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Title: TU-FG-BRB-10: A New Approach to Proton Radiography Using the Beamline X-Ray Flat Panel

Abstract

Purpose: Proton radiography, which images the patients with the same type of particles that they are to be treated with, is a promising approach for image guidance and range uncertainties reduction. This study aimed to realize quality proton radiography by measuring dose rate functions (DRF) in time domain using a single flat panel and retrieve water equivalent path length (WEPL) from them. 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 beam modulated by the modulator wheel. To retrieve WEPL and RSP, calibration models based on the intensity of DRFs only, root mean square (RMS) of DRFs only and the intensity weighted RMS were tested. The quality of obtained WEPL images (in terms of spatial resolution and level of details) and the accuracy of WEPL were compared. Results: RSPs for most of the Gammex phantom inserts were retrieved within ± 1% errors by calibration models based on the RMS and intensity weighted RMS. The mean percentage error for all inserts was reduced from 1.08% to 0.75% by matching intensity in the calibration model. In specific cases such as the insert with a titanium rod,more » the calibration model based on RMS only fails while the that based on intensity weighted RMS is still valid. The quality of retrieved WEPL images were significantly improved for calibration models including intensity matching. Conclusion: For the first time, a flat panel, which is readily available in the beamline for image guidance, was tested to acquire quality proton radiography with WEPL accurately retrieved from it. This technique is promising to be applied for image-guided proton therapy as well as patient specific RSP determination to reduce uncertainties of beam ranges.« less

Authors:
; ; ; ;  [1]
  1. Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)
Publication Date:
OSTI Identifier:
22654003
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:
61 RADIATION PROTECTION AND DOSIMETRY; 60 APPLIED LIFE SCIENCES; CALIBRATION; DOSE RATES; EFFICIENCY; IMAGES; PANELS; PROTON BEAMS; PROTON RADIOGRAPHY; RADIOPROTECTIVE SUBSTANCES; SPATIAL RESOLUTION; X RADIATION

Citation Formats

Zhang, R, Jee, K, Sharp, G, Flanz, J, and Lu, H. TU-FG-BRB-10: A New Approach to Proton Radiography Using the Beamline X-Ray Flat Panel. United States: N. p., 2016. Web. doi:10.1118/1.4957550.
Zhang, R, Jee, K, Sharp, G, Flanz, J, & Lu, H. TU-FG-BRB-10: A New Approach to Proton Radiography Using the Beamline X-Ray Flat Panel. United States. doi:10.1118/1.4957550.
Zhang, R, Jee, K, Sharp, G, Flanz, J, and Lu, H. Wed . "TU-FG-BRB-10: A New Approach to Proton Radiography Using the Beamline X-Ray Flat Panel". United States. doi:10.1118/1.4957550.
@article{osti_22654003,
title = {TU-FG-BRB-10: A New Approach to Proton Radiography Using the Beamline X-Ray Flat Panel},
author = {Zhang, R and Jee, K and Sharp, G and Flanz, J and Lu, H},
abstractNote = {Purpose: Proton radiography, which images the patients with the same type of particles that they are to be treated with, is a promising approach for image guidance and range uncertainties reduction. This study aimed to realize quality proton radiography by measuring dose rate functions (DRF) in time domain using a single flat panel and retrieve water equivalent path length (WEPL) from them. 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 beam modulated by the modulator wheel. To retrieve WEPL and RSP, calibration models based on the intensity of DRFs only, root mean square (RMS) of DRFs only and the intensity weighted RMS were tested. The quality of obtained WEPL images (in terms of spatial resolution and level of details) and the accuracy of WEPL were compared. Results: RSPs for most of the Gammex phantom inserts were retrieved within ± 1% errors by calibration models based on the RMS and intensity weighted RMS. The mean percentage error for all inserts was reduced from 1.08% to 0.75% by matching intensity in the calibration model. In specific cases such as the insert with a titanium rod, the calibration model based on RMS only fails while the that based on intensity weighted RMS is still valid. The quality of retrieved WEPL images were significantly improved for calibration models including intensity matching. Conclusion: For the first time, a flat panel, which is readily available in the beamline for image guidance, was tested to acquire quality proton radiography with WEPL accurately retrieved from it. This technique is promising to be applied for image-guided proton therapy as well as patient specific RSP determination to reduce uncertainties of beam ranges.},
doi = {10.1118/1.4957550},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}
  • Purpose: The relative stopping power (RSP) uncertainty is the largest contributor to the range uncertainty in proton therapy. The purpose of this work is to develop a robust and systematic method that yields accurate patient specific RSPs by combining pre-treatment X-ray CT and daily proton radiography. Methods: The method is formulated as a penalized least squares optimization (PLSO) problem min(|Ax-B|). The matrix A represents the cumulative path-length crossed in each material computed by calculating proton trajectories through the X-ray CT. The material RSPs are denoted by x and B is the pRad, expressed as water equivalent thickness. The equation ismore » solved using a convex-conic optimizer. Geant4 simulations were made to assess the feasibility of the method. RSP extracted from the Geant4 materials were used as a reference and the clinical HU-RSP curve as a comparison. The PLSO was first tested on a Gammex RMI-467 phantom. Then, anthropomorphic phantoms of the head, pelvis and lung were studied and resulting RSPs were evaluated. A pencil beam was generated in each phantom to evaluate the proton range accuracy achievable by using the optimized RSPs. Finally, experimental data of a pediatric head phantom (CIRS) were acquired using a recently completed experimental pCT scanner. Results: Numerical simulations showed precise RSP (<0.75%) for Gammex materials except low-density lung (LN-300) (1.2%). Accurate RSP have been obtained for the head (µ=−0.10%, 1.5σ=1.12%), lung (µ=−0.33, 1.5σ=1.02%) and pelvis anthropomorphic phantoms (µ=0.12, 1.5σ=0,99%). The range precision has been improved with an average R80 difference to the reference (µ±1.5σ) of −0.20±0.35%, −0.47±0.92% and −0.06±0.17% in the head, lung and pelvis phantoms respectively, compared to the 3.5% clinical margin. Experimental HU-RSP curve have been produced on the CIRS pediatric head. Conclusion: The proposed PLSO with prior knowledge X-ray CT shows promising potential (R80 σ<1.0% over all sites) to decrease the range uncertainty.« less
  • Purpose: We present a new system to perform prompt gamma-ray spectroscopy during proton pencil-beam scanning treatments, which enables in vivo verification of the proton range. This system will be used for the first clinical studies of this technology. Methods: After successful pre-clinical testing of prompt gamma-ray spectroscopy, a full scale system for clinical studies is now being assembled. Prompt gamma-rays will be detected during patient treatment using an array of 8 detector modules arranged behind a tungsten collimator. Each detector module consists of a lanthanum(III) bromide scintillator, a photomultiplier tube, and custom electronics for stable high voltage supply and signalmore » amplification. A new real-time data acquisition and control system samples the signals from the detectors with analog-to-digital converters, analyses events of interest, and communicates with the beam delivery systems. The timing of the detected events was synchronized to the cyclotron radiofrequency and the pencil-beam delivery. Range verification is performed by matching measured energy- and timeresolved gamma-ray spectra to nuclear reaction models based on the clinical treatment plan. Experiments in phantoms were performed using clinical beams in order to assess the performance of the systems. Results: The experiments showed reliable real-time analysis of more than 10 million detector events per second. The individual detector modules acquired accurate energy- and time-resolved gamma-ray measurements at a rate of 1 million events per second, which is typical for beams delivered with a clinical dose rate. The data acquisition system successfully tracked the delivery of the scanned pencil-beams to determine the location of range deviations within the treatment field. Conclusion: A clinical system for proton range verification using prompt gamma-ray spectroscopy has been designed and is being prepared for use during patient treatments. We anticipate to start a first clinical study in the near future. This work was supported by the Federal Share of program income earned by Massachusetts; General Hospital on C06-CA059267, Proton Therapy Research and Treatment Center.« less
  • Purpose: To evaluate the clinical performance of dual-energy CT (DECT) in determining proton stopping power ratios (SPR) and demonstrate advantages over conventional single-energy CT (SECT). Methods: SECT and DECT scans of tissue-equivalent plastics as well as animal meat samples are performed with a Siemens SOMATOM Definition Flash. The methods of Schneider et al. (1996) and Bourque et al. (2014) are used to determine proton SPR on SECT and DECT images, respectively. Waterequivalent path length (WEPL) measurements of plastics and tissue samples are performed with a 195 MeV proton beam. WEPL values are determined experimentally using the depth-dose shift and dosemore » extinction methods. Results: Comparison between CT-based and experimental WEPL is performed for 12 tissue-equivalent plastic as well as 6 meat boxes containing animal liver, kidney, heart, stomach, muscle and bones. For plastic materials, results show a systematic improvement in determining SPR with DECT, with a mean absolute error of 0.4% compared to 1.7% for SECT. For the meat samples, preliminary results show the ability for DECT to determine WEPL with a mean absolute value of 1.1% over all meat boxes. Conclusion: This work demonstrates the potential in using DECT for determining proton SPR with plastic materials in a clinical context. Further work is required to show the benefits of DECT for tissue samples. While experimental uncertainties could be a limiting factor to show the benefits of DECT over SECT for the meat samples, further work is required to adapt the DECT formalism in the context of clinical use, where noise and artifacts play an important role.« less
  • Purpose: The conversion of Hounsfield Unit (HU) to proton stopping power ratio (SPR) is a main source of uncertainty in proton therapy. In this study, the SPRs of animal tissues were measured and compared with prediction from dual energy CT (DECT) and single energy CT (SECT) calibrations. Methods: A stoichiometric calibration method for DECT was applied to predict the SPR using CT images acquired at 80 kVp and 140 kVp. The dual energy index was derived based on the HUs of the paired spectral images and used to calculate the SPRs of the materials. Tissue surrogates with known chemical compositionsmore » were used for calibration, and animal tissues (pig brain, liver, kidney; veal shank, muscle) were used for validation. The materials were irradiated with proton pencil beams, and SPRs were deduced from the residual proton range measured using a multi-layer ion chamber device. In addition, Gafchromic EBT3 films were used to measure the distal dose profiles after irradiation through the tissue samples and compared with those calculated by the treatment planning system using both DECT and SECT predicted SPRs. Results: The differences in SPR between DECT prediction and measurement were −0.31±0.36% for bone, 0.47±0.42% for brain, 0.67±0.15% for liver, 0.51±0.52% for kidney, and −0.96±0.15% for muscle. The corresponding results using SECT were 3.1±0.12%, 1.90±0.45%, −0.66±0.11%, 2.33±0.21%, and −1.70±0.17%. In the film measurements, average distances between film and calculated distal dose profiles were 0.35±0.12 mm for DECT calibration and −1.22±0.12 mm for SECT calibration for a beam with a range of 15.79 cm. Conclusion: Our study indicates that DECT is superior to SECT for proton SPR prediction and has the potential to reduce the range uncertainty to less than 2%. DECT may permit the use of tighter distal and proximal range uncertainty margins for treatment, thereby increasing the precision of proton therapy.« less
  • Purpose: This work aims at reducing the uncertainty in proton stopping power (SP) estimation by a novel combination of a linear, separable basis vector model (BVM) for stopping power calculation (Med Phys 43:600) and a statistical, model-based dual-energy CT (DECT) image reconstruction algorithm (TMI 35:685). The method was applied to experimental data. Methods: BVM assumes the photon attenuation coefficients, electron densities, and mean excitation energies (I-values) of unknown materials can be approximated by a combination of the corresponding quantities of two reference materials. The DECT projection data for a phantom with 5 different known materials was collected on a Philipsmore » Brilliance scanner using two scans at 90 kVp and 140 kVp. The line integral alternating minimization (LIAM) algorithm was used to recover the two BVM coefficient images using the measured source spectra. The proton stopping powers are then estimated from the Bethe-Bloch equation using electron densities and I-values derived from the BVM coefficients. The proton stopping powers and proton ranges for the phantom materials estimated via our BVM based DECT method are compared to ICRU reference values and a post-processing DECT analysis (Yang PMB 55:1343) applied to vendorreconstructed images using the Torikoshi parametric fit model (tPFM). Results: For the phantom materials, the average stopping power estimations for 175 MeV protons derived from our method are within 1% of the ICRU reference values (except for Teflon with a 1.48% error), with an average standard deviation of 0.46% over pixels. The resultant proton ranges agree with the reference values within 2 mm. Conclusion: Our principled DECT iterative reconstruction algorithm, incorporating optimal beam hardening and scatter corrections, in conjunction with a simple linear BVM model, achieves more accurate and robust proton stopping power maps than the post-processing, nonlinear tPFM based DECT analysis applied to conventional reconstructions of low and high energy scans. Funding Support: NIH R01CA 75371; NCI grant R01 CA 149305.« less