Heidelberg Ion Beam Therapy Center Research Articles

Preclinical investigations towards the first spacer gel application in prostate cancer treatment during particle therapy at HIT

BackgroundThe application of spacer gel represents a promising approach to reliably spare the rectal frontal wall during particle therapy (IJROBP 76:1251-1258, 2010). In order to qualify the spacer gel for the clinical use in particle therapy, a variety of measurements were performed in order to ensure the biological compatibility of the gel, its physical stability during and after the irradiation, and a proper definition of the gel in terms of the Hounsfield Unit (HU) values for the treatment planning system. The potential for the use of the spacer gel for particle therapy monitoring with off-line Positron Emission Tomography (PET) was also investigated.ResultsThe spacer gel implanted to the prostate patient in direct neighbourhood to the clinical target volume does not interfere with the particle therapy treatment planning procedure applied at Heidelberg Ion Beam Therapy Centre (HIT). The performed measurements show that Bragg-peak position of the particles can be properly predicted on the basis of computed tomography imaging with the treatment planning system used at HIT (measured water equivalent path length of 1.011 ±0.011 (2σ), measured Hounsfield Unit of 28.9 ±6.1 (2σ)). The spacer gel samples remain physically unchanged after irradiation with a dose exceeding the therapeutic dose level. The independently measured Bragg-Peak position does not change within the time interval of 10 weeks.ConclusionsAs a result of the presented experiments, the first clinical application of spacer gel implant during prostate cancer treatment with carbon ions and protons was possible at HIT in 2012. The reported pre-clinical investigations demonstrate that use of spacer gel is safe in particle therapy in presence of therapy target motion and patient positioning induced particle range variations. The spacer gel injected between prostate and rectum enlarge the distance between both organs, which is expected to clinically significantly decrease the undesirable exposure of the most critical organ at risk, i.e. rectal frontal wall. Further research on the composition of spacer gel material might lead to additional clinical benefits by validation of particle therapy of prostate via post-therapeutic PET-imaging or by patient positioning based on the gel as a radio-opaque marker.

Non-invasive monitoring of therapeutic carbon ion beams in a homogeneous phantom by tracking of secondary ions

Radiotherapy with narrow scanned carbon ion beams enables a highly accurate treatment of tumours while sparing the surrounding healthy tissue. Changes in the patient’s geometry can alter the actual ion range in tissue and result in unfavourable changes in the dose distribution. Consequently, it is desired to verify the actual beam delivery within the patient. Real-time and non-invasive measurement methods are preferable. Currently, the only technically feasible method to monitor the delivered dose distribution within the patient is based on tissue activation measurements by means of positron emission tomography (PET). An alternative monitoring method based on tracking of prompt secondary ions leaving a patient irradiated with carbon ion beams has been previously suggested. It is expected to help in overcoming the limitations of the PET-based technique like physiological washout of the beam induced activity, low signal and to allow for real-time measurements. In this paper, measurements of secondary charged particle tracks around a head-sized homogeneous PMMA phantom irradiated with pencil-like carbon ion beams are presented. The investigated energies and beam widths are within the therapeutically used range. The aim of the study is to deduce properties of the primary beam from the distribution of the secondary charged particles. Experiments were performed at the Heidelberg Ion Beam Therapy Center, Germany. The directions of secondary charged particles emerging from the PMMA phantom were measured using an arrangement of two parallel pixelated silicon detectors (Timepix). The distribution of the registered particle tracks was analysed to deduce its dependence on clinically important beam parameters: beam range, width and position. Distinct dependencies of the secondary particle tracks on the properties of the primary carbon ion beam were observed. In the particular experimental set-up used, beam range differences of 1.3 mm were detectable. In addition, variations in the beam width could be measured with a precision of 0.9 mm. Furthermore, shifts of the lateral beam position could be monitored with a sub-millimetre precision. The presented investigations demonstrate experimentally that the non-invasive measurement and analysis of secondary ion distributions around head-sized homogeneous objects provide information on the actual beam delivery. Beam range, width and position could be monitored with a precision attractive for therapeutic situations.

Implementation and initial clinical experience of offline PET/CT-based verification of scanned carbon ion treatment

Background and purposeWe report on the implementation of offline PET/CT-based treatment verification at the Heidelberg Ion Beam Therapy Centre (HIT) and present first clinical cases for post-activation measurements after scanned carbon ion irradiation. Key ingredient of this in-vivo treatment verification is the comparison of irradiation-induced patient activation measured by a PET scanner with a prediction simulated by means of Monte Carlo techniques. Material and methodsAt HIT, a commercial full-ring PET/CT scanner has been installed in close vicinity to the treatment rooms. After selected irradiation fractions, the patient either walks to the scanner for acquisition of the activation data or is transported using a shuttle system. The expected activity distribution is obtained from the production of β+-active isotopes simulated by the FLUKA code on the basis of the patient-specific treatment plan, post-processed considering the time course of the respective treatment fraction, the estimated biological washout of the induced activity and a simplified model of the imaging process. ResultsWe present four patients with different indications of head, head/neck, liver and pelvic tumours. A clear correlation between the measured PET signal and the simulated activity pattern is observed for all patients, thus supporting a proper treatment delivery. In the case of a pelvic tumour patient it was possible to detect minor treatment delivery inaccuracies. ConclusionsThe initial clinical experience proves the feasibility of the implemented strategy for offline confirmation of scanned carbon ion irradiation and therefore constitutes a first step towards a comprehensive PET/CT-based treatment verification in the clinical routine at HIT.

Ion range measurements using fluorescent nuclear track detectors

Fluorescent nuclear track detectors (FNTDs) show excellent detection properties for heavy charged particles and have, therefore, been investigated in this study in terms of their potential for in-vivo range measurements.We irradiated FNTDs with protons as well as with C, Mg, S, Fe and Xe ion beams (3–9 MeV/u) over a broad range of fluences (4.5e5–1.0e11 cm−2) with the detectors' optical c-axis positioned perpendicular to the beam direction. All measured ion ranges (for single track as well as track bulk intensity irradiations) deviate less than 3% from tabulated SRIM data (Ziegler et al., 2009), independent of particle type, energy, fluence and linear energy transfer.Proton irradiation of detectors placed inside a polymethyl methacrylate (PMMA) phantom at the Heidelberg Ion-Beam Therapy Center showed promising results for future in-vivo FNTD applications.

High-resolution fluence verification for treatment plan specific QA in ion beam radiotherapy

Ion beam radiotherapy exploits the finite range of ion beams and the increased dose deposition of ions toward the end of their range in material. This results in high dose conformation to the target region, which can be further increased using scanning ion beams. The standard method for patient-plan verification in ion beam therapy is ionization chamber dosimetry. The spatial resolution of this method is given by the distance between the chambers (typically 1 cm). However, steep dose gradients created by scanning ion beams call for more information and improved spatial resolution. Here we propose a clinically applicable method, supplementary to standard patient-plan verification. It is based on ion fluence measurements in the entrance region with high spatial resolution in the plane perpendicular to the beam, separately for each energy slice. In this paper the usability of the RID256 L amorphous silicon flat-panel detector for the measurements proposed is demonstrated for carbon ion beams. The detector provides sufficient spatial resolution for this kind of measurement (pixel pitch 0.8 mm). The experiments were performed at the Heidelberg Ion-Beam Therapy Center in Germany. This facility is equipped with a synchrotron capable of accelerating ions from protons up to oxygen to energies between 48 and 430 MeV u−1. Beam application is based on beam scanning technology. The measured signal corresponding to single energy slices was translated to ion fluence on a pixel-by-pixel basis, using calibration, which is dependent on energy and ion type. To quantify the agreement of the fluence distributions measured with those planned, a gamma-index criterion was used. In the patient field investigated excellent agreement was found between the two distributions. At least 95% of the slices contained more than 96% of points agreeing with our criteria. Due to the high spatial resolution, this method is especially valuable for measurements of strongly inhomogeneous fluence distributions like those in intensity-modulated treatment plans or plans including dose painting. Since no water phantom is needed to perform measurements, the flat-panel detector investigated has high potential for use with gantries. Before the method can be used in the clinical routine, it has to be sufficiently tested for each detector–facility combination.

Linear energy transfer and track pattern recognition of secondary radiation generated in hadron therapy beam in a PMMA target

Hadron therapy uses ion beams for irradiation of cancerous tissue taking advantage of the highly localized dose deposition in the target tumor. For a correct estimation of dose deposited in tissue surrounding the target it is necessary to consider also the contribution of energetic secondary radiation generated by primary ions. It was already experimentally demonstrated that this contribution can be measured using the semiconductor pixel detector Timepix (256 × 256 pixels with 55 μm pitch) visualizing traces of secondary particles. The resolving power of the detector enables the differentiation of traces of different types of particles. In this work we studied the possibilities of determination of different types of secondary particles in correlation with their flight direction. Such identification allows correct assignment of dose for each type of particle. The distribution of secondary particles was compared to Monte Carlo simulations. Measurements were performed with a PMMA target irradiated with a therapeutic carbon beam at the Heidelberg Ion-Beam Therapy Center (HIT).

Experimental characterization of a prototype detector system for carbon ion radiography and tomography

Ion beams exhibit a finite range and an inverted depth–dose profile, the Bragg peak. These favorable physical properties allow excellent tumor–dose conformality. However, they introduce sensitivity to range uncertainties. Although these uncertainties are typically taken into account in treatment planning, delivery of the intended dose to the patient has to be ensured daily to prevent underdosage of the tumor or overdosage of surrounding critical structures. Thus, imaging techniques play an increasingly important role for treatment planning and in situ monitoring in ion beam therapy. At the Heidelberg Ion Beam Therapy (HIT) center, a prototype detector system based on a stack of 61 ionization chambers has been assembled for the purpose of radiographic and tomographic imaging of transmitted energetic ions. Its applicability to ion-based transmission imaging was investigated experimentally. An extensive characterization of the set-up in terms of beam parameters and settings of the read-out electronics was performed. Overall, the findings of this work support the potential of an efficient experimental set-up as the range telescope equipped with high sensitivity and fast electronics to perform heavy ion radiography and tomography at HIT.

The Response of 2D TL Foils After Doses of Co-60 Gamma-ray, 6 MV X-ray and 60 MeV Proton Beams Applied in Radiotherapy

A Two-dimensional Thermoluminescence Dosimetry (2D TLD) system has been developed at the Institute of Nuclear Physics (IFJ PAN) in Krakow, Poland. The system consists of TLD foils and of a TL reader equipped with a 200 200 mm 2 heater and a CCD camera. The foils contain LiF:Mg,Cu,P powder mixed with ETFE polymer pressed at high temperature. The CCD camera is able to read out 2D images of TL light in real time, and the re-usable foils are flexible, mechanically stable and waterresistant. We have determined the response of our 2D TL foils after doses of Co-60 gamma-ray, 6MV X-ray and 60MeV proton radiotherapy beams, over the range between 1 and 30Gy, as required in clinical dosimetry. In measurements, performed at the German Cancer Research Center (DKFZ), at the Heidelberg Ion-Beam Therapy Center (HIT) and at the IFJ PAN, we compared the dose response of our foils with those of Kodak R EDR2 and Gafchromic R EBT films. We find both the sensitivity (signal per dose) and the characteristic (saturation) dose of our 2D TL foils to be higher than those of the EDR2 and EBT films, for all beam modalities tested.

Very fast front end ASIC associated with multi-anode PMTs for a scintillating-fibre beam hodoscope

For developing a scintillating-fibre beam monitor, wehave designed a front-end 16-Channel readout chip (version 2) to beassociated with Multi-anode photomultipliers Ma-PMTs (Hamamatsu H8500) in a0.35 μm BiCMOS process. Each channel of the ASIC consists of one inputcurrent conveyor driving separately a current comparator for signal eventdetection and a charge-sensitive amplifier (CSA) for signal chargemeasurement. The ASIC has brought significant improvements compared to itsprevious version: larger input dynamic range (53 dB against 33 dB), lowerpower consumption (11 mW/channel instead of 22 mW/channel under a 3.3-Vsupply), lower noise (4 fC versus 19 fC in Equivalent input Noise Charge, orENC) and a better phase margin for optimizing stability and speed. Thisdedicated chip had been used in a beam test at HIT (Heidelberg Ion-BeamTherapy Center). System testing has shown achievements of 1 mm spatialresolution (size of the scintillating fibers) and a 4 MHz count rate. Themain limitation comes from the Ma-PMTs which saturates at such a frequency.The ASIC operates normally with satisfied performances.

Quantitative carbon ion beam radiography and tomography with a flat-panel detector

High dose gradients are inherent to ion beam therapy. This results in high sensitivity to discrepancies between planned and delivered dose distributions. Therefore an accurate knowledge of the ion stopping power of the traversed tissue is critical. One proposed method to ensure high quality dose deposition is to measure the stopping power by ion radiography. Although the idea of imaging with highly energetic ions is more than forty years old, there is a lack of simple detectors suitable for this purpose. In this study the performance of an amorphous silicon flat-panel detector, originally designed for photon imaging, was investigated for quantitative carbon ion radiography and tomography. The flat-panel detector was exploited to measure the water equivalent thickness (WET) and water equivalent path length (WEPL) of a phantom at the Heidelberg Ion–Beam Therapy Center (HIT). To do so, the ambiguous correlation of detector signal to particle energy was overcome by active or passive variation of carbon ion beam energy and measurement of the signal-to-beam energy correlation. The active method enables one to determine the WET of the imaged object with an uncertainty of 0.5 mm WET. For tomographic WEPL measurements the passive method was exploited resulting in an accuracy of 0.01 WEPL. The developed imaging technique presents a method to measure the two-dimensional maps of WET and WEPL of phantoms with a simple and commercially available detector. High spatial resolution of 0.8 × 0.8 mm2 is given by the detector design. In the future this powerful tool will be used to evaluate the performance of the treatment planning algorithm by studying WET uncertainties.

First experimental-based characterization of oxygen ion beam depth dose distributions at the Heidelberg Ion-Beam Therapy Center

Over the last decades, the application of proton and heavy-ion beams to external beam radiotherapy has rapidly increased. Due to the favourable lateral and depth dose profile, the superposition of narrow ion pencil beams may enable a highly conformal dose delivery to the tumour, with better sparing of the surrounding healthy tissue in comparison to conventional radiation therapy with photons. To fully exploit the promised clinical advantages of ion beams, an accurate planning of the patient treatments is required. The clinical treatment planning system (TPS) at the Heidelberg Ion-Beam Therapy Center (HIT) is based on a fast performing analytical algorithm for dose calculation, relying, among others, on laterally integrated depth dose distributions (DDDs) simulated with the FLUKA Monte Carlo (MC) code. Important input parameters of these simulations need to be derived from a comparison of the simulated DDDs with measurements. In this work, the first measurements of 16O ion DDDs at HIT are presented with a focus on the determined Bragg peak positions and the understanding of factors influencing the shape of the distributions. The measurements are compared to different simulation approaches aiming to reproduce the acquired data at best. A simplified geometrical model is first used to optimize important input parameters, not known a priori, in the simulations. This method is then compared to a more realistic, but also more time-consuming simulation approach better accounting for the experimental set-up and the measuring process. The results of this work contributed to a pre-clinical oxygen ion beam database, which is currently used by a research TPS for corresponding radio-biological cell experiments. A future extension to a clinical database used by the clinical TPS at HIT is foreseen. As a side effect, the performed investigations showed that the typical water equivalent calibration approach of experimental data acquired with water column systems leads to slight deviations between the experimentally determined and the real Bragg peak positions. For improved accuracy, the energy dependence of the stopping power, and herewith the water equivalent thickness, of the material downstream of the water tank should be considered in the analysis of measured data.

SU-D-BRB-02: Investigations of Secondary Ion Distributions in Carbon Ion Therapy Using the Timepix Detector.

Due to the high conformity of carbon ion therapy, unpredictable changes in the patient's geometry or deviations from the planned beam properties can result in changes of the dose distribution. PET has been used successfully to monitor the actual dose distribution in the patient. However, it suffers from biological washout processes and low detection efficiency. The purpose of this contribution is to investigate the potential of beam monitoring by detection of prompt secondary ions emerging from a homogeneous phantom, simulating a patient's head. Measurements were performed at the Heidelberg Ion-Beam Therapy Center (Germany) using a carbon ion pencil beam irradiated on a cylindrical PMMA phantom (16cm diameter). For registration of the secondary ions, the Timepix detector was used. This pixelated silicon detector allows position-resolved measurements of individual ions (256×256 pixels, 55μm pitch). To track the secondary ions we used several parallel detectors (3D voxel detector). For monitoring of the beam in the phantom, we analyzed the directional distribution of the registered ions. This distribution shows a clear dependence on the initial beam energy, width and position. Detectable were range differences of 1.7mm, as well as vertical and horizontal shifts of the beam position by 1mm. To estimate the clinical potential of this method, we measured the yield of secondary ions emerging from the phantom for a beam energy of 226MeV/u. The differential distribution of secondary ions as a function of the angle from the beam axis for angles between 0 and 90° will be presented. In this setup the total yield in the forward hemisphere was found to be in the order of 10-1 secondary ions per primary carbon ion. The presented measurements show that tracking of secondary ions provides a promising method for non-invasive monitoring of ion beam parameters for clinical relevant carbon ion fluences. Research with the pixel detectors was carried out in frame of the Medipix Collaboration.

MO-A-213AB-11: First Experimental Test of Secondary Ion Tracking for the Assessment of Beam Range in a Patient-Like Phantom.

Radiation therapy with ion beams provides highly conformal dose distributions. Therefore, monitoring the dose delivery within the patient in a non- invasive way is desired. The clinically available method based on tissue activation measurements with a PET-camera shows limitations due to the low induced activities and biological washout of the activated nuclei. The prompt production of secondary ions is supposed to be less influenced by biological processes. This contribution investigates the feasibility of beam range monitoring in a patient-like geometry containing realistic tissue inhomogeneities. The experiments were performed at the Heidelberg Ion-Beam Therapy Center in Germany using carbon ion beams of 213 and 250MeV/u. Static pencil beams (FWHM of 6mm) were applied to the skull base and brain regions of a head phantom containing real bones. The emerging secondary ions were registered by the silicon detector Timepix. It was developed by the Medipix Collaboration and provides 256×256 pixels with 55um pitch. To determine the direction of the particles, a multi-layered detector (3D voxel detector, J.Jakubek etal. JINST6 C12010) was employed. The contribution of K. Gwosch etal. addresses the performance of this method in a homogeneous phantom. In the 3D distributions of the measured secondary ions clear differences between the application of lower and higher energies were observed. This Result was achieved in both brain (homogeneous) and skull base regions (containing inhomogeneities). Differences between the energies could be observed with the detector positioned on the occipital side as well as on the facial side of the head. We performed the first experiments towards beam range monitoring in a patient-like geometry exploiting tracking of prompt secondary ions with a small detector prototype. Despite the inherent tissue inhomogeneities, we found sensitivity on the beam range in both brain and skull base. Research carried out in frame of the Medipix Collaboration. Research carried out in frame of the Medipix Collaboration.

Monte Carlo simulations to support start-up and treatment planning of scanned proton and carbon ion therapy at a synchrotron-based facility

Reliable treatment planning of highly conformal scanned ion beam therapy demands accurate tools for the determination and characterization of the individual pencil-like beams building up the integral dose delivery and related mixed radiation field. At present, clinically practicable inverse treatment planning systems (TPSs) can only rely on fast-performing analytical algorithms. However, the rapidly emerging though more computationally intensive Monte Carlo (MC) methods can be employed to complement analytical TPS, e.g., via accurate calculations of the input beam-model data, together with a considerable reduction of the measuring time. Here we present the work done for the application of the FLUKA MC code to support several aspects of scanned ion beam delivery and treatment planning at the Heidelberg Ion Beam Therapy Center (HIT). Emphasis is given to the generation of the accelerator library and of experimentally validated TPS input basic data which are now in clinical use for proton and carbon ion therapy. Additionally, MC dose calculations of planned treatments in water are shown to represent a valuable tool for supporting treatment plan verification in comparison to dosimetric measurements. This paper can thus provide useful information and guidelines for the start-up and clinical operation of forthcoming ion beam therapy facilities similar to HIT.

Mapping of RBE-Weighted Doses Between HIMAC– and LEM–Based Treatment Planning Systems for Carbon Ion Therapy

A method was developed to convert clinically prescribed RBE (Relative Biological Effectiveness)-weighted doses from the approach used at the Heavy-Ion Medical Accelerator (HIMAC) at the National Institute of Radiological Science, Chiba, Japan, to the LEM (Local Effect Model)-based TReatment planning for Particles (TRiP98) approach used in the pilot project at the GSI Helmholtzzentrum, Darmstadt, and the Heidelberg Ion-Beam Therapy Center (HIT). The proposed conversion method is based on a simulation of the fixed spread-out Bragg peak (SOBP) depth dose profiles as used for the irradiation at HIMAC by LEM/TRiP98 and a recalculation of the resulting RBE-weighted dose distribution. We present data according to the clinical studies conducted at GSI in the past decade (LEM I), as well as data used in current studies (refined LEM version: LEM IV). We found conversion factors (RBE-weighted dose LEM/RBE-weighted dose HIMAC) reaching from 0.4 to 2.0 for prescribed carbon ion doses from 1 to 60 Gy (RBE) for SOBP extensions ranging from 20 to 120 mm according to the HIMAC approach. A conversion factor of 1.0 was found for approximately 5 Gy (RBE). The conversion factor decreases with increasing prescribed dose. Slightly smaller values for the LEM IV-based data set compared with LEM I were found. A significant dependence of the conversion factor from the SOBP width could be observed in particular for LEM IV, whereas the depth dependence was found to be small. For the interpretation and comparison of clinical trials performed at HIMAC and GSI/HIT, it is of extreme importance to consider these conversion factors because according to the various methods to determine the RBE-weighted dose, similar dose values might not necessarily be related to similar clinical outcomes.

Test bench to commission a third ion source beam line and a newly designed extraction system

The HIT (Heidelberg Ion Beam Therapy Center) is the first hospital-based treatment facility in Europe where patients can be irradiated with protons and carbon ions. Since the commissioning starting in 2006 two 14.5 GHz electron cyclotron resonance ion sources are routinely used to produce a variety of ion beams from protons up to oxygen. In the future a helium beam for regular patient treatment is requested, therefore a third ion source (Supernanogan source from PANTECHNIK S.A.) will be integrated. This third ECR source with a newly designed extraction system and a spectrometer line is installed at a test bench at HIT to commission and validate this section. Measurements with different extraction system setups will be presented to show the improvement of beam quality for helium, proton, and carbon beams. An outlook to the possible integration scheme of the new ion source into the production facility will be discussed.

3D measurement of the radiation distribution in a water phantom in a hadron therapy beam

Hadron therapy is a highly precise radio-therapeutic method with many advantages especially in cases when the tumour is close to sensitive organs where standard treatments cannot be used. For reliable treatment planning it is necessary to have calculation tools for maximization of the dose delivered to the targeted tissue and minimization of the dose outside of it. While the main physical processes in material irradiated by hadron beams are known, in reality the processes involved are complex so that analytical computations are impossible. Thus, the planning tools to incorporate simplified models and numerical approximations and an experimental method for high precision verification of the models within phantoms is desired.The development of sensitive, high resolution and online methods for measurement of the radiation environment inside of the irradiated object is the aim of this work. Such measurements are made possible by the resolving power of the state-of-the-art pixel detector Timepix. This quantum counting imaging device is able to record the characteristic shapes of the particle traces including their energies deposited in the detector. All these data recorded for each event allow to estimate the particle type, its energy and direction of flight. Event-by-event analysis is done using pattern recognition of the characteristic traces.The objective of the experiment is the detection and characterization of secondary radiation generated by the primary therapeutic beams in tissue equivalent material (water). Measurements were performed inside of a water phantom irradiated by a carbon beam at the Heidelberg Ion-Beam Therapy Center (HIT).

Selective detection of secondary particles and neutrons produced in ion beam therapy with 3D sensitive voxel detector

Ion beam therapy is a rapidly developing method for treatment of certain types of cancer. A main advantage of ions is that they deposit most of the energy at the end of their range according to the Bragg curve. Unfortunately, the ion beam often generates a substantial amount of energetic secondary particles with not negligible range. Thus, a fraction of the dose is deposited by other than the primary ions outside of the planned volume. It is, therefore, important to estimate and experimentally verify the distributions of these secondary particles. It is particularly difficult to identify fast neutrons generated by ions in tissue. Fast neutrons are usually detected via their interaction (scattering) with hydrogen nuclei (proton). The proton recoiled by the scattered neutron is subsequently detected by a suitable sensor. The problem is that certain fraction of secondary particles consists of protons as well. Therefore, it is necessary to distinguish protons recoiled by neutrons from protons naturally present in the sample. In this work we present the experimental technique enabling the separation of fast neutrons from protons. The technique uses a 3D sensitive voxel detector composed of several layers of Timepix pixel detectors. These layers are interlaced with a hydrogen rich material (plastic) serving as a convertor of neutrons to recoiled protons. The device records the traces of all interacting radiation providing the time stamp and/or deposited energy for each single particle. A proton passing through the detector creates a trace in all layers, whereas a protons recoiled by neutron originates in the convertor inside of the structure creating a trace in the inner layers only. This way it is possible to distinguish the protons from neutrons with very high selectivity. The technique can be easily extended for detection of slow neutrons. An initial experimental study to register the outcoming neutron radiation was performed at the Heidelberg Ion Beam Therapy Center (HIT) in Germany using medical proton and carbon ion beams. This work is carried out in frame of the Medipix Collaboration.

Investigations of a flat-panel detector for quality assurance measurements in ion beam therapy

Increased accuracy in radiation delivery to a patient provided by scanning particle beams leads to high demands on quality assurance (QA). To meet the requirements, an extensive quality assurance programme has been implemented at the Heidelberg Ion Beam Therapy Center. Currently, high-resolution radiographic films are used for beam spot position measurements and homogeneity measurements for scanned fields. However, given that using this film type is time and equipment demanding, considerations have been made to replace the radiographic films in QA by another appropriate device. In this study, the suitability of the flat-panel detector RID 256 L based on amorphous silicon was investigated as an alternative method. The currently used radiographic films were taken as a reference. Investigations were carried out for proton and carbon ion beams. The detectors were irradiated simultaneously to allow for a direct comparison. The beam parameters (e.g. energy, focus, position) currently used in the daily QA procedures were applied. Evaluation of the measurements was performed using newly implemented automatic routines. The results for the flat-panel detector were compared to the standard radiographic films. Additionally, a field with intentionally decreased homogeneity was applied to test the detector's sensitivities toward possible incorrect scan parameters. For the beam position analyses, the flat-panel detector results showed good agreement with radiographic films. For both detector types, deviations between measured and planned spot distances were found to be below 1% (1 mm). In homogeneously irradiated fields, the flat-panel detector showed a better dose response homogeneity than the currently used radiographic film. Furthermore, the flat-panel detector is sensitive to field irregularities. The flat-panel detector was found to be an adequate replacement for the radiographic film in QA measurements. In addition, it saves time and equipment because no post-exposure treatment and no developer and darkroom facilities are needed.

Experimental characterization of lateral profiles of scanned proton and carbon ion pencil beams for improved beam models in ion therapy treatment planning

Scanned ion pencil beams carry a low-dose envelope which can extend up to several centimeters from the individual beam central axis. Depending on the energy and species of the beam, this halo consists mainly of secondary particles produced by nuclear interactions in the target or of particles undergoing multiple Coulomb scattering in the beam line components. This halo is often neglected by single Gaussian beam modeling in current treatment planning systems. One possibility of improving the accuracy of treatment planning is to upgrade the used pencil beam models by adding a description of the low-dose envelope. But at the same time it is crucial to keep the calculation time and the complexity for treatment planning in reasonable limits. As a first approach we measured the lateral beam profiles of scanned proton and carbon ion pencil beams at different energies and depths in water and air at the Heidelberg Ion Beam Therapy Center. Then we tried to describe their beam halo by adding a supplementary Gaussian function to the standard single Gauss modeling which is used at the moment by our treatment planning systems. This analysis helped to identify trends in the parameters describing the lateral beam broadening to support its modeling. Finally, it is shown that the accuracy of treatment planning could be improved by the proposed upgrade of the pencil beam model. In particular, the presented experimental data can be either used directly as input for dose calculation or serve for representative comparison with the results of calculation models such as Monte Carlo simulations for the generation of lateral basic data to be input in upgraded beam models of treatment planning systems.