On the parametrization of lateral dose profiles in proton radiation therapy.

Abstract Purpose The accurate evaluation of the lateral dose profile is an important issue in the field of proton radiation therapy. The beam spread, due to Multiple Coulomb Scattering (MCS), is described by the Moliere's theory. To take into account also the contribution of nuclear interactions, modern Treatment Planning Systems (TPSs) generally approximate the dose profiles by a sum of Gaussian functions. In this paper we have compared different parametrizations for the lateral dose profile of protons in water for therapeutical energies: the goal is to improve the performances of the actual treatment planning. Methods We have simulated typical dose profiles at the CNAO (Centro Nazionale di Adroterapia Oncologica) beamline with the FLUKA code and validated them with data taken at CNAO considering different energies and depths. We then performed best fits of the lateral dose profiles for different functions using ROOT and MINUIT. Results The accuracy of the best fits was analyzed by evaluating the reduced χ2, the number of free parameters of the functions and the calculation time. The best results were obtained with the triple Gaussian and double Gaussian Lorentz–Cauchy functions which have 6 parameters, but good results were also obtained with the so called Gauss–Rutherford function which has only 4 parameters. Conclusions The comparison of the studied functions with accurate and validated Monte Carlo calculations and with experimental data from CNAO lead us to propose an original parametrization, the Gauss–Rutherford function, to describe the lateral dose profiles of proton beams

In-room test results at CNAO of an innovative PT treatments online monitor (Dose Profiler)

The use of C, He and O ions as projectiles in Particle Therapy (PT) treatments is getting more and more widespread as a consequence of their enhanced relative biological effectiveness and oxygen enhancement ratio, when compared to the protons one. The advantages related to the incoming radiation improved efficacy are requiring an accurate online monitor of the dose release spatial distribution. Such monitor is necessary to prevent unwanted damage to the tissues surrounding the tumour that can arise, for example, due to morphological changes occurred in the patient during the treatment with respect to the initial CT scan. PT treatments with ions can be monitored by detecting the secondary radiation produced by the primary beam interactions with the patient body along the path towards the target volume. Charged fragments produced in the nuclear process of projectile fragmentation can be emitted at large angles with respect to the incoming beam direction and can be detected with high efficiency in a nearly background-free environment. The Dose Profiler (DP) detector, developed within the INSIDE project, is a scintillating fibre tracker that allows an online reconstruction and backtracking of such secondary charged fragments. The construction and preliminary in-room tests performed on the DP, carried out using the 12C ions beam of the CNAO treatment centre using an anthropomorphic phantom as a target, will be reviewed in this contribution. The impact of the secondary fragments interactions with the patient body will be discussed in view of a clinical application. Furthermore, the results implications for a pre-clinical trial on CNAO patients, foreseen in 2019, will be discussed

Scintillating fiber devices for particle therapy applications

Particle Therapy (PT) is a radiation therapy technique in which solid tumors are treated with charged ions and exploits the achievable highly localized dose delivery, allowing to spare healthy tissues and organs at risk. The development of a range monitoring technique to be used on-line, during the treatment, capable to reach millimetric precision is considered one of the important steps towards an optimization of the PT efficacy and of the treatment quality. To this aim, charged secondary particles produced in the nuclear interactions between the beam particles and the patient tissues can be exploited. Besides charged secondaries, also neutrons are produced in nuclear interactions. The secondary neutron component might cause an undesired and not negligible dose deposition far away from the tumor region, enhancing the risk of secondary malignant neoplasms that can develop even years after the treatment. An accurate neutron characterization (flux, energy and emission profile) is hence needed for a better evaluation of long-term complications. In this contribution two tracker detectors, both based on scintillating fibers, are presented. The first one, named Dose Profiler (DP), is planned to be used as a beam range monitor in PT treatments with heavy ion beams, exploiting the charged secondary fragments production. The DP is currently under development within the INSIDE (Innovative Solutions for In-beam DosimEtry in hadrontherapy) project. The second one is dedicated to the measurement of the fast and ultrafast neutron component produced in PT treatments, in the framework of the MONDO (MOnitor for Neutron Dose in hadrOntherapy) project. Results of the first calibration tests performed at the Trento Protontherapy center and at CNAO (Italy) are reported, as well as simulation studies

In-room test results at CNAO of an innovative PT treatments online monitor (Dose Profiler)

The use of C, He and O ions as projectiles in Particle Therapy (PT) treatments is getting more and more widespread as a consequence of their enhanced relative biological effectiveness and oxygen enhancement ratio, when compared to the protons one. The advantages related to the incoming radiation improved efficacy are requiring an accurate online monitor of the dose release spatial distribution. Such monitor is necessary to prevent unwanted damage to the tissues surrounding the tumour that can arise, for example, due to morphological changes occurred in the patient during the treatment with respect to the initial CT scan. PT treatments with ions can be monitored by detecting the secondary radiation produced by the primary beam interactions with the patient body along the path towards the target volume. Charged fragments produced in the nuclear process of projectile fragmentation can be emitted at large angles with respect to the incoming beam direction and can be detected with high efficiency in a nearly background-free environment. The Dose Profiler (DP) detector, developed within the INSIDE project, is a scintillating fibre tracker that allows an online reconstruction and backtracking of such secondary charged fragments. The construction and preliminary in-room tests performed on the DP, carried out using the 12C ions beam of the CNAO treatment centre using an anthropomorphic phantom as a target, will be reviewed in this contribution. The impact of the secondary fragments interactions with the patient body will be discussed in view of a clinical application. Furthermore, the results implications for a pre-clinical trial on CNAO patients, foreseen in 2019, will be discussed

Burnout in the ICU : potential consequences for staff and patient well-being

Peer reviewedAuthor versio

NEMO-SN1 (Western Ionian Sea, off Eastern Sicily): A Cabled Abyssal Observatory with Tsunami Early Warning Capability

The NEMO-SN1 (NEutrino Mediterranean Observatory - Submarine Network 1) seafloor observatory is located in the central Mediterranean, Western Ionian Sea, off Eastern Sicily Island (Southern Italy) at 2100 m water depth, 25 km from the harbour of the city of Catania. It is a prototype of cabled deep-sea multiparameter observatory, and the first operating with real-time data transmission in Europe since 2005. NEMO-SN1 is also the first-established node of EMSO (European Multidisciplinary Seafloor Observatory, http://emso-eu.org), one of the European large-scale research infrastructures. EMSO will address long-term monitoring of environmental processes related to marine ecosystems, climate change and geo-hazards. NEMO-SN1 will perform geophysical and environmental long-term monitoring by acquiring seismological, geomagnetic, gravimetric, accelerometric, physico-oceanographic, hydro-acoustic, bio-acoustic measurements to study earthquake and tsunami generation, and to characterize ambient noise which includes marine mammal sounds, and environmental and anthropogenic sources. NEMO-SN1 is also equipped with a prototype tsunami detector, based on the simultaneous measurement of the seismic and bottom pressure signals and a new high performance tsunami detection algorithm. NEMO-SN1 will be a permanent tsunami early warning node in Western Ionian Sea, an area where very destructive earthquakes have occurred in the past, some of them tsunamigenic (e.g., 1693, M=7.5; 1908, M=7.4). Another important feature of NEMO-SN1 is the installation of a low frequency-high sensibility hydrophone and two (scalar and vector, respectively) magnetometers. The objective is to improve the tsunami detection capability of SN1 through the recognition of tsunami-induced hydro-acoustic and electro-magnetic precursors.SubmittedRhodes, Greece3A. Ambiente Marinorestricte

Target fragmentation in protontherapy

In protontherapy, secondary particles are produced through primary beam interactions with the patients body. The fragments are created in the inelastic interaction of the beam with the target nuclei and have low kinetic energies and/or high atomic numbers as compared to primary protons. Secondary particles produce an altered dose distribution, due to a different range of fragments and have high LET, that lead to an increase of RBE for the same delivered dose. The inclusion of target fragmentation processes is important for the accurate calculation of the treatment plan. In this study, Monte Carlo simulations were employed to estimate the effect of target fragmentation in proton therapy. In particular, the range distribution of secondary particles has been evaluated using the FLUKA code. For the evaluation of the impact of target fragmentation, the fluence of secondary particles has been calculated with simulation at different depths