Yasuyuki Futami

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.

Relationship between CT number and electron density, scatter angle and nuclear reaction for hadron-therapy treatment planning

The precise conversion of CT numbers to their electron densities is essential in treatment planning for hadron therapy. Although some conversion methods have already been proposed, it is hard to check the conversion accuracy during practical therapy. We have estimated the CT numbers of real tissues by a calculational method established by Mustafa and Jackson. The relationship between the CT numbers and the electron densities was investigated for various body tissues as well as some tissue-equivalent materials used for a conversion to check the accuracy of the current conversion methods. The result indicates a slight disagreement at the high-CT-number region. A precise estimation of the multiple scattering, nuclear reaction and range straggling of incident particles has been considered as being important to realize higher-level conformal therapy in the future. The relationship between these parameters and the CT numbers was also investigated for tissues and water. The result shows that it is sufficiently practical to replace these parameters for real tissues with those for water by adjusting the density.

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.

Treatment planning for the layer-stacking irradiation system for three-dimensional conformal heavy-ion radiotherapy

We have upgraded a heavy-ion radiotherapy treatment-planning system to adapt for the layer-stacking irradiation method, which is to conform a variable spread-out Bragg peak to a target volume by means of dynamic control of the conventional beam-modifying devices. The biophysical model, the beam-setup logic, and the dose-calculation algorithm implemented for the layer-stacking method are described and the expected clinical usability is discussed. The layer-stacking method was integrated in perfect accordance with the ongoing conventional treatments so that the established protocols, which are the clinically optimized dose fractionation schemes, will still be valid. On the other hand, a simulation study indicated a substantial improvement of dose distribution with the layer-stacking method though the significance may depend on the size, shape, and location of the tumor. The completed treatment system will provide an option for improved conformal radiotherapy without interfering with the conventional method and we expect a gradual expansion of the clinical cases applicable to the layer-stacking method.

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.

Ridge filter design and optimization for the broad‐beam three‐dimensional irradiation system for heavy‐ion radiotherapy

The broad-beam three-dimensional irradiation system under development at National Institute of Radiological Sciences (NIRS) requires a small ridge filter to spread the initially monoenergetic heavy-ion beam to a small spread-out Bragg peak (SOBP). A large SOBP covering the target volume is then achieved by a superposition of differently weighted and displaced small SOBPs. Two approaches were studied for the definition of a suitable ridge filter and experimental verifications were performed. Both approaches show a good agreement between the calculated and measured dose and lead to a good homogeneity of the biological dose in the target. However, the ridge filter design that produces a Gaussian-shaped spectrum of the particle ranges was found to be more robust to small errors and uncertainties in the beam application. Furthermore, an optimization procedure for two fields was applied to compensate for the missing dose from the fragmentation tail for the case of a simple-geometry target. The optimized biological dose distributions show that a very good homogeneity is achievable in the target.

Broad-beam three-dimensional irradiation system for heavy-ion radiotherapy at HIMAC

Abstract A three-dimensional irradiation system using a broad beam has been installed for heavy-ion cancer therapy at the Heavy Ion Medical Accelerator in Chiba (HIMAC) facility. Only the target region is irradiated at the 100% dose level; the dose level at other parts of irradiated tissues is less, using a range shifter, a multileaf collimator and a compensator. The devices are the same as those used in two-dimensional irradiation, except that the setting values of the devices can be dynamically changed during the treatment. The thickness of the absorber and the aperture of the multileaf collimator are dynamically controlled during irradiation, so that the Bragg peak is swept in the depth direction and the Bragg peak outside of the target volume is blocked by the multileaf collimator. The performance of this system was checked by irradiation of a phantom using a 290 MeV/nucleon carbon beam. The dose distribution realized by this three-dimensional irradiation agreed satisfactorily with the planned one.

Proton dosimetry intercomparison based on the ICRU report 59 protocol

BACKGROUND AND PURPOSE A new protocol for calibration of proton beams was established by the ICRU in report 59 on proton dosimetry. In this paper we report the results of an international proton dosimetry intercomparison, which was held at Loma Linda University Medical Center. The goals of the intercomparison were, first, to estimate the level of consistency in absorbed dose delivered to patients if proton beams at various clinics were calibrated with the new ICRU protocol, and second, to evaluate the differences in absorbed dose determination due to differences in 60Co-based ionization chamber calibration factors. MATERIALS AND METHODS Eleven institutions participated in the intercomparison. Measurements were performed in a polystyrene phantom at a depth of 10.27 cm water equivalent thickness in a 6-cm modulated proton beam with an accelerator energy of 155 MeV and an incident energy of approximately 135 MeV. Most participants used ionization chambers calibrated in terms of exposure or air kerma. Four ionization chambers had 60Co-based calibration in terms of absorbed dose-to-water. Two chambers were calibrated in a 60Co beam at the NIST both in terms of air kerma and absorbed dose-to-water to provide a comparison of ionization chambers with different calibrations. RESULTS The intercomparison showed that use of the ICRU report 59 protocol would result in absorbed doses being delivered to patients at their participating institutions to within +/-0.9% (one standard deviation). The maximum difference between doses determined by the participants was found to be 2.9%. Differences between proton doses derived from the measurements with ionization chambers with N(K)-, or N(W) - calibration type depended on chamber type. CONCLUSIONS Using ionization chambers with 60Co calibration factors traceable to standard laboratories and the ICRU report 59 protocol, a distribution of stated proton absorbed dose is achieved with a difference less than 3%. The ICRU protocol should be adopted for clinical proton beam calibration. A comparison of proton doses derived from measurements with different chambers indicates that the difference in results cannot be explained only by differences in 60Co calibration factors.

Initial recombination in a parallel-plate ionization chamber exposed to heavy ions

For exact determination of absorbed dose in heavy-ion irradiation fields which are used in radiation therapy and biological experiments, ionization chambers have been characterized with defined heavy-ion beams and correction factors. The LET (linear energy transfer) dependence of columnar recombination in a parallel-plate ionization chamber has been examined. Using 135 MeV/u carbon and neon beams, the ion collection efficiency was measured for several gases (air, carbon dioxide, argon and tissue-equivalent gas). 95 MeV/u argon beams and 90 MeV/u iron beams were also used for measurements of columnar recombination in air. As expected by Jaffe theory, the inverse of the ratio of the ionization charge to the saturated ionization charge had a linear relationship with the inverse of the electric field strength in the region below 0.002 V(-1) cm. The gradient of the line increases as the LET of the heavy ions increases. A strong LET dependence of the gradient was observed in air and carbon dioxide. The LET dependence was not observed in tissue-equivalent gas, nitrogen or argon. The exact depth-dose distribution of the heavy-ion beam was obtained by this correction of the initial recombination effect for the collected ionization charge. The columnar recombination in air was analysed using Jaffe theory; the obtained parameter b (a track radius) should be in the range between 0.001 cm and 0.005 cm, whereas the value obtained by Jaffe is 0.00179 cm. The value of the parameter b should increase as the LET of the heavy-ion beam increases in order to reproduce the experimental values of the initial recombination.

Carbon beam dosimetry intercomparison at HIMAC

To verify international uniformity in carbon beam dosimetry, an intercomparison programme was carried out at the heavy ion medical accelerator (HIMAC). Dose measurements with ionization chambers were performed for both unmodulated and 6 cm modulated 290 MeV/nucleon carbon beams. Although two different dosimetry procedures were employed, the evaluated values of absorbed dose were in good agreement. This comparison established a common framework for ionization chamber dosimetry between two different carbon beam therapy facilities.