S. Giordanengo

Dosimetric characterization of a large area pixel-segmented ionization chamber

A pixel-segmented ionization chamber has been designed and built by Torino University and INFN. The detector features a 24 x 24 cm2 active area divided in 1024 independent cylindrical ionization chambers and can be read out in 500 micros without introducing dead time; the digital charge quantum can be adjusted between 100 fC and 800 fC. The sensitive volume of each single ionization chamber is 0.07 cm3. The purpose of the detector is to ease the two-dimensional (2D) verifications of fields with complex shapes and large gradients. The detector was characterized in a PMMA phantom using 60Co and 6 MV x-ray photon beams. It has shown good signal linearity with respect to dose and dose rate to water. The average sensitivity of a single ionization chamber was 2.1 nC/Gy, constant within 0.5% over one month of daily measurements. Charge collection efficiency was 0.985 at the operating polarization voltage of 400 V and 3.5 Gy/min dose rate. Tissue maximum ratio and output factor have been compared with a Farmer ionization chamber and were found in good agreement. The dose profiles have been compared with the ones obtained with an ionization chamber in water phantom for the field sizes supplied by a 3D-Line dynamic multileaf collimator. These results show that this detector can be used for 2D dosimetry of x-ray photon beams, supplying a good spatial resolution and sensibly reducing the time spent in dosimetric verification of complex radiation fields.

D-IMRT verification with a 2D pixel ionization chamber: dosimetric and clinical results in head and neck cancer.

Dynamic intensity-modulated radiotherapy (D-IMRT) using the sliding-window technique is currently applied for selected treatments of head and neck cancer at Institute for Cancer Research and Treatment of Candiolo (Turin, Italy). In the present work, a PiXel-segmented ionization Chamber (PXC) has been used for the verification of 19 fields used for four different head and neck cancers. The device consists of a 32x32 matrix of 1024 parallel-plate ionization chambers arranged in a square of 24x24 cm2 area. Each chamber has 0.4 cm diameter and 0.55 cm height; a distance of 0.75 cm separates the centre of adjacent chambers. The sensitive volume of each single ionization chamber is 0.07 cm3. Each of the 1024 independent ionization chambers is read out with a custom microelectronics chip.The output factors in water obtained with the PXC at a depth of 10 cm were compared to other detectors and the maximum difference was 1.9% for field sizes down to 3x3 cm2. Beam profiles for different field dimensions were measured with the PXC and two other types of ionization chambers; the maximum distance to agreement (DTA) in the 20-80% penumbra region of a 3x3 cm2 field was 0.09 cm. The leaf speed of the multileaf collimator was varied between 0.07 and 2 cm s-1 and the detector response was constant to better than 0.6%. The behaviour of the PXC was measured while varying the dose rate between 0.21 and 1.21 Gy min-1; the mean difference was 0.50% and the maximum difference was 0.96%. Using fields obtained with an enhanced dynamic wedge and a staircase-like (step) IMRT field, the PXC has been tested for simple 1D modulated beams; comparison with film gave a maximum DTA of 0.12 cm. The PXC was then used to check four different IMRT plans for head and neck cancer treatment: cervical chordoma, parotid, ethmoid and skull base. In the comparison of the PXC versus film and PXC versus treatment planning system, the number of pixels with gamma parameter<or=1 was 97.7% and 97.6%, respectively.

Dosimetric accuracy assessment of a treatment plan verification system for scanned proton beam radiotherapy: one-year experimental results and Monte Carlo analysis of the involved uncertainties.

During one year of clinical activity at the Italian National Center for Oncological Hadron Therapy 31 patients were treated with actively scanned proton beams. Results of patient-specific quality assurance procedures are presented here which assess the accuracy of a three-dimensional dose verification technique with the simultaneous use of multiple small-volume ionization chambers. To investigate critical cases of major deviations between treatment planning system (TPS) calculated and measured data points, a Monte Carlo (MC) simulation tool was implemented for plan verification in water. Starting from MC results, the impact of dose calculation, dose delivery and measurement set-up uncertainties on plan verification results was analyzed. All resulting patient-specific quality checks were within the acceptance threshold, which was set at 5% for both mean deviation between measured and calculated doses and standard deviation. The mean deviation between TPS dose calculation and measurement was less than ±3% in 86% of the cases. When all three sources of uncertainty were accounted for, simulated data sets showed a high level of agreement, with mean and maximum absolute deviation lower than 2.5% and 5%, respectively.

Two-dimensional and quasi-three-dimensional dosimetry of hadron and photon beams with the Magic Cube and the Pixel Ionization Chamber.

Two detectors for fast two-dimensional (2D) and quasi-three-dimensional (quasi-3D) verification of the dose delivered by radiotherapy beams have been developed at University and Istituto Nazionale di Fisica Nucleare (INFN) of Torino. The Magic Cube is a stack of strip-segmented ionization chambers interleaved with water-equivalent slabs. The parallel plate ionization chambers have a sensitive area of 24 x 24 cm2, and consist of 0.375 cm wide and 24 cm long strips. There are a total of 64 strips per chamber. The Magic Cube has been tested with the clinical proton beam at Loma Linda University Medical Centre (LLUMC), and was shown to be capable of fast and precise quasi-3D dose verification. The Pixel Ionization Chamber (PXC) is a detector with pixel anode segmentation. It is a 32 x 32 matrix of 1024 cylindrical ionization cells arranged in a square 24 x 24 cm2 area. Each cell has 0.4 cm diameter and 0.55 cm height, at a pitch of 0.75 cm separates the centre of adjacent cells. The sensitive volume of each single ionization cell is 0.07 cm3. The detectors are read out using custom designed front-end microelectronics and a personal computer-based data acquisition system. The PXC has been used to verify dynamic intensity-modulated radiotherapy for head-and-neck and breast cancers.

Dosimetric commissioning and quality assurance of scanned ion beams at the Italian National Center for Oncological Hadrontherapy.

PURPOSEnTo describe the dosimetric commissioning and quality assurance (QA) of the actively scanned proton and carbon ion beams at the Italian National Center for Oncological Hadrontherapy.nnnMETHODSnThe laterally integrated depth-dose-distributions (IDDs) were acquired with the PTW Peakfinder, a variable depth water column, equipped with two Bragg peak ionization chambers. fluka Monte Carlo code was used to generate the energy libraries, the IDDs in water, and the fragment spectra for carbon beams. EBT3 films were used for spot size measurements, beam position over the scan field, and homogeneity in 2D-fields. Beam monitor calibration was performed in terms of number of particles per monitor unit using both a Farmer-type and an Advanced Markus ionization chamber. The beam position at the isocenter, beam monitor calibration curve, dose constancy in the center of the spread-out-Bragg-peak, dose homogeneity in 2D-fields, beam energy, spot size, and spot position over the scan field are all checked on a daily basis for both protons and carbon ions and on all beam lines.nnnRESULTSnThe simulated IDDs showed an excellent agreement with the measured experimental curves. The measured full width at half maximum (FWHM) of the pencil beam in air at the isocenter was energy-dependent for both particle species: in particular, for protons, the spot size ranged from 0.7 to 2.2 cm. For carbon ions, two sets of spot size are available: FWHM ranged from 0.4 to 0.8 cm (for the smaller spot size) and from 0.8 to 1.1 cm (for the larger one). The spot position was accurate to within ± 1 mm over the whole 20 × 20 cm(2) scan field; homogeneity in a uniform squared field was within ± 5% for both particle types at any energy. QA results exceeding tolerance levels were rarely found. In the reporting period, the machine downtime was around 6%, of which 4.5% was due to planned maintenance shutdowns.nnnCONCLUSIONSnAfter successful dosimetric beam commissioning, quality assurance measurements performed during a 24-month period show very stable beam characteristics, which are therefore suitable for performing safe and accurate patient treatments.

Innovative thin silicon detectors for monitoring of therapeutic proton beams: Preliminary beam tests

To fully exploit the physics potentials of particle therapy in delivering dose with high accuracy and selectivity, charged particle therapy needs further improvement. To this scope, a multidisciplinary project (MoVeIT) of the Italian National Institute for Nuclear Physics (INFN) aims at translating research in charged particle therapy into clinical outcome. New models in the treatment planning system are being developed and validated, using dedicated devices for beam characterization and monitoring in radiobiological and clinical irradiations. Innovative silicon detectors with internal gain layer (LGAD) represent a promising option, overcoming the limits of currently used ionization chambers. Two devices are being developed: one to directly count individual protons at high rates, exploiting the large signal-to-noise ratio and fast collection time in small thicknesses (1 ns in 50 μm) of LGADs, the second to measure the beam energy with time-of-flight techniques, using LGADs optimized for excellent time resolutions (Ultra Fast Silicon Detectors, UFSDs). The preliminary results of first beam tests with therapeutic beam will be presented and discussed.

Review of technologies and procedures of clinical dosimetry for scanned ion beam radiotherapy

In the last few years, the use of ions in radiation therapy is gaining interest and it is being considered medically necessary for a growing subset of tumours. Concurrently, the technologies involved in a particle therapy treatment are rapidly evolving, as well as the accuracy in the dose delivery in spite of the increased complexity. Since nowadays, the pencil beam scanning technique is showing very interesting features in terms of dose conformation and overall treatment outcome, the present review is intended to summarize the main procedures, detectors and tools adopted for the clinical dose verification. A list of dose measurements is provided, with the aim of being a valuable guidance for starting and future particle therapy facilities. Absorbed dose to water, relative dose, fluence and surrogates of the delivered dose are the main quantities measured by means of different detectors, specifically developed for point-like, 1D or 2D measurements. The dosimetric procedures are here categorized according to their purpose, distinguishing between system commissioning and clinical quality assurance. A separate discussion is dedicated to patient specific, in vivo and 4D dose verification, which aim at assessing the actual delivered dose. Together with the description of the currently used methods, challenges and perspectives toward an increasingly accurate and fast dose verification strategy are discussed.

The magic cube and the pixel ionization chamber: detectors for monitor and dosimetry of radiotherapy beams

Abstract Tumor therapy takes advantage of the energy deposition of radiation to concentrate high doses in the target while sparing healthy tissue. Elective pathologies for highly conformal radiotherapies such as photon Intensity Modulated Radiotherapy (IMRT) and radiotherapy with hadrons are head and neck, eye, prostate and in general all tumors that are either deep or located close to critical organs. In the world there are several centers that are using such techniques and a common problem that is being experienced is the verification of treatment plans and monitoring of the beam. We have designed and built two detectors that allow 2D and 3D measurements of dose and fluence of such beams. The detectors allow measurements on big surfaces, up to 25 ∗ 25 cm 2 . The active media are parallel plate, strip and pixel segmented ionization chambers with front-end Very Large Scale Integration (VLSI) readout and PC based data acquistion. The description of dosimeter, chamber and electronics will be given with results from beam tests and therapy plan verification.

‘Survival’: a simulation toolkit introducing a modular approach for radiobiological evaluations in ion beam therapy

One major rationale for the application of heavy ion beams in tumour therapy is their increased relative biological effectiveness (RBE). The complex dependencies of the RBE on dose, biological endpoint, position in the field etc require the use of biophysical models in treatment planning and clinical analysis. This study aims to introduce a new software, named Survival, to facilitate the radiobiological computations needed in ion therapy. The simulation toolkit was written in C++ and it was developed with a modular architecture in order to easily incorporate different radiobiological models. The following models were successfully implemented: the local effect model (LEM, version I, II and III) and variants of the microdosimetric-kinetic model (MKM). Different numerical evaluation approaches were also implemented: Monte Carlo (MC) numerical methods and a set of faster analytical approximations. Among the possible applications, the toolkit was used to reproduce the RBE versus LET for different ions (proton, He, C, O, Ne) and different cell lines (CHO, HSG). Intercomparison between different models (LEM and MKM) and computational approaches (MC and fast approximations) were performed. The developed software could represent an important tool for the evaluation of the biological effectiveness of charged particles in ion beam therapy, in particular when coupled with treatment simulations. Its modular architecture facilitates benchmarking and inter-comparison between different models and evaluation approaches. The code is open source (GPL2 license) and available at https://github.com/batuff/Survival.

SU-FF-T-408: Regular Lesions Stereotactic Treatment: Physical and Dosimetrical Comparison Between Circular and Mini/micro Multileaf Collimators

Purpose: The comparison of stereotactic treatments for small spherical and ellipsoidal intracranial lesions using three different collimators with single isocenter: the standard circular collimators and two dynamic multileaf collimators (DMLC) with 3 mm and 5 mm leaf thickness, micro and mini DMLC respectively. Method and Materials: Spherical and ellipsoidal lesions of different sizes were designed to evaluate treatments with collimators under consideration. For spherical lesions with diameter from 15 mm up to 35 mm a treatment with 9 arcs of 140 degrees was performed. For ellipsoidal lesions treated with circular collimators, different combinations of treatment variables were studied to achieve 80% isodose surface conformation: number of arcs, gantry start/stop angles, couch angles and arc spacing. This treatment was matched up to 9 arcs with the two DMLCs. For the comparison geometrical (penumbra, difference between the target volume and 80% isodose volume and conformal indexes) and radiobiological (EUD, TCP and NTCP) parameters were used. Results: Circular collimators and micro DMLC behave similarly with spherical targets in terms of conformal indexes and TCP/NTCP, but EUD and 20% isodose volume are greater for micro DMLC. In the case of ellipsoidal target TCP/NTCP are comparable, EUD is greater for micro DMLC but conformal indexes are higher for circular collimators. The 20% isodose volume is less with micro DMLC; the difference, however, is entirely due to the wider penumbra along the deformation axis with circular collimators. The same considerations are valid for targets with diameters ⩾ 35 mm, where mini DMLC becomes competitive versus circular collimator.Conclusion: The analysis shows that micro and mini DMLC are more functional for non spherical lesions. Circular collimators however are widely used and yield sharper dose fall off along directions perpendicular to the deformation axis and thus are preferable in the case of neighbourhood of organs at risk.