Water Equivalent Thickness Research Articles

Nanocomposite physics and structure considerations in MCNP proton shielding models

Background Deep space crewed missions require unique radiation shielding considerations. Due to mission duration and the heavy, high-energy nature of deep space radiation, the aluminum alloys that have historically been used for spacecrafts do not provide sufficient protection for crew members. Polymer-based nanocomposites have been proposed as potential radiation shielding materials for deep space applications; however, the high tunability of nanocomposites and the limited number of facilities able to produce representative radiation energies presents barriers to nanocomposite testing. Computational approaches may allow for preliminary investigation and discrimination of nanocomposite parameters like polymer and filler composition, loading percentage, and filler size and structure. Methods This work aims to investigate several modeling methods to perform radiation transport simulations for a nanocomposite, particularly with regards to modeling the filler nanostructure and the involved physics. Published experiments of a polydimethylsiloxane-carbon nanotube nanocomposite in 63 MeV and 105 MeV proton beams were digitally recreated in MCNP6.2 with three different nanocomposite structures. Additionally, several simulations were performed under various physics assumptions. The computationally determined water equivalent thicknesses are compared between modeling methods, as well as between the computational and the published experimental work. Results Nanostructure model complexity had no impact on the computed water equivalent thickness, with <1% difference between the three modeling methods. The inclusion of delta ray production and tracking physics produced a slight decrease in the computed water equivalent thickness and significantly increased the computational time for a single simulation by a factor of 35.7. Computationally determined water equivalent thicknesses are within 5% of published experimentally determined values. Conclusions Shielding capabilities of a polymer/carbon nanotube nanocomposite estimated using Monte Carlo radiation transport models agree well with published experimental results, even with a simplistic representation of the nanocomposite material. Radiation transport settings influenced the resulting water equivalent thickness as well as computational resource needs.

Comparison and evaluation of different deep learning models of synthetic CT generation from CBCT for nasopharynx cancer adaptive proton therapy.

Cone-beam computed tomography (CBCT) scanning is used for patient setup in image-guided radiotherapy. However, its inaccurate CT numbers limit its applicability in dose calculation and treatment planning. This study compares four deep learning methods for generating synthetic CT (sCT) to determine which method is more appropriate and offers potential for further clinical exploration in adaptive proton therapy for nasopharynx cancer. CBCTs and deformed planning CT (dCT) from 75 patients (60/5/10 for training, validation and testing) were used to compare cycle-consistent Generative Adversarial Network(cycleGAN), Unet, Unet+cycleGAN and conditionalGenerative Adversarial Network (cGAN) for sCT generation. The sCT images generated by each method were evaluated against dCT images using mean absolute error (MAE), structural similarity (SSIM), peak signal-to-noise ratio (PSNR), spatial non-uniformity (SNU) and radial averaging in the frequency domain. In addition, dosimetric accuracy was assessed through gamma analysis, differences in water equivalent thickness (WET), and dose-volume histogram metrics. The cGAN model has demonstrated optimal performance in the four models across various indicators. In terms of image quality under global condition, the average MAE has been reduced to 16.39HU, SSIM has increased to 95.24%, and PSNR has increased to 28.98. Regarding dosimetric accuracy, the gamma passing rate (2%/2mm) has reached 99.02%, and the WET difference is only 1.28mm. The D95 value of CTVs coverage and Dmax value of spinal cord, brainstem show no significant differences between dCT and sCT generated by cGAN model. The cGAN model has been shown to be a more suitable approach for generating sCT using CBCT, considering its characteristics and concepts. The resulting sCT has the potential for application in adaptive proton therapy.

Carbon-fiber alternative to the commercial gating surrogate for the Varian Truebeam™

Background In this study we present the Tracking Accessory 3 (TA3) as an alternative to the commercial gating block (GB) surrogate for the Varian Truebeam™ gating system (TGS). The TGS requires three visible reflectors to track the surrogate, presenting an opportunity for a surrogate to be made with less material and thus smaller dosimetric footprint than the commercial four reflector model. Materials and methods Relative dose and depth dose profiles below the TA3 and the GB were measured with radiosensitive film. Accuracy and reproducibility of the detected motion amplitude for three TA3s and one GB were determined using a respiratory phantom with surrogate to determine the camera’s tracking volume. Clinical performance was evaluated prospectively in 10 breast cancer patients treated with deep inspiration breath hold monitored with TA3 and compared to previously published results. Non-parametric statistics were applied to test for significance. Results and conclusions Surface doses were increased up to 94% and 187% for the TA3 and GB, respectively, compared to no surrogate. The surface area influenced by at least 25% increase in dose was 12 cm2 and 105 cm2 for the TA3 and GB, respectively. The water equivalent thickness of the surrogates was found to be 1 mm for the TA3 and 3 mm for GB. The difference in measured amplitude were <0.2 mm for TA3 compared to the GB. The TA3s and GB were detected at all extremes of the clinically relevant tracking volume of the TGS. Clinical performance showed no significant differences. The TA3 caused less surface dose increase compared to the commercial GB. In the tested range all surrogates measured motion amplitude within 0.2 mm of reference value, which is not a clinically relevant difference. The TA3 showed no significant differences in clinical performance to similarly positioned surrogates.

Adaptation of a Clinical Proton Pencil Beam Scanning System for FLASH Experiments

To characterize a proton pencil beam scanning system for ultra-high dose rate (UHDR) irradiations and validate it with FLASH preclinical experiments. After modifications to the beamline to maximize the beam current at isocenter in our gantry room, we characterized the UHDR beam in terms of: 1) Size and shape of the beam spot in three configurations; pristine beam, 75 mm water-equivalent-thickness (WET) range shifter (RS), and custom-built 135 mm WET RS mounted 310 mm upstream of the aperture in the snout housing. These configurations were analyzed to determine which one achieved the highest dose rate; 2) Beam transport efficiency and beam output. We compared the signal in the monitor chambers of the proton system with a Faraday cup and plane parallel ionization chamber (PPC05, IBA dosimetry) for beam current at the cyclotron from 7.5 nA to 800 nA; 3) Dose homogeneity, beam penumbra, and dose rate for the fields to be used in preclinical irradiations. All measurements were performed at isocenter, in air or at 1 cm depth in solid water, using the highest energy (about 230 MeV), which corresponded to a nominal range of 32.9 cm in water. We modeled the UHDR beam in our treatment planning system (TPS) to optimize the dose homogeneity and lateral penumbra of the irradiation fields. We performed the preclinical experiments in single fractions of 19 Gy (RBE), 21 Gy (RBE) and 23 Gy (RBE) (RBE = 1.1), targeting the pelvis of C57BL/6 mice and using survival as the endpoint. Each arm included 6-10 mice. The proton beam was used in transmission mode, positioning the center of the mouse pelvis at isocenter, and irradiating the pelvis with a 2x6 cm^2 field. Apertures were placed at 9cm from the isocenter to sharpen the lateral penumbra. The range measurements with a multi-layer ionization chamber were consistent within 1 mm with the nominal range. In UHDR mode, the spot size at the isocenter varied from 4.5 mm for the pristine beam to 9.2 mm for the 135 mm RS. The spot size at isocenter remained constant when the beam intensity varied from 7.5 nA to 800 nA at the cyclotron exit. By employing the configuration with the 135 mm RS and optimizing the fields in the TPS, we achieved a dose rate of 1 Gy (RBE)/s for the conventional regime and 75(RBE) Gy/s for the UHDR regime. The monitor chambers of the proton system were affected by recombination at high dose rates: we observed about 35% higher output for the same number of monitor units delivered at 800 nA vs 7.5 nA. The delivered dose was determined with the PPC05 for each field, as this detector did not show recombination effects. When preclinical irradiations were independently monitored, the delivered dose was typically within 1% of the intended value. In three independent experiments, a dose of 21 Gy (RBE) or higher was associated with an increased survival in the UHDR arm compared to the conventional arm. We adapted a clinical proton system for preclinical irradiations at UHDR. Our results confirm the presence of the FLASH effect.

An optimized framework for cone-beam computed tomography-based online evaluation for proton therapy.

Clinical evidence has demonstrated that proton therapy can achieve comparable tumor control probabilities compared to conventional photon therapy but with the added benefit of sparing healthy tissues. However, proton therapy is sensitive to inter-fractional anatomy changes. Online pre-fraction evaluation can effectively verify proton dose before delivery to patients, butthere is a lack of guidelines for implementing this workflow. The purpose of this study is to develop a cone-beam CT-based (CBCT) online evaluation framework for proton therapy that enables knowledge transparency and evaluates the efficiency and accuracy of each essential component. Twenty-three patients with various lesion sites were included to conduct a retrospective study of implementing the proposed CBCT evaluation framework for the clinic. The framework was implemented on the RayStation 11B Research platform. Two synthetic CT (sCT) methods, corrected CBCT (cCBCT), and virtual CT (vCT), were used, and the ground truth images were acquired from the same-day deformed quality assurance CT (dQACT) for the comparisons. The evaluation metrics for the framework include time efficiency, dose-difference distributions (gamma passing rates), and water equivalent thickness (WET) distributions. The mean online CBCT evaluation times were 1.6±0.3min and 1.9±0.4min using cCBCT and vCT, respectively. The dose calculation and deformable image registration dominated the evaluation efficiency, and accounted for 33% and 30% of the total evaluation time, respectively. The sCT generation took another 19% of the total time. Gamma passing rates were greater than 91% and 97% using 1%/1mm and 2%/2mm criteria, respectively. When the appropriate sCT was chosen, the target mean WET difference from the reference were less than 0.5mm. The appropriate sCT method choice determined the uncertainty for the framework, with the cCBCT being superior for head-and-neck patient evaluation and vCT being better for lung patient evaluation. An online CBCT evaluation framework was proposed to identify the use of the optimal sCT algorithm regarding efficiency and dosimetry accuracy. The framework is extendable to adopt advanced imaging methods and has the potential to support online adaptive radiotherapy to enhance patient benefits.It could be implemented into clinical use in the future.

Dosimetric effect of six degrees of freedom couch top with rotational setup error corrections in proton therapy.

To investigate the dosimetric effect of six degrees of freedom (6DoF) couch top with rotational corrections in proton therapy (PT). The water equivalent thickness (WET) was measured using a proton beam with a 6DoF couch top and patient immobilization base plate (PIBP) placed in front of a motorized water phantom. The accuracy verification was performed with the beam axis set perpendicular to the 6DoF couch top and tilted in 10° steps from 10° to 30°. Up to 3° rotational correction may be added during the actual treatment to correct the rotational setup error on our system. The measured and calculated values using the treatment planning system were compared. Additionally, the effect of the 3° difference was evaluated using actual measurements concerning each angle on the proton beam range. The WET of the 6DoF couch top and PIBP were 8.5±0.1mm and 6.8±0.1mm, respectively. The calculation and the actual measurement at each angle agreed within 0.2mm at the maximum. A maximum difference of approximately 0.6mm was confirmed when tilted at 3° following 30° with the 6DoF couch top plus PIBP. The dosimetric effect of the 6DoF couch top with rotational corrections in PT differs depending on the incidence angle on the couch top, and it increased with the increased oblique angle of incidence. However, the effect on the range was as small as 0.6mm at the maximum. The amount of rotational correction, the angle of incidence of the beam, and the effect of rotational corrections on the proton beam range may differ depending on the structure of the couch top. Therefore, sufficient prior confirmation, and subsequent periodical quality assurance management are important.

Deep learning based synthetic CT from cone beam CT generation for abdominal paediatric radiotherapy

Objective. Adaptive radiotherapy workflows require images with the quality of computed tomography (CT) for re-calculation and re-optimisation of radiation doses. In this work we aim to improve the quality of on-board cone beam CT (CBCT) images for dose calculation using deep learning. Approach. We propose a novel framework for CBCT-to-CT synthesis using cycle-consistent Generative Adversarial Networks (cycleGANs). The framework was tailored for paediatric abdominal patients, a challenging application due to the inter-fractional variability in bowel filling and small patient numbers. We introduced to the networks the concept of global residuals only learning and modified the cycleGAN loss function to explicitly promote structural consistency between source and synthetic images. Finally, to compensate for the anatomical variability and address the difficulties in collecting large datasets in the paediatric population, we applied a smart 2D slice selection based on the common field-of-view (abdomen) to our imaging dataset. This acted as a weakly paired data approach that allowed us to take advantage of scans from patients treated for a variety of malignancies (thoracic-abdominal-pelvic) for training purposes. We first optimised the proposed framework and benchmarked its performance on a development dataset. Later, a comprehensive quantitative evaluation was performed on an unseen dataset, which included calculating global image similarity metrics, segmentation-based measures and proton therapy-specific metrics. Main results. We found improved performance for our proposed method, compared to a baseline cycleGAN implementation, on image-similarity metrics such as Mean Absolute Error calculated for a matched virtual CT (55.0 ± 16.6 HU proposed versus 58.9 ± 16.8 HU baseline). There was also a higher level of structural agreement for gastrointestinal gas between source and synthetic images measured using the dice similarity coefficient (0.872 ± 0.053 proposed versus 0.846 ± 0.052 baseline). Differences found in water-equivalent thickness metrics were also smaller for our method (3.3 ± 2.4% proposed versus 3.7 ± 2.8% baseline). Significance. Our findings indicate that our innovations to the cycleGAN framework improved the quality and structure consistency of the synthetic CTs generated.

Robust Beam Selection Based on Water Equivalent Thickness Analysis in Passive Scattering Carbon-Ion Radiotherapy for Pancreatic Cancer.

Carbon-ion radiotherapy (CIRT) is one of the most effective radiotherapeutic modalities. This study aimed to select robust-beam configurations (BC) by water equivalent thickness (WET) analysis in passive CIRT for pancreatic cancer. The study analyzed 110 computed tomography (CT) images and 600 dose distributions of eight patients with pancreatic cancer. The robustness in the beam range was evaluated using both planning and daily CT images, and two robust BCs for the rotating gantry and fixed port were selected. The planned, daily, and accumulated doses were calculated and compared after bone matching (BM) and tumor matching (TM). The dose-volume parameters for the target and organs at risk (OARs) were evaluated. Posterior oblique beams (120-240°) in the supine position and anteroposterior beams (0° and 180°) in the prone position were the most robust to WET changes. The mean CTV V95% reductions with TM were -3.8% and -5.2% with the BC for gantry and the BC for fixed ports, respectively. Despite ensuring robustness, the dose to the OARs increased slightly with WET-based BCs but remained below the dose constraint. The robustness of dose distribution can be improved by BCs that are robust to ΔWET. Robust BC with TM improves the accuracy of passive CIRT for pancreatic cancer.

Snowfall events in the Cantabrian Mountains of northwestern Spain: WRF multiphysics ensemble assessment based on ground and multi-satellite observations

Snowfall in elevated areas of the mid-latitudes has a strong impact on infrastructure, freshwater availability, and the climate system. The Cantabrian Mountains of the northwestern Iberian Peninsula are very vulnerable to climate change because of their moderate altitudes, which limits their snowfall. Monitoring snow events is essential for the evaluation of weather and climate prediction models. However, measurement networks are scarce in mountainous areas and have great uncertainties because of blizzards. In this study, a multiphysics ensemble of the Weather Research and Forecasting (WRF) model was designed using three microphysics and two planetary boundary layer (PBL) schemes to simulate nine snowfall events in the Cantabrian Mountains during autumn and winter 2021–2022. The WRF was validated using several snow characteristics, such as liquid water equivalent, snow cover, and snow depth. Liquid water equivalent was evaluated using snow-gauge networks and satellite products in an assessment of snow cover. In addition, a monitoring network of webcams and snow poles was implemented, improving the low density of snow observations in the mountains. The results showed good model performance for detection of snow cover and slight overestimation of liquid water equivalent and snow thickness, which may have been caused by under-catchment that is generally an effect of wind on the measurement systems and by snow compaction, respectively. Morrison microphysics and Mellor-Yamada-Nakanishi-Niino (MYNN PBL) yielded better results for liquid water equivalent at higher altitudes and output greater snow cover. The results help determine the best configurations for snow modelling in the study area to develop future studies of the spatiotemporal patterns of snow distribution.

An in-house step-wedge phantom for the calibration of pixel values in CT localizer radiographs for water-equivalent diameter measurement

Abstract Introduction: To develop an in-house acrylic-based step-wedge phantom with several thickness configurations for calibrating computed tomography (CT) localizer radiographs in order to measure the water-equivalent diameter (Dw) and the size-specific dose estimate (SSDE). Method: We developed an in-house step-wedge phantom using 3 mm thick acrylic, filled with water. The phantom had five steps with thicknesses of 6, 12, 18, 24, and 30 cm. The phantom was scanned using a 64-slice Siemens Definition AS CT scanner with tube currents of 50, 100, 150, 200, and 250 mA. The relationship between pixel value (PV) and water-equivalent thickness (tw) was obtained for the different step thicknesses. This was used to calibrate the CT localizer radiographs in order to measure Dw and SSDE. The results of Dw and SSDE from the radiographs were compared with those calculated from axial CT images. Results: The relationship between PV and tw from CT localizer radiographs of the phantom step-wedge produced a linear relationship with R2 &gt; 0.990. The linear relationships of the Dw and SSDE values obtained from CT localizer radiographs and axial CT images had R2 values &gt; 0.94 with a statistical test of p-value &gt; 0.05. The Dw difference between those from CT localizer radiographs and axial CT images was 3.7% and the SSDE difference between both was 4.3%. Conclusion: We have successfully developed a step-wedge phantom to calibrate the relationship between PV and tw. Our phantom can be easily used to calibrate CT localizer radiographs in order to measure Dw and SSDE.

Inter-Seasonal Estimation of Grass Water Content Indicators Using Multisource Remotely Sensed Data Metrics and the Cloud-Computing Google Earth Engine Platform

Indicators of grass water content (GWC) have a significant impact on eco-hydrological processes such as evapotranspiration and rainfall interception. Several site-specific factors such as seasonal precipitation, temperature, and topographic variations cause soil and ground moisture content variations, which have significant impacts on GWC. Estimating GWC using multisource data may provide robust and accurate predictions, making it a useful tool for plant water quantification and management at various landscape scales. In this study, Sentinel-2 MSI bands, spectral derivatives combined with topographic and climatic variables, were used to estimate leaf area index (LAI), canopy storage capacity (CSC), canopy water content (CWC) and equivalent water thickness (EWT) as indicators of GWC within the communal grasslands in Vulindlela across wet and dry seasons based on single-year data. The results illustrate that the use of combined spectral and topo-climatic variables, coupled with random forest (RF) in the Google Earth Engine (GEE), improved the prediction accuracies of GWC variables across wet and dry seasons. LAI was optimally estimated in the wet season with an RMSE of 0.03 m−2 and R2 of 0.83, comparable to the dry season results, which exhibited an RMSE of 0.04 m−2 and R2 of 0.90. Similarly, CSC was estimated with high accuracy in the wet season (RMSE = 0.01 mm and R2 = 0.86) when compared to the RMSE of 0.03 mm and R2 of 0.93 obtained in the dry season. Meanwhile, for CWC, the wet season results show an RMSE of 19.42 g/m−2 and R2 of 0.76, which were lower than the accuracy of RMSE = 1.35 g/m−2 and R2 = 0.87 obtained in the dry season. Finally, EWT was best estimated in the dry season, yielding a model accuracy of RMSE = 2.01 g/m−2 and R2 = 0.91 as compared to the wet season (RMSE = 10.75 g/m−2 and R2 = 0.65). CSC was best optimally predicted amongst all GWC variables in both seasons. The optimal variables for estimating these GWC variables included the red-edge, near-infrared region (NIR) and short-wave infrared region (SWIR) bands and spectral derivatives, as well as environmental variables such as rainfall and temperature across both seasons. The use of multisource data improved the prediction accuracies for GWC indicators across both seasons. Such information is crucial for rangeland managers in understanding GWC variations across different seasons as well as different ecological gradients.

A likelihood-based particle imaging filter using prior information.

Particle imaging can increase precision in proton and ion therapy. Interactions with nuclei in the imaged object increase image noise and reduce image quality, especially for multinucleon ions that can fragment, such as helium. This work proposes a particle imaging filter, referred to as the Prior Filter, based on using prior information in the form of an estimated relative stopping power (RSP) map and the principles of electromagnetic interaction, to identify particles that have undergone nuclear interaction. The particles identified as having undergone nuclear interactions are then excluded from the image reconstruction, reducing the imagenoise. The Prior Filter uses Fermi-Eyges scattering and Tschalär straggling theories to determine the likelihood that a particle only interacts electromagnetically. A threshold is then set to reject those particles with a low likelihood. The filter was evaluated and compared with a filter that estimates this likelihood based on the measured distribution of energy and scattering angle within pixels, commonly implemented as the 3σ filter. Reconstructed radiographs from simulated data of a 20-cm water cylinder and an anthropomorphic chest phantom were generated with both protons and helium ions to assess the effect of the filters on noise reduction. The simulation also allowed assessment of secondary particle removal through the particle histories. Experimental data were acquired of the Catphan CTP 404 Sensitometry phantom using the U.S. proton CT (pCT) collaboration prototype scanner. The proton and helium images were filtered with both the prior filtering method and a state-of-the-art method including an implementation of the 3σ filter. For both cases, a dE-E telescope filter, designed for this type of detector, was alsoapplied. The proton radiographs showed a small reduction in noise (1mm of water-equivalent thickness [WET]) but a larger reduction in helium radiographs (up to 5-6mm of WET) due to better secondary filtering. The proton and helium CT images reflected this, with similar noise at the center of the phantom (0.02 RSP) for the proton images and an RSP noise of 0.03 for the proposed filter and 0.06 for the 3σ filter in the helium images. Images reconstructed from data with a dose reduction, up to a factor of 9, maintained a lower noise level using the Prior Filter over the state-of-the-art filteringmethod. The proposed filter results in images with equal or reduced noise compared to those that have undergone a filtering method typical of current particle imaging studies. This work also demonstrates that the proposed filter maintains better performance against the state of the art with up to a nine-fold dose reduction.

EVALUATION OF GROUNDWATER STORAGE CHANGES USING SATELLITE GRAVIMETRY MISSION IN PENINSULAR MALAYSIA

Abstract. Water stored beneath the Earth’s surface, known as groundwater is a major water supply for living things. The increase in human population leading to high urban development and industrial needs in Malaysia has made the use of groundwater more critical. The current issue faced by Malaysia is the limitation of freshwater source from dam resulting in increasing demand to gather the source of fresh water from groundwater; hence, leading to the crucial exploitation of groundwater. Therefore, this study aims to evaluate groundwater storage (GWS) using Gravity Recovery and Climate Experiment (GRACE) and Global Land Data Assimilation System (GLDAS) data in Peninsular Malaysia. GRACE data consist information on the liquid water equivalent thickness covering terrestrial water storage (TWS) of GWS, soil moisture (SM), snow water equivalent (SWE), and surface water (SW). In comparison with GLDAS data, they only consist hydrological products of SM, SWE, and SW. Therefore, the differences between the GRACE and GLDAS data are most likely to reflect the information of GWS. Due to the seasonal monsoon, the changes in GWS can also be seen in specific months. In addition, the data can also be used to identify important areas that need improvement and attention. The output of this study is expected to help authorities monitoring the changes in GWS in recharge and discharge areas for future preservation of groundwater quality. Moreover, the excessive exploitation of groundwater can also be observed for the prevention of land hazard phenomena, such land subsidence.

Verification of Uniformity of Dosimetric Characteristics of Couch Tops in Proton Radiation Therapy

In proton therapy the couches used for patient positioning and alignment can affect the uncertainty in the dose distribution from the applied proton beam. In order to limit the additional uncertainty of the proton range, it is necessary to know the determined water equivalent thickness (WET) of the couch top and carefully reflect it in the calculations of the dosimetry planning system. The method presented in this article is based on the difference in the measured depth of the proton beam detected by the multilayer ionization chamber with the beam passing through the couch top and without passing through it.&#x0D; A range shifter (proton beam modifier) installed in the nozzle with the known WET for evaluating couch tops before commissioning was used in this research work. A nozzle is a proton beam delivery system consisting of quadrupole magnets, ionization chambers and an X-ray tube. CT scans were also acquired to evaluate the internal homogeneity of the test couch tops.&#x0D; Several kVue couch inserts Proton one (Qfix Systems, Avondale, PA) were evaluated in this study. The results show that the inserts are largely interchangeable for this type of design and the use of the range shifter during treatment, using gantry angles with the proton beam passing through the couch top, does not affect its WET, adding a deflection of approximately 0.1 mm. It was also determined that the reproducibility of the WET determination method has a deviation less than ±0.03 mm. In conclusion, the described above method of couch top testing before commissioning in proton therapy can also be applied to other patient immobilization systems.

Technical note: Flat panel proton radiography with a patient specific imaging field for accurate WEPL assessment.

Proton radiography (PR) uses highly energetic proton beams to create images where energy loss is the main contrast mechanism. Water-equivalent path length (WEPL) measurements using flat panel PR (FP-PR) have potential for in vivo range verification. However, an accurate WEPL measurement via FP-PR requires irradiation with multiple energy layers, imposing high imaging doses. A FP-PR method is proposed for accurate WEPL determination based on a patient-specific imaging field with a reduced number of energies (n) to minimize imaging dose. Patient-specific FP-PRs were simulated and measured for a head and neck (HN) phantom. An energy selection algorithm estimated spot-wise the lowest energy required to cross the anatomy (Emin) using a water-equivalent thickness map. Starting from Emin, n was restricted to certain values (n=26, 24, 22, …, 2 for simulations, n=10 for measurements), resulting in patient-specific FP-PRs. A reference FP-PR with a complete set of energies was compared against patient-specific FP-PRs covering the whole anatomy via mean absolute WEPL differences (MAD), to evaluate the impact of the developed algorithm. WEPL accuracy of patient-specific FP-PRs was assessed using mean relative WEPL errors (MRE) with respect to measured multi-layer ionization chamber PRs (MLIC-PR) in the base of skull, brain, and neck regions. MADs ranged from 2.1mm (n=26) to 21.0mm (n=2) for simulated FP-PRs, and 7.2mm for measured FP-PRs (n=10). WEPL differences below 1mm were observed across the whole anatomy, except at the phantom surfaces. Measured patient-specific FP-PRs showed good agreement against MLIC-PRs, with MREs of 1.3±2.0%, -0.1±1.0%, and -0.1±0.4% in the three regions of the phantom. A method to obtain accurate WEPL measurements using FP-PR with a reduced number of energies selected for the individual patient anatomy was established in silico and validated experimentally. Patient-specific FP-PRs could provide means of in vivo range verification.

Development of integration mode proton imaging with a single CMOS detector for a small animal irradiation platform

A novel irradiation platform for preclinical proton therapy studies foresees proton imaging for accurate setup and treatment planning. Imaging at modern synchrocyclotron-based proton therapy centers with high instantaneous particle flux is possible with an integration mode setup. The aim of this work is to determine an object’s water-equivalent thickness (WET) with a commercially available large-area CMOS sensor. Image contrast is achieved by recording the proton energy deposition in detector pixels for several incoming beam energies (here, called probing energies) and applying a signal decomposition method that retrieves the water-equivalent thickness. A single planar 114 mm × 65 mm CMOS sensor (49.5 µm pixel pitch) was used for this study, aimed at small-animal imaging. In experimental campaigns, at two isochronous cyclotron-based facilities, probing energies suitable for small-animal-sized objects were produced once with built-in energy layer switching and the other time, using a custom degrader wheel. To assess water-equivalent thickness accuracy, a micro-CT calibration phantom with 10 inserts of tissue-mimicking materials was imaged at three phantom-to-detector distances: 3 mm, 13 mm, and 33 mm. For 3 mm and 13 mm phantom-to-detector distance, the average water-equivalent thickness error compared to the ground truth was about 1% and the spatial resolution was 0.16(3) mm and 0.47(2) mm, respectively. For the largest separation distance of 33 mm air gap, proton scattering had considerable impact and the water-equivalent thickness relative error increased to 30%, and the spatial resolution was larger than 1.75 mm. We conclude that a pixelated CMOS detector with dedicated post-processing methods can enable fast proton radiographic imaging in a simple and compact setup for small-animal-sized objects with high water-equivalent thickness accuracy and spatial resolution for reasonable phantom-to-detector distances.

Technical note: Water-equivalent thickness of Superflab bolus material at diagnostic x-ray energies.

The purpose of this work was to determine the water-equivalent thickness of Superflab bolus material for narrow and broad field-of-view (FOV) x-ray geometries at diagnostic x-ray energies. Transmission measurements were performed for incremental thicknesses of Superflab bolus material and water in narrow and broad FOV x-ray geometries. The transmission data was fit to a non-linear model for x-ray transmission - the Archer model. Water-equivalent thickness of Superflab was calculated based upon fitting parameters to transmission curves for 75, 95, and 115kV x-ray tube voltages. Measured x-ray transmission factors for water and Superflab were used to determine the water equivalence of Superflab. For all x-ray tube voltages and geometries, the water equivalence of Superflab was greater than one, indicating that Superflab is more attenuating than water. This effect was stronger for broad FOV geometries. At 95kV, 30cm of Superflab corresponded to 32.0cm of water in the narrow FOV geometry, and 34.3cm of water in the broad FOV geometry. The Archer model fitting parameters and Superflab water equivalence are reported for all x-ray beam conditions explored in this work. Superflab bolus material is more attenuating than water at diagnostic x-ray energies. The Archer model and its respective fitting parameters reported in this work may be used to estimate the water-equivalent thickness of Superflab for diagnostic x-ray spectra.

Evaluation of treatment planning system accuracy in estimating the stopping‐power ratio of immobilization devices for proton therapy

To assess treatment planning system (TPS) accuracy in estimating the stopping-power ratio (SPR) of immobilization devices commonly used in proton therapy and to evaluate the dosimetric effect of SPR estimation error for a set of clinical treatment plans. Computed tomography scans of selected clinical immobilization devices were acquired. Then, the water-equivalent thickness (WET) and SPR values of these devices based on the scans were estimated in a commercial TPS. The reference SPR of each device was measured using a multilayer ion chamber (MLIC), and the differences between measured and TPS-estimated SPRs were calculated. These findings were utilized to calculate corrected dose distributions of 15 clinical proton plans for three treatment sites: extremity, abdomen, and head-and-neck. The original and corrected dose distributions were compared using a set of target and organs-at-risk (OARs) dose-volume histogram (DVH) parameters. On average, the TPS-estimated SPR was 19.5% lower (range, -35.1% to 0.2%) than the MLIC-measured SPR. Due to the relatively low density of most immobilization devices used, the WET error was typically <1mm, but up to 2.2mm in certain devices. Overriding the SPR of the immobilization devices to the measured values did not result in significant changes in the DVH metrics of targets and most OARs. However, some critical OARs showed noticeable changes of up to 6.7% in maximum dose. The TPS tends to underestimate the SPR of selected proton immobilization devices by an average of about 20%, but this does not induce major WET errors because of the low density of the devices. The dosimetric effect of this SPR error was negligible for most treatment sites, although the maximum dose of a few OARs exhibited noticeable variations.

Evaluation of water equivalent thicknesses using the IEM-CSIC scanner prototype

Proton imaging has been proposed as an alternative low-dose imaging technique for acquiring relative stopping power (RSP) maps and for patient positioning. In proton therapy and hadrontherapy, the water equivalent thickness (WET) of a material represents its radiological thickness, however, its calculation requires computationally intensive methods or approximate solutions. At IEM-CSIC, we have developed a scanner prototype for imaging with protons composed of two double-sided silicon strip detectors (DSSSD) and fast scintillators with high energy resolution, detectors that are commonly used in Experimental Nuclear Physics. Two custom-made samples of aluminum, air, and polymethyl methacrylate (PMMA) were imaged and their proton radiography images (pRads) are presented in terms of WET. Pattern reproduction, spatial resolution, and sensitivity to di↵erent materials were studied. We present pRads of our samples obtained using a rather traditional approach to compute WET values. All three materials of the studied samples, aluminum, PMMA, and air, were well distinguished; the resulting WET values were in good agreement between samples.

Dosimetric study of Qfix kVue rails for pencil beam scanning proton beam

Background: The Qfix kVue table is widely used in proton beam therapy. It is made with light weight carbon fiber material in order to minimize its water-equivalent thickness. However, the design uses two rails underneath the couch in order to support the weight of the patient. These rails are structured frames made of high density carbon fiber with larger water-equivalent thickness. Moreover, depending on the relative orientation between the rail structures and the incident beam angles, the water-equivalent thickness can change significantly. Common clinical practice assumes that the rails are out of the beam path for planning and relies on the treatment staff to ensure that the rails are in the designated position relative to the patient during actual treatment. This study examines the dosimetric effects of the rails.