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At the carbon ion therapy facility of GSI Darmstadt in-beam positron emission tomography (PET) is used for imaging the beta+-activity distributions which are produced via nuclear fragmentation reactions between the carbon ions and the atomic nuclei of the irradiated tissue. On the basis of these PET images the quality of the irradiation, i.e. the position of the field, the particle range in vivo and even local deviations between the planned and the applied dose distribution, can be evaluated. However, for such an evaluation the measured beta+-activity distributions have to be compared with those predicted from the treatment plan. The predictions are calculated as follows: a Monte Carlo event generator produces list mode data files of the same format as the PET scanner in order to be processed like the measured ones for tomographic reconstruction. The event generator models the whole chain from the interaction of the projectiles with the target, i.e. their stopping and nuclear reactions, the production and the decay of positron emitters, the motion of the positrons as well as the propagation and the detection of the annihilation photons. The steps of the modelling, the experimental validation and clinical implementation are presented.

In situ and in vivo treatment plan verification and beam monitoring as well as dose control during heavy-ion tumour therapy can be performed in principle by measurements of range distributions of positron-emitting nuclei by means of PET techniques. For this purpose the performance of different types of positron camera as well as the results of in-beam PET experiments using beams of positron-active ions (15O, 17F and 19Ne with energies of 300-500 AMeV) are presented. Following the deduced performance requirements a PET scanner that is designed for clinical use in experimental heavy-ion therapy at GSI Darmstadt has been built. This limited angle tomograph consists of two large-area detector heads based on position sensitive BGO detectors and is predicted to perform the measurement of the end point of a positron-emitting ion beam for the verification of a treatment plan with a precision better than 1 mm. The maximum dose applied in the patient thereby is of the magnitude of 10 mGy.

In December 1997 the treatment of patients suffering from head and neck tumours with beams of high-energy 12C ions started at the Gesellschaft für Schwerionenforschung (GSI) in Darmstadt. By the simultaneous application of positron emission tomography (PET) the treatments are verified in-situ during the irradiation. The PET-based quality assurance procedure is a chain of consecutive steps. The starting point is the three-dimensional treatment planning on the basis of X-ray computed tomograms (CT). During the heavy ion treatment the produced positron-emitter distribution is measured simultaneously. After that the expected temporal and spatial activity distribution is computed. Both images are reconstructed iteratively and filtered. For the analysis the PET and CT images are superimposed.

Positron emission tomography (PET) offers the possibility of in-situ monitoring the tumour treatment with light ion beams by means of imaging the spatial distribution of positron-activity that is produced as a byproduct of the therapeutic irradiation via nuclear fragmentation reactions between the projectiles and the atomic nuclei of the tissue within the target volume. The implementation of this PET technique at the experimental tumour therapy facility at the Gesellschaft für Schwerionenforschung (GSI) in Darmstadt and first results of its clinical application are presented.

Seit Dezember 1997 werden an der experimentellen Therapieeinrichtung der Gesellschaft für Schwerionenforschung Darmstadt Tumorpatienten mit hochenergetischen Kohlenstoffionen behandelt. Diese Strahlen werden beim Eindringen in Gewebe kaum abgelenkt und geben ihre Energie am Ende ihrer Reichweite konzentriert und mit erhöhter biologischer Wirksamkeit ab. Mit einer speziell für diese Anwendung gebauten Positronenkamera werden während der Bestrahlung die Beta+-Zerfälle von Kernen gemessen, die als Nebenprodukt bei Fragmentierungsreaktionen der Ionen des stabilen Therapiestrahles mit den Atomen des Körpergewebes entstehen. Durch Vergleich der gemessenen mit der durch Simulationsrechnungen aus den Daten der Bestrahlungsplanung zu erwartenden Positronenemitterverteilung wird die Genauigkeit der Dosisapplikation jeder einzelnen Therapiefraktion beurteilt.

A method for the in-situ control of the heavy-ion tumour therapy by means of positron emission tomography is introduced. This method is founded on the measurement of the dynamic spatial distribution of /spl beta//sup +/-emitters generated by nuclear fragmentation during the irradiation and the relationship between the spatial distributions of the /spl beta//sup +/-radioactivity and the dose. In order to study this relationship and to arrive at deducing the dose distribution from the measured /spl beta//sup +/-activity distribution a framework of model calculations is used. Results of phantom experiments with /sup 12/C ion beams are presented, demonstrating the good agreement between experiment and simulation as well as the possibilities and limits of treatment plan verification and beam monitoring.

At the new heavy ion tumor therapy facility of the Gesellschaft fur Schwerionenforschung at Darmstadt positron emission tomography (PET) has been implemented for in-beam and in-situ therapy control, i. e. during the tumor irradiation. The components necessary for this dedicated PET-imaging and their integration into the framework of therapy planning and quality assurance of heavy ion cancer treatments are presented. Results of the first application of this PET-method to patient treatments are reported.