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Title: SU-F-J-193: Efficient Dose Extinction Method for Water Equivalent Path Length (WEPL) of Real Tissue Samples for Validation of CT HU to Stopping Power Conversion

Abstract

Purpose: For proton therapy, an accurate model of CT HU to relative stopping power (RSP) conversion is essential. In current practice, validation of these models relies solely on measurements of tissue substitutes with standard compositions. Validation based on real tissue samples would be much more direct and can address variations between patients. This study intends to develop an efficient and accurate system based on the concept of dose extinction to measure WEPL and retrieve RSP in biological tissue in large number of types. Methods: A broad AP proton beam delivering a spread out Bragg peak (SOBP) is used to irradiate the samples with a Matrixx detector positioned immediately below. A water tank was placed on top of the samples, with the water level controllable in sub-millimeter by a remotely controlled dosing pump. While gradually lowering the water level with beam on, the transmission dose was recorded at 1 frame/sec. The WEPL were determined as the difference between the known beam range of the delivered SOBP (80%) and the water level corresponding to 80% of measured dose profiles in time. A Gammex 467 phantom was used to test the system and various types of biological tissue was measured. Results: RSP formore » all Gammex inserts, expect the one made with lung-450 material (<2% error), were determined within ±0.5% error. Depends on the WEPL of investigated phantom, a measurement takes around 10 min, which can be accelerated by a faster pump. Conclusion: Based on the concept of dose extinction, a system was explored to measure WEPL efficiently and accurately for a large number of samples. This allows the validation of CT HU to stopping power conversions based on large number of samples and real tissues. It also allows the assessment of beam uncertainties due to variations over patients, which issue has never been sufficiently studied before.« less

Authors:
; ; ; ; ;  [1]
  1. Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)
Publication Date:
OSTI Identifier:
22634789
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; ANIMAL TISSUES; BRAGG CURVE; COMPUTERIZED TOMOGRAPHY; ERRORS; LUNGS; PATIENTS; PHANTOMS; PROTON BEAMS; RADIATION DOSES; RADIOTHERAPY; STOPPING POWER; VALIDATION

Citation Formats

Zhang, R, Baer, E, Jee, K, Sharp, G, Flanz, J, and Lu, H. SU-F-J-193: Efficient Dose Extinction Method for Water Equivalent Path Length (WEPL) of Real Tissue Samples for Validation of CT HU to Stopping Power Conversion. United States: N. p., 2016. Web. doi:10.1118/1.4956101.
Zhang, R, Baer, E, Jee, K, Sharp, G, Flanz, J, & Lu, H. SU-F-J-193: Efficient Dose Extinction Method for Water Equivalent Path Length (WEPL) of Real Tissue Samples for Validation of CT HU to Stopping Power Conversion. United States. doi:10.1118/1.4956101.
Zhang, R, Baer, E, Jee, K, Sharp, G, Flanz, J, and Lu, H. 2016. "SU-F-J-193: Efficient Dose Extinction Method for Water Equivalent Path Length (WEPL) of Real Tissue Samples for Validation of CT HU to Stopping Power Conversion". United States. doi:10.1118/1.4956101.
@article{osti_22634789,
title = {SU-F-J-193: Efficient Dose Extinction Method for Water Equivalent Path Length (WEPL) of Real Tissue Samples for Validation of CT HU to Stopping Power Conversion},
author = {Zhang, R and Baer, E and Jee, K and Sharp, G and Flanz, J and Lu, H},
abstractNote = {Purpose: For proton therapy, an accurate model of CT HU to relative stopping power (RSP) conversion is essential. In current practice, validation of these models relies solely on measurements of tissue substitutes with standard compositions. Validation based on real tissue samples would be much more direct and can address variations between patients. This study intends to develop an efficient and accurate system based on the concept of dose extinction to measure WEPL and retrieve RSP in biological tissue in large number of types. Methods: A broad AP proton beam delivering a spread out Bragg peak (SOBP) is used to irradiate the samples with a Matrixx detector positioned immediately below. A water tank was placed on top of the samples, with the water level controllable in sub-millimeter by a remotely controlled dosing pump. While gradually lowering the water level with beam on, the transmission dose was recorded at 1 frame/sec. The WEPL were determined as the difference between the known beam range of the delivered SOBP (80%) and the water level corresponding to 80% of measured dose profiles in time. A Gammex 467 phantom was used to test the system and various types of biological tissue was measured. Results: RSP for all Gammex inserts, expect the one made with lung-450 material (<2% error), were determined within ±0.5% error. Depends on the WEPL of investigated phantom, a measurement takes around 10 min, which can be accelerated by a faster pump. Conclusion: Based on the concept of dose extinction, a system was explored to measure WEPL efficiently and accurately for a large number of samples. This allows the validation of CT HU to stopping power conversions based on large number of samples and real tissues. It also allows the assessment of beam uncertainties due to variations over patients, which issue has never been sufficiently studied before.},
doi = {10.1118/1.4956101},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: Studies show that WEPL can be determined from modulated dose rate functions (DRF). However, the previous calibration method based on statistics of the DRF is sensitive to energy mixing of protons due to scattering through different materials (termed as range mixing here), causing inaccuracies in the determination of WEPL. This study intends to explore time-domain features of the DRF to reduce the effect of range mixing in proton radiography (pRG) by this technique. Methods: An amorphous silicon flat panel (PaxScan™ 4030CB, Varian Medical Systems, Inc., Palo Alto, CA) was placed behind phantoms to measure DRFs from a proton beammore » modulated by a specially designed modulator wheel. The performance of two methods, the previously used method based on the root mean square (RMS) and the new approach based on time-domain features of the DRF, are compared for retrieving WEPL and RSP from pRG of a Gammex phantom. Results: Calibration by T{sub 80} (the time point for 80% of the major peak) was more robust to range mixing and produced WEPL with improved accuracy. The error of RSP was reduced from 8.2% to 1.7% for lung equivalent material, with the mean error for all other materials reduced from 1.2% to 0.7%. The mean error of the full width at half maximum (FWHM) of retrieved inserts was decreased from 25.85% to 5.89% for the RMS and T{sub 80} method respectively. Monte Carlo simulations in simplified cases also demonstrated that the T{sub 80} method is less sensitive to range mixing than the RMS method. Conclusion: WEPL images have been retrieved based on single flat panel measured DRFs, with inaccuracies reduced by exploiting time-domain features as the calibration parameter. The T{sub 80} method is validated to be less sensitive to range mixing and can thus retrieve the WEPL values in proximity of interfaces with improved numerical and spatial accuracy for proton radiography.« less
  • The accuracy of computer planning of clinical proton dose distribution is partly determined by the precision of the conversion of CT Hounsfield Units to relative proton stopping powers. The calibration curves from three different sources were compared. We have found about 5% differences between proton stopping power values in the range from -700 HU to 0 HU. Calibration data for several soft tissues and phantom materials were also experimentally measured. The data for the tissues are in a good agreement with the calibration curves however data for phantom materials have significant deviations.
  • Purpose: Ion beam therapy is sensitive to uncertainties from treatment planning and dose delivery. PET imaging of induced positron emitter distributions is a practical approach for in vivo, in situ verification of ion beam treatments. Treatment verification is usually done by comparing measured activity distributions with reference distributions, evaluated in nominal conditions. Although such comparisons give valuable information on treatment quality, a proper clinical evaluation of the treatment ultimately relies on the knowledge of the actual delivered dose. Analytical deconvolution methods relating activity and dose have been studied in this context, but were not clinically applied. In this work wemore » present a feasibility study of an alternative approach for dose reconstruction from activity data, which is based on relating variations in accumulated activity to tissue density variations. Methods: First, reference distributions of dose and activity were calculated from the treatment plan and CT data. Then, the actual measured activity data were cumulatively matched with the reference activity distributions to obtain a set of activity-equivalent path lengths (AEPLs) along the rays of the pencil beams. Finally, these AEPLs were used to deform the original dose distribution, yielding the actual delivered dose. The method was tested by simulating a proton therapy treatment plan delivering 2 Gy on a homogeneous water phantom (the reference), which was compared with the same plan delivered on a phantom containing inhomogeneities. Activity and dose distributions were were calculated by means of the FLUKA Monte Carlo toolkit. Results: The main features of the observed dose distribution in the inhomogeneous situation were reproduced using the AEPL approach. Variations in particle range were reproduced and the positions, where these deviations originated, were properly identified. Conclusions: For a simple inhomogeneous phantom the 3D dose reconstruction from PET-activity induced by proton beams was shown to be feasible.« less
  • Purpose: In vivo range verification in proton therapy is highly desirable. A recent study suggested that it was feasible to use point dose measurement for in vivo beam range verification in proton therapy, provided that the spread-out Bragg peak dose distribution is delivered in a different and rather unconventional manner. In this work, the authors investigate the possibility of using a commercial implantable dosimeter with wireless reading for this particular application. Methods: The traditional proton treatment technique delivers all the Bragg peaks required for a SOBP field in a single sequence, producing a constant dose plateau across the target volume.more » As a result, a point dose measurement anywhere in the target volume will produce the same value, thus providing no information regarding the water equivalent path length to the point of measurement. However, the same constant dose distribution can be achieved by splitting the field into a complementary pair of subfields, producing two oppositely ''sloped'' depth-dose distributions, respectively. The ratio between the two distributions can be a sensitive function of depth and measuring this ratio at a point inside the target volume can provide the water equivalent path length to the dosimeter location. Two types of field splits were used in the experiment, one achieved by the technique of beam current modulation and the other by manipulating the location and width of the beam pulse relative to the range modulator track. Eight MOSFET-based implantable dosimeters at four different depths in a water tank were used to measure the dose ratios for these field pairs. A method was developed to correct the effect of the well-known LET dependence of the MOSFET detectors on the depth-dose distributions using the columnar recombination model. The LET-corrected dose ratios were used to derive the water equivalent path lengths to the dosimeter locations to be compared to physical measurements. Results: The implantable dosimeters measured the dose ratios with a reasonable relative uncertainty of 1%-3% at all depths, except when the ratio itself becomes very small. In total, 55% of the individual measurements reproduced the water equivalent path lengths to the dosimeters within 1 mm. For three dosimeters, the difference was consistently less than 1 mm. Half of the standard deviations over the repeated measurements were equal or less than 1 mm. Conclusions: With a single fitting parameter, the LET-correction method worked remarkably well for the MOSFET detectors. The overall results were very encouraging for a potential method of in vivo beam range verification with millimeter accuracy. This is sufficient accuracy to expand range of clinical applications in which the authors could use the distal fall off of the proton depth dose for tight margins.« less
  • Purpose: To verify water equivalent path length (WEPL) before treatment in proton radiotherapy using time resolved in vivo diode dosimetry. Methods: Using a passively scattered range modulated proton beam, the output of a diode driving a fast current-to-voltage amplifier is recorded at a number of depths in a water tank. At each depth, a burst of overlapping single proton pulses is observed. The rms duration of the burst is computed and the resulting data set is fitted with a cubic polynomial. Results: When the diode is subsequently set to an arbitrary depth and the polynomial is used as a calibrationmore » curve, the ''unknown'' depth is determined within 0.3 mm rms. Conclusions: A diode or a diode array, placed (for instance) in the rectum in conjunction with a rectal balloon, can potentially determine the WEPL at that point, just prior to treatment, with submillimeter accuracy, allowing the beam energy to be adjusted. The associated unwanted dose is about 0.2% of a typical single fraction treatment dose.« less