Assessing the dosimetric effects of high-Z titanium implants in proton therapy using pixel detectors

Abstract A rapid increase in the use of proton therapy for cancer treatment has been seen in the last decade due to its clinical advantages. Therefore, more and more patients with implants and other metallic devices will be among those who will be treated. This study experimentally examines the effect and changes in the delivered fields, using water-equivalent phantoms with and without titanium (Ti) dental implants positioned along the primary beam path. We measured in detail the composition and spectral-tracking characterization of particles generated in the plateau region of the Bragg curve towards the Sub-peak region using high-spatial resolution, spectral and time-sensitive imaging detectors with a pixelated array provided by the ASIC chip Timepix3. A 170 MeV proton beam was collimated and modulated in a polymethyl methacrylate (PMMA) block. Placing two dental implants behind the PMMA block, the radiation was measured using two pixeled detectors with silicon (Si) sensors. The Timepix3 (TPX3) detectors measured in detail particle fluxes, dose rates (DR) and linear energy transfer (LET) spectra for resolved particle types. Artificial intelligence (AI) based-trained neural networks (NN) calibrated in well-defined radiation fields were used to analyze and identify particles based on morphology and characteristic spectral-tracking response. The beam was characterized and single-particle tracks were registered and decomposed into particle-type groups. The resulting particle fluxes in both setups are resolved into three main classes of particles: i) protons, ii) electrons and photons, and iii) ions. Protons are the main particle component responsible for dose deposition. High-energy transfer particles (HETP), namely ions exhibited differences in both dosimetric aspects that were investigated: DR and particle fluxes, when the Ti implants were placed in the setup. The detailed multi-parametric information of the secondary radiation field provides a comprehensive understanding of the impact of Ti materials in proton therapy.