Applications of advanced and dual energy computed tomography in proton therapy

This thesis focuses on advanced reconstruction methods and Dual Energy (DE) Computed Tomography (CT) applications for proton therapy, aiming at improving patient positioning and investigating approaches to deal with metal artifacts. To tackle the first goal, an algorithm for post-processing input DE images has been developed. The outputs are tumor- and bone-canceled images, which help in recognising structures in patient body. We proved that positioning error is substantially reduced using contrast enhanced images, thus suggesting the potential of such application. If positioning plays a key role in the delivery, even more important is the quality of planning CT. For that, modern CT scanners offer possibility to tackle challenging cases, like treatment of tumors close to metal implants. Possible approaches for dealing with artifacts introduced by such rods have been investigated experimentally at Paul Scherrer Institut (Switzerland), simulating several treatment plans on an anthropomorphic phantom. In particular, we examined the cases in which none, manual or Iterative Metal Artifact Reduction (iMAR) algorithm were used to correct the artifacts, using both Filtered Back Projection and Sinogram Affirmed Iterative Reconstruction as image reconstruction techniques. Moreover, direct stopping power calculation from DE images with iMAR has also been considered as alternative approach. Delivered dose measured with Gafchromic EBT3 films was compared with the one calculated in Treatment Planning System. Residual positioning errors, daily machine dependent uncertainties and film quenching have been taken into account in the analyses. Although plans with multiple fields seemed more robust than single field, results showed in general better agreement between prescribed and delivered dose when using iMAR, especially if combined with DE approach. Thus, we proved the potential of these advanced algorithms in improving dosimetry for plans in presence of metal implants.

Analysis of fragmentation cross sections of GSI 2021 data for the FOOT experiment

Hadrontherapy is a medical treatment based on the use of charged particles beams accelerated towards deep-seated tumors on clinical patients. The reason why it is increasingly used is the favorable depth dose profile following the Bragg Peak distribution, where the release of dose is almost sharply focused near the end of the beam path. However, nuclear interactions between the beam and the human body constituents occur, generating nuclear fragments which modify the dose profile. To overcome the lack of experimental data on nuclear fragmentation reactions in the energy range of hadrontherapy interest, the FOOT (FragmentatiOn Of Target) experiment has been conceived with the main aim of measuring differential nuclear fragmentation cross sections with an uncertainty lower than 5\%. The same results are of great interest also in the radioprotection field, studying similar processes. Long-term human missions outside the Earth’s orbit are going to be planned in the next years, among which the NASA foreseen travel to Mars, and it is fundamental to protect astronauts health and electronics from radiation exposure .\\ In this thesis, a first analysis of the data taken at the GSI with a beam of $^{16}O$ at 400 $MeV/u$ impinging on a target of graphite ($C$) will be presented, showing the first preliminary results of elemental cross section and angular differential cross section. A Monte Carlo dataset was first studied to test the performance of the tracking reconstruction algorithm and to check the reliability of the full analysis chain, from hit reconstruction to cross section measurement. An high agreement was found between generated and reconstructed fragments, thus validating the adopted procedure. A preliminary experimental cross section was measured and compared with MC results, highlighting a good consistency for all the fragments.