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Uncertainties in the proton range in tissue during proton therapy limit theprecision in treatment delivery. These uncertainties result in expandedtreatment margins, thereby increasing radiation dose to healthy tissue.Real-time range verification techniques aim to reduce these uncertainties inorder to take full advantage of the finite range of the primary protons. Inthis paper, we propose a novel concept for real-time range verification basedon detection of secondary neutrons produced in nuclear interactions duringproton therapy. The proposed detector concept is simple; consisting of ahydrogen-rich converter material followed by two charged particle trackingdetectors, mimicking a proton recoil telescopic arrangement. Neutrons incidenton the converter material are converted into protons through elastic andinelastic (n,p) interactions. The protons are subsequently detected in thetracking detectors. The information on the direction and position of theseprotons is then utilized in a new reconstruction algorithm to estimate thedepth distribution of neutron production by the proton beam, which in turn iscorrelated with the primary proton range. In this paper, we present the resultsof a Monte Carlo feasibility study and show that the proposed concept could beused for real-time range verification with millimetric precision in protontherapy.

The NOVO project neutron detection for real-time range verification in proton therapy, A Monte Carlo feasibility study