Neutrons from fragmentation of light nuclei in tissue-like media: a study with the GEANT4 toolkit

MONTE-CARLO SIMULATION USING PHITS OF SECONDARY NEUTRONS PRODUCED IN-PATIENT DURING 16O ION THERAPY

In hadrontherapy, oxygen ions 16O can be currently considered as an alternative to carbon ions 12C designed specifically for the treatment of deep and radioresistant tumors. Secondary particles, particularly neutrons constitute a serious problem of undesirable additional irradiation to surrounding healthy tissue. The objective of this study is to evaluate, by Monte-Carlo simulation [code Particle and Heavy Ion Transport code System (PHITS)], the contribution in terms of dose of secondary neutrons produced during interaction 16O ion of 300 MeV u-1 in a soft tissue phantom. The dose of 16O ion, secondary particles and neutrons is evaluated, as well as the particle fluence and energy spectra of neutrons. The contribution to the total dose of secondary neutrons in a soft tissue phantom represents 0.1%. This dose, although apparently insignificant, is essential to conduct even more in-depth studies to understand the long-term effects of these secondary neutrons on the patient's body especially in pediatric case.

Assessment of secondary neutrons in particle therapy by Monte Carlo simulations

OBJECTIVE

The purpose of this study is to estimate the energy and angular distribution of secondary neutrons inside a phantom in hadron therapy, which will support decisions on detector choice and experimental setup design for in-phantom secondary neutron measurements.

APPROACH

Dedicated Monte Carlo simulations were implemented, considering clinically relevant energies of protons, helium and carbon ions. Since scored quantities can vary from different radiation transport models, the codes FLUKA, TOPAS and MCNP were used. The geometry of an active scanning beam delivery system for heavy ion treatment was implemented, and simulations of pristine and spread-out Bragg peaks were carried out. Previous studies, focused on specific ion types or single energies, are qualitatively in agreement with the obtained results.

MAIN RESULTS

The secondary neutrons energy distributions present a continuous spectrum with two peaks, one centred on the thermal/epithermal region, and one on the high-energy region, with the most probable energy ranging from 19 MeV up to 240 MeV, depending on the ion type and its initial energy. The simulations show that the secondary neutron energies may exceed 400 MeV and, therefore, suitable neutron detectors for this energy range shall be needed. Additionally, the angular distribution of the low energy neutrons is quite isotropic, whereas the fast/relativistic neutrons are mainly scattered in the down-stream direction.

SIGNIFICANCE

It would be possible to minimize the influence of the heavy ions when measuring the neutron-generated recoil protons by selecting appropriate measurement positions within the phantom. Although there are discrepancies among the three Monte Carlo codes, the results agree qualitatively and in order of magnitude, being sufficient to support further investigations with the ultimate goal of mapping the secondary neutron doses both in- and out-of-field in hadrontherapy. The obtained secondary neutron spectra are available as supplementary material.

Monte Carlo methods for device simulations in radiation therapy

Monte Carlo (MC) simulations play an important role in radiotherapy, especially as a method to evaluate physical properties that are either impossible or difficult to measure. For example, MC simulations (MCSs) are used to aid in the design of radiotherapy devices or to understand their properties. The aim of this article is to review the MC method for device simulations in radiation therapy. After a brief history of the MC method and popular codes in medical physics, we review applications of the MC method to model treatment heads for neutral and charged particle radiation therapy as well as specific in-room devices for imaging and therapy purposes. We conclude by discussing the impact that MCSs had in this field and the role of MC in future device design.

Quantitative evaluation of potential irradiation geometries for carbon-ion beam grid therapy

PURPOSE

Radiotherapy using grids containing cm-wide beam elements has been carried out sporadically for more than a century. During the past two decades, preclinical research on radiotherapy with grids containing small beam elements, 25 μm-0.7 mm wide, has been performed. Grid therapy with larger beam elements is technically easier to implement, but the normal tissue tolerance to the treatment is decreasing. In this work, a new approach in grid therapy, based on irradiations with grids containing narrow carbon-ion beam elements was evaluated dosimetrically. The aim formulated for the suggested treatment was to obtain a uniform target dose combined with well-defined grids in the irradiated normal tissue. The gain, obtained by crossfiring the carbon-ion beam grids over a simulated target volume, was quantitatively evaluated.

METHODS

The dose distributions produced by narrow rectangular carbon-ion beams in a water phantom were simulated with the PHITS Monte Carlo code. The beam-element height was set to 2.0 cm in the simulations, while the widths varied from 0.5 to 10.0 mm. A spread-out Bragg peak (SOBP) was then created for each beam element in the grid, to cover the target volume with dose in the depth direction. The dose distributions produced by the beam-grid irradiations were thereafter constructed by adding the dose profiles simulated for single beam elements. The variation of the valley-to-peak dose ratio (VPDR) with depth in water was thereafter evaluated. The separation of the beam elements inside the grids were determined for different irradiation geometries with a selection criterion.

RESULTS

The simulated carbon-ion beams remained narrow down to the depths of the Bragg peaks. With the formulated selection criterion, a beam-element separation which was close to the beam-element width was found optimal for grids containing 3.0-mm-wide beam elements, while a separation which was considerably larger than the beam-element width was found advantageous for grids containing 0.5-mm-wide beam elements. With the single-grid irradiation setup, the VPDRs were close to 1.0 already at a distance of several cm from the target. The valley doses given to the normal tissue at 0.5 cm distance from the target volume could be limited to less than 10% of the mean target dose if a crossfiring setup with four interlaced grids was used.

CONCLUSIONS

The dose distributions produced by grids containing 0.5- and 3.0-mm wide beam elements had characteristics which could be useful for grid therapy. Grids containing mm-wide carbon-ion beam elements could be advantageous due to the technical ease with which these beams can be produced and delivered, despite the reduced threshold doses observed for early and late responding normal tissue for beams of millimeter width, compared to submillimetric beams. The treatment simulations showed that nearly homogeneous dose distributions could be created inside the target volumes, combined with low valley doses in the normal tissue located close to the target volume, if the carbon-ion beam grids were crossfired in an interlaced manner with optimally selected beam-element separations. The formulated selection criterion was found useful for the quantitative evaluation of the dose distributions produced by the different irradiation setups.

DNA damage induced by carbon ions (C³⁺) beam accessed by independent component analysis of infrared spectra

PURPOSE

To understand the degradation processes and role of secondary species on deoxyribonucleic acid (DNA)-damaged fragments as a result of irradiation with energetic ions.

MATERIALS AND METHODS

Damage caused to DNA thin films as a result of exposure to 4 keV carbon ions beam was accessed by analyzing the infrared spectra, obtained in situ for different irradiation times, with both bi-dimensional (2D) correlation spectroscopy and independent component analysis (ICA).

RESULTS

Results indicated that deoxyribose, phosphate and base groups of the DNA molecule were being damaged and new reaction products as oxime and furfural groups are being formed.

CONCLUSIONS

Damage on DNA bases is consistent with the formation of oxime products which react with DNA deoxyribose products forming furfural groups and confirming that DNA damage is caused by direct and indirect processes.

Out-of-field dose measurements in a water phantom using different radiotherapy modalities

This investigation focused on the characterization of the lateral dose fall-off following the irradiation of the target with photons, protons and carbon ions. A water phantom was irradiated with a rectangular field using photons, passively delivered protons as well as scanned protons and carbon ions. The lateral dose profile in the depth of the maximum dose was measured using an ion chamber, a diamond detector and thermoluminescence detectors TLD-600 and TLD-700. The yield of thermal neutrons was estimated for all radiation types while their complete spectrum was measured with bubble detectors during the irradiation with photons. The peripheral dose delivered by photons is significantly higher compared to both protons and carbon ions and exceeds the latter by up to two orders of magnitude at distances greater than 50 mm from the field. The comparison of passive and active delivery techniques for protons shows that, for the chosen rectangular target shape, the former has a sharper penumbra whereas the latter has a lower dose in the far-out-of-field region. When comparing scanning treatments, carbon ions present a sharper dose fall-off than protons close to the target but increasing peripheral dose with increasing incident energy. For photon irradiation, the contribution to the out-of-field dose of photoneutrons appears to be of the same order of magnitude as the scattered primary beam. Charged particles show a clear supremacy over x-rays in achieving a higher dose conformality around the target and in sparing the healthy tissue from unnecessary radiation exposure. The out-of-field dose for x-rays increases with increasing beam energy because of the production of biologically harmful neutrons.

Optimizing normal tissue sparing in ion therapy using calculated isoeffective dose for ion selection

PURPOSE

To investigate how the selection of ion type affects the calculated isoeffective dose to the surrounding normal tissue as a function of both normal tissue and target tissue α/β ratios.

METHODS AND MATERIALS

A microdosimetric biologic dose model was incorporated into a Geant4 simulation of parallel opposed beams of protons, helium, lithium, beryllium, carbon, and neon ions. The beams were constructed to give a homogeneous isoeffective dose to a volume in the center of a water phantom for target tissues covering a range of cobalt equivalent α/β ratios of 1-20 Gy. Concomitant normal tissue isoeffective doses in the plateau of the ion beam were then compared for different ions across the range of normal tissue and target tissue radiosensitivities for a fixed isoeffective dose to the target tissue.

RESULTS

The ion type yielding the optimal normal tissue sparing was highly dependent on the α/β ratio of both the normal and the target tissue. For carbon ions, the calculated isoeffective dose to normal tissue at a 5-cm depth varied by almost a factor of 5, depending on the α/β ratios of the normal and target tissue. This ranges from a factor of 2 less than the isoeffective dose of a similar proton treatment to a factor of 2 greater.

CONCLUSIONS

No single ion is optimal for all treatment scenarios. The heavier ions are superior in cases in which the α/β ratio of the target tissue is low and the α/β ratio of normal tissue is high, and protons are superior in the opposite circumstances. Lithium and beryllium appear to offer dose advantages similar to carbon, with a considerably lower normal tissue dose when the α/β ratio in the target tissue is high and the α/β ratio in the normal tissue is low.

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.

Analysis of the physical interactions of therapeutic proton beams in water with the use of Geant4 Monte Carlo calculations

The processes that occur when protons traverse a medium are investigated theoretically for a full therapeutic range of energies [20 MeV, 220 MeV]. The investigation is undertaken using the Geant4 toolkit for water medium. The beam is simulated only inside the phantom, effects of beamline are included in the overall beam properties as lateral width and momentum bandwidth. Every energy deposition is catalogued according to the particle and the process that caused it. The catalogued depositions are analysed statistically. There are only few important processes such as proton ionisation and nuclear scattering (elastic/inelastic) that constitute the main features of the energy distribution. At the same time processes concerning electrons are used very often without obvious effect to the result. Such processes can be therefore approximated in the simulation codes in order to improve the performance of the code. Neutron depositions are most important before the Bragg peak, still they are by an order of magnitude smaller than those of protons. In the region behind the Bragg peak only a small number of neutrons is created in the simulation and their energy contribution through secondary protons is by orders smaller than the effect of proton-produced secondary protons within the Bragg peak. Hence, the effects of neutrons created in the calculation volume can be neglected.

A review of dosimetry studies on external-beam radiation treatment with respect to second cancer induction

It has been long known that patients treated with ionizing radiation carry a risk of developing a second cancer in their lifetimes. Factors contributing to the recently renewed concern about the second cancer include improved cancer survival rate, younger patient population as well as emerging treatment modalities such as intensity-modulated radiation treatment (IMRT) and proton therapy that can potentially elevate secondary exposures to healthy tissues distant from the target volume. In the past 30 years, external-beam treatment technologies have evolved significantly, and a large amount of data exist but appear to be difficult to comprehend and compare. This review article aims to provide readers with an understanding of the principles and methods related to scattered doses in radiation therapy by summarizing a large collection of dosimetry and clinical studies. Basic concepts and terminology are introduced at the beginning. That is followed by a comprehensive review of dosimetry studies for external-beam treatment modalities including classical radiation therapy, 3D-conformal x-ray therapy, intensity-modulated x-ray therapy (IMRT and tomotherapy) and proton therapy. Selected clinical data on second cancer induction among radiotherapy patients are also covered. Problems in past studies and controversial issues are discussed. The needs for future studies are presented at the end.

Microdosimetric evaluation of secondary particles in a phantom produced by carbon 290 MeV/nucleon ions at HIMAC

Microdosimetric single event spectra as a function of depth in a phantom for the 290 MeV/nucleon therapeutic carbon beam at HIMAC were measured by using a tissue equivalent proportional counter (TEPC). Two types of geometries were used: one is a fragment particle identification measurement (PID-mode) with time of flight (TOF) method without a backward phantom, and the other is an in-phantom measurement (IPM-mode) with a backward phantom. On the PID-mode geometry, fragments produced by carbon beam in a phantom are identified by the DeltaE-TOF distribution between two scintillation counters positioned up- and down-stream relative to the tissue equivalent proportional counter (TEPC). Lineal energy distributions for carbon and five ion fragments (proton, helium, lithium, beryllium and boron) were obtained in the lineal-energy range of 0.1-1000 keV/microm at eight depths (7.9-147.9 mm) in an acrylic phantom. In the IPM-mode geometry, the total lineal energy distributions measured at eight depths (61.9-322.9 mm) were compared with the distributions in the PID-mode. Both spectra are consistent with each other. This shows that the PID-mode measurement can be discussed as the equivalent of the phantom measurement. The dose distribution of the carbon beam and fragments were obtained separately. In the depth dose curve, the Bragg peak was observed. Relative biological effectiveness (RBE) for the carbon beam in the acrylic phantom was obtained based on a biological response function as a lineal-energy. The RBE of carbon beam had a maximum of 4.5 at the Bragg peak. Downstream of the Bragg peak, the RBE rapidly decreases. The RBE of fragments is dominated by Boron particles around the Bragg peak region.

Damage to plasmid DNA induced by low energy carbon ions

The damage induced in supercoiled plasmid DNA molecules by 1-6 keV carbon ions has been investigated as a function of ion exposure, energy and charge state. The production of short linear fragments through multiple double strand breaks has been demonstrated and exponential exposure responses for each of the topoisomers have been found. The cross section for the loss of supercoiling was calculated to be (2.2 +/- 0.5) x 10(-14) cm(2) for 2 keV C(+) ions. For singly charged carbon ions, increased damage was observed with increasing ion energy. In the case of 2 keV doubly charged ions, the damage was greater than for singly charged ions of the same energy. These observations demonstrate that ion induced damage is a function of both the kinetic and potential energies of the ion.

Biological dose calculation with Monte Carlo physics simulation for heavy-ion radiotherapy

Treatment planning of heavy-ion radiotherapy involves predictive calculation of not only the physical dose but also the biological dose in a patient body. The biological dose is defined as the product of the physical dose and the relative biological effectiveness (RBE). In carbon-ion radiotherapy at National Institute of Radiological Sciences, the RBE value has been defined as the ratio of the 10% survival dose of 200 kVp x-rays to that of the radiation of interest for in vitro human salivary gland tumour cells. In this note, the physical and biological dose distributions of a typical therapeutic carbon-ion beam are calculated using the GEANT4 Monte Carlo simulation toolkit in comparison with those with the biological dose estimate system based on the one-dimensional beam model currently used in treatment planning. The results differed between the GEANT4 simulation and the one-dimensional beam model, indicating the physical limitations in the beam model. This study demonstrates that the Monte Carlo physics simulation technique can be applied to improve the accuracy of the biological dose distribution in treatment planning of heavy-ion radiotherapy.

Distributions of positron-emitting nuclei in proton and carbon-ion therapy studied with GEANT4

Depth distributions of positron-emitting nuclei in PMMA phantoms are calculated within a Monte Carlo model for heavy-ion therapy (MCHIT) based on the GEANT4 toolkit (version 8.0). The calculated total production rates of (11)C, (10)C and (15)O nuclei are compared with experimental data and with corresponding results of the FLUKA and POSGEN codes. The distributions of e(+) annihilation points are obtained by simulating radioactive decay of unstable nuclei and transporting positrons in the surrounding medium. A finite spatial resolution of the positron emission tomography (PET) is taken into account in a simplified way. Depth distributions of beta(+)-activity as seen by a PET scanner are calculated and compared to available data for PMMA phantoms. The obtained beta(+)-activity profiles are in good agreement with PET data for proton and (12)C beams at energies suitable for particle therapy. The MCHIT capability to predict the beta(+)-activity and dose distributions in tissue-like materials of different chemical composition is demonstrated.

Octree indexing of DICOM images for voxel number reduction and improvement of Monte Carlo simulation computing efficiency

The purpose of the present study is to introduce a compression algorithm for the CT (computed tomography) data used in Monte Carlo simulations. Performing simulations on the CT data implies large computational costs as well as large memory requirements since the number of voxels in such data reaches typically into hundreds of millions voxels. CT data, however, contain homogeneous regions which could be regrouped to form larger voxels without affecting the simulation's accuracy. Based on this property we propose a compression algorithm based on octrees: in homogeneous regions the algorithm replaces groups of voxels with a smaller number of larger voxels. This reduces the number of voxels while keeping the critical high-density gradient area. Results obtained using the present algorithm on both phantom and clinical data show that compression rates up to 75% are possible without losing the dosimetric accuracy of the simulation.