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Guan F, Jiang D, Wang X, Yang M, Iga K, Li Y, Bronk L, Bronk J, Wang L, Guo Y, Sahoo N, Grosshans DR, Koong AC, Zhu XR, Mohan R. Mimicking large spot-scanning radiation fields for proton FLASH preclinical studies with a robotic motion platform. ARXIV 2024:arXiv:2409.09518v1. [PMID: 39314510 PMCID: PMC11419177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Previously, a synchrotron-based horizontal proton beamline (87.2 MeV) was successfully commissioned to deliver radiation doses in FLASH and conventional dose rate modes to small fields and volumes. In this study, we developed a strategy to increase the effective radiation field size using a custom robotic motion platform to automatically shift the positions of biological samples. The beam was first broadened with a thin tungsten scatterer and shaped by customized brass collimators for irradiating cell/organoid cultures in 96-well plates (a 7-mm-diameter circle) or for irradiating mice (1-cm2 square). Motion patterns of the robotic platform were written in G-code, with 9-mm spot spacing used for the 96-well plates and 10.6-mm spacing for the mice. The accuracy of target positioning was verified with a self-leveling laser system. The dose delivered in the experimental conditions was validated with EBT-XD film attached to the 96-well plate or the back of the mouse. Our film-measured dose profiles matched Monte Carlo calculations well (1D gamma pass rate >95%). The FLASH dose rates were 113.7 Gy/s for cell/organoid irradiation and 191.3 Gy/s for mouse irradiation. These promising results indicate that this robotic platform can be used to effectively increase the field size for preclinical experiments with proton FLASH.
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Affiliation(s)
- Fada Guan
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Dadi Jiang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Xiaochun Wang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Ming Yang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Kiminori Iga
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
- Particle Therapy Division, Hitachi America, Ltd, 2535 Augustine Drive, Santa Clara, California 95054, USA
| | - Yuting Li
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Lawrence Bronk
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Julianna Bronk
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Liang Wang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Youming Guo
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Narayan Sahoo
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - David R. Grosshans
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Albert C. Koong
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Xiaorong R. Zhu
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Radhe Mohan
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
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Liu CW, Kolano AM, Gray T, Stephans KL, Videtic GMM, Farr JB, Xia P. Cyclotron and linear accelerator generated scanning proton beams for lung cancer SBRT: Interplay effects and mitigations. Med Phys 2024; 51:3985-3994. [PMID: 38683935 DOI: 10.1002/mp.17082] [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: 02/15/2024] [Accepted: 03/23/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Pencil beam scanning (PBS) proton therapy for moving targets is known to be impacted by interplay effects between the scanning beam and organ motion. While respiratory motion in the thoracic region is the major cause for organ motion, interplay effects depend on the delivery characteristics of proton accelerators. PURPOSE To evaluate the impact of different types of PBS proton accelerators and spot sizes on interplay effects, mitigations, and plan quality for Stereotactic Body Radiation Therapy (SBRT) treatment of non-small cell lung cancer (NSCLC). METHODS Twenty NSCLC patients treated with photon SBRT were selected to represent varying tumor volumes and respiratory motion amplitudes (median: 0.6 cm with abdominal compression) for this retrospective study. For each patient, plans were created using: (1) cyclotron-generated proton beams (CPB) with spot sizes of σ = 2.7-7.0 mm; (2) linear accelerator proton beams (LPB) (σ = 2.9-5.5 mm); and (3) linear accelerator proton minibeams (LPMB) (σ = 0.9-3.9 mm). The energy switching time is one second for CPB, and 0.005 s for LPMB and LPB. Plans were robustly optimized on the gross tumor volume (GTV) using each individual phase of four-dimensional computed tomography (4DCT) scans. Initially, single-field optimization (SFO) plans were evaluated; if the plan quality did not meet the dosimetric requirement, multi-field optimization (MFO) was used. MFO plans were created for all patients for comparisons. For each patient, all plans were normalized to have the same dose received by 99% of the GTV. Interplay effects were evaluated by computing the dose on 10 breathing phases, based on the spot distribution. Volumetric repainting (VR) was performed 2-6 times for each plan. We compared volume receiving 100% of the prescribed dose (V100%RX) of the GTV, and normal lung V20Gy. RESULTS Twelve of 20 plans can be optimized sufficiently with SFO. SFO plans were less sensitive to the interplay effect compared to MFO plans in terms of target coverage for both LPB and LPMB. The following comparisons showed results utilizing the MFO technique. In the interplay evaluation without repainting, the mean V100%RX of the GTV were 99.42 ± 0.6%, 97.52 ± 3.9%, and 94.49 ± 7.3% for CPB, LPB, and LPMB plans, respectively. Following VR (2 × for CPB; 3 × for LPB; 5 × for LPMB), V100%RX of the GTV were improved (on average) by 0.13%, 1.84%, and 4.63%, respectively, achieving the acceptance criteria of V100%RX > 95%. Because of fast energy switch in linear accelerator proton machines, the delivery time for VR plans was the lowest for LPB plans, while delivery time for LPMB was on average 1 min longer than CPB plans. The advantage of small spot machines was better sparing in normal lung V20Gy, even when VR was applied. CONCLUSION In the absence of repainting, proton machines with large spot sizes generated more robust plans against interplay effects. The number of VR increased with decreasing spot sizes to achieve the acceptance criteria. VR improved the plan robustness against interplay effects for modalities with small spot sizes and fast energy changes, preserving the low dose sparing aspect of the LPMB, even when motion is included.
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Affiliation(s)
- Chieh-Wen Liu
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Anna M Kolano
- Applications of Detectors and Accelerators to Medicine (ADAM) SA, Meyrin, Switzerland
- Advanced Oncotherapy (AVO) plc, London, UK
| | - Tara Gray
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Kevin L Stephans
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gregory M M Videtic
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jonathan B Farr
- Applications of Detectors and Accelerators to Medicine (ADAM) SA, Meyrin, Switzerland
- Advanced Oncotherapy (AVO) plc, London, UK
| | - Ping Xia
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Northway SK, Vallejo BM, Liu L, Hansen EE, Tang S, Mah D, MacEwan IJ, Urbanic JJ, Chang C. A quantitative framework for patient-specific collision detection in proton therapy. J Appl Clin Med Phys 2024; 25:e14247. [PMID: 38131514 PMCID: PMC11005990 DOI: 10.1002/acm2.14247] [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: 08/08/2023] [Revised: 09/28/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Beam modifying accessories for proton therapy often need to be placed in close proximity of the patient for optimal dosimetry. However, proton treatment units are larger in size and as a result the planned treatment geometry may not be achievable due to collisions with the patient. A framework that can accurately simulate proton treatment geometry is desired. PURPOSE A quantitative framework was developed to model patient-specific proton treatment geometry, minimize air gap, and avoid collisions. METHODS The patient's external contour is converted into the International Electrotechnique Commission (IEC) gantry coordinates following the patient's orientation and each beam's gantry and table angles. All snout components are modeled by three-dimensional (3D) geometric shapes such as columns, cuboids, and frustums. Beam-specific parameters such as isocenter coordinates, snout type and extension are used to determine if any point on the external contour protrudes into the various snout components. A 3D graphical user interface is also provided to the planner to visualize the treatment geometry. In case of a collision, the framework's analytic algorithm quantifies the maximum protrusion of the external contour into the snout components. Without a collision, the framework quantifies the minimum distance of the external contour from the snout components and renders a warning if such distance is less than 5 cm. RESULTS Three different snout designs are modeled. Examples of potential collision and its aversion by snout retraction are demonstrated. Different patient orientations, including a sitting treatment position, as well as treatment plans with multiple isocenters, are successfully modeled in the framework. Finally, the dosimetric advantage of reduced air gap enabled by this framework is demonstrated by comparing plans with standard and reduced air gaps. CONCLUSION Implementation of this framework reduces incidence of collisions in the treatment room. In addition, it enables the planners to minimize the air gap and achieve better plan dosimetry.
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Affiliation(s)
- Stephen K. Northway
- Department of Radiation Medicine and Applied SciencesUniversity of California at San DiegoLa JollaCaliforniaUSA
- California Protons Cancer Therapy CenterSan DiegoCaliforniaUSA
| | - Bailey M. Vallejo
- Department of Radiation Medicine and Applied SciencesUniversity of California at San DiegoLa JollaCaliforniaUSA
- California Protons Cancer Therapy CenterSan DiegoCaliforniaUSA
| | - Lawrence Liu
- Department of Radiation Medicine and Applied SciencesUniversity of California at San DiegoLa JollaCaliforniaUSA
- California Protons Cancer Therapy CenterSan DiegoCaliforniaUSA
| | - Emily E. Hansen
- Department of Radiation Medicine and Applied SciencesUniversity of California at San DiegoLa JollaCaliforniaUSA
- California Protons Cancer Therapy CenterSan DiegoCaliforniaUSA
| | - Shikui Tang
- Texas Center for Proton TherapyIrvingTexasUSA
| | - Dennis Mah
- ProCure Proton Therapy CenterSomersetNew JerseyUSA
| | - Iain J. MacEwan
- Department of Radiation Medicine and Applied SciencesUniversity of California at San DiegoLa JollaCaliforniaUSA
- California Protons Cancer Therapy CenterSan DiegoCaliforniaUSA
| | - James J. Urbanic
- Department of Radiation Medicine and Applied SciencesUniversity of California at San DiegoLa JollaCaliforniaUSA
- California Protons Cancer Therapy CenterSan DiegoCaliforniaUSA
| | - Chang Chang
- Department of Radiation Medicine and Applied SciencesUniversity of California at San DiegoLa JollaCaliforniaUSA
- California Protons Cancer Therapy CenterSan DiegoCaliforniaUSA
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Yin L, Masumi U, Ota K, Sforza DM, Miles D, Rezaee M, Wong JW, Jia X, Li H. Feasibility of Synchrotron-Based Ultra-High Dose Rate (UHDR) Proton Irradiation with Pencil Beam Scanning for FLASH Research. Cancers (Basel) 2024; 16:221. [PMID: 38201648 PMCID: PMC10778151 DOI: 10.3390/cancers16010221] [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: 11/27/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND This study aims to present the feasibility of developing a synchrotron-based proton ultra-high dose rate (UHDR) pencil beam scanning (PBS) system. METHODS The RF extraction power in the synchrotron system was increased to generate 142.4 MeV pulsed proton beams for UHDR irradiation at ~100 nA beam current. The charge per spill was measured using a Faraday cup. The spill length and microscopic time structure of each spill was measured with a 2D strip transmission ion chamber. The measured UHDR beam fluence was used to derive the spot dwell time for pencil beam scanning. Absolute dose distributions at various depths and spot spacings were measured using Gafchromic films in a solid-water phantom. RESULTS For proton UHDR beams at 142.4 MeV, the maximum charge per spill is 4.96 ± 0.10 nC with a maximum spill length of 50 ms. This translates to an average beam current of approximately 100 nA during each spill. Using a 2 × 2 spot delivery pattern, the delivered dose per spill at 5 cm and 13.5 cm depth is 36.3 Gy (726.3 Gy/s) and 56.2 Gy (1124.0 Gy/s), respectively. CONCLUSIONS The synchrotron-based proton therapy system has the capability to deliver pulsed proton UHDR PBS beams. The maximum deliverable dose and field size per pulse are limited by the spill length and extraction charge.
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Affiliation(s)
- Lingshu Yin
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (D.M.S.); (D.M.); (M.R.); (J.W.W.); (X.J.); (H.L.)
| | - Umezawa Masumi
- Hitachi, Ltd., Research and Development Group, Center for Technology Innovation–Energy, 7-2-1, Omika-chou, Hitachi-shi 319-1292, Ibaraki-ken, Japan;
| | - Kan Ota
- Pyramid Technical Consultants, Inc., Boston, MA 02452, USA;
| | - Daniel M. Sforza
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (D.M.S.); (D.M.); (M.R.); (J.W.W.); (X.J.); (H.L.)
| | - Devin Miles
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (D.M.S.); (D.M.); (M.R.); (J.W.W.); (X.J.); (H.L.)
| | - Mohammad Rezaee
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (D.M.S.); (D.M.); (M.R.); (J.W.W.); (X.J.); (H.L.)
| | - John W. Wong
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (D.M.S.); (D.M.); (M.R.); (J.W.W.); (X.J.); (H.L.)
| | - Xun Jia
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (D.M.S.); (D.M.); (M.R.); (J.W.W.); (X.J.); (H.L.)
| | - Heng Li
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (D.M.S.); (D.M.); (M.R.); (J.W.W.); (X.J.); (H.L.)
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Abouzahr F, Cesar JP, Crespo P, Gajda M, Hu Z, Klein K, Kuo AS, Majewski S, Mawlawi O, Morozov A, Ojha A, Poenisch F, Proga M, Sahoo N, Seco J, Takaoka T, Tavernier S, Titt U, Wang X, Zhu XR, Lang K. The first probe of a FLASH proton beam by PET. Phys Med Biol 2023; 68:235004. [PMID: 37918021 DOI: 10.1088/1361-6560/ad0901] [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: 11/02/2023] [Indexed: 11/04/2023]
Abstract
The recently observed FLASH effect related to high doses delivered with high rates has the potential to revolutionize radiation cancer therapy if promising results are confirmed and an underlying mechanism understood. Comprehensive measurements are essential to elucidate the phenomenon. We report the first-ever demonstration of measurements of successive in-spill and post-spill emissions of gammas arising from irradiations by a FLASH proton beam. A small positron emission tomography (PET) system was exposed in an ocular beam of the Proton Therapy Center at MD Anderson Cancer Center to view phantoms irradiated by 3.5 × 1010protons with a kinetic energy of 75.8 MeV delivered in 101.5 ms-long spills yielding a dose rate of 164 Gy s-1. Most in-spill events were due to prompt gammas. Reconstructed post-spill tomographic events, recorded for up to 20 min, yielded quantitative imaging and dosimetric information. These findings open a new and novel modality for imaging and monitoring of FLASH proton therapy exploiting in-spill prompt gamma imaging followed by post-spill PET imaging.
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Affiliation(s)
- F Abouzahr
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - J P Cesar
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - P Crespo
- Laboratório de Instrumentação e Física Experimental de Partículas, 3004-516 Coimbra, Portugal
- Departamento de Física, Universidade de Coimbra, 3004-516 Coimbra, Portugal
| | - M Gajda
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - Z Hu
- Department of Radiation Physics, MD Anderson Cancer Center, University of Texas, Houston, TX 77030, United States of America
| | - K Klein
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - A S Kuo
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - S Majewski
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
- Biomedical Engineering, University of California Davis, CA 96616, United States of America
| | - O Mawlawi
- Department of Imaging Physics, MD Anderson Cancer Center, University of Texas, Houston, TX, 77054, United States of America
| | - A Morozov
- Laboratório de Instrumentação e Física Experimental de Partículas, 3004-516 Coimbra, Portugal
| | - A Ojha
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - F Poenisch
- Proton Therapy Center, MD Anderson Cancer Center, University of Texas, Houston, TX 77054, United States of America
| | - M Proga
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - N Sahoo
- Proton Therapy Center, MD Anderson Cancer Center, University of Texas, Houston, TX 77054, United States of America
| | - J Seco
- Div. of Biomed. Physics in Rad. Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
| | - T Takaoka
- Particle Therapy Division, Hitachi America Ltd, Houston, TX 77054, United States of America
| | - S Tavernier
- PETsys Electronics, SA, 2740-257 Taguspark, Portugal
| | - U Titt
- Department of Radiation Physics, MD Anderson Cancer Center, University of Texas, Houston, TX 77030, United States of America
| | - X Wang
- Proton Therapy Center, MD Anderson Cancer Center, University of Texas, Houston, TX 77054, United States of America
| | - X R Zhu
- Proton Therapy Center, MD Anderson Cancer Center, University of Texas, Houston, TX 77054, United States of America
| | - K Lang
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
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