Ordoñez Caesar E, Karonis Nicholas T, Duffin Kirk L, Winans John R, DeJongh Ethan A, DeJongh Don F, Coutrakon George, Myers Nicole F, Pankuch Mark, Welsh James S
Northern Illinois University, Center for Research Computing and Data, DeKalb, IL, 60115, USA.
Northern Illinois University, Computer Science Department, DeKalb, IL, 60115, USA.
J Radiat Oncol. 2019 Jun;8(2):185-198. doi: 10.1007/s13566-019-00387-x. Epub 2019 May 25.
Proton beam therapy is an emerging modality for cancer treatment that, compared to X-ray radiation therapy, promises to provide better dose delivery to clinical targets with lower doses to normal tissues. Crucial to accurate treatment planning and dose delivery is knowledge of the water equivalent path length (WEPL) of each ray, or pencil beam, from the skin to every point in the target. For protons, this length is estimated from relative stopping power based on X-ray Hounsfield units. Unfortunately, such estimates lead to 3 to 4% uncertainties in the proton range prediction. Therefore, protons in the Bragg peak may overshoot (or undershoot) the desired stopping depth in the target causing tissue damage beyond the target volume. Recent studies indicate that tomographic imaging using protons has the potential to provide directly more accurate measurement of RSPs with significantly lower radiation dose than X-rays. We are currently working on a proton radiography system that promises to provide accurate two-dimensional (2D) images of WEPL values for protons that pass through the body. These will be suitable for positioning and range verification in daily treatments. In this study, we demonstrate that this system is capable of rapidly achieving such accurate images in clinically meaningful times.
We have developed a software platform to characterize the potential performance of the prototype proton radiography system. We use Geant4 to simulate raw data detected by the device. An especially-written software - pRad - was written to process these data as they are received and uses iterative methods to generate radiographs. The software has been designed to generate a radiograph from a few million protons in under a minute after receiving the first proton from the device. We used a head phantom with known chemical compositions that could be modelled quite accurately in Geant4 simulations of proton radiographs. The radiographs are displayed as pixelated WEPL values displayed on a 2D gray scale image of WEPL values.
Rapid radiograph reconstruction of 3D phantoms using simulated proton pencil beams have been achieved with our software platform. On a modest desktop computer with a single central processing unit (CPU) and a single graphics processing unit (GPU), it takes about 11 seconds to reconstruct images using iterative linear algorithms to reconstruct a radiograph from 7.6 million protons. For the radiographic reconstructions of the head phantom described here, the mean WEPL errors, in the proton radiograph using a large majority of the pixels in the complete image were less than 1 mm when compared to images obtained without proton scattering and without detector resolution included.
We have demonstrated, through computer simulations of proton irradiation of a pediatric head phantom using the newly built pRad detector and image reconstruction software, that high quality proton radiographs can be generated for patient alignment and verification of water equivalent thickness of the patient before each treatment.
质子束治疗是一种新兴的癌症治疗方式,与X射线放射治疗相比,有望以更低的剂量对正常组织进行更好的剂量输送,从而将剂量输送到临床靶区。准确的治疗计划和剂量输送的关键在于了解从皮肤到靶区内每个点的每条射线(即笔形束)的水等效路径长度(WEPL)。对于质子而言,该长度是根据基于X射线亨氏单位的相对阻止本领来估算的。不幸的是,这种估算会导致质子射程预测存在3%至4%的不确定性。因此,处于布拉格峰的质子可能会超过(或低于)靶区中所需的阻止深度,从而导致超出靶区体积的组织损伤。最近的研究表明,使用质子进行断层成像有可能以比X射线显著更低的辐射剂量直接提供更准确的相对阻止本领测量值。我们目前正在研发一种质子射线照相系统,该系统有望为穿过人体的质子提供准确的二维(2D)水等效路径长度值图像。这些图像将适用于日常治疗中的定位和射程验证。在本研究中,我们证明了该系统能够在具有临床意义的时间内快速获得此类准确图像。
我们开发了一个软件平台来表征原型质子射线照相系统的潜在性能。我们使用Geant4来模拟该设备检测到的原始数据。编写了一个专门的软件——pRad,用于在接收到数据时对其进行处理,并使用迭代方法生成射线照片。该软件设计为在从设备接收到第一个质子后的一分钟内,从数百万个质子生成一张射线照片。我们使用了一个具有已知化学成分的头部模型,该模型在质子射线照片的Geant4模拟中能够相当准确地建模。射线照片以像素化水等效路径长度值的形式显示在水等效路径长度值的二维灰度图像上。
利用我们的软件平台,已实现使用模拟质子笔形束对三维模型进行快速射线照片重建。在一台配备单个中央处理器(CPU)和单个图形处理器(GPU)的普通台式计算机上,使用迭代线性算法从760万个质子重建一张射线照片大约需要11秒。对于此处描述的头部模型的射线照片重建,与不包括质子散射和探测器分辨率的情况下获得的图像相比,在完整图像中使用大多数像素的质子射线照片中的平均水等效路径长度误差小于1毫米。
通过使用新建的pRad探测器和图像重建软件对儿科头部模型进行质子辐照的计算机模拟,我们证明了在每次治疗前可为患者对齐和验证患者的水等效厚度生成高质量的质子射线照片。