• Nuclear Engineering and Technology
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• v.54 no.8
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• pp.3006-3016
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• 2022

In this study, the images of specific prompt gamma (PG)-rays of 719 keV emitted from proton-boron reactions were analyzed using single-photon emission computed tomography (SPECT). Quantitative evaluation of the images verified the detection of anatomical changes in tumors, one of the important factors in daily adaptive proton therapy (DAPT) and verified the possibility of application of the PG-ray images to DAPT. Six scenarios were considered based on various sizes and locations compared to the reference virtual tumor to observe the anatomical alterations in the virtual tumor. Subsequently, PG-rays SPECT images were acquired using the modified ordered subset expectation-maximization algorithm, and these were evaluated using quantitative analysis methods. The results confirmed that the pixel range and location of the highest value of the normalized pixel in the PG-rays SPECT image profile changed according to the size and location of the virtual tumor. Moreover, the alterations in the virtual tumor size and location in the PG-rays SPECT images were similar to the true size and location alterations set in the phantom. Based on the above results, the tumor anatomical alterations in DAPT could be adequately detected and verified through SPECT imaging using the 719 keV PG-rays acquired during treatment.

• Progress in Medical Physics
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• v.23 no.3
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• pp.162-168
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• 2012

In proton therapy, in vivo dose verification is one of the most important parts to fully utilize characteristics of proton dose distribution concentrating high dose with steep gradient and guarantee the patient safety. Currently, in order to image the proton dose distribution, a prompt gamma distribution detection system, which consists of an array of multiple CsI(Tl) scintillation detectors in the vertical direction, a collimator, and a multi-channel DAQ system is under development. In the present study, the optimal design of prompt gamma distribution detection system was studied by Monte Carlo simulations using the MCNPX code. For effective measurement of high-energy prompt gammas with enough imaging resolution, the dimensions of the CsI(Tl) scintillator was determined to be $6{\times}6{\times}50mm^3$. In order to maximize the detection efficiency for prompt gammas while minimizing the contribution of background gammas generated by neutron captures, the hole size and the length of the collimator were optimized as $6{\times}6mm^2$ and 150 mm, respectively. Finally, the performance of the detection system optimized in the present study was predicted by Monte Carlo simulations for a 150 MeV proton beam. Our result shows that the detection system in the optimal dimensions can effectively measure the 2D prompt gamma distribution and determine the beam range within 1 mm errors for 150 MeV proton beam.

• Journal of Radiation Protection and Research
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• v.39 no.2
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• pp.81-88
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• 2014

Recently, a new imaging method, gamma vertex imaging (GVI), was proposed for the verification of in-vivo proton dose distribution. In GVI, the vertices of prompt gammas generated by proton induced nuclear interaction were determined by tracking the Compton-recoiled electrons. The GVI system is composed of a beryllium electron converter for converting gamma to electron, two double-sided silicon strip detectors (DSSDs) for the electron tracking, and a scintillation detector for the energy determination of the electron. In the present study, the modules of a charge sensitive preamplifier (CSP) and a shaping amplifier for the analog signal processing of DSSD were developed and the performances were evaluated by comparing the energy resolutions with those of the commercial products. Based on the results, it was confirmed that the energy resolution of the developed CSP module was a little lower than that of the CR-113 (Cremat, Inc., MA), and the resolution of the shaping amplifier was similar to that of the CR-200 (Cremat, Inc., MA). The value of $V_{rms}$ representing the magnitude of noise of the developed system was estimated as 6.48 keV and it was confirmed that the trajectory of the electron can be measured by the developed system considering the minimum energy deposition ( > ~51 keV) of Compton-recoiled electron in 145-${\mu}m$-thick DSSD.

• Nuclear Engineering and Technology
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• v.51 no.2
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• pp.533-538
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• 2019

The mechanical-collimation imaging is the most mature technology in prompt gamma (PG) imaging which is considered the most promising technology for beam range verification in proton therapy. The purpose of the present study is to compare the performances of two mechanical-collimation PG cameras, knife-edge (KE) camera and multi-slit (MS) camera. For this, the PG cameras were modeled by Geant4 Monte Carlo code, and the performances of the cameras were compared for imaginary point and line sources and for proton beams incident on a cylindrical PMMA phantom. From the simulation results, the KE camera was found to show higher counting efficiency than the MS camera, being able to estimate the beam range even for $10^7$ protons. Our results, however, confirmed that in order to estimate the beam range correctly, the KE camera should be aligned, at least approximately, to the location of the proton beam range. The MS camera was found to show lower efficiency, being able to estimate the beam range correctly only when the number of the protons is at least $10^8$. For enough number of protons, however, the MS camera estimated the beam range correctly, errors being less than 1.2 mm, regardless of the location of the camera.

• Journal of Korean Neurosurgical Society
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• v.57 no.2
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• pp.127-130
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• 2015

A 59-year-old female presented with progressive right proptosis, chemosis and ocular pain. An imaging work-up including conventional catheter angiography showed a right-sided dural arteriovenous fistula of the cavernous sinus, which drained into the right superior petrosal sinus, right superior ophthalmic vein, and right inferior ophthalmic vein, and cortical venous reflux was seen via the right petrosal vein in the right posterior fossa. After failure of transvenous embolization, the patient underwent Gamma Knife radiosurgery (GKRS). At one month after GKRS, she developed increasing ocular pain and occipital headache. Repeat angiography showed partial obliteration of the fistula and loss of drainage via the superior and inferior ophthalmic veins with severe congestion, resulting in slow flow around the right cerebellar hemisphere. Prompt transarterial embolization relieved the patient's ocular symptoms and headache. We report on a case of paradoxical exacerbation of symptoms resulting from obstruction of the venous outflow after GKRS for treatment of a dural arteriovenous fistula of the cavernous sinus.

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.667-675
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• 2017

Objective : Total resection without consecutive postoperative whole brain radiation therapy is indicated for patients with a single or two sites of brain metastasis, with close follow-up by serial magnetic resonance imaging (MRI). In this study, we explored the effectiveness, usefulness, and safety of this follow-up regimen. Methods : From January 2006 to December 2015, a total of 109 patients (76 males, 33 females) underwent tumor resection as the first treatment for brain metastases (97 patients with single metastases, 12 with two metastases). The mean age was 59.8 years (range 27-80). The location of the 121 tumors in the 109 patients was supratentorial (n=98) and in the cerebellum (n=23). The origin of the primary cancers was lung (n=45), breast (n=17), gastrointestinal tract (n=18), hepatobiliary system (n=8), kidney (n=7), others (n=11), and unknown origin (n=3). The 121 tumors were totally resected. Follow-up involved regular clinical and MRI assessments. Recurrence-free survival (RFS) and overall survival (OS) after tumor resection were analyzed by Kaplan-Meier methods based on clinical prognostic factors. Results : During the follow-up, MRI scans were done for 85 patients (78%) with 97 tumors. Fifty-six of the 97 tumors showed no recurrence without adjuvant local treatment, representing a numerical tumor recurrence-free rate of 57.7%. Mean and median RFS was 13.6 and 5.3 months, respectively. Kaplan-Meier analysis revealed the cerebellar location of the tumor as the only statistically significant prognostic factor related to RFS (p=0.020). Mean and median OS was 15.2 and 8.1 months, respectively. There were no significant prognostic factors related to OS. The survival rate at one year was 8.2% (9 of 109). Conclusion : With close and regular clinical and image follow-up, initial postoperative observation without prompt postoperative radiation therapy can be applied in patients of brain metastasi(e)s when both the tumor(s) are completely resected.

• Nuclear Engineering and Technology
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• v.55 no.6
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• pp.2018-2025
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• 2023

In our previous study, we proposed an integrated PG-PET-based imaging method to increase the prediction accuracy for patient dose distributions. The purpose of the present study is to experimentally validate the feasibility of the PG-PET system. Based on the detector geometry optimized in the previous study, we constructed a dual-head PG-PET system consisting of a 16 × 16 GAGG scintillator and KETEK SiPM arrays, BaSO₄ reflectors, and an 8 × 8 parallel-hole tungsten collimator. The performance of this system as equipped with a proof of principle, we measured the PG and positron emission (PE) distributions from a 3 × 6 × 10 cm³ PMMA phantom for a 45 MeV proton beam. The measured depth was about 17 mm and the expected depth was 16 mm in the computation simulation under the same conditions as the measurements. In the comparison result, we can find a 1 mm difference between computation simulation and measurement. In this study, our results show the feasibility of the PG-PET system for in-vivo range verification. However, further study should be followed with the consideration of the typical measurement conditions in the clinic application.