A point dose method for in vivo range verification in proton therapy

Range uncertainty in proton therapy is a recognized concern. For certain treatment sites, less optimal beam directions are used to avoid the potential risk, but also with reduced benefit. In vivo dosimetry, with implanted or intra-cavity dosimeters, has been widely used for treatment verification in photon/electron therapy. The method cannot, however, verify the beam range for proton treatment, unless we deliver the treatment in a different manner. Specifically, we split the spread-out Bragg peaks in a proton field into two separate fields, each delivering a 'sloped' depth-dose distribution, rather than the usual plateau in a typical proton field. The two fields are 'sloped' in opposite directions so that the total depth-dose distribution retains the constant dose plateau covering the target volume. By measuring the doses received from both fields and calculating the ratio, the water-equivalent path length to the location of the implanted dosimeter can be verified, thus limiting range uncertainty to only the remaining part of the beam path. Production of such subfields has been experimented with a passive scattering beam delivery system. Phantom measurements have been performed to illustrate the application for in vivo beam range verification.