100438
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Article: Evaluation of the Response of HNSCC Cell Lines to γ-Rays and

Ding, Lianghao / Sishc, Brock J / Polsdofer, Elizabeth / Yordy, John S / Facoetti, Angelica / Ciocca, Mario / Saha, Debabrata / Pompos, Arnold / Davis, Anthony J / Story, Michael D

Frontiers in oncology

2022 Volume 12, Page(s) 812961

Abstract: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Thirty percent of patients will experience locoregional recurrence for which median survival is less than 1 year. Factors contributing to treatment failure ... ...

Abstract	Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Thirty percent of patients will experience locoregional recurrence for which median survival is less than 1 year. Factors contributing to treatment failure include inherent resistance to X-rays and chemotherapy, hypoxia, epithelial to mesenchymal transition, and immune suppression. The unique properties of
Language	English
Publishing date	2022-02-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.812961
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Article ; Online: Report of a National Cancer Institute special panel: Characterization of the physical parameters of particle beams for biological research.

Durante, Marco / Paganetti, Harald / Pompos, Arnold / Kry, Stephen F / Wu, Xiaodong / Grosshans, David R

Medical physics

2018 Volume 46, Issue 2, Page(s) e37–e52

Abstract: Purpose: To define the physical parameters needed to characterize a particle beam in order to allow intercomparison of different experiments performed using different ions at the same facility and using the same ion at different facilities.: Methods: ...

Abstract	Purpose: To define the physical parameters needed to characterize a particle beam in order to allow intercomparison of different experiments performed using different ions at the same facility and using the same ion at different facilities. Methods: At the request of the National Cancer Institute (NCI), a special panel was convened to review the current status of the field and to provide suggested metrics for reporting the physical parameters of particle beams to be used for biological research. A set of physical parameters and measurements that should be performed by facilities and understood and reported by researchers supported by NCI to perform pre-clinical radiobiology and medical physics of heavy ions were generated. Results: Standard measures such as radiation delivery technique, beam modifiers used, nominal energy, field size, physical dose and dose rate should all be reported. However, more advanced physical measurements, including detailed characterization of beam quality by microdosimetric spectrum and fragmentation spectra, should also be established and reported. Details regarding how such data should be incorporated into Monte Carlo simulations and the proper reporting of simulation details are also discussed. Conclusions: In order to allow for a clear relation of physical parameters to biological effects, facilities and researchers should establish and report detailed physical characteristics of the irradiation beams utilized including both standard and advanced measures. Biological researchers are encouraged to actively engage facility staff and physicists in the design and conduct of experiments. Modeling individual experimental setups will allow for the reporting of the uncertainties in the measurement or calculation of physical parameters which should be routinely reported.
MeSH term(s)	Heavy Ion Radiotherapy ; Models, Biological ; Monte Carlo Method ; National Cancer Institute (U.S.) ; Physical Phenomena ; Radiometry ; Radiotherapy Dosage ; United States
Language	English
Publishing date	2018-12-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	188780-4
ISSN	2473-4209 ; 0094-2405
ISSN (online)	2473-4209
ISSN	0094-2405
DOI	10.1002/mp.13324
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Article ; Online: BIOGUIDE-X: A First-in-Human Study of the Performance of Positron Emission Tomography-Guided Radiation Therapy.

International journal of radiation oncology, biology, physics

2023 Volume 118, Issue 5, Page(s) 1172–1180

Abstract: Purpose: Positron emission tomography (PET)-guided radiation therapy is a novel tracked dose delivery modality that uses real-time PET to guide radiation therapy beamlets. The BIOGUIDE-X study was performed with sequential cohorts of participants to (1) ...

Abstract	Purpose: Positron emission tomography (PET)-guided radiation therapy is a novel tracked dose delivery modality that uses real-time PET to guide radiation therapy beamlets. The BIOGUIDE-X study was performed with sequential cohorts of participants to (1) identify the fluorodeoxyglucose (FDG) dose for PET-guided therapy and (2) confirm that the emulated dose distribution was consistent with a physician-approved radiation therapy plan. Methods and materials: This prospective study included participants with at least 1 FDG-avid targetable primary or metastatic tumor (2-5 cm) in the lung or bone. For cohort I, a modified 3 + 3 design was used to determine the FDG dose that would result in adequate signal for PET-guided therapy. For cohort II, PET imaging data were collected on the X1 system before the first and last fractions among patients undergoing conventional stereotactic body radiation therapy. PET-guided therapy dose distributions were modeled on the patient's computed tomography anatomy using the collected PET data at each fraction as input to an "emulated delivery" and compared with the physician-approved plan. Results: Cohort I demonstrated adequate FDG activity in 6 of 6 evaluable participants (100.0%) with the first injected dose level of 15 mCi FDG. In cohort II, 4 patients with lung tumors and 5 with bone tumors were enrolled, and evaluable emulated delivery data points were collected for 17 treatment fractions. Sixteen of the 17 emulated deliveries resulted in dose distributions that were accurate with respect to the approved PET-guided therapy plan. The 17th data point was just below the 95% threshold for accuracy (dose-volume histogram score = 94.6%). All emulated fluences were physically deliverable. No toxicities were attributed to multiple FDG administrations. Conclusions: PET-guided therapy is a novel radiation therapy modality in which a radiolabeled tumor can act as its own fiducial for radiation therapy targeting. Emulated therapy dose distributions calculated from continuously acquired real-time PET data were accurate and machine-deliverable in tumors that were 2 to 5 cm in size with adequate FDG signal characteristics.
MeSH term(s)	Humans ; Fluorodeoxyglucose F18 ; Prospective Studies ; Positron-Emission Tomography ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/pathology ; Tomography, X-Ray Computed/methods ; Radiopharmaceuticals
Chemical Substances	Fluorodeoxyglucose F18 (0Z5B2CJX4D) ; Radiopharmaceuticals
Language	English
Publishing date	2023-12-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	197614-x
ISSN	1879-355X ; 0360-3016
ISSN (online)	1879-355X
ISSN	0360-3016
DOI	10.1016/j.ijrobp.2023.12.019
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Article ; Online: SU-E-T-386: Gamma Analysis of Normalized and Un-Normalized Dose Distributions.

Stojadinovic, S / Luo, O / Bao, Q / Pompos, A / Gu, X / Solberg, T

Medical physics

2012 Volume 39, Issue 6Part16, Page(s) 3793

Abstract: Purpose: The gamma index method, as currently implemented in all commercial QA software, calls for selection of a normalization point to evaluate agreement between two dose distributions. The implication of this is that there is an infinite number of ... ...

Abstract	Purpose: The gamma index method, as currently implemented in all commercial QA software, calls for selection of a normalization point to evaluate agreement between two dose distributions. The implication of this is that there is an infinite number of possible solutions! Which one to pick? A unique and more relevant solution is obtained only if no normalization point is used. Methods and materials: The set of test cases suggested by the AAPM TG1 19 were planned using Pinnacle 8.0m and delivered on a Varian 21EX linac for 6 and 18 MV photons. The recommended point and planar dose measurements were obtained using a Pinpoint ion chamber, EDR2 film and MatriXX. The gamma index method using typical 3%, 3 mm criteria with and without a normalization point was used to assess the agreement between calculated and delivered planar dose distributions. The analysis was extended to a set of data for clinically treated patients. Results: The comparison with the TG119 benchmark data showed that all point dose and planar measurements for 6 MV were within the published range. Similar results, although without published data to compare with, were obtained for 18 MV as well. For all complex tests, the percentage of points passing the gamma criteria of 3%, 3 mm was (95.8±1.6)% and (95.6±1.0)% for 6 MV and 18 MV, respectively. Without a normalization point, however, the same gamma analysis fell to (20.7±6.7)% and (13.9±4.0)% for 6 MV and 18 MV, respectively. The clinical data set showed the same trend, with the gamma passing rate declining from (98.9±0.7)% to (33.4±13.1)%. Conclusion: The gamma index method provides a unique answer for gamma passing rate only without normalizing dose distributions to any particular point. The common gamma criteria of 3%, 3 mm, however, is a very poor metric in that case.
Language	English
Publishing date	2012-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	188780-4
ISSN	2473-4209 ; 0094-2405
ISSN (online)	2473-4209
ISSN	0094-2405
DOI	10.1118/1.4735475
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