Future Developments in Charged Particle Therapy: Improving Beam Delivery for Efficiency and Efficacy

Abstract

The physical and clinical benefits of charged particle therapy (CPT) are well recognized. However, the availability of CPT and complete exploitation of dosimetric advantages are still limited by high facility costs and technological challenges. There are extensive ongoing efforts to improve upon these, which will lead to greater accessibility, superior delivery, and therefore better treatment outcomes. Yet, the issue of cost remains a primary hurdle as utility of CPT is largely driven by the affordability, complexity and performance of current technology. Modern delivery techniques are necessary but limited by extended treatment times. Several of these aspects can be addressed by developments in the beam delivery system (BDS) which determines the overall shaping and timing capabilities enabling high quality treatments. The energy layer switching time (ELST) is a limiting constraint of the BDS and a determinant of the beam delivery time (BDT), along with the accelerator and other factors. This review evaluates the delivery process in detail, presenting the limitations and developments for the BDS and related accelerator technology, toward decreasing the BDT. As extended BDT impacts motion and has dosimetric implications for treatment, we discuss avenues to minimize the ELST and overview the clinical benefits and feasibility of a large energy acceptance BDS. These developments support the possibility of advanced modalities and faster delivery for a greater range of treatment indications which could also further reduce costs. Further work to realize methodologies such as volumetric rescanning, FLASH, arc, multi-ion and online image guided therapies are discussed. In this review we examine how increased treatment efficiency and efficacy could be achieved with improvements in beam delivery and how this could lead to faster and higher quality treatments for the future of CPT.

In-Beam PET And Compton Imaging For Enhanced Accuracy Proton-Range Verification

“…Second, one has to determine which is the optimal duty-cycle for the proton beam to accomplish both PG Compton and PET imaging for a proper trade-off of statistical and systematic accuracy. The aforediscussed pulsed-beam duty-cycle requirement of less than 0.01 aligns very well with the application of this new methodology in treatments with superconducting synchrocyclotrons, which produce a pulsed beam (few µs, every 1-2 ms) 26 , and also with recent developments related to hybrid delivery approaches in flash therapy 27 .…”

Innovative Leadership Comparison of Ion Beam Applications, SA Belgium against its competitors

“…However, adoption of new technologies especially Proton beam therapy is limited because of high implementation costs, lack of expertise and technological challenges. Yap et al [5] state that the primary barrier to Charged particle therapy is still the cost as Charged particle facilities are run by affordability, functioning and complexity of current technology [5]. Advance delivery techniques are needed but limited by prolonged delivery times [5].…”

“…Yap et al [5] state that the primary barrier to Charged particle therapy is still the cost as Charged particle facilities are run by affordability, functioning and complexity of current technology [5]. Advance delivery techniques are needed but limited by prolonged delivery times [5]. In the research paper 1, Taqaddas also described the features that are desired and required in Proton treatment Planning Systems, Beam delivery systems and Imaging Definitions have been provided for more ambiguous terms in the glossary and in the text.…”

TURBO: A novel beam delivery system enabling rapid depth scanning for charged particle therapy

“…Although there are many factors which contribute to the delivery process and treatment time, the ELST is a bottleneck constraint and this deadtime whilst waiting for magnetic field adjustments to transport different beam energies has several implications, impacting treatment efficiency and efficacy [5]. As most facilities offer state-of-the-art treatments with active pencil beam scanning, the ELSTs accumulate and longer beam delivery times translate to higher costs, lower patient throughput and can decrease treatment quality: physical uncertainties and sensitivities with motion cause inferior dosage i.e.…”