Pitfalls of tungsten multileaf collimator in proton beam therapy

Vadim Moskvin, Chee Wai Cheng, Indra J. Das

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: Particle beam therapy is associated with significant startup and operational cost. Multileaf collimator (MLC) provides an attractive option to improve the efficiency and reduce the treatment cost. A direct transfer of the MLC technology from external beam radiation therapy is intuitively straightforward to proton therapy. However, activation, neutron production, and the associated secondary cancer risk in proton beam should be an important consideration which is evaluated. Methods: Monte Carlo simulation with FLUKA particle transport code was applied in this study for a number of treatment models. The authors have performed a detailed study of the neutron generation, ambient dose equivalent H(10), and activation of a typical tungsten MLC and compared with those obtained from a brass aperture used in a typical proton therapy system. Brass aperture and tungsten MLC were modeled by absorber blocks in this study, representing worst-case scenario of a fully closed collimator. Results: With a tungsten MLC, the secondary neutron dose to the patient is at least 1.5 times higher than that from a brass aperture. The H(10) from a tungsten MLC at 10 cm downstream is about 22.3 mSv/Gy delivered to water phantom by noncollimated 200 MeV beam of 20 cm diameter compared to 14 mSv/Gy for the brass aperture. For a 30-fraction treatment course, the activity per unit volume in brass aperture reaches 5.3 10 4 Bq cm -3 at the end of the last treatment. The activity in brass decreases by a factor of 380 after 24 h, additional 6.2 times after 40 days of cooling, and is reduced to background level after 1 yr. Initial activity in tungsten after 30 days of treating 30 patients per day is about 3.4 times higher than in brass that decreases only by a factor of 2 after 40 days and accumulates to 1.2 10 6 Bq cm -3 after a full year of operation. The daily utilization of the MLC leads to buildup of activity with time. The overall activity continues to increase due to 179Ta with a half-life of 1.82 yr and thus require prolonged storage for activity cooling. The H(10) near the patient side of the tungsten block is about 100 Sv/h and is 27 times higher at the upstream side of the block. This would lead to an accumulated dose for therapists in a year that may exceed occupational maximum permissible dose (50 mSv/yr). The value of H(10) at the upstream surface of the tungsten block is about 220 times higher than that of the brass. Conclusions: MLC is an efficient way for beam shaping and overall cost reduction device in proton therapy. However, based on this study, tungsten seems to be not an optimal material for MLC in proton beam therapy. Usage of tungsten MLC in clinic may create unnecessary risks associated with the secondary neutrons and induced radioactivity for patients and staff depending on the patient load. A careful selection of material for manufacturing of an optimal MLC for proton therapy is thus desired.

Original languageEnglish
Pages (from-to)6395-6406
Number of pages12
JournalMedical Physics
Volume38
Issue number12
DOIs
StatePublished - Dec 2011

Fingerprint

Proton Therapy
Tungsten
Neutrons
Costs and Cost Analysis
Monte Carlo Method
brass
Therapeutics
Health Care Costs
Radioactivity
Half-Life
Protons
Radiotherapy
Technology
Equipment and Supplies

Keywords

  • induced radioactivity
  • Monte Carlo
  • multileaf collimator
  • neutrons
  • proton beam

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging

Cite this

Pitfalls of tungsten multileaf collimator in proton beam therapy. / Moskvin, Vadim; Cheng, Chee Wai; Das, Indra J.

In: Medical Physics, Vol. 38, No. 12, 12.2011, p. 6395-6406.

Research output: Contribution to journalArticle

Moskvin, V, Cheng, CW & Das, IJ 2011, 'Pitfalls of tungsten multileaf collimator in proton beam therapy', Medical Physics, vol. 38, no. 12, pp. 6395-6406. https://doi.org/10.1118/1.3658655
Moskvin, Vadim ; Cheng, Chee Wai ; Das, Indra J. / Pitfalls of tungsten multileaf collimator in proton beam therapy. In: Medical Physics. 2011 ; Vol. 38, No. 12. pp. 6395-6406.
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N2 - Purpose: Particle beam therapy is associated with significant startup and operational cost. Multileaf collimator (MLC) provides an attractive option to improve the efficiency and reduce the treatment cost. A direct transfer of the MLC technology from external beam radiation therapy is intuitively straightforward to proton therapy. However, activation, neutron production, and the associated secondary cancer risk in proton beam should be an important consideration which is evaluated. Methods: Monte Carlo simulation with FLUKA particle transport code was applied in this study for a number of treatment models. The authors have performed a detailed study of the neutron generation, ambient dose equivalent H(10), and activation of a typical tungsten MLC and compared with those obtained from a brass aperture used in a typical proton therapy system. Brass aperture and tungsten MLC were modeled by absorber blocks in this study, representing worst-case scenario of a fully closed collimator. Results: With a tungsten MLC, the secondary neutron dose to the patient is at least 1.5 times higher than that from a brass aperture. The H(10) from a tungsten MLC at 10 cm downstream is about 22.3 mSv/Gy delivered to water phantom by noncollimated 200 MeV beam of 20 cm diameter compared to 14 mSv/Gy for the brass aperture. For a 30-fraction treatment course, the activity per unit volume in brass aperture reaches 5.3 10 4 Bq cm -3 at the end of the last treatment. The activity in brass decreases by a factor of 380 after 24 h, additional 6.2 times after 40 days of cooling, and is reduced to background level after 1 yr. Initial activity in tungsten after 30 days of treating 30 patients per day is about 3.4 times higher than in brass that decreases only by a factor of 2 after 40 days and accumulates to 1.2 10 6 Bq cm -3 after a full year of operation. The daily utilization of the MLC leads to buildup of activity with time. The overall activity continues to increase due to 179Ta with a half-life of 1.82 yr and thus require prolonged storage for activity cooling. The H(10) near the patient side of the tungsten block is about 100 Sv/h and is 27 times higher at the upstream side of the block. This would lead to an accumulated dose for therapists in a year that may exceed occupational maximum permissible dose (50 mSv/yr). The value of H(10) at the upstream surface of the tungsten block is about 220 times higher than that of the brass. Conclusions: MLC is an efficient way for beam shaping and overall cost reduction device in proton therapy. However, based on this study, tungsten seems to be not an optimal material for MLC in proton beam therapy. Usage of tungsten MLC in clinic may create unnecessary risks associated with the secondary neutrons and induced radioactivity for patients and staff depending on the patient load. A careful selection of material for manufacturing of an optimal MLC for proton therapy is thus desired.

AB - Purpose: Particle beam therapy is associated with significant startup and operational cost. Multileaf collimator (MLC) provides an attractive option to improve the efficiency and reduce the treatment cost. A direct transfer of the MLC technology from external beam radiation therapy is intuitively straightforward to proton therapy. However, activation, neutron production, and the associated secondary cancer risk in proton beam should be an important consideration which is evaluated. Methods: Monte Carlo simulation with FLUKA particle transport code was applied in this study for a number of treatment models. The authors have performed a detailed study of the neutron generation, ambient dose equivalent H(10), and activation of a typical tungsten MLC and compared with those obtained from a brass aperture used in a typical proton therapy system. Brass aperture and tungsten MLC were modeled by absorber blocks in this study, representing worst-case scenario of a fully closed collimator. Results: With a tungsten MLC, the secondary neutron dose to the patient is at least 1.5 times higher than that from a brass aperture. The H(10) from a tungsten MLC at 10 cm downstream is about 22.3 mSv/Gy delivered to water phantom by noncollimated 200 MeV beam of 20 cm diameter compared to 14 mSv/Gy for the brass aperture. For a 30-fraction treatment course, the activity per unit volume in brass aperture reaches 5.3 10 4 Bq cm -3 at the end of the last treatment. The activity in brass decreases by a factor of 380 after 24 h, additional 6.2 times after 40 days of cooling, and is reduced to background level after 1 yr. Initial activity in tungsten after 30 days of treating 30 patients per day is about 3.4 times higher than in brass that decreases only by a factor of 2 after 40 days and accumulates to 1.2 10 6 Bq cm -3 after a full year of operation. The daily utilization of the MLC leads to buildup of activity with time. The overall activity continues to increase due to 179Ta with a half-life of 1.82 yr and thus require prolonged storage for activity cooling. The H(10) near the patient side of the tungsten block is about 100 Sv/h and is 27 times higher at the upstream side of the block. This would lead to an accumulated dose for therapists in a year that may exceed occupational maximum permissible dose (50 mSv/yr). The value of H(10) at the upstream surface of the tungsten block is about 220 times higher than that of the brass. Conclusions: MLC is an efficient way for beam shaping and overall cost reduction device in proton therapy. However, based on this study, tungsten seems to be not an optimal material for MLC in proton beam therapy. Usage of tungsten MLC in clinic may create unnecessary risks associated with the secondary neutrons and induced radioactivity for patients and staff depending on the patient load. A careful selection of material for manufacturing of an optimal MLC for proton therapy is thus desired.

KW - induced radioactivity

KW - Monte Carlo

KW - multileaf collimator

KW - neutrons

KW - proton beam

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