Practical Implementation of Light Ion Beam Treatments
Author: Michael Farley Moyers and Stanislav M. VatnitskyISBN: 9781930524644
Published: 2013 March | 576 pp | eBook
Price: $ 175.00
DOODY'S | 2012
REVIEWER - Chee-Wai Cheng, Ph.D.(Indiana University School of Medicine)
**Description**
More and more medical physicists in the field of conventional external beam radiation therapy have become interested in the rapidly growing treatment modality with protons and light ion beams. This book is a timely addition to the existing publications on proton and particle beam therapy. All figures in the book are in black and white, although some of the original figures are in color and clearly labeled as such in the captions. However, an electronic version of the book is included in the form of a CD, with the color figures.
**Purpose**
The purpose is to provide a practical guide to support acceptance testing, commissioning of treatment delivery and planning systems, and setting up of routine QA programs. Overall, the authors succeed in fulfilling their goals. The practical considerations consist of useful hints and recommendations for clinical practice. The site test methods (or simply test methods) may serve as helpful guides for the various test procedures for the different components of the delivery system (or the routine QA programs).
**Audience**
The book is directed primarily at physicists who are working in proton or particle beam therapy or who have some experience in certain areas of this therapy but would like more in-depth knowledge of its different aspects. However, even physicists with little to no experience in light ion beam therapy will find this book useful for learning the basics of particle beam physics and dosimetry and getting a taste of the complexity that may be encountered in commissioning and treatment planning. It should be noted that the book is written with American readers in mind, as equipment specifications are presented in American English and have obtained U.S. FDA clearance. There is even a chapter (chapter 11) on billing based on the CPT codes used for radiation therapy in the U.S. The authors are well known in the proton and particle beam therapy community.
**Features**
The first chapter provides a brief introduction to basic light ion beam characteristics in different delivery systems. The rules of thumb are useful for readers to refer to in practice, and the references are sufficient for readers who want to know the origin of the data and/or to find out more about the beam characteristics. Chapter two provides basic information on a broad spectrum of equipment and dosimetry protocols for proton and light ion beam therapy, with an exhaustive list of references for detailed descriptions.
Chapter 3 covers specifications and acceptance testing of the beam delivery system, patient alignment system, etc. The acceptance testing described in this chapter are high level system tests performed by users to verify compliance with vendors' specifications. For each feature of the system, a site test method is described as well as the purpose of the test, where applicable. A drawback in the section on alignment is that a detailed method of isocentricity is described with equipment not commonly found in a radiation oncology department. On the other hand, the commonly accepted method of "star shot" is described as less accurate. It would be useful if the book compared the two methods. Chapter 4 is on shielding. The concepts of occupancy factor and use factor are somewhat different from the conventional external beam radiation. An experienced physicist in external beam radiation therapy for high energy x-rays will have to approach the proton shielding differently from the photon shielding calculation due to the fundamental difference in the beam delivery system and the interaction of protons with surrounding materials. Chapter 5 covers ancillary systems such as kV and MVCT, PET/CT, MRI, among others.
Planning concepts are discussed in chapter 6. Penetration uncertainties due to XCTN accuracy and XCTN to ion stopping power conversion have been the subject of research in numerous publications and are thoroughly discussed in this chapter. In the sections on motion (6.18) and margin guidelines and management (6.19), the presentation is somewhat confusing because of the use of too many acronyms, though the information is useful. Most readers will have to go over the material many times to understand it. Chapter 7, on the specifications and acceptance testing for treatment planning systems (TPS), has very detailed descriptions of the processes involved in the acceptance testing for these systems, and most photon physicists could relate their external beam TPS experience to those described in this chapter. Due to variation of equipment in light ion beam therapy, it is difficult to present general test procedures for all systems, but chapter 8 tries to tackle this issue, providing basic recipes with some examples to familiarize physicists with the commissioning of treatment systems. Training of physics personnel, therapists and other clinical staff is also briefly discussed. Chapter 9 details site-specific treatment planning and delivery, and includes head and neck, prostate, a variety of brain tumors, ocular melanoma, arteriovenous malformations, lung, liver, etc. This chapter also discusses the use of light ion beam for Parkinson disease. Chapter 10 tackles QA programs, discussing in detail QA programs for all components in a particle beam therapy system, including the daily, weekly, monthly, and annual QA for the treatment delivery system and the CT scanner. Chapter 11, on reimbursement, provides the basic CPT codes in proton therapy billing for proton facilities in the U.S. Since billing codes change frequently, this chapter is of limited use. Chapter 12 consists of a number of useful data tables and data sheets which are helpful for reference and practice.
**Assessment** In a book that intends to include everything in proton and ion beam therapy from A-Z, it is unavoidable that there are some oversights in terms of editorial mistakes. The first two chapters provide the basic physics and the dosimetry protocols. I consider these two chapters the foundation for the rest of the book, but, unfortunately, they also have the most typographical errors as well as statements that need clarification. Some examples: on page 5, the statement "Electrons lose energy at a rate of 2 MeV/cm" is true only in water; on page 26, Rres is referred to as reference depth, but later in the same paragraph, zreef is used for reference depth, then on page 28, Rres is referred to as residual range. The use of acronyms seems excessive, and some of them are not standard. Overall, however, this succeeds as a practical guide.
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Weighted Numerical Score: 87 - 3 Stars