Applications of Monte Carlo methods to special radiotherapeutic techniques

Monte Carlo (MC) methods are considered one of the most powerful and precise approaches to study and solve medical physics issues. They, indeed, can be applied in all the situations where to use deterministic algorithms is infeasible or impossible. Surprising improvements in computer technology have promoted a wide diffusion of this technique, giving rise to the born of several Monte Carlo codes, such as the GEANT4 toolkit. In this paper we show some of the applications we developed using GEANT4. In particular, the simulation of two different radiotherapy techniques, such as proton/ion therapy and stereotactic radiosurgery will be discussed. In the first case we show the main features of our last public version of the GEANT4 Hadrontherapy program, also discussing the issues related to the nuclear fragmentation. In the second case, we show the procedures followed for the simulation of a Gamma Knife device, in order to validate the Treatment Planning System (TPS) used for the dose computation

Alteration of p53 and Bax/ Bcl-2 ratio by fotemustine and proton irradiation

Deregulation of apoptosis commonly occurs in melanoma cells and could be a reason for resistance. The effectiveness of different treatments depends on their ability to activate this process. In this study the effects of combined treatments with fotemustine (FM) and proton irradiation on the regulators of apoptosis were analyzed. Sub-confluent HTB140 human melanoma cells were treated with FM (100, 250 µM) 24 h prior to irradiation (12, 16 Gy). Cells were irradiated in the middle of the therapeutic 62 MeV proton spread out Bragg peak. Flow cytometric analysis of apoptosis and the Western blot analysis of apoptotic regulators were performed 6 or 48 h after treatments. Percent of apoptotic nuclei increased after applied treatments, reaching the level of 4 to 41 %. Induction of apoptosis was associated with p53 and Bax up regulation and Bcl-2 down regulation. The obtained results imply that analyzed treatments induce apoptosis through the activation of the mitochondrial apoptotic pathway, with better pro-apoptotic effects achieved by combined treatments

Dosimetric characterization of a synthetic single crystal diamond detector in a clinical 62 MeV ocular therapy proton beam

A synthetic single crystal diamond based Schottky photodiode was tested at INFN-LNS on the proton beam line (62 MeV) dedicated to the radiation treatment of ocular disease. The diamond detector response was studied in terms of pre-irradiation dose, linearity with dose and dose rate, and angular dependence. Depth dose curves were measured for the 62 MeV pristine proton beam and for three unmodulated range-shifted proton beams; furthermore, the spread-out Bragg peak was measured for a modulated therapeutic proton beam. Beam parameters, recommended by the ICRU report 78, were evaluated to analyze depth-dose curves from diamond detector. Measured dose distributions were compared with the corresponding dose distributions acquired with reference plane-parallel ionization chambers. Field size dependence of the output factor (dose per monitor unit) in a therapeutic modulated proton beam was measured with the diamond detector over the range of ocular proton therapy collimator diameters (5-30 mm). Output factors measured with the diamond detector were compared to the ones by a Markus ionization chamber, a Scanditronix Hi-p Si stereotactic diode and a radiochromic EBT2 film. Signal stability within 0.5% was demonstrated for the diamond detector with no need of any pre-irradiation dose. Dose and dose rate dependence of the diamond response was measured: deviations from linearity resulted to be within ±0.5% over the investigated ranges of 0.5-40.0 Gy and 0.3-30.0 Gy/min respectively. Output factors from diamond detector measured with the smallest collimator (5 mm in diameter) showed a maximum deviation of about 3% with respect to the high resolution radiochromic EBT2 film. Depth-dose curves measured by diamond for unmodulated and modulated beams were in good agreement with those from the reference plane-parallel Markus chamber, with relative differences lower than ±1% in peak-to-plateau ratios, well within experimental uncertainties. A 2.5% variation in diamond detector response was observed in angular dependence measurements carried-out by varying the proton beam incidence angle in the polar direction. The dosimetric characterization of the tested synthetic single crystal diamond detector clearly indicates its suitability for relative dosimetry in ocular therapy proton beams, with no need of any correction factors accounting for dose rate and linear energy transfer dependence

Breakdown mechanisms in electrostatic deflector

The Electrostatic Beam Deflectors for the K800 Superconducting Cyclotron are the most critical elements of the beam extraction system. It has been carried out an accurate investigation from the microscopic point of view, leading to a better comprehension of the complex phenomena taking part in the breakdown process. The environmental conditions are high electric field (up to 130 kV/cm), high magnetic field (up to 5 T) in addition with high energy (70 MeV/u) and high power ion beam. It has been found that all the materials constituent the electrostatic deflector, and not only the electrodes, give an important contribute to the mechanism of breakdown that occurs in two main ways: insulator metalization and enhanced electrodes electron emission. These two effects are involved in a positive feedback process which amplifies the effects leading to a fast breakdown. These phenomena are here shown and some possible solutions are at the moment under test using several bulk (Mo, Ti, Cu) and coating materials (TiN, Diamond Like Carbon)

Charged particle's flux measurement from PMMA irradiated by 80 MeV/u carbon ion beam

Hadrontherapy is an emerging technique in cancer therapy that uses beams of charged particles. To meet the improved capability of hadrontherapy in matching the dose release with the cancer position, new dose monitoring techniques need to be developed and introduced into clinical use. The measurement of the fluxes of the secondary particles produced by the hadron beam is of fundamental importance in the design of any dose monitoring device and is eagerly needed to tune Monte Carlo simulations. We report the measurements done with charged secondary particles produced from the interaction of a 80 MeV/u fully stripped carbon ion beam at the INFN Laboratori Nazionali del Sud, Catania, with a Poly-methyl methacrylate target. Charged secondary particles, produced at 90$\degree$ with respect to the beam axis, have been tracked with a drift chamber, while their energy and time of flight has been measured by means of a LYSO scintillator. Secondary protons have been identified exploiting the energy and time of flight information, and their emission region has been reconstructed backtracking from the drift chamber to the target. Moreover a position scan of the target indicates that the reconstructed emission region follows the movement of the expected Bragg peak position. Exploting the reconstruction of the emission region, an accuracy on the Bragg peak determination in the submillimeter range has been obtained. The measured differential production rate for protons produced with $E^{\rm Prod}_{\rm kin} >$ 83 MeV and emitted at 90$\degree$ with respect to the beam line is: $dN_{\rm P}/(dN_{\rm C}d\Omega)(E^{\rm Prod}_{\rm kin} > 83 {\rm ~MeV}, \theta=90\degree)= (2.69\pm 0.08_{\rm stat} \pm 0.12_{\rm sys})\times 10^{-4} sr^{-1}$.Comment: 13 pages, 9 figure

Study of the 12C + 12C reaction at 62 A MeV for hadrontherapy applications

The largest uncertainty on the physical dose deposition in hadrontherapy is due to ion’s nuclear interaction through the traversed material. Today the simulation codes are not able to reproduce the fragmentation process with the required precision. To improve the knowledge of 12C fragmentation at intermediate energies we have measured at the Laboratori Nazionali del Sud in Catania production cross sections, energy spectra and angular distributions of fragments produced in 12C fragmentation on thin 12C target, at 62A MeV

Proton range monitoring with in-beam PET: Monte Carlo activity predictions and comparison with cyclotron data

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Proton imaging apparatus for protontherapy application

Radiotherapy with protons, due to the physical properties of these particles, offers several advantages for cancer therapy as compared to the traditional radiotherapy with photons. In the clinical use of proton beams, a pCT (proton Computed Tomography) apparatus can contribute to improve the accuracy of the patient positioning and dose distribution calculation. In this paper a pCT apparatus built by the PRIMA (PRoton IMAging) Italian Collaboration will be presented and the preliminary results will be discussed