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A framework for defining FLASH dose rate for pencil beam scanning.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiotherapy Physics

Background:

  • Pencil beam scanning (PBS) proton therapy delivers radiation with unique spatiotemporal patterns.
  • FLASH radiotherapy, a rapid form of radiation delivery, presents challenges in dose rate characterization.
  • Standardized dose rate reporting is crucial for comparing different radiotherapy modalities.

Purpose of the Study:

  • To develop a method for calculating voxel-specific dose rates in PBS proton fields.
  • To establish a representative dose rate for PBS treatment fields for inter-modality comparison.
  • To incorporate the distinct delivery characteristics of PBS FLASH radiotherapy into dose rate calculations.

Main Methods:

  • Calculated voxel dose rate as the quotient of dose and effective irradiation time, defined by a dose threshold.
  • Proposed a user-selectable p-th percentile of the dose rate distribution as a representative field dose rate.
  • Modeled 2D and 3D FLASH transmission fields using 250 MeV protons and analyzed a clinical PBS field.

Main Results:

  • Voxel dose accumulation time was a fraction of the total field delivery time.
  • Spatial dose and dose rate distributions varied significantly within the field.
  • For a 10 Gy prescription, 95% of the volume received >40 Gy/s within the first 10 cm depth.

Conclusions:

  • A novel method for calculating and reporting PBS proton treatment dose rates has been developed.
  • The proposed method accounts for the spatiotemporal dynamics of PBS FLASH.
  • Standardized dose rate reporting will facilitate research and clinical adoption of PBS FLASH radiotherapy.