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Sample records for proton spot scanning

  1. Technical Note: Spot characteristic stability for proton pencil beam scanning.

    Science.gov (United States)

    Chen, Chin-Cheng; Chang, Chang; Moyers, Michael F; Gao, Mingcheng; Mah, Dennis

    2016-02-01

    The spot characteristics for proton pencil beam scanning (PBS) were measured and analyzed over a 16 month period, which included one major site configuration update and six cyclotron interventions. The results provide a reference to establish the quality assurance (QA) frequency and tolerance for proton pencil beam scanning. A simple treatment plan was generated to produce an asymmetric 9-spot pattern distributed throughout a field of 16 × 18 cm for each of 18 proton energies (100.0-226.0 MeV). The delivered fluence distribution in air was measured using a phosphor screen based CCD camera at three planes perpendicular to the beam line axis (x-ray imaging isocenter and up/down stream 15.0 cm). The measured fluence distributions for each energy were analyzed using in-house programs which calculated the spot sizes and positional deviations of the Gaussian shaped spots. Compared to the spot characteristic data installed into the treatment planning system, the 16-month averaged deviations of the measured spot sizes at the isocenter plane were 2.30% and 1.38% in the IEC gantry x and y directions, respectively. The maximum deviation was 12.87% while the minimum deviation was 0.003%, both at the upstream plane. After the collinearity of the proton and x-ray imaging system isocenters was optimized, the positional deviations of the spots were all within 1.5 mm for all three planes. During the site configuration update, spot positions were found to deviate by 6 mm until the tuning parameters file was properly restored. For this beam delivery system, it is recommended to perform a spot size and position check at least monthly and any time after a database update or cyclotron intervention occurs. A spot size deviation tolerance of spot positions were <2 mm at any plane up/down stream 15 cm from the isocenter.

  2. Modelling of a proton spot scanning system using MCNP6

    International Nuclear Information System (INIS)

    Ardenfors, O; Gudowska, I; Dasu, A; Kopeć, M

    2017-01-01

    The aim of this work was to model the characteristics of a clinical proton spot scanning beam using Monte Carlo simulations with the code MCNP6. The proton beam was defined using parameters obtained from beam commissioning at the Skandion Clinic, Uppsala, Sweden. Simulations were evaluated against measurements for proton energies between 60 and 226 MeV with regard to range in water, lateral spot sizes in air and absorbed dose depth profiles in water. The model was also used to evaluate the experimental impact of lateral signal losses in an ionization chamber through simulations using different detector radii. Simulated and measured distal ranges agreed within 0.1 mm for R 90 and R 80 , and within 0.2 mm for R 50 . The average absolute difference of all spot sizes was 0.1 mm. The average agreement of absorbed dose integrals and Bragg-peak heights was 0.9%. Lateral signal losses increased with incident proton energy with a maximum signal loss of 7% for 226 MeV protons. The good agreement between simulations and measurements supports the assumptions and parameters employed in the presented Monte Carlo model. The characteristics of the proton spot scanning beam were accurately reproduced and the model will prove useful in future studies on secondary neutrons. (paper)

  3. Technical Note: Spot characteristic stability for proton pencil beam scanning

    International Nuclear Information System (INIS)

    Chen, Chin-Cheng; Chang, Chang; Mah, Dennis; Moyers, Michael F.; Gao, Mingcheng

    2016-01-01

    Purpose: The spot characteristics for proton pencil beam scanning (PBS) were measured and analyzed over a 16 month period, which included one major site configuration update and six cyclotron interventions. The results provide a reference to establish the quality assurance (QA) frequency and tolerance for proton pencil beam scanning. Methods: A simple treatment plan was generated to produce an asymmetric 9-spot pattern distributed throughout a field of 16 × 18 cm for each of 18 proton energies (100.0–226.0 MeV). The delivered fluence distribution in air was measured using a phosphor screen based CCD camera at three planes perpendicular to the beam line axis (x-ray imaging isocenter and up/down stream 15.0 cm). The measured fluence distributions for each energy were analyzed using in-house programs which calculated the spot sizes and positional deviations of the Gaussian shaped spots. Results: Compared to the spot characteristic data installed into the treatment planning system, the 16-month averaged deviations of the measured spot sizes at the isocenter plane were 2.30% and 1.38% in the IEC gantry x and y directions, respectively. The maximum deviation was 12.87% while the minimum deviation was 0.003%, both at the upstream plane. After the collinearity of the proton and x-ray imaging system isocenters was optimized, the positional deviations of the spots were all within 1.5 mm for all three planes. During the site configuration update, spot positions were found to deviate by 6 mm until the tuning parameters file was properly restored. Conclusions: For this beam delivery system, it is recommended to perform a spot size and position check at least monthly and any time after a database update or cyclotron intervention occurs. A spot size deviation tolerance of <15% can be easily met with this delivery system. Deviations of spot positions were <2 mm at any plane up/down stream 15 cm from the isocenter

  4. Technical Note: Spot characteristic stability for proton pencil beam scanning

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Chin-Cheng, E-mail: chen.ccc@gmail.com; Chang, Chang; Mah, Dennis [ProCure Treatment Center, Somerset, New Jersey 08873 (United States); Moyers, Michael F. [ProCure Treatment Center, Somerset, New Jersey 08873 and Shanghai Proton and Heavy Ion Center, Shanghai 201321 (China); Gao, Mingcheng [CDH Proton Center, Warrenville, Illinois 60555 (United States)

    2016-02-15

    Purpose: The spot characteristics for proton pencil beam scanning (PBS) were measured and analyzed over a 16 month period, which included one major site configuration update and six cyclotron interventions. The results provide a reference to establish the quality assurance (QA) frequency and tolerance for proton pencil beam scanning. Methods: A simple treatment plan was generated to produce an asymmetric 9-spot pattern distributed throughout a field of 16 × 18 cm for each of 18 proton energies (100.0–226.0 MeV). The delivered fluence distribution in air was measured using a phosphor screen based CCD camera at three planes perpendicular to the beam line axis (x-ray imaging isocenter and up/down stream 15.0 cm). The measured fluence distributions for each energy were analyzed using in-house programs which calculated the spot sizes and positional deviations of the Gaussian shaped spots. Results: Compared to the spot characteristic data installed into the treatment planning system, the 16-month averaged deviations of the measured spot sizes at the isocenter plane were 2.30% and 1.38% in the IEC gantry x and y directions, respectively. The maximum deviation was 12.87% while the minimum deviation was 0.003%, both at the upstream plane. After the collinearity of the proton and x-ray imaging system isocenters was optimized, the positional deviations of the spots were all within 1.5 mm for all three planes. During the site configuration update, spot positions were found to deviate by 6 mm until the tuning parameters file was properly restored. Conclusions: For this beam delivery system, it is recommended to perform a spot size and position check at least monthly and any time after a database update or cyclotron intervention occurs. A spot size deviation tolerance of <15% can be easily met with this delivery system. Deviations of spot positions were <2 mm at any plane up/down stream 15 cm from the isocenter.

  5. Spot-Scanning Proton Arc (SPArc) Therapy: The First Robust and Delivery-Efficient Spot-Scanning Proton Arc Therapy

    International Nuclear Information System (INIS)

    Ding, Xuanfeng; Li, Xiaoqiang; Zhang, J. Michele; Kabolizadeh, Peyman; Stevens, Craig; Yan, Di

    2016-01-01

    Purpose: To present a novel robust and delivery-efficient spot-scanning proton arc (SPArc) therapy technique. Methods and Materials: A SPArc optimization algorithm was developed that integrates control point resampling, energy layer redistribution, energy layer filtration, and energy layer resampling. The feasibility of such a technique was evaluated using sample patients: 1 patient with locally advanced head and neck oropharyngeal cancer with bilateral lymph node coverage, and 1 with a nonmobile lung cancer. Plan quality, robustness, and total estimated delivery time were compared with the robust optimized multifield step-and-shoot arc plan without SPArc optimization (Arc_m_u_l_t_i_-_f_i_e_l_d) and the standard robust optimized intensity modulated proton therapy (IMPT) plan. Dose-volume histograms of target and organs at risk were analyzed, taking into account the setup and range uncertainties. Total delivery time was calculated on the basis of a 360° gantry room with 1 revolutions per minute gantry rotation speed, 2-millisecond spot switching time, 1-nA beam current, 0.01 minimum spot monitor unit, and energy layer switching time of 0.5 to 4 seconds. Results: The SPArc plan showed potential dosimetric advantages for both clinical sample cases. Compared with IMPT, SPArc delivered 8% and 14% less integral dose for oropharyngeal and lung cancer cases, respectively. Furthermore, evaluating the lung cancer plan compared with IMPT, it was evident that the maximum skin dose, the mean lung dose, and the maximum dose to ribs were reduced by 60%, 15%, and 35%, respectively, whereas the conformity index was improved from 7.6 (IMPT) to 4.0 (SPArc). The total treatment delivery time for lung and oropharyngeal cancer patients was reduced by 55% to 60% and 56% to 67%, respectively, when compared with Arc_m_u_l_t_i_-_f_i_e_l_d plans. Conclusion: The SPArc plan is the first robust and delivery-efficient proton spot-scanning arc therapy technique, which could potentially be

  6. Spot-Scanning Proton Arc (SPArc) Therapy: The First Robust and Delivery-Efficient Spot-Scanning Proton Arc Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Xuanfeng, E-mail: Xuanfeng.ding@beaumont.org; Li, Xiaoqiang; Zhang, J. Michele; Kabolizadeh, Peyman; Stevens, Craig; Yan, Di

    2016-12-01

    Purpose: To present a novel robust and delivery-efficient spot-scanning proton arc (SPArc) therapy technique. Methods and Materials: A SPArc optimization algorithm was developed that integrates control point resampling, energy layer redistribution, energy layer filtration, and energy layer resampling. The feasibility of such a technique was evaluated using sample patients: 1 patient with locally advanced head and neck oropharyngeal cancer with bilateral lymph node coverage, and 1 with a nonmobile lung cancer. Plan quality, robustness, and total estimated delivery time were compared with the robust optimized multifield step-and-shoot arc plan without SPArc optimization (Arc{sub multi-field}) and the standard robust optimized intensity modulated proton therapy (IMPT) plan. Dose-volume histograms of target and organs at risk were analyzed, taking into account the setup and range uncertainties. Total delivery time was calculated on the basis of a 360° gantry room with 1 revolutions per minute gantry rotation speed, 2-millisecond spot switching time, 1-nA beam current, 0.01 minimum spot monitor unit, and energy layer switching time of 0.5 to 4 seconds. Results: The SPArc plan showed potential dosimetric advantages for both clinical sample cases. Compared with IMPT, SPArc delivered 8% and 14% less integral dose for oropharyngeal and lung cancer cases, respectively. Furthermore, evaluating the lung cancer plan compared with IMPT, it was evident that the maximum skin dose, the mean lung dose, and the maximum dose to ribs were reduced by 60%, 15%, and 35%, respectively, whereas the conformity index was improved from 7.6 (IMPT) to 4.0 (SPArc). The total treatment delivery time for lung and oropharyngeal cancer patients was reduced by 55% to 60% and 56% to 67%, respectively, when compared with Arc{sub multi-field} plans. Conclusion: The SPArc plan is the first robust and delivery-efficient proton spot-scanning arc therapy technique, which could potentially be implemented

  7. SU-E-T-510: Interplay Between Spots Sizes, Spot / Line Spacing and Motion in Spot Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Lee, TK

    2015-01-01

    Purpose In proton beam configuration for spot scanning proton therapy (SSPT), one can define the spacing between spots and lines of scanning as a ratio of given spot size. If the spacing increases, the number of spots decreases which can potentially decrease scan time, and so can whole treatment time, and vice versa. However, if the spacing is too large, the uniformity of scanned field decreases. Also, the field uniformity can be affected by motion during SSPT beam delivery. In the present study, the interplay between spot/ line spacing and motion is investigated. Methods We used four Gaussian-shape spot sizes with 0.5cm, 1.0cm, 1.5cm, and 2.0cm FWHM, three spot/line spacing that creates uniform field profile which are 1/3*FWHM, σ/3*FWHM and 2/3*FWHM, and three random motion amplitudes within, +/−0.3mm, +/−0.5mm, and +/−1.0mm. We planned with 2Gy uniform single layer of 10×10cm2 and 20×20cm2 fields. Then, mean dose within 80% area of given field size, contrubuting MU per each spot assuming 1cGy/MU calibration for all spot sizes, number of spots and uniformity were calculated. Results The plans with spot/line spacing equal to or smaller than 2/3*FWHM without motion create ∼100% uniformity. However, it was found that the uniformity decreases with increased spacing, and it is more pronounced with smaller spot sizes, but is not affected by scanned field sizes. Conclusion It was found that the motion during proton beam delivery can alter the dose uniformity and the amount of alteration changes with spot size which changes with energy and spot/line spacing. Currently, robust evaluation in TPS (e.g. Eclipse system) performs range uncertainty evaluation using isocenter shift and CT calibration error. Based on presented study, it is recommended to add interplay effect evaluation to robust evaluation process. For future study, the additional interplay between the energy layers and motion is expected to present volumetric effect

  8. Spot Weight Adaptation for Moving Target in Spot Scanning Proton Therapy.

    Science.gov (United States)

    Morel, Paul; Wu, Xiaodong; Blin, Guillaume; Vialette, Stéphane; Flynn, Ryan; Hyer, Daniel; Wang, Dongxu

    2015-01-01

    This study describes a real-time spot weight adaptation method in spot-scanning proton therapy for moving target or moving patient, so that the resultant dose distribution closely matches the planned dose distribution. The method proposed in this study adapts the weight (MU) of the delivering pencil beam to that of the target spot; it will actually hit during patient/target motion. The target spot that a certain delivering pencil beam may hit relies on patient monitoring and/or motion modeling using four-dimensional (4D) CT. After the adapted delivery, the required total weight [Monitor Unit (MU)] for this target spot is then subtracted from the planned value. With continuous patient motion and continuous spot scanning, the planned doses to all target spots will eventually be all fulfilled. In a proof-of-principle test, a lung case was presented with realistic temporal and motion parameters; the resultant dose distribution using spot weight adaptation was compared to that without using this method. The impact of the real-time patient/target position tracking or prediction was also investigated. For moderate motion (i.e., mean amplitude 0.5 cm), D95% to the planning target volume (PTV) was only 81.5% of the prescription (RX) dose; with spot weight adaptation PTV D95% achieves 97.7% RX. For large motion amplitude (i.e., 1.5 cm), without spot weight adaptation PTV D95% is only 42.9% of RX; with spot weight adaptation, PTV D95% achieves 97.7% RX. Larger errors in patient/target position tracking or prediction led to worse final target coverage; an error of 3 mm or smaller in patient/target position tracking is preferred. The proposed spot weight adaptation method was able to deliver the planned dose distribution and maintain target coverage when patient motion was involved. The successful implementation of this method would rely on accurate monitoring or prediction of patient/target motion.

  9. Spot Weight Adaptation for Moving Target in Spot Scanning Proton Therapy

    Directory of Open Access Journals (Sweden)

    Paul eMorel

    2015-05-01

    Full Text Available Purpose: This study describes a real-time spot weight adaptation method in spot-scanning proton therapy for moving target or moving patient, so that the resultant dose distribution closely matches the planned dose distribution. Materials and Methods: The method proposed in this study adapts the weight (MU of the delivering pencil beam to that of the target spot it will actually hit during patient/target motion. The target spot a certain delivering pencil beam may hit relies on patient monitoring and/or motion modeling using four-dimensional (4D CT. After the adapted delivery, the required total weight (MU for this target spot is then subtracted from the planned value. With continuous patient motion and continuous spot scanning, the planned doses to all target spots will eventually be all fulfilled. In a proof-of-principle test, a lung case was presented with realistic temporal and motion parameters; the resultant dose distribution using spot weight adaptation was compared to that without using this method. The impact of the real-time patient/target position tracking or prediction was also investigated.Results: For moderate motion (i.e., mean amplitude 0.5 cm, D95% to the planning target volume (PTV was only 81.5% of the prescription (RX dose; with spot weight adaptation PTV D95% achieves 97.7%RX. For large motion amplitude (i.e., 1.5 cm, without spot weight adaptation PTV D95% is only 42.9% of RX; with spot weight adaptation, PTV D95% achieves 97.7%RX. Larger errors in patient/target position tracking or prediction led to worse final target coverage; an error of 3mm or smaller in patient/target position tracking is preferred. Conclusion: The proposed spot weight adaptation method was able to deliver the planned dose distribution and maintain target coverage when patient motion was involved. The successful implementation of this method would rely on accurate monitoring or prediction of patient/target motion.

  10. Impact of spot size on plan quality of spot scanning proton radiosurgery for peripheral brain lesions

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Dongxu, E-mail: dongxu-wang@uiowa.edu; Dirksen, Blake; Hyer, Daniel E.; Buatti, John M.; Sheybani, Arshin; Dinges, Eric; Felderman, Nicole; TenNapel, Mindi; Bayouth, John E.; Flynn, Ryan T. [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa 52242 (United States)

    2014-12-15

    Purpose: To determine the plan quality of proton spot scanning (SS) radiosurgery as a function of spot size (in-air sigma) in comparison to x-ray radiosurgery for treating peripheral brain lesions. Methods: Single-field optimized (SFO) proton SS plans with sigma ranging from 1 to 8 mm, cone-based x-ray radiosurgery (Cone), and x-ray volumetric modulated arc therapy (VMAT) plans were generated for 11 patients. Plans were evaluated using secondary cancer risk and brain necrosis normal tissue complication probability (NTCP). Results: For all patients, secondary cancer is a negligible risk compared to brain necrosis NTCP. Secondary cancer risk was lower in proton SS plans than in photon plans regardless of spot size (p = 0.001). Brain necrosis NTCP increased monotonically from an average of 2.34/100 (range 0.42/100–4.49/100) to 6.05/100 (range 1.38/100–11.6/100) as sigma increased from 1 to 8 mm, compared to the average of 6.01/100 (range 0.82/100–11.5/100) for Cone and 5.22/100 (range 1.37/100–8.00/100) for VMAT. An in-air sigma less than 4.3 mm was required for proton SS plans to reduce NTCP over photon techniques for the cohort of patients studied with statistical significance (p = 0.0186). Proton SS plans with in-air sigma larger than 7.1 mm had significantly greater brain necrosis NTCP than photon techniques (p = 0.0322). Conclusions: For treating peripheral brain lesions—where proton therapy would be expected to have the greatest depth-dose advantage over photon therapy—the lateral penumbra strongly impacts the SS plan quality relative to photon techniques: proton beamlet sigma at patient surface must be small (<7.1 mm for three-beam single-field optimized SS plans) in order to achieve comparable or smaller brain necrosis NTCP relative to photon radiosurgery techniques. Achieving such small in-air sigma values at low energy (<70 MeV) is a major technological challenge in commercially available proton therapy systems.

  11. Impact of spot size on plan quality of spot scanning proton radiosurgery for peripheral brain lesions

    International Nuclear Information System (INIS)

    Wang, Dongxu; Dirksen, Blake; Hyer, Daniel E.; Buatti, John M.; Sheybani, Arshin; Dinges, Eric; Felderman, Nicole; TenNapel, Mindi; Bayouth, John E.; Flynn, Ryan T.

    2014-01-01

    Purpose: To determine the plan quality of proton spot scanning (SS) radiosurgery as a function of spot size (in-air sigma) in comparison to x-ray radiosurgery for treating peripheral brain lesions. Methods: Single-field optimized (SFO) proton SS plans with sigma ranging from 1 to 8 mm, cone-based x-ray radiosurgery (Cone), and x-ray volumetric modulated arc therapy (VMAT) plans were generated for 11 patients. Plans were evaluated using secondary cancer risk and brain necrosis normal tissue complication probability (NTCP). Results: For all patients, secondary cancer is a negligible risk compared to brain necrosis NTCP. Secondary cancer risk was lower in proton SS plans than in photon plans regardless of spot size (p = 0.001). Brain necrosis NTCP increased monotonically from an average of 2.34/100 (range 0.42/100–4.49/100) to 6.05/100 (range 1.38/100–11.6/100) as sigma increased from 1 to 8 mm, compared to the average of 6.01/100 (range 0.82/100–11.5/100) for Cone and 5.22/100 (range 1.37/100–8.00/100) for VMAT. An in-air sigma less than 4.3 mm was required for proton SS plans to reduce NTCP over photon techniques for the cohort of patients studied with statistical significance (p = 0.0186). Proton SS plans with in-air sigma larger than 7.1 mm had significantly greater brain necrosis NTCP than photon techniques (p = 0.0322). Conclusions: For treating peripheral brain lesions—where proton therapy would be expected to have the greatest depth-dose advantage over photon therapy—the lateral penumbra strongly impacts the SS plan quality relative to photon techniques: proton beamlet sigma at patient surface must be small (<7.1 mm for three-beam single-field optimized SS plans) in order to achieve comparable or smaller brain necrosis NTCP relative to photon radiosurgery techniques. Achieving such small in-air sigma values at low energy (<70 MeV) is a major technological challenge in commercially available proton therapy systems

  12. SU-E-J-72: Geant4 Simulations of Spot-Scanned Proton Beam Treatment Plans

    Energy Technology Data Exchange (ETDEWEB)

    Kanehira, T; Sutherland, K; Matsuura, T; Umegaki, K; Shirato, H [Hokkaido University, Sapporo, Hokkaido (Japan)

    2014-06-01

    Purpose: To evaluate density inhomogeneities which can effect dose distributions for real-time image gated spot-scanning proton therapy (RGPT), a dose calculation system, using treatment planning system VQA (Hitachi Ltd., Tokyo) spot position data, was developed based on Geant4. Methods: A Geant4 application was developed to simulate spot-scanned proton beams at Hokkaido University Hospital. A CT scan (0.98 × 0.98 × 1.25 mm) was performed for prostate cancer treatment with three or four inserted gold markers (diameter 1.5 mm, volume 1.77 mm3) in or near the target tumor. The CT data was read into VQA. A spot scanning plan was generated and exported to text files, specifying the beam energy and position of each spot. The text files were converted and read into our Geant4-based software. The spot position was converted into steering magnet field strength (in Tesla) for our beam nozzle. Individual protons were tracked from the vacuum chamber, through the helium chamber, steering magnets, dose monitors, etc., in a straight, horizontal line. The patient CT data was converted into materials with variable density and placed in a parametrized volume at the isocenter. Gold fiducial markers were represented in the CT data by two adjacent voxels (volume 2.38 mm3). 600,000 proton histories were tracked for each target spot. As one beam contained about 1,000 spots, approximately 600 million histories were recorded for each beam on a blade server. Two plans were considered: two beam horizontal opposed (90 and 270 degree) and three beam (0, 90 and 270 degree). Results: We are able to convert spot scanning plans from VQA and simulate them with our Geant4-based code. Our system can be used to evaluate the effect of dose reduction caused by gold markers used for RGPT. Conclusion: Our Geant4 application is able to calculate dose distributions for spot scanned proton therapy.

  13. A method to select aperture margin in collimated spot scanning proton therapy

    International Nuclear Information System (INIS)

    Wang, Dongxu; Smith, Blake R; Gelover, Edgar; Flynn, Ryan T; Hyer, Daniel E

    2015-01-01

    The use of collimator or aperture may sharpen the lateral dose gradient for spot scanning proton therapy. However, to date, there has not been a standard method to determine the aperture margin for a single field in collimated spot scanning proton therapy. This study describes a theoretical framework to select the optimal aperture margin for a single field, and also presents the spot spacing limit required such that the optimal aperture margin exists. Since, for a proton pencil beam partially intercepted by collimator, the maximum point dose (spot center) shifts away from the original pencil beam central axis, we propose that the optimal margin should be equal to the maximum pencil beam center shift under the condition that spot spacing is small with respect to the maximum pencil beam center shift, which can be numerically determined based on beam modeling data. A test case is presented which demonstrates agreement with the prediction made based on the proposed methods. When apertures are applied in a commercial treatment planning system this method may be implemented. (note)

  14. Quantitative analysis of treatment process time and throughput capacity for spot scanning proton therapy

    International Nuclear Information System (INIS)

    Suzuki, Kazumichi; Sahoo, Narayan; Zhang, Xiaodong; Poenisch, Falk; Mackin, Dennis S.; Liu, Amy Y.; Wu, Richard; Zhu, X. Ronald; Gillin, Michael T.; Palmer, Matthew B.; Frank, Steven J.; Lee, Andrew K.

    2016-01-01

    Purpose: To determine the patient throughput and the overall efficiency of the spot scanning system by analyzing treatment time, equipment availability, and maximum daily capacity for the current spot scanning port at Proton Therapy Center Houston and to assess the daily throughput capacity for a hypothetical spot scanning proton therapy center. Methods: At their proton therapy center, the authors have been recording in an electronic medical record system all treatment data, including disease site, number of fields, number of fractions, delivered dose, energy, range, number of spots, and number of layers for every treatment field. The authors analyzed delivery system downtimes that had been recorded for every equipment failure and associated incidents. These data were used to evaluate the patient census, patient distribution as a function of the number of fields and total target volume, and equipment clinical availability. The duration of each treatment session from patient walk-in to patient walk-out of the spot scanning treatment room was measured for 64 patients with head and neck, central nervous system, thoracic, and genitourinary cancers. The authors retrieved data for total target volume and the numbers of layers and spots for all fields from treatment plans for a total of 271 patients (including the above 64 patients). A sensitivity analysis of daily throughput capacity was performed by varying seven parameters in a throughput capacity model. Results: The mean monthly equipment clinical availability for the spot scanning port in April 2012–March 2015 was 98.5%. Approximately 1500 patients had received spot scanning proton therapy as of March 2015. The major disease sites treated in September 2012–August 2014 were the genitourinary system (34%), head and neck (30%), central nervous system (21%), and thorax (14%), with other sites accounting for the remaining 1%. Spot scanning beam delivery time increased with total target volume and accounted for

  15. Motion Interplay as a Function of Patient Parameters and Spot Size in Spot Scanning Proton Therapy for Lung Cancer

    Science.gov (United States)

    Grassberger, Clemens; Dowdell, Stephen; Lomax, Antony; Sharp, Greg; Shackleford, James; Choi, Noah; Willers, Henning; Paganetti, Harald

    2013-01-01

    Purpose Quantify the impact of respiratory motion on the treatment of lung tumors with spot scanning proton therapy. Methods and Materials 4D Monte Carlo simulations were used to assess the interplay effect, which results from relative motion of the tumor and the proton beam, on the dose distribution in the patient. Ten patients with varying tumor sizes (2.6-82.3cc) and motion amplitudes (3-30mm) were included in the study. We investigated the impact of the spot size, which varies between proton facilities, and studied single fractions and conventionally fractionated treatments. The following metrics were used in the analysis: minimum/maximum/mean dose, target dose homogeneity and 2-year local control rate (2y-LC). Results Respiratory motion reduces the target dose homogeneity, with the largest effects observed for the highest motion amplitudes. Smaller spot sizes (σ≈3mm) are inherently more sensitive to motion, decreasing target dose homogeneity on average by a factor ~2.8 compared to a larger spot size (σ≈13mm). Using a smaller spot size to treat a tumor with 30mm motion amplitude reduces the minimum dose to 44.7% of the prescribed dose, decreasing modeled 2y-LC from 87.0% to 2.7%, assuming a single fraction. Conventional fractionation partly mitigates this reduction, yielding a 2y-LC of 71.6%. For the large spot size, conventional fractionation increases target dose homogeneity and prevents a deterioration of 2y-LC for all patients. No correlation with tumor volume is observed. The effect on the normal lung dose distribution is minimal: observed changes in mean lung dose and lung V20 are interplay using a large spot size and conventional fractionation. For treatments employing smaller spot sizes and/or in the delivery of single fractions, interplay effects can lead to significant deterioration of the dose distribution and lower 2y-LC. PMID:23462423

  16. Comparison of surface doses from spot scanning and passively scattered proton therapy beams

    International Nuclear Information System (INIS)

    Arjomandy, Bijan; Sahoo, Narayan; Gillin, Michael; Cox, James; Lee, Andrew

    2009-01-01

    Proton therapy for the treatment of cancer is delivered using either passively scattered or scanning beams. Each technique delivers a different amount of dose to the skin, because of the specific feature of their delivery system. The amount of dose delivered to the skin can play an important role in choosing the delivery technique for a specific site. To assess the differences in skin doses, we measured the surface doses associated with these two techniques. For the purpose of this investigation, the surface doses in a phantom were measured for ten prostate treatment fields planned with passively scattered proton beams and ten patients planned with spot scanning proton beams. The measured doses were compared to evaluate the differences in the amount of skin dose delivered by using these techniques. The results indicate that, on average, the patients treated with spot scanning proton beams received lower skin doses by an amount of 11.8% ± 0.3% than did the patients treated with passively scattered proton beams. That difference could amount to 4 CGE per field for a prescribed dose of 76 CGE in 38 fractions treated with two equally weighted parallel opposed fields. (note)

  17. Proton therapy with spot scanning: the Rinecker Proton Therapy Center in Munich. Part 2: Technical and physical aspects

    International Nuclear Information System (INIS)

    Borchert, H. J.; Mayr, M.; Schneider, R. A.; Arnold, M. R.; Geismar, D. E.; Wilms, M.; Wisser, L.; Herbst, M.

    2008-01-01

    The Rinecker Proton Therapy Center (RPTC) in Munich is about to introduce into clinical radiation therapy, a 2D scanning technique (spot scanning) of a single proton pencil beam. It will be available at four gantries and a fifth treatment room allocates a fixed beam unit for a scattering technique. A superconducting cyclotron extracts protons with a constant energy of 250 MeV. Far upstream of the patient follows modulation of the energy with a degrader according to the prescription of the patients treatment planning. A 10 mm pencil beam at full width of half maximum (FWHM) will enable scanning of individual tumour volumes at any depth i.e. 1 minute for a target volume of 1 litre and a dose of 2 Gy. Innovative solutions will be established for other important issues such as dosimetric monitoring, safety concepts and positioning of the patient. The physical characteristics of proton beam spot scanning offer exceptional possibilities in conformal radiation therapy. Together with intensity modulated proton therapy (IMPT) it significantly improves the sparing of organs at risk and of healthy tissues. (author)

  18. Reducing Dose Uncertainty for Spot-Scanning Proton Beam Therapy of Moving Tumors by Optimizing the Spot Delivery Sequence

    International Nuclear Information System (INIS)

    Li, Heng; Zhu, X. Ronald; Zhang, Xiaodong

    2015-01-01

    Purpose: To develop and validate a novel delivery strategy for reducing the respiratory motion–induced dose uncertainty of spot-scanning proton therapy. Methods and Materials: The spot delivery sequence was optimized to reduce dose uncertainty. The effectiveness of the delivery sequence optimization was evaluated using measurements and patient simulation. One hundred ninety-one 2-dimensional measurements using different delivery sequences of a single-layer uniform pattern were obtained with a detector array on a 1-dimensional moving platform. Intensity modulated proton therapy plans were generated for 10 lung cancer patients, and dose uncertainties for different delivery sequences were evaluated by simulation. Results: Without delivery sequence optimization, the maximum absolute dose error can be up to 97.2% in a single measurement, whereas the optimized delivery sequence results in a maximum absolute dose error of ≤11.8%. In patient simulation, the optimized delivery sequence reduces the mean of fractional maximum absolute dose error compared with the regular delivery sequence by 3.3% to 10.6% (32.5-68.0% relative reduction) for different patients. Conclusions: Optimizing the delivery sequence can reduce dose uncertainty due to respiratory motion in spot-scanning proton therapy, assuming the 4-dimensional CT is a true representation of the patients' breathing patterns.

  19. Technical Note: Using experimentally determined proton spot scanning timing parameters to accurately model beam delivery time.

    Science.gov (United States)

    Shen, Jiajian; Tryggestad, Erik; Younkin, James E; Keole, Sameer R; Furutani, Keith M; Kang, Yixiu; Herman, Michael G; Bues, Martin

    2017-10-01

    To accurately model the beam delivery time (BDT) for a synchrotron-based proton spot scanning system using experimentally determined beam parameters. A model to simulate the proton spot delivery sequences was constructed, and BDT was calculated by summing times for layer switch, spot switch, and spot delivery. Test plans were designed to isolate and quantify the relevant beam parameters in the operation cycle of the proton beam therapy delivery system. These parameters included the layer switch time, magnet preparation and verification time, average beam scanning speeds in x- and y-directions, proton spill rate, and maximum charge and maximum extraction time for each spill. The experimentally determined parameters, as well as the nominal values initially provided by the vendor, served as inputs to the model to predict BDTs for 602 clinical proton beam deliveries. The calculated BDTs (T BDT ) were compared with the BDTs recorded in the treatment delivery log files (T Log ): ∆t = T Log -T BDT . The experimentally determined average layer switch time for all 97 energies was 1.91 s (ranging from 1.9 to 2.0 s for beam energies from 71.3 to 228.8 MeV), average magnet preparation and verification time was 1.93 ms, the average scanning speeds were 5.9 m/s in x-direction and 19.3 m/s in y-direction, the proton spill rate was 8.7 MU/s, and the maximum proton charge available for one acceleration is 2.0 ± 0.4 nC. Some of the measured parameters differed from the nominal values provided by the vendor. The calculated BDTs using experimentally determined parameters matched the recorded BDTs of 602 beam deliveries (∆t = -0.49 ± 1.44 s), which were significantly more accurate than BDTs calculated using nominal timing parameters (∆t = -7.48 ± 6.97 s). An accurate model for BDT prediction was achieved by using the experimentally determined proton beam therapy delivery parameters, which may be useful in modeling the interplay effect and patient throughput. The model may

  20. Motion Interplay as a Function of Patient Parameters and Spot Size in Spot Scanning Proton Therapy for Lung Cancer

    International Nuclear Information System (INIS)

    Grassberger, Clemens; Dowdell, Stephen; Lomax, Antony; Sharp, Greg; Shackleford, James; Choi, Noah; Willers, Henning; Paganetti, Harald

    2013-01-01

    Purpose: To quantify the impact of respiratory motion on the treatment of lung tumors with spot scanning proton therapy. Methods and Materials: Four-dimensional Monte Carlo simulations were used to assess the interplay effect, which results from relative motion of the tumor and the proton beam, on the dose distribution in the patient. Ten patients with varying tumor sizes (2.6-82.3 cc) and motion amplitudes (3-30 mm) were included in the study. We investigated the impact of the spot size, which varies between proton facilities, and studied single fractions and conventionally fractionated treatments. The following metrics were used in the analysis: minimum/maximum/mean dose, target dose homogeneity, and 2-year local control rate (2y-LC). Results: Respiratory motion reduces the target dose homogeneity, with the largest effects observed for the highest motion amplitudes. Smaller spot sizes (σ ≈ 3 mm) are inherently more sensitive to motion, decreasing target dose homogeneity on average by a factor 2.8 compared with a larger spot size (σ ≈ 13 mm). Using a smaller spot size to treat a tumor with 30-mm motion amplitude reduces the minimum dose to 44.7% of the prescribed dose, decreasing modeled 2y-LC from 87.0% to 2.7%, assuming a single fraction. Conventional fractionation partly mitigates this reduction, yielding a 2y-LC of 71.6%. For the large spot size, conventional fractionation increases target dose homogeneity and prevents a deterioration of 2y-LC for all patients. No correlation with tumor volume is observed. The effect on the normal lung dose distribution is minimal: observed changes in mean lung dose and lung V 20 are <0.6 Gy(RBE) and <1.7%, respectively. Conclusions: For the patients in this study, 2y-LC could be preserved in the presence of interplay using a large spot size and conventional fractionation. For treatments using smaller spot sizes and/or in the delivery of single fractions, interplay effects can lead to significant deterioration of the

  1. SU-F-T-182: A Stochastic Approach to Daily QA Tolerances On Spot Properties for Proton Pencil Beam Scanning

    International Nuclear Information System (INIS)

    St James, S; Bloch, C; Saini, J

    2016-01-01

    Purpose: Proton pencil beam scanning is used clinically across the United States. There are no current guidelines on tolerances for daily QA specific to pencil beam scanning, specifically related to the individual spot properties (spot width). Using a stochastic method to determine tolerances has the potential to optimize tolerances on individual spots and decrease the number of false positive failures in daily QA. Individual and global spot tolerances were evaluated. Methods: As part of daily QA for proton pencil beam scanning, a field of 16 spots (corresponding to 8 energies) is measured using an array of ion chambers (Matrixx, IBA). Each individual spot is fit to two Gaussian functions (x,y). The spot width (σ) in × and y are recorded (32 parameters). Results from the daily QA were retrospectively analyzed for 100 days of data. The deviations of the spot widths were histogrammed and fit to a Gaussian function. The stochastic spot tolerance was taken to be the mean ± 3σ. Using these results, tolerances were developed and tested against known deviations in spot width. Results: The individual spot tolerances derived with the stochastic method decreased in 30/32 instances. Using the previous tolerances (± 20% width), the daily QA would have detected 0/20 days of the deviation. Using a tolerance of any 6 spots failing the stochastic tolerance, 18/20 days of the deviation would have been detected. Conclusion: Using a stochastic method we have been able to decrease daily tolerances on the spot widths for 30/32 spot widths measured. The stochastic tolerances can lead to detection of deviations that previously would have been picked up on monthly QA and missed by daily QA. This method could be easily extended for evaluation of other QA parameters in proton spot scanning.

  2. Effects of spot size and spot spacing on lateral penumbra reduction when using a dynamic collimation system for spot scanning proton therapy

    International Nuclear Information System (INIS)

    Hyer, Daniel E; Hill, Patrick M; Wang, Dongxu; Smith, Blake R; Flynn, Ryan T

    2014-01-01

    The purpose of this work was to investigate the reduction in lateral dose penumbra that can be achieved when using a dynamic collimation system (DCS) for spot scanning proton therapy as a function of two beam parameters: spot size and spot spacing. This is an important investigation as both values impact the achievable dose distribution and a wide range of values currently exist depending on delivery hardware. Treatment plans were created both with and without the DCS for in-air spot sizes (σ air ) of 3, 5, 7, and 9 mm as well as spot spacing intervals of 2, 4, 6 and 8 mm. Compared to un-collimated treatment plans, the plans created with the DCS yielded a reduction in the mean dose to normal tissue surrounding the target of 26.2–40.6% for spot sizes of 3–9 mm, respectively. Increasing the spot spacing resulted in a decrease in the time penalty associated with using the DCS that was approximately proportional to the reduction in the number of rows in the raster delivery pattern. We conclude that dose distributions achievable when using the DCS are comparable to those only attainable with much smaller initial spot sizes, suggesting that the goal of improving high dose conformity may be achieved by either utilizing a DCS or by improving beam line optics. (note)

  3. Toward improved target conformity for two spot scanning proton therapy delivery systems using dynamic collimation

    Science.gov (United States)

    Moignier, Alexandra; Gelover, Edgar; Smith, Blake R.; Wang, Dongxu; Flynn, Ryan T.; Kirk, Maura L.; Lin, Liyong; Solberg, Timothy D.; Lin, Alexander; Hyer, Daniel E.

    2016-01-01

    Purpose: To quantify improvement in target conformity in brain and head and neck tumor treatments resulting from the use of a dynamic collimation system (DCS) with two spot scanning proton therapy delivery systems (universal nozzle, UN, and dedicated nozzle, DN) with median spot sizes of 5.2 and 3.2 mm over a range of energies from 100 to 230 MeV. Methods: Uncollimated and collimated plans were calculated with both UN and DN beam models implemented within our in-house treatment planning system for five brain and ten head and neck datasets in patients previously treated with spot scanning proton therapy. The prescription dose and beam angles from the clinical plans were used for both the UN and DN plans. The average reduction of the mean dose to the 10-mm ring surrounding the target between the uncollimated and collimated plans was calculated for the UN and the DN. Target conformity was analyzed using the mean dose to 1-mm thickness rings surrounding the target at increasing distances ranging from 1 to 10 mm. Results: The average reductions of the 10-mm ring mean dose for the UN and DN plans were 13.7% (95% CI: 11.6%–15.7%; p < 0.0001) and 11.5% (95% CI: 9.5%–13.5%; p < 0.0001) across all brain cases and 7.1% (95% CI: 4.4%–9.8%; p < 0.001) and 6.3% (95% CI: 3.7%–9.0%; p < 0.001), respectively, across all head and neck cases. The collimated UN plans were either more conformal (all brain cases and 60% of the head and neck cases) than or equivalent (40% of the head and neck cases) to the uncollimated DN plans. The collimated DN plans offered the highest conformity. Conclusions: The DCS added either to the UN or DN improved the target conformity. The DCS may be of particular interest for sites with UN systems looking for a more economical solution than upgrading the nozzle to improve the target conformity of their spot scanning proton therapy system. PMID:26936726

  4. Use of treatment log files in spot scanning proton therapy as part of patient-specific quality assurance

    International Nuclear Information System (INIS)

    Li Heng; Sahoo, Narayan; Poenisch, Falk; Suzuki, Kazumichi; Li Yupeng; Li Xiaoqiang; Zhang Xiaodong; Gillin, Michael T.; Zhu, X. Ronald; Lee, Andrew K.

    2013-01-01

    Purpose: The purpose of this work was to assess the monitor unit (MU) values and position accuracy of spot scanning proton beams as recorded by the daily treatment logs of the treatment control system, and furthermore establish the feasibility of using the delivered spot positions and MU values to calculate and evaluate delivered doses to patients. Methods: To validate the accuracy of the recorded spot positions, the authors generated and executed a test treatment plan containing nine spot positions, to which the authors delivered ten MU each. The spot positions were measured with radiographic films and Matrixx 2D ion-chambers array placed at the isocenter plane and compared for displacements from the planned and recorded positions. Treatment logs for 14 patients were then used to determine the spot MU values and position accuracy of the scanning proton beam delivery system. Univariate analysis was used to detect any systematic error or large variation between patients, treatment dates, proton energies, gantry angles, and planned spot positions. The recorded patient spot positions and MU values were then used to replace the spot positions and MU values in the plan, and the treatment planning system was used to calculate the delivered doses to patients. The results were compared with the treatment plan. Results: Within a treatment session, spot positions were reproducible within ±0.2 mm. The spot positions measured by film agreed with the planned positions within ±1 mm and with the recorded positions within ±0.5 mm. The maximum day-to-day variation for any given spot position was within ±1 mm. For all 14 patients, with ∼1 500 000 spots recorded, the total MU accuracy was within 0.1% of the planned MU values, the mean (x, y) spot displacement from the planned value was (−0.03 mm, −0.01 mm), the maximum (x, y) displacement was (1.68 mm, 2.27 mm), and the (x, y) standard deviation was (0.26 mm, 0.42 mm). The maximum dose difference between calculated dose to

  5. Treatment planning and verification of proton therapy using spot scanning: Initial experiences

    International Nuclear Information System (INIS)

    Lomax, Antony J.; Boehringer, Terence; Bolsi, Alessandra; Coray, Doelf; Emert, Frank; Goitein, Gudrun; Jermann, Martin; Lin, Shixiong; Pedroni, Eros; Rutz, Hanspeter; Stadelmann, Otto; Timmermann, Beate; Verwey, Jorn; Weber, Damien C.

    2004-01-01

    Since the end of 1996, we have treated more than 160 patients at PSI using spot-scanned protons. The range of indications treated has been quite wide and includes, in the head region, base-of-skull sarcomas, low-grade gliomas, meningiomas, and para-nasal sinus tumors. In addition, we have treated bone sarcomas in the neck and trunk - mainly in the sacral area - as well as prostate cases and some soft tissue sarcomas. PTV volumes for our treated cases are in the range 20-4500 ml, indicating the flexibility of the spot scanning system for treating lesions of all types and sizes. The number of fields per applied plan ranges from between 1 and 4, with a mean of just under 3 beams per plan, and the number of fluence modulated Bragg peaks delivered per field has ranged from 200 to 45 000. With the current delivery rate of roughly 3000 Bragg peaks per minute, this translates into delivery times per field of between a few seconds to 20-25 min. Bragg peak weight analysis of these spots has shown that over all fields, only about 10% of delivered spots have a weight of more than 10% of the maximum in any given field, indicating that there is some scope for optimizing the number of spots delivered per field. Field specific dosimetry shows that these treatments can be delivered accurately and precisely to within ±1 mm (1 SD) orthogonal to the field direction and to within 1.5 mm in range. With our current delivery system the mean widths of delivered pencil beams at the Bragg peak is about 8 mm (σ) for all energies, indicating that this is an area where some improvements can be made. In addition, an analysis of the spot weights and energies of individual Bragg peaks shows a relatively broad spread of low and high weighted Bragg peaks over all energy steps, indicating that there is at best only a limited relationship between pencil beam weighting and depth of penetration. This latter observation may have some consequences when considering strategies for fast re-scanning on

  6. A dynamic collimation system for penumbra reduction in spot-scanning proton therapy: Proof of concept

    Energy Technology Data Exchange (ETDEWEB)

    Hyer, Daniel E., E-mail: daniel-hyer@uiowa.edu; Hill, Patrick M.; Wang, Dongxu; Smith, Blake R.; Flynn, Ryan T. [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States)

    2014-09-15

    Purpose: In the absence of a collimation system the lateral penumbra of spot scanning (SS) dose distributions delivered by low energy proton beams is highly dependent on the spot size. For current commercial equipment, spot size increases with decreasing proton energy thereby reducing the benefit of the SS technique. This paper presents a dynamic collimation system (DCS) for sharpening the lateral penumbra of proton therapy dose distributions delivered by SS. Methods: The collimation system presented here exploits the property that a proton pencil beam used for SS requires collimation only when it is near the target edge, enabling the use of trimmers that are in motion at times when the pencil beam is away from the target edge. The device consists of two pairs of parallel nickel trimmer blades of 2 cm thickness and dimensions of 2 cm × 18 cm in the beam's eye view. The two pairs of trimmer blades are rotated 90° relative to each other to form a rectangular shape. Each trimmer blade is capable of rapid motion in the direction perpendicular to the central beam axis by means of a linear motor, with maximum velocity and acceleration of 2.5 m/s and 19.6 m/s{sup 2}, respectively. The blades travel on curved tracks to match the divergence of the proton source. An algorithm for selecting blade positions is developed to minimize the dose delivered outside of the target, and treatment plans are created both with and without the DCS. Results: The snout of the DCS has outer dimensions of 22.6 × 22.6 cm{sup 2} and is capable of delivering a minimum treatment field size of 15 × 15 cm{sup 2}. Using currently available components, the constructed system would weigh less than 20 kg. For irregularly shaped fields, the use of the DCS reduces the mean dose outside of a 2D target of 46.6 cm{sup 2} by approximately 40% as compared to an identical plan without collimation. The use of the DCS increased treatment time by 1–3 s per energy layer. Conclusions: The spread of

  7. A dynamic collimation system for penumbra reduction in spot-scanning proton therapy: Proof of concept

    International Nuclear Information System (INIS)

    Hyer, Daniel E.; Hill, Patrick M.; Wang, Dongxu; Smith, Blake R.; Flynn, Ryan T.

    2014-01-01

    Purpose: In the absence of a collimation system the lateral penumbra of spot scanning (SS) dose distributions delivered by low energy proton beams is highly dependent on the spot size. For current commercial equipment, spot size increases with decreasing proton energy thereby reducing the benefit of the SS technique. This paper presents a dynamic collimation system (DCS) for sharpening the lateral penumbra of proton therapy dose distributions delivered by SS. Methods: The collimation system presented here exploits the property that a proton pencil beam used for SS requires collimation only when it is near the target edge, enabling the use of trimmers that are in motion at times when the pencil beam is away from the target edge. The device consists of two pairs of parallel nickel trimmer blades of 2 cm thickness and dimensions of 2 cm × 18 cm in the beam's eye view. The two pairs of trimmer blades are rotated 90° relative to each other to form a rectangular shape. Each trimmer blade is capable of rapid motion in the direction perpendicular to the central beam axis by means of a linear motor, with maximum velocity and acceleration of 2.5 m/s and 19.6 m/s 2 , respectively. The blades travel on curved tracks to match the divergence of the proton source. An algorithm for selecting blade positions is developed to minimize the dose delivered outside of the target, and treatment plans are created both with and without the DCS. Results: The snout of the DCS has outer dimensions of 22.6 × 22.6 cm 2 and is capable of delivering a minimum treatment field size of 15 × 15 cm 2 . Using currently available components, the constructed system would weigh less than 20 kg. For irregularly shaped fields, the use of the DCS reduces the mean dose outside of a 2D target of 46.6 cm 2 by approximately 40% as compared to an identical plan without collimation. The use of the DCS increased treatment time by 1–3 s per energy layer. Conclusions: The spread of the lateral

  8. SU-F-T-173: One-Scan Protocol: Verifying the Delivery of Spot-Scanning Proton Beam

    Energy Technology Data Exchange (ETDEWEB)

    Chan, M; Li, J [Memorial Sloan-Kettering Cancer Center, Basking Ridge, NJ (United States); Chen, C; Mah, D [Procure Treatment Center, Somerset, NJ (United States); Tang, X [Memorial Sloan Kettering Cancer Center, West Harrison, NY (United States); Li, X [Memorial Sloan Kettering Cancer Center, Rockville Centre, NY (United States); Tang, G [Memorial Sloan Kettering Cancer Center, New York, NY (United States)

    2016-06-15

    Purpose: Radiochromic film for spot-scanning QA provides high spatial resolution and efficiency gains from one-shot irradiation for multiple depths. However, calibration can be a tedious procedure which may limit widespread use. Moreover, since there may be an energy dependence, which manifests as a depth dependence, this may require additional measurements for each patient. We present a one-scan protocol to simplify the procedure. Methods: We performed the calibration using an EBT3 film at depths of 18, 20, 24cm of Plastic Water exposed by a 6-level step-wedge plan on a Proteus Plus proton system (IBA, Belgium). The calibration doses ranged 65–250 cGy(RBE) for proton energies of 170–200MeV. A clinical prostate+nodes plan was used for validation. The planar doses at selected depths were measured with EBT3 films and analyzed using one-scan protocol (one-scan digitization of QA film and at least one film exposed to known dose). The Gamma passing rates, dose-difference maps, and profiles of 2D planar doses measured with EBT3 film, IBA MatriXX PT, versus TPS calculations were analyzed and compared. Results: The EBT3 film measurement results matched well with the TPS calculation data with an average passing rate of ∼95% for 2%/2mm and slightly lower passing rates were obtained from an ion chamber array detector. We were able to demonstrate that the use of a proton step-wedge provided clinically acceptable results and minimized variations between film-scanner orientation, inter-scan, and scanning conditions. Furthermore, it could be derived from no more than two films exposed to known doses (one could be zero) for rescaling the master calibration curve at each depth. Conclusion: The use of a proton step-wedge for calibration of EBT3 film increases efficiency. The sensitivity of the calibration to depth variations has been explored. One-scan protocol results appear to be comparable to that of the ion chamber array detector. One author has a research grant from

  9. TH-CD-209-10: Scanning Proton Arc Therapy (SPArc) - The First Robust and Delivery-Efficient Spot Scanning Proton Arc Therapy

    International Nuclear Information System (INIS)

    Ding, X; Li, X; Zhang, J; Kabolizadeh, P; Stevens, C; Yan, D

    2016-01-01

    Purpose: To develop a delivery-efficient proton spot-scanning arc therapy technique with robust plan quality. Methods: We developed a Scanning Proton Arc(SPArc) optimization algorithm integrated with (1)Control point re-sampling by splitting control point into adjacent sub-control points; (2)Energy layer re-distribution by assigning the original energy layers to the new sub-control points; (3)Energy layer filtration by deleting low MU weighting energy layers; (4)Energy layer re-sampling by sampling additional layers to ensure the optimal solution. A bilateral head and neck oropharynx case and a non-mobile lung target case were tested. Plan quality and total estimated delivery time were compared to original robust optimized multi-field step-and-shoot arc plan without SPArc optimization (Arcmulti-field) and standard robust optimized Intensity Modulated Proton Therapy(IMPT) plans. Dose-Volume-Histograms (DVH) of target and Organ-at-Risks (OARs) were analyzed along with all worst case scenarios. Total delivery time was calculated based on the assumption of a 360 degree gantry room with 1 RPM rotation speed, 2ms spot switching time, beam current 1nA, minimum spot weighting 0.01 MU, energy-layer-switching-time (ELST) from 0.5 to 4s. Results: Compared to IMPT, SPArc delivered less integral dose(−14% lung and −8% oropharynx). For lung case, SPArc reduced 60% of skin max dose, 35% of rib max dose and 15% of lung mean dose. Conformity Index is improved from 7.6(IMPT) to 4.0(SPArc). Compared to Arcmulti-field, SPArc reduced number of energy layers by 61%(276 layers in lung) and 80%(1008 layers in oropharynx) while kept the same robust plan quality. With ELST from 0.5s to 4s, it reduced 55%–60% of Arcmulti-field delivery time for the lung case and 56%–67% for the oropharynx case. Conclusion: SPArc is the first robust and delivery-efficient proton spot-scanning arc therapy technique which could be implemented in routine clinic. For modern proton machine with ELST close

  10. Spot Scanning and Passive Scattering Proton Therapy: Relative Biological Effectiveness and Oxygen Enhancement Ratio in Cultured Cells.

    Science.gov (United States)

    Iwata, Hiromitsu; Ogino, Hiroyuki; Hashimoto, Shingo; Yamada, Maho; Shibata, Hiroki; Yasui, Keisuke; Toshito, Toshiyuki; Omachi, Chihiro; Tatekawa, Kotoha; Manabe, Yoshihiko; Mizoe, Jun-etsu; Shibamoto, Yuta

    2016-05-01

    To determine the relative biological effectiveness (RBE), oxygen enhancement ratio (OER), and contribution of the indirect effect of spot scanning proton beams, passive scattering proton beams, or both in cultured cells in comparison with clinically used photons. The RBE of passive scattering proton beams at the center of the spread-out Bragg peak (SOBP) was determined from dose-survival curves in 4 cell lines using 6-MV X rays as controls. Survival of 2 cell lines after spot scanning and passive scattering proton irradiation was then compared. Biological effects at the distal end region of the SOBP were also investigated. The OER of passive scattering proton beams and 6 MX X rays were investigated in 2 cell lines. The RBE and OER values were estimated at a 10% cell survival level. The maximum degree of protection of radiation effects by dimethyl sulfoxide was determined to estimate the contribution of the indirect effect against DNA damage. All experiments comparing protons and X rays were made under the same biological conditions. The RBE values of passive scattering proton beams in the 4 cell lines examined were 1.01 to 1.22 (average, 1.14) and were almost identical to those of spot scanning beams. Biological effects increased at the distal end of the SOBP. In the 2 cell lines examined, the OER was 2.74 (95% confidence interval, 2.56-2.80) and 3.08 (2.84-3.11), respectively, for X rays, and 2.39 (2.38-2.43) and 2.72 (2.69-2.75), respectively, for protons (Pcells between X rays and protons). The maximum degree of protection was significantly higher for X rays than for proton beams (P<.05). The RBE values of spot scanning and passive scattering proton beams were almost identical. The OER was lower for protons than for X rays. The lower contribution of the indirect effect may partly account for the lower OER of protons. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. SU-E-T-337: Treatment Planning Study of Craniospinal Irradiation with Spot Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Tasson, A; Beltran, C; Laack, N; Childs, S; Tryggestad, E; Whitaker, T

    2014-01-01

    Purpose: To develop a treatment planning technique that achieves optimal robustness against systematic position and range uncertainties, and interfield position errors for craniospinal irradiation (CSI) using spot scanning proton radiotherapy. Methods: Eighteen CSI patients who had previously been treated using photon radiation were used for this study. Eight patients were less than 10 years old. The prescription dose was 23.4Gy in 1.8Gy fractions. Two different field arrangement types were investigated: 1 posterior field per isocenter and 2 posterior oblique fields per isocenter. For each field type, two delivery configurations were used: 5cm bolus attached to the treatment table and a 4.5cm range shifter located inside the nozzle. The target for each plan was the whole brain and thecal sac. For children under the age of 10, all plan types were repeated with an additional dose of 21Gy prescribed to the vertebral bodies. Treatment fields were matched by stepping down the dose in 10% increments over 9cm. Robustness against 3% and 3mm uncertainties, as well as a 3mm inter-field error was analyzed. Dose coverage of the target and critical structure sparing for each plan type will be considered. Ease of planning and treatment delivery was also considered for each plan type. Results: The mean dose volume histograms show that the bolus plan with posterior beams gave the best overall plan, and all proton plans were comparable to or better than the photon plans. The plan type that was the most robust against the imposed uncertainties was also the bolus plan with posterior beams. This is also the plan configuration that is the easiest to deliver and plan. Conclusion: The bolus plan with posterior beams achieved optimal robustness against systematic position and range uncertainties, as well as inter-field position errors

  12. Development of the compact proton beam therapy system dedicated to spot scanning with real-time tumor-tracking technology

    Science.gov (United States)

    Umezawa, Masumi; Fujimoto, Rintaro; Umekawa, Tooru; Fujii, Yuusuke; Takayanagi, Taisuke; Ebina, Futaro; Aoki, Takamichi; Nagamine, Yoshihiko; Matsuda, Koji; Hiramoto, Kazuo; Matsuura, Taeko; Miyamoto, Naoki; Nihongi, Hideaki; Umegaki, Kikuo; Shirato, Hiroki

    2013-04-01

    Hokkaido University and Hitachi Ltd. have started joint development of the Gated Spot Scanning Proton Therapy with Real-Time Tumor-Tracking System by integrating real-time tumor tracking technology (RTRT) and the proton therapy system dedicated to discrete spot scanning techniques under the "Funding Program for World-Leading Innovative R&D on Science and Technology (FIRST Program)". In this development, we have designed the synchrotron-based accelerator system by using the advantages of the spot scanning technique in order to realize a more compact and lower cost proton therapy system than the conventional system. In the gated irradiation, we have focused on the issues to maximize irradiation efficiency and minimize the dose errors caused by organ motion. In order to understand the interplay effect between scanning beam delivery and target motion, we conducted a simulation study. The newly designed system consists of the synchrotron, beam transport system, one compact rotating gantry treatment room with robotic couch, and one experimental room for future research. To improve the irradiation efficiency, the new control function which enables multiple gated irradiations per synchrotron cycle has been applied and its efficacy was confirmed by the irradiation time estimation. As for the interplay effect, we confirmed that the selection of a strict gating width and scan direction enables formation of the uniform dose distribution.

  13. More than 10 years experience of beam monitoring with the Gantry 1 spot scanning proton therapy facility at PSI

    International Nuclear Information System (INIS)

    Lin Shixiong; Boehringer, Terence; Coray, Adolf; Grossmann, Martin; Pedroni, Eros

    2009-01-01

    Purpose: The beam monitoring equipments developed for the first PSI spot scanning proton therapy facility, Gantry 1, have been successfully used for more than 10 years. The purpose of this article is to summarize the author's experience in the beam monitoring technique for dynamic proton scanning. Methods: The spot dose delivery and verification use two independent beam monitoring and computer systems. In this article, the detector construction, electronic system, dosimetry, and quality assurance results are described in detail. The beam flux monitor is calibrated with a Faraday cup. The beam position monitoring is realized by measuring the magnetic fields of deflection magnets with Hall probes before applying the spot and by checking the beam position and width with an ionization strip chamber after the spot delivery. Results: The results of thimble ionization chamber dosimetry measurements are reproducible (with a mean deviation of less than 1% and a standard deviation of 1%). The resolution in the beam position measurement is of the order of a tenth of a millimeter. The tolerance of the beam position delivery and monitoring during scanning is less than 1.5 mm. Conclusions: The experiences gained with the successful operation of Gantry 1 represent a unique and solid background for the development of a new system, Gantry 2, in order to perform new advanced scanning techniques.

  14. More than 10 years experience of beam monitoring with the Gantry 1 spot scanning proton therapy facility at PSI

    Energy Technology Data Exchange (ETDEWEB)

    Lin Shixiong; Boehringer, Terence; Coray, Adolf; Grossmann, Martin; Pedroni, Eros [Center for Proton Therapy, Paul Scherrer Institute, CH-5232 Villigen PSI (Switzerland)

    2009-11-15

    Purpose: The beam monitoring equipments developed for the first PSI spot scanning proton therapy facility, Gantry 1, have been successfully used for more than 10 years. The purpose of this article is to summarize the author's experience in the beam monitoring technique for dynamic proton scanning. Methods: The spot dose delivery and verification use two independent beam monitoring and computer systems. In this article, the detector construction, electronic system, dosimetry, and quality assurance results are described in detail. The beam flux monitor is calibrated with a Faraday cup. The beam position monitoring is realized by measuring the magnetic fields of deflection magnets with Hall probes before applying the spot and by checking the beam position and width with an ionization strip chamber after the spot delivery. Results: The results of thimble ionization chamber dosimetry measurements are reproducible (with a mean deviation of less than 1% and a standard deviation of 1%). The resolution in the beam position measurement is of the order of a tenth of a millimeter. The tolerance of the beam position delivery and monitoring during scanning is less than 1.5 mm. Conclusions: The experiences gained with the successful operation of Gantry 1 represent a unique and solid background for the development of a new system, Gantry 2, in order to perform new advanced scanning techniques.

  15. SU-F-T-169: A Periodic Quality Assurance Program for a Spot-Scanning Proton Treatment Facility

    Energy Technology Data Exchange (ETDEWEB)

    Mundy, D; Tryggestad, E; Beltran, C; Furutani, K; Gilson, G; Ito, S; Johnson, J; Kruse, J; Remmes, N; Tasson, A; Whitaker, T; Herman, M [Mayo Clinic, Rochester, MN (United States)

    2016-06-15

    Purpose: To develop daily and monthly quality assurance (QA) programs in support of a new spot-scanning proton treatment facility using a combination of commercial and custom equipment and software. Emphasis was placed on efficiency and evaluation of key quality parameters. Methods: The daily QA program was developed to test output, spot size and position, proton beam energy, and image guidance using the Sun Nuclear Corporation rf-DQA™3 device and Atlas QA software. The program utilizes standard Atlas linear accelerator tests repurposed for proton measurements and a custom jig for indexing the device to the treatment couch. The monthly QA program was designed to test mechanical performance, image quality, radiation quality, isocenter coincidence, and safety features. Many of these tests are similar to linear accelerator QA counterparts, but many require customized test design and equipment. Coincidence of imaging, laser marker, mechanical, and radiation isocenters, for instance, is verified using a custom film-based device devised and manufactured at our facility. Proton spot size and position as a function of energy are verified using a custom spot pattern incident on film and analysis software developed in-house. More details concerning the equipment and software developed for monthly QA are included in the supporting document. Thresholds for daily and monthly tests were established via perturbation analysis, early experience, and/or proton system specifications and associated acceptance test results. Results: The periodic QA program described here has been in effect for approximately 9 months and has proven efficient and sensitive to sub-clinical variations in treatment delivery characteristics. Conclusion: Tools and professional guidelines for periodic proton system QA are not as well developed as their photon and electron counterparts. The program described here efficiently evaluates key quality parameters and, while specific to the needs of our facility

  16. SU-F-T-169: A Periodic Quality Assurance Program for a Spot-Scanning Proton Treatment Facility

    International Nuclear Information System (INIS)

    Mundy, D; Tryggestad, E; Beltran, C; Furutani, K; Gilson, G; Ito, S; Johnson, J; Kruse, J; Remmes, N; Tasson, A; Whitaker, T; Herman, M

    2016-01-01

    Purpose: To develop daily and monthly quality assurance (QA) programs in support of a new spot-scanning proton treatment facility using a combination of commercial and custom equipment and software. Emphasis was placed on efficiency and evaluation of key quality parameters. Methods: The daily QA program was developed to test output, spot size and position, proton beam energy, and image guidance using the Sun Nuclear Corporation rf-DQA™3 device and Atlas QA software. The program utilizes standard Atlas linear accelerator tests repurposed for proton measurements and a custom jig for indexing the device to the treatment couch. The monthly QA program was designed to test mechanical performance, image quality, radiation quality, isocenter coincidence, and safety features. Many of these tests are similar to linear accelerator QA counterparts, but many require customized test design and equipment. Coincidence of imaging, laser marker, mechanical, and radiation isocenters, for instance, is verified using a custom film-based device devised and manufactured at our facility. Proton spot size and position as a function of energy are verified using a custom spot pattern incident on film and analysis software developed in-house. More details concerning the equipment and software developed for monthly QA are included in the supporting document. Thresholds for daily and monthly tests were established via perturbation analysis, early experience, and/or proton system specifications and associated acceptance test results. Results: The periodic QA program described here has been in effect for approximately 9 months and has proven efficient and sensitive to sub-clinical variations in treatment delivery characteristics. Conclusion: Tools and professional guidelines for periodic proton system QA are not as well developed as their photon and electron counterparts. The program described here efficiently evaluates key quality parameters and, while specific to the needs of our facility

  17. Impact of Spot Size and Beam-Shaping Devices on the Treatment Plan Quality for Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Moteabbed, Maryam, E-mail: mmoteabbed@partners.org; Yock, Torunn I.; Depauw, Nicolas; Madden, Thomas M.; Kooy, Hanne M.; Paganetti, Harald

    2016-05-01

    Purpose: This study aimed to assess the clinical impact of spot size and the addition of apertures and range compensators on the treatment quality of pencil beam scanning (PBS) proton therapy and to define when PBS could improve on passive scattering proton therapy (PSPT). Methods and Materials: The patient cohort included 14 pediatric patients treated with PSPT. Six PBS plans were created and optimized for each patient using 3 spot sizes (∼12-, 5.4-, and 2.5-mm median sigma at isocenter for 90- to 230-MeV range) and adding apertures and compensators to plans with the 2 larger spots. Conformity and homogeneity indices, dose-volume histogram parameters, equivalent uniform dose (EUD), normal tissue complication probability (NTCP), and integral dose were quantified and compared with the respective PSPT plans. Results: The results clearly indicated that PBS with the largest spots does not necessarily offer a dosimetric or clinical advantage over PSPT. With comparable target coverage, the mean dose (D{sub mean}) to healthy organs was on average 6.3% larger than PSPT when using this spot size. However, adding apertures to plans with large spots improved the treatment quality by decreasing the average D{sub mean} and EUD by up to 8.6% and 3.2% of the prescribed dose, respectively. Decreasing the spot size further improved all plans, lowering the average D{sub mean} and EUD by up to 11.6% and 10.9% compared with PSPT, respectively, and eliminated the need for beam-shaping devices. The NTCP decreased with spot size and addition of apertures, with maximum reduction of 5.4% relative to PSPT. Conclusions: The added benefit of using PBS strongly depends on the delivery configurations. Facilities limited to large spot sizes (>∼8 mm median sigma at isocenter) are recommended to use apertures to reduce treatment-related toxicities, at least for complex and/or small tumors.

  18. TU-FG-BRB-12: Real-Time Visualization of Discrete Spot Scanning Proton Therapy Beam for Quality Assurance

    International Nuclear Information System (INIS)

    Matsuzaki, Y; Jenkins, C; Yang, Y; Xing, L; Yoshimura, T; Fujii, Y; Umegaki, K

    2016-01-01

    Purpose: With the growing adoption of proton beam therapy there is an increasing need for effective and user-friendly tools for performing quality assurance (QA) measurements. The speed and versatility of spot-scanning proton beam (PB) therapy systems present unique challenges for traditional QA tools. To address these challenges a proof-of-concept system was developed to visualize, in real-time, the delivery of individual spots from a spot-scanning PB in order to perform QA measurements. Methods: The PB is directed toward a custom phantom with planar faces coated with a radioluminescent phosphor (Gd2O2s:Tb). As the proton beam passes through the phantom visible light is emitted from the coating and collected by a nearby CMOS camera. The images are processed to determine the locations at which the beam impinges on each face of the phantom. By so doing, the location of each beam can be determined relative to the phantom. The cameras are also used to capture images of the laser alignment system. The phantom contains x-ray fiducials so that it can be easily located with kV imagers. Using this data several quality assurance parameters can be evaluated. Results: The proof-of-concept system was able to visualize discrete PB spots with energies ranging from 70 MeV to 220 MeV. Images were obtained with integration times ranging from 20 to 0.019 milliseconds. If not limited by data transmission, this would correspond to a frame rate of 52,000 fps. Such frame rates enabled visualization of individual spots in real time. Spot locations were found to be highly correlated (R"2=0.99) with the nozzle-mounted spot position monitor indicating excellent spot positioning accuracy Conclusion: The system was shown to be capable of imaging individual spots for all clinical beam energies. Future development will focus on extending the image processing software to provide automated results for a variety of QA tests.

  19. TU-FG-BRB-12: Real-Time Visualization of Discrete Spot Scanning Proton Therapy Beam for Quality Assurance

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzaki, Y [Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo, Hokkaido (Japan); Jenkins, C; Yang, Y; Xing, L [Stanford University, Stanford, California (United States); Yoshimura, T; Fujii, Y [Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido (Japan); Umegaki, K [Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Hokkaido (Japan)

    2016-06-15

    Purpose: With the growing adoption of proton beam therapy there is an increasing need for effective and user-friendly tools for performing quality assurance (QA) measurements. The speed and versatility of spot-scanning proton beam (PB) therapy systems present unique challenges for traditional QA tools. To address these challenges a proof-of-concept system was developed to visualize, in real-time, the delivery of individual spots from a spot-scanning PB in order to perform QA measurements. Methods: The PB is directed toward a custom phantom with planar faces coated with a radioluminescent phosphor (Gd2O2s:Tb). As the proton beam passes through the phantom visible light is emitted from the coating and collected by a nearby CMOS camera. The images are processed to determine the locations at which the beam impinges on each face of the phantom. By so doing, the location of each beam can be determined relative to the phantom. The cameras are also used to capture images of the laser alignment system. The phantom contains x-ray fiducials so that it can be easily located with kV imagers. Using this data several quality assurance parameters can be evaluated. Results: The proof-of-concept system was able to visualize discrete PB spots with energies ranging from 70 MeV to 220 MeV. Images were obtained with integration times ranging from 20 to 0.019 milliseconds. If not limited by data transmission, this would correspond to a frame rate of 52,000 fps. Such frame rates enabled visualization of individual spots in real time. Spot locations were found to be highly correlated (R{sup 2}=0.99) with the nozzle-mounted spot position monitor indicating excellent spot positioning accuracy Conclusion: The system was shown to be capable of imaging individual spots for all clinical beam energies. Future development will focus on extending the image processing software to provide automated results for a variety of QA tests.

  20. WE-D-17A-01: A Dynamic Collimation System for Spot Scanned Proton Therapy: Conceptual Overview

    International Nuclear Information System (INIS)

    Hyer, D; Hill, P; Wang, D; Smith, B; Flynn, R

    2014-01-01

    Purpose: In the absence of a collimation system, the lateral penumbra in pencil beam scanning (PBS) proton therapy delivered at low energies is highly dependent on the spot size. This dependence, coupled with the fact that spot sizes increase with decreasing energy, reduces the benefit of the PBS technique for treating shallow tumors such as those found in the head and neck region. In order to overcome this limitation, a dynamic collimation system (DCS) was developed for sharpening the lateral penumbra of low energy proton therapy dose distributions delivered by PBS. Methods: The proposed DCS consists of two pairs of orthogonal trimmer blades which intercept the edges of the proton beam near the target edge in the beam's eye view. Each trimmer blade is capable of rapid motion in the direction perpendicular to the central beam axis by means of a linear motor, with maximum velocity and acceleration of 2.5 m/s and 19.6 m/s 2 , respectively. Two-dimensional treatment plans were created both with and without the DCS for in-air spot sizes (σ-air) of 3, 5, 7, and 9 mm, representing a wide array of clinically available equipment. Results: In its current configuration, the snout of the DCS has outer dimensions of 22.6 × 22.6 cm 2 and is capable of delivering a minimum treatment field size of 15 × 15 cm 2 . Using off the shelf components, the constructed system would weigh less than 20 kg. The treatment plans created with the DCS yielded a reduction in the mean dose to normal tissue surrounding the target of 26.2–40.6% for spot sizes of 3–9 mm, respectively. Conclusion: The DCS can be integrated with current or future proton therapy equipment and we believe it will serve as a useful tool to further improve the next generation of proton therapy delivery

  1. Technical Note: Validation of halo modeling for proton pencil beam spot scanning using a quality assurance test pattern

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Liyong, E-mail: linl@uphs.upenn.edu; Huang, Sheng; Kang, Minglei; Solberg, Timothy D.; McDonough, James E.; Ainsley, Christopher G. [Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, Pennsylvania 19104 (United States)

    2015-09-15

    Purpose: The purpose of this paper is to demonstrate the utility of a comprehensive test pattern in validating calculation models that include the halo component (low-dose tails) of proton pencil beam scanning (PBS) spots. Such a pattern has been used previously for quality assurance purposes to assess spot shape, position, and dose. Methods: In this study, a scintillation detector was used to measure the test pattern in air at isocenter for two proton beam energies (115 and 225 MeV) of two IBA universal nozzles (UN #1 and UN #2). Planar measurements were compared with calculated dose distributions based on the weighted superposition of location-independent (UN #1) or location-dependent (UN #2) spot profiles, previously measured using a pair-magnification method and between two nozzles. Results: Including the halo component below 1% of the central dose is shown to improve the gamma-map comparison between calculation and measurement from 94.9% to 98.4% using 2 mm/2% criteria for the 115 MeV proton beam of UN #1. In contrast, including the halo component below 1% of the central dose does not improve the gamma agreement for the 115 MeV proton beam of UN #2, due to the cutoff of the halo component at off-axis locations. When location-dependent spot profiles are used for calculation instead of spot profiles at central axis, the gamma agreement is improved from 98.0% to 99.5% using 2 mm/2% criteria. The two nozzles clearly have different characteristics, as a direct comparison of measured data shows a passing rate of 89.7% for the 115 MeV proton beam. At 225 MeV, the corresponding gamma comparisons agree better between measurement and calculation, and between measurements in the two nozzles. Conclusions: In addition to confirming the primary component of individual PBS spot profiles, a comprehensive test pattern is useful for the validation of the halo component at off-axis locations, especially for low energy protons.

  2. Spot Scanning Proton Therapy for Malignancies of the Base of Skull: Treatment Planning, Acute Toxicities, and Preliminary Clinical Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Grosshans, David R., E-mail: dgrossha@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhu, X. Ronald; Melancon, Adam [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Poenisch, Falk; Palmer, Matthew [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); McAleer, Mary Frances; McGovern, Susan L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gillin, Michael [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); DeMonte, Franco [Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Eric L. [Department of Radiation Oncology, University of Southern California Keck School of Medicine, Los Angeles, California (United States); Brown, Paul D.; Mahajan, Anita [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2014-11-01

    Purpose: To describe treatment planning techniques and early clinical outcomes in patients treated with spot scanning proton therapy for chordoma or chondrosarcoma of the skull base. Methods and Materials: From June 2010 through August 2011, 15 patients were treated with spot scanning proton therapy for chordoma (n=10) or chondrosarcoma (n=5) at a single institution. Toxicity was prospectively evaluated and scored weekly and at all follow-up visits according to Common Terminology Criteria for Adverse Events, version 3.0. Treatment planning techniques and dosimetric data were recorded and compared with those of passive scattering plans created with clinically applicable dose constraints. Results: Ten patients were treated with single-field-optimized scanning beam plans and 5 with multifield-optimized intensity modulated proton therapy. All but 2 patients received a simultaneous integrated boost as well. The mean prescribed radiation doses were 69.8 Gy (relative biological effectiveness [RBE]; range, 68-70 Gy [RBE]) for chordoma and 68.4 Gy (RBE) (range, 66-70) for chondrosarcoma. In comparison with passive scattering plans, spot scanning plans demonstrated improved high-dose conformality and sparing of temporal lobes and brainstem. Clinically, the most common acute toxicities included fatigue (grade 2 for 2 patients, grade 1 for 8 patients) and nausea (grade 2 for 2 patients, grade 1 for 6 patients). No toxicities of grades 3 to 5 were recorded. At a median follow-up time of 27 months (range, 13-42 months), 1 patient had experienced local recurrence and a second developed distant metastatic disease. Two patients had magnetic resonance imaging-documented temporal lobe changes, and a third patient developed facial numbness. No other subacute or late effects were recorded. Conclusions: In comparison to passive scattering, treatment plans for spot scanning proton therapy displayed improved high-dose conformality. Clinically, the treatment was well tolerated, and

  3. Impact of Spot Size and Beam-Shaping Devices on the Treatment Plan Quality for Pencil Beam Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Moteabbed, Maryam; Yock, Torunn I.; Depauw, Nicolas; Madden, Thomas M.; Kooy, Hanne M.; Paganetti, Harald

    2016-01-01

    Purpose: This study aimed to assess the clinical impact of spot size and the addition of apertures and range compensators on the treatment quality of pencil beam scanning (PBS) proton therapy and to define when PBS could improve on passive scattering proton therapy (PSPT). Methods and Materials: The patient cohort included 14 pediatric patients treated with PSPT. Six PBS plans were created and optimized for each patient using 3 spot sizes (∼12-, 5.4-, and 2.5-mm median sigma at isocenter for 90- to 230-MeV range) and adding apertures and compensators to plans with the 2 larger spots. Conformity and homogeneity indices, dose-volume histogram parameters, equivalent uniform dose (EUD), normal tissue complication probability (NTCP), and integral dose were quantified and compared with the respective PSPT plans. Results: The results clearly indicated that PBS with the largest spots does not necessarily offer a dosimetric or clinical advantage over PSPT. With comparable target coverage, the mean dose (D_m_e_a_n) to healthy organs was on average 6.3% larger than PSPT when using this spot size. However, adding apertures to plans with large spots improved the treatment quality by decreasing the average D_m_e_a_n and EUD by up to 8.6% and 3.2% of the prescribed dose, respectively. Decreasing the spot size further improved all plans, lowering the average D_m_e_a_n and EUD by up to 11.6% and 10.9% compared with PSPT, respectively, and eliminated the need for beam-shaping devices. The NTCP decreased with spot size and addition of apertures, with maximum reduction of 5.4% relative to PSPT. Conclusions: The added benefit of using PBS strongly depends on the delivery configurations. Facilities limited to large spot sizes (>∼8 mm median sigma at isocenter) are recommended to use apertures to reduce treatment-related toxicities, at least for complex and/or small tumors.

  4. Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy

    Directory of Open Access Journals (Sweden)

    X. Ronald. Zhu

    2015-04-01

    Full Text Available An intensity-modulated proton therapy (IMPT patient-specific quality assurance (PSQA program based on measurement alone can be very time consuming due to the highly modulated dose distributions of IMPT fields. Incorporating independent dose calculation and treatment log file analysis could reduce the time required for measurements. In this article, we summarize our effort to develop an efficient and effective PSQA program that consists of three components: measurements, independent dose calculation, and analysis of patient-specific treatment delivery log files. Measurements included two-dimensional (2D measurements using an ionization chamber array detector for each field delivered at the planned gantry angles with the electronic medical record (EMR system in the QA mode and the accelerator control system (ACS in the treatment mode, and additional measurements at depths for each field with the ACS in physics mode and without the EMR system. Dose distributions for each field in a water phantom were calculated independently using a recently developed in-house pencil beam algorithm and compared with those obtained using the treatment planning system (TPS. The treatment log file for each field was analyzed in terms of deviations in delivered spot positions from their planned positions using various statistical methods. Using this improved PSQA program, we were able to verify the integrity of the data transfer from the TPS to the EMR to the ACS, the dose calculation of the TPS, and the treatment delivery, including the dose delivered and spot positions. On the basis of this experience, we estimate that the in-room measurement time required for each complex IMPT case (e.g., a patient receiving bilateral IMPT for head and neck cancer is less than 1 h using the improved PSQA program. Our experience demonstrates that it is possible to develop an efficient and effective PSQA program for IMPT with the equipment and resources available in the clinic.

  5. Spot-scanning proton therapy for malignant soft tissue tumors in childhood: First experiences at the Paul Scherrer Institute

    International Nuclear Information System (INIS)

    Timmermann, Beate; Schuck, Andreas; Niggli, Felix; Weiss, Markus; Lomax, Antony Jonathan; Pedroni, Eros; Coray, Adolf; Jermann, Martin; Rutz, Hans Peter; Goitein, Gudrun

    2007-01-01

    Purpose: Radiotherapy plays a major role in the treatment strategy of childhood sarcomas. Consequences of treatment are likely to affect the survivor's quality of life significantly. We investigated the feasibility of spot-scanning proton therapy (PT) for soft tissue tumors in childhood. Methods and Materials: Sixteen children with soft tissue sarcomas were included. Median age at PT was 3.3 years. In 10 children the tumor histology was embryonal rhabdomyosarcoma. All tumors were located in the head or neck, parameningeal, or paraspinal, or pelvic region. In the majority of children, the tumor was initially unresectable (Intergroup Rhabdomyosarcoma Study [IRS] Group III in 75%). In 50% of children the tumors exceeded 5 cm. Fourteen children had chemotherapy before and during PT. Median total dose of radiotherapy was 50 cobalt Gray equivalent (CGE). All 16 children were treated with spot-scanning proton therapy at the Paul Scherrer Institute, and in 3 children the PT was intensity-modulated (IMPT). Results: After median follow-up of 1.5 years, local control was achieved in 12 children. Four children failed locally, 1 at the border of the radiation field and 3 within the field. All 4 children died of tumor recurrence. All 4 showed unfavorable characteristic either of site or histopathology of the tumor. Acute toxicity was low, with Grade 3 or 4 side effects according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG/EORTC) criteria occurring in the bone marrow only. Conclusions: Proton therapy was feasible and well tolerated. Early local control rates are comparable to those being achieved after conventional radiotherapy. For investigations on late effect, longer follow-up is needed

  6. Dosimetry intercomparison of four proton therapy institutions in Germany employing spot scanning

    Energy Technology Data Exchange (ETDEWEB)

    Baeumer, Christian; Koska, Benjamin [Westdeutsches Protonentherapiezentrum, Essen (Germany); Ackermann, Benjamin; Latzel, Harald [Heidelberger Ionenstrahl-Therapiezentrum, Heidelberg (Germany); Heidelberg Institute for Radiation Oncology (Germany); Hillbrand, Martin; Kaiser, Franz-Joachim [Rinecker Proton Therapy Center, Muenchen (Germany); Luehr, Armin [German Cancer Consortium (DKTK), Heidelberg (Germany); Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology; German Cancer Research Center (DKFZ), Heidelberg (Germany); Menkel, Stefan [Technische Univ. Dresden (Germany). Dept. of Radiation Oncology; Timmermann, Beate [Westdeutsches Protonentherapiezentrum, Essen (Germany); German Cancer Consortium (DKTK), Heidelberg (Germany); Essen Univ. Hospital (Germany). West German Cancer Center (WTZ)

    2017-08-01

    To verify the consistency of dose and range measurement in an interinstitution comparison among proton therapy institutions in Germany which use the pencil-beam scanning technique. Following a peer-to-peer approach absorbed dose and range have been intercompared in several missions at two hosting centers with two or three visiting physics teams of participating institutions using their own dosimetry equipment. A meta-analysis has been performed integrating the results of the individual missions. Dose has been determined with ionization chambers according to the dosimetry protocol IAEA TRS-398. For determination of the depth of the distal 80% dose the teams used either a scanning water phantom, a variable water column or a multi-layer ionization chamber. The systematic deviation between measured doses of the participating institutions is less than 1%. Ranges differ systematically less than 0.4 mm. The match of measured dose and range is better than expected from the respective uncertainties. As all physics teams agree on the assessment of absorbed dose and range, an important prerequisite for a start of joint clinical studies is fulfilled.

  7. SU-E-T-127: Application of TG-119 for Evaluation of Proton Spot Scanning Based Planning and Treatment Delivery

    Energy Technology Data Exchange (ETDEWEB)

    Saini, J; Cao, N; Wong, T [SCCA Proton Therapy, A Procure Center, Seattle, WA (United States); Bowen, S; Bloch, C [University of Washington, School of Medicine, Seattle, WA (United States)

    2015-06-15

    Purpose: The clinical test cases presented in AAPM TG-119 are used to evaluate the accuracy of treatment planning and delivery through spot scanning proton beams. Methods: An IBA spot scanning delivery system has been commissioned to be used with the RayStation treatment planning system. Various test cases provided in TG-119 were used for planning and delivery verification. The CT dataset and structures as provided by TG-119 were imported into a mock patient. The plans were optimized using the multi field optimization (MFO) to achieve the desired goals. The planner was given the flexibility to achieve the given dose-volume goals by creating appropriate objectives and constraints. Beams were delivered to a phantom and measurements were performed at multiple depths using the MatrixxPT detector array. The analyses were performed on beam by beam basis and quantified using the gamma index. A tolerance of 3%/3 mm in 2D was used for gamma index analysis along with dose threshold of 10%. Results: The clinical goals for targets and critical structures were met or improved for all cases except the C-Shape target with difficult constraints. The minimum gamma index using the 3%/3mm as a criterion is 93.3% for one of the planes measured for C-Shape target. Using 2%/2mm as a criterion, the minimum gamma index drops to 70%. Only Prostate target has all the planes above >90% pass using the 2%/2mm criterion. Conclusion: The overall accuracy of the treatment planning and delivery is deemed clinically acceptable. The test cases with highly modulated beams can have steep gradients in the dose profiles that can reduce the gamma index pass rate. Gamma analysis based on 3D data may be needed for routine use of 2%/2mm criterion. In addition, improvements in modelling of spot profiles in dose engine may be required for further improving the gamma index pass rate.

  8. SU-E-T-321: The Effects of a Dynamic Collimation System On Proton Pencil Beams to Improve Lateral Tissue Sparing in Spot Scanned Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hill, P; Wang, D; Flynn, R; Hyer, D [University Of Iowa, Iowa City, IA (United States)

    2014-06-01

    Purpose: To evaluate the lateral beam penumbra in pencil beam scanning proton therapy delivered using a dynamic collimator device capable of trimming a portion of the primary beam in close proximity to the patient. Methods: Monte Carlo simulations of pencil beams were performed using MCNPX. Each simulation transported a 125 MeV proton pencil beam through a range shifter, past acollimator, and into a water phantom. Two parameters were varied among the simulations, the source beam size (sigma in air from 3 to 9 mm), and the position of the edge of the collimator (placed from 0 to 30 mm from the central axis of the beam). Proton flux was tallied at the phantom surface to determine the effective beam sizefor all combinations of source beam size and collimator edge position. Results: Quantifying beam size at the phantom surface provides a useful measure tocompare performance among varying source beam sizes and collimation conditions. For arelatively large source beam size (9 mm) entering the range shifter, sigma at thesurface was found to be 10 mm without collimation versus 4 mm with collimation. Additionally, sigma at the surface achievable with collimation was found to be smallerthan for any uncollimated beam, even for very small source beam sizes. Finally, thelateral penumbra achievable with collimation was determined to be largely independentof the source beam size. Conclusion: Collimation can significantly reduce proton pencil beam lateral penumbra.Given the known dosimetric disadvantages resulting from large beam spot sizes,employing a dynamic collimation system can significantly improve lateral tissuesparing in spot-scanned dose distributions.

  9. Quality of Life and Toxicity From Passively Scattered and Spot-Scanning Proton Beam Therapy for Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Pugh, Thomas J.; Munsell, Mark F.; Choi, Seungtaek; Nguyen, Quyhn Nhu; Mathai, Benson; Zhu, X. Ron; Sahoo, Narayan; Gillin, Michael; Johnson, Jennifer L.; Amos, Richard A.; Dong, Lei; Mahmood, Usama; Kuban, Deborah A.; Frank, Steven J.; Hoffman, Karen E.; McGuire, Sean E.; Lee, Andrew K.

    2013-01-01

    Purpose: To report quality of life (QOL)/toxicity in men treated with proton beam therapy for localized prostate cancer and to compare outcomes between passively scattered proton therapy (PSPT) and spot-scanning proton therapy (SSPT). Methods and Materials: Men with localized prostate cancer enrolled on a prospective QOL protocol with a minimum of 2 years' follow-up were reviewed. Comparative groups were defined by technique (PSPT vs SSPT). Patients completed Expanded Prostate Cancer Index Composite questionnaires at baseline and every 3-6 months after proton beam therapy. Clinically meaningful differences in QOL were defined as ≥0.5 × baseline standard deviation. The cumulative incidence of modified Radiation Therapy Oncology Group grade ≥2 gastrointestinal (GI) or genitourinary (GU) toxicity and argon plasma coagulation were determined by the Kaplan-Meier method. Results: A total of 226 men received PSPT, and 65 received SSPT. Both PSPT and SSPT resulted in statistically significant changes in sexual, urinary, and bowel Expanded Prostate Cancer Index Composite summary scores. Only bowel summary, function, and bother resulted in clinically meaningful decrements beyond treatment completion. The decrement in bowel QOL persisted through 24-month follow-up. Cumulative grade ≥2 GU and GI toxicity at 24 months were 13.4% and 9.6%, respectively. There was 1 grade 3 GI toxicity (PSPT group) and no other grade ≥3 GI or GU toxicity. Argon plasma coagulation application was infrequent (PSPT 4.4% vs SSPT 1.5%; P=.21). No statistically significant differences were appreciated between PSPT and SSPT regarding toxicity or QOL. Conclusion: Both PSPT and SSPT confer low rates of grade ≥2 GI or GU toxicity, with preservation of meaningful sexual and urinary QOL at 24 months. A modest, yet clinically meaningful, decrement in bowel QOL was seen throughout follow-up. No toxicity or QOL differences between PSPT and SSPT were identified. Long-term comparative results in a

  10. An Analysis of Plan Robustness for Esophageal Tumors: Comparing Volumetric Modulated Arc Therapy Plans and Spot Scanning Proton Planning

    International Nuclear Information System (INIS)

    Warren, Samantha; Partridge, Mike; Bolsi, Alessandra; Lomax, Anthony J.; Hurt, Chris; Crosby, Thomas; Hawkins, Maria A.

    2016-01-01

    Purpose: Planning studies to compare x-ray and proton techniques and to select the most suitable technique for each patient have been hampered by the nonequivalence of several aspects of treatment planning and delivery. A fair comparison should compare similarly advanced delivery techniques from current clinical practice and also assess the robustness of each technique. The present study therefore compared volumetric modulated arc therapy (VMAT) and single-field optimization (SFO) spot scanning proton therapy plans created using a simultaneous integrated boost (SIB) for dose escalation in midesophageal cancer and analyzed the effect of setup and range uncertainties on these plans. Methods and Materials: For 21 patients, SIB plans with a physical dose prescription of 2 Gy or 2.5 Gy/fraction in 25 fractions to planning target volume (PTV)_5_0_G_y or PTV_6_2_._5_G_y (primary tumor with 0.5 cm margins) were created and evaluated for robustness to random setup errors and proton range errors. Dose–volume metrics were compared for the optimal and uncertainty plans, with P<.05 (Wilcoxon) considered significant. Results: SFO reduced the mean lung dose by 51.4% (range 35.1%-76.1%) and the mean heart dose by 40.9% (range 15.0%-57.4%) compared with VMAT. Proton plan robustness to a 3.5% range error was acceptable. For all patients, the clinical target volume D_9_8 was 95.0% to 100.4% of the prescribed dose and gross tumor volume (GTV) D_9_8 was 98.8% to 101%. Setup error robustness was patient anatomy dependent, and the potential minimum dose per fraction was always lower with SFO than with VMAT. The clinical target volume D_9_8 was lower by 0.6% to 7.8% of the prescribed dose, and the GTV D_9_8 was lower by 0.3% to 2.2% of the prescribed GTV dose. Conclusions: The SFO plans achieved significant sparing of normal tissue compared with the VMAT plans for midesophageal cancer. The target dose coverage in the SIB proton plans was less robust to random setup errors and might be

  11. An Analysis of Plan Robustness for Esophageal Tumors: Comparing Volumetric Modulated Arc Therapy Plans and Spot Scanning Proton Planning

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Samantha, E-mail: samantha.warren@oncology.ox.ac.uk [Cancer Research UK/Medical Research Council Oxford Institute for Radiation Oncology, Gray Laboratories, University of Oxford, Oxford (United Kingdom); Partridge, Mike [Cancer Research UK/Medical Research Council Oxford Institute for Radiation Oncology, Gray Laboratories, University of Oxford, Oxford (United Kingdom); Bolsi, Alessandra; Lomax, Anthony J. [Centre for Proton Therapy, Paul Scherrer Institute, Villigen (Switzerland); Hurt, Chris [Wales Cancer Trials Unit, School of Medicine, Heath Park, Cardiff (United Kingdom); Crosby, Thomas [Velindre Cancer Centre, Velindre Hospital, Cardiff (United Kingdom); Hawkins, Maria A. [Cancer Research UK/Medical Research Council Oxford Institute for Radiation Oncology, Gray Laboratories, University of Oxford, Oxford (United Kingdom)

    2016-05-01

    Purpose: Planning studies to compare x-ray and proton techniques and to select the most suitable technique for each patient have been hampered by the nonequivalence of several aspects of treatment planning and delivery. A fair comparison should compare similarly advanced delivery techniques from current clinical practice and also assess the robustness of each technique. The present study therefore compared volumetric modulated arc therapy (VMAT) and single-field optimization (SFO) spot scanning proton therapy plans created using a simultaneous integrated boost (SIB) for dose escalation in midesophageal cancer and analyzed the effect of setup and range uncertainties on these plans. Methods and Materials: For 21 patients, SIB plans with a physical dose prescription of 2 Gy or 2.5 Gy/fraction in 25 fractions to planning target volume (PTV){sub 50Gy} or PTV{sub 62.5Gy} (primary tumor with 0.5 cm margins) were created and evaluated for robustness to random setup errors and proton range errors. Dose–volume metrics were compared for the optimal and uncertainty plans, with P<.05 (Wilcoxon) considered significant. Results: SFO reduced the mean lung dose by 51.4% (range 35.1%-76.1%) and the mean heart dose by 40.9% (range 15.0%-57.4%) compared with VMAT. Proton plan robustness to a 3.5% range error was acceptable. For all patients, the clinical target volume D{sub 98} was 95.0% to 100.4% of the prescribed dose and gross tumor volume (GTV) D{sub 98} was 98.8% to 101%. Setup error robustness was patient anatomy dependent, and the potential minimum dose per fraction was always lower with SFO than with VMAT. The clinical target volume D{sub 98} was lower by 0.6% to 7.8% of the prescribed dose, and the GTV D{sub 98} was lower by 0.3% to 2.2% of the prescribed GTV dose. Conclusions: The SFO plans achieved significant sparing of normal tissue compared with the VMAT plans for midesophageal cancer. The target dose coverage in the SIB proton plans was less robust to random setup

  12. Implication of spot position error on plan quality and patient safety in pencil-beam-scanning proton therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Juan; Beltran, Chris J., E-mail: beltran.chris@mayo.edu; Herman, Michael G. [Division of Medical Physics, Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota 55905 (United States)

    2014-08-15

    Purpose: To quantitatively and systematically assess dosimetric effects induced by spot positioning error as a function of spot spacing (SS) on intensity-modulated proton therapy (IMPT) plan quality and to facilitate evaluation of safety tolerance limits on spot position. Methods: Spot position errors (PE) ranging from 1 to 2 mm were simulated. Simple plans were created on a water phantom, and IMPT plans were calculated on two pediatric patients with a brain tumor of 28 and 3 cc, respectively, using a commercial planning system. For the phantom, a uniform dose was delivered to targets located at different depths from 10 to 20 cm with various field sizes from 2{sup 2} to 15{sup 2} cm{sup 2}. Two nominal spot sizes, 4.0 and 6.6 mm of 1 σ in water at isocenter, were used for treatment planning. The SS ranged from 0.5 σ to 1.5 σ, which is 2–6 mm for the small spot size and 3.3–9.9 mm for the large spot size. Various perturbation scenarios of a single spot error and systematic and random multiple spot errors were studied. To quantify the dosimetric effects, percent dose error (PDE) depth profiles and the value of percent dose error at the maximum dose difference (PDE [ΔDmax]) were used for evaluation. Results: A pair of hot and cold spots was created per spot shift. PDE[ΔDmax] is found to be a complex function of PE, SS, spot size, depth, and global spot distribution that can be well defined in simple models. For volumetric targets, the PDE [ΔDmax] is not noticeably affected by the change of field size or target volume within the studied ranges. In general, reducing SS decreased the dose error. For the facility studied, given a single spot error with a PE of 1.2 mm and for both spot sizes, a SS of 1σ resulted in a 2% maximum dose error; a SS larger than 1.25 σ substantially increased the dose error and its sensitivity to PE. A similar trend was observed in multiple spot errors (both systematic and random errors). Systematic PE can lead to noticeable hot

  13. SU-E-T-286: Dose Verification of Spot-Scanning Proton Beam Using GafChromic EBT3 Film

    Energy Technology Data Exchange (ETDEWEB)

    Chen, C; Tang, S; Mah, D [ProCure Proton Therapy Center, Somerset, NJ (United States); Chan, M [Memorial Sloan-Kettering Cancer Center, Basking Ridge, NJ (United States)

    2015-06-15

    Purpose: Dose verification of spot-scanning proton pencil beam is performed via planar dose measurements at several depths using an ionization-chamber array, requiring repeat irradiations of each field for each depth. Here we investigate film dosimetry which has two advantages: higher resolution and efficiency from one-shot irradiation for multiple depths. Methods: Film calibration was performed using an EBT3 film at 20-cm depth of Plastic Water (CIRS, Norfolk, VA) exposed by a 10-level step wedge on a Proteus Plus proton system (IBA, Belgium). The calibration doses ranged from 25–250 cGy(RBE) for proton energies of 170–200 MeV. A uniform 1000 cm{sup 3} dose cube and a clinical prostate combined with seminal-vesicle and pelvic-nodes plan were used for this study. All treatment plans were generated in the RayStation (RaySearch Lab, Sweden). The planar doses at different depths for both cases were measured with film using triple-channel dosimetry and the MatriXX PT (IBA Dosimetry, Germany). The Gamma passing rates, dose-difference maps, and profiles of 2D planar doses measured with EBT3 film and MatriXX, versus treatment planning system (TPS) calculations were analyzed and compared using the FilmQA Pro (Ashland Inc., Bridgewater, NJ). Results: The EBT3 film measurement results matched well with the TPS calculation data with an average passing rate >95% for 2%/2mm and are comparable with the MatriXX measurements (0.7%, 1.8%, 3.8% mean differences corresponding to 3%/3mm, 3%/2mm, 2%/2mm, respectively). Overall passing rates for EBT3 films appear higher than those with MatriXX detectors. Conclusion: The energy dependence of the film response could be minimized by calibration using proton beam with mixed energies. The greater efficiency of the dose verification using GafChromic EBT3 results in a potential cost trade-off between room capacity and film cost. EBT3 film may offer distinct advantages in highly intensity-modulated fields due to its higher resolution

  14. Optimization of GATE and PHITS Monte Carlo code parameters for spot scanning proton beam based on simulation with FLUKA general-purpose code

    Energy Technology Data Exchange (ETDEWEB)

    Kurosu, Keita [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202 (United States); Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871 (Japan); Department of Radiology, Osaka University Hospital, Suita, Osaka 565-0871 (Japan); Das, Indra J. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202 (United States); Moskvin, Vadim P. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202 (United States); Department of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105 (United States)

    2016-01-15

    Spot scanning, owing to its superior dose-shaping capability, provides unsurpassed dose conformity, in particular for complex targets. However, the robustness of the delivered dose distribution and prescription has to be verified. Monte Carlo (MC) simulation has the potential to generate significant advantages for high-precise particle therapy, especially for medium containing inhomogeneities. However, the inherent choice of computational parameters in MC simulation codes of GATE, PHITS and FLUKA that is observed for uniform scanning proton beam needs to be evaluated. This means that the relationship between the effect of input parameters and the calculation results should be carefully scrutinized. The objective of this study was, therefore, to determine the optimal parameters for the spot scanning proton beam for both GATE and PHITS codes by using data from FLUKA simulation as a reference. The proton beam scanning system of the Indiana University Health Proton Therapy Center was modeled in FLUKA, and the geometry was subsequently and identically transferred to GATE and PHITS. Although the beam transport is managed by spot scanning system, the spot location is always set at the center of a water phantom of 600 × 600 × 300 mm{sup 3}, which is placed after the treatment nozzle. The percentage depth dose (PDD) is computed along the central axis using 0.5 × 0.5 × 0.5 mm{sup 3} voxels in the water phantom. The PDDs and the proton ranges obtained with several computational parameters are then compared to those of FLUKA, and optimal parameters are determined from the accuracy of the proton range, suppressed dose deviation, and computational time minimization. Our results indicate that the optimized parameters are different from those for uniform scanning, suggesting that the gold standard for setting computational parameters for any proton therapy application cannot be determined consistently since the impact of setting parameters depends on the proton irradiation

  15. Optimization of GATE and PHITS Monte Carlo code parameters for spot scanning proton beam based on simulation with FLUKA general-purpose code

    International Nuclear Information System (INIS)

    Kurosu, Keita; Das, Indra J.; Moskvin, Vadim P.

    2016-01-01

    Spot scanning, owing to its superior dose-shaping capability, provides unsurpassed dose conformity, in particular for complex targets. However, the robustness of the delivered dose distribution and prescription has to be verified. Monte Carlo (MC) simulation has the potential to generate significant advantages for high-precise particle therapy, especially for medium containing inhomogeneities. However, the inherent choice of computational parameters in MC simulation codes of GATE, PHITS and FLUKA that is observed for uniform scanning proton beam needs to be evaluated. This means that the relationship between the effect of input parameters and the calculation results should be carefully scrutinized. The objective of this study was, therefore, to determine the optimal parameters for the spot scanning proton beam for both GATE and PHITS codes by using data from FLUKA simulation as a reference. The proton beam scanning system of the Indiana University Health Proton Therapy Center was modeled in FLUKA, and the geometry was subsequently and identically transferred to GATE and PHITS. Although the beam transport is managed by spot scanning system, the spot location is always set at the center of a water phantom of 600 × 600 × 300 mm 3 , which is placed after the treatment nozzle. The percentage depth dose (PDD) is computed along the central axis using 0.5 × 0.5 × 0.5 mm 3 voxels in the water phantom. The PDDs and the proton ranges obtained with several computational parameters are then compared to those of FLUKA, and optimal parameters are determined from the accuracy of the proton range, suppressed dose deviation, and computational time minimization. Our results indicate that the optimized parameters are different from those for uniform scanning, suggesting that the gold standard for setting computational parameters for any proton therapy application cannot be determined consistently since the impact of setting parameters depends on the proton irradiation technique

  16. TH-C-BRD-07: Minimizing Dose Uncertainty for Spot Scanning Beam Proton Therapy of Moving Tumor with Optimization of Delivery Sequence

    International Nuclear Information System (INIS)

    Li, H; Zhang, X; Zhu, X; Li, Y

    2014-01-01

    Purpose: Intensity modulated proton therapy (IMPT) has been shown to be able to reduce dose to normal tissue compared to intensity modulated photon radio-therapy (IMRT), and has been implemented for selected lung cancer patients. However, respiratory motion-induced dose uncertainty remain one of the major concerns for the radiotherapy of lung cancer, and the utility of IMPT for lung patients was limited because of the proton dose uncertainty induced by motion. Strategies such as repainting and tumor tracking have been proposed and studied but repainting could result in unacceptable long delivery time and tracking is not yet clinically available. We propose a novel delivery strategy for spot scanning proton beam therapy. Method: The effective number of delivery (END) for each spot position in a treatment plan was calculated based on the parameters of the delivery system, including time required for each spot, spot size and energy. The dose uncertainty was then calculated with an analytical formula. The spot delivery sequence was optimized to maximize END and minimize the dose uncertainty. 2D Measurements with a detector array on a 1D moving platform were performed to validate the calculated results. Results: 143 2D measurements on a moving platform were performed for different delivery sequences of a single layer uniform pattern. The measured dose uncertainty is a strong function of the delivery sequence, the worst delivery sequence results in dose error up to 70% while the optimized delivery sequence results in dose error of <5%. END vs. measured dose uncertainty follows the analytical formula. Conclusion: With optimized delivery sequence, it is feasible to minimize the dose uncertainty due to motion in spot scanning proton therapy

  17. Spot-scanning beam proton therapy vs intensity-modulated radiation therapy for ipsilateral head and neck malignancies: A treatment planning comparison

    International Nuclear Information System (INIS)

    Kandula, Shravan; Zhu, Xiaorong; Garden, Adam S.; Gillin, Michael; Rosenthal, David I.; Ang, Kie-Kian; Mohan, Radhe; Amin, Mayankkumar V.; Garcia, John A.; Wu, Richard; Sahoo, Narayan; Frank, Steven J.

    2013-01-01

    Radiation therapy for head and neck malignancies can have side effects that impede quality of life. Theoretically, proton therapy can reduce treatment-related morbidity by minimizing the dose to critical normal tissues. We evaluated the feasibility of spot-scanning proton therapy for head and neck malignancies and compared dosimetry between those plans and intensity-modulated radiation therapy (IMRT) plans. Plans from 5 patients who had undergone IMRT for primary tumors of the head and neck were used for planning proton therapy. Both sets of plans were prepared using computed tomography (CT) scans with the goals of achieving 100% of the prescribed dose to the clinical target volume (CTV) and 95% to the planning TV (PTV) while maximizing conformity to the PTV. Dose-volume histograms were generated and compared, as were conformity indexes (CIs) to the PTVs and mean doses to the organs at risk (OARs). Both modalities in all cases achieved 100% of the dose to the CTV and 95% to the PTV. Mean PTV CIs were comparable (0.371 IMRT, 0.374 protons, p = 0.953). Mean doses were significantly lower in the proton plans to the contralateral submandibular (638.7 cGy IMRT, 4.3 cGy protons, p = 0.002) and parotid (533.3 cGy IMRT, 48.5 cGy protons, p = 0.003) glands; oral cavity (1760.4 cGy IMRT, 458.9 cGy protons, p = 0.003); spinal cord (2112.4 cGy IMRT, 249.2 cGy protons, p = 0.002); and brainstem (1553.52 cGy IMRT, 166.2 cGy protons, p = 0.005). Proton plans also produced lower maximum doses to the spinal cord (3692.1 cGy IMRT, 2014.8 cGy protons, p = 0.034) and brainstem (3412.1 cGy IMRT, 1387.6 cGy protons, p = 0.005). Normal tissue V 10 , V 30 , and V 50 values were also significantly lower in the proton plans. We conclude that spot-scanning proton therapy can significantly reduce the integral dose to head and neck critical structures. Prospective studies are underway to determine if this reduced dose translates to improved quality of life

  18. Dosimetric evaluation of a commercial proton spot scanning Monte-Carlo dose algorithm: comparisons against measurements and simulations.

    Science.gov (United States)

    Saini, Jatinder; Maes, Dominic; Egan, Alexander; Bowen, Stephen R; St James, Sara; Janson, Martin; Wong, Tony; Bloch, Charles

    2017-09-12

    RaySearch Americas Inc. (NY) has introduced a commercial Monte Carlo dose algorithm (RS-MC) for routine clinical use in proton spot scanning. In this report, we provide a validation of this algorithm against phantom measurements and simulations in the GATE software package. We also compared the performance of the RayStation analytical algorithm (RS-PBA) against the RS-MC algorithm. A beam model (G-MC) for a spot scanning gantry at our proton center was implemented in the GATE software package. The model was validated against measurements in a water phantom and was used for benchmarking the RS-MC. Validation of the RS-MC was performed in a water phantom by measuring depth doses and profiles for three spread-out Bragg peak (SOBP) beams with normal incidence, an SOBP with oblique incidence, and an SOBP with a range shifter and large air gap. The RS-MC was also validated against measurements and simulations in heterogeneous phantoms created by placing lung or bone slabs in a water phantom. Lateral dose profiles near the distal end of the beam were measured with a microDiamond detector and compared to the G-MC simulations, RS-MC and RS-PBA. Finally, the RS-MC and RS-PBA were validated against measured dose distributions in an Alderson-Rando (AR) phantom. Measurements were made using Gafchromic film in the AR phantom and compared to doses using the RS-PBA and RS-MC algorithms. For SOBP depth doses in a water phantom, all three algorithms matched the measurements to within  ±3% at all points and a range within 1 mm. The RS-PBA algorithm showed up to a 10% difference in dose at the entrance for the beam with a range shifter and  >30 cm air gap, while the RS-MC and G-MC were always within 3% of the measurement. For an oblique beam incident at 45°, the RS-PBA algorithm showed up to 6% local dose differences and broadening of distal fall-off by 5 mm. Both the RS-MC and G-MC accurately predicted the depth dose to within  ±3% and distal fall-off to within 2

  19. Dosimetric evaluation of a commercial proton spot scanning Monte-Carlo dose algorithm: comparisons against measurements and simulations

    Science.gov (United States)

    Saini, Jatinder; Maes, Dominic; Egan, Alexander; Bowen, Stephen R.; St. James, Sara; Janson, Martin; Wong, Tony; Bloch, Charles

    2017-10-01

    RaySearch Americas Inc. (NY) has introduced a commercial Monte Carlo dose algorithm (RS-MC) for routine clinical use in proton spot scanning. In this report, we provide a validation of this algorithm against phantom measurements and simulations in the GATE software package. We also compared the performance of the RayStation analytical algorithm (RS-PBA) against the RS-MC algorithm. A beam model (G-MC) for a spot scanning gantry at our proton center was implemented in the GATE software package. The model was validated against measurements in a water phantom and was used for benchmarking the RS-MC. Validation of the RS-MC was performed in a water phantom by measuring depth doses and profiles for three spread-out Bragg peak (SOBP) beams with normal incidence, an SOBP with oblique incidence, and an SOBP with a range shifter and large air gap. The RS-MC was also validated against measurements and simulations in heterogeneous phantoms created by placing lung or bone slabs in a water phantom. Lateral dose profiles near the distal end of the beam were measured with a microDiamond detector and compared to the G-MC simulations, RS-MC and RS-PBA. Finally, the RS-MC and RS-PBA were validated against measured dose distributions in an Alderson-Rando (AR) phantom. Measurements were made using Gafchromic film in the AR phantom and compared to doses using the RS-PBA and RS-MC algorithms. For SOBP depth doses in a water phantom, all three algorithms matched the measurements to within  ±3% at all points and a range within 1 mm. The RS-PBA algorithm showed up to a 10% difference in dose at the entrance for the beam with a range shifter and  >30 cm air gap, while the RS-MC and G-MC were always within 3% of the measurement. For an oblique beam incident at 45°, the RS-PBA algorithm showed up to 6% local dose differences and broadening of distal fall-off by 5 mm. Both the RS-MC and G-MC accurately predicted the depth dose to within  ±3% and distal fall-off to within 2

  20. Whole-pelvic radiotherapy with spot-scanning proton beams for uterine cervical cancer: a planning study

    International Nuclear Information System (INIS)

    Hashimoto, Shingo; Shibamoto, Yuta; Iwata, Hiromitsu; Ogino, Hiroyuki; Shibata, Hiroki; Toshito, Toshiyuki; Sugie, Chikao; Mizoe, Jun-etsu

    2016-01-01

    The aim of this study was to compare the dosimetric parameters of whole-pelvic radiotherapy (WPRT) for cervical cancer among plans involving 3D conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), or spot-scanning proton therapy (SSPT). The dose distributions of 3D-CRT-, IMRT-, and SSPT-based WPRT plans were compared in 10 patients with cervical cancer. All of the patients were treated with a prescribed dose of 50.4 Gy in 1.8-Gy daily fractions, and all of the plans involved the same planning target volume (PTV) constrictions. A 3D-CRT plan involving a four-field box, an IMRT plan involving seven coplanar fields, and an SSPT plan involving four fields were created. The median PTV D95% did not differ between the 3D-CRT, IMRT and SSPT plans. The median conformity index 95% and homogeneity index of the IMRT and SSPT were better than those of the 3D-CRT. The homogeneity index of the SSPT was better than that of the IMRT. SSPT resulted in lower median V20 values for the bladder wall, small intestine, colon, bilateral femoral heads, skin, and pelvic bone than IMRT. Comparing the Dmean values, SSPT spared the small intestine, colon, bilateral femoral heads, skin and pelvic bone to a greater extent than the other modalities. SSPT can reduce the irradiated volume of the organs at risk compared with 3D-CRT and IMRT, while maintaining excellent PTV coverage. Further investigations of SSPT are warranted to assess its role in the treatment of cervical cancer.

  1. Spot Scanning-Based Proton Therapy for Intracranial Meningioma: Long-Term Results From the Paul Scherrer Institute

    International Nuclear Information System (INIS)

    Weber, Damien C.; Schneider, Ralf; Goitein, Gudrun; Koch, Tamara; Ares, Carmen; Geismar, Jan H.; Schertler, Andreas; Bolsi, Alessandra; Hug, Eugen B.

    2012-01-01

    Background: To assess the long-term clinical results of spot scanning proton therapy (PT) in the treatment of intracranial meningiomas. Patients and Methods: Thirty-nine patients with meningioma (histologically proven 34/39) were treated with PT between July 1997 and January 2010. Thirty-two (82.1%) patients were treated as primary treatment (exclusive PT, n = 8; postoperative PT, n = 24). Mean age was 48.3 ± 17.9 years and 32 (82.1%) patients had skull base lesions. For patients undergoing surgery, 24 patients had a diagnosis of World Health Organization (WHO) Grade I and 10 of a WHO Grade II/III meningioma, respectively. The female-to-male ratio was 3.3. The median administered dose was 56.0 Gy (relative biologic effectiveness [RBE]) (range, 52.2–66.6) at 1.8–2.0 Gy (RBE) per fraction. Gross tumor volume (GTV) ranged from 0.76 to 546.5 cm 3 (median, 21.5). Late toxicity was assessed according to Common Terminology Criteria for Adverse Events version 3.0. Mean follow-up time was 62.0 months and all patients were followed for >6 months. Results: Six patients presented with tumor recurrence and 6 patients died during follow-up, of which 4 of tumor progression. Five-year actuarial local control and overall survival rates were 84.8% and 81.8%, respectively, for the entire cohort and 100% for benign histology. Cumulative 5-year Grade ≥3 late toxicity-free survival was 84.5%. On univariate analysis, LC was negatively influenced by WHO grade (p = 0.001), GTV (p = 0.013), and male gender (p = 0.058). Conclusions: PT is a safe and effective treatment for patients with untreated, recurrent, or incompletely resected intracranial meningiomas. WHO grade and tumor volume was an adverse prognostic factor for local control.

  2. Spot Scanning-Based Proton Therapy for Intracranial Meningioma: Long-Term Results From the Paul Scherrer Institute

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Damien C., E-mail: damien.weber@unige.ch [Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Schneider, Ralf; Goitein, Gudrun; Koch, Tamara; Ares, Carmen; Geismar, Jan H.; Schertler, Andreas; Bolsi, Alessandra; Hug, Eugen B. [Center for Proton Therapy, Paul Scherrer Institute, Viligen (Switzerland)

    2012-07-01

    Background: To assess the long-term clinical results of spot scanning proton therapy (PT) in the treatment of intracranial meningiomas. Patients and Methods: Thirty-nine patients with meningioma (histologically proven 34/39) were treated with PT between July 1997 and January 2010. Thirty-two (82.1%) patients were treated as primary treatment (exclusive PT, n = 8; postoperative PT, n = 24). Mean age was 48.3 {+-} 17.9 years and 32 (82.1%) patients had skull base lesions. For patients undergoing surgery, 24 patients had a diagnosis of World Health Organization (WHO) Grade I and 10 of a WHO Grade II/III meningioma, respectively. The female-to-male ratio was 3.3. The median administered dose was 56.0 Gy (relative biologic effectiveness [RBE]) (range, 52.2-66.6) at 1.8-2.0 Gy (RBE) per fraction. Gross tumor volume (GTV) ranged from 0.76 to 546.5 cm{sup 3} (median, 21.5). Late toxicity was assessed according to Common Terminology Criteria for Adverse Events version 3.0. Mean follow-up time was 62.0 months and all patients were followed for >6 months. Results: Six patients presented with tumor recurrence and 6 patients died during follow-up, of which 4 of tumor progression. Five-year actuarial local control and overall survival rates were 84.8% and 81.8%, respectively, for the entire cohort and 100% for benign histology. Cumulative 5-year Grade {>=}3 late toxicity-free survival was 84.5%. On univariate analysis, LC was negatively influenced by WHO grade (p = 0.001), GTV (p = 0.013), and male gender (p = 0.058). Conclusions: PT is a safe and effective treatment for patients with untreated, recurrent, or incompletely resected intracranial meningiomas. WHO grade and tumor volume was an adverse prognostic factor for local control.

  3. SU-D-BRE-06: Modeling the Dosimetric Effects of Volumetric and Layer-Based Repainting Strategies in Spot Scanning Proton Treatment Plans

    International Nuclear Information System (INIS)

    Johnson, J E; Beltran, C; Herman, M G; Kruse, J J

    2014-01-01

    Purpose: To compare multiple repainting techniques as strategies for mitigating the interplay effect in free-breathing, spot scanning proton plans. Methods: An analytic routine modeled three-dimensional dose distributions of pencil-beam proton plans delivered to a moving target. The interplay effect was studied in subsequent calculations by modeling proton delivery from a clinical synchrotron based spot scanning system and respiratory target motion, patterned from surrogate breathing traces from clinical 4DCT scans and normalized to nominal 0.5 and 1 cm amplitudes. Two distinct repainting strategies were modeled. In idealized volumetric repainting, the plan is divided up and delivered multiple times successively, with each instance only delivering a fraction of the total MU. Maximum-MU repainting involves delivering a fixed number of MU per spot and repeating a given energy layer until the prescribed MU are reached. For each of 13 patient breathing traces, the dose was computed for up to four volumetric repaints and an array of maximum-MU values. Delivery strategies were inter-compared based on target coverage, dose homogeneity, and delivery time. Results: Increasing levels of repainting generally improved plan quality and reduced dosimetric variability at the expense of longer delivery time. Motion orthogonal to the scan direction yielded substantially greater dose deviations than motion parallel to the scan direction. For a fixed delivery time, maximum-MU repainting was most effective relative to idealized volumetric repainting at small maximum-MU values. For 1 cm amplitude motion orthogonal to the scan direction, the average homogeneity metric (D5 – D95)[%] of 23.4% was reduced to 7.6% with a 168 s delivery using volumetric repainting compared with 8.7% in 157.2 s for maximum-MU repainting. The associated static target homogeneity metric was 2.5%. Conclusion: Maximum-MU repainting can provide a reasonably effective alternative to volumetric repainting for

  4. SU-G-TeP1-04: Deriving Spot Shape Criteria for Proton Pencil Beam Scanning

    International Nuclear Information System (INIS)

    Wulff, J; Huggins, A

    2016-01-01

    Purpose: The shape of a single beam in proton PBS influences the resulting dose distribution. Spot profiles are modelled as two-dimensional Gaussian (single/ double) distributions in treatment planning systems (TPS). Impact of slight deviations from an ideal Gaussian on resulting dose distributions is typically assumed to be small due to alleviation by multiple Coulomb scattering (MCS) in tissue and superposition of many spots. Quantitative limits are however not clear per se. Methods: A set of 1250 deliberately deformed profiles with sigma=4 mm for a Gaussian fit were constructed. Profiles and fit were normalized to the same area, resembling output calibration in the TPS. Depth-dependent MCS was considered. The deviation between deformed and ideal profiles was characterized by root-mean-squared deviation (RMSD), skewness/ kurtosis (SK) and full-width at different percentage of maximum (FWxM). The profiles were convolved with different fluence patterns (regular/ random) resulting in hypothetical dose distributions. The resulting deviations were analyzed by applying a gamma-test. Results were compared to measured spot profiles. Results: A clear correlation between pass-rate and profile metrics could be determined. The largest impact occurred for a regular fluence-pattern with increasing distance between single spots, followed by a random distribution of spot weights. The results are strongly dependent on gamma-analysis dose and distance levels. Pass-rates of >95% at 2%/2 mm and 40 mm depth (=70 MeV) could only be achieved for RMSD<10%, deviation in FWxM at 20% and root of quadratic sum of SK <0.8. As expected the results improve for larger depths. The trends were well resembled for measured spot profiles. Conclusion: All measured profiles from ProBeam sites passed the criteria. Given the fact, that beam-line tuning can result shape distortions, the derived criteria represent a useful QA tool for commissioning and design of future beam-line optics.

  5. Small bowel toxicity after high dose spot scanning-based proton beam therapy for paraspinal/retroperitoneal neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, R.A.; Albertini, F.; Koch, T.; Ares, C.; Lomax, A.; Goitein, G. [Paul Scherrer Institute PSI, Villigen (Switzerland). Center for Proton Therapy; Vitolo, V. [Fondazione CNAO, Pavia (Italy); Hug, E.B. [Paul Scherrer Institute PSI, Villigen (Switzerland). Center for Proton Therapy; ProCure Proton Therapy Centers, New York, NY (United States)

    2013-12-15

    Purpose: Mesenchymal tumours require high-dose radiation therapy (RT). Small bowel (SB) dose constraints have historically limited dose delivery to paraspinal and retroperitoneal targets. This retrospective study correlated SB dose-volume histograms with side-effects after proton radiation therapy (PT). Patients and methods: Between 1997 and 2008, 31 patients (mean age 52.1 years) underwent spot scanning-based PT for paraspinal/retroperitoneal chordomas (81 %), sarcomas (16 %) and meningiom (3 %). Mean total prescribed dose was 72.3 Gy (relative biologic effectiveness, RBE) delivered in 1.8-2 Gy (RBE) fractions. Mean follow-up was 3.8 years. Based on the pretreatment planning CT, SB dose distributions were reanalysed. Results: Planning target volume (PTV) was defined as gross tumour volume (GTV) plus 5-7 mm margins. Mean PTV was 560.22 cm{sup 3}. A mean of 93.2 % of the PTV was covered by at least 90 % of the prescribed dose. SB volumes (cm{sup 3}) receiving doses of 5, 20, 30, 40, 50, 60, 70, 75 and 80 Gy (RBE) were calculated to give V5, V20, V30, V40, V50, V60, V70, V75 and V80 respectively. In 7/31 patients, PT was accomplished without any significant SB irradiation (V5 = 0). In 24/31 patients, mean maximum dose (Dmax) to SB was 64.1 Gy (RBE). Despite target doses of > 70 Gy (RBE), SB received > 50 and > 60 Gy (RBE) in only 61 and 54 % of patients, respectively. Mean SB volumes (cm{sup 3}) covered by different dose levels (Gy, RBE) were: V20 (n = 24): 45.1, V50 (n = 19): 17.7, V60 (n = 17): 7.6 and V70 (n = 12): 2.4. No acute toxicity {>=} grade 2 or late SB sequelae were observed. Conclusion: Small noncircumferential volumes of SB tolerated doses in excess of 60 Gy (RBE) without any clinically-significant late adverse effects. This small retrospective study has limited statistical power but encourages further efforts with higher patient numbers to define and establish high-dose threshold models for SB toxicity in modern radiation oncology. (orig.)

  6. Integrated beam orientation and scanning-spot optimization in intensity-modulated proton therapy for brain and unilateral head and neck tumors.

    Science.gov (United States)

    Gu, Wenbo; O'Connor, Daniel; Nguyen, Dan; Yu, Victoria Y; Ruan, Dan; Dong, Lei; Sheng, Ke

    2018-04-01

    Intensity-Modulated Proton Therapy (IMPT) is the state-of-the-art method of delivering proton radiotherapy. Previous research has been mainly focused on optimization of scanning spots with manually selected beam angles. Due to the computational complexity, the potential benefit of simultaneously optimizing beam orientations and spot pattern could not be realized. In this study, we developed a novel integrated beam orientation optimization (BOO) and scanning-spot optimization algorithm for intensity-modulated proton therapy (IMPT). A brain chordoma and three unilateral head-and-neck patients with a maximal target size of 112.49 cm 3 were included in this study. A total number of 1162 noncoplanar candidate beams evenly distributed across 4π steradians were included in the optimization. For each candidate beam, the pencil-beam doses of all scanning spots covering the PTV and a margin were calculated. The beam angle selection and spot intensity optimization problem was formulated to include three terms: a dose fidelity term to penalize the deviation of PTV and OAR doses from ideal dose distribution; an L1-norm sparsity term to reduce the number of active spots and improve delivery efficiency; a group sparsity term to control the number of active beams between 2 and 4. For the group sparsity term, convex L2,1-norm and nonconvex L2,1/2-norm were tested. For the dose fidelity term, both quadratic function and linearized equivalent uniform dose (LEUD) cost function were implemented. The optimization problem was solved using the Fast Iterative Shrinkage-Thresholding Algorithm (FISTA). The IMPT BOO method was tested on three head-and-neck patients and one skull base chordoma patient. The results were compared with IMPT plans created using column generation selected beams or manually selected beams. The L2,1-norm plan selected spatially aggregated beams, indicating potential degeneracy using this norm. L2,1/2-norm was able to select spatially separated beams and achieve

  7. SU-E-T-189: Commission Range Shifter On a Spot Scanning Proton System Using Raystation Treatment Planning System

    International Nuclear Information System (INIS)

    Ding, X; Wu, H; Rosen, L

    2015-01-01

    Purpose: To treat superficial target e.g. chest wall, head&neck or cranial cases, we commissioned two range shifter(RS) in Raystation4.0 with 7.37cm(RS1) and 4.1cm(RS2) Water Equivalent Thickness(WET) respectively. However, current beam model has limitations due to the secondary scattered proton. This study provides a detailed and critical commission data and provides suggestions for using RS in clinic. Methods: RS’ WET was verified by Multi-Layer Ionization Chamber from 120MeV to 226.7MeV before TPS modeling. Spot characteristics were measured using 2D scintillate detector at ISO with different air gap. A 8×8×10cm3 cube is created in 8cm depth of water to verify the absolute dose accuracy. Plans were created with different air gap using both RS. Absolute dose verification was measured along the central axis from distal end to surface using PPC05. 10 clinical RS2 plans were measured using MatriXXPT in 3 planes (proximal, distal and midSOBP). Results: RS material’s proton stopping power is energy dependent(from 70MeV to 226.7MeV) ranging from 7.42 to 7.31cm and from 4.10 to 4.03cm respectively. We chose 7.37cm (RS1) and 4.10cm (RS2) to favor the low and median proton energy. With different air gap(3cm to 32cm), spot size expands from 3.2mm to 5.5mm(RS1) and from 3.1mm to 4.1mm(RS2) respectively(226.7MeV in air, 1-sigma). For the absolute dose verification, the larger air gap and shallower depth causes larger discrepancy between TPS and measurements. All 10 clinical plans with 5–10cm air gap passed gamma index 95% with 3%/3mm criteria and outputs differences were within 3%. Conclusion: We strongly recommend each institution to verify the WET independently and choose the value to fit the clinical needs. To minimize the output difference in Raystation4.0 while avoid potential collision to the patient, we recommend to use 5–10cm air gap to minimize the output difference within 2% and preferably use RS with smaller WET if possible

  8. SU-E-T-266: Development of Evaluation System of Optimal Synchrotron Controlling Parameter for Spot Scanning Proton Therapy with Multiple Gate Irradiations in One Operation Cycle

    International Nuclear Information System (INIS)

    Yamada, T; Fujii, Y; Miyamoto, N; Matsuura, T; Takao, S; Matsuzaki, Y; Koyano, H; Shirato, H; Nihongi, H; Umezawa, M; Matsuda, K; Umegaki, K

    2015-01-01

    Purpose: We have developed a gated spot scanning proton beam therapy system with real-time tumor-tracking. This system has the ability of multiple-gated irradiation in a single synchrotron operation cycle controlling the wait-time for consecutive gate signals during a flat-top phase so that the decrease in irradiation efficiency induced by irregular variation of gate signal is reduced. Our previous studies have shown that a 200 ms wait-time is appropriate to increase the average irradiation efficiency, but the optimal wait-time can vary patient by patient and day by day. In this research, we have developed an evaluation system of the optimal wait-time in each irradiation based on the log data of the real-time-image gated proton beam therapy (RGPT) system. Methods: The developed system consists of logger for operation of RGPT system and software for evaluation of optimal wait-time. The logger records timing of gate on/off, timing and the dose of delivered beam spots, beam energy and timing of X-ray irradiation. The evaluation software calculates irradiation time in the case of different wait-time by simulating the multiple-gated irradiation operation using several timing information. Actual data preserved in the log data are used for gate on and off time, spot irradiation time, and time moving to the next spot. Design values are used for the acceleration and deceleration times. We applied this system to a patient treated with the RGPT system. Results: The evaluation system found the optimal wait-time of 390 ms that reduced the irradiation time by about 10 %. The irradiation time with actual wait-time used in treatment was reproduced with accuracy of 0.2 ms. Conclusion: For spot scanning proton therapy system with multiple-gated irradiation in one synchrotron operation cycle, an evaluation system of the optimal wait-time in each irradiation based on log data has been developed. Funding Support: Japan Society for the Promotion of Science (JSPS) through the FIRST

  9. SU-F-T-189: Dosimetric Comparison of Spot-Scanning Proton Therapy Techniques for Liver Tumors Close to the Skin Surface

    International Nuclear Information System (INIS)

    Takao, S; Matsuzaki, Y; Matsuura, T; Umegaki, K; Fujii, Y; Fujii, T; Katoh, N; Shimizu, S; Shirato, H

    2016-01-01

    Purpose: Spot-scanning technique has been utilized to achieve conformal dose distribution to large and complicated tumors. This technique generally does not require patient-specific devices such as aperture and compensator. The commercially available spot-scanning proton therapy (SSPT) systems, however, cannot deliver proton beams to the region shallower than 4 g/cm2. Therefore some range compensation device is required to treat superficial tumors with SSPT. This study shows dosimetric comparison of the following treatment techniques: (i) with a tabletop bolus, (ii) with a nozzle-mounted applicator, and (iii) without any devices and using intensity-modulated proton therapy (IMPT) technique. Methods: The applicator composed of a combination of a mini-ridge filter and a range shifter has been manufactured by Hitachi, Ltd., and the tabletop bolus was made by .decimal, Inc. Both devices have been clinically implemented in our facility. Three patients with liver tumors close to the skin surface were examined in this study. Each treatment plan was optimized so that the prescription dose of 76 Gy(RBE) or 66 Gy(RBE) would be delivered to 99% of the clinical target volume in 20 fractions. Three beams were used for tabletop bolus plan and IMPT plan, whereas two beams were used in the applicator plan because the gantry angle available was limited due to potential collision to patient and couch. The normal liver, colon, and skin were considered as organs at risk (OARs). Results: The target heterogeneity index (HI = D_5/D_9_5) was 1.03 on average in each planning technique. The mean dose to the normal liver was considerably less than 20 Gy(RBE) in all cases. The dose to the skin could be reduced by 20 Gy(RBE) on average in the IMPT plan compared to the applicator plan. Conclusion: It has been confirmed that all treatment techniques met the dosimetric criteria for the OARs and could be implemented clinically.

  10. SU-F-T-189: Dosimetric Comparison of Spot-Scanning Proton Therapy Techniques for Liver Tumors Close to the Skin Surface

    Energy Technology Data Exchange (ETDEWEB)

    Takao, S; Matsuzaki, Y [Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo, Hokkaido (Japan); Matsuura, T; Umegaki, K [Faculty of Engineering, Hokkaido University, Sapporo, Hokkaido (Japan); Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Hokkaido (Japan); Fujii, Y; Fujii, T [Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido (Japan); Katoh, N [Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Hokkaido (Japan); Shimizu, S; Shirato, H [Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Hokkaido (Japan); Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido (Japan)

    2016-06-15

    Purpose: Spot-scanning technique has been utilized to achieve conformal dose distribution to large and complicated tumors. This technique generally does not require patient-specific devices such as aperture and compensator. The commercially available spot-scanning proton therapy (SSPT) systems, however, cannot deliver proton beams to the region shallower than 4 g/cm2. Therefore some range compensation device is required to treat superficial tumors with SSPT. This study shows dosimetric comparison of the following treatment techniques: (i) with a tabletop bolus, (ii) with a nozzle-mounted applicator, and (iii) without any devices and using intensity-modulated proton therapy (IMPT) technique. Methods: The applicator composed of a combination of a mini-ridge filter and a range shifter has been manufactured by Hitachi, Ltd., and the tabletop bolus was made by .decimal, Inc. Both devices have been clinically implemented in our facility. Three patients with liver tumors close to the skin surface were examined in this study. Each treatment plan was optimized so that the prescription dose of 76 Gy(RBE) or 66 Gy(RBE) would be delivered to 99% of the clinical target volume in 20 fractions. Three beams were used for tabletop bolus plan and IMPT plan, whereas two beams were used in the applicator plan because the gantry angle available was limited due to potential collision to patient and couch. The normal liver, colon, and skin were considered as organs at risk (OARs). Results: The target heterogeneity index (HI = D{sub 5}/D{sub 95}) was 1.03 on average in each planning technique. The mean dose to the normal liver was considerably less than 20 Gy(RBE) in all cases. The dose to the skin could be reduced by 20 Gy(RBE) on average in the IMPT plan compared to the applicator plan. Conclusion: It has been confirmed that all treatment techniques met the dosimetric criteria for the OARs and could be implemented clinically.

  11. Effectiveness and Safety of Spot Scanning Proton Radiation Therapy for Chordomas and Chondrosarcomas of the Skull Base: First Long-Term Report

    International Nuclear Information System (INIS)

    Ares, Carmen; Hug, Eugen B.; Lomax, Antony J.; Bolsi, Alessandra; Timmermann, Beate; Rutz, Hans Peter; Schuller, Jan C.; Pedroni, Eros; Goitein, Gudrun

    2009-01-01

    Purpose: To evaluate effectiveness and safety of spot-scanning-based proton radiotherapy (PT) in skull-base chordomas and chondrosarcomas. Methods and Materials: Between October 1998 and November 2005, 64 patients with skull-base chordomas (n = 42) and chondrosarcomas (n = 22) were treated at Paul Scherrer Institute with PT using spot-scanning technique. Median total dose for chordomas was 73.5 Gy(RBE) and 68.4 Gy(RBE) for chondrosarcomas at 1.8-2.0 Gy(RBE) dose per fraction. Local control (LC), disease specific survival (DSS), and overall survival (OS) rates were calculated. Toxicity was assessed according to CTCAE, v. 3.0. Results: Mean follow-up period was 38 months (range, 14-92 months). Five patients with chordoma and one patient with chondrosarcoma experienced local recurrence. Actuarial 5-year LC rates were 81% for chordomas and 94% for chondrosarcomas. Brainstem compression at the time of PT (p = 0.007) and gross tumor volume >25 mL (p = 0.03) were associated with lower LC rates. Five years rates of DSS and OS were 81% and 62% for chordomas and 100% and 91% for chondrosarcomas, respectively. High-grade late toxicity consisted of one patient with Grade 3 and one patient with Grade 4 unilateral optic neuropathy, and two patients with Grade 3 central nervous system necrosis. No patient experienced brainstem toxicity. Actuarial 5-year freedom from high-grade toxicity was 94%. Conclusions: Our data indicate safety and efficacy of spot-scanning based PT for skull-base chordomas and chondrosarcomas. With target definition, dose prescription and normal organ tolerance levels similar to passive-scattering based PT series, complication-free, tumor control and survival rates are at present comparable.

  12. Comparison of two methods for minimizing the effect of delayed charge on the dose delivered with a synchrotron based discrete spot scanning proton beam.

    Science.gov (United States)

    Whitaker, Thomas J; Beltran, Chris; Tryggestad, Erik; Bues, Martin; Kruse, Jon J; Remmes, Nicholas B; Tasson, Alexandria; Herman, Michael G

    2014-08-01

    Delayed charge is a small amount of charge that is delivered to the patient after the planned irradiation is halted, which may degrade the quality of the treatment by delivering unwarranted dose to the patient. This study compares two methods for minimizing the effect of delayed charge on the dose delivered with a synchrotron based discrete spot scanning proton beam. The delivery of several treatment plans was simulated by applying a normally distributed value of delayed charge, with a mean of 0.001(SD 0.00025) MU, to each spot. Two correction methods were used to account for the delayed charge. Method one (CM1), which is in active clinical use, accounts for the delayed charge by adjusting the MU of the current spot based on the cumulative MU. Method two (CM2) in addition reduces the planned MU by a predicted value. Every fraction of a treatment was simulated using each method and then recomputed in the treatment planning system. The dose difference between the original plan and the sum of the simulated fractions was evaluated. Both methods were tested in a water phantom with a single beam and simple target geometry. Two separate phantom tests were performed. In one test the dose per fraction was varied from 0.5 to 2 Gy using 25 fractions per plan. In the other test the number fractions were varied from 1 to 25, using 2 Gy per fraction. Three patient plans were used to determine the effect of delayed charge on the delivered dose under realistic clinical conditions. The order of spot delivery using CM1 was investigated by randomly selecting the starting spot for each layer, and by alternating per layer the starting spot from first to last. Only discrete spot scanning was considered in this study. Using the phantom setup and varying the dose per fraction, the maximum dose difference for each plan of 25 fractions was 0.37-0.39 Gy and 0.03-0.05 Gy for CM1 and CM2, respectively. While varying the total number of fractions, the maximum dose difference increased at a rate

  13. Comparison of two methods for minimizing the effect of delayed charge on the dose delivered with a synchrotron based discrete spot scanning proton beam

    International Nuclear Information System (INIS)

    Whitaker, Thomas J.; Beltran, Chris; Tryggestad, Erik; Kruse, Jon J.; Remmes, Nicholas B.; Tasson, Alexandria; Herman, Michael G.; Bues, Martin

    2014-01-01

    Purpose: Delayed charge is a small amount of charge that is delivered to the patient after the planned irradiation is halted, which may degrade the quality of the treatment by delivering unwarranted dose to the patient. This study compares two methods for minimizing the effect of delayed charge on the dose delivered with a synchrotron based discrete spot scanning proton beam. Methods: The delivery of several treatment plans was simulated by applying a normally distributed value of delayed charge, with a mean of 0.001(SD 0.00025) MU, to each spot. Two correction methods were used to account for the delayed charge. Method one (CM1), which is in active clinical use, accounts for the delayed charge by adjusting the MU of the current spot based on the cumulative MU. Method two (CM2) in addition reduces the planned MU by a predicted value. Every fraction of a treatment was simulated using each method and then recomputed in the treatment planning system. The dose difference between the original plan and the sum of the simulated fractions was evaluated. Both methods were tested in a water phantom with a single beam and simple target geometry. Two separate phantom tests were performed. In one test the dose per fraction was varied from 0.5 to 2 Gy using 25 fractions per plan. In the other test the number fractions were varied from 1 to 25, using 2 Gy per fraction. Three patient plans were used to determine the effect of delayed charge on the delivered dose under realistic clinical conditions. The order of spot delivery using CM1 was investigated by randomly selecting the starting spot for each layer, and by alternating per layer the starting spot from first to last. Only discrete spot scanning was considered in this study. Results: Using the phantom setup and varying the dose per fraction, the maximum dose difference for each plan of 25 fractions was 0.37–0.39 Gy and 0.03–0.05 Gy for CM1 and CM2, respectively. While varying the total number of fractions, the maximum dose

  14. Spot-Scanning Proton Radiation Therapy for Pediatric Chordoma and Chondrosarcoma: Clinical Outcome of 26 Patients Treated at Paul Scherrer Institute

    Energy Technology Data Exchange (ETDEWEB)

    Rombi, Barbara [Center for Proton Therapy, Paul Scherrer Institute, Villigen (Switzerland); ATreP (Provincial Agency for Proton Therapy), Trento (Italy); Ares, Carmen, E-mail: carmen.ares@psi.ch [Center for Proton Therapy, Paul Scherrer Institute, Villigen (Switzerland); Hug, Eugen B. [Center for Proton Therapy, Paul Scherrer Institute, Villigen (Switzerland); ProCure Proton Therapy Center, Somerset, New Jersey (United States); Schneider, Ralf; Goitein, Gudrun; Staab, Adrian; Albertini, Francesca; Bolsi, Alessandra; Lomax, Antony J. [Center for Proton Therapy, Paul Scherrer Institute, Villigen (Switzerland); Timmermann, Beate [Center for Proton Therapy, Paul Scherrer Institute, Villigen (Switzerland); WestGerman Proton Therapy Center Essen (Germany)

    2013-07-01

    Purpose: To evaluate the clinical results of fractionated spot-scanning proton radiation therapy (PT) in 26 pediatric patients treated at Paul Scherrer Institute for chordoma (CH) or chondrosarcoma (CS) of the skull base or axial skeleton. Methods and Materials: Between June 2000 and June 2010, 19 CH and 7 CS patients with tumors originating from the skull base (17) and the axial skeleton (9) were treated with PT. Mean age at the time of PT was 13.2 years. The mean prescribed dose was 74 Gy (relative biological effectiveness [RBE]) for CH and 66 Gy (RBE) for CS, at a dose of 1.8-2.0 Gy (RBE) per fraction. Results: Mean follow-up was 46 months. Actuarial 5-year local control (LC) rates were 81% for CH and 80% for CS. Actuarial 5-year overall survival (OS) was 89% for CH and 75% for CS. Two CH patients had local failures: one is alive with evidence of disease, while the other patient succumbed to local recurrence in the surgical pathway. One CS patient died of local progression of the disease. No high-grade late toxicities were observed. Conclusions: Spot-scanning PT for pediatric CH and CS patients resulted in excellent clinical outcomes with acceptable rates of late toxicity. Longer follow-up time and larger cohort are needed to fully assess tumor control and late effects of treatment.

  15. Technical Note: A treatment plan comparison between dynamic collimation and a fixed aperture during spot scanning proton therapy for brain treatment

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Blake, E-mail: bsmith34@wisc.edu; Gelover, Edgar; Moignier, Alexandra; Wang, Dongxu; Flynn, Ryan T.; Hyer, Daniel E. [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Lin, Liyong; Kirk, Maura; Solberg, Tim [Department of Radiation Oncology, University of Pennsylvania, TRC 2 West, 3400 Civic Center Boulevard, Philadelphia, Pennsylvania 19104 (United States)

    2016-08-15

    Purpose: To quantitatively assess the advantages of energy-layer specific dynamic collimation system (DCS) versus a per-field fixed aperture for spot scanning proton therapy (SSPT). Methods: Five brain cancer patients previously planned and treated with SSPT were replanned using an in-house treatment planning system capable of modeling collimated and uncollimated proton beamlets. The uncollimated plans, which served as a baseline for comparison, reproduced the target coverage and organ-at-risk sparing of the clinically delivered plans. The collimator opening for the fixed aperture-based plans was determined from the combined cross sections of the target in the beam’s eye view over all energy layers which included an additional margin equivalent to the maximum beamlet displacement for the respective energy of that energy layer. The DCS-based plans were created by selecting appropriate collimator positions for each row of beam spots during a Raster-style scanning pattern which were optimized to maximize the dose contributions to the target and limited the dose delivered to adjacent normal tissue. Results: The reduction of mean dose to normal tissue adjacent to the target, as defined by a 10 mm ring surrounding the target, averaged 13.65% (range: 11.8%–16.9%) and 5.18% (2.9%–7.1%) for the DCS and fixed aperture plans, respectively. The conformity index, as defined by the ratio of the volume of the 50% isodose line to the target volume, yielded an average improvement of 21.35% (19.4%–22.6%) and 8.38% (4.7%–12.0%) for the DCS and fixed aperture plans, respectively. Conclusions: The ability of the DCS to provide collimation to each energy layer yielded better conformity in comparison to fixed aperture plans.

  16. Technical Note: A treatment plan comparison between dynamic collimation and a fixed aperture during spot scanning proton therapy for brain treatment

    International Nuclear Information System (INIS)

    Smith, Blake; Gelover, Edgar; Moignier, Alexandra; Wang, Dongxu; Flynn, Ryan T.; Hyer, Daniel E.; Lin, Liyong; Kirk, Maura; Solberg, Tim

    2016-01-01

    Purpose: To quantitatively assess the advantages of energy-layer specific dynamic collimation system (DCS) versus a per-field fixed aperture for spot scanning proton therapy (SSPT). Methods: Five brain cancer patients previously planned and treated with SSPT were replanned using an in-house treatment planning system capable of modeling collimated and uncollimated proton beamlets. The uncollimated plans, which served as a baseline for comparison, reproduced the target coverage and organ-at-risk sparing of the clinically delivered plans. The collimator opening for the fixed aperture-based plans was determined from the combined cross sections of the target in the beam’s eye view over all energy layers which included an additional margin equivalent to the maximum beamlet displacement for the respective energy of that energy layer. The DCS-based plans were created by selecting appropriate collimator positions for each row of beam spots during a Raster-style scanning pattern which were optimized to maximize the dose contributions to the target and limited the dose delivered to adjacent normal tissue. Results: The reduction of mean dose to normal tissue adjacent to the target, as defined by a 10 mm ring surrounding the target, averaged 13.65% (range: 11.8%–16.9%) and 5.18% (2.9%–7.1%) for the DCS and fixed aperture plans, respectively. The conformity index, as defined by the ratio of the volume of the 50% isodose line to the target volume, yielded an average improvement of 21.35% (19.4%–22.6%) and 8.38% (4.7%–12.0%) for the DCS and fixed aperture plans, respectively. Conclusions: The ability of the DCS to provide collimation to each energy layer yielded better conformity in comparison to fixed aperture plans.

  17. Technical Note: A treatment plan comparison between dynamic collimation and a fixed aperture during spot scanning proton therapy for brain treatment

    Science.gov (United States)

    Smith, Blake; Gelover, Edgar; Moignier, Alexandra; Wang, Dongxu; Flynn, Ryan T.; Lin, Liyong; Kirk, Maura; Solberg, Tim; Hyer, Daniel E.

    2016-01-01

    Purpose: To quantitatively assess the advantages of energy-layer specific dynamic collimation system (DCS) versus a per-field fixed aperture for spot scanning proton therapy (SSPT). Methods: Five brain cancer patients previously planned and treated with SSPT were replanned using an in-house treatment planning system capable of modeling collimated and uncollimated proton beamlets. The uncollimated plans, which served as a baseline for comparison, reproduced the target coverage and organ-at-risk sparing of the clinically delivered plans. The collimator opening for the fixed aperture-based plans was determined from the combined cross sections of the target in the beam’s eye view over all energy layers which included an additional margin equivalent to the maximum beamlet displacement for the respective energy of that energy layer. The DCS-based plans were created by selecting appropriate collimator positions for each row of beam spots during a Raster-style scanning pattern which were optimized to maximize the dose contributions to the target and limited the dose delivered to adjacent normal tissue. Results: The reduction of mean dose to normal tissue adjacent to the target, as defined by a 10 mm ring surrounding the target, averaged 13.65% (range: 11.8%–16.9%) and 5.18% (2.9%–7.1%) for the DCS and fixed aperture plans, respectively. The conformity index, as defined by the ratio of the volume of the 50% isodose line to the target volume, yielded an average improvement of 21.35% (19.4%–22.6%) and 8.38% (4.7%–12.0%) for the DCS and fixed aperture plans, respectively. Conclusions: The ability of the DCS to provide collimation to each energy layer yielded better conformity in comparison to fixed aperture plans. PMID:27487886

  18. Impact of Real-Time Image Gating on Spot Scanning Proton Therapy for Lung Tumors: A Simulation Study

    Energy Technology Data Exchange (ETDEWEB)

    Kanehira, Takahiro [Department of Radiation Medicine, Graduate School of Medicine, Hokkaido University, Sapporo (Japan); Matsuura, Taeko, E-mail: matsuura@med.hokudai.ac.jp [Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo (Japan); Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo (Japan); Division of Quantum Science and Engineering, Faculty of Engineering, Hokkaido University, Sapporo (Japan); Takao, Seishin; Matsuzaki, Yuka; Fujii, Yusuke; Fujii, Takaaki [Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo (Japan); Ito, Yoichi M. [Department of Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo (Japan); Miyamoto, Naoki [Department of Medical Physics, Hokkaido University Hospital, Sapporo (Japan); Inoue, Tetsuya [Department of Radiation Medicine, Graduate School of Medicine, Hokkaido University, Sapporo (Japan); Katoh, Norio [Department of Radiation Oncology, Hokkaido University Hospital, Sapporo (Japan); Shimizu, Shinichi [Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo (Japan); Department of Radiation Oncology, Graduate School of Medicine, Hokkaido University, Sapporo (Japan); Umegaki, Kikuo [Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo (Japan); Division of Quantum Science and Engineering, Faculty of Engineering, Hokkaido University, Sapporo (Japan); Shirato, Hiroki [Department of Radiation Medicine, Graduate School of Medicine, Hokkaido University, Sapporo (Japan); Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo (Japan)

    2017-01-01

    Purpose: To investigate the effectiveness of real-time-image gated proton beam therapy for lung tumors and to establish a suitable size for the gating window (GW). Methods and Materials: A proton beam gated by a fiducial marker entering a preassigned GW (as monitored by 2 fluoroscopy units) was used with 7 lung cancer patients. Seven treatment plans were generated: real-time-image gated proton beam therapy with GW sizes of ±1, 2, 3, 4, 5, and 8 mm and free-breathing proton therapy. The prescribed dose was 70 Gy (relative biological effectiveness)/10 fractions to 99% of the target. Each of the 3-dimensional marker positions in the time series was associated with the appropriate 4-dimensional computed tomography phase. The 4-dimensional dose calculations were performed. The dose distribution in each respiratory phase was deformed into the end-exhale computed tomography image. The D99 and D5 to D95 of the clinical target volume scaled by the prescribed dose with criteria of D99 >95% and D5 to D95 <5%, V20 for the normal lung, and treatment times were evaluated. Results: Gating windows ≤ ±2 mm fulfilled the CTV criteria for all patients (whereas the criteria were not always met for GWs ≥ ±3 mm) and gave an average reduction in V20 of more than 17.2% relative to free-breathing proton therapy (whereas GWs ≥ ±4 mm resulted in similar or increased V20). The average (maximum) irradiation times were 384 seconds (818 seconds) for the ±1-mm GW, but less than 226 seconds (292 seconds) for the ±2-mm GW. The maximum increased considerably at ±1-mm GW. Conclusion: Real-time-image gated proton beam therapy with a GW of ±2 mm was demonstrated to be suitable, providing good dose distribution without greatly extending treatment time.

  19. Impact of Real-Time Image Gating on Spot Scanning Proton Therapy for Lung Tumors: A Simulation Study.

    Science.gov (United States)

    Kanehira, Takahiro; Matsuura, Taeko; Takao, Seishin; Matsuzaki, Yuka; Fujii, Yusuke; Fujii, Takaaki; Ito, Yoichi M; Miyamoto, Naoki; Inoue, Tetsuya; Katoh, Norio; Shimizu, Shinichi; Umegaki, Kikuo; Shirato, Hiroki

    2017-01-01

    To investigate the effectiveness of real-time-image gated proton beam therapy for lung tumors and to establish a suitable size for the gating window (GW). A proton beam gated by a fiducial marker entering a preassigned GW (as monitored by 2 fluoroscopy units) was used with 7 lung cancer patients. Seven treatment plans were generated: real-time-image gated proton beam therapy with GW sizes of ±1, 2, 3, 4, 5, and 8 mm and free-breathing proton therapy. The prescribed dose was 70 Gy (relative biological effectiveness)/10 fractions to 99% of the target. Each of the 3-dimensional marker positions in the time series was associated with the appropriate 4-dimensional computed tomography phase. The 4-dimensional dose calculations were performed. The dose distribution in each respiratory phase was deformed into the end-exhale computed tomography image. The D99 and D5 to D95 of the clinical target volume scaled by the prescribed dose with criteria of D99 >95% and D5 to D95 lung, and treatment times were evaluated. Gating windows ≤ ±2 mm fulfilled the CTV criteria for all patients (whereas the criteria were not always met for GWs ≥ ±3 mm) and gave an average reduction in V20 of more than 17.2% relative to free-breathing proton therapy (whereas GWs ≥ ±4 mm resulted in similar or increased V20). The average (maximum) irradiation times were 384 seconds (818 seconds) for the ±1-mm GW, but less than 226 seconds (292 seconds) for the ±2-mm GW. The maximum increased considerably at ±1-mm GW. Real-time-image gated proton beam therapy with a GW of ±2 mm was demonstrated to be suitable, providing good dose distribution without greatly extending treatment time. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Evaluation of the influence of double and triple Gaussian proton kernel models on accuracy of dose calculations for spot scanning technique.

    Science.gov (United States)

    Hirayama, Shusuke; Takayanagi, Taisuke; Fujii, Yusuke; Fujimoto, Rintaro; Fujitaka, Shinichiro; Umezawa, Masumi; Nagamine, Yoshihiko; Hosaka, Masahiro; Yasui, Keisuke; Omachi, Chihiro; Toshito, Toshiyuki

    2016-03-01

    The main purpose in this study was to present the results of beam modeling and how the authors systematically investigated the influence of double and triple Gaussian proton kernel models on the accuracy of dose calculations for spot scanning technique. The accuracy of calculations was important for treatment planning software (TPS) because the energy, spot position, and absolute dose had to be determined by TPS for the spot scanning technique. The dose distribution was calculated by convolving in-air fluence with the dose kernel. The dose kernel was the in-water 3D dose distribution of an infinitesimal pencil beam and consisted of an integral depth dose (IDD) and a lateral distribution. Accurate modeling of the low-dose region was important for spot scanning technique because the dose distribution was formed by cumulating hundreds or thousands of delivered beams. The authors employed a double Gaussian function as the in-air fluence model of an individual beam. Double and triple Gaussian kernel models were also prepared for comparison. The parameters of the kernel lateral model were derived by fitting a simulated in-water lateral dose profile induced by an infinitesimal proton beam, whose emittance was zero, at various depths using Monte Carlo (MC) simulation. The fitted parameters were interpolated as a function of depth in water and stored as a separate look-up table. These stored parameters for each energy and depth in water were acquired from the look-up table when incorporating them into the TPS. The modeling process for the in-air fluence and IDD was based on the method proposed in the literature. These were derived using MC simulation and measured data. The authors compared the measured and calculated absolute doses at the center of the spread-out Bragg peak (SOBP) under various volumetric irradiation conditions to systematically investigate the influence of the two types of kernel models on the dose calculations. The authors investigated the difference

  1. TH-CD-209-11: Simulation Study of Real-Time-Image Gating On Spot Scanning Proton Therapy for Lung Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kanehira, T; Inoue, T; Katoh, N [Department of Radiation Oncology, Graduate School of Medicine, Sapporo, Hokkaido (Japan); Matsuura, T; Umegaki, K [Faculty of Engineering, Hokkaido University, Sapporo, Hokkaido (Japan); Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo, Hokkaido (Japan); Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Hokkaido (Japan); Takao, S; Matsuzaki, Y; Fujii, Y; Fujii, T; Miyamoto, N [Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo, Hokkaido (Japan); Shimizu, S; Shirato, H [Department of Radiation Oncology, Graduate School of Medicine, Sapporo, Hokkaido (Japan); Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo, Hokkaido (Japan); Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Hokkaido (Japan)

    2016-06-15

    Purpose: To study the impact of a real-time-image gating on spot scanning proton therapy for lung tumors and to examine the suitable size of the gating window (GW). Methods: We investigated a real-time-image gated proton therapy (RGPT), in which two fluoroscopic units monitor a gold sphere fiducial in real-time, and the proton beam is irradiated only when the marker enters within the pre-assigned GW. We designed 5 treatment plans for 7 lung cancer patients: RGPT with a GW of ±1, 2, 5, and 8 mm and free-breathing proton therapy (FBPT) using the end-exhale and average images of 4-dimensional (4D) CT, respectively. 70 Gy(RBE)/10fr was prescribed to 99% of the targets. The time-series data of the three-dimensional marker positions (RTRT data) were grouped into 10 phases to associate with the phases of 4DCT. The 4D dose distributions were calculated using the plan information, RTRT Data, 4DCT, and modeled accelerator pattern. The dose distribution in each respiratory phase was deformed into the end-exhale CT. The D99 and D5-95 of CTV (with a criteria of D99>95% and D5-95<5%), V20 of Lung-GTV, and treatment times were evaluated. Results: GWs ≤ ±2 mm satisfied the criteria of CTV in all cases, whereas GWs ≥ ±5 mm did not satisfy the criteria in some cases. The V20 was reduced by more than 18.9% (relative to FBPT) for GW ≤ ±2 mm, but equaled or even surpassed the FBPT for GWs ≥ ±5 mm. The irradiation times for the ±1, 2, 5, and 8 mm GWs and FBPT were 372.4±208.3, 215.2±51.5, 180.9±31.6, 178.4±21.2, and 140.1±15.2 s, respectively. The GW of ±1 mm caused large variation in irradiation time among the patients. Conclusion: In RGPT for lung cancer, the most suitable GW, in terms of good dose preservation without prolonging the therapeutic beam delivery, is ±2 mm.

  2. Clinically Applicable Monte Carlo–based Biological Dose Optimization for the Treatment of Head and Neck Cancers With Spot-Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Wan Chan Tseung, Hok Seum, E-mail: wanchantseung.hok@mayo.edu; Ma, Jiasen; Kreofsky, Cole R.; Ma, Daniel J.; Beltran, Chris

    2016-08-01

    Purpose: Our aim is to demonstrate the feasibility of fast Monte Carlo (MC)–based inverse biological planning for the treatment of head and neck tumors in spot-scanning proton therapy. Methods and Materials: Recently, a fast and accurate graphics processor unit (GPU)–based MC simulation of proton transport was developed and used as the dose-calculation engine in a GPU-accelerated intensity modulated proton therapy (IMPT) optimizer. Besides dose, the MC can simultaneously score the dose-averaged linear energy transfer (LET{sub d}), which makes biological dose (BD) optimization possible. To convert from LET{sub d} to BD, a simple linear relation was assumed. By use of this novel optimizer, inverse biological planning was applied to 4 patients, including 2 small and 1 large thyroid tumor targets, as well as 1 glioma case. To create these plans, constraints were placed to maintain the physical dose (PD) within 1.25 times the prescription while maximizing target BD. For comparison, conventional intensity modulated radiation therapy (IMRT) and IMPT plans were also created using Eclipse (Varian Medical Systems) in each case. The same critical-structure PD constraints were used for the IMRT, IMPT, and biologically optimized plans. The BD distributions for the IMPT plans were obtained through MC recalculations. Results: Compared with standard IMPT, the biologically optimal plans for patients with small tumor targets displayed a BD escalation that was around twice the PD increase. Dose sparing to critical structures was improved compared with both IMRT and IMPT. No significant BD increase could be achieved for the large thyroid tumor case and when the presence of critical structures mitigated the contribution of additional fields. The calculation of the biologically optimized plans can be completed in a clinically viable time (<30 minutes) on a small 24-GPU system. Conclusions: By exploiting GPU acceleration, MC-based, biologically optimized plans were created for

  3. Efficient Interplay Effect Mitigation for Proton Pencil Beam Scanning by Spot-Adapted Layered Repainting Evenly Spread out Over the Full Breathing Cycle.

    Science.gov (United States)

    Poulsen, Per Rugaard; Eley, John; Langner, Ulrich; Simone, Charles B; Langen, Katja

    2018-01-01

    To develop and implement a practical repainting method for efficient interplay effect mitigation in proton pencil beam scanning (PBS). A new flexible repainting scheme with spot-adapted numbers of repainting evenly spread out over the whole breathing cycle (assumed to be 4 seconds) was developed. Twelve fields from 5 thoracic and upper abdominal PBS plans were delivered 3 times using the new repainting scheme to an ion chamber array on a motion stage. One time was static and 2 used 4-second, 3-cm peak-to-peak sinusoidal motion with delivery started at maximum inhalation and maximum exhalation. For comparison, all dose measurements were repeated with no repainting and with 8 repaintings. For each motion experiment, the 3%/3-mm gamma pass rate was calculated using the motion-convolved static dose as the reference. Simulations were first validated with the experiments and then used to extend the study to 0- to 5-cm motion magnitude, 2- to 6-second motion periods, patient-measured liver tumor motion, and 1- to 6-fraction treatments. The effect of the proposed method was evaluated for the 5 clinical cases using 4-dimensional (4D) dose reconstruction in the planning 4D computed tomography scan. The target homogeneity index, HI = (D 2 - D 98 )/D mean , of a single-fraction delivery is reported, where D 2 and D 98 is the dose delivered to 2% and 98% of the target, respectively, and D mean is the mean dose. The gamma pass rates were 59.6% ± 9.7% with no repainting, 76.5% ± 10.8% with 8 repaintings, and 92.4% ± 3.8% with the new repainting scheme. Simulations reproduced the experimental gamma pass rates with a 1.3% root-mean-square error and demonstrated largely improved gamma pass rates with the new repainting scheme for all investigated motion scenarios. One- and two-fraction deliveries with the new repainting scheme had gamma pass rates similar to those of 3-4 and 6-fraction deliveries with 8 repaintings. The mean HI for the 5 clinical cases was 14.2% with no

  4. SU-F-I-11: Software Development for 4D-CBCT Research of Real-Time-Image Gated Spot Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, T; Fujii, Y; Shimizu, S; Shirato, H [Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido (Japan); Matsuura, T; Umegaki, K [Faculty of Engineering, Hokkaido University, Sapporo, Hokkaido (Japan); Takao, S; Miyamoto, N; Matsuzaki, Y [Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo, Hokkaido (Japan)

    2016-06-15

    Purpose: To acquire correct information for inside the body in patient positioning of Real-time-image Gated spot scanning Proton Therapy (RGPT), utilization of tomographic image at exhale phase of patient respiration obtained from 4-dimensional Cone beam CT (4D-CBCT) has been desired. We developed software named “Image Analysis Platform” for 4D-CBCT researches which has technique to segment projection-images based on 3D marker position in the body. The 3D marker position can be obtained by using two axes CBCT system at Hokkaido University Hospital Proton Therapy Center. Performance verification of the software was implemented. Methods: The software calculates 3D marker position retrospectively by using matching positions on pair projection-images obtained by two axes fluoroscopy mode of CBCT system. Log data of 3D marker tracking are outputted after the tracking. By linking the Log data and gantry-angle file of projection-image, all projection-images are equally segmented to spatial five-phases according to marker 3D position of SI direction and saved to specified phase folder. Segmented projection-images are used for CBCT reconstruction of each phase. As performance verification of the software, test of segmented projection-images was implemented for sample CT phantom (Catphan) image acquired by two axes fluoroscopy mode of CBCT. Dummy marker was added on the images. Motion of the marker was modeled to move in 3D space. Motion type of marker is sin4 wave function has amplitude 10.0 mm/5.0 mm/0 mm, cycle 4 s/4 s/0 s for SI/AP/RL direction. Results: The marker was tracked within 0.58 mm accuracy in 3D for all images, and it was confirmed that all projection-images were segmented and saved to each phase folder correctly. Conclusion: We developed software for 4D-CBCT research which can segment projection-image based on 3D marker position. It will be helpful to create high quality of 4D-CBCT reconstruction image for RGPT.

  5. Development and Clinical Implementation of a Universal Bolus to Maintain Spot Size During Delivery of Base of Skull Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Both, Stefan, E-mail: Stefan.Both@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Shen, Jiajian [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona (United States); Kirk, Maura; Lin, Liyong; Tang, Shikui; Alonso-Basanta, Michelle; Lustig, Robert; Lin, Haibo; Deville, Curtiland; Hill-Kayser, Christine; Tochner, Zelig; McDonough, James [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2014-09-01

    Purpose: To report on a universal bolus (UB) designed to replace the range shifter (RS); the UB allows the treatment of shallow tumors while keeping the pencil beam scanning (PBS) spot size small. Methods and Materials: Ten patients with brain cancers treated from 2010 to 2011 were planned using the PBS technique with bolus and the RS. In-air spot sizes of the pencil beam were measured and compared for 4 conditions (open field, with RS, and with UB at 2- and 8-cm air gap) in isocentric geometry. The UB was applied in our clinic to treat brain tumors, and the plans with UB were compared with the plans with RS. Results: A UB of 5.5 cm water equivalent thickness was found to meet the needs of the majority of patients. By using the UB, the PBS spot sizes are similar with the open beam (P>.1). The heterogeneity index was found to be approximately 10% lower for the UB plans than for the RS plans. The coverage for plans with UB is more conformal than for plans with RS; the largest increase in sparing is usually for peripheral organs at risk. Conclusions: The integrity of the physical properties of the PBS beam can be maintained using a UB that allows for highly conformal PBS treatment design, even in a simple geometry of the fixed beam line when noncoplanar beams are used.

  6. SU-D-BRE-03: Dosimetric Impact of In-Air Spot Size Variations for Commissioning a Room-Matched Beam Model for Pencil Beam Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Zhang, Y; Giebeler, A; Mascia, A; Piskulich, F; Perles, L; Lepage, R; Dong, L

    2014-01-01

    Purpose: To quantitatively evaluate dosimetric consequence of spot size variations and validate beam-matching criteria for commissioning a pencil beam model for multiple treatment rooms. Methods: A planning study was first conducted by simulating spot size variations to systematically evaluate dosimetric impact of spot size variations in selected cases, which was used to establish the in-air spot size tolerance for beam matching specifications. A beam model in treatment planning system was created using in-air spot profiles acquired in one treatment room. These spot profiles were also acquired from another treatment room for assessing the actual spot size variations between the two treatment rooms. We created twenty five test plans with targets of different sizes at different depths, and performed dose measurement along the entrance, proximal and distal target regions. The absolute doses at those locations were measured using ionization chambers at both treatment rooms, and were compared against the calculated doses by the beam model. Fifteen additional patient plans were also measured and included in our validation. Results: The beam model is relatively insensitive to spot size variations. With an average of less than 15% measured in-air spot size variations between two treatment rooms, the average dose difference was −0.15% with a standard deviation of 0.40% for 55 measurement points within target region; but the differences increased to 1.4%±1.1% in the entrance regions, which are more affected by in-air spot size variations. Overall, our single-room based beam model in the treatment planning system agreed with measurements in both rooms < 0.5% within the target region. For fifteen patient cases, the agreement was within 1%. Conclusion: We have demonstrated that dosimetrically equivalent machines can be established when in-air spot size variations are within 15% between the two treatment rooms

  7. Copying of holograms by spot scanning approach.

    Science.gov (United States)

    Okui, Makoto; Wakunami, Koki; Oi, Ryutaro; Ichihashi, Yasuyuki; Jackin, Boaz Jessie; Yamamoto, Kenji

    2018-05-20

    To replicate holograms, contact copying has conventionally been used. In this approach, a photosensitive material is fixed together with a master hologram and illuminated with a coherent beam. This method is simple and enables high-quality copies; however, it requires a large optical setup for large-area holograms. In this paper, we present a new method of replicating holograms that uses a relatively compact optical system even for the replication of large holograms. A small laser spot that irradiates only part of the hologram is used to reproduce the hologram by scanning the spot over the whole area of the hologram. We report on the results of experiments carried out to confirm the copy quality, along with a guide to design scanning conditions. The results show the potential effectiveness of the large-area hologram replication technology using a relatively compact apparatus.

  8. Deformable motion reconstruction for scanned proton beam therapy using on-line x-ray imaging

    NARCIS (Netherlands)

    Zhang, Ye; Knopf, A; Tanner, Colby; Boye, Dirk; Lomax, Antony J.

    2013-01-01

    Organ motion is a major problem for any dynamic radiotherapy delivery technique, and is particularly so for spot scanned proton therapy. On the other hand, the use of narrow, magnetically deflected proton pencil beams is potentially an ideal delivery technique for tracking tumour motion on-line. At

  9. Dose error analysis for a scanned proton beam delivery system

    International Nuclear Information System (INIS)

    Coutrakon, G; Wang, N; Miller, D W; Yang, Y

    2010-01-01

    All particle beam scanning systems are subject to dose delivery errors due to errors in position, energy and intensity of the delivered beam. In addition, finite scan speeds, beam spill non-uniformities, and delays in detector, detector electronics and magnet responses will all contribute errors in delivery. In this paper, we present dose errors for an 8 x 10 x 8 cm 3 target of uniform water equivalent density with 8 cm spread out Bragg peak and a prescribed dose of 2 Gy. Lower doses are also analyzed and presented later in the paper. Beam energy errors and errors due to limitations of scanning system hardware have been included in the analysis. By using Gaussian shaped pencil beams derived from measurements in the research room of the James M Slater Proton Treatment and Research Center at Loma Linda, CA and executing treatment simulations multiple times, statistical dose errors have been calculated in each 2.5 mm cubic voxel in the target. These errors were calculated by delivering multiple treatments to the same volume and calculating the rms variation in delivered dose at each voxel in the target. The variations in dose were the result of random beam delivery errors such as proton energy, spot position and intensity fluctuations. The results show that with reasonable assumptions of random beam delivery errors, the spot scanning technique yielded an rms dose error in each voxel less than 2% or 3% of the 2 Gy prescribed dose. These calculated errors are within acceptable clinical limits for radiation therapy.

  10. Scanned proton radiotherapy for mobile targets-the effectiveness of re-scanning in the context of different treatment planning approaches and for different motion characteristics

    NARCIS (Netherlands)

    Knopf, Antje-Christin; Hong, Theodore S; Lomax, Antony

    2011-01-01

    The most advanced delivery technique for proton radiotherapy is active spot scanning. So far, predominantly static targets have been treated with active spot scanning, since mobile targets in combination with dynamic treatment delivery can lead to interplay effects, causing inhomogeneous dose

  11. Hot spots on Tc-99m MAA perfusion lung scan

    International Nuclear Information System (INIS)

    Lim, Seok Tae; Sohn, Myung Hee

    2001-01-01

    A 61 year-old woman underwent perfusion and inhalation lung scan for the evaluation of pulmonary thromboembolism. Tc-99m MAA perfusion lung scan showed multiple round hot spots in both lung fields. Tc-99m DTPA aerosol inhalation lung scan and chest radiography taken at the same time showed normal findings. A repeated perfusion lung scan taken 24 hours later demonstrated no abnormalities. Hot spots on perfusion lung scan can be caused by microsphere clumping due to faulty injection technique by radioactive embolization from upper extremity thrombophlebitis after injection. Focal hot spots can signify zones of atelectasis, where the hot spots probably represent a failure of hypoxic vasoconstriction. Artifactual hot spots due to microsphere clumping usually appear to be round and in peripheral location, and the lesions due to a loss of hypoxic vasoconstriction usually appear to be hot uptakes having linear borders. Although these artifactual hot spots have been well-known, we rarely encounter them. This report presents a case with artifactual hot spots due to microsphere clumping on Tc-99m MAA perfusion lung scan

  12. Effects of spot parameters in pencil beam scanning treatment planning.

    Science.gov (United States)

    Kraan, Aafke Christine; Depauw, Nicolas; Clasie, Ben; Giunta, Marina; Madden, Tom; Kooy, Hanne M

    2018-01-01

    Spot size σ (in air at isocenter), interspot spacing d, and spot charge q influence dose delivery efficiency and plan quality in Intensity Modulated Proton Therapy (IMPT) treatment planning. The choice and range of parameters varies among different manufacturers. The goal of this work is to demonstrate the influence of the spot parameters on dose quality and delivery in IMPT treatment plans, to show their interdependence, and to make practitioners aware of the spot parameter values for a certain facility. Our study could help as a guideline to make the trade-off between treatment quality and time in existing PBS centers and in future systems. We created plans for seven patients and a phantom, with different tumor sites and volumes, and compared the effect of small-, medium-, and large-spot widths (σ = 2.5, 5, and 10 mm) and interspot distances (1σ, 1.5σ, and 1.75σ) on dose, spot charge, and treatment time. Moreover, we quantified how postplanning charge threshold cuts affect plan quality and the total number of spots to deliver, for different spot widths and interspot distances. We show the effect of a minimum charge (or MU) cutoff value for a given proton delivery system. Spot size had a strong influence on dose: larger spots resulted in more protons delivered outside the target region. We observed dose differences of 2-13 Gy (RBE) between 2.5 mm and 10 mm spots, where the amount of extra dose was due to dose penumbra around the target region. Interspot distance had little influence on dose quality for our patient group. Both parameters strongly influence spot charge in the plans and thus the possible impact of postplanning charge threshold cuts. If such charge thresholds are not included in the treatment planning system (TPS), it is important that the practitioner validates that a given combination of lower charge threshold, interspot spacing, and spot size does not result in a plan degradation. Low average spot charge occurs for small spots, small interspot

  13. Magnetically scanned proton therapy beams: rationales and techniques

    International Nuclear Information System (INIS)

    Jones, D.T.L.; Schreuder, A.N.

    2000-01-01

    Perhaps the most important advantages of beam scanning systems for proton therapy in comparison with conventional passive beam spreading systems are: (1) Intensity modulation and inverse planning are possible. (2) There is negligible reduction in the range of the beam. (3) Integral dose is reduced as dose conformation to the proximal edge of the lesion is possible. (4) In principle no field-specific modifying devices are required. (5) There is less activation of the surroundings. (6) Scanning systems axe almost infinitely flexible. The main disadvantages include: (1) Scanning systems are more complicated and therefore potentially less reliable and more dangerous. (2) The development of such systems is more demanding in terms of cost, time and manpower. (3) More stable beams are required. (4) Dose and beam position monitoring are more difficult. (5) The problems associated with patient and organ movement axe more severe. There are several techniques which can be used for scanning. For lateral beam spreading, circular scanning (wobbling) or linear scanning can be done. In the latter case the beam can be scanned continuously or in a discrete fashion (spot scanning). Another possibility is to undertake the fastest scan in one dimension (strip scanning) and translate the patient or the scanning magnet in the other dimension. Depth variation is achieved by interposing degraders in the beam (cyclotrons) or by changing the beam energy (synchrotrons). The aim of beam scanning is to deliver a predetermined dose at any point in the body. Special safety precautions must be taken because of the high instantaneous dose rates. The beam position and the dose delivered at each point must be accurately and redundantly determined. (author)

  14. Advanced optical system for scanning-spot photorefractive keratectomy (PRK)

    Science.gov (United States)

    Mrochen, Michael; Wullner, Christian; Semchishen, Vladimir A.; Seiler, Theo

    1999-06-01

    Purpose: The goal of this presentation is to discuss the use of the Light Shaping Beam Homogenizer in an optical system for scanning-spot PRK. Methods: The basic principle of the LSBH is the transformation of any incident intensity distribution by light scattering on an irregular microlens structure z = f(x,y). The relief of this microlens structure is determined by a defined statistical function, i.e. it is defined by the mean root-squared tilt σ of the surface relief. Therefore, the beam evolution after the LSBH and in the focal plane of an imaging lens was measured for various root-squared tilts. Beside this, an optical setup for scanning-spot PRK was assembled according to the theoretical and experimental results. Results: The divergence, homogeneity and the Gaussian radius of the intensity distribution in the treatment plane of the scanning-spot PRK laser system is mainly characterized by dependent on root-mean-square tilt σ of the LSBH, as it will be explained by the theoretical description of the LSBH. Conclusions: The LSBH represents a simple, low cost beam homogenizer with low energy losses, for scanning-spot excimer laser systems.

  15. WE-E-BRB-01: Personalized Motion Management Strategies for Pencil Beam Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Zhu, X.

    2016-01-01

    Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

  16. WE-E-BRB-00: Motion Management for Pencil Beam Scanning Proton Therapy

    International Nuclear Information System (INIS)

    2016-01-01

    Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

  17. WE-E-BRB-01: Personalized Motion Management Strategies for Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, X. [UT MD Anderson Cancer Center (United States)

    2016-06-15

    Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

  18. WE-E-BRB-00: Motion Management for Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

  19. A proton microbeam deflection system to scan target surfaces

    International Nuclear Information System (INIS)

    Heck, D.

    1978-12-01

    A system to deflect the proton beam within the Karlsruhe microbeam setup is described. The deflection is achieved whithin a transverse electrical field generated between parallel electrodes. Their tension is controlled by a pattern generator, thus enabling areal and line scans with a variable number of scan points at variable scan speed. The application is demonstrated at two different examples. (orig.) [de

  20. Fundamental radiological and geometric performance of two types of proton beam modulated discrete scanning systems.

    Science.gov (United States)

    Farr, J B; Dessy, F; De Wilde, O; Bietzer, O; Schönenberg, D

    2013-07-01

    The purpose of this investigation was to compare and contrast the measured fundamental properties of two new types of modulated proton scanning systems. This provides a basis for clinical expectations based on the scanned beam quality and a benchmark for computational models. Because the relatively small beam and fast scanning gave challenges to the characterization, a secondary purpose was to develop and apply new approaches where necessary to do so. The following performances of the proton scanning systems were investigated: beamlet alignment, static in-air beamlet size and shape, scanned in-air penumbra, scanned fluence map accuracy, geometric alignment of scanning system to isocenter, maximum field size, lateral and longitudinal field uniformity of a 1 l cubic uniform field, output stability over time, gantry angle invariance, monitoring system linearity, and reproducibility. A range of detectors was used: film, ionization chambers, lateral multielement and longitudinal multilayer ionization chambers, and a scintillation screen combined with a digital video camera. Characterization of the scanned fluence maps was performed with a software analysis tool. The resulting measurements and analysis indicated that the two types of delivery systems performed within specification for those aspects investigated. The significant differences were observed between the two types of scanning systems where one type exhibits a smaller spot size and associated penumbra than the other. The differential is minimum at maximum energy and increases inversely with decreasing energy. Additionally, the large spot system showed an increase in dose precision to a static target with layer rescanning whereas the small spot system did not. The measured results from the two types of modulated scanning types of system were consistent with their designs under the conditions tested. The most significant difference between the types of system was their proton spot size and associated resolution

  1. Fundamental radiological and geometric performance of two types of proton beam modulated discrete scanning systems

    Energy Technology Data Exchange (ETDEWEB)

    Farr, J. B.; Schoenenberg, D. [Westdeutsches Protonentherapiezentrum Essen, Universitaetsklinikum-Essen, Hufelandstrasse 55, 45147 Essen (Germany); Dessy, F.; De Wilde, O.; Bietzer, O. [Ion Beam Applications, Chemin du Cyclotron, 3, 1348 Louvain-la-Neuve (Belgium)

    2013-07-15

    Purpose: The purpose of this investigation was to compare and contrast the measured fundamental properties of two new types of modulated proton scanning systems. This provides a basis for clinical expectations based on the scanned beam quality and a benchmark for computational models. Because the relatively small beam and fast scanning gave challenges to the characterization, a secondary purpose was to develop and apply new approaches where necessary to do so.Methods: The following performances of the proton scanning systems were investigated: beamlet alignment, static in-air beamlet size and shape, scanned in-air penumbra, scanned fluence map accuracy, geometric alignment of scanning system to isocenter, maximum field size, lateral and longitudinal field uniformity of a 1 l cubic uniform field, output stability over time, gantry angle invariance, monitoring system linearity, and reproducibility. A range of detectors was used: film, ionization chambers, lateral multielement and longitudinal multilayer ionization chambers, and a scintillation screen combined with a digital video camera. Characterization of the scanned fluence maps was performed with a software analysis tool.Results: The resulting measurements and analysis indicated that the two types of delivery systems performed within specification for those aspects investigated. The significant differences were observed between the two types of scanning systems where one type exhibits a smaller spot size and associated penumbra than the other. The differential is minimum at maximum energy and increases inversely with decreasing energy. Additionally, the large spot system showed an increase in dose precision to a static target with layer rescanning whereas the small spot system did not.Conclusions: The measured results from the two types of modulated scanning types of system were consistent with their designs under the conditions tested. The most significant difference between the types of system was their proton

  2. New superconducting cyclotron driven scanning proton therapy systems

    International Nuclear Information System (INIS)

    Klein, Hans-Udo; Baumgarten, Christian; Geisler, Andreas; Heese, Juergen; Hobl, Achim; Krischel, Detlef; Schillo, Michael; Schmidt, Stefan; Timmer, Jan

    2005-01-01

    Since one and a half decades ACCEL is investing in development and engineering of state of the art particle-therapy systems. A new medical superconducting 250 MeV proton cyclotron with special focus on the present and future beam requirements of fast scanning treatment systems has been designed. The first new ACCEL medical proton cyclotron is under commissioning at PSI for their PROSCAN proton therapy facility having undergone successful factory tests especially of the closed loop cryomagnetic system. The second cyclotron is part of ACCEL's integrated proton therapy system for Europe's first clinical center, RPTC in Munich. The cyclotron, the energy selection system, the beamline as well as the four gantries and patient positioners have been installed. The scanning system and major parts of the control software have already been tested. We will report on the concept of ACCEL's superconducting cyclotron driven scanning proton therapy systems and the current status of the commissioning work at PSI and RPTC

  3. Intercomparison of two dynamic treatment techniques, ring scan and spot scan, for head and neck tumors with the Piotron

    International Nuclear Information System (INIS)

    Takai, M.; Blattmann, H.; Pedroni, E.

    1988-01-01

    An evaluation of the ring scan and the spot scan was made for the pion irradiation of head and neck tumors with the Piotron. For the geometry of the Piotron, with its 60 radially converging beams, two scanning techniques have been developed, ring scan and spot scan. They have different characteristics concerning achievable dose distributions and sensitivity to tissue inhomogenities. The optimized 3-dimensional dose distributions for the treatment with ring scan and spot scan techniques were calculated for two examples of the target volume. The comparison of the dose distributions has shown that the ring scan is better in sparing normal tissues than the spot scan for a simple shape target volume but not for an irregular shape target volume with the present status of the technique. The irradiation time needed for the ring scan is longer, for the present examples three times, than for the spot scan. From the practical view point the spot scan is preferable to the ring scan for the treatment of head and neck tumors with the Piotron

  4. Spot size dependence of laser accelerated protons in thin multi-ion foils

    International Nuclear Information System (INIS)

    Liu, Tung-Chang; Shao, Xi; Liu, Chuan-Sheng; Eliasson, Bengt; Wang, Jyhpyng; Chen, Shih-Hung

    2014-01-01

    We present a numerical study of the effect of the laser spot size of a circularly polarized laser beam on the energy of quasi-monoenergetic protons in laser proton acceleration using a thin carbon-hydrogen foil. The used proton acceleration scheme is a combination of laser radiation pressure and shielded Coulomb repulsion due to the carbon ions. We observe that the spot size plays a crucial role in determining the net charge of the electron-shielded carbon ion foil and consequently the efficiency of proton acceleration. Using a laser pulse with fixed input energy and pulse length impinging on a carbon-hydrogen foil, a laser beam with smaller spot sizes can generate higher energy but fewer quasi-monoenergetic protons. We studied the scaling of the proton energy with respect to the laser spot size and obtained an optimal spot size for maximum proton energy flux. Using the optimal spot size, we can generate an 80 MeV quasi-monoenergetic proton beam containing more than 10 8 protons using a laser beam with power 250 TW and energy 10 J and a target of thickness 0.15 wavelength and 49 critical density made of 90% carbon and 10% hydrogen

  5. Dosimetry with the scanned proton beam on the PSI gantry

    International Nuclear Information System (INIS)

    Coray, A.; Pedroni, E.; Boehringer, T.; Lin, S.; Lomax, T.; Goitein, G.

    2002-01-01

    Full text: The irradiation facility at PSI is designed for the treatment of deep seated tumours with a proton beam energy of up to 270 MeV. The spot scanning technique, which uses a proton pencil beam applied to the patient, is performed on a compact isocentric gantry. An optimal three-dimensional conformation of the dose distribution to the target volume can be realized. A fast steering system and a redundant interlock system are in operation. The dose delivery is controlled by a parallel plate transmission chamber, which is calibrated in terms of number of protons per monitor unit. The therapy planning is based on an empirical model, which takes into account attenuation of primary protons and losses outside the primary beam through secondary products. The therapy plan predicts an absolute dose. The calibration of the primary monitor is done using a reference thimble ionization chamber inside a homogeneous geometrical dose volume. The reference system is calibrated in a cobalt field at the national office of metrology in terms of absorbed dose to water. The dosimetry protocol used up to last year was based on the ICRU Report Nr. 59, we have switched to the IAEA Code of Practice starting this beam period. Data on the monitor calibration for various energies and using two different reference systems will be shown. The calibration of the beam monitor using a Faraday Cup in the static pencil beam results in a good agreement with the ionization chamber measurements, with a deviation of less than 1%. Following the daily setup of the machine, an extensive quality control and safety check of the whole system is performed. The daily dosimetry quality assurance program includes: measurement of dose rate and monitor ratios; check of the beam position monitors; measurement of a depth dose curve; dose measurement in a regular dose field. The doses measured daily in a regular scanned field show a standard deviation of about 1 %. Further daily checks results, which illustrate

  6. Commissioning of output factors for uniform scanning proton beams

    International Nuclear Information System (INIS)

    Zheng Yuanshui; Ramirez, Eric; Mascia, Anthony; Ding Xiaoning; Okoth, Benny; Zeidan, Omar; Hsi Wen; Harris, Ben; Schreuder, Andries N.; Keole, Sameer

    2011-01-01

    Purpose: Current commercial treatment planning systems are not able to accurately predict output factors and calculate monitor units for proton fields. Patient-specific field output factors are thus determined by either measurements or empirical modeling based on commissioning data. The objective of this study is to commission output factors for uniform scanning beams utilized at the ProCure proton therapy centers. Methods: Using water phantoms and a plane parallel ionization chamber, the authors first measured output factors with a fixed 10 cm diameter aperture as a function of proton range and modulation width for clinically available proton beams with ranges between 4 and 31.5 cm and modulation widths between 2 and 15 cm. The authors then measured the output factor as a function of collimated field size at various calibration depths for proton beams of various ranges and modulation widths. The authors further examined the dependence of the output factor on the scanning area (i.e., uncollimated proton field), snout position, and phantom material. An empirical model was developed to calculate the output factor for patient-specific fields and the model-predicted output factors were compared to measurements. Results: The output factor increased with proton range and field size, and decreased with modulation width. The scanning area and snout position have a small but non-negligible effect on the output factors. The predicted output factors based on the empirical modeling agreed within 2% of measurements for all prostate treatment fields and within 3% for 98.5% of all treatment fields. Conclusions: Comprehensive measurements at a large subset of available beam conditions are needed to commission output factors for proton therapy beams. The empirical modeling agrees well with the measured output factor data. This investigation indicates that it is possible to accurately predict output factors and thus eliminate or reduce time-consuming patient-specific output

  7. Poster - 25: Neutron Spectral Measurements around a Scanning Proton Beam

    Energy Technology Data Exchange (ETDEWEB)

    Kildea, John; Enger, Shirin; Maglieri, Robert; Mirzakhanian, Lalageh; Dahlgren, Christina Vallhagen; Dubeau, Jacques; Witharana, Sanjeeva [Medical Physics Unit, McGill University Health Centre, Medical Physics Unit, McGill University, Medical Physics Unit, McGill University, Medical Physics Unit, McGill University, Skandion Clinic, Detec Inc., Gatineau, Quebec, Detec Inc., Gatineau, Quebec (Canada)

    2016-08-15

    We describe the measurements of neutron spectra that we undertook around a scanning proton beam at the Skandion proton therapy clinic in Uppsala, Sweden. Measurements were undertaken using an extended energy range Nested Neutron Spectrometer (NNS, Detec Inc., Gatineau, QC) operated in pulsed and current mode. Spectra were measured as a function of location in the treatment room and for various Bragg peak depths. Our preliminary unfolded data clearly show the direct, evaporation and thermal neutron peaks and we can show the effect on the neutron spectrum of a water phantom in the primary proton beam.

  8. A new scanning proton microprobe with long focus

    International Nuclear Information System (INIS)

    Zhu Jieqing; Li Minqian; Mao Yu; Chen Hanmin; Gu Yingmei; Yang Changyi; Sheng Kanglong

    1991-01-01

    A new scanning proton microprobe equipped with a long focus Russian magnetic quadruplet is set up. With excellent performances of ion optics, it can be used to do experiments of PIXE, RBS, RFS, NRA and channelling simultaneously within a micron-region. The power supplies for quadruplet and scanning coils are controlled by an IBM-PC computer and a scanning graphical monitor based on an Apple IIe microcomputer provides convenience of searching for an interesting area to scan. The advanced modes of the fast random scan and the event-by-event data collection make it possible to treat the multi-parameter and multi-detector data by means of the strategy of TQSA (Total quantitative scanning analysis). There are three types of graphical display including the innovation of three dimensional contour mapping

  9. Impact of Spot Size and Spacing on the Quality of Robustly Optimized Intensity Modulated Proton Therapy Plans for Lung Cancer.

    Science.gov (United States)

    Liu, Chenbin; Schild, Steven E; Chang, Joe Y; Liao, Zhongxing; Korte, Shawn; Shen, Jiajian; Ding, Xiaoning; Hu, Yanle; Kang, Yixiu; Keole, Sameer R; Sio, Terence T; Wong, William W; Sahoo, Narayan; Bues, Martin; Liu, Wei

    2018-06-01

    To investigate how spot size and spacing affect plan quality, robustness, and interplay effects of robustly optimized intensity modulated proton therapy (IMPT) for lung cancer. Two robustly optimized IMPT plans were created for 10 lung cancer patients: first by a large-spot machine with in-air energy-dependent large spot size at isocenter (σ: 6-15 mm) and spacing (1.3 σ), and second by a small-spot machine with in-air energy-dependent small spot size (σ: 2-6 mm) and spacing (5 mm). Both plans were generated by optimizing radiation dose to internal target volume on averaged 4-dimensional computed tomography scans using an in-house-developed IMPT planning system. The dose-volume histograms band method was used to evaluate plan robustness. Dose evaluation software was developed to model time-dependent spot delivery to incorporate interplay effects with randomized starting phases for each field per fraction. Patient anatomy voxels were mapped phase-to-phase via deformable image registration, and doses were scored using in-house-developed software. Dose-volume histogram indices, including internal target volume dose coverage, homogeneity, and organs at risk (OARs) sparing, were compared using the Wilcoxon signed-rank test. Compared with the large-spot machine, the small-spot machine resulted in significantly lower heart and esophagus mean doses, with comparable target dose coverage, homogeneity, and protection of other OARs. Plan robustness was comparable for targets and most OARs. With interplay effects considered, significantly lower heart and esophagus mean doses with comparable target dose coverage and homogeneity were observed using smaller spots. Robust optimization with a small spot-machine significantly improves heart and esophagus sparing, with comparable plan robustness and interplay effects compared with robust optimization with a large-spot machine. A small-spot machine uses a larger number of spots to cover the same tumors compared with a large-spot

  10. WE-E-BRB-02: Implementation of Pencil Beam Scanning (PBS) Proton Therapy Treatment for Liver Patient

    International Nuclear Information System (INIS)

    Lin, L.

    2016-01-01

    Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

  11. WE-E-BRB-02: Implementation of Pencil Beam Scanning (PBS) Proton Therapy Treatment for Liver Patient

    Energy Technology Data Exchange (ETDEWEB)

    Lin, L. [University of Pennsylvania (United States)

    2016-06-15

    Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

  12. Magnetic quadrupoles lens for hot spot proton imaging in inertial confinement fusion

    Energy Technology Data Exchange (ETDEWEB)

    Teng, J. [Science and Technology on Plasma Physics Laboratory, Laser Fusion Research Center, China Academy of Engineering Physics, Mianyang 621900 (China); Gu, Y.Q., E-mail: yqgu@caep.cn [Science and Technology on Plasma Physics Laboratory, Laser Fusion Research Center, China Academy of Engineering Physics, Mianyang 621900 (China); Center for Applied Physics and Technology, HEDPS, Peking University, Beijing 100871 (China); Chen, J.; Zhu, B.; Zhang, B.; Zhang, T.K.; Tan, F.; Hong, W.; Zhang, B.H. [Science and Technology on Plasma Physics Laboratory, Laser Fusion Research Center, China Academy of Engineering Physics, Mianyang 621900 (China); Wang, X.Q. [Academy of Nuclear Science and Technology, University of Science and Technology of China, Hefei 230026 (China)

    2016-08-01

    Imaging of DD-produced protons from an implosion hot spot region by miniature permanent magnetic quadrupole (PMQ) lens is proposed. Corresponding object-image relation is deduced and an adjust method for this imaging system is discussed. Ideal point-to-point imaging demands a monoenergetic proton source; nevertheless, we proved that the blur of image induced by proton energy spread is a second order effect therefore controllable. A proton imaging system based on miniature PMQ lens is designed for 2.8 MeV DD-protons and the adjust method in case of proton energy shift is proposed. The spatial resolution of this system is better than 10 μm when proton yield is above 10{sup 9} and the spectra width is within 10%.

  13. Observation and Study of Proton Aurora by using Scanning Photometer

    Science.gov (United States)

    Mochizuki, T.; Ono, T.; Kadokura, A.; Sato, N.

    2009-12-01

    The proton auroras have significant differences from electron auroras in their spectral shape. They show Doppler-shifted and broadened spectra: the spectra have Doppler-shifted (~0.5 nm shorter) peak and both bluewing (~2-4 nm) and redwing (~1.5 nm) extending. Energy spectra of precipitating protons have been estimated from this shape. Recently it is found that the intensity in the extent of the blue wing reflects more effectively by the change of the mean energy of precipitating protons than the shift of peak wavelength [Lanchester et al., 2003]. Another character of the H-beta aurora is that it is diffuse form because a proton becomes hydrogen atom due to a charge-exchange reaction with atmospheric constituent and then possible to move across the magnetic field line. By using a scanning photometer, the movement of the proton auroral belt and change of a spectrum shape associated with the variation of proton source region due to storm and substorm were reported, however, not discussed in detail yet [Deehr and Lummerzheim, 2001]. The purpose of this study is to obtain the detail characteristics of H-beta aurora for understanding of source region of energetic protons in the magnetosphere. For this purpose, a new meridian-scanning photometer (SPM) was installed at Husafell station in Iceland in last summer season and Syowa Station, Antarctica. It will contribute to investigate the distribution of energetic protons and plasma waves which cause the pitch angle scattering in the magnetosphere. The meridian-scanning photometer is able to observe at five wavelengths for H-beta emission. One channel is to measure the background level. By analyzing the data obtained by the SPM, the H-beta spectrum can be estimated by fitting a model function with it. Then it is possible to obtain distribution of precipitating protons in north-south direction. It is also possible to estimate an energy spectrum of precipitating proton, simultaneously. The instrumental parameters of the SPM is

  14. A Case Study in Proton Pencil-Beam Scanning Delivery

    International Nuclear Information System (INIS)

    Kooy, Hanne M.; Clasie, Benjamin M.; Lu, H.-M.; Madden, Thomas M.; Bentefour, Hassan; Depauw, Nicolas M.S.; Adams, Judy A.; Trofimov, Alexei V.; Demaret, Denis; Delaney, Thomas F.; Flanz, Jacob B.

    2010-01-01

    Purpose: We completed an implementation of pencil-beam scanning (PBS), a technology whereby a focused beam of protons, of variable intensity and energy, is scanned over a plane perpendicular to the beam axis and in depth. The aim of radiotherapy is to improve the target to healthy tissue dose differential. We illustrate how PBS achieves this aim in a patient with a bulky tumor. Methods and Materials: Our first deployment of PBS uses 'broad' pencil-beams ranging from 20 to 35 mm (full-width-half-maximum) over the range interval from 32 to 7 g/cm 2 . Such beam-brushes offer a unique opportunity for treating bulky tumors. We present a case study of a large (4,295 cc clinical target volume) retroperitoneal sarcoma treated to 50.4 Gy relative biological effectiveness (RBE) (presurgery) using a course of photons and protons to the clinical target volume and a course of protons to the gross target volume. Results: We describe our system and present the dosimetry for all courses and provide an interdosimetric comparison. Discussion: The use of PBS for bulky targets reduces the complexity of treatment planning and delivery compared with collimated proton fields. In addition, PBS obviates, especially for cases as presented here, the significant cost incurred in the construction of field-specific hardware. PBS offers improved dose distributions, reduced treatment time, and reduced cost of treatment.

  15. Maximizing the biological effect of proton dose delivered with scanned beams via inhomogeneous daily dose distributions

    Energy Technology Data Exchange (ETDEWEB)

    Zeng Chuan; Giantsoudi, Drosoula; Grassberger, Clemens; Goldberg, Saveli; Niemierko, Andrzej; Paganetti, Harald; Efstathiou, Jason A.; Trofimov, Alexei [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 (United States)

    2013-05-15

    Purpose: Biological effect of radiation can be enhanced with hypofractionation, localized dose escalation, and, in particle therapy, with optimized distribution of linear energy transfer (LET). The authors describe a method to construct inhomogeneous fractional dose (IFD) distributions, and evaluate the potential gain in the therapeutic effect from their delivery in proton therapy delivered by pencil beam scanning. Methods: For 13 cases of prostate cancer, the authors considered hypofractionated courses of 60 Gy delivered in 20 fractions. (All doses denoted in Gy include the proton's mean relative biological effectiveness (RBE) of 1.1.) Two types of plans were optimized using two opposed lateral beams to deliver a uniform dose of 3 Gy per fraction to the target by scanning: (1) in conventional full-target plans (FTP), each beam irradiated the entire gland, (2) in split-target plans (STP), beams irradiated only the respective proximal hemispheres (prostate split sagittally). Inverse planning yielded intensity maps, in which discrete position control points of the scanned beam (spots) were assigned optimized intensity values. FTP plans preferentially required a higher intensity of spots in the distal part of the target, while STP, by design, employed proximal spots. To evaluate the utility of IFD delivery, IFD plans were generated by rearranging the spot intensities from FTP or STP intensity maps, separately as well as combined using a variety of mixing weights. IFD courses were designed so that, in alternating fractions, one of the hemispheres of the prostate would receive a dose boost and the other receive a lower dose, while the total physical dose from the IFD course was roughly uniform across the prostate. IFD plans were normalized so that the equivalent uniform dose (EUD) of rectum and bladder did not increase, compared to the baseline FTP plan, which irradiated the prostate uniformly in every fraction. An EUD-based model was then applied to estimate tumor

  16. Maximizing the biological effect of proton dose delivered with scanned beams via inhomogeneous daily dose distributions

    International Nuclear Information System (INIS)

    Zeng Chuan; Giantsoudi, Drosoula; Grassberger, Clemens; Goldberg, Saveli; Niemierko, Andrzej; Paganetti, Harald; Efstathiou, Jason A.; Trofimov, Alexei

    2013-01-01

    Purpose: Biological effect of radiation can be enhanced with hypofractionation, localized dose escalation, and, in particle therapy, with optimized distribution of linear energy transfer (LET). The authors describe a method to construct inhomogeneous fractional dose (IFD) distributions, and evaluate the potential gain in the therapeutic effect from their delivery in proton therapy delivered by pencil beam scanning. Methods: For 13 cases of prostate cancer, the authors considered hypofractionated courses of 60 Gy delivered in 20 fractions. (All doses denoted in Gy include the proton's mean relative biological effectiveness (RBE) of 1.1.) Two types of plans were optimized using two opposed lateral beams to deliver a uniform dose of 3 Gy per fraction to the target by scanning: (1) in conventional full-target plans (FTP), each beam irradiated the entire gland, (2) in split-target plans (STP), beams irradiated only the respective proximal hemispheres (prostate split sagittally). Inverse planning yielded intensity maps, in which discrete position control points of the scanned beam (spots) were assigned optimized intensity values. FTP plans preferentially required a higher intensity of spots in the distal part of the target, while STP, by design, employed proximal spots. To evaluate the utility of IFD delivery, IFD plans were generated by rearranging the spot intensities from FTP or STP intensity maps, separately as well as combined using a variety of mixing weights. IFD courses were designed so that, in alternating fractions, one of the hemispheres of the prostate would receive a dose boost and the other receive a lower dose, while the total physical dose from the IFD course was roughly uniform across the prostate. IFD plans were normalized so that the equivalent uniform dose (EUD) of rectum and bladder did not increase, compared to the baseline FTP plan, which irradiated the prostate uniformly in every fraction. An EUD-based model was then applied to estimate tumor

  17. Maximizing the biological effect of proton dose delivered with scanned beams via inhomogeneous daily dose distributions.

    Science.gov (United States)

    Zeng, Chuan; Giantsoudi, Drosoula; Grassberger, Clemens; Goldberg, Saveli; Niemierko, Andrzej; Paganetti, Harald; Efstathiou, Jason A; Trofimov, Alexei

    2013-05-01

    Biological effect of radiation can be enhanced with hypofractionation, localized dose escalation, and, in particle therapy, with optimized distribution of linear energy transfer (LET). The authors describe a method to construct inhomogeneous fractional dose (IFD) distributions, and evaluate the potential gain in the therapeutic effect from their delivery in proton therapy delivered by pencil beam scanning. For 13 cases of prostate cancer, the authors considered hypofractionated courses of 60 Gy delivered in 20 fractions. (All doses denoted in Gy include the proton's mean relative biological effectiveness (RBE) of 1.1.) Two types of plans were optimized using two opposed lateral beams to deliver a uniform dose of 3 Gy per fraction to the target by scanning: (1) in conventional full-target plans (FTP), each beam irradiated the entire gland, (2) in split-target plans (STP), beams irradiated only the respective proximal hemispheres (prostate split sagittally). Inverse planning yielded intensity maps, in which discrete position control points of the scanned beam (spots) were assigned optimized intensity values. FTP plans preferentially required a higher intensity of spots in the distal part of the target, while STP, by design, employed proximal spots. To evaluate the utility of IFD delivery, IFD plans were generated by rearranging the spot intensities from FTP or STP intensity maps, separately as well as combined using a variety of mixing weights. IFD courses were designed so that, in alternating fractions, one of the hemispheres of the prostate would receive a dose boost and the other receive a lower dose, while the total physical dose from the IFD course was roughly uniform across the prostate. IFD plans were normalized so that the equivalent uniform dose (EUD) of rectum and bladder did not increase, compared to the baseline FTP plan, which irradiated the prostate uniformly in every fraction. An EUD-based model was then applied to estimate tumor control probability

  18. Formation of hot spots in a superconductor observed by low-temperature scanning electron microscopy

    International Nuclear Information System (INIS)

    Eichele, R.; Seifert, H.; Huebener, R.P.

    1981-01-01

    Low-temperature scanning electron microscopy can be used for the direct observation of hot spots in a superconductor. Experiments performed at 2.10 K with tim films demonstrating the method are reported

  19. Measuring a narrow Bessel beam spot by scanning a charge-coupled device (CCD) pixel

    International Nuclear Information System (INIS)

    Tiwari, S K; Ram, S P; Jayabalan, J; Mishra, S R

    2010-01-01

    By scanning a charge-coupled device (CCD) camera transverse to the beam axis and observing the variation in counts on a marked pixel, we demonstrate that we can measure a laser beam spot size smaller than the size of the CCD-pixel. We find this method particularly attractive for measuring the size of central spot of a Bessel beam, for which the established scanning knife-edge method does not work appropriately because of the large contribution of the rings surrounding the central spot to the signal

  20. The PSI Gantry 2: a second generation proton scanning gantry.

    Science.gov (United States)

    Pedroni, Eros; Bearpark, Ralph; Böhringer, Terence; Coray, Adolf; Duppich, Jürgen; Forss, Sven; George, David; Grossmann, Martin; Goitein, Gudrun; Hilbes, Christian; Jermann, Martin; Lin, Shixiong; Lomax, Antony; Negrazus, Marco; Schippers, Marco; Kotle, Goran

    2004-01-01

    PSI is still the only location in which proton therapy is applied using a dynamic beam scanning technique on a very compact gantry. Recently, this system is also being used for the application of intensity-modulated proton therapy (IMPT). This novel technical development and the success of the proton therapy project altogether have led PSI in Year 2000 to further expand the activities in this field by launching the project PROSCAN. The first step is the installation of a dedicated commercial superconducting cyclotron of a novel type. The second step is the development of a new gantry, Gantry 2. For Gantry 2 we have chosen an iso-centric compact gantry layout. The diameter of the gantry is limited to 7.5 m, less than in other gantry systems (approximately 10-12 m). The space in the treatment room is comfortably large, and the access on a fixed floor is possible any time around the patient table. Through the availability of a faster scanning system, it will be possible to treat the target volume repeatedly in the same session. For this purpose, the dynamic control of the beam intensity at the ion source and the dynamic variation of the beam energy will be used directly for the shaping of the dose.

  1. Scanning vs. single spot laser ablation (λ=213 nm) inductively coupled plasma mass spectrometry

    International Nuclear Information System (INIS)

    Gonzalez, Jhanis J.; Fernandez, Alberto; Mao Xianglei; Russo, Richard E.

    2004-01-01

    Sampling strategy is defined in this work as the interaction of a repetitively pulsed laser beam with a fixed position on a sample (single spot) or with a moving sample (scan). Analytical performance of these sampling strategies was compared by using 213 nm laser ablation ICP-MS. A geological rock (Tuff) was quantitatively analyzed based on NIST series 610-616 glass standard reference materials. Laser ablation data were compared to ICP-MS analysis of the dissolved samples. The scan strategy (50 μm/s) produced a flat, steady temporal ICP-MS response whereas the single spot strategy produced a signal that decayed with time (after 60 s). Single-spot sampling provided better accuracy and precision than the scan strategy when the first 15 s of the sampling time was eliminated from the data analysis. In addition, the single spot strategy showed less matrix dependence among the four NIST glasses

  2. Technical Note: Defining cyclotron-based clinical scanning proton machines in a FLUKA Monte Carlo system.

    Science.gov (United States)

    Fiorini, Francesca; Schreuder, Niek; Van den Heuvel, Frank

    2018-02-01

    Cyclotron-based pencil beam scanning (PBS) proton machines represent nowadays the majority and most affordable choice for proton therapy facilities, however, their representation in Monte Carlo (MC) codes is more complex than passively scattered proton system- or synchrotron-based PBS machines. This is because degraders are used to decrease the energy from the cyclotron maximum energy to the desired energy, resulting in a unique spot size, divergence, and energy spread depending on the amount of degradation. This manuscript outlines a generalized methodology to characterize a cyclotron-based PBS machine in a general-purpose MC code. The code can then be used to generate clinically relevant plans starting from commercial TPS plans. The described beam is produced at the Provision Proton Therapy Center (Knoxville, TN, USA) using a cyclotron-based IBA Proteus Plus equipment. We characterized the Provision beam in the MC FLUKA using the experimental commissioning data. The code was then validated using experimental data in water phantoms for single pencil beams and larger irregular fields. Comparisons with RayStation TPS plans are also presented. Comparisons of experimental, simulated, and planned dose depositions in water plans show that same doses are calculated by both programs inside the target areas, while penumbrae differences are found at the field edges. These differences are lower for the MC, with a γ(3%-3 mm) index never below 95%. Extensive explanations on how MC codes can be adapted to simulate cyclotron-based scanning proton machines are given with the aim of using the MC as a TPS verification tool to check and improve clinical plans. For all the tested cases, we showed that dose differences with experimental data are lower for the MC than TPS, implying that the created FLUKA beam model is better able to describe the experimental beam. © 2017 The Authors. Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists

  3. Proton pencil beam scanning for mediastinal lymphoma: the impact of interplay between target motion and beam scanning

    Science.gov (United States)

    Zeng, C.; Plastaras, J. P.; Tochner, Z. A.; White, B. M.; Hill-Kayser, C. E.; Hahn, S. M.; Both, S.

    2015-04-01

    The purpose of this study was to assess the feasibility of proton pencil beam scanning (PBS) for the treatment of mediastinal lymphoma. A group of 7 patients of varying tumor size (100-800 cc) were planned using a PBS anterior field. We investigated 17 fractions of 1.8 Gy(RBE) to deliver 30.6 Gy(RBE) to the internal target volume (ITV). Spots with σ ranging from 4 mm to 8 mm were used for all patients, while larger spots (σ = 6-16 mm) were employed for patients with motion perpendicular to the beam (⩾5 mm), based on initial 4-dimensional computed tomography (4D CT) motion evaluation. We considered volumetric repainting such that the same field would be delivered twice in each fraction. The ratio of extreme inhalation amplitude and regular tidal inhalation amplitude (free-breathing variability) was quantified as an indicator of potential irregular breathing during the scanning. Four-dimensional dose was calculated on the 4D CT scans based on the respiratory trace and beam delivery sequence, implemented by partitioning the spots into separate plans on each 4D CT phase. Four starting phases (end of inhalation, end of exhalation, middle of inhalation and middle of exhalation) were sampled for each painting and 4 energy switching times (0.5 s, 1 s, 3 s and 5 s) were tested, which resulted in 896 dose distributions for the analyzed cohort. Plan robustness was measured for the target and critical structures in terms of the percent difference between ‘delivered’ dose (4D-evaluated) and planned dose (calculated on average CT). It was found that none of the patients exhibited highly variable or chaotic breathing patterns. For all patients, the ITV D98% was degraded by Wilcoxon signed-rank tests (p < 0.05). This feasibility study demonstrates that, for mediastinal lymphoma, the impact of the interplay effect on the PBS plan robustness is minimal when volumetric repainting and/or larger spots are employed.

  4. SU-E-T-561: Development of Depth Dose Measurement Technique Using the Multilayer Ionization Chamber for Spot Scanning Method

    International Nuclear Information System (INIS)

    Takayanagi, T; Fujitaka, S; Umezawa, M; Ito, Y; Nakashima, C; Matsuda, K

    2014-01-01

    Purpose: To develop a measurement technique which suppresses the difference between profiles obtained with a multilayer ionization chamber (MLIC) and with a water phantom. Methods: The developed technique multiplies the raw MLIC data by a correction factor that depends on the initial beam range and water equivalent depth. The correction factor is derived based on a Bragg curve calculation formula considering range straggling and fluence loss caused by nuclear reactions. Furthermore, the correction factor is adjusted based on several integrated depth doses measured with a water phantom and the MLIC. The measured depth dose profiles along the central axis of the proton field with a nominal field size of 10 by 10 cm were compared between the MLIC using the new technique and the water phantom. The spread out Bragg peak was 20 cm for fields with a range of 30.6 cm and 6.9 cm. Raw MLIC data were obtained with each energy layer, and integrated after multiplying by the correction factor. The measurements were performed by a spot scanning nozzle at Nagoya Proton Therapy Center, Japan. Results: The profile measured with the MLIC using the new technique is consistent with that of the water phantom. Moreover, 97% of the points passed the 1% dose /1mm distance agreement criterion of the gamma index. Conclusion: We have demonstrated that the new technique suppresses the difference between profiles obtained with the MLIC and with the water phantom. It was concluded that this technique is useful for depth dose measurement in proton spot scanning method

  5. SU-F-BRD-12: When Does Pencil Beam Scanning Become Superior to Passive Scattered Proton Therapy for Pediatric Head and Neck Cancers?

    Energy Technology Data Exchange (ETDEWEB)

    Moteabbed, M; Depauw, N; Kooy, H; Yock, T; Paganetti, H [Massachusetts General Hospital, Boston, MA (United States)

    2015-06-15

    Purpose: To investigate the dosimetric benefits of pencil beam scanning (PBS) compared with passive scattered (PS) proton therapy for treatment of pediatric head&neck patients as a function of the PBS spot size and explore the advantages of using apertures in PBS. Methods: Ten pediatric patients with head&neck cancers treated by PS proton therapy at our institution were retrospectively selected. The histologies included rhabdomyosarcoma, ependymoma, astrocytoma, craniopharyngioma and germinoma. The prescribed dose ranged from 36 to 54 Gy(RBE). Five PBS plans were created for each patient using variable spot size (average sigma at isocenter) and choice of beam specific apertures: (1) 10mm spots, (2) 10mm spots with apertures, (3) 6mm spots, (4) 6mm spots with apertures, and (5) 3mm spots. The plans were optimized for intensity modulated proton therapy (IMPT) with no single beam uniformity constraints. Dose volume indices as well as equivalent uniform dose (EUD) were compared between PS and PBS plans. Results: Although target coverage was clinically adequate for all cases, the plans with largest (10mm) spots provide inferior quality compared with PS in terms of dose to organs-at-risk (OAR). However, adding apertures to these plans ensured lower OAR dose than PS. The average EUD difference between PBS and PS plans over all patients and organs at risk were (1) 2.5%, (2) −5.1%, (3) -5%, (4) −7.8%, and (5) −9.5%. As the spot size decreased, more conformal plans were achieved that offered similar target coverage but lower dose to the neighboring healthy organs, while alleviating the need for using apertures. Conclusion: The application of PBS does not always translate to better plan qualities compared to PS depending on the available beam spot size. We recommend that institutions with spot size larger than ∼6mm at isocenter consider using apertures to guarantee clinically comparable or superior dosimetric efficacy to PS treatments.

  6. SU-E-T-120: Analytic Dose Verification for Patient-Specific Proton Pencil Beam Scanning Plans

    International Nuclear Information System (INIS)

    Chang, C; Mah, D

    2015-01-01

    Purpose: To independently verify the QA dose of proton pencil beam scanning (PBS) plans using an analytic dose calculation model. Methods: An independent proton dose calculation engine is created using the same commissioning measurements as those employed to build our commercially available treatment planning system (TPS). Each proton PBS plan is exported from the TPS in DICOM format and calculated by this independent dose engine in a standard 40 x 40 x 40 cm water tank. This three-dimensional dose grid is then compared with the QA dose calculated by the commercial TPS, using standard Gamma criterion. A total of 18 measured pristine Bragg peaks, ranging from 100 to 226 MeV, are used in the model. Intermediate proton energies are interpolated. Similarly, optical properties of the spots are measured in air over 15 cm upstream and downstream, and fitted to a second-order polynomial. Multiple Coulomb scattering in water is approximated analytically using Preston and Kohler formula for faster calculation. The effect of range shifters on spot size is modeled with generalized Highland formula. Note that the above formulation approximates multiple Coulomb scattering in water and we therefore chose not use the full Moliere/Hanson form. Results: Initial examination of 3 patient-specific prostate PBS plans shows that agreement exists between 3D dose distributions calculated by the TPS and the independent proton PBS dose calculation engine. Both calculated dose distributions are compared with actual measurements at three different depths per beam and good agreements are again observed. Conclusion: Results here showed that 3D dose distributions calculated by this independent proton PBS dose engine are in good agreement with both TPS calculations and actual measurements. This tool can potentially be used to reduce the amount of different measurement depths required for patient-specific proton PBS QA

  7. SU-E-T-755: Timing Characteristics of Proton and Carbon Ion Treatments Using a Synchrotron and Modulated Scanning

    International Nuclear Information System (INIS)

    Zhao, J; Li, Y; Huang, Z; Deng, Y; Sun, L; Moyers, M; Hsi, W; Wu, X

    2015-01-01

    Purpose: The time required to deliver a treatment impacts not only the number of patients that can be treated each day but also the accuracy of delivery due to potential movements of patient tissues. Both macroscopic and microscopic timing characteristics of a beam delivery system were studied to examine their impacts on patient treatments. Methods: 35 patients were treated during a clinical trial to demonstrate safety and efficacy of a Siemens Iontris system prior to receiving approval from the Chinese Food and Drug Administration. The system has a variable cycle time and can provide proton beams from 48 to 221 MeV/n and carbon ions from 86 to 430 MeV/n. A modulated scanning beam delivery technique is used where the beam remains stationary at each spot aiming location and is not turned off while the spot quickly moves from one aiming location to the next. The treatment log files for 28 of the trial patients were analyzed to determine several timing characteristics. Results: The average portal time per target dose was 172.5 s/Gy for protons and 150.7 s/Gy for carbon ions. The maximum delivery time for any portal was less than 300 s. The average dwell time per spot was 12 ms for protons and 3.0 ms for carbon ions. The number of aiming positions per energy layer varied from 1 to 258 for protons and 1 to 621 for carbon ions. The average spill time and cycle time per energy layer were 1.20 and 2.68 s for protons and 0.95 and 4.73 s for carbon ions respectively. For 3 of the patients, the beam was gated on and off to reduce the effects of respiration. Conclusion: For a typical target volume of 153 cc as used in this clinical trial, the portal delivery times were acceptable

  8. A Monte Carlo pencil beam scanning model for proton treatment plan simulation using GATE/GEANT4

    Energy Technology Data Exchange (ETDEWEB)

    Grevillot, L; Freud, N; Sarrut, D [Universite de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Universite Lyon 1, Centre Leon Berard, Lyon (France); Bertrand, D; Dessy, F, E-mail: loic.grevillot@creatis.insa-lyon.fr [IBA, B-1348, Louvain-la Neuve (Belgium)

    2011-08-21

    This work proposes a generic method for modeling scanned ion beam delivery systems, without simulation of the treatment nozzle and based exclusively on beam data library (BDL) measurements required for treatment planning systems (TPS). To this aim, new tools dedicated to treatment plan simulation were implemented in the Gate Monte Carlo platform. The method was applied to a dedicated nozzle from IBA for proton pencil beam scanning delivery. Optical and energy parameters of the system were modeled using a set of proton depth-dose profiles and spot sizes measured at 27 therapeutic energies. For further validation of the beam model, specific 2D and 3D plans were produced and then measured with appropriate dosimetric tools. Dose contributions from secondary particles produced by nuclear interactions were also investigated using field size factor experiments. Pristine Bragg peaks were reproduced with 0.7 mm range and 0.2 mm spot size accuracy. A 32 cm range spread-out Bragg peak with 10 cm modulation was reproduced with 0.8 mm range accuracy and a maximum point-to-point dose difference of less than 2%. A 2D test pattern consisting of a combination of homogeneous and high-gradient dose regions passed a 2%/2 mm gamma index comparison for 97% of the points. In conclusion, the generic modeling method proposed for scanned ion beam delivery systems was applicable to an IBA proton therapy system. The key advantage of the method is that it only requires BDL measurements of the system. The validation tests performed so far demonstrated that the beam model achieves clinical performance, paving the way for further studies toward TPS benchmarking. The method involves new sources that are available in the new Gate release V6.1 and could be further applied to other particle therapy systems delivering protons or other types of ions like carbon.

  9. Dosimetric consequences of tumour motion due to respiration for a scanned proton beam

    International Nuclear Information System (INIS)

    Kraus, K M; Oelfke, U; Heath, E

    2011-01-01

    A method for simulating spot-scanned delivery to a moving tumour was developed which uses patient-specific image and plan data. The magnitude of interplay effects was investigated for two patient cases under different fractionation and respiratory motion variation scenarios. The use of volumetric rescanning for motion mitigation was also investigated. For different beam arrangements, interplay effects lead to severely distorted dose distributions for a single fraction delivery. Baseline shift variations for single fraction delivery reduced the dose to the clinical target volume (CTV) by up to 14.1 Gy. Fractionated delivery significantly reduced interplay effects; however, local overdosage of 12.3% compared to the statically delivered dose remained for breathing period variations. Variations of the tumour baseline position and respiratory period were found to have the largest influence on target inhomogeneity; these effects were reduced with fractionation. Volumetric rescanning improved the dose homogeneity. For the CTV, underdosage was improved by up to 34% in the CTV and overdosage to the lung was reduced by 6%. Our results confirm that rescanning potentially increases the dose homogeneity; however, it might not sufficiently compensate motion-induced dose distortions. Other motion mitigation techniques may be required to additionally treat lung tumours with scanned proton beams.

  10. On the interplay effects with proton scanning beams in stage III lung cancer.

    Science.gov (United States)

    Li, Yupeng; Kardar, Laleh; Li, Xiaoqiang; Li, Heng; Cao, Wenhua; Chang, Joe Y; Liao, Li; Zhu, Ronald X; Sahoo, Narayan; Gillin, Michael; Liao, Zhongxing; Komaki, Ritsuko; Cox, James D; Lim, Gino; Zhang, Xiaodong

    2014-02-01

    To assess the dosimetric impact of interplay between spot-scanning proton beam and respiratory motion in intensity-modulated proton therapy (IMPT) for stage III lung cancer. Eleven patients were sampled from 112 patients with stage III nonsmall cell lung cancer to well represent the distribution of 112 patients in terms of target size and motion. Clinical target volumes (CTVs) and planning target volumes (PTVs) were defined according to the authors' clinical protocol. Uniform and realistic breathing patterns were considered along with regular- and hypofractionation scenarios. The dose contributed by a spot was fully calculated on the computed tomography (CT) images corresponding to the respiratory phase that the spot is delivered, and then accumulated to the reference phase of the 4DCT to generate the dynamic dose that provides an estimation of what might be delivered under the influence of interplay effect. The dynamic dose distributions at different numbers of fractions were compared with the corresponding 4D composite dose which is the equally weighted average of the doses, respectively, computed on respiratory phases of a 4DCT image set. Under regular fractionation, the average and maximum differences in CTV coverage between the 4D composite and dynamic doses after delivery of all 35 fractions were no more than 0.2% and 0.9%, respectively. The maximum differences between the two dose distributions for the maximum dose to the spinal cord, heart V40, esophagus V55, and lung V20 were 1.2 Gy, 0.1%, 0.8%, and 0.4%, respectively. Although relatively large differences in single fraction, correlated with small CTVs relative to motions, were observed, the authors' biological response calculations suggested that this interfractional dose variation may have limited biological impact. Assuming a hypofractionation scenario, the differences between the 4D composite and dynamic doses were well confined even for single fraction. Despite the presence of interplay effect, the

  11. On the interplay effects with proton scanning beams in stage III lung cancer

    International Nuclear Information System (INIS)

    Li, Yupeng; Kardar, Laleh; Liao, Li; Lim, Gino; Li, Xiaoqiang; Li, Heng; Zhu, Ronald X.; Sahoo, Narayan; Gillin, Michael; Zhang, Xiaodong; Cao, Wenhua; Chang, Joe Y.; Liao, Zhongxing; Komaki, Ritsuko; Cox, James D.

    2014-01-01

    Purpose: To assess the dosimetric impact of interplay between spot-scanning proton beam and respiratory motion in intensity-modulated proton therapy (IMPT) for stage III lung cancer. Methods: Eleven patients were sampled from 112 patients with stage III nonsmall cell lung cancer to well represent the distribution of 112 patients in terms of target size and motion. Clinical target volumes (CTVs) and planning target volumes (PTVs) were defined according to the authors' clinical protocol. Uniform and realistic breathing patterns were considered along with regular- and hypofractionation scenarios. The dose contributed by a spot was fully calculated on the computed tomography (CT) images corresponding to the respiratory phase that the spot is delivered, and then accumulated to the reference phase of the 4DCT to generate the dynamic dose that provides an estimation of what might be delivered under the influence of interplay effect. The dynamic dose distributions at different numbers of fractions were compared with the corresponding 4D composite dose which is the equally weighted average of the doses, respectively, computed on respiratory phases of a 4DCT image set. Results: Under regular fractionation, the average and maximum differences in CTV coverage between the 4D composite and dynamic doses after delivery of all 35 fractions were no more than 0.2% and 0.9%, respectively. The maximum differences between the two dose distributions for the maximum dose to the spinal cord, heart V40, esophagus V55, and lung V20 were 1.2 Gy, 0.1%, 0.8%, and 0.4%, respectively. Although relatively large differences in single fraction, correlated with small CTVs relative to motions, were observed, the authors' biological response calculations suggested that this interfractional dose variation may have limited biological impact. Assuming a hypofractionation scenario, the differences between the 4D composite and dynamic doses were well confined even for single fraction. Conclusions: Despite

  12. Ultrasonic C-scan Technique for Nondestructive Evaluation of Spot Weld Quality

    International Nuclear Information System (INIS)

    Park, Ik Gun

    1994-01-01

    This paper discusses the feasibility of ultrasonic C-scan technique for nondestructive evaluation of spot weld quality. Ultrasonic evaluation for spot weld quality was performed by immersion method with the mechanical and the electronic scanning of point-focussed ultrasonic beam(25 MHz). For the sake of the approach to the quantitative measurement of nugget diameter and the discrimination of the corona bond from nugget, preliminary infinitesimal gap experiment by newton ring is tried in order to set up the optimum ultrasonic test condition. Ultrasonic image data obtained were confirmed and compared by optical microscope and SAM(Scanning Acoustic Microscope) observation of the spot-weld cross section. The results show that the nugget diameter can be measured with the accuracy of 1.0mm, and voids included in nugget can be detected to 10μm extent with simplicity and accuracy. Finally, it was found that it is necessary to make a profound study of definite discrimination of corona bond from nugget and the approach of quantitative evaluation of nugget diameter by utilizing the various image processing techniques

  13. Measurement of hot spots inside the proton at HERA and LEP/LHC

    International Nuclear Information System (INIS)

    Bartels, J.

    1991-12-01

    In this paper we discuss the measurement of regions in the proton where the density of small-χ partons is large, called 'hot spots', by means of an associated jet analysis. An analytical estimate of the cross section is presented and the jet kinematics is discussed in the HERA and LEP-LHC frame. A Monte Carlo estimate shows that the number of jets produced in deep inelastic scattering events at HERA, suitable for this analysis, amounts to a few 1000 jets for a data sample with an integrated luminosity of about 10 pb -1 . (orig.)

  14. SU-E-T-314: The Application of Cloud Computing in Pencil Beam Scanning Proton Therapy Monte Carlo Simulation

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Z [Reading Hospital, West Reading, PA (United States); Gao, M [ProCure Treatment Centers, Warrenville, IL (United States)

    2014-06-01

    Purpose: Monte Carlo simulation plays an important role for proton Pencil Beam Scanning (PBS) technique. However, MC simulation demands high computing power and is limited to few large proton centers that can afford a computer cluster. We study the feasibility of utilizing cloud computing in the MC simulation of PBS beams. Methods: A GATE/GEANT4 based MC simulation software was installed on a commercial cloud computing virtual machine (Linux 64-bits, Amazon EC2). Single spot Integral Depth Dose (IDD) curves and in-air transverse profiles were used to tune the source parameters to simulate an IBA machine. With the use of StarCluster software developed at MIT, a Linux cluster with 2–100 nodes can be conveniently launched in the cloud. A proton PBS plan was then exported to the cloud where the MC simulation was run. Results: The simulated PBS plan has a field size of 10×10cm{sup 2}, 20cm range, 10cm modulation, and contains over 10,000 beam spots. EC2 instance type m1.medium was selected considering the CPU/memory requirement and 40 instances were used to form a Linux cluster. To minimize cost, master node was created with on-demand instance and worker nodes were created with spot-instance. The hourly cost for the 40-node cluster was $0.63 and the projected cost for a 100-node cluster was $1.41. Ten million events were simulated to plot PDD and profile, with each job containing 500k events. The simulation completed within 1 hour and an overall statistical uncertainty of < 2% was achieved. Good agreement between MC simulation and measurement was observed. Conclusion: Cloud computing is a cost-effective and easy to maintain platform to run proton PBS MC simulation. When proton MC packages such as GATE and TOPAS are combined with cloud computing, it will greatly facilitate the pursuing of PBS MC studies, especially for newly established proton centers or individual researchers.

  15. SU-E-T-314: The Application of Cloud Computing in Pencil Beam Scanning Proton Therapy Monte Carlo Simulation

    International Nuclear Information System (INIS)

    Wang, Z; Gao, M

    2014-01-01

    Purpose: Monte Carlo simulation plays an important role for proton Pencil Beam Scanning (PBS) technique. However, MC simulation demands high computing power and is limited to few large proton centers that can afford a computer cluster. We study the feasibility of utilizing cloud computing in the MC simulation of PBS beams. Methods: A GATE/GEANT4 based MC simulation software was installed on a commercial cloud computing virtual machine (Linux 64-bits, Amazon EC2). Single spot Integral Depth Dose (IDD) curves and in-air transverse profiles were used to tune the source parameters to simulate an IBA machine. With the use of StarCluster software developed at MIT, a Linux cluster with 2–100 nodes can be conveniently launched in the cloud. A proton PBS plan was then exported to the cloud where the MC simulation was run. Results: The simulated PBS plan has a field size of 10×10cm 2 , 20cm range, 10cm modulation, and contains over 10,000 beam spots. EC2 instance type m1.medium was selected considering the CPU/memory requirement and 40 instances were used to form a Linux cluster. To minimize cost, master node was created with on-demand instance and worker nodes were created with spot-instance. The hourly cost for the 40-node cluster was $0.63 and the projected cost for a 100-node cluster was $1.41. Ten million events were simulated to plot PDD and profile, with each job containing 500k events. The simulation completed within 1 hour and an overall statistical uncertainty of < 2% was achieved. Good agreement between MC simulation and measurement was observed. Conclusion: Cloud computing is a cost-effective and easy to maintain platform to run proton PBS MC simulation. When proton MC packages such as GATE and TOPAS are combined with cloud computing, it will greatly facilitate the pursuing of PBS MC studies, especially for newly established proton centers or individual researchers

  16. Impact of Intrafraction and Residual Interfraction Effect on Prostate Proton Pencil Beam Scanning

    International Nuclear Information System (INIS)

    Tang, Shikui; Deville, Curtiland; Tochner, Zelig; Wang, Ken Kang-Hsin; McDonough, James; Vapiwala, Neha; Both, Stefan

    2014-01-01

    Purpose: To quantitatively evaluate the impact of interplay effect and plan robustness associated with intrafraction and residual interfraction prostate motion for pencil beam scanning proton therapy. Methods and Materials: Ten prostate cancer patients with weekly verification CTs underwent pencil beam scanning with the bilateral single-field uniform dose (SFUD) modality. A typical field had 10-15 energy layers and 500-1000 spots. According to their treatment logs, each layer delivery time was <1 s, with average time to change layers of approximately 8 s. Real-time intrafraction prostate motion was determined from our previously reported prospective study using Calypso beacon transponders. Prostate motion and beam delivering sequence of the worst-case scenario patient were synchronized to calculate the “true” dose received by the prostate. The intrafraction effect was examined by applying the worst-case scenario prostate motion on the planning CT, and the residual interfraction effect was examined on the basis of weekly CT scans. The resultant dose variation of target and critical structures was examined to evaluate the interplay effect. Results: The clinical target volume (CTV) coverage was degraded because of both effects. The CTV D 99 (percentage dose to 99% of the CTV) varied up to 10% relative to the initial plan in individual fractions. However, over the entire course of treatment the total dose degradation of D 99 was 2%-3%, with a standard deviation of <2%. Absolute differences between SFUD, intensity modulate proton therapy, and one-field-per-day SFUD plans were small. The intrafraction effect dominated over the residual interfraction effect for CTV coverage. Mean dose to the anterior rectal wall increased approximately 10% because of combined residual interfraction and intrafraction effects, the interfraction effect being dominant. Conclusions: Both intrafraction and residual interfraction prostate motion degrade CTV coverage within a clinically

  17. Impact of Intrafraction and Residual Interfraction Effect on Prostate Proton Pencil Beam Scanning

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Shikui, E-mail: shktang@gmail.com [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); ProCure Proton Therapy Center, Somerset, New Jersey (United States); Deville, Curtiland; Tochner, Zelig [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Wang, Ken Kang-Hsin [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland (United States); McDonough, James; Vapiwala, Neha; Both, Stefan [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2014-12-01

    Purpose: To quantitatively evaluate the impact of interplay effect and plan robustness associated with intrafraction and residual interfraction prostate motion for pencil beam scanning proton therapy. Methods and Materials: Ten prostate cancer patients with weekly verification CTs underwent pencil beam scanning with the bilateral single-field uniform dose (SFUD) modality. A typical field had 10-15 energy layers and 500-1000 spots. According to their treatment logs, each layer delivery time was <1 s, with average time to change layers of approximately 8 s. Real-time intrafraction prostate motion was determined from our previously reported prospective study using Calypso beacon transponders. Prostate motion and beam delivering sequence of the worst-case scenario patient were synchronized to calculate the “true” dose received by the prostate. The intrafraction effect was examined by applying the worst-case scenario prostate motion on the planning CT, and the residual interfraction effect was examined on the basis of weekly CT scans. The resultant dose variation of target and critical structures was examined to evaluate the interplay effect. Results: The clinical target volume (CTV) coverage was degraded because of both effects. The CTV D{sub 99} (percentage dose to 99% of the CTV) varied up to 10% relative to the initial plan in individual fractions. However, over the entire course of treatment the total dose degradation of D{sub 99} was 2%-3%, with a standard deviation of <2%. Absolute differences between SFUD, intensity modulate proton therapy, and one-field-per-day SFUD plans were small. The intrafraction effect dominated over the residual interfraction effect for CTV coverage. Mean dose to the anterior rectal wall increased approximately 10% because of combined residual interfraction and intrafraction effects, the interfraction effect being dominant. Conclusions: Both intrafraction and residual interfraction prostate motion degrade CTV coverage within a

  18. Simulation of eye-tracker latency, spot size, and ablation pulse depth on the correction of higher order wavefront aberrations with scanning spot laser systems.

    Science.gov (United States)

    Bueeler, Michael; Mrochen, Michael

    2005-01-01

    The aim of this theoretical work was to investigate the robustness of scanning spot laser treatments with different laser spot diameters and peak ablation depths in case of incomplete compensation of eye movements due to eye-tracker latency. Scanning spot corrections of 3rd to 5th Zernike order wavefront errors were numerically simulated. Measured eye-movement data were used to calculate the positioning error of each laser shot assuming eye-tracker latencies of 0, 5, 30, and 100 ms, and for the case of no eye tracking. The single spot ablation depth ranged from 0.25 to 1.0 microm and the spot diameter from 250 to 1000 microm. The quality of the ablation was rated by the postoperative surface variance and the Strehl intensity ratio, which was calculated after a low-pass filter was applied to simulate epithelial surface smoothing. Treatments performed with nearly ideal eye tracking (latency approximately 0) provide the best results with a small laser spot (0.25 mm) and a small ablation depth (250 microm). However, combinations of a large spot diameter (1000 microm) and a small ablation depth per pulse (0.25 microm) yield the better results for latencies above a certain threshold to be determined specifically. Treatments performed with tracker latencies in the order of 100 ms yield similar results as treatments done completely without eye-movement compensation. CONCWSIONS: Reduction of spot diameter was shown to make the correction more susceptible to eye movement induced error. A smaller spot size is only beneficial when eye movement is neutralized with a tracking system with a latency <5 ms.

  19. High resolution techniques using scanning proton microprobe (SPM)

    International Nuclear Information System (INIS)

    Cholewa, M.; Saint, A.; Prawer, S.; Laird, J.S.; Legge, G.J.F.; Bardos, R.A.; Moorhead, G.F.; Taylor, G.N.; Stuart, S.A.; Howard, J.

    1994-01-01

    The very high resolution (down to 50 nm) achieved with low beam currents (fA) in a scanning ion microprobe have lead to many nondestructive techniques of microanalysis. This paper discusses recent developments and applications in the use of 3-D STIM (scanning transmission ion microscopy) Tomography, channeling STIM and IBIC (ion beam induced charge). (orig.)

  20. Elemental microanalysis of biological and medical specimens with a scanning proton microprobe

    International Nuclear Information System (INIS)

    Legge, G.J.F.; Mazzolini, A.P.

    1979-01-01

    The scanning proton microprobe is shown to be a sensitive instrument for elemental microanalysis of cells and tissues in biological and medical specimens. The preparation of specimens and their behaviour under irradiation are crucial and the application of quantitative scanning analysis to the monitoring of such problems is illustrated

  1. Real-time beam monitoring in scanned proton therapy

    Science.gov (United States)

    Klimpki, G.; Eichin, M.; Bula, C.; Rechsteiner, U.; Psoroulas, S.; Weber, D. C.; Lomax, A.; Meer, D.

    2018-05-01

    When treating cancerous tissues with protons beams, many centers make use of a step-and-shoot irradiation technique, in which the beam is steered to discrete grid points in the tumor volume. For safety reasons, the irradiation is supervised by an independent monitoring system validating cyclically that the correct amount of protons has been delivered to the correct position in the patient. Whenever unacceptable inaccuracies are detected, the irradiation can be interrupted to reinforce a high degree of radiation protection. At the Paul Scherrer Institute, we plan to irradiate tumors continuously. By giving up the idea of discrete grid points, we aim to be faster and more flexible in the irradiation. But the increase in speed and dynamics necessitates a highly responsive monitoring system to guarantee the same level of patient safety as for conventional step-and-shoot irradiations. Hence, we developed and implemented real-time monitoring of the proton beam current and position. As such, we read out diagnostic devices with 100 kHz and compare their signals against safety tolerances in an FPGA. In this paper, we report on necessary software and firmware enhancements of our control system and test their functionality based on three exemplary error scenarios. We demonstrate successful implementation of real-time beam monitoring and, consequently, compliance with international patient safety regulations.

  2. Interplay effects in proton scanning for lung: a 4D Monte Carlo study assessing the impact of tumor and beam delivery parameters

    International Nuclear Information System (INIS)

    Dowdell, S; Grassberger, C; Sharp, G C; Paganetti, H

    2013-01-01

    Relative motion between a tumor and a scanning proton beam results in a degradation of the dose distribution (interplay effect). This study investigates the relationship between beam scanning parameters and the interplay effect, with the goal of finding parameters that minimize interplay. 4D Monte Carlo simulations of pencil beam scanning proton therapy treatments were performed using the 4DCT geometry of five lung cancer patients of varying tumor size (50.4–167.1 cc) and motion amplitude (2.9–30.1 mm). Treatments were planned assuming delivery in 35 × 2.5 Gy(RBE) fractions. The spot size, time to change the beam energy (τ es ), time required for magnet settling (τ ss ), initial breathing phase, spot spacing, scanning direction, scanning speed, beam current and patient breathing period were varied for each of the five patients. Simulations were performed for a single fraction and an approximation of conventional fractionation. For the patients considered, the interplay effect could not be predicted using the superior–inferior motion amplitude alone. Larger spot sizes (σ ∼ 9–16 mm) were less susceptible to interplay, giving an equivalent uniform dose (EUD) of 99.0 ± 4.4% (1 standard deviation) in a single fraction compared to 86.1 ± 13.1% for smaller spots (σ ∼ 2–4 mm). The smaller spot sizes gave EUD values as low as 65.3% of the prescription dose in a single fraction. Reducing the spot spacing improved the target dose homogeneity. The initial breathing phase can have a significant effect on the interplay, particularly for shorter delivery times. No clear benefit was evident when scanning either parallel or perpendicular to the predominant axis of motion. Longer breathing periods decreased the EUD. In general, longer delivery times led to lower interplay effects. Conventional fractionation showed significant improvement in terms of interplay, giving a EUD of at least 84.7% and 100.0% of the prescription dose for the small and larger spot sizes

  3. Interplay effects in proton scanning for lung: a 4D Monte Carlo study assessing the impact of tumor and beam delivery parameters.

    Science.gov (United States)

    Dowdell, S; Grassberger, C; Sharp, G C; Paganetti, H

    2013-06-21

    Relative motion between a tumor and a scanning proton beam results in a degradation of the dose distribution (interplay effect). This study investigates the relationship between beam scanning parameters and the interplay effect, with the goal of finding parameters that minimize interplay. 4D Monte Carlo simulations of pencil beam scanning proton therapy treatments were performed using the 4DCT geometry of five lung cancer patients of varying tumor size (50.4-167.1 cc) and motion amplitude (2.9-30.1 mm). Treatments were planned assuming delivery in 35 × 2.5 Gy(RBE) fractions. The spot size, time to change the beam energy (τes), time required for magnet settling (τss), initial breathing phase, spot spacing, scanning direction, scanning speed, beam current and patient breathing period were varied for each of the five patients. Simulations were performed for a single fraction and an approximation of conventional fractionation. For the patients considered, the interplay effect could not be predicted using the superior-inferior motion amplitude alone. Larger spot sizes (σ ~ 9-16 mm) were less susceptible to interplay, giving an equivalent uniform dose (EUD) of 99.0 ± 4.4% (1 standard deviation) in a single fraction compared to 86.1 ± 13.1% for smaller spots (σ ~ 2-4 mm). The smaller spot sizes gave EUD values as low as 65.3% of the prescription dose in a single fraction. Reducing the spot spacing improved the target dose homogeneity. The initial breathing phase can have a significant effect on the interplay, particularly for shorter delivery times. No clear benefit was evident when scanning either parallel or perpendicular to the predominant axis of motion. Longer breathing periods decreased the EUD. In general, longer delivery times led to lower interplay effects. Conventional fractionation showed significant improvement in terms of interplay, giving a EUD of at least 84.7% and 100.0% of the prescription dose for the small and larger spot sizes respectively. The

  4. SU-F-T-172: A Method for Log File QA On An IBA Proteus System for Patient Specific Spot Scanning Quality Assurance

    Energy Technology Data Exchange (ETDEWEB)

    Tang, S; Ho, M; Chen, C; Mah, D [ProCure NJ, Somerset, NJ (United States); Rice, I; Doan, D; Mac Rae, B [IBA, Somerset, NJ (United States)

    2016-06-15

    Purpose: The use of log files to perform patient specific quality assurance for both protons and IMRT has been established. Here, we extend that approach to a proprietary log file format and compare our results to measurements in phantom. Our goal was to generate a system that would permit gross errors to be found within 3 fractions until direct measurements. This approach could eventually replace direct measurements. Methods: Spot scanning protons pass through multi-wire ionization chambers which provide information about the charge, location, and size of each delivered spot. We have generated a program that calculates the dose in phantom from these log files and compares the measurements with the plan. The program has 3 different spot shape models: single Gaussian, double Gaussian and the ASTROID model. The program was benchmarked across different treatment sites for 23 patients and 74 fields. Results: The dose calculated from the log files were compared to those generate by the treatment planning system (Raystation). While the dual Gaussian model often gave better agreement, overall, the ASTROID model gave the most consistent results. Using a 5%–3 mm gamma with a 90% passing criteria and excluding doses below 20% of prescription all patient samples passed. However, the degree of agreement of the log file approach was slightly worse than that of the chamber array measurement approach. Operationally, this implies that if the beam passes the log file model, it should pass direct measurement. Conclusion: We have established and benchmarked a model for log file QA in an IBA proteus plus system. The choice of optimal spot model for a given class of patients may be affected by factors such as site, field size, and range shifter and will be investigated further.

  5. A study of lateral fall-off (penumbra) optimisation for pencil beam scanning (PBS) proton therapy

    Science.gov (United States)

    Winterhalter, C.; Lomax, A.; Oxley, D.; Weber, D. C.; Safai, S.

    2018-01-01

    The lateral fall-off is crucial for sparing organs at risk in proton therapy. It is therefore of high importance to minimize the penumbra for pencil beam scanning (PBS). Three optimisation approaches are investigated: edge-collimated uniformly weighted spots (collimation), pencil beam optimisation of uncollimated pencil beams (edge-enhancement) and the optimisation of edge collimated pencil beams (collimated edge-enhancement). To deliver energies below 70 MeV, these strategies are evaluated in combination with the following pre-absorber methods: field specific fixed thickness pre-absorption (fixed), range specific, fixed thickness pre-absorption (automatic) and range specific, variable thickness pre-absorption (variable). All techniques are evaluated by Monte Carlo simulated square fields in a water tank. For a typical air gap of 10 cm, without pre-absorber collimation reduces the penumbra only for water equivalent ranges between 4-11 cm by up to 2.2 mm. The sharpest lateral fall-off is achieved through collimated edge-enhancement, which lowers the penumbra down to 2.8 mm. When using a pre-absorber, the sharpest fall-offs are obtained when combining collimated edge-enhancement with a variable pre-absorber. For edge-enhancement and large air gaps, it is crucial to minimize the amount of material in the beam. For small air gaps however, the superior phase space of higher energetic beams can be employed when more material is used. In conclusion, collimated edge-enhancement combined with the variable pre-absorber is the recommended setting to minimize the lateral penumbra for PBS. Without collimator, it would be favourable to use a variable pre-absorber for large air gaps and an automatic pre-absorber for small air gaps.

  6. Scanning transmission proton microscopy tomography of reconstruction cells from simulated data

    International Nuclear Information System (INIS)

    Zhang Conghua; Li Min; Hou Qing

    2011-01-01

    For scanning transmission proton microscopy tomography, to compare cell images of the proton stopping power and relative electron density, two cell phantoms are designed and simulated by code FLUKA. The cell images are reconstructed by the filtered back projection algorithm, and compared with their tomography imaging. The images of stopping power and relative electron density slightly vary with proton energies, but the internal images are of clear with high resolution. The organic glass image of relative electron density reveals the resolution power of proton tomography. Also, the simulation results reflect effects of the boundary enhancement, the weak artifacts, and the internal structure border extension by multiple scattering. So using proton tomography to analyze internal structure of a cell is a superior. (authors)

  7. Monte Carlo simulation of secondary neutron dose for scanning proton therapy using FLUKA.

    Directory of Open Access Journals (Sweden)

    Chaeyeong Lee

    Full Text Available Proton therapy is a rapidly progressing field for cancer treatment. Globally, many proton therapy facilities are being commissioned or under construction. Secondary neutrons are an important issue during the commissioning process of a proton therapy facility. The purpose of this study is to model and validate scanning nozzles of proton therapy at Samsung Medical Center (SMC by Monte Carlo simulation for beam commissioning. After the commissioning, a secondary neutron ambient dose from proton scanning nozzle (Gantry 1 was simulated and measured. This simulation was performed to evaluate beam properties such as percent depth dose curve, Bragg peak, and distal fall-off, so that they could be verified with measured data. Using the validated beam nozzle, the secondary neutron ambient dose was simulated and then compared with the measured ambient dose from Gantry 1. We calculated secondary neutron dose at several different points. We demonstrated the validity modeling a proton scanning nozzle system to evaluate various parameters using FLUKA. The measured secondary neutron ambient dose showed a similar tendency with the simulation result. This work will increase the knowledge necessary for the development of radiation safety technology in medical particle accelerators.

  8. SU-F-BRD-15: Quality Correction Factors in Scanned Or Broad Proton Therapy Beams Are Indistinguishable

    Energy Technology Data Exchange (ETDEWEB)

    Sorriaux, J; Lee, J [Molecular Imaging Radiotherapy & Oncology, Universite Catholique de Louvain, Brussels (Belgium); ICTEAM Institute, Universite catholique de Louvain, Louvain-la-Neuve (Belgium); Testa, M; Paganetti, H [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, Massachusetts (United States); Bertrand, D; Orban de Xivry, J [Ion Beam Applications, Louvain-la-neuve, Brabant Wallon (Belgium); Palmans, H [EBG MedAustron GmbH, Wiener Neustadt (Austria); National Physical Laboratory, Teddington (United Kingdom); Vynckier, S [Cliniques Universitaires Saint-Luc, Brussels (Belgium); Sterpin, E [Molecular Imaging Radiotherapy & Oncology, Universite Catholique de Louvain, Brussels (Belgium)

    2015-06-15

    Purpose: The IAEA TRS-398 code of practice details the reference conditions for reference dosimetry of proton beams using ionization chambers and the required beam quality correction factors (kQ). Pencil beam scanning (PBS) requires multiple spots to reproduce the reference conditions. The objective is to demonstrate, using Monte Carlo (MC) calculations, that kQ factors for broad beams can be used for scanned beams under the same reference conditions with no significant additional uncertainty. We consider hereafter the general Alfonso formalism (Alfonso et al, 2008) for non-standard beam. Methods: To approach the reference conditions and the associated dose distributions, PBS must combine many pencil beams with range modulation and shaping techniques different than those used in passive systems (broad beams). This might lead to a different energy spectrum at the measurement point. In order to evaluate the impact of these differences on kQ factors, ion chamber responses are computed with MC (Geant4 9.6) in a dedicated scanned pencil beam (Q-pcsr) producing a 10×10cm2 composite field with a flat dose distribution from 10 to 16 cm depth. Ion chamber responses are also computed by MC in a broad beam with quality Q-ds (double scattering). The dose distribution of Q -pcsr matches the dose distribution of Q-ds. k-(Q-pcsr,Q-ds) is computed for a 2×2×0.2cm{sup 3} idealized air cavity and a realistic plane-parallel ion chamber (IC). Results: Under reference conditions, quality correction factors for a scanned composite field versus a broad beam are the same for air cavity dose response, k-(Q-pcsr,Q-ds) =1.001±0.001 and for a Roos IC, k-(Q-pcsr,Q-ds) =0.999±0.005. Conclusion: Quality correction factors for ion chamber response in scanned and broad proton therapy beams are identical under reference conditions within the calculation uncertainties. The results indicate that quality correction factors published in IAEA TRS-398 can be used for scanned beams in the SOBP of a

  9. SU-F-BRD-15: Quality Correction Factors in Scanned Or Broad Proton Therapy Beams Are Indistinguishable

    International Nuclear Information System (INIS)

    Sorriaux, J; Lee, J; Testa, M; Paganetti, H; Bertrand, D; Orban de Xivry, J; Palmans, H; Vynckier, S; Sterpin, E

    2015-01-01

    Purpose: The IAEA TRS-398 code of practice details the reference conditions for reference dosimetry of proton beams using ionization chambers and the required beam quality correction factors (kQ). Pencil beam scanning (PBS) requires multiple spots to reproduce the reference conditions. The objective is to demonstrate, using Monte Carlo (MC) calculations, that kQ factors for broad beams can be used for scanned beams under the same reference conditions with no significant additional uncertainty. We consider hereafter the general Alfonso formalism (Alfonso et al, 2008) for non-standard beam. Methods: To approach the reference conditions and the associated dose distributions, PBS must combine many pencil beams with range modulation and shaping techniques different than those used in passive systems (broad beams). This might lead to a different energy spectrum at the measurement point. In order to evaluate the impact of these differences on kQ factors, ion chamber responses are computed with MC (Geant4 9.6) in a dedicated scanned pencil beam (Q-pcsr) producing a 10×10cm2 composite field with a flat dose distribution from 10 to 16 cm depth. Ion chamber responses are also computed by MC in a broad beam with quality Q-ds (double scattering). The dose distribution of Q -pcsr matches the dose distribution of Q-ds. k-(Q-pcsr,Q-ds) is computed for a 2×2×0.2cm 3 idealized air cavity and a realistic plane-parallel ion chamber (IC). Results: Under reference conditions, quality correction factors for a scanned composite field versus a broad beam are the same for air cavity dose response, k-(Q-pcsr,Q-ds) =1.001±0.001 and for a Roos IC, k-(Q-pcsr,Q-ds) =0.999±0.005. Conclusion: Quality correction factors for ion chamber response in scanned and broad proton therapy beams are identical under reference conditions within the calculation uncertainties. The results indicate that quality correction factors published in IAEA TRS-398 can be used for scanned beams in the SOBP of a high

  10. SU-F-T-188: A Robust Treatment Planning Technique for Proton Pencil Beam Scanning Cranial Spinal Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, M; Mehta, M; Badiyan, S; Young, K; Malyapa, R; Regine, W; Langen, K [University of Maryland School of Medicine, Baltimore, MD (United States); Yam, M [University of Florida Proton Therapy Institute, Jacksonville, FL (United States)

    2016-06-15

    Purpose: To propose a proton pencil beam scanning (PBS) cranial spinal irradiation (CSI) treatment planning technique robust against patient roll, isocenter offset and proton range uncertainty. Method: Proton PBS plans were created (Eclipse V11) for three previously treated CSI patients to 36 Gy (1.8 Gy/fractions). The target volume was separated into three regions: brain, upper spine and lower spine. One posterior-anterior (PA) beam was used for each spine region, and two posterior-oblique beams (15° apart from PA direction, denoted as 2PO-15) for the brain region. For comparison, another plan using one PA beam for the brain target (denoted as 1PA) was created. Using the same optimization objectives, 98% CTV was optimized to receive the prescription dose. To evaluate plan robustness against patient roll, the gantry angle was increased by 3° and dose was recalculated without changing the proton spot weights. On the re-calculated plan, doses were then calculated using 12 scenarios that are combinations of isocenter shift (±3mm in X, Y, and Z directions) and proton range variation (±3.5%). The worst-case-scenario (WCS) brain CTV dosimetric metrics were compared to the nominal plan. Results: For both beam arrangements, the brain field(s) and upper-spine field overlap in the T2–T5 region depending on patient anatomy. The maximum monitor unit per spot were 48.7%, 47.2%, and 40.0% higher for 1PA plans than 2PO-15 plans for the three patients. The 2PO-15 plans have better dose conformity. At the same level of CTV coverage, the 2PO-15 plans have lower maximum dose and higher minimum dose to the CTV. The 2PO-15 plans also showed lower WCS maximum dose to CTV, while the WCS minimum dose to CTV were comparable between the two techniques. Conclusion: Our method of using two posterior-oblique beams for brain target provides improved dose conformity and homogeneity, and plan robustness including patient roll.

  11. Rotational scanning and multiple-spot focusing through a multimode fiber based on digital optical phase conjugation

    Science.gov (United States)

    Ma, Chaojie; Di, Jianglei; Li, Ying; Xiao, Fajun; Zhang, Jiwei; Liu, Kaihui; Bai, Xuedong; Zhao, Jianlin

    2018-06-01

    We demonstrate, for the first time, the rotational memory effect of a multimode fiber (MMF) based on digital optical phase conjugation (DOPC) to achieve multiple-spot focusing. An implementation interferometer is used to address the challenging alignments in DOPC. By rotating the acquired phase conjugate pattern, rotational scanning through a MMF could be achieved by recording a single off-axis hologram. The generation of two focal spots through a MMF is also demonstrated by combining the rotational memory effect with the superposition principle. The results may be useful for ultrafast scanning imaging and optical manipulation of multiple objects through a MMF.

  12. Pattern scan laser versus single spot laser in panretinal photocoagulation treatment for proliferative diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Shu Zhang

    2017-02-01

    Full Text Available AIM: To investigate the efficacy of 577-nm pattern scan laser in panretinal photocoagulation(PRPtreatment in newly diagnosed proliferative diabetic retinopathy(PDR.METHODS:Prospective and comparative observation was performed in totally 32 patients with high-risk PDR. They were randomly divided into group 1(using pattern scan laser, PSLand 2(using single spot laser, SSL, each containing 16 subjects to which totally 20 eyes received PRP. Non-perfusion region was identified with fundus fluorescein angiography(FFAbefore and 3mo after final PRP. The advantage of PSL was verified in terms of the number and the duration of PRP sessions needed for satisfactory outcomes, and the pain score.RESULTS: Three PRP sessions were needed for each eye to complete the treatment using PSL, while 4 sessions were needed using SSL. The duration of each session with PSL in group 1 was 7.3±2.3min, which was significantly shorter than that with SSL in group 2(13.2±4.1, t38=5.596, PPCONCLUSION: PSL showed clear advantages over SSL in the PRP treatment of PDR, not only in the improved efficacy, but also in the reduction of pain and the improvement of effectiveness.

  13. Feasibility of proton pencil beam scanning treatment of free-breathing lung cancer patients

    NARCIS (Netherlands)

    Jakobi, Annika; Perrin, Rosalind; Knopf, Antje; Richter, Christian

    BACKGROUND: The interplay effect might degrade the dose of pencil beam scanning proton therapy to a degree that free-breathing treatment might be impossible without further motion mitigation techniques, which complicate and prolong the treatment. We assessed whether treatment of free-breathing

  14. Measurement of stray neutron doses inside the treatment room from a proton pencil beam scanning system

    Czech Academy of Sciences Publication Activity Database

    Mojzeszek, N.; Farah, J.; Klodowska, M.; Ploc, Ondřej; Stolarczyk, L.; Waligorski, M. P. R.; Olko, P.

    2017-01-01

    Roč. 34, č. 2 (2017), s. 80-84 ISSN 1120-1797 Institutional support: RVO:61389005 Keywords : secondary neutrons * proton therapy * pencil beam scanning systtems * out-of-field doses * stray neutron doses * TEPC Subject RIV: FP - Other Medical Disciplines OBOR OECD: Radiology, nuclear medicine and medical imaging Impact factor: 1.990, year: 2016

  15. Prevalence and diagnostic performance of computed tomography angiography spot sign for intracerebral hematoma expansion depend on scan timing

    Energy Technology Data Exchange (ETDEWEB)

    Tsukabe, Akio; Watanabe, Yoshiyuki; Tanaka, Hisashi; Kunitomi, Yuki; Nishizawa, Mitsuo; Arisawa, Atsuko; Tomiyama, Noriyuki [Osaka University Graduate School of Medicine, Department of Diagnostic and Interventional Radiology, Suita, Osaka (Japan); Yoshiya, Kazuhisa; Shimazu, Takeshi [Osaka University Graduate School of Medicine, Department of Traumatology and Acute Critical Medicine, Suita, Osaka (Japan)

    2014-12-15

    The computed tomography angiography (CTA) spot sign correlates with intracerebral hemorrhage (ICH) expansion; however, various diagnostic performances for hematoma expansion, especially in sensitivity, have been reported. We aimed to assess the impact of scan timing of CTA on the diagnostic performance of the CTA spot sign for ICH expansion in two different arterial phases within patients. Eighty-three consecutive patients with primary ICH who received two sequential CTAs were recruited. Two neuroradiologists reviewed CTAs for CTA spot signs, while one reviewed initial and follow-up non-contrast CT for measuring ICH volume. The time interval between two phases was then calculated, and the diagnostic performance of CTA spot sign in each phase was evaluated. CTA spot signs were observed in 20/83 (24.1 %) patients in the early phase and 44/83 (53.0 %) patients in the late phase. The mean time interval between the two phases was 12.7 s. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for hematoma progression of CTA spot sign were 48.1, 87.5, 65.0, 77.8, and 74.7 %, respectively, in early phase and 92.6, 66.1, 56.8, 94.9, and 74.7 %, respectively, in late phase. The CTA spot sign was significantly associated with ICH expansion in early (P < 0.001) and late (P < 0.00001) phases (Pearson's chi-square test). A mere 10-s difference in scan timing could make a difference on prevalence and diagnostic performance of the CTA spot sign, suggesting a need for the standardization of the CTA protocol to generalize the approach for effective clinical application. (orig.)

  16. TH-CD-209-08: Quantification of the Interplay Effect in Proton Pencil Beam Scanning Treatment of Lung

    Energy Technology Data Exchange (ETDEWEB)

    Kang, M; Huang, S; Solberg, T; Teo, B; McDonough, J; Simone, C; Lin, L [University of Pennsylvania, Philadelphia, PA (United States); Mayer, R; Thomas, A [Walter Reed Military Hospital, Bethesda, MD (United States)

    2016-06-15

    Purpose: To quantify the dose degradation caused by the interplay effect based on a beam specific motion analysis in proton pencil beam scanning (PBS) treatment of lung tumors Methods: PBS plans were optimized on average CT using a beam-specific PTV method for 10 consecutive patients with locally advanced non-small-cell-lung-cancer (NSCLC) treated with proton therapy to 6660/180 cGy. End inhalation (CT0) and end exhalation (CT50) were selected as the two extreme scenarios to acquire the relative stopping power ratio difference (Δrsp) for a respiration cycle. The water equivalent difference (ΔWET) per radiological path was calculated from the surface of patient to the iCTV by integrating the Δrsp of each voxel. The motion magnitude of each voxel within the target follows a quasi-Gaussian distribution. A motion index (MI (>5mm WET)), defined as the percentage of target voxels with an absolute integral ΔWET larger than 5 mm, was adopted as a metric to characterize interplay. To simulate the treatment process, 4D dose was calculated by accumulating the spot dose on the corresponding respiration phase to the reference phase CT50 by deformable image registration based on spot timing and patient breathing phase. Results: The study indicated that the magnitude of target underdose in a single fraction plan is proportional to the MI (p<0.001), with larger motion equating to greater dose degradation and standard deviations. The target homogeneity, minimum, maximum and mean dose in the 4D dose accumulations of 37 fractions varied as a function of MI. Conclusion: The MI quantification metric can predict the level of dose degradation in PBS lung cancer treatment, which potentially serves as a clinical decision tool to assess whether patients are suitable to receive PBS treatment.

  17. TH-CD-209-08: Quantification of the Interplay Effect in Proton Pencil Beam Scanning Treatment of Lung

    International Nuclear Information System (INIS)

    Kang, M; Huang, S; Solberg, T; Teo, B; McDonough, J; Simone, C; Lin, L; Mayer, R; Thomas, A

    2016-01-01

    Purpose: To quantify the dose degradation caused by the interplay effect based on a beam specific motion analysis in proton pencil beam scanning (PBS) treatment of lung tumors Methods: PBS plans were optimized on average CT using a beam-specific PTV method for 10 consecutive patients with locally advanced non-small-cell-lung-cancer (NSCLC) treated with proton therapy to 6660/180 cGy. End inhalation (CT0) and end exhalation (CT50) were selected as the two extreme scenarios to acquire the relative stopping power ratio difference (Δrsp) for a respiration cycle. The water equivalent difference (ΔWET) per radiological path was calculated from the surface of patient to the iCTV by integrating the Δrsp of each voxel. The motion magnitude of each voxel within the target follows a quasi-Gaussian distribution. A motion index (MI (>5mm WET)), defined as the percentage of target voxels with an absolute integral ΔWET larger than 5 mm, was adopted as a metric to characterize interplay. To simulate the treatment process, 4D dose was calculated by accumulating the spot dose on the corresponding respiration phase to the reference phase CT50 by deformable image registration based on spot timing and patient breathing phase. Results: The study indicated that the magnitude of target underdose in a single fraction plan is proportional to the MI (p<0.001), with larger motion equating to greater dose degradation and standard deviations. The target homogeneity, minimum, maximum and mean dose in the 4D dose accumulations of 37 fractions varied as a function of MI. Conclusion: The MI quantification metric can predict the level of dose degradation in PBS lung cancer treatment, which potentially serves as a clinical decision tool to assess whether patients are suitable to receive PBS treatment.

  18. Is there a single spot size and grid for intensity modulated proton therapy? Simulation of head and neck, prostate and mesothelioma cases

    Energy Technology Data Exchange (ETDEWEB)

    Widesott, Lamberto; Lomax, Antony J.; Schwarz, Marco [AtreP, Agenzia Provinciale per la Protonterapia, 38122 Trento (Italy); Paul Scherrer Institute, 5232 Villigen (Switzerland); AtreP, Agenzia Provinciale per la Protonterapia, 38122 Trento (Italy)

    2012-03-15

    Purpose: To assess the quality of dose distributions in real clinical cases for different dimensions of scanned proton pencil beams. The distance between spots (i.e., the grid of delivery) is optimized for each dimension of the pencil beam. Methods: The authors vary the {sigma} of the initial Gaussian size of the spot, from {sigma}{sub x} = {sigma}{sub y} = 3 mm to {sigma}{sub x} = {sigma}{sub y} = 8 mm, to evaluate the impact of the proton beam size on the quality of intensity modulated proton therapy (IMPT) plans. The distance between spots, {Delta}x and {Delta}y, is optimized on the spot plane, ranging from 4 to 12 mm (i.e., each spot size is coupled with the best spot grid resolution). In our Hyperion treatment planning system (TPS), constrained optimization is applied with respect to the organs at risk (OARs), i.e., the optimization tries to satisfy the dose objectives in the planning target volume (PTV) as long as all planning objectives for the OARs are met. Three-field plans for a nasopharynx case, two-field plans for a prostate case, and two-field plans for a malignant pleural mesothelioma case are considered in our analysis. Results: For the head and neck tumor, the best grids (i.e., distance between spots) are 5, 4, 6, 6, and 8 mm for {sigma} = 3, 4, 5, 6, and 8 mm, respectively. {sigma} {<=} 5 mm is required for tumor volumes with low dose and {sigma}{<=} 4 mm for tumor volumes with high dose. For the prostate patient, the best grid is 4, 4, 5, 5, and 5 mm for {sigma} = 3, 4, 5, 6, and 8 mm, respectively. Beams with {sigma} > 3 mm did not satisfy our first clinical requirement that 95% of the prescribed dose is delivered to more than 95% of prostate and proximal seminal vesicles PTV. Our second clinical requirement, to cover the distal seminal vesicles PTV, is satisfied for beams as wide as {sigma} = 6 mm. For the mesothelioma case, the low dose PTV prescription is well respected for all values of {sigma}, while there is loss of high dose PTV coverage

  19. Comparison of Out-Of-Field Neutron Equivalent Doses in Scanning Carbon and Proton Therapies for Cranial Fields

    DEFF Research Database (Denmark)

    Athar, B.; Henker, K.; Jäkel, O.

    2010-01-01

    Purpose: The purpose of this analysis is to compare the secondary neutron lateral doses from scanning carbon and proton beam therapies. Method and Materials: We simulated secondary neutron doses for out-of-field organs in an 11-year old male patient. Scanned carbon and proton beams were simulated...

  20. Proton Therapy at the Paul Scherrer Institute

    International Nuclear Information System (INIS)

    1996-03-01

    The brochure deals with the following topics: radiation therapy and its significance, proton therapy - worldwide and at PSI, advantages of the protons, the new proton therapy facility at PSI, therapy at PSI using the spot-scan technique. figs., tabs., refs

  1. Development of a scanning proton microprobe - computer-control, elemental mapping and applications

    International Nuclear Information System (INIS)

    Loevestam, Goeran.

    1989-08-01

    A scanning proton microprobe set-up has been developed at the Pelletron accelerator in Lund. A magnetic beam scanning system and a computer-control system for beam scanning and data aquisition is described. The computer system consists of a VMEbus front-end computer and a μVax-II host-computer, interfaced by means of a high-speed data link. The VMEbus computer controls data acquisition, beam charge monitoring and beam scanning while the more sophisticated work of elemental mapping and spectrum evaluations is left to the μVax-II. The calibration of the set-up is described as well as several applications. Elemental micro patterns in tree rings and bark has been investigated by means of elemental mapping and quantitative analysis. Large variations of elemental concentrations have been found for several elements within a single tree ring. An external beam set-up has been developed in addition to the proton microprobe set-up. The external beam has been used for the analysis of antique papyrus documents. Using a scanning sample procedure and particle induced X-ray emission (PIXE) analysis, damaged and missing characters of the text could be made visible by means of multivariate statistical data evaluation and elemental mapping. Also aspects of elemental mapping by means of scanning μPIXE analysis are discussed. Spectrum background, target thickness variations and pile-up are shown to influence the structure of elemental maps considerably. In addition, a semi-quantification procedure has been developed. (author)

  2. Experimental characterization and physical modelling of the dose distribution of scanned proton pencil beams

    International Nuclear Information System (INIS)

    Pedroni, E; Scheib, S; Boehringer, T; Coray, A; Grossmann, M; Lin, S; Lomax, A

    2005-01-01

    In this paper we present the pencil beam dose model used for treatment planning at the PSI proton gantry, the only system presently applying proton therapy with a beam scanning technique. The scope of the paper is to give a general overview on the various components of the dose model, on the related measurements and on the practical parametrization of the results. The physical model estimates from first physical principles absolute dose normalized to the number of incident protons. The proton beam flux is measured in practice by plane-parallel ionization chambers (ICs) normalized to protons via Faraday-cup measurements. It is therefore possible to predict and deliver absolute dose directly from this model without other means. The dose predicted in this way agrees very well with the results obtained with ICs calibrated in a cobalt beam. Emphasis is given in this paper to the characterization of nuclear interaction effects, which play a significant role in the model and are the major source of uncertainty in the direct estimation of the absolute dose. Nuclear interactions attenuate the primary proton flux, they modify the shape of the depth-dose curve and produce a faint beam halo of secondary dose around the primary proton pencil beam in water. A very simple beam halo model has been developed and used at PSI to eliminate the systematic dependences of the dose observed as a function of the size of the target volume. We show typical results for the relative (using a CCD system) and absolute (using calibrated ICs) dosimetry, routinely applied for the verification of patient plans. With the dose model including the nuclear beam halo we can predict quite precisely the dose directly from treatment planning without renormalization measurements, independently of the dose, shape and size of the dose fields. This applies also to the complex non-homogeneous dose distributions required for the delivery of range-intensity-modulated proton therapy, a novel therapy technique

  3. Distribution of copper and other elements in ryegrass roots, determined with a scanning proton microprobe

    International Nuclear Information System (INIS)

    Mazzolini, A.P.; Legge, G.J.F.

    1982-01-01

    A scanning proton microprobe has been used to determine the distribution of Cu and other elements in Wimmera ryegrass roots grown in solution cultures. Cu was found to be localized on or near the surface of the roots in randomly distributed discrete zones. The distribution of Cu was partially correlated with those of Fe, P and Ca and possibly indicates some form of association; co-precipitation in a precipitate of ferric phosphate or hydroxy-oxide is favoured

  4. Bio-physical effects of scanned proton beams: measurements and models for discrete high dose rates scanning systems

    International Nuclear Information System (INIS)

    De-Marzi, Ludovic

    2016-01-01

    The main objective of this thesis is to develop and optimize algorithms for intensity modulated proton therapy, taking into account the physical and biological pencil beam properties. A model based on the summation and fluence weighted division of the pencil beams has been used. A new parameterization of the lateral dose distribution has been developed using a combination of three Gaussian functions. The algorithms have been implemented into a treatment planning system, then experimentally validated and compared with Monte Carlo simulations. Some approximations have been made and validated in order to achieve reasonable calculation times for clinical purposes. In a second phase, a collaboration with Institut Curie radiobiological teams has been started in order to implement radiobiological parameters and results into the optimization loop of the treatment planning process. Indeed, scanned pencil beams are pulsed and delivered at high dose rates (from 10 to 100 Gy/s), and the relative biological efficiency of protons is still relatively unknown given the wide diversity of use of these beams: the different models available and their dependence with linear energy transfers have been studied. A good agreement between dose calculations and measurements (deviations lower than 3 % and 2 mm) has been obtained. An experimental protocol has been set in order to qualify pulsed high dose rate effects and preliminary results obtained on one cell line suggested variations of the biological efficiency up to 10 %, though with large uncertainties. (author) [fr

  5. SU-F-T-138: Commissioning and Evaluating Dose Computation Models for a Dedicated Proton Line Scanning Beam Nozzle in Eclipse Treatment Planning System

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, P [Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Tao-yuan, Taiwan (China); Chang Gung University, Taoyuan, Taiwan (China); Huang, H; Cai, S; Chen, H; Wu, S; Wu, T; Lee, S; Yeh, C; Wu, T [Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Tao-yuan, Taiwan (China); Lee, C [Chang Gung University, Taoyuan, Taiwan (China)

    2016-06-15

    Purpose: In this study, we present an effective method to derive low dose envelope of the proton in-air spot fluence at beam positions other than the isocenter to reduce amount of measurements required for planning commission. Also, we demonstrate commissioning and validation results of this method to the Eclipse treatment planning system (version 13.0.29) for a Sumitomo dedicated proton line scanning beam nozzle. Methods: The in-air spot profiles at five beam-axis positions (±200, ±100 and 0 mm) were obtained in trigger mode using a MP3 Water tank (PTW-Freiburg) and a pinpoint ionization chamber (model 31014, PTW-Freiburg). Low dose envelope (below 1% of the center dose) of the spot profile at isocenter was obtained by repeated point measurements to minimize dosimetry uncertainty. The double Gaussian (DG) model was used to fit and obtain optimal σ1, σ2 and their corresponding weightings through our in-house MATLAB (Mathworks) program. σ1, σ2 were assumed to expand linearly along the beam axis from a virtual source position calculated by back projecting fitted sigmas from the single Gaussian (SG) model. Absolute doses in water were validated using an Advanced Markus chamber at the depth of 2cm with Pristine Peak (BP) R90d ranging from 5–32 cm for 10×10 cm2 scanned fields. The field size factors were verified with square fields from 2 to 20 cm at 2cm and before BP depth. Results: The absolute dose outputs were found to be within ±3%. For field size factor, the agreement between calculated and measurement were within ±2% at 2cm and ±3% before BP, except for the field size below 2×2 cm2. Conclusion: The double Gaussian model was found to be sufficient for characterizing the Sumitomo dedicated proton line scanning nozzle. With our effective double Gaussian fitting method, we are able to save significant proton beam time with acceptable output accuracy.

  6. A simulation study on proton computed tomography (CT) stopping power accuracy using dual energy CT scans as benchmark

    DEFF Research Database (Denmark)

    Hansen, David Christoffer; Seco, Joao; Sørensen, Thomas Sangild

    2015-01-01

    Background. Accurate stopping power estimation is crucial for treatment planning in proton therapy, and the uncertainties in stopping power are currently the largest contributor to the employed dose margins. Dual energy x-ray computed tomography (CT) (clinically available) and proton CT (in...... development) have both been proposed as methods for obtaining patient stopping power maps. The purpose of this work was to assess the accuracy of proton CT using dual energy CT scans of phantoms to establish reference accuracy levels. Material and methods. A CT calibration phantom and an abdomen cross section...... phantom containing inserts were scanned with dual energy and single energy CT with a state-of-the-art dual energy CT scanner. Proton CT scans were simulated using Monte Carlo methods. The simulations followed the setup used in current prototype proton CT scanners and included realistic modeling...

  7. Impact of beam angle choice on pencil beam scanning breath-hold proton therapy for lung lesions

    DEFF Research Database (Denmark)

    Gorgisyan, Jenny; Perrin, Rosalind; Lomax, Antony J

    2017-01-01

    INTRODUCTION: The breath-hold technique inter alia has been suggested to mitigate the detrimental effect of motion on pencil beam scanned (PBS) proton therapy dose distributions. The aim of this study was to evaluate the robustness of incident proton beam angles to day-to-day anatomical variation...

  8. Supine craniospinal irradiation in pediatric patients by proton pencil beam scanning.

    Science.gov (United States)

    Farace, Paolo; Bizzocchi, Nicola; Righetto, Roberto; Fellin, Francesco; Fracchiolla, Francesco; Lorentini, Stefano; Widesott, Lamberto; Algranati, Carlo; Rombi, Barbara; Vennarini, Sabina; Amichetti, Maurizio; Schwarz, Marco

    2017-04-01

    Proton therapy is the emerging treatment modality for craniospinal irradiation (CSI) in pediatric patients. Herein, special methods adopted for CSI at proton Therapy Center of Trento by pencil beam scanning (PBS) are comprehensively described. Twelve pediatric patients were treated by proton PBS using two/three isocenters. Special methods refer to: (i) patient positioning in supine position on immobilization devices crossed by the beams; (ii) planning field-junctions via the ancillary-beam technique; (iii) achieving lens-sparing by three-beams whole-brain-irradiation; (iv) applying a movable-snout and beam-splitting technique to reduce the lateral penumbra. Patient-specific quality assurance (QA) program was performed using two-dimensional ion chamber array and γ-analysis. Daily kilovoltage alignment was performed. PBS allowed to obtain optimal target coverage (mean D98%>98%) with reduced dose to organs-at-risk. Lens sparing was obtained (mean D1∼730cGyE). Reducing lateral penumbra decreased the dose to the kidneys (mean Dmean4cm (mean γ>95%) than at depths<4cm. The reported methods allowed to effectively perform proton PBS CSI. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Probing cytotoxicity of nanoparticles and organic compounds using scanning proton microscopy, scanning electron microscopy and fluorescence microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Tong Yongpeng [Institute of Nuclear Techniques, Shenzhen University, Nanhai Avenue 3688, Shenzhen 518060 (China)], E-mail: yongpengt@yahoo.com.cn; Li Changming [School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 637457 (Singapore); Liang Feng [Institute Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200025 (China); Chen Jianmin [Shenzhen Municipal Hospital for Chronic Disease Control and Prevention, Guangdong 518020 (China); Zhang Hong; Liu Guoqing; Sun Huibin [Institute of Nuclear Techniques, Shenzhen University, Nanhai Avenue 3688, Shenzhen 518060 (China); Luong, John H.T. [Biotechnology Research Institute, National Research Council Canada, Montreal, Quebec, H4P 2R2 (Canada)

    2008-12-15

    Scanning proton microscopy, scanning electron microscopy (SEM) and fluorescence microscopy have been used to probe the cytotoxicity effect of benzo[a]pyrene (BaP), ethidium bromide (EB) and nanoparticles (ZnO, Al{sub 2}O{sub 3} and TiO{sub 2}) on a T lymphoblastic leukemia Jurkat cell line. The increased calcium ion (from CaCl{sub 2}) in the culture medium stimulated the accumulation of BaP and EB inside the cell, leading to cell death. ZnO, Al{sub 2}O{sub 3} and TiO{sub 2} nanoparticles, however, showed a protective effect against these two organic compounds. Such inorganic nanoparticles complexed with BaP or EB which became less toxic to the cell. Fe{sub 2}O{sub 3} nanoparticles as an insoluble particle model scavenged by macrophage were investigated in rats. They were scavenged out of the lung tissue about 48 h after infection. This result suggest that some insoluble inorganic nanoparticles of PM (particulate matters) showed protective effects on organic toxins induced acute toxic effects as they can be scavenged by macrophage cells. Whereas, some inorganic ions such as calcium ion in PM may help environmental organic toxins to penetrate cell membrane and induce higher toxic effect.

  10. SU-E-T-542: Measurement of Internal Neutrons for Uniform Scanning Proton Beams

    Energy Technology Data Exchange (ETDEWEB)

    Islam, M; Ahmad, S [University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (United States); Zheng, Y; Rana, S [Procure Proton Therapy Center, Oklahoma City, OK (United States); Collums, T [University of Iowa Hospitals and Clinics, Iowa City, IA (United States); Monsoon, J; Benton, E [Oklahoma State University, Stillwater, OK (United States)

    2015-06-15

    Purpose: In proton radiotherapy, the production of neutrons is a wellknown problem since neutron exposure can lead to increased risk of secondary cancers later in the patient’s lifetime. The assessment of neutron exposure is, therefore, important for the overall quality of proton radiotherapy. This study investigates the secondary neutrons created inside the patient from uniform scanning proton beams. Methods: Dose equivalent due to secondary neutrons was measured outside the primary field as a function of distance from beam isocenter at three different angles, 45, 90 and 135 degree, relative to beam axis. Plastic track nuclear detector (CR-39 PNTD) was used for the measurement of neutron dose. Two experimental configurations, in-air and cylindrical-phantom, were designed. In a cylindrical-phantom configuration, a cylindrical phantom of 5.5 cm diameter and 35 cm long was placed along the beam direction and in an in-air configuration, no phantom was used. All the detectors were placed at nearly identical locations in both configurations. Three proton beams of range 5 cm, 18 cm, and 32 cm with 4 cm modulation width and a 5 cm diameter aperture were used. The contribution from internal neutrons was estimated from the differences in measured dose equivalent between in-air and cylindrical-phantom configurations at respective locations. Results: The measured ratio of neutron dose equivalent to the primary proton dose (H/D) dropped off with distance and ranged from 27 to 0.3 mSv/Gy. The contribution of internal neutrons near the treatment field edge was found to be up to 64 % of the total neutron exposure. As the distance from the field edge became larger, the external neutrons from the nozzle appear to dominate and the internal neutrons became less prominent. Conclusion: This study suggests that the contribution of internal neutrons could be significant to the total neutron dose equivalent.

  11. Proton nuclear magnetic resonance studies on bulge-containing DNA oligonucleotides from a mutational hot-spot sequence

    International Nuclear Information System (INIS)

    Woodson, S.A.; Crothers, D.M.

    1987-01-01

    A series of bulge-containing and normal double-helical synthetic oligodeoxyribonucleotides, of sequence corresponding to a frame-shift mutational hot spot in the λ C/sub I/ gene, are compared by proton magnetic resonance spectroscopy at 500 MHz. The imino proton resonances are assigned by one-dimensional nuclear Overhauser effect spectroscopy. Nonselective T 1 inversion-recovery experiments are used to determine exchangeable proton lifetimes and to compare helix stability and dynamics of the three duplexes. An extra adenosine flanking the internal G-C base pairs has a strongly localized effect on helix stability, but the destabilizing effect of an extra cytidine in a C tract is delocalized over the entire G-C run. These data lead to the conclusion that the position of the bulge migrates along the run in the fast-exchange limit on the NMR time scale. Rapid migration of the bulge defect in homopolymeric sequences may help rationalize both frame-shift mutagenesis and translational frame shifting. The authors estimate that the unfavorable free energy of a localized bulge defect is 2.9-3.2 kcal/mol, in good agreement with earlier estimates for RNA helices

  12. A study of aluminium-exposed fish using a scanning proton microprobe

    Energy Technology Data Exchange (ETDEWEB)

    Cholewa, M; Legge, G L.F. [Melbourne Univ., Parkville, VIC (Australia). School of Physics; Eeckhaoudt, S; Van Grieken, R [Universitaire Instelling Antwerpen, Antwerp (Belgium)

    1994-12-31

    A major problem has arisen in Europe with the depopulation of fresh water fish in lakes and streams collecting acid rain. The sensitivity to acidification is species specific and appears to be associated with metal levels. The Scanning Proton Microprobe (SPMP) at the Micro Analytical Research Centre of the University of Melbourne was used to study the subcellular distribution of aluminium and other elements in the gills of fish exposed to acidified water with elevated Al-levels. Experiments were performed on thin sections taken from fish exposed to media with different pH and aluminium concentration. Aluminium was found on the surface of the gill lamellae, but also inside the tissue. Bulk analysis of the gills showed much higher concentrations in the aluminium-exposed fish, compared to the control ones, but no information regarding the actual accumulation sites can be inferred. Extensive study of damage done to the sample by intense proton beams during elemental analysis was performed with scanning transmission ion microscopy. 3 refs., 3 figs.

  13. A study of aluminium-exposed fish using a scanning proton microprobe

    Energy Technology Data Exchange (ETDEWEB)

    Cholewa, M.; Legge, G.L.F. [Melbourne Univ., Parkville, VIC (Australia). School of Physics; Eeckhaoudt, S.; Van Grieken, R. [Universitaire Instelling Antwerpen, Antwerp (Belgium)

    1993-12-31

    A major problem has arisen in Europe with the depopulation of fresh water fish in lakes and streams collecting acid rain. The sensitivity to acidification is species specific and appears to be associated with metal levels. The Scanning Proton Microprobe (SPMP) at the Micro Analytical Research Centre of the University of Melbourne was used to study the subcellular distribution of aluminium and other elements in the gills of fish exposed to acidified water with elevated Al-levels. Experiments were performed on thin sections taken from fish exposed to media with different pH and aluminium concentration. Aluminium was found on the surface of the gill lamellae, but also inside the tissue. Bulk analysis of the gills showed much higher concentrations in the aluminium-exposed fish, compared to the control ones, but no information regarding the actual accumulation sites can be inferred. Extensive study of damage done to the sample by intense proton beams during elemental analysis was performed with scanning transmission ion microscopy. 3 refs., 3 figs.

  14. A study of aluminium-exposed fish using a scanning proton microprobe

    International Nuclear Information System (INIS)

    Cholewa, M.; Legge, G.L.F.

    1993-01-01

    A major problem has arisen in Europe with the depopulation of fresh water fish in lakes and streams collecting acid rain. The sensitivity to acidification is species specific and appears to be associated with metal levels. The Scanning Proton Microprobe (SPMP) at the Micro Analytical Research Centre of the University of Melbourne was used to study the subcellular distribution of aluminium and other elements in the gills of fish exposed to acidified water with elevated Al-levels. Experiments were performed on thin sections taken from fish exposed to media with different pH and aluminium concentration. Aluminium was found on the surface of the gill lamellae, but also inside the tissue. Bulk analysis of the gills showed much higher concentrations in the aluminium-exposed fish, compared to the control ones, but no information regarding the actual accumulation sites can be inferred. Extensive study of damage done to the sample by intense proton beams during elemental analysis was performed with scanning transmission ion microscopy. 3 refs., 3 figs

  15. A LabVIEWTM-based scanning and control system for proton beam micromachining

    International Nuclear Information System (INIS)

    Bettiol, Andrew A.; Kan, J.A. van; Sum, T.C.; Watt, F.

    2001-01-01

    LabVIEW TM is steadily gaining in popularity as the programming language of choice for scientific data acquisition and control. This is due to the vast array of measurement instruments and data acquisition cards supported by the LabVIEW TM environment, and the relative ease with which advanced software can be programmed. Furthermore, virtual instruments that are designed for a given system can be easily ported to other LabVIEW TM platforms and hardware. This paper describes the new LabVIEW TM based scanning and control system developed specifically for proton beam micromachining (PBM) applications. The new system is capable of scanning figures at 16-bit resolution with improved sub-microsecond scan rates. Support for electrostatic beam blanking and external dose normalization using a TTL signal have been implemented. The new software incorporates a semi-automated dose calibration system, and a number of novel dose normalization methods. Limitations of the current beam scanning hardware are discussed in light of new results obtained from micromachining experiments performed in SU-8 photoresist

  16. TH-CD-209-05: Impact of Spot Size and Spacing On the Quality of Robustly-Optimized Intensity-Modulated Proton Therapy Plans for Lung Cancer

    International Nuclear Information System (INIS)

    Liu, W; Ding, X; Hu, Y; Shen, J; Korte, S; Bues, M; Schild, S; Wong, W; Chang, J; Liao, Z; Sahoo, N; Herman, M

    2016-01-01

    Purpose: To investigate how spot size and spacing affect plan quality, especially, plan robustness and the impact of interplay effect, of robustly-optimized intensity-modulated proton therapy (IMPT) plans for lung cancer. Methods: Two robustly-optimized IMPT plans were created for 10 lung cancer patients: (1) one for a proton beam with in-air energy dependent large spot size at isocenter (σ: 5–15 mm) and spacing (1.53σ); (2) the other for a proton beam with small spot size (σ: 2–6 mm) and spacing (5 mm). Both plans were generated on the average CTs with internal-gross-tumor-volume density overridden to irradiate internal target volume (ITV). The root-mean-square-dose volume histograms (RVH) measured the sensitivity of the dose to uncertainties, and the areas under RVH curves were used to evaluate plan robustness. Dose evaluation software was developed to model time-dependent spot delivery to incorporate interplay effect with randomized starting phases of each field per fraction. Patient anatomy voxels were mapped from phase to phase via deformable image registration to score doses. Dose-volume-histogram indices including ITV coverage, homogeneity, and organs-at-risk (OAR) sparing were compared using Student-t test. Results: Compared to large spots, small spots resulted in significantly better OAR sparing with comparable ITV coverage and homogeneity in the nominal plan. Plan robustness was comparable for ITV and most OARs. With interplay effect considered, significantly better OAR sparing with comparable ITV coverage and homogeneity is observed using smaller spots. Conclusion: Robust optimization with smaller spots significantly improves OAR sparing with comparable plan robustness and similar impact of interplay effect compare to larger spots. Small spot size requires the use of larger number of spots, which gives optimizer more freedom to render a plan more robust. The ratio between spot size and spacing was found to be more relevant to determine plan

  17. TH-CD-209-05: Impact of Spot Size and Spacing On the Quality of Robustly-Optimized Intensity-Modulated Proton Therapy Plans for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Liu, W; Ding, X; Hu, Y; Shen, J; Korte, S; Bues, M [Mayo Clinic Arizona, Phoenix, AZ (United States); Schild, S; Wong, W [Mayo Clinic AZ, Phoenix, AZ (United States); Chang, J [MD Anderson Cancer Center, Houston, TX (United States); Liao, Z; Sahoo, N [UT MD Anderson Cancer Center, Houston, TX (United States); Herman, M [Mayo Clinic, Rochester, MN (United States)

    2016-06-15

    Purpose: To investigate how spot size and spacing affect plan quality, especially, plan robustness and the impact of interplay effect, of robustly-optimized intensity-modulated proton therapy (IMPT) plans for lung cancer. Methods: Two robustly-optimized IMPT plans were created for 10 lung cancer patients: (1) one for a proton beam with in-air energy dependent large spot size at isocenter (σ: 5–15 mm) and spacing (1.53σ); (2) the other for a proton beam with small spot size (σ: 2–6 mm) and spacing (5 mm). Both plans were generated on the average CTs with internal-gross-tumor-volume density overridden to irradiate internal target volume (ITV). The root-mean-square-dose volume histograms (RVH) measured the sensitivity of the dose to uncertainties, and the areas under RVH curves were used to evaluate plan robustness. Dose evaluation software was developed to model time-dependent spot delivery to incorporate interplay effect with randomized starting phases of each field per fraction. Patient anatomy voxels were mapped from phase to phase via deformable image registration to score doses. Dose-volume-histogram indices including ITV coverage, homogeneity, and organs-at-risk (OAR) sparing were compared using Student-t test. Results: Compared to large spots, small spots resulted in significantly better OAR sparing with comparable ITV coverage and homogeneity in the nominal plan. Plan robustness was comparable for ITV and most OARs. With interplay effect considered, significantly better OAR sparing with comparable ITV coverage and homogeneity is observed using smaller spots. Conclusion: Robust optimization with smaller spots significantly improves OAR sparing with comparable plan robustness and similar impact of interplay effect compare to larger spots. Small spot size requires the use of larger number of spots, which gives optimizer more freedom to render a plan more robust. The ratio between spot size and spacing was found to be more relevant to determine plan

  18. A simulation study on proton computed tomography (CT) stopping power accuracy using dual energy CT scans as benchmark.

    Science.gov (United States)

    Hansen, David C; Seco, Joao; Sørensen, Thomas Sangild; Petersen, Jørgen Breede Baltzer; Wildberger, Joachim E; Verhaegen, Frank; Landry, Guillaume

    2015-01-01

    Accurate stopping power estimation is crucial for treatment planning in proton therapy, and the uncertainties in stopping power are currently the largest contributor to the employed dose margins. Dual energy x-ray computed tomography (CT) (clinically available) and proton CT (in development) have both been proposed as methods for obtaining patient stopping power maps. The purpose of this work was to assess the accuracy of proton CT using dual energy CT scans of phantoms to establish reference accuracy levels. A CT calibration phantom and an abdomen cross section phantom containing inserts were scanned with dual energy and single energy CT with a state-of-the-art dual energy CT scanner. Proton CT scans were simulated using Monte Carlo methods. The simulations followed the setup used in current prototype proton CT scanners and included realistic modeling of detectors and the corresponding noise characteristics. Stopping power maps were calculated for all three scans, and compared with the ground truth stopping power from the phantoms. Proton CT gave slightly better stopping power estimates than the dual energy CT method, with root mean square errors of 0.2% and 0.5% (for each phantom) compared to 0.5% and 0.9%. Single energy CT root mean square errors were 2.7% and 1.6%. Maximal errors for proton, dual energy and single energy CT were 0.51%, 1.7% and 7.4%, respectively. Better stopping power estimates could significantly reduce the range errors in proton therapy, but requires a large improvement in current methods which may be achievable with proton CT.

  19. Implementation of spot scanning dose optimization and dose calculation for helium ions in Hyperion

    Energy Technology Data Exchange (ETDEWEB)

    Fuchs, Hermann, E-mail: hermann.fuchs@meduniwien.ac.at [Department of Radiation Oncology, Division of Medical Radiation Physics, Medical University of Vienna/AKH Vienna, Vienna 1090, Austria and Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna 1090 (Austria); Alber, Markus [Department for Oncology, Aarhus University Hospital, Aarhus 8000 (Denmark); Schreiner, Thomas [PEG MedAustron, Wiener Neustadt 2700 (Austria); Georg, Dietmar [Department of Radiation Oncology, Division of Medical Radiation Physics, Medical University of Vienna/AKH Vienna, Vienna 1090 (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna 1090 (Austria); Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Vienna 1090 (Austria)

    2015-09-15

    Purpose: Helium ions ({sup 4}He) may supplement current particle beam therapy strategies as they possess advantages in physical dose distribution over protons. To assess potential clinical advantages, a dose calculation module accounting for relative biological effectiveness (RBE) was developed and integrated into the treatment planning system Hyperion. Methods: Current knowledge on RBE of {sup 4}He together with linear energy transfer considerations motivated an empirical depth-dependent “zonal” RBE model. In the plateau region, a RBE of 1.0 was assumed, followed by an increasing RBE up to 2.8 at the Bragg-peak region, which was then kept constant over the fragmentation tail. To account for a variable proton RBE, the same model concept was also applied to protons with a maximum RBE of 1.6. Both RBE models were added to a previously developed pencil beam algorithm for physical dose calculation and included into the treatment planning system Hyperion. The implementation was validated against Monte Carlo simulations within a water phantom using γ-index evaluation. The potential benefits of {sup 4}He based treatment plans were explored in a preliminary treatment planning comparison (against protons) for four treatment sites, i.e., a prostate, a base-of-skull, a pediatric, and a head-and-neck tumor case. Separate treatment plans taking into account physical dose calculation only or using biological modeling were created for protons and {sup 4}He. Results: Comparison of Monte Carlo and Hyperion calculated doses resulted in a γ{sub mean} of 0.3, with 3.4% of the values above 1 and γ{sub 1%} of 1.5 and better. Treatment plan evaluation showed comparable planning target volume coverage for both particles, with slightly increased coverage for {sup 4}He. Organ at risk (OAR) doses were generally reduced using {sup 4}He, some by more than to 30%. Improvements of {sup 4}He over protons were more pronounced for treatment plans taking biological effects into account. All

  20. SU-F-T-136: Breath Hold Lung Phantom Study in Using CT Density Versus Relative Stopping Power Ratio for Proton Pencil Beam Scanning System

    Energy Technology Data Exchange (ETDEWEB)

    Syh, J; Wu, H; Rosen, L [Willis-Knighton Medical Center, Shreveport, LA (United States)

    2016-06-15

    Purpose: To evaluate mass density effects of CT conversion table and its variation in current treatment planning system of spot scanning proton beam using an IROC proton lung phantom for this study. Methods: A proton lung phantom study was acquired to Imaging and Radiation Oncology Core Houston (IROC) Quality Assurance Center. Inside the lung phantom, GAF Chromic films and couples of thermal luminescent dosimeter (TLD) capsules embedded in specified PTV and adjacent structures to monitor delivered dosage and 3D dose distribution profiles. Various material such as cork (Lung), blue water (heart), Techron HPV (ribs) and organic material of balsa wood and cork as dosimetry inserts within phantom of solid water (soft tissue). Relative stopping power (RLSP) values were provided. Our treatment planning system (TPS) doesn’t require SP instead relative density was converted relative to water. However lung phantom was irradiated by planning with density override and the results were compared with IROC measurements. The second attempt was conducted without density override and compared with IROC’s. Results: The higher passing rate of imaging and measurement results of the lung phantom irradiation met the criteria by IROC without density override. The film at coronal plane was found to be shift due to inclined cylinder insertion. The converted CT density worked as expected to correlate relative stopping power. Conclusion: The proton lung phantom provided by IROC is a useful tool to qualify our commissioned proton pencil beam delivery with TPS within reliable confidence. The relative mass stopping power ratios of materials were converted from the relative physical density relative to water and the results were satisfied.

  1. Monte Carlo investigation of the low-dose envelope from scanned proton pencil beams

    International Nuclear Information System (INIS)

    Sawakuchi, Gabriel O; Titt, Uwe; Mirkovic, Dragan; Ciangaru, George; Zhu, X Ronald; Sahoo, Narayan; Gillin, Michael T; Mohan, Radhe

    2010-01-01

    Scanned proton pencil beams carry a low-dose envelope that extends several centimeters from the individual beam's central axis. Thus, the total delivered dose depends on the size of the target volume and the corresponding number and intensity of beams necessary to cover the target volume uniformly. This dependence must be considered in dose calculation algorithms used by treatment planning systems. In this work, we investigated the sources of particles contributing to the low-dose envelope using the Monte Carlo technique. We used a validated model of our institution's scanning beam line to determine the contributions to the low-dose envelope from secondary particles created in a water phantom and particles scattered in beam line components. Our results suggested that, for high-energy beams, secondary particles produced by nuclear interactions in the water phantom are the major contributors to the low-dose envelope. For low-energy beams, the low-dose envelope is dominated by particles undergoing multiple Coulomb scattering in the beam line components and water phantom. Clearly, in the latter situation, the low-dose envelope depends directly on beam line design features. Finally, we investigated the dosimetric consequences of the low-dose envelope. Our results showed that if not modeled properly the low-dose envelope may cause clinically relevant dose disturbance in the target volume. This work suggested that this low-dose envelope is beam line specific for low-energy beams, should be thoroughly experimentally characterized and validated during commissioning of the treatment planning system, and therefore is of great concern for accurate delivery of proton scanning beam doses.

  2. The first human patient treatment on the PSI spot scanning gantry

    International Nuclear Information System (INIS)

    Munkel, G.; Bevan, A.; Blattmann, H.; Boehringer, T.; Coray, A.; Egger, E.; Lin, S.; Lomax, A.; Pedroni, E.; Schaffner, B.

    1997-01-01

    In November 1996, the first human patient was irradiated with protons on the new PSI facility. The technical and physical reliability of the device had been reviewed and tested extensively; in addition, several animal patients with spontaneous tumors had been treated before and followed up carefully in order to have a biological control and an early warning system for unexpected radiation effects. The first human patient received a boost therapy for a brain metastasis of a malignant melanoma. (author)

  3. Robust Proton Pencil Beam Scanning Treatment Planning for Rectal Cancer Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Blanco Kiely, Janid Patricia, E-mail: jkiely@sas.upenn.edu; White, Benjamin M.

    2016-05-01

    Purpose: To investigate, in a treatment plan design and robustness study, whether proton pencil beam scanning (PBS) has the potential to offer advantages, relative to interfraction uncertainties, over photon volumetric modulated arc therapy (VMAT) in a locally advanced rectal cancer patient population. Methods and Materials: Ten patients received a planning CT scan, followed by an average of 4 weekly offline CT verification CT scans, which were rigidly co-registered to the planning CT. Clinical PBS plans were generated on the planning CT, using a single-field uniform-dose technique with single-posterior and parallel-opposed (LAT) fields geometries. The VMAT plans were generated on the planning CT using 2 6-MV, 220° coplanar arcs. Clinical plans were forward-calculated on verification CTs to assess robustness relative to anatomic changes. Setup errors were assessed by forward-calculating clinical plans with a ±5-mm (left–right, anterior–posterior, superior–inferior) isocenter shift on the planning CT. Differences in clinical target volume and organ at risk dose–volume histogram (DHV) indicators between plans were tested for significance using an appropriate Wilcoxon test (P<.05). Results: Dosimetrically, PBS plans were statistically different from VMAT plans, showing greater organ at risk sparing. However, the bladder was statistically identical among LAT and VMAT plans. The clinical target volume coverage was statistically identical among all plans. The robustness test found that all DVH indicators for PBS and VMAT plans were robust, except the LAT's genitalia (V5, V35). The verification CT plans showed that all DVH indicators were robust. Conclusions: Pencil beam scanning plans were found to be as robust as VMAT plans relative to interfractional changes during treatment when posterior beam angles and appropriate range margins are used. Pencil beam scanning dosimetric gains in the bowel (V15, V20) over VMAT suggest that using PBS to treat rectal

  4. Robust Proton Pencil Beam Scanning Treatment Planning for Rectal Cancer Radiation Therapy

    International Nuclear Information System (INIS)

    Blanco Kiely, Janid Patricia; White, Benjamin M.

    2016-01-01

    Purpose: To investigate, in a treatment plan design and robustness study, whether proton pencil beam scanning (PBS) has the potential to offer advantages, relative to interfraction uncertainties, over photon volumetric modulated arc therapy (VMAT) in a locally advanced rectal cancer patient population. Methods and Materials: Ten patients received a planning CT scan, followed by an average of 4 weekly offline CT verification CT scans, which were rigidly co-registered to the planning CT. Clinical PBS plans were generated on the planning CT, using a single-field uniform-dose technique with single-posterior and parallel-opposed (LAT) fields geometries. The VMAT plans were generated on the planning CT using 2 6-MV, 220° coplanar arcs. Clinical plans were forward-calculated on verification CTs to assess robustness relative to anatomic changes. Setup errors were assessed by forward-calculating clinical plans with a ±5-mm (left–right, anterior–posterior, superior–inferior) isocenter shift on the planning CT. Differences in clinical target volume and organ at risk dose–volume histogram (DHV) indicators between plans were tested for significance using an appropriate Wilcoxon test (P<.05). Results: Dosimetrically, PBS plans were statistically different from VMAT plans, showing greater organ at risk sparing. However, the bladder was statistically identical among LAT and VMAT plans. The clinical target volume coverage was statistically identical among all plans. The robustness test found that all DVH indicators for PBS and VMAT plans were robust, except the LAT's genitalia (V5, V35). The verification CT plans showed that all DVH indicators were robust. Conclusions: Pencil beam scanning plans were found to be as robust as VMAT plans relative to interfractional changes during treatment when posterior beam angles and appropriate range margins are used. Pencil beam scanning dosimetric gains in the bowel (V15, V20) over VMAT suggest that using PBS to treat rectal cancer

  5. Focal hot spot induced by a central subclavian line on bone scan.

    Science.gov (United States)

    Moslehi, Masood; Cheki, Mohsen; Dehghani, Tohid; Eftekhari, Mansoureh

    2014-01-01

    The diagnostic accuracy of nuclear medicine reporting can be improved by awareness of these instrument-related artifacts. Both awareness and experience are also important when it comes to detecting and identifying normal (and abnormal) variants. We present a case of hot spot on the upper right chest in the region of right subclavicular region resulting from injection of radiotracer from central subclavian line. A 52-year-old woman with a history of left breast cancer and recent bone pain was referred to our nuclear medicine department for skeletal survey. Anterior views of chest show a focus of increased radiotracer uptake corresponding to anterior arch of one of the right second rib. The nuclear physician reported it as a focal rib bony lesion and recommended radiological evaluation. As technician later explained, physicians realized that injection site was a central subclavian line on the right side and hot spot on that region is due to injection site. The appearance of both skeletal and soft-tissue uptake depends heavily on imaging technique (such as the route of radiotracer administration) and the interpreting physicians should be aware of the impact of technical factors on image quality.

  6. Implementation of spot scanning dose optimization and dose calculation for helium ions in Hyperion

    DEFF Research Database (Denmark)

    Fuchs, Hermann; Alber, Markus; Schreiner, Thomas

    2015-01-01

    PURPOSE: Helium ions ((4)He) may supplement current particle beam therapy strategies as they possess advantages in physical dose distribution over protons. To assess potential clinical advantages, a dose calculation module accounting for relative biological effectiveness (RBE) was developed...... published so far. The advantage of (4)He seems to lie in the reduction of dose to surrounding tissue and to OARs. Nevertheless, additional biological experiments and treatment planning studies with larger patient numbers and more tumor indications are necessary to study the possible benefits of helium ion...

  7. A Novel Approach to Postmastectomy Radiation Therapy Using Scanned Proton Beams

    Energy Technology Data Exchange (ETDEWEB)

    Depauw, Nicolas, E-mail: ndepauw@partners.org [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Centre for Medical Radiation Physics, University of Wollongong, New South Wales (Australia); Batin, Estelle; Daartz, Julianne [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Rosenfeld, Anatoly [Centre for Medical Radiation Physics, University of Wollongong, New South Wales (Australia); Adams, Judith; Kooy, Hanne; MacDonald, Shannon; Lu, Hsiao-Ming [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2015-02-01

    Purpose: Postmastectomy radiation therapy (PMRT), currently offered at Massachusetts General Hospital, uses proton pencil beam scanning (PBS) with intensity modulation, achieving complete target coverage of the chest wall and all nodal regions and reduced dose to the cardiac structures. This work presents the current methodology for such treatment and the ongoing effort for its improvements. Methods and Materials: A single PBS field is optimized to ensure appropriate target coverage and heart/lung sparing, using an in–house-developed proton planning system with the capability of multicriteria optimization. The dose to the chest wall skin is controlled as a separate objective in the optimization. Surface imaging is used for setup because it is a suitable surrogate for superficial target volumes. In order to minimize the effect of beam range uncertainties, the relative proton stopping power ratio of the material in breast implants was determined through separate measurements. Phantom measurements were also made to validate the accuracy of skin dose calculation in the treatment planning system. Additionally, the treatment planning robustness was evaluated relative to setup perturbations and patient breathing motion. Results: PBS PMRT planning resulted in appropriate target coverage and organ sparing, comparable to treatments by passive scattering (PS) beams but much improved in nodal coverage and cardiac sparing compared to conventional treatments by photon/electron beams. The overall treatment time was much shorter than PS and also shorter than conventional photon/electron treatment. The accuracy of the skin dose calculation by the planning system was within ±2%. The treatment was shown to be adequately robust relative to both setup uncertainties and patient breathing motion, resulting in clinically satisfying dose distributions. Conclusions: More than 25 PMRT patients have been successfully treated at Massachusetts General Hospital by using single-PBS fields

  8. A Novel Approach to Postmastectomy Radiation Therapy Using Scanned Proton Beams

    International Nuclear Information System (INIS)

    Depauw, Nicolas; Batin, Estelle; Daartz, Julianne; Rosenfeld, Anatoly; Adams, Judith; Kooy, Hanne; MacDonald, Shannon; Lu, Hsiao-Ming

    2015-01-01

    Purpose: Postmastectomy radiation therapy (PMRT), currently offered at Massachusetts General Hospital, uses proton pencil beam scanning (PBS) with intensity modulation, achieving complete target coverage of the chest wall and all nodal regions and reduced dose to the cardiac structures. This work presents the current methodology for such treatment and the ongoing effort for its improvements. Methods and Materials: A single PBS field is optimized to ensure appropriate target coverage and heart/lung sparing, using an in–house-developed proton planning system with the capability of multicriteria optimization. The dose to the chest wall skin is controlled as a separate objective in the optimization. Surface imaging is used for setup because it is a suitable surrogate for superficial target volumes. In order to minimize the effect of beam range uncertainties, the relative proton stopping power ratio of the material in breast implants was determined through separate measurements. Phantom measurements were also made to validate the accuracy of skin dose calculation in the treatment planning system. Additionally, the treatment planning robustness was evaluated relative to setup perturbations and patient breathing motion. Results: PBS PMRT planning resulted in appropriate target coverage and organ sparing, comparable to treatments by passive scattering (PS) beams but much improved in nodal coverage and cardiac sparing compared to conventional treatments by photon/electron beams. The overall treatment time was much shorter than PS and also shorter than conventional photon/electron treatment. The accuracy of the skin dose calculation by the planning system was within ±2%. The treatment was shown to be adequately robust relative to both setup uncertainties and patient breathing motion, resulting in clinically satisfying dose distributions. Conclusions: More than 25 PMRT patients have been successfully treated at Massachusetts General Hospital by using single-PBS fields

  9. Effect of Intrafraction Prostate Motion on Proton Pencil Beam Scanning Delivery: A Quantitative Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Shikui, E-mail: TangS@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Deville, Curtiland; McDonough, James; Tochner, Zelig [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Wang, Ken Kang-Hsin [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University, Baltimore, Maryland (United States); Vapiwala, Neha; Both, Stefan [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2013-10-01

    Purpose: To assess the dosimetric impact caused by the interplay between intrafraction prostate motion and the intermittent delivery of proton pencil beam scanning (PBS). Methods and Materials: A cohort of 10 prostate patients was treated with PBS using a bilateral single-field uniform dose (SFUD) modality. Bilateral intensity-modulated proton therapy (IMPT) plans were generated for comparison. Because beam-on time in PBS was intermittent, the actual beam-on time was determined from treatment logs. Prostate motion was generalized according to real-time Calypso tracking data from our previously reported prospective photon trial. We investigated potential dose deviations by considering the interplay effect resulting from the worst-case scenario motion and the PBS delivery sequence. Results: For both bilateral-field SFUD and IMPT plans, clinical target volume (CTV) D{sub 99}% coverage was degraded <2% owing to prostate intrafraction motion when averaged over the course of treatment, but was >10% for the worst fraction. The standard deviation of CTV D{sub 99}% distribution was approximately 1.2%. The CTV coverage of individual fields in SFUD plans degraded as time elapsed after the initial alignment, owing to prostate drift. Intensity-modulated proton therapy and SFUD demonstrated comparable results when bilateral opposed fields were used. Single-field SFUD plans that were repainted twice, which could reduce half of the treatment time, resulted in similar CTV coverage as bilateral-field plans. Conclusions: Intrafraction prostate motion affects the actual delivered dose to CTV; however, when averaged over the course of treatment, CTV D{sub 99}% coverage degraded only approximately 2% even for the worst-case scenario. The IMPT plan results are comparable to those of the SFUD plan, and similar coverage can be achieved if treated by SFUD 1 lateral field per day when rescanning the field twice to shorten the treatment time and mitigate intrafraction motion.

  10. Linear scans of hair strands for trace elements by proton induced x-ray emission

    International Nuclear Information System (INIS)

    Jolly, R.K.; Pehrson, G.R.; Gupta, S.K.; Buckle, D.C.; Aceto, H. Jr.

    1974-01-01

    Hair strands obtained from school children in the 10 to 12 year age group were analyzed for trace element concentration as a function of distance from the root by proton-induced x-ray emission to study the history of exposure of the donors to toxic trace metals. These samples were collected from the vicinity of a copper smelter where high levels of As, Cd, Sb, and Pb have been noted. Scans show a continual build-up of Pb as a function of distance from the root, while As shows a reproducible and distinct maximum approximately 10 cm from the root. The concentration of Zn was found to be constant in all samples (without exception) to within the uncertainties of our measurements

  11. Optimization of a general-purpose, actively scanned proton beamline for ocular treatments: Geant4 simulations.

    Science.gov (United States)

    Piersimoni, Pierluigi; Rimoldi, Adele; Riccardi, Cristina; Pirola, Michele; Molinelli, Silvia; Ciocca, Mario

    2015-03-08

    The Italian National Center for Hadrontherapy (CNAO, Centro Nazionale di Adroterapia Oncologica), a synchrotron-based hospital facility, started the treatment of patients within selected clinical trials in late 2011 and 2012 with actively scanned proton and carbon ion beams, respectively. The activation of a new clinical protocol for the irradiation of uveal melanoma using the existing general-purpose proton beamline is foreseen for late 2014. Beam characteristics and patient treatment setup need to be tuned to meet the specific requirements for such a type of treatment technique. The aim of this study is to optimize the CNAO transport beamline by adding passive components and minimizing air gap to achieve the optimal conditions for ocular tumor irradiation. The CNAO setup with the active and passive components along the transport beamline, as well as a human eye-modeled detector also including a realistic target volume, were simulated using the Monte Carlo Geant4 toolkit. The strong reduction of the air gap between the nozzle and patient skin, as well as the insertion of a range shifter plus a patient-specific brass collimator at a short distance from the eye, were found to be effective tools to be implemented. In perspective, this simulation toolkit could also be used as a benchmark for future developments and testing purposes on commercial treatment planning systems.

  12. Impact of spot charge inaccuracies in IMPT treatments.

    Science.gov (United States)

    Kraan, Aafke C; Depauw, Nicolas; Clasie, Ben; Giunta, Marina; Madden, Tom; Kooy, Hanne M

    2017-08-01

    Spot charge is one parameter of pencil-beam scanning dose delivery system whose accuracy is typically high but whose required value has not been investigated. In this work we quantify the dose impact of spot charge inaccuracies on the dose distribution in patients. Knowing the effect of charge errors is relevant for conventional proton machines, as well as for new generation proton machines, where ensuring accurate charge may be challenging. Through perturbation of spot charge in treatment plans for seven patients and a phantom, we evaluated the dose impact of absolute (up to 5× 10 6 protons) and relative (up to 30%) charge errors. We investigated the dependence on beam width by studying scenarios with small, medium and large beam sizes. Treatment plan statistics included the Γ passing rate, dose-volume-histograms and dose differences. The allowable absolute charge error for small spot plans was about 2× 10 6 protons. Larger limits would be allowed if larger spots were used. For relative errors, the maximum allowable error size for small, medium and large spots was about 13%, 8% and 6% for small, medium and large spots, respectively. Dose distributions turned out to be surprisingly robust against random spot charge perturbation. Our study suggests that ensuring spot charge errors as small as 1-2% as is commonly aimed at in conventional proton therapy machines, is clinically not strictly needed. © 2017 American Association of Physicists in Medicine.

  13. Fast beam cut-off method in RF-knockout extraction for spot-scanning

    CERN Document Server

    Furukawa, T

    2002-01-01

    An irradiation method with magnetic scanning has been developed in order to provide accurate irradiation even for an irregular target shape. The scanning method has strongly required a lower ripple of the beam spill and a faster response to beam-on/off in slow extraction from a synchrotron ring. At HIMAC, RF-knockout extraction has utilized a bunched beam to reduce the beam-spill ripple. Therefore, particles near the resonance can be spilled out from the separatrices by synchrotron oscillation as well as by a transverse RF field. From this point of view, a fast beam cut-off method has been proposed and verified by both simulations and experiments. The maximum delay from the beam cut-off signal to beam-off has been improved to around 60 mu s from 700 mu s by a usual method. Unwanted dose has been considerably reduced by around a factor of 10 compared with that by the usual method.

  14. A study on repainting strategies for treating moderately moving targets with proton pencil beam scanning at the new Gantry 2 at PSI

    International Nuclear Information System (INIS)

    Zenklusen, S M; Pedroni, E; Meer, D

    2010-01-01

    Treating moving targets using a scanning gantry for proton therapy is a promising but very challenging, not yet clinically demonstrated treatment modality. The interference of organ motion with the sequence of the beam delivery produces uncontrolled dose inhomogeneities within the target. One promising approach to overcome this difficulty is to increase the speed of scanning in order to apply the dose repeatedly (so-called repainting). To obtain sufficiently high scanning speeds a new, technologically improved gantry-Gantry 2-has been designed and is currently under construction at PSI. As there are many possible repainting strategies, the way repainting will be implemented on Gantry 2 will depend on the result of a careful analysis of the various treatment delivery strategies available. To achieve this aim, and prior to the start of experimental work with Gantry 2, simulations of dose distribution errors due to organ motion under various beam delivery strategies were investigated. The effects of motion on the dose distribution were studied for moderate motion amplitudes (5 mm) for spherical target volumes in a homogeneous medium and with homogeneous dose. In total over 200 000 dose distributions have been simulated and analyzed and selected results are discussed. From the obtained results we are confident to be able to treat moderately moving targets on Gantry 2 using repainted pencil-beam spot scanning. Continuous line scanning seems to be the most elegant solution; it provides higher repainting rates and produces superior results but is probably more difficult to realize. For larger motion amplitudes, continuous line scanning still shows good results, but we plan anyways to use a gating system for these cases, not only to reduce the inhomogeneity within the target volume but also to reduce safety margins.

  15. Dual ring multilayer ionization chamber and theory-based correction technique for scanning proton therapy.

    Science.gov (United States)

    Takayanagi, Taisuke; Nihongi, Hideaki; Nishiuchi, Hideaki; Tadokoro, Masahiro; Ito, Yuki; Nakashima, Chihiro; Fujitaka, Shinichiro; Umezawa, Masumi; Matsuda, Koji; Sakae, Takeji; Terunuma, Toshiyuki

    2016-07-01

    To develop a multilayer ionization chamber (MLIC) and a correction technique that suppresses differences between the MLIC and water phantom measurements in order to achieve fast and accurate depth dose measurements in pencil beam scanning proton therapy. The authors distinguish between a calibration procedure and an additional correction: 1-the calibration for variations in the air gap thickness and the electrometer gains is addressed without involving measurements in water; 2-the correction is addressed to suppress the difference between depth dose profiles in water and in the MLIC materials due to the nuclear interaction cross sections by a semiempirical model tuned by using measurements in water. In the correction technique, raw MLIC data are obtained for each energy layer and integrated after multiplying them by the correction factor because the correction factor depends on incident energy. The MLIC described here has been designed especially for pencil beam scanning proton therapy. This MLIC is called a dual ring multilayer ionization chamber (DRMLIC). The shape of the electrodes allows the DRMLIC to measure both the percentage depth dose (PDD) and integrated depth dose (IDD) because ionization electrons are collected from inner and outer air gaps independently. IDDs for which the beam energies were 71.6, 120.6, 159, 180.6, and 221.4 MeV were measured and compared with water phantom results. Furthermore, the measured PDDs along the central axis of the proton field with a nominal field size of 10 × 10 cm(2) were compared. The spread out Bragg peak was 20 cm for fields with a range of 30.6 and 3 cm for fields with a range of 6.9 cm. The IDDs measured with the DRMLIC using the correction technique were consistent with those that of the water phantom; except for the beam energy of 71.6 MeV, all of the points satisfied the 1% dose/1 mm distance to agreement criterion of the gamma index. The 71.6 MeV depth dose profile showed slight differences in the shallow

  16. Dual ring multilayer ionization chamber and theory-based correction technique for scanning proton therapy

    International Nuclear Information System (INIS)

    Takayanagi, Taisuke; Nishiuchi, Hideaki; Fujitaka, Shinichiro; Umezawa, Masumi; Nihongi, Hideaki; Tadokoro, Masahiro; Ito, Yuki; Nakashima, Chihiro; Matsuda, Koji; Sakae, Takeji; Terunuma, Toshiyuki

    2016-01-01

    Purpose: To develop a multilayer ionization chamber (MLIC) and a correction technique that suppresses differences between the MLIC and water phantom measurements in order to achieve fast and accurate depth dose measurements in pencil beam scanning proton therapy. Methods: The authors distinguish between a calibration procedure and an additional correction: 1—the calibration for variations in the air gap thickness and the electrometer gains is addressed without involving measurements in water; 2—the correction is addressed to suppress the difference between depth dose profiles in water and in the MLIC materials due to the nuclear interaction cross sections by a semiempirical model tuned by using measurements in water. In the correction technique, raw MLIC data are obtained for each energy layer and integrated after multiplying them by the correction factor because the correction factor depends on incident energy. The MLIC described here has been designed especially for pencil beam scanning proton therapy. This MLIC is called a dual ring multilayer ionization chamber (DRMLIC). The shape of the electrodes allows the DRMLIC to measure both the percentage depth dose (PDD) and integrated depth dose (IDD) because ionization electrons are collected from inner and outer air gaps independently. Results: IDDs for which the beam energies were 71.6, 120.6, 159, 180.6, and 221.4 MeV were measured and compared with water phantom results. Furthermore, the measured PDDs along the central axis of the proton field with a nominal field size of 10 × 10 cm 2 were compared. The spread out Bragg peak was 20 cm for fields with a range of 30.6 and 3 cm for fields with a range of 6.9 cm. The IDDs measured with the DRMLIC using the correction technique were consistent with those that of the water phantom; except for the beam energy of 71.6 MeV, all of the points satisfied the 1% dose/1 mm distance to agreement criterion of the gamma index. The 71.6 MeV depth dose profile showed slight

  17. Optimization of GEANT4 settings for Proton Pencil Beam Scanning simulations using GATE

    Energy Technology Data Exchange (ETDEWEB)

    Grevillot, Loic, E-mail: loic.grevillot@gmail.co [Universite de Lyon, F-69622 Lyon (France); Creatis, CNRS UMR 5220, F-69622 Villeurbanne (France); Centre de Lutte Contre le Cancer Leon Berard, F-69373 Lyon (France); IBA, B-1348 Louvain-la-Neuve (Belgium); Frisson, Thibault [Universite de Lyon, F-69622 Lyon (France); Creatis, CNRS UMR 5220, F-69622 Villeurbanne (France); Centre de Lutte Contre le Cancer Leon Berard, F-69373 Lyon (France); Zahra, Nabil [Universite de Lyon, F-69622 Lyon (France); IPNL, CNRS UMR 5822, F-69622 Villeurbanne (France); Centre de Lutte Contre le Cancer Leon Berard, F-69373 Lyon (France); Bertrand, Damien; Stichelbaut, Frederic [IBA, B-1348 Louvain-la-Neuve (Belgium); Freud, Nicolas [Universite de Lyon, F-69622 Lyon (France); CNDRI, INSA-Lyon, F-69621 Villeurbanne Cedex (France); Sarrut, David [Universite de Lyon, F-69622 Lyon (France); Creatis, CNRS UMR 5220, F-69622 Villeurbanne (France); Centre de Lutte Contre le Cancer Leon Berard, F-69373 Lyon (France)

    2010-10-15

    This study reports the investigation of different GEANT4 settings for proton therapy applications in the context of Treatment Planning System comparisons. The GEANT4.9.2 release was used through the GATE platform. We focused on the Pencil Beam Scanning delivery technique, which allows for intensity modulated proton therapy applications. The most relevant options and parameters (range cut, step size, database binning) for the simulation that influence the dose deposition were investigated, in order to determine a robust, accurate and efficient simulation environment. In this perspective, simulations of depth-dose profiles and transverse profiles at different depths and energies between 100 and 230 MeV have been assessed against reference measurements in water and PMMA. These measurements were performed in Essen, Germany, with the IBA dedicated Pencil Beam Scanning system, using Bragg-peak chambers and radiochromic films. GEANT4 simulations were also compared to the PHITS.2.14 and MCNPX.2.5.0 Monte Carlo codes. Depth-dose simulations reached 0.3 mm range accuracy compared to NIST CSDA ranges, with a dose agreement of about 1% over a set of five different energies. The transverse profiles simulated using the different Monte Carlo codes showed discrepancies, with up to 15% difference in beam widening between GEANT4 and MCNPX in water. A 8% difference between the GEANT4 multiple scattering and single scattering algorithms was observed. The simulations showed the inability of reproducing the measured transverse dose spreading with depth in PMMA, corroborating the fact that GEANT4 underestimates the lateral dose spreading. GATE was found to be a very convenient simulation environment to perform this study. A reference physics-list and an optimized parameters-list have been proposed. Satisfactory agreement against depth-dose profiles measurements was obtained. The simulation of transverse profiles using different Monte Carlo codes showed significant deviations. This point

  18. Using a Reduced Spot Size for Intensity-Modulated Proton Therapy Potentially Improves Salivary Gland-Sparing in Oropharyngeal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Water, Tara A. van de, E-mail: t.a.van.de.water@rt.umcg.nl [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Lomax, Antony J. [Centre for Proton Therapy, Paul Scherrer Institute, Villigen-PSI (Switzerland); Bijl, Hendrik P.; Schilstra, Cornelis [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Hug, Eugen B. [Centre for Proton Therapy, Paul Scherrer Institute, Villigen-PSI (Switzerland); Langendijk, Johannes A. [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands)

    2012-02-01

    Purpose: To investigate whether intensity-modulated proton therapy with a reduced spot size (rsIMPT) could further reduce the parotid and submandibular gland dose compared with previously calculated IMPT plans with a larger spot size. In addition, it was investigated whether the obtained dose reductions would theoretically translate into a reduction of normal tissue complication probabilities (NTCPs). Methods: Ten patients with N0 oropharyngeal cancer were included in a comparative treatment planning study. Both IMPT plans delivered simultaneously 70 Gy to the boost planning target volume (PTV) and 54 Gy to the elective nodal PTV. IMPT and rsIMPT used identical three-field beam arrangements. In the IMPT plans, the parotid and submandibular salivary glands were spared as much as possible. rsIMPT plans used identical dose-volume objectives for the parotid glands as those used by the IMPT plans, whereas the objectives for the submandibular glands were tightened further. NTCPs were calculated for salivary dysfunction and xerostomia. Results: Target coverage was similar for both IMPT techniques, whereas rsIMPT clearly improved target conformity. The mean doses in the parotid glands and submandibular glands were significantly lower for three-field rsIMPT (14.7 Gy and 46.9 Gy, respectively) than for three-field IMPT (16.8 Gy and 54.6 Gy, respectively). Hence, rsIMPT significantly reduced the NTCP of patient-rated xerostomia and parotid and contralateral submandibular salivary flow dysfunction (27%, 17%, and 43% respectively) compared with IMPT (39%, 20%, and 79%, respectively). In addition, mean dose values in the sublingual glands, the soft palate and oral cavity were also decreased. Obtained dose and NTCP reductions varied per patient. Conclusions: rsIMPT improved sparing of the salivary glands and reduced NTCP for xerostomia and parotid and submandibular salivary dysfunction, while maintaining similar target coverage results. It is expected that rsIMPT improves quality

  19. SU-F-T-209: Multicriteria Optimization Algorithm for Intensity Modulated Radiation Therapy Using Pencil Proton Beam Scanning

    Energy Technology Data Exchange (ETDEWEB)

    Beltran, C; Kamal, H [Mayo Clinic, Rochester, MN (United States)

    2016-06-15

    Purpose: To provide a multicriteria optimization algorithm for intensity modulated radiation therapy using pencil proton beam scanning. Methods: Intensity modulated radiation therapy using pencil proton beam scanning requires efficient optimization algorithms to overcome the uncertainties in the Bragg peaks locations. This work is focused on optimization algorithms that are based on Monte Carlo simulation of the treatment planning and use the weights and the dose volume histogram (DVH) control points to steer toward desired plans. The proton beam treatment planning process based on single objective optimization (representing a weighted sum of multiple objectives) usually leads to time-consuming iterations involving treatment planning team members. We proved a time efficient multicriteria optimization algorithm that is developed to run on NVIDIA GPU (Graphical Processing Units) cluster. The multicriteria optimization algorithm running time benefits from up-sampling of the CT voxel size of the calculations without loss of fidelity. Results: We will present preliminary results of Multicriteria optimization for intensity modulated proton therapy based on DVH control points. The results will show optimization results of a phantom case and a brain tumor case. Conclusion: The multicriteria optimization of the intensity modulated radiation therapy using pencil proton beam scanning provides a novel tool for treatment planning. Work support by a grant from Varian Inc.

  20. SU-F-T-209: Multicriteria Optimization Algorithm for Intensity Modulated Radiation Therapy Using Pencil Proton Beam Scanning

    International Nuclear Information System (INIS)

    Beltran, C; Kamal, H

    2016-01-01

    Purpose: To provide a multicriteria optimization algorithm for intensity modulated radiation therapy using pencil proton beam scanning. Methods: Intensity modulated radiation therapy using pencil proton beam scanning requires efficient optimization algorithms to overcome the uncertainties in the Bragg peaks locations. This work is focused on optimization algorithms that are based on Monte Carlo simulation of the treatment planning and use the weights and the dose volume histogram (DVH) control points to steer toward desired plans. The proton beam treatment planning process based on single objective optimization (representing a weighted sum of multiple objectives) usually leads to time-consuming iterations involving treatment planning team members. We proved a time efficient multicriteria optimization algorithm that is developed to run on NVIDIA GPU (Graphical Processing Units) cluster. The multicriteria optimization algorithm running time benefits from up-sampling of the CT voxel size of the calculations without loss of fidelity. Results: We will present preliminary results of Multicriteria optimization for intensity modulated proton therapy based on DVH control points. The results will show optimization results of a phantom case and a brain tumor case. Conclusion: The multicriteria optimization of the intensity modulated radiation therapy using pencil proton beam scanning provides a novel tool for treatment planning. Work support by a grant from Varian Inc.

  1. SU-F-T-152: Experimental Validation and Calculation Benchmark for a Commercial Monte Carlo Pencil BeamScanning Proton Therapy Treatment Planning System in Heterogeneous Media

    Energy Technology Data Exchange (ETDEWEB)

    Lin, L; Huang, S; Kang, M; Ainsley, C; Simone, C; McDonough, J; Solberg, T [University of Pennsylvania, Philadelphia, PA (United States)

    2016-06-15

    Purpose: Eclipse AcurosPT 13.7, the first commercial Monte Carlo pencil beam scanning (PBS) proton therapy treatment planning system (TPS), was experimentally validated for an IBA dedicated PBS nozzle in the CIRS 002LFC thoracic phantom. Methods: A two-stage procedure involving the use of TOPAS 1.3 simulations was performed. First, Geant4-based TOPAS simulations in this phantom were experimentally validated for single and multi-spot profiles at several depths for 100, 115, 150, 180, 210 and 225 MeV proton beams, using the combination of a Lynx scintillation detector and a MatriXXPT ionization chamber array. Second, benchmark calculations were performed with both AcurosPT and TOPAS in a phantom identical to the CIRS 002LFC, with the exception that the CIRS bone/mediastinum/lung tissues were replaced with similar tissues that are predefined in AcurosPT (a limitation of this system which necessitates the two stage procedure). Results: Spot sigmas measured in tissue were in agreement within 0.2 mm of TOPAS simulation for all six energies, while AcurosPT was consistently found to have larger spot sigma (<0.7 mm) than TOPAS. Using absolute dose calibration by MatriXXPT, the agreements between profiles measurements and TOPAS simulation, and calculation benchmarks are over 97% except near the end of range using 2 mm/2% gamma criteria. Overdosing and underdosing were observed at the low and high density side of tissue interfaces, respectively, and these increased with increasing depth and decreasing energy. Near the mediastinum/lung interface, the magnitude can exceed 5 mm/10%. Furthermore, we observed >5% quenching effect in the conversion of Lynx measurements to dose. Conclusion: We recommend the use of an ionization chamber array in combination with the scintillation detector to measure absolute dose and relative PBS spot characteristics. We also recommend the use of an independent Monte Carlo calculation benchmark for the commissioning of a commercial TPS. Partially

  2. Measurement of stray radiation within a scanning proton therapy facility: EURADOS WG9 intercomparison exercise of active dosimetry systems

    Czech Academy of Sciences Publication Activity Database

    Farah, J.; Mares, V.; Romero-Exposito, M.; Trinkl, S.; Domingo, C.; Dufek, V.; Klodowska, M.; Kubančák, Ján; Knezevic, Z.; Ploc, Ondřej

    2015-01-01

    Roč. 42, č. 5 (2015), s. 2572-2584 ISSN 0094-2405 Institutional support: RVO:61389005 Keywords : scanning proton therapy * measurement of stray neutrons * spectrometry * ambient dose eyuivalent * intercomparison Subject RIV: BG - Nuclear, Atomic and Molecular Physics, Colliders Impact factor: 2.496, year: 2015

  3. SU-E-T-621: Planning Methodologies for Cancer of the Anal Canal: Comparing IMRT, Rapid Arc, and Pencil Beam Scanning Proton Beam

    International Nuclear Information System (INIS)

    McGlade, J; Kassaee, A

    2015-01-01

    Purpose: To evaluate planning methods for anal canal cancer and compare the results of 9-field Intensity Modulated Radiotherapy (IMRT), Volumetric Modulated Arc Therapy (Varian, RapidArc), and Proton Pencil Beam Scanning (PBS). Methods: We generated plans with IMRT, RapidArc (RA) and PBS for twenty patients for both initial phase including nodes and cone down phase of treatment using Eclipe (Varian). We evaluated the advantage of each technique for each phase. RA plans used 2 to 4 arcs and various collimator orientations. PBS used two posterior oblique fields. We evaluated the plans comparing dose volume histogram (DVH), locations of hot spots, and PTV dose conformity. Results: Due to complex shape of target, for RA plans, multiple arcs (>2) are required to achieve optimal PTV conformity. When the PTV exceeds 15 cm in the superior-inferior direction, limitations of deliverability start to dominate. The PTV should be divided into a superior and an inferior structure. The optimization is performed with fixed jaws for each structure and collimator set to 90 degrees for the inferior PTV. Proton PBS plans show little advantage in small bowel sparing when treating the nodes. However, PBS plan reduces volumetric dose to the bladder at the cost of higher doses to the perineal skin. IMRT plans provide good target conformity, but they generate hot spots outside of the target volume. Conclusion: When using one planning technique for entire course of treatment, Multiple arc (>2) RA plans are better as compared to IMRT and PBS plans. When combining techniques, RA for the initial phase in combination with PBS for the cone down phase results in the most optimal plans

  4. SU-E-T-621: Planning Methodologies for Cancer of the Anal Canal: Comparing IMRT, Rapid Arc, and Pencil Beam Scanning Proton Beam

    Energy Technology Data Exchange (ETDEWEB)

    McGlade, J; Kassaee, A [University of Pennsylvenia, Philadelphia, PA (United States)

    2015-06-15

    Purpose: To evaluate planning methods for anal canal cancer and compare the results of 9-field Intensity Modulated Radiotherapy (IMRT), Volumetric Modulated Arc Therapy (Varian, RapidArc), and Proton Pencil Beam Scanning (PBS). Methods: We generated plans with IMRT, RapidArc (RA) and PBS for twenty patients for both initial phase including nodes and cone down phase of treatment using Eclipe (Varian). We evaluated the advantage of each technique for each phase. RA plans used 2 to 4 arcs and various collimator orientations. PBS used two posterior oblique fields. We evaluated the plans comparing dose volume histogram (DVH), locations of hot spots, and PTV dose conformity. Results: Due to complex shape of target, for RA plans, multiple arcs (>2) are required to achieve optimal PTV conformity. When the PTV exceeds 15 cm in the superior-inferior direction, limitations of deliverability start to dominate. The PTV should be divided into a superior and an inferior structure. The optimization is performed with fixed jaws for each structure and collimator set to 90 degrees for the inferior PTV. Proton PBS plans show little advantage in small bowel sparing when treating the nodes. However, PBS plan reduces volumetric dose to the bladder at the cost of higher doses to the perineal skin. IMRT plans provide good target conformity, but they generate hot spots outside of the target volume. Conclusion: When using one planning technique for entire course of treatment, Multiple arc (>2) RA plans are better as compared to IMRT and PBS plans. When combining techniques, RA for the initial phase in combination with PBS for the cone down phase results in the most optimal plans.

  5. End-to-end tests using alanine dosimetry in scanned proton beams

    Science.gov (United States)

    Carlino, A.; Gouldstone, C.; Kragl, G.; Traneus, E.; Marrale, M.; Vatnitsky, S.; Stock, M.; Palmans, H.

    2018-03-01

    This paper describes end-to-end test procedures as the last fundamental step of medical commissioning before starting clinical operation of the MedAustron synchrotron-based pencil beam scanning (PBS) therapy facility with protons. One in-house homogeneous phantom and two anthropomorphic heterogeneous (head and pelvis) phantoms were used for end-to-end tests at MedAustron. The phantoms were equipped with alanine detectors, radiochromic films and ionization chambers. The correction for the ‘quenching’ effect of alanine pellets was implemented in the Monte Carlo platform of the evaluation version of RayStation TPS. During the end-to-end tests, the phantoms were transferred through the workflow like real patients to simulate the entire clinical workflow: immobilization, imaging, treatment planning and dose delivery. Different clinical scenarios of increasing complexity were simulated: delivery of a single beam, two oblique beams without and with range shifter. In addition to the dose comparison in the plastic phantoms the dose obtained from alanine pellet readings was compared with the dose determined with the Farmer ionization chamber in water. A consistent systematic deviation of about 2% was found between alanine dosimetry and the ionization chamber dosimetry in water and plastic materials. Acceptable agreement of planned and delivered doses was observed together with consistent and reproducible results of the end-to-end testing performed with different dosimetric techniques (alanine detectors, ionization chambers and EBT3 radiochromic films). The results confirmed the adequate implementation and integration of the new PBS technology at MedAustron. This work demonstrates that alanine pellets are suitable detectors for end-to-end tests in proton beam therapy and the developed procedures with customized anthropomorphic phantoms can be used to support implementation of PBS technology in clinical practice.

  6. Impact of dose engine algorithm in pencil beam scanning proton therapy for breast cancer.

    Science.gov (United States)

    Tommasino, Francesco; Fellin, Francesco; Lorentini, Stefano; Farace, Paolo

    2018-06-01

    Proton therapy for the treatment of breast cancer is acquiring increasing interest, due to the potential reduction of radiation-induced side effects such as cardiac and pulmonary toxicity. While several in silico studies demonstrated the gain in plan quality offered by pencil beam scanning (PBS) compared to passive scattering techniques, the related dosimetric uncertainties have been poorly investigated so far. Five breast cancer patients were planned with Raystation 6 analytical pencil beam (APB) and Monte Carlo (MC) dose calculation algorithms. Plans were optimized with APB and then MC was used to recalculate dose distribution. Movable snout and beam splitting techniques (i.e. using two sub-fields for the same beam entrance, one with and the other without the use of a range shifter) were considered. PTV dose statistics were recorded. The same planning configurations were adopted for the experimental benchmark. Dose distributions were measured with a 2D array of ionization chambers and compared to APB and MC calculated ones by means of a γ analysis (agreement criteria 3%, 3 mm). Our results indicate that, when using proton PBS for breast cancer treatment, the Raystation 6 APB algorithm does not allow obtaining sufficient accuracy, especially with large air gaps. On the contrary, the MC algorithm resulted into much higher accuracy in all beam configurations tested and has to be recommended. Centers where a MC algorithm is not yet available should consider a careful use of APB, possibly combined with a movable snout system or in any case with strategies aimed at minimizing air gaps. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  7. Off-axis dose equivalent due to secondary neutrons from uniform scanning proton beams during proton radiotherapy

    Science.gov (United States)

    Islam, M. R.; Collums, T. L.; Zheng, Y.; Monson, J.; Benton, E. R.

    2013-11-01

    The production of secondary neutrons is an undesirable byproduct of proton therapy and it is important to quantify the contribution from secondary neutrons to patient dose received outside the treatment volume. The purpose of this study is to investigate the off-axis dose equivalent from secondary neutrons experimentally using CR-39 plastic nuclear track detectors (PNTD) at ProCure Proton Therapy Center, Oklahoma City, OK. In this experiment, we placed several layers of CR-39 PNTD laterally outside the treatment volume inside a phantom and in air at various depths and angles with respect to the primary beam axis. Three different proton beams with max energies of 78, 162 and 226 MeV and 4 cm modulation width, a 5 cm diameter brass aperture, and a small snout located 38 cm from isocenter were used for the entire experiment. Monte Carlo simulations were also performed based on the experimental setup using a simplified snout configuration and the FLUKA Monte Carlo radiation transport code. The measured ratio of secondary neutron dose equivalent to therapeutic primary proton dose (H/D) ranged from 0.3 ± 0.08 mSv Gy-1 for 78 MeV proton beam to 37.4 ± 2.42 mSv Gy-1 for 226 MeV proton beam. Both experiment and simulation showed a similar decreasing trend in dose equivalent with distance to the central axis and the magnitude varied by a factor of about 2 in most locations. H/D was found to increase as the energy of the primary proton beam increased and higher H/D was observed at 135° compared to 45° and 90°. The overall higher H/D in air indicates the predominance of external neutrons produced in the nozzle rather than inside the body.

  8. Off-axis dose equivalent due to secondary neutrons from uniform scanning proton beams during proton radiotherapy

    International Nuclear Information System (INIS)

    Islam, M R; Collums, T L; Monson, J; Benton, E R; Zheng, Y

    2013-01-01

    The production of secondary neutrons is an undesirable byproduct of proton therapy and it is important to quantify the contribution from secondary neutrons to patient dose received outside the treatment volume. The purpose of this study is to investigate the off-axis dose equivalent from secondary neutrons experimentally using CR-39 plastic nuclear track detectors (PNTD) at ProCure Proton Therapy Center, Oklahoma City, OK. In this experiment, we placed several layers of CR-39 PNTD laterally outside the treatment volume inside a phantom and in air at various depths and angles with respect to the primary beam axis. Three different proton beams with max energies of 78, 162 and 226 MeV and 4 cm modulation width, a 5 cm diameter brass aperture, and a small snout located 38 cm from isocenter were used for the entire experiment. Monte Carlo simulations were also performed based on the experimental setup using a simplified snout configuration and the FLUKA Monte Carlo radiation transport code. The measured ratio of secondary neutron dose equivalent to therapeutic primary proton dose (H/D) ranged from 0.3 ± 0.08 mSv Gy −1  for 78 MeV proton beam to 37.4 ± 2.42 mSv Gy −1  for 226 MeV proton beam. Both experiment and simulation showed a similar decreasing trend in dose equivalent with distance to the central axis and the magnitude varied by a factor of about 2 in most locations. H/D was found to increase as the energy of the primary proton beam increased and higher H/D was observed at 135° compared to 45° and 90°. The overall higher H/D in air indicates the predominance of external neutrons produced in the nozzle rather than inside the body. (paper)

  9. Measurement of stray radiation within a scanning proton therapy facility: EURADOS WG9 intercomparison exercise of active dosimetry systems

    Energy Technology Data Exchange (ETDEWEB)

    Farah, J., E-mail: jad.farah@irsn.fr; Trompier, F. [Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Pôle Radioprotection de l’Homme, BP17, Fontenay-aux-Roses 92260 (France); Mares, V.; Schinner, K.; Wielunski, M. [Helmholtz Zentrum München, Institute of Radiation Protection, Ingolstädter Landstraße 1, Neuherberg 85764 (Germany); Romero-Expósito, M.; Domingo, C. [Departament de Física, Universitat Autònoma de Barcelona, Bellaterra E-08193 (Spain); Trinkl, S. [Helmholtz Zentrum München, Institute of Radiation Protection, Ingolstädter Landstraße 1, Neuherberg 85764, Germany and Physik-Department, Technische Universität München, Garching 85748 (Germany); Dufek, V. [Czech Technical University in Prague, FNSPE, Břehová 7, Prague 115 19, Czech Republic and National Radiation Protection Institute, Bartoškova 28, Prague 140 00 (Czech Republic); Klodowska, M.; Liszka, M.; Stolarczyk, L.; Olko, P. [Institute of Nuclear Physics PAN, Radzikowskiego 152, Krakow 31-342 (Poland); Kubancak, J. [Czech Technical University in Prague, FNSPE, Břehová 7, Prague 115 19, Czech Republic and Department of Radiation Dosimetry, Nuclear Physics Institute, Řež CZ-250 68 (Czech Republic); and others

    2015-05-15

    Purpose: To characterize stray radiation around the target volume in scanning proton therapy and study the performance of active neutron monitors. Methods: Working Group 9 of the European Radiation Dosimetry Group (EURADOS WG9—Radiation protection in medicine) carried out a large measurement campaign at the Trento Centro di Protonterapia (Trento, Italy) in order to determine the neutron spectra near the patient using two extended-range Bonner sphere spectrometry (BSS) systems. In addition, the work focused on acknowledging the performance of different commercial active dosimetry systems when measuring neutron ambient dose equivalents, H{sup ∗}(10), at several positions inside (8 positions) and outside (3 positions) the treatment room. Detectors included three TEPCs—tissue equivalent proportional counters (Hawk type from Far West Technology, Inc.) and six rem-counters (WENDI-II, LB 6411, RadEye™ NL, a regular and an extended-range NM2B). Meanwhile, the photon component of stray radiation was deduced from the low-lineal energy transfer part of TEPC spectra or measured using a Thermo Scientific™ FH-40G survey meter. Experiments involved a water tank phantom (60 × 30 × 30 cm{sup 3}) representing the patient that was uniformly irradiated using a 3 mm spot diameter proton pencil beam with 10 cm modulation width, 19.95 cm distal beam range, and 10 × 10 cm{sup 2} field size. Results: Neutron spectrometry around the target volume showed two main components at the thermal and fast energy ranges. The study also revealed the large dependence of the energy distribution of neutrons, and consequently of out-of-field doses, on the primary beam direction (directional emission of intranuclear cascade neutrons) and energy (spectral composition of secondary neutrons). In addition, neutron mapping within the facility was conducted and showed the highest H{sup ∗}(10) value of ∼51 μSv Gy{sup −1}; this was measured at 1.15 m along the beam axis. H{sup ∗}(10) values

  10. Effectiveness of different rescanning techniques for scanned proton radiotherapy in lung cancer patients

    Science.gov (United States)

    Engwall, E.; Glimelius, L.; Hynning, E.

    2018-05-01

    Non-small cell lung cancer (NSCLC) is a tumour type thought to be well-suited for proton radiotherapy. However, the lung region poses many problems related to organ motion and can for actively scanned beams induce severe interplay effects. In this study we investigate four mitigating rescanning techniques: (1) volumetric rescanning, (2) layered rescanning, (3) breath-sampled (BS) layered rescanning, and (4) continuous breath-sampled (CBS) layered rescanning. The breath-sampled methods will spread the layer rescans over a full breathing cycle, resulting in an improved averaging effect at the expense of longer treatment times. In CBS, we aim at further improving the averaging by delivering as many rescans as possible within one breathing cycle. The interplay effect was evaluated for 4D robustly optimized treatment plans (with and without rescanning) for seven NSCLC patients in the treatment planning system RayStation. The optimization and final dose calculation used a Monte Carlo dose engine to account for the density heterogeneities in the lung region. A realistic treatment delivery time structure given from the IBA ScanAlgo simulation tool served as basis for the interplay evaluation. Both slow (2.0 s) and fast (0.1 s) energy switching times were simulated. For all seven studied patients, rescanning improves the dose conformity to the target. The general trend is that the breath-sampled techniques are superior to layered and volumetric rescanning with respect to both target coverage and variability in dose to OARs. The spacing between rescans in our breath-sampled techniques is set at planning, based on the average breathing cycle length obtained in conjunction with CT acquisition. For moderately varied breathing cycle lengths between planning and delivery (up to 15%), the breath-sampled techniques still mitigate the interplay effect well. This shows the potential for smooth implementation at the clinic without additional motion monitoring equipment.

  11. Online platform for applying space–time scan statistics for prospectively detecting emerging hot spots of dengue fever

    Directory of Open Access Journals (Sweden)

    Chien-Chou Chen

    2016-11-01

    Full Text Available Abstract Background Cases of dengue fever have increased in areas of Southeast Asia in recent years. Taiwan hit a record-high 42,856 cases in 2015, with the majority in southern Tainan and Kaohsiung Cities. Leveraging spatial statistics and geo-visualization techniques, we aim to design an online analytical tool for local public health workers to prospectively identify ongoing hot spots of dengue fever weekly at the village level. Methods A total of 57,516 confirmed cases of dengue fever in 2014 and 2015 were obtained from the Taiwan Centers for Disease Control (TCDC. Incorporating demographic information as covariates with cumulative cases (365 days in a discrete Poisson model, we iteratively applied space–time scan statistics by SaTScan software to detect the currently active cluster of dengue fever (reported as relative risk in each village of Tainan and Kaohsiung every week. A village with a relative risk >1 and p value <0.05 was identified as a dengue-epidemic area. Assuming an ongoing transmission might continuously spread for two consecutive weeks, we estimated the sensitivity and specificity for detecting outbreaks by comparing the scan-based classification (dengue-epidemic vs. dengue-free village with the true cumulative case numbers from the TCDC’s surveillance statistics. Results Among the 1648 villages in Tainan and Kaohsiung, the overall sensitivity for detecting outbreaks increases as case numbers grow in a total of 92 weekly simulations. The specificity for detecting outbreaks behaves inversely, compared to the sensitivity. On average, the mean sensitivity and specificity of 2-week hot spot detection were 0.615 and 0.891 respectively (p value <0.001 for the covariate adjustment model, as the maximum spatial and temporal windows were specified as 50% of the total population at risk and 28 days. Dengue-epidemic villages were visualized and explored in an interactive map. Conclusions We designed an online analytical tool for

  12. The implication of hot spots on bone scans within the irradiated field of breast cancer patients treated with mastectomy followed by radiotherapy

    International Nuclear Information System (INIS)

    Park, Won; Huh, Seung-Jae; Yang, Jung-Hyun

    2008-01-01

    The objective of this study was to analyze the implication of abnormal hot spots in the irradiated field of patients treated with mastectomy followed by radiotherapy for breast cancer. We reviewed 1842 consecutive bone scans performed on 292 patients treated with a modified radical mastectomy and followed by radiotherapy. If abnormal hot spots at the irradiated sites were detected in the bone scans, we evaluated further studies to determine whether bone metastases were present. Radiation was given using 4 or 6 MV X-rays at a dosage of 50.4 Gy during 5.5 weeks with a dosage per fraction of 1.8 Gy. The follow-up period was 25-136 months (median 57 months). Sixty patients (20.6%) developed bone metastasis. Solitary rib metastases were identified in four patients; all were detected outside of the irradiated field. Of 232 patients who did not develop bone metastases, hot spots in the irradiated field were detected in 30 patients (12.9%). A simple rib facture at the site of a hot spot was demonstrated in four patients. The cumulative incidence of hot spots at 5 years was 12.9%. The cumulative incidence of hot spots was more common in postmenopausal women, patients who were less than 60 kg, patients who received adjuvant hormonal therapy and patients who had radiation that included the supraclavicular area. We confirmed that the hot spots within the irradiated fields might be benign, especially in patients who were postmenopause, had a low body weight, received adjuvant hormonal therapy and who had radiation that included the supraclavicular area. (author)

  13. SU-F-T-133: Uniform Scanning Proton Therapy for Lung Cancer: Toxicity and Its Correlation with Dosimetry

    International Nuclear Information System (INIS)

    Zheng, Y; Rana, S; Larson, G

    2016-01-01

    Purpose: To analyze the toxicity of uniform scanning proton therapy for lung cancer patients and its correlation with dose distribution. Methods: In this study, we analyzed the toxicity of 128 lung cancer patients, including 18 small cell lung cancer and 110 non small cell lung cancer patients. Each patient was treated with uniform scanning proton beams at our center using typically 2–4 fields. The prescription was typically 74 Cobalt gray equivalent (CGE) at 2 CGE per fraction. 4D Computerized Tomography (CT) scans were used to evaluate the target motion and contour the internal target volume, and repeated 3 times during the course of treatment to evaluate the need for plan adaptation. Toxicity data for these patients were obtained from the proton collaborative group (PCG) database. For cases of grade 3 toxicities or toxicities of interest such as esophagitis and radiation dermatitis, dose distributions were reviewed and analyzed in attempt to correlate the toxicity with radiation dose. Results: At a median follow up time of about 21 months, none of the patients had experienced Grade 4 or 5 toxicity. The most common adverse effect was dermatitis (81%: 52%-Grade 1, 28%-Grade 2, and 1% Grade 3), followed by fatigue (48%), Cough (46%), and Esophagitis (45%), as shown in Figure 1. Severe toxicities, such as Grade 3 dermatitis or pain of skin, had a clear correlation with high radiation dose. Conclusion: Uniform scanning proton therapy is well tolerated by lung cancer patients. Preliminary analysis indicates there is correlation between severe toxicity and high radiation dose. Understanding of radiation resulted toxicities and careful choice of beam arrangement are critical in minimizing toxicity of skin and other organs.

  14. SU-F-T-133: Uniform Scanning Proton Therapy for Lung Cancer: Toxicity and Its Correlation with Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Y; Rana, S; Larson, G [Procure Proton Therapy Center, Oklahoma City, OK (United States)

    2016-06-15

    Purpose: To analyze the toxicity of uniform scanning proton therapy for lung cancer patients and its correlation with dose distribution. Methods: In this study, we analyzed the toxicity of 128 lung cancer patients, including 18 small cell lung cancer and 110 non small cell lung cancer patients. Each patient was treated with uniform scanning proton beams at our center using typically 2–4 fields. The prescription was typically 74 Cobalt gray equivalent (CGE) at 2 CGE per fraction. 4D Computerized Tomography (CT) scans were used to evaluate the target motion and contour the internal target volume, and repeated 3 times during the course of treatment to evaluate the need for plan adaptation. Toxicity data for these patients were obtained from the proton collaborative group (PCG) database. For cases of grade 3 toxicities or toxicities of interest such as esophagitis and radiation dermatitis, dose distributions were reviewed and analyzed in attempt to correlate the toxicity with radiation dose. Results: At a median follow up time of about 21 months, none of the patients had experienced Grade 4 or 5 toxicity. The most common adverse effect was dermatitis (81%: 52%-Grade 1, 28%-Grade 2, and 1% Grade 3), followed by fatigue (48%), Cough (46%), and Esophagitis (45%), as shown in Figure 1. Severe toxicities, such as Grade 3 dermatitis or pain of skin, had a clear correlation with high radiation dose. Conclusion: Uniform scanning proton therapy is well tolerated by lung cancer patients. Preliminary analysis indicates there is correlation between severe toxicity and high radiation dose. Understanding of radiation resulted toxicities and careful choice of beam arrangement are critical in minimizing toxicity of skin and other organs.

  15. Integration and evaluation of automated Monte Carlo simulations in the clinical practice of scanned proton and carbon ion beam therapy.

    Science.gov (United States)

    Bauer, J; Sommerer, F; Mairani, A; Unholtz, D; Farook, R; Handrack, J; Frey, K; Marcelos, T; Tessonnier, T; Ecker, S; Ackermann, B; Ellerbrock, M; Debus, J; Parodi, K

    2014-08-21

    Monte Carlo (MC) simulations of beam interaction and transport in matter are increasingly considered as essential tools to support several aspects of radiation therapy. Despite the vast application of MC to photon therapy and scattered proton therapy, clinical experience in scanned ion beam therapy is still scarce. This is especially the case for ions heavier than protons, which pose additional issues like nuclear fragmentation and varying biological effectiveness. In this work, we present the evaluation of a dedicated framework which has been developed at the Heidelberg Ion Beam Therapy Center to provide automated FLUKA MC simulations of clinical patient treatments with scanned proton and carbon ion beams. Investigations on the number of transported primaries and the dimension of the geometry and scoring grids have been performed for a representative class of patient cases in order to provide recommendations on the simulation settings, showing that recommendations derived from the experience in proton therapy cannot be directly translated to the case of carbon ion beams. The MC results with the optimized settings have been compared to the calculations of the analytical treatment planning system (TPS), showing that regardless of the consistency of the two systems (in terms of beam model in water and range calculation in different materials) relevant differences can be found in dosimetric quantities and range, especially in the case of heterogeneous and deep seated treatment sites depending on the ion beam species and energies, homogeneity of the traversed tissue and size of the treated volume. The analysis of typical TPS speed-up approximations highlighted effects which deserve accurate treatment, in contrast to adequate beam model simplifications for scanned ion beam therapy. In terms of biological dose calculations, the investigation of the mixed field components in realistic anatomical situations confirmed the findings of previous groups so far reported only in

  16. Relative biological effectiveness in a proton spread-out Bragg peak formed by pencil beam scanning mode

    Czech Academy of Sciences Publication Activity Database

    Michaelidesová, Anna; Vachelová, Jana; Puchalská, M.; Pachnerová Brabcová, Kateřina; Vondráček, V.; Sihver, L.; Davídková, Marie

    2017-01-01

    Roč. 40, č. 2 (2017), s. 359-368 ISSN 0158-9938 R&D Projects: GA ČR(CZ) GBP108/12/G108 Institutional support: RVO:61389005 Keywords : Relative biological effectiveness * Proton therapy * Clonogennic assay * Micronuclei assay * Monte Carlo simulations * Scanning beam Subject RIV: BG - Nuclear, Atomic and Molecular Physics, Colliders OBOR OECD: Nuclear physics Impact factor: 1.171, year: 2016

  17. COMPARISON OF RESPONSE OF PASSIVE DOSIMETRY SYSTEMS IN SCANNING PROTON RADIOTHERAPY-A STUDY USING PAEDIATRIC ANTHROPOMORPHIC PHANTOMS.

    Science.gov (United States)

    Kneževic, Ž; Ambrozova, I; Domingo, C; De Saint-Hubert, M; Majer, M; Martínez-Rovira, I; Miljanic, S; Mojzeszek, N; Porwol, P; Ploc, O; Romero-Expósito, M; Stolarczyk, L; Trinkl, S; Harrison, R M; Olko, P

    2017-11-18

    Proton beam therapy has advantages in comparison to conventional photon radiotherapy due to the physical properties of proton beams (e.g. sharp distal fall off, adjustable range and modulation). In proton therapy, there is the possibility of sparing healthy tissue close to the target volume. This is especially important when tumours are located next to critical organs and while treating cancer in paediatric patients. On the other hand, the interactions of protons with matter result in the production of secondary radiation, mostly neutrons and gamma radiation, which deposit their energy at a distance from the target. The aim of this study was to compare the response of different passive dosimetry systems in mixed radiation field induced by proton pencil beam inside anthropomorphic phantoms representing 5 and 10 years old children. Doses were measured in different organs with thermoluminescent (MTS-7, MTS-6 and MCP-N), radiophotoluminescent (GD-352 M and GD-302M), bubble and poly-allyl-diglycol carbonate (PADC) track detectors. Results show that RPL detectors are the less sensitive for neutrons than LiF TLDs and can be applied for in-phantom dosimetry of gamma component. Neutron doses determined using track detectors, bubble detectors and pairs of MTS-7/MTS-6 are consistent within the uncertainty range. This is the first study dealing with measurements on child anthropomorphic phantoms irradiated by a pencil scanning beam technique. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Safety, efficacy, predictability and stability of laser in situ keratomileusis (LASIK) with a 1000-Hz scanning spot excimer laser.

    Science.gov (United States)

    Khoramnia, Ramin; Salgado, Josefina P; Wuellner, Christian; Donitzky, Christof; Lohmann, Chris P; Winkler von Mohrenfels, Christoph

    2012-09-01

    To evaluate the safety, efficacy, predictability and stability of laser in situ keratomileusis (LASIK) with a 1000-Hz scanning spot excimer laser (Concept System 1000; WaveLight GmbH, Erlangen, Germany). LASIK was performed on twenty eyes with myopia or myopic astigmatism (mean spherical equivalent refraction: -3.97±1.72 dioptres (D); mean cylinder: -0.84±0.77 D) using a microkeratome for flap creation and the Concept System 1000 for photoablation. Patients were examined preoperatively as well as 1, 3 and 6 months after the treatment. Manifest sphere and cylinder, uncorrected (UCDVA) and best corrected (BCDVA) distance visual acuity, corneal topography and pachymetry were analysed. We observed no adverse events that might have been associated with the use of a repetition rate of 1000 Hz. All eyes maintained or had improved BCDVA at 6 months after treatment when compared to preoperative values. Six months after LASIK, UCDVA was 20/20 or better in 85% and 20/25 or better in 100% of the eyes. The spherical equivalent refraction was within ±0.50 D in 95% of the eyes at 6 months after surgery. The refraction stayed stable over time; 95% of the eyes changedLASIK with the prototype 1000-Hz excimer laser was safe, efficient and predictable. The postoperative refraction was stable over time. There were no specific clinical side-effects that might be associated with the use of such a high repetition rate. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

  19. SU-G-JeP4-09: Impact of Interfractional Motion On Hypofractionated Pencil Beam Scanning Proton Therapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Moteabbed, M; Trofimov, A; Sharp, G; Wang, Y; Zietman, A; Efstathiou, J; Lu, H [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)

    2016-06-15

    Purpose: To investigate the impact of anatomy/setup variations on standard vs. hypofractionated anterolateral pencil beam scanning (PBS) proton therapy for prostate cancer. Methods: Six prostate cancer patients treated with double-scattering proton therapy, who underwent weekly verification CT scans were selected. Implanted fiducials were used for localization, and endorectal balloons for immobilization. New PBS plans using combination of lateral and anterior-oblique (AO) (±35 deg) beams were created. AO beams were added to spare the femoral heads during hypofractionation. Lateral beams delivered 50.4 Gy(RBE) to prostate plus 5-15mm of seminal vesicles and AO beams 28.8 Gy(RBE) to prostate, in 44 fractions. PTV was laterally expanded by 2.5% to account for range uncertainty. No range margins were applied for AO beams, assuming delivery with in-vivo range verification. Field-specific apertures with 1.2cm margin were used. Spot size was ∼9.5mm sigma for 172MeV @isocenter in air. Plans were optimized as single-field-uniform-dose with ∼5% maximum non-uniformity. The planned dose was recomputed on each weekly CT after aligning the fiducials with the simulation CT, scaled and accumulated via deformable image registration. Hypofractionated treatments with 12 and 5 fractions were considered. Equivalent doses were calculated for prostate (α/β= 1.5Gy), bladder and rectum (α/β= 3Gy). Results: The biological equivalent prostate dose was 86.2 and 92.9 Gyeq for the hypofractionation scenarios at 4.32 and 7.35 Gy/fx, respectively. The equivalent prostate D98 was degraded by on average 2.7 Gyeq for standard, and 3.1 and 4.0 Gyeq for the hypofractionated plans after accumulation. Differences between accumulated and planned Dmean/D2/EUD were generally reduced when reducing the number of fractions for bladder and rectum. The average Dmean/D2/EUD differences over all patients and organs-at-risk were 0.74/4.0/9.23, 0.49/3.64/5.51, 0.37/3.21/3.49 Gyeq for 44, 12 and 5 fractions

  20. Monte Carlo study of radial energy deposition from primary and secondary particles for narrow and large proton beamlet source models

    International Nuclear Information System (INIS)

    Peeler, Christopher R; Titt, Uwe

    2012-01-01

    In spot-scanning intensity-modulated proton therapy, numerous unmodulated proton beam spots are delivered over a target volume to produce a prescribed dose distribution. To accurately model field size-dependent output factors for beam spots, the energy deposition at positions radial to the central axis of the beam must be characterized. In this study, we determined the difference in the central axis dose for spot-scanned fields that results from secondary particle doses by investigating energy deposition radial to the proton beam central axis resulting from primary protons and secondary particles for mathematical point source and distributed source models. The largest difference in the central axis dose from secondary particles resulting from the use of a mathematical point source and a distributed source model was approximately 0.43%. Thus, we conclude that the central axis dose for a spot-scanned field is effectively independent of the source model used to calculate the secondary particle dose. (paper)

  1. Initial Report of Pencil Beam Scanning Proton Therapy for Posthysterectomy Patients With Gynecologic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Lilie L., E-mail: lin@xrt.upenn.edu; Kirk, Maura; Scholey, Jessica; Taku, Nicolette; Kiely, Janid B.; White, Benjamin; Both, Stefan

    2016-05-01

    Purpose: To report the acute toxicities associated with pencil beam scanning proton beam radiation therapy (PBS) for whole pelvis radiation therapy in women with gynecologic cancers and the results of a dosimetric comparison of PBS versus intensity modulated radiation therapy (IMRT) plans. Methods and Materials: Eleven patients with posthysterectomy gynecologic cancer received PBS to the whole pelvis. The patients received a dose of 45 to 50.4 Gy relative biological effectiveness (RBE) in 1.8 Gy (RBE) daily fractions. Acute toxicity was scored according to the Common Terminology Criteria for Adverse Events, version 4. A dosimetric comparison between a 2-field posterior oblique beam PBS and an IMRT plan was conducted. The Wilcoxon signed rank test was used to assess the potential dosimetric differences between the 2 plans and PBS target coverage robustness relative to setup uncertainties. Results: The median patient age was 55 years (range 23-76). The primary site was cervical in 7, vaginal in 1, and endometrial in 3. Of the 11 patients, 7 received concurrent cisplatin, 1 each received sandwich carboplatin and paclitaxel chemotherapy, both sandwich and concurrent chemotherapy, and concurrent and adjuvant chemotherapy, and 1 received no chemotherapy. All patients completed treatment. Of the 9 patients who received concurrent chemotherapy, the rate of grade 2 and 3 hematologic toxicities was 33% and 11%, respectively. One patient (9%) developed grade 3 acute gastrointestinal toxicity; no patient developed grade ≥3 genitourinary toxicity. The volume of pelvic bone marrow, bladder, and small bowel receiving 10 to 30 Gy was significantly lower with PBS than with intensity modulated radiation therapy (P<.001). The target coverage for all PBS plans was robust relative to the setup uncertainties (P>.05) with the clinical target volume mean dose percentage received by 95% and 98% of the target volume coverage changes within 2% for the individual plans. Conclusions: Our

  2. Scanning of irradiated silicon detectors using $\\alpha$ particles and low energy protons

    CERN Document Server

    Casse, G L; Glaser, M; Kohout, Z; Konícek, J; Lemeilleur, F; Leroy, C; Linhart, V; Mares, J J; Pospísil, S; Roy, P; Sopko, B; Sinor, M; Svejda, J; Vorobel, V; Wilhelm, I

    1999-01-01

    In a spectroscopic study of non-irradiated and proton-irradiated silicon diodes, the detectors were illuminated from the front side and from the rear side by various alpha particle sources (mainly ThC') and by monoenergetic protons with energies from 1.0 to 2.5~MeV. Their response characteristics have been studied as a function of the incoming particle energy and the applied bias voltage. The charge collection efficiency was determined as a function of fluence

  3. A scanning proton microprobe study of stinging emergences from the leaf of the common stinging nettle urtica dioica l.

    Science.gov (United States)

    Hughes, N. P.; Perry, C. C.; Williams, R. J. P.; Watt, F.; Grime, G. W.

    1988-03-01

    Proton-induced X-ray emission (PIXE) combined with the Oxford scanning proton microprobe (SPM) was used to investigate the abundance and spatial distribution of inorganic elements in mineralising stinging emergences from the leaf of the Common Stinging Nettle, Urtica dioica L. Elemental maps and point analytical data were collected for emergences at two stages of maturity. In all emergences calcium and silicon were spatially organised and present at high concentration. The inorganic elements K, P, S and Mn were also spatially organised during mineralisation, but at maturity these elements were present only at background levels and then showed no specific localisation. The observed changes in the inorganic content of the emergences are obviously related to the mineralisation processes. The possible biochemical significance of the distribution of the elements is discussed.

  4. Thermal conductivity profile determination in proton-irradiated ZrC by spatial and frequency scanning thermal wave methods

    International Nuclear Information System (INIS)

    Jensen, C.; Chirtoc, M.; Horny, N.; Antoniow, J. S.; Pron, H.; Ban, H.

    2013-01-01

    Using complementary thermal wave methods, the irradiation damaged region of zirconium carbide (ZrC) is characterized by quantifiably profiling the thermophysical property degradation. The ZrC sample was irradiated by a 2.6 MeV proton beam at 600 °C to a dose of 1.75 displacements per atom. Spatial scanning techniques including scanning thermal microscopy (SThM), lock-in infrared thermography (lock-in IRT), and photothermal radiometry (PTR) were used to directly map the in-depth profile of thermal conductivity on a cross section of the ZrC sample. The advantages and limitations of each system are discussed and compared, finding consistent results from all techniques. SThM provides the best resolution finding a very uniform thermal conductivity envelope in the damaged region measuring ∼52 ± 2 μm deep. Frequency-based scanning PTR provides quantification of the thermal parameters of the sample using the SThM measured profile to provide validation of a heating model. Measured irradiated and virgin thermal conductivities are found to be 11.9 ± 0.5 W m −1 K −1 and 26.7 ±1 W m −1 K −1 , respectively. A thermal resistance evidenced in the frequency spectra of the PTR results was calculated to be (1.58 ± 0.1) × 10 −6 m 2 K W −1 . The measured thermal conductivity values compare well with the thermal conductivity extracted from the SThM calibrated signal and the spatially scanned PTR. Combined spatial and frequency scanning techniques are shown to provide a valuable, complementary combination for thermal property characterization of proton-irradiated ZrC. Such methodology could be useful for other studies of ion-irradiated materials

  5. The bio-PIXE setup on the Debrecen scanning proton microprobe

    International Nuclear Information System (INIS)

    Kertesz, Zs.; Szikszai, Z.; Uzonyi, I.; Simon, A.; Kiss, A.Z.

    2004-01-01

    Complete text of publication follows. Besides the ongoing applications in archeometry, geology, material science and atmospheric aerosol study, in recent years the IBA Group in Debrecen has joined several biological and biomedical research projects. Such studies require the knowledge of accurate quantitative elemental concentrations and distributions in organic, inhomogeneous thin samples on a microscopic scale. In most cases, to carry out quantitative investigations on biomedical samples down to the cell level, the combination of proton induced X-ray emission (PIXE), Rutherford backscattering (RBS) spectrometry and scanning transmission ion microscopy (STIM) analytical methods are used simultaneously. STIM provides information on the density and structure of the sample, PIXE measures the concentration of the inorganic major and trace elements, and finally RBS serves to characterize the organic matrix, to determine the beam dose, and sometimes the sample thickness. The drawback of this combined method is that to evaluate the RBS data the hydrogen to carbon ratio in the sample must be known. The setup developed at the Debrecen microprobe facility [1] is based on the combined application of on-axis STIM and simultaneous PIXE-PIXE analytical techniques. In the PIXE-PIXE method the sample matrix is determined directly by measuring X-rays from all elements in the sample including the light elements such as carbon and oxygen, using two Si(Li) X-ray detectors. In this arrangement an ultra thin windowed Si(Li) X-ray detector serves to characterize the matrix by measuring low energy X-ray lines (0.2-9 keV) while a large area Be-windowed detector is used to detect the medium and high energy X-ray lines (>4 keV). In this way elements with atomic number higher than 5 can be detected simultaneously, reducing both radiation damage of the sample and measurement time. In addition, the knowledge of the hydrogen content of the sample is not needed, since it influences the

  6. SU-E-T-464: On the Equivalence of the Quality Correction Factor for Pencil Beam Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Sorriaux, J; Paganetti, H; Testa, M; Giantsoudi, D; Schuemann, J; Bertrand, D; Orban de Xivry, J.; Lee, J; Palmans, H; Vynckier, S; Sterpin, E

    2014-01-01

    Purpose: In current practice, most proton therapy centers apply IAEA TRS-398 reference dosimetry protocol. Quality correction factors (kQ) take into account in the dose determination process the differences in beam qualities used for calibration unit and for treatment unit. These quality correction factors are valid for specific reference conditions. TRS-398 reference conditions should be achievable in both scattered proton beams (i.e. DS) and scanned proton beams (i.e. PBS). However, it is not a priori clear if TRS-398 kQ data, which are based on Monte Carlo (MC) calculations in scattered beams, can be used for scanned beams. Using TOPAS-Geant4 MC simulations, the study aims to determine whether broad beam quality correction factors calculated in TRS-398 can be directly applied to PBS delivery modality. Methods: As reference conditions, we consider a 10×10×10 cm 3 homogeneous dose distribution delivered by PBS system in a water phantom (32/10 cm range/modulation) and an air cavity placed at the center of the spread-out-Bragg-peak. In order to isolate beam differences, a hypothetical broad beam is simulated. This hypothetical beam reproduces exactly the same range modulation, and uses the same energy layers than the PBS field. Ion chamber responses are computed for the PBS and hypothetical beams and then compared. Results: For an air cavity of 2×2×0.2 cm 3 , the ratio of ion chamber responses for the PBS and hypothetical beam qualities is 0.9991 ± 0.0016. Conclusion: Quality correction factors are insensitive to the delivery pattern of the beam (broad beam or PBS), as long as similar dose distributions are achieved. This investigation, for an air cavity, suggests that broad beam quality correction factors published in TRS-398 can be applied for scanned beams. J. Sorriaux is financially supported by a public-private partnership involving the company Ion Beam Applications (IBA)

  7. Quantitation of size of myocardial infarctions by computerized transmission tomography. Comparison with hot-spot and cold-spot radionuclide scans

    International Nuclear Information System (INIS)

    Gerber, K.H.; Higgins, C.B.

    1983-01-01

    The current study evaluated the ability to quantitate the volume of myocardial infarctions when they are outlined by intravenously administered contrast media in the myocardial perfusion phase and in the phase of delayed contrast enhancement of the infarct. Quantitation by contrast media was assessed from computerized transmission tomography (CTT) scans of the ex situ heart and compared with quantitation by technetium-99m (/sup 99m/Tc)pyrophosphate (/sup 99m/Tc PYP) and thallium-201 (201Tl) scans of the same ex situ hearts. True volume was defined by histochemical morphometry. CTT during the contrast perfusion phase uniformly underestimated infarct size but had a good correlation with true volume. CTT during enhancement phase correlated closely with true volume (r . 0.98) and most precisely measured true size (y . 1.06 X 0.23). The /sup 99m/Tc PYP scan overestimated infarct volume (predictive overestimation of 6 to 199%) but had a good correlation with true volume. 201Tl underestimated infarct volume but correlated well with true volume. Thus, quantitation of infarct volume from CTT scans performed during either the perfusion or infarct enhancement phase after intravenous contrast media provides a good estimate of true infarct volume. Delineation of the infarct by contrast media in the ex situ heart is more precise during the phase of delayed enhancement of the infarct

  8. The influence of lateral beam profile modifications in scanned proton and carbon ion therapy: a Monte Carlo study

    CERN Document Server

    Parodi, K; Kraemer, M; Sommerer, F; Naumann, J; Mairani, A; Brons, S

    2010-01-01

    Scanned ion beam delivery promises superior flexibility and accuracy for highly conformal tumour therapy in comparison to the usage of passive beam shaping systems. The attainable precision demands correct overlapping of the pencil-like beams which build up the entire dose distribution in the treatment field. In particular, improper dose application due to deviations of the lateral beam profiles from the nominal planning conditions must be prevented via appropriate beam monitoring in the beamline, prior to the entrance in the patient. To assess the necessary tolerance thresholds of the beam monitoring system at the Heidelberg Ion Beam Therapy Center, Germany, this study has investigated several worst-case scenarios for a sensitive treatment plan, namely scanned proton and carbon ion delivery to a small target volume at a shallow depth. Deviations from the nominal lateral beam profiles were simulated, which may occur because of misaligned elements or changes of the beam optic in the beamline. Data have been an...

  9. Prevention of haematoma progression by tranexamic acid in intracerebral haemorrhage patients with and without spot sign on admission scan

    DEFF Research Database (Denmark)

    Ovesen, Christian; Jakobsen, Janus Christian; Gluud, Christian

    2018-01-01

    OBJECTIVE: We present the statistical analysis plan of a prespecified Tranexamic Acid for Hyperacute Primary Intracerebral Haemorrhage (TICH)-2 sub-study aiming to investigate, if tranexamic acid has a different effect in intracerebral haemorrhage patients with the spot sign on admission compared...... to spot sign negative patients. The TICH-2 trial recruited above 2000 participants with intracerebral haemorrhage arriving in hospital within 8 h after symptom onset. They were included irrespective of radiological signs of on-going haematoma expansion. Participants were randomised to tranexamic acid...... versus matching placebo. In this subgroup analysis, we will include all participants in TICH-2 with a computed tomography angiography on admission allowing adjudication of the participants' spot sign status. RESULTS: Primary outcome will be the ability of tranexamic acid to limit absolute haematoma...

  10. Collimated proton pencil-beam scanning for superficial targets: impact of the order of range shifter and aperture

    Science.gov (United States)

    Bäumer, C.; Janson, M.; Timmermann, B.; Wulff, J.

    2018-04-01

    To assess if apertures shall be mounted upstream or downstream of a range shifting block if these field-shaping devices are combined with the pencil-beam scanning delivery technique (PBS). The lateral dose fall-off served as a benchmark parameter. Both options realizing PBS-with-apertures were compared to the uniform scanning mode. We also evaluated the difference regarding the out-of-field dose caused by interactions of protons in beam-shaping devices. The potential benefit of the downstream configuration over the upstream configuration was estimated analytically. Guided by this theoretical evaluation a mechanical adapter was developed which transforms the upstream configuration provided by the proton machine vendor to a downstream configuration. Transversal dose profiles were calculated with the Monte-Carlo based dose engine of the commercial treatment planning system RayStation 6. Two-dimensional dose planes were measured with an ionization chamber array and a scintillation detector at different depths and compared to the calculation. Additionally, a clinical example for the irradiation of the orbit was compared for both PBS options and a uniform scanning treatment plan. Assuming the same air gap the lateral dose fall-off at the field edge at a few centimeter depth is 20% smaller for the aperture-downstream configuration than for the upstream one. For both options of PBS-with-apertures the dose fall-off is larger than in uniform scanning delivery mode if the minimum accelerator energy is 100 MeV. The RayStation treatment planning system calculated the width of the lateral dose fall-off with an accuracy of typically 0.1 mm–0.3 mm. Although experiments and calculations indicate a ranking of the three delivery options regarding lateral dose fall-off, there seems to be a limited impact on a multi-field treatment plan.

  11. [Scanning electron microscopic investigations of cutting edge quality in lamellar keratotomy using the Wavelight femtosecond laser (FS-200) : What influence do spot distance and an additional tunnel have?

    Science.gov (United States)

    Hammer, T; Höche, T; Heichel, J

    2018-01-01

    Femtosecond lasers (fs-lasers) are established cutting instruments for the creation of LASIK flaps. Previous studies often showed even rougher surfaces after application of fs-laser systems compared to lamellar keratotomy with mechanical microkeratomes. When cutting the cornea with fs-lasers, an intrastromal gas development occurs, which has a potentially negative influence on the cutting quality if the gas cannot be dissipated; therefore, manufacturers have chosen the way of gas assimilation in so-called pockets. The investigated system creates a tunnel which opens under the conjunctiva. The aim of this study was to investigate the effects of a tunnel as well as the influence of different spot distances on the quality of cut surfaces and edges. In this experimental study on freshly enucleated porcine eyes (n = 15), the following cuts were carried out with the FS-200 (Wavelight, Erlangen, Germany): 1. standard setting (spot and line separation 8 µm), 2. with tunnel for gas drainage, 3. without gas-conducting tunnel, 4. with increased spot spacing (spot and line separation 9 μm instead of 8 μm) and 5. with reduced spot spacing (spot and line separation 7 μm instead of 8 μm). Subsequently, scanning electron microscopy (FEI Quanta 650, Hillsboro, OR) of the cut edges and surfaces as well as the gas drain tunnel were performed. The evaluation was based on an established score. The current fs-laser system (200 Hz) is able to create smooth cutting surfaces and sharp edges. The changed density of laser pulses compared to the standard settings with a reduced or increased distance between the pulses, did not achieve any further improvement in the surface quality. The gas-conducting tunnel could be detected by scanning electron microscope. In the case of cutting without a tunnel, roughened surfaces and irregularities on the cutting edges were found. When the FS-200 fs-laser is used, LASIK cuts with very smooth cut surfaces and sharp cutting

  12. Proton backscatter as a means of mass normalization in PIXE scanning of human hair

    International Nuclear Information System (INIS)

    Russell, S.B.; Gibson, R.S.; Faiq, S.; Campbell, J.L.

    1981-01-01

    Variations in linear density along a given hair can cause changes in X-ray intensity which do not reflect elemental concentration changes. Hairs from different subjects vary by a factor approx. 5 in linear density, so that very different X-ray intensities need not necessarily reflect different concentrations. We investigate the usefulness of the backscattered proton intensity as a means of determining the mass undergoing PIXE analysis. Specimen damage can be avoided in the BS measurement via low currents without loss of statistics. A correlation is found between BS intensity and mass, but a laser diffraction measurement of the hair diameter provides an equally satisfactory mass determination. (orig.)

  13. Proton therapy project at PSI

    International Nuclear Information System (INIS)

    Nakagawa, K.; Akanuma, A.; Karasawa, K.

    1990-01-01

    Particle radiation which might present steeper dose distribution has received much attention as the third particle facility at the Paul Scherrer Institute (PSI), Switzerland. Proton conformation with sharp fall-off is considered to be the radiation beam suitable for confining high doses to a target volume without complications and for verifying which factor out of high RBE or physical dose distribution is more essential for local control in malignant tumors. This paper discusses the current status of the spot scanning method, which allows three dimensional conformation radiotherapy, and preliminary results. Preliminary dose distribution with proton conformation technique was acquired by modifying a computer program for treatment planning in pion treatment. In a patient with prostate carcinoma receiving both proton and pion radiation therapy, proton conformation was found to confine high doses to the target area and spare both the bladder and rectum well; and pion therapy was found to deliver non-homogeneous radiation to these organs. Although there are some obstacles in the proton project at PSI, experimental investigations are encouraging. The dynamic spot scanning method with combination of the kicker magnet, wobbler magnet, range shifter, patient transporter, and position sensitive monitor provides highly confined dose distribution, making it possible to increase total doses and thus to improve local control rate. Proton confirmation is considered to be useful for verifying possible biological effectiveness of negative pion treatment of PSI as well. (N.K.)

  14. Is it necessary to plan with safety margins for actively scanned proton therapy?

    Science.gov (United States)

    Albertini, F.; Hug, E. B.; Lomax, A. J.

    2011-07-01

    In radiation therapy, a plan is robust if the calculated and the delivered dose are in agreement, even in the case of different uncertainties. The current practice is to use safety margins, expanding the clinical target volume sufficiently enough to account for treatment uncertainties. This, however, might not be ideal for proton therapy and in particular when using intensity modulated proton therapy (IMPT) plans as degradation in the dose conformity could also be found in the middle of the target resulting from misalignments of highly in-field dose gradients. Single field uniform dose (SFUD) and IMPT plans have been calculated for different anatomical sites and the need for margins has been assessed by analyzing plan robustness to set-up and range uncertainties. We found that the use of safety margins is a good way to improve plan robustness for SFUD and IMPT plans with low in-field dose gradients but not necessarily for highly modulated IMPT plans for which only a marginal improvement in plan robustness could be detected through the definition of a planning target volume.

  15. Online image guided tumour tracking with scanned proton beams : a comprehensive simulation study

    NARCIS (Netherlands)

    Zhang, Ye; Knopf, A; Tanner, Colby; Lomax, Antony J.

    2014-01-01

    Tumour tracking with scanned particle beams potentially requires accurate 3D information on both tumour motion and related density variations. We have previously developed a model-based motion reconstruction method, which allows for the prediction of deformable motions from sparsely sampled

  16. Adjuvant intensity-modulated proton therapy in malignant pleural mesothelioma. A comparison with intensity-modulated radiotherapy and a spot size variation assessment

    Energy Technology Data Exchange (ETDEWEB)

    Lorentini, S. [Agenzia Provinciale per la Protonterapia (ATreP), Trento (Italy); Padova Univ. (Italy). Medical Physics School; Amichetti, M.; Fellin, F.; Schwarz, M. [Agenzia Provinciale per la Protonterapia (ATreP), Trento (Italy); Spiazzi, L. [Brescia Hospital (Italy). Medical Physics Dept.; Tonoli, S.; Magrini, S.M. [Brescia Hospital (Italy). Radiation Oncology Dept.

    2012-03-15

    Intensity-modulated radiation therapy (IMRT) is the state-of-the-art treatment for patients with malignant pleural mesothelioma (MPM). The goal of this work was to assess whether intensity-modulated proton therapy (IMPT) could further improve the dosimetric results allowed by IMRT. We re-planned 7 MPM cases using both photons and protons, by carrying out IMRT and IMPT plans. For both techniques, conventional dose comparisons and normal tissue complication probability (NTCP) analysis were performed. In 3 cases, additional IMPT plans were generated with different beam dimensions. IMPT allowed a slight improvement in target coverage and clear advantages in dose conformity (p < 0.001) and dose homogeneity (p = 0.01). Better organ at risk (OAR) sparing was obtained with IMPT, in particular for the liver (D{sub mean} reduction of 9.5 Gy, p = 0.001) and ipsilateral kidney (V{sub 20} reduction of 58%, p = 0.001), together with a very large reduction of mean dose for the contralateral lung (0.2 Gy vs 6.1 Gy, p = 0.0001). NTCP values for the liver showed a systematic superiority of IMPT with respect to IMRT for both the esophagus (average NTCP 14% vs. 30.5%) and the ipsilateral kidney (p = 0.001). Concerning plans obtained with different spot dimensions, a slight loss of target coverage was observed along with sigma increase, while maintaining OAR irradiation always under planning constraints. Results suggest that IMPT allows better OAR sparing with respect to IMRT, mainly for the liver, ipsilateral kidney, and contralateral lung. The use of a spot dimension larger than 3 x 3 mm (up to 9 x 9 mm) does not compromise dosimetric results and allows a shorter delivery time.

  17. SU-E-J-78: Adaptive Planning Workflow in a Pencil Beam Scanning Proton Therapy Center

    Energy Technology Data Exchange (ETDEWEB)

    Blakey, M; Price, S; Robison, B; Niek, S; Moe, S; Renegar, J; Mark, A; Spenser, W [Provision Healthcare Partners, Knoxville, TN (United States)

    2015-06-15

    Purpose: The susceptibility of proton therapy to changes in patient setup and anatomy necessitates an adaptive planning process. With the right planning tools and clinical workflow, an adaptive plan can be created in a timely manner without adding significant workload to the treatment planning staff. Methods: In our center, a weekly QA CT is performed on most patients to assess setup, anatomy change, and tumor response. The QA CT is fused to the treatment planning CT, the contours are transferred via deformable registration, and the plan dose is recalculated on the QA CT. A physicist assesses the dose distribution, and an adaptive plan is requested based on tumor coverage or OAR dose changes. After the physician confirms or alters the deformed contours, a dosimetrist develops an adaptive plan using our TPS adaptation module. The plan is assessed for robustness and is then reviewed by the physician. Patient QA is performed within three days following the first adapted treatment. Results: Of the patients who received QA CTs, 19% required at least one adaptive plan (18.5% H&N, 18.5% brain, 11.1% breast, 14.8% chestwall, 14.8% lung, 18.5% pelvis and 3.8% abdomen). Of these patients, 14% went on a break, while the remainder was treated with the previous plan during the re-planning process. Adaptive plans were performed based on tumor shrinkage, anatomy change or positioning uncertainties for 37.9%, 44.8%, and 17.3% of the patients, respectively. On average, 3 full days are required between the QA CT and the first adapted plan treatment. Conclusion: Adaptive planning is a crucial component of proton therapy and should be applied to any site when the QA CT shows significant deviation from the plan. With an efficient workflow, an adaptive plan can be applied without delaying patient treatment or burdening the dosimetry and medical physics team.

  18. SU-E-J-78: Adaptive Planning Workflow in a Pencil Beam Scanning Proton Therapy Center

    International Nuclear Information System (INIS)

    Blakey, M; Price, S; Robison, B; Niek, S; Moe, S; Renegar, J; Mark, A; Spenser, W

    2015-01-01

    Purpose: The susceptibility of proton therapy to changes in patient setup and anatomy necessitates an adaptive planning process. With the right planning tools and clinical workflow, an adaptive plan can be created in a timely manner without adding significant workload to the treatment planning staff. Methods: In our center, a weekly QA CT is performed on most patients to assess setup, anatomy change, and tumor response. The QA CT is fused to the treatment planning CT, the contours are transferred via deformable registration, and the plan dose is recalculated on the QA CT. A physicist assesses the dose distribution, and an adaptive plan is requested based on tumor coverage or OAR dose changes. After the physician confirms or alters the deformed contours, a dosimetrist develops an adaptive plan using our TPS adaptation module. The plan is assessed for robustness and is then reviewed by the physician. Patient QA is performed within three days following the first adapted treatment. Results: Of the patients who received QA CTs, 19% required at least one adaptive plan (18.5% H&N, 18.5% brain, 11.1% breast, 14.8% chestwall, 14.8% lung, 18.5% pelvis and 3.8% abdomen). Of these patients, 14% went on a break, while the remainder was treated with the previous plan during the re-planning process. Adaptive plans were performed based on tumor shrinkage, anatomy change or positioning uncertainties for 37.9%, 44.8%, and 17.3% of the patients, respectively. On average, 3 full days are required between the QA CT and the first adapted plan treatment. Conclusion: Adaptive planning is a crucial component of proton therapy and should be applied to any site when the QA CT shows significant deviation from the plan. With an efficient workflow, an adaptive plan can be applied without delaying patient treatment or burdening the dosimetry and medical physics team

  19. Data smoothing techniques applied to proton microprobe scans of teleost hard parts

    International Nuclear Information System (INIS)

    West, I.F.; Gauldie, R.W.; Coote, G.E.

    1992-01-01

    We use a proton microprobe to examine the distribution of elements in otoliths and scales of teleost (bony) fish. The elements of principal interest are calcium and strontium in otoliths and calcium and fluorine in scales. Changes in the distribution of these elements across hard structures may allow inferences about the life histories of fish. Otoliths and scales of interest are up to a centimeter in linear dimension and to reveal the structures of interest up to 200 sampling points are required in each dimension. The time needed to accumulate high X-ray counts at each sampling point can be large, particularly for strontium. To reduce microprobe usage we use data smoothing techniques to reveal changing patterns with modest X-ray count accumulations at individual data points. In this paper we review performance for revealing pattern at modest levels of X-ray count accumulations of a selection of digital filters (moving average smoothers), running median filters, robust locally weighted regression filters and adaptive spline filters. (author)

  20. Quantum nature of protons in water probed by scanning tunneling microscopy and spectroscopy

    Science.gov (United States)

    Guo, Jing; Lü, Jing-Tao; Feng, Yexin; Chen, Ji; Peng, Jinbo; Lin, Zeren; Meng, Xiangzhi; Wang, Zhichang; Li, Xin-Zheng; Wang, En-Ge; Jiang, Ying; Jing-Tao Lü Team; Xin-Zheng Li Team

    The complexity of hydrogen-bonding interaction largely arises from the quantum nature of light hydrogen nuclei, which has remained elusive for decades. Here we report the direct assessment of nuclear quantum effects on the strength of a single hydrogen bond formed at a water-salt interface, using tip-enhanced inelastic electron tunneling spectroscopy (IETS) based on a low-temperature scanning tunneling microscope (STM). The IETS signals are resonantly enhanced by gating the frontier orbitals of water via a chlorine-terminated STM tip, such that the hydrogen-bonding strength can be determined with unprecedentedly high accuracy from the redshift in the O-H stretching frequency of water. Isotopic substitution experiments combined with quantum simulations reveal that the anharmonic quantum fluctuations of hydrogen nuclei weaken the weak hydrogen bonds and strengthen the relatively strong ones. However, this trend can be completely reversed when the hydrogen bond is strongly coupled to the polar atomic sites of the surface.

  1. Robustness of the Voluntary Breath-Hold Approach for the Treatment of Peripheral Lung Tumors Using Hypofractionated Pencil Beam Scanning Proton Therapy

    DEFF Research Database (Denmark)

    Dueck, Jenny; Knopf, Antje-Christin; Lomax, Antony

    2016-01-01

    PURPOSE: The safe clinical implementation of pencil beam scanning (PBS) proton therapy for lung tumors is complicated by the delivery uncertainties caused by breathing motion. The purpose of this feasibility study was to investigate whether a voluntary breath-hold technique could limit the delive...

  2. Feasibility of Pencil Beam Scanned Intensity Modulated Proton Therapy in Breath-hold for Locally Advanced Non-Small Cell Lung Cancer

    DEFF Research Database (Denmark)

    Gorgisyan, Jenny; Munck Af Rosenschold, Per; Perrin, Rosalind

    2017-01-01

    PURPOSE: We evaluated the feasibility of treating patients with locally advanced non-small cell lung cancer (NSCLC) with pencil beam scanned intensity modulated proton therapy (IMPT) in breath-hold. METHODS AND MATERIALS: Fifteen NSCLC patients who had previously received 66 Gy in 33 fractions wi...

  3. Consensus Guidelines for Implementing Pencil-Beam Scanning Proton Therapy for Thoracic Malignancies on Behalf of the PTCOG Thoracic and Lymphoma Subcommittee

    NARCIS (Netherlands)

    Chang, Joe Y.; Zhang, Xiaodong; Knopf, Antje; Li, Heng; Mori, Shinichiro; Dong, Lei; Lu, Hsiao-Ming; Liu, Wei; Badiyan, Shahed N.; Both, Stephen; Meijers, Arturs; Lin, Liyong; Flampouri, Stella; Li, Zuofeng; Umegaki, Kikuo; Simone, Charles B.; Zhu, Xiaorong R.

    2017-01-01

    Pencil-beam scanning (PBS) proton therapy (PT), particularly intensity modulated PT, represents the latest advanced PT technology for treating cancers, including thoracic malignancies. On the basis of virtual clinical studies, PBS-PT appears to have great potential in its ability to tightly tailor

  4. Molecular Determinants Underlying Binding Specificities of the ABL Kinase Inhibitors: Combining Alanine Scanning of Binding Hot Spots with Network Analysis of Residue Interactions and Coevolution.

    Directory of Open Access Journals (Sweden)

    Amanda Tse

    Full Text Available Quantifying binding specificity and drug resistance of protein kinase inhibitors is of fundamental importance and remains highly challenging due to complex interplay of structural and thermodynamic factors. In this work, molecular simulations and computational alanine scanning are combined with the network-based approaches to characterize molecular determinants underlying binding specificities of the ABL kinase inhibitors. The proposed theoretical framework unveiled a relationship between ligand binding and inhibitor-mediated changes in the residue interaction networks. By using topological parameters, we have described the organization of the residue interaction networks and networks of coevolving residues in the ABL kinase structures. This analysis has shown that functionally critical regulatory residues can simultaneously embody strong coevolutionary signal and high network centrality with a propensity to be energetic hot spots for drug binding. We have found that selective (Nilotinib and promiscuous (Bosutinib, Dasatinib kinase inhibitors can use their energetic hot spots to differentially modulate stability of the residue interaction networks, thus inhibiting or promoting conformational equilibrium between inactive and active states. According to our results, Nilotinib binding may induce a significant network-bridging effect and enhance centrality of the hot spot residues that stabilize structural environment favored by the specific kinase form. In contrast, Bosutinib and Dasatinib can incur modest changes in the residue interaction network in which ligand binding is primarily coupled only with the identity of the gate-keeper residue. These factors may promote structural adaptability of the active kinase states in binding with these promiscuous inhibitors. Our results have related ligand-induced changes in the residue interaction networks with drug resistance effects, showing that network robustness may be compromised by targeted mutations

  5. Molecular Determinants Underlying Binding Specificities of the ABL Kinase Inhibitors: Combining Alanine Scanning of Binding Hot Spots with Network Analysis of Residue Interactions and Coevolution

    Science.gov (United States)

    Tse, Amanda; Verkhivker, Gennady M.

    2015-01-01

    Quantifying binding specificity and drug resistance of protein kinase inhibitors is of fundamental importance and remains highly challenging due to complex interplay of structural and thermodynamic factors. In this work, molecular simulations and computational alanine scanning are combined with the network-based approaches to characterize molecular determinants underlying binding specificities of the ABL kinase inhibitors. The proposed theoretical framework unveiled a relationship between ligand binding and inhibitor-mediated changes in the residue interaction networks. By using topological parameters, we have described the organization of the residue interaction networks and networks of coevolving residues in the ABL kinase structures. This analysis has shown that functionally critical regulatory residues can simultaneously embody strong coevolutionary signal and high network centrality with a propensity to be energetic hot spots for drug binding. We have found that selective (Nilotinib) and promiscuous (Bosutinib, Dasatinib) kinase inhibitors can use their energetic hot spots to differentially modulate stability of the residue interaction networks, thus inhibiting or promoting conformational equilibrium between inactive and active states. According to our results, Nilotinib binding may induce a significant network-bridging effect and enhance centrality of the hot spot residues that stabilize structural environment favored by the specific kinase form. In contrast, Bosutinib and Dasatinib can incur modest changes in the residue interaction network in which ligand binding is primarily coupled only with the identity of the gate-keeper residue. These factors may promote structural adaptability of the active kinase states in binding with these promiscuous inhibitors. Our results have related ligand-induced changes in the residue interaction networks with drug resistance effects, showing that network robustness may be compromised by targeted mutations of key mediating

  6. SU-F-T-207: Does the Greater Flexibility of Pencil Beam Scanning Reduce the Need for a Proton Gantry?

    Energy Technology Data Exchange (ETDEWEB)

    Yan, S; Depauw, N; Flanz, J; Adams, J; Gorissen, BL; Shih, H; Bortfeld, T; Lu, H [Massachusetts General Hospital and Harvard Medical School, Department of Radiation Oncology, Boston, MA (United States)

    2016-06-15

    Purpose: Gantry-less proton treatment facility could lower the capital cost of proton therapy. This study investigates the dosimetric feasibility of using only coplanar pencil beam scanning (PBS) beams for those patients who had beam angles that would not have been deliverable without the gantry. Those coplanar beams are implemented on gantry-less horizontal beam-line with patients in sitting or standing positions. Methods: We have selected ten patients (seven head-and-neck, one thoracic, one abdominal and one pelvic case) with clinically delivered double scattering (DS) or PBS treatment plans with beam angles that were challenging to achieve without a gantry. After removing these beams angles, PBS plans were optimized for gantry-less intensity modulated proton therapy (IMPT) or single field optimization (SFO) with multi-criteria optimization (MCO). For head-and-neck patients who were treated by DS, we generated PBS plans with non-coplanar beams for comparison. Dose-volume-histograms (DVHs), target homogeneity index (HI), mean dose, D-2 and D-98 were reported. Robustness analysis was performed with ±2.5 mm setup errors and ±3.5% range uncertainties for three head-and-neck patients. Results: PBS-gantry-less plans provided more homogenous target coverage and significant improvements on organs-at-risk (OARs) sparing, compared to passive scattering treatments with a gantry. The PBS gantry-less treatments reduced the HI for target coverage by 1.3% to 47.2%, except for a suprasellar patient and a liver patient. The PBS-gantry-less plans reduced the D-mean of OARs by 3.6% to 67.4%. The PBS-gantry plans had similar target coverage and only marginal improvements on OAR sparing as compared to the PBS-gantry-less plans. These two PBS plans also had similar robustness relative to range uncertainties and setup errors. Conclusion: The gantry-less plans have with less mean dose to OARs and more homogeneous target coverage. Although the PBS-gantry plans have slightly improved

  7. Chlorophyll and its degradation products in the two-spotted spider mite, Tetranychus urticae: observations using epifluorescence and confocal laser scanning microscopy.

    Science.gov (United States)

    Occhipinti, Andrea; Maffei, Massimo E

    2013-10-01

    Chlorophyll and chlorophyll degradation products were observed in the two-spotted spider mite (Tetranychus urticae) using epifluorescence microscopy (EFM) and confocal laser scanning microscopy (CLSM). A clear red fluorescence (EFM) and a fluorescence induced by a laser wavelength of 650 nm (CLSM) were observed. In the lateral caeca, in the ventriculus and in the excretory organ, a bright light blue fluorescence was observed in close association with chlorophyll by using EFM. The same material can be localized with CLSM by using a laser with a wavelength of 488 nm. By comparison with synthetic guanine, this bright fluorescence is supposed to be guanine. The presence of guanine fluorescence in the mite pellets confirms this hypothesis. A possible mechanism for guanine formation is discussed.

  8. Safety, efficacy, and predictability of laser in situ keratomileusis to correct myopia or myopic astigmatism with a 750 Hz scanning-spot laser system.

    Science.gov (United States)

    Tomita, Minoru; Watabe, Miyuki; Yukawa, Satoshi; Nakamura, Nobuo; Nakamura, Tadayuki; Magnago, Thomas

    2014-02-01

    To evaluate the clinical outcomes of laser in situ keratomileusis (LASIK) to correct myopia or myopic astigmatism using the Amaris 750S 750 Hz excimer laser. Private LASIK center, Tokyo, Japan. Case series. Patients with myopia or myopic astigmatism (spherical equivalent -0.50 to -11.63 diopters [D]), a corrected distance visual acuity (CDVA) of 20/20 or better, and an estimated residual bed thickness of 300 μm or more had LASIK using the aspheric aberration-free ablation profile of the 750 Hz scanning-spot laser and the Femto LDV Crystal Line femtosecond laser for flap creation. Study parameters included uncorrected distance visual acuity (UDVA), CDVA, manifest refraction, astigmatism, and higher-order aberrations (HOAs). The study included 1280 eyes (685 patients). At 3 months, 96.6% of eyes had a UDVA of 20/20 or better and 99.1% had 20/32 or better; 94.1% of eyes were within ± 0.50 D of the intended correction and 98.9% were within ± 1.00 D; 89.7% of eyes had no residual cylinder and 96.0% had a postoperative astigmatism of less than 0.50 D. All eyes had a postoperative CDVA of 20/20 or better. The HOAs increased postoperatively (PLaser in situ keratomileusis with the 750 Hz scanning-spot laser was safe, effective, and predictable. No specific clinical side effects that might be associated with a high repetition rate occurred. Mr. Magnago is an employee of Schwind eye-tech-solutions GmbH. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. TU-EF-304-04: A Heart Motion Model for Proton Scanned Beam Chest Radiotherapy

    International Nuclear Information System (INIS)

    White, B; Kiely, J Blanco; Lin, L; Freedman, G; Both, S; Vennarini, S; Santhanam, A; Low, D

    2015-01-01

    Purpose: To model fast-moving heart surface motion as a function of cardiac-phase in order to compensate for the lack of cardiac-gating in evaluating accurate dose to coronary structures. Methods: Ten subjects were prospectively imaged with a breath-hold, cardiac-gated MRI protocol to determine heart surface motion. Radial and planar views of the heart were resampled into a 3-dimensional volume representing one heartbeat. A multi-resolution optical flow deformable image registration algorithm determined tissue displacement during the cardiac-cycle. The surface of the heart was modeled as a thin membrane comprised of voxels perpendicular to a pencil beam scanning (PBS) beam. The membrane’s out-of-plane spatial displacement was modeled as a harmonic function with Lame’s equations. Model accuracy was assessed with the root mean squared error (RMSE). The model was applied to a cohort of six chest wall irradiation patients with PBS plans generated on phase-sorted 4DCT. Respiratory motion was separated from the cardiac motion with a previously published technique. Volumetric dose painting was simulated and dose accumulated to validate plan robustness (target coverage variation accepted within 2%). Maximum and mean heart surface dose assessed the dosimetric impact of heart and coronary artery motion. Results: Average and maximum heart surface displacements were 2.54±0.35mm and 3.6mm from the end-diastole phase to the end-systole cardiac-phase respectively. An average RMSE of 0.11±0.04 showed the model to be accurate. Observed errors were greatest between the circumflex artery and mitral valve level of the heart anatomy. Heart surface displacements correspond to a 3.6±1.0% and 5.1±2.3% dosimetric impact on the maximum and mean heart surface DVH indicators respectively. Conclusion: Although heart surface motion parallel to beam’s direction was substantial, its maximum dosimetric impact was 5.1±2.3%. Since PBS delivers low doses to coronary structures relative to

  10. Measurements of lateral penumbra for uniform scanning proton beams under various beam delivery conditions and comparison to the XiO treatment planning system

    International Nuclear Information System (INIS)

    Rana, Suresh; Zeidan, Omar; Ramirez, Eric; Rains, Michael; Gao, Junfang; Zheng, Yuanshui

    2013-01-01

    Purpose: The main purposes of this study were to (1) investigate the dependency of lateral penumbra (80%–20% distance) of uniform scanning proton beams on various factors such as air gap, proton range, modulation width, compensator thickness, and depth, and (2) compare the lateral penumbra calculated by a treatment planning system (TPS) with measurements.Methods: First, lateral penumbra was measured using solid–water phantom and radiographic films for (a) air gap, ranged from 0 to 35 cm, (b) proton range, ranged from 8 to 30 cm, (c) modulation, ranged from 2 to 10 cm, (d) compensator thickness, ranged from 0 to 20 cm, and (e) depth, ranged from 7 to 15 cm. Second, dose calculations were computed in a virtual water phantom using the XiO TPS with pencil beam algorithm for identical beam conditions and geometrical configurations that were used for the measurements. The calculated lateral penumbra was then compared with the measured one for both the horizontal and vertical scanning magnets of our uniform scanning proton beam delivery system.Results: The results in the current study showed that the lateral penumbra of horizontal scanning magnet was larger (up to 1.4 mm for measurement and up to 1.0 mm for TPS) compared to that of vertical scanning magnet. Both the TPS and measurements showed an almost linear increase in lateral penumbra with increasing air gap as it produced the greatest effect on lateral penumbra. Lateral penumbra was dependent on the depth and proton range. Specifically, the width of lateral penumbra was found to be always lower at shallower depth than at deeper depth within the spread out Bragg peak (SOBP) region. The lateral penumbra results were less sensitive to the variation in the thickness of compensator, whereas lateral penumbra was independent of modulation. Overall, the comparison between the results of TPS with that of measurements indicates a good agreement for lateral penumbra, with TPS predicting higher values compared to

  11. Proton therapy posterior beam approach with pencil beam scanning for esophageal cancer. Clinical outcome, dosimetry, and feasibility

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Yue-Can [Shengjing Hospital of China Medical University, Department of Medical Oncology, Cancer Center, Shenyang (China); University of Washington Medical Center, Department of Radiation Oncology, 1959 NE Pacific Street, Campus Box 356043, Seattle, WA (United States); Vyas, Shilpa; Apisarnthanarax, Smith; Zeng, Jing [University of Washington Medical Center, Department of Radiation Oncology, 1959 NE Pacific Street, Campus Box 356043, Seattle, WA (United States); Dang, Quang; Schultz, Lindsay [Seattle Cancer Care Alliance Proton Therapy Center, Seattle, WA (United States); Bowen, Stephen R. [University of Washington Medical Center, Department of Radiation Oncology, 1959 NE Pacific Street, Campus Box 356043, Seattle, WA (United States); University of Washington Medical Center, Department of Radiology, Seattle, WA (United States); Shankaran, Veena [University of Washington Medical Center, Department of Medical Oncology, Seattle, WA (United States); Farjah, Farhood [University of Washington Medical Center, Department of Surgery, Division of Cardiothoracic Surgery, Seattle, WA (United States); University of Washington Medical Center, Department of Surgery, Surgical Outcomes Research Center, Seattle, WA (United States); Oelschlager, Brant K. [University of Washington Medical Center, Department of Surgery, Seattle, WA (United States)

    2016-12-15

    The aim of this study is to present the dosimetry, feasibility, and preliminary clinical results of a novel pencil beam scanning (PBS) posterior beam technique of proton treatment for esophageal cancer in the setting of trimodality therapy. From February 2014 to June 2015, 13 patients with locally advanced esophageal cancer (T3-4N0-2M0; 11 adenocarcinoma, 2 squamous cell carcinoma) were treated with trimodality therapy (neoadjuvant chemoradiation followed by esophagectomy). Eight patients were treated with uniform scanning (US) and 5 patients were treated with a single posterior-anterior (PA) beam PBS technique with volumetric rescanning for motion mitigation. Comparison planning with PBS was performed using three plans: AP/PA beam arrangement; PA plus left posterior oblique (LPO) beams, and a single PA beam. Patient outcomes, including pathologic response and toxicity, were evaluated. All 13 patients completed chemoradiation to 50.4 Gy (relative biological effectiveness, RBE) and 12 patients underwent surgery. All 12 surgical patients had an R0 resection and pathologic complete response was seen in 25 %. Compared with AP/PA plans, PA plans have a lower mean heart (14.10 vs. 24.49 Gy, P < 0.01), mean stomach (22.95 vs. 31.33 Gy, P = 0.038), and mean liver dose (3.79 vs. 5.75 Gy, P = 0.004). Compared to the PA/LPO plan, the PA plan reduced the lung dose: mean lung dose (4.96 vs. 7.15 Gy, P = 0.020) and percentage volume of lung receiving 20 Gy (V{sub 20}; 10 vs. 17 %, P < 0.01). Proton therapy with a single PA beam PBS technique for preoperative treatment of esophageal cancer appears safe and feasible. (orig.) [German] Wir stellen die Vergleichsdosimetrie, Realisierbarkeit und die vorlaeufigen klinischen Ergebnisse einer neuen Pencil-Beam-Scanning(-PBS)/Posterior-Beam-Methode innerhalb der Protonentherapie fuer Speiseroehrenkrebs im Setting einer trimodalen Therapie vor. Von Februar 2014 bis Juni 2015 erhielten 13 Patienten mit lokal fortgeschrittenem

  12. SU-E-T-400: Evaluation of Shielding and Activation at Two Pencil Beam Scanning Proton Facilities

    International Nuclear Information System (INIS)

    Remmes, N; Mundy, D; Classic, K; Beltran, C; Kruse, J; Herman, M; Stoker, J; Nelson, K; Bues, M

    2015-01-01

    Purpose: To verify acceptably low dose levels around two newly constructed identical pencil beam scanning proton therapy facilities and to evaluate accuracy of pre-construction shielding calculations. Methods: Dose measurements were taken at select points of interest using a WENDI-2 style wide-energy neutron detector. Measurements were compared to pre-construction shielding calculations. Radiation badges with neutron dose measurement capabilities were worn by personnel and also placed at points throughout the facilities. Seven neutron and gamma detectors were permanently installed throughout the facility, continuously logging data. Potential activation hazards have also been investigated. Dose rates near water tanks immediately after prolonged irradiation have been measured. Equipment inside the treatment room and accelerator vault has been surveyed and/or wipe tested. Air filters from air handling units, sticky mats placed outside of the accelerator vault, and water samples from the magnet cooling water loops have also been tested. Results: All radiation badges have been returned with readings below the reporting minimum. Measurements of mats, air filters, cooling water, wipe tests and surveys of equipment that has not been placed in the beam have all come back at background levels. All survey measurements show the analytical shielding calculations to be conservative by at least a factor of 2. No anomalous events have been identified by the building radiation monitoring system. Measurements of dose rates close to scanning water tanks have shown dose rates of approximately 10 mrem/hr with a half-life less than 5 minutes. Measurements around the accelerator show some areas with dose rates slightly higher than 10 mrem/hr. Conclusion: The shielding design is shown to be adequate. Measured dose rates are below those predicted by shielding calculations. Activation hazards are minimal except in certain very well defined areas within the accelerator vault and for objects

  13. SU-F-T-121: Abdominal Compression Effectively Reduces the Interplay Effect and Enables Pencil Beam Scanning Proton Therapy of Liver Tumors

    International Nuclear Information System (INIS)

    Souris, K; Glick, A; Kang, M; Lin, H; McDonough, J; Simone, C; Solberg, T; Ben-Josef, E; Lin, L; Janssens, G; Sterpin, E; Lee, J

    2016-01-01

    Purpose: To study if abdominal compression can reduce breathing motion and mitigate interplay effect in pencil beam scanning proton therapy (PBSPT) treatment of liver tumors in order to better spare healthy liver volumes compared with photon therapy. Methods: Ten patients, six having large tumors initially treated with IMRT and four having small tumors treated with SBRT, were replanned for PBSPT. ITV and beam-specific PTVs based on 4D-CT were used to ensure target coverage in PBSPT. The use of an abdominal compression belt and volumetric repainting was investigated to mitigate the interplay effect between breathing motion and PBSPT dynamic delivery. An in-house Matlab script has been developed to simulate this interplay effect. The dose is computed on each phase individually by sorting all spots according to their simulated delivery timing. The final dose distribution is then obtained by accumulating all dose maps to a reference phase. Results: For equivalent target coverage PBSPT reduced average healthy liver dose by 9.5% of the prescription dose compared with IMRT/SBRT. Abdominal compression of 113.2±42.2 mmHg was effective for all 10 patients and reduced average motion by 2.25 mm. As a result, the average ITV volume decreased from 128.2% to 123.1% of CTV volume. Similarly, the average beam-specific PTV volume decreased from 193.2% to 183.3%. For 8 of the 10 patients, the average motion was reduced below 5 mm, and up to 3 repainting were sufficient to mitigate interplay. For the other two patients with larger residual motion, 4–5 repainting were needed. Conclusion: We recommend evaluation of the 4DCT motion histogram following simulation and the interplay effect following treatment planning in order to personalize the use of compression and volumetric repainting for each patient. Abdominal compression enables safe and more effective PBS treatment of liver tumors by reduction of motion and interplay effect. Kevin Souris is supported by IBA and Televie Grant

  14. SU-F-T-121: Abdominal Compression Effectively Reduces the Interplay Effect and Enables Pencil Beam Scanning Proton Therapy of Liver Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Souris, K [Universite catholique de Louvain, Brussels (Belgium); University of Pennsylvania, Philadelphia, PA (United States); Glick, A; Kang, M; Lin, H; McDonough, J; Simone, C; Solberg, T; Ben-Josef, E; Lin, L [University of Pennsylvania, Philadelphia, PA (United States); Janssens, G [IBA, Louvain-la-neuve (Belgium); Sterpin, E [Universite catholique de Louvain, Brussels (Belgium); KU Leuven, Leuven (Belgium); Lee, J [Universite catholique de Louvain, Brussels (Belgium)

    2016-06-15

    Purpose: To study if abdominal compression can reduce breathing motion and mitigate interplay effect in pencil beam scanning proton therapy (PBSPT) treatment of liver tumors in order to better spare healthy liver volumes compared with photon therapy. Methods: Ten patients, six having large tumors initially treated with IMRT and four having small tumors treated with SBRT, were replanned for PBSPT. ITV and beam-specific PTVs based on 4D-CT were used to ensure target coverage in PBSPT. The use of an abdominal compression belt and volumetric repainting was investigated to mitigate the interplay effect between breathing motion and PBSPT dynamic delivery. An in-house Matlab script has been developed to simulate this interplay effect. The dose is computed on each phase individually by sorting all spots according to their simulated delivery timing. The final dose distribution is then obtained by accumulating all dose maps to a reference phase. Results: For equivalent target coverage PBSPT reduced average healthy liver dose by 9.5% of the prescription dose compared with IMRT/SBRT. Abdominal compression of 113.2±42.2 mmHg was effective for all 10 patients and reduced average motion by 2.25 mm. As a result, the average ITV volume decreased from 128.2% to 123.1% of CTV volume. Similarly, the average beam-specific PTV volume decreased from 193.2% to 183.3%. For 8 of the 10 patients, the average motion was reduced below 5 mm, and up to 3 repainting were sufficient to mitigate interplay. For the other two patients with larger residual motion, 4–5 repainting were needed. Conclusion: We recommend evaluation of the 4DCT motion histogram following simulation and the interplay effect following treatment planning in order to personalize the use of compression and volumetric repainting for each patient. Abdominal compression enables safe and more effective PBS treatment of liver tumors by reduction of motion and interplay effect. Kevin Souris is supported by IBA and Televie Grant

  15. Pencil beam scanning proton therapy vs rotational arc radiation therapy: A treatment planning comparison for postoperative oropharyngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Apinorasethkul, Ontida, E-mail: Ontida.a@gmail.com; Kirk, Maura; Teo, Kevin; Swisher-McClure, Samuel; Lukens, John N.; Lin, Alexander

    2017-04-01

    Patients diagnosed with head and neck cancer are traditionally treated with photon radiotherapy. Proton therapy is currently being used clinically and may potentially reduce treatment-related toxicities by minimizing the dose to normal organs in the treatment of postoperative oropharyngeal cancer. The finite range of protons has the potential to significantly reduce normal tissue toxicity compared to photon radiotherapy. Seven patients were planned with both proton and photon modalities. The planning goal for both modalities was achieving the prescribed dose to 95% of the planning target volume (PTV). Dose-volume histograms were compared in which all cases met the target coverage goals. Mean doses were significantly lower in the proton plans for the oral cavity (1771 cGy photon vs 293 cGy proton, p < 0.001), contralateral parotid (1796 cGy photon vs 1358 proton, p < 0.001), and the contralateral submandibular gland (3608 cGy photon vs 3251 cGy proton, p = 0.03). Average total integral dose was 9.1% lower in proton plans. The significant dosimetric sparing seen with proton therapy may lead to reduced side effects such as pain, weight loss, taste changes, and dry mouth. Prospective comparisons of protons vs photons for disease control, toxicity, and patient-reported outcomes are therefore warranted and currently being pursued.

  16. Improvements in pencil beam scanning proton therapy dose calculation accuracy in brain tumor cases with a commercial Monte Carlo algorithm.

    Science.gov (United States)

    Widesott, Lamberto; Lorentini, Stefano; Fracchiolla, Francesco; Farace, Paolo; Schwarz, Marco

    2018-05-04

    validation of a commercial Monte Carlo (MC) algorithm (RayStation ver6.0.024) for the treatment of brain tumours with pencil beam scanning (PBS) proton therapy, comparing it via measurements and analytical calculations in clinically realistic scenarios. Methods: For the measurements a 2D ion chamber array detector (MatriXX PT)) was placed underneath the following targets: 1) anthropomorphic head phantom (with two different thickness) and 2) a biological sample (i.e. half lamb's head). In addition, we compared the MC dose engine vs. the RayStation pencil beam (PB) algorithm clinically implemented so far, in critical conditions such as superficial targets (i.e. in need of range shifter), different air gaps and gantry angles to simulate both orthogonal and tangential beam arrangements. For every plan the PB and MC dose calculation were compared to measurements using a gamma analysis metrics (3%, 3mm). Results: regarding the head phantom the gamma passing rate (GPR) was always >96% and on average > 99% for the MC algorithm; PB algorithm had a GPR ≤90% for all the delivery configurations with single slab (apart 95 % GPR from gantry 0° and small air gap) and in case of two slabs of the head phantom the GPR was >95% only in case of small air gaps for all the three (0°, 45°,and 70°) simulated beam gantry angles. Overall the PB algorithm tends to overestimate the dose to the target (up to 25%) and underestimate the dose to the organ at risk (up to 30%). We found similar results (but a bit worse for PB algorithm) for the two targets of the lamb's head where only two beam gantry angles were simulated. Conclusions: our results suggest that in PBS proton therapy range shifter (RS) need to be used with extreme caution when planning the treatment with an analytical algorithm due to potentially great discrepancies between the planned dose and the dose delivered to the patients, also in case of brain tumours where this issue could be underestimated. Our results also

  17. Characterizing the Hot Spots Involved in RON-MSPβ Complex Formation Using In Silico Alanine Scanning Mutagenesis and Molecular Dynamics Simulation

    Directory of Open Access Journals (Sweden)

    Omid Zarei

    2017-04-01

    Full Text Available Purpose: Implication of protein-protein interactions (PPIs in development of many diseases such as cancer makes them attractive for therapeutic intervention and rational drug design. RON (Recepteur d’Origine Nantais tyrosine kinase receptor has gained considerable attention as promising target in cancer therapy. The activation of RON via its ligand, macrophage stimulation protein (MSP is the most common mechanism of activation for this receptor. The aim of the current study was to perform in silico alanine scanning mutagenesis and to calculate binding energy for prediction of hot spots in protein-protein interface between RON and MSPβ chain (MSPβ. Methods: In this work the residues at the interface of RON-MSPβ complex were mutated to alanine and then molecular dynamics simulation was used to calculate binding free energy. Results: The results revealed that Gln193, Arg220, Glu287, Pro288, Glu289, and His424 residues from RON and Arg521, His528, Ser565, Glu658, and Arg683 from MSPβ may play important roles in protein-protein interaction between RON and MSP. Conclusion: Identification of these RON hot spots is important in designing anti-RON drugs when the aim is to disrupt RON-MSP interaction. In the same way, the acquired information regarding the critical amino acids of MSPβ can be used in the process of rational drug design for developing MSP antagonizing agents, the development of novel MSP mimicking peptides where inhibition of RON activation is required, and the design of experimental site directed mutagenesis studies.

  18. Liver spots

    Science.gov (United States)

    ... skin changes - liver spots; Senile or solar lentigines; Skin spots - aging; Age spots ... Liver spots are changes in skin color that occur in older skin. The coloring may be due to aging, exposure to the sun ...

  19. Geant4 simulation of clinical proton and carbon ion beams for the treatment of ocular melanomas with the full 3-D pencil beam scanning system

    Energy Technology Data Exchange (ETDEWEB)

    Farina, Edoardo; Riccardi, Cristina; Rimoldi, Adele; Tamborini, Aurora [University of Pavia and the INFN section of Pavia, via Bassi 6, 27100 Pavia (Italy); Piersimoni, Pierluigi [Division of Radiation Research, Loma Linda University, Loma Linda, CA 92354 (United States); Ciocca, Mario [Medical Physics Unit, CNAO Foundation, Strada Campeggi 53, 27100 Pavia (Italy)

    2015-07-01

    This work investigates the possibility to use carbon ion beams delivered with active scanning modality, for the treatment of ocular melanomas at the Centro Nazionale di Adroterapia Oncologica (CNAO) in Pavia. The radiotherapy with carbon ions offers many advantages with respect to the radiotherapy with protons or photons, such as a higher relative radio-biological effectiveness (RBE) and a dose release better localized to the tumor. The Monte Carlo (MC) Geant4 10.00 patch-03 toolkit is used to reproduce the complete CNAO extraction beam line, including all the active and passive components characterizing it. The simulation of proton and carbon ion beams and radiation scanned field is validated against CNAO experimental data. For the irradiation study of the ocular melanoma an eye-detector, representing a model of a human eye, is implemented in the simulation. Each element of the eye is reproduced with its chemical and physical properties. Inside the eye-detector a realistic tumor volume is placed and used as the irradiation target. A comparison between protons and carbon ions eye irradiations allows to study possible treatment benefits if carbon ions are used instead of protons. (authors)

  20. Robustness of the Voluntary Breath-Hold Approach for the Treatment of Peripheral Lung Tumors Using Hypofractionated Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dueck, Jenny, E-mail: jenny.dueck@psi.ch [Section of Radiotherapy, Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Center for Proton Therapy, Paul Scherrer Institut, Villigen PSI (Switzerland); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark); Knopf, Antje-Christin [Joint Department of Physics at the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London (United Kingdom); Lomax, Antony [Center for Proton Therapy, Paul Scherrer Institut, Villigen PSI (Switzerland); Department of Physics, ETH Zürich, Zürich (Switzerland); Albertini, Francesca [Center for Proton Therapy, Paul Scherrer Institut, Villigen PSI (Switzerland); Persson, Gitte F. [Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Josipovic, Mirjana [Section of Radiotherapy, Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark); Aznar, Marianne [Section of Radiotherapy, Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen (Denmark); Weber, Damien C. [Center for Proton Therapy, Paul Scherrer Institut, Villigen PSI (Switzerland); University of Zürich, Zürich (Switzerland); Munck af Rosenschöld, Per [Section of Radiotherapy, Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark)

    2016-05-01

    Purpose: The safe clinical implementation of pencil beam scanning (PBS) proton therapy for lung tumors is complicated by the delivery uncertainties caused by breathing motion. The purpose of this feasibility study was to investigate whether a voluntary breath-hold technique could limit the delivery uncertainties resulting from interfractional motion. Methods and Materials: Data from 15 patients with peripheral lung tumors previously treated with stereotactic radiation therapy were included in this study. The patients had 1 computed tomographic (CT) scan in voluntary breath-hold acquired before treatment and 3 scans during the treatment course. PBS proton treatment plans with 2 fields (2F) and 3 fields (3F), respectively, were calculated based on the planning CT scan and subsequently recalculated on the 3 repeated CT scans. Recalculated plans were considered robust if the V{sub 95%} (volume receiving ≥95% of the prescribed dose) of the gross target volume (GTV) was within 5% of what was expected from the planning CT data throughout the simulated treatment. Results: A total of 14/15 simulated treatments for both 2F and 3F met the robustness criteria. Reduced V{sub 95%} was associated with baseline shifts (2F, P=.056; 3F, P=.008) and tumor size (2F, P=.025; 3F, P=.025). Smaller tumors with large baseline shifts were also at risk for reduced V{sub 95%} (interaction term baseline/size: 2F, P=.005; 3F, P=.002). Conclusions: The breath-hold approach is a realistic clinical option for treating lung tumors with PBS proton therapy. Potential risk factors for reduced V{sub 95%} are small targets in combination with large baseline shifts. On the basis of these results, the baseline shift of the tumor should be monitored (eg, through image guided therapy), and appropriate measures should be taken accordingly. The intrafractional motion needs to be investigated to confirm that the breath-hold approach is robust.

  1. Robustness of the Voluntary Breath-Hold Approach for the Treatment of Peripheral Lung Tumors Using Hypofractionated Pencil Beam Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Dueck, Jenny; Knopf, Antje-Christin; Lomax, Antony; Albertini, Francesca; Persson, Gitte F.; Josipovic, Mirjana; Aznar, Marianne; Weber, Damien C.; Munck af Rosenschöld, Per

    2016-01-01

    Purpose: The safe clinical implementation of pencil beam scanning (PBS) proton therapy for lung tumors is complicated by the delivery uncertainties caused by breathing motion. The purpose of this feasibility study was to investigate whether a voluntary breath-hold technique could limit the delivery uncertainties resulting from interfractional motion. Methods and Materials: Data from 15 patients with peripheral lung tumors previously treated with stereotactic radiation therapy were included in this study. The patients had 1 computed tomographic (CT) scan in voluntary breath-hold acquired before treatment and 3 scans during the treatment course. PBS proton treatment plans with 2 fields (2F) and 3 fields (3F), respectively, were calculated based on the planning CT scan and subsequently recalculated on the 3 repeated CT scans. Recalculated plans were considered robust if the V 95% (volume receiving ≥95% of the prescribed dose) of the gross target volume (GTV) was within 5% of what was expected from the planning CT data throughout the simulated treatment. Results: A total of 14/15 simulated treatments for both 2F and 3F met the robustness criteria. Reduced V 95% was associated with baseline shifts (2F, P=.056; 3F, P=.008) and tumor size (2F, P=.025; 3F, P=.025). Smaller tumors with large baseline shifts were also at risk for reduced V 95% (interaction term baseline/size: 2F, P=.005; 3F, P=.002). Conclusions: The breath-hold approach is a realistic clinical option for treating lung tumors with PBS proton therapy. Potential risk factors for reduced V 95% are small targets in combination with large baseline shifts. On the basis of these results, the baseline shift of the tumor should be monitored (eg, through image guided therapy), and appropriate measures should be taken accordingly. The intrafractional motion needs to be investigated to confirm that the breath-hold approach is robust.

  2. Development of a 3D optical scanning-based automatic quality assurance system for proton range compensators

    International Nuclear Information System (INIS)

    Kim, MinKyu; Ju, Sang Gyu; Chung, Kwangzoo; Hong, Chae-Seon; Kim, Jinsung; Ahn, Sung Hwan; Jung, Sang Hoon; Han, Youngyih; Chung, Yoonsun; Cho, Sungkoo; Choi, Doo Ho; Kim, Jungkuk; Shin, Dongho

    2015-01-01

    Purpose: A new automatic quality assurance (AutoRCQA) system using a three-dimensional scanner (3DS) with system automation was developed to improve the accuracy and efficiency of the quality assurance (QA) procedure for proton range compensators (RCs). The system performance was evaluated for clinical implementation. Methods: The AutoRCQA system consists of a three-dimensional measurement system (3DMS) based on 3DS and in-house developed verification software (3DVS). To verify the geometrical accuracy, the planned RC data (PRC), calculated with the treatment planning system (TPS), were reconstructed and coregistered with the measured RC data (MRC) based on the beam isocenter. The PRC and MRC inner surfaces were compared with composite analysis (CA) using 3DVS, using the CA pass rate for quantitative analysis. To evaluate the detection accuracy of the system, the authors designed a fake PRC by artificially adding small cubic islands with side lengths of 1.5, 2.5, and 3.5 mm on the inner surface of the PRC and performed CA with the depth difference and distance-to-agreement tolerances of [1 mm, 1 mm], [2 mm, 2 mm], and [3 mm, 3 mm]. In addition, the authors performed clinical tests using seven RCs [computerized milling machine (CMM)-RCs] manufactured by CMM, which were designed for treating various disease sites. The systematic offsets of the seven CMM-RCs were evaluated through the automatic registration function of AutoRCQA. For comparison with conventional technique, the authors measured the thickness at three points in each of the seven CMM-RCs using a manual depth measurement device and calculated thickness difference based on the TPS data (TPS-manual measurement). These results were compared with data obtained from 3DVS. The geometrical accuracy of each CMM-RC inner surface was investigated using the TPS data by performing CA with the same criteria. The authors also measured the net processing time, including the scan and analysis time. Results: The Auto

  3. SU-F-J-199: Predictive Models for Cone Beam CT-Based Online Verification of Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yin, L; Lin, A; Ahn, P; Solberg, T; McDonough, J; Teo, B [The Hospital of the University of Pennsylvania, Philadelphia, PA (United States); Janssens, G [IBA, Louvain-la-neuve (Belgium)

    2016-06-15

    Purpose: To utilize online CBCT scans to develop models for predicting DVH metrics in proton therapy of head and neck tumors. Methods: Nine patients with locally advanced oropharyngeal cancer were retrospectively selected in this study. Deformable image registration was applied to the simulation CT, target volumes, and organs at risk (OARs) contours onto each weekly CBCT scan. Intensity modulated proton therapy (IMPT) treatment plans were created on the simulation CT and forward calculated onto each corrected CBCT scan. Thirty six potentially predictive metrics were extracted from each corrected CBCT. These features include minimum/maximum/mean over and under-ranges at the proximal and distal surface of PTV volumes, and geometrical and water equivalent distance between PTV and each OARs. Principal component analysis (PCA) was used to reduce the dimension of the extracted features. Three principal components were found to account for over 90% of variances in those features. Datasets from eight patients were used to train a machine learning model to fit these principal components with DVH metrics (dose to 95% and 5% of PTV, mean dose or max dose to OARs) from the forward calculated dose on each corrected CBCT. The accuracy of this model was verified on the datasets from the 9th patient. Results: The predicted changes of DVH metrics from the model were in good agreement with actual values calculated on corrected CBCT images. Median differences were within 1 Gy for most DVH metrics except for larynx and constrictor mean dose. However, a large spread of the differences was observed, indicating additional training datasets and predictive features are needed to improve the model. Conclusion: Intensity corrected CBCT scans hold the potential to be used for online verification of proton therapy and prediction of delivered dose distributions.

  4. Measurement of visible cross sections in proton-lead collisions at √sNN = 5.02 TeV in van der Meer scans with the ALICE detector

    NARCIS (Netherlands)

    Abelev, B.; Adam, J.; Adamová, D.; Aggarwal, M. M.; Agnello, M.; Agostinelli, A.; Agrawal, N.; Ahammed, Z.; Ahmad, N.; Ahmed, I.; Ahn, S. U.; Ahn, S. A.; Aimo, I.; Aiola, S.; Ajaz, M.; Akindinov, A.; Alam, S. N.; Aleksandrov, D.; Alessandro, B.; Alexandre, D.; Alici, A.; Alkin, A.; Alme, J.; Alt, T.; Altinpinar, S.; Altsybeev, I.; Alves Garcia Prado, C.; Andrei, C.; Andronic, A.; Anguelov, V.; Anielski, J.; Anti.cíc, T.; Antinori, F.; Antonioli, P.; Aphecetche, L.; Appelshäuser, H.; Arbor, N.; Arcelli, S.; Armesto, N.; Arnaldi, R.; Aronsson, T.; Arsene, I. C.; Arslandok, M.; Augustinus, A.; Averbeck, R.; Awes, T. C.; Azmi, M. D.; Bach, M.; Badala, A.; Baek, Y. W.; Bagnasco, S.; Bailhache, R.; Bala, R.; Baldisseri, A.; Baltasar Dos Santos Pedrosa, F.; Baral, R. C.; Barbera, R.; Barile, F.; Barnaföldi, G. G.; Barnby, L. S.; Barret, V.; Bartke, J.; Basile, M.; Bastid, N.; Basu, S.; Bathen, B.; Batigne, G.; Batyunya, B.; Batzing, P. C.; Baumann, C.; Bearden, I. G.; Beck, H.; Bedda, C.; Behera, N. K.; Belikov, I.; Bellini, F.; Bellwied, R.; Belmont-Moreno, E.; Belmont, R.; Bencedi, G.; Beole, S.; Berceanu, I.; Bercuci, A.; Berdnikov, Y.; Berenyi, D.; Berger, M. E.; Bertens, R. A.; Berzano, D.; Betev, L.; Bhasin, A.; Bhat, I. R.; Bhati, A. K.; Bhattacharjee, B.; Bhom, J.; Bianchi, L.; Bianchi, N.; Bianchin, C.; Biel.cík, J.; Biel.cíková, J.; Bilandzic, A.; Bjelogrlic, S.; Blanco, F.; Blau, D.; Blume, C.; Bock, F.; Bogdanov, A.; Bøggild, H.; Bogolyubsky, M.; Böhmer, F. V.; Boldizsár, L.; Bombara, M.; Book, J.; Borel, H.; Borissov, A.; Bossú, F.; Botje, M.; Botta, E.; Böttger, S.; Braun-Munzinger, P.; Bregant, M.; Breitner, T.; Broker, T. A.; Browning, T. A.; Broz, M.; Bruna, E.; Bruno, G. E.; Budnikov, D.; Buesching, H.; Bufalino, S.; Buncic, P.; Busch, O.; Buthelezi, Z.; Caffarri, D.; Cai, X.; Caines, H.; Calero Diaz, L.; Caliva, A.; Calvo Villar, E.; Camerini, P.; Carena, F.; Carena, W.; Castillo Castellanos, J.; Casula, E. A R; Catanescu, V.; Cavicchioli, C.; Ceballos Sanchez, C.; Cepila, J.; Cerello, P.; Chang, B.; Chapeland, S.; Charvet, J. L.; Chattopadhyay, S.; Chattopadhyay, S.; Chelnokov, V.; Cherney, M.; Cheshkov, C.; Cheynis, B.; Chibante Barroso, V.; Chinellato, D. D.; Chochula, P.; Chojnacki, M.; Choudhury, S.; Christakoglou, P.; Christensen, C. H.; Christiansen, P.; Chujo, T.; Chung, S. U.; Cicalo, C.; Cifarelli, L.; Cindolo, F.; Cleymans, J.; Colamaria, F.; Colella, D.; Collu, A.; Colocci, M.; Conesa Balbastre, G.; Conesa del Valle, Z.; Connors, M. E.; Contreras, J. G.; Cormier, T. M.; Corrales Morales, Y.; Cortese, P.; Cortés Maldonado, I.; Cosentino, M. R.; Costa, F.; Crochet, P.; Cruz Albino, R.; Cuautle, E.; Cunqueiro, L.; Dainese, A.; Dang, R.; Danu, A.; Das, D.; Das, I.; Das, K.; Das, S.; Dash, A.; Dash, S.; De, S.; Delagrange, H.; Deloff, A.; Dénes, E.; D'Erasmo, G.; De Caro, A.; De Cataldo, G.; De Cuveland, J.; De Falco, A.; De Gruttola, D.; De Marco, N.; De Pasquale, S.; De Rooij, R.; Diaz Corchero, M. A.; Dietel, T.; Dillenseger, P.; Divìa, R.; Di Bari, D.; Di Liberto, S.; Di Mauro, A.; Di Nezza, P.; Djuvsland, O.; Dobrin, A.; Dobrowolski, T.; Domenicis Gimenez, D.; Dönigus, B.; Dordic, O.; Dørheim, S.; Dubey, A. K.; Dubla, A.; Ducroux, L.; Dupieux, P.; Dutta Majumdar, A. K.; Ehlers, R. J.; Elia, D.; Engel, H.; Erazmus, B.; Erdal, H. A.; Eschweiler, D.; Espagnon, B.; Esposito, M.; Estienne, M.; Esumi, S.; Evans, D.; Evdokimov, S.; Fabris, D.; Faivre, J.; Falchieri, D.; Fantoni, A.; Fasel, M.; Fehlker, D.; Feldkamp, L.; Felea, D.; Feliciello, A.; Feofilov, G.; Ferencei, J.; Fernández Téllez, A.; Ferreiro, E. G.; Ferretti, A.; Festanti, A.; Figiel, J.; Figueredo, M. A S; Filchagin, S.; Finogeev, D.; Fionda, F. M.; Fiore, E. M.; Floratos, E.; Floris, M.; Foertsch, S.; Foka, P.; Fokin, S.; Fragiacomo, E.; Francescon, A.; Frankenfeld, U.; Fuchs, U.; Furget, C.; Fusco Girard, M.; Gaardhøje, J. J.; Gagliardi, M.; Gago, A. M.; Gallio, M.; Gangadharan, D. R.; Ganoti, P.; Garabatos, C.; Garcia-Solis, E.; Gargiulo, C.; Garishvili, I.; Gerhard, J.; Germain, M.; Gheata, A.; Gheata, M.; Ghidini, B.; Ghosh, P.; Ghosh, S. K.; Gianotti, P.; Giubellino, P.; Gladysz-Dziadus, E.; Glässel, P.; Gomez Ramirez, A.; González-Zamora, P.; Gorbunov, S.; Görlich, L.; Gotovac, S.; Graczykowski, L. K.; Grelli, A.; Grigoras, A.; Grigoras, C.; Grigoriev, V.; Grigoryan, A.; Grigoryan, S.; Grinyov, B.; Grion, N.; Grosse-Oetringhaus, J. F.; Grossiord, J. Y.; Grosso, R.; Guber, F.; Guernane, R.; Guerzoni, B.; Guilbaud, M.; Gulbrandsen, K.; Gulkanyan, H.; Gumbo, M.; Gunji, T.; Gupta, A.; Gupta, R.; H. Khan, K.; Haake, R.; Haaland, O.; Hadjidakis, C.; Haiduc, M.; Hamagaki, H.; Hamar, G.; Hanratty, L. D.; Hansen, A.; Harris, J. W.; Hartmann, H.; Harton, A.; Hatzifotiadou, D.; Hayashi, S.; Heckel, S. T.; Heide, M.; Helstrup, H.; Herghelegiu, A.; Herrera Corral, G.; Hess, B. A.; Hetland, K. F.; Hippolyte, B.; Hladky, J.; Hristov, P.; Huang, M.; Humanic, T. J.; Hutter, D.; Hwang, D. S.; Ilkaev, R.; Ilkiv, I.; Inaba, M.; Innocenti, G. M.; Ionita, C.; Ippolitov, M.; Irfan, M.; Ivanov, M.; Ivanov, V.; Jacholkowski, A.; Jacobs, P. M.; Jahnke, C.; Jang, H. J.; Janik, M. A.; Jayarathna, P. H S Y; Jena, S.; Jimenez Bustamante, R. T.; Jones, P. G.; Jung, H.; Jusko, A.; Kadyshevskiy, V.; Kalcher, S.; Kalinak, P.; Kalweit, A.; Kamin, J.; Kang, J. H.; Kaplin, V.; Kar, S.; Karasu Uysal, A.; Karavichev, O.; Karavicheva, T.; Karpechev, E.; Kebschull, U.; Keidel, R.; Khan, M. M.; Khan, P.; Khan, S. A.; Khanzadeev, A.; Kharlov, Y.; Kileng, B.; Kim, B.; Kim, D. W.; Kim, D. J.; Kim, J. S.; Kim, M.; Kim, M.; Kim, S.; Kim, T.; Kirsch, S.; Kisel, I.; Kiselev, S.; Kisiel, A.; Kiss, G.; Klay, J. L.; Klein, J.; Klein-Bösing, C.; Kluge, A.; Knichel, M. L.; Knospe, A. G.; Kobdaj, C.; Köhler, M. K.; Kollegger, T.; Kolojvari, A.; Kondratiev, V.; Kondratyeva, N.; Konevskikh, A.; Kovalenko, V.; Kowalski, M.; Kox, S.; Koyithatta Meethaleveedu, G.; Kral, J.; Králik, I.; Kramer, F.; Krav.cáková, A.; Krelina, M.; Kretz, M.; Krivda, M.; Krizek, F.; Kryshen, E.; Krzewicki, M.; Kucera, V.; Kucheriaev, Y.; Kugathasan, T.; Kuhn, C.; Kuijer, P. G.; Kulakov, I.; Kumar, J.; Kurashvili, P.; Kurepin, A.; Kurepin, A. B.; Kuryakin, A.; Kushpil, S.; Kweon, M. J.; Kwon, Y.; Ladron De Guevara, P.; Lagana Fernandes, C.; Lakomov, I.; Langoy, R.; Lara, C.; Lardeux, A.; Lattuca, A.; La Pointe, S. L.; La Rocca, P.; Lea, R.; Leardini, L.; Lee, G. R.; Legrand, I.; Lehnert, J.; Lemmon, R. C.; Lenti, V.; Leogrande, E.; Leoncino, M.; Léon Monźon, I.; Lévai, P.; Li, S.; Lien, J.; Lietava, R.; Lindal, S.; Lindenstruth, V.; Lippmann, C.; Lisa, M. A.; Ljunggren, H. M.; Lodato, D. F.; Loenne, P. I.; Loggins, V. R.; Loginov, V.; Lohner, D.; Loizides, C.; Lopez, X.; Ĺopez Torres, E.; Lu, X. G.; Luettig, P.; Lunardon, M.; Luparello, G.; Luzzi, C.; Ma, R.; Maevskaya, A.; Mager, M.; Mahapatra, D. P.; Mahmood, S. M.; Maire, A.; Majka, R. D.; Malaev, M.; Maldonado Cervantes, I.; Malinina, L.; Mal'Kevich, D.; Malzacher, P.; Mamonov, A.; Manceau, L.; Manko, V.; Manso, F.; Manzari, V.; Marchisone, M.; Mare.s, J.; Margagliotti, G. V.; Margotti, A.; Marín, A.; Markert, C.; Marquard, M.; Martashvili, I.; Martin, N. A.; Martinengo, P.; Martínez, M. I.; Martínez García, G.; Martin Blanco, J.; Martynov, Y.; Mas, A.; Masciocchi, S.; Masera, M.; Masoni, A.; Massacrier, L.; Mastroserio, A.; Matyja, A.; Mayer, C.; Mazer, J.; Mazzoni, M. A.; Meddi, F.; Menchaca-Rocha, A.; Mercado Pérez, J.; Meres, M.; Miake, Y.; Mikhaylov, K.; Milano, L.; Milosevic, J.; Mischke, A.; Mishra, A. N.; Mískowiec, D.; Mitra, J.; Mitu, C. M.; Mlynarz, J.; Mohammadi, N.; Mohanty, B.; Molnar, L.; Montano Zetina, L.; Montes, E.; Morando, M.; Moreira De Godoy, D. A.; Moretto, S.; Morreale, A.; Morsch, A.; Muccifora, V.; Mudnic, E.; Mühlheim, D.; Muhuri, S.; Mukherjee, M.; Müller, H.; Munhoz, M. G.; Murray, S.; Musa, L.; Musinsky, J.; Nandi, B. K.; Nania, R.; Nappi, E.; Nattrass, C.; Nayak, K.; Nayak, T. K.; Nazarenko, S.; Nedosekin, A.; Nicassio, M.; Niculescu, M.; Nielsen, B. S.; Nikolaev, S.; Nikulin, S.; Nikulin, V.; Nilsen, B. S.; Noferini, F.; Nomokonov, P.; Nooren, G.; Nyanin, A.; Nystrand, J.; Oeschler, H.; Oh, S.; Oh, S. K.; Okatan, A.; Olah, L.; Oleniacz, J.; Oliveira Da Silva, A. C.; Onderwaater, J.; Oppedisano, C.; Ortiz Velasquez, A.; Oskarsson, A.; Otwinowski, J.; Oyama, K.; Sahoo, P.; Pachmayer, Y.; Pachr, M.; Pagano, P.; Paíc, G.; Painke, F.; Pajares, C.; Pal, S. K.; Palmeri, A.; Pant, D.; Papikyan, V.; Pappalardo, G. S.; Pareek, P.; Park, W. J.; Parmar, S.; Passfeld, A.; Patalakha, D. I.; Paticchio, V.; Paul, B.; Pawlak, T.; Peitzmann, T.; Pereira Da Costa, H.; Pereira De Oliveira Filho, E.; Peresunko, D.; Pérez Lara, C. E.; Pesci, A.; Peskov, V.; Pestov, Y.; Petrá.cek, V.; Petran, M.; Petris, M.; Petrovici, M.; Petta, C.; Piano, S.; Pikna, M.; Pillot, P.; Pinazza, O.; Pinsky, L.; Piyarathna, D. B.; Ploskón, M.; Planinic, M.; Pluta, J.; Pochybova, S.; Podesta-Lerma, P. L M; Poghosyan, M. G.; Pohjoisaho, E. H O; Polichtchouk, B.; Poljak, N.; Pop, A.; Porteboeuf-Houssais, S.; Porter, J.; Potukuchi, B.; Prasad, S. K.; Preghenella, R.; Prino, F.; Pruneau, C. A.; Pshenichnov, I.; Puddu, G.; Pujahari, P.; Punin, V.; Putschke, J.; Qvigstad, H.; Rachevski, A.; Raha, S.; Rak, J.; Rakotozafindrabe, A.; Ramello, L.; Raniwala, R.; Raniwala, S.; Räsänen, S. S.; Rascanu, B. T.; Rathee, D.; Rauf, A. W.; Razazi, V.; Read, K. F.; Real, J. S.; Redlich, K.; Reed, R. J.; Rehman, A.; Reichelt, P.; Reicher, M.; Reidt, F.; Renfordt, R.; Reolon, A. R.; Reshetin, A.; Rettig, F.; Revol, J. P.; Reygers, K.; Riabov, V.; Ricci, R. A.; Richert, T.; Richter, M.; Riedler, P.; Riegler, W.; Riggi, F.; Rivetti, A.; Rocco, E.; Rodríguez Cahuantzi, M.; Rodriguez Manso, A.; Røed, K.; Rogochaya, E.; Rohni, S.; Rohr, D.; Röhrich, D.; Romita, R.; Ronchetti, F.; Rosnet, P.; Rossi, A.; Roukoutakis, F.; Roy, A.; Roy, C.; Roy, P.; Rubio Montero, A. J.; Rui, R.; Russo, R.; Ryabinkin, E.; Ryabov, Y.; Rybicki, A.; Sadovsky, S.; Safarík, K.; Sahlmuller, B.; Sahoo, R.; Sahu, P. K.; Saini, J.; Sakai, S.; Salgado, C. A.; Salzwedel, J.; Sambyal, S.; Samsonov, V.; Sanchez Castro, X.; Sánchez Rodríguez, F. J.; Sándor, L.; Sandoval, A.; Sano, M.; Santagati, G.; Sarkar, D.; Scapparone, E.; Scarlassara, F.; Scharenberg, R. P.; Schiaua, C.; Schicker, R.; Schmidt, C.; Schmidt, H. R.; Schuchmann, S.; Schukraft, J.; Schulc, M.; Schuster, T.; Schutz, Y.; Schwarz, K.; Schweda, K.; Scioli, G.; Scomparin, E.; Scott, R.; Segato, G.; Seger, J. E.; Sekiguchi, Y.; Selyuzhenkov, I.; Seo, J.; Serradilla, E.; Sevcenco, A.; Shabetai, A.; Shabratova, G.; Shahoyan, R.; Shangaraev, A.; Sharma, N.; Sharma, S.; Shigaki, K.; Shtejer, K.; Sibiriak, Y.; Siddhanta, S.; Siemiarczuk, T.; Silvermyr, D.; Silvestre, C.; Simatovic, G.; Singaraju, R.; Singh, R.; Singha, S.; Singhal, V.; Sinha, B. C.; Sinha, T.; Sitar, B.; Sitta, M.; Skaali, T. B.; Skjerdal, K.; Slupecki, M.; Smirnov, N.; Snellings, R. J M; Søgaard, C.; Soltz, R.; Song, J.; Song, M.; Soramel, F.; Sorensen, S.; Spacek, M.; Sputowska, I.; Spyropoulou-Stassinaki, M.; Srivastava, B. K.; Stachel, J.; Stan, I.; Stefanek, G.; Steinpreis, M.; Stenlund, E.; Steyn, G.; Stiller, J. H.; Stocco, D.; Stolpovskiy, M.; Strmen, P.; Suaide, A. A P; Sugitate, T.; Suire, C.; Suleymanov, M.; Sultanov, R.; Sumbera, M.; Susa, T.; Symons, T. J M; Szabo, A.; Szanto De Toledo, A.; Szarka, I.; Szczepankiewicz, A.; Szymanski, M.; Takahashi, J.; Tangaro, M. A.; Tapia Takaki, J. D.; Tarantola Peloni, A.; Tarazona Martinez, A.; Tarzila, M. G.; Tauro, A.; Tejeda Munoz, G.; Telesca, A.; Terrevoli, C.; Thäder, J.; Thomas, D.; Tieulent, R.; Timmins, A. R.; Toia, A.; Torii, H.; Trubnikov, V.; Trzaska, W. H.; Tsuji, T.; Tumkin, A.; Turrisi, R.; Tveter, T. S.; Ulery, J.; Ullaland, K.; Uras, A.; Usai, G. L.; Vajzer, M.; Vala, M.; Valencia Palomo, L.; Vallero, S.; Vande Vyvre, P.; Vannucci, L.; Van Der Maarel, J.; Van Hoorne, J. W.; Van Leeuwen, M.; Vargas, A.; Vargyas, M.; Varma, R.; Vasileiou, M.; Vasiliev, A.; Vechernin, V.; Veldhoen, M.; Velure, A.; Venaruzzo, M.; Vercellin, E.; Vergara Limon, S.; Vernet, R.; Verweij, M.; Vickovic, L.; Viesti, G.; Viinikainen, J.; Vilakazi, Z.; Villalobos Baillie, O.; Vinogradov, A.; Vinogradov, L.; Vinogradov, Y.; Virgili, T.; Viyogi, Y. P.; Vodopyanov, A.; Völkl, M. A.; Voloshin, K.; Voloshin, S. A.; Volpe, G.; Von Haller, B.; Vorobyev, I.; Vranic, D.; Vrláková, J.; Vulpescu, B.; Vyushin, A.; Wagner, B.; Wagner, J.; Wagner, V.; Wang, M.; Wang, Y.; Watanabe, D.; Weber, M.; Wessels, J. P.; Westerhoff, U.; Wiechula, J.; Wikne, J.; Wilde, M.; Wilk, G.; Wilkinson, J.; Williams, M. C S; Windelband, B.; Winn, M.; Xiang, C.; Yaldo, C. G.; Yamaguchi, Y.; Yang, H.; Yang, P.; Yang, S.; Yano, S.; Yasnopolskiy, S.; Yi, J.; Yin, Z.; Yoo, I. K.; Yushmanov, I.; Zaccolo, V.; Zach, C.; Zaman, A.; Zampolli, C.; Zaporozhets, S.; Zarochentsev, A.; Závada, P.; Zaviyalov, N.; Zbroszczyk, H.; Zgura, I. S.; Zhalov, M.; Zhang, H.; Zhang, X.; Zhang, Y.; Zhao, C.; Zhigareva, N.; Zhou, D.; Zhou, F.; Zhou, Y.; Zhu, H.; Zhu, J.; Zhu, X.; Zichichi, A.; Zimmermann, A.; Zimmermann, M. B.; Zinovjev, G.; Zoccarato, Y.; Zyzak, M.

    2014-01-01

    In 2013, the Large Hadron Collider provided proton-lead and lead-proton collisions at the center-of-mass energy per nucleon pair s NN=5.02 TeV . Van der Meer scans were performed for both configurations of colliding beams, and the cross section was measured for two reference processes, based on

  5. Optimization of GATE and PHITS Monte Carlo code parameters for uniform scanning proton beam based on simulation with FLUKA general-purpose code

    Energy Technology Data Exchange (ETDEWEB)

    Kurosu, Keita [Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871 (Japan); Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871 (Japan); Takashina, Masaaki; Koizumi, Masahiko [Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871 (Japan); Das, Indra J. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202 (United States); Moskvin, Vadim P., E-mail: vadim.p.moskvin@gmail.com [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202 (United States)

    2014-10-01

    Although three general-purpose Monte Carlo (MC) simulation tools: Geant4, FLUKA and PHITS have been used extensively, differences in calculation results have been reported. The major causes are the implementation of the physical model, preset value of the ionization potential or definition of the maximum step size. In order to achieve artifact free MC simulation, an optimized parameters list for each simulation system is required. Several authors have already proposed the optimized lists, but those studies were performed with a simple system such as only a water phantom. Since particle beams have a transport, interaction and electromagnetic processes during beam delivery, establishment of an optimized parameters-list for whole beam delivery system is therefore of major importance. The purpose of this study was to determine the optimized parameters list for GATE and PHITS using proton treatment nozzle computational model. The simulation was performed with the broad scanning proton beam. The influences of the customizing parameters on the percentage depth dose (PDD) profile and the proton range were investigated by comparison with the result of FLUKA, and then the optimal parameters were determined. The PDD profile and the proton range obtained from our optimized parameters list showed different characteristics from the results obtained with simple system. This led to the conclusion that the physical model, particle transport mechanics and different geometry-based descriptions need accurate customization in planning computational experiments for artifact-free MC simulation.

  6. Optimization of GATE and PHITS Monte Carlo code parameters for uniform scanning proton beam based on simulation with FLUKA general-purpose code

    International Nuclear Information System (INIS)

    Kurosu, Keita; Takashina, Masaaki; Koizumi, Masahiko; Das, Indra J.; Moskvin, Vadim P.

    2014-01-01

    Although three general-purpose Monte Carlo (MC) simulation tools: Geant4, FLUKA and PHITS have been used extensively, differences in calculation results have been reported. The major causes are the implementation of the physical model, preset value of the ionization potential or definition of the maximum step size. In order to achieve artifact free MC simulation, an optimized parameters list for each simulation system is required. Several authors have already proposed the optimized lists, but those studies were performed with a simple system such as only a water phantom. Since particle beams have a transport, interaction and electromagnetic processes during beam delivery, establishment of an optimized parameters-list for whole beam delivery system is therefore of major importance. The purpose of this study was to determine the optimized parameters list for GATE and PHITS using proton treatment nozzle computational model. The simulation was performed with the broad scanning proton beam. The influences of the customizing parameters on the percentage depth dose (PDD) profile and the proton range were investigated by comparison with the result of FLUKA, and then the optimal parameters were determined. The PDD profile and the proton range obtained from our optimized parameters list showed different characteristics from the results obtained with simple system. This led to the conclusion that the physical model, particle transport mechanics and different geometry-based descriptions need accurate customization in planning computational experiments for artifact-free MC simulation

  7. SU-F-T-123: The Simulated Effect of the Breath-Hold Reproducibility Treating Locally-Advanced Lung Cancer with Pencil Beam Scanned Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dueck, J [Paul Scherrer Institut, Villigen PSI (Switzerland); Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark); Perrin, R [Paul Scherrer Institut, Villigen PSI (Switzerland); Persson, G F; Engelholm, S A [Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Lomax, A [Paul Scherrer Institut, Villigen PSI (Switzerland); Department of Physics, ETH, Zürich (Switzerland); Josipovic, M; Rosenschöld, AF [Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark); Weber, D C [Paul Scherrer Institut, Villigen PSI (Switzerland); University of Zürich, Zürich (Switzerland); Munck, P

    2016-06-15

    Purpose: The breath-hold (BH) technique has been suggested to mitigate motion and reduce target coverage degradation due to motion effects. The aim of this study was to investigate the effect of inter-BH residual motion on the dose distribution for pencil beam scanned (PBS) proton therapy of locally-advanced lung cancer patients. Methods: A dataset of visually-guided BH CT scans was acquired (10 scans per patient) taken from five lung cancer patients: three intra-fractionally repeated CT scans on treatment days 2,16 and 31, in addition to the day 0 planning CT scan. Three field intensity-modulated proton therapy (IMPT) plans were constructed on the planning CT scan. Dose delivery on fraction 2, 16 and 31 were simulated on the three consecutive CT scans, assuming BH duration of 20s and soft tissue match. The dose was accumulated in the planning CT using deformable image registration, and scaled to simulate the full treatment of 66Gy(RBE) in 33 fractions. Results: The mean dose to the lungs and heart, and maximum dose to the spinal cord and esophagus were within 1% of the planned dose. The CTV V95% decreased and the inhomogeneity (D5%–D95%) increased on average 4.1% (0.4–12.2%) and 5.8% (2.2–13.4%), respectively, over the five patient cases. Conclusion: The results showed that the BH technique seems to spare the OARs in spite of inter-BH residual motion. However, small degradation of target coverage occurred for all patients, with 3/5 patients having a decrease in V95% ≤1%. For the remaining two patients, where V95% decreased up to 12%, the cause could be related to treatment related anatomical changes and, as in photon therapy, plan adaptation may be necessary to ensure target coverage. This study showed that BH could be a potential treatment option to reliably mitigate motion for the treatment of locally-advanced lung cancer using PBS proton therapy.

  8. MSPT: Motion Simulator for Proton Therapy

    International Nuclear Information System (INIS)

    Morel, Paul

    2014-01-01

    In proton therapy, the delivery method named spot scanning, can provide a particularly efficient treatment in terms of tumor coverage and healthy tissues protection. The dosimetric benefits of proton therapy may be greatly degraded due to intra-fraction motions. Hence, the study of mitigation or adaptive methods is necessary. For this purpose, we developed an open-source 4D dose computation and evaluation software, MSPT (Motion Simulator for Proton Therapy), for the spot-scanning delivery technique. It aims at highlighting the impact of intra-fraction motions during a treatment delivery by computing the dose distribution in the moving patient. In addition, the use of MSPT allowed us to develop and propose a new motion mitigation strategy based on the adjustment of the beam's weight when the proton beam is scanning across the tumor. In photon therapy, a main concern for deliveries using a multi-leaf collimator (MLC) relies on finding a series of MLC configurations to deliver properly the treatment. The efficiency of such series is measured by the total beam-on time and the total setup time. In our work, we study the minimization of these efficiency criteria from an algorithmic point of view, for new variants of MLCs: the rotating MLC and the dual-layer MLC. In addition, we propose an approximation algorithm to find a series of configurations that minimizes the total beam-on time for the rotating MLC. (author) [fr

  9. SU-E-CAMPUS-T-05: Validation of High-Resolution 3D Patient QA for Proton Pencil Beam Scanning and IMPT by Polymer Gel Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Cardin, A; Avery, S; Ding, X; Kassaee, A; Lin, L [University of Pennsylvania, Philadelphia, PA (United States); Maryanski, M [MGS Research, Inc., Madison, CT (United States)

    2014-06-15

    Purpose: Validation of high-resolution 3D patient QA for proton pencil beam scanning and IMPT by polymer gel dosimetry. Methods: Four BANG3Pro polymer gel dosimeters (manufactured by MGS Research Inc, Madison, CT) were used for patient QA at the Robert's Proton Therapy Center (RPTC, Philadelphia, PA). All dosimeters were sealed in identical thin-wall Pyrex glass spheres. Each dosimeter contained a set of markers for 3D registration purposes. The dosimeters were mounted in a consistent and reproducible manner using a custom build holder. Two proton pencil beam scanning plans were designed using Varian Eclipse™ treatment planning system: 1) A two-field intensity modulated proton therapy (IMPT) plan and 2) one single field uniform dose (SFUD) plan. The IMPT fields were evaluated as a composite plan and individual fields, the SFUD plan was delivered as a single field plan.Laser CT scanning was performed using the manufacturer's OCTOPUS-IQ axial transmission laser CT scanner using a 1 mm slice thickness. 3D registration, analysis, and OD/cm to absorbed dose calibrations were perfomed using DICOM RT-Dose and CT files, and software developed by the manufacturer. 3D delta index, a metric equivalent to the gamma tool, was used for dose comparison. Results: Very good agreement with single IMPT fields and with SFUD was obtained. Composite IMPT fields had a less satisfactory agreement. The single fields had 3D delta index passing rates (3% dose difference, 3 mm DTA) of 98.98% and 94.91%. The composite 3D delta index passing rate was 80.80%. The SFUD passing rate was 93.77%. Required shifts of the dose distributions were less than 4 mm. Conclusion: A formulation of the BANG3Pro polymer gel dosimeter, suitable for 3D QA of proton patient plans is established and validated. Likewise, the mailed QA analysis service provided by the manufacturer is a practical option when required resources are unavailable. We fully disclose that the subject of this research regards a

  10. SU-F-T-598: Robotic Radiosurgery System Versus Pencil Beam Scanning Proton Therapy for Definitive Intracranial Treatments

    International Nuclear Information System (INIS)

    Lin, M; Pompos, A; Gu, X; Yan, Y; Abdulrahman, R; Timmerman, R; Jiang, S

    2016-01-01

    Purpose: To characterize the dose distributions of Cyberknife and intensity-modulated-proton-therapy (IMPT). Methods: A total of 20 patients previously treated with Cyberknife were selected. The original planning-target-volume (PTV) was used in the ‘IMPT-ideal’ plan assuming a comparable image-guidance with Cyberknife. A 3mm expansion was made to create the proton-PTV for the ‘IMPT-3mm’ plan representing the current proton-therapy where a margin of 3mm is used to account for the inferior image-guidance. The proton range uncertainty was taken-care in beam-design by adding the proximal- and distal-margins (3%water-equivalent-depth+1mm) for both proton plans. The IMPT plans were generated to meet the same target coverage as the Cyberknife-plans. The plan quality of IMPT-ideal and IMPT-3mm were compared to the Cyberknife-plan. To characterize plan quality, we defined the ratio(R) of volumes encompassed by the selected isodose surfaces for Cyberknife and IMPT plans (VCK/VIMPT). Comparisons were made for both Cyberknife versus IMPT-ideal and Cyberknife versusIMPT-3mm to further discuss the impact of setup error margins used in proton therapy and the correlation with target size and location. Results: IMPT-ideal plans yield comparable plan quality as CK plans and slightly better OAR sparing while the IMPT-3mm plan results in a higher dose to the OARs, especially for centralized tumors. Comparing to the IMPT-ideal plans, a slightly larger 80% (Ravg=1.05) dose cloud and significantly larger 50% (Ravg=1.3) and 20% (Ravg=1.60) dose clouds are seen in CK plans. However, the 3mm expansion results in a larger high and medium dose clouds in IMPT-3mm plans (Ravg=0.65 for 80%-isodose; Ravg=0.93 for 50%-isodose). The trend increases with the size of the target and the distance from the brainstem to the center of target. Conclusion: Cyberknife is more preferable for treating centralized targets and proton therapy is advantageous for the large and peripheral targets. Advanced

  11. SU-F-T-598: Robotic Radiosurgery System Versus Pencil Beam Scanning Proton Therapy for Definitive Intracranial Treatments

    Energy Technology Data Exchange (ETDEWEB)

    Lin, M; Pompos, A; Gu, X; Yan, Y; Abdulrahman, R; Timmerman, R; Jiang, S [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: To characterize the dose distributions of Cyberknife and intensity-modulated-proton-therapy (IMPT). Methods: A total of 20 patients previously treated with Cyberknife were selected. The original planning-target-volume (PTV) was used in the ‘IMPT-ideal’ plan assuming a comparable image-guidance with Cyberknife. A 3mm expansion was made to create the proton-PTV for the ‘IMPT-3mm’ plan representing the current proton-therapy where a margin of 3mm is used to account for the inferior image-guidance. The proton range uncertainty was taken-care in beam-design by adding the proximal- and distal-margins (3%water-equivalent-depth+1mm) for both proton plans. The IMPT plans were generated to meet the same target coverage as the Cyberknife-plans. The plan quality of IMPT-ideal and IMPT-3mm were compared to the Cyberknife-plan. To characterize plan quality, we defined the ratio(R) of volumes encompassed by the selected isodose surfaces for Cyberknife and IMPT plans (VCK/VIMPT). Comparisons were made for both Cyberknife versus IMPT-ideal and Cyberknife versusIMPT-3mm to further discuss the impact of setup error margins used in proton therapy and the correlation with target size and location. Results: IMPT-ideal plans yield comparable plan quality as CK plans and slightly better OAR sparing while the IMPT-3mm plan results in a higher dose to the OARs, especially for centralized tumors. Comparing to the IMPT-ideal plans, a slightly larger 80% (Ravg=1.05) dose cloud and significantly larger 50% (Ravg=1.3) and 20% (Ravg=1.60) dose clouds are seen in CK plans. However, the 3mm expansion results in a larger high and medium dose clouds in IMPT-3mm plans (Ravg=0.65 for 80%-isodose; Ravg=0.93 for 50%-isodose). The trend increases with the size of the target and the distance from the brainstem to the center of target. Conclusion: Cyberknife is more preferable for treating centralized targets and proton therapy is advantageous for the large and peripheral targets. Advanced

  12. Laser Pyrometer For Spot Temperature Measurements

    Science.gov (United States)

    Elleman, D. D.; Allen, J. L.; Lee, M. C.

    1988-01-01

    Laser pyrometer makes temperature map by scanning measuring spot across target. Scanning laser pyrometer passively measures radiation emitted by scanned spot on target and calibrated by similar passive measurement on blackbody of known temperature. Laser beam turned on for active measurements of reflectances of target spot and reflectance standard. From measurements, temperature of target spot inferred. Pyrometer useful for non-contact measurement of temperature distributions in processing of materials.

  13. Performance tests and comparison of microdosimetric measurements with four tissue-equivalent proportional counters in scanning proton therapy

    Czech Academy of Sciences Publication Activity Database

    Farah, J.; De Saint-Hubert, M.; Mojzeszek, N.; Chiriotti, S.; Gryzinski, M.; Ploc, Ondřej; Trompier, F.; Turek, Karel; Vanhavere, F.; Olko, P.

    2017-01-01

    Roč. 96, JAN (2017), s. 42-52 ISSN 1350-4487 EU Projects: European Commission(XE) 662287 - CONCERT Institutional support: RVO:61389005 Keywords : tissue-equivalent proportional counters * microdosimetry * proton therapy * stray neutrons and prothons Subject RIV: JF - Nuclear Energetics OBOR OECD: Nuclear related engineering Impact factor: 1.442, year: 2016

  14. SU-D-BRC-01: An Automatic Beam Model Commissioning Method for Monte Carlo Simulations in Pencil-Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Qin, N; Shen, C; Tian, Z; Jiang, S; Jia, X [UT Southwestern Medical Ctr, Dallas, TX (United States)

    2016-06-15

    Purpose: Monte Carlo (MC) simulation is typically regarded as the most accurate dose calculation method for proton therapy. Yet for real clinical cases, the overall accuracy also depends on that of the MC beam model. Commissioning a beam model to faithfully represent a real beam requires finely tuning a set of model parameters, which could be tedious given the large number of pencil beams to commmission. This abstract reports an automatic beam-model commissioning method for pencil-beam scanning proton therapy via an optimization approach. Methods: We modeled a real pencil beam with energy and spatial spread following Gaussian distributions. Mean energy, and energy and spatial spread are model parameters. To commission against a real beam, we first performed MC simulations to calculate dose distributions of a set of ideal (monoenergetic, zero-size) pencil beams. Dose distribution for a real pencil beam is hence linear superposition of doses for those ideal pencil beams with weights in the Gaussian form. We formulated the commissioning task as an optimization problem, such that the calculated central axis depth dose and lateral profiles at several depths match corresponding measurements. An iterative algorithm combining conjugate gradient method and parameter fitting was employed to solve the optimization problem. We validated our method in simulation studies. Results: We calculated dose distributions for three real pencil beams with nominal energies 83, 147 and 199 MeV using realistic beam parameters. These data were regarded as measurements and used for commission. After commissioning, average difference in energy and beam spread between determined values and ground truth were 4.6% and 0.2%. With the commissioned model, we recomputed dose. Mean dose differences from measurements were 0.64%, 0.20% and 0.25%. Conclusion: The developed automatic MC beam-model commissioning method for pencil-beam scanning proton therapy can determine beam model parameters with

  15. SU-F-T-208: An Efficient Planning Approach to Posterior Fossa Tumor Bed Boosts Using Proton Pencil Beam Scanning in Fixed-Beam Room

    International Nuclear Information System (INIS)

    Ju, N; Chen, C; Gans, S; Hug, E; Cahlon, O; Chon, B; Tsai, H; Sine, K; Mah, D; Wolden, S; Yeh, B

    2016-01-01

    Purpose: A fixed-beam room could be underutilized in a multi-room proton center. We investigated the use of proton pencil beam scanning (PBS) on a fixed-beam as an alternative for posterior fossa tumor bed (PF-TB) boost treatments which were usually treating on a gantry with uniform scanning. Methods: Five patients were treated with craniospinal irradiation (CSI, 23.4 or 36.0 Gy(RBE)) followed by a PF-TB boost to 54 Gy(RBE) with proton beams. Three PF-TB boost plans were generated for each patient: (1) a uniform scanning (US) gantry plan with 4–7 posterior fields shaped with apertures and compensators (2) a PBS plan using bi-lateral and vertex fields with a 3-mm planning organ-at-risk volume (PRV) expansion around the brainstem and (3) PBS fields using same beam arrangement but replacing the PRV with robust optimization considering a 3-mm setup uncertainty. Results: A concave 54-Gy(RBE) isodose line surrounding the brainstem could be achieved using all three techniques. The mean V95% of the PTV was 99.7% (range: 97.6% to 100%) while the V100% of the PTV ranged from 56.3% to 93.1% depending on the involvement of the brainstem with the PTV. The mean doses received by 0.05 cm"3 of the brainstem were effectively identical: 54.0 Gy(RBE), 53.4 Gy(RBE) and 53.3 Gy(RBE) for US, PBS optimized with PRV, and PBS optimized with robustness plans respectively. The cochlea mean dose increased by 23% of the prescribed boost dose in average from the bi-lateral fields used in the PBS plan. Planning time for the PBS plan with PRV was 5–10 times less than the US plan and the robustly optimized PBS plan. Conclusion: We have demonstrated that a fixed-beam with PBS can deliver a dose distribution comparable to a gantry plan using uniform scanning. Planning time can be reduced substantially using a PRV around the brainstem instead of robust optimization.

  16. SU-F-T-208: An Efficient Planning Approach to Posterior Fossa Tumor Bed Boosts Using Proton Pencil Beam Scanning in Fixed-Beam Room

    Energy Technology Data Exchange (ETDEWEB)

    Ju, N; Chen, C; Gans, S; Hug, E; Cahlon, O; Chon, B; Tsai, H; Sine, K; Mah, D [Procure Treatment Center, Somerset, New Jersey (United States); Wolden, S [Memorial Sloan Kettering Cancer Center, New York, NY (United States); Yeh, B [Mount Sinai Hospital, New York, NY (United States)

    2016-06-15

    Purpose: A fixed-beam room could be underutilized in a multi-room proton center. We investigated the use of proton pencil beam scanning (PBS) on a fixed-beam as an alternative for posterior fossa tumor bed (PF-TB) boost treatments which were usually treating on a gantry with uniform scanning. Methods: Five patients were treated with craniospinal irradiation (CSI, 23.4 or 36.0 Gy(RBE)) followed by a PF-TB boost to 54 Gy(RBE) with proton beams. Three PF-TB boost plans were generated for each patient: (1) a uniform scanning (US) gantry plan with 4–7 posterior fields shaped with apertures and compensators (2) a PBS plan using bi-lateral and vertex fields with a 3-mm planning organ-at-risk volume (PRV) expansion around the brainstem and (3) PBS fields using same beam arrangement but replacing the PRV with robust optimization considering a 3-mm setup uncertainty. Results: A concave 54-Gy(RBE) isodose line surrounding the brainstem could be achieved using all three techniques. The mean V95% of the PTV was 99.7% (range: 97.6% to 100%) while the V100% of the PTV ranged from 56.3% to 93.1% depending on the involvement of the brainstem with the PTV. The mean doses received by 0.05 cm{sup 3} of the brainstem were effectively identical: 54.0 Gy(RBE), 53.4 Gy(RBE) and 53.3 Gy(RBE) for US, PBS optimized with PRV, and PBS optimized with robustness plans respectively. The cochlea mean dose increased by 23% of the prescribed boost dose in average from the bi-lateral fields used in the PBS plan. Planning time for the PBS plan with PRV was 5–10 times less than the US plan and the robustly optimized PBS plan. Conclusion: We have demonstrated that a fixed-beam with PBS can deliver a dose distribution comparable to a gantry plan using uniform scanning. Planning time can be reduced substantially using a PRV around the brainstem instead of robust optimization.

  17. Comparative study of layered and volumetric rescanning for different scanning speeds of proton beam in liver patients

    NARCIS (Netherlands)

    Bernatowicz, K; Lomax, Antony J.; Knopf, A

    2013-01-01

    In recent years, particle therapy has become a widely accepted form of cancer treatment and technological advances in beam delivery technology (i.e. pencil beam scanning (PBS)) have enabled the application of highly conformal dose distributions to static targets. Current research focuses on the

  18. Dosimetric accuracy of a treatment planning system for actively scanned proton beams and small target volumes: Monte Carlo and experimental validation

    Science.gov (United States)

    Magro, G.; Molinelli, S.; Mairani, A.; Mirandola, A.; Panizza, D.; Russo, S.; Ferrari, A.; Valvo, F.; Fossati, P.; Ciocca, M.

    2015-09-01

    This study was performed to evaluate the accuracy of a commercial treatment planning system (TPS), in optimising proton pencil beam dose distributions for small targets of different sizes (5-30 mm side) located at increasing depths in water. The TPS analytical algorithm was benchmarked against experimental data and the FLUKA Monte Carlo (MC) code, previously validated for the selected beam-line. We tested the Siemens syngo® TPS plan optimisation module for water cubes fixing the configurable parameters at clinical standards, with homogeneous target coverage to a 2 Gy (RBE) dose prescription as unique goal. Plans were delivered and the dose at each volume centre was measured in water with a calibrated PTW Advanced Markus® chamber. An EBT3® film was also positioned at the phantom entrance window for the acquisition of 2D dose maps. Discrepancies between TPS calculated and MC simulated values were mainly due to the different lateral spread modeling and resulted in being related to the field-to-spot size ratio. The accuracy of the TPS was proved to be clinically acceptable in all cases but very small and shallow volumes. In this contest, the use of MC to validate TPS results proved to be a reliable procedure for pre-treatment plan verification.

  19. Dosimetric accuracy of a treatment planning system for actively scanned proton beams and small target volumes: Monte Carlo and experimental validation

    International Nuclear Information System (INIS)

    Magro, G; Molinelli, S; Mairani, A; Mirandola, A; Panizza, D; Russo, S; Valvo, F; Fossati, P; Ciocca, M; Ferrari, A

    2015-01-01

    This study was performed to evaluate the accuracy of a commercial treatment planning system (TPS), in optimising proton pencil beam dose distributions for small targets of different sizes (5–30 mm side) located at increasing depths in water. The TPS analytical algorithm was benchmarked against experimental data and the FLUKA Monte Carlo (MC) code, previously validated for the selected beam-line. We tested the Siemens syngo ® TPS plan optimisation module for water cubes fixing the configurable parameters at clinical standards, with homogeneous target coverage to a 2 Gy (RBE) dose prescription as unique goal. Plans were delivered and the dose at each volume centre was measured in water with a calibrated PTW Advanced Markus ® chamber. An EBT3 ® film was also positioned at the phantom entrance window for the acquisition of 2D dose maps. Discrepancies between TPS calculated and MC simulated values were mainly due to the different lateral spread modeling and resulted in being related to the field-to-spot size ratio. The accuracy of the TPS was proved to be clinically acceptable in all cases but very small and shallow volumes. In this contest, the use of MC to validate TPS results proved to be a reliable procedure for pre-treatment plan verification. (paper)

  20. Dosimetric accuracy of a treatment planning system for actively scanned proton beams and small target volumes: Monte Carlo and experimental validation

    CERN Document Server

    Magro, G; Mairani, A; Mirandola, A; Panizza, D; Russo, S; Ferrari, A; Valvo, F; Fossati, P; Ciocca, M

    2015-01-01

    This study was performed to evaluate the accuracy of a commercial treatment planning system (TPS), in optimising proton pencil beam dose distributions for small targets of different sizes (5–30 mm side) located at increasing depths in water. The TPS analytical algorithm was benchmarked against experimental data and the FLUKA Monte Carlo (MC) code, previously validated for the selected beam-line. We tested the Siemens syngo® TPS plan optimisation module for water cubes fixing the configurable parameters at clinical standards, with homogeneous target coverage to a 2 Gy (RBE) dose prescription as unique goal. Plans were delivered and the dose at each volume centre was measured in water with a calibrated PTW Advanced Markus® chamber. An EBT3® film was also positioned at the phantom entrance window for the acquisition of 2D dose maps. Discrepancies between TPS calculated and MC simulated values were mainly due to the different lateral spread modeling and resulted in being related to the field-to-spot size r...

  1. Evaluation of Robustness to Setup and Range Uncertainties for Head and Neck Patients Treated With Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Malyapa, Robert [Centre for Proton Radiotherapy, PSI (Switzerland); Lowe, Matthew [Manchester Academic Health Science Centre, Faculty of Medical and Human Sciences, University of Manchester (United Kingdom); Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester (United Kingdom); Bolsi, Alessandra; Lomax, Antony J. [Centre for Proton Radiotherapy, PSI (Switzerland); Weber, Damien C. [University of Zürich, Zürich (Switzerland); Albertini, Francesca, E-mail: francesca.albertini@psi.ch [Centre for Proton Radiotherapy, PSI (Switzerland)

    2016-05-01

    Purpose: To evaluate the robustness of head and neck plans for treatment with intensity modulated proton therapy to range and setup errors, and to establish robustness parameters for the planning of future head and neck treatments. Methods and Materials: Ten patients previously treated were evaluated in terms of robustness to range and setup errors. Error bar dose distributions were generated for each plan, from which several metrics were extracted and used to define a robustness database of acceptable parameters over all analyzed plans. The patients were treated in sequentially delivered series, and plans were evaluated for both the first series and for the combined error over the whole treatment. To demonstrate the application of such a database in the head and neck, for 1 patient, an alternative treatment plan was generated using a simultaneous integrated boost (SIB) approach and plans of differing numbers of fields. Results: The robustness database for the treatment of head and neck patients is presented. In an example case, comparison of single and multiple field plans against the database show clear improvements in robustness by using multiple fields. A comparison of sequentially delivered series and an SIB approach for this patient show both to be of comparable robustness, although the SIB approach shows a slightly greater sensitivity to uncertainties. Conclusions: A robustness database was created for the treatment of head and neck patients with intensity modulated proton therapy based on previous clinical experience. This will allow the identification of future plans that may benefit from alternative planning approaches to improve robustness.

  2. Evaluation of Robustness to Setup and Range Uncertainties for Head and Neck Patients Treated With Pencil Beam Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Malyapa, Robert; Lowe, Matthew; Bolsi, Alessandra; Lomax, Antony J.; Weber, Damien C.; Albertini, Francesca

    2016-01-01

    Purpose: To evaluate the robustness of head and neck plans for treatment with intensity modulated proton therapy to range and setup errors, and to establish robustness parameters for the planning of future head and neck treatments. Methods and Materials: Ten patients previously treated were evaluated in terms of robustness to range and setup errors. Error bar dose distributions were generated for each plan, from which several metrics were extracted and used to define a robustness database of acceptable parameters over all analyzed plans. The patients were treated in sequentially delivered series, and plans were evaluated for both the first series and for the combined error over the whole treatment. To demonstrate the application of such a database in the head and neck, for 1 patient, an alternative treatment plan was generated using a simultaneous integrated boost (SIB) approach and plans of differing numbers of fields. Results: The robustness database for the treatment of head and neck patients is presented. In an example case, comparison of single and multiple field plans against the database show clear improvements in robustness by using multiple fields. A comparison of sequentially delivered series and an SIB approach for this patient show both to be of comparable robustness, although the SIB approach shows a slightly greater sensitivity to uncertainties. Conclusions: A robustness database was created for the treatment of head and neck patients with intensity modulated proton therapy based on previous clinical experience. This will allow the identification of future plans that may benefit from alternative planning approaches to improve robustness.

  3. Potential Benefits of Scanned Intensity-Modulated Proton Therapy Versus Advanced Photon Therapy With Regard to Sparing of the Salivary Glands in Oropharyngeal Cancer

    International Nuclear Information System (INIS)

    Water, Tara A. van de; Lomax, Antony J.; Bijl, Hendrik P.; Jong, Marije E. de; Schilstra, Cornelis; Hug, Eugen B.; Langendijk, Johannes A.

    2011-01-01

    Purpose: To test the hypothesis that scanned intensity-modulated proton therapy (IMPT) results in a significant dose reduction to the parotid and submandibular glands as compared with intensity-modulated radiotherapy with photons (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) for oropharyngeal cancer. In addition, we investigated whether the achieved dose reductions would theoretically translate into a reduction of salivary dysfunction and xerostomia. Methods and Materials: Ten patients with N0 oropharyngeal carcinoma were used. The intensity-modulated plans delivered simultaneously 70 Gy to the boost planning target volume (PTV2) and 54 Gy to the elective nodal areas (PTV1). The 3D-CRT technique delivered sequentially 70 Gy and 46 Gy to PTV2 and PTV1, respectively. Normal tissue complication probabilities were calculated for salivary dysfunction and xerostomia. Results: Planning target volume coverage results were similar for IMPT and IMRT. Intensity-modulated proton therapy clearly improved the conformity. The 3D-CRT results were inferior to these results. The mean dose to the parotid glands by 3D-CRT (50.8 Gy), IMRT (25.5 Gy), and IMPT (16.8 Gy) differed significantly. For the submandibular glands no significant differences between IMRT and IMPT were found. The dose reductions obtained with IMPT theoretically translated into a significant reduction in normal tissue complication probability. Conclusion: Compared with IMRT and 3D-CRT, IMPT improved sparing of the organs at risk, while keeping similar target coverage results. The dose reductions obtained with IMPT vs. IMRT and 3D-CRT varied widely per individual patient. Intensity-modulated proton therapy theoretically translated into a clinical benefit for most cases, but this requires clinical validation.

  4. Assessment of Early Toxicity and Response in Patients Treated With Proton and Carbon Ion Therapy at the Heidelberg Ion Therapy Center Using the Raster Scanning Technique

    Energy Technology Data Exchange (ETDEWEB)

    Rieken, Stefan; Habermehl, Daniel; Nikoghosyan, Anna; Jensen, Alexandra [Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg (Germany); Haberer, Thomas [Heidelberg Ion Therapy Center, Heidelberg (Germany); Jaekel, Oliver [Heidelberg Ion Therapy Center, Heidelberg (Germany); Department of Medical Physics, German Cancer Research Center (DKFZ), Heidelberg (Germany); Muenter, Marc W.; Welzel, Thomas; Debus, Juergen [Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg (Germany); Combs, Stephanie E., E-mail: Stephanie.Combs@med.uni-hedielberg.de [Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg (Germany)

    2011-12-01

    Puropose: To asses early toxicity and response in 118 patients treated with scanned ion beams to validate the safety of intensity-controlled raster scanning at the Heidelberg Ion Therapy Center. Patients and Methods: Between November 2009 and June 2010, we treated 118 patients with proton and carbon ion radiotherapy (RT) using active beam delivery. The main indications included skull base chordomas and chondrosarcomas, salivary gland tumors, and gliomas. We evaluated early toxicity within 6 weeks after RT and the initial clinical and radiologic response for quality assurance in our new facility. Results: In all 118 patients, few side effects were observed, in particular, no high numbers of severe acute toxicity were found. In general, the patients treated with particle therapy alone showed only a few single side effects, mainly Radiation Therapy Oncology Group/Common Terminology Criteria grade 1. The most frequent side effects and cumulative incidence of single side effects were observed in the head-and-neck patients treated with particle therapy as a boost and photon intensity-modulated RT. The toxicities included common radiation-attributed reactions known from photon RT, including mucositis, dysphagia, and skin erythema. The most predominant imaging responses were observed in patients with high-grade gliomas and those with salivary gland tumors. For skull base tumors, imaging showed a stable tumor outline in most patients. Thirteen patients showed improvement of pre-existing clinical symptoms. Conclusions: Side effects related to particle treatment were rare, and the overall tolerability of the treatment was shown. The initial response was promising. The data have confirmed the safe delivery of carbon ions and protons at the newly opened Heidelberg facility.

  5. SU-E-T-254: Optimization of GATE and PHITS Monte Carlo Code Parameters for Uniform Scanning Proton Beam Based On Simulation with FLUKA General-Purpose Code

    Energy Technology Data Exchange (ETDEWEB)

    Kurosu, K [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Department of Medical Physics ' Engineering, Osaka University Graduate School of Medicine, Osaka (Japan); Takashina, M; Koizumi, M [Department of Medical Physics ' Engineering, Osaka University Graduate School of Medicine, Osaka (Japan); Das, I; Moskvin, V [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States)

    2014-06-01

    Purpose: Monte Carlo codes are becoming important tools for proton beam dosimetry. However, the relationships between the customizing parameters and percentage depth dose (PDD) of GATE and PHITS codes have not been reported which are studied for PDD and proton range compared to the FLUKA code and the experimental data. Methods: The beam delivery system of the Indiana University Health Proton Therapy Center was modeled for the uniform scanning beam in FLUKA and transferred identically into GATE and PHITS. This computational model was built from the blue print and validated with the commissioning data. Three parameters evaluated are the maximum step size, cut off energy and physical and transport model. The dependence of the PDDs on the customizing parameters was compared with the published results of previous studies. Results: The optimal parameters for the simulation of the whole beam delivery system were defined by referring to the calculation results obtained with each parameter. Although the PDDs from FLUKA and the experimental data show a good agreement, those of GATE and PHITS obtained with our optimal parameters show a minor discrepancy. The measured proton range R90 was 269.37 mm, compared to the calculated range of 269.63 mm, 268.96 mm, and 270.85 mm with FLUKA, GATE and PHITS, respectively. Conclusion: We evaluated the dependence of the results for PDDs obtained with GATE and PHITS Monte Carlo generalpurpose codes on the customizing parameters by using the whole computational model of the treatment nozzle. The optimal parameters for the simulation were then defined by referring to the calculation results. The physical model, particle transport mechanics and the different geometrybased descriptions need accurate customization in three simulation codes to agree with experimental data for artifact-free Monte Carlo simulation. This study was supported by Grants-in Aid for Cancer Research (H22-3rd Term Cancer Control-General-043) from the Ministry of Health

  6. SU-E-T-262: Planning for Proton Pencil Beam Scanning (PBS): Applications of Gradient Optimization for Field Matching

    Energy Technology Data Exchange (ETDEWEB)

    Lin, H; Kirk, M; Zhai, H; Ding, X; Liu, H; Hill-Kayser, C; Lustig, R; Tochner, Z; Deville, C; Vapiwala, N; McDonough, J; Both, S [University Pennsylvania, Philadelphia, PA (United States)

    2014-06-01

    Purpose: To propose the gradient optimization(GO) approach in planning for matching proton PBS fields and present two commonly used applications in our institution. Methods: GO is employed for PBS field matching in the scenarios that when the size of the target is beyond the field size limit of the beam delivery system or matching is required for beams from different angles to either improve the sparing of important organs or to pass through a short and simple beam path. Overlap is designed between adjacent fields and in the overlapped junction, the dose was optimized such that it gradually decreases in one field and the decrease is compensated by increase from another field. Clinical applications of this approach on craniospinal irradiation(CSI) and whole pelvis treatment were presented. Mathematical model was developed to study the relationships between dose errors, setup errors and junction lengths. Results: Uniform and conformal dose coverage to the entire target volumes was achieved for both applications using GO approach. For CSI, the gradient matching (6.7cm junction) between fields overcame the complexity of planning associated with feathering match lines. A slow dose gradient in the junction area significantly reduced the sensitivity of the treatment to setup errors. For whole pelvis, gradient matching (4cm junction) between posterior fields for superior target and bilateral fields for inferior target provided dose sparing to organs such as bowel, bladder and rectum. For a setup error of 3 mm in longitudinal direction from one field, mathematical model predicted dose errors of 10%, 6% and 4.3% for junction length of 3, 5 and 7cm. Conclusion: This GO approach improves the quality of the PBS treatment plan with matching fields while maintaining the safety of treatment delivery relative to potential misalignments.

  7. SU-E-T-262: Planning for Proton Pencil Beam Scanning (PBS): Applications of Gradient Optimization for Field Matching

    International Nuclear Information System (INIS)

    Lin, H; Kirk, M; Zhai, H; Ding, X; Liu, H; Hill-Kayser, C; Lustig, R; Tochner, Z; Deville, C; Vapiwala, N; McDonough, J; Both, S

    2014-01-01

    Purpose: To propose the gradient optimization(GO) approach in planning for matching proton PBS fields and present two commonly used applications in our institution. Methods: GO is employed for PBS field matching in the scenarios that when the size of the target is beyond the field size limit of the beam delivery system or matching is required for beams from different angles to either improve the sparing of important organs or to pass through a short and simple beam path. Overlap is designed between adjacent fields and in the overlapped junction, the dose was optimized such that it gradually decreases in one field and the decrease is compensated by increase from another field. Clinical applications of this approach on craniospinal irradiation(CSI) and whole pelvis treatment were presented. Mathematical model was developed to study the relationships between dose errors, setup errors and junction lengths. Results: Uniform and conformal dose coverage to the entire target volumes was achieved for both applications using GO approach. For CSI, the gradient matching (6.7cm junction) between fields overcame the complexity of planning associated with feathering match lines. A slow dose gradient in the junction area significantly reduced the sensitivity of the treatment to setup errors. For whole pelvis, gradient matching (4cm junction) between posterior fields for superior target and bilateral fields for inferior target provided dose sparing to organs such as bowel, bladder and rectum. For a setup error of 3 mm in longitudinal direction from one field, mathematical model predicted dose errors of 10%, 6% and 4.3% for junction length of 3, 5 and 7cm. Conclusion: This GO approach improves the quality of the PBS treatment plan with matching fields while maintaining the safety of treatment delivery relative to potential misalignments

  8. Dose delivery study for a novel compact proton accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Kraus, Kim Melanie

    2014-01-15

    Proton therapy has played an important role in the treatment of cancer with radiation therapy for more than 60 years. Active spot scanning to deliver highly conformal dose to the tumor has been developed. However, the availability of proton therapy to the patients is still limited, partly, due to the high costs and sizes of large proton therapy centers. Therefore, a novel compact proton single room facility based on a linear accelerator mounted on a gantry has been proposed, named TULIP (TUrning LInac for Proton therapy). This accelerator allows for active energy variation on a milliseconds time scale. This work aims to assess the possibilities of dose delivery with TULIP to exploit its beneficial features with respect to dose delivery. We developed a software tool, simulating the dose delivery to the tumor. By means of this software tool, we assessed different delivery methods and found 3D spot scanning to be superior to rotational dose delivery with regard to dose and irradiation time. In a second part, we expanded the investigations to dose delivery to moving targets. Due to fast energy variation, we found TULIP to be preferably suitable for rescanning, confirmed by irradiation times of only a few minutes.

  9. Dose delivery study for a novel compact proton accelerator

    International Nuclear Information System (INIS)

    Kraus, Kim Melanie

    2014-01-01

    Proton therapy has played an important role in the treatment of cancer with radiation therapy for more than 60 years. Active spot scanning to deliver highly conformal dose to the tumor has been developed. However, the availability of proton therapy to the patients is still limited, partly, due to the high costs and sizes of large proton therapy centers. Therefore, a novel compact proton single room facility based on a linear accelerator mounted on a gantry has been proposed, named TULIP (TUrning LInac for Proton therapy). This accelerator allows for active energy variation on a milliseconds time scale. This work aims to assess the possibilities of dose delivery with TULIP to exploit its beneficial features with respect to dose delivery. We developed a software tool, simulating the dose delivery to the tumor. By means of this software tool, we assessed different delivery methods and found 3D spot scanning to be superior to rotational dose delivery with regard to dose and irradiation time. In a second part, we expanded the investigations to dose delivery to moving targets. Due to fast energy variation, we found TULIP to be preferably suitable for rescanning, confirmed by irradiation times of only a few minutes.

  10. Bier spots

    OpenAIRE

    Ahu Yorulmaz,; Seray Kulcu Cakmak; Esra Ar?; Ferda Artuz

    2015-01-01

    Also called as physiologic anemic macules, Bier spots are small, hypopigmented irregularly shaped macules against a background of diffuse erythema, which creates an appearance of speckled vascular mottling of the skin. Bier spots most commonly appear on distal portions of the limbs though there are case reports describing diffuse involvement, which also affect trunk and mucous membranes of the patient. Although the exact pathophysiological mechanisms underlying Bier spots still need to be elu...

  11. Fan-beam intensity modulated proton therapy.

    Science.gov (United States)

    Hill, Patrick; Westerly, David; Mackie, Thomas

    2013-11-01

    falloff of a proton depth-dose distribution was found to provide sufficient control over the dose distribution to meet objectives, even with coarse lateral resolution and channel widths as large as 2 cm. Treatment plans on both phantom and patient data show that dose conformity suffers when treatments are delivered from less than approximately ten angles. Treatment time for a sample prostate delivery is estimated to be on the order of 10 min, and neutron production is estimated to be comparable to that found for existing collimated systems. Fan beam proton therapy is a method of delivering intensity modulated proton therapy which may be employed as an alternative to magnetic scanning systems. A fan beam of protons can be created by a set of quadrupole magnets and modified by a dual-purpose range and intensity modulator. This can be used to deliver inversely planned treatments, with spot intensities optimized to meet user defined dose objectives. Additionally, the ability of a fan beam delivery system to effectively treat multiple beam spots simultaneously may provide advantages as compared to spot scanning deliveries.

  12. An experimental approach to improve the Monte Carlo modelling of offline PET/CT-imaging of positron emitters induced by scanned proton beams

    International Nuclear Information System (INIS)

    Bauer, J; Unholtz, D; Kurz, C; Parodi, K

    2013-01-01

    We report on the experimental campaign carried out at the Heidelberg Ion-Beam Therapy Center (HIT) to optimize the Monte Carlo (MC) modelling of proton-induced positron-emitter production. The presented experimental strategy constitutes a pragmatic inverse approach to overcome the known uncertainties in the modelling of positron-emitter production due to the lack of reliable cross-section data for the relevant therapeutic energy range. This work is motivated by the clinical implementation of offline PET/CT-based treatment verification at our facility. Here, the irradiation induced tissue activation in the patient is monitored shortly after the treatment delivery by means of a commercial PET/CT scanner and compared to a MC simulated activity expectation, derived under the assumption of a correct treatment delivery. At HIT, the MC particle transport and interaction code FLUKA is used for the simulation of the expected positron-emitter yield. For this particular application, the code is coupled to externally provided cross-section data of several proton-induced reactions. Studying experimentally the positron-emitting radionuclide yield in homogeneous phantoms provides access to the fundamental production channels. Therefore, five different materials have been irradiated by monoenergetic proton pencil beams at various energies and the induced β + activity subsequently acquired with a commercial full-ring PET/CT scanner. With the analysis of dynamically reconstructed PET images, we are able to determine separately the spatial distribution of different radionuclide concentrations at the starting time of the PET scan. The laterally integrated radionuclide yields in depth are used to tune the input cross-section data such that the impact of both the physical production and the imaging process on the various positron-emitter yields is reproduced. The resulting cross-section data sets allow to model the absolute level of measured β + activity induced in the investigated

  13. An experimental approach to improve the Monte Carlo modelling of offline PET/CT-imaging of positron emitters induced by scanned proton beams

    Science.gov (United States)

    Bauer, J.; Unholtz, D.; Kurz, C.; Parodi, K.

    2013-08-01

    We report on the experimental campaign carried out at the Heidelberg Ion-Beam Therapy Center (HIT) to optimize the Monte Carlo (MC) modelling of proton-induced positron-emitter production. The presented experimental strategy constitutes a pragmatic inverse approach to overcome the known uncertainties in the modelling of positron-emitter production due to the lack of reliable cross-section data for the relevant therapeutic energy range. This work is motivated by the clinical implementation of offline PET/CT-based treatment verification at our facility. Here, the irradiation induced tissue activation in the patient is monitored shortly after the treatment delivery by means of a commercial PET/CT scanner and compared to a MC simulated activity expectation, derived under the assumption of a correct treatment delivery. At HIT, the MC particle transport and interaction code FLUKA is used for the simulation of the expected positron-emitter yield. For this particular application, the code is coupled to externally provided cross-section data of several proton-induced reactions. Studying experimentally the positron-emitting radionuclide yield in homogeneous phantoms provides access to the fundamental production channels. Therefore, five different materials have been irradiated by monoenergetic proton pencil beams at various energies and the induced β+ activity subsequently acquired with a commercial full-ring PET/CT scanner. With the analysis of dynamically reconstructed PET images, we are able to determine separately the spatial distribution of different radionuclide concentrations at the starting time of the PET scan. The laterally integrated radionuclide yields in depth are used to tune the input cross-section data such that the impact of both the physical production and the imaging process on the various positron-emitter yields is reproduced. The resulting cross-section data sets allow to model the absolute level of measured β+ activity induced in the investigated

  14. Bier spots

    Directory of Open Access Journals (Sweden)

    Ahu Yorulmaz,

    2015-10-01

    Full Text Available Also called as physiologic anemic macules, Bier spots are small, hypopigmented irregularly shaped macules against a background of diffuse erythema, which creates an appearance of speckled vascular mottling of the skin. Bier spots most commonly appear on distal portions of the limbs though there are case reports describing diffuse involvement, which also affect trunk and mucous membranes of the patient. Although the exact pathophysiological mechanisms underlying Bier spots still need to be elucidated, Bier spots have been suggested to be a vascular anomaly caused by vasoconstriction of small vessels. In addition, several diseases have been proposed to be associated with Bier spots, including scleroderma renal crisis, cryoglobulinemia, Peutz-Jeghers syndrome, alopecia areata and hypoplasia of the aorta, although it has not been shown whether these associations are casual or coincidental. The clinical presentation of Bier spots is quite typical. These tiny whitish macules easily become prominent when the affected limb is placed in a dependent position and fade away when the limb is raised. Here we report a case of Bier spots in a 32-year-old male patient with characteristical clinical manifestations.

  15. Age Spots

    Science.gov (United States)

    ... for Every Season How to Choose the Best Skin Care Products In This Section Dermatologic Surgery What is dermatologic ... for Every Season How to Choose the Best Skin Care Products Age Spots Treatment Options Learn more about treatment ...

  16. Spotted inflation

    International Nuclear Information System (INIS)

    Matsuda, Tomohiro

    2010-01-01

    We describe new scenarios for generating curvature perturbations when inflaton (curvaton) has significant interactions. We consider a ''spot'', which arises from interactions associated with an enhanced symmetric point (ESP) on the trajectory. Our first example uses the spot to induce a gap in the field equation. We observe that the gap in the field equation may cause generation of curvature perturbation if it does not appear simultaneous in space. The mechanism is similar to the scenario of inhomogeneous phase transition. Then we observe that the spot interactions may initiate warm inflation in the cold Universe. Creation of cosmological perturbation is discussed in relation to the inflaton dynamics and the modulation associated with the spot interactions

  17. SU-F-T-197: Investigating Optimal Oblique-Beam Arrangement for Bilateral Metallic Prosthesis Prostate Cancer in Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Rana, S; Tesfamicael, B; Park, S [McLaren Proton Therapy Center, Karmanos Cancer Institute at McLaren-Flint, Flint, MI (United States); Zheng, Y; Singh, H; Twyford, T [Procure Proton Therapy Center, Oklahoma City, OK (United States); Cheng, C [Vantage Oncology, West Hills, CA (United States)

    2016-06-15

    Purpose: The main purpose of this study is to investigate the optimum oblique-beam arrangement for bilateral metallic prosthesis prostate cancer treatment in pencil beam scanning (PBS) proton therapy. Methods: A computed tomography dataset of bilateral metallic prosthesis prostate cancer case was selected for this retrospective study. A total of four beams (rightanterior- oblique [RAO], left-anterior-oblique [LAO], left-posterior-oblique [LPO], and right-posterior-oblique [RPO]) were selected for treatment planning. PBS plans were generated using multi-field-optimization technique for a total dose of 79.2 Gy[RBE] to be delivered in 44 fractions. Specifically, five different PBS plans were generated based on 2.5% ± 2 mm range uncertainty using five different beam arrangements (i)LAO+RAO+LPO+RPO, (ii)LAO+RAO, (iii)LPO+RPO, (iv)RAO+LPO, and (v)LAO+RPO. Each PBS plan was optimized by applying identical dose-volume constraints to the PTV, rectum, and bladder. Treatment plans were then compared based on the dose-volume histograms results. Results: The PTV coverage was found to be greater than 99% in all five plans. The homogeneity index (HI) was found to be almost identical (range, 0.03–0.04). The PTV mean dose was found to be comparable (range, 81.0–81.1 Gy[RBE]). For the rectum, the lowest mean dose (8.0 Gy[RBE]) and highest mean dose (31.1 Gy[RBE]) were found in RAO+LAO plan and LPO+RPO plan, respectively. LAO+RAO plan produced the most favorable dosimetric results of the rectum in the medium-dose region (V50) and high-dose region (V70). For the bladder, the lowest (5.0 Gy[RBE]) and highest mean dose (10.3 Gy[RBE]) were found in LPO+RPO plan and RAO+LAO plan, respectively. Other dosimetric results (V50 and V70) of the bladder were slightly better in LPO+RPO plan than in other plans. Conclusion: Dosimetric findings from this study suggest that two anterior-oblique proton beams arrangement (LAO+RAO) is a more favorable option with the possibility of reducing rectal

  18. SU-E-T-147: Beam Specific Planning Target Volumes Incorporating 4DCT for Pencil Beam Scanning Proton Therapy of Thoracic Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Lin, L; Kang, M; Huang, S; McDonough, J; Solberg, T; Simone, C [University of Pennsylvania, Philadelphia, PA (United States); Mayer, R [Henry Jackson Foundation, Bethesda, MD (United States); Thomas, A [ATC healthcare, Bethesda, MD (United States)

    2015-06-15

    Purpose: The purpose of this study is to determine whether organ sparing and target coverage can be simultaneously maintained for pencil beam scanning (PBS) proton therapy treatment of thoracic tumors in the presence of motion, stopping power uncertainties and patient setup variations. Methods: Ten consecutive patients that were previously treated with proton therapy to 66.6/1.8 Gy (RBE) using double scattering (DS) were replanned with PBS. Minimum and maximum intensity images from 4DCT were used to introduce flexible smearing in the determination of the beam specific PTV (BSPTV). Datasets from eight 4DCT phases, using ±3% uncertainty in stopping power, and ±3 mm uncertainty in patient setup in each direction were used to create 8*12*10=960 PBS plans for the evaluation of ten patients. Plans were normalized to provide identical coverage between DS and PBS. Results: The average lung V20, V5, and mean doses were reduced from 29.0%, 35.0%, and 16.4 Gy with DS to 24.6%, 30.6%, and 14.1 Gy with PBS, respectively. The average heart V30 and V45 were reduced from 10.4% and 7.5% in DS to 8.1% and 5.4% for PBS, respectively. Furthermore, the maximum spinal cord, esophagus and heart dose were decreased from 37.1 Gy, 71.7 Gy and 69.2 Gy with DS to 31.3 Gy, 67.9 Gy and 64.6 Gy with PBS. The conformity index (CI), homogeneity index (HI), and global maximal dose were improved from 3.2, 0.08, 77.4 Gy with DS to 2.8, 0.04 and 72.1 Gy with PBS. All differences are statistically significant, with p values <0.05, with the exception of the heart V45 (p= 0.146). Conclusion: PBS with BSPTV achieves better organ sparing and improves target coverage using a repainting method for the treatment of thoracic tumors. Incorporating motion-related uncertainties is essential This work was supported by the US Army Medical Research and Materiel Command under Contract Agreement No. DAMD17-W81XWH-07-2-0121 and W81XWH-09-2-0174.

  19. Experimental validation of a Monte Carlo proton therapy nozzle model incorporating magnetically steered protons

    International Nuclear Information System (INIS)

    Peterson, S W; Polf, J; Archambault, L; Beddar, S; Bues, M; Ciangaru, G; Smith, A

    2009-01-01

    The purpose of this study is to validate the accuracy of a Monte Carlo calculation model of a proton magnetic beam scanning delivery nozzle developed using the Geant4 toolkit. The Monte Carlo model was used to produce depth dose and lateral profiles, which were compared to data measured in the clinical scanning treatment nozzle at several energies. Comparisons were also made between measured and simulated off-axis profiles to test the accuracy of the model's magnetic steering. Comparison of the 80% distal dose fall-off values for the measured and simulated depth dose profiles agreed to within 1 mm for the beam energies evaluated. Agreement of the full width at half maximum values for the measured and simulated lateral fluence profiles was within 1.3 mm for all energies. The position of measured and simulated spot positions for the magnetically steered beams agreed to within 0.7 mm of each other. Based on these results, we found that the Geant4 Monte Carlo model of the beam scanning nozzle has the ability to accurately predict depth dose profiles, lateral profiles perpendicular to the beam axis and magnetic steering of a proton beam during beam scanning proton therapy.

  20. Theoretical Benefits of Dynamic Collimation in Pencil Beam Scanning Proton Therapy for Brain Tumors: Dosimetric and Radiobiological Metrics

    Energy Technology Data Exchange (ETDEWEB)

    Moignier, Alexandra, E-mail: alexandra-moignier@uiowa.edu [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); Gelover, Edgar; Wang, Dongxu; Smith, Blake; Flynn, Ryan [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); Kirk, Maura; Lin, Liyong; Solberg, Timothy; Lin, Alexander [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Hyer, Daniel [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States)

    2016-05-01

    Purpose: To quantify the dosimetric benefit of using a dynamic collimation system (DCS) for penumbra reduction during the treatment of brain tumors by pencil beam scanning proton therapy (PBS PT). Methods and Materials: Collimated and uncollimated brain treatment plans were created for 5 patients previously treated with PBS PT and retrospectively enrolled in an institutional review board–approved study. The in-house treatment planning system, RDX, was used to generate the plans because it is capable of modeling both collimated and uncollimated beamlets. The clinically delivered plans were reproduced with uncollimated plans in terms of target coverage and organ at risk (OAR) sparing to ensure a clinically relevant starting point, and collimated plans were generated to improve the OAR sparing while maintaining target coverage. Physical and biological comparison metrics, such as dose distribution conformity, mean and maximum doses, normal tissue complication probability, and risk of secondary brain cancer, were used to evaluate the plans. Results: The DCS systematically improved the dose distribution conformity while preserving the target coverage. The average reduction of the mean dose to the 10-mm ring surrounding the target and the healthy brain were 13.7% (95% confidence interval [CI] 11.6%-15.7%; P<.0001) and 25.1% (95% CI 16.8%-33.4%; P<.001), respectively. This yielded an average reduction of 24.8% (95% CI 0.8%-48.8%; P<.05) for the brain necrosis normal tissue complication probability using the Flickinger model, and 25.1% (95% CI 16.8%-33.4%; P<.001) for the risk of secondary brain cancer. A general improvement of the OAR sparing was also observed. Conclusion: The lateral penumbra reduction afforded by the DCS increases the normal tissue sparing capabilities of PBS PT for brain cancer treatment while preserving target coverage.

  1. Theoretical Benefits of Dynamic Collimation in Pencil Beam Scanning Proton Therapy for Brain Tumors: Dosimetric and Radiobiological Metrics

    International Nuclear Information System (INIS)

    Moignier, Alexandra; Gelover, Edgar; Wang, Dongxu; Smith, Blake; Flynn, Ryan; Kirk, Maura; Lin, Liyong; Solberg, Timothy; Lin, Alexander; Hyer, Daniel

    2016-01-01

    Purpose: To quantify the dosimetric benefit of using a dynamic collimation system (DCS) for penumbra reduction during the treatment of brain tumors by pencil beam scanning proton therapy (PBS PT). Methods and Materials: Collimated and uncollimated brain treatment plans were created for 5 patients previously treated with PBS PT and retrospectively enrolled in an institutional review board–approved study. The in-house treatment planning system, RDX, was used to generate the plans because it is capable of modeling both collimated and uncollimated beamlets. The clinically delivered plans were reproduced with uncollimated plans in terms of target coverage and organ at risk (OAR) sparing to ensure a clinically relevant starting point, and collimated plans were generated to improve the OAR sparing while maintaining target coverage. Physical and biological comparison metrics, such as dose distribution conformity, mean and maximum doses, normal tissue complication probability, and risk of secondary brain cancer, were used to evaluate the plans. Results: The DCS systematically improved the dose distribution conformity while preserving the target coverage. The average reduction of the mean dose to the 10-mm ring surrounding the target and the healthy brain were 13.7% (95% confidence interval [CI] 11.6%-15.7%; P<.0001) and 25.1% (95% CI 16.8%-33.4%; P<.001), respectively. This yielded an average reduction of 24.8% (95% CI 0.8%-48.8%; P<.05) for the brain necrosis normal tissue complication probability using the Flickinger model, and 25.1% (95% CI 16.8%-33.4%; P<.001) for the risk of secondary brain cancer. A general improvement of the OAR sparing was also observed. Conclusion: The lateral penumbra reduction afforded by the DCS increases the normal tissue sparing capabilities of PBS PT for brain cancer treatment while preserving target coverage.

  2. SU-F-T-215: An Investigation Of Multi-Scanner CT Hounsfield Unit Calibration for Pencil Beam Scanning Proton Therapy Using 3D Gamma Analysis

    International Nuclear Information System (INIS)

    Zhang, J; Li, X; Liu, G; Liu, Q; Liang, J; Ding, X

    2016-01-01

    Purpose: We compare and investigate the dosimetric impacts on pencil beam scanning (PBS) proton treatment plans generated with CT calibration curves from four different CT scanners and one averaged ‘global’ CT calibration curve. Methods: The four CT scanners are located at three different hospital locations within the same health system. CT density calibration curves were collected from these scanners using the same CT calibration phantom and acquisition parameters. Mass density to HU value tables were then commissioned in a commercial treatment planning system. Five disease sites were chosen for dosimetric comparisons at brain, lung, head and neck, adrenal, and prostate. Three types of PBS plans were generated at each treatment site using SFUD, IMPT, and robustness optimized IMPT techniques. 3D dose differences were investigated using 3D Gamma analysis. Results: The CT calibration curves for all four scanners display very similar shapes. Large HU differences were observed at both the high HU and low HU regions of the curves. Large dose differences were generally observed at the distal edges of the beams and they are beam angle dependent. Out of the five treatment sites, lung plans exhibits the most overall range uncertainties and prostate plans have the greatest dose discrepancy. There are no significant differences between the SFUD, IMPT, and the RO-IMPT methods. 3D gamma analysis with 3%, 3 mm criteria showed all plans with greater than 95% passing rate. Two of the scanners with close HU values have negligible dose difference except for lung. Conclusion: Our study shows that there are more than 5% dosimetric differences between different CT calibration curves. PBS treatment plans generated with SFUD, IMPT, and the robustness optimized IMPT has similar sensitivity to the CT density uncertainty. More patient data and tighter gamma criteria based on structure location and size will be used for further investigation.

  3. Variable-spot ion beam figuring

    International Nuclear Information System (INIS)

    Wu, Lixiang; Qiu, Keqiang; Fu, Shaojun

    2016-01-01

    This paper introduces a new scheme of ion beam figuring (IBF), or rather variable-spot IBF, which is conducted at a constant scanning velocity with variable-spot ion beam collimated by a variable diaphragm. It aims at improving the reachability and adaptation of the figuring process within the limits of machine dynamics by varying the ion beam spot size instead of the scanning velocity. In contrast to the dwell time algorithm in the conventional IBF, the variable-spot IBF adopts a new algorithm, which consists of the scan path programming and the trajectory optimization using pattern search. In this algorithm, instead of the dwell time, a new concept, integral etching time, is proposed to interpret the process of variable-spot IBF. We conducted simulations to verify its feasibility and practicality. The simulation results indicate the variable-spot IBF is a promising alternative to the conventional approach.

  4. Dosimetric consequences of pencil beam width variations in scanned beam particle therapy

    International Nuclear Information System (INIS)

    Chanrion, M A; Ammazzalorso, F; Wittig, A; Engenhart-Cabillic, R; Jelen, U

    2013-01-01

    Scanned ion beam delivery enables the highest degree of target dose conformation attainable in external beam radiotherapy. Nominal pencil beam widths (spot sizes) are recorded during treatment planning system commissioning. Due to changes in the beam-line optics, the actual spot sizes may differ from these commissioning values, leading to differences between planned and delivered dose. The purpose of this study was to analyse the dosimetric consequences of spot size variations in particle therapy treatment plans. For 12 patients with skull base tumours and 12 patients with prostate carcinoma, scanned-beam carbon ion and proton treatment plans were prepared and recomputed simulating spot size changes of (1) ±10% to simulate the typical magnitude of fluctuations, (2) ±25% representing the worst-case scenario and (3) ±50% as a part of a risk analysis in case of fault conditions. The primary effect of the spot size variation was a dose deterioration affecting the target edge: loss of target coverage and broadening of the lateral penumbra (increased spot size) or overdosage and contraction of the lateral penumbra (reduced spot size). For changes ⩽25%, the resulting planning target volume mean 95%-isodose line coverage (CI-95%) deterioration was ranging from negligible to moderate. In some cases changes in the dose to adjoining critical structures were observed. (paper)

  5. SPOT Program

    Science.gov (United States)

    Smith, Jason T.; Welsh, Sam J.; Farinetti, Antonio L.; Wegner, Tim; Blakeslee, James; Deboeck, Toni F.; Dyer, Daniel; Corley, Bryan M.; Ollivierre, Jarmaine; Kramer, Leonard; hide

    2010-01-01

    A Spacecraft Position Optimal Tracking (SPOT) program was developed to process Global Positioning System (GPS) data, sent via telemetry from a spacecraft, to generate accurate navigation estimates of the vehicle position and velocity (state vector) using a Kalman filter. This program uses the GPS onboard receiver measurements to sequentially calculate the vehicle state vectors and provide this information to ground flight controllers. It is the first real-time ground-based shuttle navigation application using onboard sensors. The program is compact, portable, self-contained, and can run on a variety of UNIX or Linux computers. The program has a modular objec-toriented design that supports application-specific plugins such as data corruption remediation pre-processing and remote graphics display. The Kalman filter is extensible to additional sensor types or force models. The Kalman filter design is also strong against data dropouts because it uses physical models from state and covariance propagation in the absence of data. The design of this program separates the functionalities of SPOT into six different executable processes. This allows for the individual processes to be connected in an a la carte manner, making the feature set and executable complexity of SPOT adaptable to the needs of the user. Also, these processes need not be executed on the same workstation. This allows for communications between SPOT processes executing on the same Local Area Network (LAN). Thus, SPOT can be executed in a distributed sense with the capability for a team of flight controllers to efficiently share the same trajectory information currently being computed by the program. SPOT is used in the Mission Control Center (MCC) for Space Shuttle Program (SSP) and International Space Station Program (ISSP) operations, and can also be used as a post -flight analysis tool. It is primarily used for situational awareness, and for contingency situations.

  6. WE-E-BRB-03: Implementation of PBS Proton Therapy Treatment for Free Breathing Lung Cancer Patients

    International Nuclear Information System (INIS)

    Li, H.

    2016-01-01

    Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

  7. WE-E-BRB-03: Implementation of PBS Proton Therapy Treatment for Free Breathing Lung Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Li, H. [UT MD Anderson Cancer Center (United States)

    2016-06-15

    Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

  8. Measurement of visible cross sections in proton-lead collisions at $\\sqrt{s_{NN}}$=5.02 TeV in van der Meer scans with the ALICE detector

    CERN Document Server

    Abelev, Betty Bezverkhny; Adamova, Dagmar; Aggarwal, Madan Mohan; Agnello, Michelangelo; Agostinelli, Andrea; Agrawal, Neelima; Ahammed, Zubayer; Ahmad, Nazeer; Ahmed, Ijaz; Ahn, Sang Un; Ahn, Sul-Ah; Aimo, Ilaria; Aiola, Salvatore; Ajaz, Muhammad; Akindinov, Alexander; Alam, Sk Noor; Aleksandrov, Dmitry; Alessandro, Bruno; Alexandre, Didier; Alici, Andrea; Alkin, Anton; Alme, Johan; Alt, Torsten; Altinpinar, Sedat; Altsybeev, Igor; Alves Garcia Prado, Caio; Andrei, Cristian; Andronic, Anton; Anguelov, Venelin; Anielski, Jonas; Anticic, Tome; Antinori, Federico; Antonioli, Pietro; Aphecetche, Laurent Bernard; Appelshaeuser, Harald; Arbor, Nicolas; Arcelli, Silvia; Armesto Perez, Nestor; Arnaldi, Roberta; Aronsson, Tomas; Arsene, Ionut Cristian; Arslandok, Mesut; Augustinus, Andre; Averbeck, Ralf Peter; Awes, Terry; Azmi, Mohd Danish; Bach, Matthias Jakob; Badala, Angela; Baek, Yong Wook; Bagnasco, Stefano; Bailhache, Raphaelle Marie; Bala, Renu; Baldisseri, Alberto; Baltasar Dos Santos Pedrosa, Fernando; Baral, Rama Chandra; Barbera, Roberto; Barile, Francesco; Barnafoldi, Gergely Gabor; Barnby, Lee Stuart; Ramillien Barret, Valerie; Bartke, Jerzy Gustaw; Basile, Maurizio; Bastid, Nicole; Basu, Sumit; Bathen, Bastian; Batigne, Guillaume; Batyunya, Boris; Batzing, Paul Christoph; Baumann, Christoph Heinrich; Bearden, Ian Gardner; Beck, Hans; Bedda, Cristina; Behera, Nirbhay Kumar; Belikov, Iouri; Bellini, Francesca; Bellwied, Rene; Belmont Moreno, Ernesto; Belmont Iii, Ronald John; Bencedi, Gyula; Beole, Stefania; Berceanu, Ionela; Bercuci, Alexandru; Berdnikov, Yaroslav; Berenyi, Daniel; Berger, Martin Emanuel; Bertens, Redmer Alexander; Berzano, Dario; Betev, Latchezar; Bhasin, Anju; Bhat, Inayat Rasool; Bhati, Ashok Kumar; Bhattacharjee, Buddhadeb; Bhom, Jihyun; Bianchi, Livio; Bianchi, Nicola; Bianchin, Chiara; Bielcik, Jaroslav; Bielcikova, Jana; Bilandzic, Ante; Bjelogrlic, Sandro; Blanco, Fernando; Blau, Dmitry; Blume, Christoph; Bock, Friederike; Bogdanov, Alexey; Boggild, Hans; Bogolyubskiy, Mikhail; Boehmer, Felix Valentin; Boldizsar, Laszlo; Bombara, Marek; Book, Julian Heinz; Borel, Herve; Borissov, Alexander; Bossu, Francesco; Botje, Michiel; Botta, Elena; Boettger, Stefan; Braun-Munzinger, Peter; Bregant, Marco; Breitner, Timo Gunther; Broker, Theo Alexander; Browning, Tyler Allen; Broz, Michal; Bruna, Elena; Bruno, Giuseppe Eugenio; Budnikov, Dmitry; Buesching, Henner; Bufalino, Stefania; Buncic, Predrag; Busch, Oliver; Buthelezi, Edith Zinhle; Caffarri, Davide; Cai, Xu; Caines, Helen Louise; Calero Diaz, Liliet; Caliva, Alberto; Calvo Villar, Ernesto; Camerini, Paolo; Carena, Francesco; Carena, Wisla; Castillo Castellanos, Javier Ernesto; Casula, Ester Anna Rita; Catanescu, Vasile Ioan; Cavicchioli, Costanza; Ceballos Sanchez, Cesar; Cepila, Jan; Cerello, Piergiorgio; Chang, Beomsu; Chapeland, Sylvain; Charvet, Jean-Luc Fernand; Chattopadhyay, Subhasis; Chattopadhyay, Sukalyan; Chelnokov, Volodymyr; Cherney, Michael Gerard; Cheshkov, Cvetan Valeriev; Cheynis, Brigitte; Chibante Barroso, Vasco Miguel; Dobrigkeit Chinellato, David; Chochula, Peter; Chojnacki, Marek; Choudhury, Subikash; Christakoglou, Panagiotis; Christensen, Christian Holm; Christiansen, Peter; Chujo, Tatsuya; Chung, Suh-Urk; Cicalo, Corrado; Cifarelli, Luisa; Cindolo, Federico; Cleymans, Jean Willy Andre; Colamaria, Fabio Filippo; Colella, Domenico; Collu, Alberto; Colocci, Manuel; Conesa Balbastre, Gustavo; Conesa Del Valle, Zaida; Connors, Megan Elizabeth; Contreras Nuno, Jesus Guillermo; Cormier, Thomas Michael; Corrales Morales, Yasser; Cortese, Pietro; Cortes Maldonado, Ismael; Cosentino, Mauro Rogerio; Costa, Filippo; Crochet, Philippe; Cruz Albino, Rigoberto; Cuautle Flores, Eleazar; Cunqueiro Mendez, Leticia; Dainese, Andrea; Dang, Ruina; Danu, Andrea; Das, Debasish; Das, Indranil; Das, Kushal; Das, Supriya; Dash, Ajay Kumar; Dash, Sadhana; De, Sudipan; Delagrange, Hugues; Deloff, Andrzej; Denes, Ervin Sandor; D'Erasmo, Ginevra; De Caro, Annalisa; De Cataldo, Giacinto; De Cuveland, Jan; De Falco, Alessandro; De Gruttola, Daniele; De Marco, Nora; De Pasquale, Salvatore; De Rooij, Raoul Stefan; Diaz Corchero, Miguel Angel; Dietel, Thomas; Dillenseger, Pascal; Divia, Roberto; Di Bari, Domenico; Di Liberto, Sergio; Di Mauro, Antonio; Di Nezza, Pasquale; Djuvsland, Oeystein; Dobrin, Alexandru Florin; Dobrowolski, Tadeusz Antoni; Domenicis Gimenez, Diogenes; Donigus, Benjamin; Dordic, Olja; Dorheim, Sverre; Dubey, Anand Kumar; Dubla, Andrea; Ducroux, Laurent; Dupieux, Pascal; Dutt Mazumder, Abhee Kanti; Ehlers Iii, Raymond James; Elia, Domenico; Engel, Heiko; Erazmus, Barbara Ewa; Erdal, Hege Austrheim; Eschweiler, Dominic; Espagnon, Bruno; Esposito, Marco; Estienne, Magali Danielle; Esumi, Shinichi; Evans, David; Evdokimov, Sergey; Fabris, Daniela; Faivre, Julien; Falchieri, Davide; Fantoni, Alessandra; Fasel, Markus; Fehlker, Dominik; Feldkamp, Linus; Felea, Daniel; Feliciello, Alessandro; Feofilov, Grigory; Ferencei, Jozef; Fernandez Tellez, Arturo; Gonzalez Ferreiro, Elena; Ferretti, Alessandro; Festanti, Andrea; Figiel, Jan; Araujo Silva Figueredo, Marcel; Filchagin, Sergey; Finogeev, Dmitry; Fionda, Fiorella; Fiore, Enrichetta Maria; Floratos, Emmanouil; Floris, Michele; Foertsch, Siegfried Valentin; Foka, Panagiota; Fokin, Sergey; Fragiacomo, Enrico; Francescon, Andrea; Frankenfeld, Ulrich Michael; Fuchs, Ulrich; Furget, Christophe; Fusco Girard, Mario; Gaardhoeje, Jens Joergen; Gagliardi, Martino; Gago Medina, Alberto Martin; Gallio, Mauro; Gangadharan, Dhevan Raja; Ganoti, Paraskevi; Garabatos Cuadrado, Jose; Garcia-Solis, Edmundo Javier; Gargiulo, Corrado; Garishvili, Irakli; Gerhard, Jochen; Germain, Marie; Gheata, Andrei George; Gheata, Mihaela; Ghidini, Bruno; Ghosh, Premomoy; Ghosh, Sanjay Kumar; Gianotti, Paola; Giubellino, Paolo; Gladysz-Dziadus, Ewa; Glassel, Peter; Gomez Ramirez, Andres; Gonzalez Zamora, Pedro; Gorbunov, Sergey; Gorlich, Lidia Maria; Gotovac, Sven; Graczykowski, Lukasz Kamil; Grelli, Alessandro; Grigoras, Alina Gabriela; Grigoras, Costin; Grigoryev, Vladislav; Grigoryan, Ara; Grigoryan, Smbat; Grynyov, Borys; Grion, Nevio; Grosse-Oetringhaus, Jan Fiete; Grossiord, Jean-Yves; Grosso, Raffaele; Guber, Fedor; Guernane, Rachid; Guerzoni, Barbara; Guilbaud, Maxime Rene Joseph; Gulbrandsen, Kristjan Herlache; Gulkanyan, Hrant; Gumbo, Mervyn; Gunji, Taku; Gupta, Anik; Gupta, Ramni; Khan, Kamal; Haake, Rudiger; Haaland, Oystein Senneset; Hadjidakis, Cynthia Marie; Haiduc, Maria; Hamagaki, Hideki; Hamar, Gergoe; Hanratty, Luke David; Hansen, Alexander; Harris, John William; Hartmann, Helvi; Harton, Austin Vincent; Hatzifotiadou, Despina; Hayashi, Shinichi; Heckel, Stefan Thomas; Heide, Markus Ansgar; Helstrup, Haavard; Herghelegiu, Andrei Ionut; Herrera Corral, Gerardo Antonio; Hess, Benjamin Andreas; Hetland, Kristin Fanebust; Hippolyte, Boris; Hladky, Jan; Hristov, Peter Zahariev; Huang, Meidana; Humanic, Thomas; Hutter, Dirk; Hwang, Dae Sung; Ilkaev, Radiy; Ilkiv, Iryna; Inaba, Motoi; Innocenti, Gian Michele; Ionita, Costin; Ippolitov, Mikhail; Irfan, Muhammad; Ivanov, Marian; Ivanov, Vladimir; Jacholkowski, Adam Wlodzimierz; Jacobs, Peter Martin; Jahnke, Cristiane; Jang, Haeng Jin; Janik, Malgorzata Anna; Pahula Hewage, Sandun; Jena, Satyajit; Jimenez Bustamante, Raul Tonatiuh; Jones, Peter Graham; Jung, Hyungtaik; Jusko, Anton; Kadyshevskiy, Vladimir; Kalcher, Sebastian; Kalinak, Peter; Kalweit, Alexander Philipp; Kamin, Jason Adrian; Kang, Ju Hwan; Kaplin, Vladimir; Kar, Somnath; Karasu Uysal, Ayben; Karavichev, Oleg; Karavicheva, Tatiana; Karpechev, Evgeny; Kebschull, Udo Wolfgang; Keidel, Ralf; Khan, Mohammed Mohisin; Khan, Palash; Khan, Shuaib Ahmad; Khanzadeev, Alexei; Kharlov, Yury; Kileng, Bjarte; Kim, Beomkyu; Kim, Do Won; Kim, Dong Jo; Kim, Jinsook; Kim, Mimae; Kim, Minwoo; Kim, Se Yong; Kim, Taesoo; Kirsch, Stefan; Kisel, Ivan; Kiselev, Sergey; Kisiel, Adam Ryszard; Kiss, Gabor; Klay, Jennifer Lynn; Klein, Jochen; Klein-Boesing, Christian; Kluge, Alexander; Knichel, Michael Linus; Knospe, Anders Garritt; Kobdaj, Chinorat; Kohler, Markus Konrad; Kollegger, Thorsten; Kolozhvari, Anatoly; Kondratev, Valerii; Kondratyeva, Natalia; Konevskikh, Artem; Kovalenko, Vladimir; Kowalski, Marek; Kox, Serge; Koyithatta Meethaleveedu, Greeshma; Kral, Jiri; Kralik, Ivan; Kramer, Frederick; Kravcakova, Adela; Krelina, Michal; Kretz, Matthias; Krivda, Marian; Krizek, Filip; Kryshen, Evgeny; Krzewicki, Mikolaj; Kucera, Vit; Kucheryaev, Yury; Kugathasan, Thanushan; Kuhn, Christian Claude; Kuijer, Paulus Gerardus; Kulakov, Igor; Kumar, Jitendra; Kurashvili, Podist; Kurepin, Alexander; Kurepin, Alexey; Kuryakin, Alexey; Kushpil, Svetlana; Kweon, Min Jung; Kwon, Youngil; Ladron De Guevara, Pedro; Lagana Fernandes, Caio; Lakomov, Igor; Langoy, Rune; Lara Martinez, Camilo Ernesto; Lardeux, Antoine Xavier; Lattuca, Alessandra; La Pointe, Sarah Louise; La Rocca, Paola; Lea, Ramona; Leardini, Lucia; Lee, Graham Richard; Legrand, Iosif; Lehnert, Joerg Walter; Lemmon, Roy Crawford; Lenti, Vito; Leogrande, Emilia; Leoncino, Marco; Leon Monzon, Ildefonso; Levai, Peter; Li, Shuang; Lien, Jorgen Andre; Lietava, Roman; Lindal, Svein; Lindenstruth, Volker; Lippmann, Christian; Lisa, Michael Annan; Ljunggren, Hans Martin; Lodato, Davide Francesco; Lonne, Per-Ivar; Loggins, Vera Renee; Loginov, Vitaly; Lohner, Daniel; Loizides, Constantinos; Lopez, Xavier Bernard; Lopez Torres, Ernesto; Lu, Xianguo; Luettig, Philipp Johannes; Lunardon, Marcello; Luparello, Grazia; Luzzi, Cinzia; Ma, Rongrong; Maevskaya, Alla; Mager, Magnus; Mahapatra, Durga Prasad; Mahmood, Sohail Musa; Maire, Antonin; Majka, Richard Daniel; Malaev, Mikhail; Maldonado Cervantes, Ivonne Alicia; Malinina, Liudmila; Mal'Kevich, Dmitry; Malzacher, Peter; Mamonov, Alexander; Manceau, Loic Henri Antoine; Manko, Vladislav; Manso, Franck; Manzari, Vito; Marchisone, Massimiliano; Mares, Jiri; Margagliotti, Giacomo Vito; Margotti, Anselmo; Marin, Ana Maria; Markert, Christina; Marquard, Marco; Martashvili, Irakli; Martin, Nicole Alice; Martinengo, Paolo; Martinez Hernandez, Mario Ivan; Martinez-Garcia, Gines; Martin Blanco, Javier; Martynov, Yevgen; Mas, Alexis Jean-Michel; Masciocchi, Silvia; Masera, Massimo; Masoni, Alberto; Massacrier, Laure Marie; Mastroserio, Annalisa; Matyja, Adam Tomasz; Mayer, Christoph; Mazer, Joel Anthony; Mazzoni, Alessandra Maria; Meddi, Franco; Menchaca-Rocha, Arturo Alejandro; Mercado-Perez, Jorge; Meres, Michal; Miake, Yasuo; Mikhaylov, Konstantin; Milano, Leonardo; Milosevic, Jovan; Mischke, Andre; Mishra, Aditya Nath; Miskowiec, Dariusz Czeslaw; Mitra, Jubin; Mitu, Ciprian Mihai; Mlynarz, Jocelyn; Mohammadi, Naghmeh; Mohanty, Bedangadas; Molnar, Levente; Montano Zetina, Luis Manuel; Montes Prado, Esther; Morando, Maurizio; Moreira De Godoy, Denise Aparecida; Moretto, Sandra; Morreale, Astrid; Morsch, Andreas; Muccifora, Valeria; Mudnic, Eugen; Muhlheim, Daniel Michael; Muhuri, Sanjib; Mukherjee, Maitreyee; Muller, Hans; Gameiro Munhoz, Marcelo; Murray, Sean; Musa, Luciano; Musinsky, Jan; Nandi, Basanta Kumar; Nania, Rosario; Nappi, Eugenio; Nattrass, Christine; Nayak, Kishora; Nayak, Tapan Kumar; Nazarenko, Sergey; Nedosekin, Alexander; Nicassio, Maria; Niculescu, Mihai; Nielsen, Borge Svane; Nikolaev, Sergey; Nikulin, Sergey; Nikulin, Vladimir; Nilsen, Bjorn Steven; Noferini, Francesco; Nomokonov, Petr; Nooren, Gerardus; Nyanin, Alexander; Nystrand, Joakim Ingemar; Oeschler, Helmut Oskar; Oh, Saehanseul; Oh, Sun Kun; Okatan, Ali; Olah, Laszlo; Oleniacz, Janusz; Oliveira Da Silva, Antonio Carlos; Onderwaater, Jacobus; Oppedisano, Chiara; Ortiz Velasquez, Antonio; Oskarsson, Anders Nils Erik; Otwinowski, Jacek Tomasz; Oyama, Ken; Sahoo, Pragati; Pachmayer, Yvonne Chiara; Pachr, Milos; Pagano, Paola; Paic, Guy; Painke, Florian; Pajares Vales, Carlos; Pal, Susanta Kumar; Palmeri, Armando; Pant, Divyash; Papikyan, Vardanush; Pappalardo, Giuseppe; Pareek, Pooja; Park, Woojin; Parmar, Sonia; Passfeld, Annika; Patalakha, Dmitry; Paticchio, Vincenzo; Paul, Biswarup; Pawlak, Tomasz Jan; Peitzmann, Thomas; Pereira Da Costa, Hugo Denis Antonio; Pereira De Oliveira Filho, Elienos; Peresunko, Dmitry Yurevich; Perez Lara, Carlos Eugenio; Pesci, Alessandro; Peskov, Vladimir; Pestov, Yury; Petracek, Vojtech; Petran, Michal; Petris, Mariana; Petrovici, Mihai; Petta, Catia; Piano, Stefano; Pikna, Miroslav; Pillot, Philippe; Pinazza, Ombretta; Pinsky, Lawrence; Piyarathna, Danthasinghe; Ploskon, Mateusz Andrzej; Planinic, Mirko; Pluta, Jan Marian; Pochybova, Sona; Podesta Lerma, Pedro Luis Manuel; Poghosyan, Martin; Pohjoisaho, Esko Heikki Oskari; Polishchuk, Boris; Poljak, Nikola; Pop, Amalia; Porteboeuf, Sarah Julie; Porter, R Jefferson; Potukuchi, Baba; Prasad, Sidharth Kumar; Preghenella, Roberto; Prino, Francesco; Pruneau, Claude Andre; Pshenichnov, Igor; Puddu, Giovanna; Pujahari, Prabhat Ranjan; Punin, Valery; Putschke, Jorn Henning; Qvigstad, Henrik; Rachevski, Alexandre; Raha, Sibaji; Rak, Jan; Rakotozafindrabe, Andry Malala; Ramello, Luciano; Raniwala, Rashmi; Raniwala, Sudhir; Rasanen, Sami Sakari; Rascanu, Bogdan Theodor; Rathee, Deepika; Rauf, Aamer Wali; Razazi, Vahedeh; Read, Kenneth Francis; Real, Jean-Sebastien; Redlich, Krzysztof; Reed, Rosi Jan; Rehman, Attiq Ur; Reichelt, Patrick Simon; Reicher, Martijn; Reidt, Felix; Renfordt, Rainer Arno Ernst; Reolon, Anna Rita; Reshetin, Andrey; Rettig, Felix Vincenz; Revol, Jean-Pierre; Reygers, Klaus Johannes; Riabov, Viktor; Ricci, Renato Angelo; Richert, Tuva Ora Herenui; Richter, Matthias Rudolph; Riedler, Petra; Riegler, Werner; Riggi, Francesco; Rivetti, Angelo; Rocco, Elena; Rodriguez Cahuantzi, Mario; Rodriguez Manso, Alis; Roeed, Ketil; Rogochaya, Elena; Sharma, Rohni; Rohr, David Michael; Roehrich, Dieter; Romita, Rosa; Ronchetti, Federico; Rosnet, Philippe; Rossi, Andrea; Roukoutakis, Filimon; Roy, Ankhi; Roy, Christelle Sophie; Roy, Pradip Kumar; Rubio Montero, Antonio Juan; Rui, Rinaldo; Russo, Riccardo; Ryabinkin, Evgeny; Ryabov, Yury; Rybicki, Andrzej; Sadovskiy, Sergey; Safarik, Karel; Sahlmuller, Baldo; Sahoo, Raghunath; Sahu, Pradip Kumar; Saini, Jogender; Sakai, Shingo; Salgado Lopez, Carlos Alberto; Salzwedel, Jai Samuel Nielsen; Sambyal, Sanjeev Singh; Samsonov, Vladimir; Sanchez Castro, Xitzel; Sanchez Rodriguez, Fernando Javier; Sandor, Ladislav; Sandoval, Andres; Sano, Masato; Santagati, Gianluca; Sarkar, Debojit; Scapparone, Eugenio; Scarlassara, Fernando; Scharenberg, Rolf Paul; Schiaua, Claudiu Cornel; Schicker, Rainer Martin; Schmidt, Christian Joachim; Schmidt, Hans Rudolf; Schuchmann, Simone; Schukraft, Jurgen; Schulc, Martin; Schuster, Tim Robin; Schutz, Yves Roland; Schwarz, Kilian Eberhard; Schweda, Kai Oliver; Scioli, Gilda; Scomparin, Enrico; Scott, Rebecca Michelle; Segato, Gianfranco; Seger, Janet Elizabeth; Sekiguchi, Yuko; Selyuzhenkov, Ilya; Seo, Jeewon; Serradilla Rodriguez, Eulogio; Sevcenco, Adrian; Shabetai, Alexandre; Shabratova, Galina; Shahoyan, Ruben; Shangaraev, Artem; Sharma, Natasha; Sharma, Satish; Shigaki, Kenta; Shtejer Diaz, Katherin; Sibiryak, Yury; Siddhanta, Sabyasachi; Siemiarczuk, Teodor; Silvermyr, David Olle Rickard; Silvestre, Catherine Micaela; Simatovic, Goran; Singaraju, Rama Narayana; Singh, Ranbir; Singha, Subhash; Singhal, Vikas; Sinha, Bikash; Sarkar - Sinha, Tinku; Sitar, Branislav; Sitta, Mario; Skaali, Bernhard; Skjerdal, Kyrre; Slupecki, Maciej; Smirnov, Nikolai; Snellings, Raimond; Soegaard, Carsten; Soltz, Ron Ariel; Song, Jihye; Song, Myunggeun; Soramel, Francesca; Sorensen, Soren Pontoppidan; Spacek, Michal; Sputowska, Iwona Anna; Spyropoulou-Stassinaki, Martha; Srivastava, Brijesh Kumar; Stachel, Johanna; Stan, Ionel; Stefanek, Grzegorz; Steinpreis, Matthew Donald; Stenlund, Evert Anders; Steyn, Gideon Francois; Stiller, Johannes Hendrik; Stocco, Diego; Stolpovskiy, Mikhail; Strmen, Peter; Alarcon Do Passo Suaide, Alexandre; Sugitate, Toru; Suire, Christophe Pierre; Suleymanov, Mais Kazim Oglu; Sultanov, Rishat; Sumbera, Michal; Susa, Tatjana; Symons, Timothy; Szabo, Alexander; Szanto De Toledo, Alejandro; Szarka, Imrich; Szczepankiewicz, Adam; Szymanski, Maciej Pawel; Takahashi, Jun; Tangaro, Marco-Antonio; Tapia Takaki, Daniel Jesus; Tarantola Peloni, Attilio; Tarazona Martinez, Alfonso; Tarzila, Madalina-Gabriela; Tauro, Arturo; Tejeda Munoz, Guillermo; Telesca, Adriana; Terrevoli, Cristina; Thaeder, Jochen Mathias; Thomas, Deepa; Tieulent, Raphael Noel; Timmins, Anthony Robert; Toia, Alberica; Torii, Hisayuki; Trubnikov, Victor; Trzaska, Wladyslaw Henryk; Tsuji, Tomoya; Tumkin, Alexandr; Turrisi, Rosario; Tveter, Trine Spedstad; Ulery, Jason Glyndwr; Ullaland, Kjetil; Uras, Antonio; Usai, Gianluca; Vajzer, Michal; Vala, Martin; Valencia Palomo, Lizardo; Vallero, Sara; Vande Vyvre, Pierre; Vannucci, Luigi; Van Der Maarel, Jasper; Van Hoorne, Jacobus Willem; Van Leeuwen, Marco; Diozcora Vargas Trevino, Aurora; Vargyas, Marton; Varma, Raghava; Vasileiou, Maria; Vasiliev, Andrey; Vechernin, Vladimir; Veldhoen, Misha; Velure, Arild; Venaruzzo, Massimo; Vercellin, Ermanno; Vergara Limon, Sergio; Vernet, Renaud; Verweij, Marta; Vickovic, Linda; Viesti, Giuseppe; Viinikainen, Jussi Samuli; Vilakazi, Zabulon; Villalobos Baillie, Orlando; Vinogradov, Alexander; Vinogradov, Leonid; Vinogradov, Yury; Virgili, Tiziano; Viyogi, Yogendra; Vodopyanov, Alexander; Volkl, Martin Andreas; Voloshin, Kirill; Voloshin, Sergey; Volpe, Giacomo; Von Haller, Barthelemy; Vorobyev, Ivan; Vranic, Danilo; Vrlakova, Janka; Vulpescu, Bogdan; Vyushin, Alexey; Wagner, Boris; Wagner, Jan; Wagner, Vladimir; Wang, Mengliang; Wang, Yifei; Watanabe, Daisuke; Weber, Michael; Wessels, Johannes Peter; Westerhoff, Uwe; Wiechula, Jens; Wikne, Jon; Wilde, Martin Rudolf; Wilk, Grzegorz Andrzej; Wilkinson, Jeremy John; Williams, Crispin; Windelband, Bernd Stefan; Winn, Michael Andreas; Xiang, Changzhou; Yaldo, Chris G; Yamaguchi, Yorito; Yang, Hongyan; Yang, Ping; Yang, Shiming; Yano, Satoshi; Yasnopolskiy, Stanislav; Yi, Jungyu; Yin, Zhongbao; Yoo, In-Kwon; Yushmanov, Igor; Zaccolo, Valentina; Zach, Cenek; Zaman, Ali; Zampolli, Chiara; Zaporozhets, Sergey; Zarochentsev, Andrey; Zavada, Petr; Zavyalov, Nikolay; Zbroszczyk, Hanna Paulina; Zgura, Sorin Ion; Zhalov, Mikhail; Zhang, Haitao; Zhang, Xiaoming; Zhang, Yonghong; Zhao, Chengxin; Zhigareva, Natalia; Zhou, Daicui; Zhou, Fengchu; Zhou, You; Zhou, Zhuo; Zhu, Hongsheng; Zhu, Jianhui; Zhu, Xiangrong; Zichichi, Antonino; Zimmermann, Alice; Zimmermann, Markus Bernhard; Zinovjev, Gennady; Zoccarato, Yannick Denis; Zyzak, Maksym

    2014-11-04

    In 2013, the Large Hadron Collider provided proton-lead and lead-proton collisions at the center-of-mass energy per nucleon pair $\\sqrt{s_{NN}}$ = 5.02 TeV. Van der Meer scans were performed for both configurations of colliding beams, and the cross section was measured for two reference processes, based on particle detection by the T0 and V0 detectors, with pseudo-rapidity coverage 4.6 < $\\eta$ < 4.9, -3.3 < $\\eta$ < -3.0 and 2.8 < $\\eta$ < 5.1, -3.7 < $\\eta$ < -1.7, respectively. Given the asymmetric detector acceptance, the cross section was measured separately for the two configurations. The measured visible cross sections are used to calculate the integrated luminosity of the proton-lead and lead-proton data samples, and to indirectly measure the cross section for a third, configuration-independent, reference process, based on neutron detection by the Zero Degree Calorimeters.

  9. Proton-proton bremsstrahlung

    International Nuclear Information System (INIS)

    Fearing, H.W.

    1990-01-01

    We summarize some of the information about the nucleon-nucleon force which has been obtained by comparing recent calculations of proton-proton bremsstrahlung with cross section and analyzing power data from the new TRIUMF bremsstrahlung experiment. Some comments are made as to how these results can be extended to neutron-proton bremsstrahlung. (Author) 17 refs., 6 figs

  10. SU-E-T-110: An Investigation On Monitor Unit Threshold and Effects On IMPT Delivery in Proton Pencil Beam Planning System

    International Nuclear Information System (INIS)

    Syh, J; Ding, X; Syh, J; Patel, B; Rosen, L; Wu, H

    2015-01-01

    Purpose: An approved proton pencil beam scanning (PBS) treatment plan might not be able to deliver because of existed extremely low monitor unit per beam spot. A dual hybrid plan with higher efficiency of higher spot monitor unit and the efficacy of less number of energy layers were searched and optimized. The range of monitor unit threshold setting was investigated and the plan quality was evaluated by target dose conformity. Methods: Certain limitations and requirements need to be checks and tested before a nominal proton PBS treatment plan can be delivered. The plan needs to be met the machine characterization, specification in record and verification to deliver the beams. Minimal threshold of monitor unit, e.g. 0.02, per spot was set to filter the low counts and plan was re-computed. Further MU threshold increment was tested in sequence without sacrificing the plan quality. The number of energy layer was also alternated due to elimination of low count layer(s). Results: Minimal MU/spot threshold, spot spacing in each energy layer and total number of energy layer and the MU weighting of beam spots of each beam were evaluated. Plan optimization between increases of the spot MU (efficiency) and less energy layers of delivery (efficacy) was adjusted. 5% weighting limit of total monitor unit per beam was feasible. Scarce spreading of beam spots was not discouraging as long as target dose conformity within 3% criteria. Conclusion: Each spot size is equivalent to the relative dose in the beam delivery system. The energy layer is associated with the depth of the targeting tumor. Our work is crucial to maintain the best possible quality plan. To keep integrity of all intrinsic elements such as spot size, spot number, layer number and the carried weighting of spots in each layer is important in this study

  11. SU-E-T-396: Dosimetric Accuracy of Proton Therapy for Patients with Metal Implants in CT Scans Using Metal Deletion Technique (MDT) Artifacts Reduction

    International Nuclear Information System (INIS)

    Li, X; Kantor, M; Zhu, X; Frank, S; Sahoo, N; Li, H

    2014-01-01

    Purpose: To evaluate the dosimetric accuracy for proton therapy patients with metal implants in CT using metal deletion technique (MDT) artifacts reduction. Methods: Proton dose accuracies under CT metal artifacts were first evaluated using a water phantom with cylindrical inserts of different materials (titanium and steel). Ranges and dose profiles along different beam angles were calculated using treatment planning system (Eclipse version 8.9) on uncorrected CT, MDT CT, and manually-corrected CT, where true Hounsfield units (water) were assigned to the streak artifacts. In patient studies, the treatment plans were developed on manually-corrected CTs, then recalculated on MDT and uncorrected CTs. DVH indices were compared between the dose distributions on all the CTs. Results: For water phantom study with 1/2 inch titanium insert, the proton range differences estimated by MDT CT were with 1% for all beam angles, while the range error can be up to 2.6% for uncorrected CT. For the study with 1 inch stainless steel insert, the maximum range error calculated by MDT CT was 1.09% among all the beam angles compared with maximum range error with 4.7% for uncorrected CT. The dose profiles calculated on MDT CTs for both titanium and steel inserts showed very good agreements with the ones calculated on manually-corrected CTs, while large dose discrepancies calculated using uncorrected CTs were observed in the distal end region of the proton beam. The patient study showed similar dose distribution and DVHs for organs near the metal artifacts recalculated on MDT CT compared with the ones calculated on manually-corrected CT, while the differences between uncorrected and corrected CTs were much pronounced. Conclusion: In proton therapy, large dose error could occur due to metal artifact. The MDT CT can be used for proton dose calculation to achieve similar dose accuracy as the current clinical practice using manual correction

  12. Prevention of haematoma progression by tranexamic acid in intracerebral haemorrhage patients with and without spot sign on admission scan: a statistical analysis plan of a pre-specified sub-study of the TICH-2 trial.

    Science.gov (United States)

    Ovesen, Christian; Jakobsen, Janus Christian; Gluud, Christian; Steiner, Thorsten; Law, Zhe; Flaherty, Katie; Dineen, Rob A; Bath, Philip M; Sprigg, Nikola; Christensen, Hanne

    2018-06-13

    We present the statistical analysis plan of a prespecified Tranexamic Acid for Hyperacute Primary Intracerebral Haemorrhage (TICH)-2 sub-study aiming to investigate, if tranexamic acid has a different effect in intracerebral haemorrhage patients with the spot sign on admission compared to spot sign negative patients. The TICH-2 trial recruited above 2000 participants with intracerebral haemorrhage arriving in hospital within 8 h after symptom onset. They were included irrespective of radiological signs of on-going haematoma expansion. Participants were randomised to tranexamic acid versus matching placebo. In this subgroup analysis, we will include all participants in TICH-2 with a computed tomography angiography on admission allowing adjudication of the participants' spot sign status. Primary outcome will be the ability of tranexamic acid to limit absolute haematoma volume on computed tomography at 24 h (± 12 h) after randomisation among spot sign positive and spot sign negative participants, respectively. Within all outcome measures, the effect of tranexamic acid in spot sign positive/negative participants will be compared using tests of interaction. This sub-study will investigate the important clinical hypothesis that spot sign positive patients might benefit more from administration of tranexamic acid compared to spot sign negative patients. Trial registration ISRCTN93732214 ( http://www.isrctn.com ).

  13. Relationship between hot spot residues and ligand binding hot spots in protein-protein interfaces.

    Science.gov (United States)

    Zerbe, Brandon S; Hall, David R; Vajda, Sandor; Whitty, Adrian; Kozakov, Dima

    2012-08-27

    In the context of protein-protein interactions, the term "hot spot" refers to a residue or cluster of residues that makes a major contribution to the binding free energy, as determined by alanine scanning mutagenesis. In contrast, in pharmaceutical research, a hot spot is a site on a target protein that has high propensity for ligand binding and hence is potentially important for drug discovery. Here we examine the relationship between these two hot spot concepts by comparing alanine scanning data for a set of 15 proteins with results from mapping the protein surfaces for sites that can bind fragment-sized small molecules. We find the two types of hot spots are largely complementary; the residues protruding into hot spot regions identified by computational mapping or experimental fragment screening are almost always themselves hot spot residues as defined by alanine scanning experiments. Conversely, a residue that is found by alanine scanning to contribute little to binding rarely interacts with hot spot regions on the partner protein identified by fragment mapping. In spite of the strong correlation between the two hot spot concepts, they fundamentally differ, however. In particular, while identification of a hot spot by alanine scanning establishes the potential to generate substantial interaction energy with a binding partner, there are additional topological requirements to be a hot spot for small molecule binding. Hence, only a minority of hot spots identified by alanine scanning represent sites that are potentially useful for small inhibitor binding, and it is this subset that is identified by experimental or computational fragment screening.

  14. Luminescence imaging of water during proton-beam irradiation for range estimation

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Seiichi, E-mail: s-yama@met.nagoya-u.ac.jp; Okumura, Satoshi; Komori, Masataka [Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya 461-8673 (Japan); Toshito, Toshiyuki [Department of Proton Therapy Physics, Nagoya Proton Therapy Center, Nagoya City West Medical Center, Nagoya 462-8508 (Japan)

    2015-11-15

    Purpose: Proton therapy has the ability to selectively deliver a dose to the target tumor, so the dose distribution should be accurately measured by a precise and efficient method. The authors found that luminescence was emitted from water during proton irradiation and conjectured that this phenomenon could be used for estimating the dose distribution. Methods: To achieve more accurate dose distribution, the authors set water phantoms on a table with a spot scanning proton therapy system and measured the luminescence images of these phantoms with a high-sensitivity, cooled charge coupled device camera during proton-beam irradiation. The authors imaged the phantoms of pure water, fluorescein solution, and an acrylic block. Results: The luminescence images of water phantoms taken during proton-beam irradiation showed clear Bragg peaks, and the measured proton ranges from the images were almost the same as those obtained with an ionization chamber. Furthermore, the image of the pure-water phantom showed almost the same distribution as the tap-water phantom, indicating that the luminescence image was not related to impurities in the water. The luminescence image of the fluorescein solution had ∼3 times higher intensity than water, with the same proton range as that of water. The luminescence image of the acrylic phantom had a 14.5% shorter proton range than that of water; the proton range in the acrylic phantom generally matched the calculated value. The luminescence images of the tap-water phantom during proton irradiation could be obtained in less than 2 s. Conclusions: Luminescence imaging during proton-beam irradiation is promising as an effective method for range estimation in proton therapy.

  15. Luminescence imaging of water during proton-beam irradiation for range estimation

    International Nuclear Information System (INIS)

    Yamamoto, Seiichi; Okumura, Satoshi; Komori, Masataka; Toshito, Toshiyuki

    2015-01-01

    Purpose: Proton therapy has the ability to selectively deliver a dose to the target tumor, so the dose distribution should be accurately measured by a precise and efficient method. The authors found that luminescence was emitted from water during proton irradiation and conjectured that this phenomenon could be used for estimating the dose distribution. Methods: To achieve more accurate dose distribution, the authors set water phantoms on a table with a spot scanning proton therapy system and measured the luminescence images of these phantoms with a high-sensitivity, cooled charge coupled device camera during proton-beam irradiation. The authors imaged the phantoms of pure water, fluorescein solution, and an acrylic block. Results: The luminescence images of water phantoms taken during proton-beam irradiation showed clear Bragg peaks, and the measured proton ranges from the images were almost the same as those obtained with an ionization chamber. Furthermore, the image of the pure-water phantom showed almost the same distribution as the tap-water phantom, indicating that the luminescence image was not related to impurities in the water. The luminescence image of the fluorescein solution had ∼3 times higher intensity than water, with the same proton range as that of water. The luminescence image of the acrylic phantom had a 14.5% shorter proton range than that of water; the proton range in the acrylic phantom generally matched the calculated value. The luminescence images of the tap-water phantom during proton irradiation could be obtained in less than 2 s. Conclusions: Luminescence imaging during proton-beam irradiation is promising as an effective method for range estimation in proton therapy

  16. Crack imaging by pulsed laser spot thermography

    International Nuclear Information System (INIS)

    Li, T; Almond, D P; Rees, D A S; Weekes, B

    2010-01-01

    A surface crack close to a spot heated by a laser beam impedes lateral heat flow and produces alterations to the shape of the thermal image of the spot that can be monitored by thermography. A full 3D simulation has been developed to simulate heat flow from a laser heated spot in the proximity of a crack. The modelling provided an understanding of the ways that different parameters affect the thermal images of laser heated spots. It also assisted in the development of an efficient image processing strategy for extracting the scanned cracks. Experimental results show that scanning pulsed laser spot thermography has considerable potential as a remote, non-contact crack imaging technique.

  17. Rapid rock analysis and microprobe scanning of dermatological material using proton-induced x-ray and γ-ray emission

    International Nuclear Information System (INIS)

    Carlsson, L.E.

    1983-01-01

    The dissertation report comprises 6 articles that have or will appear in open literature. The use of PIXE and PIGE analysis techniques on geological materials, and also on drill cores, is discussed. The accuracy of the methods have been tested on standards. The effect of sample thickness has been studied. A proton microprobe has been compared with an electron microprobe on human skin sections. Both probes give highly reproducible results, but a small systematic deviation between the probes is found. (author)

  18. Ion Prostate Irradiation (IPI) – a pilot study to establish the safety and feasibility of primary hypofractionated irradiation of the prostate with protons and carbon ions in a raster scan technique

    International Nuclear Information System (INIS)

    Habl, Gregor; Herfarth, Klaus; Hatiboglu, Gencay; Edler, Lutz; Uhl, Matthias; Krause, Sonja; Roethke, Matthias; Schlemmer, Heinz P; Hadaschik, Boris; Debus, Juergen

    2014-01-01

    Due to physical characteristics, ions like protons or carbon ions can administer the dose to the target volume more efficiently than photons since the dose can be lowered at the surrounding normal tissue. Radiation biological considerations are based on the assumption that the α/β value for prostate cancer cells is 1.5 Gy, so that a biologically more effective dose could be administered due to hypofractionation without increasing risks of late effects of bladder (α/β = 4.0) and rectum (α/β = 3.9). The IPI study is a prospective randomized phase II study exploring the safety and feasibility of primary hypofractionated irradiation of the prostate with protons and carbon ions in a raster scan technique. The study is designed to enroll 92 patients with localized prostate cancer. Primary aim is the assessment of the safety and feasibility of the study treatment on the basis of incidence grade III and IV NCI-CTC-AE (v. 4.02) toxicity and/or the dropout of the patient from the planned therapy due to any reason. Secondary endpoints are PSA-progression free survival (PSA-PFS), overall survival (OS) and quality-of-life (QoL). This pilot study aims at the evaluation of the safety and feasibility of hypofractionated irradiation of the prostate with protons and carbon ions in prostate cancer patients in an active beam technique. Additionally, the safety results will be compared with Japanese results recently published for carbon ion irradiation. Due to the missing data of protons in this hypofractionated scheme, an in depth evaluation of the toxicity will be created to gain basic data for a following comparison study with carbon ion irradiation. Clinical Trial Identifier: http://clinicaltrials.gov/show/NCT01641185 (clinicaltrials.gov)

  19. Registration of pencil beam proton radiography data with X-ray CT.

    Science.gov (United States)

    Deffet, Sylvain; Macq, Benoît; Righetto, Roberto; Vander Stappen, François; Farace, Paolo

    2017-10-01

    Proton radiography seems to be a promising tool for assessing the quality of the stopping power computation in proton therapy. However, range error maps obtained on the basis of proton radiographs are very sensitive to small misalignment between the planning CT and the proton radiography acquisitions. In order to be able to mitigate misalignment in postprocessing, the authors implemented a fast method for registration between pencil proton radiography data obtained with a multilayer ionization chamber (MLIC) and an X-ray CT acquired on a head phantom. The registration was performed by optimizing a cost function which performs a comparison between the acquired data and simulated integral depth-dose curves. Two methodologies were considered, one based on dual orthogonal projections and the other one on a single projection. For each methodology, the robustness of the registration algorithm with respect to three confounding factors (measurement noise, CT calibration errors, and spot spacing) was investigated by testing the accuracy of the method through simulations based on a CT scan of a head phantom. The present registration method showed robust convergence towards the optimal solution. For the level of measurement noise and the uncertainty in the stopping power computation expected in proton radiography using a MLIC, the accuracy appeared to be better than 0.3° for angles and 0.3 mm for translations by use of the appropriate cost function. The spot spacing analysis showed that a spacing larger than the 5 mm used by other authors for the investigation of a MLIC for proton radiography led to results with absolute accuracy better than 0.3° for angles and 1 mm for translations when orthogonal proton radiographs were fed into the algorithm. In the case of a single projection, 6 mm was the largest spot spacing presenting an acceptable registration accuracy. For registration of proton radiography data with X-ray CT, the use of a direct ray-tracing algorithm to compute

  20. SU-E-T-566: Neutron Dose Cloud Map for Compact ProteusONE Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Syh, J; Patel, B; Syh, J; Rosen, L; Wu, H [Willis-Knighton Medical Center, Shreveport, LA (United States)

    2015-06-15

    Purpose: To establish the base line of neutron cloud during patient treatment in our new compact Proteus One proton pencil beam scanning (PBS) system with various beam delivery gantry angles, with or without range shifter (RS) at different body sites. Pencil beam scanning is an emerging treatment technique, for the concerns of neutron exposure, this study is to evaluate the neutron dose equivalent per given delivered dose under various treatment conditions at our proton therapy center. Methods: A wide energy neutron dose equivalent detector (SWENDI-II, Thermo Scientific, MA) was used for neutron dose measurements. It was conducted in the proton therapy vault during beam was on. The measurement location was specifically marked in order to obtain the equivalent dose of neutron activities (H). The distances of 100, 150 and 200 cm at various locations are from the patient isocenter. The neutron dose was measured of proton energy layers, # of spots, maximal energy range, modulation width, field radius, gantry angle, snout position and delivered dose in CGE. The neutron dose cloud is reproducible and is useful for the future reference. Results: When distance increased the neutron equivalent dose (H) reading did not decrease rapidly with changes of proton energy range, modulation width or spot layers. For cranial cases, the average mSv/CGE was about 0.02 versus 0.032 for pelvis cases. RS will induce higher H to be 0.10 mSv/CGE in average. Conclusion: From this study, neutron per dose ratio (mSv/CGE) slightly depends upon various treatment parameters for pencil beams. For similar treatment conditions, our measurement demonstrates this value for pencil beam scanning beam has lowest than uniform scanning or passive scattering beam with a factor of 5. This factor will be monitored continuously for other upcoming treatment parameters in our facility.

  1. Rocky Mountain spotted fever

    Science.gov (United States)

    ... spotted fever on the foot Rocky Mountain spotted fever, petechial rash Antibodies Deer and dog tick References McElligott SC, Kihiczak GG, Schwartz RA. Rocky Mountain spotted fever and other rickettsial infections. In: Lebwohl MG, Heymann ...

  2. A comparison of two prompt gamma imaging techniques with collimator-based cameras for range verification in proton therapy

    Science.gov (United States)

    Lin, Hsin-Hon; Chang, Hao-Ting; Chao, Tsi-Chian; Chuang, Keh-Shih

    2017-08-01

    In vivo range verification plays an important role in proton therapy to fully utilize the benefits of the Bragg peak (BP) for delivering high radiation dose to tumor, while sparing the normal tissue. For accurately locating the position of BP, camera equipped with collimators (multi-slit and knife-edge collimator) to image prompt gamma (PG) emitted along the proton tracks in the patient have been proposed for range verification. The aim of the work is to compare the performance of multi-slit collimator and knife-edge collimator for non-invasive proton beam range verification. PG imaging was simulated by a validated GATE/GEANT4 Monte Carlo code to model the spot-scanning proton therapy and cylindrical PMMA phantom in detail. For each spot, 108 protons were simulated. To investigate the correlation between the acquired PG profile and the proton range, the falloff regions of PG profiles were fitted with a 3-line-segment curve function as the range estimate. Factors including the energy window setting, proton energy, phantom size, and phantom shift that may influence the accuracy of detecting range were studied. Results indicated that both collimator systems achieve reasonable accuracy and good response to the phantom shift. The accuracy of range predicted by multi-slit collimator system is less affected by the proton energy, while knife-edge collimator system can achieve higher detection efficiency that lead to a smaller deviation in predicting range. We conclude that both collimator systems have potentials for accurately range monitoring in proton therapy. It is noted that neutron contamination has a marked impact on range prediction of the two systems, especially in multi-slit system. Therefore, a neutron reduction technique for improving the accuracy of range verification of proton therapy is needed.

  3. Proton solar flares

    International Nuclear Information System (INIS)

    Shaposhnikova, E.F.

    1979-01-01

    The observations of proton solar flares have been carried out in 1950-1958 using the extrablackout coronograph of the Crimea astrophysical observatory. The experiments permit to determine two characteristic features of flares: the directed motion of plasma injection flux from the solar depths and the appearance of a shock wave moving from the place of the injection along the solar surface. The appearance of the shock wave is accompanied by some phenomena occuring both in the sunspot zone and out of it. The consistent flash of proton flares in the other groups of spots, the disappearance of fibres and the appearance of eruptive prominences is accomplished in the sunspot zone. Beyond the sunspot zone the flares occur above spots, the fibres disintegrate partially or completely and the eruptive prominences appear in the regions close to the pole

  4. High resolution Cerenkov light imaging of induced positron distribution in proton therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Seiichi, E-mail: s-yama@met.nagoya-u.ac.jp; Fujii, Kento; Morishita, Yuki; Okumura, Satoshi; Komori, Masataka [Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Aichi 461-8673 (Japan); Toshito, Toshiyuki [Department of Proton Therapy Physics, Nagoya Proton Therapy Center, Nagoya City West Medical Center, Aichi 462-8508 (Japan)

    2014-11-01

    Purpose: In proton therapy, imaging of the positron distribution produced by fragmentation during or soon after proton irradiation is a useful method to monitor the proton range. Although positron emission tomography (PET) is typically used for this imaging, its spatial resolution is limited. Cerenkov light imaging is a new molecular imaging technology that detects the visible photons that are produced from high-speed electrons using a high sensitivity optical camera. Because its inherent spatial resolution is much higher than PET, the authors can measure more precise information of the proton-induced positron distribution with Cerenkov light imaging technology. For this purpose, they conducted Cerenkov light imaging of induced positron distribution in proton therapy. Methods: First, the authors evaluated the spatial resolution of our Cerenkov light imaging system with a {sup 22}Na point source for the actual imaging setup. Then the transparent acrylic phantoms (100 × 100 × 100 mm{sup 3}) were irradiated with two different proton energies using a spot scanning proton therapy system. Cerenkov light imaging of each phantom was conducted using a high sensitivity electron multiplied charge coupled device (EM-CCD) camera. Results: The Cerenkov light’s spatial resolution for the setup was 0.76 ± 0.6 mm FWHM. They obtained high resolution Cerenkov light images of the positron distributions in the phantoms for two different proton energies and made fused images of the reference images and the Cerenkov light images. The depths of the positron distribution in the phantoms from the Cerenkov light images were almost identical to the simulation results. The decay curves derived from the region-of-interests (ROIs) set on the Cerenkov light images revealed that Cerenkov light images can be used for estimating the half-life of the radionuclide components of positrons. Conclusions: High resolution Cerenkov light imaging of proton-induced positron distribution was possible. The

  5. High resolution Cerenkov light imaging of induced positron distribution in proton therapy

    International Nuclear Information System (INIS)

    Yamamoto, Seiichi; Fujii, Kento; Morishita, Yuki; Okumura, Satoshi; Komori, Masataka; Toshito, Toshiyuki

    2014-01-01

    Purpose: In proton therapy, imaging of the positron distribution produced by fragmentation during or soon after proton irradiation is a useful method to monitor the proton range. Although positron emission tomography (PET) is typically used for this imaging, its spatial resolution is limited. Cerenkov light imaging is a new molecular imaging technology that detects the visible photons that are produced from high-speed electrons using a high sensitivity optical camera. Because its inherent spatial resolution is much higher than PET, the authors can measure more precise information of the proton-induced positron distribution with Cerenkov light imaging technology. For this purpose, they conducted Cerenkov light imaging of induced positron distribution in proton therapy. Methods: First, the authors evaluated the spatial resolution of our Cerenkov light imaging system with a 22 Na point source for the actual imaging setup. Then the transparent acrylic phantoms (100 × 100 × 100 mm 3 ) were irradiated with two different proton energies using a spot scanning proton therapy system. Cerenkov light imaging of each phantom was conducted using a high sensitivity electron multiplied charge coupled device (EM-CCD) camera. Results: The Cerenkov light’s spatial resolution for the setup was 0.76 ± 0.6 mm FWHM. They obtained high resolution Cerenkov light images of the positron distributions in the phantoms for two different proton energies and made fused images of the reference images and the Cerenkov light images. The depths of the positron distribution in the phantoms from the Cerenkov light images were almost identical to the simulation results. The decay curves derived from the region-of-interests (ROIs) set on the Cerenkov light images revealed that Cerenkov light images can be used for estimating the half-life of the radionuclide components of positrons. Conclusions: High resolution Cerenkov light imaging of proton-induced positron distribution was possible. The authors

  6. The Amsterdam proton microbeam

    International Nuclear Information System (INIS)

    Bos, A.J.J.

    1984-01-01

    The aim of the work presented in this thesis is to develop a microbeam setup such that small beam spot sizes can be produced routinely, and to investigate the capabilities of the setup for micro-PIXE analysis. The development and performance of the Amsterdam proton microbeam setup are described. The capabilities of the setup for micro-PIXE are shown with an investigation into the presence of trace elements in human hair. (Auth.)

  7. CRionScan: A stand-alone real time controller designed to perform ion beam imaging, dose controlled irradiation and proton beam writing

    Science.gov (United States)

    Daudin, L.; Barberet, Ph.; Serani, L.; Moretto, Ph.

    2013-07-01

    High resolution ion microbeams, usually used to perform elemental mapping, low dose targeted irradiation or ion beam lithography needs a very flexible beam control system. For this purpose, we have developed a dedicated system (called “CRionScan”), on the AIFIRA facility (Applications Interdisciplinaires des Faisceaux d'Ions en Région Aquitaine). It consists of a stand-alone real-time scanning and imaging instrument based on a Compact Reconfigurable Input/Output (Compact RIO) device from National Instruments™. It is based on a real-time controller, a Field Programmable Gate Array (FPGA), input/output modules and Ethernet connectivity. We have implemented a fast and deterministic beam scanning system interfaced with our commercial data acquisition system without any hardware development. CRionScan is built under LabVIEW™ and has been used on AIFIRA's nanobeam line since 2009 (Barberet et al., 2009, 2011) [1,2]. A Graphical User Interface (GUI) embedded in the Compact RIO as a web page is used to control the scanning parameters. In addition, a fast electrostatic beam blanking trigger has been included in the FPGA and high speed counters (15 MHz) have been implemented to perform dose controlled irradiation and on-line images on the GUI. Analog to Digital converters are used for the beam current measurement and in the near future for secondary electrons imaging. Other functionalities have been integrated in this controller like LED lighting using Pulse Width Modulation and a “NIM Wilkinson ADC” data acquisition.

  8. CRionScan: A stand-alone real time controller designed to perform ion beam imaging, dose controlled irradiation and proton beam writing

    Energy Technology Data Exchange (ETDEWEB)

    Daudin, L., E-mail: daudin@cenbg.in2p3.fr [Université Bordeaux, CENBG, UMR 5797, F-33170 Gradignan (France); CNRS, IN2P3, CENBG, UMR 5797, F-33170 Gradignan (France); Barberet, Ph.; Serani, L.; Moretto, Ph. [Université Bordeaux, CENBG, UMR 5797, F-33170 Gradignan (France); CNRS, IN2P3, CENBG, UMR 5797, F-33170 Gradignan (France)

    2013-07-01

    High resolution ion microbeams, usually used to perform elemental mapping, low dose targeted irradiation or ion beam lithography needs a very flexible beam control system. For this purpose, we have developed a dedicated system (called “CRionScan”), on the AIFIRA facility (Applications Interdisciplinaires des Faisceaux d’Ions en Région Aquitaine). It consists of a stand-alone real-time scanning and imaging instrument based on a Compact Reconfigurable Input/Output (Compact RIO) device from National Instruments™. It is based on a real-time controller, a Field Programmable Gate Array (FPGA), input/output modules and Ethernet connectivity. We have implemented a fast and deterministic beam scanning system interfaced with our commercial data acquisition system without any hardware development. CRionScan is built under LabVIEW™ and has been used on AIFIRA’s nanobeam line since 2009 (Barberet et al., 2009, 2011) [1,2]. A Graphical User Interface (GUI) embedded in the Compact RIO as a web page is used to control the scanning parameters. In addition, a fast electrostatic beam blanking trigger has been included in the FPGA and high speed counters (15 MHz) have been implemented to perform dose controlled irradiation and on-line images on the GUI. Analog to Digital converters are used for the beam current measurement and in the near future for secondary electrons imaging. Other functionalities have been integrated in this controller like LED lighting using Pulse Width Modulation and a “NIM Wilkinson ADC” data acquisition.

  9. SU-F-T-195: Systematic Constraining of Contralateral Parotid Gland Led to Improved Dosimetric Outcomes for Multi-Field Optimization with Scanning Beam Proton Therapy: Promising Results From a Pilot Study in Patients with Base of Tongue Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Wu, R; Liu, A; Poenisch, F; Palmer, M; Gillin, M; Zhu, X [Department of Radiation Physics, UT MD Anderson Cancer Center, Houston, TX (United States); Crowford, C; Georges, R; Amin, M [Department of Medical Dosimetry, MD Anderson Cancer Ctr, Houston, TX (United States); Sio, T; Gunn, B; Frank, S [Radiation Oncology Department MD Anderson Cancer Ctr, Houston, TX (United States)

    2016-06-15

    Purpose: Treatment planning for Intensity Modulated Proton Therapy (IMPT) for head and neck cancer is time-consuming due to the large number of organs-at-risk (OAR) to be considered. As there are many competing objectives and also wide range of acceptable OAR constraints, the final approved plan may not be most optimal for the given structures. We evaluated the dose reduction to the contralateral parotid by implementing standardized constraints during optimization for scanning beam proton therapy planning. Methods: Twenty-four (24) consecutive patients previously treated for base of tongue carcinoma were retrospectively selected. The doses were 70Gy, 63Gy and 57Gy (SIB in 33 fractions) for high-, intermediate-, and standard-risk clinical target volumes (CTV), respectively; the treatment included bilateral neck. Scanning beams using MFO with standardized bilateral anterior oblique and PA fields were applied. New plans where then developed and optimized by employing additional contralateral parotid constraints at multiple defined dose levels. Using a step-wise iterative process, the volume-based constraints at each level were then further reduced until known target coverages were compromised. The newly developed plans were then compared to the original clinically approved plans using paired student t-testing. Results: All 24 newly optimized treatment plans maintained initial plan quality as compared to the approved plans, and the 98% prescription dose coverage to the CTV’s were not compromised. Representative DVH comparison is shown in FIGURE 1. The contralateral parotid doses were reduced at all levels of interest when systematic constraints were applied to V10, V20, V30 and V40Gy (All P<0.0001; TABLE 1). Overall, the mean contralateral parotid doses were reduced by 2.26 Gy on average, a ∼13% relative improvement. Conclusion: Applying systematic and volume-based contralateral parotid constraints for IMPT planning significantly reduced the dose at all dosimetric

  10. Proton diffraction

    International Nuclear Information System (INIS)

    Den Besten, J.L.; Jamieson, D.N.; Allen, L.J.

    1998-01-01

    The Lindhard theory on ion channeling in crystals has been widely accepted throughout ion beam analysis for use in simulating such experiments. The simulations use a Monte Carlo method developed by Barret, which utilises the classical 'billiard ball' theory of ions 'bouncing' between planes or tubes of atoms in the crystal. This theory is not valid for 'thin' crystals where the planes or strings of atoms can no longer be assumed to be of infinite proportions. We propose that a theory similar to that used for high energy electron diffraction can be applied to MeV ions, especially protons, in thin crystals to simulate the intensities of transmission channeling and of RBS spectra. The diffraction theory is based on a Bloch wave solution of the Schroedinger equation for an ion passing through the periodic crystal potential. The widely used universal potential for proton-nucleus scattering is used to construct the crystal potential. Absorption due to thermal diffuse scattering is included. Experimental parameters such as convergence angle, beam tilt and scanning directions are considered in our calculations. Comparison between theory and experiment is encouraging and suggests that further work is justified. (authors)

  11. MO-FG-CAMPUS-JeP1-03: Luminescence Imaging of Water During Proton Beam Irradiation for Range Estimation

    International Nuclear Information System (INIS)

    Yamamoto, S; Komori, M; Toshito, T; Watabe, H

    2016-01-01

    Purpose: Since proton therapy has the ability to selectively deliver a dose to a target tumor, the dose distribution should be accurately measured. A precise and efficient method to evaluate the dose distribution is desired. We found that luminescence was emitted from water during proton irradiation and thought this phenomenon could be used for estimating the dose distribution. Methods: For this purpose, we placed water phantoms set on a table with a spot-scanning proton-therapy system, and luminescence images of these phantoms were measured with a high-sensitivity cooled charge coupled device (CCD) camera during proton-beam irradiation. We also conducted the imaging of phantoms of pure-water, fluorescein solution and acrylic block. We made three dimensional images from the projection data. Results: The luminescence images of water phantoms during the proton-beam irradiations showed clear Bragg peaks, and the measured proton ranges from the images were almost the same as those obtained with an ionization chamber. The image of the pure-water phantom also showed almost the same distribution as the tap-water phantom, indicating that the luminescence image was not related to impurities in the water. The luminescence image of fluorescein solution had ∼3 times higher intensity than water, with the same proton range as that of water. The luminescence image of the acrylic phantom had 14.5% shorter proton range than that of water; the proton range in the acrylic phantom was relatively matched with the calculated value. The luminescence images of the tap-water phantom during proton irradiation could be obtained in less than 2 sec. Three dimensional images were successfully obtained which have more quantitative information. Conclusion: Luminescence imaging during proton-beam irradiation has the potential to be a new method for range estimations in proton therapy.

  12. MO-FG-CAMPUS-JeP1-03: Luminescence Imaging of Water During Proton Beam Irradiation for Range Estimation

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, S; Komori, M [Nagoya University, Nagoya, Aichi (Japan); Toshito, T [Nagoya Proton Therapy Center, Nagoya, Aichi (Japan); Watabe, H [Tohoku University, Sendai, Miyagi (Japan)

    2016-06-15

    Purpose: Since proton therapy has the ability to selectively deliver a dose to a target tumor, the dose distribution should be accurately measured. A precise and efficient method to evaluate the dose distribution is desired. We found that luminescence was emitted from water during proton irradiation and thought this phenomenon could be used for estimating the dose distribution. Methods: For this purpose, we placed water phantoms set on a table with a spot-scanning proton-therapy system, and luminescence images of these phantoms were measured with a high-sensitivity cooled charge coupled device (CCD) camera during proton-beam irradiation. We also conducted the imaging of phantoms of pure-water, fluorescein solution and acrylic block. We made three dimensional images from the projection data. Results: The luminescence images of water phantoms during the proton-beam irradiations showed clear Bragg peaks, and the measured proton ranges from the images were almost the same as those obtained with an ionization chamber. The image of the pure-water phantom also showed almost the same distribution as the tap-water phantom, indicating that the luminescence image was not related to impurities in the water. The luminescence image of fluorescein solution had ∼3 times higher intensity than water, with the same proton range as that of water. The luminescence image of the acrylic phantom had 14.5% shorter proton range than that of water; the proton range in the acrylic phantom was relatively matched with the calculated value. The luminescence images of the tap-water phantom during proton irradiation could be obtained in less than 2 sec. Three dimensional images were successfully obtained which have more quantitative information. Conclusion: Luminescence imaging during proton-beam irradiation has the potential to be a new method for range estimations in proton therapy.

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

    Energy Technology Data Exchange (ETDEWEB)

    Mirandola, Alfredo, E-mail: mirandola@cnao.it; Molinelli, S.; Vilches Freixas, G.; Mairani, A.; Gallio, E.; Panizza, D.; Russo, S.; Ciocca, M. [Fondazione CNAO, strada Campeggi 53, Pavia 27100 (Italy); Donetti, M. [INFN, Torino 10125, Italy and Fondazione CNAO, strada Campeggi 53, Pavia 27100 (Italy); Magro, G. [INFN–Dipartimento di Fisica, Università degli Studi di Pavia, Via U. Bassi 6, Pavia 27100, Italy and Fondazione CNAO, strada Campeggi 53, Pavia 27100 (Italy); Giordanengo, S. [INFN, Torino 10125 (Italy); Orecchia, R. [Fondazione CNAO, strada Campeggi 53, Pavia 27100, Italy and Radiotherapy Division, European Institute of Oncology, Via Ripamonti 435, Milano 20141 (Italy)

    2015-09-15

    Purpose: To 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. Methods: The 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. Results: The 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{sup 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. Conclusions: After successful dosimetric beam commissioning, quality assurance measurements

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

    International Nuclear Information System (INIS)

    Mirandola, Alfredo; Molinelli, S.; Vilches Freixas, G.; Mairani, A.; Gallio, E.; Panizza, D.; Russo, S.; Ciocca, M.; Donetti, M.; Magro, G.; Giordanengo, S.; Orecchia, R.

    2015-01-01

    Purpose: To 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. Methods: The 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. Results: The 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. Conclusions: After successful dosimetric beam commissioning, quality assurance measurements

  15. Surface, structural and tensile properties of proton beam irradiated zirconium

    Energy Technology Data Exchange (ETDEWEB)

    Rafique, Mohsin; Chae, San; Kim, Yong-Soo, E-mail: yongskim@hanyang.ac.kr

    2016-02-01

    This paper reports the surface, structural and tensile properties of proton beam irradiated pure zirconium (99.8%). The Zr samples were irradiated by 3.5 MeV protons using MC-50 cyclotron accelerator at different doses ranging from 1 × 10{sup 13} to 1 × 10{sup 16} protons/cm{sup 2}. Both un-irradiated and irradiated samples were characterized using Field Emission Scanning Electron Microscope (FESEM), X-ray Diffraction (XRD) and Universal Testing Machine (UTM). The average surface roughness of the specimens was determined by using Nanotech WSxM 5.0 develop 7.0 software. The FESEM results revealed the formation of bubbles, cracks and black spots on the samples’ surface at different doses whereas the XRD results indicated the presence of residual stresses in the irradiated specimens. Williamson–Hall analysis of the diffraction peaks was carried out to investigate changes in crystallite size and lattice strain in the irradiated specimens. The tensile properties such as the yield stress, ultimate tensile stress and percentage elongation exhibited a decreasing trend after irradiation in general, however, an inconsistent behavior was observed in their dependence on proton dose. The changes in tensile properties of Zr were associated with the production of radiation-induced defects including bubbles, cracks, precipitates and simultaneous recovery by the thermal energy generated with the increase of irradiation dose.

  16. Surface, structural and tensile properties of proton beam irradiated zirconium

    Science.gov (United States)

    Rafique, Mohsin; Chae, San; Kim, Yong-Soo

    2016-02-01

    This paper reports the surface, structural and tensile properties of proton beam irradiated pure zirconium (99.8%). The Zr samples were irradiated by 3.5 MeV protons using MC-50 cyclotron accelerator at different doses ranging from 1 × 1013 to 1 × 1016 protons/cm2. Both un-irradiated and irradiated samples were characterized using Field Emission Scanning Electron Microscope (FESEM), X-ray Diffraction (XRD) and Universal Testing Machine (UTM). The average surface roughness of the specimens was determined by using Nanotech WSxM 5.0 develop 7.0 software. The FESEM results revealed the formation of bubbles, cracks and black spots on the samples' surface at different doses whereas the XRD results indicated the presence of residual stresses in the irradiated specimens. Williamson-Hall analysis of the diffraction peaks was carried out to investigate changes in crystallite size and lattice strain in the irradiated specimens. The tensile properties such as the yield stress, ultimate tensile stress and percentage elongation exhibited a decreasing trend after irradiation in general, however, an inconsistent behavior was observed in their dependence on proton dose. The changes in tensile properties of Zr were associated with the production of radiation-induced defects including bubbles, cracks, precipitates and simultaneous recovery by the thermal energy generated with the increase of irradiation dose.

  17. SpotADAPT

    DEFF Research Database (Denmark)

    Kaulakiene, Dalia; Thomsen, Christian; Pedersen, Torben Bach

    2015-01-01

    by Amazon Web Services (AWS). The users aiming for the spot market are presented with many instance types placed in multiple datacenters in the world, and thus it is difficult to choose the optimal deployment. In this paper, we propose the framework SpotADAPT (Spot-Aware (re-)Deployment of Analytical...... of typical analytical workloads and real spot price traces. SpotADAPT's suggested deployments are comparable to the theoretically optimal ones, and in particular, it shows good cost benefits for the budget optimization -- on average SpotADAPT is at most 0.3% more expensive than the theoretically optimal...

  18. Rocky Mountain Spotted Fever

    Science.gov (United States)

    ... with facebook share with twitter share with linkedin Rocky Mountain Spotted Fever Credit: CDC A male cayenne tick, Amblyomma cajennense, ... and New Mexico. Why Is the Study of Rocky Mountain Spotted Fever a Priority for NIAID? Tickborne diseases are becoming ...

  19. The Melbourne proton microprobe

    International Nuclear Information System (INIS)

    Legge, G.J.F.; McKenzie, C.D.; Mazzolini, A.P.

    1979-01-01

    A scanning proton microprobe is described which operates in ultra-high vacuum with a resolution of ten microns. The operating principles and main features of the design are discussed and the ability of such an instrument to detect trace elements down to a few ppm by mass is illustrated

  20. Inverse planning of intensity modulated proton therapy

    International Nuclear Information System (INIS)

    Nill, S.; Oelfke, U.; Bortfeld, T.

    2004-01-01

    A common requirement of radiation therapy is that treatment planning for different radiation modalities is devised on the basis of the same treatment planning system (TPS). The present study presents a novel multi-modal TPS with separate modules for the dose calculation, the optimization engine and the graphical user interface, which allows to integrate different treatment modalities. For heavy-charged particles, both most promising techniques, the distal edge tracking (DET) and the 3-dimensional scanning (3D) technique can be optimized. As a first application, the quality of optimized intensity-modulated treatment plans for photons (IMXT) and protons (IMPT) was analyzed in one clinical case on the basis of the achieved physical dose distributions. A comparison of the proton plans with the photon plans showed no significant improvement in terms of target volume dose, however there was an improvement in terms of organs at risk as well as a clear reduction of the total integral dose. For the DET technique, it is possible to create a treatment plan with almost the same quality of the 3D technique, however with a clearly reduced number (factor of 5) of beam spots as well as a reduced optimization time. Due to its modular design, the system can be easily expanded to more sophisticated dose-calculation algorithms or to modeling of biological effects. (orig.) [de

  1. A Monte-Carlo study to assess the effect of 1.5 T magnetic fields on the overall robustness of pencil-beam scanning proton radiotherapy plans for prostate cancer

    Science.gov (United States)

    Kurz, Christopher; Landry, Guillaume; Resch, Andreas F.; Dedes, George; Kamp, Florian; Ganswindt, Ute; Belka, Claus; Raaymakers, Bas W.; Parodi, Katia

    2017-11-01

    Combining magnetic-resonance imaging (MRI) and proton therapy (PT) using pencil-beam scanning (PBS) may improve image-guided radiotherapy. We aimed at assessing the impact of a magnetic field on PBS-PT plan quality and robustness. Specifically, the robustness against anatomical changes and positioning errors in an MRI-guided scenario with a 30 cm radius 1.5 T magnetic field was studied for prostate PT. Five prostate cancer patients with three consecutive CT images (CT1-3) were considered. Single-field uniform dose PBS-PT plans were generated on the segmented CT1 with Monte-Carlo-based treatment planning software for inverse optimization. Plans were optimized at 90° gantry angle without B-field (no B), with  ±1.5 T B-field (B and minus B), as well as at 81° gantry angle and  +1.5 T (B G81). Plans were re-calculated on aligned CT2 and CT3 to study the impact of anatomical changes. Dose distributions were compared in terms of changes in DVH parameters, proton range and gamma-index pass-rates. To assess the impact of positioning errors, DVH parameters were compared for  ±5 mm CT1 patient shifts in anterior-posterior (AP) and left-right (LR) direction. Proton beam deflection considerably reduced robustness against inter-fractional changes for the B scenario. Range agreement, gamma-index pass-rates and PTV V95% were significantly lower compared to no B. Improved robustness was obtained for minus B and B G81, the latter showing only minor differences to no B. The magnetic field introduced slight dosimetric changes under LR shifts. The impact of AP shifts was considerably larger, and equivalent for scenarios with and without B-field. Results suggest that robustness equivalent to PT without magnetic field can be achieved by adaptation of the treatment parameters, such as B-field orientation (minus B) with respect to the patient and/or gantry angle (B G81). MRI-guided PT for prostate cancer might thus be implemented without compromising robustness

  2. A comprehensive dosimetric study of pancreatic cancer treatment using three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), volumetric-modulated radiation therapy (VMAT), and passive-scattering and modulated-scanning proton therapy (PT)

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Xuanfeng; Dionisi, Francesco; Tang, Shikui; Ingram, Mark; Hung, Chun-Yu; Prionas, Evangelos; Lichtenwalner, Phil; Butterwick, Ian; Zhai, Huifang; Yin, Lingshu; Lin, Haibo; Kassaee, Alireza; Avery, Stephen, E-mail: stephen.avery@uphs.upenn.edu

    2014-07-01

    With traditional photon therapy to treat large postoperative pancreatic target volume, it often leads to poor tolerance of the therapy delivered and may contribute to interrupted treatment course. This study was performed to evaluate the potential advantage of using passive-scattering (PS) and modulated-scanning (MS) proton therapy (PT) to reduce normal tissue exposure in postoperative pancreatic cancer treatment. A total of 11 patients with postoperative pancreatic cancer who had been previously treated with PS PT in University of Pennsylvania Roberts Proton Therapy Center from 2010 to 2013 were identified. The clinical target volume (CTV) includes the pancreatic tumor bed as well as the adjacent high-risk nodal areas. Internal (iCTV) was generated from 4-dimensional (4D) computed tomography (CT), taking into account target motion from breathing cycle. Three-field and 4-field 3D conformal radiation therapy (3DCRT), 5-field intensity-modulated radiation therapy, 2-arc volumetric-modulated radiation therapy, and 2-field PS and MS PT were created on the patients’ average CT. All the plans delivered 50.4 Gy to the planning target volume (PTV). Overall, 98% of PTV was covered by 95% of the prescription dose and 99% of iCTV received 98% prescription dose. The results show that all the proton plans offer significant lower doses to the left kidney (mean and V{sub 18} {sub Gy}), stomach (mean and V{sub 20} {sub Gy}), and cord (maximum dose) compared with all the photon plans, except 3-field 3DCRT in cord maximum dose. In addition, MS PT also provides lower doses to the right kidney (mean and V{sub 18} {sub Gy}), liver (mean dose), total bowel (V{sub 20} {sub Gy} and mean dose), and small bowel (V{sub 15} {sub Gy} absolute volume ratio) compared with all the photon plans and PS PT. The dosimetric advantage of PT points to the possibility of treating tumor bed and comprehensive nodal areas while providing a more tolerable treatment course that could be used for dose

  3. A comprehensive dosimetric study of pancreatic cancer treatment using three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), volumetric-modulated radiation therapy (VMAT), and passive-scattering and modulated-scanning proton therapy (PT)

    International Nuclear Information System (INIS)

    Ding, Xuanfeng; Dionisi, Francesco; Tang, Shikui; Ingram, Mark; Hung, Chun-Yu; Prionas, Evangelos; Lichtenwalner, Phil; Butterwick, Ian; Zhai, Huifang; Yin, Lingshu; Lin, Haibo; Kassaee, Alireza; Avery, Stephen

    2014-01-01

    With traditional photon therapy to treat large postoperative pancreatic target volume, it often leads to poor tolerance of the therapy delivered and may contribute to interrupted treatment course. This study was performed to evaluate the potential advantage of using passive-scattering (PS) and modulated-scanning (MS) proton therapy (PT) to reduce normal tissue exposure in postoperative pancreatic cancer treatment. A total of 11 patients with postoperative pancreatic cancer who had been previously treated with PS PT in University of Pennsylvania Roberts Proton Therapy Center from 2010 to 2013 were identified. The clinical target volume (CTV) includes the pancreatic tumor bed as well as the adjacent high-risk nodal areas. Internal (iCTV) was generated from 4-dimensional (4D) computed tomography (CT), taking into account target motion from breathing cycle. Three-field and 4-field 3D conformal radiation therapy (3DCRT), 5-field intensity-modulated radiation therapy, 2-arc volumetric-modulated radiation therapy, and 2-field PS and MS PT were created on the patients’ average CT. All the plans delivered 50.4 Gy to the planning target volume (PTV). Overall, 98% of PTV was covered by 95% of the prescription dose and 99% of iCTV received 98% prescription dose. The results show that all the proton plans offer significant lower doses to the left kidney (mean and V 18 Gy ), stomach (mean and V 20 Gy ), and cord (maximum dose) compared with all the photon plans, except 3-field 3DCRT in cord maximum dose. In addition, MS PT also provides lower doses to the right kidney (mean and V 18 Gy ), liver (mean dose), total bowel (V 20 Gy and mean dose), and small bowel (V 15 Gy absolute volume ratio) compared with all the photon plans and PS PT. The dosimetric advantage of PT points to the possibility of treating tumor bed and comprehensive nodal areas while providing a more tolerable treatment course that could be used for dose escalation and combining with radiosensitizing

  4. MO-A-201-01: A Cliff’s Notes Version of Proton Therapy

    International Nuclear Information System (INIS)

    Kruse, J.

    2016-01-01

    Proton therapy is a rapidly growing modality in the fight against cancer. From a high-level perspective the process of proton therapy is identical to x-ray based external beam radiotherapy. However, this course is meant to illustrate for x-ray physicists the many differences between x-ray and proton based practices. Unlike in x-ray therapy, proton dose calculations use CT Hounsfield Units (HU) to determine proton stopping power and calculate the range of a beam in a patient. Errors in stopping power dominate the dosimetric uncertainty in the beam direction, while variations in patient position determine uncertainties orthogonal to the beam path. Mismatches between geometric and range errors lead to asymmetric uncertainties, and so while geometric uncertainties in x-ray therapy are mitigated through the use of a Planning Target Volume (PTV), this approach is not suitable for proton therapy. Robust treatment planning and evaluation are critical in proton therapy, and will be discussed in this course. Predicting the biological effect of a proton dose distribution within a patient is also a complex undertaking. The proton therapy community has generally regarded the Radiobiological Effectiveness (RBE) of a proton beam to be 1.1 everywhere in the patient, but there are increasing data to suggest that the RBE probably climbs higher than 1.1 near the end of a proton beam when the energy deposition density increases. This lecture will discuss the evidence for variable RBE in proton therapy and describe how this is incorporated into current proton treatment planning strategies. Finally, there are unique challenges presented by the delivery process of proton therapy. Many modern systems use a spot scanning technique which has several advantages over earlier scattered beam designs. However, the time dependence of the dose deposition leads to greater concern with organ motion than with scattered protons or x-rays. Image guidance techniques in proton therapy may also differ

  5. MO-A-201-00: A Cliff’s Notes Version of Proton Therapy

    International Nuclear Information System (INIS)

    2016-01-01

    Proton therapy is a rapidly growing modality in the fight against cancer. From a high-level perspective the process of proton therapy is identical to x-ray based external beam radiotherapy. However, this course is meant to illustrate for x-ray physicists the many differences between x-ray and proton based practices. Unlike in x-ray therapy, proton dose calculations use CT Hounsfield Units (HU) to determine proton stopping power and calculate the range of a beam in a patient. Errors in stopping power dominate the dosimetric uncertainty in the beam direction, while variations in patient position determine uncertainties orthogonal to the beam path. Mismatches between geometric and range errors lead to asymmetric uncertainties, and so while geometric uncertainties in x-ray therapy are mitigated through the use of a Planning Target Volume (PTV), this approach is not suitable for proton therapy. Robust treatment planning and evaluation are critical in proton therapy, and will be discussed in this course. Predicting the biological effect of a proton dose distribution within a patient is also a complex undertaking. The proton therapy community has generally regarded the Radiobiological Effectiveness (RBE) of a proton beam to be 1.1 everywhere in the patient, but there are increasing data to suggest that the RBE probably climbs higher than 1.1 near the end of a proton beam when the energy deposition density increases. This lecture will discuss the evidence for variable RBE in proton therapy and describe how this is incorporated into current proton treatment planning strategies. Finally, there are unique challenges presented by the delivery process of proton therapy. Many modern systems use a spot scanning technique which has several advantages over earlier scattered beam designs. However, the time dependence of the dose deposition leads to greater concern with organ motion than with scattered protons or x-rays. Image guidance techniques in proton therapy may also differ

  6. MO-A-201-00: A Cliff’s Notes Version of Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    Proton therapy is a rapidly growing modality in the fight against cancer. From a high-level perspective the process of proton therapy is identical to x-ray based external beam radiotherapy. However, this course is meant to illustrate for x-ray physicists the many differences between x-ray and proton based practices. Unlike in x-ray therapy, proton dose calculations use CT Hounsfield Units (HU) to determine proton stopping power and calculate the range of a beam in a patient. Errors in stopping power dominate the dosimetric uncertainty in the beam direction, while variations in patient position determine uncertainties orthogonal to the beam path. Mismatches between geometric and range errors lead to asymmetric uncertainties, and so while geometric uncertainties in x-ray therapy are mitigated through the use of a Planning Target Volume (PTV), this approach is not suitable for proton therapy. Robust treatment planning and evaluation are critical in proton therapy, and will be discussed in this course. Predicting the biological effect of a proton dose distribution within a patient is also a complex undertaking. The proton therapy community has generally regarded the Radiobiological Effectiveness (RBE) of a proton beam to be 1.1 everywhere in the patient, but there are increasing data to suggest that the RBE probably climbs higher than 1.1 near the end of a proton beam when the energy deposition density increases. This lecture will discuss the evidence for variable RBE in proton therapy and describe how this is incorporated into current proton treatment planning strategies. Finally, there are unique challenges presented by the delivery process of proton therapy. Many modern systems use a spot scanning technique which has several advantages over earlier scattered beam designs. However, the time dependence of the dose deposition leads to greater concern with organ motion than with scattered protons or x-rays. Image guidance techniques in proton therapy may also differ

  7. MO-A-201-01: A Cliff’s Notes Version of Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kruse, J. [Mayo Clinic (United States)

    2016-06-15

    Proton therapy is a rapidly growing modality in the fight against cancer. From a high-level perspective the process of proton therapy is identical to x-ray based external beam radiotherapy. However, this course is meant to illustrate for x-ray physicists the many differences between x-ray and proton based practices. Unlike in x-ray therapy, proton dose calculations use CT Hounsfield Units (HU) to determine proton stopping power and calculate the range of a beam in a patient. Errors in stopping power dominate the dosimetric uncertainty in the beam direction, while variations in patient position determine uncertainties orthogonal to the beam path. Mismatches between geometric and range errors lead to asymmetric uncertainties, and so while geometric uncertainties in x-ray therapy are mitigated through the use of a Planning Target Volume (PTV), this approach is not suitable for proton therapy. Robust treatment planning and evaluation are critical in proton therapy, and will be discussed in this course. Predicting the biological effect of a proton dose distribution within a patient is also a complex undertaking. The proton therapy community has generally regarded the Radiobiological Effectiveness (RBE) of a proton beam to be 1.1 everywhere in the patient, but there are increasing data to suggest that the RBE probably climbs higher than 1.1 near the end of a proton beam when the energy deposition density increases. This lecture will discuss the evidence for variable RBE in proton therapy and describe how this is incorporated into current proton treatment planning strategies. Finally, there are unique challenges presented by the delivery process of proton therapy. Many modern systems use a spot scanning technique which has several advantages over earlier scattered beam designs. However, the time dependence of the dose deposition leads to greater concern with organ motion than with scattered protons or x-rays. Image guidance techniques in proton therapy may also differ

  8. Scanning Terahertz Heterodyne Imaging Systems

    Science.gov (United States)

    Siegel, Peter; Dengler, Robert

    2007-01-01

    Scanning terahertz heterodyne imaging systems are now at an early stage of development. In a basic scanning terahertz heterodyne imaging system, (see Figure 1) two far-infrared lasers generate beams denoted the local-oscillator (LO) and signal that differ in frequency by an amount, denoted the intermediate frequency (IF), chosen to suit the application. The LO beam is sent directly to a mixer as one of two inputs. The signal beam is focused to a spot on or in the specimen. After transmission through or reflection from the specimen, the beams are focused to a spot on a terahertz mixer, which extracts the IF outputs. The specimen is mounted on a translation stage, by means of which the focal spot is scanned across the specimen to build up an image.

  9. Proton therapy

    International Nuclear Information System (INIS)

    Smith, Alfred R

    2006-01-01

    Proton therapy has become a subject of considerable interest in the radiation oncology community and it is expected that there will be a substantial growth in proton treatment facilities during the next decade. I was asked to write a historical review of proton therapy based on my personal experiences, which have all occurred in the United States, so therefore I have a somewhat parochial point of view. Space requirements did not permit me to mention all of the existing proton therapy facilities or the names of all of those who have contributed to proton therapy. (review)

  10. SU-E-T-470: Beam Performance of the Radiance 330 Proton Therapy System

    International Nuclear Information System (INIS)

    Nazaryan, H; Nazaryan, V; Wang, F; Flanz, J; Alexandrov, V

    2014-01-01

    Purpose: The ProTom Radiance 330 proton radiotherapy system is a fully functional, compact proton radiotherapy system that provides advanced proton delivery capabilities. It supports three-dimensional beam scanning with energy and intensity modulation. A series of measurements have been conducted to characterize the beam performance of the first installation of the system at the McLaren Proton Therapy Center in Flint, Michigan. These measurements were part of the technical commissioning of the system. Select measurements and results are presented. Methods: The Radiance 330 proton beam energy range is 70–250 MeV for treatment, and up to 330 MeV for proton tomography and radiography. Its 3-D scanning capability, together with a small beam emittance and momentum spread, provides a highly efficient beam delivery. During the technical commissioning, treatment plans were created to deliver uniform maps at various energies to perform Gamma Index analysis. EBT3 Gafchromic films were irradiated using the Planned irradiation maps. Bragg Peak chamber was used to test the dynamic range during a scan in one layer for high (250 MeV) and Low (70 MeV) energies. The maximum and minimum range, range adjustment and modulation, distal dose falloff (80%–20%), pencil beam spot size, spot placement accuracy were also measured. The accuracy testing included acquiring images, image registration, receiving correction vectors and applying the corrections to the robotic patient positioner. Results: Gamma Index analysis of the Treatment Planning System (TPS) data vs. Measured data showed more than 90% of points within (3%, 3mm) for the maps created by the TPS. At Isocenter Beam Size (One sigma) < 3mm at highest energy (250 MeV) in air. Beam delivery was within 0.6 mm of the intended target at the entrance and the exit of the beam, through the phantom. Conclusion: The Radiance 330 Beam Performance Measurements have confirmed that the system operates as designed with excellent clinical

  11. SU-E-T-470: Beam Performance of the Radiance 330 Proton Therapy System

    Energy Technology Data Exchange (ETDEWEB)

    Nazaryan, H; Nazaryan, V; Wang, F [ProTom International, Inc., Flower Mound, TX (United States); Flanz, J [Massachusetts General Hospital, Boston, MA (United States); Alexandrov, V [ZAO ProTom, Protvino, Moscow region (Russian Federation)

    2014-06-01

    Purpose: The ProTom Radiance 330 proton radiotherapy system is a fully functional, compact proton radiotherapy system that provides advanced proton delivery capabilities. It supports three-dimensional beam scanning with energy and intensity modulation. A series of measurements have been conducted to characterize the beam performance of the first installation of the system at the McLaren Proton Therapy Center in Flint, Michigan. These measurements were part of the technical commissioning of the system. Select measurements and results are presented. Methods: The Radiance 330 proton beam energy range is 70–250 MeV for treatment, and up to 330 MeV for proton tomography and radiography. Its 3-D scanning capability, together with a small beam emittance and momentum spread, provides a highly efficient beam delivery. During the technical commissioning, treatment plans were created to deliver uniform maps at various energies to perform Gamma Index analysis. EBT3 Gafchromic films were irradiated using the Planned irradiation maps. Bragg Peak chamber was used to test the dynamic range during a scan in one layer for high (250 MeV) and Low (70 MeV) energies. The maximum and minimum range, range adjustment and modulation, distal dose falloff (80%–20%), pencil beam spot size, spot placement accuracy were also measured. The accuracy testing included acquiring images, image registration, receiving correction vectors and applying the corrections to the robotic patient positioner. Results: Gamma Index analysis of the Treatment Planning System (TPS) data vs. Measured data showed more than 90% of points within (3%, 3mm) for the maps created by the TPS. At Isocenter Beam Size (One sigma) < 3mm at highest energy (250 MeV) in air. Beam delivery was within 0.6 mm of the intended target at the entrance and the exit of the beam, through the phantom. Conclusion: The Radiance 330 Beam Performance Measurements have confirmed that the system operates as designed with excellent clinical

  12. [Why proton therapy? And how?

    Science.gov (United States)

    Thariat, Juliette; Habrand, Jean Louis; Lesueur, Paul; Chaikh, Abdulhamid; Kammerer, Emmanuel; Lecomte, Delphine; Batalla, Alain; Balosso, Jacques; Tessonnier, Thomas

    2018-03-01

    Proton therapy is a radiotherapy, based on the use of protons, charged subatomic particles that stop at a given depth depending on their initial energy (pristine Bragg peak), avoiding any output beam, unlike the photons used in most of the other modalities of radiotherapy. Proton therapy has been used for 60 years, but has only become ubiquitous in the last decade because of recent major advances in particle accelerator technology. This article reviews the history of clinical implementation of protons, the nature of the technological advances that now allows its expansion at a lower cost. It also addresses the technical and physical specificities of proton therapy and the clinical situations for which proton therapy may be relevant but requires evidence. Different proton therapy techniques are possible. These are explained in terms of their clinical potential by explaining the current terminology (such as cyclotrons, synchrotrons or synchrocyclotrons, using superconducting magnets, fixed line or arm rotary with passive diffusion delivery or active by scanning) in basic words. The requirements associated with proton therapy are increased due to the precision of the depth dose deposit. The learning curve of proton therapy requires that clinical indications be prioritized according to their associated uncertainties (such as range uncertainties and movement in lung tumors). Many clinical indications potentially fall under proton therapy ultimately. Clinical strategies are explained in a paralleled manuscript. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  13. Multifield Optimization Intensity Modulated Proton Therapy for Head and Neck Tumors: A Translation to Practice

    Energy Technology Data Exchange (ETDEWEB)

    Frank, Steven J., E-mail: sjfrank@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Cox, James D. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gillin, Michael; Mohan, Radhe [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Garden, Adam S.; Rosenthal, David I.; Gunn, G. Brandon [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Weber, Randal S. [Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Kies, Merrill S. [Department of Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lewin, Jan S. [Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Munsell, Mark F. [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Palmer, Matthew B. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Sahoo, Narayan; Zhang, Xiaodong; Liu, Wei; Zhu, X. Ronald [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2014-07-15

    Background: We report the first clinical experience and toxicity of multifield optimization (MFO) intensity modulated proton therapy (IMPT) for patients with head and neck tumors. Methods and Materials: Fifteen consecutive patients with head and neck cancer underwent MFO-IMPT with active scanning beam proton therapy. Patients with squamous cell carcinoma (SCC) had comprehensive treatment extending from the base of the skull to the clavicle. The doses for chemoradiation therapy and radiation therapy alone were 70 Gy and 66 Gy, respectively. The robustness of each treatment plan was also analyzed to evaluate sensitivity to uncertainties associated with variations in patient setup and the effect of uncertainties with proton beam range in patients. Proton beam energies during treatment ranged from 72.5 to 221.8 MeV. Spot sizes varied depending on the beam energy and depth of the target, and the scanning nozzle delivered the spot scanning treatment “spot by spot” and “layer by layer.” Results: Ten patients presented with SCC and 5 with adenoid cystic carcinoma. All 15 patients were able to complete treatment with MFO-IMPT, with no need for treatment breaks and no hospitalizations. There were no treatment-related deaths, and with a median follow-up time of 28 months (range, 20-35 months), the overall clinical complete response rate was 93.3% (95% confidence interval, 68.1%-99.8%). Xerostomia occurred in all 15 patients as follows: grade 1 in 10 patients, grade 2 in 4 patients, and grade 3 in 1 patient. Mucositis within the planning target volumes was seen during the treatment of all patients: grade 1 in 1 patient, grade 2 in 8 patients, and grade 3 in 6 patients. No patient experienced grade 2 or higher anterior oral mucositis. Conclusions: To our knowledge, this is the first clinical report of MFO-IMPT for head and neck tumors. Early clinical outcomes are encouraging and warrant further investigation of proton therapy in prospective clinical trials.

  14. Nuclear Scans

    Science.gov (United States)

    Nuclear scans use radioactive substances to see structures and functions inside your body. They use a special ... images. Most scans take 20 to 45 minutes. Nuclear scans can help doctors diagnose many conditions, including ...

  15. Spot market for uranium

    International Nuclear Information System (INIS)

    Colhoun, C.

    1982-01-01

    The spot market is always quoted for the price of uranium because little information is available about long-term contracts. A review of the development of spot market prices shows the same price curve swings that occur with all raw materials. Future long-term contracts will probably be lower to reflect spot market prices, which are currently in the real-value range of $30-$35. An upswing in the price of uranium could come in the next few months as utilities begin making purchases and trading from stockpiles. The US, unlike Europe and Japan, has already reached a supply and demand point where the spot market share is increasing. Forecasters cannot project the market price, they can only predict the presence of an oscillating spot or a secondary market. 5 figures

  16. Medical Proton Accelerator Project

    International Nuclear Information System (INIS)

    Comsan, M.N.H.

    2008-01-01

    A project for a medical proton accelerator for cancer treatment is outlined. The project is motivated by the need for a precise modality for cancer curing especially in children. Proton therapy is known by its superior radiation and biological effectiveness as compared to photon or electron therapy. With 26 proton and 3 heavy-ion therapy complexes operating worldwide only one (p) exists in South Africa, and none in south Asia and the Middle East. The accelerator of choice should provide protons with energy 75 MeV for eye treatment and 250 MeV for body treatment. Four treatment rooms are suggested: two with isocentric gantries, one with fixed beams and one for development. Passive scanning is recommended. The project can serve Middle East and North Africa with ∼ 400 million populations. The annual capacity of the project is estimated as 1,100 to be compared with expected radiation cases eligible for proton cancer treatment of not less than 200,000

  17. Mononucleosis spot test

    Science.gov (United States)

    Monospot test; Heterophile antibody test; Heterophile agglutination test; Paul-Bunnell test; Forssman antibody test ... The mononucleosis spot test is done when symptoms of mononucleosis are ... Fatigue Fever Large spleen (possibly) Sore throat Tender ...

  18. Arc cathode spots

    International Nuclear Information System (INIS)

    Schrade, H.O.

    1989-01-01

    Arc spots are usually highly unstable and jump statistically over the cathode surface. In a magnetic field parallel to the surface, preferably they move in the retrograde direction; i.e., opposite to the Lorentzian rule. If the field is inclined with respect to the surface, the spots drift away at a certain angle with respect to the proper retrograde direction (Robson drift motion). These well-known phenomena are explained by one stability theory

  19. Renal scan

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003790.htm Renal scan To use the sharing features on this ... anaphylaxis . Alternative Names Renogram; Kidney scan Images Kidney anatomy Kidney - blood and urine flow References Chernecky CC, ...

  20. CT Scan

    Science.gov (United States)

    ... disease, lung nodules and liver masses Monitor the effectiveness of certain treatments, such as cancer treatment Detect ... scan done in a hospital or an outpatient facility. CT scans are painless and, with newer machines, ...

  1. Scanning by use of TV

    International Nuclear Information System (INIS)

    Drevermann, H.

    1981-01-01

    The use of TV read out for scanning and measuring holographic pictures seems to give less problems than the use of optical projection as is usual for conventional bubble chamber photos. Whereas the measuring of conventional bubble chamber pictures seems to give no problems, it is not clear whether scanning by use of TV is possible. Therefore scanning pictures from experiment NA16 (taken in LEBC) with TV only was tried using the TV system of ERASME, where the CRT system is used as a camera. It should be mentioned that this system, being a flying spot device, cannot be adapted for holography. (author)

  2. EPR/alanine dosimetry for two therapeutic proton beams

    Energy Technology Data Exchange (ETDEWEB)

    Marrale, Maurizio, E-mail: maurizio.marrale@unipa.it [Dipartimento di Fisica e Chimica, Università di Palermo, Viale delle Scienze, Edificio 18, 90128 Palermo (Italy); Gruppo V Sezione INFN di Catania, Via Santa Sofia, 64, 95123 Catania (Italy); Carlino, Antonio [Dipartimento di Fisica e Chimica, Università di Palermo, Viale delle Scienze, Edificio 18, 90128 Palermo (Italy); EBG MedAustron GmbH, Marie Curie-Straße 5, A-2700 Wiener Neustadt (Austria); Gallo, Salvatore [Dipartimento di Fisica e Chimica, Università di Palermo, Viale delle Scienze, Edificio 18, 90128 Palermo (Italy); Gruppo V Sezione INFN di Catania, Via Santa Sofia, 64, 95123 Catania (Italy); Laboratorio PH3DRA, Dipartimento di Fisica e Astronomia, Università di Catania, Via Santa Sofia 64, 95123 Catania (Italy); Longo, Anna; Panzeca, Salvatore [Dipartimento di Fisica e Chimica, Università di Palermo, Viale delle Scienze, Edificio 18, 90128 Palermo (Italy); Gruppo V Sezione INFN di Catania, Via Santa Sofia, 64, 95123 Catania (Italy); Bolsi, Alessandra; Hrbacek, Jan; Lomax, Tony [Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen PSI (Switzerland)

    2016-02-01

    In this work the analysis of the electron paramagnetic resonance (EPR) response of alanine pellets exposed to two different clinical proton beams employed for radiotherapy is performed. One beam is characterized by a passive delivery technique and is dedicated to the eyes treatment (OPTIS2 beam line). Alanine pellets were irradiated with a 70 MeV proton beam corresponding to 35 mm range in eye tissue. We investigated how collimators with different sizes and shape used to conform the dose to the planned target volume influence the delivered dose. For this purpose we performed measurements with varying the collimator size (Output Factor) and the results were compared with those obtained with other dosimetric techniques (such as Markus chamber and diode detector). This analysis showed that the dosimeter response is independent of collimator diameter if this is larger than or equal to 10 mm. The other beam is characterized by an active spot-scanning technique, the Gantry1 beam line (maximum energy 230 MeV), and is used to treat deep-seated tumors. The dose linearity of alanine response in the clinical dose range was tested and the alanine dose response at selected locations in depth was measured and compared with the TPS planned dose in a quasi-clinical scenario. The alanine response was found to be linear in the dose in the clinical explored range (from 10 to 70 Gy). Furthermore, a depth dose profile in a quasi-clinical scenario was measured and compared to the dose computed by the Treatment Planning System PSIPLAN. The comparison of calibrated proton alanine measurements and TPS dose shows a difference under 1% in the SOBP and a “quenching” effect up to 4% in the distal part of SOBP. The positive dosimetric characteristics of the alanine pellets confirm the feasibility to use these detectors for “in vivo” dosimetry in clinical proton beams.

  3. EPR/alanine dosimetry for two therapeutic proton beams

    International Nuclear Information System (INIS)

    Marrale, Maurizio; Carlino, Antonio; Gallo, Salvatore; Longo, Anna; Panzeca, Salvatore; Bolsi, Alessandra; Hrbacek, Jan; Lomax, Tony

    2016-01-01

    In this work the analysis of the electron paramagnetic resonance (EPR) response of alanine pellets exposed to two different clinical proton beams employed for radiotherapy is performed. One beam is characterized by a passive delivery technique and is dedicated to the eyes treatment (OPTIS2 beam line). Alanine pellets were irradiated with a 70 MeV proton beam corresponding to 35 mm range in eye tissue. We investigated how collimators with different sizes and shape used to conform the dose to the planned target volume influence the delivered dose. For this purpose we performed measurements with varying the collimator size (Output Factor) and the results were compared with those obtained with other dosimetric techniques (such as Markus chamber and diode detector). This analysis showed that the dosimeter response is independent of collimator diameter if this is larger than or equal to 10 mm. The other beam is characterized by an active spot-scanning technique, the Gantry1 beam line (maximum energy 230 MeV), and is used to treat deep-seated tumors. The dose linearity of alanine response in the clinical dose range was tested and the alanine dose response at selected locations in depth was measured and compared with the TPS planned dose in a quasi-clinical scenario. The alanine response was found to be linear in the dose in the clinical explored range (from 10 to 70 Gy). Furthermore, a depth dose profile in a quasi-clinical scenario was measured and compared to the dose computed by the Treatment Planning System PSIPLAN. The comparison of calibrated proton alanine measurements and TPS dose shows a difference under 1% in the SOBP and a “quenching” effect up to 4% in the distal part of SOBP. The positive dosimetric characteristics of the alanine pellets confirm the feasibility to use these detectors for “in vivo” dosimetry in clinical proton beams.

  4. The proton therapy nozzles at Samsung Medical Center: A Monte Carlo simulation study using TOPAS

    Science.gov (United States)

    Chung, Kwangzoo; Kim, Jinsung; Kim, Dae-Hyun; Ahn, Sunghwan; Han, Youngyih

    2015-07-01

    To expedite the commissioning process of the proton therapy system at Samsung Medical Center (SMC), we have developed a Monte Carlo simulation model of the proton therapy nozzles by using TOol for PArticle Simulation (TOPAS). At SMC proton therapy center, we have two gantry rooms with different types of nozzles: a multi-purpose nozzle and a dedicated scanning nozzle. Each nozzle has been modeled in detail following the geometry information provided by the manufacturer, Sumitomo Heavy Industries, Ltd. For this purpose, the novel features of TOPAS, such as the time feature or the ridge filter class, have been used, and the appropriate physics models for proton nozzle simulation have been defined. Dosimetric properties, like percent depth dose curve, spreadout Bragg peak (SOBP), and beam spot size, have been simulated and verified against measured beam data. Beyond the Monte Carlo nozzle modeling, we have developed an interface between TOPAS and the treatment planning system (TPS), RayStation. An exported radiotherapy (RT) plan from the TPS is interpreted by using an interface and is then translated into the TOPAS input text. The developed Monte Carlo nozzle model can be used to estimate the non-beam performance, such as the neutron background, of the nozzles. Furthermore, the nozzle model can be used to study the mechanical optimization of the design of the nozzle.

  5. Studies of absorbed dose determinations and spatial dose distributions for high energy proton beams

    International Nuclear Information System (INIS)

    Hiraoka, Takeshi

    1982-01-01

    Absolute dose determinations were made with three types of ionization chamber and a Faraday cup. Methane based tissue equivalent (TE) gas, nitrogen, carbon dioxide, air were used as an ionizing gas with flow rate of 10 ml per minute. Measurements were made at the entrance position of unmodulated beams and for a beam of a spread out Bragg peak at a depth of 17.3 mm in water. For both positions, the mean value of dose determined by the ionization chambers was 0.993 +- 0.014 cGy for which the value of TE gas was taken as unity. The agreement between the doses estimated by the ionization chambers and the Faraday cup was within 5%. Total uncertainty estimated in the ionization chamber and the Faraday cup determinations is 6 and 4%, respectively. Common sources of error in calculating the dose from ionization chamber measurements are depend on the factors of ion recombination, W value, and mass stopping power ratio. These factors were studied by both experimentally and theoretically. The observed values for the factors show a good agreement to the predicted one. Proton beam dosimetry intercomparison between Japan and the United States was held. Good agreement was obtained with standard deviation of 1.6%. The value of the TE calorimeter is close to the mean value of all. In the proton spot scanning system, lateral dose distributions at any depth for one spot beam can be simulated by the Gaussian distribution. From the Gaussian distributions and the central axis depth doses for one spot beam, it is easy to calculate isodose distributions in the desired field by superposition of dose distribution for one spot beam. Calculated and observed isodose curves were agreed within 1 mm at any dose levels. (J.P.N.)

  6. Two-dimensional pencil beam scaling: an improved proton dose algorithm for heterogeneous media

    International Nuclear Information System (INIS)

    Szymanowski, Hanitra; Oelfke, Uwe

    2002-01-01

    New dose delivery techniques with proton beams, such as beam spot scanning or raster scanning, require fast and accurate dose algorithms which can be applied for treatment plan optimization in clinically acceptable timescales. The clinically required accuracy is particularly difficult to achieve for the irradiation of complex, heterogeneous regions of the patient's anatomy. Currently applied fast pencil beam dose calculations based on the standard inhomogeneity correction of pathlength scaling often cannot provide the accuracy required for clinically acceptable dose distributions. This could be achieved with sophisticated Monte Carlo simulations which are still unacceptably time consuming for use as dose engines in optimization calculations. We therefore present a new algorithm for proton dose calculations which aims to resolve the inherent problem between calculation speed and required clinical accuracy. First, a detailed derivation of the new concept, which is based on an additional scaling of the lateral proton fluence is provided. Then, the newly devised two-dimensional (2D) scaling method is tested for various geometries of different phantom materials. These include standard biological tissues such as bone, muscle and fat as well as air. A detailed comparison of the new 2D pencil beam scaling with the current standard pencil beam approach and Monte Carlo simulations, performed with GEANT, is presented. It was found that the new concept proposed allows calculation of absorbed dose with an accuracy almost equal to that achievable with Monte Carlo simulations while requiring only modestly increased calculation times in comparison to the standard pencil beam approach. It is believed that this new proton dose algorithm has the potential to significantly improve the treatment planning outcome for many clinical cases encountered in highly conformal proton therapy. (author)

  7. PDMS patterning by proton beam

    International Nuclear Information System (INIS)

    Szilasi, S.Z.; Huszank, R.; Csik, A.; Rajta, I.; Cserhati, C.

    2008-01-01

    Complete text of publication follows. In this paper the poly-(dimethylsiloxane) (PDMS) is introduced as a resist material for proton beam writing. We were looking for a biocompatible micropatternable polymer in which the chemical structure changes significantly due to proton beam exposure making the polymer capable of proton beam writing. PDMS is a commonly used silicon-based organic polymer, optically clear, and generally considered to be inert, non-toxic biocompatible polymer. PDMS is also notably hydrophobic, meaning that water cannot easily penetrate its surface. This property has led extended use of PDMS in microfluidics too. PDMS is a crosslinkable polymer, it acts like a rubbery solid when it is cross-linked. In this state, the polymer does not deform permanently under stress or strain. Up to now the PDMS has been used as a casting or replicating material in microfabrication to form microchannels, micromolding, or creating microstamps, etc. PDMS has not been used as a resist material for direct write techniques. In this work we investigated the surface topography of the irradiated regions of PDMS under and without stress (on the cut surface and on the original fluid surface, respectively). In the samples wherein stress was not developed, noticeable compaction was observed. In case of those samples wherein stress was developed, noticeable swelling occurred. During the irradiation around the actual position of the beam spot we experienced significant swelling that reduced in time. To determine the large scale remaining changes in the surface topography at the cut edges of the samples we used Scanning Electron Microscope (SEM). After numerous profilometer measurements we experienced that the irradiated areas became harder, so the probe could move on it without sinking. The unirradiated areas of the PDMS were so soft, that the probe sank in the medium even with the smallest load (5 x 10 -7 N). Because of this phenomenon the irradiated areas seem to be higher

  8. A GPU-accelerated and Monte Carlo-based intensity modulated proton therapy optimization system.

    Science.gov (United States)

    Ma, Jiasen; Beltran, Chris; Seum Wan Chan Tseung, Hok; Herman, Michael G

    2014-12-01

    Conventional spot scanning intensity modulated proton therapy (IMPT) treatment planning systems (TPSs) optimize proton spot weights based on analytical dose calculations. These analytical dose calculations have been shown to have severe limitations in heterogeneous materials. Monte Carlo (MC) methods do not have these limitations; however, MC-based systems have been of limited clinical use due to the large number of beam spots in IMPT and the extremely long calculation time of traditional MC techniques. In this work, the authors present a clinically applicable IMPT TPS that utilizes a very fast MC calculation. An in-house graphics processing unit (GPU)-based MC dose calculation engine was employed to generate the dose influence map for each proton spot. With the MC generated influence map, a modified least-squares optimization method was used to achieve the desired dose volume histograms (DVHs). The intrinsic CT image resolution was adopted for voxelization in simulation and optimization to preserve spatial resolution. The optimizations were computed on a multi-GPU framework to mitigate the memory limitation issues for the large dose influence maps that resulted from maintaining the intrinsic CT resolution. The effects of tail cutoff and starting condition were studied and minimized in this work. For relatively large and complex three-field head and neck cases, i.e., >100,000 spots with a target volume of ∼ 1000 cm(3) and multiple surrounding critical structures, the optimization together with the initial MC dose influence map calculation was done in a clinically viable time frame (less than 30 min) on a GPU cluster consisting of 24 Nvidia GeForce GTX Titan cards. The in-house MC TPS plans were comparable to a commercial TPS plans based on DVH comparisons. A MC-based treatment planning system was developed. The treatment planning can be performed in a clinically viable time frame on a hardware system costing around 45,000 dollars. The fast calculation and

  9. A GPU-accelerated and Monte Carlo-based intensity modulated proton therapy optimization system

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Jiasen, E-mail: ma.jiasen@mayo.edu; Beltran, Chris; Seum Wan Chan Tseung, Hok; Herman, Michael G. [Department of Radiation Oncology, Division of Medical Physics, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905 (United States)

    2014-12-15

    Purpose: Conventional spot scanning intensity modulated proton therapy (IMPT) treatment planning systems (TPSs) optimize proton spot weights based on analytical dose calculations. These analytical dose calculations have been shown to have severe limitations in heterogeneous materials. Monte Carlo (MC) methods do not have these limitations; however, MC-based systems have been of limited clinical use due to the large number of beam spots in IMPT and the extremely long calculation time of traditional MC techniques. In this work, the authors present a clinically applicable IMPT TPS that utilizes a very fast MC calculation. Methods: An in-house graphics processing unit (GPU)-based MC dose calculation engine was employed to generate the dose influence map for each proton spot. With the MC generated influence map, a modified least-squares optimization method was used to achieve the desired dose volume histograms (DVHs). The intrinsic CT image resolution was adopted for voxelization in simulation and optimization to preserve spatial resolution. The optimizations were computed on a multi-GPU framework to mitigate the memory limitation issues for the large dose influence maps that resulted from maintaining the intrinsic CT resolution. The effects of tail cutoff and starting condition were studied and minimized in this work. Results: For relatively large and complex three-field head and neck cases, i.e., >100 000 spots with a target volume of ∼1000 cm{sup 3} and multiple surrounding critical structures, the optimization together with the initial MC dose influence map calculation was done in a clinically viable time frame (less than 30 min) on a GPU cluster consisting of 24 Nvidia GeForce GTX Titan cards. The in-house MC TPS plans were comparable to a commercial TPS plans based on DVH comparisons. Conclusions: A MC-based treatment planning system was developed. The treatment planning can be performed in a clinically viable time frame on a hardware system costing around 45

  10. Cooperative scans

    NARCIS (Netherlands)

    M. Zukowski (Marcin); P.A. Boncz (Peter); M.L. Kersten (Martin)

    2004-01-01

    textabstractData mining, information retrieval and other application areas exhibit a query load with multiple concurrent queries touching a large fraction of a relation. This leads to individual query plans based on a table scan or large index scan. The implementation of this access path in most

  11. Investigation of shinning Spot Defect on Hot-Dip Galvanized Steel Sheets

    International Nuclear Information System (INIS)

    Yonggang, Liu; Lei, Cui

    2014-01-01

    Shinning spot defects on galvanized steel sheets were studied by optical microscope, scanning electron microscope(SEM), Energy Dispersive Spectrometer (EDS) and Laser-Induced Breakdown Spectroscopy Original Position Statistic Distribution Analysis (LIBSOPA) in this study. The research shows that the coating thickness of shinning spot defects which caused by the substrate defect is much lower than normal area, and when skin passed, the shinning spot defect area can not touch with skin pass roll which result in the surface of shinning spot is flat while normal area is rough. The different coating morphologies have different effects on the reflection of light, which cause the shinning spot defects more brighter than normal area

  12. Proton decay theory

    International Nuclear Information System (INIS)

    Marciano, W.J.

    1983-01-01

    Topics include minimal SU(5) predictions, gauge boson mediated proton decay, uncertainties in tau/sub p/, Higgs scalar effects, proton decay via Higgs scalars, supersymmetric SU(5), dimension 5 operators and proton decay, and Higgs scalars and proton decay

  13. TV spots' impact.

    Science.gov (United States)

    El-bakly, S

    1994-09-01

    The Information, Education and Communication (IEC) Center of the State Information Service was established in 1979 for the purpose of providing information to the people on the population issue. The Ministry of Information has accorded the State Information Service free TV and radio air time for family planning dramas and spots. In the early years information campaigns were organized to make people aware of the population problem by slogans, songs, and cartoons. Around 1984 misconceptions about family planning and contraceptives were attacked through a number of TV and radio spots. A few years later 21 spots on specific contraceptive methods were broadcast which were aired for three years over 3000 times. They were extremely successful. The impact of these TV spots was one of the major reasons why the contraceptive prevalence rate increased from 30% in 1984 to 38% in 1988 and 47% in 1992. Spots were also broadcast about the social implications of large families. The TV soap opera "And The Nile Flows On", with the family planning message interwoven into it, was very well received by the target audience. A program entitled "Wedding of the Month" features couples who know family planning well. The most successful radio program is a 15-20 minute long quiz show for residents of the villages where the Select Villages Project is being implemented. The State Information Service has 60 local information centers in the 26 governorates of Egypt that make plans for the family planning campaign. In 1992 the Minya Initiative, a family planning project was implemented in the Minya Governorate. As a result, the contraceptive prevalence rate rose from 22% to 30% over 18 months. A new project, the Select Village Project, was developed in 1993 that replicates the Minya Initiative on the village level in other governorates. This new project that was implemented in sixteen governorates.

  14. Evaluation and mitigation of the interplay effects for intensity modulated proton therapy for lung cancer in a clinical setting

    Science.gov (United States)

    Kardar, Laleh; Li, Yupeng; Li, Xiaoqiang; Li, Heng; Cao, Wenhua; Chang, Joe Y.; Liao, Li; Zhu, Ronald X.; Sahoo, Narayan; Gillin, Michael; Liao, Zhongxing; Komaki, Ritsuko; Cox, James D.; Lim, Gino; Zhang, Xiaodong

    2015-01-01

    Purpose The primary aim of this study was to evaluate the impact of interplay effects for intensity-modulated proton therapy (IMPT) plans for lung cancer in the clinical setting. The secondary aim was to explore the technique of iso-layered re-scanning for mitigating these interplay effects. Methods and Materials Single-fraction 4D dynamic dose without considering re-scanning (1FX dynamic dose) was used as a metric to determine the magnitude of dosimetric degradation caused by 4D interplay effects. The 1FX dynamic dose was calculated by simulating the machine delivery processes of proton spot scanning on moving patient described by 4D computed tomography (4DCT) during the IMPT delivery. The dose contributed from an individual spot was fully calculated on the respiratory phase corresponding to the life span of that spot, and the final dose was accumulated to a reference CT phase by using deformable image registration. The 1FX dynamic dose was compared with the 4D composite dose. Seven patients with various tumor volumes and motions were selected. Results The CTV prescription coverage for the 7 patients were 95.04%, 95.38%, 95.39%, 95.24%, 95.65%, 95.90%, and 95.53%, calculated with use of the 4D composite dose, and were 89.30%, 94.70%, 85.47%, 94.09%, 79.69%, 91.20%, and 94.19% with use of the 1FX dynamic dose. For the 7 patients, the CTV coverage, calculated by using single-fraction dynamic dose, were 95.52%, 95.32%, 96.36%, 95.28%, 94.32%, 95.53%, and 95.78%, using maximum MU limit value of 0.005. In other words, by increasing the number of delivered spots in each fraction, the degradation of CTV coverage improved up to 14.6%. Conclusions Single-fraction 4D dynamic dose without re-scanning was validated as a surrogate to evaluate the interplay effects for IMPT for lung cancer in the clinical setting. The interplay effects can be potentially mitigated by increasing the number of iso-layered re-scanning in each fraction delivery. PMID:25407877

  15. Radionuclide scanning

    International Nuclear Information System (INIS)

    Shapiro, B.

    1986-01-01

    Radionuclide scanning is the production of images of normal and diseased tissues and organs by means of the gamma-ray emissions from radiopharmaceutical agents having specific distributions in the body. The gamma rays are detected at the body surface by a variety of instruments that convert the invisible rays into visible patterns representing the distribution of the radionuclide in the body. The patterns, or images, obtained can be interpreted to provide or to aid diagnoses, to follow the course of disease, and to monitor the management of various illnesses. Scanning is a sensitive technique, but its specificity may be low when interpreted alone. To be used most successfully, radionuclide scanning must be interpreted in conjunction with other techniques, such as bone radiographs with bone scans, chest radiographs with lung scans, and ultrasonic studies with thyroid scans. Interpretation is also enhanced by providing pertinent clinical information because the distribution of radiopharmaceutical agents can be altered by drugs and by various procedures besides physiologic and pathologic conditions. Discussion of the patient with the radionuclide scanning specialist prior to the study and review of the results with that specialist after the study are beneficial

  16. Proton therapy

    International Nuclear Information System (INIS)

    Jongen, Y.

    1995-01-01

    Ideal radiotherapy deposits a large amount of energy in the tumour volume, and none in the surrounding healthy tissues. Proton therapy comes closer to this goal because of a greater concentration of dose, well defined proton ranges and points of energy release which are precisely known - the Bragg peak1. In the past, the development of clinical proton therapy has been hampered by complexity, size, and cost. To be clinically effective, energies of several hundred MeV are required; these were previously unavailable for hospital installations, and pioneering institutions had to work with complex, inadequate equipment originally intended for nuclear physics research. Recently a number of specialist organizations and commercial companies have been working on dedicated systems for proton therapy. One, IBA of Belgium, has equipment for inhouse hospital operation which encompasses a complete therapy centre, delivered as a turnkey package and incorporating a compact, automated, higher energy cyclotron with isocentric gantries. Their system will be installed at Massachusetts General Hospital, Boston. The proton therapy system comprises: - a 235 MeV isochronous cyclotron to deliver beams of up to 1.5 microamps, but with a hardware limitation to restrict the maximum possible dose; - variable energy beam (235 to 70 MeV ) with energy spread and emittance verification; - a beam transport and switching system to connect the exit of the energy selection system to the entrances of a number of gantries and fixed beamlines. Along the beam transport system, the beam characteristics are monitored with non-interceptive multiwire ionization chambers for automatic tuning; - gantries fitted with nozzles and beamline elements for beam control; both beam scattering and beam wobbling techniques are available for shaping the beam;

  17. WE-D-BRB-01: Basic Physics of Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Arjomandy, B. [McLaren Cancer Institute (United States)

    2016-06-15

    The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.

  18. WE-D-BRB-00: Basics of Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.

  19. WE-D-BRB-00: Basics of Proton Therapy

    International Nuclear Information System (INIS)

    2016-01-01

    The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.