Characterization of prompt gamma ray emission for in vivo range verification in particle therapy: A simulation study

An exploratory study of shielding strategies for boron neutron capture discrimination in 10B Neutron Capture Enhanced Particle Therapy

PURPOSE

To evaluate the impact of a range of shielding strategies on the rate of false positive detections by a simulated detector for application in Neutron Capture Enhanced Particle Therapy (NCEPT).

METHODS

In this work, we extend a previously published method for neutron capture detection and discrimination. A Geant4 Monte Carlo model was designed, with the simulated irradiation of a poly(methyl methacrylate) phantom and cubic 10B insert with carbon and helium ion beams and various shielding configurations.

RESULTS

In the free-space configuration, shielding the crystal actually decreases the ratio of true/false positive detections (RTF) by more than 50% and increases the activation of the detector. In a closed-space configuration with a model of the beamline neutron fluence, RTF also decreases with shielding, although activation decreases in this case. However, for a detector with boron present in the printed circuit boards (PCBs), shielding with a thin layer of Gd2O3 improves RTF by up to 21%.

CONCLUSIONS

Shielding of the detector crystal itself is unnecessary as shielding actually degrades discrimination accuracy relative to the unshielded detector. However, if the detector PCBs contain boron, then shielding the electronics provides a valuable increase in overall detector selectivity.

First experimental verification of prompt gamma imaging with carbon ion irradiation

Prompt Gamma Imaging (PGI) is a promising technique for range verification in Particle Therapy. This technique was already tested in clinical environment with a knife-edge-collimator camera for proton treatments but remains relatively unexplored for Carbon Ion Radiation Therapy (CIRT). Previous FLUKA simulations suggested that PG profile shifts could be detected in CIRT with a precision of ∼ 4 mm ([Formula: see text]) for a particle statistic equal to [Formula: see text] C-ions using a 10 × 10 cm2 camera. An experimental campaign was carried out at CNAO (Pavia, Italy) to verify these results, using a knife-edge-collimator camera prototype based on a 5 × 5 cm2 pixelated LYSO crystal. PG profiles were measured irradiating a plastic phantom with a C-ion pencil beam at clinical energies and intensities, also moving the detector to extend the FOV to 13 × 5 cm2. The prototype detected Bragg-peak shifts with ∼ 4 mm precision for a statistic of [Formula: see text] C-ions ([Formula: see text] for the extended FOV), slightly larger than expected. Nevertheless, the detector demonstrated significant potential for verifying the precision in dose delivery following a treatment fraction, which remains fundamental in the clinical environment. For the first time to our knowledge, range verification based on PGI was applied to a C-ion beam at clinical energy and intensities.

Prompt-gamma track-length estimator with time tagging from proton tracking

The design of prompt-gamma detectors necessitates numerous Monte Carlo simulations to precisely develop and optimize the detection stages in proton therapy. Alongside the advancement of MC simulations, various variance reduction methods have been explored to speed-up calculations. Among these techniques, track-length estimators are interesting scoring methods for achieving both speed and accuracy in Monte Carlo simulations of rare events. This paper introduces an extension of the GATE vpgTLE module that incorporates the prompt-gamma emission time, which is tagged from the proton tracking, enhancing its utility for studies focused on detector design and optimization that rely on time measurements. The results obtained from a clinical radiotherapy plan are presented. We demonstrate that the new vpgTLE tally with time tagging is accurate, except for certain prompt-gamma lines corresponding to long mean-life nuclei.

Prompt-gamma fall-off estimation with C-ion irradiation at clinical energies, using a knife-edge slit camera: A Monte Carlo study

PURPOSE

In-vivo range verification has been a hot topic in particle therapy since two decades. Many efforts have been done for proton therapy, while fewer studies were conducted considering a beam of carbon ions. In the present work, a simulation study was performed to show whether it is possible to measure the prompt-gamma fall-off inside the high neutron background typical of carbon-ion irradiation, using a knife-edge slit camera. In addition to this, we wanted to estimate the uncertainty in retrieving the particle range in the case of a pencil beam of C-ions at clinically relevant energy of 150 MeVu.

METHODS

For these purposes, the Monte Carlo code FLUKA was adopted for simulations and three different analytical methods were implemented to get the accuracy in the range retrieval of the simulated set-up.

RESULTS

The analysis of simulation data has brought to the promising and desired precision of about 4 mm in the determination of the dose profile fall-off in case of a spill irradiation, for which all the three cited methods were coherent in their predictions.

CONCLUSIONS

The Prompt Gamma Imaging technique should be further studied as a tool to reduce range uncertainties affecting carbon ion radiation therapy.

Detection and discrimination of neutron capture events for NCEPT dose quantification

Neutron Capture Enhanced Particle Therapy (NCEPT) boosts the effectiveness of particle therapy by capturing thermal neutrons produced by beam-target nuclear interactions in and around the treatment site, using tumour-specific [Formula: see text]B or [Formula: see text]Gd-based neutron capture agents. Neutron captures release high-LET secondary particles together with gamma photons with energies of 478 keV or one of several energies up to 7.94 MeV, for [Formula: see text]B and [Formula: see text]Gd, respectively. A key requirement for NCEPT's translation is the development of in vivo dosimetry techniques which can measure both the direct ion dose and the dose due to neutron capture. In this work, we report signatures which can be used to discriminate between photons resulting from neutron capture and those originating from other processes. A Geant4 Monte Carlo simulation study into timing and energy thresholds for discrimination of prompt gamma photons resulting from thermal neutron capture during NCEPT was conducted. Three simulated [Formula: see text] mm[Formula: see text] cubic PMMA targets were irradiated by [Formula: see text]He or [Formula: see text]C ion beams with a spread out Bragg peak (SOBP) depth range of 60 mm; one target is homogeneous while the others include [Formula: see text] mm[Formula: see text] neutron capture inserts (NCIs) of pure [Formula: see text]B or [Formula: see text]Gd located at the distal edge of the SOBP. The arrival times of photons and neutrons entering a simulated [Formula: see text] mm[Formula: see text] ideal detector were recorded. A temporal mask of 50-60 ns was found to be optimal for maximising the discrimination of the photons resulting from the neutron capture by boron and gadolinium. A range of candidate detector and thermal neutron shielding materials were simulated, and detections meeting the proposed acceptance criteria (i.e. falling within the target energy window and arriving 60 ns post beam-off) were classified as true or false positives, depending on their origin. The ratio of true/false positives ([Formula: see text]) was calculated; for targets with [Formula: see text]B and [Formula: see text]Gd NCIs, the detector materials which resulted in the highest [Formula: see text] were cadmium-shielded CdTe and boron-shielded LSO, respectively. The optimal irradiation period for both carbon and helium ions was 1 µs for the [Formula: see text]B NCI and 1 ms for the [Formula: see text]Gd NCI.

Metallic Nanoparticles: A Useful Prompt Gamma Emitter for Range Monitoring in Proton Therapy?

In clinical practice, dose delivery in proton therapy treatment is affected by uncertainties related to the range of the beam in the patient, which requires medical physicists to introduce safety margins on the penetration depth of the beam. Although this ensures an irradiation of the entire clinical target volume with the prescribed dose, these safety margins also lead to the exposure of nearby healthy tissues and a subsequent risk of side effects. Therefore, non-invasive techniques that allow for margin reduction through online monitoring of prompt gammas emitted along the proton tracks in the patient are currently under development. This study provides the proof-of-concept of metal-based nanoparticles, injected into the tumor, as a prompt gamma enhancer, helping in the beam range verification. It identifies the limitations of this application, suggesting a low feasibility in a realistic clinical scenario but opens some avenues for improvement.

Prompt-gamma emission in GEANT4 revisited and confronted with experiment

PURPOSE

The field of online monitoring of the beam range is one of the most researched topics in proton therapy over the last decade. The development of detectors that can be used for beam range verification under clinical conditions is a challenging task. One promising possible solution are modalities that record prompt-gamma radiation produced by the interactions of the proton beam with the target tissue. A good understanding of the energy spectra of the prompt gammas and the yields in certain energy regions is crucial for a successful design of a prompt-gamma detector. Monte-Carlo simulations are an important tool in development and testing of detector concepts, thus the proper modelling of the prompt-gamma emission in those simulations are of vital importance. In this paper, we confront a number of GEANT4 simulations of prompt-gamma emission, performed with different versions of the package and different physics lists, with experimental data obtained from a phantom irradiation with proton beams of four different energies in the range 70-230 MeV.

METHODS

The comparison is made on different levels: features of the prompt-gamma energy spectrum, gamma emission depth profiles for discrete transitions and the width of the distal fall-off in those profiles.

RESULTS

The best agreement between the measurements and the simulations is found for the GEANT4 version 10.4.2 and the reference physics list QGSP_BIC_HP.

CONCLUSIONS

Modifications to prompt-gamma emission modelling in higher versions of the software increase the discrepancy between the simulation results and the experimental data.

Carbon-11 and Carbon-12 beam range verifications through prompt gamma and annihilation gamma measurements: Monte Carlo simulations

Range uncertainty remains a big concern in particle therapy, as it may cause target dose degradation and normal tissue overdosing. Positron emission tomography (PET) and prompt gamma imaging (PGI) are two promising modalities for range verification. However, the relatively long acquisition time of PET and the relatively low yield of PGI pose challenges for real-time range verification. In this paper, we explore using the primary Carbon-11 (C-11) ion beams to enhance the gamma yield compared to the primary C-12 ion beams to improve PET and PGI by using Monte Carlo simulations of water and PMMA phantoms at four incident energies (95, 200, 300, and 430 MeV u-1). Prompt gammas (PGs) and annihilation gammas (AGs) were recorded for post-processing to mimic PGI and PET imaging, respectively. We used both time-of-flight (TOF) and energy selections for PGI, which boosted the ratio of PGs to background neutrons to 2.44, up from 0.87 without the selections. At the lowest incident energy (100 MeVu-1), PG yield from C-11 was 0.82 times of that from C-12, while AG yield from C-11 was 6 ∼ 11 folds higher than from C-12 in PMMA. At higher energies, PG differences between C-11 and C-12 were much smaller, while AG yield from C-11 was 30%∼90% higher than from C-12 using minute-acquisition. With minute-acquisition, the AG depth distribution of C-11 showed a sharp peak coincident with the Bragg peak due to the decay of the primary C-11 ions, but that of C-12 had no such one. The high AG yield and distinct peaks could lead to more precise range verification of C-11 than C-12. These results demonstrate that using C-11 ion beams for potentially combined PGI and PET has great potential to improve online single-spot range verification accuracy and precision.