IMRT

Alternative : robust prescription

Heterogeneous*prescrip.on* D P D P Dilated Dila;on2by22

PET dilated deblurred

1%

α Σ

2%

Deblurring2using2

σ

Robust*prescrip.on* D RP D Planned Planning2

QVH ! ) (± α Σ,σ 2 >95%22 for2all2direc;ons22 ( Q 0.95

Yes2

Treat !

3%

QVH ! ) planning ) planning

( Q 0.95

>95%22 <5%22

( Q 1.05

* α Σ ! !"#$$%& (! ± !!) ⊗ !(!, !) ! Yes2

Displacements2by222 Blurring2by2222 σ

Profiles acquired through center of tumor

70 72 74 76 78 80 82 84 86 88 90

GTV PTV

Spherical%tumor%

Dose (Gy)

Original prescription Dilated prescription Robust prescription

Only dependent on σ and Σ independant of TPS

−3

−2

−1

0

1

2

3

Position from center of tumor (cm)

9%

Court. of E.Sterpin,