In order to be able to treat mobile tumours with active, scanned proton therapy, adequate motion mitigation techniques have to be applied. Re-scanning is such an approach, where the interplay effect between tumour motion and treatment delivery is statistically smeared out. Different re-scanning methods have been used for the irradiation of a spherical target volume and motion amplitudes of up to 10 mm. The resulting dose distributions have been captured in two dimensions by imaging a scintillating screen at the iso-centre for different motion starting phases. Dose inhomogeneity increased approximately linearly with motion amplitude, while the influence of motion period and direction was small. Re-scanning the whole target volume reduced the interplay effect more than re-scanning only the iso-energy layers. Even for 10 mm motion amplitude, no hot or cold spots were seen for 10 re-scans of the whole volume. A fast energy change and fast beam scanning is vital for this kind of re-scanning, as available on Gantry 2 at the Paul Scherrer Institute. For larger motion amplitudes, re-scanning should be combined with gating, breath-hold or tracking to reduce the internal target volume.
Motion-induced range changes and incorrectly placed dose spots strongly affect the quality of pencil-beam-scanned (PBS) proton therapy, especially in thoracic tumour sites, where density changes are large. Thus motion-mitigation techniques are necessary, which must be validated in a realistic patient-like geometry. We report on the development and characterisation of a dynamic, anthropomorphic, thorax phantom that can realistically mimic thoracic motions and anatomical features for verifications of proton and photon 4D treatments. The presented phantom is of an average thorax size, and consists of inflatable, deformable lungs surrounded by a skeleton and skin. A mobile 'tumour' is embedded in the lungs in which dosimetry devices (such as radiochromic films) can be inserted. Motion of the tumour and deformation of the thorax is controlled via a custom made pump system driving air into and out of the lungs. Comprehensive commissioning tests have been performed to evaluate the mechanical performance of the phantom, its visibility on CT and MR imaging and its feasibility for dosimetric validation of 4D proton treatments. The phantom performed well on both regular and irregular pre-programmed breathing curves, reaching peak-to-peak amplitudes in the tumour of <20 mm. Some hysteresis in the inflation versus deflation phases was seen. All materials were clearly visualised in CT scans, and all, except the bone and lung components, were MRI visible. Radiochromic film measurements in the phantom showed that imaging for repositioning was required (as for a patient treatment). Dosimetry was feasible with Gamma Index agreements (4%/4 mm) between film dose and planned dose >90% in the central planes of the target. The results of this study demonstrate that this anthropomorphic thorax phantom is suitable for imaging and dosimetric studies in a thoracic geometry closely-matched to lung cancer patients under realistic motion conditions.
The PEL1/PGS1 gene of the yeast Saccharomyces cerevisiae is essential for the viability of rho-/rho degrees mutants and the normal cardiolipin content of cells. The PEL1-GFP fusion gene has been found to complement the pel1/pgs1 mutation and its fluorescent protein was localized to mitochondria similarly to the beta-galactosidase activity of a protein encoded by the PEL1-lacZ fusion gene. The expression of the PEL1-lacZ reporter gene was repressed in cells grown in the presence of inositol and choline, reduced in the ino2 and ino4 strains, but constitutive in the opi1 null-mutant strain. The results demonstrate that Pel1p, playing a vital role in cells impaired in the mitochondrial DNA, is localized in the mitochondria and expressed in response to inositol and choline.
The main direction proposed by the community of experts in the field of laser-driven ion acceleration is to improve particle beam features (maximum energy, charge, emittance, divergence, monochromaticity, shot-to-shot stability) in order to demonstrate reliable and compact approaches to be used for multidisciplinary applications, thus, in principle, reducing the overall cost of a laser-based facility compared to a conventional accelerator one and, at the same time, demonstrating innovative and more effective sample irradiation geometries. The mission of the laser-driven ion target area at ELI-Beamlines (Extreme Light Infrastructure) in Dolní Břežany, Czech Republic, called ELI Multidisciplinary Applications of laser-Ion Acceleration (ELIMAIA) , is to provide stable, fully characterized and tuneable beams of particles accelerated by Petawatt-class lasers and to offer them to the user community for multidisciplinary applications. The ELIMAIA beamline has been
Organ motion is one of the major obstacles in radiotherapy and charged particle therapy. Even more so, the theoretical advantages of dose distributions in scanned ion beam therapy may be lost due to the interplay between organ motion and beam scanning. Several techniques for dealing with this problem have been devised. In re-scanning, the target volume is scanned several times to average out the motion effects. In gating and breath-hold, dose is only delivered if the tumour is in a narrow window of position. Experiments have been performed to verify if gating and re-scanning are effective means of motion mitigation. Dose distributions were acquired in a lateral plane of a homogeneous phantom. For a spherical target volume and regular motion gating was sufficient. However, for realistic, irregular motion or a patient target volume, gating did not reduce the interplay effect to an acceptable level. Combining gating with re-scanning recovered the dose distributions. The simplest re-scanning approach, where a treatment plan is duplicated several times and applied in sequence, was not efficient. Simulations of different combinations of gating window sizes and re-scanning schemes revealed that reducing the gating window is the most efficient approach. However, very small gating windows are not robust for irregular motion.
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