Inter-center comparison of proton range verification prototypes with an anthropomorphic head phantom

Objective. To compare in reproducible and equalized conditions the performance of two independent proton range verification systems based on prompt gamma-ray detectors from two different proton therapy centers.Approach. An anthropomorphic head phantom with calibrated stopping power, serving as ground truth, was irradiated with comparable treatment plans, spot positions and energies in both facilities. Clinical beam current, tumor contour and dose were used. The absolute range measurement was compared to the expected value according to the ground truth. The statistical precision was assessed by repeating each measurement ten times. Sensitivity to relative range shifts was evaluated by introducing 2 mm and 5 mm plastic slabs on half of the field.Main results. The resulting absolute range accuracy was within 2.4 mm in all cases. Relative range shifts were detected with deviations lower than 14%.Significance. The performance of both systems was deemed worthy of clinical application for the detection of range deviations. This study represents the first comparison of independent prompt gamma-ray-based proton range verification systems under equalized conditions with realistic treatment fields and beam currents.