Particle therapy is an established method to treat deep-seated tumours using accelerator-produced ion beams. For treatment planning, the precise knowledge of the relative stopping power (RSP) within the patient is vital. Conversion errors from x-ray computed tomography (CT) measurements to RSP introduce uncertainties in the applied dose distribution. Using a proton computed tomography (pCT) system to measure the SP directly could potentially increase the accuracy of treatment planning. A pCT demonstrator, consisting of double-sided silicon strip detectors (DSSD) as tracker and plastic scintillator slabs coupled to silicon photomultipliers (SiPM) as a range telescope, was developed. After a significant hardware upgrade of the range telescope, a 3D tomogram of an aluminium stair phantom was recorded at the MedAustron facility in Wiener Neustadt, Austria. In total, 80 projections with 6.5 × 105 primary events were acquired and used for the reconstruction of the RSP distribution in the phantom. After applying a straight-line approximation for the particle path inside the phantom, the most probable value (MPV) of the RSP distribution could be measured with an accuracy of 0.59%. The RSP resolution inside the phantom was only 9.3% due to a limited amount of projections and measured events per projection.

Objective.For dose calculations in ion beam therapy, it is vital to accurately determine the relative stopping power (RSP) distribution within the treatment volume. A suitable imaging modality to achieve the required RSP accuracy is proton computed tomography (pCT), which usually uses a tracking system and a separate residual energy (or range) detector to directly measure the RSP distribution. This work investigates the potential of a novel pCT system based on a single detector technology, namely low gain avalanche detectors (LGADs). LGADs are fast 4D-tracking detectors, which can be used to simultaneously measure the particle position and time with precise timing and spatial resolution. In contrast to standard pCT systems, the residual energy is determined via a time-of-flight (TOF) measurement between different 4D-tracking stations.Approach.To show the potential of using 4D-tracking for proton imaging, we studied and optimized the design parameters for a realistic TOF-pCT system using Monte Carlo simulations. We calculated the RSP accuracy and RSP resolution inside the inserts of the CTP404 phantom and compared the results to a simulation of an ideal pCT system.Main results.After introducing a dedicated calibration procedure for the TOF calorimeter, RSP accuracies less than 0.6% could be achieved. We also identified the design parameters with the strongest impact on the RSP resolution and proposed a strategy to further improve the image quality.Significance.This comprehensive study of the most important design aspects for a novel TOF-pCT system could help guide future hardware developments and, once implemented, improve the quality of treatment planning in ion beam therapy.

In proton therapy, the knowledge of the proton stopping power, i.e. the energy deposition per unit length within human tissue, is essential for accurate treatment planning. One suitable method to directly measure the stopping power is proton computed tomography (pCT). Due to the proton interaction mechanisms in matter, pCT image reconstruction faces some challenges: the unique path of each proton has to be considered separately in the reconstruction process adding complexity to the reconstruction problem. This study shows that the GPU-based open-source software toolkit TIGRE, which was initially intended for X-ray CT reconstruction, can be applied to the pCT image reconstruction problem using a straight line approach for the proton path. This simplified approach allows for reconstructions within seconds. To validate the applicability of TIGRE to pCT, several Monte Carlo simulations modeling a pCT setup with two Catphan® modules as phantoms were performed. Ordered-Subset Simultaneous Algebraic Reconstruction Technique (OS-SART) and Adaptive-Steepest-Descent Projection Onto Convex Sets (ASD-POCS) were used for image reconstruction. Since the accuracy of the approach is limited by the straight line approximation of the proton path, requirements for further improvement of TIGRE for pCT are addressed.

MedAustron is a synchrotron-based particle therapy centre located in Wiener Neustadt, Austria. It features three irradiation rooms for particle therapy, where proton beams with energies up to 252.7 MeV and carbon ions of up to 402.8 MeV/u are available for cancer treatment. In addition to the treatment rooms, MedAustron features a unique beamline exclusively for non-clinical research (NCR). This research beamline is also commissioned for proton energies up to 800 MeV, while available carbon ion energies correspond to the ones available in the clinical treatment rooms. Based on the requirements for particle therapy, all irradiation rooms offer particle rates of up to 10^9 particles/s for protons and 10^7 particles/s for carbon ions. However, for research purposes, lower particle fluxes are required and were therefore commissioned for the NCR beamline. Three particle flux settings with particle rates ranging from ~2.4x10^3 particles/s to ~5.2x10^6 particles/s were established for seven proton energies below 252.7 MeV. In addition to the particle rate, the spot sizes and beam energies were measured for these settings. Furthermore, three low flux settings for 800 MeV protons with particle rates ranging from ~2x10^3 particles/s to ~1.3x10^6 particles/s were commissioned. Since the commissioned low flux settings are in a regime well below the limits of the available standard beam diagnostics, setting up the beam under these new operational conditions entirely relied on the use of external detectors. Furthermore, a beam position measurement based alignment without using the standard beam profile monitors was performed for 800 MeV protons.

MedAustron is an Austrian cancer treatment facility using protons in the energy range from 62.4MeV to 252.7MeV and carbon ions with energies up to 400 MeV/u for external beam radiotherapy. The facility features a unique beam line exclusively for non-clinical research, which will be commissioned for even higher proton energies of up to 800MeV. A demonstrator of a proton computed tomography system consisting of a tracking telescope and a residual energy detector is being developed and will be tested in beam at MedAustron. Currently, this demonstrator consists of a beam telescope composed of four double-sided silicon-strip detectors. A rotating table serving as sample holder is placed between the second and third detector. The tracking telescope is triggered by two scintillation detectors operated in coincidence and is placed downstream behind the silicon detectors. This telescope was tested in beam to obtain a radiography of an aluminium sample. Additionally, the tracking telescope was modelled in Geant4 to simulate particle tracks. An image reconstruction method exploiting material dependent variations of the scattering angle of protons was used to obtain a three dimensional image of an irradiated sample.