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@ARTICLE{Dolde:136855,
      author       = {K. Dolde$^*$ and P. Naumann and C. Dávid$^*$ and R.
                      Gnirs$^*$ and M. Kachelrieß$^*$ and A. J. Lomax and N.
                      Saito and D. C. Weber and A. Pfaffenberger$^*$ and Y. Zhang},
      title        = {4{D} dose calculation for pencil beam scanning proton
                      therapy of pancreatic cancer using repeated 4{DMRI}
                      datasets.},
      journal      = {Physics in medicine and biology},
      volume       = {63},
      number       = {16},
      issn         = {1361-6560},
      address      = {Bristol},
      publisher    = {IOP Publ.},
      reportid     = {DKFZ-2018-01293},
      pages        = {165005},
      year         = {2018},
      abstract     = {4D magnetic resonance imaging (4DMRI) has a high potential
                      for pancreatic cancer treatments using proton therapy, by
                      providing time-resolved volumetric images with a high
                      soft-tissue contrast without exposing the patient to any
                      additional imaging dose. In this study, we aim to show the
                      feasibility of 4D treatment planning for pencil beam
                      scanning (PBS) proton therapy of pancreatic cancer, based on
                      five repeated 4DMRI datasets and 4D dose calculations (4DDC)
                      for one pancreatic cancer patient. To investigate the
                      dosimetric impacts of organ motion, deformation vector
                      fields were extracted from 4DMRI, which were then used to
                      warp a static CT of the patient, so as to generate synthetic
                      4DCT (4DCT-MRI). CTV motion amplitudes  <15 mm were
                      observed for this patient. The results from 4DDC show
                      pronounced interplay effects in the CTV with dose
                      homogeneity d5/d95 and dose coverage v95 being 1.14 and
                      $91\%,$ respectively, after a single fraction of the
                      treatment. An averaging effect was further observed when
                      increasing the number of fractions. Motion effects can
                      become less dominant and dose homogeneity
                      d5/d95  =  1.03 and dose coverage
                      v95  =  [Formula: see text] within the CTV can be
                      achieved after 28 fractions. The observed inter-fractional
                      organ and tumor motion variations underline the importance
                      of 4D imaging before and during PBS proton therapy.},
      cin          = {E040 / E020 / E010 / E025},
      ddc          = {570},
      cid          = {I:(DE-He78)E040-20160331 / I:(DE-He78)E020-20160331 /
                      I:(DE-He78)E010-20160331 / I:(DE-He78)E025-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30020079},
      doi          = {10.1088/1361-6560/aad43f},
      url          = {https://inrepo02.dkfz.de/record/136855},
}