Geoghegan Theodore, Patwardhan Kaustubh, Nelson Nicholas, Hill Patrick, Flynn Ryan, Smith Blake, Hyer Daniel
Department of Radiation Oncology, University of Iowa Hospitals & Clinics, 200 Hawkins Dr., Iowa City, IA 52242.
Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705.
J Med Device. 2022 Jun 1;16(2):021013. doi: 10.1115/1.4053722. Epub 2022 Mar 2.
Radiation therapy is integral to cancer treatments for more than half of patients. Pencil beam scanning (PBS) proton therapy is the latest radiation therapy technology that uses a beam of protons that are magnetically steered and delivered to the tumor. One of the limiting factors of PBS accuracy is the beam cross-sectional size, similar to how a painter is only as accurate as the size of their brush allows. To address this, collimators can be used to shape the beam along the tumor edge to minimize the dose spread outside of the tumor. Under development is a dynamic collimation system (DCS) that uses two pairs of nickel trimmers that collimate the beam at the tumor periphery, limiting dose from spilling into healthy tissue. Herein, we establish the dosimetric and mechanical acceptance criteria for the DCS based on a functioning prototype and Monte Carlo methods, characterize the mechanical accuracy of the prototype, and validate that the acceptance criteria are met. From Monte Carlo simulations, we found that the trimmers must be positioned within ±0.5 mm and ±1.0 deg for the dose distributions to pass our gamma analysis. We characterized the trimmer positioners at jerk values up to 400 m/s and validated their accuracy to 50 m. We measured and validated the rotational trimmer accuracy to ±0.5 deg with a FARO ScanArm. Lastly, we calculated time penalties associated with the DCS and found that the additional time required to treat one field using the DCS varied from 25-52 s.
放射治疗是超过半数癌症患者治疗方案中不可或缺的一部分。笔形束扫描(PBS)质子治疗是最新的放射治疗技术,它利用一束通过磁场控制并输送到肿瘤部位的质子。PBS精度的限制因素之一是束流横截面大小,这类似于画家的作画精度仅取决于其画笔的大小。为了解决这个问题,可以使用准直器沿着肿瘤边缘对束流进行塑形,以尽量减少肿瘤外的剂量扩散。正在研发的一种动态准直系统(DCS),它使用两对镍微调器在肿瘤周边对准直束流,限制剂量泄漏到健康组织中。在此,我们基于一个功能原型和蒙特卡罗方法建立了DCS的剂量学和机械验收标准,表征了该原型的机械精度,并验证是否满足验收标准。通过蒙特卡罗模拟,我们发现微调器必须定位在±0.5毫米和±1.0度范围内,剂量分布才能通过我们的伽马分析。我们在高达400米/秒的急动值下对微调器定位器进行了表征,并验证了其在50米范围内的精度。我们使用FARO ScanArm测量并验证了旋转微调器的精度为±0.5度。最后,我们计算了与DCS相关的时间惩罚,发现使用DCS治疗一个射野所需的额外时间在25 - 52秒之间变化。