Time‐resolved dose rate measurements in pencil beam scanning proton FLASH therapy with a fiber‐coupled scintillator detector system
Authors: Kanouta Eleni , Poulsen Per Rugaard , Kertzscher Gustavo , Sitarz Mateusz Krzysztof , Sørensen Brita Singers , Johansen Jacob Graversen 
Published: December 2022

AbstractBackgroundThe spatial and temporal dose rate distribution of pencil beam scanning (PBS) proton therapy is important in ultra‐high dose rate (UHDR) or FLASH irradiations. Validation of the temporal structure of the dose rate is crucial for quality assurance and may be performed using detectors with high temporal resolution and large dynamic range.PurposeTo provide time‐resolved in vivo dose rate measurements using a scintillator‐based detector during proton PBS pre‐clinical mouse experiments with dose rates ranging from conventional to UHDR.MethodsAll irradiations were performed at the entrance plateau of a 250 MeV PBS proton beam. A detector system with four fiber‐coupled ZnSe:O inorganic scintillators and 20 μs temporal resolution was used for dose rate measurements. The system was first characterized in terms of precision and stem signal. The detector precision was determined through repeated irradiations with the same field. The stem signal contribution was quantified by irradiating two of the detector probes alongside a bare fiber (fiber without a coupled scintillator). Next, the detector system was calibrated against an ionization chamber (IC) with all four detector probes and the IC placed in a water bath at 2 cm depth. A scan pattern covering 9.6 × 9.6 cm was used. Multiple irradiations with different requested nozzle currents provided instantaneous dose rates at the detector positions in the range of 7–1270 Gy/s. The correspondence of the detector signal (in Volts) to the instantaneous dose rate (in Gy/s) was found. The instantaneous dose rate was calculated from the beam current and the spot‐to‐detector distance assuming a Gaussian beam profile at distances up to 8 mm from the spot. Afterwards, the calibrated system was used in vivo, in mouse experiments, where mouse legs were irradiated with a constant dose and varying field dose rates of 0.7–87.5 Gy/s. The instantaneous dose rate was measured for each delivered spot and the delivered dose was determined as the integrated instantaneous dose rate. The spot dose profile and PBS dose rate map were calculated. The dose contamination to neighbouring mice were measured together with the upper limit of the dose to the mouse body.ResultsThe detectors showed high precision with ≤0.4% fluctuations in the measured dose. The stem signal exceeded 10% for spots <5 mm from the optical fiber and >18 mm from the scintillator. It contributed up to 0.2% to the total dose, which was considered negligible. All four detectors showed a non‐linear relation between signal and instantaneous dose rate, which was modelled with a polynomial response function. In the mouse experiments, the measured scintillator dose showed 1.8% fluctuations, independent of the field dose rate. The in vivo measured spot dose profile had tails that deviated from a Gaussian profile with measurable dose contributions from spots up to 85 mm from the detector. Neighbour mouse irradiation contributed ∼1% of the total mouse dose. The upper limit of the mouse body dose was 6% of the mouse leg dose.ConclusionsA fiber‐coupled inorganic scintillator‐based detector system can provide high precision in vivo measurements of the instantaneous dose rate if correction for the non‐linear dose rate dependency is applied.