Design and characterization of a prototype tertiary device for proton beam stereotactic radiosurgery.

Though potentially beneficial, proton beam stereotactic radiosurgery has not been adopted widely secondary to the technical challenge of safely delivering multiple focused beams of proton radiation. In this study, we describe the design and characterization of a proton beam stereotactic radiosurgery system that can be adopted by existing passive scattering systems. This system utilizes a helmet-like device in which patient-specific brass apertures required for final beam collimation are positioned on a scaffold that is separate from the treatment gantry. The proton snout is then fitted with a generic aperture to focus the primary proton beam onto the patient specific apertures that are in the helmet-like device. The patient-specific apertures can all be placed at the start of the treatment, thus treatment with multiple beams can be accomplished without the delay of switching the apertures. In this report we describe a prototype design of this collimation system and dosimetric testing to verify efficacy. Subsequently, we describe a custom 3D printing of a prototype device and report on overall localization accuracy using Winston-Lutz tests. Our results show that it is possible to develop an add-on device for proton beam radiosurgery that is safe and efficient and capable of wide adoption on existing proton delivery systems.

Direct response to proton beam linear energy transfer (LET) in a novel polymer gel dosimeter formulation.

Linear energy transfer (LET) of clinical proton beams is an important parameter influencing the biological effects of radiation. This work demonstrates LET-induced response enhancement in novel formulations of polymer gel dosimeters, potentially useful for LET mapping of clinical proton beams. A series of four polymer gel dosimeters (labeled A through D), prepared based on the BANG3-Pro2 formulation, but with varying concentrations of polymerization modifiers, were irradiated by a clinical proton beam with a spread out Bragg peak modulation (SOBP) and read out using the OCTOPUS-IQ optical CT scanner. The evaluation of optical density profiles in the SOBP (constant physical dose) revealed response deviations at the distal end consistent with variations in gel composition. Maximum response deviations were as follows: -3% (under-response) for gel A, and over-response of 2%, 12%, and 17% for gels B, C, and D, respectively, relative to the mean dose in the center of the SOBP. This enhancement in optical response was correlated to LET by analytical calculations. Gels A and B showed no measurable dependence on LET. Gel C responded linearly in the limited range from 1.5 to 3.5 keV/µm. LET response of gel D was linear up to at least 5.5 keV/µm, with the threshold at about 1.3 keV/µm. These results suggest that it may be possible to develop a polymer gel system with direct optical response to LET for mapping of LET distributions for particle therapy beams.

A spatial resolution study of a new optical tomography-based polymer gel dosimetry system.

A spatial resolution investigation of the OCTOPUSTM-IQ scanner in combination with the new BANG3-Pro2(r) polymer gel was performed by scanning a high-contrast needle phantom. The phantom contained five thin needles (0.3_mm diameter) embedded in gel positioned in different patterns: needles were inserted (a) at 45° angle from the center of the gel container, and (b) vertically along the gel axis. The non-irradiated needle phantoms were scanned at various slice spacings (0.25-1.0_mm) and for two different laser beam orientations. Optical density profiles and their full width at half maximum (FWHM) were evaluated for resolution limit. The modulation transfer function (MTF) corresponding to measured point spread function (PSF) data was calculated. With high resolution scanning mode and 0.25_mm pixel resolution, the measured PSFs at the center of the gel dosimeter have a FWHM of 0.95_mm. The MTF for the 0.25_mm reconstruction pixel size suggests that the resolution of the system is 0.5_mm or less. We also observed a progressive degradation of the vertical needle images with off-axis distance, attributable to the defocusing of the laser beam. No significant degradation was observed up to the maximum useful reconstructed image radius of 50_mm from the gel dosimeter center axis.

Dosimetric evaluation of a novel polymer gel dosimeter for proton therapy.

PURPOSE: The aim of this study is to evaluate the dosimetric performance of a newly developed proton-sensitive polymer gel formulation for proton therapy dosimetry. METHODS: Using passive scattered modulated and nonmodulated proton beams, the dose response of the gel was assessed. A next-generation optical CT scanner is used as the readout mechanism of the radiation-induced absorbance in the gel medium. Comparison of relative dose profiles in the gel to ion chamber profiles in water is performed. A simple and easily reproducible calibration protocol is established for routine gel batch calibrations. Relative stopping power ratio measurement of the gel medium was performed to ensure accurate water-equivalent depth dose scaling. Measured dose distributions in the gel were compared to treatment planning system for benchmark irradiations and quality of agreement is assessed using clinically relevant gamma index criteria. RESULTS: The dosimetric response of the gel was mapped up to 600 cGy using an electron-based calibration technique. Excellent dosimetric agreement is observed between ion chamber data and gel. The most notable result of this work is the fact that this gel has no observed dose quenching in the Bragg peak region. Quantitative dose distribution comparisons to treatment planning system calculations show that most (> 97%) of the gel dose maps pass the 3%/3 mm gamma criterion. CONCLUSIONS: This study shows that the new proton-sensitive gel dosimeter is capable of reproducing ion chamber dose data for modulated and nonmodulated Bragg peak beams with different clinical beam energies. The findings suggest that the gel dosimeter can be used as QA tool for millimeter range verification of proton beam deliveries in the dosimeter medium.

Performance evaluation of an improved optical computed tomography polymer gel dosimeter system for 3D dose verification of static and dynamic phantom deliveries.

The performance of a next-generation optical computed tomography scanner (OCTOPUS-5X) is characterized in the context of three-dimensional gel dosimetry. Large-volume (2.2 L), muscle-equivalent, radiation-sensitive polymer gel dosimeters (BANG-3) were used. Improvements in scanner design leading to shorter acquisition times are discussed. The spatial resolution, detectable absorbance range, and reproducibility are assessed. An efficient method for calibrating gel dosimeters using the depth-dose relationship is applied, with photon- and electron-based deliveries yielding equivalent results. A procedure involving a preirradiation scan was used to reduce the edge artifacts in reconstructed images, thereby increasing the useful cross-sectional area of the dosimeter by nearly a factor of 2. Dose distributions derived from optical density measurements using the calibration coefficient show good agreement with the treatment planning system simulations and radiographic film measurements. The feasibility of use for motion (four-dimensional) dosimetry is demonstrated on an example comparing dose distributions from static and dynamic delivery of a single-field photon plan. The capability to visualize three-dimensional dose distributions is also illustrated.

Evaluation of a diode array for QA measurements on a helical tomotherapy unit.

A helical tomotherapy system is used in our clinic to deliver intensity-modulated radiation therapy (IMRT) treatments. Since this machine is designed to deliver IMRT treatments, the traditional field flatness requirements are no longer applicable. This allows the unit to operate without a field flatness filter and consequently the 400 mm wide fan beam is highly inhomogeneous in intensity. The shape of this beam profile is mapped during machine commissioning and for quality assurance purposes the shape of the beam profile needs to be monitored. The use of a commercial diode array for quality assurance measurements is investigated. Central axis beam profiles were acquired at different depths using solid water built-up material. These profiles were compared with ion chamber scans taken in a water tank to test the accuracy of the diode array measurements. The sensitivity of the diode array to variations in the beam profile was checked. Over a seven week period, beam profiles were repeatedly measured. The observed variations are compared with those observed with an on-board beam profile monitor. The diode measurements were in agreement with the ion chamber scans. In the high dose, low gradient region the average ratio between the diode and ion chamber readings was 1.000 +/- 0.005 (+/- 1 standard deviation). In the penumbra region the agreement was poorer but all diodes passed the distance to agreement (DTA) requirement of 2 mm. The trend in the beam profile variations that was measured with the diode array device was in agreement with the on-board monitor. While the calculated amount of variation differs between the devices, both were sensitive to subtle variations in the beam profile. The diode array is a valuable tool to quickly and accurately monitor the beam profile on a helical tomotherapy unit.