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Heavy-ion therapy, particularly using scanned (active) beam delivery,provides a precise and highly conformal dose distribution, with maximum dosedeposition for each pencil beam at its endpoint (Bragg peak), and low entranceand exit dose. To take full advantage of this precision, robust rangeverification methods are required; these methods ensure that the Bragg peak ispositioned correctly in the patient and the dose is delivered as prescribed.Relative range verification allows intra-fraction monitoring of Bragg peakspacing to ensure full coverage with each fraction, as well as inter-fractionmonitoring to ensure all fractions are delivered consistently. To validate theproposed filtered Interaction Vertex Imaging method for relative rangeverification, a ${}^{16}$O beam was used to deliver 12 Bragg peak positions ina 40 mm poly-(methyl methacrylate) phantom. Secondary particles produced in thephantom were monitored using position-sensitive silicon detectors. Eventsrecorded on these detectors, along with a measurement of the treatment beamaxis, were used to reconstruct the sites of origin of these secondary particlesin the phantom. The distal edge of the depth distribution of thesereconstructed points was determined with logistic fits, and the translation indepth required to minimize the $\chi^2$ statistic between these fits was usedto compute the range shift between any two Bragg peak positions. In all cases,the range shift was determined with sub-millimeter precision, to a standarddeviation of the mean of 220(10) $\mu$m. This result validates filteredInteraction Vertex Imaging as a reliable relative range verification method,which should be capable of monitoring each energy step in each fraction of ascanned heavy-ion treatment plan.

Intra- and Inter-Fraction Relative Range Verification in Heavy-Ion Therapy Using Filtered Interaction Vertex Imaging