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Palmans H, Lourenço A, Medin J, Vatnitsky S, Andreo P. Current best estimates of beam quality correction factors for reference dosimetry of clinical proton beams. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac9172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 09/12/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective. To review the currently available data on beam quality correction factors,
k
Q
,
for ionization chambers in clinical proton beams and derive their current best estimates for the updated recommendations of the IAEA TRS-398 Code of Practice. Approach. The reviewed data come from 20 publications from which
k
Q
values can be derived either directly from calorimeter measurements, indirectly from comparison with other chambers or from Monte Carlo calculated overall chamber factors,
f
Q
.
For cylindrical ionization chambers, a distinction is made between data obtained in the centre of a spread-out Bragg peak and those obtained in the plateau region of single-energy fields. For the latter, the effect of depth dose gradients has to be considered. To this end an empirical model for previously published displacement correction factors for single-layer scanned beams was established, while for unmodulated scattered beams experimental data were used. From all the data, chamber factors,
f
Q
,
and chamber perturbation correction factors,
p
Q
,
were then derived and analysed. Main results. The analysis showed that except for the beam quality dependence of the water-to-air mass stopping power ratio and, for cylindrical ionization chambers in unmodulated beams, of the displacement correction factor, there is no remaining beam quality dependence of the chamber perturbation correction factors
p
Q
.
Based on this approach, average values of the beam quality independent part of the perturbation factors were derived to calculate
k
Q
values consistent with the data in the literature. Significance. The resulting data from this analysis are current best estimates of
k
Q
values for modulated scattered beams and single-layer scanned beams used in proton therapy. Based on this, a single set of harmonized values is derived to be recommended in the update of IAEA TRS-398.
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Carlino A, Palmans H, Gouldstone C, Trnkova P, Noerrevang O, Vestergaard A, Freixas GV, Bosmans G, Lorentini S, Schwarz M, Koska B, Wulff J, Vatnitsky S, Stock M. Results of an independent dosimetry audit for scanned proton beam therapy facilities. Z Med Phys 2021; 31:145-153. [PMID: 33712295 DOI: 10.1016/j.zemedi.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/13/2020] [Accepted: 01/25/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE An independent dosimetry audit based on end-to-end testing of the entire chain of radiation therapy delivery is highly recommended to ensure consistent treatments among proton therapy centers. This study presents an auditing methodology developed by the MedAustron Ion Beam Therapy Center (Austria) in collaboration with the National Physical Laboratory (UK) and audit results for five scanned proton beam therapy facilities in Europe. METHODS The audit procedure used a homogeneous and an anthropomorphic head phantom. The phantoms were loaded either with an ionization chamber or with alanine pellets and radiochromic films. Homogeneously planned doses of 10Gy were delivered to a box-like target volume in the homogeneous phantom and to two clinical scenarios with increasing complexity in the head phantom. RESULTS For all tests the mean of the local differences of the absolute dose to water determined with the alanine pellets compared to the predicted dose from the treatment planning system installed at the audited institution was determined. The mean value taken over all tests performed was -0.1±1.0%. The measurements carried out with the ionization chamber were consistent with the dose determined by the alanine pellets with a mean deviation of -0.5±0.6%. CONCLUSION The developed dosimetry audit method was successfully applied at five proton centers including various "turn-key" Cyclotron solutions by IBA, Varian and Mevion. This independent audit with extension to other tumour sites and use of the correspondent anthropomorphic phantoms may be proposed as part of a credentialing procedure for future clinical trials in proton beam therapy.
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Affiliation(s)
- Antonio Carlino
- MedAustron Ion Therapy Center, Medical Physics, Wiener Neustadt, Austria.
| | - Hugo Palmans
- MedAustron Ion Therapy Center, Medical Physics, Wiener Neustadt, Austria; National Physical Laboratory, Teddington, United Kingdom
| | | | - Petra Trnkova
- HollandPTC, Huismansingel 4, Delft, The Netherlands; Erasmus MC, Department of Radiation Oncology, Rotterdam, The Netherlands
| | - Ole Noerrevang
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Vestergaard
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Gloria Vilches Freixas
- Maastro Proton Therapy, Department of Radiation Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Geert Bosmans
- Maastro Proton Therapy, Department of Radiation Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Stefano Lorentini
- Centro di Protonterapia, APSS, Via al Desert 14, 38122 Trento, Italy
| | - Marco Schwarz
- Centro di Protonterapia, APSS, Via al Desert 14, 38122 Trento, Italy; TIFPA-INFN, Trento, Italy
| | - Benjamin Koska
- West German Proton Therapy Centre Essen, Hufelandstr. 55, Essen, Germany; University Hospital Essen, Hufelandstr. 55, Essen, Germany
| | - Jörg Wulff
- West German Proton Therapy Centre Essen, Hufelandstr. 55, Essen, Germany; University Hospital Essen, Hufelandstr. 55, Essen, Germany
| | | | - Markus Stock
- MedAustron Ion Therapy Center, Medical Physics, Wiener Neustadt, Austria
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Guida F, Barbato A, Ciocca M, Schwarz M, Lorentini S, Mastella E, Cirrone GAP, Petringa G, Liotta M, Tarabelli De Fatis P, Masi M, Mettivier G, Russo P. Dose intercomparison at Italian hadrontherapy centers. Phys Med 2019; 68:83-87. [PMID: 31765885 DOI: 10.1016/j.ejmp.2019.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To perform the first dosimetric intercomparison for proton beams in Italy using ionization chambers, according to the IAEA TRS-398 code of practice. METHODS Measurement sites included: National Center for Oncological Hadron Therapy (CNAO, Pavia), Center for Proton Therapy (CTP, Trento) and Center for Hadron Therapy and for advanced Nuclear Applications (CATANA, Catania). For comparison we also included a 6 MV photon beam produced at Istituti Clinici Scientifici Maugeri (ICSM, Pavia). For proton beams, both single pseudo-monoenergetic layers (in order to obtain a planned dose of 2 Gy at the reference depth of 2 cm in a water phantom) and Spread-out Bragg peaks (SOBP) have been delivered. Measurements were performed with a PTW Farmer 30010-1 and a PTW Advanced Markus type 34,045 ionization chamber. RESULTS Data obtained at CATANA, CNAO and CPT in terms of absorbed dose to water depth show good consistency within the experimental uncertainties, with a weighted mean of 1.99 ± 0.01 Gy and a standard error of 0.003 Gy, with reference to a nominal dose of 2 Gy as designed by the treatment planning system. CONCLUSIONS The results showed a standard deviation of less than 1% for single layer and SOBP beams, for all chambers and a percent deviation less than 1.5% for single layer measurements. The weighted means of the absorbed doses for clinical proton beams (118.19 MeV and 173.61 MeV) are consistent within less than 1%. These results agree within the 1.5% difference considered acceptable for national dose intercomparison.
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Affiliation(s)
- F Guida
- Università di Napoli Federico II, Dipartimento di Fisica "Ettore Pancini", Napoli, Italy; INFN Sezione di Napoli, Napoli, Italy
| | - A Barbato
- Università di Napoli Federico II, Dipartimento di Fisica "Ettore Pancini", Napoli, Italy; INFN Sezione di Napoli, Napoli, Italy
| | | | - M Schwarz
- Centro di Protonterapia, APSS, Trento, Italy
| | - S Lorentini
- Centro di Protonterapia, APSS, Trento, Italy
| | | | | | - G Petringa
- INFN-LNS, Catania, Italy; Università di Catania, Dipartimento di Fisica ed Astronomia, Catania, Italy
| | - M Liotta
- Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | | | - M Masi
- Università di Napoli Federico II, Dipartimento di Fisica "Ettore Pancini", Napoli, Italy; INFN Sezione di Napoli, Napoli, Italy
| | - G Mettivier
- Università di Napoli Federico II, Dipartimento di Fisica "Ettore Pancini", Napoli, Italy; INFN Sezione di Napoli, Napoli, Italy.
| | - P Russo
- Università di Napoli Federico II, Dipartimento di Fisica "Ettore Pancini", Napoli, Italy; INFN Sezione di Napoli, Napoli, Italy
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Arjomandy B, Taylor P, Ainsley C, Safai S, Sahoo N, Pankuch M, Farr JB, Yong Park S, Klein E, Flanz J, Yorke ED, Followill D, Kase Y. AAPM task group 224: Comprehensive proton therapy machine quality assurance. Med Phys 2019; 46:e678-e705. [DOI: 10.1002/mp.13622] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 12/11/2022] Open
Affiliation(s)
- Bijan Arjomandy
- Karmanos Cancer Institute at McLaren‐Flint McLaren Proton Therapy Center Flint MI USA
| | - Paige Taylor
- Imaging and Radiation Oncology Core (IROC) Houston University of Texas MD Anderson Cancer Center Houston TX USA
| | | | - Sairos Safai
- Center for Proton Therapy Paul Scherrer Institute Villigen Switzerland
| | - Narayan Sahoo
- University of Texas, MD Anderson Cancer Center Houston TX USA
| | - Mark Pankuch
- Northwestern Medicine Chicago Proton Center Warrenville IL USA
| | - Jonathan B. Farr
- Applications of Detectors and Accelerators to Medicine 1217Meyrin Switzerland
| | | | - Eric Klein
- Rhode Island Hospital, The Warren Alpert Medical School of Brown University Providence RI USA
| | - Jacob Flanz
- Massachusetts General Hospital, Burr Proton Therapy Center Boston MA
- Harvard Medical School Cambridge MA USA
| | | | - David Followill
- Imaging and Radiation Oncology Core (IROC) Houston University of Texas MD Anderson Cancer Center Houston TX USA
| | - Yuki Kase
- Proton Therapy Division Shizuoka Cancer Center Shizuoka Japan
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Carlino A, Gouldstone C, Kragl G, Traneus E, Marrale M, Vatnitsky S, Stock M, Palmans H. End-to-end tests using alanine dosimetry in scanned proton beams. ACTA ACUST UNITED AC 2018; 63:055001. [DOI: 10.1088/1361-6560/aaac23] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Dosimetry intercomparison of four proton therapy institutions in Germany employing spot scanning. Z Med Phys 2017; 27:80-85. [DOI: 10.1016/j.zemedi.2016.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 06/14/2016] [Accepted: 06/29/2016] [Indexed: 11/19/2022]
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Yonekura Y, Tsujii H, Hopewell JW, López PO, Cosset JM, Paganetti H, Montelius A, Schardt D, Jones B, Nakamura T. ICRP Publication 127: Radiological Protection in Ion Beam Radiotherapy. Ann ICRP 2014; 43:5-113. [PMID: 25915952 DOI: 10.1177/0146645314559144] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The goal of external-beam radiotherapy is to provide precise dose localisation in the treatment volume of the target with minimal damage to the surrounding normal tissue. Ion beams, such as protons and carbon ions, provide excellent dose distributions due primarily to their finite range, allowing a significant reduction of undesired exposure of normal tissue. Careful treatment planning is required for the given type and localisation of the tumour to be treated in order to maximise treatment efficiency and minimise the dose to normal tissue. Radiation exposure in out-of-field volumes arises from secondary neutrons and photons, particle fragments, and photons from activated materials. These unavoidable doses should be considered from the standpoint of radiological protection of the patient. Radiological protection of medical staff at ion beam radiotherapy facilities requires special attention. Appropriate management and control are required for the therapeutic equipment and the air in the treatment room that can be activated by the particle beam and its secondaries. Radiological protection and safety management should always conform with regulatory requirements. The current regulations for occupational exposures in photon radiotherapy are applicable to ion beam radiotherapy with protons or carbon ions. However, ion beam radiotherapy requires a more complex treatment system than conventional radiotherapy, and appropriate training of staff and suitable quality assurance programmes are recommended to avoid possible accidental exposure of patients, to minimise unnecessary doses to normal tissue, and to minimise radiation exposure of staff.
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