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1、RespiratorymotionmanagementinparticletherapyaEikeRietzelAbteilungBiophysik,GSIHelmholtzzentrumfürSchwerionenforschung,Planckstraße1,64291Darmstadt,GermanyandSiemensHealthcareSector,Workflow&Solutions,ParticleTherapy,Hofmannstraße26,91052Erlangen,GermanyChr
2、istophBertAbteilungBiophysik,GSIHelmholtzzentrumfürSchwerionenforschung,Planckstraße1,64291Darmstadt,GermanyReceived30December2008;revised23September2009;acceptedforpublication25September2009;published6January2010Clinicaloutcomesofchargedparticletherapya
3、reverypromising.Currently,severaldedicatedcentersthatusescanningbeamtechnologyareeitherclosetoclinicaluseorunderconstruction.Sincescannedbeamtreatmentsoftargetsthatmovewithrespirationmostlikelyresultinmarkedlocalover-andunderdosageduetointerplayoftargetmot
4、ionanddynamicbeamapplication,dedicatedmotionmitigationtechniqueshavetobeemployed.Todate,themotionmitigationtech-niques,rescanning,beamgating,andbeamtracking,havebeenproposedandtestedinexperimentalstudies.Rescanningreliesonrepeatedirradiationsofthetargetwit
5、hthenumberofparticlesreducedaccordinglyperscantostatisticallyaveragelocalmisdosage.Specificdevelopmentstoprohibittemporalcorrelationbetweenbeamscanningandtargetmotionwillberequiredtoguaranteead-equateaveraging.Forbeamgating,residualtargetmotionwithingatingw
6、indowshastobemiti-gatedinordertoavoidlocalmisdosage.Possiblythemostpromisingstrategyistoincreasetheoverlapofadjacentparticlepencilbeamslaterallyaswellaslongitudinallytoeffectivelyreducethesensitivityagainstsmallresidualtargetmotion.Themostconformalandpoten
7、tiallymostprecisemotionmitigationtechniqueisbeamtracking.Individualparticlepencilbeamshavetobeadaptedlaterallyaswellaslongitudinallyaccordingtothetargetmotion.Withinthenextseveralyears,itcanbeanticipatedthatrescanningaswellasbeamgatingwillbereadyforclinica
8、luse.Forrescanning,treatmentplanningmarginsthatincorporatethefullextentoftargetmotionaswellasmotioninduceddensityvariationsinthebeampathswillresultinreducedtargetconformityoftheapplieddosedistributions.Duetot
