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Irradiations at Ultra High Dose Rate (UHDR) regimes, exceeding 40 Gy/s in single fractions lasting less than 200 ms, have shown an equivalent antitumor effect compared to conventional radio-therapy with reduced harm to normal tissues. This work details the hardware and software modi-fications implemented to deliver 10 MeV UHDR electron beams with a Linear Accelerator Elekta SL 18 MV and the beam characteristics obtained. GafChromic EBT XD films and an Advanced Markus chamber were used for the dosimetry characterization, while a silicon sensor assessed the machine's beam pulses stability and repeatability. Dose per pulse, average dose rate and instantaneous dose rate in the pulse were evaluated for four experimental settings, varying the source-to-surface dis-tance and the beam collimation, i.e. with and without the use of a cylindrical applicator. Results showed dose per pulse from 0.6 Gy to a few tens of Gy and average dose rate up to 300 Gy/s. The obtained results demonstrate the possibility to perform in-vitro radiobiology experiments and test of new technologies for beam monitoring and dosimetry at the upgraded LINAC, thus contributing to the electron UHDR research field.

The $\textrm{HRI}_\textrm{EUV}$ telescope was calibrated on ground at the Physikalisch-Technische Bundesanstalt (PTB), Germany's national metrology institute, using the Metrology Light Source (MLS) synchrotron in April 2017 during the calibration campaign of the Extreme Ultraviolet Imager (EUI) instrument onboard the Solar Orbiter mission. We use the pre-flight end-to-end calibration and component-level (mirror multilayer coatings, filters, detector) characterization results to establish the beginning-of-life performance of the $\textrm{HRI}_\textrm{EUV}$ telescope which shall serve as a reference for radiometric analysis and monitoring of the telescope in-flight degradation. Calibration activities at component level and end-to-end calibration of the instrument were performed at PTB/MLS synchrotron light source (Berlin, Germany) and the SOLEIL synchrotron. Each component optical property is measured and compared to its semi-empirical model. This pre-flight characterization is used to estimate the parameters of the semi-empirical models. The end-to-end response is measured and validated by comparison with calibration measurements, as well as with its main design performance requirements. The telescope spectral response semi-empirical model is validated by the pre-flight end-to-end ground calibration of the instrument. It is found that $\textrm{HRI}_\textrm{EUV}$ is a highly efficient solar EUV telescope with a peak efficiency superior to 1 e$^-$.ph$^{-1}$), low detector noise ($\approx$ 3 e- rms), low dark current at operating temperature, and a pixel saturation above 120 ke- in low-gain or combined image mode. The ground calibration also confirms a well-modeled spectral selectivity and rejection, and low stray light. The EUI instrument achieves state-of-the-art performance in terms of signal-to-noise and image spatial resolution.

Purpose: To present a methodology to analyze the variation of RBE with fractionation from clinical data of tumor control probability (TCP) and to apply it to study the response of prostate cancer to proton therapy. M&M: We analyzed the dependence of the RBE on the dose per fraction by using the LQ model and the Poisson TCP formalism. Clinical TCPs for prostate cancer treated with photon and proton therapy for conventional fractionation (2 Gy(RBE)x37 fractions), moderate hypofractionation (3 Gy(RBE)x20 fractions) and hypofractionation (7.25 Gy(RBE)x5 fractions) were obtained from the literature and analyzed. Results: The theoretical analysis showed three distinct regions with RBE monotonically decreasing, increasing or staying constant with the dose per fraction, depending on the change of ({\alpha}, \{beta}) values between photon and proton irradiation (the equilibrium point being at({\alpha}_p/\{beta}_p)=({\alpha}_X/\{beta}_X)({\alpha}_X/{\alpha}_p)). An analysis of the clinical data showed RBE values that decline with increasing dose per fraction: for low risk RBE=1.124, 1.119, and 1.102 for 1.82 Gy, 2.73 Gy and 6.59 Gy per fraction (physical proton doses), respectively; for intermediate risk RBE=1.119, and 1.102 for 1.82 Gy, and 6.59 Gy per fraction (physical proton doses), respectively. These values are nonetheless very close to the nominal 1.1 value. Conclusions: We presented a methodology to analyze the RBE for different fractionations, and we used it to study clinical data for prostate cancer. The analysis shows a monotonically decreasing RBE with increasing dose per fraction, which is expected from the LQ formalism and the changes in ({\alpha}, \{beta}) between photon and proton irradiation. However, the calculations in this study have to be considered with care as they may be biased by limitations in the modeling and/or by the clinical data set used for the analysis., Comment: Minor changes to match accepted manuscript; in press Medical Physics

In this contribution, we present an innovative design of the Low-Gain Avalanche Diode (LGAD) gain layer, the p$^+$ implant responsible for the local and controlled signal multiplication. In the standard LGAD design, the gain layer is obtained by implanting $\sim$ 5E16/cm$^3$ atoms of an acceptor material, typically Boron or Gallium, in the region below the n$^{++}$ electrode. In our design, we aim at designing a gain layer resulting from the overlap of a p$^+$ and an n$^+$ implants: the difference between acceptor and donor doping will result in an effective concentration of about 5E16/cm$^3$, similar to standard LGADs. At present, the gain mechanism of LGAD sensors under irradiation is maintained up to a fluence of $\sim$ 1-2E15/cm$^2$, and then it is lost due to the acceptor removal mechanism. The new design will be more resilient to radiation, as both acceptor and donor atoms will undergo removal with irradiation, but their difference will maintain constant. The compensated design will empower the 4D tracking ability typical of the LGAD sensors well above 1E16/cm$^2$., Comment: Keywords: Silicon sensor, LGAD, Compensation, Compensated LGAD, Gain layer, 4D tracking, Radiation hardness

Purpose: To describe the dosimetric commissioning and quality assurance (QA) of the actively scanned proton and carbon ion beams at the Italian National Center for Oncological Hadrontherapy. Methods: The laterally integrated depth-dose-distributions (IDDs) were acquired with the PTW Peakfinder, a variable depth water column, equipped with two Bragg peak ionization chambers. FLUKA MC code was used to generate the energy libraries, the IDDs in water, and the fragment spectra for carbon beams. EBT3 films were used for spot size measurements, beam position over the scan field, and homogeneity in 2D-fields. Beam monitor calibration was performed in terms of number of particles per MU using both a Farmer-type and an Advanced Markus ionization chamber. The beam position at the isocenter, beam monitor calibration curve, dose constancy in the center of the spread-out-Bragg-peak, dose homogeneity in 2D-fields, beam energy, spot size, and spot position over the scan field are all checked on a daily basis for both protons and carbon ions and on all beam lines. Results: The simulated IDDs showed an excellent agreement with the measured experimental curves. The measured FWHM of the pencil beam in air at the isocenter was from 0.7 to 2.2 cm for protons. For carbon ions, two sets of spot size are available: from 0.4 to 0.8 cm (for the smaller) and from 0.8 to 1.1 cm (for the larger one). The spot position was within +/-1 mm over the whole 20x20 cm2 scan field; homogeneity in a uniform squared field was within +/-5% for both particle types at any energy. QA results exceeding tolerance levels were rarely found. In the reporting period, the machine downtime was around 6%, of which 4.5% was due to planned maintenance shutdowns. Conclusions: After successful dosimetric beam commissioning, quality assurance measurements performed during a 24-month period show very stable beam characteristics.

A prototype of proton counter was developed by the University and the National Institute for Nuclear Physics of Torino to be used as online fluence beam monitor in particle therapy. The single particle identification approach aims at increasing the sensitivity and readout speed with respect to the state-of-the-art gas ionization chambers. The sensitive area is 2,7 x 2,7 cm^2 to cover the clinical beam cross section characterized by a full width at half maximum of about 1 cm at the isocenter. The sensor is a thin Low Gain Avalanche Diode segmented in 146 strips with 180 micrometer pitch and with 50 micrometer active thickness, designed and produced by the Fondazione Bruno Kessler (Trento, Italy). The frontend readout to identify the single proton signal provided by each strip is based on a 24channel custom ASICs, named ABACUS, optimized to discriminate the signal pulses in a wide charge range (3-150 fC) with a maximum dead-time of 10 ns. With these specifications, at the maximum fluence rate of 10^8 p/(cm^2s) in the clinical energy range (60-230 MeV) and considering the silicon strips described above, a maximum pileup counting inefficiency less than 1 percent is achieved. A frontend board housing 6 ABACUS chips to readout the 146 strips was developed, the digital outputs being sent to 3 FPGAs (Kintex7) for the counting. A LabVIEW program implements the interface with the FPGAs, displays online the counting rate from each strip and stores the data for offline analysis.

This paper describes the dose delivery system used at the Centro Nazionale di Adroterapia Oncologica (CNAO) for ion beam modulated scanning radiotherapy. CNAO Foundation, INFN and University of Torino have developed and commissioned a Dose Delivery System (DDS) to monitor and guide ion beams accelerated by a synchrotron and to distribute the dose with a 3D scanning technique. The target volume, segmented in several layers orthogonally to the beam direction, is irradiated by thousands of pencil beams which must be steered and held to the prescribed positions until the prescribed number of particles has been delivered. At CNAO, these operations are performed by the DDS. The main components of this system are 2 independent beam monitoring detectors (BOX1 and BOX2), interfaced with 2 control systems performing real-time control, and connected to the scanning magnets and the beam chopper. As a reaction to any potential hazard, a DDS interlock signal is sent to the Patient Interlock System which immediately stops the irradiation. The tasks and operations performed by the DDS are described following the data flow from the Treatment Planning System through the end of the treatment delivery. The ability of the DDS to guarantee a safe and accurate treatment was validated during the commissioning phase by means of checks of the charge collection efficiency, gain uniformity of the chambers and 2D dose distribution homogeneity and stability. A high level of reliability and robustness has been proven by 3 years of system activity. The DDS described in this paper is one among the few worldwide existing systems to operate ion beam for modulated scanning radiotherapy. It has proven to guide and control the therapeutic pencil beams with accuracy and stability showing dose deviations lower than the acceptance threshold of 5% and 2.5% respectively during daily Quality Assurance measurements.

Hypersonic flight regime is conventionally defined for Mach larger than 5; in these conditions, the flying object becomes enveloped in a plasma. This plasma is densest in thin surface layers, but in typical situations of interest it impacts electromagnetic wave propagation in an electrically large volume. We address this problem with a hybrid approach. We employ Equivalence Theorem to separate the inhomogeneous plasma region from the surrounding free space via an equivalent (Huygens) surface, and the Eikonal approximation to Maxwell equations in the large inhomogeneous region for obtaining equivalent currents on the separating surface. Then, we obtain the scattered field via (exact) free space radiation of these surface equivalent currents. The method is extensively tested against reference results and then applied to a real-life re-entry vehicle with full 3D plasma computed via Computational Fluid Dynamic (CFD) simulations. We address both scattering (RCS) from the entire vehicle and radiation from the on-board antennas. From our results, significant radio link path losses can be associated with plasma spatial variations (gradients) and collisional losses, to an extent that matches well the usually perceived blackout in crossing layers in cutoff. Furthermore, we find good agreement with existing literature concerning significant alterations of the radar response (RCS) due to the plasma envelope.

Microwave hyperthermia aims at selectively heating cancer cells to a supra-physiological temperature. For non-superficial tumors, this can be achieved by means of an antenna array equipped with a proper cooling system (the water bolus) to avoid overheating of the skin. In patient-specific treatment planning, antenna feedings are optimized to maximize the specific absorption rate (SAR) inside the tumor, or to directly maximize the temperature there, involving a higher numerical cost. We present here a method to effect a low-complexity temperature-based planning. It arises from recognizing that SAR and temperature have shifted peaks due to thermal boundary conditions at the water bolus and for physiological effects like air flow in respiratory ducts. In our method, temperature focusing on the tumor is achieved via a SAR-based optimization of the antenna excitations, but optimizing its target to account for the cooling effects. The temperature optimization process is turned into finding a SAR peak position that maximizes the chosen temperature objective function. Application of this method to the 3D head and neck region provides a temperature coverage that is consistently better than that obtained with SAR-optimization alone, also considering uncertainties in thermal parameters. This improvement is obtained by solving the bioheat equation a reduced number of times, avoiding its inclusion in a global optimization process., Comment: 7 pages, 6 figure, accepted for publication in IEEE Journal of Electromagnetics, RF and Microwaves in Medicine and Biology

Using personal generated health data (PGHD) during medical consultations can be beneficial for both patients and clinicians. However, multiple acceptance barriers such as lack of PGHD reliability prevents a routine usage of this data. A clinical decision support system, called FullFlow, has been developed to address these acceptance barriers. The objective of this study was to determine if FullFlow was useful during consultations and to verify the hypothesis that the higher PGHD reliability, the more effective the system is. The assessment relied on a medical pilot during which clinicians and patients with diabetes used the FullFlow during medical consultations. The data collection relied on a post-consultation questionnaire in addition to system logs. This study showed that the PGHD reliability was low for an overwhelming majority of consultations. The information displayed was useful in half of the consultations according to the clinicians who answered the questionnaire. Despite this, the overwhelming majority of clinicians who answered the questionnaire found that the designed FullFlow system permitted to gain insights of the situation of the patients. The study showed the higher the PGHD reliability is, the more useful the system is for clinicians. PGHD usage in clinical settings can permit clinicians to gain valuable information regarding the situations of their patients. A clinical decision system can present useful information to clinicians. While the PGHD reliability is correlated to the usefulness of such system, it is not the only factor impacting it: context of the clinicians and patients such as novelty of usage and personal goals also plays a role in determining on how such system is useful for clinicians. However, due to a limited number of participants, a new medical pilot must be performed in order to confirm the results of this study., Comment: arXiv admin note: this version has been removed by arXiv administrators because the submitter did not have the right to agree to the license applied

Fast procedures for the beam quality assessment and for the monitoring of beam energy modulations during the irradiation are among the most urgent improvements in particle therapy. Indeed, the online measurement of the particle beam energy could allow assessing the range of penetration during treatments, encouraging the development of new dose delivery techniques for moving targets. Towards this end, the proof of concept of a new device, able to measure in a few seconds the energy of clinical proton beams (from 60 to 230 MeV) from the Time of Flight (ToF) of protons, is presented. The prototype consists of two Ultra Fast Silicon Detector (UFSD) pads, featuring an active thickness of 80 um and a sensitive area of 3 x 3 mm2, aligned along the beam direction in a telescope configuration, connected to a broadband amplifier and readout by a digitizer. Measurements were performed at the Centro Nazionale di Adroterapia Oncologica (CNAO, Pavia, Italy), at five different clinical beam energies and four distances between the sensors (from 7 to 97 cm) for each energy. In order to derive the beam energy from the measured average ToF, several systematic effects were considered, Monte Carlo simulations were developed to validate the method and a global fit approach was adopted to calibrate the system. The results were benchmarked against the energy values obtained from the water equivalent depths provided by CNAO. Deviations of few hundreds of keV have been achieved for all considered proton beam energies for both 67 and 97 cm distances between the sensors and few seconds of irradiation were necessary to collect the required statistics. These preliminary results indicate that a telescope of UFSDs could achieve in a few seconds the accuracy required for the clinical application and therefore encourage further investigations towards the improvement and the optimization of the present prototype.

Radiation therapy aims to deliver the prescribed amount of dose to a tumour at the same time as sparing the surrounding tissues as much as possible. In charged particle therapy, delivering the prescribed dose is equivalent to delivering the prescribed number of ions of a given energy at each position of the irradiation field. The accurate delivery is committed to a dose delivery (DD) system that shapes, guides and controls the beam before the patient entrance. Most of the early DD systems provided uniform lateral dose profiles by using different devices, mainly patient-specific, placed in the beam line to shape the three-dimensional final target dose. More recently, systems that provide highly conformal dose distributions using thousands of narrow beams at well-defined energy were developed which feature advanced scanning magnets and real-time beam monitors, without patient-specific hardware. This lecture will cover the general dose delivery concept as well as the different DD instrumentations depending mainly on the beam delivery technique and on the particle and accelerator types. Some characteristic worldwide DD and beam monitor systems will be mentioned., Comment: presented at the CAS- CERN Accelerator School on Accelerators for Medical Application, V\"osendorf, Austria, 26 May - 5 June, 2015

Electromagnetic computations, where the wavelength is small in relation to the geometry of interest, become computationally demanding. In order to manage computations for realistic problems like electromagnetic scattering from aircraft, the use of parallel computing is essential. In this paper, we describe how a solver based on a hierarchical nested equivalent source approximation can be implemented in parallel using a task based programming model. We show that the effort for moving from the serial implementation to a parallel implementation is modest due to the task based programming paradigm, and that the performance achieved on a multicore system is excellent provided that the task size, depending on the method parameters, is large enough.

In this paper we report results from a neutron irradiation campaign of Ultra-Fast Silicon Detectors (UFSD) with fluences of 1e14, 3e14, 6e14, 1e15, 3e15, 6e15 n/cm2. The UFSD used in this study are circular 50 micro-meter thick Low-Gain Avalanche Detectors (LGAD), with a 1.0 mm diameter active area. They have been produced by Hamamatsu Photonics (HPK), Japan, with pre-radiation internal gain in the range 10-100 depending on the bias voltage. The sensors were tested pre-irradiation and post-irradiation with minimum ionizing particle (MIPs) from a 90Sr based \b{eta}-source. The leakage current, internal gain and the timing resolution were measured as a function of bias voltage at -20C and -30C. The timing resolution was extracted from the time difference with a second calibrated UFSD in coincidence, using the constant fraction method for both. The dependence of the gain upon the irradiation fluence is consistent with the concept of acceptor removal and the gain decreases from about 80 pre-irradiation to 7 after a fluence of 6e15 n/cm2. Consequently, the timing resolution was found to deteriorate from 20 ps to 50 ps. The results indicate that the most accurate time resolution is obtained at a value of the constant fraction discriminator (CFD) threshold used to determine the time of arrival varying with fluence, from 10% pre-radiation to 60% at the highest fluence. Key changes to the pulse shape induced by irradiation, i.e. (i) a reduce sensitivity of the pulse shape on the initial non-uniform charge deposition, (ii) the shortening of the rise time and (iii) the reduced pulse height, were compared with the WF2 simulation program and found to be in agreement., Comment: 18 pages, 21 figures, 1 table