Carbon ions beam therapy monitoring with the INSIDE in-beam PET

Pennazio, Francesco; Battistoni, G.; Bisogni, Maria Giuseppina; Camarlinghi, N.; Ferrari, A.; Ferrero, Veronica; Fiorina, Elisa; Morrocchi, M.; Sala, P.; Sportelli, Giancarlo; Wheadon, R.; Cerello, Piergiorgio

doi:10.1088/1361-6560/aacab8

Cited by 34 publications

(34 citation statements)

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“…Monte Carlo simulations of the proton beam treatment plan, in particular, have already been discussed and validated in a previous work [16]. The carbon ion treatment plan simulation validation with experimental data is also ongoing [21]. In order to evaluate the contribution of Field 2 during the acquisition time interval c, in which the total distribution is given by the superposition of both beam fields coincidence event rates, the activity background given by the decay of Field 1 has first to be assessed.…”

Section: Second Field Activity Extractionmentioning

confidence: 98%

Double-Field Hadrontherapy Treatment Monitoring With the INSIDE In-Beam PET Scanner: Proof of Concept

Ferrero

Bisogni

Camarlinghi

et al. 2018

IEEE Trans. Radiat. Plasma Med. Sci.

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Positron Emission Tomography (PET) is a well established imaging technique for range monitoring in hadrontherapy. Multiple fields delivery is a standard protocol in treatments, but because of washout and residual activity background from previous irradiation plans, to this date a quantitative verification of the particle range for each beam field is still an open issue. In this paper, the proof of concept of a new method to evaluate with a PET detector the activity range of the second field of a treatment is discussed. A proton and a carbon ion treatment plan with two parallelopposed beam fields were delivered on PMMA phantoms. In both cases, the second beam field was extracted from the first irradiation residual activity and compared to a reference image, obtained from the experimental acquisition of the second field alone. Results demonstrate good agreement between the extracted second field and the reference image, with average difference in the activity range along the preferential direction of the beam less than 0.5 mm for protons, and 1.5 mm for carbon ions. Without taking into account any preferential direction, differences within 0.5 mm were found for both cases. The method will soon be tested with non-homogeneous phantoms and, successively, also with in-vivo clinical data.

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Section: Second Field Activity Extractionmentioning

confidence: 98%

Double-Field Hadrontherapy Treatment Monitoring With the INSIDE In-Beam PET Scanner: Proof of Concept

Ferrero

Bisogni

Camarlinghi

et al. 2018

IEEE Trans. Radiat. Plasma Med. Sci.

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“…The in-beam PET implementation, previously investigated at synchrocyclotrons, are incapable of providing such statistics due to the imaging of positron emitting nuclides with half-lives between 2 and 20 min during the irradiation pauses. For example, Pennazio et al [59] reach a 1-2 mm range precision 190 s after the start of the irradiation. Thus, the absence of prompt feedback precludes the intra-fraction initiation of corrective actions to improve the dose delivery accuracy.…”

Section: Introductionmentioning

confidence: 99%

“…An advantage of the PET technique is that it is based on a well-established nuclear medicine imaging technology and thus requires less effort in translation to routine clinical use. Three main strategies have been proposed for clinical implementation: "In-beam" imaging during the irradiation with a scanner integrated into the beam delivery nozzle [36,58,59]; "in-room" imaging after completion of the irradiation with a PET scanner installed in the treatment room and starting within about 2 min after the irradiation [35,60,61]; and offline imaging after completion of the irradiation with a PET scanner installed outside the treatment room and starting more than 5 min after irradiation [62][63][64][65]. The delayed data acquisition with respect to the irradiation, in the in-room and offline implementations, presents an advantage for the PET in vivo verification technique.…”

Section: Introductionmentioning

confidence: 99%

“…The limitations experienced at that time include the unavailability of on-line detection systems which allow the detection of short-lived nuclides and reduce biological washout of the nuclides; signal deterioration by background radiation; poor detector spatial resolution and sensitivity. Several decades after this investigation, most of these limitations have received significant attention and detection systems for on-line monitoring with improved detector resolution and sensitivity [35,36,59,[69][70][71][72][73] and methods for suppressing background radiation [69,74] have been developed. More recent investigations into the feasibility of in-beam PET for therapeutic 3 He beams [75] and off-line PET with 4 He beams [76] provide a quantitative estimation of the production rates of the relevant radionuclides mentioned in Ref.…”

Section: Introductionmentioning

confidence: 99%

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Real-Time PET Imaging for Range Verification of Helium Radiotherapy

et al. 2020

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Real-time range verification of particle beams is important for optimal exploitation of the tissue-sparing advantages of particle therapy. Positron Emission Tomography (PET) of the beam-induced positron emitters such as 15 O (T 1/2 = 122 s) and 11 C (T 1/2 = 1223 s) has been used for monitoring of therapy in both clinical and preclinical studies. However, the half-lives of these nuclides preclude prompt feedback, i.e., on a sub-second timescale, on dose delivery. The in vivo verification technique relying on the in-beam PET imaging of very short-lived positron emitters such as 12 N (T 1/2 = 11 ms), recently proposed and investigated in feasibility experiments with a proton beam, provides millimeter precision in range measurement a few tens of milliseconds after the start of an irradiation. With the increasing interest in helium therapy, it becomes relevant to study the feasibility of prompt feedback using PET also for helium beams. A recent study has demonstrated the production of very short-lived nuclides (T 1/2 = 10 ms attributed to 12 N and/or 13 O) during irradiation of water and graphite with helium ions. This work is aimed at investigating the range verification potential of imaging these very short-lived nuclides. PMMA targets were irradiated with a 90 AMeV 4 He pencil beam consisting of a series of pulses of 10 ms beam-on and 90 ms beam-off. Two modules of a modified Siemens Biograph mCT PET scanner (21 × 21 cm 2), installed 25 cm apart, were used to image the beam-induced PET activity during the beam-off periods. For the irradiation of PMMA, we identify the very short-lived activity earlier observed to be 12 N (T 1/2 = 11.0 ms). The range precision determined from the 12 N activity profile that is measured after just one beam pulse was found to be 9.0 and 4.1 mm (1σ) with 1.3 × 10 7 4 He ions per pulse and 6.6 × 10 7 4 He ions per pulse, respectively. When considering 4.0 × 10 7 4 He ions, which is about the intensity of the most intense distal layer spot in a helium therapy plan, a range verification precision in PMMA of 5.7 mm (1σ) can be realized. The range precision scales approximately with the inverse square root of the number of 4 He ions, i.e., the relative statistical accuracy of the number of coincidence events. Thus, when summing data over about 10 distal layer spots, this study shows good prospects for obtaining 1.8 mm (1σ) precision in range verification, within 50 ms after the start of a helium irradiation by in-beam PET imaging (scanner 29% solid angle) of 12 N.

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“…Recent results from the INSIDE project in-beam PET scanner show the irradiation of PMMA targets with carbon beams (Pennazio et al, 2018). In-spill (beam-on) data is discarded due to the increase in noise it produces, and only inter-spill (beam-off ) data is used to reconstruct the PET image for range verification, but using the beam-on data is being investigated.…”

Section: Overview Of the Current State Of Pet And Prompt Gamma Detectmentioning

confidence: 99%

Positron emission tomography for quality assurance in proton therapy

Buitenhuis¹

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Introduction Cancer is one of the leading causes of death in The Netherlands. In 2017, all types of cancer combined caused 47,000 of 150,000 recorded causes of death (Centraal Bureau voor de Statistiek, 2017). There are several ways to treat cancer. The most common treatments include radiotherapy, surgery, chemotherapy, targeted therapy, hormonal therapy and immunotherapy. Often, different treatment modalities are combined to maximize their efficacy. For example, patients might receive radiotherapy after surgery to remove any traces of cancer cells that were left. Radiotherapy uses ionizing radiation to kill tumor cells by damaging their DNA. This radiation can be applied internally (brachytherapy) or externally. For brachytherapy, radioactive sources are implanted in and around the tumor, which deliver dose directly at the right location. However, for this method, the tumor needs to be in a relatively easily accessible location. For some patients, radioactive substances that accumulate in the tumor are injected. This radiation then delivers most dose at the site where it accumulates. More often, the radiation is applied using a source outside of the body. In the past, radioactive sources such as 60 Co were used to supply MeV gamma rays. Nowadays, a linear accelerator is used in most radiotherapy facilities to produce MeV electron beams. These electrons are stopped in a tungsten absorber to generate MeV X-rays, which penetrate deeply into the body. Other particles can also be used, such as protons or even heavier nuclides. Accelerating these particles to clinically useful energies requires large particle accelerators. Already in 1946, Robert R. Wilson wrote about how protons with an energy in the order of 100 MeV are very interesting for radio-3. Beam-on imaging of short-lived positron emitters during proton therapy proton bunches, such as prompt gamma rays, were removed from the data via an anti-coincidence filter with the cyclotron RF. The resulting energy spectrum allowed good identification of the 511 keV PET counts during beam-on. A method was developed to subtract the long-lived background from the 12 N image by introducing a beam-off period into the cyclotron beam time structure. We measured 2D images and 1D profiles of the 12 N distribution. A range shift of 5 mm was measured as 6 ± 3 mm using the 12 N profile. A larger, more efficient, PET system with a higher data throughput capability will allow beam-on 12 N PET imaging of single spots in the distal layer of an irradiation with an increased signal-to-background ratio and thus better accuracy. A simulation shows that a large dual panel scanner, which images a single spot directly after it is delivered, can measure a 5 mm range shift with millimeter accuracy: 5.5 ± 1.1 mm for 1.64 × 10 8 protons and 5.2 ± 0.5 mm for 8.2 × 10 8 protons. This makes fast and accurate feedback on the dose delivery during treatment possible.

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Carbon ions beam therapy monitoring with the INSIDE in-beam PET

Cited by 34 publications

References 40 publications

Double-Field Hadrontherapy Treatment Monitoring With the INSIDE In-Beam PET Scanner: Proof of Concept

Double-Field Hadrontherapy Treatment Monitoring With the INSIDE In-Beam PET Scanner: Proof of Concept

Real-Time PET Imaging for Range Verification of Helium Radiotherapy

Positron emission tomography for quality assurance in proton therapy

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