Optimizing calibration settings for accurate water equivalent path length assessment using flat panel proton radiography.

Proton range uncertainties can compromise the effectiveness of proton therapy treatments. Water equivalent path length (WEPL) assessment by flat panel detector proton radiography (FP-PR) can provide means of range uncertainty detection. Since WEPL accuracy intrinsically relies on the FP-PR calibration parameters, the purpose of this study is to establish an optimal calibration procedure that ensures high accuracy of WEPL measurements. To that end, several calibration settings were investigated. FP-PR calibration datasets were obtained simulating PR fields with different proton energies, directed towards water-equivalent material slabs of increasing thickness. The parameters investigated were the spacing between energy layers (ΔE) and the increment in thickness of the water-equivalent material slabs (ΔX) used for calibration. 30 calibrations were simulated, as a result of combining ΔE=9, 7, 5, 3, 1 MeV and ΔX=10, 8, 5, 3, 2, 1 mm. FP-PRs through a CIRS electron density phantom were simulated, and WEPL images corresponding to each calibration were obtained. Ground truth WEPL values were provided by range probing multi-layer ionization chamber simulations on each insert of the phantom. Relative WEPL errors between FP-PR simulations and ground truth were calculated for each insert. Mean relative WEPL errors and standard deviations across all inserts were computed for WEPL images obtained with each calibration. Large mean and standard deviations were found in WEPL images obtained with large ΔE values (ΔE= 9 or 7MeV), for any ΔX. WEPL images obtained with ΔE≤ 5MeV and ΔX≤ 5mm resulted in a WEPL accuracy with mean values within ±0.5% and standard deviations around 1%. An optimal FP calibration in the framework of this study was established, characterized by 3MeV≤ ΔE ≤ 5MeV and 2mm ≤ ΔX ≤ 5mm. Within these boundaries, highly accurate WEPL acquisitions using FP-PR are feasible and practical, holding the potential to assist future online range verification quality control procedures.