In vivo range verification in particle therapy.

Area of Science:

• Medical Physics
• Radiation Oncology
• Radiotherapy Physics

Background:

• Ion beam therapy offers precise dose deposition but faces uncertainties in Bragg peak localization.
• Accurate targeting of the Bragg peak within tumors is crucial for maximizing therapeutic efficacy and minimizing off-target toxicity.
• Current limitations in verifying beam range and dose delivery hinder the full clinical potential of ion therapy.

Purpose of the Study:

• To critically review current and emerging methods for verifying ion therapy treatments.
• To assess the applicability of different verification techniques across various anatomical locations.
• To discuss future directions for enhancing ion therapy precision and enabling biologically adapted treatments.

Main Methods:

• Review of pretreatment methods for characterizing patient position, anatomy, and tissue properties.
• Analysis of in vivo verification techniques, including secondary emission detection and physiological change monitoring.
• Evaluation of methods for real-time or near real-time assessment of beam range and dose delivery.

Main Results:

• Several promising methods are under development or clinical testing for ion therapy verification.
• Pretreatment characterization and in vivo monitoring show potential for improving range accuracy.
• Detection of secondary particles and physiological responses offers avenues for real-time feedback.

Conclusions:

• Integration of multiple verification modalities is a key future direction.
• Novel exploitation of measurable signals can lead to biologically adapted ion therapy.
• Continued research is essential to overcome uncertainties and optimize ion beam treatments.