Dosimetric evaluation of hybrid brass/stainless-steel apertures for proton therapy

In passive scattering proton therapy, patient specific collimators (apertures) are used to laterally shape the proton beam, and compensators are employed to distally conform proton dose to the target. Brass is a commonly used material for apertures and recently a hybrid brass/stainless-steel (BR/SST) aperture design has been introduced to reduce treatment cost without clinical flow change. We measured stopping power and leakage dose for apertures made of stainless steel and brass in the Proton Therapy system. The linear stopping power ratios for stainless steel (type 304) and brass to water were calculated to be 5.46 and 5.51, respectively. Measured stopping power ratios of SST and BR were 5.51  ±  0.04 and 5.56  ±  0.08, respectively, which agrees with the calculated values within 1%. Leakage dose on the downstream surface of two slabs of Ø18 cm stainless steel apertures (total thickness of 6.5 cm) for the maximum available proton energy (235 MeV) was 1.283% ± 0.004% of the prescription dose, and was smaller compared to the 1.358% ± 0.005% leakage dose measured for existing brass apertures of identical physical dimensions. Therefore, the existing beam range limits for brass aperture slabs used at our institution with safety margin allowances for material composition and delivered beam range uncertainties can be safely applied for the new BR/SST aperture design. Potential range differences in the brass and stainless steel interface regions of the hybrid design were further investigated using EBT3 GafChromic film. Film dosimetry revealed no discernible range variations across the brass and stainless steel interface regions. Neutron dose to the patient from brass and stainless steel apertures was simulated using the Monte Carlo method. The results indicate that stainless steel produces similar patient neutron dose compared to brass. Material activation dose rates of stainless steel were measured over a period of 7 d after irradiation. The measurements showed that the proton induced SST activity is initially lower and also decays at a faster rate than that induced in brass, therefore requires no changes in radiation protection requirements on material disposals. The Monte Carlo simulation confirmed higher initial activity of brass than stainless steel shortly after irradiation. The hybrid BR/SST aperture design is suitable for clinical use to replace the current brass apertures for all clinically used proton ranges. The existing aperture disposal procedures also satisfy radiation protection requirements for the new hybrid type apertures.