Ion beam therapy, as an emerging radiation therapy modality, requires continuous efforts to develop and improve tools for patient treatment planning (TP) and research applications. Dose and fluence ...computation algorithms using the Monte Carlo (MC) technique have served for decades as reference tools for accurate dose computations for radiotherapy. In this work, a novel MC-based treatment-planning (MCTP) tool for ion beam therapy using the pencil beam scanning technique is presented. It allows single-field and simultaneous multiple-fields optimization for realistic patient treatment conditions and for dosimetric quality assurance for irradiation conditions at state-of-the-art ion beam therapy facilities. It employs iterative procedures that allow for the optimization of absorbed dose and relative biological effectiveness (RBE)-weighted dose using radiobiological input tables generated by external RBE models. Using a re-implementation of the local effect model (LEM), the MCTP tool is able to perform TP studies using ions with atomic numbers Z ≤ 8. Example treatment plans created with the MCTP tool are presented for carbon ions in comparison with a certified analytical treatment-planning system. Furthermore, the usage of the tool to compute and optimize mixed-ion treatment plans, i.e. plans including pencil beams of ions with different atomic numbers, is demonstrated. The tool is aimed for future use in research applications and to support treatment planning at ion beam facilities.
Abstract In recent years, there has been a significant focus on improving the effectiveness of radiotherapy (RT) and particle therapy in treating tumors while minimizing damage to healthy tissue. A ...promising development is offered by the observation of the so-called FLASH effect, where ultra-high dose rates delivered in a short time have shown to protect healthy tissues while maintaining anti-tumor efficacy. However, conventional detectors face challenges in monitoring charged beams at these ultra-high dose rates due to non-linear effects. To address this challenge, the FlashDC (Flash Detector beam Counter) has been developed. It uses air fluorescence to monitor beam fluence and spatial distribution in real-time with high accuracy and minimal impact on treatment delivery. This innovative detector offers a linear response for various charged beams, dose rates, and energies, making it a cost-effective solution. Multiple prototypes have been developed and optimized using Monte Carlo simulations. The analysis of data from recent test beam campaigns with electrons delivered at FLASH intensities has demonstrated a linear correlation between the detector signal and the delivered dose per pulse, confirming that fluorescence can be used for beam monitoring in FLASH-RT studies. This contribution introduces the FlashDC monitor, discusses its expected performance, and presents preliminary test beam results obtained with electron beams in FLASH mode.
The high dose conformity and healthy tissue sparing achievable in Particle Therapy when using C ions calls for safety factors in treatment planning, to prevent the tumor under-dosage related to the ...possible occurrence of inter-fractional morphological changes during a treatment. This limitation could be overcome by a range monitor, still missing in clinical routine, capable of providing on-line feedback. The Dose Profiler (DP) is a detector developed within the INnovative Solution for In-beam Dosimetry in hadronthErapy (INSIDE) collaboration for the monitoring of carbon ion treatments at the CNAO facility (Centro Nazionale di Adroterapia Oncologica) exploiting the detection of charged secondary fragments that escape from the patient. The DP capability to detect inter-fractional changes is demonstrated by comparing the obtained fragment emission maps in different fractions of the treatments enrolled in the first ever clinical trial of such a monitoring system, performed at CNAO. The case of a CNAO patient that underwent a significant morphological change is presented in detail, focusing on the implications that can be drawn for the achievable inter-fractional monitoring DP sensitivity in real clinical conditions. The results have been cross-checked against a simulation study.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The radiation used in hadrontherapy treatments interacts with the patient body producing secondary particles, either neutral or charged, that can be used for dose and Bragg peak monitoring and to ...provide a fast feedback on the treatment plans. Recent results obtained from the authors on simplified setups (mono-energetic primary beams interacting with homogeneous tissue-like target) have already indicated the correlation that exists between the flux of these secondaries coming from the target (e.g. protons and photons) and the position of the primary beam Bragg peak. In this paper, the measurements of charged particle fluxes produced by the interaction of a 220 MeV/u carbon ion beam at GSI, Darmstadt, with a polymethyl methacrylate target are reported. The emission region of protons (p), deuterons (d) and tritons (t) has been characterized using a drift chamber while the particle time-of-flight, used to compute the kinetic energy spectra, was measured with a LYSO scintillator. The energy released in the LYSO crystal was used for particle identification purposes. The measurements were repeated with the setup at 60° and 90° with respect to the primary beam direction. The accuracy on the fragments emission profile reconstruction and its relationship with the Bragg peak position have been studied. Based on the acquired experimental evidence, a method to monitor the dose profile and the position of the Bragg peak inside the target is proposed.
A
bstract
Using 1.63 fb
−1
of integrated luminosity collected by the KLOE experiment about 7 × 10
4
K
S
→
π
±
e
∓
ν
decays have been reconstructed. The measured value of the charge asymmetry for this ...decay is
A
S
= (−4.9 ± 5.7
stat
± 2.6
syst
) × 10
−3
, which is almost twice more precise than the previous KLOE result. The combination of these two measurements gives
A
S
= (−3.8 ± 5.0
stat
± 2.6
syst
) × 10
−3
and, together with the asymmetry of the
K
L
semileptonic decay, provides significant tests of the
CPT
symmetry. The obtained results are in agreement with
CPT
invariance.
The MOnitor for Neutron Dose in hadrOntherapy (MONDO) project addresses the technical challenges posed by a neutron tracker detector aiming for a high detection efficiency and a good backtracking ...precision. The project aims to develop a tracking device capable of fully reconstructing the four momentum of fast and ultrafast secondary neutrons produced, e.g., in particle therapy (PT) treatments or in other physical processes. The MONDO tracker uses, as active material, squared scintillating fibers readout by dedicated CMOS-based digital single-photon avalanche diode (SPAD) array sensors. The expected light output, when operating in neutron monitoring applications, was experimentally evaluated in order to optimize the design of the MONDO detector readout. A small detector prototype (4 × 4 × 4.8 cm) has been built and tested at a test beam facility. The detection capabilities have been measured using a traditional photomultiplier (PMT) and a particle beam of 450-MeV electrons crossing a single layer of fibers. The observed number of photoelectrons in this case is (7.2 ± 1.4). A detector prototype was also tested with an SPAD-based SBAM (SPAD-Based Acquisition readout for MONDO experiment) sensor (SPADnet-I) to study the tracking performances. SBAM is a novel sensor developed to match the need of high single-photon detection efficiency and high spatial resolution and compactness. The sensor expected performance is discussed in view of an operation tailored for PT applications. In this contribution, we also report the results of a simulation performed to optimize the full MONDO detector layout.
The high dose conformity and healthy tissue sparing achievable in Particle Therapy when using C ions calls for safety factors in treatment planning, to prevent the tumor under-dosage related to the ...possible occurrence of inter-fractional morphological changes during a treatment. This limitation could be overcome by a range monitor, still missing in clinical routine, capable of providing on-line feedback. The Dose Profiler (DP) is a detector developed within the INnovative Solution for In-beam Dosimetry in hadronthErapy (INSIDE) collaboration for the monitoring of carbon ion treatments at the CNAO facility (Centro Nazionale di Adroterapia Oncologica) exploiting the detection of charged secondary fragments that escape from the patient. The DP capability to detect inter-fractional changes is demonstrated by comparing the obtained fragment emission maps in different fractions of the treatments enrolled in the first ever clinical trial of such a monitoring system, performed at CNAO. The case of a CNAO patient that underwent a significant morphological change is presented in detail, focusing on the implications that can be drawn for the achievable inter-fractional monitoring DP sensitivity in real clinical conditions. The results have been cross-checked against a simulation study.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The background induced by the high penetration power of the radiation is the main limiting factor of the current radio-guided surgery (RGS). To partially mitigate it, a RGS with β(+)-emitting ...radio-tracers has been suggested in literature. Here we propose the use of β(-)-emitting radio-tracers and β(-) probes and discuss the advantage of this method with respect to the previously explored ones: the electron low penetration power allows for simple and versatile probes and could extend RGS to tumours for which background originating from nearby healthy tissue makes probes less effective. We developed a β(-) probe prototype and studied its performances on phantoms. By means of a detailed simulation we have also extrapolated the results to estimate the performances in a realistic case of meningioma, pathology which is going to be our first in-vivo test case. A good sensitivity to residuals down to 0.1 ml can be reached within 1 s with an administered activity smaller than those for PET-scans thus making the radiation exposure to medical personnel negligible.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Partial breast irradiation for the treatment of early-stage breast cancer patients can be performed by means of Intra Operative electron Radiation Therapy (IOeRT). One of the main limitations of this ...technique is the absence of a treatment planning system (TPS) that could greatly help in ensuring a proper coverage of the target volume during irradiation. An IOeRT TPS has been developed using a fast Monte Carlo (MC) and an ultrasound imaging system to provide the best irradiation strategy (electron beam energy, applicator position and bevel angle) and to facilitate the optimisation of dose prescription and delivery to the target volume while maximising the organs at risk sparing. The study has been performed in silico, exploiting MC simulations of a breast cancer treatment. Ultrasound-based input has been used to compute the absorbed dose maps in different irradiation strategies and a quantitative comparison between the different options was carried out using Dose Volume Histograms.
The system was capable of exploring different beam energies and applicator positions in few minutes, identifying the best strategy with an overall computation time that was found to be completely compatible with clinical implementation. The systematic uncertainty related to tissue deformation during treatment delivery with respect to imaging acquisition was taken into account.
The potential and feasibility of a GPU based full MC TPS implementation of IOeRT breast cancer treatments has been demonstrated in-silico. This long awaited tool will greatly improve the treatment safety and efficacy, overcoming the limits identified within the clinical trials carried out so far.
•A fast GPU based MC has been developed for IOeRT breast treatment planning.•The input is an ultrasound image with defined PTV and OARs.•Different applicator positions, dimensions and angles and beam energies are tested.•Plan is optimised using absorbed dose maps and related DVHs.•Results in the context of conventional and FLASH irradiations are discussed.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract
Translation of electron FLASH radiotherapy in clinical practice requires the use of high energy accelerators to treat deep tumours and Very High Electron Energy (VHEE) could represent a ...valid technique to achieve this goal. In this scenario, a VHEE FLASH linac is under study at the University La Sapienza of Rome (Italy) in collaboration with the Italian Institute for Nuclear Research (INFN) and the Institut Curie (France). Here we present the preliminary results of a compact C-band system aiming to reach an high accelerating gradient and an high pulse current necessary to deliver high dose per pulse and ultra-high dose rate required for FLASH effect. We propose a system composed of a low energy high current injector linac followed by a modular section of high accelerating gradient structures. CST code is used to define the required LINAC’s RF parameters and beam dynamics simulations are performed using TSTEP and ASTRA.
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