Radiographic film dosimetry of proton beams for depth-dose constancy check and beam profile measurement

Radiochromic film dosimetry for protons up to 10 MeV with EBT2, EBT3 and unlaminated EBT3 films

Passive dosimetry with radiochromic films is widely used in proton radiotherapy, both in clinical and scientific environments, thanks to its simplicity, high spatial resolution and dose-rate independence. However, film under-response for low-energy protons, the so-called linear-energy transfer (LET) quenching, must be accounted and corrected for. We perform a meta-analysis on existing film under-response data with EBT, EBT2 and EBT3 GAFchromic™ films and provide a common framework to integrate it, based on the calculation of dose-averaged LET in the active layer of the films. We also report on direct measurements with the 10 MeV proton beam at the Center for Microanalysis of Materials (CMAM) for EBT2, EBT3 and unlaminated EBT3 films, focusing on the 20-80 keVμm^-1LET range, where previous data was scarce. Measured film relative efficiency (RE) values are in agreement with previously reported data from the literature. A model on film RE constructed with combined literature and own experimental values in the 5-80 keVμm^-1LET range is presented, supporting the hypothesis of a linear decrease of RE with LET, with no remarkable differences between the three types of films analyzed.

Dosimetric Effect of Biozorb Markers for Accelerated Partial Breast Irradiation in Proton Therapy

Purpose

To investigate dosimetric implications of biodegradable Biozorb (BZ) markers for proton accelerated partial breast irradiation (APBI) plans.

Materials and Methods

Six different BZs were placed within in-house breast phantoms to acquire computed tomography (CT) images. A contour correction method with proper mass density overriding for BZ titanium clip and surrounding tissue was applied to minimize inaccuracies found in the CT images in the RayStation planning system. Each breast phantom was irradiated by a monoenergetic proton beam (103.23 MeV and 8×8 cm²) using a pencil-beam scanning proton therapy system. For a range perturbation study, doses were measured at 5 depths below the breast phantoms by using an ionization chamber and compared to the RayStation calculations with 3 scenarios for the clip density: the density correction method (S1: 1.6 g/cm³), raw CT (S2), and titanium density (S3: 4.54 g/cm³). For the local dose perturbation study, the radiographic EDR2 film was placed at 0 and 2 cm below the phantoms and compared to the RayStation calculations. Clinical effects of the perturbations were retrospectively examined with 10 APBI plans for the 3 scenarios (approved by our institutional review board).

Results

In the range perturbation study, the S1 simulation showed a good agreement with the chamber measurements, while excess pullbacks of 1∼2 mm were found in the S2 and S3 simulations. The film study showed local dose shadowing and perturbation by the clips that RayStation could not predict. In the plan study, no significant differences in the plan quality were found among the 3 scenarios. However, substantial range pullbacks were observed for S3.

Conclusion

The density correction method could minimize the dose and range difference between measurement and RayStation prediction. It should be avoided to simply override the known physical density of the BZ clips for treatment planning owing to overestimation of the range pullback.

Dual-storage phosphor proton therapy dosimetry: Simultaneous quantification of dose and linear energy transfer

PURPOSE

To investigate the feasibility of using the high Z_eff storage phosphor material BaFBrI:Eu²⁺ in conjunction with the low Z_eff storage phosphor material KCl:Eu²⁺ for simultaneous proton dose and linear energy transfer (LET) measurements by (a) measuring the fundamental optical and dosimetric properties of BaFBrI:Eu²⁺ , (b) evaluating its compatibility in being readout simultaneously with KCl:Eu²⁺ dosimeters, and (c) modeling and validating its LET dependence under elevated proton LET irradiation.

METHODS

A commercial BaFBrI:Eu²⁺ storage phosphor detector (Model ST-VI, Fujifilm) was characterized with energy dispersive x-ray spectroscopy (EDS) analysis to obtain its elemental composition. The dosimeters were irradiated using both a Mevion S250 proton therapy unit (at the center of a spread-out Bragg peak, SOBP) and a Varian Clinac iX linear accelerator with the latter being a low LET irradiation. The photostimulated luminescence (PSL) emission spectra, excitation spectra, and luminescent lifetimes of the detector were measured after proton and photon irradiations. Dosimetric properties including dose linearity, dose rate dependence, radiation hardness, temporal, and readout stabilities were studied using a laboratory optical reader after proton irradiations. In addition, its proton energy dependence was analytically modeled and experimentally validated by irradiating the detectors at various depths within the SOBP (Range: 15.0 g/cm² , Modulation: 10.0 g/cm² ).

RESULTS

The active detector composition for the high Z_eff storage phosphor detector was found to be BaFBr_0.85 I_0.15 :Eu²⁺ . The BaFBr_0.85 I_0.15 :Eu²⁺ material's excitation and emission spectra were in agreement under proton and photon irradiations, with peaks of 586 ± 1 nm and 400 ± 1 nm, respectively, with a full width at half maximum (FWHM) of 119 ± 3 nm and 30 ± 2 nm, respectively. As dosimeter response under photon irradiation is generally believed to be free from LET effect, these results suggest LET independence of charge storage center types resulted from ionizing radiations. There is sufficient spectral overlaps with KCl:Eu²⁺ dosimeters allowing both dosimeters to be readout under equivalent readout conditions, that is, 594 nm stimulation and 420 nm detection wavelengths. Its PSL characteristic lifetime was found to be less than 5 microseconds which would make it suitable for fast 2D readout post irradiation. Its 420 nm emission band intensity was found to be linear up to 10 Gy absolute proton dose under the same irradiation conditions, dose rate independent, stable in time and under multiple readouts, and with high radiation hardness under cumulative proton dose histories up to 200 Gy as tested in this study. BaFBr_0.85 I_0.15 :Eu²⁺ showed significant proton energy-dependent dose under-response in regions of high LET which could be modeled by stopping power ratio calculations with an accuracy of 3% in low LET regions and a distance-to-agreement (DTA) of 1 mm in high LET regions (>5 keV/μm).

CONCLUSION

We have proven the feasibility of dual-storage phosphor proton dosimetry for simultaneous proton dose and LET measurements. BaFBr_0.85 I_0.15 :Eu²⁺ has shown equally excellent dosimetry performance as its low Z_eff complement KCl:Eu²⁺ with distinctive LET dependence merely as a result of its higher Z_eff . These promising results pave the way for future studies involving simultaneous proton dose and LET measurements using this novel approach.

Liver phantom design and dosimetric verification in participating institutions for a proton beam therapy in patients with resectable hepatocellular carcinoma: Japan Clinical Oncology Group trial (JCOG1315C)

BACKGROUND AND PURPOSE

In Japan, the first domestic clinical trial of proton beam therapy for the liver was initiated as the Japan Clinical Oncology Group trial (JCOG1315C: Non-randomized controlled study comparing proton beam therapy and hepatectomy for resectable hepatocellular carcinoma). Purposes of this study were to develop a new dosimetric verification system and to carry out a credentialing for the JCOG1315C clinical trial.

MATERIALS AND METHODS

Accuracy and differences in doses in proton treatment planning among participating institutions were surveyed and investigated. We designed and developed a suitable water tank-type liver phantom for a dosimetric verification of proton beam therapy for liver. In a visiting survey of five institutions participating in the clinical trial, we performed the dosimetric verification using the liver phantom and an air-filled ionization chamber.

RESULTS

The shape of the dose distributions calculated in proton treatment planning was characteristic and dependent on the manufacturers of the proton beam therapy system, the proton treatment planning system and the setup at the participating institutions. Widths of the lateral penumbra were 5.8-12.7 mm among participating institutions. The accuracy between the calculated and the measured doses in the proton irradiation was within 3% at five measurement points including both points on the isocenter and off the isocenter.

CONCLUSIONS

These findings confirmed the accuracy of the delivery doses in the institutions participating in the clinical trial, and the clinical trial with integration of all institutions (five institutions) could be initiated.

Characterization of EBT3 radiochromic films for dosimetry of proton beams in the presence of magnetic fields

PURPOSE

Radiochromic film dosimetry is extensively used for quality assurance in photon and proton beam therapy. So far, GafchromicTM EBT3 film appears as a strong candidate to be used in future magnetic resonance (MR) based therapy systems. The response of Gafchromic EBT3 films in the presence of magnetic fields has already been addressed for different MR-linacs systems. However, a detailed evaluation of the influence of external magnetic fields on the film response and calibration curves for proton therapy has not yet been reported. This study aims to determine the dose responses of EBT3 films for clinical proton beams exposed to magnetic field strengths up to 1 T in order to investigate the feasibility of EBT3 film as an accurate dosimetric tool for a future MR particle therapy system (MRPT).

METHODS

The dosimetric characteristics of EBT3 films were studied for a proton beam passing through magnetic field strengths of B = 0, 0.5, and 1 T. Absorbed dose calibration and measurements were performed using clinical proton beams in the nominal energy range of 62.4-252.6 MeV. Irradiations were done using an in-house developed PMMA slab phantom placed in the center of a dipole research magnet. Monte Carlo (MC) simulations using the GATE/Geant4 toolkit were performed to predict the effect of magnetic fields on the energy deposited by proton beams in the phantom. Planned and measured doses from 3D box cube irradiations were compared to assess the accuracy of the dosimetric method using EBT3 films with/without the external magnetic field.

RESULTS

Neither for the mean pixel value nor for the net optical density, any significant deviations were observed due to the presence of an external magnetic field (B ≤ 1T) for doses up to 10 Gy. Dose-response curves for the red channel were fitted by a three-parameter function for the field-free case and for B = 1T, showing for both cases an R-square coefficient of unity and almost identical fitting parameters. Independently of the magnetic field, EBT3 films showed an under-response as high as 8% in the Bragg peak region, similarly to previously reported effects for particle therapy. No noticeable influence of the magnetic field strength was observed on the quenching effect of the EBT3 films.

CONCLUSIONS

For the first time detailed absorbed dose calibrations of EBT3 films for proton beams in magnetic field regions were performed. Results showed that EBT3 films represent an attractive solution for the dosimetry of a future MRPT system. As film response functions for protons are not affected by the magnetic field strenght, they can be used for further investigations to evaluate the dosimetric effects induced due to particle beams bending in magnetic fields regions.