Journal Article DKFZ-2026-01071

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Validation of an analytical approach for in vivo PET verification in carbon ion therapy: comparison with Monte Carlo simulations and PET monitoring measurements.

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2026
IOP Publ. Bristol

Physics in medicine and biology 71(9), 095010 () [10.1088/1361-6560/ae6226]
 GO

Abstract: As carbon ion therapy is highly sensitive to range uncertainties, it can benefit greatly from range verification. Positron emission tomography (PET) provides a valuable approach, in which predicted positron emitter distributions (PED) can be used to calculate the expected activity distribution, which is then compared with the irradiation-induced PET signal. In a previous work, we developed an analytical approach to predict 3D PED from dose distributions, providing a faster alternative to Monte Carlo (MC) simulations at a comparable accuracy, and with potential for integration into analytical treatment planning systems (TPS). The purpose of this work is to validate this analytical approach using real clinical cases where offline PET/Computed tomography (CT) monitoring was employed.Four carbon ion therapy patients treated at the Heidelberg Ion Beam Therapy Center were selected, and their treatment plans and CT images were used for MC simulations and analytical prediction ofβ+-activity distributions. The analytically predicted activity distributions, derived from the simulated dose distributions with our analytical approach, were then compared with both simulated results and measured offline PET data.Main results.The analytical and MC activity distributions demonstrated a good match in range with mean deviations less than 0.5 mm, and in amplitude with mean normalized root-mean-square error less than 2%. Range shifts between the measured PET signals and the analytical activity patterns were evaluated and found to be consistent with published results.The obtained results demonstrate the capability of our analytical approach to predict PET images for range verification in carbon ion therapy under real clinical scenarios, offering faster predictions than MC simulations while maintaining comparable accuracy. The solution proposed also offers the possibility of a straightforward integration into TPS by leveraging the commonly used pencil beam algorithms present in analytical carbon ion dose engines.

Keyword(s): Monte Carlo Method (MeSH) ; Heavy Ion Radiotherapy: methods (MeSH) ; Humans (MeSH) ; Radiotherapy Planning, Computer-Assisted: methods (MeSH) ; Positron-Emission Tomography (MeSH) ; Positron Emission Tomography Computed Tomography (MeSH) ; Radiotherapy Dosage (MeSH) ; analytical prediction ; carbon ion therapy ; offline PET ; positron emission tomography ; range verification

Classification:

Note: #NCTZFB26#

Contributing Institute(s):
  1. KKE Translationale Radioonkologie (E210)
  2. Koordinierungsstelle NCT Heidelberg (HD02)
Research Program(s):
  1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2026
Database coverage:
Medline ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; JCR ; National-Konsortium ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
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 Record created 2026-05-07, last modified 2026-05-20



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