The Bragg Peak

In Chapter 16 of Intermediate Physics for Medicine and Biology, Russ Hobbie and I discuss the Bragg peak.

Protons are also used to treat tumors (Khan 2010, Ch. 26; Goitein 2008). Their advantage is the increase of stopping power at low energies. It is possible to make them come to rest in the tissue to be destroyed, with an enhanced dose relative to intervening tissue and almost no dose distally (“downstream”) as shown by the Bragg peak in Fig.16.47.

Energy loss versus depth for a 150 MeV proton beam in water, with and without straggling (fluctuations in the range). The Bragg peak enhances the energy deposition at the end of the proton range. Adapted from Fig. 16.47 in Intermediate Physics for Medicine and Biology.

William Henry Bragg

Sir William Henry Bragg (1862 – 1942) was an English scientist who shared the 1915 Nobel Prize in Physics with his son Lawrence Bragg for their analysis of crystal structure using X-rays. In 2004, Andrew Brown and Herman Suit published an article commemorating “The Centenary of the Discovery of the Bragg Peak” (Radiotherapy and Oncology, Volume 73, Pages 265-268).

In December 1904, William Henry Bragg, Professor of Mathematics and Physics at the University of Adelaide and his assistant Richard Kleeman published in the Philosophical Magazine (London) novel observations on radioactivity. Their paper “On the ionization of curves of radium,” gave measurements of the ionization produced in air by alpha particles, at varying distances from a very thin source of radium salt. The recorded ionization curves “brought to light a fact, which we believe to have been hitherto unobserved. It is, that the alpha particle is a more efficient ionizer towards the extreme end of its course.” This was promptly followed by further results in the Philosophical Magazine in 1905. Their finding was contrary to the accepted wisdom of the day, viz. that the ionizations produced by alpha particles decrease exponentially with range. From theoretical considerations, they concluded that an alpha particle possesses a definite range in air, determined by its initial energy and produces increasing ionization density near the end of its range due to its diminishing speed.

Although Bragg discovered the Bragg peak for alpha particles, the same behavior is found for other heavy charged particles such as protons. It is the key concept underlying the development of proton therapy. Brown and Suit conclude

The first patient treatment by charged particle therapy occurred within a decade of Wilson’s paper [the first use of protons in therapy, published in 1946]. Since then, the radiation oncology community has been evaluating various particle beams for clinical use. By December 2004, a century after Bragg’s original publication, the approximate number of patients treated by proton–neon beams is 47,000 (Personal communication, Janet Sisterson, Editor, Particles) [over 170,000 today]. There have been several clear clinical gains. None of these would have been possible, were it not for the demonstration that radically different depth dose curves were feasible.