Abstract: Proton therapy aims at irradiating tumors with millimeter precision while sparing surrounding healthy tissues. With pencil-beam scanning (PBS), it can deliver highly conformal dose distributions by optimizing the position and energy of many small proton beamlets. However, these capabilities are not fully exploited clinically. One of the main problems is daily variation in patient’s geometry. Adaptive image-guided approaches address this problem by adapting the original treatment plan to daily variations in patient positioning and anatomical changes. In this talk, I will discuss adaptation approaches in proton therapy based on in-room CBCT, CT-on-rails, and a hypothetical in-room MRI. I will briefly present an adaptive workflow established at MGH, compare CBCT and CT-on-rails in the context of adaptive treatments, and discuss some ongoing efforts to explore in-room MRI adaptation possibilities. 

About the speaker: Dr. Nesteruk is a Research Fellow in Dr. Paganetti’s lab at the MGH and Harvard Medical School. He received his PhD in Physics from the University of Bern in Switzerland in 2017. Since 2017 he has been working on technology development and dose delivery in proton therapy. Currently, he is working on the project funded by the Swiss National Science Foundation to investigate different imaging modalities for online adaptive proton therapy.