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  • 1
    In: Medical Physics, Wiley, Vol. 48, No. 8 ( 2021-08), p. 4411-4424
    Abstract: Ion beam radiotherapy offers enhances dose conformity to the tumor volume while better sparing healthy tissue compared to conventional photon radiotherapy. However, the increased dose gradient also makes it more sensitive to uncertainties. While the most important uncertainty source is the patient itself, the beam delivery is also subject to uncertainties. Most of the proton therapy centers used cyclotrons, which deliver typically a stable beam over time, allowing a continuous extraction of the beam. Carbon‐ion beam radiotherapy (CIRT) in contrast uses synchrotrons and requires a larger and energy‐dependent extrapolation of the nozzle‐measured positions to obtain the lateral beam positions in the isocenter, since the nozzle‐to‐isocenter distance is larger than for cyclotrons. Hence, the control of lateral pencil beam positions at isocenter in CIRT is more sensitive to uncertainties than in proton radiotherapy. Therefore, an independent monitoring of the actual lateral positions close to the isocenter would be very valuable and provide additional information. However, techniques capable to do so are scarce, and they are limited in precision, accuracy and effectivity. Methods The detection of secondary ions (charged nuclear fragments) has previously been exploited for the Bragg peak position of C‐ion beams. In our previous work, we investigated for the first time the feasibility of lateral position monitoring of pencil beams in CIRT. However, the reported precision and accuracy were not sufficient for a potential implementation into clinical practice. In this work, it is shown how the performance of the method is improved to the point of clinical relevance. To minimize the observed uncertainties, a mini‐tracker based on hybrid silicon pixel detectors was repositioned downstream of an anthropomorphic head phantom. However, the secondary‐ion fluence rate in the mini‐tracker rises up to 1.5 × 10 5 ions/s/cm 2 , causing strong pile‐up of secondary‐ion signals. To solve this problem, we performed hardware changes, optimized the detector settings, adjusted the setup geometry and developed new algorithms to resolve ambiguities in the track reconstruction. The performance of the method was studied on two treatment plans delivered with a realistic dose of 3 Gy (RBE) and averaged dose rate of 0.27 Gy/s at the Heidelberg Ion‐Beam Therapy Center (HIT) in Germany. The measured lateral positions were compared to reference beam positions obtained either from the beam nozzle or from a multi‐wire proportional chamber positioned at the room isocenter. Results The presented method is capable to simultaneously monitor both lateral pencil beam coordinates over the entire tumor volume during the treatment delivery, using only a 2‐cm 2 mini‐tracker. The effectivity (defined as the fraction of analyzed pencil beams) was 100%. The reached precision of (0.6 to 1.5) mm and accuracy of (0.5 to 1.2) mm are in line with the clinically accepted uncertainty for QA measurements of the lateral pencil beam positions. Conclusions It was demonstrated that the performance of the method for a non‐invasive lateral position monitoring of pencil beams is sufficient for a potential clinical implementation. The next step is to evaluate the method clinically in a group of patients in a future observational clinical study.
    Type of Medium: Online Resource
    ISSN: 0094-2405 , 2473-4209
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 1466421-5
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  • 2
    In: Physica Medica, Elsevier BV, Vol. 104 ( 2022-12), p. S36-S37
    Type of Medium: Online Resource
    ISSN: 1120-1797
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 1122650-X
    detail.hit.zdb_id: 2110535-2
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  • 3
    In: Frontiers in Oncology, Frontiers Media SA, Vol. 11 ( 2021-11-29)
    Abstract: The dose conformity of carbon-ion beam radiotherapy, which allows the reduction of the dose deposition in healthy tissue and the escalation of the dose to the tumor, is associated with a high sensitivity to anatomical changes during and between treatment irradiations. Thus, the monitoring of inter-fractional anatomical changes is crucial to ensure the dose conformity, to potentially reduce the size of the safety margins around the tumor and ultimately to reduce the irradiation of healthy tissue. To do so, monitoring methods of carbon-ion radiotherapy in depth using secondary-ion tracking are being investigated. In this work, the detection and localization of a small air cavity of 2 mm thickness were investigated at different detection angles of the mini-tracker relative to the beam axis. The experiments were conducted with a PMMA head phantom at the Heidelberg Ion-Beam Therapy Center (HIT) in Germany. In a clinic-like irradiation of a single field of 3 Gy (RBE), secondary-ion emission profiles were measured by a 2 cm 2 mini-tracker composed of two silicon pixel detectors. Two positions of the cavity in the head phantom were studied: in front and in the middle of the tumor volume. The significance of the cavity detection was found to be increased at smaller detection angles, while the accuracy of the cavity localization was improved at larger detection angles. Detection angles of 20° – 30° were found to be a good compromise for accessing both, the detectability and the position of the air cavity along the depth in the head of a patient.
    Type of Medium: Online Resource
    ISSN: 2234-943X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2649216-7
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  • 4
    Online Resource
    Online Resource
    Wiley ; 2020
    In:  Medical Physics Vol. 47, No. 5 ( 2020-05), p. 2300-2308
    In: Medical Physics, Wiley, Vol. 47, No. 5 ( 2020-05), p. 2300-2308
    Abstract: Recently, there has been increasing interest in the development of scintillator‐based detectors for the measurement of depth–dose curves of therapeutic proton beams (Beaulieu and Beddar [2016], Phys Med Biol ., 61 :R305–R343). These detectors allow the measurement of single beam parameters such as the proton range or the reconstruction of the full three‐dimensional dose distribution. Thus, scintillation detectors could play an important role in beam quality assurance, online beam monitoring, and proton imaging. However, the light output of the scintillator as a function of dose deposition is subject to quenching effects due to the high‐specific energy loss of incident protons, particularly in the Bragg peak. The aim of this work is to develop a model that describes the percent depth‐light curve in a quenching scintillator and allow the extraction of information about the beam range and the strength of the quenching. Methods A mathematical expression of a depth‐light curve, derived from a combination of Birks’ law (Birks [1951], Proc Phys Soc A ., 64 :874) and Bortfeld’s Bragg curve (Bortfeld [1997], Med Phys ., 24 :2024–2033) that is termed a “quenched Bragg” curve, is presented. The model is validated against simulation and measurement. Results A fit of the quenched Bragg model to simulated depth‐light curves in a polystyrene‐based scintillator shows good agreement between the two, with a maximum deviation of 2.5% at the Bragg peak. The differences are larger behind the Bragg peak and in the dose build‐up region. In the same simulation, the difference between the reconstructed range and the reference proton range is found to be always smaller than 0.16 mm. The comparison with measured data shows that the fitted beam range agrees with the reference range within their respective uncertainties. Conclusions The quenched Bragg model is, therefore, an accurate tool for the range measurement from quenched depth–dose curves. Moreover, it allows the reconstruction of the beam energy spread, the particle fluence, and the magnitude of the quenching effect from a measured depth‐light curve.
    Type of Medium: Online Resource
    ISSN: 0094-2405 , 2473-4209
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 1466421-5
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  • 5
    Online Resource
    Online Resource
    IOP Publishing ; 2020
    In:  Physics in Medicine & Biology Vol. 65, No. 16 ( 2020-08-21), p. 165001-
    In: Physics in Medicine & Biology, IOP Publishing, Vol. 65, No. 16 ( 2020-08-21), p. 165001-
    Abstract: The commissioning and operation of a particle therapy centre requires an extensive set of detectors for measuring various parameters of the treatment beam. Among the key devices are detectors for beam range quality assurance. In this work, a novel range telescope based on a plastic scintillator and read out by a large-scale CMOS sensor is presented. The detector is made of a stack of 49 plastic scintillator sheets with a thickness of 2–3 mm and an active area of 100 × 100 mm 2 , resulting in a total physical stack thickness of 124.2 mm. This compact design avoids optical artefacts that are common in other scintillation detectors. The range of a proton beam is reconstructed using a novel Bragg curve model that incorporates scintillator quenching effects. Measurements to characterise the performance of the detector were carried out at the Heidelberger Ionenstrahl-Therapiezentrum (HIT, Heidelberg, GER) and the Clatterbridge Cancer Centre (CCC, Bebington, UK). The maximum difference between the measured range and the reference range was found to be 0.41 mm at a proton beam range of 310 mm and was dominated by detector alignment uncertainties. With the new detector prototype, the water-equivalent thickness of PMMA degrader blocks has been reconstructed within ± 0.1 mm. An evaluation of the radiation hardness proves that the range reconstruction algorithm is robust following the deposition of 6,300 Gy peak dose into the detector. Furthermore, small variations in the beam spot size and transverse beam position are shown to have a negligible effect on the range reconstruction accuracy. The potential for range measurements of ion beams is also investigated.
    Type of Medium: Online Resource
    ISSN: 0031-9155 , 1361-6560
    RVK:
    Language: Unknown
    Publisher: IOP Publishing
    Publication Date: 2020
    detail.hit.zdb_id: 1473501-5
    SSG: 12
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  • 6
    In: Physica Medica, Elsevier BV, Vol. 34 ( 2017-02), p. 7-17
    Type of Medium: Online Resource
    ISSN: 1120-1797
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
    detail.hit.zdb_id: 1122650-X
    detail.hit.zdb_id: 2110535-2
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  • 7
    In: Physica Medica, Elsevier BV, Vol. 104 ( 2022-12), p. S118-
    Type of Medium: Online Resource
    ISSN: 1120-1797
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 1122650-X
    detail.hit.zdb_id: 2110535-2
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  • 8
    In: Medical Physics, Wiley, Vol. 46, No. 8 ( 2019-08), p. 3734-3738
    Abstract: The purpose of this study is to characterize the magnitude and depth of dose buildup in pencil beam scanning proton therapy. Methods We simulate the integrated depth–dose curve of realistic proton pencil beams in a water phantom using the Geant4 Monte Carlo toolkit. We independently characterize the electronic and protonic components of dose buildup as a function of proton beam energy from 40 to 400 MeV, both with and without an air gap. Results At clinical energies, electronic buildup over a distance of about 1 mm leads to a dose reduction at depth of the basal layer (0.07 mm) by up to 6% compared to if no buildup effect were present. Protonic buildup reduces the dose to the basal layer by up to 16% and has effects at depths of up to 150 mm. Secondary particles with a mass number A   〉  1 do not contribute to dose buildup. An air gap of 1 m has no significant effect on protonic buildup but reduces electronic buildup below 1%. Conclusions Protonic and electronic dose buildup are relevant for accurate dosimetry in proton therapy although a realistic air gap reduces the electronic buildup to levels where it can be safely neglected. We recommend including electrons and secondary protons in Monte Carlo‐based treatment planning systems down to a predicted range of 10–20 μ m in order to accurately model the dose at depths of the basal layer, no matter the size of the air gap between nozzle and patient.
    Type of Medium: Online Resource
    ISSN: 0094-2405 , 2473-4209
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 1466421-5
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  • 9
    In: Medical Physics, Wiley, Vol. 49, No. 3 ( 2022-03), p. 1776-1792
    Abstract: Noninvasive methods to monitor carbon‐ion beams in patients are desired to fully exploit the advantages of carbon‐ion radiotherapy. Prompt secondary ions produced in nuclear fragmentations of carbon ions are of particular interest for monitoring purposes as they can escape the patient and thus be detected and tracked to measure the radiation field in the irradiated object. This study aims to evaluate the performance of secondary‐ion tracking to detect, visualize, and localize an internal air cavity used to mimic inter‐fractional changes in the patient anatomy at different depths along the beam axis. Methods In this work, a homogeneous head phantom was irradiated with a realistic carbon‐ion treatment plan with a typical prescribed fraction dose of 3 Gy(RBE). Secondary ions were detected by a mini‐tracker with an active area of 2 cm 2 , based on the Timepix3 semiconductor pixel detector technology. The mini‐tracker was placed 120 mm behind the center of the target at an angle of 30 degrees with respect to the beam axis. To assess the performance of the developed method, a 2‐mm thick air cavity was inserted in the head phantom at several depths: in front of as well as at the entrance, in the middle, and at the distal end of the target volume. Different reconstruction methods of secondary‐ion emission profile were studied using the FLUKA Monte Carlo simulation package. The perturbations in the emission profiles caused by the air cavity were analyzed to detect the presence of the air cavity and localize its position. Results The perturbations in the radiation field mimicked by the 2‐mm thick cavity were found to be significant. A detection significance of at least three standard deviations in terms of spatial distribution of the measured tracks was found for all investigated cavity depths, while the highest significance (six standard deviations) was obtained when the cavity was located upstream of the tumor. For a tracker with an eight‐fold sensitive area, the detection significance rose to at least nine standard deviations and up to 17 standard deviations, respectively. The cavity could be detected at all depths and its position measured within 6.5 ± 1.4 mm, which is sufficient for the targeted clinical performance of 10 mm. Conclusion The presented systematic study concerning the detection and localization of small inter‐fractional structure changes in a realistic clinical setting demonstrates that secondary ions carry a large amount of information on the internal structure of the irradiated object and are thus attractive to be further studied for noninvasive monitoring of carbon‐ion treatments.
    Type of Medium: Online Resource
    ISSN: 0094-2405 , 2473-4209
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 1466421-5
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