1

A comparison of single-phase and phase-gated average verification planning for phase-

gated proton treatment

I. Abstract
II. Introduction
A. PI: IMPT offers treatment advantages for chest and abdominal treatment sites.
(Reference: Tryggestad et al,1 Hu et al,2 Deiter et al3, Evans et al4)
B. PII: Verification planning registers scans, calculates dose, evaluates target coverage
and organ doses, allowing modifications for treatment adjustments and efficient
maintenance of plan quality. (Reference: Hu et al,2 Evans et al,4 Green et al5)
C. PIII: Target motion affects IMPT accuracy. Respiratory gating helps mitigate dose
degradation. 4DCT is used for motion evaluation and planning. (Reference:
Tryggestad et al,1 Taasti et al,6 Gelover et al,7 Gut et al,8)
D. PIV: Chest and abdominal treatment sites require 4D phase gating for motion
management, necessitating efficient workflows and automation. (Reference:
Tryggestad et al,1 Gelover et al,7 Mundy et al,9)
E. PV: ART improves IMPT accuracy through real-time treatment plan modification.
Efficient workflows and specialized automation tools are essential for
implementation. (Reference: Tryggestad et al,1 Green et al5)
F. PVI: Summarize introduction points.
1. Problem: The problem is that the verification process for patients receiving
phase-gated proton treatment requires the creation of a new phase-gated average
scan which is time consuming, requires additional clinical resources, and is
incompatible with current software used for automatic verification planning. 
2. Purpose: The purpose of this study was to compare target coverage reported on
phase-gated average verification plans to target coverage on single-phase
verification plans to ensure that the results were within clinically acceptable
standards.
3. Hypothesis: The first research hypothesis (H1) is that the target coverage (V95%)
on a single-phase verification plan will be within 5% of the target coverage
(V95%) on a phase-gated average verification plan.
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III. Materials and Methods

A. PI: Study selection
1. Patient selection criteria
a. Inclusion criteria (4D treatments)
b. Exclusion criteria (not 4D treatments)
2. Study Population
a. Number of patients
b. 4D lung patients
c. 4D liver patients
d. 4D esophagus patients
B. PII: Study Design
1. 4D verification with phase gated average scan
a. MIM workflow
b. Eclipse import and verification plan process
2. Single 50-phase scan
a. MIM workflow
b. Eclipse import and verification plan process
C. PIII: Plan Comparison
1. Physician review and contour modification
D. PIV: Data Collection
1. Dose statistics
2. Physician review
E. PV: Statistical Analysis

IV. Results
V. Discussion
VI. Conclusion
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References
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