• Nuclear Engineering and Technology
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• v.54 no.3
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• pp.1016-1023
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• 2022

In proton therapy, a highly conformal proton dose can be delivered to the tumor by means of the steep distal dose penumbra at the end of the beam range. The proton beam range, however, is highly sensitive to range uncertainty, which makes accurately locating the proton range in the patient difficult. In-vivo range verification is a method to manage range uncertainty, one of the promising techniques being prompt gamma imaging (PGI). In earlier studies, we proposed gamma electron vertex imaging (GEVI), and constructed a proof-of-principle system. The system successfully demonstrated the GEVI imaging principle for therapeutic proton pencil beams without scanning, but showed some limitations under clinical conditions, particularly for pencil beam scanning proton therapy. In the present study, we upgraded the GEVI system in several aspects and tested the performance improvements such as for range-shift verification in the context of line scanning proton treatment. Specifically, the system showed better performance in obtaining accurate prompt gamma (PG) distributions in the clinical environment. Furthermore, high shift-detection sensitivity and accuracy were shown under various range-shift conditions using line scanning proton beams.

• Progress in Medical Physics
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• v.27 no.4
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• pp.267-271
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• 2016

In this study, we present the commissioning and validation results of a dedicated scanning nozzle. The dedicated scanning nozzle is installed in one of the two gantry treatment rooms at Samsung Proton Therapy Center. Following a successful completion of the acceptance test, the commissioning process including the beam data measurement for treatment planning system has been conducted. Extended measurements have been conducted as a validation of the clinical performance of the nozzle and various quality assurance protocols have been prepared.

• Progress in Medical Physics
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• v.18 no.4
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• pp.226-232
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• 2007

We studied a Monte Carlo simulation of the proton beam delivery system at the National Cancer Center (NCC) using the Geant4 Monte Carlo toolkit and tested its feasibility as a dose verification framework. The Monte Carlo technique for dose calculation methodology has been recognized as the most accurate way for understanding the dose distribution in given materials. In order to take advantage of this methodology for application to external-beam radiotherapy, a precise modeling of the nozzle elements along with the beam delivery path and correct initial beam characteristics are mandatory. Among three different treatment modes, double/single-scattering, uniform scanning and pencil beam scanning, we have modeled and simulated the double-scattering mode for the nozzle elements, including all components and varying the time and space with the Geant4.8.2 Monte Carlo code. We have obtained simulation data that showed an excellent correlation to the measured dose distributions at a specific treatment depth. We successfully set up the Monte Carlo simulation platform for the NCC proton therapy facility. It can be adapted to the precise dosimetry for therapeutic proton beam use at the NCC. Additional Monte Carlo work for the full proton beam energy range can be performed.

• Nuclear Engineering and Technology
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• v.52 no.9
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• pp.2064-2071
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• 2020

For proton pencil beam scanning (PBS) technology, the accuracy of the dose distribution in a patient is sensitive to the properties of the incident beam. However, mechanical deformation of the proton therapy facility may occur, and this could be an important factor affecting the proton dose distribution in patients. In this paper, we investigated the effect of deformation on an SC200 proton facility's beam isocenter properties. First, mechanical deformation of the PBS nozzle, L-shape plate, and gantry were simulated using a Finite Element code, ANSYS. Then, the impact of the mechanical deformation on the beam's isocenter properties was evaluated using empirical formulas. In addition, we considered the simplest case that could affect the properties of the incident beam (i.e. if only the bending magnet (BG3) has an error in its mounting alignment), and the effect of the beam optics offset on the isocenter characteristics was evaluated. The results showed that the deformation of the beam position in the X and Y direction was less than 0.27 mm, which meets the structural design requirements. Compared to the mechanical deformation of the L-shape plate, the deformation of the gantry had more influence on the beam's isocenter properties. When the error in the mounting alignment of the BG3 is equal to or more than 0.3 mm, the beam deformation at the isocenter exceeds the maximum accepted deformation limits. Generally speaking, for the current design of the SC200 scanning beam delivery system, the effects of mechanical deformation meet the maximum accepted beam deformation limits. In order to further study the effect of the incident beam optics on the isocenter properties, a fine-scale Monte Carlo model including factors relating to the PBS nozzle and the BG3 should be developed in future research.

• Progress in Medical Physics
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• v.31 no.3
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• pp.71-80
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• 2020

This paper provides a brief review of the advanced technologies for carbon ion radiotherapy (CIRT), with a focus on current developments. Compared to photon beam therapy, treatment using heavy ions, especially a carbon beam, has potential advantages due to its physical and biological properties. Carbon ion beams with high linear energy transfer demonstrate high relative biological effectiveness in cell killing, particularly at the Bragg peak. With these unique properties, CIRT allows for accurate targeting and dose escalation for tumors with better sparing of adjacent normal tissues. Recently, the available CIRT technologies included fast pencil beam scanning, superconducting rotating gantry, respiratory motion management, and accurate beam modeling for the treatment planning system. These techniques provide precise treatment, operational efficiency, and patient comfort. Currently, there are 12 CIRT facilities worldwide; with technological improvements, they continue to grow in number. Ongoing technological developments include the use of multiple ion beams, effective beam delivery, accurate biological modeling, and downsizing the facility.

• Progress in Medical Physics
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• v.27 no.3
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• pp.162-168
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• 2016

Proton therapy is increasingly being actively used in the treatment of cancer. In contrast to photons, protons have the potential advantage of delivering higher doses to the cancerous tissue and lower doses to the surrounding normal tissue. However, a range shifter is needed to degrade the beam energy in order to apply the pencil beam scanning technique to tumors located close to the minimum range. The secondary neutrons are produced in the beam path including within the patient's body as a result of nuclear interactions. Therefore, unintended side effects may possibly occur. The research related to the secondary neutrons generated during proton therapy has been presented in a variety of studies worldwide, since 2007. In this study, we measured the magnitude of the secondary neutron dose depending on the location of the detector and the use of a range shifter at the beam nozzle of the proton scanning mode, which was recently installed. In addition, the production of secondary neutrons was measured and estimated as a function of the distance between the isocenter and detector. The neutron dose was measured using WENDI-II (Wide Energy Neutron Detection Instruments) and a Plastic Water phantom; a Zebra dosimeter and 4-cm-thick range shifter were also employed as a phantom. In conclusion, we need to consider the secondary neutron dose at proton scanning facilities to employ the range shifter reasonably and effectively.

• Progress in Medical Physics
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• v.31 no.3
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• pp.99-110
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• 2020

With hope and concern, the first Korean proton therapy facility was introduced to the National Cancer Center (NCC) in 2007. It added a new chapter to the history of Korean radiation therapy. There have been challenging clinical trials using proton beam therapy, which has seen many impressive results in cancer treatment. Compared to the rapidly increasing number of proton therapy facilities in the world, only one more proton therapy center has been added since 2007 in Korea. The Samsung Medical Center installed a proton therapy facility in 2015. Most radiation oncology practitioners would agree that the physical properties of the proton beam provide a clear advantage in radiation treatment. But the expensive cost of proton therapy facilities is still one of the main reasons that hospitals are reluctant to introduce them in Korea. I herein introduce the history of proton therapy and the cutting edge technology used in proton therapy. In addition, I will cover the role of a medical physicist in proton therapy and the future prospects of proton therapy, based on personal experience in participating in proton therapy programs from the beginning at the NCC.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.180-182
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• 2002

A Proton Therapy Center was established this year in National Cancer Center, Korea. We chose IBA of Belgium as the vendor of the equipment package. A 230 MeV fixed-energy cyclotron will deliver proton beams into two gantry rooms, one horizontal beam room, and one experimental station. The building for the equipment is currently under design with a special emphasis on radiation shielding. Installation of equipments is expected to begin in September next year starting with the first gantry, and the acceptance test will be performed about a year later. To generate therapeutic radiation fields the wobbling method will be a main treatment mode for the first gantry. A pencil beam scanning system on the other hand will be equipped for the second gantry relying on the availability at the time of installation. The beam scanning with intensity modulation adapted will be a most advanced form in radiation therapy known as IMPT. Some details on the project progress, scope of the system, and design of building are described.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.153-158
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• 2013

Purpose: After making two plans, the Double Scattering (DS) Mode and The Pencil Beam Scanning (PBS) Mode, of patients on early prostate cancer, we not only compare the dose conformity and the dose homogeneity by analyzing each DVH, CN and HI, but also evaluate normal structures's sparing effect on each mode. Materials and Methods: Planes about nine patients, who did proton therapy, on prostate cancer was setted using the Eclipse proton external beam planning system. The prescription dose, every $2.5 Gy{\times}28$ fractions=70 Gy, was delivered to the PTV. The CN and the HI were getted by anlazing each DVHs for the DS Plan and the PBS Plan. Also, normal structures' %volumes according to dose of the PBS are campared with those of the DS. Results: The average CN of the PTV is increase 16.63% from DS $0.68{\pm}0.07$ to PBS $0.79{\pm}0.01$, and the average IN of the PTV is decrease -22.66 % from DS $0.12{\pm}0.03$ to PBS $0.09{\pm}0.01$. The PBS has litter %Volumes of normal structures than the DS about every patient except Rectum. The average %Volume of Left Femoral Head receiving ${\geq}30$ Gy shows most high decreasing rate, -79.93%, from DS to PBS and the average %Volume of Rectum receiving ${\geq}70$ Gy shows most low decreasing rate, -3.03%, from DS to PBS. Conclusion: Therefore, the PBS is more effective achieving the dose conformity and the dose Homogeneity than DS, and better to reduce unnecessary dose arriving normal structures, especially the femoral heads.

• Progress in Medical Physics
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• v.28 no.1
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• pp.22-26
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• 2017

We have developed an analytic software that can easily analyze the spot position and width of proton beam therapy nozzles in a periodic quality assurance. The developed software consists of an image processing method that conducts an analysis using center-of-spot geometry and a Gaussian fitting method that conducts an analysis through Gaussian fitting. By using the software, an analysis of 210 proton spots with energies 150, 190, and 230 MeV showed a deviation of approximately 3% from the mean. The software we developed to analyze proton spot positions and widths provides an accurate analysis and reduces the time for analysis.