Beam Position Projection Algorithms in Proton Pencil Beam Scanning.

Beam position uncertainties along the beam trajectory arise from the accelerator, beamline, and scanning magnets (SMs). They can be monitored in real time, e.g.

Late Radiation-Induced Carotid Artery Stenosis and Stroke in Pediatric Patient Treated With Proton Radiation Therapy for Skull-Base Chordoma.

Radiation vasculopathy is a well-recognized late complication of radiation therapy. We present a case of a stroke 29 years after high-dose proton radiation therapy for skull-base chordoma due to occlusion of bilateral internal carotid arteries.

Pencil beam scanning dose calibration at reduced source-to-axis distance.

Background: Pencil beam scanning (PBS) monitoring chambers use an ionization control signal, monitor units (MUs), or gigaprotons (Gp) to irradiate a pencil beam and normalize dose calculations. The nozzle deflects the beam from the nozzle axis by an angle subtended at the source-to-axis distance (τ) from the isocenter. If the angle is not correctly considered in calibrations or calculations, it can lead to systematic errors.

Implementation of apertures in a proton pencil-beam dose algorithm.

The use of field-specific apertures, routine in scattered or uniform-scanned proton fields, are still a necessity in pencil-beam scanned (PBS) fields to sharpen the penumbral edge at low energies and in high fraction dose application beyond that achievable with small spot size. We describe a model implemented in our clinical pencil-beam algorithm that models the insertion of a shaped aperture, including shapes adapted per energy layer such as may be achieved with a multi-leaf collimator. The model decomposes the spot transport into discrete steps.