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Register a new userElectron FLASH Delivery at Treatment Room Isocenter for Efficient Reversible Conversion of a Clinical LINAC
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Purpose: In this study, procedures were developed to achieve efficient reversible conversion of a clinical linear accelerator (LINAC) and deliver electron FLASH (eFLASH) or conventional beams to the treatment room isocenter. Material & Methods: The LINAC was converted to deliver eFLASH beam within 20 minutes by retracting the x-ray target from the beams path, positioning the carousel on an empty port, and selecting 10 MV photon beam energy in the treatment console. Dose per pulse and average dose rate were measured in a solid water phantom at different depths with Gafchromic film and OSLD. A pulse controller counted the pulses via scattered radiation signal and gated the delivery for preset pulse count. A fast photomultiplier tube-based Cherenkov detector measured per pulse beam output at 2 ns sampling rate. After conversion back to clinical mode, conventional beam output, flatness, symmetry, field size and energy were measured for all clinically commissioned energies. Results: Dose per pulse of 0.86 +/- 0.01 Gy (310 +/- 7 Gy/s average dose rate) were achieved at isocenter. The dose from simultaneous irradiation of film and OSLD were within 1%. The PMT showed the LINAC required about 5 pulses before the output stabilized and its long-term stability was within 3% for measurements performed at 3 minutes intervals. The dose, flatness, symmetry, and photon energy were unchanged from baseline and within tolerance (1%, 3%, 2%, and 0.1% respectively) after reverting to conventional beams. Conclusion: 10 MeV FLASH beams were achieved at the isocenter of the treatment room. The beam output was reproducible but requires further investigation of the ramp up time in the first 5 pulses, equivalent to <100 cGy. The eFLASH beam can irradiate both small and large subjects in minimally modified clinical settings and dose rates can be further increased by reducing the source to surface distance.
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Purpose: A Monte Carlo (MC) beam model and its implementation in a clinical treatment planning system (TPS, Varian Eclipse) are presented for a modified ultra-high dose-rate electron FLASH radiotherapy (eFLASH-RT) LINAC. Methods: The gantry head without scattering foils or targets, representative of the LINAC modifications, was modelled in Geant4. The energy spectrum ({sigma}E) and beam source emittance cone angle ({theta}cone) were varied to match the calculated and Gafchromic film measured central-axis percent depth dose (PDD) and lateral profiles. Its Eclipse configuration was validated with measured profiles of the open field and nominal fields for clinical applicators. eFLASH-RT plans were MC forward calculated in Geant4 for a mouse brain treatment and compared to a conventional (Conv-RT) plan in Eclipse for a human patient with metastatic renal cell carcinoma. Results: The beam model and its Eclipse configuration agreed best with measurements at {sigma}E=0.5 MeV and {theta}cone=3.9+/-0.2 degrees to clinically acceptable accuracy (the absolute average error was within 1.5% for in-water lateral, 3% for in-air lateral, and 2% for PDD). The forward dose calculation showed dose was delivered to the entire mouse brain with adequate conformality. The human patient case demonstrated the planning capability with routine accessories in relatively complex geometry to achieve an acceptable plan (90% of the tumor volume receiving 95% and 90% of the prescribed dose for eFLASH and Conv-RT, respectively). Conclusion: To the best of our knowledge, this is the first functional beam model commissioned in a clinical TPS for eFLASH-RT, enabling planning and evaluation with minimal deviation from Conv-RT workflow. It facilitates the clinical translation as eFLASH-RT and Conv-RT plan quality were comparable for a human patient. The methods can be expanded to model other eFLASH irradiators.
Purpose: The purpose of this work was to provide a flexible platform for FLASH research with protons by adapting a former clinical pencil beam scanning gantry to irradiations with ultrahigh dose rates. Methods: PSI Gantry 1 treated patients until December 2018. We optimized the beamline parameters to transport the 250 MeV beam extracted from the PSI COMET accelerator to the treatment room, maximizing the transmission of beam intensity to the sample. We characterized a dose monitor on the gantry to ensure good control of the dose, delivered in spot-scanning mode. We characterized the beam for different dose rates and field sizes for transmission irradiations. We explored scanning possibilities in order to enable conformal irradiations or transmission irradiations of large targets (with transverse scanning). Results: We achieved a transmission of 86 % from the cyclotron to the treatment room. We reached a peak dose rate of 9000 Gy/s at 3 mm water equivalent depth, along the central axis of a single pencil beam. Field sizes of up to 5x5 mm$^{2}$ were achieved for single spot FLASH irradiations. Fast transverse scanning allowed to cover a field of 16x1.2 cm$^{2}$. With the use of a nozzle-mounted range shifter we are able to span depths in water ranging from 19.6 to 37.9 cm. Various dose levels were delivered with a precision within less than 1 %. Conclusions: We have realized a proton FLASH irradiation setup able to investigate continuously a wide dose rate spectrum, from 1 to 9000 Gy/s in a single spot irradiation as well as in the pencil beam scanning mode. As such, we have developed a versatile test bench for FLASH research.
The human aorta is a high-risk area for vascular diseases, which are commonly restored by thoracic endovascular aortic repair. In this paper, we report a promising shear-activated targeted nanoparticle drug delivery strategy to assist in the treatment of coarctation of the aorta and aortic aneurysm. Idealized three-dimensional geometric models of coarctation of the aorta and aortic aneurysm are designed, respectively. The unique hemodynamic environment of the diseased aorta is used to improve nanoparticle drug delivery. Micro-carriers with nanoparticle drugs would be targeting activated to release nanoparticle drugs by local abnormal shear stress rate (SSR). Coarctation of the aorta provides a high SSR hemodynamic environment, while the aortic aneurysm is exposed to low SSR. Results show that the upstream near-wall area of the diseased location is an ideal injection point for the micro-carriers, which could be activated by the abnormal SSR. Released nanoparticle drugs would be successfully targeted delivered to the aortic diseased wall. Besides, coarctation of the aorta would prevent blood flow to the descending aorta, while the effect of the aortic aneurysm on the blood flow distribution is negligible. This study preliminary demonstrates the feasibility of shear-activated targeted nanoparticle drug delivery in the treatment of aortic diseases and provides a theoretical basis for developing novel therapy.
We propose and analyze in detail a method to measure the in-air spatial spread parameter of clinical electron beams. Measurements are performed at the center of the beam and below the adjustable collimators sited in asymmetrical configuration in order to avoid the distortions due to the presence of the applicator. The main advantage of our procedure lies in the fact that the dose profiles are fitted by means of a function which includes, additionally to the Gaussian step usually considered, a background which takes care of the dose produced by different mechanisms that the Gaussian model does not account for. As a result, the spatial spread is obtained directly from the fitting procedure and the accuracy permits a good determination of the angular spread. The way the analysis is done is alternative to that followed by the usual methods based on the evaluation of the penumbra width. Besides, the spatial spread found shows the quadratic-cubic dependence with the distance to the source predicted by the Fermi-Eyges theory. However, the corresponding values obtained for the scattering power are differing from those quoted by ICRU nr. 35 by a factor ~2 or larger, what requires of a more detailed investigation.
We report results of the beam commissioning and first operation of the 1.3 GHz superconducting RF electron linear accelerator at Fermilab Accelerator Science and Technology (FAST) facility. Construction of the linac was completed and the machine was commissioned with beam in 2017. The maximum total beam energy of about 300 MeV was achieved with the record energy gain of 250 MeV in the ILC-type SRF cryomodule. The photoinjector was tuned to produce trains of 200 pC bunches with a frequency of 3 MHz at a repetition rate of 1 Hz. This report describes the aspects of machine commissioning such as tuning of the SRF cryomodule and beam optics optimization. We also present highlights of an experimental program carried out parasitically during the two-month run, including studies of wake-fields, and advanced beam phase space manipulation.
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