Investigating particle track topology for range telescopes in particle radiography using convolutional neural networks.

BACKGROUND: Proton computed tomography (pCT) and radiography (pRad) are proposed modalities for improved treatment plan accuracy and in situ treatment validation in proton therapy. The pCT system of the Bergen pCT collaboration is able to handle very high particle intensities by means of track reconstruction. However, incorrectly reconstructed and secondary tracks degrade the image quality. We have investigated whether a convolutional neural network (CNN)-based filter is able to improve the image quality. MATERIAL AND METHODS: The CNN was trained by simulation and reconstruction of tens of millions of proton and helium tracks. The CNN filter was then compared to simple energy loss threshold methods using the Area Under the Receiver Operating Characteristics curve (AUROC), and by comparing the image quality and Water Equivalent Path Length (WEPL) error of proton and helium radiographs filtered with the same methods. RESULTS: The CNN method led to a considerable improvement of the AUROC, from 74.3% to 97.5% with protons and from 94.2% to 99.5% with helium. The CNN filtering reduced the WEPL error in the helium radiograph from 1.03 mm to 0.93 mm while no improvement was seen in the CNN filtered pRads. CONCLUSION: The CNN improved the filtering of proton and helium tracks. Only in the helium radiograph did this lead to improved image quality.

Design optimization of a pixel-based range telescope for proton computed tomography.

PURPOSE: A pixel-based range telescope for tracking particles during proton imaging is described. The detector applies a 3D matrix of stacked Monolithic Active Pixel Sensors with fast readout speeds. This study evaluates different design alternatives of the range telescope on basis of the protons' range accuracy and the track reconstruction efficiency. METHOD: Detector designs with different thicknesses of the energy-absorbing plates between each sensor layer are simulated using the GATE/Geant4 Monte Carlo software. Proton tracks traversing the detector layers are individually reconstructed, and a Bragg curve fitting procedure is applied for the calculation of each proton's range. RESULTS: Simulations show that the setups with 4 mm and thinner absorber layers of aluminum have a low range uncertainty compared to the physical range straggling, systematic errors below 0.3 mm water equivalent thickness and a track reconstruction capability exceeding ten million protons per second. CONCLUSIONS: In order to restrict the total number of layers and to yield the required tracking and range resolution properties, a design recommendation is reached where the proposed range telescope applies 3.5 mm thick aluminum absorber slabs between each sensor layer.

Estimated risk of radiation-induced cancer following paediatric cranio-spinal irradiation with electron, photon and proton therapy.

BACKGROUND: Improvement in radiotherapy during the past decades has made the risk of developing a radiation-induced secondary cancer as a result of dose to normal tissue a highly relevant survivorship issue. Important factors expected to influence secondary cancer risk include dose level and dose heterogeneity, as well as gender and type of tissue irradiated. The elevated radio-sensitivity in children calls for models particularly tailored to paediatric cancer patients. MATERIAL AND METHODS: Treatment plans of six paediatric medulloblastoma patients were analysed with respect to secondary cancer risk following cranio-spinal irradiation (CSI), using either: 1) electrons and photons combined; 2) conformal photons; 3) double-scattering (DS) protons; or 4) intensity-modulated proton therapy (IMPT). The relative organ equivalent dose (OED) concept was applied in three dose-risk scenarios: a linear response model, a plateau response and an organ specific linear-exponential response. Life attributable risk (LAR) was calculated based on the BEIR VII committee's preferred models for estimating age- and site-specific solid cancer incidence. Uncertainties in the model input parameters were evaluated by error propagation using a Monte Carlo sampling procedure. RESULTS: Both DS protons and IMPT achieved a significantly better dose conformity compared to the photon and electron irradiation techniques resulting in a six times lower overall risk of radiation-induced cancer. Secondary cancer risk in the thyroid and lungs contributed most to the overall risk in all compared modalities, while no significant difference was observed for the bones. Variations between DS protons and IMPT were small, as were differences between electrons and photons. CONCLUSION: Regardless of technique, using protons decreases the estimated risk of secondary cancer following paediatric CSI compared to conventional photon and electron techniques. Substantial uncertainties in the LAR estimates support relative risk comparisons by OED.

Intensity-modulated radiotherapy of pelvic lymph nodes in locally advanced prostate cancer: planning procedures and early experiences.

PURPOSE: We present planning and early clinical outcomes of a study of intensity-modulated radiotherapy (IMRT) for locally advanced prostate cancer. METHODS AND MATERIALS: A total of 43 patients initially treated with an IMRT plan delivering 50 Gy to the prostate, seminal vesicles, and pelvic lymph nodes, followed by a conformal radiotherapy (CRT) plan delivering 20 Gy to the prostate and seminal vesicles, were studied. Dose-volume histogram (DVH) data for the added plans were compared with dose-volume histogram data for the sum of two CRT plans for 15 cases. Gastrointestinal (GI) and genitourinary (GU) toxicity, based on the Radiation Therapy Oncology Group scoring system, was recorded weekly throughout treatment as well as 3 to 18 months after treatment and are presented. RESULTS: Treatment with IMRT both reduced normal tissue doses and increased the minimum target doses. Intestine volumes receiving more than 40 and 50 Gy were significantly reduced (e.g., at 50 Gy, from 81 to 19 cm(3); p = 0.026), as were bladder volumes above 40, 50, and 60 Gy, rectum volumes above 30, 50, and 60 Gy, and hip joint muscle volumes above 20, 30, and 40 Gy. During treatment, Grade 2 GI toxicity was reported by 12 of 43 patients (28%), and Grade 2 to 4 GU toxicity was also observed among 12 patients (28%). With 6 to 18 months of follow-up, 2 patients (5%) experienced Grade 2 GI effects and 7 patients (16%) experienced Grade 2 GU effects. CONCLUSIONS: Use of IMRT for pelvic irradiation in prostate cancer reduces normal tissue doses, improves target coverage, and has a promising toxicity profile.

Relative electron dosimetry using the Scanditronix-Wellhöfer Beam Imaging System-2G.

The Beam Imaging System 2G (BIS-2G) from Scanditronix-Wellhöfer is a two-dimensional (2D) charge-coupled device (CCD)-camera that measures the scintillation light produced by incident radiation. We examined the performance of the BIS-2G as a tool in quality control of patient boluses. In an attempt to simplify the production of the patient boluses, bolus edges were built as staircases and the dose distributions were measured and compared to the dose profiles below corresponding sloped bolus edges. Perspex plates covering half the irradiated field were used as generalized bolus edges. All BIS-2G measurements were performed using buildup of solid water while a diode measured corresponding dose profiles in a water phantom. Below the patient boluses, regions with doses < 95% and > 107% of the prescribed dose were defined. Below the edge, the relative doses measured by the BIS-2G were generally within 3% in dose and 3 mm in position compared to the diode measurements. Close to the field edge below the bolus, the BIS-2G measurements were in some cases as much as 7% lower in dose than the diode measurements. The BIS-2G measurements revealed hotspots below the patient boluses covering 1-16% of the total irradiated area. The highest point dose measured below the patient boluses ranged from 105% to 125% of the prescribed dose. For all bolus thicknesses, each edge in the staircase bolus caused a fluctuation in dose and increased the maximum dose compared to the sloped edge. For several cases, the maximum dose increased with 13% in relative dose, e.g., from 103% to 116%. The BIS-2G was found to be a useful tool in quality control of patient boluses, revealing large hot spots in the treatment volume for several patients. Bolus edges built as staircases cause considerable dose fluctuations and increase the maximum dose, and can therefore not be recommended.

Measurements and treatment planning calculations of electron dose distributions below bolus edges.

Electron dose distributions below bolus edges of various thicknesses and angles were measured using a diode in a water phantom. The measurements were compared with treatment planning calculations using the gamma method. Below 5 mm boluses, the dose variations were acceptable for all angles, while for boluses thicker than 5mm, the lowest edge gave the smallest dose variations. The calculated dose distributions agreed well with the measured dose distributions.