Investigation of time-resolved proton radiography using x-ray flat-panel imaging system.

Proton beam therapy benefits from the Bragg peak and delivers highly conformal dose distributions. However, the location of the end-of-range is subject to uncertainties related to the accuracy of the relative proton stopping power estimates and thereby the water-equivalent path length (WEPL) along the beam. To remedy the range uncertainty, an in vivo measurement of the WEPL through the patient, i.e. a proton-range radiograph, is highly desirable. Towards that goal, we have explored a novel method of proton radiography based on the time-resolved dose measured by a flat panel imager (FPI). A 226 MeV pencil beam and a custom-designed range modulator wheel (MW) were used to create a time-varying broad beam. The proton imaging technique used exploits this time dependency by looking at the dose rate at the imager as a function of time. This dose rate function (DRF) has a unique time-varying dose pattern at each depth of penetration. A relatively slow rotation of the MW (0.2 revolutions per second) and a fast image acquisition (30 frames per second, ~33 ms sampling) provided a sufficient temporal resolution for each DRF. Along with the high output of the CsI:Tl scintillator, imaging with pixel binning (2 × 2) generated high signal-to-noise data at a very low radiation dose (~0.1 cGy). Proton radiographs of a head phantom and a Gammex CT calibration phantom were taken with various configurations. The results of the phantom measurements show that the FPI can generate low noise and high spatial resolution proton radiographs. The WEPL values of the CT tissue surrogate inserts show that the measured relative stopping powers are accurate to ~2%. The panel did not show any noticeable radiation damage after the accumulative dose of approximately 3831 cGy. In summary, we have successfully demonstrated a highly practical method of generating proton radiography using an x-ray flat panel imager.

MO-F-213AB-03: Potential Reduction in Out-Of-Field Dose in Pencil Beam Scanning Proton Therapy Through Use of a Patient-Specific Aperture.

PURPOSE: Patient specific apertures are commonly employed in passive double scattering (DS) proton therapy (PT). This study was aimed at identifying the potential benefits of using such an aperture in pencil beam scanning (PBS). METHODS: An accurate Geant4 Monte Carlo model of the PBS PT treatment head at Massachusetts General Hospital (MGH) was developed based on an existing model of the passive double-scattering (DS) system. The Monte Carlo code specifies the treatment head at MGH with sub-millimeter accuracy and was configured based on the results of experimental measurements performed at MGH. This model was then used to compare out-of-field doses in simulated DS treatments and PBS treatments. The PBS treatments were simulated both with and without the patient-specific aperture used in the DS treatment. RESULTS: For the conditions explored, a typical prostate field, the lateral penumbra in PBS is wider than in DS, leading to higher absorbed doses and equivalent doses adjacent to the primary field edge. For lateral distances greater than 10cm from the field edge, the doses in PBS appear to be lower than those observed for DS. Including an aperture at nozzle exit reduces the penumbral width by preventing wide-angle scatter from reaching the patient. This can reduce the dose in PBS for lateral distances of less than 10cm from the field edge by over an order of magnitude and allow better dose conformity. CONCLUSIONS: Placing a patient-specific aperture at nozzle exit during PBS treatments can potentially reduce doses lateral to the primary radiation field by over an order of magnitude. This has the potential to further improve the normal tissue sparing capabilities of PBS. The magnitude of this effect depends on the beam spot size of the scanning system and is thus facility dependent.

Direct absorbed dose to water determination based on water calorimetry in scanning proton beam delivery.

PURPOSE: The aim of this manuscript is to describe the direct measurement of absolute absorbed dose to water in a scanned proton radiotherapy beam using a water calorimeter primary standard. METHODS: The McGill water calorimeter, which has been validated in photon and electron beams as well as in HDR 192Ir brachytherapy, was used to measure the absorbed dose to water in double scattering and scanning proton irradiations. The measurements were made at the Massachusetts General Hospital proton radiotherapy facility. The correction factors in water calorimetry were numerically calculated and various parameters affecting their magnitude and uncertainty were studied. The absorbed dose to water was compared to that obtained using an Exradin T1 Chamber based on the IAEA TRS-398 protocol. RESULTS: The overall 1-sigma uncertainty on absorbed dose to water amounts to 0.4% and 0.6% in scattered and scanned proton water calorimetry, respectively. This compares to an overall uncertainty of 1.9% for currently accepted IAEA TRS-398 reference absorbed dose measurement protocol. The absorbed dose from water calorimetry agrees with the results from TRS-398 well to within 1-sigma uncertainty. CONCLUSIONS: This work demonstrates that a primary absorbed dose standard based on water calorimetry is feasible in scattered and scanned proton beams.

Monte Carlo calculations in support of the commissioning of the Northeast Proton Therapy Center.

Monte Carlo studies were conducted related to the design of the Northeast Proton Therapy Center (NPTC). These studies were also helpful for commissioning the beam delivery performance of the facility. The calculations included preventing proton leakage from the beam delivery nozzle, anomalies in the dose distributions and studies, which could influence future beam delivery techniques. Using simulations it was possible to reduce the proton leakage by over an order of magnitude, while minimizing the weight of the assembly. Interestingly, the thickness of the brass shielding has no influence on the secondary neutron radiation since the number of generated neutrons is almost independent of the amount of brass if the primary beam is completely stopped. Monte Carlo simulations are able to study the effect of small beam misalignments with respect to apertures in the nozzle. Such tolerances are very difficult to define experimentally. Studying the effects of nuclear interactions we showed that, if the dose distributions would be optimized theoretically using the primary proton dose alone, there would be about a 5 % dose increase at the proximal end of a SOBP. In radiobiology studies we found that the RBE at beam entrance increases due to the build-up of the secondary particle fluence.

Solid state microdosimetry in hadron therapy.

A report of recent developments in silicon microdosimetry is presented. SOI based microdosemeters have shown promise as a viable alternative to traditional tissue-equivalent proportional counters. The application of these silicon microdosemeters to such radiation therapy modalities as boron neutron capture therapy (BNCT), boron neutron capture synovectomy (BNCS), proton therapy (PT), and fast neutron therapy (FNT) has been performed. Several shortcomings of the current silicon microdosemeter were identified and will be taken into account in the design of a second-generation device.

Verification of the alignment of a therapeutic radiation beam relative to its patient positioner.

An easily-used system has been developed for routine measurements of the alignment of beams used for radiation therapy. The position of a beam of circular cross section is measured with respect to a steel sphere fixed to the patient positioning table and which should coincide with the isocenter. Since measurements can be done at all gantry angles (if one is available) and with all possible orientations of the patient table, the system is particularly suited for rapid and accurate measurements of gantry and/or couch isocentricity. Because it directly measures beam-to-positioner offset, the system provides an inclusive alignment verification of the total treatment system. The system has been developed for use with proton beams, but it could equally be used for alignment checks of an x-ray beam from a linear accelerator or other source. The measuring instrument consists of a scintillation screen viewed by a CCD camera, mounted on the gantry downstream of the sphere. The steel sphere is not large enough to stop protons of all energies of interest; however, it will always modify the energy and direction of protons which intersect it, creating a region of lower intensity (a "shadow") in the light spot created by the proton beam hitting the screen. The position of the shadow with respect to the light spot is a measure of the alignment of the system. An image-analysis algorithm has been developed for an automatic determination of the position of the shadow with respect to the light spot. The specifications and theoretical analysis of the system have been derived from Monte Carlo simulations, which are validated by measurements. We have demonstrated that the device detects beam misalignments with an accuracy (1 s.d.) of 0.05 mm, which is in agreement with the expected performance. This accuracy is more than sufficient to detect the maximum allowed misalignment of +/-0.5 mm.