PO-1410: Trend lines on patient specific quality assurance in ion beam therapy with protons and carbon ions

Patient specific quality assurance can be improved using an independent dose calculation system. In addition, the implementation of such a system may support light ion beam therapy facilities in reducing the needs for beam time, by substituting some of the experimental patient-specific quality assurance procedures by independent dose calculation. The GATE-RTion-based IDEAL system for light ion beam therapy was developed for this purpose. It was built in a DICOM-in, DICOM-out fashion, for easy integration into a state-of-the-art technology-based workflow for scanned ion beam therapy. This article describes the IDEAL system, followed by its clinical implementation at MedAustron for proton and carbon ion beams. Medical physics acceptance and commissioning steps are presented together with key results: for 3D proton and carbon ion reference boxes, 97% of the points agreed within 5% from the measurements. Experimental validation of stopping powers using real pig samples were between 1.8% and 3.8% for soft tissues. Finally, five clinical cases are described, i.e. two proton and three carbon ion treatments. Dosimetric benchmarking against TPS calculations are presented and discussed in details. As expected, the IDEAL software evidenced limitations arising from the pencil beam algorithm available in the TPS for carbon ions, especially in the presence of air cavities. The IDEAL system was found to satisfy the clinical requirements for independent dose calculation of scanned ion beam delivery systems and is being clinically implemented at MedAustron. The open-source code as well as the documentation was released on the OpenGATE collaboration website, thus allowing for long term maintenance and future upgrades based on a more widespread utilization.

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Analysis of ion beam teletherapy patient-specific quality assurance

Medical Dosimetry ◽

10.1016/j.meddos.2018.01.002 ◽

2019 ◽

Vol 44 (1) ◽

pp. 43-50 ◽

Cited By ~ 1

Author(s):

Xiaoli Liu ◽

Yu Deng ◽

Nicki Schlegel ◽

Zhijie Huang ◽

Michael F. Moyers

Keyword(s):

Quality Assurance ◽

Ion Beam ◽

Patient Specific

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Quality assurance for a treatment planning system in scanned ion beam therapy

Medical Physics ◽

10.1118/1.599025 ◽

2000 ◽

Vol 27 (7) ◽

pp. 1588-1600 ◽

Cited By ~ 43

Author(s):

O. Jäkel ◽

G. H. Hartmann ◽

C. P. Karger ◽

P. Heeg ◽

J. Rassow

Keyword(s):

Quality Assurance ◽

Treatment Planning ◽

Ion Beam ◽

Planning System ◽

Treatment Planning System ◽

Ion Beam Therapy

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Laser Acceleration of Ions for Radiation Therapy

Reviews of Accelerator Science and Technology ◽

10.1142/s1793626809000296 ◽

2009 ◽

Vol 02 (01) ◽

pp. 201-228 ◽

Cited By ~ 81

Author(s):

Toshiki Tajima ◽

Dietrich Habs ◽

Xueqing Yan

Keyword(s):

Scaling Laws ◽

Ion Beam ◽

Clinical Approach ◽

Carbon Ions ◽

Dense Particle ◽

Ion Beam Therapy ◽

Conventional Technology ◽

Ion Therapy ◽

Laser Acceleration ◽

Cost Efficient

Ion beam therapy for cancer has proven to be a successful clinical approach, affording as good a cure as surgery and a higher quality of life. However, the ion beam therapy installation is large and expensive, limiting its availability for public benefit. One of the hurdles is to make the accelerator more compact on the basis of conventional technology. Laser acceleration of ions represents a rapidly developing young field. The prevailing acceleration mechanism (known as target normal sheath acceleration, TNSA), however, shows severe limitations in some key elements. We now witness that a new regime of coherent acceleration of ions by laser (CAIL) has been studied to overcome many of these problems and accelerate protons and carbon ions to high energies with higher efficiencies. Emerging scaling laws indicate possible realization of an ion therapy facility with compact, cost-efficient lasers. Furthermore, dense particle bunches may allow the use of much higher collective fields, reducing the size of beam transport and dump systems. Though ultimate realization of a laser-driven medical facility may take many years, the field is developing fast with many conceptual innovations and technical progress.

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FRoG—A New Calculation Engine for Clinical Investigations with Proton and Carbon Ion Beams at CNAO

Cancers ◽

10.3390/cancers10110395 ◽

2018 ◽

Vol 10 (11) ◽

pp. 395 ◽

Cited By ~ 7

Author(s):

KyungDon Choi ◽

Stewart Mein ◽

Benedikt Kopp ◽

Giuseppe Magro ◽

Silvia Molinelli ◽

...

Keyword(s):

Ion Beam ◽

Local Effect ◽

Ion Beams ◽

Patient Specific ◽

Clinical Activity ◽

Processing Unit ◽

Carbon Ions ◽

Carbon Ion ◽

Dosimetric Data ◽

Biological Dose

A fast and accurate dose calculation engine for hadrontherapy is critical for both routine clinical and advanced research applications. FRoG is a graphics processing unit (GPU)-based forward calculation tool developed at CNAO (Centro Nazionale di Adroterapia Oncologica) and at HIT (Heidelberg Ion Beam Therapy Center) for fast and accurate calculation of both physical and biological dose. FRoG calculation engine adopts a triple Gaussian parameterization for the description of the lateral dose distribution. FRoG provides dose, dose-averaged linear energy transfer, and biological dose-maps, -profiles, and -volume-histograms. For the benchmark of the FRoG calculation engine, using the clinical settings available at CNAO, spread-out Bragg peaks (SOBPs) and patient cases for both proton and carbon ion beams have been calculated and compared against FLUKA Monte Carlo (MC) predictions. In addition, FRoG patient-specific quality assurance (QA) has been performed for twenty-five proton and carbon ion fields. As a result, for protons, biological dose values, using a relative biological effectiveness (RBE) of 1.1, agree on average with MC within ~1% for both SOBPs and patient plans. For carbon ions, RBE-weighted dose (DRBE) agreement against FLUKA is within ~2.5% for the studied SOBPs and patient plans. Both MKM (Microdosimetric Kinetic Model) and LEM (Local Effect Model) DRBE are implemented and tested in FRoG to support the NIRS (National Institute of Radiological Sciences)-based to LEM-based biological dose conversion. FRoG matched the measured QA dosimetric data within ~2.0% for both particle species. The typical calculation times for patients ranged from roughly 1 to 4 min for proton beams and 3 to 6 min for carbon ions on a NVIDIA® GeForce® GTX 1080 Ti. This works demonstrates FRoG’s potential to bolster clinical activity with proton and carbon ion beams at CNAO.

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