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International audience; Purpose: Dosimetry is of major value in the preclinical phase of radiopharmaceutical development and its clinical use may be considered an inherent part of therapy to establish the maximum tolerated dose and dose-response relationship. The OpenGATE collaboration is constantly improving the GATE Monte Carlo simulation platform for dosimetry calculations. Our team, as part of the collaboration, has proposed a method implementing S-factor calculation using GATE.Methods: The usual strategy of internal emitter dose estimation using the MIRD formalism establishes that dose can be determined by the product of S-factor times cumulated activity in the source organ.Our procedure is based on the definition of sources and targets volumes from RT-struct DICOM files obtained from patient CT scans. In GATE 8.0 (estimated release by spring 2017) it will be possible to manage DICOM files; we modified in addition the code to have the possibility to manage RT-struct files.Contoured organs from CT scan can be converted into voxelized volumes inside GATE, then simulations can be easily performed choosing a source volume and specifying target volumes. This approach has been validated in different preclinical dosimetry studies.Results: We are now able to perform S-factor calculations in preclinical models with a computing time of around 6 hours on a single CPU (Intel Xeon 3.00GHz) for an initial number of particles (gamma E=140keV) of 10⁷ and with 3 defined materials (soft tissue, lung and bone).Conclusion: We look ahead to create a useful and convenient tool for personalized internal dosimetry in the purpose of speed up S-factor calculation in preclinical and clinical trials. We consider adding S-factor calculation tool to GATE after the next release (by end 2017).Funding Support, Disclosures, and Conflict of Interest: This work was supported by grants from ANR (Agence Nationale pour la Recherche), Programme Recherche translationnelle en sante (DS0411) 2015 under contract ANR-15-CE18-003 and from ITMO "Technologies pour la sante" - AVIESAN

Hadrontherapy is a recent and particularly attractive modality. Characterized by a specific dose deposition profile in matter and by a high biological effectiveness, ions are found to be very well-suited for cancer treatment. As an emergent modality, the research in hadrontherapy is extremely active and promises many improvements for the future. However, there is no tool to date to quantify the clinical benefit for the patient related to the proposed improvements, the use of a gantry for example. In this work, we propose to use the treatment planning system, usually dedicated to clinical practice, in a prospective purpose. Suppressing the classical constraints of precision and time, our optimization method is based on a genetic algorithm designed to approach a global solution including a high number of balistic parameters (free irradiation fields) for all regions of dosimetric interest. The optimization strategy is progressively complicated in order to efficientely take into account the main issues of the inverse planning problem. The robustness of plans towards the uncertainties related to the application of the treatment, essential in hadrontherapy, is evaluated. The results show that the inclusion, in the optimization, of parameters usually fixed by the human planner leads systematically to an improved treatment quality. The final product of this work is a prospective optimization tool characterized by an easy set-up system and the ability to perform comparative studies on the relevance of new irradiation modalities.; L'hadronthérapie est une modalité d'irradiation récente particulièrement attractive. Les ions, par leur profil caractéristique de dépôt de dose dans la matière et leur efficacité biologique accrue, sont des particules parfaitement adaptées pour le traitement du cancer. C’est une modalité émergente et les travaux de recherche et de développement qui en font l'objet se poursuivent de manière soutenue. Cependant, il n'existe à ce jour aucun outil permettant de quantifier pour le patient le gain clinique associé aux améliorations proposées, comme l’apport d’une gantry par exemple. Nous proposons dans ce travail de concevoir un module de planification inverse du traitement pour un but prospectif. Détachée des contraintes usuelles de précision et de temps de calcul, notre méthode d'optimisation se base sur un algorithme génétique afin d'approcher d'une solution globale vis-à-vis d'un grand nombre de paramètres balistiques (champs d’irradiation libres) et en associant les diverses régions d'intérêt dosimétrique. La stratégie d'optimisation retenue est progressivement complexifiée afin de prendre en compte de manière efficace les différents enjeux de la planification. La robustesse du plan vis-à-vis des incertitudes inhérentes au traitement, primordiale en hadronthérapie, est évaluée. Dans toutes les situations testées, il apparaît que l'inclusion dans l'optimisation de paramètres habituellement fixés manuellement permet une amélioration de la qualité de traitement. Nous proposons au terme de cette étude un outil prospectif d'optimisation au réglage simple et capable de mener des études comparées sur la pertinence de nouvelles modalités d’irradiation.

Hadrontherapy is a recent and particularly attractive modality. Characterized by a specific dose deposition profile in matter and by a high biological effectiveness, ions are found to be very well-suited for cancer treatment. As an emergent modality, the research in hadrontherapy is extremely active and promises many improvements for the future. However, there is no tool to date to quantify the clinical benefit for the patient related to the proposed improvements, the use of a gantry for example. In this work, we propose to use the treatment planning system, usually dedicated to clinical practice, in a prospective purpose. Suppressing the classical constraints of precision and time, our optimization method is based on a genetic algorithm designed to approach a global solution including a high number of balistic parameters (free irradiation fields) for all regions of dosimetric interest. The optimization strategy is progressively complicated in order to efficientely take into account the main issues of the inverse planning problem. The robustness of plans towards the uncertainties related to the application of the treatment, essential in hadrontherapy, is evaluated. The results show that the inclusion, in the optimization, of parameters usually fixed by the human planner leads systematically to an improved treatment quality. The final product of this work is a prospective optimization tool characterized by an easy set-up system and the ability to perform comparative studies on the relevance of new irradiation modalities., L'hadronthérapie est une modalité d'irradiation récente particulièrement attractive. Les ions, par leur profil caractéristique de dépôt de dose dans la matière et leur efficacité biologique accrue, sont des particules parfaitement adaptées pour le traitement du cancer. C’est une modalité émergente et les travaux de recherche et de développement qui en font l'objet se poursuivent de manière soutenue. Cependant, il n'existe à ce jour aucun outil permettant de quantifier pour le patient le gain clinique associé aux améliorations proposées, comme l’apport d’une gantry par exemple. Nous proposons dans ce travail de concevoir un module de planification inverse du traitement pour un but prospectif. Détachée des contraintes usuelles de précision et de temps de calcul, notre méthode d'optimisation se base sur un algorithme génétique afin d'approcher d'une solution globale vis-à-vis d'un grand nombre de paramètres balistiques (champs d’irradiation libres) et en associant les diverses régions d'intérêt dosimétrique. La stratégie d'optimisation retenue est progressivement complexifiée afin de prendre en compte de manière efficace les différents enjeux de la planification. La robustesse du plan vis-à-vis des incertitudes inhérentes au traitement, primordiale en hadronthérapie, est évaluée. Dans toutes les situations testées, il apparaît que l'inclusion dans l'optimisation de paramètres habituellement fixés manuellement permet une amélioration de la qualité de traitement. Nous proposons au terme de cette étude un outil prospectif d'optimisation au réglage simple et capable de mener des études comparées sur la pertinence de nouvelles modalités d’irradiation.

International audience; New treatment planning systems adapted to proton spot scanningtechniques have been recently proposed to simultaneouslyoptimize several fields and thus improve dose delivery.The only parameters usually optimized are the field fluenceswhereas other parameters (e.g. beam directions) are chosenby medical physicists and are limited by technological constraints.We investigate a genetic algorithm approach designed tooptimize the number of beams, target points and irradiationdirections at the same time. This tool is intended to pave theway towards optimal treatment ballistics. The optimizationframework is designed to be versatile and to account formany degrees of freedom, without any a priori technologicalconstraint.