Frédéric Stichelbaut

Prompt gamma imaging with a slit camera for real-time range control in proton therapy.

Treatments delivered by proton therapy are affected by uncertainties on the range of the beam within the patient. To reduce these margins and deliver safer treatments, different projects are currently investigating real-time range control by imaging prompt gammas emitted along the proton tracks in the patient. This study reports on the development and test of a prompt gamma camera using a slit collimator to obtain a 1-dimensional projection of the beam path on a scintillator detector. A first prototype slit camera using the HICAM gamma detector, originally developed for low-energy gamma-ray imaging in nuclear medicine and modified for this purpose, was tested successfully up to 230 MeV beam energy. Results now confirm the potential of this concept for real-time range monitoring with millimeter accuracy in pencil beam scanning mode for the whole range of clinical energies. With the experience gained, a new prototype is under study for clinical beam currents. In this work, we present both the profiles obtained at 230 MeV using HICAM and the description of the new gamma camera prototype design.

Monte Carlo calculations of positron emitter yields in proton radiotherapy

Positron emission tomography (PET) is a promising tool for monitoring the three-dimensional dose distribution in charged particle radiotherapy. PET imaging during or shortly after proton treatment is based on the detection of annihilation photons following the ß(+)-decay of radionuclides resulting from nuclear reactions in the irradiated tissue. Therapy monitoring is achieved by comparing the measured spatial distribution of irradiation-induced ß(+)-activity with the predicted distribution based on the treatment plan. The accuracy of the calculated distribution depends on the correctness of the computational models, implemented in the employed Monte Carlo (MC) codes that describe the interactions of the charged particle beam with matter and the production of radionuclides and secondary particles. However, no well-established theoretical models exist for predicting the nuclear interactions and so phenomenological models are typically used based on parameters derived from experimental data. Unfortunately, the experimental data presently available are insufficient to validate such phenomenological hadronic interaction models. Hence, a comparison among the models used by the different MC packages is desirable. In this work, starting from a common geometry, we compare the performances of MCNPX, GATE and PHITS MC codes in predicting the amount and spatial distribution of proton-induced activity, at therapeutic energies, to the already experimentally validated PET modelling based on the FLUKA MC code. In particular, we show how the amount of ß(+)-emitters produced in tissue-like media depends on the physics model and cross-sectional data used to describe the proton nuclear interactions, thus calling for future experimental campaigns aiming at supporting improvements of MC modelling for clinical application of PET monitoring.

Real-time proton beam range monitoring by means of prompt-gamma detection with a collimated camera

Prompt-gamma profile was measured at WPE-Essen using 160 MeV protons impinging a movable PMMA target. A single collimated detector was used with time-of-flight (TOF) to reduce the background due to neutrons. The target entrance rise and the Bragg peak falloff retrieval precision was determined as a function of incident proton number by a fitting procedure using independent data sets. Assuming improved sensitivity of this camera design by using a greater number of detectors, retrieval precisions of 1 to 2 mm (rms) are expected for a clinical pencil beam. TOF improves the contrast-to-noise ratio and the performance of the method significantly.

Overview of the IBA accelerator-based BNCT system

During the last few years, IBA started the development of an accelerator-based BNCT system. The accelerator is a Dynamitron built by RDI in USA and will produce a 20 mA proton beam at 2.8 MeV. Neutrons will be produced by the (7)Li(p,n)(7)Be nuclear reaction using a thin lithium target. The neutron energy spectrum will be tailored using a beam shaping assembly. This overview presents the current status of the system: after a description of every component, some design issues, solutions and experimental tests will be discussed.

Time-resolved imaging of prompt-gamma rays for proton range verification using a knife-edge slit camera based on digital photon counters

Proton range monitoring may facilitate online adaptive proton therapy and improve treatment outcomes. Imaging of proton-induced prompt gamma (PG) rays using a knife-edge slit collimator is currently under investigation as a potential tool for real-time proton range monitoring. A major challenge in collimated PG imaging is the suppression of neutron-induced background counts. In this work, we present an initial performance test of two knife-edge slit camera prototypes based on arrays of digital photon counters (DPCs). PG profiles emitted from a PMMA target upon irradiation with a 160 MeV proton pencil beams (about 6.5 × 10(9) protons delivered in total) were measured using detector modules equipped with four DPC arrays coupled to BGO or LYSO : Ce crystal matrices. The knife-edge slit collimator and detector module were placed at 15 cm and 30 cm from the beam axis, respectively, in all cases. The use of LYSO : Ce enabled time-of-flight (TOF) rejection of background events, by synchronizing the DPC readout electronics with the 106 MHz radiofrequency signal of the cyclotron. The signal-to-background (S/B) ratio of 1.6 obtained with a 1.5 ns TOF window and a 3 MeV-7 MeV energy window was about 3 times higher than that obtained with the same detector module without TOF discrimination and 2 times higher than the S/B ratio obtained with the BGO module. Even 1 mm shifts of the Bragg peak position translated into clear and consistent shifts of the PG profile if TOF discrimination was applied, for a total number of protons as low as about 6.5 × 10(8) and a detector surface of 6.6 cm × 6.6 cm.

Neutron H*(10) inside a proton therapy facility: comparison between Monte Carlo simulations and WENDI-2 measurements

Inside an IBA proton therapy centre, secondary neutrons are produced due to nuclear interactions of the proton beam with matter mainly inside the cyclotron, the beam line, the treatment nozzle and the patient. Accurate measurements of the neutron ambient dose equivalent H*(10) in such a facility require the use of a detector that has a good sensitivity for neutrons ranging from thermal energies up to 230 MeV, such as for instance the WENDI-2 detector. WENDI-2 measurements have been performed at the Westdeutsches Protonentherapiezentrum Essen, at several positions around the cyclotron room and around a gantry treatment room operated in two different beam delivery modes: Pencil Beam Scanning and Double Scattering. These measurements are compared with Monte Carlo simulation results for the neutron H*(10) obtained with MCNPX 2.5.0 and GEANT4 9.6.

Application of the HICAM camera for imaging of prompt gamma rays in measurements of proton beam range

The HICAM gamma camera is an imaging device recently developed in the framework of a European project, based on Silicon Drift Detectors (SDDs) as photodetectors. Although originally designed for low-energy gamma-ray imaging in nuclear medicine (140 keV of 99mTc), in this work we attempt to use the camera, suitably modified, to image high energy prompt gamma rays (2 to 7 MeV) emitted by a target irradiated by protons. The final objective of our experiment is to assess the feasibility of proton beam range measurements by prompt gamma imaging with a slit camera, and the HICAM camera was chosen for a first prototype. Although a SDD-based camera would not be fast enough for real treatment conditions, the prototype here employed benefited from the camera modularity, compactness, high resolution and low noise. The camera here employed is composed of 25 SDDs of 1 cm2 active area each, arranged in a 5×5 format, already used in clinical and research environments with a high intrinsic spatial resolution (∼1 mm). The SDD matrix has been coupled to a LYSO crystal (1cm thickness), to improve efficiency with high-energy gammas, and has been characterized preliminarily with a 60Co source. Good imaging performances have been obtained in this test. Moreover, results of a first test of the camera to detect prompt gammas emitted with a proton beam impinging on a plastic target are presented in this work.

SECONDARY NEUTRON DOSES IN A PROTON THERAPY CENTRE.

The formation of secondary high-energy neutrons in proton therapy can be a concern for radiation protection of staff. In this joint intercomparative study (CERN, SCK•CEN and IBA/IRISIB/ULB), secondary neutron doses were assessed with different detectors in several positions in the Proton Therapy Centre, Essen (Germany). The ambient dose equivalent H(*)(10) was assessed with Berthold LB 6411, WENDI-2, tissue-equivalent proportional counter (TEPC) and Bonner spheres (BS). The personal dose equivalent Hp(10) was measured with two types of active detectors and with bubble detectors. Using spectral and basic angular information, the reference Hp(10) was estimated. Results concerning staff exposure show H(*)(10) doses between 0.5 and 1 nSv/monitoring unit in a technical room. The LB 6411 showed an underestimation of H(*)(10), while WENDI-2 and TEPC showed good agreement with the BS data. A large overestimation for Hp(10) was observed for the active personal dosemeters, while the bubble detectors showed only a slight overestimation.

Secondary neutron doses in a compact proton therapy system.

Proton therapy offers several advantages compared with classical radiotherapy owing to a better dose conformity to the tumour volume. However, proton interactions with beam transport elements and the human tissues lead to the production of secondary neutrons, resulting in an extra whole-body dose with some carcinogenic potential. In this study, the secondary neutron doses generated with an active beam scanning system and with two compact proton therapy systems recently appeared on the market are compared.

Prompt gamma imaging with a slit camera for real-time range control in proton therapy: Experimental validation up to 230 MeV with HICAM and development of a new prototype

Treatments delivered by proton therapy are affected by uncertainties on the range of the beam within the patient. To reduce these margins and deliver safer treatments, different projects are currently investigating real-time range control by imaging prompt gammas emitted along the proton tracks in the patient. This study reports on the development and test of a prompt gamma camera using a slit collimator to obtain a 1-dimensional projection of the beam path on a scintillator detector. A first prototype slit camera using the HICAM gamma detector, originally developed for low-energy gamma-ray imaging in nuclear medicine and modified for this purpose, was tested successfully up to 230 MeV beam energy. Results now confirm the potential of this concept for real-time range monitoring with millimeter accuracy in pencil beam scanning mode for the whole range of clinical energies. With the experience gained, a new prototype is under study for clinical beam currents. In this work, we present both the profiles obtained at 230 MeV using HICAM and the description of the new gamma camera prototype design.