均匀磁场下碳离子笔形束的剂量变化分析及位置修正方法

分析外加均匀磁场对于碳离子笔形束剂量分布的影响,并考虑修正这种影响,为磁共振成像引导碳离子放射治疗的临床应用提供指导。本文利用蒙特卡罗方法模拟计算了不同能量碳离子笔形束在不同强度磁场下的剂量分布情况,发现垂直于碳离子束入射方向的均匀磁场对于碳离子笔形束射程缩短的影响很小,磁场对碳离子束的主要影响是引起束流横向偏转,特别是碳离子束布拉格峰位置的横向侧移。横向侧移程度与碳离子束的能量和磁场强度相关,根据模拟结果,得到了一个计算碳离子束布拉格峰在磁场中相对横向偏转的方程,并提出一种校正外加磁场引起的碳离子束布拉格峰横移的角度修正方法。这些结果可用于指导磁共振图像引导碳离子放射治疗计划系统的研发。     

应用于在束PET的光纤链路设计

医用重离子加速器(Heavy-Ion Medical Machine,HIMM)中安装在束正电子发射断层扫描装置(In-beam Positron Emission Tomography,In-beam PET)可实现治疗时对肿瘤靶区的照射剂量和位置分布的实时监测功能.在束PET工作时,事件经探测器阵列采集,由前端数据...     

碳离子治疗计划中的RBE加权剂量鲁棒优化方法

提出基于混合束模型的相对生物学效应(RBE)加权剂量鲁棒优化方法,用于减少碳离子束射程和摆位偏差对生物剂量分布的影响。建立概率组合鲁棒优化模型,利用二次型目标函数表达式,分别制定针对物理吸收剂量和RBE加权剂量的碳离子束治疗计划,并基于共轭梯度优化算法求解出各自最优的权重解,使得靶区和危及器官(OAR)实际剂量分布在射程和摆位偏差组合情况下尽量满足剂量要求。采用C型靶模型测试鲁棒优化方法的有效性。与基于计划靶区(PTV)的常规优化方法相比,针对物理吸收剂量的鲁棒优化计划临床靶区(CTV)的$ \Delta {D}_{95{\text{%}} } $减少10.00 cGy,OAR的$ \Delta {D}_{5{\text{%}} } $和$ \Delta {D}_{\mathrm{m}\mathrm{a}\mathrm{x}} $分别减少21.50和35.97 cGy,计划的鲁棒性得到了很好的提升。针对RBE加权剂量的鲁棒优化计划CTV的$ \Delta {D}_{95{\text{%}} } $降低14.00 cGy(RBE),OAR的$ \Delta {D}_{5{\text{%}} } $和$ \Delta {D}_{\mathrm{m}\mathrm{a}\mathrm{x}} $分别减少19.00和26.28 cGy(RBE),说明该方法不仅减少了CTV的生物剂量变化,也减少了OAR的生物剂量热点。该结果证明了基于混合束模型的RBE加权剂量鲁棒优化方法在有效提高碳离子放疗计划鲁棒性的同时使OAR也得到了很好的保护。     

碳离子在不同材料叶片的多叶光栅上产生的次级粒子研究

在碳离子放射治疗中,碳离子束与治疗头设备和患者身体相互作用产生的次级粒子可以到达患者体内的许多区域,在产生的次级粒子中以中子和$\gamma $射线的产额为最大。在不影响束流配送功能的情况下,减少碳离子放疗中产生的次级中子和$\gamma $射线对于降低放疗后出现的正常组织并发症及二次肿瘤风险有着非常重要的意义。本文利用蒙特卡罗(Monte Carlo)方法模拟计算了被动式束流配送系统下,400 MeV/u碳离子束照射到由不同材料叶片构成的多叶光栅(MLC)形成典型的10 cm×10 cm方形射野时,在水模体中产生的次级中子和$\gamma $射线所沉积的剂量及空间分布等。模拟结果显示:碳离子束通过MLC形成射野后在水模体中产生的次级中子主要分布在水模体的入射端,次级$\gamma $射线较为均匀的分布在整个水模体内,且较多分布在具有展宽Bragg峰(SOBP)射野在水模体中贯穿时的坪区。对于MLC叶片材料的选择,则需根据实际情况对叶片厚度以及次级粒子当量剂量的要求来确定。本文通过模拟研究不同MLC叶片材料产生次级粒子的情况,为被动式束流配送系统中MLC叶片及其他元件的材料选择提供了科学依据。     

均匀磁场下碳离子束剂量平均LET及纳剂量学量的分布

随着磁共振成像(MRI)技术的发展,图像引导放射治疗在放射肿瘤学中的作用和重要性正在迅速增加,本研究分析了外加均匀磁场对碳离子束的剂量平均LET以及纳剂量学量的影响。通过基于GEANT4内核的GATE蒙特卡罗(Monte Carlo, MC)模拟平台,模拟计算了不同磁场环境下,不同能量碳离子束剂量平均LET和纳剂量学量的分布。结果发现,平行磁场对碳离子束的剂量平均LET和纳剂量学量均无显著影响,垂直磁场对碳离子束的剂量平均LET及纳剂量学量的影响主要集中在布拉格峰区域,其影响主要是碳离子束在磁场中受到洛伦兹力作用而发生横向偏转,进而使得碳离子束布拉格峰位置发生横向侧移导致的。这些结果为进一步研究磁场对碳离子束治疗性能的影响打下了坚实的基础。     

大分割碳离子放射治疗中相对生物学效应与剂量依赖关系的研究

应用碳离子束进行大分割放射治疗从而缩短治疗周期是碳离子束治疗的优势之一。为研究大分割放疗增加单次照射剂量后,碳离子束相对生物学效应（RBE）的变化,应用细胞存活线性平方（LQ）模型推导出RBE与剂量的依赖关系。基于此关系研究了具有不同辐射敏感性的肿瘤细胞和正常组织细胞RBE随剂量的变化。结果表明,在0~20 Gy范围内,不论肿瘤细胞与正常组织细胞具有怎样的辐射敏感性,肿瘤细胞的RBE值始终大于正常组织细胞。此外,基于理论推导和对相关实验数据的分析,证实了RBE随剂量增加而递增现象的存在。这些结果对应用碳离子束进行大分割放射治疗具有重要的指导作用。Short treatment course due to the suitability of hypofractionated regimen for carbon ion beam is one of the advantages of carbon ion radiotherapy. To study the dependence of relative biological effectiveness (RBE) on dose, the relationship between RBE and dose was deduced through the linear-quadratic (LQ) model. Based on the relationship, the change of RBE of tumor cells and normal tissue cells with different radiosensitivities with dose was studied. The results showed that the RBE value of tumor cells was always greater than that of normal tissue cells in the dose range of 0~20 Gy, regardless of the radiosensitivity of tumor and normal tissue cells. In addition, based on theoretical deduction and analysis of the relevant experimental data, the existence of RBE increase with increasing dose was verified. These results are of great significance for conducting hypofractionated radiotherapy with carbon ion beam.     

120～430MeV/u碳离子的微剂量学特性研究（英文）

单粒子微剂量谱在放射治疗中是一个极其重要的参数,它可以用来评估辐射场的生物学效应。利用蒙特卡洛程序FLUKA模拟计算了由碳离子产生的混合辐射场能量沉积的微观模式。从已公开发表的文献中选取了实验测量300 MeV/u碳离子的线能能谱,并与相同物理条件下模拟计算得到的线能能谱相比较,结果吻合得很好。此外,还计算了120~430 MeV/u的碳离子的剂量平均线能能谱、频率平均线能和剂量平均线能。所得到的频率平均线能值为185~28.3 keV/μm而剂量平均线能值则为272~64.1 keV/μm。本文的结果对于制定碳离子放射治疗的治疗计划有着重要的意义。     

重离子加速器示范装置被动式束流配送系统次级中子特征的蒙特卡罗研究

在碳离子放射治疗中,碳离子束在剂量配送过程中会与束流输运线相互作用,形成以中子辐射为主的外辐射场.由于中子是高LET射线,具有较高的相对生物学效应,减少碳离子放疗中产生的次级中子有助于降低放疗后正常组织并发症几率及二次肿瘤风险.利用蒙特卡罗方法对保守情况(能量为400 MeV/u,多叶光栅完全闭合)下碳离子治疗被动式束...     

基于LNDM模型的碳离子束混合辐射场相同剂量平均LET下关键纳剂量学指标及RBE分析

纳剂量学量正在成为新的表征辐射品质的量,也是用于精确计算相对生物学效应(RBE)的基础数据。具有相同剂量平均传能线密度(LET)离子束混合辐射场导致的生物学效应也未必相同。为研究关键纳剂量学指标[电离簇尺寸N_ICS$\geqslant 1 $的条件概率密度分布的一阶矩($M_1^{{C_1}}$)、N_ICS$\geqslant 2$的条件概率密度分布的一阶矩($M_1^{{C_2}}$)、N_ICS$\geqslant 2 $的累计概率($F_2^{{C_1}}$)和N_ICS$\geqslant 3 $的累计概率($F_3^{{C_2}}$)]以及RBE在相同剂量平均LET混合辐射场中的分布,在蒙特卡罗(Monte Carlo,MC)模拟的基础上,结合单能离子束关键纳剂量学指标数据集,计算得到了不同能量碳离子束在不同贯穿深度处相同剂量平均LET混合辐射场中的$M_1^{{C_1}}$、$M_1^{{C_2}}$、$F_2^{{C_1}}$、$F_3^{{C_2}}$及RBE值。计算结果显示:在相同剂量平均LET混合辐射场中,不同能量碳离子束的$F_3^{{C_2}}$没有发生显著变化,而$M_1^{{C_1}}$、$M_1^{{C_2}}$和$F_2^{{C_1}}$变化显著,且随能量的增大而减小,并且随剂量平均LET的增加,$M_1^{{C_1}}$、$M_1^{{C_2}}$和$F_2^{{C_1}}$变化差异逐渐变大。正是由于$M_1^{{C_1}}$、$M_1^{{C_2}}$、$F_2^{{C_1}}$和$F_3^{{C_2}}$的不同,在相同剂量平均LET混合辐射场中基于纳剂量学模型计算得到的RBE值也显著不同。这些结果表明,剂量平均LET并不能很好地用于描述离子束混合辐射场的品质,而关键纳剂量学指标则有望成为表征离子束混合辐射场品质的量。     

碳离子治疗中分野照射技术的Monte Carlo模拟

为阐述分野照射治疗方式应用于中国科学院近代物理研究所(IMP) 肿瘤重离子临床治疗试验研究的理论基础,利用Monte Carlo (MC) 软件包Gate/Geant4 模拟计算了碳离子束分野照射分衔接处的横向剂量分布,得到了患者摆位误差±1.0 mm范围内的横向剂量分布和分野衔接处中心剂量随分野间距的变化关系,计算了分野间距5.0 mm的横向剂量分布。将分野间距5.0 mm的分野照射与整野照射的MC结果进行比较,发现:在靶区范围内两者模拟的剂量偏差在6.8% 以内,符合程度较好,并提出了在患者定位精确度较高的情况下(即患者治疗体位摆位误差在±1.0 mm范围) 解决分野衔接处剂量热点问题的可行方法,从而较大幅度地提高了分野照射时靶区范围内的剂量均匀性。To characterize the theoretical basis of eld patching technique in carbon ion beam therapy, Monte Carlo software package Gate/Geant4 was used to simulate the lateral dose distribution of matched elds. The lateral dose distribution of the matched elds within 1.0 millimeter of patient positioning error and the relationship between the central dose of the matched elds and the eld patching gap were obtained. Moreover, the lateral dose pro le of eld patching irradiation with 5.0 mm gap was simulated. While comparing the lateral dose distribution of eld patching irradiation with 5.0 mm gap with the undivided eld irradiation, a good agreement between both results with a maximum dose deviation of 6.8% was observed within the target volume.Hence a feasible method for solving the issue of dose hotspots during eld patching under the condition of higher patient positioning accuracies (patient positioning error within 1.0 millimeter) was proposed and the dose homogeneit within the target volume could be greatly improved when eld patching technique is adopted in carbon ion beam therapy.     

The comparison of the proton dose distribution calculated with the treatment planning system and measured with alanine detectors in the eye phantom irradiated under therapeutic conditions

The paper describes the applicability of commercially available alanine detectors produced by Synergy Health for verification of the dose distribution calculated by the treatment planning system (TPS) used in proton eye radiotherapy – Eclipse Ocular Proton Planning (EOPP) program, version 8.9.06, Varian Medical Systems. The TPS-planned dose distribution at selected points in the eye phantom is compared to the dose registered by alanine detectors at these points during a simulated therapeutic irradiation at the proton eye radiotherapy facility in the Henryk Niewodniczanski Institute of Nuclear Physics (IFJ PAN), Krakow, Poland. The phantom was irradiated to obtain, a typical for choroidal melanoma, fraction dose of 15 CGE (13,64 Gy) at the tumor location. The dose registered with alanine pellets located inside the simulated tumor volume demonstrates a good agreement with the TPS-planned dose. The typical for proton radiotherapy, steep dose fall-off outside the treated area is registered by the alanine pellets however, it is difficult to assess it quantitatively, because the dose related EPR signal is registered from the entire pellet volume.     

IMP重离子治癌中的剂量计算方法

针对深部肿瘤重离子治疗临床试验的需求,首先在水介质中进行生物有效剂量的优化计算,然后根据CT图像中像素CT值与水等效长度转换系数之间的关系, 结合水中的深度剂量分布曲线对每个像素进行积分得到CT图像上的生物有效剂量分布。同时介绍了基于被动式束流配送系统适形照射时的剂量确定方式, 并提出二维适形放疗也应使用分层照射方式以适应治疗时的不同要求。 这些方法适合目前及今后在IMP进行的重离子治癌临床试验研究中治疗计划系统的需要。Basic algorithms of biological effective dose optimization and dose distribution on CT image for the heavy ion therapy project at the Institute of Modern Physics (IMP), Chinese Academy of Sciences (CAS) are reported in this paper. Firstly, biological effective dose optimization is conducted in water. According to the relationship between CT number and water equivalent path length, an integral algorithm is used to calculate the average dose within a pixel and then the dose distribution in tissue is derived. Secondly, the dose determination of layer stacking conformal irradiation is described and the layer stacking method is proposed to be applied in two dimensional conformal irradiation. These methods are sufficient to the requirements of the ongoing and future heavy ion clinical trials conducted at IMP.     

初步的IMP重离子治疗计划系统

中国科学院近代物理研究所基于兰州重离子研究装置(HIRFL/HIRFL-CSR),在被动型束流配送系统下采用二维分层适形照射治疗技术开展重离子治癌临床试验研究。为了更好地利用重离子束在肿瘤放射治疗中的生物物理优势并保障重离子临床治疗试验的顺利实施,一个初级版本的重离子治疗计划系统已经设计完成。此计划系统是针对被动型束流配送系统下的二维分层适形照射治疗方式来进行设计的。介绍了此系统的设计框架、可提供的功能以及利用宽束算法进行剂量计算在此系统中的实现。通过人体仿真体模实验证实由该治疗计划系统给出的靶区计划剂量与实测剂量的偏差在5%之内。最后讨论了设计较为完备的重离子治疗计划系统仍需解决的问题。     

Microdosimetric characterisation of a therapeutic proton beam used for conjunctival melanoma treatments

In this study we have investigated the radiation quality of proton beams used to treat conjunctival melanomas at the Biomedical Cyclotron in Nice. To quantify radiation quality we have used a mini tissue-equivalent proportional counter (TEPC). Microdosimetric spectra have been measured at different depths and lateral positions in a Plexiglas eye phantom. A weighting function, which was derived from evaluations of the early effects on the mouse intestine, was applied to the spectra to obtain the microdosimetric assessment of relative biological effectiveness (RBEμ).Data show that RBEμ varies significantly in the eye phantom, from 1.1 to 1.7. However, within the conjunctiva the RBE-weighted dose varies in a similar fashion to the absorbed, although it is up to 20% higher than the corresponding absorbed dose.     

Fast-neutron dose evaluation in BNCT with Fricke gel layer detectors

Boron neutron capture therapy (BNCT) is a cancer radiotherapy that uses epithermal and thermal neutron beams. The determination of the absorbed dose in healthy tissue, separating the various dose contributions having different radiobiological effectiveness (RBE) is of great importance for therapy planning. However, a standard code of practice has not yet been established because suitable methods for dosimetry in BNCT are still in progress.A study about the characterization of the epithermal column of the LVR-15 research reactor in ?e? (CZ) has been performed, in particular concerning the fast-neutron dose. This dose is not negligible and its determination is important owing to its high RBE. Fast-neutron and photon dose distributions in a water phantom have been measured by means of Fricke gel layer dosimeters. Even if gel layer dosimetry is not yet standardized, it is presently the only method for obtaining images of each dose contribution in BNCT neutron fields.The results were compared with values measured with thermoluminescence detectors, twin ionization chambers data taken from literature and Monte Carlo simulations.     

Measurement-based Monte Carlo simulation of high definition dose evaluation for nasopharyngeal cancer patients treated by using intensity modulated radiation therapy

Measurement-based Monte Carlo (MBMC) simulation using a high definition (HD) phantom was used to evaluate the dose distribution in nasopharyngeal cancer (NPC) patients treated with intensity modulated radiation therapy (IMRT). Around nasopharyngeal cavity, there exists many small volume organs-at-risk (OARs) such as the optic nerves, auditory nerves, cochlea, and semicircular canal which necessitate the use of a high definition phantom for accurate and correct dose evaluation. The aim of this research was to study the advantages of using an HD phantom for MBMC simulation in NPC patients treated with IMRT. The MBMC simulation in this study was based on the IMRT treatment plan of three NPC patients generated by the anisotropic analytical algorithm (AAA) of the Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA, USA) using a calculation grid of 2 mm². The NPC tumor was treated to a cumulative dose of 7000 cGy in 35 fractions using the shrinking-field sequential IMRT (SIMRT) method. The BEAMnrc MC Code was used to simulate a Varian EX21 linear accelerator treatment head. The HD phantom contained 0.5 × 0.5 × 1 mm³ voxels for the nasopharyngeal area and 0.5 × 0.5 × 3 mm³ for the rest of the head area. An efficiency map was obtained for the amorphous silicon aS1000 electronic portal imaging device (EPID) to adjust the weighting of each particle in the phase-space file for each IMRT beam. Our analysis revealed that small volume organs such as the eighth cranial nerve, semicircular canal, cochlea and external auditory canal showed an absolute dose difference of ≥200 cGy, while the dose difference for larger organs such as the parotid glands and tumor was negligible for the MBMC simulation using the HD phantom. The HD phantom was found to be suitable for Monte Carlo dose volume analysis of small volume organs.     

Studies on the application of a low-voltage peak to the postsurgical follow-up CT scan in abdominal cancer patients in order to reduce the exposure of patients to radiation

This study examined the radiation dose, computed tomography (CT) number, contrast and image quality of patients requiring periodic follow-up abdominal CT examinations at various tube voltages. The subjects were divided into two groups. One group consisted of patients who underwent a clinical analysis and the other group was a phantom one. Somatom Sensation 16 (Siemens, Erlangen, Germany) was used. Twenty patients who underwent a periodic follow-up examination by CT were selected randomly. The tube current was fixed to 150 mA, and the tube voltage was adjusted according to the appropriate value of each examination. The computed tomography dose index (CTDI) values were measured. The CT number of each organ was measured by setting up a 1 cm diameter return on investment (ROI) in the abdominal organs at the same height of the first lumbar vertebra using images of the arterial phase. Two radiologists in consensus graded the quality of the abdominal images into three groups. An abdomen-shaped acrylic phantom was used in the phantom study. An ion chamber was inserted into the holes located at the center and periphery of the phantom, where the radiation dose was automatically displayed on the reader. Tube voltages of 80, 100, 120 and 140 kVp were applied to the phantom (diluted contrast medium with water at 1:10 ratio) and the phantom was scanned. The CT number was measured from a 1 cm diameter ROI at the center of the image. The CTDI value decreased by 36% at 100 kVp (7.50 mGy) compared with that at 120 kVp (11.70 mGy). According to the radiologists’ evaluation, there were 17 equivalent, 3 acceptable and 0 unacceptable levels in the group of 20 subjects. The radiation dose in the phantom study decreased with increasing tube voltages from 80 to 140 kVp. The peripheral and central doses decreased by 38% and 41%, respectively. The CT numbers at 80, 100, 120 and 140 kVp were 1365.9±4.4, 1046.1±3.7, 862.8±3.2 and 737.5±3.0 HU, respectively. In conclusion, in a follow-up observation for the detection of a recurrence or metastasis after surgery or patients with chronic abdominal diseases, the exposure doses can be reduced using a low-voltage peak CT examination without greatly changing the image quality.