Feasibility of quantitative PET/CT dosimetry for proton therapy using polymer gels

A feasibility study of proton beam PET/CT off-line quantitative dosimetry using polymer gels is presented. A newly developed proton-sensitive polymer gel dosimeter (BANG®3-Pro2) is used as a dosimeter and a tissue-equivalent phantom medium for this study. We explore a new approach to correlating measured proton 3-dimensional (3D) dose distributions directly to measured positron emission from in the gel medium using PET/CT imaging. A large cylindrical volume (2.2 Litres) of the gel was irradiated with a clinical modulated proton beam using irregular-shaped aperture geometry. The gel was imaged in a nearby PET/CT unit immediately (<3 min) after irradiation. Dose distribution in the gel was generated using an optical tomography scanning system. Direct 3D spatial comparison of dose and positron emission distributions was then performed. Profiles along the beam path show that the distal fall-off of the dose is nearly 2 cm deeper than the activity profile which is comparable to previous studies with plastic phantoms and Monte Carlo simulations of activity distributions. Planar PET and dose distributions at depth and perpendicular to beam axis show a strong one-to-one spatial correlation. This phantom study demonstrates that the gel medium could be potentially useful for quantifying various physical factors that can influence the PET activity range verification method in patients.