S Avery

MO-F-CAMPUS-T-02: Dosimetric Accuracy of the CrystalBallâ„¢: New Reusable Radiochromic Polymer Gel Dosimeter for Patient QA in Proton Therapy

Purpose: To evaluate the accuracy of monoexponential normalization in a new class of commercial, reusable, human-soft-tissue-equivalent, radiochromic polymer gel dosimeters for patient-specific QA in proton therapy. Methods: Eight formulations of the dosimeter (sealed in glass spheres of 166 mm OD), were exposed to a 150 MeV proton beam (5 cm x 5 cm square field, range 15 cm, modulation10 cm), with max dose ranging from 2.5 Gy to 20 Gy, depending on formulation. Exposed dosimeters were promptly placed in the commercial OCTOPUS™ laser CT scanner which was programmed to scan the central slice every 5 minutes for 20 hours (15 seconds per slice scan). This procedure was repeated several times. Reconstructed data were analyzed using the log-lin scale to determine the time range over which a monoexponential relaxation model could be applied. Next, a simple test plan was devised and delivered to each dosimeter. The OCTOPUS™ was programmed to rescan the central slice at the end of each volume scan, for signal relaxation reference. Monoexponential normalization was applied to sinograms before FBP reconstruction. Dose calibration was based on a volume-lookup table built within the central spherical volume of 12 cm diameter. 3D gamma and sigma passing rates were measured at 3%/3mm criteria down to 50% isodose. Results: Approximately monoexponential signal relaxation time ranges from 25 minutes to 3.5 hours, depending on formulation, followed by a slower-relaxation component. Noise in reconstructed OD/cm images is less than 0.5%. Dose calibration accuracy is better than 99%. Measured proton PDDs demonstrate absence of Bragg-peak quenching. Estimated number of useful cycles is at least 20, with a theoretical limit above 100. 3D gamma and sigma passing rates exceed 95%. Conclusion: Monoexponential normalization was found to yield adequate dosimetric accuracy in the new class of commercial radiochromic polymer gel dosimeters for patient QA in proton therapy.

3D prompt gamma imaging for proton beam range verification

We tested the ability of a single Compton camera (CC) to produce 3-dimensional (3D) images of prompt gammas (PGs) emitted during the irradiation of a tissue-equivalent plastic phantom with proton pencil beams for clinical doses delivered at clinical dose rates. PG measurements were made with a small prototype CC placed at three different locations along the proton beam path. We evaluated the ability of the CC to produce images at each location for two clinical scenarios: (1) the delivery of a single 2 Gy pencil beam from a hypo-fractionated treatment (~9  ×  108 protons), and (2) a single pencil beam from a standard treatment (~1  ×  108 protons). Additionally, the data measured at each location were combined to simulate measurements with a larger scale, clinical CC and its ability to image shifts in the Bragg peak (BP) range for both clinical scenarios. With our prototype CC, the location of the distal end of the BP could be seen with the CC placed up to 4 cm proximal or distal to the BP distal falloff. Using the data from the simulated full scale clinical CC, 3D images of the PG emission were produced with the delivery of as few as 1  ×  108 protons, and shifts in the proton beam range as small as 2 mm could be detected for delivery of a 2 Gy spot. From these results we conclude that 3D PG imaging for proton range verification under clinical beam delivery conditions is possible with a single CC.

MO-FG-CAMPUS-JeP1-02: Proton Range Verification of Scanned Pencil Beams Using Prompt Gamma Imaging

PURPOSE Prompt gammas are emitted along the proton beam path and have an emission profile correlated with the depth dose profile. In this study, the accuracy of in-vivo proton range verification using a 1-D prompt gamma camera is assessed. METHODS The 1-D camera is comprised of a tungsten slit collimator positioned in front of a linear array of LYSO scintillating crystals coupled to silicon photomultipliers. The imaged gamma profiles of individual pencil beam spots and energy layers were analyzed by determining the relative shifts from the expected gamma profiles based on analytic prediction or reference measurements. The range retrieval precision was evaluated by reproducibility measurements and by irradiation through a heterogeneous phantom composed of materials with known stopping power ratios. The camera was evaluated at clinical doses in pencil beam scanning mode on a head-and-neck phantom (HN). Two scenarios were studied: 5 mm systematic range error; and setup error of 10 mm transverse to the proton beam. RESULTS The camera range retrieval precision was 2 mm at clinical doses. For the heterogeneous phantom and HN phantom studies, the discrepancies between the analytic model and measurements were less than 2 mm for both spot and iso-energy layer analysis. For the simulated 5 mm range error, the retrieved shifts were 4.3±2.0 mm. For the 10 mm setup error, large shifts (> 4 mm) were observed for some spots due to differences in the irradiated and expected beam path from the measurements without setup error. CONCLUSION Our studies demonstrated that in-vivo proton range verification is feasible using a 1D prompt gamma camera with a 2 mm range retrieval precision. Pencil beam spot under or over ranging can be detected via comparison between measured and expected profiles.

Measurement of Acoustic Emissions Generated by a Pulsed Proton Beam from a Hospital-Based Clinical Cyclotron

113 Further Development of Spinal Tissue Radiotherapy Retreatment Modelling, with inclusion of Hadrontherapy. J. Belmonte-Beitia1, G. Fernandez Calvo1, E. A. Gaffney2, J. Hopewell3, B. Jones4, T. E. Woolley2. 1 Department of Mathematics, U. Castilla-La Mancha, Ciudad Real, Spain 2 Wolfson Centre for Mathematical Biology, U. Oxford, UK 3 Particle Therapy Cancer Research Institute and Green Templeton College, U. Oxford, UK 4 Gray Laboratory, CRUK/MRC Oxford Institute for Radiation Oncology, U. Oxford, UK

TU-FG-BRB-05: A 3 Dimensional Prompt Gamma Imaging System for Range Verification in Proton Radiotherapy

PURPOSE To report on the initial developments of a clinical 3-dimensional (3D) prompt gamma (PG) imaging system for proton radiotherapy range verification. METHODS The new imaging system under development consists of a prototype Compton camera to measure PG emission during proton beam irradiation and software to reconstruct, display, and analyze 3D images of the PG emission. For initial test of the system, PGs were measured with a prototype CC during a 200 cGy dose delivery with clinical proton pencil beams (ranging from 100 MeV - 200 MeV) to a water phantom. Measurements were also carried out with the CC placed 15 cm from the phantom for a full range 150 MeV pencil beam and with its range shifted by 2 mm. Reconstructed images of the PG emission were displayed by the clinical PG imaging software and compared to the dose distributions of the proton beams calculated by a commercial treatment planning system. RESULTS Measurements made with the new PG imaging system showed that a 3D image could be reconstructed from PGs measured during the delivery of 200 cGy of dose, and that shifts in the Bragg peak range of as little as 2 mm could be detected. CONCLUSION Initial tests of a new PG imaging system show its potential to provide 3D imaging and range verification for proton radiotherapy. Based on these results, we have begun work to improve the system with the goal that images can be produced from delivery of as little as 20 cGy so that the system could be used for in-vivo proton beam range verification on a daily basis.

SU-C-207A-04: Accuracy of Acoustic-Based Proton Range Verification in Water

PURPOSE To determine the accuracy and dose required for acoustic-based proton range verification (protoacoustics) in water. METHODS Proton pulses with 17 µs FWHM and instantaneous currents of 480 nA (5.6 × 107 protons/pulse, 8.9 cGy/pulse) were generated by a clinical, hospital-based cyclotron at the University of Pennsylvania. The protoacoustic signal generated in a water phantom by the 190 MeV proton pulses was measured with a hydrophone placed at multiple known positions surrounding the dose deposition. The background random noise was measured. The protoacoustic signal was simulated to compare to the experiments. RESULTS The maximum protoacoustic signal amplitude at 5 cm distance was 5.2 mPa per 1 × 107 protons (1.6 cGy at the Bragg peak). The background random noise of the measurement was 27 mPa. Comparison between simulation and experiment indicates that the hydrophone introduced a delay of 2.4 µs. For acoustic data collected with a signal-to-noise ratio (SNR) of 21, deconvolution of the protoacoustic signal with the proton pulse provided the most precise time-of-flight range measurement (standard deviation of 2.0 mm), but a systematic error (-4.5 mm) was observed. CONCLUSION Based on water phantom measurements at a clinical hospital-based cyclotron, protoacoustics is a potential technique for measuring the proton Bragg peak range with 2.0 mm standard deviation. Simultaneous use of multiple detectors is expected to reduce the standard deviation, but calibration is required to remove systematic error. Based on the measured background noise and protoacoustic amplitude, a SNR of 5.3 is projected for a deposited dose of 2 Gy.

WE-AB-204-02: Definition of D&I/AAPM Efforts (Stephen Avery/Will Ngwa)

Many efforts have been made to increase diversity in the science workforce. In order for us to be competitive in innovation and ingenuity we need to reach out to any source of intellectual talent. Having greater diversity can only increase the creativity in medical physics. In order for students to succeed academically they need role models and mentors with whom they can identify. Literature has shown that racial and ethnic diversity has both direct and indirect positive effects on the educational outcomes, career advancement and motivation of students. Diversity not only focuses on race, ethnicity and gender, but it can also include socioeconomic status, sexual orientation and more. Underrepresented populations have had low numbers over the years not only in medical physics but also in the sciences in general. With the rapidly changing face of our country we need to address how we attract and train the next generation of scientists to stay competitive. It is necessary to examine the role that diversity and inclusion play in the long term goals of institutions, workplaces and classrooms. To increase innovation we must engage people from all walks of life with different perspectives and life experiences to solve the problems that we will face. Diversity should be viewed as a strategy to achieve our goals instead of acts of good citizenship. Many of todays businesses and corporations have discovered that embracing diversity prepares future leaders in todays global market. This lecture will provide insight to how differences within our society can drive innovation. We will provide an overview of the role diversity and inclusion plays in the clinic, education and research to develop the future workforce in medical physics. LEARNING OBJECTIVES 1. Understanding the role diversity and inclusion plays in medical physics. 2. The importance of developing education and research strategies for a global workforce. 3. How to develop a roadmap to diversity excellence within AAPM.

MO‐F‐CAMPUS‐J‐01: Acoustic Range Verification of Proton Beams: Simulation of Heterogeneity and Clinical Proton Pulses

Purpose: Through simulation, to assess acoustic-based range verification of proton beams (protoacoustics) under clinical conditions. Methods: Pressure waves generated by the energy deposition of a 150 MeV, 8 mm FWHM pulsed pencil proton beam were numerically simulated through two Methods: 1) For a homogeneous water medium, an analytical wave-equation solution was used to calculate the time-dependent pressure measured at detector points surrounding the proton Bragg peak. 2) For heterogeneity studies, a CT tissue image was used to calculate the proton dose deposition and define the acoustic properties of the voxels through which numerical pressure wave propagation was simulated with the k-Wave matlab toolbox. The simulations were used to assess the dependence of the acoustic amplitude and range-verification accuracy on proton pulse rise time and tissue heterogeneity. Results: As the proton pulse rise time is increased from 1 to 40 µs, the amplitude of the expected acoustic emission decreases (a 60% drop distal to the Bragg peak), the central frequency of the expected signal decreases (from 45 to 6 kHz), and the accuracy of the range-verification decreases (from <1 mm to 16 mm at 5 cm distal to the Bragg peak). For a 300 nA pulse, the expected pressure range is on the order of 0.1 Pa, which is observable with commercial detectors. For the heterogeneous medium, our test case shows that pressure waves emitted by an anterior pencil beam directed into the abdomen and detected posteriorly can determine the Bragg peak range to an accuracy of <2mm for a 1 µs proton pulse. Conclusion: For proton pulses with fast rise-times, protoacoustics is a promising potential method for monitoring penetration depth through heterogeneous tissue. The loss of range-verification accuracy with increasing rise-times, however, suggests the need for comparisons to modeling to improve accuracy for slower cyclotron proton sources.

WE-EF-303-07: Imaging of Prompt Gamma Rays Emitted During Delivery of Clinical Proton Beams with a Compton Camera: Feasibility Studies for Range Verification

Purpose: Evaluation of a prototype Compton camera (CC) for imaging prompt gamma rays (PG) emitted during clinical proton beam irradiation for in vivo beam range verification. Methods: We irradiated a water phantom with 114 MeV and 150 MeV proton pencil beams at clinical beam currents ranging from 1 nA up to 5 nA. The CC was placed 15 cm from the beam central axis and PGs from 0.2 MeV up to 6.5 MeV were measured during irradiation. From the measured data, 2-dimensional (2D) PG images were reconstructed. One-dimensional (1D) profiles from the PG images were compared to measured depth dose curves. Results: The CC was able to measure PG emission during delivery of both a single 150 MeV pencil beam and a 5 cm × 5 cm mono-energetic layer of 114 MeV pencil beams. From the 2D images, a strong correlation was seen between the depth of the distal falloff of PG emission and the Bragg peak (BP). 1D profiles extracted from the PG images show that the distal 60% falloff of the PG emission lined up well with the distal 90% of the BP. Shifts as small as 3 mm in the beam range could be detected on both the 2D PG images and 1D profiles with an uncertainty of 1.5 mm. With the current CC prototype, a minimum dose delivery of 400 cGy was required to produce usable PG images. Conclusions: It was possible to measure and image PG emission with our prototype CC during proton beam delivery and to detect shifts in the BP range in the images. Therefore prompt gamma imaging with a CC for the purpose of in vivo range verification is feasible. However, for the studied system improvements in detector efficiency and reconstruction algorithms are necessary to make it clinically viable.

3D dose verification with polymer gel detectors of brain-spine match line for proton pencil beam cranio-spinal: A preliminary study

This paper is intended as a preliminary study to demonstrate the quality assurance benefits from polymer gel detectors for proton pencil beam cranio-spinal treatments. A stable gel type was selected for protons to suppress the LET dependence at the end of the Bragg peak. The depth dose distributions in the gels were examined with regard of its dose dependences and compared to baseline measurements. The preliminary experimental results indicate polymer gel detectors may be able to verify dose in three dimensions along match line for proton therapy treatments.