SU-F-J-65: Prediction of Patient Setup Errors and Errors in the Calibration Curve from Prompt Gamma Proton Range Measurements.

PURPOSE: To understand the extent to which the prompt gamma camera measurements can be used to predict the residual proton range due to setup errors and errors in the calibration curve.

METHODS: We generated ten variations on a default calibration curve (CC) and ten corresponding range maps (RM). Starting with the default RM, we chose a square array of N beamlets, which were then rotated by a random angle θ and shifted by a random vector s. We added a 5% distal Gaussian noise to each beamlet in order to introduce discrepancies that exist between the ranges predicted from the prompt gamma measurements and those simulated with Monte Carlo algorithms. For each RM, s, θ, along with an offset u in the CC, were optimized using a simple Euclidian distance between the default ranges and the ranges produced by the given RM.

RESULTS: The application of our method lead to the maximal overrange of 2.0mm and underrange of 0.6mm on average. Compared to the situations where s, θ, and u were ignored, these values were larger: 2.1mm and 4.3mm. In order to quantify the need for setup error corrections, we also performed computations in which u was corrected for, but s and θ were not. This yielded: 3.2mm and 3.2mm. The average computation time for 170 beamlets was 65 seconds.

CONCLUSION: These results emphasize the necessity to correct for setup errors and the errors in the calibration curve. The simplicity and speed of our method makes it a good candidate for being implemented as a tool for in-room adaptive therapy. This work also demonstrates that the Prompt gamma range measurements can indeed be useful in the effort to reduce range errors. Given these results, and barring further refinements, this approach is a promising step towards an adaptive proton radiotherapy.