Search

Three-dimensional (3D) pencil-beam scanning is an ideal irradiation technique to make the best use of the characteristics of a carbon-ion beam and to provide flexible dose delivery. To suppress beam spread due to multiple scattering and nuclear reactions, we developed a full energy scanning method. In some cases, such as eye treatments, the irradiation fields are very small and short ranged. Accordingly, we prepared a minimum low-energy carbon-ion beam corresponding to water-equivalent residual ranges of less than 2 mm. We performed experimental verification for low-energy carbon-ion beams ranging from 55.6 to 96.0 MeV/u. The accuracy of 3D dose delivery with the low-energy carbon-ion beam was verified by measuring the dose distributions for different target volumes. The results confirmed that the measured dose distributions agree well with the calculated ones. Then, the first eye treatment with low-energy carbon-ion beam to a patient was performed in 2018. [ABSTRACT FROM AUTHOR]

At National Institute of Radiological Sciences (NIRS), we have been commissioning a rotating-gantry system for carbon-ion radiotherapy. This rotating gantry can transport heavy ions at 430 MeV/u to an isocenter with irradiation angles of ±180° that can rotate around the patient so that the tumor can be irradiated from any direction. A three-dimensional pencil-beam scanning irradiation system equipped with the rotating gantry enables the optimal use of physical characteristics of carbon ions to provide accurate treatment. To ensure the treatment quality using such a complex system, the calibration of the primary dose monitor, output check, range check, dose rate check, machine safety check, and some mechanical tests should be performed efficiently. For this purpose, we have developed a measurement system dedicated for quality assurance (QA) of this gantry system: the Daily QA system. The system consists of an ionization chamber system and a scintillator system. The ionization chamber system is used for the calibration of the primary dose monitor, output check, and dose rate check, and the scintillator system is used for the range check, isocenter, and gantry angle. The performance of the Daily QA system was verified by a beam test. The stability of the output was within 0.5%, and the range was within 0.5 mm. The coincidence of the coordinates between the patient-positioning system and the irradiation system was verified using the Daily QA system. Our present findings verified that the new Daily QA system for a rotating gantry is capable of verifying the irradiation system with sufficient accuracy. [ABSTRACT FROM AUTHOR]

Reports on the immunohistochemical evidence for an increased oxidative stress and carbonyl modification of proteins by autoxidation products of carbohydrates and lipids in glomerular lesions of IgA nephropathy. Modification of proteins under oxidative stress; Reaction of glomeruli with both anti-malondialdehydelysine (MDA) and anti-4-hydroxynonenenal antibodies; Immunostaining in the expanded mesangial area.

A study of multiple-ion therapy with charged heavy-ion beams was performed to improve outcomes of refractory cancer treatments. We proposed the accelerator operation method for applying the multiple-ion therapy, to quickly switch the ion species and energies of the output beams. In this method, the irradiation ion species can be changed only by switching the selected ion source and the injector parameters, and the output beam energies can be varied without changing the magnetic operation patterns of the synchrotron. We verified the effectiveness of our approach by conducting experiments at the Heavy Ion Medical Accelerator in Chiba (HIMAC) and confirmed that the approach can provide the fast switching of both the ion species and the beam energies. The experimental results also demonstrated that our approach will greatly reduce the commissioning time and the routine adjustments for multiple-ion beams. [ABSTRACT FROM AUTHOR]

Since 2011, a three-dimensional (3D) scanning irradiation system has been utilized for treatments at the National Institute of Radiological Sciences-Heavy Ion Medical Accelerator in Chiba (NIRS-HIMAC). In 2012, a hybrid depth scanning method was introduced for the depth direction, in which 11 discrete beam energies are used in conjunction with the range shifter. To suppress beam spread due to multiple scattering and nuclear reactions, we then developed a full energy scanning method. Accelerator tuning and beam commissioning tests prior to a treatment with this method are time-consuming, however. We therefore devised a new approach to obtain the pencil beam dataset, including consideration of the contribution of large-angle scattered (LAS) particles, which reduces the time spent on beam data preparation. The accuracy of 3D dose delivery using this new approach was verified by measuring the dose distributions for different target volumes. Results confirmed that the measured dose distributions agreed well with calculated doses. Following this evaluation, treatments using the full energy scanning method were commenced in September 2015. [ABSTRACT FROM AUTHOR]

The HIMAC clinical study has been conducted with a carbon-ion beam since June 1994. Since 2006, as a new treatment research project, NIRS has developed both the accelerator and beam-delivery technologies for the sophisticated heavy-ion radiotherapy, which brings a pencil-beam 3D rescanning technology for both the static and moving-tumor treatments. In this technology, the depth-scanning technique was improved to the full-energy depth scanning by realizing a variable-energy operation of the HIMAC synchrotron itself. At present, a heavy-ion rotating gantry has been developed with the superconducting technology and is in a beam-commissioning stage. As a future plan, we just start a study of a multi-ions irradiation for more sophisticated LET-painting and a design study of a superconducting synchrotron for more compact heavy-ion radiotherapy facility. [ABSTRACT FROM AUTHOR]

A ridge filter (RGF), a beam energy modulation device, is usually used for particle radiotherapy with a pencil beam scanning system. The conventional RGF has a one-dimensional (1D) periodic laterally stepped structure in orthogonal plane with a central beam direction. The energy of a beam passing through the different thicknesses of the stepped RGF is modulated. Although the lateral pencil beam size is required to cover the several stepped RGF units to modulate its energy as designed, the current trend is to decrease lateral beam size to improve the scanning system. As a result, the beam size becomes smaller than the size of the individual RGF unit. The aim of this study was to develop a new RGF with two-dimensional (2D) honeycomb geometry to simultaneously achieve both a decrease in lateral beam size and the desired energy modulation. The conventional 1D-RGF and the 2D-RGF with honeycomb geometry were both designed so that the Bragg peak size of a 79 MeV/u carbon ion pencil beam in water was 1 mm RMS in the beam direction. To validate the design of the 2D-RGF, we calculated depth dose distributions in water using a simplified Monte Carlo method. In the calculations, we decreased the lateral pencil beam size at the entrance of the RGF and investigated the threshold of lateral beam size with which the pencil beam can reproduce the desired Bragg peak size for each type of RGF. In addition, we calculated lateral dose distributions in air downstream from the RGF and evaluated the inhomogeneity of the lateral dose distributions. Using the 2D-RGF, the threshold of lateral beam size with which the pencil beam can reproduce the desired Bragg peak size was smaller than that using the 1D-RGF. Moreover, the distance from the RGF at which the lateral dose distribution becomes uniform was shorter using the 2D-RGF than that using the 1D-RGF. These results indicate that when the periodic length of both RGFs is the same, the 2D-RGF allows use of a pencil beam with smaller lateral beam size and a shorter distance from the RGF to the target, resulting in improvement in the conformity of dose distribution in a tumor. [ABSTRACT FROM AUTHOR]

A superconducting rotating-gantry for carbon-ion radiotherapy was developed. This isocentric rotating gantry can transport carbon ions having the maximum kinetic energy of E = 430 MeV/ u to an isocenter with irradiation angles of over ±180°, and is further capable of performing three-dimensional raster-scanning irradiation. By using combined-function superconducting magnets, we could design a compact rotating gantry for carbon-ion radiotherapy. Construction of the gantry structure began since early 2014, and the installation of the entire gantry system to the Heavy Ion Medical Accelerator in Chiba (HIMAC) complex was completed by the end of September, 2015. Beam tuning subsequently began since October, 2015, and carbon ions, as accelerated by the HIMAC upper synchrotron, having kinetic energies of between E = 430–48 MeV/ u were successfully transported with the rotating gantry to the isocenter. The size and shape of the beam spots at the isocenter is being tuned over various combinations of the beam energies and the gantry angle. We will present the recent progress as well as the current status of the superconducting rotating-gantry. [ABSTRACT FROM AUTHOR]

At Heavy Ion Medical Accelerator in Chiba (HIMAC) in National Institute of Radiological Sciences (NIRS), more than 9000 patients have been successfully treated by carbon ion beams since 1994. The successful results of treatments have led us to construct a new treatment facility equipped with a three-dimensional pencil beam scanning irradiation system, which is one of sophisticated techniques for cancer therapy with high energetic ion beam. This new facility comprises two treatment rooms having fixed beam lines and one treatment room having rotating gantry line. The challenge of this project is to realize treatment of a moving target by scanning irradiation. Thus, to realize this, the development of the fast scanning system is one of the most important issues in this project. After intense commissioning and quality assurance tests, the treatment with scanned ion beam was started in May 2011. After treatment of static target starts, we have developed related technologies. As a result, we can start treatment of moving target and treatment without range shifter plates since 2015. In this paper, the developments of the scanning irradiation system are described. [ABSTRACT FROM AUTHOR]

Controlling beam position in three-dimensional pencil-beam scanning is important because errors in beam position disturb the uniformity of irradiated dose distribution. To suppress this, we have developed a simple procedure for beamline tuning. Beamline tuning is performed with steering magnets and fluorescent screen monitors to converge a beam’s trajectory to a central orbit. The misalignment between beam position and a reference axis is determined through a verification system, which consists of a screen monitor and an acrylic phantom. If beam position deviates from the reference axis, two pairs of steering magnets, which are placed downstream of the beam transport line, correct the beam. These adjustments are iterated until the deviations for 11 energies of the beam are within 0.5 mm of the reference axis. To demonstrate the success of the proposed procedure, we used it to perform beam commissioning at the Kanagawa Cancer Center.
 [ABSTRACT FROM AUTHOR]

Multiple-energy synchrotron operation was developed to realize fast 3D scanning irradiation for carbon-ion radiotherapy. This type of operation can output various carbon-ion beams with different energies in a single synchrotron cycle. The beam control system used in this kind of operation was developed to quickly provide the beam energy and intensity required from the irradiation control system. The performance of the system was verified by experimental tests. The system could output beams of 197 different energies in 63 s. The beam intensity could be controlled for all the output beams without large ripples or overshooting. The experimental test of irradiation for prostate cancer treatment was also successfully performed, and the test results proved that our system can greatly reduce the irradiation time. [ABSTRACT FROM AUTHOR]

A superconducting rotating-gantry for carbon-ion radiotherapy was developed. This isocentric gantry can transport carbon ions having kinetic energies of between E =430 and 48 MeV/ u to an isocenter over an angle of ±180°, and is further capable of performing three-dimensional raster-scanning irradiation. Construction of the entire rotating-gantry system was completed by the end of September 2015. Prior to beam commissioning, phase-space distributions of extracted carbon beams from the synchrotron were deduced by using an empirical method. In this method, phase-space distributions at the extraction channel of the synchrotron were modeled with 8 parameters, and the best parameters were determined so as to minimize a difference between the calculated and measured beam profiles by using a simplex method. Based on the phase-space distributions, beam optics through the beam-transport lines as well as the rotating gantry were designed. Since horizontal and vertical beam emittances, as extracted slowly from the synchrotron, generally differ with each other, a horizontal–vertical beam coupling would occur when the gantry rotates. Thus, the size and shape of beam spots at the isocenter should vary depending on the gantry angle. To compensate for the difference in the emittances, we employed a method to utilize multiple Coulomb scattering of the beam particles by a thin scatterer. Having compensated for the emittances and designed beam optics through the rotating gantry, beam commissioning over various combinations of gantry angles and beam energies was performed. By finely tuning the superconducting quadrupoles of the rotating gantry, we could successfully obtain the designed beam quality, which satisfies the requirements of scanning irradiation. [ABSTRACT FROM AUTHOR]

Background: Type A hepatitis is still a considerable problem in both underdeveloped and developed countries. Why some patients progress to fulminant type A hepatitis and others do not is unclear. Aims: To determine if nucleotide differences in the genome of hepatitis A virus (HAV) are responsible for the range of clinical severities, we analysed the 5' non-translated region (5'NTR) of the HAV genome, which has an internal ribosomal entry site and is important for cap independent translation of the viral message. Methods: Serum samples from 84 Japanese patients with sporadic type A hepatitis from five distant regions of Japan, comprising 12 patients with fulminant hepatitis (FH), 13 with severe acute hepatitis (AHs), and 59 with acute hepatitis (AH), were examined for HAV RNA. The fragment between nucleotides 75 and 638 of the 5'NTR was amplified by reverse transcription-polymerase chain reaction, and the nucleotide sequence was determined by direct sequencing. Results: Comparison of sequences of the 5'NTR revealed relatively fewer nucleotide substitutions in FH and AHs patients compared with the considerable sequence variations found in strains of AH. This tendency was most prominent between nucleotides 200 and 500. Strains from FH and AHs cases had fewer nucleotide substitutions (p<0.001) in this region. Conclusions: Nucleotide variations in the central portion of the 5'NTR of HAV may influence the severity of type A hepatitis. [ABSTRACT FROM AUTHOR]