{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:26:12Z","timestamp":1787009172140,"version":"build-2736575974"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The Pencil Beam Scanning (PBS) technique in modern particle therapy offers a highly conformal dose distribution but poses challenges due to the interplay effect, an interaction between respiration-induced organ movement and PBS. This study evaluates the effectiveness of different volumetric rescanning strategies in mitigating this effect in liver cancer proton therapy. We used a Geant4-based Monte Carlo simulation toolkit, \u2018TOPAS,\u2019 and an image registration toolbox, \u2018Elastix,\u2019 to calculate 4D dose distributions from 5 patients\u2019 four-dimensional computed tomography (4DCT). We analyzed the homogeneity index (HI) value of the Clinical Tumor Volume (CTV) at different rescan numbers and treatment times. Our results indicate that dose homogeneity stabilizes at a low point after a week of treatment, implying that both rescanning and fractionation treatments help mitigate the interplay effect. Notably, an increase in the number of rescans doesn\u2019t significantly reduce the mean dose to normal tissue but effectively prevents high localized doses to tissue adjacent to the CTV. Rescanning techniques, based on statistical averaging, require no extra equipment or patient cooperation, making them widely accessible. However, the number of rescans, tumor location, diaphragm movement, and treatment fractionation significantly influence their effectiveness. Therefore, deciding the number of rescans should involve considering the number of beams, treatment fraction size, and total delivery time to avoid unnecessary treatment extension without significant clinical benefits. The results showed that 2\u20133 rescans are more clinically suitable for liver cancer patients undergoing proton therapy.<\/jats:p>","DOI":"10.1093\/jrr\/rrad093","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T12:22:43Z","timestamp":1698754963000},"page":"100-108","source":"Crossref","is-referenced-by-count":5,"title":["An investigation into the impact of volumetric rescanning and fractionation treatment on dose homogeneity in liver cancer proton therapy"],"prefix":"10.1093","volume":"65","author":[{"given":"Pei-Yi","family":"Lee","sequence":"first","affiliation":[{"name":"Proton and Radiation Therapy Center , Department of Radiation Oncology, , No. 129, Dapi Rd., Niaosong Dist., Kaohsiung City, 833401 , Taiwan"},{"name":"Kaohsiung Chang Gung Memorial Hospital , Department of Radiation Oncology, , No. 129, Dapi Rd., Niaosong Dist., Kaohsiung City, 833401 , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing-Shen","family":"Huang","sequence":"additional","affiliation":[{"name":"Proton and Radiation Therapy Center , Department of Radiation Oncology, , No. 129, Dapi Rd., Niaosong Dist., Kaohsiung City, 833401 , Taiwan"},{"name":"Kaohsiung Chang Gung Memorial Hospital , Department of Radiation Oncology, , No. 129, Dapi Rd., Niaosong Dist., Kaohsiung City, 833401 , Taiwan"},{"name":"Proton and Radiation Therapy Center , Department of Radiation Oncology, , No. 15, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 333011 , Taiwan"},{"name":"Linkou Chang Gung Memorial Hospital , Department of Radiation Oncology, , No. 15, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 333011 , Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University , No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 333323 , Taiwan"},{"name":"Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University , No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 333323 , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shen-Hao","family":"Lee","sequence":"additional","affiliation":[{"name":"Proton and Radiation Therapy Center , Department of Radiation Oncology, , No. 15, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 333011 , Taiwan"},{"name":"Linkou Chang Gung Memorial Hospital , Department of Radiation Oncology, , No. 15, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 333011 , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsz-Yui","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University , No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 333323 , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Yen","sequence":"additional","affiliation":[{"name":"Institute of Physics , Academia Sinica, No. 128, Sec. 2, Academia Rd., Nangang Dist., Taipei City, 115201 , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsair-Fwu","family":"Lee","sequence":"additional","affiliation":[{"name":"Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Science and Technology , No. 415, Jiangong Rd., Sanmin Dist., Kaohsiung City, 807618 , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Chun","family":"Cho","sequence":"additional","affiliation":[{"name":"Research Center for Radiation Medicine, Chang Gung University , No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 333323 , Taiwan"},{"name":"Institute for Radiological Research, Chang Gung University , No. 259, Wenhua 1st Rd., Guishan Dist., Taiwan Taoyuan City, 333323 Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"2024012223381729900_ref1","doi-asserted-by":"crossref","first-page":"e1940","DOI":"10.1002\/rcs.1940","article-title":"Respiratory motion estimation of the liver with abdominal motion as a surrogate","volume":"14","author":"Fahmi","year":"2018","journal-title":"Int J Med Robot"},{"key":"2024012223381729900_ref2","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1378\/chest.14-1425","article-title":"The effect of respiratory motion on pulmonary nodule location during electromagnetic navigation bronchoscopy","volume":"147","author":"Chen","year":"2015","journal-title":"Chest"},{"key":"2024012223381729900_ref3","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1177\/028418518402500208","article-title":"Cranio-caudal movements of the liver, pancreas and kidneys in 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