Experimental measurement of the correlation between CT number and heavy ion range

For precision delivery of the Bragg peak of a heavy-ion beam to a target volume in ion beam therapy, it is necessary to know the tissue stopping power. A general approach to solve this problem in ion beam therapy is to convert X-ray CT (computed tomography) numbers into water-equivalent path length (WEPL) coefficients using a CT-WEPL calibration curve for all voxels traversed by the beam. This work aims at establishing a CT-WEPL coefficient calibration curve for the heavy ion therapy project at IMP, so as to compute the range of carbon ion beams in tissues easily according to the patient CT data. Several tissue-equivalent materials were applied to measure their WEPL coefficients using a high-energy carbon ion beam in this work. A CT-WEPL calibration curve was obtained through fitting the measured data, which can be used directly for dose optimization and facilitates the design of patient treatment plans significantly at IMP.     

辐照诱导人正常肝细胞系HL-7702 细胞远后的微卫星不稳定性

采用高传能线密度(LET) 的12C6+离子束和低LET 的X 射线辐照人正常肝细胞系HL-7702 细胞,利用微卫星不稳定性(MSI) 检测来分析直接受照射细胞和通过转移培养基方式旁细胞传代八代子细胞以MSI 表征的远后效应。实验结果表明,12C6+离子束诱导的远后效应较X射线的低;旁细胞的远后效应较直接受照射细胞的高;辐射引起的MSI 与杂合性丢失(LOH) 的发生率具有位点特异性。结果提示,重离子放射治疗较X 射线放射治疗对正常组织引发的辐射风险要小,可通过对MSI 高发位点的筛选来评估放疗后患者长期生存状况和二次癌症发生风险。Human normal liver cell line HL-7702 cells were irradiated with high linear energy transfer (LET) 12C6+ ions and low-LET X-rays, respectively. Delayed effect in terms of microsatellite instability (MSI) in progenies of the directly irradiated cells and bystander cells, obtained in the way of medium transfer at the 8th passage postirradiation,were examined. The delayed effect induced by the high-LET 12C6+ ions was different from that induced by the low-LET X-rays, and a higher incidence of MSI was observed in the progenies of the cells after exposure to the X-rays than to the 12C6+ ions. We also found that the delayed effect in the progenies of the bystander cells was much more severe than thoseof directly irradiated cells. Furthermore, the events of MSI and loss of heterozygosity (LOH) induced by the ionizing radiations were not randomly distributed throughout the genome and specific loci existed indeed. These results imply that the radiation risk to normal tissues is lower in heavy ion therapy than in conventional X-ray radiotherapy, and the analysis of microsatellite loci with MSI high frequency occurrence can be applied to access long-term survival condition and second cancer risk for the patients after radiotherapy.     

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.     

重离子放射治疗双微小展宽峰组合照射方法

在基于被动式束流配送系统的分层适形重离子治疗当中,需要利用微型脊形过滤器（mini ridge filter,mini-RF）将单能重离子束Bragg峰展宽为峰区近似高斯分布的微小展宽峰（mini spread-out Bragg peak,mini-SOBP）,从而达到减少照射分层数及照射时间的目的。采用较宽的mini-SOBP可以有效减少照射分层数,但会增大展宽Bragg峰（SOBP）远端剂量跌落距离,增加对靶区后方正常组织或危及器官的辐照剂量。这一问题可以通过双mini-SOBP的组合照射方法来解决。使用2种mini-RF对单能重离子束Bragg峰略微展宽得到2种半高宽（FWHM）且剂量分布近似高斯分布的mini-SOBP,通过基于放射生物学模型的剂量优化,证实了在SOBP平顶区按生物有效剂量均匀和物理吸收剂量均匀的展宽情况下,双mini-SOBP组合照射方法均可以在减少照射分层数的同时较大幅度地减小SOBP远端剂量跌落距离。In layer-stacking conformal heavy-ion therapy based on passive beam delivery system,it is necessary to minimize the layer numbers and reduce irradiation time for layer-stacking conformal heavy-ion therapy.Gaussian shaped mini spread-out Bragg peaks (mini-SOBP) were generated by mini ridge filters (mini-RF) for monoenergetic heavy ion beams.It is effective to minimize the layer number by using mini-SOBPs with the bigger full width at the half maximum (FWHM),but in this way the distal dose fall-off distance of a spread-out Bragg peak (SOBP) will be enlarged,increasing the radiation damage to normal tissue or organ at risk behind the target volume.This issue could be solved by using mini-SOBPs based combinatorial irradiation method.In this study,Gaussian shaped mini-SOBPs with two different FWHMs were generated by two different mini-RFs for monoenergetic heavy ion beams.Based on radiobiological model calculations and dose optimizations,the mini-SOBPs based combinatorial irradiation method was confirmed to reduce the distal dose fall-off distances of SOBPs while minimizing the layer numbers for layer-stacking conformal heavy-ion therapy.     

离子束治疗中的靶区运动补偿方法

相对于被动式束流配送系统,由患者呼吸因素而引起的肿瘤靶区运动会对主动式束流配送系统下的离子束放射治疗带来非常严重的影响,造成离子束辐射场剂量分布的严重畸变,甚至对肿瘤靶区周围的健康组织造成严重损伤,很大程度上影响离子束治疗的疗效。因此,在主动式束流配送系统下,建立针对由呼吸因素引起的运动肿瘤靶区的适形调强照射方法就显得必要,且具有重要意义。系统介绍了呼吸运动探测、4D-CT 以及目前主要的3 种运动补偿方法(多次扫描、呼吸门控和主动跟踪技术),并对这3 种方法在靶区适形度、稳健性以及技术复杂度等方面进行了比较。在靶区适形度方面主动跟踪技术优于门控技术,而门控技术又优于多次扫描技术;在稳健性方面多次扫描技术优于门控技术,而门控技术优于主动跟踪技术;在技术复杂度方面,多次扫描技术最简单,其次是门控技术,而主动跟踪技术最复杂。Active beam scanning results in serious distortion of ion-beam irradiation field in the presence of target motion and causes damage to healthy tissues round tumor target compared to passive beam shaping techniques. Therefore,it is necessary to establish suitable conformal irradiation methods for moving targets caused by the factor such as respiration in active ion beam scanning system. In this paper, motion detection, 4D-CT and three main ion beam specific mitigation techniques, namely rescanning, gating and beam tracking, are introduced. In addition, three motion mitigation techniques are compared comprehensively in terms of target conformation, robustness and mplementation complexity,respectively. For target conformation, the beam tracking is superior to gating, and gating is better than beam rescanning;the robustness decreases in the order rescanning-gating-beam tracking; for implementation complexity, beam rescanning is the most simple technology, followed by gating, while beam tracking is the most complex technique.     

HIRFL装置主动式点扫描束流配送系统的Monte Carlo模拟优化

为获得适用于HIRFL 装置主动式点扫描束流配送系统配送的碳离子束,利用Monte Carlo (MC) 工具SHIELD-HIT12A 研究了配送距离和微型脊形过滤器结构周期对治疗室等中心处束斑半高宽(FWHM) 和剂量平坦度的影响。模拟研究发现:束流配送距离越短,束斑FWHM越小,但剂量平坦度越差;微型脊形滤器结构周期是影响剂量平坦度的关键因素,周期越小,剂量平坦度越好。通过模拟研究得出:在HIRFL装置重离子治疗终端将真空窗设置在距等中心距离小于125 cm 时,采用结构周期为2 mm微型脊形过滤器可以满足主动式点扫描照射对束斑FWHM和剂量平坦度的要求。To obtain carbon ion beams suitable for the active spot scanning beam delivery system at the Heavy Ion Research Facility in Lanzhou (HIRFL), the Monte Carlo program SHIELD-HIT12A was used to study the influences of beam delivery distance and structure period of mini ridge filter on full width at the half maximum (FWHM) of beam spot and dose flatness at the isocenter of the treatment room. The present simulation study shows that the shorter was the beam delivery distance, the smaller was the FWHM of beam spot, but the worse was the dose flatness. The structure period of mini ridge filter was a key factor to account for the dose flatness at the isocenter. The smaller was the structure period of mini ridge filter, the better was the dose flatness. Based on the simulation results, we conclude that 2 mm structure period for a mini ridge filter statisfies the requirements on the FWHM of beam spot and dose flatness at the isocenter for the active spot scanning beam delivery system at HIRFL when the distance between the vacuum window and the isocenter is set shorter than 125 cm in the nozzle.