Real-time Dose Research Articles

Design and Construction of Experimental System for Validation of a New Image Reconstruction Technique with Limited-view-angle Projection Data for BNCT-SPECT

Abstract. Boron Neutron Capture Therapy (BNCT) is expected to be a promising radiation therapy for cancer, and research on various issues associated with it is still in progress. One of the unsolved issues is the construction of a system for observing the effect of the treatment (local boron dose) in real time under high-background circumstances. Thus, we set out to establish a method for measuring gamma-rays emitted promptly from the body following the boron neutron capture reaction and reconstructing images in a SPECT-like manner. We call this method BNCT-SPECT. We have been developing a new image reconstruction method based on Bayesian estimation for the BNCT-SPECT method. In the present study, the aims were to design and construct an experimental system capable of validating BNCT-SPECT and its image reconstruction method and to confirm BNCT-SPECTs performance. The crucial takeaway from this study is that we should consider the use of extremely high background radiation during BNCT. For the validation of BNCT-SPECT, we attempted to reproduce these conditions, despite this being quite challenging. We first constructed an experimental system capable of reproducing such conditions. Theoretical investigation was carried out to facilitate the design of the system using the Monte Carlo transport calculation code MCNP. Finally, we performed experiments with some standard gamma-ray sources to complete the system.

Time-resolved observation of DHR123 nano-clay radio-fluorogenic gel dosimeters by photoluminescence-detected pulse radiolysis

The importance of real-time dose evaluation has increased for recent advanced radiotherapy. However, conventional methods for real-time dosimetry using gel dosimeters face challenges owing to the delayed dose response caused by the slow completion of radiation-induced chemical reactions. In this study, a novel technique called photoluminescence-detected pulse radiolysis (PLPR) was developed, and its potential to allow real-time dose measurements using nano-clay radio-fluorogenic gel (NC-RFG) dosimeters was investigated. PLPR is a time-resolved observation method, and enables time-resolved fluorescence measurement. NC-RFG dosimeters were prepared, typically consisting of 100 μM dihydrorhodamine 123 (DHR123) and 2.0 wt.% nano-clay, along with catalytic and dissolving additives. We successfully achieved time-resolved observation of the increase in fluorescence intensity upon irradiation of the dosimeter. Dose evaluation was possible at 1 s after irradiation. The dose-rate effect was not observed for the deoxygenated dosimeter, but was observed for the aerated dosimeter. Besides the dose-rate effect, linear dose responses were obtained for both conditions. Furthermore, we made a novel observation of a decay in the fluorescence intensity over time in the early stages which named fluorescence secondary loss (FSL) and elucidated the conditions under which this phenomenon occurs.

Assessment of controlled assistance from e-bikes as a mitigation strategy for individual PM exposure

Abstract Background While promoting active mobility and outdoor activities can benefit health (HLT), it also increases Exposure (EXP) to air pollutants, such as particulate matter (PM), due to the increased ventilation rate (VR) under physical activity. Traditional assessments of individual (IND) PM EXP involve costly equipment inaccessible to the public, but real-time low-cost sensors (LCS) are now emerging. This study presents a proof of concept to demonstrate the use of LCS for examining the real-time IND respiratory dose deposited (RDD) to PM cycling across the Brescia province. Methods An e-bike was ridden 33 times between 2022 and 2023 wearing a LCS for PM concentration [PM] linked to a GPS. Respiratory dose deposited(RDD) was calculated for six different locations within each route based on experimental PM and various VR. Results The LCS allows for the study of the spatial and temporal variability of [PM], revealing a significant difference (p < 0.01) according to the heating system operation and no significant difference (p > 0.05) depending on the location. RDD increases with [PM] and VR. Real-time and integrated RDD is calculated for routes with high (> 50 µg/m3), medium (25 µg/m3), and low (<10 µg/m3) [PM2.5]. The e-bike assistance is activated when the WHO interim target 4 of [PM] is reached to reduce VR, which corresponds to a shift to a lower physical activity intensity. The RDD calculated using the e-bike assistance over the path reduces RDD by about 23% and 11% over the high and medium [PM], while it never activates for the low [PM]. Conclusions This study demonstrates that the use of LCS allows the estimation of IND RDD, and the implementation of mitigation strategies based on controlled assistance from e-bikes would enable the reduction of PM individual EXP. Key messages • The integration of HLT data from wearable and air quality LCS enables the promotion of active mobility and outdoor activities controlling the EXP to air pollutants. • Establishing generalized guidelines based on this mitigation strategies for individual exposure reduction may also inform policy recommendations for promoting active and green mobility.

Quality assurance for online adaptive radiotherapy: a secondary dose verification model with geometry-encoded U-Net

Abstract Background & Purpose: In online adaptive radiotherapy (ART), quick computation-based secondary dose verification is crucial for ensuring the quality of ART plans while the patient is positioned on the treatment couch. However, traditional dose verification algorithms are generally time-consuming, reducing the efficiency of ART workflow. This study aims to develop an ultra-fast deep-learning (DL) based secondary dose verification algorithm to accurately estimate dose distributions using CT and fluence maps (FMs). 
Methods: We integrated FMs into the CT image domain by explicitly resolving the geometry of treatment delivery. For each gantry angle, an FM was constructed based on the optimized multi-leaf collimator apertures and corresponding monitoring units (MUs). To effectively encode treatment beam configuration, the constructed FMs were back-projected to 30 cm away from the isocenter with respect to the exact geometry of the treatment machines. Then, a 3D U-Net was utilized to take the integrated CT and FM volume as input to estimate dose. Training and validation were performed on 381 prostate cancer cases, with an additional 40 testing cases for independent evaluation of model performance.
Results: The proposed model can estimate dose in ~15 ms for each patient. The average γ passing rate (3%/2mm, 10% threshold) for the estimated dose was 99.9% ± 0.15% on testing patients. The mean dose differences for the planning target volume (PTV) and organs at risk (OARs) were 0.07%±0.34% and 0.48%±0.72%, respectively.
Conclusion: We have developed a geometry-resolved DL framework for accurate dose estimation and demonstrated its potential in real-time online ART doses verification.

Preliminary study of a compact epithermal neutron absolute flux intensity measurement system for real-time in-vivo dose monitoring in boron neutron capture therapy

Boron neutron capture therapy (BNCT) is a radiotherapy technology that selectively kills tumor cells via the 10B(n, α)7Li reactions. Epithermal neutrons (0.5 eV–10 keV) are emitted and converted into thermal neutrons, which have a larger neutron capture reaction cross-section, by slowing down in the human body before reaching the tumor. Recently, the development of an epithermal neutron absolute flux intensity measurement technique has become crucial for real-time in-vivo dose monitoring in BNCT. In this study, a concept for a measurement system consisting of multiple compact scintillator with optical fibers detectors covered with neutron absorbers of various thicknesses is proposed. The designed system achieves a consistent response to epithermal neutrons with a theoretical coefficient of variation not higher than 5% for both LiCAF and EJ-254 scintillators. The theoretical feasibility of the proposed measurement system was investigated by an irradiation experiment carried out at the heavy water neutron irradiation facility at the Kyoto University Reactor. The experimental results indicated that further improvement and refinement are necessary to meet the high accuracy and precision required for real-time dose monitoring in clinical applications.

Dosimetric saturation effect study and correction calculation method of ionization chamber at ultra-high dose rate (FLASH)

Backgroundand Purpose: FLASH radiotherapy has aroused strong interest among researchers, but how to monitor dose in real time and lack of generally accepted ion correction model are one of the challenges. This study is based on previous research work, the dosimetric verification of FLASH ionization chamber was performed using a 200 keV electron beam irradiation platform at an ultra-high dose rate. At the same time, the finite element program is written to analyze and calculate the ion correction factor. In addition, the results are compared with the calculation results of Boag model. MethodsIn this study, the pressure of the sensitive volume in the detector was adjusted to 16 mbar for the purpose of dosimetry of dose rates in excess of 100 Gy/s. In order to monitor the response of the detector, the beam frequency and pulse width were adjusted accordingly. However, due to the saturation effect of the ionization chamber, the processes of electron ion pair drift, attachment, recombination and diffusion in the sensitive volume were modelled on the basis of the relevant physical principles. Finally, the correction factor was calculated by the finite element analysis. ResultsThe experimental results demonstrate that the FLASH ionization chamber is capable of meeting the requirements of dose measurement and beam monitoring of the electron beam at ultra-high dose rates. Furthermore, the analytical model is able to more accurately describe the saturation effect and calculate the correction factor. ConclusionIn this paper, the method of reducing air pressure is employed for the purpose of monitoring the dose of ultra-high dose rate. Simultaneously, the finite element method was employed to analyze the physical process of electron–ion pairs within the chamber and to calculate the ion correction factor analytically. A comparison with the Boag model indicates that the proposed approach is effective. However, the results exhibit a certain degree of divergence from experimental outcomes. This discrepancy may be attributed to the influence of the input parameters, which require further calibration to enhance the accuracy and the robustness of the model.

Real-time delivered dose assessment in carbon ion therapy of moving targets

Abstract Purpose:
Real-time adaptive particle therapy is being investigated as a means to maximize the treatment delivery accuracy. To react to dosimetric errors, a system for fast and reliable verification of the agreement between planned and delivered doses is essential. This study presents a clinically feasible, real-time 4D-dose reconstruction system, synchronized with the treatment delivery and motion of the patient, which can provide the necessary feedback on the quality of the delivery.
Methods:
A GPU-based analytical dose engine capable of millisecond dose calculation for carbon ion therapy has been developed and interfaced with the next generation of the Dose Delivery System (DDS) in use at Centro Nazionale di Adroterapia Oncologica (CNAO). The system receives the spot parameters and the motion information of the patient during the treatment and performs the reconstruction of the planned and delivered 4Ddoses. After each iso-energy layer, the results are displayed on a graphical user interface by the end of the spill pause of the synchrotron, permitting verification against the reference dose.
The framework has been verified experimentally at CNAO for a lung cancer case based on a virtual phantom 4DCT. The patient’s motion was mimicked by a moving Ionization Chambers (ICs) 2D-array.
Results:
For the investigated static and 4D-optimized treatment delivery cases, real time dose reconstruction was-achieved with an average pencil beam dose calculation speed up to more than one order of magnitude smaller than the spot delivery. The reconstructed doses have been benchmarked against offline log-file based dose reconstruction with the TRiP98 treatment planning system, as well as QA measurements with the ICs 2D-array, where an average gamma-index passing rate (3%/3mm) of 99.8% and 98.3%, respectively, were achieved.
Conclusion:
This work provides the first real-time 4D-dose reconstruction engine for carbon ion therapy. The framework integration with the CNAO DDS paves the way for a swift transition to the clinics.

Cherenkov imaging combined with scintillation dosimetry provides real-time positional and dose monitoring for radiotherapy patients with cardiac implanted electronic devices

Background and purposeCardiac implanted electronic devices (CIED) require dose monitoring during each fraction of radiotherapy, which can be time consuming and may have delayed read-out times. This study explores the potential of Cherenkov imaging combined with scintillation dosimetry as an alternative verification system. Methods and materialsTime-gated, complementary metal–oxide–semiconductor (iCMOS) cameras were used to collect video images of anthropomorphic phantoms and patients undergoing radiation treatment near chest wall cardiac devices. Scintillator discs and optically stimulated luminescence dosimeters (OSLDs) were used for dose measurement. Accuracy of spatial delivery was assessed by overlaying predicted surface dose outlines derived from the treatment planning system (TPS) with the Cherenkov images. Dose measurements from OSLDs and scintillators were compared. ResultsIn phantom studies, Cherenkov images visibly indicated when dose was delivered to the CIED as compared to non-overlapping dose deliveries. Comparison with dose overlays revealed congruence at the planned position and non-congruence when the phantom was shifted from the initial position. Absolute doses derived from scintillator discs aligned well with the OSLD measurements and TPS predictions for three different positions, measuring within 10 % for in-field positions and within 5 % for out-of-field positions. For two patients with CIEDs imaged over 18 fractions, Cherenkov imaging confirmed positional accuracy for all fractions, and dose measured by scintillator discs deviated by <0.015 Gy from the OSLD measurements. ConclusionsCherenkov imaging combined with scintillation dosimetry presents an alternative methodology for CIED monitoring with the added benefit of instantly detecting deviations, enabling timely corrective actions or proper patient triage.

A review of diamond dosimeters in advanced radiotherapy techniques.

This review article synthesizes key findings from studies on the use of diamond dosimeters in advanced radiotherapy techniques, showcasing their applications, challenges, and contributions to enhancing dosimetric accuracy. The article explores various dosimeters, highlighting synthetic diamond dosimeters as potential candidates especially due to their high spatial resolution and negligible ion recombination effect. The clinically validated commercial dosimeter, PTW microDiamond (mD), faces limitations in small fields, proton and hadron therapy and ultra-high dose per pulse (UHDPP) conditions. Variability in reported values for field sizes 2 2 is noted, reflecting the competition between volume averaging and density perturbation effects. PTW's introduction of flashDiamond (fD) holds promise for dosimetric measurements in UHDPP conditions and is reliable for commissioning ultra-high dose rate (UHDR) electron beam systems, pending the clinical validation of the device. Other advancements in diamond detectors, such as in 3D configurations and real-time dose per pulse x-ray detectors, are considered valuable in overcoming challenges posed by modern radiotherapy techniques, alongside relative dosimetry and pre-treatment verifications. The studies discussed collectively provide a comprehensive overview of the evolving landscape of diamond dosimetry in the field of radiotherapy, and offer insights into future directions for research and development in thefield.

1763: A compact gamma-ray detector coupled with a pinhole collimator for real-time dose monitoring in BNCT

1763: A compact gamma-ray detector coupled with a pinhole collimator for real-time dose monitoring in BNCT

Real time eye dose reduction in fluoroscopy with auditory and visual feedback dosimeter through swine model experiments

This paper proposes measurement and reduction of eye dose in real time for the physician and the assistant performing fluoroscopy guided arterial puncture. Eye dose rates were measured for 30 fluoroscopy-guided punctures of bilateral femoral arteries in pigs. Fifteen fluoroscopy-guided punctures were performed using real time radiation dosimeter without auditory and visual feedback and other fifteen punctures were done using real time radiation dosimeter with visual and auditory feedback worn on forehead by an interventional cardiologist having experience of more than 10 years. The mean radiation dose rate for eyes of physician during arterial puncturing with real time radiation dosimeter with auditory feedback was 0.07 mSv/h (n = 15) whereas it was 0.18 mSv/h (n = 15) without visual and auditory feedback. The percentage of reduction with the device was 61% for eyes. In case of assistant the reduction was 33% for eyes (n = 15). The real time visual and auditory feedback dosimeter has reduced the eye dose rate of the physician and assistant and also helped him staying away from the X-ray source. Real time radiation dosimeters can be an effective tool to measure and reduce the dose to the eyes. The radiation eye dose rate for physician and assistant was significantly reduced by using real time radiation dosimeter with visual and auditory feedback. The real time radiation dosimeter not only helps in measuring but also help in minimizing the radiation dose rate for the physician and assistant in real time.

X-ray spectrum estimation from the transmission method using the radioluminescence of an Al2O3:C crystal

The X-ray spectrum of X-ray tube is crucial for radiation dose calculations. Due to the high photon flux, it is difficult to directly measure the primary spectrum of X-ray tube. Transmission measurement is one of indirect method used to determine the primary spectrum of X-ray tube. Although the method is experimentally simple, X-ray spectrum estimation from transmission method is a seriously ill-conditioned problem. In this paper, a new transmission measurement instrument with an the Al2O3:C crystal detector is proposed. Real-time dose rate attenuation data from transmission method are collected by using the radioluminescence(RL) of the Al2O3:C crystal. The expectation-maximization (EM) method is applied for X-ray spectrum estimation from transmission method. The method is demonstrated on typical simulated spectra of 80,100,120,140 and 160 kV from X-ray tubes. The X-ray spectra are simulated with the Monte Carlo code Geant4. The EM method is successfully applied to seriously ill-conditioned and under determined estimation problems. The results showed that the X-ray spectrum estimation method is a robust technique for estimating the primary spectrum of X-ray tube, and that the new instrument for transmission measurements can be used to accurately estimate X-ray spectrum.

MOSkin dosimetry for an ultra-high dose-rate, very high-energy electron irradiation environment at PEER

FLASH radiotherapy, which refers to the delivery of radiation at ultra-high dose-rates (UHDRs), has been demonstrated with various forms of radiation and is the subject of intense research and development recently, including the use of very high-energy electrons (VHEEs) to treat deep-seated tumors. Delivering FLASH radiotherapy in a clinical setting is expected to place high demands on real-time quality assurance and dosimetry systems. Furthermore, very high-energy electron research currently requires the transformation of existing non-medical accelerators into radiotherapy research environments. Accurate dosimetry is crucial for any such transformation. In this article, we assess the response of the MOSkin, developed by the Center for Medical Radiation Physics, which is designed for on-patient, real-time skin dose measurements during radiotherapy, and whether it exhibits dose-rate independence when exposed to 100 MeV electron beams at the Pulsed Energetic Electrons for Research (PEER) end-station. PEER utilizes the electron beam from a 100 MeV linear accelerator when it is not used as the injector for the ANSTO Australian Synchrotron. With the estimated pulse dose-rates ranging from (7.84±0.21)×105 Gy/s to (1.28±0.03)×107 Gy/s and an estimated peak bunch dose-rate of (2.55±0.06)×108 Gy/s, MOSkin measurements were verified against a scintillating screen to confirm that the MOSkin responds proportionally to the charge delivered and, therefore, exhibits dose-rate independence in this irradiation environment.

Development and first implementation of a novel multi-modality cardiac motion and dosimetry phantom for radiotherapy applications.

Cardiac applications in radiation therapy are rapidly expanding including magnetic resonance guided radiation therapy (MRgRT) for real-time gating for targeting and avoidance near the heart or treating ventricular tachycardia (VT). This work describes the development and implementation of a novel multi-modality and magnetic resonance (MR)-compatible cardiac phantom. The patient-informed 3D model was derived from manual contouring of a contrast-enhanced Coronary Computed Tomography Angiography scan, exported as a Stereolithography model, then post-processed to simulate female heart with an average volume. The model was 3D-printed using Elastic50A to provide MR contrast to water background. Two rigid acrylic modules containing cardiac structures were designed and assembled, retrofitting to an MR-safe programmable motor to supply cardiac and respiratory motion in superior-inferior directions. One module contained a cavity for an ion chamber (IC), and the other was equipped with multiple interchangeable cavities for plastic scintillation detectors (PSDs). Images were acquired on a 0.35 T MR-linac for validation of phantom geometry, motion, and simulated online treatment planning and delivery. Three motion profiles were prescribed: patient-derived cardiac (sine waveform, 4.3mm peak-to-peak, 60 beats/min), respiratory (cos4 waveform, 30mm peak-to-peak, 12 breaths/min), and a superposition of cardiac (sine waveform, 4mm peak-to-peak, 70 beats/min) and respiratory (cos4 waveform, 24mm peak-to-peak, 12 breaths/min). The amplitude of the motion profiles was evaluated from sagittal cine images at eight frames/s with a resolution of 2.4mm × 2.4mm. Gated dosimetry experiments were performed using the two module configurations for calculating dose relative to stationary. A CT-based VT treatment plan was delivered twice under cone-beam CT guidance and cumulative stationary doses to multi-point PSDs were evaluated. No artifacts were observed on any images acquired during phantom operation. Phantom excursions measured 49.3±25.8%/66.9±14.0%, 97.0±2.2%/96.4±1.7%, and 90.4±4.8%/89.3±3.5% of prescription for cardiac, respiratory, and cardio-respiratory motion profiles for the 2-chamber (PSD) and 12-substructure (IC) phantom modules respectively. In the gated experiments, the cumulative dose was<2% from expected using the IC module. Real-time dose measured for the PSDs at 10Hz acquisition rate demonstrated the ability to detect the dosimetric consequences of cardiac, respiratory, and cardio-respiratory motion when sampling of different locations during a single delivery, and the stability of our phantom dosimetric results over repeated cycles for the high dose and high gradient regions. For the VT delivery, high dose PSD was<1% from expected (5-6 cGy deviation of 5.9Gy/fraction) and high gradient/low dose regions had deviations<3.6% (6.3 cGy less than expected 1.73Gy/fraction). A novel multi-modality modular heart phantom was designed, constructed, and used for gated radiotherapy experiments on a 0.35 T MR-linac. Our phantom was capable of mimicking cardiac, cardio-respiratory, and respiratory motion while performing dosimetric evaluations of gated procedures using IC and PSD configurations. Time-resolved PSDs with small sensitive volumes appear promising for low-amplitude/high-frequency motion and multi-point data acquisition for advanced dosimetric capabilities. Illustrating VT planning and delivery further expands our phantom to address the unmet needs of cardiac applications in radiotherapy.

High-performance oxygen terminated synthetic single crystal diamond detector for high gamma dose rate measurement

A high-performance oxygen terminated synthetic single crystal diamond (SCD) detector (4.5 × 4.5 × 0.5 mm3) is presented. The SCD detector exhibits an extremely low leakage current value of 0.29 pA/mm2 with an electric field of 0.3 V/μm. The charge collection spectrum measured with a238Pu source (5.48 MeV α-particles) irradiation shows that the electron and hole charge collection efficiency (CCE) reach as high as 99.1% and 98.9%, with an energy resolution as low as 2.87% and 2.53%, respectively, compared to Si detector. The SCD detector shows excellent radiation hardness and stability under 60Co γ-ray irradiation with a dose rate of 12.737 kGy/h at 150 V bias and is able to withstand a cumulative dose of up to at least 9.3 kGy. The detector output in current mode is linearly related to the dynamic dose rate (0.409 Gy/h-12.737 kGy/h). Similarly, the counting rate of the detector in counting mode exhibits a strong linear variation within the range of 2.6 mGy/h-1269.36 Gy/h. Our results fully indicate that our fabricated SCD detector can be potentially applied to harsh γ irradiation scenarios, which is of guiding significance on real-time dose monitoring.

Strategic reuse of rapid antigen tests for coagulation status assessment: an integrated machine learning approach

Addressing the pressing demand for rapid and inexpensive coagulation testing in cardiovascular care, this study introduces a novel application of repurposed COVID-19 rapid antigen tests (RATs) as paper-based lateral flow assays (LFAs) combined with machine learning for coagulation status evaluation. By further developing a mobile app prototype, we present a platform that enables clinicians to perform immediate and accurate anticoagulant dosing adjustments using existing post-pandemic resources. Our proof-of-concept employs a random forest machine learning classifier to interpret image feature variations on RAT NC membrane, correlating red blood cell (RBC) wicked diffusion distance in recalcified citrated whole blood with changes in coagulative viscosity, easily interpreted. Enhanced by confocal imaging studies of paper microfluidics, our approach provides insights into the mechanisms dissecting coagulation components, achieving high classification precision, recall, and F1-scores. The inverse relationship between RBC wicked diffusion distance and enoxaparin concentration paves the way for machine learning to inform real-time dose prescription adjustments, aligning with individual patient profiles to optimize therapeutic outcomes. This study not only demonstrates the potential of leveraging surplus RATs for coagulation management but also exemplifies a cost-effective, rapid, and smart strategy to enhance clinical decision-making in the post-pandemic era.Graphical

Patient-specific deep learning for 3D protoacoustic image reconstruction and dose verification in proton therapy.

Protoacoustic (PA) imaging has the potential to provide real-time 3D dose verification of proton therapy. However, PA images are susceptible to severe distortion due to limited angle acquisition. Our previous studies showed the potential of using deep learning to enhance PA images. As the model was trained using a limited number of patients' data, its efficacy was limited when applied to individualpatients. In this study, we developed a patient-specific deep learning method for protoacoustic imaging to improve the reconstruction quality of protoacoustic imaging and the accuracy of dose verification for individualpatients. Our method consists of two stages: in the first stage, a group model is trained from a diverse training set containing all patients, where a novel deep learning network is employed to directly reconstruct the initial pressure maps from the radiofrequency (RF) signals; in the second stage, we apply transfer learning on the pre-trained group model using patient-specific dataset derived from a novel data augmentation method to tune it into a patient-specific model. Raw PA signals were simulated based on computed tomography (CT) images and the pressure map derived from the planned dose. The reconstructed PA images were evaluated against the ground truth by using the root mean squared errors (RMSE), structural similarity index measure (SSIM) and gamma index on 10 specific prostate cancer patients. The significance level was evaluated by t-test with the p-value threshold of 0.05 compared with the results from the groupmodel. The patient-specific model achieved an average RMSE of 0.014 ( ), and an average SSIM of 0.981 ( ), out-performing the group model. Qualitative results also demonstrated that our patient-specific approach acquired better imaging quality with more details reconstructed when comparing with the group model. Dose verification achieved an average RMSE of 0.011 ( ), and an average SSIM of 0.995 ( ). Gamma index evaluation demonstrated a high agreement (97.4% [ ] and 97.9% [ ] for 1%/3 and 1%/5mm) between the predicted and the ground truth dose maps. Our approach approximately took 6 s to reconstruct PA images for each patient, demonstrating its feasibility for online 3D dose verification for prostate protontherapy. Our method demonstrated the feasibility of achieving 3D high-precision PA-based dose verification using patient-specific deep-learning approaches, which can potentially be used to guide the treatment to mitigate the impact of range uncertainty and improve the precision. Further studies are needed to validate the clinical impact of thetechnique.

Balancing Performance and Portability: A Study on CsI(Tl) Crystal Sizes for Real-Time Gamma-Ray Spectrum and Dose Monitoring

Current radiation dosimeters sometimes face accuracy limitations or provide only cumulative doses over long periods. To contribute to this area, we developed a portable monitor that measures the energy spectrum and dose of gamma rays in real time. To achieve this, we used an improved sequential Bayesian estimation algorithm. The dose rate was then derived from the energy spectrum by applying a flux-to-dose conversion coefficient. The monitor consists mainly of a CsI(Tl) scintillator and a multi-pixel photon counter (MPPC). In developing this device, we focused on striking a balance between measurement accuracy, ease of use, and portability. As an essential aspect of the research, we investigated the influence of the CsI(Tl) crystal size on the performance of the monitor to determine an optimal size. This was accomplished by calculating the detection efficiency and energy resolution through experimental measurements using standard gamma-ray sources and simulations using MCNP5. Within the scope of the research, detector response functions were created for each crystal size for an energy range of 10 keV to 3 MeV. Considering an optimal balance of detection efficiency and energy resolution alongside a compact size suitable for portable applications, the crystal measuring 2.6 × 2.6 × 1.3 cm3 was deemed preferable.

Validation and reproducibility of in vivo dosimetry for pencil beam scanned FLASH proton treatment in mice

PurposeTo investigate quality assurance (QA) techniques for in vivo dosimetry and establish its routine uses for proton FLASH small animal experiments with a saturated monitor chamber. Methods and Materials227 mice were irradiated at FLASH or conventional (CONV) dose rates with a 250 MeV FLASH-capable proton beamline using pencil beam scanning to characterize the proton FLASH effect on abdominal irradiation and examining various endpoints. A 2D strip ionization chamber array (SICA) detector was positioned upstream of collimation and used for in vivo dose monitoring during irradiation. Before each irradiation series, SICA signal was correlated with the isocenter dose at each delivered dose rate. Dose, dose rate, and 2D dose distribution for each mouse were monitored with the SICA detector. ResultsCalibration curves between the upstream SICA detector signal and the delivered dose at isocenter had good linearity with minimal R2 values of 0.991 (FLASH) and 0.985 (CONV), and slopes were consistent for each modality. After reassigning mice, standard deviations were less than 1.85 % (FLASH) and 0.83 % (CONV) for all dose levels, with no individual subject dose falling outside a ± 3.6 % range of the designated dose. FLASH fields had a field-averaged dose rate of 79.0 ± 0.8 Gy/s and mean local average dose rate of 160.6 ± 3.0 Gy/s. In vivo dosimetry allowed for the accurate detection of variation between the delivered and the planned dose. ConclusionIn vivo dosimetry benefits FLASH experiments through enabling real-time dose and dose rate monitoring allowing mouse cohort regrouping when beam fluctuation causes delivered dose to vary from planned dose.

Time-resolved clinical dose volume metrics, calculations and predictions based on source tracking measurements and uncertainties to aid treatment verification and error detection for HDR brachytherapy—a proof-of-principle study

Objective. High-dose-rate (HDR) brachytherapy lacks routinely available treatment verification methods. Real-time tracking of the radiation source during HDR brachytherapy can enhance treatment verification capabilities. Recent developments in source tracking allow for measurement of dwell times and source positions with high accuracy. However, more clinically relevant information, such as dose discrepancies, is still needed. To address this, a real-time dose calculation implementation was developed to provide more relevant information from source tracking data. A proof-of-principle of the developed tool was shown using source tracking data obtained from a 3D-printed anthropomorphic phantom. Approach. Software was developed to calculate dose-volume-histograms (DVH) and clinical dose metrics from experimental HDR prostate treatment source tracking data, measured in a realistic pelvic phantom. Uncertainty estimation was performed using repeat measurements to assess the inherent dose measuring uncertainty of the in vivo dosimetry (IVD) system. Using a novel approach, the measurement uncertainty can be incorporated in the dose calculation, and used for evaluation of cumulative dose and clinical dose-volume metrics after every dwell position, enabling real-time treatment verification. Main results. The dose calculated from source tracking measurements aligned with the generated uncertainty bands, validating the approach. Simulated shifts of 3 mm in 5/17 needles in a single plan caused DVH deviations beyond the uncertainty bands, indicating errors occurred during treatment. Clinical dose-volume metrics could be monitored in a time-resolved approach, enabling early detection of treatment plan deviations and prediction of their impact on the final dose that will be delivered in real-time. Significance. Integrating dose calculation with source tracking enhances the clinical relevance of IVD methods. Phantom measurements show that the developed tool aids in tracking treatment progress, detecting errors in real-time and post-treatment evaluation. In addition, it could be used to define patient-specific action limits and error thresholds, while taking the uncertainty of the measurement system into consideration.