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.

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 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.

Spectroscopic study of prompt-gamma emission for range verification in proton therapy.

We present the results of an investigation of the prompt-gamma emission from an interaction of a proton beam with phantom materials. Measurements were conducted with a novel setup allowing the precise selection of the investigated depth in the phantom, featuring three different materials composed of carbon, oxygen and hydrogen. We studied two beam energies of 70.54 and 130.87MeV and two detection angles: 90° and 120°. The results are presented in form of profiles of the prompt-gamma yield as a function of depth. In the analysis we focused on the transitions with the largest cross sections: 12C4.44→g.s. and 16O6.13→g.s.. We compare the profiles obtained under various irradiation conditions, with emphasis on the shape of the distal fall-off. The results are also compared to calculations including different cross-section models. They are in agreement with the model exploiting published cross-section data, but the comparison with the Talys model shows discrepancies.