Purpose The presence of range uncertainties hinders the exploitation of the full potential of charged particle therapy. Several range verification techniques have been proposed to mitigate this limitation. Prompt gamma spectroscopy (PGS) is among the most promising solutions for online and in vivo range verification. In this work, we present the experimental results of the detection of prompt gamma radiation, induced by 4He beams at the Heidelberg Ion‐Beam Therapy Center (HIT). The results were obtained, using a spectroscopic unit of which the design has been optimized using Monte Carlo simulations. Methods The spectroscopic unit is composed by a primary cerium bromide (CeBr3) crystal surrounded by a secondary bismuth germanate (BGO) crystal for anticoincidence detection (AC). The digitalization of the signals is performed with an advanced FADC/FPGA system. The 4He beams at clinical energies and intensities are delivered to multiple targets in the experimental cave at the HIT. We analyze the production of prompt gamma on oxygen and carbon targets, as well as high Z materials such as titanium and aluminum. The quantitative analysis includes a systematic comparison of the signal‐to‐noise ratio (SNR) improvement for the spectral lines when introducing the AC detection. Moreover, the SNR improvement could provide a reduction of the number of events required to draw robust conclusions. We perform a statistic analysis to determine the magnitude of such an effect. Results We present the energy spectra detected by the primary CeBr3 and the secondary BGO. The combination of these two detectors leads to an average increase of the signal‐to‐noise ratio by a factor 2.1, which confirms the Monte Carlo predictions. The spectroscopic unit is capable of detecting efficiently the discrete gamma emission over the full energy spectrum. We identify and analyze 19 independent spectral lines in an energy range spacing from Eγ=0.718 MeV to Eγ=6.13 MeV. Moreover, when introducing the AC detection, the number of events required to determine robustly the intensity of the discrete lines decreases. Finally, the analysis of the low‐energy reaction lines determines whether a thin metal insert is introduced in the beam direction. Conclusions This work provides the experimental characterization of the spectroscopy unit in development for range verification through PGS at the HIT. Excellent performances have been demonstrated over the full prompt gamma energy spectrum with 4He beams at clinical energies and intensities.

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Purpose To assess the effects of daily adaptive MR-guided replanning in stereotactic body radiation therapy (SBRT) of liver metastases based on a patient individual longitudinal dosimetric analysis. Methods Fifteen patients assigned to SBRT for oligometastatic liver metastases underwent daily MR-guided target localization and on-table treatment plan re-optimization. Gross tumor volume (GTV) and organs at risk (OARs) were adapted to the anatomy-of-the-day. A reoptimized plan (RP) and a rigidly shifted baseline plan (sBP) without re-optimization were generated for each fraction. After extraction of DVH parameters for GTV, planning target volume (PTV), and OARs (stomach, duodenum, bowel, liver, heart) plans were compared on a per-patient basis. Results Median pre-treatment GTV and PTV were 14.9 cc (interquartile range (IQR): 7.7–32.9) and 62.7 cc (IQR: 42.4–105.5) respectively. SBRT with RP improved PTV coverage (V100%) for 47/75 of the fractions and reduced doses to the most proximal OARs (D1cc, Dmean) in 33/75 fractions compared to sBP. RP significantly improved PTV coverage (V100%) for metastases within close proximity to an OAR by 4.0% (≤ 0.2 cm distance from the edge of the PTV to the edge of the OAR; n = 7; p = 0.01), but only by 0.2% for metastases farther away from OAR (> 2 cm distance; n = 7; p = 0.37). No acute grade 3 treatment-related toxicities were observed. Conclusions MR-guided online replanning SBRT improved target coverage and OAR sparing for liver metastases with a distance from the edge of the PTV to the nearest luminal OAR < 2 cm. Only marginal improvements in target coverage were observed for target distant to critical OARs, indicating that these patients do not benefit from daily adaptive replanning.

This work provides the optimal geometry for primary and secondary crystals to be used in range verification through PGS. The simulations show that such a PGS system may allow for the simultaneous detection of the discrete lines from a thin metal implant within a water phantom.