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Hofmaier, Jan; Walter, Franziska; Hadi, Indrawati; Rottler, Maya; von Bestenbostel, Rieke; Dedes, George; Parodi, Katia; Niyazi, Maximilian; Belka, Claus and Kamp, Florian (2021): Combining inter-observer variability, range and setup uncertainty in a variance-based sensitivity analysis for proton therapy. In: Physics & Imaging in Radiation Oncology, Vol. 20: pp. 117-120

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Margin concepts in proton therapy aim to ensure full dose coverage of the clinical target volume (CTV) in presence of setup and range uncertainty. Due to inter-observer variability (IOV), the CTV itself is uncertain. We present a framework to evaluate the combined impact of IOV, setup and range uncertainty in a variance-based sensitivity analysis (SA). For ten patients with skull base meningioma, the mean calculation time to perform the SA including 1.6 x 10(4) dose recalculations was 59 min. For two patients in this dataset, IOV had a relevant impact on the estimated CTV D-95% uncertainty.

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