title: Quantification and visualization of charged particle range variations.
abstract: OBJECTIVE
  Range variations during respiration affect the penetration of charged particle beams and can result in beam overshoot or undershoot to the target. We have developed analysis tools to quantify the water equivalent pathlength (WEL) variations resulting from respiration (WEL analyzer, Aqualyzer), as well as a data explorer to view WEL variations interactively.
  
  
  METHODS
  The metrics to characterize and quantify penetration of a charged particle beam during respiration were calculated semiautomatically. The analysis involved the generation of images that (1) encode the radiologic pathlength across a beam's eye view image during the respiratory phase, (2) display the variation of the radiologic pathlength relative to a reference respiratory phase, (3) display isopenetration as a function of breathing, and (4) show range fluctuation images for a compensating bolus when applied to four-dimensional computed tomography. Additional quantities relevant to the analysis of charged particle beams in a breathing patient that are calculated include the beam overshoot volume and beam overshoot distance. These quantities are calculated as a function of time, gantry angle, and position.
  
  
  RESULTS
  The software was applied to test cases to illustrate its utility in the analysis of range variations of charged particle beams in the treatment of lung tumors.
  
  
  CONCLUSIONS
  WEL analysis is useful in the rapid assessment of range variations in the treatment of lung tumors and in determining the optimal gantry angle and respiratory gating window. The extension of encoding range fluctuations to a beam's eye view display is helpful in designing plans that are more robust in the presence of motion.
authors: Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. shinshin@nirs.go.jp
authors: Shinichiro
authors: S
authors: Mori
authors: George T Y
authors: GT
authors: Chen
mesh_terms: D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D009068:Movement; D011859:Radiography; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012119:Respiration; D012984:Software; D013679:Technology, Radiologic / Q000379:methods; D013997:Time Factors; D035501:Uncertainty