Monitoring proton therapy with PET

Protons are being used in radiation therapy because of typically better dose conformity and reduced total energy deposited in the patient as compared with photon techniques. Both aspects are related to the finite range of a proton beam. The finite range also allows advanced dose shaping. These benefits can only be fully utilized if the end of range can be predicted accurately in the patient. The prediction of the range in tissue is associated with considerable uncertainties owing to imaging, patient set-up, beam delivery, interfractional changes in patient anatomy and dose calculation. Consequently, a significant range (of the order of several millimetres) is added to the prescribed range in order to ensure tumour coverage. Thus, reducing range uncertainties would allow a reduction of the treatment volume and reduce dose to potential organs at risk.