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FLASH radiotherapy and the associated dosimetric challenges

Ceberg, S. LU ; Mannerberg, A. LU ; Konradsson, E. LU ; Blomstedt, M. ; Kügele, M. LU orcid ; Kadhim, M. LU ; Edvardsson, A. LU ; Bäck, S. Å.J. LU ; Petersson, K. LU and Jamtheim Gustafsson, C. LU , et al. (2023) 12th International Conference on 3D and Advanced Dosimetry, IC3DDose 2022 2630.
Abstract

At Lund University and Skåne University Hospital in Lund, Sweden, we have, as the first clinic, modified a clinical Elekta Precise linear accelerator for convertible delivery of ultrahigh dose rate (FLASH) irradiation. Whereas recently published reviews highlighted the need for standardised protocols for ultra-high dose rate beam dosimetry to be able to determine the true potential of FLASH irradiation, several dosimetry studies as well as in-vitro and in-vivo experiments have been carried out at our unit. Dosimetric procedures for verification of accurate dose delivery of FLASH irradiation to cell cultures, zebrafish embryos and small animals have been established using radiochromic films and thermo-luminescent dosimeters. Also,... (More)

At Lund University and Skåne University Hospital in Lund, Sweden, we have, as the first clinic, modified a clinical Elekta Precise linear accelerator for convertible delivery of ultrahigh dose rate (FLASH) irradiation. Whereas recently published reviews highlighted the need for standardised protocols for ultra-high dose rate beam dosimetry to be able to determine the true potential of FLASH irradiation, several dosimetry studies as well as in-vitro and in-vivo experiments have been carried out at our unit. Dosimetric procedures for verification of accurate dose delivery of FLASH irradiation to cell cultures, zebrafish embryos and small animals have been established using radiochromic films and thermo-luminescent dosimeters. Also, recently the first experience of electron FLASH radiotherapy (FLASH-RT) in canine patients in our clinical setting was published. Our research facilities also include a laboratory for 3D polymer gel manufacturing. Recently, we started investigating the feasibility of a NIPAM polymer gel dosimeter for ultra-high dose rate dosimetry. Furthermore, in the bunker of the modified Elekta linear accelerator, a Surface Guided Radiotherapy (SGRT) system is accessible. The CatalystTM system (C-Rad Positioning, Uppsala, Sweden) provides optical surface imaging for patient setup, real-time motion monitoring and breathing adapted treatment. Aiming at treating patients using ultra-high dose rates, a real-time validation of the alignment between the beam and the target is crucial as the dose is delivered in a fraction of a second. Our research group has during the last decade investigated and developed SGRT workflows which improved patient setup and breathing adapted treatment for several cancer patient groups. Recently, we also started investigating the feasibility of a real-time motion monitoring system for surface guided FLASH-RT. Both FLASH related studies; 3D polymer gel dosimetry and surface guided FLASH-RT are to our knowledge the first of their kind. Following an introduction to the field of FLASH and the associated dosimetric challenges, we here aim to present the two ongoing studies including some preliminary results.

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organization
publishing date
type
Chapter in Book/Report/Conference proceeding
publication status
published
subject
host publication
Journal of Physics: Conference Series
volume
2630
article number
012010
conference name
12th International Conference on 3D and Advanced Dosimetry, IC3DDose 2022
conference location
Quebec City, Canada
conference dates
2022-07-19 - 2022-07-22
external identifiers
  • scopus:85189359609
DOI
10.1088/1742-6596/2630/1/012010
language
English
LU publication?
yes
id
3e33af93-9556-4ccb-9544-e547d6036052
date added to LUP
2024-04-22 14:18:36
date last changed
2024-04-22 14:19:38
@inproceedings{3e33af93-9556-4ccb-9544-e547d6036052,
  abstract     = {{<p>At Lund University and Skåne University Hospital in Lund, Sweden, we have, as the first clinic, modified a clinical Elekta Precise linear accelerator for convertible delivery of ultrahigh dose rate (FLASH) irradiation. Whereas recently published reviews highlighted the need for standardised protocols for ultra-high dose rate beam dosimetry to be able to determine the true potential of FLASH irradiation, several dosimetry studies as well as in-vitro and in-vivo experiments have been carried out at our unit. Dosimetric procedures for verification of accurate dose delivery of FLASH irradiation to cell cultures, zebrafish embryos and small animals have been established using radiochromic films and thermo-luminescent dosimeters. Also, recently the first experience of electron FLASH radiotherapy (FLASH-RT) in canine patients in our clinical setting was published. Our research facilities also include a laboratory for 3D polymer gel manufacturing. Recently, we started investigating the feasibility of a NIPAM polymer gel dosimeter for ultra-high dose rate dosimetry. Furthermore, in the bunker of the modified Elekta linear accelerator, a Surface Guided Radiotherapy (SGRT) system is accessible. The Catalyst<sup>TM</sup> system (C-Rad Positioning, Uppsala, Sweden) provides optical surface imaging for patient setup, real-time motion monitoring and breathing adapted treatment. Aiming at treating patients using ultra-high dose rates, a real-time validation of the alignment between the beam and the target is crucial as the dose is delivered in a fraction of a second. Our research group has during the last decade investigated and developed SGRT workflows which improved patient setup and breathing adapted treatment for several cancer patient groups. Recently, we also started investigating the feasibility of a real-time motion monitoring system for surface guided FLASH-RT. Both FLASH related studies; 3D polymer gel dosimetry and surface guided FLASH-RT are to our knowledge the first of their kind. Following an introduction to the field of FLASH and the associated dosimetric challenges, we here aim to present the two ongoing studies including some preliminary results.</p>}},
  author       = {{Ceberg, S. and Mannerberg, A. and Konradsson, E. and Blomstedt, M. and Kügele, M. and Kadhim, M. and Edvardsson, A. and Bäck, S. Å.J. and Petersson, K. and Jamtheim Gustafsson, C. and Ceberg, C.}},
  booktitle    = {{Journal of Physics: Conference Series}},
  language     = {{eng}},
  title        = {{FLASH radiotherapy and the associated dosimetric challenges}},
  url          = {{http://dx.doi.org/10.1088/1742-6596/2630/1/012010}},
  doi          = {{10.1088/1742-6596/2630/1/012010}},
  volume       = {{2630}},
  year         = {{2023}},
}