Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland.
Department of Physics, ETH Zurich, Zurich, Switzerland.
Med Phys. 2021 Dec;48(12):7613-7622. doi: 10.1002/mp.15278. Epub 2021 Oct 29.
In proton therapy, the potential of using high-dose rates in the cancer treatment is being explored. High-dose rates could improve efficiency and throughput in standard clinical practice, allow efficient utilization of motion mitigation techniques for moving targets, and potentially enhance normal tissue sparing due to the so-called FLASH effect. However, high-dose rates are difficult to reach when lower energy beams are applied in cyclotron-based proton therapy facilities, because they result in large beam sizes and divergences downstream of the degrader, incurring large losses from the cyclotron to the patient position (isocenter). In current facilities, the emittance after the degrader is reduced using circular collimators; however, this does not provide an optimal matching to the acceptance of the following beamline, causing a low transmission for these energies. We, therefore, propose to use a collimation system, asymmetric in both beam size and divergence, resulting in symmetric emittance in both beam transverse planes as required for a gantry system. This new emittance selection, together with a new optics design for the following beamline and gantry, allows a better matching to the beamline acceptance and an improvement of the transmission.
We implemented a custom method to design the collimator sizes and shape required to select high emittance, to be transported by the following beamline using new beam optics (designed with TRANSPORT) to maximize acceptance matching. For predicting the transmission in the new configuration (new collimators + optics), we used Monte Carlo simulations implemented in BDSIM, implementing a model of PSI Gantry 2 which we benchmarked against measurements taken in the current clinical scenario (circular collimators + clinical optics).
From the BDSIM simulations, we found that the new collimator system and matching beam optics results in an overall transmission from the cyclotron to the isocenter for a 70 MeV beam of 0.72%. This is an improvement of almost a factor of 6 over the current clinical performance (0.13% transmission). The new optics satisfies clinical beam requirements at the isocenter.
We developed a new emittance collimation system for PSI's PROSCAN beamline which, by carefully selecting beam size and divergence asymmetrically, increases the beam transmission for low-energy beams in current state-of-the-art cyclotron-based proton therapy gantries. With these improvements, we could predict almost 1% transmission for low-energy beams at PSI's Gantry 2. Such a system could easily be implemented in facilities interested in increasing dose rates for efficient motion mitigation and FLASH experiments alike.
在质子治疗中,正在探索在癌症治疗中使用高剂量率的潜力。高剂量率可以提高标准临床实践的效率和吞吐量,允许对移动目标的运动缓解技术进行有效的利用,并且由于所谓的 FLASH 效应,有可能增强正常组织的保护。然而,当在基于回旋加速器的质子治疗设施中应用低能量束时,高剂量率很难实现,因为它们会导致束流尺寸增大,并且在减速剂下游发散,从而导致从回旋加速器到患者位置(等中心)的大量损失。在当前的设施中,使用圆形准直器降低减速后的发射度;然而,这并没有为后续束线的接收提供最佳匹配,从而导致这些能量的传输率较低。因此,我们建议使用一种准直系统,该系统在束流尺寸和发散度上不对称,从而在两个横向平面的束流发射度上产生对称,这是转台系统所需的。这种新的发射度选择,再加上后续束线和转台的新光学设计,可以更好地与束线接收相匹配,并提高传输率。
我们实施了一种定制方法来设计准直器的尺寸和形状,以选择高发射度,然后使用新的光束光学(使用 TRANSPORT 设计)将其输送到后续束线,以最大限度地提高接收匹配度。为了预测新配置(新准直器+光学)中的传输,我们使用 BDSIM 中的蒙特卡罗模拟,实现了对 PSI 转台 2 的模型,该模型经过了与当前临床情况(圆形准直器+临床光学)中测量结果的基准测试。
从 BDSIM 模拟中,我们发现新的准直器系统和匹配的光束光学系统导致从回旋加速器到等中心的 70 MeV 束的总传输率为 0.72%。这比当前临床性能(0.13%的传输率)提高了近 6 倍。新的光学系统满足等中心处的临床光束要求。
我们为 PSI 的 PROSCAN 束线开发了一种新的发射度准直系统,该系统通过仔细选择不对称的束流尺寸和发散度,提高了当前最先进的回旋加速器基于质子治疗转台中低能束的传输率。有了这些改进,我们可以预测 PSI 转台 2 上低能束的传输率接近 1%。这种系统可以很容易地在有兴趣提高剂量率以实现高效运动缓解和 FLASH 实验的设施中实施。