Very High Energy Electron (VHEE) Radiotherapy: Image Guidance and Dose Delivery

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Radiotherapy depends on accurate delivery of a certain amount of dose (enough to kill the tumour) to the right place. For this purpose modern radiotherapy equipment has extensive QA and is combined with advanced image guidance capabilities.VHEE (Very High Energy Electron) radiotherapy (in the energy range of ~70 to 250 MeV) is currently under development and promises rapid delivery of dose by means of electromagnetically steered e-beams. Because of the high energy, the delivery is range-insensitive and hence it is generally applicable even in inhomogeneous parts of the body. It also has the potential to be significantly cheaper than radiotherapy equipment in use at present.Furthermore VHEE has the potential for extremely rapid and large dose delivery to cancerous tissue. It is also able to take advantage of recent in vivo "FLASH" studies -in which a high dose is delivered to tissue extremely rapidly -allowing complete eradication tumours while promising reduction in the occurrence and severity of early and late complications affecting normal tissue. This studentship entails exploring the feasibility of integrating VHEE therapy with absolute dose measurement, and image guidance. The advantage of rapid dose delivery (within seconds), makes dose measurement more complicated, and also image guidance, because localisation of the tumour has to be performed in a similar timeframe.In a future practical application of VHEE radiotherapy, both issues must be addressed. In this project we will study:1 Effect of patient motion on image guidance followed by flash delivery. This is relevant for VHEE as well as protons.2 Relate treatment time to accuracy requirements.3 Explore in-vivo dosimetry based on flat panel imagers.As the project progresses we anticipate a close collaboration with clinicians and clinical scientists developing. This project has the potential to develop a new paradigm in radiotherapy: entailing rapid delivery of very high doses to patients via high energy electron beams. There is a focus in this project on image guidance and dose delivery -two essential elements that have been lacking from current studies but are integral to the practicality of VHEE facility. The collaboration with experts in this field from the Christie NHS Trust is important to this project Simulation of dose delivery with GEANT4 and experiments at the Christie NHS Trust, and CERN are important to the success of this research.