Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
Int J Radiat Oncol Biol Phys. 2021 Jul 1;110(3):872-882. doi: 10.1016/j.ijrobp.2021.01.011. Epub 2021 Jan 11.
PURPOSE: In this study, procedures were developed to achieve efficient reversible conversion of a clinical linear accelerator (LINAC) and deliver ultrahigh-dose-rate (UHDR) electron or conventional beams to the treatment room isocenter for FLASH radiation therapy. METHODS AND MATERIALS: The LINAC was converted to deliver UHDR beam within 20 minutes by retracting the x-ray target from the beam's path, positioning the carousel on an empty port, and selecting 10 MV photon beam energy in the treatment console. Dose rate surface and depth dose profiles were measured in solid water phantom at different field sizes with Gafchromic film and an optically stimulated luminescent dosimeter (OSLD). A pulse controller counted the pulses via scattered radiation signal and gated the delivery for a preset pulse count. A fast photomultiplier tube-based Cherenkov detector measured the per pulse beam output at a 2-ns sampling rate. After conversion back to clinical mode, conventional beam output, flatness, symmetry, field size, and energy were measured for all clinically commissioned energies. RESULTS: The surface average dose rates at the isocenter for 1-cm diameter and 1.5-in diameter circular fields and for a jaws-wide-open field were 238 ± 5 Gy/s, 262 ± 5 Gy/s, and 290 ± 5 Gy/s, respectively. The radial symmetry of the beams was within 2.4%, 0.5%, and 0.2%, respectively. The doses from simultaneous irradiation of film and OSLD were within 1%. The photomultiplier tube showed the LINAC required ramp up time in the first 4 to 6 pulses before the output stabilized, after which its stability was within 3%. CONCLUSIONS: At the isocenter of the treatment room, 10 MeV UHDR beams were achieved. The beam output was reproducible but requires further investigation of the ramp up time, equivalent to ∼1 Gy, requiring dose monitoring. The UHDR beam can irradiate both small and large subjects to investigate potential FLASH radiobiological effects in minimally modified clinical settings, and the dose rate can be further increased by reducing the source-to-surface distance.
目的:在这项研究中,开发了一些程序,以实现对临床直线加速器(LINAC)的高效可逆转换,并将超高剂量率(UHDR)电子束或常规束输送到治疗室等中心,用于 FLASH 放射治疗。
方法与材料:通过将 X 射线靶从光束路径中缩回、将转筒定位在空端口上,并在治疗控制台中选择 10MV 光子束能量,将 LINAC 在 20 分钟内转换为可提供 UHDR 束。在不同的射野尺寸下,用水中模体中的 Gafchromic 胶片和光激励发光剂量计(OSLD)测量剂量率表面和深度剂量分布。脉冲控制器通过散射辐射信号计数脉冲,并为预设的脉冲计数对其进行传输。基于快速光电倍增管的切伦科夫探测器以 2ns 的采样率测量每个脉冲的束输出。转换回临床模式后,对所有临床批准的能量进行常规束输出、平坦度、对称性、射野尺寸和能量测量。
结果:在等中心处,1cm 直径和 1.5in 直径的圆形射野以及 jaws-wide-open 射野的表面平均剂量率分别为 238±5Gy/s、262±5Gy/s 和 290±5Gy/s。光束的径向对称性分别为 2.4%、0.5%和 0.2%。胶片和 OSLD 的同时照射剂量在 1%以内。光电倍增管显示,LINAC 在输出稳定之前,在前 4 到 6 个脉冲中需要上升时间,之后其稳定性在 3%以内。
结论:在治疗室等中心处,实现了 10 MeV UHDR 束。束输出具有可重复性,但需要进一步研究上升时间,相当于约 1Gy,需要进行剂量监测。UHDR 束可以照射大小不同的受试者,在最小化修改临床设置的情况下研究潜在的 FLASH 放射生物学效应,并且通过减小源皮距可以进一步提高剂量率。
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