Evaluation of Proton Therapy Accuracy Using a PMMA Phantom and PET Prediction Module.

Junyu Zhang,Weiwei Wang,Jiangang Zhang,Yinxiangzi Sheng,Rong Zhou,Jingyi Cheng,Wenchien Hsi,Yan Lu,Jiade Lu,Leijun Shi

doi:10.3389/fonc.2018.00523

Abstract

Purpose: Positron emission tomography (PET) scanning is a widely used method of proton therapy verification. In this study, a proton radiotherapy accuracy verification process was developed by comparing predicted and measured PET data to verify the correctness of PET prediction and was tested at the Shanghai Proton and Heavy Ion Center.Method: Irradiation was performed on a polymethyl methacrylate (PMMA) phantom. There were two dose groups, to which 2 and 4 Gy doses were delivered, and each dose group had different designed dose depths ranging from 5 to 20 cm. The predicted PET results were obtained using a PET prediction calculation module. The measured data were collected with a PET/computed tomography device. The predicted and measured PET data were normalized to similar PET amplitude values before comparison and were compared using depth and lateral profiles for the position error. The error was evaluated at the position corresponding to 50% of the maximum on the PET curves. The mean and standard deviation were calculated based on the data sampled in the scoring area. Gamma index analysis is also applied in the comparison.Results: In the depth comparison, the 2 and 4 Gy dose cases yielded similar mean depth errors between 1 and −1 mm, and the deviation was <2 mm. In the lateral comparison, the 2 Gy cases had a mean lateral error around 1 mm, and the 4 Gy cases had a mean lateral error <1 mm, with a standard deviation <1 mm for both the 2 and 4 Gy cases. All the cases have a gamma passing rate over 95%.Conclusion: The comparison of these PMMA phantom cases revealed good agreement between the predicted and measured PET data, with depth and lateral position errors <2 mm in total, considering the uncertainty. The comparison results demonstrate that the PET predictions obtained in PMMA phantom tests for single proton beam therapy verification are reliable and that the research can be extended to verification in human body treatment with further investigation.

Highlights

Proton therapy has already been confirmed to be an efficient method of solid tumor treatment [1]
A proton beam can deposit most of its dose at the end of the beam range in the so-called Bragg peak and can reduce the dose deposited along the beam track in normal tissue
A commonly used method is positron emission tomography (PET) [2,3,4], which can be employed to score the positron-emitting isotopes generated by the incident protons

Summary

Introduction

Proton therapy has already been confirmed to be an efficient method of solid tumor treatment [1]. A commonly used method is positron emission tomography (PET) [2,3,4], which can be employed to score the positron-emitting isotopes generated by the incident protons. The generated positron-emitting isotopes can be scored, the nuclear reaction process is different from the proton energy deposition process. The predicted images can be generated by Monte Carlo simulation [2, 7]. By simulating the treatment plan, both the dose and activity distributions can be scored. Frey et al [9] provided a method of predicting PET activity distributions that takes much less time than Monte Carlo prediction, and a prediction script called PET-RV was developed based on this algorithm

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