1. An integrated system for the on-line monitoring
of particle therapy treatment accuracy
Elisa Fiorina
(Universita’ di Torino and INFN, TORINO)
on behalf of the INSIDE collaboration
N. Belcari
N. Camarlinghi
A. Del Guerra
S. Ferretti
E. Kostara
A. Kraan
B. Liu
N. Marino
M. Morrocchi
M.A. Piliero
G. Pirrone
V. Rosso
G. Sportelli
P. Cerello
S. Coli
E. Fiorina
G. Giraudo
F. Pennazio
C. Peroni
A. Rivetti
R. Wheadon
A. Attili,
S. Giordanengo
E. De Lucia
R. Faccini
P.M. Frallicciardi
M. Marafini
C. Morone
V. Patera
L. Piersanti
A. Sarti
A. Sciubba
C. Voena
F. Ciciriello
F. Corsi
F. Licciulli
C. Marzocca
G. Matarrese
G. Battistoni
M. Cecchetti
F. Cappucci
S. Muraro
P. Sala
INSIDE coordinator: M. G. Bisogni
partners:
M. Ciocca, M. Donetti, A. Mairani

2. b+ activity distribution secondary particles emission
Hadrontherapy monitoring
Real time monitor of Bragg Peak depth with passive signals by secondary particles
b+ activity distribution
11C, 15O, 10C,…
J Pawelke et al., Proceedings IBIBAM, , Heidelberg
prompt
secondary particles emission
L.  Piersanti  et  al.  Phys.  Med.  Biol.  59  1857 1
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

3. Prompt secondary particles emission? b+ activity distribution?
The Project
Prompt secondary particles emission?
Tracker +
Calorimeter =
DOSE PROFILER
b+ activity distribution?
IN-BEAM PET HEADS
INnovative Solutions for In-beam DosimEtry in Hadrontherapy
Designed to:
be integrated in the gantry
be operated in-beam
provide an IMMEDIATE feedback on the particle range
based on the combination of a in-beam PET scanner and a tracking system @ 2
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

4. FE board (Tofpet ASIC[1])
In-beam PET heads
10x 20 x 5 cm3
Distance from the
isocenter=25 cm
256 LFS pixel crystals (3x3x20mm3) coupled one to one to MPPCs (Multi Pixel Photon Counters, SiPMs).
FE board (Tofpet ASIC[1])
The INSIDE system is mounted on a cart to be fully compatible with clinics
In-beam PET module
[1] Work partly funded by the European Union 7th Framework Program (FP7/ ) under Grant Agreement No EndoTOFPET-US and supported by a Marie Curie Early Initial Training Network Fellowship of the European Union 7th Framework Program (PITN-GA PicoSEC-MCNet). 3
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

5. Dose Profiler Elettronics: BASIC32, FPGA water cooling
28 x 28 x 35 cm3
6 planes of orthogonal squared scintillating fibers coupled to SiPMs
an electromagnetic calorimeter coupled to Position Sensitive PMTs.
plastic scintillator: to avoid electron back scattering
Calorimeter: LYSO crystals
2 layers of 192 fibers (0.5x0.5 mm^2)
1mm ^3 sipm
multi anode PMTs
6 fibre planes
plastic scintillator
calorimeter 4
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

6. The System Specifications
IN-BEAM PET HEADS
DOSE PROFILER
Signal
b+ decay
Prompt secondary particles
Acquisition phases
In-spill, inter-spill
and after-treatment
In-spill
Position
heads face to face
perpendicular to the beam axis
fitted position wrt the isocenter
forward direction
60o angle wrt the beam axis
Distance from beam isocenter
25 cm
about 40 cm
Output
3D PET image
Emission point distribution
Lentezza, sensibilita’ meglio con I protoni
Calibrazione piu’ complicata, solo coi carboni
Bragg Peak depth online check before patient irradiation with the complete treatment session. 5
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

7. PHANTOM/PATIENT SIMULATION DOSE PROFILER SIMULATION
MC simulations
Essential for system design, development and operation planning.
Dose Delivery
BEAM
SIMULATION
PHANTOM/PATIENT SIMULATION
CNAO beam pipe and nozzle
beam space and time structure (from the beam monitoring system)
phantom: different materials
patient: Computed Tomography
PET
DOSE PROFILER SIMULATION
two-steps approach
detector response
full12C beam simulation
INTEGRAL CHAMBERS
Giordanengo et al., Rom. Rep. in Phys., Vol. 66(1), 2014
Fluka is a general purpose tool for calculations of particle transport and interactions with matter 6
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

8. PET simulations (I) In-beam PET heads simulated geometry
STEP 1:
Beam simulation
Time-tagged
activity scoring
STEP 2:
PET simulation
Data analysis & PET image reconstruction
About 1/100 of primary hadrons
Annihilation time and position (gold standard)
Isotope production map:
11C (t1/2= s)
15O (t1/2=122.4s)
10C (t1/2=19.290s)
All positrons are simulated.
Detector simulation.
Same as real data:
Line Of Response (LOR) list extraction
Image reconstruction (MLEM algorithm, 5 iterations)
100x
In-beam PET heads simulated geometry
LFS side
Simulated detector:
10% s DE/E
460 ps s time resolution
2.5 ns coincidence time window
LFS
MPPC
first the treatment beam is simulated with partial statistics, then, starting from the isotopes production map, the full-statistics PET simulation of the INSIDE detectors is performed. 7
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

9. PET simulations (II) ANNIHILATION DISTRIBUTION
treatment
after treatment
25 cm
p beam
PMMA
Monoenergetic 2D proton treatment:
uniform irradiation
4.5x4.5x0.3cm3 E=66.34 MeV
4.50E+10 protons
59 spill
7.63E+8 average protons/spill
11C, 10C and 15O simulated annihilations
for the whole treatment plan = 3.2E+8 in 1800s.
Simulated isotopes: 86% during treatment, 95% after treatment 8
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

10. ACTIVITY PROFILE ANALYSIS
PET simulations (III)
annihilation map overlayed in colors
simulated PET image
ACTIVITY PROFILE ANALYSIS
25 cm
p beam
p beam
p beam
PMMA
Monoenergetic 1D proton treatment:
single E=68.3 MeV
2.E+11 protons
102 spill
1.96E+9 average protons/spill
p beam 9
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

11. Pixelated LYSO crystal
Dose profiler simulation (I)
Dose Profiler simulation
Simulation output postprocessing
Track reconstruction and data analysis
12C beams
Detector simulation
Phantom and patient
Necessary for reconstruction and data analysis
Same as real data.
Dose profiler simulated geometry
Each LYSO crystal matches with 4 MAPMT anodes
Lookup tables for energy correction
BaSo4
Pixelated LYSO crystal
Fiber plans
Pixelated LYSO crystal, 23x23 active pixels surrounded by BaSo4 (Barium Sulfate) inactive gap.
LYSO crystal read out by Multi Anode PMT (64 channels): no 1-to-1 correspondence between pixel and anodes.
Since each pixel can share the light with 4 anodes top, two Lookup tables to associate the correct fraction of pixel energy to the appropriate number of involved anodes are implemented.
Calorimeter 10
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

12. Dose profiler simulations (II)
PHANTOM CASE
Single spot 12C 220 MeV/u
Simulated tracks inside the Dose Profiler g p g p 11
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

13. Dose profiler simulations (III)
PATIENT CASE
One beam, C
Energy in [137.28, ] MeV/u range.
Photons (>1 MeV) =
Protons (>20 MeV) =
Preliminary evaluation
Preliminary evaluation
Photons in Profiler
Protons in Profiler
MeV/u
Treatment Plan Slice Number
MeV/u
MeV/u
Treatment Plan Slice Number
MeV/u 12
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

14. PET beam test May 2015 @ (I) Monoenergetic 1D proton treatments
Single spot, 2E+11 protons
phantom
25 cm
Energy [MeV]
68.3
72.03
84.3
spill
102 98
183
average protons/spill
1.96E+9
2.04E+9
1.09E+9
p beam
PMMA
PET modules
TOT raw [ns]
chip 7, channel 40
DATA ANALYSIS:
Online/offline analysis
For each channel, automated:
energy window selection
time delay calibration
3D PET image reconstruction
Profile analysis
INSIDE GUI 13
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

15. *detector calibration to be optimised
PET beam test May (II)
MeV
PET reconstructed images
in-spill
inter-spill
preliminary
preliminary
preliminary
p beam
p beam
after treatment
preliminary
Coincidence Time Resolution (CTR)*
Interspill = 699 ps σ (blue)
Inspill = 851 ps σ (red)
*detector calibration to be optimised
Disegnato per lavorare ad alto rate
p beam 14
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

16. PET beam test May 2015 @ (III)
Correction for isotopes not simulated
(14% during, 5% after treatment)
preliminary
Quantitative compatible simulation and real data profiles.
Distal fall off evaluation: simulation and real data difference < 1 mm
68 MeV
The MC simulation is a reliable tool to evaluate the performance of the full in-beam PET system.
72 MeV 15
E. Fiorina th Pisa Meeting on Advanced Detectors, May 26th 2015

17. Conclusions & Prospects
The INSIDE Project combines:
b+ activity detection: IN-BEAM PET HEADS
secondary particle tracking: DOSE PROFILER
to provide 3D real-time monitoring in hadrontherapy
MC simulations:
essential for system design, development and operation
In-beam PET: two-steps technique reduces the simulation time (70x), validation on real data
Dose Profiler: secondary particle signal
quantification with 12C beam
In-beam PET first modules (tested at CNAO, May 2015):
very satisfactory results
both in-spill and inter-spill/after treat. PET images
adequate coincidence time resolution
The INSIDE system commissioning at CNAO by the early of 2016.
This paper has been supported by Ministero dell’Istruzione, dell’Università e della Ricerca of the Italian government under the program  PRIN   project nr. 2010P98A75 and by European Union’s Seventh Framework Program for research, technological development and demonstration under grant agreement no (INFIERI) 16
Contacts: Maria Giuseppina Bisogni Elisa Fiorina