Influence of fragment reaction of relativistic heavy charged particles on heavy-ion radiotherapy

Virtual cone-beam computed tomography simulator with human phantom library and its application to the elemental material decomposition

PURPOSE

The purpose of this study is to develop a virtual CBCT simulator with a head and neck (HN) human phantom library and to demonstrate the feasibility of elemental material decomposition (EMD) for quantitative CBCT imaging using this virtual simulator.

METHODS

The library of 36 HN human phantoms were developed by extending the ICRP 110 adult phantoms based on human age, height, and weight statistics. To create the CBCT database for the library, a virtual CBCT simulator that simulated the direct and scattered X-ray on a flat panel detector using ray-tracing and deep-learning (DL) models was used. Gaussian distributed noise was also included on the flat panel detector, which was evaluated using a real CBCT system. The usefulness of the virtual CBCT system was demonstrated through the application of the developed DL-based EMD model for case involving virtual phantom and real patient.

RESULTS

The virtual simulator could generate various virtual CBCT images based on the human phantom library, and the prediction of the EMD could be successfully performed by preparing the CBCT database from the proposed virtual system, even for a real patient. The CBCT image degradation owing to the scattered X-ray and the statistical noise affected the prediction accuracy, although these effects were minimal. Furthermore, the elemental distribution using the real CBCT image was also predictable.

CONCLUSIONS

This study demonstrated the potential of using computer vision for medical data preparation and analysis, which could have important implications for improving patient outcomes, especially in adaptive radiation therapy.

Development of a more accurate Geant4 quantum molecular dynamics model for hadron therapy

Objective. Although in heavy-ion therapy, the quantum molecular dynamics (QMD) model is one of the most fundamental physics models providing an accurate daughter-ion production yield in the final state, there are still non-negligible differences with the experimental results. The aim of this study is to improve fragment production in water phantoms by developing a more accurate QMD model in Geant4. Approach. A QMD model was developed by implementing modern Skyrme interaction parameter sets, as well as by incorporating with an ad hoc α-cluster model in the initial nuclear state. Two adjusting parameters were selected that can significantly affect the fragment productions in the QMD model: the radius to discriminate a cluster to which nucleons belong after the nucleus–nucleus reaction, denoted by R, and the squared standard deviation of the Gaussian packet, denoted by L. Squared Mahalanobis’s distance of fragment yields and angular distributions with 1, 2, and the higher atomic number for the produced fragments were employed as objective functions, and multi-objective optimization (MOO), which make it possible to compare quantitatively the simulated production yields with the reference experimental data, was performed. Main results. The MOO analysis showed that the QMD model with modern Skyrme parameters coupled with the proposed α-cluster model, denoted as SkM* α, can drastically improve light fragments yields in water. In addition, the proposed model reproduced the kinetic energy distribution of the fragments accurately. The optimized L in SkM* α was confirmed to be realistic by the charge radii analysis in the ground state formation. Significance. The proposed framework using MOO was demonstrated to be very useful in judging the superiority of the proposed nuclear model. The optimized QMD model is expected to improve the accuracy of heavy-ion therapy dosimetry.

Monte Carlo study of out-of-field exposure in carbon-ion radiotherapy: Organ doses in pediatric brain tumor treatment

PURPOSE

To estimate out-of-field doses during carbon-ion radiotherapy (CIRT) for pediatric cerebellar ependymoma.

METHODS

Given that the out-of-field dose of CIRT depends on beam parameters, we set them for treatment of typical pediatric cerebellar ependymoma based on a previous study. The out-of-field dose during CIRT for pediatric cerebellar ependymoma was then estimated using the Particle and Heavy-Ion Transport code System with Monte Carlo simulations and a computational phantom developed at the University of Florida. From the simulation results, out-of-field doses at dose equivalents of passive beam and active scanning beam CIRT were calculated and compared to the secondary neutron-equivalent dose of passive beam CIRT and proton therapy.

RESULTS

The out-of-field dose equivalent decreases from 1.45 mSv/Gy (relative biological effectiveness - RBE) at the thyroid to 0.06 mSv/Gy (RBE) at the bladder, verifying decay as the distance from the treatment target increases. The out-of-field neutron-equivalent dose in organs per prescribed dose for passive beam CIRT is lower than that for passive beam proton therapy. Moreover, the out-of-field organ dose equivalent per prescribed dose for the active scanning beam CIRT is lower than that for the passive beam CIRT.

CONCLUSIONS

Active scanning beam CIRT is promising for pediatric cerebellar ependymoma regarding out-of-field exposure, outperforming the comparison radiotherapy modalities.

DOSE-RATE AND CELL-KILLING SENSITIVITY OF HIGH-LINEAR ENERGY TRANSFER ION BEAM

It is believed that the dose-rate of radiation will have an influence on cell sensitivity. The dose-rate effects on cell survival can be expressed by the change of the β term in the linear quadratic model. The value at a high-dose-rate decreases below 60 Gy/h and reaches zero at 0.2 Gy/h or less for photons. However, the effect for a high-LET ion-beam is not well known. At HIMAC, cells were exposed to 70 keV/μm carbon-ion beams at different dose-rates between 0.5 and 600 Gy/h at room temperature. The β values for all survival curves show no significant differences among the dose-rates tested for HSG, V79 and CHO cells. Changing the ion-beam dose-rate had no effect on cell survival. This suggests that high-LET particle beams, such as galactic cosmic rays, may not exhibit a dose-rate effect on cell survival. Low-dose-rate radiation showed an effect similar to high-dose-rate radiation.

Report of a National Cancer Institute special panel: Characterization of the physical parameters of particle beams for biological research

PURPOSE

To define the physical parameters needed to characterize a particle beam in order to allow intercomparison of different experiments performed using different ions at the same facility and using the same ion at different facilities.

METHODS

At the request of the National Cancer Institute (NCI), a special panel was convened to review the current status of the field and to provide suggested metrics for reporting the physical parameters of particle beams to be used for biological research. A set of physical parameters and measurements that should be performed by facilities and understood and reported by researchers supported by NCI to perform pre-clinical radiobiology and medical physics of heavy ions were generated.

RESULTS

Standard measures such as radiation delivery technique, beam modifiers used, nominal energy, field size, physical dose and dose rate should all be reported. However, more advanced physical measurements, including detailed characterization of beam quality by microdosimetric spectrum and fragmentation spectra, should also be established and reported. Details regarding how such data should be incorporated into Monte Carlo simulations and the proper reporting of simulation details are also discussed.

CONCLUSIONS

In order to allow for a clear relation of physical parameters to biological effects, facilities and researchers should establish and report detailed physical characteristics of the irradiation beams utilized including both standard and advanced measures. Biological researchers are encouraged to actively engage facility staff and physicists in the design and conduct of experiments. Modeling individual experimental setups will allow for the reporting of the uncertainties in the measurement or calculation of physical parameters which should be routinely reported.

Opportunistic dose amplification for proton and carbon ion therapy via capture of internally generated thermal neutrons

This paper presents Neutron Capture Enhanced Particle Therapy (NCEPT), a method for enhancing the radiation dose delivered to a tumour relative to surrounding healthy tissues during proton and carbon ion therapy by capturing thermal neutrons produced inside the treatment volume during irradiation. NCEPT utilises extant and in-development boron-10 and gadolinium-157-based drugs from the related field of neutron capture therapy. Using Monte Carlo simulations, we demonstrate that a typical proton or carbon ion therapy treatment plan generates an approximately uniform thermal neutron field within the target volume, centred around the beam path. The tissue concentrations of neutron capture agents required to obtain an arbitrary 10% increase in biological effective dose are estimated for realistic treatment plans, and compared to concentrations previously reported in the literature. We conclude that the proposed method is theoretically feasible, and can provide a worthwhile improvement in the dose delivered to the tumour relative to healthy tissue with readily achievable concentrations of neutron capture enhancement drugs.

Histone Deacetylase Inhibitor Induced Radiation Sensitization Effects on Human Cancer Cells after Photon and Hadron Radiation Exposure

Suberoylanilide hydroxamic acid (SAHA) is a histone deacetylase inhibitor, which has been widely utilized throughout the cancer research field. SAHA-induced radiosensitization in normal human fibroblasts AG1522 and lung carcinoma cells A549 were evaluated with a combination of γ-rays, proton, and carbon ion exposure. Growth delay was observed in both cell lines during SAHA treatment; 2 μM SAHA treatment decreased clonogenicity and induced cell cycle block in G1 phase but 0.2 μM SAHA treatment did not show either of them. Low LET (Linear Energy Transfer) irradiated A549 cells showed radiosensitization effects on cell killing in cycling and G1 phase with 0.2 or 2 μM SAHA pretreatment. In contrast, minimal sensitization was observed in normal human cells after low and high LET radiation exposure. The potentially lethal damage repair was not affected by SAHA treatment. SAHA treatment reduced the rate of γ-H2AX foci disappearance and suppressed RAD51 and RPA (Replication Protein A) focus formation. Suppression of DNA double strand break repair by SAHA did not result in the differences of SAHA-induced radiosensitization between human cancer cells and normal cells. In conclusion, our results suggest SAHA treatment will sensitize cancer cells to low and high LET radiation with minimum effects to normal cells.

Equivalency of the quality of sublethal lesions after photons and high-linear energy transfer ion beams

The quality of the sublethal damage (SLD) after irradiation with high-linear energy transfer (LET) ion beams was investigated with low-LET photons. Chinese hamster V79 cells and human squamous carcinoma SAS cells were first exposed to a priming dose of different ion beams at different LETs at the Heavy Ion Medical Accelerator in the Chiba facility. The cells were kept at room temperature and then exposed to a secondary test dose of X-rays. Based on the repair kinetics study, the surviving fraction of cells quickly increased with the repair time, and reached a plateau in 2-3 h, even when cells had received priming monoenergetic high-LET beams or spread-out Bragg peak beams as well as X-ray irradiation. The shapes of the cell survival curves from the secondary test X-rays, after repair of the damage caused by the high-LET irradiation, were similar to those obtained from cells exposed to primary X-rays only. Complete SLD repairs were observed, even when the LET of the primary ion beams was very high. These results suggest that the SLD caused by high-LET irradiation was repaired well, and likewise, the damage caused by the X-rays. In cells where the ion beam had made a direct hit in the core region in an ion track, lethal damage to the domain was produced, resulting in cell death. On the other hand, in domains that had received a glancing hit in the low-LET penumbra region, the SLD produced was completely repaired.

A Novel Method for Fragmentation Studies in Particle Therapy: Principles of Ion Identification

Purpose

In carbon ion beam radiation therapy, fragmentation processes within the patient lead to changes in the composition of the particle field with increasing depth. Consequences are alterations of the resulting dose distribution and its biological effectiveness. To enable accurate treatment planning, the characteristics of the ion spectra resulting from fragmentation processes need to be known for various ion energies and target materials. In this work, we present a novel method for ion type identification using a small and highly flexible setup based on a single detector and designed to simplify measurements and overcome current shortages in available fragmentation data.

Materials and Methods

The presented approach is based on the pixelated, semiconductor detector Timepix. The large number of pixels with small pitch, all individually calibrated for energy deposition, enables detection and visualization of single particle tracks. For discrimination among different ion species, the pattern recognition analysis of the detector signal is used. Fragmentation spectra resulting from a primary carbon ion beam at various depths of tissue-equivalent material were studied to identify different ion species in mixed particle fields. The performance of the method was evaluated quantitatively using reference data from an established technique.

Results

All ion species resulting from carbon ion fragmentation in tissue-equivalent material could be separated. For measurements behind a 158-mm-thick water tank, the relative fractions of H, He, Be, and B ions detected agreed with corresponding reference data within the limits of uncertainty. For the relatively rare lithium ions, the agreement was within 2.3 Δ_ref (uncertainty of reference).

Conclusion

For designated configurations, the presented ion type identification method enables studies of therapeutic carbon ion beams with a simple, small, and configurable detection setup. The technique is promising to enable online fragmentation studies over a wide range of beam and target parameters in the future.

L Band EPR Tooth Dosimetry for Heavy Ion Irradiation

Electron Paramagnetic Resonance (EPR) tooth dosimetry is being developed as a device to rapidly assess large populations that were potentially exposed to radiation during a major radiation accident or terrorist event. While most exposures are likely to be due to fallout and therefore involve low linear energy transfer (LET) radiation, there is also a potential for exposures to high LET radiation, for which the effect on teeth has been less well characterized by EPR. Therefore, the aim of this paper is to acquire fundamental response curves for high LET radiation in tooth dosimetry using L band EPR. For this purpose, we exposed human teeth to high energy carbon ions using the heavy ion medical accelerator in Chiba at the National Institute of Radiological Sciences. The primary findings were that EPR signals for carbon ion irradiation were about one-tenth the amplitude of the response to the same dose of 150 kVp X-rays.

Radiation track, DNA damage and response-a review

The purpose of this paper has been to review the current status and progress of the field of radiation biophysics, and draw attention to the fact that physics, in general, and radiation physics in particular, with the aid of mathematical modeling, can help elucidate biological mechanisms and cancer therapies. We hypothesize that concepts of condensed-matter physics along with the new genomic knowledge and technologies and mechanistic mathematical modeling in conjunction with advances in experimental DNA (Deoxyrinonucleic acid molecule) repair and cell signaling have now provided us with unprecedented opportunities in radiation biophysics to address problems in targeted cancer therapy, and genetic risk estimation in humans. Obviously, one is not dealing with 'low-hanging fruit', but it will be a major scientific achievement if it becomes possible to state, in another decade or so, that we can link mechanistically the stages between the initial radiation-induced DNA damage; in particular, at doses of radiation less than 2 Gy and with structural changes in genomic DNA as a precursor to cell inactivation and/or mutations leading to genetic diseases. The paper presents recent development in the physics of radiation track structure contained in the computer code system KURBUC, in particular for low-energy electrons in the condensed phase of water for which we provide a comprehensive discussion of the dielectric response function approach. The state-of-the-art in the simulation of proton and carbon ion tracks in the Bragg peak region is also presented. The paper presents a critical discussion of the models used for elastic scattering, and the validity of the trajectory approach in low-electron transport. Brief discussions of mechanistic and quantitative aspects of microdosimetry, DNA damage and DNA repair are also included as developed by the authors' work.

Nuclear reaction measurements on tissue-equivalent materials and GEANT4 Monte Carlo simulations for hadrontherapy

When a carbon beam interacts with human tissues, many secondary fragments are produced into the tumor region and the surrounding healthy tissues. Therefore, in hadrontherapy precise dose calculations require Monte Carlo tools equipped with complex nuclear reaction models. To get realistic predictions, however, simulation codes must be validated against experimental results; the wider the dataset is, the more the models are finely tuned.Since no fragmentation data for tissue-equivalent materials at Fermi energies are available in literature, we measured secondary fragments produced by the interaction of a 55.6 MeV u(-1) (12)C beam with thick muscle and cortical bone targets. Three reaction models used by the Geant4 Monte Carlo code, the Binary Light Ions Cascade, the Quantum Molecular Dynamic and the Liege Intranuclear Cascade, have been benchmarked against the collected data. In this work we present the experimental results and we discuss the predictive power of the above mentioned models.

Solution Radioactivated by Hadron Radiation Can Increase Sister Chromatid Exchanges

When energetic particles irradiate matter, it becomes activated by nuclear reactions. Radioactivation induced cellular effects are not clearly understood, but it could be a part of bystander effects. This investigation is aimed at understanding the biological effects from radioactivation in solution induced by hadron radiation. Water or phosphate buffered saline was activated by being exposed to hadron radiation including protons, carbon- and iron-ions. 1 mL of radioactivated solution was transferred to flasks with Chinese hamster ovary (CHO) cells cultured in 5 mL of complete media. The induction of sister chromatid exchanges (SCE) was used to observe any increase in DNA damage responses. The energy spectrum and the half-lives of the radioactivation were analyzed by NaI scintillation detector in order to identify generated radionuclides. In the radioactivated solution, 511 keV gamma-rays were observed, and their half-lives were approximately 2 min, 10 min, and 20 min. They respectively correspond to the beta+ decay of 15O, 13N, and 11C. The SCE frequencies in CHO cells increased depending on the amount of radioactivation in the solution. These were suppressed with a 2-hour delayed solution transfer or pretreatment with dimethyl sulfoxide (DMSO). Our results suggest that the SCE induction by radioactivated solution was mediated by free radicals produced by the annihilated gamma-rays. Since the SCE induction and DMSO modulation are also reported in radiation-induced bystander effects, our results imply that radioactivation of the solution may have some contribution to the bystander effects from hadron radiation. Further investigations are required to assess if radioactivation effects would attribute an additional level of cancer risk of the hadron radiation therapy itself.

Influence of nuclear interactions in polyethylene range compensators for carbon-ion radiotherapy

PURPOSE

A recent study revealed that polyethylene (PE) would cause extra carbon-ion attenuation per range shift by 0.45%/cm due to compositional differences in nuclear interactions. The present study aims to assess the influence of PE range compensators on tumor dose in carbon-ion radiotherapy.

METHODS

Carbon-ion radiation was modeled to be composed of primary carbon ions and secondary particles, for each of which the dose and the relative biological effectiveness (RBE) were estimated at a tumor depth in the middle of spread-out Bragg peak. Assuming exponential behavior for attenuation and yield of these components with depth, the PE effect on dose was calculated for clinical carbon-ion beams and was partly tested by experiment. The two-component model was integrated into a treatment-planning system and the PE effect was estimated in two clinical cases.

RESULTS

The attenuation per range shift by PE was 0.1%-0.3%/cm in dose and 0.2%-0.4%/cm in RBE-weighted dose, depending on energy and range-modulation width. This translates into reduction of RBE-weighted dose by up to 3% in extreme cases. In the treatment-planning study, however, the effect on RBE-weighted dose to tumor was typically within 1% reduction.

CONCLUSIONS

The extra attenuation of primary carbon ions in PE was partly compensated by increased secondary particles for tumor dose. In practical situations, the PE range compensators would normally cause only marginal errors as compared to intrinsic uncertainties in treatment planning, patient setup, beam delivery, and clinical response.

Comparison of the bromodeoxyuridine-mediated sensitization effects between low-LET and high-LET ionizing radiation on DNA double-strand breaks

The incorporation of halogenated pyrmidines such as bromo- and iodo-deoxyuridines (BrdU, IdU) into DNA as thymidine analogs enhances cellular radiosensitivity when high-linear energy transfer (LET) radiation is not used. Although it is known that high-LET ionizing radiation confers fewer biological effects resulting from halogenated pyrimidine incorporation, the exact mechanisms of reduced radiosensitivity with high-LET radiation are not clear. We investigated the radiosensitization effects of halogenated pyrimidines with high-LET radiation using accelerated carbon and iron ions. Cells synchronized into the G1 phase after unifilar (1 cell cycle) and bifilar (2 cell cycles) substitution with 10 µM BrdU were exposed to various degrees of LET with heavy ions and X-rays. We then carried out a colony formation assay to measure cell survival. The γ-H2AX focus formation assay provided a measure of DNA double-strand break (DSB) formation and repair kinetics. Chromosomal aberration formations for the first post-irradiation metaphase were also scored. For both low-LET X-rays and carbon ions (13 keV/µm), BrdU incorporation led to impaired DNA repair kinetics, a larger initial number of DNA DSBs more frequent chromosomal aberrations at the first post-irradiated metaphase, and increased radiosensitivity for cell lethality. The enhancement ratio was higher after bifilar substitution. In contrast, no such synergistic enhancements were observed after high-LET irradiation with carbon and iron ions (70 and 200 keV/µm, respectively), even after bifilar substitution. Our results suggest that BrdU substitution did not modify the number and quality of DNA DSBs produced by high-LET radiation. The incorporation of halogenated pyrimidines may produce more complex/clustered DNA damage along with radicals formed by low-LET ionizing radiation. In contrast, the severity of damage produced by high-LET radiation may undermine the effects of BrdU and account for the observed minimal radiosensitization effects.

Influence of track directions on the biological consequences in cells irradiated with high LET heavy ions

PURPOSE

The impact of the damage distribution to cellular survival and chromosomal aberrations following high Linear Energy Transfer (LET) radiation was investigated.

MATERIALS AND METHODS

High LET iron-ions (500 MeV/n, LET 200 keV/μm) were delivered to G1-phase synchronized Chinese Hamster Ovary (CHO) cells located at a vertical or horizontal angle relative to the ion beam in order to give same dose but different fluence and damage distribution.

RESULTS

Horizontal irradiation produced DNA double-strand break (DSB) along each ion track represented as clustered lines, and vertical irradiation produced a greater fluence. The initial damages measured by premature chromosome condensation were equal per dose in both irradiation types. Horizontal irradiation proved to be less effective in cell killing than vertical at doses of more than 3 Gy. Vertical irradiation produced a higher number of metaphase chromosomal aberrations compared to horizontally irradiated samples. In particular, formation of exchange-type aberrations was the same, but that of deletion-type aberrations were significantly higher after vertical irradiation than horizontal irradiation.

CONCLUSIONS

Therefore, we concluded that high fluence per dose is more effective than low fluence per dose to produce radiation-induced chromosomal aberrations and to kill exposed cells following high LET heavy-ion exposure.

Design of ridge filters for spread-out Bragg peaks with Monte Carlo simulation in carbon ion therapy

Spread-out Bragg peaks made by ridge filters or wheel range modulators are used in charged particle therapy with passive methods to achieve uniform biological responses in irradiated tumors. Following the biological responses needed to design the ridge filters, which were developed at the National Institute of Radiological Sciences in Japan, new ridge filters were designed using recent developments in heavy-ion reactions and dosimetry. The Monte Carlo code of Geant4 was used to calculate the qualities of carbon ion beams in a water phantom. The results obtained from the simulation were corrected so that they agreed with the measurements of depth dose distributions. The calculations of biological responses to fragments other than carbon ions were assumed to be for helium ions. The measured dose distributions with the designed ridge filters were compared to the calculated distributions. A beam modifying system using this adaptable method was successively applied to carbon ion therapy at Gunma University.

Medical Applications of Accelerators

Particle accelerators play an essential role in the field of medical applications. A large variety of systems is in use for diagnostic purposes, such as the production of radioactive tracers for imaging or x-ray radiography. The dominant application, however, is related to the treatment of cancer patients. This article puts emphasis on cancer treatment, presenting the status and developments of the corresponding technical systems, and gives a brief overview of the biophysical properties and medical aspects of these treatments.

In vitro characterization of cells derived from chordoma cell line U-CH1 following treatment with X-rays, heavy ions and chemotherapeutic drugs

Background

Chordoma, a rare cancer, is usually treated with surgery and/or radiation. However, very limited characterizations of chordoma cells are available due to a minimal availability (only two lines validated by now) and the extremely long doubling time. In order to overcome this situation, we successfully derived a cell line with a shorter doubling time from the first validated chordoma line U-CH1 and obtained invaluable cell biological data.

Method

After isolating a subpopulation of U-CH1 cells with a short doubling time (U-CH1-N), cell growth, cell cycle distribution, DNA content, chromosome number, p53 status, and cell survival were examined after exposure to X-rays, heavy ions, camptothecin, mitomycin C, cisplatin and bleocin. These data were compared with those of HeLa (cervical cancer) and U87-MG (glioblastoma) cells.

Results

The cell doubling times for HeLa, U87-MG and U-CH1-N were approximately 18 h, 24 h and 3 days respectively. Heavy ion irradiation resulted in more efficient cell killing than x-rays in all three cell lines. Relative biological effectiveness (RBE) at 10% survival for U-CH1-N was about 2.45 for 70 keV/μm carbon and 3.86 for 200 keV/μm iron ions. Of the four chemicals, bleocin showed the most marked cytotoxic effect on U-CH1-N.

Conclusion

Our data provide the first comprehensive cellular characterization using cells of chordoma origin and furnish the biological basis for successful clinical results of chordoma treatment by heavy ions.

Spectra of linear energy transfer and other dosimetry characteristics as measured in C290 MeV/n MONO and SOBP ion beams at HIMAC-BIO (NIRS, Japan) with different detectors

Active mobile dosimetry unit (Liulin), passive plastic nuclear track detectors (PNTD) and thermoluminescent detectors (TLD) were exposed in a C290 MeV/n beam at HIMAC-BIO (NIRS, Japan). Two different types of beam configuration were used--monoenergetic beam (MONO) and spread-out Bragg peak (SOBP); the detectors were placed at several depths from the entrance up to the depths behind the Bragg peak. Relative response of TLDs in beams has been studied as a function of the depth, and it was re-proved that it can depend on the linear energy transfer (LET). Liulin measures energy deposition in Si; the spectra of energy deposited in Si can be transformed to the spectra of lineal energy or LET. PNTDs are able to determine the LET of registered particles directly. The limitation of both methods is in the range in which they can determine the LET-Liulin is able to measure perpendicularly incident charged particles up to ∼35 keV/µm (in water), PNTD can measure from ∼7 to 400 keV/µm, independently of the registration angle. The results from both methods are compared and combined for both beams' configuration, and a good agreement is observed.

Spectrometry of linear energy transfer with track-etched detectors in carbon ion beams, MONO and SOBP

Five various materials employed as track-etched detectors (TEDs) were exposed in beams of carbon ions with energy 290 MeV. u(-1) in the HIMAC-BIO facility in Japan. The exposures were performed behind various types of polymethyl methacrylate shielding. The beam had two possible set-ups--monoenergetic set-up and modulated spread-out Bragg peak set-up. All used TEDs are polyallyl diglycol carbonates (PADCs): Page from Mouldings (Pershore) Ltd, Tastrak from Track Analysis Systems Ltd, both from the UK; USF4 from American Technical Plastics from the USA and two products of Japan Fukuvi Chemical Industry Co., Ltd--TD1 and Baryotrak. Spectra of linear energy transfer and depth-dose distributions were obtained. Besides, differences among PADCs are discussed.

Microdosimetric approach to NIRS-defined biological dose measurement for carbon-ion treatment beam

The RBE-weighted absorbed dose, called "biological dose," has been routinely used for carbon-ion treatment planning in Japan to formulate dose prescriptions for treatment protocols. This paper presents a microdosimetric approach to measuring the biological dose, which was redefined to be derived from microdosimetric quantities measured by a tissue-equivalent proportional counter (TEPC). The TEPC was calibrated in (60)Co gamma rays to assure a traceability of the TEPC measurement to Japanese standards and to eliminate the discrepancies among matching counters. The absorbed doses measured by the TEPC were reasonably coincident with those measured by a reference ionization chamber. The RBE value was calculated from the microdosimetric spectrum on the basis of the microdosimetric kinetic model. The biological doses obtained by the TEPC were compared with those prescribed in the carbon-ion treatment planning system. We found that it was reasonable for the measured biological doses to decrease with depth around the rear SOBP region because of beam divergence, scattering effect, and fragmentation reaction. These results demonstrate that the TEPC can be an effective tool to assure the radiation quality in carbon-ion radiotherapy.

Benchmarking nuclear models of FLUKA and GEANT4 for carbon ion therapy

As carbon ions, at therapeutic energies, penetrate tissue, they undergo inelastic nuclear reactions and give rise to significant yields of secondary fragment fluences. Therefore, an accurate prediction of these fluences resulting from the primary carbon interactions is necessary in the patient's body in order to precisely simulate the spatial dose distribution and the resulting biological effect. In this paper, the performance of nuclear fragmentation models of the Monte Carlo transport codes, FLUKA and GEANT4, in tissue-like media and for an energy regime relevant for therapeutic carbon ions is investigated. The ability of these Monte Carlo codes to reproduce experimental data of charge-changing cross sections and integral and differential yields of secondary charged fragments is evaluated. For the fragment yields, the main focus is on the consideration of experimental approximations and uncertainties such as the energy measurement by time-of-flight. For GEANT4, the hadronic models G4BinaryLightIonReaction and G4QMD are benchmarked together with some recently enhanced de-excitation models. For non-differential quantities, discrepancies of some tens of percent are found for both codes. For differential quantities, even larger deviations are found. Implications of these findings for the therapeutic use of carbon ions are discussed.

The Monte Carlo code MCPTV--Monte Carlo dose calculation in radiation therapy with carbon ions

The Monte Carlo code MCPTV is presented. MCPTV is designed for dose calculation in treatment planning in radiation therapy with particles and especially carbon ions. MCPTV has a voxel-based concept and can perform a fast calculation of the dose distribution on patient CT data. Material and density information from CT are taken into account. Electromagnetic and nuclear interactions are implemented. Furthermore the algorithm gives information about the particle spectra and the energy deposition in each voxel. This can be used to calculate the relative biological effectiveness (RBE) for each voxel. Depth dose distributions are compared to experimental data giving good agreement. A clinical example is shown to demonstrate the capabilities of the MCPTV dose calculation.

Comparison of DNA breaks at entrance channel and Bragg peak induced by fast C6+ ions--influence of the addition of platinum atoms on DNA

When energetic carbon ion beam (GeV range) goes through the matter, inelastic processes such as electronic ionization, molecular and nuclear fragmentation occur. For carbontherapy (hadrontherapy) purpose, it is of interest to compare the number of DNA breaks -single SSB or double DSB- for a given dose at the entrance channel and at the Bragg peak to look for a possible differential effect in the number of DNA breaks induced at these two locations. Samples of free plasmids DNA and complexes of plasmids DNA added with molecules containing platinum have been placed at different locations of an experimental setup simulating penetration depths of the ion beam in water and irradiated by carbon ions 290 MeV/amu. The DNA breaks have been quantified by subsequent electrophoresis on agarose gels. To disentangle the respective role of the direct and indirect effect, a free radical scavenger of hydroxyl radicals HO degree-dimethylsulfoxide DMSO- has been added in some of the experiments. In the range of Linear Energy Transfer-LET 13 - 110 keV/microm-, the number of the DSB was found to be constant versus the LET for a given dose. Contrary, the number of the SSB decreases at the Bragg peak compared to the entrance channel. In the presence of platinum, the number of single and double breaks was considerably enhanced, and follows a similar behaviour than in the free-DNA experiments. Quantitative results on DNA damages do not show significant enhancement due to the nuclear or to the molecular fragmentation in the present experiments.