PMMA Phantom Research Articles

Photon energy estimation in diagnostic radiology using OSL dosimeters: Experimental validation and Monte Carlo simulations

The EGSnrc Monte Carlo software toolkit was used to evaluate the energy response and estimate the photon energy based on the E3/E4 ratio for the InLight XA Optical Luminescence Dosimeters (OSLDs).The InLight XA OSLDs were irradiated with Cs-137 source and ISO 4037-1 narrow-spectrum series X-ray qualities (N40, N60, N80, and N100). The virtual OSLDs on the surface of the PMMA phantom were constructed in EGSnrc, energy response and ratio E3/E4 of the dosimeters was determined and compared to the physical measurements.Good agreement was found between the simulated and measurement approaches in estimating the photon energy with a percentage difference of less than 6%. The E3/E4 ratio from simulation, physical measurements, and microStar system showed very good agreement results with the maximum difference of 9.3% and 10.94%, respectively. Furthermore, the OSLDs energy response varied significantly at energy below 100 keV due to the photoelectric effect.The results of this study identify and address the over-response of OSLDs to low-energy photons, offering correction factors to minimize errors, especially in diagnostic radiology applications. These findings have the potential to improve dose accuracy for patients and radiation workers by providing more precise photon energy estimations, particularly at lower energy ranges, such as in diagnostic X-rays. The function used to evaluate photon energy using E3/E4 ratio has a great influence on the accuracy of such algorithms. It also ensures that imaging equipment is properly calibrated for the specific energy ranges needed, enhancing diagnostic accuracy. Furthermore, precise dose measurements are essential for maintaining regulatory compliance and long-term patient exposure records, ultimately promoting safer and more effective radiological practices.

Novel Bragg peak characterization method using proton flux measurements on plastic scintillators

Objective. Bragg peak measurements play a key role in the beam quality assurance in proton therapy. Used as base data for the treatment planning softwares, the accuracy of the data is crucial when defining the range of the protons in the patient.Approach. In this paper a protocol to reconstruct a Pristine Bragg Peak exploring the direct correlation between the particle flux and the dose deposited by particles is presented. Proton flux measurements at the HollandPTC and FLUKA Monte Carlo simulations are used for this purpose. This new protocol is applicable to plastic scintillator detectors developed for Quality Assurance applications. In order to obtain the Bragg curve using a plastic fiber detector, a PMMA phantom with a decoupled and moveable stepper was designed. The step phantom allows to change the depth of material in front of the fiber detector during irradiations. The Pristine Bragg Peak reconstruction protocol uses the measured flux of particles at each position and multiplies it by the average dose obtained from the Monte Carlo simulation at each position.Main results. The results show that with this protocol it is possible to reconstruct the Bragg Peak with an accuracy of about 470µm, which is in accordance with the tolerances set by the AAPM.Significance. It has the advantage to be able to overcome the quenching problem of scintillators in the high ionization density region of the Bragg peak.

The influence of daily imaging and target margin reduction on secondary cancer risk in image-guided and adaptive proton therapy

Objective. Image-guided and adaptive proton therapy rely on daily CBCT or CT imaging, which increases radiation dose and radiation-induced cancer risk. Online adaptation however also reduces setup uncertainty, and the additional risk might be compensated by reducing the setup robustness margin. This work developed a framework to investigate how much this robustness margin should be reduced to offset the secondary cancer risk from additional imaging dose and applied it to proton therapy for head-and-neck cancer.Approach. For five patients with head-and-neck cancer, voxel-wise CT and CBCT imaging doses were estimated with Monte Carlo radiation transport simulations, calibrated with air and PMMA phantom measurements. The total dose of several image-guided and adaptive treatments protocols was calculated by summing the planning CT dose, daily and weekly CBCT or CT dose, and therapy dose, robustly optimized with setup margins between 0 and 4 mm. These were compared to a reference protocol with 4 mm setup margin without daily imaging. All plans further used 3% range robustness. Organ-wise excess absolute risk (EAR) of cancer was calculated with three models to determine at which setup margin the total EAR of image-guided and adaptive treatment protocols was equal to the total EAR of the reference.Results. The difference between the simulated and measured CT and CBCT doses was within 10%. Using the Monte Carlo models, we found that a 1 mm setup margin reduction was sufficient for most patients, treatment protocols, and cancer risk models to compensate the additional risk imposed by daily and weekly imaging. For some protocols, even a smaller reduction sufficed, depending on the imaging frequency and type. The risk reduction by reducing the margin was mainly due to reducing the risk for carcinomas in the brain and, for some patients, the oral cavity.Significance. Our framework allows to compare an increased imaging dose with the reduced treatment dose from margin reductions in terms of radiation-induced cancer risk. It is extendable to different treatment sites, modalities, and imaging protocols, in clinic-specific or even patient-specific assessments.

Monte Carlo calculation of LiF:Mg,Cu,P thermoluminescent dosimeter correction factors for 18F, 131I and 90Y submersion dosimetry

Accurate measurement of absorbed dose from beta-emitting therapeutic radionuclides is important to ensure safe and effective delivery to patients. Thermoluminescent dosimeters (TLDs) are a commercially available option to measure dose, but several confounding factors complicate this process. To preserve their integrity during the measurement, it is necessary to enclose TLDs in a waterproof envelope, which unavoidably attenuates the beta particles. Additionally, the exclusion of radioactivity in the volume occupied by the TLD, the finite volume effect, further complicates the measurement. The purpose of this study is to calculate the correction factors to convert the TLD measured dose to the absorbed dose in water, Dw, for three common radionuclides and the LiF:Mg,Cu,P TLD (Thermo Fisher Scientific™, Waltham, MA). Correction factors were calculated for four different size LiF:Mg,Cu,P TLD dosimeters inside a PMMA cylindrical phantom with 90YCl3, C6H1118FO5, and Na131I aqueous solutions. Specific correction factors are required to account for finite volume, energy, and geometry for each LiF:Mg,Cu,P TLD size, radionuclide, and phantom geometry combination. Additionally, for the PMMA phantom, specific material correction factors are also required to account for the additional materials inside the phantom. The absorbed dose calculations performed with LiF:Mg,Cu,P TLDs showed good agreement with Monte Carlo simulations. Overall, these findings contribute to improving the accuracy of absorbed dose measurements from beta-emitting radionuclides in liquid solutions using TLDs.

Inhomogeneity detection within a head-sized phantom using tracking of charged nuclear fragments in ion beam therapy

Objective.The highly conformal carbon-ion radiotherapy is associated with an increased sensitivity of the dose distributions to internal changes in the patient during the treatment course. Hence, monitoring methodologies capable of detecting such changes are of vital importance. We established experimental setup conditions to address the sensitivity of a monitoring approach based on secondary-fragment tracking for detecting clinically motivated air cavity dimensions in a homogeneous head-sized PMMA phantom in 40 mm depth.Approach.The air cavities were positioned within the entrance channel of a treatment field of 50 mm diameter at three lateral positions. The measured secondary-fragment emission profiles were compared to a reference measurement without cavities. The experiments were conducted at the Heidelberg Ion-Beam Therapy Center in Germany at typical doses and dose rates.Main results.Significances above a detectability threshold of 2σfor the larger cavities (20 mm diameter and 4 mm thickness, and 20 mm diameter and 2 mm thickness) across the entire treatment field. The smallest cavity of 10 mm diameter and 2 mm thickness, which is on the lower limit of clinical interest, could not be detected at any position. We also demonstrated that it is feasible to reconstruct the lateral position of the cavity on average within 2.8 mm, once the cavity is detected. This is sufficient for the clinicians to estimate medical effects of such a cavity and to decide about the need for a control imaging CT.Significance.This investigation defines well-controlled reference conditions for the evaluation of the performance of any kind of treatment monitoring method and its capability to detect internal changes within head-sized objects. Four air cavities with volumes between 0.31 cm3and 1.26 cm3were narrowed down around the detectability threshold of this secondary-fragment-based monitoring method.

High-sensitivity and spatial resolution benchtop cone beam XFCT imaging system with pixelated photon counting detectors using enhanced multipixel events correction method

Objective.High atomic number element nanoparticles have shown potential in tumor diagnosis and therapy. X-ray fluorescence computed tomography (XFCT) technology enables quantitative imaging of high atomic number elements by specifically detecting characteristic x-ray signals. The potential for further biomedical applications of XFCT depends on balancing sensitivity, spatial resolution, and imaging speed in existing XFCT imaging systems.Approach.In this study, we utilized a high-energy resolution pixelated photon-counting detector for XFCT imaging. We tackled degradation caused by multi-pixel events in the photon-counting detector through energy and interaction position corrections. Sensitivity and spatial resolution imaging experiments were conducted using PMMA phantoms to validate the effectiveness of the multi-pixel events correction algorithm.Main results.After correction, the system's sensitivity and spatial resolution have both improved. Furthermore, XFCT/CBCT dual-modality imaging of gadolinium nanoparticles within mice subcutaneous tumor was successfully achieved.Significance.These results demonstrate the preclinical research application potential of the XFCT/CBCT dual-modality imaging system in high atomic number nanoparticle-based tumor diagnosis and therapy.

Implementation of Patient-Specific Quality Control in Radiotherapy Treatments with ArcCheck

Introduction: Quality control is essential to ensure safety and prevent errors in the administration of ionizing radiation across various radiotherapy techniques. Objective: To evaluate the performance of the ArcCheck detector with the goal of implementing a specific quality control technique for patients treated with dynamic arc therapy. Methods: Fifty patients treated with 6 MV and 10 MV energies on the Clinac® Varian CX were selected. Doses at the isocenter of each treatment plan were analyzed using a PMMA phantom (30 x 30 x 15 cm³) to validate reference values between the treatment planning system and the ionization chamber. The treatment plans were also recreated using the ArcCheck. Results: The mean dose difference at the isocenter was -0.96% and -1.34% for 6 MV and 10 MV, respectively. The average passing rate of the dose distributions in the gamma analysis exceeded 98.0% for both energies. Conclusion: The results demonstrated good concordance with the TG-119 and TG-218 protocols, supporting the use of the detector for quality control in patient-specific treatments.

Monte Carlo dose calculation for photon and electron radiotherapy on dynamically deforming anatomy.

Dose calculation in radiotherapy aims to accurately estimate and assess the dose distribution of a treatment plan. Monte Carlo (MC) dose calculation is considered the gold standard owing to its ability to accurately simulate particle transport in inhomogeneous media. However, uncertainties such as the patient's dynamically deforming anatomy can still lead to differences between the delivered and planned dose distribution. Development and validation of a deformable voxel geometry for MC dose calculations (DefVoxMC) to account for dynamic deformation in the dose calculation process of photon- and electron-based radiotherapy treatment plans for clinically motivated cases. DefVoxMC relies on the subdivision of a regular voxel geometry into dodecahedrons. It allows shifting the dodecahedrons' corner points according to the deformation in the patient's anatomy using deformation vector fields (DVF). DefVoxMC is integrated into the Swiss Monte Carlo Plan (SMCP) to allow the MC dose calculation of photon- and electron-based treatment plans on the deformable voxel geometry. DefVoxMC is validated in two steps. A compression test and a Fano test are performed in silico. Delta4 (for photon beams) and EBT4 film measurements in a cubic PMMA phantom (for electron beams) are performed on a TrueBeam in Developer Mode for clinically motivated treatment plans. During these measurements, table motion is used to mimic rigid dynamic patient motion. The measured and calculated dose distributions are compared using gamma passing rate (GPR) (3% / 2mm (global), 10% threshold). DefVoxMC is used to study the impact of patient-recorded breathing motion on the dose distribution for clinically motivated lung and breast cases, each prescribed 50Gy to 50% of the target volume. A volumetric modulated arc therapy (VMAT) and an arc mixed-beam radiotherapy (Arc-MBRT) plan are created for the lung and breast case, respectively. For the dose calculation, the dynamic deformation of the patient's anatomy is described by DVFs obtained from deformable image registration of the different phases of 4DCTs. The resulting dose distributions are compared to the ones of the static situation using dose-volume histograms and dose differences. DefVoxMC is successfully integrated into the SMCP to enable the MC dose calculation of photon- and electron-based treatments on a dynamically deforming patient anatomy. The compression and the Fano test agree within 1.0% and 0.1% with the expected result, respectively. Delta4 and EBT4 film measurements agree with the calculated dose by a GPR>95%. For the clinically motivated cases, breathing motion resulted in areas with a dose increase of up to 26.9Gy (lung) and up to 7.6Gy (breast) compared to the static situation. The largest dose differences are observed in high-dose-gradient regions perpendicular to the beam plane, consequently decreasing the planning target volume coverage (V95%) by 4.2% for the lung case and 2.0% for the breast case. A novel method for MC dose calculation for photon- and electron-based treatments on dynamically deforming anatomy is successfully developed and validated. Applying DefVoxMC to clinically motivated cases, we found that breathing motion has non-negligible impact on the dosimetric plan quality.

First Dosimetric and Biological Verification for Spot-Scanning Hadron Arc Radiation Therapy With Carbon Ions

Purpose: Spot-scanning Hadron Arc therapy (SHArc) is a novel delivery technique for ion beams with potentially improved dose conformity and dose-averaged linear energy transfer (LETd) redistribution. The first dosimetric validation and in vitro verification of carbon ion arc delivery is presented. Methods: Intensity Modulated Particle Therapy (IMPT) and SHArc plans were designed to deliver homogenous physical dose or biological dose in a cylindrical PMMA phantom. Additional IMPT carbon plans were optimized for testing different LETd-boosting strategies. Verifications of planned doses were performed with an ionization chamber and clonogenic survival assay was conducted using A549 cancer lung cell line. Radiation-induced nuclear 53BP1 foci were assessed to evaluate the cellular response in both normoxic and hypoxic conditions. Results: Dosimetric measurements and clonogenic assay results showed a good agreement to planned dose and survival distributions. Measured survival fractions and foci confirmed carbon ions SHArc as potential modality to overcome hypoxia-induced radio-resistance. LETd-boosted IMPT plans reached similar LETd in the target as in SHArc plans promising similar features against hypoxia but at the cost of an increased entrance dose. SHArc resulted, however, in a lower dose bath but in a larger volume around the target. Conclusion: The first proof of principle of carbon ions SHArc delivery was performed and experimental evidence suggests this novel modality as an attractive approach for treating hypoxic tumor.

Wide cone beam CT dosimetry: Analysis of results and uncertainty evaluation

ObjectiveTo investigate the consistency of the recommended methodology, we analyzed the dosimetric results obtained for each setup beam shaping filter and tube voltage and evaluated the uncertainty associated with the full dose measurement process. MethodsA 300-mm PTIC was used to validate the results obtained with the 100-mm PTIC. Considering the other dosimetric parts, a cylindrical 160-mm diameter PMMA phantom and a cylindrical 320-mm diameter PMMA phantom were also used in the experimental protocol. ResultsFor the lowest and highest tube voltages available, the CTDIair,160 values obtained by 1-step dosimetry with the 300-mm PTIC were greater than the respective values obtained by 2- and 3-step dosimetry with the 100-mm PTIC. ConclusionThis study established that careful positioning of the 100-mm PTIC in 2 or 3 steps, as well as proper execution of the other dosimetric parts recommended by the IAEA, represents a validated approach within up to 20% uncertainty for wide cone beam CT dosimetry.

Stopping power and range estimations in proton therapy based on prompt gamma timing: motion models and automated parameter optimization

Objective. Particle therapy treatments are currently limited by uncertainties of the delivered dose. Verification techniques like Prompt-Gamma-Timing-based Stopping Power Estimation (PGT-SPE) may allow for reduction of safety margins in treatment planning. Approach. From Prompt-Gamma-Timing measurements, we reconstruct the spatiotemporal distribution of prompt gamma emissions, which is linked to the average motion of the primary particles. The stopping power is determined by fitting a model of the average particle motion. Here, we compare a previously published implementation of the particle motion model with an alternative formulation and present two formulations to automatically select the hyperparameters of our procedure. The performance was assessed using Monte-Carlo simulations of proton beams (60 MeV–219 MeV) impinging on a homogeneous PMMA phantom. Main results. The range was successfully determined within a standard deviation of 3 mm for proton beam energies from 70 MeV to 219 MeV. Stopping power estimates showed errors below 5% for beam energies above 160 MeV. At lower energies, the estimation performance degraded to unsatisfactory levels due to the short range of the protons. The new motion model improved the estimation performance by up to 5% for beam energies from 100 MeV to 150 MeV with mean errors ranging from 6% to 18%. The automated hyperparameter optimization matched the average error of previously reported manual selections, while significantly reducing the outliers. Significance. The data-driven hyperparameter optimization allowed for a reproducible and fast evaluation of our method. The updated motion model and evaluation at new beam energies bring us closer to applying PGT-SPE in more complex scenarios. Direct comparison of stopping power estimates between treatment planning and measurements during irradiation would offer a more direct verification than other secondary-particle-based techniques.

A combined analytical and Monte Carlo method for detailed simulations of antiscatter grids in x-ray medical imaging: implementing scatter within the grid

Objective. To implement a hybrid method, which combines analytical tracking and interaction simulation using Monte Carlo (MC) techniques, in order to model photon transport inside antiscatter grids (ASG) for x-ray imaging. Approach. A new tally was developed for PENELOPE (v.2018) and penEasy (v. 2020) MC code to simulate photon transmission through ASGs. Two established analytical algorithms from the literature were implemented in this tally. In addition, a new hybrid method was introduced by extending one of the analytical algorithms to include photon-interactions inside the grid, while preserving the imaged grid structure. Calculations of primary (TP), scatter (TS), and total (TT) grid transmissions in addition to the Q factor (Q = TP2/TT ) were performed. The new tally was validated for a quadric geometry ASG, and experimental measurements with a PMMA phantom of several thicknesses. In addition, the contribution of the scatter inside the grid was studied for three interspace materials, and a high resolution image of the grid was simulated. Main results. An excellent agreement was found between the two analytical models compared with the quadric grid without scatter, and the hybrid method with the geometrical grid with scatter. Average deviations of 0.2% and 1.4% were found between TP and TS for the hybrid method and quadric grid, while for the hybrid method and experimental measurements these values were 1% and 20%. Antiscatter grids with aluminium as interspace material had the highest amount of scatter from inside the grid to the final image, followed up by paper fibre and air. The high resolution image of the grid was equivalent using the quadric geometry or the hybrid mode. Significance. The hybrid method provides a means of studying scattered radiation from the antiscatter grid with the advantage of higher performance, with results that are consistent with a full quadric geometry simulation of the ASG.

A two-layer Timepix3 stack for improved charged particle tracking and radiation field decomposition

Abstract We characterize a novel instrument designed for radiation field decomposition and particle trajectory reconstruction for application in harsh radiation environments. The device consists of two Timepix3 assemblies with 500 µm thick silicon sensors in a face-to-face geometry. These detectors are interleaved with a set of neutron converters: 6LiF for thermal neutrons, polyethylene (PE) for fast neutrons above 1 MeV, and PE with an additional aluminum recoil proton filter for neutrons above ∼4 MeV. Application of the coincidence and anticoincidence technique together with pattern recognition allows improved separation of charged and neutral particles, their discrimination against γ-rays and assessment of the overall directionality of the fast neutron field. The instrument's charged particle tracking and separation capabilities were studied at the Danish Center for Particle Therapy (DCPT), the Proton Synchrotron, and Super Proton Synchrotron with protons (50–240 MeV), pions (1–10 GeV/c and 180 GeV/c). After developing temporal and spatial coincidence assignment methodology, we determine the relative amount of coincident detections as a function of the impact angle, present the device's impact angle resolving power (both in coincidence and anticoicidence channels). The detector response to neutrons was studied at the Czech Metrology Institute (CMI), at n_ToF and the Los Alamos Neutron Science Center (LANSCE), covering the entire spectrum from thermal up to 600 MeV. The measured tracks were assigned to their corresponding neutron energy by application of the time of flight technique. We present the achieved neutron detection efficiency as a function of neutron kinetic energy and demonstrate how the ratio of events found below the different converters can be used to assess the hardness of the neutron spectrum. As an application, we determine the neutron content within a PMMA phantom just behind the Bragg-peak during clinical irradiation condition with protons of 160 MeV.

First experimental demonstration of real-time neutron capture discrimination in helium and carbon ion therapy

This work provides the first experimental proof of an increased neutron capture photon signal following the introduction of boron to a PMMA phantom during helium and carbon ion therapies in Neutron Capture Enhanced Particle Therapy (NCEPT). NCEPT leverages 10\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$^{10}$$\\end{document}B neutron capture, leading to the emission of detectable 478 keV photons. Experiments were performed at the Heavy Ion Medical Accelerator in Chiba, Japan, with two Poly(methyl methacrylate) (PMMA) targets, one bearing a boron insert. The BeNEdiCTE gamma-ray detector measured an increase in the 478 keV signal of 45 ± 7% and 26 ± 2% for carbon and helium ion irradiation, respectively. Our Geant4 Monte Carlo simulation model, developed to investigate photon origins, found less than 30% of detected photons originated from the insert, while boron in the detector’s circuit boards contributed over 65%. Further, the model investigated detector sensitivity, establishing its capability to record a 10% increase in 478 keV photon detection at a target 10\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$^{10}$$\\end{document}B concentration of 500 ppm using spectral windowing alone, and 25% when combined with temporal windowing. The linear response extended to concentrations up to 20,000 ppm. The increase in the signal in all evaluated cases confirm the potential of the proposed detector design for neutron capture quantification in NCEPT.

Development of focusing multi-knife-edge camera for proton beam range verification: A Monte Carlo study

Proton range uncertainties limit the ability to make full clinical use of the sharp distal falloff of the proton beam. To overcome this limitation, prompt gamma (PG) imaging system with mechanical collimation can be used in non-invasive proton beam range verification. In this study, we developed a focusing multi-knife-edge collimator to improve the counting efficiency and accuracy in detecting proton beam range. Unlike the common design of a single-knife-edge slit (SKE) collimator, the multi-knife-edge slit (MKE) collimator consists of three slits and focuses on the target detection area. To compare the performances of these two collimator designs, Monte Carlo simulation was unitized to model the cameras for measuring the PGs during proton irradiation. The simulation was performed using the GATE v9.1. The setup included a pencil beam of 100 MeV, 160 MeV, and 230 MV protons incident upon a cylindrical PMMA phantom with three different proton numbers of 107, 108, and 109. The detection PG profiles were fitted with a 3-line-segment fitting method to estimate the range of proton beams. Both cameras were aimed at the expected range depth for the corresponding proton beam energies. Experiments for range shifts were conducted by shifting the phantom between −20 mm and 20 mm along the beam axis. Results demonstrate that the MKE camera exhibits approximately twice the efficiency of the SKE camera in detecting PGs. In range shift retrieval, with the delivery of 108 protons, the MKE camera achieves submillimeter accuracy (except for incident protons at 230 MeV), while the SKE camera achieves accuracy within 2 mm. In conclusion, this study assesses the feasibility of the MKE camera and illustrates its potential application for range shift detection, contributing to precise range monitoring in proton therapy.

Improving input contrast estimation to an x-ray imaging system

Objective. An appropriate parameter to study the performance of an x-ray imaging system is contrast transfer, or the system’s ability to capture contrast in the radiation beam and bring it to the image. However, determining the input contrast to the system is difficult, as it is heavily affected by secondary radiation, which in turn depends on a multitude of factors. This work presents a method to improve the calculation of input contrast to the imaging system when PMMA phantoms are used. Approach. An expression to obtain input contrast from primary radiation attenuation and scatter-to-primary ratio is shown, and the approximation upon which it is based is discussed. Primary and secondary radiation emerging from the phantoms are calculated for monoenergetic pencil beams impinging on planar PMMA phantoms of different thicknesses. Monte Carlo simulations of two types of anti-scatter grids are also incorporated into the calculations. Main results. The primary and secondary components of radiant energy and grid transmission factors are presented for monoenergetic beams with energies from 10 to 150 keV. These results are then used to calculate input contrast for polyenergetic beams when using a commercial image quality phantom combined with different thicknesses of PMMA and anti-scatter grids. Significance. The information of the object contrast carried by the beam constitutes the input to the imaging system. An accurate determination of this input contrast can be carried out in a wide variety of situations from the study of a reduced number of cases, as those presented in this work for monoenergetic beams, PMMA phantoms of different thicknesses and anti-scatter grids. The relationship between the input contrast and the contrast due to primary radiation used in this work provides a good approximation for the different combinations of inserts, phantoms, grids, and energy spectra analyzed here.

Quasi-real-time range monitoring by in-beam PET: a case for 15O

A fast and reliable range monitoring method is required to take full advantage of the high linear energy transfer provided by therapeutic ion beams like carbon and oxygen while minimizing damage to healthy tissue due to range uncertainties. Quasi-real-time range monitoring using in-beam positron emission tomography (PET) with therapeutic beams of positron-emitters of carbon and oxygen is a promising approach. The number of implanted ions and the time required for an unambiguous range verification are decisive factors for choosing a candidate isotope. An experimental study was performed at the FRS fragment-separator of GSI Helmholtzzentrum für Schwerionenforschung GmbH, Germany, to investigate the evolution of positron annihilation activity profiles during the implantation of ^{14}O and ^{15}O ion beams in a PMMA phantom. The positron activity profile was imaged by a dual-panel version of a Siemens Biograph mCT PET scanner. Results from a similar experiment using ion beams of carbon positron-emitters ^{11}C and ^{10}C performed at the same experimental setup were used for comparison. Owing to their shorter half-lives, the number of implanted ions required for a precise positron annihilation activity peak determination is lower for ^{10}C compared to ^{11}C and likewise for ^{14}O compared to ^{15}O, but their lower production cross-sections make it difficult to produce them at therapeutically relevant intensities. With a similar production cross-section and a 10 times shorter half-life than ^{11}C, ^{15}O provides a faster conclusive positron annihilation activity peak position determination for a lower number of implanted ions compared to ^{11}C. A figure of merit formulation was developed for the quantitative comparison of therapy-relevant positron-emitting beams in the context of quasi-real-time beam monitoring. In conclusion, this study demonstrates that among the positron emitters of carbon and oxygen, ^{15}O is the most feasible candidate for quasi-real-time range monitoring by in-beam PET that can be produced at therapeutically relevant intensities. Additionally, this study demonstrated that the in-flight production and separation method can produce beams of therapeutic quality, in terms of purity, energy, and energy spread.

OPTIMISASI DOSIS DAN KUALITAS CITRA PADA PEMERIKSAAN PULMONARY ARTERY CATHETER (PAC) DAN PERCUTANEUS CORONARY INTERVENTION (PCI) SEBAGAI UPAYA PROTEKSI RADIASI PASIEN DI CATHLAB RSUP ADAM MALIK MEDAN

The radiation exposure a patient receives during diagnosis and treatment cannot be fully avoided. However, it is crucial to optimize the radiation dose to ensure it is only as much as needed. The purpose of this study is to minimize the patient's radiation exposure during interventions and produce optimal image quality. To accomplish this, dose optimization and image quality were evaluated during PAC and PCI procedures in the Cathlab room at Adam Malik Hospital using Philips Allura Xper FD20. The study was retrospective, using patient dose audits from January 2020 to February 2023, with 250 PACs and 139 PCI mature patients. The median dose value (Q2) was compared to the National diagnostic reference level (NDRL) third quartile (Q3) value to determine optimal patient dose levels. We used a 28 cm PMMA phantom and a 2 cm imaging quality in-house phantom to represent the patient and a solid-state detector to measure surface dose. Medical physicists, radiographers, cardiologists, and nurses worked together in optimization cycles to ensure dose levels were kept to a minimum. Image quality was assessed by calculating the signal difference-to-noise ratio (SDNR), and images were recorded in DICOM format and analyzed using Image J software. Entrance Surface Air Kerma (ESAK) values were recorded to calculate Figure of Merit (FOM) values for each change in physical parameters. The study showed that the distance between the image detector and the object significantly affects the patient's dose. A distance of 14 cm resulted in a higher dose than a distance of 2 cm. The SDNR value varied with the object image distance (OID) factor, and increasing the object's distance to the image detector did not increase the SDNR value. Setting the OID spacing to a minimum is recommended for PAC and PCI procedures to minimize the patient's radiation exposure. The FOM values were affected by both the ESAK and SDNR values. Keywords: Dose Optimization, Image Quality, objek to image distance (OID), Pulmonary Artery Catheter, Percutaneous Coronary Intervention, Cathlab.

Improved sub-milimeter range-verification method for proton therapy using a composite hadron tumour marker (HTM)

Objective. The results of a follow-up experiment investigating a novel method for sub-milimetre range verification (RV) in proton therapy (PT) are presented. Approach. The method consists of implanting a hadron tumour marker (HTM) near the planned treatment volume, and measuring the γ-ray signals emitted as a result of activation by the proton beam. These signals are highly correlated with the energy of the beam impinging on the HTM and can provide an absolute measurement of the range of the beam relative to the position of the HTM, which is independent of any uncertainties in beam delivery. Main results. Three candidate HTM materials were identified and combined into a single composite HTM, which makes use of the strongest reaction in each material. The setup of the previous experiment was improved on by using high-purity germanium detectors to measure the γ-ray signal with a higher resolution than was previously achieved. A PMMA phantom was also used to simulate the γ-ray background from tissue activation. HTM RV using the data collected in this study yielded range measurements whose average deviation from the expected value was 0.13(22)mm. Significance. Range uncertainty in PT limits the prescribed treatment plan for cancer patients with large safety margins and constrains the direction of the proton beam in relation to any organ at risk. The sub-milimetre range uncertainty achieved in this study using HTM RV, if implemented clinically, would allow for a reduction in the size of safety margins, increasing the therapeutic window for PT.

Influence of the background in Compton camera images for proton therapy treatment monitoring

Objective. Background events are one of the most relevant contributions to image degradation in Compton camera imaging for hadron therapy treatment monitoring. A study of the background and its contribution to image degradation is important to define future strategies to reduce the background in the system. Approach. In this simulation study, the percentage of different kinds of events and their contribution to the reconstructed image in a two-layer Compton camera have been evaluated. To this end, GATE v8.2 simulations of a proton beam impinging on a PMMA phantom have been carried out, for different proton beam energies and at different beam intensities. Main results. For a simulated Compton camera made of Lanthanum (III) Bromide monolithic crystals, coincidences caused by neutrons arriving from the phantom are the most common type of background produced by secondary radiations in the Compton camera, causing between 13% and 33% of the detected coincidences, depending on the beam energy. Results also show that random coincidences are a significant cause of image degradation at high beam intensities, and their influence in the reconstructed images is studied for values of the time coincidence windows from 500 ps to 100 ns. Significance. Results indicate the timing capabilities required to retrieve the fall-off position with good precision. Still, the noise observed in the image when no randoms are considered make us consider further background rejection methods.