Ion Beam Radiotherapy

The image features a scientific apparatus, including a series of transparent tubes and a cube-like device with circular holes. The focus is on the detailed structure of the equipment, which appears to be used for experimental or analytical purposes. Figure 1: a) Stack of ionization chambers for dose verification in ion beam radiotherapy. b) Dose distribution with indicated measurement positions. c) Rotatable solid-state phantom carrying 24 ionization chambers for dose verification in ion beam radiotherapy
Figure 1: a) Stack of ionization chambers for dose verification in ion beam radiotherapy. b) Dose distribution with indicated measurement positions. c) Rotatable solid-state phantom carrying 24 ionization chambers for dose verification in ion beam radiotherapy

During the heavy ion therapy project GSI, we contributed to the development of patient positioning, treatment planning and dosimetry, which were then employed for patient treatments from 1997 - 2008. During this time many physical, biological (Experimental radiobiology of ion beams) and clinical investigations have been performed. The developments in medical physics have been transferred to the Heidelberg Ion Beam Radiotherapy Center (HIT), which started clinical operation in 2009. The experience gained at GSI is also incorporated into scientific and educational courses on ion beam radiotherapy and as well as into radiation protection trainings.

Highly resolved three-dimensional (3D) dose measurements are of great importance in radiotherapy to verify that the dose distribution is delivered to the patient as planned. In spite of available commercial dose verification systems, the measurement of truly 3D dose distributions is still an unsolved problem in ion beam radiotherapy. For photon beams, radiation-sensitive gel dosimeters may be used for 3D dosimetry. For ion beams, however, most of these gel dosimeters show a severe under-response (‘quenching’) in regions of high linear energy transfer (LET), limiting their application in proton and carbon radiotherapy. An exception is the so-called nanoclay (NC)-Fricke gel in combination with magnetic resonance (MR) readout of the T1-relaxation time (Bayer et al 2024). This promising gel dosimeter system is investigated and optimized in close cooperation with the research groups Translational Research for Ion Beam Therapy and Medical Engineering as well as with the Division of Medical Physics in Radiology and the Junior Group Translational Radiotheranostics. This interdisciplinary project involves radiation physics of ion beams, MR imaging, 3D printing and radiochemistry. Current research focuses on the development and optimization of accurate and efficient irradiation and MR readout protocols as well as on increasing the radiosensitivity of the NC-Fricke gel system. The final goal is to develop a dosimetry system that can be used in anthropomorphic phantoms to simulate patient treatments within end-to-end tests (Bakhtiari Moghaddam et al. 2025).

The image presents two graphs. The top graph shows a dose versus depth plot with varying colored data points and error bars. The bottom section features a heatmap indicating ion beam intensity, with an arrow labeled "ion beam" and a color gradient representing intensity levels from 0 to 4. Monoenergetic Bragg-peak (upper panel) determined with MR-readout of the irradiated NC-Fricke gel (lower panel).
Monoenergetic Bragg-peak (upper panel) determined with MR-readout of the irradiated NC-Fricke gel (lower panel).

Selected publications (in chronological order)

  • Bakhtiari Moghaddam A., Runz A., Figueiredo Augusto R., Echner G., Johnen W., Gabriel R., Häring P., Lang C., Seeber S., Murillo C., Ackermann B., Pestana R., Beyer C., Weykamp F., Jochim M., Qubala A., Batista V., Jäkel P., Karger C.P.: A Dynamic Anthropomorphic Phantom for End-to-End Testing in Image- and Surface-Guided Adaptive Radiotherapy. Medical Physics 52, e70107, 2025
    https://doi.org/10.1002/mp.70107
  • Qubala A, Horn J, Karger C.P., Winter M., Ellerbrock M., Jäkel O., Henkner K.: Patient-specific quality assurance at the Heidelberg Ion Beam Therapy Center: 10 years experience in treatment plan verification. Medical Physics 53, e70237, 2026
    https://doi.org/10.1002/mp.70237
  • Bayer V., Vedelago J., Dorsch S., Beyer C., Brons S., Johnen W., Biegger P., Weber U., Runz A., Karger C.P.: Carbon ion mono-energetic and spread-out Bragg peak measurements using nanocomposite Fricke gel dosimeters with LET-independent response. Radiation Measurements. 176, 107175, 2024 
    https://doi.org/10.1016/j.radmeas.2024.107175
  • Henkner K., Winter M., Echner G., Ackermann B., Brons S., Horn J., Jäkel O., Karger C.P.: A motorized solid-state phantom for patient-specific dose verification in ion beam radiotherapy. Physics in Medicine and Biology 60, 7151-7163, 2015
    https://iopscience.iop.org/article/10.1088/0031-9155/60/18/7151
  • Karger C.P., Schulz-Ertner D., Didinger B.H., Debus J., Jäkel O.: Influence of setup errors on spinal cord dose and treatment plan quality for cervical spine tumors: A phantom study for photon IMRT and heavy charged particle radiotherapy. Physics in Medicine and Biology 48, 3171-3189, 2003 
    https://iopscience.iop.org/article/10.1088/0031-9155/48/19/006
  • Jäkel O., Krämer M., Karger C.P., Debus J.: Treatment planning for heavy ion radiotherapy: clinical implementation and application. Physics in Medicine and Biology 46, 1101-1116, 2001
    https://iopscience.iop.org/article/10.1088/0031-9155/46/4/314
  • Jäkel O., Jacob C., Schardt D., Karger C.P., Hartmann G.H.: Relation between carbon ion ranges and X-ray CT numbers for tissue equivalent phantom materials. Medical Physics 28, 701-703, 2001
    https://aapm.onlinelibrary.wiley.com/doi/abs/10.1118/1.1357455
  • Jäkel O., Hartmann G.H., Karger C.P., Heeg P., Rassow J.: Quality assurance for a treatment planning system in scanned ion beam therapy. Medical Physics 27, 1588-1600, 2000
    https://aapm.onlinelibrary.wiley.com/doi/abs/10.1118/1.599025
  • Karger C.P., Hartmann G.H., Jäkel O., Heeg P.: Quality management of medical physics issues at the German heavy ion therapy project. Medical Physics 27, 725-736, 2000
    https://aapm.onlinelibrary.wiley.com/doi/abs/10.1118/1.598935
  • Hartmann G.H., Jäkel O., Heeg P., Karger C.P., Krießbach A.: Determination of water absorbed dose in a carbon ion beam using thimble ionization chambers. Physics in Medicine and Biology 44, 1193-1206, 1999
    https://iopscience.iop.org/article/10.1088/0031-9155/44/5/008
  • Karger C.P., Jäkel O., Hartmann G.H., Heeg P.: A system for three-dimensional dosimetric verification of treatment plans in intensity-modulated radiotherapy with heavy ions. Medical Physics 26, 2125-2132, 1999
    https://aapm.onlinelibrary.wiley.com/doi/abs/10.1118/1.598728

Reviews (in chronological order)

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Prof. Dr. Christian Karger

Research Group Leader
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