MR imaging based treatment planning for radiotherapy of prostate cancer is limited due to MR imaging system related geometrical distortions, especially for patients with large body sizes. On our 0.23 T open scanner equipped with the gradient distortion correction (GDC) software, the residual image distortions after the GDC were <5 mm within the central 36 cm x 36 cm area for a standard 48 cm field of view (FOV). In order to use MR imaging alone for treatment planning the effect of residual MR distortions on external patient contour determination, especially for the peripheral regions outside the 36 cm x 36 cm area, must be investigated and corrected. In this work, we performed phantom measurements to quantify MR system related residual geometric distortions after the GDC and the effective FOV. Our results show that for patients with larger lateral dimensions (>36 cm), the differences in patient external contours between distortion-free CT images and GDC-corrected MR images were 1-2 cm because of the combination of greater gradient distortion and loss of field homogeneity away from the isocentre and the uncertainties in patient setup during CT and MRI scans. The measured distortion maps were used to perform point-by-point corrections for patients with large dimensions inside the effective FOV. Using the point-by-point method, the geometrical distortion after the GDC were reduced to <3 mm for external contour determination and the effective FOV was expanded from 36 cm to 42 cm.
A particle track-repeating algorithm has been developed for proton beam dose calculation for radiotherapy. Monoenergetic protons with 250 MeV kinetic energy were simulated in an infinite water phantom using the GEANT3 Monte Carlo code. The changes in location, angle and energy for every transport step and the energy deposition along the track were recorded for the primary protons and all secondary particles. When calculating dose for a patient with a realistic proton beam, the pre-generated particle tracks were repeated in the patient geometry consisting of air, soft tissue and bone. The medium and density for each dose scoring voxel in the patient geometry were derived from patient CT data. The starting point, at which a proton track was repeated, was determined according to the incident proton energy. Thus, any protons with kinetic energy less than 250 MeV can be simulated. Based on the direction of the incident proton, the tracks were first rotated and for the subsequent steps, the scattering angles were simply repeated for air and soft tissue but adjusted properly based on the scattering power for bone. The particle step lengths were adjusted based on the density for air and soft tissue and also on the stopping powers for bone while keeping the energy deposition unchanged in each step. The difference in nuclear interactions and secondary particle generation between water and these materials was ignored. The algorithm has been validated by comparing the dose distributions in uniform water and layered heterogeneous phantoms with those calculated using the GEANT3 code for 120, 150, 180 and 250 MeV proton beams. The differences between them were within 2%. The new algorithm was about 13 times faster than the GEANT3 Monte Carlo code for a uniform phantom geometry and over 700 times faster for a heterogeneous phantom geometry.
Modulated electron radiotherapy (MERT) may potentially be an effective modality for the treatment of shallow tumors, but dose calculation accuracy and delivery efficiency challenges remain. The purpose of this work is to investigate the dose accuracy of MERT delivery using a photon multileaf collimator (pMLC) on a Siemens Primus accelerator. A Monte Carlo (MC)-based inverse treatment planning system was developed for the 3D treatment planning process. Phase space data of 6, 9, 12 and 15 MeV electron beams were commissioned and used as the input source for MC dose calculations. A treatment plan was performed based on the 3D CT data of a heterogeneous 'breast phantom' that mimics a breast cancer patient, and delivered with 22 segments, each associated with a particular energy and Monitor Unit value. Film and ion chamber dosimetry was carefully performed for the conversion from measurement reading to dose, and the results were employed for plan verification using the heterogeneous breast phantom and a solid water phantom. Dose comparisons between measurements and calculations showed agreement within 2% or 1 mm. We conclude that our in-house MC treatment planning system is capable of performing treatment planning and accurate dose calculations for MERT using the pMLC to deliver radiation therapy to the intact breast.
In this paper, we present the shielding analysis to determine the necessary neutron and photon shielding for a laser-accelerated proton therapy system. Laser-accelerated protons coming out of a solid high-density target have broad energy and angular spectra leading to dose distributions that cannot be directly used for therapeutic applications. A special particle selection and collimation device is needed to generate desired proton beams for energy- and intensity-modulated proton therapy. A great number of unwanted protons and even more electrons as a side-product of laser acceleration have to be stopped by collimation devices and shielding walls, posing a challenge in radiation shielding. Parameters of primary particles resulting from the laser-target interaction have been investigated by particle-in-cell simulations, which predicted energy spectra with 300 MeV maximum energy for protons and 270 MeV for electrons at a laser intensity of 2 x 10(21) W cm(-2). Monte Carlo simulations using FLUKA have been performed to design the collimators and shielding walls inside the treatment gantry, which consist of stainless steel, tungsten, polyethylene and lead. A composite primary collimator was designed to effectively reduce high-energy neutron production since their highly penetrating nature makes shielding very difficult. The necessary shielding for the treatment gantry was carefully studied to meet the criteria of head leakage <0.1% of therapeutic absorbed dose. A layer of polyethylene enclosing the whole particle selection and collimation device was used to shield neutrons and an outer layer of lead was used to reduce photon dose from neutron capture and electron bremsstrahlung. It is shown that the two-layer shielding design with 10-12 cm thick polyethylene and 4 cm thick lead can effectively absorb the unwanted particles to meet the shielding requirements.
In conventional particle accelerators, protons are produced in long pulses, in which the average inter-proton distance is in the order of tens of centimeters or more. Therefore, the radiobiology of conventionally accelerated protons is primarily governed by the interaction of a single proton with the cell. In a laser-plasma interaction scheme, the accelerated protons come as a single bunch of particles (less than 1 ps in duration) with inter particle distances that are many orders of magnitude shorter than those in conventional particle accelerators. As laser-accelerated protons traverse the medium, they not only interact with each other, but also with the host medium. It is shown that when the average distance between protons in a cluster is less than or equal to their velocity divided by the characteristic frequency of the collective excitations supported by the medium, the cluster's linear stopping power increases and can reach several times that of sparsely distributed protons. As a result, the elevated radio biological effectiveness of the proton cluster may take place and conditions for its experimental observation are presented.
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