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Cho J 1 , Ibbott G 1 , Gillin M 1 , Gonzalez- Lepera C 2 , Titt U 1 , and Mawlawi O 3 .

Proton beam range verification using proton activated fiducials and off-site PET AAPM Best in Physics, Indianapolis, August 7, 2013. Cho J 1 , Ibbott G 1 , Gillin M 1 , Gonzalez- Lepera C 2 , Titt U 1 , and Mawlawi O 3 .

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Cho J 1 , Ibbott G 1 , Gillin M 1 , Gonzalez- Lepera C 2 , Titt U 1 , and Mawlawi O 3 .

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  1. Proton beam range verification using proton activated fiducials and off-site PETAAPM Best in Physics, Indianapolis, August 7, 2013 Cho J1, Ibbott G1, Gillin M1, Gonzalez-LeperaC2, Titt U1, andMawlawi O3. Departments of 1 Radiation Physics, 2 Nuclear Medicine and 3 Imaging Physics University of Texas MD Anderson Cancer Center, Houston, TX

  2. Outline • Background • Use of PET for proton range verification and its limitations • Purpose • Proton activated fiducial markers for range verification • Measurements • Activation comparison of 68Zn, Cu, and tissue-substitute materials • Future application

  3. Proton range uncertainty

  4. Dose Proton range verification by imaging tissue activation Proton Tissue activation • Limitations • No or weak PET signal • at the end of proton range PET Min et al,IJROBP 2013 PET • Activity washout • Short half-lives → Requires in-beam or on-site PET (additional cost !) Parodiet al, NIH public access 2007

  5. Purpose: 68Zn and 63Cu as implantable markers • Overcome limitations by • High PET signal • at the end of proton range Activated marker • No activity washout Not activated marker • Relatively long half-lives → Off-site PET utilized (already available !)

  6. 68Zn and Cu(70% 63Cu) activation (no background) 30 min PET scan after 50 min delay 12.5 Gy

  7. 68Zn and Cu activation (with background) 30 min PET scan after 48 min delay Signal reduced

  8. 68Zn and Cu activation in soft-tissue phantom 126 min delay, 30 min PET scan

  9. 68Zn and Cu activation in soft-tissue phantom Proton Range YES! Proton Range ???

  10. Limitation PET • Point verification vs. Volume verification • Invasive • Fiducialmigration • Sensitivity (signal vs. fiducial volume)

  11. Conclusion • 68Zn / Cu foils were activated much stronger and at deeper depths than PC. • 68Zn / Cu foils’ activation were stronger than background activation from balsa wood and meat phantom. • 68Zn / Cu may be feasible as implantable fiducial markers for proton range verification.

  12. Future application as a fiducial replacement Proton activated fiducial Non-activated fiducial

  13. Thank you. Acknowledgement Reinhard Schulte at Loma Linda University Medical Center. Pablo Yepes at Rice University. Wen Hsi at ProCure Treatment Center. Francesco Stingo Lawrence Bronk Bryan Steward Kevin Casey Kevin Vredevoogd Richard Amos Matthew Kerr at UT MD Anderson Cancer Center.

  14. 68Zn and Cu activation with depth 12.5 Gy 50 min delay, 150 min PET scan

  15. Sensitivity of 68Zn and Cu for different volumes

  16. Purpose: 68Zn and 63Cu as implantable markers • Overcome limitations by • High PET signal • at the end of proton range Activated marker • No activity washout Not activated marker • Relatively long half-lives → Off-site PET utilized (already available !)

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