First Experience With Real-Time EPID-Based Delivery Verification During IMRT and VMAT Sessions

International Nuclear Information System (INIS)

Woodruff, Henry C.; Fuangrod, Todsaporn; Van Uytven, Eric; McCurdy, Boyd M.C.; Beek, Timothy van; Bhatia, Shashank; Greer, Peter B.

2015-01-01

Purpose: Gantry-mounted megavoltage electronic portal imaging devices (EPIDs) have become ubiquitous on linear accelerators. WatchDog is a novel application of EPIDs, in which the image frames acquired during treatment are used to monitor treatment delivery in real time. We report on the preliminary use of WatchDog in a prospective study of cancer patients undergoing intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) and identify the challenges of clinical adoption. Methods and Materials: At the time of submission, 28 cancer patients (head and neck, pelvis, and prostate) undergoing fractionated external beam radiation therapy (24 IMRT, 4 VMAT) had ≥1 treatment fraction verified in real time (131 fractions or 881 fields). EPID images acquired continuously during treatment were synchronized and compared with model-generated transit EPID images within a frame time (∼0.1 s). A χ comparison was performed to cumulative frames to gauge the overall delivery quality, and the resulting pass rates were reported graphically during treatment delivery. Every frame acquired (500-1500 per fraction) was saved for postprocessing and analysis. Results: The system reported the mean ± standard deviation in real time χ 91.1% ± 11.5% (83.6% ± 13.2%) for cumulative frame χ analysis with 4%, 4 mm (3%, 3 mm) criteria, global over the integrated image. Conclusions: A real-time EPID-based radiation delivery verification system for IMRT and VMAT has been demonstrated that aims to prevent major mistreatments in radiation therapy.

First Experience With Real-Time EPID-Based Delivery Verification During IMRT and VMAT Sessions

Energy Technology Data Exchange (ETDEWEB)

Woodruff, Henry C., E-mail: henry.woodruff@newcastle.edu.au [Faculty of Science and Information Technology, School of Mathematical and Physical Sciences, University of Newcastle, New South Wales (Australia); Fuangrod, Todsaporn [Faculty of Engineering and Built Environment, School of Electrical Engineering and Computer Science, University of Newcastle, New South Wales (Australia); Van Uytven, Eric; McCurdy, Boyd M.C.; Beek, Timothy van [Division of Medical Physics, CancerCare Manitoba, Winnipeg, Manitoba (Canada); Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba (Canada); Department of Radiology, University of Manitoba, Winnipeg, Manitoba (Canada); Bhatia, Shashank [Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, New South Wales (Australia); Greer, Peter B. [Faculty of Science and Information Technology, School of Mathematical and Physical Sciences, University of Newcastle, New South Wales (Australia); Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, New South Wales (Australia)

2015-11-01

Purpose: Gantry-mounted megavoltage electronic portal imaging devices (EPIDs) have become ubiquitous on linear accelerators. WatchDog is a novel application of EPIDs, in which the image frames acquired during treatment are used to monitor treatment delivery in real time. We report on the preliminary use of WatchDog in a prospective study of cancer patients undergoing intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) and identify the challenges of clinical adoption. Methods and Materials: At the time of submission, 28 cancer patients (head and neck, pelvis, and prostate) undergoing fractionated external beam radiation therapy (24 IMRT, 4 VMAT) had ≥1 treatment fraction verified in real time (131 fractions or 881 fields). EPID images acquired continuously during treatment were synchronized and compared with model-generated transit EPID images within a frame time (∼0.1 s). A χ comparison was performed to cumulative frames to gauge the overall delivery quality, and the resulting pass rates were reported graphically during treatment delivery. Every frame acquired (500-1500 per fraction) was saved for postprocessing and analysis. Results: The system reported the mean ± standard deviation in real time χ 91.1% ± 11.5% (83.6% ± 13.2%) for cumulative frame χ analysis with 4%, 4 mm (3%, 3 mm) criteria, global over the integrated image. Conclusions: A real-time EPID-based radiation delivery verification system for IMRT and VMAT has been demonstrated that aims to prevent major mistreatments in radiation therapy.

Experimental IMRT breast dosimetry in a thorax phantom

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Pimenta, Elsa B.; Campos, Tarcisio P.R.; Nogueira, Luciana B.; Lima, Andre C.S., E-mail: elsabpimenta@gmail.com, E-mail: tprcampos@pq.cnpq.br, E-mail: lucibn19@yahoo.com.br, E-mail: radioterapia.andre@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Centro de Tratamento em Radioterapia, Betim, MG (Brazil)

2017-11-01

Radiation therapy (RT) is an essential therapeutic method. RT is often used as adjuvant therapy in the treatment of breast cancer. The dose-volume restrictions of the organs at risk limit the prescribed dose to the target volume and biological and clinical effects may influence the final treatment outcome. The breast RT provides large risks to the adjacent organs and consequently the recommended dosimetry to the prescribed dose volume (PTV) is 50 Gy, lower than the most prescribed dose in other treatments (70-85 Gy). Such values implies in less tumor control compared to other sites. The present research proposal aimed to measure absorbed dose in a thorax phantom with synthetic breasts provided by an Intensity-Modulate Radiation Therapy (IMRT) protocol in a RT center. On the methodology, IMRT protocol was selected following recommendations from the Radiation Therapy Oncology Group (RTOG). Radiochromic films and a thorax simulator were prepared by the Ionizing Radiation Research Group (NRI). Dosimeters were calibrated on a selected linear accelerator (LINAC). The comparison of the dosimetry from treatment planning system (TPS), Xio (Elekta) and from experimental data was performed. The spatial distribution of the breast internal dose and in the adjacent organs was depicted by the experimental data. In the film's calibration, the quadratic polynomial fit presented a satisfactory coefficient. Two-dimensional dose profiles were obtained in the breast suggesting that films can supply details and information that TPS does not provide. At the phantom's dosimetry, the internal mean doses taken at the synthetic breast presented usual values above the prescribed dose, besides overall values were within the dosimetric MSKCC criterion. The non full reproduction of the build-up region in the films had occurred due to the asymmetrical positioning of the films in the inner breast, in addition to their non constant distance from the skin. The hot regions were present may

Investigating the feasibility of 3D dosimetry in the RPC IMRT H and N phantom

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Sakhalkar, H S; Sterling, D [Department of Radiation Oncology Physics, Duke University Medical Center, Durham, NC (United States); Adamovics, J [Department of Chemistry and Biology, Rider University, Lawrenceville, NJ (United States); Ibbott, G [Department of Radiation Physics, M. D. Anderson Cancer Center, Houston, Tx (United States); Oldham, M, E-mail: mark.oldham@duke.edu

2009-05-01

An urgent requirement for 3D dosimetry has been recognized because of high failure rate ({approx}25%) in RPC credentialing, which relies on point and 2D dose measurements. Comprehensive 3D dosimetry is likely to resolve more errors and improve IMRT quality assurance. This work presents an investigation of the feasibility of PRESAGE/optical-CT 3D dosimetry in the Radiologic Physics Center (RPC) IMRT H and N phantom. The RPC H and N phantom (with standard and PRESAGE dosimetry inserts alternately) was irradiated with the same IMRT plan. The TLD and EBT film measurement data from standard insert irradiation was provided by RPC. The 3D dose measurement data from PRESAGE insert irradiation was readout using the OCTOPUS{sup TM} 5X optical-CT scanner at Duke. TLD, EBT and PRESAGE dose measurements were inter-compared with Eclipse calculations to evaluate consistency of planning and delivery. Results showed that the TLD point dose measurements agreed with Eclipse calculations to within 5% dose-difference. Relative dose comparison between Eclipse dose, EBT dose and PRESAGE dose was conducted using profiles and gamma comparisons (4% dose-difference and 4 mm distance-to-agreement). Profiles showed good agreement between measurement and calculation except along steep dose gradient regions where Eclipse modelling might be inaccurate. Gamma comparisons showed that the measurement and calculation showed good agreement (>96%) if edge artefacts in measurements are ignored. In conclusion, the PRESAGE/optical-CT dosimetry system was found to be feasible as an independent dosimetry tool in the RPC IMRT H and N phantom.

Investigating the feasibility of 3D dosimetry in the RPC IMRT H and N phantom

International Nuclear Information System (INIS)

Sakhalkar, H S; Sterling, D; Adamovics, J; Ibbott, G; Oldham, M

2009-01-01

An urgent requirement for 3D dosimetry has been recognized because of high failure rate (∼25%) in RPC credentialing, which relies on point and 2D dose measurements. Comprehensive 3D dosimetry is likely to resolve more errors and improve IMRT quality assurance. This work presents an investigation of the feasibility of PRESAGE/optical-CT 3D dosimetry in the Radiologic Physics Center (RPC) IMRT H and N phantom. The RPC H and N phantom (with standard and PRESAGE dosimetry inserts alternately) was irradiated with the same IMRT plan. The TLD and EBT film measurement data from standard insert irradiation was provided by RPC. The 3D dose measurement data from PRESAGE insert irradiation was readout using the OCTOPUS TM 5X optical-CT scanner at Duke. TLD, EBT and PRESAGE dose measurements were inter-compared with Eclipse calculations to evaluate consistency of planning and delivery. Results showed that the TLD point dose measurements agreed with Eclipse calculations to within 5% dose-difference. Relative dose comparison between Eclipse dose, EBT dose and PRESAGE dose was conducted using profiles and gamma comparisons (4% dose-difference and 4 mm distance-to-agreement). Profiles showed good agreement between measurement and calculation except along steep dose gradient regions where Eclipse modelling might be inaccurate. Gamma comparisons showed that the measurement and calculation showed good agreement (>96%) if edge artefacts in measurements are ignored. In conclusion, the PRESAGE/optical-CT dosimetry system was found to be feasible as an independent dosimetry tool in the RPC IMRT H and N phantom.

Dosimetry of parotid glands in IMRT plan of nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Lian Jiancheng; Yu Xinsheng; Jiang Guoliang

2007-01-01

Objective: To evaluate the effect of different intensity-modulated radiation therapy (IMRT) plan on the dosimetry of parotid in patients with nasopharyngeal carcinoma. Methods: Under the same constraints and objections, the IMRT plan of nasopharyngeal carcinoma with sparing unilateral parotid and the IMRT plan added plan tumor volume (PTV) margin for parotid gland was investigated. Results: Between conventional IMRT plan and the IMRT plan spared unilateral parotid, their target coverage, homogeneity index and conformal index of PTV 70 is similar. On PTV 60 , D min in the plan of sparing one parotid gland was more than that in normal IMRT plan (P 95 in the plan of sparing one parotid gland have improved (P 50%VOL and D mean of parotid gland were similar between the two plans. Between conventional IMRT plan and the IMRT plan added 2 or 3 mm margin for parotid gland, their target coverage, homogeneity index and conformal index of PTV 70 is similar. D min , D mean and D 95 of PTV 60 have decreased tendency from normal IMRT plan to 2 mm margin plan to 3 mm margin plan. D max of brainstem and spine cord have increased tendency from normal IMRT plan to 2 mm margin plan to 3 mm margin plan. Conclusions: The IMRT plan of nasopharyngeal carcinoma with sparing unilateral parotid may be adopted not to protect both two parotids, while PTV margin for parotid added as parotid move. (authors)

Comparison of Real-Time Intraoperative Ultrasound-Based Dosimetry With Postoperative Computed Tomography-Based Dosimetry for Prostate Brachytherapy

International Nuclear Information System (INIS)

Nag, Subir; Shi Peipei; Liu Bingren; Gupta, Nilendu; Bahnson, Robert R.; Wang, Jian Z.

2008-01-01

Purpose: To evaluate whether real-time intraoperative ultrasound (US)-based dosimetry can replace conventional postoperative computed tomography (CT)-based dosimetry in prostate brachytherapy. Methods and Materials: Between December 2001 and November 2002, 82 patients underwent 103 Pd prostate brachytherapy. An interplant treatment planning system was used for real-time intraoperative transrectal US-guided treatment planning. The dose distribution was updated according to the estimated seed position to obtain the dose-volume histograms. Postoperative CT-based dosimetry was performed a few hours later using the Theraplan-Plus treatment planning system. The dosimetric parameters obtained from the two imaging modalities were compared. Results: The results of this study revealed correlations between the US- and CT-based dosimetry. However, large variations were found in the implant-quality parameters of the two modalities, including the doses covering 100%, 90%, and 80% of the prostate volume and prostate volumes covered by 100%, 150%, and 200% of the prescription dose. The mean relative difference was 38% and 16% for doses covering 100% and 90% of the prostate volume and 10% and 21% for prostate volumes covered by 100% and 150% of the prescription dose, respectively. The CT-based volume covered by 200% of the prescription dose was about 30% greater than the US-based one. Compared with CT-based dosimetry, US-based dosimetry significantly underestimated the dose to normal organs, especially for the rectum. The average US-based maximal dose and volume covered by 100% of the prescription dose for the rectum was 72 Gy and 0.01 cm 3 , respectively, much lower than the 159 Gy and 0.65 cm 3 obtained using CT-based dosimetry. Conclusion: Although dosimetry using intraoperative US-based planning provides preliminary real-time information, it does not accurately reflect the postoperative CT-based dosimetry. Until studies have determined whether US-based dosimetry or

Implementation of IMRT and VMAT using Delta4 phantom and portal dosimetry as dosimetry verification tools

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Daci, Lulzime, E-mail: lulzime.daci@nodlandssykehuset.no [Nordland Hospital Trust, Bodø (Norway); Malkaj, Partizan, E-mail: malkaj-p@hotmail.com [Faculty of Mathematics Engineering and Physics Engineering, Polytechnic University of Tirana (Albania)

2016-03-25

In this study we analyzed and compared the dose distribution of different IMRT and VMAT plans with the intent to provide pre-treatment quality assurance using two different tools. Materials/Methods: We have used the electronic portal imaging device EPID after calibration to dose and correction for the background offset signal and also the Delta4 phantom after en evaluation of angular sensitivity. The Delta4 phantom has a two-dimensional array with ionization chambers. We analyzed three plans for each anatomical site calculated by Eclipse treatment planning system. The measurements were analyzed using γ-evaluation method with passing criteria 3% absolute dose and 3 mm distance to agreement (DTA). For all the plans the range of score has been from 97% to 99% for gantry fixed at 0° while for rotational planes there was a slightly decreased pass rates and above 95%. Point measurement with a ionization chamber were done in additional to see the accuracy of portal dosimetry and to evaluate the Delta4 device to various dose rates. Conclusions: Both Delt4 and Portal dosimetry shows good results between the measured and calculated doses. While Delta4 is more accurate in measurements EPID is more time efficient. We have decided to use both methods in the first steps of IMRT and VMAT implementation and later on to decide which of the tools to use depending on the complexity of plans, how much accurate we want to be and the time we have on the machine.

Implementation of IMRT and VMAT using Delta4 phantom and portal dosimetry as dosimetry verification tools

International Nuclear Information System (INIS)

Daci, Lulzime; Malkaj, Partizan

2016-01-01

In this study we analyzed and compared the dose distribution of different IMRT and VMAT plans with the intent to provide pre-treatment quality assurance using two different tools. Materials/Methods: We have used the electronic portal imaging device EPID after calibration to dose and correction for the background offset signal and also the Delta4 phantom after en evaluation of angular sensitivity. The Delta4 phantom has a two-dimensional array with ionization chambers. We analyzed three plans for each anatomical site calculated by Eclipse treatment planning system. The measurements were analyzed using γ-evaluation method with passing criteria 3% absolute dose and 3 mm distance to agreement (DTA). For all the plans the range of score has been from 97% to 99% for gantry fixed at 0° while for rotational planes there was a slightly decreased pass rates and above 95%. Point measurement with a ionization chamber were done in additional to see the accuracy of portal dosimetry and to evaluate the Delta4 device to various dose rates. Conclusions: Both Delt4 and Portal dosimetry shows good results between the measured and calculated doses. While Delta4 is more accurate in measurements EPID is more time efficient. We have decided to use both methods in the first steps of IMRT and VMAT implementation and later on to decide which of the tools to use depending on the complexity of plans, how much accurate we want to be and the time we have on the machine.

OSL Based Anthropomorphic Phantom and Real-Time Organ Dosimetry

Energy Technology Data Exchange (ETDEWEB)

David E. Hintenlang, Ph.D

2009-02-10

The overall objective of this project was the development of a dosimetry system that provides the direct measurement of organ does in real-time with a sensitivity that makes it an effective tool for applications in a wide variety of health physics applications. The system included the development of a real-time readout system for fiber optic coupled (FOC) dosimeters that is integrated with a state-of-art anthropomorphic phantom to provide instantaneous measures of organ doses throughout the phantom. The small size of the FOC detectors and optical fibers allow the sensitive volume of the detector to be located at organ centroids (or multiple locations distributed through the organ) within a tissue equivalent, anthropomorphic phantom without perturbing the tissue equivalent features of the phantom. The developed phantom/dosimetry system can be used in any environment where personnel may be exposed to gamma or x-ray radiations to provide the most accurate determinations of organ and effective doses possible to date.

OSL Based Anthropomorphic Phantom and Real-Time Organ Dosimetry

International Nuclear Information System (INIS)

Hintenlang, David E.

2009-01-01

The overall objective of this project was the development of a dosimetry system that provides the direct measurement of organ doses in real-time with a sensitivity that makes it an effective tool for applications in a wide variety of health physics applications. The system included the development of a real-time readout system for fiber optic coupled (FOC) dosimeters that is integrated with a state-of-art anthropomorphic phantom to provide instantaneous measures of organ doses throughout the phantom. The small size of the FOC detectors and optical fibers allow the sensitive volume of the detector to be located at organ centroids (or multiple locations distributed through the organ) within a tissue equivalent, anthropomorphic phantom without perturbing the tissue equivalent features of the phantom. The developed phantom/dosimetry system can be used in any environment where personnel may be exposed to gamma or x-ray radiations to provide the most accurate determinations of organ and effective doses possible to date

Patient specific quality assurance of IMRT: quantitative approach using film dosimetry and optimization

International Nuclear Information System (INIS)

Shin, Kyung Hwan; Park, Sung Yong; Park, Dong Hyun

2005-01-01

Film dosimetry an a part of patient specific intensity modulated radiation therapy quality assurance (IMRT QA) was performed to develop a new optimization method of film isocenter offset and to then suggest new quantitative criteria for film dosimetry. Film dosimetry was performed on 14 IMRT patients with head and neck cancers. An optimization method for obtaining the local minimum was developed to adjust for the error in the film isocenter offset, which is the largest part of the systemic errors. The adjust value of the film isocenter offset under optimization was 1 mm in 12 patients, while only two patients showed 2 mm translation. The means of absolute average dose difference before and after optimization were 2.36 and 1.56%, respectively, and the mean radios over a 5% tolerance were 9.67 and 2.88%. After optimization, the differences in the dose decreased dramatically. A low dose range cutoff (L-Cutoff) had been suggested for clinical application. New quantitative criteria of a ratio of over a 5%, but less than 10% tolerance, and for an absolute average dose difference less than 3% have been suggested for the verification of film dosimetry. The new optimization method was effective in adjusting for the film dosimetry error, and the newly quantitative criteria suggested in this research are believed to be sufficiently accurate and clinically useful

A multi-centre dosimetry audit on advanced radiotherapy in lung as part of the Isotoxic IMRT study

Directory of Open Access Journals (Sweden)

Yat Tsang

2017-10-01

Conclusion: This multi-centre dosimetry audit of complex IMRT/VMAT delivery provides confidence in the accuracy of modern planning and delivery systems in inhomogeneous tissues. The findings from this study can be used as a reference for future dosimetry audits.

WE-AB-BRB-03: Real-Time Volumetric Scintillation Dosimetry for Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Beddar, S. [UT MD Anderson Cancer Center (United States)

2016-06-15

Despite widespread IMRT treatments at modern radiation therapy clinics, precise dosimetric commissioning of an IMRT system remains a challenge. In the most recent report from the Radiological Physics Center (RPC), nearly 20% of institutions failed an end-to-end test with an anthropomorphic head and neck phantom, a test that has rather lenient dose difference and distance-to-agreement criteria of 7% and 4 mm. The RPC report provides strong evidence that IMRT implementation is prone to error and that improved quality assurance tools are required. At the heart of radiation therapy dosimetry is the multidimensional dosimeter. However, due to the limited availability of water-equivalent dosimetry materials, research and development in this important field is challenging. In this session, we will review a few dosimeter developments that are either in the laboratory phase or in the pre-commercialization phase. 1) Radiochromic plastic. Novel formulations exhibit light absorbing optical contrast with very little scatter, enabling faster, broad beam optical CT design. 2) Storage phosphor. After irradiation, the dosimetry panels will be read out using a dedicated 2D scanning apparatus in a non-invasive, electro-optic manner and immediately restored for further use. 3) Liquid scintillator. Scintillators convert the energy from x-rays and proton beams into visible light, which can be recorded with a scientific camera (CCD or CMOS) from multiple angles. The 3D shape of the dose distribution can then be reconstructed. 4) Cherenkov emission imaging. Gated intensified imaging allows video-rate passive detection of Cherenkov emission during radiation therapy with the room lights on. Learning Objectives: To understand the physics of a variety of dosimetry techniques based upon optical imaging To investigate the strategies to overcome respective challenges and limitations To explore novel ideas of dosimeter design Supported in part by NIH Grants R01CA148853, R01CA182450, R01CA109558

WE-AB-BRB-03: Real-Time Volumetric Scintillation Dosimetry for Radiation Therapy

International Nuclear Information System (INIS)

Beddar, S.

2016-01-01

Despite widespread IMRT treatments at modern radiation therapy clinics, precise dosimetric commissioning of an IMRT system remains a challenge. In the most recent report from the Radiological Physics Center (RPC), nearly 20% of institutions failed an end-to-end test with an anthropomorphic head and neck phantom, a test that has rather lenient dose difference and distance-to-agreement criteria of 7% and 4 mm. The RPC report provides strong evidence that IMRT implementation is prone to error and that improved quality assurance tools are required. At the heart of radiation therapy dosimetry is the multidimensional dosimeter. However, due to the limited availability of water-equivalent dosimetry materials, research and development in this important field is challenging. In this session, we will review a few dosimeter developments that are either in the laboratory phase or in the pre-commercialization phase. 1) Radiochromic plastic. Novel formulations exhibit light absorbing optical contrast with very little scatter, enabling faster, broad beam optical CT design. 2) Storage phosphor. After irradiation, the dosimetry panels will be read out using a dedicated 2D scanning apparatus in a non-invasive, electro-optic manner and immediately restored for further use. 3) Liquid scintillator. Scintillators convert the energy from x-rays and proton beams into visible light, which can be recorded with a scientific camera (CCD or CMOS) from multiple angles. The 3D shape of the dose distribution can then be reconstructed. 4) Cherenkov emission imaging. Gated intensified imaging allows video-rate passive detection of Cherenkov emission during radiation therapy with the room lights on. Learning Objectives: To understand the physics of a variety of dosimetry techniques based upon optical imaging To investigate the strategies to overcome respective challenges and limitations To explore novel ideas of dosimeter design Supported in part by NIH Grants R01CA148853, R01CA182450, R01CA109558

Accuracy of Real-time Couch Tracking During 3-dimensional Conformal Radiation Therapy, Intensity Modulated Radiation Therapy, and Volumetric Modulated Arc Therapy for Prostate Cancer

International Nuclear Information System (INIS)

Wilbert, Juergen; Baier, Kurt; Hermann, Christian; Flentje, Michael; Guckenberger, Matthias

2013-01-01

Purpose: To evaluate the accuracy of real-time couch tracking for prostate cancer. Methods and Materials: Intrafractional motion trajectories of 15 prostate cancer patients were the basis for this phantom study; prostate motion had been monitored with the Calypso System. An industrial robot moved a phantom along these trajectories, motion was detected via an infrared camera system, and the robotic HexaPOD couch was used for real-time counter-steering. Residual phantom motion during real-time tracking was measured with the infrared camera system. Film dosimetry was performed during delivery of 3-dimensional conformal radiation therapy (3D-CRT), step-and-shoot intensity modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT). Results: Motion of the prostate was largest in the anterior–posterior direction, with systematic (∑) and random (σ) errors of 2.3 mm and 2.9 mm, respectively; the prostate was outside a threshold of 5 mm (3D vector) for 25.0%±19.8% of treatment time. Real-time tracking reduced prostate motion to ∑=0.01 mm and σ = 0.55 mm in the anterior–posterior direction; the prostate remained within a 1-mm and 5-mm threshold for 93.9%±4.6% and 99.7%±0.4% of the time, respectively. Without real-time tracking, pass rates based on a γ index of 2%/2 mm in film dosimetry ranged between 66% and 72% for 3D-CRT, IMRT, and VMAT, on average. Real-time tracking increased pass rates to minimum 98% on average for 3D-CRT, IMRT, and VMAT. Conclusions: Real-time couch tracking resulted in submillimeter accuracy for prostate cancer, which transferred into high dosimetric accuracy independently of whether 3D-CRT, IMRT, or VMAT was used.

Micro ionization chamber dosimetry in IMRT verification: Clinical implications of dosimetric errors in the PTV

International Nuclear Information System (INIS)

Sanchez-Doblado, Francisco; Capote, Roberto; Rosello, Joan V.; Leal, Antonio; Lagares, Juan I.; Arrans, Rafael; Hartmann, Guenther H.

2005-01-01

Background and purpose: Absolute dose measurements for Intensity Modulated Radiotherapy (IMRT) beamlets is difficult due to the lack of lateral electron equilibrium. Recently we found that the absolute dosimetry in the penumbra region of the IMRT beamlet, can suffer from significant errors (Capote et al., Med Phys 31 (2004) 2416-2422). This work has the goal to estimate the error made when measuring the Planning Target Volume's (PTV) absolute dose by a micro ion chamber (μIC) in typical IMRT treatment. The dose error comes from the assumption that the dosimetric parameters determining the absolute dose are the same as for the reference conditions. Materials and Methods: Two IMRT treatment plans for common prostate carcinoma case, derived by forward and inverse optimisation, were considered. Detailed geometrical simulation of the μIC and the dose verification set-up was performed. The Monte Carlo (MC) simulation allows us to calculate the delivered dose to water and the dose delivered to the active volume of the ion chamber. However, the measured dose in water is usually derived from chamber readings assuming reference conditions. The MC simulation provides needed correction factors for ion chamber dosimetry in non reference conditions. Results: Dose calculations were carried out for some representative beamlets, a combination of segments and for the delivered IMRT treatments. We observe that the largest dose errors (i.e. the largest correction factors) correspond to the smaller contribution of the corresponding IMRT beamlets to the total dose delivered in the ionization chamber within PTV. Conclusion: The clinical impact of the calculated dose error in PTV measured dose was found to be negligible for studied IMRT treatments

A fiducial detection algorithm for real-time image guided IMRT based on simultaneous MV and kV imaging.

Science.gov (United States)

Mao, Weihua; Riaz, Nadeem; Lee, Louis; Wiersma, Rodney; Xing, Lei

2008-08-01

The advantage of highly conformal dose techniques such as 3DCRT and IMRT is limited by intrafraction organ motion. A new approach to gain near real-time 3D positions of internally implanted fiducial markers is to analyze simultaneous onboard kV beam and treatment MV beam images (from fluoroscopic or electronic portal image devices). Before we can use this real-time image guidance for clinical 3DCRT and IMRT treatments, four outstanding issues need to be addressed. (1) How will fiducial motion blur the image and hinder tracking fiducials? kV and MV images are acquired while the tumor is moving at various speeds. We find that a fiducial can be successfully detected at a maximum linear speed of 1.6 cm/s. (2) How does MV beam scattering affect kV imaging? We investigate this by varying MV field size and kV source to imager distance, and find that common treatment MV beams do not hinder fiducial detection in simultaneous kV images. (3) How can one detect fiducials on images from 3DCRT and IMRT treatment beams when the MV fields are modified by a multileaf collimator (MLC)? The presented analysis is capable of segmenting a MV field from the blocking MLC and detecting visible fiducials. This enables the calculation of nearly real-time 3D positions of markers during a real treatment. (4) Is the analysis fast enough to track fiducials in nearly real time? Multiple methods are adopted to predict marker positions and reduce search regions. The average detection time per frame for three markers in a 1024 x 768 image was reduced to 0.1 s or less. Solving these four issues paves the way to tracking moving fiducial markers throughout a 3DCRT or IMRT treatment. Altogether, these four studies demonstrate that our algorithm can track fiducials in real time, on degraded kV images (MV scatter), in rapidly moving tumors (fiducial blurring), and even provide useful information in the case when some fiducials are blocked from view by the MLC. This technique can provide a gating signal or

Germanium-doped optical fiber for real-time radiation dosimetry

International Nuclear Information System (INIS)

Mizanur Rahman, A.K.M.; Zubair, H.T.; Begum, Mahfuza; Abdul-Rashid, H.A.; Yusoff, Z.; Ung, N.M.; Mat-Sharif, K.A.; Wan Abdullah, W.S.; Amouzad Mahdiraji, Ghafour; Amin, Y.M.; Maah, M.J.; Bradley, D.A.

2015-01-01

Over the past three decades growing demand for individualized in vivo dosimetry and subsequent dose verification has led to the pursuit of newer, novel and economically feasible materials for dosimeters. These materials are to facilitate features such as real-time sensing and fast readouts. In this paper, purposely composed SiO 2 :Ge optical fiber is presented as a suitable candidate for dosimetry. The optical fiber is meant to take advantage of the RL/OSL technique, providing both online remote monitoring of dose rate, and fast readouts for absorbed dose. A laboratory-assembled OSL reader has been used to acquire the RL/OSL response to LINAC irradiations (6 MV photons). The notable RL characteristics observed include constant level of luminescence for the same dose rate (providing better consistency compared to TLD-500), and linearity of response in the radiotherapy range (1 Gy/min to 6 Gy/min). The OSL curve was found to conform to an exponential decay characteristic (illumination with low LED source). The Ge doping resulted in an effective atomic number, Z eff , of 13.5 (within the bone equivalent range). The SiO 2 :Ge optical fiber sensor, with efficient coupling, can be a viable solution for in vivo dosimetry, besides a broad range of applications. - Highlights: • Purposely fabricated Ge doped silica fiber for real-time dose measurements. • Constant RL response for dose rates in radiotherapy range. • Linearity of RL curve during irradiation using LINAC. • RL response comparison between SiO 2 :Ge optical fiber and TLD-500.

The Quality Control of Intensity Modulated Radiation Therapy (IMRT for ONCOR Siemens Linear Accelerators Using Film Dosimetry

Directory of Open Access Journals (Sweden)

Keyvan Jabbari

2012-03-01

Full Text Available Introduction Intensity Modulated Radiation Therapy (IMRT has made a significant progress in radiation therapy centers in recent years. In this method, each radiation beam is divided into many subfields that create a field with a modulated intensity. Considering the complexity of this method, the quality control for IMRT is a topic of interest for researchers. This article is about the various steps of planning and quality control of Siemens linear accelerators for IMRT, using film dosimetry. This article in addition to review of the techniques, discusses the details of experiments and possible sources of errors which are not mentioned in the protocols and other references. Materials and Methods This project was carried out in Isfahan Milad hospital which has two Siemens ONCOR linear accelerators. Both accelerators are equipped with Multi-Leaf Collimators (MLC which enables us to perform IMRT delivery in the step-and-shoot method. The quality control consists of various experiments related to the sections of radiation therapy. In these experiments, the accuracy of some components such as treatment planning system, imaging device (CT, MLC, control system of accelerator, and stability of the output are evaluated. The dose verification is performed using film dosimetry method. The films were KODAK-EDR2, which were calibrated before the experiments. One of the important steps is the comparison of the calculated dose with planning system and the measured dose in experiments. Results The results of the experiments in various steps have been acceptable according to the standard protocols. The calibration of MLC and evaluation of the leakage through the leaves of MLC was performed by using the film dosimetry and visual check. In comparison with calculated and measured dose, more that 80% of the points have to be in agreement within 3% of the value. In our experiments, between 85 and 90% of the points had such an agreement with IMRT delivery. Conclusion

SU-E-T-66: A Prototype for Couch Based Real-Time Dosimetry in External Beam Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Ramachandran, P [Peter MacCallum Cancer Centre, Bendigo (Australia)

2015-06-15

Purpose: The main purpose of this study is to design a prototype for couch-based based real time dosimetry system in external beam radiotherapy Methods: A prototype of 100 ionization chambers was designed on a printed circuit board by etching the copper layer and each ionization chamber was wired to a 50 pin connector. The signals from the two 50 pin connectors collected from the ionization chambers were then transferred to a PXI module from National Instruments. The PXI module houses a current amplifier that amplifies the charge collected from the ionization chamber. The amplified signal is then sent to a digital multimeter module for converting the analog signal to digital signal. A software was designed in labview to read and display the signals obtained from the PXI module. A couch attachment frame was designed to house the 100 ionization chamber module. The frame was fixed underneath the treatment couch for measuring the dose during treatment. Resutls: The ionization chamber based prototype dosimetry was tested for simple radiotherapy treatment fields and found to be a useful device for measuring real time dosimetry at the treatment couch plane. This information could be used to assess the delivered dose to a patient during radiotherapy. It could be used as an invivo dosimeter during radiotherapy. Conclusion: In this study, a prototype for couch based real time dosimetry system was designed and tested. The prototype forms a basis for the development of large scale couch based real time dosimetry system that could be used to perform morning QA prior to treatment, assess real time doses delivered to patient and as a device to monitor the output of the treatment beam. Peter MacCallum Cancer Foundation.

SU-E-T-66: A Prototype for Couch Based Real-Time Dosimetry in External Beam Radiotherapy

International Nuclear Information System (INIS)

Ramachandran, P

2015-01-01

Purpose: The main purpose of this study is to design a prototype for couch-based based real time dosimetry system in external beam radiotherapy Methods: A prototype of 100 ionization chambers was designed on a printed circuit board by etching the copper layer and each ionization chamber was wired to a 50 pin connector. The signals from the two 50 pin connectors collected from the ionization chambers were then transferred to a PXI module from National Instruments. The PXI module houses a current amplifier that amplifies the charge collected from the ionization chamber. The amplified signal is then sent to a digital multimeter module for converting the analog signal to digital signal. A software was designed in labview to read and display the signals obtained from the PXI module. A couch attachment frame was designed to house the 100 ionization chamber module. The frame was fixed underneath the treatment couch for measuring the dose during treatment. Resutls: The ionization chamber based prototype dosimetry was tested for simple radiotherapy treatment fields and found to be a useful device for measuring real time dosimetry at the treatment couch plane. This information could be used to assess the delivered dose to a patient during radiotherapy. It could be used as an invivo dosimeter during radiotherapy. Conclusion: In this study, a prototype for couch based real time dosimetry system was designed and tested. The prototype forms a basis for the development of large scale couch based real time dosimetry system that could be used to perform morning QA prior to treatment, assess real time doses delivered to patient and as a device to monitor the output of the treatment beam. Peter MacCallum Cancer Foundation

Time-resolved dosimetry using a pinpoint ionization chamber as quality assurance for IMRT and VMAT

Energy Technology Data Exchange (ETDEWEB)

Louwe, Robert J. W., E-mail: rob.louwe@ccdbh.org.nz; Satherley, Thomas; Day, Rebecca A.; Greig, Lynne [Department of Radiation Oncology, Wellington Blood and Cancer Centre, Wellington Hospital, Wellington 6242 (New Zealand); Wendling, Markus; Monshouwer, René [Department of Radiation Oncology, Radboud University Medical Center, Nijmegen 6500 HB (Netherlands)

2015-04-15

study showed that time-resolved dosimetry using an ionization chamber is feasible and can be largely automated which limits the required additional time compared to integrated dose measurements. It provides a unique QA method which enables identification and quantification of the contribution of various error sources during IMRT and VMAT delivery.

Real-time volumetric scintillation dosimetry

International Nuclear Information System (INIS)

Beddar, S

2015-01-01

The goal of this brief review is to review the current status of real-time 3D scintillation dosimetry and what has been done so far in this area. The basic concept is to use a large volume of a scintillator material (liquid or solid) to measure or image the dose distributions from external radiation therapy (RT) beams in three dimensions. In this configuration, the scintillator material fulfills the dual role of being the detector and the phantom material in which the measurements are being performed. In this case, dose perturbations caused by the introduction of a detector within a phantom will not be at issue. All the detector configurations that have been conceived to date used a Charge-Coupled Device (CCD) camera to measure the light produced within the scintillator. In order to accurately measure the scintillation light, one must correct for various optical artefacts that arise as the light propagates from the scintillating centers through the optical chain to the CCD chip. Quenching, defined in its simplest form as a nonlinear response to high-linear energy transfer (LET) charged particles, is one of the disadvantages when such systems are used to measure the absorbed dose from high-LET particles such protons. However, correction methods that restore the linear dose response through the whole proton range have been proven to be effective for both liquid and plastic scintillators. Volumetric scintillation dosimetry has the potential to provide fast, high-resolution and accurate 3D imaging of RT dose distributions. Further research is warranted to optimize the necessary image reconstruction methods and optical corrections needed to achieve its full potential

Investigation of a pulsed current annealing method in reusing MOSFET dosimeters for in vivo IMRT dosimetry

Energy Technology Data Exchange (ETDEWEB)

Luo, Guang-Wen; Qi, Zhen-Yu, E-mail: qizhy@sysucc.org.cn; Deng, Xiao-Wu [Department of Radiation Oncology, Sun Yat-Sen University Cancer Center and State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060 (China); Rosenfeld, Anatoly [Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522 (Australia)

2014-05-15

Purpose: To explore the feasibility of pulsed current annealing in reusing metal oxide semiconductor field-effect transistor (MOSFET) dosimeters forin vivo intensity modulated radiation therapy (IMRT) dosimetry. Methods: Several MOSFETs were irradiated atd{sub max} using a 6 MV x-ray beam with 5 V on the gate and annealed with zero bias at room temperature. The percentage recovery of threshold voltage shift during multiple irradiation-annealing cycles was evaluated. Key dosimetry characteristics of the annealed MOSFET such as the dosimeter's sensitivity, reproducibility, dose linearity, and linearity of response within the dynamic range were investigated. The initial results of using the annealed MOSFETs for IMRT dosimetry practice were also presented. Results: More than 95% of threshold voltage shift can be recovered after 24-pulse current continuous annealing in 16 min. The mean sensitivity degradation was found to be 1.28%, ranging from 1.17% to 1.52%, during multiple annealing procedures. Other important characteristics of the annealed MOSFET remained nearly consistent before and after annealing. Our results showed there was no statistically significant difference between the annealed MOSFETs and their control samples in absolute dose measurements for IMRT QA (p = 0.99). The MOSFET measurements agreed with the ion chamber results on an average of 0.16% ± 0.64%. Conclusions: Pulsed current annealing provides a practical option for reusing MOSFETs to extend their operational lifetime. The current annealing circuit can be integrated into the reader, making the annealing procedure fully automatic.

Investigation of a pulsed current annealing method in reusing MOSFET dosimeters for in vivo IMRT dosimetry.

Science.gov (United States)

Luo, Guang-Wen; Qi, Zhen-Yu; Deng, Xiao-Wu; Rosenfeld, Anatoly

2014-05-01

To explore the feasibility of pulsed current annealing in reusing metal oxide semiconductor field-effect transistor (MOSFET) dosimeters for in vivo intensity modulated radiation therapy (IMRT) dosimetry. Several MOSFETs were irradiated at d(max) using a 6 MV x-ray beam with 5 V on the gate and annealed with zero bias at room temperature. The percentage recovery of threshold voltage shift during multiple irradiation-annealing cycles was evaluated. Key dosimetry characteristics of the annealed MOSFET such as the dosimeter's sensitivity, reproducibility, dose linearity, and linearity of response within the dynamic range were investigated. The initial results of using the annealed MOSFETs for IMRT dosimetry practice were also presented. More than 95% of threshold voltage shift can be recovered after 24-pulse current continuous annealing in 16 min. The mean sensitivity degradation was found to be 1.28%, ranging from 1.17% to 1.52%, during multiple annealing procedures. Other important characteristics of the annealed MOSFET remained nearly consistent before and after annealing. Our results showed there was no statistically significant difference between the annealed MOSFETs and their control samples in absolute dose measurements for IMRT QA (p = 0.99). The MOSFET measurements agreed with the ion chamber results on an average of 0.16% ± 0.64%. Pulsed current annealing provides a practical option for reusing MOSFETs to extend their operational lifetime. The current annealing circuit can be integrated into the reader, making the annealing procedure fully automatic.

Investigation of a pulsed current annealing method in reusing MOSFET dosimeters for in vivo IMRT dosimetry

International Nuclear Information System (INIS)

Luo, Guang-Wen; Qi, Zhen-Yu; Deng, Xiao-Wu; Rosenfeld, Anatoly

2014-01-01

Purpose: To explore the feasibility of pulsed current annealing in reusing metal oxide semiconductor field-effect transistor (MOSFET) dosimeters forin vivo intensity modulated radiation therapy (IMRT) dosimetry. Methods: Several MOSFETs were irradiated atd max using a 6 MV x-ray beam with 5 V on the gate and annealed with zero bias at room temperature. The percentage recovery of threshold voltage shift during multiple irradiation-annealing cycles was evaluated. Key dosimetry characteristics of the annealed MOSFET such as the dosimeter's sensitivity, reproducibility, dose linearity, and linearity of response within the dynamic range were investigated. The initial results of using the annealed MOSFETs for IMRT dosimetry practice were also presented. Results: More than 95% of threshold voltage shift can be recovered after 24-pulse current continuous annealing in 16 min. The mean sensitivity degradation was found to be 1.28%, ranging from 1.17% to 1.52%, during multiple annealing procedures. Other important characteristics of the annealed MOSFET remained nearly consistent before and after annealing. Our results showed there was no statistically significant difference between the annealed MOSFETs and their control samples in absolute dose measurements for IMRT QA (p = 0.99). The MOSFET measurements agreed with the ion chamber results on an average of 0.16% ± 0.64%. Conclusions: Pulsed current annealing provides a practical option for reusing MOSFETs to extend their operational lifetime. The current annealing circuit can be integrated into the reader, making the annealing procedure fully automatic

An investigation of PRESAGE® 3D dosimetry for IMRT and VMAT radiation therapy treatment verification

International Nuclear Information System (INIS)

Jackson, Jake; Juang, Titania; Oldham, Mark; Adamovics, John

2015-01-01

The purpose of this work was to characterize three formulations of PRESAGE ® dosimeters (DEA-1, DEA-2, and DX) and to identify optimal readout timing and procedures for accurate in-house 3D dosimetry. The optimal formulation and procedure was then applied for the verification of an intensity modulated radiation therapy (IMRT) and a volumetric modulated arc therapy (VMAT) treatment technique. PRESAGE ® formulations were studied for their temporal stability post-irradiation, sensitivity, and linearity of dose response. Dosimeters were read out using a high-resolution optical-CT scanner. Small volumes of PRESAGE ® were irradiated to investigate possible differences in sensitivity for large and small volumes (‘volume effect’). The optimal formulation and read-out technique was applied to the verification of two patient treatments: an IMRT plan and a VMAT plan. A gradual decrease in post-irradiation optical-density was observed in all formulations with DEA-1 exhibiting the best temporal stability with less than 4% variation between 2–22 h post-irradiation. A linear dose response at the 4 h time point was observed for all formulations with an R 2 value >0.99. A large volume effect was observed for DEA-1 with sensitivity of the large dosimeter being ∼63% less than the sensitivity of the cuvettes. For the IMRT and VMAT treatments, the 3D gamma passing rates for 3%/3 mm criteria using absolute measured dose were 99.6 and 94.5% for the IMRT and VMAT treatments, respectively. In summary, this work shows that accurate 3D dosimetry is possible with all three PRESAGE ® formulations. The optimal imaging windows post-irradiation were 3–24 h, 2–6 h, and immediately for the DEA-1, DEA-2, and DX formulations, respectively. Because of the large volume effect, small volume cuvettes are not yet a reliable method for calibration of larger dosimeters to absolute dose. Finally, PRESAGE ® is observed to be a useful method of 3D verification when careful

On line CALDoseX: real time Monte Carlo calculation via Internet for dosimetry in radiodiagnostic

International Nuclear Information System (INIS)

Kramer, Richard; Cassola, Vagner Ferreira; Lira, Carlos Alberto Brayner de Oliveira; Khoury, Helen Jamil; Cavalcanti, Arthur; Lins, Rafael Dueire

2011-01-01

The CALDose X 4.1 is a software which uses thr MASH and FASH phantoms. Patient dosimetry with reference phantoms is limited because the results can be applied only for patients which possess the same body mass and right height that the reference phantom. In this paper, the dosimetry of patients for diagnostic with X ray was extended by using a series of 18 phantoms with defined gender, different body masses and heights, in order to cover the real anatomy of the patients. It is possible to calculate absorbed doses in organs and tissues by real time Monte Carlo dosimetry through the Internet through a dosimetric service called CALDose X on line

Experience in the treatment of IMRT in prostate cancer. Planning, dosimetry and quality control

International Nuclear Information System (INIS)

Gomez Barrado, A.; Garcia Vicente, F.; Fernandez Bedoya, V.; Bermudez Luna, R.; Perez Gonzalez, L.; Torres Escobar, J. J.

2011-01-01

The aim of this study is to review the treatment of prostate cancer at our center. A description of the entire procedure, involving clinical dosimetry, and procedures for verification of treatment, including physical dosimetry and parallel computing system MSure (Standard Imaging, Inc., Middleton) as part of these procedures. This system is based on the model published by trifuente Yang et al. (Yang et al. 2002) for testing treatments regarding the number of monitor unit (MU) given. In addition, this software has a module for the testing of treatments for intensity modulated radiotherapy (IMRT), which will be analyzed in this study.

Adaptive error detection for HDR/PDR brachytherapy: Guidance for decision making during real-time in vivo point dosimetry

DEFF Research Database (Denmark)

Kertzscher Schwencke, Gustavo Adolfo Vladimir; Andersen, Claus E.; Tanderup, Kari

2014-01-01

Purpose:This study presents an adaptive error detection algorithm (AEDA) for real-timein vivo point dosimetry during high dose rate (HDR) or pulsed dose rate (PDR) brachytherapy (BT) where the error identification, in contrast to existing approaches, does not depend on an a priori reconstruction ......, and the AEDA’s capacity to distinguish between true and false error scenarios. The study further shows that the AEDA can offer guidance in decision making in the event of potential errors detected with real-time in vivo point dosimetry....... of the dosimeter position reconstruction. Given its nearly exclusive dependence on stable dosimeter positioning, the AEDA allows for a substantially simplified and time efficient real-time in vivo BT dosimetry implementation. Methods:In the event of a measured potential treatment error, the AEDA proposes the most...

Feasibility of CBCT dosimetry for IMRT using a normoxic polymethacrylic-acid gel dosimeter

Science.gov (United States)

Bong, Ji Hye; Kwon, Soo-Il; Kim, Kum Bae; Kim, Mi Suk; Jung, Hai Jo; Ji, Young Hoon; Ko, In Ok; Park, Ji Ae; Kim, Kyeong Min

2013-09-01

The purpose of this study is to evaluate the availability of cone-beam computed tomography(CBCT) for gel dosimetry. The absorbed dose was analyzed by using intensity-modulated radiation therapy(IMRT) to irradiate several tumor shapes with a calculated dose and several tumor acquiring images with CBCT in order to verify the possibility of reading a dose on the polymer gel dosimeter by means of the CBCT image. The results were compared with those obtained using magnetic resonance imaging(MRI) and CT. The linear correlation coefficients at doses less than 10 Gy for the polymer gel dosimeter were 0.967, 0.933 and 0.985 for MRI, CT and CBCT, respectively. The dose profile was symmetric on the basis of the vertical axis in a circular shape, and the uniformity was 2.50% for the MRI and 8.73% for both the CT and the CBCT. In addition, the gradient in the MR image of the gel dosimeter irradiated in an H shape was 109.88 while the gradients of the CT and the CBCT were 71.95 and 14.62, respectively. Based on better image quality, the present study showed that CBCT dosimetry for IMRT could be restrictively performed using a normoxic polymethacrylic-acid gel dosimeter.

Development of a 3D remote dosimetry protocol compatible with MRgIMRT.

Science.gov (United States)

Mein, Stewart; Rankine, Leith; Adamovics, John; Li, Harold; Oldham, Mark

2017-11-01

To develop a novel remote 3D dosimetry protocol to verify Magnetic Resonance-guided Radiation Therapy (MRgRT) treatments. The protocol was applied to investigate the accuracy of TG-119 IMRT irradiations delivered by the MRIdian ® system (ViewRay ® , Oakwood Village, OH, USA) allowing for a 48-hour delay between irradiation at a field institution and subsequent readout at a base institution. The 3D dosimetry protocol utilizes a novel formulation of PRESAGE ® radiochromic dosimeters developed for high postirradiation stability and compatibility with optical-CT readout. Optical-CT readout was performed with an in-house system utilizing telecentric lenses affording high-resolution scanning. The protocol was developed from preparatory experiments to characterize PRESAGE ® response in relevant conditions. First, linearity and sensitivity of PRESAGE ® dose-response in the presence of a magnetic field was evaluated in a small volume study (4 ml cuvettes) conducted under MRgRT conditions and irradiated with doses 0-15 Gy. Temporal and spatial stability of the dose-response were investigated in large volume studies utilizing large field-of-view (FOV) 2 kg cylindrical PRESAGE ® dosimeters. Dosimeters were imaged at t = 1 hr and t = 48 hrs enabling the development of correction terms to model any observed spatial and temporal changes postirradiation. Polynomial correction factors for temporal and spatial changes in PRESAGE ® dosimeters (C T and C R respectively) were obtained by numerical fitting to time-point data acquired in six irradiated dosimeters. A remote dosimetry protocol was developed where PRESAGE ® change in optical-density (ΔOD) readings at time t = X (the irradiation to return shipment time interval) were corrected back to a convenient standard time t = 1 hr using the C T and C R corrections. This refined protocol was then applied to TG-119 (American Association of Physicists in Medicine, Task Group 119) plan deliveries on the MRIdian �

SU-F-BRE-13: Replacing Pre-Treatment Phantom QA with 3D In-Vivo Portal Dosimetry for IMRT Breast Cancer

Energy Technology Data Exchange (ETDEWEB)

Stroom, J; Vieira, S; Greco, C [Champalimaud Foundation, Lisbon (Portugal); Olaciregui-Ruiz, I; Rozendaal, R; Herk, M van [The Netherlands Cancer Institute, Amsterdam, North Holland (Netherlands); Moser, E [Champalimaud Foundation, Lisbon, Lisbon (Portugal)

2014-06-15

Purpose: Pre-treatment QA of individual treatment plans requires costly linac time and physics effort. Starting with IMRT breast treatments, we aim to replace pre-treatment QA with in-vivo portal dosimetry. Methods: Our IMRT breast cancer plans are routinely measured using the ArcCheck device (SunNuclear). 2D-Gamma analysis is performed with 3%/3mm criteria and the percentage of points with gamma<1 (nG1) is calculated within the 50% isodose surface. Following AAPM recommendations, plans with nG1<90% are approved; others need further inspection and might be rejected. For this study, we used invivo portal dosimetry (IPD) to measure the 3D back-projected dose of the first three fractions for IMRT breast plans. Patient setup was online corrected before for all measured fractions. To reduce patient related uncertainties, the three IPD results were averaged and 3D-gamma analysis was applied with abovementioned criteria . For a subset of patients, phantom portal dosimetry (PPD) was also performed on a slab phantom. Results: Forty consecutive breast patients with plans that fitted the EPID were analysed. The average difference between planned and IPD dose in the reference point was −0.7+/−1.6% (1SD). Variation in nG1 between the 3 invivo fractions was about 6% (1SD). The average nG1 for IPD was 89+/−6%, worse than ArcCheck (95+/−3%). This can be explained by patient related factors such as changes in anatomy and/or model deficiencies due to e.g. inhomogeneities. For the 20 cases with PPD, mean nG1 was equal to ArcCheck values, which indicates that the two systems are equally accurate. These data therefore suggest that proper criteria for 3D invivo verification of breast treatments should be nG1>80% instead of nG1>90%, which, for our breast cases, would result in 5% (2/40) further inspections. Conclusion: First-fraction in-vivo portal dosimetry using new gamma-evaluation criteria will replace phantom measurements in our institution, saving resources and yielding 3D

MO-DE-BRA-04: Hands-On Fluoroscopy Safety Training with Real-Time Patient and Staff Dosimetry

International Nuclear Information System (INIS)

Vanderhoek, M; Bevins, N

2016-01-01

Purpose: Fluoroscopically guided interventions (FGI) are routinely performed across many different hospital departments. However, many involved staff members have minimal training regarding safe and optimal use of fluoroscopy systems. We developed and taught a hands-on fluoroscopy safety class incorporating real-time patient and staff dosimetry in order to promote safer and more optimal use of fluoroscopy during FGI. Methods: The hands-on fluoroscopy safety class is taught in an FGI suite, unique to each department. A patient equivalent phantom is set on the patient table with an ion chamber positioned at the x-ray beam entrance to the phantom. This provides a surrogate measure of patient entrance dose. Multiple solid state dosimeters (RaySafe i2 dosimetry systemTM) are deployed at different distances from the phantom (0.1, 1, 3 meters), which provide surrogate measures of staff dose. Instructors direct participating clinical staff to operate the fluoroscopy system as they view live fluoroscopic images, patient entrance dose, and staff doses in real-time. During class, instructors work with clinical staff to investigate how patient entrance dose, staff doses, and image quality are affected by different parameters, including pulse rate, magnification, collimation, beam angulation, imaging mode, system geometry, distance, and shielding. Results: Real-time dose visualization enables clinical staff to directly see and learn how to optimize their use of their own fluoroscopy system to minimize patient and staff dose, yet maintain sufficient image quality for FGI. As a direct result of the class, multiple hospital departments have implemented changes to their imaging protocols, including reduction of the default fluoroscopy pulse rate and increased use of collimation and lower dose fluoroscopy modes. Conclusion: Hands-on fluoroscopy safety training substantially benefits from real-time patient and staff dosimetry incorporated into the class. Real-time dose display helps

MO-DE-BRA-04: Hands-On Fluoroscopy Safety Training with Real-Time Patient and Staff Dosimetry

Energy Technology Data Exchange (ETDEWEB)

Vanderhoek, M; Bevins, N [Henry Ford Health System, Detroit, MI (United States)

2016-06-15

Purpose: Fluoroscopically guided interventions (FGI) are routinely performed across many different hospital departments. However, many involved staff members have minimal training regarding safe and optimal use of fluoroscopy systems. We developed and taught a hands-on fluoroscopy safety class incorporating real-time patient and staff dosimetry in order to promote safer and more optimal use of fluoroscopy during FGI. Methods: The hands-on fluoroscopy safety class is taught in an FGI suite, unique to each department. A patient equivalent phantom is set on the patient table with an ion chamber positioned at the x-ray beam entrance to the phantom. This provides a surrogate measure of patient entrance dose. Multiple solid state dosimeters (RaySafe i2 dosimetry systemTM) are deployed at different distances from the phantom (0.1, 1, 3 meters), which provide surrogate measures of staff dose. Instructors direct participating clinical staff to operate the fluoroscopy system as they view live fluoroscopic images, patient entrance dose, and staff doses in real-time. During class, instructors work with clinical staff to investigate how patient entrance dose, staff doses, and image quality are affected by different parameters, including pulse rate, magnification, collimation, beam angulation, imaging mode, system geometry, distance, and shielding. Results: Real-time dose visualization enables clinical staff to directly see and learn how to optimize their use of their own fluoroscopy system to minimize patient and staff dose, yet maintain sufficient image quality for FGI. As a direct result of the class, multiple hospital departments have implemented changes to their imaging protocols, including reduction of the default fluoroscopy pulse rate and increased use of collimation and lower dose fluoroscopy modes. Conclusion: Hands-on fluoroscopy safety training substantially benefits from real-time patient and staff dosimetry incorporated into the class. Real-time dose display helps

Application of monomer/polymer gel dosimetry to study the effects of tissue inhomogeneities on intensity-modulated radiation therapy (IMRT) dose distributions.

Science.gov (United States)

Vergote, Koen; De Deene, Yves; Claus, Filip; De Gersem, Werner; Van Duyse, Bart; Paelinck, Leen; Achten, Eric; De Neve, Wilfried; De Wagter, Carlos

2003-04-01

When planning an intensity-modulated radiation therapy (IMRT) treatment in a heterogeneous region (e.g. the thorax), the dose computation algorithm of a treatment planning system may need to account for these inhomogeneities in order to obtain a reliable prediction of the dose distribution. An accurate dose verification technique such as monomer/polymer gel dosimetry is suggested to verify the outcome of the planning system. The effects of low-density structures: (a) on narrow high-energy (18 MV) photon beams; and (b) on a class-solution IMRT treatment delivered to a thorax phantom have been examined using gel dosimetry. The used phantom contained air cavities that could be filled with water to simulate a homogeneous or heterogeneous configuration. The IMRT treatment for centrally located lung tumors was delivered on both cases, and gel derived dose maps were compared with computations by both the GRATIS and Helax-TMS planning system. Dose rebuildup due to electronic disequilibrium in a narrow photon beam is demonstrated. The gel measurements showed good agreement with diamond detector measurements. Agreement between measured IMRT dose maps and dose computations was demonstrated by several quantitative techniques. An underdosage of the planning target volume (PTV) was revealed. The homogeneity of the phantom had only a minor influence on the dose distribution in the PTV. An expansion of low-level isodoses in the lung volume was predicted by collapsed cone computations in the heterogeneous case. For the class-solution described, the dose in centrally located mediastinal tumors can be computed with sufficient accuracy, even when neglecting the lower lung density. Polymer gel dosimetry proved to be a valuable technique to verify dose calculation algorithms for IMRT in 3D in heterogeneous configurations.

Real-time optical-fibre luminescence dosimetry for radiotherapy: physical characteristics and applications in photon beams

DEFF Research Database (Denmark)

Aznar, M.C.; Andersen, C.E.; Bøtter-Jensen, L.

2004-01-01

, real-time read-out and the ability to measure both dose rate and absorbed dose. The measurements describing reproducibility and output dependence on dose rate, field size and energy all had standard deviations smaller than 1%. The signal variation with the angle of incidence was smaller than 2% (1 SD......). Measurements performed in clinical situations suggest the potential of using this real-time system for in vivo dosimetry in radiotherapy....

Fast film dosimetry calibration method for IMRT treatment plan verification

International Nuclear Information System (INIS)

Schwob, N.; Wygoda, A.

2004-01-01

Intensity-Modulated Radiation Therapy (IMRT) treatments are delivered dynamically and as so, require routinely performed verification measurements [1]. Radiographic film dosimetry is a well-adapted method for integral measurements of dynamic treatments fields, with some drawbacks related to the known problems of dose calibration of films. Classically, several films are exposed to increasing doses, and a Net Optical Density (N.O.D) vs. dose sensitometric curve (S.C.) is generated. In order to speed up the process, some authors have developed a method based on the irradiation of a single film with a non-uniform pattern of O.D., delivered with a dynamic MLC. However, this curve still needs to be calibrated to dose by the means of measurements in a water phantom. It is recommended to make a new calibration for every series of measurements, in order to avoid the processing quality dependence of the film response. These frequent measurements are very time consuming. We developed a simple method for quick dose calibration of films, including a check of the accuracy of the calibration curve obtained

An algorithm for real-time dosimetry in intensity-modulated radiation therapy using the radioluminescence signal from Al2O3:C

DEFF Research Database (Denmark)

Andersen, C.E.; Marckmann, C.J.; Aznar, Marianne

2006-01-01

radiation beams. The dosimetry system has been used for dose measurements in a phantom during an intensity-modulated radiation therapy (IMRT) treatment with 6 MV photons. The RL measurement results are in excellent agreement (i.e. within 1%) with both the OSL results and the dose delivered according...

MO-E-BRB-04: Real-Time Exit-Fluence Delivery Validation

Energy Technology Data Exchange (ETDEWEB)

Siebers, J. [University of Virginia Health System (United States)

2015-06-15

Recent high profile reports of technical failures and human errors causing severe radiation- induced injuries and deaths come in support of the sustained efforts to ensure patient safety in the delivery of radiation treatments. In addition, highly conformal radiation therapies and escalated fraction doses mandate increased and sustained accuracy of the entire radiotherapy process. Consequently, and as a Result of AAPM and ASTRO led efforts patient specific quality assurance for specialized radiation treatments such as IMRT, SRS/SBRT and Arc Therapy had become a three-tier process: Pre-treatment, during treatment, and post treatment patient specific QA. Traditional patient QA consists of pre-treatment data transfer integrity dosimetric verifications and during-treatment geometric verifications. However, as treatment adaptation becomes closer to deployment in the clinics, during treatment validation via exit detectors had become a realistic QA option, permitting plan assessment in near real time. Post-treatment, machine logs allow comparisons of a range of mechanical parameters. A combination of these techniques could be used in evaluating inter-fraction, and intra-fraction delivery over a long time period such as an year, to evaluate the significant errors per site, per treatment technique. This type of data mining over longer periods of time provides the potential to recognize suboptimal radiation treatments, while allowing to identify systematic, possibly significant errors. This would allow creation of a data base of realized errors, small and large in dosimetry that could be for process or equipment improvement. This educational symposium will describe and review patient QA techniques, results, and strategies for patient specific quality assurance. Learning Objectives: review the goals of pre-treatment QA for various specialized procedures review methods and means for pre-treatment QA, limitations and tolerances review the scenarios where Varian/Tomo Log files

MO-E-BRB-04: Real-Time Exit-Fluence Delivery Validation

International Nuclear Information System (INIS)

Siebers, J.

2015-01-01

Recent high profile reports of technical failures and human errors causing severe radiation- induced injuries and deaths come in support of the sustained efforts to ensure patient safety in the delivery of radiation treatments. In addition, highly conformal radiation therapies and escalated fraction doses mandate increased and sustained accuracy of the entire radiotherapy process. Consequently, and as a Result of AAPM and ASTRO led efforts patient specific quality assurance for specialized radiation treatments such as IMRT, SRS/SBRT and Arc Therapy had become a three-tier process: Pre-treatment, during treatment, and post treatment patient specific QA. Traditional patient QA consists of pre-treatment data transfer integrity dosimetric verifications and during-treatment geometric verifications. However, as treatment adaptation becomes closer to deployment in the clinics, during treatment validation via exit detectors had become a realistic QA option, permitting plan assessment in near real time. Post-treatment, machine logs allow comparisons of a range of mechanical parameters. A combination of these techniques could be used in evaluating inter-fraction, and intra-fraction delivery over a long time period such as an year, to evaluate the significant errors per site, per treatment technique. This type of data mining over longer periods of time provides the potential to recognize suboptimal radiation treatments, while allowing to identify systematic, possibly significant errors. This would allow creation of a data base of realized errors, small and large in dosimetry that could be for process or equipment improvement. This educational symposium will describe and review patient QA techniques, results, and strategies for patient specific quality assurance. Learning Objectives: review the goals of pre-treatment QA for various specialized procedures review methods and means for pre-treatment QA, limitations and tolerances review the scenarios where Varian/Tomo Log files

SU-E-T-643: Pure Alanine Dosimeter for Verification Dosimetry in IMRT

International Nuclear Information System (INIS)

Al-Karmi, Anan M.; Zraiqat, Fadi

2015-01-01

Purpose: The objective of this study was evaluation of accuracy of pure alanine dosimeters measuring intensity-modulated radiation therapy (IMRT) dose distributions in a thorax phantom. Methods: Alanine dosimeters were prepared in the form of 110 mg pure L-α-alanine powder filled into clear tissue-equivalent polymethylmethacrylate (PMMA) plastic tubes with the dimensions 25 mm length, 3 mm inner diameter, and 1 mm wall thickness. A dose-response calibration curve was established for the alanine by placing the dosimeters at 1.5 cm depth in a 30×30×30 cm 3 solid water phantom and then irradiating on a linac with 6 MV photon beam at 10×10 cm 2 field size to doses ranging from 1 to 5 Gy. Electron paramagnetic resonance (EPR) spectroscopy was used to determine the absorbed dose in alanine. An IMRT treatment plan was designed for a commercial heterogeneous CIRS thorax phantom and the dose values were calculated at three different points located in tissue, lung, and bone equivalent materials. A set of dose measurements was carried out to compare measured and calculated dose values by placing the alanine dosimeters at those selected locations inside the thorax phantom and delivering the IMRT to the phantom. Results: The alanine dose measurements and the IMRT plan dose calculations were found to be in agreement within ±2%. Specifically, the deviations were −0.5%, 1.3%, and −1.7% for tissue, lung, and bone; respectively. The slightly large deviations observed for lung and bone may be attributed to tissue inhomogeneity, steep dose gradients in these regions, and uncontrollable changes in spectrometer conditions. Conclusion: The results described herein confirmed that pure alanine dosimeter was suitable for in-phantom dosimetry of IMRT beams because of its high sensitivity and acceptable accuracy. This makes the dosimeter a promising option for quality control of the therapeutic beams, complementing the commonly used ionization chambers, TLDs, and films

High-accuracy dosimetry study for intensity-modulated radiation therapy(IMRT) commissioning

International Nuclear Information System (INIS)

Jeong, Hae Sun

2010-02-01

Intensity-modulated radiation therapy (IMRT), an advanced modality of high-precision radiotherapy, allows for an increase in dose to the tumor volume without increasing the dose to nearby critical organs. In order to successfully achieve the treatment, intensive dosimetry with accurate dose verification is necessary. A dosimetry for IMRT, however, is a challenging task due to dosimetric ally unfavorable phenomena such as dramatic changes of the dose at the field boundaries, dis-equilibrium of the electrons, non-uniformity between the detector and the phantom materials, and distortion of scanner-read doses. In the present study, therefore, the LEGO-type multi-purpose dosimetry phantom was developed and used for the studies on dose measurements and correction. Phantom materials for muscle, fat, bone, and lung tissue were selected after considering mass density, atomic composition, effective atomic number, and photon interaction coefficients. The phantom also includes dosimeter holders for several different types of detectors including films, which accommodates a construction of different designs of phantoms as necessary. In order to evaluate its performance, the developed phantom was tested by measuring the point dose and the percent depth dose (PDD) for small size fields under several heterogeneous conditions. However, the measurements with the two types of dosimeter did not agree well for the field sizes less than 1 x 1 cm 2 in muscle and bone, and less than 3 x 3 cm 2 in air cavity. Thus, it was recognized that several studies on small fields dosimetry and correction methods for the calculation with a PMCEPT code are needed. The under-estimated values from the ion chamber were corrected with a convolution method employed to eliminate the volume effect of the chamber. As a result, the discrepancies between the EBT film and the ion chamber measurements were significantly decreased, from 14% to 1% (1 x 1 cm 2 ), 10% to 1% (0.7 x 0.7 cm 2 ), and 42% to 7% (0.5 x 0

Experience in the treatment of IMRT in prostate cancer. Planning, dosimetry and quality control; Experiencia en el tratamiento de IMRT en cancer de prostata. Planificacion, dosimetria y control de calidad

Energy Technology Data Exchange (ETDEWEB)

Gomez Barrado, A.; Garcia Vicente, F.; Fernandez Bedoya, V.; Bermudez Luna, R.; Perez Gonzalez, L.; Torres Escobar, J. J.

2011-07-01

The aim of this study is to review the treatment of prostate cancer at our center. A description of the entire procedure, involving clinical dosimetry, and procedures for verification of treatment, including physical dosimetry and parallel computing system MSure (Standard Imaging, Inc., Middleton) as part of these procedures. This system is based on the model published by trifuente Yang et al. (Yang et al. 2002) for testing treatments regarding the number of monitor unit (MU) given. In addition, this software has a module for the testing of treatments for intensity modulated radiotherapy (IMRT), which will be analyzed in this study.

High-accuracy dosimetry study for intensity-modulated radiation therapy(IMRT) commissioning

Energy Technology Data Exchange (ETDEWEB)

Jeong, Hae Sun

2010-02-15

Intensity-modulated radiation therapy (IMRT), an advanced modality of high-precision radiotherapy, allows for an increase in dose to the tumor volume without increasing the dose to nearby critical organs. In order to successfully achieve the treatment, intensive dosimetry with accurate dose verification is necessary. A dosimetry for IMRT, however, is a challenging task due to dosimetric ally unfavorable phenomena such as dramatic changes of the dose at the field boundaries, dis-equilibrium of the electrons, non-uniformity between the detector and the phantom materials, and distortion of scanner-read doses. In the present study, therefore, the LEGO-type multi-purpose dosimetry phantom was developed and used for the studies on dose measurements and correction. Phantom materials for muscle, fat, bone, and lung tissue were selected after considering mass density, atomic composition, effective atomic number, and photon interaction coefficients. The phantom also includes dosimeter holders for several different types of detectors including films, which accommodates a construction of different designs of phantoms as necessary. In order to evaluate its performance, the developed phantom was tested by measuring the point dose and the percent depth dose (PDD) for small size fields under several heterogeneous conditions. However, the measurements with the two types of dosimeter did not agree well for the field sizes less than 1 x 1 cm{sup 2} in muscle and bone, and less than 3 x 3 cm{sup 2} in air cavity. Thus, it was recognized that several studies on small fields dosimetry and correction methods for the calculation with a PMCEPT code are needed. The under-estimated values from the ion chamber were corrected with a convolution method employed to eliminate the volume effect of the chamber. As a result, the discrepancies between the EBT film and the ion chamber measurements were significantly decreased, from 14% to 1% (1 x 1 cm{sup 2}), 10% to 1% (0.7 x 0.7 cm{sup 2}), and 42

In Vivo Diode Dosimetry for Imrt Treatments Generated by Pinnacle Treatment Planning System

International Nuclear Information System (INIS)

Alaei, Parham; Higgins, Patrick D.; Gerbi, Bruce J.

2009-01-01

Dose verification using diodes has been proposed and used for intensity modulated radiation therapy (IMRT) treatments. We have previously evaluated diode response for IMRT deliveries planned with the Eclipse/Helios treatment planning system. The Pinnacle treatment planning system generates plans that are delivered in a different fashion than Eclipse. Whereas the Eclipse-generated segments are delivered in organized progression from one side of each field to the other, Pinnacle-generated segments are delivered in a much more randomized fashion to different areas within the field. This makes diode measurements at a point more challenging because the diode may be exposed fully or partially to multiple small segments during one single field's treatment as opposed to being exposed to very few segments scanning across the diode during an Eclipse-generated delivery. We have evaluated in vivo dosimetry for Pinnacle-generated IMRT plans and characterized the response of the diode to various size segments on phantom. We present results of patient measurements on approximately 300 fields, which show that 76% of measurements agree to within 10% of the treatment-plan generated calculated doses. Of the other 24%, about 11% are within 15% of the calculated dose. Comparison of these with phantom measurements indicates that many of the discrepancies are due to diode positioning on patients and increased diode response at short source-to-surface distances (SSDs), with the remainder attributable to other factors such as segment size and partial irradiation of the diode

Management of three-dimensional intrafraction motion through real-time DMLC tracking

International Nuclear Information System (INIS)

Sawant, Amit; Venkat, Raghu; Srivastava, Vikram; Carlson, David; Povzner, Sergey; Cattell, Herb; Keall, Paul

2008-01-01

Tumor tracking using a dynamic multileaf collimator (DMLC) represents a promising approach for intrafraction motion management in thoracic and abdominal cancer radiotherapy. In this work, we develop, empirically demonstrate, and characterize a novel 3D tracking algorithm for real-time, conformal, intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT)-based radiation delivery to targets moving in three dimensions. The algorithm obtains real-time information of target location from an independent position monitoring system and dynamically calculates MLC leaf positions to account for changes in target position. Initial studies were performed to evaluate the geometric accuracy of DMLC tracking of 3D target motion. In addition, dosimetric studies were performed on a clinical linac to evaluate the impact of real-time DMLC tracking for conformal, step-and-shoot (S-IMRT), dynamic (D-IMRT), and VMAT deliveries to a moving target. The efficiency of conformal and IMRT delivery in the presence of tracking was determined. Results show that submillimeter geometric accuracy in all three dimensions is achievable with DMLC tracking. Significant dosimetric improvements were observed in the presence of tracking for conformal and IMRT deliveries to moving targets. A gamma index evaluation with a 3%-3 mm criterion showed that deliveries without DMLC tracking exhibit between 1.7 (S-IMRT) and 4.8 (D-IMRT) times more dose points that fail the evaluation compared to corresponding deliveries with tracking. The efficiency of IMRT delivery, as measured in the lab, was observed to be significantly lower in case of tracking target motion perpendicular to MLC leaf travel compared to motion parallel to leaf travel. Nevertheless, these early results indicate that accurate, real-time DMLC tracking of 3D tumor motion is feasible and can potentially result in significant geometric and dosimetric advantages leading to more effective management of intrafraction motion

An external dosimetry audit programme to credential static and rotational IMRT delivery for clinical trials quality assurance.

Science.gov (United States)

Eaton, David J; Tyler, Justine; Backshall, Alex; Bernstein, David; Carver, Antony; Gasnier, Anne; Henderson, Julia; Lee, Jonathan; Patel, Rushil; Tsang, Yatman; Yang, Huiqi; Zotova, Rada; Wells, Emma

2017-03-01

External dosimetry audits give confidence in the safe and accurate delivery of radiotherapy. The RTTQA group have performed an on-site audit programme for trial recruiting centres, who have recently implemented static or rotational IMRT, and those with major changes to planning or delivery systems. Measurements of reference beam output were performed by the host centre, and by the auditor using independent equipment. Verification of clinical plans was performed using the ArcCheck helical diode array. A total of 54 measurement sessions were performed between May 2014 and June 2016 at 28 UK institutions, reflecting the different combinations of planning and delivery systems used at each institution. Average ratio of measured output between auditor and host was 1.002±0.006. Average point dose agreement for clinical plans was -0.3±1.8%. Average (and 95% lower confidence intervals) of gamma pass rates at 2%/2mm, 3%/2mm and 3%/3mm respectively were: 92% (80%), 96% (90%) and 98% (94%). Moderately significant differences were seen between fixed gantry angle and rotational IMRT, and between combination of planning systems and linac manufacturer, but not between anatomical treatment site or beam energy. An external audit programme has been implemented for universal and efficient credentialing of IMRT treatments in clinical trials. Good agreement was found between measured and expected doses, with few outliers, leading to a simple table of optimal and mandatory tolerances for approval of dosimetry audit results. Feedback was given to some centres leading to improved clinical practice. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Theoretical and practical model for implementing intensity modulated radiotherapy (IMRT) based on openness in head and neck tumors

International Nuclear Information System (INIS)

Napoles Morales, Misleidy; Yanes Lopez, Yaima; Ascension, Yudith; Alfonso La Guardia, Rodolfo; Calderon, Carlos

2009-01-01

Certain requirements have been internationally recommended for the transition from radiation therapy (3D-CRT) to intensity modulated radiation therapy (IMRT). They have been filling in clinical practice in the physical, dosimetry and quality of treatment. Prior to the implementation of IMRT have been developed preclinical will proceed according to the treatment planning techniques in the real images of patients, validating the rationale for the transition from the point of view and radiobiological dosimetry. The comparison was based on a group of patients eligible for IMRT, which were actually treated with 3D-CRT. IMRT plans were designed and applied to virtually the same patients, simulating the IMRT treatment. The prescribed dose and fractionation were similar in both techniques, to be able to compare radiobiology. The results show the rationality of IMRT in terms of reducing complications and the possibility of scaling doses in the PTV. Were used Dose Volume Histograms (HDV) obtained from the dosimetric calculations for radiobiological evaluation of treatment plans, letting through a software: 'Albireo Target' version 4.0.1.2008 calculate the equivalent uniform dose (EUD) for tumor and organs of risks (OAR) and tumor control probability (TCP) and the likelihood of damage to healthy tissue (NTCP). The results obtained with IMRT plans were more significant than with 3D-CRT especially in terms of EUD for organs at risk and NTCP. These results allow us to create the definitive basis for the implementation of IMRT in our environment. (Author)

Software tool for portal dosimetry research.

Science.gov (United States)

Vial, P; Hunt, P; Greer, P B; Oliver, L; Baldock, C

2008-09-01

This paper describes a software tool developed for research into the use of an electronic portal imaging device (EPID) to verify dose for intensity modulated radiation therapy (IMRT) beams. A portal dose image prediction (PDIP) model that predicts the EPID response to IMRT beams has been implemented into a commercially available treatment planning system (TPS). The software tool described in this work was developed to modify the TPS PDIP model by incorporating correction factors into the predicted EPID image to account for the difference in EPID response to open beam radiation and multileaf collimator (MLC) transmitted radiation. The processes performed by the software tool include; i) read the MLC file and the PDIP from the TPS, ii) calculate the fraction of beam-on time that each point in the IMRT beam is shielded by MLC leaves, iii) interpolate correction factors from look-up tables, iv) create a corrected PDIP image from the product of the original PDIP and the correction factors and write the corrected image to file, v) display, analyse, and export various image datasets. The software tool was developed using the Microsoft Visual Studio.NET framework with the C# compiler. The operation of the software tool was validated. This software provided useful tools for EPID dosimetry research, and it is being utilised and further developed in ongoing EPID dosimetry and IMRT dosimetry projects.

MO-B-BRB-02: 3D Dosimetry in the Clinic: IMRT Technique Validation in Sweden

Energy Technology Data Exchange (ETDEWEB)

Ceberg, S. [Lund University (Sweden)

2016-06-15

Full three-dimensional (3D) dosimetry using volumetric chemical dosimeters probed by 3D imaging systems has long been a promising technique for the radiation therapy clinic, since it provides a unique methodology for dose measurements in the volume irradiated using complex conformal delivery techniques such as IMRT and VMAT. To date true 3D dosimetry is still not widely practiced in the community; it has been confined to centres of specialized expertise especially for quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. The potential for improved clinical applicability has been advanced considerably in the last decade by the development of improved 3D dosimeters (e.g., radiochromic plastics, radiochromic gel dosimeters and normoxic polymer gel systems) and by improved readout protocols using optical computed tomography or magnetic resonance imaging. In this session, established users of some current 3D chemical dosimeters will briefly review the current status of 3D dosimetry, describe several dosimeters and their appropriate imaging for dose readout, present workflow procedures required for good dosimetry, and analyze some limitations for applications in select settings. We will review the application of 3D dosimetry to various clinical situations describing how 3D approaches can complement other dose delivery validation approaches already available in the clinic. The applications presented will be selected to inform attendees of the unique features provided by full 3D techniques. Learning Objectives: L. John Schreiner: Background and Motivation Understand recent developments enabling clinically practical 3D dosimetry, Appreciate 3D dosimetry workflow and dosimetry procedures, and Observe select examples from the clinic. Sofie Ceberg: Application to dynamic radiotherapy Observe full dosimetry under dynamic radiotherapy during respiratory motion, and Understand how the measurement of high resolution dose data in an

MO-B-BRB-02: 3D Dosimetry in the Clinic: IMRT Technique Validation in Sweden

International Nuclear Information System (INIS)

Ceberg, S.

2016-01-01

Full three-dimensional (3D) dosimetry using volumetric chemical dosimeters probed by 3D imaging systems has long been a promising technique for the radiation therapy clinic, since it provides a unique methodology for dose measurements in the volume irradiated using complex conformal delivery techniques such as IMRT and VMAT. To date true 3D dosimetry is still not widely practiced in the community; it has been confined to centres of specialized expertise especially for quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. The potential for improved clinical applicability has been advanced considerably in the last decade by the development of improved 3D dosimeters (e.g., radiochromic plastics, radiochromic gel dosimeters and normoxic polymer gel systems) and by improved readout protocols using optical computed tomography or magnetic resonance imaging. In this session, established users of some current 3D chemical dosimeters will briefly review the current status of 3D dosimetry, describe several dosimeters and their appropriate imaging for dose readout, present workflow procedures required for good dosimetry, and analyze some limitations for applications in select settings. We will review the application of 3D dosimetry to various clinical situations describing how 3D approaches can complement other dose delivery validation approaches already available in the clinic. The applications presented will be selected to inform attendees of the unique features provided by full 3D techniques. Learning Objectives: L. John Schreiner: Background and Motivation Understand recent developments enabling clinically practical 3D dosimetry, Appreciate 3D dosimetry workflow and dosimetry procedures, and Observe select examples from the clinic. Sofie Ceberg: Application to dynamic radiotherapy Observe full dosimetry under dynamic radiotherapy during respiratory motion, and Understand how the measurement of high resolution dose data in an

Development of real-time radiation exposure dosimetry system using synthetic ruby for interventional radiology

International Nuclear Information System (INIS)

Hosokai, Yoshiyuki; Win, Thet Pe; Muroi, Kenzo; Matsumoto, Kenki; Takahashi, Kaito; Usui, Akihito; Saito, Haruo; Kozakai, Masataka

2017-01-01

Interventional radiology (IVR) tends to involve long procedures, consequently delivering high radiation doses to the patient. Radiation-induced injuries that occur because of the effect of the high radiation doses are a considerable problem for those performing IVR. For example, skin injuries can include skin erythema if the skin is exposed to radiation doses beyond the threshold level of 2 Gy. One of the reasons for this type of injury is that the local skin dose cannot be monitored in real time. Although there are systems employed to measure the exposure dose, some do not work in real time (such as thermoluminescence dosimeters and fluorescent glass dosimeters), while certain real-time measurement systems that enter the field of view (such as patient skin dosimeters and dosimeters using a nontoxic phosphor) interfere with IVR. However, synthetic ruby has been shown to emit light in response to radiation. The luminous wavelength is 693 nm. It is possible to monitor the radiation dose by detecting the emitted light. However, small synthetic rubies emit a tiny amount of light that is difficult to detect using common systems such as photodiodes. A large enough synthetic ruby to increase the quantity of emitted light would however enter the field of view and interfere with the IVR procedure. Additionally, although a photodiode system could reduce the system size, the data is susceptible to effects from the X-rays and outside temperature. Therefore, use of a sensitive photon counting system as used in nuclear medicine could potentially have a beneficial effect in detecting the weak light signal. A real-time radiation exposure dosimetry system for use in IVR should be sufficiently sensitive, not interfere with the IVR procedure, and ideally have the possibility of development into a system that can provide simultaneous multipoint measurements. This article discusses the development of a realtime radiation exposure dosimetry system for use in IVR that employs a small

A novel approach to EPID-based 3D volumetric dosimetry for IMRT and VMAT QA

Science.gov (United States)

Alhazmi, Abdulaziz; Gianoli, Chiara; Neppl, Sebastian; Martins, Juliana; Veloza, Stella; Podesta, Mark; Verhaegen, Frank; Reiner, Michael; Belka, Claus; Parodi, Katia

2018-06-01

Intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) are relatively complex treatment delivery techniques and require quality assurance (QA) procedures. Pre-treatment dosimetric verification represents a fundamental QA procedure in daily clinical routine in radiation therapy. The purpose of this study is to develop an EPID-based approach to reconstruct a 3D dose distribution as imparted to a virtual cylindrical water phantom to be used for plan-specific pre-treatment dosimetric verification for IMRT and VMAT plans. For each depth, the planar 2D dose distributions acquired in air were back-projected and convolved by depth-specific scatter and attenuation kernels. The kernels were obtained by making use of scatter and attenuation models to iteratively estimate the parameters from a set of reference measurements. The derived parameters served as a look-up table for reconstruction of arbitrary measurements. The summation of the reconstructed 3D dose distributions resulted in the integrated 3D dose distribution of the treatment delivery. The accuracy of the proposed approach was validated in clinical IMRT and VMAT plans by means of gamma evaluation, comparing the reconstructed 3D dose distributions with Octavius measurement. The comparison was carried out using (3%, 3 mm) criteria scoring 99% and 96% passing rates for IMRT and VMAT, respectively. An accuracy comparable to the one of the commercial device for 3D volumetric dosimetry was demonstrated. In addition, five IMRT and five VMAT were validated against the 3D dose calculation performed by the TPS in a water phantom using the same passing rate criteria. The median passing rates within the ten treatment plans was 97.3%, whereas the lowest was 95%. Besides, the reconstructed 3D distribution is obtained without predictions relying on forward dose calculation and without external phantom or dosimetric devices. Thus, the approach provides a fully automated, fast and easy QA

Dynamic-MLC leaf control utilizing on-flight intensity calculations: A robust method for real-time IMRT delivery over moving rigid targets

International Nuclear Information System (INIS)

McMahon, Ryan; Papiez, Lech; Rangaraj, Dharanipathy

2007-01-01

An algorithm is presented that allows for the control of multileaf collimation (MLC) leaves based entirely on real-time calculations of the intensity delivered over the target. The algorithm is capable of efficiently correcting generalized delivery errors without requiring the interruption of delivery (self-correcting trajectories), where a generalized delivery error represents anything that causes a discrepancy between the delivered and intended intensity profiles. The intensity actually delivered over the target is continually compared to its intended value. For each pair of leaves, these comparisons are used to guide the control of the following leaf and keep this discrepancy below a user-specified value. To demonstrate the basic principles of the algorithm, results of corrected delivery are shown for a leading leaf positional error during dynamic-MLC (DMLC) IMRT delivery over a rigid moving target. It is then shown that, with slight modifications, the algorithm can be used to track moving targets in real time. The primary results of this article indicate that the algorithm is capable of accurately delivering DMLC IMRT over a rigid moving target whose motion is (1) completely unknown prior to delivery and (2) not faster than the maximum MLC leaf velocity over extended periods of time. These capabilities are demonstrated for clinically derived intensity profiles and actual tumor motion data, including situations when the target moves in some instances faster than the maximum admissible MLC leaf velocity. The results show that using the algorithm while calculating the delivered intensity every 50 ms will provide a good level of accuracy when delivering IMRT over a rigid moving target translating along the direction of MLC leaf travel. When the maximum velocities of the MLC leaves and target were 4 and 4.2 cm/s, respectively, the resulting error in the two intensity profiles used was 0.1±3.1% and -0.5±2.8% relative to the maximum of the intensity profiles. For

Study of the positioning of the films of the MLC by a Test of bands and your influence in the clinic dosimetry in IMRT

International Nuclear Information System (INIS)

Serrano Zabaleta, S.; Millan Cebrian, E.; Calvo Carrillo, S.; Alba Escorihuela, V.; Garcia Romero, A.; Ortega Pardina, P.; Canella Anoz, M.; Hernandez Vitoria, A.

2015-01-01

We performed a test of adjacent bands inspired by the proposed in AAPM Report No. 72, we provides a parameter characterizing the state of the MLC as to the actual position of its blades. This test has been validated by studying repeatability and reproducibility and has found the correlation between the parameter and creep detected by the ILD. Subsequently it has studied the impact of changes in the positioning of the blades on clinical dosimetry in IMRT patients, reconstructing the patient dose by Matrix Evolution team and Compass software, IBA Dosimetry. (Author)

IMRT delivery verification using a spiral phantom

International Nuclear Information System (INIS)

Richardson, Susan L.; Tome, Wolfgang A.; Orton, Nigel P.; McNutt, Todd R.; Paliwal, Bhudatt R.

2003-01-01

In this paper we report on the testing and verification of a system for IMRT delivery quality assurance that uses a cylindrical solid water phantom with a spiral trajectory for radiographic film placement. This spiral film technique provides more complete dosimetric verification of the entire IMRT treatment than perpendicular film methods, since it samples a three-dimensional dose subspace rather than using measurements at only one or two depths. As an example, the complete analysis of the predicted and measured spiral films is described for an intracranial IMRT treatment case. The results of this analysis are compared to those of a single field perpendicular film technique that is typically used for IMRT QA. The comparison demonstrates that both methods result in a dosimetric error within a clinical tolerance of 5%, however the spiral phantom QA technique provides a more complete dosimetric verification while being less time consuming. To independently verify the dosimetry obtained with the spiral film, the same IMRT treatment was delivered to a similar phantom in which LiF thermoluminescent dosimeters were arranged along the spiral trajectory. The maximum difference between the predicted and measured TLD data for the 1.8 Gy fraction was 0.06 Gy for a TLD located in a high dose gradient region. This further validates the ability of the spiral phantom QA process to accurately verify delivery of an IMRT plan

Stereotactic IMRT using a MMLC

International Nuclear Information System (INIS)

Hoban, P.; Short, R.; Biggs, D.; Rose, A.; Smee, R.; Schneider, M.

2001-01-01

Full text: The leaf width of the multileaf collimator (MLC) used for intensity modulated radiotherapy (IMRT ) largely determines the resolution of the intensity maps that define the entire profile of each beam. In turn it is this resolution, and consequently the achievable degree of beam modulation, that determines the ability to conform the 3D dose distribution to complex target volumes. As such, the leaf width is of more importance than in fixed-field MLC treatments where only the beam edges are affected.A Radionics micro-multileaf collimator (MMLC) with 4 mm leaf width, attached to a Siemens Primus linear accelerator, is in use for stereotactic IMRT at PbWH. Treatment planning is performed with the XPlan system including an integrated IMRT module. Cases treated have so far been with conventional fractionation, including both malignant and benign cranial lesions. Meningiomas in particular often require a complex dose distribution because of their en-plaque nature and/or proximity to the brainstem. Stereotactic localisation and fixation is with the Gill-Thomas-Cosman head-ring or Head and Neck localiser. Cases are typically planned both for fixed-field treatment and IMRT, with IMRT being used if significant benefit is seen. IMRT treatment with the Siemens MLC is also an option. A quality assurance system has been set up, including a flowchart/checklist and phantom dosimetry using TLDs. As expected, treatment plans show IMRT with the MMLC to consistently be the best option dosimetrically. In particular, for a given target coverage there is always better sparing of nearby organs at risk (OARs) with MMLC rather than MLC-based IMRT. Adjustments such as the inclusion of a margin around the target volume or an increase in the penalty for target underdosage improve coverage for MLC plans but generally at the expense of increased OAR involvement. MMLC IMRT treatments commonly require 30-50 fields and can be delivered in approximately 10-15 minutes using an autosequence

A real-time dynamic-MLC control algorithm for delivering IMRT to targets undergoing 2D rigid motion in the beam's eye view

International Nuclear Information System (INIS)

McMahon, Ryan; Berbeco, Ross; Nishioka, Seiko; Ishikawa, Masayori; Papiez, Lech

2008-01-01

An MLC control algorithm for delivering intensity modulated radiation therapy (IMRT) to targets that are undergoing two-dimensional (2D) rigid motion in the beam's eye view (BEV) is presented. The goal of this method is to deliver 3D-derived fluence maps over a moving patient anatomy. Target motion measured prior to delivery is first used to design a set of planned dynamic-MLC (DMLC) sliding-window leaf trajectories. During actual delivery, the algorithm relies on real-time feedback to compensate for target motion that does not agree with the motion measured during planning. The methodology is based on an existing one-dimensional (1D) algorithm that uses on-the-fly intensity calculations to appropriately adjust the DMLC leaf trajectories in real-time during exposure delivery [McMahon et al., Med. Phys. 34, 3211-3223 (2007)]. To extend the 1D algorithm's application to 2D target motion, a real-time leaf-pair shifting mechanism has been developed. Target motion that is orthogonal to leaf travel is tracked by appropriately shifting the positions of all MLC leaves. The performance of the tracking algorithm was tested for a single beam of a fractionated IMRT treatment, using a clinically derived intensity profile and a 2D target trajectory based on measured patient data. Comparisons were made between 2D tracking, 1D tracking, and no tracking. The impact of the tracking lag time and the frequency of real-time imaging were investigated. A study of the dependence of the algorithm's performance on the level of agreement between the motion measured during planning and delivery was also included. Results demonstrated that tracking both components of the 2D motion (i.e., parallel and orthogonal to leaf travel) results in delivered fluence profiles that are superior to those that track the component of motion that is parallel to leaf travel alone. Tracking lag time effects may lead to relatively large intensity delivery errors compared to the other sources of error investigated

On line CALDose{sub X}: real time Monte Carlo calculation via Internet for dosimetry in radiodiagnostic; CALDose{sub X} online: Calculos de Monte Carlo em tempo real via Internet para dosimetria em radiodiagnostico

Energy Technology Data Exchange (ETDEWEB)

Kramer, Richard; Cassola, Vagner Ferreira; Lira, Carlos Alberto Brayner de Oliveira; Khoury, Helen Jamil, E-mail: rkramer@uol.com.b, E-mail: vagner.cassola@gmail.co [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Dept. de Energia Nuclear; Cavalcanti, Arthur; Lins, Rafael Dueire, E-mail: rdl@ufpe.b [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Centro de Tecnologia e Geociencias. Dept. de Eletronica e Sistemas

2011-10-26

The CALDose{sub X} 4.1 is a software which uses thr MASH and FASH phantoms. Patient dosimetry with reference phantoms is limited because the results can be applied only for patients which possess the same body mass and right height that the reference phantom. In this paper, the dosimetry of patients for diagnostic with X ray was extended by using a series of 18 phantoms with defined gender, different body masses and heights, in order to cover the real anatomy of the patients. It is possible to calculate absorbed doses in organs and tissues by real time Monte Carlo dosimetry through the Internet through a dosimetric service called CALDose{sub X} on line

Real-time in vivo luminescence dosimetry in radiotherapy and mammography using Al2O3:C

International Nuclear Information System (INIS)

Aznar, M.C.

2005-07-01

New treatment and clinical imaging techniques have created a need for accurate and practical in vivo dosimeters in radiation medicine. This work describes the development of a new optical-fiber radiation dosimeter system, based on radioluminescence (RL) and optically stimulated luminescence (OSL) from carbon-doped aluminium oxide (Al2O3:C), for applications in radiotherapy and mammography. This system offers several features, such as a small detector, high sensitivity, real-time read-out, and the ability to measure both dose rate and absorbed dose. Measurement protocols and algorithms for the correction of responses were developed to enable a reliable absorbed dose assessment from the RL and OSL signals. At radiotherapy energies, the variation of the signal with beam parameters was smaller than 1% (1 SD). Treatment-like experiments in phantoms, and in vivo measurements during complex patient treatments (such as intensity-modulated radiation therapy) indicate that the RL/OSL dosimetry system can reliably measure the absorbed dose within 2%. The real-time RL signal also enables an individual dose assessment from each field. The RL/OSL dosimetry system was also used during mammography examinations. In such conditions, the reproducibility of the measurements showed to be around 3%. In vivo measurements on three patients showed that the presence of the RL/OSL probes did not degrade the diagnostic quality of the radiograph and that the system could be used to measure exit doses (i.e., absorbed doses on the inferior surface of the breast). A Monte Carlo study proved that the energy dependence of the RL/OSL system at these low energies could be reduced by optimizing the design of the probes. It is concluded that the new RL/OSL dosimetry system shows considerable potential for applications in both radiotherapy and mammography. (au)

WE-AB-BRB-00: Session in Memory of Robert J. Shalek: High Resolution Dosimetry from 2D to 3D to Real-Time 3D

Energy Technology Data Exchange (ETDEWEB)

NONE

2016-06-15

Despite widespread IMRT treatments at modern radiation therapy clinics, precise dosimetric commissioning of an IMRT system remains a challenge. In the most recent report from the Radiological Physics Center (RPC), nearly 20% of institutions failed an end-to-end test with an anthropomorphic head and neck phantom, a test that has rather lenient dose difference and distance-to-agreement criteria of 7% and 4 mm. The RPC report provides strong evidence that IMRT implementation is prone to error and that improved quality assurance tools are required. At the heart of radiation therapy dosimetry is the multidimensional dosimeter. However, due to the limited availability of water-equivalent dosimetry materials, research and development in this important field is challenging. In this session, we will review a few dosimeter developments that are either in the laboratory phase or in the pre-commercialization phase. 1) Radiochromic plastic. Novel formulations exhibit light absorbing optical contrast with very little scatter, enabling faster, broad beam optical CT design. 2) Storage phosphor. After irradiation, the dosimetry panels will be read out using a dedicated 2D scanning apparatus in a non-invasive, electro-optic manner and immediately restored for further use. 3) Liquid scintillator. Scintillators convert the energy from x-rays and proton beams into visible light, which can be recorded with a scientific camera (CCD or CMOS) from multiple angles. The 3D shape of the dose distribution can then be reconstructed. 4) Cherenkov emission imaging. Gated intensified imaging allows video-rate passive detection of Cherenkov emission during radiation therapy with the room lights on. Learning Objectives: To understand the physics of a variety of dosimetry techniques based upon optical imaging To investigate the strategies to overcome respective challenges and limitations To explore novel ideas of dosimeter design Supported in part by NIH Grants R01CA148853, R01CA182450, R01CA109558

WE-AB-BRB-00: Session in Memory of Robert J. Shalek: High Resolution Dosimetry from 2D to 3D to Real-Time 3D

International Nuclear Information System (INIS)

2016-01-01

Despite widespread IMRT treatments at modern radiation therapy clinics, precise dosimetric commissioning of an IMRT system remains a challenge. In the most recent report from the Radiological Physics Center (RPC), nearly 20% of institutions failed an end-to-end test with an anthropomorphic head and neck phantom, a test that has rather lenient dose difference and distance-to-agreement criteria of 7% and 4 mm. The RPC report provides strong evidence that IMRT implementation is prone to error and that improved quality assurance tools are required. At the heart of radiation therapy dosimetry is the multidimensional dosimeter. However, due to the limited availability of water-equivalent dosimetry materials, research and development in this important field is challenging. In this session, we will review a few dosimeter developments that are either in the laboratory phase or in the pre-commercialization phase. 1) Radiochromic plastic. Novel formulations exhibit light absorbing optical contrast with very little scatter, enabling faster, broad beam optical CT design. 2) Storage phosphor. After irradiation, the dosimetry panels will be read out using a dedicated 2D scanning apparatus in a non-invasive, electro-optic manner and immediately restored for further use. 3) Liquid scintillator. Scintillators convert the energy from x-rays and proton beams into visible light, which can be recorded with a scientific camera (CCD or CMOS) from multiple angles. The 3D shape of the dose distribution can then be reconstructed. 4) Cherenkov emission imaging. Gated intensified imaging allows video-rate passive detection of Cherenkov emission during radiation therapy with the room lights on. Learning Objectives: To understand the physics of a variety of dosimetry techniques based upon optical imaging To investigate the strategies to overcome respective challenges and limitations To explore novel ideas of dosimeter design Supported in part by NIH Grants R01CA148853, R01CA182450, R01CA109558

Quasi 3D dosimetry (EPID, conventional 2D/3D detector matrices)

International Nuclear Information System (INIS)

Bäck, A

2015-01-01

Patient specific pretreatment measurement for IMRT and VMAT QA should preferably give information with a high resolution in 3D. The ability to distinguish complex treatment plans, i.e. treatment plans with a difference between measured and calculated dose distributions that exceeds a specified tolerance, puts high demands on the dosimetry system used for the pretreatment measurements and the results of the measurement evaluation needs a clinical interpretation. There are a number of commercial dosimetry systems designed for pretreatment IMRT QA measurements. 2D arrays such as MapCHECK ® (Sun Nuclear), MatriXX Evolution (IBA Dosimetry) and OCTAVIOUS ® 1500 (PTW), 3D phantoms such as OCTAVIUS ® 4D (PTW), ArcCHECK ® (Sun Nuclear) and Delta 4 (ScandiDos) and software for EPID dosimetry and 3D reconstruction of the dose in the patient geometry such as EPIDose TM (Sun Nuclear) and Dosimetry Check TM (Math Resolutions) are available. None of those dosimetry systems can measure the 3D dose distribution with a high resolution (full 3D dose distribution). Those systems can be called quasi 3D dosimetry systems. To be able to estimate the delivered dose in full 3D the user is dependent on a calculation algorithm in the software of the dosimetry system. All the vendors of the dosimetry systems mentioned above provide calculation algorithms to reconstruct a full 3D dose in the patient geometry. This enables analyzes of the difference between measured and calculated dose distributions in DVHs of the structures of clinical interest which facilitates the clinical interpretation and is a promising tool to be used for pretreatment IMRT QA measurements. However, independent validation studies on the accuracy of those algorithms are scarce. Pretreatment IMRT QA using the quasi 3D dosimetry systems mentioned above rely on both measurement uncertainty and accuracy of calculation algorithms. In this article, these quasi 3D dosimetry systems and their use in patient specific

Time-gated scintillator imaging for real-time optical surface dosimetry in total skin electron therapy

Science.gov (United States)

Bruza, Petr; Gollub, Sarah L.; Andreozzi, Jacqueline M.; Tendler, Irwin I.; Williams, Benjamin B.; Jarvis, Lesley A.; Gladstone, David J.; Pogue, Brian W.

2018-05-01

The purpose of this study was to measure surface dose by remote time-gated imaging of plastic scintillators. A novel technique for time-gated, intensified camera imaging of scintillator emission was demonstrated, and key parameters influencing the signal were analyzed, including distance, angle and thickness. A set of scintillator samples was calibrated by using thermo-luminescence detector response as reference. Examples of use in total skin electron therapy are described. The data showed excellent room light rejection (signal-to-noise ratio of scintillation SNR  ≈  470), ideal scintillation dose response linearity, and 2% dose rate error. Individual sample scintillation response varied by 7% due to sample preparation. Inverse square distance dependence correction and lens throughput error (8% per meter) correction were needed. At scintillator-to-source angle and observation angle  <50°, the radiant energy fluence error was smaller than 1%. The achieved standard error of the scintillator cumulative dose measurement compared to the TLD dose was 5%. The results from this proof-of-concept study documented the first use of small scintillator targets for remote surface dosimetry in ambient room lighting. The measured dose accuracy renders our method to be comparable to thermo-luminescent detector dosimetry, with the ultimate realization of accuracy likely to be better than shown here. Once optimized, this approach to remote dosimetry may substantially reduce the time and effort required for surface dosimetry.

Impact of Salivary Gland Dosimetry on Post-IMRT Recovery of Saliva Output and Xerostomia Grade for Head-and-Neck Cancer Patients Treated With or Without Contralateral Submandibular Gland Sparing: A Longitudinal Study

International Nuclear Information System (INIS)

Wang Zhonghe; Yan Chao; Zhang Zhiyuan; Zhang Chenping; Hu Haisheng; Tu Wenyong; Kirwan, Jessica; Mendenhall, William M.

2011-01-01

Purpose: To observe the recovery of saliva output and effect on xerostomia grade after intensity-modulated radiotherapy (IMRT) with or without contralateral submandibular gland (cSMG) sparing and to assess the impact of salivary gland dosimetry on this recovery among patients with head-and-neck cancer. Methods and Materials: Between May 2007 and May 2008, 52 patients with head-and-neck cancer received definitive (n = 5 patients) and postoperative (n = 47 patients) IMRT at our institution, with at least one parotid gland spared. Of these patients, 26 patients with a low risk of recurrence in the cSMG region underwent IMRT and had their cSMGs spared (cSMG-sparing group). The remaining 26 high-risk patients had no cSMGs spared (cSMG-unspared group). Xerostomia grades and salivary flow rates were monitored at five time points (before IMRT and at 2, 6, 12, and 18 months after IMRT). Results: Average mean doses and mean volumes receiving 30 Gy (V30) of the cSMGs were lower in the cSMG-sparing group than in the cSMG-unspared group (mean dose, 20.4 Gy vs. 57.4 Gy; mean V30, 14.7% vs. 99.8%, respectively). Xerostomia grades at 2 and 6 months post-IMRT were also significantly lower among patients in the cSMG-sparing group than in the cSMG-unspared group, but differences were not significant at 12 and 18 months after IMRT. Patients in the cSMG-sparing group had significantly better mean unstimulated salivary flow rates at each time point post- IMRT as well as better mean stimulated salivary flow rates at 2 months post-IMRT. Conclusions: Recovery of saliva output and grade of xerostomia post-IMRT in patients whose cSMGs were spared were much better than in patients whose cSMGs were not spared. The influence of the mean doses to the cSMG and parotid gland on the recovery of saliva output was equivalent to that of the mean V30 to the glands.

Impact of Salivary Gland Dosimetry on Post-IMRT Recovery of Saliva Output and Xerostomia Grade for Head-and-Neck Cancer Patients Treated With or Without Contralateral Submandibular Gland Sparing: A Longitudinal Study

Energy Technology Data Exchange (ETDEWEB)

Wang Zhonghe; Yan Chao [Division of Radiation Oncology, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Zhang Zhiyuan; Zhang Chenping [Department of Oral and Maxillofacial Surgery, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Hu Haisheng; Tu Wenyong [Division of Radiation Oncology, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Kirwan, Jessica [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); Mendenhall, William M., E-mail: mendwm@shands.ufl.edu [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States)

2011-12-01

Purpose: To observe the recovery of saliva output and effect on xerostomia grade after intensity-modulated radiotherapy (IMRT) with or without contralateral submandibular gland (cSMG) sparing and to assess the impact of salivary gland dosimetry on this recovery among patients with head-and-neck cancer. Methods and Materials: Between May 2007 and May 2008, 52 patients with head-and-neck cancer received definitive (n = 5 patients) and postoperative (n = 47 patients) IMRT at our institution, with at least one parotid gland spared. Of these patients, 26 patients with a low risk of recurrence in the cSMG region underwent IMRT and had their cSMGs spared (cSMG-sparing group). The remaining 26 high-risk patients had no cSMGs spared (cSMG-unspared group). Xerostomia grades and salivary flow rates were monitored at five time points (before IMRT and at 2, 6, 12, and 18 months after IMRT). Results: Average mean doses and mean volumes receiving 30 Gy (V30) of the cSMGs were lower in the cSMG-sparing group than in the cSMG-unspared group (mean dose, 20.4 Gy vs. 57.4 Gy; mean V30, 14.7% vs. 99.8%, respectively). Xerostomia grades at 2 and 6 months post-IMRT were also significantly lower among patients in the cSMG-sparing group than in the cSMG-unspared group, but differences were not significant at 12 and 18 months after IMRT. Patients in the cSMG-sparing group had significantly better mean unstimulated salivary flow rates at each time point post- IMRT as well as better mean stimulated salivary flow rates at 2 months post-IMRT. Conclusions: Recovery of saliva output and grade of xerostomia post-IMRT in patients whose cSMGs were spared were much better than in patients whose cSMGs were not spared. The influence of the mean doses to the cSMG and parotid gland on the recovery of saliva output was equivalent to that of the mean V30 to the glands.

Teledosimetry: Personal and Area Dosimetry Control in order to evaluate the risk in real time

International Nuclear Information System (INIS)

Galan Montenegro, P.; Macias Jaen, J.; Bodineau Gil, C.; Sanchez Hidalgo, M.

2004-01-01

Telemedicine is now an essential part of Health care and so, in addition to the scientific programme in the Carlos Haya Hospital in Malaga, Physics Department is involved into a process of change about the vision as a new Health Centre of XXI Century: Knowledge Hospital, by digital architecture and digitally integrated in its world. The Integrating the Health care Enterprise is the model used in order to get a big grade of relationship between medical images and information system. This change must be done in colaboration between some Departments of our centre, because it is a multidisciplinary task. It is understood that Teledosimetry can be considered as an important part of Telemedicine in the Radiological Protection field for workers and general public. In order to get this objective, the first step since 2000 it has been to prepare the internal hospital network with personal dosimetry information. From here workers in our hospital can obtain their dosimetry information data in more than 300 computers and since 2003, from home too. For access, each one of all have got an user identification and a password and so it can be guaranteed the privacy. We transform dose data reported by CND (Dosimetry National Center) in a big and visible database in PHP4 and Javascript format. This process is marked of problems about all due to the big manipulated information. Our intention is to make a better and friendly control, customisable and in real-time of the information dosimetry by a modular monitoring system of electronic dosimeters by the web. These radiation detectors would be located in representatives places. (Author)

Teledosimetry: Personal and Area Dosimetry Control in order to evaluate the risk in real time

Energy Technology Data Exchange (ETDEWEB)

Galan Montenegro, P.; Macias Jaen, J.; Bodineau Gil, C.; Sanchez Hidalgo, M.

2004-07-01

Telemedicine is now an essential part of Health care and so, in addition to the scientific programme in the Carlos Haya Hospital in Malaga, Physics Department is involved into a process of change about the vision as a new Health Centre of XXI Century: Knowledge Hospital, by digital architecture and digitally integrated in its world. The Integrating the Health care Enterprise is the model used in order to get a big grade of relationship between medical images and information system. This change must be done in colaboration between some Departments of our centre, because it is a multidisciplinary task. It is understood that Teledosimetry can be considered as an important part of Telemedicine in the Radiological Protection field for workers and general public. In order to get this objective, the first step since 2000 it has been to prepare the internal hospital network with personal dosimetry information. From here workers in our hospital can obtain their dosimetry information data in more than 300 computers and since 2003, from home too. For access, each one of all have got an user identification and a password and so it can be guaranteed the privacy. We transform dose data reported by CND (Dosimetry National Center) in a big and visible database in PHP4 and Javascript format. This process is marked of problems about all due to the big manipulated information. Our intention is to make a better and friendly control, customisable and in real-time of the information dosimetry by a modular monitoring system of electronic dosimeters by the web. These radiation detectors would be located in representatives places. (Author)

A silicon strip detector dose magnifying glass for IMRT dosimetry

International Nuclear Information System (INIS)

Wong, J. H. D.; Carolan, M.; Lerch, M. L. F.; Petasecca, M.; Khanna, S.; Perevertaylo, V. L.; Metcalfe, P.; Rosenfeld, A. B.

2010-01-01

Purpose: Intensity modulated radiation therapy (IMRT) allows the delivery of escalated radiation dose to tumor while sparing adjacent critical organs. In doing so, IMRT plans tend to incorporate steep dose gradients at interfaces between the target and the organs at risk. Current quality assurance (QA) verification tools such as 2D diode arrays, are limited by their spatial resolution and conventional films are nonreal time. In this article, the authors describe a novel silicon strip detector (CMRP DMG) of high spatial resolution (200 μm) suitable for measuring the high dose gradients in an IMRT delivery. Methods: A full characterization of the detector was performed, including dose per pulse effect, percent depth dose comparison with Farmer ion chamber measurements, stem effect, dose linearity, uniformity, energy response, angular response, and penumbra measurements. They also present the application of the CMRP DMG in the dosimetric verification of a clinical IMRT plan. Results: The detector response changed by 23% for a 390-fold change in the dose per pulse. A correction function is derived to correct for this effect. The strip detector depth dose curve agrees with the Farmer ion chamber within 0.8%. The stem effect was negligible (0.2%). The dose linearity was excellent for the dose range of 3-300 cGy. A uniformity correction method is described to correct for variations in the individual detector pixel responses. The detector showed an over-response relative to tissue dose at lower photon energies with the maximum dose response at 75 kVp nominal photon energy. Penumbra studies using a Varian Clinac 21EX at 1.5 and 10.0 cm depths were measured to be 2.77 and 3.94 mm for the secondary collimators, 3.52 and 5.60 mm for the multileaf collimator rounded leaf ends, respectively. Point doses measured with the strip detector were compared to doses measured with EBT film and doses predicted by the Philips Pinnacle treatment planning system. The differences were 1.1%�

Optimal dose reduction in computed tomography methodologies predicted from real-time dosimetry

Science.gov (United States)

Tien, Christopher Jason

Over the past two decades, computed tomography (CT) has become an increasingly common and useful medical imaging technique. CT is a noninvasive imaging modality with three-dimensional volumetric viewing abilities, all in sub-millimeter resolution. Recent national scrutiny on radiation dose from medical exams has spearheaded an initiative to reduce dose in CT. This work concentrates on dose reduction of individual exams through two recently-innovated dose reduction techniques: organ dose modulation (ODM) and tube current modulation (TCM). ODM and TCM tailor the phase and amplitude of x-ray current, respectively, used by the CT scanner during the scan. These techniques are unique because they can be used to achieve patient dose reduction without any appreciable loss in image quality. This work details the development of the tools and methods featuring real-time dosimetry which were used to provide pioneering measurements of ODM or TCM in dose reduction for CT.

Hybrid IMRT plans-concurrently treating conventional and IMRT beams for improved breast irradiation and reduced planning time

International Nuclear Information System (INIS)

Mayo, Charles S.; Urie, Marcia M.; Fitzgerald, Thomas J.

2005-01-01

Purpose: To evaluate a hybrid intensity modulated radiation therapy (IMRT) technique as a class solution for treatment of the intact breast. Methods and materials: The following five plan techniques were compared for 10 breast patients using dose-volume histogram analysis: conventional wedged-field tangents (Tangents), forward-planned field-within-a-field tangents (FIF), IMRT-only tangents (IMRT tangents), conventional open plus IMRT tangents (4-field hybrid), and conventional open plus IMRT tangents with 2 anterior oblique IMRT beams (6-field hybrid). Results: The 4-field hybrid and FIF achieved dose distributions better than Tangents and IMRT tangents. The volume of tissue outside the planning target volume receiving ≥110% of prescribed dose was largest for IMRT tangents (average 158 cc) and least for 6-field hybrid (average 1 cc); the FIF and 4-field hybrid were comparable (average 15 cc). Heart volume ≥30 Gy averaged 13 cc for all techniques, except Tangents, for which it was 32 cc. Average total lung volume ≥20 Gy was 7% for all. Contralateral breast doses were < 3% for all. Planning time for hybrid techniques was significantly less than for conventional FIF technique. Conclusions: The 4-field hybrid technique is a viable class solution. The 6-field hybrid technique creates the most conformal dose distribution at the expense of more normal tissue receiving low dose

SU-F-T-395: Evaluation of Best Dosimetry Achievable with VMAT and IMRT Treatment Techniques Targeting Borderline Resectable Pancreatic Cancer

Energy Technology Data Exchange (ETDEWEB)

Harpool, K; Schnell, E; Herman, T; Ahmad, S; De La Fuente Herman, T [University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)

2016-06-15

Purpose: To determine from retrospective study the most appropriate technique for targeting small borderline operable pancreatic cancer surrounding blood vessels by evaluating the dosimetry and normal tissue sparing achievable using Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiation Therapy (IMRT). Methods: Treatment plans from ten patients who have undergone treatment with a prescribed dose of 4950 cGy, at 275 cGy per fraction, were analyzed. All plans were replanned using Eclipse TPS (Varian Medical Systems, Palo Alto, CA) with complementary VMAT or IMRT techniques to obtain paired data sets for comparison. The coverage to at least 95% of the planned target volume (PTV) was normalized to receive 100% of the prescription dose. The normal tissue constraints followed the quantitative analysis of normal tissue effects in the clinic (QUANTEC) guidelines and the organs at risks (OARs) were liver, kidneys, spinal cord and bowel. The plan evaluation was based on conformity index (CI), homogeneity index (HI), uniformity index (UI), DVH parameters, and student’s-t statistics (2 tails). Results: The VMAT technique delivered less maximum dose to the right kidney, left kidney, total kidney, liver, spinal cord, and bowel by 9.3%, 5.9%, 6.7%, 3.9%, 15.1%, 3.9%, and 4.3%, respectively. The averaged V15 for the total kidney was 10.21% for IMRT and 7.29% for VMAT. The averaged V20 for the bowel was 19.89% for IMRT and 14.06% for VMAT. On average, the CI for IMRT was 1.20 and 1.16 for VMAT (p = 0.20). The HI was 0.08 for both techniques (p = 0.91) and UI was 1.05 and 1.06 for IMRT and VMAT respectively (p = 0.59). Conclusion: Both techniques achieve adequate PTV coverage. Although VMAT techniques show better normal tissue sparing from excessive dose, no significant differences were observed. Slight discrepancies may rise from different versions of calculation algorithms.

Occupational dosimetry in real time hemodynamic rooms. utility of the system Dose-aware as a training tool

International Nuclear Information System (INIS)

Pinto Monedero, M.; Rodriguez Cobo, C.; Pifarre Martinez, X.; Ruiz Martin, J.; Barros Candelero, J. M.; Goicolea Ruigomez, J.; Diaz Blaires, G.; Garcia Lunar

2014-01-01

This paper presents the results from a study in a real time dosimetry system used in the catheter laboratory room of our center. The objective was to know the occupational doses per procedure, on the one hand, and, on the other hand, to evaluate its utility as a learning tool for radiation protection purposes with the simultaneous video recording of the interventions. 83 diagnostic and therapeutic procedures were analyzed, and an average dose per procedure of 0,37 μSv and 0,10 μSv for the main cardiologist and nurse were obtained, respectively. 36 of these interventions were also recorded and the images were synchronized with the dosimetric information stored and the dosimetry system. The findings were presented to the interventional cardiology team in a learning session. They showed a high level of satisfaction with this new method of optimizing the occupational doses through a customized learning session. (Author)

Evaluation of delivered monitor unit accuracy of gated step-and-shoot IMRT using a two-dimensional detector array

Energy Technology Data Exchange (ETDEWEB)

Cheong, Kwang-Ho; Kang, Sei-Kwon; Lee, MeYeon; Kim, Su SSan; Park, SoAh; Hwang, Tae-Jin; Kim, Kyoung Ju; Oh, Do Hoon; Bae, Hoonsik; Suh, Tae-Suk [Department of Radiation Oncology, Hallym University College of Medicine, Seoul, 431070 (Korea, Republic of) and Department of Biomedical Engineering, College of Medicine, Catholic University of Korea, Seoul 137701 (Korea, Republic of); Department of Radiation Oncology, Hallym University College of Medicine, Seoul 431070 (Korea, Republic of); Department of Biomedical Engineering, College of Medicine, Catholic University of Korea, Seoul 137701 (Korea, Republic of)

2010-03-15

Purpose: To overcome the problem of organ motion in intensity-modulated radiation therapy (IMRT), gated IMRT is often used for the treatment of lung cancer. In this study, the authors investigated the accuracy of the delivered monitor units (MUs) from each segment during gated IMRT using a two-dimensional detector array for user-specific verification purpose. Methods: The authors planned a 6 MV photon, seven-port step-and-shoot lung IMRT delivery. The respiration signals for gated IMRT delivery were obtained from the one-dimensional moving phantom using the real-time position management (RPM) system (Varian Medical Systems, Palo Alto, CA). The beams were delivered using a Clinac iX (Varian Medical Systems, Palo Alto, CA) with the Millennium 120 MLC. The MatriXX (IBA Dosimetry GmbH, Germany) was validated through consistency and reproducibility tests as well as comparison with measurements from a Farmer-type ion chamber. The authors delivered beams with varying dose rates and duty cycles and analyzed the MatriXX data to evaluate MU delivery accuracy. Results: There was quite good agreement between the planned segment MUs and the MUs computed from the MatriXX within {+-}2% error. The beam-on times computed from the MatriXX data were almost identical for all cases, and they matched well with the RPM beam-on and beam-off signals. A slight difference was observed between them, but it was less than 40 ms. The gated IMRT delivery demonstrated an MU delivery accuracy that was equivalent to ungated IMRT, and the delivered MUs with a gating signal agreed with the planned MUs within {+-}0.5 MU regardless of dose rate and duty cycle. Conclusions: The authors can conclude that gated IMRT is able to deliver an accurate dose to a patient during a procedure. The authors believe that the methodology and results can be transferred to other vendors' devices, particularly those that do not provide MLC log data for a verification purpose.

MO-FG-202-09: Virtual IMRT QA Using Machine Learning: A Multi-Institutional Validation

International Nuclear Information System (INIS)

Valdes, G; Scheuermann, R; Solberg, T; Chan, M; Deasy, J

2016-01-01

Purpose: To validate a machine learning approach to Virtual IMRT QA for accurately predicting gamma passing rates using different QA devices at different institutions. Methods: A Virtual IMRT QA was constructed using a machine learning algorithm based on 416 IMRT plans, in which QA measurements were performed using diode-array detectors and a 3%local/3mm with 10% threshold. An independent set of 139 IMRT measurements from a different institution, with QA data based on portal dosimetry using the same gamma index and 10% threshold, was used to further test the algorithm. Plans were characterized by 90 different complexity metrics. A weighted poison regression with Lasso regularization was trained to predict passing rates using the complexity metrics as input. Results: In addition to predicting passing rates with 3% accuracy for all composite plans using diode-array detectors, passing rates for portal dosimetry on per-beam basis were predicted with an error <3.5% for 120 IMRT measurements. The remaining measurements (19) had large areas of low CU, where portal dosimetry has larger disagreement with the calculated dose and, as such, large errors were expected. These beams need to be further modeled to correct the under-response in low dose regions. Important features selected by Lasso to predict gamma passing rates were: complete irradiated area outline (CIAO) area, jaw position, fraction of MLC leafs with gaps smaller than 20 mm or 5mm, fraction of area receiving less than 50% of the total CU, fraction of the area receiving dose from penumbra, weighted Average Irregularity Factor, duty cycle among others. Conclusion: We have demonstrated that the Virtual IMRT QA can predict passing rates using different QA devices and across multiple institutions. Prediction of QA passing rates could have profound implications on the current IMRT process.

MO-FG-202-09: Virtual IMRT QA Using Machine Learning: A Multi-Institutional Validation

Energy Technology Data Exchange (ETDEWEB)

Valdes, G; Scheuermann, R; Solberg, T [University of Pennsylvania, Philadelphia, PA (United States); Chan, M; Deasy, J [Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

2016-06-15

Purpose: To validate a machine learning approach to Virtual IMRT QA for accurately predicting gamma passing rates using different QA devices at different institutions. Methods: A Virtual IMRT QA was constructed using a machine learning algorithm based on 416 IMRT plans, in which QA measurements were performed using diode-array detectors and a 3%local/3mm with 10% threshold. An independent set of 139 IMRT measurements from a different institution, with QA data based on portal dosimetry using the same gamma index and 10% threshold, was used to further test the algorithm. Plans were characterized by 90 different complexity metrics. A weighted poison regression with Lasso regularization was trained to predict passing rates using the complexity metrics as input. Results: In addition to predicting passing rates with 3% accuracy for all composite plans using diode-array detectors, passing rates for portal dosimetry on per-beam basis were predicted with an error <3.5% for 120 IMRT measurements. The remaining measurements (19) had large areas of low CU, where portal dosimetry has larger disagreement with the calculated dose and, as such, large errors were expected. These beams need to be further modeled to correct the under-response in low dose regions. Important features selected by Lasso to predict gamma passing rates were: complete irradiated area outline (CIAO) area, jaw position, fraction of MLC leafs with gaps smaller than 20 mm or 5mm, fraction of area receiving less than 50% of the total CU, fraction of the area receiving dose from penumbra, weighted Average Irregularity Factor, duty cycle among others. Conclusion: We have demonstrated that the Virtual IMRT QA can predict passing rates using different QA devices and across multiple institutions. Prediction of QA passing rates could have profound implications on the current IMRT process.

IMRT QA using machine learning: A multi-institutional validation.

Science.gov (United States)

Valdes, Gilmer; Chan, Maria F; Lim, Seng Boh; Scheuermann, Ryan; Deasy, Joseph O; Solberg, Timothy D

2017-09-01

To validate a machine learning approach to Virtual intensity-modulated radiation therapy (IMRT) quality assurance (QA) for accurately predicting gamma passing rates using different measurement approaches at different institutions. A Virtual IMRT QA framework was previously developed using a machine learning algorithm based on 498 IMRT plans, in which QA measurements were performed using diode-array detectors and a 3%local/3 mm with 10% threshold at Institution 1. An independent set of 139 IMRT measurements from a different institution, Institution 2, with QA data based on portal dosimetry using the same gamma index, was used to test the mathematical framework. Only pixels with ≥10% of the maximum calibrated units (CU) or dose were included in the comparison. Plans were characterized by 90 different complexity metrics. A weighted poison regression with Lasso regularization was trained to predict passing rates using the complexity metrics as input. The methodology predicted passing rates within 3% accuracy for all composite plans measured using diode-array detectors at Institution 1, and within 3.5% for 120 of 139 plans using portal dosimetry measurements performed on a per-beam basis at Institution 2. The remaining measurements (19) had large areas of low CU, where portal dosimetry has a larger disagreement with the calculated dose and as such, the failure was expected. These beams need further modeling in the treatment planning system to correct the under-response in low-dose regions. Important features selected by Lasso to predict gamma passing rates were as follows: complete irradiated area outline (CIAO), jaw position, fraction of MLC leafs with gaps smaller than 20 or 5 mm, fraction of area receiving less than 50% of the total CU, fraction of the area receiving dose from penumbra, weighted average irregularity factor, and duty cycle. We have demonstrated that Virtual IMRT QA can predict passing rates using different measurement techniques and across multiple

Real-time in vivo luminescence dosimetry in radiotherapy and mammography using Al{sub 2}O{sub 3}:C

Energy Technology Data Exchange (ETDEWEB)

Aznar, M.C.

2005-06-15

New treatment and clinical imaging techniques have created a need for accurate and practical in vivo dosimeters in radiation medicine. This work describes the development of a new optical-fiber radiation dosimeter system, based on radioluminescence (RL) and optically stimulated luminescence (OSL) from carbon-doped aluminium oxide (Al2O3:C), for applications in radiotherapy and mammography. This system offers several features, such as a small detector, high sensitivity, real-time read-out, and the ability to measure both dose rate and absorbed dose. Measurement protocols and algorithms for the correction of responses were developed to enable a reliable absorbed dose assessment from the RL and OSL signals. At radiotherapy energies, the variation of the signal with beam parameters was smaller than 1% (1 SD). Treatment-like experiments in phantoms, and in vivo measurements during complex patient treatments (such as intensity-modulated radiation therapy) indicate that the RL/OSL dosimetry system can reliably measure the absorbed dose within 2%. The real-time RL signal also enables an individual dose assessment from each field. The RL/OSL dosimetry system was also used during mammography examinations. In such conditions, the reproducibility of the measurements showed to be around 3%. In vivo measurements on three patients showed that the presence of the RL/OSL probes did not degrade the diagnostic quality of the radiograph and that the system could be used to measure exit doses (i.e., absorbed doses on the inferior surface of the breast). A Monte Carlo study proved that the energy dependence of the RL/OSL system at these low energies could be reduced by optimizing the design of the probes. It is concluded that the new RL/OSL dosimetry system shows considerable potential for applications in both radiotherapy and mammography. (au)

Virtual film technique used in 3d and step-shot IMRT planning check

International Nuclear Information System (INIS)

Wang, Y.; Zealey, W.; Deng, X.; Huang, S.; Qi, Z.

2004-01-01

Full text: A virtual film technique developed and used in segmented field dose reconstruction for IMRT planning dose distribution check. Film dosimetry analysis is commonly used for the isodose curve comparison but the result can be affected by film dosimetry technical problems, and the film processing also takes a significant amount of workload. This study is focused on using digital image technique to reconstruct dose distribution for a 3D plan by mapping water-scanning data on screen in black and white intensity value, and by simulating the film analysis process to plot equivalent Isodose curve for the planning Isodose comparison check. In-house developed software is used to select the TPR (Tissue-Phantom Ratio) and OCR (Off Central-Axis Ratio) data for different beam field types and sizes; each point dose of the field is interpolated and converted into the greyscale pixel value. The location of the pixel is calculated by the triangular function according to the beam entry position and gantry/collimator angles. After each segment field is processed, the program gathers all the segments and overlays the greyscale value pixel by pixel for all the segments into a combined map. The background value is calibrated to match the water scan curve background level. The penumbra slope is adjusted by an interpolated divergent angle according to the OAD (Off Central-Axis Distance) of the field. A normal film dosimetry analysis can then be performed to plot the Isodose curves. By comparing some typical fields with both single beam and segmented IMRT fields, with the point dose checked by ionization measurement, the central point dose discrepancy is within ±2% and the maximum 3-5% for a random point using TLD technique. Compare the Isodose overlaying result to planning curves for both perpendicular and lateral beam. Although the curve shape for the virtual film viewed is more artificial compared with real film, the results are easier to compare for the quantity analysis with

Time-resolved dosimetry using a pinpoint ionization chamber as quality assurance for IMRT and VMAT

NARCIS (Netherlands)

Louwe, R.J.; Wendling, M.; Monshouwer, R.; Satherley, T.; Day, R.A.; Greig, L.

2015-01-01

PURPOSE: To develop a method to verify the dose delivery in relation to the individual control points of intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) using an ionization chamber. In addition to more effective problem solving during patient-specific quality

Study of the positioning of the films of the MLC by a Test of bands and your influence in the clinic dosimetry in IMRT; Estudio del posicionamiento de las laminas del MLC mediante un test de bandas y su influencia en la dosimetria clinica en IMRT

Energy Technology Data Exchange (ETDEWEB)

Serrano Zabaleta, S.; Millan Cebrian, E.; Calvo Carrillo, S.; Alba Escorihuela, V.; Garcia Romero, A.; Ortega Pardina, P.; Canella Anoz, M.; Hernandez Vitoria, A.

2015-07-01

We performed a test of adjacent bands inspired by the proposed in AAPM Report No. 72, we provides a parameter characterizing the state of the MLC as to the actual position of its blades. This test has been validated by studying repeatability and reproducibility and has found the correlation between the parameter and creep detected by the ILD. Subsequently it has studied the impact of changes in the positioning of the blades on clinical dosimetry in IMRT patients, reconstructing the patient dose by Matrix Evolution team and Compass software, IBA Dosimetry. (Author)

TH-A-BRC-03: AAPM TG218: Measurement Methods and Tolerance Levels for Patient-Specific IMRT Verification QA

Energy Technology Data Exchange (ETDEWEB)

Miften, M. [University of Colorado School of Medicine (United States)

2016-06-15

AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance - Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline

TH-A-BRC-03: AAPM TG218: Measurement Methods and Tolerance Levels for Patient-Specific IMRT Verification QA

International Nuclear Information System (INIS)

Miften, M.

2016-01-01

AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance - Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline

A reusable OSL-film for 2D radiotherapy dosimetry

Science.gov (United States)

Wouter, Crijns; Dirk, Vandenbroucke; Paul, Leblans; Tom, Depuydt

2017-11-01

Optical stimulated luminescence (OSL) combines reusability, sub-mm resolution, and a linear dose response in a single radiation detection technology. Such a combination is currently lacking in radiotherapy dosimetry. But OSL-films have a strong energy dependent response to keV photons due to a relative high effective atomic number (Z eff). The current work studied the applicability of a 2D OSL-film with a reduced Z eff as (IMRT/VMAT) dosimeter. Based on their commercial OSL-film experience, Agfa Healthcare N.V. produced a new experimental OSL-film for RT dosimetry. This film had a lower effective atomic number compared to the films used in radiology. Typical 2D dosimeter requirements such as uniformity, dose response, signal stability with time, and angular dependence were evaluated. Additionally, the impact of a possible residual energy dependence was assessed for the infield as well as the out-of-field region of both static beams and standard intensity modulated patterns (chair and pyramid). The OSL-film’s reusable nature allowed for a film specific absolute and linear calibration including a flood-field uniformity correction. The OSL-film was scanned with a CR-15X engine based reader using a strict timing (i.e. 4 min after ‘beam on’ or as soon as possible) to account for spontaneous recombination. The OSL-film had good basic response properties: non-uniformities  ⩽2.6%, a linear dose response (0-32 Gy), a linear signal decay (0.5% min-1) over the 20 min measured, and limited angular dependence  ⩽2.6%. Due to variations of the energy spectrum, larger dose differences were noted outside the central region of the homogenous phantom and outside both static and IMRT fields. However, the OSL-film’s measured dose differences of the IMRT patterns were lower than those of Gafchromic EBT measurements ([-1.6%, 2.1%] versus [-2.9%, 3.6%]). The current OSL-film could be used as a reusable high resolution dosimeter with read-out immediately after

Improved real-time dosimetry using the radioluminescence signal from Al2O3:C

International Nuclear Information System (INIS)

Damkjaer, S.M.S.; Andersen, C.E.; Aznar, M.C.

2008-01-01

Carbon-doped aluminum oxide (Al 2 O 3 :C) is a highly sensitive luminescence material for ionizing radiation dosimetry, and it is well established that the optically stimulated luminescence (OSL) signal from Al 2 O 3 :C can be used for absorbed-dose measurements. During irradiation, Al 2 O 3 :C also emits prompt radioluminescence (RL) which allows for real-time dose verification. The RL-signal is not linear in the absorbed dose due to sensitivity changes and the presence of shallow traps. Despite this the signal can be processed to obtain a reliable dose rate signal in real time. Previously a simple algorithm for correcting the RL-signal has been published and here we report two improvements: a better and more stable calibration method which is independent of a reference dose rate and a correction for the effect of the shallow traps. Good agreement was found between reference doses and doses derived from the RL-signal using the new algorithm (the standard deviation of the residuals were ∼2% including phantom positioning errors). The RL-algorithm was found to greatly reduce the influence of shallow traps in the range from 0 to 3 Gy and the RL dose-rate measurements with a time resolution of 0.1 s closely matched dose-rate changes monitored with an ionization chamber

SU-F-T-295: MLCs Performance and Patient-Specific IMRT QA Using Log File Analysis

Energy Technology Data Exchange (ETDEWEB)

Osman, A [King Fahd University of Petroleum and Minerals, Dhahran (Saudi Arabia); American University of Biuret Medical Center, Biuret (Lebanon); Maalej, N [King Fahd University of Petroleum and Minerals, Dhahran (Saudi Arabia); Jayesh, K; Abdel-Rahman, W [King Fahad Specialist Hospital-Dammam, Eastern Province (Saudi Arabia)

2016-06-15

Purpose: To analyze the performance of the multi-leaf collimators (MLCs) from the log files recorded during the intensity modulated radiotherapy (IMRT) treatment and to construct the relative fluence maps and do the gamma analysis to compare the planned and executed MLCs movement. Methods: We developed a program to extract and analyze the data from dynamic log files (dynalog files) generated from sliding window IMRT delivery treatments. The program extracts the planned and executed (actual or delivered) MLCs movement, calculates and compares the relative planned and executed fluences. The fluence maps were used to perform the gamma analysis (with 3% dose difference and 3 mm distance to agreement) for 3 IMR patients. We compared our gamma analysis results with those obtained from portal dose image prediction (PDIP) algorithm performed using the EPID. Results: For 3 different IMRT patient treatments, the maximum difference between the planned and the executed MCLs positions was 1.2 mm. The gamma analysis results of the planned and delivered fluences were in good agreement with the gamma analysis from portal dosimetry. The maximum difference for number of pixels passing the gamma criteria (3%/3mm) was 0.19% with respect to portal dosimetry results. Conclusion: MLC log files can be used to verify the performance of the MLCs. Patientspecific IMRT QA based on MLC movement log files gives similar results to EPID dosimetry results. This promising method for patient-specific IMRT QA is fast, does not require dose measurements in a phantom, can be done before the treatment and for every fraction, and significantly reduces the IMRT workload. The author would like to thank King Fahd University of petroleum and Minerals for the support.

SU-G-TeP4-02: A Method for Evaluating the Direct Impact of Failed IMRT QAs On Patient Dose

International Nuclear Information System (INIS)

Geneser, S; Butkus, M

2016-01-01

Purpose: We developed a method to calculate patient doses corresponding to IMRT QA measurements in order to determine and assess the actual dose delivered for plans with failed (or borderline) IMRT QA. This work demonstrates the feasibility of automatically computing delivered patient dose from portal dosimetry measurements in the Varian TPS system, which would provide a valuable and clinically viable IMRT QA tool for physicists and physicians. Methods: IMRT QA fluences were measured using portal dosimetry, processed using in-house matlab software, and imported back into Eclipse to calculate dose on the planning CT. To validate the proposed workflow, the Eclipse calculated portal dose for a 5-field sliding window prostate boost plan was processed as described above. The resulting dose was compared to the planned dose and found to be within 0.5 Gy. Two IMRT QA results for the prostate boost plan (one that failed and one that passed) were processed and the resulting patient doses were evaluated. Results: The max dose difference between IMRT QA #1 and the original planned and approved dose is 4.5 Gy, while the difference between the planned and IMRT QA #2 dose is 4.0 Gy. The inferior portion of the PTV is slightly underdosed in both plans, and the superior portion is slightly overdosed. The patient dose resulting from IMRT QA #1 and #2 differs by only 0.5 Gy. With this new information, it may be argued that the evaluated plan alteration to obtain passing gamma analysis produced clinically irrelevant differences. Conclusion: Evaluation of the delivered QA dose on the planning CT provides valuable information about the clinical relevance of failed or borderline IMRT QAs. This particular workflow demonstrates the feasibility of pushing the measured IMRT QA portal dosimetry results directly back onto the patient planning CT within the Varian system.

SU-G-TeP4-02: A Method for Evaluating the Direct Impact of Failed IMRT QAs On Patient Dose

Energy Technology Data Exchange (ETDEWEB)

Geneser, S; Butkus, M [Yale University School of Medicine/YNHH Radiology, New Haven, CT (United States)

2016-06-15

Purpose: We developed a method to calculate patient doses corresponding to IMRT QA measurements in order to determine and assess the actual dose delivered for plans with failed (or borderline) IMRT QA. This work demonstrates the feasibility of automatically computing delivered patient dose from portal dosimetry measurements in the Varian TPS system, which would provide a valuable and clinically viable IMRT QA tool for physicists and physicians. Methods: IMRT QA fluences were measured using portal dosimetry, processed using in-house matlab software, and imported back into Eclipse to calculate dose on the planning CT. To validate the proposed workflow, the Eclipse calculated portal dose for a 5-field sliding window prostate boost plan was processed as described above. The resulting dose was compared to the planned dose and found to be within 0.5 Gy. Two IMRT QA results for the prostate boost plan (one that failed and one that passed) were processed and the resulting patient doses were evaluated. Results: The max dose difference between IMRT QA #1 and the original planned and approved dose is 4.5 Gy, while the difference between the planned and IMRT QA #2 dose is 4.0 Gy. The inferior portion of the PTV is slightly underdosed in both plans, and the superior portion is slightly overdosed. The patient dose resulting from IMRT QA #1 and #2 differs by only 0.5 Gy. With this new information, it may be argued that the evaluated plan alteration to obtain passing gamma analysis produced clinically irrelevant differences. Conclusion: Evaluation of the delivered QA dose on the planning CT provides valuable information about the clinical relevance of failed or borderline IMRT QAs. This particular workflow demonstrates the feasibility of pushing the measured IMRT QA portal dosimetry results directly back onto the patient planning CT within the Varian system.

Ghosting effect in Siemens electronic portal imaging devices (EPIDs) for step and shoot IMRT dosimetry

International Nuclear Information System (INIS)

Deshpande, S.; Vial, P.; Goozee, G.; Holloway, L.

2010-01-01

Full text: To assess the ghosting effect of a Siemens EPID (Optivue 1000: while acquiring IMRT fluence with step and shoot delivery. Six sets of segmented fields with 1,2,3,5, J( and 20 monitor units (MU) per segment were designed. Each set consisted of ten segments of equal MU and field size (J 0 x 10 cm 2 ) Standard single fields (non-segmented) of the same total MU as the segmented fields were also created (10-200 MU). EPID images for these fields were acquired with multi-frame acquisition mode. The integrated EPID response was determined as the mean central 20 x 21 pixel readout multiplied by the number of frames. The same fields wen measured with an ionization chamber at a depth of dose maximum in, solid water phantom. The total signal measured from the segmented fields was compared to the corresponding non-segmented fields. The ratio of EPID response between segmented and non-segmented delivery indicates an under-response for segmented fields by 5, 4, 2.5 and 2% for 1,2,3, and 5 MU per segment exposures respectively compared to ionisation chamber response (se Fig. I). The ratio was within 2% for 5 MU per segment and above. Th error bar in Fig. I indicate the intra-segment response variation. The Siemens EPID exhibited significant ghosting effect and variation in response for small M U segments. EPID dosimetry ( IMRT fields with less than 5 MU per segment requires corrections t maintain dose calibration accuracy to within 2%. (author)

Real time monitoring of electron processors

International Nuclear Information System (INIS)

Nablo, S.V.; Kneeland, D.R.; McLaughlin, W.L.

1995-01-01

A real time radiation monitor (RTRM) has been developed for monitoring the dose rate (current density) of electron beam processors. The system provides continuous monitoring of processor output, electron beam uniformity, and an independent measure of operating voltage or electron energy. In view of the device's ability to replace labor-intensive dosimetry in verification of machine performance on a real-time basis, its application to providing archival performance data for in-line processing is discussed. (author)

Advantages and disadvantages of luminescence dosimetry

Energy Technology Data Exchange (ETDEWEB)

Olko, Pawel, E-mail: Pawel.Olko@ifj.edu.p [Institute of Nuclear Physics Polish Academy of Science (IFJ PAN), Krakow (Poland)

2010-03-15

Owing to their excellent dosimetric properties, luminescence detectors of ionizing radiation are now extensively applied in individual dosimetry services. The most frequently used personal dosemeters are based on Optically Stimulated Luminescence (OSL), radiophotoluminescence (RPL) or thermoluminescence (TL). Luminescence detectors have also found several applications in clinical dosimetry, especially around new radiation modalities in radiotherapy, such as Intensity Modulated Radiotherapy (IMRT) or ion beam radiotherapy. Requirements of luminescence detectors applied in individual and clinical dosimetry and some recent developments in luminescence of detectors and techniques leading to significant improvements of the functionality and accuracy of dosimetry systems are reviewed and discussed.

Alanine dosimetry for clinical applications. Proceedings

International Nuclear Information System (INIS)

Anton, M.

2006-05-01

The following topics are dealt with: Therapy level alanine dosimetry at the UK Nationational Physical Laboratory, alanine as a precision validation tool for reference dosimetry, composition of alanine pellet dosimeters, the angular dependence of the alanine ESR spectrum, the CIAE alanine dosimeter for radiotherapy level, a correction for temporal evolution effects in alanine dosimetry, next-generation services foe e-traceability to ionization radiation national standards, establishing e-traceability to HIST high-dose measurement standards, alanine dosimetry of dose delivery from clinical accelerators, the e-scan alanine dosimeter reader, alanine dosimetry at ISS, verification of the integral delivered dose for IMRT treatment in the head and neck region with ESR/alanine dosimetry, alanine dosimetry in helical tomotherapy beams, ESR dosimetry research and development at the University of Palermo, lithium formate as a low-dose EPR radiation dosimeter, sensitivity enhancement of alanine/EPR dosimetry. (HSI)

Phantoms for IMRT dose distribution measurement and treatment verification

International Nuclear Information System (INIS)

Low, Daniel A.; Gerber, Russell L.; Mutic, Sasa; Purdy, James A.

1998-01-01

Background: The verification of intensity-modulated radiation therapy (IMRT) patient treatment dose distributions is currently based on custom-built or modified dose measurement phantoms. The only commercially available IMRT treatment planning and delivery system (Peacock, NOMOS Corp.) is supplied with a film phantom that allows accurate spatial localization of the dose distribution using radiographic film. However, measurements using other dosimeters are necessary for the thorough verification of IMRT. Methods: We have developed a phantom to enable dose measurements using a cylindrical ionization chamber and the localization of prescription isodose curves using a matrix of thermoluminescent dosimetry (TLD) chips. The external phantom cross-section is identical to that of the commercial phantom, to allow direct comparisons of measurements. A supplementary phantom has been fabricated to verify the IMRT dose distributions for pelvis treatments. Results: To date, this phantom has been used for the verification of IMRT dose distributions for head and neck and prostate cancer treatments. Designs are also presented for a phantom insert to be used with polymerizing gels (e.g., BANG-2) to obtain volumetric dose distribution measurements. Conclusion: The phantoms have proven useful in the quantitative evaluation of IMRT treatments

Reducing dose calculation time for accurate iterative IMRT planning

International Nuclear Information System (INIS)

Siebers, Jeffrey V.; Lauterbach, Marc; Tong, Shidong; Wu Qiuwen; Mohan, Radhe

2002-01-01

A time-consuming component of IMRT optimization is the dose computation required in each iteration for the evaluation of the objective function. Accurate superposition/convolution (SC) and Monte Carlo (MC) dose calculations are currently considered too time-consuming for iterative IMRT dose calculation. Thus, fast, but less accurate algorithms such as pencil beam (PB) algorithms are typically used in most current IMRT systems. This paper describes two hybrid methods that utilize the speed of fast PB algorithms yet achieve the accuracy of optimizing based upon SC algorithms via the application of dose correction matrices. In one method, the ratio method, an infrequently computed voxel-by-voxel dose ratio matrix (R=D SC /D PB ) is applied for each beam to the dose distributions calculated with the PB method during the optimization. That is, D PB xR is used for the dose calculation during the optimization. The optimization proceeds until both the IMRT beam intensities and the dose correction ratio matrix converge. In the second method, the correction method, a periodically computed voxel-by-voxel correction matrix for each beam, defined to be the difference between the SC and PB dose computations, is used to correct PB dose distributions. To validate the methods, IMRT treatment plans developed with the hybrid methods are compared with those obtained when the SC algorithm is used for all optimization iterations and with those obtained when PB-based optimization is followed by SC-based optimization. In the 12 patient cases studied, no clinically significant differences exist in the final treatment plans developed with each of the dose computation methodologies. However, the number of time-consuming SC iterations is reduced from 6-32 for pure SC optimization to four or less for the ratio matrix method and five or less for the correction method. Because the PB algorithm is faster at computing dose, this reduces the inverse planning optimization time for our implementation

Real-time dosimetry system in catheterisation laboratory: utility as a learning tool in radiation protection

International Nuclear Information System (INIS)

Pinto Monedero, M.; Rodriguez Cobo, C.; Pifarre Martinez, X.; Ruiz Martin, J.; Barros Candelero, J.M.; Goicolea Ruigomez, J.; Diaz Blaires, G.; Garcia Lunar, I.

2015-01-01

Document available in abstract form only. Full text of publication follows: Workers at the catheter laboratory are among the most exposed to ionising radiation in hospitals. However, it is difficult to be certain of the radiation doses received by the staff, as personal dosemeters are often misused, and thus, the dose history is not reliable. Moreover, the information provided by personal dosemeters corresponds to the monthly accumulated dose, so corrective actions tends to be delayed. The purpose of this work is, on the one hand, to use a real-time dosimetry system to establish the occupational doses per procedure of workers at the catheter laboratories and, on the other hand, to evaluate its utility as a learning tool for radiation protection purposes with the simultaneous video recording of the interventions. (authors)

Is intraoperative real-time dosimetry in prostate seed brachytherapy predictive of biochemical outcome?

Directory of Open Access Journals (Sweden)

Daniel Taussky

2017-06-01

Full Text Available Purpose : To analyze intraoperative (IO dosimetry using transrectal ultrasound (TRUS, performed before and after prostate low-dose-rate brachytherapy (LDR-BT, and compare it to dosimetry performed 30 days following the LDR-BT implant (Day 30. Material and methods : A total of 236 patients underwent prostate LDR-BT using 125 I that was performed with a three-dimensional TRUS-guided interactive inverse preplanning system (preimplant dosimetry. After the implant procedure, the TRUS was repeated in the operating room, and the dosimetry was recalculated (postimplant dosimetry and compared to dosimetry on Day 30 computed tomography (CT scans. Area under curve (AUC statistics was used for models predictive of dosimetric parameters at Day 30. Results : The median follow-up for patients without BF was 96 months, the 5-year and 8-year biochemical recurrence (BR-free rate was 96% and 90%, respectively. The postimplant median D 90 was 3.8 Gy lower (interquartile range [IQR], 12.4-0.9, and the V 100 only 1% less (IQR, 2.9-0.2% than the preimplant dosimetry. When comparing the postimplant and the Day 30 dosimetries, the postimplant median D 90 was 9.6 Gy higher (IQR [–] 9.5-30.3 Gy, and the V 100 was 3.2% greater (0.2-8.9% than Day 30 postimplant dosimetry. The variables that best predicted the D 90 of Day 30 was the postimplant D 90 (AUC = 0.62, p = 0.038. None of the analyzed values for IO or Day 30 dosimetry showed any predictive value for BR. Conclusions : Although improving the IO preimplant and postimplant dosimetry improved dosimetry on Day 30, the BR-free rate was not dependent on any dosimetric parameter. Unpredictable factors such as intraprostatic seed migration and IO factors, prevented the accurate prediction of Day 30 dosimetry.

Optical Real-Time Space Radiation Monitor, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — Real-time dosimetry is needed to provide immediate feedback, so astronauts can minimize their exposure to ionizing radiation during periods of high solar activity....

TH-A-BRC-02: AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance

Energy Technology Data Exchange (ETDEWEB)

Goetsch, S. [San Diego Medical Physics (United States)

2016-06-15

AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance - Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline

TH-A-BRC-02: AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance

International Nuclear Information System (INIS)

Goetsch, S.

2016-01-01

AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance - Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline

Verification of eye lens dose in IMRT by MOSFET measurement.

Science.gov (United States)

Wang, Xuetao; Li, Guangjun; Zhao, Jianling; Song, Ying; Xiao, Jianghong; Bai, Sen

2018-04-17

The eye lens is recognized as one of the most radiosensitive structures in the human body. The widespread use of intensity-modulated radiotherapy (IMRT) complicates dose verification and necessitates high standards of dose computation. The purpose of this work was to assess the computed dose accuracy of eye lens through measurements using a metal-oxide-semiconductor field-effect transistor (MOSFET) dosimetry system. Sixteen clinical IMRT plans of head and neck patients were copied to an anthropomorphic head phantom. Measurements were performed using the MOSFET dosimetry system based on the head phantom. Two MOSFET detectors were imbedded in the eyes of the head phantom as the left and the right lens, covered by approximately 5-mm-thick paraffin wax. The measurement results were compared with the calculated values with a dose grid size of 1 mm. Sixteen IMRT plans were delivered, and 32 measured lens doses were obtained for analysis. The MOSFET dosimetry system can be used to verify the lens dose, and our measurements showed that the treatment planning system used in our clinic can provide adequate dose assessment in eye lenses. The average discrepancy between measurement and calculation was 6.7 ± 3.4%, and the largest discrepancy was 14.3%, which met the acceptability criterion set by the American Association of Physicists in Medicine Task Group 53 for external beam calculation for multileaf collimator-shaped fields in buildup regions. Copyright © 2018 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Contralateral breast doses measured by film dosimetry: tangential techniques and an optimized IMRT technique

International Nuclear Information System (INIS)

Saur, S; Frengen, J; Fjellsboe, L M B; Lindmo, T

2009-01-01

The contralateral breast (CLB) doses for three tangential techniques were characterized by using a female thorax phantom and GafChromic EBT film. Dose calculations by the pencil beam and collapsed cone algorithms were included for comparison. The film dosimetry reveals a highly inhomogeneous dose distribution within the CLB, and skin doses due to the medial fields that are several times higher than the interior dose. These phenomena are not correctly reproduced by the calculation algorithms. All tangential techniques were found to give a mean CLB dose of approximately 0.5 Gy. All wedged fields resulted in higher CLB doses than the corresponding open fields, and the lateral open fields resulted in higher CLB doses than the medial open fields. More than a twofold increase in the mean CLB dose from the medial open field was observed for a 90 deg. change of the collimator orientation. Replacing the physical wedge with a virtual wedge reduced the mean dose to the CLB by 35% and 16% for the medial and lateral fields, respectively. Lead shielding reduced the skin dose for a tangential technique by approximately 50%, but the mean CLB dose was only reduced by approximately 11%. Finally, a technique based on open medial fields in combination with several IMRT fields is proposed as a technique for minimizing the CLB dose. With and without lead shielding, the mean CLB dose using this technique was found to be 0.20 and 0.27 Gy, respectively.

Four-dimensional dose distributions of step-and-shoot IMRT delivered with real-time tumor tracking for patients with irregular breathing: Constant dose rate vs dose rate regulation

International Nuclear Information System (INIS)

Yang Xiaocheng; Han-Oh, Sarah; Gui Minzhi; Niu Ying; Yu, Cedric X.; Yi Byongyong

2012-01-01

Purpose: Dose-rate-regulated tracking (DRRT) is a tumor tracking strategy that programs the MLC to track the tumor under regular breathing and adapts to breathing irregularities during delivery using dose rate regulation. Constant-dose-rate tracking (CDRT) is a strategy that dynamically repositions the beam to account for intrafractional 3D target motion according to real-time information of target location obtained from an independent position monitoring system. The purpose of this study is to illustrate the differences in the effectiveness and delivery accuracy between these two tracking methods in the presence of breathing irregularities. Methods: Step-and-shoot IMRT plans optimized at a reference phase were extended to remaining phases to generate 10-phased 4D-IMRT plans using segment aperture morphing (SAM) algorithm, where both tumor displacement and deformation were considered. A SAM-based 4D plan has been demonstrated to provide better plan quality than plans not considering target deformation. However, delivering such a plan requires preprogramming of the MLC aperture sequence. Deliveries of the 4D plans using DRRT and CDRT tracking approaches were simulated assuming the breathing period is either shorter or longer than the planning day, for 4 IMRT cases: two lung and two pancreatic cases with maximum GTV centroid motion greater than 1 cm were selected. In DRRT, dose rate was regulated to speed up or slow down delivery as needed such that each planned segment is delivered at the planned breathing phase. In CDRT, MLC is separately controlled to follow the tumor motion, but dose rate was kept constant. In addition to breathing period change, effect of breathing amplitude variation on target and critical tissue dose distribution is also evaluated. Results: Delivery of preprogrammed 4D plans by the CDRT method resulted in an average of 5% increase in target dose and noticeable increase in organs at risk (OAR) dose when patient breathing is either 10% faster or

Integration method of 3D MR spectroscopy into treatment planning system for glioblastoma IMRT dose painting with integrated simultaneous boost

International Nuclear Information System (INIS)

Ken, Soléakhéna; Cassol, Emmanuelle; Delannes, Martine; Celsis, Pierre; Cohen-Jonathan, Elizabeth Moyal; Laprie, Anne; Vieillevigne, Laure; Franceries, Xavier; Simon, Luc; Supper, Caroline; Lotterie, Jean-Albert; Filleron, Thomas; Lubrano, Vincent; Berry, Isabelle

2013-01-01

To integrate 3D MR spectroscopy imaging (MRSI) in the treatment planning system (TPS) for glioblastoma dose painting to guide simultaneous integrated boost (SIB) in intensity-modulated radiation therapy (IMRT). For sixteen glioblastoma patients, we have simulated three types of dosimetry plans, one conventional plan of 60-Gy in 3D conformational radiotherapy (3D-CRT), one 60-Gy plan in IMRT and one 72-Gy plan in SIB-IMRT. All sixteen MRSI metabolic maps were integrated into TPS, using normalization with color-space conversion and threshold-based segmentation. The fusion between the metabolic maps and the planning CT scans were assessed. Dosimetry comparisons were performed between the different plans of 60-Gy 3D-CRT, 60-Gy IMRT and 72-Gy SIB-IMRT, the last plan was targeted on MRSI abnormalities and contrast enhancement (CE). Fusion assessment was performed for 160 transformations. It resulted in maximum differences <1.00 mm for translation parameters and ≤1.15° for rotation. Dosimetry plans of 72-Gy SIB-IMRT and 60-Gy IMRT showed a significantly decreased maximum dose to the brainstem (44.00 and 44.30 vs. 57.01 Gy) and decreased high dose-volumes to normal brain (19 and 20 vs. 23% and 7 and 7 vs. 12%) compared to 60-Gy 3D-CRT (p < 0.05). Delivering standard doses to conventional target and higher doses to new target volumes characterized by MRSI and CE is now possible and does not increase dose to organs at risk. MRSI and CE abnormalities are now integrated for glioblastoma SIB-IMRT, concomitant with temozolomide, in an ongoing multi-institutional phase-III clinical trial. Our method of MR spectroscopy maps integration to TPS is robust and reliable; integration to neuronavigation systems with this method could also improve glioblastoma resection or guide biopsies

Polymer gel dosimetry

Energy Technology Data Exchange (ETDEWEB)

Baldock, C [Institute of Medical Physics, School of Physics, University of Sydney (Australia); De Deene, Y [Radiotherapy and Nuclear Medicine, Ghent University Hospital (Belgium); Doran, S [CRUK Clinical Magnetic Resonance Research Group, Institute of Cancer Research, Surrey (United Kingdom); Ibbott, G [Radiation Physics, UT M D Anderson Cancer Center, Houston, TX (United States); Jirasek, A [Department of Physics and Astronomy, University of Victoria, Victoria, BC (Canada); Lepage, M [Centre d' imagerie moleculaire de Sherbrooke, Departement de medecine nucleaire et de radiobiologie, Universite de Sherbrooke, Sherbrooke, QC (Canada); McAuley, K B [Department of Chemical Engineering, Queen' s University, Kingston, ON (Canada); Oldham, M [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Schreiner, L J [Cancer Centre of South Eastern Ontario, Kingston, ON (Canada)], E-mail: c.baldock@physics.usyd.edu.au, E-mail: yves.dedeene@ugent.be

2010-03-07

Polymer gel dosimeters are fabricated from radiation sensitive chemicals which, upon irradiation, polymerize as a function of the absorbed radiation dose. These gel dosimeters, with the capacity to uniquely record the radiation dose distribution in three-dimensions (3D), have specific advantages when compared to one-dimensional dosimeters, such as ion chambers, and two-dimensional dosimeters, such as film. These advantages are particularly significant in dosimetry situations where steep dose gradients exist such as in intensity-modulated radiation therapy (IMRT) and stereotactic radiosurgery. Polymer gel dosimeters also have specific advantages for brachytherapy dosimetry. Potential dosimetry applications include those for low-energy x-rays, high-linear energy transfer (LET) and proton therapy, radionuclide and boron capture neutron therapy dosimetries. These 3D dosimeters are radiologically soft-tissue equivalent with properties that may be modified depending on the application. The 3D radiation dose distribution in polymer gel dosimeters may be imaged using magnetic resonance imaging (MRI), optical-computerized tomography (optical-CT), x-ray CT or ultrasound. The fundamental science underpinning polymer gel dosimetry is reviewed along with the various evaluation techniques. Clinical dosimetry applications of polymer gel dosimetry are also presented. (topical review)

TH-EF-204-04: Experience of IMRT and Other Conformal Techniques in Russia

International Nuclear Information System (INIS)

Krylova, T.

2016-01-01

Joanna E. Cygler, Jan Seuntjens, J. Daniel Bourland, M. Saiful Huq, Josep Puxeu Vaque, Daniel Zucca Aparicio, Tatiana Krylova, Yuri Kirpichev, Eric Ford, Caridad Borras Stereotactic Radiation Therapy (SRT) utilizes small static and dynamic (IMRT) fields, to successfully treat malignant and benign diseases using techniques such as Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT). SRT is characterized by sharp dose gradients for individual fields and their resultant dose distributions. For appropriate targets, small field radiotherapy offers improved treatment quality by allowing better sparing of organs at risk while delivering the prescribed target dose. Specialized small field treatment delivery systems, such as robotic-controlled linear accelerators, gamma radiosurgery units, and dynamic arc linear accelerators may utilize rigid fixation, image guidance, and tumor tracking, to insure precise dose delivery to static or moving targets. However, in addition to great advantages, small field delivery techniques present special technical challenges for dose calibration due to unique geometries and small field sizes not covered by existing reference dosimetry protocols such as AAPM TG-51 or IAEA TRS 398. In recent years extensive research has been performed to understand small field dosimetry and measurement instrumentation. AAPM, IAEA and ICRU task groups are expected to provide soon recommendations on the dosimetry of small radiation fields. In this symposium we will: 1] discuss the physics, instrumentation, methodologies and challenges for small field radiation dose measurements; 2] review IAEA and ICRU recommendations on prescribing, recording and reporting of small field radiation therapy; 3] discuss selected clinical applications and technical aspects for specialized image-guided, small field, linear accelerator based treatment techniques such as IMRT and SBRT. Learning Objectives: To learn the physics of small fields in contrast to

TH-EF-204-04: Experience of IMRT and Other Conformal Techniques in Russia

Energy Technology Data Exchange (ETDEWEB)

Krylova, T. [Russian Research Cancer Center (Russian Federation)

2016-06-15

Joanna E. Cygler, Jan Seuntjens, J. Daniel Bourland, M. Saiful Huq, Josep Puxeu Vaque, Daniel Zucca Aparicio, Tatiana Krylova, Yuri Kirpichev, Eric Ford, Caridad Borras Stereotactic Radiation Therapy (SRT) utilizes small static and dynamic (IMRT) fields, to successfully treat malignant and benign diseases using techniques such as Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT). SRT is characterized by sharp dose gradients for individual fields and their resultant dose distributions. For appropriate targets, small field radiotherapy offers improved treatment quality by allowing better sparing of organs at risk while delivering the prescribed target dose. Specialized small field treatment delivery systems, such as robotic-controlled linear accelerators, gamma radiosurgery units, and dynamic arc linear accelerators may utilize rigid fixation, image guidance, and tumor tracking, to insure precise dose delivery to static or moving targets. However, in addition to great advantages, small field delivery techniques present special technical challenges for dose calibration due to unique geometries and small field sizes not covered by existing reference dosimetry protocols such as AAPM TG-51 or IAEA TRS 398. In recent years extensive research has been performed to understand small field dosimetry and measurement instrumentation. AAPM, IAEA and ICRU task groups are expected to provide soon recommendations on the dosimetry of small radiation fields. In this symposium we will: 1] discuss the physics, instrumentation, methodologies and challenges for small field radiation dose measurements; 2] review IAEA and ICRU recommendations on prescribing, recording and reporting of small field radiation therapy; 3] discuss selected clinical applications and technical aspects for specialized image-guided, small field, linear accelerator based treatment techniques such as IMRT and SBRT. Learning Objectives: To learn the physics of small fields in contrast to

Improved real-time dosimetry using the radioluminescence signal from Al2O3:C

DEFF Research Database (Denmark)

Damkjær, Sidsel Marie Skov; Andersen, Claus Erik; Aznar, Marianne

2008-01-01

15th International Conference on Solid State Dosimetry Location: Delft Univ Technol, Delft, NETHERLANDS Date: JUL 08-13, 2007 Abstract: Carbon-doped aluminum oxide (Al2O3:C) is a highly sensitive luminescence material for ionizing radiation dosimetry, and it is well established that the optically...... to greatly reduce the influence of shallow traps in the range from 0 to 3 Gy and the RL dose-rate measurements with a time resolution of 0. 1 s closely matched dose-rate changes monitored with in ionization chamber. (c) 2007 Elsevier Ltd. All rights reserved....

SU-E-T-521: Feasibility Study of a Rotational Step-And-Shoot IMRT Treatment Planning Approach

International Nuclear Information System (INIS)

Zhu, X; Chang, S; Cullip, T; Yuan, L; Zhang, X; Lian, J; Tang, X; Tracton, G; Dooley, J

2014-01-01

Purpose: Rotational step-and-shot IMRT (r-IMRT) could improve delivery efficiency with good dose conformity, especially if it can leverage the burst mode of the accelerator where radiation is turned on/off momentarily while the gantry rotates continuously. The challenge for the r-IMRT planning is to minimize the number of beams to achieve a fast and smooth rotational delivery. Methods: Treatment plans for r-IMRT were created using an in-house treatment planning system. To generate the plan using a very few beams, gantry angle was optimized by weighting the beam monitoring unit (MU), and beam shape optimization was a combination of column search with k-means clustering. A prostate case and a head and neck case were planned using r-IMRT. The dosimetry is compared to s-IMRT planned with Varian Eclipse treatment planning system. Results: With the same PTV dose coverage D95=100%, the r-IMRT plans shows comparable sparing as the s-IMRT plans in the prostate for the rectum D10cc and the bladder Dmean, and in the head and neck for the spinal cord Dmax, the brain stem Dmax, the left/right parotid Dmean, the larynx Dmean, and the mandible Dmean. Both plans meet the established institutional clinical dosimetric criteria. The r-IMRT plan uses 19 beam/405 MU for the prostate, and 68 beam/880 MU for the head and neck, while the s-IMRT uses 7 beam/724 MU and 9 beam/1812 MU, respectively. Compared to the corresponding s-IMRT, r-IMRT has a reduction of MUs of 44% for the prostate case and 41% for the head and neck case. Conclusions: We have demonstrated the feasibility of a rotational step and shoot IMRT treatment planning approach that significantly shortens the conventional IMRT treatment beam-on time without degrading the dose comformity

SU-E-T-521: Feasibility Study of a Rotational Step-And-Shoot IMRT Treatment Planning Approach

Energy Technology Data Exchange (ETDEWEB)

Zhu, X [Univ. of North Carolina at Chapel Hill, Chapel Hill, NC (United States); Chang, S [UNC School of Medicine, Chapel Hill, NC (United States); Cullip, T [UNC Hospitals, Chapel Hill, NC (United States); Yuan, L; Zhang, X [Duke University, Durham, NC (United States); Lian, J; Tang, X [UniversityNorth Carolina, Chapel Hill, NC (United States); Tracton, G; Dooley, J [University of North Carolina, Chapel Hill, NC (United States)

2014-06-01

Purpose: Rotational step-and-shot IMRT (r-IMRT) could improve delivery efficiency with good dose conformity, especially if it can leverage the burst mode of the accelerator where radiation is turned on/off momentarily while the gantry rotates continuously. The challenge for the r-IMRT planning is to minimize the number of beams to achieve a fast and smooth rotational delivery. Methods: Treatment plans for r-IMRT were created using an in-house treatment planning system. To generate the plan using a very few beams, gantry angle was optimized by weighting the beam monitoring unit (MU), and beam shape optimization was a combination of column search with k-means clustering. A prostate case and a head and neck case were planned using r-IMRT. The dosimetry is compared to s-IMRT planned with Varian Eclipse treatment planning system. Results: With the same PTV dose coverage D95=100%, the r-IMRT plans shows comparable sparing as the s-IMRT plans in the prostate for the rectum D10cc and the bladder Dmean, and in the head and neck for the spinal cord Dmax, the brain stem Dmax, the left/right parotid Dmean, the larynx Dmean, and the mandible Dmean. Both plans meet the established institutional clinical dosimetric criteria. The r-IMRT plan uses 19 beam/405 MU for the prostate, and 68 beam/880 MU for the head and neck, while the s-IMRT uses 7 beam/724 MU and 9 beam/1812 MU, respectively. Compared to the corresponding s-IMRT, r-IMRT has a reduction of MUs of 44% for the prostate case and 41% for the head and neck case. Conclusions: We have demonstrated the feasibility of a rotational step and shoot IMRT treatment planning approach that significantly shortens the conventional IMRT treatment beam-on time without degrading the dose comformity.

Development and evaluation of a phantom for multi-purpose dosimetry in intensity-modulated radiation therapy

International Nuclear Information System (INIS)

Jeong, Hae Sun; Kim, Chan Hyeong; Park, Joo Hwan; Han, Young Yih; Kum, O Yeon

2011-01-01

A LEGO-type multi-purpose dosimetry phantom was developed for intensity-modulated radiation therapy (IMRT), which requires various types of challenging dosimetry. Polystyrene, polyethylene, polytetrafluoroethylene (PTFE), and polyurethane foam (PU-F) were selected to represent muscle, fat, bone, and lung tissue, respectively, after considering the relevant mass densities, elemental compositions, effective atomic numbers, and photon interaction coefficients. The phantom, which is composed of numerous small pieces that are similar to LEGO blocks, provides dose and dose distribution measurements in homogeneous and heterogeneous media. The phantom includes dosimeter holders for several types of dosimeters that are frequently used in IMRT dosimetry. An ion chamber and a diode detector were used to test dosimetry in heterogeneous media under radiation fields of various sizes. The data that were measured using these dosimeters were in disagreement when the field sizes were smaller than 1.5 x 1.5 cm 2 for polystyrene and PTFE, or smaller than 3 x 3 cm 2 for an air cavity. The discrepancy was as large as 41% for the air cavity when the field size was 0.7 x 0.7 cm 2 , highlighting one of the challenges of IMRT small field dosimetry. The LEGO-type phantom is also very useful for two-dimensional dosimetry analysis, which elucidates the electronic dis-equilibrium phenomena on or near the heterogeneity boundaries

Development and evaluation of a phantom for multi-purpose dosimetry in intensity-modulated radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Jeong, Hae Sun; Kim, Chan Hyeong [Hanyang University, Seoul (Korea, Republic of); Park, Joo Hwan [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Han, Young Yih [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kum, O Yeon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

2011-08-15

A LEGO-type multi-purpose dosimetry phantom was developed for intensity-modulated radiation therapy (IMRT), which requires various types of challenging dosimetry. Polystyrene, polyethylene, polytetrafluoroethylene (PTFE), and polyurethane foam (PU-F) were selected to represent muscle, fat, bone, and lung tissue, respectively, after considering the relevant mass densities, elemental compositions, effective atomic numbers, and photon interaction coefficients. The phantom, which is composed of numerous small pieces that are similar to LEGO blocks, provides dose and dose distribution measurements in homogeneous and heterogeneous media. The phantom includes dosimeter holders for several types of dosimeters that are frequently used in IMRT dosimetry. An ion chamber and a diode detector were used to test dosimetry in heterogeneous media under radiation fields of various sizes. The data that were measured using these dosimeters were in disagreement when the field sizes were smaller than 1.5 x 1.5 cm{sup 2} for polystyrene and PTFE, or smaller than 3 x 3 cm{sup 2} for an air cavity. The discrepancy was as large as 41% for the air cavity when the field size was 0.7 x 0.7 cm{sup 2}, highlighting one of the challenges of IMRT small field dosimetry. The LEGO-type phantom is also very useful for two-dimensional dosimetry analysis, which elucidates the electronic dis-equilibrium phenomena on or near the heterogeneity boundaries

Experience on IMRT treatment for prostate cancer. Planning, dosimetry and quality assurance; Experiencia en el tratamiento de IMRT en cancer de prostata. Planificacion, dosimetria y garantia de calidad

Energy Technology Data Exchange (ETDEWEB)

Gomez Barrado, A.; Garcia Vicente, F.; Fernandez Bedoya, V.; Zapatero Laborda, A.; Fernandez, I.; Bermudez Luna, R.; Perez Gonzalez, L.; Torres Escobar, J. J.

2011-07-01

In this study a revision concerning the treatment of prostate cancer with intensity-modulated radiation therapy (IMRT) is performed. Planning and verification of treatments involving dose calculations and image positioning are considered. A set of 110 patients is analysed concerning dosimetry and 92 considering image verification. Dose calculation is verified both experimentally and by means of a monitor unit (MU) calculation system. Positioning control of the prostate is achieved using intraprostatic fiducial markers and digitally reconstructed radiographs (DRRs) as well as a home-made software. All patients studied were consistent with the specifications of the treatment protocol regarding dose prescription in planning target volume (PTV), organ at risk (OAR) dose limitations, dosimetric quality assurance and positioning control. The procedure includes a learning curve considering every aspect of the treatment. The MU calculation system itself has been proved as an effective and functional tool for treatment verification. (Author) 12 refs.

SU-E-T-483: In Vivo Dosimetry of Conventional and Rotational Intensity Modulated Radiotherapy Using Integral Quality Monitor (IQM)

Energy Technology Data Exchange (ETDEWEB)

Lin, L; Qian, J; Gonzales, R; Keck, J; Armour, E; Wong, J [Johns Hopkins University, Baltimore, MD (United States)

2015-06-15

Purpose: To investigate the accuracy, sensitivity and constancy of integral quality monitor (IQM), a new system for in vivo dosimetry of conventional intensity modulated radiation therapy (IMRT) or rotational volumetric modulated arc therapy (VMAT) Methods: A beta-version IQM system was commissioned on an Elekta Infinity LINAC equipped with 160-MLCs Agility head. The stationary and rotational dosimetric constancy of IQM was evaluated, using five-field IMRT and single-or double-arc VMAT plans for prostate and head-and-neck (H&N) patients. The plans were delivered three times over three days to assess the constancy of IQM response. Picket fence (PF) fields were used to evaluate the sensitivity of detecting MLC leaf errors. A single leaf offset was intentionally introduced during delivery of various PF fields with segment apertures of 3×1, 5×1, 10×1, and 24×1cm2. Both 2mm and 5mm decrease in the field width were used. Results: Repeated IQM measurements of prostate and H&N IMRT deliveries showed 0.4 and 0.5% average standard deviation (SD) for segment-by-segment comparison and 0.1 and 0.2% for cumulative comparison. The corresponding SDs for VMAT deliveries were 6.5, 9.4% and 0.7, 1.3%, respectively. Statistical analysis indicates that the dosimetric differences detected by IQM were significant (p < 0.05) in all PF test deliveries. The largest average IQM signal response of a 2 mm leaf error was found to be 2.1% and 5.1% by a 5mm leaf error for 3×1 cm2 field size. The same error in 24×1 cm2 generates a 0.7% and 1.4% difference in the signal. Conclusion: IQM provides an effective means for real-time dosimetric verification of IMRT/ VMAT treatment delivery. For VMAT delivery, the cumulative dosimetry of IQM needs to be used in clinical practice.

Quality correction factors of composite IMRT beam deliveries: Theoretical considerations

International Nuclear Information System (INIS)

Bouchard, Hugo

2012-01-01

Purpose: In the scope of intensity modulated radiation therapy (IMRT) dosimetry using ionization chambers, quality correction factors of plan-class-specific reference (PCSR) fields are theoretically investigated. The symmetry of the problem is studied to provide recommendable criteria for composite beam deliveries where correction factors are minimal and also to establish a theoretical limit for PCSR delivery k Q factors. Methods: The concept of virtual symmetric collapsed (VSC) beam, being associated to a given modulated composite delivery, is defined in the scope of this investigation. Under symmetrical measurement conditions, any composite delivery has the property of having a k Q factor identical to its associated VSC beam. Using this concept of VSC, a fundamental property of IMRT k Q factors is demonstrated in the form of a theorem. The sensitivity to the conditions required by the theorem is thoroughly examined. Results: The theorem states that if a composite modulated beam delivery produces a uniform dose distribution in a volume V cyl which is symmetric with the cylindrical delivery and all beams fulfills two conditions in V cyl : (1) the dose modulation function is unchanged along the beam axis, and (2) the dose gradient in the beam direction is constant for a given lateral position; then its associated VSC beam produces no lateral dose gradient in V cyl , no matter what beam modulation or gantry angles are being used. The examination of the conditions required by the theorem lead to the following results. The effect of the depth-dose gradient not being perfectly constant with depth on the VSC beam lateral dose gradient is found negligible. The effect of the dose modulation function being degraded with depth on the VSC beam lateral dose gradient is found to be only related to scatter and beam hardening, as the theorem holds also for diverging beams. Conclusions: The use of the symmetry of the problem in the present paper leads to a valuable theorem showing

Real-time motion-adaptive-optimization (MAO) in TomoTherapy

Energy Technology Data Exchange (ETDEWEB)

Lu Weiguo; Chen Mingli; Ruchala, Kenneth J; Chen Quan; Olivera, Gustavo H [TomoTherapy Inc., 1240 Deming Way, Madison, WI (United States); Langen, Katja M; Kupelian, Patrick A [MD Anderson Cancer Center-Orlando, Orlando, FL (United States)], E-mail: wlu@tomotherapy.com

2009-07-21

IMRT delivery follows a planned leaf sequence, which is optimized before treatment delivery. However, it is hard to model real-time variations, such as respiration, in the planning procedure. In this paper, we propose a negative feedback system of IMRT delivery that incorporates real-time optimization to account for intra-fraction motion. Specifically, we developed a feasible workflow of real-time motion-adaptive-optimization (MAO) for TomoTherapy delivery. TomoTherapy delivery is characterized by thousands of projections with a fast projection rate and ultra-fast binary leaf motion. The technique of MAO-guided delivery calculates (i) the motion-encoded dose that has been delivered up to any given projection during the delivery and (ii) the future dose that will be delivered based on the estimated motion probability and future fluence map. These two pieces of information are then used to optimize the leaf open time of the upcoming projection right before its delivery. It consists of several real-time procedures, including 'motion detection and prediction', 'delivered dose accumulation', 'future dose estimation' and 'projection optimization'. Real-time MAO requires that all procedures are executed in time less than the duration of a projection. We implemented and tested this technique using a TomoTherapy (registered) research system. The MAO calculation took about 100 ms per projection. We calculated and compared MAO-guided delivery with two other types of delivery, motion-without-compensation delivery (MD) and static delivery (SD), using simulated 1D cases, real TomoTherapy plans and the motion traces from clinical lung and prostate patients. The results showed that the proposed technique effectively compensated for motion errors of all test cases. Dose distributions and DVHs of MAO-guided delivery approached those of SD, for regular and irregular respiration with a peak-to-peak amplitude of 3 cm, and for medium and large

Real-time motion-adaptive-optimization (MAO) in TomoTherapy

International Nuclear Information System (INIS)

Lu Weiguo; Chen Mingli; Ruchala, Kenneth J; Chen Quan; Olivera, Gustavo H; Langen, Katja M; Kupelian, Patrick A

2009-01-01

IMRT delivery follows a planned leaf sequence, which is optimized before treatment delivery. However, it is hard to model real-time variations, such as respiration, in the planning procedure. In this paper, we propose a negative feedback system of IMRT delivery that incorporates real-time optimization to account for intra-fraction motion. Specifically, we developed a feasible workflow of real-time motion-adaptive-optimization (MAO) for TomoTherapy delivery. TomoTherapy delivery is characterized by thousands of projections with a fast projection rate and ultra-fast binary leaf motion. The technique of MAO-guided delivery calculates (i) the motion-encoded dose that has been delivered up to any given projection during the delivery and (ii) the future dose that will be delivered based on the estimated motion probability and future fluence map. These two pieces of information are then used to optimize the leaf open time of the upcoming projection right before its delivery. It consists of several real-time procedures, including 'motion detection and prediction', 'delivered dose accumulation', 'future dose estimation' and 'projection optimization'. Real-time MAO requires that all procedures are executed in time less than the duration of a projection. We implemented and tested this technique using a TomoTherapy (registered) research system. The MAO calculation took about 100 ms per projection. We calculated and compared MAO-guided delivery with two other types of delivery, motion-without-compensation delivery (MD) and static delivery (SD), using simulated 1D cases, real TomoTherapy plans and the motion traces from clinical lung and prostate patients. The results showed that the proposed technique effectively compensated for motion errors of all test cases. Dose distributions and DVHs of MAO-guided delivery approached those of SD, for regular and irregular respiration with a peak-to-peak amplitude of 3 cm, and for medium and large prostate motions. The results conceptually

Lithium formate EPR dosimetry for verifications of planned dose distributions prior to intensity-modulated radiation therapy

Science.gov (United States)

Gustafsson, H.; Lund, E.; Olsson, S.

2008-09-01

The objective of the present investigation was to evaluate lithium formate electron paramagnetic resonance (EPR) dosimetry for measurement of dose distributions in phantoms prior to intensity-modulated radiation therapy (IMRT). Lithium formate monohydrate tablets were carefully prepared, and blind tests were performed in clinically relevant situations in order to determine the precision and accuracy of the method. Further experiments confirmed that within the accuracy of the current method, the dosimeter response was independent of beam energies and dose rates used for IMRT treatments. The method was applied to IMRT treatment plans, and the dose determinations were compared to ionization chamber measurements. The experiments showed that absorbed doses above 3 Gy could be measured with an uncertainty of less than 2.5% of the dose (coverage factor k = 1.96). Measurement time was about 15 min using a well-calibrated dosimeter batch. The conclusion drawn from the investigation was that lithium formate EPR dosimetry is a promising new tool for absorbed dose measurements in external beam radiation therapy, especially for doses above 3 Gy.

Lithium formate EPR dosimetry for verifications of planned dose distributions prior to intensity-modulated radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Gustafsson, H; Lund, E [Department of Medical and Health Sciences, Radiation Physics, Faculty of Health Sciences, Linkoeping University, S-581 85 Linkoeping (Sweden); Olsson, S [Division of Radiation Physics, Linkoeping University Hospital, S-581 85 Linkoeping (Sweden)], E-mail: hakgu@imv.liu.se

2008-09-07

The objective of the present investigation was to evaluate lithium formate electron paramagnetic resonance (EPR) dosimetry for measurement of dose distributions in phantoms prior to intensity-modulated radiation therapy (IMRT). Lithium formate monohydrate tablets were carefully prepared, and blind tests were performed in clinically relevant situations in order to determine the precision and accuracy of the method. Further experiments confirmed that within the accuracy of the current method, the dosimeter response was independent of beam energies and dose rates used for IMRT treatments. The method was applied to IMRT treatment plans, and the dose determinations were compared to ionization chamber measurements. The experiments showed that absorbed doses above 3 Gy could be measured with an uncertainty of less than 2.5% of the dose (coverage factor k = 1.96). Measurement time was about 15 min using a well-calibrated dosimeter batch. The conclusion drawn from the investigation was that lithium formate EPR dosimetry is a promising new tool for absorbed dose measurements in external beam radiation therapy, especially for doses above 3 Gy.

3D dosimetry by optical-CT scanning

Science.gov (United States)

Oldham, Mark

2006-12-01

The need for an accurate, practical, low-cost 3D dosimetry system is becoming ever more critical as modern dose delivery techniques increase in complexity and sophistication. A recent report from the Radiological Physics Center (RPC) (1), revealed that 38% of institutions failed the head-and-neck IMRT phantom credentialing test at the first attempt. This was despite generous passing criteria (within 7% dose-difference or 4mm distance-to-agreement) evaluated at a half-dozen points and a single axial plane. The question that arises from this disturbing finding is - what percentage of institutions would have failed if a comprehensive 3D measurement had been feasible, rather than measurements restricted to the central film-plane and TLD points? This question can only be adequately answered by a comprehensive 3D-dosimetry system, which presents a compelling argument for its development as a clinically viable low cost dosimetry solution. Optical-CT dosimetry is perhaps the closest system to providing such a comprehensive solution. In this article, we review the origins and recent developments of optical-CT dosimetry systems. The principle focus is on first generation systems known to have highest accuracy but longer scan times.

Development and implementation of In-vivo dosimetry with OSL in special techniques (IMRT, TBI, TSE); Desarrollo e implementacion de dosimetria In-vivo con OSL en tecnicas especiales (IMRT, TBI, TSE)

Energy Technology Data Exchange (ETDEWEB)

Bourel, V., E-mail: vbourel@favaloro.edu.ar [Universidad Favaloro, Buenos Aires (Argentina)

2015-10-15

Full text: Special techniques of radiation treatments generally require a quality control very thorough because in general tend to be high-risk techniques of complications due to imparting high doses in a small volume or involve a very large volume of the patient are the techniques of total body irradiation either photons or electrons. In these techniques a moderate error in the given dose can mean a very significant variation in tumor control probability (Tcp) or the likelihood of complications in normal tissues has happened in known published accidents and can be deduced from the typical sigmoid curve of response vs. dose. The technique In-vivo dosimetry has proved useful a final tool to detect any possible error in the chain of procedures to which is subjected prior to radiation treatment. This chain of procedures includes initial imaging, treatment planning involving the calibration of the equipment s, location and immobilization of the patient. The In-vivo dosimetry involves a measurement of the dose delivered to the patient in the treatment conditions to detect a possible deviation between the prescribed and the delivered dose. The experience so far has been done mainly with semiconductor elements (diodes) or thermoluminescent dosimetry. The advent of the optically stimulated luminescence dosimeters (OSLD), particularly in the nano Dots form, is a very appropriate tool for its size, ease of handling, accurate and fast reading. With these dosimeters has been developed and implemented the In-vivo dosimetry in three techniques in which the accuracy of the dose delivered is extremely important. These techniques are the treatment of intensity modulated radiation therapy (IMRT) that seeks to impart a very high dose in the tumor tissues protecting organs in risk around the target and the techniques of total body irradiation with photons, whose function is to generate immune suppression in patients before being transplanted, or with electrons for the treatment of

SU-F-T-283: A Novel Device to Enable Portal Dosimetry for Flattening Filter Free Beams

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Faught, A; Wu, Q; Adamson, J [Duke University Medical Center, Durham, NC (United States)

2016-06-15

Purpose: Varian’s electronic portal imaging device (EPID) based portal dosimetry tool is a popular and effective means of performing IMRT QA. EPIDs for older models of the TrueBeam accelerator utilize a 40cmx30cm Image Detection Unit (IDU) that saturates at the center for standard source to imager distances with high dose rate flattening filter free (FFF) beams. This makes portal dosimetry not possible and an alternative means of IMRT QA necessary. We developed a filter that would attenuate the beam to a dose rate measureable by the IDU for portal dosimetry IMRT QA. Methods: Multipurpose 304 stainless steel plates were placed on an accessory tray to attenuate the beam. Profiles of an open field measured on the IDU were acquired with varying number of plates to assess the thickness needed to reduce the maximum dose rates of 6XFFF and 10XFFF beams to measurable levels. A new portal dose image prediction (PDIP) model was commissioned based on open field measurements with plates in position, and a modified beam profile was input to portal dosimetry calibration at the console to empirically correct for attenuation and scatter. The portal dosimetry tool was used to assess agreement between predicted and measured doses for open 25×25cm{sup 2} fields and intensity modulated fields using 6XFFF and 10XFFF beams. Results: Thicknesses of 2.5cm and 3.8cm of steel were required to reduce the highest dose rates to a measureable level for 6XFFF and 10XFFF, respectively. Gamma analysis using a 3%/3mm relative criterion with the filter in place and using the new PDIP model resulted in 98.2% and 93.6% of pixels passing while intensity modulated fields showed passing rates of 98.2% and 99.0%. Conclusion: Use of the filter allows for portal dosimetry to be used for IMRT QA of FFF plans in place of purchasing a second option for IMRT QA.

Superior sulcus non-small cell lung carcinoma: A comparison of IMRT and 3D-RT dosimetry.

Science.gov (United States)

Truntzer, Pierre; Antoni, Delphine; Santelmo, Nicola; Schumacher, Catherine; Falcoz, Pierre-Emmanuel; Quoix, Elisabeth; Massard, Gilbert; Noël, Georges

2016-01-01

A dosimetric study comparing intensity modulated radiotherapy (IMRT) by TomoTherapy to conformational 3D radiotherapy (3D-RT) in patients with superior sulcus non-small cell lung cancer (NSCLC). IMRT became the main technique in modern radiotherapy. However it was not currently used for lung cancers. Because of the need to increase the dose to control lung cancers but because of the critical organs surrounding the tumors, the gains obtainable with IMRT is not still demonstrated. A dosimetric comparison of the planned target and organs at risk parameters between IMRT and 3D-RT in eight patients who received preoperative or curative intent irradiation. In the patients who received at least 66 Gy, the mean V95% was significantly better with IMRT than 3D-RT (p = 0.043). IMRT delivered a lower D2% compared to 3D-RT (p = 0.043). The IH was significantly better with IMRT (p = 0.043). The lung V 5 Gy and V 13 Gy were significantly higher in IMRT than 3D-RT (p = 0.043), while the maximal dose (D max) to the spinal cord was significantly lower in IMRT (p = 0.043). The brachial plexus D max was significantly lower in IMRT than 3D-RT (p = 0.048). For patients treated with 46 Gy, no significant differences were found. Our study showed that IMRT is relevant for SS-NSCLC. In patients treated with a curative dose, it led to a reduction of the exposure of critical organs, allowing a better dose distribution in the tumor. For the patients treated with a preoperative schedule, our results provide a basis for future controlled trials to improve the histological complete response by increasing the radiation dose.

Real-time in vivo rectal wall dosimetry using plastic scintillation detectors for patients with prostate cancer

Science.gov (United States)

Wootton, Landon; Kudchadker, Rajat; Lee, Andrew; Beddar, Sam

2014-02-01

We designed and constructed an in vivo dosimetry system using plastic scintillation detectors (PSDs) to monitor dose to the rectal wall in patients undergoing intensity-modulated radiation therapy for prostate cancer. Five patients were enrolled in an Institutional Review Board-approved protocol for twice weekly in vivo dose monitoring with our system, resulting in a total of 142 in vivo dose measurements. PSDs were attached to the surface of endorectal balloons used for prostate immobilization to place the PSDs in contact with the rectal wall. Absorbed dose was measured in real time and the total measured dose was compared with the dose calculated by the treatment planning system on the daily computed tomographic image dataset. The mean difference between measured and calculated doses for the entire patient population was -0.4% (standard deviation 2.8%). The mean difference between daily measured and calculated doses for each patient ranged from -3.3% to 3.3% (standard deviation ranged from 5.6% to 7.1% for four patients and was 14.0% for the last, for whom optimal positioning of the detector was difficult owing to the patient's large size). Patients tolerated the detectors well and the treatment workflow was not compromised. Overall, PSDs performed well as in vivo dosimeters, providing excellent accuracy, real-time measurement and reusability.

Commissioning of Portal Dosimetry and characterization of an EPID; Comissionamento de Portal Dosimetry e caracterizacao de EPID

Energy Technology Data Exchange (ETDEWEB)

Olbi, D.S.; Sales, C.P. [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina; Nakandakari, M.V.N., E-mail: diego.olbi@hc.fm.usp.br [Instituto do Cancer do Estado de Sao Paulo, SP (Brazil). Servico de Radioterapia

2016-07-01

The development of technologies compensator blocks, MLC, high dose rate accelerators, treatment planning systems, among others, permitted that new treatment techniques in radiotherapy were created. Such techniques have the capacity to modulate radiation beam fluency (IMRT, VMAT), or to deliver high doses in few fractions or unique fractions (SRS). Following the same tendency, quality control of planning became more complex. It is necessary to evaluate the fluency delivered by the accelerator. Its levels of does and its spatial distribution should co-occur with the fluency calculated by TPS. Acquisition of new detector devices in quality control of treatments is fundamental to apply techniques. Portal Vision is a device EPID has the capacity to operate either in image mode or dosimetry mode, with the allowance of Portal Dosimetry. To evaluated planning in IMRT, the device is irradiated using planning e, therefore, the fluency measured is compared with calculated fluency, through gamma analysis. The aim of this work was to perform tests of commissioning of this device. (author)

Dosimetric impact of interplay effect in lung IMRT and VMAT treatment using in-house dynamic thorax phantom

International Nuclear Information System (INIS)

Mukhlisin; Pawiro, S A

2016-01-01

Tumor motion due to patient's respiratory is a significant problem in radiotherapy treatment of lung cancer. The purpose of this project is to study the interplay effect through dosimetry verification between the calculated and delivered dose, as well as the dosimetric impact of leaf interplay with breathing-induced tumor motion in IMRT and VMAT treatment. In this study, a dynamic thorax phantom was designed and constructed for dosimetry measurement. The phantom had a linear sinusoidal tumor motion toward superior-inferior direction with variation of amplitudes and periods. TLD-100 LiF:Mg,Ti and Gafchromic EBT2 film were used to measure dose in the midpoint target and the spinal cord. The IMRT and VMAT treatment had prescription dose of 200 cGy per fraction. The dosimetric impact due to interplay effect during IMRT and VMAT treatment were resulted in the range of 0.5% to -6.6% and 0.9% to -5.3% of target dose reduction, respectively. Meanwhile, mean dose deviation of spinal cord in IMRT and VMAT treatment were around 1.0% to -6.9% and 0.9% to -6.3%, respectively. The results showed that if respiratory management technique were not implemented, the presence of lung tumor motion during dose delivery in IMRT and VMAT treatment causes dose discrepancies inside tumor volume. (paper)

Six years of experience in the planning and verification of the IMRT dynamics with portal dosimetry; Seis anos de expereincia en la planificacion y verificacion de la IMRT dinamica con portal dosimetry

Energy Technology Data Exchange (ETDEWEB)

Molina Lopez, M. Y.; Pardo Perez, E.; Ruiz Maqueda, S.; Castro Novais, J.; Diaz Gavela, A. A.

2013-07-01

The objective of this study is the make a review of the method of verification of the IMRT throughout the 6 years of functioning of the service of-radiophysics and radiology protection, analyzing the parameters of each field evaluation to the 718 made IMRT during this period. (Author)

In vivo portal dosimetry for head-and-neck VMAT and lung IMRT: Linking γ-analysis with differences in dose–volume histograms of the PTV

International Nuclear Information System (INIS)

Rozendaal, Roel Arthur; Mijnheer, Ben J.; Herk, Marcel van; Mans, Anton

2014-01-01

Purpose: To relate the results of γ-analysis and dose–volume histogram (DVH) analysis of the PTV for detecting dose deviations with in vivo dosimetry for two treatment sites. Methods and materials: In vivo 3D dose distributions were reconstructed for 722 fractions of 200 head-and-neck (H and N) VMAT treatments and 183 fractions of 61 lung IMRT plans. The reconstructed and planned dose distributions in the PTV were compared using (a) the γ-distribution and (b) the differences in D2, D50 and D98 between the two dose distributions. Using pre-defined tolerance levels, all fractions were classified as deviating or not deviating by both methods. The mutual agreement, the sensitivity and the specificity of the two methods were compared. Results: For lung IMRT, the classification of the fractions was nearly identical for γ- and DVH-analyses of the PTV (94% agreement) and the sensitivity and specificity were comparable for both methods. Less agreement (80%) was found for H and N VMAT, while γ-analysis was both less sensitive and less specific. Conclusions: DVH- and γ-analyses perform nearly equal in finding dose deviations in the PTV for lung IMRT treatments; for H and N VMAT treatments, DVH-analysis is preferable. As a result of this study, a smooth transition to using DVH-analysis clinically for detecting in vivo dose deviations in the PTV is within reach

Inverse IMRT workflow process at Austin health

International Nuclear Information System (INIS)

Rykers, K.; Fernando, W.; Grace, M.; Liu, G.; Rolfo, A.; Viotto, A.; Mantle, C.; Lawlor, M.; Au-Yeung, D.; Quong, G.; Feigen, M.; Lim-Joon, D.; Wada, M.

2004-01-01

Full text: The work presented here will review the strategies adopted at Austin Health to bring IMRT into clinical use. IMRT is delivered using step and shoot mode on an Elekta Precise machine with 40 pairs of 1cm wide MLC leaves. Planning is done using CMS Focus/XiO. A collaborative approach for RO's, Physicists and RTs from concept to implementation was adopted. An overview will be given of the workflow for the clinic, the equipment used, tolerance levels and the lessons learned. 1. Strategic Planning for IMRT 2. Training a. MSKCC (New York) b.ESTRO (Amsterdam) c.Elekta (US and UK) 3. Linac testing and data acquisition a. Equipment and software review and selection b. Linac reliability/geometric and mechanical checks c. Draft Patient QA procedure d. EPI Image matching checks and procedures 4. Planning system checks a. export of dose matrix (options) b. dose calculation choices 5. IMRT Research Initiatives a. IMRT Planning Studies, Stabilisation, On-line Imaging 6. Equipment Procurement and testing a. Physics and Linac Equipment, Hardware, Software/Licences, Stabilisation 7. Establishing a DICOM Environment a. Prescription sending, Image transfer for EPI checks b. QA Files 8. Physics QA (Pre-Treatment) a.Clinical plan review; DVH checks b. geometry; dosimetry checks; DICOM checks c. 2D Distance to agreement; mm difference reports; Gamma function index 9. Documentation a.Protocol Development i. ICRU 50/62 reporting and prescribing b. QA for Physics c. QA for RT's d. Generation of a report for RO/patient history. Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine

SU-E-T-454: Impact of Calculation Grid Size On Dosimetry and Radiobiological Parameters for Head and Neck IMRT

Energy Technology Data Exchange (ETDEWEB)

Srivastava, S; Das, I [Purdue University, West Lafayette, IN (United States); Indiana University Health Methodist Hospital, Indianapolis, IN (United States); Indiana University- School of Medicine, Indianapolis, IN (United States); Cheng, C [Purdue University, West Lafayette, IN (United States); Indiana University Health Methodist Hospital, Indianapolis, IN (United States)

2014-06-01

Purpose: IMRT has become standard of care for complex treatments to optimize dose to target and spare normal tissues. However, the impact of calculation grid size is not widely known especially dose distribution, tumor control probability (TCP) and normal tissue complication probability (NTCP) which is investigated in this study. Methods: Ten head and neck IMRT patients treated with 6 MV photons were chosen for this study. Using Eclipse TPS, treatment plans were generated for different grid sizes in the range 1–5 mm for the same optimization criterion with specific dose-volume constraints. The dose volume histogram (DVH) was calculated for all IMRT plans and dosimetric data were compared. ICRU-83 dose points such as D2%, D50%, D98%, as well as the homogeneity and conformity indices (HI, CI) were calculated. In addition, TCP and NTCP were calculated from DVH data. Results: The PTV mean dose and TCP decreases with increasing grid size with an average decrease in mean dose by 2% and TCP by 3% respectively. Increasing grid size from 1–5 mm grid size, the average mean dose and NTCP for left parotid was increased by 6.0% and 8.0% respectively. Similar patterns were observed for other OARs such as cochlea, parotids and spinal cord. The HI increases up to 60% and CI decreases on average by 3.5% between 1 and 5 mm grid that resulted in decreased TCP and increased NTCP values. The number of points meeting the gamma criteria of ±3% dose difference and ±3mm DTA was higher with a 1 mm on average (97.2%) than with a 5 mm grid (91.3%). Conclusion: A smaller calculation grid provides superior dosimetry with improved TCP and reduced NTCP values. The effect is more pronounced for smaller OARs. Thus, the smallest possible grid size should be used for accurate dose calculation especially in H and N planning.

Radiation dose verification using real tissue phantom in modern radiotherapy techniques

International Nuclear Information System (INIS)

Gurjar, Om Prakash; Mishra, S.P.; Bhandari, Virendra; Pathak, Pankaj; Patel, Prapti; Shrivastav, Garima

2014-01-01

In vitro dosimetric verification prior to patient treatment has a key role in accurate and precision radiotherapy treatment delivery. Most of commercially available dosimetric phantoms have almost homogeneous density throughout their volume, while real interior of patient body has variable and varying densities inside. In this study an attempt has been made to verify the physical dosimetry in actual human body scenario by using goat head as 'head phantom' and goat meat as 'tissue phantom'. The mean percentage variation between planned and measured doses was found to be 2.48 (standard deviation (SD): 0.74), 2.36 (SD: 0.77), 3.62 (SD: 1.05), and 3.31 (SD: 0.78) for three-dimensional conformal radiotherapy (3DCRT) (head phantom), intensity modulated radiotherapy (IMRT; head phantom), 3DCRT (tissue phantom), and IMRT (tissue phantom), respectively. Although percentage variations in case of head phantom were within tolerance limit (< ± 3%), but still it is higher than the results obtained by using commercially available phantoms. And the percentage variations in most of cases of tissue phantom were out of tolerance limit. On the basis of these preliminary results it is logical and rational to develop radiation dosimetry methods based on real human body and also to develop an artificial phantom which should truly represent the interior of human body. (author)

Radiation dose verification using real tissue phantom in modern radiotherapy techniques

Directory of Open Access Journals (Sweden)

Om Prakash Gurjar

2014-01-01

Full Text Available In vitro dosimetric verification prior to patient treatment has a key role in accurate and precision radiotherapy treatment delivery. Most of commercially available dosimetric phantoms have almost homogeneous density throughout their volume, while real interior of patient body has variable and varying densities inside. In this study an attempt has been made to verify the physical dosimetry in actual human body scenario by using goat head as "head phantom" and goat meat as "tissue phantom". The mean percentage variation between planned and measured doses was found to be 2.48 (standard deviation (SD: 0.74, 2.36 (SD: 0.77, 3.62 (SD: 1.05, and 3.31 (SD: 0.78 for three-dimensional conformal radiotherapy (3DCRT (head phantom, intensity modulated radiotherapy (IMRT; head phantom, 3DCRT (tissue phantom, and IMRT (tissue phantom, respectively. Although percentage variations in case of head phantom were within tolerance limit (< ± 3%, but still it is higher than the results obtained by using commercially available phantoms. And the percentage variations in most of cases of tissue phantom were out of tolerance limit. On the basis of these preliminary results it is logical and rational to develop radiation dosimetry methods based on real human body and also to develop an artificial phantom which should truly represent the interior of human body.

Developments in physical dosimetry and radiation protection; Entwicklungen in der physikalischen Dosimetrie im Strahlenschutz

Energy Technology Data Exchange (ETDEWEB)

Fiebich, Martin [Technische Hochschule Mittelhessen, Giessen (Germany). Inst. fuer Medizinische Physik und Strahlenschutz

2017-07-01

In the frame of physical dosimetry new dose units have been defined: the depth personal dose (equivalent dose in 10 mm depth) and the surface personal dose (equivalent dose in 0.07 mm depth). Physical dosimetry is applied for the determination of occupational radiation exposure, the radiation protected area control, the estimation of radiation exposure of patients during radiotherapy, for quality assurance and in research projects and optimization challenges. Developments have appeared with respect to punctual measuring chambers, eye lens dosimetry, OSL (optically stimulated luminescence) dosimetry, real-time dosimetry and Monte Carlo methods. New detection limits of about 1 micro Gy were reached.

Novel, full 3D scintillation dosimetry using a static plenoptic camera

Science.gov (United States)

Goulet, Mathieu; Rilling, Madison; Gingras, Luc; Beddar, Sam; Beaulieu, Luc; Archambault, Louis

2014-01-01

Purpose: Patient-specific quality assurance (QA) of dynamic radiotherapy delivery would gain from being performed using a 3D dosimeter. However, 3D dosimeters, such as gels, have many disadvantages limiting to quality assurance, such as tedious read-out procedures and poor reproducibility. The purpose of this work is to develop and validate a novel type of high resolution 3D dosimeter based on the real-time light acquisition of a plastic scintillator volume using a plenoptic camera. This dosimeter would allow for the QA of dynamic radiation therapy techniques such as intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT). Methods: A Raytrix R5 plenoptic camera was used to image a 10 × 10 × 10 cm3 EJ-260 plastic scintillator embedded inside an acrylic phantom at a rate of one acquisition per second. The scintillator volume was irradiated with both an IMRT and VMAT treatment plan on a Clinac iX linear accelerator. The 3D light distribution emitted by the scintillator volume was reconstructed at a 2 mm resolution in all dimensions by back-projecting the light collected by each pixel of the light-field camera using an iterative reconstruction algorithm. The latter was constrained by a beam's eye view projection of the incident dose acquired using the portal imager integrated with the linac and by physical consideration of the dose behavior as a function of depth in the phantom. Results: The absolute dose difference between the reconstructed 3D dose and the expected dose calculated using the treatment planning software Pinnacle3 was on average below 1.5% of the maximum dose for both integrated IMRT and VMAT deliveries, and below 3% for each individual IMRT incidences. Dose agreement between the reconstructed 3D dose and a radiochromic film acquisition in the same experimental phantom was on average within 2.1% and 1.2% of the maximum recorded dose for the IMRT and VMAT delivery, respectively. Conclusions: Using plenoptic camera

An evaluation of gating window size, delivery method, and composite field dosimetry of respiratory-gated IMRT

International Nuclear Information System (INIS)

Hugo, Geoffrey D.; Agazaryan, Nzhde; Solberg, Timothy D.

2002-01-01

A respiratory gating system has been developed based on a commercial patient positioning system. The purpose of this study is to investigate the ability of the gating system to reproduce normal, nongated IMRT operation and to quantify the errors produced by delivering a nongated IMRT treatment onto a moving target. A moving phantom capable of simultaneous two-dimensional motion was built, and an analytical liver motion function was used to drive the phantom. Studies were performed to assess the effect of gating window size and choice of delivery method (segmented and dynamic multileaf collimation). Additionally, two multiple field IMRT cases were delivered to quantify the error in gated and nongated IMRT with motion. Dosimetric error between nonmoving and moving deliveries is related to gating window size. By reducing the window size, the error can be reduced. Delivery error can be reduced for both dynamic and segmented delivery with gating. For the implementation of dynamic IMRT delivery in this study, dynamic delivery was found to generate larger delivery errors than segmented delivery in most cases studied. For multiple field IMRT delivery, the largest errors were generated in regions where high field modulation was present parallel to the axis of motion. Gating was found to reduce these large errors to clinically acceptable levels

Recent developments in polymer gel dosimetry

International Nuclear Information System (INIS)

John Schreiner, L.; Olding, Tim; Holmes, Oliver; McAuley, Kim

2008-01-01

Modern radiation therapy particularly with intensity modulation techniques (IMRT) offers the potential to improve patient outcomes by better limiting high doses to the tumour alone. In this presentation we report our progress in developing gel dosimetry with new less toxic dosimeters using a fast commercial optical computed tomography (OCT) scanner. We will demonstrate that these adjustments in the approach to gel dosimetry help facilitate its introduction into clinical use. We will review practical advances in system quality assurance and scatter correction to improve optical CT quantification, and show an example of a clinical implementation of an IGRT treatment validation

Single-Arc IMRT?

International Nuclear Information System (INIS)

Bortfeld, Thomas; Webb, Steve

2009-01-01

The idea of delivering intensity-modulated radiation therapy (IMRT) with a multileaf collimator in a continuous dynamic mode during a single rotation of the gantry has recently gained momentum both in research and industry. In this note we investigate the potential of this Single-Arc IMRT technique at a conceptual level. We consider the original theoretical example case from Brahme et al that got the field of IMRT started. Using analytical methods, we derive deliverable intensity 'landscapes' for Single-Arc as well as standard IMRT and Tomotherapy. We find that Tomotherapy provides the greatest flexibility in shaping intensity landscapes and that it allows one to deliver IMRT in a way that comes close to the ideal case in the transverse plane. Single-Arc and standard IMRT make compromises in different areas. Only in relatively simple cases that do not require substantial intensity modulation will Single-Arc be dosimetrically comparable to Tomotherapy. Compared with standard IMRT, Single-Arc could be dosimetrically superior in certain cases if one is willing to accept the spreading of low dose values over large volumes of normal tissue. In terms of treatment planning, Single-Arc poses a more challenging optimization problem than Tomotherapy or standard IMRT. We conclude that Single-Arc holds potential as an efficient IMRT technique especially for relatively simple cases. In very complex cases, Single-Arc may unduly compromise the quality of the dose distribution, if one tries to keep the treatment time below 2 min or so. As with all IMRT techniques, it is important to explore the tradeoff between plan quality and the efficiency of its delivery carefully for each individual case. (note)

Telepositional portable real time radiation monitoring system

International Nuclear Information System (INIS)

Talpalariu, Jeni; Matei, Corina; Popescu, Oana

2010-01-01

Technology development for complex portable networks is on going to meet the area dosimetry challenge, improving the basic design using new telepositional GPS satellite methods and GSM terrestrial civil radio transmission networks. The system and devices proposed overcome the limitations of fixed and portable dosimeters, providing wireless real time radiations data and geospatial information's means, using many portable dosimeter stations and a mobile dosimeter computerised central console. (authors)

Dosimetry applied to radiology and radiotherapy

International Nuclear Information System (INIS)

Yoshimura, Elisabeth Mateus

2010-01-01

Full text. The uses of ionizing radiation in medicine are increasing worldwide, and the population doses increase as well. The actual radiation protection philosophy is based on the balance of risks and benefits related to the practices, and patient dosimetry has an important role in the implementation of this point of view. In radiology the goal is to obtain an image with diagnostic quality with the minimum patient dose. In modern Radiotherapy the cure indexes are higher, giving rise to longer survival times to the patients. Dosimetry in radiotherapy helps the treatment planning systems to get a better protection to critical organs, with higher doses to the tumor, with a guarantee of better life quality to the patient. We will talk about the new trends in dosimetry of medical procedures, including experimental techniques and calculation tools developed to increase reliability and precision of dose determination. In radiology the main concerns of dosimetry are: the transition from film- radiography to digital image, the pediatric patient doses, and the choice of dosimetric quantities to quantify fluoroscopy and tomography patient doses. As far as Radiotherapy is concerned, there is a search for good experimental techniques to quantify doses to tissues adjacent to the target volumes in patients treated with new radiotherapy techniques, as IMRT and heavy particle therapy. (author)

Pareto navigation-algorithmic foundation of interactive multi-criteria IMRT planning

International Nuclear Information System (INIS)

Monz, M; Kuefer, K H; Bortfeld, T R; Thieke, C

2008-01-01

Inherently, IMRT treatment planning involves compromising between different planning goals. Multi-criteria IMRT planning directly addresses this compromising and thus makes it more systematic. Usually, several plans are computed from which the planner selects the most promising following a certain procedure. Applying Pareto navigation for this selection step simultaneously increases the variety of planning options and eases the identification of the most promising plan. Pareto navigation is an interactive multi-criteria optimization method that consists of the two navigation mechanisms 'selection' and 'restriction'. The former allows the formulation of wishes whereas the latter allows the exclusion of unwanted plans. They are realized as optimization problems on the so-called plan bundle-a set constructed from pre-computed plans. They can be approximately reformulated so that their solution time is a small fraction of a second. Thus, the user can be provided with immediate feedback regarding his or her decisions. Pareto navigation was implemented in the MIRA navigator software and allows real-time manipulation of the current plan and the set of considered plans. The changes are triggered by simple mouse operations on the so-called navigation star and lead to real-time updates of the navigation star and the dose visualizations. Since any Pareto-optimal plan in the plan bundle can be found with just a few navigation operations the MIRA navigator allows a fast and directed plan determination. Besides, the concept allows for a refinement of the plan bundle, thus offering a middle course between single plan computation and multi-criteria optimization. Pareto navigation offers so far unmatched real-time interactions, ease of use and plan variety, setting it apart from the multi-criteria IMRT planning methods proposed so far

Pareto navigation: algorithmic foundation of interactive multi-criteria IMRT planning.

Science.gov (United States)

Monz, M; Küfer, K H; Bortfeld, T R; Thieke, C

2008-02-21

Inherently, IMRT treatment planning involves compromising between different planning goals. Multi-criteria IMRT planning directly addresses this compromising and thus makes it more systematic. Usually, several plans are computed from which the planner selects the most promising following a certain procedure. Applying Pareto navigation for this selection step simultaneously increases the variety of planning options and eases the identification of the most promising plan. Pareto navigation is an interactive multi-criteria optimization method that consists of the two navigation mechanisms 'selection' and 'restriction'. The former allows the formulation of wishes whereas the latter allows the exclusion of unwanted plans. They are realized as optimization problems on the so-called plan bundle -- a set constructed from pre-computed plans. They can be approximately reformulated so that their solution time is a small fraction of a second. Thus, the user can be provided with immediate feedback regarding his or her decisions. Pareto navigation was implemented in the MIRA navigator software and allows real-time manipulation of the current plan and the set of considered plans. The changes are triggered by simple mouse operations on the so-called navigation star and lead to real-time updates of the navigation star and the dose visualizations. Since any Pareto-optimal plan in the plan bundle can be found with just a few navigation operations the MIRA navigator allows a fast and directed plan determination. Besides, the concept allows for a refinement of the plan bundle, thus offering a middle course between single plan computation and multi-criteria optimization. Pareto navigation offers so far unmatched real-time interactions, ease of use and plan variety, setting it apart from the multi-criteria IMRT planning methods proposed so far.

Commissioning of Portal Dosimetry and characterization of an EPID

International Nuclear Information System (INIS)

Olbi, D.S.; Sales, C.P.; Nakandakari, M.V.N.

2016-01-01

The development of technologies compensator blocks, MLC, high dose rate accelerators, treatment planning systems, among others, permitted that new treatment techniques in radiotherapy were created. Such techniques have the capacity to modulate radiation beam fluency (IMRT, VMAT), or to deliver high doses in few fractions or unique fractions (SRS). Following the same tendency, quality control of planning became more complex. It is necessary to evaluate the fluency delivered by the accelerator. Its levels of does and its spatial distribution should co-occur with the fluency calculated by TPS. Acquisition of new detector devices in quality control of treatments is fundamental to apply techniques. Portal Vision is a device EPID has the capacity to operate either in image mode or dosimetry mode, with the allowance of Portal Dosimetry. To evaluated planning in IMRT, the device is irradiated using planning e, therefore, the fluency measured is compared with calculated fluency, through gamma analysis. The aim of this work was to perform tests of commissioning of this device. (author)

Conformal intensity-modulated radiotherapy (IMRT) delivered by robotic linac-conformality versus efficiency of dose delivery

International Nuclear Information System (INIS)

Webb, Steve

2000-01-01

Intensity-modulated radiotherapy (IMRT) may be delivered with a high-energy-photon linac mounted on a robotic gantry and executing a complex trajectory. In a previous paper an inverse-planning technique was developed for such an application. Here the work is extended to demonstrate the dependence of conformality on the size of the elemental pencil beam, on the complexity of the trajectory and on the sampling of azimuth and elevation of the collimated source. The improved conformality of complex trajectories is demonstrated and benchmarked relative to simpler trajectories, more representative of existing non-robotic IMRT techniques. Specifically, by choosing a very fine pencil beam, exquisitely conformal dose distributions have been obtained. Important sampling considerations have been determined. Expressions have been derived for the dosimetry and monitor-unit efficiency of robotic IMRT. Equivalent trajectories were computed for executing the complex robotic trajectories instead by using a conventional linac. The work benchmarks an ideal in IMRT against which more practical and more common techniques may be measured. (author)

MAGAT gel dosimetry for its application in small field treatment techniques

International Nuclear Information System (INIS)

Gopishankar, N; Vivekanandhan, S; Kale, S S; Rath, G K; Kumaran, S Senthil; Thulkar, Sanjay; Subramani, V; Laviraj, M A; Bisht, R K; Mahapatra, A K

2010-01-01

Purpose of this work is to present the role of in-house manufactured MAGAT gel for treatment verification in small field dosimetric techniques such as Gammaknife (GK) and intensity-modulated radiation therapy (IMRT). Magnetic resonance imaging (MRI) is one of the most extensively used imaging technique for polymer gel dosimetry hence we used this method for gel evaluation. Different MR scanners and MRI sequences were used in this study for obtaining calibration plot between R2 and absorbed dose. An experimental plan was created for Gammaknife and IMRT. The prepared gel was filled in spherical glass phantom and in-house designed human head shape phantom for verification purpose. We used 8 TE values for all the imaging sequences for two reasons. Firstly it is sufficient enough to give good signal to noise ratio. Second considering the enormous scanning time involved in multiple spin echo sequence. MATLAB based in-house programs were used for R2 estimation and dose comparison. The isodose comparison with MAGAT gel showed reasonable agreement for both Gammaknife and IMRT techniques.

A Quality Assurance Method that Utilizes 3D Dosimetry and Facilitates Clinical Interpretation

Energy Technology Data Exchange (ETDEWEB)

Oldham, Mark, E-mail: mark.oldham@duke.edu [Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Thomas, Andrew; O' Daniel, Jennifer; Juang, Titania [Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Ibbott, Geoffrey [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Adamovics, John [Rider University, Lawrenceville, New Jersey (United States); Kirkpatrick, John P. [Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

2012-10-01

Purpose: To demonstrate a new three-dimensional (3D) quality assurance (QA) method that provides comprehensive dosimetry verification and facilitates evaluation of the clinical significance of QA data acquired in a phantom. Also to apply the method to investigate the dosimetric efficacy of base-of-skull (BOS) intensity-modulated radiotherapy (IMRT) treatment. Methods and Materials: Two types of IMRT QA verification plans were created for 6 patients who received BOS IMRT. The first plan enabled conventional 2D planar IMRT QA using the Varian portal dosimetry system. The second plan enabled 3D verification using an anthropomorphic head phantom. In the latter, the 3D dose distribution was measured using the DLOS/Presage dosimetry system (DLOS = Duke Large-field-of-view Optical-CT System, Presage Heuris Pharma, Skillman, NJ), which yielded isotropic 2-mm data throughout the treated volume. In a novel step, measured 3D dose distributions were transformed back to the patient's CT to enable calculation of dose-volume histograms (DVH) and dose overlays. Measured and planned patient DVHs were compared to investigate clinical significance. Results: Close agreement between measured and calculated dose distributions was observed for all 6 cases. For gamma criteria of 3%, 2 mm, the mean passing rate for portal dosimetry was 96.8% (range, 92.0%-98.9%), compared to 94.9% (range, 90.1%-98.9%) for 3D. There was no clear correlation between 2D and 3D passing rates. Planned and measured dose distributions were evaluated on the patient's anatomy, using DVH and dose overlays. Minor deviations were detected, and the clinical significance of these are presented and discussed. Conclusions: Two advantages accrue to the methods presented here. First, treatment accuracy is evaluated throughout the whole treated volume, yielding comprehensive verification. Second, the clinical significance of any deviations can be assessed through the generation of DVH curves and dose overlays on

Six years of experience in the planning and verification of the IMRT dynamics with portal dosimetry

International Nuclear Information System (INIS)

Molina Lopez, M. Y.; Pardo Perez, E.; Ruiz Maqueda, S.; Castro Novais, J.; Diaz Gavela, A. A.

2013-01-01

The objective of this study is the make a review of the method of verification of the IMRT throughout the 6 years of functioning of the service of-radiophysics and radiology protection, analyzing the parameters of each field evaluation to the 718 made IMRT during this period. (Author)

Occupational dosimetry in real time hemodynamic rooms. utility of the system Dose-aware as a training tool; Dosimetria ocupacional en tiempo real en salas de hemodinamica. Utilidad del Sistema Dose-Aware como herramienta formativa

Energy Technology Data Exchange (ETDEWEB)

Pinto Monedero, M.; Rodriguez Cobo, C.; Pifarre Martinez, X.; Ruiz Martin, J.; Barros Candelero, J. M.; Goicolea Ruigomez, J.; Diaz Blaires, G.; Garcia Lunar

2014-02-01

This paper presents the results from a study in a real time dosimetry system used in the catheter laboratory room of our center. The objective was to know the occupational doses per procedure, on the one hand, and, on the other hand, to evaluate its utility as a learning tool for radiation protection purposes with the simultaneous video recording of the interventions. 83 diagnostic and therapeutic procedures were analyzed, and an average dose per procedure of 0,37 {mu}Sv and 0,10 {mu}Sv for the main cardiologist and nurse were obtained, respectively. 36 of these interventions were also recorded and the images were synchronized with the dosimetric information stored and the dosimetry system. The findings were presented to the interventional cardiology team in a learning session. They showed a high level of satisfaction with this new method of optimizing the occupational doses through a customized learning session. (Author)

Comparison of radiotherapy dosimetry for 3D-CRT, IMRT, and SBRT based on electron density calibration

International Nuclear Information System (INIS)

Kartutik, K; Pawiro, S A; Wibowo, W E

2016-01-01

Accurate calculation of dose distribution affected by inhomogeneity tissue is required in radiotherapy planning. This study was performed to determine the ratio between radiotherapy planning using 3D-CRT, IMRT, and SBRT based on a calibrated curve of CT-number in the lung for different target's shape in 3D-CRT, IMRT, and spinal cord for SBRT. Calibration curves of CT-number were generated under measurement basis and introduced into TPS, then planning was performed for 3D-CRT, IMRT, and SBRT with 7, and 15 radiation fields. Afterwards, planning evaluation was performed by comparing the DVH curve, HI, and CI. 3D-CRT and IMRT produced the lowest HI at calibration curve of CIRS 002LFC with the value 0.24 and 10. Whereas SBRT produced the lowest HI on a linear calibration curve with a value of 0.361. The highest CI in IMRT and SBRT technique achieved using a linear calibration curve was 0.97 and 1.77 respectively. For 3D-CRT, the highest CI was obtained by using calibration curve of CIRS 062M with the value of 0.45. From the results of CI and HI, it is concluded that the calibration curve of CT-number does not significantly differ with Schneider's calibrated curve, and inverse planning gives a better result than forward planning. (paper)

SU-E-T-83: A Study On Evaluating the Directional Dependency of 2D Seven 29 Ion Chamber Array Clinically with Different IMRT Plans

Energy Technology Data Exchange (ETDEWEB)

Kumar, Syam [Malabar Cancer Centre, Kannur, Kerala (India); Aswathi, C.P. [University of Calicut, Calicut, Kerala (India)

2015-06-15

Purpose: To evaluate the directional dependency of 2D seven 29 ion chamber array clinically with different IMRT plans. Methods: 25 patients already treated with IMRT plans were selected for the study. Verification plans were created for each treatment plan in eclipse 10 treatment planning system using the AAA algorithm with the 2D array and the Octavius CT phantom. Verification plans were done 2 times for a single patient. First plan with real IMRT (plan-related approach) and second plan with zero degree gantry angle (field-related approach). Measurements were performed on a Varian Clinac-iX, linear accelerator equipped with a millennium 120 multileaf collimator. Fluence was measured for all the delivered plans and analyzed using the verisoft software. Comparison was done by selecting the fluence delivered in static gantry (zero degree gantry) versus IMRT with real gantry angles. Results: The gamma pass percentage is greater than 97 % for all IMRT delivered with zero gantry angle and between 95%–98% for real gantry angles. Dose difference between the TPS calculated and measured for IMRT delivered with zero gantry angle was found to be between (0.03 to 0.06Gy) and with real gantry angles between (0.02 to 0.05Gy). There is a significant difference between the gamma analysis between the zero degree and true angle with a significance of 0.002. Standard deviation of gamma pass percentage between the IMRT plans with zero gantry angle was 0.68 and for IMRT with true gantry angle was found to be 0.74. Conclusion: The gamma analysis for IMRT with zero degree gantry angles shows higher pass percentage than IMRT delivered with true gantry angles. Verification plans delivered with true gantry angles lower the verification accuracy when 2D array is used for measurement.

Dosimetry optimization at COGEMA-La Hague

International Nuclear Information System (INIS)

Kalimbadjian, J.

2000-01-01

At the present time, the la Hague site strives to apply international recommendations together with national regulations concerning radiation protection, and especially the respect of limitation and optimization principles. The application of these principles is based on the implementation of a passive dosimetry and an active dosimetry. The monthly passive dosimetry is monitored by means of a photographic dosimetry film, completed with lithium fluorine thermoluminescent film badges. This personal dosimetry common to X, β, γ and neutron radiations is carried out in close relationship between the Radiation Protection Department, the Occupational Medical Department and the staff running the Plant. The application or ALARA's principle as well as that of radiation protection optimization implies to implement a complementary active dosimetry enabling to gain in real time, the personal dosimetry of each intervening person, either they be COGEMA's workers or external companies'. This active dosimetry provides with following information: This preventive dosimetry is based on the knowledge of doses integration in real time and is fitted with alarm thresholds according to the total amount of doses and dose rates. Thresholds on the dose rate are also set relatively to the radiological environment. This knowledge of doses and dose rates allows a stricter management of the works, while analyzing them according to the nature of the work, to the location and to the skills of the intervening people. This dosimetry allows to analyze and optimize doses integration according to the works nature for the whole intervening staff. The la Hague Site has developed an active personal dosimetry system, common to every intervening person, COGEMA or external companies. The DOSICARD was thus elaborated, shaped as an electronic dosimeter fitted with an alarm and a smart card. The access to controlled areas is conditioned to information given by the DOSICARD concerning medical aptitudes and

Prone Hypofractionated Whole-Breast Radiotherapy Without a Boost to the Tumor Bed: Comparable Toxicity of IMRT Versus a 3D Conformal Technique

Energy Technology Data Exchange (ETDEWEB)

Hardee, Matthew E.; Raza, Shahzad; Becker, Stewart J.; Jozsef, Gabor; Lymberis, Stella C. [Department of Radiation Oncology, New York University School of Medicine, New York, NY (United States); Hochman, Tsivia; Goldberg, Judith D. [Division of Biostatistics, New York University School of Medicine, New York, NY (United States); DeWyngaert, Keith J. [Department of Radiation Oncology, New York University School of Medicine, New York, NY (United States); Formenti, Silvia C., E-mail: silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University School of Medicine, New York, NY (United States)

2012-03-01

Purpose: We report a comparison of the dosimetry and toxicity of three-dimensional conformal radiotherapy (3D-CRT) vs. intensity-modulated radiotherapy (IMRT) among patients treated in the prone position with the same fractionation and target of the hypofractionation arm of the Canadian/Whelan trial. Methods and Materials: An institutional review board-approved protocol identified a consecutive series of early-stage breast cancer patients treated according to the Canadian hypofractionation regimen but in the prone position. Patients underwent IMRT treatment planning and treatment if the insurance carrier approved reimbursement for IMRT; in case of refusal, a 3D-CRT plan was used. A comparison of the dosimetric and toxicity outcomes during the acute, subacute, and long-term follow-up of the two treatment groups is reported. Results: We included 97 consecutive patients with 100 treatment plans in this study (3 patients with bilateral breast cancer); 40 patients were treated with 3D-CRT and 57 with IMRT. IMRT significantly reduced the maximum dose (Dmax median, 109.96% for 3D-CRT vs. 107.28% for IMRT; p < 0.0001, Wilcoxon test) and improved median dose homogeneity (median, 1.15 for 3D-CRT vs. 1.05 for IMRT; p < 0.0001, Wilcoxon test) when compared with 3D-CRT. Acute toxicity consisted primarily of Grade 1 to 2 dermatitis and occurred in 92% of patients. Grade 2 dermatitis occurred in 13% of patients in the 3D-CRT group and 2% in the IMRT group. IMRT moderately decreased rates of acute pruritus (p = 0.03, chi-square test) and Grade 2 to 3 subacute hyperpigmentation (p = 0.01, Fisher exact test). With a minimum of 6 months' follow-up, the treatment was similarly well tolerated in either group, including among women with large breast volumes. Conclusion: Hypofractionated breast radiotherapy is well tolerated when treating patients in the prone position, even among those with large breast volumes. Breast IMRT significantly improves dosimetry but yields only a modest

Radiotherapy quality insurance by individualized in vivo dosimetry: state of the art; Dosimetrie individuelle in vivo pour le controle de qualite en radiotherapie: etat de l'art

Energy Technology Data Exchange (ETDEWEB)

Ismail, A.; Giraud, J.Y.; Sihanath, R.; Balosso, J. [University Hospital of Grenoble, Dept. of Radiotherapy, 38 - Grenoble (France); Ismail, A. [Syrian Atomic Energy Commission, Radioprotection Dept., Damascus (Syrian Arab Republic); Luc, G.N.; Pittet, P.; Galvanc, J.M. [Claude-Bernard Univ., Lyon Nanotechnology Institute, 69 - Lyon (France)

2009-06-15

The quality insurance in radiotherapy in the frame of highly complex technical process as Intensity modulated radiotherapy (I.M.R.T.) needs independent control of the delivered dose to the patient. Actually, up to now, most of the radiotherapy treatments rely only on computed dosimetry through a rather complicated series of linked simulation tool. This dosimetry approach requires also qualified treatment means based on cautious quality insurance procedures. However, erroneous parameters could be difficult to detect and systematical errors could happen leading to radiotherapy accidents. In this context, in vivo dosimetry has a critical role of final control of the delivered dose. As many beam incidences and ports are used for any photon therapy treatment, external control could be very tedious and time consuming. Therefore, innovations are needed for in vivo dosimetry to provide ergonomic and efficient tools for these controls. This paper presents a review of technologies and products that can be used for in vivo dosimetry. It proposes also a reflection on the concepts to develop future devices suitable for this purpose. The technical means with their physical principles are reviewed, the clinical experiences demonstrating the feasibility of new techniques are then summarized and finally, the early clinical use and its impact on clinical practice is review. (authors)

A real-time virtual delivery system for photon radiotherapy delivery monitoring

Directory of Open Access Journals (Sweden)

Feng Shi

2014-03-01

Full Text Available Purpose: Treatment delivery monitoring is important for radiotherapy, which enables catching dosimetric error at the earliest possible opportunity. This project develops a virtual delivery system to monitor the dose delivery process of photon radiotherapy in real-time using GPU-based Monte Carlo (MC method.Methods: The simulation process consists of 3 parallel CPU threads. A thread T1 is responsible for communication with a linac, which acquires a set of linac status parameters, e.g. gantry angles, MLC configurations, and beam MUs every 20 ms. Since linac vendors currently do not offer interface to acquire data in real time, we mimic this process by fetching information from a linac dynalog file at the set frequency. Instantaneous beam fluence map (FM is calculated based. A FM buffer is also created in T1 and the instantaneous FM is accumulated to it. This process continues, until a ready signal is received from thread T2 on which an in-house developed MC dose engine executes on GPU. At that moment, the accumulated FM is transferred to T2 for dose calculations, and the FM buffer in T1 is cleared. Once the dose calculation finishes, the resulting 3D dose distribution is directed to thread T3, which displays it in three orthogonal planes in color wash overlaid on the CT image. This process continues to monitor the 3D dose distribution in real-time.Results: An IMRT and a VMAT cases used in our patient-specific QA are studied. Maximum dose differences between our system and treatment planning system are 0.98% and 1.58% for the IMRT and VMAT cases, respectively. The update frequency is >10Hz and the relative uncertainty level is 2%.Conclusion: By embedding a GPU-based MC code in a novel data/work flow, it is possible to achieve real-time MC dose calculations to monitor delivery process.------------------------------Cite this article as: Shi F, Gu X, Graves YJ, Jiang S, Jia X. A real-time virtual delivery system for photon radiotherapy delivery

SU-E-T-133: Assessing IMRT Treatment Delivery Accuracy and Consistency On a Varian TrueBeam Using the SunNuclear PerFraction EPID Dosimetry Software

Energy Technology Data Exchange (ETDEWEB)

Dieterich, S [UC Davis Medical Center, Sacramento, CA (United States); Trestrail, E; Holt, R [Pacific Crest Medical Physics, Chico, CA (United States); Saini, S [Sun Nuclear Corporation, Melbourne, FL (Australia); Pfeiffer, I [VMTH, UC Davis, Davis, CA (United States); Kent, M; Hansen, K [Surgical and Radiological Sciences, UC Davis, Davis, CA (United States)

2015-06-15

Purpose: To assess if the TrueBeam HD120 collimator is delivering small IMRT fields accurately and consistently throughout the course of treatment using the SunNuclear PerFraction software. Methods: 7-field IMRT plans for 8 canine patients who passed IMRT QA using SunNuclear Mapcheck DQA were selected for this study. The animals were setup using CBCT image guidance. The EPID fluence maps were captured for each treatment field and each treatment fraction, with the first fraction EPID data serving as the baseline for comparison. The Sun Nuclear PerFraction Software was used to compare the EPID data for subsequent fractions using a Gamma (3%/3mm) pass rate of 90%. To simulate requirements for SRS, the data was reanalyzed using a Gamma (3%/1mm) pass rate of 90%. Low-dose, low- and high gradient thresholds were used to focus the analysis on clinically relevant parts of the dose distribution. Results: Not all fractions could be analyzed, because during some of the treatment courses the DICOM tags in the EPID images intermittently change from CU to US (unspecified), which would indicate a temporary loss of EPID calibration. This technical issue is still being investigated. For the remaining fractions, the vast majority (7/8 of patients, 95% of fractions, and 96.6% of fields) are passing the less stringent Gamma criteria. The more stringent Gamma criteria caused a drop in pass rate (90 % of fractions, 84% of fields). For the patient with the lowest pass rate, wet towel bolus was used. Another patient with low pass rates experienced masseter muscle wasting. Conclusion: EPID dosimetry using the PerFraction software demonstrated that the majority of fields passed a Gamma (3%/3mm) for IMRT treatments delivered with a TrueBeam HD120 MLC. Pass rates dropped for a DTA of 1mm to model SRS tolerances. PerFraction pass rates can flag missing bolus or internal shields. Sanjeev Saini is an employee of Sun Nuclear Corporation. For this study, a pre-release version of PerFRACTION 1

Evaluation tools of quality control for patients submitted to IMRT

International Nuclear Information System (INIS)

Lavor, Milton

2011-01-01

Intensity modulated radiation therapy (IMRT) is currently been implemented in a rapidly growing number of centers in Brazil. As consequence many institutions are now facing the problem of performing a comprehensive quality control program before and during the implementation of IMRT in the clinical routine practice. The aim of this work is to evaluate and propose a methodology for quality assurance in IMRT treatments. An ionization chamber and a two-dimensional array detector were performed to assess the absolute value of the total dose of all fields in one specific point. The relative total dose distribution of all fields was measured with a radiochromic film and a two-dimensional array at one depth in a phantom. A comparison between measured and calculated dose distributions was performed using the gamma-index method, assessing the percentage of points that meet the criteria of +-3% dose difference and +-3 mm distance to agreement. As a result of 113 tested IMRT beams using ionization chamber and 81 using two-dimensional array, the proposal was to take an action level of about +- 5% compared to the treatment planning systems and measurements, for the verification of the dose in a single point at the low gradient dose region. Analysis of the two-dimensional array measurements showed that the gamma value was <1 for 97.7% of the data and for the film the gamma value was <1 for 96.6% of the data. This can be concluded that for an accurate delivery of dose in 'sliding-window' IMRT with micro multileaf collimator, the absolute value of the total dose and the relative total dose distribution should be checked by absolute and relative dosimetry respectively. (author)

Establishment of action levels for quality control of IMRT flat panel: experience with the algorithm iGRiMLO

International Nuclear Information System (INIS)

Gonzalez, V.; Dolores, VV. de los; Pastor, V.; Martinez, J.; Gimeno, J.; Guardino, C.; Crispin, V.

2011-01-01

Algorithm has been used at our institution iGRiMLO scheduled for individual verification of treatment plans for intensity modulated radiotherapy (IMRT) step and shoot through portal dosimetry pretreatment of non-transmission, triggering the plan directly to a portal imaging device (EPID) of an amorphous silicon flat panel.

Clinical validation of an in-house EPID dosimetry system for IMRT QA at the Prince of Wales Hospital

Science.gov (United States)

Tyler, M.; Vial, P.; Metcalfe, P.; Downes, S.

2013-06-01

In this study a simple method using standard flood-field corrected Electronic Portal Imaging Device (EPID) images for routine Intensity Modulated Radiation Therapy (IMRT) Quality Assurance (QA) was investigated. The EPID QA system was designed and tested on a Siemens Oncor Impression linear accelerator with an OptiVue 1000ST EPID panel (Siemens Medical Solutions USA, Inc, USA) and an Elekta Axesse linear accelerator with an iViewGT EPID (Elekta AB, Sweden) for 6 and 10 MV IMRT fields with Step-and-Shoot and dynamic-MLC delivery. Two different planning systems were used for patient IMRT field generation for comparison with the measured EPID fluences. All measured IMRT plans had >95% agreement to the planning fluences (using 3 cGy / 3 mm Gamma Criteria) and were comparable to the pass-rates calculated using a 2-D diode array dosimeter.

Clinical validation of an in-house EPID dosimetry system for IMRT QA at the Prince of Wales Hospital

International Nuclear Information System (INIS)

Tyler, M; Downes, S; Vial, P; Metcalfe, P

2013-01-01

In this study a simple method using standard flood-field corrected Electronic Portal Imaging Device (EPID) images for routine Intensity Modulated Radiation Therapy (IMRT) Quality Assurance (QA) was investigated. The EPID QA system was designed and tested on a Siemens Oncor Impression linear accelerator with an OptiVue 1000ST EPID panel (Siemens Medical Solutions USA, Inc, USA) and an Elekta Axesse linear accelerator with an iViewGT EPID (Elekta AB, Sweden) for 6 and 10 MV IMRT fields with Step-and-Shoot and dynamic-MLC delivery. Two different planning systems were used for patient IMRT field generation for comparison with the measured EPID fluences. All measured IMRT plans had >95% agreement to the planning fluences (using 3 cGy / 3 mm Gamma Criteria) and were comparable to the pass-rates calculated using a 2-D diode array dosimeter.

A system for remote dosimetry audit of 3D-CRT, IMRT and VMAT based on lithium formate dosimetry

International Nuclear Information System (INIS)

Adolfsson, Emelie; Gustafsson, Håkan; Lund, Eva; Alm Carlsson, Gudrun; Olsson, Sara; Carlsson Tedgren, Åsa

2014-01-01

Summary: The aim of this work was to develop and test a remote end-to-end audit system using lithium formate EPR dosimeters. Four clinics were included in a pilot study, absorbed doses determined in the PTV agreed with TPS calculated doses within ±5% for 3D-CRT and ±7% (k = 1) for IMRT/VMAT dose plans

Dosimetric verification of IMRT plans

International Nuclear Information System (INIS)

Bulski, W.; Cheimicski, K.; Rostkowska, J.

2012-01-01

Intensity modulated radiotherapy (IMRT) is a complex procedure requiring proper dosimetric verification. IMRT dose distributions are characterized by steep dose gradients which enable to spare organs at risk and allow for an escalation of the dose to the tumor. They require large number of radiation beams (sometimes over 10). The fluence measurements for individual beams are not sufficient for evaluation of the total dose distribution and to assure patient safety. The methods used at the Centre of Oncology in Warsaw are presented. In order to measure dose distributions in various cross-sections the film dosimeters were used (radiographic Kodak EDR2 films and radiochromic Gafchromic EBT films). The film characteristics were carefully examined. Several types of tissue equivalent phantoms were developed. A methodology of comparing measured dose distributions against the distributions calculated by treatment planning systems (TPS) was developed and tested. The tolerance level for this comparison was set at 3% difference in dose and 3 mm in distance to agreement. The so called gamma formalism was used. The results of these comparisons for a group of over 600 patients are presented. Agreement was found in 87 % of cases. This film dosimetry methodology was used as a benchmark to test and validate the performance of commercially available 2D and 3D matrices of detectors (ionization chambers or diodes). The results of these validations are also presented. (authors)

Monte Carlo investigation of collapsed versus rotated IMRT plan verification.

Science.gov (United States)

Conneely, Elaine; Alexander, Andrew; Ruo, Russell; Chung, Eunah; Seuntjens, Jan; Foley, Mark J

2014-05-08

IMRT QA requires, among other tests, a time-consuming process of measuring the absorbed dose, at least to a point, in a high-dose, low-dose-gradient region. Some clinics use a technique of measuring this dose with all beams delivered at a single gantry angle (collapsed delivery), as opposed to the beams delivered at the planned gantry angle (rotated delivery). We examined, established, and optimized Monte Carlo simulations of the dosimetry for IMRT verification of treatment plans for these two different delivery modes (collapsed versus rotated). The results of the simulations were compared to the treatment planning system dose calculations for the two delivery modes, as well as to measurements taken. This was done in order to investigate the validity of the use of a collapsed delivery technique for IMRT QA. The BEAMnrc, DOSXYZnrc, and egs_chamber codes were utilized for the Monte Carlo simulations along with the MMCTP system. A number of different plan complexity metrics were also used in the analysis of the dose distributions in a bid to qualify why verification in a collapsed delivery may or may not be optimal for IMRT QA. Following the Alfonso et al. formalism, the kfclin,frefQclin,Q correction factor was calculated to correct the deviation of small fields from the reference conditions used for beam calibration. We report on the results obtained for a cohort of 20 patients. The plan complexity was investigated for each plan using the complexity metrics of homogeneity index, conformity index, modulation complexity score, and the fraction of beams from a particular plan that intersect the chamber when performing the QA. Rotated QA gives more consistent results than the collapsed QA technique. The kfclin,frefQclin,Qfactor deviates less from 1 for rotated QA than for collapsed QA. If the homogeneity index is less than 0.05 then the kfclin,frefQclin,Q factor does not deviate from unity by more than 1%. A value this low for the homogeneity index can only be obtained

A Practical Use for FXG Gel Dosimetry

Energy Technology Data Exchange (ETDEWEB)

Olding, T; Salomons, G; Darko, J; Schreiner, L J, E-mail: Tim.Olding@krcc.on.c

2010-11-01

In-phantom Fricke-xylenol orange-gelatin (FXG) gel dosimetry yields three dimensional (3D) dose data for intensity modulated radiation therapy (IMRT) treatment plan verification within 18-24 hours from the point of request. The information obtained from a 3% dose difference, 3 mm distance-to-agreement gamma function comparison between treatment plan dose and gel-measured dose then provides a useful secondary 3D quality assurance check of the treatment plan prior to delivery.

Verification of patient position and delivery of IMRT by electronic portal imaging

International Nuclear Information System (INIS)

Fielding, Andrew L.; Evans, Philip M.; Clark, Catharine H.

2004-01-01

Background and purpose: The purpose of the work presented in this paper was to determine whether patient positioning and delivery errors could be detected using electronic portal images of intensity modulated radiotherapy (IMRT). Patients and methods: We carried out a series of controlled experiments delivering an IMRT beam to a humanoid phantom using both the dynamic and multiple static field method of delivery. The beams were imaged, the images calibrated to remove the IMRT fluence variation and then compared with calibrated images of the reference beams without any delivery or position errors. The first set of experiments involved translating the position of the phantom both laterally and in a superior/inferior direction a distance of 1, 2, 5 and 10 mm. The phantom was also rotated 1 and 2 deg. For the second set of measurements the phantom position was kept fixed and delivery errors were introduced to the beam. The delivery errors took the form of leaf position and segment intensity errors. Results: The method was able to detect shifts in the phantom position of 1 mm, leaf position errors of 2 mm, and dosimetry errors of 10% on a single segment of a 15 segment IMRT step and shoot delivery (significantly less than 1% of the total dose). Conclusions: The results of this work have shown that the method of imaging the IMRT beam and calibrating the images to remove the intensity modulations could be a useful tool in verifying both the patient position and the delivery of the beam

MO-B-BRB-04: 3D Dosimetry in End-To-End Dosimetry QA

Energy Technology Data Exchange (ETDEWEB)

Ibbott, G. [UT MD Anderson Cancer Center (United States)

2016-06-15

Full three-dimensional (3D) dosimetry using volumetric chemical dosimeters probed by 3D imaging systems has long been a promising technique for the radiation therapy clinic, since it provides a unique methodology for dose measurements in the volume irradiated using complex conformal delivery techniques such as IMRT and VMAT. To date true 3D dosimetry is still not widely practiced in the community; it has been confined to centres of specialized expertise especially for quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. The potential for improved clinical applicability has been advanced considerably in the last decade by the development of improved 3D dosimeters (e.g., radiochromic plastics, radiochromic gel dosimeters and normoxic polymer gel systems) and by improved readout protocols using optical computed tomography or magnetic resonance imaging. In this session, established users of some current 3D chemical dosimeters will briefly review the current status of 3D dosimetry, describe several dosimeters and their appropriate imaging for dose readout, present workflow procedures required for good dosimetry, and analyze some limitations for applications in select settings. We will review the application of 3D dosimetry to various clinical situations describing how 3D approaches can complement other dose delivery validation approaches already available in the clinic. The applications presented will be selected to inform attendees of the unique features provided by full 3D techniques. Learning Objectives: L. John Schreiner: Background and Motivation Understand recent developments enabling clinically practical 3D dosimetry, Appreciate 3D dosimetry workflow and dosimetry procedures, and Observe select examples from the clinic. Sofie Ceberg: Application to dynamic radiotherapy Observe full dosimetry under dynamic radiotherapy during respiratory motion, and Understand how the measurement of high resolution dose data in an

Parotid gland shrinkage during IMRT predicts the time to Xerostomia resolution.

Science.gov (United States)

Sanguineti, Giuseppe; Ricchetti, Francesco; Wu, Binbin; McNutt, Todd; Fiorino, Claudio

2015-01-17

To assess the impact of mid-treatment parotid gland shrinkage on long term xerostomia during IMRT for oropharyngeal SCC. All patients treated with IMRT at a single Institution from November 2007 to June 2010 and undergoing weekly CT scans were selected. Parotid glands were contoured retrospectively on the mid treatment CT scan. For each parotid gland, the percent change relative to the planning volume was calculated and combined as weighted average. Patients were considered to be xerostomic if developed GR2+ dry mouth according to CTCAE v3.0. Predictors of the time to xerostomia resolution or downgrade to 1 were investigated at both uni- and multivariate analysis. 85 patients were selected. With a median follow up of 35.8 months (range: 2.4-62.6 months), the actuarial rate of xerostomia is 26.2% (SD: 5.3%) and 15.9% (SD: 5.3%) at 2 and 3 yrs, respectively. At multivariate analysis, mid-treatment shrink along with weighted average mean parotid dose at planning and body mass index are independent predictors of the time to xerostomia resolution. Patients were pooled in 4 groups based on median values of both mid-treatment shrink (cut-off: 19.6%) and mean WA parotid pl-D (cut-off: 35.7 Gy). Patients with a higher than median parotid dose at planning and who showed poor shrinkage at mid treatment are the ones with the outcome significantly worse (3-yr rate of xerostomia ≈ 50%) than the other three subgroups (3-yr rate of xerostomia ≈ 10%). For a given planned dose, patients whose parotids significantly shrink during IMRT are less likely to be long-term supplemental fluids dependent.

Innovation and the future of advanced dosimetry: 2D to 5D

Science.gov (United States)

Oldham, Mark

2017-05-01

Recent years have witnessed a remarkable evolution in the techniques, capabilities and applications of 3D dosimetry. Initially the goal was simple: to innovate new techniques capable of comprehensively measuring and verifying exquisitely intricate dose distributions from a paradigm changing emerging new therapy, IMRT. Basic questions emerged: how well were treatment planning systems modelling the complex delivery, and how could treatments be verified for safe use on patients? Since that time, equally significant leaps of innovation have continued in the technology of treatment delivery. In addition, clinical practice has been transformed by the addition of on-board imaging capabilities, which tend to hypo-fractionation strategies and margin reduction. The net result is a high stakes treatment setting where the clinical morbidity of any unintended treatment deviation is exacerbated by the combination of highly conformal dose distributions given with reduced margins with fractionation regimens unfriendly to healthy tissue. Not surprisingly this scenario is replete with challenges and opportunities for new and improved dosimetry systems. In particular tremendous interest exists in comprehensive 3D dosimetry systems, and systems that can resolve the dose in moving structures (4D) and even in deforming structures (5D). Despite significant progress in the capability of multi-dimensional dosimetry systems, it is striking that true 3D dosimetry systems are today largely found in academic institutions or specialist clinics. The reasons will be explored. We will highlight innovations occurring both in treatment delivery and in advanced dosimetry methods designed to verify them, and explore current and future opportunities for advanced dosimetry tools in clinical practice and translational research.

Carcinoma of the anal canal: Intensity modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3DCRT)

Science.gov (United States)

Sale, Charlotte; Moloney, Phillip; Mathlum, Maitham

2013-01-01

Introduction Patients with anal canal carcinoma treated with standard conformal radiotherapy frequently experience severe acute and late toxicity reactions to the treatment area. Roohipour et al. (Dis Colon Rectum 2008; 51: 147–53) stated a patient's tolerance of chemoradiation to be an important prediction of treatment success. A new intensity modulated radiation therapy (IMRT) technique for anal carcinoma cases has been developed at the Andrew Love Cancer Centre aimed at reducing radiation to surrounding healthy tissue. Methods A same-subject repeated measures design was used for this study, where five anal carcinoma cases at the Andrew Love Cancer Centre were selected. Conformal and IMRT plans were generated and dosimetric evaluations were performed. Each plan was prescribed a total of 54 Gray (Gy) over a course of 30 fractions to the primary site. Results The IMRT plans resulted in improved dosimetry to the planning target volume (PTV) and reduction in radiation to the critical structures (bladder, external genitalia and femoral heads). Statistically there was no difference between the IMRT and conformal plans in the dose to the small and large bowel; however, the bowel IMRT dose–volume histogram (DVH) doses were consistently lower. Conclusion The IMRT plans were superior to the conformal plans with improved dose conformity and reduced radiation to the surrounding healthy tissue. Anecdotally it was found that patients tolerated the IMRT treatment better than the three-dimensional (3D) conformal radiation therapy. This study describes and compares the planning techniques. PMID:26229623

Carcinoma of the anal canal: Intensity modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3DCRT)

International Nuclear Information System (INIS)

Sale, Charlotte; Moloney, Phillip; Mathlum, Maitham

2013-01-01

Patients with anal canal carcinoma treated with standard conformal radiotherapy frequently experience severe acute and late toxicity reactions to the treatment area. Roohipour et al. (Dis Colon Rectum 2008; 51: 147–53) stated a patient's tolerance of chemoradiation to be an important prediction of treatment success. A new intensity modulated radiation therapy (IMRT) technique for anal carcinoma cases has been developed at the Andrew Love Cancer Centre aimed at reducing radiation to surrounding healthy tissue. A same-subject repeated measures design was used for this study, where five anal carcinoma cases at the Andrew Love Cancer Centre were selected. Conformal and IMRT plans were generated and dosimetric evaluations were performed. Each plan was prescribed a total of 54 Gray (Gy) over a course of 30 fractions to the primary site. The IMRT plans resulted in improved dosimetry to the planning target volume (PTV) and reduction in radiation to the critical structures (bladder, external genitalia and femoral heads). Statistically there was no difference between the IMRT and conformal plans in the dose to the small and large bowel; however, the bowel IMRT dose–volume histogram (DVH) doses were consistently lower. The IMRT plans were superior to the conformal plans with improved dose conformity and reduced radiation to the surrounding healthy tissue. Anecdotally it was found that patients tolerated the IMRT treatment better than the three-dimensional (3D) conformal radiation therapy. This study describes and compares the planning techniques

Carcinoma of the anal canal: Intensity modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3DCRT).

Science.gov (United States)

Sale, Charlotte; Moloney, Phillip; Mathlum, Maitham

2013-12-01

Patients with anal canal carcinoma treated with standard conformal radiotherapy frequently experience severe acute and late toxicity reactions to the treatment area. Roohipour et al. (Dis Colon Rectum 2008; 51: 147-53) stated a patient's tolerance of chemoradiation to be an important prediction of treatment success. A new intensity modulated radiation therapy (IMRT) technique for anal carcinoma cases has been developed at the Andrew Love Cancer Centre aimed at reducing radiation to surrounding healthy tissue. A same-subject repeated measures design was used for this study, where five anal carcinoma cases at the Andrew Love Cancer Centre were selected. Conformal and IMRT plans were generated and dosimetric evaluations were performed. Each plan was prescribed a total of 54 Gray (Gy) over a course of 30 fractions to the primary site. The IMRT plans resulted in improved dosimetry to the planning target volume (PTV) and reduction in radiation to the critical structures (bladder, external genitalia and femoral heads). Statistically there was no difference between the IMRT and conformal plans in the dose to the small and large bowel; however, the bowel IMRT dose-volume histogram (DVH) doses were consistently lower. The IMRT plans were superior to the conformal plans with improved dose conformity and reduced radiation to the surrounding healthy tissue. Anecdotally it was found that patients tolerated the IMRT treatment better than the three-dimensional (3D) conformal radiation therapy. This study describes and compares the planning techniques.

Carcinoma of the anal canal: Intensity modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3DCRT)

Energy Technology Data Exchange (ETDEWEB)

Sale, Charlotte; Moloney, Phillip; Mathlum, Maitham [Andrew Love Cancer Centre, Geelong Hospital, Geelong, Victoria (Australia)

2013-12-15

Patients with anal canal carcinoma treated with standard conformal radiotherapy frequently experience severe acute and late toxicity reactions to the treatment area. Roohipour et al. (Dis Colon Rectum 2008; 51: 147–53) stated a patient's tolerance of chemoradiation to be an important prediction of treatment success. A new intensity modulated radiation therapy (IMRT) technique for anal carcinoma cases has been developed at the Andrew Love Cancer Centre aimed at reducing radiation to surrounding healthy tissue. A same-subject repeated measures design was used for this study, where five anal carcinoma cases at the Andrew Love Cancer Centre were selected. Conformal and IMRT plans were generated and dosimetric evaluations were performed. Each plan was prescribed a total of 54 Gray (Gy) over a course of 30 fractions to the primary site. The IMRT plans resulted in improved dosimetry to the planning target volume (PTV) and reduction in radiation to the critical structures (bladder, external genitalia and femoral heads). Statistically there was no difference between the IMRT and conformal plans in the dose to the small and large bowel; however, the bowel IMRT dose–volume histogram (DVH) doses were consistently lower. The IMRT plans were superior to the conformal plans with improved dose conformity and reduced radiation to the surrounding healthy tissue. Anecdotally it was found that patients tolerated the IMRT treatment better than the three-dimensional (3D) conformal radiation therapy. This study describes and compares the planning techniques.

Surface dosimetry for breast radiotherapy in the presence of immobilization cast material

International Nuclear Information System (INIS)

Kelly, Andrew; Hardcastle, Nicholas; Metcalfe, Peter; Cutajar, Dean; Quinn, Alexandra; Cardoso, Michael; Rosenfeld, Anatoly; Foo, Kerwyn; Barlin, Sheree

2011-01-01

Curative breast radiotherapy typically leaves patients with varying degrees of cosmetic damage. One problem interfering with cosmetically acceptable breast radiotherapy is the external contour for large pendulous breasts which often results in high doses to skin folds. Thermoplastic casts are often employed to secure the breasts to maintain setup reproducibility and limit the presence of skin folds. This paper aims to determine changes in surface dose that can be attributed to the use of thermoplastic immobilization casts. Skin dose for a clinical hybrid conformal/IMRT breast plan was measured using radiochromic film and MOSFET detectors at a range of water equivalent depths representative of the different skin layers. The radiochromic film was used as an integrating dosimeter, while the MOSFETs were used for real-time dosimetry to isolate the contribution of skin dose from individual IMRT segments. Strips of film were placed at various locations on the breast and the MOSFETs were used to measure skin dose at 16 positions spaced along the film strips for comparison of data. The results showed an increase in skin dose in the presence of the immobilization cast of up to 45.7% and 62.3% of the skin dose without the immobilization cast present as measured with Gafchromic EBT film and MOSFETs, respectively. The increase in skin dose due to the immobilization cast varied with the angle of beam incidence and was greatest when the beam was normally incident on the phantom. The increase in surface dose with the immobilization cast was greater under entrance dose conditions compared to exit dose conditions.

Surface dosimetry for breast radiotherapy in the presence of immobilization cast material

Science.gov (United States)

Kelly, Andrew; Hardcastle, Nicholas; Metcalfe, Peter; Cutajar, Dean; Quinn, Alexandra; Foo, Kerwyn; Cardoso, Michael; Barlin, Sheree; Rosenfeld, Anatoly

2011-02-01

Curative breast radiotherapy typically leaves patients with varying degrees of cosmetic damage. One problem interfering with cosmetically acceptable breast radiotherapy is the external contour for large pendulous breasts which often results in high doses to skin folds. Thermoplastic casts are often employed to secure the breasts to maintain setup reproducibility and limit the presence of skin folds. This paper aims to determine changes in surface dose that can be attributed to the use of thermoplastic immobilization casts. Skin dose for a clinical hybrid conformal/IMRT breast plan was measured using radiochromic film and MOSFET detectors at a range of water equivalent depths representative of the different skin layers. The radiochromic film was used as an integrating dosimeter, while the MOSFETs were used for real-time dosimetry to isolate the contribution of skin dose from individual IMRT segments. Strips of film were placed at various locations on the breast and the MOSFETs were used to measure skin dose at 16 positions spaced along the film strips for comparison of data. The results showed an increase in skin dose in the presence of the immobilization cast of up to 45.7% and 62.3% of the skin dose without the immobilization cast present as measured with Gafchromic EBT film and MOSFETs, respectively. The increase in skin dose due to the immobilization cast varied with the angle of beam incidence and was greatest when the beam was normally incident on the phantom. The increase in surface dose with the immobilization cast was greater under entrance dose conditions compared to exit dose conditions.

SU-E-T-21: A Novel Sampling Algorithm to Reduce Intensity-Modulated Radiation Therapy (IMRT) Optimization Time

International Nuclear Information System (INIS)

Tiwari, P; Xie, Y; Chen, Y; Deasy, J

2014-01-01

Purpose: The IMRT optimization problem requires substantial computer time to find optimal dose distributions because of the large number of variables and constraints. Voxel sampling reduces the number of constraints and accelerates the optimization process, but usually deteriorates the quality of the dose distributions to the organs. We propose a novel sampling algorithm that accelerates the IMRT optimization process without significantly deteriorating the quality of the dose distribution. Methods: We included all boundary voxels, as well as a sampled fraction of interior voxels of organs in the optimization. We selected a fraction of interior voxels using a clustering algorithm, that creates clusters of voxels that have similar influence matrix signatures. A few voxels are selected from each cluster based on the pre-set sampling rate. Results: We ran sampling and no-sampling IMRT plans for de-identified head and neck treatment plans. Testing with the different sampling rates, we found that including 10% of inner voxels produced the good dose distributions. For this optimal sampling rate, the algorithm accelerated IMRT optimization by a factor of 2–3 times with a negligible loss of accuracy that was, on average, 0.3% for common dosimetric planning criteria. Conclusion: We demonstrated that a sampling could be developed that reduces optimization time by more than a factor of 2, without significantly degrading the dose quality

Time dependent pre-treatment EPID dosimetry for standard and FFF VMAT.

Science.gov (United States)

Podesta, Mark; Nijsten, Sebastiaan M J J G; Persoon, Lucas C G G; Scheib, Stefan G; Baltes, Christof; Verhaegen, Frank

2014-08-21

Methods to calibrate Megavoltage electronic portal imaging devices (EPIDs) for dosimetry have been previously documented for dynamic treatments such as intensity modulated radiotherapy (IMRT) using flattened beams and typically using integrated fields. While these methods verify the accumulated field shape and dose, the dose rate and differential fields remain unverified. The aim of this work is to provide an accurate calibration model for time dependent pre-treatment dose verification using amorphous silicon (a-Si) EPIDs in volumetric modulated arc therapy (VMAT) for both flattened and flattening filter free (FFF) beams. A general calibration model was created using a Varian TrueBeam accelerator, equipped with an aS1000 EPID, for each photon spectrum 6 MV, 10 MV, 6 MV-FFF, 10 MV-FFF. As planned VMAT treatments use control points (CPs) for optimization, measured images are separated into corresponding time intervals for direct comparison with predictions. The accuracy of the calibration model was determined for a range of treatment conditions. Measured and predicted CP dose images were compared using a time dependent gamma evaluation using criteria (3%, 3 mm, 0.5 sec). Time dependent pre-treatment dose verification is possible without an additional measurement device or phantom, using the on-board EPID. Sufficient data is present in trajectory log files and EPID frame headers to reliably synchronize and resample portal images. For the VMAT plans tested, significantly more deviation is observed when analysed in a time dependent manner for FFF and non-FFF plans than when analysed using only the integrated field. We show EPID-based pre-treatment dose verification can be performed on a CP basis for VMAT plans. This model can measure pre-treatment doses for both flattened and unflattened beams in a time dependent manner which highlights deviations that are missed in integrated field verifications.

Dosimetry and planning audit of IMRT prostate treatment in the Czech Republic with a pelvic phantom

International Nuclear Information System (INIS)

Koniarova, I.; Horakova, I.; Dufek, V.; Kotik, L.

2014-01-01

In 2013, the national end-to-end audit of IMRT prostate treatment with a pelvic phantom has been carried out in the Czech Republic. It has been performed by the NRPI on site and the participation was voluntary. All departments (17) where IMRT is used for prostate treatment participated. In total, 21 plans have been evaluated. Phantom with clearly defined structures that were the same for all departments has been used. There was a dosimetric and a planning part of the audit. The determination of absorbed doses with ionization chambers placed in the PTV and in the rectum and the comparison to the planned doses was performed. Planar dose distribution was verified with gafchromic film. Majority of departments were able to deliver the IMRT plan successfully. The dose to PTV measured with ionization chamber in the phantom exceeded tolerance level of 3% in 4 cases. The mean of measured to planned dose for PTV was 0.991 ± 0.004. In one case, the tolerance level for planar dose was significantly exceeded. Constraints used for planning, volumes calculation, and DVHs were analyzed. (authors)

Dosimetry systems for radiation processing

International Nuclear Information System (INIS)

McLaughlin, W.L.; Desrosiers, M.F.

1995-01-01

Dosimetry serves important functions in radiation processing, where large absorbed doses and dose rates from photon and electron sources have to be measured with reasonable accuracy. Proven dosimetry systems are widely used to perform radiation measurements in development of new processes, validation, qualification and verification (quality control) of established processes and archival documentation of day-to-day and plant-to-plant processing uniformity. Proper calibration and traceability of routine dosimetry systems to standards are crucial to the success of many large-volume radiation processes. Recent innovations and advances in performance of systems that enhance radiation measurement assurance and process diagnostics include dose-mapping media (new radiochromic film and solutions), optical waveguide systems for food irradiation, solid-state devices for real-time and passive dosimetry over wide dose-rate and dose ranges, and improved analytical instruments and data acquisition. (author)

Fast protocol for radiochromic film dosimetry using a cloud computing web application.

Science.gov (United States)

Calvo-Ortega, Juan-Francisco; Pozo, Miquel; Moragues, Sandra; Casals, Joan

2017-07-01

To investigate the feasibility of a fast protocol for radiochromic film dosimetry to verify intensity-modulated radiotherapy (IMRT) plans. EBT3 film dosimetry was conducted in this study using the triple-channel method implemented in the cloud computing application (Radiochromic.com). We described a fast protocol for radiochromic film dosimetry to obtain measurement results within 1h. Ten IMRT plans were delivered to evaluate the feasibility of the fast protocol. The dose distribution of the verification film was derived at 15, 30, 45min using the fast protocol and also at 24h after completing the irradiation. The four dose maps obtained per plan were compared using global and local gamma index (5%/3mm) with the calculated one by the treatment planning system. Gamma passing rates obtained for 15, 30 and 45min post-exposure were compared with those obtained after 24h. Small differences respect to the 24h protocol were found in the gamma passing rates obtained for films digitized at 15min (global: 99.6%±0.9% vs. 99.7%±0.5%; local: 96.3%±3.4% vs. 96.3%±3.8%), at 30min (global: 99.5%±0.9% vs. 99.7%±0.5%; local: 96.5%±3.2% vs. 96.3±3.8%) and at 45min (global: 99.2%±1.5% vs. 99.7%±0.5%; local: 96.1%±3.8% vs. 96.3±3.8%). The fast protocol permits dosimetric results within 1h when IMRT plans are verified, with similar results as those reported by the standard 24h protocol. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Real-time beam monitoring for error detection in IMRT plans and impact on dose-volume histograms. A multi-center study

Energy Technology Data Exchange (ETDEWEB)

Marrazzo, Livia; Arilli, Chiara; Casati, Marta [Careggi University Hospital, Medical Physic Unit, Florence (Italy); Pasler, Marlies [Lake Constance Radiation Oncology Center, Singen-Friedrichshafen (Germany); Kusters, Martijn; Canters, Richard [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands); Fedeli, Luca; Calusi, Silvia [University of Florence, Department of Experimental and Clinical Biomedical Sciences ' ' Mario Serio' ' , Florence (Italy); Talamonti, Cinzia; Pallotta, Stefania [Careggi University Hospital, Medical Physic Unit, Florence (Italy); University of Florence, Department of Experimental and Clinical Biomedical Sciences ' ' Mario Serio' ' , Florence (Italy); Simontacchi, Gabriele [Careggi University Hospital, Radiation Oncology Unit, Florence (Italy); Livi, Lorenzo [University of Florence, Department of Experimental and Clinical Biomedical Sciences ' ' Mario Serio' ' , Florence (Italy); Careggi University Hospital, Radiation Oncology Unit, Florence (Italy)

2018-03-15

This study aimed to test the sensitivity of a transmission detector for online dose monitoring of intensity-modulated radiation therapy (IMRT) for detecting small delivery errors. Furthermore, the correlation of changes in detector output induced by small delivery errors with other metrics commonly employed to quantify the deviations between calculated and delivered dose distributions was investigated. Transmission detector measurements were performed at three institutions. Seven types of errors were induced in nine clinical step-and-shoot (S and S) IMRT plans by modifying the number of monitor units (MU) and introducing small deviations in leaf positions. Signal reproducibility was investigated for short- and long-term stability. Calculated dose distributions were compared in terms of γ passing rates and dose-volume histogram (DVH) metrics (e.g., D{sub mean}, D{sub x%}, V{sub x%}). The correlation between detector signal variations, γ passing rates, and DVH parameters was investigated. Both short- and long-term reproducibility was within 1%. Dose variations down to 1 MU (∇signal 1.1 ± 0.4%) as well as changes in field size and positions down to 1 mm (∇signal 2.6 ± 1.0%) were detected, thus indicating high error-detection sensitivity. A moderate correlation of detector signal was observed with γ passing rates (R{sup 2} = 0.57-0.70), while a good correlation was observed with DVH metrics (R{sup 2} = 0.75-0.98). The detector is capable of detecting small delivery errors in MU and leaf positions, and is thus a highly sensitive dose monitoring device for S and S IMRT for clinical practice. The results of this study indicate a good correlation of detector signal with DVH metrics; therefore, clinical action levels can be defined based on the presented data. (orig.) [German] In dieser Arbeit wurde die Sensitivitaet bezueglich der Fehlererkennung eines Transmissionsdetektors fuer die Online-Dosisueberwachung von intensitaetsmodulierter Strahlentherapie (IMRT

Esophagus and contralateral lung-sparing IMRT for locally advanced lung cancer in the community hospital setting

Directory of Open Access Journals (Sweden)

Johnny eKao

2015-06-01

Full Text Available Background: The optimal technique for performing lung IMRT remains poorly defined. We hypothesize that improved dose distributions associated with normal tissue sparing IMRT can allow for safe dose escalation resulting in decreased acute and late toxicity. Methods: We performed a retrospective analysis of 82 consecutive lung cancer patients treated with curative intent from 1/10 to 9/14. From 1/10 to 4/12, 44 patients were treated with the community standard of 3-dimensional conformal radiotherapy or IMRT without specific esophagus or contralateral lung constraints (standard RT. From 5/12 to 9/14, 38 patients were treated with normal tissue-sparing IMRT with selective sparing of contralateral lung and esophagus. The study endpoints were dosimetry, toxicity and overall survival.Results: Despite higher mean prescribed radiation doses in the normal tissue-sparing IMRT cohort (64.5 Gy vs. 60.8 Gy, p=0.04, patients treated with normal tissue-sparing IMRT had significantly lower lung V20, V10, V5, mean lung, maximum esophagus and mean esophagus doses compared to patients treated with standard RT (p≤0.001. Patients in the normal tissue-sparing IMRT group had reduced acute grade ≥3 esophagitis (0% vs. 11%, p<0.001, acute grade ≥2 weight loss (2% vs. 16%, p=0.04, late grade ≥2 pneumonitis (7% vs. 21%, p=0.02. The 2-year overall survival was 52% with normal tissue-sparing IMRT arm compared to 28% for standard RT (p=0.015.Conclusion: These data provide proof of principle that suboptimal radiation dose distributions are associated with significant acute and late lung and esophageal toxicity that may result in hospitalization or even premature mortality. Strict attention to contralateral lung and esophageal dose volume constraints are feasible in the community hospital setting without sacrificing disease control.

Comparison of film dosimetry and Monte Carlo simulations in small field IMRT

Energy Technology Data Exchange (ETDEWEB)

Kim, S.R.; Suh, T.S.; Choe, B.Y.; Lee, H.K. [The Catholic Univ., Seoul (Korea, Republic of); Sohn. Jason W. [Washington Univ., St. Louis (United States)

2002-07-01

Intensity modulated radiation therapy(IMRT) is a recent useful technique that conforms a high dose to the target volume while restricting dose to the surrounding critical organs. In IMRT, the small size beam let is used for intensity modulation. Thus, dose calculation in small field is very important. But, dose calculation in small field is not accurate in recent RTP system because electronic disequilibrium and the effect of multiple scattering electron are not considered in dose calculation. and therefore, We have evaluated the errors of depth dose and beam profile between measurement data and Monte Carlo simulation. With a homogeneous phantom and two heterogeneous phantoms, A thermoluminescent dosimeter (TLD) and radiochromic films have been selected for dose measurement in 6 MV photon beams. A linear accelerator Varian 2300C (Varian Medical Systems, USA) equipped with a multileaf collimator have been used in dose measurement. The results of simulations using the Monte Carlo systems BEAM/EGS4 (NRC, Canada) to model the beam geometry have been compared with dose measurements. Generally good agreements were found between measurements and dose calculations of Monte Carlo simulation. But some discrepancies were found in this study. Thus further study will be needed to compensate these errors.

A methodology for direct quantification of over-ranging length in helical computed tomography with real-time dosimetry.

Science.gov (United States)

Tien, Christopher J; Winslow, James F; Hintenlang, David E

2011-01-31

In helical computed tomography (CT), reconstruction information from volumes adjacent to the clinical volume of interest (VOI) is required for proper reconstruction. Previous studies have relied upon either operator console readings or indirect extrapolation of measurements in order to determine the over-ranging length of a scan. This paper presents a methodology for the direct quantification of over-ranging dose contributions using real-time dosimetry. A Siemens SOMATOM Sensation 16 multislice helical CT scanner is used with a novel real-time "point" fiber-optic dosimeter system with 10 ms temporal resolution to measure over-ranging length, which is also expressed in dose-length-product (DLP). Film was used to benchmark the exact length of over-ranging. Over-ranging length varied from 4.38 cm at pitch of 0.5 to 6.72 cm at a pitch of 1.5, which corresponds to DLP of 131 to 202 mGy-cm. The dose-extrapolation method of Van der Molen et al. yielded results within 3%, while the console reading method of Tzedakis et al. yielded consistently larger over-ranging lengths. From film measurements, it was determined that Tzedakis et al. overestimated over-ranging lengths by one-half of beam collimation width. Over-ranging length measured as a function of reconstruction slice thicknesses produced two linear regions similar to previous publications. Over-ranging is quantified with both absolute length and DLP, which contributes about 60 mGy-cm or about 10% of DLP for a routine abdominal scan. This paper presents a direct physical measurement of over-ranging length within 10% of previous methodologies. Current uncertainties are less than 1%, in comparison with 5% in other methodologies. Clinical implantation can be increased by using only one dosimeter if codependence with console readings is acceptable, with an uncertainty of 1.1% This methodology will be applied to different vendors, models, and postprocessing methods--which have been shown to produce over-ranging lengths

A SiPM based real time dosimeter for radiotherapic beams

Energy Technology Data Exchange (ETDEWEB)

Berra, A., E-mail: alessandro.berra@gmail.it [Università degli Studi dell' Insubria e INFN sezione di Milano Bicocca, Via Valleggio, 11 22100 Como (Italy); Conti, V. [Ospedale Sant' Anna, Servizio di Fisica Sanitaria, Como (Italy); Lietti, D.; Milan, L.; Novati, C. [Università degli Studi dell' Insubria e INFN sezione di Milano Bicocca, Via Valleggio, 11 22100 Como (Italy); Ostinelli, A. [Ospedale Sant' Anna, Servizio di Fisica Sanitaria, Como (Italy); Prest, M.; Romanó, C. [Università degli Studi dell' Insubria e INFN sezione di Milano Bicocca, Via Valleggio, 11 22100 Como (Italy); Vallazza, E. [INFN sezione di Trieste (Italy)

2015-02-11

This paper describes the development of a scintillator dosimeter prototype for radiotherapic applications based on plastic scintillating fibers readout by Silicon PhotoMultipliers. The dosimeter, whose probes are water equivalent, could be used for quality control measurements, beam characterization and in vivo dosimetry, allowing a real time measurement of the dose spatial distribution. This paper describes the preliminary percentual depth dose scan performed with clinical 6 and 18 MV photon beams, comparing the results with a reference curve. The measurements were performed using a Varian Clinac iX linear accelerator at the Radiotherapy Department of the St. Anna Hospital in Como (IT). The prototype has given promising results, allowing real time measurements of relative dose without applying any correction factors.

Rotational IMRT techniques compared to fixed gantry IMRT and Tomotherapy: multi-institutional planning study for head-and-neck cases

International Nuclear Information System (INIS)

Wiezorek, Tilo; Schubert, Kai; Wagner, Daniela; Wendt, Thomas G; Brachwitz, Tim; Georg, Dietmar; Blank, Eyck; Fotina, Irina; Habl, Gregor; Kretschmer, Matthias; Lutters, Gerd; Salz, Henning

2011-01-01

Recent developments enable to deliver rotational IMRT with standard C-arm gantry based linear accelerators. This upcoming treatment technique was benchmarked in a multi-center treatment planning study against static gantry IMRT and rotational IMRT based on a ring gantry for a complex parotid gland sparing head-and-neck technique. Treatment plans were created for 10 patients with head-and-neck tumours (oropharynx, hypopharynx, larynx) using the following treatment planning systems (TPS) for rotational IMRT: Monaco (ELEKTA VMAT solution), Eclipse (Varian RapidArc solution) and HiArt for the helical tomotherapy (Tomotherapy). Planning of static gantry IMRT was performed with KonRad, Pinnacle and Panther DAO based on step&shoot IMRT delivery and Eclipse for sliding window IMRT. The prescribed doses for the high dose PTVs were 65.1Gy or 60.9Gy and for the low dose PTVs 55.8Gy or 52.5Gy dependend on resection status. Plan evaluation was based on target coverage, conformity and homogeneity, DVHs of OARs and the volume of normal tissue receiving more than 5Gy (V 5Gy ). Additionally, the cumulative monitor units (MUs) and treatment times of the different technologies were compared. All evaluation parameters were averaged over all 10 patients for each technique and planning modality. Depending on IMRT technique and TPS, the mean CI values of all patients ranged from 1.17 to 2.82; and mean HI values varied from 0.05 to 0.10. The mean values of the median doses of the spared parotid were 26.5Gy for RapidArc and 23Gy for VMAT, 14.1Gy for Tomo. For fixed gantry techniques 21Gy was achieved for step&shoot+KonRad, 17.0Gy for step&shoot+Panther DAO, 23.3Gy for step&shoot+Pinnacle and 18.6Gy for sliding window. V 5Gy values were lowest for the sliding window IMRT technique (3499 ccm) and largest for RapidArc (5480 ccm). The lowest mean MU value of 408 was achieved by Panther DAO, compared to 1140 for sliding window IMRT. All IMRT delivery technologies with their associated TPS

Development of a novel endorectal balloon for two-dimensional in-vivo rectal dosimetry

Energy Technology Data Exchange (ETDEWEB)

Lim, Young Kyung; Jeang, Eun Hee; Min, Soon Ki; Cho, Kwan Ho [National Cancer Center, Goyang (Korea, Republic of); Hwang, Ui Jung [National Medical Center, Seoul (Korea, Republic of); Choi, Sang Hyoun [Korea Cancer Center Hospital, Seoul (Korea, Republic of); Kwak, Jung Won [Asan Medical Center, Seoul (Korea, Republic of)

2016-05-15

In the present study, a new endorectal balloon equipped with radiochromic film was developed, and its dosimetric property was evaluated. A metal-oxide-semiconductor field-effect transistor (MOSFET) was used in a rectal balloon to measure the rectal dose in 3D-CRT and IMRT. Additionally, a thermoluminescent dosimeter (TLD) was attached directly onto the rectal balloon to measure the rectal dose in IMRT and proton therapy. However, in vivo dosimetry that uses such point dosimeters cannot provide 2D dose distribution in a rectal wall (RW). In order to obtain the 2D dose distribution in the rectal wall, a 2D dosimeter that incorporates radiosensitive film is required. A new endorectal balloon capable of 2D in vivo rectal dosimetry was developed. Unlike conventional ERBs, this 2DD-ERB was equipped with a radiosensitive film on the outside of the balloon to directly measure the 2D dose distribution delivered to the ARW by the treatment beam. The dosimetric properties of the 2DD-ERB were measured, and the results showed that the measured dose distributions agreed well with their respective treatment plans within 4%. The film-equipped endorectal balloon is expected to be used as an in vivo dosimeter for measuring the dose distribution in the rectal wall in the modern radiotherapy techniques, such as IMRT, VMAT, HT, and IMPT.

Dosimetry challenges for implementing emerging technologies

Energy Technology Data Exchange (ETDEWEB)

Yin Fangfang; Oldham, Mark; Cai Jing; Wu Qiuwen, E-mail: Fangfang.yin@duke.ed [Department of Radiation Oncology Duke University Medical Center, Durham, NC 27516 (United States)

2010-11-01

During the last 10 years, radiation therapy technologies have gone through major changes, mainly related introduction of sophisticated delivery and imaging techniques to improve the target localization accuracy and dose conformity. While implementation of these emerging technologies such as image-guided SRS/SBRT, IMRT/IMAT, IGRT, 4D motion management, and special delivery technologies showed substantial clinical gains for patient care, many other factors, such as training/quality, efficiency/efficacy, and cost/effectiveness etc. remain to be challenging. This talk will address technical challenges for dosimetry verification of implementing these emerging technologies in radiation therapy.

Analysis of intra-fraction prostate motion and derivation of duration-dependent margins for radiotherapy using real-time 4D ultrasound

Directory of Open Access Journals (Sweden)

Eric Pei Ping Pang

2018-01-01

Full Text Available Background and purpose: During radiotherapy, prostate motion changes over time. Quantifying and accounting for this motion is essential. This study aimed to assess intra-fraction prostate motion and derive duration-dependent planning margins for two treatment techniques. Material and methods: A four-dimension (4D transperineal ultrasound Clarity® system was used to track prostate motion. We analysed 1913 fractions from 60 patients undergoing volumetric-modulated arc therapy (VMAT to the prostate. The mean VMAT treatment duration was 3.4 min. Extended monitoring was conducted weekly to simulate motion during intensity-modulated radiation therapy (IMRT treatment (an additional seven minutes. A motion-time trend analysis was conducted and the mean intra-fraction motion between VMAT and IMRT treatments compared. Duration-dependent margins were calculated and anisotropic margins for VMAT and IMRT treatments were derived. Results: There were statistically significant differences in the mean intra-fraction motion between VMAT and the simulated IMRT duration in the inferior (0.1 mm versus 0.3 mm and posterior (−0.2 versus −0.4 mm directions respectively (p ≪ 0.01. An intra-fraction motion trend inferiorly and posteriorly was observed. The recommended minimum anisotropic margins are 1.7 mm/2.7 mm (superior/inferior; 0.8 mm (left/right, 1.7 mm/2.9 mm (anterior/posterior for VMAT treatments and 2.9 mm/4.3 mm (superior/inferior, 1.5 mm (left/right, 2.8 mm/4.8 mm (anterior/posterior for IMRT treatments. Smaller anisotropic margins were required for VMAT compared to IMRT (differences ranging from 1.2 to 1.6 mm superiorly/inferiorly, 0.7 mm laterally and 1.1–1.9 mm anteriorly/posteriorly. Conclusions: VMAT treatment is preferred over IMRT as prostate motion increases with time. Larger margins should be employed in the inferior and posterior directions for both treatment durations. Duration-dependent margins should

IMRT limits nephrotoxicity after chemoradiotherapy for gastric cancer

International Nuclear Information System (INIS)

Trip, Anouk Kirsten; Nijkamp, Jasper; Tinteren, Harm van; Cats, Annemieke; Boot, Henk; Jansen, Edwin Petrus Marianus; Verheij, Marcel

2014-01-01

Objective: This observational study compares the effect of different radiotherapy techniques on late nephrotoxicity after postoperative chemoradiotherapy for gastric cancer. Patients and methods: Dosimetric parameters were compared between AP–PA, 3D-conformal and IMRT techniques. Renal function was measured by 99m Tc-MAG-3 renography, glomerular filtration rate (GFR) and the development of hypertension. Mixed effects models were used to compare renal function over time. Results: Eighty-seven patients treated between 2002 and 2010 were included, AP–PA (n = 31), 3D-conformal (n = 25) and IMRT (n = 31), all 45 Gy in 25 fractions. Concurrent chemotherapy: 5FU/leucovorin (n = 4), capecitabine (n = 37), and capecitabine/cisplatin (n = 46). Median follow-up time was 4.7 years (range 0.2–8). With IMRT, the mean dose to the left kidney was significantly lower. Left kidney function decreased progressively in the total study population, however with IMRT this occurred at a lower rate. A dose–effect relationship was present between mean dose to the left kidney and the left kidney function. GFR decreased only moderately in time, which was not different between techniques. Six patients developed hypertension, of whom none in the IMRT group. Conclusions: This study confirms progressive late nephrotoxicity in patients treated with postoperative chemoradiotherapy by different techniques for gastric cancer. Nephrotoxicity was less severe with IMRT and should be considered the preferred technique

IMRT limits nephrotoxicity after chemoradiotherapy for gastric cancer.

Science.gov (United States)

Trip, Anouk Kirsten; Nijkamp, Jasper; van Tinteren, Harm; Cats, Annemieke; Boot, Henk; Jansen, Edwin Petrus Marianus; Verheij, Marcel

2014-08-01

This observational study compares the effect of different radiotherapy techniques on late nephrotoxicity after postoperative chemoradiotherapy for gastric cancer. Dosimetric parameters were compared between AP-PA, 3D-conformal and IMRT techniques. Renal function was measured by (99m)Tc-MAG-3 renography, glomerular filtration rate (GFR) and the development of hypertension. Mixed effects models were used to compare renal function over time. Eighty-seven patients treated between 2002 and 2010 were included, AP-PA (n=31), 3D-conformal (n=25) and IMRT (n=31), all 45 Gy in 25 fractions. Concurrent chemotherapy: 5FU/leucovorin (n=4), capecitabine (n=37), and capecitabine/cisplatin (n=46). Median follow-up time was 4.7 years (range 0.2-8). With IMRT, the mean dose to the left kidney was significantly lower. Left kidney function decreased progressively in the total study population, however with IMRT this occurred at a lower rate. A dose-effect relationship was present between mean dose to the left kidney and the left kidney function. GFR decreased only moderately in time, which was not different between techniques. Six patients developed hypertension, of whom none in the IMRT group. This study confirms progressive late nephrotoxicity in patients treated with postoperative chemoradiotherapy by different techniques for gastric cancer. Nephrotoxicity was less severe with IMRT and should be considered the preferred technique. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A comparative study on patient specific absolute dosimetry using slab phantom, acrylic body phantom and goat head phantom

Directory of Open Access Journals (Sweden)

Om Prakash Gurjar

2015-01-01

Full Text Available Purpose: To compare the results of patient specific absolute dosimetry using slab phantom, acrylic body phantom and goat head phantom. Methods: Fifteen intensity modulated radiotherapy (IMRT plans already planned on treatment planning system (TPS for head-and-neck cancer patients were exported on all three kinds of phantoms viz. slab phantom, acrylic body phantom and goat head phantom, and dose was calculated using anisotropic analytic algorithm (AAA. All the gantry angles were set to zero in case of slab phantom while set to as it is in actual plan in case of other two phantoms. All the plans were delivered by linear accelerator (LA and dose for each plan was measured by 0.13 cc ion chamber. The percentage (% variations between planned and measured doses were calculated and analyzed. Results: The mean % variations between planned and measured doses of all IMRT quality assurance (QA plans were as 0.65 (Standard deviation (SD: 0.38 with confidence limit (CL 1.39, 1.16 (SD: 0.61 with CL 2.36 and 2.40 (SD: 0.86 with CL 4.09 for slab phantom, acrylic head phantom and goat head phantom respectively. Conclusion: Higher dose variations found in case of real tissue phantom compare to results in case of slab and acrylic body phantoms. The algorithm AAA does not calculate doses in heterogeneous medium as accurate as it calculates in homogeneous medium. Therefore the patient specific absolute dosimetry should be done using heterogeneous phantom mimicking density wise as well as design wise to the actual human body.  

Rotational IMRT techniques compared to fixed gantry IMRT and Tomotherapy: multi-institutional planning study for head-and-neck cases

Directory of Open Access Journals (Sweden)

Lutters Gerd

2011-02-01

Full Text Available Abstract Background Recent developments enable to deliver rotational IMRT with standard C-arm gantry based linear accelerators. This upcoming treatment technique was benchmarked in a multi-center treatment planning study against static gantry IMRT and rotational IMRT based on a ring gantry for a complex parotid gland sparing head-and-neck technique. Methods Treatment plans were created for 10 patients with head-and-neck tumours (oropharynx, hypopharynx, larynx using the following treatment planning systems (TPS for rotational IMRT: Monaco (ELEKTA VMAT solution, Eclipse (Varian RapidArc solution and HiArt for the helical tomotherapy (Tomotherapy. Planning of static gantry IMRT was performed with KonRad, Pinnacle and Panther DAO based on step&shoot IMRT delivery and Eclipse for sliding window IMRT. The prescribed doses for the high dose PTVs were 65.1Gy or 60.9Gy and for the low dose PTVs 55.8Gy or 52.5Gy dependend on resection status. Plan evaluation was based on target coverage, conformity and homogeneity, DVHs of OARs and the volume of normal tissue receiving more than 5Gy (V5Gy. Additionally, the cumulative monitor units (MUs and treatment times of the different technologies were compared. All evaluation parameters were averaged over all 10 patients for each technique and planning modality. Results Depending on IMRT technique and TPS, the mean CI values of all patients ranged from 1.17 to 2.82; and mean HI values varied from 0.05 to 0.10. The mean values of the median doses of the spared parotid were 26.5Gy for RapidArc and 23Gy for VMAT, 14.1Gy for Tomo. For fixed gantry techniques 21Gy was achieved for step&shoot+KonRad, 17.0Gy for step&shoot+Panther DAO, 23.3Gy for step&shoot+Pinnacle and 18.6Gy for sliding window. V5Gy values were lowest for the sliding window IMRT technique (3499 ccm and largest for RapidArc (5480 ccm. The lowest mean MU value of 408 was achieved by Panther DAO, compared to 1140 for sliding window IMRT. Conclusions All

Stereotactic radiosurgery photon field profile dosimetry using conventional dosimeters and polymer gel dosimetry. Analysis and inter-comparison

Energy Technology Data Exchange (ETDEWEB)

Pappas, E; Maris, T G; Zacharopoulou, F; Papadakis, A [Department of Medical Physics, Faculty of Medicine, University of Crete, 711 10 Stavrakia-Heraklion, Crete (Greece); Manolopoulos, S; Green, S [Queen Elizabeth Medical Centre, University Hospital Birmingham NHS Trust, Birmingham B15 2TH (United Kingdom); Wojnecki, C, E-mail: epappas@edu.med.uoc.gr

2009-05-01

Small photon fields are increasingly used in modern radiotherapy and especially in IMRT and SRS/SRT treatments. Accurate beam profile measurements of such beams are crucial for a precise and effective treatment. In this work four different dosimetric methods have been used for profile measurements of three small 6 MV circular fields having diameters of 7.5, 15.0 and 30.0 mm. A small sensitive volume air ion chamber, a diamond detector, a novel silicon-diode array and Vinyl-Pyrrolidone based polymer gel dosimetry. The results of this work reveal the well-known disadvantages and/or problems of the conventional dosimeters for this kind of measurements and support that polymer gel dosimetry may overcome these problems. Conclusively, it is estimated that polymer gels could play an important role towards the minimization of the total SRS/SRT treatment error that is related with small field profile measurements.

Multi-wire detector characterization for daily quality control on IMRT; Caracterizacao de um detector planar de multiplos fios para controle de qualidade diario de tratamentos com IMRT

Energy Technology Data Exchange (ETDEWEB)

Ferrari, Vilma A.; Watanabe, Erika Y.; Santos, Gabriela R.; Menegussi, Gisela, E-mail: vilmaferrari@uol.com.br [Instituto do Cancer do Estado de Sao Paulo (ICESP), SP (Brazil). Setor de Radioterapia

2012-08-15

Several dosimetry devices are being developed for quality control of radiation treatments using modern techniques as, for example, the Intensity Modulated Radiation Therapy (IMRT). The main function of these devices are to daily quality control of treatments of patients submitted to IMRT technique. The aim of this study is to characterize a type of planar multi-wire detector - DAVID (PTW) - for use in clinical practice. It was evaluated the influence of the system in the radiation beam by measuring the absorption factors and surface dose. We also analyzed the dose-linearity, reproducibility, the dependence with the dose rate and the angle of the linac head. Small errors in the position of the multi-leaf were inserted to evaluate the sensitivity of the system. The results showed that the detector can absorb up to 6.7% of the dose, depending of the energy beam and the field size. A significant increase in surface dose was observed, indicating that individual analysis is necessary for each patient. The system showed good reproducibility, linear response with dose, low dependence with dose rate and low dependence with the angle of the linac head. When small errors were inserted in the position of the multi-leaf, the system was able to detect them. Thus, the detector DAVID proved to be suitable for daily verification of IMRT treatments. (author)

Inverse planning IMRT

International Nuclear Information System (INIS)

Rosenwald, J.-C.

2008-01-01

The lecture addressed the following topics: Optimizing radiotherapy dose distribution; IMRT contributes to optimization of energy deposition; Inverse vs direct planning; Main steps of IMRT; Background of inverse planning; General principle of inverse planning; The 3 main components of IMRT inverse planning; The simplest cost function (deviation from prescribed dose); The driving variable : the beamlet intensity; Minimizing a 'cost function' (or 'objective function') - the walker (or skier) analogy; Application to IMRT optimization (the gradient method); The gradient method - discussion; The simulated annealing method; The optimization criteria - discussion; Hard and soft constraints; Dose volume constraints; Typical user interface for definition of optimization criteria; Biological constraints (Equivalent Uniform Dose); The result of the optimization process; Semi-automatic solutions for IMRT; Generalisation of the optimization problem; Driving and driven variables used in RT optimization; Towards multi-criteria optimization; and Conclusions for the optimization phase. (P.A.)

Use of computational methods for substitution and numerical dosimetry of real bones

International Nuclear Information System (INIS)

Silva, I.C.S.; Gonzalez, K.M.L.; Barbosa, A.J.A.; Lucindo Junior, C.R.; Vieira, J.W.; Lima, F.R.A.

2017-01-01

Estimating the dose that ionizing radiation deposits in the soft tissues of the skeleton within the cavities of the trabecular bones represents one of the greatest difficulties faced by numerical dosimetry. The Numerical Dosimetry Group (GDN/CNPq) Brazil, Recife-PE has used a method based on micro-CT images. The problem of the implementation of micro-CT is the difficulty in obtaining samples of real bones (OR). The objective of this work was to evaluate the sample of a virtual block of trabecular bone through the nonparametric method based on the voxel frequencies (VF) and samples of the climbing plant called Luffa aegyptica, whose dry fruit is known as vegetal bush (BV) substitution of OR samples. For this, a theoretical study of the two techniques developed by the GDN was made. The study showed in both techniques, after the dosimetric evaluations, that the actual sample can be replaced by the synthetic samples, since they have shown dose estimates close to the actual one

IMRT treatment of anal cancer with a scrotal shield

International Nuclear Information System (INIS)

Hood, Rodney C.; Wu, Q. Jackie; McMahon, Ryan; Czito, Brian; Willett, Christopher

2012-01-01

The risk of sterility in males undergoing radiotherapy in the pelvic region indicates the use of a shielding device, which offers protection to the testes for patients wishing to maintain fertility. The use of such devices in the realm of intensity-modulated radiotherapy (IMRT) in the pelvic region can pose many obstacles during simulation, treatment planning, and delivery of radiotherapy. This work focuses on the development and execution of an IMRT plan for the treatment of anal cancer using a scrotal shielding device on a clinical patient. An IMRT plan was developed using Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA), using a wide array of gantry angles as well as fixed jaw and fluence editing techniques. When possible, the entire target volume was encompassed by the treatment field. When the beam was incident on the scrotal shield, the jaw was fixed to avoid the device and the collimator rotation optimized to irradiate as much of the target as possible. This technique maximizes genital sparing and allows minimal irradiation of the gonads. When this fixed-jaw technique was found to compromise adequate coverage of the target, manual fluence editing techniques were used to avoid the shielding device. Special procedures for simulation, imaging, and treatment verification were also developed. In vivo dosimetry was used to verify and ensure acceptable dose to the gonads. The combination of these techniques resulted in a highly conformal plan that spares organs and risk and avoids the genitals as well as entrance of primary radiation onto the shielding device.

3-D dose verification for IMRT using optical CT based polymer gel dosimetry

Energy Technology Data Exchange (ETDEWEB)

Wuu, C [Department of Radiation Oncology, Columbia University, New York, New York (United States); Xu, Y [Department of Radiation Oncology, Columbia University, New York, New York (United States); Maryanski, M J [Department of Radiation Oncology, Columbia University, New York, New York (United States); MGS Research Inc., Madison, Connecticut (United States)

2004-01-01

In this study BANG[reg] polymer gels in conjunction with OCTOPUS{sup TM} optical CT scanner (MGS Research Inc., Madison, CT) was employed to measure the relative 3D dose distribution of an IMRT treatment. Measured relative dose distributions from the gel measurement were compared with those from treatment planning system calculations and EDR2 film measurements with regard to planar dose distributions in axial, coronal, and sagittal orientations.

3-D dose verification for IMRT using optical CT based polymer gel dosimetry

International Nuclear Information System (INIS)

Wuu, C; Xu, Y; Maryanski, M J

2004-01-01

In this study BANG[reg] polymer gels in conjunction with OCTOPUS TM optical CT scanner (MGS Research Inc., Madison, CT) was employed to measure the relative 3D dose distribution of an IMRT treatment. Measured relative dose distributions from the gel measurement were compared with those from treatment planning system calculations and EDR2 film measurements with regard to planar dose distributions in axial, coronal, and sagittal orientations

Dosimetry for audit and clinical trials: challenges and requirements

International Nuclear Information System (INIS)

Kron, T; Haworth, A; Williams, I

2013-01-01

Many important dosimetry audit networks for radiotherapy have their roots in clinical trial quality assurance (QA). In both scenarios it is essential to test two issues: does the treatment plan conform with the clinical requirements and is the plan a reasonable representation of what is actually delivered to a patient throughout their course of treatment. Part of a sound quality program would be an external audit of these issues with verification of the equivalence of plan and treatment typically referred to as a dosimetry audit. The increasing complexity of radiotherapy planning and delivery makes audits challenging. While verification of absolute dose delivered at a reference point was the standard of external dosimetry audits two decades ago this is often deemed inadequate for verification of treatment approaches such as Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT). As such, most dosimetry audit networks have successfully introduced more complex tests of dose delivery using anthropomorphic phantoms that can be imaged, planned and treated as a patient would. The new challenge is to adapt this approach to ever more diversified radiotherapy procedures with image guided/adaptive radiotherapy, motion management and brachytherapy being the focus of current research.

Tenth DOE workshop on personnel neutron dosimetry

International Nuclear Information System (INIS)

1984-06-01

The purpose of this workshop is to promote the international exchange of information on neutron dosimetry. The development of an accurate real-time dosemeter is an immediate need which must be met. Assessment of the neutron dose equivalent at low doses with a reasonable degree of accuracy must be accomplished to provide validity to exposure records. These and other aspects of personal neutron dosimetry are discussed. Separate abstracts have been prepared for each paper for inclusion in the Energy Data Base

Impact of gantry rotation time on plan quality and dosimetric verification. Volumetric modulated arc therapy (VMAT) vs. intensity modulated radiotherapy (IMRT)

Energy Technology Data Exchange (ETDEWEB)

Pasler, Marlies; Wirtz, Holger; Lutterbach, Johannes [Gemeinschaftspraxis fuer Strahlentherapie Singen-Friedrichshafen, Singen (Germany)

2011-12-15

To compare plan quality criteria and dosimetric accuracy of step-and-shoot intensity-modulated radiotherapy (ss-IMRT) and volumetric modulated arc radiotherapy (VMAT) using two different gantry rotation times. This retrospective planning study based on 20 patients was comprised of 10 prostate cancer (PC) and 10 head and neck (HN) cancer cases. Each plan contained two target volumes: a primary planning target volume (PTV) and a boost volume. For each patient, one ss-IMRT plan and two VMAT plans at 90 s (VMAT90) and 120 s (VMAT120) per arc were generated with the Pinnacle {sup copyright} planning system. Two arcs were provided for the PTV plans and a single arc for boost volumes. Dosimetric verification of the plans was performed using a 2D ionization chamber array placed in a full scatter phantom. VMAT reduced delivery time and monitor units for both treatment sites compared to IMRT. VMAT120 vs. VMAT90 increased delivery time and monitor units in PC plans without improving plan quality. For HN cases, VMAT120 provided comparable organs at risk sparing and better target coverage and conformity than VMAT90. In the VMAT plan verification, an average of 97.1% of the detector points passed the 3 mm, 3% {gamma} criterion, while in IMRT verification it was 98.8%. VMAT90, VMAT120, and IMRT achieved comparable treatment plans. Slower gantry movement in VMAT120 plans only improves dosimetric quality for highly complex targets.

Impact of gantry rotation time on plan quality and dosimetric verification. Volumetric modulated arc therapy (VMAT) vs. intensity modulated radiotherapy (IMRT)

International Nuclear Information System (INIS)

Pasler, Marlies; Wirtz, Holger; Lutterbach, Johannes

2011-01-01

To compare plan quality criteria and dosimetric accuracy of step-and-shoot intensity-modulated radiotherapy (ss-IMRT) and volumetric modulated arc radiotherapy (VMAT) using two different gantry rotation times. This retrospective planning study based on 20 patients was comprised of 10 prostate cancer (PC) and 10 head and neck (HN) cancer cases. Each plan contained two target volumes: a primary planning target volume (PTV) and a boost volume. For each patient, one ss-IMRT plan and two VMAT plans at 90 s (VMAT90) and 120 s (VMAT120) per arc were generated with the Pinnacle copyright planning system. Two arcs were provided for the PTV plans and a single arc for boost volumes. Dosimetric verification of the plans was performed using a 2D ionization chamber array placed in a full scatter phantom. VMAT reduced delivery time and monitor units for both treatment sites compared to IMRT. VMAT120 vs. VMAT90 increased delivery time and monitor units in PC plans without improving plan quality. For HN cases, VMAT120 provided comparable organs at risk sparing and better target coverage and conformity than VMAT90. In the VMAT plan verification, an average of 97.1% of the detector points passed the 3 mm, 3% γ criterion, while in IMRT verification it was 98.8%. VMAT90, VMAT120, and IMRT achieved comparable treatment plans. Slower gantry movement in VMAT120 plans only improves dosimetric quality for highly complex targets.

Shortening of culture time in conventional cytogenetic dosimetry

International Nuclear Information System (INIS)

Lamadrid, Ana I.; Gonzalez, Jorge E.; Romero, Ivonne; Garcia, Omar; Roy, Laurence

2008-01-01

Conventional cytogenetic dosimetry based on chromosome aberration in metaphases is a 'gold standard' of bio-dosimetry techniques for radiation dose assessment. This method is laborious and time consuming, the culturing process requires about 48 hours to obtain a satisfactory number of lymphocytes in mitosis. The current approach to reduce the dose estimation time by cytogenetic dosimetry is the preliminary estimation of dose counting only 50 metaphases. Another possibility is to reduce the culture time. The possibility of reduce the culture time under 48 hours adding Calyculin A has been suggested recently. In the present study we tested shorter times using Calyculin A and considering the G2/M-PCC index as culture quality indicator. Peripheral blood from healthy individuals was irradiated and then maintained at 37 C degrees for 2 hours allowing to act the cellular reparation mechanisms, lymphocytes were culture in RPMI 1640 supplemented with foetal calf serum and phytohemagglutinin. Colcemid was added 24 hours after cultures started and Calyculin A was added for the last hour. The cells were collected by centrifugation between 30 to 48 hours. The cells were treated with a hypotonic solution and the fixed cells dropped onto slides. The slides were stained with Giemsa. The incidence of metaphases with chromosomes well defined was scored. Two operators participated to the scoring according the same criteria. The results were analyzed to comparing the G2/M-PCC index relatives to achieve the shortest culture duration. The culture time reduction to 40 hours gives enough G2/M-PCC cells for dose estimation analysis. Lower culture times produced very low G2/M-PCC index. (author)

In vivo dosimetry: measurement of entrance and exit dose using MOSFET dosimeter

International Nuclear Information System (INIS)

Gopiraj, A.; Billimagga, Ramesh S.; Rekha, M.; Ramasubramaniam, V.

2007-01-01

Patient dose verification is an essential part of a Quality Assurance (QA) program in a Radiotherapy Department. As the transition is made from the conventional two-dimensional (2D) to three-dimensional (3D) conformal and intensity modulated therapy, it is recommended that new treatment techniques be checked systematically to guarantee accurate dose delivery by means of a comprehensive in vivo dosimetry program (i.e. real-time dosimetry during patient treatment). The authors conducted a study to assess the clinical utility of in vivo dosimetry in the Dept. of Radiation Oncology using MOSFET dosimetry system

MO-B-BRB-00: Three Dimensional Dosimetry

Energy Technology Data Exchange (ETDEWEB)

NONE

2016-06-15

Full three-dimensional (3D) dosimetry using volumetric chemical dosimeters probed by 3D imaging systems has long been a promising technique for the radiation therapy clinic, since it provides a unique methodology for dose measurements in the volume irradiated using complex conformal delivery techniques such as IMRT and VMAT. To date true 3D dosimetry is still not widely practiced in the community; it has been confined to centres of specialized expertise especially for quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. The potential for improved clinical applicability has been advanced considerably in the last decade by the development of improved 3D dosimeters (e.g., radiochromic plastics, radiochromic gel dosimeters and normoxic polymer gel systems) and by improved readout protocols using optical computed tomography or magnetic resonance imaging. In this session, established users of some current 3D chemical dosimeters will briefly review the current status of 3D dosimetry, describe several dosimeters and their appropriate imaging for dose readout, present workflow procedures required for good dosimetry, and analyze some limitations for applications in select settings. We will review the application of 3D dosimetry to various clinical situations describing how 3D approaches can complement other dose delivery validation approaches already available in the clinic. The applications presented will be selected to inform attendees of the unique features provided by full 3D techniques. Learning Objectives: L. John Schreiner: Background and Motivation Understand recent developments enabling clinically practical 3D dosimetry, Appreciate 3D dosimetry workflow and dosimetry procedures, and Observe select examples from the clinic. Sofie Ceberg: Application to dynamic radiotherapy Observe full dosimetry under dynamic radiotherapy during respiratory motion, and Understand how the measurement of high resolution dose data in an

New developments in radiochromic film dosimetry

International Nuclear Information System (INIS)

Soares, C. G.

2006-01-01

NIST has been a pioneer in the use of radiochromic film for medical dosimetry applications. Beginning in 1988 with experiments with 90 Sr/Y ophthalmic applicators, this work has continued into the present. A review of the latest applications is presented, which include high activity low-energy photon source dosimetry and ultra-high resolution film densitometry for dose enhancement near stents and microbeam radiation therapy dosimetry. An exciting recent development is the availability of a new radiochromic emulsion which has been developed for IMRT dosimetry. This emulsion is an order of magnitude more sensitive than was previously available. Measurements of the sensitivity and uniformity of samples of this new film are reported, using a spectrophotometer and two scanning laser densitometers. A unique feature of the new emulsion is that the peak of the absorbance spectrum falls at the wavelength of the HeNe lasers used in the densitometer, maximising sensitivity. When read at a wavelength of 633 nm, sensitivities on the order of 900 mAU Gy -1 were determined for this new film type, compared with about 40 mAU Gy -1 for type HS film, 20 mAU Gy -1 for type MD-55-2 film, and 3 mAU Gy -1 for type HD-810. Film uniformities were found to be good, on the order of 6% peak to peak. However, there is a strong polarisation effect in the samples examined, requiring care in film orientation during readout. (authors)

IMRT treatment of anal cancer with a scrotal shield.

Science.gov (United States)

Hood, Rodney C; Wu, Q Jackie; McMahon, Ryan; Czito, Brian; Willett, Christopher

2012-01-01

The risk of sterility in males undergoing radiotherapy in the pelvic region indicates the use of a shielding device, which offers protection to the testes for patients wishing to maintain fertility. The use of such devices in the realm of intensity-modulated radiotherapy (IMRT) in the pelvic region can pose many obstacles during simulation, treatment planning, and delivery of radiotherapy. This work focuses on the development and execution of an IMRT plan for the treatment of anal cancer using a scrotal shielding device on a clinical patient. An IMRT plan was developed using Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA), using a wide array of gantry angles as well as fixed jaw and fluence editing techniques. When possible, the entire target volume was encompassed by the treatment field. When the beam was incident on the scrotal shield, the jaw was fixed to avoid the device and the collimator rotation optimized to irradiate as much of the target as possible. This technique maximizes genital sparing and allows minimal irradiation of the gonads. When this fixed-jaw technique was found to compromise adequate coverage of the target, manual fluence editing techniques were used to avoid the shielding device. Special procedures for simulation, imaging, and treatment verification were also developed. In vivo dosimetry was used to verify and ensure acceptable dose to the gonads. The combination of these techniques resulted in a highly conformal plan that spares organs and risk and avoids the genitals as well as entrance of primary radiation onto the shielding device. Copyright © 2012 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Peripheral doses from pediatric IMRT

International Nuclear Information System (INIS)

Klein, Eric E.; Maserang, Beth; Wood, Roy; Mansur, David

2006-01-01

Peripheral dose (PD) data exist for conventional fields (≥10 cm) and intensity-modulated radiotherapy (IMRT) delivery to standard adult-sized phantoms. Pediatric peripheral dose reports are limited to conventional therapy and are model based. Our goal was to ascertain whether data acquired from full phantom studies and/or pediatric models, with IMRT treatment times, could predict Organ at Risk (OAR) dose for pediatric IMRT. As monitor units (MUs) are greater for IMRT, it is expected IMRT PD will be higher; potentially compounded by decreased patient size (absorption). Baseline slab phantom peripheral dose measurements were conducted for very small field sizes (from 2 to 10 cm). Data were collected at distances ranging from 5 to 72 cm away from the field edges. Collimation was either with the collimating jaws or the multileaf collimator (MLC) oriented either perpendicular or along the peripheral dose measurement plane. For the clinical tests, five patients with intracranial or base of skull lesions were chosen. IMRT and conventional three-dimensional (3D) plans for the same patient/target/dose (180 cGy), were optimized without limitation to the number of fields or wedge use. Six MV, 120-leaf MLC Varian axial beams were used. A phantom mimicking a 3-year-old was configured per Center for Disease Control data. Micro (0.125 cc) and cylindrical (0.6 cc) ionization chambers were appropriated for the thyroid, breast, ovaries, and testes. The PD was recorded by electrometers set to the 10 -10 scale. Each system set was uniquely calibrated. For the slab phantom studies, close peripheral points were found to have a higher dose for low energy and larger field size and when MLC was not deployed. For points more distant from the field edge, the PD was higher for high-energy beams. MLC orientation was found to be inconsequential for the small fields tested. The thyroid dose was lower for IMRT delivery than that predicted for conventional (ratio of IMRT/cnventional ranged from

Automated IMRT planning with regional optimization using planning scripts.

Science.gov (United States)

Xhaferllari, Ilma; Wong, Eugene; Bzdusek, Karl; Lock, Michael; Chen, Jeff

2013-01-07

Intensity-modulated radiation therapy (IMRT) has become a standard technique in radiation therapy for treating different types of cancers. Various class solutions have been developed for simple cases (e.g., localized prostate, whole breast) to generate IMRT plans efficiently. However, for more complex cases (e.g., head and neck, pelvic nodes), it can be time-consuming for a planner to generate optimized IMRT plans. To generate optimal plans in these more complex cases which generally have multiple target volumes and organs at risk, it is often required to have additional IMRT optimization structures such as dose limiting ring structures, adjust beam geometry, select inverse planning objectives and associated weights, and additional IMRT objectives to reduce cold and hot spots in the dose distribution. These parameters are generally manually adjusted with a repeated trial and error approach during the optimization process. To improve IMRT planning efficiency in these more complex cases, an iterative method that incorporates some of these adjustment processes automatically in a planning script is designed, implemented, and validated. In particular, regional optimization has been implemented in an iterative way to reduce various hot or cold spots during the optimization process that begins with defining and automatic segmentation of hot and cold spots, introducing new objectives and their relative weights into inverse planning, and turn this into an iterative process with termination criteria. The method has been applied to three clinical sites: prostate with pelvic nodes, head and neck, and anal canal cancers, and has shown to reduce IMRT planning time significantly for clinical applications with improved plan quality. The IMRT planning scripts have been used for more than 500 clinical cases.

WE-AB-BRB-02: Methods and Applications of 3D Radiochromic Dosimetry

Energy Technology Data Exchange (ETDEWEB)

Oldham, M. [Duke University Medical Center (United States)

2016-06-15

Despite widespread IMRT treatments at modern radiation therapy clinics, precise dosimetric commissioning of an IMRT system remains a challenge. In the most recent report from the Radiological Physics Center (RPC), nearly 20% of institutions failed an end-to-end test with an anthropomorphic head and neck phantom, a test that has rather lenient dose difference and distance-to-agreement criteria of 7% and 4 mm. The RPC report provides strong evidence that IMRT implementation is prone to error and that improved quality assurance tools are required. At the heart of radiation therapy dosimetry is the multidimensional dosimeter. However, due to the limited availability of water-equivalent dosimetry materials, research and development in this important field is challenging. In this session, we will review a few dosimeter developments that are either in the laboratory phase or in the pre-commercialization phase. 1) Radiochromic plastic. Novel formulations exhibit light absorbing optical contrast with very little scatter, enabling faster, broad beam optical CT design. 2) Storage phosphor. After irradiation, the dosimetry panels will be read out using a dedicated 2D scanning apparatus in a non-invasive, electro-optic manner and immediately restored for further use. 3) Liquid scintillator. Scintillators convert the energy from x-rays and proton beams into visible light, which can be recorded with a scientific camera (CCD or CMOS) from multiple angles. The 3D shape of the dose distribution can then be reconstructed. 4) Cherenkov emission imaging. Gated intensified imaging allows video-rate passive detection of Cherenkov emission during radiation therapy with the room lights on. Learning Objectives: To understand the physics of a variety of dosimetry techniques based upon optical imaging To investigate the strategies to overcome respective challenges and limitations To explore novel ideas of dosimeter design Supported in part by NIH Grants R01CA148853, R01CA182450, R01CA109558

WE-AB-BRB-02: Methods and Applications of 3D Radiochromic Dosimetry

International Nuclear Information System (INIS)

Oldham, M.

2016-01-01

Despite widespread IMRT treatments at modern radiation therapy clinics, precise dosimetric commissioning of an IMRT system remains a challenge. In the most recent report from the Radiological Physics Center (RPC), nearly 20% of institutions failed an end-to-end test with an anthropomorphic head and neck phantom, a test that has rather lenient dose difference and distance-to-agreement criteria of 7% and 4 mm. The RPC report provides strong evidence that IMRT implementation is prone to error and that improved quality assurance tools are required. At the heart of radiation therapy dosimetry is the multidimensional dosimeter. However, due to the limited availability of water-equivalent dosimetry materials, research and development in this important field is challenging. In this session, we will review a few dosimeter developments that are either in the laboratory phase or in the pre-commercialization phase. 1) Radiochromic plastic. Novel formulations exhibit light absorbing optical contrast with very little scatter, enabling faster, broad beam optical CT design. 2) Storage phosphor. After irradiation, the dosimetry panels will be read out using a dedicated 2D scanning apparatus in a non-invasive, electro-optic manner and immediately restored for further use. 3) Liquid scintillator. Scintillators convert the energy from x-rays and proton beams into visible light, which can be recorded with a scientific camera (CCD or CMOS) from multiple angles. The 3D shape of the dose distribution can then be reconstructed. 4) Cherenkov emission imaging. Gated intensified imaging allows video-rate passive detection of Cherenkov emission during radiation therapy with the room lights on. Learning Objectives: To understand the physics of a variety of dosimetry techniques based upon optical imaging To investigate the strategies to overcome respective challenges and limitations To explore novel ideas of dosimeter design Supported in part by NIH Grants R01CA148853, R01CA182450, R01CA109558

Identifying afterloading PDR and HDR brachytherapy errors using real-time fiber-coupled Al2O3:C dosimetry and a novel statistical error decision criterion

International Nuclear Information System (INIS)

Kertzscher, Gustavo; Andersen, Claus E.; Siebert, Frank-Andre; Nielsen, Soren Kynde; Lindegaard, Jacob C.; Tanderup, Kari

2011-01-01

Background and purpose: The feasibility of a real-time in vivo dosimeter to detect errors has previously been demonstrated. The purpose of this study was to: (1) quantify the sensitivity of the dosimeter to detect imposed treatment errors under well controlled and clinically relevant experimental conditions, and (2) test a new statistical error decision concept based on full uncertainty analysis. Materials and methods: Phantom studies of two gynecological cancer PDR and one prostate cancer HDR patient treatment plans were performed using tandem ring applicators or interstitial needles. Imposed treatment errors, including interchanged pairs of afterloader guide tubes and 2-20 mm source displacements, were monitored using a real-time fiber-coupled carbon doped aluminum oxide (Al 2 O 3 :C) crystal dosimeter that was positioned in the reconstructed tumor region. The error detection capacity was evaluated at three dose levels: dwell position, source channel, and fraction. The error criterion incorporated the correlated source position uncertainties and other sources of uncertainty, and it was applied both for the specific phantom patient plans and for a general case (source-detector distance 5-90 mm and position uncertainty 1-4 mm). Results: Out of 20 interchanged guide tube errors, time-resolved analysis identified 17 while fraction level analysis identified two. Channel and fraction level comparisons could leave 10 mm dosimeter displacement errors unidentified. Dwell position dose rate comparisons correctly identified displacements ≥5 mm. Conclusion: This phantom study demonstrates that Al 2 O 3 :C real-time dosimetry can identify applicator displacements ≥5 mm and interchanged guide tube errors during PDR and HDR brachytherapy. The study demonstrates the shortcoming of a constant error criterion and the advantage of a statistical error criterion.

Film Dosimetry for Intensity Modulated Radiation Therapy

International Nuclear Information System (INIS)

Benites-Rengifo, J.; Martinez-Davalos, A.; Celis, M.; Larraga, J.

2004-01-01

Intensity Modulated Radiation Therapy (IMRT) is an oncology treatment technique that employs non-uniform beam intensities to deliver highly conformal radiation to the targets while minimizing doses to normal tissues and critical organs. A key element for a successful clinical implementation of IMRT is establishing a dosimetric verification process that can ensure that delivered doses are consistent with calculated ones for each patient. To this end we are developing a fast quality control procedure, based on film dosimetry techniques, to be applied to the 6 MV Novalis linear accelerator for IMRT of the Instituto Nacional de Neurologia y Neurocirugia (INNN) in Mexico City. The procedure includes measurements of individual fluence maps for a limited number of fields and dose distributions in 3D using extended dose-range radiographic film. However, the film response to radiation might depend on depth, energy and field size, and therefore compromise the accuracy of measurements. In this work we present a study of the dependence of Kodak EDR2 film's response on the depth, field size and energy, compared with those of Kodak XV2 film. The first aim is to devise a fast and accurate method to determine the calibration curve of film (optical density vs. doses) commonly called a sensitometric curve. This was accomplished by using three types of irradiation techniques: Step-and-shoot, dynamic and static fields

Planning issues for IMRT

International Nuclear Information System (INIS)

Hoban, P.; Schneider, M.; Smee, R.

2001-01-01

Full text: Despite the 'inverse planning' stage of an intensity modulated radiotherapy (IMRT) treatment there remains a large number of variables that can, and must, be set manually. These variables can significantly affect the quality of the dose distribution arrived at by the optimisation. Clinical IMRT planning with the Radionics XPlan system for micro-multileaf collimator (MMLC) delivery has allowed for important lessons to be learned regarding the best beam and organ configurations prior to optimisation of beamlet weights. Important user-definable variables are beam directions, organ parameters (dose goals/penalties), and the margin (if any) around the planning target volume (PTV) used to aid coverage. Conventional stereotactic radiotherapy (SRT) treatments typically involve non-coplanar beams since there is often an advantage in terms of cranial organ at risk (OAR) sparing. IMRT can also benefit from such a configuration. The balance between target coverage and OAR sparing is largely controlled by user-defined goal doses and penalties. Once optimisation has been performed, intensity maps can be discretised into a selected number of levels. Less levels means less field segments and thus a shorter treatment time. Although IMRT beams attempt to spare structures which are in the 'beam's eye view' (BEV) of the target volume, sparing is greater if beams which minimise the involvement of OARs in their view are used. It has been found that the use of a margin is an effective way to ensure adequate PTV coverage. Alternatively the PTV penalties can be made larger. The best result is often obtained by the use of a 3-4 mm margin, whose penalty for underdosage is somewhat less than that for the PTV. Discretising the intensity maps to 4 or 5 levels is typically a good balance between shortening treatment time and not overly degrading the dose distribution. Beam configuration is still an important step in IMRT planning, even though optimisation of intensity maps is

Emphasizing Conformal Avoidance Versus Target Definition for IMRT Planning in Head-and-Neck Cancer

International Nuclear Information System (INIS)

Harari, Paul M.; Song Shiyu; Tome, Wolfgang A.

2010-01-01

Purpose: To describe a method for streamlining the process of elective nodal volume definition for head-and-neck (H and N) intensity-modulated radiotherapy (IMRT) planning. Methods and Materials: A total of 20 patients who had undergone curative-intent RT for H and N cancer underwent comprehensive treatment planning using three distinct, plan design techniques: conventional three-field design, target-defined IMRT (TD-IMRT), and conformal avoidance IMRT (CA-IMRT). For each patient, the conventional three-field design was created first, thereby providing the 'outermost boundaries' for subsequent IMRT design. In brief, TD-IMRT involved physician contouring of the gross tumor volume, high- and low-risk clinical target volume, and normal tissue avoidance structures on consecutive 1.25-mm computed tomography images. CA-IMRT involved physician contouring of the gross tumor volume and normal tissue avoidance structures only. The overall physician time for each approach was monitored, and the resultant plans were rigorously compared. Results: The average physician working time for the design of the respective H and N treatment contours was 0.3 hour for the conventional three-field design plan, 2.7 hours for TD-IMRT, and 0.9 hour for CA-IMRT. Dosimetric analysis confirmed that the largest volume of tissue treated to an intermediate (50 Gy) and high (70 Gy) dose occurred with the conventional three-field design followed by CA-IMRT and then TD-IMRT. However, for the two IMRT approaches, comparable results were found in terms of salivary gland and spinal cord protection. Conclusion: CA-IMRT for H and N treatment offers an alternative to TD-IMRT. The overall time for physician contouring was substantially reduced (approximately threefold), yielding a more standardized elective nodal volume. Because of the complexity of H and N IMRT target design, CA-IMRT might ultimately prove a safer and more reliable method to export to general radiation oncology practitioners, particularly

Internal Audit of a Comprehensive IMRT Program for Prostate Cancer: A Model for Centers in Developing Countries?

International Nuclear Information System (INIS)

Koh, Wee Yao; Ren Wei; Mukherjee, Rahul K.; Chung, Hans T.

2009-01-01

Purpose: With improving regional prosperity, significant capital investments have been made to rapidly expand radiotherapy capacity across Southeast Asia. Yet little has been reported on the implementation of adequate quality assurance (QA) in patient management. The objective of this study is to perform an in-depth QA assessment of our definitive intensity-modulated radiotherapy (IMRT) program for prostate cancer since its inception. Methods and Materials: The department's prostate IMRT program was modeled after that of University of California San Francisco. A departmental protocol consisting of radiotherapy volume/dose and hormone sequencing/duration and a set of 18 dose objectives to the target and critical organs were developed, and all plans were presented at the weekly departmental QA rounds. All patients treated with definitive IMRT for nonmetastatic prostate cancer were retrospectively reviewed. Protocol adherence, dosimetry data, toxicities, and outcomes were evaluated. Results: Since 2005, 76 patients received IMRT: 54 with whole-pelvis and 22 with prostate-only treatment. Of the 1,140 recorded dosimetric end points, 39 (3.3%) did not meet the protocol criteria. At QA rounds, no plans required a revision. Only one major protocol violation was observed. Two and two cases of Grade 3-4 acute and late toxicities, respectively, were observed. Five (8.8%) patients developed proctitis, but only one required argon laser therapy. Conclusions: Our comprehensive, practice-adapted QA measures appeared to ensure that we were able to consistently generate conforming IMRT plans with acceptable toxicities. These measures can be easily integrated into other clinics contemplating on developing such a program.

SU-E-T-538: Evaluation of IMRT Dose Calculation Based on Pencil-Beam and AAA Algorithms.

Science.gov (United States)

Yuan, Y; Duan, J; Popple, R; Brezovich, I

2012-06-01

To evaluate the accuracy of dose calculation for intensity modulated radiation therapy (IMRT) based on Pencil Beam (PB) and Analytical Anisotropic Algorithm (AAA) computation algorithms. IMRT plans of twelve patients with different treatment sites, including head/neck, lung and pelvis, were investigated. For each patient, dose calculation with PB and AAA algorithms using dose grid sizes of 0.5 mm, 0.25 mm, and 0.125 mm, were compared with composite-beam ion chamber and film measurements in patient specific QA. Discrepancies between the calculation and the measurement were evaluated by percentage error for ion chamber dose and γ〉l failure rate in gamma analysis (3%/3mm) for film dosimetry. For 9 patients, ion chamber dose calculated with AAA-algorithms is closer to ion chamber measurement than that calculated with PB algorithm with grid size of 2.5 mm, though all calculated ion chamber doses are within 3% of the measurements. For head/neck patients and other patients with large treatment volumes, γ〉l failure rate is significantly reduced (within 5%) with AAA-based treatment planning compared to generally more than 10% with PB-based treatment planning (grid size=2.5 mm). For lung and brain cancer patients with medium and small treatment volumes, γ〉l failure rates are typically within 5% for both AAA and PB-based treatment planning (grid size=2.5 mm). For both PB and AAA-based treatment planning, improvements of dose calculation accuracy with finer dose grids were observed in film dosimetry of 11 patients and in ion chamber measurements for 3 patients. AAA-based treatment planning provides more accurate dose calculation for head/neck patients and other patients with large treatment volumes. Compared with film dosimetry, a γ〉l failure rate within 5% can be achieved for AAA-based treatment planning. © 2012 American Association of Physicists in Medicine.

The use of gel dosimetry for verification of electron and photon treatment plans in carcinoma of the scalp

International Nuclear Information System (INIS)

Trapp, J V; Partridge, M; Hansen, V N; Childs, P; Bedford, J; Warrington, A P; Leach, M O; Webb, S

2004-01-01

In recent years there has been a large amount of research into the potential use of radiation sensitive gels for three-dimensional verification of clinical radiotherapy doses. In this paper we report the use of a MAGIC gel dosimeter (Fong et al 2001 Phys. Med. Biol. 46 3105) for the verification of a specific patient's radiation therapy dose distribution. A 69-year-old male patient presented with a squamous cell carcinoma extending approximately 180 deg. across the top of the scalp (anterior to posterior) and from just over midline to 90 deg. left of the skull. The patient's treatment was commenced using two electron fields. For gel dosimetry, phantoms were produced in which the outer surface spatially corresponded to the outer contours of the patient's anatomy in the region of irradiation. The phantoms were treated with either electrons or intensity modulated radiation therapy (IMRT) with photons. The results identified a hot spot between the matched electron fields and confirmed the more homogeneous dose distribution produced by the IMRT planning system. The IMRT plan was then clinically implemented. The application of a clinical dose to a phantom shaped to a specific patient as well as the ability to select a slice at will during phantom imaging means that gel dosimetry can no longer be considered to simply have potential alone, but is now in fact a useful dosimetric tool

SU-C-201-02: Dosimetric Verification of SBRT with FFF-VMAT Using a 3-D Radiochromic/Optical-CT Dosimetry System

Energy Technology Data Exchange (ETDEWEB)

Na, Y; Black, P; Wuu, C [Columbia University, New York, NY (United States); Adamovics, J [Department of Chemistry and Biology, Rider University, Skillman, NJ (United States)

2016-06-15

Purpose: With an increasing use of small field size and high dose rate irradiation in the advances of radiotherapy techniques, such as stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS), an in-depth quality assurance (QA) system is required. The purpose of this study is to investigate a high resolution optical CT-based 3D radiochromic dosimetry system for SBRT with intensity modulated radiotherapy (IMRT) and flattening filter free (FFF) volumetric modulated arc therapy (VMAT). Methods: Cylindrical PRESAGE radiochromic dosimeters of 10cm height and 11cm diameter were used to validate SBRT. Four external landmarks were placed on the surface of each dosimeter to define the isocenter of target. SBRT plans were delivered using a Varian TrueBeam™ linear accelerator (LINAC). Three validation plans, SBRT with IMRT (6MV 600MU/min), FFF-VMAT (10MV 2400MU/min), and mixed FFF-VMAT (6MV 1400MU/min, 10MV 2400MU/min), were delivered to the PRESAGE dosimeters. Each irradiated PRESAGE dosimeter was scanned using a single laser beam optical CT scanner and reconstructed with a 1mm × 1mm high spatial resolution. The comparison of measured dose distributions of irradiated PRESAGE dosimeters to those calculated by Pinnacle{sup 3} treatment planning system (TPS) were performed with a 10% dose threshold, 3% dose difference (DD), and 3mm distance-to-agreement (DTA) Gamma criteria. Results: The average pass rates for the gamma comparisons between PRESAGE and Pinnacle{sup 3} in the transverse, sagittal, coronal planes were 94.6%, 95.9%, and 96.4% for SBRT with IMRT, FFF-VMAT, and mixed FFF-VMAT plans, respectively. A good agreement of the isodose distributions of those comparisons were shown at the isodose lines 50%, 70%, 80%, 90% and 98%. Conclusion: This study demonstrates the feasibility of the high resolution optical CT-based 3D radiochromic dosimetry system for validation of SBRT with IMRT and FFF-VMAT. This dosimetry system offers higher precision QA with 3D

WE-AB-BRB-01: Memorial Introduction; Storage Phosphor Panels for Radiation Therapy Dosimetry

Energy Technology Data Exchange (ETDEWEB)

Li, H. [Washington University School of Medicine (United States)

2016-06-15

Despite widespread IMRT treatments at modern radiation therapy clinics, precise dosimetric commissioning of an IMRT system remains a challenge. In the most recent report from the Radiological Physics Center (RPC), nearly 20% of institutions failed an end-to-end test with an anthropomorphic head and neck phantom, a test that has rather lenient dose difference and distance-to-agreement criteria of 7% and 4 mm. The RPC report provides strong evidence that IMRT implementation is prone to error and that improved quality assurance tools are required. At the heart of radiation therapy dosimetry is the multidimensional dosimeter. However, due to the limited availability of water-equivalent dosimetry materials, research and development in this important field is challenging. In this session, we will review a few dosimeter developments that are either in the laboratory phase or in the pre-commercialization phase. 1) Radiochromic plastic. Novel formulations exhibit light absorbing optical contrast with very little scatter, enabling faster, broad beam optical CT design. 2) Storage phosphor. After irradiation, the dosimetry panels will be read out using a dedicated 2D scanning apparatus in a non-invasive, electro-optic manner and immediately restored for further use. 3) Liquid scintillator. Scintillators convert the energy from x-rays and proton beams into visible light, which can be recorded with a scientific camera (CCD or CMOS) from multiple angles. The 3D shape of the dose distribution can then be reconstructed. 4) Cherenkov emission imaging. Gated intensified imaging allows video-rate passive detection of Cherenkov emission during radiation therapy with the room lights on. Learning Objectives: To understand the physics of a variety of dosimetry techniques based upon optical imaging To investigate the strategies to overcome respective challenges and limitations To explore novel ideas of dosimeter design Supported in part by NIH Grants R01CA148853, R01CA182450, R01CA109558

WE-AB-BRB-01: Memorial Introduction; Storage Phosphor Panels for Radiation Therapy Dosimetry

International Nuclear Information System (INIS)

Li, H.

2016-01-01

Despite widespread IMRT treatments at modern radiation therapy clinics, precise dosimetric commissioning of an IMRT system remains a challenge. In the most recent report from the Radiological Physics Center (RPC), nearly 20% of institutions failed an end-to-end test with an anthropomorphic head and neck phantom, a test that has rather lenient dose difference and distance-to-agreement criteria of 7% and 4 mm. The RPC report provides strong evidence that IMRT implementation is prone to error and that improved quality assurance tools are required. At the heart of radiation therapy dosimetry is the multidimensional dosimeter. However, due to the limited availability of water-equivalent dosimetry materials, research and development in this important field is challenging. In this session, we will review a few dosimeter developments that are either in the laboratory phase or in the pre-commercialization phase. 1) Radiochromic plastic. Novel formulations exhibit light absorbing optical contrast with very little scatter, enabling faster, broad beam optical CT design. 2) Storage phosphor. After irradiation, the dosimetry panels will be read out using a dedicated 2D scanning apparatus in a non-invasive, electro-optic manner and immediately restored for further use. 3) Liquid scintillator. Scintillators convert the energy from x-rays and proton beams into visible light, which can be recorded with a scientific camera (CCD or CMOS) from multiple angles. The 3D shape of the dose distribution can then be reconstructed. 4) Cherenkov emission imaging. Gated intensified imaging allows video-rate passive detection of Cherenkov emission during radiation therapy with the room lights on. Learning Objectives: To understand the physics of a variety of dosimetry techniques based upon optical imaging To investigate the strategies to overcome respective challenges and limitations To explore novel ideas of dosimeter design Supported in part by NIH Grants R01CA148853, R01CA182450, R01CA109558

Implementation of IMRT in a real case of breast cancer radiotherapy in the 'Hospital Hermanos Ameijeiras' Service

International Nuclear Information System (INIS)

Rodriguez Zayas, Michael; Correa Pablos, Tamara; Perez Guevara, Adrian; Gonzalez Perez, Yelina; Sola Rodriguez, Yeline; Reyes Gonzalez, Tommy; Caballero, Roberto; Del Castillo Carrillo, Concepcion; Mena Huerta, Yailen

2009-01-01

Patients with left breast cancer suggest a clinical challenge because it radiates significantly heart, lung and contralateral breast with tangential beam techniques. We performed a study to: (1) design a plan using intensity modulated radiation therapy (IMRT), (2) compare IMRT plan with a plan of 3DCRT beam shear, (3) quantify the benefits of a treatment modality over another. A case diagnosed with breast cancer and treated with IMRT planned. The planning is done with the TPS Precise Plan version 2.16, with the inverse method based on openings, the treatment is carried out by way of step and shoot in the Elekta Precise Linac model with nominal energy of photons 6mV (TPR20, 10 = 0.681). (Author)

Dose discrepancies in the buildup region and their impact on dose calculations for IMRT fields

International Nuclear Information System (INIS)

Hsu, Shu-Hui; Moran, Jean M.; Chen Yu; Kulasekere, Ravi; Roberson, Peter L.

2010-01-01

Purpose: Dose accuracy in the buildup region for radiotherapy treatment planning suffers from challenges in both measurement and calculation. This study investigates the dosimetry in the buildup region at normal and oblique incidences for open and IMRT fields and assesses the quality of the treatment planning calculations. Methods: This study was divided into three parts. First, percent depth doses and profiles (for 5x5, 10x10, 20x20, and 30x30 cm 2 field sizes at 0 deg., 45 deg., and 70 deg. incidences) were measured in the buildup region in Solid Water using an Attix parallel plate chamber and Kodak XV film, respectively. Second, the parameters in the empirical contamination (EC) term of the convolution/superposition (CVSP) calculation algorithm were fitted based on open field measurements. Finally, seven segmental head-and-neck IMRT fields were measured on a flat phantom geometry and compared to calculations using γ and dose-gradient compensation (C) indices to evaluate the impact of residual discrepancies and to assess the adequacy of the contamination term for IMRT fields. Results: Local deviations between measurements and calculations for open fields were within 1% and 4% in the buildup region for normal and oblique incidences, respectively. The C index with 5%/1 mm criteria for IMRT fields ranged from 89% to 99% and from 96% to 98% at 2 mm and 10 cm depths, respectively. The quality of agreement in the buildup region for open and IMRT fields is comparable to that in nonbuildup regions. Conclusions: The added EC term in CVSP was determined to be adequate for both open and IMRT fields. Due to the dependence of calculation accuracy on (1) EC modeling, (2) internal convolution and density grid sizes, (3) implementation details in the algorithm, and (4) the accuracy of measurements used for treatment planning system commissioning, the authors recommend an evaluation of the accuracy of near-surface dose calculations as a part of treatment planning commissioning.

Eight years of IMRT quality assurance with ionization chambers and film dosimetry: experience of the montpellier comprehensive cancer center

Directory of Open Access Journals (Sweden)

Dubois Jean-Bernard

2011-07-01

Full Text Available Abstract Background To present the results of quality assurance (QA in IMRT of film dosimetry and ionization chambers measurements with an eight year follow-up. Methods All treatment plans were validated under the linear accelerator by absolute and relative measures obtained with ionization chambers (IC and with XomatV and EDR2 films (Kodak. Results The average difference between IC measured and computed dose at isocenter with the gantry angle of 0° was 0.07 ± 1.22% (average ± 1 SD for 2316 prostate, 1.33 ± 3.22% for 808 head and neck (h&n, and 0.37 ± 0.62% for 108 measurements of prostate bed fields. Pelvic treatment showed differences of 0.49 ± 1.86% in 26 fields for prostate cases and 2.07 ± 2.83% in 109 fields of anal canal. Composite measurement at isocenter for each patient showed an average difference with computed dose of 0.05 ± 0.87% for 386 prostate, 1.49 ± 1.86% for 158 h&n, 0.37 ± 0.34% for 23 prostate bed, 0.80 ± 0.28% for 4 pelvis, and 2.31 ± 0.56% for 17 anal canal cases. On the first 250 h&n analyzed by film in absolute dose, the average of the points crossing a gamma index 3% and 3 mm was 93%. This value reached 99% for the prostate fields. Conclusion More than 3500 beams were found to be within the limits defined as validated for treatment between 2001 and 2008.

[Statistical process control applied to intensity modulated radiotherapy pretreatment controls with portal dosimetry].

Science.gov (United States)

Villani, N; Gérard, K; Marchesi, V; Huger, S; François, P; Noël, A

2010-06-01

The first purpose of this study was to illustrate the contribution of statistical process control for a better security in intensity modulated radiotherapy (IMRT) treatments. This improvement is possible by controlling the dose delivery process, characterized by pretreatment quality control results. So, it is necessary to put under control portal dosimetry measurements (currently, the ionisation chamber measurements were already monitored by statistical process control thanks to statistical process control tools). The second objective was to state whether it is possible to substitute ionisation chamber with portal dosimetry in order to optimize time devoted to pretreatment quality control. At Alexis-Vautrin center, pretreatment quality controls in IMRT for prostate and head and neck treatments were performed for each beam of each patient. These controls were made with an ionisation chamber, which is the reference detector for the absolute dose measurement, and with portal dosimetry for the verification of dose distribution. Statistical process control is a statistical analysis method, coming from industry, used to control and improve the studied process quality. It uses graphic tools as control maps to follow-up process, warning the operator in case of failure, and quantitative tools to evaluate the process toward its ability to respect guidelines: this is the capability study. The study was performed on 450 head and neck beams and on 100 prostate beams. Control charts, showing drifts, both slow and weak, and also both strong and fast, of mean and standard deviation have been established and have shown special cause introduced (manual shift of the leaf gap of the multileaf collimator). Correlation between dose measured at one point, given with the EPID and the ionisation chamber has been evaluated at more than 97% and disagreement cases between the two measurements were identified. The study allowed to demonstrate the feasibility to reduce the time devoted to

Statistical process control applied to intensity modulated radiotherapy pretreatment controls with portal dosimetry

International Nuclear Information System (INIS)

Villani, N.; Noel, A.; Villani, N.; Gerard, K.; Marchesi, V.; Huger, S.; Noel, A.; Francois, P.

2010-01-01

Purpose The first purpose of this study was to illustrate the contribution of statistical process control for a better security in intensity modulated radiotherapy (I.M.R.T.) treatments. This improvement is possible by controlling the dose delivery process, characterized by pretreatment quality control results. So, it is necessary to put under control portal dosimetry measurements (currently, the ionisation chamber measurements were already monitored by statistical process control thanks to statistical process control tools). The second objective was to state whether it is possible to substitute ionisation chamber with portal dosimetry in order to optimize time devoted to pretreatment quality control. Patients and methods At Alexis-Vautrin center, pretreatment quality controls in I.M.R.T. for prostate and head and neck treatments were performed for each beam of each patient. These controls were made with an ionisation chamber, which is the reference detector for the absolute dose measurement, and with portal dosimetry for the verification of dose distribution. Statistical process control is a statistical analysis method, coming from industry, used to control and improve the studied process quality. It uses graphic tools as control maps to follow-up process, warning the operator in case of failure, and quantitative tools to evaluate the process toward its ability to respect guidelines: this is the capability study. The study was performed on 450 head and neck beams and on 100 prostate beams. Results Control charts, showing drifts, both slow and weak, and also both strong and fast, of mean and standard deviation have been established and have shown special cause introduced (manual shift of the leaf gap of the multi-leaf collimator). Correlation between dose measured at one point, given with the E.P.I.D. and the ionisation chamber has been evaluated at more than 97% and disagreement cases between the two measurements were identified. Conclusion The study allowed to

Implementation of DMLC quality control using EPID (Portal Dosimetry); Implementacao de um controle de qualidade de DMLC utilizando um EPID (Portal Dosimetry)

Energy Technology Data Exchange (ETDEWEB)

Mattos, Fabio R.; Furnari, Laura, E-mail: mattos.fr@gmail.com [Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Faculdade de Medicina; Universidade de Sao Paulo (INRAD/HC/FMUSP), Sao Paulo, SP (Brazil). Instituto de Radiologia. Setor de Radioterapia

2017-11-01

A Quality Assurance (QA) to ensure the expected performance of a Multileaf Collimator System (MLC) is essential to deliver dose in a safety and appropriate way. The time required for equipment control and dosimetry may be reduced when the Electronic Portal Image Device (EPID) is used. The aim of this work was to check the resolution limits of the detection system for IMRT mode, and to propose a set of tests that can provide positioning analysis of a multileaf system. A Varian iX Clinac equipped with an 80 leaf Millenium MLC, and an amorphous silicon based EPID (aS1000) was used. The EPID proved itself effective for detecting errors up to 0.5 mm. The proposed tests provided relevant results of leaf position, and revealed that the MLC system is within acceptable limits found in literature. (author)

IMRT plan verification in radiotherapy

International Nuclear Information System (INIS)

Vlk, P.

2006-01-01

This article describes the procedure for verification of IMRT (Intensity modulated radiation therapy) plan, which is used in the Oncological Institute of St. Elisabeth in Bratislava. It contains basic description of IMRT technology and developing a deployment plan for IMRT planning system CORVUS 6.0, the device Mimic (Multilammelar intensity modulated collimator) and the overall process of verifying the schedule created. The aim of verification is particularly good control of the functions of MIMIC and evaluate the overall reliability of IMRT planning. (author)

The use of IMRT in Germany

International Nuclear Information System (INIS)

Frenzel, Thorsten; Kruell, Andreas

2015-01-01

Intensity modulated radiotherapy (IMRT) is frequently used, but there are no data about current frequency regarding specific tumor sites and equipment used for quality assurance (QA). An online survey about IMRT was executed from April to October 2014 by the collaborative IMRT working group (AK IMRT) of the German Association of Medical Physicists (DGMP). A total of 23 German institutions took part in the survey. Most reports came from users working with Elekta, Varian, and Siemens treatment machines, but also from TomoTherapy and BrainLab. Most frequent IMRT technology was volumetric modulated arc therapy (58.37 %: VMAT/''rapid arc''), followed by step-and-shoot IMRT (14.66 %), dynamic MLC (dMLC: 14.53 %), TomoTherapy (9.25 %), and 3.2 % other techniques. Different commercial hard- and software solutions are available for QA, whereas many institutes still develop their own phantoms. Data of 26,779 patients were included in the survey; 44 % were treated using IMRT techniques. IMRT was most frequently used for anal cancer, (whole) craniospinal irradiation, head and neck cancer, prostate cancer, other tumors in the pelvic region, gynecological tumors (except for breast cancer), and brain tumors. An estimated 10 % of all patients treated in 2014 with radiation in Germany were included in the survey. It is representative for the members of the AK IMRT. IMRT may be on the way to replace other treatment techniques. However, many scientific questions are still open. In particular, it is unclear when the IMRT technique should not be used. (orig.) [de

Real-time systems

OpenAIRE

Badr, Salah M.; Bruztman, Donald P.; Nelson, Michael L.; Byrnes, Ronald Benton

1992-01-01

This paper presents an introduction to the basic issues involved in real-time systems. Both real-time operating sys and real-time programming languages are explored. Concurrent programming and process synchronization and communication are also discussed. The real-time requirements of the Naval Postgraduate School Autonomous Under Vehicle (AUV) are then examined. Autonomous underwater vehicle (AUV), hard real-time system, real-time operating system, real-time programming language, real-time sy...

MRI-based treatment planning for radiotherapy: Dosimetric verification for prostate IMRT

International Nuclear Information System (INIS)

Chen, Lili; Price, Robert A.; Wang Lu; Li Jinsheng; Qin Lihong; McNeeley, Shawn; Ma, C.-M. Charlie; Freedman, Gary M.; Pollack, Alan

2004-01-01

Purpose: Magnetic resonance (MR) and computed tomography (CT) image fusion with CT-based dose calculation is the gold standard for prostate treatment planning. MR and CT fusion with CT-based dose calculation has become a routine procedure for intensity-modulated radiation therapy (IMRT) treatment planning at Fox Chase Cancer Center. The use of MRI alone for treatment planning (or MRI simulation) will remove any errors associated with image fusion. Furthermore, it will reduce treatment cost by avoiding redundant CT scans and save patient, staff, and machine time. The purpose of this study is to investigate the dosimetric accuracy of MRI-based treatment planning for prostate IMRT. Methods and materials: A total of 30 IMRT plans for 15 patients were generated using both MRI and CT data. The MRI distortion was corrected using gradient distortion correction (GDC) software provided by the vendor (Philips Medical System, Cleveland, OH). The same internal contours were used for the paired plans. The external contours were drawn separately between CT-based and MR imaging-based plans to evaluate the effect of any residual distortions on dosimetric accuracy. The same energy, beam angles, dose constrains, and optimization parameters were used for dose calculations for each paired plans using a treatment optimization system. The resulting plans were compared in terms of isodose distributions and dose-volume histograms (DVHs). Hybrid phantom plans were generated for both the CT-based plans and the MR-based plans using the same leaf sequences and associated monitor units (MU). The physical phantom was then irradiated using the same leaf sequences to verify the dosimetry accuracy of the treatment plans. Results: Our results show that dose distributions between CT-based and MRI-based plans were equally acceptable based on our clinical criteria. The absolute dose agreement for the planning target volume was within 2% between CT-based and MR-based plans and 3% between measured dose

Use of personal, real time in-cabin dosimetry on space shuttle flights

International Nuclear Information System (INIS)

Angelo, J.A. Jr.; Madonna, R.G.; Quam, W.; Warren, J.; Dockter, M.

1984-01-01

The use of real time dosimeters onboard the Space Shuttle is described. Data taken during STS-8 with a small gamma ray counter (HRM-III) and a neutron/proton dosimeter (the Pocket Rem Meter [PRM]) are presented. The data agree with NASA predictions for gamma ray background and neutron-proton dosage received for the STS-8 mission. 1 figure, 1 table

Longitudinal comparison of quality of life after real-time tumor-tracking intensity-modulated radiation therapy and radical prostatectomy in patients with localized prostate cancer

International Nuclear Information System (INIS)

Shinohara, Nobuo; Maruyama, Satoru; Abe, Takashige; Nonomura, Katsuya; Shimizu, Shinichi; Nishioka, Kentaro; Shirato, Hiroki; C-Hatanaka, Kanako; Oba, Koji

2013-01-01

The purpose of this study was to compare the quality of life (QOL) in patients with localized prostate cancer (PC) after intensity-modulated radiation therapy assisted with a fluoroscopic real-time intensity-modulated radiation therapy (RT-IMRT) tumor-tracking system versus the QOL after radical prostatectomy (RP). Between 2003 and 2006, 71 patients were enrolled in this longitudinal prospective study. Each patient was allowed to decide which treatment modality they would receive. Of the 71 patients, 23 patients underwent RT-IMRT, while 48 opted for RP. No patient received neo-adjuvant or adjuvant hormone therapy. The global QOL and disease-specific-QOL were evaluated before treatment and again at 1, 3 and 5 years after treatment. There was no significant difference in the background characteristics between the two groups. The 5-year biochemical progression-free survival was 90% in the RT-IMRT and 79% in the RP group. In the RT-IMRT group, there was no significant deterioration of the global QOL or disease-specific QOL through 5 years post-treatment. In the RP group, the urinary function, sexual function, and sexual bother indicators significantly deteriorated after treatment. Urinary and sexual function was significantly better in the RT-IMRT group at 1, 3 and 5 years post-treatment compared to the RP group. RT-IMRT may be a preferable treatment for localized PC because of similar efficacy to RP but better post-treatment QOL. (author)

Investigation of the use of MOSFET for clinical IMRT dosimetric verification

International Nuclear Information System (INIS)

Chuang, Cynthia F.; Verhey, Lynn J.; Xia Ping

2002-01-01

With advanced conformal radiotherapy using intensity modulated beams, it is important to have radiation dose verification measurements prior to treatment. Metal oxide semiconductor field effect transistors (MOSFET) have the advantage of a faster and simpler reading procedure compared to thermoluminescent dosimeters (TLD), and with the commercial MOSFET system, multiple detectors can be used simultaneously. In addition, the small size of the detector could be advantageous, especially for point dose measurements in small homogeneous dose regions. To evaluate the feasibility of MOSFET for routine IMRT dosimetry, a comprehensive set of experiments has been conducted, to investigate the stability, linearity, energy, and angular dependence. For a period of two weeks, under a standard measurement setup, the measured dose standard deviation using the MOSFETs was ±0.015 Gy with the mean dose being 1.00 Gy. For a measured dose range of 0.3 Gy to 4.2 Gy, the MOSFETs present a linear response, with a linearity coefficient of 0.998. Under a 10x10 cm 2 square field, the dose variations measured by the MOSFETs for every 10 degrees from 0 to 180 degrees is ±2.5%. The percent depth dose (PDD) measurements were used to verify the energy dependence. The measured PDD using the MOSFETs from 0.5 cm to 34 cm depth agreed to within ±3% when compared to that of the ionization chamber. For IMRT dose verification, two special phantoms were designed. One is a solid water slab with 81 possible MOSFET placement holes, and another is a cylindrical phantom with 48 placement holes. For each IMRT phantom verification, an ionization chamber and 3 to 5 MOSFETs were used to measure multiple point doses at different locations. Preliminary results show that the agreement between dose measured by MOSFET and that calculated by Corvus is within 5% error, while the agreement between ionization chamber measurement and the calculation is within 3% error. In conclusion, MOSFET detectors are suitable for

Dosimetric comparison of standard three-dimensional conformal radiotherapy followed by intensity-modulated radiotherapy boost schedule (sequential IMRT plan) with simultaneous integrated boost-IMRT (SIB IMRT) treatment plan in patients with localized carcinoma prostate.

Science.gov (United States)

Bansal, A; Kapoor, R; Singh, S K; Kumar, N; Oinam, A S; Sharma, S C

2012-07-01

DOSIMETERIC AND RADIOBIOLOGICAL COMPARISON OF TWO RADIATION SCHEDULES IN LOCALIZED CARCINOMA PROSTATE: Standard Three-Dimensional Conformal Radiotherapy (3DCRT) followed by Intensity Modulated Radiotherapy (IMRT) boost (sequential-IMRT) with Simultaneous Integrated Boost IMRT (SIB-IMRT). Thirty patients were enrolled. In all, the target consisted of PTV P + SV (Prostate and seminal vesicles) and PTV LN (lymph nodes) where PTV refers to planning target volume and the critical structures included: bladder, rectum and small bowel. All patients were treated with sequential-IMRT plan, but for dosimetric comparison, SIB-IMRT plan was also created. The prescription dose to PTV P + SV was 74 Gy in both strategies but with different dose per fraction, however, the dose to PTV LN was 50 Gy delivered in 25 fractions over 5 weeks for sequential-IMRT and 54 Gy delivered in 27 fractions over 5.5 weeks for SIB-IMRT. The treatment plans were compared in terms of dose-volume histograms. Also, Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) obtained with the two plans were compared. The volume of rectum receiving 70 Gy or more (V > 70 Gy) was reduced to 18.23% with SIB-IMRT from 22.81% with sequential-IMRT. SIB-IMRT reduced the mean doses to both bladder and rectum by 13% and 17%, respectively, as compared to sequential-IMRT. NTCP of 0.86 ± 0.75% and 0.01 ± 0.02% for the bladder, 5.87 ± 2.58% and 4.31 ± 2.61% for the rectum and 8.83 ± 7.08% and 8.25 ± 7.98% for the bowel was seen with sequential-IMRT and SIB-IMRT plans respectively. For equal PTV coverage, SIB-IMRT markedly reduced doses to critical structures, therefore should be considered as the strategy for dose escalation. SIB-IMRT achieves lesser NTCP than sequential-IMRT.

Statistical process control applied to intensity modulated radiotherapy pretreatment controls with portal dosimetry;Maitrise statistique des processus appliquee aux controles avant traitement par dosimetrie portale en radiotherapie conformationnelle avec modulation d'intensite

Energy Technology Data Exchange (ETDEWEB)

Villani, N.; Noel, A. [Laboratoire de recherche en radiophysique, CRAN UMR 7039, Nancy universite-CNRS, 54 - Vandoeuvre-les-Nancy (France); Villani, N.; Gerard, K.; Marchesi, V.; Huger, S.; Noel, A. [Departement de radiophysique, centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Francois, P. [Institut Curie, 75 - Paris (France)

2010-06-15

Purpose The first purpose of this study was to illustrate the contribution of statistical process control for a better security in intensity modulated radiotherapy (I.M.R.T.) treatments. This improvement is possible by controlling the dose delivery process, characterized by pretreatment quality control results. So, it is necessary to put under control portal dosimetry measurements (currently, the ionisation chamber measurements were already monitored by statistical process control thanks to statistical process control tools). The second objective was to state whether it is possible to substitute ionisation chamber with portal dosimetry in order to optimize time devoted to pretreatment quality control. Patients and methods At Alexis-Vautrin center, pretreatment quality controls in I.M.R.T. for prostate and head and neck treatments were performed for each beam of each patient. These controls were made with an ionisation chamber, which is the reference detector for the absolute dose measurement, and with portal dosimetry for the verification of dose distribution. Statistical process control is a statistical analysis method, coming from industry, used to control and improve the studied process quality. It uses graphic tools as control maps to follow-up process, warning the operator in case of failure, and quantitative tools to evaluate the process toward its ability to respect guidelines: this is the capability study. The study was performed on 450 head and neck beams and on 100 prostate beams. Results Control charts, showing drifts, both slow and weak, and also both strong and fast, of mean and standard deviation have been established and have shown special cause introduced (manual shift of the leaf gap of the multi-leaf collimator). Correlation between dose measured at one point, given with the E.P.I.D. and the ionisation chamber has been evaluated at more than 97% and disagreement cases between the two measurements were identified. Conclusion The study allowed to

In-vivo dosimetry in external radiotherapy with amorphous silicon Portal Imaging Devices: from method to clinical validation

International Nuclear Information System (INIS)

Boissard, Philippe

2012-01-01

In vivo dose verification is used to prevent major deviations between the prescribed dose and the dose really delivered to the patient. This quality control was, nationally and internationally, widely recommended by scientific organizations. In France, its implementation and its use are now regulated. To do this, small detectors are fixed on the patient skin at the beginning of the treatment. However, the treatment delay is increased and not all treatment techniques could be assessed, such as IMRT plans (Intensity Modulated Radiation Therapy). In this context, Transit dosimetry performed with Electronic Portal Imaging Devices (EPIDs) appears as an interesting alternative for in vivo dose verification. During the treatment session, a transit dose is measured with the EPID, in two dimensions, and the dose in the patient is estimated from back projection of the portal dose. This work presents a quick and simple alternative method for verification of dose delivered to the patient using photon beams. Verifications in cases of complexes patient shapes and Intensity Modulated Radiation Therapy (IMRT) have been improved by using a Clarkson-Cunningham's integration method. 46 phantom test cases were designed to assess the accuracy of the method for 4, 6, 10 and 20 MV photon beams. For some points of interest the dose reconstructed by the method is compared to the dose measured with an ionization chamber. An additional in vivo uncertainty due to day to day deviations is defined and investigated. In the same time, a clinical study was driven during three years. In vivo dosimetry was performed for 494 patients treated for various tumors sites. Most of the patients were treated for a prostate cancer using IMRT. The in vivo dose is here compared to the dose calculated by the Treatment Planning System, TPS. The results of these two ways of validations are within the accepted tolerance of classical in vivo dosimetry. From the phantom study, we have estimated that the standard

The personal dosimetry in Mexico

International Nuclear Information System (INIS)

Salazar, M.A.

2006-01-01

The Personal Dosimetry in Mexico, has an approximately 30 year-old history; and it had been and it is at the moment, one of the more important resources with which the personnel that works with ionizing radiation sources counts for its protection. The Personal Dosimetry begins with the film dosimetry, technique that even continues being used at the present time by some users, and the main reason of its use is for economic reasons. At the moment this technique, it has been surpassed, by the Thermoluminescent dosimetry, which has taken a lot of peak, mainly by the technological development with which it is counted at the present time; what has given as a result that this technique becomes tip technology; that supported in the characteristic of the used materials, as the handling and processing of the information associated with the new PC, digitizer cards, software etc, what has allowed increases it potential. In this work the current necessities of the market are presented as well as an analysis of the future real necessities in Mexico, at national level, the companies that provide this service and that they spread to satisfy this necessity of the market, including the different used technologies are also mentioned. The application ranges, at the same time, of the advantages and disadvantages of the different systems of Personal Dosimetry in the market. The companies that at the moment provide the service of Personal Dosimetry, its use materials and equipment in indistinct form, for the monitoring of gamma radiation, beta particles, different qualities of x-ray radiation, and sometimes neutrons. The monitoring of the exposed personnel at the diverse sources of ionizing radiation mentioned is carried out in many occasions without having with the materials (detectors), neither the appropriate infrastructure and therefore without the quality control that guarantees a correct evaluation of the dose equivalent, as a result of the exposure to the ionizing radiations; it

Patient reported outcome measures (PROMs) following forward planned field-in field IMRT: Results from the Cambridge Breast IMRT trial

International Nuclear Information System (INIS)

Mukesh, Mukesh B.; Qian, Wendi; Wilkinson, Jennifer S.; Dorling, Leila; Barnett, Gillian C.; Moody, Anne M.; Wilson, Charles; Twyman, Nicola; Burnet, Neil G.; Wishart, Gordon C.; Coles, Charlotte E.

2014-01-01

Background: The use of intensity-modulated radiotherapy (IMRT) in breast cancer reduces clinician-assessed breast tissue toxicity including fibrosis, telangectasia and sub-optimal cosmesis. Patient reported outcome measures (PROMs) are also important as they provide the patient’s perspective. This longitudinal study reports on (a) the effect of forward planned field-in-field IMRT (∼simple IMRT) on PROMs compared to standard RT at 5 years after RT, (b) factors affecting PROMs at 5 years after RT and (c) the trend of PROMs over 5 years of follow up. Methods: PROMs were assessed at baseline (pre-RT), 6, 24 and 60 months after completion of RT using global health (EORTC QLQ C30) and 4 breast symptom questions (BR23). Also, 4 breast RT-specific questions were included at 6, 24 and 60 months: change in skin appearance, firmness to touch, reduction in breast size and overall change in breast appearance since RT. The benefits of simple IMRT over standard RT at 5 years after RT were assessed using standard t-test for global health and logistic regression analysis for breast symptom questions and breast RT-specific questions. Clinical factors affecting PROMs at 5 years were investigated using a multivariate analysis. A repeated mixed model was applied to explore the trend over time for each of PROMs. Results: (89%) 727/815, 84%, 81% and 61% patients completed questionnaires at baseline, 6, 24 and 60 months respectively. Patients reported worse toxicity for all four BR23 breast symptoms at 6 months, which then improved over time (p < 0.0001). They also reported improvement in skin appearance and breast hardness over time (p < 0.0001), with no significant change for breast shrinkage (p = 0.47) and overall breast appearance (p = 0.13). At 5 years, PROMs assessments did not demonstrate a benefit for simple IMRT over standard radiotherapy. Large breast volume, young age, baseline surgical cosmesis and post-operative infection were the most important variables to affect PROMs

WE-AB-BRB-12: Nanoscintillator Fiber-Optic Detector System for Microbeam Radiation Therapy Dosimetry

Energy Technology Data Exchange (ETDEWEB)

Rivera, J [University of North Carolina and North Carolina State University, Chapel Hill, NC (United States); Dooley, J; Chang, S [University of North Carolina School of Medicine, Chapel Hill, NC (United States); Belley, M; Yoshizumi, T [Duke University Medical Center, Durham, NC (United States); Stanton, I; Langloss, B; Therien, M [Duke University, Durham, NC (United States)

2015-06-15

Purpose: Microbeam Radiation Therapy (MRT) is an experimental radiation therapy that has demonstrated a higher therapeutic ratio than conventional radiation therapy in animal studies. There are several roadblocks in translating the promising treatment technology to clinical application, one of which is the lack of a real-time, high-resolution dosimeter. Current clinical radiation detectors have poor spatial resolution and, as such, are unsuitable for measuring microbeams with submillimeter-scale widths. Although GafChromic film has high spatial resolution, it lacks the real-time dosimetry capability necessary for MRT preclinical research and potential clinical use. In this work we have demonstrated the feasibility of using a nanoscintillator fiber-optic detector (nanoFOD) system for real-time MRT dosimetry. Methods: A microplanar beam array is generated using a x-ray research irradiator and a custom-made, microbeam-forming collimator. The newest generation nanoFOD has an effective size of 70 µm in the measurement direction and was calibrated against a kV ion chamber (RadCal Accu-Pro) in open field geometry. We have written a computer script that performs automatic data collection with immediate background subtraction. A computer-controlled detector positioning stage is used to precisely measure the microbeam peak dose and beam profile by translating the stage during data collection. We test the new generation nanoFOD system, with increased active scintillation volume, against the previous generation system. Both raw and processed data are time-stamped and recorded to enable future post-processing. Results: The real-time microbeam dosimetry system worked as expected. The new generation dosimeter has approximately double the active volume compared to the previous generation resulting in over 900% increase in signal. The active volume of the dosimeter still provided the spatial resolution that meets the Nyquist criterion for our microbeam widths. Conclusion: We have

100 years of solid state dosimetry and radiation protection dosimetry

International Nuclear Information System (INIS)

Bartlett, David T.

2008-01-01

The use of solid state detectors in radiation dosimetry has passed its 100th anniversary. The major applications of these detectors in radiation dosimetry have been in personal dosimetry, retrospective dosimetry, dating, medical dosimetry, the characterization of radiation fields, and also in microdosimetry and radiobiology research. In this introductory paper for the 15th International Conference, I shall speak of the history of solid state dosimetry and of the radiation measurement quantities that developed at the same time, mention some landmark developments in detectors and applications, speak a bit more about dosimetry and measurement quantities, and briefly look at the past and future

Intensity modulated radiotherapy (IMRT) with compensators

International Nuclear Information System (INIS)

Salz, H.; Wiezorek, T.; Scheithauer, M.; Kleen, W.; Schwedas, M.; Wendt, T.G.

2002-01-01

The irradiation with intensity-modulated fields is possible with static as well as dynamic methods. In our university hospital, the intensity-modulated radiotherapy (IMRT) with compensators was prepared and used for the first time for patient irradiation in July 2001. The compensators consist of a mixture of tin granulate and wax, which is filled in a milled negative mould. The treatment planning is performed with Helax-TMS (MDS Nordion). An additional software is used for editing the modulation matrix ('Modifix'). Before irradiation of the first patient, extensive measurements have been carried out in terms of quality assurance of treatment planning and production of compensators. The results of the verification measurements have shown that IMRT with compensators possesses high spatial and dosimetric exactness. The calculated dose distributions are applied correctly. The accuracy of the calculated monitor units is normally better than 3%; in small volumes, further dosimetric inaccuracies between calculated and measured dose distributions are mostly less than 3%. Therefore, the compensators contribute to the achievement of high-level IMRT even when apparatuses without MLC are used. This paper describes the use of the IMRT with compensators, presents the limits of this technology, and discusses the first practical experiences. (orig.) [de

Post mastectomy linac IMRT irradiation of chest wall and regional nodes: dosimetry data and acute toxicities

International Nuclear Information System (INIS)

Ma, Jinli; Li, Jiongyan; Xie, Jiang; Chen, Jian; Zhu, Chuanying; Cai, Gang; Zhang, Zhen; Guo, Xiaomao; Chen, Jiayi

2013-01-01

Conventional post-mastectomy radiation therapy is delivered with tangential fields for chest wall and separate fields for regional nodes. Although chest wall and regional nodes delineation has been discussed with RTOG contouring atlas, CT-based planning to treat chest wall and regional nodes as a whole target has not been widely accepted. We herein discuss the dosimetric characteristics of a linac IMRT technique for treating chest wall and regional nodes as a whole PTV after modified radical mastectomy, and observe acute toxicities following irradiation. Patients indicated for PMRT were eligible. Chest wall and supra/infraclavicular region +/−internal mammary nodes were contoured as a whole PTV on planning CT. A simplified linac IMRT plan was designed using either integrated full beams or two segments of half beams split at caudal edge of clavicle head. DVHs were used to evaluate plans. The acute toxicities were followed up regularly. Totally, 85 patients were enrolled. Of these, 45 had left-sided lesions, and 35 received IMN irradiation. Planning designs yielded 55 integrated and 30 segmented plans, with median number of beams of 8 (6–12). The integrated and segmented plans had similar conformity (1.41±0.14 vs. 1.47±0.15, p=0.053) and homogeneity indexes (0.13±0.01 vs. 0.14±0.02, p=0.069). The percent volume of PTV receiving >110% prescription dose was <5%. As compared to segmented plans, integrated plans typically increased V 5 of ipsilateral lung (p=0.005), and heart (p=0.001) in patients with left-sided lesions. Similarly, integrated plans had higher spinal cord D max (p=0.009), ipsilateral humeral head (p<0.001), and contralateral lung D mean (p=0.019). During follow-up, 36 (42%) were identified to have ≥ grade 2 radiation dermatitis (RD). Of these, 35 developed moist desquamation. The median time to onset of moist desquamation was 6 (4–7) weeks from start of RT. The sites of moist desquamation were most frequently occurred in anterior axillary

9th International Conference on 3D Radiation Dosimetry

International Nuclear Information System (INIS)

2017-01-01

IC3DDose 2016 - 9th International Conference on 3D Radiation Dosimetry Preface It was a great pleasure to welcome participants to IC3DDose 2016, the 9th International Conference on 3D Radiation Dosimetry, held from 7–10 November 2016 in Galveston, Texas. The series of conferences has evolved considerably during its history. At the first conference, DOSGEL’99, the discussion centered around gel dosimetry. Held in Lexington, Kentucky in 1999, it was timed to coincide with the American Association of Physicists in Medicine (AAPM) Annual Meeting in Nashville, Tennessee. It was my honour to organize that first conference, and it was once again my honour to organize the 9th conference in the series now known as IC3DDose which was held in Galveston, Texas. As was the case with recent IC3DDose conferences, the topic has broadened considerably beyond gel dosimetry. Not only have newer 3D volumetric dosimeters appeared on the scene, but novel electronic dosimetry systems and software that generate quasi-3D dose information have also. These changes have tracked advances in radiation oncology as techniques such as IMRT, VMAT, and IGRT have become almost ubiquitous. At the same time, dynamic treatments including gating and tracking now enjoy widespread use. Novel treatment technologies have appeared with perhaps the most disruptive being combined MR imaging-treatment units such as the ViewRay MR-cobalt unit and the Elekta/Philips MR-Linac. The potential benefits offered by 3D dosimetry were explored, compared and evaluated during IC3DDose 2016. Novel and improved readout techniques, some of which take advantage of the contemporary treatment environment and new QA systems and procedures, as well as other aspects of clinical dosimetry were well represented in the program. Over the past several years, the importance of safety in radiation therapy has been highlighted. The benefits of 3D dosimetry in contributing to safe and accurate treatments cannot be overstated. The

Verification of IMRT dose distributions using a water beam imaging system

International Nuclear Information System (INIS)

Li, J.S.; Boyer, Arthur L.; Ma, C.-M.

2001-01-01

A water beam imaging system (WBIS) has been developed and used to verify dose distributions for intensity modulated radiotherapy using dynamic multileaf collimator. This system consisted of a water container, a scintillator screen, a charge-coupled device camera, and a portable personal computer. The scintillation image was captured by the camera. The pixel value in this image indicated the dose value in the scintillation screen. Images of radiation fields of known spatial distributions were used to calibrate the device. The verification was performed by comparing the image acquired from the measurement with a dose distribution from the IMRT plan. Because of light scattering in the scintillator screen, the image was blurred. A correction for this was developed by recognizing that the blur function could be fitted to a multiple Gaussian. The blur function was computed using the measured image of a 10 cmx10 cm x-ray beam and the result of the dose distribution calculated using the Monte Carlo method. Based on the blur function derived using this method, an iterative reconstruction algorithm was applied to recover the dose distribution for an IMRT plan from the measured WBIS image. The reconstructed dose distribution was compared with Monte Carlo simulation result. Reasonable agreement was obtained from the comparison. The proposed approach makes it possible to carry out a real-time comparison of the dose distribution in a transverse plane between the measurement and the reference when we do an IMRT dose verification

Clinical experience transitioning from IMRT to VMAT for head and neck cancer

Energy Technology Data Exchange (ETDEWEB)

Studenski, Matthew T., E-mail: matthew.studenski@jeffersonhospital.org [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States); Bar-Ad, Voichita; Siglin, Joshua [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States); Cognetti, David; Curry, Joseph [Department of Otolaryngology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States); Tuluc, Madalina [Department of Pathology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States); Harrison, Amy S. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States)

2013-07-01

To quantify clinical differences for volumetric modulated arc therapy (VMAT) versus intensity modulated radiation therapy (IMRT) in terms of dosimetric endpoints and planning and delivery time, twenty head and neck cancer patients have been considered for VMAT using Nucletron Oncentra MasterPlan delivered via an Elekta linear accelerator. Differences in planning time between IMRT and VMAT were estimated accounting for both optimization and calculation. The average delivery time per patient was obtained retrospectively using the record and verify software. For the dosimetric comparison, all contoured organs at risk (OARs) and planning target volumes (PTVs) were evaluated. Of the 20 cases considered, 14 had VMAT plans approved. Six VMAT plans were rejected due to unacceptable dose to OARs. In terms of optimization time, there was minimal difference between the two modalities. The dose calculation time was significantly longer for VMAT, 4 minutes per 358 degree arc versus 2 minutes for an entire IMRT plan. The overall delivery time was reduced by 9.2 ± 3.9 minutes for VMAT (51.4 ± 15.6%). For the dosimetric comparison of the 14 clinically acceptable plans, there was almost no statistical difference between the VMAT and IMRT. There was also a reduction in monitor units of approximately 32% from IMRT to VMAT with both modalities demonstrating comparable quality assurance results. VMAT provides comparable coverage of target volumes while sparing OARs for the majority of head and neck cases. In cases where high dose modulation was required for OARs, a clinically acceptable plan was only achievable with IMRT. Due to the long calculation times, VMAT plans can cause delays during planning but marked improvements in delivery time reduce patient treatment times and the risk of intra-fraction motion.

Change of tumor target volume during waiting time for intensity-modulated radiotherapy (IMRT) in nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Chen Bo; Yi Junlin; Gao Li; Xu Guozhen; Huang Xiaodong; Zhang Zhong; Luo Jingwei; Li Suyan

2007-01-01

Objective: To determine the influence of change in tumor target volume of nasopharyngeal carcinoma (NPC) while waiting for intensity modulated radiation therapy (IMRT). Methods: From March 2005 to December 2005, 31 patients with nasopharyngeal carcinoma received IMRT as the initial treatment at the Cancer Hospital of Chinese Academic of Medical Sciences. The original simulation CT scan was acquired before IMRT planning. A second CT scan was acquired before the start of radiotherapy. Wait- ing time was defined as the duration between CT simulation and start of radiotherapy. CT-CT fusion was used to minimize the error of delineation between the first tumor target volume (GTV) and the second tumor target volume (sGTV). Tumor target volume was calculated by treatment planning system. T test was carried out to analyse the difference between GTV and sGTV. Pearson correlation and multivariate linear regression was used to analyse the influence factor of the change betweent GTV and sGTV. Results: Median waiting time was 18 days (range, 9-27 days). There were significant differences between GTV and sGTV of both primary tumor (P=0.009) and metastatic lymphoma (P=0.005 ). Both Pearson correlation and multivariate linear regression showed that the change of primary tumor target volume had significant correlation with the first tumor target volume but had no significant correlation with the waiting time, sex, age, T stage and N stage (1992 Chinese Fuzhou Staging Classification). Conclusions: Within the range of the waiting time ob- served in our study, large volume primary tumor would have had a significant increase in volume, but whether the therapeutic effect would be influenced or not would need to be proved by study of large number of cases. Patients with large volume tumor should be considered to reduce the influence of waiting time by enlarging gross target volume and clinical targe volume and by neoadjuveant chemotherapy. For avoiding the unnecessary high-dose to normal

Comparative evaluation of Map-Check and Arc-Check for dosimetric verification in patients treaties with IMRT; Evaluacion comparativa de MapCHECK y ArcCHECK para verificacion dosimetrica en pacientes tratados con IMRT

Energy Technology Data Exchange (ETDEWEB)

Garcia, B.; Marquina, J.; Ramirez, J.; Gonzales, A., E-mail: bertha.garcia@aliada.com.pe [ALIADA, Oncologia Integral, Av. Jose Galvez Barrenechea 1044, San Isidro, Lima 27 (Peru)

2014-08-15

The dosimetric controls that are realized to the patients in the Intensity-Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) techniques; are indispensable since allows in real time to verify the quantity of imparted dose to the patient, these controls should be carried out every time that will begin a treatment, because these techniques impart dose dynamically modulating the dose intensity and movements of the Multi leaf Collimator (MLC), for they exist different diodes devices prepared in spiral (3-D) and planar form (2-D); that allows to estimate the dose fluence in a certain area. Treatment studies for head and neck with IMRT were compared regarding the reading average carried out by the diodes in the corresponding areas, using the criteria of the gamma index like dose difference 3% or 3m m of distance for both diode arrangements, in the IMRT case was found in Arc-Check a minor difference of 3/3 for an average of 99.37% of read diodes in a correct way contrary to the reading obtained with the Map-Check 3/3 an average of difference of 96.19%; in IMRT the difference was lower due to different factors like sensibility of the diodes reading, resolution, diodes disposition, as well as the average reading of entrance and exit of the radiation beams. Within the parameters delivered by the diodes arrangement is considered the positioning correction for both acceptance indexes like the gamma factor and the Distance-to-agreement (Dta), the existent difference of reading in factor gamma and Dta fundamentally is the way in like they compare the dose distribution; the Gamma uses dose averages of high and low gradients and Dta use only averages of areas of high gradients between the nearest points giving the distance as a result among the distribution point and the nearest point what makes stricter. (Author)

Prostate Dose Escalation by a Innovative Inverse Planning-Driven IMRT

National Research Council Canada - National Science Library

Xing, Lei

2008-01-01

...) Developed a voxel-specific penalty scheme for TRV-based inverse planning; (iv) Established a cine-EPID image retrospective dose reconstruction in IMRT dose delivery for adaptive planning and IMRT dose verification. These works are both timely and important and should lead to widespread impact on prostate cancer management.

Online in vivo dosimetry in conformal radio therapies with MOSkin detectors

International Nuclear Information System (INIS)

Gambarini, G.; Tenconi, C.; Mantaut, N.; Carrara, M.; Borroni, M.; Pignoli, E.; Cutajar, D.; Petasecca, M.; Fuduli, I.; Lerch, M.; Rosenfeld, A.

2012-10-01

A novel MOSFET based dosimeter, the MOSkin, has been developed at the Centre for Medical Radiation Physics, University of Wollongong (Australia). This dosimeter is designed with suitable packaging that allows skin dose measurements at depths of 0.07 mm, as recommended by the ICRP. Initially proposed for real-time skin dose measurement, it is now studied for real-time in vivo dosimetry during high dose rate (Hdr) brachytherapy and intensity modulated radiotherapy. MOSkin detectors have shown good characteristics of reproducibility and linearity. Experiments performed with the 192 Ir source of a Hdr brachytherapy facility have shown negligible energy response for photons from the Ir-192 source. The angular response is within the experimental error when used in a dual-MOSkin configuration. In this work, urethral dose measurements were performed in a tissue-equivalent phantom reproducing prostate brachytherapy treatments. The obtained urethral doses were compared to the dose values calculated by the treatment planning system and the discrepancy was found to be within 4%, showing that dual-MOSkin detectors can be profitably utilized for real-time in vivo dosimetry during a brachytherapy treatment. (Author)

In vivo dosimetry in external beam radiotherapy

International Nuclear Information System (INIS)

Mijnheer, Ben; Beddar, Sam; Izewska, Joanna; Reft, Chester

2013-01-01

In vivo dosimetry (IVD) is in use in external beam radiotherapy (EBRT) to detect major errors, to assess clinically relevant differences between planned and delivered dose, to record dose received by individual patients, and to fulfill legal requirements. After discussing briefly the main characteristics of the most commonly applied IVD systems, the clinical experience of IVD during EBRT will be summarized. Advancement of the traditional aspects of in vivo dosimetry as well as the development of currently available and newly emerging noninterventional technologies are required for large-scale implementation of IVD in EBRT. These new technologies include the development of electronic portal imaging devices for 2D and 3D patient dosimetry during advanced treatment techniques, such as IMRT and VMAT, and the use of IVD in proton and ion radiotherapy by measuring the decay of radiation-induced radionuclides. In the final analysis, we will show in this Vision 20/20 paper that in addition to regulatory compliance and reimbursement issues, the rationale for in vivo measurements is to provide an accurate and independent verification of the overall treatment procedure. It will enable the identification of potential errors in dose calculation, data transfer, dose delivery, patient setup, and changes in patient anatomy. It is the authors’ opinion that all treatments with curative intent should be verified through in vivo dose measurements in combination with pretreatment checks

In vivo dosimetry in external beam radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Mijnheer, Ben [Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX (Netherlands); Beddar, Sam [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Izewska, Joanna [Division of Human Health, International Atomic Energy Agency, Vienna 1400 (Austria); Reft, Chester [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois 60637 (United States)

2013-07-15

In vivo dosimetry (IVD) is in use in external beam radiotherapy (EBRT) to detect major errors, to assess clinically relevant differences between planned and delivered dose, to record dose received by individual patients, and to fulfill legal requirements. After discussing briefly the main characteristics of the most commonly applied IVD systems, the clinical experience of IVD during EBRT will be summarized. Advancement of the traditional aspects of in vivo dosimetry as well as the development of currently available and newly emerging noninterventional technologies are required for large-scale implementation of IVD in EBRT. These new technologies include the development of electronic portal imaging devices for 2D and 3D patient dosimetry during advanced treatment techniques, such as IMRT and VMAT, and the use of IVD in proton and ion radiotherapy by measuring the decay of radiation-induced radionuclides. In the final analysis, we will show in this Vision 20/20 paper that in addition to regulatory compliance and reimbursement issues, the rationale for in vivo measurements is to provide an accurate and independent verification of the overall treatment procedure. It will enable the identification of potential errors in dose calculation, data transfer, dose delivery, patient setup, and changes in patient anatomy. It is the authors' opinion that all treatments with curative intent should be verified through in vivo dose measurements in combination with pretreatment checks.

Use of SMT phototransistors for dosimetry in computerized tomography

International Nuclear Information System (INIS)

Magalhaes, C.M.S. de; Silva, J.O. da; Antonio Filho, J.; Santos, L.A.P. dos

2007-01-01

A dosimetry system using commercially available SMT (Surface-Mount Technology) phototransistors is evaluated for dose measurements in X-ray computed tomography. First, the phototransistors were characterized at the laboratory using a Pantak X-ray in the standard radiation quality RQR9 from IEC61267. The following tests were realized: energy dependence, response with dose rate and repetitiveness. The phototransistors yielded a real-time readout and a 6430 Sub-femto-ammeter Keithley was used to obtain their electrical current. This methodology allowed the correlating of their results with a standard ionisation chamber, a NE2571 ionization chamber coupled to a NE2670 electrometer that measured the applied dose at the detector position. After the characterization of the phototransistors, free-in-air and in head phantom dose measurements were carried out with the dosimetry system at the Hospital. Phototransistors were used to determine the dose profile measurements along the axis of rotation undergoing CT head examination. A Flip-Flop electrometer was used to obtain these measurements. The results indicated that the current values were reliable when compared with the results of doses of CT ionization chamber under the same conditions. The loss of radiation sensitivity, postirradiation, with time is not significant and the SMT phototransistor brings some features to CT dosimetry including high sensitivity, small size, real-time measurements and linearity. (author)

Image-guided radiotherapy in near real time with intensity-modulated radiotherapy megavoltage treatment beam imaging.

Science.gov (United States)

Mao, Weihua; Hsu, Annie; Riaz, Nadeem; Lee, Louis; Wiersma, Rodney; Luxton, Gary; King, Christopher; Xing, Lei; Solberg, Timothy

2009-10-01

To utilize image-guided radiotherapy (IGRT) in near real time by obtaining and evaluating the online positions of implanted fiducials from continuous electronic portal imaging device (EPID) imaging of prostate intensity-modulated radiotherapy (IMRT) delivery. Upon initial setup using two orthogonal images, the three-dimensional (3D) positions of all implanted fiducial markers are obtained, and their expected two-dimensional (2D) locations in the beam's-eye-view (BEV) projection are calculated for each treatment field. During IMRT beam delivery, EPID images of the megavoltage treatment beam are acquired in cine mode and subsequently analyzed to locate 2D locations of fiducials in the BEV. Simultaneously, 3D positions are estimated according to the current EPID image, information from the setup portal images, and images acquired at other gantry angles (the completed treatment fields). The measured 2D and 3D positions of each fiducial are compared with their expected 2D and 3D setup positions, respectively. Any displacements larger than a predefined tolerance may cause the treatment system to suspend the beam delivery and direct the therapists to reposition the patient. Phantom studies indicate that the accuracy of 2D BEV and 3D tracking are better than 1 mm and 1.4 mm, respectively. A total of 7330 images from prostate treatments were acquired and analyzed, showing a maximum 2D displacement of 6.7 mm and a maximum 3D displacement of 6.9 mm over 34 fractions. This EPID-based, real-time IGRT method can be implemented on any external beam machine with portal imaging capabilities without purchasing any additional equipment, and there is no extra dose delivered to the patient.

TU-C-17A-06: Evaluating IMRT Plan Deliverability Via PTV Shape and MLC Motion

International Nuclear Information System (INIS)

McGurk, R; Smith, VA; Price, M

2014-01-01

Purpose: For step-and-shoot intensity-modulated radiation therapy (IMRT) plans, the dosimetry and deliverability can be affected by the number and shape of the segments used. Thus, plan deliverability is likely related to target volume and shape. We investigated whether the sphericity of target volumes and the previously proposed Modulation Complexity Score (MCS) could be used together to improve the detection of IMRT fields that failed quality assurance (QA). Methods: 526 and 353 IMRT fields from 32 prostate and 28 head-and-neck (H'N) patients, respectively, were analyzed. MCS was used to quantify the complexity of multi-leaf collimator shapes and motion patterns for each field. Sphericity was calculated using the surface area and volume of each patient’s planning target volume (PTV). Logistic regression models with MCS-alone or MCS and sphericity terms were fit to PlanUNC IMRT pass/fail results (5% dose difference, 4mm distance-to-agreement criteria) using SAS 9.3 (Cary, NC). Model concordance, discordance and area under the curve (AUC) were used to quantify model accuracy. Results: Mean (±1 standard deviation) MCS for prostate and H'N were 0.58(±0.15) and 0.40 (±0.14), respectively. Mean sphericity scores were 0.75(±0.05) for prostate and 0.63 (±0.12) for H'N. Both metrics were significantly different between treatment locations (p<0.01, Wilcoxon Rank Sum Test) indicating greater complexity in shape and variations for H'N PTVs. For prostate, concordance, discordance and AUC using MCS alone were 80.8%, 18.7% and 0.811. Including sphericity in the model improved these to 81.7%, 17.7% and 0.820. For H'N, the original concordance, discordance and AUC were of 72.9%, 26.9% and 0.729. Including sphericity into the model improved these metrics to 76.5%, 23.2% and 0.729. Conclusion: Sphericity provides a quantitative measure of PTV shape. While improvement in IMRT QA failure detection was modest for both prostate and H'N plans

Automatic verification of step-and-shoot IMRT field segments using portal imaging

International Nuclear Information System (INIS)

Woo, M.K.; Lightstone, A.W.; Shan, G.; Kumaraswamy, L.; Li, Y.

2003-01-01

In step-and-shoot IMRT, many individual beam segments are delivered. These segments are generated by the IMRT treatment planning system and subsequently transmitted electronically through computer hardware and software modules before they are finally delivered. Hence, an independent system that monitors the actual field shape during treatment delivery is an added level of quality assurance in this complicated process. In this paper we describe the development and testing of such a system. The system verifies the field shape by comparing the radiation field detected by the built-in portal imaging system on the linac to the actual field shape planned on the treatment planning system. The comparison is based on a software algorithm that detects the leaf edge positions of the radiation field on the portal image and compares that to the calculated positions. The process is fully automated and requires minimal intervention of the radiation therapists. The system has been tested with actual clinical plan sequences and was able to alert the operator of incorrect settings in real time

A comprehensive evaluation of the PRESAGE/optical-CT 3D dosimetry system

Energy Technology Data Exchange (ETDEWEB)

Sakhalkar, H. S.; Adamovics, J.; Ibbott, G.; Oldham, M. [Department of Radiation Oncology Physics, Duke University Medical Center, Durham, North Carolina 27710 (United States); Department of Chemistry and Biology, Rider University, Lawrenceville, New Jersey 08648 (United States); Department of Radiation Physics, M. D. Anderson Cancer Center, Houston, Texas 77030 (United States); Department of Radiation Oncology Physics, Duke University Medical Center, Durham, North Carolina 27710 (United States)

2009-01-15

This work presents extensive investigations to evaluate the robustness (intradosimeter consistency and temporal stability of response), reproducibility, precision, and accuracy of a relatively new 3D dosimetry system comprising a leuco-dye doped plastic 3D dosimeter (PRESAGE) and a commercial optical-CT scanner (OCTOPUS 5x scanner from MGS Research, Inc). Four identical PRESAGE 3D dosimeters were created such that they were compatible with the Radiologic Physics Center (RPC) head-and-neck (H and N) IMRT credentialing phantom. Each dosimeter was irradiated with a rotationally symmetric arrangement of nine identical small fields (1x3 cm{sup 2}) impinging on the flat circular face of the dosimeter. A repetitious sequence of three dose levels (4, 2.88, and 1.28 Gy) was delivered. The rotationally symmetric treatment resulted in a dose distribution with high spatial variation in axial planes but only gradual variation with depth along the long axis of the dosimeter. The significance of this treatment was that it facilitated accurate film dosimetry in the axial plane, for independent verification. Also, it enabled rigorous evaluation of robustness, reproducibility and accuracy of response, at the three dose levels. The OCTOPUS 5x commercial scanner was used for dose readout from the dosimeters at daily time intervals. The use of improved optics and acquisition technique yielded substantially improved noise characteristics (reduced to {approx}2%) than has been achieved previously. Intradosimeter uniformity of radiochromic response was evaluated by calculating a 3D gamma comparison between each dosimeter and axially rotated copies of the same dosimeter. This convenient technique exploits the rotational symmetry of the distribution. All points in the gamma comparison passed a 2% difference, 1 mm distance-to-agreement criteria indicating excellent intradosimeter uniformity even at low dose levels. Postirradiation, the dosimeters were all found to exhibit a slight increase in

A comprehensive evaluation of the PRESAGE/optical-CT 3D dosimetry system

International Nuclear Information System (INIS)

Sakhalkar, H. S.; Adamovics, J.; Ibbott, G.; Oldham, M.

2009-01-01

This work presents extensive investigations to evaluate the robustness (intradosimeter consistency and temporal stability of response), reproducibility, precision, and accuracy of a relatively new 3D dosimetry system comprising a leuco-dye doped plastic 3D dosimeter (PRESAGE) and a commercial optical-CT scanner (OCTOPUS 5x scanner from MGS Research, Inc). Four identical PRESAGE 3D dosimeters were created such that they were compatible with the Radiologic Physics Center (RPC) head-and-neck (H and N) IMRT credentialing phantom. Each dosimeter was irradiated with a rotationally symmetric arrangement of nine identical small fields (1x3 cm 2 ) impinging on the flat circular face of the dosimeter. A repetitious sequence of three dose levels (4, 2.88, and 1.28 Gy) was delivered. The rotationally symmetric treatment resulted in a dose distribution with high spatial variation in axial planes but only gradual variation with depth along the long axis of the dosimeter. The significance of this treatment was that it facilitated accurate film dosimetry in the axial plane, for independent verification. Also, it enabled rigorous evaluation of robustness, reproducibility and accuracy of response, at the three dose levels. The OCTOPUS 5x commercial scanner was used for dose readout from the dosimeters at daily time intervals. The use of improved optics and acquisition technique yielded substantially improved noise characteristics (reduced to ∼2%) than has been achieved previously. Intradosimeter uniformity of radiochromic response was evaluated by calculating a 3D gamma comparison between each dosimeter and axially rotated copies of the same dosimeter. This convenient technique exploits the rotational symmetry of the distribution. All points in the gamma comparison passed a 2% difference, 1 mm distance-to-agreement criteria indicating excellent intradosimeter uniformity even at low dose levels. Postirradiation, the dosimeters were all found to exhibit a slight increase in

SU-E-T-163: Evaluation of Dose Distributions Recalculated with Per-Field Measurement Data Under the Condition of Respiratory Motion During IMRT for Liver Cancer

Energy Technology Data Exchange (ETDEWEB)

Song, J; Yoon, M; Nam, T; Ahn, S; Chung, W [Chonnam National University Hwasun Hospital, Hwasun-kun, Chonnam (Korea, Republic of)

2014-06-01

Purpose: The dose distributions within the real volumes of tumor targets and critical organs during internal target volume-based intensity-modulated radiation therapy (ITV-IMRT) for liver cancer were recalculated by applying the effects of actual respiratory organ motion, and the dosimetric features were analyzed through comparison with gating IMRT (Gate-IMRT) plan results. Methods: The 4DCT data for 10 patients who had been treated with Gate-IMRT for liver cancer were selected to create ITV-IMRT plans. The ITV was created using MIM software, and a moving phantom was used to simulate respiratory motion. The period and range of respiratory motion were recorded in all patients from 4DCT-generated movie data, and the same period and range were applied when operating the dynamic phantom to realize coincident respiratory conditions in each patient. The doses were recalculated with a 3 dose-volume histogram (3DVH) program based on the per-field data measured with a MapCHECK2 2-dimensional diode detector array and compared with the DVHs calculated for the Gate-IMRT plan. Results: Although a sufficient prescription dose covered the PTV during ITV-IMRT delivery, the dose homogeneity in the PTV was inferior to that with the Gate-IMRT plan. We confirmed that there were higher doses to the organs-at-risk (OARs) with ITV-IMRT, as expected when using an enlarged field, but the increased dose to the spinal cord was not significant and the increased doses to the liver and kidney could be considered as minor when the reinforced constraints were applied during IMRT plan optimization. Conclusion: Because Gate-IMRT cannot always be considered an ideal method with which to correct the respiratory motional effect, given the dosimetric variations in the gating system application and the increased treatment time, a prior analysis for optimal IMRT method selection should be performed while considering the patient's respiratory condition and IMRT plan results.

Characterization of radiochromic films EBT3 by means of the scanner Vidar dosimetry Pro Red and Epson 10000-XL use; Caracterizacion de films radiocromicos EBT3 mediante el uso de scanner Vidar dosimetry Pro Red y Epson 10000-XL

Energy Technology Data Exchange (ETDEWEB)

Medina, L.; Garrigo, E.; Venencia, D.; Adrada, A.; Filipuzzi, M., E-mail: fisicamedina11@gmail.com [Instituto Privado de Radioterapia, Obispo Oro 423, X5000BFI Cordoba (Argentina)

2014-08-15

The Radiochromic film have become an attractive tool for verification of dose distributions in IMRT because these have high spatial resolution film, are near water equivalent and not require revealed, A critical aspect of the use of these film is used for digitizing scanner The purpose of this paper is to characterize EBT3 using two types of scanner. Were employed The Radiochromic film EBT3, was used photon beam 6 MV generated by a linear accelerator Siemens Primus, he films were irradiated at a dose range between 0 Gy a 9 Gy. The stabilization time after irradiation was 24 hours. The films were digitized with a scanner Epson 10000-XL y el VIDAR Dosimetry Pro Red. We used the software for construction of the calibration curve. The resolution of each dosimetry system was analyzed through the results of the spatial response function by analyzing a step pattern. The Epson scanner is most sensitive to the red channel. This is less than that obtained with the Vidar. The Vidar scanner spatial response profiles disturbs not opposed to Epson analyzed. The calibration curves for both dosimetry systems can be employed. However, the sensitivity and repeatability of the system is better than Red Vidar Epson 10000-XL. (author)

Heterogeneity in head and neck IMRT target design and clinical practice

International Nuclear Information System (INIS)

Hong, Theodore S.; Tomé, Wolfgang A.; Harari, Paul M.

2012-01-01

Purpose: To assess patterns of H and N IMRT practice with particular emphasis on elective target delineation. Materials and methods: Twenty institutions with established H and N IMRT expertise were solicited to design clinical target volumes for the identical H and N cancer case. To limit contouring variability, a primary tonsil GTV and ipsilateral level II node were pre-contoured. Participants were asked to accept this GTV, and contour their recommended CTV and PTV. Dose prescriptions, contouring time, and recommendations regarding chemotherapy were solicited. Results: All 20 institutions responded. Remarkable heterogeneity in H and N IMRT design and practice was identified. Seventeen of 20 centers recommended treatment of bilateral necks whereas 3/20 recommended treatment of the ipsilateral neck only. The average CTV volume was 250 cm 3 (range 37–676 cm 3 ). Although there was high concordance in coverage of ipsilateral neck levels II and III, substantial variation was identified for levels I, V, and the contralateral neck. Average CTV expansion was 4.1 mm (range 0–15 mm). Eight of 20 centers recommended chemotherapy (cisplatin), whereas 12/20 recommended radiation alone. Responders prescribed on average 69 and 68 Gy to the tumor and metastatic node GTV, respectively. Average H and N target volume contouring time was 102.5 min (range 60–210 min). Conclusion: This study identifies substantial heterogeneity in H and N IMRT target definition, prescription, neck treatment, and use of chemotherapy among practitioners with established H and N IMRT expertise. These data suggest that continued efforts to standardize and simplify the H and N IMRT process are desirable for the safe and effective global advancement of H and N IMRT practice.

Letter to the Editor on 'Single-Arc IMRT?'.

Science.gov (United States)

Otto, Karl

2009-04-21

In the note 'Single Arc IMRT?' (Bortfeld and Webb 2009 Phys. Med. Biol. 54 N9-20), Bortfeld and Webb present a theoretical investigation of static gantry IMRT (S-IMRT), single-arc IMRT and tomotherapy. Based on their assumptions they conclude that single-arc IMRT is inherently limited in treating complex cases without compromising delivery efficiency. Here we present an expansion of their work based on the capabilities of the Varian RapidArc single-arc IMRT system. Using the same theoretical framework we derive clinically deliverable single-arc IMRT plans based on these specific capabilities. In particular, we consider the range of leaf motion, the ability to rapidly and continuously vary the dose rate and the choice of collimator angle used for delivery. In contrast to the results of Bortfeld and Webb, our results show that single-arc IMRT plans can be generated that closely match the theoretical optimum. The disparity in the results of each investigation emphasizes that the capabilities of the delivery system, along with the ability of the optimization algorithm to exploit those capabilities, are of particular importance in single-arc IMRT. We conclude that, given the capabilities available with the RapidArc system, single-arc IMRT can produce complex treatment plans that are delivered efficiently (in approximately 2 min).

Local confidence limits for IMRT and VMAT techniques: a study based on TG119 test suite

International Nuclear Information System (INIS)

Thomas, M.; Chandroth, M.

2014-01-01

The aim of this study was to generate a local confidence limit (CL) for intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) techniques used at Waikato Regional Cancer Centre. This work was carried out based on the American Association of Physicists in Medicine (AAPM) Task Group (TG) 119 report. The AAPM TG 119 report recommends CLs as a bench mark for IMRT commissioning and delivery based on its multiple institutions planning and dosimetry comparisons. In this study the locally obtained CLs were compared to TG119 benchmarks. Furthermore, the same bench mark was used to test the capabilities and quality of the VMAT technique in our clinic. The TG 119 test suite consists of two primary and four clinical tests for evaluating the accuracy of IMRT planning and dose delivery systems. Pre defined structure sets contoured on computed tomography images were downloaded from AAPM website and were transferred to a locally designed phantom. For each test case two plans were generated using IMRT and VMAT optimisation. Dose prescriptions and planning objectives recommended by TG119 report were followed to generate the test plans in Eclipse Treatment Planning System. For each plan the point dose measurements were done using an ion chamber at high dose and low dose regions. The planar dose distribution was analysed for percentage of points passing the gamma criteria of 3 %/3 mm, for both the composite plan and individual fields of each plan. The CLs were generated based on the results from the gamma analysis and point dose measurements. For IMRT plans, the CLs obtained were (1) from point dose measurements: 2.49 % at high dose region and 2.95 % for the low dose region (2) from gamma analysis: 2.12 % for individual fields and 5.9 % for the composite plan. For VMAT plans, the CLs obtained were (1) from point dose measurements: 2.56 % at high dose region and 2.6 % for the low dose region (2) from gamma analysis: 1.46 % for individual fields and 0

Dosimetric comparison of RapidArc with fixed gantry dynamic IMRT for loco-regionally advanced nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Wu Hao; Han Shukui; Sun Yan; Jiang Fan

2010-01-01

Objective: To compare the dosimetric difference of RapidArc and fixed gantry angle dynamic IMRT (dIMRT) for loco-regionally advanced nasopharyngeal carcinoma. Methods: Ten previously treated patients with loco-regionally advanced nasopharyngeal carcinoma were replanned with RapidArc and dIMRT, respectively. The prescription dose was GTV 70 Gy/33 f and PTV 60 Gy/33 f. All plans met the requirement: 95% of PTV was covered by 60 Gy. Dose-volume histogram data, isodose distribution, monitor units, and treatment time were compared. Results: Dose distribution has no significant difference between the two techniques. RapidArc reduced the dose of the brainstem, mandible, and other normal tissues compared with dIMRT. Mean monitor units were 589.5 and 1381.0 for RapidArc and dIMRT (reduced by 57% relatively). Mean treatment time was 2.33 min and 7.82 min for RapidArc and dIMRT (reduced by 70% relatively). Conclusions: Compared with dIMRT, RapidArc achieves equal target coverage and OAR sparing while using fewer monitor units and less time during radiotherapy for patient with loco-regionally advanced nasopharyngeal carcinoma. (authors)

Real Time Revisited

Science.gov (United States)

Allen, Phillip G.

1985-12-01

The call for abolishing photo reconnaissance in favor of real time is once more being heard. Ten years ago the same cries were being heard with the introduction of the Charge Coupled Device (CCD). The real time system problems that existed then and stopped real time proliferation have not been solved. The lack of an organized program by either DoD or industry has hampered any efforts to solve the problems, and as such, very little has happened in real time in the last ten years. Real time is not a replacement for photo, just as photo is not a replacement for infra-red or radar. Operational real time sensors can be designed only after their role has been defined and improvements made to the weak links in the system. Plodding ahead on a real time reconnaissance suite without benefit of evaluation of utility will allow this same paper to be used ten years from now.

A new implementation of multichannel radiochromic film dosimetry; Una nueva implementacion del analisis multicanal para la dosimetria mediante peliculas radiocromicas

Energy Technology Data Exchange (ETDEWEB)

Rodriguez Rodriguez, C.; Martin Martin, G.; Bermudez Luna, R.; Lopez Fernandez, A.; Tores Olombrada, M. V. de

2014-07-01

The aims of this paper are to carry out a new implementation of the multichannel radiochromic film dosimetry (Micke A, Lewis D, Yu X. Multichannel film dosimetry with nonuniformity correction. Med Phys 2011;38:2523-34), to quantify the variation in gamma index as compared to the single channel film dosimetry, and to determine if the procedure achieves similar results by means of a different scanner that the one used by Micke et al. Radiochromic EBT2 films and a Microtek 9000 XL scanner were used. Our procedure simplifies the system calibration splitting it into two factors, manufactured batch and digitalization specific. Absorbed dose spatial distributions from an open radiotherapy beam without any modulation and 20 IMRT treatments were determined. Their gamma index maps were calculated and a comparison of the results from single channel and multichannel dosimetry was performed. A 5% mean increase in concordance was obtained by using the multichannel film dosimetry. Our results are similar to those reported by Micke et al. even though we are using a different scanner. (Author)

Evaluation of a new self-developing instant film for imaging and dosimetry

International Nuclear Information System (INIS)

Watanabe, Y.; Patel, G. N.; Patel, P.

2006-01-01

Radiation sensitive films are standard dosimetric tools in radiation therapy. Films are used for machine quality assurance (QA) and treatment planning software evaluation. With the advent of intensity modulated radiation therapy (IMRT), simple and fast imaging technology is needed for patient-specific verification of radiation fields. Conventional radiographic films are often used. Radiochromic films, e.g. Gafchromic films, were recently introduced to the market. But these films have some disadvantages. JP Laboratories have developed a prototype radiochromic film, called SIFID (self-developing, instant film for imaging and dosimetry) with superior performance such that SIFID is unaffected by ambient light for months, stable up to 90 deg. C and can be archived. SIFID is made of polymerizable diacetylene. The film develops blue colour instantly upon absorbing radiation. We evaluated the film for radiation therapy applications. Our preliminary data demonstrate its feasibility as a dosimetric tool for IMRT QA as well as for other applications. (authors)

Development of independent MU/treatment time verification algorithm for non-IMRT treatment planning: A clinical experience

Science.gov (United States)

Tatli, Hamza; Yucel, Derya; Yilmaz, Sercan; Fayda, Merdan

2018-02-01

The aim of this study is to develop an algorithm for independent MU/treatment time (TT) verification for non-IMRT treatment plans, as a part of QA program to ensure treatment delivery accuracy. Two radiotherapy delivery units and their treatment planning systems (TPS) were commissioned in Liv Hospital Radiation Medicine Center, Tbilisi, Georgia. Beam data were collected according to vendors' collection guidelines, and AAPM reports recommendations, and processed by Microsoft Excel during in-house algorithm development. The algorithm is designed and optimized for calculating SSD and SAD treatment plans, based on AAPM TG114 dose calculation recommendations, coded and embedded in MS Excel spreadsheet, as a preliminary verification algorithm (VA). Treatment verification plans were created by TPSs based on IAEA TRS 430 recommendations, also calculated by VA, and point measurements were collected by solid water phantom, and compared. Study showed that, in-house VA can be used for non-IMRT plans MU/TT verifications.

Online in vivo dosimetry in conformal radio therapies with MOSkin detectors

Energy Technology Data Exchange (ETDEWEB)

Gambarini, G.; Tenconi, C.; Mantaut, N. [Universita degli Studi di Milano, Department of Physics, Via Festa del Perdono 7, 20122 Milano (Italy); Carrara, M.; Borroni, M.; Pignoli, E. [Fondazione IRCCS Istituto Nazionale dei Tumori, Medical Physics Unit, Via Giuseppe Ponzio 44, Milan (Italy); Cutajar, D.; Petasecca, M.; Fuduli, I.; Lerch, M.; Rosenfeld, A. [University of Wollongong, Centre for Medical Radiation Physics, 2522 Wollongong, New South Wales (Australia)

2012-10-15

A novel MOSFET based dosimeter, the MOSkin, has been developed at the Centre for Medical Radiation Physics, University of Wollongong (Australia). This dosimeter is designed with suitable packaging that allows skin dose measurements at depths of 0.07 mm, as recommended by the ICRP. Initially proposed for real-time skin dose measurement, it is now studied for real-time in vivo dosimetry during high dose rate (Hdr) brachytherapy and intensity modulated radiotherapy. MOSkin detectors have shown good characteristics of reproducibility and linearity. Experiments performed with the {sup 192}Ir source of a Hdr brachytherapy facility have shown negligible energy response for photons from the Ir-192 source. The angular response is within the experimental error when used in a dual-MOSkin configuration. In this work, urethral dose measurements were performed in a tissue-equivalent phantom reproducing prostate brachytherapy treatments. The obtained urethral doses were compared to the dose values calculated by the treatment planning system and the discrepancy was found to be within 4%, showing that dual-MOSkin detectors can be profitably utilized for real-time in vivo dosimetry during a brachytherapy treatment. (Author)

Poster - Thurs Eve-09: Evaluation of a commercial 2D ion-chamber array for intensity modulated radiation therapy dose measurements.

Science.gov (United States)

Mei, X; Bracken, G; Kerr, A

2008-07-01

Experimental verification of calculated dose from a treatment planning system is often essential for quality assurance (QA) of intensity modulated radiation therapy (IMRT). Film dosimetry and single ion chamber measurements are commonly used for IMRT QA. Film dosimetry has very good spatial resolution, but is labor intensive and absolute dose is not reliable. Ion chamber measurements are still required for absolute dose after measurements using films. Dosimeters based on 2D detector arrays that can measure 2D dose in real-time are gaining wider use. These devices provide a much easier and reliable tool for IMRT QA. We report the evaluation of a commercial 2D ion chamber array, including its basic performance characteristics, such as linearity, reproducibility and uniformity of relative ion chamber sensitivities, and comparisons between measured 2D dose and calculated dose with a commercial treatment planning system. Our analysis shows this matrix has excellent linearity and reproducibility, but relative sensitivities are tilted such that the +Y region is over sensitive, while the -Y region is under sensitive. Despite this behavior, our results show good agreement between measured 2D dose profiles and Eclipse planned data for IMRT test plans and a few verification plans for clinical breast field-in-field plans. The gamma values (3% or 3 mm distance-to-agreement) are all less than 1 except for one or two pixels at the field edge This device provides a fast and reliable stand-alone dosimeter for IMRT QA. © 2008 American Association of Physicists in Medicine.

Restricted Field IMRT Dramatically Enhances IMRT Planning for Mesothelioma

International Nuclear Information System (INIS)

Allen, Aaron M.; Schofield, Deborah; Hacker, Fred; Court, Laurence E.; Czerminska, Maria M.S.

2007-01-01

Purpose: To improve the target coverage and normal tissue sparing of intensity-modulated radiotherapy (IMRT) for mesothelioma after extrapleural pneumonectomy. Methods and Materials: Thirteen plans from patients previously treated with IMRT for mesothelioma were replanned using a restricted field technique. This technique was novel in two ways. It limited the entrance beams to 200 o around the target and three to four beams per case had their field apertures restricted down to the level of the heart or liver to further limit the contralateral lung dose. New constraints were added that included a mean lung dose of <9.5 Gy and volume receiving ≥5 Gy of <55%. Results: In all cases, the planning target volume coverage was excellent, with an average of 97% coverage of the planning target volume by the target dose. No change was seen in the target coverage with the new technique. The heart, kidneys, and esophagus were all kept under tolerance in all cases. The average mean lung dose, volume receiving ≥20 Gy, and volume receiving ≥5 Gy with the new technique was 6.6 Gy, 3.0%, and 50.8%, respectively, compared with 13.8 Gy, 15%, and 90% with the previous technique (p < 0.0001 for all three comparisons). The maximal value for any case in the cohort was 8.0 Gy, 7.3%, and 57.5% for the mean lung dose, volume receiving ≥20 Gy, and volume receiving ≥5 Gy, respectively. Conclusion: Restricted field IMRT provides an improved method to deliver IMRT to a complex target after extrapleural pneumonectomy. An upcoming Phase I trial will provide validation of these results

Image-Guided Radiotherapy in Near Real Time With Intensity-Modulated Radiotherapy Megavoltage Treatment Beam Imaging

International Nuclear Information System (INIS)

Mao Weihua; Hsu, Annie; Riaz, Nadeem; Lee, Louis; Wiersma, Rodney; Luxton, Gary; King, Christopher; Xing Lei; Solberg, Timothy

2009-01-01

Purpose: To utilize image-guided radiotherapy (IGRT) in near real time by obtaining and evaluating the online positions of implanted fiducials from continuous electronic portal imaging device (EPID) imaging of prostate intensity-modulated radiotherapy (IMRT) delivery. Methods and Materials: Upon initial setup using two orthogonal images, the three-dimensional (3D) positions of all implanted fiducial markers are obtained, and their expected two-dimensional (2D) locations in the beam's-eye-view (BEV) projection are calculated for each treatment field. During IMRT beam delivery, EPID images of the megavoltage treatment beam are acquired in cine mode and subsequently analyzed to locate 2D locations of fiducials in the BEV. Simultaneously, 3D positions are estimated according to the current EPID image, information from the setup portal images, and images acquired at other gantry angles (the completed treatment fields). The measured 2D and 3D positions of each fiducial are compared with their expected 2D and 3D setup positions, respectively. Any displacements larger than a predefined tolerance may cause the treatment system to suspend the beam delivery and direct the therapists to reposition the patient. Results: Phantom studies indicate that the accuracy of 2D BEV and 3D tracking are better than 1 mm and 1.4 mm, respectively. A total of 7330 images from prostate treatments were acquired and analyzed, showing a maximum 2D displacement of 6.7 mm and a maximum 3D displacement of 6.9 mm over 34 fractions. Conclusions: This EPID-based, real-time IGRT method can be implemented on any external beam machine with portal imaging capabilities without purchasing any additional equipment, and there is no extra dose delivered to the patient.

SU-F-T-522: Dosimetric Study of Junction Dose in Double Isocenter Flatten and Flatten Filter Free IMRT and VMAT Plan Delivery

Energy Technology Data Exchange (ETDEWEB)

Samuvel, K; Yadav, G; Bhushan, M; Tamilarasu, S; Kumar, L; Suhail, M [Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi (India)

2016-06-15

Purpose: To quantify the dosimetric accuracy of junction dose in double isocenter flattened and flatten filter free(FFF) intensity modulated radiation therapy(IMRT) and volumetric modulated arc therapy(VMAT) plan delivery using pelvis phantom. Methods: Five large field pelvis patients were selected for this study. Double isocenter IMRT and VMAT treatment plans were generated in Eclipse Treatment planning System (V.11.0) using 6MV FB and FFF beams. For all the plans same distance 17.0cm was kept between one isocenter to another isocenter. IMRT Plans were made with 7 coplanar fields and VMAT plans were made with full double arcs. Dose calculation was performed using AAA algorithms with dose grid size of 0.25 cm. Verification plans were calculated on Scanditronix Wellhofer pelvis slab phantom. Measurement point was selected and calculated, where two isocenter plan fields are overlapping, this measurement point was kept at distance 8.5cm from both isocenter. The plans were delivered using Varian TrueBeamTM machine on pelvis slab phantom. Point dose measurements was carried out using CC13 ion chamber volume of 0.13cm3. Results: The measured junction point dose are compared with TPS calculated dose. The mean difference observed was 4.5%, 6.0%, 4.0% and 7.0% for IMRT-FB,IMRT-FFF, VMAT-FB and VMAT-FFF respectively. The measured dose results shows closer agreement with calculated dose in Flatten beam planning in both IMRT and VMAT, whereas in FFF beam plan dose difference are more compared with flatten beam plan. Conclusion: Dosimetry accuracy of Large Field junction dose difference was found less in Flatten beam compared with FFF beam plan delivery. Even though more dosimetric studies are required to analyse junction dose for FFF beam planning using multiple point dose measurements and fluence map verification in field junction area.

Evaluation of intrafraction patient movement for CNS and head and neck IMRT

International Nuclear Information System (INIS)

Kim, Siyong; Akpati, Hilary C.; Kielbasa, Jerrold E.; Li, Jonathan G.; Liu, Chihray; Amdur, Robert J.; Palta, Jatinder R.

2004-01-01

Intrafraction patient motion is much more likely in intensity-modulated radiation therapy (IMRT) than in conventional radiotherapy primarily due to longer beam delivery times in IMRT treatment. In this study, we evaluated the uncertainty of intrafraction patient displacement in CNS and head and neck IMRT patients. Immobilization is performed in three steps: (1) the patient is immobilized with thermoplastic facemask, (2) the patient displacement is monitored using a commercial stereotactic infrared IR camera (ExacTrac, BrainLab) during treatment, and (3) repositioning is carried out as needed. The displacement data were recorded during beam-on time for the entire treatment duration for 5 patients using the camera system. We used the concept of cumulative time versus patient position uncertainty, referred to as an uncertainty time histogram (UTH), to analyze the data. UTH is a plot of the accumulated time during which a patient stays within the corresponding movement uncertainty. The University of Florida immobilization procedure showed an effective immobilization capability for CNS and head and neck IMRT patients by keeping the patient displacement less than 1.5 mm for 95% of treatment time (1.43 mm for 1, and 1.02 mm for 1, and less than 1.0 mm for 3 patients). The maximum displacement was 2.0 mm

IMRT fluence map editing to control hot and cold spots

International Nuclear Information System (INIS)

Taylor Cook, J.; Tobler, Matt; Leavitt, Dennis D.; Watson, Gordon

2005-01-01

Manually editing intensity-modulated radiation therapy (IMRT) fluence maps effectively controls hot and cold spots that the IMRT optimization cannot control. Many times, re-optimizing does not reduce the hot spots or increase the cold spots. In fact, re-optimizing only places the hot and cold spots in different locations. Fluence-map editing provides manual control of dose delivery and provides the best treatment plan possible. Several IMRT treatments were planned using the Varian Eclipse planning system. We compare the effects on dose distributions between fluence-map editing and re-optimization, discuss techniques for fluence-map editing, and analyze differences between fluence editing on one beam vs. multiple beams. When editing a beam's fluence map, it is essential to choose a beam that least affects dose to the tumor and critical structures. Editing fluence maps gives an advantage in treatment planning and provides controlled delivery of IMRT dose

Tomotherapy: IMRT and tomographic verification

International Nuclear Information System (INIS)

Mackie, T.R.

2000-01-01

Full text: External beam radiation therapy delivery began around the turn of the century with the use of one or a few kilovoltage beams directed to the presumed site of the tumor. Often the treatment lasted until erythema dose was reached. Delivering the beams rotationally allowed the dose to be focused on the tumor and the skin to be spared. With the advent of megavoltage radiation therapy in the 1950's, using Co-60 teletherapy and betatrons, the treatment could once again be delivered from only a few beam directions and the dose to the skin would be kept below tolerance. Fields were shaped by lead blocks and later by custom-made blocks fabricated from low-melting temperature heavy metal. Linear accelerators did not fundamentally change the way in which radiation was delivered. It is likely that this delivery paradigm would not have changed had it not been for the advent of computers. Brahme and Cormack showed in the late 1980's that highly conformal treatments could be delivered with non-uniform intensity beams. At that time the only way in which the intensity modulated beams could be delivered was using custom-milled compensators. Fabricating and using compensators for multiple fields is time-consuming and labor-intensive. Serial tomotherapy was the first successful delivery method for IMRT and went back to the earlier practice of rotation therapy. The NOMOS Peacock system uses a binary (on-off) multileaf collimator (MLC) system to modulate a fan beam of radiation. It uses an optimization system to determine when leaves should be opened and closed. The system delivers two beam slices at once and the couch is indexed to the next slices by precisely translating the couch. This approach was first used in 1994 and to-date has treated several thousand patients. Prior to the advent of IMRT, accelerator vendors introduced the multileaf collimator (MLC) to provide field shaping without the need to fabricate custom blocking. Most new linear accelerator purchases today

The Real-Time Dose Measurement Scintillating Fiber Array for Brachytherapy Procedures

Science.gov (United States)

Tynes, Lawrence

2007-03-01

Brachytherapy is a treatment modality that uses tiny radioactive sources (few mm in length) by delivering enough doses to kill cancer tumors or plaque build-up. The type of sources used in hospitals include both gamma and beta emitters. Presently, the technique suffers from not having a single detector with the capability of providing accurate dose distribution information within sub-mm accuracy. The current standard is based primarily on well chambers and film dosimetry. The Center for Advanced Medical Instrumentation (CAMI) at Hampton University is developing a Scintillating Fiber Based Beta Detector prototype in collaboration with the National Institute for Standards and Technology (NIST) to address this problem. The device is composed of an array of 1x1 mm^2 scintillating fibers optically coupled to photo-multiplier tubes for photon-to-current conversion. A CAMAC LabView based data acquisition system is used for real time data collection and histogramming, data analysis. A set of data were collected at the nearby Bon Secours DePaul Medical Center using a GammaMed 12i HDR after-loader housing a 6.62 mCi Ir-192 source. Preliminary comparison between our device and film dosimetry will be discussed.

A national dosimetric audit of IMRT

International Nuclear Information System (INIS)

Budgell, Geoff; Berresford, Joe; Trainer, Michael; Bradshaw, Ellie; Sharpe, Peter; Williams, Peter

2011-01-01

Background and purpose: A dosimetric audit of IMRT has been carried out within the UK between June 2009 and March 2010 in order to provide an independent check of safe implementation and to identify problems in the modelling and delivery of IMRT. Methods and materials: A mail based audit involving film and alanine dosimeters was utilized. Measurements were made for each individual field in an IMRT plan isocentrically in a flat water-equivalent phantom at a depth of 5 cm. The films and alanine dosimeters were processed and analysed centrally; additional ion chamber measurements were made by each participating centre. Results: 57 of 62 centres participated, with a total of 78 plans submitted. For the film measurements, all 176 fields from the less complex IMRT plans (including prostate and breast plans) achieved over 95% pixels passing a gamma criterion of 3%/3 mm within the 20% isodose. For the more complex IMRT plans (mainly head and neck) 8/245 fields (3.3%) achieved less than 95% pixels passing a 4%/4 mm gamma criterion. Of the alanine measurements, 4/78 (5.1%) of the measurements differed by >5% from the dose predicted by the treatment planning system. Three of these were large deviations of -77.1%, -29.1% and 14.1% respectively. Excluding the three measurements outside 10%, the mean difference was 0.05% with a standard deviation of 1.5%. The out of tolerance results have been subjected to further investigations. Conclusions: A dosimetric audit has been successfully carried out of IMRT implementation by over 90% of UK radiotherapy departments. The audit shows that modelling and delivery of IMRT is accurate, suggesting that the implementation of IMRT has been carried out safely.

A CaS : Ce, Sm-based dosimeter for online dosimetry measurement

International Nuclear Information System (INIS)

Sun Yurun; Chen Zhaoyang; Fan Yanwei; Yan Shiyou; He Chengfa

2011-01-01

A film dosimeter based on optically stimulated luminescence (OSL) material of CaS : Ce, Sm was developed for online irradiation dosimetry measurement. The stimulation is provided by a laser with a wavelength of 980 nm, and the OSL luminescence is collected by a photodiode. Using 60 Co γ-rays, we investigated the dosimetry characteristic of the dosimeter at different dose rates and total doses. The real-time detection results showed that the OSL signals versus total ionizing dose exhibited a good linearity in a dose range of 0.1-185 Gy. (authors)

Comparative evaluation of Map-Check and Arc-Check for dosimetric verification in patients treaties with IMRT

International Nuclear Information System (INIS)

Garcia, B.; Marquina, J.; Ramirez, J.; Gonzales, A.

2014-08-01

The dosimetric controls that are realized to the patients in the Intensity-Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) techniques; are indispensable since allows in real time to verify the quantity of imparted dose to the patient, these controls should be carried out every time that will begin a treatment, because these techniques impart dose dynamically modulating the dose intensity and movements of the Multi leaf Collimator (MLC), for they exist different diodes devices prepared in spiral (3-D) and planar form (2-D); that allows to estimate the dose fluence in a certain area. Treatment studies for head and neck with IMRT were compared regarding the reading average carried out by the diodes in the corresponding areas, using the criteria of the gamma index like dose difference 3% or 3m m of distance for both diode arrangements, in the IMRT case was found in Arc-Check a minor difference of 3/3 for an average of 99.37% of read diodes in a correct way contrary to the reading obtained with the Map-Check 3/3 an average of difference of 96.19%; in IMRT the difference was lower due to different factors like sensibility of the diodes reading, resolution, diodes disposition, as well as the average reading of entrance and exit of the radiation beams. Within the parameters delivered by the diodes arrangement is considered the positioning correction for both acceptance indexes like the gamma factor and the Distance-to-agreement (Dta), the existent difference of reading in factor gamma and Dta fundamentally is the way in like they compare the dose distribution; the Gamma uses dose averages of high and low gradients and Dta use only averages of areas of high gradients between the nearest points giving the distance as a result among the distribution point and the nearest point what makes stricter. (Author)

Monaco and film dosimetry of 3D CRT, IMRT and VMAT cases in a realistic pelvic prosthetic phantom

Science.gov (United States)

Ade, Nicholas; du Plessis, F. C. P.

2018-04-01

The dosimetry of patients with metallic hip implants during irradiation of pelvic lesions is challenging due to dose distortions caused by implants. This work presents a dosimetric comparison of various multi-field photon-beam dose distributions in the presence of unilateral hip titanium prosthesis (UHTiP) embedded in a unique pelvic phantom made out of water-equivalent nylon slices. The impact of the UHTiP on the accuracy of dose calculations from a Monaco TPS (treatment planning system) using the X-ray voxel Monte Carlo (XVMC) algorithm was benchmarked against measured dose data using Gafchromic EBT3 film. Multi-field beam arrangements including a 4-field box, 5-field 3DCRT (three-dimensional conformal radiation therapy), 6-field IMRT (intensity modulated radiation therapy) and a single-arc VMAT (volumetric modulated arc therapy) plan were set up for 6 MV and 15 MV beams. These plans were generated for the pelvic phantom that contains the prosthesis with film inserted. Compared to Monaco TPS dose calculations, film measurements showed enhanced dose in the prosthesis which was not predicted by Monaco due to its limitation in relative density assignment. The enhanced prosthesis dose increased with increase in beam energy and decreased with the complexity of the treatment plans, with VMAT giving the least escalated dose. The dose increased between 5% and 19% for 6 MV and between 6% and 21% for 15 MV. A gamma index analysis showed that 70-92% of dose points (excluding the prosthesis) were within 3% discrepancy. Increasing the number of treatment fields increases target dose coverage and improves the agreement between film and Monaco. When the relative electron density (RED) in the prosthesis was varied between 3.72 and 15 the dose discrepancy between film and Monaco increased from 30% to 57% for 6 MV and from 30% to 50% for 15 MV. The study indicates that beam weights for fields that pass through the prosthesis should be minimised and its RED must be correct for

Virtual EPID standard phantom audit (VESPA) for remote IMRT and VMAT credentialing

Science.gov (United States)

Miri, Narges; Lehmann, Joerg; Legge, Kimberley; Vial, Philip; Greer, Peter B.

2017-06-01

A virtual EPID standard phantom audit (VESPA) has been implemented for remote auditing in support of facility credentialing for clinical trials using IMRT and VMAT. VESPA is based on published methods and a clinically established IMRT QA procedure, here extended to multi-vendor equipment. Facilities are provided with comprehensive instructions and CT datasets to create treatment plans. They deliver the treatment directly to their EPID without any phantom or couch in the beam. In addition, they deliver a set of simple calibration fields per instructions. Collected EPID images are uploaded electronically. In the analysis, the dose is projected back into a virtual cylindrical phantom. 3D gamma analysis is performed. 2D dose planes and linear dose profiles are provided and can be considered when needed for clarification. In addition, using a virtual flat-phantom, 2D field-by-field or arc-by-arc gamma analyses are performed. Pilot facilities covering a range of planning and delivery systems have performed data acquisition and upload successfully. Advantages of VESPA are (1) fast turnaround mainly driven by the facility’s capability of providing the requested EPID images, (2) the possibility for facilities performing the audit in parallel, as there is no need to wait for a phantom, (3) simple and efficient credentialing for international facilities, (4) a large set of data points, and (5) a reduced impact on resources and environment as there is no need to transport heavy phantoms or audit staff. Limitations of the current implementation of VESPA for trials credentialing are that it does not provide absolute dosimetry, therefore a Level I audit is still required, and that it relies on correctly delivered open calibration fields, which are used for system calibration. The implemented EPID based IMRT and VMAT audit system promises to dramatically improve credentialing efficiency for clinical trials and wider applications.

Clinical development of a failure detection-based online repositioning strategy for prostate IMRT--experiments, simulation, and dosimetry study.

Science.gov (United States)

Liu, Wu; Qian, Jianguo; Hancock, Steven L; Xing, Lei; Luxton, Gary

2010-10-01

To implement and evaluate clinic-ready adaptive imaging protocols for online patient repositioning (motion tracking) during prostate IMRT using treatment beam imaging supplemented by minimal, as-needed use of on-board kV. The authors examine the two-step decision-making strategy: (1) Use cine-MV imaging and online-updated characterization of prostate motion to detect target motion that is potentially beyond a predefined threshold and (2) use paired MV-kV 3D localization to determine overthreshold displacement and, if needed, reposition the patient. Two levels of clinical implementation were evaluated: (1) Field-by-field based motion correction for present-day linacs and (2) instantaneous repositioning for new-generation linacs with capabilities of simultaneous MV-kV imaging and remote automatic couch control during treatment delivery. Experiments were performed on a Varian Trilogy linac in clinical mode using a 4D motion phantom programed with prostate motion trajectories taken from patient data. Dosimetric impact was examined using a 2D ion chamber array. Simulations were done for 536 trajectories from 17 patients. Despite the loss of marker detection efficiency caused by the MLC leaves sometimes obscuring the field at the marker's projected position on the MV imager, the field-by-field correction halved (from 23% to 10%) the mean percentage of time that target displacement exceeded a 3 mm threshold, as compared to no intervention. This was achieved at minimal cost in additional imaging (average of one MV-kV pair per two to three treatment fractions) and with a very small number of repositionings (once every four to five fractions). Also with low kV usage (approximation 2/fraction), the instantaneous repositioning approach reduced overthreshold time by more than 75% (23% to 5%) even with severe MLC blockage as often encountered in current IMRT and could reduce the overthreshold time tenfold (to < 2%) if the MLC blockage problem were relieved. The information

Clinical development of a failure detection-based online repositioning strategy for prostate IMRT--Experiments, simulation, and dosimetry study

International Nuclear Information System (INIS)

Liu Wu; Qian Jianguo; Hancock, Steven L.; Xing, Lei; Luxton, Gary

2010-01-01

Purpose: To implement and evaluate clinic-ready adaptive imaging protocols for online patient repositioning (motion tracking) during prostate IMRT using treatment beam imaging supplemented by minimal, as-needed use of on-board kV. Methods: The authors examine the two-step decision-making strategy: (1) Use cine-MV imaging and online-updated characterization of prostate motion to detect target motion that is potentially beyond a predefined threshold and (2) use paired MV-kV 3D localization to determine overthreshold displacement and, if needed, reposition the patient. Two levels of clinical implementation were evaluated: (1) Field-by-field based motion correction for present-day linacs and (2) instantaneous repositioning for new-generation linacs with capabilities of simultaneous MV-kV imaging and remote automatic couch control during treatment delivery. Experiments were performed on a Varian Trilogy linac in clinical mode using a 4D motion phantom programed with prostate motion trajectories taken from patient data. Dosimetric impact was examined using a 2D ion chamber array. Simulations were done for 536 trajectories from 17 patients. Results: Despite the loss of marker detection efficiency caused by the MLC leaves sometimes obscuring the field at the marker's projected position on the MV imager, the field-by-field correction halved (from 23% to 10%) the mean percentage of time that target displacement exceeded a 3 mm threshold, as compared to no intervention. This was achieved at minimal cost in additional imaging (average of one MV-kV pair per two to three treatment fractions) and with a very small number of repositionings (once every four to five fractions). Also with low kV usage (∼2/fraction), the instantaneous repositioning approach reduced overthreshold time by more than 75% (23% to 5%) even with severe MLC blockage as often encountered in current IMRT and could reduce the overthreshold time tenfold (to <2%) if the MLC blockage problem were relieved. The

Visual simultaneous localization and mapping (VSLAM) methods applied to indoor 3D topographical and radiological mapping in real-time

International Nuclear Information System (INIS)

Hautot, F.; Dubart, P.; Chagneau, B.; Bacri, C.O.; Abou-Khalil, R.

2017-01-01

New developments in the field of robotics and computer vision enable to merge sensors to allow fast real-time localization of radiological measurements in the space/volume with near real-time radioactive sources identification and characterization. These capabilities lead nuclear investigations to a more efficient way for operators' dosimetry evaluation, intervention scenarios and risks mitigation and simulations, such as accidents in unknown potentially contaminated areas or during dismantling operations. This paper will present new progresses in merging RGB-D camera based on SLAM (Simultaneous Localization and Mapping) systems and nuclear measurement in motion methods in order to detect, locate, and evaluate the activity of radioactive sources in 3-dimensions

3-D dosimetric evaluation of 2.5 mm HD120 multileaf system for intensity modulated stereotactic radiosurgery using optical CT based polymer gel dosimetry

International Nuclear Information System (INIS)

Wuu, C-S; Kessel, Jack; Xu, Y

2009-01-01

A Trilogy TX equipped with a 2.5 mm HD120 multileaf collimator system is available for the treatment of radiosurgery and IMRT. In this study, we evaluated the 3-D dosimetric impact of leaf width on an IMRT radiosurgery plan by comparing the target coverage and the dose gradient around the target, produced from both a 2.5 mm HD120 high-definition MLC system and a 5mm-leaf-width millennium 120 MLC system, using an optical CT based polymer gel dosimetry system. The 2.5 mm MLC improves target conformity and surrounding tissue sparing when compared to that of 5 mm MLC.

A planning and delivery study of a rotational IMRT technique with burst delivery

International Nuclear Information System (INIS)

Kainz, Kristofer; Chen, Guang-Pei; Chang, Yu-Wen; Prah, Douglas; Sharon Qi, X.; Shukla, Himanshu P.; Stahl, Johannes; Allen Li, X.

2011-01-01

Purpose: A novel rotational IMRT (rIMRT) technique using burst delivery (continuous gantry rotation with beam off during MLC repositioning) is investigated. The authors evaluate the plan quality and delivery efficiency and accuracy of this dynamic technique with a conventional flat 6 MV photon beam. Methods: Burst-delivery rIMRT was implemented in a planning system and delivered with a 160-MLC linac. Ten rIMRT plans were generated for five anonymized patient cases encompassing head and neck, brain, prostate, and prone breast. All plans were analyzed retrospectively and not used for treatment. Among the varied plan parameters were the number of optimization points, number of arcs, gantry speed, and gantry angle range (alpha) over which the beam is turned on at each optimization point. Combined rotational/step-and-shoot rIMRT plans were also created by superimposing multiple-segment static fields at several optimization points. The rIMRT trial plans were compared with each other and with plans generated using helical tomotherapy and VMAT. Burst-mode rotational IMRT plans were delivered and verified using a diode array, ionization chambers, thermoluminescent dosimeters, and film. Results: Burst-mode rIMRT can achieve plan quality comparable to helical tomotherapy, while the former may lead to slightly better OAR sparing for certain cases and the latter generally achieves slightly lower hot spots. Few instances were found in which increasing the number of optimization points above 36, or superimposing step-and-shoot IMRT segments, led to statistically significant improvements in OAR sparing. Using an additional rIMRT partial arc yielded substantial OAR dose improvements for the brain case. Measured doses from the rIMRT plan delivery were within 4% of the plan calculation in low dose gradient regions. Delivery time range was 228-375 s for single-arc rIMRT 200-cGy prescription with a 300 MU/min dose rate, comparable to tomotherapy and VMAT. Conclusions: Rotational IMRT

Three-dimensional portal image-based dose reconstruction in a virtual phantom for rapid evaluation of IMRT plans

International Nuclear Information System (INIS)

Ansbacher, W.

2006-01-01

A new method for rapid evaluation of intensity modulated radiation therapy (IMRT) plans has been developed, using portal images for reconstruction of the dose delivered to a virtual three-dimensional (3D) phantom. This technique can replace an array of less complete but more time-consuming measurements. A reference dose calculation is first created by transferring an IMRT plan to a cylindrical phantom, retaining the treatment gantry angles. The isocenter of the fields is placed on or near the phantom axis. This geometry preserves the relative locations of high and low dose regions and has the required symmetry for the dose reconstruction. An electronic portal image (EPI) is acquired for each field, representing the dose in the midplane of a virtual phantom. The image is convolved with a kernel to correct for the lack of scatter, replicating the effect of the cylindrical phantom surrounding the dose plane. This avoids the need to calculate fluence. Images are calibrated to a reference field that delivers a known dose to the isocenter of this phantom. The 3D dose matrix is reconstructed by attenuation and divergence corrections and summed to create a dose matrix (PI-dose) on the same grid spacing as the reference calculation. Comparison of the two distributions is performed with a gradient-weighted 3D dose difference based on dose and position tolerances. Because of its inherent simplicity, the technique is optimally suited for detecting clinically significant variances from a planned dose distribution, rather than for use in the validation of IMRT algorithms. An analysis of differences between PI-dose and calculation, δ PI , compared to differences between conventional quality assurance (QA) and calculation, δ CQ , was performed retrospectively for 20 clinical IMRT cases. PI-dose differences at the isocenter were in good agreement with ionization chamber differences (mean δ PI =-0.8%, standard deviation σ=1.5%, against δ CQ =0.3%, σ=1.0%, respectively). PI

Intensity-modulated radiotherapy (IMRT) for carcinoma of the maxillary sinus: A comparison of IMRT planning systems

International Nuclear Information System (INIS)

Ahmed, Raef S.; Ove, Roger; Duan, Jun; Popple, Richard; Cobb, Glenn

2006-01-01

The treatment of maxillary sinus carcinoma with forward planning can be technically difficult when the neck also requires radiotherapy. This difficulty arises because of the need to spare the contralateral face while treating the bilateral neck. There is considerable potential for error in clinical setup and treatment delivery. We evaluated intensity-modulated radiotherapy (IMRT) as an improvement on forward planning, and compared several inverse planning IMRT platforms. A composite dose-volume histogram (DVH) was generated from a complex forward planned case. We compared the results with those generated by sliding window fixed field dynamic multileaf collimator (MLC) IMRT, using sets of coplanar beams. All setups included an anterior posterior (AP) beam, and 3-, 5-, 7-, and 9-field configurations were evaluated. The dose prescription and objective function priorities were invariant. We also evaluated 2 commercial tomotherapy IMRT delivery platforms. DVH results from all of the IMRT approaches compared favorably with the forward plan. Results for the various inverse planning approaches varied considerably across platforms, despite an attempt to prescribe the therapy similarly. The improvement seen with the addition of beams in the fixed beam sliding window case was modest. IMRT is an effective means of delivering radiotherapy reliably in the complex setting of maxillary sinus carcinoma with neck irradiation. Differences in objective function definition and optimization algorithms can lead to unexpected differences in the final dose distribution, and our evaluation suggests that these factors are more significant than the beam arrangement or number of beams

Assessment of new radiation oncology technology and treatments in radiation oncology the ANROTAT project and collection of IMRT specific data

International Nuclear Information System (INIS)

Haworth, A.; Corry, J.; Kron, T.; Duchesne, G.; Ng, M.; Burmeister, B.

2010-01-01

Full text: Medical physicists (MP) are familiar with assessing new radiation oncology technology and treatments ( ROT A T) for their own departments but are not usually involved in providing advice to government for funding these technologies. This paper describes the role of the MP within the Commonwealth Government Department of Health and Aging initiative to develop a generic framework for assessment of ROTAT and the collection of data to support Med care Benefits Scheme (MBS) funding of IMRT. The clinical trials group TROG is developing a generic framework for the assessment of NROTAT. This will be tested and data collected to support applications for MBS funding of IMRT and IGRT. The tumour sites of nasopharynx, post-prostatectomy and anal canal have been selected to represent sites that are commonly, occasionally and rarely treated with IMRT respectively. Site selection for data collection will represent a broad range of clinical practices. Data quality is assured through TROG QA procedures and will include dosimetry audits. The final report will assess the clinical efficacy, cost effectiveness and safety of IMRT compared to 3DCRT. Existing clinical trial protocols form the basis for data collection and surrogate endpoints are being developed. Key publications have been identified that correlate specific dose-volume histogram parameters with clinical end-points, recognising limitations of these data in the 1MRT setting. Engagement of MPs within this project will help ensure collection of high quality data that ultimately aims to secure appropriate funding to ensure our patients receive best clinical care. (author)

Preliminary studies for implementation of a MCL quality control using EPID (Portal Dosimetry); Estudos preliminares para implementacao de um controle de qualidade de MLC com o uso do EPID (Portal Dosimetry)

Energy Technology Data Exchange (ETDEWEB)

Mattos, Fabio R.; Furnari, Laura [Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Faculdade de Medicina

2016-07-01

A Quality Control (CQ) to ensure the expected performance of a Multileaf Collimator System (MLC) is essential for delivering dose in a safety and appropriate way. The time required for equipment control and dosimetry may be lowered when the Electronic Portal Image Device (EPID) is used. The aim of this paper was to check the resolution limits of the detection system for IMRT mode, and to do the analysis of three tests of MLC performance: Picket Fence, Slinding GAP, MLC versus Gantry. A Varian iX Clinac equipped with an 80 leaf Millennium MLC and with amorphous silicon based EPID (aS1000) was use. The EPID proved Effective, where errors up to 0,5 mm can be detected. Information about interleaf transmissions, dose profile and gravity influence in the leaf banks also were included. (author)

Optical fibre luminescence sensor for real-time LDR brachytherapy dosimetry

Science.gov (United States)

Woulfe, P.; O'Keeffe, S.; Sullivan, F. J.

2018-02-01

An optical fibre sensor for monitoring low dose radiation is presented. The sensor is based on a scintillation material embedded within the optical fibre core, which emits visible light when exposed to low level ionising radiation. The incident level of ionising radiation can be determined by analysing the optical emission. An optical fibre sensor is developed, based on radioluminescence whereby radiation sensitive scintillation material, terbium doped gadolinium oxysulphide (Gd2O2S:Tb), is embedded in a cavity of 700μm of a 1mm plastic optical fibre. The sensor is designed for in-vivo monitoring of the radiation dose during radio-active seed implantation for low dose rate (LDR) brachytherapy, in prostate cancer treatment, providing radiation oncologists with real-time information of the radiation dose to the target area and/or nearby organs at risk (OARs). The radiation from the brachytherapy seeds causes emission of visible light from the scintillation material through the process of radioluminescence, which penetrates the fibre, propagating along the optical fibre for remote detection using a multi-pixel photon counter. The sensor demonstrates a high sensitivity to 0.397mCi of Iodine125, the radioactive source most commonly used in brachytherapy for treating prostate cancer.

Characterization of radiochromic films EBT3 by means of the scanner Vidar dosimetry Pro Red and Epson 10000-XL use

International Nuclear Information System (INIS)

Medina, L.; Garrigo, E.; Venencia, D.; Adrada, A.; Filipuzzi, M.

2014-08-01

The Radiochromic film have become an attractive tool for verification of dose distributions in IMRT because these have high spatial resolution film, are near water equivalent and not require revealed, A critical aspect of the use of these film is used for digitizing scanner The purpose of this paper is to characterize EBT3 using two types of scanner. Were employed The Radiochromic film EBT3, was used photon beam 6 MV generated by a linear accelerator Siemens Primus, he films were irradiated at a dose range between 0 Gy a 9 Gy. The stabilization time after irradiation was 24 hours. The films were digitized with a scanner Epson 10000-XL y el VIDAR Dosimetry Pro Red. We used the software for construction of the calibration curve. The resolution of each dosimetry system was analyzed through the results of the spatial response function by analyzing a step pattern. The Epson scanner is most sensitive to the red channel. This is less than that obtained with the Vidar. The Vidar scanner spatial response profiles disturbs not opposed to Epson analyzed. The calibration curves for both dosimetry systems can be employed. However, the sensitivity and repeatability of the system is better than Red Vidar Epson 10000-XL. (author)

IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients.

Science.gov (United States)

Fregnani, Eduardo Rodrigues; Parahyba, Cláudia Joffily; Morais-Faria, Karina; Fonseca, Felipe Paiva; Ramos, Pedro Augusto Mendes; de Moraes, Fábio Yone; da Conceição Vasconcelos, Karina Gondim Moutinho; Menegussi, Gisela; Santos-Silva, Alan Roger; Brandão, Thais B

2016-09-07

Radiotherapy (RT) is frequently used in the treatment of head and neck cancer, but different side-effects are frequently reported, including a higher frequency of radiation-related caries, what may be consequence of direct radiation to dental tissue. The intensity-modulated radiotherapy (IMRT) was developed to improve tumor control and decrease patient's morbidity by delivering radiation beams only to tumor shapes and sparing normal tissue. However, teeth are usually not included in IMRT plannings and the real efficacy of IMRT in the dental context has not been addressed. Therefore, the aim of this study is to assess whether IMRT delivers lower radiation doses to dental structures than conformal 3D radiotherapy (3DRT). Radiation dose delivery to dental structures of 80 patients treated for head and neck cancers (oral cavity, tongue, nasopharynx and oropharynx) with IMRT (40 patients) and 3DRT (40 patients) were assessed by individually contouring tooth crowns on patients' treatment plans. Clinicopathological data were retrieved from patients' medical files. The average dose of radiation to teeth delivered by IMRT was significantly lower than with 3DRT (p = 0.007); however, only patients affected by nasopharynx and oral cavity cancers demonstrated significantly lower doses with IMRT (p = 0.012 and p = 0.011, respectively). Molars received more radiation with both 3DRT and IMRT, but the latter delivered significantly lower radiation in this group of teeth (p dental groups. Maxillary teeth received lower doses than mandibular teeth, but only IMRT delivered significantly lower doses (p = 0.011 and p = 0.003). Ipsilateral teeth received higher doses than contralateral teeth with both techniques and IMRT delivered significantly lower radiation than 3DRT for contralateral dental structures (p radiation doses to teeth than 3DRT, but only for some groups of patients and teeth, suggesting that this decrease was more likely due to the protection of

Diode In-vivo Dosimetry for External Beam Radiotherapy: Patient Data Analysis

International Nuclear Information System (INIS)

Mrcela, I.; Bokulic, T.; Budanec, M; Froebe, A.; Soldic, Z.; Kusic, Z.

2008-01-01

In-vivo dosimetry is known as simple and reliable method for checking the final accuracy of the dose delivered in external radiotherapy making a supplement to the regular quality control. Entrance dose measurements in the beginning of the treatment assure detection of major errors that can affect the therapy outcome. Silicon diodes are often the detectors of choice for their ability of real time dose measurements and the simplicity of use. There are many publications describing the procedures for the implementation of in-vivo dosimetry. Routine in-vivo dosimetry has been introduced in our department after initial procedures including physical characterization, calibration and determination of correction factors for the detectors in use. This work presents patient data analysis with more than 700 field measurements taken in last 2 years period

SU-E-T-164: Clinical Implementation of ASi EPID Panels for QA of IMRT/VMAT Plans.

Science.gov (United States)

Hosier, K; Wu, C; Beck, K; Radevic, M; Asche, D; Bareng, J; Kroner, A; Lehmann, J; Logsdon, M; Dutton, S; Rosenthal, S

2012-06-01

To investigate various issues for clinical implementation of aSi EPID panels for IMRT/VMAT QA. Six linacs are used in our clinic for EPID-based plan QA; two Varian Truebeams, two Varian 2100 series, two Elekta Infiniti series. Multiple corrections must be accounted for in the calibration of each panel for dosimetric use. Varian aSi panels are calibrated with standard dark field, flood field, and 40×40 diagonal profile for beam profile correction. Additional corrections to account for off-axis and support arm backscatter are needed for larger field sizes. Since Elekta iViewGT system does not export gantry angle with images, a third-party inclinometer must be physically mounted to back of linac gantry and synchronized with data acquisition via iViewGT PC clock. A T/2 offset correctly correlates image and gantry angle for arc plans due to iView image time stamp at the end of data acquisition for each image. For both Varian and Elekta panels, a 5 MU 10×10 calibration field is used to account for the nonlinear MU to dose response at higher energies. Acquired EPID images are deconvolved via a high pass filter in Fourier space and resultant fluence maps are used to reconstruct a 3D dose 'delivered' to patient using DosimetryCheck. Results are compared to patient 3D dose computed by TPS using a 3D-gamma analysis. 120 IMRT and 100 VMAT cases are reported. Two 3D gamma quantities (Gamma(V10) and Gamma(PTV)) are proposed for evaluating QA results. The Gamma(PTV) is sensitive to MLC offsets while Gamma(V10) is sensitive to gantry rotations. When a 3mm/3% criteria and 90% or higher 3D gamma pass rate is used, all IMRT and 90% of VMAT QA pass QA. After appropriate calibration of aSi panels and setup of image acquisition systems, EPID based 3D dose reconstruction method is found clinically feasible. © 2012 American Association of Physicists in Medicine.

WE-AB-303-06: Combining DAO with MV + KV Optimization to Improve Skin Dose Sparing with Real-Time Fluoroscopy

Energy Technology Data Exchange (ETDEWEB)

Grelewicz, Z; Wiersma, R [The University of Chicago, Chicago, IL (United States)

2015-06-15

Purpose: Real-time fluoroscopy may allow for improved patient positioning and tumor tracking, particularly in the treatment of lung tumors. In order to mitigate the effects of the imaging dose, previous studies have demonstrated the effect of including both imaging dose and imaging constraints into the inverse treatment planning object function. That method of combined MV+kV optimization may Result in plans with treatment beams chosen to allow for more gentle imaging beam-on times. Direct-aperture optimization (DAO) is also known to produce treatment plans with fluence maps more conducive to lower beam-on times. Therefore, in this work we demonstrate the feasibility of a combination of DAO and MV+kV optimization for further optimized real-time kV imaging. Methods: Therapeutic and imaging beams were modeled in the EGSnrc Monte Carlo environment, and applied to a patient model for a previously treated lung patient to provide dose influence matrices from DOSXYZnrc. An MV + kV IMRT DAO treatment planning system was developed to compare DAO treatment plans with and without MV+kV optimization. The objective function was optimized using simulated annealing. In order to allow for comparisons between different cases of the stochastically optimized plans, the optimization was repeated twenty times. Results: Across twenty optimizations, combined MV+kV IMRT resulted in an average of 12.8% reduction in peak skin dose. Both non-optimized and MV+kV optimized imaging beams delivered, on average, mean dose of approximately 1 cGy per fraction to the target, with peak doses to target of approximately 6 cGy per fraction. Conclusion: When using DAO, MV+kV optimization is shown to Result in improvements to plan quality in terms of skin dose, when compared to the case of MV optimization with non-optimized kV imaging. The combination of DAO and MV+kV optimization may allow for real-time imaging without excessive imaging dose. Financial support for the work has been provided in part by NIH

Comparison of VMAT and IMRT strategies for cervical cancer patients using automated planning.

Science.gov (United States)

Sharfo, Abdul Wahab M; Voet, Peter W J; Breedveld, Sebastiaan; Mens, Jan Willem M; Hoogeman, Mischa S; Heijmen, Ben J M

2015-03-01

In a published study on cervical cancer, 5-beam IMRT was inferior to single arc VMAT. Here we compare 9, 12, and 20 beam IMRT with single and dual arc VMAT. For each of 10 patients, automated plan generation with the in-house Erasmus-iCycle optimizer was used to assist an expert planner in generating the five plans with the clinical TPS. For each patient, all plans were clinically acceptable with a high and similar PTV coverage. OAR sparing increased when going from 9 to 12 to 20 IMRT beams, and from single to dual arc VMAT. For all patients, 12 and 20 beam IMRT were superior to single and dual arc VMAT, with substantial variations in gain among the study patients. As expected, delivery of VMAT plans was significantly faster than delivery of IMRT plans. Often reported increased plan quality for VMAT compared to IMRT has not been observed for cervical cancer. Twenty and 12 beam IMRT plans had a higher quality than single and dual arc VMAT. For individual patients, the optimal delivery technique depends on a complex trade-off between plan quality and treatment time that may change with introduction of faster delivery systems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Comparison of VMAT and IMRT strategies for cervical cancer patients using automated planning

International Nuclear Information System (INIS)

Sharfo, Abdul Wahab M.; Voet, Peter W.J.; Breedveld, Sebastiaan; Mens, Jan Willem M.; Hoogeman, Mischa S.; Heijmen, Ben J.M.

2015-01-01

Background and purpose: In a published study on cervical cancer, 5-beam IMRT was inferior to single arc VMAT. Here we compare 9, 12, and 20 beam IMRT with single and dual arc VMAT. Material and methods: For each of 10 patients, automated plan generation with the in-house Erasmus-iCycle optimizer was used to assist an expert planner in generating the five plans with the clinical TPS. Results: For each patient, all plans were clinically acceptable with a high and similar PTV coverage. OAR sparing increased when going from 9 to 12 to 20 IMRT beams, and from single to dual arc VMAT. For all patients, 12 and 20 beam IMRT were superior to single and dual arc VMAT, with substantial variations in gain among the study patients. As expected, delivery of VMAT plans was significantly faster than delivery of IMRT plans. Conclusions: Often reported increased plan quality for VMAT compared to IMRT has not been observed for cervical cancer. Twenty and 12 beam IMRT plans had a higher quality than single and dual arc VMAT. For individual patients, the optimal delivery technique depends on a complex trade-off between plan quality and treatment time that may change with introduction of faster delivery systems

Can All Centers Plan Intensity-Modulated Radiotherapy (IMRT) Effectively? An External Audit of Dosimetric Comparisons Between Three-Dimensional Conformal Radiotherapy and IMRT for Adjuvant Chemoradiation for Gastric Cancer

International Nuclear Information System (INIS)

Chung, Hans T.; Lee, Brian; Park, Eileen; Lu, Jiade J.; Xia Ping

2008-01-01

Purpose: To compare dosimetric endpoints between three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) at our center with limited IMRT experience, and to perform an external audit of the IMRT plans. Methods and Materials: Ten patients, who received adjuvant chemoradiation for gastric cancer, formed the study cohort. For standardization, the planning target volume (PTV) and organs at risk were recontoured with the assistance of a study protocol radiologic atlas. The cohort was replanned with CMS Xio to generate coplanar 3D-CRT and IMRT plans. All 10 datasets, including volumes but without the plans (i.e., blinded), were transmitted to an experienced center where IMRT plans were designed using Nomos Corvus (IMRT-C) and ADAC Pinnacle (IMRT-P). All IMRT plans were normalized to D95% receiving 45 Gy. Results: Intensity-modulated radiotherapy yielded higher PTV V45 (volume that receives ≥45 Gy) (p < 0.001) than 3D-CRT. No difference in V20 was seen in the right (p = 0.9) and left (p 0.3) kidneys, but the liver mean dose (p < 0.001) was superior with IMRT. For the external audit, IMRT-C (p = 0.002) and IMRT-P (p < 0.001) achieved significantly lower left kidney V20 than IMRT, and IMRT-P (p < 0.001) achieved lower right kidney V20 than IMRT. The IMRT-C (p = 0.003) but not IMRT-P (p = 0.6) had lower liver mean doses than IMRT. Conclusions: At our institution with early IMRT experience, IMRT improved PTV dose coverage and liver doses but not kidney doses. An external audit of IMRT plans showed that an experienced center can yield superior IMRT plans

MO-B-BRB-03: 3D Dosimetry in the Clinic: Validating Special Techniques

Energy Technology Data Exchange (ETDEWEB)

Juang, T. [Stanford Cancer Center (United States)

2016-06-15

Full three-dimensional (3D) dosimetry using volumetric chemical dosimeters probed by 3D imaging systems has long been a promising technique for the radiation therapy clinic, since it provides a unique methodology for dose measurements in the volume irradiated using complex conformal delivery techniques such as IMRT and VMAT. To date true 3D dosimetry is still not widely practiced in the community; it has been confined to centres of specialized expertise especially for quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. The potential for improved clinical applicability has been advanced considerably in the last decade by the development of improved 3D dosimeters (e.g., radiochromic plastics, radiochromic gel dosimeters and normoxic polymer gel systems) and by improved readout protocols using optical computed tomography or magnetic resonance imaging. In this session, established users of some current 3D chemical dosimeters will briefly review the current status of 3D dosimetry, describe several dosimeters and their appropriate imaging for dose readout, present workflow procedures required for good dosimetry, and analyze some limitations for applications in select settings. We will review the application of 3D dosimetry to various clinical situations describing how 3D approaches can complement other dose delivery validation approaches already available in the clinic. The applications presented will be selected to inform attendees of the unique features provided by full 3D techniques. Learning Objectives: L. John Schreiner: Background and Motivation Understand recent developments enabling clinically practical 3D dosimetry, Appreciate 3D dosimetry workflow and dosimetry procedures, and Observe select examples from the clinic. Sofie Ceberg: Application to dynamic radiotherapy Observe full dosimetry under dynamic radiotherapy during respiratory motion, and Understand how the measurement of high resolution dose data in an

MO-B-BRB-01: 3D Dosimetry in the Clinic: Background and Motivation

Energy Technology Data Exchange (ETDEWEB)

Schreiner, L. [Cancer Center of Southeastern Ontario (Canada)

2016-06-15

Full three-dimensional (3D) dosimetry using volumetric chemical dosimeters probed by 3D imaging systems has long been a promising technique for the radiation therapy clinic, since it provides a unique methodology for dose measurements in the volume irradiated using complex conformal delivery techniques such as IMRT and VMAT. To date true 3D dosimetry is still not widely practiced in the community; it has been confined to centres of specialized expertise especially for quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. The potential for improved clinical applicability has been advanced considerably in the last decade by the development of improved 3D dosimeters (e.g., radiochromic plastics, radiochromic gel dosimeters and normoxic polymer gel systems) and by improved readout protocols using optical computed tomography or magnetic resonance imaging. In this session, established users of some current 3D chemical dosimeters will briefly review the current status of 3D dosimetry, describe several dosimeters and their appropriate imaging for dose readout, present workflow procedures required for good dosimetry, and analyze some limitations for applications in select settings. We will review the application of 3D dosimetry to various clinical situations describing how 3D approaches can complement other dose delivery validation approaches already available in the clinic. The applications presented will be selected to inform attendees of the unique features provided by full 3D techniques. Learning Objectives: L. John Schreiner: Background and Motivation Understand recent developments enabling clinically practical 3D dosimetry, Appreciate 3D dosimetry workflow and dosimetry procedures, and Observe select examples from the clinic. Sofie Ceberg: Application to dynamic radiotherapy Observe full dosimetry under dynamic radiotherapy during respiratory motion, and Understand how the measurement of high resolution dose data in an

MO-B-BRB-01: 3D Dosimetry in the Clinic: Background and Motivation

International Nuclear Information System (INIS)

Schreiner, L.

2016-01-01

Full three-dimensional (3D) dosimetry using volumetric chemical dosimeters probed by 3D imaging systems has long been a promising technique for the radiation therapy clinic, since it provides a unique methodology for dose measurements in the volume irradiated using complex conformal delivery techniques such as IMRT and VMAT. To date true 3D dosimetry is still not widely practiced in the community; it has been confined to centres of specialized expertise especially for quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. The potential for improved clinical applicability has been advanced considerably in the last decade by the development of improved 3D dosimeters (e.g., radiochromic plastics, radiochromic gel dosimeters and normoxic polymer gel systems) and by improved readout protocols using optical computed tomography or magnetic resonance imaging. In this session, established users of some current 3D chemical dosimeters will briefly review the current status of 3D dosimetry, describe several dosimeters and their appropriate imaging for dose readout, present workflow procedures required for good dosimetry, and analyze some limitations for applications in select settings. We will review the application of 3D dosimetry to various clinical situations describing how 3D approaches can complement other dose delivery validation approaches already available in the clinic. The applications presented will be selected to inform attendees of the unique features provided by full 3D techniques. Learning Objectives: L. John Schreiner: Background and Motivation Understand recent developments enabling clinically practical 3D dosimetry, Appreciate 3D dosimetry workflow and dosimetry procedures, and Observe select examples from the clinic. Sofie Ceberg: Application to dynamic radiotherapy Observe full dosimetry under dynamic radiotherapy during respiratory motion, and Understand how the measurement of high resolution dose data in an

MO-B-BRB-03: 3D Dosimetry in the Clinic: Validating Special Techniques

International Nuclear Information System (INIS)

Juang, T.

2016-01-01

Full three-dimensional (3D) dosimetry using volumetric chemical dosimeters probed by 3D imaging systems has long been a promising technique for the radiation therapy clinic, since it provides a unique methodology for dose measurements in the volume irradiated using complex conformal delivery techniques such as IMRT and VMAT. To date true 3D dosimetry is still not widely practiced in the community; it has been confined to centres of specialized expertise especially for quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. The potential for improved clinical applicability has been advanced considerably in the last decade by the development of improved 3D dosimeters (e.g., radiochromic plastics, radiochromic gel dosimeters and normoxic polymer gel systems) and by improved readout protocols using optical computed tomography or magnetic resonance imaging. In this session, established users of some current 3D chemical dosimeters will briefly review the current status of 3D dosimetry, describe several dosimeters and their appropriate imaging for dose readout, present workflow procedures required for good dosimetry, and analyze some limitations for applications in select settings. We will review the application of 3D dosimetry to various clinical situations describing how 3D approaches can complement other dose delivery validation approaches already available in the clinic. The applications presented will be selected to inform attendees of the unique features provided by full 3D techniques. Learning Objectives: L. John Schreiner: Background and Motivation Understand recent developments enabling clinically practical 3D dosimetry, Appreciate 3D dosimetry workflow and dosimetry procedures, and Observe select examples from the clinic. Sofie Ceberg: Application to dynamic radiotherapy Observe full dosimetry under dynamic radiotherapy during respiratory motion, and Understand how the measurement of high resolution dose data in an

A feasibility study of using conventional jaws to deliver complex IMRT plans for head and neck cancer

International Nuclear Information System (INIS)

Mu, G; Xia, P

2009-01-01

Previous studies have demonstrated that simple intensity-modulated radiotherapy (IMRT) plans can be produced with a series of rectangular segments formed by conventional jaws. This study investigates whether complex IMRT plans for head and neck cancer can be delivered with the conventional jaws efficiently. Six nasopharyngeal cancer patients, previously treated with multi-leaf collimator (MLC)-IMRT plans, were re-planned using conventional jaw delivery options. All IMRT plans were subject to the plan acceptance criteria of the RTOG-0225 protocol. For a selected patient, the maximum number of segments varied from five to nine per beam, and was tested for both jaws-only IMRT (JO-IMRT) plans and MLC-IMRT plans. Subsequently, JO-IMRT plans and MLC-IMRT on the same treatment planning system were attempted for all patients with identical beams. The dose distribution, dose volume histograms (DVH), the conformal index (COIN), the uniformity index and delivery efficiency were compared between the MLC-IMRT and JO-IMRT plans. All JO-IMRT plans met the RTOG-0225 criteria for tumor coverage and sensitive structures sparing. The corresponding MLC-IMRT and JO-IMRT plans show comparable conformality and uniformity, with average COINs of the planning gross tumor volume(pGTV) 37.7% ± 18.7% versus 37.9% ± 18.1%, and the average uniformity index 82.8% ± 2.5% versus 83.6% ± 3.1%, respectively. The average monitor unit for JO-IMRT plans was about twice that of MLC-IMRT plans. In conclusion, conventional jaws can be used solely to deliver complex IMRT plans for patients with nasopharyngeal cancer yet still within a practical delivery time.

Exclusive image guided IMRT vs. radical prostatectomy followed by postoperative IMRT for localized prostate cancer: a matched-pair analysis based on risk-groups

International Nuclear Information System (INIS)

Azelie, Caroline; Créhange, Gilles; Gauthier, Mélanie; Mirjolet, Céline; Cormier, Luc; Martin, Etienne; Peignaux-Casasnovas, Karine; Truc, Gilles; Chamois, Jérôme; Maingon, Philippe

2012-01-01

To investigate whether patients treated for a localized prostate cancer (PCa) require a radical prostatectomy followed by postoperative radiotherapy or exclusive radiotherapy, in the modern era of image guided IMRT. 178 patients with PCa were referred for daily exclusive image guided IMRT (IG-IMRT) using an on-line 3D ultra-sound based system and 69 patients were referred for postoperative IMRT without image guidance after radical prostatectomy (RP + IMRT). Patients were matched in a 1:1 ratio according to their baseline risk group before any treatment. Late toxicity was scored using the CTV v3.0 scale. Biochemical failure was defined as a postoperative PSA ≤ 0.1 ng/mL followed by 1 consecutive rising PSA for the postoperative group of patients and by the Phoenix definition (nadir + 2 ng/mL) for the group of patients treated with exclusive radiotherapy. A total of 98 patients were matched (49:49). From the start of any treatment, the median follow-up was 56.6 months (CI 95% = [49.6-61.2], range [18.2-115.1]). No patient had late gastrointestinal grade ≥ 2 toxicity in the IG-IMRT group vs. 4% in the RP + IMRT group. Forty two percent of the patients in both groups had late grade ≥ 2 genitourinary toxicity. The 5-year FFF rates in the IG-IMRT group and in the RP + IMRT groups were 93.1% [80.0-97.8] and 76.5% [58.3-87.5], respectively (p = 0.031). Patients with a localized PCa treated with IG-IMRT had better oncological outcome than patients treated with RP + IMRT. Further improvements in postoperative IMRT using image guidance and dose escalation are urgently needed

Interactive dose shaping - efficient strategies for CPU-based real-time treatment planning

International Nuclear Information System (INIS)

Ziegenhein, P; Kamerling, C P; Oelfke, U

2014-01-01

Conventional intensity modulated radiation therapy (IMRT) treatment planning is based on the traditional concept of iterative optimization using an objective function specified by dose volume histogram constraints for pre-segmented VOIs. This indirect approach suffers from unavoidable shortcomings: i) The control of local dose features is limited to segmented VOIs. ii) Any objective function is a mathematical measure of the plan quality, i.e., is not able to define the clinically optimal treatment plan. iii) Adapting an existing plan to changed patient anatomy as detected by IGRT procedures is difficult. To overcome these shortcomings, we introduce the method of Interactive Dose Shaping (IDS) as a new paradigm for IMRT treatment planning. IDS allows for a direct and interactive manipulation of local dose features in real-time. The key element driving the IDS process is a two-step Dose Modification and Recovery (DMR) strategy: A local dose modification is initiated by the user which translates into modified fluence patterns. This also affects existing desired dose features elsewhere which is compensated by a heuristic recovery process. The IDS paradigm was implemented together with a CPU-based ultra-fast dose calculation and a 3D GUI for dose manipulation and visualization. A local dose feature can be implemented via the DMR strategy within 1-2 seconds. By imposing a series of local dose features, equal plan qualities could be achieved compared to conventional planning for prostate and head and neck cases within 1-2 minutes. The idea of Interactive Dose Shaping for treatment planning has been introduced and first applications of this concept have been realized.

IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients

International Nuclear Information System (INIS)

Fregnani, Eduardo Rodrigues; Parahyba, Cláudia Joffily; Morais-Faria, Karina; Fonseca, Felipe Paiva; Ramos, Pedro Augusto Mendes; Moraes, Fábio Yone de; Conceição Vasconcelos, Karina Gondim Moutinho da; Menegussi, Gisela; Santos-Silva, Alan Roger; Brandão, Thais B.

2016-01-01

Radiotherapy (RT) is frequently used in the treatment of head and neck cancer, but different side-effects are frequently reported, including a higher frequency of radiation-related caries, what may be consequence of direct radiation to dental tissue. The intensity-modulated radiotherapy (IMRT) was developed to improve tumor control and decrease patient’s morbidity by delivering radiation beams only to tumor shapes and sparing normal tissue. However, teeth are usually not included in IMRT plannings and the real efficacy of IMRT in the dental context has not been addressed. Therefore, the aim of this study is to assess whether IMRT delivers lower radiation doses to dental structures than conformal 3D radiotherapy (3DRT). Radiation dose delivery to dental structures of 80 patients treated for head and neck cancers (oral cavity, tongue, nasopharynx and oropharynx) with IMRT (40 patients) and 3DRT (40 patients) were assessed by individually contouring tooth crowns on patients’ treatment plans. Clinicopathological data were retrieved from patients’ medical files. The average dose of radiation to teeth delivered by IMRT was significantly lower than with 3DRT (p = 0.007); however, only patients affected by nasopharynx and oral cavity cancers demonstrated significantly lower doses with IMRT (p = 0.012 and p = 0.011, respectively). Molars received more radiation with both 3DRT and IMRT, but the latter delivered significantly lower radiation in this group of teeth (p < 0.001), whereas no significant difference was found for the other dental groups. Maxillary teeth received lower doses than mandibular teeth, but only IMRT delivered significantly lower doses (p = 0.011 and p = 0.003). Ipsilateral teeth received higher doses than contralateral teeth with both techniques and IMRT delivered significantly lower radiation than 3DRT for contralateral dental structures (p < 0.001). IMRT delivered lower radiation doses to teeth than 3DRT, but only for some groups of patients and

A Comprehensive Comparison of IMRT and VMAT Plan Quality for Prostate Cancer Treatment

International Nuclear Information System (INIS)

Quan, Enzhuo M.; Li Xiaoqiang; Li Yupeng; Wang Xiaochun; Kudchadker, Rajat J.; Johnson, Jennifer L.; Kuban, Deborah A.; Lee, Andrew K.; Zhang Xiaodong

2012-01-01

Purpose: We performed a comprehensive comparative study of the plan quality between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) for the treatment of prostate cancer. Methods and Materials: Eleven patients with prostate cancer treated at our institution were randomly selected for this study. For each patient, a VMAT plan and a series of IMRT plans using an increasing number of beams (8, 12, 16, 20, and 24 beams) were examined. All plans were generated using our in-house–developed automatic inverse planning (AIP) algorithm. An existing eight-beam clinical IMRT plan, which was used to treat the patient, was used as the reference plan. For each patient, all AIP-generated plans were optimized to achieve the same level of planning target volume (PTV) coverage as the reference plan. Plan quality was evaluated by measuring mean dose to and dose–volume statistics of the organs at risk, especially the rectum, from each type of plan. Results: For the same PTV coverage, the AIP-generated VMAT plans had significantly better plan quality in terms of rectum sparing than the eight-beam clinical and AIP-generated IMRT plans (p < 0.0001). However, the differences between the IMRT and VMAT plans in all the dosimetric indices decreased as the number of beams used in IMRT increased. IMRT plan quality was similar or superior to that of VMAT when the number of beams in IMRT was increased to a certain number, which ranged from 12 to 24 for the set of patients studied. The superior VMAT plan quality resulted in approximately 30% more monitor units than the eight-beam IMRT plans, but the delivery time was still less than 3 min. Conclusions: Considering the superior plan quality as well as the delivery efficiency of VMAT compared with that of IMRT, VMAT may be the preferred modality for treating prostate cancer.

Quality assurance device for four-dimensional IMRT or SBRT and respiratory gating using patient-specific intrafraction motion kernels.

Science.gov (United States)

Nelms, Benjamin E; Ehler, Eric; Bragg, Henry; Tomé, Wolfgang A

2007-09-17

Emerging technologies such as four-dimensional computed tomography (4D CT) and implanted beacons are expected to allow clinicians to accurately model intrafraction motion and to quantitatively estimate internal target volumes (ITVs) for radiation therapy involving moving targets. In the case of intensity-modulated (IMRT) and stereotactic body radiation therapy (SBRT) delivery, clinicians must consider the interplay between the temporal nature of the modulation and the target motion within the ITV. A need exists for a 4D IMRT/SBRT quality assurance (QA) device that can incorporate and analyze customized intrafraction motion as it relates to dose delivery and respiratory gating. We built a 4D IMRT/SBRT prototype device and entered (X, Y, Z)(T) coordinates representing a motion kernel into a software application that 1. transformed the kernel into beam-specific two-dimensional (2D) motion "projections," 2. previewed the motion in real time, and 3. drove a recision X-Y motorized device that had, atop it, a mounted planar IMRT QA measurement device. The detectors that intersected the target in the beam's-eye-view of any single phase of the breathing cycle (a small subset of all the detectors) were defined as "target detectors" to be analyzed for dose uniformity between multiple fractions. Data regarding the use of this device to quantify dose variation fraction-to-fraction resulting from target motion (for several delivery modalities and with and without gating) have been recently published. A combined software and hardware solution for patient-customized 4D IMRT/SBRT QA is an effective tool for assessing IMRT delivery under conditions of intrafraction motion. The 4D IMRT QA device accurately reproduced the projected motion kernels for all beam's-eye-view motion kernels. This device has been proved to, effectively quantify the degradation in dose uniformity resulting from a moving target within a static planning target volume, and, integrate with a commercial

Quality assurance device for four‐dimensional IMRT or SBRT and respiratory gating using patient‐specific intrafraction motion kernels

Science.gov (United States)

Ehler, Eric; Bragg, Henry; Tomé, Wolfgang A.

2007-01-01

Emerging technologies such as four‐dimensional computed tomography (4D CT) and implanted beacons are expected to allow clinicians to accurately model intrafraction motion and to quantitatively estimate internal target volumes (ITVs) for radiation therapy involving moving targets. In the case of intensity‐modulated (IMRT) and stereotactic body radiation therapy (SBRT) delivery, clinicians must consider the interplay between the temporal nature of the modulation and the target motion within the ITV. A need exists for a 4D IMRT/SBRT quality assurance (QA) device that can incorporate and analyze customized intrafraction motion as it relates to dose delivery and respiratory gating. We built a 4D IMRT/SBRT prototype device and entered (X, Y, Z)(T) coordinates representing a motion kernel into a software application that transformed the kernel into beam‐specific two‐dimensional (2D) motion “projections,”previewed the motion in real time, anddrove a precision X–Y motorized device that had, atop it, a mounted planar IMRT QA measurement device. The detectors that intersected the target in the beam's‐eye‐view of any single phase of the breathing cycle (a small subset of all the detectors) were defined as “target detectors” to be analyzed for dose uniformity between multiple fractions. Data regarding the use of this device to quantify dose variation fraction‐to‐fraction resulting from target motion (for several delivery modalities and with and without gating) have been recently published. A combined software and hardware solution for patient‐customized 4D IMRT/ SBRT QA is an effective tool for assessing IMRT delivery under conditions of intrafraction motion. The 4D IMRT QA device accurately reproduced the projected motion kernels for all beam's‐eye‐view motion kernels. This device has been proved to • effectively quantify the degradation in dose uniformity resulting from a moving target within a static planning target volume, and • integrate

A method for evaluating treatment quality using in vivo EPID dosimetry and statistical process control in radiation therapy.

Science.gov (United States)

Fuangrod, Todsaporn; Greer, Peter B; Simpson, John; Zwan, Benjamin J; Middleton, Richard H

2017-03-13

Purpose Due to increasing complexity, modern radiotherapy techniques require comprehensive quality assurance (QA) programmes, that to date generally focus on the pre-treatment stage. The purpose of this paper is to provide a method for an individual patient treatment QA evaluation and identification of a "quality gap" for continuous quality improvement. Design/methodology/approach A statistical process control (SPC) was applied to evaluate treatment delivery using in vivo electronic portal imaging device (EPID) dosimetry. A moving range control chart was constructed to monitor the individual patient treatment performance based on a control limit generated from initial data of 90 intensity-modulated radiotherapy (IMRT) and ten volumetric-modulated arc therapy (VMAT) patient deliveries. A process capability index was used to evaluate the continuing treatment quality based on three quality classes: treatment type-specific, treatment linac-specific, and body site-specific. Findings The determined control limits were 62.5 and 70.0 per cent of the χ pass-rate for IMRT and VMAT deliveries, respectively. In total, 14 patients were selected for a pilot study the results of which showed that about 1 per cent of all treatments contained errors relating to unexpected anatomical changes between treatment fractions. Both rectum and pelvis cancer treatments demonstrated process capability indices were less than 1, indicating the potential for quality improvement and hence may benefit from further assessment. Research limitations/implications The study relied on the application of in vivo EPID dosimetry for patients treated at the specific centre. Sampling patients for generating the control limits were limited to 100 patients. Whilst the quantitative results are specific to the clinical techniques and equipment used, the described method is generally applicable to IMRT and VMAT treatment QA. Whilst more work is required to determine the level of clinical significance, the

Q A IMRT comparison specific patient by means of radiochromic films, radiographic films and ionization chambers arrangement; Comparacion de QA IMRT paciente especifico mediante films radiocromicos, films radiograficos y arreglo de camaras de ionizacion

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Medina, L.; Venencia, D.; Garrigo, E., E-mail: fisicamedina11@gmail.com [Instituto Privado de Radioterapia, Obispo Oro 423, X5000BFI Cordoba (Argentina)

2014-08-15

IMRT uses radiation beams of nonuniform intensity. Quality assurance (Q A) specific patient is mandatory in this treatment modality. The purpose of this study is to compare results of patient specific Q A IMRT dose distributions of the total plan and individual fields using different dosimetric systems. We used a photon beam 6 MV generated for linear accelerator PRIMUS, were used planning systems iPLAN and Konrad for IMRT inverse planning with modality Step and Shoot. For plans total dose distributions were measured with radiographic films EDR2 and Radiochromic Film EBT3. For individual fields the dose distributions were measured with radiographic films X-Omat-V, Radiochromic Film EBT3 and PTW 2D-Array. We used a scanner VIDAR Dosimetry Pro Red and software Rit v6.1 for analysis, was used Gamma index [Γ] for comparison of measured and calculated dose recording the number of pixels with Γ> 1. We analyzed 50 plan dose distributions total 50 individual fields. For the total plan the number of pixels with Γ>1 (3%-3m m) was 0.7%±1.2 [0.1%; 2.82%] for EBT3 y 1%±1.8 [0.2%; 3%] for EDR2. For individual fields (5%-3m m) was obtained 0.97%±1,7 [0%, 3%] for X-Omat-V, 0.84%±1.1[0.3%,3.1%] for EBT3 and 2.6%±1.9 [0.01%,6.8%] PTW 2D-Array. All three methods can be used. Radiochromic Films revealed the advantage and disadvantage of the cost. Both systems are slightly better film to PTW 2D-Array. (author)

IMRT for Image-Guided Single Vocal Cord Irradiation

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Osman, Sarah O.S., E-mail: s.osman@erasmusmc.nl [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Astreinidou, Eleftheria; Boer, Hans C.J. de; Keskin-Cambay, Fatma; Breedveld, Sebastiaan; Voet, Peter; Al-Mamgani, Abrahim; Heijmen, Ben J.M.; Levendag, Peter C. [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

2012-02-01

Purpose: We have been developing an image-guided single vocal cord irradiation technique to treat patients with stage T1a glottic carcinoma. In the present study, we compared the dose coverage to the affected vocal cord and the dose delivered to the organs at risk using conventional, intensity-modulated radiotherapy (IMRT) coplanar, and IMRT non-coplanar techniques. Methods and Materials: For 10 patients, conventional treatment plans using two laterally opposed wedged 6-MV photon beams were calculated in XiO (Elekta-CMS treatment planning system). An in-house IMRT/beam angle optimization algorithm was used to obtain the coplanar and non-coplanar optimized beam angles. Using these angles, the IMRT plans were generated in Monaco (IMRT treatment planning system, Elekta-CMS) with the implemented Monte Carlo dose calculation algorithm. The organs at risk included the contralateral vocal cord, arytenoids, swallowing muscles, carotid arteries, and spinal cord. The prescription dose was 66 Gy in 33 fractions. Results: For the conventional plans and coplanar and non-coplanar IMRT plans, the population-averaged mean dose {+-} standard deviation to the planning target volume was 67 {+-} 1 Gy. The contralateral vocal cord dose was reduced from 66 {+-} 1 Gy in the conventional plans to 39 {+-} 8 Gy and 36 {+-} 6 Gy in the coplanar and non-coplanar IMRT plans, respectively. IMRT consistently reduced the doses to the other organs at risk. Conclusions: Single vocal cord irradiation with IMRT resulted in good target coverage and provided significant sparing of the critical structures. This has the potential to improve the quality-of-life outcomes after RT and maintain the same local control rates.

IMRT for Image-Guided Single Vocal Cord Irradiation

International Nuclear Information System (INIS)

Osman, Sarah O.S.; Astreinidou, Eleftheria; Boer, Hans C.J. de; Keskin-Cambay, Fatma; Breedveld, Sebastiaan; Voet, Peter; Al-Mamgani, Abrahim; Heijmen, Ben J.M.; Levendag, Peter C.

2012-01-01

Purpose: We have been developing an image-guided single vocal cord irradiation technique to treat patients with stage T1a glottic carcinoma. In the present study, we compared the dose coverage to the affected vocal cord and the dose delivered to the organs at risk using conventional, intensity-modulated radiotherapy (IMRT) coplanar, and IMRT non-coplanar techniques. Methods and Materials: For 10 patients, conventional treatment plans using two laterally opposed wedged 6-MV photon beams were calculated in XiO (Elekta-CMS treatment planning system). An in-house IMRT/beam angle optimization algorithm was used to obtain the coplanar and non-coplanar optimized beam angles. Using these angles, the IMRT plans were generated in Monaco (IMRT treatment planning system, Elekta-CMS) with the implemented Monte Carlo dose calculation algorithm. The organs at risk included the contralateral vocal cord, arytenoids, swallowing muscles, carotid arteries, and spinal cord. The prescription dose was 66 Gy in 33 fractions. Results: For the conventional plans and coplanar and non-coplanar IMRT plans, the population-averaged mean dose ± standard deviation to the planning target volume was 67 ± 1 Gy. The contralateral vocal cord dose was reduced from 66 ± 1 Gy in the conventional plans to 39 ± 8 Gy and 36 ± 6 Gy in the coplanar and non-coplanar IMRT plans, respectively. IMRT consistently reduced the doses to the other organs at risk. Conclusions: Single vocal cord irradiation with IMRT resulted in good target coverage and provided significant sparing of the critical structures. This has the potential to improve the quality-of-life outcomes after RT and maintain the same local control rates.

Visual Simultaneous Localization And Mapping (VSLAM) methods applied to indoor 3D topographical and radiological mapping in real-time

Science.gov (United States)

Hautot, Felix; Dubart, Philippe; Bacri, Charles-Olivier; Chagneau, Benjamin; Abou-Khalil, Roger

2017-09-01

New developments in the field of robotics and computer vision enables to merge sensors to allow fast realtime localization of radiological measurements in the space/volume with near-real time radioactive sources identification and characterization. These capabilities lead nuclear investigations to a more efficient way for operators' dosimetry evaluation, intervention scenarii and risks mitigation and simulations, such as accidents in unknown potentially contaminated areas or during dismantling operations

Impact of margin on tumour and normal tissue dosimetry in patients treated with IMRT using an endorectal balloon for prostate immobilization

International Nuclear Information System (INIS)

Ahmad, S.

2004-01-01

Full text: In treatment of prostate cancer with IMRT (Intensity Modulated Radiation Therapy), clinical target volume margin is determined by organ motion and set-up error. However, the margin width that achieves the desired dose escalation while minimizing normal tissue exposure is dependent upon the patient immobilization and/or organ localization techniques. In this study, we compare the impact of margin width on the dosimetry of tumour and normal tissues using the endorectal balloon for prostate immobilization. IMRT plans were generated for ten patients using margin widths of 0, 3, 5, 8 and 10 mm. Patients had a planning CT scan in the prone position with an endorectal balloon filled with 100 cc of air for prostate immobilization. The Corvus version 3.0.11 was used for treatment planning. The dose for the prostate and seminal vesicles was 70 Gy in 2 Gy per fractions, prescribed at the 83% isodose line. Dose restrictions to normal tissues were as follows: 33% of bladder was allowed to receive above 65 Gy, 15% of rectum above 68 Gy and 10% of femurs above 45 Gy. Analysis of Variance was used to compare the target and normal tissue doses. Tumour control probability and normal tissue complication probability calculations are currently being performed and will be presented. The mean doses ranged from 73.93 to 75.31 Gy for the prostate and from 73.71 to 75.31 Gy for the seminal vesicles. A 10 mm margin produced significantly lower mean doses compared to 0 or 5 mm for both targets (prostate p 0.062). For bladder and rectum the mean doses ranged from 18.49 to 22.30 Gy (p=0.605) and from 29.34 to 31.33 Gy (p=0.135), respectively, while the percent rectal volumes above 68 Gy were significantly higher for margins of 5, 8 and 10 mm (p<0.006) ranging from 10.72% to 15.81%. Mean doses to the femurs and pelvis were significantly higher for 8 and 10 mm margins, ranging from 20.9 to 29.39 Gy for femurs (p<0.015) and from 15.05 to 19.98 Gy for pelvis (p<0.0005). Also the percent

Clinical development of a failure detection-based online repositioning strategy for prostate IMRT--Experiments, simulation, and dosimetry study

Energy Technology Data Exchange (ETDEWEB)

Liu Wu; Qian Jianguo; Hancock, Steven L.; Xing, Lei; Luxton, Gary [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California 94305-5847 (United States) and Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut 06510 (United States); Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California 94305-5847 (United States)

2010-10-15

Purpose: To implement and evaluate clinic-ready adaptive imaging protocols for online patient repositioning (motion tracking) during prostate IMRT using treatment beam imaging supplemented by minimal, as-needed use of on-board kV. Methods: The authors examine the two-step decision-making strategy: (1) Use cine-MV imaging and online-updated characterization of prostate motion to detect target motion that is potentially beyond a predefined threshold and (2) use paired MV-kV 3D localization to determine overthreshold displacement and, if needed, reposition the patient. Two levels of clinical implementation were evaluated: (1) Field-by-field based motion correction for present-day linacs and (2) instantaneous repositioning for new-generation linacs with capabilities of simultaneous MV-kV imaging and remote automatic couch control during treatment delivery. Experiments were performed on a Varian Trilogy linac in clinical mode using a 4D motion phantom programed with prostate motion trajectories taken from patient data. Dosimetric impact was examined using a 2D ion chamber array. Simulations were done for 536 trajectories from 17 patients. Results: Despite the loss of marker detection efficiency caused by the MLC leaves sometimes obscuring the field at the marker's projected position on the MV imager, the field-by-field correction halved (from 23% to 10%) the mean percentage of time that target displacement exceeded a 3 mm threshold, as compared to no intervention. This was achieved at minimal cost in additional imaging (average of one MV-kV pair per two to three treatment fractions) and with a very small number of repositionings (once every four to five fractions). Also with low kV usage ({approx}2/fraction), the instantaneous repositioning approach reduced overthreshold time by more than 75% (23% to 5%) even with severe MLC blockage as often encountered in current IMRT and could reduce the overthreshold time tenfold (to <2%) if the MLC blockage problem were

Application of MOSFET detectors for dosimetry in small animal radiography using short exposure times.

Science.gov (United States)

De Lin, Ming; Toncheva, Greta; Nguyen, Giao; Kim, Sangroh; Anderson-Evans, Colin; Johnson, G Allan; Yoshizumi, Terry T

2008-08-01

Digital subtraction angiography (DSA) X-ray imaging for small animals can be used for functional phenotyping given its ability to capture rapid physiological changes at high spatial and temporal resolution. The higher temporal and spatial requirements for small-animal imaging drive the need for short, high-flux X-ray pulses. However, high doses of ionizing radiation can affect the physiology. The purpose of this study was to verify and apply metal oxide semiconductor field effect transistor (MOSFET) technology to dosimetry for small-animal diagnostic imaging. A tungsten anode X-ray source was used to expose a tissue-equivalent mouse phantom. Dose measurements were made on the phantom surface and interior. The MOSFETs were verified with thermoluminescence dosimeters (TLDs). Bland-Altman analysis showed that the MOSFET results agreed with the TLD results (bias, 0.0625). Using typical small animal DSA scan parameters, the dose ranged from 0.7 to 2.2 cGy. Application of the MOSFETs in the small animal environment provided two main benefits: (1) the availability of results in near real-time instead of the hours needed for TLD processes and (2) the ability to support multiple exposures with different X-ray techniques (various of kVp, mA and ms) using the same MOSFET. This MOSFET technology has proven to be a fast, reliable small animal dosimetry method for DSA imaging and is a good system for dose monitoring for serial and gene expression studies.

Intensity-Modulated Radiotherapy (IMRT) vs Helical Tomotherapy (HT) in Concurrent Chemoradiotherapy (CRT) for Patients with Anal Canal Carcinoma (ACC): an analysis of dose distribution and toxicities

International Nuclear Information System (INIS)

Yeung, Rosanna; McConnell, Yarrow; Warkentin, Heather; Graham, Darren; Warkentin, Brad; Joseph, Kurian; Doll, Corinne M

2015-01-01

Intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT) have been adopted for radiotherapy treatment of anal canal carcinoma (ACC) due to better conformality, dose homogeneity and normal-tissue sparing compared to 3D-CRT. To date, only one published study compares dosimetric parameters of IMRT vs HT in ACC, but there are no published data comparing toxicities. Our objectives were to compare dosimetry and toxicities between these modalities. This is a retrospective study of 35 ACC patients treated with radical chemoradiotherapy at two tertiary cancer institutions from 2008–2010. The use of IMRT vs HT was primarily based on center availability. The majority of patients received fluorouracil (5-FU) and 1–2 cycles of mitomycin C (MMC); 2 received 5-FU and cisplatin. Primary tumor and elective nodes were prescribed to ≥54Gy and ≥45Gy, respectively. Patients were grouped into two cohorts: IMRT vs HT. The primary endpoint was a dosimetric comparison between the cohorts; the secondary endpoint was comparison of toxicities. 18 patients were treated with IMRT and 17 with HT. Most IMRT patients received 5-FU and 1 MMC cycle, while most HT patients received 2 MMC cycles (p < 0.01), based on center policy. HT achieved more homogenous coverage of the primary tumor (HT homogeneity and uniformity index 0.14 and 1.02 vs 0.29 and 1.06 for IMRT, p = 0.01 and p < 0.01). Elective nodal coverage did not differ. IMRT achieved better bladder, femoral head and peritoneal space sparing (V30 and V40, p ≤ 0.01), and lower mean skin dose (p < 0.01). HT delivered lower bone marrow (V10, p < 0.01) and external genitalia dose (V20 and V30, p < 0.01). Grade 2+ hematological and non-hematological toxicities were similar. Febrile neutropenia and unscheduled treatment breaks did not differ (both p = 0.13), nor did 3-year overall and disease-free survival (p = 0.13, p = 0.68). Chemoradiotherapy treatment of ACC using IMRT vs HT results in differences in dose homogenity and

Fluence complexity for IMRT field and simplification of IMRT verification

International Nuclear Information System (INIS)

Hanushova, Tereza; Vondarchek, Vladimir

2013-01-01

Intensity Modulated Radiation Therapy (IMRT) requires dosimetric verification of each patient’s plan, which is time consuming. This work deals with the idea of minimizing the number of fields for control, or even replacing plan verification by machine quality assurance (QA). We propose methods for estimation of fluence complexity in an IMRT field based on dose gradients and investigate the relation between results of gamma analysis and this quantity. If there is a relation, it might be possible to only verify the most complex field of a plan. We determine the average fluence complexity in clinical fields and design a test fluence corresponding to this amount of complexity which might be used in daily QA and potentially replace patient-related verification. Its applicability is assessed in clinical practice. The relation between fluence complexity and results of gamma analysis has been confirmed for plans but not for single fields. There is an agreement between the suggested test fluence and clinical fields in the average gamma parameter. A critical value of average gamma has been specified for the test fluence as a criterion for distinguishing between poorly and well deliverable plans. It will not be possible to only verify the most complex field of a plan but verification of individual plans could be replaced by a morning check of the suggested test fluence, together with a well-established set of QA tests. (Author)

Dosimetry; La dosimetrie

Energy Technology Data Exchange (ETDEWEB)

Le Couteulx, I.; Apretna, D.; Beaugerie, M.F. [Electricite de France (EDF), 75 - Paris (France)] [and others

2003-07-01

Eight articles treat the dosimetry. Two articles evaluate the radiation doses in specific cases, dosimetry of patients in radiodiagnosis, three articles are devoted to detectors (neutrons and x and gamma radiations) and a computer code to build up the dosimetry of an accident due to an external exposure. (N.C.)

Irradiation of head-and-neck tumors with intensity modulated radiotherapy (IMRT). Comparison between two IMRT techniques with 3D conformal irradiation

International Nuclear Information System (INIS)

Heeger, Jonas

2013-01-01

For 12 patients with inoperable head-neck carcinoma that were treated with 3D conformal irradiation techniques additional irradiation plans using IMRT were developed. It was shown that the IMRT techniques are superior to the 3D conformal technique. The new rapid arc technique is unclear with respect to the critical organs (parotid glands, spinal canal and mandibles) but is significantly advantageous for the other normal tissue with respect to conformity (steeper dose gradients) and thus radiation dose reduction. The resulting lower irradiation time and the reduced radiation exposure being important for the treatment economy and patients' comfort should favor the more planning intensive rapid arc technique.

SIFT: A method to verify the IMRT fluence delivered during patient treatment using an electronic portal imaging device

International Nuclear Information System (INIS)

Vieira, Sandra C.; Dirkx, Maarten L.P.; Heijmen, Ben J.M.; Boer, Hans C.J. de

2004-01-01

Purpose: Radiotherapy patients are increasingly treated with intensity-modulated radiotherapy (IMRT) and high tumor doses. As part of our quality control program to ensure accurate dose delivery, a new method was investigated that enables the verification of the IMRT fluence delivered during patient treatment using an electronic portal imaging device (EPID), irrespective of changes in patient geometry. Methods and materials: Each IMRT treatment field is split into a static field and a modulated field, which are delivered in sequence. Images are acquired for both fields using an EPID. The portal dose image obtained for the static field is used to determine changes in patient geometry between the planning CT scan and the time of treatment delivery. With knowledge of these changes, the delivered IMRT fluence can be verified using the portal dose image of the modulated field. This method, called split IMRT field technique (SIFT), was validated first for several phantom geometries, followed by clinical implementation for a number of patients treated with IMRT. Results: The split IMRT field technique allows for an accurate verification of the delivered IMRT fluence (generally within 1% [standard deviation]), even if large interfraction changes in patient geometry occur. For interfraction radiological path length changes of 10 cm, deliberately introduced errors in the delivered fluence could still be detected to within 1% accuracy. Application of SIFT requires only a minor increase in treatment time relative to the standard IMRT delivery. Conclusions: A new technique to verify the delivered IMRT fluence from EPID images, which is independent of changes in the patient geometry, has been developed. SIFT has been clinically implemented for daily verification of IMRT treatment delivery

MO-AB-BRA-03: Development of Novel Real Time in Vivo EPID Treatment Verification for Brachytherapy

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Fonseca, G; Podesta, M [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Reniers, B [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Research Group NuTeC, CMK, Hasselt University, Agoralaan Gebouw H, Diepenbeek B-3590 (Belgium); Verhaegen, F [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Medical Physics Unit, Department of Oncology, McGill University, Montreal, Quebec H3G 1A4 (Canada)

2016-06-15

Purpose: High Dose Rate (HDR) brachytherapy treatments are employed worldwide to treat a wide variety of cancers. However, in vivo dose verification remains a challenge with no commercial dosimetry system available to verify the treatment dose delivered to the patient. We propose a novel dosimetry system that couples an independent Monte Carlo (MC) simulation platform and an amorphous silicon Electronic Portal Imaging Device (EPID) to provide real time treatment verification. Methods: MC calculations predict the EPID response to the photon fluence emitted by the HDR source by simulating the patient, the source dwell positions and times, and treatment complexities such as tissue compositions/densities and different applicators. Simulated results are then compared against EPID measurements acquired with ∼0.14s time resolution which allows dose measurements for each dwell position. The EPID has been calibrated using an Ir-192 HDR source and experiments were performed using different phantoms, including tissue equivalent materials (PMMA, lung and bone). A source positioning accuracy of 0.2 mm, without including the afterloader uncertainty, was ensured using a robotic arm moving the source. Results: An EPID can acquire 3D Cartesian source positions and its response varies significantly due to differences in the material composition/density of the irradiated object, allowing detection of changes in patient geometry. The panel time resolution allows dose rate and dwell time measurements. Moreover, predicted EPID images obtained from clinical treatment plans provide anatomical information that can be related to the patient anatomy, mostly bone and air cavities, localizing the source inside of the patient using its anatomy as reference. Conclusion: Results obtained show the feasibility of the proposed dose verification system that is capable to verify all the brachytherapy treatment steps in real time providing data about treatment delivery quality and also applicator

Software for simulating IMRT protocol

Energy Technology Data Exchange (ETDEWEB)

Fonseca, Thelma C.F.; Campos, Tarcisio P.R. de, E-mail: tcff@ufmg.b, E-mail: campos@nuclear.ufmg.b [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept. de Engenharia Nuclear

2009-07-01

The Intensity Modulated Radiation Therapy - IMRT is an advanced technique to cancer treatment widely used on oncology around the world. The present paper describes the SOFT-RT software which is a tool for simulating IMRT protocol. Also, it will be present a cerebral tumor case of studied in which three irradiation windows with distinct orientation were applied. The SOFT-RT collect and export data to MCNP code. This code simulates the photon transport on the voxel model. Later, a out-module from SOFT-RT import the results and express the dose-response superimposing dose and voxel model in a tree-dimensional graphic representation. The present paper address the IMRT software and its function as well a cerebral tumor case of studied is showed. The graphic interface of the SOFT-RT illustrates the example case. (author)

Software for simulating IMRT protocol

International Nuclear Information System (INIS)

Fonseca, Thelma C.F.; Campos, Tarcisio P.R. de

2009-01-01

The Intensity Modulated Radiation Therapy - IMRT is an advanced technique to cancer treatment widely used on oncology around the world. The present paper describes the SOFT-RT software which is a tool for simulating IMRT protocol. Also, it will be present a cerebral tumor case of studied in which three irradiation windows with distinct orientation were applied. The SOFT-RT collect and export data to MCNP code. This code simulates the photon transport on the voxel model. Later, a out-module from SOFT-RT import the results and express the dose-response superimposing dose and voxel model in a tree-dimensional graphic representation. The present paper address the IMRT software and its function as well a cerebral tumor case of studied is showed. The graphic interface of the SOFT-RT illustrates the example case. (author)

Detection of anatomical changes in lung cancer patients with 2D time-integrated, 2D time-resolved and 3D time-integrated portal dosimetry: a simulation study

Science.gov (United States)

Wolfs, Cecile J. A.; Brás, Mariana G.; Schyns, Lotte E. J. R.; Nijsten, Sebastiaan M. J. J. G.; van Elmpt, Wouter; Scheib, Stefan G.; Baltes, Christof; Podesta, Mark; Verhaegen, Frank

2017-08-01

The aim of this work is to assess the performance of 2D time-integrated (2D-TI), 2D time-resolved (2D-TR) and 3D time-integrated (3D-TI) portal dosimetry in detecting dose discrepancies between the planned and (simulated) delivered dose caused by simulated changes in the anatomy of lung cancer patients. For six lung cancer patients, tumor shift, tumor regression and pleural effusion are simulated by modifying their CT images. Based on the modified CT images, time-integrated (TI) and time-resolved (TR) portal dose images (PDIs) are simulated and 3D-TI doses are calculated. The modified and original PDIs and 3D doses are compared by a gamma analysis with various gamma criteria. Furthermore, the difference in the D 95% (ΔD 95%) of the GTV is calculated and used as a gold standard. The correlation between the gamma fail rate and the ΔD 95% is investigated, as well the sensitivity and specificity of all combinations of portal dosimetry method, gamma criteria and gamma fail rate threshold. On the individual patient level, there is a correlation between the gamma fail rate and the ΔD 95%, which cannot be found at the group level. The sensitivity and specificity analysis showed that there is not one combination of portal dosimetry method, gamma criteria and gamma fail rate threshold that can detect all simulated anatomical changes. This work shows that it will be more beneficial to relate portal dosimetry and DVH analysis on the patient level, rather than trying to quantify a relationship for a group of patients. With regards to optimizing sensitivity and specificity, different combinations of portal dosimetry method, gamma criteria and gamma fail rate should be used to optimally detect certain types of anatomical changes.

Detection of anatomical changes in lung cancer patients with 2D time-integrated, 2D time-resolved and 3D time-integrated portal dosimetry: a simulation study.

Science.gov (United States)

Wolfs, Cecile J A; Brás, Mariana G; Schyns, Lotte E J R; Nijsten, Sebastiaan M J J G; van Elmpt, Wouter; Scheib, Stefan G; Baltes, Christof; Podesta, Mark; Verhaegen, Frank

2017-07-12

The aim of this work is to assess the performance of 2D time-integrated (2D-TI), 2D time-resolved (2D-TR) and 3D time-integrated (3D-TI) portal dosimetry in detecting dose discrepancies between the planned and (simulated) delivered dose caused by simulated changes in the anatomy of lung cancer patients. For six lung cancer patients, tumor shift, tumor regression and pleural effusion are simulated by modifying their CT images. Based on the modified CT images, time-integrated (TI) and time-resolved (TR) portal dose images (PDIs) are simulated and 3D-TI doses are calculated. The modified and original PDIs and 3D doses are compared by a gamma analysis with various gamma criteria. Furthermore, the difference in the D 95% (ΔD 95% ) of the GTV is calculated and used as a gold standard. The correlation between the gamma fail rate and the ΔD 95% is investigated, as well the sensitivity and specificity of all combinations of portal dosimetry method, gamma criteria and gamma fail rate threshold. On the individual patient level, there is a correlation between the gamma fail rate and the ΔD 95% , which cannot be found at the group level. The sensitivity and specificity analysis showed that there is not one combination of portal dosimetry method, gamma criteria and gamma fail rate threshold that can detect all simulated anatomical changes. This work shows that it will be more beneficial to relate portal dosimetry and DVH analysis on the patient level, rather than trying to quantify a relationship for a group of patients. With regards to optimizing sensitivity and specificity, different combinations of portal dosimetry method, gamma criteria and gamma fail rate should be used to optimally detect certain types of anatomical changes.

Combined kV and MV imaging for real-time tracking of implanted fiducial markers

International Nuclear Information System (INIS)

Wiersma, R. D.; Mao Weihua; Xing, L.

2008-01-01

In the presence of intrafraction organ motion, target localization uncertainty can greatly hamper the advantage of highly conformal dose techniques such as intensity modulated radiation therapy (IMRT). To minimize the adverse dosimetric effect caused by tumor motion, a real-time knowledge of the tumor position is required throughout the beam delivery process. The recent integration of onboard kV diagnostic imaging together with MV electronic portal imaging devices on linear accelerators can allow for real-time three-dimensional (3D) tumor position monitoring during a treatment delivery. The aim of this study is to demonstrate a near real-time 3D internal fiducial tracking system based on the combined use of kV and MV imaging. A commercially available radiotherapy system equipped with both kV and MV imaging systems was used in this work. A hardware video frame grabber was used to capture both kV and MV video streams simultaneously through independent video channels at 30 frames per second. The fiducial locations were extracted from the kV and MV images using a software tool. The geometric tracking capabilities of the system were evaluated using a pelvic phantom with embedded fiducials placed on a moveable stage. The maximum tracking speed of the kV/MV system is approximately 9 Hz, which is primarily limited by the frame rate of the MV imager. The geometric accuracy of the system is found to be on the order of less than 1 mm in all three spatial dimensions. The technique requires minimal hardware modification and is potentially useful for image-guided radiation therapy systems

Real-time shadows

CERN Document Server

Eisemann, Elmar; Assarsson, Ulf; Wimmer, Michael

2011-01-01

Important elements of games, movies, and other computer-generated content, shadows are crucial for enhancing realism and providing important visual cues. In recent years, there have been notable improvements in visual quality and speed, making high-quality realistic real-time shadows a reachable goal. Real-Time Shadows is a comprehensive guide to the theory and practice of real-time shadow techniques. It covers a large variety of different effects, including hard, soft, volumetric, and semi-transparent shadows.The book explains the basics as well as many advanced aspects related to the domain

Dependable Real-Time Systems

Science.gov (United States)

1991-09-30

0196 or 413 545-0720 PI E-mail Address: krithi@nirvan.cs.umass.edu, stankovic(ocs.umass.edu Grant or Contract Title: Dependable Real - Time Systems Grant...Dependable Real - Time Systems " Grant or Contract Number: N00014-85-k-0398 L " Reporting Period: 1 Oct 87 - 30 Sep 91 , 2. Summary of Accomplishments ’ 2.1 Our...in developing a sound approach to scheduling tasks in complex real - time systems , (2) developed a real-time operating system kernel, a preliminary

A fast dose calculation method based on table lookup for IMRT optimization

International Nuclear Information System (INIS)

Wu Qiuwen; Djajaputra, David; Lauterbach, Marc; Wu Yan; Mohan, Radhe

2003-01-01

This note describes a fast dose calculation method that can be used to speed up the optimization process in intensity-modulated radiotherapy (IMRT). Most iterative optimization algorithms in IMRT require a large number of dose calculations to achieve convergence and therefore the total amount of time needed for the IMRT planning can be substantially reduced by using a faster dose calculation method. The method that is described in this note relies on an accurate dose calculation engine that is used to calculate an approximate dose kernel for each beam used in the treatment plan. Once the kernel is computed and saved, subsequent dose calculations can be done rapidly by looking up this kernel. Inaccuracies due to the approximate nature of the kernel in this method can be reduced by performing scheduled kernel updates. This fast dose calculation method can be performed more than two orders of magnitude faster than the typical superposition/convolution methods and therefore is suitable for applications in which speed is critical, e.g., in an IMRT optimization that requires a simulated annealing optimization algorithm or in a practical IMRT beam-angle optimization system. (note)

Accuracy required and achievable in radiotherapy dosimetry: have modern technology and techniques changed our views?

Science.gov (United States)

Thwaites, David

2013-06-01

In this review of the accuracy required and achievable in radiotherapy dosimetry, older approaches and evidence-based estimates for 3DCRT have been reprised, summarising and drawing together the author's earlier evaluations where still relevant. Available evidence for IMRT uncertainties has been reviewed, selecting information from tolerances, QA, verification measurements, in vivo dosimetry and dose delivery audits, to consider whether achievable uncertainties increase or decrease for current advanced treatments and practice. Overall there is some evidence that they tend to increase, but that similar levels should be achievable. Thus it is concluded that those earlier estimates of achievable dosimetric accuracy are still applicable, despite the changes and advances in technology and techniques. The one exception is where there is significant lung involvement, where it is likely that uncertainties have now improved due to widespread use of more accurate heterogeneity models. Geometric uncertainties have improved with the wide availability of IGRT.

LabVIEW Real-Time

CERN Multimedia

CERN. Geneva; Flockhart, Ronald Bruce; Seppey, P

2003-01-01

With LabVIEW Real-Time, you can choose from a variety of RT Series hardware. Add a real-time data acquisition component into a larger measurement and automation system or create a single stand-alone real-time solution with data acquisition, signal conditioning, motion control, RS-232, GPIB instrumentation, and Ethernet connectivity. With the various hardware options, you can create a system to meet your precise needs today, while the modularity of the system means you can add to the solution as your system requirements grow. If you are interested in Reliable and Deterministic systems for Measurement and Automation, you will profit from this seminar. Agenda: Real-Time Overview LabVIEW RT Hardware Platforms - Linux on PXI Programming with LabVIEW RT Real-Time Operating Systems concepts Timing Applications Data Transfer

Dose verification in HDR brachytherapy and IMRT with Fricke gel-layer dosimeters

International Nuclear Information System (INIS)

Gambarini, G.; Negri, A.; Bartesaghi, G.; Pirola, L.; Carrara, M.; Gambini, I.; Tomatis, S.; Fallai, C.; Zonca, G.; Stokucova, J.

2009-10-01

At the Department of Physics of the Universita degli Studi di Milano in collaboration with the Medical Physics Unit and the Radiotherapy Unit of the Fondazione IRCCS Istituto Nazionale dei Tumori di Milano the research of a dosimetric technique based on Fricke gel layers and optical analysis in under study. In fact, Fricke gel layer dosimeters (FGLD) have various advantages such as the tissue-equivalence for photons in the clinical energy interval, the possibility to obtain the spatial information about continuous dose distribution and not only a point dose distribution as it is for example in the case of ionization chambers, TLD or diodes and the possibility to obtain the information about 3D dose distributions. In this work, specific applications of FGLD to absolute dosimetry in radiotherapy have been studied, i.e. in-phantom measurements of complex intensity modulated radiation therapy fields (IMRT) and complex brachytherapy fields. (Author)

Concepts of real time and semi-real time material control

International Nuclear Information System (INIS)

Lovett, J.E.

1975-01-01

After a brief consideration of the traditional material balance accounting on an MBA basis, this paper explores the basic concepts of real time and semi-real time material control, together with some of the major problems to be solved. Three types of short-term material control are discussed: storage, batch processing, and continuous processing. (DLC)

Real Time Systems

DEFF Research Database (Denmark)

Christensen, Knud Smed

2000-01-01

Describes fundamentals of parallel programming and a kernel for that. Describes methods for modelling and checking parallel problems. Real time problems.......Describes fundamentals of parallel programming and a kernel for that. Describes methods for modelling and checking parallel problems. Real time problems....

Real time expert systems

International Nuclear Information System (INIS)

Asami, Tohru; Hashimoto, Kazuo; Yamamoto, Seiichi

1992-01-01

Recently, aiming at the application to the plant control for nuclear reactors and traffic and communication control, the research and the practical use of the expert system suitable to real time processing have become conspicuous. In this report, the condition for the required function to control the object that dynamically changes within a limited time is presented, and the technical difference between the real time expert system developed so as to satisfy it and the expert system of conventional type is explained with the actual examples and from theoretical aspect. The expert system of conventional type has the technical base in the problem-solving equipment originating in STRIPS. The real time expert system is applied to the fields accompanied by surveillance and control, to which conventional expert system is hard to be applied. The requirement for the real time expert system, the example of the real time expert system, and as the techniques of realizing real time processing, the realization of interruption processing, dispersion processing, and the mechanism of maintaining the consistency of knowledge are explained. (K.I.)

An analysis of tolerance levels in IMRT quality assurance procedures

International Nuclear Information System (INIS)

Basran, Parminder S.; Woo, Milton K.

2008-01-01

Increased use of intensity modulated radiation therapy (IMRT) has resulted in increased efforts in patient quality assurance (QA). Software and detector systems intended to streamline the IMRT quality assurance process often report metrics, such as percent discrepancies between measured and computed doses, which can be compared to benchmark or threshold values. The purpose of this work is to examine the relationships between two different types of IMRT QA processes in order to define, or refine, appropriate tolerances values. For 115 IMRT plans delivered in a 3 month period, we examine the discrepancies between (a) the treatment planning system (TPS) and results from a commercial independent monitor unit (MU) calculation program; (b) TPS and results from a commercial diode-array measurement system; and (c) the independent MU calculation and the diode-array measurements. Statistical tests were performed to assess significance in the IMRT QA results for different disease site and machine models. There is no evidence that the average total dose discrepancy in the monitor unit calculation depends on the disease site. Second, the discrepancies in the two IMRT QA methods are independent: there is no evidence that a better --or worse--monitor unit validation result is related to a better--or worse--diode-array measurement result. Third, there is marginal benefit in repeating the independent MU calculation with a more suitable dose point, if the initial IMRT QA failed a certain tolerance. Based on these findings, the authors conclude at some acceptable tolerances based on disease site and IMRT QA method. Specifically, monitor unit validations are expected to have a total dose discrepancy of 3% overall, and 5% per beam, independent of disease site. Diode array measurements are expected to have a total absolute dose discrepancy of 3% overall, and 3% per beam, independent of disease site. The percent of pixels exceeding a 3% and 3 mm threshold in a gamma analysis should be

AP-PA field orientation followed by IMRT reduces lung exposure in comparison to conventional 3D conformal and sole IMRT in centrally located lung tumors

Directory of Open Access Journals (Sweden)

Soyfer Viacheslav

2012-02-01

Full Text Available Abstract Little attention has been paid to the fact that intensity modulated radiation therapy (IMRT techniques do not easily enable treatment with opposed beams. Three treatment plans (3 D conformal, IMRT, and combined (anterior-posterior-posterio-anterior (AP-PA + IMRT of 7 patients with centrally-located lung cancer were compared for exposure of lung, spinal cord and esophagus. Combined IMRT and AP-PA techniques offer better lung tissue sparing compared to plans predicated solely on IMRT for centrally-located lung tumors.

After low and high dose-rate interstitial brachytherapy followed by IMRT radiotherapy for intermediate and high risk prostate cancer

International Nuclear Information System (INIS)

Nakamura, Satoshi; Murakami, Naoya; Inaba, Koji; Wakita, Akihisa; Kobayashi, Kazuma; Takahashi, Kana; Okamoto, Hiroyuki; Umezawa, Rei; Morota, Madoka; Sumi, Minako; Igaki, Hiroshi; Ito, Yoshinori; Itami, Jun

2016-01-01

The study aimed to compare urinary symptoms in patients with clinically localized prostate cancer after a combination of either low-dose-rate or high-dose-rate interstitial brachytherapy along with intensity-modulated radiation therapy (LDR-ISBT + IMRT or HDR-ISBT + IMRT). From June 2009 to April 2014, 16 and 22 patients were treated with LDR-ISBT + IMRT and HDR-ISBT + IMRT, respectively. No patient from these groups was excluded from this study. The prescribed dose of LDR-ISBT, HDR-ISBT, and IMRT was 115 Gy, 20 Gy in 2 fractions, and 46 Gy in 23 fractions, respectively. Obstructive and irritative urinary symptoms were assessed by the International Prostate Symptom Score (IPSS) examined before and after treatments. After ISBT, IPSS was evaluated in the 1st and 4th weeks, then every 2–3 months for the 1st year, and every 6 months thereafter. The median follow-up of the patients treated with LDR-ISBT + IMRT and HDR-ISBT + IMRT was 1070.5 days and 1048.5 days, respectively (p = 0.321). The IPSS-increment in the LDR-ISBT + IMRT group was greater than that in the HDR-ISBT + IMRT between 91 and 180 days after ISBT (p = 0.015). In the LDR-ISBT + IMRT group, the IPSS took longer time to return to the initial level than in the HDR-ISBT + IMRT group (in LDR-ISBT + IMRT group, the recovery time was 90 days later). The dose to urethra showed a statistically significant association with the IPSS-increment in the irritative urinary symptoms (p = 0.011). Clinical outcomes were comparable between both the groups. Both therapeutic modalities are safe and well suited for patients with clinically localized prostate cancer; however, it took patients longer to recover from LDR-ISBT + IMRT than from HDR-ISBT + IMRT. It is possible that fast dose delivery induced early symptoms and early recovery, while gradual dose delivery induced late symptoms and late recovery. Urethral dose reductions were associated with small increments in IPSS

Automated IMRT planning in Pinnacle. A study in head-and-neck cancer

International Nuclear Information System (INIS)

Kusters, J.M.A.M.; Kollenburg, P.G.M. van; Kunze-Busch, M.C.; Wendling, M.; Dijkema, T.; Kaanders, J.H.A.M.; Bzdusek, K.; Kumar, P.

2017-01-01

This study evaluates the performance and planning efficacy of the Auto-Planning (AP) module in the clinical version of Pinnacle 9.10 (Philips Radiation Oncology Systems, Fitchburg, WI, USA). Twenty automated intensity-modulated radiotherapy (IMRT) plans were compared with the original manually planned clinical IMRT plans from patients with oropharyngeal cancer. Auto-Planning with IMRT offers similar coverage of the planning target volume as the original manually planned clinical plans, as well as better sparing of the contralateral parotid gland, contralateral submandibular gland, larynx, mandible, and brainstem. The mean dose of the contralateral parotid gland and contralateral submandibular gland could be reduced by 2.5 Gy and 1.7 Gy on average. The number of monitor units was reduced with an average of 143.9 (18%). Hands-on planning time was reduced from 1.5-3 h to less than 1 h. The Auto-Planning module was able to produce clinically acceptable head and neck IMRT plans with consistent quality. (orig.) [de

Automated IMRT planning in Pinnacle : A study in head-and-neck cancer.

Science.gov (United States)

Kusters, J M A M; Bzdusek, K; Kumar, P; van Kollenburg, P G M; Kunze-Busch, M C; Wendling, M; Dijkema, T; Kaanders, J H A M

2017-12-01

This study evaluates the performance and planning efficacy of the Auto-Planning (AP) module in the clinical version of Pinnacle 9.10 (Philips Radiation Oncology Systems, Fitchburg, WI, USA). Twenty automated intensity-modulated radiotherapy (IMRT) plans were compared with the original manually planned clinical IMRT plans from patients with oropharyngeal cancer. Auto-Planning with IMRT offers similar coverage of the planning target volume as the original manually planned clinical plans, as well as better sparing of the contralateral parotid gland, contralateral submandibular gland, larynx, mandible, and brainstem. The mean dose of the contralateral parotid gland and contralateral submandibular gland could be reduced by 2.5 Gy and 1.7 Gy on average. The number of monitor units was reduced with an average of 143.9 (18%). Hands-on planning time was reduced from 1.5-3 h to less than 1 h. The Auto-Planning module was able to produce clinically acceptable head and neck IMRT plans with consistent quality.

Planner concepts in IMRT planning

International Nuclear Information System (INIS)

Sahoo, Suvendu Kr.; Rath, A.K.; Patnaik, S.; Mishra, S.K.

2008-01-01

IMRT is the most sophisticated, innovative, three- dimensional conformal radiation treatment that delivers highly focused radiation with minimal impact to surrounding normal tissue. As it is a computer control technique, the planar should have adequate knowledge to execute the plan in proper way other wise it is very difficult to get the optimal plan. In this article we want to high light, planner should have the basic concepts before starting the IMRT planning

Incorporating prior knowledge into beam orientation optimization in IMRT

International Nuclear Information System (INIS)

Pugachev, Andrei M.S.; Lei Xing

2002-01-01

Purpose: Selection of beam configuration in currently available intensity-modulated radiotherapy (IMRT) treatment planning systems is still based on trial-and-error search. Computer beam orientation optimization has the potential to improve the situation, but its practical implementation is hindered by the excessive computing time associated with the calculation. The purpose of this work is to provide an effective means to speed up the beam orientation optimization by incorporating a priori geometric and dosimetric knowledge of the system and to demonstrate the utility of the new algorithm for beam placement in IMRT. Methods and Materials: Beam orientation optimization was performed in two steps. First, the quality of each possible beam orientation was evaluated using beam's-eye-view dosimetrics (BEVD) developed in our previous study. A simulated annealing algorithm was then employed to search for the optimal set of beam orientations, taking into account the BEVD scores of different incident beam directions. During the calculation, sampling of gantry angles was weighted according to the BEVD score computed before the optimization. A beam direction with a higher BEVD score had a higher probability of being included in the trial configuration, and vice versa. The inclusion of the BEVD weighting in the stochastic beam angle sampling process made it possible to avoid spending valuable computing time unnecessarily at 'bad' beam angles. An iterative inverse treatment planning algorithm was used for beam intensity profile optimization during the optimization process. The BEVD-guided beam orientation optimization was applied to an IMRT treatment of paraspinal tumor. The advantage of the new optimization algorithm was demonstrated by comparing the calculation with the conventional scheme without the BEVD weighting in the beam sampling. Results: The BEVD tool provided useful guidance for the selection of the potentially good directions for the beams to incident and was used

Comparison of whole-field simultaneous integrated boost VMAT and IMRT in the treatment of nasopharyngeal cancer

Energy Technology Data Exchange (ETDEWEB)

Jin, Xiance; Yi, Jinling; Zhou, Yongqiang; Yan, Huawei; Han, Ce; Xie, Congying, E-mail: billy07@wzhospital.cn

2013-01-01

To study the feasibility of using volumetric-modulated arc therapy (VMAT) to deliver whole-field simultaneous integrated boost (WF-SIB) to treat patients with nasopharyngeal cancer (NPC). WF-SIB intensity-modulated radiotherapy (IMRT) plans, one-arc WF-SIB VMAT plans, and two-arc WF-SIB VMAT plans were generated with identical objective functions for 8 patients with NPC of various stages. Isodose distributions and dose-volume histograms were evaluated. Dosimetric and biological quality indices of clinical target volume (CTV) and organs at risk (OARs) were calculated to study the optimization capability of these 3 modalities in the treatment of patients with NPC. The optimization time, delivery time, required monitor units (MUs), and delivery accuracy were also compared to investigate the feasibility of these 3 modalities. There was no significant difference (p = 0.92) in target coverage (TC) between WF-SIB IMRT (99.00 ± 0.79) and two-arc WF-SIB VMAT (97.98 ± 1.29). However, both had higher TC than one-arc VMAT plans (89.92 ± 6.32, p < 0.01). IMRT demonstrated the best protection of the spinal cord, whereas two-arc VMAT showed the minimum D{sub max} to OARs. No other significant differences were observed among these 3 modalities on CTV coverage and OAR sparing. The delivery and MU efficiency of one-arc and two-arc WF-SIB VMAT were greatly improved compared with WF-SIB IMRT. The optimization time of one-arc and two-arc WF-SIB VMAT plans were 5 and 10 times greater than that of WF-SIB IMRT, respectively. The delivery accuracy of WF-SIB VMAT was not affected by the increased freedom. For patients with NPC, one-arc WF-SIB VMAT might not be able to achieve sufficient TC, whereas two-arc WF-SIB VMAT was able to achieve reasonable TC. No significant advantage on OAR protection was demonstrated by VMAT compared with IMRT. WF-SIB VMAT has significantly shorter delivery times, but WF-SIB IMRT may still be the first treatment choice for patients with NPC.

Comparative dosimetric analysis of IMRT and VMAT (RapidArc in brain, head and neck, breast and prostate malignancies

Directory of Open Access Journals (Sweden)

Mirza Athar Ali

2015-03-01

Full Text Available Purpose: Intensity modulated radiotherapy (IMRT in the recent past has established itself as a gold standard for organs at risk (OAR sparing, target coverage and dose conformity. With the advent of a rotational treatment technology such as volumetric modulated arc therapy (VMAT, an inter-comparison is warranted to address the advantages and disadvantages of each technique. Methods: Twenty patients were selected retrospectively from our patient database. Sites included were brain, head and neck, chest wall, and prostate, with five patients for each site. For all the selected patients, both the IMRT and VMAT treatment plans were generated. Plan comparison was done in terms of OAR dose, dose homogeneity index (HI, dose conformity index (CI, target coverage, low isodose volumes, monitor units (MUs, and treatment time.Results: The VMAT showed better sparing of “parotids minus planning target volume (PTV”, spinal cord and head of femur as compared to the IMRT. The lung V40 for VMAT was lower, whereas the lung V10, contralateral lung mean dose, contralateral breast mean dose and mean body dose were lower with IMRT for chest wall cases. Both the VMAT and IMRT achieved comparable HI except for the brain site, where IMRT scored over VMAT. The CI achieved by the IMRT and VMAT were similar except for chest wall cases, whereas the VMAT achieved better dose conformity. The target coverage was comparable with both the plans. The VMAT clearly scored over IMRT in terms of average MUs (486 versus 812 respectively and average treatment time (2.54 minutes versus 5.54 minutes per treatment session. Conclusion: The VMAT (RapidArc has a potential to generate treatment plans for various anatomical sites which are comparable with the corresponding IMRT plans in terms of OAR sparing and plan quality parameters. The VMAT significantly reduces treatment time as compared to the IMRT, thus VMAT can increase the throughput of a busy radiotherapy department.

Fiber-coupled Al₂O₃:C radioluminescence dosimetry for total body irradiations

DEFF Research Database (Denmark)

Buranurak, Siritorn; Andersen, Claus E.

2016-01-01

in the context of Total Body Irradiations (TBIs) where patients are treated with large fields of 6 or 18 MV photons at an extended source-to-surface distance (SSD). The study shows that Al2O3:C dosimetry using the saturated-RL protocol may be suitable for real-time in vivo dosimetry during TBI treatments from...... the perspective of the good agreement with alanine dosimetry and other critical phantom tests, including the ability to cope with the large stem signal experienced during TBI treatments at extended SSD. In contrast, the chromatic stem removal technique often used for organic plastic scintillators did not work...

A real-time in vivo dosimetric verification method for high-dose rate intracavitary brachytherapy of nasopharyngeal carcinoma

Energy Technology Data Exchange (ETDEWEB)

Qi Zhenyu; Deng Xiaowu; Cao Xinping; Huang Shaomin; Lerch, Michael; Rosenfeld, Anatoly [State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060 (China) and Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522 (Australia); State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060 (China); Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522 (Australia)

2012-11-15

Purpose: A real-time in vivo dosimetric verification method using metal-oxide-semiconductor field effect transistor (MOSFET) dosimeters has been developed for patient dosimetry in high-dose rate (HDR) intracavitary brachytherapy of nasopharyngeal carcinoma (NPC). Methods: The necessary calibration and correction factors for MOSFET measurements in {sup 192}Iridium source were determined in a water phantom. With the detector placed inside a custom-made nasopharyngeal applicator, the actual dose delivered to the tumor was measured in vivo and compared to the calculated values using a commercial brachytherapy planning system. Results: Five MOSFETs were independently calibrated with the HDR source, yielding calibration factors of 0.48 {+-} 0.007 cGy/mV. The maximum sensitivity variation was no more than 7% in the clinically relevant distance range of 1-5 cm from the source. A total of 70 in vivo measurements in 11 NPC patients demonstrated good agreement with the treatment planning. The mean differences between the planned and the actually delivered dose within a single treatment fraction were -0.1%{+-} 3.8% and -0.1%{+-} 3.7%, respectively, for right and left side assessments. The maximum dose deviation was less than 8.5%. Conclusions: In vivo measurement using the real-time MOSFET dosimetry system is possible to evaluate the actual dose to the tumor received by the patient during a treatment fraction and thus can offer another line of security to detect and prevent large errors.

Statistical process control analysis for patient-specific IMRT and VMAT QA.

Science.gov (United States)

Sanghangthum, Taweap; Suriyapee, Sivalee; Srisatit, Somyot; Pawlicki, Todd

2013-05-01

This work applied statistical process control to establish the control limits of the % gamma pass of patient-specific intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) quality assurance (QA), and to evaluate the efficiency of the QA process by using the process capability index (Cpml). A total of 278 IMRT QA plans in nasopharyngeal carcinoma were measured with MapCHECK, while 159 VMAT QA plans were undertaken with ArcCHECK. Six megavolts with nine fields were used for the IMRT plan and 2.5 arcs were used to generate the VMAT plans. The gamma (3%/3 mm) criteria were used to evaluate the QA plans. The % gamma passes were plotted on a control chart. The first 50 data points were employed to calculate the control limits. The Cpml was calculated to evaluate the capability of the IMRT/VMAT QA process. The results showed higher systematic errors in IMRT QA than VMAT QA due to the more complicated setup used in IMRT QA. The variation of random errors was also larger in IMRT QA than VMAT QA because the VMAT plan has more continuity of dose distribution. The average % gamma pass was 93.7% ± 3.7% for IMRT and 96.7% ± 2.2% for VMAT. The Cpml value of IMRT QA was 1.60 and VMAT QA was 1.99, which implied that the VMAT QA process was more accurate than the IMRT QA process. Our lower control limit for % gamma pass of IMRT is 85.0%, while the limit for VMAT is 90%. Both the IMRT and VMAT QA processes are good quality because Cpml values are higher than 1.0.

Dosimetry characteristics of HDPE–SWCNT nanocomposite for real time application

Energy Technology Data Exchange (ETDEWEB)

Malekie, Shahryar [Radiation Application Research School, Nuclear Science & Technology Research Institute, P.O. Box 11365-3486, Tehran (Iran, Islamic Republic of); Ziaie, Farhood, E-mail: fziaie@aeoi.org.ir [Radiation Application Research School, Nuclear Science & Technology Research Institute, P.O. Box 11365-3486, Tehran (Iran, Islamic Republic of); Feizi, Shahzad [Radiation Application Research School, Nuclear Science & Technology Research Institute, P.O. Box 11365-3486, Tehran (Iran, Islamic Republic of); Esmaeli, Abdolreza [Plasma and Fusion Research School, Nuclear Science & Technology Research Institute, Tehran (Iran, Islamic Republic of)

2016-10-11

In this experimental work, different dosimetric characteristics of high density polyethylene-single wall carbon nanotube nanocomposite were investigated. The nanocomposite samples were prepared with different nanotube contents of 0.22, 0.25, and 0.39 weight percentages which were before, exactly in, and after percolation region of the nanocomposite, respectively. The samples were exposed to {sup 60}Co gamma radiation source over the dose rate of 65–214 mGy/min, while the applied bias was 100 V. A linear response achieved for the sample contained 0.25 nanotube wt% verified that the percolation threshold is the optimum point for dosimetric purposes. The current–voltage characteristics curve measured for 0.25 CNT wt% nanocomposite showed that the behavior of this sample was bias polarity independent. Also, the results showed that the response of this nanocomposite was energy-independent. The maximum discrepancy of photocurrent due to angular variation within 0–90° with respect to beam incidence and the reproducibility of the response were measured as 5.4% and 0.8%, respectively. The stability study showed that this material may be suitable for protection dose level control. Therefore, this kind of nanocomposite requiring calibration can be used as a real-time dosimeter. - Highlights: • HDPE–SWCNT nanocomposite was used in this experiment. • Achieved linear response in EPT region verifying that is optimum point for dosimetric purposes. • The response of this nanocomposite was energy-independent. • The angular dependence and the reproducibility of the response were measured. • The stability study shows that this material is suitable for protection dose level control.

Process algebra with timing : real time and discrete time

NARCIS (Netherlands)

Baeten, J.C.M.; Middelburg, C.A.; Bergstra, J.A.; Ponse, A.J.; Smolka, S.A.

2001-01-01

We present real time and discrete time versions of ACP with absolute timing and relative timing. The starting-point is a new real time version with absolute timing, called ACPsat, featuring urgent actions and a delay operator. The discrete time versions are conservative extensions of the discrete

Process algebra with timing: Real time and discrete time

NARCIS (Netherlands)

Baeten, J.C.M.; Middelburg, C.A.

1999-01-01

We present real time and discrete time versions of ACP with absolute timing and relative timing. The startingpoint is a new real time version with absolute timing, called ACPsat , featuring urgent actions and a delay operator. The discrete time versions are conservative extensions of the discrete

Definitive Upfront Stereotactic Ablative Radiotherapy Combined with Image-Guided, Intensity Modulated Radiotherapy (IG-IMRT or IG-IMRT Alone for Locally Advanced Non-Small Cell Lung Cancer.

Directory of Open Access Journals (Sweden)

Alexander Chi

Full Text Available Image-guided (IG intensity-modulated radiotherapy (IMRT enables maximal tumor margin reduction for the sparing of organs at risk (OARs when used to treat locally advanced non-small cell lung cancer (NSCLC with definitive chemo-radiation. It also allows for the incorporation of stereotactic ablative radiotherapy (SABR into the treatment regimen. Here, we describe our initial experience in combining definitive upfront SABR to the primary lesion with chemo-radiation delivered with conventionally fractionated IG-IMRT to the remaining regional disease; along with clinical outcome following chemo-radiation with conventionally fractionated IG-IMRT alone in the treatment of locally advanced NSCLC.The clinical outcome of 29 patients with locally advanced NSCLC who underwent conventionally fractionated IG-IMRT, or definitive upfront SABR followed by IG-IMRT combined with chemotherapy (induction, concurrent, or both was retrospectively reviewed.After a median follow up of 23.7 months, the median overall survival (OS and progression-free survival (PFS were 19.8 and 11.3 months, respectively. The 2 year local, regional, and distant control was 60%, 62%, and 38%, respectively. No local failure was observed in 3 patients following SABR + IG-IMRT while 6/26 patients failed locally following IG-IMRT alone. SABR + IG-IMRT was well tolerated. No ≥ grade 3 radiation-related toxicity was observed.Definitive upfront SABR followed by IG-IMRT in selected patients with locally advanced NSCLC warrants further investigation in future clinical trials, while chemo-radiation with IG-IMRT alone was well tolerated.

Comparative study between IMRT planning and RapidArc® sliding window for head and neck tumors; Estudo comparativo de planejamento entre IMRT sliding window e RapidArc® para tumores de cabeca e pescoco

Energy Technology Data Exchange (ETDEWEB)

Pirani, Luiz F.; Silva, Leonardo P.; Lima, Marilia B.; Bittencourt, Guilherme R.; Ferreira, Anne Caroline M.; Batista, Delano V.S., E-mail: nando_lfp@yahoo.com.br [Instituto Nacional de Cancer (INCA), Rio de Janeiro, RJ (Brazil)

2012-12-15

This study aims to evaluate the RapidArc (RA) technique in the treatment of head and neck tumors and compare the results of treatments with intensity modulated radiation therapy (IMRT) in the National Cancer Institute (INCA). Head and neck carcinomas have a natural history with relative expansion to others regions, especially in advanced levels. Faster treatments, with better coverage of the Planning Target Volume (PTV) and sparing more risks organs (ROs) are necessary and bring a better clinical impact. Ten patients with head and neck cancer, planned with IMRT technique were replanned using the RA technique. Some dosimetric indexes were calculated for both techniques, with the intention of verifying which of them, at the same time, would promote greater coverage of the PTV and preserve more healthy tissue. In terms of coverage, both indexes were similar. The RA technique was more efficient for delivered doses to ROs. The number of monitor units (MU), number of fields and treatments time estimated were lower than IMRT technique. Finally, the results have showed that the RA technique clearly reduces the treatment time, reducing the average and maximum dose to ROs and conforming the target as IMRT technique. (author)

A multicentre 'end to end' dosimetry audit of motion management (4DCT-defined motion envelope) in radiotherapy.

Science.gov (United States)

Palmer, Antony L; Nash, David; Kearton, John R; Jafari, Shakardokht M; Muscat, Sarah

2017-12-01

External dosimetry audit is valuable for the assurance of radiotherapy quality. However, motion management has not been rigorously audited, despite its complexity and importance for accuracy. We describe the first end-to-end dosimetry audit for non-SABR (stereotactic ablative body radiotherapy) lung treatments, measuring dose accumulation in a moving target, and assessing adequacy of target dose coverage. A respiratory motion lung-phantom with custom-designed insert was used. Dose was measured with radiochromic film, employing triple-channel dosimetry and uncertainty reduction. The host's 4DCT scan, outlining and planning techniques were used. Measurements with the phantom static and then moving at treatment delivery separated inherent treatment uncertainties from motion effects. Calculated and measured dose distributions were compared by isodose overlay, gamma analysis, and we introduce the concept of 'dose plane histograms' for clinically relevant interpretation of film dosimetry. 12 radiotherapy centres and 19 plans were audited: conformal, IMRT (intensity modulated radiotherapy) and VMAT (volumetric modulated radiotherapy). Excellent agreement between planned and static-phantom results were seen (mean gamma pass 98.7% at 3% 2 mm). Dose blurring was evident in the moving-phantom measurements (mean gamma pass 88.2% at 3% 2 mm). Planning techniques for motion management were adequate to deliver the intended moving-target dose coverage. A novel, clinically-relevant, end-to-end dosimetry audit of motion management strategies in radiotherapy is reported. Copyright © 2017 Elsevier B.V. All rights reserved.

Automated IMRT planning in Pinnacle. A study in head-and-neck cancer

Energy Technology Data Exchange (ETDEWEB)

Kusters, J.M.A.M.; Kollenburg, P.G.M. van; Kunze-Busch, M.C.; Wendling, M.; Dijkema, T.; Kaanders, J.H.A.M. [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands); Bzdusek, K. [Philips Healthcare, Philips Radiation Oncology Systems, Fitchburg, WI (United States); Kumar, P. [Philips Electronics India Ltd., Philips Innovation Campus, Bangalore (India)

2017-12-15

This study evaluates the performance and planning efficacy of the Auto-Planning (AP) module in the clinical version of Pinnacle 9.10 (Philips Radiation Oncology Systems, Fitchburg, WI, USA). Twenty automated intensity-modulated radiotherapy (IMRT) plans were compared with the original manually planned clinical IMRT plans from patients with oropharyngeal cancer. Auto-Planning with IMRT offers similar coverage of the planning target volume as the original manually planned clinical plans, as well as better sparing of the contralateral parotid gland, contralateral submandibular gland, larynx, mandible, and brainstem. The mean dose of the contralateral parotid gland and contralateral submandibular gland could be reduced by 2.5 Gy and 1.7 Gy on average. The number of monitor units was reduced with an average of 143.9 (18%). Hands-on planning time was reduced from 1.5-3 h to less than 1 h. The Auto-Planning module was able to produce clinically acceptable head and neck IMRT plans with consistent quality. (orig.) [German] Diese Studie untersucht die Leistungsfaehigkeit und Planungseffektivitaet des Auto-Planning-Moduls in der klinischen Version von Pinnacle 9.10 (Philips Radiation Oncology Systems, Fitchburg, WI, USA). Zwanzig automatisch erstellte Plaene fuer die intensitaetsmodulierte Strahlentherapie (IMRT) wurden mit den urspruenglichen manuell erstellten klinischen IMRT-Plaenen von Patienten mit Oropharynxkarzinom verglichen. Die automatisch erstellten IMRT-Plaene bieten eine vergleichbare Deckung des Planungszielvolumens (PTV) wie die urspruenglichen, manuell erstellten klinischen Plaene sowie eine verbesserte Schonung der kontralateralen Ohrspeicheldruese, der kontralateralen Unterkieferspeicheldruese, des Kehlkopfs, des Unterkiefers und des Hirnstamms. Die mittlere Dosis der kontralateralen Ohr- und kontralateralen Unterkieferspeicheldruese konnte um durchschnittlich 2,5 bzw. 1,7 Gy reduziert werden. Die Anzahl der Monitoreinheiten wurde im Durchschnitt um 143

How to perform dosimetry with Optical CT

International Nuclear Information System (INIS)

Wuu, Cheng-Shie; Xu, Y

2010-01-01

Both polymer gels and PRESAGE radiochromic solid dosimeter, in conjunction with optical CT scanning system, have been employed to measure 3-D dose distribution. The 3-D dose maps obtained from these systems can provide a useful tool for dose verification on complex treatments such as IMRT, radiosurgery, and RapidArc. These complex treatments present high dose gradient regions in the boundaries between the target and the surrounding critical organs. Dose accuracy in these areas can be critical, and may affect the treatment. There is a pressing need for a dosimeter that allows for accurate determination of 3-D dose distribution with high spatial resolution. In this paper, performance of polymer gels and PRESAGE dosimeter with optical CT scanning is reviewed and evaluated in terms of their sensitivity calibration, irradiation, optimization of scanning procedures, precision, and accuracy. Clinical applications of optical-CT dosimetry are presented.

Real-time radiography

International Nuclear Information System (INIS)

Bossi, R.H.; Oien, C.T.

1981-01-01

Real-time radiography is used for imaging both dynamic events and static objects. Fluorescent screens play an important role in converting radiation to light, which is then observed directly or intensified and detected. The radiographic parameters for real-time radiography are similar to conventional film radiography with special emphasis on statistics and magnification. Direct-viewing fluoroscopy uses the human eye as a detector of fluorescent screen light or the light from an intensifier. Remote-viewing systems replace the human observer with a television camera. The remote-viewing systems have many advantages over the direct-viewing conditions such as safety, image enhancement, and the capability to produce permanent records. This report reviews real-time imaging system parameters and components

Time evolution of regional CT density changes in normal lung after IMRT for NSCLC

International Nuclear Information System (INIS)

Bernchou, Uffe; Schytte, Tine; Bertelsen, Anders; Bentzen, Søren M.; Hansen, Olfred; Brink, Carsten

2013-01-01

Purpose: This study investigates the clinical radiobiology of radiation induced lung disease in terms of regional computed tomography (CT) density changes following intensity modulated radiotherapy (IMRT) for non-small-cell lung cancer (NSCLC). Methods: A total of 387 follow-up CT scans in 131 NSCLC patients receiving IMRT to a prescribed dose of 60 or 66 Gy in 2 Gy fractions were analyzed. The dose-dependent temporal evolution of the density change was analyzed using a two-component model, a superposition of an early, transient component and a late, persistent component. Results: The CT density of healthy lung tissue was observed to increase significantly (p 12 months. Conclusions: The radiobiology of lung injury may be analyzed in terms of CT density change. The initial transient change in density is consistent with radiation pneumonitis, while the subsequent stabilization of the density is consistent with pulmonary fibrosis

Real-time vision systems

Energy Technology Data Exchange (ETDEWEB)

Johnson, R.; Hernandez, J.E.; Lu, Shin-yee [Lawrence Livermore National Lab., CA (United States)

1994-11-15

Many industrial and defence applications require an ability to make instantaneous decisions based on sensor input of a time varying process. Such systems are referred to as `real-time systems` because they process and act on data as it occurs in time. When a vision sensor is used in a real-time system, the processing demands can be quite substantial, with typical data rates of 10-20 million samples per second. A real-time Machine Vision Laboratory (MVL) was established in FY94 to extend our years of experience in developing computer vision algorithms to include the development and implementation of real-time vision systems. The laboratory is equipped with a variety of hardware components, including Datacube image acquisition and processing boards, a Sun workstation, and several different types of CCD cameras, including monochrome and color area cameras and analog and digital line-scan cameras. The equipment is reconfigurable for prototyping different applications. This facility has been used to support several programs at LLNL, including O Division`s Peacemaker and Deadeye Projects as well as the CRADA with the U.S. Textile Industry, CAFE (Computer Aided Fabric Inspection). To date, we have successfully demonstrated several real-time applications: bullet tracking, stereo tracking and ranging, and web inspection. This work has been documented in the ongoing development of a real-time software library.

Topics in radiation dosimetry radiation dosimetry

CERN Document Server

1972-01-01

Radiation Dosimetry, Supplement 1: Topics in Radiation Dosimetry covers instruments and techniques in dealing with special dosimetry problems. The book discusses thermoluminescence dosimetry in archeological dating; dosimetric applications of track etching; vacuum chambers of radiation measurement. The text also describes wall-less detectors in microdosimetry; dosimetry of low-energy X-rays; and the theory and general applicability of the gamma-ray theory of track effects to various systems. Dose equivalent determinations in neutron fields by means of moderator techniques; as well as developm

New approach to the dosimetry of ionizing radiations by fluorescence measurement, according to the single photon counting technique, correlated in time at the nanosecond scale

International Nuclear Information System (INIS)

Sohier, Till

2011-01-01

This research thesis reports the first fundamental study of the dosimetry of charged and gamma radiations by measurement of fluorescence resolved in time at a nanosecond scale, in organic matter. This method allows an in-depth and real-time analysis of the deposited dose, while taking ionisation as well as excitation processes into account. The author describes mechanisms of interaction and deposition of energy on dense matter, reports the detailed study of the ion-matter interaction, and the interaction of secondary electrons produced within traces. He addresses mechanisms of energy relaxation, and more particularly the study or organic scintillators. Then, he presents the adopted experimental approach: experimental observation with a statistic reconstitution of the curve representing the intensity of the emitted fluorescence in time and with a nanosecond resolution by using a scintillating sensor for time correlated single photon counting (TCSPC). The next part reports the development of an experimental multi-modal platform for dosimetry by TCSPC aimed at the measurement of fluorescence decays under pulsed excitation (nanosecond pulsed ion beams) and continuous flow excitation (non pulsed beams and radioactive sources). Experimental results are then presented for fluorescence measurements, and compared with measurements obtained by using an ionization chamber under the same irradiation conditions: dose deposited by hellions and carbon ions within polyvinyl toluene and polyethylene terephthalate, use of scintillating optic fibers under gamma irradiation of Caesium 137 and Cobalt 60. A new experimental approach is finally presented to perform dosimetry measurements while experimentally ignoring luminescence produced by Cerenkov effect [fr

Fast IMRT by increasing the beam number and reducing the number of segments

International Nuclear Information System (INIS)

Bratengeier, Klaus; Gainey, Mark B; Flentje, Michael

2011-01-01

The purpose of this work is to develop fast deliverable step and shoot IMRT technique. A reduction in the number of segments should theoretically be possible, whilst simultaneously maintaining plan quality, provided that the reduction is accompanied by an increased number of gantry angles. A benefit of this method is that the segment shaping could be performed during gantry motion, thereby reducing the delivery time. The aim was to find classes of such solutions whose plan quality can compete with conventional IMRT. A planning study was performed. Step and shoot IMRT plans were created using direct machine parameter optimization (DMPO) as a reference. DMPO plans were compared to an IMRT variant having only one segment per angle ('2-Step Fast'). 2-Step Fast is based on a geometrical analysis of the topology of the planning target volume (PTV) and the organs at risk (OAR). A prostate/rectum case, spine metastasis/spinal cord, breast/lung and an artificial PTV/OAR combination of the ESTRO-Quasimodo phantom were used for the study. The composite objective value (COV), a quality score, and plan delivery time were compared. The delivery time for the DMPO reference plan and the 2-Step Fast IMRT technique was measured and calculated for two different linacs, a twelve year old Siemens Primus™ ('old' linac) and two Elekta Synergy™ 'S' linacs ('new' linacs). 2-Step Fast had comparable or better quality than the reference DMPO plan. The number of segments was smaller than for the reference plan, the number of gantry angles was between 23 and 34. For the modern linac the delivery time was always smaller than that for the reference plan. The calculated (measured) values showed a mean delivery time reduction of 21% (21%) for the new linac, and of 7% (3%) for the old linac compared to the respective DMPO reference plans. For the old linac, the data handling time per beam was the limiting factor for the treatment time reduction. 2-Step

Fast IMRT by increasing the beam number and reducing the number of segments

Directory of Open Access Journals (Sweden)

Bratengeier Klaus

2011-12-01

Full Text Available Abstract Purpose The purpose of this work is to develop fast deliverable step and shoot IMRT technique. A reduction in the number of segments should theoretically be possible, whilst simultaneously maintaining plan quality, provided that the reduction is accompanied by an increased number of gantry angles. A benefit of this method is that the segment shaping could be performed during gantry motion, thereby reducing the delivery time. The aim was to find classes of such solutions whose plan quality can compete with conventional IMRT. Materials/Methods A planning study was performed. Step and shoot IMRT plans were created using direct machine parameter optimization (DMPO as a reference. DMPO plans were compared to an IMRT variant having only one segment per angle ("2-Step Fast". 2-Step Fast is based on a geometrical analysis of the topology of the planning target volume (PTV and the organs at risk (OAR. A prostate/rectum case, spine metastasis/spinal cord, breast/lung and an artificial PTV/OAR combination of the ESTRO-Quasimodo phantom were used for the study. The composite objective value (COV, a quality score, and plan delivery time were compared. The delivery time for the DMPO reference plan and the 2-Step Fast IMRT technique was measured and calculated for two different linacs, a twelve year old Siemens Primus™ ("old" linac and two Elekta Synergy™ "S" linacs ("new" linacs. Results 2-Step Fast had comparable or better quality than the reference DMPO plan. The number of segments was smaller than for the reference plan, the number of gantry angles was between 23 and 34. For the modern linac the delivery time was always smaller than that for the reference plan. The calculated (measured values showed a mean delivery time reduction of 21% (21% for the new linac, and of 7% (3% for the old linac compared to the respective DMPO reference plans. For the old linac, the data handling time per beam was the limiting factor for the treatment time

Real-time tomosynthesis for radiation therapy guidance.

Science.gov (United States)

Hsieh, Scott S; Ng, Lydia W

2017-11-01

Fluoroscopy has been a tool of choice for monitoring treatments or interventions because of its extremely fast imaging times. However, the contrast obtained in fluoroscopy may be insufficient for certain clinical applications. In stereotactic ablative radiation therapy of the lung, fluoroscopy often lacks sufficient contrast for gating treatment. The purpose of this work is to describe and assess a real-time tomosynthesis design that can produce sufficient contrast for guidance of lung tumor treatment within a small field of view. Previous tomosynthesis designs in radiation oncology have temporal resolution on the order of seconds. The proposed system design uses parallel acquisition of multiple frames by simultaneously illuminating the field of view with multiple sources, enabling a temporal resolution of up to 30 frames per second. For a small field of view, a single flat-panel detector could be used if different sectors of the detector are assigned to specific sources. Simulated images were generated by forward projection of existing clinical datasets. The authors varied the number of tubes and the power of each tube in order to determine the impact on tumor visualization. Visualization of the tumor was much clearer in tomosynthesis than in fluoroscopy. Contrast generally improved with the number of sources used, and a minimum of four sources should be used. The high contrast of the lung allows very low system power, and in most cases, less than 1 mA was needed. More power is required in the lateral direction than the AP direction. The proposed system produces images adequate for real-time guidance of radiation therapy. The additional hardware requirements are modest, and the system is capable of imaging at high frame rates and low dose. Further development, including a prototype system and a dosimetry study, is needed to further evaluate the feasibility of this device for radiation therapy guidance. © 2017 American Association of Physicists in Medicine.

Q A IMRT comparison specific patient by means of radiochromic films, radiographic films and ionization chambers arrangement

International Nuclear Information System (INIS)

Medina, L.; Venencia, D.; Garrigo, E.

2014-08-01

IMRT uses radiation beams of nonuniform intensity. Quality assurance (Q A) specific patient is mandatory in this treatment modality. The purpose of this study is to compare results of patient specific Q A IMRT dose distributions of the total plan and individual fields using different dosimetric systems. We used a photon beam 6 MV generated for linear accelerator PRIMUS, were used planning systems iPLAN and Konrad for IMRT inverse planning with modality Step and Shoot. For plans total dose distributions were measured with radiographic films EDR2 and Radiochromic Film EBT3. For individual fields the dose distributions were measured with radiographic films X-Omat-V, Radiochromic Film EBT3 and PTW 2D-Array. We used a scanner VIDAR Dosimetry Pro Red and software Rit v6.1 for analysis, was used Gamma index [Γ] for comparison of measured and calculated dose recording the number of pixels with Γ> 1. We analyzed 50 plan dose distributions total 50 individual fields. For the total plan the number of pixels with Γ>1 (3%-3m m) was 0.7%±1.2 [0.1%; 2.82%] for EBT3 y 1%±1.8 [0.2%; 3%] for EDR2. For individual fields (5%-3m m) was obtained 0.97%±1,7 [0%, 3%] for X-Omat-V, 0.84%±1.1[0.3%,3.1%] for EBT3 and 2.6%±1.9 [0.01%,6.8%] PTW 2D-Array. All three methods can be used. Radiochromic Films revealed the advantage and disadvantage of the cost. Both systems are slightly better film to PTW 2D-Array. (author)

The personal dosimetry in Mexico; La dosimetria personal en Mexico

Energy Technology Data Exchange (ETDEWEB)

Salazar, M.A. [Proxtronics/ Asesoria Integral en Dosimetria Termoluminiscente S.A. de C.V., Canal de Miramontes 2030-14, Col. Educacion, 04400 Mexico D.F. (Mexico)]. e-mail: aidtsa@avantel.net

2006-07-01

The Personal Dosimetry in Mexico, has an approximately 30 year-old history; and it had been and it is at the moment, one of the more important resources with which the personnel that works with ionizing radiation sources counts for its protection. The Personal Dosimetry begins with the film dosimetry, technique that even continues being used at the present time by some users, and the main reason of its use is for economic reasons. At the moment this technique, it has been surpassed, by the Thermoluminescent dosimetry, which has taken a lot of peak, mainly by the technological development with which it is counted at the present time; what has given as a result that this technique becomes tip technology; that supported in the characteristic of the used materials, as the handling and processing of the information associated with the new PC, digitizer cards, software etc, what has allowed increases it potential. In this work the current necessities of the market are presented as well as an analysis of the future real necessities in Mexico, at national level, the companies that provide this service and that they spread to satisfy this necessity of the market, including the different used technologies are also mentioned. The application ranges, at the same time, of the advantages and disadvantages of the different systems of Personal Dosimetry in the market. The companies that at the moment provide the service of Personal Dosimetry, its use materials and equipment in indistinct form, for the monitoring of gamma radiation, beta particles, different qualities of x-ray radiation, and sometimes neutrons. The monitoring of the exposed personnel at the diverse sources of ionizing radiation mentioned is carried out in many occasions without having with the materials (detectors), neither the appropriate infrastructure and therefore without the quality control that guarantees a correct evaluation of the dose equivalent, as a result of the exposure to the ionizing radiations; it

Radiochromic film dosimetry

International Nuclear Information System (INIS)

Xu Zhiyong

2002-01-01

Radiochromic film dosimetry was developed to measure ionization irradiation dose for industry and medicine. At this time, there are no comprehensive guideline on the medical application, calibration method and densitometer system for medicine. The review gives update on Radiochromic film dosimetry used for medicine, including principles, film model and material, characteristics, calibration method, scanning densitometer system and medical application

Institutional Patient-specific IMRT QA Does Not Predict Unacceptable Plan Delivery

Energy Technology Data Exchange (ETDEWEB)

Kry, Stephen F., E-mail: sfkry@mdanderson.org [Imaging and Radiation Oncology Core at Houston, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Molineu, Andrea [Imaging and Radiation Oncology Core at Houston, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Kerns, James R.; Faught, Austin M.; Huang, Jessie Y.; Pulliam, Kiley B.; Tonigan, Jackie [Imaging and Radiation Oncology Core at Houston, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); The University of Texas Health Science Center Houston, Graduate School of Biomedical Sciences, Houston, Texas (United States); Alvarez, Paola [Imaging and Radiation Oncology Core at Houston, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Stingo, Francesco [The University of Texas Health Science Center Houston, Graduate School of Biomedical Sciences, Houston, Texas (United States); Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Followill, David S. [Imaging and Radiation Oncology Core at Houston, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); The University of Texas Health Science Center Houston, Graduate School of Biomedical Sciences, Houston, Texas (United States)

2014-12-01

Purpose: To determine whether in-house patient-specific intensity modulated radiation therapy quality assurance (IMRT QA) results predict Imaging and Radiation Oncology Core (IROC)-Houston phantom results. Methods and Materials: IROC Houston's IMRT head and neck phantoms have been irradiated by numerous institutions as part of clinical trial credentialing. We retrospectively compared these phantom results with those of in-house IMRT QA (following the institution's clinical process) for 855 irradiations performed between 2003 and 2013. The sensitivity and specificity of IMRT QA to detect unacceptable or acceptable plans were determined relative to the IROC Houston phantom results. Additional analyses evaluated specific IMRT QA dosimeters and analysis methods. Results: IMRT QA universally showed poor sensitivity relative to the head and neck phantom, that is, poor ability to predict a failing IROC Houston phantom result. Depending on how the IMRT QA results were interpreted, overall sensitivity ranged from 2% to 18%. For different IMRT QA methods, sensitivity ranged from 3% to 54%. Although the observed sensitivity was particularly poor at clinical thresholds (eg 3% dose difference or 90% of pixels passing gamma), receiver operator characteristic analysis indicated that no threshold showed good sensitivity and specificity for the devices evaluated. Conclusions: IMRT QA is not a reasonable replacement for a credentialing phantom. Moreover, the particularly poor agreement between IMRT QA and the IROC Houston phantoms highlights surprising inconsistency in the QA process.

Institutional Patient-specific IMRT QA Does Not Predict Unacceptable Plan Delivery

International Nuclear Information System (INIS)

Kry, Stephen F.; Molineu, Andrea; Kerns, James R.; Faught, Austin M.; Huang, Jessie Y.; Pulliam, Kiley B.; Tonigan, Jackie; Alvarez, Paola; Stingo, Francesco; Followill, David S.

2014-01-01

Purpose: To determine whether in-house patient-specific intensity modulated radiation therapy quality assurance (IMRT QA) results predict Imaging and Radiation Oncology Core (IROC)-Houston phantom results. Methods and Materials: IROC Houston's IMRT head and neck phantoms have been irradiated by numerous institutions as part of clinical trial credentialing. We retrospectively compared these phantom results with those of in-house IMRT QA (following the institution's clinical process) for 855 irradiations performed between 2003 and 2013. The sensitivity and specificity of IMRT QA to detect unacceptable or acceptable plans were determined relative to the IROC Houston phantom results. Additional analyses evaluated specific IMRT QA dosimeters and analysis methods. Results: IMRT QA universally showed poor sensitivity relative to the head and neck phantom, that is, poor ability to predict a failing IROC Houston phantom result. Depending on how the IMRT QA results were interpreted, overall sensitivity ranged from 2% to 18%. For different IMRT QA methods, sensitivity ranged from 3% to 54%. Although the observed sensitivity was particularly poor at clinical thresholds (eg 3% dose difference or 90% of pixels passing gamma), receiver operator characteristic analysis indicated that no threshold showed good sensitivity and specificity for the devices evaluated. Conclusions: IMRT QA is not a reasonable replacement for a credentialing phantom. Moreover, the particularly poor agreement between IMRT QA and the IROC Houston phantoms highlights surprising inconsistency in the QA process

TH-CD-BRA-02: 3D Remote Dosimetry for MRI-Guided Radiation Therapy: A Hybrid Approach

Energy Technology Data Exchange (ETDEWEB)

Rankine, L [Washington University School of Medicine, Saint Louis, MO (United States); The University of North Carolina at Chapel Hill, Chapel Hill, NC (United States); Mein, S; Juang, T; Miles, D [Duke University Medical Physics Graduate Program, Durham, NC (United States); Adamovics, J [Rider University, Skillman, NJ (United States); Cai, B; Curcuru, A; Mutic, S; Wang, Y; Li, H [Washington University School of Medicine, Saint Louis, MO (United States); Oldham, M [Duke University Medical Center, Durham, NC (United States)

2016-06-15

Purpose: To validate the dosimetric accuracy of a commercially available MR-IGRT system using a combination of 3D dosimetry measurements (with PRESAGE(R) radiochromic plastic and optical-CT readout) and an in-house developed GPU-accelerated PENELOPE Monte-Carlo dose calculation system. Methods: {sup 60}Co IMRT subject to a 0.35T lateral magnetic field has recently been commissioned in our institution following AAPM’s TG-119 recommendations. We performed PRESAGE(R) sensitivity studies in 4ml cuvettes to verify linearity, MR-compatibility, and energy-independence. Using 10cm diameter PRESAGE(R), we delivered an open calibration field to examine the percent depth dose and a symmetrical 3-field plan with three adjacent regions of varying dose to determine uniformity within the dosimeter under a magnetic field. After initial testing, TG-119 plans were created in the TPS and then delivered to 14.5cm 2kg PRESAGE(R) dosimeters. Dose readout was performed via optical-CT at a second institution specializing in remote 3D dosimetry. Absolute dose was measured using an IBA CC01 ion chamber and the institution standard patient-specific QA methods were used to validate plan delivery. Calculated TG-119 plans were then compared with an independent Monte Carlo dose calculation (gPENELOPE). Results: PRESAGE(R) responds linearly (R{sup 2}=0.9996) to {sup 60}Co irradiation, in the presence of a 0.35T magnetic field, with a sensitivity of 0.0305(±0.003)cm{sup −1}Gy{sup −1}, within 1% of a 6MV non-MR linac irradiation (R{sup 2}=0.9991) with a sensitivity of 0.0302(±0.003)cm{sup −1}Gy{sup −1}. Analysis of TG-119 clinical plans using 3D-gamma (3%/3mm, 10% threshold) give passing rates of: HN 99.1%, prostate 98.0%, C-shape 90.8%, and multi-target 98.5%. The TPS agreed with gPENELOPE with a mean gamma passing rate of 98.4±1.5% (2%/2mm) with the z-score distributions following a standard normal distribution. Conclusion: We demonstrate for the first time that 3D remote dosimetry

Memory controllers for real-time embedded systems predictable and composable real-time systems

CERN Document Server

Akesson, Benny

2012-01-01

  Verification of real-time requirements in systems-on-chip becomes more complex as more applications are integrated. Predictable and composable systems can manage the increasing complexity using formal verification and simulation.  This book explains the concepts of predictability and composability and shows how to apply them to the design and analysis of a memory controller, which is a key component in any real-time system. This book is generally intended for readers interested in Systems-on-Chips with real-time applications.   It is especially well-suited for readers looking to use SDRAM memories in systems with hard or firm real-time requirements. There is a strong focus on real-time concepts, such as predictability and composability, as well as a brief discussion about memory controller architectures for high-performance computing. Readers will learn step-by-step how to go from an unpredictable SDRAM memory, offering highly variable bandwidth and latency, to a predictable and composable shared memory...

Develop real-time dosimetry concepts and instrumentation for long-term missions

International Nuclear Information System (INIS)

Braby, L.A.; Ratcliffe, C.A.; Metting, N.F.; Lien, M.K.

1984-06-01

The objective was to develop a small, self-contained system to measure dose and evaluate dose equivalent in real time in the complex radiation environment encountered in space. The device utilizes a microdosimetric approach. The instrument consists of two propane filled proportional counters, one of which measures energy deposition by penetrating radiations with LET between 0.24 and 200 keV/μm. The second detector is intended for particles with LET greater than or equal to 200 keV/μm for a minimum of 100 μm. This detector is physically larger in order to obtain reasonable counting statistics on these infrequent micro lesion-forming events. The detectors are combined with an electronic system which consists of three multi-channel analyzers with independent analog to digital converters, computer controlled detector bias supplies, signal conditioning amplifiers, data recording and display devices and a microcomputer which controls the system and calculates dose and dose equivalent. This report includes a brief discussion of microdosimetry as it applies to health physics, an evaluation of different methods for calculating dose equivalent, descriptions of the hardware and software making up the prototype instrument and the results of evaluations of the instrument when exposed to a variety of radiations. Included are operating instructions, software listings, and circuit diagrams. 18 references, 9 figures, 8 tables

Micro-Mini & Nano-Dosimetry & Innovative Technologies in Radiation Therapy (MMND&ITRO2016)

Science.gov (United States)

2017-01-01

The biennial MMND (formerly MMD) - IPCT workshops, founded in collaboration with Memorial Sloan Kettering Cancer Center (MSKCC) in 2001, has become an important international multidisciplinary forum for the discussion of advanced dosimetric technology for radiation therapy quality assurance (QA) and space science, as well as advanced technologies for prostate cancer treatment. In more recent years, the interests of participants and the scope of the workshops have extended far beyond prostate cancer treatment alone to include all aspects of radiation therapy, radiation science and technology. We therefore decided to change the name in 2016 to Innovative Technologies in Radiation Oncology (ITRO). MMND ITRO 2016 was held on 26-31 January, 2016 at the beautiful Wrest Point Hotel in Hobart, Tasmania and attracted an outstanding international faculty and nearly 200 delegates from 18 countries (http://mmnditro2016.com/) The MMND 2016 program continued to cover advanced medical physics aspects of IMRT, IGRT, VMAT, SBRT, MRI LINAC, innovative brachytherapy, and synchrotron MRT. The demand for sophisticated real time and high temporal and spatial resolution (down to the submillimetre scale) dosimetry methods and instrumentation for end-to-end QA for these radiotherapy technologies is increasing. Special attention was paid to the contribution of advanced imaging and the application of nanoscience to the recent improvements in imaging and radiotherapy. The last decade has seen great progress in charged particle therapy technology which has spread throughout the world and attracted strong current interest in Australia. This demands a better understanding of the fundamental aspects of ion interactions with biological tissue and the relative biological effectiveness (RBE) of protons and heavy ions. The further development of computational and experimental micro-and nano-dosimetry for ions has important application in radiobiology based treatment planning and space radiation

IMRT treatment planning-A comparative inter-system and inter-centre planning exercise of the ESTRO QUASIMODO group

International Nuclear Information System (INIS)

Bohsung, Joerg; Gillis, Sofie; Arrans, Rafael; Bakai, Annemarie; De Wagter, Carlos; Knoeoes, Tommy; Mijnheer, Ben J.; Paiusco, Marta; Perrin, Bruce A.; Welleweerd, Hans; Williams, Peter

2005-01-01

Background and purpose: The purpose of this work was a comparison of realistic IMRT plans based on the same CT-image data set and a common predefined set of dose objectives for the planning target volume and the organs at risk. This work was part of the larger European QUASIMODO IMRT verification project. Materials and methods: Eleven IMRT plans were produced by nine different European groups, each applying a representative set of clinically used IMRT treatment planning systems. The plans produced were to be deliverable in a clinically acceptable treatment time with the local technical equipment. All plans were characterized using a set of different quality measures such as dose-volume histograms, number of monitor units and treatment time. Results: Only one plan was able to fulfil all dose objectives strictly; six plans failed some of the objectives but were still considered to be clinically acceptable; four plans were not able to reach the objectives. Additional quality scores such as the number of monitor units and treatment time showed large variations, which mainly depend on the delivery technique. Conclusion: The presented planning study showed that with nearly all presently available IMRT planning and delivery systems comparable dose distributions could be achieved if the planning goals are clearly defined in advance

Dosimetric evaluation of the response of the TLD-100 dosemeters in the IMRT technique by 'Step and Shoot'; Evaluacion dosimetrica de la respuesta de los dosimetros TLD-100 en la tecnica de IMRT por 'Step and Shoot'

Energy Technology Data Exchange (ETDEWEB)

Vasquez, J. [Fundacion Clinica Valle del Lili, A.A. 020338, Cali (Colombia); Benavides, S.O. [Depto. de Fisica, Universidad del Valle, A.A. 25360, Cali (Colombia)

2005-07-01

We show the results of the dosimetry response of LiF thermoluminescent crystals: TLD-100, where they were radiated in a linear accelerator Siemens Primus Hl using the Intensity Modulated Radiation Therapy (IMRT) by step and shoot technique. Previous to the crystals calibration and response evaluation, the acceptation procedures recommended by the TG-53 protocol for validation of the technique were carried out. The planning system utilized was the Theraplan Plus 3.8, using the algorithm of Pencil Kernel. The register and verification system was Lantis 5.2. The response curve of dose versus charge was obtained from the readings of the TLD in a Harshaw 3500. The crystals were radiated in a Bench- Marck phantom with doses previously determined by using ionization chambers for square radiation fields, in a beam with a 0.68 TPR20,10 corresponding to 6 MV of energy. We compare the response of these through of radiation of segmented fields in a Anthropomorphic phantom and the calculated doses by the planning system. The results obtained in the crystals response show deviations less than 5 % between the measured dose and the calculated dose in the zones of low gradient. It allows its implementation like routine control of quality by IMRT. (Author)

Radiation processing dosimetry - past, present and future

International Nuclear Information System (INIS)

McLaughlin, W.L.

1999-01-01

Since the two United Nations Conferences were held in Geneva in 1955 and 1958 on the Peaceful Uses of Atomic Energy and the concurrent foundation of the International Atomic Energy Agency in 1957, the IAEA has fostered high-dose dosimetry and its applications. This field is represented in industrial radiation processing, agricultural programmes, and therapeutic and preventative medicine. Such dosimetry is needed specifically for pest and quarantine control and in the processing of medical products, pharmaceuticals, blood products, foodstuffs, solid, liquid and gaseous wastes, and a variety of useful commodities, e.g. polymers, composites, natural rubber and elastomers, packaging, electronic, and automotive components, as well as in radiotherapy. Improvements and innovations of dosimetry materials and analytical systems and software continue to be important goals for these applications. Some of the recent advances in high-dose dosimetry include tetrazolium salts and substituted polydiacetylene as radiochromic media, on-line real-time as well as integrating semiconductor and diamond-detector monitors, quantitative label dosimeters, photofluorescent sensors for broad dose range applications, and improved and simplified parametric and computational codes for imaging and simulating 3D radiation dose distributions in model products. The use of certain solid-state devices, e.g. optical quality LiF, at low (down to 4K) and high (up to 500 K) temperatures, is of interest for materials testing. There have also been notable developments in experimental dose mapping procedures, e.g. 2D and 3D dose distribution analyses by flat-bed optical scanners and software applied to radiochromic and photofluorescent images. In addition, less expensive EPR spectrometers and new EPR dosimetry materials and high-resolution semiconductor diode arrays, charge injection devices, and photostimulated storage phosphors have been introduced. (author)

Comparison of intraoperative dosimetric implant representation with postimplant dosimetry in patients receiving prostate brachytherapy.

Science.gov (United States)

Stone, Nelson N; Hong, Suzanne; Lo, Yeh-Chi; Howard, Victor; Stock, Richard G

2003-01-01

To compare the results of intraoperative dosimetry with those of CT-based postimplant dosimetry in patients undergoing prostate seed implantation. Seventy-seven patients with T1-T3 prostate cancer received an ultrasound-guided permanent seed implant (36 received (125)I, 7 (103)Pd, and 34 a partial (103)Pd implant plus external beam radiation therapy). The implantation was augmented with an intraoperative dosimetric planning system. After the peripheral needles were placed, 5-mm axial images were acquired into the treatment planning system. Soft tissue structures (prostate, urethra, and rectum) were contoured, and exact needle positions were registered. Seeds were placed with an applicator, and their positions were entered into the planning system. The dose distributions for the implant were calculated after interior needle and seed placement. Postimplant dosimetry was performed 1 month later on the basis of CT imaging. Prostate and urethral doses were compared, by using paired t tests, for the real-time dosimetry in the operating room (OR) and the postimplant dosimetry. The mean preimplant prostate volume was 39.8 cm(3), the postneedle planning volume was 41.5 cm(3) (psystem provides a close match to the actual delivered doses. These data support the use of this system to modify the implant during surgery to achieve more consistent dosimetry results.

Lhermitte's Sign Developing after IMRT for Head and Neck Cancer

Directory of Open Access Journals (Sweden)

Dong C. Lim

2010-01-01

Full Text Available Background. Lhermitte's sign (LS is a benign form of myelopathy with neck flexion producing an unpleasant electric-shock sensation radiating down the extremities. Although rare, it can occur after head and neck radiotherapy. Results. We report a case of Lhermitte's developing after curative intensity-modulated radiotherapy (IMRT for a patient with locoregionally advanced oropharyngeal cancer. IMRT delivers a conformal dose of radiation in head and neck cancer resulting in a gradient of radiation dose throughout the spinal cord. Using IMRT, more dose is delivered to the anterior spinal cord than the posterior cord. Conclusions. Lhermitte's sign can develop after IMRT for head and neck cancer. We propose an anterior spinal cord structure, the spinothalamic tract to be the target of IMRT-caused LS.

Adaptive Radiation Therapy for Postprostatectomy Patients Using Real-Time Electromagnetic Target Motion Tracking During External Beam Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Zhu, Mingyao [Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, Missouri (United States); Bharat, Shyam [Philips Research North America, Briarcliff Manor, New York (United States); Michalski, Jeff M.; Gay, Hiram A. [Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, Missouri (United States); Hou, Wei-Hsien [St Louis University School of Medicine, St Louis, Missouri (United States); Parikh, Parag J., E-mail: pparikh@radonc.wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, Missouri (United States)

2013-03-15

Purpose: Using real-time electromagnetic (EM) transponder tracking data recorded by the Calypso 4D Localization System, we report inter- and intrafractional target motion of the prostate bed, describe a strategy to evaluate treatment adequacy in postprostatectomy patients receiving intensity modulated radiation therapy (IMRT), and propose an adaptive workflow. Methods and Materials: Tracking data recorded by Calypso EM transponders was analyzed for postprostatectomy patients that underwent step-and-shoot IMRT. Rigid target motion parameters during beam delivery were calculated from recorded transponder positions in 16 patients with rigid transponder geometry. The delivered doses to the clinical target volume (CTV) were estimated from the planned dose matrix and the target motion for the first 3, 5, 10, and all fractions. Treatment adequacy was determined by comparing the delivered minimum dose (D{sub min}) with the planned D{sub min} to the CTV. Treatments were considered adequate if the delivered CTV D{sub min} is at least 95% of the planned CTV D{sub min}. Results: Translational target motion was minimal for all 16 patients (mean: 0.02 cm; range: −0.12 cm to 0.07 cm). Rotational motion was patient-specific, and maximum pitch, yaw, and roll were 12.2, 4.1, and 10.5°, respectively. We observed inadequate treatments in 5 patients. In these treatments, we observed greater target rotations along with large distances between the CTV centroid and transponder centroid. The treatment adequacy from the initial 10 fractions successfully predicted the overall adequacy in 4 of 5 inadequate treatments and 10 of 11 adequate treatments. Conclusion: Target rotational motion could cause underdosage to partial volume of the postprostatectomy targets. Our adaptive treatment strategy is applicable to post-prostatectomy patients receiving IMRT to evaluate and improve radiation therapy delivery.

Future of medical physics: Real-time MRI-guided proton therapy.

Science.gov (United States)

Oborn, Bradley M; Dowdell, Stephen; Metcalfe, Peter E; Crozier, Stuart; Mohan, Radhe; Keall, Paul J

2017-08-01

With the recent clinical implementation of real-time MRI-guided x-ray beam therapy (MRXT), attention is turning to the concept of combining real-time MRI guidance with proton beam therapy; MRI-guided proton beam therapy (MRPT). MRI guidance for proton beam therapy is expected to offer a compelling improvement to the current treatment workflow which is warranted arguably more than for x-ray beam therapy. This argument is born out of the fact that proton therapy toxicity outcomes are similar to that of the most advanced IMRT treatments, despite being a fundamentally superior particle for cancer treatment. In this Future of Medical Physics article, we describe the various software and hardware aspects of potential MRPT systems and the corresponding treatment workflow. Significant software developments, particularly focused around adaptive MRI-based planning will be required. The magnetic interaction between the MRI and the proton beamline components will be a key area of focus. For example, the modeling and potential redesign of a magnetically compatible gantry to allow for beam delivery from multiple angles towards a patient located within the bore of an MRI scanner. Further to this, the accuracy of pencil beam scanning and beam monitoring in the presence of an MRI fringe field will require modeling, testing, and potential further development to ensure that the highly targeted radiotherapy is maintained. Looking forward we envisage a clear and accelerated path for hardware development, leveraging from lessons learnt from MRXT development. Within few years, simple prototype systems will likely exist, and in a decade, we could envisage coupled systems with integrated gantries. Such milestones will be key in the development of a more efficient, more accurate, and more successful form of proton beam therapy for many common cancer sites. © 2017 American Association of Physicists in Medicine.

A Liquid Scintillator System for Dosimetry of Photon and Proton Beams

International Nuclear Information System (INIS)

Beddar S

2010-01-01

We have developed a 3D system based on liquid scintillator (LS) for the dosimetry of photon and proton therapy. We have validated the LS detector system for fast and accurate quality assurance of IMRT and proton therapy fields. Further improvements are required to optimize the quantitative analysis of the light output provided by the system in photon beams. We have also demonstrated its usefulness for protons as it can determine the position and the range of proton beams. This system has also been shown to be capable of fast, sub-millimeter spatial localization of proton spots delivered in a 3D volume and could be used for quality assurance of IMPT. Further developments are on-going to measure beam intensities in 3D.

Radiotherapy beyond cancer: Target localization in real-time MRI and treatment planning for cardiac radiosurgery

International Nuclear Information System (INIS)

Ipsen, S.; Blanck, O.; Rades, D.; Oborn, B.; Bode, F.; Liney, G.; Hunold, P.; Schweikard, A.; Keall, P. J.

2014-01-01

Purpose: Atrial fibrillation (AFib) is the most common cardiac arrhythmia that affects millions of patients world-wide. AFib is usually treated with minimally invasive, time consuming catheter ablation techniques. While recently noninvasive radiosurgery to the pulmonary vein antrum (PVA) in the left atrium has been proposed for AFib treatment, precise target location during treatment is challenging due to complex respiratory and cardiac motion. A MRI linear accelerator (MRI-Linac) could solve the problems of motion tracking and compensation using real-time image guidance. In this study, the authors quantified target motion ranges on cardiac magnetic resonance imaging (MRI) and analyzed the dosimetric benefits of margin reduction assuming real-time motion compensation was applied. Methods: For the imaging study, six human subjects underwent real-time cardiac MRI under free breathing. The target motion was analyzed retrospectively using a template matching algorithm. The planning study was conducted on a CT of an AFib patient with a centrally located esophagus undergoing catheter ablation, representing an ideal case for cardiac radiosurgery. The target definition was similar to the ablation lesions at the PVA created during catheter treatment. Safety margins of 0 mm (perfect tracking) to 8 mm (untracked respiratory motion) were added to the target, defining the planning target volume (PTV). For each margin, a 30 Gy single fraction IMRT plan was generated. Additionally, the influence of 1 and 3 T magnetic fields on the treatment beam delivery was simulated using Monte Carlo calculations to determine the dosimetric impact of MRI guidance for two different Linac positions. Results: Real-time cardiac MRI showed mean respiratory target motion of 10.2 mm (superior–inferior), 2.4 mm (anterior–posterior), and 2 mm (left–right). The planning study showed that increasing safety margins to encompass untracked respiratory motion leads to overlapping structures even in the

Radiotherapy beyond cancer: Target localization in real-time MRI and treatment planning for cardiac radiosurgery

Energy Technology Data Exchange (ETDEWEB)

Ipsen, S. [Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006, Australia and Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck 23562 (Germany); Blanck, O.; Rades, D. [Department of Radiation Oncology, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck, Luebeck 23562 (Germany); Oborn, B. [Illawarra Cancer Care Centre (ICCC), Wollongong, New South Wales 2500, Australia and Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, New South Wales 2500 (Australia); Bode, F. [Medical Department II, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck, Luebeck 23562 (Germany); Liney, G. [Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, New South Wales 2170 (Australia); Hunold, P. [Department of Radiology and Nuclear Medicine, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck, Luebeck 23562 (Germany); Schweikard, A. [Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck 23562 (Germany); Keall, P. J., E-mail: paul.keall@sydney.edu.au [Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006 (Australia)

2014-12-15

Purpose: Atrial fibrillation (AFib) is the most common cardiac arrhythmia that affects millions of patients world-wide. AFib is usually treated with minimally invasive, time consuming catheter ablation techniques. While recently noninvasive radiosurgery to the pulmonary vein antrum (PVA) in the left atrium has been proposed for AFib treatment, precise target location during treatment is challenging due to complex respiratory and cardiac motion. A MRI linear accelerator (MRI-Linac) could solve the problems of motion tracking and compensation using real-time image guidance. In this study, the authors quantified target motion ranges on cardiac magnetic resonance imaging (MRI) and analyzed the dosimetric benefits of margin reduction assuming real-time motion compensation was applied. Methods: For the imaging study, six human subjects underwent real-time cardiac MRI under free breathing. The target motion was analyzed retrospectively using a template matching algorithm. The planning study was conducted on a CT of an AFib patient with a centrally located esophagus undergoing catheter ablation, representing an ideal case for cardiac radiosurgery. The target definition was similar to the ablation lesions at the PVA created during catheter treatment. Safety margins of 0 mm (perfect tracking) to 8 mm (untracked respiratory motion) were added to the target, defining the planning target volume (PTV). For each margin, a 30 Gy single fraction IMRT plan was generated. Additionally, the influence of 1 and 3 T magnetic fields on the treatment beam delivery was simulated using Monte Carlo calculations to determine the dosimetric impact of MRI guidance for two different Linac positions. Results: Real-time cardiac MRI showed mean respiratory target motion of 10.2 mm (superior–inferior), 2.4 mm (anterior–posterior), and 2 mm (left–right). The planning study showed that increasing safety margins to encompass untracked respiratory motion leads to overlapping structures even in the

Radiotherapy beyond cancer: target localization in real-time MRI and treatment planning for cardiac radiosurgery.

Science.gov (United States)

Ipsen, S; Blanck, O; Oborn, B; Bode, F; Liney, G; Hunold, P; Rades, D; Schweikard, A; Keall, P J

2014-12-01

Atrial fibrillation (AFib) is the most common cardiac arrhythmia that affects millions of patients world-wide. AFib is usually treated with minimally invasive, time consuming catheter ablation techniques. While recently noninvasive radiosurgery to the pulmonary vein antrum (PVA) in the left atrium has been proposed for AFib treatment, precise target location during treatment is challenging due to complex respiratory and cardiac motion. A MRI linear accelerator (MRI-Linac) could solve the problems of motion tracking and compensation using real-time image guidance. In this study, the authors quantified target motion ranges on cardiac magnetic resonance imaging (MRI) and analyzed the dosimetric benefits of margin reduction assuming real-time motion compensation was applied. For the imaging study, six human subjects underwent real-time cardiac MRI under free breathing. The target motion was analyzed retrospectively using a template matching algorithm. The planning study was conducted on a CT of an AFib patient with a centrally located esophagus undergoing catheter ablation, representing an ideal case for cardiac radiosurgery. The target definition was similar to the ablation lesions at the PVA created during catheter treatment. Safety margins of 0 mm (perfect tracking) to 8 mm (untracked respiratory motion) were added to the target, defining the planning target volume (PTV). For each margin, a 30 Gy single fraction IMRT plan was generated. Additionally, the influence of 1 and 3 T magnetic fields on the treatment beam delivery was simulated using Monte Carlo calculations to determine the dosimetric impact of MRI guidance for two different Linac positions. Real-time cardiac MRI showed mean respiratory target motion of 10.2 mm (superior-inferior), 2.4 mm (anterior-posterior), and 2 mm (left-right). The planning study showed that increasing safety margins to encompass untracked respiratory motion leads to overlapping structures even in the ideal scenario, compromising

Dosimetric evaluation of the response of the TLD-100 dosemeters in the IMRT technique by 'Step and Shoot'

International Nuclear Information System (INIS)

Vasquez, J.; Benavides, S.O.

2005-01-01

We show the results of the dosimetry response of LiF thermoluminescent crystals: TLD-100, where they were radiated in a linear accelerator Siemens Primus Hl using the Intensity Modulated Radiation Therapy (IMRT) by step and shoot technique. Previous to the crystals calibration and response evaluation, the acceptation procedures recommended by the TG-53 protocol for validation of the technique were carried out. The planning system utilized was the Theraplan Plus 3.8, using the algorithm of Pencil Kernel. The register and verification system was Lantis 5.2. The response curve of dose versus charge was obtained from the readings of the TLD in a Harshaw 3500. The crystals were radiated in a Bench- Marck phantom with doses previously determined by using ionization chambers for square radiation fields, in a beam with a 0.68 TPR20,10 corresponding to 6 MV of energy. We compare the response of these through of radiation of segmented fields in a Anthropomorphic phantom and the calculated doses by the planning system. The results obtained in the crystals response show deviations less than 5 % between the measured dose and the calculated dose in the zones of low gradient. It allows its implementation like routine control of quality by IMRT. (Author)

Essays in real-time forecasting

OpenAIRE

Liebermann, Joelle

2012-01-01

This thesis contains three essays in the field of real-time econometrics, and more particularlyforecasting.The issue of using data as available in real-time to forecasters, policymakers or financialmarkets is an important one which has only recently been taken on board in the empiricalliterature. Data available and used in real-time are preliminary and differ from ex-postrevised data, and given that data revisions may be quite substantial, the use of latestavailable instead of real-time can s...

SU-F-J-218: Predicting Radiation-Induced Xerostomia by Dosimetrically Accounting for Daily Setup Uncertainty During Head and Neck IMRT

International Nuclear Information System (INIS)

Park, S; Quon, H; McNutt, T; Lee, J; Plishker, W; Shekhar, R

2016-01-01

Purpose: To determine if the accumulated parotid dosimetry using planning CT to daily CBCT deformation and dose re-calculation can predict for radiation-induced xerostomia. Methods: To track and dosimetrically account for the effects of anatomical changes on the parotid glands, we propagated physicians’ contours from planning CT to daily CBCT using a deformable registration with iterative CBCT intensity correction. A surface mesh for each OAR was created with the deformation applied to the mesh to obtain the deformed parotid volumes. Daily dose was computed on the deformed CT and accumulated to the last fraction. For both the accumulated and the planned parotid dosimetry, we tested the prediction power of different dosimetric parameters including D90, D50, D10, mean, standard deviation, min/max dose to the combined parotids and patient age to severe xerostomia (NCI-CTCAE grade≥2 at 6 mo follow-up). We also tested the dosimetry to parotid sub-volumes. Three classification algorithms, random tree, support vector machine, and logistic regression were tested to predict severe xerostomia using a leave-one-out validation approach. Results: We tested our prediction model on 35 HN IMRT cases. Parameters from the accumulated dosimetry model demonstrated an 89% accuracy for predicting severe xerostomia. Compared to the planning dosimetry, the accumulated dose consistently demonstrated higher prediction power with all three classification algorithms, including 11%, 5% and 30% higher accuracy, sensitivity and specificity, respectively. Geometric division of the combined parotid glands into superior-inferior regions demonstrated ∼5% increased accuracy than the whole volume. The most influential ranked features include age, mean accumulated dose of the submandibular glands and the accumulated D90 of the superior parotid glands. Conclusion: We demonstrated that the accumulated parotid dosimetry using CT-CBCT registration and dose re-calculation more accurately predicts for

SU-F-J-218: Predicting Radiation-Induced Xerostomia by Dosimetrically Accounting for Daily Setup Uncertainty During Head and Neck IMRT

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Park, S; Quon, H; McNutt, T; Lee, J [Johns Hopkins University, Baltimor, MD (United States); Plishker, W [IGI Technologies, Inc., College Park, MD (United States); Shekhar, R [IGI Technologies, Inc., College Park, MD (United States); Children’s National Medical Center, Washington, DC (United States)

2016-06-15

Purpose: To determine if the accumulated parotid dosimetry using planning CT to daily CBCT deformation and dose re-calculation can predict for radiation-induced xerostomia. Methods: To track and dosimetrically account for the effects of anatomical changes on the parotid glands, we propagated physicians’ contours from planning CT to daily CBCT using a deformable registration with iterative CBCT intensity correction. A surface mesh for each OAR was created with the deformation applied to the mesh to obtain the deformed parotid volumes. Daily dose was computed on the deformed CT and accumulated to the last fraction. For both the accumulated and the planned parotid dosimetry, we tested the prediction power of different dosimetric parameters including D90, D50, D10, mean, standard deviation, min/max dose to the combined parotids and patient age to severe xerostomia (NCI-CTCAE grade≥2 at 6 mo follow-up). We also tested the dosimetry to parotid sub-volumes. Three classification algorithms, random tree, support vector machine, and logistic regression were tested to predict severe xerostomia using a leave-one-out validation approach. Results: We tested our prediction model on 35 HN IMRT cases. Parameters from the accumulated dosimetry model demonstrated an 89% accuracy for predicting severe xerostomia. Compared to the planning dosimetry, the accumulated dose consistently demonstrated higher prediction power with all three classification algorithms, including 11%, 5% and 30% higher accuracy, sensitivity and specificity, respectively. Geometric division of the combined parotid glands into superior-inferior regions demonstrated ∼5% increased accuracy than the whole volume. The most influential ranked features include age, mean accumulated dose of the submandibular glands and the accumulated D90 of the superior parotid glands. Conclusion: We demonstrated that the accumulated parotid dosimetry using CT-CBCT registration and dose re-calculation more accurately predicts for

Dependence of fluence errors in dynamic IMRT on leaf-positional errors varying with time and leaf number

International Nuclear Information System (INIS)

Zygmanski, Piotr; Kung, Jong H.; Jiang, Steve B.; Chin, Lee

2003-01-01

In d-MLC based IMRT, leaves move along a trajectory that lies within a user-defined tolerance (TOL) about the ideal trajectory specified in a d-MLC sequence file. The MLC controller measures leaf positions multiple times per second and corrects them if they deviate from ideal positions by a value greater than TOL. The magnitude of leaf-positional errors resulting from finite mechanical precision depends on the performance of the MLC motors executing leaf motions and is generally larger if leaves are forced to move at higher speeds. The maximum value of leaf-positional errors can be limited by decreasing TOL. However, due to the inherent time delay in the MLC controller, this may not happen at all times. Furthermore, decreasing the leaf tolerance results in a larger number of beam hold-offs, which, in turn leads, to a longer delivery time and, paradoxically, to higher chances of leaf-positional errors (≤TOL). On the other end, the magnitude of leaf-positional errors depends on the complexity of the fluence map to be delivered. Recently, it has been shown that it is possible to determine the actual distribution of leaf-positional errors either by the imaging of moving MLC apertures with a digital imager or by analysis of a MLC log file saved by a MLC controller. This leads next to an important question: What is the relation between the distribution of leaf-positional errors and fluence errors. In this work, we introduce an analytical method to determine this relation in dynamic IMRT delivery. We model MLC errors as Random-Leaf Positional (RLP) errors described by a truncated normal distribution defined by two characteristic parameters: a standard deviation σ and a cut-off value Δx 0 (Δx 0 ∼TOL). We quantify fluence errors for two cases: (i) Δx 0 >>σ (unrestricted normal distribution) and (ii) Δx 0 0 --limited normal distribution). We show that an average fluence error of an IMRT field is proportional to (i) σ/ALPO and (ii) Δx 0 /ALPO, respectively, where

Characterising an aluminium oxide dosimetry system.

Science.gov (United States)

Conheady, Clement F; Gagliardi, Frank M; Ackerly, Trevor

2015-09-01

In vivo dosimetry is recommended as a defence-in-depth strategy in radiotherapy treatments and is currently employed by clinics around the world. The characteristics of a new optically stimulated luminescence dosimetry system were investigated for the purpose of replacing an aging thermoluminescence dosimetry system for in vivo dosimetry. The stability of the system was not sufficient to satisfy commissioning requirements and therefore it has not been released into clinical service at this time.

The effect of concomitant chemotherapy on parotid gland function following head and neck IMRT

International Nuclear Information System (INIS)

Miah, Aisha B.; Gulliford, Sarah L.; Bhide, Shreerang A.; Zaidi, Shane H.; Newbold, Kate L.; Harrington, Kevin J.; Nutting, Christopher M.

2013-01-01

Purpose: To determine whether concomitant chemotherapy increases the incidence of high grade xerostomia following parotid-sparing intensity-modulated radiotherapy (IMRT) in patients with locally advanced head and neck squamous cell cancer. Materials and methods: The incidence of high grade (⩾G2) acute (CTCAEv3.0) and late (LENTSOMA and RTOG) xerostomia was compared between patients treated with either IMRT or concomitant chemo-IMRT (c-IMRT) in 2 prospective studies. Parotid gland mean tolerance doses (D 50 ) were reported using non-linear logistic regression analysis. Results: Thirty-six patients received IMRT alone and 60 patients received c-IMRT. Patients received 65 Gy in 30 daily fractions to the primary site and involved nodal groups and 54 Gy in 30 fractions to elective nodal groups, mean doses to the parotid glands were comparable. Concomitant cisplatin 100 mg/m 2 was administered on days 1 and 29 of IMRT. The incidence of ⩾G2 subjective xerostomia was similar in both groups; acute-64.7% (IMRT) versus 60.3% (c-IMRT), p = 0.83; late-43% (IMRT) versus 34% (c-IMRT), p = 0.51. Recovery of parotid salivary flow at 1 year was higher with IMRT (64% vs 50%), but not statistically significant (p = 0.15). D 50 for absence of parotid saliva flow at 1 year was 23.2 Gy (95% CI: 17.7–28.7) for IMRT and 21.1 Gy (11.8–30.3) for c-IMRT. Conclusion: Concomitant c-IMRT does not increase the incidence of acute or late xerostomia relative to IMRT alone

The effect of concomitant chemotherapy on parotid gland function following head and neck IMRT.

Science.gov (United States)

Miah, Aisha B; Gulliford, Sarah L; Bhide, Shreerang A; Zaidi, Shane H; Newbold, Kate L; Harrington, Kevin J; Nutting, Christopher M

2013-03-01

To determine whether concomitant chemotherapy increases the incidence of high grade xerostomia following parotid-sparing intensity-modulated radiotherapy (IMRT) in patients with locally advanced head and neck squamous cell cancer. The incidence of high grade (≥G2) acute (CTCAEv3.0) and late (LENTSOMA and RTOG) xerostomia was compared between patients treated with either IMRT or concomitant chemo-IMRT (c-IMRT) in 2 prospective studies. Parotid gland mean tolerance doses (D₅₀) were reported using non-linear logistic regression analysis. Thirty-six patients received IMRT alone and 60 patients received c-IMRT. Patients received 65 Gy in 30 daily fractions to the primary site and involved nodal groups and 54 Gy in 30 fractions to elective nodal groups, mean doses to the parotid glands were comparable. Concomitant cisplatin 100mg/m(2) was administered on days 1 and 29 of IMRT. The incidence of ≥G2 subjective xerostomia was similar in both groups; acute-64.7% (IMRT) versus 60.3% (c-IMRT), p=0.83; late-43% (IMRT) versus 34% (c-IMRT), p=0.51. Recovery of parotid salivary flow at 1 year was higher with IMRT (64% vs 50%), but not statistically significant (p=0.15). D₅₀ for absence of parotid saliva flow at 1 year was 23.2 Gy (95% CI: 17.7-28.7) for IMRT and 21.1 Gy (11.8-30.3) for c-IMRT. Concomitant c-IMRT does not increase the incidence of acute or late xerostomia relative to IMRT alone. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Ovation Prime Real-Time

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