Objective: Proton therapy as the next generation radiation-based cancer therapy offers dominant advantages over conventional radiation therapy due to the utilization of the Bragg peak; however, range uncertainty in beam delivery substantially mitigates the advantages of proton therapy. This work reports using protoacoustic measurements to determine the location of proton Bragg peak deposition within a water phantom in real time during beam delivery. Approach: In protoacoustics, proton beams have a definitive range, depositing a majority of the dose at the Bragg peak; this dose is then converted to heat. The resulting thermoelastic expansion generates a 3D acoustic wave, which can be detected by acoustic detectors to localize the Bragg peak. Main results: Protoacoustic measurements were performed with a synchrocyclotron proton machine over the exhaustive energy range from 45.5MeV to 227.15MeV in clinic. It was found that the amplitude of the acoustic waves is proportional to proton dose deposition, and therefore encodes dosimetric information. With the guidance of protoacoustics, each individual proton beam (7pC/pulse) can be directly visualized with sub-millimeter (<0.7 mm) resolution using single beam pulse for the first time. Significance: The ability to localize the Bragg peak in real-time and obtain acoustic signals proportional to dose within tumors could enable precision proton therapy and hope to progress towards in-vivo measurements.
Cancer has been and continues to be a leading cause of death globally. More than half of all cancer patients undergo ionizing radiation therapy and dosimetry is crucial to the success and improvement of these treatments - ensuring that an accurate radiation dose is delivered to the target location. Despite widespread clinical use, the delivered dose can only be planned and verified via simulations with phantoms, and an in-tumor, on-line dose verification is still unavailable after more than one-hundred years of clinical application. X-ray-induced acoustic computed tomography (XACT) has recently shown the potential for imaging the delivered radiation dose within the tumor. Prior XACT imaging systems require tens of averages to achieve reasonable images. Here, we demonstrate that our XACT signals can be detected for each individual X-ray pulse (4µs) with sub-mGy sensitivity from a clinical linear accelerator during radiotherapy. Single-pulse XACT imaging holds great potential for personalized precision radiotherapy.
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