A new detector for the beam energy measurement in proton therapy: a feasibility study
A. Vignati, S. Giordanengo, F. Mas Milian, Z. Ahmadi Ganjeh, M. Donetti, F. Fausti, M. Ferrero, O. Hammad Ali, O. A. Martì Villarreal, G. Mazza, Z. Shakarami, V… 展开作者
A. Vignati, S. Giordanengo, F. Mas Milian, Z. Ahmadi Ganjeh, M. Donetti, F. Fausti, M. Ferrero, O. Hammad Ali, O. A. Martì Villarreal, G. Mazza, Z. Shakarami, V. Sola, A. Staiano, R. Cirio, R. Sacchi, V. Monaco, .
Fast procedures for the beam quality assessment and for the monitoring of beam energy modulations during the irradiation are among the most urgent improvements in particle therapy. Indeed, the online measurement of the particle beam energy could allow assessing the range of penetration during treatments, encouraging the development of new dose delivery techniques for moving targets. Towards this end, the proof of concept of a new device, able to measure in a few seconds the energy of clinical proton beams (from 60 to 230 MeV) from the Time of Flight (ToF) of protons, is presented. The prototype consists of two Ultra Fast Silicon Detector (UFSD) pads, featuring an active thickness of 80 um and a sensitive area of 3 x 3 mm2, aligned along the beam direction in a telescope configuration, connected to a broadband amplifier and readout by a digitizer. Measurements were performed at the Centro Nazionale di Adroterapia Oncologica (CNAO, Pavia, Italy), at five different clinical beam energies and four distances between the sensors (from 7 to 97 cm) for each energy. In order to derive the beam energy from the measured average ToF, several systematic effects were considered, Monte Carlo simulations were developed to validate the method and a global fit approach was adopted to calibrate the system. The results were benchmarked against the energy values obtained from the water equivalent depths provided by CNAO. Deviations of few hundreds of keV have been achieved for all considered proton beam energies for both 67 and 97 cm distances between the sensors and few seconds of irradiation were necessary to collect the required statistics. These preliminary results indicate that a telescope of UFSDs could achieve in a few seconds the accuracy required for the clinical application and therefore encourage further investigations towards the improvement and the optimization of the present prototype.
In proton therapy both the energy, which determines the range, and the distal slope, which reflects the rate at which the protons decelerate, are of import if we are to ensure accurate dose deposition and maximum tissue sparing. This publication describes a Geant4 model and presents a two-dimensional polynomial relationship between energy, the energy spread and the distal slope for beams with Gaussian energy spectra for proton therapy. This simple polynomial relationship will be useful for non-invasive or minimally invasive near real-time monitoring of the energy and energy spread of a proton …
We present calculations and simulations on the role of the p+$^{11}$B$\to$3$α$ reaction in proton therapy. This reaction has been recently suggested to be responsible for a decrease in the survival probability of tumor cells, when they are irradiated with low-energy protons. However, at the concentration levels typical of the proposed boron carrier (sodium borocaptate, Na$_{2}$B$_{12}$H$_{11}$SH, in short BSH), i.e. less than 100 ppm, both calculations and Monte Carlo simulations suggest that the dose related to this reaction is orders of magnitude lower than the dose delivered by the primary …
Background and Objective: Recent experimental studies using ultra-high dose rate radiation therapy (FLASH-RT) have shown improved normal tissue sparing and comparable tumor control compared to conventional dose rate RT. Pencil beam scanning (PBS) proton therapy with superior dosimetry characteristics has begun to draw attention to the delivery of conformal FLASH-RT for preclinical studies. This review aims to provide recent updates on the development of PBS FLASH-RT. Methods: The information summarized in this review article is based on search results in databases such as PubMed and search eng…
Secondary radiation in a radiation therapy environment is considered a cause for post-treatment side effects including secondary carcinogenesis. In a proton-therapy setup, neutrons deliver a considerable extra dose to the patient. Various measurements and calculations of neutron dose suggest a wide range of values for this quantity. This paper provides a comparison between the previously published values and analyzes the Monte Carlo calculated neutron dose from the present work using the neutron cross-section data. The purpose is to provide a range for the convergence of several neutron-absorb…
The advanced imaging and delivery techniques in proton therapy allow conformal high-dose irradiation of the target volume with high accuracy using pencil beam scanning or beam shaping apertures. These irradiation methods increasingly include small radiation fields with large dose gradients, which require detector systems with high spatial resolution for quality assurance. In addition the measurement of all success parameters for daily quality assurance with only one proton field and one simple detector system would save a lot of time in clinical usage. Based on their good spatial resolution an…
Previous measurements have shown large cross sections for the 11B(p,$α$)8Be reaction and K-shell ionization of boron from H+ ions. Past publications have shown that this reaction will likely increase the efficacy of proton therapy. This study investigates the size of boron particles for optimum treatment enhancement in proton therapy. Simulations of protons passing through varying sized boron particles were developed to compare energy outputs for alpha particles and low energy electrons. The results for the boron particle radius that produced the largest radiation output are presented in graph…
This contribution describes general concepts for control and safety systems in proton therapy. These concepts are illustrated by concrete examples implemented in the Proscan facility at PSI.
Proton Pencil-Beam Scanning Stereotactic Body Radiation Therapy and Hypofractionated Radiation Therapy for Thoracic Malignancies: Patterns of Practice Survey and Recommendations for Future Development from NRG Oncology and PTCOG
The proton boron fusion reaction, 11B(p, 3α), is investigated using MCNP6 to assess the viability for potential use in radiation therapy. The 11B(p, 3α) is theoretically desirable because it could combine the localized dose delivery protons exhibit (Bragg peak) with the creation of three high LET α particles that locally deposit energy in tumor regions. Simple simulations of a proton pencil beam incident upon a water phantom and a water phantom with an axial region also containing boron were modeled using MCNP6 in order to determine the extent of the impact boron had upon the calculated energy…
PET imaging is a non-invasive technique for particle range verification in proton therapy. It is based on measuring the beta+ annihilations caused by nuclear interactions of the protons in the patient. In this work we present measurements for proton range verification in phantoms, performed at the CNAO particle therapy treatment center in Pavia, Italy, with our 10 x 10 cm^2 planar PET prototype DoPET. PMMA phantoms were irradiated with mono-energetic proton beams and clinical treatment plans, and PET data were acquired during and shortly after proton irradiation. We created 1-D profiles of the…
Cao et al (2018) published an article on inverse planning based on dose-averaged linear energy transfer (LET). Their claim that the problem can be cast as a linear optimization model relies on an incorrect application of the Charnes-Cooper transformation. In this comment we show that their linear model is simlar to one where dose-averaged LET is multiplied with dose, explaining why their model was nonetheless able to improve the LET distribution.
Physical and biological range uncertainties limit the clinical potential of Proton Beam Therapy (PBT). In this proceedings, we report on two research projects, which we are conducting in parallel and which both tackle the problem of range uncertainties. One aims at developing software tools and the other at developing detector instrumentation. Regarding the first, we report on our development and pre-clinical application of a GPU-accelerated Monte Carlo (MC) simulation toolkit Fred. Concerning the letter, we report on our investigations of plastic scintillator based PET detectors for particle …
To expedite the commissioning process of the proton therapy system at Samsung Medical Center (SMC), we have developed a Monte Carlo simulation model of the proton therapy nozzles using TOPAS. At SMC proton therapy center, we have two gantry rooms with different types of nozzles; a multi-purpose nozzle and a dedicated scanning nozzle. Each nozzle has been modeled in detail following the geometry information provided by the manufacturer, Sumitomo Heavy Industries, Ltd. For this purpose, novel features of TOPAS, such as the time feature or the ridge filter class, have been used. And the appropria…
Background: A relative biological effectiveness (RBE) of 1.1 is used for proton therapy though clinical evidence of varying RBE was raised. Clinical studies on RBE variability have been conducted for decades for carbon radiation, which could advance the understanding of the clinical proton RBE given an ion-independent RBE model. In this work, such a model, linear and simple, using the beam quantity Q = Z^2/E (Z = ion charge, E = kinetic energy per nucleon) was tested and compared to the commonly used, proton-specific and linear energy transfer (LET) based Wedenberg RBE model. Material and meth…
Herein is a simulation study on the radio enhancement potential of calcium tungstate (CaWO4) and hafnium oxide (HfO2) nanoparticles (NPs) relative to gold (Au) NPs. The work utilizes the extensively studied Au NP as the "gold standard" to which the novel materials can be compared. All three materials were investigated in-silico with the software Penetration and Energy Loss of Positrons and Electrons (PENELOPE) developed by Francesc Salvat and distributed in the United States by the Radiation Safety Information Computational Center (RSICC) at Oak Ridge National Laboratory. The aims are: (1) Do …
For the in vivo range verification in proton therapy, it has been tried to measure the spatial distribution of the prompt gammas generated by the proton-induced interactions with the close relationship with the proton dose distribution. However, the high energy of the prompt gammas and background gammas are still problematic in measuring the distribution. In this study, we suggested a new method determining the in vivo range by utilizing the time structure of the prompt gammas formed with the rotation of a range modulation wheel (RMW) in the passive scattering proton therapy. To validate the M…
The radiotherapy of malignant diseases has reached much progress during the past decade. Thus, intensity modulated radiation therapy (IMRT) and VMAT (Rapidarc) now belong to the standard modalities of tumor treatment with high energy radiation in clinical practice. In recent time, the particle therapy (protons and partially with heavy carbon ions) has reached an important completion of these modalities with regard to some suitable applications. In spite of this enrichment essential features need further research activities and publications in this field: Nuclear reactions and the role of the r…
Therapeutic protons acting on O18-substituted thymidine increase cytotoxicity in radio-resistant human cancer cells. We consider here the physics behind the irradiation during proton beam therapy and diagnosis using O18-enriched thymine in DNA, with attention to the effect of the presence of thymine-18 on cancer cell death.
The total nuclear cross-section Qtot(E) resulting from the interaction of protons with nuclei is decomposed in 3 different contributions: 1. elastic scatter at the complete nucleus, which adopts a part of the proton kinetic energy; 2. inelastic scatter at a nucleus, which changes its quantum numbers by vibrations, rotations, transition to highly excited states; 3. proper nuclear reactions with change of the mass and/or charge number. Then different particles leave the hit nucleus (neutrons, protons, etc.), which is now referred to as 'heavy recoil' nucleus. The scatter parts of Qtot(E) accordi…
Depth distributions of positron-emitting nuclei in PMMA phantoms are calculated within a Monte Carlo model for Heavy-Ion Therapy (MCHIT) based on the GEANT4 toolkit (version 8.0). The calculated total production rates of $^{11}$C, $^{10}$C and $^{15}$O nuclei are compared with experimental data and with corresponding results of the FLUKA and POSGEN codes. The distributions of e$^+$ annihilation points are obtained by simulating radioactive decay of unstable nuclei and transporting positrons in surrounding medium. A finite spatial resolution of the Positron Emission Tomography (PET) is taken in…
This manuscript provides a response to a recent report by Mazzone et al. available online on arXiv that, in turn, tentatively aims at demonstrating the inefficacy of proton boron capture in hadrotherapy. We clarify that Mazzone et al. do not add any scientific or technical insights to the points extensively discussed in the original manuscript by Cirrone et al., and/or in the series of iterations had with the Referee, which ultimately lead to the publication of our original and pioneering experimental work. Here we summarize some of the key points of the long scientific debate we had during th…
Introduction. Treatment planning systems (TPS) are an essential component for simulating and optimizing a radiation therapy treatment before administering it to the patient. It ensures that the tumor is well covered and the dose to the healthy tissues is minimized. However, the TPS provided by commercial companies often come with a large panel of tools, each implemented in the form of a black-box making it difficult for researchers to use them for implementing and testing new ideas. To address this issue, we have developed an open-source TPS. Approach. We have developed an open-source software…
We apply the recently proposed superiorization methodology (SM) to the inverse planning problem in radiation therapy. The inverse planning problem is represented here as a constrained minimization problem of the total variation (TV) of the intensity vector over a large system of linear two-sided inequalities. The SM can be viewed conceptually as lying between feasibility-seeking for the constraints and full-fledged constrained minimization of the objective function subject to these constraints. It is based on the discovery that many feasibility-seeking algorithms (of the projection methods var…
In this study, two proton beam delivery designs, passive scattering proton therapy (PSPT) and pencil beam scanning (PBS), were quantitatively compared in terms of dosimetric indices. The GATE Monte Carlo code was used to simulate the proton beam system; and the developed simulation engines were benchmarked with respect to the experimental measurements. A water phantom was used to simulate system energy parameters using a set of depth-dose data in the energy range of 120-235 MeV. To compare the performance of PSPT against PBS, multiple dosimetric parameters including FWHM, peak position, range,…
Background and purpose: The relative biological effectiveness (RBE) varies along the treatment field. However, in clinical practice, a constant RBE of 1.1 is assumed, which can result in undesirable side effects. This study provides an accurate overview of current clinical practice for considering proton RBE in Europe. Materials and Methods: A survey was devised and sent to all proton therapy centres in Europe that treat patients. The online questionnaire consisted of 39 questions addressing various aspects of RBE consideration in clinical practice, including treatment planning, patient follow…
Uncertainties in the proton range in tissue during proton therapy limit the precision in treatment delivery. These uncertainties result in expanded treatment margins, thereby increasing radiation dose to healthy tissue. Real-time range verification techniques aim to reduce these uncertainties in order to take full advantage of the finite range of the primary protons. In this paper, we propose a novel concept for real-time range verification based on detection of secondary neutrons produced in nuclear interactions during proton therapy. The proposed detector concept is simple; consisting of a h…
Beam modelling of Hitachi PROBEAT proton therapy system for a GPU-based Fast Monte Carlo dose engine
University of Nebraska Omaha（内布拉斯加大学奥马哈分校）；Rice University（莱斯大学）；The University of Texas MD Anderson Cancer（德克萨斯大学安德森癌症中心）；Mevion Medical System（美维医疗系统）；Emory University（埃默里大学）
The First Nozzle-Mounted Compton Camera Prompt Gamma Imaging System for In Vivo Proton Therapy Dose Verification
University of Maryland School of Medicine（马里兰大学医学院）；University of Cape Town（开普敦大学）；University of Wisconsin School of Medicine and Public Health（威斯康星大学医学院与公共卫生学院）；University of Maryland, Baltimore County（马里兰大学巴尔的摩县分校）；H3D, Inc.（H3D公司）
When using superconducting (SC) magnets in a gantry for proton therapy, the gantry will benefit from some reduction in size and a large reduction in weight. In this contribution we show an important additional advantage of SC magnets in proton therapy treatments. We present the design of a gantry with a SC bending section and achromatic beam optics with a very large beam momentum acceptance of $\pm15\%$. Due to the related very large energy acceptance, approximately 70% of the treatments can be performed without changing the magnetic field for synchronization with energy modulation. In our des…
Background and purpose: In-beam Positron Emission Tomography (PET) is one of the modalities that can be used for in-vivo non-invasive treatment monitoring in proton therapy. PET distributions obtained during various treatment sessions can be compared in order to identify regions that have anatomical changes. The purpose of this work is to test and compare different analysis methods in the context of inter-fractional PET image comparison for proton treatment verification. Methods: For our study we used the FLUKA Monte Carlo code and artificially generated CT scans to simulate in-beam PET distri…
Radiotherapy is one of the main methods in the successful treatment of cancer. The tumor is irradiated with photons or charged particles (e.g. protons), and in the case of massive charged particles, the treatment results in less unnecessary dose outside the tumor and therefore less side effects for the patient and a faster recovery. However, the dose planning of hadron therapy is calculated from photon CT measurements, which results in large uncertainties in the planning and therefore in a necessary enlargement of the treatment area. This uncertainty can be reduced by performing the CT scan us…
Purpose: Dual-energy CT (DECT) has been used to derive relative stopping power (RSP) map by obtaining the energy dependence of photon interactions. The DECT-derived RSP maps could potentially be compromised by image noise levels and the severity of artifacts when using physics-based mapping techniques, which would affect subsequent clinical applications. This work presents a noise-robust learning-based method to predict RSP maps from DECT for proton radiation therapy. Methods: The proposed method uses a residual attention cycle-consistent generative adversarial (CycleGAN) network. CycleGAN wer…
The purpose of this study was to use various dosimetrical indices to determine the best IMRT modality technique for treating patients with prostate cancer. Ten patients with prostate cancer were included in this study. Intensity modulated radiation therapy plans were designed to include different modalities, including the linac step and shoot, Tomotherapy, RapidArc, and Proton systems. Various dosimetrical indices, like the prescription isodose to target volume (PITV) ratio, conformity index (CI), homogeneity index (HI), target coverage index (TCI), modified dose homogeneity index (MHI), confo…
A work recently published experimentally demonstrates an increase in the radiobiological efficacy of clinical proton beams when a tumour is treated in the presence of a concentration of 11B. The paper, for the first time, demonstrates the potential role of the p+11B to 3α (for brevity, p-B) reaction in the biological enhancement of proton therapy effectiveness. The work reports robust experimental data in terms of clonogenic cell survival and chromosomal aberrations and unambiguously shows the presence of an enhancement when cells were exposed to a clinical proton beam subject to treatment wit…
Radiotherapy of pregnant cancer patients is not common, but when applied accurate assessment of the fetus dose is required, especially since the treatment planning systems are not able and do not allow accurate assessment of out-of-field doses. Proton therapy significantly reduces out-of-field doses, such as dose to the fetus, when compared to the photon radiotherapy techniques and as such could be promising for pregnant cancer patients. Within this study Monte Carlo calculations are performed on the three different computational phantoms representing pregnant women, all in second trimester of…
In this paper we study a feasibility-seeking problem with percentage violation constraints. These are additional constraints, that are appended to an existing family of constraints, which single out certain subsets of the existing constraints and declare that up to a specified fraction of the number of constraints in each subset is allowed to be violated by up to a specified percentage of the existing bounds. Our motivation to investigate problems with percentage violation constraints comes from the field of radiation therapy treatment planning wherein the fully-discretized inverse planning pr…
We study the propagation of nucleons and nuclei in tissue-like media within a Monte Carlo Model for Heavy-ion Therapy (MCHIT) based on the GEANT4 toolkit (version 8.2). The model takes into account fragmentation of projectile nuclei and secondary interactions of produced nuclear fragments. Model predictions are validated with available experimental data obtained for water and PMMA phantoms irradiated by monoenergetic carbon-ion beams. The MCHIT model describes well (1) the depth-dose distributions in water and PMMA, (2) the doses measured for fragments of certain charge, (3) the distributions …
Variation of the relative biological effectiveness with fractionation in proton therapy: analysis of prostate cancer response
Instituto de Investigación Sanitaria de Santiago (IDIS)（圣地亚哥卫生研究所）；Complexo Hospitalario Universitario de Santiago de Compostela（圣地亚哥-德孔波斯特拉大学医院复合体）；Istituto Nazionale di Fisica Nucleare-Torino Section（意大利国家核物理研究所都灵分部）；Universidade de Santiago de Compostela（圣地亚哥-德孔波斯特拉大学）
