WP4 Coordinators
The coordinators for the WP4 are: A. Schiavi and M. Schwarz
WP4 Participants
The WP4 Participants are as listed in the following table:
| Name | Unit | FTE | Name | Unit | FTE | Name | Unit | FTE |
| Schwarz M. | TIFPA | 0.02 | Kraan A. | PI | 0.1 | Sart A. | RM1 | 0.5 |
| Muraro S. | MI | 0.2 | Paiar F. | PI | 0.1 | Schiabi A. | RM1 | 0.3 |
| Mattei I. | MI | 0.2 | Rosso V. | PI | 0.1 | Patera V. | RM1 | 0.1 |
| Dong Y. | MI | 0.2 | Ursino S. | PI | 0.1 |
Main Goals
The main goal of the WP4 is to explore the full potential of FLASH irradiation by performing a thorough study using Monte Carlo simulations. Profiting from the synergy with WP1 few cases of tumor treatment will be explored using protons and electrons in comparison with conventional RT. Particular care will be taken in exploring the impact of different beam delivery strategies, trying to evaluate how protons and electrons can help in simplifying the patient irradiation while achieving the same efficacy in terms of TCP.
Task 1 - Identification of clinical cases
The identification of tumors (kind, location, and dosimetry/planning protocols) where the FLASH effect could offer the highest differential benefit with respect to conventional irradiations (PI and TIFPA) will be pursued. The selection of actual clinical cases and comparison using MC tools and optimization techniques (PI) will also be subject of research.
Task 2 - Enabling Monte Carlo simulations
Task 2 focuses on the setup a complete start-to-end workflow for MC simulations. The code FLUKA will be used to perform detailed simulations of patient irradiation plans. Fundamental is the definition of beamline models for proton and electron beams, as also input patient geometry and morphology from imaging diagnostic data (e.g. CT or NMR). The setup of MC time-resolved scorers to provide dose-rate and radiation quality information on the timescale indicated by WP1 studies (Roma1, MI and TIFPA) will also be pursued.
Task 3 - Treatment plan optimisation using DADR DMF
An optimization tool running on GPU hardware will be implemented to enable fast exploration of optimization strategies (Roma1). The first attempt will use the most favourable Dose Modifying Factor (DMF) assuming a Dose-Averaged Dose-Rate (DADR). The selected plans will be simulated and optimized (Roma1 and MI), and the outcome will be compared with current state-of-the-art irradiation techniques (PI and TIFPA).
Task 4 - Inverse planning using “FRIDA DMF”
A new model for DMF will be investigated in close collaboration with the other FRIDA WPs. The so-called “FRIDA DMF” will be implemented in the optimization tool (Roma1), splitting the local dose deposition into two main contributions: a FLASH dose and a time-diluted dose.
WP4 Deliverables
The WP4 Deliverables are summarized in the following table:
| Deliv. | Short Name | Description | When (M) | Deliv. | Short Name | Description | When (M) |
| D4.1 | Identify tumors | Identification of tumors where the FLASH effect could offer the highest differential benefit. | 6 | D4.8 | VHEE and proton cases | Evaluation and optimization of the selected cases using VHEE electron and proton beams. | 28 |
| D4.2 | Case selection | Selection of actual clinical cases for the identified tumors. | 12 | D4.9 | FRIDA DMF | Implementation of DMF depending on considered tissue and irradiation time-structure. | 32 |
| D4.3 | MC irradiation workflow | Complete start-to-end workflow for MC simulation of an irradiation plan using electrons or protons beams. | 6 | D3.3.1 | Final evaluation and comparison | Report on comparison of treatment plans with standard and FLASH dose-rates. Report on preclinical static DMF and FRIDA dynamic DMF. | 36 |
| D4.4 | Optimization using DADR DMF | Optimization of treatment plan using the dose influence matrix produced by MC simulations. Use DADR DMF. | 6 | ||||
| D4.5 | MC source for FLASH | Implementation of a pencil beam source for MC simulations taking into account pulse time-structure for RF accelerator and laser-plasma acceleration. | 12 | ||||
| D4.6 | MC time-resolved scorers | Implementation of scorers capable of recording dose deposition and radiation quality on the relevant time scales. | 16 | ||||
| D4.7 | IORT case study | Complete evaluation of a low-energy electron treatment for IORT using static DMF. | 20 |