Ionoacoustic tomography of the proton Bragg peak in combination with ultrasound and optoacoustic imaging

Kellnberger, Stephan; Assmann, W.; Lehrack, Sebastian; Reinhardt, S.; Thirolf, P. G.; Queirós, Daniel; Sergiadis, George D.; Dollinger, G.; Parodi, Katia; Ntziachristos, Vasilis

doi:10.1038/srep29305

Cited by 59 publications

(61 citation statements)

References 39 publications

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“…Clinical application of ultrasound imaging in particle therapy has been rare. However, ionoacoustic imaging for detecting the Bragg peak is still pursued …”

Section: Beyond Radiological Image Guidancementioning

confidence: 99%

Current state and future applications of radiological image guidance for particle therapy

Landry

Hua

2018

Medical Physics

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In this review paper, we first give a short overview of radiological image guidance in photon radiotherapy, placing emphasis on the fact that linac based radiotherapy has outpaced particle therapy in the adoption of volumetric image guidance. While cone beam computed tomography (CBCT) has been an established technique in linac treatment rooms for almost two decades, the widespread adoption of volumetric image guidance in particle therapy, whether by means of CBCT or in‐room CT imaging, is recent. This lag may be attributable to the bespoke nature and lower number of particle therapy installations, as well as the differences in geometry between those installations and linac treatment rooms. In addition, for particle therapy the so called shift invariance of the dose distribution rarely applies. An overview of the different volumetric image guidance solutions found at modern particle therapy facilities is provided, covering gantry, nozzle, C‐arm, and couch‐mounted CBCT as well different in‐room CT configurations. A summary of the use of in‐room volumetric imaging data beyond anatomy‐based positioning is also presented as well as the necessary corrections to CBCT images for accurate water equivalent thickness calculation. Finally, the use of non‐ionizing imaging modalities is discussed.

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“…Clinical application of ultrasound imaging in particle therapy has been rare. However, ionoacoustic imaging for detecting the Bragg peak is still pursued …”

Section: Beyond Radiological Image Guidancementioning

confidence: 99%

Current state and future applications of radiological image guidance for particle therapy

Landry

Hua

2018

Medical Physics

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“…To this end, ionoacoustic measurements of the proton Bragg peak in combination with ultrasound and optoacoustic imaging was reported for the first time in an ex vivo mouse experiment at a nonclinical low‐energy (approximately 20 MeV) pulsed proton source, as seen in Fig. . In the same year, Patch et al.…”

Section: Proton Therapy Range Verificationmentioning

confidence: 98%

“…6. 70 In the same year, Patch et al performed intrinsically co-registered ionoacoustic and ultrasonic acquisitions of water and a gelatine phantom by another specially manipulated non-clinical low-energy (50 MeV) proton source using a cardiac ultrasound transducer array. 65 This measurement required a signal integration of 1024 pulses corresponding to over 2000 Gy of total dose delivery.…”

Section: B Recent Workmentioning

confidence: 99%

Ionizing radiation‐induced acoustics for radiotherapy and diagnostic radiology applications

et al. 2018

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Acoustic waves are induced via the thermoacoustic effect in objects exposed to a pulsed beam of ionizing radiation. This phenomenon has interesting potential applications in both radiotherapy dosimetry and treatment guidance as well as low-dose radiological imaging. After initial work in the field in the 1980s and early 1990s, little research was done until 2013 when interest was rejuvenated, spurred on by technological advances in ultrasound transducers and the increasing complexity of radiotherapy delivery systems. Since then, many studies have been conducted and published applying ionizing radiation-induced acoustic principles into three primary research areas: Linear accelerator photon beam dosimetry, proton therapy range verification, and radiological imaging. This review article introduces the theoretical background behind ionizing radiation-induced acoustic waves, summarizes recent advances in the field, and provides an outlook on how the detection of ionizing radiationinduced acoustic waves can be used for relative and in vivo dosimetry in photon therapy, localization of the Bragg peak in proton therapy, and as a low-dose medical imaging modality. Future prospects and challenges for the clinical implementation of these techniques are discussed.

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“…Methods include both direct (implanted dosimeters) and indirect methods, e.g. prompt gamma, Compton camera and iono-acoustic imaging [66, 67]. For such measurements to be meaningful, the results need to be spatially correlated with patient anatomy in the treatment position.…”

Section: In-room Imaging and Image-guidance For Imptmentioning

confidence: 99%

Empowering Intensity Modulated Proton Therapy Through Physics and Technology: An Overview

Mohan

Das

Ling

2017

International Journal of Radiation Oncology*Biology*Physics

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Considering the clinical potential of protons attributable to their physical characteristics, interest in proton therapy has increased greatly in this century as has the number of proton therapy installations. Until recently, passively scattered proton therapy (PSPT) was used almost entirely. Notably, overall clinical results to date have not shown convincing benefit protons over photons. A rapid transition is now occurring with the implementation of the most advanced form of proton therapy, the intensity-modulated proton therapy (IMPT). IMPT is superior to PSPT and IMRT dosimetrically. However, numerous limitations exist in the present IMPT methods. In particular, compared to IMRT, IMPT is highly vulnerable to various uncertainties. In this overview we identify three major areas of current limitations of IMPT: treatment planning, treatment delivery, and motion management, and discuss current and future efforts for improvement. For treatment planning, we need to reduce uncertainties in proton range and in computed dose distributions, improve robust planning and optimization, enhance adaptive treatment planning and delivery, and consider how to exploit the variability in the relative biological effectiveness (RBE) of protons for clinical benefit. The quality of proton therapy also depends on the characteristics of the IMPT delivery systems and image-guidance. Efforts are needed to optimize the beamlet spot size for both improved dose conformality and faster delivery. For the latter, faster energy switching time and increased dose-rate are also needed. Real-time in-room volumetric imaging for guiding IMPT is in its early stages with CBCT and CT-on-rails, and continued improvements are anticipated. In addition, imaging of the proton beams themselves using, for instance, prompt gamma emissions, is being developed to determine the proton range and to reduce range uncertainty. With the realization of the advances described above, we posit that IMPT, thus empowered, will lead to substantially improved clinical results.

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Ionoacoustic tomography of the proton Bragg peak in combination with ultrasound and optoacoustic imaging

Cited by 59 publications

References 39 publications

Current state and future applications of radiological image guidance for particle therapy

Current state and future applications of radiological image guidance for particle therapy

Ionizing radiation‐induced acoustics for radiotherapy and diagnostic radiology applications

Empowering Intensity Modulated Proton Therapy Through Physics and Technology: An Overview

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