Ultra-high dose rate dosimetry: Challenges and opportunities for FLASH radiation therapy.
Ultra-high dose rate dosimetry: Challenges and opportunities for FLASH radiation therapy.
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超高剂量率剂量学：闪光放射治疗的挑战和机遇。
DOI：
10.1002/mp.15649
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发表时间：
2022-07
期刊：
影响因子：
3.8
通讯作者：
Darafsheh, Arash
中科院分区：
文献类型：
--
作者：
Romano, Francesco;Bailat, Claude;Jorge, Patrik Goncalves;Lerch, Michael Lloyd Franz;Darafsheh, Arash
FLASH放射治疗（RT）的临床转化需要解决与超高剂量率（UHDR）射束的剂量测定和射束监测相关的挑战。目前使用的探测器在UHDR制度下受到饱和效应的影响，需要引入校正因子。科学界对确定UHDR剂量学最可靠的解决方案和合适的实验方法有很大的兴趣。这种兴趣表现在最近提出的关于UHDR剂量学的国家和国际项目越来越多。要获得所需的解决方案和方法，就需要进一步优化已经建立的技术，并研究新的辐射探测和剂量测定方法。新的知识也将出现，以填补在经验证的协议，评估新的剂量测定程序和标准化方法方面的差距。在本文中，我们讨论了来自特殊的光束参数表征UHDR光束的FLASH RT的主要挑战。这些挑战有很大的不同，这取决于加速器类型和技术，用于产生相关的UHDR辐射环境。我们还介绍了一些关于辐射束产生中的不同时间结构以及每个脉冲的剂量和剂量率如何影响探测器响应的一般考虑。最后，我们讨论的要求，必须表征任何拟议的剂量计在世界人权宣言辐射环境中使用。提供了当前技术的详细状态，目的是讨论探测器的功能和它们的性能特点和/或UHDR制度的限制。我们报告的进一步发展，建立探测器和新的方法，目前正在调查，以期预测未来的方向，剂量测定方法，实用程序和协议。由于与FLASH RT的UHDR辐射环境相关的几个正在进行的探测器和剂量测定开发，因此不可能提供最适合FLASH RT剂量测定的探测器的简单建议列表。然而，本文确实为读者提供了最新剂量测定方法的详细描述，并描述了在UHDR辐照条件下运行的探测器的行为，并就当前挑战提供了专家讨论，我们认为这些挑战很重要，仍然需要在FLASH RT的临床翻译中解决。
The clinical translation of FLASH radiotherapy (RT) requires challenges related to dosimetry and beam monitoring of ultra‐high dose rate (UHDR) beams to be addressed. Detectors currently in use suffer from saturation effects under UHDR regimes, requiring the introduction of correction factors. There is significant interest from the scientific community to identify the most reliable solutions and suitable experimental approaches for UHDR dosimetry. This interest is manifested through the increasing number of national and international projects recently proposed concerning UHDR dosimetry. Attaining the desired solutions and approaches requires further optimization of already established technologies as well as the investigation of novel radiation detection and dosimetry methods. New knowledge will also emerge to fill the gap in terms of validated protocols, assessing new dosimetric procedures and standardized methods. In this paper, we discuss the main challenges coming from the peculiar beam parameters characterizing UHDR beams for FLASH RT. These challenges vary considerably depending on the accelerator type and technique used to produce the relevant UHDR radiation environment. We also introduce some general considerations on how the different time structure in the production of the radiation beams, as well as the dose and dose‐rate per pulse, can affect the detector response. Finally, we discuss the requirements that must characterize any proposed dosimeters for use in UDHR radiation environments. A detailed status of the current technology is provided, with the aim of discussing the detector features and their performance characteristics and/or limitations in UHDR regimes. We report on further developments for established detectors and novel approaches currently under investigation with a view to predict future directions in terms of dosimetry approaches, practical procedures, and protocols. Due to several on‐going detector and dosimetry developments associated with UHDR radiation environment for FLASH RT it is not possible to provide a simple list of recommendations for the most suitable detectors for FLASH RT dosimetry. However, this article does provide the reader with a detailed description of the most up‐to‐date dosimetric approaches, and describes the behavior of the detectors operated under UHDR irradiation conditions and offers expert discussion on the current challenges which we believe are important and still need to be addressed in the clinical translation of FLASH RT.
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