Devices and methods for monitoring particle therapy on body parts of a patient.

Abstract

A device (110) and method for monitoring treatment of a body part (112) of a patient (114) with a beam (116) comprising particles (118) are disclosed. Hereinafter, the device (110) comprises: a beam delivery unit (120) designated for delivering the beam (116) comprising particles (118) and adjusting the propagation direction (124) of the beam (116) onto the body part (112) of the patient (114); and a verification unit (130) designated for verifying the treatment of the body part (112) of the patient (114) by determining information regarding transient gamma radiation (140) provided by the beam (116). The delivery of the range and dose of the particles (118) to the site (112), the transient gamma radiation (140) being generated by the interaction of the particles (118) with the body site (112) of the patient (114) at at least two separate interaction points (150), wherein the verification unit (130) includes an axis of symmetry (149) symmetrical about the at least two separate interaction points (150) and perpendicularly positioned relative to the propagation direction (124) of the beam (116). The device (110) and method are preferably used in the field of ion therapy, particularly for verifying the range and dose delivery of the particles (118) provided by the beam (116) to the body site (112) of the patient (114), especially to the tumor tissue of the patient (114).

Description

Technical Field

[0001] This invention relates to an apparatus and method for monitoring treatment of a patient's body parts with a beam comprising particles. The apparatus and method according to the invention are preferably used in the field of ion beam therapy, particularly for verifying the extent and dose delivery of particles delivered by the beam to a patient's body parts, especially to the patient's tumor tissue. However, other types of applications are also possible. Background Technology

[0002] Particle therapy with hadron beams holds great clinical potential in terms of efficacy and effectiveness, where hadrons are ions, particularly those selected from protons or those selected from helium, carbon, or oxygen, or neutrons. Carbon ion beams are particularly promising in this context due to their reduced lateral diffusion and increased biological effects. Synchrotrons are typically used as the master accelerator for particles with energies above 50 MeV, with maximum energies for clinical use typically between 230 and 250 MeV / u, but values ​​up to 515 MeV / u are also possible. The accelerated particle beam is then delivered to at least one patient treatment chamber using a series of vacuum tubes and shaping and focusing magnets. Within the treatment chamber, the beam can be a fixed beam with a fixed orientation relative to a horizontal or vertical direction or relative to a specific angle, or it can be delivered to any desired direction by applying a rotating gantry. In this context, a gantry refers to a unit adapted to rotate fully 360° for delivering the beam at an angle specified by the treatment. Furthermore, the beam can be provided by a delivery nozzle designed to shape the beam to conform to the three-dimensional geometry of the tumor, preferably to both the cross-sectional shape and the shape of the distal surface. For this purpose, range modulators, de-energizers, collimators, and compensators can be used. Active magnetic scanning is also possible. Generally, the patient can be accurately positioned to receive treatment. For this purpose, robotic instruments specified for accurate patient positioning relative to six directions of movement or rotation can be used. Preferably, the therapy control system can further serve as an interface for controlling and monitoring the treatment.

[0003] Generally, it is desirable to prevent healthy organs of a patient from receiving radiation, particularly particles delivered by a beam. For this purpose, the so-called “Bragg peak” is known to significantly reduce side effects on the patient. As commonly used, the term “Bragg peak” refers to a prominent peak within the so-called “Bragg curve,” a graphical representation of the energy loss of an incident beam relative to the distance the beam travels through matter (particularly through the patient’s tissue). Hadron beams exhibit a favorable effect: the Bragg peak appears immediately before the hadrons settle within the matter, particularly within the patient’s tissue. Therefore, to address the aforementioned problem of preventing healthy organs from receiving radiation, an improved range regarding the location of the Bragg peak within the tissue is desired. In this paper, it is particularly intended to apply a range verification method that minimizes range uncertainty and thus reduces the safety margin.

[0004] Among techniques for range verification of ion hadron beams in patient tissues, transient gamma imaging has proven to be the most promising for real-time ion beam tracking in clinical settings. Unlike other range verification techniques, such as positron emission tomography (PET), which relies on photon emission over longer timescales, transient gamma imaging allows for rapid detection of emitted gamma radiation due to the near-instantaneous emission of gamma radiation resulting from the nuclear interaction of the hadron beam with the tissue. However, transient gamma radiation has been described as not isotropic, but rather exhibiting a higher yield relative to back-peak and forward-peak gamma radiation. Furthermore, range verification is further complicated by the presence of segments along the beam direction following the Bragg peak.

[0005] J.Krimmer,D.Dauvergne,JMLétang,and Testa, Prompt-gamma monitoring in hadron therapy: A review, Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment 878, 2018, pp. 58-73. This paper provides an overview of all techniques for improving quality assurance in hadron therapy using prompt-gamma radiation detection and discusses existing techniques. In this paper, secondary radiation emission caused by nuclear reactions is correlated with ion pathways in matter. Therefore, this penetrating radiation can be used for in vivo control in hadron therapy, where the primary beam is absorbed within the patient. Prompt-gamma radiation is proposed to validate ion ranges in real time within secondary radiation emission. This validation is a desirable condition for reducing treatment planning uncertainty. This overview covers efforts made globally over the past decade to promote the use of prompt-gamma-based devices in clinical settings. Dedicated cameras are necessary to overcome the challenges of wide and high-energy distributions, large backgrounds, high transient count rates, and compatibility constraints with patient irradiation. Several types of prompt-gamma imaging devices, either physically collimated or electronically collimated, have been proposed. In addition, other methods based on specific calculations using time-of-flight or photon energy measurements, besides direct transient gamma imaging, are proposed.

[0006] Fernando Hueso-Gonzalez, Moritz Rabe, Thomas A Ruggieri, Thomas Bortfeld, and Joost M Verburg, in their paper "A full-scale clinical prototype for proton rangeverification using prompt gamma-ray spectroscopy," Phys. Med. Biol. 63, 2018, 185019, presented a full-scale clinical prototype system for in vivo range verification of proton pencil beams using prompt gamma-ray spectroscopy. The detection system consists of eight LaBr3 scintillators and a tungsten collimator mounted on a rotating frame. Custom electronics and calibration algorithms were developed to measure energy- and time-resolved gamma-ray spectra at clinical dose rates during proton irradiation. Detailed models of the expected gamma-ray emission for each individual pencil beam were created using experimentally determined nuclear reaction cross-sections and GPU-accelerated Monte Carlo simulations. The absolute range of the proton pencil beam was determined by minimizing the difference between the measured results and this model, thus making the absolute range of the beam and the elemental concentration of the irradiated material free parameters. The system is characterized by simulating clinically similar situations by irradiating different phantoms with a scanning pencil beam. A dose of 0.9 Gy was delivered to a 5 × 10 × 10 cm... 3 A beam current of 2 nA was incident on the phantom. The robustness of the validation method was tested and the accuracy of the detection range was calculated using different range offsetters and materials. When a pencil-shaped beam spot was focused within a cylindrical region of 10 mm radius and 10 mm depth, the absolute proton range of each spot in the distal energy layer was determined with an average statistical precision of 1.1 mm and an average systematic bias of 0.5 mm at a 95% confidence level. Intentionally introduced small range errors were successfully detected, and even large differences in elemental composition did not affect the accuracy of range validation. Therefore, this system is suitable for range validation during patient treatment in clinical studies. However, this system was designed for proton beams accelerated at a cyclotron, where a good correlation between the arrival time of the incident protons and the RF of the cyclotron was observed.

[0007] Yunhe Xie, El Hassane Bentefour, Guillaume Janssens, Julien Smeets, Francois Vander Stappen, Lucian Hotoiu, Lingshu Yin, Derek Dolney, Stephen Avery, Fionnbarr O'Grady, Damien Prieels, James McDonough, Timothy D. Solberg, Robert A. Lustig, Alexander Lin, and Boon-Keng K. Teo, Prompt Gamma Imaging for In VivoRange Verification of Pencil Beam Scanning Proton Therapy, Radiation Oncology, Vol. 99 (2017), pp. 210-218, report clinical results and value assessment of transient gamma imaging for in vivo proton range verification in a pencil beam scanning mode specifically designed for use in cyclotron accelerators. A standalone, cart-mounted prototype transient gamma camera, utilizing a knife-edge slit collimator, was used to record transient gamma signals emitted along the proton orbit during proton therapy in brain cancer patients. The recorded transient gamma depth detection profile of a single pencil beam spot was compared with the expected profile simulated according to the treatment plan.

[0008] Chul Hee Min, Han Rim Lee, Chan Hyeong Kim, and Se Byeong Lee, Development of array-type prompt gamma measurement system for in vivo rangeverification in proton therapy, Med. Phys. 39(4), 2012. To effectively measure the relationship between prompt gamma and background gamma, Monte Carlo simulations with MCNPX codes were used to optimize the configuration of the measurement system. The Monte Carlo method was used to understand the influence of background gamma, primarily neutron-trapped gamma, on the measured gamma distribution. To reduce the influence of background gamma, an optimized energy window of 4 MeV–10 MeV was used when measuring prompt gamma. Parameterized sources were used in the optimization study to maximize computational speed. A simplified test measurement system combining a single Csl(TI) scintillation detector, a multi-slit collimation system, and a motion system specified for moving only one detector from one measurement position to the next was constructed and applied to therapeutic proton beams of 80–220 MeV. To accurately determine the distal dose edge, an S-curve fitting method was applied to the measured distribution of the transient gamma. The half-value position between the maximum and minimum values ​​in the curve fitting was then determined as the distal dose edge and compared with the beam range evaluated by the proton dose distribution.

[0009] Christian Richter, Guntram Pausch, Steffen Barczyk, Marlen Priegnitz, Isabell Keitz, Julia Thiele, Julien Smeets, Francois Vander Stappen, Luca Bombelli, Carlo Fiorini, Lucian Hotoiu, Irene Perali, Damien Prieels, Wolfgang Enghardt, and Michael Baumann, First clinical application of a prompt gamma-based in vivo proton range verification system, Radiotherapy and Oncology 118, pp. 232-237, 2016, describes the use of a prototype slit-slit camera to measure the prompt gamma depth distribution in seven consecutive segments during proton therapy for head and neck tumors. Inter-segmental variations in the prompt gamma profile were evaluated. For three segments, in-room controlled CT was acquired and dose-related variations were assessed.

[0010] K.Rusiecka,A.Wrońska,P.Bednarczyk,D. A. Bubak, S. Feyen, L. Kelleter, A. K.Laihem,J.Leidner,A.Magiera,G.Obrzud,A.Stahl,M. Determination of Gamma Angular Distribution from the Shape ofSpectral Line for the First Excited State of Carbon Nucleus,World Journal ofNuclear Science and Technology, 2016, Volume 6, Pages 63-70, and K. Rusiecka, A. Wrońska, A. Magiera, G. Gazdowicz, G. Obrzud, L. Kelleter, K. Laihem, J. Leidner, A. Stahl, A. Chrobak, A. Shape of the spectral line and gamma angulardistribution of the 12C(p,p'γ 4.44 The 12c reaction, Acta Physica Polonica B, Vol. 49 (No. 9), 1637, 2018, presents a model to explain the shape of the nuclear reaction-specific spectral lines used in the transient gamma spectroscopy of proton beams with initial beam energies of 70.54 MeV and 88.97 MeV. The angular distribution of this gamma emission exhibits two local maxima near 50 degrees and 130 degrees. Furthermore, J. Kiener, Shape and angular distribution of the 4.439-MeV γ-ray line from proton inelastic scattering off... 12 These results were confirmed using simulations based on a 68-MeV proton beam stopped in human tissue, C, Physical Review C 99, 014605, 2019.

[0011] EP 2 977 083 A1 discloses an apparatus and method for validating charged hadron therapy by detecting and / or quantifying transient gamma generated when a target is irradiated with a charged hadron beam. The apparatus includes a collimator with a slit-shaped portion configured to be perpendicular to the beamline and facing the target, a detection device adapted to detect the transient gamma, and a calculation and representation device. In the apparatus and method of the invention, the slit is configured to allow transient gamma emitted from a depth range in the target to pass through, the depth being measured in the direction of the charged hadron beam. Furthermore, the detection device is configured to detect transient gamma emitted from each location within the range, and the calculation and representation device is configured to derive a value representing the dose at the location where the transient gamma was emitted from the detected transient gamma, and to represent the dose-related distribution at multiple locations within the range.

[0012] US 2011 / 0057110 A1 discloses a method for real-time measurement of the local dose received by a target region when it is bombarded by an incident hadron beam that produces at least transient gamma rays and neutrons. The method involves collimating the target region and measuring the particles emitted by the target by placing a detector at a distance from the target region. The detector is linked to a device for measuring particle energy and time-of-flight, such as a tracker including a scintillation fiber or polycrystalline diamond detector. The number of transient gamma rays received by the detector is determined by selecting recorded events, and a two-way charged particle detection system positioned in front of the target within the incident hadron beam is used to obtain the lateral position of the incident hadrons, providing spatial information about the beam.

[0013] US 2015 / 0321025 A1 discloses an apparatus and method for validating charged hadron therapy. The apparatus includes a collimator comprising a plurality of collimator plates having a given thickness, the plates being spaced apart to form an array of common slit-shaped openings, configured to be placed perpendicular to the beamline to allow the passage of transient gamma from the target. The collimator is defined by at least three geometric parameters: the width and depth of the slit-shaped opening, and a fill factor. This disclosure also relates to a method for validating charged hadron therapy using a multi-slit camera.

[0014] WO 2015 / 040225 A1 discloses an apparatus and method for monitoring the particle radiation range of a cyclotron, as a radiation device for radiotherapy, the radiation device having at least one detector capable of detecting a single gamma particle and at least one analyzer. When a gamma particle (event) is detected, a signal is generated in the detector, thereby correlating the signal in time with the arrival of the gamma particle in the detector. The analyzer, which analyzes the signal from the detector, assigns the detection time to each event or to selected events. The radiation device or a separate particle detector provides a reference signal that is correlated with the appearance of a single particle or particle beam from the radiation device with a time uncertainty of ≤10 ns. A technique also known as transient gamma timing (PGT) correlates the time difference between the arrival of an incident proton in the target incident plane and the time when a transient gamma is detected at the gamma detector. Transient gammas from protons that travel further in the target are detected later than those that stop earlier, which causes a time distribution shift that may be related to the proton range.

[0015] WO 2017 / 156113A1 discloses a technique for imaging radioactive emissions in a target volume, the technique comprising receiving data indicating a set of one or more known emission energies associated with a high-energy particle source and determining a Compton line for each emission energy in the set. A Compton camera collects location and deposited energy from interactions associated with a single source event from the target volume of the object. For a single source event, a cone is determined with the earliest deposited energy E1 and a first scattering angle θ1, as well as the possible location of the source event. If E1 is not within a predetermined interval of the Compton line for at least one of the known emission energies, then the specific location of the high-energy particle source within the target volume does not include the single source event. The solution is presented on a display device.

[0016] WO 2012 / 011083 A1 discloses a device for monitoring photon radiotherapy, comprising a radiation detector plus a porous collimator, readout electronics, and a data acquisition system capable of processing detected events and beam position. The device is supported by a fixed or telescopic arm attached to a LINAC support structure, or by a separate support. Radiation-absorbing material can be placed between the LINAC head and the collimator. Furthermore, a shielding material can be used close to the device between the device and the LINAC head. The porous collimator only allows photons to be collected when photons escaping from the target / patient on the couch are emitted approximately perpendicular to the central axis of the beam direction.

[0017] EP 2 078 537 A1 discloses a radiotherapy support device, the radiotherapy support device comprising a storage unit for storing absorbed dose volume data representing the spatial distribution of absorbed dose in an object, a generation unit for generating fused data associated with the morphological volume data of the object and the absorbed dose volume data for association with multiple segments, and a display unit for displaying an image having an absorbed dose distribution superimposed on a two-dimensional morphological image of the object using the fused data.

[0018] US 2006 / 0113482 A1 discloses an image-guided radiotherapy apparatus and method, wherein a radiotherapy radiation source and a gamma-ray photon imaging device are positioned relative to a patient area, such that the patient can be treated by a beam emitted from the radiotherapy apparatus and images can be captured by the gamma-ray photon imaging device. In some embodiments, radiotherapy treatment and imaging can be performed substantially simultaneously and / or can be performed without moving the patient. The gamma-ray photon imaging device can be coupled relative to any part of a building structure and can be movable, may be mounted on a portable frame capable of moving toward and from the radiotherapy radiation source and the patient, or may take other forms. In some embodiments, the gamma-ray photon imaging device can be used for imaging in conjunction with other types of medical interventions.

[0019] EP 2 950 119 A1 discloses a particle beam system for delivering particles or particle beams to a target, wherein the system includes a detector for detecting a transient gamma. The transient gamma is detected at two different locations relative to the target and synchronously with a reference timing signal to obtain a transient gamma timing profile. The time width difference between the two timing profiles is used to infer the penetration depth of the particle beam in the target. Furthermore, it discloses a method for verifying the penetration depth of a high-energy particle beam by correlating the difference between the two transient gamma timing profiles with the positional difference of the detector relative to the target.

[0020] WO 2012 / 152938 A2 discloses a method and apparatus for verifying beam range in a target irradiated by a charged hadron beam, such as a proton beam. Beam range is the location of the Bragg peak in the target, i.e., the location where the largest portion of the dose is delivered. The method utilizes a transient gamma camera configured with a slit-shaped opening to generate a one-dimensional profile of the dose distribution along the beamline. The camera is mounted such that the slit is oriented perpendicular to the beamline. The method includes the steps of: calculating the position of the camera relative to the target to obtain multiple beam energies and beam spots to be irradiated. The method further includes the steps of: verifying the beam range of the multiple beam spots and delivering values ​​representing the difference between the estimated beam range and the actual beam range. The apparatus is provided with a positioning module for positioning the camera.

[0021] JP 2010 032451 A discloses an apparatus for confirming the irradiation location of a particle beam using a device in a particle beam irradiation system capable of applying two or more types of particle beams. The system includes a particle beam generator that generates two or more particle beams, an irradiation apparatus that emits the particle beams onto an object to be irradiated, a gamma-ray detector that detects gamma rays generated from the object to be irradiated based on the particle beams emitted from the irradiation apparatus, a signal processor that determines whether a gamma-ray detection signal from the gamma-ray detector originates from a transient gamma ray or from an annihilation gamma ray, and an irradiation field confirmation device that detects the field irradiated by the particle beam whose gamma-ray detection signal, determined by the signal processor, is from a transient gamma ray and obtains the field irradiated by the particle beam whose gamma-ray detection signal is determined to originate from an annihilation gamma ray.

[0022] WO 2012 / 104416 A1 discloses an apparatus and method for validating charged hadron therapy by detecting and / or quantifying transient gamma generated when a target is irradiated with a charged hadron beam. The apparatus includes a collimator with a slit-shaped portion configured to be perpendicular to the beamline and facing the target, a detection device adapted to detect the transient gamma, and a calculation and representation device. In the apparatus and method, the slit is configured to allow transient gamma emitted from a depth range within the target to pass through, the depth being measured in the direction of the charged hadron beam. Furthermore, the detection device is configured to detect transient gamma emitted from each location within the range, and the calculation and representation device is configured to derive a value representing the dose at the location where the transient gamma was emitted from the detected transient gamma, and to represent the dose-related distribution at multiple locations within the range.

[0023] The problem to be solved

[0024] Therefore, an object of the present invention is to provide an apparatus and method for monitoring treatment of a patient’s body parts with a beam comprising particles, said apparatus and method at least partially avoiding the disadvantages of known apparatus and methods.

[0025] Therefore, a specific objective of the present invention is to provide an apparatus and method for monitoring treatment of a patient's body parts, the apparatus and method achieving higher resolution in determining the Bragg peak for verifying the range and dose delivery of particles delivered by a beam to the patient's body parts.

[0026] Specifically, it is expected that the apparatus and method can be designed to take into account the anisotropic portion of the transient gamma radiation and the segment that appears in the beam direction after the Bragg peak when verifying range and dose delivery. Summary of the Invention

[0027] This problem is addressed by means of apparatus and methods for monitoring treatment of a patient's body parts with a beam comprising particles, and by computer program products comprising executable instructions for carrying out the methods according to the subject matter of the independent claim. Preferred embodiments of the invention, which can be implemented in isolation or in any arbitrary combination, are disclosed in the dependent claims.

[0028] As used in this specification, the term "comprising" or its grammatical variations will be used to specify the presence of a stated feature, integer, step, or component or group thereof, but will not preclude the presence or addition of one or more other features, integers, steps, components or groups thereof. The same applies to the term "having" or its grammatical variations, which are used as synonyms for the term "comprising".

[0029] In a first aspect of the invention, an apparatus is disclosed for monitoring treatment of a patient's body parts with a beam comprising particles, wherein the detector comprises:

[0030] - A beam delivery unit, specified for delivering a beam comprising particles and adjusting the propagation direction of the beam onto a body part of the patient; and

[0031] - A verification unit, designated to verify the extent and dose delivery of the particles provided by the beam to the patient's body part by determining information regarding the transient gamma radiation generated through the interaction of the particles with the patient's body part at at least two separate points of interaction.

[0032] The verification unit includes an axis of symmetry that is symmetrical about the at least two individual interaction points and is positioned perpendicularly to the propagation direction of the beam.

[0033] Therefore, the device for monitoring treatment of a patient's body parts can preferably be used to monitor particle therapy on a patient's body parts, wherein the patient's body parts include tumor tissue. In this document, the tumor tissue may include tumor modifications that may have been introduced into the patient's tissues through cancer. As commonly used, the term "cancer" refers to a disease of animals, particularly mammals and especially humans, characterized by the uncontrolled growth of a group of body cells (usually referred to as "cancer cells"). This uncontrolled growth may be accompanied by invasion and destruction of surrounding tissues (i.e., "invasion") and the possible spread of cancer cells to other parts of the body (i.e., "metastasis"). Preferably, cancer can be selected from the list consisting of: acute lymphoblastic leukemia, acute myeloid leukemia, adrenocortical carcinoma, AIDS-related lymphoma, anal cancer, appendiceal cancer, astrocytoma, atypical teratoma, basal cell carcinoma, bile duct cancer, bladder cancer, brainstem glioma, breast cancer, Burkitt lymphoma, carcinoid tumor, cerebellar astrocytoma, cervical cancer, chordoma, chronic lymphocytic leukemia, chronic myeloid leukemia, colon cancer, Colorectal cancer, craniopharyngioma, endometrial cancer, ependymoblastoma, ependymoma, esophageal cancer, extracranial germ cell tumors, gonadal germ cell tumors, extrahepatic bile duct cancer, bile duct cancer, gastric cancer, gastrointestinal stromal tumors, trophoblastic tumors, hairy cell leukemia, head and neck cancer, hepatocellular carcinoma, Hodgkin's lymphoma, hypopharyngeal cancer, hypothalamic and visual pathway gliomas, intraocular melanoma, Kaposi's sarcoma, laryngeal cancer, medulloblastoma, medullary epithelial tumor, melanoma. Tumors, Merkel cell carcinoma, mesothelioma, oral cancer, multiple endocrine neoplasia syndrome, multiple myeloma, mycosis fungoides, nasal and sinus carcinoma, nasopharyngeal carcinoma, neuroblastoma, non-Hodgkin's lymphoma, non-small cell lung cancer, oral cancer, oropharyngeal carcinoma, osteosarcoma, ovarian cancer, ovarian epithelial carcinoma, ovarian germ cell tumor, low-grade potential ovarian tumor, pancreatic cancer, papilloma, paranasal sinus and nasal cavity carcinoma, parathyroid carcinoma, penile cancer, pharyngeal cancer, phytotoxicity. Chromocytoma, pituitary adenoma, pleural pulmonary blastoma, primary central nervous system lymphoma, prostate cancer, rectal cancer, renal cell carcinoma, retinoblastoma, rhabdomyosarcoma, salivary gland cancer, Korsakoff syndrome, small cell lung cancer, small bowel cancer, soft tissue sarcoma, squamous cell carcinoma, squamous neck cancer, testicular cancer, laryngeal cancer, thymic carcinoma, thymoma, thyroid cancer, urethral cancer, uterine sarcoma, vaginal cancer, vulvar cancer, Waldenström macroglobulinemia, and Wilms' tumor.

[0034] Alternatively or additionally, the apparatus used to monitor treatment of a patient's body parts can also be used to determine the presence and / or elemental composition within the patient's body parts being irradiated by particles provided by the beam. Therefore, according to the invention, the term "patient's body parts" includes, on the one hand, tissues already developed within the patient's body, particularly tumor tissue already formed within a specific body part as described above, but on the other hand, it also includes inserts intentionally or unintentionally introduced into a specific body part of the patient. By way of example, studying a patient's body composition may relate to whole-body nitrogen as a direct measure of whole-body protein as an assessment of nutritional status. It can also be used to detect early cases of cadmium poisoning in the liver and kidneys in certain polluted areas. Furthermore, total hydrogen, total chloride, and total calcium in the body can be measured, for which thorough in vivo activation analysis (IVAA) can be employed. By another example, determining the elemental composition of the irradiated target can be used to calculate the oxygen and / or carbon concentrations of the irradiated tumor tissue, thereby detecting different types of cancer through changes in their oxygen and / or carbon concentrations. By another example, inserts can be or include implants that are surgically introduced into the patient primarily for medical purposes. As another example, inserts may be introduced into the patient due to accident or injury. Therefore, the device according to the invention can also be used to determine the presence and / or elemental composition of inserts, such as metallic implants, within a patient, particularly in an arrangement where the metallic implant may be close to the target volume for irradiation. Thus, the term "treatment" refers, on the one hand, to radiotherapy applications, particularly radiotherapy applications for treating cancer within tumor tissue, but on the other hand, it can also refer to determining the presence and / or elemental composition of inserts, such as implants, within a patient by treating this particular body site with a particle beam. Furthermore, the term "patient" refers, on the one hand, to anyone undergoing treatment involving a particle beam according to the invention, regardless of whether that person requires any medical treatment, and on the other hand, to a phantom, particularly a humanoid phantom. Hereinafter, neutrons, protons, or light ions can excite nitrogen, carbon, and / or oxygen atoms from the human body, which can decay by emitting transient gamma radiation. Hereinafter, the low-energy line associated with the implant can be used as a device to investigate the presence of metals or other high-Z materials, thereby allowing for a non-invasive assessment of the composition of the irradiated target. For example, in prostate cancer, an implant can be inserted into the rectum to provide information on whether the organ is suitable for irradiation. In this study, the rectum is sensitive to radiation but is close to the prostate, making it desirable for the patient to be protected from radiation.

[0035] As indicated above, this device is used in situations where a patient's body part is subjected to treatment involving a beam comprising particles. As used herein, the term "beam" refers to a plurality of particles emitted in a specific direction, the direction of propagation of which the emission forms the direction of propagation of the beam, also simply referred to as the "propagation direction" of the beam. Furthermore, a beam can be a bundle comprising particles and having a predetermined extension in a direction perpendicular to the propagation direction.

[0036] According to the invention, the apparatus includes a beam delivery unit. The term "beam delivery unit" refers to a device designated for delivering a beam and adjusting the propagation direction of the beam onto a body part of a patient. For this purpose, the beam delivery unit may preferably include a receiver for an incident particle beam provided by a radiation source and an adjustable delivery nozzle designated for shaping the incident particle beam in such a way that the incident particle beam is preferably conformable, as far as possible, to the solid geometry of the patient's body part in terms of its cross-sectional shape and the shape of its distal surface. For this purpose, the beam delivery unit may also include at least one of a range modulator, a de-energizer, a collimator, or a compensator. However, other types of embodiments of the beam delivery unit are also contemplated.

[0037] According to the invention, the beam comprises hadron particles selected from neutrons or ions propagating along the beam direction. Specifically, the ions preferred herein are particularly selected from protons. 1 p, or selected from helium 4 He ions, carbon 12 C ions or oxygen 16 O ions, because each of these kinds or types of ions shows high clinical potential in terms of efficacy and effectiveness. Therefore, carbon ions 12 C is particularly preferred because it exhibits reduced lateral diffusion and increased biological effects. Ions used in this invention can preferably be provided by a radiation source selected from cyclotrons or synchrotrons, in which particles are accelerated using a combination of electric and magnetic fields. In a cyclotron, particles travel in a spiral manner due to a constantly applied magnetic field, while in a synchrotron, the magnetic field is continuously adjusted in such a way that it allows the accelerated particles to be kept in a circular orbit, thereby creating a fixed closed-loop path for the particles. A portion of the particles provided in this manner is then used to generate desired ion beams that propagate in one or more beamlines.

[0038] As further indicated above, it is desirable to minimize the reception of particles delivered by the beam into the patient's healthy organs. For this purpose, the device according to the invention is specified for monitoring treatment of a patient's body parts with a particle beam. As commonly used, the term "monitoring" refers to the process of continuously acquiring data and deriving desired information from it. For this purpose, multiple measurement signals from which desired information can be determined can be generated and evaluated. In this document, multiple measurement signals may be recorded at fixed or variable time intervals, or alternatively or additionally upon the occurrence of at least one predetermined event. In particular, the device according to the invention can be specifically specified for continuously determining the particle range in the patient's body parts and the dose delivery into the patient's body parts.

[0039] Based on monitoring, verification of the range and dose delivery of particles supplied by a particle beam to a patient's body site can be performed. As commonly used, the term "verification" refers to providing evidence regarding the range of particles in the patient's body site and the dose delivery entering the patient's body site, specifically regarding the location of the so-called "Bragg peak" within the patient's body site. As indicated above, the term "Bragg peak" refers to a prominent peak within the so-called "Bragg curve," which represents a graphical representation of the energy loss of the incident beam with respect to the distance the beam travels through the patient's body site. Advantageously, the Bragg peak appears immediately before the particles supplied by the beam settle within the patient's body site. In this document, the term "range" refers to the distance the particles travel within the patient's body site, which is primarily determined by the Bragg peak, while the term "dose delivery" refers to the intensity of the particle radiation at the Bragg peak. Therefore, such verification can reduce range uncertainty and safety margins during patient treatment, significantly reducing side effects on the patient by preventing radiation from reaching the patient's healthy organs.

[0040] Furthermore, the apparatus according to the invention includes a verification unit. As used herein, the term "verification unit" refers to a device designated for verifying the extent and dose delivery of particles supplied by a beam to a patient's body part. For this purpose, the verification unit is adapted to determine information regarding transient gamma radiation generated through the interaction of particles with the irradiated body part of the patient. As commonly used, the term "interaction" refers to the response provided by the patient's body part upon particle irradiation. As further commonly used, the term "transient gamma radiation" refers to secondary radiation emission caused by nuclear reactions associated with particle paths in matter. For this purpose, the particle energy supplied by the incident beam is absorbed within the patient's body part. Thus, the transient gamma radiation generated in this manner can be used for verification according to the invention, preferably for real-time verification of the extent of particles within the patient's body part and dose delivery into the patient's body part under clinical conditions, preferably resulting in reduced uncertainty in treatment planning.

[0041] According to the invention, treatment of a patient's body parts with a particle beam is monitored by determining information regarding transient gamma radiation at at least two individual interaction points, preferably at two, four, six, eight, twelve, or more different interaction points, wherein two, four, six, eight, or twelve interaction points are preferred. Generally, the number of interaction points selected for monitoring purposes can be adjusted to obtain sufficient information with high spatial resolution by minimizing any effort. As used herein, the term "interaction point" refers to a location within the patient's body part where the body part exhibits a specific response upon irradiation by a particle that can be observed by a verification unit. As indicated above, transient gamma radiation is not isotropic but has a higher yield relative to both backward and forward peak gamma radiation. Furthermore, the verification of the desired range is further complicated by the presence of segments in the beam direction following the Bragg peak. Therefore, determining the transient gamma radiation at at least two individual interaction points between the particle and the patient's body part allows for improved accuracy in verifying the particle range within the Bragg peak compared to other devices and methods according to the prior art.

[0042] According to the invention, the verification unit includes an axis of symmetry, wherein the axis of symmetry is symmetrical about individual interaction points. As commonly used, the term "axis of symmetry" refers to the arrangement and configuration of the verification unit, wherein the two halves of the verification unit generated by the axis of symmetry are identical, in particular, relative to each other, in such a way that one half appears as an image of the other half in a mirror. Hereinafter, the two halves may exist physically simultaneously in the verification unit, such as through a symmetrical arrangement of corresponding detector elements. In an alternative embodiment, as described in more detail below, in which only a single detector element may be physically present in the verification unit, the single detector element may be movable within the verification unit to a symmetrical position about the respective interaction points.

[0043] Further according to the invention, the axis of symmetry of the verification unit is positioned perpendicular to the propagation direction of the beam. As used herein, the term "perpendicular" refers to an angle of 90°±10°, preferably 90°±1°, and preferably 90°±0.1° relative to the propagation direction of the beam. Similarly, the term "parallel" refers to an angle of 0°±10°, preferably 0°±1°, and preferably 0°±0.1° relative to the propagation direction of the beam. Therefore, information regarding the transient gamma radiation determined by the verification unit includes only the component perpendicular to the propagation direction of the beam.

[0044] Because the verification unit's axis of symmetry is arranged perpendicularly to the beam propagation direction, at least one plane can be formed, in which at least two of the detector elements of the verification unit can be positioned symmetrically, or in the alternative embodiments indicated above, a single detector element of the verification unit can be symmetrically movable. In cases where the verification unit may include four, six, or more detector elements, two of the symmetrically positioned detector elements can form a separate plane. However, regardless of the number of detector elements within a plane, each plane can intersect the beam propagation direction. In other words, the plane comprises a straight line along the beam direction and one of a plurality of possible points from the detector elements, such that all detected transient gammas lie within this plane.

[0045] Furthermore, the "emission angle" can be defined by the origin of the transient gamma ray at a specific interaction point along the beam direction and the detection point of the corresponding detector element. Since all detected transient gamma rays lie within the plane defined above, the emission angle can be rotated in the plane around the interaction point, which serves as the origin of the transient gamma ray to be detected. Reconstruction of the detection line within the patient's body part and at least one detector element involves knowing the position of at least one detection point and the position of the straight line defined by the beam direction. In other words, the interaction point can be detected by intersecting the detection line with the propagation direction of the beam. As a result of the arrangement according to the invention, several emission angles are positioned coplanarly in the plane. Different planes that may not intersect the straight line are independent of the detection point. Therefore, for each transient gamma radiation generated by the interaction of the beam with the patient's body part, the origin of the transient gamma radiation may be associated with the location where the interaction occurs. At this location, the beam may exhibit a specific energy that decreases with increasing depth of the beam within the patient's body part. As another result, the angular cross section may depend on the emission angle as shown by Rusiecka et al. and Kiener (see above), where some emission angles may exhibit a higher cross section than others, thus leading to a higher expected transient gamma yield for certain emission angles compared to others.

[0046] As another result of the perpendicular arrangement of the verification unit's axis of symmetry relative to the beam propagation direction, the verification unit is specified to move perpendicular to the beam propagation direction in at least one plane formed by the detector element and the beam propagation direction. Thus, the detector element is specifically designed to acquire information about transient gamma radiation, which is generated as secondary radiation emission through the interaction of particles with the patient's body parts at at least two separate points of interaction where the particles strike the patient's body parts.

[0047] As a particularly important result of using at least two separate interaction points to monitor treatment of a patient's body parts with a particle beam, the apparatus and method according to the invention are designed to determine the absolute value of the particle range within the patient's body part. Hereinafter, the term "absolute value" refers to a data point provided in both numerical and physical units, where the physical units specifically refer to distances within the patient's body part, such as given in μm. This feature contrasts with known apparatuses and methods that can only provide particle ranges in relative values, where the term "relative value" refers to another data point within the patient's body part provided only in numerical form or in the form of numbers and arbitrary units unrelated to physical units, such as distance. As a result of determining the absolute value of the particle range, distances within the patient's body part can be determined with high spatial resolution, thereby allowing treatment of the patient's body part by the incident beam to be limited to a desired particle range, particularly to tumor tissue including tumor-modified tissue introduced by cancer.

[0048] According to the present invention, the axis of symmetry of the verification unit can be arranged perpendicularly to the propagation direction of the beam in various embodiments.

[0049] In a preferred embodiment, the device further includes a single rotating gantry and a patient positioning platform, wherein at least one of the gantry and the patient positioning platform is movable relative to the other in such a way that the beam propagation direction can be adjusted to different positions relative to the patient. As commonly used, the term "movable" refers to the characteristic that the position of the component indicating the corresponding component is not fixed, allowing the component to be moved to different positions. This configuration allows the distance and / or relative orientation between the gantry and the patient positioning platform to be corrected by moving only a single component of the device.

[0050] As further commonly used, the term "patient positioning platform" refers to a receiving unit designated for receiving a patient, moving the patient to a designated appropriate position for receiving treatment, and maintaining the patient in that position during treatment. For this purpose, robotic instruments can preferably be used to accurately position the patient relative to six directions of movement or rotation. However, other types of patient positioning platforms are also feasible. Since patients typically exhibit a geometry with rotational symmetry along a longitudinal axis, the patient positioning platform can preferably be designed to reflect this geometry. As a result of this configuration, the patient positioning platform may include a platform with an elongated shape, which can preferably be adapted to the longitudinal axis of the patient. Furthermore, the elongated shape of the patient positioning platform can be used to define a "plane" for the patient positioning platform, such as by employing adjustment functions like fitting functions.

[0051] As further commonly used, the term "rotating gantry" or simply "gantry" refers to a gantry adapted to receive a patient positioning platform and rotate relative to the patient positioning platform, preferably rotating 360° to deliver the particle beam to the patient's body part at any desired angle, particularly at an angle specified by the treatment. According to this embodiment, the gantry, the patient positioning platform, or both can be designated to be movable to adjust the direction of particle propagation relative to the patient as needed.

[0052] In this preferred embodiment, the rack may include movable sidewalls and a movable front wall, wherein the front wall may be positioned perpendicular to the sidewalls. As used herein, the term "sidewall" refers to a first portion of the rack's inner surface positioned parallel to the longitudinal axis of the patient, while the term "front wall" refers to another portion of the rack's inner surface positioned perpendicular to the longitudinal axis of the patient. Furthermore, the remainder of the rack may be open to allow access to the patient positioning platform by the patient, medical staff, or service personnel. As a result of this embodiment, the front wall may be oriented perpendicularly to the sidewalls. However, other types of embodiments for the rack, and other arrangements that may involve different orientations and / or orientations of the patient positioning platform within the rack, are also feasible.

[0053] In a particular embodiment, both the beam delivery unit and the verification unit are coupled to the sidewall and are capable of moving synchronously with the sidewall to different positions relative to the patient positioning platform. As used herein, the term "synchronous" refers to the manner of movement of at least two individual components, wherein the individual components move with the same direction vector and the same rotation vector, where each of the direction vector or rotation vector may be a zero vector. As a result of this embodiment, the axis of symmetry of the verification unit can be maintained perpendicular to the direction of beam propagation during treatment, although only the sidewall can move, while other parts of the device, such as the front wall or the patient positioning platform, can remain in place.

[0054] In an alternative implementation, the beam delivery unit may be attached to the sidewall and can move to different positions relative to the patient positioning platform with the sidewall, while the verification unit may be attached to the front wall and can move to different positions relative to the patient positioning platform with the front wall in a manner synchronized with the beam delivery unit. As indicated above, the front wall may preferably be vertically oriented relative to the sidewall, such that in this configuration, the vertical arrangement of the verification unit relative to the beam propagation direction can be maintained in a particularly easy manner during treatment.

[0055] In another alternative embodiment, the beam delivery unit may be positioned in a fixed location relative to the patient positioning platform, wherein the beam delivery unit may be designated to deliver a beam at any orientation relative to the patient positioning platform, preferably at an angle of 0° or 90°. Alternatively, the beam delivery unit may be designated to deliver a beam at an angle of 45° ± 45°. Thus, the beam delivery unit may be positioned vertically or near vertically relative to the plane defined by the patient positioning platform, while the verification unit may be positioned perpendicular to it to avoid interfering with the movement of the patient positioning platform, preferably at a 45° angle, or be able to move around the patient positioning platform to a desired location to avoid conflict with the patient positioning platform. As a result of this configuration, the verification unit may always maintain a desired vertical orientation relative to the direction of beam propagation, regardless of the movement of the beam delivery unit.

[0056] In another alternative embodiment, a toroidal gantry, such as that disclosed in WO 2019 / 224215 A1, can be used, wherein the gantry does not rotate. Hereinafter, the beam has various possible orientations and the magnetic field within the toroidal plane is zero. However, the device according to the invention can be used by rotating independently of the gantry but still perpendicular to the beam's orientation. Hereinafter, synchronization of the device can be provided by using prior information related to the beam's orientation, wherein at least one detector element is not synchronized with the gantry but with the beam's orientation. Alternatively, a separate device can be attached to the possible delivery angle of the beam.

[0057] Further preferred embodiments of the invention, which can be implemented in isolation or in any arbitrary combination, are disclosed in more detail below.

[0058] In a particularly preferred embodiment, the verification unit may include at least one detector element, wherein the detector element is designated to determine the transient gamma radiation generated by the interaction of the particle with the body part of the patient.

[0059] As used herein, the term "detector element" refers to a device designated for generating a measurable signal from incident transient gamma radiation. For this purpose, the measurable signal can preferably be selected from electrical signals, particularly voltage or current. Specifically, the detector element can be selected from at least one of the following: photomultiplier tube (PMT), solid-state single-photon sensing device (silicon photomultiplier tube; SiPM), charge-connected device (CCD), complementary metal-oxide-semiconductor (CMOS), or quantum image sensor (QIS) chip. However, other types of detector elements are also feasible. Where the verification unit may include more than a single detector element, it is particularly preferred that the individual detector elements have the same type and class to increase the comparability of the measured signals between the individual detector elements.

[0060] In this particularly preferred embodiment, the verification unit may include at least two detector elements, preferably two, four, six, eight, twelve, or more detector elements. Hereinafter, the two detector elements are spaced apart from each other, and thus can preferably determine information about the transient gamma radiation at at least two separate interaction points simultaneously. However, alternatively or additionally, it may also be feasible to determine information about the transient gamma radiation sequentially.

[0061] Furthermore, preferably, each detector element can be designated to move toward or away from the patient's body part in a manner perpendicular to the beam propagation direction, such that the distance between each detector element and the patient's body part remains equal for each detector element. Maintaining the same distance between each detector element and the patient's body part allows for the determination of desired information regarding transient gamma radiation of equal intensity, thereby improving the comparability of signals measured between each detector element. As used herein, the term "toward or away from the body part" refers to movement that reduces or increases the distance between a particular detector element and the patient's body part. By moving a particular detector element in this manner, the distance between two individual points of interaction can be adjusted. As a result, the position along the beam propagation direction can be focused or defocused, thereby setting the spatial resolution for detecting transient gamma radiation in this manner. For this purpose, in a particular embodiment, each detector element can be applied to a separate member of a support, wherein the support can be directly coupled to a frame, such as to a side wall of the frame, and wherein at least one separate member can be movable relative to the frame in a direction perpendicular to the beam propagation direction. In another configuration, four or more detector elements can be arranged in an array. For further details regarding the detector elements, supports, and individual components of the supports, reference can be made to the embodiments described below. However, other arrangements of the detector elements are also conceivable.

[0062] In an alternative implementation, the verification unit may comprise only a single detector element. However, in order to determine information about the transient gamma radiation at at least two individual interaction points, the single detector element may preferably be designated for placement at at least two different locations within the verification unit relative to the patient's body part. During movement between placements at at least two different locations, for the same reasons indicated above, it is preferable to maintain a distance between the detector element and the patient's body part for each different location. In this alternative implementation, the single detector element can thus be moved between the at least two different locations on a first timescale that is faster than a second timescale that moves the detector element toward or away from the patient's body part perpendicular to the beam propagation direction, thereby allowing the distance between the individual interaction points to be adjusted as described above. Herein, moving the detector element toward or away from the body part may be associated with equal-energy slices (IES). For each slice, the detector element may be moved to a location according to the desired resolution. Herein, the most distal slices may require a more concentrated configuration to achieve higher resolution. By way of example, the transmission time for each slice may be 5 seconds, followed by a 4-second pause between two subsequent slices. In this embodiment, the 4-second pause can constitute the second timescale as defined above, where the 5-second first timescale can be the delivery time including the movement between two different locations of the detector element. However, this implementation can still be used to focus on the most distal slice in cases where multiple IES deliveries are performed to improve delivery speed. Although using only a single detector element may be advantageous for device quality assurance purposes due to its simplicity, for actual patient treatment, at least two, preferably four, six, eight, or twelve detector elements may be particularly preferred, as this configuration allows for enhanced sensitivity of the verification unit and thus increases the spatial resolution for determining the particle range within the patient's body parts.

[0063] Furthermore, the verification unit may also include a collimator unit. As commonly used, the term "collimator unit" refers to a device designated for collimating and shaping the detection of transient gamma radiation after it has been generated by the interaction of particles with the patient's body part, but before it enters at least one detector element. Collimating the transient gamma radiation before it is detected in the corresponding detector element can advantageously result in a desired increase in the spatial resolution for the detection of transient gamma radiation within the patient's body part. However, verification units without a collimator unit are also conceivable.

[0064] Furthermore, the verification unit may also include an evaluation device. As commonly used, the term "evaluation device" refers to a device designated for determining information about transient gamma radiation that has been acquired by at least one detector element, and specifically based on a measurable signal provided to the evaluation device by at least one detector element. For this purpose, a wired connection may be provided, or alternatively or additionally, a wireless connection may be provided between at least one detector element and the evaluation device.

[0065] The evaluation device according to the invention can be particularly designed to verify the particle range and dose delivery of particles delivered by a beam to a patient's body site, wherein such information can be based on a measurable signal provided to the evaluation device by at least one detector element. For this purpose, the evaluation device may include a fast analog-to-digital converter, preferably having a sampling rate of 10 ns, more preferably 4 ns, even more preferably 1 ns or lower. In this document, the fast analog-to-digital converter may preferably be selected from at least one of the following: a flash analog-to-digital converter (FADC), a field-programmable gate array (FPGA), a Visa module Eurocard (VME) digitizer, a time readout board (TRB), or an oscilloscope. However, other types of fast analog-to-digital converters are also contemplated.

[0066] In another aspect of the invention, a method for monitoring treatment of a patient's body parts with a beam comprising particles is disclosed. The method according to the invention comprises at least the following steps; however, additional steps may also be performed. In a preferred embodiment, the indicated steps may be performed sequentially; however, subsequent steps may be performed at least partially concurrently with the preceding step. In an alternative preferred embodiment, the mentioned steps may be performed, in particular, in a combined method or a hybrid method combining sequential and combined methods, to minimize the time and / or storage space required to perform the method. Furthermore, other steps not indicated herein may also be performed.

[0067] Specifically, a method for monitoring treatment of a patient's body parts with a beam comprising particles includes the following steps:

[0068] - Provides a device, as described elsewhere in this document, for monitoring treatment of a patient’s body parts with a beam comprising particles;

[0069] - Delivering a beam containing particles and adjusting the direction of propagation of the beam to the patient's body parts;

[0070] - Determine information regarding the transient gamma radiation generated by the interaction of the particles with the patient's body part at at least two separate points of interaction, including the beam containing the particles and the patient's body part; and

[0071] - Verify the range and dose delivery of the particles delivered by the beam to the patient's body part.

[0072] In a particularly preferred embodiment, determining information about the transient gamma radiation may preferably include

[0073] - Specify at least two positions along the propagation direction of the beam by moving at least one detector element included in the verification unit perpendicular to the propagation direction of the beam;

[0074] - To move a separate component of the support member further comprising the verification unit, wherein at least one detector element is applied to the separate component, wherein the separate component moves toward or away from the body part of the patient in such a way that the position along the delivery direction of the beam is focused or defocused, thereby setting the spatial resolution for detecting the transient gamma radiation; and

[0075] - Detect the signal generated by the interaction between the transient gamma radiation and the at least one detector element.

[0076] In this particularly preferred embodiment, determining information about the transient gamma radiation may also preferably include

[0077] - Determine multiple angular cross-sections between the particle and the patient's body part, wherein each angular cross-section is determined for a different emission angle ranging from 30° to 150°; and

[0078] - Evaluate the energy of the beam and the transient gamma radiation generated by the interaction of the particles with the patient's body parts at each interaction point.

[0079] In this particularly preferred embodiment, evaluating the energy of the beam and the transient gamma radiation at each interaction point can specifically include

[0080] -Reconstruct the detection line between the interaction point within the patient's body part and the at least one detector element;

[0081] - To detect the interaction point by intersecting the detection line with the propagation direction of the beam; and

[0082] - To determine multiple interaction points relative to the energy and the angular cross-section, thereby verifying the range and dose delivery of the particles delivered by the beam to the patient's body part.

[0083] In addition to the indicated method steps, other method steps may be performed, particularly the "planned treatment" steps, which may include the following sub-steps:

[0084] - Defines the direction of beam propagation;

[0085] - It is limited to at least one body part that will be treated with the dose;

[0086] - Defined as at least one other body part that is protected from harm by not receiving the dose; and

[0087] - A beam of at least one energy and a plurality of particles to be delivered to at least one region within at least one body part to be treated.

[0088] In this preferred embodiment, if an error is detected between the treatment plan and the measurement according to the following additional sub-steps, the delivery of particles from the beam to the patient's body part can be corrected:

[0089] -Measure the range difference and dose difference between the treatment plan and the data obtained during treatment using the method and apparatus according to the invention;

[0090] - Determine whether at least one difference could lead to an excessively large deviation, necessitating any further action;

[0091] - If the deviation is too large, a new treatment plan should also be established using the information obtained from the method and apparatus according to the present invention; and

[0092] - Update the steps indicated above for "delivering a beam containing particles and adjusting the direction of propagation of the beam to the patient's body parts".

[0093] In another preferred embodiment of the invention, a model can be established for each beam energy and emission angle to determine the instantaneous gamma yield with a certain energy, wherein the model may preferably include the angular cross section between the particle and the patient's body part, the characteristics of the detector element, the beam, the relative position between the patient and the verification unit, and optional treatment plan.

[0094] In another aspect, the present invention relates to a method for monitoring treatment of a patient's body parts with a beam comprising particles, as described elsewhere herein. This method can be performed frequently, particularly during device commissioning or during periodic quality assessments such as weekly, bi-weekly, or monthly. This method may include the following steps:

[0095] - Provides a device, as described elsewhere in this document, for monitoring treatment of a patient’s body parts with a beam comprising particles;

[0096] - Delivering a beam containing particles and adjusting the direction of propagation of the beam to the patient's body parts;

[0097] - Calculate the energy of the beam at a certain depth within the patient's body and measure the energy and yield of the transient gamma radiation;

[0098] - Determine multiple angular cross sections for each beam energy, emission angle, and instantaneous gamma yield with a certain energy;

[0099] -Optionally, the energy of the beam at a certain depth within the alternative phantom is combined with the energy of the transient gamma radiation;

[0100] - Establish a model for each beam energy and emission angle to determine the instantaneous gamma yield with a given energy;

[0101] - Identify multiple interaction points relative to the energy and the angular cross-section, thereby verifying the range of the particles delivered by the beam to the body part of the patient and the dose delivery;

[0102] - Compare the model's predictions with results obtained from measurements of transient gamma radiation; and

[0103] - Verify the range and dose delivery of the particles delivered by the beam to the patient's body part.

[0104] For further details regarding the method, refer to the apparatus according to the invention for monitoring treatment of a patient’s body parts with a beam comprising particles, as described elsewhere in this document.

[0105] In another aspect, the present invention relates to a computer program product comprising executable instructions for performing the methods described elsewhere herein. For further details regarding the computer program product, reference may be made to the method and apparatus according to the invention for monitoring treatment of a patient's body parts with a beam comprising particles, as described elsewhere in this document.

[0106] The apparatus and method according to the invention offer significant advantages over known apparatus and methods. In particular, the apparatus and method for monitoring treatment of a patient's body parts with a beam comprising particles are capable of monitoring the treatment of the patient's body parts with higher resolution for determining the Bragg peak for verifying the range and dose delivery of particles delivered to the patient's body parts by the beam. Specifically, the apparatus and method can advantageously take into account the anisotropic portion of the transient gamma radiation and the fragment appearing in the beam direction after the Bragg peak when verifying range and dose delivery. Furthermore, it can be used to determine the elemental composition of the irradiated target. Furthermore, it can be used to track high atomic number materials within the beam path. Furthermore, it can be used for pre-treatment quality assurance and planning validation.

[0107] This invention is in particular in contrast to US 2006 / 0113482 A1, which discloses a coupled and movable photonic imaging device that rotates around a patient, wherein the portable frame can be coupled with Hueso- Similar approaches proposed by others (see above) involve the movement of radiation sources and patients in radiotherapy. According to the invention, the beam's range can be controlled in real time by measuring the transient gamma radiation at various closer or farther points of interaction along the beam direction. Therefore, the geometric problems involved are different and are variables for their respective purposes. While their response lines are isotropic and the signal generated by positron annihilation in an organ depends on the uptake of said organ, the response line according to the invention relates to the emission from the patient's body parts that are actually being traversed by the beam. US 2006 / 0113482 A1 attempts to track or image the patient in anatomical, morphological, and / or functional views to adapt to the patient's treatment, whereas according to the invention, performing beam tracking and / or imaging is for adjusting beam positioning within the patient's body parts.

[0108] This invention also contrasts in particular with EP2 950 119 A1, which discloses the determination of photon travel offset rather than Bragg peak. This photon travel offset is defined as the distance a photon travels within a time interval equal to the difference between a first time width and a second time width. The first and second time widths are thus obtained from timing profiles of two detectors from a specific interval of scan extension rather than individual interaction points. The information obtained from the photon travel offset is then used to calculate the penetration depth in the target, but the delivered dose, which depends on other parameters, is not calculated.

[0109] This invention also contrasts in particular with WO 2012 / 152938 A2, which does not disclose symmetry in either detector arrangement or movement. The concept of using a slit camera device proposed therein relies more on asymmetric detection of interaction points. The detectors are also relatively thin and cannot absorb the full energy of the transient gamma radiation, necessitating multiple detectors to improve spatial resolution. Slit cameras are described in more detail in WO 2012 / 104416 A1, which follows the same basic concept. Similarly, JP 2010 032451 A and Richter et al. do not disclose corresponding spatial symmetry regarding detector setup. They also do not disclose methods for retrieving the delivered dose from the transient gamma distribution. In this context, Richter et al. only disclose CT-based dose reconstruction. Attached Figure Description

[0110] Other optional details and features of the invention may be derived, preferably in conjunction with the dependent claims, from the subsequent description of the preferred embodiments. In the dependent claims, corresponding features may be implemented in isolation or in any combination. The invention is not limited to the preferred embodiments. Like reference numerals in the figures refer to the same elements, elements having the same or similar functions, or elements corresponding to each other in terms of function.

[0111] Figure 1 A preferred embodiment of the apparatus according to the invention for monitoring treatment of a patient’s body parts with a particle beam is shown in top view, wherein the apparatus includes a beam delivery unit arranged on the side and a verification unit having two separate detector elements.

[0112] Figure 2 A perspective view illustrates another preferred embodiment of a device for monitoring treatment of a patient's body parts with a particle beam, wherein the device includes a beam delivery unit arranged laterally and a verification unit having eight individual detector elements.

[0113] Figure 3 A perspective view illustrates another preferred embodiment of a device for monitoring treatment of a patient's body parts with a particle beam, wherein the device includes a beam delivery unit arranged at the top and a verification unit having two individual detector elements; and

[0114] Figure 4a and Figure 4b The side view further illustrates the monitoring equipment, including... Figure 3 A preferred embodiment of a method for treating a patient's body parts with a beam of particles, wherein the detector element is in Figure 4a and Figure 4b The distance between two individual interaction points is adjusted to set the spatial resolution for detecting transient gamma radiation. Detailed Implementation

[0115] Figure 1 A preferred embodiment of the apparatus 110 according to the invention for monitoring treatment of a body part 112 of a patient 114 with a beam 116 comprising particles 118 is shown in top view. As indicated above, preferably, the particles 118 used in the context of the invention are selected from neutrons. 0 n, proton 1 p, or selected from helium 4 He ions, carbon 12 C ions or oxygen 16 O ions are hadrons because these particles 118 have shown great clinical potential in terms of efficacy and effectiveness. However, the device 110 of the present invention can still use other types of particles 118.

[0116] like Figure 1 As schematically depicted, the device 110 includes a beam delivery unit 120 provided herein in the form of an adjustable delivery nozzle 122. According to the invention, the beam delivery unit 120 is designed to both deliver an incident beam 116 comprising particles 118 and simultaneously adjust the propagation direction 124 of the beam 116 such that the particles 118 included in the beam 116 can actually impact a desired body part 112 of the patient 114, selected as the target volume of the particles 118, to perform the intended treatment. Therefore, the beam delivery unit 120, in particular the adjustable delivery nozzle 122, can shape the incident beam 116 such that the beam 116 can be conformed as closely as possible to the solid geometry of the body part 112 in terms of the cross-sectional shape of the body part 112 to be irradiated and the shape of the distal surface of the body part 112. For this purpose, the beam delivery unit 120 may also include at least one of a scanning magnet, a range modulator, a de-energizer, a collimator, or a compensator (not depicted herein). However, other arrangements of the beam delivery unit 120 are also conceivable.

[0117] in this regard, Figure 1 Further schematically shown is the so-called Bragg curve 126, a graphical representation of the energy loss of the incident beam 116 relative to the distance the beam 116 travels through the irradiated body part 112 of the patient 114. The beam 116, including hadron particles 118, exhibits a favorable effect: the peak of the Bragg curve 126, also represented as the Bragg peak 128, appears immediately before the hadron particles 118 come to rest. Therefore, to prevent healthy organs from receiving radiation, it is desirable for the Bragg peak 128 to be located within the irradiated body part 112 of the patient 114.

[0118] To address this issue, device 110 includes a verification unit 130 designated for verifying the range and dose delivery of particles 118 delivered by beam 116 to the irradiated body part 112 of patient 116. Figure 1 In a preferred embodiment, the verification unit 130 includes two separate detector elements 132 spaced apart from each other and thus capable of determining information preferably simultaneously. However, alternatively or additionally, determining information sequentially is also feasible. Hereinafter, each detector element 132 is attached to a support 134 having a separate member 136 movable toward or away from the body part 112 of the patient 114 as indicated by arrow 138, wherein the distance between each detector element 132 and the body part 112 of the patient 114 remains constant. (See below for further details.) Figure 4a and Figure 4bAs described in more detail in the context, the individual member 136 can therefore be moved toward or away from the patient's body part in order to set the spatial resolution for the individual detector element 132. It is indicated here that the support 134 and the corresponding individual member 136 can be provided as shown or in various different arrangements or configurations, as long as it is possible to attach the detector element 132 and move the detector element 132 toward or away from the patient's body part 112 in the indicated manner.

[0119] For the purpose of verifying the extent and dose delivery of particles 118 irradiating body part 112 of patient 114, verification unit 130 is adapted to determine information regarding transient gamma radiation 140, which is generated by the interaction of particles 118 provided by incident beam 116 with the irradiated body part 112 of patient 114. As described above, transient gamma radiation 140 refers to secondary radiation emission caused by nuclear reactions associated with the path of particles 118, the path of which is provided by the energy of incident beam 116, which is absorbed within body part 112 of patient 114. Therefore, transient gamma radiation 140 generated in this manner constitutes a suitable tool for verifying, preferably in real-time, the extent of particles within body part 112 of patient 114 and dose delivery into body part 112 of patient 114 under clinical conditions, thereby allowing for reduction of uncertainties in treatment planning.

[0120] Therefore, each detector element 132 included in the verification unit 130 is designated to determine the generation of the transient gamma radiation 140 through the interaction of the particles 118 with the irradiated body part 112 of the patient 114. For this purpose, the detector element 132 is designed to generate a measurable signal from the incident transient gamma radiation 140, wherein the measurable signal may preferably be selected from electrical signals, particularly voltage or current. Specifically, the detector element 132 may therefore be selected from at least one of the following: photomultiplier tube (PMT), solid-state single-photon sensing device (silicon photomultiplier tube; SiPM), charge-connected device (CCD), complementary metal-oxide-semiconductor (CMOS), or quantum image sensor (QIS) chip.

[0121] However, other types of detector elements are also feasible. If the verification unit 130 can be as follows... Figures 1 to 4b The diagram includes at least two separate detector elements 132, and particularly preferably, the separate detector elements 132 have the same type and kind in order to increase the comparability of the measured signals between the separate detector elements 132.

[0122] like Figure 1As further shown, the verification unit 130 may preferably include a collimator unit 142, which is designated for collimating and shaping the transient gamma radiation 140 after it has been generated by the interaction of the particles 118 with the body part 112 of the patient 112, but before it enters the corresponding detector element 132. Collimating the transient gamma radiation 140 using the collimator unit 142 shown before it is detected in the corresponding detector element 132 can advantageously result in a desired increase in the spatial resolution of the detection of the transient gamma radiation 140 within the body part 112 of the patient 114. However, it is also conceivable that the verification unit 140 may not be provided with a collimator unit 142.

[0123] Furthermore, the verification unit 140 may also include an evaluation device 144, which is specifically designated for determining, in particular, information about the transient gamma radiation 140 acquired by the detector element 132 by evaluating a measurable signal provided to the evaluation device 144 by the detector element 132. For information exchange, such as... Figure 1 The wired connection 145, schematically depicted, may alternatively or additionally provide a wireless connection (not depicted here) between the detector element 132 and the evaluation device 144. The evaluation device 144 may be specifically designed to verify the particle range and dose delivery of particles 118 delivered by beam 116 to body site 112 of patient 114. For this purpose, the evaluation device 144 may include a fast analog-to-digital converter (ADC) preferably having a sampling rate of 10 ns, more preferably 4 ns, even more preferably 1 ns or lower. In this document, the fast ADC may preferably be selected from at least one of the following: flash analog-to-digital converter (FADC), field-programmable gate array (FPGA), Visa Module Eurocard (VME) digitizer, time readout board (TRB), or oscilloscope. However, other types of fast ADCs are also contemplated.

[0124] Furthermore, the evaluation device 144 can be connected to a monitor 146 and a keyboard 148, which may preferably be located outside the device 110. Alternatively or additionally, a processing device (not depicted here) may also be connected to the evaluation device 144 via wired or wireless means, wherein the processing device may be designed to control the evaluation device 144, for example, in a master-slave relationship. However, other types of processing devices may also be feasible.

[0125] According to the invention, the axis of symmetry 149 of the verification unit 130 is positioned perpendicularly to the propagation direction 124 of the beam 116, thereby producing the arrangement of the verification unit 130, wherein the verification unit 130 is positioned such that it determines desired information about the transient gamma radiation 140 in an orientation perpendicular to the propagation direction 124 of the beam 116. Therefore, the information about the transient gamma radiation 140 determined by the verification unit 130 includes only the component perpendicular to the propagation direction 124 of the beam 116. For this purpose, the verification unit 130 is designated to move perpendicular to the propagation direction 124 of the beam 116, thereby allowing the verification unit 130 to determine information about the transient gamma radiation 140 at at least two individual interaction points 150 where the particle 118 impacts the body part 112 of the patient 114. For further details, see below. Figure 4a and Figure 4b The description.

[0126] like Figure 1 As shown, the perpendicular arrangement of the verification unit 130's axis of symmetry 149 relative to the propagation direction 124 of the beam 116 is provided by the relative arrangement of the rotating gantry 152 and the patient positioning platform 154, which are also included in the device 110. Figure 1 As schematically depicted, the patient positioning platform 154 includes a receiving unit designated for receiving a patient 114, for moving the patient 114 to a designated appropriate position for receiving treatment, and for maintaining the patient 114 in this position during the duration of treatment. For this purpose, robotic instruments can preferably be used to accurately position the patient 114 relative to six directions of movement or rotation.

[0127] Furthermore, the rotating gantry 152 is adapted to receive the patient positioning platform 154 and preferably rotates a full circle of 360° relative to the patient positioning platform 154 in a continuous manner or in arbitrary or predefined steps, thereby delivering the beam 116 to the body part 112 of the patient 114 at any desired angle, particularly at an angle that can be specified by the treatment plan. According to this embodiment, the rotating gantry 152 and / or the patient positioning platform 154 can be moved to adjust the propagation direction 124 of the beam 116 relative to the patient 114 in a desired manner. Therefore, the distance and / or relative orientation between the rotating gantry 152 and the patient positioning platform 154 can be corrected by a single part of the moving device 110.

[0128] According to this preferred embodiment of device 110, the rotating frame 152 may include a movable sidewall 156 and a movable front wall 158, wherein the front wall 158 may be positioned vertically relative to the sidewall 156. Figure 1As schematically depicted, the beam delivery unit 120 can be coupled to the sidewall 156 and can move to different positions relative to the patient positioning platform 154 along with the sidewall 156, while the verification unit 130 can be coupled to the front wall 158 and can move to different positions relative to the patient positioning platform 154 along with the front wall 158 in a manner synchronized with the beam delivery unit 120. Since the front wall 158 can preferably be vertically oriented relative to the sidewall 156, the vertical arrangement of the axis of symmetry 149 of the verification unit 130 relative to the propagation direction 124 of the beam 116 can be maintained in a particularly easy manner during treatment of the patient 114.

[0129] In another embodiment of the invention (not depicted here), both the beam delivery unit 120 and the verification unit 130 can be coupled to the sidewall 156 and can move synchronously with the sidewall 156 to different positions 154 relative to the patient positioning platform, thereby maintaining the perpendicular arrangement of the axis of symmetry 149 of the verification unit 130 relative to the propagation direction 124 of the beam 116 during treatment, but only the sidewall 156 can move, while other parts of the device, such as the front wall 158 or the patient positioning platform 154, can remain in place.

[0130] In another embodiment of the invention (not depicted herein), the beam delivery unit 120 may be configured in a vertical or near-vertical orientation relative to the plane defined by the patient positioning platform 154, wherein a near-vertical orientation refers to a deviation of ±15°, preferably ±5°, from the vertical direction, while the verification unit 130 may be configured perpendicular to it to avoid interfering with the movement of the patient positioning platform 154, preferably at an angle of 45°. Alternatively, the verification unit 130 may be able to move around the patient positioning platform 154 to a desired position to avoid conflict with the patient positioning platform 154.

[0131] Figure 2 Another preferred embodiment of the device 110 according to the invention is shown, wherein the verification unit comprises eight individual detector elements 132. Hereinafter, the axis of symmetry 149 of the verification unit 150 is orthogonal to the propagation direction 124 of the beam 116; however, the detector elements 132 can be rotated up to approximately ±140°. As schematically depicted, four of the detector elements 132 are applied to individual supports 134 in such a way that they can move together toward or away from the body part 112 of the patient 114. However, another number of individual detector elements 132 or individual detector elements 132 in different arrangements are also feasible. Thus, treatment of the body part 112 of the patient 114 with particles 118 provided by the beam 116 can preferably be monitored at two or more different points of interaction, thereby increasing the accuracy of verification of the particle range within the Bragg peak 138 compared to known devices according to the prior art.

[0132] for Figure 2 For a detailed description of the other features shown, please refer to the above text. Figure 1 The description.

[0133] Figure 3 Another preferred embodiment of the device 110 according to the invention is shown, wherein the beam delivery unit 120 may be arranged in a horizontal or near-horizontal orientation relative to the plane defined by the patient positioning platform 154. Figure 3 The beam delivery unit 120, schematically depicted here again in the form of an adjustable delivery nozzle 122, is designed to deliver the beam 116 in a vertical orientation relative to the patient positioning platform 154. However, the beam delivery unit 120 can alternatively be designed to deliver the beam at an angle of 45 ± 45°. Thus, the verification unit 130 can always remain vertically oriented relative to the propagation direction 124 of the beam 116, regardless of the movement of the beam delivery unit 120.

[0134] for Figure 3 For a detailed description of the other features shown, please refer to the above text. Figure 1 The description.

[0135] Figure 4a and Figure 4b Further shown in the side view according to Figure 3 In a preferred embodiment, the detector element 132 is positioned such that a separate component 136 of the support 134 is located away from the body part 112 of the patient 114. Figure 4a and Figure 4b The distance 160 between the two individual interaction points 150 can be adjusted in this way, thereby setting the spatial resolution for detecting the transient gamma radiation 140. As a result of using at least two individual interaction points 150 to determine information about the transient gamma radiation 140, the device 110 is designed to determine the absolute value of the particle range within the body part 112 of the patient 114. As a result of determining the absolute value of the particle range, the distance within the body part 112 of the patient 114 can be determined with high spatial resolution, thereby allowing the treatment of the body part 112 by the particles 118 of the incident beam 116 to be limited to the desired particle range, particularly to tumor tissue including tumor-modified tissue introduced by cancer.

[0136] In another embodiment of the invention, the verification unit 130 may comprise only a single detector element 132, wherein, however, in order to determine information regarding the transient gamma radiation 140 at at least two individual interaction points 150, the single detector element 132 may preferably be designed to be placed at at least two different locations within the verification unit 130 relative to the body part 112 of the patient 114. During movement between placements at at least two different locations, a distance may be maintained between the single detector element 132 and the body part 112 for each location. In this embodiment, the single detector element 132 can thus be moved between at least two different locations on a first timescale, which is faster than a second timescale that causes the single detector element 132 to move toward or away from the body part 112 perpendicular to the propagation direction 124 of the beam 116, thereby allowing the distance between the individual interaction points to be adjusted as described above. Therefore, Figure 1 , Figure 3 , Figure 4a and Figure 4b This embodiment can be considered as being shown when a single detector element 132 is displayed at two different locations simultaneously.

[0137] Although using a single detector element 132 can be particularly advantageous for device quality assurance due to its simplicity, for the actual treatment of patient 114, at least two, preferably four, six, eight or twelve detector elements 132 may be preferred, because at least two separate detector elements 132 can allow for increased sensitivity and thus increased spatial resolution of the defined particle range within body part 112 of patient 114.

[0138] Reference list of numbers

[0139] 110 device

[0140] 112 Body

[0141] 114 patients

[0142] 116 beams

[0143] 118 particles

[0144] 120 beam delivery unit

[0145] 122 Adjustable delivery nozzle

[0146] 124 Direction of Dissemination

[0147] 126 Bragg Curve

[0148] 128 Prague Peak

[0149] 130 verification units

[0150] 132 Detector Element

[0151] 134 Support component

[0152] 136 Individual components

[0153] 138 arrows

[0154] 140 instantaneous gamma radiation

[0155] 142 Collimator Units

[0156] 144 Evaluation Device

[0157] 145 Wired connection

[0158] 146 monitors

[0159] 148-keyboard

[0160] 149 Axis of Symmetry

[0161] 150 interaction points

[0162] 152 Rotating Frame

[0163] 154 Patient Location Platform

[0164] 156 Sidewall

[0165] 158 Anterior Wall

[0166] 160 distance

Claims

1. A device for monitoring treatment of a patient's body parts with a beam comprising particles, the device comprising: - Beam delivery unit, which is designated to deliver a beam comprising particles and to adjust the propagation direction of the beam to a part of the patient's body; as well as - A verification unit, designated to verify the extent and dose delivery of the particles provided by the beam to the patient's body part by determining information regarding the transient gamma radiation generated through the interaction of the particles with the patient's body part at at least two separate points of interaction. The verification unit includes an axis of symmetry symmetrical about the at least two individual interaction points and positioned perpendicularly to the propagation direction of the beam. This axis of symmetry relates to the setup and arrangement of the verification unit, wherein the two halves of the verification unit generated by the axis of symmetry are identical relative to each other. The verification unit includes at least two separate detector elements, which are designated to determine the transient gamma radiation generated by the interaction of the particles with the patient's body part. The at least two detector elements are spaced apart from each other in a manner symmetrical about the axis of symmetry of the verification unit, wherein each detector element is designated to be able to move toward or away from the patient's body part perpendicular to the propagation direction of the beam, such that the distance between each detector element and the patient's body part is equal for each detector element.

2. The apparatus of claim 1, further comprising a single rotating gantry and a patient positioning platform, wherein the patient positioning platform is designated for receiving the patient, wherein at least one of the rotating gantry and the patient positioning platform is movable relative to the other, wherein the rotating gantry includes a movable sidewall and a movable front wall, wherein the front wall is positioned perpendicular to the movable sidewall, and wherein the propagation direction of the beam is adjustable to different positions relative to the body part of the patient.

3. The apparatus of claim 2, wherein both the beam delivery unit and the verification unit are coupled to the movable sidewall and are capable of moving synchronously with the movable sidewall to different positions relative to the patient positioning platform.

4. The apparatus of claim 2, wherein the beam delivery unit is coupled to the movable sidewall and is movable to different positions relative to the patient positioning platform along with the movable sidewall, and wherein the verification unit is coupled to the front wall and is movable to different positions relative to the patient positioning platform along with the front wall in a manner synchronized with the beam delivery unit.

5. The apparatus of claim 2, wherein the beam delivery unit is disposed in a fixed position relative to the patient positioning platform, wherein the beam delivery unit is designated to deliver the beam in any orientation relative to the patient positioning platform, and wherein the verification unit is movable to different positions relative to a plane determined by the patient positioning platform.

6. The apparatus according to any one of claims 1-5, wherein the verification unit further comprises a collimator unit for collimating and shaping the transient gamma radiation generated by the interaction between the particle and the patient's body part before it enters the at least one detector element.

7. The apparatus according to any one of claims 1-5, wherein the verification unit further comprises an evaluation device, wherein the evaluation device is designated for verifying the range of the particles delivered by the beam to the body part of the patient and the dose delivery based on the information about the transient gamma radiation determined by the at least one detector element.

8. The apparatus of claim 6, wherein the verification unit further comprises an evaluation device, wherein the evaluation device is designated for verifying the extent and dose delivery of the particles delivered by the beam to the body part of the patient based on the information about the transient gamma radiation determined by the at least one detector element.

9. A computer program product comprising executable instructions for performing a method for monitoring treatment of a patient's body parts with a beam comprising particles, the method comprising the steps of: - Provide an apparatus according to any one of claims 1 to 8; - Delivering a beam comprising particles and adjusting the direction of propagation of the beam to the patient's body parts; - Determine information regarding the transient gamma radiation generated by the interaction of the particles with the patient's body part at at least two separate points of interaction, including the beam containing the particles and the patient's body part; and - Verify the range and dose delivery of the particles delivered by the beam to the patient's body part.

10. The computer program product of claim 9, wherein determining the information regarding the transient gamma radiation comprises: - At least one position along the propagation direction of the beam is specified by moving at least one detector element included in the verification unit perpendicular to the propagation direction of the beam; - Move a separate component of the support member further comprising the verification unit, wherein at least one detector element is applied to the separate component, wherein the separate component moves toward or away from the body part of the patient in such a way that the position along the propagation direction of the beam is focused or defocused, thereby setting the spatial resolution for detecting the transient gamma radiation. as well as - Detect the signal generated by the interaction between the transient gamma radiation and the at least one detector element.

11. The computer program product of claim 10, wherein determining the information regarding the transient gamma radiation further comprises: - Determine multiple angular cross sections between the particle and the patient's body part, wherein each angular cross section is determined for a different emission angle from 30° to 150°; as well as - Evaluate the energy of the beam and the transient gamma radiation generated by the interaction of the particles with the patient's body part for each interaction point.

12. The computer program product of claim 11, wherein evaluating the energy of the beam and the transient gamma radiation for each interaction point includes... - Reconstruct the detection line between the interaction point within the patient's body part and the at least one detector element; - The detection line is made to intersect with the propagation direction of the beam to detect the interaction point; as well as - Multiple interaction points are determined relative to the energy and the angular cross-section, thereby verifying the range and dose delivery of the particles delivered by the beam to the patient's body part.

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