Solid state microdosimetry of a 148 MeV proton spread-out Bragg peak with a pixelated silicon telescope

A constant value of the Relative Biological Effectiveness (RBE), equal to 1.1, to weight the physical dose of proton therapy treatment planning collides with the experimental evidence of an increase of effectiveness along the depth dose profile, especially at the end of the particle range. In this context, it is desirable to develop new optimized treatment planning systems that account for a variable RBE when weighting the physical dose. In particular, due to the increasing interest on microdosimetry as a possible methodology for measuring physical quantities correlated with the biological effectiveness of the therapeutic beam, the development of new Tissue-Equivalent Proportional Counters (TEPCs) specifically designed for the clinical environment are in progress. In this framework, the silicon technology allows to produce solid state detectors of real micrometric dimensions. This is a valid alternative to the TEPC from a practical point of view, being simple, easy-of-use and more versatile. The feasibility of a solid state microdosimeter based on a monolithic double stage silicon telescope has been previously proposed and deeply investigated by comparing its response to the one obtained by reference TEPCs in various radiation fields. The device is constituted by a matrix of cylindrical elements, 2 μm in thickness and 9 μm in diameter, coupled to a single E stage, 500 μm in thickness. Each segmented ΔE stage acts as a solid state microdosimeter, while the E stage gives information on the energy of the impinging proton up to about 8 MeV. This work is dedicated to the description of the microdosimetric characterization of the 148 MeV energy-modulated proton beam at the radiobiological research line of the Trento Proton Therapy Centre by means of a pixelated silicon microdosimeter. All measurements were carried out at different positions across the spread-out Bragg peak (SOBP) and the corresponding microdosimetric distributions were derived by applying a novel extrapolation algorithm. Finally, microdosimetric assessment of Relative Biological Effectiveness was carried out by weighting the dose distribution of the lineal energy with the Loncol's biological weighting function. Benefits and possible limitations of this approach are discussed

Microdosimetry on nanometric scale with a new low-pressure avalanche-confinement TEPC

The tissue equivalent proportional counter (TEPC) is the most accurate device for measuring the microdosimetric properties of a particle beam, nevertheless no detailed information on the track structure of the impinging particles can be obtained, since the lower operation limit of common TEPCs is about 0.3 μm. On the other hand, the pattern of particle interactions is measured by track-nanodosimetry, which derives the single-event distribution of ionization cluster size at the nanometric scale. Anyway, only three nanodosimeters are available worldwide. A feasibility study for extending the performances of TEPC down to the nanometric region was performed and a novel avalanche-confinement TEPC was designed and constructed. This detector is constituted by a cylindrical chamber, based on a three-electrode structure, connected to a vacuum and gas flow system to ensure a continuous replacement of the tissue equivalent gas, thus allowing to simulate different biological site sizes in the range 300-25 nm. This TEPC can be calibrated by exploiting a built-in alpha source and a miniaturized solid-state detector as a trigger. Irradiations with photons, fast neutrons and two hadron beams demonstrated the good performances of the device. A satisfactory agreement with FLUKA simulations was obtained

Modeling the Subsurface Structure of Sunspots

While sunspots are easily observed at the solar surface, determining their subsurface structure is not trivial. There are two main hypotheses for the subsurface structure of sunspots: the monolithic model and the cluster model. Local helioseismology is the only means by which we can investigate subphotospheric structure. However, as current linear inversion techniques do not yet allow helioseismology to probe the internal structure with sufficient confidence to distinguish between the monolith and cluster models, the development of physically realistic sunspot models are a priority for helioseismologists. This is because they are not only important indicators of the variety of physical effects that may influence helioseismic inferences in active regions, but they also enable detailed assessments of the validity of helioseismic interpretations through numerical forward modeling. In this paper, we provide a critical review of the existing sunspot models and an overview of numerical methods employed to model wave propagation through model sunspots. We then carry out an helioseismic analysis of the sunspot in Active Region 9787 and address the serious inconsistencies uncovered by \citeauthor{gizonetal2009}~(\citeyear{gizonetal2009,gizonetal2009a}). We find that this sunspot is most probably associated with a shallow, positive wave-speed perturbation (unlike the traditional two-layer model) and that travel-time measurements are consistent with a horizontal outflow in the surrounding moat.Comment: 73 pages, 19 figures, accepted by Solar Physic

Timing and severity of inhibitor development in recombinant versus plasma-derived factor VIII concentrates: a SIPPET analysis

Essentials Recombinant factor VIII (rFVIII) was contrasted with plasma-derived FVIII (pdFVIII). In previously untreated patients with hemophilia A, rFVIII led to more inhibitors than pdFVIII. Inhibitors with rFVIII developed earlier, and the peak rate was higher than with pdFVIII. Inhibitors with rFVIII were more severe (higher titre) than with pdFVIII. Summary: Background The development of neutralizing antibodies (inhibitors) against factor VIII (FVIII) is the most severe complication in the early phases of treatment of severe hemophilia A. Recently, a randomized trial, the Survey of Inhibitors in Plasma-Product Exposed Toddlers (SIPPET) demonstrated a 2-fold higher risk of inhibitor development in children treated with recombinant FVIII (rFVIII) products than with plasma-derived FVIII (pdFVIII) during the first 50 exposure days (EDs). Objective/Methods In this post-hoc SIPPET analysis we evaluated the rate of inhibitor incidence over time by every 5 EDs (from 0 to 50 EDs) in patients treated with different classes of FVIII product, made possible by a frequent testing regime. Results The highest rate of inhibitor development occurred in the first 10 EDs, with a large contrast between rFVIII and pdFVIII during the first 5 EDs: hazard ratio 3.14 (95% confidence interval [CI], 1.01\ue2\u80\u939.74) for all inhibitors and 4.19 (95% CI, 1.18\ue2\u80\u9314.8) for high-titer inhibitors. For patients treated with pdFVIII, the peak of inhibitor development occurred later (6\ue2\u80\u9310 EDs) and lasted for a shorter time. Conclusion These results emphasize the high immunologic vulnerability of patients during the earliest exposure to FVIII concentrates, with the strongest response to recombinant FVIII products

An Avalanche confinement TEPC as connecting bridge from micro to nanodosimetry

It is recognized today that the observable radiobiological effects of ionizing radiations are strongly correlated to the clustering of damages in micrometer-and nanometer-sized subcellular structures, hence to the particle track structure. The characteristic properties of track structure are directly measurable nowadays with bulky experimental apparatuses, which cannot be easily operated in a clinical environment. It is therefore interesting to investigate the feasibility of new portable detectors able to characterize the real therapeutic beams. With this in mind, a novel avalanche-confinement Tissue Equivalent Proportional Counter (TEPC) was constructed for simulating nanometric sites down to 25 nm. Experimental cluster size distributions measured with this TEPC were compared with Monte Carlo simulations of the same experiment and with cluster size distributions measured with the Startrack nanodosimeter

Numerical modeling of the gas gain of low-pressure Tissue-Equivalent Proportional Counters

Proportional counters are radiation detectors widely used in many applications. The design of the counter, to best fit each application, needs an accurate knowledge and physical modeling of the electron avalanche process. A particular proportional counter is the tissue-equivalent proportional counter (TEPC), the reference detector for experimental microdosimetry, which consists of a spherical or cylindrical chamber filled with low-density tissue-equivalent gas to simulate the energy deposition in tissue sites of micrometric size. The lower operation limit of standard TEPCs operated in the pulse-height analysis mode is about 0.3μm. In order to overcome this technological limit, different avalanche-confinement nano-microdosimetric TEPCs capable of measuring microdosimetric spectra in the nanometric domain were designed and constructed. In this work, a novel numerical tool developed for the Monte Carlo simulation of the electron avalanche process inside a low-pressure TEPC is described. The Monte Carlo code allows to simulate complex 3D electric field configurations exploiting COMSOL finite elements analysis. Several models for the electron interactions (i.e. scattering and ionization) are included in the code. The code has been benchmarked with the experimental results of a wall-less avalanche-confinement TEPC in terms of absolute gas gain for different operating conditions (i.e. gas pressures and electrode voltages). The results show that the code is capable of reproducing the absolute value of the gas gain for the avalanche-confinement TEPC simulating some tenths of nanometers in site size. Moreover, the code can reproduce both the extension and the shape of the proportional counter working windows. The code was also applied for simulating the probability of absorption of electrons by the central third electrode: the helix. The results show a non-negligible probability of absorption in the common range of operation. This code will be further applied for optimizing the TEPC design, capable of simulating site sizes closer to the nanometer region