M. Kanazawa

Respiratory gated irradiation system for heavy-ion radiotherapy

PURPOSE In order to reduce the treatment margin of the moving target due to breathing, we developed a gated irradiation system for heavy-ion radiotherapy. METHODS AND MATERIALS The motion of a patient due to respiration is detected by the motion of the body surface around the chest wall. A respiratory sensor was developed using an infrared light spot and a position-sensitive detector. A timing signal to request a beam is generated in response to the respiration waveform, and a carbon beam is extracted from the synchrotron using a RF-knockout method. CT images for treatment planning are taken in synchronization with the respiratory motion. For patient positioning, digitized fluoroscopic images superimposed with the respiration waveform were used. The relation between the respiratory sensor signal and the organ motion was examined using digitized video images from fluoroscopy. The performance of our gated system was demonstrated by using the moving phantom, and dose profiles were measured in the direction of phantom motion. RESULTS The timing of gate-on is set at the end of the expiratory phase, because the motion of the diaphragm is slower and more reproducible than during the inspiratory phase. The signal of the respiratory sensor shows a phase difference of 120 milliseconds between lower and upper locations on the chest wall. The motion of diaphragm is delayed by 200 milliseconds from the respiration waveform at the lower location. The beam extraction system worked according to the beam on/off logic for gating, and the gated CT scanner performed well. The lateral penumbra size of the dose profile along the moving axis was distinguishably decreased by the gated irradiation. The ratio of the nongated to gated lateral fall-off was 4.3, 3.5, and 2. 0 under the stroke of 40.0, 29.0, and 13.0 mm respectively. CONCLUSION We developed a total treatment system of gated irradiation for heavy-ion radiotherapy. We found that with this system the target margin along the body axis could be decreased to 5-10 mm although the target moved twice or three times. Over 150 patients with lung or liver cancer had already been treated by this gated irradiation system by the end of July 1999.

Heavy ion synchrotron for medical use —HIMAC project at NIRS-Japan—

Abstract A heavy ion synchrotron complex for medical use is being constructed at Chiba, Japan. General feature and present status of this project are described.

Slow beam extraction by a transverse RF field with AM and FM

Abstract A beam extraction method using a transverse rf electric field with amplitude and frequency modulation has been studied in order to develop an irradiation method which is synchronized with the breathing of a patient for high-quality charged particle therapy. The dependence of the extracted beam intensity on the voltage, the frequency band width and the center frequency of the transverse rf electric field has been investigated. The extracted beam intensity was slightly increased from that of the ordinary slow extraction method with a third order resonance. The response of the extracted beam intensity to the applied transverse rf electric field was as prompt as within 1 ms. The horizontal emittance of beams extracted by the present method was reduced by about 70% compared with that by the ordinary one due to utilizing a constant separatrix. Amplitude modulation can control the global beam spill structure. The frequency modulation reduced the effect of the current ripple of the main quadrupole magnets.

Washout measurement of radioisotope implanted by radioactive beams in the rabbit.

Washout of 10C and 11C implanted by radioactive beams in brain and thigh muscle of rabbits was studied. The biological washout effect in a living body is important in the range verification system or three-dimensional volume imaging in heavy ion therapy. Positron emitter beams were implanted in the rabbit and the annihilation gamma-rays were measured by an in situ positron camera which consisted of a pair of scintillation cameras set on either side of the target. The ROI (region of interest) was set as a two-dimensional position distribution and the time-activity curve of the ROI was measured. Experiments were done under two conditions: live and dead. By comparing the two sets of measurement data, it was deduced that there are at least three components in the washout process. Time-activity curves of both brain and thigh muscle were clearly explained by the three-component model analysis. The three components ratios (and washout half-lives) were 35% (2.0 s), 30% (140 s) and 35% (10 191 s) for brain and 30% (10 s), 19% (195 s) and 52% (3175 s) for thigh muscle. The washout effect must be taken into account for the verification of treatment plans by means of positron camera measurements.

Washout studies of 11C in rabbit thigh muscle implanted by secondary beams of HIMAC

Heavy ion therapy has two definite advantages: good dose localization and higher biological effect. Range calculation of the heavy ions is an important factor in treatment planning. X-ray CT numbers are used to estimate the heavy ion range by looking up values in a conversion table which relates empirically photon attenuation in tissues to particle stopping power; this is one source of uncertainty in the treatment planning. Use of positron emitting radioactive beams along with a positron emission tomograph or a positron camera gives range information and may be used as a means of checking in heavy ion treatment planning. However, the metabolism of the implanted positron emitters in a living object is unpredictable because the chemical forms of these emitters are unknown and the metabolism is dependent on the organ species and may be influenced by many factors such as blood flow rate and fluid components present. In this paper, the washout rate of 11C activity implanted by injecting energetic 11C beams into thigh muscle of a rear leg of a rabbit is presented. The washout was found to consist of two components, the shorter one was about 4.2 +/- 1.1 min and the longer one ranged from 91 to 124 min. About one third of the implanted beta+ activity can be used for imaging and the rest was washed out of the target area.

Spot Scanning Using Radioactive 11C Beams for Heavy-Ion Radiotherapy

A scheme for spot scanning using 11C beams has been developed in order to form and verify a three-dimensionally conformal irradiation field for cancer radiotherapy. By selecting the momentum spread of a 11C beam, we could considerably decrease the distal falloff of the irradiation field, thus conserving the beam quality. To estimate and optimize the dose distribution in the irradiation field, it is essential to evaluate the precise dose distribution of spot beams. The coupling of the lateral dose and depth-dose distributions originating from a wide momentum spread should be taken into account to calculate the dose distribution of 11C beams. The reconstructed dose distribution of the irradiation field was in good agreement with the experimental results, i.e., within ±0.2%. An irradiation field of 35×35×43 mm3 was optimized and spot scanning using 11C beams was carried out. The flatness was within ±2.3% with an error of 1% in the detector resolution.

Application of an RI-beam for cancer therapy: In-vivo verification of the ion-beam range by means of positron imaging

Abstract In cancer treatment with heavy ions, verification of the ion range in the patients body is important. For this purpose, a positron emitter beam provides the possibility of range verification. To use the positron emitter beam, we have constructed a secondary beam course and its irradiation system. In this paper the constructed system is presented together with some results of beam experiments.

Range verification system using positron emitting beams for heavy-ion radiotherapy

It is desirable to reduce range ambiguities in treatment planning for making full use of the major advantage of heavy-ion radiotherapy, that is, good dose localization. A range verification system using positron emitting beams has been developed to verify the ranges in patients directly. The performance of the system was evaluated in beam experiments to confirm the designed properties. It was shown that a 10C beam could be used as a probing beam for range verification when measuring beam properties. Parametric measurements indicated the beam size and the momentum acceptance and the target volume did not influence range verification significantly. It was found that the range could be measured within an analysis uncertainty of +/-0.3 mm under the condition of 2.7 x 10(5) particle irradiation, corresponding to a peak dose of 96 mGyE (gray-equivalent dose), in a 150 mm diameter spherical polymethyl methacrylate phantom which simulated a human head.

Advanced RF-KO slow-extraction method for the reduction of spill ripple

Two advanced RF-knockout (RF-KO) slow-extraction methods have been developed at HIMAC in order to reduce the spill ripple for accurate heavy-ion cancer therapy: the dual frequency modulation (FM) method and the separated function method. As a result of simulations and experiments, it was verified that the spill ripple could be considerably reduced using these advanced methods, compared with the ordinary RF-KO method. The dual FM method and the separated function method bring about a low spill ripple within standard deviations of around 25% and of 15% during beam extraction within around 2 s, respectively, which are in good agreement with the simulation results.

Slow beam extraction at TARN II

Abstract A slow beam extraction system using the third order resonance has been constructed at TARN II and beam extraction tests have been performed. By the ordinary scheme where the tune is shifted to the resonance with ramping the excitation strength of the lattice quadrupole magnets, an extraction efficiency of 90% is attained. A new scheme increasing the horizontal emittance of the circulating beam is applied to extract the beam. A very long beam spill of 800 s is obtained by this scheme. A method using a transverse rf field is also studied experimentally, resulting in an extracted beam with smaller emittance.