This work presents the tests of a multi-gap detector (MGD), composed of three parallel-plate ionization chambers (ICs) with different gap widths, assembled to prove the capability of correcting for charge volume recombination which is expected to occur when high fluence rates are delivered. Such beam conditions occur with a compact accelerator for charged particle therapy developed to reduce the costs, to accomplish faster treatments and to exploit different beam delivery techniques and dose rates as needed, for example, for range modulation and FLASH irradiations, respectively. The MGD was tested with carbon ions at the Centro Nazionale di Adroterapia Oncologica (CNAO Pavia, Italy), and with protons in two different beam lines: at Bern University Hospital with continuous beams and at the Laboratori Nazionale del Sud (Catania, Italy) of the Italian National Center of Nuclear Physics (INFN) with pulsed beams. For each accelerator, we took measurements with different beam intensities (up to the maximum rate of ionization achievable) and changed the detector bias voltage (V) in order to study the charge collection efficiency. Charge recombination models were used to evaluate the expected collected charge and to measure the linearity of the rate of ionization with the beam fluence rate. A phenomenological approach was used to determine the collection efficiency (f1) of the chamber with thinnest gap from the relative efficiencies, f1/f2 and f1/f3, exploiting the condition that, for each measurement, the three chambers were exposed to the same rate of ionization. Results prove that two calibration curves can be determined and used to correct the online measurements for the charge losses in the ICs for recombination.

https://www.mdpi.com/2076-3417/12/23/12160/pdf?version=1669632991

Fluence Beam Monitor for High-Intensity Particle Beams Based on a Multi-Gap Ionization Chamber and a Method for Ion Recombination Correction

Abstract We report on a hybrid in-beam PET and prompt-gamma Compton imaging system aimed at quasi real-time ion-range verification in proton-therapy treatments. Proof-of-concept experiments were carried out at the radiobiology beam line of the CNA cyclotron facility using a set of two synchronous Compton imagers and different target materials. The time structure of the 18 MeV proton beam was shaped with a series of beam-on and beam-off intervals, thereby mimicking a pulsed proton beam on a long time scale. During beam-on intervals, Compton imaging was performed utilizing the high energy $$\gamma$$ <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mi>γ</mml:mi> </mml:math> -rays promptly emitted from the nuclear reactions occurring in the targets. In the course of the beam-off intervals in situ positron-emission tomography was accomplished with the same imagers using the $$\beta ^{+}$$ <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:msup> <mml:mi>β</mml:mi> <mml:mo>+</mml:mo> </mml:msup> </mml:math> decay of activated nuclei. The targets used were stacks of different materials covering also various proton ranges and energies. A systematic study on the performance of these two complementary imaging techniques is reported and the experimental results interpreted on the basis of Monte Carlo calculations. The results demonstrate the possibility to combine both imaging techniques in a concomitant way, where high-efficiency prompt-gamma imaging is complemented with the high spatial accuracy of PET. Empowered by these results we suggest that a pulsed beam with a suitable duty cycle, in conjunction with in situ Compton- and PET-imaging may help to attain complementary information and quasi real-time range monitoring with high accuracy. 

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Hybrid in-beam PET- and Compton prompt-gamma imaging aimed at enhanced proton-range verification

BACKGROUND
Intensity-modulated proton therapy (IMPT) is a well-known delivery method of proton therapy. Besides higher plan quality, reducing the delivery time is also essential to IMPT plans. It can enhance patient comfort, reduce treatment costs, and improve delivery efficiency. From the perspective of treatment efficacy, it contributes to mitigating the intra-fractional motions and improving the accuracy of radiotherapy, especially for moving tumors.


PURPOSE
However, there is a tradeoff problem between the plan quality and delivery time. We consider the potential of a large momentum acceptance (LMA) beamline and apply the spots and energy layers reduction method to reduce the delivery time.


METHODS
The delivery time for each field consists of the energy layer switching time, spot traveling time, and dose delivery time. The larger momentum spread and higher intensity beam offered by the LMA beamline contribute to reducing the total delivery time compared to the conventional beamline. In addition to the dose fidelity term, an L1 and logarithm items were added to the objective function to increase the sparsity of the low-weighted spots and energy layers. After that, the low-weighted spots and layers were iteratively excluded in the reduced plan, which reduced the energy layer switching time and spot traveling time. We used the standard, reduced, and LMA-reduced plans to validate the proposed method and tested it on prostate and nasopharyngeal cases. Then, we compared and evaluated the plan quality, treatment time, and plan robustness against delivery uncertainty.


RESULTS
Compared with the standard plans, the number of spots in the LMA-reduced plans was on average reduced by 13 400 (95.6%) for prostate cases and by 48 300 (80.7%) for nasopharyngeal cases and the number of energy layers was on average reduced by 49 (61.3%) for prostate cases and by 97 (50.5%) for nasopharyngeal cases. And, the delivery time of the LMA-reduced plans was shortened from 34.5 to 8.6 s for prostate cases and from 163.8 to 53.6 s for nasopharyngeal cases. The LMA-reduced plans had comparable robustness to the spot monitor unit (MU) error compared with the standard plans, but the LMA-reduced plans became more sensitive to spot position uncertainty.


CONCLUSION
The delivery efficiency can be significantly improved using the LMA beamline and spots and energy layers reduction strategies. The method is promising to improve the efficiency of motion mitigation strategies for treating moving tumors.

Improving delivery efficiency using spots and energy layers reduction algorithms based on a large momentum acceptance beamline.

COPYRIGHT © 2022 Ye, Sun, Xie, Wang and Cai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Editorial: Medical Application and Radiobiology Research of Particle Radiation

Editorial: Medical Application and Radiobiology Research of Particle Radiation

BACKGROUND
Pencil beam scanning (PBS) proton therapy allows for far superior dose conformality compared with passive scattering techniques. However, one drawback of PBS is that the beam delivery time can be long, particularly when treating superficial disease. Minimizing beam delivery time is important for patient comfort and precision of treatment delivery. Mini-ridge filters (MRF) have been shown to reduce beam delivery time for synchrotron-based PBS. Given that cyclotron systems are widely used in proton therapy it is necessary to investigate the potential clinical benefit of mini-ridge filters in such systems.


PURPOSE
To demonstrate the clinical benefit of using a MRF to reduce beam delivery time for patients with large target volumes and superficial disease in cyclotron-based PBS proton therapy.


METHODS
A MRF beam model was generated by simulating the effect of a MRF on our clinical beam data assuming a fixed snout position relative to isocenter. The beam model was validated with a series of measurements. The model was used to optimize treatment plans in a water phantom and on six patient DICOM datasets to further study the effect of the MRF and for comparison with physician approved clinical treatment plans. Beam delivery time was measured for six plans with and without the MRF to demonstrate the reduction achievable. Plans with and without MRF were reviewed to confirm clinical acceptability by a radiation oncologist. Patient specific QA measurements were carried out with a two dimensional ionization chamber array detector for one representative patient's plan optimized with the MRF beam model.


RESULTS
Results show good agreement between the simulated beam model and measurements with mean and maximum deviations of 0.06 mm (0.45%) and 0.61 mm (4.9%). The increase in Bragg peak width (FWHM) ranged from 2.7 mm at 226 MeV to 6.1 mm at 70 MeV. The mean and maximum reduction in beam delivery time observed per field was 29.1 s (32.2%) and 79.7 s (55.3%).


CONCLUSION
MRFs can be used to reduce treatment time in cyclotron-based PBS proton therapy without sacrificing plan quality. This is particularly beneficial for patients with large targets and superficial disease such as in breast cancer where treatment times are generally long, as well as patients treated with deep inspiration breath hold (DIBH). This article is protected by copyright. All rights reserved.

The use of a mini-ridge filter with cyclotron-based pencil beam scanning proton therapy.

The physical and clinical benefits of charged particle therapy (CPT) are well recognised and recent developments have led to the rapid emergence of facilities, resulting in wider adoption worldwide. Nonetheless, the availability of CPT and complete exploitation of dosimetric advantages are still limited by high facility costs and technological challenges. There are extensive ongoing efforts to improve upon these, which will lead to greater accessibility, superior delivery, and therefore better treatment outcomes. Several of these aspects can be addressed by developments to the beam delivery system (BDS) which determine the overall shaping and timing capabilities to provide high quality treatments. Modern delivery techniques are necessary but are limited by extended treatment times. The energy layer switching time (ELST) is a limiting constraint of the BDS and a determinant of the beam delivery time (BDT), along with the accelerator and other factors. This review evaluates the delivery process in detail, presenting the limitations and developments for the BDS and related accelerator technology, toward decreasing the BDT. As extended BDT impacts motion and has dosimetric implications for treatment, we discuss avenues to minimise the ELST and overview the clinical benefits and feasibility of a large energy acceptance BDS. These developments support the possibility of delivering advanced methodologies such as volumetric rescanning, FLASH and arc therapy and can further reduce costs given a faster delivery for a greater range of treatment indications. Further work to realise multi-ion, image guided and adaptive therapies is also discussed. In this review we examine how increased treatment efficiency and efficacy could be achieved with an improved BDS and how this could lead to faster and higher quality treatments for the future of CPT.

Suzie Sheehy

Papers

Future Developments in Charged Particle Therapy: Improving Beam Delivery for Efficiency and Efficacy