A proton therapy system in Nagoya Proton Therapy Center.

The purpose of this paper is to describe an outline of a proton therapy system in Nagoya Proton Therapy Center (NPTC). The NPTC has a synchrotron with a linac injector and three treatment rooms: two rooms are equipped with a gantry and the other one is equipped with a fixed horizontal beamline. One gantry treatment room has a pencil beam scanning treatment delivery nozzle. The other two treatment rooms have a passive scattering treatment delivery nozzle. In the scanning treatment delivery nozzle, an energy absorber and an aperture system to treat head and neck cancer have been equipped. In the passive treatment delivery nozzle, a multi-leaf collimator is equipped. We employ respiratory gating to treat lung and liver cancers for passive irradiation. The proton therapy system passed all acceptance tests. The first patient was treated on February 25, 2013, using passive scattering fixed beams. Respiratory gating is commonly used to treat lung and liver cancers in the passive scattering system. The MLCs are our first choice to limit the irradiation field. The use of the aperture for scanning irradiation reduced the lateral fall off by half or less. The energy absorber and aperture system in scanning delivery is beneficial to treat head and neck cancer.

A patient-specific aperture system with an energy absorber for spot scanning proton beams: Verification for clinical application.

PURPOSE: In the authors' proton therapy system, the patient-specific aperture can be attached to the nozzle of spot scanning beams to shape an irradiation field and reduce lateral fall-off. The authors herein verified this system for clinical application. METHODS: The authors prepared four types of patient-specific aperture systems equipped with an energy absorber to irradiate shallow regions less than 4 g/cm(2). The aperture was made of 3-cm-thick brass and the maximum water equivalent penetration to be used with this system was estimated to be 15 g/cm(2). The authors measured in-air lateral profiles at the isocenter plane and integral depth doses with the energy absorber. All input data were obtained by the Monte Carlo calculation, and its parameters were tuned to reproduce measurements. The fluence of single spots in water was modeled as a triple Gaussian function and the dose distribution was calculated using a fluence dose model. The authors compared in-air and in-water lateral profiles and depth doses between calculations and measurements for various apertures of square, half, and U-shaped fields. The absolute doses and dose distributions with the aperture were then validated by patient-specific quality assurance. Measured data were obtained by various chambers and a 2D ion chamber detector array. RESULTS: The patient-specific aperture reduced the penumbra from 30% to 70%, for example, from 34.0 to 23.6 mm and 18.8 to 5.6 mm. The calculated field width for square-shaped apertures agreed with measurements within 1 mm. Regarding patient-specific aperture plans, calculated and measured doses agreed within -0.06% ± 0.63% (mean ± SD) and 97.1% points passed the 2%-dose/2 mm-distance criteria of the γ-index on average. CONCLUSIONS: The patient-specific aperture system improved dose distributions, particularly in shallow-region plans.

[Analysis of radioactivation induced by high-energy X-rays in medical linear accelerators -estimation of short-lived radioactivated nuclides-].

In medical linear accelerators, radioactivation is induced on the target and neighborhood parts by photoneutrons accompanying a photo-nuclear reaction and leading to higher acceleration energy. We measured the residual radiation from the radioactivated materials according to the time, and tried to identify radioactivated nuclides and their relative quantities by means of measurement results. It was presumed that the main source of residual radiations was the Target, Flattening filter and Primary collimator in the linac head. Among those materials (copper, tungsten), we calculated decrement curves of residual radiations from radioactivated nuclides generated with photo-nuclear reaction or thermal neutron capture reaction by various ratios, and we investigated the ratio that best fit the measured data. Consequently, it was presumed that (66)Cu generated with thermal neutron capture reaction contributed the most to residual radiation, followed by (62)Cu generated with photo-nuclear reaction contributed. It is important to understand various characteristics of these nuclides and to undertake management of the device.

[Analysis of photonuclear activation effect of high-energy medical linear accelerators--measurement of spatial dose distribution and temporal decay curve, and assessment of personnel dosimetry].

The characteristics of activation after high-energy X-rays have been generated by medical linear accelerators were measured using an ionization chamber. Radiation doses increased with rising X-ray energy, based on 10 MV, 15 MV, and 18 MVX-ray measurements. When the total irradiation dose was changed, radiation dose increased with total irradiation dose. When the collimator opened, the radiation dose at a position 15 cm from the isocenter reached about the maximum, which was 2.2 times the dose at the isocenter. The radiation dose became about 0.3 times its level at a position 40 cm from the isocenter, in the outer irradiation field. The dose distribution in the treatment room became almost the same dose extending from the isocenter to 200 cm. Radiation dose decreased gradually while moving away from the target on the treatment beam axis. But it increased again as it approached the floor face. The occupational exposure dose, which was presumed from measurements of the radiation dose 50 cm from the isocenter, was about 0.9 mSv during a year, assuming 600 MU for 1 person, 8 people a day, and 245 days a year. Radiation dose changed with X-ray energy in the machine used, and it was a geometrical constituent in the treatment room. It is important to understand the characteristics of radiation generated by medical linear accelerators.