Beam Central Axis Research Articles

A dosimetrically motivated pathfinding approach for non-isocentric dynamic trajectory radiotherapy

Objective.Non-isocentric dynamic trajectory radiotherapy (DTRT) involves dynamic table translations in synchrony with intensity modulation and dynamic gantry, table, and/or collimator rotation. This work aims to develop and evaluate a novel dosimetrically motivated path determination technique for non-isocentric DTRT.Approach.The path determination considers all available beam directions, given on a user-specified grid of gantry angle, table angle, and longitudinal, vertical, and lateral table position. Additionally, the source-to-target distance of all beam directions can be extended by moving the table away from the gantry along the central beam axis to increase the collision-free space. The path determination uses a column generation algorithm to iteratively add beam directions to paths until a user-defined total path length is reached. A subsequent direct aperture optimization of the intensity modulation along the paths creates deliverable plans. Non-isocentric DTRT plans using the path determination and using a manual path setup were created for a craniospinal and a spinal irradiation case. Furthermore, VMAT, isocentric DTRT, and non-isocentric DTRT plans are created for a breast, head and neck (H&N), and esophagus case. Additionally, a HyperArc plan is created for the H&N case. The plans are compared in terms of the dosimetric treatment plan quality and estimated delivery time.Main results.For the craniospinal and spinal irradiation case, using path determination results in dose distributions with improved conformity but a slightly worse target homogeneity compared to manual path setup. The non-isocentric DTRT plans maintained target coverage while reducing the mean dose to organs-at-risk on average by 1.7 Gy (breast), 1.0 Gy (H&N), and 1.6 Gy (esophagus) compared to the VMAT plans and by 0.8 Gy (breast), 0.6 Gy (H&N), and 0.8 Gy (esophagus) compared to the isocentric DTRT plans.Significance.A general dosimetrically motivated path determination applicable to non-isocentric DTRT plans is successfully developed, further advancing the treatment planning for non-isocentric DTRT.

Evaluation of computed tomography anode voltage in clinical application: the influence of profiled filters

Monitoring of operational parameters of X-ray diagnostic equipment, including computer tomographs, is mandatory during acceptance and periodic tests in medical organizations. The importance of control of anode voltage of X-ray radiator is described (as one of the main technical parameters in diagnostic tests of patients, which can influence the quality of visualization and safe operation of the equipment). Anode voltage is evaluated by non-invasive methods using universal dosimeters in the user mode of equipment operation. The influence of profiled filters of Somatom Definition AS, SOMATOM go.All (Siemens, Germany) scanners on the accuracy of anode voltage measurement was investigated. The tests were conducted in clinic conditions without partial removal of the gantry (a structural element of the tomograph, inside which the system “X-ray emitter – detector” is located) and connection to the high-voltage circuit of the device. The distance between the sensitive elements of the measuring device and the displacement of the center of the sensing area relative to the position of the central axis of the X-ray beam of computed tomography scanner were taken into account. Normalized curves of kerma values, anode voltage values and their approximating analytical functions were obtained using a Piranha R&F/M 657 universal dosimeter (RTI Electronics AB, Sweden) at its displacement relative to the laser centralizer of computed tomography scanner. Based on the scheme for noninvasive estimation of anode voltage value, a formula of the relative deviation of the measured value of the anode voltage associated with the presence of a profiled filter at the output of the X-ray emitter of the tomograph and the displacement of the center point of the sensitive area of the measuring device relative to the central axis of the X-ray beam of the tomograph is obtained. The validity of the data based on the formula is confirmed experimentally. The results of the study will be helpful to technical specialists who maintain or control the X-ray computed tomography operating parameters.

Relative profile measurements in 1.5T MR-linacs: investigation of central axis deviations

Objective. In 1.5 T MR-linacs, the absorbed dose central axis (CAX) deviates from the beam's CAX due to inherent profile asymmetry. In addition, a measured CAX deviation may be biased due to potential lateral (to the beam) effective point of measurement (EPOML) shifts of the detector employed. By investigating CAX deviations, the scope of this study is to determine a set ofEPOMLshifts for profile measurements in 1.5 T MR-linacs.Approach. The Semiflex 3D ion chamber and microDiamond detector (PTW, Germany) were considered in the experimental study while three more detectors were included in the Monte Carlo (MC) study. CAX deviations in the crossline and inline profiles were calculated based on inflection points of the 10×10 cm2field, at five centers. In MC simulations, the experimental setup was reproduced. A small water voxel was simulated to calculate CAX deviation without the impact of the detector-specificEPOMLshift.Main results. All measurements were consistent among the five centers. MC-based and experimental measurements were in agreement within uncertainties. Placing the microDiamond in the vertical orientation does not appear to affect the detector'sEPOML, which is on its central longitudinal axis. For the Semiflex 3D in the crossline direction, the CAX deviation was 2.3 mm, i.e. 1 mm larger than the ones measured using the microDiamond and simulated considering the ideal water detector. Thus, anEPOMLshift of 1 mm is recommended for crossline profile measurements under both Semiflex 3D orientations. For the inline profile, anEPOMLshift of -0.5 mm was determined only for the parallel configuration. In the MC study, CAX deviations were found detector- and orientation-dependent. The dead volume is responsible for theEPOMLshift only in the inline profile and under the parallel orientation.Significance. This work contributes to data availability on the correction or mitigation of the magnetic field-induced changes in the detectors' response.

Effects of ionization chamber orientation in photon and neutron beams

Boron neutron capture therapy (BNCT) is a biologically targeted radiotherapy modality that utilizes a neutron beam. Ionization chambers are used in neutron beam dosimetry which is part of the commissioning process and periodic quality assurance. Ionization chambers used in BNCT are a bit larger in size compared to conventional external beam radiotherapy counterparts and a fixed horizontal beam direction poses its challenges among other considerations. Because of this, more flexible ionization chamber positioning would be preferred even in a large water phantom. In this work, we explain the effects and uncertainties that depend on chamber orientation. We compared depth dose curves measured with Exradin T2 and M2 ion chambers with two radiation sources, 6X photon and epithermal neutron beam, and in two orientations; one where the ionization chamber rod was positioned in perpendicular and the other where it was positioned in parallel orientation compared to the beam central axis. The perpendicular orientation is the reference orientation used in calibration. However, the parallel orientation allowed us to measure depth dose closer to the surface and the measurements had smaller systematic uncertainties because of a more straightforward alignment process. We can convert the data between the two different orientations with two simple correction parameters; correction factor which adjusted amplitude (k) and shift which adjusted the change of the effective point position in depth direction (Δ). All correction factor results were within 1.000±0.015 and all shift results were smaller or the same order of magnitude compared to the positioning accuracy, 0.05mm - 0.5mm. Even without the usage of corrections, the measurements were already almost in agreement. Because of this, we would recommend taking into consideration 2% additional uncertainty if measurements are performed in parallel orientation and no such correction parameters are used.

The development of a cylindrical phantom for nanoDotTM calibration with multiple beam angles

Background: The nanoDotTM dosimeter, an optically stimulated luminescent dosimeter (OSLD), is compact and precise, ideal for various applications like radiation dosimetry. The nanoDotTM requires calibration before use with the detector alignment perpendicular to the central beam axis. It exhibits angular dependence that may impact the calibration factor, requiring the fabrication of a specific cylindrical phantom for the calibration procedure. Objective: This study aimed to develop a cylindrical phantom for nanoDotTM calibration to facilitate dose measurements in composite fields with various beam angles and to evaluate the nanoDotTM calibration factors for different plans. Materials and methods: The cylindrical phantom was constructed using cast nylon material to accommodate the nanoDotTM or a cylindrical ionization chamber (IC). The novel phantom underwent validation for physical characteristics, including dimensions, density, and uniformity. Validation for the calibration factor, using cylindrical phantom (CF cylin) under standard conditions with a 10x10 cm² field size at 10 cm depth was conducted with 6 MV X-rays, comparing it with calibration factor using slab solid water phantoms (CFsolid). The CFcylin for different numbers of beams were determined and validated against a reference IC in various planning conditions. Furthermore, angular correction factors were determined for their application in the single-beam calibration factor. Results: The cylindrical phantom had dimensions of 20 cm in diameter and 30 cm in length, a density of 1.145 g/cm³ and good uniformity. As a result of single beam, the CF cylin, agreed well with CFsolid, showing a difference of -0.069%. The CFcylin increased with the number of beams, ranging between 1.179 and 1.242. Additionally, the angular correction factor increased as the number of beams increased, peaking at 1.058 with 9 beams. When comparing the results to the IC, it was observed that with an increase in the number of beams to 4 beams, the single-beam calibration factor exhibited a variation of more than 2%. However, when applying the CF cylin specific to the number of beams or correcting for the angular correction factor, the dose differences between nanoDotTM and IC measurements were within 2%. Conclusion: The developed cylindrical phantom is suitable for nanoDotTM calibration under single beam angle and in composite fields with various beam angles. The new calibration factors for specific numbers of beams allow for accurate dose measurements using nanoDotTM, thus reducing the dose difference from the IC to acceptable levels. Further studies should investigate its application in clinical situations.

Experimental validation of absorbed dose-to-medium calculation algorithms in heterogeneous media.

Objective.The aim of this work was to determine heterogeneous correction factors h[fclin,frefQclinQref]m,wdetto validate absorbed dose-to-medium Dm,fclinm,Qclincalculation algorithms from detector readings. The impact of detector orientation perpendicular and parallel to the beam central axis on the correction factors was also investigated.Approach.The h[fclin,frefQclinQref]m,wdetfactors were calculated for four types of detectors (PTW PinPoint T31016, PTW microDiamond T60016, PTW microSilicon T60023 and EBT3 film) placed in different media (cortical bone, lung, Teflon, adipose tissue and RW3) for the 6 MV energy beam with a 10x10 cm2field size. These corrections were then applied to the detector measurements performed at different depths in heterogeneous phantoms.Main results.The h[fclin,frefQclinQref]m,wdetfactors mainly depended on the media and slightly on the type of detector. Considering all detectors, the largest corrections were found in high-density media with values ranging from 0.911 to 0.934 in cortical bone. For comparison, the corrections in other media were closer to unity with values from 0.966 (lung and RW3) to 0.991 (adipose tissue). Except for the PinPoint T31016, detector orientation-dependence was observed especially in high-density media. A good agreement (≤ 1.5%) was found between Dm,fclinm,Qclincalculations and the detector readings corrected with the h[fclin,frefQclinQref]m,wdetfactor for all studied heterogeneous phantoms.SignificanceThis paper could serve as an initial guideline for medical physicists involved in the validation of the advanced type-b dose calculation algorithms reporting Dm,fclinm,Qclin. To our knowledge, this is the first study to assess the impact of the orientation of different detectors in heterogeneous media. The orientation dependence of the detector response observed in water may not reflect what is observed in heterogeneous media, especially in high-density media. The knowledge of the h[fclin,frefQclinQref]m,wdetfactors becomes mandatory for accurate interpretation of detector readings and comparisons with Dm,fclinm,Qclincalculations.

Long-Term Follow-Up of Patients with Conjunctival Lymphoma after Individualized Lens-Sparing Electron Radiotherapy: Results from a Longitudinal Study.

Irradiation with electrons is the primary treatment regime for localized conjunctival low-grade lymphomas. However, radiation-induced cataracts are a major cause of treatment-related morbidity. This study investigates whether lens-sparing electron irradiation produces sufficient disease control rates while preventing cataract formation. All consecutive patients with strictly conjunctival, low-grade Ann Arbor stage IE lymphoma treated with superficial electron irradiation between 1999 and 2021 at our department were reviewed. A total of 56 patients with 65 treated eyes were enrolled with a median follow-up of 65 months. The median dose was 30.96 Gy. A lens-spearing technique featuring a hanging rod blocking the central beam axis was used in 89.2% of all cases. Cumulative incidences of 5- and 10-year infield recurrences were 4.3% and 14.6%, incidences of 5- and 10-year outfield progression were 10.4% and 13.4%. We used patients with involvement of retroorbital structures treated with whole-orbit photon irradiation without lens protection-of which we reported in a previous study-as a control group. The cumulative cataract incidence for patients treated with electrons and lens protection was significantly lower (p = 0.005) when compared to patients irradiated without lens protection. Thus, electrons are an effective treatment option for conjunctival low-grade lymphomas. The presented lens-sparing technique effectively prevents cataract formation.

Monitoring linear accelerator beam with daily quality assurance phantom

This paper aims to analyze the output constancy of a medical linear accelerator using PTW, and to study the suitability as a daily quality assurance device. It is assumed that the device is sensitive enough to detect minor variations in central axis beam, flatness, symmetry, and beam quality factor. PTW, QUICKCHECKwebline is the most efficient wireless device used in daily quality assurance. The measurements of output doses of photons ( 6MV and 15 MV) and electrons (6,9,12, and 15MeV) from a medical linear accelerator before the daily treatment have been graphically analyzed. This study assures the output stability of Varian Clinac iX 2100 CD linear accelerator at Bhaktapur Cancer Hospital, Bhaktapur, Nepal. The beam flatness, symmetry, beam quality factor, and central axis of photon and electron beam have been analyzed for 10x10cm2 and 20x20cm2 field size in separate ways. Among the measurements, observed parameters lie under the tolerance limit as recommended by American Association of Physicists in Medicine viz. ±3%. The outcomes of the measurements are in the acceptable range for the treatment procedure of patients.

Design, testing and characterization of a proton central axis alignment device for the dynamic collimation system

Objective. Proton therapy conformity has improved over the years by evolving from passive scattering to spot scanning delivery technologies with smaller proton beam spot sizes. Ancillary collimation devices, such the Dynamic Collimation System (DCS), further improves high dose conformity by sharpening the lateral penumbra. However, as spot sizes are reduced, collimator positional errors play a significant impact on the dose distributions and hence accurate collimator to radiation field alignment is critical. Approach. The purpose of this work was to develop a system to align and verify coincidence between the center of the DCS and the proton beam central axis. The Central Axis Alignment Device (CAAD) is composed of a camera and scintillating screen-based beam characterization system. Within a light-tight box, a 12.3-megapixel camera monitors a P43/Gadox scintillating screen via a 45° first-surface mirror. When a collimator trimmer of the DCS is placed in the uncalibrated center of the field, the proton radiation beam continuously scans a 7×7 cm2 square field across the scintillator and collimator trimmer while a 7 s exposure is acquired. From the relative positioning of the trimmer to the radiation field, the true center of the radiation field can be calculated. Main results. The CAAD can calculate the offset between the proton beam radiation central axis and the DCS central axis within 0.054 mm accuracy and 0.075 mm reproducibility. Significance. Using the CAAD, the DCS is now able to be aligned accurately to the proton radiation beam central axis and no longer relies on an x-ray source in the gantry head which is only validated to within 1.0 mm of the proton beam.

An integrated 3D printed radioluminescent-based phantom for quality assurance on a robotic-arm linac

Objective. To develop, characterize and improve upon a high-resolution 3D printed radioluminescence-based imaging phantom for quality assurance (QA) of a robotic arm linear accelerator. Approach. A phantom was constructed which consisted of a scintillating sheet, fiducial markers, a low-cost complementary metal-oxide semiconductor camera and a 3D printed light–tight enclosure. The camera, equipped with a 12 mm lens, was angled 45 degrees from the horizontal axis with a direct line of sight of the scintillating sheet. A perspective image transformation with optical distortion correction was employed to obtain beam’s eye view images for different collimators. Beam profiles, Iris™ field size, multileaf collimator leaf positioning and central laser-radiation field coincidence QA tests were performed and compared against data obtained with gafchromic film. The phantom’s short-term stability, sensitivity to changes in output, field size and leaf positioning were also assessed. Main Results. The limiting resolution of the optical system was measured to be ∼0.26 mm. Field size, as measured by the radioluminescence system for Iris apertures, agreed to within 0.2 mm of the values measured using film. The imaging system was sensitive to field size changes well below 0.2 mm and output changes as small as 1 monitor unit (MU). For the optical setup, the mean leaf deviation error for banks X1 and X2 was 0.21 and 0.17 mm at 800 mm source to axis distance, whereas the mean difference for the film dataset was 0.16 mm and 0.22 mm for banks X1 and X2, respectively. The optical system was able to detect leaf positioning errors as small as 0.2 mm. Compared with film data, excellent agreement was seen for relative central axis beam profiles for 10 mm and 5 mm beams. Significance. The phantom presented here is an alternative to film and electronic portal imager devices, due to its low-cost, portability, and high spatial and temporal resolution.

Cylindrical ionization chamber response in static and dynamic 6 and 15 MV photon beams

Purpose. To investigate the response of the CC13 ionization chamber under non-reference photon beam conditions, focusing on penumbra and build-up regions of static fields and on dynamic intensity-modulated beams. Methods. Measurements were performed in 6 MV 100 × 100, 20 × 100, and 20 × 20 mm2 static fields. Monte Carlo calculations were performed for the static fields and for 6 and 15 MV dynamic beam sequences using a Varian multi-leaf collimator. The chamber was modelled using EGSnrc egs_chamber software. Conversion factors were calculated by relating the absorbed dose to air in the chamber air cavity to the absorbed dose to water. Correction and point-dose correction factors were calculated to quantify the conversion factor variations. Results. The correction factors for positions on the beam central axis and at the penumbra centre were 0.98–1.02 for all static fields and depths investigated. The largest corrections were obtained for chamber positions beyond penumbra centre in the off-axis direction. Point-dose correction factors were 0.54–0.71 at 100 mm depth and their magnitude increased with decreasing field size and measurement depth. Factors of 0.99–1.03 were obtained inside and near the integrated penumbra of the dynamic field at 100 mm depth, and of 0.92–0.94 beyond the integrated penumbra centre. The variations in the ionization chamber response across the integrated dynamic penumbra qualitatively followed the behaviour across penumbra of static fields. Conclusions. Without corrections, the CC13 chamber was of limited usefulness for profile measurements in 20-mm-wide fields. However, measurements in dynamic small irregular beam openings resembling the conditions of pre-treatment patient quality assurance were feasible. Uncorrected ionization chamber response could be applied for dose verification at 100 mm depth inside and close to large gradients of dynamically accumulating high- and low-dose regions assuming 3% tolerance between measured and calculated doses.

Ionoacoustic application of an optical hydrophone to detect proton beam range in water.

Proton range uncertainty has been the main factor limiting the ability of proton therapy to concentrate doses to tumors to their full potential. Ionoacoustic (IA) range verification is an approach to reducing this uncertainty by detecting thermoacoustic waves emitted from an irradiated volume immediately following a pulsed proton beam delivery; however, the signal weakness has been an obstacle to its clinical application. To increase the signal-to-noise ratio (SNR) with the conventional piezoelectric hydrophone (PH), the detector-sensitive volume needs to be large, but it could narrow the range of available beam angles and disturb real-time images obtained during beam delivery. To prevent this issue, we investigated a millimeter-sized optical hydrophone (OH) that exploits the laser interferometric principle. For two types of IA waves [γ-wave emitted from the Bragg peak (BP) and a spherical IA wave with resonant frequency (SPIRE) emitted from the gold fiducial marker (GM)], comparisons were made with PH in terms of waveforms, SNR, range detection accuracy, and signal intensity robustness against the small detector misalignment, particularly for SPIRE. A 100-MeV proton beam with a 27 ns pulse width and 4 mm beam size was produced using a fixed-field alternating gradient accelerator and was irradiated to the water phantom. The GM was set on the beam's central axis. Acrylic plates of various thicknesses, up to 12mm, were set in front of the phantoms to shift the proton range. OH was set distal and lateral to the beam, and the range was estimated using the time-of-flight method for γ-wave and by comparing with the calibration data (SPIRE intensity versus the distance between the GM and BP) derived from an IA wave transport simulation for SPIRE. The BP dose per pulse was 0.5-0.6Gy. To measure the variation in SPIRE amplitude against the hydrophone misalignment, the hydrophone was shifted by±2mm at a maximum in lateral directions. Despite its small size, OH could detect γ-wave with a higher SNR than the conventional PH (diameter, 29mm), and a single measurement was sufficient to detect the beam range with a submillimeter accuracy in water. In the SPIRE measurement, OH was far more robust against the detector misalignment than the focused PH (FPH) used in our previous study [5%/mm (OH) versus 80%/mm (FPH)], and the correlation between the measured SPIRE intensity and the distance between the GM and BP agreed well with the simulation results. However, the OH sensitivity was lower than the FPH sensitivity, and about 5.6-Gy dose was required to decrease the intensity variation among measurements to less than 10%. The miniature OH was found to detect weak IA signals produced by proton beams with a BP dose used in hypofractionated regimens. The OH sensitivity improvement at the MHz regime is worth exploring as the next step.

Impact of secondary particles on the magnetic field generated by a proton pencil beam: a finite-element analysis based on Geant4-DNA simulations.

To investigate the static magnetic field generated by a proton pencil beam as a candidate for range verification by means of Monte Carlo simulations, thereby improving upon existing analytical calculations. We focus on the impact of statistical current fluctuations and secondary protons and electrons. We considered a pulsed beam (10 s pulse duration) during the duty cycle with a peak beam current of 0.2 A and an initial energy of 100MeV. We ran Geant4-DNA Monte Carlo simulations of a proton pencil beam in water and extracted independent particle phase spaces. We calculated longitudinal and radial current density of protons and electrons, serving as an input for a magnetic field estimation based on a finite element analysis in a cylindrical geometry. We made sure to allow for non-solenoidal current densities as is the case of a stopping proton beam. The rising proton charge density toward the range is not perturbed by energy straggling and only lowered through nuclear reactions by up to 15%, leading to an approximately constant longitudinal current. Their relative low density however (at most 0.37 protons/mm3 for the 0.2 A current and a beam cross-sectionof 2.5mm), gives rise to considerable current density fluctuations. The radial proton current resulting from lateral scattering and being two orders of magnitude weaker than the longitudinal current is subject to even stronger fluctuations. Secondary electrons with energies above 10eV, that far outnumber the primary protons, reduce the primary proton current by only 10% due to their largely isotropic flow. A small fraction of electrons (<1%), undergoing head-on collisions, constitutes the relevant electron current. In the far-field, both contributions to the magnetic field strength (longitudinal and lateral) are independent of the beam spot size. We also find that the nuclear reaction-related losses cause a shift of 1.3mm to the magnetic field profile relative to the actual range, which is further enlarged to 2.4mm by the electron current (at a distance of mm away from the central beam axis). For mm, the shift increases linearly. While the current density variations cause significant magnetic field uncertainty close to the central beam axis with a relative standard deviation (RSD) close to 100%, they average out at a distance of 10cm, where the RSD of the total magnetic field drops below 2%. With the small influence of the secondary electrons together with the low RSD, our analysis encourages an experimental detection of the magnetic field through sensitive instrumentation, such as optical magnetometry orSQUIDs.

Optimization of Radiation Shielding Considerations for Designing Halcyon Vault.

To determine the radiation shielding considerations for optimization of Halcyon vault shielding requirements. The primary and leakage workloads were estimated using actual clinical treatment planning and treatment delivery data acquired from three busy operational clinical Halcyon facilities. The effective use factor was determined based on a newer approach proposed in this paper using the percentage of patients treated with different treatment techniques. The transmission factor of the primary beam block, maximum head leakage, and patient scatter fractions around the Halcyon machine were experimentally determined. The first tenth-value layer (TVL1) and equilibrium tenth-value layer (TVLe) for 6 MV - flattening-filter-free (FFF) primary X-ray beam for ordinary concrete were measured. The primary and leakage workloads are estimated as 1 × 105 cGy/wk and 3.1 × 105 cGy/wk at 1 m respectively. The effective use factor is found as 0.114. The primary beam-block transmission factor is determined as 1.7 × 10-4 at 1 m distance from isocenter along the central beam axis. The maximum head leakage is noted as 6.23 × 10-4. The patient scatter fractions are reported for various planar angles around the Halcyon machine at a radial distance of 1 m in a horizontal plane passing through isocenter. The TVL1 and TVLe of 6 MV-FFF X-ray beam energy for ordinary concrete are found to be 33 and 29 cm, respectively. Using experimentally determined shielding considerations, the optimized vault shielding requirements for the Halcyon facility are calculated and a typical layout drawing is proposed.

Dosimetric Impact on the Flattening Filter and Addition of Gold Nanoparticles in Radiotherapy: A Monte Carlo Study on Depth Dose Using the 6 and 10 MV FFF Photon Beams.

Purpose: This phantom study investigated through Monte Carlo simulation how the dose enhancement varied with depth, when gold nanoparticles (NPs) were added using the flattening filter-free (FFF) photon beams in gold NP-enhanced radiotherapy. Method: A phantom with materials varying from pure water to a mixture of water and gold NPs at different concentrations (3–40 mg/mL) were irradiated by the 6 and 10 MV flattening filter (FF) and FFF photon beams. Monte Carlo simulations were carried out to determine the depth doses along the central beam axis of the phantom up to a depth of 40 cm. The dose enhancement ratio (DER) and FFF enhancement ratio (FFFER) were calculated based on the Monte Carlo results. Results: The DER values were found decreased with an increase of depth and increase of NP concentration in the phantom. For the maximum NP concentration of 40 mg/mL, the DER values decreased 6.9, 12, 4.6 and 7.2% at a phantom depth from 2 to 40 cm, using the 6 MV FF, 6 MV FFF, 10 MV FF and 10 MV FFF photon beams, respectively. The maximum DER values for the 6 MV beams were 1.08 (FF) and 1.14 (FFF), while those for the 10 MV beams were 1.04 (FF) and 1.07 (FFF). When the FF was removed from the linear accelerator head, the FFFER showed a more significant increase of dose enhancement for the 6 MV beams (1.057) than the 10 MV (1.031). Conclusion: From the DER and FFFER values based on the Monte Carlo results, it is concluded that the dose enhancement with depth was dependent on the NP and beam variables, namely, NP concentration, presence of FF in the beam and beam energy. Dose enhancement was more significant when using the lower photon beam energy (i.e., 6 MV), FFF photon beam and higher NP concentration in the study.

Optimization of FLASH proton beams using a track-repeating algorithm.

Radiation with high dose rate (FLASH) has shown to reduce toxicities to normal tissues around the target and maintain tumor control with the same amount of dose compared to conventional radiation. This phenomenon has been widely studied in electron therapy, which is often used for shallow tumor treatment. Proton therapy is considered a more suitable treatment modality for deep-seated tumors. The feasibility of FLASH proton therapy has recently been demonstrated by a series of pre- and clinical trials. One of the challenges is to efficiently generate wide enough dose distributions in both lateral and longitudinal directions to cover the entire tumor volume. The goal of this paper is to introduce a set of automatic FLASH proton beam optimization algorithms developed recently. To develop a fast and efficient optimizer for the design of a passive scattering proton FLASH radiotherapy delivery at The University of Texas MD Anderson Proton Therapy Center, based on the fast dose calculator (FDC). A track-repeating algorithm, FDC, was validated versus Geant4 simulations and applied to calculate dose distributions in various beamline setups. The design of the components was optimized to deliver homogeneous fields with well-defined diameters between 11.0 and 20.5mm, as well as a spread-out Bragg peak (SOBP) with modulations between 8.5 and 39.0mm. A ridge filter, a high-Z material scatterer, and a collimator with range compensator were inserted in the beam path, and their shapes and sizes were optimized to spread out the Bragg peak, widen the beam, and reduce the penumbra. The optimizer was developed and tested using two proton energies (87.0 and 159.5MeV) in a variety of beamline arrangements. Dose rates of the optimized beams were estimated by scaling their doses to those of unmodified beams. The optimized 87.0-MeV beams, with a distance from the beam pipe window to the phantom surface (window-to-surface distance [WSD]) of 550mm, produced an 8.5-mm-wide SOBP (proximal 90% to distal 90% of the maximum dose); 14.5, 12.0, and 11.0-mm lateral widths at the 50%, 80%, and 90% dose location, respectively; and a 2.5-mm penumbra from 80% to 20% in the lateral profile. The 159.5-MeV beam had an SOBP of 39.0mm and lateral widths of 20.5, 15.0, and 12.5mm at 50%, 80%, and 90% dose location, respectively, when the WSD was 550mm. Wider lateral widths were obtained with increased WSD. The SOBP modulations changed when the ridge filters with different characteristics were inserted. Dose rates on the beam central axis for all optimized beams (other than the 87.0-MeV beam with 2000-mm WSD) were above that needed for the FLASH effect threshold (40Gy/s) except at the very end of the depth dose profile scaling with a dose rate of 1400Gy/s at the Bragg peak in the unmodified beams. The optimizer was able to instantly design the individual beamline components for each of the beamline setups, without the need of time intensive iterative simulations. An efficient system, consisting of an optimizer and an FDC have been developed and validated in a variety of beamline setups, comprising two proton energies, several WSDs, and SOBPs. The set of automatic optimization algorithms produces beam shaping element designs efficiently and with excellent quality.

Skin Dose Modeling and Measurement in a High Field In-Line MRI-Linac System

The Australian MRI-Linac prototype radiotherapy system has been shown to generate significant entry skin or surface dose increases. This arises from electron contamination focusing toward the isocenter caused by the 1 T MRI field being in-line with the x-ray beam. The aim of this study is to present accurate Monte Carlo modeling of these skin dose changes and to compare them with previous experimental measurements. Accurate skin dose modeling will improve confidence in the pathway forward to treatment planning for clinical trials. A COMSOL Multiphysics model of the Australian MRI-Linac system was used to generate a 3D magnetic field map to be used in corresponding Geant4 Monte Carlo simulations. The Geant4 simulations included the x-ray source (6 MV Linac), multileaf collimators (MLCs), and a 30 cm × 30 cm × 30 cm water phantom located with its front surface at the beam isocenter. Simulations were performed with a source to surface distance (SSD) of 1,819 mm for nominal field sizes 2 cm × 2 cm, 6 cm × 6 cm, and 10 cm × 10 cm. Central axis percentage depth dose (PDD) and surface (or skin) doses at 70 μm depth were calculated by using high-resolution scoring voxels of 10 μm thickness. The results were compared with corresponding experimental data collected using MOSkin™ on the Australian MRI-Linac prototype system. The accurate modeling provides great detail into how the electron contamination is heavily confined and focused toward the beam central axis due to the presence of in-line magnetic field. This concentration significantly increases the skin dose up to 320% for the field size of 10 cm × 10 cm. For 2 cm × 2 cm and 6 cm × 6 cm, the surface skin dose is 128% and 217%, respectively, as compared to the skin dose in the absence of the magnetic field. The simulation results are in generally good agreement, ±10%, with previously collected experimental data for the same nominal field sizes. For the first time, detailed Geant4 Monte Carlo simulations of the electron contamination in the Australian MRI-Linac system have been performed and confirmed to be sufficiently accurate. These simulations will provide a solid framework for estimating the skin dose changes in more clinically relevant treatment plan scenarios that are envisaged in the near future.

Improved simultaneous LET and dose measurements in proton therapy

The objective of this study was to improve the precision of linear energy transfer (LET) measurements using text {Al}_2text {O}_3text {:C} optically stimulated luminescence detectors (OSLDs) in proton beams, and, with that, improve OSL dosimetry by correcting the readout for the LET-dependent ionization quenching. The OSLDs were irradiated in spot-scanning proton beams at different doses for fluence-averaged LET values in the (0.4–6.5) hbox {keV}, upmu hbox {m}^{-1} range (in water). A commercial automated OSL reader with a built-in beta source was used for the readouts, which enabled a reference irradiation and readout of each OSLD to establish individual corrections. Pulsed OSL was used to separately measure the blue (F-center) and UV (F^+-center) emission bands of text {Al}_2text {O}_3text {:C} and the ratio between them (UV/blue signal) was used for the LET measurements. The average deviation between the simulated and measured LET values along the central beam axis amounts to 5.5% if both the dose and LET are varied, but the average deviation is reduced to 3.5% if the OSLDs are irradiated with the same doses. With the measurement procedure and automated equipment used here, the variation in the signals used for LET estimates and quenching-corrections is reduced from 0.9 to 0.6%. The quenching-corrected OSLD doses are in agreement with ionization chamber measurements within the uncertainties. The automated OSLD corrections are demonstrated to improve the LET estimates and the ionization quenching-corrections in proton dosimetry for a clinically relevant energy range up to 230 MeV. It is also for the first time demonstrated how the LET can be estimated for different doses.

Accurate dose measurements using Cherenkov emission polarization imaging.

Cherenkov radiation carries the potential of direct in-water dose measurements, but its precision is currently limited by a strong anisotropy. Taking advantage of polarization imaging, this work proposes a new approach for high-accuracy Cherenkov emission dose measurements. Cherenkov radiation produced in a 15×15×20-cm3 water tank is imaged with a cooled charge-coupled device (CCD) camera from four polarizer transmission axes [0, 45, 90, 135°]. The water tank is positioned at the isocenter of a 5×5-cm2 , 6-, and 18-MV photon beam. Using Malus' law, the polarized portion of the signal is extracted. Corrections are applied to the polarized signal following azimuthal and polar Cherenkov emission angular distributions extracted from Monte Carlo simulations. Projected percent depth dose and beam profiles are measured and compared with the prediction from a treatment planning system (TPS). Corrected polarized signals on the central axis reduced deviations at depth (mean ± standard deviation) from 8%±5% to 0.8%±1% at 6MV and 8%±7% to 1%±3% at 18MV. For the profile measurement, differences between the corrected polarized signal and the TPS calculations are 1%±3% and 2%±3% on the central axis at 6 and 18MV respectively. In these conditions, Cherenkov emission is shown to be partly polarized. This work proposes a novel polarization imaging approach enabling high-precision water-based dose measurements using the Cherenkov radiation. The method allows a correction of the Cherenkov emission anisotropy within 4% on the beam central axis and in depth.

Online Bayesian optimization for a recoil mass separator

The SEparator for CApture Reactions (SECAR) is a next-generation recoil separator system at the Facility for Rare Isotope Beams (FRIB) designed for the direct measurement of capture reactions on unstable nuclei in inverse kinematics. To maximize the performance of this system, stringent requirements on the beam alignment to the central beam axis and on the ion-optical settings need to be achieved. These can be difficult to attain through manual tuning by human operators without potentially leaving the system in a sub-optimal and irreproducible state. In this work, we present the first development of online Bayesian optimization with a Gaussian process model to tune an ion beam through a nuclear astrophysics recoil separator. We show that this method achieves small incoming angular deviations (\textless 1 mrad) in an efficient and reproducible manner that is at least three times faster than standard hand-tuning. Additionally, we present a Bayesian method for experimental optimization of the ion optics, and show that it validates the nominal theoretical ion-optical settings of the device, and improves the mass separation by 32\% for some beams.