Oliver, S., Vijande, J., Tejedor-Aguilar, N., Miro, R., Rovira-Escutia, J. J., Ballester, F., et al. (2023). Monte Carlo flattening filter design to high energy intraoperative electron beam homogenization. Radiat. Phys. Chem., 212, 111102–6pp.
Abstract: Intraoperative radiotherapy using mobile linear accelerators is used for a wide variety of malignancies. However, when large fields are used in combination with high energies, a deterioration of the flatness dose profile is measured with respect to smaller fields and lower energies. Indeed, for the LIAC HWL of Sordina, this deterioration is observed for the 12 MeV beam combined with 10 cm (or larger) diameter applicator. Aimed to solve this problem, a flattening filter has been designed and validated evaluating the feasibility of its usage at the upper part of the applicator. The design of the filter was based on Monte Carlo simulations because of its accuracy in modeling components of clinical devices, among other purposes. The LIAC 10 cm diameter applicator was modeled and simulated independently by two different research groups using two different MC codes, reproducing the heterogeneity of the 12 MeV energy beam. Then, an iterative process of filter design was carried out. Finally, the MC designed conical filter with the optimal size and height to obtain the desired flattened beam was built in-house using a 3D printer. During the experimental validation of the applicator-filter, percentage depth dose, beam profiles, absolute and peripheral dose measurements were performed to demonstrate the effectiveness of the filter addition in the applicator. These measurements conclude that the beam has been flattened, from 5.9% with the standard configuration to 1.6% for the configuration with the filter, without significant increase of the peripheral dose. Consequently, the new filter-applicator LIAC configuration can be used also in a conventional surgery room. A reduction of 16% of the output dose and a reduction of 1.1 mm in the D50 of the percentage depth dose was measured with respect to the original configuration. This work is a proof-of-concept that demonstrates that it is possible to add a filter able to flatten the beam delivered by the Sordina LIAC HWL. Future studies will focus on more refined technical solutions fully compatible with the integrity of the applicator, including its sterilization, to be safely introduced in the clinical practice.
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Degiovanni, A., Amaldi, U., Bonomi, R., Garlasche, M., Garonna, A., Verdu-Andres, S., et al. (2011). TERA high gradient test program of RF cavities for medical linear accelerators. Nucl. Instrum. Methods Phys. Res. A, 657(1), 55–58.
Abstract: The scientific community and the medical industries are putting a considerable effort into the design of compact, reliable and cheap accelerators for hadrontherapy. Up to now only circular accelerators are used to deliver beams with energies suitable for the treatment of deep seated tumors. The TERA Foundation has proposed and designed a hadrontherapy facility based on the cyclinac concept: a high gradient linear accelerator placed downstream of a cyclotron used as an injector. The overall length of the linac, and therefore its final cost, is almost inversely proportional to the average accelerating gradient achieved in the linac. TERA, in collaboration with the CLIC RF group, has started a high gradient test program. The main goal is to study the high gradient behavior of prototype cavities and to determine the appropriate linac operating frequency considering important issues such as machine reliability and availability of distributed power sources. A preliminary test of a 3 GHz cavity has been carried out at the beginning of 2010, giving encouraging results. Further investigations are planned before the end of 2011. A set of 5.7 GHz cavities is under production and will be tested in a near future. The construction and test of a multi-cell structure is also foreseen.
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Amaldi, U., Bonomi, R., Braccini, S., Crescenti, M., Degiovanni, A., Garlasche, M., et al. (2010). Accelerators for hadrontherapy: From Lawrence cyclotrons to linacs. Nucl. Instrum. Methods Phys. Res. A, 620(2-3), 563–577.
Abstract: Hadrontherapy with protons and carbon ions is a fast developing methodology in radiation oncology. The accelerators used and planned for this purpose are reviewed starting from the cyclotrons used in the thirties. As discussed in the first part of this paper, normal and superconducting cyclotrons are still employed, together with synchrotrons, for proton therapy while for carbon ion therapy synchrotrons have been till now the only option. The latest developments concern a superconducting cyclotron for carbon ion therapy, fast-cycling high frequency linacs and 'single room' proton therapy facilities. These issues are discussed in the second part of the paper by underlining the present challenges, in particular the treatment of moving organs.
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