[en] Purpose: Asymmetric collimation is a relatively new method of junctioning abutting fields with non-diverging beam edges. When this technique is used at the junction of lateral and low anterior fields in three field head and neck set ups, there should, in theory, be a perfect match. There should be no overdose or underdose at the match line. We have performed dosimetric measurements to evaluate the actual dosimetry at the central axis. Materials and Methods: X-ray verification film was placed in a water-equivalent phantom at a depth of 4 cm, corresponding to an isocentric distance of 100 cm. A double exposure technique was used to mimic two half-beam blocked fields abutting at the central axis. Each half of the film was irradiated with 50 monitor units using a 6 MV photon beam. One of the collimators was set to an off-axis position to force a gap or overlap of the radiation fields at the isocenter in increments of 1 mm. The films were scanned with a laser densitometer with a resolution of 300 μm. The beam profiles were evaluated at the region of overdose or underdose around the match line. Results: The dose on the central axis varied linearly from - 50% (field gap of 3 mm) to + 50% (field overlap of 3 mm). Surprisingly, the width (defined as a full-width, half-maximum, FWHM) of the region of overdose or underdose around the match line is 3 mm for field gaps or overlaps of 1 and 2 mm. The width of the region is 4.5 mm for field gaps or overlaps of 3 mm. The larger than expected width of this region is due to the addition of the two abutting penumbras. Conclusion: Asymmetric collimation with half-beam blocks may overdose the spinal cord. Calibration specifications generally allow for a 1 mm tolerance in the position of each independent jaw. In a calibrated machine, this could lead to a 2 mm field overlap. A field overlap of just 1 mm results in a FWHM region of overdose measuring 3 mm with a maximum dose of 140%. To our knowledge, there are no current recommendations for the quality evaluation of independent jaws. We recommend 1) that a block ≥ 5 mm be placed over the spinal cord in one of the abutting fields to prevent spinal cord overdose, or 2) that independent jaws should be evaluated as part of a quality assurance program

[en] Our research program had four main thrusts, only one of which can be considered as measurements of N-N parameters: (1) Finishing the data analyses associated with recent LAMPF and TRIUMPF N-N experiments, whose overall purpose has been the determination of the nucleon-nucleon amplitudes, both for isospin 0 and 1 at medium energies; (2) continuing work on BNL E871, a search for rare decay modes of the KL; (3) work on the RHIC-STAR project, an experiment to create and study a quark gluon plasma and nuclear matter at high energy density; (4) beginning a new AGS experiment (E896) which will search for the lowest mass state of the predicted strange di-baryons, the Ho, and other exotic states of nuclear matter through nucleus-nucleus collisions

[en] Surgically implanted electromagnetic transponders have been used in external beam radiotherapy for target localization and position monitoring in real time. The effect of transponders on proton therapy dose distributions has not been reported. A Monte Carlo implementation of the transponder geometry is validated against film measurements in a proton SOBP and subsequently used to generate dose distributions for transponders at different positions and orientations in the proton SOBP. The maximum dose deficit is extracted in each case. Dose shadows of up to 60% occur for transponders positioned very near the end of range of the Bragg peak. However, if transponders are positioned further than 5 mm from the end of range, and are not oriented parallel to the beam direction, then the dose deficit can be kept below 10%. (paper)

[en] The configuration of a treatment planning system (TPS) for double-scattering-based proton therapy requires many user inputs. Most of these are either gathered during the routine collection of commissioning data, or can be supplied by the equipment vendor; however, this is not true of all. In this study we developed a technique both to (a) expedite the extraction of those undetermined TPS parameters related to the range modulator wheels that can only otherwise be obtained by the time-consuming process of trial-and-error, and (b) demonstrate how, for a commonly-employed, commercially-available TPS, the judicious determination of such parameters can be used to optimize the resultant modelling of longitudinal dose distributions delivered by a double scattering proton therapy system. Our technique is simple to implement, robust in nature and also provides insight allowing parameters that must be contrived in that model to be related directly to physical aspects of the beam delivery system. (note)

[en] Purpose: To propose and validate a craniospinal irradiation approach using a proton pencil beam scanning technique that overcomes the complexity of the planning associated with feathering match lines. Methods and Materials: Ten craniospinal irradiation patients had treatment planned with gradient dose optimization using the proton pencil beam scanning technique. The robustness of the plans was evaluated by shifting the isocenter of each treatment field by ±3 mm in the longitudinal direction and was compared with the original nonshifted plan with metrics of conformity number, homogeneity index, and maximal cord doses. An anthropomorphic phantom study using film measurements was carried out on a plan with 5-cm junction length. To mimic setup errors in the phantom study, fields were recalculated with isocenter shifts of 1, 3, 5, and 10 mm longitudinally, and compared with the original plans and measurements. Results: Uniform dose coverage to the entire target volumes was achieved using the gradient optimization approach with averaged junction lengths of 6.7 ± 0.5 cm. The average conformity number and homogeneity index equaled 0.78 ± 0.03 and 1.09 ± 0.01, respectively. Setup errors of 3 mm per field (6 mm in worst-case scenario) caused on average 4.6% lower conformity number 2.5% higher homogeneity index and maximal cord dose of 4216.1 ± 98.2 cGy. When the junction length was 5 cm or longer, setup errors of 6 mm resulted in up to 12% dosimetric deviation. Consistent results were reached between film measurements and planned dose profiles in the junction area. Conclusions: Longitudinal setup errors directly reduce the dosimetric accuracy of the proton craniospinal irradiation treatment with matched proton pencil beam scanning fields. The reported technique creates a slow dose gradient in the junction area, which makes the treatment more robust to longitudinal setup errors compared to conventional feathering methods

[en] Purpose: To apply the dual ionization chamber method for mixed radiation fields to an accurate comparison of the secondary neutron dose arising from the use of a tungsten alloy multileaf collimator (MLC) as opposed to a brass collimator system for defining the shape of a therapeutic proton field. Methods: Hydrogenous and nonhydrogenous ionization chambers were constructed with large volumes to enable measurements of absorbed doses below 10^-4 Gy in mixed radiation fields using the dual ionization chamber method for mixed-field dosimetry. Neutron dose measurements were made with a nominal 230 MeV proton beam incident on a closed tungsten alloy MLC and a solid brass block. The chambers were cross-calibrated against a ⁶⁰Co-calibrated Farmer chamber in water using a 6 MV x-ray beam and Monte Carlo simulations were performed to account for variations in ionization chamber response due to differences in secondary neutron energy spectra. Results: The neutron and combined proton plus γ-ray absorbed doses are shown to be nearly equivalent downstream from either a closed tungsten alloy MLC or a solid brass block. At 10 cm downstream from the distal edge of the collimating material the neutron dose from the closed MLC was (5.3 ± 0.4) x 10^-5 Gy/Gy. The neutron dose with brass was (6.4 ± 0.7) x 10^-5 Gy/Gy. Further from the secondary neutron source, at 50 cm, the neutron doses remain close for both the MLC and brass block at (6.9 ± 0.6) x 10^-6 Gy/Gy and (6.3 ± 0.7) x 10^-6 Gy/Gy, respectively. Conclusions: The dual ionization chamber method is suitable for measuring secondary neutron doses resulting from proton irradiation. The results of measurements downstream from a closed tungsten alloy MLC and a brass block indicate that, even in an overly pessimistic worst-case scenario, secondary neutron production in a tungsten alloy MLC leads to absorbed doses that are nearly equivalent to those seen from brass collimators. Therefore, the choice of tungsten alloy in constructing the leaves of a proton MLC is appropriate, and does not lead to a substantial increase in the secondary neutron dose to the patient compared to that generated in a brass collimator.

[en] Dose calculations of pencil beam scanning treatment plans rely on the accuracy of proton spot profiles; not only the primary component but also the broad tail components. Four films are placed at several locations in air and multiple depths in Solidwater® for six selected energies. The films used for the primary components are exposed to 50–200 MU to avoid saturation; the films used for the tail components are exposed to 800, 8000 and 80 000 MU. By applying a pair/magnification method and merging these data, dose kernels down to 10⁻⁴ of the central spot dose can be generated. From these kernels one can calculate the dose-per-MU for different field sizes and shapes. Measurements agree within 1% of dose-kernel-based calculations for output versus field size comparisons. Asymmetric, comet-shaped profile tails have a bigger impact at superficial depths and low energies: the output difference between two orientations at the surface of a rectangular field of 40 mm×200 mm is about 2% at the isocentre at 100 MeV. Integration of these dose kernels from 0 to 40 mm radius shows that the charge deficit in the Bragg peak chamber varies <2% from entrance to the end of range for energies <180 MeV, but exceeds 5% at 225 MeV. (paper)

[en] The presence of a low-dose envelope, or ‘halo’, in the fluence profile of a proton spot can increase the output of a pencil beam scanning field by over 10%. This study evaluated whether the Monte Carlo simulation code, TOPAS 1.0-beta 8, based on Geant4.9.6 with its default physics list, can predict the spot halo at depth in phantom by incorporating a halo model within the proton source distribution. Proton sources were modelled using three 2D Gaussian functions, and optimized until simulated spot profiles matched measurements at the phantom surface out to a radius of 100 mm. Simulations were subsequently compared with profiles measured using EBT3 film in Solidwater"® phantoms at various depths for 100, 115, 150, 180, 210 and 225 MeV proton beams. Simulations predict measured profiles within a 1 mm distance to agreement for 2D profiles extending to the 0.1% isodose, and within 1 mm/1% Gamma criteria over the integrated curve of spot profile as a function of radius. For isodose lines beyond 0.1% of the central spot dose, the simulated primary spot sigma is smaller than the measurement by up to 15%, and can differ by over 1 mm. The choice of particle interaction algorithm and phantom material were found to cause ∼1 mm range uncertainty, a maximal 5% (0.3 mm) difference in spot sigma, and maximal 1 mm and ∼2 mm distance to agreement in isodoses above and below the 0.1% level, respectively. Based on these observations, therefore, the selection of physics model and the application of Solidwater"® as water replacement material in simulation and measurement should be used with caution. (paper)

[en] The space radiation environment imposes increased dangers of exposure to ionizing radiation, particularly during a solar particle event (SPE). These events consist primarily of low energy protons that produce a highly inhomogeneous dose distribution. Due to this inherent dose heterogeneity, experiments designed to investigate the radiobiological effects of SPE radiation present difficulties in evaluating and interpreting dose to sensitive organs. To address this challenge, we used the Geant4 Monte Carlo simulation framework to develop dosimetry software that uses computed tomography (CT) images and provides radiation transport simulations incorporating all relevant physical interaction processes. We found that this simulation accurately predicts measured data in phantoms and can be applied to model dose in radiobiological experiments with animal models exposed to charged particle (electron and proton) beams. This study clearly demonstrates the value of Monte Carlo radiation transport methods for two critically interrelated uses: (1) determining the overall dose distribution and dose levels to specific organ systems for animal experiments with SPE-like radiation, and (2) interpreting the effect of random and systematic variations in experimental variables (e.g. animal movement during long exposures) on the dose distributions and consequent biological effects from SPE-like radiation exposure. The software developed and validated in this study represents a critically important new tool that allows integration of computational and biological modeling for evaluating the biological outcomes of exposures to inhomogeneous SPE-like radiation dose distributions, and has potential applications for other environmental and therapeutic exposure simulations. (author)

[en] Dose calculation for pencil beam scanning proton therapy requires accurate measurement of the broad tails of the proton spot profiles for every nozzle in clinical use. By applying a pair/magnification method and merging film data, 200 mm × 240 mm dose kernels extending to 10"−"4 of the central spot dose are generated for six selected energies of the IBA dedicated and universal nozzles (DN and UN). One-dimensional, circular profiles up to 100 mm in radius are generated from the asymmetric profiles to facilitate spot profile comparison. For the highest energy, 225 MeV, the output of both the DN and the UN for field sizes from 40 to 200 mm increases in parallel, slowest at the surface (∼1%) and fastest at a depth of 150 mm (∼9%). In contrast, at the lowest energy, 100 MeV, the output of the DN across the same range of field sizes increases 3–4% versus 6–7% for the UN throughout all the depths. The charge deficits in the measured depth-dose of Bragg peaks are similar between the UN and the DN. At 100 MeV, the field size factor difference at the surface between two orientations of a rectangular 40 mm × 200 mm field is 1.4% at isocentre for the DN versus 2% for the UN. Though the one-dimensional distributions are similar for the primary and tail components at different positions, the primary components of the DN spots are more elliptical 270 mm upstream than at isocentre. (paper)