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Register a new userFirst tests for an online treatment monitoring system with in-beam PET for proton therapy
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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 beta+ activity along the proton beam-axis, and evaluated the difference between the proximal rise and the distal fall-off position of the activity distribution. A good agreement with FLUKA Monte Carlo predictions was obtained. We also assessed the system response when the PMMA phantom contained an air cavity. The system was able to detect these cavities quickly after irradiation.
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Background: Treatment verification with PET imaging in charged particle therapy is conventionally done by comparing measurements of spatial distributions with Monte Carlo (MC) predictions. However, decay curves can provide additional independent information about the treatment and the irradiated tissue. Most studies performed so far focus on long time intervals. Here we investigate the reliability of MC predictions of space and time (decay rate) profiles shortly after irradiation, and we show how the decay rates can give an indication about the elements of which the phantom is made up. Methods and Materials: Various phantoms were irradiated in clinical and near-clinical conditions at the Cyclotron Centre of the Bronowice proton therapy centre. PET data were acquired with a planar 16x16 cm$^2$ PET system. MC simulations of particle interactions and photon propagation in the phantoms were performed using the FLUKA code. The analysis included a comparison between experimental data and MC simulations of space and time profiles, as well as a fitting procedure to obtain the various isotope contributions in the phantoms. Results and conclusions: There was a good agreement between data and MC predictions in 1-dimensional space and decay rate distributions. The fractions of $^{11}$C, $^{15}$O and $^{10}$C that were obtained by fitting the decay rates with multiple simple exponentials generally agreed well with the MC expectations. We found a small excess of $^{10}$C in data compared to what was predicted in MC, which was clear especially in the PE phantom.
Charged particle therapy (CPT) is an advanced modality of radiation therapy which has grown rapidly worldwide, driven by recent developments in technology and methods of delivery. To ensure safe and high quality treatments, various instruments are used for a range of different measurements such as for quality assurance, monitoring and dosimetry purposes. With the emergence of new and enhanced delivery techniques, systems with improved capabilities are needed to exceed existing performance limitations of conventional tools. The Medipix3 is a hybrid pixel detector able to count individual protons with millisecond time resolution at clinical flux with near instant readout and count rate linearity. The system has previously demonstrated use in medical and other applications, showing wide versatility and potential for particle therapy. In this work we present measurements of the Medipix3 detector in the 60 MeV ocular proton therapy beamline at the Clatterbridge Cancer Centre, UK. The beam current and lateral beam profiles were evaluated at multiple positions in the treatment line and compared with EBT3 Gafchromic film. The recorded count rate linearity and temporal analysis of the beam structure was measured with Medipix3 across the full range of available beam intensities, up to $3.12 times 10^{10}$ protons/s. We explore the capacity of Medipix3 to provide non-reference measurements and its applicability as a tool for dosimetry and beam monitoring for CPT. This is the first known time the performance of the Medipix3 detector technology has been tested within a clinical, high proton flux environment.
We summarize recent results and ongoing activities in mathematical algorithms and computer science methods related to proton computed tomography (pCT) and intensity-modulated particle therapy (IMPT) treatment planning. Proton therapy necessitates a high level of delivery accuracy to exploit the selective targeting imparted by the Bragg peak. For this purpose, pCT utilizes the proton beam itself to create images. The technique works by sending a low-intensity beam of protons through the patient and measuring the position, direction, and energy loss of each exiting proton. The pCT technique allows reconstruction of the volumetric distribution of the relative stopping power (RSP) of the patient tissues for use in treatment planning and pre-treatment range verification. We have investigated new ways to make the reconstruction both efficient and accurate. Better accuracy of RSP also enables more robust inverse approaches to IMPT. For IMPT, we developed a framework for performing intensity-modulation of the proton pencil beams. We expect that these developments will lead to additional project work in the years to come, which requires a regular exchange between experts in the fields of mathematics, computer science, and medical physics. We have initiated such an exchange by organizing annual workshops on pCT and IMPT algorithm and technology developments. This report is, admittedly, tilted toward our interdisciplinary work and methods. We offer a comprehensive overview of results, problems, and challenges in pCT and IMPT with the aim of making other scientists wanting to tackle such issues and to strengthen their interdisciplinary collaboration by bringing together cutting-edge know-how from medicine, computer science, physics, and mathematics to bear on medical physics problems at hand.
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.
We study the spatial distributions of $beta^+$-activity produced by therapeutic beams of $^3$He and $^{12}$C ions in various tissue-like materials. The calculations were performed within a Monte Carlo model for Heavy-Ion Therapy (MCHIT) based on the GEANT4 toolkit. The contributions from $^{10,11}$C, $^{13}$N, $^{14,15}$O, $^{17,18}$F and $^{30}$P positron-emitting nuclei were calculated and compared with experimental data obtained during and after irradiation. Positron emitting nuclei are created by $^{12}$C beam in fragmentation reactions of projectile and target nuclei. This leads to a $beta^+$-activity profile characterised by a noticeable peak located close to the Bragg peak in the corresponding depth-dose distribution. On the contrary, as the most of positron-emitting nuclei are produced by $^3$He beam in target fragmentation reactions, the calculated total $beta^+$-activity during or soon after the irradiation period is evenly distributed within the projectile range. However, we predict also the presence of $^{13}$N, $^{14}$O, $^{17,18}$F created in charge-transfer reactions by low-energy $^3$He ions close to the end of their range in several tissue-like media. The time evolution of $beta^+$-activity profiles was investigated for both kinds of beams. Due to the production of $^{18}$F nuclide the $beta^+$-activity profile measured 2 or 3 hours after irradiation with $^{3}$He ions will have a distinct peak correlated with the maximum of depth-dose distribution. We found certain advantages of low-energy $^{3}$He beams over low-energy proton beams for reliable PET monitoring during particle therapy of shallow located tumours. In this case the distal edge of $beta^+$-activity distribution from $^{17}$F nuclei clearly marks the range of $^{3}$He in tissues.
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