{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:15:41Z","timestamp":1790705741894,"version":"4.1.0"},"reference-count":28,"publisher":"IOP Publishing","issue":"24","license":[{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/publishingsupport.iopscience.iop.org\/iop-standard\/v1"},{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Science Foundation of China","doi-asserted-by":"crossref","award":["8220294"],"award-info":[{"award-number":["8220294"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Nature Science Research Project of Anhui Province","award":["2208085MA13"],"award-info":[{"award-number":["2208085MA13"]}]},{"name":"the National Key Research and Development Program of China","award":["2018YFE0114100"],"award-info":[{"award-number":["2018YFE0114100"]}]}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Phys. Med. Biol."],"published-print":{"date-parts":[[2022,12,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objective.<\/jats:italic>\n                    Proton therapy after breast-conserving surgery (BCS) can substantially reduce the dose to lung and cardiac structures. However, these dosimetric benefits are subject to beam range uncertainty in patient. The conversion of the CT-Hounsfield unit (HU) into relative stopping power (RSP) is the primary contribution to range uncertainty. Hence, an accurate HU-RSP conversion is essential.\n                    <jats:italic>Approach.<\/jats:italic>\n                    Real tissue samples, including muscle and adipose, were prepared. The water equivalent path length (WEPL) of these samples was measured under homogeneous conditions using a 12-diode detector array of our time-resolved\n                    <jats:italic>in vivo<\/jats:italic>\n                    range verification system (IRVS). The HU-RSP conversion was improved using the measured WEPL and HU for adipose tissue. The measured WEPL values were compared with the treatment planning calculation results based on the stoichiometric CT-HU calibration technique. The effect was investigated for both with and without adipose tissue in HU-RSP conversion.\n                    <jats:italic>Main results.<\/jats:italic>\n                    The IRVS was calibrated based on the solid water phantom. The relative differences in WEPL (RSP) between measurements and calculations for muscle, adipose, and water was \u22121.19% (\u22120.75%), \u22124.25%(\u22124%), and \u22120.23%(\u22120.07%), respectively. Based on the improved HU-RSP conversion, the relative differences in WEPL was reduced to \u22120.97%(\u22120.62%), \u22121.50%(\u22121.46%), and \u22120.22% (0.00%), respectively.\n                    <jats:italic>Significance.<\/jats:italic>\n                    The WEPL deviation of adipose tissue is larger than the testing limit of 3.5% for beam range robustness in current clinical practice. However, the improved HU-RSP conversion reduced this deviation. The main component of breast tissue is adipose. Hence, the proton treatment of BCS can be undershooting if no proper measures are taken against this specific uncertainty.\n                  <\/jats:p>","DOI":"10.1088\/1361-6560\/aca315","type":"journal-article","created":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T17:40:45Z","timestamp":1668534045000},"page":"245006","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Improvement of proton beam range uncertainty in breast treatment using tissue samples"],"prefix":"10.1088","volume":"67","author":[{"given":"Xiangli","family":"Cui","sequence":"first","affiliation":[{"name":"Chinese Academy of Sciences"},{"name":"Chinese Academy of Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungwook","family":"Jee","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man","family":"Hu","sequence":"additional","affiliation":[{"name":"Shandong First Medical University and Shandong Academy of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Bao","sequence":"additional","affiliation":[{"name":"Chinese Academy of Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiao-Ming","family":"Lu","sequence":"additional","affiliation":[{"name":"Hefei Ion Medical Center, Hefei, Anhui, 230088,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2022,12,7]]},"reference":[{"key":"pmbaca315bib1","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1016\/j.ijrobp.2009.02.062","type":"journal-article","article-title":"Postoperative proton radiotherapy for localized and locoregional breast cancer: potential for clinically relevant improvements?","volume":"76","author":"Ares","year":"2010","journal-title":"Int. J. Radiat. Biol. Phys."},{"key":"pmbaca315bib2","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1002\/mp.15283","type":"journal-article","article-title":"Experimental comparison of photon versus particle computed tomography to predict tissue relative stopping powers","volume":"49","author":"B\u00e4r","year":"2022","journal-title":"Med. Phys."},{"key":"pmbaca315bib3","doi-asserted-by":"publisher","first-page":"5473","DOI":"10.1088\/0031-9155\/57\/17\/5473","type":"journal-article","article-title":"Effect of tissue heterogeneity on an in vivo range verification technique for proton therapy","volume":"57","author":"Bentefour","year":"2012","journal-title":"Phys. Med. Biol."},{"key":"pmbaca315bib4","doi-asserted-by":"publisher","first-page":"1936","DOI":"10.1118\/1.4915923","type":"journal-article","article-title":"Validation of an in-vivo proton beam range check method in an anthropomorphic pelvic phantom using dose measurements","volume":"42","author":"Bentefour","year":"2015","journal-title":"Med. Phys."},{"key":"pmbaca315bib5","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1177\/153303460300200504","type":"journal-article","article-title":"Treatment planning for conformal proton radiation therapy","volume":"2","author":"Bussiere","year":"2003","journal-title":"Technol. Cancer. Res. T"},{"key":"pmbaca315bib6","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1109\/REDW.2010.6062516","type":"conference-proceedings","article-title":"The use of diodes as dose and fluence probes in the experimental beamline at the Francis H Burr Proton Therapy Center","author":"Cascio","year":"2011"},{"key":"pmbaca315bib7","doi-asserted-by":"publisher","first-page":"678","DOI":"10.3389\/fonc.2018.00678","type":"journal-article","article-title":"Is proton therapy a \u2018pro\u2019 for breast cancer? A comparison of proton vs.non-proton radiotherapy using the national cancer database","volume":"8","author":"Chowdhary","year":"2019","journal-title":"Front. Oncol."},{"key":"pmbaca315bib8","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1200\/JCO.1994.12.3.447","type":"journal-article","article-title":"Cause-specific mortality in long-term survivors of breast-cancer who participated in trials of radiotherapy","volume":"12","author":"Cuzick","year":"1994","journal-title":"J. Clin.Oncol."},{"key":"pmbaca315bib9","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1056\/NEJMoa1209825","type":"journal-article","article-title":"Risk of ischemic heart disease in women after radiotherapy for breast cancer. NENGL","volume":"368","author":"Darby","year":"2013","journal-title":"J. MED."},{"key":"pmbaca315bib10","doi-asserted-by":"publisher","first-page":"2087","DOI":"10.1016\/S0140-6736(05)67887-7","type":"journal-article","article-title":"Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials","volume":"366","author":"Early Breast Cancer Trialists\u2019 Collaborative Group (EBCTCG)","year":"2005","journal-title":"Lancet"},{"key":"pmbaca315bib11","doi-asserted-by":"publisher","first-page":"1707","DOI":"10.1016\/S0140-6736(11)61629-2","type":"journal-article","article-title":"Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10801 women in 17 randomised trials","volume":"378","author":"Early Breast Cancer Trialists\u2019 Collaborative Group (EBCTCG)","year":"2011","journal-title":"Lancet"},{"key":"pmbaca315bib12","doi-asserted-by":"publisher","first-page":"S77","DOI":"10.1016\/j.ijrobp.2009.04.093","type":"journal-article","article-title":"Radiation dose-volume effects in the heart","volume":"76","author":"Gagliardi","year":"2010","journal-title":"Int. J. Radiat. Oncol."},{"key":"pmbaca315bib13","doi-asserted-by":"publisher","first-page":"2282","DOI":"10.1118\/1.3567498","type":"journal-article","article-title":"Water equivalent path length measurement in proton radiotherapy using time resolved diode dosimetry","volume":"38","author":"Gottschalk","year":"2011","journal-title":"Med. Phys."},{"key":"pmbaca315bib14","doi-asserted-by":"publisher","first-page":"3049","DOI":"10.1088\/0031-9155\/61\/8\/3049","type":"journal-article","article-title":"Clinical commissioning of an in vivo range verification system for prostate cancer treatment with anterior and anterior oblique proton beams","volume":"61","author":"Hoesl","year":"2016","journal-title":"Phys. Med. Biol."},{"key":"pmbaca315bib15","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1088\/0031-9155\/53\/5\/016","type":"journal-article","article-title":"A potential method for in vivo range verification in proton therapy treatment","volume":"53","author":"Hsiao-Ming","year":"2008","journal-title":"Phys. Med. Biol."},{"key":"pmbaca315bib16","first-page":"18","type":"journal-article","volume":"23","author":"ICRP","year":"1975","journal-title":"Report of the Task Group on Reference Man ICRP Publication"},{"key":"pmbaca315bib17","first-page":"20","type":"journal-article","article-title":"Tissue substitutes in radiation dosimetry and measurements","volume":"44","author":"ICRU","year":"1989","journal-title":"ICRU Report"},{"key":"pmbaca315bib18","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.radonc.2013.03.028","type":"journal-article","article-title":"Intensity modulated proton therapy for postmastectomy radiation of bilateral implant reconstructed breasts: a treatment planning study","volume":"107","author":"Jimenez","year":"2013","journal-title":"Radiother. Oncol."},{"key":"pmbaca315bib19","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1186\/1748-717X-8-71","type":"journal-article","article-title":"Proton radiotherapy for chest wall and regional lymphatic radiation; dose comparisons and treatment delivery","volume":"8","author":"Macdonald","year":"2013","journal-title":"Radiat. Oncol."},{"key":"pmbaca315bib20","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/978-3-319-70197-4_7","type":"journal-article","article-title":"Advancements and personalization of breast cancer treatment strategies in radiation therapy","volume":"173","author":"Moran","year":"2018","journal-title":"Cancer Treat Res."},{"key":"pmbaca315bib21","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/j.ijrobp.2021.05.110","type":"journal-article","article-title":"Proton therapy for breast cancer: a consensus statement from the particle therapy cooperative group breast cancer subcommittee","volume":"111","author":"Mutter","year":"2021","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"pmbaca315bib22","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1200\/JCO.2011.34.5900","type":"journal-article","article-title":"Distribution of coronary artery stenosis after radiation for breast cancer","volume":"30","author":"Nilsson","year":"2012","journal-title":"J. Clin. Oncol."},{"key":"pmbaca315bib23","doi-asserted-by":"publisher","first-page":"R99","DOI":"10.1088\/0031-9155\/57\/11\/R99","type":"journal-article","article-title":"Range uncertainties in proton therapy and the role of Monte Carlo simulations","volume":"57","author":"Paganetti","year":"2012","journal-title":"Phys. Med. Biol."},{"key":"pmbaca315bib24","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1088\/0031-9155\/43\/6\/016","type":"journal-article","article-title":"The precision of proton range calculations in proton radiotherapy treatment planning: experimental verification of the relation between CT-HU and proton stopping power","volume":"43","author":"Schaffner","year":"1998","journal-title":"Phys. Med. Biol."},{"key":"pmbaca315bib25","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1088\/0031-9155\/41\/1\/009","type":"journal-article","article-title":"The calibration of CT Hounsfield units for radiotherapy treatment planning","volume":"41","author":"Scheneider","year":"1996","journal-title":"Phys. Med. Biol."},{"key":"pmbaca315bib26","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1200\/JCO.2015.63.6456","type":"journal-article","article-title":"DBCG-IMN: a population-based cohort study on the effect of internal mammary node irradiation in early node-positive breast cancer","volume":"34","author":"Thorsen","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"pmbaca315bib27","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1259\/0007-1285-59-708-1209","type":"journal-article","article-title":"The composition of body-tissues","volume":"59","author":"Woodard","year":"1986","journal-title":"Br. J. Radiol."},{"key":"pmbaca315bib28","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/aaae91","type":"journal-article","article-title":"Ex vivo validation of a stoichiometric dual energy CT proton stopping power ratio calibration","volume":"63","author":"Xie","year":"2018","journal-title":"Phys. Med. Biol."}],"container-title":["Physics in Medicine &amp; Biology"],"original-title":[],"link":[{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6560\/aca315","content-type":"text\/html","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6560\/aca315\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6560\/aca315","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6560\/aca315\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6560\/aca315\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6560\/aca315\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6560\/aca315\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"similarity-checking"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6560\/aca315\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T16:47:35Z","timestamp":1778777255000},"score":1,"resource":{"primary":{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6560\/aca315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,7]]},"references-count":28,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12,7]]},"published-print":{"date-parts":[[2022,12,21]]}},"URL":"https:\/\/doi.org\/10.1088\/1361-6560\/aca315","relation":{},"ISSN":["0031-9155","1361-6560"],"issn-type":[{"value":"0031-9155","type":"print"},{"value":"1361-6560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,7]]},"assertion":[{"value":"Improvement of proton beam range uncertainty in breast treatment using tissue samples","name":"article_title","label":"Article Title"},{"value":"Physics in Medicine & Biology","name":"journal_title","label":"Journal Title"},{"value":"paper","name":"article_type","label":"Article Type"},{"value":"\u00a9 2022 Institute of Physics and Engineering in Medicine. All rights, including for text and data mining, AI training, and similar technologies, are reserved.","name":"copyright_information","label":"Copyright Information"},{"value":"2022-06-08","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2022-11-15","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2022-12-07","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}