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Photoelectric-enhanced radiation therapy is a bimodal therapy, consisting of the administration of highly radiation-absorbing substances into the tumor area and localized regional irradiation with orthovoltage x-rays. Irradiation can be performed by a modified computed tomography (CT) unit equipped with an additional x-ray optical module which converts the polychromatic, fan-shaped CT beam into a monochromatized and focused beam for energy-tuned photoelectric-enhanced radiotherapy. A dedicated x-ray optical module designed for spatial collimation, focusing, and monochromatization was mounted at the exit of the x-ray tube of a clinical CT unit. Spectrally resolved measurements of the resulting beam were performed using an energy-dispersive detection system calibrated by synchrotron radiation. The spatial photon fluence was determined by film dosimetry. Depth-dose measurements were performed and compared to the polychromatic CT and a therapeutic 6 MV beam. The spatial dose distribution in phantoms using a rotating radiation source (quasimonochromatic CT and 6 MV, respectively) was investigated by gel dosimetry. The photoelectric dose enhancement for an iodine fraction of 1% in tissue was calculated and verified experimentally. The x-ray optical module selectively filters the energy of the tungsten Kalpha emission line with an FWHM of 5 keV. The relative photon fluence distribution demonstrates the focusing characteristic of the x-ray optical module. A beam width of about 3 mm was determined at the isocenter of the CT gantry. The depth-dose measurements resulted in a half-depth value of approximately 36 mm for the CT beams (quasi-monochromatic, polychromatic) compared to 154 mm for the 6 MV beam. The rotation of the radiation source leads to a steep dose gradient at the center of rotation; the gel dosimetry yields an entrance-to-peak dose ratio of 1:10.8 for the quasi-monochromatic CT and 1:37.3 for a 6 MV beam of the same size. The photoelectric dose enhancement factor increases from 2.2 to 2.4 by using quasi-monochromatic instead of polychromatic radiation. An additional increase in the radiation dose by a factor of 1.4 due to the focusing characteristic of the x-ray optical module was calculated. Photoelectric-enhanced radiation therapy based on a clinical CT unit combined with an x-ray optical module is a novel therapy option in radiation oncology. The optimized quasi-monochromatic radiation is strongly focused and ensures high photoelectric dose enhancement for iodine.

Introduction: Computed tomography (CT) is a widespread and highly precise technique working in the energy range around 50-100 keV. For radiotherapy, however, the MeV energy range enables a better dose distribution. This gap between diagnosis and therapy can be overcome by the use of a modified CT machine in combination with heavy elements targeted to the tumour and used as photoelectric radiation enhancer., Materials and Methods: The experimental setup consists of an X-ray optical module mounted at the exit of the X-ray tube of a clinical CT. The module converts the standard fan-shaped beam into a high intensity, monochromatized and focused beam. The radiation was characterized using an energy-dispersive detection system calibrated by synchrotron radiation and gel dosimetry. The photoelectric radiation enhancement for different elements was calculated and experimentally verified., Results: The X-ray optical module filters selectively the energy of the tungsten K alpha-emission line (59.3 keV) with a full width at half maximum (FWHM) of 5 keV and focused the radiation onto a focal spot which coincides with the isocentre of the gantry. This results in a steep dose gradient at the centre of rotation qualified for locoregional radiation therapy. The photon energy of the quasi-monochromatic radiation agrees with the energy range of maximal photoelectric dose enhancement for gadolinium and iodine., Conclusion: An additional X-ray optical module optimized for targeted therapy and photoelectric dose enhancement allows the combination of diagnosis and radiotherapy on a clinical CT.

We demonstrate femtosecond operation of a Nd-doped mi-crostructure fiber laser. The fiber provides gain and anomalous dispersion at the lasing wavelength of 1.06 microm and enables the construction of short and simple cavity designs. The laser is passively mode-locked by the combined action of a saturable absorber mirror, fiber nonlinearity, and dispersion and produces transform limited sub-400-fs pulses with a pulse energy as high as 100 pJ.