W Luo

Monte Carlo based IMRT dose verification using MLC log files and R/V outputs

Conventional IMRT dose verification using film and ion chamber measurements is useful but limited with respect to the actual dose distribution received by the patient. The Monte Carlo simulation has been introduced as an independent dose verification tool for IMRT using the patient CT data and MLC leaf sequence files, which validates the dose calculation accuracy but not the plan delivery accuracy. In this work, we propose a Monte Carlo based IMRT dose verification method that reconstructs the patient dose distribution using the patient CT, actual beam data based on the information from the record and verify system (R/V), and the MLC log files obtained during dose delivery that record the MLC leaf positions and MUs delivered. Comparing the Monte Carlo dose calculation with the original IMRT plan using these data simultaneously validates the accuracy of both the IMRT dose calculation and beam delivery. Such log file based Monte Carlo simulations are expected to be employed as a useful and efficient IMRT QA modality to validate the dose delivered to the patient. We have run Monte Carlo simulations for eight IMRT prostate plans using this method and the results for the target dose were consistent with the original CORVUS treatment plans to within 3.0% and 2.0% with and without heterogeneity corrections in the dose calculation. However, significant dose deviations in nearby critical structures have been observed. The results showed that up to 9.0% of the bladder dose and up to 38.0% of the rectum dose, to which leaf position errors were found to contribute <2%, were underestimated by the CORVUS treatment planning system. The concept of average leaf position error has been defined to analyze MLC leaf position errors for an IMRT plan. A linear correlation between the target dose error and the average position error has been found based on log file based Monte Carlo simulations, showing that an average position error of 0.2 mm can result in a target dose error of about 1.0%.

Replanning During Intensity Modulated Radiation Therapy Improved Quality of Life in Patients With Nasopharyngeal Carcinoma

PURPOSE Anatomic and dosimetric changes have been reported during intensity modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). The purpose of this study was to evaluate the effects of replanning on quality of life (QoL) and clinical outcomes during the course of IMRT for NPC patients. METHODS AND MATERIALS Between June 2007 and August 2011, 129 patients with NPC were enrolled. Forty-three patients received IMRT without replanning, while 86 patients received IMRT replanning after computed tomography (CT) images were retaken part way through therapy. Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Head and Neck Quality of Life Questionnaire 35 were completed before treatment began and at the end of treatment and at 1, 3, 6, and 12 months after the completion of treatment. Overall survival (OS) data were compared using the Kaplan-Meier method. RESULTS IMRT replanning had a profound impact on the QoL of NPC patients, as determined by statistically significant changes in global QoL and other QoL scales. Additionally, the clinical outcome comparison indicates that replanning during IMRT for NPC significantly improved 2-year local regional control (97.2% vs 92.4%, respectively, P=.040) but did not improve 2-year OS (89.8% vs 82.2%, respectively, P=.475). CONCLUSIONS IMRT replanning improves QoL as well as local regional control in patients with NPC. Future research is needed to determine the criteria for replanning for NPC patients undergoing IMRT.

Development of a laser-driven proton accelerator for cancer therapy

Recent advances in laser technology have made proton (light ion) acceleration possible using laser-induced plasmas. In this work, we report our work for the last few years on the investigation of a new proton therapy system for radiation oncology, which employs laser-accelerated protons. If successfully developed, the new system will be compact, cost-effective, and capable of delivering energy-and intensity-modulated proton therapy (EIMPT). We have focused our research on three major aspects: (1) target design for laser-proton acceleration, (2) system design for particle/energy selection and beam collimation, and (3) dosimetric studies on the use of laser-accelerated protons for cancer therapy. We have performed particle-in-cell (PIC) simulations to investigate optimal target configurations for proton/ion acceleration. We also performed Monte Carlo simulations to study the beam characteristics and the feasibility of using such beams for cancer treatment. Since laser-accelerated protons have broad energy and angular distributions, which are not suitable for radiotherapy applications directly, we have designed a compact particle selection and beam collimating system for EIMPT beam delivery. We also proposed a new gantry design to make the whole system compact to retrofit existing linac vaults. We have compared Monte Carlo calculated dose distributions using X-ray IMRT and laser-proton EIMPT. Our results show that EIMPT using laser protons produces superior target coverage and much reduced critical structure dose and integral dose compared to X-ray IMRT.

Particle selection and beam collimation system for laser‐accelerated proton beam therapy

In a laser-accelerated proton therapy system, the initial protons have broad energy and angular distributions, which are not suitable for direct therapeutic applications. A compact particle selection and collimation device is needed to deliver small pencil beams of protons with desired energy spectra. In this work, we characterize a superconducting magnet system that produces a desired magnetic field configuration to spread the protons with different energies and emitting angles for particle selection. Four magnets are set side by side along the beam axis; each is made of NbTi wires which carry a current density of approximately 10(5) A/cm2 at 4.2 K, and produces a magnetic field of approximately 4.4 T in the corresponding region. Collimation is applied to both the entrance and the exit of the particle selection system to generate a desired proton pencil beam. In the middle of the magnet system, where the magnetic field is close to zero, a particle selection collimator allows only the protons with desired energies to pass through for therapy. Simulations of proton transport in the presence of the magnetic field show that the selected protons have successfully refocused on the beam axis after passing through the magnetic field with the optimal magnet system. The energy spread for any given characteristic proton energy has been obtained. It is shown that the energy spread is a function of the magnetic field strength and collimator size and reaches the full width at half maximum of 25 MeV for 230 MeV protons. Dose distributions have also been calculated with the GEANT3 Monte Carlo code to study the dosimetric properties of the laser-accelerated proton beams for radiation therapy applications.

Improved experimental limits on the production of magnetic monopoles

We present new limits on low mass accelerator-produced pointlike Dirac magnetic monopoles trapped and bound in matter surrounding the D0 collision region of the Tevatron at Fermilab (experiment E-882). In the context of a Drell-Yan mechanism, we obtain cross section limits for the production of monopoles with magnetic charge values of 1, 2, 3, and 6 times the minimum Dirac charge of the order of picobarns, some 100 times smaller than found in similar previous Fermilab searches. Mass limits inferred from these cross section limits are presented.

Energy optimization procedure for treatment planning with laser-accelerated protons

A simple analytical model is found that predicts the exact proton spectrum needed to obtain a spread-out-Bragg peak (SOBP) distribution for laser-accelerated proton beams. The theory is based on the solution to the Boltzmann kinetic equation for the proton distribution function. The resulting analytical expression allows one to calculate the SOBP proton energy spectra for the different beamlet sizes and modulation depths that can be readily implemented in the calculation of energy and intensity modulated proton dose distributions. Since the practical implementation of energy modulation for proton beams is realized through the discrete superposition of individual Bragg peaks, it is shown that there exists an optimal relationship between the energy sampling size and the width of the initial proton energy distribution.

Investigation of optimal beam margins for stereotactic radiotherapy of lung-cancer using Monte Carlo dose calculations.

This work investigated the selection of beam margins in lung-cancer stereotactic body radiotherapy (SBRT) with 6 MV photon beams. Monte Carlo dose calculations were used to systematically and quantitatively study the dosimetric effects of beam margins for different lung densities (0.1, 0.15, 0.25, 0.35 and 0.5 g cm(-3)), planning target volumes (PTVs) (14.4, 22.1 and 55.3 cm3) and numbers of beam angles (three, six and seven) in lung-cancer SBRT in order to search for optimal beam margins for various clinical situations. First, a large number of treatment plans were generated in a commercial treatment planning system, and then recalculated using Monte Carlo simulations. All the plans were normalized to ensure that 95% of the PTV at least receives the prescription dose and compared quantitatively. Based on these plans, the relationships between the beam margin and quantities such as the lung toxicity (quantified by V20, the percentage volume of the two lungs receiving at least 20 Gy) and the maximum target (PTV) dose were established for different PTVs and lung densities. The impact of the number of beam angles on the relationship between V20 and the beam margin was assessed. Quantitative information about optimal beam margins for lung-cancer SBRT was obtained for clinical applications.

Limits on production of magnetic monopoles utilizing samples from the D0 and CDF detectors at the Fermilab Tevatron

We present 90% confidence level limits on magnetic monopole production at the Fermilab Tevatron from three sets of samples obtained from the D0 and CDF detectors each exposed to a proton-antiproton luminosity of

Shielding design for a laser-accelerated proton therapy system.

\sim175 {pb}^{-1}

Analysis of image quality for real-time target tracking using simultaneous kV-MV imaging.

(experiment E-882). Limits are obtained for the production cross-sections and masses for low-mass accelerator-produced pointlike Dirac monopoles trapped and bound in material surrounding the D0 and CDF collision regions. In the absence of a complete quantum field theory of magnetic charge, we estimate these limits on the basis of a Drell-Yan model. These results (for magnetic charge values of 1, 2, 3, and 6 times the minimum Dirac charge) extend and improve previously published bounds.