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Clark M, Harms J, Vasyltsiv R, Sloop A, Kozelka J, Simon B, Zhang R, Gladstone D, Bruza P. Quantitative, real-time scintillation imaging for experimental comparison of different dose and dose rate estimations in UHDR proton pencil beams. Med Phys 2024; 51:6402-6411. [PMID: 38860497 DOI: 10.1002/mp.17247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Ultra-high dose rate radiotherapy (UHDR-RT) has demonstrated normal tissue sparing capabilities, termed the FLASH effect; however, available dosimetry tools make it challenging to characterize the UHDR beams with sufficiently high concurrent spatial and temporal resolution. Novel dosimeters are needed for safe clinical implementation and improved understanding of the effect of UHDR-RT. PURPOSE Ultra-fast scintillation imaging has been shown to provide a unique tool for spatio-temporal dosimetry of conventional cyclotron pencil beam scanning (PBS) deliveries, indicating the potential use for characterization of UHDR PBS proton beams. The goal of this work is to introduce this novel concept and demonstrate its capabilities in recording high-resolution dose rate maps at FLASH-capable proton beam currents, as compared to log-based dose rate calculation, internally developed UHDR beam simulation, and a fast point detector (EDGE diode). METHODS The light response of a scintillator sheet located at isocenter and irradiated by PBS proton fields (40-210 nA, 250 MeV) was imaged by an ultra-fast iCMOS camera at 4.5-12 kHz sampling frequency. Camera sensor and image intensifier gain were optimized to maximize the dynamic range; the camera acquisition rate was also varied to evaluate the optimal sampling frequency. Large field delivery enabled flat field acquisition for evaluation of system response homogeneity. Image intensity was calibrated to dose with film and the recorded spatio-temporal data was compared to a PPC05 ion chamber, log-based reconstruction, and EDGE diode. Dose and dose rate linearity studies were performed to evaluate agreement under various beam conditions. Calculation of full-field mean and PBS dose rate maps were calculated to highlight the importance of high resolution, full-field information in UHDR studies. RESULTS Camera response was linear with dose (R2 = 0.997) and current (R22 = 0.98) in the range from 2-22 Gy and 40-210 nA, respectively, when compared to ion chamber readings. The deviation of total irradiation time calculated with the imaging system from the log file recordings decreased from 0.07% to 0.03% when imaging at 12 kfps versus 4.5 kfps. Planned and delivered spot positions agreed within 0.2 ± $\pm$ 0.1 mm and total irradiation time agreed within 0.2 ± $\pm$ 0.2 ms when compared with the log files, indicating the high concurrent spatial and temporal resolution. For all deliveries, the PBS dose rate measured at the diode location agreed between the imaging and the diode within 3% ± $\pm$ 2% and with the simulation within 5% ± $\pm$ 3% CONCLUSIONS: Full-field mapping of dose and dose rate is imperative for complete understanding of UHDR PBS proton dose delivery. The high linearity and various spatiotemporal metric reporting capabilities confirm the continued use of this camera system for UHDR beam characterization, especially for spatially resolved dose rate information.
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Affiliation(s)
- Megan Clark
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, USA
| | - Joseph Harms
- Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Roman Vasyltsiv
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, USA
| | - Austin Sloop
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, USA
| | | | - Bill Simon
- Sun Nuclear Inc., Melbourne, Florida, USA
| | - Rongxiao Zhang
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, USA
| | - David Gladstone
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, USA
| | - Petr Bruza
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, USA
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Oh K, Hyun MA, Gallagher KJ, Yan Y, Zhou S. Characterization of a commercial plastic scintillator for electron FLASH dosimetry. J Appl Clin Med Phys 2024; 25:e14451. [PMID: 38952057 PMCID: PMC11302813 DOI: 10.1002/acm2.14451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 06/12/2024] [Accepted: 06/15/2024] [Indexed: 07/03/2024] Open
Abstract
PURPOSE This study investigated the potential of a commercially available plastic scintillator, the Exradin W2, as a real-time dosimeter for ultra-high-dose-rate (UHDR) electron beams. This work aimed to characterize this system's performance under UHDR conditions and addressed limitations inherent to other conventional dosimetry systems. METHODS AND MATERIALS We assessed the W2's performance as a UHDR electron dosimeter using a 16 MeV UHDR electron beam from the FLASH research extension (FLEX) system. Additionally, the vendor provided a beta firmware upgrade to better handle the processing of the high signal generated in the UHDR environment. We evaluated the W2 regarding dose-per-pulse, pulse repetition rate, charge versus distance, and pulse linearity. Absorbed dose measurements were compared against those from a plane-parallel ionization chamber, optically stimulated luminescent dosimeters and radiochromic film. RESULTS We observed that the 1 × 1 mm W2 scintillator with the MAX SD was more suitable for UHDR dosimetry compared to the 1 × 3 mm W2 scintillator, capable of matching film measurements within 2% accuracy for dose-per-pulse up to 3.6 Gy/pulse. The W2 accurately ascertained the inverse square relationship regarding charge versus virtual source distance with R2 of ∼1.00 for all channels. Pulse linearity was accurately measured with the W2, demonstrating a proportional response to the delivered pulse number. There was no discernible impact on the measured charge of the W2 when switching between the available repetition rates of the FLEX system (18-180 pulses/s), solidifying consistent beam output across pulse frequencies. CONCLUSIONS This study tested a commercial plastic scintillator detector in a UHDR electron beam, paving the way for its potential use as a real-time, patient-specific dosimetry tool for future FLASH radiotherapy treatments. Further research is warranted to test and improve the signal processing of the W2 dosimetry system to accurately measure in UHDR environments using exceedingly high dose-per-pulse and pulse numbers.
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Affiliation(s)
- Kyuhak Oh
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | - Megan A. Hyun
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | | | - Ying Yan
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | - Sumin Zhou
- University of Nebraska Medical CenterOmahaNebraskaUSA
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Fenwick JD, Kumar S, Pardo-Montero J. Collection efficiencies of cylindrical and plane parallel ionization chambers: analytical and numerical results and implications for experimentally determined correction factors. Phys Med Biol 2024; 69:155023. [PMID: 39013400 PMCID: PMC11285487 DOI: 10.1088/1361-6560/ad63ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 06/25/2024] [Accepted: 07/16/2024] [Indexed: 07/18/2024]
Abstract
Objectives.To derive a collection efficiency formula,fGauss, for cylindrical ionization chambers in pulsed radiation beams from a volume recombination model of Boaget al(1996Phys. Med. Biol.41885-97) including free electrons. To validatefGaussand a parallel plate chamber formulafexpusing an ion transport code and calculate changes in collection efficiencies caused by electric field charge screening at 0.1-100 mGy doses-per-pulse. And to determine collection efficienciesCE∞predicted at infinite voltage in the absence of avalanche effects by fitting scaled formulae to efficiencies computed for 100-400 V chamber voltages and 10 and 100 mGy doses-per-pulse.Approach.Calculations were performed for an idealized parallel plate chamber with 2 mm electrode separationd, and for an idealized cylindrical chamber with 0.5 and 2.333 mm inner and electrode radiirinandrout.Main results.fGaussandfexppredict the same collection efficiencies for cylindrical and parallel plate chambers satisfyingd2=(rout2-rin2)ln(rout/rin)/2, an equivalence condition met by the chambers studied. Without charge screening, efficiencies computed using the code equalledfGaussandfexp. With screening, efficiencies changed by ⩽0.03%, ⩽1.1% and ⩽21.3% at 1, 10 and 100 mGy doses-per-pulse, and differed between the chambers by ⩽0.9% and ⩽19.6% at ⩽10 and 100 mGy dose-per-pulse. For fits offexpandfGauss,CE∞values were ⩽1.2% and ⩽17.6% from unity at 10 and 100 mGy per pulse respectively, closer than for other formulae tested.Significance.Allowing for screening,fGaussandfexpdescribed computed collection efficiencies to within 0.03%, 1.1% and 21.3% at doses-per-pulse ⩽1, 10 and 100 mGy. Equivalence of the two chambers broke down at 100 mGy per pulse. Departures ofCE∞values from unity suggest that collection efficiencies determined experimentally by fittingfGaussorfexpto readings made at multiple voltages will be accurate to within 1.2% and 17.6% at 10 and 100 mGy per pulse respectively.
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Affiliation(s)
- John D Fenwick
- Department of Medical Physics and Bioengineering, 8th Floor, Malet Place Engineering Building, University College London, Gower Street, London WC1E 6BT, England, United Kingdom
| | - Sudhir Kumar
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, CT & CRS Building, Anushaktinagar, Mumbai 400094, India
| | - Juan Pardo-Montero
- Group of Medical Physics and Biomathematics, Instituto de Investigación Sanitaria de Santiago (IDIS), 15706 Santiago de Compostela, Spain
- Department of Medical Physics, Complexo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain
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Subiel A, Bourgouin A, Kranzer R, Peier P, Frei F, Gomez F, Knyziak A, Fleta C, Bailat C, Schüller A. Metrology for advanced radiotherapy using particle beams with ultra-high dose rates. Phys Med Biol 2024; 69:14TR01. [PMID: 38830362 DOI: 10.1088/1361-6560/ad539d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 06/03/2024] [Indexed: 06/05/2024]
Abstract
Dosimetry of ultra-high dose rate beams is one of the critical components which is required for safe implementation of FLASH radiotherapy (RT) into clinical practice. In the past years several national and international programmes have emerged with the aim to address some of the needs that are required for translation of this modality to clinics. These involve the establishment of dosimetry standards as well as the validation of protocols and dosimetry procedures. This review provides an overview of recent developments in the field of dosimetry for FLASH RT, with particular focus on primary and secondary standard instruments, and provides a brief outlook on the future work which is required to enable clinical implementation of FLASH RT.
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Affiliation(s)
- Anna Subiel
- National Physical Laboratory, Hampton Road, Teddington TW11 0LW, United Kingdom
- University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Alexandra Bourgouin
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
- National Research Council of Canada (NRC), 1200 Montreal Road, Ottawa, ON, K1A0R6, Canada
| | | | - Peter Peier
- Federal Institute of Metrology METAS, Lindenweg 50, 3003 Bern-Wabern, Switzerland
| | - Franziska Frei
- Federal Institute of Metrology METAS, Lindenweg 50, 3003 Bern-Wabern, Switzerland
| | - Faustino Gomez
- University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Adrian Knyziak
- Central Office of Measures (GUM), Elektoralna 2 Str., 00-139 Warsaw, Poland
| | - Celeste Fleta
- Instituto de Microelectrónica de Barcelona, Centro Nacional de Microelectrónica, IMB-CNM (CSIC), Barcelona, Spain
| | - Claude Bailat
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Andreas Schüller
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
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Claessens M, Vanreusel V, Gasparini A, Nascimento LDF, Yalvec B, Reniers B, Verellen D. Automated determination of the ion-recombination correction factor (k sat) in ultra-high dose rate electron radiation therapy. Med Phys 2024; 51:4536-4545. [PMID: 38639653 DOI: 10.1002/mp.17085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 03/06/2024] [Accepted: 03/13/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Plane-parallel ionization chambers are the recommended secondary standard systems for clinical reference dosimetry of electrons. Dosimetry in high dose rate and dose-per-pulse (DPP) is challenging as ionization chambers are subject to ion recombination, especially when dose rate and/or DPP is increased beyond the range of conventional radiotherapy. The lack of universally accepted models for correction of ion recombination in UDHR is still an issue as it is, especially in FLASH-RT research, which is crucial in order to be able to accurately measure the dose for a wide range of dose rates and DPPs. PURPOSE The objective of this study was to show the feasibility of developing an Artificial Intelligence model to predict the ion-recombination factor-ksat for a plane-parallel Advanced Markus ionization chamber for conventional and ultra-high dose rate electron beams based on machine parameters. In addition, the predicted ksat of the AI model was compared with the current applied analytical models for this correction factor. METHODS A total number of 425 measurements was collected with a balanced variety in machine parameter settings. The specific ksat values were determined by dividing the output of the reference dosimeter (optically stimulated luminescence [OSL]) by the output of the AM chamber. Subsequently, a XGBoost regression model was trained, which used the different machine parameters as input features and the corresponding ksat value as output. The prediction accuracy of this regression model was characterized by R2-coefficient of determination, mean absolute error and root mean squared error. In addition, the model was compared with the Two-Voltage (TVA) method and empirical Petersson model for 19 different dose-per-pulse values ranging from conventional to UDHR regimes. The Akiake Information criterion (AIC) was calculated for the three different models. RESULTS The XGBoost regression model reached a R2-score of 0.94 on the independent test set with a MAE of 0.067 and RMSE of 0.106. For the additional 19 random data points, the ksat values predicted by the XGBoost model showed to be in agreement, within the uncertainties, with the ones determined by the Petersson model and better than the TVA method for doses per pulse >3.5 Gy with a maximum deviation from the ground truth of 14.2%, 16.7%, and -36.0%, respectively, for DPP >4 Gy. CONCLUSION The proposed method of using AI for ksat determination displays efficiency. For the investigated DPPs, the ksat values obtained with the XGBoost model were in concurrence with the ones obtained with the current available analytical models within the boundaries of uncertainty, certainly for the DPP characterizing UDHR. But the overall performance of the AI model, taking the number of free parameters into account, lacked efficiency. Future research should optimize the determination of the experimental ksat, and investigate the determination the ksat for DPPs higher than the ones investigated in this study, while also evaluating the prediction of the proposed XGBoost model for UDHR machines of different centers.
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Affiliation(s)
- Michaël Claessens
- Department of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium
- Centre for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Antwerp, Belgium
| | - Verdi Vanreusel
- Department of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium
- Centre for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Antwerp, Belgium
- Research in Dosimetric Applications (RDA), SCK CEN, Mol, Antwerp, Belgium
| | - Alessia Gasparini
- Department of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium
- Centre for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Antwerp, Belgium
| | | | - Burak Yalvec
- NuTeC, CMK, Hasselt University, Hasselt, Belgium
| | | | - Dirk Verellen
- Department of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium
- Centre for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Antwerp, Belgium
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Bancheri J, Seuntjens J. A semi-analytical procedure to determine the ion recombination correction factor in high dose-per-pulse beams. Med Phys 2024; 51:4458-4471. [PMID: 38446555 DOI: 10.1002/mp.17005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND The conventional theories and methods of determining the ion recombination correction factor, such as Boag theory and the related two voltage method and Jaffé plot extrapolation, do not seem to yield accurate results in FLASH /high dose per pulse (DPP) beams ( > $>$ 10 mGy DPP). This is due to the presence of a large free electron fraction that distorts the electric field inside the chamber sensitive volume. To understand the influence of these effects on the ion recombination correction factor and to develop new expressions for it, it is necessary to re-visit the underlying physics. PURPOSE To present a mathematical procedure to develop an analytical expression for the ion recombination correction factor. The expression is the basis for an extrapolation method so the correction factor can be determined in a clinical setting. METHODS A semi-analytical solution method, the homotopy perturbation method (HPM), is used to solve the partial differential equations (PDEs) describing the charge carrier physics, including space charge and free electrons. The electron velocity and attachment rate are modeled as functions of the electric field strength. An expression for the charge collection efficiency and ion recombination correction factor are developed. A fit procedure based on this expression is used to compare it to measured data from previously published articles. Another fit procedure using a general equation is also proposed and compared to the data. RESULTS The series obtained for the charge collection efficiency and the ion recombination correction factor are determined to be asymptotic series and the optimal truncation established. The ion recombination correction factor exhibits a1 / V 2 $1/V^2$ dependency due to the free electron presence. The fit using this expression agrees well with measured data as long as (1) the DPP is below 1 Gy for chambers with a 1 mm plate separation and (2) when the DPP is below 3 Gy for chambers with a 0.5 mm plate separation. In these DPP ranges, the deviation between measured and fit value did not exceed 6%. In both chamber cases the voltage range where the fit applies decreases as DPP increases. The general equation yielded comparable results. CONCLUSIONS The HPM was shown to be applicable to a complex system of PDEs and generate meaningful and novel solutions, as they include both space charge and free electrons. The HPM also lends itself to other chamber geometries. The fit procedure was also shown to yield accurate results for the ion recombination correction up to the 1 Gy DPP level.
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Affiliation(s)
- Julien Bancheri
- Department of Physics & Medical Physics Unit, McGill University, Montreal, Quebec, Canada
| | - Jan Seuntjens
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Department of Medical Biophysics, University of Toronto, Toronto, Canada
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Konradsson E, Ericsson Szecsenyi R, Wahlqvist P, Thoft A, Blad B, Bäck SÅ, Ceberg C, Petersson K. Reconfiguring a Plane-Parallel Transmission Ionization Chamber to Extend the Operating Range into the Ultra-High Dose-per-pulse Regime. Radiat Res 2024; 201:252-260. [PMID: 38308528 DOI: 10.1667/rade-23-00177.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/24/2024] [Indexed: 02/04/2024]
Abstract
This study aims to investigate the feasibility of enhancing the charge collection efficiency (CCE) of a transmission chamber by reconfiguring its design and operation. The goal was to extend the range of dose-per-pulse (DPP) values with no or minimal recombination effects up to the ultra-high dose rate (UHDR) regime. The response of two transmission chambers, with electrode distance of 1 mm and 0.6 mm, respectively, was investigated as a function of applied voltage. The chambers were mounted one-by-one in the electron applicator of a 10 MeV FLASH-modified clinical linear accelerator. The chamber signals were measured as a function of nominal DPP, which was determined at the depth of dose maximum using EBT-XD film in solid water and ranged from 0.6 mGy per pulse to 0.9 Gy per pulse, for both the standard voltage of 320 V and the highest possible safe voltage of 1,200 V. The CCE was calculated and fitted with an empirical logistic function that incorporated the electrode distance and the chamber voltage. The CCE decreased with increased DPP. The CCE at the highest achievable DPP was 24% (36%) at 320 V and 51% (82%) at 1,200 V, for chambers with 1 mm (0.6 mm) electrode distance. For the combination of 1,200 V- and 0.6-mm electrode distance, the CCE was ∼100% for average dose rate up to 70 Gy/s at the depth of dose maximum in the phantom at a source-to-surface distance of 100 cm. Our findings indicate that minor modifications to a plane-parallel transmission chamber can substantially enhance the CCE and extending the chamber's operating range to the UHDR regime. This supports the potential of using transmission chamber-based monitoring solutions for UHDR beams, which could facilitate the delivery of UHDR treatments using an approach similar to conventional clinical delivery.
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Affiliation(s)
- Elise Konradsson
- Medical Radiation Physics, Department of Clinical Sciences, Lund University, Lund, Sweden
| | | | - Pontus Wahlqvist
- Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Andreas Thoft
- Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Börje Blad
- Medical Radiation Physics, Department of Clinical Sciences, Lund University, Lund, Sweden
- Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Sven Åj Bäck
- Medical Radiation Physics, Department of Clinical Sciences, Lund University, Lund, Sweden
- Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Crister Ceberg
- Medical Radiation Physics, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Kristoffer Petersson
- Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
- Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, United Kingdom
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Motta S, Dal Bello R, Christensen JB, Bossin L, Yukihara EG. Dosimetry of ultra-high dose rate electron beams using thermoluminescence and optically stimulated luminescence detectors. Phys Med Biol 2024; 69:035022. [PMID: 38198704 DOI: 10.1088/1361-6560/ad1cf5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/10/2024] [Indexed: 01/12/2024]
Abstract
Objective.The aim of this work is to investigate the dose rate dependence of thermoluminescence and optically stimulated luminescence detectors (TLDs and OSLDs) in a wide uniform ultra-high dose rate electron beam and demonstrate the potential use of TLDs and OSLDs to correct the ion recombination in air-filled ionization chambers. This study avoids previously reported complications related to the field size and homogeneity.Approach.Two types of OSLDs (BeO and Al2O3:C) and three types of TLDs (LiF:Mg,Ti, LiF:Mg,Cu,P, CaF2:Tm) were irradiated simultaneously in a uniform 16 MeV electron beam generated by a clinically decommissioned C-Arm LINAC, modified to deliver doses per pulse between 8.3 × 10-4Gy and 1.255 Gy, corresponding to instantaneous dose rates between 2 × 102Gy s-1and 3 × 105Gy s-1. A prototype ultra-thin parallel plate ionization chamber was employed as reference detector.Main results.Reproducible results were achieved both at conventional (standard deviation of the data <2%) and at the highest dose per pulse (standard deviation of the data <4%). No trend in the dose rate response of the TLDs and OSLDs was observed in the investigated dose per pulse range. The Al2O3:C OSLD was found to be the most precise detector, with a standard deviation of the data <2% at all investigated dose rates and dose levels.Significance.The dose rate independence of the investigated TLDs and OSLDs make them good candidates for dosimetry at ultra-high dose rates, at least up to 3 × 105Gy s-1. A dose rate independent method to measure the dose per pulse is proposed, which can be applied to characterize ultra-high dose rate electron beams and correct for ion recombination in ionization chambers.
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Affiliation(s)
- S Motta
- Department of Radiation Safety and Security, Paul Scherrer Institute, Villigen PSI, Switzerland
- Department of Physics, ETH Zürich, Zürich, Switzerland
| | - R Dal Bello
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - J B Christensen
- Department of Radiation Safety and Security, Paul Scherrer Institute, Villigen PSI, Switzerland
| | - L Bossin
- Department of Radiation Safety and Security, Paul Scherrer Institute, Villigen PSI, Switzerland
| | - E G Yukihara
- Department of Radiation Safety and Security, Paul Scherrer Institute, Villigen PSI, Switzerland
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Oh K, Gallagher KJ, Hyun M, Schott D, Wisnoskie S, Lei Y, Hendley S, Wong J, Wang S, Graff B, Jenkins C, Rutar F, Ahmed M, McNeur J, Taylor J, Schmidt M, Senadheera L, Smith W, Umstadter D, Lele SM, Dai R, Jianghu (James) D, Yan Y, Su‐min Z. Initial experience with an electron FLASH research extension (FLEX) for the Clinac system. J Appl Clin Med Phys 2024; 25:e14159. [PMID: 37735808 PMCID: PMC10860433 DOI: 10.1002/acm2.14159] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/04/2023] [Accepted: 08/21/2023] [Indexed: 09/23/2023] Open
Abstract
PURPOSE Radiotherapy delivered at ultra-high-dose-rates (≥40 Gy/s), that is, FLASH, has the potential to effectively widen the therapeutic window and considerably improve the care of cancer patients. The underlying mechanism of the FLASH effect is not well understood, and commercial systems capable of delivering such dose rates are scarce. The purpose of this study was to perform the initial acceptance and commissioning tests of an electron FLASH research product for preclinical studies. METHODS A linear accelerator (Clinac 23EX) was modified to include a non-clinical FLASH research extension (the Clinac-FLEX system) by Varian, a Siemens Healthineers company (Palo Alto, CA) capable of delivering a 16 MeV electron beam with FLASH and conventional dose rates. The acceptance, commissioning, and dosimetric characterization of the FLEX system was performed using radiochromic film, optically stimulated luminescent dosimeters, and a plane-parallel ionization chamber. A radiation survey was conducted for which the shielding of the pre-existing vault was deemed sufficient. RESULTS The Clinac-FLEX system is capable of delivering a 16 MeV electron FLASH beam of approximately 1 Gy/pulse at isocenter and reached a maximum dose rate >3.8 Gy/pulse near the upper accessory mount on the linac gantry. The percent depth dose curves of the 16 MeV FLASH and conventional modes for the 10 × 10 cm2 applicator agreed within 0.5 mm at a range of 50% of the maximum dose. Their respective profiles agreed well in terms of flatness but deviated for field sizes >10 × 10 cm2 . The output stability of the FLASH system exhibited a dose deviation of <1%. Preliminary cell studies showed that the FLASH dose rate (180 Gy/s) had much less impact on the cell morphology of 76N breast normal cells compared to the non-FLASH dose rate (18 Gy/s), which induced large-size cells. CONCLUSION Our studies characterized the non-clinical Clinac-FLEX system as a viable solution to conduct FLASH research that could substantially increase access to ultra-high-dose-rate capabilities for scientists.
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Affiliation(s)
- Kyuhak Oh
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | | | - Megan Hyun
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | - Diane Schott
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | | | - Yu Lei
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | | | - Jeffrey Wong
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | - Shuo Wang
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | - Brendan Graff
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | | | - Frank Rutar
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | - Md Ahmed
- Varian Medical SystemsPalo AltoCaliforniaUSA
| | | | | | | | | | - Wendy Smith
- Varian Medical SystemsPalo AltoCaliforniaUSA
| | | | | | - Ran Dai
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | | | - Ying Yan
- University of Nebraska Medical CenterOmahaNebraskaUSA
| | - Zhou Su‐min
- University of Nebraska Medical CenterOmahaNebraskaUSA
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Liu K, Holmes S, Hooten B, Schüler E, Beddar S. Evaluation of ion chamber response for applications in electron FLASH radiotherapy. Med Phys 2024; 51:494-508. [PMID: 37696271 PMCID: PMC10840726 DOI: 10.1002/mp.16726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 09/13/2023] Open
Abstract
Ion chambers are required for calibration and reference dosimetry applications in radiation therapy (RT). However, exposure of ion chambers in ultra-high dose rate (UHDR) conditions pertinent to FLASH-RT leads to severe saturation and ion recombination, which limits their performance and usability. The purpose of this study was to comprehensively evaluate a set of commonly used commercially available ion chambers in RT, all with different design characteristics, and use this information to produce a prototype ion chamber with improved performance in UHDR conditions as a first step toward ion chambers specific for FLASH-RT. The Advanced Markus and Exradin A10, A26, and A20 ion chambers were evaluated. The chambers were placed in a water tank, at a depth of 2 cm, and exposed to an UHDR electron beam at different pulse repetition frequency (PRF), pulse width (PW), and pulse amplitude settings on an IntraOp Mobetron. Ion chamber responses were investigated for the various beam parameter settings to isolate their dependence on integrated dose, mean dose rate and instantaneous dose rate, dose-per-pulse (DPP), and their design features such as chamber type, bias voltage, and collection volume. Furthermore, a thin parallel-plate (TPP) prototype ion chamber with reduced collector plate separation and volume was constructed and equally evaluated as the other chambers. The charge collection efficiency of the investigated ion chambers decreased with increasing DPP, whereas the mean dose rate did not affect the response of the chambers (± 1%). The dependence of the chamber response on DPP was found to be solely related to the total dose within the pulse, and not on mean dose rate, PW, or instantaneous dose rate within the ranges investigated. The polarity correction factor (Ppol ) values of the TPP prototype, A10, and Advanced Markus chambers were found to be independent of DPP and dose rate (± 2%), while the A20 and A26 chambers yielded significantly larger variations and dependencies under the same conditions. Ion chamber performance evaluated under different irradiation conditions of an UHDR electron beam revealed a strong dependence on DPP and a negligible dependence on the mean and instantaneous dose rates. These results suggest that modifications to ion chambers design to improve their usability in UHDR beamlines should focus on minimizing DPP effects, with emphasis on optimizing the electric field strength, through the construction of smaller electrode separation and larger bias voltages. This was confirmed through the production and evaluation of a prototype ion chamber specifically designed with these characteristics.
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Affiliation(s)
- Kevin Liu
- Division of Radiation Oncology, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Graduate School of Biomedical Sciences, The University of Texas, Houston, Texas, USA
| | | | | | - Emil Schüler
- Division of Radiation Oncology, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Graduate School of Biomedical Sciences, The University of Texas, Houston, Texas, USA
| | - Sam Beddar
- Division of Radiation Oncology, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Graduate School of Biomedical Sciences, The University of Texas, Houston, Texas, USA
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11
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Bourgouin A, Paz-Martín J, Gedik YC, Frei F, Peier P, Rossomme S, Schönfeld AA, Schüller A, Rodriguez FG, Kapsch RP. Charge collection efficiency of commercially available parallel-plate ionisation chambers in ultra-high dose-per-pulse electron beams. Phys Med Biol 2023; 68:235002. [PMID: 37934049 DOI: 10.1088/1361-6560/ad0a58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/07/2023] [Indexed: 11/08/2023]
Abstract
Objective. This investigation aims to experimentally determine the charge collection efficiency (CCE) of six commercially available parallel-plate ionisation chamber (PPIC) models in ultra-high dose-per-pulse (UHDPP) electron beams.Approach. The CCE of 22 PPICs has been measured in UHDPP electron beams at the National Metrology Institution of Germany (PTB). The CCE was determined for a dose per pulse (DPP) range between 0.1 and 6.4 Gy (pulse duration of 2.5μs). The results obtained with the different PPICs were compared to evaluate the reproducibility, intra- and inter-model variation, and the performance of a CCE empirical model.Main results. The intra-model variation was, on average, 4.0%, which is more than three times the total combined relative standard uncertainty and was found to be greater at higher DPP (up to 20%). The inter-model variation for the PPIC with 2 mm electrode spacing, which was found to be, on average, 10%, was also significant compared to the relative uncertainty and the intra-model variation. The observed CCE variation could not be explained only by the expected deviation of the electrode spacing from the nominal value within the manufacturing tolerance. It should also be noted that a substantial polarity effect, between 0.914(5) and 1.201(3), was observed, and significant intra- and inter-model variation was observed on this effect.Significance. For research and pre-clinical study, the commercially available PPIC with a well-known CCE (directly measured for the specific chamber) and with a small electrode spacing could be used for relative and absolute dosimetry with a lower-limit uncertainty of 1.6% (k= 1) in the best case. However, to use a PPIC as a secondary standard in UHDPP electron beams for clinical purposes would require new model development to reduce the ion recombination, the polarity effect, and the total standard uncertainty on the dose measurement.
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Affiliation(s)
- Alexandra Bourgouin
- Dosimetry for Radiation Therapy and Diagnostic Radiology, Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
| | - Jose Paz-Martín
- Departamento de Física de Partículas, Universidad de Santiago, Santiago de Compostela, Spain
| | - Yunus Can Gedik
- Nuclear Energy Research Institute (NÜKEN), Turkish Energy Nuclear and Mineral Research Agency (TENMAK), Ankara, Turkey
| | - Franziska Frei
- Eidgenössisches Institut für Metrologie (METAS), Bern-Wabern, Switzerland
| | - Peter Peier
- Eidgenössisches Institut für Metrologie (METAS), Bern-Wabern, Switzerland
| | | | - Andreas A Schönfeld
- Sun Nuclear, A Mirion Medical Company, Melbourne, FL, United States of America
| | - Andreas Schüller
- Dosimetry for Radiation Therapy and Diagnostic Radiology, Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
| | | | - Ralf-Peter Kapsch
- Dosimetry for Radiation Therapy and Diagnostic Radiology, Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
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12
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Choi DH, Kim JS, Lee R, Ahn SH, Ahn WS. Dosimetric verification of annual quality assurance for a linear accelerator using a transmission type detector. Sci Rep 2023; 13:17994. [PMID: 37865666 PMCID: PMC10590446 DOI: 10.1038/s41598-023-45114-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/16/2023] [Indexed: 10/23/2023] Open
Abstract
The purpose of our study is to establish an efficient quality assurance (QA) procedure using a transmission-type detector (IBA, Stealth chamber), a reference signal detector, as a field chamber. Relative dosimetry items, including monitor unit linearity, output constancy based on dose rate and field size, and output factor were measured and compared with results obtained from the Farmer-type chamber (IBA, Wellhofer, FC65-G). Moreover, output for each field size was measured to assess its applicability to small fields. Results using the Stealth chamber were in good agreement with the FC65-G within 1.0%, except for output constancy according to gantry angle, which had a 1.1% error rate for the Stealth chamber and 2.7% for the FC65-G. Differences of up to - 6.26% output factor were observed for the Stealth chamber and up to - 0.56% for the CC-13 ionization chamber (IBA) in the 3 × 3 cm2 field. Our study confirmed the possibility of using Stealth chambers for relative dosimetry measurement in QA.
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Affiliation(s)
- Dong Hyeok Choi
- Department of Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Medical Physics and Biomedical Engineering Lab (MPBEL), Yonsei University College of Medicine, Seoul, South Korea
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Sung Kim
- Department of Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Medical Physics and Biomedical Engineering Lab (MPBEL), Yonsei University College of Medicine, Seoul, South Korea
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Rena Lee
- Department of Biomedical Engineering, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - So Hyun Ahn
- Ewha Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, South Korea.
| | - Woo Sang Ahn
- Department of Radiation Oncology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea.
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13
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No HJ, Wu YF, Dworkin ML, Manjappa R, Skinner L, Ashraf MR, Lau B, Melemenidis S, Viswanathan V, Yu ASJ, Surucu M, Schüler E, Graves EE, Maxim PG, Loo BW. Clinical Linear Accelerator-Based Electron FLASH: Pathway for Practical Translation to FLASH Clinical Trials. Int J Radiat Oncol Biol Phys 2023; 117:482-492. [PMID: 37105403 DOI: 10.1016/j.ijrobp.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/03/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE Ultrahigh-dose-rate (UHDR) radiation therapy (RT) has produced the FLASH effect in preclinical models: reduced toxicity with comparable tumor control compared with conventional-dose-rate RT. Early clinical trials focused on UHDR RT feasibility using specialized devices. We explore the technical feasibility of practical electron UHDR RT on a standard clinical linear accelerator (LINAC). METHODS AND MATERIALS We tuned the program board of a decommissioned electron energy for UHDR electron delivery on a clinical LINAC without hardware modification. Pulse delivery was controlled using the respiratory gating interface. A short source-to-surface distance (SSD) electron setup with a standard scattering foil was configured and tested on an anthropomorphic phantom using circular blocks with 3- to 20-cm field sizes. Dosimetry was evaluated using radiochromic film and an ion chamber profiler. RESULTS UHDR open-field mean dose rates at 100, 80, 70, and 59 cm SSD were 36.82, 59.52, 82.01, and 112.83 Gy/s, respectively. At 80 cm SSD, mean dose rate was ∼60 Gy/s for all collimated field sizes, with an R80 depth of 6.1 cm corresponding to an energy of 17.5 MeV. Heterogeneity was <5.0% with asymmetry of 2.2% to 6.2%. The short SSD setup was feasible under realistic treatment conditions simulating broad clinical indications on an anthropomorphic phantom. CONCLUSIONS Short SSD and tuning for high electron beam current on a standard clinical LINAC can deliver flat, homogenous UHDR electrons over a broad, clinically relevant range of field sizes and depths with practical working distances in a configuration easily reversible to standard clinical use.
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Affiliation(s)
- Hyunsoo Joshua No
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Yufan Fred Wu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Michael Louis Dworkin
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Rakesh Manjappa
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Lawrie Skinner
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - M Ramish Ashraf
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Brianna Lau
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Stavros Melemenidis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Vignesh Viswanathan
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Amy Shu-Jung Yu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Murat Surucu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Emil Schüler
- Department of Radiation Physics, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Edward Elliot Graves
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Peter Gregor Maxim
- Department of Radiation Oncology, University of California, Irvine, Orange, California
| | - Billy W Loo
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California.
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14
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Cotterill J, Flynn S, Thomas R, Subiel A, Lee N, Shipley D, Palmans H, Lourenço A. Monte Carlo modelling of a prototype small-body portable graphite calorimeter for ultra-high dose rate proton beams. Phys Imaging Radiat Oncol 2023; 28:100506. [PMID: 38045641 PMCID: PMC10692912 DOI: 10.1016/j.phro.2023.100506] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
Background and purpose Accurate dosimetry in Ultra-High Dose Rate (UHDR) beams is challenging because high levels of ion recombination occur within ionisation chambers used as reference dosimeters. A Small-body Portable Graphite Calorimeter (SPGC) exhibiting a dose-rate independent response was built to offer reduced uncertainty on secondary standard dosimetry in UHDR regimes. The aim of this study was to quantify the effect of the geometry and material properties of the device on the dose measurement. Materials and methods A detailed model of the SPGC was built in the Monte Carlo code TOPAS (v3.6.1) to derive the impurity and gap correction factors, k i m p and k g a p . A dose conversion factor, D w MC / D g MC , was also calculated using FLUKA (v2021.2.0). These factors convert the average dose to its graphite core to the dose-to-water for a 249.7 MeV mono-energetic spot-scanned clinical proton beam. The effect of the surrounding Styrofoam on the dose measurement was examined in the simulations by substituting it for graphite. Results The k i m p and k g a p correction factors were 0.9993 ± 0.0002 and 1.0000 ± 0.0001, respectively when the Styrofoam was not substituted, and 1.0037 ± 0.0002 and 0.9999 ± 0.0001, respectively when substituted for graphite. The dose conversion factor was calculated to be 1.0806 ± 0.0001. All uncertainties are Type A. Conclusions Impurity and gap correction factors, and the dose conversion factor were calculated for the SPGC in a FLASH proton beam. Separating out the effect of scatter from Styrofoam insulation showed this as the dominating correction factor, amounting to 1.0043 ± 0.0002.
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Affiliation(s)
- John Cotterill
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Sam Flynn
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, UK
- Particle Physics Group, University of Birmingham, Edgbaston B15 2TT, UK
| | - Russell Thomas
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, UK
- University of Surrey, Faculty of Engineering and Physical Science, Guildford GU2 7XH, UK
| | - Anna Subiel
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, UK
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - Nigel Lee
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, UK
| | - David Shipley
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Hugo Palmans
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, UK
- Medical Physics Group, MedAustron Ion Therapy Center, A-2700 Wiener Neustadt, Austria
| | - Ana Lourenço
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, UK
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
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15
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Marinelli M, di Martino F, Del Sarto D, Pensavalle JH, Felici G, Giunti L, De Liso V, Kranzer R, Verona C, Verona Rinati G. A diamond detector based dosimetric system for instantaneous dose rate measurements in FLASH electron beams. Phys Med Biol 2023; 68:175011. [PMID: 37494946 DOI: 10.1088/1361-6560/acead0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/25/2023] [Indexed: 07/28/2023]
Abstract
Objective.A reliable determination of the instantaneous dose rate (I-DR) delivered in FLASH radiotherapy treatments is believed to be crucial to assess the so-called FLASH effect in preclinical and biological studies. At present, no detectors nor real-time procedures are available to do that in ultra high dose rate (UH-DR) electron beams, typically consisting ofμs pulses characterized by I-DRs of the order of MGy/s. A dosimetric system is proposed possibly overcoming the above reported limitation, based on the recently developed flashDiamond (fD) detector (model 60025, PTW-Freiburg, Germany).Approach.A dosimetric system is proposed, based on a flashDiamond detector prototype, properly modified and adapted for very fast signal transmission. It was used in combination with a fast transimpedance amplifier and a digital oscilloscope to record the temporal traces of the pulses delivered by an ElectronFlash linac (SIT S.p.A., Italy). The proposed dosimetric systems was investigated in terms of the temporal characteristics of its response and the capability to measure the absolute delivered dose and instantaneous dose rate (I-DR). A 'standard' flashDiamond was also investigated and its response compared with the one of the specifically designed prototype.Main results. Temporal traces recorded in several UH-DR irradiation conditions showed very good signal to noise ratios and rise and decay times of the order of a few tens ns, faster than the ones obtained by the current transformer embedded in the linac head. By analyzing such signals, a calibration coefficient was derived for the fD prototype and found to be in agreement within 1% with the one obtained under reference60Co irradiation. I-DRs as high as about 2 MGy s-1were detected without any undesired saturation effect. Absolute dose per pulse values extracted by integrating the I-DR signals were found to be linear up to at least 7.13 Gy and in very good agreement with the ones obtained by connecting the fD to a UNIDOS electrometer (PTW-Freiburg, Germany). A good short term reproducibility of the linac output was observed, characterized by a pulse-to-pulse variation coefficient of 0.9%. Negligible differences were observed when replacing the fD prototype with a standard one, with the only exception of a somewhat slower response time for the latter detector type.Significance.The proposed fD-based system was demonstrated to be a suitable tool for a thorough characterization of UH-DR beams, providing accurate and reliable time resolved I-DR measurements from which absolute dose values can be straightforwardly derived.
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Affiliation(s)
- Marco Marinelli
- Dipartimento di Ingegneria Industriale, Università di Roma Tor Vergata, Roma, Italy
| | - Fabio di Martino
- U.O.Fisica Sanitaria, Azienda Universitaria Ospedaliera Pisana, Pisa, Italy
| | - Damiano Del Sarto
- U.O.Fisica Sanitaria, Azienda Universitaria Ospedaliera Pisana, Pisa, Italy
| | | | | | | | | | - Rafael Kranzer
- PTW-Freiburg, Freiburg D-79115, Germany
- University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University Oldenburg, D-26121 Germany
| | - Claudio Verona
- Dipartimento di Ingegneria Industriale, Università di Roma Tor Vergata, Roma, Italy
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16
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Siddique S, Ruda HE, Chow JCL. FLASH Radiotherapy and the Use of Radiation Dosimeters. Cancers (Basel) 2023; 15:3883. [PMID: 37568699 PMCID: PMC10417829 DOI: 10.3390/cancers15153883] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Radiotherapy (RT) using ultra-high dose rate (UHDR) radiation, known as FLASH RT, has shown promising results in reducing normal tissue toxicity while maintaining tumor control. However, implementing FLASH RT in clinical settings presents technical challenges, including limited depth penetration and complex treatment planning. Monte Carlo (MC) simulation is a valuable tool for dose calculation in RT and has been investigated for optimizing FLASH RT. Various MC codes, such as EGSnrc, DOSXYZnrc, and Geant4, have been used to simulate dose distributions and optimize treatment plans. Accurate dosimetry is essential for FLASH RT, and radiation detectors play a crucial role in measuring dose delivery. Solid-state detectors, including diamond detectors such as microDiamond, have demonstrated linear responses and good agreement with reference detectors in UHDR and ultra-high dose per pulse (UHDPP) ranges. Ionization chambers are commonly used for dose measurement, and advancements have been made to address their response nonlinearities at UHDPP. Studies have proposed new calculation methods and empirical models for ion recombination in ionization chambers to improve their accuracy in FLASH RT. Additionally, strip-segmented ionization chamber arrays have shown potential for the experimental measurement of dose rate distribution in proton pencil beam scanning. Radiochromic films, such as GafchromicTM EBT3, have been used for absolute dose measurement and to validate MC simulation results in high-energy X-rays, triggering the FLASH effect. These films have been utilized to characterize ionization chambers and measure off-axis and depth dose distributions in FLASH RT. In conclusion, MC simulation provides accurate dose calculation and optimization for FLASH RT, while radiation detectors, including diamond detectors, ionization chambers, and radiochromic films, offer valuable tools for dosimetry in UHDR environments. Further research is needed to refine treatment planning techniques and improve detector performance to facilitate the widespread implementation of FLASH RT, potentially revolutionizing cancer treatment.
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Affiliation(s)
- Sarkar Siddique
- Department of Physics, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada;
| | - Harry E. Ruda
- Centre of Advance Nanotechnology, Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON M5S 3E4, Canada;
- Department of Materials Science and Engineering, University of Toronto, Toronto, ON M5S 3E4, Canada
| | - James C. L. Chow
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1X6, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada
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17
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Fenwick JD, Kumar S. Collection efficiencies of ionization chambers in pulsed radiation beams: an exact solution of an ion recombination model including free electron effects. Phys Med Biol 2022; 68:015016. [PMID: 36571457 DOI: 10.1088/1361-6560/aca74e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022]
Abstract
Objective.Boaget al(1996) formulated a key model of collection efficiency for ionization chambers in pulsed radiation beams, in which some free electrons form negatively charged ions with a density that initially varies exponentially across the chamber. This non-uniform density complicates ion recombination calculations, in comparison with Boag's 1950 work in which a collection efficiency formula,f, was straightforwardly obtained assuming a uniform negative ion cloud. Boaget al(1996) therefore derived collection efficiency formulaef',f″ andf'″ based on three approximate descriptions of the exponentially-varying negative ion cloud, each uniform within a region. Collection efficiencies calculated by Boaget al(1996) using these formulae differed by a maximum of 5.1% relative (at 144 mGy dose-per-pulse with 212 V applied over a 1 mm electrode separation) and all three formulae are often used together. Here an exact solution of the exponentially-varying model is obtained.Approach.The exact solution was derived from a differential equation relating the number of negative ions collected from within some distance of the anode to numbers of ions initially located within that region. Using the resulting formula,fexp, collection efficiencies were calculated for a range of ionization chamber properties and doses-per-pulse, and compared withf,f',f″ andf″' values and results from an ion transport code.Main results.fexpvalues agreed to 5 decimal places with ion transport code results. The maximum relative difference betweenfexpandf″', which was often closest tofexp, was 0.78% for the chamber properties and doses-per-pulse studied by Boaget al(1996), rising to 6.1% at 1 Gy dose-per-pulse and 2 mm electrode separation.Significance.Use offexpshould reduce ambiguities in collection efficiencies calculated using the approximate formulae, although like themfexpdoes not account for electric field distortion, which becomes substantial at doses-per-pulse ≥100 mGy.
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Affiliation(s)
- John D Fenwick
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, The Sherrington Building, Ashton Street, Liverpool L69 3BX, United Kingdom
| | - Sudhir Kumar
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, CT & CRS Building, Anushaktinagar, Mumbai-400094, India
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18
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Kranzer R, Schüller A, Gómez Rodríguez F, Weidner J, Paz-Martín J, Looe HK, Poppe B. Charge collection efficiency, underlying recombination mechanisms, and the role of electrode distance of vented ionization chambers under ultra-high dose-per-pulse conditions. Phys Med 2022; 104:10-17. [PMID: 36356499 PMCID: PMC9719440 DOI: 10.1016/j.ejmp.2022.10.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/23/2022] [Accepted: 10/23/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Investigating and understanding of the underlying mechanisms affecting the charge collection efficiency (CCE) of vented ionization chambers under ultra-high dose rate pulsed electron radiation. This is an important step towards real-time dosimetry with ionization chambers in FLASH radiotherapy. METHODS Parallel-plate ionization chambers (PPIC) with three different electrode distances were build and investigated with electron beams with ultra-high dose-per-pulse (DPP) up to 5.4 Gy. The measurements were compared with simulations. The experimental determination of the CCE was done by comparison against the reference dose based on alanine dosimetry. The numerical solution of a system of partial differential equations taking into account charge creations by the radiation, their transport and reaction in an applied electric field was used for the simulations of the CCE and the underlying effects. RESULTS A good agreement between the experimental results and the simulated CCE could be achieved. The recombination losses found under ultra-high DPP could be attributed to a temporal and spatial charge carrier imbalance and the associated electric field distortion. With ultra-thin electrode distances down to 0.25 mm and a suitable chamber voltage, a CCE greater than 99 % could be achieved under the ultra-high DPP conditions investigated. CONCLUSIONS Well-guarded ultra-thin PPIC are suited for real-time dosimetry under ultra-high DPP conditions. This allows dosimetry also for FLASH RT according to common codes of practice, traceable to primary standards. The numerical approach used allows the determination of appropriate correction factors beyond the DPP ranges where established theories are applicable to account for remaining recombination losses.
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Affiliation(s)
- Rafael Kranzer
- PTW-Freiburg (R&D), Freiburg 79115, Germany; University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University Oldenburg, 26121, Germany
| | - Andreas Schüller
- Physikalisch-Technische Bundesanstalt, Braunschweig 38116, Germany
| | - Faustino Gómez Rodríguez
- Departamento de Fisica de Particulas, Universidad de Santiago, Santiago de Compostela, Spain; Laboratorio de Radiofisica, Universidad de Santiago, Santiago de Compostela, Spain
| | | | - Jose Paz-Martín
- Departamento de Fisica de Particulas, Universidad de Santiago, Santiago de Compostela, Spain
| | - Hui Khee Looe
- University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University Oldenburg, 26121, Germany
| | - Björn Poppe
- University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University Oldenburg, 26121, Germany
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19
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Lv Y, Lv Y, Wang Z, Lan T, Feng X, Chen H, Zhu J, Ma X, Du J, Hou G, Liao W, Yuan K, Wu H. FLASH radiotherapy: A promising new method for radiotherapy. Oncol Lett 2022; 24:419. [PMID: 36284652 PMCID: PMC9580247 DOI: 10.3892/ol.2022.13539] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/10/2022] [Indexed: 11/06/2022] Open
Abstract
Among the treatments for malignant tumors, radiotherapy is of great significance both as a main treatment and as an adjuvant treatment. Radiation therapy damages cancer cells with ionizing radiation, leading to their death. However, radiation-induced toxicity limits the dose delivered to the tumor, thereby constraining the control effect of radiotherapy on tumor growth. In addition, the delayed toxicity caused by radiotherapy significantly harms the physical and mental health of patients. FLASH-RT, an emerging class of radiotherapy, causes a phenomenon known as the 'FLASH effect', which delivers radiotherapy at an ultra-high dose rate with lower toxicity to normal tissue than conventional radiotherapy to achieve local tumor control. Although its mechanism remains to be fully elucidated, this modality constitutes a potential new approach to treating malignant tumors. In the present review, the current research progress of FLASH-RT and its various particular effects are described, including the status of research on FLASH-RT and its influencing factors. The hypothetic mechanism of action of FLASH-RT is also summarized, providing insight into future tumor treatments.
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Affiliation(s)
- Yinghao Lv
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Yue Lv
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Zhen Wang
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
- Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, P.R. China
| | - Tian Lan
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Xuping Feng
- Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, P.R. China
| | - Hao Chen
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Jiang Zhu
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Xiao Ma
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Jinpeng Du
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Guimin Hou
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Wenwei Liao
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Kefei Yuan
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
- Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, P.R. China
| | - Hong Wu
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
- Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, P.R. China
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20
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Numerical modeling of air-vented parallel plate ionization chambers for ultra-high dose rate applications. Phys Med 2022; 103:147-156. [DOI: 10.1016/j.ejmp.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/26/2022] [Accepted: 10/07/2022] [Indexed: 11/21/2022] Open
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21
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Zhao Z, Xu Z, Zhao T, Kang X, She Q, Mao R, Duan L, Yang H, Feng Y, Dong J, Li M. A prototype of beam profile measurement system for HIAF-HFRS beam line. J NUCL SCI TECHNOL 2022. [DOI: 10.1080/00223131.2022.2113165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Zulong Zhao
- Chinese Academy of Sciences, Institute of Modern Physics, Lanzhou, Gansu, China
- University of Chinese Academy of Sciences, School of nuclear science and technology, Beijing, Huairou, China
| | - Zhiguo Xu
- Chinese Academy of Sciences, Institute of Modern Physics, Lanzhou, Gansu, China
- University of Chinese Academy of Sciences, School of nuclear science and technology, Beijing, Huairou, China
| | - Tiecheng Zhao
- Chinese Academy of Sciences, Institute of Modern Physics, Lanzhou, Gansu, China
| | - Xincai Kang
- Chinese Academy of Sciences, Institute of Modern Physics, Lanzhou, Gansu, China
| | - Qianshun She
- Chinese Academy of Sciences, Institute of Modern Physics, Lanzhou, Gansu, China
| | - Ruishi Mao
- Chinese Academy of Sciences, Institute of Modern Physics, Lanzhou, Gansu, China
| | - Linmin Duan
- Chinese Academy of Sciences, Institute of Modern Physics, Lanzhou, Gansu, China
| | - Herun Yang
- Chinese Academy of Sciences, Institute of Modern Physics, Lanzhou, Gansu, China
| | - Yongchun Feng
- Chinese Academy of Sciences, Institute of Modern Physics, Lanzhou, Gansu, China
| | - Jinmei Dong
- Chinese Academy of Sciences, Institute of Modern Physics, Lanzhou, Gansu, China
| | - Min Li
- Chinese Academy of Sciences, Institute of Modern Physics, Lanzhou, Gansu, China
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22
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Bourgouin A, Keszti F, Schönfeld AA, Hackel T, Kozelka J, Hildreth J, Simon W, Schüller A, Kapsch RP, Renaud J. The probe-format graphite calorimeter, Aerrow, for absolute dosimetry in ultra-high pulse dose rate electron beams. Med Phys 2022; 49:6635-6645. [PMID: 35912973 DOI: 10.1002/mp.15899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/02/2022] [Accepted: 07/22/2022] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The purpose of this investigation is to evaluate the use of a probe-format graphite calorimeter, Aerrow, as an absolute and relative dosimeter of high-energy pulse dose rate (UHPDR) electron beams for in-water reference and depth-dose type measurements, respectively. METHODS In this paper, the calorimeter system is used to investigate the potential influence of dose per pulses delivered up to 5.6 Gy, the number of pulses delivered per measurement and its potential for relative measurement (depth dose curve measurement). The calorimeter system is directly compared against an Advanced Markus ion chamber. The finite element method was used to calculate heat transfer corrections along the percentage depth dose of a 20 MeV electron beam. Monte Carlo-calculated dose conversion factors necessary to calculate absorbed dose to-water at a point from the measured dose-to-graphite are also presented. RESULTS The comparison of Aerrow against a fully calibrated Advanced Markus chamber, corrected for the saturation effect, has shown consistent results in terms of dose to water determination. The measured reference depth is within 0.5 mm from the expected value from Monte Carlo simulation. The relative standard uncertainty estimated for Aerrow was 1.06%, which is larger compared to alanine dosimetry (McEwen et al. https://doi.org/10.1088/0026-1394/52/2/272) but has the advantage of being a real time detector. CONCLUSION In this investigation, it was demonstrated that the Aerrow probe-type graphite calorimeter can be used for relative and absolute dosimetry in water in an UHPDR electron beam. To the author's knowledge, this is the first reported use of an absorbed dose calorimeter for an in-water percentage depth dose curve measurement. The use of the Aerrow in quasi-adiabatic mode has greatly simplified the signal readout, compared to isothermal mode, as the resistance was directly measured with a high-stability Digital-Multimetre (DMM). This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Alexandra Bourgouin
- Dosimetry for radiation therapy and diagnostic radiology, Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
| | - Federico Keszti
- Medical Physics Unit, McGill University, Montreal, Quebec, Canada
| | | | - Thomas Hackel
- Dosimetry for radiation therapy and diagnostic radiology, Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
| | - Jakub Kozelka
- Research, Sun Nuclear, A Mirion Medical Company, Melbourne, Florida, USA
| | - Jeff Hildreth
- Research, Sun Nuclear, A Mirion Medical Company, Melbourne, Florida, USA
| | - William Simon
- Research, Sun Nuclear, A Mirion Medical Company, Melbourne, Florida, USA
| | - Andreas Schüller
- Dosimetry for radiation therapy and diagnostic radiology, Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
| | - Ralf-Peter Kapsch
- Dosimetry for radiation therapy and diagnostic radiology, Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
| | - James Renaud
- Medical and Industrial Dosimetry, National Research Council of Canada (NRC), Ottawa, Ontario, Canada
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23
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Rinati GV, Felici G, Galante F, Gasparini A, Kranzer R, Mariani G, Pacitti M, Prestopino G, Schüller A, Vanreusel V, Verellen D, Verona C, Marinelli M. Application of a novel diamond detector for commissioning of FLASH radiotherapy electron beams. Med Phys 2022; 49:5513-5522. [PMID: 35652248 PMCID: PMC9543846 DOI: 10.1002/mp.15782] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/18/2022] [Accepted: 05/23/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose A diamond detector prototype was recently proposed by Marinelli et al. (Medical Physics 2022, https://doi.org/10.1002/mp.15473) for applications in ultrahigh‐dose‐per‐pulse (UH‐DPP) and ultrahigh‐dose‐rate (UH‐DR) beams, as used in FLASH radiotherapy (FLASH‐RT). In the present study, such so‐called flashDiamond (fD) was investigated from the dosimetric point of view, under pulsed electron beam irradiation. It was then used for the commissioning of an ElectronFlash linac (SIT S.p.A., Italy) both in conventional and UH‐DPP modalities. Methods Detector calibration was performed in reference conditions, under 60Co and electron beam irradiation. Its response linearity was investigated in UH‐DPP conditions. For this purpose, the DPP was varied in the 1.2–11.9 Gy range, by changing either the beam applicator or the pulse duration from 1 to 4 μs. Dosimetric validation of the fD detector prototype was then performed in conventional modality, by measuring percentage depth dose (PDD) curves, beam profiles, and output factors (OFs). All such measurements were carried out in a motorized water phantom. The obtained results were compared with the ones from commercially available dosimeters, namely, a microDiamond, an Advanced Markus ionization chamber, a silicon diode detector, and EBT‐XD GAFchromic films. Finally, the fD detector was used to fully characterize the 7 and 9 MeV UH‐DPP electron beams delivered by the ElectronFlash linac. In particular, PDDs, beam profiles, and OFs were measured, for both energies and all the applicators, and compared with the ones from EBT‐XD films irradiated in the same experimental conditions. Results The fD calibration coefficient resulted to be independent from the investigated beam qualities. The detector response was found to be linear in the whole investigated DPP range. A very good agreement was observed among PDDs, beam profiles, and OFs measured by the fD prototype and reference detectors, both in conventional and UH‐DPP irradiation modalities. Conclusions The fD detector prototype was validated from the dosimetric point of view against several commercial dosimeters in conventional beams. It was proved to be suitable in UH‐DPP and UH‐DR conditions, for which no other commercial real‐time active detector is available to date. It was shown to be a very useful tool to perform fast and reproducible beam characterizations in standard clinical motorized water phantom setups. All of the previously mentioned demonstrate the suitability of the proposed detector for the commissioning of UH‐DR linac beams for preclinical FLASH‐RT applications.
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Affiliation(s)
- Gianluca Verona Rinati
- Dipartimento di Ingegneria Industriale, Università di Roma "Tor Vergata,", Roma, 00133, Italy
| | | | | | - Alessia Gasparini
- Iridium Kankernetwerk, Antwerp, 2610, Belgium.,Antwerp University, Faculty of Medicine and Health Sciences, Antwerp, 2610, Belgium
| | - Rafael Kranzer
- PTW-Freiburg, Freiburg, 79115, Germany.,University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University, Oldenburg, 26121, Germany
| | | | | | - Giuseppe Prestopino
- Dipartimento di Ingegneria Industriale, Università di Roma "Tor Vergata,", Roma, 00133, Italy
| | - Andreas Schüller
- Physikalisch-Technische Bundesanstalt, Braunschweig, 38116, Germany
| | - Verdi Vanreusel
- Iridium Kankernetwerk, Antwerp, 2610, Belgium.,Antwerp University, Faculty of Medicine and Health Sciences, Antwerp, 2610, Belgium
| | - Dirk Verellen
- Iridium Kankernetwerk, Antwerp, 2610, Belgium.,Antwerp University, Faculty of Medicine and Health Sciences, Antwerp, 2610, Belgium
| | - Claudio Verona
- Dipartimento di Ingegneria Industriale, Università di Roma "Tor Vergata,", Roma, 00133, Italy
| | - Marco Marinelli
- Dipartimento di Ingegneria Industriale, Università di Roma "Tor Vergata,", Roma, 00133, Italy
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24
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Ashraf MR, Rahman M, Cao X, Duval K, Williams BB, Hoopes PJ, Gladstone DJ, Pogue BW, Zhang R, Bruza P. Individual pulse monitoring and dose control system for pre-clinical implementation of FLASH-RT. Phys Med Biol 2022; 67:10.1088/1361-6560/ac5f6f. [PMID: 35313290 PMCID: PMC10305796 DOI: 10.1088/1361-6560/ac5f6f] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 03/21/2022] [Indexed: 11/11/2022]
Abstract
Objective.Existing ultra-high dose rate (UHDR) electron sources lack dose rate independent dosimeters and a calibrated dose control system for accurate delivery. In this study, we aim to develop a custom single-pulse dose monitoring and a real-time dose-based control system for a FLASH enabled clinical linear accelerator (Linac).Approach.A commercially available point scintillator detector was coupled to a gated integrating amplifier and a real-time controller for dose monitoring and feedback control loop. The controller was programmed to integrate dose for each radiation pulse and stop the radiation beam when the prescribed dose was delivered. Additionally, the scintillator was mounted in a solid water phantom and placed underneath mice skin forin vivodose monitoring. The scintillator was characterized in terms of its radiation stability, mean dose-rate (Ḋm), and dose per pulse (Dp) dependence.Main results.TheDpexhibited a consistent ramp-up period across ∼4-5 pulse. The plastic scintillator was shown to be linear withḊm(40-380 Gy s-1) andDp(0.3-1.3 Gy Pulse-1) to within +/- 3%. However, the plastic scintillator was subject to significant radiation damage (16%/kGy) for the initial 1 kGy and would need to be calibrated frequently. Pulse-counting control was accurately implemented with one-to-one correspondence between the intended and the actual delivered pulses. The dose-based control was sufficient to gate on any pulse of the Linac.In vivodosimetry monitoring with a 1 cm circular cut-out revealed that during the ramp-up period, the averageDpwas ∼0.045 ± 0.004 Gy Pulse-1, whereas after the ramp-up it stabilized at 0.65 ± 0.01 Gy Pulse-1.Significance.The tools presented in this study can be used to determine the beam parameter space pertinent to the FLASH effect. Additionally, this study is the first instance of real-time dose-based control for a modified Linac at ultra-high dose rates, which provides insight into the tool required for future clinical translation of FLASH-RT.
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Affiliation(s)
- M. Ramish Ashraf
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
| | - Mahbubur Rahman
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
| | - Xu Cao
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
| | - Kayla Duval
- Department of Medicine, Geisel School of Medicine, Dartmouth College Hanover NH 03755 USA
| | - Benjamin B. Williams
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
- Department of Medicine, Geisel School of Medicine, Dartmouth College Hanover NH 03755 USA
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756 USA
| | - P. Jack Hoopes
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756 USA
- Department of Surgery, Geisel School of Medicine, Dartmouth College, Hanover NH 03755 USA
| | - David J. Gladstone
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
- Department of Medicine, Geisel School of Medicine, Dartmouth College Hanover NH 03755 USA
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756 USA
| | - Brian W. Pogue
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756 USA
- Department of Surgery, Geisel School of Medicine, Dartmouth College, Hanover NH 03755 USA
| | - Rongxiao Zhang
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
- Department of Medicine, Geisel School of Medicine, Dartmouth College Hanover NH 03755 USA
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756 USA
| | - Petr Bruza
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
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25
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Rodríguez FG, Gonzalez-Castaño DM, Fernández NG, Pardo-Montero J, Schüller A, Gasparini A, Vanreusel V, Verellen D, Felici G, Kranzer R, Paz-Martín J. Development of an ultra-thin parallel plate ionization chamber for dosimetry in flash radiotherapy. Med Phys 2022; 49:4705-4714. [PMID: 35416306 PMCID: PMC9545838 DOI: 10.1002/mp.15668] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022] Open
Abstract
Background Conventional air ionization chambers (ICs) exhibit ion recombination correction factors that deviate substantially from unity when irradiated with dose per pulse magnitudes higher than those used in conventional radiotherapy. This fact makes these devices unsuitable for the dosimetric characterization of beams in ultra‐high dose per pulse as used for FLASH radiotherapy. Purpose We present the design, development, and characterization of an ultra‐thin parallel plate IC that can be used in ultra‐high dose rate (UHDR) deliveries with minimal recombination. Methods The charge collection efficiency (CCE) of parallel plate ICs was modeled through a numerical solution of the coupled differential equations governing the transport of charged carriers produced by ionizing radiation. It was used to find out the optimal parameters for the purpose of designing an IC capable of exhibiting a linear response with dose (deviation less than 1%) up to 10 Gy per pulse at 4
μs pulse duration. As a proof of concept, two vented parallel plate IC prototypes have been built and tested in different ultra‐high pulse dose rate electron beams. Results It has been found that by reducing the distance between electrodes to a value of 0.25 mm it is possible to extend the dose rate operating range of parallel plate ICs to ultra‐high dose per pulse range, at standard voltage of clinical grade electrometers, well into several Gy per pulse. The two IC prototypes exhibit behavior as predicted by the numerical simulation. One of the so‐called ultra‐thin parallel plate ionization chamber (UTIC) prototypes was able to measure up to 10 Gy per pulse, 4
μs pulse duration, operated at 300 V with no significant deviation from linearity within the uncertainties (ElectronFlash Linac, SIT). The other prototype was tested up to 5.4 Gy per pulse, 2.5
μs pulse duration, operated at 250 V with CCE higher than 98.6% (Metrological Electron Accelerator Facility, MELAF at Physikalisch‐Technische Bundesanstalt, PTB). Conclusions This work demonstrates the ability to extend the dose rate operating range of ICs to ultra‐high dose per pulse range by reducing the spacing between electrodes. The results show that UTICs are suitable for measurement in UHDR electron beams.
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Affiliation(s)
- Faustino Gómez Rodríguez
- Department of Particle Physics, University of Santiago, Santiago de Compostela, Spain.,Radiation Physics Laboratory, University of Santiago, Santiago de Compostela, Spain
| | | | | | - Juan Pardo-Montero
- Group of Medical Physics and Biomathematics, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain.,Department of Medical Physics, Complexo Hospitalario Universitario de Santiago de Compostela, Spain
| | - Andreas Schüller
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
| | - Alessia Gasparini
- Department of Radiotherapy, Iridium Network, Belgium.,Faculty of Medicine and Health sciences, University of Antwerp, Belgium.,SCK CEN, Research in dosimetric applications, Mol, Belgium
| | - Verdi Vanreusel
- Department of Radiotherapy, Iridium Network, Belgium.,Faculty of Medicine and Health sciences, University of Antwerp, Belgium.,SCK CEN, Research in dosimetric applications, Mol, Belgium
| | - Dirk Verellen
- Department of Radiotherapy, Iridium Network, Belgium.,Faculty of Medicine and Health sciences, University of Antwerp, Belgium
| | | | - Rafael Kranzer
- PTW, Freiburg, Germany.,University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University Oldenburg, Germany
| | - Jose Paz-Martín
- Department of Particle Physics, University of Santiago, Santiago de Compostela, Spain
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26
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Farr J, Grilj V, Malka V, Sudharsan S, Schippers M. Ultra‐High dose rate radiation production and delivery systems intended for FLASH. Med Phys 2022; 49:4875-4911. [PMID: 35403262 PMCID: PMC9544515 DOI: 10.1002/mp.15659] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 02/21/2022] [Accepted: 03/15/2022] [Indexed: 11/05/2022] Open
Abstract
Higher dose rates, a trend for radiotherapy machines, can be beneficial in shortening treatment times for radiosurgery and mitigating the effects of motion. Recently, even higher doses (e.g., 100 times greater) have become targeted because of their potential to generate the FLASH effect (FE). We refer to these physical dose rates as ultra‐high (UHDR). The complete relationship between UHDR and the FE is unknown. But UHDR systems are needed to explore the relationship further and to deliver clinical UHDR treatments, where indicated. Despite the challenging set of unknowns, the authors seek to make reasonable assumptions to probe how existing and developing technology can address the UHDR conditions needed to provide beam generation capable of producing the FE in preclinical and clinical applications. As a preface, this paper discusses the known and unknown relationships between UHDR and the FE. Based on these, different accelerator and ionizing radiation types are then discussed regarding the relevant UHDR needs. The details of UHDR beam production are discussed for existing and potential future systems such as linacs, cyclotrons, synchrotrons, synchrocyclotrons, and laser accelerators. In addition, various UHDR delivery mechanisms are discussed, along with required developments in beam diagnostics and dose control systems.
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Affiliation(s)
- Jonathan Farr
- Applications of Detectors and Accelerators to Medicine Meyrin 1217 Switzerland
| | - Veljko Grilj
- Lausanne University Hospital Lausanne 1011 Switzerland
| | - Victor Malka
- Weizmann Institute of Science Rehovot 7610001 Israel
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27
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Romano F, Bailat C, Jorge PG, Lerch MLF, Darafsheh A. Ultra‐high dose rate dosimetry: challenges and opportunities for FLASH radiation therapy. Med Phys 2022; 49:4912-4932. [PMID: 35404484 PMCID: PMC9544810 DOI: 10.1002/mp.15649] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/03/2022] [Accepted: 02/20/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Francesco Romano
- Istituto Nazionale di Fisica Nucleare Sezione di Catania Catania Italy
| | - Claude Bailat
- Institute of Radiation Physics Lausanne University Hospital Lausanne University Switzerland
| | - Patrik Gonçalves Jorge
- Institute of Radiation Physics Lausanne University Hospital Lausanne University Switzerland
- Department of Radiation Oncology Lausanne University Hospital Lausanne Switzerland
- Radio‐Oncology Laboratory DO/CHUV Lausanne University Hospital Lausanne Switzerland
| | | | - Arash Darafsheh
- Department of Radiation Oncology Washington University School of Medicine St. Louis MO 63110 USA
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28
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Kranzer R, Schüller A, Bourgouin A, Hackel T, Poppinga D, Lapp M, Looe HK, Poppe B. Response of diamond detectors in ultra-high dose-per-pulse electron beams for dosimetry at FLASH radiotherapy. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac594e] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/28/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective. With increasing investigation of the so-called FLASH effect, the need for accurate real time dosimetry for ultra-high dose rates is also growing. Considering the ultra-high dose-per-pulse (DPP) necessary to produce the ultra-high dose rates for investigations of the FLASH effect, real time dosimetry is a major challenge. In particular, vented ionization chambers, as used for dosimetry in conventional radiotherapy, show significant deviations from linearity with increasing DPP. This is due to recombination losses in the sensitive air volume. Solid state detectors could be an alternative. Due to their good stability of the response with regard to the accumulated dose, diamond detectors such as the microDiamond could be suitable here. The aims of this work are to investigate the response of microDiamond and adapted microDiamond prototypes in ultra-high DPP electron beams, to understand the underlying effects and to draw conclusions for further detector developments. Approach. For the study, an electron beam with a DPP up to 6.5 Gy and a pulse duration of 2.5 μs was used to fulfill the conditions under which the FLASH effect was observed. As a dose rate-independent reference, alanine dosimeters were used. Main Results. It has been shown that the commercially available microDiamond detectors have limitations in terms of linearity at ultra-high DPP. But this is not an intrinsic limitation of the detector principle. The deviations from linearity were correlated with the series resistance and the sensitivity. It could be shown that the linear range can be extended towards ultra-high DPP range by reducing the sensitivity in combination with a low series resistance of the detectors. Significance. The work shows that synthetic single crystal diamond detectors working as Schottky photodiodes are in principle suitable for FLASH-RT dosimetry at electron linear accelerators.
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29
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Taylor PA, Moran JM, Jaffray DA, Buchsbaum JC. A roadmap to clinical trials for FLASH. Med Phys 2022; 49:4099-4108. [PMID: 35366339 PMCID: PMC9321729 DOI: 10.1002/mp.15623] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 02/17/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022] Open
Abstract
While FLASH radiation therapy is inspiring enthusiasm to transform the field, it is neither new nor well understood with respect to the radiobiological mechanisms. As FLASH clinical trials are designed, it will be important to ensure we can deliver dose consistently and safely to every patient. Much like hyperthermia and proton therapy, FLASH is a promising new technology that will be complex to implement in the clinic and similarly will require customized credentialing for multi‐institutional clinical trials. There is no doubt that FLASH seems promising, but many technologies that we take for granted in conventional radiation oncology, such as rigorous dosimetry, 3D treatment planning, volumetric image guidance, or motion management, may play a major role in defining how to use, or whether to use, FLASH radiotherapy. Given the extended time frame for patients to experience late effects, we recommend moving deliberately but cautiously forward toward clinical trials. In this paper, we review the state of quality assurance and safety systems in FLASH, identify critical pre‐clinical data points that need to be defined, and suggest how lessons learned from previous technological advancements will help us close the gaps and build a successful path to evidence‐driven FLASH implementation.
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Affiliation(s)
- Paige A Taylor
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jean M Moran
- Memorial Sloan Kettering Cancer, New York, New York
| | - David A Jaffray
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jeffrey C Buchsbaum
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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30
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Marinelli M, Felici G, Galante F, Gasparini A, Giuliano L, Heinrich S, Pacitti M, Prestopino G, Vanreusel V, Verellen D, Verona C, Verona Rinati G. Design, realization, and characterization of a novel diamond detector prototype for FLASH radiotherapy dosimetry. Med Phys 2022; 49:1902-1910. [PMID: 35064594 PMCID: PMC9306529 DOI: 10.1002/mp.15473] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE FLASH radiotherapy (RT) is an emerging technique in which beams with ultra-high dose rates (UH-DR) and dose per pulse (UH-DPP) are used. Commercially available active real-time dosimeters have been shown to be unsuitable in such conditions, due to severe response nonlinearities. In the present study, a novel diamond-based Schottky diode detector was specifically designed and realized to match the stringent requirements of FLASH-RT. METHODS A systematic investigation of the main features affecting the diamond response in UH-DPP conditions was carried out. Several diamond Schottky diode detector prototypes with different layouts were produced at Rome Tor Vergata University in cooperation with PTW-Freiburg. Such devices were tested under electron UH-DPP beams. The linearity of the prototypes was investigated up to DPPs of about 26 Gy/pulse and dose rates of approximately 1 kGy/s. In addition, percentage depth dose (PDD) measurements were performed in different irradiation conditions. Radiochromic films were used for reference dosimetry. RESULTS The response linearity of the diamond prototypes was shown to be strongly affected by the size of their active volume as well as by their series resistance. By properly tuning the design layout, the detector response was found to be linear up to at least 20 Gy/pulse, well into the UH-DPP range conditions. PDD measurements were performed by three different linac applicators, characterized by DPP values at the point of maximum dose of 3.5, 17.2, and 20.6 Gy/pulse, respectively. The very good superimposition of three curves confirmed the diamond response linearity. It is worth mentioning that UH-DPP irradiation conditions may lead to instantaneous detector currents as high as several mA, thus possibly exceeding the electrometer specifications. This issue was properly addressed in the case of the PTW UNIDOS electrometers. CONCLUSIONS The results of the present study clearly demonstrate the feasibility of a diamond detector for FLASH-RT applications.
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Affiliation(s)
- Marco Marinelli
- Industrial Engineering DepartmentUniversity of Rome “Tor Vergata”RomeItaly
| | | | | | - Alessia Gasparini
- Iridium Kankernetwerk, AntwerpBelgium
- University of AntwerpAntwerpBelgium
| | - Lucia Giuliano
- Institut CurieInserm U 1021‐CNRS UMR 3347University Paris‐SaclayPSL Research UniversityOrsayFrance
| | - Sophie Heinrich
- Institut CurieInserm U 1021‐CNRS UMR 3347University Paris‐SaclayPSL Research UniversityOrsayFrance
| | | | | | - Verdi Vanreusel
- Iridium Kankernetwerk, AntwerpBelgium
- University of AntwerpAntwerpBelgium
| | - Dirk Verellen
- Iridium Kankernetwerk, AntwerpBelgium
- University of AntwerpAntwerpBelgium
| | - Claudio Verona
- Industrial Engineering DepartmentUniversity of Rome “Tor Vergata”RomeItaly
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31
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Ultra-High Dose Rate (FLASH) Carbon Ion Irradiation: Dosimetry and First Cell Experiments. Int J Radiat Oncol Biol Phys 2021; 112:1012-1022. [PMID: 34813912 DOI: 10.1016/j.ijrobp.2021.11.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 11/07/2021] [Accepted: 11/15/2021] [Indexed: 01/05/2023]
Abstract
PURPOSE To establish a beam monitoring and dosimetry system to enable the FLASH dose rate carbon ion irradiation and investigate, at different oxygen concentrations, the in vitro biological response in comparison to the conventional dose rate. METHODS AND MATERIALS CHO-K1 cell response to irradiation at different dose rates and at different levels of oxygenation was studied using clonogenic assay. The Heidelberg Ion-Beam Therapy Center (HIT) synchrotron, after technical improvements, was adjusted to extract ≥5 × 108 12C ions within approximately 150 milliseconds. The beam monitors were filled with helium. RESULTS The FLASH irradiation with beam scanning yields a dose of 7.5 Gy (homogeneity of ±5%) for a 280 MeV/u beam in a volume of at least 8 mm in diameter and a corresponding dose rate of 70 Gy/s (±20%). The dose repetition accuracy is better than 2%, the systematic uncertainty is better than 2%. Clonogenic assay demonstrates a significant FLASH sparing effect which is strongly oxygenation-dependent and mostly pronounced at 0.5% O2 but absent at 0% and 21% O2. CONCLUSION The FLASH dose rates >40 Gy/s were achieved with carbon beams. Cell survival analysis revealed FLASH dose rate sparing in hypoxia (0.5%-4% O2).
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32
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Diffenderfer ES, Sørensen BS, Mazal A, Carlson DJ. The current status of preclinical proton FLASH radiation and future directions. Med Phys 2021; 49:2039-2054. [PMID: 34644403 DOI: 10.1002/mp.15276] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/12/2021] [Accepted: 09/17/2021] [Indexed: 11/05/2022] Open
Abstract
We review the current status of proton FLASH experimental systems, including preclinical physical and biological results. Technological limitations on preclinical investigation of FLASH biological mechanisms and determination of clinically relevant parameters are discussed. A review of the biological data reveals no reproduced proton FLASH effect in vitro and a significant in vivo FLASH sparing effect of normal tissue toxicity observed with multiple proton FLASH irradiation systems. Importantly, multiple studies suggest little or no difference in tumor growth delay for proton FLASH when compared to conventional dose rate proton radiation. A discussion follows on future areas of development with a focus on the determination of the optimal parameters for maximizing the therapeutic ratio between tumor and normal tissue response and ultimately clinical translation of proton FLASH radiation.
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Affiliation(s)
- Eric S Diffenderfer
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Brita S Sørensen
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark.,Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Alejandro Mazal
- Department of Medical Physics, Centro de Protonterapia Quironsalud, Madrid, Spain
| | - David J Carlson
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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33
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Ashraf M, Rahman M, Zhang R, Cao X, Williams BB, Hoopes PJ, Gladstone DJ, Pogue BW, Bruza P. Technical Note: Single-pulse beam characterization for FLASH-RT using optical imaging in a water tank. Med Phys 2021; 48:2673-2681. [PMID: 33730367 PMCID: PMC10771323 DOI: 10.1002/mp.14843] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 11/07/2022] Open
Abstract
PURPOSE High dose rate conditions, coupled with problems related to small field dosimetry, make dose characterization for FLASH-RT challenging. Most conventional dosimeters show significant dependence on dose rate at ultra-high dose rate conditions or fail to provide sufficiently fast temporal data for pulse to pulse dosimetry. Here fast 2D imaging of radioluminescence from a water and quinine phantom was tested for dosimetry of individual 4 μs linac pulses. METHODS A modified clinical linac delivered an electron FLASH beam of >50 Gy/s to clinical isocenter. This modification removed the x-ray target and flattening filter, leading to a beam that was symmetric and gaussian, as verified with GafChromic EBT-XD film. Lateral projected 2D dose distributions for each linac pulse were imaged in a quinine-doped water tank using a gated intensified camera, and an inverse Abel transform reconstruction provided 3D images for on-axis depth dose values. A total of 20 pulses were delivered with a 10 MeV, 1.5 cm circular beam, and beam with jaws wide open (40 × 40 cm2 ), and a 3D dose distribution was recovered for each pulse. Beam output was analyzed on a pulse by pulse basis. RESULTS The Rp , Dmax , and the R50 measured with film and optical methods agreed to within 1 mm for the 1.5 cm circular beam and the beam with jaws wide open. Cross beam profiles for both beams agreed with film data with >95% passing rate (2%/2 mm gamma criteria). The optical central axis depth dose agreed with film data, except for near the surface. A temporal pulse analysis revealed a ramp-up period where the dose per pulse increased for the first few pulses and then stabilized. CONCLUSIONS Optical imaging of radioluminescence was presented as a valuable tool for establishing a baseline for the recently initiated electron FLASH beam at our institution.
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Affiliation(s)
- M.Ramish Ashraf
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
| | - Mahbubur Rahman
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
| | - Rongxiao Zhang
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
- Department of Medicine, Geisel School of Medicine, Dartmouth College Hanover NH 03755 USA
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756 USA
| | - Xu Cao
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
| | - Benjamin B. Williams
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
- Department of Medicine, Geisel School of Medicine, Dartmouth College Hanover NH 03755 USA
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756 USA
| | - P. Jack Hoopes
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756 USA
- Department of Surgery, Geisel School of Medicine, Dartmouth College, Hanover NH 0375 USA
| | - David J. Gladstone
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
- Department of Medicine, Geisel School of Medicine, Dartmouth College Hanover NH 03755 USA
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756 USA
| | - Brian W. Pogue
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756 USA
- Department of Surgery, Geisel School of Medicine, Dartmouth College, Hanover NH 0375 USA
| | - Petr Bruza
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755, US
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Poppinga D, Kranzer R, Farabolini W, Gilardi A, Corsini R, Wyrwoll V, Looe HK, Delfs B, Gabrisch L, Poppe B. VHEE beam dosimetry at CERN Linear Electron Accelerator for Research under ultra-high dose rate conditions. Biomed Phys Eng Express 2020; 7. [PMID: 34037536 DOI: 10.1088/2057-1976/abcae5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/16/2020] [Indexed: 01/28/2023]
Abstract
The aim of this work is the dosimetric characterization of a plane parallel ionization chamber under defined beam setups at the CERN Linear Electron Accelerator for Research (CLEAR). A laser driven electron beam with energy of 200 MeV at two different field sizes of approximately 3.5 mm FWHM and approximately 7 mm FWHM were used at different pulse structures. Thereby the dose-per-pulse range varied between approximately 0.2 and 12 Gy per pulse. This range represents approximately conventional dose rate range beam conditions up to ultra-high dose rate (UHDR) beam conditions. The experiment was based on a water phantom which was integrated into the horizontal beamline and radiochromic films and an Advanced Markus ionization chamber was positioned in the water phantom. In addition, the experimental setup were modelled in the Monte Carlo simulation environment FLUKA. In a first step the radiochromic film measurements were used to verify the beamline setup. Depth dose distributions and dose profiles measured by radiochromic film were compared with Monte Carlo simulations to verify the experimental conditions. Second, the radiochromic films were used for reference dosimetry to characterize the ionization chamber. In particular, polarity effects and the ion collection efficiency of the ionization chamber were investigated for both field sizes and the complete dose rate range. As a result of the study, significant polarity effects and recombination loss of the ionization chamber were shown and characterized. However, the work shows that the behavior of the ionization chamber at the laser driven beam line at the CLEAR facility is comparable to classical high dose-per-pulse electron beams. This allows the use of ionization chambers on the CLEAR system and thus enables active dose measurement during the experiment. Compared to passive dose measurement with film, this is an important step forward in the experimental equipment of the facility.
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Affiliation(s)
| | - Rafael Kranzer
- PTW Freiburg, Freiburg, Germany.,University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University, Oldenburg, Germany
| | | | - Antonio Gilardi
- Federico II, DIETI, University of Napoli, Napoli, Italy.,CERN, CH1211 Geneva, Switzerland.,National Institute for Nuclear Physics (INFN), Section of Napoli, Italy
| | | | | | - Hui Khee Looe
- University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University, Oldenburg, Germany
| | - Björn Delfs
- University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University, Oldenburg, Germany
| | - Lukas Gabrisch
- University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University, Oldenburg, Germany
| | - Björn Poppe
- University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University, Oldenburg, Germany
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