Dataset for predicting single-spot proton ranges in proton therapy of prostate cancer.

The number of radiotherapy patients treated with protons has increased from less than 60,000 in 2007 to more than 220,000 in 2019. However, the considerable uncertainty in the positioning of the Bragg peak deeper in the patient raised new challenges in the proton therapy of prostate cancer (PCPT). Here, we describe and share a dataset where 43 single-spot anterior beams with defined proton energies were delivered to a prostate phantom with an inserted endorectal balloon (ERB) filled either with water only or with a silicon-water mixture. The nuclear reactions between the protons and the silicon yield a distinct prompt gamma energy line of 1.78 MeV. Such energy peak could be identified by means of prompt gamma spectroscopy (PGS) for the protons hitting the ERB with a three-sigma threshold. The application of a background-suppression technique showed an increased rejection capability for protons hitting the prostate and the ERB with water only. We describe each dataset, document the full processing chain, and provide the scripts for the statistical analysis.

Towards real-time PGS range monitoring in proton therapy of prostate cancer.

Proton therapy of prostate cancer (PCPT) was linked with increased levels of gastrointestinal toxicity in its early use compared to intensity-modulated radiation therapy (IMRT). The higher radiation dose to the rectum by proton beams is mainly due to anatomical variations. Here, we demonstrate an approach to monitor rectal radiation exposure in PCPT based on prompt gamma spectroscopy (PGS). Endorectal balloons (ERBs) are used to stabilize prostate movement during radiotherapy. These ERBs are usually filled with water. However, other water solutions containing elements with higher atomic numbers, such as silicon, may enable the use of PGS to monitor the radiation exposure of the rectum. Protons hitting silicon atoms emit prompt gamma rays with a specific energy of 1.78 MeV, which can be used to monitor whether the ERB is being hit. In a binary approach, we search the silicon energy peaks for every irradiated prostate region. We demonstrate this technique for both single-spot irradiation and real treatment plans. Real-time feedback based on the ERB being hit column-wise is feasible and would allow clinicians to decide whether to adapt or continue treatment. This technique may be extended to other cancer types and organs at risk, such as the oesophagus.

PIBS: Proton and ion beam spectroscopy for in vivo measurements of oxygen, carbon, and calcium concentrations in the human body.

Proton and ion beam therapy has proven to benefit tumour control with lower side-effects, mostly in paediatrics. Here we demonstrate a feasible technique for proton and ion beam spectroscopy (PIBS) capable of determining the elemental compositions of the irradiated tissues during particle therapy. This follows the developments in prompt gamma imaging for online range verification and the inheritance from prompt gamma neutron activation analysis. Samples of water solutions were prepared to emulate varying oxygen and carbon concentrations. The irradiation of those samples and other tissue surrogate inserts by protons and ion beams under clinical conditions clearly showed a logarithmic relationship between the target elemental composition and the prompt gamma production. This finding is in line with the known logarithmic dependence of the pH with the proton molar concentration. Elemental concentration changes of 1% for calcium and 2% for oxygen in adipose, brain, breast, liver, muscle and bone-related tissue surrogates were clearly identified. Real-time in vivo measurements of oxygen, carbon and calcium concentrations will be evaluated in a pre-clinical and clinical environment. This technique should have an important impact in the assessment of tumour hypoxia over the course of several treatment fractions and the tracking of calcifications in brain metastases.

Prompt gamma spectroscopy for absolute range verification of 12C ions at synchrotron-based facilities.

The physical range uncertainty limits the exploitation of the full potential of charged particle therapy. In this work, we face this issue aiming to measure the absolute Bragg peak position in the target. We investigate p, 4He, 12C and 16O beams accelerated at the Heidelberg Ion-Beam Therapy Center. The residual range of the primary 12C ions is correlated to the energy spectrum of the prompt gamma radiation. The prompt gamma spectroscopy method was demonstrated for proton beams accelerated by cyclotrons and is developed here for the first time for heavier ions accelerated by a synchrotron. We develop a detector system that includes (i) a spectroscopic unit based on cerium(III) bromide and bismuth germanium oxide scintillating crystals, (ii) a beam trigger based on an array of scintillating fibers and (iii) a data acquisition system based on a FlashADC. We test the system in two different scenarios. In the first series of experiments, we detect and identify 19 independent spectral lines over a wide gamma energy spectrum in the presence of the four ion species for different targets, including a water target with a titanium insert. In the second series of experiments, we introduce a collimator aiming to relate the spectral information to the range of the primary particles. We perform extensive measurements for a 12C beam and demonstrate submillimetric precision for the measurement of its Bragg peak position in the experimental setup. The features of the energy and time spectra for gamma radiation induced by p, 4He and 16O are investigated upstream and downstream from the Bragg peak position. We conclude the analysis by extrapolating the required future developments, which would be needed to achieve range verification with a 2 mm accuracy during a single fraction delivery of [Formula: see text] physical dose.

Results from the experimental evaluation of CeBr 3 scintillators for 4 He prompt gamma spectroscopy.

PURPOSE: The presence of range uncertainties hinders the exploitation of the full potential of charged particle therapy. Several range verification techniques have been proposed to mitigate this limitation. Prompt gamma spectroscopy (PGS) is among the most promising solutions for online and in vivo range verification. In this work, we present the experimental results of the detection of prompt gamma radiation, induced by 4 He beams at the Heidelberg Ion-Beam Therapy Center (HIT). The results were obtained, using a spectroscopic unit of which the design has been optimized using Monte Carlo simulations. METHODS: The spectroscopic unit is composed by a primary cerium bromide (CeBr 3 ) crystal surrounded by a secondary bismuth germanate (BGO) crystal for anticoincidence detection (AC). The digitalization of the signals is performed with an advanced FADC/FPGA system. The 4 He beams at clinical energies and intensities are delivered to multiple targets in the experimental cave at the HIT. We analyze the production of prompt gamma on oxygen and carbon targets, as well as high Z materials such as titanium and aluminum. The quantitative analysis includes a systematic comparison of the signal-to-noise ratio (SNR) improvement for the spectral lines when introducing the AC detection. Moreover, the SNR improvement could provide a reduction of the number of events required to draw robust conclusions. We perform a statistic analysis to determine the magnitude of such an effect. RESULTS: We present the energy spectra detected by the primary CeBr 3 and the secondary BGO. The combination of these two detectors leads to an average increase of the signal-to-noise ratio by a factor 2.1, which confirms the Monte Carlo predictions. The spectroscopic unit is capable of detecting efficiently the discrete gamma emission over the full energy spectrum. We identify and analyze 19 independent spectral lines in an energy range spacing from E γ = 0.718  MeV to E γ = 6.13  MeV. Moreover, when introducing the AC detection, the number of events required to determine robustly the intensity of the discrete lines decreases. Finally, the analysis of the low-energy reaction lines determines whether a thin metal insert is introduced in the beam direction. CONCLUSIONS: This work provides the experimental characterization of the spectroscopy unit in development for range verification through PGS at the HIT. Excellent performances have been demonstrated over the full prompt gamma energy spectrum with 4 He beams at clinical energies and intensities.

CeBr3 scintillators for 4 He prompt gamma spectroscopy: Results from a Monte Carlo optimization study.

PURPOSE: Range uncertainties limit the potential of charged particle therapy. In vivo and online range verification techniques could increase the confidence in the dose delivery distribution and lead to more conformal treatments. Prompt gamma imaging and prompt gamma spectroscopy (PGS) have been demonstrated for such a purpose. The successful application of these techniques requires the development of a dedicated detector system optimized to the radiation energy ranges and the intensity. In this work, we investigated a detector system based on CeBr3 crystals capable of performing spectroscopy of the prompt gamma radiation induced by 4 He beams. METHODS: We performed Monte Carlo simulations to optimize the detector system. The study was carried out both with the Geant4 toolkit and the FLUKA package. The simulated system consisted of a primary crystal for spectroscopy and secondary crystals for noise reduction in anticoincidence (AC). For comparison purposes, we considered a configuration without AC crystals. We first defined the dimensions of the primary cerium bromide (CeBr3 ) crystal and the secondary bismuth germanate (BGO) or CeBr3 crystals. We then evaluated their detection performance for monoenergetic gamma radiation up to 7 MeV in such way that the probability of the photo-peak detection was maximized in comparison to the number of escape peak and Compton events. We simulated realistic prompt gamma radiation spectra induced by 4 He beams on homogeneous targets (water, graphite, and aluminum) and on implants (water with an aluminum insert). Finally, we tested the performances of the optimized systems in the detection of the realistic gamma spectra. The quantitative analysis was accomplished by comparing the signal-to-noise ratio between the different configurations and the ability to resolve the discrete reactions. RESULTS: We present the optimized dimensions for the primary CeBr3 crystals with and without AC shielding. The specific values are given over a wide range of crystal volumes. The results show an optimal primary CeBr3 crystal with an approximately diameter to length ratio of 1 without AC shielding and 0.5 with AC shielding. The secondary BGO and CeBr3 should have a transverse dimension of 3 and 4.56 cm, respectively. The analysis of the prompt gamma spectra from 4 He beams highlighted the presence of specific discrete reactions not observed in 1 H studies, for example, 12 C transition 0+ (7.65 MeV) →2+ (4.44 MeV). This reaction is responsible for the generation of the 3.21 MeV prompt gamma peak. The optimized primary crystal provides a significant increase in the signal-to-noise ratio together with an improved resolution of the discrete gamma lines, especially in the high-energy region. The detection configuration with an optimized anticoincidence crystal improved the signal-to-noise ratio up to a factor of 3.5. CONCLUSIONS: This work provides the optimal geometry for primary and secondary crystals to be used in range verification through PGS. The simulations show that such a PGS system may allow for the simultaneous detection of the discrete lines from a thin metal implant within a water phantom.