Development of an easy-to-handle range measurement tool using a plastic scintillator for proton beam therapy

Development and application of a novel scintillation gel-based 3D dosimetry system for radiotherapy

PURPOSE

This study introduced a novel 3D dosimetry system for radiotherapy in order to address the limitations of traditional quality assurance methods in precision radiotherapy techniques.

METHODS

The research required the use of scintillation material, optical measurements, and a dose reconstruction algorithm. The scintillation material, which mimics human soft tissue characteristics, served as a both physical phantom and a radiation detector. The dose distribution inside the scintillator can be converted to light distributions, which were measured by optical cameras from different angles and manifested as pixel values. The proposed dose reconstruction algorithm, LASSO-TV, effectively reconstructed the dose distribution from pixel values, overcoming challenges such as limited projection directions and large-scale matrices.

RESULTS

Various clinical plans were tested and validated, including a modified segment from the SBRT plan and IMRT clinical plan. The dosimetry system can execute full 3D dose determinations as a function of time with a spatial resolution of 1-2 mm, enabling high-resolution measurements for dynamic dose distribution. Comparative analysis with mainstream device MapCHECK2 confirmed the accuracy of the system, with a relative measurement error of within 5%.

CONCLUSIONS

Testing and validation results demonstrated the dosimetry system's promising potential for dynamic treatment quality assurance.

High spatiotemporal resolution scintillation imaging of pulsed pencil beam scanning proton beams produced by a gantry-mounted synchrocyclotron

BACKGROUND

A dosimeter with high spatial and temporal resolution would be of significant interest for pencil beam scanning (PBS) proton beams' characterization, especially when facing small fields and beams with high temporal dynamics. Optical imaging of scintillators has potential in providing sub-millimeter spatial resolution with pulse-by-pulse basis temporal resolution when the imaging system is capable of operating in synchrony with the beam-producing accelerator.

PURPOSE

We demonstrate the feasibility of imaging PBS proton beams as they pass through a plastic scintillator detector to simultaneously obtain multiple beam parameters, including proton range, pencil beam's widths at different depths, spot's size, and spot's position on a pulse-by-pulse basis with sub-millimeter resolution.

MATERIALS AND METHODS

A PBS synchrocyclotron was used for proton irradiation. A BC-408 plastic scintillator block with 30 × 30 × 5 cm3 size, and another block with 30 × 30 × 0.5 cm3 size, positioned in an optically sealed housing, were used sequentially to measure the proton range, and spot size/location, respectively. A high-speed complementary metal-oxide-semiconductor (CMOS) camera system synchronized with the accelerator's pulses through a gating module was used for imaging. Scintillation images, captured with the camera directly facing the 5-cm-thick scintillator, were corrected for background (BG), and ionization quenching of the scintillator to obtain the proton range. Spots' position and size were obtained from scintillation images of the 0.5-cm-thick scintillator when a 45° mirror was used to reflect the scintillation light toward the camera.

RESULTS

Scintillation images with 0.16 mm/pixel resolution corresponding to all proton pulses were captured. Pulse-by-pulse analysis showed that variations of the range, spots' position, and size were within ± 0.2% standard deviation of their average values. The absolute ranges were within ± 1 mm of their expected values. The average spot-positions were mostly within ± 0.8 mm and spots' sigma agreed within 0.2 mm of the expected values.

CONCLUSION

Scintillation-imaging PBS beams with high-spatiotemporal resolution is feasible and may help in efficient and cost-effective acceptance testing and commissioning of existing and even emerging technologies such as FLASH, grid, mini-beams, and so forth.

Verification system for intensity-modulated radiation therapy with scintillator

In the preparation of intensity-modulated radiation therapy (IMRT), patient-specific verification is widely employed to optimize the treatment. To accurately estimate the accumulated dose and obtain the field-by-field or segment-by-segment verification, an original IMRT verification tool using scintillator light and an analysis workflow was developed in this study. The raw light distribution was calibrated with respect to the irradiated field size dependency and light diffusion in the water. The calibrated distribution was converted to dose quantity and subsequently compared with the results of the clinically employed plan. A criterion of 2-mm dose-to-agreement and 3% dose difference was specified in the gamma analysis with a 10% dose threshold. By applying the light diffusion calibration, the maximum dose difference was corrected from 7.7 cGy to 3.9 cGy around the field edge for a 60 cGy dose, 7 × 7 cm² irradiation field, and 10 MV beam energy. Equivalent performance was confirmed in the chromodynamic film. The average dose difference and gamma pass rate of the accumulated dose distributions in six patients were 0.8 ± 4.5 cGy and 97.4%, respectively. In the field-by-field analysis, the average dose difference and gamma pass rate in seven fields of Patient 1 were 0.2 ± 1.2 cGy and 93.9%, respectively. In the segment-by-segment analysis, the average dose difference and gamma pass rate in nine segments of Patient 1 and a 305° gantry angle were - 0.03 ± 0.2 cGy and 93.9%, respectively. This system allowed the simultaneous and independent analysis of each field or segment in the accumulated dose analysis.

Characterization of a new scintillation imaging system for proton pencil beam dose rate measurements

The goal of this work was to create a technique that could measure all possible spatial and temporal delivery rates used in pencil-beam scanning (PBS) proton therapy. The proposed system used a fast scintillation screen for full-field imaging to resolve temporal and spatial patterns as it was delivered. A fast intensified CMOS camera used continuous mode with 10 ms temporal frame rate and 1 × 1 mm2 spatial resolution, imaging a scintillation screen during clinical proton PBS delivery. PBS plans with varying dose, dose rate, energy, field size, and spot-spacing were generated, delivered and imaged. The captured images were post processed to provide dose and dose rate values after background subtraction, perspective transformation, uniformity correction for the camera and the scintillation screen, and calibration into dose. The linearity in scintillation response with respect to varying dose rate, dose, and field size was within 2%. The quenching corrected response with varying energy was also within 2%. Large spatio-temporal variations in dose rate were observed, even for plans delivered with similar dose distributions. Dose and dose rate histograms and maximum dose rate maps were generated for quantitative evaluations. With the fastest PBS delivery on a clinical system, dose rates up to 26.0 Gy s-1 were resolved. The scintillation imaging technique was able to quantify proton PBS dose rate profiles with spot weight as low as 2 MU, with spot-spacing of 2.5 mm, having a 1 × 1 mm2 spatial resolution. These dose rate temporal profiles, spatial maps, and cumulative dose rate histograms provide useful metrics for the potential evaluation and optimization of dose rate in treatment plans.

A scintillator-based range telescope for particle therapy

The commissioning and operation of a particle therapy centre requires an extensive set of detectors for measuring various parameters of the treatment beam. Among the key devices are detectors for beam range quality assurance. In this work, a novel range telescope based on a plastic scintillator and read out by a large-scale CMOS sensor is presented. The detector is made of a stack of 49 plastic scintillator sheets with a thickness of 2-3 mm and an active area of 100 × 100 mm², resulting in a total physical stack thickness of 124.2 mm. This compact design avoids optical artefacts that are common in other scintillation detectors. The range of a proton beam is reconstructed using a novel Bragg curve model that incorporates scintillator quenching effects. Measurements to characterise the performance of the detector were carried out at the Heidelberger Ionenstrahl-Therapiezentrum (HIT, Heidelberg, GER) and the Clatterbridge Cancer Centre (CCC, Bebington, UK). The maximum difference between the measured range and the reference range was found to be 0.41 mm at a proton beam range of 310 mm and was dominated by detector alignment uncertainties. With the new detector prototype, the water-equivalent thickness of PMMA degrader blocks has been reconstructed within ± 0.1 mm. An evaluation of the radiation hardness proves that the range reconstruction algorithm is robust following the deposition of 6,300 Gy peak dose into the detector. Furthermore, small variations in the beam spot size and transverse beam position are shown to have a negligible effect on the range reconstruction accuracy. The potential for range measurements of ion beams is also investigated.

Estimation and correction of Cerenkov-light on luminescence image of water for carbon-ion therapy dosimetry

PURPOSE

The luminescence images of water during the irradiation of carbon-ions provide useful information such as the ranges and the widths of carbon-ion beams. However, measured luminescence images show higher intensities in shallow depths and wider lateral profiles than those of the dose distributions. These differences prevent the luminescence imaging of water from being applied to a quality assurance for carbon-ion therapy. We assumed that the differences were due to the contaminations of Cerenkov-light from the secondary electrons of carbon-ions as well as the prompt gamma photons in the measured image. In this study, we applied a correction method to a luminescence image of water during the irradiation of carbon-ion beams.

METHODS

We estimated the distribution of the Cerenkov-light in water during the irradiation of carbon-ions by Monte Carlo simulation and subtracted the simulated Cerenkov-light from the depth and lateral profiles of the measured luminescence image for 241.5 MeV/u-carbon-ions.

RESULTS

With these corrections, we successfully obtained depth and lateral profiles whose distributions are almost identical to the dose distributions of carbon-ions. The high intensities in the shallow depth areas decreased and the Bragg peak intensity increased. The beam widths of the measured images approached those of the ionization chamber.

CONCLUSIONS

These results indicate that the luminescence imaging of water with our proposed correction has potential to be used for dose distribution measurements for carbon-ion therapy dosimetry.

Ionization quenching correction for a 3D scintillator detector exposed to scanning proton beams

The ionization quenching phenomenon in scintillators must be corrected to obtain accurate dosimetry in particle therapy. The purpose of this study was to develop a methodology for correcting camera projection measurements of a 3D scintillator detector exposed to proton pencil beams. Birks' ionization quenching model and the energy deposition by secondary electrons (EDSE) model were used to correct the light captured by a prototype 3D scintillator detector. The detector was made of a 20 cm × 20 cm × 20 cm tank filled with liquid scintillator, and three cameras. The detector was exposed to four proton-beam energies (84.6, 100.9, 144.9, and 161.6 MeV) at The University of Texas MD Anderson Cancer Center's Proton Therapy Center. The dose and track averaged linear energy transfer (LET) were obtained using validated Monte Carlo (MC) simulations. The corrected light output was compared to the dose calculated by the MC simulation. Optical artefact corrections were used to correct for refraction at the air-scintillator interface, and image perspective. These corrections did not account for the non-orthogonal integration of data off the central axis of the image. Therefore, we compared the light output to an integrated MC dose and LET along the non-orthogonal path. After accounting for the non-orthogonal integration of the data, the corrected light output reduced the dose error at the Bragg peak region from 15% to 3% for low proton-beam energies. Overall, the doses at the Bragg peak region using the Birks' model and EDSE model were less than ±3% and ±7% of the MC dose, respectively. We have improved the application of Birks' model quenching corrections in 3D scintillators by numerically projecting the dose and LET 3D grid to camera projections. This study shows that scintillator projections can be corrected using average LET values at the central axes.

A mathematical expression for depth-light curves of therapeutic proton beams in a quenching scintillator

PURPOSE

Recently, there has been increasing interest in the development of scintillator-based detectors for the measurement of depth-dose curves of therapeutic proton beams (Beaulieu and Beddar [2016], Phys Med Biol., 61:R305-R343). These detectors allow the measurement of single beam parameters such as the proton range or the reconstruction of the full three-dimensional dose distribution. Thus, scintillation detectors could play an important role in beam quality assurance, online beam monitoring, and proton imaging. However, the light output of the scintillator as a function of dose deposition is subject to quenching effects due to the high-specific energy loss of incident protons, particularly in the Bragg peak. The aim of this work is to develop a model that describes the percent depth-light curve in a quenching scintillator and allow the extraction of information about the beam range and the strength of the quenching.

METHODS

A mathematical expression of a depth-light curve, derived from a combination of Birks' law (Birks [1951], Proc Phys Soc A., 64:874) and Bortfeld's Bragg curve (Bortfeld [1997], Med Phys., 24:2024-2033) that is termed a "quenched Bragg" curve, is presented. The model is validated against simulation and measurement.

RESULTS

A fit of the quenched Bragg model to simulated depth-light curves in a polystyrene-based scintillator shows good agreement between the two, with a maximum deviation of 2.5% at the Bragg peak. The differences are larger behind the Bragg peak and in the dose build-up region. In the same simulation, the difference between the reconstructed range and the reference proton range is found to be always smaller than 0.16 mm. The comparison with measured data shows that the fitted beam range agrees with the reference range within their respective uncertainties.

CONCLUSIONS

The quenched Bragg model is, therefore, an accurate tool for the range measurement from quenched depth-dose curves. Moreover, it allows the reconstruction of the beam energy spread, the particle fluence, and the magnitude of the quenching effect from a measured depth-light curve.

A novel and fast method for proton range verification using a step wedge and 2D scintillator

PURPOSE

To implement and evaluate a novel and fast method for proton range verification by using a planar scintillator and step wedge.

METHODS

A homogenous proton pencil beam plan with 35 energies was designed and delivered to a 2D flat scintillator with a step wedge. The measurement was repeated 15 times (3 different days, 5 times per day). The scintillator image was smoothed, the Bragg peak and distal fall off regions were fitted by an analytical equation, and the proton range was calculated using simple trigonometry. The accuracy of this method was verified by comparing the measured ranges to those obtained using an ionization chamber and a scanning water tank, the gold standard. The reproducibility was evaluated by comparing the ranges over 15 repeated measurements. The sensitivity was evaluated by delivering to same beam to the system with a film inserted under the wedge.

RESULTS

The range accuracy of all 35 proton energies measured over 3 days was within 0.2 mm. The reproducibility in 15 repeated measurements for all 35 proton ranges was ±0.045 mm. The sensitivity to range variation is 0.1 mm for the worst case. This efficient procedure permits measurement of 35 proton ranges in less than 3 min. The automated data processing produces results immediately. The setup of this system took less than 5 min. The time saving by this new method is about two orders of magnitude when compared with the time for water tank range measurements.

CONCLUSIONS

A novel method using a scintillator with a step wedge to measure the proton range was implemented and evaluated. This novel method is fast and sensitive, and the proton range measured by this method was accurate and highly reproducible.

Determination of the Range and Spread-Out Bragg Peak Width of Proton Beams Using a Large-Volume Liquid Scintillator

Purpose

To determine the range, spread-out Bragg peak (SOBP) width, and output of a passive-scattering proton beam with a liquid scintillator detector, without the need for quenching correction.

Materials and Methods

The depth-light profiles of 3 beam energies (140, 160, and 180 MeV) with 6 SOBP widths at each energy, produced in a 20 × 20 × 20-cm³ liquid scintillator tank, were collected by a charge-coupled device camera. By defining landmarks on the light signals, measured ranges and SOBP widths were acquired. A linear dependence was found between nominal and measured properties, and calibration factors were obtained by comparing those properties. The daily output stability and reproducibility of the liquid scintillator detector were studied by conducting 8 repeated measurements over 2 weeks in a ⁶⁰Co beam.

Results

The beam ranges were determined with submillimeter accuracy without the need for any correction. The maximum difference between the measured and nominal range was 1.0 mm. The mean difference between the measured and nominal SOBP widths after correction was 0.1 mm (σ = 1.8 mm), with a maximum difference of 3.5 mm. The light output was reproducible with an SD of 0.14%.

Conclusions

The method described here makes it possible to quickly and accurately determine the range and SOBP width of a passive-scattering proton beam in a liquid scintillator, without the need for quenching correction. In addition, the detector proved to be reliable over time, showing good output consistency with a high degree of precision.

Fast range measurement of spot scanning proton beams using a volumetric liquid scintillator detector

Accurate confirmation and verification of the range of spot scanning proton beams is crucial for correct dose delivery. Current methods to measure proton beam range using ionization chambers are either time-consuming or result in measurements with poor spatial resolution. The large-volume liquid scintillator detector allows real-time measurements of the entire dose profile of a spot scanning proton beam. Thus, liquid scintillator detectors are an ideal tool for measuring the proton beam range for commissioning and quality assurance. However, optical artefacts may decrease the accuracy of measuring the proton beam range within the scintillator tank. The purpose of the current study was to 1) develop a geometric calibration system to accurately calculate physical distances within the liquid scintillator detector, taking into account optical artefacts; and 2) assess the accuracy, consistency, and robustness of proton beam range measurement using the liquid scintillator detector with our geometric calibration system. The range of the proton beam was measured with the calibrated liquid scintillator system and was compared to the nominal range. Measurements were made on three different days to evaluate the setup robustness from day to day, and three sets of measurements were made for each day to evaluate the consistency from delivery to delivery. All proton beam ranges measured using the liquid scintillator system were within half a millimeter of the nominal range. The delivery-to-delivery standard deviation of the range measurement was 0.04 mm, and the day-to-day standard deviation was 0.10 mm. In addition to the accuracy and robustness demonstrated by these results when our geometric calibration system was used, the liquid scintillator system allowed the range of all 94 proton beams to be measured in just two deliveries, making the liquid scintillator detector a perfect tool for range measurement of spot scanning proton beams.

Calculations and measurements of the scintillator-to-water stopping power ratio of liquid scintillators for use in proton radiotherapy

Liquid scintillators are a promising detector for high-resolution three-dimensional proton therapy dosimetry. Because the scintillator comprises both the active volume of the detector and the phantom material, an ideal scintillator will exhibit water equivalence in its radiological properties. One of the most fundamental of these is the scintillator's stopping power. The objective of this study was to compare calculations and measurements of scintillator-to-water stopping power ratios to evaluate the suitability of the liquid scintillators BC-531 and OptiPhase HiSafe 3 for proton dosimetry. We also measured the relative scintillation output of the two scintillators. Both calculations and measurements show that the linear stopping power of OptiPhase is significantly closer to water than that of BC-531. BC-531 has a somewhat higher scintillation output. OptiPhase can be mixed with water at high concentrations, which further improves its scintillator-to-water stopping power ratio. However, this causes the solution to become cloudy, which has a negative impact on the scintillation output and spatial resolution of the detector. OptiPhase is preferred over BC-531 for proton dosimetry because its density and scintillator-to-water stopping power ratio are more water equivalent.

Optical artefact characterization and correction in volumetric scintillation dosimetry

The goals of this study were (1) to characterize the optical artefacts affecting measurement accuracy in a volumetric liquid scintillator detector, and (2) to develop methods to correct for these artefacts. The optical artefacts addressed were photon scattering, refraction, camera perspective, vignetting, lens distortion, the lens point spread function, stray radiation, and noise in the camera. These artefacts were evaluated by theoretical and experimental means, and specific correction strategies were developed for each artefact. The effectiveness of the correction methods was evaluated by comparing raw and corrected images of the scintillation light from proton pencil beams against validated Monte Carlo calculations. Blurring due to the lens and refraction at the scintillator tank-air interface were found to have the largest effect on the measured light distribution, and lens aberrations and vignetting were important primarily at the image edges. Photon scatter in the scintillator was not found to be a significant source of artefacts. The correction methods effectively mitigated the artefacts, increasing the average gamma analysis pass rate from 66% to 98% for gamma criteria of 2% dose difference and 2 mm distance to agreement. We conclude that optical artefacts cause clinically meaningful errors in the measured light distribution, and we have demonstrated effective strategies for correcting these optical artefacts.

Verification of proton range, position, and intensity in IMPT with a 3D liquid scintillator detector system

PURPOSE

Intensity-modulated proton therapy (IMPT) using spot scanned proton beams relies on the delivery of a large number of beamlets to shape the dose distribution in a highly conformal manner. The authors have developed a 3D system based on liquid scintillator to measure the spatial location, intensity, and depth of penetration (energy) of the proton beamlets in near real-time.

METHODS

The detector system consists of a 20 × 20 × 20 cc liquid scintillator (LS) material in a light tight enclosure connected to a CCD camera. This camera has a field of view of 25.7 by 19.3 cm and a pixel size of 0.4 mm. While the LS is irradiated, the camera continuously acquires images of the light distribution produced inside the LS. Irradiations were made with proton pencil beams produced with a spot-scanning nozzle. Pencil beams with nominal ranges in water between 9.5 and 17.6 cm were scanned to irradiate an area of 10 × 10 cm square on the surface of the LS phantom. Image frames were acquired at 50 ms per frame.

RESULTS

The signal to noise ratio of a typical Bragg peak was about 170. Proton range measured from the light distribution produced in the LS was accurate to within 0.3 mm on average. The largest deviation seen between the nominal and measured range was 0.6 mm. Lateral position of the measured pencil beam was accurate to within 0.4 mm on average. The largest deviation seen between the nominal and measured lateral position was 0.8 mm; however, the accuracy of this measurement could be improved by correcting light scattering artifacts. Intensity of single proton spots were measured with precision ranging from 3 % for the smallest spot intensity (0.005 MU) to 0.5 % for the largest spot (0.04 MU).

CONCLUSIONS

Our LS detector system has been shown to be capable of fast, submillimeter spatial localization of proton spots delivered in a 3D volume. This system could be used for beam range, intensity and position verification in IMPT.

Quenching correction for volumetric scintillation dosimetry of proton beams

Volumetric scintillation dosimetry has the potential to provide fast, high-resolution, three-dimensional radiation dosimetry. However, scintillators exhibit a nonlinear response at the high linear energy transfer (LET) values characteristic of proton Bragg peaks. The purpose of this study was to develop a quenching correction method for volumetric scintillation dosimetry of proton beams. Scintillation light from a miniature liquid scintillator detector was measured along the central axis of a 161.6 MeV proton pencil beam. Three-dimensional dose and LET distributions were calculated for 85.6, 100.9, 144.9 and 161.6 MeV beams using a validated Monte Carlo model. LET values were also calculated using an analytical formula. A least-squares fit to the data established the empirical parameters of a quenching correction model. The light distribution in a tank of liquid scintillator was measured with a CCD camera at all four beam energies. The quenching model and LET data were used to correct the measured light distribution. The calculated and measured Bragg peak heights agreed within ±3% for all energies except 85.6 MeV, where the agreement was within ±10%. The quality of the quenching correction was poorer for sharp low-energy Bragg peaks because of blurring and detector size effects. The corrections performed using analytical LET values resulted in doses within 1% of those obtained using Monte Carlo LET values. The proposed method can correct for quenching with sufficient accuracy for dosimetric purposes. The required LET values may be computed effectively using Monte Carlo or analytical methods. Future detectors should improve blurring correction methods and optimize the pixel size to improve accuracy for low-energy Bragg peaks.

Investigation of the feasibility of a simple method for verifying the motion of a binary multileaf collimator synchronized with the rotation of the gantry for helical tomotherapy

In this paper, we suggest a new method for verifying the motion of a binary multileaf collimator (MLC) in helical tomotherapy. For this we used a combination of a cylindrical scintillator and a general-purpose camcorder. The camcorder records the light from the scintillator following photon irradiation, which we use to track the motion of the binary MLC. The purpose of this study is to demonstrate the feasibility of this method as a binary MLC quality assurance (QA) tool. First, the verification was performed using a simple binary MLC pattern with a constant leaf open time; secondly, verification using the binary MLC pattern used in a clinical setting was also performed. Sinograms of simple binary MLC patterns, in which leaves that were open were detected as "open" from the measured light, define the sensitivity which, in this case, was 1.000. On the other hand, the specificity, which gives the fraction of closed leaves detected as "closed", was 0.919. The leaf open error identified by our method was -1.3 ± 7.5%. The 68.6% of observed leaves were performed within ± 3% relative error. The leaf open error was expressed by the relative errors calculated on the sinogram. In the clinical binary MLC pattern, the sensitivity and specificity were 0.994 and 0.997, respectively. The measurement could be performed with -3.4 ± 8.0% leaf open error. The 77.5% of observed leaves were performed within ± 3% relative error. With this method, we can easily verify the motion of the binary MLC, and the measurement unit developed was found to be an effective QA tool.

New method for obtaining position and time structure of source in HDR remote afterloading brachytherapy unit utilizing light emission from scintillator

When using a HDR remote afterloading brachytherapy unit, results of treatment can be greatly influenced by both source position and treatment time. The purpose of this study is to obtain information on the source of the HDR remote afterloading unit, such as its position and time structure, with the use of a simple system consisting of a plastic scintillator block and a charge‐coupled device (CCD) camera. The CCD camera was used for recording images of scintillation luminescence at a fixed rate of 30 frames per second in real time. The source position and time structure were obtained by analyzing the recorded images. For a preset source‐step‐interval of 5 mm, the measured value of the source position was 5.0±1.0mm, with a pixel resolution of 0.07 mm in the recorded images. For a preset transit time of 30 s, the measured value was 30.0±0.6 s, when the time resolution of the CCD camera was 1/30 s. This system enabled us to obtain the source dwell time and movement time. Therefore, parameters such as I192r source position, transit time, dwell time, and movement time at each dwell position can be determined quantitatively using this plastic scintillator‐CCD camera system.

PACS number: 87.53.Jw