Integrated-mode proton radiography with 2D lateral projections.

Integrated-mode proton radiography leading to water equivalent thickness (WET) maps is an avenue of interest for motion management, patient positioning, andin vivorange verification. Radiographs can be obtained using a pencil beam scanning setup with a large 3D monolithic scintillator coupled with optical cameras. Established reconstruction methods either (1) involve a camera at the distal end of the scintillator, or (2) use a lateral view camera as a range telescope. Both approaches lead to limited image quality. The purpose of this work is to propose a third, novel reconstruction framework that exploits the 2D information provided by two lateral view cameras, to improve image quality achievable using lateral views. The three methods are first compared in a simulated Geant4 Monte Carlo framework using an extended cardiac torso (XCAT) phantom and a slanted edge. The proposed method with 2D lateral views is also compared with the range telescope approach using experimental data acquired with a plastic volumetric scintillator. Scanned phantoms include a Las Vegas (contrast), 9 tissue-substitute inserts (WET accuracy), and a paediatric head phantom. Resolution increases from 0.24 (distal) to 0.33 lp mm-1(proposed method) on the simulated slanted edge phantom, and the mean absolute error on WET maps of the XCAT phantom is reduced from 3.4 to 2.7 mm with the same methods. Experimental data from the proposed 2D lateral views indicate a 36% increase in contrast relative to the range telescope method. High WET accuracy is obtained, with a mean absolute error of 0.4 mm over 9 inserts. Results are presented for various pencil beam spacing ranging from 2 to 6 mm. This work illustrates that high quality proton radiographs can be obtained with clinical beam settings and the proposed reconstruction framework with 2D lateral views, with potential applications in adaptive proton therapy.

Comparison of reconstructed prompt gamma emissions using maximum likelihood estimation and origin ensemble algorithms for a Compton camera system tailored to proton range monitoring.

Compton-based prompt gamma (PG) imaging is being investigated by several groups as a potential solution for in vivo range monitoring in proton therapy. The performance of this technique depends on the detector system as well as the ability of the reconstruction method to obtain good spatial resolution to establish a quantitative correlation between the PG emission and the proton beam range in the patient. To evaluate the feasibility of PG imaging for range monitoring, we quantitatively evaluated the emission distributions reconstructed by a Maximum Likelihood Expectation Maximization (MLEM) and a Stochastic Origin Ensemble (SOE) algorithm. To this end, we exploit experimental and Monte Carlo (MC) simulation data acquired with the Polaris-J Compton Camera (CC) prototype. The differences between the proton beam range (RD) defined as the 80% distal dose fall-off and the PG range (RPG), obtained by fitting the distal end of the reconstructed profile with a sigmoid function, were quantified. A comparable performance of both reconstruction algorithms was found. For both experimental and simulated irradiation scenarios, the correlation between RD and RPG was within 5 mm. These values were consistent with the ground truth distance (RD-RPGg≈ 3 mm) calculated by using the expected PG emission available from MC simulation. Furthermore, shifts of 3 mm in the proton beam range were resolved with the MLEM algorithm by calculating the relative difference between the RPG for each reconstructed profile. In non-homogeneous targets, the spatial changes in the PG emission due to the different materials could not be fully resolved from the reconstructed profiles; however, the fall-off region still resembled the ground truth emission. For this scenario, the PG correlation (RD-RPG) varied from 0.1 mm to 4 mm, which is close to the ground truth correlation (3 mm). This work provides a framework for the evaluation of the range monitoring capabilities of a CC device for PG imaging. The two investigated image reconstruction algorithms showed a comparable and consistent performance for homogeneous and heterogeneous targets.

Image quality evaluation of projection- and depth dose-based approaches to integrating proton radiography using a monolithic scintillator detector.

The purpose of this study is to compare the image quality of an integrating proton radiography (PR) system, composed of a monolithic scintillator and two digital cameras, using integral lateral-dose and integral depth-dose image reconstruction techniques. Monte Carlo simulations were used to obtain the energy deposition in a 3D monolithic scintillator detector (30 × 30 × 30 cm3poly vinyl toluene organic scintillator) to create radiographs of various phantoms-a slanted aluminum cube for spatial resolution analysis and a Las Vegas phantom for contrast analysis. The light emission of the scintillator was corrected using Birks scintillation model. We compared two integrating PR methods and the expected results from an idealized proton tracking radiography system. Four different image reconstruction methods were utilized in this study: integral scintillation light projected from the beams-eye view, depth-dose based reconstruction methods both with and without optimization, and single particle tracking PR was used for reference data. Results showed that heterogeneity artifact due to medium-interface mismatch was identified from the Las Vegas phantom simulated in air. Spatial resolution was found to be highest for single-event reconstruction. Contrast levels, ranked from best to worst, were found to correspond to particle tracking, optimized depth-dose, depth-dose, and projection-based image reconstructions. The image quality of a monolithic scintillator integrating PR system was sufficient to warrant further exploration. These results show promise for potential clinical use as radiographic techniques for visualizing internal patient anatomy during proton radiotherapy.

Computational model for detector timing effects in Compton-camera based prompt-gamma imaging for proton radiotherapy.

This paper describes a realistic simulation of a Compton-camera (CC) based prompt-gamma (PG) imaging system for proton range verification for a range of clinical dose rates, and its comparison to PG measured data with a pre-clinical CC. We used a Monte Carlo plus Detector Effects (MCDE) model to simulate the production of prompt gamma-rays (PG) and their energy depositions in the CC. With Monte Carlo, we simulated PG emission resulting from irradiation of a high density polyethylene phantom with a 150 MeV proton pencil beam at dose rates of 5.0 × 108, 2.6 × 109, and 4.6 × 109 p+ s-1. Realistic detector timing effects (e.g. delayed triggering time, event-coincidence, dead time, etc,) were added in post-processing to allow for flexible count rate variations. We acquired PG emission measurements with our pre-clinical CC during irradiation with a clinical 150 MeV proton pencil beam at the same dose rates. For simulations and measurements, three primary changes could be seen in the PG emission data as the dose rate increased: (1) reduction in the total number of detected events due to increased dead-time percentage; (2) increase in false-coincidence events (i.e. multiple PGs interacting, rather than a single PG scatter); and (3) loss of distinct PG emission peaks in the energy spectrum. We used the MCDE model to estimate the quality of our measured PG data, primarily with regards to true and false double-scatters and triple-scatters recorded by the CC. The simulation results showed that of the recorded double-scatter PG interactions 22%, 57%, and 70% were false double-scatters and for triple-scatter interactions 3%, 21%, and 35% were false events at 5.0 × 108, 2.6 × 109, and 4.6 × 109 p+ s-1, respectively. These false scatter events represent noise in the data, and the high percentage of these events in the data represents a major limitation in our ability to produce usable PG images with our prototype CC.

Ionization quenching correction for a 3D scintillator detector exposed to scanning proton beams.

The ionization quenching phenomenon in scintillators must be corrected to obtain accurate dosimetry in particle therapy. The purpose of this study was to develop a methodology for correcting camera projection measurements of a 3D scintillator detector exposed to proton pencil beams. Birks' ionization quenching model and the energy deposition by secondary electrons (EDSE) model were used to correct the light captured by a prototype 3D scintillator detector. The detector was made of a 20 cm × 20 cm × 20 cm tank filled with liquid scintillator, and three cameras. The detector was exposed to four proton-beam energies (84.6, 100.9, 144.9, and 161.6 MeV) at The University of Texas MD Anderson Cancer Center's Proton Therapy Center. The dose and track averaged linear energy transfer (LET) were obtained using validated Monte Carlo (MC) simulations. The corrected light output was compared to the dose calculated by the MC simulation. Optical artefact corrections were used to correct for refraction at the air-scintillator interface, and image perspective. These corrections did not account for the non-orthogonal integration of data off the central axis of the image. Therefore, we compared the light output to an integrated MC dose and LET along the non-orthogonal path. After accounting for the non-orthogonal integration of the data, the corrected light output reduced the dose error at the Bragg peak region from 15% to 3% for low proton-beam energies. Overall, the doses at the Bragg peak region using the Birks' model and EDSE model were less than ±3% and ±7% of the MC dose, respectively. We have improved the application of Birks' model quenching corrections in 3D scintillators by numerically projecting the dose and LET 3D grid to camera projections. This study shows that scintillator projections can be corrected using average LET values at the central axes.

Assessment of setup uncertainty in hypofractionated liver radiation therapy with a breath-hold technique using automatic image registration-based image guidance.

BACKGROUND: Target localization in radiation therapy is affected by numerous sources of uncertainty. Despite measures to minimize the breathing motion, the treatment of hypofractionated liver radiation therapy is further challenged by residual uncertainty coming from involuntary organ motion and daily changes in the shape and location of abdominal organs. To address the residual uncertainty, clinics implement image-guided radiation therapy at varying levels of soft-tissue contrast. This study utilized the treatment records from the patients that have received hypofractionated liver radiation therapy using in-room computed tomography (CT) imaging to assess the setup uncertainty and to estimate the appropriate planning treatment volume (PTV) margins in the absence of in-room CT imaging. METHODS: We collected 917 pre-treatment daily in-room CT images from 69 patients who received hypofractionated radiation therapy to the liver with the inspiration breath-hold technique. For each treatment, the daily CT was initially aligned to the planning CT based on the shape of the liver automatically using a CT-CT alignment software. After the initial alignment, manual shift corrections were determined by visual inspection of the two images, and the corrections were applied to shift the patient to the physician-approved treatment position. Considering the final alignment as the gold-standard setup, systematic and random uncertainties in the automatic alignment were quantified, and the uncertainties were used to calculate the PTV margins. RESULTS: The median discrepancy between the final and automatic alignment was 1.1 mm (0-24.3 mm), and 38% of treated fractions required manual corrections of ≥3 mm. The systematic uncertainty was 1.5 mm in the anterior-posterior (AP) direction, 1.1 mm in the left-right (LR) direction, and 2.4 mm in the superior-inferior (SI) direction. The random uncertainty was 2.2 mm in the AP, 1.9 mm in the LR, and 2.2 mm in the SI direction. The PTV margins recommended to be used in the absence of in-room CT imaging were 5.3 mm in the AP, 3.5 mm in the LR, and 5.1 mm in the SI direction. CONCLUSIONS: Manual shift correction based on soft-tissue alignment is substantial in the treatment of the abdominal region. In-room CT can reduce PTV margin by up to 5 mm, which may be especially beneficial for dose escalation and normal tissue sparing in hypofractionated liver radiation therapy.

A systematic characterization of the low-energy photon response of plastic scintillation detectors.

To characterize the low energy behavior of scintillating materials used in plastic scintillation detectors (PSDs), 3 PSDs were developed using polystyrene-based scintillating materials emitting in different wavelengths. These detectors were exposed to National Institute of Standards and Technology (NIST)-matched low-energy beams ranging from 20 kVp to 250 kVp, and to (137)Cs and (60)Co beams. The dose in polystyrene was compared to the dose in air measured by NIST-calibrated ionization chambers at the same location. Analysis of every beam quality spectrum was used to extract the beam parameters and the effective mass energy-absorption coefficient. Monte Carlo simulations were also performed to calculate the energy absorbed in the scintillators' volume. The scintillators' expected response was then compared to the experimental measurements and an energy-dependent correction factor was identified to account for low-energy quenching in the scintillators. The empirical Birks model was then compared to these values to verify its validity for low-energy electrons. The clear optical fiber response was below 0.2% of the scintillator's light for x-ray beams, indicating that a negligible amount of fluorescence contamination was produced. However, for higher-energy beams ((137)Cs and (60)Co), the scintillators' response was corrected for the Cerenkov stem effect. The scintillators' response increased by a factor of approximately 4 from a 20 kVp to a (60)Co beam. The decrease in sensitivity from ionization quenching reached a local minimum of about [Formula: see text] between 40 keV and 60 keV x-ray beam mean energy, but dropped by 20% for very low-energy (13 keV) beams. The Birks model may be used to fit the experimental data, but it must take into account the energy dependence of the kB quenching parameter. A detailed comprehension of intrinsic scintillator response is essential for proper calibration of PSD dosimeters for radiology.

Imaging of prompt gamma rays emitted during delivery of clinical proton beams with a Compton camera: feasibility studies for range verification.

The purpose of this paper is to evaluate the ability of a prototype Compton camera (CC) to measure prompt gamma rays (PG) emitted during delivery of clinical proton pencil beams for prompt gamma imaging (PGI) as a means of providing in vivo verification of the delivered proton radiotherapy beams. A water phantom was irradiated with clinical 114 MeV and 150 MeV proton pencil beams. Up to 500 cGy of dose was delivered per irradiation using clinical beam currents. The prototype CC was placed 15 cm from the beam central axis and PGs from 0.2 MeV up to 6.5 MeV were measured during irradiation. From the measured data (2D) images of the PG emission were reconstructed. (1D) profiles were extracted from the PG images and compared to measured depth dose curves of the delivered proton pencil beams. The CC was able to measure PG emission during delivery of both 114 MeV and 150 MeV proton beams at clinical beam currents. 2D images of the PG emission were reconstructed for single 150 MeV proton pencil beams as well as for a 5 × 5 cm mono-energetic layer of 114 MeV pencil beams. Shifts in the Bragg peak (BP) range were detectable on the 2D images. 1D profiles extracted from the PG images show that the distal falloff of the PG emission profile lined up well with the distal BP falloff. Shifts as small as 3 mm in the beam range could be detected from the 1D PG profiles with an accuracy of 1.5 mm or better. However, with the current CC prototype, a dose of 400 cGy was required to acquire adequate PG signal for 2D PG image reconstruction. It was possible to measure PG interactions with our prototype CC during delivery of proton pencil beams at clinical dose rates. Images of the PG emission could be reconstructed and shifts in the BP range were detectable. Therefore PGI with a CC for in vivo range verification during proton treatment delivery is feasible. However, improvements in the prototype CC detection efficiency and reconstruction algorithms are necessary to make it a clinically viable PGI system.

Passively scattered proton beam entrance dosimetry with a plastic scintillation detector.

We tested the feasibility of using plastic scintillation detectors (PSDs) for proton entrance dosimetry. A PSD built with BCF-12 scintillating fiber was used to measure the absolute entrance dose of a passively scattered proton beam for energies ranging from 140 to 250 MeV, and for a range of spread out Bragg peak (SOBP) widths at two energies, to quantify the effect of ionization quenching on the response of the detector and to determine the necessity of Cerenkov radiation correction in proton beams. The overall accuracy and precision of the PSD was evaluated by measuring lateral beam profiles and comparing the results with profiles measured using film. The PSD under-responded owing to ionization quenching, exhibiting approximately a 7% loss of signal at the highest energy studied (250 MeV) and a 10% loss of signal at the lowest energy studied (140 MeV). For a given nominal energy, varying the SOBP width did not significantly alter the response of the PSD. Cerenkov radiation contributed negligibly to the PSD signal and can be safely ignored without introducing more than 1% error in the measured dose. Profiles measured with the PSD and film agreed to within the uncertainty of the detector, demonstrating good relative accuracy. Although correction factors were necessary to account for ionization quenching, the magnitude of the correction varied minimally over a broad range of energies; PSDs therefore represent a practical detector for proton entrance dosimetry.

Variation of kQclin,Qmsr (fclin,fmsr) for the small-field dosimetric parameters percentage depth dose, tissue-maximum ratio, and off-axis ratio.

PURPOSE: Evaluate the ability of different dosimeters to correctly measure the dosimetric parameters percentage depth dose (PDD), tissue-maximum ratio (TMR), and off-axis ratio (OAR) in water for small fields. METHODS: Monte Carlo (MC) simulations were used to estimate the variation of kQclin,Qmsr (fclin,fmsr) for several types of microdetectors as a function of depth and distance from the central axis for PDD, TMR, and OAR measurements. The variation of kQclin,Qmsr (fclin,fmsr) enables one to evaluate the ability of a detector to reproduce the PDD, TMR, and OAR in water and consequently determine whether it is necessary to apply correction factors. The correctness of the simulations was verified by assessing the ratios between the PDDs and OARs of 5- and 25-mm circular collimators used with a linear accelerator measured with two different types of dosimeters (the PTW 60012 diode and PTW PinPoint 31014 microchamber) and the PDDs and the OARs measured with the Exradin W1 plastic scintillator detector (PSD) and comparing those ratios with the corresponding ratios predicted by the MC simulations. RESULTS: MC simulations reproduced results with acceptable accuracy compared to the experimental results; therefore, MC simulations can be used to successfully predict the behavior of different dosimeters in small fields. The Exradin W1 PSD was the only dosimeter that reproduced the PDDs, TMRs, and OARs in water with high accuracy. With the exception of the EDGE diode, the stereotactic diodes reproduced the PDDs and the TMRs in water with a systematic error of less than 2% at depths of up to 25 cm; however, they produced OAR values that were significantly different from those in water, especially in the tail region (lower than 20% in some cases). The microchambers could be used for PDD measurements for fields greater than those produced using a 10-mm collimator. However, with the detector stem parallel to the beam axis, the microchambers could be used for TMR measurements for all field sizes. The microchambers could not be used for OAR measurements for small fields. CONCLUSIONS: Compared with MC simulation, the Exradin W1 PSD can reproduce the PDDs, TMRs, and OARs in water with a high degree of accuracy; thus, the correction used for converting dose is very close to unity. The stereotactic diode is a viable alternative because it shows an acceptable systematic error in the measurement of PDDs and TMRs and a significant underestimation in only the tail region of the OAR measurements, where the dose is low and differences in dose may not be therapeutically meaningful.

3D reconstruction of scintillation light emission from proton pencil beams using limited viewing angles-a simulation study.

An accurate and high-resolution quality assurance (QA) method for proton radiotherapy beams is necessary to ensure correct dose delivery to the target. Detectors based on a large volume of liquid scintillator have shown great promise in providing fast and high-resolution measurements of proton treatment fields. However, previous work with these detectors has been limited to two-dimensional measurements, and the quantitative measurement of dose distributions was lacking. The purpose of the current study is to assess the feasibility of reconstructing three-dimensional (3D) scintillation light distributions of spot scanning proton beams using a scintillation system. The proposed system consists of a tank of liquid scintillator imaged by charge-coupled device cameras at three orthogonal viewing angles. Because of the limited number of viewing angles, we developed a profile-based technique to obtain an initial estimate that can improve the quality of the 3D reconstruction. We found that our proposed scintillator system and profile-based technique can reconstruct a single energy proton beam in 3D with a gamma passing rate (3%/3 mm local) of 100.0%. For a single energy layer of an intensity modulated proton therapy prostate treatment plan, the proposed method can reconstruct the 3D light distribution with a gamma pass rate (3%/3 mm local) of 99.7%. In addition, we also found that the proposed method is effective in detecting errors in the treatment plan, indicating that it can be a very useful tool for 3D proton beam QA.

Detecting prompt gamma emission during proton therapy: the effects of detector size and distance from the patient.

Recent studies have suggested that the characteristics of prompt gammas (PGs) emitted from excited nuclei during proton therapy are advantageous for determining beam range during treatment delivery. Since PGs are only emitted while the beam is on, the feasibility of using PGs for online treatment verification depends greatly on the design of highly efficient detectors. The purpose of this work is to characterize how PG detection changes as a function of distance from the patient as a means of guiding the design and usage of clinical PG imaging detectors. Using a Monte Carlo model (GEANT4.9.4) we studied the detection rate (PGs per incident proton) of a high purity germanium detector for both the total PG emission and the characteristic 6.13 MeV PG emission from (16)O emitted during proton irradiation. The PG detection rate was calculated as a function of distance from the isocenter of the proton treatment nozzle for: (1) a water phantom irradiated with a proton pencil beam and (2) a prostate patient irradiated with a scanning beam proton therapy treatment field (lateral field size: ∼6 cm × 6 cm, beam range: 23.5 cm). An analytical expression of the PG detection rate as a function of distance from isocenter, detector size, and proton beam energy was then developed. The detection rates were found to be 1.3 × 10(-6) for oxygen and 3.9 × 10(-4) for the total PG emission, respectively, with the detector placed 11 cm from isocenter for a 40 MeV pencil beam irradiating a water phantom. The total PG detection rate increased by ∼85 ± 3% for beam energies greater than 150 MeV. The detection rate was found to be approximately 2.1 × 10(-6) and 1.7 × 10(-3) for oxygen and total PG emission, respectively, during delivery of a single pencil beam during a scanning beam treatment for prostate cancer. The PG detection rate as a function of distance from isocenter during irradiation of a water phantom with a single proton pencil beam was described well by the model of a point source irradiating a cylindrical detector of a known diameter over the range of beam energies commonly used for proton therapy. For the patient studies, it was necessary to divide the point source equation by an exponential factor in order to correctly predict the falloff of the PG detection rate as a function of distance from isocenter.

Optical artefact characterization and correction in volumetric scintillation dosimetry.

The goals of this study were (1) to characterize the optical artefacts affecting measurement accuracy in a volumetric liquid scintillator detector, and (2) to develop methods to correct for these artefacts. The optical artefacts addressed were photon scattering, refraction, camera perspective, vignetting, lens distortion, the lens point spread function, stray radiation, and noise in the camera. These artefacts were evaluated by theoretical and experimental means, and specific correction strategies were developed for each artefact. The effectiveness of the correction methods was evaluated by comparing raw and corrected images of the scintillation light from proton pencil beams against validated Monte Carlo calculations. Blurring due to the lens and refraction at the scintillator tank-air interface were found to have the largest effect on the measured light distribution, and lens aberrations and vignetting were important primarily at the image edges. Photon scatter in the scintillator was not found to be a significant source of artefacts. The correction methods effectively mitigated the artefacts, increasing the average gamma analysis pass rate from 66% to 98% for gamma criteria of 2% dose difference and 2 mm distance to agreement. We conclude that optical artefacts cause clinically meaningful errors in the measured light distribution, and we have demonstrated effective strategies for correcting these optical artefacts.

Performance assessment of a 2D array of plastic scintillation detectors for IMRT quality assurance.

The purposes of this work are to assess the performance of a 2D plastic scintillation detectors array prototype for quality assurance in intensity-modulated radiation therapy (IMRT) and to determine its sensitivity and specificity to positioning errors of one multileaf collimator (MLC) leaf and one MLC leaf bank by applying the principles of signal detection theory. Ten treatment plans (step-and-shoot delivery) and one volumetric modulated arc therapy plan were measured and compared to calculations from two treatment-planning systems (TPSs) and to radiochromic films. The averages gamma passing rates per beam found for the step-and-shoot plans were 95.8% for the criteria (3%, 2 mm), 97.8% for the criteria (4%, 2 mm), and 98.1% for the criteria (3%, 3 mm) when measurements were compared to TPS calculations. The receiver operating characteristic curves for the one leaf errors and one leaf bank errors were determined from simulations (theoretical upper limits) and measurements. This work concludes that arrays of plastic scintillation detectors could be used for IMRT quality assurance in clinics. The use of signal detection theory could improve the quality of dosimetric verifications in radiation therapy by providing optimal discrimination criteria for the detection of different classes of errors.

The effects of Doppler broadening and detector resolution on the performance of three-stage Compton cameras.

PURPOSE: The authors investigated how the characteristics of the detectors used in a three-stage Compton camera (CC) affect the CC's ability to accurately measure the emission distribution and energy spectrum of prompt gammas (PG) emitted by nuclear de-excitations during proton therapy. The detector characteristics they studied included the material (high-purity germanium [HPGe] and cadmium zinc telluride [CZT]), Doppler broadening (DB), and resolution (lateral, depth, and energy). METHODS: The authors simulated three-stage HPGe and CZT CCs of various configurations, detecting gammas from point sources with energies ranging from 0.511 to 7.12 MeV. They also simulated a proton pencil beam irradiating a tissue target to study how the detector characteristics affect the PG data measured by CCs in a clinical proton therapy setting. They used three figures of merit: the distance of closest approach (DCA) and the point of closest approach (PCA) between the measured and actual position of the PG emission origin, and the calculated energy resolution. RESULTS: For CCs with HPGe detectors, DB caused the DCA to be greater than 3 mm for 14% of the 6.13 MeV gammas and 20% of the 0.511 MeV gammas. For CCs with CZT detectors, DB caused the DCA to be greater than 3 mm for 18% of the 6.13 MeV gammas and 25% of the 0.511 MeV gammas. The full width at half maximum (FWHM) of the PCA in the z direction for HPGe and CZT detectors ranged from 1.3 to 0.4 mm for gammas with incident energy ranging from 0.511 to 7.12 MeV. For CCs composed of HPGe detectors, the resolution of incident gamma energy calculated by the CC ranged from 6% to 1% for gammas with true incident energies from 0.511 to 7.12 MeV. For CCs composed of CZT detectors, the resolution of gamma energy calculated by the CC ranged from 10% to 1% for gammas with true incident energies from 0.511 to 7.12 MeV. For HPGe and CZT CCs in which all detector effect were included, the DCA was less than 3 mm for 75% and 68% of the detected gammas, respectively, and restricting gammas to those having energy greater than 2.0 MeV increased these percentages to 83% and 77% for HPGe and CZT, respectively. Distributions of the true gamma origins and the PCA after detector characteristics had been included showed good agreement on beam range and some loss of resolution for the lateral profile of the PG emission. Characteristic energy lines were evident in the calculated gamma energy spectrum. CONCLUSIONS: The authors found the following: (1) DB is the dominant source of spatial and energy resolution loss in the CCs at all energy levels; (2) the largest difference in the spatial resolution of HPGe and CZT CCs is that the spatial resolution distributions of CZT have broader tails. The differences in the FWHM of these distributions are small; (3) the energy resolution of both HPGe and CZT three-stage CCs is adequate for PG spectroscopy; and (4) restricting the gammas to those having energy greater than 2.0 MeV can improve the achievable image resolution.

Quenching correction for volumetric scintillation dosimetry of proton beams.

Volumetric scintillation dosimetry has the potential to provide fast, high-resolution, three-dimensional radiation dosimetry. However, scintillators exhibit a nonlinear response at the high linear energy transfer (LET) values characteristic of proton Bragg peaks. The purpose of this study was to develop a quenching correction method for volumetric scintillation dosimetry of proton beams. Scintillation light from a miniature liquid scintillator detector was measured along the central axis of a 161.6 MeV proton pencil beam. Three-dimensional dose and LET distributions were calculated for 85.6, 100.9, 144.9 and 161.6 MeV beams using a validated Monte Carlo model. LET values were also calculated using an analytical formula. A least-squares fit to the data established the empirical parameters of a quenching correction model. The light distribution in a tank of liquid scintillator was measured with a CCD camera at all four beam energies. The quenching model and LET data were used to correct the measured light distribution. The calculated and measured Bragg peak heights agreed within ±3% for all energies except 85.6 MeV, where the agreement was within ±10%. The quality of the quenching correction was poorer for sharp low-energy Bragg peaks because of blurring and detector size effects. The corrections performed using analytical LET values resulted in doses within 1% of those obtained using Monte Carlo LET values. The proposed method can correct for quenching with sufficient accuracy for dosimetric purposes. The required LET values may be computed effectively using Monte Carlo or analytical methods. Future detectors should improve blurring correction methods and optimize the pixel size to improve accuracy for low-energy Bragg peaks.

Validating plastic scintillation detectors for photon dosimetry in the radiologic energy range.

PURPOSE: Photon dosimetry in the kilovolt (kV) energy range represents a major challenge for diagnostic and interventional radiology and superficial therapy. Plastic scintillation detectors (PSDs) are potentially good candidates for this task. This study proposes a simple way to obtain accurate correction factors to compensate for the response of PSDs to photon energies between 80 and 150 kVp. The performance of PSDs is also investigated to determine their potential usefulness in the diagnostic energy range. METHODS: A 1-mm-diameter, 10-mm-long PSD was irradiated by a Therapax SXT 150 unit using five different beam qualities made of tube potentials ranging from 80 to 150 kVp and filtration thickness ranging from 0.8 to 0.2 mmAl + 1.0 mmCu. The light emitted by the detector was collected using an 8-m-long optical fiber and a polychromatic photodiode, which converted the scintillation photons to an electrical current. The PSD response was compared with the reference free air dose rate measured with a calibrated Farmer NE2571 ionization chamber. PSD measurements were corrected using spectra-weighted corrections, accounting for mass energy-absorption coefficient differences between the sensitive volumes of the ionization chamber and the PSD, as suggested by large cavity theory (LCT). Beam spectra were obtained from x-ray simulation software and validated experimentally using a CdTe spectrometer. Correction factors were also obtained using Monte Carlo (MC) simulations. Percent depth dose (PDD) measurements were compensated for beam hardening using the LCT correction method. These PDD measurements were compared with uncorrected PSD data, PDD measurements obtained using Gafchromic films, Monte Carlo simulations, and previous data. RESULTS: For each beam quality used, the authors observed an increase of the energy response with effective energy when no correction was applied to the PSD response. Using the LCT correction, the PSD response was almost energy independent, with a residual 2.1% coefficient of variation (COV) over the 80-150-kVp energy range. Monte Carlo corrections reduced the COV to 1.4% over this energy range. All PDD measurements were in good agreement with one another except for the uncorrected PSD data, in which an over-response was observed with depth (13% at 10 cm with a 100 kVp beam), showing that beam hardening had a non-negligible effect on the PSD response. A correction based on LCT compensated very well for this effect, reducing the over-response to 3%. CONCLUSION: In the diagnostic energy range, PSDs show high-energy dependence, which can be corrected using spectra-weighted mass energy-absorption coefficients, showing no considerable sign of quenching between these energies. Correction factors obtained by Monte Carlo simulations confirm that the approximations made by LCT corrections are valid. Thus, PSDs could be useful for real-time dosimetry in radiology applications.

Evaluation of a stochastic reconstruction algorithm for use in Compton camera imaging and beam range verification from secondary gamma emission during proton therapy.

In this paper, we study the feasibility of using the stochastic origin ensemble (SOE) algorithm for reconstructing images of secondary gammas emitted during proton radiotherapy from data measured with a three-stage Compton camera. The purpose of this study was to evaluate the quality of the images of the gamma rays emitted during proton irradiation produced using the SOE algorithm and to measure how well the images reproduce the distal falloff of the beam. For our evaluation, we performed a Monte Carlo simulation of an ideal three-stage Compton camera positioned above and orthogonal to a proton pencil beam irradiating a tissue phantom. Scattering of beam protons with nuclei in the phantom produces secondary gamma rays, which are detected by the Compton camera and used as input to the SOE algorithm. We studied the SOE reconstructed images as a function of the number of iterations, the voxel probability parameter, and the number of detected gammas used by the SOE algorithm. We quantitatively evaluated the capabilities of the SOE algorithm by calculating and comparing the normalized mean square error (NMSE) of SOE reconstructed images. We also studied the ability of the SOE reconstructed images to predict the distal falloff of the secondary gamma production in the irradiated tissue. Our results show that the images produced with the SOE algorithm converge in ~10,000 iterations, with little improvement to the image NMSE for iterations above this number. We found that the statistical noise of the images is inversely proportional to the ratio of the number of gammas detected to the SOE voxel probability parameter value. In our study, the SOE predicted distal falloff of the reconstructed images agrees with the Monte Carlo calculated distal falloff of the gamma emission profile in the phantom to within ±0.6 mm for the positions of maximum emission (100%) and 90%, 50% and 20% distal falloff of the gamma emission profile. We conclude that the SOE algorithm is an effective method for reconstructing images of a proton pencil beam from the data collected by an ideal Compton camera and that these images accurately model the distal falloff of secondary gamma emission during proton irradiation.

Dosimetric performance and array assessment of plastic scintillation detectors for stereotactic radiosurgery quality assurance.

PURPOSE: To compare the performance of plastic scintillation detectors (PSD) for quality assurance (QA) in stereotactic radiosurgery conditions to a microion-chamber (IC), Gafchromic EBT2 films, 60 008 shielded photon diode (SD) and unshielded diodes (UD), and assess a new 2D crosshair array prototype adapted to small field dosimetry. METHODS: The PSD consists of a 1 mm diameter by 1 mm long scintillating fiber (BCF-60, Saint-Gobain, Inc.) coupled to a polymethyl-methacrylate optical fiber (Eska premier, Mitsubishi Rayon Co., Ltd., Tokyo, Japan). Output factors (S(c,p)) for apertures used in radiosurgery ranging from 4 to 40 mm in diameter have been measured. The PSD crosshair array (PSDCA) is a water equivalent device made up of 49 PSDs contained in a 1.63 cm radius area. Dose profiles measurements were taken for radiosurgery fields using the PSDCA and were compared to other dosimeters. Moreover, a typical stereotactic radiosurgery treatment using four noncoplanar arcs was delivered on a spherical phantom in which UD, IC, or PSD was placed. Using the Xknife planning system (Integra Radionics Burlington, MA), 15 Gy was prescribed at the isocenter, where each detector was positioned. RESULTS: Output Factors measured by the PSD have a mean difference of 1.3% with Gafchromic EBT2 when normalized to a 10 × 10 cm(2) field, and 1.0% when compared with UD measurements normalized to the 35 mm diameter cone. Dose profiles taken with the PSD crosshair array agreed with other single detectors dose profiles in spite of the presence of the 49 PSDs. Gamma values comparing 1D dose profiles obtained with PSD crosshair array with Gafchromic EBT2 and UD measured profiles shows 98.3% and 100.0%, respectively, of detector passing the gamma acceptance criteria of 0.3 mm and 2%. The dose measured by the PSD for a complete stereotactic radiosurgery treatment is comparable to the planned dose corrected for its SD-based S(c,p) within 1.4% and 0.7% for 5 and 35 mm diameter cone, respectively. Furthermore, volume averaging of the IC can be observed for the 5 mm aperture where it differs by as much as 9.1% compared to the PSD measurement. The angular dependency of the UD is also observed, unveiled by an under-response around 2.5% of both 5 and 35 mm apertures. CONCLUSIONS: Output Factors and dose profiles measurements performed, respectively, with the PSD and the PSDCA were in agreement with those obtained with the UD and EBT2 films. For stereotactic radiosurgery treatment verification, the PSD gives accurate results compared to the planning system and the IC once the latter is corrected to compensate for the averaging effect of the IC. The PSD provides precise results when used as a single detector or in a dense array, resulting in a great potential for stereotactic radiosurgery QA measurements.

Study of the response of plastic scintillation detectors in small-field 6 MV photon beams by Monte Carlo simulations.

PURPOSE: To investigate the response of plastic scintillation detectors (PSDs) in a 6 MV photon beam of various field sizes using Monte Carlo simulations. METHODS: Three PSDs were simulated: A BC-400 and a BCF-12, each attached to a plastic-core optical fiber, and a BC-400 attached to an air-core optical fiber. PSD response was calculated as the detector dose per unit water dose for field sizes ranging from 10 x 10 down to 0.5 x 0.5 cm2 for both perpendicular and parallel orientations of the detectors to an incident beam. Similar calculations were performed for a CC01 compact chamber. The off-axis dose profiles were calculated in the 0.5 x 0.5 cm2 photon beam and were compared to the dose profile calculated for the CC01 chamber and that calculated in water without any detector. The angular dependence of the PSDs' responses in a small photon beam was studied. RESULTS: In the perpendicular orientation, the response of the BCF-12 PSD varied by only 0.5% as the field size decreased from 10 x 10 to 0.5 x 0.5 cm2, while the response of BC-400 PSD attached to a plastic-core fiber varied by more than 3% at the smallest field size because of its longer sensitive region. In the parallel orientation, the response of both PSDs attached to a plastic-core fiber varied by less than 0.4% for the same range of field sizes. For the PSD attached to an air-core fiber, the response varied, at most, by 2% for both orientations. CONCLUSIONS: The responses of all the PSDs investigated in this work can have a variation of only 1%-2% irrespective of field size and orientation of the detector if the length of the sensitive region is not more than 2 mm long and the optical fiber stems are prevented from pointing directly to the incident source.