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arxiv: 2605.05441 · v2 · pith:PUKUXJX2new · submitted 2026-05-06 · ⚛️ physics.med-ph · physics.acc-ph· physics.ins-det

Development of a Proton Therapy Research Beamline with FLASH and Minibeam Capabilities at the 18 MeV Bern Medical Cyclotron

Pith reviewed 2026-05-21 09:16 UTC · model grok-4.3

classification ⚛️ physics.med-ph physics.acc-phphysics.ins-det
keywords proton beamlineFLASH radiotherapyminibeamradiobiologycyclotrondosimetrySFRTpre-clinical studies
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The pith

The 18 MeV Bern Medical Cyclotron can be adapted into a research beamline that delivers protons for FLASH and minibeam radiobiology studies with stable rates from 0.01 to 100 Gy/s and uniformity below 8 percent.

A machine-rendered reading of the paper's core claim, the machinery that carries it, and where it could break.

The paper describes modifications to the beam transfer line of an existing medical cyclotron to enable controlled proton irradiation experiments. Passive elements such as collimators and scattering foils shape the beam into uniform fields or minibeam grids while supporting both standard and ultra-high dose rates. A dosimetry approach using an ionization chamber and corrected radiochromic film allows quantitative dose assessment at the low energies reaching cell samples. A sympathetic reader would care because the setup offers a practical way to test emerging radiotherapy ideas that aim to improve tumor control while reducing damage to surrounding tissue.

Core claim

The central claim is that the adapted beam transfer line of the 18 MeV Bern Medical Cyclotron provides a flexible platform for pre-clinical proton radiobiology. It supports both conventional and FLASH regimes across dose rates from 0.01 to 100 Gy/s, achieves dose uniformity below 8 percent within a 20 mm radius, and produces well-resolved minibeam patterns at extracted energies of 15.54 MeV in air and 8.14 MeV at the cells. The combination of passive beam shaping and LET-corrected film dosimetry makes quantitative in-vitro measurements feasible.

What carries the argument

The adapted Beam Transfer Line that uses passive collimators, scattering foils, and extended drift space to shape the proton beam, together with an in-beam ionization chamber and LET-dependent radiochromic film dosimetry.

If this is right

  • The beamline supports systematic pre-clinical studies of proton FLASH and spatially fractionated radiotherapy under controlled conditions.
  • Low proton energies enable compact minibeam grids with clear spatial separation at the target.
  • Stable operation across 0.01 to 100 Gy/s allows direct comparison of biological effects between conventional and ultra-high dose rates.
  • Dose uniformity below 8 percent within a 20 mm radius provides reliable irradiation fields for repeatable cell experiments.
  • LET-corrected dosimetry makes quantitative dose reporting feasible for in-vitro setups.

Where Pith is reading between the lines

These are editorial extensions of the paper, not claims the author makes directly.

  • Similar passive adaptations could be applied at other medical cyclotrons to increase access to proton radiobiology platforms.
  • The low-energy minibeam configuration may help isolate the contribution of spatial fractionation from dose-rate effects in future cell studies.
  • Long-term operation of this beamline could generate standardized datasets for comparing proton and photon versions of FLASH and SFRT.

Load-bearing premise

Passive collimation, scattering foils, and LET-dependent film corrections produce quantitatively accurate and reproducible dose distributions for in-vitro cell studies at the low extracted energies.

What would settle it

A measurement campaign that finds dose non-uniformity above 8 percent or systematic discrepancies larger than reported uncertainties between ionization chamber and film readings at 15.54 MeV would indicate the claim does not hold.

read the original abstract

Advanced radiotherapy approaches such as FLASH irradiation and spatially fractionated radiotherapy (SFRT) show potential to improve the therapeutic ratio, yet their biological mechanisms and optimal delivery parameters remain uncertain. Progress requires accessible proton research platforms with flexible temporal and spatial dose delivery. We report on the adaptation of the Beam Transfer Line (BTL) of the Bern Medical Cyclotron (BMC) for radiobiology research with FLASH and proton minibeam capabilities. The BMC is optimized for the production of radionuclides for medical imaging, and is able to extract currents up to 150 $ \mathrm{\mu A}$. The 18 MeV proton beam was passively shaped using collimators, scattering foils, and extended drift space to generate irradiation fields. A dosimetric framework was implemented using an in-beam ionization chamber and radiochromic film with LET-dependent corrections. Beam uniformity and SFRT profiles with various grid spacings were evaluated at realistic target distances. The developed beamline enables stable delivery under controlled conditions in both conventional and FLASH regimes, spanning dose rates from 0.01 to 100 Gy/s. Dose uniformity within a 20 mm radius was below 8\%. Film measurements confirmed the need for LET-dependent corrections and indicated that quantitative dosimetry in in-vitro setups is achievable with appropriate LET corrections. The low proton energy (15.54(12) MeV extracted into air, 8.14(28) MeV delivered to cells in flask) facilitates compact SFRT implementation with well-resolved minibeams. The adapted BMC provides a flexible and accessible platform for systematic pre-clinical proton radiobiology studies under varied dose-rate and spatial delivery conditions. This supports optimization of emerging modalities such as proton FLASH and SFRT and helps bridge accelerator technology and radiobiology.

Editorial analysis

A structured set of objections, weighed in public.

Desk editor's note, referee report, simulated authors' rebuttal, and a circularity audit. Tearing a paper down is the easy half of reading it; the pith above is the substance, this is the friction.

Referee Report

2 major / 2 minor

Summary. The manuscript reports the adaptation of the Beam Transfer Line at the 18 MeV Bern Medical Cyclotron for proton radiobiology research, enabling FLASH and minibeam (SFRT) capabilities via passive collimation, scattering foils, and drift space. It describes implementation of a dosimetric framework using an in-beam ionization chamber and radiochromic film with LET-dependent corrections, achieving stable delivery across 0.01–100 Gy/s with dose uniformity below 8% within a 20 mm radius at low energies (15.54(12) MeV in air, 8.14(28) MeV at cells). The work positions the adapted BMC as a flexible platform for pre-clinical studies of dose-rate and spatial fractionation effects.

Significance. If the reported dosimetry holds under independent validation, this provides a valuable, accessible low-energy platform for systematic pre-clinical proton radiobiology, particularly for FLASH and SFRT optimization where high-energy facilities are less practical for compact minibeam setups. The direct experimental measurements of beam stability and hardware adaptations constitute a clear strength.

major comments (2)
  1. [Dosimetric framework] Dosimetric framework (abstract and results sections): The central claim of quantitatively accurate and reproducible dose distributions for in-vitro studies rests on LET-dependent radiochromic film corrections at the reported 8.14(28) MeV exit energy (high LET ~15–25 keV/µm, ~0.7 mm range). The manuscript does not specify the origin of the LET correction factor, its applicability to the exact minibeam/FLASH conditions, or cross-validation against an independent detector such as a thin-window ionization chamber or Faraday cup; this leaves unquantified systematic uncertainty in the uniformity <8% and absolute dose values.
  2. [Results on beam uniformity] Beam uniformity and dose-rate results: The reported uniformity below 8% within 20 mm and dose-rate span rely on film measurements, yet the text provides limited description of data exclusion criteria, baseline comparisons to other detectors, and full error propagation that includes film quenching, beam stability, and LET correction uncertainties; these gaps directly affect the robustness of the reproducibility claims for cell studies.
minor comments (2)
  1. Clarify the precise method and any range straggling calculations used to arrive at the delivered energy of 8.14(28) MeV at the cell flask position.
  2. Add explicit discussion of how the passive scattering and collimation setup scales with the reported grid spacings for SFRT profiles.

Simulated Author's Rebuttal

2 responses · 0 unresolved

We thank the referee for their constructive and detailed review of our manuscript on the adaptation of the Bern Medical Cyclotron beamline for proton radiobiology research with FLASH and minibeam capabilities. We address each major comment point by point below, indicating where revisions will be made to improve clarity and robustness.

read point-by-point responses
  1. Referee: [Dosimetric framework] Dosimetric framework (abstract and results sections): The central claim of quantitatively accurate and reproducible dose distributions for in-vitro studies rests on LET-dependent radiochromic film corrections at the reported 8.14(28) MeV exit energy (high LET ~15–25 keV/µm, ~0.7 mm range). The manuscript does not specify the origin of the LET correction factor, its applicability to the exact minibeam/FLASH conditions, or cross-validation against an independent detector such as a thin-window ionization chamber or Faraday cup; this leaves unquantified systematic uncertainty in the uniformity <8% and absolute dose values.

    Authors: We agree that the manuscript would benefit from greater detail on the LET correction procedure to support the quantitative dosimetry claims. The corrections applied to the EBT3 radiochromic film data were drawn from established proton-specific calibration curves in the literature that account for LET-dependent quenching at energies around 8 MeV. In the revised version we will expand the methods section to cite the precise origin of the correction factors, discuss their suitability for the minibeam grid and high-dose-rate FLASH conditions employed, and present additional cross-comparisons with the in-beam ionization chamber measurements. These additions will also include an estimate of the remaining systematic uncertainty in the reported uniformity and absolute dose values. revision: yes

  2. Referee: [Results on beam uniformity] Beam uniformity and dose-rate results: The reported uniformity below 8% within 20 mm and dose-rate span rely on film measurements, yet the text provides limited description of data exclusion criteria, baseline comparisons to other detectors, and full error propagation that includes film quenching, beam stability, and LET correction uncertainties; these gaps directly affect the robustness of the reproducibility claims for cell studies.

    Authors: We acknowledge that the current description of the analysis pipeline is insufficiently detailed. The revised manuscript will include an expanded data-analysis subsection that specifies the criteria used to exclude outlier film measurements, presents direct baseline comparisons between film and ionization-chamber readings, and provides a complete error-propagation analysis that incorporates contributions from film quenching, temporal beam stability, and LET-correction uncertainties. These changes will strengthen the reproducibility statements for the in-vitro irradiation conditions. revision: yes

Circularity Check

0 steps flagged

No circularity: experimental hardware adaptation and direct measurements

full rationale

The paper describes physical adaptation of the Bern Medical Cyclotron beam transfer line using collimators, scattering foils and drift space, followed by direct measurements of dose rate, uniformity and minibeam profiles with an in-beam ionization chamber and radiochromic film. All reported quantities (dose rates 0.01–100 Gy/s, uniformity <8% within 20 mm, energies 15.54 MeV in air and 8.14 MeV at cells) are obtained from experimental data rather than any derivation, prediction or fitted parameter that reduces to the inputs by construction. No self-citations, uniqueness theorems or ansatzes are invoked to support the central claims. The work is therefore self-contained as an empirical report.

Axiom & Free-Parameter Ledger

0 free parameters · 2 axioms · 0 invented entities

The central claim rests on standard beam-transport physics and established dosimetry practices rather than new free parameters or invented entities.

axioms (2)
  • standard math Proton beam transport through drift space and passive scatterers follows standard electromagnetic and multiple-scattering physics.
    Invoked implicitly when describing beam shaping and uniformity evaluation.
  • domain assumption Radiochromic film response can be corrected for LET dependence to yield accurate absorbed dose.
    Stated as necessary for quantitative dosimetry in the abstract.

pith-pipeline@v0.9.0 · 5919 in / 1401 out tokens · 37840 ms · 2026-05-21T09:16:00.966154+00:00 · methodology

discussion (0)

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Reference graph

Works this paper leans on

24 extracted references · 24 canonical work pages

  1. [1]

    Velalopoulou, I.V

    A. Velalopoulou, I.V. Karagounis, G.M. Cramer, M.M. Kim, G. Skoufos, D. Goia et al.,Flash proton radiotherapy spares normal epithelial and mesenchymal tissues while preserving sarcoma response, Cancer Research81(2021) 4808–4821

  2. [2]

    F. Yang, J. Wu, L.C. Orlandini, H. Li and X. Wang,Proton minibeam radiotherapy: a review, Frontiers in Oncology15(2025)

  3. [3]

    S.E. Lee, H. Sheen, Y. Kim, S. Cho, S.H. Ahn, K. Sasai et al.,Localized normal tissue-sparing effects of proton flash radiotherapy in a preclinical lung irradiation model,British Journal of Radiology99 (2026) 459–467

  4. [4]

    Baratto-Roldán, M.d.C

    A. Baratto-Roldán, M.d.C. Jiménez-Ramos, M.C. Battaglia, J. García-López, M.I. Gallardo, M.A. Cortés-Giraldo et al.,Feasibility study of a proton irradiation facility for radiobiological measurements at an 18 mev cyclotron,Instruments2(2018) 26

  5. [5]

    Baratto-Roldán, M.d.C

    A. Baratto-Roldán, M.d.C. Jiménez-Ramos, S. Jimeno, P. Huertas, J. García-López, M.I. Gallardo et al.,Preparation of a radiobiology beam line at the 18 mev proton cyclotron facility at cna,Physica Medica74(2020) 19–29

  6. [6]

    Constanzo, M

    J. Constanzo, M. Vanstalle, C. Finck, D. Brasse and M. Rousseau,Dosimetry and characterization of a 25-mev proton beam line for preclinical radiobiology research,Medical Physics46(2019) 2356–2362

  7. [7]

    Ghithan, P

    S. Ghithan, P. Crespo, S.d. Carmo, R.F. Marques, F. Fraga, H. Simões et al.,Development of a pet cyclotron based irradiation setup for proton radiobiology,Journal of Instrumentation10(2015) P02010–P02010. – 19 –

  8. [8]

    Fabbrizi, J.R

    M.R. Fabbrizi, J.R. Hughes, L.D. Punshon, L. Hawkins, V. Sorokin, A. Ormrod et al., Radiobiological characterisation of a 28 mev proton beam delivered by the mc-40 cyclotron,Cell Death Discovery11(2025)

  9. [9]

    Braccini,The new bern pet cyclotron, its research beam line, and the development of an innovative beam monitor detector, inAIP Conference Proceedings, AIP, 2013, DOI

    S. Braccini,The new bern pet cyclotron, its research beam line, and the development of an innovative beam monitor detector, inAIP Conference Proceedings, AIP, 2013, DOI

  10. [10]

    Auger, S

    M. Auger, S. Braccini, A. Ereditato, K.P. Nesteruk and P. Scampoli,Low current performance of the bern medical cyclotron down to the pa range,Measurement Science and Technology26(2015) 094006

  11. [11]

    Gottstein, L

    A. Gottstein, L. Mercolli, E. Kasanda, I. Mateu, L. Eggimann, E. Zyaee et al.,Beam energy measurement using a bayesian approach with the stacked foil method,Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment1084(2026) 171241

  12. [12]

    Potkins, S

    D.E. Potkins, S. Braccini, K.P. Nesteruk, T.S. Carzaniga, A. Vedda, N. Chiodini et al.,A low-cost beam profiler based on cerium-doped silica fibers,Physics Procedia90(2017) 215–222

  13. [13]

    PD-1021 Datasheet and Product Info | Analog Devices

    “PD-1021 Datasheet and Product Info | Analog Devices.” https://www.analog.com/en/products/pd-1021.html#documentation

  14. [14]

    Pytrinamic: TRINAMIC’s Python Technology Access Package

    “Pytrinamic: TRINAMIC’s Python Technology Access Package..”

  15. [15]

    Monitor ionization chamber 786

    PTW dosimetry Freiburg, “Monitor ionization chamber 786.”

  16. [16]

    Wilmington, 8145 Blazer Dr, United States, 2023

    Ashland Advanced Materials,EBT-3 FILM SPECIFICATION AND USER GUIDE. Wilmington, 8145 Blazer Dr, United States, 2023

  17. [17]

    BT.601 : Studio encoding parameters of digital television for standard 4:3 and wide screen 16:9 aspect ratios

    “BT.601 : Studio encoding parameters of digital television for standard 4:3 and wide screen 16:9 aspect ratios.” https://www.itu.int/rec/R-REC-BT.601-7-201103-I/en

  18. [18]

    Campajola, P

    L. Campajola, P. Casolaro and F.D. Capua,Absolute dose calibration of EBT3 Gafchromic films, Journal of Instrumentation12(2017) P08015

  19. [19]

    Stucki, W

    G. Stucki, W. Muench and H. Quintel,The METAS absorbed dose to water calibration service for high energy photon and electron beam radiotherapy, IAEA (Dec, 2003)

  20. [20]

    LISE++ : Rare Isotope Beam Production

    “LISE++ : Rare Isotope Beam Production.” https://lise.frib.msu.edu/lise.html

  21. [21]

    Ziegler, M

    J.F. Ziegler, M. Ziegler and J. Biersack,Srim – the stopping and range of ions in matter (2010), Nuclear Instruments and Methods in Physics Research Section B: Beam Interactions with Materials and Atoms268(2010) 1818–1823

  22. [22]

    Sanchez-Parcerisa, I

    D. Sanchez-Parcerisa, I. Sanz-García, P. Ibáñez, S. España, A. Espinosa, C. Gutiérrez-Neira et al., Radiochromic film dosimetry for protons up to 10 MeV with EBT2, EBT3 and unlaminated EBT3 films,Physics in Medicine & Biology66(2021) 115006

  23. [23]

    Reinhardt, M

    S. Reinhardt, M. Würl, C. Greubel, N. Humble, J.J. Wilkens, M. Hillbrand et al.,Investigation of ebt2 and ebt3 films for proton dosimetry in the 4–20 mev energy range,Radiation and Environmental Biophysics54(2015) 71–79

  24. [24]

    Sanchez-Parcerisa, I

    D. Sanchez-Parcerisa, I. Sanz-García, P. Ibáñez, S. España, A. Espinosa, C. Gutiérrez-Neira et al., Radiochromic film dosimetry for protons up to 10 mev with ebt2, ebt3 and unlaminated ebt3 films, Physics in Medicine & Biology66(2021) 115006. – 20 –