A high-resolution large-area detector for quality assurance in radiotherapy.

Hadron therapy is an advanced radiation modality for treating cancer, which currently uses protons and carbon ions. Hadrons allow for a highly conformal dose distribution to the tumour, minimising the detrimental side-effects due to radiation received by healthy tissues. Treatment with hadrons requires sub-millimetre spatial resolution and high dosimetric accuracy. This paper discusses the design, fabrication and performance tests of a detector based on Gas Electron Multipliers (GEM) coupled to a matrix of thin-film transistors (TFT), with an active area of 60 × 80 mm2 and 200 ppi resolution. The experimental results show that this novel detector is able to detect low-energy (40 kVp X-rays), high-energy (6 MeV) photons used in conventional radiation therapy and protons and carbon ions of clinical energies used in hadron therapy. The GEM-TFT is a compact, fully scalable, radiation-hard detector that measures secondary electrons produced by the GEMs with sub-millimetre spatial resolution and a linear response for proton currents from 18 pA to 0.7 nA. Correcting known detector defects may aid in future studies on dose uniformity, LET dependence, and different gas mixture evaluation, improving the accuracy of QA in radiotherapy.

Comparison between CLYC-6 and 3He for thermal neutron detection.

A Cs2LiYCl6:Ce crystal, enriched in 6Li to > 95% (CLYC-6), was investigated for thermal neutron detection: it was characterised in terms of intrinsic efficiency and γ-ray discrimination capability and compared with a 3He counter (partial 3He pressure 2.3 atm). The intrinsic efficiency was determined by irradiating the detectors with thermal neutrons. The γ-ray discrimination capability was evaluated in a mixed neutron/137Cs field. The intrinsic efficiency per unit volume is about a factor of 6.45 larger for CLYC-6 than for the 3He counter. The detectors' performances in the presence of an intense γ-ray background are comparable: up to γ-ray fluence rates of the order of 105 cm-2·s-1, both detectors correctly reject γ-rays. At fluence rates of the order of 106 cm-2·s-1, CLYC-6 starts being affected by count losses due to γ-ray-induced dead time, while the 3He counter starts suffering from pile-up. Above this γ-ray intensity, both detectors are not reliable.

EURADOS REM-COUNTER INTERCOMPARISON AT MAASTRO PROTON THERAPY CENTRE: COMPARISON WITH LITERATURE DATA.

The Maastro Proton Therapy Centre is the first European facility housing the Mevion S250i Hyperscan synchrocyclotron. The proximity of the accelerator to the patient, the presence of an active pencil beam delivery system downstream of a passive energy degrader and the pulsed structure of the beam make the Mevion stray neutron field unique amongst proton therapy facilities. This paper reviews the results of a rem-counter intercomparison experiment promoted by the European Radiation Dosimetry Group at Maastro and compares them with those at other proton therapy facilities. The Maastro neutron H*(10) in the room (100-200 µSv/Gy at about 2 m from the isocentre) is in line with accelerators using purely passive or wobbling beam delivery modalities, even though Maastro shows a dose gradient peaked near the accelerator. Unlike synchrotron- and cyclotron-based facilities, the pulsed beam at Maastro requires the employment of rem-counters specifically designed to withstand pulsed neutron fields.

Joint EURADOS WG9-WG11 rem-counter intercomparison in a Mevion S250i proton therapy facility with Hyperscan pulsed synchrocyclotron.

Objective Proton therapy is gaining popularity because of the improved dose delivery over conventional radiation therapy. The secondary dose to healthy tissues is dominated by secondary neutrons. Commercial rem-counters are valuable instruments for the on-line assessment of neutron ambient dose equivalent (H*(10)). In general, however, a priori knowledge of the type of facility and of the radiation field is required for the proper choice of any survey meter. The novel Mevion S250i Hyperscan synchrocyclotron mounts the accelerator directly on the gantry. It provides a scanned 227 MeV proton beam, delivered in pulses with a pulse width of 10 µs at 750 Hz frequency, which is afterwards degraded in energy by a range shifter modulator system. This environment is particularly challenging for commercial rem-counters; therefore, we tested the reliability of some of the most widespread rem-counters to understand their limits in the Mevion S250i stray neutron field. Approach This work, promoted by the European Radiation Dosimetry Group (EURADOS), describes a rem-counter intercomparison at the Maastro Proton Therapy centre in the Netherlands, which houses the novel Mevion S250i Hyperscan system. Several rem-counters were employed in the intercomparison (LUPIN, LINUS, WENDI-II, LB6411, NM2B-458, NM2B-495Pb), which included simulation of a patient treatment protocol employing a water tank phantom. The outcomes of the experiment were compared with models and data from the literature. Main results We found that only the LUPIN allowed for a correct assessment of H*(10) within a 20% uncertainty. All other rem-counters underestimated the reference H*(10) by factors from 2 to more than 10, depending on the detector model and on the neutron dose per pulse. In pulsed fields, the neutron dose per pulse is a fundamental parameter, while the average neutron dose rate is a secondary quantity. An average 150-200 µSv/GyRBE neutron H*(10) at various positions around the phantom and at distances between 186 cm and 300 cm from it was measured per unit therapeutic dose delivered to the target. Significance Our results are partially in line with results obtained at similar Mevion facilities employing passive energy modulation. Comparisons with facilities employing active energy modulation confirmed that the neutron H*(10) can increase up to more than a factor of 10 when passive energy modulation is employed. The challenging environment of the Mevion stray neutron field requires the use of specific rem-counters sensitive to high-energy neutrons (up to a few hundred MeV) and specifically designed to withstand pulsed neutron fields.

A thermal neutron source for the CERN radiation Calibration Laboratory.

This work presents the design, construction and experimental characterisation of a lightweight and low-cost thermal neutron assembly, to be used with the existing Am-Be source irradiator of CERN radiation Calibration Laboratory (Cal Lab). The assembly consists of a cylindrical moderator (18 cm diameter, 25.5 cm height and 5.5 kg weight) and an optional reflector box (5 cm thick walls, 20 kg weight). The moderator is tailored to fit on the Am-Be source in its irradiation position, while the box encloses the detector under test during the irradiation. The exposure volume delimited by the box is 30 × 30 × 30 cm3. The thermal neutron fluence at the exposure location, i.e., 30 cm from the source, was optimized by FLUKA Monte Carlo (MC) simulations. The simulations were validated with measurements performed with a bare 3He proportional counter. The thermal neutron fluence at the nominal irradiation position is 7.43 × 102 cm-2s-1 with the cylindrical moderator only, and 5.75 × 103 cm-2s-1 with the cylinder and the reflector box, with the detector placed at the centre of the box. The thermal neutron fluence inside the box is rather uniform (variation <5%).

A GEMPix-based integrated system for measurements of 3D dose distributions in water for carbon ion scanning beam radiotherapy.

PURPOSE: Commercially available systems for ion beam reference dosimetry in water are mainly based on ionization chambers. In those systems, a large number of small detectors are typically arranged in a two-dimensional (2D) array or matrix to achieve high spatial resolution (order of several millimeters) and large field coverage at the same time. The goal of this work was to investigate the reliability of a detector of superior spatial resolution to perform three-dimensional (3D) ionization measurements in carbon ion pencil beams. METHODS: The GEMPix is a small gaseous detector with a highly pixelated readout, consisting of a drift region (with 2.8 cm3  × 2.8 cm3  × 0.3 cm3 volume), three gas electron multipliers (GEMs) for signal amplification and four Timepix ASICs with 55 µm pixel pitch and a total of 262,144 pixels. An integrated system was designed and built, which consists of a commercial water phantom with a three-axis motorized arm, a reference large-area ionization chamber for signal normalization to the beam output and the GEMPix itself. Measurements at different depths in water have been performed at the Italian National Centre for Oncological Hadrontherapy (CNAO) with three carbon ion beam energies. Lateral beam profiles measured with the GEMPix at the shallowest depth were compared to those measured with radiochromic EBT3 films in air in the position of the reference ionization chamber. The Timepix readout was calibrated in energy by using one independent depth scan with carbon ions of 150 mm range. Bragg peak curves were also simulated using the Monte Carlo FLUKA code as a reference. RESULTS: Beam profiles measured with the GEMPix were smooth and showed similar shape and full width at half maximum when compared to those measured with radiochromic EBT3 films. Smooth, reproducible Bragg curves were obtained with statistical uncertainties of about 2%, matching FLUKA simulations of the Bragg curves within 15% for most data points. This difference is partially explained for the measurement with carbon ions of 150 mm range by a saturation effect in the GEMs. The high granularity of the readout allowed to produce 2D images of the deposited dose at different depths, as well as 3D data distributions. CONCLUSIONS: This paper demonstrates the capability of the GEMPix detector to measure the 3D dose distribution of carbon ions in water for a clinical pencil beam reliably. In the future, the detector area will be increased to cover fields of scanned beams. Measurements at higher beam intensities and with protons are planned.

Impact of the newly proposed ICRU/ICRP quantities on neutron calibration fields and extended range neutron rem-counters.

In July 2017, the International Commission on Radiation Units and Measurements (ICRU) and the International Commission on Radiological Protection (ICRP) proposed the introduction of new operational quantities for external radiation exposure, with the aim of improving coherence between protection quantities and operational quantities within the system of radiological protection. A change in operational quantities will impact both instrumentation and reference radiation fields used for their calibration. This paper evaluates the potential impact of the new quantity ambient dose, H*, meant to replace ambient dose equivalent, H*(10), on two neutron reference fields, the Am-Be source and the CERF high-energy workplace field, and on the response of two models of extended-range neutron rem counters (LINUS and LUPIN). The conclusions are that calibration procedures should in general not be affected and that changes should only be expected in calibration coefficients. Considering the acceptable measurement uncertainties for operational radiation protection, for the extended-range rem counters changes in their design would not be required for measurements outside particle accelerators shielding and for aircrew dosimetry. One can expect that this type of instrument can still be calibrated with Am-Be source neutrons and employed in neutron fields with energy distributions spanning several decades. For uses in radiation fields with very peculiar neutron energy distribution, a specific workplace field calibration may instead be required.

CERN IRRADIATION FACILITIES.

CERN provides unique irradiation facilities for applications in dosimetry, metrology, intercomparison of radiation protection devices, benchmark of Monte Carlo codes and radiation damage studies to electronics.

New radiation protection calibration facility at CERN.

The CERN radiation protection group has designed a new state-of-the-art calibration laboratory to replace the present facility, which is >20 y old. The new laboratory, presently under construction, will be equipped with neutron and gamma sources, as well as an X-ray generator and a beta irradiator. The present work describes the project to design the facility, including the facility placement criteria, the 'point-zero' measurements and the shielding study performed via FLUKA Monte Carlo simulations.

Instrument intercomparison in the high-energy mixed field at the CERN-EU reference field (CERF) facility.

This paper discusses an intercomparison campaign performed in the mixed radiation field at the CERN-EU (CERF) reference field facility. Various instruments were employed: conventional and extended-range rem counters including a novel instrument called LUPIN, a bubble detector using an active counting system (ABC 1260) and two tissue-equivalent proportional counters (TEPCs). The results show that the extended range instruments agree well within their uncertainties and within 1σ with the H*(10) FLUKA value. The conventional rem counters are in good agreement within their uncertainties and underestimate H*(10) as measured by the extended range instruments and as predicted by FLUKA. The TEPCs slightly overestimate the FLUKA value but they are anyhow consistent with it when taking the comparatively large total uncertainties into account, and indicate that the non-neutron part of the stray field accounts for ∼30 % of the total H*(10).

Comparison of the performance of different instruments in the stray neutron field around the CERN Proton Synchrotron.

This paper discusses an intercomparison campaign carried out in several locations around the CERN Proton Synchrotron. The locations were selected in order to perform the measurements in different stray field conditions. Various neutron detectors were employed: ionisation chambers, conventional and extended range rem counters, both commercial and prototype ones, including a novel instrument called LUPIN, specifically conceived to work in pulsed fields. The attention was focused on the potential differences in the instrument readings due to dead-time losses that are expected to affect most commercial units. The results show that the ionisation chambers and LUPIN agree well with the expected H*(10) values, as derived from FLUKA simulations, showing no relevant underestimations even in strongly pulsed fields. On the contrary, the dead-time losses of the other rem counters induced an underestimation in pulsed fields that was more important for instruments characterised by a higher dead time.

Applications of particle accelerators in medicine.

There are nearly 20,000 particle accelerators in operation worldwide, about half of them employed for biomedical uses. This paper focuses on some recent advances in the two main medical domains where accelerators find their use, radionuclide production and radiation therapy. The paper first discusses the use of high-energy electron and proton accelerators for the potential, future production of (99)Mo, which is presently provided by fission reactors. Next, it reviews the rationale for the use of protons and carbon ions in cancer therapy, discussing the requirements imposed on accelerator technology and looking at some recent developments.

Shielding of proton accelerators.

This paper discusses some of the methods that can be employed for calculating shielding of proton accelerators, showing that a simple analytical model is often useful for a first estimate before going into complex Monte Carlo simulations. In particular what we call the Monte Carlo 'hybrid' approach, which employs source terms and attenuation length data calculated by Monte Carlo simulations under generic geometrical conditions, with a point-source line-of-sight model is discussed. Examples are given of the application of this method to the shielding calculations of two versions of the CERN SPL (2- and 3.5-GeV energy), comparing its results with Monte Carlo simulations of the full geometry.

Instrument response in complex radiation fields.

This paper aims at giving an overview of the main issues for estimating the radiation protection quantities in complex radiation fields. The measurability (or non-measurability) of the radiation protection quantities is discussed together with the main approaches for their estimate. The main mechanisms through which the various components of complex radiation fields are generated are also outlined. The main instruments employed for estimating the radiation protection quantities are described and discussed together with their response. Finally, a practical example is given, by discussing the results of an inter-comparison exercise held at the Gesellschaft für Schwerionenforschung mbH in Darmstadt (Germany) in the framework of the COordinated Network for RAdiation Dosimetry project, funded by the European Commission.

Further progress in the characterisation of complex radiation fields.

One of the topics which forms part of CONRAD project addresses the problems related to the dosimetry of complex-mixed radiation fields at workplaces. This topic was included in work package (WP) 6. WP 6 was established to co-ordinate research activities in two areas:the development of new techniques and the improvement of current techniques for characterisation of complex workplace fields (including high-energy fields and pulsed fields): measurement and calculation of particle energy and direction distributions (Subgroup A); and model improvements for dose assessment of solar particle events (Subgroup B). In both cases in order to aid the research, WP 6 increases the efficiency of resource utilisation, and facilitates the technology transfer to practical application and for the development of standards. This contribution presents a general overview of activities of SG A; specific results related to the benchmark experiment at GSI Darmstadt are presented separately, and will be published in other way. As far as the results acquired in the frame of the SG B activities, these are presented in the meeting held as part of EURADOS AM 2008.

Workplace characterisation in mixed neutron-gamma fields, specific requirements and available methods at high-energy accelerators.

A good knowledge of the radiation field present outside the shielding of high-energy particle accelerators is very important to be able to select the type of detectors (active and/or passive) to be employed for area monitoring and the type of personal dosemeter required for estimating the doses received by individuals. Around high-energy electron and proton accelerators the radiation field is usually dominated by neutrons and photons, with minor contributions from other charged particles. Under certain circumstances, muon radiation in the forward beam direction may also be present. Neutron dosimetry and spectrometry are of primary importance to characterise the radiation field and thus to correctly evaluate personnel exposure. Starting from the beam parameters important for radiation monitoring, the paper first briefly reviews the stray radiation fields encountered around high-energy accelerators and then addresses the relevant techniques employed for their monitoring. Recent developments to increase the response of neutron measuring devices beyond 10-20 MeV are illustrated. Instruments should be correctly calibrated either in reference monoenergetic radiation fields or in a field similar to the field in which they are used (workplace calibration). The importance of the instrument calibration is discussed and available neutron calibration facilities are briefly reviewed.

Shielding design for the front end of the CERN SPL.

CERN is designing a 2.2-GeV Superconducting Proton Linac (SPL) with a beam power of 4 MW, to be used for the production of a neutrino superbeam. The SPL front end will initially accelerate 2 x 10(14) negative hydrogen ions per second up to an energy of 120 MeV. The FLUKA Monte Carlo code was employed for shielding design. The proposed shielding is a combined iron-concrete structure, which also takes into consideration the required RF wave-guide ducts and access labyrinths to the machine. Two beam-loss scenarios were investigated: (1) constant beam loss of 1 Wm(-1) over the whole accelerator length and (2) full beam loss occurring at various locations. A comparison with results based on simplified approaches is also presented.

Measurements of radiation fields around high-energy proton accelerators.

Monitoring of ionising radiation around high-energy particle accelerators is a difficult task due to the complexity of the radiation field, which is made up of neutrons, charged hadrons, muons, photons and electrons, with energy spectra extending over a wide energy range. The dose-equivalent outside a thick shield is mainly owing to neutrons, with some contribution from photons and, to a minor extent, the other particles. Neutron dosimetry and spectrometry are thus of primary importance to correctly evaluate the exposure of personnel. This paper reviews the relevant techniques and instrumentation employed for monitoring radiation fields around high-energy proton accelerators, with particular emphasis on the recent development to increase the response of neutron measuring devices > 20 MeV. Rem-counters, pressurised ionisation chambers, superheated emulsions, tissue-equivalent proportional counters and Bonner sphere spectrometers are discussed.