H. Rohling

Characterization of the microbunch time structure of proton pencil beams at a clinical treatment facility.

Proton therapy is an advantageous treatment modality compared to conventional radiotherapy. In contrast to photons, charged particles have a finite range and can thus spare organs at risk. Additionally, the increased ionization density in the so-called Bragg peak close to the particle range can be utilized for maximum dose deposition in the tumour volume. Unfortunately, the accuracy of the therapy can be affected by range uncertainties, which have to be covered by additional safety margins around the treatment volume. A real-time range and dose verification is therefore highly desired and would be key to exploit the major advantages of proton therapy. Prompt gamma rays, produced in nuclear reactions between projectile and target nuclei, can be used to measure the protons range. The prompt gamma-ray timing (PGT) method aims at obtaining this information by determining the gamma-ray emission time along the proton path using a conventional time-of-flight detector setup. First tests at a clinical accelerator have shown the feasibility to observe range shifts of about 5 mm at clinically relevant doses. However, PGT spectra are smeared out by the bunch time spread. Additionally, accelerator related proton bunch drifts against the radio frequency have been detected, preventing a potential range verification. At OncoRay, first experiments using a proton bunch monitor (PBM) at a clinical pencil beam have been conducted. Elastic proton scattering at a hydrogen-containing foil could be utilized to create a coincident proton-proton signal in two identical PBMs. The selection of coincident events helped to suppress uncorrelated background. The PBM setup was used as time reference for a PGT detector to correct for potential bunch drifts. Furthermore, the corrected PGT data were used to image an inhomogeneous phantom. In a further systematic measurement campaign, the bunch time spread and the proton transmission rate were measured for several beam energies between 69 and 225 MeV as well as for variable momentum limiting slit openings. We conclude that the usage of a PBM increases the robustness of the PGT method in clinical conditions and that the obtained data will help to create reliable range verification procedures in clinical routine.

Characterization of scintillator crystals for usage as prompt gamma monitors in particle therapy

Particle therapy in oncology is advantageous compared to classical radiotherapy due to its well-defined penetration depth. In the so-called Bragg peak, the highest dose is deposited; the tissue behind the cancerous area is not exposed. Different factors influence the range of the particle and thus the target area, e.g. organ motion, mispositioning of the patient or anatomical changes. In order to avoid over-exposure of healthy tissue and under-dosage of cancerous regions, the penetration depth of the particle has to be monitored, preferably already during the ongoing therapy session. The verification of the ion range can be performed using prompt gamma emissions, which are produced by interactions between projectile and tissue, and originate from the same location and time of the nuclear reaction. The prompt gamma emission profile and the clinically relevant penetration depth are correlated. Various imaging concepts based on the detection of prompt gamma rays are currently discussed: collimated systems with counting detectors, Compton cameras with (at least) two detector planes, or the prompt gamma timing method, utilizing the particle time-of-flight within the body. For each concept, the detection system must meet special requirements regarding energy, time, and spatial resolution. Nonetheless, the prerequisites remain the same: the gamma energy region (2 to 10 MeV), high counting rates and the stability in strong background radiation fields. The aim of this work is the comparison of different scintillation crystals regarding energy and time resolution for optimized prompt gamma detection.

Simulation Study of a Combined Pair Production – Compton Camera for In-Vivo Dosimetry During Therapeutic Proton Irradiation

Proton and light ion beams are applied to the therapeutic irradiation of cancer patients due to the favorable dose deposition of these particles in tissue. By means of accelerated ions, a high dose can be accurately deposited in the tumor while normal tissue is spared. Since minor changes in the patients tissue along the beam path can compromise the success of the treatment, an in-vivo monitoring of the dose deposition is highly desired. Cameras detecting the prompt γ-rays emitted during therapy are under investigation for this purpose. Due to the energy spectrum of prompt γ-rays with a range between a few keV and several MeV, it is reasonable to consider the utilization of electron-positron pair production events to reconstruct the origin of these prompt photons. The combined use as a pair production and Compton camera is expected to increase its efficiency. We evaluated if a pair production camera could be suitable in this context by means of Monte-Carlo simulations. Modelling of the pair production events taking place in a prototype detector dedicated to Compton imaging were performed. We analyzed the efficiency of the detector system regarding pair production and Compton events. The most crucial property of this pair production camera is the angular resolution. The results of this work indicate that the spatial resolution of the considered detection system used as pair production camera is, for principal reasons, insufficient for an application to range assessment in particle therapy. Furthermore, the efficiency of the pair production camera under study is one order of magnitude lower than the efficiency of the setup applied to the detection of Compton events.

Compton imaging in a high energetic photon field

Through the well defined range of charged particles in matter, cancer irradiation by means of ions can be very tumor conformal. However, external range verification is needed to fully exploit the advantages of ion beam therapy. Nuclear interactions between the projectiles and targets result in excited nuclei which emit photons in the MeV energy range during deexcitation. With a Compton camera, it should be possible to image the origin of these photons which is correlated to the beam position. A prototype Compton camera comprising CdZnTe layers and scintillation detectors has been developed and tested with radioactive point sources. In this work, the performance of the camera is tested at a tandetron beam line in a clean radiation field of 4.44 MeV photons. It was shown that Compton imaging at this energy is feasible.

Optimizing secondary radiation imaging systems for range verification in hadron therapy

Hadron-therapy (HT) aims to treat tumors by maximizing the dose released to the target and sparing the dose to normal tissues. For a successful outcome it is very important to determine where the maximum dose is deposited; therefore range verification is necessary for treatment optimization and patient safety. Secondary positron emitting isotopes and prompt gamma radiation are produced after the hadron beam passage. This secondary radiation coming from tissue activation could be used for quality control of treatment, provided that it can be detected and employed to reconstruct the beam path using imaging techniques. This is one of the main goals of the ENVISION project: to evaluate and develop on-line monitoring devices for HT, like PET for detecting the annihilation photons from positrons and Compton Cameras (CCs) for prompt gamma radiation detection. In both technologies high sensitivity is required to increase the signal-to-noise ratio of the reconstructed image for a given therapeutic dose. This simulation study focuses on the sensitivity optimization of such devices, PET and CC, taking into account its use and constraints for on-line HT monitoring. Several configurations of both technologies have been investigated using sources generated from hadron beams. In the case of PET data, the time-of-flight (TOF) information has been included too. For individual hadron beams acquired after 5 minutes, differences in range of 3 mm are detected for all the PET configurations, except for the partial-ring of 60 cm diameter. In addition, patient data from a carbon ion treatment at GSI have been simulated and reconstructed. The system with higher sensitivity and angular sampling recovers more accurately areas with no activity (nasal cavity). In the case of the CC data, the quality of the reconstructed image when using 2-interaction events is notably improved when the detector layers are placed covering a larger solid angle.

From prompt gamma distribution to dose: a novel approach combining an evolutionary algorithm and filtering based on Gaussian-powerlaw convolutions

Range verification and dose monitoring in proton therapy is considered as highly desirable. Different methods have been developed worldwide, like particle therapy positron emission tomography (PT-PET) and prompt gamma imaging (PGI). In general, these methods allow for a verification of the proton range. However, quantification of the dose from these measurements remains challenging. For the first time, we present an approach for estimating the dose from prompt γ-ray emission profiles. It combines a filtering procedure based on Gaussian-powerlaw convolution with an evolutionary algorithm. By means of convolving depth dose profiles with an appropriate filter kernel, prompt γ-ray depth profiles are obtained. In order to reverse this step, the evolutionary algorithm is applied. The feasibility of this approach is demonstrated for a spread-out Bragg-peak in a water target.

Evaluation of resistive-plate-chamber-based TOF-PET applied to in-beam particle therapy monitoring

Particle therapy is a highly conformal radiotherapy technique which reduces the dose deposited to the surrounding normal tissues. In order to fully exploit its advantages, treatment monitoring is necessary to minimize uncertainties related to the dose delivery. Up to now, the only clinically feasible technique for the monitoring of therapeutic irradiation with particle beams is Positron Emission Tomography (PET). In this work we have compared a Resistive Plate Chamber (RPC)-based PET scanner with a scintillation-crystal-based PET scanner for this application. In general, the main advantages of the RPC-PET system are its excellent timing resolution, low cost, and the possibility of building large area systems. We simulated a partial-ring scanner based on an RPC prototype under construction within the Fondazione per Adroterapia Oncologica (TERA). For comparison with the crystal-based PET scanner we have chosen the geometry of a commercially available PET scanner, the Philips Gemini TF. The coincidence time resolution used in the simulations takes into account the current achievable values as well as expected improvements of both technologies. Several scenarios (including patient data) have been simulated to evaluate the performance of different scanners. Initial results have shown that the low sensitivity of the RPC hampers its application to hadron-beam monitoring, which has an intrinsically low positron yield compared to diagnostic PET. In addition, for in-beam PET there is a further data loss due to the partial ring configuration. In order to improve the performance of the RPC-based scanner, an improved version of the RPC detector (modifying the thickness of the gas and glass layers), providing a larger sensitivity, has been simulated and compared with an axially extended version of the crystal-based device. The improved version of the RPC shows better performance than the prototype, but the extended version of the crystal-based PET outperforms all other options.

A compton imaging prototype for range verification in particle therapy

During the 2012 AAPM Annual Meeting 33 percent of the delegates considered the range uncertainty in proton therapy as the main obstacle of becoming a mainstream treatment modality. Utilizing prompt gamma emission, a side product of particle tissue interaction opens the possibility of in-beam dose verification, due to the direct correlation between prompt gamma emission and particle dose deposition. Compton imaging has proven to be a technique to measure three dimensional gamma emission profiles ([1], [2]) and opens the possibility of adaptive dose monitoring and treatment correction.

Scintillator characterization at energies relevant for a prompt gamma detection system in particle therapy

The proton therapy in oncology requires instantaneous and reliable particle range verification, which can be achieved using prompt gamma emissions. The characteristic requirements of prompt gamma detection include the energy range of up to several MeV, increased background due to secondary emissions and high counting rates. Different concepts make use of the prompt gamma emissions for verification of dose deposition location, e.g. collimated systems or Compton cameras. Additionally to prompt gamma imaging, the prompt gamma timing method has been proposed, utilizing the proton transit time inside the body. Those approaches imply different needs on energy-, spatial- or timing-resolution of the detection system. Various scintillator materials with multiple shapes have been characterized with respect to those requirements using classical photomultiplier tubes (PMT) and different experimental setups and locations. The light output, non-linearity and energy resolution were measured using gamma sources. The timing was characterized at the ELBE facility at Helmholtz-Zentrum Dresden-Rossendorf (HZDR), using the bremsstrahlung beam with photons up to 12.5 MeV. Measurements at the 3 MV Tandetron accelerator at HZDR provided information of the energy resolution at therapy relevant energies of 4.4 MeV.

Model for the design of a prompt gamma detection system using large scintillators and digital silicon photomultipliers

Proton therapy is supposed to be advantageous compared to classical radiation therapy in oncology. But range uncertainties can arise easily and have to be corrected for, preferably immediately during irradiation. Prompt gammas are a good means of instantaneous localization of the dose deposition. Detection systems have to cope with high counting rates, an energy region of up to several MeV and increased background due to secondary emissions, while providing reliable information on energy, timing and location of the detected gamma ray. Various concepts utilize these prompt gammas for dose verification like collimated systems, Compton cameras or prompt gamma timing method. The digital silicon photomultiplier (dSiPM), being a favorable alternative to PMTs because of good timing performances and no requirement of further electronics, has been modelled in order to understand the complex behavior when working with monolithic scintillation crystals. Especially the selection of trigger- and validation-parameters may lead to different spectrum shapes. This model will be helpful for finding best parameter settings for the required task, because it determines the photons lost in various processes as well as the trigger timing information. Comparison of modelled spectra and measured spectra are presented.