Development of proton computed tomography for applications in proton therapy

Determination of the Bragg peak position in proton therapy requires accurate knowledge of the electron density and ratio of effective atomic number and mass (Z/A) of the body tissues traversed. While the Z/A ratio is fairly constant for human tissues, the density of tissues varies significantly. One possibility to obtain accurate electron density information of tissues is to use protons of sufficient energy to penetrate the patient and measure their energy loss. From these transmission measurements, it is possible to reconstruct a three-dimensional map of electron densities using algebraic techniques. The interest in proton computed tomography (pCT) has considerably increased in recent years due to the more common use of proton accelerators for cancer treatment world-wide and a modern design concept based on current high-energy physics technology has been suggested. This contribution gives a status update on the pCT project carried out by the pCT Collaboration, a group of institutions sharing interest and expertise in the development of pCT. We will present updated imaging data obtained with a small pCT prototype developed in collaboration with the Santa Cruz Institute of Particle Physics and installed on the proton research beam line at Loma Linda University Medical Center. We will discuss hardware decisions regarding the next-generation pCT scanner, which will permit scanning of head-sized objects. Progress has also been made in the formulation of the most likely path of protons through an object and parallelizable iterative reconstruction algorithms that can be implemented on general-purpose commodity graphics processing units. Finally, we will present simulation studies for utilizing pCT technology for on-line proton dose verification and tumor imaging with positron emission tomography (PET).