Development and evaluation of an in-beam PET system for proton therapy monitoring

Objective. In-beam positron emission tomography (PET) has important development prospects in real-time monitoring of proton therapy. However, in the beam-on operation, the high bursts of radiation events pose challenges to the performance of the PET system.Approach. In this study, we developed a dual-head in-beam PET system for proton therapy monitoring and evaluated its performance. The system has two PET detection heads, each with6×3Plug&Imaging (PnI) detection units. Each PnI unit consists of6×6lutetium-yttrium oxyorthosilicate crystal arrays. The size of each crystal strip is3.95×3.95×20 mm3, which is one-to-one coupled with a silicon photomultiplier. The overall size of the head is15.3×7.65 cm2.Main results. The in-beam PET system achieved a single count rate of 48 Mcps at the activity of 144.9 MBq, an absolute sensitivity of 2.717%, and a spatial resolution of approximately 2.6 mm (full width at half maximum) at the center of the field-of-view. When imaging a Derenzo phantom, the system could resolve rods with a diameter of 2.0 mm. Time-dynamic [18F]-Fluorodeoxyglucose mouse imaging was performed, demonstrating the metabolic processes in the mouse. This shows that the in-beam PET system has the potential for biology-guided proton therapy. The in-beam PET system was used to monitor the range of a 130 MeV proton beam irradiating a polymethyl methacrylate (PMMA) phantom, with a beam intensity of6.0×109p s-1and an irradiation duration of one minute. PET data were acquired only during the one-minute irradiation. We simulated the range shift by moving the PMMA and adding an air gap, showing that the error between the actual and the measured range is less than 1 mm.Significance. The results demonstrate that the system has a high count rate and the capability of range monitoring in beam-on operation, which is beneficial for achieving real-time range verification of proton beams in the future.

Feasibility of the J-PET to monitor the range of therapeutic proton beams

PURPOSE

The aim of this work is to investigate the feasibility of the Jagiellonian Positron Emission Tomography (J-PET) scanner for intra-treatment proton beam range monitoring.

METHODS

The Monte Carlo simulation studies with GATE and PET image reconstruction with CASToR were performed in order to compare six J-PET scanner geometries. We simulated proton irradiation of a PMMA phantom with a Single Pencil Beam (SPB) and Spread-Out Bragg Peak (SOBP) of various ranges. The sensitivity and precision of each scanner were calculated, and considering the setup's cost-effectiveness, we indicated potentially optimal geometries for the J-PET scanner prototype dedicated to the proton beam range assessment.

RESULTS

The investigations indicate that the double-layer cylindrical and triple-layer double-head configurations are the most promising for clinical application. We found that the scanner sensitivity is of the order of 10-5 coincidences per primary proton, while the precision of the range assessment for both SPB and SOBP irradiation plans was found below 1 mm. Among the scanners with the same number of detector modules, the best results are found for the triple-layer dual-head geometry. The results indicate that the double-layer cylindrical and triple-layer double-head configurations are the most promising for the clinical application, CONCLUSIONS:: We performed simulation studies demonstrating that the feasibility of the J-PET detector for PET-based proton beam therapy range monitoring is possible with reasonable sensitivity and precision enabling its pre-clinical tests in the clinical proton therapy environment. Considering the sensitivity, precision and cost-effectiveness, the double-layer cylindrical and triple-layer dual-head J-PET geometry configurations seem promising for future clinical application.

Quantitative assessment of radionuclide production yields in in-beam and offline PET measurements at different proton irradiation facilities

Objective. Reliable radionuclide production yield data are a prerequisite for positron-emission-tomography (PET) based in vivo proton treatment verification. In this context, activation data acquired at two different treatment facilities with different imaging systems were analyzed to provide experimentally determined radionuclide yields in thick targets and were compared with each other to investigate the impact of the respective imaging technique. Approach. Homogeneous thick targets (PMMA, gelatine, and graphite) were irradiated with mono-energetic proton pencil-beams at two distinct energies. Material activation was measured (i) in-beam during and after beam delivery with a double-head prototype PET camera and (ii) offline shortly after beam delivery with a commercial full-ring PET/CT scanner. Integral as well as depth-resolved β +-emitter yields were determined for the dominant positron-emitting radionuclides 11C, 15O, 13N and (in-beam only) 10C. In-beam data were used to investigate the qualitative impact of different monitoring time schemes on activity depth profiles and their quantitative impact on count rates and total activity. Main results. Production yields measured with the in-beam camera were comparable to or higher compared to respective offline results. Depth profiles of radionuclide-specific yields obtained from the double-head camera showed qualitative differences to data acquired with the full-ring camera with a more convex profile shape. Considerable impact of the imaging timing scheme on the activity profile was observed for gelatine only with a range variation of up to 3.5 mm. Evaluation of the coincidence rate and the total number of observed events in the considered workflows confirmed a strongly decreasing rate in targets with a large oxygen fraction. Significance. The observed quantitative and qualitative differences between the datasets underline the importance of a thorough system commissioning. Due to the lack of reliable cross-section data, in-house phantom measurements are still considered a gold standard for careful characterization of the system response and to ensure a reliable beam range verification.

A proof-of-concept study of an in-situ partial-ring time-of-flight PET scanner for proton beam verification

Development of a PET system capable of in-situ imaging requires a design that can accommodate the proton treatment beam nozzle. Among the several PET instrumentation approaches developed thus far, the dual-panel PET scanner is often used as it is simpler to develop and integrate within the proton therapy gantry. Partial-angle coverage of these systems can however lead to limited-angle artefacts in the reconstructed PET image. We have previously demonstrated via simulations that time-of-flight (TOF) reconstruction reduces the artifacts accompanying limited-angle data, and permits proton range measurement with 1-2 mm accuracy and precision. In this work we show measured results from a small proof-of-concept dual-panel PET system that uses TOF information to reconstruct PET data acquired after proton irradiation. The PET scanner comprises of two detector modules, each comprised of an array of 4×4×30 mm³ lanthanum bromide scintillator. Measurements are performed with an oxygen-rich gel-water, an adipose tissue equivalent material, and in vitro tissue phantoms. For each phantom measurement, 2 Gy dose was deposited using 54 - 100 MeV proton beams. For each phantom, a Monte Carlo simulation generating the expected distribution of PET isotope from the corresponding proton irradiation was also performed. Proton range was calculated by drawing multiple depth-profiles over a central region encompassing the proton dose deposition. For each profile, proton range was calculated using two techniques (a) 50% pick-off from the distal edge of the profile, and (b) comparing the measured and Monte Carlo profile to minimize the absolute sum of differences over the entire profile. A 10 min PET acquisition acquired with minimal delay post proton-irradiation is compared with a 10 min PET scan acquired after a 20 min delay. Measurements show that PET acquisition with minimal delay is necessary to collect ¹⁵O signal, and maximize ¹¹C signal collection with a short PET acquisition. In comparison with the 50% pick-off technique, the shift technique is more robust and offers better precision in measuring the proton range for the different phantoms. Range measurements from PET images acquired with minimal delay, and the shift technique demonstrate the ability to achieve <1.5 mm accuracy and precision in estimating proton range.

Novel On-line PET Imaging for Intra-Beam Range Verification and Delivery Optimization: A Simulation Feasibility Study

On-line PET image-based method uses an initial particle beam to measure the particle beam range (BR) within the same fraction so that any measured range-shift with respect to the predicted BR can be compensated before the rest therapeutic beam deliveries. However, the method requires to use a low-dose initial beam to minimize the risk of beam overshooting, which leads to low image count and inaccurate BR measurement. In this in-silico study, we evaluated the feasibility of a new on-line PET imaging method that measures BR at the mid-plane of a target volume with part of the high-dose therapy beams to verify BR and guide adaptive treatment re-planning. Simulations included various processes of proton beam radiations to a tumor inside a human brain phantom, positron and PET image generation at the mid-plane with initial beams, activity range measurement, and range-shift compensated beam delivery. The results demonstrated that the new method, under the simulated conditions, can achieve ~1.1 mm mid-plane BR measurement accuracy and closely match the delivered range-shift compensated dose distribution with the planned one. Overall, it is promising that this new method may significantly improve particle therapy accuracy.