Fast procedures for the beam quality assessment and for the monitoring of beam energy modulations during the irradiation are among the most urgent improvements in particle therapy.Indeed, the online measurement of the particle beam energy could allow assessing the range of penetration during treatments, encouraging the development of new dose delivery techniques for moving targets.
The emergent FLASH RadioTherapy (RT) uses ultrahigh dose-rate irradiation (up to 10 7 Gy/s instantaneous dose-rate in each µs pulse) to deliver a single high dose of irradiation in a very short time (<200 ms). Pre-clinical studies at ultrahigh dose-rates recently showed an increased ratio between tumoricidal effect and normal tissue toxicity (therapeutic index), compared to conventional RT at standard Gy/min dose-rates. If confirmed by biological in vivo validations, this could represent a breakthrough in cancer treatment. However, the reliability and the accuracy of experimental studies are nowadays limited by the lack of detectors able to measure online the beam fluence at FLASH dose-rates. The behavior of standard beam monitors (gas-filled ionization chambers) is compromised by the volume recombination caused by the amount of charges created per unit volume and unit time, due to the large dose-rate. Moreover, due to the lack of proper monitoring devices and to the uncertainties of its future applications, very few facilities are able to deliver at present FLASH irradiations. In this contribution, we report about the physical and technological challenges of monitoring high and ultra-high dose-rates with electrons and photon beams, starting from the pre-clinical and clinical constraints for new devices. Based on the extensive experience in silicon detectors for monitoring applications in RT with external beams, the work then investigates silicon sensors as a possible option to tackle such extreme requirements and a rugged thin and large (e.g., 10 × 10 cm 2) flat detector (silicon-based sensor + readout electronics) is therefore outlined. This study aims at presenting the FLASH-RT dosimetry problem and analyzing the possibilities for a silicon sensor to be employed as sensing device for several FLASH scenarios, including some ideas on the readout part. However, more detailed simulations and studies are demanded to delineate more precisely the technical choices to be undertaken in order to tackle the clinical accuracy required on the beam fluence, typically a few %, during photon and electron high and ultra-high irradiations, the required minimal perturbation of the beam and the high level of radiation resistance.
To investigate the feasibility of radioluminescence imaging (RLI) as a novel 2D quality assurance (QA) dosimetry system for CyberKnife®. Methods: We developed a field size measurement system based on a commercial complementary metal oxide semiconductor (CMOS) camera facing a radioluminescence screen located at the isocenter normal to the beam axis. The radioluminescence light collected by a lens was used to measure 2D dose distributions. An image transformation procedure, based on two reference phantoms, was developed to correct for projective distortion due to the angle (15 • ) between the optical and beam axis. Dose profiles were measured for field sizes ranging from 5 mm to 60 mm using fixed circular and iris collimators and compared against gafchromic (GC) film. The corresponding full width at half maximum (FWHM) was measured using RLI and benchmarked against GC film. A small shift in the source-to-surface distance (SSD) of the measurement plane was intentionally introduced to test the sensitivity of the RLI system to field size variations. To assess reproducibility, the entire RLI procedure was tested by acquiring the 60 mm circle field three times on two consecutive days. Results:The implemented procedure for perspective image distortion correction showed improvements of up to 1 mm using the star phantom against the square phantom. The FWHM measurements using the RLI system indicated a strong agreement with GC film with maximum absolute difference equal to 0.131 mm for fixed collimators and 0.056 mm for the iris. A 2D analysis of RLI with respect to GC film showed that the differences in the central region are negligible, while small discrepancies are in the penumbra region. Changes in field sizes of 0.2 mm were detectable by RLI. Repeatability measurements of the beam FWHM have shown a standard deviation equal to 0.11 mm. Conclusions:The first application of a RLI approach for CyberKnife® field size measurement was presented and tested. Results are in agreement with GC film measurements.Spatial resolution and immediate availability of the data indicate that RLI is a feasible technique for robotic radiosurgery QA.
The University of Torino (UniTO) and the National Institute for Nuclear Physics (INFN-TO) are investigating the use of Ultra Fast Silicon Detectors (UFSD) for beam monitoring in radiobiological experiments with therapeutic proton beams. The single particle identification approach of solid state detectors aims at increasing the sensitivity and reducing the response time of the conventional monitoring devices, based on gas detectors. Two prototype systems are being developed to count the number of beam particles and to measure the beam energy with time-of-flight (ToF) techniques. The clinically driven precision (< 1%) in the number of particles delivered and the uncertainty < 1 mm in the depth of penetration (range) in radiobiological experiments (up to 108 protons/s fluxes) are the goals to be pursued. The future translation into clinics would allow the implementation of faster and more accurate treatment modalities, nowadays prevented by the limits of state-of-the-art beam monitors. The experimental results performed with clinical proton beams at CNAO (Centro Nazionale di Adroterapia Oncologica, Pavia) and CPT (Centro di Protonterapia, Trento) showed a counting inefficiency <2% up to 100 MHz/cm2, and a deviation of few hundreds of keV of measured beam energies with respect to nominal ones. The progresses of the project are reported.
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