Kenji Hotta

Experimental evaluation of a MOSFET dosimeter for proton dose measurements

The metal oxide semiconductor field-effect transistor (MOSFET) dosimeter has been widely studied for use as a dosimeter for patient dose verification. The major advantage of this detector is its size, which acts as a point dosimeter, and also its ease of use. The commercially available TN502RD MOSFET dosimeter manufactured by Thomson and Nielsen has never been used for proton dosimetry. Therefore we used the MOSFET dosimeter for the first time in proton dose measurements. In this study, the MOSFET dosimeter was irradiated with 190 MeV therapeutic proton beams. We experimentally evaluated dose reproducibility, linearity, fading effect, beam intensity dependence and angular dependence for the proton beam. Furthermore, the Bragg curve and spread-out Bragg peak were also measured and the linear-energy transfer (LET) dependence of the MOSFET response was investigated. Many characteristics of the MOSFET response for proton beams were the same as those for photon beams reported in previous papers. However, the angular MOSFET responses at 45, 90, 135, 225, 270 and 315 degrees for proton beams were over-responses of about 15%, and moreover the MOSFET response depended strongly on the LET of the proton beam. This study showed that the angular dependence and LET dependence of the MOSFET response must be considered very carefully for quantitative proton dose evaluations.

Improved dose-calculation accuracy in proton treatment planning using a simplified Monte Carlo method verified with three-dimensional measurements in an anthropomorphic phantom

Treatment planning for proton tumor therapy requires a fast and accurate dose-calculation method. We have implemented a simplified Monte Carlo (SMC) method in the treatment planning system of the National Cancer Center Hospital East for the double-scattering beam delivery scheme. The SMC method takes into account the scattering effect in materials more accurately than the pencil beam algorithm by tracking individual proton paths. We confirmed that the SMC method reproduced measured dose distributions in a heterogeneous slab phantom better than the pencil beam method. When applied to a complex anthropomorphic phantom, the SMC method reproduced the measured dose distribution well, satisfying an accuracy tolerance of 3 mm and 3% in the gamma index analysis. The SMC method required approximately 30 min to complete the calculation over a target volume of 500 cc, much less than the time required for the full Monte Carlo calculation. The SMC method is a candidate for a practical calculation technique with sufficient accuracy for clinical application.

Application of the pencil-beam redefinition algorithm in heterogeneous media for proton beam therapy.

In proton beam therapy, changes in the proton range due to lateral heterogeneity may cause serious errors in the dose distribution. In the present study, the pencilbeam redefinition algorithm (PBRA) was applied to proton beam therapy to address the problem of lateral density heterogeneity. In the calculation, the phase-space parameters were characterized for multiple range (i.e. proton energy) bins for given pencil beams. The particles that were included in each pencil beam were transported and redefined periodically until they had stopped. The redefined beams formed a detouring path that was different from that of the non-redefined pencil beams, and the path of each redefined beam was straight. The results calculated by the PBRA were compared with measured proton dose distributions in a heterogeneous slab phantom and an anthropomorphic phantom. Through the beam redefinition process, the PBRA was able to predict the measured proton-detouring effects. Therefore, the PBRA may allow improved calculation accuracy when dealing with lateral heterogeneities in proton therapy applications.

Proton dose distribution measurements using a MOSFET detector with a simple dose-weighted correction method for LET effects

We experimentally evaluated the proton beam dose reproducibility, sensitivity, angular dependence and depth‐dose relationships for a new Metal Oxide Semiconductor Field Effect Transistor (MOSFET) detector. The detector was fabricated with a thinner oxide layer and was operated at high‐bias voltages. In order to accurately measure dose distributions, we developed a practical method for correcting the MOSFET response to proton beams. The detector was tested by examining lateral dose profiles formed by protons passing through an L‐shaped bolus. The dose reproducibility, angular dependence and depth‐dose response were evaluated using a 190 MeV proton beam. Depth‐output curves produced using the MOSFET detectors were compared with results obtained using an ionization chamber (IC). Since accurate measurements of proton dose distribution require correction for LET effects, we developed a simple dose‐weighted correction method. The correction factors were determined as a function of proton penetration depth, or residual range. The residual proton range at each measurement point was calculated using the pencil beam algorithm. Lateral measurements in a phantom were obtained for pristine and SOBP beams. The reproducibility of the MOSFET detector was within 2%, and the angular dependence was less than 9%. The detector exhibited a good response at the Bragg peak (0.74 relative to the IC detector). For dose distributions resulting from protons passing through an L‐shaped bolus, the corrected MOSFET dose agreed well with the IC results. Absolute proton dosimetry can be performed using MOSFET detectors to a precision of about 3% (1 sigma). A thinner oxide layer thickness improved the LET in proton dosimetry. By employing correction methods for LET dependence, it is possible to measure absolute proton dose using MOSFET detectors. PACS number: 87.56.‐v

The basic study of a bi-material range compensator for improving dose uniformity for proton therapy

A range compensator (abbreviated as a RC hereafter) is used to form a conformal dose distribution for heavy-charged-particle therapy. However, it induces distortion of the dose distribution. The induced inhomogeneity may result in a calibration error of a monitor unit (MU) assigned to a transmission ionization chamber. By using a bi-material RC made from a low-Z material and a high-Z material instead of the regular RC, the dose inhomogeneity has been obviously reduced by equalizing the lateral dose distributions formed by pencil beams traversing elements of the RC with different base thicknesses at the same water-equivalent depth. We designed and manufactured a 4 x 4 matrix-shaped single-material RC and a bi-material RC with the same range losses at corresponding elements of the RCs. The bi-material RC is made from chemical wood (the main chemical component is an ABS resin) as a low-Z material and from brass as a high-Z material. Sixteen segments of the RC are designed so that the range-loss differences of the adjacent segments of the RC range from 0 to 50 mm in steps of 5 mm. We measured dose distributions in water formed by a 160 MeV proton beam traversing the single-material RC or the bi-material RC, using the HIMAC biology beam port. Large dips and bumps were observed in the dose distribution formed by the use of the single-material RC; the dose uniformity has been significantly improved in the target region by the use of the bi-material RC. The improvement has been obtained at the expense of blurring lateral penumbra. For clinical application of this method to a patient with large density inhomogeneity, a simple modification method of the original calculation model has been given.

Improvement of spread-out Bragg peak flatness for a carbon-ion beam by the use of a ridge filter with a ripple filter

We have developed a novel design method of ridge filters for carbon-ion therapy using a broad-beam delivery system to improve the flatness of a biologically effective dose in the spread-out Bragg peak (SOBP). So far, the flatness of the SOBP is limited to about ±5% for carbon beams since the weight control of component Bragg curves composing the SOBP is difficult. This difficulty arises from using a large number of ridge-bar steps (e.g. about 100 for a SOBP width of 60 mm) required to form the SOBP for the pristine Bragg curve with an extremely sharp distal falloff. Instead of using a single ridge filter, we introduce a ripple filter to broaden the Bragg peak so that the number of ridge-bar steps can be reduced to about 30 for SOBP with of 60 mm for the ridge filter designed for the broadened Bragg peak. Thus we can manufacture the ridge filter more accurately and then attain a better flatness of the SOBP due to well-controlled weights of the component Bragg curves. We placed the ripple filter on the same frame of the ridge filter and arranged the direction of the ripple-filter-bar array perpendicular to that of the ridge-filter-bar array. We applied this method to a 290 MeV u(-1) carbon-ion beam in Heavy Ion Medical Accelerator in Chiba and verified the effectiveness by measurements.

In vivo proton dosimetry using a MOSFET detector in an anthropomorphic phantom with tissue inhomogeneity

When in vivo proton dosimetry is performed with a metal‐oxide semiconductor field‐effect transistor (MOSFET) detector, the response of the detector depends strongly on the linear energy transfer. The present study reports a practical method to correct the MOSFET response for linear energy transfer dependence by using a simplified Monte Carlo dose calculation method (SMC). A depth‐output curve for a mono‐energetic proton beam in polyethylene was measured with the MOSFET detector. This curve was used to calculate MOSFET output distributions with the SMC (SMCMOSFET). The SMCMOSFET output value at an arbitrary point was compared with the value obtained by the conventional SMCPPIC, which calculates proton dose distributions by using the depth‐dose curve determined by a parallel‐plate ionization chamber (PPIC). The ratio of the two values was used to calculate the correction factor of the MOSFET response at an arbitrary point. The dose obtained by the MOSFET detector was determined from the product of the correction factor and the MOSFET raw dose. When in vivo proton dosimetry was performed with the MOSFET detector in an anthropomorphic phantom, the corrected MOSFET doses agreed with the SMCPPIC results within the measurement error. To our knowledge, this is the first report of successful in vivo proton dosimetry with a MOSFET detector. PACS number: 87.56.‐v

Proton beam therapy for olfactory neuroblastoma

PURPOSE To clarify the efficacy and feasibility of proton beam therapy (PBT) for olfactory neuroblastoma (ONB). METHODS AND MATERIALS We retrospectively reviewed 42 consecutive patients who received PBT with curative intent for ONB at National Cancer Center Hospital East from November 1999 to March 2012. RESULTS Five patients (12%) had Kadish A disease, nine (21%) had Kadish B, and twenty-eight (67%) had Kadish C. All patients except one received a total dose of 65Gy (relative biological effectiveness: RBE) in 26 fractions. Twenty-four patients (57%) received induction and/or concurrent chemotherapy. The median follow-up for all eligible patients was 69months (7-186). The 5-year overall survival (OS) and progression-free survival (PFS) rates were 100% and 80% for Kadish A, 86 and 65% for Kadish B, and 76% and 39% for Kadish C, respectively. The sites of the first progression were local in six patients (30%), regional in eight (40%), distant in two (10%), local and regional in two (10%), and local and distant in two (10%). Late adverse events of grade 3-4 were seen in six patients (ipsilateral visual impairment, 3; bilateral visual impairment, 1; liquorrhea, 1; cataract, 1). CONCLUSION PBT was a safe and effective modality for ONB.

Evaluation of monitor unit calculation based on measurement and calculation with a simplified Monte Carlo method for passive beam delivery system in proton beam therapy

Calibrating the dose per monitor unit (DMU) for individual patients is important to deliver the prescribed dose in radiation therapy. We have developed a DMU calculation method combining measurement data and calculation with a simplified Monte Carlo method for the double scattering system in proton beam therapy at the National Cancer Center Hospital East in Japan. The DMU calculation method determines the clinical DMU by the multiplication of three factors: a beam spreading device factor FBSD, a patient‐specific device factor FPSD, and a field‐size correction factor FFS(A). We compared the calculated and the measured DMU for 75 dose fields in clinical cases. The calculated DMUs were in agreement with measurements in ±1.1% for all of 25 fields in prostate cancer cases, and in ±3% for 94% of 50 fields in head and neck (H&N) and lung cancer cases, including irregular shape fields and small fields. Although the FBSD in the DMU calculations is dominant as expected, we found that the patient‐specific device factor and field‐size correction also contribute significantly to the calculated DMU. This DMU calculation method will be able to substitute the conventional DMU measurement for the majority of clinical cases with a reasonable calculation time required for clinical use. PACS number: 87.55.khCalibrating the dose per monitor unit (DMU) for individual patients is important to deliver the prescribed dose in radiation therapy. We have developed a DMU calculation method combining measurement data and calculation with a simplified Monte Carlo method for the double scattering system in proton beam therapy at the National Cancer Center Hospital East in Japan. The DMU calculation method determines the clinical DMU by the multiplication of three factors: a beam spreading device factor FBSD, a patient-specific device factor FPSD, and a field-size correction factor FFS(A). We compared the calculated and the measured DMU for 75 dose fields in clinical cases. The calculated DMUs were in agreement with measurements in ±1.1% for all of 25 fields in prostate cancer cases, and in ±3% for 94% of 50 fields in head and neck (H&N) and lung cancer cases, including irregular shape fields and small fields. Although the FBSD in the DMU calculations is dominant as expected, we found that the patient-specific device factor and field-size correction also contribute significantly to the calculated DMU. This DMU calculation method will be able to substitute the conventional DMU measurement for the majority of clinical cases with a reasonable calculation time required for clinical use. PACS number: 87.55.kh.

Development of Continuous Line Scanning System Prototype for Proton Beam Therapy

Purpose Taking advantage of the continuous, high-intensity beam of the cyclotron at the National Cancer Center Hospital East, we developed a continuous line scanning system (CLSS) prototype for prostate cancer in collaboration with Sumitomo Heavy Industries, Ltd (Tokyo, Japan). Materials and Methods The CLSS modulates dose distribution at each beam energy level by varying scanning speed while keeping the beam intensity constant through a beam-intensity control system and a rapid on/off beam-switching system. In addition, we developed a beam alignment system to improve the precision of the beam position. The scanning control system is used to control the scanning pattern and set the value of the nozzle apparatus. It also collects data for monitoring and for cyclotron parameters and transmits information to the scanning power supplies and monitor amplifiers, which serve as the measurement system, and to the nozzle-control and beam-transfer systems. The specifications of the line scanning beam were determined in performance tests. Finally, a patient-specific dosimetric measurement for prostate cancer was also performed. Results The beam size, position, intensity, and scanning speed of our CLSS were found to be well within clinical requirements. The CLSS produced an accurate 3-dimensional dose distribution for clinical treatment planning. Conclusion The performance of our new CLSS was confirmed to comply with clinical requirements. We have been employing it in prostate cancer treatments since October 23, 2015.