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• W2092111446 abstract "Proton therapy is promising and sophisticated treatment modalities against prostate cancer and other malignancies. The proton-irradiated area can be confirmed by coincidence detection of pair annihilation gamma rays from positron emitting isotopes generated by nuclear reaction of irradiated proton nuclei and nuclei in the irradiation target, called autoactivation. In Hyogo Ion Beam Medical Center, the confirmation of the proton-irradiated area using a clinical PET apparatus has been performed in all patients treated with proton therapy, and several noteworthy findings are detected. Thus, the purposes of this study are to investigate which positron emitting isotopes are detected in our clinical settings, and to evaluate whether anatomical or physiological factors affected or not in patients with prostate cancer treated with proton therapy. Autoactivation data were evaluated in thirty patients treated with 210 MeV proton beam to a fraction dose of 2 Gy equivalent (GyE). Those patients were received totally 74 GyE. Doses were calculated on the basis of the pencil beam algorithm. Beam parameters including width of spread-out Bragg peak (SOBP) and degrader thickness were adequately selected with 3D treatment-planning system (FOCUS-M, CMS Japan Co., Tokyo and Mitsubishi Electric Co., Kobe). Surrounding critical structures, including the rectum, bladder and femoral heads, were also delineated on each CT slice to generate dose-volume histograms (DVHs). Calculation of radioactivity induced by the autoactivation started at 5 min after proton irradiation for 10 min by using a PET apparatus (HEADTOME V SET-2300W, Shimadzu Co., Kyoto) and a vendor-provided software for interpreting image data. Regions of interest were set in following 5 portions; PTV center, urinary bladder within PTV, urinary bladder outside PTV, rectum (outside PTV), and contra-lateral femoral head (outside PTV). Experimentaly, 6 GyE of proton beam was irradiated to following materials containing certain percentage of several target nuclei for positron emitting: Tough water phantom (12C, 16O), charcoal (12C), blood sample (12C, 16O). Diffusion effect of water in the autoactivation was compared to that of ice-block (20 cm × 20 cm × 20 cm) both with setting a 6 cm width of SOBP. Isodose curve (95%) and distribution of the autoactivation were well-matched in terms of beam range in axial image of PTV center level in all patients. However, in sagital and coronal image, and axial image of bladder level, the autoactivation spread out of 95% of the isodose curve. Mean calculated radioactivities in those 30 patients with prostate cancer were 39 Bq in PTV center, 36 Bq in urinary bladder within PTV, 19 Bq in urinary bladder outside PTV, 4 in rectum (outside PTV), and 2 in contra-lateral femoral head, respectively. From this result, urine in the urinary bladder seemed to be a major diffusion mediator of autoactivation after the proton irradiation. In our experimental setting and time point, the major component detected as a positron emitting isotopes by the PET apparatus was defined as 15O, not only 11C. Imaging of the autoactivation has an impact to confirm a proton beam in patients with prostate cancer. However, physiological factors, especially urine in the urinary bladder, need to be taken into account for the comparison to the dose distribution in the future." @default.
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• W2092111446 date "2007-11-01" @default.
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• W2092111446 title "Confirmation of Proton Beam by Positron Emission Tomography (PET) Apparatus in Patients With Prostate Cancer" @default.
• W2092111446 doi "https://doi.org/10.1016/j.ijrobp.2007.07.1447" @default.
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