Ultra-high dose rate radiation has been reported to produce a more favorable toxicity and tumor control profile compared to conventional dose rates that are used for patient treatment. So far, the so-called FLASH effect has been validated for electron, photon and scattered proton beam, but not yet for proton pencil beam scanning (PBS). Because PBS is the state-of-the-art delivery modality for proton therapy and constitutes a wide and growing installation base, we determined the benefit of FLASH PBS on skin and soft tissue toxicity. Using a pencil beam scanning nozzle and the plateau region of a 250 MeV proton beam, a uniform physical dose of 35 Gy (toxicity study) or 15 Gy (tumor control study) was delivered to the right hind leg of mice at various dose rates: Sham, Conventional (Conv, 1 Gy/s), Flash60 (57 Gy/s) and Flash115 (115 Gy/s). Acute radiation effects were quantified by measurements of plasma and skin levels of TGF-β1 and skin toxicity scoring. Delayed irradiation response was defined by hind leg contracture as a surrogate of irradiation-induced skin and soft tissue toxicity and by plasma levels of 13 different cytokines (CXCL1, CXCL10, Eotaxin, IL1-beta, IL-6, MCP-1, Mip1alpha, TNF-alpha, TNF-beta, VEGF, G-CSF, GM-CSF and TGF- β1). Plasma and skin levels of TGF-β1, skin toxicity and leg contracture were all significantly decreased in FLASH compared to Conv groups of mice. FLASH and Conv PBS had similar efficacy with regards to growth control of MOC1 and MOC2 head and neck cancer cells transplanted into syngeneic, immunocompetent mice. These results demonstrate consistent delivery of FLASH PBS radiation from 1 to 115 Gy/s in a clinical gantry. Radiation response following delivery of 35 Gy indicates potential benefits of FLASH versus conventional PBS that are related to skin and soft tissue toxicity.

To develop a method of (a) calculating the dose rate of voxels within a proton field delivered using pencil beam scanning (PBS), and (b) reporting a representative dose rate for the PBS treatment field that enables correspondence between multiple treatment modalities. This method takes into account the unique spatiotemporal delivery patterns of PBS FLASH radiotherapy. Methods: The dose rate at each voxel of a PBS radiation field is approximately the quotient of the voxel's dose and "effective" irradiation time. Each voxel's "effective" irradiation time starts when the cumulative dose rises above a chosen threshold value, and stops when its cumulative dose reaches its total dose minus the same threshold value. The above calculation yields a distribution of dose rates for the voxels within a PBS treatment field. To report a representative dose rate for the PBS field, we propose a user-selectable parameter of pth percentile of the dose rate distribution, such that (100 − p) % of the field is above the corresponding dose rate. To demonstrate the method described above, we design FLASH transmission fields using 250 MeV protons and calculate the PBS dose rate distributions in both two-dimensional (2D) and three-dimensional (3D) models. To further evaluate the formalism, we provide an example of a clinical PBS treatment field. Results: With the 2D PBS transmission field, it is demonstrated that the time to accumulate the total dose at a voxel is limited to a fraction of the delivery time of the entire field. In addition, the spatial distributions of dose and dose rate are quite different within the field. For the 10 × 10 cm 2 PBS field irradiating a 3D water phantom, the prescribed dose of 10 Gy at 10 cm depth is delivered in 1.0 s. The dose rate decreases in the irradiated volume with increasing depth (until the Bragg peak) due to increase of beam spot size by Coulomb scattering. For example, 95% of the irradiated volume between 0 and 10 cm depth receive >40 Gy/s, whereas between 0-20 cm and 0-30 cm depth, 95% of the irradiated volume received >36 Gy/s and >24 Gy/s, respectively. For the clinical PBS treatment field, the scanning pattern conforms to the PTV. PBS dose rate data are presented for the PTV and adjacent normal organs. Conclusion: We have developed a method of calculating the dose rate distribution of a PBS proton field and have recommended nomenclature for reporting PBS treatment dose rate. We believe that standardizing the method for calculating and reporting PBS treatment dose rates, in a manner that corresponds with other treatment modalities, will advance the research and potential application of PBS FLASH radiotherapy.

II-VI colloidal semiconductor nanocrystals (NCs), such as CdSe NCs, are often plagued by efficient nonradiative recombination processes that severely limit their use in energy-conversion schemes. While these processes are now well-known to occur at the surface, a full understanding of the exact nature of surface defects and of their role in deactivating the excited states of NCs has yet to be established, which is partly due to challenges associated with the direct probing of the complex and dynamic surface of colloidal NCs. Here, we report a detailed study of the surface of cadmium-rich zinc-blende CdSe NCs. The surfaces of these cadmium-rich species are characterized by the presence of cadmium carboxylate complexes (CdX) that act as Lewis acid (Z-type) ligands that passivate undercoordinated selenide surface species. The systematic displacement of CdX from the surface by N,N,N',N'-tetramethylethylene-1,2-diamine (TMEDA) has been studied using a combination of H NMR and photoluminescence spectroscopies. We demonstrate the existence of two independent surface sites that differ strikingly in the binding affinity for CdX and that are under dynamic equilibrium with each other. A model involving coupled dual equilibria allows a full characterization of the thermodynamics of surface binding (free energy, as well as enthalpic and entropic terms), showing that entropic contributions are responsible for the difference between the two surface sites. Importantly, we demonstrate that cadmium vacancies only lead to important photoluminescence quenching when created on one of the two sites, allowing a complete picture of the surface composition to be drawn where each site is assigned to specific NC facet locale, with CdX binding affinity and nonradiative recombination efficiencies that differ by up to two orders of magnitude.

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An efficient piecewise-focused pixelated strip scintillator for MV imaging is described that offers more than a 20-fold dose efficiency improvement over Cu-GOS.

The authors demonstrate the feasibility of accurately modeling x-ray detector DQE(f) with completion times on the order of several minutes using a single CPU. Convenience of simulation can be achieved using GEANT4 which offers both gamma and optical photon transport capabilities.

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Cancer radiotherapy (RT) with the irradiation at ultra-high dose rates, namely FLASH-RT, can substantially reduce radiation-induced normal tissue toxicities while maintaining tumor response. Currently, clinical FLASH-RT on deep-seated tumors can only be performed with proton beams. One way to achieve ultra-high dose rates at depth is through the use of high-energy transmission beams (TB), where the Bragg peaks (BP) fall outside the body. However, planning with TB alone does not fully leverage the degrees of freedom for dose shaping as traditional intensity modulated proton therapy (IMPT) which uses the BP of multi-energy proton beams at the tumor target. This work will develop a simultaneous dose and dose rate optimization (SDDRO) method with the joint use of TB and BP, namely SDDRO-Joint. Specifically, BP are placed inside tumor targets to improve the target dose conformality and sparse the normal-tissue dose, while TB primarily cover the tumor boundary to achieve ultra-high dose rate coverage of organs-at-risk (OAR) close to tumor targets. The sparing of OAR and other normal tissues via SDDRO-Joint is jointly by TB and BP, i.e. the FLASH sparing by TB and the dose sparing by BP. The results suggest that the addition of BP substantially increased the target dose conformality for SDDRO. Noticeably SDDRO-Joint also provided slightly higher conformal index values than the conventional IMPT method with BP alone.