Comparison of PET Concepts for Dose Delivery Monitoring of Particle Therapy

Tumor therapy using particle beams is highly precise and requires methods for monitoring of dose delivery. Solutions based on positron emission tomography (PET) are successfully implemented for the radiation therapy with carbon ions and protons at the Gesellschaft für Schwerionenforschung, Darmstadt, Germany, at the Heavy Ion Medical Accelerator at Chiba, Japan, at the Massachusetts General Hospital, Boston, USA, at the Hyogo Ion Beam Medical Center, Japan as well as at the National Cancer Center Kashiwa, Japan. Furthermore, the PET monitoring technique has been tested experimentally for 3He, 7Li, and 16O. The main requirements for the PET monitoring are (1) to produce images containing relevant information for the evaluation of dose delivery and (2) to reduce the additional time required for imaging as much as possible. There are three technical realizations: (1) In-beam PET (measurement during the irradiation), (2) In-room PET (measurement immediately after the irradiation of each portal using a PET scanner placed in the therapy room), (3) Off-line PET (measurement after the complete irradiation by means of a PET scanner located in a different room). These three concepts have been evaluated concerning workflow, counting statistics, and imaging. The treatment workflow is mostly affected by off-line PET. In the case of in-room and off-line PET, the counting statistics is approximately one half of that for in-beam PET if reasonable measuring times (<= 15 min) are assumed. Furthermore, there is an information loss using off-line PET. Thus, in-beam and in-room PET are the most feasible concepts to integrate PET into the particle therapy for dose monitoring.