Prompt gamma rays detected with a BGO block Compton camera reveal range deviations of therapeutic proton beams

The dose deposition profile of protons is interesting for tumour treatment due to the increased ionization density at the end of their track. However, the inaccurate knowledge of the proton stopping point limits the precision of the therapy. Prompt gamma rays, a by-product of the irradiation, are candidates for an indirect measurement of the particle range. Compton cameras have been proposed for prompt gamma ray imaging, but struggle with high trigger rates and low coincident efficiency. The feasibility in a clinical environment has yet to be proved. At Universitäts Protonen Therapie Dresden, two bismuth germanate (BGO) block detectors arranged face-to-face are deployed for imaging tests with a homogeneous target irradiated by a proton pencil beam. Shifts of the target, increase of its thickness and beam energy variation experiments are conducted. Each measurement lasts about 15 minutes at a low proton beam current. The effect of one centimetre proton range deviations on the backprojected images is analysed. The number of valid Compton events as well as the trigger rate expected in a realistic treatment plan with pencil beam scanning are estimated. The results support the use of a high density material despite its moderate energy resolution, in order to maximize the coincident efficiency. Nevertheless, they discourage the applicability of a two-plane Compton camera in a clinical scenario with usual beam currents.