Physical and engineering aspect of carbon beam therapy Tatsuaki Kanai*, Nobuyuki Kanematsu*, Shinichi Minohara*, Ken Yusa*, Eriko Urakabe*, Hideyuki Mizuno†, Yasushi Iseki¶, Mitsutaka Kanazawa*, Atsushi Kitagawa*, Takehiro Tomitani* *Research center of charged particle therapy,National Institute of Radiological Sciences, 4-9-1, Anagawa, Inage-ku, Chiba-shi, 263-8255 CHIBA, JAPAN † Saitama Cancer Center, Ina-machi, Saitama, Japan ¶ Dept. of Energy Sciences, Tokyo Institute of Technology, Nagatsuta, Yokohama, Japan Abstract. Conformal irradiation system of HIMAC has been up-graded for a clinical trial using a technique of a layer-stacking method. The system has been developed for localizing irradiation dose to target volume more effectively than the present irradiation dose. With dynamic control of the beam modifying devices, a pair of wobbler magnets, and multileaf collimator and range shifter, during the irradiation, more conformal radiotherapy can be achieved. The system, which has to be adequately safe for patient irradiations, was constructed and tested from a viewpoint of safety and the quality of the dose localization realized. A secondary beam line has been constructed for use of radioactive beam in heavy-ion radiotherapy. Spot scanning method has been adapted for the beam delivery system of the radioactive beam. Dose distributions of the spot beam were measured and analyzed taking into account of aberration of the beam optics. Distributions of the stopped positron–emitter beam can be observed by PET. Pencil beam of the positron-emitter, about 1 mm size, can also be used for measurements ranges of the test beam in patients using positron camera. The positron camera, consisting of a pair of Anger-type scintillation detectors, has been developed for this verification before treatment. Wash-out effect of the positron-emitter was examined using the positron camera installed. In this report, present status of the HIMAC irradiation system is described in detail. INTRODUCTION since June 1994. Now we have already treated over 1000 patients using our carbon beams. During these Clinical trials of carbon beam radiotherapy have eight years, the irradiation system at HIMAC has been been started using heavy-ion accelerator complex, improved. In our system, a passive method has been HIMAC (Heavy Ion Medical Accelerator in Chiba) at adapted for spreading the Bragg peak in depth direction NIRS (National Institute of Radiological Sciences) and for broadening the narrow accelerated beam in CP680, Application of Accelerators in Research and Industry: 17th Int'l. Conference, edited by J. L. Duggan and I. L. Morgan © 2003 American Institute of Physics 0-7354-0149-7/03/$20.00 1146 lateral direction. Through this passive method, the conformal irradiation using layer-stacking. Another irradiation system can be applicable to moving target, development of the irradiation technique is use of for example, lung or liver. positron emitter as the therapeutic beam. In this method, large In this fraction of dose is sometimes given to the skin of the report, the improvements at HIMAC system will be patient. presented. In order to increase dose localization and then to decrease dose to skin, we have developed Multi-leaf Collimator Target Wobbler Scatterer Magnets Compensator Monitors Ridge Filter Range Shifter Figure 1. Illustration of the conformal irradiation using layer-stacking method cannot be changed. With dynamic control of the beam CONFORMAL IRRADIATION SYSTEM USING A LAYER-STACKING METHOD modifying devices during the irradiation, more conformal radiotherapy can be achieved. Uniform fields can be made by a pair of wobbler magnets and a Conformal irradiation system of HIMAC has been scatterer. The Bragg peak of the mono-energetic beam up-graded for a clinical trial using a technique of a is layer-stacking method [1,2]. Fig. 1 illustrates the layer gaussian-modulating ridge filter is adapted to prevent stacking method for the conformal irradiation. The hot or cold spot due to moving of target volume during system has been developed for localizing irradiation the irradiation [3]. Width of the broadened Bragg peak dose to target volume more effectively than the present was designed to be 2.5 mm. The mini-peak is swept irradiation dose. In a present passive irradiation method longitudinally by inserting a range shifter for making a using a ridge filter, a scatterer, a pair of wobbler SOBP. The target volume is divided parallel to distal magnets, and multileaf collimator, the width of a edge of the target volume. The curved layer of the spread-out Bragg peak (SOBP) in the radiation field mini-peak according to the divided target is made by 1147 slightly broadened by a ridge filter. A the compensator placed just up-stream of the patient. Fig. 2 shows typical example of the result of dose Each layer is sequentially irradiated from the deepest distribution realized by installed system, in which one by the mini-peak. By this longitudinal sweep of uniform dose distribution is planned to put on the target the Bragg peak, SOBP can be made and covered the for test of the system. whole target volume. When irradiating the mini-peak SPOT SCANNING SYSTEM FOR 11C BEAM by layer by layer, the irradiation field is shrunk along the target volume by a multileaf collimator. By this procedure, unwanted irradiation to normal tissues can be avoided. In order to safely perform treatments by An irradiated volume can be verified by observing this conformal therapy, moving devices should be annihilation-pair gamma rays from the stopping watched during the irradiation and the synchronousness position in the patient when positron emitter beams, among the devices should be checked. The system, such as which has to be adequately safe for patient irradiations, irradiation system of the radioactive beam has been was constructed and tested from a viewpoint of safety installed in HIMAC for using positron emitter as the and the quality of the dose localization realized. therapeutic beams [4]. A spot scanning technique is 11 C, are used as therapeutic beam. An adopted for spreading the radioactive beam because of considerably low intensity. In the spot scanning, the position of each spot is controlled by excitation of a pair of scanning magnets and inserting range shifter. Because 11C spot beams have a wide momentum spread (2%), the aberration should be taken into account to calculate their dose distribution. We measured the beam envelope and the dose distribution of the spot-beam. Based on these measurements, the dose distributions of 11 C beams are calculated and the irradiation volume is designed in water phantom. Fig. 3 and 4 show the optimized dose distribution using the 11 C beam for a concave target. Fig. 3 shows two-dimensional dose distribution in a central plane. Fig. 4 shows dose distributions at the depth of 164 mm and 184 mm. Gap of the concave target is 30 mm in this case. As shown in these figures, penumbra size Figure 2 Typical example of the dose distribution was relatively large size because of the large emittance realized by the layer-stacking method. of the radioactive beam. 1148 In the application of the probing beam, it is very (a) important to know washout effect of the positron x [mm] emitter in the patient because of blood flow. The washout z [mm] effect is experimentally examined by measuring the stopped positron emitter in the brain and muscle of rabbit using developed positron camera. We 164 184 observed three components of the washout effect [6]. Biological decay constants for the fast, middle and Figure. 3. Iso-dose contour for a concave target (b) slow components of a brain and a thigh muscle were 2 1.2 sec., 140 sec., 10191 sec. and 10 sec., 195 sec., 3175 Dose (arbitrary units) 1 sec., respectively. 0.8 0.6 CONCLUSIONS 0.4 z=164 z=184 0.2 0 -60 -40 -20 0 x [mm] 20 40 Recent developments at HIMAC beam delivery system are described. The conformal therapy using the layer 60 stacking method will soon be applied for patient Figure 4. Dose distributions at 164 and 184 mm depth. treatments. Utilization of the positron emitter beam for therapy is DEVELOPMENT OF POSITRON CAMERA still at a stage of feasibility study. Now, experimental evidences of the merit should be shown for the real treatment of the patient. 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