State primary standard for units of absorbed dose and absorbed dose rate of photon, electron, proton radiation and in carbon ion beams, quantity, fuence, fux density and energy of particles in proton beams and heavy charged particles GET 38-2024

GET 38-2024 State primary standard for absorbed dose and absorbed dose rate of photon, electron, and proton radiation and in carbon ion beams and particle quantity, fluence, flux density, and energy in proton and heavy charged particle beams

Powerful radiotherapy for hepatocellular carcinoma.

Purpose: To develop an algorithm to resolve intrinsic problems with dose calculations using pencil beams when particles involved in each beam are overreaching a lateral density interface or when they are detouring in a laterally heterogeneous medium. Method and Materials: A finding on a Gaussian distribution, such that it can be approximately decomposed into multiple narrower, shifted, and scaled ones, was applied to dynamic splitting of pencil beams implemented in a dose calculation algorithm for proton and ion beams. The method was tested in an experiment with a range-compensated carbon-ion beam. Its effectiveness and efficiency were evaluated for carbon-ion and proton beams in a heterogeneous phantom model. Results: The splitting dose calculation reproduced the detour effect observed in the experiment, which amounted to about 10% at a maximum or as large as the lateral particle-disequilibrium effect. The proton-beam dose generally showed large scattering effects including the overreach and detour effects. The overall computational times were 9 s and 45 s for non-splitting and splitting carbon-ion beams and 15 s and 66 s for non-splitting and splitting proton beams. Conclusions: The beam-splitting method was developed and verified to resolve the intrinsic size limitation of the Gaussian pencil-beam model in dose calculation algorithms. The computational speed slowed down by factor of 5, which would be tolerable for dose accuracy improvement at a maximum of 10%, in our test case.

Successful results in carbon-ion and proton radiotherapies can extend patients' lives and thus present a treatment option for younger patients; however, the undesired exposure to normal tissues outside the treatment volume is a concern. Organ-specific information on the absorbed dose and the biological effectiveness in the patient is essential for assessing the risk, but experimental dose assessment has seldom been done. In this study, absorbed doses, quality factors, and dose equivalents in water phantom outside of the irradiation field were determined based on lineal energy distributions measured with a commercial tissue equivalent proportional counter (TEPC) at passive carbon-ion and proton radiotherapy facilities. Measurements at eight positions in the water phantom were carried out at the Heavy-Ion Medical Accelerator in Chiba of the National Institute of Radiological Sciences for 400 and 290 MeV/u carbon beams and at the National Cancer Center Hospital East for a 235 MeV proton beam. The dose equivalent per treatment absorbed dose at the center of the range-modulated region H/Dt, decreased as the position became farther from the beam axis and farther from the phantom surface. The values of H/Dt ranged from 6.7 to 0.16 mSv/Gy for the 400 MeV/u carbon beam, from 1.3 to 0.055 mSv/Gy for the 290 MeV/u carbon beam, and from 4.7 to 0.24 mSv/GV for the 235 MeV proton beam. The values of the dose-averaged quality factor QD ranged from 2.4 to 4.6 for the 400 MeV/u beam, from 2.8 to 5.3 for the 290 MeV/u beam, and from 5.1 to 8.2 for the proton beam. The authors also observed differences in the distributions of H/Dt and QD between the carbon and proton beams. The authors experimentally obtained absorbed doses, dose-averaged quality factors, and dose equivalents in water phantom outside of the irradiation field in passive carbon-ion and proton radiotherapies with TEPC. These data are very useful for estimating the risk of secondary cancer after receiving passive radiotherapies and for verifying Monte Carlo calculations.

In this work, the LET-dependence of the response of synthetic diamond detectors is investigated in different particle beams. Measurements were performed in three nonmodulated particle beams (proton, carbon, and oxygen). The response of five synthetic diamond detectors was compared to the response of a Markus or an Advanced Markus ionization chamber. The synthetic diamond detectors were used with their axis parallel to the beam axis and without any bias voltage. A high bias voltage was applied to the ionization chambers, to minimize ion recombination, for which no correction is applied (+300 V and +400 V were applied to the Markus and Advanced Markus ionization chambers respectively). The ratio between the normalized response of the synthetic diamond detectors and the normalized response of the ionization chamber shows an under-response of the synthetic diamond detectors in carbon and oxygen ion beams. No under-response of the synthetic diamond detectors is observed in protons. For each beam, combining results obtained for the five synthetic diamond detectors and considering the uncertainties, a linear fit of the ratio between the normalized response of the synthetic diamond detectors and the normalized response of the ionization chamber is determined. The response of the synthetic diamond detectors can be described as a function of LET as (-6.22E-4 ± 3.17E-3) • LET + (0.99 ± 0.01) in proton beam, (-2.51E-4 ± 1.18E-4) • LET + (1.01 ± 0.01) in carbon ion beam and (-2.77E-4 ± 0.56E-4) • LET + (1.03 ± 0.01) in oxygen ion beam. Combining results obtained in carbon and oxygen ion beams, a LET dependence of about 0.026% (±0.013%) per keV/μm is estimated. Due to the high LET value, a LET dependence of the response of the synthetic diamond detector was observed in the case of carbon and oxygen beams. The effect was found to be negligible in proton beams, due to the low LET value. The under-response of the synthetic diamond detector may result from the recombination of electron/hole in the thin synthetic diamond layer, due to the high LET-values. More investigations are required to confirm this assumption.

The more important heavy charged particle radiotherapy of the future is more likely to be with heavy ions rather than protons

Monte Carlo simulations play a crucial role for in-vivo treatment monitoring based on PET and prompt gamma imaging in proton and carbon-ion therapies. The accuracy of the nuclear fragmentation models implemented in these codes might affect the quality of the treatment verification. In this paper, we investigate the nuclear models implemented in GATE/Geant4 and FLUKA by comparing the angular and energy distributions of secondary particles exiting a homogeneous target of PMMA. Comparison results were restricted to fragmentation of 16O and 12C. Despite the very simple target and set-up, substantial discrepancies were observed between the two codes. For instance, the number of high energy (>1 MeV) prompt gammas exiting the target was about twice as large with GATE/Geant4 than with FLUKA both for proton and carbon ion beams. Such differences were not observed for the predicted annihilation photon production yields, for which ratios of 1.09 and 1.20 were obtained between GATE and FLUKA for the proton beam and the carbon ion beam, respectively. For neutrons and protons, discrepancies from 14% (exiting protons–carbon ion beam) to 57% (exiting neutrons–proton beam) have been identified in production yields as well as in the energy spectra for neutrons.

Dose distribution and energy straggling for proton and carbon ion beams in water are investigated by using a hadrontherapy model based on the Geant4 toolkit. By gridding water phantom in N × N × N voxels along X, Y and Z axes, irradiation dose distribution in all the voxels is calculated. Results indicate that carbon ion beams have more advantages than proton beams. Proton beams have bigger width of the Bragg peak and broader lateral dose distribution than carbon ion beams for the same position of Bragg peaks. Carbon ion has a higher local ionization density and produces more secondary electrons than proton, so carbon ion beams can achieve a higher value of relative biological effectiveness.

Proton and carbon ion beams have a very sharp Bragg peak. For proton beams of energies smaller than 100 MeV, fitting with a gaussian the region of the maximum of the Bragg peak, the sigma along the beam direction is smaller than 1 mm, while for carbon ion beams, the sigma derived with the same technique is smaller than 1 mm for energies up to 360 MeV. In order to use low energy proton and carbon ion beams in hadrontherapy and to achieve an acceptable homogeneity of the spread out Bragg peak (SOBP) either the peak positions along the beam have to be quite close to each other or the longitudinal peak shape needs to be broaden at least few millimeters by means of a properly designed ripple filter. With a synchrotron accelerator in conjunction with active scanning techniques the use of a ripple filter is necessary to reduce the numbers of energy switches necessary to obtain a smooth SOBP, leading also to shorter overall irradiation times.We studied the impact of the design of the ripple filter on the dose uniformity in the SOBP region by means of Monte Carlo simulations, implemented using the package Geant4. We simulated the beam delivery line supporting both proton and carbon ion beams using different energies of the beams. We compared the effect of different kind of ripple filters and their advantages.

Usefulness of positron-emission tomographic images after proton therapy

The calibration coefficients of a parallel plate ionization chamber are examined by comparing the coefficients obtained through three methods: a calculation from a 60Co calibration coefficient, , a cross-calibration of a parallel plate ionization chamber using a cylindrical ionization chamber at the plateau region of a mono-energetic beam and a cross-calibration of the chamber using a cylindrical chamber at the middle of the SOBP of the therapeutic beams. This paper also examines reference conditions for determining absorbed dose to water in the cases of therapeutic carbon and proton beams. In the dose calibration procedure recommended by IAEA, irradiation fields should be larger than 10 cm in diameter and the water phantom should extend by at least 5 cm beyond each side of the field. These recommendations are experimentally verified for proton and carbon beams. For proton beams, the calibration coefficients obtained by these three methods approximately agreed. For carbon beams, the calibration coefficients obtained by the second method were about 1.0% larger than those obtained by the third method, and the calibration coefficients obtained by cross-calibration using 290 MeV/u beams were 0.5% lower than those obtained using 400 MeV/u beams. The calibration coefficient obtained by the first method agreed roughly with the results obtained by SOBP beams.

Preclinical biological assessment of proton and carbon ion beams at Hyogo Ion Beam Medical Center

Cylindrical ionization chambers are used for the determination of absorbed dose in beams of heavy charged particles, where the effective point of measurement, Peff (the point in depth to which the measured dose refers), is a priori not known. A measurement of Peff for a Farmer-type chamber in a carbon ion beam is presented. It is based on a comparison of relative depth dose curves measured with a cylindrical chamber and a plane-parallel Markus chamber. Both measurements were compared against another high-precision relative depth dose measurement using large-area plane-parallel chambers. For Peff, a value of 72±7% of the inner radius of the chamber is obtained. The relative depth dose curve for the cylindrical chamber is calculated using an averaging of the depth dose values over the curved inner surface of the active volume while taking account of the different depths of points on the inner surface. Within the measurement uncertainty of 0.2 mm the measurements agree well with the calculated Bragg curve for the Farmer chamber. The result for Peff is in correspondence with the value suggested in a new code of practice by the IAEA for protons and ions, and somewhat less than that suggested by Palmans for protons. The measurements show that cylindrical chambers are in general well suited for depth dose measurements in fields of heavy charged particles if the correct Peff is used.

Advances in hadrontherapy dosimetry

Simple SummaryUsing a consistent experimental protocol, we found a large heterogeneity in the relative biological effectiveness (RBE) values of both proton and carbon-ion beams in various sarcomas and normal-tissue-derived cell lines. Our data suggest that proton beam therapy may be more beneficial for some types of tumors. In carbon-ion therapy, for some types of tumors, large heterogeneity in RBE should prompt consideration of dose reduction or an increased dose per fraction. In particular, a higher RBE value in normal tissues requires caution. Specific dose evaluations for tumor and normal tissues are needed for both proton and carbon-ion therapies.This study investigated variations in the relative biological effectiveness (RBE) values among various sarcoma and normal-tissue-derived cell lines (normal cell line) in proton beam and carbon-ion irradiations. We used a consistent protocol that specified the timing of irradiation after plating cells and detailed the colony formation assay. We examined the cell type dependence of RBE for proton beam and carbon-ion irradiations using four human sarcoma cell lines (MG63 osteosarcoma, HT1080 fibrosarcoma, SW872 liposarcoma, and SW1353 chondrosarcoma) and three normal cell lines (HDF human dermal fibroblast, hTERT-HME1 mammary gland, and NuLi-1 bronchus epithelium). The cells were irradiated with gamma rays, proton beams at the center of the spread-out Bragg peak, or carbon-ion beams at 54.4 keV/μm linear energy transfer. In all sarcoma and normal cell lines, the average RBE values in proton beam and carbon-ion irradiations were 1.08 ± 0.11 and 2.08 ± 0.36, which were consistent with the values of 1.1 and 2.13 used in current treatment planning systems, respectively. Up to 34% difference in the RBE of the proton beam was observed between MG63 and HT1080. Similarly, a 32% difference in the RBE of the carbon-ion beam was observed between SW872 and the other sarcoma cell lines. In proton beam irradiation, normal cell lines had less variation in RBE values (within 10%), whereas in carbon-ion irradiation, RBE values differed by up to 48% between hTERT-HME1 and NuLi-1. Our results suggest that specific dose evaluations for tumor and normal tissues are necessary for treatment planning in both proton and carbon-ion therapies.