Peak temperature ratio of TLD glow curves to investigate the spatial variation of LET in a clinical proton beam

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Peak temperature ratio of TLD glow curves to investigate the spatial variation of LET in a clinical proton beam University of Chicago CDH Proton Center LET study C. Reft 1, H. Ramirez 2 and M. Pankuch 2 1 University of Chicago, 2 CDH Proton Center

Purpose 1. Investigate the possibility of using two peak analysis in TLDs to measure LET of a proton beam 2. Use two peak analysis in TLDs to measure the spatial variation of LET in the SOBP of a clinical proton beam 3. Use two peak analysis in TLDs to measure the LET in the distal dose fall-off region in a clinical proton beam

Bragg Peak

Proton Therapy Advantages: Conformal dose distribution dose escalation Significantly lower integral dose

Proton Therapy Concerns: Out-of field dose mostly from neutrons Typically with field size In field dose patient dose (neutrons) proton energy and field size Variation of LET along the length of the proton beam

Why determine low and high LET components? LET related to RBE

) Biological damages depends on: 1.Absorbed dose 2.Spatial distribution of absorbed dose 3.Relative biological effectiveness (RBE)

Proton therapy uses a generic, spatially invariant RBE = 1.1 Evidence that RBE increases with LET The LET may vary in different portions of the SOBP

= Relative Biological Effectiveness (RBE) RBE Dose of std rad (250 kvp x-rays) to produce Biol Eff Dose of test rad to produce the same Biol Eff

Hi LET particle

v e n t s c o i n c i d e s w i t h t h e d i a m e t e r o f t h e D N A d o u b l e h e l i x ( i. e., a b o u t 2 0 o r 2 n m ). R a d i a t i o n o f t h i s q u a l i t y i s Diagram illustrating why radiation with a LET of 100 kev/μm has the greatest RBE for cell killing, mutagenesis, or oncogenic transformation. For this LET, the average separation between ionizing events coincides with the diameter of the DNA double helix (i.e., about 20A or 2 nm). Radiation of this quality is most likely to produce a double-strand break from one track for a given absorbed dose

Examples of radiation and their LET Particle Effective Energy (MeV) LET KeV/μ Photon 0.025 6 Photon 0.057 1.6 Photon 0.075 1.8 Photon 1.25 (Co-60) 0.25 Photon 2.0 0.30 Photon 6.0 0.30 Electron 12.0 0.40 Proton 10.0 4.7 Proton 150 0.5 Neutron 1.0 80 Neutron 14 40 Alpha 2.5 166 Heavy nuclei Various energies 200-1000

TLD 700 glow curve after 0.10 Gy from 6 MV without the 80 0 C anneal following the 400 0 C anneal

Glow curve for TLD700 irradiated With low LET radiation

P 1 P 2 Glow curve for TLD700 irradiated in a clinical proton beam showing Peak 1 and Peak 2

High Temperature Ratio = HTR = Area under P2/Area under P1 = P2/P1

P 1 P 2 Glow curve for TLD 700 irradiated in a clinical proton beam

Charge (nc) TLD700 dose response of peaks P 1 and P 2 illustrating the sensitivity differences between the two peaks. P 2 exhibits supralinearity above 30 cgy. 180 160 140 120 P1(~190 C) P2(~260 C)x10 P2/P1x1000 Linear (P1(~190 C)) Poly. (P2(~260 C)x10) y = 1.5517x - 0.4745 R² = 0.9998 100 80 60 y = 0.002x 2 + 0.4016x + 0.1557 R² = 0.9996 40 20 0 0 20 40 60 80 100 120 Dose (cgy)

Critical requirement: Relate HTR (P2/P1) to LET

TLDs TLDs TLDs TLDs TLDs TLDs TLDs Schematic diagram of the wax phantom showing the location of the TLDs for measurements in the dose fall-off region of the distal SOBP

Location of TLDs in the wax phantom at the various depths in the dose fall-off region of the distal SOBP

Sealed wax phantom containing TLDs used in obtaining the LET from TLD measurements of P2/P1 in the dose fall-off region of the distal SOBP

Spatial variation of LET values obtained from TLD measurements in the SOBP z HTR LET Dose cm (P2/P1) P 6MV KeV/µ cgy 19 1.25 ± 0.019.74 ±.07 22.4 ±.7 10 1.46 ± 0.021 1.11 ±.10 28.4 ±.9 4 1.51 ± 0.021 1.22 ±.11 29.4 ± 1.0 2 1.65 ± 0.04 1.60 ±.14 29.7 ± 1.0 z is the distance from the Bragg peak Proton range: 20 cm Modulation: 12

Summary of the LET values obtained from TLD measurements in the dose fall-off region of the distal SOBP WET cm PDD HTR (P2/P1) p 6MV LET KeV/µ 3.0 Center of SOBP 1.62 ±.04 1.51 ±.12 5.9 100 2.44 ±.03 5.26 ±.19 6.1 90 2.73 ± 0.04 7.26 ±.30 6.2 80 3.00 ± 0.05 9.44 ±.41 6.3 50 3.34 ± 0.07 12.6 ±.70 6.5 20 3.69 ± 0.11 16.4 ± 1.2 Proton range : 6.1 cm SOBP width: 6.0 cm Modulation: 6 cm

Variation of LET in the SOBP at distances from the distal R 90 (cm) from measurements of P2/P1 in irradiated TLD700 Distance from R 90 (cm) LET (KeV/µ) -19 0.74-10 1.11-6 1.20-3 1.51-2 1.60-0.3 5.26 0 7.26 0.1 9.44 0.2 12.6 0.4 16.4

Plot of P1/P2 P2/P1 varies from 1.01 LET varies from 2 8Kev/µ

Conclusions: 1. Two peak analysis of TLD 700 glow curve provides information on proton LET due to the increased sensitivity of P2 in TLD700 to LET radiation 2. A calibration curve relating (P2/P1) ratios to LETs is required to extract proton LETs 3. The spatial variation of LET in the SOBP and in the distal dose fall-off region was obtained from measurements of P2/P1 in irradiated TLD700 4. Since radiation LET is related to RBE, LET values obtained from P2/P1 measurements in irradiated TLD700 can provide radiobiological information for proton beams

Thank you for your attention Questions???