Investigation of time-resolved proton radiography using x-ray flat-panel imaging system

A denoising method based on deep learning for proton radiograph using energy resolved dose function

Objective.Proton radiograph has been broadly applied in proton radiotherapy which is affected by scattered protons which result in the lower spatial resolution of proton radiographs than that of x-ray images. Traditional image denoising method may lead to the change of water equivalent path length (WEPL) resulting in the lower WEPL measurement accuracy. In this study, we proposed a new denoising method of proton radiographs based on energy resolved dose function curves.Approach.Firstly, the corresponding relationship between the distortion of WEPL characteristic curve, and energy and proportion of scattered protons was established. Then, to improve the accuracy of proton radiographs, deep learning technique was used to remove scattered protons and correct deviated WEPL values. Experiments on a calibration phantom to prove the effectiveness and feasibility of this method were performed. In addition, an anthropomorphic head phantom was selected to demonstrate the clinical relevance of this technology and the denoising effect was analyzed.Main results.The curves of WEPL profiles of proton radiographs became smoother and deviated WEPL values were corrected. For the calibration phantom proton radiograph, the average absolute error of WEPL values decreased from 2.23 to 1.72, the mean percentage difference of all materials of relative stopping power decreased from 1.24 to 0.39, and the average relative WEPL corrected due to the denoising process was 1.06%. In addition, WEPL values correcting were also observed on the proton radiograph for anthropomorphic head phantom due to this denoising process.Significance.The experiments showed that this new method was effective for proton radiograph denoising and had greater advantages than end-to-end image denoising methods, laying the foundation for the implementation of precise proton radiotherapy.

A Monte-Carlo-based study of a single-2D-detector proton-radiography system

PURPOSE

To assess the feasibility of a proton radiography (pRG) system based on a single thin pixelated detector for water-equivalent path length (WEPL) and relative stopping power (RSP) measurements.

METHODS

A model of a pRG system consisting of a single pixelated detector measuring energy deposition and proton fluence was investigated in a Geant4-based Monte Carlo study. At the position directly after an object traversed by a broad proton beam, spatial 2D distributions are calculated of the energy deposition in, and the number of protons entering the detector. Their ratio relates to the 2D distribution of the average stopping power of protons in the detector. The system response is calibrated against the residual range in water of the protons to provide the 2D distribution of the WEPL of the object. The WEPL distribution is converted into the distribution of the RSP of the object. Simulations have been done, where the system has been tested on 13 samples of homogeneous materials of which the RSPs have been calculated and compared with RSPs determined from simulations of residual-range-in-water, which we refer to as reference RSPs.

RESULTS

For both human-tissue- and non-human-tissue-equivalent materials, the RSPs derived with the detector agree with the reference values within 1%.

CONCLUSION

The study shows that a pRG system based on one thin pixelated detection screen has the potential to provide RSP predictions with an accuracy of 1%.

A novel proton-integrating radiography system design using a monolithic scintillator detector: experimental studies

Research on proton-based imaging systems aims to improve treatment planning, internal anatomy visualization, and patient alignment for proton radiotherapy. The purpose of this study was to demonstrate a new proton radiography system design consisting of a monolithic plastic scintillator volume and two optical cameras for use with scanning proton pencil beams. Unlike the thin scintillating plates currently used for proton radiography, the plastic scintillator volume (20 × 20 × 20 cm³) captures a wider distribution of proton beam energy depositions and avoids proton-beam modulation. The proton imaging system's characteristics were tested using image uniformity (2.6% over a 5 × 5 cm² area), stability (0.37%), and linearity (R² = 1) studies. We used the light distribution produced within the plastic scintillator to generate proton radiographs via two different approaches: (a) integrating light by using a camera placed along the beam axis, and (b) capturing changes to the proton Bragg peak positions with a camera placed perpendicularly to the beam axis. The latter method was used to plot and evaluate relative shifts in percentage depth light (PDL) profiles of proton beams with and without a phantom in the beam path. A curvelet minimization algorithm used differences in PDL profiles to reconstruct and refine the phantom water-equivalent thickness (WET) map. Gammex phantoms were used to compare the proton radiographs generated by these two methods. The relative accuracies in calculating WET of the phantoms using the calibration-based beam-integration (and the PDL) methods were -0.18 ± 0.35% (-0.29 ± 3.11%), -0.11 ± 0.51% (-0.15 ± 2.64%), -2.94 ± 1.20% (-0.75 ± 6.11%), and -1.65 ± 0.35% (0.36 ± 3.93%) for solid water, adipose, cortical bone, and PMMA, respectively. Further exploration of this unique multicamera-based imaging system is warranted and could lead to clinical applications that improve treatment planning and patient alignment for proton radiotherapy.

Optimizing calibration settings for accurate water equivalent path length assessment using flat panel proton radiography

OBJECTIVE

Proton range uncertainties can compromise the effectiveness of proton therapy treatments. Water equivalent path length (WEPL) assessment by flat panel detector proton radiography (FP-PR) can provide means of range uncertainty detection. Since WEPL accuracy intrinsically relies on the FP-PR calibration parameters, the purpose of this study is to establish an optimal calibration procedure that ensures high accuracy of WEPL measurements. To that end, several calibration settings were investigated.

APPROACH

FP-PR calibration datasets were obtained simulating PR fields with different proton energies, directed towards water-equivalent material slabs of increasing thickness. The parameters investigated were the spacing between energy layers (ΔE) and the increment in thickness of the water-equivalent material slabs (ΔX) used for calibration. 30 calibrations were simulated, as a result of combining ΔE = 9, 7, 5, 3, 1 MeV and ΔX = 10, 8, 5, 3, 2, 1 mm. FP-PRs through a CIRS electron density phantom were simulated, and WEPL images corresponding to each calibration were obtained. Ground truth WEPL values were provided by range probing multi-layer ionization chamber simulations on each insert of the phantom. Relative WEPL errors between FP-PR simulations and ground truth were calculated for each insert. Mean relative WEPL errors and standard deviations across all inserts were computed for WEPL images obtained with each calibration.

MAIN RESULTS

Large mean and standard deviations were found in WEPL images obtained with large ΔEvalues (ΔE = 9 or 7 MeV), for any ΔX. WEPL images obtained with ΔE ≤ 5 MeV and ΔX ≤ 5 mm resulted in a WEPL accuracy with mean values within ±0.5% and standard deviations around 1%.

SIGNIFICANCE

An optimal FP calibration in the framework of this study was established, characterized by 3 MeV ≤ ΔE ≤ 5 MeV and 2 mm ≤ ΔX ≤ 5 mm. Within these boundaries, highly accurate WEPL acquisitions using FP-PR are feasible and practical, holding the potential to assist future online range verification quality control procedures.

Artificial intelligence supported single detector multi-energy proton radiography system

Proton radiography imaging was proposed as a promising technique to evaluate internal anatomical changes, to enable pre-treatment patient alignment, and most importantly, to optimize the patient specific CT number to stopping-power ratio conversion. The clinical implementation rate of proton radiography systems is still limited due to their complex bulky design, together with the persistent problem of (in)elastic nuclear interactions and multiple Coulomb scattering (i.e. range mixing). In this work, a compact multi-energy proton radiography system was proposed in combination with an artificial intelligence network architecture (ProtonDSE) to remove the persistent problem of proton scatter in proton radiography. A realistic Monte Carlo model of the Proteus^®One accelerator was built at 200 and 220 MeV to isolate the scattered proton signal in 236 proton radiographies of 80 digital anthropomorphic phantoms. ProtonDSE was trained to predict the proton scatter distribution at two beam energies in a 60%/25%/15% scheme for training, testing, and validation. A calibration procedure was proposed to derive the water equivalent thickness image based on the detector dose response relationship at both beam energies. ProtonDSE network performance was evaluated with quantitative metrics that showed an overall mean absolute percentage error below 1.4% ± 0.4% in our test dataset. For one example patient, detector dose to WET conversions were performed based on the total dose (ITotal), the primary proton dose (IPrimary), and the ProtonDSE corrected detector dose (ICorrected). The determined WET accuracy was compared with respect to the reference WET by idealistic raytracing in a manually delineated region-of-interest inside the brain. The error was determined 4.3% ± 4.1% forWET(ITotal),2.2% ± 1.4% forWET(IPrimary),and 2.5% ± 2.0% forWET(ICorrected).

Feasibility of energy-resolved dose imaging technique in pencil beam scanning mode

Purpose:Proton energy-resolved dose imaging (pERDI) is a recently proposed technique to generate water equivalent path length (WEPL) images using a single detector. Owing to its simplicity in instrumentation, analysis and the possibility of using the in-room x-ray flat panels as detectors, this technique offers a promising avenue towards a clinically usable imaging system for proton therapy using scanned beams. The purpose of this study is to estimate the achievable accuracy in WEPL and Relative Stopping Power (RSP) using the pERDI technique and to assess the minimum dose required to achieve such accuracy. The novelty of this study is the first demonstration of the feasibility of pERDI technique in the pencil beam scanning (PBS) mode.Methods:A solid water wedge was placed in front of a 2D detector (Lynx). A library of energy-resolved dose functions (ERDF) was generated from the dose deposited in the detector by 50 PBS layers of energy varying from 100 MeV to 225 MeV. This set-up is further used to image the following configurations using the pERDI technique: stair-case shaped solid water phantom (configuration 1), electron density phantom (configuration 2) and head phantom (configuration 3). The result from configuration 1 was used to determine the achievable WEPL accuracy. The result from configuration 2 was used to estimate the relative uncertainty in RSP. Configuration 3 was used to evaluate the effect of range mixing on the WEPL. In all three cases, the variation of the accuracy with respect to dose, by varying the number of scanning layers, was also studied.Results:An accuracy of 1 mm in WEPL was achieved using the Lynx detector with an imaging field of 10 PBS layers or more, which is equivalent to a total dose of 5 cGy. The RSP is measured with a precision better than 2% for all homogeneous inserts of tissue surrogates. The pERDI technique failed for tissues surrogates with total WEPL outside the calibration window (WEPL < 70 mm) like in the case of lung exhale and lung inhale. The imaging of an anthropomorphic head phantom, in the same condition, produced a WEPL radiograph and compared to the WEPL derived from CT using gamma index analysis. The gamma index failed in the heterogeneous areas due to range mixing.Conclusions:The pERDI technique is a promising clinically usable imaging modality for reducing range uncertainties and set-up errors in proton therapy. The first results have demonstrated that WEPL and RSP can be estimated with clinically acceptable accuracy using the Lynx detector. Similar accuracy is also expected with in-room flat-panel detectors but at significantly reduced imaging dose. Though the issue of range mixing is still to be addressed, we expect that a statistical moment analysis of the ERDFs can be implemented to filter out the regions with high gradient of range mixing.

A Monte Carlo feasibility study on quantitative laser-driven proton radiography

Laser-accelerated proton bunches with kinetic energies up to several tens of MeV and at repetition rates in the order of Hz are nowadays achievable at several research centres housing high-power laser system. The unique features of such ultra-short bunches are also arousing interest in the field of radiological and biomedical applications. For many of these applications, accurate positioning of the biological target is crucial, raising the need for on-site imaging. One convenient option is proton radiography, which can exploit the polyenergetic spectrum of laser-accelerated proton bunches. We present a Monte Carlo (MC) feasibility study to assess the applicability and potential of laser-driven proton radiography of millimetre to centimetre sized objects. Our radiography setup consists of a thin time-of-flight spectrometer operated in transmission prior to the object and a pixelated silicon detector for imaging. Proton bunches with kinetic energies up to 20MeV and up to 100MeV were investigated. The water equivalent thickness (WET) of the traversed material is calculated from the energy deposition inside an imaging detector, using an online generated calibration curve that is based on a MC generated look-up table and the reconstructed proton energy distribution. With a dose of 43mGy for a 1mm thin object imaged with protons up to 20MeV, the reconstructed WET of defined regions-of-interest was within 1.5% of the ground truth values. The spatial resolution, which strongly depends on the gap between object and imaging detector, was 2.5lpmm^-1 for a realistic distance of 5mm. Due to this relatively high imaging dose, our proposed setup for laser-driven proton radiography is currently limited to objects with low radio-sensitivity, but possibilities for further dose reduction are presented and discussed.

High quality proton portal imaging using deep learning for proton radiation therapy: a phantom study

Purpose; For shoot-through proton treatments, like FLASH radiotherapy, there will be protons exiting the patient which can be used for proton portal imaging (PPI), revealing valuable information for the validation of tumor location in the beam's-eye-view at native gantry angles. However, PPI has poor inherent contrast and spatial resolution. To deal with this issue, we propose a deep-learning-based method to use kV digitally reconstructed radiographs (DRR) to improve PPI image quality. Method; We used a residual generative adversarial network (GAN) framework to learn the nonlinear mapping between PPIs and DRRs. Residual blocks were used to force the model to focus on the structural differences between DRR and PPI. To assess the accuracy of our method, we used 149 images for training and 30 images for testing. PPIs were acquired using a double-scattered proton beam. The DRRs acquired from CT acted as learning targets in the training process and were used to evaluate results from the proposed method using a six-fold cross-validation scheme. Results; Qualitatively, the corrected PPIs showed enhanced spatial resolution and captured fine details present in the DRRs that are missed in the PPIs. The quantitative results for corrected PPIs show average normalized mean error (NME), normalized mean absolute error (NMAE), peak signal-to-noise ratio (PSNR) and structural similarity (SSIM) index of -0.1%, 0.3%, 39.14 dB, and 0.987, respectively. Conclusion; The results indicate the proposed method can generate high quality corrected PPIs and this work shows the potential to use a deep-learning model to make PPI available in proton radiotherapy. This will allow for beam's-eye-view (BEV) imaging with the particle used for treatment, leading to a valuable alternative to orthogonal x-rays or cone-beam CT for patient position verification.

A novel design of proton computed tomography detected by multiple-layer ionization chamber with strip chambers: A feasibility study with Monte Carlo simulation

PURPOSE

Uncertainty in proton range can be reduced by proton computed tomography (CT). A novel design of proton CT using a multiple-layer ionization chamber with two strip ionization chambers on the surface is proposed to simplify the imaging acquisition and reconstruction.

METHODS

Two strip ionization chambers facing the proton source were coupled into a multiple-layer ionization chamber (MLIC). The strip chambers measured locations and lateral profiles of incident proton beamlets after exiting the imaging object, while the integral of depth dose measured in the MLIC was translated into the residual energy of the beamlet. The simulation was performed at five levels of imaging dose to demonstrate the feasibility and performance expectations of our design. The energy of the proton beamlet was set to 150 ± 0.6 MeV. A collimator with a round slit of 1 cm in diameter was placed in the central beam axis upstream from steering magnets. Proton stopping power ratio (SPR) was reconstructed through inverse radon transform on sinograms generated with proton beamlets scanning through an imaging phantom from a half-circle gantry rotation. The imaging phantom was 10 cm in diameter. The base was made of water-equivalent material holding 13-tissue equivalent inserts constructed according to ICRP 1975 (Task Group on Reference Man. "Report of the Task Group on Reference Man: A Report", Pergamon Press 23, 1975). All inserts were 1 cm in diameter with materials ranging from lung to cortical bone. Percentage discrepancies were reported by comparing to the ground truths. The imaging dose and quality were also evaluated.

RESULTS

The maximum deviation in reconstructed proton SPR from the ground truths was reported to be 1.02% in one of the 13 inserts when the number of protons per beamlet passing through the slit dropped to 10³ . Imaging dose was correlated linearly to incident protons and was determined to be 0.54 cGy if 5 × 10² protons per beamlet were used. Imaging quality was acceptable for planning purpose and held consistently through all levels of imaging dose. Spatial resolution was measured as five line pairs per cm consistently in all simulations varying in imaging dose.

CONCLUSIONS

Proton CT using a multiple-layer ionization chamber with two strip ionization chambers on the surface simplifies data acquisition while achieving excellent accuracy in proton SPR and acceptable spatial resolution. The imaging dose is lower compared to kV CBCT, making it potentially a great tool for localization and plan adaption in proton therapy.

Time-resolved diode dosimetry calibration through Monte Carlo modeling for in vivo passive scattered proton therapy range verification

Purpose

Our group previously introduced an in vivo proton range verification methodology in which a silicon diode array system is used to correlate the dose rate profile per range modulation wheel cycle of the detector signal to the water‐equivalent path length (WEPL) for passively scattered proton beam delivery. The implementation of this system requires a set of calibration data to establish a beam‐specific response to WEPL fit for the selected ‘scout’ beam (a 1 cm overshoot of the predicted detector depth with a dose of 4 cGy) in water‐equivalent plastic. This necessitates a separate set of measurements for every ‘scout’ beam that may be appropriate to the clinical case. The current study demonstrates the use of Monte Carlo simulations for calibration of the time‐resolved diode dosimetry technique.

Methods

Measurements for three ‘scout’ beams were compared against simulated detector response with Monte Carlo methods using the Tool for Particle Simulation (TOPAS). The ‘scout’ beams were then applied in the simulation environment to simulated water‐equivalent plastic, a CT of water‐equivalent plastic, and a patient CT data set to assess uncertainty.

Results

Simulated detector response in water‐equivalent plastic was validated against measurements for ‘scout’ spread out Bragg peaks of range 10 cm, 15 cm, and 21 cm (168 MeV, 177 MeV, and 210 MeV) to within 3.4 mm for all beams, and to within 1 mm in the region where the detector is expected to lie.

Conclusion

Feasibility has been shown for performing the calibration of the detector response for three ‘scout’ beams through simulation for the time‐resolved diode dosimetry technique in passive scattered proton delivery.