Stuart Green

Stuart Green
University Hospitals Birmingham NHS Foundation Trust | uhb · Medical Physics

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148
Publications
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Publications

Publications (148)
Article
Pencil beam scanning is an effective form of proton radiotherapy for cancer treatment. Small beams of protons are magnetically deflected in order to conform to a tumour shape, and exploiting the Bragg peak in order to minimise dose deposited in healthy tissues. Compared to other therapy modalities, it presents many dosimetric challenges requiring n...
Article
Objective Single prolonged breath-holds of >5 min can be obtained in cancer patients. Currently, however, the preparation time in each radiotherapy session is a practical limitation for clinical adoption of this new technique. Here, we show by how much our original preparation time can be shortened without unduly compromising breath-hold duration....
Article
Objective Breast cancer radiotherapy is increasingly delivered supine with multiple, short breath-holds. There may be heart and lung sparing advantages for locoregional breast cancer of both prone treatment and in a single breath-hold. We test here whether single prolonged breath-holds are possible in the prone, front crawl position. Methods 19 he...
Article
Full-text available
Background & purpose: Multiple, short breath-holds are now used in single radiotherapy treatment sessions. Here we investigated the feasibility and safety of multiple prolonged breath-holds in a single session. We measured how long is a second breath-hold if we prematurely terminate a single, prolonged breath-hold of >5 min either by using a singl...
Article
Full-text available
Purpose: Proton CT is widely recognised as a beneficial alternative to conventional X-ray CT for treatment planning in proton beam radiotherapy. A novel proton CT imaging system, based entirely on solid-state detector technology, is presented. Compared to conventional scintillator-based calorimeters, positional sensitive detectors allow for multip...
Article
Purpose In proton therapy precise knowledge of the beam range is essential to guarantee the treatment’s efficacy and to avoid unnecessary toxicities. Over a fractionated course of treatment anatomical changes can severely impact the delivered dose distribution from that planned; evaluation of these changes on a fraction-by-fraction basis is essenti...
Article
In proton beam therapy precise knowledge of the proton beam range is essential to guarantee the treatment’s efficacy and to avoid unnecessary toxicities. Unlike photon beams, protons stop inside the patient’s body, therefore a direct detection of the distal fall-off is impossible. One technique to determine the beam range is to detect the prompt ga...
Article
The University of Birmingham MC40 Cyclotron is capable of delivering up to 40 MeV protons and 53 MeV He ions at a huge range of currents varying from fA to μA. A switching magnet allows the beam to be transported to one of twelve experimental areas. One of these is the medical beam line, which, in recent years has been used for the development of a...
Article
Full-text available
Proton therapy is rapidly gaining importance in the field of radiotherapy, because of its potential to deliver the planned dose over a small depth range and sparing dose to healthy tissue, when compared to conventional radiotherapy. Proton therapy, however, makes the need of new imaging modalities for treatment planning, based on direct measurement...
Article
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Purpose: Radiography and tomography using proton beams promise benefit to image guidance and treatment planning for proton therapy. A novel proton tracking detector is described and experimental demonstrations at a therapy facility are reported. A new type of proton CT reconstructing relative “scattering power” rather than “stopping power” is also...
Article
Full-text available
Objective: Multiple, short and deep inspiratory breath-holds with air of approximately 20 s are now used in radiotherapy to reduce the influence of ventilatory motion and damage to healthy tissue. There may be further clinical advantages in delivering each treatment session in only one single, prolonged breath-hold. We have previously developed te...
Article
Objective: Variability in the breathing pattern of patients with cancer during radiotherapy requires mitigation, including enlargement of the planned treatment field, treatment gating and breathing guidance interventions. Here, we provide the first demonstration of how easy it is to mechanically ventilate patients with breast cancer while fully co...
Article
In this study, a scintillator–based measurement instrument is proposed which is capable of measuring a two–dimensional map of thermal neutrons within a phantom based on the detection of 2.22 MeV gamma rays generated via nth+H→D+γ reaction. The proposed instrument locates around a small rectangular water phantom (14 cm×15 cm×20 cm) used in Birmingha...
Presentation
Full-text available
Recent findings from the Cancer Genome Atlas (TCGA) project have highlighted the highly heterogeneous nature of glioma and identified a number of distinct molecular subtypes. Though we are yet to fully understand their biological and clinical implications, genetic alterations such as IDH1 mutation, MGMT promoter methylation and 1p19q co-deletion ha...
Article
The accelerator based Boron Neutron Capture Therapy beam at the University of Birmingham is based around a solid thick lithium target cooled by heavy water. Significant upgrades to Birmingham's Dynamitron accelerator are planned prior to commencing a clinical trial. These upgrades will result in an increase in maximum achievable beam current to at...
Article
Full-text available
Since the first proof of concept in the early 70s, a number of technologies has been proposed to perform proton CT (pCT), as a means of mapping tissue stopping power for accurate treatment planning in proton therapy. Previous prototypes of energy-range detectors for pCT have been mainly based on the use of scintillator-based calorimeters, to measur...
Article
Full-text available
Proton radiotherapy has demonstrated benefits in the treatment of certain cancers. Accurate measurements of the proton stopping powers in body tissues are required in order to fully optimise the delivery of such treaments. The PRaVDA Consortium is developing a novel, fully solid state device to measure these stopping powers. The PRaVDA Range Telesc...
Article
Full-text available
We report the effect of low-energy thermal neutron irradiation on the antiproliferative activities of a highly hydrophobic organometallic arene ruthenium dithiolato-carborane complex [Ru(p-cymene)(1,2-dicarba-closo-dodecarborane-1,2-dithiolato)] (1), and of its formulation in Pluronic® triblock copolymer P123 core-shell micelles (RuMs). Complex 1 w...
Article
Due to an error in the manuscript submission process Dr. Francesca Fiorini of the Oxford Institute for Radiation Oncology was not included in the list of authors of the published work entitled “Instrumentation for diagnostics and control of laser-accelerated proton (ion) beams”. We deeply regret the occurrence and inconvenience of this error. This...
Poster
Full-text available
BNCT is a biologically targeted form of enhanced cellular radiotherapy where preferential accumulation of boron in the cancerous as opposed to adjacent normal cells is able to interact with incident neutrons to cause irreversible alpha particle DNA damage. The key to the implementation of this potentially powerful and selective therapy is the deliv...
Article
Full-text available
Objective: While there is recent interest in using repeated deep inspiratory breath-holds, or prolonged single breath-holds, to improve radiotherapy delivery, breath-holding has risks. There are no published guidelines for monitoring patient safety, and there is little clinical awareness of the pronounced blood pressure rise and the potential for...
Presentation
Who benefits most of BNCT? – A review on literature data on the prognostic value of protein expression of amino acid transporter 4F2hc/LAT1 C. L. Schütz1 ; D. Ngoga1 ; A. Detta1 ; S. Green2 ; G. Cruickshank1 1University of Birmingham, Queen Elizabeth Hospital, Department of Neurosurgery 2University of Birmingham, Queen Elizabeth Hospital, Departmen...
Presentation
BNCT is a biologically targeted radiotherapy where preferential boron uptake interacts with a neutron beam in cancerous cells causing irreparable alpha DNA damage. This requires the delivery of at least 30 parts per million (ppm) of 10B into tumour tissue and 30ppm boron) indicates potential BNCT targeting after surgery. Tumour boron uptake is gove...
Presentation
Full-text available
INTRODUCTION: The interaction between an epithermal neutron beam, now deliverable with LINAC technology, and tumour cell accumulated Boron from borono-phenylalanine (BPA), releases an intracellular alpha particle and Li ion causing irrecoverable double strand DNA breaks, insensitive to hypoxia and cell cycle state. Augmented uptake of BPA in GBM ce...
Article
Boron Neutron Capture Therapy (BNCT) is a binary cancer therapy particularly well-suited to treating aggressive tumours that exhibit a high degree of infiltration of the surrounding healthy tissue. Such tumours, for example of the brain and lung, provide some of the most challenging problems in oncology. The first element of the therapy is boron-10...
Presentation
Full-text available
A mutational and gene expression analysis to identify the four suggested molecular subtype of 58 patients with high and low grade glioma, examining the extent to which the expression of LAT 1 varied across the glioma subtypes. Using the National Cancer Institute’s Repository for molecular brain neoplasia data (REMBRANDT), We examined the effect of...
Article
Full-text available
Despite the early recognition of the potential of proton imaging to assist proton therapy (Cormack 1963 J. Appl. Phys. 34 2722), the modality is still removed from clinical practice, with various approaches in development. For proton-counting radiography applications such as computed tomography (CT), the water-equivalent-path-length that each proto...
Article
We present a new simulation method to predict the maximum possible yield of X-rays produced by electron beams accelerated by petawatt lasers irradiating thick solid targets. The novelty of the method lies in the simulation of the electron refiluxing inside the target implemented with the Monte Carlo code Fluka. The mechanism uses initial theoretica...
Article
We present a study of the under-response of the new Gafchromic EBT3 films and a procedure to accurately perform 2D and 3D proton dosimetry measurements for both pristine and spread out Bragg peaks (SOBP) of any energy. These new films differ from the previous EBT2 generation by a slightly different active layer composition, which we show has not ef...
Article
Full-text available
Suitable instrumentation for laser-accelerated proton (ion) beams is critical for development of integrated, laser-driven ion accelerator systems. Instrumentation aimed at beam diagnostics and control must be applied to the driving laser pulse, the laser-plasma that forms at the target and the emergent proton (ion) bunch in a correlated way to deve...
Article
The ultra short duration of laser-driven multi-MeV ion bursts offers the possibility of radiobiological studies at extremely high dose rates. Employing the TARANIS Terawatt laser at Queen's University, the effect of proton irradiation at MeV-range energies on live cells has been investigated at dose rates exceeding 109 Gy/s as a single exposure. A...
Article
The potential that laser based particle accelerators offer to solve sizing and cost issues arising with conventional proton therapy has generated great interest in the understanding and development of laser ion acceleration, and in investigating the radiobiological effects induced by laser accelerated ions. Laser-driven ions are produced in bursts...
Article
Full-text available
In 2011, the Clinical and Translational Radiotherapy Research Working Group (CTRad) of the National Cancer Research Institute brought together UK radiotherapy physics leaders for a think tank meeting. Following a format that CTRad had previously and successfully used with clinical oncologists, 23 departments were asked to complete a pre-meeting eva...
Article
Full-text available
The ultrashort duration of laser-driven multi-MeV ion bursts offers the possibility of radiobiological studies at extremely high dose rates. Employing the TARANIS Terawatt laser at Queen's University, the effect of proton irradiation at MeV-range energies on live cells has been investigated at dose rates exceeding 109Gy/s as a single exposure. A cl...
Article
Full-text available
The ultrashort duration of laser-driven multi-MeV ion bursts offers the possibility of radiobiological studies at extremely high dose rates. Employing the TARANIS Terawatt laser at Queen's University, the effect of proton irradiation at MeV-range energies on live cells has been investigated at dose rates exceeding 10(9) Gy/s as a single exposure. A...
Article
Particle therapy has a long history. The experimentation with particles for their therapeutic application got started soon after they were produced in the laboratory. Physicists played a major role in proposing the potential applications in radiotherapy as well as in the development of particle therapy. A brief review of the current status of parti...
Presentation
In vitro recovery experiments to establish and optimise microdialysis recovery of Boron (10B) and clinical trial results of BPA uptake in patients wit glioblastoma.
Article
Laser-driven proton and ion acceleration is an area of increasing research interest given the recent development of short pulse-high intensity lasers. Several groups have reported experiments to understand whether a laser-driven beam can be applied for radiobiological purposes and in each of these, the method to obtain dose and spectral analysis wa...
Article
The relative biological effectiveness of two epithermal neutron sources, a reactor based source at Studsvik, Sweden, and a proton accelerator-based source in Birmingham, UK, was studied in relation to the proportional absorbed dose distribution as a function of neutron energy. Evidence for any interactions between the effects of biological damage i...
Article
Full-text available
A new approach to spectroscopy of laser induced proton beams using radiochromic film (RCF) is presented. This approach allows primary standards of absorbed dose-to-water as used in radiotherapy to be transferred to the calibration of GafChromic HD-810 and EBT in a 29 MeV proton beam from the Birmingham cyclotron. These films were then irradiated in...
Article
Full-text available
Next generation intense, short-pulse laser facilities require new high repetition rate diagnostics for the detection of ionizing radiation. We have designed a new scintillator-based ion beam profiler capable of measuring the ion beam transverse profile for a number of discrete energy ranges. The optical response and emission characteristics of four...
Article
This work discusses the development of online dosimetry of the boron dose via Single Photon Emission Computed Tomography (SPECT) during a BNCT treatment irradiation. Such a system will allow the online computation of boron dose maps without the large current uncertainties in the assessment of the boron concentration in different tissues. The first...
Article
This work aims to demonstrate that nuclear activation of an irradiated metal foil can determine the number of accelerated particles in the initial irradiation beam. Even if this is not a novel technique it can be really useful to find out whether other commonly used techniques fail. Tests of the method have been carried out using the proton beam ac...
Article
The advantage of using ion beams in radiotherapy is easily understood in terms of the Bragg peak effect if compared to widely used x-ray irradiation systems. There is therefore a large literature about cell irradiation using ions from conventional accelerators. Employing the TARANIS Terawatt laser at Queen's University, the effect of proton irradia...
Article
In boron neutron capture therapy (BNCT) the delivered dose to the patient depends both on the neutron beam characteristics and on the 10B body distribution which, in turn, is governed by the tumor specificity of the 10B drug-carrier. BNCT dosimetry is a complex matter due to the several interactions that neutrons can undergo with the different nucl...
Article
Full-text available
Dosimetry using a PMMA phantom was performed in 15 and 29 MeV proton beams from the Birmingham cyclotron, with a Markus parallel-plate ionization chamber and GafChromic EBT and MD-V2-55 film. Simulations of the depth-dose curves were performed with FLUKA 2008.3 and MCNPX 2.5.0, which agreed almost perfectly with each other in range and only differe...
Article
Full-text available
Ongoing controversy surrounds the adverse health effects of the use of depleted uranium (DU) munitions. The biological effects of gamma-radiation arise from the direct or indirect interaction between secondary electrons and the DNA of living cells. The probability of the absorption of X-rays and gamma-rays with energies below about 200 keV by parti...
Article
New methods are required for a better interpretation of the response of ionisation chambers in order to improve further the determination of the absorbed doses in a mixed neutron-gamma BNCT field. Simulations might help to understand in particular the behaviour of the sensitivity factors of an ionisation chamber in the mixed field. The study presen...
Article
Small photon fields are increasingly used in modern radiotherapy and especially in IMRT and SRS/SRT treatments. Accurate beam profile measurements of such beams are crucial for a precise and effective treatment. In this work four different dosimetric methods have been used for profile measurements of three small 6 MV circular fields having diameter...
Article
Full-text available
To investigate the premise that levels of endogenous volatile organic compounds (VOC) in breath reflect those in blood, the concentration of acetone and isoprene were measured in radial arterial blood, peripheral venous blood and breath samples from ten healthy volunteers. Coefficients of repeatability as a percentage of mean are less than 30% in b...
Article
In many radiotherapy situations patients are exposed to mixed field radiation. In particular in BNCT, as with all neutron beam exposures, a significant fraction of the dose is contributed by low LET gamma ray photons. The components of such a mixed field may show a synergistic interaction and produce a greater cell kill effect than would be anticip...
Article
The dual ionisation chamber technique is the recommended method for mixed field dosimetry of epithermal neutron beams. This paper presents initial data from an ongoing inter-comparison study involving two identical pairs of ionisation chambers used at the BNCT facilities of Petten, NL and of the University of Birmingham, UK. The goal of this study...
Article
This article reports on the development of a prototype of a SPECT tomograph system for online dosimetry in BNCT based on LaBr(3)(Ce) scintillation detectors. The setup shielding was optimized to be used in the accelerator based BNCT facility of the University of Birmingham. The system was designed and built. An image of a (241)Am point source was r...