Particle tracking, recognition and LET evaluation of out-of-field proton therapy delivered to a phantom with implants.

OBJECTIVE: This study aims to assess the composition of scattered particles generated in proton therapy for tumors situated proximal to titanium dental implants. The investigation involves decomposing the mixed field and recording Linear Energy Transfer (LET) spectra to quantify the influence of metallic dental inserts located behind the tumor. Approach: A therapeutic conformal proton beam was used to deliver the treatment plan to an anthropomorphic head phantom with two types of implants inserted in the target volume (made of titanium and plastic, respectively). The scattered radiation resulted during the irradiation was detected by a hybrid semiconductor pixel detector MiniPIX Timepix3 that was placed distal to the Spread-out Bragg peak. Visualization and field decomposition of stray radiation were generated using algorithms trained in particle recognition based on artificial intelligence convolution neural networks (AI CNN). Spectral sensitive aspects of the scattered radiation were collected using two angular positions of the detector relative to the beam direction: 0° and 60°. Results: Using AI CNN, 3 classes of particles were identified: protons, electrons & photons, and ions & fast neutrons. Placing a Titanium implant in the beam's path resulted in predominantly electrons and photons, contributing 52.2%, whereas for plastic implants, the contribution was 65.4%. Scattered protons comprised 45.5% and 31.9% with and without metal inserts, respectively. The LET spectra was derived for each group of particles identified, with values ranging from 0.01 to 7.5 keV·µm-1 for Titanium implants/plastic implants. The low-LET component was primarily composed of electrons and photons, while the high-LET component corresponded to protons and ions. Significance: This method, complemented by directional maps, holds potential for evaluating and validating treatment plans involving stray radiation near organs at risk, offering precise discrimination of the mixt field, enhancing in this way the LET calculation. .

Ultra-Hypofractionated Proton Therapy in Localized Prostate Cancer: Passive Scattering versus Intensity-Modulated Proton Therapy.

Few studies have directly compared passive scattering (PS) to intensity-modulated proton therapy (IMPT) in the delivery of ultra-hypofractionated proton beams to the localized prostate cancer (PCa). In this preliminary study involving five patients previously treated with CyberKnife, treatment plans were created for PS and IMPT (36.25 CGE in five fractions with two opposing fields) to compare the dosimetric parameters to the planning target volume (PTV) and organs-at-risk (OAR: rectum, bladder, femoral heads). Both plans met the acceptance criteria. Significant differences were observed in the minimum and maximum doses to the PTV. The mean dose to the PTV was lower for PS (35.62 ± 0.26 vs. 37.18 ± 0.14; p = 0.002). Target coverage (D98%) was better for IMPT (96.79% vs. 99.10%; p = 0.004). IMPT resulted in significantly lower mean doses to the rectum (16.75 CGE vs. 6.88 CGE; p = 0.004) and bladder (17.69 CGE vs. 5.98 CGE p = 0.002). High dose to the rectum (V36.25 CGE) were lower with PS, but not significantly opposite to high dose to the bladder. No significant differences were observed in mean conformity index values, with a non-significant trend towards higher mean homogeneity index values for PS. Non-significant differences in the gamma index for both fields were observed. These findings suggest that both PS and IMPT ultra-hypofractionated proton therapy for PCa are highly precise, offering good target coverage and sparing of normal tissues and OARs.

Dose distribution at the Bragg peak: Dose measurements using EBT and RTQA gafchromic film set at two positions to the central beam axis.

AIM: To evaluate the impact of radiochromic film positioning relative to the central beam axis (CAX) in proton beam therapy. Secondarily, to compare the dosimetric measurements obtained by RTQA and EBT film and to compare these to the doses calculated by the treatment planning system (TPS). METHODS: The EBT and RTQA dosimetric radiochromic films were immersed in a water phantom and irradiated with a proton beam. The films were placed parallel to the CAX and at a 5° angle on the horizontal plane to assess the effect of film inclination on Bragg peak profiles. Calibration was performed by irradiating small pieces of film at doses ranging from 0.0 Gy to 3.5 Gy in increments of 0.5 Gy. The TPS was used to create treatment plans for two different geometrical targets (cylindrical and cuboidal). After irradiation, all film pieces were scanned on a flatbed scanner and red channel data were extracted from the 48-bit RGB images using ImageJ, Photoshop, Origin8, and Excel software. The dose distributions from the irradiated films were compared to the dose obtained from the TPS. Bragg peak profiles were abstracted from the irradiated films and compared. RESULTS: The dosimetric measurements obtained by both EBT and RTQA positioned at a 5° to the CAX closely matched the dose calculated by the TPS for the cylindrical target. In contrast, dose distributions measured in the cuboidal targets were less precise. Gamma index (GI) values (3%/3 mm acceptance criteria for isodose >90% of dose) were 99.8% and 93% for EBT film placed at a 5° angle versus 47.1% and 80.8% for EBT film parallel to the beam. The dosimetric measurements in RTQA film positioned parallel to the CAX showed GI values with <27% agreement with the TPS-calculated dose. CONCLUSION: Our finding show that RTQA film can be used to accurately measure doses in the proton beam at the region of Bragg peak; however, to obtain the most accurate readings, the film should be positioned at a small angle to the CAX.

Wax boluses and accuracy of EBT and RTQA radiochromic film detectors in radiotherapy with the JINR Phasotron proton beam.

AIM: To present the results obtained using radiochromic films EBT and RTQA 1010P for the reconstruction the dose distributions for targets irradiated by proton beam and modified by wax boluses. BACKGROUND: In Medico-Technical Complex at the Joint Institute for Nuclear Research in Dubna implemented technology of wax boluses. MATERIALS AND METHODS: Wax boluses are easier to make and they give better dose distributions than boluses made from modeling clay previously used at our center. We irradiated two imaginary targets, one shaped as a cylinder and the other one as two cuboids. The evaluated calibration curve was used for calculation of the dose distributions measured by the EBT and RTQA radiochromic film. In both cases, the measured dose distributions were compared to the dose distributions calculated by the treatment planning system (TPS). We also compared dose distributions using three different conformity indices at a 95% isodose. RESULTS: Better target coverage and better compliance of measurements (semiconductor detectors and radiochromic films) with calculated doses was obtained for cylindrical target than for cuboidal target. The 95% isodose covered well the tumor for both target shapes, while for cuboidal target larger volume around the target received therapeutic dose, due to the complicated target shape. The use wax boluses provided to be effective tool in modifying proton beam to achieve appropriate shape of isodose distribution. CONCLUSION: EBT film yielded the best visual matching. Both EBT and RTQA films confirmed good conformity between calculated and measured doses, thus confirming that wax boluses used to modify the proton beam resulted in good dose distributions.

The comparison of doses measured by radiochromic films and semiconductor detector in a 175MeV proton beam.

We wanted to verify the response of radiochromic films in a 175MeV clinical proton beam used at the Joint Institute for Nuclear Research in Dubna against doses measured using semiconductor detectors and compare the results with published data from other centres. Radiochromic films (RCFs) MD-55 and a Vidar VXR-16 scanner were used. The films were irradiated in an unmodulated proton beam and with a beam modulated with a bolus and a ridge filter. Obtained dose distributions were compared with dose distributions measured with a Si-semiconductor detector. For the unmodulated beam the difference between the RCF and the semiconductor detector was 12% in the Bragg peak top. For the modulated beam the difference inside the spread-out Bragg peak region was 4%. Observed deviations between doses measured with RCF and Si-detector outside the Bragg peak were caused by the inhomogeneity of radiochromic emulsion. In the Bragg peak region the RCF doses were lower than those measured by semiconductors. The results were in agreement with published data from other proton therapy centres.