Tatsuaki Kanai

Biophysical characteristics of HIMAC clinical irradiation system for heavy-ion radiation therapy

PURPOSE The irradiation system and biophysical characteristics of carbon beams are examined regarding radiation therapy. METHODS AND MATERIALS An irradiation system was developed for heavy-ion radiotherapy. Wobbler magnets and a scatterer were used for flattening the radiation field. A patient-positioning system using X ray and image intensifiers was also installed in the irradiation system. The depth-dose distributions of the carbon beams were modified to make a spread-out Bragg peak, which was designed based on the biophysical characteristics of monoenergetic beams. A dosimetry system for heavy-ion radiotherapy was established to deliver heavy-ion doses safely to the patients according to the treatment planning. A carbon beam of 80 keV/microm in the spread-out Bragg peak was found to be equivalent in biological responses to the neutron beam that is produced at cyclotron facility in National Institute Radiological Sciences (NIRS) by bombarding 30-MeV deuteron beam on beryllium target. The fractionation schedule of the NIRS neutron therapy was adapted for the first clinical trials using carbon beams. RESULTS Carbon beams, 290, 350, and 400 MeV/u, were used for a clinical trial from June of 1994. Over 300 patients have already been treated by this irradiation system by the end of 1997.

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.

Inactivation of Aerobic and Hypoxic Cells from Three Different Cell Lines by Accelerated 3He-, 12C- and 20Ne-Ion Beams

Abstract Furusawa, Y., Fukutsu, K., Aoki, M., Itsukaichi, H., Eguchi-Kasai, K., Ohara, H., Yatagai, F., Kanai, T. and Ando, K. Inactivation of Aerobic and Hypoxic Cells from Three Different Cell Lines by Accelerated 3He-, 12C- and 20Ne-Ion Beams. The LET-RBE spectra for cell killing for cultured mammalian cells exposed to accelerated heavy ions were investigated to design a spread-out Bragg peak beam for cancer therapy at HIMAC, National Institute of Radiological Sciences, Chiba, prior to clinical trials. Cells that originated from a human salivary gland tumor (HSG cells) as well as V79 and T1 cells were exposed to 3He-, 12C- and 20Ne-ion beams with an LET ranging from approximately 20–600 keV/μm under both aerobic and hypoxic conditions. Cell survival curves were fitted by equations from the linear-quadratic model and the target model to obtain survival parameters. RBE, OER, α and D0 were analyzed as a function of LET. The RBE increased with LET, reaching a maximum at around 200 keV/μm, then decreased with a further increase in LET. Clear splits of the LET-RBE or -OER spectra were found among ion species and/or cell lines. At a given LET, the RBE value for 3He ions was higher than that for the other ions. The position of the maximum RBE shifts to higher LET values for heavier ions. The OER value was 3 for X rays but started to decrease at an LET of around 50 keV/μm, passed below 2 at around 100 keV/μm, and then reached a minimum above 300 keV/μm, but the values remained greater than 1. The OER was significantly lower for 3He ions than the others.

Irradiation of mixed beam and design of spread-out Bragg peak for heavy-ion radiotherapy.

Data on cellular inactivation resulting from mixed irradiation with charged-particle beams of different linear energy transfer (LET) are needed to design a spread-out Bragg peak (SOBP) for heavy-ion radiotherapy. The present study was designed to study the relationship between the physical (LET) and biological (cell killing) properties by using different monoenergetic beams of 3He, 4He and 12C ions (12 and 18.5 MeV/nucleon) and to attempt to apply the experimental data in the design of the SOBP (3 cm width) with a 135 MeV/nucleon carbon beam. Experimental studies of the physical and biological measurements using sequentially combined irradiation were carried out to establish a close relationship between LET and cell inactivation. The results indicated that the dose-cell survival relationship for the combined high- and low-LET beams could be described by a linear-quadratic (LQ) model, in which new coefficients alpha and beta for the combined irradiation were obtained in terms of dose-averaged alpha and square root of beta for the single irradiation with monoenergetic beams. Based on the relationship obtained, the actual SOBP designed for giving a uniform biological effect at 3 cm depth was tested with the 135 MeV/nucleon carbon beam. The results of measurements of both physical (LET) and biological (90% level of cell killing, etc.) properties clearly demonstrated that the SOBP successfully and satisfactorily retained its high dose localization and uniform depth distribution of the biological effect. Based on the application of these results, more useful refinement and development can be expected for the heavy-ion radiotherapy currently under way at the National Institute of Radiological Sciences, Japan.

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.

RELATIVE BIOLOGICAL EFFECTIVENESS FOR CELL-KILLING EFFECT ON VARIOUS HUMAN CELL LINES IRRADIATED WITH HEAVY-ION MEDICAL ACCELERATOR IN CHIBA (HIMAC) CARBON-ION BEAMS

PURPOSE To clarify the relative biological effectiveness (RBE) values of various human cell lines for carbon-ion beams with 2 different linear energy transfer (LET) beams and to investigate the relationship between the cell-killing effect and the biophysical characters, such as the chromosome number and the area of the cell nucleus, using qualitatively different kinds of radiations. METHODS AND MATERIALS Sixteen different human cell lines were irradiated with carbon-ion beams, having 2 different LET values (LET(infinity) = 13.3 and approximately 77 keV/microm), accelerated by the Heavy Ion Medical Accelerator in Chiba (HIMAC) at National Institute of Radiological Sciences in Japan. Cell-killing effect was detected as reproductive cell death using a colony-formation assay. The number of chromosomes was observed in a metaphase spread using the conventional method. The area of the cell nucleus was calculated as an ellipse on photographs using a micrometer. RESULTS The RBE values calculated by the D(10), which is determined as the dose (Gy) required to reduce the surviving fraction to 10%, relative to X-rays, range from 1.06 to 1.33 for 13-keV/microm-beam and from 2.00 to 3. 01 for approximate 77-keV/microm-beam irradiation on each cell line. There was a good correlation in the D(10) values of each cell line between X-rays and carbon-ion beams. However, the D(10) values did not clearly depend on either the chromosome number or the area of the cell nuclei. CONCLUSION The RBE values for HIMAC carbon-ion beams are consistent with previous reports using carbon-ion beams with the similar LET values, and the cellular radiosensitivity of different cell lines well correlate among different types of radiation.

Spot scanning system for proton radiotherapy

In order to provide a uniform and desirable dose distribution over a large radiation field, spot beam scanning is one of the most useful methods. A new spot beam scanning system was constructed for a 70 MeV proton beam. The lateral dose distribution was uniform with +/- 2.5% for an 18 cm square field. It was possible to control the dose at each point in the radiation field by this spot scanning method. This system has been confirmed to be satisfactory for delivering a proton beam in the desired field shape and dose level.

Microdosimetric Measurements and Estimation of Human Cell Survival for Heavy-Ion Beams

Abstract Kase, Y., Kanai, T., Matsumoto, Y., Furusawa, Y., Okamoto, H., Asaba, T., Sakama, M. and Shinoda, H. Microdosimetric Measurements and Estimation of Human Cell Survival for Heavy-Ion Beams. Radiat. Res. 166, 629–638 (2006). The microdosimetric spectra for high-energy beams of photons and proton, helium, carbon, neon, silicon and iron ions (LET = 0.5–880 keV/μm) were measured with a spherical-walled tissue-equivalent proportional counter at various depths in a plastic phantom. Survival curves for human tumor cells were also obtained under the same conditions. Then the survival curves were compared with those estimated by a microdosimetric model based on the spectra and the biological parameters for each cell line. The estimated α terms of the liner-quadratic model with a fixed β value reproduced the experimental results for cell irradiation for ion beams with LETs of less than 450 keV/μm, except in the region near the distal peak.

Design study of a raster scanning system for moving target irradiation in heavy-ion radiotherapy

A project to construct a new treatment facility as an extension of the existing heavy-ion medical accelerator in chiba (HIMAC) facility has been initiated for further development of carbon-ion therapy. The greatest challenge of this project is to realize treatment of a moving target by scanning irradiation. For this purpose, we decided to combine the rescanning technique and the gated irradiation method. To determine how to avoid hot and/or cold spots by the relatively large number of rescannings within an acceptable irradiation time, we have studied the scanning strategy, scanning magnets and their control, and beam intensity dynamic control. We have designed a raster scanning system and carried out a simulation of irradiating moving targets. The result shows the possibility of practical realization of moving target irradiation with pencil beam scanning. We describe the present status of our design study of the raster scanning system for the HIMAC new treatment facility.

Preclinical biological assessment of proton and carbon ion beams at Hyogo Ion Beam Medical Center

PURPOSE To assess the biologic effects of proton and carbon ion beams before clinical use. METHODS AND MATERIALS Cultured cells from human salivary gland cancer (HSG cells) were irradiated at 5 points along a 190 MeV per nucleon proton and a 320 MeV per nucleon carbon ion beam, with Bragg peaks modulated to 6 cm widths. A linac 4 MV X-ray was used as a reference. Relative biologic effectiveness (RBE) values at each point were calculated from survival curves. Cells were also irradiated in a cell-stack phantom to identify that localized cell deaths were observed at predefined depth. Total body irradiation of C3H/He mice was performed, and the number of regenerating crypts per jejunal section was compared to calculate intestinal RBE values. For carbon ion and referential 4 MV X-ray beams, mouse right legs were irradiated by four-fractional treatment and followed up for skin reaction scoring. RESULTS RBE values calculated from cell survival curves at the dose that would reduce cell survival to 10% (D10) ranged from 1.01 to 1.05 for protons and from 1.23 to 2.56 for carbon ions. The cell-stack phantom irradiation revealed localized cell deaths at predefined depth. The intestinal RBE values ranged from 1.01 to 1.08 for protons and from 1.15 to 1.88 for carbon ions. The skin RBE value was 2.16 at C320/6 cm spread-out Bragg peak (SOBP) center. CONCLUSION The radiobiologic measurements of proton and carbon ion beams at Hyogo Ion Beam Medical Center are consistent with previous reports using proton beams in clinical settings and carbon ion beams with similar linear energy transfer (LET) values.