TY  - JOUR
AU  - Galeone, Cosimo
AU  - Nakas, A.
AU  - Donetti, M.
AU  - Martire, Maria Chiara
AU  - Milian, F. M.
AU  - Pella, A.
AU  - Paganelli, C.
AU  - Sacchi, R.
AU  - Vignati, A.
AU  - Durante, Marco
AU  - Baroni, G.
AU  - Giordanengo, S.
AU  - Graeff, Christian
TI  - Real-time motion modeling and treatment verification for irregular motion in carbon ion therapy: a feasibility study
JO  - Physics in medicine and biology
VL  - 70
IS  - 16
SN  - 0031-9155
CY  - Bristol
PB  - IOP Publ.
M1  - GSI-2025-01090
SP  - 165009
PY  - 2025
N1  - Original content from this work may be used under the terms of the Creative Commons Attribution 4.0 licence.
AB  - Objective.Irregular motion impacts treatment accuracy and can be compensated by larger margins or online adaptive approaches. A seamless workflow for fast and accurate 4D-dose reconstruction allows dosimetric monitoring intra- and inter-fractionally, as a basis for adaptive therapy. This study presents a real-time, motion-adaptive framework that combines motion modeling and treatment verification, integrated into the dose delivery and monitoring systems to enable continuous assessment of the delivered 4D-dose.Approach.The framework includes a GPU-based analytical algorithm for real-time dose reconstruction in carbon ion therapy, interfaced with the dose delivery and optical tracking systems at the Centro Nazionale di Adroterapia Oncologica (CNAO). A motion model, driven by external surrogate tracking, generates a virtual CT every 150 ms, used for 4D-dose reconstruction with measured spot parameters. Planned and delivered doses are compared after each iso-energy slice. The framework was validated at CNAO using a geometric target and a 4D lung tumor phantom with a moving 2D ionization chamber array, under regular and irregular motion patterns.Main results.The framework successfully generated real-time CT images of the lung phantom, showing strong agreement with ground-truth images. Dose reconstructions were performed within inter-spill times during delivery, ensuring rapid assessment. Comparisons against detector measurements yielded an average gamma-index passing rate of 99
KW  - Heavy Ion Radiotherapy: methods
KW  - Feasibility Studies
KW  - Humans
KW  - Movement
KW  - Phantoms, Imaging
KW  - Time Factors
KW  - Radiotherapy Planning, Computer-Assisted: methods
KW  - Radiotherapy Dosage
KW  - Four-Dimensional Computed Tomography
KW  - Lung Neoplasms: radiotherapy
KW  - Lung Neoplasms: diagnostic imaging
KW  - Lung Neoplasms: physiopathology
KW  - adaptive therapy (Other)
KW  - irregular motion (Other)
KW  - motion model (Other)
KW  - particle therapy (Other)
KW  - real-time dose calculation (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:40730202
UR  - <Go to ISI:>//WOS:001548428600001
DO  - DOI:10.1088/1361-6560/adf592
UR  - https://repository.gsi.de/record/362217
ER  -