Response characterization of radiochromic OC-1 films in photon, electron, and proton beams.

Background: Radiochromic film (RCF) dosimeters with their high spatial resolution and tissue equivalent properties are conveniently used for two-dimensional and small-field dosimetry. OC-1 is a new model of RCF dosimeter that was commercially introduced recently. Due to its novelty there is a need to characterize its response in various radiation beam types.

Proton 3D dose measurement with a multi-layer strip ionization chamber (MLSIC) device.

. In current clinical practice for quality assurance (QA), intensity modulated proton therapy (IMPT) fields are verified by measuring planar dose distributions at one or a few selected depths in a phantom. A QA device that measures full 3D dose distributions at high spatiotemporal resolution would be highly beneficial for existing as well as emerging proton therapy techniques such as FLASH radiotherapy.

Millimeter wave-based patient setup verification and motion tracking during radiotherapy.

Background: Position verification and motion monitoring are critical for safe and precise radiotherapy (RT). Existing approaches to these tasks based on visible light or x-ray are suboptimal either because they cannot penetrate obstructions to the patient's skin or introduce additional radiation exposure. The low-cost mmWave radar is an ideal solution for these tasks as it can monitor patient position and motion continuously throughout the treatment delivery.

Dosimetric evaluation of dose shaping by adaptive aperture and its impact on plan quality.

Mevion's single-room HYPERSCAN proton therapy system employs a proton multileaf collimator called the adaptive aperture (AA), which collimates individual spots in the proton delivery as determined by the Treatment Planning System (TPS). The purpose of this study is to assess the dosimetric benefits of the AA, specifically in the dynamic aperture (DA) mode, and evaluate its impact on proton treatment plan quality as compared to a traditional pencil beam scanning (PBS) system (Varian ProBeam). The spot dose distributions with dynamic collimation (DA), a unique AA shape for each energy layer, and with static collimation (SA), a single AA collimation shape shared by all energy layers per field, were calculated and compared with the spot dose distribution of the Varian ProBeam proton therapy system.

Simulation study of a novel small animal FLASH irradiator (SAFI) with integrated inverse-geometry CT based on circularly distributed kV X-ray sources.

Ultra-high dose rate (UHDR) radiotherapy (RT) or FLASH-RT can potentially reduce normal tissue toxicity. A small animal irradiator that can deliver FLASH-RT treatments similar to clinical RT treatments is needed for pre-clinical studies of FLASH-RT. We designed and simulated a novel small animal FLASH irradiator (SAFI) based on distributed x-ray source technology.

Validation of a deep learning-based material estimation model for Monte Carlo dose calculation in proton therapy.

. Computed tomography (CT) to material property conversion dominates proton range uncertainty, impacting the quality of proton treatment planning. Physics-based and machine learning-based methods have been investigated to leverage dual-energy CT (DECT) to predict proton ranges.

A multi-layer strip ionization chamber (MLSIC) device for proton pencil beam scan quality assurance.

. Proton pencil beam scanning (PBS) treatment fields needs to be verified before treatment deliveries to ensure patient safety. In current practice, treatment beam quality assurance (QA) is measured at a few selected depths using film or a 2D detector array, which is insensitive and time-consuming.

Design and optimization of thin-film tungsten (W)-diamond target for multi-pixel X-ray sources.

Background: Emerging multi-pixel X-ray source technology enables new designs for X-ray imaging systems. The power of multi-pixel X-ray sources with a fixed anode is limited by focal spot power density.

Purpose: The purpose of this study is to optimize the W-diamond target and predict its performance in multi-pixel X-ray sources.

A reconstruction approach for proton computed tomography by modeling the integral depth dose of the scanning proton pencil beam.

Purpose: To present a proton computed tomography (pCT) reconstruction approach that models the integral depth dose (IDD) of the clinical scanning proton beam into beamlets. Using a multilayer ionization chamber (MLIC) as the imager, the proposed pCT system and the reconstruction approach can minimize extra ambient neutron dose and simplify the beamline design by eliminating an additional collimator to confine the proton beam.

Methods: Monte Carlo simulation was applied to digitally simulate the IDDs of the exiting proton beams detected by the MLIC.

Tetrahedron beam imaging with a multi-pixel thermionic emission X-ray source and a photon-counting detector: A benchtop experimental study.

Purpose: A tetrahedron beam (TB) X-ray system with a linear X-ray source array and a linear detector array positioned orthogonal to each other may overcome the X-ray scattering problem of traditional cone-beam X-ray systems. We developed a TB imaging benchtop system using a linear array X-ray source to demonstrate the principle and benefits of TB imaging.

Methods: A multi-pixel thermionic emission X-ray (MPTEX) source with 48 focal spots in 4-mm spacing was developed in-house.

Dosimetric impact of range uncertainty in passive scattering proton therapy.

Purpose: The objective of this study was to investigate the dosimetric impact of range uncertainty in a large cohort of patients receiving passive scatter proton therapy.

Methods: A cohort of 120 patients were reviewed in this study retrospectively, of which 61 were brain, 39 lung, and 20 prostate patients. Range uncertainties of ±3.

A novel proton counting detector and method for the validation of tissue and implant material maps for Monte Carlo dose calculation.

The presence of artificial implants complicates the delivery of proton therapy due to inaccurate characterization of both the implant and the surrounding tissues. In this work, we describe a method to characterize implant and human tissue mimicking materials in terms of relative stopping power (RSP) using a novel proton counting detector. Each proton is tracked by directly measuring the deposited energy along the proton track using a fast, pixelated spectral detector AdvaPIX-TPX3 (TPX3).

Feasibility study of surface motion tracking with millimeter wave technology during radiotherapy.

Purpose: Continuous monitoring of patient movement is crucial to administering safe radiation therapy (RT). Conventional optical approaches often cannot be used when the patient's surface is blocked by immobilization devices. Millimeter waves (mmWaves) are capable of penetrating nonconductive objects.

Investigating neutron activated contrast agent imaging for tumor localization in proton therapy: a feasibility study for proton neutron gamma-x detection (PNGXD).

Proton neutron gamma-x detection (PNGXD) is a novel imaging concept being investigated for tumor localization during proton therapy that uses secondary neutron interactions with a gadolinium contrast agent (GDCA) to produce characteristic photons within the 40-200 keV energy region. The purpose of this study is to experimentally investigate the feasibility of implementing this procedure by performing experimental measurements on a passive double scattering proton treatment unit. Five experimental measurements were performed with varying concentrations and irradiation conditions.

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).

Characterizing a Geant4 Monte Carlo model of a multileaf collimator for a TrueBeam™ linear accelerator.

Purpose: The purpose of this work was to develop and validate a multileaf collimator (MLC) model for a TrueBeam™ linac using Geant4 Monte Carlo (MC) simulation kit.

Methods: A Geant4 application was developed to accurately represent TrueBeam™ linac. Pre-computed phase-space file in a plane just above the jaws was used for radiation transport.

Design and numerical simulations of W-diamond transmission target for distributed x-ray sources.

Distributed x-ray sources enable novel designs of x-ray imaging systems. However, the x-ray power of such sources is limited by the focal spot power density of the fixed anode. To further improve x-ray output, we have designed and evaluated a diamond-W transmission target for multi-pixel x-ray sources.

Toward adaptive proton therapy guided with a mobile helical CT scanner.

Purpose: To evaluate the feasibility of image-guided adaptive proton therapy (IGAPT) with a mobile helical-CT without rails.

Method: CT images were acquired with a 32-slice mobile CT (mCT) scanning through a 6 degree-of-freedom robotic couch rotated isocentrically 90 degrees from an initial setup position. The relationship between the treatment isocenter and the mCT imaging isocenter was established by a stereotactic reference frame attached to the treatment couch.

Radiation therapy for deep periocular cancer treatments when protons are unavailable: is combining electrons and orthovoltage therapy beneficial?

Deep periocular cancers can be difficult to plan and treat with radiation, given the difficulties in apposing bolus to skin, and the proximity to the retina and other optic structures. We sought to compare the combination of electrons and orthovoltage therapy (OBE) with existing modalities for these lesions. Four cases-a retro-orbital melanoma (Case 1) and basal cell carcinomas, extending across the eyelid (Case 2) or along the medial canthus (Cases 3-4)-were selected for comparison.

A machine learning approach to the accurate prediction of monitor units for a compact proton machine.

Purpose: Clinical treatment planning systems for proton therapy currently do not calculate monitor units (MUs) in passive scatter proton therapy due to the complexity of the beam delivery systems. Physical phantom measurements are commonly employed to determine the field-specific output factors (OFs) but are often subject to limited machine time, measurement uncertainties and intensive labor. In this study, a machine learning-based approach was developed to predict output (cGy/MU) and derive MUs, incorporating the dependencies on gantry angle and field size for a single-room proton therapy system.

Automatic x-ray image contrast enhancement based on parameter auto-optimization.

Purpose: Insufficient image contrast associated with radiation therapy daily setup x-ray images could negatively affect accurate patient treatment setup. We developed a method to perform automatic and user-independent contrast enhancement on 2D kilo voltage (kV) and megavoltage (MV) x-ray images. The goal was to provide tissue contrast optimized for each treatment site in order to support accurate patient daily treatment setup and the subsequent offline review.

Development of multi-pixel x-ray source using oxide-coated cathodes.

Multiple pixel x-ray sources facilitate new designs of imaging modalities that may result in faster imaging speed, improved image quality, and more compact geometry. We are developing a high-brightness multiple-pixel thermionic emission x-ray (MPTEX) source based on oxide-coated cathodes. Oxide cathodes have high emission efficiency and, thereby, produce high emission current density at low temperature when compared to traditional tungsten filaments.

Commissioning and initial experience with the first clinical gantry-mounted proton therapy system.

The purpose of this study is to describe the comprehensive commissioning process and initial clinical experience of the Mevion S250 proton therapy system, a gantry-mounted, single-room proton therapy platform clinically implemented in the S. Lee Kling Proton Therapy Center at Barnes-Jewish Hospital in St. Louis, MO, USA.

A three-field monoisocentric inverse breast treatment planning technique without half-beam blocking.

The purpose of this study was to introduce a three-field monoisocentric inverse treatment planning method without half-beam blocks for breast cancer radiation treatments. Three-field monoisocentric breast treatment planning with half-beam blocks limits the tangential field length to 20 cm. A dual-isocenter approach accommodates patients with larger breasts, but prolongs treatment time and may introduce dose uncertainty at the matching plane due to daily setup variations.