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This report describes continued work on the award Neurocognitive Effects of Radiotherapy , which examines the neurocognitive and imaging impact of proton therapy for patients will low grade glioma and base of skull meningioma. A total of 48 patients have been enrolled, 18 of whom have enrolled in 2014. All patients have completed a 4-5 hour neurocognitive testing assessment at baseline by Dr. Carol Armstrong. In addition, all patients have completed a 1 hour standard MRI as well as additional testing including diffuse tensor imaging (DTI), perfusion and diffusion. The majority of patients have completed baseline and at least two additional time-points in regards to both neurocognitive testing and MRI. Eight patients have completed neurocognitive and imaging evaluation at all planned timeponts, and preliminary data analysis is provided in this report. Local control and overall survival remain 100% in both testing cohorts. Although data are preliminary, neurocognitive results suggest that, on measures of verbal retrieval from long-term memory (retrieval after interface and retrieval after time), patients treated with proton therapy show post-treatment decline, but a stronger recovery and larger memory capacity compared to those treated with photons. Implicit cognition was tested via cerebellar tests, and results were compared for 20 patients and 20 controls. Control patients appeared to perform better than patients after proton therapy on specific cerebellar tests, including Timing Functions Test and Serial Response Test, although the performance of the two groups on the Audiovisual Attentional Shift Test did not differ. These tests have not been used previously within the proton radiation population, and appear to be promising tools for elucidating differences in implicit cognition in this and future studies. Imaging analysis has been carried out independently from neurocognitive analysis., The original document contains color images.

This report describes the final report of work on the award Proton Therapy Dose Characterization and Verification which includes investigation in the following areas: (A) the use of positron emission tomography (PET) to determine the dose deposited by a therapeutic proton beam, (B) studies of the radiobiological effect of proton therapy, and (C) support for matching patients to clinical trials. This report also covers a continuation award Development of Technology for Image-Guided Proton Therapy that focuses on transferring technology currently in conventional radiotherapy systems to the proton treatment rooms, especially that technology related to daily patient localization. A component of both of these awards also supports the work done by the Walter Reed Army Medical Center scientists., The original document contains color images.

This final report describes the work that was done during the past eight years of work on the award. The main focus during the initial 5 years of the project was to develop design and construct- FDA approved multileaf collimator (MLC) to be used clinically in the proton therapy center at UPENN. During these years a work on Phase 2 and 3 of the projects started and once the proton center opened in January of 2010 phase 2 and 3 moved to the center stage and the work focused on the development of scanned beam technology for proton therapy and the development of adaptive, image guided, telemedicine and techniques for quality and efficient proton therapy. This research project is a joint collaborative effort between the University of Pennsylvania (HUP) and the Walter Reed Army Medical Center (WRAMC), currently in Bethesda Maryland, and is part of a larger project to build a state-of-the-art proton radiotherapy facility in Philadelphia and development of telemedicine for proton radiotherapy for the US military., The original document contains color images.

This report describes the fifth year of work on the award Proton Therapy Dose Characterization and Verification which includes investigation in the following areas: (A) the use of positron emission tomography (PET) to determine the dose deposited by a therapeutic proton beam, (B) studies of the radiobiological effect of proton therapy, and (C) support for matching patients to clinical trials. This report also covers the second year of a continuation award Development of Technology for Image-Guided Proton Therapy that focuses on transferring technology currently in conventional radiotherapy systems to the proton treatment rooms, especially that technology related to daily patient localization. A component of both of these awards also supports the work done by the Walter Reed Army Medical Center scientists., The original document contains color images.

This report is the annual report for Phase one, out of three phases, of a DOD grant that was given to UPENN and Walter Reed Medical center to develop Proton Therapy center. This report describes the seventh year of a project to design and construct multileaf collimators (MLC) to be used in proton radiotherapy, the sixth year of the project to develop scanned beam technology for proton radiotherapy, and the fifth year of the project to develop image guided treatment protocols for proton therapy. This research project is a joint collaborative effort between the University of Pennsylvania (HUP) and the Walter Reed Army Medical Center (WRAMC), and is part of a larger project to build a state-of-the-art proton radiotherapy facility in Philadelphia. The accomplishments during the past year of the project are described in this report., The original document contains color images.

This report describes the fourth year of work on the award Proton Therapy Dose Characterization and Verification which includes investigation in the following areas: (A) the use of positron emission tomography (PET) to determine the dose deposited by a therapeutic proton beam, (B) studies of the radiobiological effect of proton therapy, and (C) support for matching patients to clinical trials. This report also covers the third year of a continuation award Development of Technology for Image-Guided Proton Therapy that focuses on transferring technology currently in conventional radiotherapy systems to the proton treatment rooms, especially that technology related to daily patient localization. A component of both of these awards also supports the work done by the Walter Reed Army Medical Center scientists. That work is reported in grant #W81XWH-04-2-0022., The original document contains color images.

This report describes the sixth year of a project to design and construct multileaf collimators (MLC) to be used in proton radiotherapy, the fifth year of the project to develop scanned beam technology for proton radiotherapy, and the fourth year of the project to develop image guided treatment protocols for proton therapy. This research project is a joint collaborative effort between the University of Pennsylvania (HUP) and the Walter Reed Army Medical Center (WRAMC) and is part of a larger project to build a state-of-the-art proton radiotherapy facility in Philadelphia. The accomplishments during the past year of the project are described in this report., The original document contains color images.

This report describes the second year of a project to design and construct multileaf collimators (MLC) to be used in proton radiotherapy, and the first year of the project to develop scanned beam technology for proton radiotherapy. This research project is a joint collaborative effort between the University of Pennsylvania (HUP) and the Walter Reed Army Medical Center (WRAMC) and is part of a larger project to build a state-of-the-art proton radiotherapy facility in Philadelphia in collaboration with the Children s Hospital of Philadelphia (CHOP). The accomplishments during the past year of the project are described in this report. (1) We developed software to read in DICOM-RT datasets and convert them to the GEANT4 geometry structure so we can calculate dose and display DVHs on CT data, (2) We incorporated a realistic proton nozzle into the GEANT4 Monte Carlo, (3) We started the study of spot-scanning optimization and have implemented two algorithms so far, and (4) The WRAMC group has started studying how heterogeneities affect the dose distribution in proton therapy., The original document contains color images.