Abstract
Heavy ion therapy can deliver high doses with high precision. However, image guidance is needed to reduce range uncertainty. Radioactive ions are potentially ideal projectiles for radiotherapy because their decay can be used to visualize the beam. Positron-emitting ions that can be visualized with PET imaging were already studied for therapy application during the pilot therapy project at the Lawrence Berkeley Laboratory, and later within the EULIMA EU project, the GSI therapy trial in Germany, MEDICIS at CERN, and at HIMAC in Japan. The results show that radioactive ion beams provide a large improvement in image quality and signal-to-noise ratio compared to stable ions. The main hindrance toward a clinical use of radioactive ions is their challenging production and the low intensities of the beams. New research projects are ongoing in Europe and Japan to assess the advantages of radioactive ion beams for therapy, to develop new detectors, and to build sources of radioactive ions for medical synchrotrons.
Highlights
∼50% of cancer patients in Europe experience radiotherapy, generally by X-rays, as part of their treatment [1]
Even if image guidance is less common in charged particle therapy (CPT) compared to conventional radiotherapy, the physics of charged particles offers unique opportunities for in vivo range verification
radioactive ion beams (RIB) have been proposed as the ideal bullet for image-guided particle therapy
Summary
∼50% of cancer patients in Europe experience radiotherapy, generally by X-rays, as part of their treatment [1]. CPT is less robust than conventional radiotherapy because of considerable uncertainty on the particle range and poor image guidance [13]. Image guidance is essential for CPT, even more so than for X-rays, because a shift in the Bragg peak has a much larger impact on the dose than for photons (Figure 1). For moving targets this occurs through the interplay effect, causing underdosage to part of the target [15]. Even if image guidance is less common in CPT compared to conventional radiotherapy, the physics of charged particles offers unique opportunities for in vivo range verification. The radioactive projectile fragments provide a peak in the activity
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