Poster — Thur Eve — 56: Design of Quality Assurance Methodology for VMAT system on Agility System equipped with CVDR

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thind, K; Tolakanahalli, R

2014-08-15

The aim of this study was to analyze the feasibility of designing comprehensive QA plans using iComCAT for Elekta machines equipped with Agility multileaf collimator and continuously variable dose rate. Test plans with varying MLC speed, gantry speed, and dose rate were created and delivered in a controlled manner. A strip test was designed with three 1 cm MLC positions and delivered using dynamic, StepNShoot and VMAT techniques. Plans were also designed to test error in MLC position with various gantry speeds and various MLC speeds. The delivery fluence was captured using the electronic portal-imaging device. Gantry speed was foundmore » to be within tolerance as per the Canadian standards. MLC positioning errors at higher MLC speed with gravity effects does add more than 2 mm discrepancy. More tests need to be performed to evaluate MLC performance using independent measurement systems. The treatment planning system with end-to-end testing necessary for commissioning was also investigated and found to have >95% passing rates within 3%/3mm gamma criteria. Future studies involve performing off-axis gantry starshot pattern and repeating the tests on three matched Elekta linear accelerators.« less

An MLC-based linac QA procedure for the characterization of radiation isocenter and room lasers' position.

PubMed

Rosca, Florin; Lorenz, Friedlieb; Hacker, Fred L; Chin, Lee M; Ramakrishna, Naren; Zygmanski, Piotr

2006-06-01

We have designed and implemented a new stereotactic linac QA test with stereotactic precision. The test is used to characterize gantry sag, couch wobble, cone placement, MLC offsets, and room lasers' positions relative to the radiation isocenter. Two MLC star patterns, a cone pattern, and the laser line patterns are recorded on the same imaging medium. Phosphor plates are used as imaging medium due to their sensitivity to red light. The red light of room lasers erases some of the irradiation information stored on the phosphor plates enabling accurate and direct measurements for the position of room lasers and radiation isocenter. Using film instead of the phosphor plate as imaging medium is possible, however, it is less practical. The QA method consists of irradiating four phosphor plates that record the gantry sag between the 0 degrees and 180 degrees gantry angles, the position and stability of couch rotational axis, the sag between the 90 degrees and 270 degrees gantry angles, the accuracy of cone placement on the collimator, the MLC offsets from the collimator rotational axis, and the position of laser lines relative to the radiation isocenter. The estimated accuracy of the method is +/- 0.2 mm. The observed reproducibility of the method is about +/- 0.1 mm. The total irradiation/ illumination time is about 10 min per image. Data analysis, including the phosphor plate scanning, takes less than 5 min for each image. The method characterizes the radiation isocenter geometry with the high accuracy required for the stereotactic radiosurgery. In this respect, it is similar to the standard ball test for stereotactic machines. However, due to the usage of the MLC instead of the cross-hair/ball, it does not depend on the cross-hair/ball placement errors with respect to the lasers and it provides more information on the mechanical integrity of the linac/couch/laser system. Alternatively, it can be used as a highly accurate QA procedure for the nonstereotactic machines. Noteworthy is its ability to characterize the MLC position accuracy, which is an important factor in IMRT delivery.

Multileaf collimator performance monitoring and improvement using semiautomated quality control testing and statistical process control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Létourneau, Daniel, E-mail: daniel.letourneau@rmp.uh.on.ca; McNiven, Andrea; Keller, Harald

2014-12-15

Purpose: High-quality radiation therapy using highly conformal dose distributions and image-guided techniques requires optimum machine delivery performance. In this work, a monitoring system for multileaf collimator (MLC) performance, integrating semiautomated MLC quality control (QC) tests and statistical process control tools, was developed. The MLC performance monitoring system was used for almost a year on two commercially available MLC models. Control charts were used to establish MLC performance and assess test frequency required to achieve a given level of performance. MLC-related interlocks and servicing events were recorded during the monitoring period and were investigated as indicators of MLC performance variations. Methods:more » The QC test developed as part of the MLC performance monitoring system uses 2D megavoltage images (acquired using an electronic portal imaging device) of 23 fields to determine the location of the leaves with respect to the radiation isocenter. The precision of the MLC performance monitoring QC test and the MLC itself was assessed by detecting the MLC leaf positions on 127 megavoltage images of a static field. After initial calibration, the MLC performance monitoring QC test was performed 3–4 times/week over a period of 10–11 months to monitor positional accuracy of individual leaves for two different MLC models. Analysis of test results was performed using individuals control charts per leaf with control limits computed based on the measurements as well as two sets of specifications of ±0.5 and ±1 mm. Out-of-specification and out-of-control leaves were automatically flagged by the monitoring system and reviewed monthly by physicists. MLC-related interlocks reported by the linear accelerator and servicing events were recorded to help identify potential causes of nonrandom MLC leaf positioning variations. Results: The precision of the MLC performance monitoring QC test and the MLC itself was within ±0.22 mm for most MLC leaves and the majority of the apparent leaf motion was attributed to beam spot displacements between irradiations. The MLC QC test was performed 193 and 162 times over the monitoring period for the studied units and recalibration had to be repeated up to three times on one of these units. For both units, rate of MLC interlocks was moderately associated with MLC servicing events. The strongest association with the MLC performance was observed between the MLC servicing events and the total number of out-of-control leaves. The average elapsed time for which the number of out-of-specification or out-of-control leaves was within a given performance threshold was computed and used to assess adequacy of MLC test frequency. Conclusions: A MLC performance monitoring system has been developed and implemented to acquire high-quality QC data at high frequency. This is enabled by the relatively short acquisition time for the images and automatic image analysis. The monitoring system was also used to record and track the rate of MLC-related interlocks and servicing events. MLC performances for two commercially available MLC models have been assessed and the results support monthly test frequency for widely accepted ±1 mm specifications. Higher QC test frequency is however required to maintain tighter specification and in-control behavior.« less

Comparison of secondary neutron dose in proton therapy resulting from the use of a tungsten alloy MLC or a brass collimator system.

PubMed

Diffenderfer, Eric S; Ainsley, Christopher G; Kirk, Maura L; McDonough, James E; Maughan, Richard L

2011-11-01

To apply the dual ionization chamber method for mixed radiation fields to an accurate comparison of the secondary neutron dose arising from the use of a tungsten alloy multileaf collimator (MLC) as opposed to a brass collimator system for defining the shape of a therapeutic proton field. Hydrogenous and nonhydrogenous ionization chambers were constructed with large volumes to enable measurements of absorbed doses below 10(-4) Gy in mixed radiation fields using the dual ionization chamber method for mixed-field dosimetry. Neutron dose measurements were made with a nominal 230 MeV proton beam incident on a closed tungsten alloy MLC and a solid brass block. The chambers were cross-calibrated against a (60)Co-calibrated Farmer chamber in water using a 6 MV x-ray beam and Monte Carlo simulations were performed to account for variations in ionization chamber response due to differences in secondary neutron energy spectra. The neutron and combined proton plus γ-ray absorbed doses are shown to be nearly equivalent downstream from either a closed tungsten alloy MLC or a solid brass block. At 10 cm downstream from the distal edge of the collimating material the neutron dose from the closed MLC was (5.3 ± 0.4) × 10(- 5) Gy/Gy. The neutron dose with brass was (6.4 ± 0.7) × 10(- 5) Gy/Gy. Further from the secondary neutron source, at 50 cm, the neutron doses remain close for both the MLC and brass block at (6.9 ± 0.6) × 10(- 6) Gy/Gy and (6.3 ± 0.7) × 10(- 6) Gy/Gy, respectively. The dual ionization chamber method is suitable for measuring secondary neutron doses resulting from proton irradiation. The results of measurements downstream from a closed tungsten alloy MLC and a brass block indicate that, even in an overly pessimistic worst-case scenario, secondary neutron production in a tungsten alloy MLC leads to absorbed doses that are nearly equivalent to those seen from brass collimators. Therefore, the choice of tungsten alloy in constructing the leaves of a proton MLC is appropriate, and does not lead to a substantial increase in the secondary neutron dose to the patient compared to that generated in a brass collimator.

SU-F-T-481: Physics Evaluation of a Newly Released InCise™ Multileaf Collimator for CyberKnife M6™ System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, L; Chin, E; Lo, A

2016-06-15

Purpose: This work reports the results of the physics evaluation of a newly released InCise™2 Multileaf Collimator (MLC) installed in our institution. Methods: Beam property data was measured with unshielded diode and EBT2 films. The measurements included MLC leaf transmission, beam profiles, output factors and tissue-phantom ratios. MLC performance was evaluated for one month after commissioning. Weekly Garden Fence tests were performed for leaf / bank positioning in standard (A/P) and clinically relevant non-standard positions, before and after MLC driving exercises of 10+ minutes. Daily Picket Fence test and AQA test, End-to-End tests and dosimetric quality assurance were performed tomore » evaluate the overall system performance. Results: All measurements including beam energy, flatness and symmetry, were within manufacture specifications. Leaf transmission was 0.4% <0.5% specification. The values of output factors ranged from 0.825 (7.6 mm × 7.5 mm) to 1.026 (115.0 mm × 100.1 mm). Average beam penumbra at 10 cm depth ranged from 2.7mm/2.7mm(7.6 mm × 7.5 mm) to 6.0 mm/6.2mm(84.6 mm × 84.7 mm). Slight penumbra difference (<10% from average penumbra for fields >20 mm) was observed in the direction perpendicular to leaf motion due to the tilting of the leaf housing. Mean leaf position offsets was −0.08±0.07mm and −0.13 ± 0.08 for X1 and X2 leaf banks in 13 Garden Fence tests. No significant difference on average leaf positioning offsets was observed between different leaf orientations and before/after MLC driving exercises. Six End-to-End tests showed 0.43±0.23mm overall targeting accuracy. Picket-Fence and AQA showed stable performance of MLC during the test period. Dosimetric point dose measurements for test cases agreed with calculation within 3%. All film measurements on relative dose had Gamma (2%, 2mm) passing rate of >95%. Conclusion: The Incise™2 MLC for CyberKnife M6™ was proven to be accurate and reliable, and it is currently in clinical use. Stanford was one of the physics evaluation sites for the newly released InCise 2 MLC for Accuray Inc.« less

SU-E-T-312: Dosimetric Consideration for the Agility MLC When Planning Rotational SRT/SBRT Treatments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kong, X; Harris, J; Spitznagel, D

2015-06-15

Purpose: To analyze the radiation transmission of the Agility MLC and make recommendation based on the MLC dosimetric characteristics for SRT, SBRT and VMAT planning Method and Materials: Agility MLC is the newest model from Elekta and has no back up diaphragm behind leaves for this generation. Leaves are single focused with rounded end; composed of leafs each 0.5cm wide, 9cm thick, constructed from tungsten alloy and provide low transmission <0.5%. Total radiation transmission from leaves and diaphragm is <0.13%. A 360degree arc was generated using iCom tools; leaves were programmed closed while keeping the diaphragm fully open to maximizemore » the MLC transmission effect. Gafchromic EBT films were sandwiched between 4cm of solid water and situated at midplane to take dose measurement. 5000MU was delivered using 6MV VersaHD, various collimator angles, and a 5cm central axis offset was tested also. Films were scanned with Epson 10000XL scanner and analyzed using DoseLab Pro. Results: Due to the rounded leaf end and nature of rotation therapy, dose accumulation through the leaf gap is significant. By offsetting the leaf gap from central axis, this accumulation can be greatly reduced. There are dark bands showing accumulation of interleaf transmission which is improved by increasing collimator angle from 0 to 45dgree. However for 45 degree, in most cases, there are larger volumes sweeping under MLC alone, which needs considered planning. Conclusions: While inter-leaf leakage is minimized by using collimator angles greater than 0 degrees, the location of the leaf gap must also be managed. The leaf gap position becomes critically important when the treatment area is off axis such is the case when more than one PTV is being treated. With VMAT for SRT, SBRT becoming a more popular planning technique, special attention needs to be paid when initially setting up the field geometry.« less

SU-G-TeP4-03: A Multileaf Collimator Calibration and Quality Assurance Technique Using An Electronic Portal Imaging Device

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lebron, S; Yan, G; Li, J

2016-06-15

Purpose: To develop an accurate and quick multileaf collimator (MLC) calibration and quality assurance technique using an electronic portal imaging device (EPID) Methods: The MLC models used include the MLCi and Agility (Elekta Ltd). This technique consists of two 22(L)x10(W) cm{sup 2} fields with 0{sup 0} and 180{sup 0} collimator angles centered to an offset EPID. The MLC opening is estimated by calculating the profile at the image’s center in the image’s horizontal direction. Scans in the image’s vertical direction were calculated every 20 pixels in the inner 70% of estimated MLC opening. The profiles’ edges were fitted with linearmore » equations to determine the image’s rotation angle. Then, crossline profiles were scanned at the center of each leaf taking into account the leaf’s width at isocenter and the rotation angle. The profiles’ edges determine the location of the leaves’ edges and these were subtracted from the reference leaf’s position in order to determine the relative leaf offsets. The edge location of all profiles was determined by using the parameterized gradient of the penumbra region. The technique was tested against an established diode array-based method, and for different MLC systems, patterns, gantry angles, days, energies, beam modalities and MLC openings. Results: The differences between the proposed and established methods were 0.26±0.19mm. The leaf offsets’ deviation was <0.3mm (5 months period). For pattern fields, the differences between predetermined and calculated offsets were 0.18±0.18mm. The leaf offset deviation of measurements with different energies and MLC openings were <0.1mm and <0.3mm, respectively. The differences between offsets of FF and FFF beams were 0.01±0.02mm (<0.07mm). The differences between the offsets at different gantry angles were 0.08±0.15mm. Conclusion: The proposed method proved to be accurate and efficient in calculating the relative leaf offsets. Parameterized field edge is essential to obtain accurate result by eliminating the noise from EPID.« less

An experimental comparison of conventional two-bank and novel four-bank dynamic MLC tracking.

PubMed

Davies, G A; Clowes, P; McQuaid, D; Evans, P M; Webb, S; Poludniowski, G

2013-03-07

The AccuLeaf mMLC featuring four multileaf-collimator (MLC) banks has been used for the first time for an experimental comparison of conventional two-bank with novel four-bank dynamic MLC tracking of a two-dimensional sinusoidal respiratory motion. This comparison was performed for a square aperture, and for three conformal treatment apertures from clinical radiotherapy lung cancer patients. The system latency of this prototype tracking system was evaluated and found to be 1.0 s and the frequency at which MLC positions could be updated, 1 Hz, and therefore accurate MLC tracking of irregular patient motion would be difficult with the system in its current form. The MLC leaf velocity required for two-bank-MLC and four-bank-MLC tracking was evaluated for the apertures studied and a substantial decrease was found in the maximum MLC velocity required when four-banks were used for tracking rather than two. A dosimetric comparison of the two techniques was also performed and minimal difference was found between two-bank-MLC and four-bank-MLC tracking. The use of four MLC banks for dynamic MLC tracking is shown to be potentially advantageous for increasing the delivery efficiency compared with two-bank-MLC tracking where difficulties are encountered if large leaf shifts are required to track motion perpendicular to the direction of leaf travel.

Effect of tertiary multileaf collimator (MLC) on foetal dose during three-dimensional conformal radiation therapy (3DCRT) of a brain tumour during pregnancy.

PubMed

Sharma, Dayananda S; Jalali, Rakesh; Tambe, Chandrashekhar M; Animesh; Deshpande, Deepak D

2004-01-01

The aim of this work was to measure the dose to foetus both in vivo and in vitro during three-dimensional conformal radiation therapy (3DCRT) in a pregnant patient with a pituitary adenoma. The study was then extended to assess the components contributing to the foetal dose such as collimator scatter, internal scatter, head leakage, wedge scatter and multileaf collimator (MLC) effect. A 30-year-old pregnant woman with a non-functioning pituitary macroadenoma was planned for 3DCRT with 6MV X-ray using four equally weighted MLC-shaped non-coplanar wedged portals. In vivo dosimetry was carried out using thermoluminescent (TL) phosphor powder, which was placed at different positions on the patient, corresponding to different locations in the uterus and also at external os. In vitro measurements were also performed on a simulated phantom using the same set-up parameters and beam arrangement to verify the in vivo measured dose. Experiments were carried out to measure the respective contributions of different components towards peripheral dose. In vitro measured dose to foetus was found to be slightly more than that of in vivo measurement with a maximum of 0.044% of the prescribed dose of 45Gy, which corresponded to 0.0199+/-0.0008Gy. Thermoluminescence dosimeter (TLD) kept at the external os of the patient showed a dose of 0.031% of the prescribed dose. Among the various components of the peripheral dose (foetal dose) measured, head leakage was found to be the leading cause contributing 52%, followed by wedge scatter (31%), collimator scatter (14%) and internal scatter (13%). The use of MLC reduced not only the volume of normal brain irradiation as compared to open fields but also the peripheral dose by 10%. Radiotherapy of brain tumours during pregnancy poses a unique clinical situation and decisions to deliver radiotherapy should be taken after detailed in vitro and in vivo dosimetric measurements. Our findings suggest that the beam arrangement using 3-4-fields generally used for 3DCRT of brain tumour with MLC for optimal coverage can be employed for pregnant patients even in early trimester. A possible increase in foetal dose from wedges to a large extent can be compensated with the use of MLC.

Dynamic tumor tracking using the Elekta Agility MLC

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fast, Martin F., E-mail: martin.fast@icr.ac.uk; Nill, Simeon, E-mail: simeon.nill@icr.ac.uk; Bedford, James L.

2014-11-01

Purpose: To evaluate the performance of the Elekta Agility multileaf collimator (MLC) for dynamic real-time tumor tracking. Methods: The authors have developed a new control software which interfaces to the Agility MLC to dynamically program the movement of individual leaves, the dynamic leaf guides (DLGs), and the Y collimators (“jaws”) based on the actual target trajectory. A motion platform was used to perform dynamic tracking experiments with sinusoidal trajectories. The actual target positions reported by the motion platform at 20, 30, or 40 Hz were used as shift vectors for the MLC in beams-eye-view. The system latency of the MLCmore » (i.e., the average latency comprising target device reporting latencies and MLC adjustment latency) and the geometric tracking accuracy were extracted from a sequence of MV portal images acquired during irradiation for the following treatment scenarios: leaf-only motion, jaw + leaf motion, and DLG + leaf motion. Results: The portal imager measurements indicated a clear dependence of the system latency on the target position reporting frequency. Deducting the effect of the target frequency, the leaf adjustment latency was measured to be 38 ± 3 ms for a maximum target speed v of 13 mm/s. The jaw + leaf adjustment latency was 53 ± 3 at a similar speed. The system latency at a target position frequency of 30 Hz was in the range of 56–61 ms for the leaves (v ≤ 31 mm/s), 71–78 ms for the jaw + leaf motion (v ≤ 25 mm/s), and 58–72 ms for the DLG + leaf motion (v ≤ 59 mm/s). The tracking accuracy showed a similar dependency on the target position frequency and the maximum target speed. For the leaves, the root-mean-squared error (RMSE) was between 0.6–1.5 mm depending on the maximum target speed. For the jaw + leaf (DLG + leaf) motion, the RMSE was between 0.7–1.5 mm (1.9–3.4 mm). Conclusions: The authors have measured the latency and geometric accuracy of the Agility MLC, facilitating its future use for clinical tracking applications.« less

Automatic detection of MLC relative position errors for VMAT using the EPID-based picket fence test

NASA Astrophysics Data System (ADS)

Christophides, Damianos; Davies, Alex; Fleckney, Mark

2016-12-01

Multi-leaf collimators (MLCs) ensure the accurate delivery of treatments requiring complex beam fluences like intensity modulated radiotherapy and volumetric modulated arc therapy. The purpose of this work is to automate the detection of MLC relative position errors  ⩾0.5 mm using electronic portal imaging device-based picket fence tests and compare the results to the qualitative assessment currently in use. Picket fence tests with and without intentional MLC errors were measured weekly on three Varian linacs. The picket fence images analysed covered a time period ranging between 14-20 months depending on the linac. An algorithm was developed that calculated the MLC error for each leaf-pair present in the picket fence images. The baseline error distributions of each linac were characterised for an initial period of 6 months and compared with the intentional MLC errors using statistical metrics. The distributions of median and one-sample Kolmogorov-Smirnov test p-value exhibited no overlap between baseline and intentional errors and were used retrospectively to automatically detect MLC errors in routine clinical practice. Agreement was found between the MLC errors detected by the automatic method and the fault reports during clinical use, as well as interventions for MLC repair and calibration. In conclusion the method presented provides for full automation of MLC quality assurance, based on individual linac performance characteristics. The use of the automatic method has been shown to provide early warning for MLC errors that resulted in clinical downtime.

Development of a Multileaf Collimator for Proton Radiotherapy

DTIC Science & Technology

2007-06-01

for proton radiotherapy, and the first year of the project to develop image guided treatment protocols for proton therapy . This research...multileaf collimator (MLC) for proton therapy and investigates the issues that must be resolved to use an MLC in proton therapy . The second technology...the contract included three development agreements directly related to the work supported by this grant to develop technology for proton therapy .

SU-E-T-392: Evaluation of Ion Chamber/film and Log File Based QA to Detect Delivery Errors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nelson, C; Mason, B; Kirsner, S

2015-06-15

Purpose: Ion chamber and film (ICAF) is a method used to verify patient dose prior to treatment. More recently, log file based QA has been shown as an alternative for measurement based QA. In this study, we delivered VMAT plans with and without errors to determine if ICAF and/or log file based QA was able to detect the errors. Methods: Using two VMAT patients, the original treatment plan plus 7 additional plans with delivery errors introduced were generated and delivered. The erroneous plans had gantry, collimator, MLC, gantry and collimator, collimator and MLC, MLC and gantry, and gantry, collimator, andmore » MLC errors. The gantry and collimator errors were off by 4{sup 0} for one of the two arcs. The MLC error introduced was one in which the opening aperture didn’t move throughout the delivery of the field. For each delivery, an ICAF measurement was made as well as a dose comparison based upon log files. Passing criteria to evaluate the plans were ion chamber less and 5% and film 90% of pixels pass the 3mm/3% gamma analysis(GA). For log file analysis 90% of voxels pass the 3mm/3% 3D GA and beam parameters match what was in the plan. Results: Two original plans were delivered and passed both ICAF and log file base QA. Both ICAF and log file QA met the dosimetry criteria on 4 of the 12 erroneous cases analyzed (2 cases were not analyzed). For the log file analysis, all 12 erroneous plans alerted a mismatch in delivery versus what was planned. The 8 plans that didn’t meet criteria all had MLC errors. Conclusion: Our study demonstrates that log file based pre-treatment QA was able to detect small errors that may not be detected using an ICAF and both methods of were able to detect larger delivery errors.« less

SU-E-T-195: Gantry Angle Dependency of MLC Leaf Position Error

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ju, S; Hong, C; Kim, M

Purpose: The aim of this study was to investigate the gantry angle dependency of the multileaf collimator (MLC) leaf position error. Methods: An automatic MLC quality assurance system (AutoMLCQA) was developed to evaluate the gantry angle dependency of the MLC leaf position error using an electronic portal imaging device (EPID). To eliminate the EPID position error due to gantry rotation, we designed a reference maker (RM) that could be inserted into the wedge mount. After setting up the EPID, a reference image was taken of the RM using an open field. Next, an EPID-based picket-fence test (PFT) was performed withoutmore » the RM. These procedures were repeated at every 45° intervals of the gantry angle. A total of eight reference images and PFT image sets were analyzed using in-house software. The average MLC leaf position error was calculated at five pickets (-10, -5, 0, 5, and 10 cm) in accordance with general PFT guidelines using in-house software. This test was carried out for four linear accelerators. Results: The average MLC leaf position errors were within the set criterion of <1 mm (actual errors ranged from -0.7 to 0.8 mm) for all gantry angles, but significant gantry angle dependency was observed in all machines. The error was smaller at a gantry angle of 0° but increased toward the positive direction with gantry angle increments in the clockwise direction. The error reached a maximum value at a gantry angle of 90° and then gradually decreased until 180°. In the counter-clockwise rotation of the gantry, the same pattern of error was observed but the error increased in the negative direction. Conclusion: The AutoMLCQA system was useful to evaluate the MLC leaf position error for various gantry angles without the EPID position error. The Gantry angle dependency should be considered during MLC leaf position error analysis.« less

SU-E-T-604: Penumbra Characteristics of a New InCiseâ„¢ Multileaf Collimator of CyberKnife M6â„¢ System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hwang, M; Jang, S; Ozhasoglu, C

2015-06-15

Purpose: The InCise™ Multileaf Collimator (MLC) of CyberKnife M6™ System has been released recently. The purpose of this study was to explore the dosimetric characteristics of the new MLC. In particular, the penumbra characteristics of MLC fields at varying locations are evaluated. Methods: EBT3-based film measurements were performed with varying MLC fields ranging from 7.5 mm to 27.5 mm. Seventeen regions of interests (ROIs) were identified for irradiation. These are regions located at the central area (denoted as reference field), at the left/right edge areas of reference open field, at an intermediate location between central and edge area. Single beammore » treatment plans were designed by using the MultiPlan and was delivered using the Blue Phantom. Gafchromic films were irradiated at 1.5 cm depth in the Blue Phantom and analyzed using the Film Pro software. Variation of maximum dose, penumbra of MLC-defined fields, and symmetry/flatness were calculated as a function of locations of MLC fields. Results: The InCise™ MLC System showed relatively consistent dose distribution and penumbra size with varying locations of MLC fields. The measured maximum dose varied within 5 % at different locations compared to that at the central location and agreed with the calculated data well within 2%. The measured penumbrae were in the range of 2.9 mm and 3.7 mm and were relatively consistent regardless of locations. However, dose profiles in the out-of-field and in-field regions varied with locations and field sizes. Strong variation was seen for all fields located at 55 mm away from the central field. The MLC leakage map showed that the leakage is dependent on position. Conclusion: The size of penumbra and normalized maximum dose for MLC-defined fields were consistent in different regions of MLC. However, dose profiles in the out-field region varied with locations and field sizes.« less

A method for photon beam Monte Carlo multileaf collimator particle transport

NASA Astrophysics Data System (ADS)

Siebers, Jeffrey V.; Keall, Paul J.; Kim, Jong Oh; Mohan, Radhe

2002-09-01

Monte Carlo (MC) algorithms are recognized as the most accurate methodology for patient dose assessment. For intensity-modulated radiation therapy (IMRT) delivered with dynamic multileaf collimators (DMLCs), accurate dose calculation, even with MC, is challenging. Accurate IMRT MC dose calculations require inclusion of the moving MLC in the MC simulation. Due to its complex geometry, full transport through the MLC can be time consuming. The aim of this work was to develop an MLC model for photon beam MC IMRT dose computations. The basis of the MC MLC model is that the complex MLC geometry can be separated into simple geometric regions, each of which readily lends itself to simplified radiation transport. For photons, only attenuation and first Compton scatter interactions are considered. The amount of attenuation material an individual particle encounters while traversing the entire MLC is determined by adding the individual amounts from each of the simplified geometric regions. Compton scatter is sampled based upon the total thickness traversed. Pair production and electron interactions (scattering and bremsstrahlung) within the MLC are ignored. The MLC model was tested for 6 MV and 18 MV photon beams by comparing it with measurements and MC simulations that incorporate the full physics and geometry for fields blocked by the MLC and with measurements for fields with the maximum possible tongue-and-groove and tongue-or-groove effects, for static test cases and for sliding windows of various widths. The MLC model predicts the field size dependence of the MLC leakage radiation within 0.1% of the open-field dose. The entrance dose and beam hardening behind a closed MLC are predicted within +/-1% or 1 mm. Dose undulations due to differences in inter- and intra-leaf leakage are also correctly predicted. The MC MLC model predicts leaf-edge tongue-and-groove dose effect within +/-1% or 1 mm for 95% of the points compared at 6 MV and 88% of the points compared at 18 MV. The dose through a static leaf tip is also predicted generally within +/-1% or 1 mm. Tests with sliding windows of various widths confirm the accuracy of the MLC model for dynamic delivery and indicate that accounting for a slight leaf position error (0.008 cm for our MLC) will improve the accuracy of the model. The MLC model developed is applicable to both dynamic MLC and segmental MLC IMRT beam delivery and will be useful for patient IMRT dose calculations, pre-treatment verification of IMRT delivery and IMRT portal dose transmission dosimetry.

Development of an iterative reconstruction method to overcome 2D detector low resolution limitations in MLC leaf position error detection for 3D dose verification in IMRT.

PubMed

Visser, R; Godart, J; Wauben, D J L; Langendijk, J A; Van't Veld, A A; Korevaar, E W

2016-05-21

The objective of this study was to introduce a new iterative method to reconstruct multi leaf collimator (MLC) positions based on low resolution ionization detector array measurements and to evaluate its error detection performance. The iterative reconstruction method consists of a fluence model, a detector model and an optimizer. Expected detector response was calculated using a radiotherapy treatment plan in combination with the fluence model and detector model. MLC leaf positions were reconstructed by minimizing differences between expected and measured detector response. The iterative reconstruction method was evaluated for an Elekta SLi with 10.0 mm MLC leafs in combination with the COMPASS system and the MatriXX Evolution (IBA Dosimetry) detector with a spacing of 7.62 mm. The detector was positioned in such a way that each leaf pair of the MLC was aligned with one row of ionization chambers. Known leaf displacements were introduced in various field geometries ranging from  -10.0 mm to 10.0 mm. Error detection performance was tested for MLC leaf position dependency relative to the detector position, gantry angle dependency, monitor unit dependency, and for ten clinical intensity modulated radiotherapy (IMRT) treatment beams. For one clinical head and neck IMRT treatment beam, influence of the iterative reconstruction method on existing 3D dose reconstruction artifacts was evaluated. The described iterative reconstruction method was capable of individual MLC leaf position reconstruction with millimeter accuracy, independent of the relative detector position within the range of clinically applied MU's for IMRT. Dose reconstruction artifacts in a clinical IMRT treatment beam were considerably reduced as compared to the current dose verification procedure. The iterative reconstruction method allows high accuracy 3D dose verification by including actual MLC leaf positions reconstructed from low resolution 2D measurements.

Dosimetric performance of the new high-definition multileaf collimator for intracranial stereotactic radiosurgery.

PubMed

Dhabaan, Anees; Elder, Eric; Schreibmann, Eduard; Crocker, Ian; Curran, Walter J; Oyesiku, Nelson M; Shu, Hui-Kuo; Fox, Tim

2010-06-21

The objective was to evaluate the performance of a high-definition multileaf collimator (MLC) of 2.5 mm leaf width (MLC2.5) and compare to standard 5 mm leaf width MLC (MLC5) for the treatment of intracranial lesions using dynamic conformal arcs (DCA) technique with a dedicated radiosurgery linear accelerator. Simulated cases of spherical targets were created to study solely the effect of target volume size on the performance of the two MLC systems independent of target shape complexity. In addition, 43 patients previously treated for intracranial lesions in our institution were retrospectively planned using DCA technique with MLC2.5 and MLC5 systems. The gross tumor volume ranged from 0.07 to 40.57 cm3 with an average volume of 5.9 cm3. All treatment parameters were kept the same for both MLC-based plans. The plan evaluation was performed using figures of merits (FOM) for a rapid and objective assessment on the quality of the two treatment plans for MLC2.5 and MLC5. The prescription isodose surface was selected as the greatest isodose surface covering >or= 95% of the target volume and delivering 95% of the prescription dose to 99% of target volume. A Conformity Index (CI) and conformity distance index (CDI) were used to quantifying the dose conformity to a target volume. To assess normal tissue sparing, a normal tissue difference (NTD) was defined as the difference between the volume of normal tissue receiving a certain dose utilizing MLC5 and the volume receiving the same dose using MLC2.5. The CI and normal tissue sparing for the simulated spherical targets were better with the MLC2.5 as compared to MLC5. For the clinical patients, the CI and CDI results indicated that the MLC2.5 provides better treatment conformity than MLC5 even at large target volumes. The CI's range was 1.15 to 2.44 with a median of 1.59 for MLC2.5 compared to 1.60-2.85 with a median of 1.71 for MLC5. Improved normal tissue sparing was also observed for MLC2.5 over MLC5, with the NTD always positive, indicating improvement, and ranging from 0.1 to 8.3 for normal tissue receiving 50% (NTV50), 70% (NTV70) and 90% (NTV90) of the prescription dose. The MLC2.5 has a dosimetric advantage over the MLC5 in Linac-based radiosurgery using DCA method for intracranial lesions, both in treatment conformity and normal tissue sparing when target shape complexity increases.

Evaluation of dosimetric effect caused by slowing with multi-leaf collimator (MLC) leaves for volumetric modulated arc therapy (VMAT)

PubMed Central

Wang, Iris Z.; Kumaraswamy, Lalith K.; Podgorsak, Matthew B.

2016-01-01

Background This study is to report 1) the sensitivity of intensity modulated radiation therapy (IMRT) QA method for clinical volumetric modulated arc therapy (VMAT) plans with multi-leaf collimator (MLC) leaf errors that will not trigger MLC interlock during beam delivery; 2) the effect of non-beam-hold MLC leaf errors on the quality of VMAT plan dose delivery. Materials and methods. Eleven VMAT plans were selected and modified using an in-house developed software. For each control point of a VMAT arc, MLC leaves with the highest speed (1.87-1.95 cm/s) were set to move at the maximal allowable speed (2.3 cm/s), which resulted in a leaf position difference of less than 2 mm. The modified plans were considered as ‘standard’ plans, and the original plans were treated as the ‘slowing MLC’ plans for simulating ‘standard’ plans with leaves moving at relatively lower speed. The measurement of each ‘slowing MLC’ plan using MapCHECK®2 was compared with calculated planar dose of the ‘standard’ plan with respect to absolute dose Van Dyk distance-to-agreement (DTA) comparisons using 3%/3 mm and 2%/2 mm criteria. Results All ‘slowing MLC’ plans passed the 90% pass rate threshold using 3%/3 mm criteria while one brain and three anal VMAT cases were below 90% with 2%/2 mm criteria. For ten out of eleven cases, DVH comparisons between ‘standard’ and ‘slowing MLC’ plans demonstrated minimal dosimetric changes in targets and organs-at-risk. Conclusions For highly modulated VMAT plans, pass rate threshold (90%) using 3%/3mm criteria is not sensitive in detecting MLC leaf errors that will not trigger the MLC leaf interlock. However, the consequential effects of non-beam hold MLC errors on target and OAR doses are negligible, which supports the reliability of current patient-specific IMRT quality assurance (QA) method for VMAT plans. PMID:27069458

SU-F-T-366: Dosimetric Parameters Enhancement of 120-Leaf Millennium MLC Using EGSnrc and IAEA Phase-Space Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Haddad, K; Alopoor, H

Purpose: Recently, the multileaf collimators (MLC) have become an important part of any LINAC collimation systems because they reduce the treatment planning time and improves the conformity. Important factors that affects the MLCs collimation performance are leaves material composition and their thickness. In this study, we investigate the main dosimetric parameters of 120-leaf Millennium MLC including dose in the buildup point, physical penumbra as well as average and end leaf leakages. Effects of the leaves geometry and density on these parameters are evaluated Methods: From EGSnrc Monte Carlo code, BEAMnrc and DOSXYZnrc modules are used to evaluate the dosimetric parametersmore » of a water phantom exposed to a Varian xi for 100cm SSD. Using IAEA phasespace data just above MLC (Z=46cm) and BEAMnrc, for the modified 120-leaf Millennium MLC a new phase space data at Z=52cm is produces. The MLC is modified both in leaf thickness and material composition. EGSgui code generates 521ICRU library for tungsten alloys. DOSXYZnrc with the new phase space evaluates the dose distribution in a water phantom of 60×60×20 cm3 with voxel size of 4×4×2 mm3. Using DOSXYZnrc dose distributions for open beam and closed beam as well as the leakages definition, end leakage, average leakage and physical penumbra are evaluated. Results: A new MLC with improved dosimetric parameters is proposed. The physical penumbra for proposed MLC is 4.7mm compared to 5.16 mm for Millennium. Average leakage in our design is reduced to 1.16% compared to 1.73% for Millennium, the end leaf leakage suggested design is also reduced to 4.86% compared to 7.26% of Millennium. Conclusion: The results show that the proposed MLC with enhanced dosimetric parameters could improve the conformity of treatment planning.« less

Performance of a multi leaf collimator system for MR-guided radiation therapy.

PubMed

Cai, Bin; Li, Harold; Yang, Deshan; Rodriguez, Vivian; Curcuru, Austen; Wang, Yuhe; Wen, Jie; Kashani, Rojano; Mutic, Sasa; Green, Olga

2017-12-01

The purpose of this study was to investigate and characterize the performance of a Multi Leaf Collimator (MLC) designed for Cobalt-60 based MR-guided radiation therapy system in a 0.35 T magnetic field. The MLC design and unique assembly features in the ViewRay MRIdian system were first reviewed. The RF cage shielding of MLC motor and cables were evaluated using ACR phantoms with real-time imaging and quantified by signal-to-noise ratio. The dosimetric characterizations, including the leaf transmission, leaf penumbra, tongue-and-groove effect, were investigated using radiosensitive films. The output factor of MLC-defined fields was measured with ionization chambers for both symmetric fields from 2.1 × 2.1 cm 2 to 27.3 × 27.3 cm 2 and asymmetric fields from 10.5 × 10.5 cm 2 to 10.5 × 2.0 cm 2 . Multi leaf collimator (MLC) positional accuracy was assessed by delivering either a picket fence (PF) style pattern on radiochromic films with wire-jig phantom or double and triple-rectangular patterns on ArcCheck-MR (Sun Nuclear, Melbourne, FL, USA) with gamma analysis as the pass/fail indicator. Leaf speed tests were performed to assess the capability of full range leaf travel within manufacture's specifications. Multi leaf collimator plan delivery reproducibility was tested by repeatedly delivering both open fields and fields with irregular shaped segments over 1-month period. Comparable SNRs within 4% were observed for MLC moving and stationary plans on vendor-reconstructed images, and the direct k-space reconstructed images showed that the three SNRs are within 1%. The maximum leaf transmission for all three MLCs was less than 0.35% and the average leakage was 0.153 ± 0.006%, 0.151 ± 0.008%, and 0.159 ± 0.015% for head 1, 2, and 3, respectively. Both the leaf edge and leaf end penumbra showed comparable values within 0.05 cm, and the measured values are within 0.1 cm with TPS values. The leaf edge TG effect indicated 10% underdose and the leaf end TG showed a shifted dose distribution with 0.3 cm offset. The leaf positioning test showed a 0.2 cm accuracy in the PF style test, and a gamma passing rate above 96% was observed with a 3%/2 mm criteria when comparing the measured double/triple-rectangular pattern fluence with TPS calculated fluence. The average leaf speed when executing the test plan fell in a range from 1.86 to 1.95 cm/s. The measured and TPS calculated output factors were within 2% for squared fields and within 3% for rectangular fields. The reproducibility test showed the deviation of output factors were well within 2% for square fields and the gamma passing rate within 1.5% for fields with irregular segments. The Monte Carlo predicted output factors were within 2% compared to TPS values. 15 out of the 16 IMRT plans have gamma passing rate more than 98% compared to the TPS fluence with an average passing rate of 99.1 ± 0.6%. The MRIdian MLC has a good RF noise shielding design, low radiation leakage, good positioning accuracy, comparable TG effect, and can be modeled by an independent Monte Carlo calculation platform. © 2017 American Association of Physicists in Medicine.

Measurement and Monte Carlo simulation for energy- and intensity-modulated electron radiotherapy delivered by a computer-controlled electron multileaf collimator.

PubMed

Jin, Lihui; Eldib, Ahmed; Li, Jinsheng; Emam, Ismail; Fan, Jiajin; Wang, Lu; Ma, C-M

2014-01-06

The dosimetric advantage of modulated electron radiotherapy (MERT) has been explored by many investigators and is considered to be an advanced radiation therapy technique in the utilization of electrons. A computer-controlled electron multileaf collimator (MLC) prototype, newly designed to be added onto a Varian linac to deliver MERT, was investigated both experimentally and by Monte Carlo simulations. Four different electron energies, 6, 9, 12, and 15 MeV, were employed for this investigation. To ensure that this device was capable of delivering the electron beams properly, measurements were performed to examine the electron MLC (eMLC) leaf leakage and to determine the appropriate jaw positioning for an eMLC-shaped field in order to eliminate a secondary radiation peak that could otherwise appear outside of an intended radiation field in the case of inappropriate jaw positioning due to insufficient radiation blockage from the jaws. Phase space data were obtained by Monte Carlo (MC) simulation and recorded at the plane just above the jaws for each of the energies (6, 9, 12, and 15 MeV). As an input source, phase space data were used in MC dose calculations for various sizes of the eMLC shaped field (10 × 10 cm2, 3.4 × 3.4 cm2, and 2 × 2 cm2) with respect to a water phantom at source-to-surface distance (SSD) = 94 cm, while the jaws, eMLC leaves, and some accessories associated with the eMLC assembly as well were modeled as modifiers in the calculations. The calculated results were then compared with measurements from a water scanning system. The results showed that jaw settings with 5 mm margins beyond the field shaped by the eMLC were appropriate to eliminate the secondary radiation peak while not widening the beam penumbra; the eMLC leaf leakage measurements ranged from 0.3% to 1.8% for different energies based on in-phantom measurements, which should be quite acceptable for MERT. Comparisons between MC dose calculations and measurements showed agreement within 1%/1 mm based on percentage depth doses (PDDs) and off-axis dose profiles for a range of field sizes for each of the electron energies. Our current work has demonstrated that the eMLC and other relevant components in the linac were correctly modeled and simulated via our in-house MC codes, and the eMLC is capable of accurately delivering electron beams for various eMLC-shaped field sizes with appropriate jaw settings. In the next stage, patient-specific verification with a full MERT plan should be performed.

Beam focal spot position determination for an Elekta linac with the Agility® head; practical guide with a ready-to-go procedure.

PubMed

Chojnowski, Jacek M; Taylor, Lee M; Sykes, Jonathan R; Thwaites, David I

2018-05-14

A novel phantomless, EPID-based method of measuring the beam focal spot offset of a linear accelerator was proposed and validated for Varian machines. In this method, one set of jaws and the MLC were utilized to form a symmetric field and then a 180 o collimator rotation was utilized to determine the radiation isocenter defined by the jaws and the MLC, respectively. The difference between these two isocentres is directly correlated with the beam focal spot offset of the linear accelerator. In the current work, the method has been considered for Elekta linacs. An Elekta linac with the Agility ® head does not have two set of jaws, therefore, a modified method is presented making use of one set of diaphragms, the MLC and a full 360 o collimator rotation. The modified method has been tested on two Elekta Synergy ® linacs with Agility ® heads and independently validated. A practical guide with instructions and a MATLAB ® code is attached for easy implementation. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

High-resolution field shaping utilizing a masked multileaf collimator.

PubMed

Williams, P C; Cooper, P

2000-08-01

Multileaf collimators (MLCs) have become an important tool in the modern radiotherapy department. However, the current limit of resolution (1 cm at isocentre) can be too coarse for acceptable shielding of all fields. A number of mini- and micro-MLCs have been developed, with thinner leaves to achieve approved resolution. Currently however, such devices are limited to modest field sizes and stereotactic applications. This paper proposes a new method of high-resolution beam collimation by use of a tertiary grid collimator situated below the conventional MLC. The width of each slit in the grid is a submultiple of the MLC width. A composite shaped field is thus built up from a series of subfields, with the main MLC defining the length of each strip within each subfield. Presented here are initial findings using a prototype device. The beam uniformity achievable with such a device was examined by measuring transmission profiles through the grid using a diode. Profiles thus measured were then copied and superposed to generate composite beams, from which the uniformity achievable could be assessed. With the average dose across the profile normalized to 100%, hot spots up to 5.0% and troughs of 3% were identified for a composite beam of 2 x 5.0 mm grids, as measured at Dmax for a 6 MV beam. For a beam composed from 4 x 2.5 mm grids, the maximum across the profile was 3.0% above the average, and the minimum 2.5% below. Actual composite profiles were also formed using the integrating properties of film, with the subfield indexing performed using an engineering positioning stage. The beam uniformity for these fields compared well with that achieved in theory using the diode measurements. Finally sine wave patterns were generated to demonstrate the potential improvements in field shaping and conformity using this device as opposed to the conventional MLC alone. The scalloping effect on the field edge commonly seen on MLC fields was appreciably reduced by use of 2 x 5.0 mm grids, and still further by the use of 4 x 2.5 mm grids, as would be expected. This was also achieved with a small or negligible broadening of the beam penumbra as measured at Dmax.

TH-AB-202-02: Real-Time Verification and Error Detection for MLC Tracking Deliveries Using An Electronic Portal Imaging Device

DOE Office of Scientific and Technical Information (OSTI.GOV)

J Zwan, B; Central Coast Cancer Centre, Gosford, NSW; Colvill, E

2016-06-15

Purpose: The added complexity of the real-time adaptive multi-leaf collimator (MLC) tracking increases the likelihood of undetected MLC delivery errors. In this work we develop and test a system for real-time delivery verification and error detection for MLC tracking radiotherapy using an electronic portal imaging device (EPID). Methods: The delivery verification system relies on acquisition and real-time analysis of transit EPID image frames acquired at 8.41 fps. In-house software was developed to extract the MLC positions from each image frame. Three comparison metrics were used to verify the MLC positions in real-time: (1) field size, (2) field location and, (3)more » field shape. The delivery verification system was tested for 8 VMAT MLC tracking deliveries (4 prostate and 4 lung) where real patient target motion was reproduced using a Hexamotion motion stage and a Calypso system. Sensitivity and detection delay was quantified for various types of MLC and system errors. Results: For both the prostate and lung test deliveries the MLC-defined field size was measured with an accuracy of 1.25 cm{sup 2} (1 SD). The field location was measured with an accuracy of 0.6 mm and 0.8 mm (1 SD) for lung and prostate respectively. Field location errors (i.e. tracking in wrong direction) with a magnitude of 3 mm were detected within 0.4 s of occurrence in the X direction and 0.8 s in the Y direction. Systematic MLC gap errors were detected as small as 3 mm. The method was not found to be sensitive to random MLC errors and individual MLC calibration errors up to 5 mm. Conclusion: EPID imaging may be used for independent real-time verification of MLC trajectories during MLC tracking deliveries. Thresholds have been determined for error detection and the system has been shown to be sensitive to a range of delivery errors.« less

Modeling of a multileaf collimator

NASA Astrophysics Data System (ADS)

Kim, Siyong

A comprehensive physics model of a multileaf collimator (MLC) field for treatment planning was developed. Specifically, an MLC user interface module that includes a geometric optimization tool and a general method of in- air output factor calculation were developed. An automatic tool for optimization of MLC conformation is needed to realize the potential benefits of MLC. It is also necessary that a radiation therapy treatment planning (RTTP) system is capable of modeling MLC completely. An MLC geometric optimization and user interface module was developed. The planning time has been reduced significantly by incorporating the MLC module into the main RTTP system, Radiation Oncology Computer System (ROCS). The dosimetric parameter that has the most profound effect on the accuracy of the dose delivered with an MLC is the change in the in-air output factor that occurs with field shaping. It has been reported that the conventional method of calculating an in-air output factor cannot be used for MLC shaped fields accurately. Therefore, it is necessary to develop algorithms that allow accurate calculation of the in-air output factor. A generalized solution for an in-air output factor calculation was developed. Three major contributors of scatter to the in-air output-flattening filter, wedge, and tertiary collimator-were considered separately. By virtue of a field mapping method, in which a source plane field determined by detector's eye view is mapped into a detector plane field, no additional dosimetric data acquisition other than the standard data set for a range of square fields is required for the calculation of head scatter. Comparisons of in-air output factors between calculated and measured values show a good agreement for both open and wedge fields. For rectangular fields, a simple equivalent square formula was derived based on the configuration of a linear accelerator treatment head. This method predicts in-air output to within 1% accuracy. A two-effective-source algorithm was developed to account for the effect of source to detector distance on in-air output for wedge fields. Two effective sources, one for head scatter and the other for wedge scatter, were dealt with independently. Calculations provided less than 1% difference of in-air output factors from measurements. This approach offers the best comprehensive accuracy in radiation delivery with field shapes defined using MLC. This generalized model works equally well with fields shaped by any type of tertiary collimator and have the necessary framework to extend its application to intensity modulated radiation therapy.

Quality assurance of dynamic parameters in volumetric modulated arc therapy.

PubMed

Manikandan, A; Sarkar, B; Holla, R; Vivek, T R; Sujatha, N

2012-07-01

The purpose of this study was to demonstrate quality assurance checks for accuracy of gantry speed and position, dose rate and multileaf collimator (MLC) speed and position for a volumetric modulated arc treatment (VMAT) modality (Synergy S; Elekta, Stockholm, Sweden), and to check that all the necessary variables and parameters were synchronous. Three tests (for gantry position-dose delivery synchronisation, gantry speed-dose delivery synchronisation and MLC leaf speed and positions) were performed. The average error in gantry position was 0.5° and the average difference was 3 MU for a linear and a parabolic relationship between gantry position and delivered dose. In the third part of this test (sawtooth variation), the maximum difference was 9.3 MU, with a gantry position difference of 1.2°. In the sweeping field method test, a linear relationship was observed between recorded doses and distance from the central axis, as expected. In the open field method, errors were encountered at the beginning and at the end of the delivery arc, termed the "beginning" and "end" errors. For MLC position verification, the maximum error was -2.46 mm and the mean error was 0.0153 ±0.4668 mm, and 3.4% of leaves analysed showed errors of >±1 mm. This experiment demonstrates that the variables and parameters of the Synergy S are synchronous and that the system is suitable for delivering VMAT using a dynamic MLC.

WE-AB-209-06: Dynamic Collimator Trajectory Algorithm for Use in VMAT Treatment Deliveries

DOE Office of Scientific and Technical Information (OSTI.GOV)

MacDonald, L; Thomas, C; Syme, A

2016-06-15

Purpose: To develop advanced dynamic collimator positioning algorithms for optimal beam’s-eye-view (BEV) fitting of targets in VMAT procedures, including multiple metastases stereotactic radiosurgery procedures. Methods: A trajectory algorithm was developed, which can dynamically modify the angle of the collimator as a function of VMAT control point to provide optimized collimation of target volume(s). Central to this algorithm is a concept denoted “whitespace”, defined as area within the jaw-defined BEV field, outside of the PTV, and not shielded by the MLC when fit to the PTV. Calculating whitespace at all collimator angles and every control point, a two-dimensional topographical map depictingmore » the tightness-of-fit of the MLC was generated. A variety of novel searching algorithms identified a number of candidate trajectories of continuous collimator motion. Ranking these candidate trajectories according to their accrued whitespace value produced an optimal solution for navigation of this map. Results: All trajectories were normalized to minimum possible (i.e. calculated without consideration of collimator motion constraints) accrued whitespace. On an acoustic neuroma case, a random walk algorithm generated a trajectory with 151% whitespace; random walk including a mandatory anchor point improved this to 148%; gradient search produced a trajectory with 137%; and bi-directional gradient search generated a trajectory with 130% whitespace. For comparison, a fixed collimator angle of 30° and 330° accumulated 272% and 228% of whitespace, respectively. The algorithm was tested on a clinical case with two metastases (single isocentre) and identified collimator angles that allow for simultaneous irradiation of the PTVs while minimizing normal tissue irradiation. Conclusion: Dynamic collimator trajectories have the potential to improve VMAT deliveries through increased efficiency and reduced normal tissue dose, especially in treatment of multiple cranial metastases, without significant safety concerns that hinder immediate clinical implementation.« less

SU-C-BRB-04: Characteristics and Performance Evaluation of the First Commercial MLC for a Robotic Delivery System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fuerweger, C; European Cyberknife Center Munich, Munich, DE; Prins, P

Purpose: To assess characteristics and performance of the “Incise™” MLC (41 leaf pairs, 2.5mm width, FFF linac) mounted on the robotic SRS/SBRT platform “CyberKnife M6™” in a pre-clinical 5 months (11/2014–03/2015) test period. Methods: Beam properties were measured with unshielded diodes and EBT3 film. The CyberKnife workspace for MLC was analyzed by transforming robot node coordinates (cranial / body paths) into Euler geometry. Bayouth tests for leaf / bank position accuracy were performed in standard (A/P) and clinically relevant non-standard positions, before and after exercising the MLC for 10+ minutes. Total system and delivery accuracy were assessed in End-to-End testsmore » and dosimetric verification of exemplary plans. Stability over time was evaluated in Picket-Fence-and adapted Winston-Lutz-tests (AQA) for different collimator angles. Results: Penumbrae (80–20%, with 100%=2*dose at inflection point; SAD 80cm; 10cm depth) parallel / perpendicular to leaf motion were 2.87/2.64mm for the smallest (0×76×0.75cm{sup 2}) and 5.34/4.94mm for the largest (9.76×9.75cm{sup 2}) square field. MLC circular field penumbrae exceeded fixed cones by 10–20% (e.g. 60mm: 4.0 vs. 3.6mm; 20mm: 3.6 vs. 2.9mm). Interleaf leakage was <0.5%. Clinically accessible workspace with MLC covered (non-coplanar) gantry angles of [-113°;+112°] (cranial) and [-108°;+102°] (body), and collimator angles of [-100°;+107°] (cranial) and [-91°;+100°] (body). Average leaf position offsets were ≤0.2mm in 14 standard A/P Bayouth tests and ≤0.6mm in 8 non-standard direction tests. Pre-test MLC exercise increased jaggedness (range ±0.3mm vs. ±0.5mm) and allowed to identify one malfunctioning leaf motor. Total system accuracy with MLC was 0.39±0.06mm in 6 End-to-End tests. Picket-Fence and AQA showed no adverse trends during the test period. Conclusion: The Incise™ MLC for CyberKnife M6™ displayed high accuracy and mechanical stability over the test period. The specific CyberKnife geometry and performance after exercise demand dedicated QA measures. This work is in part funded by a research grant from Accuray Inc, Sunnyvale, USA. Erasmus MC Cancer Institute also has research collaborations with Elekta AB, Stockholm, Sweden. C Fuerweger has previously received speaker honoraria from Accuray Inc, Sunnyvale, USA.« less

Automating linear accelerator quality assurance.

PubMed

Eckhause, Tobias; Al-Hallaq, Hania; Ritter, Timothy; DeMarco, John; Farrey, Karl; Pawlicki, Todd; Kim, Gwe-Ya; Popple, Richard; Sharma, Vijeshwar; Perez, Mario; Park, SungYong; Booth, Jeremy T; Thorwarth, Ryan; Moran, Jean M

2015-10-01

The purpose of this study was 2-fold. One purpose was to develop an automated, streamlined quality assurance (QA) program for use by multiple centers. The second purpose was to evaluate machine performance over time for multiple centers using linear accelerator (Linac) log files and electronic portal images. The authors sought to evaluate variations in Linac performance to establish as a reference for other centers. The authors developed analytical software tools for a QA program using both log files and electronic portal imaging device (EPID) measurements. The first tool is a general analysis tool which can read and visually represent data in the log file. This tool, which can be used to automatically analyze patient treatment or QA log files, examines the files for Linac deviations which exceed thresholds. The second set of tools consists of a test suite of QA fields, a standard phantom, and software to collect information from the log files on deviations from the expected values. The test suite was designed to focus on the mechanical tests of the Linac to include jaw, MLC, and collimator positions during static, IMRT, and volumetric modulated arc therapy delivery. A consortium of eight institutions delivered the test suite at monthly or weekly intervals on each Linac using a standard phantom. The behavior of various components was analyzed for eight TrueBeam Linacs. For the EPID and trajectory log file analysis, all observed deviations which exceeded established thresholds for Linac behavior resulted in a beam hold off. In the absence of an interlock-triggering event, the maximum observed log file deviations between the expected and actual component positions (such as MLC leaves) varied from less than 1% to 26% of published tolerance thresholds. The maximum and standard deviations of the variations due to gantry sag, collimator angle, jaw position, and MLC positions are presented. Gantry sag among Linacs was 0.336 ± 0.072 mm. The standard deviation in MLC position, as determined by EPID measurements, across the consortium was 0.33 mm for IMRT fields. With respect to the log files, the deviations between expected and actual positions for parameters were small (<0.12 mm) for all Linacs. Considering both log files and EPID measurements, all parameters were well within published tolerance values. Variations in collimator angle, MLC position, and gantry sag were also evaluated for all Linacs. The performance of the TrueBeam Linac model was shown to be consistent based on automated analysis of trajectory log files and EPID images acquired during delivery of a standardized test suite. The results can be compared directly to tolerance thresholds. In addition, sharing of results from standard tests across institutions can facilitate the identification of QA process and Linac changes. These reference values are presented along with the standard deviation for common tests so that the test suite can be used by other centers to evaluate their Linac performance against those in this consortium.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Riis, Hans L.; Zimmermann, Sune J.; Hjelm-Hansen, Mogens

Purpose: The delivery of high quality stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) treatments to the patient requires knowledge of the position of the isocenter to submillimeter accuracy. To meet the requirements the deviation between the radiation and mechanical isocenters must be less than 1 mm. The use of add-on micromultileaf collimators ({mu}MLCs) in SRS and SRT is an additional challenge to the anticipated high-level geometric and dosimetric accuracy of the treatment. The aim of this work was to quantify the gantry excursions during rotation with and without an add-on {mu}MLC attached to the gantry head. In addition, the shiftmore » in the position of the isocenter and its correlation to the kV beam center of the cone-beam CT system was included in the study. Methods: The quantification of the gantry rotational performance was done using a pointer supported by an in-house made rigid holder attached to the gantry head of the accelerator. The pointer positions were measured using a digital theodolite. To quantify the effect of an {mu}MLC of 50 kg, the measurements were repeated with the {mu}MLC attached to the gantry head. The displacement of the isocenter due to an add-on {mu}MLC of 50 kg was also investigated. In case of the pointer measurement the {mu}MLC was simulated by weights attached to the gantry head. A method of least squares was applied to determine the position and displacement of the mechanical isocenter. Additionally, the displacement of the radiation isocenter was measured using a ball-bearing phantom and the electronic portal image device system. These measurements were based on 8 MV photon beams irradiated onto the ball from the four cardinal angles and two opposed collimator angles. The measurements and analysis of the data were carried out automatically using software delivered by the manufacturer. Results: The displacement of the mechanical isocenter caused by a 50 kg heavy {mu}MLC was found to be (-0.01 {+-} 0.05, -0.10 {+-} 0.03, -0.26 {+-} 0.05) mm in lateral, longitudinal, and vertical direction, respectively. Similarly, the displacement of the radiation isocenter was found to be (0.00 {+-} 0.03, -0.08 {+-} 0.06, -0.32 {+-} 0.02) mm. Good agreement was found between the displacement of the two isocenters. A displacement of the kV cone-beam CT beam center due to the attached weight of 50 kg could not be detected. Conclusions: General characteristics of the gantry arm excursions and displacements caused by an add-on {mu}MLC have been reported. A 50 kg heavy add-on {mu}MLC results in a isocenter displacement downward of 0.26-0.32 mm. The authors recommend that the beam center of the kV cone-beam CT image system should be matched to the isocenter related to the weight of the {mu}MLC. Consequently, the imperfections in isocenter localizations are transferred to the conventional radiotherapy where the clinical consequences of uncertainties in the submillimeter regime are negligible.« less

Real-time auto-adaptive margin generation for MLC-tracked radiotherapy

NASA Astrophysics Data System (ADS)

Glitzner, M.; Fast, M. F.; de Senneville, B. Denis; Nill, S.; Oelfke, U.; Lagendijk, J. J. W.; Raaymakers, B. W.; Crijns, S. P. M.

2017-01-01

In radiotherapy, abdominal and thoracic sites are candidates for performing motion tracking. With real-time control it is possible to adjust the multileaf collimator (MLC) position to the target position. However, positions are not perfectly matched and position errors arise from system delays and complicated response of the electromechanic MLC system. Although, it is possible to compensate parts of these errors by using predictors, residual errors remain and need to be compensated to retain target coverage. This work presents a method to statistically describe tracking errors and to automatically derive a patient-specific, per-segment margin to compensate the arising underdosage on-line, i.e. during plan delivery. The statistics of the geometric error between intended and actual machine position are derived using kernel density estimators. Subsequently a margin is calculated on-line according to a selected coverage parameter, which determines the amount of accepted underdosage. The margin is then applied onto the actual segment to accommodate the positioning errors in the enlarged segment. The proof-of-concept was tested in an on-line tracking experiment and showed the ability to recover underdosages for two test cases, increasing {{V}90 %} in the underdosed area about 47 % and 41 % , respectively. The used dose model was able to predict the loss of dose due to tracking errors and could be used to infer the necessary margins. The implementation had a running time of 23 ms which is compatible with real-time requirements of MLC tracking systems. The auto-adaptivity to machine and patient characteristics makes the technique a generic yet intuitive candidate to avoid underdosages due to MLC tracking errors.

Technology assessment of multileaf collimation: a North American users survey.

PubMed

Klein, E E; Tepper, J; Sontag, M; Franklin, M; Ling, C; Kubo, D

1999-06-01

The American Association of Physicists in Medicine (AAPM) initiated an Assessment of Technology Subcommittee (ATS) to help the radiotherapy community evaluate emerging technologies. The ATS decided to first address multileaf collimation (MLC) by means of a North American users survey. The survey attempted to address issues such as MLC utility, efficacy, cost-effectiveness, and customer satisfaction. The survey was designed with 38 questions, with cross-tabulation set up to decipher a particular clinic's perception of MLC. The surveys were coded according to MLC types, which were narrowed to four: Elekta, Siemens, Varian 52-leaf, and Varian 80-leaf. A 40% return rate was desired. A 44% (108 of 250) return was achieved. On an MLC machine, 76.5% of photon patients are being treated with MLC. The main reasons for not using MLC were stair stepping, field size limitation, and physician objection. The most common sites in which MLC is being used are lung, pelvis, and prostate. The least used sites are head & neck and mantle fields. Of the facilities, 31% claimed an increase in number of patients being treated since MLC was installed, and 44% claimed an increase in the number of fields. Though the staffing for block cutting has decreased, therapist staffing has not. However, 91% of the facilities claimed a decreased workload for the therapists, despite the increase in daily treated patients and fields. Of the facilities that justified MLC purchase for more daily patients, 63% are actually treating more patients. Only 26% of the facilities that justified an MLC purchase for intensity-modulated radiotherapy (IMRT) are currently using it for that purpose. The satisfaction rating (1 = low to 5 = high) for department groups averaged 4.0. Therapists ranked MLC as 4.6. Our survey shows that most users have successfully introduced MLC into the clinic as a block replacement. Most have found MLC to be cost-effective and efficient. The use of MLC for IMRT has progressed slower, but users anticipate escalated use.

SU-D-201-04: Evaluation of Elekta Agility MLC Performance Using Statistical Process Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Meyers, SM; Balderson, MJ; Letourneau, D

2016-06-15

Purpose: to evaluate the performance and stability of the Elekta Agility MLC model using an automated quality control (QC) test in combination with statistical process control tools. Methods: Leaf positions were collected daily for 11 Elekta units over 5–19 months using the automated QC test, which analyzes 23 MV images to determine the location of MLC leaves relative to the radiation isocenter. The leaf positions are measured at 5 nominal positions, and images are acquired at collimator 0° and 180° to capture all MLC leaves in the field-of-view. Leaf positioning accuracy was assessed using individual and moving range control charts.more » Control limits were recomputed following MLC recalibration (occurred 1–2 times for 4 units). Specification levels of ±0.5, ±1 and ±1.5mm were tested. The mean and range of duration between out-of-control and out-of-specification events were determined. Results: Leaf position varied little over time, as confirmed by very tight individual control limits (mean ±0.19mm, range 0.09–0.44). Mean leaf position error was −0.03mm (range −0.89–0.83). Due to sporadic out-of-control events, the mean in-control duration was 3.3 days (range 1–23). Data stayed within ±1mm specification for 205 days on average (range 3–372) and within ±1.5mm for the entire date range. Measurements stayed within ±0.5mm for 1 day on average (range 0–17); however, our MLC leaves were not calibrated to this level of accuracy. Conclusion: The Elekta Agility MLC model was found to perform with high stability, as evidenced by the tight control limits. The in-specification durations support the current recommendation of monthly MLC QC tests with a ±1mm tolerance. Future work is on-going to determine if Agility performance can be optimized further using high-frequency QC test results to drive recalibration frequency. Factors that can affect leaf positioning accuracy, including beam spot motion, leaf gain calibration, drifting leaves, and image artifacts, are under investigation.« less

Characterization of a commercial multileaf collimator used for intensity modulated radiation therapy.

PubMed

Low, D A; Sohn, J W; Klein, E E; Markman, J; Mutic, S; Dempsey, J F

2001-05-01

The characteristics of a commercial multileaf collimator (MLC) to deliver static and dynamic multileaf collimation (SMLC and DMLC, respectively) were investigated to determine their influence on intensity modulated radiation therapy (IMRT) treatment planning and quality assurance. The influence of MLC leaf positioning accuracy on sequentially abutted SMLC fields was measured by creating abutting fields with selected gaps and overlaps. These data were also used to measure static leaf positioning precision. The characteristics of high leaf-velocity DMLC delivery were measured with constant velocity leaf sequences starting with an open field and closing a single leaf bank. A range of 1-72 monitor units (MU) was used providing a range of leaf velocities. The field abutment measurements yielded dose errors (as a percentage of the open field max dose) of 16.7+/-0.7% mm(-1) and 12.8+/-0.7% mm(-1) for 6 MV and 18 MV photon beams, respectively. The MLC leaf positioning precision was 0.080+/-0.018 mm (single standard deviation) highlighting the excellent delivery hardware tolerances for the tested beam delivery geometry. The high leaf-velocity DMLC measurements showed delivery artifacts when the leaf sequence and selected monitor units caused the linear accelerator to move the leaves at their maximum velocity while modulating the accelerator dose rate to deliver the desired leaf and MU sequence (termed leaf-velocity limited delivery). According to the vendor, a unique feature to their linear accelerator and MLC is that the dose rate is reduced to provide the correct cm MU(-1) leaf velocity when the delivery is leaf-velocity limited. However, it was found that the system delivered roughly 1 MU per pulse when the delivery was leaf-velocity limited causing dose profiles to exhibit discrete steps rather than a smooth dose gradient. The root mean square difference between the steps and desired linear gradient was less than 3% when more than 4 MU were used. The average dose per MU was greater and less than desired for closing and opening leaf patterns, respectively, when the delivery was leaf-velocity limited. The results indicated that the dose delivery artifacts should be minor for most clinical cases, but limit the assumption of dose linearity when significantly reducing the delivered dose for dosimeter characterization studies or QA measurements.

Measurement and Monte Carlo simulation for energy‐ and intensity‐modulated electron radiotherapy delivered by a computer‐controlled electron multileaf collimator

PubMed Central

Eldib, Ahmed; Li, Jinsheng; Emam, Ismail; Fan, Jiajin; Wang, Lu; Ma, C‐M

2014-01-01

The dosimetric advantage of modulated electron radiotherapy (MERT) has been explored by many investigators and is considered to be an advanced radiation therapy technique in the utilization of electrons. A computer‐controlled electron multileaf collimator (MLC) prototype, newly designed to be added onto a Varian linac to deliver MERT, was investigated both experimentally and by Monte Carlo simulations. Four different electron energies, 6, 9, 12, and 15 MeV, were employed for this investigation. To ensure that this device was capable of delivering the electron beams properly, measurements were performed to examine the electron MLC (eMLC) leaf leakage and to determine the appropriate jaw positioning for an eMLC‐shaped field in order to eliminate a secondary radiation peak that could otherwise appear outside of an intended radiation field in the case of inappropriate jaw positioning due to insufficient radiation blockage from the jaws. Phase space data were obtained by Monte Carlo (MC) simulation and recorded at the plane just above the jaws for each of the energies (6, 9, 12, and 15 MeV). As an input source, phase space data were used in MC dose calculations for various sizes of the eMLC shaped field (10×10 cm2, 3.4×3.4 cm2, and 2×2 cm2) with respect to a water phantom at source‐to‐surface distance (SSD)=94cm, while the jaws, eMLC leaves, and some accessories associated with the eMLC assembly as well were modeled as modifiers in the calculations. The calculated results were then compared with measurements from a water scanning system. The results showed that jaw settings with 5 mm margins beyond the field shaped by the eMLC were appropriate to eliminate the secondary radiation peak while not widening the beam penumbra; the eMLC leaf leakage measurements ranged from 0.3% to 1.8% for different energies based on in‐phantom measurements, which should be quite acceptable for MERT. Comparisons between MC dose calculations and measurements showed agreement within 1%/1mm based on percentage depth doses (PDDs) and off‐axis dose profiles for a range of field sizes for each of the electron energies. Our current work has demonstrated that the eMLC and other relevant components in the linac were correctly modeled and simulated via our in‐house MC codes, and the eMLC is capable of accurately delivering electron beams for various eMLC‐shaped field sizes with appropriate jaw settings. In the next stage, patient‐specific verification with a full MERT plan should be performed. PACS number: 87.55.ne PMID:24423848

The dosimetric impact of inversely optimized arc radiotherapy plan modulation for real-time dynamic MLC tracking delivery.

PubMed

Falk, Marianne; Larsson, Tobias; Keall, Paul; Chul Cho, Byung; Aznar, Marianne; Korreman, Stine; Poulsen, Per; Munck Af Rosenschold, Per

2012-03-01

Real-time dynamic multileaf collimator (MLC) tracking for management of intrafraction tumor motion can be challenging for highly modulated beams, as the leaves need to travel far to adjust for target motion perpendicular to the leaf travel direction. The plan modulation can be reduced by using a leaf position constraint (LPC) that reduces the difference in the position of adjacent MLC leaves in the plan. The purpose of this study was to investigate the impact of the LPC on the quality of inversely optimized arc radiotherapy plans and the effect of the MLC motion pattern on the dosimetric accuracy of MLC tracking delivery. Specifically, the possibility of predicting the accuracy of MLC tracking delivery based on the plan modulation was investigated. Inversely optimized arc radiotherapy plans were created on CT-data of three lung cancer patients. For each case, five plans with a single 358° arc were generated with LPC priorities of 0 (no LPC), 0.25, 0.5, 0.75, and 1 (highest possible LPC), respectively. All the plans had a prescribed dose of 2 Gy × 30, used 6 MV, a maximum dose rate of 600 MU/min and a collimator angle of 45° or 315°. To quantify the plan modulation, an average adjacent leaf distance (ALD) was calculated by averaging the mean adjacent leaf distance for each control point. The linear relationship between the plan quality [i.e., the calculated dose distributions and the number of monitor units (MU)] and the LPC was investigated, and the linear regression coefficient as well as a two tailed confidence level of 95% was used in the evaluation. The effect of the plan modulation on the performance of MLC tracking was tested by delivering the plans to a cylindrical diode array phantom moving with sinusoidal motion in the superior-inferior direction with a peak-to-peak displacement of 2 cm and a cycle time of 6 s. The delivery was adjusted to the target motion using MLC tracking, guided in real-time by an infrared optical system. The dosimetric results were evaluated using gamma index evaluation with static target measurements as reference. The plan quality parameters did not depend significantly on the LPC (p ≥ 0.066), whereas the ALD depended significantly on the LPC (p < 0.001). The gamma index failure rate depended significantly on the ALD, weighted to the percentage of the beam delivered in each control point of the plan (ALD(w)) when MLC tracking was used (p < 0.001), but not for delivery without MLC tracking (p ≥ 0.342). The gamma index failure rate with the criteria of 2% and 2 mm was decreased from > 33.9% without MLC tracking to <31.4% (LPC 0) and <2.2% (LPC 1) with MLC tracking. The results indicate that the dosimetric robustness of MLC tracking delivery of an inversely optimized arc radiotherapy plan can be improved by incorporating leaf position constraints in the objective function without otherwise affecting the plan quality. The dosimetric robustness may be estimated prior to delivery by evaluating the ALD(w) of the plan.

Quality assurance of dynamic parameters in volumetric modulated arc therapy

PubMed Central

Manikandan, A; Sarkar, B; Holla, R; Vivek, T R; Sujatha, N

2012-01-01

Objectives The purpose of this study was to demonstrate quality assurance checks for accuracy of gantry speed and position, dose rate and multileaf collimator (MLC) speed and position for a volumetric modulated arc treatment (VMAT) modality (Synergy® S; Elekta, Stockholm, Sweden), and to check that all the necessary variables and parameters were synchronous. Methods Three tests (for gantry position–dose delivery synchronisation, gantry speed–dose delivery synchronisation and MLC leaf speed and positions) were performed. Results The average error in gantry position was 0.5° and the average difference was 3 MU for a linear and a parabolic relationship between gantry position and delivered dose. In the third part of this test (sawtooth variation), the maximum difference was 9.3 MU, with a gantry position difference of 1.2°. In the sweeping field method test, a linear relationship was observed between recorded doses and distance from the central axis, as expected. In the open field method, errors were encountered at the beginning and at the end of the delivery arc, termed the “beginning” and “end” errors. For MLC position verification, the maximum error was −2.46 mm and the mean error was 0.0153 ±0.4668 mm, and 3.4% of leaves analysed showed errors of >±1 mm. Conclusion This experiment demonstrates that the variables and parameters of the Synergy® S are synchronous and that the system is suitable for delivering VMAT using a dynamic MLC. PMID:22745206

SU-E-T-195: Commissioning the Neutron Production of a Varian TrueBeam Linac

DOE Office of Scientific and Technical Information (OSTI.GOV)

Irazola, L; Brualla, L; Rosello, J

2015-06-15

Purpose: The purpose of this work is the characterization of a new Varian TrueBeam™ facility in terms of neutron production, in order to estimate neutron equivalent dose in organs during radiotherapy treatments. Methods: The existing methodology [1] was used with the reference SRAMnd detector, calibrated in terms of thermal neutron fluence at the reference field operated by PTB (Physikalisch-Technische-Bundesanstalt) at the GeNF (Geesthacht-Neutron-Facility) with the GKSS reactor FRG-1 [2]. Thermal neutron fluence for the 5 available possibilities was evaluated: 15 MV and 10&6 MV with and without Flattening Filter (FF and FFF, respectively). Irradiation conditions are as described in [3].more » In addition, three different collimator-MLC configurations were studied for 15 MV: (a) collimator of 10×10 cm{sup 2} and MLC fully retracted (reference), (b) field sizes of 20×20 cm{sup 2} and 10×10 cm{sup 2} for collimator and MLC respectively, and (c) collimator and MLC aperture of 10×10 cm{sup 2}. Results: Thermal fluence rate at the “reference point” [3], as a consequence of the neutron production, obtained for (a) conformation in 15 MV is (1.45±0.11) x10{sup 4} n•cm{sup 2}/MU. Configurations (b) and (c) gave fluences of 96.6% and 97.8% of the reference (a). Neutron production decreases up to 8.6% and 5.7% for the 10 MV FF and FFF beams, respectively. Finally, it decreases up to 2.8% and 0.1% for the 6 MV FF and FFF modes, respectively. Conclusion: This work evaluates thermal neutron production of Varian TrueBeam™ system for organ equivalent dose estimation. The small difference in collimator-MLC configuration shows the universality of the methodology [3]. A decrease in this production is shown when decreasing energy from 15 to 10 MV and an almost negligible production was found for 6 MV. Moreover, a lower neutron contribution is observed for the FFF modes.[1]Phys Med Biol,2012;57:6167–6191.[2]Radiat Meas,2010;45:1513–1517.[3]Med Phys,2015;42:276–281.« less

SU-F-T-230: A Simple Method to Assess Accuracy of Dynamic Wave Arc Irradiation Using An Electronic Portal Imaging Device and Log Files

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hirashima, H; Miyabe, Y; Yokota, K

2016-06-15

Purpose: The Dynamic Wave Arc (DWA) technique, where the multi-leaf collimator (MLC) and gantry/ring move simultaneously in a predefined non-coplanar trajectory, has been developed on the Vero4DRT. The aim of this study is to develop a simple method for quality assurance of DWA delivery using an electronic portal imaging device (EPID) measurements and log files analysis. Methods: The Vero4DRT has an EPID on the beam axis, the resolution of which is 0.18 mm/pixel at the isocenter plane. EPID images were acquired automatically. To verify the detection accuracy of the MLC position by EPID images, the MLC position with intentional errorsmore » was assessed. Tests were designed considering three factors: (1) accuracy of the MLC position (2) dose output consistency with variable dose rate (160–400 MU/min), gantry speed (2.4–6°/s), ring speed (0.5–2.5°/s), and (3) MLC speed (1.6–4.2 cm/s). All the patterns were delivered to the EPID and compared with those obtained with a stationary radiation beam with a 0° gantry angle. The irradiation log, including the MLC position and gantry/ring angle, were recorded simultaneously. To perform independent checks of the machine accuracy, the MLC position and gantry/ring angle position were assessed using log files. Results: 0.1 mm intentional error can be detected by the EPID, which is smaller than the EPID pixel size. The dose outputs with different conditions of the dose rate and gantry/ring speed and MLC speed showed good agreement, with a root mean square (RMS) error of 0.76%. The RMS error between the detected and recorded data were 0.1 mm for the MLC position, 0.12° for the gantry angle, and 0.07° for the ring angle. Conclusion: The MLC position and dose outputs in variable conditions during DWA irradiation can be easily detected using EPID measurements and log file analysis. The proposed method is useful for routine verification. This research is (partially) supported by the Practical Research for Innovative Cancer Control (15Ack0106151h0001) from Japan Agency for Medical Research and development, AMED. Authors Takashi Mizowaki and Masahiro Hiraoka have consultancy agreement with Mitsubishi Heavy Industries, Ltd., Japan.« less

Spatial variation of dosimetric leaf gap and its impact on dose delivery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kumaraswamy, Lalith K., E-mail: Lalith.Kumaraswamy@roswellpark.org; Schmitt, Jonathan D.; Bailey, Daniel W.

Purpose: During dose calculation, the Eclipse treatment planning system (TPS) retracts the multileaf collimator (MLC) leaf positions by half of the dosimetric leaf gap (DLG) value (measured at central axis) for all leaf positions in a dynamic MLC plan to accurately model the rounded leaf ends. The aim of this study is to map the variation of DLG along the travel path of each MLC leaf pair and quantify how this variation impacts delivered dose. Methods: 6 MV DLG values were measured for all MLC leaf pairs in increments of 1.0 cm (from the line intersecting the CAX and perpendicularmore » to MLC motion) to 13.0 cm off axis distance at dmax. The measurements were performed on two Varian linear accelerators, both employing the Millennium 120-leaf MLCs. The measurements were performed at several locations in the beam with both a Sun Nuclear MapCHECK device and a PTW pinpoint ion chamber. Results: The measured DLGs for the middle 40 MLC leaf pairs (each 0.5 cm width) at positions along a line through the CAX and perpendicular to MLC leaf travel direction were very similar, varying maximally by only 0.2 mm. The outer 20 MLC leaf pairs (each 1.0 cm width) have much lower DLG values, about 0.3–0.5 mm lower than the central MLC leaf pair, at their respective central line position. Overall, the mean and the maximum variation between the 0.5 cm width leaves and the 1.0 cm width leaf pairs are 0.32 and 0.65 mm, respectively. Conclusions: The spatial variation in DLG is caused by the variation of intraleaf transmission through MLC leaves. Fluences centered on the CAX would not be affected since DLG does not vary; but any fluences residing significantly off axis with narrow sweeping leaves may exhibit significant dose differences. This is due to the fact that there are differences in DLG between the true DLG exhibited by the 1.0 cm width outer leaves and the constant DLG value utilized by the TPS for dose calculation. Since there are large differences in DLG between the 0.5 cm width leaf pairs and 1.0 cm width leaf pairs, there is a need to correct the TPS plans, especially those with high modulation (narrow dynamic MLC gap), with 2D variation of DLG.« less

Feasibility of using the linac real-time log data for VMAT treatment verification

NASA Astrophysics Data System (ADS)

Midi, N. S.; Zin, Hafiz M.

2017-05-01

This study investigates the feasibility of using the real-time log data from a linac to verify Volumetric Modulated Arc Therapy (VMAT) treatment. The treatment log data for an Elekta Synergy linac can be recorded at a sampling rate of 4 Hz using the service graphing tool on the linac control computer. A treatment plan that simulates a VMAT treatment was delivered from the linac and all the dynamic treatment parameters including monitor unit (MU), Multileaf Collimator (MLC) position, jaw position, gantry angle and collimator angle were recorded in real-time using the service graphing tool. The recorded raw data were extracted and analysed using algorithms written in Matlab (MathWorks, Natick, MA). The actual treatment parameters logged using the service graphing tool was compared to the prescription and the deviations were analysed. The MLC position errors travelling at the speed range from -3.25 to 5.92 cm/s were between -1.7 mm to 2.5 mm, well within the 3.5 mm tolerance value (AAPM TG-142). The discrepancies of other delivery parameters were also within the tolerance. The real-time linac parameters logged using the service graphing tool can be used as a supplementary data for patient specific VMAT pre-treatment quality assurance.

SU-E-T-515: Field-In-Field Compensation Technique Using Multi-Leaf Collimator to Deliver Total Body Irradiation (TBI) Dose

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lakeman, T; Wang, IZ; Roswell Park Cancer Institute, Buffalo, NY

Purpose: Total body irradiation (TBI) uses large parallel-opposed radiation fields to suppress the patient's immune system and eradicate the residual cancer cells in preparation of recipient for bone marrow transplant. The manual placement of lead compensators has been used conventionally to compensate for the varying thickness through the entire body in large-field TBI. The goal of this study is to pursue utilizing the modern field-in-field (FIF) technique with the multi-leaf collimator (MLC) to more accurately and efficiently deliver dose to patients in need of TBI. Method: Treatment plans utilizing the FIF technique to deliver a total body dose were createdmore » retrospectively for patients for whom CT data had been previously acquired. Treatment fields include one pair of opposed open large fields (collimator=45°) with a specific weighting and a succession of smaller fields (collimator=90°) each with their own weighting. The smaller fields are shaped by moving MLC to block the sections of the patient which have already received close to 100% of the prescribed dose. The weighting factors for each of these fields were calculated using the attenuation coefficient of the initial lead compensators and the separation of the patient in different positions in the axial plane. Results: Dose-volume histograms (DVH) were calculated for evaluating the FIF compensation technique. The maximum body doses calculated from the DVH were reduced from the non-compensated 179.3% to 148.2% in the FIF plans, indicating a more uniform dose with the FIF compensation. All calculated monitor units were well within clinically acceptable limits and exceeded those of the original lead compensation plan by less than 50 MU (only ~1.1% increase). Conclusion: MLC FIF technique for TBI will not significantly increase the beam on time while it can substantially reduce the compensator setup time and the potential risk of errors in manually placing lead compensators.« less

SU-F-P-36: Automation of Linear Accelerator Star Shot Measurement with Advanced XML Scripting and Electronic Portal Imaging Device

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nguyen, N; Knutson, N; Schmidt, M

Purpose: To verify a method used to automatically acquire jaw, MLC, collimator and couch star shots for a Varian TrueBeam linear accelerator utilizing Developer Mode and an Electronic Portal Imaging Device (EPID). Methods: An XML script was written to automate motion of the jaws, MLC, collimator and couch in TrueBeam Developer Mode (TBDM) to acquire star shot measurements. The XML script also dictates MV imaging parameters to facilitate automatic acquisition and recording of integrated EPID images. Since couch star shot measurements cannot be acquired using a combination of EPID and jaw/MLC collimation alone due to a fixed imager geometry, amore » method utilizing a 5mm wide steel ruler placed on the table and centered within a 15×15cm2 open field to produce a surrogate of the narrow field aperture was investigated. Four individual star shot measurements (X jaw, Y jaw, MLC and couch) were obtained using our proposed as well as traditional film-based method. Integrated EPID images and scanned measurement films were analyzed and compared. Results: Star shot (X jaw, Y jaw, MLC and couch) measurements were obtained in a single 5 minute delivery using the TBDM XML script method compared to 60 minutes for equivalent traditional film measurements. Analysis of the images and films demonstrated comparable isocentricity results, agreeing within 0.3mm of each other. Conclusion: The presented automatic approach of acquiring star shot measurements using TBDM and EPID has proven to be more efficient than the traditional film approach with equivalent results.« less

SU-F-T-459: ArcCHECK Machine QA : Highly Efficient Quality Assurance Tool for VMAT, SRS & SBRT Linear Accelerator Delivery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mhatre, V; Patwe, P; Dandekar, P

Purpose: Quality assurance (QA) of complex linear accelerators is critical and highly time consuming. ArcCHECK Machine QA tool is used to test geometric and delivery aspects of linear accelerator. In this study we evaluated the performance of this tool. Methods: Machine QA feature allows user to perform quality assurance tests using ArcCHECK phantom. Following tests were performed 1) Gantry Speed 2) Gantry Rotation 3) Gantry Angle 4)MLC/Collimator QA 5)Beam Profile Flatness & Symmetry. Data was collected on trueBEAM stX machine for 6 MV for a period of one year. The Gantry QA test allows to view errors in gantry angle,more » rotation & assess how accurately the gantry moves around the isocentre. The MLC/Collimator QA tool is used to analyze & locate the differences between leaf bank & jaw position of linac. The flatness & Symmetry test quantifies beam flatness & symmetry in IEC-y & x direction. The Gantry & Flatness/Symmetry test can be performed for static & dynamic delivery. Results: The Gantry speed was 3.9 deg/sec with speed maximum deviation around 0.3 deg/sec. The Gantry Isocentre for arc delivery was 0.9mm & static delivery was 0.4mm. The maximum percent positive & negative difference was found to be 1.9 % & – 0.25 % & maximum distance positive & negative diff was 0.4mm & – 0.3 mm for MLC/Collimator QA. The Flatness for Arc delivery was 1.8 % & Symmetry for Y was 0.8 % & X was 1.8 %. The Flatness for gantry 0°,270°,90° & 180° was 1.75,1.9,1.8 & 1.6% respectively & Symmetry for X & Y was 0.8,0.6% for 0°, 0.6,0.7% for 270°, 0.6,1% for 90° & 0.6,0.7% for 180°. Conclusion: ArcCHECK Machine QA is an useful tool for QA of Modern linear accelerators as it tests both geometric & delivery aspects. This is very important for VMAT, SRS & SBRT treatments.« less

TH-AB-BRA-01: A Novel Doubly-Focused Multileaf Collimator Design for MR-Guided Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, H; Mutic, S; Green, O

2016-06-15

Purpose: To describe the physical and dosimetric properties of a novel double-stack multileaf collimator (MLC). Methods: One of the compromises made in the MLC design has been to employ linear-motion singly-divergent shapes. Because the MLC leading edge moves linearly, it is rounded to provide a consistent, albeit compromised penumbra. The MLC employed in the new linac-based MR-IGRT unit is designed to be doubly focused in that each leaf moves in an arc centered at the source, and the sides of the leaves are machined such that they lie parallel to a line between the leaf edge and the source. Themore » curvature of the MLC keeps motors and encoders in lower magnetic field. However, high spatial-resolution leaves are difficult to manufacture to sufficiently tight tolerances and difficult to move due to restricted space on the gantry. Wider leaves alleviate this problem with less moving parts but the coarse resolution disallows treating very small lesions. This compromise has been overcome by splitting the MLC leaf bank into two sets, stacked one upon the other and offset half of a leaf width. The dosimetry has been simulated using Monte-Carlo and a 6 MV linac in a 0.35 T magnetic field. Results: The combined MLC leaf set has a spatial resolution of effectively half of the leaf width, 4mm here. The dosimetry resolution and conformality are consistent with 4mm wide MLC assisted by inverse fluence modulation. Also, because each leaf junction is backed up by the stacked leaf that lies over the junction, the problem of tongue-and-groove dosimetry has been greatly reduced. The novel MLC design allows the use of more powerful leaf motors than would be otherwise possible if a single MLC bank is employed. Conclusions: The stacked MLC will provide highly conformal dose distributions suitable for stereotactic radiation therapy of small lesions. The research was funded by ViewRay, Inc.« less

Design considerations for a computer controlled multileaf collimator for the Harper Hospital fast neutron therapy facility.

PubMed

Maughan, Richard L; Yudelev, Mark; Aref, Amr; Chuba, Paul J; Forman, Jeffrey; Blosser, Emanuel J; Horste, Timothy

2002-04-01

The d(48.5) + Be neutron beam from the Harper Hospital superconducting cyclotron is collimated using a unique multirod collimator (MRC). A computer controlled multileaf collimator (MLC) is being designed to improve efficiency and allow for the future development of intensity modulated radiation therapy with neutrons. For the current study the use of focused or unfocused collimator leaves has been studied. Since the engineering effort associated with the leaf design and materials choice impacts significantly on cost, it was desirable to determine the clinical impact of using unfocused leaves in the MLC design. The MRC is a useful tool for studying the effects of using focused versus unfocused beams on beam penumbra. The effects of the penumbra for the different leaf designs on tumor and normal tissue DVHs in two selected sites (prostate and head and neck) was investigated. The increase in the penumbra resulting from using unfocused beams was small (approximately 1.5 mm for a 5 x 5 cm2 field and approximately 7.6 mm for a 25 x 25 cm2 field at 10 cm depth) compared to the contribution of phantom scatter to the penumbra width (5.4 and 20 mm for the small and large fields at 10 cm depth, respectively). Comparison of DVHs for tumor and critical normal tissue in a prostate and head and neck case showed that the dosimetric disadvantages of using an unfocused rather than focused beam were minimal and only significant at shallow depths. For the rare cases, where optimum penumbra conditions are required, a MLC incorporating tapered leaves and, thus, providing focused collimation in one plane is necessary.

Quantitative measurement of MLC leaf displacements using an electronic portal image device

NASA Astrophysics Data System (ADS)

Yang, Yong; Xing, Lei

2004-04-01

The success of an IMRT treatment relies on the positioning accuracy of the MLC (multileaf collimator) leaves for both step-and-shoot and dynamic deliveries. In practice, however, there exists no effective and quantitative means for routine MLC QA and this has become one of the bottleneck problems in IMRT implementation. In this work we present an electronic portal image device (EPID) based method for fast and accurate measurement of MLC leaf positions at arbitrary locations within the 40 cm × 40 cm radiation field. The new technique utilizes the fact that the integral signal in a small region of interest (ROI) is a sensitive and reliable indicator of the leaf displacement. In this approach, the integral signal at a ROI was expressed as a weighted sum of the contributions from the displacements of the leaf above the point and the adjacent leaves. The weighting factors or linear coefficients of the system equations were determined by fitting the integral signal data for a group of pre-designed MLC leaf sequences to the known leaf displacements that were intentionally introduced during the creation of the leaf sequences. Once the calibration is done, the system can be used for routine MLC leaf positioning QA to detect possible leaf errors. A series of tests was carried out to examine the functionality and accuracy of the technique. Our results show that the proposed technique is potentially superior to the conventional edge-detecting approach in two aspects: (i) it deals with the problem in a systematic approach and allows us to take into account the influence of the adjacent MLC leaves effectively; and (ii) it may improve the signal-to-noise ratio and is thus capable of quantitatively measuring extremely small leaf positional displacements. Our results indicate that the technique can detect a leaf positional error as small as 0.1 mm at an arbitrary point within the field in the absence of EPID set-up error and 0.3 mm when the uncertainty is considered. Given its simplicity, efficiency and accuracy, we believe that the technique is ideally suitable for routine MLC leaf positioning QA. This work was presented at the 45th Annual Meeting of American Society of Therapeutic Radiology and Oncology (ASTRO), Salt Lake City, UT, 2003. A US Patent is pending (application no. 10/197,232).

SU-E-T-467: Implementation of Monte Carlo Dose Calculation for a Multileaf Collimator Equipped Robotic Radiotherapy System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, JS; Fan, J; Ma, C-M

Purpose: To improve the treatment efficiency and capabilities for full-body treatment, a robotic radiosurgery system has equipped with a multileaf collimator (MLC) to extend its accuracy and precision to radiation therapy. To model the MLC and include it in the Monte Carlo patient dose calculation is the goal of this work. Methods: The radiation source and the MLC were carefully modeled to consider the effects of the source size, collimator scattering, leaf transmission and leaf end shape. A source model was built based on the output factors, percentage depth dose curves and lateral dose profiles measured in a water phantom.more » MLC leaf shape, leaf end design and leaf tilt for minimizing the interleaf leakage and their effects on beam fluence and energy spectrum were all considered in the calculation. Transmission/leakage was added to the fluence based on the transmission factors of the leaf and the leaf end. The transmitted photon energy was tuned to consider the beam hardening effects. The calculated results with the Monte Carlo implementation was compared with measurements in homogeneous water phantom and inhomogeneous phantoms with slab lung or bone material for 4 square fields and 9 irregularly shaped fields. Results: The calculated output factors are compared with the measured ones and the difference is within 1% for different field sizes. The calculated dose distributions in the phantoms show good agreement with measurements using diode detector and films. The dose difference is within 2% inside the field and the distance to agreement is within 2mm in the penumbra region. The gamma passing rate is more than 95% with 2%/2mm criteria for all the test cases. Conclusion: Implementation of Monte Carlo dose calculation for a MLC equipped robotic radiosurgery system is completed successfully. The accuracy of Monte Carlo dose calculation with MLC is clinically acceptable. This work was supported by Accuray Inc.« less

SU-D-201-01: A Multi-Institutional Study Quantifying the Impact of Simulated Linear Accelerator VMAT Errors for Nasopharynx

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pogson, E; Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW; Ingham Institute for Applied Medical Research, Sydney, NSW

Purpose: To quantify the impact of differing magnitudes of simulated linear accelerator errors on the dose to the target volume and organs at risk for nasopharynx VMAT. Methods: Ten nasopharynx cancer patients were retrospectively replanned twice with one full arc VMAT by two institutions. Treatment uncertainties (gantry angle and collimator in degrees, MLC field size and MLC shifts in mm) were introduced into these plans at increments of 5,2,1,−1,−2 and −5. This was completed using an in-house Python script within Pinnacle3 and analysed using 3DVH and MatLab. The mean and maximum dose were calculated for the Planning Target Volume (PTV1),more » parotids, brainstem, and spinal cord and then compared to the original baseline plan. The D1cc was also calculated for the spinal cord and brainstem. Patient average results were compared across institutions. Results: Introduced gantry angle errors had the smallest effect of dose, no tolerances were exceeded for one institution, and the second institutions VMAT plans were only exceeded for gantry angle of ±5° affecting different sided parotids by 14–18%. PTV1, brainstem and spinal cord tolerances were exceeded for collimator angles of ±5 degrees, MLC shifts and MLC field sizes of ±1 and beyond, at the first institution. At the second institution, sensitivity to errors was marginally higher for some errors including the collimator error producing doses exceeding tolerances above ±2 degrees, and marginally lower with tolerances exceeded above MLC shifts of ±2. The largest differences occur with MLC field sizes, with both institutions reporting exceeded tolerances, for all introduced errors (±1 and beyond). Conclusion: The plan robustness for VMAT nasopharynx plans has been demonstrated. Gantry errors have the least impact on patient doses, however MLC field sizes exceed tolerances even with relatively low introduced errors and also produce the largest errors. This was consistent across both departments. The authors acknowledge funding support from the NSW Cancer Council.« less

SU-E-T-331: Dosimetric Impact of Multileaf Collimator Leaf Width On Stereotactic Radiosurgery (SRS) RapidArc Treatment Plans for Single and Multiple Brain Metastases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hossain, S; Keeling, V; Ahmad, S

Purpose: To determine the effects of multileaf collimator (MLC) leaf width on normal-brain-tissue doses and dose conformity of SRS RapidArc treatment plans for brain tumors. Methods: Ten patients with 24 intracranial tumors (seven with 1–2 and three with 4–6 lesions) were planned using RapidArc for both Varian Millennium 120 MLC (5 mm leaf width) and high definition (HD) MLC (2.5 mm leaf width). Between 2 and 8 arcs were used with two full coplanar arcs and the rest non-coplanar half arcs. 6 MV beams were used and plans were optimized with a high priority to the Normal Tissue Objective (tomore » achieve dose conformity and sharp dose fall-off) and normal brain tissue. Calculation was done using AAA on a 1 mm grid size. The prescription dose ranged from 14–22 Gy. Plans were normalized such that 99% of the target received the prescription dose. Identical beam geometries, optimizations, calculations, and normalizations were used for both plans. Paddick Conformity Index (PCI), V4, V8 and V12 Gy for normal brain tissue and Integral Dose were used for analysis. Results: In all cases, HD MLC plans performed better in sparing normal brain tissue, achieving a higher PCI with a lower Integral Dose. The average PCI for all 24 targets was 0.75±0.23 and 0.70±0.23 (p ≤0.0015) for HD MLC and Millennium MLC plans, respectively. The average ratio of normal brain doses for Millennium MLC to HD MLC plans was 1.30±0.16, 1.27±0.15, and 1.31±0.18 for the V4, V8, and V12, respectively. The differences in normal brain dose for all criteria were statistically significant with p-value < 0.02. On average Millennium MLC plans had a 16% higher integral dose than HD MLC plans. Conclusion: Significantly better dose conformity with reduced volume of normal brain tissue and integral dose was achieved with HD MLC plans compared to Millennium MLC plans.« less

Diode‐based transmission detector for IMRT delivery monitoring: a validation study

PubMed Central

Li, Taoran; Wu, Q. Jackie; Matzen, Thomas; Yin, Fang‐Fang

2016-01-01

The purpose of this work was to evaluate the potential of a new transmission detector for real‐time quality assurance of dynamic‐MLC‐based radiotherapy. The accuracy of detecting dose variation and static/dynamic MLC position deviations was measured, as well as the impact of the device on the radiation field (surface dose, transmission). Measured dose variations agreed with the known variations within 0.3%. The measurement of static and dynamic MLC position deviations matched the known deviations with high accuracy (0.7–1.2 mm). The absorption of the device was minimal (∼ 1%). The increased surface dose was small (1%–9%) but, when added to existing collimator scatter effects could become significant at large field sizes (≥30×30 cm2). Overall the accuracy and speed of the device show good potential for real‐time quality assurance. PACS number(s): 87.55.Qr PMID:27685115

TU-FG-201-04: Computer Vision in Autonomous Quality Assurance of Linear Accelerators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, H; Jenkins, C; Yu, S

Purpose: Routine quality assurance (QA) of linear accelerators represents a critical and costly element of a radiation oncology center. Recently, a system was developed to autonomously perform routine quality assurance on linear accelerators. The purpose of this work is to extend this system and contribute computer vision techniques for obtaining quantitative measurements for a monthly multi-leaf collimator (MLC) QA test specified by TG-142, namely leaf position accuracy, and demonstrate extensibility for additional routines. Methods: Grayscale images of a picket fence delivery on a radioluminescent phosphor coated phantom are captured using a CMOS camera. Collected images are processed to correct formore » camera distortions, rotation and alignment, reduce noise, and enhance contrast. The location of each MLC leaf is determined through logistic fitting and a priori modeling based on knowledge of the delivered beams. Using the data collected and the criteria from TG-142, a decision is made on whether or not the leaf position accuracy of the MLC passes or fails. Results: The locations of all MLC leaf edges are found for three different picket fence images in a picket fence routine to 0.1mm/1pixel precision. The program to correct for image alignment and determination of leaf positions requires a runtime of 21– 25 seconds for a single picket, and 44 – 46 seconds for a group of three pickets on a standard workstation CPU, 2.2 GHz Intel Core i7. Conclusion: MLC leaf edges were successfully found using techniques in computer vision. With the addition of computer vision techniques to the previously described autonomous QA system, the system is able to quickly perform complete QA routines with minimal human contribution.« less

Dose calculation of dynamic trajectory radiotherapy using Monte Carlo.

PubMed

Manser, P; Frauchiger, D; Frei, D; Volken, W; Terribilini, D; Fix, M K

2018-04-06

Using volumetric modulated arc therapy (VMAT) delivery technique gantry position, multi-leaf collimator (MLC) as well as dose rate change dynamically during the application. However, additional components can be dynamically altered throughout the dose delivery such as the collimator or the couch. Thus, the degrees of freedom increase allowing almost arbitrary dynamic trajectories for the beam. While the dose delivery of such dynamic trajectories for linear accelerators is technically possible, there is currently no dose calculation and validation tool available. Thus, the aim of this work is to develop a dose calculation and verification tool for dynamic trajectories using Monte Carlo (MC) methods. The dose calculation for dynamic trajectories is implemented in the previously developed Swiss Monte Carlo Plan (SMCP). SMCP interfaces the treatment planning system Eclipse with a MC dose calculation algorithm and is already able to handle dynamic MLC and gantry rotations. Hence, the additional dynamic components, namely the collimator and the couch, are described similarly to the dynamic MLC by defining data pairs of positions of the dynamic component and the corresponding MU-fractions. For validation purposes, measurements are performed with the Delta4 phantom and film measurements using the developer mode on a TrueBeam linear accelerator. These measured dose distributions are then compared with the corresponding calculations using SMCP. First, simple academic cases applying one-dimensional movements are investigated and second, more complex dynamic trajectories with several simultaneously moving components are compared considering academic cases as well as a clinically motivated prostate case. The dose calculation for dynamic trajectories is successfully implemented into SMCP. The comparisons between the measured and calculated dose distributions for the simple as well as for the more complex situations show an agreement which is generally within 3% of the maximum dose or 3mm. The required computation time for the dose calculation remains the same when the additional dynamic moving components are included. The results obtained for the dose comparisons for simple and complex situations suggest that the extended SMCP is an accurate dose calculation and efficient verification tool for dynamic trajectory radiotherapy. This work was supported by Varian Medical Systems. Copyright © 2018. Published by Elsevier GmbH.

Poster - Thur Eve - 10: Long term stability of VMAT quality assurance parameters using an EPID.

PubMed

Pekar, J; Diamond, K R

2012-07-01

The rapidly growing use of volumetric modulated arc therapy (VMAT) treatments in radiation therapy calls for a quantitative, automated, and reliable quality assurance (QA) procedure that can be used routinely in the clinical setting. In this work, we present a series VMAT QA procedures used to assess dynamic multi-leaf collimator (MLC) positional accuracy, variable dose-rate accuracy, and MLC leaf speed accuracy. The QA procedures were performed using amorphous silicon electronic portal imaging devices (EPID) to determine the long term stability of the measured parameters on two Varian linear accelerators. The measurements were repeated weekly on both linear accelerators for a period of three months and the EPID images were analyzed using custom Matlab software. The results of the picket fence tests indicate that MLC leaf positions can be identified to within 0.11 mm and 0.15 mm for static gantry delivery and VMAT delivery respectively. In addition, the dose-rate, gantry speed and MLC leaf speed tests both show very good stability over the measurement period. The measurements thus far, suggest that a number of the dosimetry tests may be suitable for quarterly QA for Varian iX and Trilogy linacs. However, additional measurements are required to confirm the frequency with which each test is required for safe and reliable VMAT delivery at our centre. © 2012 American Association of Physicists in Medicine.

Two-argument total scatter factor for small fields simultaneously collimated by MLC and jaws: application to stereotactic radiosurgery and radiotherapy

NASA Astrophysics Data System (ADS)

Han, Zhaohui; Friesen, Scott; Hacker, Fred; Zygmanski, Piotr

2018-01-01

Direct use of the total scatter factor (S tot) for independent monitor unit (MU) calculations can be a good alternative approach to the traditional separate treatment of head/collimator scatter (S c) and phantom scatter (S p), especially for stereotactic small fields under the simultaneous collimation of secondary jaws and tertiary multileaf collimators (MLC). We have carried out the measurement of S tot in water for field sizes down to 0.5  ×  0.5 cm2 on a Varian TrueBeam STx medical linear accelerator (linac) equipped with high definition MLCs. Both the jaw field size (c) and MLC field size (s) significantly impact the linac output factors, especially when c \\gg s and s is small (e.g. s  <  5 cm). The combined influence of MLC and jaws gives rise to a two-argument dependence of the total scatter factor, S tot(c,s), which is difficult to functionally decouple. The (c,s) dependence can be conceived as a set of s-dependent functions (‘branches’) defined on domain [s min, s max  =  c] for a given jaw size of c. We have also developed a heuristic model of S tot to assist the clinical implementation of the measured S tot data for small field dosimetry. The model has two components: (i) empirical fit formula for the s-dependent branches and (ii) interpolation scheme between the branches. The interpolation scheme preserves the characteristic shape of the measured branches and effectively transforms the measured trapezoidal domain in (c,s) plane to a rectangular domain to facilitate easier two-dimensional interpolation to determine S tot for arbitrary (c,s) combinations. Both the empirical fit and interpolation showed good agreement with experimental validation data.

Investigation of the feasibility of a simple method for verifying the motion of a binary multileaf collimator synchronized with the rotation of the gantry for helical tomotherapy

PubMed Central

Uematsu, Masahiro; Ito, Makiko; Hama, Yukihiro; Inomata, Takayuki; Fujii, Masahiro; Nishio, Teiji; Nakamura, Naoki; Nakagawa, Keiichi

2012-01-01

In this paper, we suggest a new method for verifying the motion of a binary multileaf collimator (MLC) in helical tomotherapy. For this we used a combination of a cylindrical scintillator and a general‐purpose camcorder. The camcorder records the light from the scintillator following photon irradiation, which we use to track the motion of the binary MLC. The purpose of this study is to demonstrate the feasibility of this method as a binary MLC quality assurance (QA) tool. First, the verification was performed using a simple binary MLC pattern with a constant leaf open time; secondly, verification using the binary MLC pattern used in a clinical setting was also performed. Sinograms of simple binary MLC patterns, in which leaves that were open were detected as “open” from the measured light, define the sensitivity which, in this case, was 1.000. On the other hand, the specificity, which gives the fraction of closed leaves detected as “closed”, was 0.919. The leaf open error identified by our method was −1.3±7.5%. The 68.6% of observed leaves were performed within ± 3% relative error. The leaf open error was expressed by the relative errors calculated on the sinogram. In the clinical binary MLC pattern, the sensitivity and specificity were 0.994 and 0.997, respectively. The measurement could be performed with −3.4±8.0% leaf open error. The 77.5% of observed leaves were performed within ± 3% relative error. With this method, we can easily verify the motion of the binary MLC, and the measurement unit developed was found to be an effective QA tool. PACS numbers: 87.56.Fc, 87.56.nk PMID:22231222

SU-F-BRB-12: A Novel Haar Wavelet Based Approach to Deliver Non-Coplanar Intensity Modulated Radiotherapy Using Sparse Orthogonal Collimators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nguyen, D; Ruan, D; Low, D

2015-06-15

Purpose: Existing efforts to replace complex multileaf collimator (MLC) by simple jaws for intensity modulated radiation therapy (IMRT) resulted in unacceptable compromise in plan quality and delivery efficiency. We introduce a novel fluence map segmentation method based on compressed sensing for plan delivery using a simplified sparse orthogonal collimator (SOC) on the 4π non-coplanar radiotherapy platform. Methods: 4π plans with varying prescription doses were first created by automatically selecting and optimizing 20 non-coplanar beams for 2 GBM, 2 head & neck, and 2 lung patients. To create deliverable 4π plans using SOC, which are two pairs of orthogonal collimators withmore » 1 to 4 leaves in each collimator bank, a Haar Fluence Optimization (HFO) method was used to regulate the number of Haar wavelet coefficients while maximizing the dose fidelity to the ideal prescription. The plans were directly stratified utilizing the optimized Haar wavelet rectangular basis. A matching number of deliverable segments were stratified for the MLC-based plans. Results: Compared to the MLC-based 4π plans, the SOC-based 4π plans increased the average PTV dose homogeneity from 0.811 to 0.913. PTV D98 and D99 were improved by 3.53% and 5.60% of the corresponding prescription doses. The average mean and maximal OAR doses slightly increased by 0.57% and 2.57% of the prescription doses. The average number of segments ranged between 5 and 30 per beam. The collimator travel time to create the segments decreased with increasing leaf numbers in the SOC. The two and four leaf designs were 1.71 and 1.93 times more efficient, on average, than the single leaf design. Conclusion: The innovative dose domain optimization based on compressed sensing enables uncompromised 4π non-coplanar IMRT dose delivery using simple rectangular segments that are deliverable using a sparse orthogonal collimator, which only requires 8 to 16 leaves yet is unlimited in modulation resolution. This work is supported in part by Varian Medical Systems, Inc. and NIH R43 CA18339.« less

Determination of the optimal tolerance for MLC positioning in sliding window and VMAT techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hernandez, V., E-mail: vhernandezmasgrau@gmail.com; Abella, R.; Calvo, J. F.

2015-04-15

Purpose: Several authors have recommended a 2 mm tolerance for multileaf collimator (MLC) positioning in sliding window treatments. In volumetric modulated arc therapy (VMAT) treatments, however, the optimal tolerance for MLC positioning remains unknown. In this paper, the authors present the results of a multicenter study to determine the optimal tolerance for both techniques. Methods: The procedure used is based on dynalog file analysis. The study was carried out using seven Varian linear accelerators from five different centers. Dynalogs were collected from over 100 000 clinical treatments and in-house software was used to compute the number of tolerance faults as amore » function of the user-defined tolerance. Thus, the optimal value for this tolerance, defined as the lowest achievable value, was investigated. Results: Dynalog files accurately predict the number of tolerance faults as a function of the tolerance value, especially for low fault incidences. All MLCs behaved similarly and the Millennium120 and the HD120 models yielded comparable results. In sliding window techniques, the number of beams with an incidence of hold-offs >1% rapidly decreases for a tolerance of 1.5 mm. In VMAT techniques, the number of tolerance faults sharply drops for tolerances around 2 mm. For a tolerance of 2.5 mm, less than 0.1% of the VMAT arcs presented tolerance faults. Conclusions: Dynalog analysis provides a feasible method for investigating the optimal tolerance for MLC positioning in dynamic fields. In sliding window treatments, the tolerance of 2 mm was found to be adequate, although it can be reduced to 1.5 mm. In VMAT treatments, the typically used 5 mm tolerance is excessively high. Instead, a tolerance of 2.5 mm is recommended.« less

VMAT testing for an Elekta accelerator

PubMed Central

Sweeney, Larry E.; Marshall, Edward I.; Mahendra, Saikanth

2012-01-01

Volumetric‐modulated arc therapy (VMAT) has been shown to be able to deliver plans equivalent to intensity‐modulated radiation therapy (IMRT) in a fraction of the treatment time. This improvement is important for patient immobilization/ localization compliance due to comfort and treatment duration, as well as patient throughput. Previous authors have suggested commissioning methods for this modality. Here, we extend the methods reported for the Varian RapidArc system (which tested individual system components) to the Elekta linear accelerator, using custom files built using the Elekta iComCAT software. We also extend the method reported for VMAT commissioning of the Elekta accelerator by verifying maximum values of parameters (gantry speed, multileaf collimator (MLC) speed, and backup jaw speed), investigating: 1) beam profiles as a function of dose rate during an arc, 2) over/under dosing due to MLC reversals, and 3) over/under dosing at changing dose rate junctions. Equations for construction of the iComCAT files are given. Results indicate that the beam profile for lower dose rates varies less than 3% from that of the maximum dose rate, with no difference during an arc. The gantry, MLC, and backup jaw maximum speed are internally consistent. The monitor unit chamber is stable over the MUs and gantry movement conditions expected. MLC movement and position during VMAT delivery are within IMRT tolerances. Dose rate, gantry speed, and MLC speed are accurately controlled. Over/under dosing at junctions of MLC reversals or dose rate changes are within clinical acceptability. PACS numbers: 87.55.de, 87.55.Qr, 87.56.bd PMID:22402389

Pitfalls of tungsten multileaf collimator in proton beam therapy.

PubMed

Moskvin, Vadim; Cheng, Chee-Wai; Das, Indra J

2011-12-01

Particle beam therapy is associated with significant startup and operational cost. Multileaf collimator (MLC) provides an attractive option to improve the efficiency and reduce the treatment cost. A direct transfer of the MLC technology from external beam radiation therapy is intuitively straightforward to proton therapy. However, activation, neutron production, and the associated secondary cancer risk in proton beam should be an important consideration which is evaluated. Monte Carlo simulation with FLUKA particle transport code was applied in this study for a number of treatment models. The authors have performed a detailed study of the neutron generation, ambient dose equivalent [H∗(10)], and activation of a typical tungsten MLC and compared with those obtained from a brass aperture used in a typical proton therapy system. Brass aperture and tungsten MLC were modeled by absorber blocks in this study, representing worst-case scenario of a fully closed collimator. With a tungsten MLC, the secondary neutron dose to the patient is at least 1.5 times higher than that from a brass aperture. The H∗(10) from a tungsten MLC at 10 cm downstream is about 22.3 mSv/Gy delivered to water phantom by noncollimated 200 MeV beam of 20 cm diameter compared to 14 mSv/Gy for the brass aperture. For a 30-fraction treatment course, the activity per unit volume in brass aperture reaches 5.3 × 10⁴ Bq cm(-3) at the end of the last treatment. The activity in brass decreases by a factor of 380 after 24 h, additional 6.2 times after 40 days of cooling, and is reduced to background level after 1 yr. Initial activity in tungsten after 30 days of treating 30 patients per day is about 3.4 times higher than in brass that decreases only by a factor of 2 after 40 days and accumulates to 1.2 × 10⁶ Bq cm(-3) after a full year of operation. The daily utilization of the MLC leads to buildup of activity with time. The overall activity continues to increase due to (179)Ta with a half-life of 1.82 yr and thus require prolonged storage for activity cooling. The H∗(10) near the patient side of the tungsten block is about 100 μSv/h and is 27 times higher at the upstream side of the block. This would lead to an accumulated dose for therapists in a year that may exceed occupational maximum permissible dose (50 mSv/yr). The value of H∗(10) at the upstream surface of the tungsten block is about 220 times higher than that of the brass. MLC is an efficient way for beam shaping and overall cost reduction device in proton therapy. However, based on this study, tungsten seems to be not an optimal material for MLC in proton beam therapy. Usage of tungsten MLC in clinic may create unnecessary risks associated with the secondary neutrons and induced radioactivity for patients and staff depending on the patient load. A careful selection of material for manufacturing of an optimal MLC for proton therapy is thus desired.

SU-E-T-261: Plan Quality Assurance of VMAT Using Fluence Images Reconstituted From Log-Files

DOE Office of Scientific and Technical Information (OSTI.GOV)

Katsuta, Y; Shimizu, E; Matsunaga, K

2014-06-01

Purpose: A successful VMAT plan delivery includes precise modulations of dose rate, gantry rotational and multi-leaf collimator (MLC) shapes. One of the main problem in the plan quality assurance is dosimetric errors associated with leaf-positional errors are difficult to analyze because they vary with MU delivered and leaf number. In this study, we calculated integrated fluence error image (IFEI) from log-files and evaluated plan quality in the area of all and individual MLC leaves scanned. Methods: The log-file reported the expected and actual position for inner 20 MLC leaves and the dose fraction every 0.25 seconds during prostate VMAT onmore » Elekta Synergy. These data were imported to in-house software that developed to calculate expected and actual fluence images from the difference of opposing leaf trajectories and dose fraction at each time. The IFEI was obtained by adding all of the absolute value of the difference between expected and actual fluence images corresponding. Results: In the area all MLC leaves scanned in the IFEI, the average and root mean square (rms) were 2.5 and 3.6 MU, the area of errors below 10, 5 and 3 MU were 98.5, 86.7 and 68.1 %, the 95 % of area was covered with less than error of 7.1 MU. In the area individual MLC leaves scanned in the IFEI, the average and rms value were 2.1 – 3.0 and 3.1 – 4.0 MU, the area of errors below 10, 5 and 3 MU were 97.6 – 99.5, 81.7 – 89.5 and 51.2 – 72.8 %, the 95 % of area was covered with less than error of 6.6 – 8.2 MU. Conclusion: The analysis of the IFEI reconstituted from log-file was provided detailed information about the delivery in the area of all and individual MLC leaves scanned.« less

SU-F-T-629: Effect of Multi-Leaf Collimator (MLC) Width On Plan Quality of Single-Isocenter VMAT Intracranial Stereotactic Radiosurgery for Multiple Metastases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kraus, J; Thomas, E; Wu, X

2016-06-15

Purpose: Single-isocenter VMAT has been shown able to create high quality plans for complex intracranial multiple metastasis SRS cases. Linacs capable of the technique are typically outfitted with an MLC that consists of a combination of 5 mm and 10 mm leaves (standard) or 2.5 mm and 5 mm leaves (high-definition). In this study, we test the hypothesis that thinner collimator leaves are associated with improved plan quality. Methods: Ten multiple metastasis cases were identified and planned for VMAT SRS using a 10 MV flattening filter free beam. Plans were created for a standard (std) and a high-definition (HD) MLC.more » Published values for leaf transmission factor and dosimetric leaf gap were utilized. All other parameters were invariant. Conformity (plan and individual target), moderate isodose spill (V50%), and low isodose spill (mean brain dose) were selected for analysis. Results: Compared to standard MLC, HD-MLC improved overall plan conformity (median: Paddick CI-HD = 0.83, Paddick CI-std = 0.79; p = 0.004 and median: RTOG CI-HD =1.18, RTOG CI-std =1.24; p = 0.01 ), improved individual lesion conformity (median: Paddick CI-HD,i =0.77, Paddick CI-std,i =0.72; p < 0.001 and median: RTOG CI-HD,i = 1.28, RTOG CI-std,i =1.35; p < 0.001), improved moderate isodose spill (median: V50%-HD = 37.0 cc, V50%-std = 45.7 cc; p = 0.002), and improved low dose spill (median: dmean-HD = 2.90 Gy, dmean-std = 3.19 Gy; p = 0.002). Conclusion: For the single-isocenter VMAT SRS of multiple metastasis plans examined, use of HD-MLC modestly improved conformity, moderate isodose, and low isodose spill compared to standard MLC. However, in all cases we were able to generate clinically acceptable plans with the standard MLC. More work is need to further quantify the difference in cases with higher numbers of small targets and to better understand any potential clinical significance. This research was supported in part by Varian Medical Systems.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stathakis, S; Defoor, D; Linden, P

Purpose: To study the frequency of Multi-Leaf Collimator (MLC) leaf failures, investigate methods to predict them and reduce linac downtime. Methods: A Varian HD120 MLC was used in our study. The hyperterminal MLC errors logged from 06/2012 to 12/2014 were collected. Along with the hyperterminal errors, the MLC motor changes and all other MLC interventions by the linear accelerator engineer were recorded. The MLC dynalog files were also recorded on a daily basis for each treatment and during linac QA. The dynalog files were analyzed to calculate root mean square errors (RMS) and cumulative MLC travel distance per motor. Anmore » in-house MatLab code was used to analyze all dynalog files, record RMS errors and calculate the distance each MLC traveled per day. Results: A total of 269 interventions were recorded over a period of 18 months. Of these, 146 included MLC motor leaf change, 39 T-nut replacements, and 84 MLC cleaning sessions. Leaves close to the middle of each side required the most maintenance. In the A bank, leaves A27 to A40 recorded 73% of all interventions, while the same leaves in the B bank counted for 52% of the interventions. On average, leaves in the middle of the bank had their motors changed approximately every 1500m of travel. Finally, it was found that the number of RMS errors increased prior to an MLC motor change. Conclusion: An MLC dynalog file analysis software was developed that can be used to log daily MLC usage. Our eighteen-month data analysis showed that there is a correlation between the distance an MLC travels, the RMS and the life of the MLC motor. We plan to use this tool to predict MLC motor failures and with proper and timely intervention, reduce the downtime of the linac during clinical hours.« less

WE-AB-BRB-10: Filmless QA of CyberKnife MLC-Collimated and Iris-Collimated Fields

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gersh, J; Spectrum Medical Physics, LLC, Greenville, SC

Purpose: Current methods of CK field shape QA is based on the use of radiochromic film. Though accurate results can be attained, these methods are prone to error, time consuming, and expensive. The techniques described herein perform similar QA using the FOIL Detector (Field, Output, and Image Localization). A key feature of this in-house QA solution, and central to this study, is an aSi flat-panel detector which provides the user with the means to perform accurate, immediate, and quantitative field analysis. Methods: The FOIL detector is automatically aligned in the CK beam using fiducial markers implanted within the detector case.more » Once the system is aligned, a treatment plan is delivered which irradiates the flat-panel imager using the field being tested. The current study tests each of the clinically-used fields shaped using the Iris variable-aperture collimation system using a plan which takes 6 minutes to deliver. The user is immediately provided with field diameter and beam profile, as well as a comparison to baseline values. Additionally, the detector is used to acquire and analyze leaf positions of the InCise multi-leaf collimation system. Results: Using a 6-minute plan consisting of 11 beams of 25MU-per-beam, the FOIL detector provided the user with a quantitative analysis of all clinically-used field shapes. The FOIL detector was also able to clearly resolve field edge junctions in a picket fence test, including slight over-travel of individual leaves as well as inter-leaf leakage. Conclusion: The FOIL system provided comparable field diameter and profile data when compared to methods using film; providing results much faster and with 5% of the MU used for film. When used with the MLC system, the FOIL detector provided the means for immediate quantification of the performance of the system through analysis of leaf positions in a picket fence test field. Author is the President/Owner of Spectrum Medical Physics, LLC, a company which maintains contracts with Siemens Healthcare and Standard Imaging, Inc.« less

VMAT optimization with dynamic collimator rotation.

PubMed

Lyu, Qihui; O'Connor, Daniel; Ruan, Dan; Yu, Victoria; Nguyen, Dan; Sheng, Ke

2018-04-16

Although collimator rotation is an optimization variable that can be exploited for dosimetric advantages, existing Volumetric Modulated Arc Therapy (VMAT) optimization uses a fixed collimator angle in each arc and only rotates the collimator between arcs. In this study, we develop a novel integrated optimization method for VMAT, accounting for dynamic collimator angles during the arc motion. Direct Aperture Optimization (DAO) for Dynamic Collimator in VMAT (DC-VMAT) was achieved by adding to the existing dose fidelity objective an anisotropic total variation term for regulating the fluence smoothness, a binary variable for forming simple apertures, and a group sparsity term for controlling collimator rotation. The optimal collimator angle for each beam angle was selected using the Dijkstra's algorithm, where the node costs depend on the estimated fluence map at the current iteration and the edge costs account for the mechanical constraints of multi-leaf collimator (MLC). An alternating optimization strategy was implemented to solve the DAO and collimator angle selection (CAS). Feasibility of DC-VMAT using one full-arc with dynamic collimator rotation was tested on a phantom with two small spherical targets, a brain, a lung and a prostate cancer patient. The plan was compared against a static collimator VMAT (SC-VMAT) plan using three full arcs with 60 degrees of collimator angle separation in patient studies. With the same target coverage, DC-VMAT achieved 20.3% reduction of R50 in the phantom study, and reduced the average max and mean OAR dose by 4.49% and 2.53% of the prescription dose in patient studies, as compared with SC-VMAT. The collimator rotation co-ordinated with the gantry rotation in DC-VMAT plans for deliverability. There were 13 beam angles in the single-arc DC-VMAT plan in patient studies that requires slower gantry rotation to accommodate multiple collimator angles. The novel DC-VMAT approach utilizes the dynamic collimator rotation during arc delivery. In doing so, DC-VMAT affords more sophisticated intensity modulation, alleviating the limitation previously imposed by the square beamlet from the MLC leaf thickness and achieves higher effective modulation resolution. Consequently, DC-VMAT with a single arc manages to achieve superior dosimetry than SC-VMAT with three full arcs. © 2018 American Association of Physicists in Medicine.

A novel method for routine quality assurance of volumetric-modulated arc therapy.

PubMed

Wang, Qingxin; Dai, Jianrong; Zhang, Ke

2013-10-01

Volumetric-modulated arc therapy (VMAT) is delivered through synchronized variation of gantry angle, dose rate, and multileaf collimator (MLC) leaf positions. The delivery dynamic nature challenges the parameter setting accuracy of linac control system. The purpose of this study was to develop a novel method for routine quality assurance (QA) of VMAT linacs. ArcCheck is a detector array with diodes distributing in spiral pattern on cylindrical surface. Utilizing its features, a QA plan was designed to strictly test all varying parameters during VMAT delivery on an Elekta Synergy linac. In this plan, there are 24 control points. The gantry rotates clockwise from 181° to 179°. The dose rate, gantry speed, and MLC positions cover their ranges commonly used in clinic. The two borders of MLC-shaped field seat over two columns of diodes of ArcCheck when the gantry rotates to the angle specified by each control point. The ratio of dose rate between each of these diodes and the diode closest to the field center is a certain value and sensitive to the MLC positioning error of the leaf crossing the diode. Consequently, the positioning error can be determined by the ratio with the help of a relationship curve. The time when the gantry reaches the angle specified by each control point can be acquired from the virtual inclinometer that is a feature of ArcCheck. The gantry speed between two consecutive control points is then calculated. The aforementioned dose rate is calculated from an acm file that is generated during ArcCheck measurements. This file stores the data measured by each detector in 50 ms updates with each update in a separate row. A computer program was written in MATLAB language to process the data. The program output included MLC positioning errors and the dose rate at each control point as well as the gantry speed between control points. To evaluate this method, this plan was delivered for four consecutive weeks. The actual dose rate and gantry speed were compared with the QA plan specified. Additionally, leaf positioning errors were intentionally introduced to investigate the sensitivity of this method. The relationship curves were established for detecting MLC positioning errors during VMAT delivery. For four consecutive weeks measured, 98.4%, 94.9%, 89.2%, and 91.0% of the leaf positioning errors were within ± 0.5 mm, respectively. For the intentionally introduced leaf positioning systematic errors of -0.5 and +1 mm, the detected leaf positioning errors of 20 Y1 leaf were -0.48 ± 0.14 and 1.02 ± 0.26 mm, respectively. The actual gantry speed and dose rate closely followed the values specified in the VMAT QA plan. This method can assess the accuracy of MLC positions and the dose rate at each control point as well as the gantry speed between control points at the same time. It is efficient and suitable for routine quality assurance of VMAT.

SU-E-T-425: Spherical Dose Distributions for Radiosurgery Using a Standardized MLC Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Popple, R; Brezovich, I; Wu, X

2014-06-01

Purpose: To investigate a standardized MLC treatment plan to generate small spherical dose distributions. Methods: The static virtual cone plan comprised six table positions with clockwise and counterclockwise arcs having collimator angles 45 and 135 degrees, respectively, at each position. The central two leaves of a 2.5 mm leaf width MLC were set to a constant gap. Control points were weighted proportional to the sine of the gantry angle. Plans were created for the 10 MV flattening-filter-free beam of a TrueBeam STx (Varian Medical Systems) with gaps of 1, 1.5, 2, and 3 mm and were delivered to a phantommore » containing radiochromic film. Dose was calculated using the Eclipse AAA (Varian Medical Systems). A dynamic plan in which the table and gantry moved simultaneously with 1.5 mm gap was also created and delivered using the TrueBeam developer mode. Results: The full-width-half-max (FWHM) varied with leaf gap, ranging from 5.2 to 6.2 mm. Calculated FWHM was smaller than measured by 0.7 mm for the 1 mm gap and ≤ 0.4 mm for the larger gaps. The measured-to-calculated dose ratio was 0.93, 0.96, 1.01, and 0.99 for 1 mm, 1.5 mm, 2 mm, and 3 mm gaps, respectively. The dynamic results were the same as the static. The position deviations between the phantom target position and the center of the dose distribution were < 0.4 mm. Conclusion: The virtual cone can deliver spherical dose distributions suitable for radio surgery of small targets such as the trigeminal nerve. The Eclipse AAA accurately calculates the expected dose, particularly for leaf gap ≥ 1.5 mm. The measured dose distribution is slightly larger than the calculation, which is likely due to systematic leaf position error, isocenter variation due to gantry sag and table eccentricity, and inaccuracy in MLC leaf end modeling.« less

Incorporating geometric ray tracing to generate initial conditions for intensity modulated arc therapy optimization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oliver, Mike; Gladwish, Adam; Craig, Jeff

2008-07-15

Purpose and background: Intensity modulated arc therapy (IMAT) is a rotational variant of Intensity modulated radiation therapy (IMRT) that is achieved by allowing the multileaf collimator (MLC) positions to vary as the gantry rotates around the patient. This work describes a method to generate an IMAT plan through the use of a fast ray tracing technique based on dosimetric and geometric information for setting initial MLC leaf positions prior to final IMAT optimization. Methods and materials: Three steps were used to generate an IMAT plan. The first step was to generate arcs based on anatomical contours. The second step wasmore » to generate ray importance factor (RIF) maps by ray tracing the dose distribution inside the planning target volume (PTV) to modify the MLC leaf positions of the anatomical arcs to reduce the maximum dose inside the PTV. The RIF maps were also segmented to create a new set of arcs to improve the dose to low dose voxels within the PTV. In the third step, the MLC leaf positions from all arcs were put through a leaf position optimization (LPO) algorithm and brought into a fast Monte Carlo dose calculation engine for a final dose calculation. The method was applied to two phantom cases, a clinical prostate case and the Radiological Physics Center (RPC)'s head and neck phantom. The authors assessed the plan improvements achieved by each step and compared plans with and without using RIF. They also compared the IMAT plan with an IMRT plan for the RPC phantom. Results: All plans that incorporated RIF and LPO had lower objective function values than those that incorporated LPO only. The objective function value was reduced by about 15% after the generation of RIF arcs and 52% after generation of RIF arcs and leaf position optimization. The IMAT plan for the RPC phantom had similar dose coverage for PTV1 and PTV2 (the same dose volume histogram curves), however, slightly lower dose to the normal tissues compared to a six-field IMRT plan. Conclusion: The use of a ray importance factor can generate initial IMAT arcs efficiently for further MLC leaf position optimization to obtain more favorable IMAT plan.« less

SU-E-T-24: Development and Implementation of an Automated Algorithm to Determine Radiation Isocenter, Radiation vs. Light Field Coincidence, and Analyze Strip Tests.

PubMed

Hyer, D; Mart, C

2012-06-01

The aim of this study was to develop a phantom and analysis software that could be used to quickly and accurately determine the location of radiation isocenter using the Electronic Portal Imaging Device (EPID). The phantom could then be used as a static reference point for performing other tests including: radiation vs. light field coincidence, MLC and Jaw strip tests, and Varian Optical Guidance Platform (OGP) calibration. The solution proposed uses a collimator setting of 10×10 cm to acquire EPID images of the new phantom constructed from LEGO® blocks. Images from a number of gantry and collimator angles are analyzed by the software to determine the position of the jaws and center of the phantom in each image. The distance between a chosen jaw and the phantom center is then compared to the same distance measured after a 180 degree collimator rotation to determine if the phantom is centered in the dimension being investigated. The accuracy of the algorithm's measurements were verified by independent measurement to be approximately equal to the detector's pitch. Light versus radiation field as well as MLC and Jaw strip tests are performed using measurements based on the phantom center once located at the radiation isocenter. Reproducibility tests show that the algorithm's results were objectively repeatable. Additionally, the phantom and software are completely independent of linac vendor and this study presents results from two major linac manufacturers. An OGP calibration array was also integrated into the phantom to allow calibration of the OGP while the phantom is positioned at radiation isocenter to reduce setup uncertainty contained in the calibration. This solution offers a quick, objective method to perform isocenter localization as well as laser alignment, OGP calibration, and other tests on a monthly basis. © 2012 American Association of Physicists in Medicine.

SU-F-T-540: Comprehensive Fluence Delivery Optimization with Multileaf Collimation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weppler, S; Villarreal-Barajas, J; Department of Medical Physics, Tom Baker Cancer Center, Calgary, Alberta

2016-06-15

Purpose: Multileaf collimator (MLC) leaf sequencing is performed via commercial black-box implementations, on which a user has limited to no access. We have developed an explicit, generic MLC sequencing model to serve as a tool for future investigations of fluence map optimization, fluence delivery optimization, and rotational collimator delivery methods. Methods: We have developed a novel, comprehensive model to effectively account for a variety of transmission and penumbra effects previously treated on an ad hoc basis in the literature. As the model is capable of quantifying a variety of effects, we utilize the asymmetric leakage intensity across each leaf tomore » deliver fluence maps with pixel size smaller than the narrowest leaf width. Developed using linear programming and mixed integer programming formulations, the model is implemented using state of the art open-source solvers. To demonstrate the versatility of the algorithm, a graphical user interface (GUI) was developed in MATLAB capable of accepting custom leaf specifications and transmission parameters. As a preliminary proof-ofconcept, we have sequenced the leaves of a Varian 120 Leaf Millennium MLC for five prostate cancer patient fields and one head and neck field. Predetermined fluence maps have been processed by data smoothing methods to obtain pixel sizes of 2.5 cm{sup 2}. The quality of output was analyzed using computer simulations. Results: For the prostate fields, an average root mean squared error (RMSE) of 0.82 and gamma (0.5mm/0.5%) of 91.4% were observed compared to RMSE and gamma (0.5mm/0.5%) values of 7.04 and 34.0% when the leakage considerations were omitted. Similar results were observed for the head and neck case. Conclusion: A model to sequence MLC leaves to optimality has been proposed. Future work will involve extensive testing and evaluation of the method on clinical MLCs and comparison with black-box leaf sequencing algorithms currently used by commercial treatment planning systems.« less

SU-E-T-247: Multi-Leaf Collimator Model Adjustments Improve Small Field Dosimetry in VMAT Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Young, L; Yang, F

2014-06-01

Purpose: The Elekta beam modulator linac employs a 4-mm micro multileaf collimator (MLC) backed by a fixed jaw. Out-of-field dose discrepancies between treatment planning system (TPS) calculations and output water phantom measurements are caused by the 1-mm leaf gap required for all moving MLCs in a VMAT arc. In this study, MLC parameters are optimized to improve TPS out-of-field dose approximations. Methods: Static 2.4 cm square fields were created with a 1-mm leaf gap for MLCs that would normally park behind the jaw. Doses in the open field and leaf gap were measured with an A16 micro ion chamber andmore » EDR2 film for comparison with corresponding point doses in the Pinnacle TPS. The MLC offset table and tip radius were adjusted until TPS point doses agreed with photon measurements. Improvements to the beam models were tested using static arcs consisting of square fields ranging from 1.6 to 14.0 cm, with 45° collimator rotation, and 1-mm leaf gap to replicate VMAT conditions. Gamma values for the 3-mm distance, 3% dose difference criteria were evaluated using standard QA procedures with a cylindrical detector array. Results: The best agreement in point doses within the leaf gap and open field was achieved by offsetting the default rounded leaf end table by 0.1 cm and adjusting the leaf tip radius to 13 cm. Improvements in TPS models for 6 and 10 MV photon beams were more significant for smaller field sizes 3.6 cm or less where the initial gamma factors progressively increased as field size decreased, i.e. for a 1.6cm field size, the Gamma increased from 56.1% to 98.8%. Conclusion: The MLC optimization techniques developed will achieve greater dosimetric accuracy in small field VMAT treatment plans for fixed jaw linear accelerators. Accurate predictions of dose to organs at risk may reduce adverse effects of radiotherapy.« less

Development, physical properties and clinical applicability of a mechanical Multileaf Collimator for the use in Cobalt-60 radiotherapy

NASA Astrophysics Data System (ADS)

Langhans, Marco; Echner, Gernot; Runz, Armin; Baumann, Martin; Xu, Mark; Ueltzhöffer, Stefan; Häring, Peter; Schlegel, Wolfgang

2015-04-01

According to the Directory of Radiotherapy Centres (DIRAC) there are 2348 Cobalt-60 (Co-60) teletherapy units worldwide, most of them in low and middle income countries, compared to 11046 clinical accelerators. To improve teletherapy with Co-60, a mechanical Multi-Leaf Collimator (MLC) was developed, working with pneumatic pressure and thus independent of electricity supply. Instead of tungsten, brass was used as leaf material to make the mechanical MLC more affordable. The physical properties and clinical applicability of this mechanical MLC are presented here. The leakage strongly depends on the fieldsize of the therapy unit due to scatter effects. The maximum transmission through the leaves measured 2.5 cm from the end-to-end gap, within a field size of 20 cm × 30 cm defined by jaws of the therapy unit at 80 cm SAD, amounts 4.2%, normalized to an open 10 cm × 10 cm field, created by the mechanical MLC. Within a precollimated field size of 12.5 cm × 12.5 cm, the end-to-end leakage is 6.5% normalized to an open 10 cm × 10 cm field as well. This characteristic is clinically acceptable considering the criteria for non-IMRT MLCs of the International Electrotechnical Commission (IEC 60601-2-1). The penumbra for a 10 cm × 10 cm field was measured to be 9.14 mm in plane and 8.38 mm cross plane. The clinical applicability of the designed mechanical MLC was affirmed by measurements relating to all relevant clinical properties such as penumbra, leakage, output factors and field widths. Hence this novel device presents an apt way forward to make radiotherapy with conformal fields possible in low-infrastructure environments, using gantry based Co-60 therapy units.

SU-E-T-610: Comparison of Treatment Times Between the MLCi and Agility Multileaf Collimators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ramsey, C; Bowling, J

2014-06-01

Purpose: The Agility is a new 160-leaf MLC developed by Elekta for use in their Infinity and Versa HD linacs. As compared to the MLCi, the Agility increased the maximum leaf speed from 2 cm/s to 3.5 cm/s, and the maximum primary collimator speed from 1.5 cm/s to 9.0 cm/s. The purpose of this study was to determine if the Agility MLC resulted in improved plan quality and/or shorter treatment times. Methods: An Elekta Infinity that was originally equipped with a 80 leaf MLCi was upgraded to an 160 leaf Agility. Treatment plan quality was evaluated using the Pinnacle planningmore » system with SmartArc. Optimization was performed once for the MLCi and once for the Agility beam models using the same optimization parameters and the same number of iterations. Patient treatment times were measured for all IMRT, VMAT, and SBRT patients treated on the Infinity with the MLCi and Agility MLCs. Treatment times were extracted from the EMR and measured from when the patient first walked into the treatment room until exiting the treatment room. Results: 11,380 delivery times were measured for patients treated with the MLCi, and 1,827 measurements have been made for the Agility MLC. The average treatment times were 19.1 minutes for the MLCi and 20.8 minutes for the Agility. Using a t-test analysis, there was no difference between the two groups (t = 0.22). The dose differences between patients planned with the MLCi and the Agility MLC were minimal. For example, the dose difference for the PTV, GTV, and cord for a head and neck patient planned using Pinnacle were effectively equivalent. However, the dose to the parotid glands was slightly worse with the Agility MLC. Conclusion: There was no statistical difference in treatment time, or any significant dosimetric difference between the Agility MLC and the MLCi.« less

SU-E-T-784: Using MLC Log Files for Daily IMRT Delivery Verification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stathakis, S; Defoor, D; Linden, P

2015-06-15

Purpose: To verify daily intensity modulated radiation therapy (IMRT) treatments using multi-leaf collimator (MLC) log files. Methods: The MLC log files from a NovalisTX Varian linear accelerator were used in this study. The MLC files were recorded daily for all patients undergoing IMRT or volumetric modulated arc therapy (VMAT). The first record of each patient was used as reference and all records for subsequent days were compared against the reference. An in house MATLAB software code was used for the comparisons. Each MLC log file was converted to a fluence map (FM) and a gamma index (γ) analysis was usedmore » for the evaluation of each daily delivery for every patient. The tolerance for the gamma index was set to 2% dose difference and 2mm distance to agreement while points with signal of 10% or lower of the maximum value were excluded from the comparisons. Results: The γ between each of the reference FMs and the consecutive daily fraction FMs had an average value of 99.1% (ranged from 98.2 to 100.0%). The FM images were reconstructed at various resolutions in order to study the effect of the resolution on the γ and at the same time reduce the time for processing the images. We found that the comparison of images with the highest resolution (768×1024) yielded on average a lower γ (99.1%) than the ones with low resolution (192×256) (γ 99.5%). Conclusion: We developed an in-house software that allows us to monitor the quality of daily IMRT and VMAT treatment deliveries using information from the MLC log files of the linear accelerator. The information can be analyzed and evaluated as early as after the completion of each daily treatment. Such tool can be valuable to assess the effect of MLC positioning on plan quality, especially in the context of adaptive radiotherapy.« less

Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 02: Feasibility of using multileaf collimation for stereotactic radiosurgery of arteriovenous malformation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Young; Ruschin, Mark

SRS using linac and cones offers steep dose fall-off but a tradeoff exists between conformality and treatment time, which depends on the number of isocentres. Purpose of this study is to quantify planning metrics between cones- and MLC-based SRS for arteriovenous malformation(AVM). Seven AVM cases treated with cones were re-planned with MLC on Pinnacle treatment planning system. Planning target volume(PTV) was created with 1mm uniform margin to the AVM to account for MLC positional variation. Clinically-planned prescription dose(15–25Gy) was used. Four plans were generated per case:non-coplanar VMAT(ncV), single-arc VMAT(saV), non-coplanar IMRT(ncI), non-coplanar conformal(ncC). Plans were compared for conformity(CI), heterogeneity(HI) andmore » gradient(GI) indices and brain doses. Estimated treatment times and monitor units(MU) were compared. Cone-based plans required 2–6 isocentres. Though CI-RTOG was similar for plans(median=0.98), CI-Paddick was most favourable for ncV(median=0.86) and worst for cones(0.54). HI for MLC plans(median=1.19–1.27) were lower than cone-based plans(1.43). GI was similar for all plans. For 2/7 ncC had brainstem maximum dose>16.7Gy and therefore were clinically unacceptable. Brain V12Gy,V10Gy,V2Gy were lowest in the cones plan. ncV brain V12Gy,V10Gy,V2Gy were lowest of all MLC-based plans studied. Treatment MUs were similar for MLC-based plans and up to 70% lower than clinically delivered plans. ncV showed best conformality in this study. Of the MLC-based plans, ncV also showed lowest normal tissue dose with reasonable treatment time.« less

Brushed permanent magnet DC MLC motor operation in an external magnetic field.

PubMed

Yun, J; St Aubin, J; Rathee, S; Fallone, B G

2010-05-01

Linac-MR systems for real-time image-guided radiotherapy will utilize the multileaf collimators (MLCs) to perform conformal radiotherapy and tumor tracking. The MLCs would be exposed to the external fringe magnetic fields of the linac-MR hybrid systems. Therefore, an experimental investigation of the effect of an external magnetic field on the brushed permanent magnet DC motors used in some MLC systems was performed. The changes in motor speed and current were measured for varying external magnetic field strengths up to 2000 G generated by an EEV electromagnet. These changes in motor characteristics were measured for three orientations of the motor in the external magnetic field, mimicking changes in motor orientations due to installation and/or collimator rotations. In addition, the functionality of the associated magnetic motor encoder was tested. The tested motors are used with the Varian 120 leaf Millennium MLC (Maxon Motor half leaf and full leaf motors) and the Varian 52 leaf MKII MLC (MicroMo Electronics leaf motor) including a carriage motor (MicroMo Electronics). In most cases, the magnetic encoder of the motors failed prior to any damage to the gearbox or the permanent magnet motor itself. This sets an upper limit of the external magnetic field strength on the motor function. The measured limits of the external magnetic fields were found to vary by the motor type. The leaf motor used with a Varian 52 leaf MKII MLC system tolerated up to 450 +/- 10 G. The carriage motor tolerated up to 2000 +/- 10 G field. The motors used with the Varian 120 leaf Millennium MLC system were found to tolerate a maximum of 600 +/- 10 G. The current Varian MLC system motors can be used for real-time image-guided radiotherapy coupled to a linac-MR system, provided the fringe magnetic fields at their locations are below the determined tolerance levels. With the fringe magnetic fields of linac-MR systems expected to be larger than the tolerance levels determined, some form of magnetic shielding would be required.

SU-F-T-508: A Collimator-Based 3-Dimensional Grid Therapy Technique in a Small Animal Radiation Research Platform

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jin, J; Kong, V; Zhang, H

Purpose: Three dimensional (3D) Grid Therapy using MLC-based inverse-planning has been proposed to achieve the features of both conformal radiotherapy and spatially fractionated radiotherapy, which may deliver very high dose in a single fraction to portions of a large tumor with relatively low normal tissue dose. However, the technique requires relatively long delivery time. This study aims to develop a collimator-based 3D grid therapy technique. Here we report the development of the technique in a small animal radiation research platform. Methods: Similar as in the MLC-based technique, 9 non-coplanar beams in special channeling directions were used for the 3D gridmore » therapy technique. Two specially designed grid collimators were fabricated, and one of them was selectively used to match the corresponding gantry/couch angles so that the grid opening of all 9 beams are met in the 3D space in the target. A stack of EBT3 films were used as 3D dosimetry to demonstrate the 3D grid-like dose distribution in the target. Three 1-mm beams were delivered to the stack of films in the area outside the target for alignment when all the films were scanned to reconstruct the 3D dosimtric image. Results: 3D film dosimetry showed a lattice-like dose distribution in the 3D target as well as in the axial, sagittal and coronal planes. The dose outside the target also showed a grid like dose distribution, and the average dose gradually decreased with the distance to the target. The peak to valley ratio was approximately 5:1. The delivery time was 7 minutes for 18 Gy peak dose, comparing to 6 minutes to deliver a 18-Gy 3D conformal plan. Conclusion: We have demonstrated the feasibility of the collimator-based 3D grid therapy technique which can significantly reduce delivery time comparing to MLC-based inverse planning technique.« less

Dosimetric comparison using different multileaf collimeters in intensity-modulated radiotherapy for upper thoracic esophageal cancer.

PubMed

Gong, Youling; Wang, Shichao; Zhou, Lin; Liu, Yongmei; Xu, Yong; Lu, You; Bai, Sen; Fu, Yuchuan; Xu, Qingfeng; Jiang, Qingfeng

2010-07-15

To study the impacts of multileaf collimators (MLC) width [standard MLC width of 10 mm (sMLC) and micro-MLC width of 4 mm (mMLC)] in the intensity-modulated radiotherapy (IMRT) planning for the upper thoracic esophageal cancer (UTEC). 10 patients with UTEC were retrospectively planned with the sMLC and the mMLC. The monitor unites (MUs) and dose volume histogram-based parameters [conformity index (CI) and homogeneous index (HI)] were compared between the IMRT plans with sMLC and with mMLC. The IMRT plans with the mMLC were more efficient (average MUs: 703.1 +/- 68.3) than plans with the sMLC (average MUs: 833.4 +/- 73.8) (p < 0.05). Also, compared to plans with the sMLC, the plans with the mMLC showed advantages in dose coverage of the planning gross tumor volume (Pgtv) (CI 0.706 +/- 0.056/HI 1.093 +/- 0.021) and the planning target volume (PTV) (CI 0.707 +/- 0.029/HI 1.315 +/- 0.013) (p < 0.05). In addition, the significant dose sparing in the D5 (3260.3 +/- 374.0 vs 3404.5 +/- 374.4)/gEUD (1815.1 +/- 281.7 vs 1849.2 +/- 297.6) of the spinal cord, the V10 (33.2 +/- 6.5 vs 34.0 +/- 6.7), V20 (16.0 +/- 4.6 vs 16.6 +/- 4.7), MLD (866.2 +/- 174.1 vs 887.9 +/- 172.1) and gEUD (938.6 +/- 175.2 vs 956.8 +/- 171.0) of the lungs were observed in the plans with the mMLC, respectively (p < 0.05). Comparing to the sMLC, the mMLC not only demonstrated higher efficiencies and more optimal target coverage, but also considerably improved the dose sparing of OARs in the IMRT planning for UTEC.

Quality assurance for online adapted treatment plans: Benchmarking and delivery monitoring simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Taoran, E-mail: taoran.li.duke@gmail.com; Wu, Qiuwen; Yang, Yun

Purpose: An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. Methods: The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system wasmore » designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system’s performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery. Results: Online adapted plans were found to have similar delivery accuracy in comparison to clinical IMRT plans when validated with portal dosimetry IMRT QA. FEMs for the simulated deliveries with intentional MLC errors exhibited distinct patterns for different MLC error magnitudes and directions, indicating that the proposed delivery monitoring system is highly specific in detecting the source of errors. Implementing the proposed QA system for online adapted plans revealed excellent delivery accuracy: over 99% of leaf position differences were within 0.5 mm, and >99% of pixels in the FEMs had fluence errors within 0.5 MU. Patterns present in the FEMs and MLC control point analysis for actual patient cases agreed with the error pattern analysis results, further validating the system’s ability to reveal and differentiate MLC deviations. Calculation of the fluence map based on the DMI was performed within 2 ms after receiving each DMI input. Conclusions: The proposed online delivery monitoring system requires minimal additional resources and time commitment to the current clinical workflow while still maintaining high sensitivity to leaf position errors and specificity to error types. The presented online delivery monitoring system therefore represents a promising QA system candidate for online adaptive radiation therapy.« less

Quality assurance for online adapted treatment plans: benchmarking and delivery monitoring simulation.

PubMed

Li, Taoran; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q

2015-01-01

An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system was designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system's performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery. Online adapted plans were found to have similar delivery accuracy in comparison to clinical IMRT plans when validated with portal dosimetry IMRT QA. FEMs for the simulated deliveries with intentional MLC errors exhibited distinct patterns for different MLC error magnitudes and directions, indicating that the proposed delivery monitoring system is highly specific in detecting the source of errors. Implementing the proposed QA system for online adapted plans revealed excellent delivery accuracy: over 99% of leaf position differences were within 0.5 mm, and >99% of pixels in the FEMs had fluence errors within 0.5 MU. Patterns present in the FEMs and MLC control point analysis for actual patient cases agreed with the error pattern analysis results, further validating the system's ability to reveal and differentiate MLC deviations. Calculation of the fluence map based on the DMI was performed within 2 ms after receiving each DMI input. The proposed online delivery monitoring system requires minimal additional resources and time commitment to the current clinical workflow while still maintaining high sensitivity to leaf position errors and specificity to error types. The presented online delivery monitoring system therefore represents a promising QA system candidate for online adaptive radiation therapy.

Radio frequency noise from an MLC: a feasibility study of the use of an MLC for linac-MR systems.

PubMed

Lamey, M; Yun, J; Burke, B; Rathee, S; Fallone, B G

2010-02-21

Currently several groups are actively researching the integration of a megavoltage teletherapy unit with magnetic resonance (MR) imaging for real-time image-guided radiotherapy. The use of a multileaf collimator (MLC) for intensity-modulated radiotherapy for linac-MR units must be investigated. The MLC itself will likely reside in the fringe field of the MR and the motors will produce radio frequency (RF) noise. The RF noise power spectral density from a Varian 52-leaf MLC motor, a Varian Millennium MLC motor and a brushless fan motor has been measured as a function of the applied magnetic field using a near field probe set. For the Varian 52-leaf MLC system, the RF noise produced by 13 of 52 motors is studied as a function of distance from the MLC. Data are reported in the frequency range suitable for 0.2-1.5 T linac-MR systems. Below 40 MHz the Millennium MLC motor tested showed more noise than the Varian 52-leaf motor or the brushless fan motor. The brushless motor showed a small dependence on the applied magnetic field. Images of a phantom were taken by the prototype linac-MR system with the MLC placed in close proximity to the magnet. Several orientations of the MLC in both shielded and non-shielded configurations were studied. For the case of a non-shielded MLC and associated cables, the signal-to-noise ratio (SNR) was reduced when 13 of 52 MLC leaves were moved during imaging. When the MLC and associated cables were shielded, the measured SNR of the images with 13 MLC leaves moving was experimentally the same as the SNR of the stationary MLC image. When the MLC and cables are shielded, subtraction images acquired with and without MLC motion contains no systematic signal. This study illustrates that the small RF noise produced by functioning MLC motors can be effectively shielded to avoid SNR degradation. A functioning MLC can be incorporated into a linac-MR unit.

Radio frequency noise from an MLC: a feasibility study of the use of an MLC for linac-MR systems

PubMed Central

Lamey, M; Yun, J; Burke, B; Rathee, S; Fallone, B G

2010-01-01

Currently several groups are actively researching the integration of a megavoltage teletherapy unit with magnetic resonance (MR) imaging for real-time image-guided radiotherapy. The use of a multileaf collimator (MLC) for intensity-modulated radiotherapy for linac-MR units must be investigated. The MLC itself will likely reside in the fringe field of the MR and the motors will produce radio frequency (RF) noise. The RF noise power spectral density from a Varian 52-leaf MLC motor, a Varian Millennium MLC motor and a brushless fan motor has been measured as a function of the applied magnetic field using a near field probe set. For the Varian 52-leaf MLC system, the RF noise produced by 13 of 52 motors is studied as a function of distance from the MLC. Data are reported in the frequency range suitable for 0.2–1.5 T linac-MR systems. Below 40 MHz the Millennium MLC motor tested showed more noise than the Varian 52-leaf motor or the brushless fan motor. The brushless motor showed a small dependence on the applied magnetic field. Images of a phantom were taken by the prototype linac-MR system with the MLC placed in close proximity to the magnet. Several orientations of the MLC in both shielded and non-shielded configurations were studied. For the case of a non-shielded MLC and associated cables, the signal-to-noise ratio (SNR) was reduced when 13 of 52 MLC leaves were moved during imaging. When the MLC and associated cables were shielded, the measured SNR of the images with 13 MLC leaves moving was experimentally the same as the SNR of the stationary MLC image. When the MLC and cables are shielded, subtraction images acquired with and without MLC motion contains no systematic signal. This study illustrates that the small RF noise produced by functioning MLC motors can be effectively shielded to avoid SNR degradation. A functioning MLC can be incorporated into a linac-MR unit. PMID:20090187

SU-E-T-804: Verification of the BJR-25 Method of KQ Determination for CyberKnife Absolute Dosimetry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gersh, J; Spectrum Medical Physics, LLC - Greenville, SC; Willett, B

2015-06-15

Purpose: Absolute calibration of the CyberKnife is performed using a 6cm-diameter cone defined at 80cm SAD. Since kQ is defined using PDD values determined using 10×10 cm fields at 100cm SSD, the PDD must be corrected in order to correctly apply the quality conversion factor. The accepted method is based on equivalent field-size conversions of PDD values using BJR25. Using the new InCise MLC system, the CK is capable of generating a rectangular field equivalent to 10×10 cm square field. In this study, a comparison is made between kQ values determined using the traditional BJR25 method and the MLC methodmore » introduced herein. Methods: First, kQ(BJR) is determined: a PDD is acquired using a 6cm circular field at 100cm SSD, its field size converted to an equivalent square, and PDD converted to a 10×10cm field using the appropriate BJR25 table. Maintaining a consistent setup, the collimator is changed, and the MLC method is used. Finally, kQ is determined using PDDs acquired with a 9.71×10.31cm at 100cm SSD. This field is produced by setting the field to a size of 7.77×8.25cm (since it is defined at 80cm SAD). An exact 10×10cm field since field size is relegated to increments of its leaf width (0.25cm). This comparison is made using an Exradin A1SL, IBA CC08, IBA CC13, and an Exradin A19. For each detector and collimator type, the beam injector was adjusted to give 5 different beam qualities; representing a range of clinical systems. Results: Averaging across all beam qualities, kQ(MLC) differed from kQ(BJR) by less than 0.15%. The difference between the values increased with detector volume. Conclusion: For CK users with standard cone collimators, the BJR25 method has been verified. For CK users the MLC system, a technique is described to determine kQ. Primary author is the President/Owner of Spectrum Medical Physics, LLC, a company which maintains contracts with Siemens Healthcare and Standard Imaging, Inc.« less

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

PubMed

McMahon, Ryan; Papiez, Lech; Rangaraj, Dharanipathy

2007-08-01

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 the same target motion, the error was shown to increase rapidly as (1) the maximum MLC leaf velocity was reduced below 75% of the maximum target velocity and (2) the system response time was increased.

Comparision of beam data requirements for MLC commissioning on a TPS

NASA Astrophysics Data System (ADS)

Solaiappan, Gopi; Singaravelu, Ganesan; Prakasarao, Aruna; Supe, Sanjay S.

2008-01-01

The treatment planning system (TPS) has become a key element in the radiotherapy process with the introduction of computer tomography (CT) based 3D conformal treatment planning. Commissioning of a MLC on a TPS either for conformal radiotherapy or intensity modulated radiation therapy (IMRT) requires beam data to be generated on a linear accelerator. Most of the TPS require these beam data to be generated with routine collimator jaws. However some TPS demand the data to be provided for MLC shaped fields. This prompted us to investigate whether beam data with jaws differ than that with MLC and whether the jaw based beam data would suffice for the commissioning of a MLC on a TPS. Beam data like percentage depth dose (PDD), cross beam profiles and output factors was acquired for jaws and MLC defined square fields for 6, 10 and 23 MV photon beams. Percentage depth dose and cross beam profiles were acquired with a radiation field analyzer RFA-200, CC13-S ion chambers with active volume of 0.13 cm3 and OmniPro-Accept software from Scanditronix-Wellhofer. A Medtec-TG51 water tank with Max-4000 electrometer and 0.6 cc PTW ionization chamber and a mini phantom from Standard Imaging was utilized for output measurements for millennium-120 MLC (Varian Medical Systems) and SRS diode detector (Scanditronix-Wellhofer) of 0.6 mm diameter of active area and 0.3 mm of active volume thickness for micro-MLC (BrainLab). The difference in PDD in the build-up region for millennium MLC was ±1.0% for 6 MV photons. For 10 MV photons the PDD difference was within ±4.0%. The difference in PDD for 23 MV photons ranged from 0% to 40.0%. PDD difference from build-up depth to about 28 cm was within ±1.0%. Difference in PDD crossed ±1.0% at 30 cm depth for 6 MV photons. The difference in PDD in the build-up region for mMLC was ±8.0% for 6 MV photons. For the smallest field size studied with micro-MLC i.e. 0.6 × 0.6 cm2 difference in PDD was more than ±1.0% in the build-up region and beyond a depth of 8.0 cm. The profiles for jaws and MLC agreed within the umbra region. However in the penumbra region small differences in doses were observed. The collimator scatter factor (Sc), phantom scatter factor (Sp) and output factor values for MLC were different that those for jaws. The differences in beam characteristics could have implication for intensity modulated radiation therapy and stereotactic radiosurgery in terms of dose in the build up region, exit dose, dose to the planning target volume (PTV) and organ at risk (OAR). Impact of these dosimetric differences between jaw and MLC needs to be further studied in terms of dose volume histograms for PTV and OAR and its further impact on tumor control probability (TCP) and normal tissue complication probability (NTCP).

Fast regional readout CMOS Image Sensor for dynamic MLC tracking

NASA Astrophysics Data System (ADS)

Zin, H.; Harris, E.; Osmond, J.; Evans, P.

2014-03-01

Advanced radiotherapy techniques such as volumetric modulated arc therapy (VMAT) require verification of the complex beam delivery including tracking of multileaf collimators (MLC) and monitoring the dose rate. This work explores the feasibility of a prototype Complementary metal-oxide semiconductor Image Sensor (CIS) for tracking these complex treatments by utilising fast, region of interest (ROI) read out functionality. An automatic edge tracking algorithm was used to locate the MLC leaves edges moving at various speeds (from a moving triangle field shape) and imaged with various sensor frame rates. The CIS demonstrates successful edge detection of the dynamic MLC motion within accuracy of 1.0 mm. This demonstrates the feasibility of the sensor to verify treatment delivery involving dynamic MLC up to ~400 frames per second (equivalent to the linac pulse rate), which is superior to any current techniques such as using electronic portal imaging devices (EPID). CIS provides the basis to an essential real-time verification tool, useful in accessing accurate delivery of complex high energy radiation to the tumour and ultimately to achieve better cure rates for cancer patients.

SU-F-T-527: A Novel Dynamic Multileaf Collimator Leaf-Sequencing Algorithm in Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jing, J; Lin, H; Chow, J

Purpose: A novel leaf-sequencing algorithm is developed for generating arbitrary beam intensity profiles in discrete levels using dynamic multileaf collimator (MLC). The efficiency of this dynamic MLC leaf-sequencing method was evaluated using external beam treatment plans delivered by intensity modulated radiation therapy technique. Methods: To qualify and validate this algorithm, integral test for the beam segment of MLC generated by the CORVUS treatment planning system was performed with clinical intensity map experiments. The treatment plans were optimized and the fluence maps for all photon beams were determined. This algorithm started with the algebraic expression for the area under the beammore » profile. The coefficients in the expression can be transformed into the specifications for the leaf-setting sequence. The leaf optimization procedure was then applied and analyzed for clinical relevant intensity profiles in cancer treatment. Results: The macrophysical effect of this method can be described by volumetric plan evaluation tools such as dose-volume histograms (DVHs). The DVH results are in good agreement compared to those from the CORVUS treatment planning system. Conclusion: We developed a dynamic MLC method to examine the stability of leaf speed including effects of acceleration and deceleration of leaf motion in order to make sure the stability of leaf speed did not affect the intensity profile generated. It was found that the mechanical requirements were better satisfied using this method. The Project is sponsored by the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, S; Guerrero, M; Zhang, B

Purpose: To implement a comprehensive non-measurement-based verification program for patient-specific IMRT QA Methods: Based on published guidelines, a robust IMRT QA program should assess the following components: 1) accuracy of dose calculation, 2) accuracy of data transfer from the treatment planning system (TPS) to the record-and-verify (RV) system, 3) treatment plan deliverability, and 4) accuracy of plan delivery. Results: We have implemented an IMRT QA program that consist of four components: 1) an independent re-calculation of the dose distribution in the patient anatomy with a commercial secondary dose calculation program: Mobius3D (Mobius Medical Systems, Houston, TX), with dose accuracy evaluationmore » using gamma analysis, PTV mean dose, PTV coverage to 95%, and organ-at-risk mean dose; 2) an automated in-house-developed plan comparison system that compares all relevant plan parameters such as MU, MLC position, beam iso-center position, collimator, gantry, couch, field size settings, and bolus placement, etc. between the plan and the RV system; 3) use of the RV system to check the plan deliverability and further confirm using “mode-up” function on treatment console for plans receiving warning; and 4) implementation of a comprehensive weekly MLC QA, in addition to routine accelerator monthly and daily QA. Among 1200 verifications, there were 9 cases of suspicious calculations, 5 cases of delivery failure, no data transfer errors, and no failure of weekly MLC QA. These 9 suspicious cases were due to the PTV extending to the skin or to heterogeneity correction effects, which would not have been caught using phantom measurement-based QA. The delivery failure was due to the rounding variation of MLC position between the planning system and RV system. Conclusion: A very efficient, yet comprehensive, non-measurement-based patient-specific QA program has been implemented and used clinically for about 18 months with excellent results.« less

SU-E-T-179: Clinical Impact of IMRT Failure Modes at Or Near TG-142 Tolerance Criteria Levels

DOE Office of Scientific and Technical Information (OSTI.GOV)

Faught, J Tonigan; Balter, P; Johnson, J

2015-06-15

Purpose: Quantitatively assess the clinical impact of 11 critical IMRT dose delivery failure modes. Methods: Eleven step-and-shoot IMRT failure modes (FMs) were introduced into twelve Pinnacle v9.8 treatment plans. One standard and one highly modulated plan on the IROC IMRT phantom and ten previous H&N patient treatment plans were used. FMs included physics components covered by basic QA near tolerance criteria levels (TG-142) such as beam energy, MLC positioning, and MLC modeling. Resultant DVHs were compared to those of failure-free plans and the severity of plan degradation was assessed considering PTV coverage and OAR and normal tissue tolerances and usedmore » for FMEA severity scoring. Six of these FMs were physically simulated and phantom irradiations performed. TLD and radiochromic film results are used for comparison to treatment planning studies. Results: Based on treatment planning studies, the largest clinical impact from the phantom cases was induced by 2 mm systematic MLC shift in one bank with the combination of a D95% target under dose near 16% and OAR overdose near 8%. Cord overdoses of 5%–11% occurred with gantry angle, collimator angle, couch angle, MLC leaf end modeling, and MLC transmission and leakage modeling FMs. PTV coverage and/or OAR sparing was compromised in all FMs introduced in phantom plans with the exception of CT number to electron density tables, MU linearity, and MLC tongue-and-groove modeling. Physical measurements did not entirely agree with treatment planning results. For example, symmetry errors resulted in the largest physically measured discrepancies of up to 3% in the PTVs while a maximum of 0.5% deviation was seen in the treatment planning studies. Patient treatment plan study results are under analysis. Conclusion: Even in the simplistic anatomy of the IROC phantom, some basic physics FMs, just outside of TG-142 tolerance criteria, appear to have the potential for large clinical implications.« less

NOTE: Reducing the number of segments in unidirectional MLC segmentations

NASA Astrophysics Data System (ADS)

Mellado, X.; Cruz, S.; Artacho, J. M.; Canellas, M.

2010-02-01

In intensity-modulated radiation therapy (IMRT), fluence matrices obtained from a treatment planning system are usually delivered by a linear accelerator equipped with a multileaf collimator (MLC). A segmentation method is needed for decomposing these fluence matrices into segments suitable for the MLC, and the number of segments used is an important factor for treatment time. In this work, an algorithm for reduction of the number of segments (NS) is presented for unidirectional segmentations, where there is no backtracking of the MLC leaves. It uses a geometrical representation of the segmentation output for searching the key values in a fluence matrix that complicate its decomposition. The NS reduction is achieved by performing minor modifications in these values, under the conditions of avoiding substantial modifications of the dose-volume histogram, and does not increase in average the total number of monitor units delivered. The proposed method was tested using two clinical cases planned with the PCRT 3D® treatment planning system.

Electromagnetic-Guided MLC Tracking Radiation Therapy for Prostate Cancer Patients: Prospective Clinical Trial Results.

PubMed

Keall, Paul J; Colvill, Emma; O'Brien, Ricky; Caillet, Vincent; Eade, Thomas; Kneebone, Andrew; Hruby, George; Poulsen, Per R; Zwan, Benjamin; Greer, Peter B; Booth, Jeremy

2018-06-01

To report on the primary and secondary outcomes of a prospective clinical trial of electromagnetic-guided multileaf collimator (MLC) tracking radiation therapy for prostate cancer. Twenty-eight men with prostate cancer were treated with electromagnetic-guided MLC tracking with volumetric modulated arc therapy. A total of 858 fractions were delivered, with the dose per fraction ranging from 2 to 13.75 Gy. The primary outcome was feasibility, with success determined if >95% of fractions were successfully delivered. The secondary outcomes were (1) the improvement in beam-target geometric alignment, (2) the improvement in dosimetric coverage of the prostate and avoidance of critical structures, and (3) no acute grade ≥3 genitourinary or gastrointestinal toxicity. All 858 planned fractions were successfully delivered with MLC tracking, demonstrating the primary outcome of feasibility (P < .001). MLC tracking improved the beam-target geometric alignment from 1.4 to 0.90 mm (root-mean-square error). MLC tracking improved the dosimetric coverage of the prostate and reduced the daily variation in dose to critical structures. No acute grade ≥3 genitourinary or gastrointestinal toxicity was observed. Electromagnetic-guided MLC tracking radiation therapy for prostate cancer is feasible. The patients received improved geometric targeting and delivered dose distributions that were closer to those planned than they would have received without electromagnetic-guided MLC tracking. No significant acute toxicity was observed. Copyright © 2018 Elsevier Inc. All rights reserved.

On the suitability of Elekta’s Agility 160 MLC for tracked radiation delivery: closed-loop machine performance

NASA Astrophysics Data System (ADS)

Glitzner, M.; Crijns, S. P. M.; de Senneville, B. Denis; Lagendijk, J. J. W.; Raaymakers, B. W.

2015-03-01

For motion adaptive radiotherapy, dynamic multileaf collimator tracking can be employed to reduce treatment margins by steering the beam according to the organ motion. The Elekta Agility 160 MLC has hitherto not been evaluated for its tracking suitability. Both dosimetric performance and latency are key figures and need to be assessed generically, independent of the used motion sensor. In this paper, we propose the use of harmonic functions directly fed to the MLC to determine its latency during continuous motion. Furthermore, a control variable is extracted from a camera system and fed to the MLC. Using this setup, film dosimetry and subsequent γ statistics are performed, evaluating the response when tracking (MRI)-based physiologic motion in a closed-loop. The delay attributed to the MLC itself was shown to be a minor contributor to the overall feedback chain as compared to the impact of imaging components such as MRI sequences. Delay showed a linear phase behaviour of the MLC employed in continuously dynamic applications, which enables a general MLC-characterization. Using the exemplary feedback chain, dosimetry showed a vast increase in pass rate employing γ statistics. In this early stage, the tracking performance of the Agility using the test bench yielded promising results, making the technique eligible for translation to tracking using clinical imaging modalities.

SU-F-T-384: Step and Shoot IMRT, VMAT and Autoplan VMAT Nasopharnyx Plan Robustness to Linear Accelerator Delivery Errors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pogson, EM; Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW; Ingham Institute for Applied Medical Research, Sydney, NSW

Purpose: To identify the robustness of different treatment techniques in respect to simulated linac errors on the dose distribution to the target volume and organs at risk for step and shoot IMRT (ssIMRT), VMAT and Autoplan generated VMAT nasopharynx plans. Methods: A nasopharynx patient dataset was retrospectively replanned with three different techniques: 7 beam ssIMRT, one arc manual generated VMAT and one arc automatically generated VMAT. Treatment simulated uncertainties: gantry, collimator, MLC field size and MLC shifts, were introduced into these plans at increments of 5,2,1,−1,−2 and −5 (degrees or mm) and recalculated in Pinnacle. The mean and maximum dosesmore » were calculated for the high dose PTV, parotids, brainstem, and spinal cord and then compared to the original baseline plan. Results: Simulated gantry angle errors have <1% effect on the PTV, ssIMRT is most sensitive. The small collimator errors (±1 and ±2 degrees) impacted the mean PTV dose by <2% for all techniques, however for the ±5 degree errors mean target varied by up to 7% for the Autoplan VMAT and 10% for the max dose to the spinal cord and brain stem, seen in all techniques. The simulated MLC shifts introduced the largest errors for the Autoplan VMAT, with the larger MLC modulation presumably being the cause. The most critical error observed, was the MLC field size error, where even small errors of 1 mm, caused significant changes to both the PTV and the OAR. The ssIMRT is the least sensitive and the Autoplan the most sensitive, with target errors of up to 20% over and under dosages observed. Conclusion: For a nasopharynx patient the plan robustness observed is highest for the ssIMRT plan and lowest for the Autoplan generated VMAT plan. This could be caused by the more complex MLC modulation seen for the VMAT plans. This project is supported by a grant from NSW Cancer Council.« less

SU-G-TeP4-15: The Roucoulette: A Set of Quality Control Tests for Dynamic Trajectory (4Pi) Treatment Delivery Techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Teke, T

Purpose: To present and validate a set of quality control tests for trajectory treatment delivery using synchronized dynamic couch (translation and rotation), MLC and collimator motion. Methods: The quality control tests are based on the Picket fence test, which consist of 5 narrow band 2mm width spaced at 2.5cm intervals, and adds progressively synchronized dynamic motions. The tests were exposed on GafChromic EBT3 films. The first test is a regular (no motion and MLC static while beam is on) Picket Fence test used as baseline. The second test includes simultaneous collimator and couch rotation, each stripe corresponding to a differentmore » rotation speed. Errors in these tests were introduced (0.5 degree and 1 degree error in rotation synchronization) to assess the error sensitivity of this test. The second test is similar to the regular Picket Fence but now including dynamic MLC motion and couch translation (including acceleration during delivery) while the beam is on. Finally in the third test, which is a combination of the first and second test, the Picket Fence pattern is delivered using synchronized collimator and couch rotation and synchronized dynamic MLC and couch translation including acceleration. Films were analyzed with FilmQA Pro. Results: The distance between the peaks in the dose profile where measured (18.5cm away from the isocentre in the inplane direction where non synchronized rotation would have the largest effect) and compared to the regular Picket Fence tests. For well synchronized motions distances between peaks where between 24.9–25.4 mm identical to the regular Picket Fence test. This range increased to 24.4–26.4mm and 23.4–26.4mm for 0.5 degree and 1 degree error respectively. The amplitude also decreased up to 15% when errors are introduced. Conclusion: We demonstrated that the Roucoulette tests can be used as a quality control tests for trajectory treatment delivery using synchronized dynamic motion.« less

Commissioning and quality assurance for VMAT delivery systems: An efficient time-resolved system using real-time EPID imaging.

PubMed

Zwan, Benjamin J; Barnes, Michael P; Hindmarsh, Jonathan; Lim, Seng B; Lovelock, Dale M; Fuangrod, Todsaporn; O'Connor, Daryl J; Keall, Paul J; Greer, Peter B

2017-08-01

An ideal commissioning and quality assurance (QA) program for Volumetric Modulated Arc Therapy (VMAT) delivery systems should assess the performance of each individual dynamic component as a function of gantry angle. Procedures within such a program should also be time-efficient, independent of the delivery system and be sensitive to all types of errors. The purpose of this work is to develop a system for automated time-resolved commissioning and QA of VMAT control systems which meets these criteria. The procedures developed within this work rely solely on images obtained, using an electronic portal imaging device (EPID) without the presence of a phantom. During the delivery of specially designed VMAT test plans, EPID frames were acquired at 9.5 Hz, using a frame grabber. The set of test plans was developed to individually assess the performance of the dose delivery and multileaf collimator (MLC) control systems under varying levels of delivery complexities. An in-house software tool was developed to automatically extract features from the EPID images and evaluate the following characteristics as a function of gantry angle: dose delivery accuracy, dose rate constancy, beam profile constancy, gantry speed constancy, dynamic MLC positioning accuracy, MLC speed and acceleration constancy, and synchronization between gantry angle, MLC positioning and dose rate. Machine log files were also acquired during each delivery and subsequently compared to information extracted from EPID image frames. The largest difference between measured and planned dose at any gantry angle was 0.8% which correlated with rapid changes in dose rate and gantry speed. For all other test plans, the dose delivered was within 0.25% of the planned dose for all gantry angles. Profile constancy was not found to vary with gantry angle for tests where gantry speed and dose rate were constant, however, for tests with varying dose rate and gantry speed, segments with lower dose rate and higher gantry speed exhibited less profile stability. MLC positional accuracy was not observed to be dependent on the degree of interdigitation. MLC speed was measured for each individual leaf and slower leaf speeds were shown to be compensated for by lower dose rates. The test procedures were found to be sensitive to 1 mm systematic MLC errors, 1 mm random MLC errors, 0.4 mm MLC gap errors and synchronization errors between the MLC, dose rate and gantry angle controls systems of 1°. In general, parameters measured by both EPID and log files agreed with the plan, however, a greater average departure from the plan was evidenced by the EPID measurements. QA test plans and analysis methods have been developed to assess the performance of each dynamic component of VMAT deliveries individually and as a function of gantry angle. This methodology relies solely on time-resolved EPID imaging without the presence of a phantom and has been shown to be sensitive to a range of delivery errors. The procedures developed in this work are both comprehensive and time-efficient and can be used for streamlined commissioning and QA of VMAT delivery systems. © 2017 American Association of Physicists in Medicine.

SU-G-JeP1-12: Head-To-Head Performance Characterization of Two Multileaf Collimator Tracking Algorithms for Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Caillet, V; Colvill, E; Royal North Shore Hospital, St Leonards, Sydney

2016-06-15

Purpose: Multi-leaf collimator (MLC) tracking is being clinically pioneered to continuously compensate for thoracic and abdominal motion during radiotherapy. The purpose of this work is to characterize the performance of two MLC tracking algorithms for cancer radiotherapy, based on a direct optimization and a piecewise leaf fitting approach respectively. Methods: To test the algorithms, both physical and in silico experiments were performed. Previously published high and low modulation VMAT plans for lung and prostate cancer cases were used along with eight patient-measured organ-specific trajectories. For both MLC tracking algorithm, the plans were run with their corresponding patient trajectories. The physicalmore » experiments were performed on a Trilogy Varian linac and a programmable phantom (HexaMotion platform). For each MLC tracking algorithm, plan and patient trajectory, the tracking accuracy was quantified as the difference in aperture area between ideal and fitted MLC. To compare algorithms, the average cumulative tracking error area for each experiment was calculated. The two-sample Kolmogorov-Smirnov (KS) test was used to evaluate the cumulative tracking errors between algorithms. Results: Comparison of tracking errors for the physical and in silico experiments showed minor differences between the two algorithms. The KS D-statistics for the physical experiments were below 0.05 denoting no significant differences between the two distributions pattern and the average error area (direct optimization/piecewise leaf-fitting) were comparable (66.64 cm2/65.65 cm2). For the in silico experiments, the KS D-statistics were below 0.05 and the average errors area were also equivalent (49.38 cm2/48.98 cm2). Conclusion: The comparison between the two leaf fittings algorithms demonstrated no significant differences in tracking errors, neither in a clinically realistic environment nor in silico. The similarities in the two independent algorithms give confidence in the use of either algorithm for clinical implementation.« less

SU-E-I-49: The Evaluation of Usability of Multileaf Collimator for Diagnostic Radiation in Cephalometric Exposure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Han, S; Kim, K; Jung, H

Purpose: This study evaluated usability of Multileaf collimator (MLC) for diagnostic radiation in cephalometric exposure using optical stimulated luminance dosimeters (OSLDs) Methods: The MLC material was made alloy tool steel (SKD-11) and the density of it is 7.89g/m3 that is similar to it of steel (Fe, 7.85 g/m3) and the MLC was attached to general radiography unit (Rex-650R, Listem Inc, Korea) for cephalometric exposure. The OSLDs that used were nanoDotTM Dosimeter (Landauer Inc, Glenwood, USA) and we read out OSLDs with micro star system (Landauer Inc, Glenwood, USA). The Optical annealing system contained fluorescent lamps (Osram lumilux, 24 W, 280more » ∼780 nm). To measure absorbed dose using OSLDs, was carried out dosimetric characteristics of OSLDs. Based on these, we evaluated dose reduction of critical organ (Eyes, Thyroids) with MLC in cephalometric exposure Results: The dosimetric characteristics were following that batch homogeneity was 1.21% and reproducibility was 0.96% of the coefficient of variation The linearity was that the correlation of between dose and count was fitted by linear function (dose,mGy = 0.00029 × Count, R2 =0.997). The range of angular dependence was from −3.6% to 3.7% variation when each degree was normalized by zero degree. The organ dose of Rt. eye, Lt eye, thyroids were 77.8 μGy, 337.0 μGy, 323.1μGy, respectively in open field and the dose reduction of organ dose was 10.6%(8.3μGy), 12.4 %(42 μGy), 87.1%(281.4μGy) with MLC Conclusion: We certified dose reduction of organ dose in cephalometric exposure. The dose reduction of Eye was 11% because of reduction of field size and it of thyroids was 87% by primary beam shielding.« less

Maximizing the potential of direct aperture optimization through collimator rotation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Milette, Marie-Pierre; Otto, Karl; Medical Physics, BC Cancer Agency-Vancouver Centre, Vancouver, British Columbia

Intensity-modulated radiation therapy (IMRT) treatment plans are conventionally produced by the optimization of fluence maps followed by a leaf sequencing step. An alternative to fluence based inverse planning is to optimize directly the leaf positions and field weights of multileaf collimator (MLC) apertures. This approach is typically referred to as direct aperture optimization (DAO). It has been shown that equivalent dose distributions may be generated that have substantially fewer monitor units (MU) and number of apertures compared to fluence based optimization techniques. Here we introduce a DAO technique with rotated apertures that we call rotating aperture optimization (RAO). The advantagesmore » of collimator rotation in IMRT have been shown previously and include higher fluence spatial resolution, increased flexibility in the generation of aperture shapes and less interleaf effects. We have tested our RAO algorithm on a complex C-shaped target, seven nasopharynx cancer recurrences, and one multitarget nasopharynx carcinoma patient. A study was performed in order to assess the capabilities of RAO as compared to fixed collimator angle DAO. The accuracy of fixed and rotated collimator aperture delivery was also verified. An analysis of the optimized treatment plans indicates that plans generated with RAO are as good as or better than DAO while maintaining a smaller number of apertures and MU than fluence based IMRT. Delivery verification results show that RAO is less sensitive to tongue and groove effects than DAO. Delivery time is currently increased due to the collimator rotation speed although this is a mechanical limitation that can be eliminated in the future.« less

MO-F-CAMPUS-T-01: Radiosurgery of Multiple Brain Metastases with Single-Isocenter VMAT: Optimizing Treatment Geometry to Reduce Normal Brain Dose

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, Q; Snyder, K; Liu, C

Purpose: To develop an optimization algorithm to reduce normal brain dose by optimizing couch and collimator angles for single isocenter multiple targets treatment of stereotactic radiosurgery. Methods: Three metastatic brain lesions were retrospectively planned using single-isocenter volumetric modulated arc therapy (VMAT). Three matrices were developed to calculate the projection of each lesion on Beam’s Eye View (BEV) by the rotating couch, collimator and gantry respectively. The island blocking problem was addressed by computing the total area of open space between any two lesions with shared MLC leaf pairs. The couch and collimator angles resulting in the smallest open areas weremore » the optimized angles for each treatment arc. Two treatment plans with and without couch and collimator angle optimization were developed using the same objective functions and to achieve 99% of each target volume receiving full prescription dose of 18Gy. Plan quality was evaluated by calculating each target’s Conformity Index (CI), Gradient Index (GI), and Homogeneity index (HI), and absolute volume of normal brain V8Gy, V10Gy, V12Gy, and V14Gy. Results: Using the new couch/collimator optimization strategy, dose to normal brain tissue was reduced substantially. V8, V10, V12, and V14 decreased by 2.3%, 3.6%, 3.5%, and 6%, respectively. There were no significant differences in the conformity index, gradient index, and homogeneity index between two treatment plans with and without the new optimization algorithm. Conclusion: We have developed a solution to the island blocking problem in delivering radiation to multiple brain metastases with shared isocenter. Significant reduction in dose to normal brain was achieved by using optimal couch and collimator angles that minimize total area of open space between any of the two lesions with shared MLC leaf pairs. This technique has been integrated into Eclipse treatment system using scripting API.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Belley, M; Schmidt, M; Knutson, N

Purpose: Physics second-checks for external beam radiation therapy are performed, in-part, to verify that the machine parameters in the Record-and-Verify (R&V) system that will ultimately be sent to the LINAC exactly match the values initially calculated by the Treatment Planning System (TPS). While performing the second-check, a large portion of the physicists’ time is spent navigating and arranging display windows to locate and compare the relevant numerical values (MLC position, collimator rotation, field size, MU, etc.). Here, we describe the development of a software tool that guides the physicist by aggregating and succinctly displaying machine parameter data relevant to themore » physics second-check process. Methods: A data retrieval software tool was developed using Python to aggregate data and generate a list of machine parameters that are commonly verified during the physics second-check process. This software tool imported values from (i) the TPS RT Plan DICOM file and (ii) the MOSAIQ (R&V) Structured Query Language (SQL) database. The machine parameters aggregated for this study included: MLC positions, X&Y jaw positions, collimator rotation, gantry rotation, MU, dose rate, wedges and accessories, cumulative dose, energy, machine name, couch angle, and more. Results: A GUI interface was developed to generate a side-by-side display of the aggregated machine parameter values for each field, and presented to the physicist for direct visual comparison. This software tool was tested for 3D conformal, static IMRT, sliding window IMRT, and VMAT treatment plans. Conclusion: This software tool facilitated the data collection process needed in order for the physicist to conduct a second-check, thus yielding an optimized second-check workflow that was both more user friendly and time-efficient. Utilizing this software tool, the physicist was able to spend less time searching through the TPS PDF plan document and the R&V system and focus the second-check efforts on assessing the patient-specific plan-quality.« less

Monte Carlo modeling and simulations of the High Definition (HD120) micro MLC and validation against measurements for a 6 MV beam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borges, C.; Zarza-Moreno, M.; Heath, E.

2012-01-15

Purpose: The most recent Varian micro multileaf collimator (MLC), the High Definition (HD120) MLC, was modeled using the BEAMNRC Monte Carlo code. This model was incorporated into a Varian medical linear accelerator, for a 6 MV beam, in static and dynamic mode. The model was validated by comparing simulated profiles with measurements. Methods: The Varian Trilogy (2300C/D) accelerator model was accurately implemented using the state-of-the-art Monte Carlo simulation program BEAMNRC and validated against off-axis and depth dose profiles measured using ionization chambers, by adjusting the energy and the full width at half maximum (FWHM) of the initial electron beam. Themore » HD120 MLC was modeled by developing a new BEAMNRC component module (CM), designated HDMLC, adapting the available DYNVMLC CM and incorporating the specific characteristics of this new micro MLC. The leaf dimensions were provided by the manufacturer. The geometry was visualized by tracing particles through the CM and recording their position when a leaf boundary is crossed. The leaf material density and abutting air gap between leaves were adjusted in order to obtain a good agreement between the simulated leakage profiles and EBT2 film measurements performed in a solid water phantom. To validate the HDMLC implementation, additional MLC static patterns were also simulated and compared to additional measurements. Furthermore, the ability to simulate dynamic MLC fields was implemented in the HDMLC CM. The simulation results of these fields were compared with EBT2 film measurements performed in a solid water phantom. Results: Overall, the discrepancies, with and without MLC, between the opened field simulations and the measurements using ionization chambers in a water phantom, for the off-axis profiles are below 2% and in depth-dose profiles are below 2% after the maximum dose depth and below 4% in the build-up region. On the conditions of these simulations, this tungsten-based MLC has a density of 18.7 g cm{sup -3} and an overall leakage of about 1.1 {+-} 0.03%. The discrepancies between the film measured and simulated closed and blocked fields are below 2% and 8%, respectively. Other measurements were performed for alternated leaf patterns and the agreement is satisfactory (to within 4%). The dynamic mode for this MLC was implemented and the discrepancies between film measurements and simulations are within 4%. Conclusions: The Varian Trilogy (2300 C/D) linear accelerator including the HD120 MLC was successfully modeled and simulated using the Monte Carlo BEAMNRC code by developing an independent CM, the HDMLC CM, either in static and dynamic modes.« less

Comparative Analysis of Different Measurement Techniques for MLC Characterization: Preliminary Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Larraga-Gutierrez, J. M.; Ballesteros-Zebadua, P.; Garcia-Garduno, O. A.

2008-08-11

Radiation transmission, leakage and beam penumbra are essential dosimetric parameters related to the commissioning of a multileaf collimation system. This work shows a comparative analysis of commonly used film detectors: X-OMAT V2 and EDR2 radiographic films, and GafChromic EBT registered radiochromic film. The results show that X-OMAT over-estimates radiation leakage and 80-20% beam penumbra. However, according to the reference values reported by the manufacturer for these dosimetric parameters, all three films are adequate for MLC dosimetric characterization, but special care must be taken when X-OMAT V2 film is used due to its low energy photon dependence.

Automatic online adaptive radiation therapy techniques for targets with significant shape change: a feasibility study.

PubMed

Court, Laurence E; Tishler, Roy B; Petit, Joshua; Cormack, Robert; Chin, Lee

2006-05-21

This work looks at the feasibility of an online adaptive radiation therapy concept that would detect the daily position and shape of the patient, and would then correct the daily treatment to account for any changes compared with planning position. In particular, it looks at the possibility of developing algorithms to correct for large complicated shape change. For co-planar beams, the dose in an axial plane is approximately associated with the positions of a single multi-leaf collimator (MLC) pair. We start with a primary plan, and automatically generate several secondary plans with gantry angles offset by regular increments. MLC sequences for each plan are calculated keeping monitor units (MUs) and number of segments constant for a given beam (fluences are different). Bulk registration (3D) of planning and daily CT images gives global shifts. Slice-by-slice (2D) registration gives local shifts and rotations about the longitudinal axis for each axial slice. The daily MLC sequence is then created for each axial slice/MLC leaf pair combination, by taking the MLC positions from the pre-calculated plan with the nearest rotation, and shifting using a beam's-eye-view calculation to account for local linear shifts. A planning study was carried out using two head and neck region MR images of a healthy volunteer which were contoured to simulate a base-of-tongue treatment: one with the head straight (used to simulate the planning image) and the other with the head tilted to the left (the daily image). Head and neck treatment was chosen to evaluate this technique because of its challenging nature, with varying internal and external contours, and multiple degrees of freedom. Shape change was significant: on a slice-by-slice basis, local rotations in the daily image varied from 2 to 31 degrees, and local shifts ranged from -0.2 to 0.5 cm and -0.4 to 0.0 cm in right-left and posterior-anterior directions, respectively. The adapted treatment gave reasonable target coverage (100%, 90% and 80% of the base-of-tongue, left nodes and right nodes, respectively, receiving the daily prescription dose), and kept the daily cord dose below the limit used in the original plan (65%, equivalent to 46 Gy over 35 fractions). Most of the loss of coverage was due to one shoulder being raised more superior relative to the other shoulder compared with the plan. This type of skew-like motion is not accounted for by the proposed ART technique. In conclusion, this technique has potential to correct for fairly extreme daily changes in patient setup, but some control of the daily position would still be necessary. Importantly, it was possible to combine treatments from different plans (MLC sequences) to correct for position and shape change.

SU-E-T-325: The New Evaluation Method of the VMAT Plan Delivery Using Varian DynaLog Files and Modulation Complexity Score (MCS)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tateoka, K; Graduate School of Medicine, Sapporo Medical University, Sapporo, JP; Fujimomo, K

2014-06-01

Purpose: The aim of the study is to evaluate the use of Varian DynaLog files to verify VMAT plans delivery and modulation complexity score (MCS) of VMAT. Methods: Delivery accuracy of machine performance was quantified by multileaf collimator (MLC) position errors, gantry angle errors and fluence delivery accuracy for volumetric modulated arc therapy (VMAT). The relationship between machine performance and plan complexity were also investigated using the modulation complexity score (MCS). Plan and Actual MLC positions, gantry angles and delivered fraction of monitor units were extracted from Varian DynaLog files. These factors were taken from the record and verify systemmore » of MLC control file. Planned and delivered beam data were compared to determine leaf position errors and gantry angle errors. Analysis was also performed on planned and actual fluence maps reconstructed from those of the DynaLog files. This analysis was performed for all treatment fractions of 5 prostate VMAT plans. The analysis of DynaLog files have been carried out by in-house programming in Visual C++. Results: The root mean square of leaf position and gantry angle errors were about 0.12 and 0.15, respectively. The Gamma of planned and actual fluence maps at 3%/3 mm criterion was about 99.21. The gamma of the leaf position errors were not directly related to plan complexity as determined by the MCS. Therefore, the gamma of the gantry angle errors were directly related to plan complexity as determined by the MCS. Conclusion: This study shows Varian dynalog files for VMAT plan can be diagnosed delivery errors not possible with phantom based quality assurance. Furthermore, the MCS of VMAT plan can evaluate delivery accuracy for patients receiving of VMAT. Machine performance was found to be directly related to plan complexity but this is not the dominant determinant of delivery accuracy.« less

Detector system dose verification comparisons for arc therapy: couch vs. gantry mount

PubMed Central

Manikandan, Arjunan; Nandy, Maitreyee; Sureka, Chandra Sekaran; Gossman, Michael S.; Sujatha, Nadendla; Rajendran, Vivek Thirupathur

2014-01-01

The aim of this study was to assess the performance of a gantry‐mounted detector system and a couch set detector system using a systematic multileaf collimator positional error manually introduced for volumetric‐modulated arc therapy. Four head and neck and esophagus VMAT plans were evaluated by measurement using an electronic portal imaging device and an ion chamber array. Each plan was copied and duplicated with a 1 mm systematic MLC positional error in the left leaf bank. Direct comparison of measurements for plans with and without the error permitted observational characteristics for quality assurance performance between detectors. A total of 48 different plans were evaluated for this testing. The mean percentage planar dose differences required to satisfy a 95% match between plans with and without the MLCPE were 5.2% ± 0.5% for the chamber array with gantry motion, 8.12% ± 1.04% for the chamber array with a static gantry at 0°, and 10.9% ± 1.4% for the EPID with gantry motion. It was observed that the EPID was less accurate due to overresponse of the MLCPE in the left leaf bank. The EPID always images bank‐A on the ipsilateral side of the detector, whereas for a chamber array or for a patient, that bank changes as it crosses the ‐90° or +90° position. A couch set detector system can reproduce the TPS calculated values most consistently. We recommend it as the most reliable patient specific QA system for MLC position error testing. This research is highlighted by the finding of up to 12.7% dose variation for H/N and esophagus cases for VMAT delivery, where the mere source of error was the stated clinically acceptability of 1 mm MLC position deviation of TG‐142. PACS numbers: 87.56.‐v, 87.55.‐x, 07.57.KP, 29.40.‐n, 85.25.Pb PMID:24892330

SU-E-T-293: Simplifying Assumption for Determining Sc and Sp

DOE Office of Scientific and Technical Information (OSTI.GOV)

King, R; Cheung, A; Anderson, R

Purpose: Scp(mlc,jaw) is a two-dimensional function of collimator field size and effective field size. Conventionally, Scp(mlc,jaw) is treated as separable into components Sc(jaw) and Sp(mlc). Scp(mlc=jaw) is measured in phantom and Sc(jaw) is measured in air with Sp=Scp/Sc. Ideally, Sc and Sp would be able to predict measured values of Scp(mlc,jaw) for all combinations of mlc and jaw. However, ideal Sc and Sp functions do not exist and a measured two-dimensional Scp dataset cannot be decomposed into a unique pair of one-dimensional functions.If the output functions Sc(jaw) and Sp(mlc) were equal to each other and thus each equal to Scp(mlc=jaw){supmore » 0.5}, this condition would lead to a simpler measurement process by eliminating the need for in-air measurements. Without the distorting effect of the buildup-cap, small-field measurement would be limited only by the dimensions of the detector and would thus be improved by this simplification of the output functions. The goal of the present study is to evaluate an assumption that Sc=Sp. Methods: For a 6 MV x-ray beam, Sc and Sp were determined both by the conventional method and as Scp(mlc=jaw){sup 0.5}. Square field benchmark values of Scp(mlc,jaw) were then measured across the range from 2×2 to 29×29. Both Sc and Sp functions were then evaluated as to their ability to predict these measurements. Results: Both methods produced qualitatively similar results with <4% error for all cases and >3% error in 1 case. The conventional method produced 2 cases with >2% error, while the squareroot method produced only 1 such case. Conclusion: Though it would need to be validated for any specific beam to which it might be applied, under the conditions studied, the simplifying assumption that Sc = Sp is justified.« less

Matching extended-SSD electron beams to multileaf collimated photon beams in the treatment of head and neck cancer.

PubMed

Steel, Jared; Stewart, Allan; Satory, Philip

2009-09-01

Matching the penumbra of a 6 MeV electron beam to the penumbra of a 6 MV photon beam is a dose optimization challenge, especially when the electron beam is applied from an extended source-to-surface distance (SSD), as in the case of some head and neck treatments. Traditionally low melting point alloy blocks have been used to define the photon beam shielding over the spinal cord region. However, these are inherently time consuming to construct and employ in the clinical situation. Multileaf collimators (MLCs) provide a fast and reproducible shielding option but generate geometrically nonconformal approximations to the desired beam edge definition. The effects of substituting Cerrobend for the MLC shielding mode in the context of beam matching with extended-SSD electron beams are the subject of this investigation. Relative dose beam data from a Varian EX 2100 linear accelerator were acquired in a water tank under the 6 MeV electron beam at both standard and extended-SSD and under the 6 MV photon beam defined by Cerrobend and a number of MLC stepping regimes. The effect of increasing the electron beam SSD on the beam penumbra was assessed. MLC stepping was also assessed in terms of the effects on both the mean photon beam penumbra and the intraleaf dose-profile nonuniformity relative to the MLC midleaf. Computational techniques were used to combine the beam data so as to simulate composite relative dosimetry in the water tank, allowing fine control of beam abutment gap variation. Idealized volumetric dosimetry was generated based on the percentage depth-dose data for the beam modes and the abutment geometries involved. Comparison was made between each composite dosimetry dataset and the relevant ideal dosimetry dataset by way of subtraction. Weighted dose-difference volume histograms (DDVHs) were produced, and these, in turn, summed to provide an overall dosimetry score for each abutment and shielding type/angle combination. Increasing the electron beam SSD increased the penumbra width (defined as the lateral distance of the 80% and 20% isodose contours) by 8-10 mm at the depths of 10-20 mm. Mean photon beam penumbra width increased with increased MLC stepping, and the mean MLC penumbra was approximately 1.5 times greater than that across the corresponding Cerrobend shielding. Intraleaf dose discrepancy in the direction orthogonal to the beam edge also increased with MLC stepping. The weighted DDVH comparison techniques allowed the composite dosimetry resulting from the interplay of the abovementioned variables to be ranked. The MLC dosimetry ranked as good or better than that resulting from beam matching with Cerrobend for all except large field overlaps (-2.5 mm gap). The results for the linear-weighted DDVH comparison suggest that optimal MLC abutment dosimetry results from an optical surface gap of around 1 +/- 0.5 mm. Furthermore, this appears reasonably lenient to abutment gap variation, such as that arising from uncertainty in beam markup or other setup errors.

Evaluation of collimator rotation for volumetric modulated arc therapy lung stereotactic body radiation therapy using flattening filter free.

PubMed

Sandrini, Emmily Santos; da Silva, Ademir Xavier; da Silva, Claudia Menezes

2018-05-25

The collimator in volumetric modulated arc therapy (VMAT) planning is rotated to minimize tongue-and-groove effect and interleaf leakage. The aim of this study was to evaluate the effect of collimator angle on the dosimetric results of VMAT plan for patients with lung cancer undergoing stereotactic body radiation therapy (SBRT) treatment. In the present investigation discrepancies between the calculated dose distributions with different collimators rotations have been studied. Six different collimators rotations (0, 10, 20, 30, 45 and 90 degrees), 6 MV x-ray non-flattened from a TrueBeam accelerator equipped with High-Definition 120MLC were used, as well as two planning technique: One full arc and two half arcs. For rotation between 10 and 45 degrees there were not found a significant variation meanwhile collimator rotation of 0 and 90° may impact on dose distribution resulting in unexpected dose variation. The homogeneity, conformity and gradient indexes as well as dose in organs at risk reached their best values with the half arcs technique and collimator angle between 20° and 45°. Copyright © 2018 Elsevier Ltd. All rights reserved.

SU-F-T-371: Development of a Linac Monte Carlo Model to Calculate Surface Dose

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prajapati, S; Yan, Y; Gifford, K

2016-06-15

Purpose: To generate and validate a linac Monte Carlo (MC) model for surface dose prediction. Methods: BEAMnrc V4-2.4.0 was used to model 6 and 18 MV photon beams for a commercially available linac. DOSXYZnrc V4-2.4.0 calculated 3D dose distributions in water. Percent depth dose (PDD) and beam profiles were extracted for comparison to measured data. Surface dose and at depths in the buildup region was measured with radiochromic film at 100 cm SSD for 4 × 4 cm{sup 2} and 10 × 10 cm{sup 2} collimator settings for open and MLC collimated fields. For the 6 MV beam, films weremore » placed at depths ranging from 0.015 cm to 2 cm and for 18 MV, 0.015 cm to 3.5 cm in Solid Water™. Films were calibrated for both photon energies at their respective dmax. PDDs and profiles were extracted from the film and compared to the MC data. The MC model was adjusted to match measured PDD and profiles. Results: For the 6 MV beam, the mean error(ME) in PDD between film and MC for open fields was 1.9%, whereas it was 2.4% for MLC. For the 18 MV beam, the ME in PDD for open fields was 2% and was 3.5% for MLC. For the 6 MV beam, the average root mean square(RMS) deviation for the central 80% of the beam profile for open fields was 1.5%, whereas it was 1.6% for MLC. For the 18 MV beam, the maximum RMS for open fields was 3%, and was 3.1% for MLC. Conclusion: The MC model of a linac agreed to within 4% of film measurements for depths ranging from the surface to dmax. Therefore, the MC linac model can predict surface dose for clinical applications. Future work will focus on adjusting the linac MC model to reduce RMS error and improve accuracy.« less

Planning and delivery of four-dimensional radiation therapy with multileaf collimators

NASA Astrophysics Data System (ADS)

McMahon, Ryan L.

This study is an investigation of the application of multileaf collimators (MLCs) to the treatment of moving anatomy with external beam radiation therapy. First, a method for delivering intensity modulated radiation therapy (IMRT) to moving tumors is presented. This method uses an MLC control algorithm that calculates appropriate MLC leaf speeds in response to feedback from real-time imaging. The algorithm does not require a priori knowledge of a tumor's motion, and is based on the concept of self-correcting DMLC leaf trajectories . This gives the algorithm the distinct advantage of allowing for correction of DMLC delivery errors without interrupting delivery. The algorithm is first tested for the case of one-dimensional (1D) rigid tumor motion in the beam's eye view (BEV). For this type of motion, it is shown that the real-time tracking algorithm results in more accurate deliveries, with respect to delivered intensity, than those which ignore motion altogether. This is followed by an appropriate extension of the algorithm to two-dimensional (2D) rigid motion in the BEV. For this type of motion, it is shown that the 2D real-time tracking algorithm results in improved accuracy (in the delivered intensity) in comparison to deliveries which ignore tumor motion or only account for tumor motion which is aligned with MLC leaf travel. Finally, a method is presented for designing DMLC leaf trajectories which deliver a specified intensity over a moving tumor without overexposing critical structures which exhibit motion patterns that differ from that of the tumor. In addition to avoiding overexposure of critical organs, the method can, in the case shown, produce deliveries that are superior to anything achievable using stationary anatomy. In this regard, the method represents a systematic way to include anatomical motion as a degree of freedom in the optimization of IMRT while producing treatment plans that are deliverable with currently available technology. These results, combined with those related to the real-time MLC tracking algorithm, show that an MLC is a promising tool to investigate for the delivery of four-dimensional radiation therapy.

Verification of dosimetric accuracy on the TrueBeam STx: rounded leaf effect of the high definition MLC.

PubMed

Kielar, Kayla N; Mok, Ed; Hsu, Annie; Wang, Lei; Luxton, Gary

2012-10-01

The dosimetric leaf gap (DLG) in the Varian Eclipse treatment planning system is determined during commissioning and is used to model the effect of the rounded leaf-end of the multileaf collimator (MLC). This parameter attempts to model the physical difference between the radiation and light field and account for inherent leakage between leaf tips. With the increased use of single fraction high dose treatments requiring larger monitor units comes an enhanced concern in the accuracy of leakage calculations, as it accounts for much of the patient dose. This study serves to verify the dosimetric accuracy of the algorithm used to model the rounded leaf effect for the TrueBeam STx, and describes a methodology for determining best-practice parameter values, given the novel capabilities of the linear accelerator such as flattening filter free (FFF) treatments and a high definition MLC (HDMLC). During commissioning, the nominal MLC position was verified and the DLG parameter was determined using MLC-defined field sizes and moving gap tests, as is common in clinical testing. Treatment plans were created, and the DLG was optimized to achieve less than 1% difference between measured and calculated dose. The DLG value found was tested on treatment plans for all energies (6 MV, 10 MV, 15 MV, 6 MV FFF, 10 MV FFF) and modalities (3D conventional, IMRT, conformal arc, VMAT) available on the TrueBeam STx. The DLG parameter found during the initial MLC testing did not match the leaf gap modeling parameter that provided the most accurate dose delivery in clinical treatment plans. Using the physical leaf gap size as the DLG for the HDMLC can lead to 5% differences in measured and calculated doses. Separate optimization of the DLG parameter using end-to-end tests must be performed to ensure dosimetric accuracy in the modeling of the rounded leaf ends for the Eclipse treatment planning system. The difference in leaf gap modeling versus physical leaf gap dimensions is more pronounced in the more recent versions of Eclipse for both the HDMLC and the Millennium MLC. Once properly commissioned and tested using a methodology based on treatment plan verification, Eclipse is able to accurately model radiation dose delivered for SBRT treatments using the TrueBeam STx.

Potential of discrete Gaussian edge feathering method for improving abutment dosimetry in eMLC-delivered segmented-field electron conformal therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eley, John G.; Hogstrom, Kenneth R.; Matthews, Kenneth L.

2011-12-15

Purpose: The purpose of this work was to investigate the potential of discrete Gaussian edge feathering of the higher energy electron fields for improving abutment dosimetry in the planning volume when using an electron multileaf collimator (eMLC) to deliver segmented-field electron conformal therapy (ECT). Methods: A discrete (five-step) Gaussian edge spread function was used to match dose penumbras of differing beam energies (6-20 MeV) at a specified depth in a water phantom. Software was developed to define the leaf eMLC positions of an eMLC that most closely fit each electron field shape. The effect of 1D edge feathering of themore » higher energy field on dose homogeneity was computed and measured for segmented-field ECT treatment plans for three 2D PTVs in a water phantom, i.e., depth from the water surface to the distal PTV surface varied as a function of the x-axis (parallel to leaf motion) and remained constant along the y-axis (perpendicular to leaf motion). Additionally, the effect of 2D edge feathering was computed and measured for one radially symmetric, 3D PTV in a water phantom, i.e., depth from the water surface to the distal PTV surface varied as a function of both axes. For the 3D PTV, the feathering scheme was evaluated for 0.1-1.0-cm leaf widths. Dose calculations were performed using the pencil beam dose algorithm in the Pinnacle{sup 3} treatment planning system. Dose verification measurements were made using a prototype eMLC (1-cm leaf width). Results: 1D discrete Gaussian edge feathering reduced the standard deviation of dose in the 2D PTVs by 34, 34, and 39%. In the 3D PTV, the broad leaf width (1 cm) of the eMLC hindered the 2D application of the feathering solution to the 3D PTV, and the standard deviation of dose increased by 10%. However, 2D discrete Gaussian edge feathering with simulated eMLC leaf widths of 0.1-0.5 cm reduced the standard deviation of dose in the 3D PTV by 33-28%, respectively. Conclusions: A five-step discrete Gaussian edge spread function applied in 2D improves the abutment dosimetry but requires an eMLC leaf resolution better than 1 cm.« less

SU-F-T-429: Craniospinal Irradiation by VMAT Technique: Impact of FFF Beam and High Resolution MLC On Plan Quality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ganesh, T; Sarkar, B; Munshi, A

2016-06-15

Purpose: Objective of this study was to evaluate the impact of using flattening filter free (FFF) beam with 0.5 cm multileaf collimator (MLC) leaves over conventional flattened beam with 1 cm leaf width MLC on the treatment plan quality in cranio-spinal irradiation (CSI). Methods: For five medulloblastoma cases (3 males and 2 females), who were previously treated by volumetric modulated arc therapy (VMAT) technique using conventional flattened beam shaped by 1 cm width MLC leaves, four test plans were generated and compared against the delivered plan. These retrospective plans consisted of four different combinations of flattened and FFF beams frommore » Elekta’s Agility treatment head with 0.5 cm width MLC leaves. Sparing of organs at risks (OAR) in terms of dose to 5%, 50%, 75% and 90% volumes, mean and maximum dose were evaluated. Results: All plans satisfied the planning objective of covering 95% of PTV by at least 95% of prescription dose. Marginal variation of dose spillage was observed between different VMAT plans at very low dose range (1–5 Gy). Variation in dose statistics for PTVs and OARs were within 1% or 1 Gy. Amongst the five plans, the plan with flattened beam with 1 cm MLC had the highest number of MUs, 2.13 times higher than the plan with Agility MLC with FFF beam that had the least number of MUs. No statistically significant difference (p≥0.05) was observed between the reference plan and the retrospectively generated plans in terms of PTV coverage, cold spot, hot spot and organ at risk doses. Conclusion: In the treatment of CSI cases by VMAT technique, FFF beams and/or finer width MLC did not exhibit advantage over the flattened beams or wider MLC in terms of plan quality except for reduction in MUs.« less

Quantifying the performance of in vivo portal dosimetry in detecting four types of treatment parameter variations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bojechko, C.; Ford, E. C., E-mail: eford@uw.edu

Purpose: To quantify the ability of electronic portal imaging device (EPID) dosimetry used during treatment (in vivo) in detecting variations that can occur in the course of patient treatment. Methods: Images of transmitted radiation from in vivo EPID measurements were converted to a 2D planar dose at isocenter and compared to the treatment planning dose using a prototype software system. Using the treatment planning system (TPS), four different types of variability were modeled: overall dose scaling, shifting the positions of the multileaf collimator (MLC) leaves, shifting of the patient position, and changes in the patient body contour. The gamma passmore » rate was calculated for the modified and unmodified plans and used to construct a receiver operator characteristic (ROC) curve to assess the detectability of the different parameter variations. The detectability is given by the area under the ROC curve (AUC). The TPS was also used to calculate the impact of the variations on the target dose–volume histogram. Results: Nine intensity modulation radiation therapy plans were measured for four different anatomical sites consisting of 70 separate fields. Results show that in vivo EPID dosimetry was most sensitive to variations in the machine output, AUC = 0.70 − 0.94, changes in patient body habitus, AUC = 0.67 − 0.88, and systematic shifts in the MLC bank positions, AUC = 0.59 − 0.82. These deviations are expected to have a relatively small clinical impact [planning target volume (PTV) D{sub 99} change <7%]. Larger variations have even higher detectability. Displacements in the patient’s position and random variations in MLC leaf positions were not readily detectable, AUC < 0.64. The D{sub 99} of the PTV changed by up to 57% for the patient position shifts considered here. Conclusions: In vivo EPID dosimetry is able to detect relatively small variations in overall dose, systematic shifts of the MLC’s, and changes in the patient habitus. Shifts in the patient’s position which can introduce large changes in the target dose coverage were not readily detected.« less

SU-G-BRA-16: Target Dose Comparison for Dynamic MLC Tracking and Mid- Ventilation Planning in Lung Radiotherapy Subject to Intrafractional Baseline Drifts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Menten, MJ; Fast, MF; Nill, S

Purpose: Lung tumor motion during radiotherapy can be accounted for by expanded treatment margins, for example using a mid-ventilation planning approach, or by localizing the tumor in real-time and adapting the treatment beam with multileaf collimator (MLC) tracking. This study evaluates the effect of intrafractional changes in the average tumor position (baseline drifts) on these two treatment techniques. Methods: Lung stereotactic treatment plans (9-beam IMRT, 54Gy/3 fractions, mean treatment time: 9.63min) were generated for three patients: either for delivery with MLC tracking (isotropic GTV-to-PTV margin: 2.6mm) or planned with a mid-ventilation approach and delivered without online motion compensation (GTV-to-PTV margin:more » 4.4-6.3mm). Delivery to a breathing patient was simulated using DynaTrack, our in-house tracking and delivery software. Baseline drifts in cranial and posterior direction were simulated at a rate of 0.5, 1.0 or 1.5mm/min. For dose reconstruction, the corresponding 4DCT phase was selected for each time point of the delivery. Baseline drifts were accounted for by rigidly shifting the CT to ensure correct relative beam-to-target positioning. Afterwards, the doses delivered to each 4DCT phase were accumulated deformably on the mid-ventilation phase using research RayStation v4.6 and dose coverage of the GTV was evaluated. Results: When using the mid-ventilation planning approach, dose coverage of the tumor deteriorated substantially in the presence of baseline drifts. The reduction in D98% coverage of the GTV in a single fraction ranged from 0.4-1.2, 0.6-3.3 and 4.5-6.2Gy, respectively, for the different drift rates. With MLC tracking the GTV D98% coverage remained unchanged (+/− 0.1Gy) regardless of drift. Conclusion: Intrafractional baseline drifts reduce the tumor dose in treatments based on mid-ventilation planning. In rare, large target baseline drifts tumor dose coverage may drop below the prescription, potentially affecting clinical outcome in hypofractionated treatment protocols. Dynamic MLC tracking preserves tumor dose coverage even in the presence of extreme baseline drifts. We acknowledge financial and technical support of the MLC tracking research from Elekta AB. Research at ICR is supported by CRUK under Programme C33589/A19727 and NHS funding to the NIHR Biomedical Research Centre at RMH and ICR. MFF is supported by CRUK under Programme C33589/A19908.« less

SU-E-T-214: Intensity Modulated Proton Therapy (IMPT) Based On Passively Scattered Protons and Multi-Leaf Collimation: Prototype TPS and Dosimetry Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sanchez-Parcerisa, D; Carabe-Fernandez, A

2014-06-01

Purpose. Intensity-modulated proton therapy is usually implemented with multi-field optimization of pencil-beam scanning (PBS) proton fields. However, at the view of the experience with photon-IMRT, proton facilities equipped with double-scattering (DS) delivery and multi-leaf collimation (MLC) could produce highly conformal dose distributions (and possibly eliminate the need for patient-specific compensators) with a clever use of their MLC field shaping, provided that an optimal inverse TPS is developed. Methods. A prototype TPS was developed in MATLAB. The dose calculation process was based on a fluence-dose algorithm on an adaptive divergent grid. A database of dose kernels was precalculated in order tomore » allow for fast variations of the field range and modulation during optimization. The inverse planning process was based on the adaptive simulated annealing approach, with direct aperture optimization of the MLC leaves. A dosimetry study was performed on a phantom formed by three concentrical semicylinders separated by 5 mm, of which the inner-most and outer-most were regarded as organs at risk (OARs), and the middle one as the PTV. We chose a concave target (which is not treatable with conventional DS fields) to show the potential of our technique. The optimizer was configured to minimize the mean dose to the OARs while keeping a good coverage of the target. Results. The plan produced by the prototype TPS achieved a conformity index of 1.34, with the mean doses to the OARs below 78% of the prescribed dose. This Result is hardly achievable with traditional conformal DS technique with compensators, and it compares to what can be obtained with PBS. Conclusion. It is certainly feasible to produce IMPT fields with MLC passive scattering fields. With a fully developed treatment planning system, the produced plans can be superior to traditional DS plans in terms of plan conformity and dose to organs at risk.« less

SU-E-T-178: Clinical Feasibility of Multi-Leaf Collimator Based Dynamic Wedge

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jeong, C; Kwak, J; Ahn, S

2015-06-15

Purpose: A multi-leaf collimator (MLC) based dynamic wedge (MDW), which provide similar dose profile of physical wedge (PW) along x-jaw direction while significant monitor unit (MU) reduction, was developed and investigated for clinical use. Methods: A novel technique was used to create the wedge profile using MLC. A modification was applied to the DICOM-RT format file of the plan made with the PW to replace PW with MDW. The Varian enhanced dynamic wedge profile was used to produce MLC sequence, while the MU of the wedged field was recalculated using PW factor and fluence map. The profiles for all possiblemore » MDWs to substitute PWs were verified in 6/15 MV x-ray irradiations. New plans with MDWs were compared with the original plans in 5 rectal, 5 RT breast and 5 liver cases. Results: The wedge profile of the MDW fields were well matched with those of PWs inside the fields while less scatter than PW out of the fields. For plan comparisons of the clinical cases no significant dose discrepancy was observed between MDW plan and PW’s with the dose volume histograms. The maximum and mean doses in PTVs are agreed within 1.0%. The Result of OARs of MDW plans are slightly improved in the maximum doses (3.22 ∼ 150.4 cGy) and the mean doses (17.18 ∼ 85.52 cGy) on average for all cases while the prescribed doses are 45 Gy for rectal cases, 40 or 45 Gy for liver cases and 50 Gy for breast cases. The MUs of the fields which replace PW with MDW are reduced to 68% of those of PW. Conclusion: We developed a novel dynamic wedge technique with MLC that shows clinical advantage compared to PW.« less

Real-time tracking of respiratory-induced tumor motion by dose-rate regulation

NASA Astrophysics Data System (ADS)

Han-Oh, Yeonju Sarah

We have developed a novel real-time tumor-tracking technology, called Dose-Rate-Regulated Tracking (DRRT), to compensate for tumor motion caused by breathing. Unlike other previously proposed tumor-tracking methods, this new method uses a preprogrammed dynamic multileaf collimator (MLC) sequence in combination with real-time dose-rate control. This new scheme circumvents the technical challenge in MLC-based tumor tracking, that is to control the MLC motion in real time, based on real-time detected tumor motion. The preprogrammed MLC sequence describes the movement of the tumor, as a function of breathing phase, amplitude, or tidal volume. The irregularity of tumor motion during treatment is handled by real-time regulation of the dose rate, which effectively speeds up or slows down the delivery of radiation as needed. This method is based on the fact that all of the parameters in dynamic radiation delivery, including MLC motion, are enslaved to the cumulative dose, which, in turn, can be accelerated or decelerated by varying the dose rate. Because commercially available MLC systems do not allow the MLC delivery sequence to be modified in real time based on the patient's breathing signal, previously proposed tumor-tracking techniques using a MLC cannot be readily implemented in the clinic today. By using a preprogrammed MLC sequence to handle the required motion, the task for real-time control is greatly simplified. We have developed and tested the pre- programmed MLC sequence and the dose-rate regulation algorithm using lung-cancer patients breathing signals. It has been shown that DRRT can track the tumor with an accuracy of less than 2 mm for a latency of the DRRT system of less than 0.35 s. We also have evaluated the usefulness of guided breathing for DRRT. Since DRRT by its very nature can compensate for breathing-period changes, guided breathing was shown to be unnecessary for real-time tracking when using DRRT. Finally, DRRT uses the existing dose-rate control system that is provided for current linear accelerators. Therefore, DRRT can be achieved with minimal modification of existing technology, and this can shorten substantially the time necessary to establish DRRT in clinical practice.

TH-AB-202-03: A Novel Tool for Computing Deliverable Doses in Dynamic MLC Tracking Treatments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fast, M; Kamerling, C; Menten, M

2016-06-15

Purpose: In tracked dynamic multi-leaf collimator (MLC) treatments, segments are continuously adapted to the target centroid motion in beams-eye-view. On-the-fly segment adaptation, however, potentially induces dosimetric errors due to the finite MLC leaf width and non-rigid target motion. In this study, we outline a novel tool for computing the 4d dose of lung SBRT plans delivered with MLC tracking. Methods: The following automated workflow was developed: A) centroid tracking, where the initial segments are morphed to each 4dCT phase based on the beams-eye-view GTV shift (followed by a dose calculation on each phase); B) re-optimized tracking, in which all morphedmore » initial plans from (A) are further optimised (“warm-started”) in each 4dCT phase using the initial optimisation parameters but phase-specific volume definitions. Finally, both dose sets are accumulated to the reference phase using deformable image registration. Initial plans were generated according to the RTOG-1021 guideline (54Gy, 3-Fx, equidistant 9-beam IMRT) on the peak-exhale (reference) phase of a phase-binned 4dCT. Treatment planning and delivery simulations were performed in RayStation (research v4.6) using our in-house segment-morphing algorithm, which directly links to RayStation through a native C++ interface. Results: Computing the tracking plans and 4d dose distributions via the in-house interface takes 5 and 8 minutes respectively for centroid and re-optimized tracking. For a sample lung SBRT patient with 14mm peak-to-peak motion in sup-inf direction, mainly perpendicular leaf motion (0-collimator) resulted in small dose changes for PTV-D95 (−13cGy) and GTV-D98 (+18cGy) for the centroid tracking case compared to the initial plan. Modest reductions of OAR doses (e.g. spinal cord D2: −11cGy) were achieved in the idealized tracking case. Conclusion: This study presents an automated “1-click” workflow for computing deliverable MLC tracking doses in RayStation. Adding a non-deliverable re-optimized tracking scenario is expected to help quantify plan robustness for more challenging patients with anatomy deformations. We acknowledge support of the MLC tracking research from Elekta AB. MFF is supported by Cancer Research UK under Programme C33589/A19908. Research at ICR is also supported by Cancer Research UK under Programme C33589/A19727 and NHS funding to the NIHR Biomedical Research Centre at RMH and ICR.« less

Electromagnetic guided couch and multileaf collimator tracking on a TrueBeam accelerator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hansen, Rune; Ravkilde, Thomas; Worm, Esben Schjødt

2016-05-15

Purpose: Couch and MLC tracking are two promising methods for real-time motion compensation during radiation therapy. So far, couch and MLC tracking experiments have mainly been performed by different research groups, and no direct comparison of couch and MLC tracking of volumetric modulated arc therapy (VMAT) plans has been published. The Varian TrueBeam 2.0 accelerator includes a prototype tracking system with selectable couch or MLC compensation. This study provides a direct comparison of the two tracking types with an otherwise identical setup. Methods: Several experiments were performed to characterize the geometric and dosimetric performance of electromagnetic guided couch and MLCmore » tracking on a TrueBeam accelerator equipped with a Millennium MLC. The tracking system latency was determined without motion prediction as the time lag between sinusoidal target motion and the compensating motion of the couch or MLC as recorded by continuous MV portal imaging. The geometric and dosimetric tracking accuracies were measured in tracking experiments with motion phantoms that reproduced four prostate and four lung tumor trajectories. The geometric tracking error in beam’s eye view was determined as the distance between an embedded gold marker and a circular MLC aperture in continuous MV images. The dosimetric tracking error was quantified as the measured 2%/2 mm gamma failure rate of a low and a high modulation VMAT plan delivered with the eight motion trajectories using a static dose distribution as reference. Results: The MLC tracking latency was approximately 146 ms for all sinusoidal period lengths while the couch tracking latency increased from 187 to 246 ms with decreasing period length due to limitations in the couch acceleration. The mean root-mean-square geometric error was 0.80 mm (couch tracking), 0.52 mm (MLC tracking), and 2.75 mm (no tracking) parallel to the MLC leaves and 0.66 mm (couch), 1.14 mm (MLC), and 2.41 mm (no tracking) perpendicular to the leaves. The motion-induced gamma failure rate was in mean 0.1% (couch tracking), 8.1% (MLC tracking), and 30.4% (no tracking) for prostate motion and 2.9% (couch), 2.4% (MLC), and 41.2% (no tracking) for lung tumor motion. The residual tracking errors were mainly caused by inadequate adaptation to fast lung tumor motion for couch tracking and to prostate motion perpendicular to the MLC leaves for MLC tracking. Conclusions: Couch and MLC tracking markedly improved the geometric and dosimetric accuracies of VMAT delivery. However, the two tracking types have different strengths and weaknesses. While couch tracking can correct perfectly for slowly moving targets such as the prostate, MLC tracking may have considerably larger dose errors for persistent target shift perpendicular to the MLC leaves. Advantages of MLC tracking include faster dynamics with better adaptation to fast moving targets, the avoidance of moving the patient, and the potential to track target rotations and deformations.« less

A novel software and conceptual design of the hardware platform for intensity modulated radiation therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nguyen, Dan; Ruan, Dan; O’Connor, Daniel

Purpose: To deliver high quality intensity modulated radiotherapy (IMRT) using a novel generalized sparse orthogonal collimators (SOCs), the authors introduce a novel direct aperture optimization (DAO) approach based on discrete rectangular representation. Methods: A total of seven patients—two glioblastoma multiforme, three head & neck (including one with three prescription doses), and two lung—were included. 20 noncoplanar beams were selected using a column generation and pricing optimization method. The SOC is a generalized conventional orthogonal collimators with N leaves in each collimator bank, where N = 1, 2, or 4. SOC degenerates to conventional jaws when N = 1. For SOC-basedmore » IMRT, rectangular aperture optimization (RAO) was performed to optimize the fluence maps using rectangular representation, producing fluence maps that can be directly converted into a set of deliverable rectangular apertures. In order to optimize the dose distribution and minimize the number of apertures used, the overall objective was formulated to incorporate an L2 penalty reflecting the difference between the prescription and the projected doses, and an L1 sparsity regularization term to encourage a low number of nonzero rectangular basis coefficients. The optimization problem was solved using the Chambolle–Pock algorithm, a first-order primal–dual algorithm. Performance of RAO was compared to conventional two-step IMRT optimization including fluence map optimization and direct stratification for multileaf collimator (MLC) segmentation (DMS) using the same number of segments. For the RAO plans, segment travel time for SOC delivery was evaluated for the N = 1, N = 2, and N = 4 SOC designs to characterize the improvement in delivery efficiency as a function of N. Results: Comparable PTV dose homogeneity and coverage were observed between the RAO and the DMS plans. The RAO plans were slightly superior to the DMS plans in sparing critical structures. On average, the maximum and mean critical organ doses were reduced by 1.94% and 1.44% of the prescription dose. The average number of delivery segments was 12.68 segments per beam for both the RAO and DMS plans. The N = 2 and N = 4 SOC designs were, on average, 1.56 and 1.80 times more efficient than the N = 1 SOC design to deliver. The mean aperture size produced by the RAO plans was 3.9 times larger than that of the DMS plans. Conclusions: The DAO and dose domain optimization approach enabled high quality IMRT plans using a low-complexity collimator setup. The dosimetric quality is comparable or slightly superior to conventional MLC-based IMRT plans using the same number of delivery segments. The SOC IMRT delivery efficiency can be significantly improved by increasing the leaf numbers, but the number is still significantly lower than the number of leaves in a typical MLC.« less

A novel software and conceptual design of the hardware platform for intensity modulated radiation therapy.

PubMed

Nguyen, Dan; Ruan, Dan; O'Connor, Daniel; Woods, Kaley; Low, Daniel A; Boucher, Salime; Sheng, Ke

2016-02-01

To deliver high quality intensity modulated radiotherapy (IMRT) using a novel generalized sparse orthogonal collimators (SOCs), the authors introduce a novel direct aperture optimization (DAO) approach based on discrete rectangular representation. A total of seven patients-two glioblastoma multiforme, three head & neck (including one with three prescription doses), and two lung-were included. 20 noncoplanar beams were selected using a column generation and pricing optimization method. The SOC is a generalized conventional orthogonal collimators with N leaves in each collimator bank, where N = 1, 2, or 4. SOC degenerates to conventional jaws when N = 1. For SOC-based IMRT, rectangular aperture optimization (RAO) was performed to optimize the fluence maps using rectangular representation, producing fluence maps that can be directly converted into a set of deliverable rectangular apertures. In order to optimize the dose distribution and minimize the number of apertures used, the overall objective was formulated to incorporate an L2 penalty reflecting the difference between the prescription and the projected doses, and an L1 sparsity regularization term to encourage a low number of nonzero rectangular basis coefficients. The optimization problem was solved using the Chambolle-Pock algorithm, a first-order primal-dual algorithm. Performance of RAO was compared to conventional two-step IMRT optimization including fluence map optimization and direct stratification for multileaf collimator (MLC) segmentation (DMS) using the same number of segments. For the RAO plans, segment travel time for SOC delivery was evaluated for the N = 1, N = 2, and N = 4 SOC designs to characterize the improvement in delivery efficiency as a function of N. Comparable PTV dose homogeneity and coverage were observed between the RAO and the DMS plans. The RAO plans were slightly superior to the DMS plans in sparing critical structures. On average, the maximum and mean critical organ doses were reduced by 1.94% and 1.44% of the prescription dose. The average number of delivery segments was 12.68 segments per beam for both the RAO and DMS plans. The N = 2 and N = 4 SOC designs were, on average, 1.56 and 1.80 times more efficient than the N = 1 SOC design to deliver. The mean aperture size produced by the RAO plans was 3.9 times larger than that of the DMS plans. The DAO and dose domain optimization approach enabled high quality IMRT plans using a low-complexity collimator setup. The dosimetric quality is comparable or slightly superior to conventional MLC-based IMRT plans using the same number of delivery segments. The SOC IMRT delivery efficiency can be significantly improved by increasing the leaf numbers, but the number is still significantly lower than the number of leaves in a typical MLC.

SU-E-T-354: Efficient and Enhanced QA Testing of Linear Accelerators Using a Real-Time Beam Monitor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jung, J; Farrokhkish, M; Norrlinger, B

2015-06-15

Purpose: To investigate the feasibility of performing routine QA tests of linear accelerators (Linac) using the Integral Quality Monitoring (IQM) system. The system, consisting of a 1-D sensitivity gradient large area ion-chamber mounted at the collimator, allows automatic collection and analysis of beam data. Methods: The IQM was investigated to perform several QA constancy tests, similar to those recommended by AAPM TG142, of a Linac including: beam output, MLC calibration, beam symmetry, relative dose factor (RDF), dose linearity, output as a function of gantry angle and dose rate. All measurements by the IQM system accompanied a reference measurement using amore » conventional dosimetry system and were performed on an Elekta Infinity Linac with Agility MLC. The MLC calibration check is done using a Picket-Fence type 2×10cm{sup 2} field positioned at different off-axis locations along the chamber gradient. Beam symmetry constancy values are established by signals from an 4×4cm{sup 2} aperture located at various off-axis positions; the sensitivity of the test was determined by the changes in the signals in response to a tilt in the beam. The data for various square field sizes were used to develop a functional relationship with RDF. Results: The IQM tracked the beam output well within 1% of the reference ion-chamber readings. The Picket-Fence type field test detected a 1mm shift error of one MLC bank. The system was able to detect 2.5% or greater beam asymmetry. The IQM results for all other QA tests were found to agree with the reference values to within 0.5%. Conclusion: It was demonstrated that the IQM system can effectively monitor the Linac performance parameters for the purpose of routine QA constancy tests. With minimum user interactions a comprehensive set of tests can be performed efficiently, allowing frequent monitoring of the Linac. The presenting author’s salary is funded by the manufacturer of the QA device. All the other authors have financial interests with the commercialization of this QA device.« less

Fast leaf-fitting with generalized underdose/overdose constraints for real-time MLC tracking

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moore, Douglas, E-mail: douglas.moore@utsouthwestern.edu; Sawant, Amit; Ruan, Dan

2016-01-15

Purpose: Real-time multileaf collimator (MLC) tracking is a promising approach to the management of intrafractional tumor motion during thoracic and abdominal radiotherapy. MLC tracking is typically performed in two steps: transforming a planned MLC aperture in response to patient motion and refitting the leaves to the newly generated aperture. One of the challenges of this approach is the inability to faithfully reproduce the desired motion-adapted aperture. This work presents an optimization-based framework with which to solve this leaf-fitting problem in real-time. Methods: This optimization framework is designed to facilitate the determination of leaf positions in real-time while accounting for themore » trade-off between coverage of the PTV and avoidance of organs at risk (OARs). Derived within this framework, an algorithm is presented that can account for general linear transformations of the planned MLC aperture, particularly 3D translations and in-plane rotations. This algorithm, together with algorithms presented in Sawant et al. [“Management of three-dimensional intrafraction motion through real-time DMLC tracking,” Med. Phys. 35, 2050–2061 (2008)] and Ruan and Keall [Presented at the 2011 IEEE Power Engineering and Automation Conference (PEAM) (2011) (unpublished)], was applied to apertures derived from eight lung intensity modulated radiotherapy plans subjected to six-degree-of-freedom motion traces acquired from lung cancer patients using the kilovoltage intrafraction monitoring system developed at the University of Sydney. A quality-of-fit metric was defined, and each algorithm was evaluated in terms of quality-of-fit and computation time. Results: This algorithm is shown to perform leaf-fittings of apertures, each with 80 leaf pairs, in 0.226 ms on average as compared to 0.082 and 64.2 ms for the algorithms of Sawant et al., Ruan, and Keall, respectively. The algorithm shows approximately 12% improvement in quality-of-fit over the Sawant et al. approach, while performing comparably to Ruan and Keall. Conclusions: This work improves upon the quality of the Sawant et al. approach, but does so without sacrificing run-time performance. In addition, using this framework allows for complex leaf-fitting strategies that can be used to account for PTV/OAR trade-off during real-time MLC tracking.« less

Multileaf collimator tracking integrated with a novel x-ray imaging system and external surrogate monitoring

NASA Astrophysics Data System (ADS)

Krauss, Andreas; Fast, Martin F.; Nill, Simeon; Oelfke, Uwe

2012-04-01

We have previously developed a tumour tracking system, which adapts the aperture of a Siemens 160 MLC to electromagnetically monitored target motion. In this study, we exploit the use of a novel linac-mounted kilovoltage x-ray imaging system for MLC tracking. The unique in-line geometry of the imaging system allows the detection of target motion perpendicular to the treatment beam (i.e. the directions usually featuring steep dose gradients). We utilized the imaging system either alone or in combination with an external surrogate monitoring system. We equipped a Siemens ARTISTE linac with two flat panel detectors, one directly underneath the linac head for motion monitoring and the other underneath the patient couch for geometric tracking accuracy assessments. A programmable phantom with an embedded metal marker reproduced three patient breathing traces. For MLC tracking based on x-ray imaging alone, marker position was detected at a frame rate of 7.1 Hz. For the combined external and internal motion monitoring system, a total of only 85 x-ray images were acquired prior to or in between the delivery of ten segments of an IMRT beam. External motion was monitored with a potentiometer. A correlation model between external and internal motion was established. The real-time component of the MLC tracking procedure then relied solely on the correlation model estimations of internal motion based on the external signal. Geometric tracking accuracies were 0.6 mm (1.1 mm) and 1.8 mm (1.6 mm) in directions perpendicular and parallel to the leaf travel direction for the x-ray-only (the combined external and internal) motion monitoring system in spite of a total system latency of ˜0.62 s (˜0.51 s). Dosimetric accuracy for a highly modulated IMRT beam-assessed through radiographic film dosimetry-improved substantially when tracking was applied, but depended strongly on the respective geometric tracking accuracy. In conclusion, we have for the first time integrated MLC tracking with x-ray imaging in the in-line geometry and demonstrated highly accurate respiratory motion tracking.

Intensity-modulated radiation therapy (IMRT) with different combinations of treatment-planning systems and linacs: issues and how to detect them.

PubMed

Dobler, Barbara; Lorenz, Friedlieb; Wertz, Hansjörg; Polednik, Martin; Wolff, Dirk; Steil, Volker; Lohr, Frank; Wenz, Frederik

2006-08-01

To compare different combinations of intensity-modulated radiation therapy (IMRT) system components with regard to quality assurance (QA), especially robustness against malfunctions and dosimetry. Three different treatment-planning systems (TPS), two types of linacs and three multileaf collimator (MLC) types were compared: commissioning procedures were performed for the combination of the TPS Corvus 5.0 (Nomos) and KonRad v2.1.3 (Siemens OCS) with the linacs KD2 (Siemens) and Synergy (Elekta). For PrecisePLAN 2.03 (Elekta) measurements were performed for Elekta Synergy only. As record and verify (R&V) system Multi-Access v7 (IMPAC) was used. The use of the serial tomotherapy system Peacock (Nomos) was investigated in combination with the Siemens KD2 linac. In the comparison of calculated to measured dose, problems were encountered for the combination of KonRad and Elekta MLC as well as for the Peacock system. Multi-Access failed to assign the collimator angle correctly for plans with multiple collimator angles per beam. Communication problems of Multi-Access with both linacs were observed, resulting in incorrect recording of the treatment. All reported issues were addressed by the manufacturers. For the commissioning of IMRT systems, the whole chain from the TPS to the linac has to be investigated. Components that passed the commissioning in another clinical environment can have severe malfunctions when used in a new environment. Therefore, not only single components but the whole chain from planning to delivery has to be evaluated in commissioning and checked regularly for QA.

A quantitative method to the analysis of MLC leaf position and speed based on EPID and EBT3 film for dynamic IMRT treatment with different types of MLC.

PubMed

Li, Yinghui; Chen, Lixin; Zhu, Jinhan; Wang, Bin; Liu, Xiaowei

2017-07-01

A quantitative method based on the electronic portal imaging system (EPID) and film was developed for MLC position and speed testing; this method was used for three MLC types (Millennium, MLCi, and Agility MLC). To determine the leaf position, a picket fence designed by the dynamic (DMLC) model was used. The full-width half-maximum (FWHM) values of each gap measured by EPID and EBT3 were converted to the gap width using the FWHM versus nominal gap width relationship. The algorithm developed for the picket fence analysis was able to quantify the gap width, the distance between gaps, and each individual leaf position. To determine the leaf speed, a 0.5 × 20 cm 2 MLC-defined sliding gap was applied across a 14 × 20 cm 2 symmetry field. The linacs ran at a fixed-dose rate. The use of different monitor units (MUs) for this test led to different leaf speeds. The effect of leaf transmission was considered in a speed accuracy analysis. The difference between the EPID and film results for the MLC position is less than 0.1 mm. For the three MLC types, twice the standard deviation (2 SD) is provided; 0.2, 0.4, and 0.4 mm for gap widths of three MLC types, and 0.1, 0.2, and 0.2 mm for distances between gaps. The individual leaf positions deviate from the preset positions within 0.1 mm. The variations in the speed profiles for the EPID and EBT3 results are consistent, but the EPID results are slightly better than the film results. Different speeds were measured for each MLC type. For all three MLC types, speed errors increase with increasing speed. The analysis speeds deviate from the preset speeds within approximately 0.01 cm s -1 . This quantitative analysis of MLC position and speed provides an intuitive evaluation for MLC quality assurance (QA). © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Commissioning of the tongue-and-groove modelling in treatment planning systems: from static fields to VMAT treatments

NASA Astrophysics Data System (ADS)

Hernandez, Victor; Vera-Sánchez, Juan Antonio; Vieillevigne, Laure; Saez, Jordi

2017-08-01

Adequate modelling of the multi-leaf collimator (MLC) by treatment planning systems (TPS) is essential for accurate dose calculations in intensity-modulated radiation-therapy. For this reason modern TPSs incorporate MLC characteristics such as the leaf end curvature, MLC transmission and the tongue-and-groove. However, the modelling of the tongue-and-groove is often neglected during TPS commissioning and it is not known how accurate it is. This study evaluates the dosimetric consequences of the tongue-and-groove effect for two different MLC models using both film dosimetry and ionisation chambers. A set of comprehensive tests are presented that evaluate the ability of TPSs to accurately model this effect in (a) static fields, (b) sliding window beams and (c) VMAT arcs. The tests proposed are useful for the commissioning of TPSs and for the validation of major upgrades. With the ECLIPSE TPS, relevant differences were found between calculations and measurements for beams with dynamic MLCs in the presence of the TG effect, especially for the High Definition MLC, small gap sizes and the 1 mm calculation grid. For this combination, dose differences as high as 10% and 7% were obtained for dynamic MLC gaps of 5 mm and 10 mm, respectively. These differences indicate inadequate modelling of the tongue-and-groove effect, which might not be identified without the proposed tests. In particular, the TPS tended to underestimate the calculated dose, which may require tuning of other configuration parameters in the TPS (such as the dosimetric leaf gap) in order to maximise the agreement between calculations and measurements in clinical plans. In conclusion, a need for better modelling of the MLC by TPSs is demonstrated, one of the relevant aspects being the tongue-and-groove effect. This would improve the accuracy of TPS calculations, especially for plans using small MLC gaps, such as plans with small target volumes or high complexities. Improved modelling of the MLC would also reduce the need for tuning parameters in the TPS, facilitating a more comprehensive configuration and commissioning of TPSs.

Dose-to-water conversion for the backscatter-shielded EPID: A frame-based method to correct for EPID energy response to MLC transmitted radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zwan, Benjamin J., E-mail: benjamin.zwan@uon.edu.au; O’Connor, Daryl J.; King, Brian W.

2014-08-15

Purpose: To develop a frame-by-frame correction for the energy response of amorphous silicon electronic portal imaging devices (a-Si EPIDs) to radiation that has transmitted through the multileaf collimator (MLC) and to integrate this correction into the backscatter shielded EPID (BSS-EPID) dose-to-water conversion model. Methods: Individual EPID frames were acquired using a Varian frame grabber and iTools acquisition software then processed using in-house software developed inMATLAB. For each EPID image frame, the region below the MLC leaves was identified and all pixels in this region were multiplied by a factor of 1.3 to correct for the under-response of the imager tomore » MLC transmitted radiation. The corrected frames were then summed to form a corrected integrated EPID image. This correction was implemented as an initial step in the BSS-EPID dose-to-water conversion model which was then used to compute dose planes in a water phantom for 35 IMRT fields. The calculated dose planes, with and without the proposed MLC transmission correction, were compared to measurements in solid water using a two-dimensional diode array. Results: It was observed that the integration of the MLC transmission correction into the BSS-EPID dose model improved agreement between modeled and measured dose planes. In particular, the MLC correction produced higher pass rates for almost all Head and Neck fields tested, yielding an average pass rate of 99.8% for 2%/2 mm criteria. A two-sample independentt-test and fisher F-test were used to show that the MLC transmission correction resulted in a statistically significant reduction in the mean and the standard deviation of the gamma values, respectively, to give a more accurate and consistent dose-to-water conversion. Conclusions: The frame-by-frame MLC transmission response correction was shown to improve the accuracy and reduce the variability of the BSS-EPID dose-to-water conversion model. The correction may be applied as a preprocessing step in any pretreatment portal dosimetry calculation and has been shown to be beneficial for highly modulated IMRT fields.« less

Analysis of Neutron Production in Passively Scattered Ion-Beam Therapy.

PubMed

Heo, Seunguk; Yoo, Seunghoon; Song, Yongkeun; Kim, Eunho; Shin, Jaeik; Han, Soorim; Jung, Wongyun; Nam, Sanghee; Lee, Rena; Lee, Kitae; Cho, Sungho

2017-07-01

A new treatment facility for heavy ion therapy since 2010 was constructed. In the broad beam, a range shifter, ridge filter and multi leaf collimator (MLC) for the generation of the spread-out Bragg peak is used. In this case, secondary neutrons produced by the interactions of the ion field with beam-modifying devices (e.g. double-scattering system, beam shaping collimators and range compensators) are very important for patient safety. Therefore, these components must be carefully examined in the context of secondary neutron yield and associated secondary cancer risk. In this article, Monte Carlo simulation has been carried out with the FLUktuierende KAskade particle transport code, the fluence and distribution of neutron generation and the neutron dose equivalent from the broad beam components are compared using carbon and proton beams. As a result, it is confirmed that the yield of neutron production using a carbon beam from all components of the broad beam was higher than using a proton beam. The ambient dose by neutrons per heavy ion and proton ion from the MLC surface was 0.12-0.18 and 0.0067-0.0087 pSv, respectively, which shows that heavy ions generate more neutrons than protons. However, ambient dose per treatment 2 Gy, which means physical dose during treatment by ion beam, is higher than carbon beam because proton therapy needs more beam flux to make 2-Gy prescription dose. Therefore, the neutron production from the MLC, which is closed to the patient, is a very important parameter for patient safety. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Dosimetric effect of Elekta Beam Modulator micromultileaf in three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for prostate cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carosi, Alessandra, E-mail: alessandra.carosi@katamail.com; Ingrosso, Gianluca; Ponti, Elisabetta

2014-07-01

The purpose of this study is to analyze the dosimetric effect of Elekta Beam Modulator in 3-dimensional conformal radiation therapy (3DCRT) and in intensity-modulated radiation therapy (IMRT) for localized prostate cancer. We compared treatment plans developed with 2 different Elekta multileaf collimators (MLC): Beam Modulator micro-MLC (mMLC) (4-mm leaf width at the isocenter) and standard MLC (10-mm leaf width at the isocenter). The comparison was performed for 15 patients with localized prostate cancer in 3DCRT and IMRT delivery; a total of 60 treatment plans were processed. The dose-volume histograms were used to provide the quantitative comparison between plans. In particular,more » we analyzed differences between rectum and bladder sparing in terms of a set of appropriate Vx (percentage of organ at risk [OAR] volume receiving the x dose) and differences between target conformity and coverage in terms of coverage factor and conformation number. Our analysis demonstrates that in 3DCRT there is an advantage in the use of Elekta Beam Modulator mMLC in terms of organ sparing; in particular, a significant decrease in rectal V{sub 60} and V{sub 50} (p = 0.001) and in bladder V{sub 70} and V{sub 65} (p = 0.007 and 0.002, respectively) was found. Moreover, a better target dose conformity was obtained (p = 0.002). IMRT plans comparison demonstrated no significant differences between the use of the 4 or 10-mm MLCs. Our analysis shows that in 3DCRT the use of the Elekta Beam Modulator mMLC gives a gain in target conformity and in OARs dose sparing whereas in IMRT plans there is no advantage.« less

A high-speed scintillation-based electronic portal imaging device to quantitatively characterize IMRT delivery.

PubMed

Ranade, Manisha K; Lynch, Bart D; Li, Jonathan G; Dempsey, James F

2006-01-01

We have developed an electronic portal imaging device (EPID) employing a fast scintillator and a high-speed camera. The device is designed to accurately and independently characterize the fluence delivered by a linear accelerator during intensity modulated radiation therapy (IMRT) with either step-and-shoot or dynamic multileaf collimator (MLC) delivery. Our aim is to accurately obtain the beam shape and fluence of all segments delivered during IMRT, in order to study the nature of discrepancies between the plan and the delivered doses. A commercial high-speed camera was combined with a terbium-doped gadolinium-oxy-sulfide (Gd2O2S:Tb) scintillator to form an EPID for the unaliased capture of two-dimensional fluence distributions of each beam in an IMRT delivery. The high speed EPID was synchronized to the accelerator pulse-forming network and gated to capture every possible pulse emitted from the accelerator, with an approximate frame rate of 360 frames-per-second (fps). A 62-segment beam from a head-and-neck IMRT treatment plan requiring 68 s to deliver was recorded with our high speed EPID producing approximately 6 Gbytes of imaging data. The EPID data were compared with the MLC instruction files and the MLC controller log files. The frames were binned to provide a frame rate of 72 fps with a signal-to-noise ratio that was sufficient to resolve leaf positions and segment fluence. The fractional fluence from the log files and EPID data agreed well. An ambiguity in the motion of the MLC during beam on was resolved. The log files reported leaf motions at the end of 33 of the 42 segments, while the EPID observed leaf motions in only 7 of the 42 segments. The static IMRT segment shapes observed by the high speed EPID were in good agreement with the shapes reported in the log files. The leaf motions observed during beam-on for step-and-shoot delivery were not temporally resolved by the log files.

Treatment planning systems for external whole brain radiation therapy: With and without MLC (multi leaf collimator) optimization

NASA Astrophysics Data System (ADS)

Budiyono, T.; Budi, W. S.; Hidayanto, E.

2016-03-01

Radiation therapy for brain malignancy is done by giving a dose of radiation to a whole volume of the brain (WBRT) followed by a booster at the primary tumor with more advanced techniques. Two external radiation fields given from the right and left side. Because the shape of the head, there will be an unavoidable hotspot radiation dose of greater than 107%. This study aims to optimize planning of radiation therapy using field in field multi-leaf collimator technique. A study of 15 WBRT samples with CT slices is done by adding some segments of radiation in each field of radiation and delivering appropriate dose weighting using a TPS precise plan Elekta R 2.15. Results showed that this optimization a more homogeneous radiation on CTV target volume, lower dose in healthy tissue, and reduced hotspots in CTV target volume. Comparison results of field in field multi segmented MLC technique with standard conventional technique for WBRT are: higher average minimum dose (77.25% ± 0:47%) vs (60% ± 3:35%); lower average maximum dose (110.27% ± 0.26%) vs (114.53% ± 1.56%); lower hotspot volume (5.71% vs 27.43%); and lower dose on eye lenses (right eye: 9.52% vs 18.20%); (left eye: 8.60% vs 16.53%).

Applications of Machine Learning for Radiation Therapy.

PubMed

Arimura, Hidetaka; Nakamoto, Takahiro

2016-01-01

Radiation therapy has been highly advanced as image guided radiation therapy (IGRT) by making advantage of image engineering technologies. Recently, novel frameworks based on image engineering technologies as well as machine learning technologies have been studied for sophisticating the radiation therapy. In this review paper, the author introduces several researches of applications of machine learning for radiation therapy. For examples, a method to determine the threshold values for standardized uptake value (SUV) for estimation of gross tumor volume (GTV) in positron emission tomography (PET) images, an approach to estimate the multileaf collimator (MLC) position errors between treatment plans and radiation delivery time, and prediction frameworks for esophageal stenosis and radiation pneumonitis risk after radiation therapy are described. Finally, the author introduces seven issues that one should consider when applying machine learning models to radiation therapy.

Technical Note: A novel leaf sequencing optimization algorithm which considers previous underdose and overdose events for MLC tracking radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wisotzky, Eric, E-mail: eric.wisotzky@charite.de, E-mail: eric.wisotzky@ipk.fraunhofer.de; O’Brien, Ricky; Keall, Paul J., E-mail: paul.keall@sydney.edu.au

2016-01-15

Purpose: Multileaf collimator (MLC) tracking radiotherapy is complex as the beam pattern needs to be modified due to the planned intensity modulation as well as the real-time target motion. The target motion cannot be planned; therefore, the modified beam pattern differs from the original plan and the MLC sequence needs to be recomputed online. Current MLC tracking algorithms use a greedy heuristic in that they optimize for a given time, but ignore past errors. To overcome this problem, the authors have developed and improved an algorithm that minimizes large underdose and overdose regions. Additionally, previous underdose and overdose events aremore » taken into account to avoid regions with high quantity of dose events. Methods: The authors improved the existing MLC motion control algorithm by introducing a cumulative underdose/overdose map. This map represents the actual projection of the planned tumor shape and logs occurring dose events at each specific regions. These events have an impact on the dose cost calculation and reduce recurrence of dose events at each region. The authors studied the improvement of the new temporal optimization algorithm in terms of the L1-norm minimization of the sum of overdose and underdose compared to not accounting for previous dose events. For evaluation, the authors simulated the delivery of 5 conformal and 14 intensity-modulated radiotherapy (IMRT)-plans with 7 3D patient measured tumor motion traces. Results: Simulations with conformal shapes showed an improvement of L1-norm up to 8.5% after 100 MLC modification steps. Experiments showed comparable improvements with the same type of treatment plans. Conclusions: A novel leaf sequencing optimization algorithm which considers previous dose events for MLC tracking radiotherapy has been developed and investigated. Reductions in underdose/overdose are observed for conformal and IMRT delivery.« less

SU-G-BRA-17: Tracking Multiple Targets with Independent Motion in Real-Time Using a Multi-Leaf Collimator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ge, Y; Keall, P; Poulsen, P

Purpose: Multiple targets with large intrafraction independent motion are often involved in advanced prostate, lung, abdominal, and head and neck cancer radiotherapy. Current standard of care treats these with the originally planned fields, jeopardizing the treatment outcomes. A real-time multi-leaf collimator (MLC) tracking method has been developed to address this problem for the first time. This study evaluates the geometric uncertainty of the multi-target tracking method. Methods: Four treatment scenarios are simulated based on a prostate IMAT plan to treat a moving prostate target and static pelvic node target: 1) real-time multi-target MLC tracking; 2) real-time prostate-only MLC tracking; 3)more » correcting for prostate interfraction motion at setup only; and 4) no motion correction. The geometric uncertainty of the treatment is assessed by the sum of the erroneously underexposed target area and overexposed healthy tissue areas for each individual target. Two patient-measured prostate trajectories of average 2 and 5 mm motion magnitude are used for simulations. Results: Real-time multi-target tracking accumulates the least uncertainty overall. As expected, it covers the static nodes similarly well as no motion correction treatment and covers the moving prostate similarly well as the real-time prostate-only tracking. Multi-target tracking reduces >90% of uncertainty for the static nodal target compared to the real-time prostate-only tracking or interfraction motion correction. For prostate target, depending on the motion trajectory which affects the uncertainty due to leaf-fitting, multi-target tracking may or may not perform better than correcting for interfraction prostate motion by shifting patient at setup, but it reduces ∼50% of uncertainty compared to no motion correction. Conclusion: The developed real-time multi-target MLC tracking can adapt for the independently moving targets better than other available treatment adaptations. This will enable PTV margin reduction to minimize health tissue toxicity while remain tumor coverage when treating advanced disease with independently moving targets involved. The authors acknowledge funding support from the Australian NHMRC Australia Fellowship and NHMRC Project Grant No. APP1042375.« less

Quality control procedures for dynamic treatment delivery techniques involving couch motion.

PubMed

Yu, Victoria Y; Fahimian, Benjamin P; Xing, Lei; Hristov, Dimitre H

2014-08-01

In this study, the authors introduce and demonstrate quality control procedures for evaluating the geometric and dosimetric fidelity of dynamic treatment delivery techniques involving treatment couch motion synchronous with gantry and multileaf collimator (MLC). Tests were designed to evaluate positional accuracy, velocity constancy and accuracy for dynamic couch motion under a realistic weight load. A test evaluating the geometric accuracy of the system in delivering treatments over complex dynamic trajectories was also devised. Custom XML scripts that control the Varian TrueBeam™ STx (Serial #3) axes in Developer Mode were written to implement the delivery sequences for the tests. Delivered dose patterns were captured with radiographic film or the electronic portal imaging device. The couch translational accuracy in dynamic treatment mode was 0.01 cm. Rotational accuracy was within 0.3°, with 0.04 cm displacement of the rotational axis. Dose intensity profiles capturing the velocity constancy and accuracy for translations and rotation exhibited standard deviation and maximum deviations below 3%. For complex delivery involving MLC and couch motions, the overall translational accuracy for reproducing programmed patterns was within 0.06 cm. The authors conclude that in Developer Mode, TrueBeam™ is capable of delivering dynamic treatment delivery techniques involving couch motion with good geometric and dosimetric fidelity.

The first clinical implementation of electromagnetic transponder-guided MLC tracking.

PubMed

Keall, Paul J; Colvill, Emma; O'Brien, Ricky; Ng, Jin Aun; Poulsen, Per Rugaard; Eade, Thomas; Kneebone, Andrew; Booth, Jeremy T

2014-02-01

We report on the clinical process, quality assurance, and geometric and dosimetric results of the first clinical implementation of electromagnetic transponder-guided MLC tracking which occurred on 28 November 2013 at the Northern Sydney Cancer Centre. An electromagnetic transponder-based positioning system (Calypso) was modified to send the target position output to in-house-developed MLC tracking code, which adjusts the leaf positions to optimally align the treatment beam with the real-time target position. Clinical process and quality assurance procedures were developed and performed. The first clinical implementation of electromagnetic transponder-guided MLC tracking was for a prostate cancer patient being treated with dual-arc VMAT (RapidArc). For the first fraction of the first patient treatment of electromagnetic transponder-guided MLC tracking we recorded the in-room time and transponder positions, and performed dose reconstruction to estimate the delivered dose and also the dose received had MLC tracking not been used. The total in-room time was 21 min with 2 min of beam delivery. No additional time was needed for MLC tracking and there were no beam holds. The average prostate position from the initial setup was 1.2 mm, mostly an anterior shift. Dose reconstruction analysis of the delivered dose with MLC tracking showed similar isodose and target dose volume histograms to the planned treatment and a 4.6% increase in the fractional rectal V60. Dose reconstruction without motion compensation showed a 30% increase in the fractional rectal V60 from that planned, even for the small motion. The real-time beam-target correction method, electromagnetic transponder-guided MLC tracking, has been translated to the clinic. This achievement represents a milestone in improving geometric and dosimetric accuracy, and by inference treatment outcomes, in cancer radiotherapy.

The first clinical implementation of electromagnetic transponder-guided MLC tracking

PubMed Central

Keall, Paul J.; Colvill, Emma; O’Brien, Ricky; Ng, Jin Aun; Poulsen, Per Rugaard; Eade, Thomas; Kneebone, Andrew; Booth, Jeremy T.

2014-01-01

Purpose: We report on the clinical process, quality assurance, and geometric and dosimetric results of the first clinical implementation of electromagnetic transponder-guided MLC tracking which occurred on 28 November 2013 at the Northern Sydney Cancer Centre. Methods: An electromagnetic transponder-based positioning system (Calypso) was modified to send the target position output to in-house-developed MLC tracking code, which adjusts the leaf positions to optimally align the treatment beam with the real-time target position. Clinical process and quality assurance procedures were developed and performed. The first clinical implementation of electromagnetic transponder-guided MLC tracking was for a prostate cancer patient being treated with dual-arc VMAT (RapidArc). For the first fraction of the first patient treatment of electromagnetic transponder-guided MLC tracking we recorded the in-room time and transponder positions, and performed dose reconstruction to estimate the delivered dose and also the dose received had MLC tracking not been used. Results: The total in-room time was 21 min with 2 min of beam delivery. No additional time was needed for MLC tracking and there were no beam holds. The average prostate position from the initial setup was 1.2 mm, mostly an anterior shift. Dose reconstruction analysis of the delivered dose with MLC tracking showed similar isodose and target dose volume histograms to the planned treatment and a 4.6% increase in the fractional rectal V60. Dose reconstruction without motion compensation showed a 30% increase in the fractional rectal V60 from that planned, even for the small motion. Conclusions: The real-time beam-target correction method, electromagnetic transponder-guided MLC tracking, has been translated to the clinic. This achievement represents a milestone in improving geometric and dosimetric accuracy, and by inference treatment outcomes, in cancer radiotherapy. PMID:24506591

IMRT sequencing for a six-bank multi-leaf system.

PubMed

Topolnjak, R; van der Heide, U A; Lagendijk, J J W

2005-05-07

In this study, we present a sequencer for delivering step-and-shoot IMRT using a six-bank multi-leaf system. Such a system was proposed earlier and combines a high-resolution field-shaping ability with a large field size. It consists of three layers of two opposing leaf banks with 1 cm leaves. The layers are rotated relative to each other at 60 degrees . A low-resolution mode of sequencing is achieved by using one layer of leaves as primary MLC, while the other two are used to improve back-up collimation. For high-resolution sequencing, an algorithm is presented that creates segments shaped by all six banks. Compared to a hypothetical mini-MLC with 0.4 cm leaves, a similar performance can be achieved, but a trade-off has to be made between accuracy and the number of segments.

Using narrow beam profiles to quantify focal spot size, for accurate Monte Carlo simulations of SRS/SRT systems

NASA Astrophysics Data System (ADS)

Kairn, T.; Crowe, S. B.; Charles, P. H.; Trapp, J. V.

2014-03-01

This study investigates the variation of photon field penumbra shape with initial electron beam diameter, for very narrow beams. A Varian Millenium MLC (Varian Medical Systems, Palo Alto, USA) and a Brainlab m3 microMLC (Brainlab AB. Feldkirchen, Germany) were used, with one Varian iX linear accelerator, to produce fields that were (nominally) 0.20 cm across. Dose profiles for these fields were measured using radiochromic film and compared with the results of simulations completed using BEAMnrc and DOSXYZnrc, where the initial electron beam was set to FWHM = 0.02, 0.10, 0.12, 0.15, 0.20 and 0.50 cm. Increasing the electron-beam FWHM produced increasing occlusion of the photon source by the closely spaced collimator leaves and resulted in blurring of the simulated profile widths from 0.24 to 0.58 cm, for the MLC, from 0.11 to 0.40 cm, for the microMLC. Comparison with measurement data suggested that the electron spot size in the clinical linear accelerator was between FWHM = 0.10 and 0.15 cm, encompassing the result of our previous output-factor based work, which identified a FWHM of 0.12 cm. Investigation of narrow-beam penumbra variation has been found to be a useful procedure, with results varying noticeably with linear accelerator spot size and allowing FWHM estimates obtained using other methods to be verified.

SU-F-T-469: A Clinically Observed Discrepancy Between Image-Based and Log- Based MLC Position

DOE Office of Scientific and Technical Information (OSTI.GOV)

Neal, B; Ahmed, M; Siebers, J

2016-06-15

Purpose: To present a clinical case which challenges the base assumption of log-file based QA, by showing that the actual position of a MLC leaf can suddenly deviate from its programmed and logged position by >1 mm as observed with real-time imaging. Methods: An EPID-based exit-fluence dosimetry system designed to prevent gross delivery errors was used in cine mode to capture portal images during treatment. Visual monitoring identified an anomalous MLC leaf pair gap not otherwise detected by the automatic position verification. The position of the erred leaf was measured on EPID images and log files were analyzed for themore » treatment in question, the prior day’s treatment, and for daily MLC test patterns acquired on those treatment days. Additional standard test patterns were used to quantify the leaf position. Results: Whereas the log file reported no difference between planned and recorded positions, image-based measurements showed the leaf to be 1.3±0.1 mm medial from the planned position. This offset was confirmed with the test pattern irradiations. Conclusion: It has been clinically observed that log-file derived leaf positions can differ from their actual positions by >1 mm, and therefore cannot be considered to be the actual leaf positions. This cautions the use of log-based methods for MLC or patient quality assurance without independent confirmation of log integrity. Frequent verification of MLC positions through independent means is a necessary precondition to trusting log file records. Intra-treatment EPID imaging provides a method to capture departures from MLC planned positions. Work was supported in part by Varian Medical Systems.« less

Development and evaluation of aperture-based complexity metrics using film and EPID measurements of static MLC openings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Götstedt, Julia; Karlsson Hauer, Anna; Bäck, Anna, E-mail: anna.back@vgregion.se

Purpose: Complexity metrics have been suggested as a complement to measurement-based quality assurance for intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). However, these metrics have not yet been sufficiently validated. This study develops and evaluates new aperture-based complexity metrics in the context of static multileaf collimator (MLC) openings and compares them to previously published metrics. Methods: This study develops the converted aperture metric and the edge area metric. The converted aperture metric is based on small and irregular parts within the MLC opening that are quantified as measured distances between MLC leaves. The edge area metricmore » is based on the relative size of the region around the edges defined by the MLC. Another metric suggested in this study is the circumference/area ratio. Earlier defined aperture-based complexity metrics—the modulation complexity score, the edge metric, the ratio monitor units (MU)/Gy, the aperture area, and the aperture irregularity—are compared to the newly proposed metrics. A set of small and irregular static MLC openings are created which simulate individual IMRT/VMAT control points of various complexities. These are measured with both an amorphous silicon electronic portal imaging device and EBT3 film. The differences between calculated and measured dose distributions are evaluated using a pixel-by-pixel comparison with two global dose difference criteria of 3% and 5%. The extent of the dose differences, expressed in terms of pass rate, is used as a measure of the complexity of the MLC openings and used for the evaluation of the metrics compared in this study. The different complexity scores are calculated for each created static MLC opening. The correlation between the calculated complexity scores and the extent of the dose differences (pass rate) are analyzed in scatter plots and using Pearson’s r-values. Results: The complexity scores calculated by the edge area metric, converted aperture metric, circumference/area ratio, edge metric, and MU/Gy ratio show good linear correlation to the complexity of the MLC openings, expressed as the 5% dose difference pass rate, with Pearson’s r-values of −0.94, −0.88, −0.84, −0.89, and −0.82, respectively. The overall trends for the 3% and 5% dose difference evaluations are similar. Conclusions: New complexity metrics are developed. The calculated scores correlate to the complexity of the created static MLC openings. The complexity of the MLC opening is dependent on the penumbra region relative to the area of the opening. The aperture-based complexity metrics that combined either the distances between the MLC leaves or the MLC opening circumference with the aperture area show the best correlation with the complexity of the static MLC openings.« less

Evaluation of MLC leaf transmission on IMRT treatment plan quality of patients with advanced lung cancer.

PubMed

Chen, Jiayun; Fu, Guishan; Li, Minghui; Song, Yixin; Dai, Jianrong; Miao, Junjie; Liu, Zhiqiang; Li, Yexiong

2017-12-14

The purpose of this paper was to evaluate the impact of leaf treatment of multileaf collimator (MLC) in plan quality of intensity-modulated radiotherapy (IMRT) of patients with advanced lung cancer. Five MLCs with different leaf transmissions (0.01%, 0.5%, 1.2%, 1.8%, and 3%) were configured for an accelerator in a treatment planning system. Correspondingly, 5 treatment plans with the same optimization setting were created and evaluated quantitatively for each patient (11 patients total) who was diagnosed with advanced lung cancer. All of the 5 plans for each patient met the dose requirement for the planning treatment volumes (PTVs) and had similar target dose homogeneity and conformity. On average, the doses to selected organs were as follows: (1) V 5 , V 20 , and the mean dose of total lung; (2) the maximum and mean dose to spinal cord planning organ-at-risk volume (PRV); and (3) V 30 and V 40 of heart, decreased slightly when MLC transmission was decreased, but with no statistical differences. There is a clear grouping of plans having total quality score (S D ) value, which is used to evaluate plan quality: (1) more than 1 (patient nos. 1 to 3, 5, and 8), and more than 2.5 (patient no. 6); (2) less than 1 (patient nos. 7 and 10); (3) around 1 (patient nos. 4, 9, and 11). As MLC transmission increased, overall S D values increased as well and plan dose requirement was harder to meet. The clinical requirements were violated increasingly as MLC transmission became large. Total S D with and without normal tissue (NT) showed similar results, with no statistically significant differences. Therefore, decrease of MLC transmission did have minimum impact on plan, and it improved target coverage and reduced normal tissue radiation slightly, with no statistical significance. Plan quality could not be significantly improved by MLC transmission reduction. However, lower MLC transmission may have advantages on lung sparing to low- and intermediate-dose exposure. Besides conventional fraction, hyperfraction, or stereotactic body radiotherapy (SBRT), the reduction on lung sparing is still essential because it is highly relevant to radiation pneumonitis (RP). It has potential to diminish incidence of RP and improve patient's quality of life after irradiation with lowered MLC transmission. Copyright © 2017 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Impact of Multileaf Collimator Configuration Parameters on the Dosimetric Accuracy of 6-MV Intensity-Modulated Radiation Therapy Treatment Plans.

PubMed

Petersen, Nick; Perrin, David; Newhauser, Wayne; Zhang, Rui

2017-01-01

The purpose of this study was to evaluate the impact of selected configuration parameters that govern multileaf collimator (MLC) transmission and rounded leaf offset in a commercial treatment planning system (TPS) (Pinnacle 3 , Philips Medical Systems, Andover, MA, USA) on the accuracy of intensity-modulated radiation therapy (IMRT) dose calculation. The MLC leaf transmission factor was modified based on measurements made with ionization chambers. The table of parameters containing rounded-leaf-end offset values was modified by measuring the radiation field edge as a function of leaf bank position with an ionization chamber in a scanning water-tank dosimetry system and comparing the locations to those predicted by the TPS. The modified parameter values were validated by performing IMRT quality assurance (QA) measurements on 19 gantry-static IMRT plans. Planar dose measurements were performed with radiographic film and a diode array (MapCHECK2) and compared to TPS calculated dose distributions using default and modified configuration parameters. Based on measurements, the leaf transmission factor was changed from a default value of 0.001 to 0.005. Surprisingly, this modification resulted in a small but statistically significant worsening of IMRT QA gamma-index passing rate, which revealed that the overall dosimetric accuracy of the TPS depends on multiple configuration parameters in a manner that is coupled and not intuitive because of the commissioning protocol used in our clinic. The rounded leaf offset table had little room for improvement, with the average difference between the default and modified offset values being -0.2 ± 0.7 mm. While our results depend on the current clinical protocols, treatment unit and TPS used, the methodology used in this study is generally applicable. Different clinics could potentially obtain different results and improve their dosimetric accuracy using our approach.

Complexity metric based on fraction of penumbra dose - initial study

NASA Astrophysics Data System (ADS)

Bäck, A.; Nordström, F.; Gustafsson, M.; Götstedt, J.; Karlsson Hauer, A.

2017-05-01

Volumetric modulated arc therapy improve radiotherapy outcome for many patients compared to conventional three dimensional conformal radiotherapy but require a more extensive, most often measurement based, quality assurance. Multi leaf collimator (MLC) aperture-based complexity metrics have been suggested to be used to distinguish complex treatment plans unsuitable for treatment without time consuming measurements. This study introduce a spatially resolved complexity score that correlate to the fraction of penumbra dose and will give information on the spatial distribution and the clinical relevance of the calculated complexity. The complexity metric is described and an initial study on the correlation between the complexity score and the difference between measured and calculated dose for 30 MLC openings is presented. The result of an analysis of the complexity scores were found to correlate to differences between measurements and calculations with a Pearson’s r-value of 0.97.

Validation of Dosimetric Leaf Gap (DLG) prior to its implementation in Treatment Planning System (TPS): TrueBeam™ millennium 120 leaf MLC.

PubMed

Shende, Ravindra; Patel, Ganesh

2017-01-01

Objective of present study is to determine optimum value of DLG and its validation prior to being incorporated in TPS for Varian TrueBeam™ millennium 120 leaves MLC. Partial transmission through the rounded leaf ends of the Multi Leaf Collimator (MLC) causes a conflict between the edges of the light field and radiation field. Parameter account for this partial transmission is called Dosimetric Leaf Gap (DLG). The complex high precession technique, such as Intensity Modulated Radiation Therapy (IMRT), entails the modeling of optimum value of DLG inside Eclipse Treatment Planning System (TPS) for precise dose calculation. Distinct synchronized uniformed extension of sweeping dynamic MLC leaf gap fields created by Varian MLC shaper software were use to determine DLG. DLG measurements performed with both 0.13 cc semi-flex ionization chamber and 2D-Array I-Matrix were used to validate the DLG; similarly, values of DLG from TPS were estimated from predicted dose. Similar mathematical approaches were employed to determine DLG from delivered and TPS predicted dose. DLG determined from delivered dose measured with both ionization chamber (DLG Ion ) and I-Matrix (DLG I-Matrix ) compared with DLG estimate from TPS predicted dose (DLG TPS ). Measurements were carried out for all available 6MV, 10MV, 15MV, 6MVFFF and 10MVFFF beam energies. Maximum and minimum DLG deviation between measured and TPS calculated DLG was found to be 0.2 mm and 0.1 mm, respectively. Both of the measured DLGs (DLG Ion and DLG I-Matrix ) were found to be in a very good agreement with estimated DLG from TPS (DLG TPS ). Proposed method proved to be helpful in verifying and validating the DLG value prior to its clinical implementation in TPS.

A novel method for dose distribution registration using fiducial marks made by a megavoltage beam in film dosimetry for intensity-modulated radiation therapy quality assurance.

PubMed

Nakayama, Shinichi; Monzen, Hajime; Oonishi, Yuuichi; Mizote, Rika; Iramina, Hiraku; Kaneshige, Souichirou; Mizowaki, Takashi

2015-06-01

Photographic film is widely used for the dose distribution verification of intensity-modulated radiation therapy (IMRT). However, analysis for verification of the results is subjective. We present a novel method for marking the isocenter using irradiation from a megavoltage (MV) beam transmitted through slits in a multi-leaf collimator (MLC). We evaluated the effect of the marking irradiation at 500 monitor units (MU) on the total transmission through the MLC using an ionization chamber and Radiochromic Film. Film dosimetry was performed for quality assurance (QA) of IMRT plans. Three methods of registration were used for each film: marking by irradiating with an MV beam through slits in the MLC (MLC-IC); marking with a fabricated phantom (Phantom-IC); and a subjective method based on isodose lines (Manual). Each method was subjected to local γ-analysis. The effect of the marking irradiation on the total transmission was 0.16%, as measured by a ionization chamber at a 10-cm depth in a solid phantom, while the inter-leaf transmission was 0.3%, determined from the film. The mean pass rates for each registration method agreed within ± 1% when the criteria used were a distance-to-agreement (DTA) of 3 mm and a dose difference (DD) of 3%. For DTA/DD criteria of 2mm/3%, the pass rates in the sagittal plane were 96.09 ± 0.631% (MLC-IC), 96.27 ± 0.399% (Phantom-IC), and 95.62 ± 0.988% (Manual). The present method is a versatile and useful method of improving the objectivity of film dosimetry for IMRT QA. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

A dosimetric evaluation of the Eclipse AAA algorithm and Millennium 120 MLC for cranial intensity-modulated radiosurgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Calvo Ortega, Juan Francisco, E-mail: jfcdrr@yahoo.es; Moragues, Sandra; Pozo, Miquel

2014-07-01

The aim of this study is to assess the accuracy of a convolution-based algorithm (anisotropic analytical algorithm [AAA]) implemented in the Eclipse planning system for intensity-modulated radiosurgery (IMRS) planning of small cranial targets by using a 5-mm leaf-width multileaf collimator (MLC). Overall, 24 patient-based IMRS plans for cranial lesions of variable size (0.3 to 15.1 cc) were planned (Eclipse, AAA, version 10.0.28) using fixed field-based IMRS produced by a Varian linear accelerator equipped with a 120 MLC (5-mm width on central leaves). Plan accuracy was evaluated according to phantom-based measurements performed with radiochromic film (EBT2, ISP, Wayne, NJ). Film 2Dmore » dose distributions were performed with the FilmQA Pro software (version 2011, Ashland, OH) by using the triple-channel dosimetry method. Comparison between computed and measured 2D dose distributions was performed using the gamma method (3%/1 mm). Performance of the MLC was checked by inspection of the DynaLog files created by the linear accelerator during the delivery of each dynamic field. The absolute difference between the calculated and measured isocenter doses for all the IMRS plans was 2.5% ± 2.1%. The gamma evaluation method resulted in high average passing rates of 98.9% ± 1.4% (red channel) and 98.9% ± 1.5% (blue and green channels). DynaLog file analysis revealed a maximum root mean square error of 0.46 mm. According to our results, we conclude that the Eclipse/AAA algorithm provides accurate cranial IMRS dose distributions that may be accurately delivered by a Varian linac equipped with a Millennium 120 MLC.« less

The effect of MLC speed and acceleration on the plan delivery accuracy of VMAT

PubMed Central

Park, J M; Wu, H-G; Kim, J H; Carlson, J N K

2015-01-01

Objective: To determine a new metric utilizing multileaf collimator (MLC) speeds and accelerations to predict plan delivery accuracy of volumetric modulated arc therapy (VMAT). Methods: To verify VMAT delivery accuracy, gamma evaluations, analysis of mechanical parameter difference between plans and log files, and analysis of changes in dose–volumetric parameters between plans and plans reconstructed with log files were performed with 40 VMAT plans. The average proportion of leaf speeds ranging from l to h cm s−1 (Sl–h and l–h = 0–0.4, 0.4–0.8, 0.8–1.2, 1.2–1.6 and 1.6–2.0), mean and standard deviation of MLC speeds were calculated for each VMAT plan. The same was carried out for accelerations in centimetre per second squared (Al–h and l–h = 0–4, 4–8, 8–12, 12–16 and 16–20). The correlations of those indicators to plan delivery accuracy were analysed with Spearman's correlation coefficient (rs). Results: The S1.2–1.6 and mean acceleration of MLCs showed generally higher correlations to plan delivery accuracy than did others. The highest rs values were observed between S1.2–1.6 and global 1%/2 mm (rs = −0.698 with p < 0.001) as well as mean acceleration and global 1%/2 mm (rs = −0.650 with p < 0.001). As the proportion of MLC speeds and accelerations >0.4 and 4 cm s−2 increased, the plan delivery accuracy of VMAT decreased. Conclusion: The variations in MLC speeds and accelerations showed considerable correlations to VMAT delivery accuracy. Advances in knowledge: As the MLC speeds and accelerations increased, VMAT delivery accuracy reduced. PMID:25734490

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

PubMed

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

2008-05-01

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.

SU-E-T-424: Dosimetric Verification of Modulated Electron Radiation Therapy Delivered Using An Electron Specific Multileaf Collimator for Treatment of Scalp Cases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eldib, A; Al-Azhar University Cairo; Jin, L

2014-06-01

Purpose: Modulated electron radiotherapy (MERT) has the potential to achieve better treatment outcome for shallow tumors such as those of breast and scalp. In a separate study with scalp lesions, MERT was compared to volumetric modulated arc therapy. Our results showed a reduction in the dose reaching the brain with MERT. However dose calculation accuracy and delivery efficiency challenges remain. Thus in the current study we proceed to add more cases to demonstrate MERT beneficial outcome and its delivery accuracy using an electron specific multileaf collimator (eMLC). Methods: We have used the MCBEAM code for treatment head simulation and formore » generating phase space files to be used as radiation source input for our Monte Carlo based treatment planning system (MC TPS). MCPLAN code is used for calculation of patient specific dose deposition coefficient and for final MERT plan dose calculation. An in-house developed optimization code is used for the optimization process. MERT plans were generated for real patients and head and neck phantom. Film was used for dosimetric verification. The film was cut following the contour of the curved phantom surface and then sealed with black masking tape. In the measurement, the sealed film packet was sandwiched between two adjacent slabs of the head and neck phantom. The measured 2D dose distribution was then compared with calculations. Results: The eMLC allows effective treatment of scalps with multi-lesions spreading around the patient head, which was usually difficult to plan or very time consuming with conventional applicators. MERT continues to show better reduction in the brain dose. The dosimetric measurements showed slight discrepancy, which was attributed to the film setup. Conclusion: MERT can improve treatment plan quality for patients with scalp cancers. Our in-house MC TPS is capable of performing treatment planning and accurate dose calculation for MERT using the eMLC.« less

The influence of plan modulation on the interplay effect in VMAT liver SBRT treatments.

PubMed

Hubley, Emily; Pierce, Greg

2017-08-01

Volumetric modulated arc therapy (VMAT) uses multileaf collimator (MLC) leaves, gantry speed, and dose rate to modulate beam fluence, producing the highly conformal doses required for liver radiotherapy. When targets that move with respiration are treated with a dynamic fluence, there exists the possibility for interplay between the target and leaf motions. This study employs a novel motion simulation technique to determine if VMAT liver SBRT plans with an increase in MLC leaf modulation are more susceptible to dosimetric differences in the GTV due to interplay effects. For ten liver SBRT patients, two VMAT plans with different amounts of MLC leaf modulation were created. Motion was simulated using a random starting point in the respiratory cycle for each fraction. To isolate the interplay effect, motion was also simulated using four specific starting points in the respiratory cycle. The dosimetric differences caused by different starting points were examined by subtracting resultant dose distributions from each other. When motion was simulated using random starting points for each fraction, or with specific starting points, there were significantly more dose differences in the GTV (maximum 100cGy) for more highly modulated plans, but the overall plan quality was not adversely affected. Plans with more MLC leaf modulation are more susceptible to interplay effects, but dose differences in the GTV are clinically negligible in magnitude. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Caillet, V; Colvill, E; Royal North Shore Hospital, Sydney, NSW

Purpose: The objective of this study was to investigate the dosimetric benefits of multi-leaf collimator (MLC) tracking for lung SABR treatments in end-to-end clinically realistic planning and delivery scenarios. Methods: The clinical benefits of MLC tracking were assessed using previously delivered treatment plans and physical experiments. The 10 most recent single lesion lung SABR patients were re-planned following a 4D-GTV-based real-time adaptive protocol (PTV defined as the end-of-exhalation GTV plus 5.0 mm margins). The plans were delivered on a Trilogy Varian linac. Electromagnetic transponders (Calypso, Varian Medical Systems, USA) were embedded into a programmable moving phantom (HexaMotion platform) tracked withmore » the Varian Calypso system. For each physical experiment, the MLC positions were collected and used as input for dose reconstruction. For both planned and physical experiments, the OAR dose metrics from the conventional and real-time adaptive SABR plans (Mean Lung Dose (MLD), V20 for lung, and near-maximum dose (D2%) for spine and heart) were statistically compared. The Wilcoxon test was used to compare plan and physical experiment dose metrics. Results: While maintaining target coverage, percentage reductions in dose metrics to the OARs were observed for both planned and physical experiments. Comparing the two plans showed MLD percentage reduction (MLDr) of 25.4% (absolute differences of 1.41 Gy) and 28.9% (1.29%) for the V20r. D2% percentage reduction for spine and heart were respectively 27.9% (0.3 Gy) and 20.2% (0.3 Gy). For the physical experiments, MLDr was 23.9% (1.3 Gy), and V20r 37.4% (1.6%). D2% reduction for spine and heart were respectively 27.3% (0.3 Gy) and 19.6% (0.3 Gy). For both plans and physical experiments, significant OAR dose differences (p<0.05) were found between the conventional SABR and real-time adaptive plans. Conclusion: Application of MLC tracking for lung SABR patients has the potential to reduce the dose to OARs during radiation therapy.« less

Methods to model and predict the ViewRay treatment deliveries to aid patient scheduling and treatment planning.

PubMed

Liu, Shi; Wu, Yu; Wooten, H Omar; Green, Olga; Archer, Brent; Li, Harold; Yang, Deshan

2016-03-08

A software tool is developed, given a new treatment plan, to predict treatment delivery time for radiation therapy (RT) treatments of patients on ViewRay magnetic resonance image-guided radiation therapy (MR-IGRT) delivery system. This tool is necessary for managing patient treatment scheduling in our clinic. The predicted treatment delivery time and the assessment of plan complexities could also be useful to aid treatment planning. A patient's total treatment delivery time, not including time required for localization, is modeled as the sum of four components: 1) the treatment initialization time; 2) the total beam-on time; 3) the gantry rotation time; and 4) the multileaf collimator (MLC) motion time. Each of the four components is predicted separately. The total beam-on time can be calculated using both the planned beam-on time and the decay-corrected dose rate. To predict the remain-ing components, we retrospectively analyzed the patient treatment delivery record files. The initialization time is demonstrated to be random since it depends on the final gantry angle of the previous treatment. Based on modeling the relationships between the gantry rotation angles and the corresponding rotation time, linear regression is applied to predict the gantry rotation time. The MLC motion time is calculated using the leaves delay modeling method and the leaf motion speed. A quantitative analysis was performed to understand the correlation between the total treatment time and the plan complexity. The proposed algorithm is able to predict the ViewRay treatment delivery time with the average prediction error 0.22min or 1.82%, and the maximal prediction error 0.89 min or 7.88%. The analysis has shown the correlation between the plan modulation (PM) factor and the total treatment delivery time, as well as the treatment delivery duty cycle. A possibility has been identified to significantly reduce MLC motion time by optimizing the positions of closed MLC pairs. The accuracy of the proposed prediction algorithm is sufficient to support patient treatment appointment scheduling. This developed software tool is currently applied in use on a daily basis in our clinic, and could also be used as an important indicator for treatment plan complexity.

SU-E-T-629: Prediction of the ViewRay Radiotherapy Treatment Time for Clinical Logistics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, S; Wooten, H; Wu, Y

Purpose: An algorithm is developed in our clinic, given a new treatment plan, to predict treatment delivery time for radiation therapy (RT) treatments of patients on ViewRay magnetic resonance-image guided radiation therapy (MR-IGRT) delivery system. This algorithm is necessary for managing patient treatment appointments, and is useful as an indicator to assess the treatment plan complexity. Methods: A patient’s total treatment delivery time, not including time required for localization, may be described as the sum of four components: (1) the treatment initialization time; (2) the total beam-on time; (3) the gantry rotation time; and (4) the multileaf collimator (MLC) motionmore » time. Each of the four components is predicted separately. The total beam-on time can be calculated using both the planned beam-on time and the decay-corrected delivery dose rate. To predict the remaining components, we quantitatively analyze the patient treatment delivery record files. The initialization time is demonstrated to be random since it depends on the final gantry angle and MLC leaf positions of the previous treatment. Based on modeling the relationships between the gantry rotation angles and the corresponding rotation time, and between the furthest MLC leaf moving distance and the corresponding MLC motion time, the total delivery time is predicted using linear regression. Results: The proposed algorithm has demonstrated the feasibility of predicting the ViewRay treatment delivery time for any treatment plan of any patient. The average prediction error is 0.89 minutes or 5.34%, and the maximal prediction error is 2.09 minutes or 13.87%. Conclusion: We have developed a treatment delivery time prediction algorithm based on the analysis of previous patients’ treatment delivery records. The accuracy of our prediction is sufficient for guiding and arranging patient treatment appointments on a daily basis. The predicted delivery time could also be used as an indicator to assess the treatment plan complexity. This work was supported by a research grant from Viewray Inc.« less

Determination of MLC model parameters for Monaco using commercial diode arrays.

PubMed

Kinsella, Paul; Shields, Laura; McCavana, Patrick; McClean, Brendan; Langan, Brian

2016-07-08

Multileaf collimators (MLCs) need to be characterized accurately in treatment planning systems to facilitate accurate intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT). The aim of this study was to examine the use of MapCHECK 2 and ArcCHECK diode arrays for optimizing MLC parameters in Monaco X-ray voxel Monte Carlo (XVMC) dose calculation algorithm. A series of radiation test beams designed to evaluate MLC model parameters were delivered to MapCHECK 2, ArcCHECK, and EBT3 Gafchromic film for comparison. Initial comparison of the calculated and ArcCHECK-measured dose distributions revealed it was unclear how to change the MLC parameters to gain agreement. This ambiguity arose due to an insufficient sampling of the test field dose distributions and unexpected discrepancies in the open parts of some test fields. Consequently, the XVMC MLC parameters were optimized based on MapCHECK 2 measurements. Gafchromic EBT3 film was used to verify the accuracy of MapCHECK 2 measured dose distributions. It was found that adjustment of the MLC parameters from their default values resulted in improved global gamma analysis pass rates for MapCHECK 2 measurements versus calculated dose. The lowest pass rate of any MLC-modulated test beam improved from 68.5% to 93.5% with 3% and 2 mm gamma criteria. Given the close agreement of the optimized model to both MapCHECK 2 and film, the optimized model was used as a benchmark to highlight the relatively large discrepancies in some of the test field dose distributions found with ArcCHECK. Comparison between the optimized model-calculated dose and ArcCHECK-measured dose resulted in global gamma pass rates which ranged from 70.0%-97.9% for gamma criteria of 3% and 2 mm. The simple square fields yielded high pass rates. The lower gamma pass rates were attributed to the ArcCHECK overestimating the dose in-field for the rectangular test fields whose long axis was parallel to the long axis of the ArcCHECK. Considering ArcCHECK measurement issues and the lower gamma pass rates for the MLC-modulated test beams, it was concluded that MapCHECK 2 was a more suitable detector than ArcCHECK for the optimization process. © 2016 The Authors

Modulation indices for volumetric modulated arc therapy.

PubMed

Park, Jong Min; Park, So-Yeon; Kim, Hyoungnyoun; Kim, Jin Ho; Carlson, Joel; Ye, Sung-Joon

2014-12-07

The aim of this study is to present a modulation index (MI) for volumetric modulated arc therapy (VMAT) based on the speed and acceleration analysis of modulating-parameters such as multi-leaf collimator (MLC) movements, gantry rotation and dose-rate, comprehensively. The performance of the presented MI (MIt) was evaluated with correlation analyses to the pre-treatment quality assurance (QA) results, differences in modulating-parameters between VMAT plans versus dynamic log files, and differences in dose-volumetric parameters between VMAT plans versus reconstructed plans using dynamic log files. For comparison, the same correlation analyses were performed for the previously suggested modulation complexity score (MCS(v)), leaf travel modulation complexity score (LTMCS) and MI by Li and Xing (MI Li&Xing). In the two-tailed unpaired parameter condition, p values were acquired. The Spearman's rho (r(s)) values of MIt, MCSv, LTMCS and MI Li&Xing to the local gamma passing rate with 2%/2 mm criterion were -0.658 (p < 0.001), 0.186 (p = 0.251), 0.312 (p = 0.05) and -0.455 (p = 0.003), respectively. The values of rs to the modulating-parameter (MLC positions) differences were 0.917, -0.635, -0.857 and 0.795, respectively (p < 0.001). For dose-volumetric parameters, MIt showed higher statistically significant correlations than the conventional MIs. The MIt showed good performance for the evaluation of the modulation-degree of VMAT plans.

Photon caliper to achieve submillimeter positioning accuracy

NASA Astrophysics Data System (ADS)

Gallagher, Kyle J.; Wong, Jennifer; Zhang, Junan

2017-09-01

The purpose of this study was to demonstrate the feasibility of using a commercial two-dimensional (2D) detector array with an inherent detector spacing of 5 mm to achieve submillimeter accuracy in localizing the radiation isocenter. This was accomplished by delivering the Vernier ‘dose’ caliper to a 2D detector array where the nominal scale was the 2D detector array and the non-nominal Vernier scale was the radiation dose strips produced by the high-definition (HD) multileaf collimators (MLCs) of the linear accelerator. Because the HD MLC sequence was similar to the picket fence test, we called this procedure the Vernier picket fence (VPF) test. We confirmed the accuracy of the VPF test by offsetting the HD MLC bank by known increments and comparing the known offset with the VPF test result. The VPF test was able to determine the known offset within 0.02 mm. We also cross-validated the accuracy of the VPF test in an evaluation of couch hysteresis. This was done by using both the VPF test and the ExacTrac optical tracking system to evaluate the couch position. We showed that the VPF test was in agreement with the ExacTrac optical tracking system within a root-mean-square value of 0.07 mm for both the lateral and longitudinal directions. In conclusion, we demonstrated the VPF test can determine the offset between a 2D detector array and the radiation isocenter with submillimeter accuracy. Until now, no method to locate the radiation isocenter using a 2D detector array has been able to achieve such accuracy.

Peripheral doses from pediatric IMRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

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

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 tomore » 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{sup -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 0.47-0.94) doses {approx}[0.4-1.8 cGy]/[0.9-2.9 cGy]/fraction, respectively. Prior phantom reports are for fields 10 cm or greater, while pediatric central nervous system fields range from 4 to 7 cm, and effectively much smaller for IMRT (2-6 cm). Peripheral dose in close proximity (<10 cm from the field edge) is dominated by internal scatter; therefore, field-size differences overwhelm phantom size affects and increased MU. Distant peripheral dose, dominated by head leakage, was higher than predicted, even when accounting for MUs ({approx}factor of 3) likely due to the pediatric phantom size. The ratio of the testes dose ranged from 3.3-5.3 for IMRT/conventional. PD to OAR for pediatric IMRT cannot be predicted from large-field full phantom studies. For regional OAR, doses are likely lower than predicted by existing ''large field'' data, while the distant PD is higher.« less

Effect of MLC leaf width on treatment adaptation and accuracy for concurrent irradiation of prostate and pelvic lymph nodes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shang Qingyang; Qi Peng; Ferjani, Samah

2013-06-15

Purpose: The aim of the study was to evaluate the impact of multileaf collimator (MLC) leaf width on treatment adaptation and delivery accuracy for concurrent treatment of the prostate and pelvic lymph nodes with intensity modulated radiation therapy (IMRT). Methods: Seventy-five kilovoltage cone beam CTs (KV-CBCT) from six patients were included for this retrospective study. For each patient, three different IMRT plans were created based on a planning CT using three different MLC leaf widths of 2.5, 5, and 10 mm, respectively. For each CBCT, the prostate displacement was determined by a dual image registration. Adaptive plans were created bymore » shifting selected MLC leaf pairs to compensate for daily prostate movements. To evaluate the impact of MLC leaf width on the adaptive plan for each daily CBCT, three MLC shifted plans were created using three different leaf widths of MLCs (a total of 225 adaptive treatment plans). Selective dosimetric endpoints for the tumor volumes and organs at risk (OARs) were evaluated for these adaptive plans. Using the planning CT from a selected patient, MLC shifted plans for three hypothetical longitudinal shifts of 2, 4, and 8 mm were delivered on the three linear accelerators to test the deliverability of the shifted plans and to compare the dose accuracy of the shifted plans with the original IMRT plans. Results: Adaptive plans from 2.5 and 5 mm MLCs had inadequate dose coverage to the prostate (D99 < 97%, or D{sub mean} < 99% of the planned dose) in 6%-8% of the fractions, while adaptive plans from 10 mm MLC led to inadequate dose coverage to the prostate in 25.3% of the fractions. The average V{sub 56Gy} of the prostate over the six patients was improved by 6.4% (1.6%-32.7%) and 5.8% (1.5%-35.7%) with adaptive plans from 2.5 and 5 mm MLCs, respectively, when compared with adaptive plans from 10 mm MLC. Pelvic lymph nodes were well covered for all MLC adaptive plans, as small differences were observed for D99, D{sub mean}, and V{sub 50.4Gy}. Similar OAR sparing could be achieved for the bladder and rectum with all three MLCs for treatment adaptation. The MLC shifted plans can be accurately delivered on all three linear accelerators with accuracy similar to their original IMRT plans, where gamma (3%/3 mm) passing rates were 99.6%, 93.0%, and 92.1% for 2.5, 5, and 10 mm MLCs, respectively. The percentages of pixels with dose differences between the measurement and calculation being less than 3% of the maximum dose were 85.9%, 82.5%, and 70.5% for the original IMRT plans from the three MLCs, respectively. Conclusions: Dosimetric advantages associated with smaller MLC leaves were observed in terms of the coverage to the prostate, when the treatment was adapted to account for daily prostate movement for concurrent irradiation of the prostate and pelvic lymph nodes. The benefit of switching the MLC from 10 to 5 mm was significant (p Much-Less-Than 0.01); however, switching the MLC from 5 to 2.5 mm would not gain significant (p= 0.15) improvement. IMRT plans with smaller MLC leaf widths achieved more accurate dose delivery.« less

Can cost make a difference dosimetrically? Volumetric modulated arc therapy study for multileaf collimators of various widths for head and neck and prostate cancers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ho, Jong-Han, E-mail: jonghanho@gmail.com; Hagler, Shane; Lujano, Carrie

Cancer is a global health issue that disproportionately kills based on stage of disease, cellular pathology, and genetics, to name a few. Another variable to consider in this ongoing fight is treatment machine complexity that leads to elevated development and purchasing cost, leading to a reduced use. Reducing the complexity (in hopes of lowering costs) would benefit underdeveloped, low- and middle-income countries by introducing newer treatment technology, as their currently accepted standards do not meet standards of more advanced, developed countries. In this study, unilateral head and neck (H&N), and prostate cases using volumetric modulated arc therapy (VMAT) were testedmore » with multiple segment widths of 5, 10, 15, and 20 mm to create treatable plans. Pinnacle 9.10v was used for planning purposes. A total of 12 cases were planned with varying multileaf collimator (MLC) widths. Treatment plans were evaluated retrospectively. Results show that altering the MLC widths from 5 through 20 mm produces both comparable and treatable plans up to 99% and 98% target coverage for H&N and prostate, respectively, albeit clinically significant hot spots were shown to increase with increasing segment width. Furthermore, the results show that increasing widths can produce comparable treatment plans as measured against our current Food and Drug Administration (FDA)–approved treatment devices—leading to an increase in treatment efficacy in economically underdeveloped countries.« less

Software tool for portal dosimetry research.

PubMed

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.

SU-F-BRE-16: VMAT Commissioning and Quality Assurance (QA) of An Elekta Synergy-STM Linac Using ICOM Test HarnessTM

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nguyen, A; Ironwood CRC, Phoenix, AZ; Rajaguru, P

2014-06-15

Purpose: To establish a set of tests based on the iCOM software that can be used to commission and perform periodic QA of VMAT delivery on the Elekta Synergy-S, commonly known as the Beam Modulator (BM). Methods: iCOM is used to create and deliver customized treatment fields to characterize the system in terms of 1) MLC positioning accuracy under static and dynamic delivery with full gantry rotation, 2) MLC positioning with known errors, 3) Maximum dose rate, 4) Maximum MLC speed, 5) Maximum gantry speed, 6) Synchronization: gantry speed versus dose rate, and 7) Synchronization: MLC speed versus dose rate.more » The resulting images were captured on the iView GT and exported in DICOM format to Dosimetry Check™ system for visual and quantitative analysis. For the initial commissioning phase, the system tests described should be supplemented with extensive patient QAs covering all clinically relevant treatment sites. Results: The system performance test suite showed that on our Synergy-S, MLC positioning was accurate under both static and dynamic deliveries. Intentional errors of 1 mm were also easily identified on both static and dynamic picket fence tests. Maximum dose rate was verified with stop watch to be consistently between 475-480 MU/min. Maximum gantry speed and MLC speed were 5.5 degree/s and 2.5 cm/s respectively. After accounting for beam flatness, both synchronization tests, gantry versus dose rate and MLC speed versus dose rate, were successful as the fields were uniform across the strips and there were no obvious cold/hot spots. Conclusion: VMAT commissioning and quality assurance should include machine characterization tests in addition to patient QAs. Elekta iCOM is a valuable tool for the design of customized VMAT field with specific MU, MLC leaf positions, dose rate, and indirect control of MLC and gantry speed at each of its control points.« less

Daily QA of linear accelerators using only EPID and OBI

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sun, Baozhou, E-mail: bsun@radonc.wustl.edu; Goddu, S. Murty; Yaddanapudi, Sridhar

2015-10-15

Purpose: As treatment delivery becomes more complex, there is a pressing need for robust quality assurance (QA) tools to improve efficiency and comprehensiveness while simultaneously maintaining high accuracy and sensitivity. This work aims to present the hardware and software tools developed for comprehensive QA of linear accelerator (LINAC) using only electronic portal imaging devices (EPIDs) and kV flat panel detectors. Methods: A daily QA phantom, which includes two orthogonally positioned phantoms for QA of MV-beams and kV onboard imaging (OBI) is suspended from the gantry accessory holder to test both geometric and dosimetric components of a LINAC and an OBI.more » The MV component consists of a 0.5 cm water-equivalent plastic sheet incorporating 11 circular steel plugs for transmission measurements through multiple thicknesses and one resolution plug for MV-image quality testing. The kV-phantom consists of a Leeds phantom (TOR-18 FG phantom supplied by Varian) for testing low and high contrast resolutions. In the developed process, the existing LINAC tools were used to automate daily acquisition of MV and kV images and software tools were developed for simultaneous analysis of these images. A method was developed to derive and evaluate traditional QA parameters from these images [output, flatness, symmetry, uniformity, TPR{sub 20/10}, and positional accuracy of the jaws and multileaf collimators (MLCs)]. The EPID-based daily QA tools were validated by performing measurements on a detuned 6 MV beam to test its effectiveness in detecting errors in output, symmetry, energy, and MLC positions. The developed QA process was clinically commissioned, implemented, and evaluated on a Varian TrueBeam LINAC (Varian Medical System, Palo Alto, CA) over a period of three months. Results: Machine output constancy measured with an EPID (as compared against a calibrated ion-chamber) is shown to be within ±0.5%. Beam symmetry and flatness deviations measured using an EPID and a 2D ion-chamber array agree within ±0.5% and ±1.2% for crossline and inline profiles, respectively. MLC position errors of 0.5 mm can be detected using a picket fence test. The field size and phantom positioning accuracy can be determined within 0.5 mm. The entire daily QA process takes ∼15 min to perform tests for 5 photon beams, MLC tests, and imaging checks. Conclusions: The exclusive use of EPID-based QA tools, including a QA phantom and simultaneous analysis software tools, has been demonstrated as a viable, efficient, and comprehensive process for daily evaluation of LINAC performance.« less

Multiple Leader Candidate and Competitive Position Allocation for Robust Formation against Member Robot Faults

PubMed Central

Kwon, Ji-Wook; Kim, Jin Hyo; Seo, Jiwon

2015-01-01

This paper proposes a Multiple Leader Candidate (MLC) structure and a Competitive Position Allocation (CPA) algorithm which can be applicable for various applications including environmental sensing. Unlike previous formation structures such as virtual-leader and actual-leader structures with position allocation including a rigid allocation and an optimization based allocation, the formation employing the proposed MLC structure and CPA algorithm is robust against the fault (or disappearance) of the member robots and reduces the entire cost. In the MLC structure, a leader of the entire system is chosen among leader candidate robots. The CPA algorithm is the decentralized position allocation algorithm that assigns the robots to the vertex of the formation via the competition of the adjacent robots. The numerical simulations and experimental results are included to show the feasibility and the performance of the multiple robot system employing the proposed MLC structure and the CPA algorithm. PMID:25954956

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

PubMed Central

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

2008-01-01

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 1024×768 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 be used for intra-fractional tumor tracking on a Linac equipped with a kV imaging system. Any motion exceeding a preset threshold can warn the therapist to suspend a treatment session and reposition the patient. PMID:18777916

TomoTherapy MLC verification using exit detector data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen Quan; Westerly, David; Fang Zhenyu

2012-01-15

Purpose: Treatment delivery verification (DV) is important in the field of intensity modulated radiation therapy (IMRT). While IMRT and image guided radiation therapy (IGRT), allow us to create more conformal plans and enables the use of tighter margins, an erroneously executed plan can have detrimental effects on the treatment outcome. The purpose of this study is to develop a DV technique to verify TomoTherapy's multileaf collimator (MLC) using the onboard mega-voltage CT detectors. Methods: The proposed DV method uses temporal changes in the MVCT detector signal to predict actual leaf open times delivered on the treatment machine. Penumbra and scatteredmore » radiation effects may produce confounding results when determining leaf open times from the raw detector data. To reduce the impact of the effects, an iterative, Richardson-Lucy (R-L) deconvolution algorithm is applied. Optical sensors installed on each MLC leaf are used to verify the accuracy of the DV technique. The robustness of the DV technique is examined by introducing different attenuation materials in the beam. Additionally, the DV technique has been used to investigate several clinical plans which failed to pass delivery quality assurance (DQA) and was successful in identifying MLC timing discrepancies as the root cause. Results: The leaf open time extracted from the exit detector showed good agreement with the optical sensors under a variety of conditions. Detector-measured leaf open times agreed with optical sensor data to within 0.2 ms, and 99% of the results agreed within 8.5 ms. These results changed little when attenuation was added in the beam. For the clinical plans failing DQA, the dose calculated from reconstructed leaf open times played an instrumental role in discovering the root-cause of the problem. Throughout the retrospective study, it is found that the reconstructed dose always agrees with measured doses to within 1%. Conclusions: The exit detectors in the TomoTherapy treatment systems can provide valuable information about MLC behavior during delivery. A technique to estimate the TomoTherapy binary MLC leaf open time from exit detector signals is described. This technique is shown to be both robust and accurate for delivery verification.« less

Monte Carlo modeling of HD120 multileaf collimator on Varian TrueBeam linear accelerator for verification of 6X and 6X FFF VMAT SABR treatment plans

PubMed Central

Gete, Ermias; Duzenli, Cheryl; Teke, Tony

2014-01-01

A Monte Carlo (MC) validation of the vendor‐supplied Varian TrueBeam 6 MV flattened (6X) phase‐space file and the first implementation of the Siebers‐Keall MC MLC model as applied to the HD120 MLC (for 6X flat and 6X flattening filterfree (6X FFF) beams) are described. The MC model is validated in the context of VMAT patient‐specific quality assurance. The Monte Carlo commissioning process involves: 1) validating the calculated open‐field percentage depth doses (PDDs), profiles, and output factors (OF), 2) adapting the Siebers‐Keall MLC model to match the new HD120‐MLC geometry and material composition, 3) determining the absolute dose conversion factor for the MC calculation, and 4) validating this entire linac/MLC in the context of dose calculation verification for clinical VMAT plans. MC PDDs for the 6X beams agree with the measured data to within 2.0% for field sizes ranging from 2 × 2 to 40 × 40 cm2. Measured and MC profiles show agreement in the 50% field width and the 80%‐20% penumbra region to within 1.3 mm for all square field sizes. MC OFs for the 2 to 40 cm2 square fields agree with measurement to within 1.6%. Verification of VMAT SABR lung, liver, and vertebra plans demonstrate that measured and MC ion chamber doses agree within 0.6% for the 6X beam and within 2.0% for the 6X FFF beam. A 3D gamma factor analysis demonstrates that for the 6X beam, > 99% of voxels meet the pass criteria (3%/3 mm). For the 6X FFF beam, > 94% of voxels meet this criteria. The TrueBeam accelerator delivering 6X and 6X FFF beams with the HD120 MLC can be modeled in Monte Carlo to provide an independent 3D dose calculation for clinical VMAT plans. This quality assurance tool has been used clinically to verify over 140 6X and 16 6X FFF TrueBeam treatment plans. PACS number: 87.55.K‐ PMID:24892341

SU-F-T-549: Validation of a Method for in Vivo 3D Dose Reconstruction for SBRT Using a New Transmission Detector

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nakaguchi, Y; Shimohigashi, Y; Onizuka, R

Purpose: Recently, there has been increased clinical use of stereotactic body radiation therapy (SBRT). SBRT treatments will strongly benefit from in vivo patient dose verification, as any errors in delivery can be more detrimental to the radiobiology of the patient as compared to conventional therapy. In vivo dose measurements, a commercially available quality assurance platform which is able to correlate the delivered dose to the patient’s anatomy and take into account tissue inhomogeneity, is the COMPASS system (IBA Dosimetry, Germany) using a new transmission detector (Dolphin, IBA Dosimetry). In this work, we evaluate a method for in vivo 3D dosemore » reconstruction for SBRT using a new transmission detector, which was developed for in vivo dose verification for intensity-modulated radiation therapy (IMRT). Methods: We evaluated the accuracy of measurement for SBRT using simple small fields (2×2−10×10 cm2), a multileaf collimator (MLC) test pattern, and clinical cases. The dose distributions from the COMPASS were compared with those of EDR2 films (Kodak, USA) and the Monte Carlo simulations (MC). For clinical cases, we compared MC using dose-volume-histograms (DVHs) and dose profiles. Results: The dose profiles from the COMPASS for small fields and the complicated MLC test pattern agreed with those of EDR2 films, and MC within 3%. This showed the COMPASS with Dolphin system showed good spatial resolution and can measure small fields which are required for SBRT. Those results also suggest that COMPASS with Dolphin is able to detect MLC leaf position errors for SBRT. In clinical cases, the COMPASS with Dolphin agreed well with MC. The Dolphin detector, which consists of ionization chambers, provided stable measurement. Conclusion: COMPASS with Dolphin detector showed a useful in vivo 3D dose reconstruction for SBRT. The accuracy of the results indicates that this approach is suitable for clinical implementation.« less

Real-time tracking of tumor motions and deformations along the leaf travel direction with the aid of a synchronized dynamic MLC leaf sequencer.

PubMed

Tacke, Martin; Nill, Simeon; Oelfke, Uwe

2007-11-21

Advanced radiotherapeutical techniques like intensity-modulated radiation therapy (IMRT) are based on an accurate knowledge of the location of the radiation target. An accurate dose delivery, therefore, requires a method to account for the inter- and intrafractional target motion and the target deformation occurring during the course of treatment. A method to compensate in real time for changes in the position and shape of the target is the use of a dynamic multileaf collimator (MLC) technique which can be devised to automatically arrange the treatment field according to real-time image information. So far, various approaches proposed for leaf sequencers have had to rely on a priori known target motion data and have aimed to optimize the overall treatment time. Since for a real-time dose delivery the target motion is not known a priori, the velocity range of the leading leaves is restricted by a safety margin to c x v(max) while the following leaves can travel with an additional maximum speed to compensate for the respective target movements. Another aspect to be considered is the tongue and groove effect. A uniform radiation field can only be achieved if the leaf movements are synchronized. The method presented in this note is the first to combine a synchronizing sequencer and real-time tracking with a dynamic MLC. The newly developed algorithm is capable of online optimizing the leaf velocities by minimizing the overall treatment time while at the same time it synchronizes the leaf trajectories in order to avoid the tongue and groove effect. The simultaneous synchronization is performed with the help of an online-calculated mid-time leaf trajectory which is common for all leaf pairs and which takes into account the real-time target motion and deformation information.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cheung, Michael L M; Chan, Anthony T C; The Chinese University of Hong Kong

Purpose: To develop a formulation for 4D treatment planning for a tumour tracking volumetric modulated arc therapy treatment (VMAT) plan for lung cancer. Methods: A VMAT plan was optimized based on a reference phase of the 4DCT of a lung cancer patient. The PTV was generated from the GTV of the reference phase. The collimator angle was set to 90 degrees such that the MLC travels along superior-inferior direction which is the main component of movement of a lung tumour. Then, each control point of the VMAT plan was assigned to a particular phase of the 4DCT in chronological order.more » The MLC positions of each control point were shifted according to the position of the tumour centroid of its assigned phase to form a tumour tracking VMAT plan. The control points of the same phase were grouped to form a pseudo VMAT plan for that particular phase. Dose calculation was performed for each pseudo VMAT plan on the corresponding phase of the 4DCT. The CTs of all phases were registered to the reference phase CT according to the displacement of the tumour centroid. The individual dose distributions of the pseudo VMAT plans were summed up and displayed on the reference phase of the 4DCT. A control VMAT plan was optimized based on a PTV generated from the ITV of all phases and compared with the tumour tracking VMAT plan. Results: Both plans achieved >95% volume coverage at the prescription dose level (96% for the tumour tracking plan and 97% for the control plan). But the normal lung volume irradiated at the prescription dose level was 39% less for the tumour tracking plan than the control plan. Conclusion: A formulation of 4D treatment planning for tumour tracking VMAT plans for lung cancer was developed.« less

SU-E-T-627: Precision Modelling of the Leaf-Bank Rotation in Elekta’s Agility MLC: Is It Necessary?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vujicic, M; Belec, J; Heath, E

Purpose: To demonstrate the method used to determine the leaf bank rotation angle (LBROT) as a parameter for modeling the Elekta Agility multi-leaf collimator (MLC) for Monte Carlo simulations and to evaluate the clinical impact of LBROT. Methods: A detailed model of an Elekta Infinity linac including an Agility MLC was built using the EGSnrc/BEAMnrc Monte Carlo code. The Agility 160-leaf MLC is modelled using the MLCE component module which allows for leaf bank rotation using the parameter LBROT. A precise value of LBROT is obtained by comparing measured and simulated profiles of a specific field, which has leaves arrangedmore » in a repeated pattern such that one leaf is opened and the adjacent one is closed. Profile measurements from an Agility linac are taken with gafchromic film, and an ion chamber is used to set the absolute dose. The measurements are compared to Monte Carlo (MC) simulations and the LBROT is adjusted until a match is found. The clinical impact of LBROT is evaluated by observing how an MC dose calculation changes with LBROT. A clinical Stereotactic Body Radiation Treatment (SBRT) plan is calculated using BEAMnrc/DOSXYZnrc simulations with different input values for LBROT. Results: Using the method outlined above, the LBROT is determined to be 9±1 mrad. Differences as high as 4% are observed in a clinical SBRT plan between the extreme case (LBROT not modeled) and the nominal case. Conclusion: In small-field radiation therapy treatment planning, it is important to properly account for LBROT as an input parameter for MC dose calculations with the Agility MLC. More work is ongoing to elucidate the observed differences by determining the contributions from transmission dose, change in field size, and source occlusion, which are all dependent on LBROT. This work was supported by OCAIRO (Ontario Consortium of Adaptive Interventions in Radiation Oncology), funded by the Ontario Research Fund.« less

Intracranial stereotactic radiosurgery with an adapted linear accelerator vs. robotic radiosurgery: Comparison of dosimetric treatment plan quality.

PubMed

Treuer, Harald; Hoevels, Moritz; Luyken, Klaus; Visser-Vandewalle, Veerle; Wirths, Jochen; Kocher, Martin; Ruge, Maximilian

2015-06-01

Stereotactic radiosurgery with an adapted linear accelerator (linac-SRS) is an established therapy option for brain metastases, benign brain tumors, and arteriovenous malformations. We intended to investigate whether the dosimetric quality of treatment plans achieved with a CyberKnife (CK) is at least equivalent to that for linac-SRS with circular or micromultileaf collimators (microMLC). A random sample of 16 patients with 23 target volumes, previously treated with linac-SRS, was replanned with CK. Planning constraints were identical dose prescription and clinical applicability. In all cases uniform optimization scripts and inverse planning objectives were used. Plans were compared with respect to coverage, minimal dose within target volume, conformity index, and volume of brain tissue irradiated with ≥ 10 Gy. Generating the CK plan was unproblematic with simple optimization scripts in all cases. With the CK plans, coverage, minimal target volume dosage, and conformity index were significantly better, while no significant improvement could be shown regarding the 10 Gy volume. Multiobjective comparison for the irradiated target volumes was superior in the CK plan in 20 out of 23 cases and equivalent in 3 out of 23 cases. Multiobjective comparison for the treated patients was superior in the CK plan in all 16 cases. The results clearly demonstrate the superiority of the irradiation plan for CK compared to classical linac-SRS with circular collimators and microMLC. In particular, the average minimal target volume dose per patient, increased by 1.9 Gy, and at the same time a 14% better conformation index seems to be an improvement with clinical relevance.

SU-E-P-32: Adapting An MMLC to a Conventional Linac to Perform Stereotactic Applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Emam, I; Hosini, M

2015-06-15

Purpose: Micro-MLCs minimizes beam scalloping effects caused by conventional-MLCs and facilitates conformal dynamic treatment delivery. But their effect on dosimetric parameters require careful investigations. Physical and dosimetric parameters and Linac mechanical stability with mMLC (net weight 30 Kg) attached to the gantry are to be investigated. Moreover, output study along with recommended jaws offsets are studied. Adaptation of an mMLC to our 16-years old conventional Linac is investigated in this work Methods: BrainLab mMLC (m3) mounted in a detachable chassis to the Philips SL-15 Linac (30kg). Gantry and collimator spoke shots measurements are made using a calibrated film in amore » solid phantom and compared with pin-point measurements. Leaf penumbra, transmission, leakage between the leaves, percentage depth dose (PDD) are measured using IBA pin-point ion chamber at 6 and 10 MV. For output measurements (using brass build-up cap), jaws are modified continuously regarding to m3-fields while output factor are compared with fixed jaws situation, while the mMLC leaf configuration is modified for different m3-fields Results: Mean transmission through leaves is 1.9±0.1% and mean leakage between leaves is 2.8±0.15%. Between opposing leaves abutting along the central beam-axis mean transmission is 15±3%, but it is reduced to 4.5±0.6% by moving the abutment position 4.5cm off-axis. The penumbra was sharper for m3 -fields than jaws-fields (maximum difference is 1.51±0.2%). m3-fields PDD show ∼3% variation from those of jaws-fields. m3-fields output factors show large variations (<4%) from Jaws defined fields. Output for m3-rectangular fields show slight variation in case of leaf-end&leaf-side as well as X-jaw&Y-jaw exchange. Circular m3-fields output factors shows close agreement with their corresponding square jaws-defined fields using 2mm Jaws offsets, If jaws are retracted to m3 limits, differences become <5%. Conclusion: BrainLab m3 is successfully adapted to our 16 old Philips-SL-15 Linac. Dosimetric properties should be taken into account for treatment planning considerations.« less

Methods to model and predict the ViewRay treatment deliveries to aid patient scheduling and treatment planning

PubMed Central

Liu, Shi; Wu, Yu; Wooten, H. Omar; Green, Olga; Archer, Brent; Li, Harold

2016-01-01

A software tool is developed, given a new treatment plan, to predict treatment delivery time for radiation therapy (RT) treatments of patients on ViewRay magnetic resonance image‐guided radiation therapy (MR‐IGRT) delivery system. This tool is necessary for managing patient treatment scheduling in our clinic. The predicted treatment delivery time and the assessment of plan complexities could also be useful to aid treatment planning. A patient's total treatment delivery time, not including time required for localization, is modeled as the sum of four components: 1) the treatment initialization time; 2) the total beam‐on time; 3) the gantry rotation time; and 4) the multileaf collimator (MLC) motion time. Each of the four components is predicted separately. The total beam‐on time can be calculated using both the planned beam‐on time and the decay‐corrected dose rate. To predict the remain‐ing components, we retrospectively analyzed the patient treatment delivery record files. The initialization time is demonstrated to be random since it depends on the final gantry angle of the previous treatment. Based on modeling the relationships between the gantry rotation angles and the corresponding rotation time, linear regression is applied to predict the gantry rotation time. The MLC motion time is calculated using the leaves delay modeling method and the leaf motion speed. A quantitative analysis was performed to understand the correlation between the total treatment time and the plan complexity. The proposed algorithm is able to predict the ViewRay treatment delivery time with the average prediction error 0.22 min or 1.82%, and the maximal prediction error 0.89 min or 7.88%. The analysis has shown the correlation between the plan modulation (PM) factor and the total treatment delivery time, as well as the treatment delivery duty cycle. A possibility has been identified to significantly reduce MLC motion time by optimizing the positions of closed MLC pairs. The accuracy of the proposed prediction algorithm is sufficient to support patient treatment appointment scheduling. This developed software tool is currently applied in use on a daily basis in our clinic, and could also be used as an important indicator for treatment plan complexity. PACS number(s): 87.55.N PMID:27074472

SU-F-T-463: Light-Field Based Dynalog Verification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Atwal, P; Ramaseshan, R

2016-06-15

Purpose: To independently verify leaf positions in so-called dynalog files for a Varian iX linac with a Millennium 120 MLC. This verification provides a measure of confidence that the files can be used directly as part of a more extensive intensity modulated radiation therapy / volumetric modulated arc therapy QA program. Methods: Initial testing used white paper placed at the collimator plane and a standard hand-held digital camera to image the light and shadow of a static MLC field through the paper. Known markings on the paper allow for image calibration. Noise reduction was attempted with removal of ‘inherent noise’more » from an open-field light image through the paper, but the method was found to be inconsequential. This is likely because the environment could not be controlled to the precision required for the sort of reproducible characterization of the quantum noise needed in order to meaningfully characterize and account for it. A multi-scale iterative edge detection algorithm was used for localizing the leaf ends. These were compared with the planned locations from the treatment console. Results: With a very basic setup, the image of the central bank A leaves 15–45, which are arguably the most important for beam modulation, differed from the planned location by [0.38±0.28] mm. Similarly, for bank B leaves 15–45 had a difference of [0.42±0.28] mm Conclusion: It should be possible to determine leaf position accurately with not much more than a modern hand-held camera and some software. This means we can have a periodic and independent verification of the dynalog file information. This is indicated by the precision already achieved using a basic setup and analysis methodology. Currently, work is being done to reduce imaging and setup errors, which will bring the leaf position error down further, and allow meaningful analysis over the full range of leaves.« less

Stereotactic Arrhythmia Radioablation (STAR) of Ventricular Tachycardia: A Treatment Planning Study

PubMed Central

Fahimian, Benjamin; Soltys, Scott G; Zei, Paul; Lo, Anthony; Gardner, Edward A; Maguire, Patrick J; Loo Jr., Billy W

2016-01-01

Purpose The first stereotactic arrhythmia radioablation (STAR) of ventricular tachycardia (VT) was delivered at Stanford on a robotic radiosurgery system (CyberKnife® G4) in 2012. The results warranted further investigation of this treatment. Here we compare dosimetrically three possible treatment delivery platforms for STAR. Methods The anatomy and target volume of the first treated patient were used for this study. A dose of 25 Gy in one fraction was prescribed to the planning target volume (PTV). Treatment plans were created on three treatment platforms: CyberKnife® G4 system with Iris collimator (Multiplan, V. 4.6)(Plan #1), CyberKnife® M6 system with InCise 2TM multileaf collimator (Multiplan V. 5.3)(Plan #2) and Varian TrueBeamTM STx with HD 120TM MLC and 10MV flattening filter free (FFF) beam (Eclipse planning system, V.11) (Plan #3 coplanar and #4 noncoplanar VMAT plans). The four plans were compared by prescription isodose line, plan conformity index, dose gradient, as well as dose to the nearby critical structures. To assess the delivery efficiency, planned monitor units (MU) and estimated treatment time were evaluated. Results Plans #1-4 delivered 25 Gy to the PTV to the 75.0%, 83.0%, 84.3%, and 84.9% isodose lines and with conformity indices of 1.19, 1.16, 1.05, and 1.05, respectively. The dose gradients for plans #1-4 were 3.62, 3.42, 3.93, and 3.73 with the CyberKnife® MLC plan (Plan #2) the best, and the TrueBeamTM STx co-planar plan (Plan #3) the worst. The dose to nearby critical structures (lung, stomach, bowel, and esophagus) were all well within tolerance. The MUs for plans #1-4 were 27671, 16522, 6275, and 6004 for an estimated total-treatment-time/beam-delivery-time of 99/69, 65/35, 37/7, and 56/6 minutes, respectively, under the assumption of 30 minutes pretreatment setup time. For VMAT gated delivery, a 40% duty cycle, 2400MU/minute dose rate, and an extra 10 minutes per extra arc were assumed. Conclusion Clinically acceptable plans were created with all three platforms. Plans with MLC were considerably more efficient in MU. CyberKnife® M6 with InCise 2TM collimator provided the most conformal plan (steepest dose drop-off) with significantly reduced MU and treatment time. VMAT plans were most efficient in MU and delivery time. Fluoroscopic image guidance removes the need for additional fiducial marker placement; however, benefits may be moderated by worse dose gradient and more operator-dependent motion management by gated delivery. PMID:27570715

SU-G-JeP2-03: Automatic Quantification of MLC Positional Accuracy in An MRI Guided Radiotherapy System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, X; Studenski, M; Yang, F

Purpose: MRI-guided-radiotherapy (MRIGRT) systems lack many features of traditional Linac based RT systems and specialized tests need to be developed to evaluate MLC performance. This work describes automatic tools for the analysis of positional accuracy of an MLC equipped MRIGRT system. Methods: This MLC analysis tool was developed for the MRIdian™ RT system which has three Co-60 equipped treatment heads each with a double focused MLC containing 30 leaf pairs, leaf thickness is 1.05cm defined at isocenter (SAD 105 cm). For MLC positional analysis a picket fence test was performed using a 25.4cm × 25.4cm Gafchromic™ RTQA2 film placed betweenmore » 5cm solidwater and a 30cm × 30cm × 1cm jigwire phantom with seven embedded parallel metal strips 4cm apart. A plan was generated to deliver 2Gy per field and seven 23.1cm × 2cm fields centered over each wire in the phantom. For each leaf pair the center of the radiation profile was determined by fitting the horizontal profile with a Gaussian model and determining the center of the FWHM. This was compared with the metal strip location to determine any deviation. The following metrics were used to evaluate the deviations per gantry angle including maximum, minimum, mean, Kurtosis, and skewness. Results: The identified maximum/mean leaf deviations are, 1.32/0.55 mm for gantry 0°, 1.59/0.76 mm for gantry 90°, and 1.19/0.39 mm for gantry 270°. The percentage of leaf deviation less than 1mm are 90.0% at 0°, 74.6% at 90°, and 97.0% at 270°. Kurtosis/skewness of the leaf deviation are 2.41/0.14 at 0°, 2.53/0.23 at 90°, 3.33/0.83 at 270°, respectively. Conclusion: This work presents an automatic tool for evaluation of the MLC position accuracy of the MRIdian™ radiotherapy system which can be used to benchmark the performance of the MLC system for each treatment head and track the results longitudinally.« less

Potential benefits of dosimetric VMAT tracking verified with 3D film measurements.

PubMed

Crijns, Wouter; Defraene, Gilles; Van Herck, Hans; Depuydt, Tom; Haustermans, Karin; Maes, Frederik; Van den Heuvel, Frank

2016-05-01

To evaluate three different plan adaptation strategies using 3D film-stack dose measurements of both focal boost and hypofractionated prostate VMAT treatments. The adaptation strategies (a couch shift, geometric tracking, and dosimetric tracking) were applied for three realistic intrafraction prostate motions. A focal boost (35 × 2.2 and 35 × 2.7 Gy) and a hypofractionated (5 × 7.25 Gy) prostate VMAT plan were created for a heterogeneous phantom that allows for internal prostate motion. For these plans geometric tracking and dosimetric tracking were evaluated by ionization chamber (IC) point dose measurements (zero-D) and measurements using a stack of EBT3 films (3D). The geometric tracking applied translations, rotations, and scaling of the MLC aperture in response to realistic prostate motions. The dosimetric tracking additionally corrected the monitor units to resolve variations due to difference in depth, tissue heterogeneity, and MLC-aperture. The tracking was based on the positions of four fiducial points only. The film measurements were compared to the gold standard (i.e., IC measurements) and the planned dose distribution. Additionally, the 3D measurements were converted to dose volume histograms, tumor control probability, and normal tissue complication probability parameters (DVH/TCP/NTCP) as a direct estimate of clinical relevance of the proposed tracking. Compared to the planned dose distribution, measurements without prostate motion and tracking showed already a reduced homogeneity of the dose distribution. Adding prostate motion further blurs the DVHs for all treatment approaches. The clinical practice (no tracking) delivered the dose distribution inside the PTV but off target (CTV), resulting in boost dose errors up to 10%. The geometric and dosimetric tracking corrected the dose distribution's position. Moreover, the dosimetric tracking could achieve the planned boost DVH, but not the DVH of the more homogeneously irradiated prostate. A drawback of both the geometric and dosimetric tracking was a reduced MLC blocking caused by the rotational component of the MLC aperture corrections. Because of the used CTV to PTV margins and the high doses in the considered fractionation schemes, the TCP differed less than 0.02 from the planned value for all targets and all correction methods. The rectal NTCP constraints, however, could not be realized using any of these methods. The geometric and dosimetric tracking use only a limited input, but they deposit the dose distribution with higher geometric accuracy than the clinical practice. The latter case has boost dose errors up to 10%. The increased accuracy has a modest impact [Δ(NT)CP < 0.02] because of the applied margins and the high dose levels used. To allow further margin reduction tracking methods are vital. The proposed methodology could further be improved by implementing a rotational correction using collimator rotations.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crijns, Wouter, E-mail: wouter.crijns@uzleuven.be; Depuydt, Tom; Haustermans, Karin

Purpose: To evaluate three different plan adaptation strategies using 3D film-stack dose measurements of both focal boost and hypofractionated prostate VMAT treatments. The adaptation strategies (a couch shift, geometric tracking, and dosimetric tracking) were applied for three realistic intrafraction prostate motions. Methods: A focal boost (35 × 2.2 and 35 × 2.7 Gy) and a hypofractionated (5 × 7.25 Gy) prostate VMAT plan were created for a heterogeneous phantom that allows for internal prostate motion. For these plans geometric tracking and dosimetric tracking were evaluated by ionization chamber (IC) point dose measurements (zero-D) and measurements using a stack of EBT3more » films (3D). The geometric tracking applied translations, rotations, and scaling of the MLC aperture in response to realistic prostate motions. The dosimetric tracking additionally corrected the monitor units to resolve variations due to difference in depth, tissue heterogeneity, and MLC-aperture. The tracking was based on the positions of four fiducial points only. The film measurements were compared to the gold standard (i.e., IC measurements) and the planned dose distribution. Additionally, the 3D measurements were converted to dose volume histograms, tumor control probability, and normal tissue complication probability parameters (DVH/TCP/NTCP) as a direct estimate of clinical relevance of the proposed tracking. Results: Compared to the planned dose distribution, measurements without prostate motion and tracking showed already a reduced homogeneity of the dose distribution. Adding prostate motion further blurs the DVHs for all treatment approaches. The clinical practice (no tracking) delivered the dose distribution inside the PTV but off target (CTV), resulting in boost dose errors up to 10%. The geometric and dosimetric tracking corrected the dose distribution’s position. Moreover, the dosimetric tracking could achieve the planned boost DVH, but not the DVH of the more homogeneously irradiated prostate. A drawback of both the geometric and dosimetric tracking was a reduced MLC blocking caused by the rotational component of the MLC aperture corrections. Because of the used CTV to PTV margins and the high doses in the considered fractionation schemes, the TCP differed less than 0.02 from the planned value for all targets and all correction methods. The rectal NTCP constraints, however, could not be realized using any of these methods. Conclusions: The geometric and dosimetric tracking use only a limited input, but they deposit the dose distribution with higher geometric accuracy than the clinical practice. The latter case has boost dose errors up to 10%. The increased accuracy has a modest impact [Δ(NT)CP < 0.02] because of the applied margins and the high dose levels used. To allow further margin reduction tracking methods are vital. The proposed methodology could further be improved by implementing a rotational correction using collimator rotations.« less

Magnetic decoupling of the linac in a low field biplanar linac-MR system.

PubMed

St Aubin, J; Steciw, S; Fallone, B G

2010-09-01

The integration of a low field biplanar magnetic resonance (MR) imager and linear accelerator (linac) causes magnetic interference at the linac due to the MR fringe fields. In order to eliminate this interference, passive and active magnetic shielding designs are investigated. The optimized design of passive magnetic shielding was performed using the finite element method. The design was required to achieve no greater than a 20% electron beam loss within the linac waveguide and electron gun, no greater than 0.06 T at the multileaf collimator (MLC) motors, and generate a distortion of the main MR imaging volume of no greater than 300 ppm. Through the superposition of the analytical solution for a single current carrying wire loop, active shielding designs in the form of three and four sets of coil pairs surrounding the linac waveguide and electron gun were also investigated. The optimized current and coil center locations that yielded the best cancellation of the MR fringe fields at the linac were determined using sequential quadratic programming. Optimized passive shielding in the form of two steel cylinders was designed to meet the required constraints. When shielding the MLC motors along with the waveguide and electron gun, the thickness of the cylinders was less than 1 mm. If magnetically insensitive MLC motors are used, no MLC shielding would be required and the waveguide shield (shielding the waveguide and electron gun) became 1.58 mm thick. In addition, the optimized current and coil spacing for active shielding was determined for both three and four coil pair configurations. The results of the active shielding optimization produced no beam loss within the waveguide and electron gun and a maximum MR field distortion of 91 ppm over a 30 cm diameter spherical volume. Very simple passive and active shielding designs have been shown to magnetically decouple the linac from the MR imager in a low field biplanar linac-MR system. The MLC passive shielding produced the largest distortion of the MR field over the imaging volume. With the use of magnetically insensitive motors, the MR field distortion drops substantially since no MLC shield is required. The active shielding designs yielded no electron beam loss within the linac.

Do technological advances in linear accelerators improve dosimetric outcomes in stereotaxy? A head-on comparison of seven linear accelerators using volumetric modulated arc therapy-based stereotactic planning.

PubMed

Sarkar, B; Pradhan, A; Munshi, A

2016-01-01

Linear accelerator (Linac) based stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) using volumetric modulated arc therapy (VMAT) has been used for treating small intracranial lesions. Recent development in the Linacs such as inbuilt micro multileaf collimator (MLC) and flattening filter free (FFF) beam are intended to provide a better dose conformity and faster delivery when using VMAT technique. This study was aimed to compare the dosimetric outcomes and monitor units (MUs) of the stereotactic treatment plans for different commercially available MLC models and beam profiles. Ten patients having 12 planning target volume (PTV)/gross target volume's (GTVs) who received the SRS/SRT treatment in our clinic using Axesse Linac (considered reference arm gold standard) were considered for this study. The test arms comprised of plans using Elekta Agility with FFF, Elekta Agility with the plane beam, Elekta APEX, Varian Millennium 120, Varian Millennium 120HD, and Elekta Synergy in Monaco treatment planning system. Planning constraints and calculation grid spacing were not altered in the test plans. To objectively evaluate the efficacy of MLC-beam model, the resultant dosimetric outcomes were subtracted from the reference arm parameters. V95%, V100%, V105%, D1%, maximum dose, and mean dose of PTV/GTV showed a maximum inter MLC - beam model variation of 1.5% and 2% for PTV and GTV, respectively. Average PTV conformity index and heterogeneity index shows a variation in the range 0.56-0.63 and 1.08-1.11, respectively. Mean dose difference (excluding Axesse) for all organs varied between 1.1 cGy and 74.8 cGy (mean dose = 6.1 cGy standard deviation [SD] = 26.9 cGy) and 1.7 cGy-194.5 cGy (mean dose 16.1 cGy SD = 57.2 cGy) for single and multiple fraction, respectively. The dosimetry of VMAT-based SRS/SRT treatment plan had minimal dependence on MLC and beam model variations. All tested MLC and beam model could fulfil the desired PTV coverage and organs at risk dose constraints. The only notable difference was the halving of the MU for FFF beam as compared to the plane beam. This has the potential to reduce the total patient on couch time by 15% (approximately 2 min).

Experimental investigation of a moving averaging algorithm for motion perpendicular to the leaf travel direction in dynamic MLC target tracking.

PubMed

Yoon, Jai-Woong; Sawant, Amit; Suh, Yelin; Cho, Byung-Chul; Suh, Tae-Suk; Keall, Paul

2011-07-01

In dynamic multileaf collimator (MLC) motion tracking with complex intensity-modulated radiation therapy (IMRT) fields, target motion perpendicular to the MLC leaf travel direction can cause beam holds, which increase beam delivery time by up to a factor of 4. As a means to balance delivery efficiency and accuracy, a moving average algorithm was incorporated into a dynamic MLC motion tracking system (i.e., moving average tracking) to account for target motion perpendicular to the MLC leaf travel direction. The experimental investigation of the moving average algorithm compared with real-time tracking and no compensation beam delivery is described. The properties of the moving average algorithm were measured and compared with those of real-time tracking (dynamic MLC motion tracking accounting for both target motion parallel and perpendicular to the leaf travel direction) and no compensation beam delivery. The algorithm was investigated using a synthetic motion trace with a baseline drift and four patient-measured 3D tumor motion traces representing regular and irregular motions with varying baseline drifts. Each motion trace was reproduced by a moving platform. The delivery efficiency, geometric accuracy, and dosimetric accuracy were evaluated for conformal, step-and-shoot IMRT, and dynamic sliding window IMRT treatment plans using the synthetic and patient motion traces. The dosimetric accuracy was quantified via a tgamma-test with a 3%/3 mm criterion. The delivery efficiency ranged from 89 to 100% for moving average tracking, 26%-100% for real-time tracking, and 100% (by definition) for no compensation. The root-mean-square geometric error ranged from 3.2 to 4.0 mm for moving average tracking, 0.7-1.1 mm for real-time tracking, and 3.7-7.2 mm for no compensation. The percentage of dosimetric points failing the gamma-test ranged from 4 to 30% for moving average tracking, 0%-23% for real-time tracking, and 10%-47% for no compensation. The delivery efficiency of moving average tracking was up to four times higher than that of real-time tracking and approached the efficiency of no compensation for all cases. The geometric accuracy and dosimetric accuracy of the moving average algorithm was between real-time tracking and no compensation, approximately half the percentage of dosimetric points failing the gamma-test compared with no compensation.

SU-E-T-562: Motion Tracking Optimization for Conformal Arc Radiotherapy Plans: A QUASAR Phantom Based Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu, Z; Wang, I; Yao, R

Purpose: This study is to use plan parameters optimization (Dose rate, collimator angle, couch angle, initial starting phase) to improve the performance of conformal arc radiotherapy plans with motion tracking by increasing the plan performance score (PPS). Methods: Two types of 3D conformal arc plans were created based on QUASAR respiratory motion phantom with spherical and cylindrical targets. Sinusoidal model was applied to the MLC leaves to generate motion tracking plans. A MATLAB program was developed to calculate PPS of each plan (ranges from 0–1) and optimize plan parameters. We first selected the dose rate for motion tracking plans andmore » then used simulated annealing algorithm to search for the combination of the other parameters that resulted in the plan of the maximal PPS. The optimized motion tracking plan was delivered by Varian Truebeam Linac. In-room cameras and stopwatch were used for starting phase selection and synchronization between phantom motion and plan delivery. Gaf-EBT2 dosimetry films were used to measure the dose delivered to the target in QUASAR phantom. Dose profiles and Truebeam trajectory log files were used for plan delivery performance evaluation. Results: For spherical target, the maximal PPS (PPSsph) of the optimized plan was 0.79: (Dose rate: 500MU/min, Collimator: 90°, Couch: +10°, starting phase: 0.83π). For cylindrical target, the maximal PPScyl was 0.75 (Dose rate: 300MU/min, Collimator: 87°, starting phase: 0.97π) with couch at 0°. Differences of dose profiles between motion tracking plans (with the maximal and the minimal PPS) and 3D conformal plans were as follows: PPSsph=0.79: %ΔFWHM: 8.9%, %Dmax: 3.1%; PPSsph=0.52: %ΔFWHM: 10.4%, %Dmax: 6.1%. PPScyl=0.75: %ΔFWHM: 4.7%, %Dmax: 3.6%; PPScyl=0.42: %ΔFWHM: 12.5%, %Dmax: 9.6%. Conclusion: By achieving high plan performance score through parameters optimization, we can improve target dose conformity of motion tracking plan by decreasing total MLC leaf travel distance and leaf speed.« less

Impact of the MLC on the MRI field distortion of a prototype MRI-linac

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kolling, Stefan; Keall, Paul; Oborn, Brad

2013-12-15

Purpose: To cope with intrafraction tumor motion, integrated MRI-linac systems for real-time image guidance are currently under development. The multileaf collimator (MLC) is a key component in every state-of-the-art radiotherapy treatment system, allowing for accurate field shaping and tumor tracking. This work quantifies the magnetic impact of a widely used MLC on the MRI field homogeneity for such a modality.Methods: The finite element method was employed to model a MRI-linac assembly comprised of a 1.0 T split-bore MRI magnet and the key ferromagnetic components of a Varian Millennium 120 MLC, namely, the leaves and motors. Full 3D magnetic field maps ofmore » the system were generated. From these field maps, the peak-to-peak distortion within the MRI imaging volume was evaluated over a 30 cm diameter sphere volume (DSV) around the isocenter and compared to a maximum preshim inhomogeneity of 300 μT. Five parametric studies were performed: (1) The source-to-isocenter distance (SID) was varied from 100 to 200 cm, to span the range of a compact system to that with lower magnetic coupling. (2) The MLC model was changed from leaves only to leaves with motors, to determine the contribution to the total distortion caused by MLC leaves and motors separately. (3) The system was configured in the inline or perpendicular orientation, i.e., the linac treatment beam was oriented parallel or perpendicular to the magnetic field direction. (4) The treatment field size was varied from 0 × 0 to 20×20 cm{sup 2}, to span the range of clinical treatment fields. (5) The coil currents were scaled linearly to produce magnetic field strengths B{sub 0} of 0.5, 1.0, and 1.5 T, to estimate how the MLC impact changes with B{sub 0}.Results: (1) The MLC-induced MRI field distortion fell continuously with increasing SID. (2) MLC leaves and motors were found to contribute to the distortion in approximately equal measure. (3) Due to faster falloff of the fringe field, the field distortion was generally smaller in the perpendicular beam orientation. The peak-to-peak DSV distortion was below 300 μT at SID≥130 cm (perpendicular) and SID≥140 cm (inline) for the 1.0 T design. (4) The simulation of different treatment fields was identified to cause dynamic changes in the field distribution. However, the estimated residual distortion was below 1.2 mm geometric distortion at SID≥120 cm (perpendicular) and SID≥130 cm (inline) for a 10 mT/m frequency-encoding gradient. (5) Due to magnetic saturation of the MLC materials, the field distortion remained constant at B{sub 0}>1.0 T.Conclusions: This work shows that the MRI field distortions caused by the MLC cannot be ignored and must be thoroughly investigated for any MRI-linac system. The numeric distortion values obtained for our 1.0 T magnet may vary for other magnet designs with substantially different fringe fields, however the concept of modest increases in the SID to reduce the distortion to a shimmable level is generally applicable.« less

SU-E-T-444: Gravity Effect On Maximum Leaf Speed in Dynamic IMRT Treatments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Olasolo, J; Pellejero, S; Gracia, M

Purpose: A leaf sequencing algorithm has been recently developed in our department. Our purpose is to utilize this algorithm to reduce treatment time by studying the feasibility of using several maximum leaf speeds depending on gantry angle and leaf thickness (0.5 or 1 cm at isocenter). To do so, the gravity effect on MLC performance has been examined by means of analysing the dynalog files. Methods: Leaf position errors has been ascertained according to gantry angle and leaf speed in MLC Millenium120 (Varian). In order to do this, the following test has been designed: all leaves move in synchrony, withmore » same speed and 1 cm gap between opposite leaves. This test is implemented for 18 different speeds: 0.25-0.5-0.75-1-1.25-1.5-1.75-2-2.1-2.2-2.3-2.4-2.5-2.6-2.7-2.8-2.9-3.0 cm/s and 8 gantry angles: 0-45-90-135-180-225-270-315. Collimator angle is 2 degrees in all cases since it is the most usual one in IMRT treatments in our department. Dynamic tolerance is 2 mm. Dynalogs files of 10 repetitions of the test are analysed with a Mathlab in-house developed software and RMS error and 95th percentiles are calculated. Varian recommends 2.5 cm/s as the maximum leaf speed for its segmentation algorithm. In our case, we accept this speed in the most restrictive situation: gantry angle 270 and 1 cm leaf thickness. Maximum speeds for the rest of the cases are calculated by keeping the difference between 95th percentile and dynamic tolerance. In this way, beam hold-off probability does not increase. Results: Maximum speeds every 45 degrees of gantry rotation have been calculated for both leaf thickness. These results are 2.9-2.9-2.9-2.9-2.7-2.6-2.6-2.7 cm/s for 0.5 cm leaf thickness and 2.7-2.7-2.7-2.7-2.6-2.5-2.5-2.6 cm/s for 1 cm leaf thickness. Conclusion: Gravity effect on MLC positioning has been studied. Maximum leaf speed according to leaf thickness and gantry angle have been calculated which reduces treatment time.« less

Tomotherapy as a tool in image-guided radiation therapy (IGRT): theoretical and technological aspects

PubMed Central

Yartsev, S; Kron, T; Van Dyk, J

2007-01-01

Helical tomotherapy (HT) is a novel treatment approach that combines Intensity-Modulate Radiation Therapy (IMRT) delivery with in-built image guidance using megavoltage (MV) CT scanning. The technique utilises a 6 MV linear accelerator mounted on a CT type ring gantry. The beam is collimated to a fan beam, which is intensity modulated using a binary multileaf collimator (MLC). As the patient advances slowly through the ring gantry, the linac rotates around the patient with a leaf-opening pattern optimised to deliver a highly conformal dose distribution to the target in the helical beam trajectory. The unit also allows the acquisition of MVCT images using the same radiation source detuned to reduce its effective energy to 3.5 MV, making the dose required for imaging less than 3 cGy. This paper discusses the major features of HT and describes the advantages and disadvantages of this approach in the context of the commercial Hi-ART system. PMID:21614257

Commissioning and validation of fluence-based 3D VMAT dose reconstruction system using new transmission detector.

PubMed

Nakaguchi, Yuji; Oono, Takeshi; Maruyama, Masato; Shimohigashi, Yoshinobu; Kai, Yudai; Nakamura, Yuya

2018-06-01

In this study, we evaluated the basic performance of the three-dimensional dose verification system COMPASS (IBA Dosimetry). This system is capable of reconstructing 3D dose distributions on the patient anatomy based on the fluence measured using a new transmission detector (Dolphin, IBA Dosimetry) during treatment. The stability of the absolute dose and geometric calibrations of the COMPASS system with the Dolphin detector were investigated for fundamental validation. Furthermore, multileaf collimator (MLC) test patterns and a complicated volumetric modulated arc therapy (VMAT) plan were used to evaluate the accuracy of the reconstructed dose distributions determined by the COMPASS. The results from the COMPASS were compared with those of a Monte Carlo simulation (MC), EDR2 film measurement, and a treatment planning system (TPS). The maximum errors for the absolute dose and geometrical position were - 0.28% and 1.0 mm for 3 months, respectively. The Dolphin detector, which consists of ionization chamber detectors, was firmly mounted on the linear accelerator and was very stable. For the MLC test patterns, the TPS showed a > 5% difference at small fields, while the COMPASS showed good agreement with the MC simulation at small fields. However, the COMPASS produced a large error for complex small fields. For a clinical VMAT plan, COMPASS was more accurate than TPS. COMPASS showed real delivered-dose distributions because it uses the measured fluence, a high-resolution detector, and accurate beam modeling. We confirm here that the accuracy and detectability of the delivered dose of the COMPASS system are sufficient for clinical practice.

MO-FG-BRA-06: Electromagnetic Beacon Insertion in Lung Cancer Patients and Resultant Surrogacy Errors for Dynamic MLC Tumour Tracking

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hardcastle, N; Booth, J; Caillet, V

Purpose: To assess endo-bronchial electromagnetic beacon insertion and to quantify the geometric accuracy of using beacons as a surrogate for tumour motion in real-time multileaf collimator (MLC) tracking of lung tumours. Methods: The LIGHT SABR trial is a world-first clinical trial in which the MLC leaves move with lung tumours in real time on a standard linear accelerator. Tracking is performed based on implanted electromagnetic beacons (CalypsoTM, Varian Medical Systems, USA) as a surrogate for tumour motion. Five patients have been treated and have each had three beacons implanted endo-bronchially under fluoroscopic guidance. The centre of mass (C.O.M) has beenmore » used to adapt the MLC in real-time. The geometric error in using the beacon C.O.M as a surrogate for tumour motion was measured by measuring the tumour and beacon C.O.M in all phases of the respiratory cycle of a 4DCT. The surrogacy error was defined as the difference in beacon and tumour C.O.M relative to the reference phase (maximum exhale). Results: All five patients have had three beacons successfully implanted with no migration between simulation and end of treatment. Beacon placement relative to tumour C.O.M varied from 14 to 74 mm and in one patient spanned two lobes. Surrogacy error was measured in each patient on the simulation 4DCT and ranged from 0 to 3 mm. Surrogacy error as measured on 4DCT was subject to artefacts in mid-ventilation phases. Surrogacy error was a function of breathing phase and was typically larger at maximum inhale. Conclusion: Beacon placement and thus surrogacy error is a major component of geometric uncertainty in MLC tracking of lung tumours. Surrogacy error must be measured on each patient and incorporated into margin calculation. Reduction of surrogacy error is limited by airway anatomy, however should be taken into consideration when performing beacon insertion and planning. This research is funded by Varian Medical Systems via a collaborative research agreement.« less

Rounded leaf end modeling in Pinnacle VMAT treatment planning for fixed jaw linacs

PubMed Central

Yang, Fei; Cao, Ning; Meyer, Juergen

2016-01-01

During volume‐modulated arc therapies (VMAT), dosimetric errors are introduced by multiple open dynamic leaf gaps that are present in fixed diaphragm linear accelerators. The purpose of this work was to develop a methodology for adjusting the rounded leaf end modeling parameters to improve out‐of‐field dose agreement in SmartArc VMAT treatment plans delivered by fixed jaw linacs where leaf gap dose is not negligible. Leaf gap doses were measured for an Elekta beam modulator linac with 0.4 cm micro‐multileaf collimators (MLC) using an A16 micro‐ionization chamber, a MatriXX ion chamber detector array, and Kodak EDR2 film dosimetry in a solid water phantom. The MLC offset and rounded end tip radius were adjusted in the Pinnacle treatment planning system (TPS) to iteratively arrive at the optimal configuration for 6 MV and 10 MV photon energies. Improvements in gamma index with a 3%/3 mm acceptance criteria and an inclusion threshold of 5% of maximum dose were measured, analyzed, and validated using an ArcCHECK diode detector array for field sizes ranging from 1.6 to 14 cm square field arcs and Task Group (TG) 119 VMAT test cases. The best results were achieved for a rounded leaf tip radius of 13 cm with a 0.1 cm MLC offset. With the optimized MLC model, measured gamma indices ranged between 99.9% and 91.7% for square field arcs with sizes between 3.6 cm and 1.6 cm, with a maximum improvement of 42.7% for the 1.6 cm square field size. Gamma indices improved up to 2.8% in TG‐119 VMAT treatment plans. Imaging and Radiation Oncology Core (IROC) credentialing of a VMAT plan with the head and neck phantom passed with a gamma index of 100%. Fine‐tune adjustments to MLC rounded leaf ends may improve patient‐specific QA pass rates and provide more accurate predictions of dose deposition to avoidance structures. PACS number(s): 87.55.D‐, 87.55.kd, 87.55.kh PMID:27929490

DOE Office of Scientific and Technical Information (OSTI.GOV)

Petasecca, M., E-mail: marcop@uow.edu.au; Newall, M. K.; Aldosari, A. H.

Purpose: Spatial and temporal resolutions are two of the most important features for quality assurance instrumentation of motion adaptive radiotherapy modalities. The goal of this work is to characterize the performance of the 2D high spatial resolution monolithic silicon diode array named “MagicPlate-512” for quality assurance of stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS) combined with a dynamic multileaf collimator (MLC) tracking technique for motion compensation. Methods: MagicPlate-512 is used in combination with the movable platform HexaMotion and a research version of radiofrequency tracking system Calypso driving MLC tracking software. The authors reconstruct 2D dose distributions of smallmore » field square beams in three modalities: in static conditions, mimicking the temporal movement pattern of a lung tumor and tracking the moving target while the MLC compensates almost instantaneously for the tumor displacement. Use of Calypso in combination with MagicPlate-512 requires a proper radiofrequency interference shielding. Impact of the shielding on dosimetry has been simulated by GEANT4 and verified experimentally. Temporal and spatial resolutions of the dosimetry system allow also for accurate verification of segments of complex stereotactic radiotherapy plans with identification of the instant and location where a certain dose is delivered. This feature allows for retrospective temporal reconstruction of the delivery process and easy identification of error in the tracking or the multileaf collimator driving systems. A sliding MLC wedge combined with the lung motion pattern has been measured. The ability of the MagicPlate-512 (MP512) in 2D dose mapping in all three modes of operation was benchmarked by EBT3 film. Results: Full width at half maximum and penumbra of the moving and stationary dose profiles measured by EBT3 film and MagicPlate-512 confirm that motion has a significant impact on the dose distribution. Motion, no motion, and motion with MLC tracking profiles agreed within 1 and 0.4 mm, respectively, for all field sizes tested. Use of electromagnetic tracking system generates a fluctuation of the detector baseline up to 10% of the full scale signal requiring a proper shielding strategy. MagicPlate-512 is also able to reconstruct the dose variation pulse-by-pulse in each pixel of the detector. An analysis of the dose transients with motion and motion with tracking shows that the tracking feedback algorithm used for this experiment can compensate effectively only the effect of the slower transient components. The fast changing components of the organ motion can contribute only to discrepancy of the order of 15% in penumbral region while the slower components can change the dose profile up to 75% of the expected dose. Conclusions: MagicPlate-512 is shown to be, potentially, a valid alternative to film or 2D ionizing chambers for quality assurance dosimetry in SRS or SBRT. Its high spatial and temporal resolutions allow for accurate reconstruction of the profile in any conditions with motion and with tracking of the motion. It shows excellent performance to reconstruct the dose deposition in real time or retrospectively as a function of time for detailed analysis of the effect of motion in a specific pixel or area of interest.« less

QALMA: A computational toolkit for the analysis of quality protocols for medical linear accelerators in radiation therapy

NASA Astrophysics Data System (ADS)

Rahman, Md Mushfiqur; Lei, Yu; Kalantzis, Georgios

2018-01-01

Quality Assurance (QA) for medical linear accelerator (linac) is one of the primary concerns in external beam radiation Therapy. Continued advancements in clinical accelerators and computer control technology make the QA procedures more complex and time consuming which often, adequate software accompanied with specific phantoms is required. To ameliorate that matter, we introduce QALMA (Quality Assurance for Linac with MATLAB), a MALAB toolkit which aims to simplify the quantitative analysis of QA for linac which includes Star-Shot analysis, Picket Fence test, Winston-Lutz test, Multileaf Collimator (MLC) log file analysis and verification of light & radiation field coincidence test.

Monte Carlo simulated corrections for beam commissioning measurements with circular and MLC shaped fields on the CyberKnife M6 System: a study including diode, microchamber, point scintillator, and synthetic microdiamond detectors.

PubMed

Francescon, P; Kilby, W; Noll, J M; Masi, L; Satariano, N; Russo, S

2017-02-07

Monte Carlo simulation was used to calculate correction factors for output factor (OF), percentage depth-dose (PDD), and off-axis ratio (OAR) measurements with the CyberKnife M6 System. These include the first such data for the InCise MLC. Simulated detectors include diodes, air-filled microchambers, a synthetic microdiamond detector, and point scintillator. Individual perturbation factors were also evaluated. OF corrections show similar trends to previous studies. With a 5 mm fixed collimator the diode correction to convert a measured OF to the corresponding point dose ratio varies between  -6.1% and  -3.5% for the diode models evaluated, while in a 7.6 mm  ×  7.7 mm MLC field these are  -4.5% to  -1.8%. The corresponding microchamber corrections are  +9.9% to  +10.7% and  +3.5% to  +4.0%. The microdiamond corrections have a maximum of  -1.4% for the 7.5 mm and 10 mm collimators. The scintillator corrections are  <1% in all beams. Measured OF showed uncorrected inter-detector differences  >15%, reducing to  <3% after correction. PDD corrections at d  >  d max were  <2% for all detectors except IBA Razor where a maximum 4% correction was observed at 300 mm depth. OAR corrections were smaller inside the field than outside. At the beam edge microchamber OAR corrections were up to 15%, mainly caused by density perturbations, which blurs the measured penumbra. With larger beams and depths, PTW and IBA diode corrections outside the beam were up to 20% while the Edge detector needed smaller corrections although these did vary with orientation. These effects are most noticeable for large field size and depth, where they are dominated by fluence and stopping power perturbations. The microdiamond OAR corrections were  <3% outside the beam. This paper provides OF corrections that can be used for commissioning new CyberKnife M6 Systems and retrospectively checking estimated corrections used previously. We recommend the PDD and OAR corrections are used to guide detector selection and inform the evaluation of results rather than to explicitly correct measurements.

Monte Carlo simulated corrections for beam commissioning measurements with circular and MLC shaped fields on the CyberKnife M6 System: a study including diode, microchamber, point scintillator, and synthetic microdiamond detectors

NASA Astrophysics Data System (ADS)

Francescon, P.; Kilby, W.; Noll, J. M.; Masi, L.; Satariano, N.; Russo, S.

2017-02-01

Monte Carlo simulation was used to calculate correction factors for output factor (OF), percentage depth-dose (PDD), and off-axis ratio (OAR) measurements with the CyberKnife M6 System. These include the first such data for the InCise MLC. Simulated detectors include diodes, air-filled microchambers, a synthetic microdiamond detector, and point scintillator. Individual perturbation factors were also evaluated. OF corrections show similar trends to previous studies. With a 5 mm fixed collimator the diode correction to convert a measured OF to the corresponding point dose ratio varies between  -6.1% and  -3.5% for the diode models evaluated, while in a 7.6 mm  ×  7.7 mm MLC field these are  -4.5% to  -1.8%. The corresponding microchamber corrections are  +9.9% to  +10.7% and  +3.5% to  +4.0%. The microdiamond corrections have a maximum of  -1.4% for the 7.5 mm and 10 mm collimators. The scintillator corrections are  <1% in all beams. Measured OF showed uncorrected inter-detector differences  >15%, reducing to  <3% after correction. PDD corrections at d  >  d max were  <2% for all detectors except IBA Razor where a maximum 4% correction was observed at 300 mm depth. OAR corrections were smaller inside the field than outside. At the beam edge microchamber OAR corrections were up to 15%, mainly caused by density perturbations, which blurs the measured penumbra. With larger beams and depths, PTW and IBA diode corrections outside the beam were up to 20% while the Edge detector needed smaller corrections although these did vary with orientation. These effects are most noticeable for large field size and depth, where they are dominated by fluence and stopping power perturbations. The microdiamond OAR corrections were  <3% outside the beam. This paper provides OF corrections that can be used for commissioning new CyberKnife M6 Systems and retrospectively checking estimated corrections used previously. We recommend the PDD and OAR corrections are used to guide detector selection and inform the evaluation of results rather than to explicitly correct measurements.

SU-G-BRC-04: Collimator Angle Optimization in Volumetric Modulated Arc Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Andersen, A; Johnson, C; Bartlett, G

2016-06-15

Purpose: Volumetric modulated arc therapy (VMAT) has revolutionized radiation treatment by decreasing treatment time and monitor units, thus reducing scattered and whole body radiation dose. As the collimator angle changes the apparent leaf gap becomes larger which can impact plan quality, organ at risk (OAR) sparing as well as IMRT QA passing rate which is investigated. Methods: Two sites (prostate and head and neck) that have maximum utilization of VMAT were investigated. Two previously treated VMAT patients were chosen. For each patient 10 plans were created by maintaining constant optimization constraints while varying collimator angles from 0-90 deg at anmore » interval of 10 degrees for the first arc and the appropriate complimentary angle for the second arc. Plans were created with AAA algorithm using 6 MV beam on a Varian IX machine with Millennium 120 MLC. The dose-volume histogram (DVH) for each plan was exported and dosimetric parameters (D98, D95, D50, D2) as well homogeneity index (HI) and conformity index (CI) were computed. Each plan was validated for QA using ArcCheck with gamma index passing criteria of 2%/2 mm and 3%/3 mm. Additionally, normal tissue complication probability (NTCP) for each OAR was computed using Uzan-Nahum software. Results: The CI values for both sites had no impact as target volume coverage in every collimator angle were the same since it was optimized for adequate coverage. The HI which is representative of DVH gradient or dose uniformity in PTV showed a clear trend in both sites. The NTCP for OAR (brain and cochlea) in H&N plan and (bladder and rectum) in prostate plan showed a distinct superiority for collimator angles between 15-30 deg. The gamma passing rates were not correlated with angle. Conclusion: Based on CI, HI, NTCP and gamma passing index, it can be concluded that collimator angles should be maintained within 15–30 deg.« less

SU-G-BRB-03: Assessing the Sensitivity and False Positive Rate of the Integrated Quality Monitor (IQM) Large Area Ion Chamber to MLC Positioning Errors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boehnke, E McKenzie; DeMarco, J; Steers, J

2016-06-15

Purpose: To examine both the IQM’s sensitivity and false positive rate to varying MLC errors. By balancing these two characteristics, an optimal tolerance value can be derived. Methods: An un-modified SBRT Liver IMRT plan containing 7 fields was randomly selected as a representative clinical case. The active MLC positions for all fields were perturbed randomly from a square distribution of varying width (±1mm to ±5mm). These unmodified and modified plans were measured multiple times each by the IQM (a large area ion chamber mounted to a TrueBeam linac head). Measurements were analyzed relative to the initial, unmodified measurement. IQM readingsmore » are analyzed as a function of control points. In order to examine sensitivity to errors along a field’s delivery, each measured field was divided into 5 groups of control points, and the maximum error in each group was recorded. Since the plans have known errors, we compared how well the IQM is able to differentiate between unmodified and error plans. ROC curves and logistic regression were used to analyze this, independent of thresholds. Results: A likelihood-ratio Chi-square test showed that the IQM could significantly predict whether a plan had MLC errors, with the exception of the beginning and ending control points. Upon further examination, we determined there was ramp-up occurring at the beginning of delivery. Once the linac AFC was tuned, the subsequent measurements (relative to a new baseline) showed significant (p <0.005) abilities to predict MLC errors. Using the area under the curve, we show the IQM’s ability to detect errors increases with increasing MLC error (Spearman’s Rho=0.8056, p<0.0001). The optimal IQM count thresholds from the ROC curves are ±3%, ±2%, and ±7% for the beginning, middle 3, and end segments, respectively. Conclusion: The IQM has proven to be able to detect not only MLC errors, but also differences in beam tuning (ramp-up). Partially supported by the Susan Scott Foundation.« less

SU-F-T-465: Two Years of Radiotherapy Treatments Analyzed Through MLC Log Files

DOE Office of Scientific and Technical Information (OSTI.GOV)

Defoor, D; Kabat, C; Papanikolaou, N

Purpose: To present treatment statistics of a Varian Novalis Tx using more than 90,000 Varian Dynalog files collected over the past 2 years. Methods: Varian Dynalog files are recorded for every patient treated on our Varian Novalis Tx. The files are collected and analyzed daily to check interfraction agreement of treatment deliveries. This is accomplished by creating fluence maps from the data contained in the Dynalog files. From the Dynalog files we have also compiled statistics for treatment delivery times, MLC errors, gantry errors and collimator errors. Results: The mean treatment time for VMAT patients was 153 ± 86 secondsmore » while the mean treatment time for step & shoot was 256 ± 149 seconds. Patient’s treatment times showed a variation of 0.4% over there treatment course for VMAT and 0.5% for step & shoot. The average field sizes were 40 cm2 and 26 cm2 for VMAT and step & shoot respectively. VMAT beams contained and average overall leaf travel of 34.17 meters and step & shoot beams averaged less than half of that at 15.93 meters. When comparing planned and delivered fluence maps generated using the Dynalog files VMAT plans showed an average gamma passing percentage of 99.85 ± 0.47. Step & shoot plans showed an average gamma passing percentage of 97.04 ± 0.04. 5.3% of beams contained an MLC error greater than 1 mm and 2.4% had an error greater than 2mm. The mean gantry speed for VMAT plans was 1.01 degrees/s with a maximum of 6.5 degrees/s. Conclusion: Varian Dynalog files are useful for monitoring machine performance treatment parameters. The Dynalog files have shown that the performance of the Novalis Tx is consistent over the course of a patients treatment with only slight variations in patient treatment times and a low rate of MLC errors.« less

SWIMRT: A graphical user interface using the sliding window algorithm to construct a fluence map machine file

PubMed Central

Chow, James C.L.; Grigorov, Grigor N.; Yazdani, Nuri

2006-01-01

A custom‐made computer program, SWIMRT, to construct “multileaf collimator (MLC) machine” file for intensity‐modulated radiotherapy (IMRT) fluence maps was developed using MATLAB® and the sliding window algorithm. The user can either import a fluence map with a graphical file format created by an external treatment‐planning system such as Pinnacle3 or create his or her own fluence map using the matrix editor in the program. Through comprehensive calibrations of the dose and the dimension of the imported fluence field, the user can use associated image‐processing tools such as field resizing and edge trimming to modify the imported map. When the processed fluence map is suitable, a “MLC machine” file is generated for our Varian 21 EX linear accelerator with a 120‐leaf Millennium MLC. This machine file is transferred to the MLC console of the LINAC to control the continuous motions of the leaves during beam irradiation. An IMRT field is then irradiated with the 2D intensity profiles, and the irradiated profiles are compared to the imported or modified fluence map. This program was verified and tested using film dosimetry to address the following uncertainties: (1) the mechanical limitation due to the leaf width and maximum traveling speed, and (2) the dosimetric limitation due to the leaf leakage/transmission and penumbra effect. Because the fluence map can be edited, resized, and processed according to the requirement of a study, SWIMRT is essential in studying and investigating the IMRT technique using the sliding window algorithm. Using this program, future work on the algorithm may include redistributing the time space between segmental fields to enhance the fluence resolution, and readjusting the timing of each leaf during delivery to avoid small fields. Possible clinical utilities and examples for SWIMRT are given in this paper. PACS numbers: 87.53.Kn, 87.53.St, 87.53.Uv PMID:17533330

Optimizing fiducial visibility on periodically acquired megavoltage and kilovoltage image pairs during prostate volumetric modulated arc therapy

PubMed Central

Zhang, Pengpeng; Happersett, Laura; Ravindranath, Bosky; Zelefsky, Michael; Mageras, Gig; Hunt, Margie

2016-01-01

Purpose: Robust detection of implanted fiducials is essential for monitoring intrafractional motion during hypofractionated treatment. The authors developed a plan optimization strategy to ensure clear visibility of implanted fiducials and facilitate 3D localization during volumetric modulated arc therapy (VMAT). Methods: Periodic kilovoltage (kV) images were acquired at 20° gantry intervals and paired with simultaneously acquired 4.4° short arc megavoltage digital tomosynthesis (MV-DTS) to localize three fiducials during VMAT delivery for hypofractionated prostate cancer treatment. Beginning with the original optimized plan, control point segments where fiducials were consistently blocked by multileaf collimator (MLC) within each 4.4° MV-DTS interval were first identified. For each segment, MLC apertures were edited to expose the fiducial that led to the least increase in the cost function. Subsequently, MLC apertures of all control points not involved with fiducial visualization were reoptimized to compensate for plan quality losses and match the original dose–volume histogram. MV dose for each MV-DTS was also kept above 0.4 MU to ensure acceptable image quality. Different imaging (gantry) intervals and visibility margins around fiducials were also evaluated. Results: Fiducials were consistently blocked by the MLC for, on average, 36% of the imaging control points for five hypofractionated prostate VMAT plans but properly exposed after reoptimization. Reoptimization resulted in negligible dosimetric differences compared with original plans and outperformed simple aperture editing: on average, PTV D98 recovered from 87% to 94% of prescription, and PTV dose homogeneity improved from 9% to 7%. Without violating plan objectives and compromising delivery efficiency, the highest imaging frequency and largest margin that can be achieved are a 10° gantry interval, and 15 mm, respectively. Conclusions: VMAT plans can be made to accommodate MV-kV imaging of fiducials. Fiducial visualization rate and workflow efficiency are significantly improved with an automatic modification and reoptimization approach. PMID:27147314

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tien, C; Brewer, M; Studenski, M

Purpose: Dynamic-jaw tracking maximizes the area blocked by both jaw and MLC in RapidArc. We developed a method to quantify jaw tracking. Methods: An Eclipse Scripting API (ESAPI) was used to export beam parameters for each arc’s control points. The specific beam parameters extracted were: gantry angle, control point number, meterset, x-jaw positions, y-jaw positions, MLC bank-number, MLC leaf-number, and MLC leaf-position. Each arc contained 178 control points with 120 MLC positions. MATLAB routines were written to process these parameters in order to calculate both the beam aperture (unblocked) size for each control point. An average aperture size was weightedmore » by meterset. Jaw factor was defined as the ratio between dynamic-jaw to static-jaw aperture size. Jaw factor was determined for forty retrospectively replanned patients treated with static-jaw delivery sites including lung, brain, prostate, H&N, rectum, and bladder. Results: Most patients had multiple arcs and reduced-field boosts, resulting in 151 fields. Of these, the lowest (0.4722) and highest (0.9622) jaw factor was observed in prostate and rectal cases, respectively. The median jaw factor was 0.7917 meaning there is the potential unincreased blocking by 20%. Clinically, the dynamic-jaw tracking represents an area surrounding the target which would receive MLC-only leakage transmission of 1.68% versus 0.1% with jaws. Jaw-tracking was more pronounced at areas farther from the target. In prostate patients, the rectum and bladder had 5.5% and 6.3% lower mean dose, respectively; the structures closer to the prostate such as the rectum and bladder both had 1.4% lower mean dose. Conclusion: A custom ESAPI script was coupled with a MATLAB routine in order to extract beam parameters from static-jaw plans and their replanned dynamic-jaw deliveries. The effects were quantified using jaw factor which is the ratio between the meterset weighted aperture size for dynamic-jaw fields versus static-jaw fields.« less

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Osman, A; American University of Biuret Medical Center, Biuret; Maalej, N

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% dosemore » 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.« less

Matching of electron beams for conformal therapy of target volumes at moderate depths.

PubMed

Zackrisson, B; Karlsson, M

1996-06-01

The basic requirements for conformal electron therapy are an accelerator with a wide range of energies and field shapes. The beams should be well characterised in a full 3-D dose planning system which has been verified for the geometries of the current application. Differences in the basic design of treatment units have been shown to have a large influence on beam quality and dosimetry. Modern equipment can deliver electron beams of good quality with a high degree of accuracy. A race-track microtron with minimised electron scattering and a multi-leaf collimator (MLC) for electron collimating will facilitate the isocentric technique as a general treatment technique for electrons. This will improve the possibility of performing combined electron field techniques in order to conform the dose distribution with no or minimal use of a bolus. Furthermore, the isocentric technique will facilitate multiple field arrangements that decrease the problems with distortion of the dose distribution due to inhomogeneities, etc. These situations are demonstrated by clinical examples where isocentric, matched electron fields for treatment of the nose, thyroid and thoracic wall have been used.

MagicPlate-512: A 2D silicon detector array for quality assurance of stereotactic motion adaptive radiotherapy.

PubMed

Petasecca, M; Newall, M K; Booth, J T; Duncan, M; Aldosari, A H; Fuduli, I; Espinoza, A A; Porumb, C S; Guatelli, S; Metcalfe, P; Colvill, E; Cammarano, D; Carolan, M; Oborn, B; Lerch, M L F; Perevertaylo, V; Keall, P J; Rosenfeld, A B

2015-06-01

Spatial and temporal resolutions are two of the most important features for quality assurance instrumentation of motion adaptive radiotherapy modalities. The goal of this work is to characterize the performance of the 2D high spatial resolution monolithic silicon diode array named "MagicPlate-512" for quality assurance of stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS) combined with a dynamic multileaf collimator (MLC) tracking technique for motion compensation. MagicPlate-512 is used in combination with the movable platform HexaMotion and a research version of radiofrequency tracking system Calypso driving MLC tracking software. The authors reconstruct 2D dose distributions of small field square beams in three modalities: in static conditions, mimicking the temporal movement pattern of a lung tumor and tracking the moving target while the MLC compensates almost instantaneously for the tumor displacement. Use of Calypso in combination with MagicPlate-512 requires a proper radiofrequency interference shielding. Impact of the shielding on dosimetry has been simulated by (GEANT)4 and verified experimentally. Temporal and spatial resolutions of the dosimetry system allow also for accurate verification of segments of complex stereotactic radiotherapy plans with identification of the instant and location where a certain dose is delivered. This feature allows for retrospective temporal reconstruction of the delivery process and easy identification of error in the tracking or the multileaf collimator driving systems. A sliding MLC wedge combined with the lung motion pattern has been measured. The ability of the MagicPlate-512 (MP512) in 2D dose mapping in all three modes of operation was benchmarked by EBT3 film. Full width at half maximum and penumbra of the moving and stationary dose profiles measured by EBT3 film and MagicPlate-512 confirm that motion has a significant impact on the dose distribution. Motion, no motion, and motion with MLC tracking profiles agreed within 1 and 0.4 mm, respectively, for all field sizes tested. Use of electromagnetic tracking system generates a fluctuation of the detector baseline up to 10% of the full scale signal requiring a proper shielding strategy. MagicPlate-512 is also able to reconstruct the dose variation pulse-by-pulse in each pixel of the detector. An analysis of the dose transients with motion and motion with tracking shows that the tracking feedback algorithm used for this experiment can compensate effectively only the effect of the slower transient components. The fast changing components of the organ motion can contribute only to discrepancy of the order of 15% in penumbral region while the slower components can change the dose profile up to 75% of the expected dose. MagicPlate-512 is shown to be, potentially, a valid alternative to film or 2D ionizing chambers for quality assurance dosimetry in SRS or SBRT. Its high spatial and temporal resolutions allow for accurate reconstruction of the profile in any conditions with motion and with tracking of the motion. It shows excellent performance to reconstruct the dose deposition in real time or retrospectively as a function of time for detailed analysis of the effect of motion in a specific pixel or area of interest.

Mlc Is a Transcriptional Activator with a Key Role in Integrating Cyclic AMP Receptor Protein and Integration Host Factor Regulation of Leukotoxin RNA Synthesis in Aggregatibacter actinomycetemcomitans

PubMed Central

Childress, Catherine; Feuerbacher, Leigh A.; Phillips, Linda; Burgum, Alex

2013-01-01

Aggregatibacter actinomycetemcomitans, a periodontal pathogen, synthesizes leukotoxin (LtxA), a protein that helps the bacterium evade the host immune response. Transcription of the ltxA operon is induced during anaerobic growth. The cyclic AMP (cAMP) receptor protein (CRP) indirectly increases ltxA expression, but the intermediary regulator is unknown. Integration host factor (IHF) binds to and represses the leukotoxin promoter, but neither CRP nor IHF is responsible for the anaerobic induction of ltxA RNA synthesis. Thus, we have undertaken studies to identify other regulators of leukotoxin transcription and to demonstrate how these proteins work together to modulate leukotoxin synthesis. First, analyses of ltxA RNA expression from defined leukotoxin promoter mutations in the chromosome identify positions −69 to −35 as the key control region and indicate that an activator protein modulates leukotoxin transcription. We show that Mlc, which is a repressor in Escherichia coli, functions as a direct transcriptional activator in A. actinomycetemcomitans; an mlc deletion mutant reduces leukotoxin RNA synthesis, and recombinant Mlc protein binds specifically at the −68 to −40 region of the leukotoxin promoter. Furthermore, we show that CRP activates ltxA expression indirectly by increasing the levels of Mlc. Analyses of Δmlc, Δihf, and Δihf Δmlc strains demonstrate that Mlc can increase RNA polymerase (RNAP) activity directly and that IHF represses ltxA RNA synthesis mainly by blocking Mlc binding. Finally, a Δihf Δmlc mutant still induces ltxA during anaerobic growth, indicating that there are additional factors involved in leukotoxin transcriptional regulation. A model for the coordinated regulation of leukotoxin transcription is presented. PMID:23475968

Electron intensity modulation for mixed-beam radiation therapy with an x-ray multi-leaf collimator

NASA Astrophysics Data System (ADS)

Weinberg, Rebecca

The current standard treatment for head and neck cancer at our institution uses intensity-modulated x-ray therapy (IMRT), which improves target coverage and sparing of critical structures by delivering complex fluence patterns from a variety of beam directions to conform dose distributions to the shape of the target volume. The standard treatment for breast patients is field-in-field forward-planned IMRT, with initial tangential fields and additional reduced-weight tangents with blocking to minimize hot spots. For these treatment sites, the addition of electrons has the potential of improving target coverage and sparing of critical structures due to rapid dose falloff with depth and reduced exit dose. In this work, the use of mixed-beam therapy (MBT), i.e., combined intensity-modulated electron and x-ray beams using the x-ray multi-leaf collimator (MLC), was explored. The hypothesis of this study was that addition of intensity-modulated electron beams to existing clinical IMRT plans would produce MBT plans that were superior to the original IMRT plans for at least 50% of selected head and neck and 50% of breast cases. Dose calculations for electron beams collimated by the MLC were performed with Monte Carlo methods. An automation system was created to facilitate communication between the dose calculation engine and the treatment planning system. Energy and intensity modulation of the electron beams was accomplished by dividing the electron beams into 2x2-cm2 beamlets, which were then beam-weight optimized along with intensity-modulated x-ray beams. Treatment plans were optimized to obtain equivalent target dose coverage, and then compared with the original treatment plans. MBT treatment plans were evaluated by participating physicians with respect to target coverage, normal structure dose, and overall plan quality in comparison with original clinical plans. The physician evaluations did not support the hypothesis for either site, with MBT selected as superior in 1 out of the 15 head and neck cases (p=1) and 6 out of 18 breast cases (p=0.95). While MBT was not shown to be superior to IMRT, reductions were observed in doses to critical structures distal to the target along the electron beam direction and to non-target tissues, at the expense of target coverage and dose homogeneity.

SU-F-T-506: Development and Commissioning of the Effective and Efficient Grid Therapy Using High Dose Rate Flattening Filter Free Beam and Multileaf Collimator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, M; Wen, N; Beyer, C

Purpose: Treating bulky tumors with grid therapy (GT) has demonstrated high response rates. Long delivery time (∼15min), with consequent increased risk of intrafraction motion, is a major disadvantage of conventional MLC-based GT (MLC-GT). The goal of this study was to develop and commission a MLC-GT technique with similar dosimetric characteristics, but more efficient delivery. Methods: Grid plan was designed with 10X-FFF (2400MU/min) beam and MLC in a commercial treatment planning system (TPS). Grid size was 1cm by 1cm and grid-to-grid distance was 2cm. Field-in-field technique was used to flatten the dose profile at depth of 10cm. Prescription was 15Gy atmore » 1.5cm depth. Doses were verified at depths of 1.5cm, 5cm and 10cm. Point dose was measured with a plastic scintillator detector (PSD) while the planar dose was measured with calibrated Gafchromic EBT3 films in a 20cm think, 30cmx30cm solid water phantom. The measured doses were compared to the doses calculated in the treatment planning system. Percent depth dose (PDD) within the grid was also measured using EBT3 film. Five clinical cases were planned to compare beam-on time. Results: The valley-to-peak dose ratio at the 3 depths was approximately 10–15%, which is very similar to published result. The average point dose difference between the PSD measurements and TPS calculation is 2.1±0.6%. Film dosimetry revealed good agreement between the delivered and calculated dose. The average gamma passing rates at the 3 depths were 95% (3%, 1mm). The average percent difference between the measured PDD and calculated PDD was 2.1% within the depth of 20cm. The phantom plan delivery time was 3.6 min. Average beam-on time was reduced by 66.1±5.6% for the 5 clinical cases. Conclusion: An effective and efficient GT technique was developed and commissioned for the treatment of bulky tumors using FFF beam combined with MLC and automation. The Department of Radiation Oncology at Henry Ford Health System receives research support from Varian Medical Systems and Philips Health Care.« less

SU-E-T-479: IMRT Plan Recalculation in Patient Based On Dynalog Data and the Effect of a Single Failing MLC Motor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morcos, M; Mitrou, E

2015-06-15

Purpose: Using Linac dynamic logs (Dynalogs) we evaluate the impact of a single failing MLC motor on the deliverability of an IMRT plan by assessing the recalculated dose volume histograms (DVHs) taking the delivered MLC positions and beam hold-offs into consideration. Methods: This is a retrospective study based on a deteriorating MLC motor (leaf 36B) which was observed to be failing via Dynalog analysis. To investigate further, Eclipse-importable MLC files were generated from Dynalogs to recalculate the actual delivered dose and to assess the clinical impact through DVHs. All deliveries were performed on a Varian 21EX linear accelerator equipped withmore » Millennium-120 MLC. The analysis of Dynalog files and subsequent conversion to Eclipse-importable MLC files were all performed by in-house programming in Python. Effects on plan DVH are presented in the following section on a particular brain-IMRT plan which was delivered with a failing MLC motor which was then replaced. Results: Global max dose increased by 13.5%, max dose to the brainstem PRV increased by 8.2%, max dose to the optic chiasm increased by 7.6%, max dose to optic nerve increased by 8.8% and the mean dose to the PTV increased by 7.9% when comparing the original plan to the fraction with the failing MLC motor. The reason the dose increased was due to the failure being on the B-bank which is the lagging side on a sliding window delivery, therefore any failures on this side will cause an over-irradiation as the B-bank leaves struggles to keep the window from growing. Conclusion: Our findings suggest that a single failing MLC motor may jeopardize the entire delivery. This may be due to the bad MLC motor drawing too much current causing all MLCs on the same bank to underperform. This hypothesis will be investigated in a future study.« less

SU-F-T-288: Impact of Trajectory Log Files for Clarkson-Based Independent Dose Verification of IMRT and VMAT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Takahashi, R; Kamima, T; Tachibana, H

2016-06-15

Purpose: To investigate the effect of the trajectory files from linear accelerator for Clarkson-based independent dose verification in IMRT and VMAT plans. Methods: A CT-based independent dose verification software (Simple MU Analysis: SMU, Triangle Products, Japan) with a Clarksonbased algorithm was modified to calculate dose using the trajectory log files. Eclipse with the three techniques of step and shoot (SS), sliding window (SW) and Rapid Arc (RA) was used as treatment planning system (TPS). In this study, clinically approved IMRT and VMAT plans for prostate and head and neck (HN) at two institutions were retrospectively analyzed to assess the dosemore » deviation between DICOM-RT plan (PL) and trajectory log file (TJ). An additional analysis was performed to evaluate MLC error detection capability of SMU when the trajectory log files was modified by adding systematic errors (0.2, 0.5, 1.0 mm) and random errors (5, 10, 30 mm) to actual MLC position. Results: The dose deviations for prostate and HN in the two sites were 0.0% and 0.0% in SS, 0.1±0.0%, 0.1±0.1% in SW and 0.6±0.5%, 0.7±0.9% in RA, respectively. The MLC error detection capability shows the plans for HN IMRT were the most sensitive and 0.2 mm of systematic error affected 0.7% dose deviation on average. Effect of the MLC random error did not affect dose error. Conclusion: The use of trajectory log files including actual information of MLC location, gantry angle, etc should be more effective for an independent verification. The tolerance level for the secondary check using the trajectory file may be similar to that of the verification using DICOM-RT plan file. From the view of the resolution of MLC positional error detection, the secondary check could detect the MLC position error corresponding to the treatment sites and techniques. This research is partially supported by Japan Agency for Medical Research and Development (AMED)« less

SU-E-T-346: Effect of Jaw Position On Dose to Critical Structures in 3-D Conformal Radiotherapy Treatment of Pancreatic Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paudel, N; Han, E; Liang, X

Purpose: Three-dimensional conformal therapy remains a valid and widely used modality for pancreatic radiotherapy treatment. It usually meets dose constraints on critical structures. However, careful positioning of collimation jaws can reduce dose to the critical structures. Here we investigate the dosimetric effect of jaw position in MLC-based 3-D conformal treatment planning on critical structures. Methods: We retrospectively selected seven pancreatic cancer patients treated with 3-D conformal radiotherapy. We started with treatment plans (Varian Truebeam LINAC, Eclipse TPS, AAA, 18MV) having both x and y jaws aligned with the farthest extent of the block outline (8mm around PTV). Then we subsequentlymore » moved either both x-jaws or all x and y jaws outwards upto 3 cm in 1 cm increments and investigated their effect on average and maximum dose to neighboring critical structures keeping the same coverage to treatment volume. Results: Lateral displacement of both x-jaws by 1cm each increased kidney and spleen mean dose by as much as 1.7% and 1.3% respectively and superior inferior displacement increased liver, right kidney, stomach and spleen dose by as much as 2.1%, 2%, 5.2% and 1.6% respectively. Displacement of all x and y-jaws away by 1cm increased the mean dose to liver, right kidney, left kidney, bowels, cord, stomach and spleen by as much as 4.9%, 5.9%, 2.1%, 2.8%, 7.4%, 10.4% and 4.2% respectively. Percentage increase in mean dose due to 2 and 3cm jaw displacement increased almost linearly with the displaced distance. Changes in maximum dose were much smaller (mostly negligible) than the changes in mean dose. Conclusion: Collimation jaw position affects dose mostly to critical structures adjacent to it. Though treatment plans with MLCs conforming the block margin usually meet dose constraints to critical structures, keeping jaws all the way in, to the edge of the block reduces dose to the critical structures during radiation treatment.« less

Feasibility of using Geant4 Monte Carlo simulation for IMRT dose calculations for the Novalis Tx with a HD-120 multi-leaf collimator

NASA Astrophysics Data System (ADS)

Jung, Hyunuk; Shin, Jungsuk; Chung, Kwangzoo; Han, Youngyih; Kim, Jinsung; Choi, Doo Ho

2015-05-01

The aim of this study was to develop an independent dose verification system by using a Monte Carlo (MC) calculation method for intensity modulated radiation therapy (IMRT) conducted by using a Varian Novalis Tx (Varian Medical Systems, Palo Alto, CA, USA) equipped with a highdefinition multi-leaf collimator (HD-120 MLC). The Geant4 framework was used to implement a dose calculation system that accurately predicted the delivered dose. For this purpose, the Novalis Tx Linac head was modeled according to the specifications acquired from the manufacturer. Subsequently, MC simulations were performed by varying the mean energy, energy spread, and electron spot radius to determine optimum values of irradiation with 6-MV X-ray beams by using the Novalis Tx system. Computed percentage depth dose curves (PDDs) and lateral profiles were compared to the measurements obtained by using an ionization chamber (CC13). To validate the IMRT simulation by using the MC model we developed, we calculated a simple IMRT field and compared the result with the EBT3 film measurements in a water-equivalent solid phantom. Clinical cases, such as prostate cancer treatment plans, were then selected, and MC simulations were performed. The accuracy of the simulation was assessed against the EBT3 film measurements by using a gamma-index criterion. The optimal MC model parameters to specify the beam characteristics were a 6.8-MeV mean energy, a 0.5-MeV energy spread, and a 3-mm electron radius. The accuracy of these parameters was determined by comparison of MC simulations with measurements. The PDDs and the lateral profiles of the MC simulation deviated from the measurements by 1% and 2%, respectively, on average. The computed simple MLC fields agreed with the EBT3 measurements with a 95% passing rate with 3%/3-mm gamma-index criterion. Additionally, in applying our model to clinical IMRT plans, we found that the MC calculations and the EBT3 measurements agreed well with a passing rate of greater than 95% on average with a 3%/3-mm gamma-index criterion. In summary, the Novalis Tx Linac head equipped with a HD-120 MLC was successfully modeled by using a Geant4 platform, and the accuracy of the Geant4 platform was successfully validated by comparisons with measurements. The MC model we have developed can be a useful tool for pretreatment quality assurance of IMRT plans and for commissioning of radiotherapy treatment planning.

A fixed-jaw method to protect critical organs during intensity-modulated radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Jiayun; Chen, Xinyuan; Huang, Manni, E-mail: dai_jianrong@163.com

2014-01-01

Intensity-modulated radiotherapy (IMRT) plays an important role in cancer radiotherapy. For some patients being treated with IMRT, the extremely low tolerances of critical organs (such as lens, ovaries, and testicles) cannot be met during treatment planning. The aim of this article is to introduce a new planning method to overcome that problem. In current planning practice, jaw positions are automatically set to cover all target volumes by the planning system (e.g., Pinnacle{sup 3} system). Because of such settings, critical organs may be fully blocked by the multileaf collimator (MLC), but they still sit in the field that is shaped bymore » collimator jaws. These critical organs receive doses from the transmission and leakage of MLC leaves. We manually fixed jaw positions to block them to further reduce such doses. This method has been used for different treatment sites in our clinic, and it was thoroughly evaluated in patients with radical hysterectomy plus ovarian transposition after surgery. For each patient, 2 treatment plans were designed with the same optimization parameters: the original plan with automatically chosen jaw positions (called O-plan) and the plan with fixed-jaw positions (named F-plan). In the F-plan, the jaws were manually fixed to block the ovaries. For target coverage, the mean conformity index (CI) of the F-plan (1.28 ± 0.02) was remarkably lower than that of the O-plan (1.53 ± 0.09) (p < 0.05). The F-plan and the O-plan performed similarly in target dose homogeneity. Meanwhile, for the critical organ sparing, the mean dose of both ovaries were much lower in the F-plan than that in the O-plan (p < 0.05). The V{sub 20}, V{sub 30}, and V{sub 40} of bladder were also lower in the F-plan (93.57 ± 1.98, 73.99 ± 5.76, and 42.33 ± 3.7, respectively) than those in the O-plan (97.98 ± 1.11, 85.07 ± 4.04, and 49.71 ± 3.63, respectively) (p < 0.05). The maximum dose to the spinal cord planning organ at risk (OAR) volume (PRV) in the O-plan (3940.24 ± 102.8) was higher than that in the F-plan (3628.18 ± 131.45) with significant differences (p < 0.01). For other OARs, there were no significant differences in doses between these 2 plans except that the high-dose regions of the rectum were higher for V{sub 40} in the O-plan than that in the F-plan (p < 0.01). But the monitor units (MUs) in the F-plan were 1.4 times as much as that in the O-plan. Thus the treatment time could be longer by using the F-plan. As it results in more MUs in spite of better plan quality, it is recommended to be used only in situations in which clinical requirements to critical organs cannot be met with the regular method.« less

Ultrafast treatment plan optimization for volumetric modulated arc therapy (VMAT)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Men Chunhua; Romeijn, H. Edwin; Jia Xun

2010-11-15

Purpose: To develop a novel aperture-based algorithm for volumetric modulated arc therapy (VMAT) treatment plan optimization with high quality and high efficiency. Methods: The VMAT optimization problem is formulated as a large-scale convex programming problem solved by a column generation approach. The authors consider a cost function consisting two terms, the first enforcing a desired dose distribution and the second guaranteeing a smooth dose rate variation between successive gantry angles. A gantry rotation is discretized into 180 beam angles and for each beam angle, only one MLC aperture is allowed. The apertures are generated one by one in a sequentialmore » way. At each iteration of the column generation method, a deliverable MLC aperture is generated for one of the unoccupied beam angles by solving a subproblem with the consideration of MLC mechanic constraints. A subsequent master problem is then solved to determine the dose rate at all currently generated apertures by minimizing the cost function. When all 180 beam angles are occupied, the optimization completes, yielding a set of deliverable apertures and associated dose rates that produce a high quality plan. Results: The algorithm was preliminarily tested on five prostate and five head-and-neck clinical cases, each with one full gantry rotation without any couch/collimator rotations. High quality VMAT plans have been generated for all ten cases with extremely high efficiency. It takes only 5-8 min on CPU (MATLAB code on an Intel Xeon 2.27 GHz CPU) and 18-31 s on GPU (CUDA code on an NVIDIA Tesla C1060 GPU card) to generate such plans. Conclusions: The authors have developed an aperture-based VMAT optimization algorithm which can generate clinically deliverable high quality treatment plans at very high efficiency.« less

Ultrafast treatment plan optimization for volumetric modulated arc therapy (VMAT).

PubMed

Men, Chunhua; Romeijn, H Edwin; Jia, Xun; Jiang, Steve B

2010-11-01

To develop a novel aperture-based algorithm for volumetric modulated are therapy (VMAT) treatment plan optimization with high quality and high efficiency. The VMAT optimization problem is formulated as a large-scale convex programming problem solved by a column generation approach. The authors consider a cost function consisting two terms, the first enforcing a desired dose distribution and the second guaranteeing a smooth dose rate variation between successive gantry angles. A gantry rotation is discretized into 180 beam angles and for each beam angle, only one MLC aperture is allowed. The apertures are generated one by one in a sequential way. At each iteration of the column generation method, a deliverable MLC aperture is generated for one of the unoccupied beam angles by solving a subproblem with the consideration of MLC mechanic constraints. A subsequent master problem is then solved to determine the dose rate at all currently generated apertures by minimizing the cost function. When all 180 beam angles are occupied, the optimization completes, yielding a set of deliverable apertures and associated dose rates that produce a high quality plan. The algorithm was preliminarily tested on five prostate and five head-and-neck clinical cases, each with one full gantry rotation without any couch/collimator rotations. High quality VMAT plans have been generated for all ten cases with extremely high efficiency. It takes only 5-8 min on CPU (MATLAB code on an Intel Xeon 2.27 GHz CPU) and 18-31 s on GPU (CUDA code on an NVIDIA Tesla C1060 GPU card) to generate such plans. The authors have developed an aperture-based VMAT optimization algorithm which can generate clinically deliverable high quality treatment plans at very high efficiency.

Intensity- and energy-modulated electron radiotherapy by means of an xMLC for head and neck shallow tumors

NASA Astrophysics Data System (ADS)

Salguero, Francisco Javier; Arráns, Rafael; Atriana Palma, Bianey; Leal, Antonio

2010-03-01

The purpose of this paper is to assess the feasibility of delivering intensity- and energy-modulated electron radiation treatment (MERT) by a photon multileaf collimator (xMLC) and to evaluate the improvements obtained in shallow head and neck (HN) tumors. Four HN patient cases covering different clinical situations were planned by MERT, which used an in-house treatment planning system that utilized Monte Carlo dose calculation. The cases included one oronasal, two parotid and one middle ear tumors. The resulting dose-volume histograms were compared with those obtained from conventional photon and electron treatment techniques in our clinic, which included IMRT, electron beam and mixed beams, most of them using fixed-thickness bolus. Experimental verification was performed with plane-parallel ionization chambers for absolute dose verification, and a PTW ionization chamber array and radiochromic film for relative dosimetry. A MC-based treatment planning system for target with compromised volumes in depth and laterally has been validated. A quality assurance protocol for individual MERT plans was launched. Relative MC dose distributions showed a high agreement with film measurements and absolute ion chamber dose measurements performed at a reference point agreed with MC calculations within 2% in all cases. Clinically acceptable PTV coverage and organ-at-risk sparing were achieved by using the proposed MERT approach. MERT treatment plans, based on delivery of intensity-modulated electron beam using the xMLC, for superficial head and neck tumors, demonstrated comparable or improved PTV dose homogeneity with significantly lower dose to normal tissues. The clinical implementation of this technique will be able to offer a viable alternative for the treatment of shallow head and neck tumors.

Delivery time comparison for intensity-modulated radiation therapy with/without flattening filter: a planning study

NASA Astrophysics Data System (ADS)

Fu, Weihua; Dai, Jianrong; Hu, Yimin; Han, Dongsheng; Song, Yixin

2004-04-01

The treatment delivery time of intensity-modulated radiation therapy (IMRT) with a multileaf collimator (MLC) is generally longer than that of conventional radiotherapy. In theory, removing the flattening filter from the treatment head may reduce the beam-on time by enhancing the output dose rate, and then reduce the treatment delivery time. And in practice, there is a possibility of delivering the required fluence distribution by modulating the unflattened non-uniform fluence distribution. However, the reduction of beam-on time may be discounted by the increase of leaf-travel time and (or) verification-and-recording (V&R) time. Here we investigate the overall effect of flattening filter on the treatment delivery time of IMRT with MLCs implemented in the step and shoot method, as well as with compensators on six hybrid machines. We compared the treatment delivery time with/without flattening filter for ten nasopharynx cases and ten prostate cases by observing the variations of the ratio of the beam-on time, segment number, leaf-travel time and the treatment delivery time with dose rate, leaf speed and V&R time. The results show that, without the flattening filter, the beam-on time reduces for both static MLC and compensator-based techniques; the number of segments and the leaf-travel time increase slightly for the static MLC technique; the relative IMRT treatment delivery time decreases more with lower dose rate, higher leaf speed and shorter V&R overhead time. The absolute treatment delivery time reduction depends on the fraction dose. It is not clinically significant at a fraction dose of 2 Gy for the technique of removing the flattening filter, but becomes significant when the fraction dose is as high as that for radiosurgery.

Comparison of the helical tomotherapy against the multileaf collimator-based intensity-modulated radiotherapy and 3D conformal radiation modalities in lung cancer radiotherapy

PubMed Central

Mavroidis, P; Shi, C; Plataniotis, G A; Delichas, M G; Costa Ferreira, B; Rodriguez, S; Lind, B K; Papanikolaou, N

2011-01-01

Objectives The aim of this study was to compare three-dimensional (3D) conformal radiotherapy and the two different forms of IMRT in lung cancer radiotherapy. Methods Cases of four lung cancer patients were investigated by developing a 3D conformal treatment plan, a linac MLC-based step-and-shoot IMRT plan and an HT plan for each case. With the use of the complication-free tumour control probability (P+) index and the uniform dose concept as the common prescription point of the plans, the different treatment plans were compared based on radiobiological measures. Results The applied plan evaluation method shows the MLC-based IMRT and the HT treatment plans are almost equivalent over the clinically useful dose prescription range; however, the 3D conformal plan inferior. At the optimal dose levels, the 3D conformal treatment plans give an average P+ of 48.1% for a effective uniform dose to the internal target volume (ITV) of 62.4 Gy, whereas the corresponding MLC-based IMRT treatment plans are more effective by an average ΔP+ of 27.0% for a Δ effective uniform dose of 16.3 Gy. Similarly, the HT treatment plans are more effective than the 3D-conformal plans by an average ΔP+ of 23.8% for a Δ effective uniform dose of 11.6 Gy. Conclusion A radiobiological treatment plan evaluation can provide a closer association of the delivered treatment with the clinical outcome by taking into account the dose–response relations of the irradiated tumours and normal tissues. The use of P – effective uniform dose diagrams can complement the traditional tools of evaluation to compare and effectively evaluate different treatment plans. PMID:20858664

Alignment focus of daily image guidance for concurrent treatment of prostate and pelvic lymph nodes.

PubMed

Ferjani, Samah; Huang, Guangshun; Shang, Qingyang; Stephans, Kevin L; Zhong, Yahua; Qi, Peng; Tendulkar, Rahul D; Xia, Ping

2013-10-01

To determine the dosimetric impact of daily imaging alignment focus on the prostate soft tissue versus the pelvic bones for the concurrent treatment of the prostate and pelvic lymph nodes (PLN) and to assess whether multileaf collimator (MLC) tracking or adaptive planning (ART) is necessary with the current clinical planning margins of 8 mm/6 mm posterior to the prostate and 5 mm to the PLN. A total of 124 kilovoltage cone-beam computed tomography (kV-CBCT) images from 6 patients were studied. For each KV-CBCT, 4 plans were retrospectively created using an isocenter shifting method with 2 different alignment focuses (prostate, PLN), an MLC shifting method, and the ART method. The selected dosimetric endpoints were compared among these plans. For the isoshift contour, isoshift bone, MLC shift, and ART plans, D99 of the prostate was ≥97% of the prescription dose in 97.6%, 73.4%, 98.4%, and 96.8% of 124 fractions, respectively. Accordingly, D99 of the PLN was ≥97% of the prescription dose in 98.4%, 98.4%, 98.4%, and 100% of 124 fractions, respectively. For the rectum, D5 exceeded 105% of the planned D5 (and D5 of ART plans) in 11% (4%), 10% (2%), and 13% (5%) of 124 fractions, respectively. For the bladder, D5 exceeded 105% of the planned D5 (and D5 of ART) plans in 0% (2%), 0% (2%), and 0% (1%) of 124 fractions, respectively. For concurrent treatment of the prostate and PLN, with a planning margin to the prostate of 8 mm/6 mm posterior and a planning margin of 5 mm to the PLN, aligning to the prostate soft tissue can achieve adequate dose coverage to the both target volumes; aligning to the pelvic bone would result in underdosing to the prostate in one-third of fractions. With these planning margins, MLC tracking and ART methods have no dosimetric advantages. Copyright © 2013 Elsevier Inc. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thiyagarajan, Rajesh; Karrthick, KP; Kataria, Tejinder

Purpose: Performing DQA for Bilateral (B-L) breast tomotherapy is a challenging task due to the limitation of any commercially available detector array or film. Aim of this study is to perform DQA for B-L breast tomotherapy plan using MLC fluence sinogram. Methods: Treatment plan was generated on Tomotherapy system for B-L breast tumour. B-L breast targets were given 50.4 Gy prescribed over 28 fractions. Plan is generated with 6 MV photon beam & pitch was set to 0.3. As the width of the total target is 39 cm (left & right) length is 20 cm. DQA plan delivered without anymore » phantom on the mega voltage computed tomography (MCVT) detector system. The pulses recorded by MVCT system were exported to the delivery analysis software (Tomotherapy Inc.) for reconstruction. The detector signals are reconstructed to a sonogram and converted to MLC fluence sonogram. The MLC fluence sinogram compared with the planned fluence sinogram. Also point dose measured with cheese phantom and ionization chamber to verify the absolute dose component Results: Planned fluence sinogram and reconstructed MLC fluence sinogram were compared using Gamma metric. MLC positional difference and intensity of the beamlet were used as parameters to evaluate gamma. 3 mm positional difference and 3% beamlet intensity difference were used set for gamma calculation. A total of 26784 non-zero beamlets were included in the analysis out of which 161 beamlets had gamma more than 1. The gamma passing rate found to be 99.4%. Point dose measurements were within 1.3% of the calculated dose. Conclusion: MLC fluence sinogram based delivery quality assurance performed for bilateral breast irradiation. This would be a suitable alternate for large volume targets like bilateral breast, Total body irradiation etc. However conventional method of DQA should be used to validate this method periodically.« less

Pixelated gamma detector

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dolinsky, Sergei Ivanovich; Yanoff, Brian David; Guida, Renato

2016-12-27

A pixelated gamma detector includes a scintillator column assembly having scintillator crystals and optical transparent elements alternating along a longitudinal axis, a collimator assembly having longitudinal walls separated by collimator septum, the collimator septum spaced apart to form collimator channels, the scintillator column assembly positioned adjacent to the collimator assembly so that the respective ones of the scintillator crystal are positioned adjacent to respective ones of the collimator channels, the respective ones of the optical transparent element are positioned adjacent to respective ones of the collimator septum, and a first photosensor and a second photosensor, the first and the secondmore » photosensor each connected to an opposing end of the scintillator column assembly. A system and a method for inspecting and/or detecting defects in an interior of an object are also disclosed.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, X; Yang, F

Purpose: Knowing MLC leaf positioning error over the course of treatment would be valuable for treatment planning, QA design, and patient safety. The objective of the current study was to quantify the MLC positioning accuracy for VMAT delivery of head and neck treatment plans. Methods: A total of 837 MLC log files were collected from 14 head and neck cancer patients undergoing full arc VMAT treatment on one Varian Trilogy machine. The actual and planned leaf gaps were extracted from the retrieved MLC log files. For a given patient, the leaf gap error percentage (LGEP), defined as the ratio ofmore » the actual leaf gap over the planned, was evaluated for each leaf pair at all the gantry angles recorded over the course of the treatment. Statistics describing the distribution of the largest LGEP (LLGEP) of the 60 leaf pairs including the maximum, minimum, mean, Kurtosis, and skewness were evaluated. Results: For the 14 studied patients, their PTV located at tonsil, base of tongue, larynx, supraglottis, nasal cavity, and thyroid gland with volume ranging from 72.0 cm{sup 3} to 602.0 cm{sup 3}. The identified LLGEP differed between patients. It ranged from 183.9% to 457.7% with a mean of 368.6%. For the majority of the patients, the LLGEP distributions peaked at non-zero positions and showed no obvious dependence on gantry rotations. Kurtosis and skewness, with minimum/maximum of 66.6/217.9 and 6.5/12.6, respectively, suggested relatively more peaked while right-skewed leaf error distribution pattern. Conclusion: The results indicate pattern of MLC leaf gap error differs between patients of lesion located at similar anatomic site. Understanding the systemic mechanisms underlying these observed error patterns necessitates examining more patient-specific plan parameters in a large patient cohort setting.« less

Multileaf collimator tongue-and-groove effect on depth and off-axis doses: A comparison of treatment planning data with measurements and Monte Carlo calculations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Hee Jung; Department of Biomedical Engineering, Seoul National University, Seoul; Department of Radiation Oncology, Soonchunhyang University Hospital, Seoul

2015-01-01

To investigate how accurately treatment planning systems (TPSs) account for the tongue-and-groove (TG) effect, Monte Carlo (MC) simulations and radiochromic film (RCF) measurements were performed for comparison with TPS results. Two commercial TPSs computed the TG effect for Varian Millennium 120 multileaf collimator (MLC). The TG effect on off-axis dose profile at 3 depths of solid water was estimated as the maximum depth and the full width at half maximum (FWHM) of the dose dip at an interleaf position. When compared with the off-axis dose of open field, the maximum depth of the dose dip for MC and RCF rangedmore » from 10.1% to 20.6%; the maximum depth of the dose dip gradually decreased by up to 8.7% with increasing depths of 1.5 to 10 cm and also by up to 4.1% with increasing off-axis distances of 0 to 13 cm. However, TPS results showed at most a 2.7% decrease for the same depth range and a negligible variation for the same off-axis distances. The FWHM of the dose dip was approximately 0.19 cm for MC and 0.17 cm for RCF, but 0.30 cm for Eclipse TPS and 0.45 cm for Pinnacle TPS. Accordingly, the integrated value of TG dose dip for TPS was larger than that for MC and RCF and almost invariant along the depths and off-axis distances. We concluded that the TG dependence on depth and off-axis doses shown in the MC and RCF results could not be appropriately modeled by the TPS versions in this study.« less

The first patient treatment of electromagnetic-guided real time adaptive radiotherapy using MLC tracking for lung SABR.

PubMed

Booth, Jeremy T; Caillet, Vincent; Hardcastle, Nicholas; O'Brien, Ricky; Szymura, Kathryn; Crasta, Charlene; Harris, Benjamin; Haddad, Carol; Eade, Thomas; Keall, Paul J

2016-10-01

Real time adaptive radiotherapy that enables smaller irradiated volumes may reduce pulmonary toxicity. We report on the first patient treatment of electromagnetic-guided real time adaptive radiotherapy delivered with MLC tracking for lung stereotactic ablative body radiotherapy. A clinical trial was developed to investigate the safety and feasibility of MLC tracking in lung. The first patient was an 80-year old man with a single left lower lobe lung metastasis to be treated with SABR to 48Gy in 4 fractions. In-house software was integrated with a standard linear accelerator to adapt the treatment beam shape and position based on electromagnetic transponders implanted in the lung. MLC tracking plans were compared against standard ITV-based treatment planning. MLC tracking plan delivery was reconstructed in the patient to confirm safe delivery. Real time adaptive radiotherapy delivered with MLC tracking compared to standard ITV-based planning reduced the PTV by 41% (18.7-11cm 3 ) and the mean lung dose by 30% (202-140cGy), V20 by 35% (2.6-1.5%) and V5 by 9% (8.9-8%). An emerging technology, MLC tracking, has been translated into the clinic and used to treat lung SABR patients for the first time. This milestone represents an important first step for clinical real-time adaptive radiotherapy that could reduce pulmonary toxicity in lung radiotherapy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

SU-F-T-313: Clinical Results of a New Customer Acceptance Test for Elekta VMAT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rusk, B; Fontenot, J

Purpose: To report the results of a customer acceptance test (CAT) for VMAT treatments for two matched Elekta linear accelerators. Methods: The CAT tests were performed on two clinically matched Elekta linear accelerators equipped with a 160-leaf MLC. Functional tests included performance checks of the control system during dynamic movements of the diaphragms, MLC, and gantry. Dosimetric tests included MLC picket fence tests at static and variable dose rates and a diaphragm alignment test, all performed using the on-board EPID. Additionally, beam symmetry during arc delivery was measured at the four cardinal angles for high and low dose rate modesmore » using a 2D detector array. Results of the dosimetric tests were analyzed using the VMAT CAT analysis tool. Results: Linear accelerator 1 (LN1) met all stated CAT tolerances. Linear accelerator 2 (LN2) passed the geometric, beam symmetry, and MLC position error tests but failed the relative dose average test for the diaphragm abutment and all three picket fence fields. Though peak doses in the abutment regions were consistent, the average dose was below the stated tolerance corresponding to a leaf junction that was too narrow. Despite this, no significant differences in patient specific VMAT quality assurance measured were observed between the accelerators and both passed monthly MLC quality assurance performed with the Hancock test. Conclusion: Results from the CAT showed LN2 with relative dose averages in the abutment regions of the diaphragm and MLC tests outside the tolerances resulting from differences in leaf gap distances. Tolerances of the dose average tests from the CAT may be small enough to detect MLC errors which do not significantly affect patient QA or the routine MLC tests.« less

Adaptive intensity modulated radiotherapy for advanced prostate cancer

NASA Astrophysics Data System (ADS)

Ludlum, Erica Marie

The purpose of this research is to develop and evaluate improvements in intensity modulated radiotherapy (IMRT) for concurrent treatment of prostate and pelvic lymph nodes. The first objective is to decrease delivery time while maintaining treatment quality, and evaluate the effectiveness and efficiency of novel one-step optimization compared to conventional two-step optimization. Both planning methods are examined at multiple levels of complexity by comparing the number of beam apertures, or segments, the amount of radiation delivered as measured by monitor units (MUs), and delivery time. One-step optimization is demonstrated to simplify IMRT planning and reduce segments (from 160 to 40), MUs (from 911 to 746), and delivery time (from 22 to 7 min) with comparable plan quality. The second objective is to examine the capability of three commercial dose calculation engines employing different levels of accuracy and efficiency to handle high--Z materials, such as metallic hip prostheses, included in the treatment field. Pencil beam, convolution superposition, and Monte Carlo dose calculation engines are compared by examining the dose differences for patient plans with unilateral and bilateral hip prostheses, and for phantom plans with a metal insert for comparison with film measurements. Convolution superposition and Monte Carlo methods calculate doses that are 1.3% and 34.5% less than the pencil beam method, respectively. Film results demonstrate that Monte Carlo most closely represents actual radiation delivery, but none of the three engines accurately predict the dose distribution when high-Z heterogeneities exist in the treatment fields. The final objective is to improve the accuracy of IMRT delivery by accounting for independent organ motion during concurrent treatment of the prostate and pelvic lymph nodes. A leaf-shifting algorithm is developed to track daily prostate position without requiring online dose calculation. Compared to conventional methods of adjusting patient position, adjusting the multileaf collimator (MLC) leaves associated with the prostate in each segment significantly improves lymph node dose coverage (maintains 45 Gy compared to 42.7, 38.3, and 34.0 Gy for iso-shifts of 0.5, 1 and 1.5 cm). Altering the MLC portal shape is demonstrated as a new and effective solution to independent prostate movement during concurrent treatment.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chengqiang, L; Yin, Y; Chen, L

Purpose: To investigate the impact of MLC position errors on simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) for patients with nasopharyngeal carcinoma. Methods: To compare the dosimetric differences between the simulated plans and the clinical plans, ten patients with locally advanced NPC treated with SIB-IMRT were enrolled in this study. All plans were calculated with an inverse planning system (Pinnacle3, Philips Medical System{sub )}. Random errors −2mm to 2mm{sub )},shift errors{sub (} 2mm,1mm and 0.5mm) and systematic extension/ contraction errors (±2mm, ±1mm and ±0.5mm) of the MLC leaf position were introduced respectively into the original plans to create the simulated plans.more » Dosimetry factors were compared between the original and the simulated plans. Results: The dosimetric impact of the random and system shift errors of MLC position was insignificant within 2mm, the maximum changes in D95% of PGTV,PTV1,PTV2 were-0.92±0.51%,1.00±0.24% and 0.62±0.17%, the maximum changes in the D0.1cc of spinal cord and brainstem were 1.90±2.80% and −1.78±1.42%, the maximum changes in the Dmean of parotids were1.36±1.23% and −2.25±2.04%.However,the impact of MLC extension or contraction errors was found significant. For 2mm leaf extension errors, the average changes in D95% of PGTV,PTV1,PTV2 were 4.31±0.67%,4.29±0.65% and 4.79±0.82%, the averaged value of the D0.1cc to spinal cord and brainstem were increased by 7.39±5.25% and 6.32±2.28%,the averaged value of the mean dose to left and right parotid were increased by 12.75±2.02%,13.39±2.17% respectively. Conclusion: The dosimetric effect was insignificant for random MLC leaf position errors up to 2mm. There was a high sensitivity to dose distribution for MLC extension or contraction errors.We should pay attention to the anatomic changes in target organs and anatomical structures during the course,individual radiotherapy was recommended to ensure adaptive doses.« less

Improving a scissor-action couch for conformal arc radiotherapy and radiosurgery.

PubMed

Li, Kaile; Yu, Cedric X; Ma, Lijun

2004-01-01

We have developed a method to improve the setup accuracy of a Varian Clinac 6/100 couch for delivering conformal arc therapy using a tertiary micro multileaf collimator (MLC) system. Several immobilization devices have been developed to improve the mechanical stability and isocenter alignment of the couch: turn-knob harnesses, double-track alignment plates, and a drop-in rod that attaches the couch to the concrete floor. These add-on components minimize the intercomponent motion of the couch's scissor elevator, which allows consistent treatment setup. The accuracy of our isocenter couch alignment is an improvement over the above devices, within 1 mm of their accuracy. The couch has been used with over 15 patients and with over 50 modulated conformal arc treatment deliveries at our institution.

Investigation of the accuracy of MV radiation isocentre calculations in the Elekta cone-beam CT software XVI.

PubMed

Riis, Hans L; Moltke, Lars N; Zimmermann, Sune J; Ebert, Martin A; Rowshanfarzad, Pejman

2016-06-07

Accurate determination of the megavoltage (MV) radiation isocentre of a linear accelerator (linac) is an important task in radiotherapy. The localization of the MV radiation isocentre is crucial for correct calibration of the in-room lasers and the cone-beam CT scanner used for patient positioning prior to treatment. Linac manufacturers offer tools for MV radiation isocentre localization. As a user, there is no access to the documentation for the underlying method and calculation algorithm used in the commercial software. The idea of this work was to evaluate the accuracy of the software tool for MV radiation isocentre calculation as delivered by Elekta using independent software. The image acquisition was based on the scheme designed by the manufacturer. Eight MV images were acquired in each series of a ball-bearing (BB) phantom attached to the treatment couch. The images were recorded at cardinal angles of the gantry using the electronic portal imaging device (EPID). Eight Elekta linacs with three different types of multileaf collimators (MLCs) were included in the test. The influence of MLC orientation, x-ray energy, and phantom modifications were examined. The acquired images were analysed using the Elekta x-ray volume imaging (XVI) software and in-house developed (IHD) MATLAB code. Results from the two different software were compared. A discrepancy in the longitudinal direction of the isocentre localization was found averaging 0.23 mm up to a maximum of 0.75 mm. The MLC orientation or the phantom asymmetry in the longitudinal direction do not appear to cause the discrepancy. The main cause of the differences could not be clearly identified. However, it is our opinion that the commercial software delivered by the linac manufacturer should be improved to reach better stability and precise results in the MV radiation isocentre calculations.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mihailescu, Lucian

This disclosure provides systems, methods, and apparatus related to ion beam therapy. In one aspect, a system includes a position sensitive detector and a collimator. The position sensitive detector configured to detect gamma rays generated by an ion beam interacting with a target. The collimator is positioned between the target and the position sensitive detector. The collimator includes a plurality of knife-edge slits, with a first knife-edge slit intersecting with a second knife-edge slit.

Experience of micromultileaf collimator linear accelerator based single fraction stereotactic radiosurgery: Tumor dose inhomogeneity, conformity, and dose fall off

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hong, Linda X.; Garg, Madhur; Lasala, Patrick

2011-03-15

Purpose: Sharp dose fall off outside a tumor is essential for high dose single fraction stereotactic radiosurgery (SRS) plans. This study explores the relationship among tumor dose inhomogeneity, conformity, and dose fall off in normal tissues for micromultileaf collimator (mMLC) linear accelerator (LINAC) based cranial SRS plans. Methods: Between January 2007 and July 2009, 65 patients with single cranial lesions were treated with LINAC-based SRS. Among them, tumors had maximum diameters {<=}20 mm: 31; between 20 and 30 mm: 21; and >30 mm: 13. All patients were treated with 6 MV photons on a Trilogy linear accelerator (Varian Medical Systems,more » Palo Alto, CA) with a tertiary m3 high-resolution mMLC (Brainlab, Feldkirchen, Germany), using either noncoplanar conformal fixed fields or dynamic conformal arcs. The authors also created retrospective study plans with identical beam arrangement as the treated plan but with different tumor dose inhomogeneity by varying the beam margins around the planning target volume (PTV). All retrospective study plans were normalized so that the minimum PTV dose was the prescription dose (PD). Isocenter dose, mean PTV dose, RTOG conformity index (CI), RTOG homogeneity index (HI), dose gradient index R{sub 50}-R{sub 100} (defined as the difference between equivalent sphere radius of 50% isodose volume and prescription isodose volume), and normal tissue volume (as a ratio to PTV volume) receiving 50% prescription dose (NTV{sub 50}) were calculated. Results: HI was inversely related to the beam margins around the PTV. CI had a ''V'' shaped relationship with HI, reaching a minimum when HI was approximately 1.3. Isocenter dose and mean PTV dose (as percentage of PD) increased linearly with HI. R{sub 50}-R{sub 100} and NTV{sub 50} initially declined with HI and then reached a plateau when HI was approximately 1.3. These trends also held when tumors were grouped according to their maximum diameters. The smallest tumor group (maximum diameters {<=}20 mm) had the most HI dependence for dose fall off. For treated plans, CI averaged 2.55{+-}0.79 with HI 1.23{+-}0.06; the average R{sub 50}-R{sub 100} was 0.41{+-}0.08, 0.55{+-}0.10, and 0.65{+-}0.09 cm, respectively, for tumors {<=}20 mm, between 20 and 30 mm, and >30 mm. Conclusions: Tumor dose inhomogeneity can be used as an important and convenient parameter to evaluate mMLC LINAC-based SRS plans. Sharp dose fall off in the normal tissue is achieved with sufficiently high tumor dose inhomogeneity. By adjusting beam margins, a homogeneity index of approximately 1.3 would provide best conformity for the authors' SRS system.« less

Automated collimation testing by determining the statistical correlation coefficient of Talbot self-images.

PubMed

Rana, Santosh; Dhanotia, Jitendra; Bhatia, Vimal; Prakash, Shashi

2018-04-01

In this paper, we propose a simple, fast, and accurate technique for detection of collimation position of an optical beam using the self-imaging phenomenon and correlation analysis. Herrera-Fernandez et al. [J. Opt.18, 075608 (2016)JOOPDB0150-536X10.1088/2040-8978/18/7/075608] proposed an experimental arrangement for collimation testing by comparing the period of two different self-images produced by a single diffraction grating. Following their approach, we propose a testing procedure based on correlation coefficient (CC) for efficient detection of variation in the size and fringe width of the Talbot self-images and thereby the collimation position. When the beam is collimated, the physical properties of the self-images of the grating, such as its size and fringe width, do not vary from one Talbot plane to the other and are identical; the CC is maximum in such a situation. For the de-collimated position, the size and fringe width of the self-images vary, and correspondingly the CC decreases. Hence, the magnitude of CC is a measure of degree of collimation. Using the method, we could set the collimation position to a resolution of 1 μm, which relates to ±0.25   μ    radians in terms of collimation angle (for testing a collimating lens of diameter 46 mm and focal length 300 mm). In contrast to most collimation techniques reported to date, the proposed technique does not require a translation/rotation of the grating, use of complicated phase evaluation algorithms, or an intricate method for determination of period of the grating or its self-images. The technique is fully automated and provides high resolution and precision.

Towards real-time VMAT verification using a prototype, high-speed CMOS active pixel sensor.

PubMed

Zin, Hafiz M; Harris, Emma J; Osmond, John P F; Allinson, Nigel M; Evans, Philip M

2013-05-21

This work investigates the feasibility of using a prototype complementary metal oxide semiconductor active pixel sensor (CMOS APS) for real-time verification of volumetric modulated arc therapy (VMAT) treatment. The prototype CMOS APS used region of interest read out on the chip to allow fast imaging of up to 403.6 frames per second (f/s). The sensor was made larger (5.4 cm × 5.4 cm) using recent advances in photolithographic technique but retains fast imaging speed with the sensor's regional read out. There is a paradigm shift in radiotherapy treatment verification with the advent of advanced treatment techniques such as VMAT. This work has demonstrated that the APS can track multi leaf collimator (MLC) leaves moving at 18 mm s(-1) with an automatic edge tracking algorithm at accuracy better than 1.0 mm even at the fastest imaging speed. Evaluation of the measured fluence distribution for an example VMAT delivery sampled at 50.4 f/s was shown to agree well with the planned fluence distribution, with an average gamma pass rate of 96% at 3%/3 mm. The MLC leaves motion and linac pulse rate variation delivered throughout the VMAT treatment can also be measured. The results demonstrate the potential of CMOS APS technology as a real-time radiotherapy dosimeter for delivery of complex treatments such as VMAT.

Magnetic resonance imaging for precise radiotherapy of small laboratory animals.

PubMed

Frenzel, Thorsten; Kaul, Michael Gerhard; Ernst, Thomas Michael; Salamon, Johannes; Jäckel, Maria; Schumacher, Udo; Krüll, Andreas

2017-03-01

Radiotherapy of small laboratory animals (SLA) is often not as precisely applied as in humans. Here we describe the use of a dedicated SLA magnetic resonance imaging (MRI) scanner for precise tumor volumetry, radiotherapy treatment planning, and diagnostic imaging in order to make the experiments more accurate. Different human cancer cells were injected at the lower trunk of pfp/rag2 and SCID mice to allow for local tumor growth. Data from cross sectional MRI scans were transferred to a clinical treatment planning system (TPS) for humans. Manual palpation of the tumor size was compared with calculated tumor size of the TPS and with tumor weight at necropsy. As a feasibility study MRI based treatment plans were calculated for a clinical 6MV linear accelerator using a micro multileaf collimator (μMLC). In addition, diagnostic MRI scans were used to investigate animals which did clinical poorly during the study. MRI is superior in precise tumor volume definition whereas manual palpation underestimates their size. Cross sectional MRI allow for treatment planning so that conformal irradiation of mice with a clinical linear accelerator using a μMLC is in principle feasible. Several internal pathologies were detected during the experiment using the dedicated scanner. MRI is a key technology for precise radiotherapy of SLA. The scanning protocols provided are suited for tumor volumetry, treatment planning, and diagnostic imaging. Copyright © 2016. Published by Elsevier GmbH.

A dose optimization method for electron radiotherapy using randomized aperture beams

NASA Astrophysics Data System (ADS)

Engel, Konrad; Gauer, Tobias

2009-09-01

The present paper describes the entire optimization process of creating a radiotherapy treatment plan for advanced electron irradiation. Special emphasis is devoted to the selection of beam incidence angles and beam energies as well as to the choice of appropriate subfields generated by a refined version of intensity segmentation and a novel random aperture approach. The algorithms have been implemented in a stand-alone programme using dose calculations from a commercial treatment planning system. For this study, the treatment planning system Pinnacle from Philips has been used and connected to the optimization programme using an ASCII interface. Dose calculations in Pinnacle were performed by Monte Carlo simulations for a remote-controlled electron multileaf collimator (MLC) from Euromechanics. As a result, treatment plans for breast cancer patients could be significantly improved when using randomly generated aperture beams. The combination of beams generated through segmentation and randomization achieved the best results in terms of target coverage and sparing of critical organs. The treatment plans could be further improved by use of a field reduction algorithm. Without a relevant loss in dose distribution, the total number of MLC fields and monitor units could be reduced by up to 20%. In conclusion, using randomized aperture beams is a promising new approach in radiotherapy and exhibits potential for further improvements in dose optimization through a combination of randomized electron and photon aperture beams.

SU-F-T-524: Investigation of the Dosimertric Benefits of Interchangeable Source Size of a Novel Rotating Gamma System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eldib, A; Chibani, O; Chen, L

Purpose: Tremendous technological developments were made for conformal therapy techniques with linear accelerators, while less attention was paid to cobalt-60 units. The aim of the current study is to explore the dosimetric benefits of a novel rotating gamma ray system enhanced with interchangeable source sizes and multi-leaf collimator (MLC). Material and Methods: CybeRT is a novel rotating gamma ray machine with a ring gantry that ensures an iso-center accuracy of less than 0.3 mm. The new machine has a 70cm source axial distance allowing for improved penumbra compared to conventional machines. MCBEAM was used to simulate Cobalt-60 beams from themore » CybeRT head, while the MCPLAN code was used for modeling the MLC and for phantom/patient dose calculation. The CybeRT collimation will incorporate a system allowing for interchanging source sizes. In this work we have created phase space files for 1cm and 2cm source sizes. Evaluation of the system was done by comparing CybeRT beams with the 6MV beams in a water phantom and in patient geometry. Treatment plans were compared based on isodose distributions and dose volume histograms. Results: Profiles for the 1cm source were comparable to that from 6MV in the order of 6mm for 10×10 cm{sup 2} field size at the depth of maximum dose. This could ascribe to Cobalt-60 beams producing lowerenergy secondary electrons. Although, the 2cm source have a larger penumbra however it could be still used for large targets with proportionally increased dose rate. For large lung targets, the difference between cobalt and 6MV plans is clinically insignificant. Our preliminary results showed that interchanging source sizes will allow cobalt beams for volumetric arc therapy of both small lesions and large tumors. Conclusion: The CybeRT system will be a cost effective machine capable of performing advanced radiation therapy treatments of both small tumors and large target volumes.« less

The sensitivity of patient specific IMRT QC to systematic MLC leaf bank offset errors.

PubMed

Rangel, Alejandra; Palte, Gesa; Dunscombe, Peter

2010-07-01

Patient specific IMRT QC is performed routinely in many clinics as a safeguard against errors and inaccuracies which may be introduced during the complex planning, data transfer, and delivery phases of this type of treatment. The purpose of this work is to evaluate the feasibility of detecting systematic errors in MLC leaf bank position with patient specific checks. 9 head and neck (H&N) and 14 prostate IMRT beams were delivered using MLC files containing systematic offsets (+/- 1 mm in two banks, +/- 0.5 mm in two banks, and 1 mm in one bank of leaves). The beams were measured using both MAPCHECK (Sun Nuclear Corp., Melbourne, FL) and the aS1000 electronic portal imaging device (Varian Medical Systems, Palo Alto, CA). Comparisons with calculated fields, without offsets, were made using commonly adopted criteria including absolute dose (AD) difference, relative dose difference, distance to agreement (DTA), and the gamma index. The criteria most sensitive to systematic leaf bank offsets were the 3% AD, 3 mm DTA for MAPCHECK and the gamma index with 2% AD and 2 mm DTA for the EPID. The criterion based on the relative dose measurements was the least sensitive to MLC offsets. More highly modulated fields, i.e., H&N, showed greater changes in the percentage of passing points due to systematic MLC inaccuracy than prostate fields. None of the techniques or criteria tested is sufficiently sensitive, with the population of IMRT fields, to detect a systematic MLC offset at a clinically significant level on an individual field. Patient specific QC cannot, therefore, substitute for routine QC of the MLC itself.

SU-E-J-67: Evaluation of Adaptive MLC Morphing for Online Correction of Prostate Cancer Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sandhu, R; Qin, A; Yan, D

Purpose: Online adaptive MLC morphing is desirable over translational couch shifts to accommodate target position as well as anatomic changes. A reliable method of adaptive MLC segment to target during prostate cancer IMRT treatment is proposed and evaluated by comparison with daily online-image guidance (IGRT) correction and online-IMRT planning. Methods: The MLC adaptive algorithm involves following steps; move the MLC segments according to target translational shifts, and then morph the segment shape to maintain the spatial relationship between the planning-target contour and MLC segment. Efficacy of this method was evaluated retrospectively using daily-CBCT images on seven prostate patients treated withmore » seven-beam IMRT treatment to deliver 64Gy in 20 fractions. Daily modification was simulated with three approaches; daily-IGRT correction based on implanted radio-markers, adaptive MLC morphing, and online-IMRT planning, with no-residual variation. The selected dosimetric endpoints and nEUD (normalized equivalent uniform dose to online-IMRT planning) of each organ of interest were determined for evaluation and comparison. Results: For target(prostate), bladder and rectal-wall, the mean±sd of nEUD were 97.6%+3.2%, 103.9%±4.9% and 97.4%±1.1% for daily-IGRT correction; and 100.2%+0.2%, 108.9%±5.1% and 99.8%±1.2% for adaptive MLC morphing, respectively. For daily-IGRT correction, adaptive MLC morphing and online-IMRT planning, target D99 was <95% of the prescription dose in 30%, 0% and 0% of 140 fractions, respectively. For the rectal-wall, D5 exceeded 105% of the planned-D5 in 2.8%, 11.4% and 0% of 140 fractions, respectively. For the bladder, Dmax exceeded 105% of the planned-D5 in 2.8%, 5.6% and 0% of 140 fractions, respectively. D30 of bladder and rectal-wall were well within the planned-D30 for all three approaches. Conclusion: The proposed method of adaptive MLC morphing can be beneficial for the prostate patient population with large deformation and rotation. It is superior to the daily-IGRT correction, and comparable to the online-IMRT planning for dose to the target and rectal-wall.« less

Direct aperture optimization using an inverse form of back-projection.

PubMed

Zhu, Xiaofeng; Cullip, Timothy; Tracton, Gregg; Tang, Xiaoli; Lian, Jun; Dooley, John; Chang, Sha X

2014-03-06

Direct aperture optimization (DAO) has been used to produce high dosimetric quality intensity-modulated radiotherapy (IMRT) treatment plans with fast treatment delivery by directly modeling the multileaf collimator segment shapes and weights. To improve plan quality and reduce treatment time for our in-house treatment planning system, we implemented a new DAO approach without using a global objective function (GFO). An index concept is introduced as an inverse form of back-projection used in the CT multiplicative algebraic reconstruction technique (MART). The index, introduced for IMRT optimization in this work, is analogous to the multiplicand in MART. The index is defined as the ratio of the optima over the current. It is assigned to each voxel and beamlet to optimize the fluence map. The indices for beamlets and segments are used to optimize multileaf collimator (MLC) segment shapes and segment weights, respectively. Preliminary data show that without sacrificing dosimetric quality, the implementation of the DAO reduced average IMRT treatment time from 13 min to 8 min for the prostate, and from 15 min to 9 min for the head and neck using our in-house treatment planning system PlanUNC. The DAO approach has also shown promise in optimizing rotational IMRT with burst mode in a head and neck test case.

Feasibility study of the neutron dose for real-time image-guided proton therapy: A Monte Carlo study

NASA Astrophysics Data System (ADS)

Kim, Jin Sung; Shin, Jung Suk; Kim, Daehyun; Shin, Eunhyuk; Chung, Kwangzoo; Cho, Sungkoo; Ahn, Sung Hwan; Ju, Sanggyu; Chung, Yoonsun; Jung, Sang Hoon; Han, Youngyih

2015-07-01

Two full rotating gantries with different nozzles (multipurpose nozzle with MLC, scanning dedicated nozzle) for a conventional cyclotron system are installed and being commissioned for various proton treatment options at Samsung Medical Center in Korea. The purpose of this study is to use Monte Carlo simulation to investigate the neutron dose equivalent per therapeutic dose, H/D, for X-ray imaging equipment under various treatment conditions. At first, we investigated the H/D for various modifications of the beamline devices (scattering, scanning, multi-leaf collimator, aperture, compensator) at the isocenter and at 20, 40 and 60 cm distances from the isocenter, and we compared our results with those of other research groups. Next, we investigated the neutron dose at the X-ray equipment used for real-time imaging under various treatment conditions. Our investigation showed doses of 0.07 ~ 0.19 mSv/Gy at the X-ray imaging equipment, depending on the treatment option and interestingly, the 50% neutron dose reduction was observed due to multileaf collimator during proton scanning treatment with the multipurpose nozzle. In future studies, we plan to measure the neutron dose experimentally and to validate the simulation data for X-ray imaging equipment for use as an additional neutron dose reduction method.

Synchronized moving aperture radiation therapy (SMART): superimposing tumor motion on IMRT MLC leaf sequences under realistic delivery conditions

NASA Astrophysics Data System (ADS)

Xu, Jun; Papanikolaou, Nikos; Shi, Chengyu; Jiang, Steve B.

2009-08-01

Synchronized moving aperture radiation therapy (SMART) has been proposed to account for tumor motions during radiotherapy in prior work. The basic idea of SMART is to synchronize the moving radiation beam aperture formed by a dynamic multileaf collimator (DMLC) with the tumor motion induced by respiration. In this paper, a two-dimensional (2D) superimposing leaf sequencing method is presented for SMART. A leaf sequence optimization strategy was generated to assure the SMART delivery under realistic delivery conditions. The study of delivery performance using the Varian LINAC and the Millennium DMLC showed that clinical factors such as collimator angle, dose rate, initial phase and machine tolerance affect the delivery accuracy and efficiency. An in-house leaf sequencing software was developed to implement the 2D superimposing leaf sequencing method and optimize the motion-corrected leaf sequence under realistic clinical conditions. The analysis of dynamic log (Dynalog) files showed that optimization of the leaf sequence for various clinical factors can avoid beam hold-offs which break the synchronization of SMART and fail the SMART dose delivery. Through comparison between the simulated delivered fluence map and the planed fluence map, it was shown that the motion-corrected leaf sequence can greatly reduce the dose error.

Synchronized moving aperture radiation therapy (SMART): superimposing tumor motion on IMRT MLC leaf sequences under realistic delivery conditions.

PubMed

Xu, Jun; Papanikolaou, Nikos; Shi, Chengyu; Jiang, Steve B

2009-08-21

Synchronized moving aperture radiation therapy (SMART) has been proposed to account for tumor motions during radiotherapy in prior work. The basic idea of SMART is to synchronize the moving radiation beam aperture formed by a dynamic multileaf collimator (DMLC) with the tumor motion induced by respiration. In this paper, a two-dimensional (2D) superimposing leaf sequencing method is presented for SMART. A leaf sequence optimization strategy was generated to assure the SMART delivery under realistic delivery conditions. The study of delivery performance using the Varian LINAC and the Millennium DMLC showed that clinical factors such as collimator angle, dose rate, initial phase and machine tolerance affect the delivery accuracy and efficiency. An in-house leaf sequencing software was developed to implement the 2D superimposing leaf sequencing method and optimize the motion-corrected leaf sequence under realistic clinical conditions. The analysis of dynamic log (Dynalog) files showed that optimization of the leaf sequence for various clinical factors can avoid beam hold-offs which break the synchronization of SMART and fail the SMART dose delivery. Through comparison between the simulated delivered fluence map and the planed fluence map, it was shown that the motion-corrected leaf sequence can greatly reduce the dose error.

Beam feasibility study of a collimator with in-jaw beam position monitors

NASA Astrophysics Data System (ADS)

Wollmann, Daniel; Nosych, Andriy A.; Valentino, Gianluca; Aberle, Oliver; Aßmann, Ralph W.; Bertarelli, Alessandro; Boccard, Christian; Bruce, Roderik; Burkart, Florian; Calvo, Eva; Cauchi, Marija; Dallocchio, Alessandro; Deboy, Daniel; Gasior, Marek; Jones, Rhodri; Kain, Verena; Lari, Luisella; Redaelli, Stefano; Rossi, Adriana

2014-12-01

At present, the beam-based alignment of the LHC collimators is performed by touching the beam halo with both jaws of each collimator. This method requires dedicated fills at low intensities that are done infrequently and makes this procedure time consuming. This limits the operational flexibility, in particular in the case of changes of optics and orbit configuration in the experimental regions. The performance of the LHC collimation system relies on the machine reproducibility and regular loss maps to validate the settings of the collimator jaws. To overcome these limitations and to allow a continuous monitoring of the beam position at the collimators, a design with jaw-integrated Beam Position Monitors (BPMs) was proposed and successfully tested with a prototype (mock-up) collimator in the CERN SPS. Extensive beam experiments allowed to determine the achievable accuracy of the jaw alignment for single and multi-turn operation. In this paper, the results of these experiments are discussed. The non-linear response of the BPMs is compared to the predictions from electromagnetic simulations. Finally, the measured alignment accuracy is compared to the one achieved with the present collimators in the LHC.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hussain, A

Purpose: Novel linac machines, TrueBeam (TB) and Elekta Versa have updated head designing and software control system, include flattening-filter-free (FFF) photon and electron beams. Later on FFF beams were also introduced on C-Series machines. In this work FFF beams for same energy 6MV but from different machine versions were studied with reference to beam data parameters. Methods: The 6MV-FFF percent depth doses, profile symmetry and flatness, dose rate tables, and multi-leaf collimator (MLC) transmission factors were measured during commissioning process of both C-series and Truebeam machines. The scanning and dosimetric data for 6MV-FFF beam from Truebeam and C-Series linacs wasmore » compared. A correlation of 6MV-FFF beam from Elekta Versa with that of Varian linacs was also found. Results: The scanning files were plotted for both qualitative and quantitative analysis. The dosimetric leaf gap (DLG) for C-Series 6MV-FFF beam is 1.1 mm. Published values for Truebeam dosimetric leaf gap is 1.16 mm. 6MV MLC transmission factor varies between 1.3 % and 1.4 % in two separate measurements and measured DLG values vary between 1.32 mm and 1.33 mm on C-Series machine. MLC transmission factor from C-Series machine varies between 1.5 % and 1.6 %. Some of the measured data values from C-Series FFF beam are compared with Truebeam representative data. 6MV-FFF beam parameter values like dmax, OP factors, beam symmetry and flatness and additional parameters for C-Series and Truebeam liancs will be presented and compared in graphical form and tabular data form if selected. Conclusion: The 6MV flattening filter (FF) beam data from C-Series & Truebeam and 6MV-FFF beam data from Truebeam has already presented. This particular analysis to compare 6MV-FFF beam from C-Series and Truebeam provides opportunity to better elaborate FFF mode on novel machines. It was found that C-Series and Truebeam 6MV-FFF dosimetric and beam data was quite similar.« less

SU-E-T-545: A MLC-Equipped Robotic Radiosurgery-Radiotherapy Combined System in Treating Hepatic Lesions: Delivery Efficiency as Compared to a Standard Linac for Treating Hepatic Lesions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jin, L; Price, R; Wang, L

Purpose: The CyberKnife (CK) M6 Series introduced a mulitleaf collimator (MLC) beam for extending its capability to the conventional radiotherapy. This work is to investigate delivery efficiency of this system as compared to a standard Varian linac when treating hepatic lesions. Methods: Nine previously treated patients were divided into three groups with three patients in each. Group one: fractionated radiotherapy; Group two: SBRT-like treatments and Group three: fractionated radiotherapy targeting two PTVs. The clinically used plans were generated with the Eclipse treatment planning system (TPS). We re-planned these cases using a Mulitplan (MP) TPS for the CK M6 and normalizedmore » to the same PTV dose coverage. CK factors (CF) (defined as modulation scaling factor in this work), number of nodes (NN), number of MLC segments (NS) and beam delivery time (BT) with an estimated image interval of 60 seconds, were used for evaluation of delivery efficiency. Results: Generated plans from the MP and Eclipse TPS demonstrated the similar quality in terms of PTV confomality index, minimum and maximum PTV doses, and doses received by critical structures. Group one: CF ranged from 8.1 to 8.7, NN from 30 to 40, NS from 120 to 155 and BT from 20 to 23 minutes; group two: CF from 4.7 to 8.5, NN from 15 to 19, NS from 82 to 141 and BT from 18 to 24 minutes; and group three: CF from 7.9 to 10, NN from 47 to 49, NS from 110 to 113 and BT from 20 to 22 minutes. Conclusions: Delivery time is longer for the CK M6 than for the Varian linac (7.8 to 13.7 minutes). Further investigation will be necessary to determine if a PTV reduction from the tracking feature will shorten the delivery time without decreasing plan quality.« less

Independent Monte-Carlo dose calculation for MLC based CyberKnife radiotherapy

NASA Astrophysics Data System (ADS)

Mackeprang, P.-H.; Vuong, D.; Volken, W.; Henzen, D.; Schmidhalter, D.; Malthaner, M.; Mueller, S.; Frei, D.; Stampanoni, M. F. M.; Dal Pra, A.; Aebersold, D. M.; Fix, M. K.; Manser, P.

2018-01-01

This work aims to develop, implement and validate a Monte Carlo (MC)-based independent dose calculation (IDC) framework to perform patient-specific quality assurance (QA) for multi-leaf collimator (MLC)-based CyberKnife® (Accuray Inc., Sunnyvale, CA) treatment plans. The IDC framework uses an XML-format treatment plan as exported from the treatment planning system (TPS) and DICOM format patient CT data, an MC beam model using phase spaces, CyberKnife MLC beam modifier transport using the EGS++ class library, a beam sampling and coordinate transformation engine and dose scoring using DOSXYZnrc. The framework is validated against dose profiles and depth dose curves of single beams with varying field sizes in a water tank in units of cGy/Monitor Unit and against a 2D dose distribution of a full prostate treatment plan measured with Gafchromic EBT3 (Ashland Advanced Materials, Bridgewater, NJ) film in a homogeneous water-equivalent slab phantom. The film measurement is compared to IDC results by gamma analysis using 2% (global)/2 mm criteria. Further, the dose distribution of the clinical treatment plan in the patient CT is compared to TPS calculation by gamma analysis using the same criteria. Dose profiles from IDC calculation in a homogeneous water phantom agree within 2.3% of the global max dose or 1 mm distance to agreement to measurements for all except the smallest field size. Comparing the film measurement to calculated dose, 99.9% of all voxels pass gamma analysis, comparing dose calculated by the IDC framework to TPS calculated dose for the clinical prostate plan shows 99.0% passing rate. IDC calculated dose is found to be up to 5.6% lower than dose calculated by the TPS in this case near metal fiducial markers. An MC-based modular IDC framework was successfully developed, implemented and validated against measurements and is now available to perform patient-specific QA by IDC.

SU-F-T-402: The Effect of Extremely Narrow MLC Leaf Width On the Plan Quality of VMAT for Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, J; Park, S; Kim, J

2016-06-15

Purpose: To investigate the effect of multi-leaf collimators (MLCs) with leaf width of 1.25 mm on the plan quality of volumetric modulated arc therapy (VMAT) for prostate cancer. Methods: A total of 20 patients with prostate cancer were retrospectively selected. Using a high definition MLC (HD MLC), primary and boost VMAT plans with two full arcs were generated for each patient (original plan). After that, by shifting patient CT images by 1.25 mm in the cranio-caudal direction between the 1st and the 2nd arc, we simulated fluences made with MLCs with leaf width of 1.25 mm. After shifting, primary andmore » boost plans were generated for each patient (shifted plan). A sum plan was generated by summation of the primary and boost plan for each patient. Dose-volumetric parameters were calculated and compared. Results: Both homogeneity index (HI) and conformity index (CI) of the shifted plans were better than those of the original plans in primary plans (HI = 0.044 vs. 0.040 with p < 0.001 and CI = 1.056 vs. 1.044 with p = 0.006). Similarly, the shifted plans for boost target volume showed better homogeneity and conformity than did the original plans (HI = 0.042 vs. 0.037 with p = 0.006 and CI = 1.015 vs. 1.009 with p < 0.001). The total body volumes of the original plans irradiated by the prescription dose were larger than those of the shifted plans in sum plans (60.9 cc vs. 49.0 cc with p = 0.007). Conclusion: Use of extremely narrow MLCs could increase dose homogeneity and conformity of the target volume for prostate VMAT. This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No. 2015R1C1A1A02036331).« less

Improvement of VMAT plan quality for head and neck cancer with high resolution fluences generated by couch shift between arcs.

PubMed

Park, Jong Min; Park, So-Yeon; Wu, Hong-Gyun; Kim, Jung-In

2018-02-01

To investigate the changes in quality of the volumetric modulated arc therapy (VMAT) plans with couch-shift between arcs by half of a multi-leaf collimator (MLC) leaf width. A total of 22 patients with head-and-neck cancer were retrospectively selected. Since the smallest MLC leaf width was 5 mm in this study, the couch was shifted by 2.5 mm in the longitudinal-direction between arcs to increase the resolution of fluence map. A total of three types of VMAT plans were generated for each patient; the three types of plans were a two-full-arc plan without couch-shift (NS plan), a two-half-arc-pair plan with couch-shift (HAS plan), and a two-full-arc pair plan with couch-shift (FAS plan). Changes in the dose-volumetric parameters were investigated. The FAS plan showed the best plan quality for the target volumes and organs at risk compared to the NS and HAS plans. However, the magnitudes of differences among the three types of plans were minimal, and every plan was clinically acceptable. The average integral doses of the NS, HAS, and FAS plans were 160,549 ± 37,600 Gy-cc, 147,828 ± 33,343 Gy-cc, and 156,030 ± 36,263 Gy-cc, respectively. The average monitor unit of the NS, HAS, and FAS plans were 717 ± 120 MU, 648 ± 100 MU, and 763 ± 158 MU, respectively. The HAS plan was better than the others in terms of normal tissue sparing and plan efficiency. By shifting the couch by half of the MLC leaf width in the longitudinal direction between arcs, the VMAT plan quality could be improved. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wijesooriya, K; Seitter, K; Desai, V

Purpose: To present our single institution experience on catching errors with trajectory log file analysis. The reported causes of failures, probability of occurrences (O), severity of effects (S), and the probability of the failures to be undetected (D) could be added to guidelines of FMEA analysis. Methods: From March 2013 to March 2014, 19569 patient treatment fields/arcs were analyzed. This work includes checking all 131 treatment delivery parameters for all patients, all treatment sites and all treatment delivery fractions. TrueBeam trajectory log files for all treatment field types as well as all imaging types were accessed, read in every 20ms,more » and every control point (total of 37 million parameters) compared to the physician approved plan in the planning system. Results: Couch angle outlier occurrence: N= 327, range = −1.7 −1.2 deg; gantry angle outlier occurrence: N =59, range = 0.09 – 5.61 deg, collimator angle outlier occurrence: N = 13, range = −0.2 – 0.2 deg. VMAT cases have slightly larger variations in mechanical parameters. MLC: 3D single control point fields have a maximum deviation of 0.04 mm, 39 step and shoot IMRT cases have MLC −0.3 – 0.5 mm deviations, all (1286) VMAT cases have −0.9 – 0.7 mm deviations. Two possible serious errors were found: 1) A 4 cm isocenter shift for the PA beam of an AP-PA pair, under-dosing a portion of PTV by 25%. 2) Delivery with MLC leaves abutted behind the jaws as opposed to the midline as planned, leading to a under-dosing of a small volume of the PTV by 25%, by just the boost plan. Due to their error origin, neither of these errors could have been detected by pre-treatment verification. Conclusion: Performing Trajectory Log file analysis could catch typically undetected errors to avoid potentially adverse incidents.« less

Estimating the uncertainty of calculated out-of-field organ dose from a commercial treatment planning system.

PubMed

Wang, Lilie; Ding, George X

2018-06-12

Therapeutic radiation to cancer patients is accompanied by unintended radiation to organs outside the treatment field. It is known that the model-based dose algorithm has limitation in calculating the out-of-field doses. This study evaluated the out-of-field dose calculated by the Varian Eclipse treatment planning system (v.11 with AAA algorithm) in realistic treatment plans with the goal of estimating the uncertainties of calculated organ doses. Photon beam phase-space files for TrueBeam linear accelerator were provided by Varian. These were used as incident sources in EGSnrc Monte Carlo simulations of radiation transport through the downstream jaws and MLC. Dynamic movements of the MLC leaves were fully modeled based on treatment plans using IMRT or VMAT techniques. The Monte Carlo calculated out-of-field doses were then compared with those calculated by Eclipse. The dose comparisons were performed for different beam energies and treatment sites, including head-and-neck, lung, and pelvis. For 6 MV (FF/FFF), 10 MV (FF/FFF), and 15 MV (FF) beams, Eclipse underestimated out-of-field local doses by 30%-50% compared with Monte Carlo calculations when the local dose was <1% of prescribed dose. The accuracy of out-of-field dose calculations using Eclipse is improved when collimator jaws were set at the smallest possible aperture for MLC openings. The Eclipse system consistently underestimates out-of-field dose by a factor of 2 for all beam energies studied at the local dose level of less than 1% of prescribed dose. These findings are useful in providing information on the uncertainties of out-of-field organ doses calculated by Eclipse treatment planning system. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

A stochastic convolution/superposition method with isocenter sampling to evaluate intrafraction motion effects in IMRT.

PubMed

Naqvi, Shahid A; D'Souza, Warren D

2005-04-01

Current methods to calculate dose distributions with organ motion can be broadly classified as "dose convolution" and "fluence convolution" methods. In the former, a static dose distribution is convolved with the probability distribution function (PDF) that characterizes the motion. However, artifacts are produced near the surface and around inhomogeneities because the method assumes shift invariance. Fluence convolution avoids these artifacts by convolving the PDF with the incident fluence instead of the patient dose. In this paper we present an alternative method that improves the accuracy, generality as well as the speed of dose calculation with organ motion. The algorithm starts by sampling an isocenter point from a parametrically defined space curve corresponding to the patient-specific motion trajectory. Then a photon is sampled in the linac head and propagated through the three-dimensional (3-D) collimator structure corresponding to a particular MLC segment chosen randomly from the planned IMRT leaf sequence. The photon is then made to interact at a point in the CT-based simulation phantom. Randomly sampled monoenergetic kernel rays issued from this point are then made to deposit energy in the voxels. Our method explicitly accounts for MLC-specific effects (spectral hardening, tongue-and-groove, head scatter) as well as changes in SSD with isocentric displacement, assuming that the body moves rigidly with the isocenter. Since the positions are randomly sampled from a continuum, there is no motion discretization, and the computation takes no more time than a static calculation. To validate our method, we obtained ten separate film measurements of an IMRT plan delivered on a phantom moving sinusoidally, with each fraction starting with a random phase. For 2 cm motion amplitude, we found that a ten-fraction average of the film measurements gave an agreement with the calculated infinite fraction average to within 2 mm in the isodose curves. The results also corroborate the existing notion that the interfraction dose variability due to the interplay between the MLC motion and breathing motion averages out over typical multifraction treatments. Simulation with motion waveforms more representative of real breathing indicate that the motion can produce penumbral spreading asymmetric about the static dose distributions. Such calculations can help a clinician decide to use, for example, a larger margin in the superior direction than in the inferior direction. In the paper we demonstrate that a 15 min run on a single CPU can readily illustrate the effect of a patient-specific breathing waveform, and can guide the physician in making informed decisions about margin expansion and dose escalation.

Dependence of cross-bridge kinetics on myosin light chain isoforms in rabbit and rat skeletal muscle fibres.

PubMed

Andruchov, Oleg; Andruchova, Olena; Wang, Yishu; Galler, Stefan

2006-02-15

Cross-bridge kinetics underlying stretch-induced force transients was studied in fibres with different myosin light chain (MLC) isoforms from skeletal muscles of rabbit and rat. The force transients were induced by stepwise stretches (< 0.3% of fibre length) applied on maximally Ca2+-activated skinned fibres. Fast fibre types IIB, IID (or IIX) and IIA and the slow fibre type I containing the myosin heavy chain isoforms MHC-IIb, MHC-IId (or MHC-IIx), MHC-IIa and MHC-I, respectively, were investigated. The MLC isoform content varied within fibre types. Fast fibre types contained the fast regulatory MLC isoform MLC2f and different proportions of the fast alkali MLC isoforms MLC1f and MLC3f. Type I fibres contained the slow regulatory MLC isoform MLC2s and the slow alkali MLC isoform MLC1s. Slow MLC isoforms were also present in several type IIA fibres. The kinetics of force transients differed by a factor of about 30 between fibre types (order from fastest to slowest kinetics: IIB > IID > IIA > I). The kinetics of the force transients was not dependent on the relative content of MLC1f and MLC3f. Type IIA fibres containing fast and slow MLC isoforms were about 1.2 times slower than type IIA fibres containing only fast MLC isoforms. We conclude that while the cross-bridge kinetics is mainly determined by the MHC isoforms present, it is affected by fast and slow MLC isoforms but not by the relative content of MLC1f and MLC3f. Thus, the physiological role of fast and slow MLC isoforms in type IIA fibres is a fine-tuning of the cross-bridge kinetics.

The effect of iron on metronidazole activity against Trichomonas vaginalis in vitro.

PubMed

Elwakil, Hala Salah; Tawfik, Rania Ayman; Alam-Eldin, Yosra Hussein; Nassar, Doaa Ashraf

2017-11-01

Metronidazole is administered in an inactive form then activated to its cytotoxic form within the hydrogenosome of trichomonads. Two hydrogenosomal proteins, pyruvate ferredoxin oxidoreductase (PFOR) and ferredoxin, play a critical role in the reductive activation of metronidazole. The expression of these proteins and other hydrogenosomal proteins are likewise positively regulated by iron. In the present study, the effect of iron on minimal lethal concentration (MLC) of metronidazole on in vitro cultured Trichomonas vaginalis(T. vaginalis) isolates was investigated. Interestingly, Addition of Ferrous ammonium sulphate (FAS) to T. vaginalis culture led to decrease in the MLC of metronidazole. On using aerobic assay, MLC of metronidazole on untreated T. vaginalis of both isolates was 12.5 μg/ml that decreased to 0.38 μg/ml on FAS treated trichomonads. Also anaerobic assay revealed that MLC on untreated parasites was 3.12 μg/ml that decreased to 0.097 μg/ml and 0.19 μg/ml for isolate 1 and isolate 2 respectively after iron addition. It was concluded that, addition of iron to in vitro cultured T. vaginalis decreases metronidazole MLC that was detected by both aerobic and anaerobic assays. Copyright © 2017 Elsevier Inc. All rights reserved.

TH-AB-202-05: BEST IN PHYSICS (JOINT IMAGING-THERAPY): First Online Ultrasound-Guided MLC Tracking for Real-Time Motion Compensation in Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ipsen, S; Bruder, R; Schweikard, A

Purpose: While MLC tracking has been successfully used for motion compensation of moving targets, current real-time target localization methods rely on correlation models with x-ray imaging or implanted electromagnetic transponders rather than direct target visualization. In contrast, ultrasound imaging yields volumetric data in real-time (4D) without ionizing radiation. We report the first results of online 4D ultrasound-guided MLC tracking in a phantom. Methods: A real-time tracking framework was installed on a 4D ultrasound station (Vivid7 dimension, GE) and used to detect a 2mm spherical lead marker inside a water tank. The volumetric frame rate was 21.3Hz (47ms). The marker wasmore » rigidly attached to a motion stage programmed to reproduce nine tumor trajectories (five prostate, four lung). The 3D marker position from ultrasound was used for real-time MLC aperture adaption. The tracking system latency was measured and compensated by prediction for lung trajectories. To measure geometric accuracy, anterior and lateral conformal fields with 10cm circular aperture were delivered for each trajectory. The tracking error was measured as the difference between marker position and MLC aperture in continuous portal imaging. For dosimetric evaluation, 358° VMAT fields were delivered to a biplanar diode array dosimeter using the same trajectories. Dose measurements with and without MLC tracking were compared to a static reference dose using a 3%/3 mm γ-test. Results: The tracking system latency was 170ms. The mean root-mean-square tracking error was 1.01mm (0.75mm prostate, 1.33mm lung). Tracking reduced the mean γ-failure rate from 13.9% to 4.6% for prostate and from 21.8% to 0.6% for lung with high-modulation VMAT plans and from 5% (prostate) and 18% (lung) to 0% with low modulation. Conclusion: Real-time ultrasound tracking was successfully integrated with MLC tracking for the first time and showed similar accuracy and latency as other methods while holding the potential to measure target motion non-invasively. SI was supported by the Graduate School for Computing in Medicine and Life Science, German Excellence Initiative [grant DFG GSC 235/1].« less

TU-C-17A-05: Dose Domain Optimization of MLC Leaf Patterns for Highly Complicated 4Ï€ IMRT Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nguyen, D; Yu, V; Ruan, D

Purpose: Highly conformal non-coplanar 4π radiotherapy plans typically require more than 20 intensity-modulated fields to deliver. A novel method to calculate multileaf collimator (MLC) leaf patterns is introduced to maximize delivery efficiency, accuracy and plan quality. Methods: 4 GBM patients, with a prescription dose of 59.4 Gy or 60 Gy, were evaluated using the 4π algorithm using 20 beams. The MLC calculation utilized a least square minimization of the dose distribution, with an anisotropic total variation regularization term to encourage piecewise continuity in the fluence maps. Transforming the fluence to the dose domain required multiplying the fluence with a sparsemore » matrix. Exploiting this property made it feasible to solve the problem using CVX, a MATLAB-based convex modeling framework. The fluence was stratified into even step sizes, and the MLC segments, limited to 300, were calculated. The patients studied were replanned using Eclipse with the same beam angles. Results: Compared to the original 4π plan, the stratified 4π plan increased the maximum/mean dose for, in Gy, by 1.0/0.0 (brainstem), 0.5/0.2 (chiasm), 0.0/0.0 (spinal cord), 1.9/0.3 (L eye), 0.7/0.2 (R eye), 0.4/0.4 (L lens), 0.3/0.3 (R lens), 1.0/0.8 (L Optical Nerve), 0.5/0.3 (R Optical Nerve), 0.3/0.2 (L Cochlea), 0.1/0.1 (R Cochlea), 4.6/0.2 (brain), 2.4/0.1 (brain-PTV), 5.1/0.9 (PTV). Compared to Eclipse, which generated an average of 607 segments, the stratified plan reduced (−) or increased (+) the maximum/mean dose, in Gy, by −10.2/−4.1 (brainstem), −10.5/−8.9 (chiasm), +0.0/−0.1 (spinal cord), −4.9/−3.4 (L eye), −4.1/−2.5 (R eye), −2.8/−2.7 (L lens), −2.1/−1.9 (R lens), −7.6/−6.5 (L Optical Nerve), −8.9/−6.1 (R Optical Nerve), −1.3/−1.9 (L Cochlea), −1.8/−1.8 (R Cochlea), +1.7/−2.1 (brain), +3.2/−2.6 (brain-PTV), +1.8/+0.3 Gy (PTV. The stratified plan was also more homogeneous in the PTV. Conclusion: This novel solver can transform complicated fluence maps into significantly fewer deliverable MLC segments than the commercial system while achieving superior dosimetry. Funding support partially contributed by Varian.« less

Megalencephalic leukoencephalopathy with subcortical cysts: Characterization of disease variants.

PubMed

Hamilton, Eline M C; Tekturk, Pinar; Cialdella, Fia; van Rappard, Diane F; Wolf, Nicole I; Yalcinkaya, Cengiz; Çetinçelik, Ümran; Rajaee, Ahmad; Kariminejad, Ariana; Paprocka, Justyna; Yapici, Zuhal; Bošnjak, Vlatka Mejaški; van der Knaap, Marjo S

2018-04-17

To provide an overview of clinical and MRI characteristics of the different variants of the leukodystrophy megalencephalic leukoencephalopathy with subcortical cysts (MLC) and identify possible differentiating features. We performed an international multi-institutional, cross-sectional observational study of the clinical and MRI characteristics in patients with genetically confirmed MLC. Clinical information was obtained by questionnaires for physicians and retrospective chart review. We included 204 patients with classic MLC, 187 of whom had recessive mutations in MLC1 (MLC1 variant) and 17 in GLIALCAM (MLC2A variant) and 38 patients with remitting MLC caused by dominant GLIALCAM mutations (MLC2B variant). We observed a relatively wide variability in neurologic disability among patients with classic MLC. No clinical differences could be identified between patients with MLC1 and MLC2A. Patients with MLC2B invariably had a milder phenotype with preservation of motor function, while intellectual disability and autism were relatively frequent. Systematic MRI review revealed no MRI features that distinguish between MLC1 and MLC2A. Radiologic improvement was observed in all patients with MLC2B and also in 2 patients with MLC1. In MRIs obtained in the early disease stage, absence of signal abnormalities of the posterior limb of the internal capsule and cerebellar white matter and presence of only rarefied subcortical white matter instead of true subcortical cysts were suggestive of MLC2B. Clinical and MRI features did not distinguish between classic MLC with MLC1 or GLIALCAM mutations. Absence of signal abnormalities of the internal capsule and cerebellar white matter are MRI findings that point to the remitting phenotype. Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Treatment plan comparison between helical tomotherapy and MLC-based IMRT using radiobiological measures

NASA Astrophysics Data System (ADS)

Mavroidis, Panayiotis; Costa Ferreira, Brigida; Shi, Chengyu; Lind, Bengt K.; Papanikolaou, Nikos

2007-07-01

The rapid implementation of advanced treatment planning and delivery technologies for radiation therapy has brought new challenges in evaluating the most effective treatment modality. Intensity-modulated radiotherapy (IMRT) using multi-leaf collimators (MLC) and helical tomotherapy (HT) are becoming popular modes of treatment delivery and their application and effectiveness continues to be investigated. Presently, there are several treatment planning systems (TPS) that can generate and optimize IMRT plans based on user-defined objective functions for the internal target volume (ITV) and organs at risk (OAR). However, the radiobiological parameters of the different tumours and normal tissues are typically not taken into account during dose prescription and optimization of a treatment plan or during plan evaluation. The suitability of a treatment plan is typically decided based on dosimetric criteria such as dose-volume histograms (DVH), maximum, minimum, mean and standard deviation of the dose distribution. For a more comprehensive treatment plan evaluation, the biologically effective uniform dose ({\\bar{\\bar{D}}}) is applied together with the complication-free tumour control probability (P+). Its utilization is demonstrated using three clinical cases that were planned with two different forms of IMRT. In this study, three different cancer types at different anatomical sites were investigated: head and neck, lung and prostate cancers. For each cancer type, a linac MLC-based step-and-shoot IMRT plan and a HT plan were developed. The MLC-based IMRT treatment plans were developed on the Philips treatment-planning platform, using the Pinnacle 7.6 software release. For the tomotherapy HiArt plans, the dedicated tomotherapy treatment planning station was used, running version 2.1.2. By using {\\bar{\\bar{D}}} as the common prescription point of the treatment plans and plotting the tissue response probabilities versus {\\bar{\\bar{D}}} for a range of prescription doses, a number of plan trials can be compared based on radiobiological measures. The applied plan evaluation method shows that in the head and neck cancer case the HT treatment gives better results than MLC-based IMRT in terms of expected clinical outcome (P+ of 62.2% and 46.0%, {\\bar{\\bar{D}}} to the ITV of 72.3 Gy and 70.7 Gy, respectively). In the lung cancer and prostate cancer cases, the MLC-based IMRT plans are better over the clinically useful dose prescription range. For the lung cancer case, the HT and MLC-based IMRT plans give a P+ of 66.9% and 72.9%, {\\bar{\\bar{D}}} to the ITV of 64.0 Gy and 66.9 Gy, respectively. Similarly, for the prostate cancer case, the two radiation modalities give a P+ of 68.7% and 72.2%, {\\bar{\\bar{D}}} to the ITV of 86.0 Gy and 85.9 Gy, respectively. If a higher risk of complications (higher than 5%) could be allowed, the complication-free tumour control could increase by over 40%, 2% and 30% compared to the initial dose prescription for the three cancer cases, respectively. Both MLC-based IMRT and HT can encompass the often-large ITV required while they minimize the volume of the organs at risk receiving high doses. Radiobiological evaluation of treatment plans may provide an improved correlation of the delivered treatment with the clinical outcome by taking into account the dose-response characteristics of the irradiated targets and normal tissues. There may exist clinical cases, which may look dosimetrically similar but in radiobiological terms may be quite different. In such situations, traditional dose-based evaluation tools can be complemented by the use of P_ +{-}{\\bar{\\bar{D}}} diagrams to effectively evaluate and compare treatment plans.

The value of thyroid shielding in intraoral radiography

PubMed Central

Hazenoot, Bart; Sanderink, Gerard C H; Berkhout, W Erwin R

2016-01-01

Objectives: To evaluate the utility of the application of a thyroid shield in intraoral radiography when using rectangular collimation. Methods: Experimental data were obtained by measuring the absorbed dose at the position of the thyroid gland in a RANDO® (The Phantom Laboratory, Salem, NY) male phantom with a dosemeter. Four protocols were tested: round collimation and rectangular collimation, both with and without thyroid shield. Five exposure positions were deployed: upper incisor (Isup), upper canine (Csup), upper premolar (Psup), upper molar (Msup) and posterior bitewing (BW). Exposures were made with 70 kV and 7 mA and were repeated 10 times. The exposure times were as recommended for the exposure positions for the respective collimator type by the manufacturer for digital imaging. The data were statistically analyzed with a three-way ANOVA test. Significance was set at p < 0.01. Results: The ANOVA test revealed that the differences between mean doses of all protocols and geometries were statistically significant, p < 0.001. For the Isup, thyroid dose levels were comparable with both collimators at a level indicating primary beam exposure. Thyroid shield reduced this dose with circa 75%. For the Csup position, round collimation also revealed primary beam exposure, and thyroid shield yield was 70%. In Csup with rectangular collimation, the thyroid dose was reduced with a factor 4 compared with round collimation and thyroid shield yielded an additional 42% dose reduction. The thyroid dose levels for the Csup, Psup, Msup and BW exposures were lower with rectangular collimation without thyroid shield than with round collimation with thyroid shield. With rectangular collimation, the thyroid shield in Psup, Msup and BW reduced the dose 10% or less, where dose levels were already low, implying no clinical significance. Conclusions: For the exposures in the upper anterior region, thyroid shield results in an important dose reduction for the thyroid. For the other exposures, thyroid shield augments little to the reduction achieved by rectangular collimation. The use of thyroid shield is to be advised, when performing upper anterior radiography. PMID:27008105

SU-G-BRB-10: New Generation of High Frame-Rate and High Spatial-Resolution EPID QA System for Full-Body MLC-Based Robotic Radiosurgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Han, B; Xing, L; Wang, L

Purpose: To systematically investigate an ultra-high spatial-resolution amorphous silicon flat-panel electronic portal imaging device (EPID) for MLC-based full-body robotic radiosurgery geometric and dosimetric quality assurance (QA). Methods: The high frame-rate and ultra-high spatial resolution EPID is an outstanding detector for measuring profiles, MLC-shaped radiosurgery field aperture verification, and small field dosimetry. A Monte Carlo based technique with a robotic linac specific response and calibration is developed to convert a raw EPID-measured image of a radiosurgery field into water-based dose distribution. The technique is applied to measure output factors and profiles for 6MV MLC-defined radiosurgery fields with various sizes ranging frommore » 7.6mm×7.7mm to 100mm×100.1mm and the results are compared with the radiosurgery diode scan measurements in water tank. The EPID measured field sizes and the penumbra regions are analyzed to evaluate the MLC positioning accuracy. Results: For all MLC fields, the EPID measured output factors of MLC-shaped fields are in good agreement with the diode measurements. The mean output difference between the EPID and diode measurement is 0.05±0.87%. The max difference is −1.33% for 7.6mm×7.7mm field. The MLC field size derived from the EPID measurements are in good agreement comparing to the diode scan result. For crossline field sizes, the mean difference is −0.17mm±0.14mm with a maximum of −0.35mm for the 30.8mm×30.8mm field. For inline field sizes, the mean difference is +0.08mm±0.18mm with a maximum of +0.45mm for the 100mm×100.1mm field. The high resolution EPID is able to measure the whole radiation field, without the need to align the detector center perfectly at field center as diode or ion chamber measurement. The setup time is greatly reduced so that the whole process is possible for machine and patient-specific QA. Conclusion: The high spatial-resolution EPID is proved to be an accurate and efficient tool for QA of MLC-equipped robotic radiosurgery system.« less

The performance of a wire mesh collimator SPECT camera for different breast volumes in prone position

NASA Astrophysics Data System (ADS)

Roslan, R. E.; Saad, W. H. Mohd; Saripan, M. I.; Hashim, S.; Choong, W.-S.

2010-07-01

The multihole collimator is the most commonly used collimator in conventional SPECT cameras for general purpose imaging. However, there are some limitations with this collimator, which includes the lack of sensitivity as a trade-off for obtaining better spatial resolution. This paper looks at the performance of a wire mesh collimator that was introduced recently in order to improve the ability of SPECT cameras in mapping breast cancer cells, utilizing the Technetium-99 m 140 keV radiotracer. In this work, various volumes of breast are modelled and simulated using Monte Carlo N-Particle (MCNP5) code, derived based on the real cup sizes and volumes in prone position. The size of tumour is 1 cm in diameter with tumour to background ratios (TBRs) ranging between TBR from 1:1 to TBR 20:1, and located 2 cm inside breast skin. The results show that wire mesh collimator 1 (WM-1) has the highest sensitivity and signal to noise ratio (SNR) in comparison with wire mesh collimator 2 (WM-2) and the multihole collimator (MHC). This indicates the potential of using a wire mesh collimator for early mapping of breast cancer cells.

Underestimation of Low-Dose Radiation in Treatment Planning of Intensity-Modulated Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jang, Si Young; Liu, H. Helen; Mohan, Radhe

2008-08-01

Purpose: To investigate potential dose calculation errors in the low-dose regions and identify causes of such errors for intensity-modulated radiotherapy (IMRT). Methods and Materials: The IMRT treatment plans of 23 patients with lung cancer and mesothelioma were reviewed. Of these patients, 15 had severe pulmonary complications after radiotherapy. Two commercial treatment-planning systems (TPSs) and a Monte Carlo system were used to calculate and compare dose distributions and dose-volume parameters of the target volumes and critical structures. The effect of tissue heterogeneity, multileaf collimator (MLC) modeling, beam modeling, and other factors that could contribute to the differences in IMRT dose calculationsmore » were analyzed. Results: In the commercial TPS-generated IMRT plans, dose calculation errors primarily occurred in the low-dose regions of IMRT plans (<50% of the radiation dose prescribed for the tumor). Although errors in the dose-volume histograms of the normal lung were small (<5%) above 10 Gy, underestimation of dose <10 Gy was found to be up to 25% in patients with mesothelioma or large target volumes. These errors were found to be caused by inadequate modeling of MLC transmission and leaf scatter in commercial TPSs. The degree of low-dose errors depends on the target volumes and the degree of intensity modulation. Conclusions: Secondary radiation from MLCs contributes a significant portion of low dose in IMRT plans. Dose underestimation could occur in conventional IMRT dose calculations if such low-dose radiation is not properly accounted for.« less

[Overexpression of LaeA enhances mevastatin production and reduces sporulation of Penicillium citrinum].

PubMed

Zheng, Yueliang; Cao, Shuang; Huang, Yuqi; Liao, Guojian; Hu, Changhua

2014-12-04

To study the regulation of laeA overexpression on mevastatin production and sporulation in Penicillium citrinum. We cloned the laeA gene from Penicillium citrinum and constructed the vector pGiHTGi-laeA. The plasmid pGiHTGi-laeA was transformed in Penicillium citrinum by agrobacterium tumefaciens-mediated transformation. Positive transformants were detected by cloning the hygromycin gene. The mevastatin production of the wild type and OE:: laeA was compared by HPLC. The conidia number was counted by blood counting chamber. The biosynthetic gene cluster expression quantity of mevastatin in the wild type and OE: :laeA were analyzed by qRT-PCR. We constructed the plasmid pGiHTGi-laeA, and screened the positive transformants that overexpress the laeA in Penicillium citrinum. With the overexpression of laeA, the mevastatin production was increased from (0.69 ± 0.12) mg/g to (4.02 ± 0.50) mg/g dry cell weight. Compared to the wild type strain, the laeA expression quantity in the OE :: laeA strain increased 29%, and the mlcB expression increased 72%, the mlcR expression increased 153%. Moreover, the overexpression of laeA would decrease the conidia number. Overexpression of LaeA enhances mevastatin production and reduces sporulation of Penicillium citrinum, with increases expression of pathway-regulator mlcR, and biosynthetic gene MlcR. These results could guide global regulatory mechanism of mevastatin biosynthesis and the exploitation of high-production strain.

Final implementation, commissioning, and performance of embedded collimator beam position monitors in the Large Hadron Collider

NASA Astrophysics Data System (ADS)

Valentino, Gianluca; Baud, Guillaume; Bruce, Roderik; Gasior, Marek; Mereghetti, Alessio; Mirarchi, Daniele; Olexa, Jakub; Redaelli, Stefano; Salvachua, Belen; Valloni, Alessandra; Wenninger, Jorg

2017-08-01

During Long Shutdown 1, 18 Large Hadron Collider (LHC) collimators were replaced with a new design, in which beam position monitor (BPM) pick-up buttons are embedded in the collimator jaws. The BPMs provide a direct measurement of the beam orbit at the collimators, and therefore can be used to align the collimators more quickly than using the standard technique which relies on feedback from beam losses. Online orbit measurements also allow for reducing operational margins in the collimation hierarchy placed specifically to cater for unknown orbit drifts, therefore decreasing the β* and increasing the luminosity reach of the LHC. In this paper, the results from the commissioning of the embedded BPMs in the LHC are presented. The data acquisition and control software architectures are reviewed. A comparison with the standard alignment technique is provided, together with a fill-to-fill analysis of the measured orbit in different machine modes, which will also be used to determine suitable beam interlocks for a tighter collimation hierarchy.

Forskolin induces myosin light chain dephosphorylation in bovine trabecular meshwork cells.

PubMed

Ramachandran, Charanya; Satpathy, Minati; Mehta, Dolly; Srinivas, Sangly P

2008-02-01

Enhanced contractility of the actin cytoskeleton in trabecular meshwork (TM) cells is implicated in increased resistance to aqueous humor outflow. In this study, we have investigated effects of forskolin, which is known to elevate cAMP and also enhance aqueous humor outflow, on myosin light chain (MLC) phosphorylation, a biochemical marker of actin contractility. Experiments were performed using cultured bovine TM cells. Phosphorylated MLC (pMLC), expressed as the % of untreated cells, was assessed by urea-glycerol gel electrophoresis and Western blotting. RhoA activity was determined by affinity precipitation of RhoA-GTP to RhoA binding domain of an effector of RhoA. Intracellular cAMP levels were measured by ELISA. Exposure to LPA (lysophosphatidic acid) led to increased MLC phosphorylation (LPA: pMLC=133%) and activation of RhoA. These responses of LPA were suppressed by co-treatment with forskolin (LPA+forskolin: pMLC=88%). Similarly, ET-1 and nocodazole-induced MLC phosphorylation (ET-1: pMLC=145%; nocodazole: pMLC=145%) as well as RhoA activation were suppressed by co-treatment with forskolin (ET-1+forskolin: pMLC=99%; nocodazole+forskolin: pMLC=107%). Exposure to forskolin alone led to MLC dephosphorylation (pMLC=68%). Forskolin alone led to a 4-fold increase in cAMP levels. This increase was not affected when co-treated with LPA or ET-1. Forskolin prevents MLC phosphorylation induced by LPA, ET-1, and nocodazole through inhibition of RhoA-Rho kinase axis. MLC dephosphorylation and consequent relaxation of actin cytoskeleton in TM cells presumably underlies the increased outflow facility reported in response to forskolin.

SU-E-T-473: A Patient-Specific QC Paradigm Based On Trajectory Log Files and DICOM Plan Files

DOE Office of Scientific and Technical Information (OSTI.GOV)

DeMarco, J; McCloskey, S; Low, D

Purpose: To evaluate a remote QC tool for monitoring treatment machine parameters and treatment workflow. Methods: The Varian TrueBeamTM linear accelerator is a digital machine that records machine axis parameters and MLC leaf positions as a function of delivered monitor unit or control point. This information is saved to a binary trajectory log file for every treatment or imaging field in the patient treatment session. A MATLAB analysis routine was developed to parse the trajectory log files for a given patient, compare the expected versus actual machine and MLC positions as well as perform a cross-comparison with the DICOM-RT planmore » file exported from the treatment planning system. The parsing routine sorts the trajectory log files based on the time and date stamp and generates a sequential report file listing treatment parameters and provides a match relative to the DICOM-RT plan file. Results: The trajectory log parsing-routine was compared against a standard record and verify listing for patients undergoing initial IMRT dosimetry verification and weekly and final chart QC. The complete treatment course was independently verified for 10 patients of varying treatment site and a total of 1267 treatment fields were evaluated including pre-treatment imaging fields where applicable. In the context of IMRT plan verification, eight prostate SBRT plans with 4-arcs per plan were evaluated based on expected versus actual machine axis parameters. The average value for the maximum RMS MLC error was 0.067±0.001mm and 0.066±0.002mm for leaf bank A and B respectively. Conclusion: A real-time QC analysis program was tested using trajectory log files and DICOM-RT plan files. The parsing routine is efficient and able to evaluate all relevant machine axis parameters during a patient treatment course including MLC leaf positions and table positions at time of image acquisition and during treatment.« less

Apparatus and method for variable angle slant hole collimator

DOEpatents

Lee, Seung Joon; Kross, Brian J.; McKisson, John E.

2017-07-18

A variable angle slant hole (VASH) collimator for providing collimation of high energy photons such as gamma rays during radiological imaging of humans. The VASH collimator includes a stack of multiple collimator leaves and a means of quickly aligning each leaf to provide various projection angles. Rather than rotate the detector around the subject, the VASH collimator enables the detector to remain stationary while the projection angle of the collimator is varied for tomographic acquisition. High collimator efficiency is achieved by maintaining the leaves in accurate alignment through the various projection angles. Individual leaves include unique angled cuts to maintain a precise target collimation angle. Matching wedge blocks driven by two actuators with twin-lead screws accurately position each leaf in the stack resulting in the precise target collimation angle. A computer interface with the actuators enables precise control of the projection angle of the collimator.

The β1 subunit of the Na,K-ATPase pump interacts with megalencephalic leucoencephalopathy with subcortical cysts protein 1 (MLC1) in brain astrocytes: new insights into MLC pathogenesis

PubMed Central

Brignone, Maria S.; Lanciotti, Angela; Macioce, Pompeo; Macchia, Gianfranco; Gaetani, Matteo; Aloisi, Francesca; Petrucci, Tamara C.; Ambrosini, Elena

2011-01-01

Megalencephalic leucoencephalopathy with subcortical cysts (MLC) is a rare congenital leucodystrophy caused by mutations in MLC1, a membrane protein of unknown function. MLC1 expression in astrocyte end-feet contacting blood vessels and meninges, along with brain swelling, fluid cysts and myelin vacuolation observed in MLC patients, suggests a possible role for MLC1 in the regulation of fluid and ion homeostasis and cellular volume changes. To identify MLC1 direct interactors and dissect the molecular pathways in which MLC1 is involved, we used NH2-MLC1 domain as a bait to screen a human brain library in a yeast two-hybrid assay. We identified the β1 subunit of the Na,K-ATPase pump as one of the interacting clones and confirmed it by pull-downs, co-fractionation assays and immunofluorescence stainings in human and rat astrocytes in vitro and in brain tissue. By performing ouabain-affinity chromatography on astrocyte and brain extracts, we isolated MLC1 and the whole Na,K-ATPase enzyme in a multiprotein complex that included Kir4.1, syntrophin and dystrobrevin. Because Na,K-ATPase is involved in intracellular osmotic control and volume regulation, we investigated the effect of hypo-osmotic stress on MLC1/Na,K-ATPase relationship in astrocytes. We found that hypo-osmotic conditions increased MLC1 membrane expression and favoured MLC1/Na,K-ATPase-β1 association. Moreover, hypo-osmosis induced astrocyte swelling and the reversible formation of endosome-derived vacuoles, where the two proteins co-localized. These data suggest that through its interaction with Na,K-ATPase, MLC1 is involved in the control of intracellular osmotic conditions and volume regulation in astrocytes, opening new perspectives for understanding the pathological mechanisms of MLC disease. PMID:20926452

Seizures and disturbed brain potassium dynamics in the leukodystrophy megalencephalic leukoencephalopathy with subcortical cysts

PubMed Central

Dubey, Mohit; Brouwers, Eelke; Hamilton, Eline M.C.; Stiedl, Oliver; Bugiani, Marianna; Koch, Henner; Kole, Maarten H.P.; Boschert, Ursula; Wykes, Robert C.; Mansvelder, Huibert D.; van der Knaap, Marjo S.

2018-01-01

Objective Loss of function of the astrocyte‐specific protein MLC1 leads to the childhood‐onset leukodystrophy “megalencephalic leukoencephalopathy with subcortical cysts” (MLC). Studies on isolated cells show a role for MLC1 in astrocyte volume regulation and suggest that disturbed brain ion and water homeostasis is central to the disease. Excitability of neuronal networks is particularly sensitive to ion and water homeostasis. In line with this, reports of seizures and epilepsy in MLC patients exist. However, systematic assessment and mechanistic understanding of seizures in MLC are lacking. Methods We analyzed an MLC patient inventory to study occurrence of seizures in MLC. We used two distinct genetic mouse models of MLC to further study epileptiform activity and seizure threshold through wireless extracellular field potential recordings. Whole‐cell patch‐clamp recordings and K+‐sensitive electrode recordings in mouse brain slices were used to explore the underlying mechanisms of epilepsy in MLC. Results An early onset of seizures is common in MLC. Similarly, in MLC mice, we uncovered spontaneous epileptiform brain activity and a lowered threshold for induced seizures. At the cellular level, we found that although passive and active properties of individual pyramidal neurons are unchanged, extracellular K+ dynamics and neuronal network activity are abnormal in MLC mice. Interpretation Disturbed astrocyte regulation of ion and water homeostasis in MLC causes hyperexcitability of neuronal networks and seizures. These findings suggest a role for defective astrocyte volume regulation in epilepsy. Ann Neurol 2018;83:636–649 PMID:29466841

Technical Report: Evaluation of peripheral dose for flattening filter free photon beams.

PubMed

Covington, E L; Ritter, T A; Moran, J M; Owrangi, A M; Prisciandaro, J I

2016-08-01

To develop a comprehensive peripheral dose (PD) dataset for the two unflattened beams of nominal energy 6 and 10 MV for use in clinical care. Measurements were made in a 40 × 120 × 20 cm(3) (width × length × depth) stack of solid water using an ionization chamber at varying depths (dmax, 5, and 10 cm), field sizes (3 × 3 to 30 × 30 cm(2)), and distances from the field edge (5-40 cm). The effects of the multileaf collimator (MLC) and collimator rotation were also evaluated for a 10 × 10 cm(2) field. Using the same phantom geometry, the accuracy of the analytic anisotropic algorithm (AAA) and Acuros dose calculation algorithm was assessed and compared to the measured values. The PDs for both the 6 flattening filter free (FFF) and 10 FFF photon beams were found to decrease with increasing distance from the radiation field edge and the decreasing field size. The measured PD was observed to be higher for the 6 FFF than for the 10 FFF for all field sizes and depths. The impact of collimator rotation was not found to be clinically significant when used in conjunction with MLCs. AAA and Acuros algorithms both underestimated the PD with average errors of -13.6% and -7.8%, respectively, for all field sizes and depths at distances of 5 and 10 cm from the field edge, but the average error was found to increase to nearly -69% at greater distances. Given the known inaccuracies of peripheral dose calculations, this comprehensive dataset can be used to estimate the out-of-field dose to regions of interest such as organs at risk, electronic implantable devices, and a fetus. While the impact of collimator rotation was not found to significantly decrease PD when used in conjunction with MLCs, results are expected to be machine model and beam energy dependent. It is not recommended to use a treatment planning system to estimate PD due to the underestimation of the out-of-field dose and the inability to calculate dose at extended distances due to the limits of the dose calculation matrix.

Intensity modulated neutron radiotherapy optimization by photon proxy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Snyder, Michael; Hammoud, Ahmad; Bossenberger, Todd

2012-08-15

Purpose: Introducing intensity modulation into neutron radiotherapy (IMNRT) planning has the potential to mitigate some normal tissue complications seen in past neutron trials. While the hardware to deliver IMNRT plans has been in use for several years, until recently the IMNRT planning process has been cumbersome and of lower fidelity than conventional photon plans. Our in-house planning system used to calculate neutron therapy plans allows beam weight optimization of forward planned segments, but does not provide inverse optimization capabilities. Commercial treatment planning systems provide inverse optimization capabilities, but currently cannot model our neutron beam. Methods: We have developed a methodologymore » and software suite to make use of the robust optimization in our commercial planning system while still using our in-house planning system to calculate final neutron dose distributions. Optimized multileaf collimator (MLC) leaf positions for segments designed in the commercial system using a 4 MV photon proxy beam are translated into static neutron ports that can be represented within our in-house treatment planning system. The true neutron dose distribution is calculated in the in-house system and then exported back through the MATLAB software into the commercial treatment planning system for evaluation. Results: The planning process produces optimized IMNRT plans that reduce dose to normal tissue structures as compared to 3D conformal plans using static MLC apertures. The process involves standard planning techniques using a commercially available treatment planning system, and is not significantly more complex than conventional IMRT planning. Using a photon proxy in a commercial optimization algorithm produces IMNRT plans that are more conformal than those previously designed at our center and take much less time to create. Conclusions: The planning process presented here allows for the optimization of IMNRT plans by a commercial treatment planning optimization algorithm, potentially allowing IMNRT to achieve similar conformality in treatment as photon IMRT. The only remaining requirements for the delivery of very highly modulated neutron treatments are incremental improvements upon already implemented hardware systems that should be readily achievable.« less

SU-E-J-57: First Development of Adapting to Intrafraction Relative Motion Between Prostate and Pelvic Lymph Nodes Targets

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ge, Y; Colvill, E; O’Brien, R

2015-06-15

Purpose Large intrafraction relative motion of multiple targets is common in advanced head and neck, lung, abdominal, gynaecological and urological cancer, jeopardizing the treatment outcomes. The objective of this study is to develop a real-time adaptation strategy, for the first time, to accurately correct for the relative motion of multiple targets by reshaping the treatment field using the multi-leaf collimator (MLC). Methods The principle of tracking the simultaneously treated but differentially moving tumor targets is to determine the new aperture shape that conforms to the shifted targets. Three dimensional volumes representing the individual targets are projected to the beam’s eyemore » view. The leaf openings falling inside each 2D projection will be shifted according to the measured motion of each target to form the new aperture shape. Based on the updated beam shape, new leaf positions will be determined with optimized trade-off between the target underdose and healthy tissue overdose, and considerations of the physical constraints of the MLC. Taking a prostate cancer patient with pelvic lymph node involvement as an example, a preliminary dosimetric study was conducted to demonstrate the potential treatment improvement compared to the state-of- art adaptation technique which shifts the whole beam to track only one target. Results The world-first intrafraction adaptation system capable of reshaping the beam to correct for the relative motion of multiple targets has been developed. The dose in the static nodes and small bowel are closer to the planned distribution and the V45 of small bowel is decreased from 110cc to 75cc, corresponding to a 30% reduction by this technique compared to the state-of-art adaptation technique. Conclusion The developed adaptation system to correct for intrafraction relative motion of multiple targets will guarantee the tumour coverage and thus enable PTV margin reduction to minimize the high target dose to the adjacent organs-at-risk. The authors acknowledge funding support from the Australian NHMRC Australia Fellowship and NHMRC Project Grant No. APP1042375.« less

Dynamic simulation of motion effects in IMAT lung SBRT.

PubMed

Zou, Wei; Yin, Lingshu; Shen, Jiajian; Corradetti, Michael N; Kirk, Maura; Munbodh, Reshma; Fang, Penny; Jabbour, Salma K; Simone, Charles B; Yue, Ning J; Rengan, Ramesh; Teo, Boon-Keng Kevin

2014-11-01

Intensity modulated arc therapy (IMAT) has been widely adopted for Stereotactic Body Radiotherapy (SBRT) for lung cancer. While treatment dose is optimized and calculated on a static Computed Tomography (CT) image, the effect of the interplay between the target and linac multi-leaf collimator (MLC) motion is not well described and may result in deviations between delivered and planned dose. In this study, we investigated the dosimetric consequences of the inter-play effect on target and organs at risk (OAR) by simulating dynamic dose delivery using dynamic CT datasets. Fifteen stage I non-small cell lung cancer (NSCLC) patients with greater than 10 mm tumor motion treated with SBRT in 4 fractions to a dose of 50 Gy were retrospectively analyzed for this study. Each IMAT plan was initially optimized using two arcs. Simulated dynamic delivery was performed by associating the MLC leaf position, gantry angle and delivered beam monitor units (MUs) for each control point with different respiratory phases of the 4D-CT using machine delivery log files containing time stamps of the control points. Dose maps associated with each phase of the 4D-CT dose were calculated in the treatment planning system and accumulated using deformable image registration onto the exhale phase of the 4D-CT. The original IMAT plans were recalculated on the exhale phase of the CT for comparison with the dynamic simulation. The dose coverage of the PTV showed negligible variation between the static and dynamic simulation. There was less than 1.5% difference in PTV V95% and V90%. The average inter-fraction and cumulative dosimetric effects among all the patients were less than 0.5% for PTV V95% and V90% coverage and 0.8 Gy for the OARs. However, in patients where target is close to the organs, large variations were observed on great vessels and bronchus for as much as 4.9 Gy and 7.8 Gy. Limited variation in target dose coverage and OAR constraints were seen for each SBRT fraction as well as over all four fractions. Large dose variations were observed on critical organs in patients where these organs were closer to the target.

The transcription factor Mlc promotes Vibrio cholerae biofilm formation through repression of phosphotransferase system components.

PubMed

Pickering, Bradley S; Lopilato, Jane E; Smith, Daniel R; Watnick, Paula I

2014-07-01

The phosphoenol phosphotransferase system (PTS) is a multicomponent signal transduction cascade that regulates diverse aspects of bacterial cellular physiology in response to the availability of high-energy sugars in the environment. Many PTS components are repressed at the transcriptional level when the substrates they transport are not available. In Escherichia coli, the transcription factor Mlc (for makes large colonies) represses transcription of the genes encoding enzyme I (EI), histidine protein (HPr), and the glucose-specific enzyme IIBC (EIIBC(Glc)) in defined media that lack PTS substrates. When glucose is present, the unphosphorylated form of EIIBC(Glc) sequesters Mlc to the cell membrane, preventing its interaction with DNA. Very little is known about Vibrio cholerae Mlc. We found that V. cholerae Mlc activates biofilm formation in LB broth but not in defined medium supplemented with either pyruvate or glucose. Therefore, we questioned whether V. cholerae Mlc functions differently than E. coli Mlc. Here we have shown that, like E. coli Mlc, V. cholerae Mlc represses transcription of PTS components in both defined medium and LB broth and that E. coli Mlc is able to rescue the biofilm defect of a V. cholerae Δmlc mutant. Furthermore, we provide evidence that Mlc indirectly activates transcription of the vps genes by repressing expression of EI. Because activation of the vps genes by Mlc occurs under only a subset of the conditions in which repression of PTS components is observed, we conclude that additional inputs present in LB broth are required for activation of vps gene transcription by Mlc. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

SU-C-201-04: Noise and Temporal Resolution in a Near Real-Time 3D Dosimeter

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rilling, M; Centre de recherche sur le cancer, Universite Laval, Quebec City, QC; Radiation oncology department, CHU de Quebec, Quebec City, QC

Purpose: To characterize the performance of a real-time three-dimensional scintillation dosimeter in terms of signal-to-noise ratio (SNR) and temporal resolution of 3D dose measurements. This study quantifies its efficiency in measuring low dose levels characteristic of EBRT dynamic treatments, and in reproducing field profiles for varying multileaf collimator (MLC) speeds. Methods: The dosimeter prototype uses a plenoptic camera to acquire continuous images of the light field emitted by a 10×10×10 cm{sup 3} plastic scintillator. Using EPID acquisitions, ray tracing-based iterative tomographic algorithms allow millimeter-sized reconstruction of relative 3D dose distributions. Measurements were taken at 6MV, 400 MU/min with the scintillatormore » centered at the isocenter, first receiving doses from 1.4 to 30.6 cGy. Dynamic measurements were then performed by closing half of the MLCs at speeds of 0.67 to 2.5 cm/s, at 0° and 90° collimator angles. A reference static half-field was obtained for measured profile comparison. Results: The SNR steadily increases as a function of dose and reaches a clinically adequate plateau of 80 at 10 cGy. Below this, the decrease in light collected and increase in pixel noise diminishes the SNR; nonetheless, the EPID acquisitions and the voxel correlation employed in the reconstruction algorithms result in suitable SNR values (>75) even at low doses. For dynamic measurements at varying MLC speeds, central relative dose profiles are characterized by gradients at %D{sub 50} of 8.48 to 22.7 %/mm. These values converge towards the 32.8 %/mm-gradient measured for the static reference field profile, but are limited by the dosimeter’s current acquisition rate of 1Hz. Conclusion: This study emphasizes the efficiency of the 3D dose distribution reconstructions, while identifying limits of the current prototype’s temporal resolution in terms of dynamic EBRT parameters. This work paves the way for providing an optimized, second-generational real-time 3D scintillation dosimeter capable of highly efficient and precise dose measurements. The presenting author is financially supported by an Alexander-Graham Bell doctoral scholarship from the Natural Sciences and Engineering Research Council of Canada (NSERC).« less

The potential impact of multidimesional geriatric assessment in the social security system.

PubMed

Corbi, Graziamaria; Ambrosino, Immacolata; Massari, Marco; De Lucia, Onofrio; Simplicio, Sirio; Dragone, Michele; Paolisso, Giuseppe; Piccioni, Massimo; Ferrara, Nicola; Campobasso, Carlo Pietro

2018-01-12

To evaluate the efficacy of multidimensional geriatric assessment (MGA/CGA) in patients over 65 years old in predicting the release of the accompaniment allowance (AA) indemnity by a Local Medico-Legal Committee (MLC-NHS) and by the National Institute of Social Security Committee (MLC-INPS). In a longitudinal observational study, 200 Italian elder citizens requesting AA were first evaluated by MLC-NHS and later by MLC-INPS. Only MLC-INPS performed a MGA/CGA (including SPMSQ, Barthel Index, GDS-SF, and CIRS). This report was written according to the STROBE guidelines. The data analysis was performed on January 2016. The evaluation by the MLC-NHS and by the MLC-INPS was in agreement in 66% of cases. In the 28%, the AA benefit was recognized by the MLC-NHS, but not by the MLC-INPS. By the multivariate analysis, the best predictors of the AA release, by the MLC-NHS, were represented by gender and the Barthel Index score. The presence of carcinoma, the Barthel Index score, and the SPMQ score were the best predictors for the AA release by MLC-INPS. MGA/CGA could be useful in saving financial resources reducing the risk of incorrect indemnity release. It can improve the accuracy of the impairment assessment in social security system.

Neutron range spectrometer

DOEpatents

Manglos, S.H.

1988-03-10

A neutron range spectrometer and method for determining the neutron energy spectrum of a neutron emitting source are disclosed. Neutrons from the source are colliminated along a collimation axis and a position sensitive neutron counter is disposed in the path of the collimated neutron beam. The counter determines positions along the collimation axis of interactions between the neutrons in the neutron beam and a neutron-absorbing material in the counter. From the interaction positions, a computer analyzes the data and determines the neutron energy spectrum of the neutron beam. The counter is preferably shielded and a suitable neutron-absorbing material is He-3. 1 fig.

Experimental investigation of the response of an amorphous silicon EPID to intensity modulated radiotherapy beams.

PubMed

Greer, Peter B; Vial, Philip; Oliver, Lyn; Baldock, Clive

2007-11-01

The aim of this work was to experimentally determine the difference in response of an amorphous silicon (a-Si) electronic portal imaging device (EPID) to the open and multileaf collimator (MLC) transmitted beam components of intensity modulated radiation therapy (IMRT) beams. EPID dose response curves were measured for open and MLC transmitted (MLCtr) 10 x 10 cm2 beams at central axis and with off axis distance using a shifting field technique. The EPID signal was obtained by replacing the flood-field correction with a pixel sensitivity variation matrix correction. This signal, which includes energy-dependent response, was then compared to ion-chamber measurements. An EPID calibration method to remove the effect of beam energy variations on EPID response was developed for IMRT beams. This method uses the component of open and MLCtr fluence to an EPID pixel calculated from the MLC delivery file and applies separate radially dependent calibration factors for each component. The calibration procedure does not correct for scatter differences between ion chamber in water measurements and EPID response; these must be accounted for separately with a kernel-based approach or similar method. The EPID response at central axis for the open beam was found to be 1.28 +/- 0.03 of the response for the MLCtr beam, with the ratio increasing to 1.39 at 12.5 cm off axis. The EPID response to MLCtr radiation did not change with off-axis distance. Filtering the beam with copper plates to reduce the beam energy difference between open and MLCtr beams was investigated; however, these were not effective at reducing EPID response differences. The change in EPID response for uniform sliding window IMRT beams with MLCtr dose components from 0.3% to 69% was predicted to within 2.3% using the separate EPID response calibration factors for each dose component. A clinical IMRT image calibrated with this method differed by nearly 30% in high MLCtr regions from an image calibrated with an open beam calibration factor only. Accounting for the difference in EPID response to open and MLCtr radiation should improve IMRT dosimetry with a-Si EPIDs.

SU-F-T-586: Pre-Treatment QA of InCise2 MLC Plans On a Cyberknife-M6 Using the Delta4 System in SBRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schmidhalter, D; Henzen, D; Malthaner, M

Purpose: Performing pre-treatment quality assurance (QA) with the Delta4 system (ScandiDos Inc., Madison, WI) is well established for linac-based radiotherapy. This is not true when using a Cyberknife (Accuray Inc., Sunnyvale, CA) where, typically film-based QA is applied. The goal of this work was to test the feasibility to use the Delta4 system for pre-treatment QA for stereotactic body radiation therapy (SBRT) using a Cyberknife-M6 equipped with the InCise2 multileaf collimator (MLC). Methods: In order to perform measurements without accelerator pulse signal, the Tomotherapy option within the Delta4 software was used. Absolute calibration of the Delta4 phantom was performed usingmore » a 10×10 cm{sup 2} field shaped by the InCise2 MLC of the Cyberknife-M6. Five fiducials were attached to the Delta4 phantom in order to be able to track the phantom before and during measurements. For eight SBRT treatment plans (two liver, two prostate, one lung, three bone metastases) additional verification plans were recalculated on the Delta4 phantom using MultiPlan. Dicom data was exported from MultiPlan and was adapted in order to be compatible with the Delta4 software. The measured and calculated dose distributions were compared using the gamma analysis of the Delta4 system. Results: All eight SBRT plans were successfully measured with the aid of the Delta4 system. In the mean, 98.0±1.9%, 95.8±4.1% and 88.40±11.4% of measured dose points passed the gamma analysis using a global dose deviation criterion of 3% (100% corresponds to the dose maximum) and a distance-to-agreement criterion of 3 mm, 2 mm and 1 mm, respectively, and a threshold of 20%. Conclusion: Pre-treatment QA of SBRT plans using the Delta4 system on a Cyberknife-M6 is feasible. Measured dose distributions of SBRT plans showed clinically acceptable agreement with the corresponding calculated dose distributions.« less

SU-E-T-605: Performance Evaluation of MLC Leaf-Sequencing Algorithms in Head-And-Neck IMRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jing, J; Lin, H; Chow, J

2015-06-15

Purpose: To investigate the efficiency of three multileaf collimator (MLC) leaf-sequencing algorithms proposed by Galvin et al, Chen et al and Siochi et al using external beam treatment plans for head-and-neck intensity modulated radiation therapy (IMRT). Methods: IMRT plans for head-and-neck were created using the CORVUS treatment planning system. The plans were optimized and the fluence maps for all photon beams determined. Three different MLC leaf-sequencing algorithms based on Galvin et al, Chen et al and Siochi et al were used to calculate the final photon segmental fields and their monitor units in delivery. For comparison purpose, the maximum intensitymore » of fluence map was kept constant in different plans. The number of beam segments and total number of monitor units were calculated for the three algorithms. Results: From results of number of beam segments and total number of monitor units, we found that algorithm of Galvin et al had the largest number of monitor unit which was about 70% larger than the other two algorithms. Moreover, both algorithms of Galvin et al and Siochi et al have relatively lower number of beam segment compared to Chen et al. Although values of number of beam segment and total number of monitor unit calculated by different algorithms varied with the head-and-neck plans, it can be seen that algorithms of Galvin et al and Siochi et al performed well with a lower number of beam segment, though algorithm of Galvin et al had a larger total number of monitor units than Siochi et al. Conclusion: Although performance of the leaf-sequencing algorithm varied with different IMRT plans having different fluence maps, an evaluation is possible based on the calculated number of beam segment and monitor unit. In this study, algorithm by Siochi et al was found to be more efficient in the head-and-neck IMRT. The Project Sponsored by the Fundamental Research Funds for the Central Universities (J2014HGXJ0094) and the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry.« less

SU-E-T-593: Outcomes and Toxicities From a Clinical Trial of APBI Using MERT+IMRT with the Same XMLC

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jimenez-Ortega, E.; Ureba, A.; Barbeiro, A.R.

2015-06-15

Purpose: We present the results from a clinical trial of accelerated partial breast irradiation (APBI), using mixed modulated photon and electron beams (MERT+IMRT) with the same photon multileaf collimator (xMLC). Methods: Seven patients were enrolled in the first year of the APBI clinical trial. Patients were selected following the conditions included in the NSABP B-39/RTOG 0413 protocol. The targets and clinically relevant normal structures were contoured on the CT images following this protocol for APBI-EBRT. All treatments were delivered using combined modulated electron and photon beams by means of the same xMLC installed in a SIEMENS Primus linac, with amore » reduced SSD equal to 60 cm for electron beams. The plans were performed with a treatment planning system based on full Monte Carlo simulations, called CARMEN, developed by our group. Simultaneously, an alternative IMRT plan was calculated with the commercial TPS PINNACLE v8.0m (Philips), and both plans were compared. An ad-hoc breast phantom with semi-spherical geometry called NAOMI was designed for a specific QA protocol. Patients received a total dose of 38.5 Gy, delivered in 10 fractions over 5 consecutive days, with a twice-a-day hypofractionated schema.Follow-up visits during 2.5 years on average were repeated at 1 month post-treatment, every 3 months for the first year, and every 6 months for the second year. Toxicity was scored according to National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE version 3.0). Results: This APBI technique achieved high loco-regional control rates and showed low acute toxicity (grade 1 of CTCAE) and no toxicities from first month onwards. Photographic assessment of cosmesis showed skin excellent results. Conclusion: The clinical results achieved with MERT+IMRT by using the same xMLC are comparable or even better than those obtained with other APBI techniques, thanks to a software solution without any additional equipment or specific device.« less

Final Aperture Superposition Technique applied to fast calculation of electron output factors and depth dose curves

DOE Office of Scientific and Technical Information (OSTI.GOV)

Faddegon, B.A.; Villarreal-Barajas, J.E.; Mt. Diablo Regional Cancer Center, 2450 East Street, Concord, California

2005-11-15

The Final Aperture Superposition Technique (FAST) is described and applied to accurate, near instantaneous calculation of the relative output factor (ROF) and central axis percentage depth dose curve (PDD) for clinical electron beams used in radiotherapy. FAST is based on precalculation of dose at select points for the two extreme situations of a fully open final aperture and a final aperture with no opening (fully shielded). This technique is different than conventional superposition of dose deposition kernels: The precalculated dose is differential in position of the electron or photon at the downstream surface of the insert. The calculation for amore » particular aperture (x-ray jaws or MLC, insert in electron applicator) is done with superposition of the precalculated dose data, using the open field data over the open part of the aperture and the fully shielded data over the remainder. The calculation takes explicit account of all interactions in the shielded region of the aperture except the collimator effect: Particles that pass from the open part into the shielded part, or visa versa. For the clinical demonstration, FAST was compared to full Monte Carlo simulation of 10x10,2.5x2.5, and 2x8 cm{sup 2} inserts. Dose was calculated to 0.5% precision in 0.4x0.4x0.2 cm{sup 3} voxels, spaced at 0.2 cm depth intervals along the central axis, using detailed Monte Carlo simulation of the treatment head of a commercial linear accelerator for six different electron beams with energies of 6-21 MeV. Each simulation took several hours on a personal computer with a 1.7 Mhz processor. The calculation for the individual inserts, done with superposition, was completed in under a second on the same PC. Since simulations for the pre calculation are only performed once, higher precision and resolution can be obtained without increasing the calculation time for individual inserts. Fully shielded contributions were largest for small fields and high beam energy, at the surface, reaching a maximum of 5.6% at 21 MeV. Contributions from the collimator effect were largest for the large field size, high beam energy, and shallow depths, reaching a maximum of 4.7% at 21 MeV. Both shielding contributions and the collimator effect need to be taken into account to achieve an accuracy of 2%. FAST takes explicit account of the shielding contributions. With the collimator effect set to that of the largest field in the FAST calculation, the difference in dose on the central axis (product of ROF and PDD) between FAST and full simulation was generally under 2%. The maximum difference of 2.5% exceeded the statistical precision of the calculation by four standard deviations. This occurred at 18 MeV for the 2.5x2.5 cm{sup 2} field. The differences are due to the method used to account for the collimator effect.« less

Numerical Calculations of Short-Range Wakefields of Collimators

NASA Astrophysics Data System (ADS)

Ng, C. K.

2001-12-01

The performance of future linear colliders are limited by the effect of short-range collimator wakefields on the beam. The beam quality is sensitive to the positioning of collimators at the end of the linac. The determination of collimator wakefields has been difficult, largely because of the scarcity of measurement data, and of the limitation of applicability of analytical results to realistic structures. In this paper, numerical methods using codes such as MAFIA are used to determine a series of tapered collimators with rectangular apertures that have been built for studies at SLAC (Stanford Linear Accelerator Center). We will study the dependences of the wakefield on the collimator taper angle, the collimator gap as well as the bunch length. Calculations are also compared with measurements.

Successive approximation algorithm for beam-position-monitor-based LHC collimator alignment

NASA Astrophysics Data System (ADS)

Valentino, Gianluca; Nosych, Andriy A.; Bruce, Roderik; Gasior, Marek; Mirarchi, Daniele; Redaelli, Stefano; Salvachua, Belen; Wollmann, Daniel

2014-02-01

Collimators with embedded beam position monitor (BPM) button electrodes will be installed in the Large Hadron Collider (LHC) during the current long shutdown period. For the subsequent operation, BPMs will allow the collimator jaws to be kept centered around the beam orbit. In this manner, a better beam cleaning efficiency and machine protection can be provided at unprecedented higher beam energies and intensities. A collimator alignment algorithm is proposed to center the jaws automatically around the beam. The algorithm is based on successive approximation and takes into account a correction of the nonlinear BPM sensitivity to beam displacement and an asymmetry of the electronic channels processing the BPM electrode signals. A software implementation was tested with a prototype collimator in the Super Proton Synchrotron. This paper presents results of the tests along with some considerations for eventual operation in the LHC.

Isolation and characterization of ventricular-like cells derived from NKX2-5eGFP/w and MLC2vmCherry/w double knock-in human pluripotent stem cells.

PubMed

Yamauchi, Kaori; Li, Junjun; Morikawa, Kumi; Liu, Li; Shirayoshi, Yasuaki; Nakatsuji, Norio; Elliott, David A; Hisatome, Ichiro; Suemori, Hirofumi

2018-01-01

Human pluripotent stem cell (hPSC)-derived cardiomyocytes (CMs) are a promising source for cell transplantation into the damaged heart, which has limited regenerative ability. Many methods have been developed to obtain large amounts of functional CMs from hPSCs for therapeutic applications. However, during the differentiation process, a mixed population of various cardiac cells, including ventricular, atrial, and pacemaker cells, is generated, which hampers the proper functional analysis and evaluation of cell properties. Here, we established NKX2-5 eGFP/w and MLC2v mCherry/w hPSC double knock-ins that allow for labeling, tracing, purification, and analysis of the development of ventricular cells from early to late stages. As with the endogenous transcriptional activities of these genes, MLC2v-mCherry expression following NKX2-5-eGFP expression was observed under previously established culture conditions, which mimic the in vivo cardiac developmental process. Patch-clamp and microelectrode array electrophysiological analyses showed that the NKX2-5 and MLC2v double-positive cells possess ventricular-like properties. The results demonstrate that the NKX2-5 eGFP/w and MLC2v mCherry/w hPSCs provide a powerful model system to capture region-specific cardiac differentiation from early to late stages. Our study would facilitate subtype-specific cardiac development and functional analysis using the hPSC-derived sources. Copyright © 2017 Elsevier Inc. All rights reserved.

Micellar liquid chromatography

NASA Astrophysics Data System (ADS)

Basova, Elena M.; Ivanov, Vadim M.; Shpigun, Oleg A.

1999-12-01

Background and possibilities of practical applications of micellar liquid chromatography (MLC) are considered. Various retention models in MLC, the effects of the nature and concentration of surfactants and organic modifiers, pH, temperature and ionic strength on the MLC efficiency and selectivity are discussed. The advantages and limitations of MLC are demonstrated. The performance of MLC is critically evaluated in relationship to the reversed-phase HPLC and ion-pair chromatography. The potential of application of MLC for the analysis of pharmaceuticals including that in biological fluids and separation of inorganic anions, transition metal cations, metal chelates and heteropoly compounds is described. The bibliography includes 146 references.

Method and system for determining depth distribution of radiation-emitting material located in a source medium and radiation detector system for use therein

DOEpatents

Benke, Roland R.; Kearfott, Kimberlee J.; McGregor, Douglas S.

2003-03-04

A method, system and a radiation detector system for use therein are provided for determining the depth distribution of radiation-emitting material distributed in a source medium, such as a contaminated field, without the need to take samples, such as extensive soil samples, to determine the depth distribution. The system includes a portable detector assembly with an x-ray or gamma-ray detector having a detector axis for detecting the emitted radiation. The radiation may be naturally-emitted by the material, such as gamma-ray-emitting radionuclides, or emitted when the material is struck by other radiation. The assembly also includes a hollow collimator in which the detector is positioned. The collimator causes the emitted radiation to bend toward the detector as rays parallel to the detector axis of the detector. The collimator may be a hollow cylinder positioned so that its central axis is perpendicular to the upper surface of the large area source when positioned thereon. The collimator allows the detector to angularly sample the emitted radiation over many ranges of polar angles. This is done by forming the collimator as a single adjustable collimator or a set of collimator pieces having various possible configurations when connected together. In any one configuration, the collimator allows the detector to detect only the radiation emitted from a selected range of polar angles measured from the detector axis. Adjustment of the collimator or the detector therein enables the detector to detect radiation emitted from a different range of polar angles. The system further includes a signal processor for processing the signals from the detector wherein signals obtained from different ranges of polar angles are processed together to obtain a reconstruction of the radiation-emitting material as a function of depth, assuming, but not limited to, a spatially-uniform depth distribution of the material within each layer. The detector system includes detectors having different properties (sensitivity, energy resolution) which are combined so that excellent spectral information may be obtained along with good determinations of the radiation field as a function of position.

Is mini-laparoscopic cholecystectomy any better than the gold standard?: A comparative study.

PubMed

Shaikh, Haris R; Abbas, Asad; Aleem, Salik; Lakhani, Miqdad R

2017-01-01

Mini-laparoscopic cholecystectomy (MLC) has widened the horizons of modern laparoscopic surgery. Standard four port laparoscopic cholecystectomy (SLC), which has long been established as the "Gold Standard" for gall bladder diseases, is under reconsideration following the advent of further minimally-invasive procedures including MLC. Our study aims to provide a comparison between MLC and SLC and assesses whether MLC has any added benefits. Patients with symptomatic gall bladder disease undergoing MLC or SLC during the 2.5-month period were included in the study. Thirty-two patients underwent MLC while SLC was performed on 40 patients by the same surgeon. Data was collected prospectively and analysed retrospectively using a predesigned questionnaire. In our study, both the groups had similar age, body mass index (BMI) and gender distribution. No cases of MLC required insertion of additional ports. The mean operative time for MLC was 38.2 min (33-61 min), which is longer than SLC; but it was not statistically significant. There was no significant difference in mean operative blood loss, postoperative pain, analgesia requirement and mobilization. Patients who underwent MLC were able to return to normal activity earlier than patients undergoing SLC (P < 0.01). Our experience suggests that MLC can safely be used as an alternative to SLC. Compared to SLC, it has the added benefit of an early return to work along with excellent cosmetic results. Further large scale trials are required to prove any additional benefit of MLC.

Is mini-laparoscopic cholecystectomy any better than the gold standard?: A comparative study

PubMed Central

Shaikh, Haris R.; Abbas, Asad; Aleem, Salik; Lakhani, Miqdad R.

2017-01-01

BACKGROUND: Mini-laparoscopic cholecystectomy (MLC) has widened the horizons of modern laparoscopic surgery. Standard four port laparoscopic cholecystectomy (SLC), which has long been established as the “Gold Standard” for gall bladder diseases, is under reconsideration following the advent of further minimally-invasive procedures including MLC. Our study aims to provide a comparison between MLC and SLC and assesses whether MLC has any added benefits. MATERIALS AND METHODS: Patients with symptomatic gall bladder disease undergoing MLC or SLC during the 2.5-month period were included in the study. Thirty-two patients underwent MLC while SLC was performed on 40 patients by the same surgeon. Data was collected prospectively and analysed retrospectively using a predesigned questionnaire. RESULTS: In our study, both the groups had similar age, body mass index (BMI) and gender distribution. No cases of MLC required insertion of additional ports. The mean operative time for MLC was 38.2 min (33-61 min), which is longer than SLC; but it was not statistically significant. There was no significant difference in mean operative blood loss, postoperative pain, analgesia requirement and mobilization. Patients who underwent MLC were able to return to normal activity earlier than patients undergoing SLC (P < 0.01). CONCLUSION: Our experience suggests that MLC can safely be used as an alternative to SLC. Compared to SLC, it has the added benefit of an early return to work along with excellent cosmetic results. Further large scale trials are required to prove any additional benefit of MLC. PMID:27251827

SU-F-T-271: Comparing IMRT QA Pass Rates Before and After MLC Calibration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mazza, A; Perrin, D; Fontenot, J

Purpose: To compare IMRT QA pass rates before and after an in-house MLC leaf calibration procedure. Methods: The MLC leaves and backup jaws on four Elekta linear accelerators with MLCi2 heads were calibrated using the EPID-based RIT Hancock Test as the means for evaluation. The MLCs were considered to be successfully calibrated when they could pass the Hancock Test with criteria of 1 mm jaw position tolerance, and 1 mm leaf position tolerance. IMRT QA results were collected pre- and postcalibration and analyzed using gamma analysis with 3%/3mm DTA criteria. AAPM TG-119 test plans were also compared pre- and post-calibration,more » at both 2%/2mm DTA and 3%/3mm DTA. Results: A weighted average was performed on the results for all four linear accelerators. The pre-calibration IMRT QA pass rate was 98.3 ± 0.1%, compared with the post-calibration pass rate of 98.5 ± 0.1%. The TG-119 test plan results showed more of an improvement, particularly at the 2%/2mm criteria. The averaged results were 89.1% pre and 96.1% post for the C-shape plan, 94.8% pre and 97.1% post for the multi-target plan, 98.6% pre and 99.7% post for the prostate plan, 94.7% pre and 94.8% post for the head/neck plan. Conclusion: The patient QA results did not show statistically significant improvement at the 3%/3mm DTA criteria after the MLC calibration procedure. However, the TG-119 test cases did show significant improvement at the 2%/2mm level.« less

Design and performance evaluation of a 20-aperture multipinhole collimator for myocardial perfusion imaging applications.

PubMed

Bowen, Jason D; Huang, Qiu; Ellin, Justin R; Lee, Tzu-Cheng; Shrestha, Uttam; Gullberg, Grant T; Seo, Youngho

2013-10-21

Single photon emission computed tomography (SPECT) myocardial perfusion imaging remains a critical tool in the diagnosis of coronary artery disease. However, after more than three decades of use, photon detection efficiency remains poor and unchanged. This is due to the continued reliance on parallel-hole collimators first introduced in 1964. These collimators possess poor geometric efficiency. Here we present the performance evaluation results of a newly designed multipinhole collimator with 20 pinhole apertures (PH20) for commercial SPECT systems. Computer simulations and numerical observer studies were used to assess the noise, bias and diagnostic imaging performance of a PH20 collimator in comparison with those of a low energy high resolution (LEHR) parallel-hole collimator. Ray-driven projector/backprojector pairs were used to model SPECT imaging acquisitions, including simulation of noiseless projection data and performing MLEM/OSEM image reconstructions. Poisson noise was added to noiseless projections for realistic projection data. Noise and bias performance were investigated for five mathematical cardiac and torso (MCAT) phantom anatomies imaged at two gantry orbit positions (19.5 and 25.0 cm). PH20 and LEHR images were reconstructed with 300 MLEM iterations and 30 OSEM iterations (ten subsets), respectively. Diagnostic imaging performance was assessed by a receiver operating characteristic (ROC) analysis performed on a single MCAT phantom; however, in this case PH20 images were reconstructed with 75 pixel-based OSEM iterations (four subsets). Four PH20 projection views from two positions of a dual-head camera acquisition and 60 LEHR projections were simulated for all studies. At uniformly-imposed resolution of 12.5 mm, significant improvements in SNR and diagnostic sensitivity (represented by the area under the ROC curve, or AUC) were realized when PH20 collimators are substituted for LEHR parallel-hole collimators. SNR improves by factors of 1.94-2.34 for the five patient anatomies and two orbital positions studied. For the ROC analysis the PH20 AUC is larger than the LEHR AUC with a p-value of 0.0067. Bias performance, however, decreases with the use of PH20 collimators. Systematic analyses showed PH20 collimators present improved diagnostic imaging performance over LEHR collimators, requiring only collimator exchange on existing SPECT cameras for their use.

Design and performance evaluation of a 20-aperture multipinhole collimator for myocardial perfusion imaging applications

NASA Astrophysics Data System (ADS)

Bowen, Jason D.; Huang, Qiu; Ellin, Justin R.; Lee, Tzu-Cheng; Shrestha, Uttam; Gullberg, Grant T.; Seo, Youngho

2013-10-01

Single photon emission computed tomography (SPECT) myocardial perfusion imaging remains a critical tool in the diagnosis of coronary artery disease. However, after more than three decades of use, photon detection efficiency remains poor and unchanged. This is due to the continued reliance on parallel-hole collimators first introduced in 1964. These collimators possess poor geometric efficiency. Here we present the performance evaluation results of a newly designed multipinhole collimator with 20 pinhole apertures (PH20) for commercial SPECT systems. Computer simulations and numerical observer studies were used to assess the noise, bias and diagnostic imaging performance of a PH20 collimator in comparison with those of a low energy high resolution (LEHR) parallel-hole collimator. Ray-driven projector/backprojector pairs were used to model SPECT imaging acquisitions, including simulation of noiseless projection data and performing MLEM/OSEM image reconstructions. Poisson noise was added to noiseless projections for realistic projection data. Noise and bias performance were investigated for five mathematical cardiac and torso (MCAT) phantom anatomies imaged at two gantry orbit positions (19.5 and 25.0 cm). PH20 and LEHR images were reconstructed with 300 MLEM iterations and 30 OSEM iterations (ten subsets), respectively. Diagnostic imaging performance was assessed by a receiver operating characteristic (ROC) analysis performed on a single MCAT phantom; however, in this case PH20 images were reconstructed with 75 pixel-based OSEM iterations (four subsets). Four PH20 projection views from two positions of a dual-head camera acquisition and 60 LEHR projections were simulated for all studies. At uniformly-imposed resolution of 12.5 mm, significant improvements in SNR and diagnostic sensitivity (represented by the area under the ROC curve, or AUC) were realized when PH20 collimators are substituted for LEHR parallel-hole collimators. SNR improves by factors of 1.94-2.34 for the five patient anatomies and two orbital positions studied. For the ROC analysis the PH20 AUC is larger than the LEHR AUC with a p-value of 0.0067. Bias performance, however, decreases with the use of PH20 collimators. Systematic analyses showed PH20 collimators present improved diagnostic imaging performance over LEHR collimators, requiring only collimator exchange on existing SPECT cameras for their use.

Trastuzumab Alters the Expression of Genes Essential for Cardiac Function and Induces Ultrastructural Changes of Cardiomyocytes in Mice

PubMed Central

ElZarrad, M. Khair; Mukhopadhyay, Partha; Mohan, Nishant; Hao, Enkui; Dokmanovic, Milos; Hirsch, Dianne S.; Shen, Yi; Pacher, Pal; Wu, Wen Jin

2013-01-01

Treatment with trastuzumab, a humanized monoclonal antibody directed against the extracellular domain of Human Epidermal Growth Factor Receptor 2 (HER2), very successfully improves outcomes for women with HER2-positive breast cancer. However, trastuzumab treatment was recently linked to potentially irreversible serious cardiotoxicity, the mechanisms of which are largely elusive. This study reports that trastuzumab significantly alters the expression of myocardial genes essential for DNA repair, cardiac and mitochondrial functions, which is associated with impaired left ventricular performance in mice coupled with significant ultrastructural alterations in cardiomyocytes revealed by electron microscopy. Furthermore, trastuzumab treatment also promotes oxidative stress and apoptosis in myocardium of mice, and elevates serum levels of cardiac troponin-I (cTnI) and cardiac myosin light chain-1 (cMLC1). The elevated serum levels of cMLC1 in mice treated with trastuzumab highlights the potential that cMLC1 could be a useful biomarker for trastuzumab-induced cardiotoxicity. PMID:24255707

Ion source for high-precision mass spectrometry

DOEpatents

Todd, Peter J.; McKown, Henry S.; Smith, David H.

1984-01-01

The invention is directed to a method for increasing the precision of positive-ion relative abundance measurements conducted in a sector mass spectrometer having an ion source for directing a beam of positive ions onto a collimating slit. The method comprises incorporating in the source an electrostatic lens assembly for providing a positive-ion beam of circular cross section for collimation by the slit.

SU-F-T-530: Characterization of a 60-Leaf Motorized MLC Designed for Cobalt-60 Units

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu, L; Smith, L; Ciresianu, A

2016-06-15

Purpose: In a continuing effort to improve conformal radiation therapy with Cobalt-60 units, a 60-leaf MLC was designed, manufactured, and released to market. This work describes the physics measurements taken to characterize the clinical performance of this MLC. Methods: A 60 leaf MLC was custom designed with tungsten leaves of 4.5 cm height, single focused, achieving field size of 30×30 cm^2 when mounted on a 100cm SAD Cobalt-60 unit. Leakage and output factor measurements were performed using a single ion chamber in a solid water phantom. Penumbra and surface dose were measured using scanning chambers and diodes in a watermore » phantom. Radiation-light coincidence measurements were performed using radiographic films. Results: With MLC mounted, measured penumbras at all depths are smaller than with jaws only. Surface doses were not significantly affected by the presence of MLC, and remained below values recommended by regulatory bodies. Light-radiation coincidences were found to be better than 3 mm for all field sizes. Leakage through the MLC was found to be strongly dependent on field size, increasing from 1.0 % for a 10×10 cm field to 2.0% for a 30×30 cm field. Such results meet the requirements of IEC 60601-2-11. The MLC was found to have significant influence on the output factor, when field size defined by MLC is significantly smaller than field size defined by jaws. Such effect is also observed on linear accelerators, but it is more pronounced on Cobalt-60 units. A 10×10 “diamond” MLC shape inside a 14×14 cm jaw showed output factor that is 5.7% higher than 10×10 cm field defined by matching MLC and jaws. Conclusion: The MLC offers clinically acceptable performance in penumbra, surface dose, and light-radiation coincidence. Several units of this MLC have recently been installed and used clinically. Validation of Cobalt-60 based IMRT with this MLC is ongoing. The authors are employees of Best Theratrnics Ltd.« less

Disrupting MLC1 and GlialCAM and ClC-2 interactions in leukodystrophy entails glial chloride channel dysfunction

NASA Astrophysics Data System (ADS)

Hoegg-Beiler, Maja B.; Sirisi, Sònia; Orozco, Ian J.; Ferrer, Isidre; Hohensee, Svea; Auberson, Muriel; Gödde, Kathrin; Vilches, Clara; de Heredia, Miguel López; Nunes, Virginia; Estévez, Raúl; Jentsch, Thomas J.

2014-03-01

Defects in the astrocytic membrane protein MLC1, the adhesion molecule GlialCAM or the chloride channel ClC-2 underlie human leukoencephalopathies. Whereas GlialCAM binds ClC-2 and MLC1, and modifies ClC-2 currents in vitro, no functional connections between MLC1 and ClC-2 are known. Here we investigate this by generating loss-of-function Glialcam and Mlc1 mouse models manifesting myelin vacuolization. We find that ClC-2 is unnecessary for MLC1 and GlialCAM localization in brain, whereas GlialCAM is important for targeting MLC1 and ClC-2 to specialized glial domains in vivo and for modifying ClC-2’s biophysical properties specifically in oligodendrocytes (OLs), the cells chiefly affected by vacuolization. Unexpectedly, MLC1 is crucial for proper localization of GlialCAM and ClC-2, and for changing ClC-2 currents. Our data unmask an unforeseen functional relationship between MLC1 and ClC-2 in vivo, which is probably mediated by GlialCAM, and suggest that ClC-2 participates in the pathogenesis of megalencephalic leukoencephalopathy with subcortical cysts.

Evaluation of clinically applied treatment beams with respect to bunker shielding parameters for a Cyberknife M6.

PubMed

Henzen, Dominik; Schmidhalter, Daniel; Zanella, Claudia Christina; Volken, Werner; Mackeprang, Paul-Henry; Malthaner, Marco; Fix, Michael Karl; Manser, Peter

2018-01-01

Compared to a conventional linear accelerator, the Cyberknife (CK) is a unique system with respect to radiation protection shielding and the variety and number of non-coplanar beams are two key components regarding this aspect. In this work, a framework to assess the direction distribution and modulation factor (MF) of clinically applied treatment beams of a CyberKnife M6 is developed. Database filtering options allow studying the influence of different parameters such as collimator types, treatment sites or different bunker sizes. A distribution of monitor units (MU) is generated by projecting treatment beams onto the walls, floor and ceiling of the CyberKnife bunker. This distribution is found to be highly heterogeneous and depending, among other parameters, on the bunker size. For our bunker design, 10%-13% of the MUs are delivered to the right and left wall, each. The floor receives more than 64% of the applied MUs, while the wall behind the patient's head is not hit by primary treatment beams. Between 0% and 5% of the total MUs are delivered to the wall at the patient's feet. This number highly depends on the treatment site, e.g., for extracranial patients no beams hit that wall. Collimator choice was found to have minor influence on the distribution of MUs. On the other hand, the MF depends on the collimator type as well as on the treatment site. The MFs (delivered MU/prescribed dose) for all treatments, all MLC treatments, cranial and extracranial treatments are 8.3, 6.4, 7.7, and 9.9 MU/cGy, respectively. The developed framework allows assessing and monitoring important parameters regarding radiation protection of a CK-M6 using the actually applied treatment beams. Furthermore, it enables evaluating different clinical and constructional situations using the filtering options. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Effect of collimator angles on the dosimetric results of volumetric modulated arc therapy planning for patients with a locally-advanced nasopharyngeal carcinoma

NASA Astrophysics Data System (ADS)

Kim, Yong Ho; Park, Dahl; Park, Ha Ryung; Kim, Won Taek; Kim, Dong Hyun; Bae, Jin Suk; Jeon, Gye Rok; Ro, Jung Hoon; Ki, Yongkan

2017-03-01

In volumetric modulated arc therapy (VMAT) planning, usually the collimator is rotated to minimize interleaf leakage and the tongue-and-groove effect. The objective of this study was to evaluate the effect of collimator angle on the dosimetric results of VMAT plans for patients with a locally-advanced nasopharyngeal carcinoma (LA-NPC). VMAT treatment planning sets were generated using the same planning parameters, but with different collimator angles for 11 LA-NPC patients. Each set was composed of 10 plans with collimator angles at 0, 5, 10, 15, 20, 25, 35, 40, and 45 degrees. Dosimetric parameters, such as target coverage, organs at risk (OAR), and dose conformity, were analyzed at various collimator angles. With increasing collimator angles, the absorbed doses to the optic apparatus were increased by up to 35% comparing to that at a collimator angle of 0°. The best value of the conformity index (CI) was 0.971 ± 0.023 at collimator angles of 20° and 30°. The worst value of CI was 0.917 ± 0.051 at a collimator angle of 0°. The homogeneity index (HI)95 and HI98 had the best values of 0.106 ± 0.040 and 0.079 ± 0.031, respectively, at a collimator angle of 25°. The worst values of HI95 and HI98 were 0.136 ± 0.039 and 0.105 ± 0.032, respectively, at a collimator angle of of 0°. The maximum doses for some OARs (body, ear, parotid gland, mandible, and brainstem) and the HI did not show any statistically significant differences. However, the mean doses had positive correlations ( r = 0.449 0.773, p<0.001) with the irradiated volume. The CI had a weak positive correlation ( r = 0.316, p<0.001) with the irradiated volume. Other comparison parameters were evaluated as functions of the collimator angle. These findings will give useful information for choosing the collimator angle in VMAT plans for patients with a LA-NPC.

Ion source for high-precision mass spectrometry

DOEpatents

Todd, P.J.; McKown, H.S.; Smith, D.H.

1982-04-26

The invention is directed to a method for increasing the precision of positive-ion relative abundance measurements conducted in a sector mass spectrometer having an ion source for directing a beam of positive ions onto a collimating slit. The method comprises incorporating in the source an electrostatic lens assembly for providing a positive-ion beam of circular cross section for collimation by the slit. 2 figures, 3 tables.

Antimicrobial Activity and Biocompatibility of the Psidium cattleianum Extracts for Endodontic Purposes.

PubMed

Massunari, Loiane; Novais, Renata Zoccal; Oliveira, Márcio Teixeira; Valentim, Diego; Dezan Junior, Eloi; Duque, Cristiane

2017-01-01

Psidium cattleianum (PC) has been displaying inhibitory effect against a variety of microorganisms, but this effect has not yet been tested against endodontic pathogens. The aim of this study was to evaluate the antimicrobial activity and biocompatibility of the aqueous (PCAE) and hydroethanolic (PCHE) extracts from Psidium cattleianum (PC) leaves. Minimum inhibitory concentration (MIC) and minimum lethal concentration (MLC) were determined using the microdilution broth method in order to analyze the antimicrobial effect against Enterococcus faecalis, Pseudomonas aeruginosa, Actinomyces israelii and Candida albicans in planktonic conditions. Biofilm assays were conducted only with the extracts that were able to determine the MLC for microorganisms in planktonic conditions. Immediate and late tissue reactions against PC extracts were evaluated using edemogenic test and histological analysis of subcutaneous implants in Wistar rats. The results showed that the MIC and MLC values ranged between 0.25 and 4 mg/mL. The MLC obtained for PCHE inhibited 100% growth of all the tested strains, except for C. albicans. PCAE had the same effect for E. faecalis and P. aeruginosa. Both PC extracts were able to eliminate E. faecalis biofilms and only the PCHE eliminated P. aeruginosa biofilms. The positive controls inhibited the growth of all tested strains in MIC and MLC essays, but no CHX tested concentrations were able to eliminate A. israelii biofilm. PCAE caused a discrete increase in the edema over time, while PCHE caused a higher initial edema, which decreased progressively. Both PCAE and PCHE extracts were biocompatible, but PCHE showed better results with slight levels of inflammation at 28 days. In conclusion, PCHE was biocompatible and presented better antimicrobial effect against important pathogens associated with persistent endodontic infections.

Inhibiting Myosin Light Chain Kinase Induces Apoptosis In Vitro and In Vivo

PubMed Central

Fazal, Fabeha; Gu, Lianzhi; Ihnatovych, Ivanna; Han, YooJeong; Hu, WenYang; Antic, Nenad; Carreira, Fernando; Blomquist, James F.; Hope, Thomas J.; Ucker, David S.; de Lanerolle, Primal

2005-01-01

Previous short-term studies have correlated an increase in the phosphorylation of the 20-kDa light chain of myosin II (MLC20) with blebbing in apoptotic cells. We have found that this increase in MLC20 phosphorylation is rapidly followed by MLC20 dephosphorylation when cells are stimulated with various apoptotic agents. MLC20 dephosphorylation is not a consequence of apoptosis because MLC20 dephosphorylation precedes caspase activation when cells are stimulated with a proapoptotic agent or when myosin light chain kinase (MLCK) is inhibited pharmacologically or by microinjecting an inhibitory antibody to MLCK. Moreover, blocking caspase activation increased cell survival when MLCK is inhibited or when cells are treated with tumor necrosis factor alpha. Depolymerizing actin filaments or detaching cells, processes that destabilize the cytoskeleton, or inhibiting myosin ATPase activity also resulted in MLC20 dephosphorylation and cell death. In vivo experiments showed that inhibiting MLCK increased the number of apoptotic cells and retarded the growth of mammary cancer cells in mice. Thus, MLC20 dephosphorylation occurs during physiological cell death and prolonged MLC20 dephosphorylation can trigger apoptosis. PMID:15988034

Myosin‑II heavy chain and formin mediate the targeting of myosin essential light chain to the division site before and during cytokinesis

PubMed Central

Feng, Zhonghui; Okada, Satoshi; Cai, Guoping; Zhou, Bing; Bi, Erfei

2015-01-01

MLC1 is a haploinsufficient gene encoding the essential light chain for Myo1, the sole myosin‑II heavy chain in the budding yeast Saccharomyces cerevisiae. Mlc1 defines an essential hub that coordinates actomyosin ring function, membrane trafficking, and septum formation during cytokinesis by binding to IQGAP, myosin‑II, and myosin‑V. However, the mechanism of how Mlc1 is targeted to the division site during the cell cycle remains unsolved. By constructing a GFP‑tagged MLC1 under its own promoter control and using quantitative live‑cell imaging coupled with yeast mutants, we found that septin ring and actin filaments mediate the targeting of Mlc1 to the division site before and during cytokinesis, respectively. Both mechanisms contribute to and are collectively required for the accumulation of Mlc1 at the division site during cytokinesis. We also found that Myo1 plays a major role in the septin‑dependent Mlc1 localization before cytokinesis, whereas the formin Bni1 plays a major role in the actin filament–dependent Mlc1 localization during cytokinesis. Such a two‑tiered mechanism for Mlc1 localization is presumably required for the ordered assembly and robustness of cytokinesis machinery and is likely conserved across species. PMID:25631819

Embryonic essential myosin light chain regulates fetal lung development in rats.

PubMed

Santos, Marta; Moura, Rute S; Gonzaga, Sílvia; Nogueira-Silva, Cristina; Ohlmeier, Steffen; Correia-Pinto, Jorge

2007-09-01

Congenital diaphragmatic hernia (CDH) is currently the most life-threatening congenital anomaly the major finding of which is lung hypoplasia. Lung hypoplasia pathophysiology involves early developmental molecular insult in branching morphogenesis and a late mechanical insult by abdominal herniation in maturation and differentiation processes. Since early determinants of lung hypoplasia might appear as promising targets for prenatal therapy, proteomics analysis of normal and nitrofen-induced hypoplastic lungs was performed at 17.5 days after conception. The major differentially expressed protein was identified by mass spectrometry as myosin light chain 1a (MLC1a). Embryonic essential MLC1a and regulatory myosin light chain 2 (MLC2) were characterized throughout normal and abnormal lung development by immunohistochemistry and Western blot. Disruption of MLC1a expression was assessed in normal lung explant cultures by antisense oligodeoxynucleotides. Since early stages of normal lung development, MLC1a was expressed in vascular smooth muscle (VSM) cells of pulmonary artery, and MLC2 was present in parabronchial smooth muscle and VSM cells of pulmonary vessels. In addition, early smooth muscle differentiation delay was observed by immunohistochemistry of alpha-smooth muscle actin and transforming growth factor-beta1. Disruption of MLC1a expression during normal pulmonary development led to significant growth and branching impairment, suggesting a role in branching morphogenesis. Both MLC1a and MLC2 were absent from hypoplastic fetal lungs during pseudoglandular stage of lung development, whereas their expression partially recovered by prenatal treatment with vitamin A. Thus, a deficiency in contractile proteins MLC1a and MLC2 might have a role among the early molecular determinants of lung hypoplasia in the rat model of nitrofen-induced CDH.

Ca2+-dependent rapid Ca2+ sensitization of contraction in arterial smooth muscle.

PubMed

Dimopoulos, George J; Semba, Shingo; Kitazawa, Kazuyo; Eto, Masumi; Kitazawa, Toshio

2007-01-05

Ca(2+) ion is a universal intracellular messenger that regulates numerous biological functions. In smooth muscle, Ca(2+) with calmodulin activates myosin light chain (MLC) kinase to initiate a rapid MLC phosphorylation and contraction. To test the hypothesis that regulation of MLC phosphatase is involved in the rapid development of MLC phosphorylation and contraction during Ca(2+) transient, we compared Ca(2+) signal, MLC phosphorylation, and 2 modes of inhibition of MLC phosphatase, phosphorylation of CPI-17 Thr38 and MYPT1 Thr853, during alpha(1) agonist-induced contraction with/without various inhibitors in intact rabbit femoral artery. Phenylephrine rapidly induced CPI-17 phosphorylation from a negligible amount to a peak value of 0.38+/-0.04 mol of Pi/mol within 7 seconds following stimulation, similar to the rapid time course of Ca(2+) rise and MLC phosphorylation. This rapid CPI-17 phosphorylation was dramatically inhibited by either blocking Ca(2+) release from the sarcoplasmic reticulum or by pretreatment with protein kinase C inhibitors, suggesting an involvement of Ca(2+)-dependent protein kinase C. This was followed by a slow Ca(2+)-independent and Rho-kinase/protein kinase C-dependent phosphorylation of CPI-17. In contrast, MYPT1 phosphorylation had only a slow component that increased from 0.29+/-0.09 at rest to the peak of 0.68+/-0.14 mol of Pi/mol at 1 minute, similar to the time course of contraction. Thus, there are 2 components of the Ca(2+) sensitization through inhibition of MLC phosphatase. Our results support the hypothesis that the initial rapid Ca(2+) rise induces a rapid inhibition of MLC phosphatase coincident with the Ca(2+)-induced MLC kinase activation to synergistically initiate a rapid MLC phosphorylation and contraction in arteries with abundant CPI-17 content.

Use of plan quality degradation to evaluate tradeoffs in delivery efficiency and clinical plan metrics arising from IMRT optimizer and sequencer compromises

PubMed Central

Wilkie, Joel R.; Matuszak, Martha M.; Feng, Mary; Moran, Jean M.; Fraass, Benedick A.

2013-01-01

Purpose: Plan degradation resulting from compromises made to enhance delivery efficiency is an important consideration for intensity modulated radiation therapy (IMRT) treatment plans. IMRT optimization and/or multileaf collimator (MLC) sequencing schemes can be modified to generate more efficient treatment delivery, but the effect those modifications have on plan quality is often difficult to quantify. In this work, the authors present a method for quantitative assessment of overall plan quality degradation due to tradeoffs between delivery efficiency and treatment plan quality, illustrated using comparisons between plans developed allowing different numbers of intensity levels in IMRT optimization and/or MLC sequencing for static segmental MLC IMRT plans. Methods: A plan quality degradation method to evaluate delivery efficiency and plan quality tradeoffs was developed and used to assess planning for 14 prostate and 12 head and neck patients treated with static IMRT. Plan quality was evaluated using a physician's predetermined “quality degradation” factors for relevant clinical plan metrics associated with the plan optimization strategy. Delivery efficiency and plan quality were assessed for a range of optimization and sequencing limitations. The “optimal” (baseline) plan for each case was derived using a clinical cost function with an unlimited number of intensity levels. These plans were sequenced with a clinical MLC leaf sequencer which uses >100 segments, assuring delivered intensities to be within 1% of the optimized intensity pattern. Each patient's optimal plan was also sequenced limiting the number of intensity levels (20, 10, and 5), and then separately optimized with these same numbers of intensity levels. Delivery time was measured for all plans, and direct evaluation of the tradeoffs between delivery time and plan degradation was performed. Results: When considering tradeoffs, the optimal number of intensity levels depends on the treatment site and on the stage in the process at which the levels are limited. The cost of improved delivery efficiency, in terms of plan quality degradation, increased as the number of intensity levels in the sequencer or optimizer decreased. The degradation was more substantial for the head and neck cases relative to the prostate cases, particularly when fewer than 20 intensity levels were used. Plan quality degradation was less severe when the number of intensity levels was limited in the optimizer rather than the sequencer. Conclusions: Analysis of plan quality degradation allows for a quantitative assessment of the compromises in clinical plan quality as delivery efficiency is improved, in order to determine the optimal delivery settings. The technique is based on physician-determined quality degradation factors and can be extended to other clinical situations where investigation of various tradeoffs is warranted. PMID:23822412

Exploiting Auto-Collimation for Real-Time Onboard Monitoring of Space Optical Camera Geometric Parameters

NASA Astrophysics Data System (ADS)

Liu, W.; Wang, H.; Liu, D.; Miu, Y.

2018-05-01

Precise geometric parameters are essential to ensure the positioning accuracy for space optical cameras. However, state-of-the-art onorbit calibration method inevitably suffers from long update cycle and poor timeliness performance. To this end, in this paper we exploit the optical auto-collimation principle and propose a real-time onboard calibration scheme for monitoring key geometric parameters. Specifically, in the proposed scheme, auto-collimation devices are first designed by installing collimated light sources, area-array CCDs, and prisms inside the satellite payload system. Through utilizing those devices, the changes in the geometric parameters are elegantly converted into changes in the spot image positions. The variation of geometric parameters can be derived via extracting and processing the spot images. An experimental platform is then set up to verify the feasibility and analyze the precision index of the proposed scheme. The experiment results demonstrate that it is feasible to apply the optical auto-collimation principle for real-time onboard monitoring.

The HEAO-A Scanning Modulation Collimator instrument

NASA Technical Reports Server (NTRS)

Roy, A.; Ballas, J.; Jagoda, N.; Mckinnon, P.; Ramsey, A.; Wester, E.

1977-01-01

The Scanning Modulation Collimator X-ray instrument for the HEAO-A satellite was designed to measure celestial radiation in the range between 1 and 15 KeV and to resolve, and correlate, the position of X-ray sources with visible light sources on the celestial sphere to within 5 arc seconds. The positional accuracy is made possible by mechanical collimation of the X-ray sources viewed by the instrument. High sensitivity is provided from two systems each containing four gas filled proportional counters followed by preamplification, signal summing, pulse height analysis, pulse shape discrimination, X-ray event accumulators and telemetry processing electronics.

SU-F-T-637: Single-Isocenter Versus Multiple-Isocenter VMAT SRS for Unusual Multiple Metastasis Case with Two Widely Separated Lesions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas, EM; Popple, RA; Fiveash, JB

Purpose: Single-isocenter (SI) volumetric modulated arc therapy has been shown to be an effective and efficient approach to multiple metastasis radiosurgery. However, certain extreme cases raise the question of whether multiple-isocenter (MI) approaches can still generate superior plans. In this study, we ask this question with respect to a clinical case with two very widely separated lesions. Methods: A patient with two widely separated (d = 12cm) tumors was treated with SI-VMAT SRS using 10MV flattening filter free (FFF) beam with high-definition multi-leaf collimator (HD-MLC, 2.5/5mm) in two non-coplanar arcs using concentric rings to enforce steep gradient. Because of lesionmore » positioning with respect to collimator angle selection, lesions were treated by 5mm leaves. We re-planned the case with a congruent arc arrangement but separate isocenter for each lesion. In this manner, lesions were treated by 2.5mm leaves. Conformity index (CI), V50%, and mean brain dose were compared. Results: Neither conformity (CI-SI = 1.12, CI-MI = 1.08) nor V50% (V50%-SI =8.82cc, V50%-MI =8.81cc) were improved by utilizing a separate isocenter for each lesion. Mean brain dose was slightly reduced (dmean-SI = 118.4 cGy, dmean-MI = 88.7 cGy) by using multiple isocenters. Conclusion: For this case with a lesion at the apex of the brain and another distantly located at the base of skull, employing a separate isocenter for each target did not meaningfully improve plan quality. Single-isocenter VMAT has been shown feasible and equivalent to multiple-isocenter VMAT for multiple metastasis cases in general. In this extreme case, single- and multiple- isocenter VMAT were also equivalent. If rotational setup errors are appropriately corrected, the increased delivery efficiency of the single-isocenter approach renders it preferable to the multiple isocenter approach. Dr’s Thomas, Popple, and Fiveash have all received honoraria from Varian Medical Systems for discussing their experiences with stereotactic radiosurgery.« less

Optical cone beam tomography of Cherenkov-mediated signals for fast 3D dosimetry of x-ray photon beams in water.

PubMed

Glaser, Adam K; Andreozzi, Jacqueline M; Zhang, Rongxiao; Pogue, Brian W; Gladstone, David J

2015-07-01

To test the use of a three-dimensional (3D) optical cone beam computed tomography reconstruction algorithm, for estimation of the imparted 3D dose distribution from megavoltage photon beams in a water tank for quality assurance, by imaging the induced Cherenkov-excited fluorescence (CEF). An intensified charge-coupled device coupled to a standard nontelecentric camera lens was used to tomographically acquire two-dimensional (2D) projection images of CEF from a complex multileaf collimator (MLC) shaped 6 MV linear accelerator x-ray photon beam operating at a dose rate of 600 MU/min. The resulting projections were used to reconstruct the 3D CEF light distribution, a potential surrogate of imparted dose, using a Feldkamp-Davis-Kress cone beam back reconstruction algorithm. Finally, the reconstructed light distributions were compared to the expected dose values from one-dimensional diode scans, 2D film measurements, and the 3D distribution generated from the clinical Varian ECLIPSE treatment planning system using a gamma index analysis. A Monte Carlo derived correction was applied to the Cherenkov reconstructions to account for beam hardening artifacts. 3D light volumes were successfully reconstructed over a 400 × 400 × 350 mm(3) volume at a resolution of 1 mm. The Cherenkov reconstructions showed agreement with all comparative methods and were also able to recover both inter- and intra-MLC leaf leakage. Based upon a 3%/3 mm criterion, the experimental Cherenkov light measurements showed an 83%-99% pass fraction depending on the chosen threshold dose. The results from this study demonstrate the use of optical cone beam computed tomography using CEF for the profiling of the imparted dose distribution from large area megavoltage photon beams in water.

Scattered dose to gonads and associated risks from radiotherapy for common pediatric malignancies : a phantom study.

PubMed

Mazonakis, Michalis; Zacharopoulou, Fotini; Kachris, Stefanos; Varveris, Charalambos; Damilakis, John; Gourtsoyiannis, Nicholas

2007-06-01

To measure the scattered dose to ovaries and testes from radiotherapy for common pediatric malignancies and to assess the relevant risks for radiation-induced gonadal damage and hereditary disorders in future generations. Radiotherapy for central nervous system tumors, acute leukemia, neuroblastoma, Hodgkin's disease, Wilms' tumor, and sarcoma was simulated on three humanoid phantoms representing patients of 5, 10, and 15 years of age. Ovarian and testicular dose measurements were performed using thermoluminescent dosimeters on a linear accelerator with multileaf collimator (MLC) producing 6-MV X-rays. The effect of lead block introduction into the primary beam on the gonadal dose was evaluated. Gonadal dose from radiotherapy for abdominal tumors was measured using an 18-MV photon beam. For a tumor dose range of 12-55 Gy, the scattered dose to ovaries was 0.5-62.4 cGy depending upon the patient's age (corresponding phantom) and treatment site. The corresponding dose to testes was 0.4-145.0 cGy. The use of blocks for field shaping can increase the gonadal dose up to a factor of 2.0 compared to that measured using MLC. Abdominal irradiation with 18-MV instead of 6-MV X-rays reduced the gonadal dose by more than 1.3 times. For female and male patients, the risk for induction of hereditary disorders was less than 81 x 10(-4) and 188 x 10(-4), respectively. The present dosimetric data suggest that pediatric radiotherapy is not associated with a risk for permanent damage to gonads excluded from the treatment volume. The risk for development of hereditary disorders in offspring conceived after exposure is low.

Verification measurements and clinical evaluation of the iPlan RT Monte Carlo dose algorithm for 6 MV photon energy

NASA Astrophysics Data System (ADS)

Petoukhova, A. L.; van Wingerden, K.; Wiggenraad, R. G. J.; van de Vaart, P. J. M.; van Egmond, J.; Franken, E. M.; van Santvoort, J. P. C.

2010-08-01

This study presents data for verification of the iPlan RT Monte Carlo (MC) dose algorithm (BrainLAB, Feldkirchen, Germany). MC calculations were compared with pencil beam (PB) calculations and verification measurements in phantoms with lung-equivalent material, air cavities or bone-equivalent material to mimic head and neck and thorax and in an Alderson anthropomorphic phantom. Dosimetric accuracy of MC for the micro-multileaf collimator (MLC) simulation was tested in a homogeneous phantom. All measurements were performed using an ionization chamber and Kodak EDR2 films with Novalis 6 MV photon beams. Dose distributions measured with film and calculated with MC in the homogeneous phantom are in excellent agreement for oval, C and squiggle-shaped fields and for a clinical IMRT plan. For a field with completely closed MLC, MC is much closer to the experimental result than the PB calculations. For fields larger than the dimensions of the inhomogeneities the MC calculations show excellent agreement (within 3%/1 mm) with the experimental data. MC calculations in the anthropomorphic phantom show good agreement with measurements for conformal beam plans and reasonable agreement for dynamic conformal arc and IMRT plans. For 6 head and neck and 15 lung patients a comparison of the MC plan with the PB plan was performed. Our results demonstrate that MC is able to accurately predict the dose in the presence of inhomogeneities typical for head and neck and thorax regions with reasonable calculation times (5-20 min). Lateral electron transport was well reproduced in MC calculations. We are planning to implement MC calculations for head and neck and lung cancer patients.

Fluence field modulated CT on a clinical TomoTherapy radiation therapy machine

NASA Astrophysics Data System (ADS)

Szczykutowicz, Timothy P.; Hermus, James

2015-03-01

Purpose: The multi-leaf collimator (MLC) assembly present on TomoTherapy (Accuray, Madison WI) radiation therapy (RT) and mega voltage CT machines is well suited to perform fluence field modulated CT (FFMCT). In addition, there is a demand in the RT environment for FFMCT imaging techniques, specifically volume of interest (VOI) imaging. Methods: A clinical TomoTherapy machine was programmed to deliver 30% imaging dose outside predefined VOIs. Four different size ROIs were placed at varying distances from isocenter. Projections intersecting the VOI received "full dose" while those not intersecting the VOI received 30% of the dose (i.e. the incident fluence for non VOI projections was 30% of the incident fluence for projections intersecting the VOI). Additional scans without fluence field modulation were acquired at "full" and 30% dose. The noise (pixel standard deviation) was measured inside the VOI region and compared between the three scans. Results: The VOI-FFMCT technique produced an image noise 1.09, 1.05, 1.05, and 1.21 times higher than the "full dose" scan for ROI sizes of 10 cm, 13 cm, 10 cm, and 6 cm respectively within the VOI region. Conclusions: Noise levels can be almost unchanged within clinically relevant VOIs sizes for RT applications while the integral imaging dose to the patient can be decreased, and/or the image quality in RT can be dramatically increased with no change in dose relative to non-FFMCT RT imaging. The ability to shift dose away from regions unimportant for clinical evaluation in order to improve image quality or reduce imaging dose has been demonstrated. This paper demonstrates that FFMCT can be performed using the MLC on a clinical TomoTherapy machine for the first time.

Quantitative evaluation of patient-specific quality assurance using online dosimetry system

NASA Astrophysics Data System (ADS)

Jung, Jae-Yong; Shin, Young-Ju; Sohn, Seung-Chang; Min, Jung-Whan; Kim, Yon-Lae; Kim, Dong-Su; Choe, Bo-Young; Suh, Tae-Suk

2018-01-01

In this study, we investigated the clinical performance of an online dosimetry system (Mobius FX system, MFX) by 1) dosimetric plan verification using gamma passing rates and dose volume metrics and 2) error-detection capability evaluation by deliberately introduced machine error. Eighteen volumetric modulated arc therapy (VMAT) plans were studied. To evaluate the clinical performance of the MFX, we used gamma analysis and dose volume histogram (DVH) analysis. In addition, to evaluate the error-detection capability, we used gamma analysis and DVH analysis utilizing three types of deliberately introduced errors (Type 1: gantry angle-independent multi-leaf collimator (MLC) error, Type 2: gantry angle-dependent MLC error, and Type 3: gantry angle error). A dosimetric verification comparison of physical dosimetry system (Delt4PT) and online dosimetry system (MFX), gamma passing rates of the two dosimetry systems showed very good agreement with treatment planning system (TPS) calculation. For the average dose difference between the TPS calculation and the MFX measurement, most of the dose metrics showed good agreement within a tolerance of 3%. For the error-detection comparison of Delta4PT and MFX, the gamma passing rates of the two dosimetry systems did not meet the 90% acceptance criterion with the magnitude of error exceeding 2 mm and 1.5 ◦, respectively, for error plans of Types 1, 2, and 3. For delivery with all error types, the average dose difference of PTV due to error magnitude showed good agreement between calculated TPS and measured MFX within 1%. Overall, the results of the online dosimetry system showed very good agreement with those of the physical dosimetry system. Our results suggest that a log file-based online dosimetry system is a very suitable verification tool for accurate and efficient clinical routines for patient-specific quality assurance (QA).

Incorrect dosimetric leaf separation in IMRT and VMAT treatment planning: Clinical impact and correlation with pretreatment quality assurance.

PubMed

Sjölin, Maria; Edmund, Jens Morgenthaler

2016-07-01

Dynamic treatment planning algorithms use a dosimetric leaf separation (DLS) parameter to model the multi-leaf collimator (MLC) characteristics. Here, we quantify the dosimetric impact of an incorrect DLS parameter and investigate whether common pretreatment quality assurance (QA) methods can detect this effect. 16 treatment plans with intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT) technique for multiple treatment sites were calculated with a correct and incorrect setting of the DLS, corresponding to a MLC gap difference of 0.5mm. Pretreatment verification QA was performed with a bi-planar diode array phantom and the electronic portal imaging device (EPID). Measurements were compared to the correct and incorrect planned doses using gamma evaluation with both global (G) and local (L) normalization. Correlation, specificity and sensitivity between the dose volume histogram (DVH) points for the planning target volume (PTV) and the gamma passing rates were calculated. The change in PTV and organs at risk DVH parameters were 0.4-4.1%. Good correlation (>0.83) between the PTVmean dose deviation and measured gamma passing rates was observed. Optimal gamma settings with 3%L/3mm (per beam and composite plan) and 3%G/2mm (composite plan) for the diode array phantom and 2%G/2mm (composite plan) for the EPID system were found. Global normalization and per beam ROC analysis of the diode array phantom showed an area under the curve <0.6. A DLS error can worsen pretreatment QA using gamma analysis with reasonable credibility for the composite plan. A low detectability was demonstrated for a 3%G/3mm per beam gamma setting. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

SU-G-TeP2-04: Comprehensive Machine Isocenter Evaluation with Separation of Gantry, Collimator, and Table Variables

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hancock, S; Clements, C; Hyer, D

2016-06-15

Purpose: To develop and demonstrate application of a method that characterizes deviation of linac x-ray beams from the centroid of the volumetric radiation isocenter as a function of gantry, collimator, and table variables. Methods: A set of Winston-Lutz ball-bearing images was used to determine the gantry radiation isocenter as the midrange of deviation values resulting from gantry and collimator rotation. Also determined were displacement of table axis from gantry isocenter and recommended table axis adjustment. The method, previously reported, has been extended to include the effect of collimator walkout by obtaining measurements with 0 and 180 degree collimator rotation formore » each gantry angle. Twelve images were used to characterize the volumetric isocenter for the full range of available gantry, collimator, and table rotations. Results: Three Varian True Beam, two Elekta Infinity and four Versa HD linacs at five institutions were tested using identical methodology. Varian linacs exhibited substantially less deviation due to head sag than Elekta linacs (0.4 mm vs. 1.2 mm on average). One linac from each manufacturer had additional isocenter deviation of 0.3 to 0.4 mm due to jaw instability with gantry and collimator rotation. For all linacs, the achievable isocenter tolerance was dependent on adjustment of collimator position offset, transverse position steering, and alignment of the table axis with gantry isocenter, facilitated by these test results. The pattern and magnitude of table axis wobble vs. table angle was reproducible and unique to each machine. Conclusion: This new method provides a comprehensive set of isocenter deviation values including all variables. It effectively facilitates minimization of deviation between beam center and target (ball-bearing) position. This method was used to quantify the effect of jaw instability on isocenter deviation and to identify the offending jaw. The test is suitable for incorporation into a routine machine QA program. Software development was performed by Radiological Imaging Technology, Inc.« less

The "collimator monitoring fill factor" of a two-dimensional detector array, a measure of its ability to detect collimation errors.

PubMed

Stelljes, Tenzin Sonam; Looe, Hui Khee; Harder, Dietrich; Poppe, Björn

2017-03-01

Two-dimensional detector arrays are routinely used for constancy checks and treatment plan verification in photon-beam radiotherapy. In addition to the spatial resolution of the dose profiles, the "coverage" of the radiation field with respect to the detection of any beam collimation deficiency appears as the second characteristic feature of a detector array. The here proposed "collimator monitoring fill factor" (CM fill factor) has been conceived to serve as a quantitative characteristic of this "coverage". The CM fill factor is defined as the probability of a 2D array to detect any collimator position error. Therefore, it is represented by the ratio of the "sensitive area" of a single detector, in which collimator position errors are detectable, and the geometrical "cell area" associated with this detector within the array. Numerical values of the CM fill factor have been Monte Carlo simulated for 2D detector arrays equipped with air-vented ionization chambers, liquid-filled ionization chambers and diode detectors and were compared with the "FWHM fill factor" defined by Gago-Arias et al. (2012). For arrays with vented ionization chambers, the differences between the CM fill factor and the FWHM fill factor are moderate, but occasionally the latter exceeds unity. For narrower detectors such as liquid-filled ionization chambers and Si diodes and for small sampling distances, large differences between the FWHM fill factor and the CM fill factor have been observed. These differences can be explained by the shapes of the fluence response functions of these narrow detectors. A new parameter "collimator monitoring fill factor" (CM fill factor), applicable to quantitate the collimator position error detection probability of a 2D detector array, has been proposed. It is designed as a help in classifying the clinical performance of two-dimensional detector arrays in photon-beam radiotherapy. © 2017 American Association of Physicists in Medicine.

Reduction of structural loads using maneuver load control on the Advanced Fighter Technology Integration (AFTI)/F-111 mission adaptive wing

NASA Technical Reports Server (NTRS)

Thornton, Stephen V.

1993-01-01

A transonic fighter-bomber aircraft, having a swept supercritical wing with smooth variable-camber flaps was fitted with a maneuver load control (MLC) system that implements a technique to reduce the inboard bending moments in the wing by shifting the spanwise load distribution inboard as load factor increases. The technique modifies the spanwise camber distribution by automatically commanding flap position as a function of flap position, true airspeed, Mach number, dynamic pressure, normal acceleration, and wing sweep position. Flight test structural loads data were obtained for loads in both the wing box and the wing root. Data from uniformly deflected flaps were compared with data from flaps in the MLC configuration where the outboard segment of three flap segments was deflected downward less than the two inboard segments. The changes in the shear loads in the forward wing spar and at the roots of the stabilators also are presented. The camber control system automatically reconfigures the flaps through varied flight conditions. Configurations having both moderate and full trailing-edge flap deflection were tested. Flight test data were collected at Mach numbers of 0.6, 0.7, 0.8, and 0.9 and dynamic pressures of 300, 450, 600, and 800 lb/sq ft. The Reynolds numbers for these flight conditions ranged from 26 x 10(exp 6) to 54 x 10(exp 6) at the mean aerodynamic chord. Load factor increases of up to 1.0 g achieved with no increase in wing root bending moment with the MLC flap configuration.

SU-C-BRB-02: Symmetric and Asymmetric MLC Based Lung Shielding and Dose Optimization During Translating Bed TBI

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahmed, S; Kakakhel, MB; Ahmed, SBS

2015-06-15

Purpose: The primary aim was to introduce a dose optimization method for translating bed total body irradiation technique that ensures lung shielding dynamically. Symmetric and asymmetric dynamic MLC apertures were employed for this purpose. Methods: The MLC aperture sizes were defined based on the radiological depth values along the divergent ray lines passing through the individual CT slices. Based on these RD values, asymmetrically shaped MLC apertures were defined every 9 mm of the phantom in superior-inferior direction. Individual MLC files were created with MATLAB™ and were imported into Eclipse™ treatment planning system for dose calculations. Lungs can be shieldedmore » to an optimum level by reducing the MLC aperture width over the lungs. The process was repeated with symmetrically shaped apertures. Results: Dose-volume histogram (DVH) analysis shows that the asymmetric MLC based technique provides better dose coverage to the body and optimum shielding of the lungs compared to symmetrically shaped beam apertures. Midline dose homogeneity is within ±3% with asymmetric MLC apertures whereas it remains within ±4.5% with symmetric ones (except head region where it drops down to −7%). The substantial over and under dosage of ±5% at tissue interfaces has been reduced to ±2% with asymmetric MLC technique. Lungs dose can be reduced to any desired limit. In this experiment lungs dose was reduced to 80% of the prescribed dose, as was desired. Conclusion: The novel asymmetric MLC based technique assures optimum shielding of OARs (e.g. lungs) and better 3-D dose homogeneity and body-dose coverage in comparison with the symmetric MLC aperture optimization. The authors acknowledge the financial and infrastructural support provided by Pakistan Institute of Engineering & Applied Sciences (PIEAS), Islamabad and Aga Khan University Hospital (AKUH), Karachi during the course of this research project. Authors have no conflict of interest with any national / international body for the presented work.« less

SU-G-BRA-14: Dose in a Rigidly Moving Phantom with Jaw and MLC Compensation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chao, E; Lucas, D

Purpose: To validate dose calculation for a rigidly moving object with jaw motion and MLC shifts to compensate for the motion in a TomoTherapy™ treatment delivery. Methods: An off-line version of the TomoTherapy dose calculator was extended to perform dose calculations for rigidly moving objects. A variety of motion traces were added to treatment delivery plans, along with corresponding jaw compensation and MLC shift compensation profiles. Jaw compensation profiles were calculated by shifting the jaws such that the center of the treatment beam moved by an amount equal to the motion in the longitudinal direction. Similarly, MLC compensation profiles weremore » calculated by shifting the MLC leaves by an amount that most closely matched the motion in the transverse direction. The same jaw and MLC compensation profiles were used during simulated treatment deliveries on a TomoTherapy system, and film measurements were obtained in a rigidly moving phantom. Results: The off-line TomoTherapy dose calculator accurately predicted dose profiles for a rigidly moving phantom along with jaw motion and MLC shifts to compensate for the motion. Calculations matched film measurements to within 2%/1 mm. Jaw and MLC compensation substantially reduced the discrepancy between the delivered dose distribution and the calculated dose with no motion. For axial motion, the compensated dose matched the no-motion dose within 2%/1mm. For transverse motion, the dose matched within 2%/3mm (approximately half the width of an MLC leaf). Conclusion: The off-line TomoTherapy dose calculator accurately computes dose delivered to a rigidly moving object, and accurately models the impact of moving the jaws and shifting the MLC leaf patterns to compensate for the motion. Jaw tracking and MLC leaf shifting can effectively compensate for the dosimetric impact of motion during a TomoTherapy treatment delivery.« less

SU-F-T-650: The Comparison of Robotic Partial Breast Stereotactic Irradiation Using MLC Vs. Iris Cone

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ding, C; Timmerman, R; Jiang, S

Purpose: To evaluate the dosimetric impact on treatment planning for partial breast stereotactic irradiation using Cyberknife with MLC versus Iris Cone. Methods: Ten patients whom underwent lumpectomy for DCIS or stage I invasive non-lobular epithelial breast cancer were included in this study. All patients were previously treated on the Cyberknife using Iris cone with the prescription dose of 37.5Gy in 5 fractions covering at least 95% of PTV on our phase I SBRT 5 fraction partial breast irradiation trial. Retrospectively, treatment planning was performed and compared using the new Cyberknife M6 MLC system for each patient. Using the same contoursmore » and critical organ constraints for both MLC and Iris cone plans, the dose on target and critical organs were analyzed accordingly. Results: Dose to critical organs such as ipsilateral lung, contralateral lung, heart, skin, ipsilateral breast, and rib were analyzed, as well as conformity index and high dose spillage of the target area. In 9 of 10 patients, the MLC plans had less total ipsilateral breast volume encompassing the 50% prescription isodose (mean:22.3±8.2% MLC vs. 31.6±8.0 Iris, p=0.00014) .The MLC plans mean estimated treatment delivery time was significantly less than the Iris plans (51±3.9min vs. 56.2±9min, p=0.03) Both MLC and Iris cone plans were able to meet all dose constraints and there was no statistical difference between those dose constraints. Conclusion: Both MLC and Iris Cone can deliver conformal dose to a partial breast target and satisfy the dose constraints of critical organs. The new Cyberknife with MLC can deliver a more conformal dose in the lower dose region and spare more ipsilateral breast tissue to the 50% prescription isodose. The treatment time for partial breast SBRT plans was also reduced using MLC. Project receives research support from Accuray Inc.« less

Comparison of MLC error sensitivity of various commercial devices for VMAT pre-treatment quality assurance.

PubMed

Saito, Masahide; Sano, Naoki; Shibata, Yuki; Kuriyama, Kengo; Komiyama, Takafumi; Marino, Kan; Aoki, Shinichi; Ashizawa, Kazunari; Yoshizawa, Kazuya; Onishi, Hiroshi

2018-05-01

The purpose of this study was to compare the MLC error sensitivity of various measurement devices for VMAT pre-treatment quality assurance (QA). This study used four QA devices (Scandidos Delta4, PTW 2D-array, iRT systems IQM, and PTW Farmer chamber). Nine retrospective VMAT plans were used and nine MLC error plans were generated for all nine original VMAT plans. The IQM and Farmer chamber were evaluated using the cumulative signal difference between the baseline and error-induced measurements. In addition, to investigate the sensitivity of the Delta4 device and the 2D-array, global gamma analysis (1%/1, 2%/2, and 3%/3 mm), dose difference (1%, 2%, and 3%) were used between the baseline and error-induced measurements. Some deviations of the MLC error sensitivity for the evaluation metrics and MLC error ranges were observed. For the two ionization devices, the sensitivity of the IQM was significantly better than that of the Farmer chamber (P < 0.01) while both devices had good linearly correlation between the cumulative signal difference and the magnitude of MLC errors. The pass rates decreased as the magnitude of the MLC error increased for both Delta4 and 2D-array. However, the small MLC error for small aperture sizes, such as for lung SBRT, could not be detected using the loosest gamma criteria (3%/3 mm). Our results indicate that DD could be more useful than gamma analysis for daily MLC QA, and that a large-area ionization chamber has a greater advantage for detecting systematic MLC error because of the large sensitive volume, while the other devices could not detect this error for some cases with a small range of MLC error. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

SU-E-T-501: Initial Orthovoltage Beam Profile Analysis of a Small Brass MLC

DOE Office of Scientific and Technical Information (OSTI.GOV)

Loughery, B; Snyder, M

2015-06-15

Purpose To create brass leaves for an orthovoltage MLC and take initial beam profile measurements. Methods The low-energy MLC was designed in previous work. Brass was chosen for its self-lubrication and low cost. Stock brass rectangles (30cm × 1.0cm × 0.5cm) were ordered with pre-cut gear rack along the topmost long edges. Leaf designs were translated into G-code, then cut with a Tormach CNC-1100 mill. Intense bowing was observed in the beam direction, which required straightening via an in-house jig. Straightened leaves were placed into MLC assembly and mounted to a 320 kVp orthovoltage tube. EDR2 film was irradiated inmore » four situations: MLC open so one edge was isocentric, and MLC open more than isocentric, completely closed MLC, and an open field shot with the MLC removed. The first two scans tested penumbra for our rectangular edges due to unfocused design. The final two scans tested transmission and interleaf leakage. All four experiments were set to 120 kVp and 10 mA for two minutes. Results Transmission and interleaf leakage were found to be zero. Interleaf leakage is faintly visible on film, but undetected by our film scanner despite high spatial resolution. Penumbra at isocenter was found to be 0.72mm, which matched the penumbras of true field edges. Penumbra off-isocenter was 1.1mm. Mechanically, leaves are moving smoothly once straightened. Conclusion Beam profiles through our brass MLC are acceptable. Leaves attenuate and move as designed. Looking forward, we intend to animate our MLC to deliver more complicated treatment plans.« less

Gender differences in the regulation of MLC20 phosphorylation and smooth muscle contraction in rat stomach

PubMed Central

Al-Shboul, Othman A.; Al-Dwairi, Ahmed N.; Alqudah, Mohammad A.; Mustafa, Ayman G.

2018-01-01

Evidence of sex-related differences in gastrointestinal (GI) functions has been reported in the literature. In addition, various GI disorders have disproportionate prevalence between the sexes. An essential step in the initiation of smooth muscle contraction is the phosphorylation of the 20-kDa regulatory myosin light chain (MLC20) by the Ca2+/calmodulin-dependent myosin light chain kinase (MLCK). However, whether male stomach smooth muscle inherits different contractile signaling mechanisms for the regulation of MLC20 phosphorylation from that in females has not been established. The present study was designed to investigate sex-associated differences in the regulation of MLC20 phosphorylation and thus muscle contraction in gastric smooth muscle cells (GSMCs). Experiments were performed on GSMCs freshly isolated from male and female rats. Contraction of the GSMCs in response to acetylcholine (ACh), a muscarinic agonist, was measured via scanning micrometry in the presence or absence of the MLCK inhibitor, ML-7. Additionally, the protein levels of MLC20, MLCK and phosphorylated MLC20 were measured by ELISA. The protein levels of MLC20 and MLCK were indifferent between the sexes. ACh induced greater contraction (P<0.05) as well as greater MLC20 phosphorylation (P<0.05) in male GSMCs compared with female. Pretreatment of GSMCs with ML-7 significantly reduced the ACh-induced contraction (P<0.05) and MLC20 phosphorylation (P<0.05) in the male and female cells, and notably, abolished the contractile differences between the sexes. In conclusion, MLC20 phosphorylation and thus muscle contraction may be activated to a greater extent in male rat stomach compared with that in females. PMID:29599980

Influence of fast and slow alkali myosin light chain isoforms on the kinetics of stretch-induced force transients of fast-twitch type IIA fibres of rat.

PubMed

Andruchov, Oleg; Galler, Stefan

2008-03-01

This study contributes to understand the physiological role of slow myosin light chain isoforms in fast-twitch type IIA fibres of skeletal muscle. These isoforms are often attached to the myosin necks of rat type IIA fibres, whereby the slow alkali myosin light chain isoform MLC1s is much more frequent and abundant than the slow regulatory myosin light chain isoform MLC2s. In the present study, single-skinned rat type IIA fibres were maximally Ca(2+) activated and subjected to stepwise stretches for causing a perturbation of myosin head pulling cycles. From the time course of the resulting force transients, myosin head kinetics was deduced. Fibres containing MLC1s exhibited slower kinetics independently of the presence or absence of MLC2s. At the maximal MLC1s concentration of about 75%, the slowing was about 40%. The slowing effect of MLC1s is possibly due to differences in the myosin heavy chain binding sites of the fast and slow alkali MLC isoforms, which changes the rigidity of the myosin neck. Compared with the impact of myosin heavy chain isoforms in various fast-twitch fibre types, the influence of MLC1s on myosin head kinetics of type IIA fibres is much smaller. In conclusion, the physiological role of fast and slow MLC isoforms in type IIA fibres is a fine-tuning of the myosin head kinetics.

Steering and collimating ballistic electrons with amphoteric refraction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Radu, A.; Dragoman, D.; Iftimie, S.

2012-07-15

We show that amphoteric refraction of ballistic electrons, i.e., positive or negative refraction depending on the incidence angle, occurs at an interface between an isotropic and an anisotropic medium and can be employed to steer and collimate electron beams. The steering angle is determined by the materials' parameters, but the degree of collimation can be tuned in a significant range by changing the energy of ballistic electrons.

Surface buildup dose dependence on photon field delivery technique for IMRT

PubMed Central

Yokoyama, Shigeru; Roberson, Peter L.; Litzenberg, Dale W.; Moran, Jean M.; Fraass, Benedick A.

2004-01-01

The more complex delivery techniques required for implementation of intensity‐modulated radiotherapy (IMRT) based on inverse planning optimization have changed the relationship between dose at depth and dose at buildup regions near the surface. Surface buildup dose is dependent on electron contamination primarily from the unblocked view of the flattening filter and secondarily from air and collimation systems. To evaluate the impact of beam segmentation on buildup dose, measurements were performed with 10×10 cm2 fields, which were delivered with 3 static 3.5×10 cm2 or 3×10 cm2 strips, 5 static 2×10 cm2 strips, 10 static 1×10 cm2 strips, and 1.1×10 cm2 dynamic delivery, compared with a 10×10 cm2 open field. Measurements were performed in water and Solid Water using parallel plate chambers, a stereotactic diode, and thermoluminescent dosimeters (TLDs) for a 6 MV X‐ray beam. Depth doses at 2 mm depth (relative to dose at 10 cm depth) were lower by 6%, 7%, 11%, and 10% for the above field delivery techniques, respectively, compared to the open field. These differences are most influenced by differences in multileaf collimator (MLC) transmission contributing to the useful beam. An example IMRT field was also studied to assess variations due to delivery technique (static vs. dynamic) and intensity level. Buildup dose is weakly dependent on the multileaf delivery technique for efficient IMRT fields. PACS numbers: 87.53.‐j, 87.53.Dq PMID:15738914

Combining MLC and SVM Classifiers for Learning Based Decision Making: Analysis and Evaluations

PubMed Central

Zhang, Yi; Ren, Jinchang; Jiang, Jianmin

2015-01-01

Maximum likelihood classifier (MLC) and support vector machines (SVM) are two commonly used approaches in machine learning. MLC is based on Bayesian theory in estimating parameters of a probabilistic model, whilst SVM is an optimization based nonparametric method in this context. Recently, it is found that SVM in some cases is equivalent to MLC in probabilistically modeling the learning process. In this paper, MLC and SVM are combined in learning and classification, which helps to yield probabilistic output for SVM and facilitate soft decision making. In total four groups of data are used for evaluations, covering sonar, vehicle, breast cancer, and DNA sequences. The data samples are characterized in terms of Gaussian/non-Gaussian distributed and balanced/unbalanced samples which are then further used for performance assessment in comparing the SVM and the combined SVM-MLC classifier. Interesting results are reported to indicate how the combined classifier may work under various conditions. PMID:26089862

Combining MLC and SVM Classifiers for Learning Based Decision Making: Analysis and Evaluations.

PubMed

Zhang, Yi; Ren, Jinchang; Jiang, Jianmin

2015-01-01

Maximum likelihood classifier (MLC) and support vector machines (SVM) are two commonly used approaches in machine learning. MLC is based on Bayesian theory in estimating parameters of a probabilistic model, whilst SVM is an optimization based nonparametric method in this context. Recently, it is found that SVM in some cases is equivalent to MLC in probabilistically modeling the learning process. In this paper, MLC and SVM are combined in learning and classification, which helps to yield probabilistic output for SVM and facilitate soft decision making. In total four groups of data are used for evaluations, covering sonar, vehicle, breast cancer, and DNA sequences. The data samples are characterized in terms of Gaussian/non-Gaussian distributed and balanced/unbalanced samples which are then further used for performance assessment in comparing the SVM and the combined SVM-MLC classifier. Interesting results are reported to indicate how the combined classifier may work under various conditions.

SU-G-TeP4-07: Automatic EPID-Based 2D Measurement of MLC Leaf Offset as a Quality Control Tool

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ritter, T; Moran, J; Schultz, B

Purpose: The MLC dosimetric leaf gap (DLG) and transmission are measured parameters which impact the dosimetric accuracy of IMRT and VMAT plans. This investigation aims to develop an efficient and accurate routine constancy check of the physical DLG in two dimensions. Methods: The manufacturer’s recommended DLG measurement method was modified by using 5 fields instead of 11 and by utilizing the Electronic Portal Imaging Device (EPID). Validations were accomplished using an ion chamber (IC) in solid water and a 2D IC array. EPID data was collected for 6 months on multiple TrueBeam linacs using both Millennium and HD MLCs atmore » 5 different clinics in an international consortium. Matlab code was written to automatically analyze the images and calculate the 2D results. Sensitivity was investigated by introducing deliberate leaf position errors. MLC calibration and initialization history was recorded to allow quantification of their impact. Results were analyzed using statistical process control (SPC). Results: The EPID method took approximately 5 minutes. Due to detector response, the EPID measured DLG and transmission differed from the IC values but were reproducible and consistent with changes measured using the ICs. For the Millennium MLC, the EPID measured DLG and transmission were both consistently lower than IC results. The EPID method was implemented as leaf offset and transmission constancy tests (LOC and TC). Based on 6 months of measurements, the initial leaf-specific action thresholds for changes from baseline were set to 0.1 mm. Upper and lower control limits for variation were developed for each machine. Conclusion: Leaf offset and transmission constancy tests were implemented on Varian HD and Millennium MLCs using an EPID and found to be efficient and accurate. The test is effective for monitoring MLC performance using dynamic delivery and performing process control on the DLG in 2D, thus enhancing dosimetric accuracy. This work was supported by a grant from Varian Medical Systems.« less

Mechanistic studies of a cell-permeant peptide designed to enhance myosin light chain phosphorylation in polarized intestinal epithelia.

PubMed

Almansour, Khaled; Taverner, Alistair; Eggleston, Ian M; Mrsny, Randall J

2018-06-10

Tight junction (TJ) structures restrict the movement of solutes between adjacent epithelial cells to maintain homeostatic conditions. A peptide, termed PIP 640, with the capacity to regulate the transient opening of intestinal TJ structures through an endogenous mechanism involving the induction of myosin light chain (MLC) phosphorylation at serine 19 (MLC-pS 19 ) has provided a promising new method to enhance the in vivo oral bioavailability of peptide therapeutics. PIP 640 is a decapeptide composed of all D-amino acids (rrdykvevrr-NH 2 ) that contains a central sequence designed to emulates a specific domain of C-kinase potentiated protein phosphatase-1 inhibitor-17 kDa (CPI-17) surrounded by positively-charged amino acids that provide a cell penetrating peptide (CPP)-like character. Here, we examine compositional requirements of PIP 640 with regard to its actions on MLC phosphorylation, its intracellular localization to TJ structures, and its interactions with MLC phosphatase (MLCP) elements that correlate with enhanced solute uptake. These studies showed that a glutamic acid and tyrosine within this peptide are critical for PIP 640 to retain its ability to increase MLC-pS 19 levels and enhance the permeability of macromolecular solutes of the size range of therapeutic peptides without detectable cytotoxicity. On the other hand, exchange of the aspartic acid for alanine and then arginine resulted in an increasingly greater bias toward protein phosphatase-1 (PP1) relative to MLCP inhibition, an outcome that resulted in increased paracellular permeability for solutes in the size range of therapeutic peptides, but with a significant increase in cytotoxicity. Together, these data further our understanding of the composition requirements of PIP 640 with respect to the desired goal of transiently altering the intestinal epithelial cell paracellular barrier properties through an endogenous mechanism, providing a novel approach to enhance the oral bioavailability of poorly absorbed therapeutic agents of < ~ 5 kDa. Copyright © 2018 Elsevier B.V. All rights reserved.

MO-FG-202-04: Gantry-Resolved Linac QA for VMAT: A Comprehensive and Efficient System Using An Electronic Portal Imaging Device

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zwan, B J; University of Newcastle, Newcastle, NSW; Barnes, M

2016-06-15

Purpose: To automate gantry-resolved linear accelerator (linac) quality assurance (QA) for volumetric modulated arc therapy (VMAT) using an electronic portal imaging device (EPID). Methods: A QA system for VMAT was developed that uses an EPID, frame-grabber assembly and in-house developed image processing software. The system relies solely on the analysis of EPID image frames acquired without the presence of a phantom. Images were acquired at 8.41 frames per second using a frame grabber and ancillary acquisition computer. Each image frame was tagged with a gantry angle from the linac’s on-board gantry angle encoder. Arc-dynamic QA plans were designed to assessmore » the performance of each individual linac component during VMAT. By analysing each image frame acquired during the QA deliveries the following eight machine performance characteristics were measured as a function of gantry angle: MLC positional accuracy, MLC speed constancy, MLC acceleration constancy, MLC-gantry synchronisation, beam profile constancy, dose rate constancy, gantry speed constancy, dose-gantry angle synchronisation and mechanical sag. All tests were performed on a Varian iX linear accelerator equipped with a 120 leaf Millennium MLC and an aS1000 EPID (Varian Medical Systems, Palo Alto, CA, USA). Results: Machine performance parameters were measured as a function of gantry angle using EPID imaging and compared to machine log files and the treatment plan. Data acquisition is currently underway at 3 centres, incorporating 7 treatment units, at 2 weekly measurement intervals. Conclusion: The proposed system can be applied for streamlined linac QA and commissioning for VMAT. The set of test plans developed can be used to assess the performance of each individual components of the treatment machine during VMAT deliveries as a function of gantry angle. The methodology does not require the setup of any additional phantom or measurement equipment and the analysis is fully automated to allow for regular routine testing.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weinmann, Amanda L.; Hruska, Carrie B.; Conners, Amy L.

Purpose: Molecular breast imaging (MBI) is a dedicated nuclear medicine breast imaging modality that employs dual-head cadmium zinc telluride (CZT) gamma cameras to functionally detect breast cancer. MBI has been shown to detect breast cancers otherwise occult on mammography and ultrasound. Currently, a MBI-guided biopsy system does not exist to biopsy such lesions. Our objective was to consider the utility of a novel conical slant-hole (CSH) collimator for rapid (<1 min) and accurate monitoring of lesion position to serve as part of a MBI-guided biopsy system. Methods: An initial CSH collimator design was derived from the dimensions of a parallel-holemore » collimator optimized for MBI performed with dual-head CZT gamma cameras. The parameters of the CSH collimator included the collimator height, cone slant angle, thickness of septa and cones of the collimator, and the annular areas exposed at the base of the cones. These parameters were varied within the geometric constraints of the MBI system to create several potential CSH collimator designs. The CSH collimator designs were evaluated using Monte Carlo simulations. The model included a breast compressed to a thickness of 6 cm with a 1-cm diameter lesion located 3 cm from the collimator face. The number of particles simulated was chosen to represent the count density of a low-dose, screening MBI study acquired with the parallel-hole collimator for 10 min after a {approx}150 MBq (4 mCi) injection of Tc-99m sestamibi. The same number of particles was used for the CSH collimator simulations. In the resulting simulated images, the count sensitivity, spatial resolution, and accuracy of the lesion depth determined from the lesion profile width were evaluated. Results: The CSH collimator design with default parameters derived from the optimal parallel-hole collimator provided 1-min images with error in the lesion depth estimation of 1.1 {+-} 0.7 mm and over 21 times the lesion count sensitivity relative to 1-min images acquired with the current parallel-hole collimator. Sensitivity was increased via more vertical cone slant angles, larger annular areas, thinner cone walls, shorter cone heights, and thinner radiating septa. Full width at half maximum trended in the opposite direction as sensitivity for all parameters. There was less error in the depth estimates for less vertical slant angles, smaller annular areas, thinner cone walls, cone heights near 1 cm, and generally thinner radiating septa. Conclusions: A Monte Carlo model was used to demonstrate the feasibility of a CSH collimator design for rapid biopsy application in molecular breast imaging. Specifically, lesion depth of a 1-cm diameter lesion positioned in the center of a typical breast can be estimated with error of less than 2 mm using circumferential count profiles of images acquired in 1 min.« less

Effect of Fiberoptic Collimation Technique on 808 nm Wavelength Laser Stimulation of Cochlear Neurons.

PubMed

Wang, Jingxuan; Lu, Jianren; Tian, Lan

2016-06-01

The purpose of this study was to evaluate the effects of fiberoptic collimation technique on auditory neural stimulation in the cochlea with 808 nm wavelength lasers. Recently, the pulsed near-infrared lasers in the 800-1000 nm wavelength range have been investigated as an emerging technique to trigger auditory neural response in the cochlea. A laser beam divergence in the optical stimulation pathway exists, which may affect stimulation efficiency and spatial selectivity. The fiberoptic collimation technique was proposed for cochlear neuron stimulation, and the C-lens element was designed as the collimation structure. The spiral ganglion cells in deafened guinea pigs' cochlea were irradiated with collimated and uncollimated near-infrared lasers. Optically evoked auditory brainstem response (OABR) under the two laser output modes were recorded. Laser with the collimation technique evoked an average 58% higher OABR amplitude than the uncollimated laser output. In addition, the collimated laser setup consumed on average 35.2% of laser energy compared with the uncollimated laser when evoking the same OABR amplitude. The fiberoptic collimation technique improved stimulation efficiency and reduced stimulating energy consumption in near-infrared neural stimulation in cochlea. The positive effects of laser collimation technique could benefit further research in optically based cochlear implants.

SU-E-T-430: Modeling MLC Leaf End in 2D for Sliding Window IMRT and Arc Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liang, X; Zhu, T

2014-06-01

Purpose: To develop a 2D geometric model for MLC accounting for leaf end dose leakage for dynamic IMRT and Rapidarc therapy. Methods: Leaf-end dose leakage is one of the problems for MLC dose calculation and modeling. Dosimetric leaf gap used to model the MLC and to count for leakage in dose calculation, but may not be accurate for smaller leaf gaps. We propose another geometric modeling method to compensate for the MLC round-shape leaf ends dose leakage, and improve the accuracy of dose calculation and dose verification. A triangular function is used to geometrically model the MLC leaf end leakagemore » in the leaf motion direction, and a step function is used in the perpendicular direction. Dose measurements with different leaf gap, different window width, and different window height were conducted, and the results were used to fit the analytical model to get the model parameters. Results: Analytical models have been obtained for stop-and-shoot and dynamic modes for MLC motion. Parameters a=0.4, lw'=5.0 mm for 6X and a=0.54, lw'=4.1 mm for 15x were obtained from the fitting process. The proposed MLC leaf end model improves the dose profile at the two ends of the sliding window opening. This improvement is especially significant for smaller sliding window openings, which are commonly used for highly modulated IMRT plans and arc therapy plans. Conclusion: This work models the MLC round leaf end shape and movement pattern for IMRT dose calculation. The theory, as well as the results in this work provides a useful tool for photon beam IMRT dose calculation and verification.« less

Myosin Light Chain Kinase Mediates Intestinal Barrier Disruption following Burn Injury

PubMed Central

Chen, Chuanli; Wang, Pei; Su, Qin; Wang, Shiliang; Wang, Fengjun

2012-01-01

Background Severe burn injury results in the loss of intestinal barrier function, however, the underlying mechanism remains unclear. Myosin light chain (MLC) phosphorylation mediated by MLC kinase (MLCK) is critical to the pathophysiological regulation of intestinal barrier function. We hypothesized that the MLCK-dependent MLC phosphorylation mediates the regulation of intestinal barrier function following burn injury, and that MLCK inhibition attenuates the burn-induced intestinal barrier disfunction. Methodology/Principal Findings Male balb/c mice were assigned randomly to either sham burn (control) or 30% total body surface area (TBSA) full thickness burn without or with intraperitoneal injection of ML-9 (2 mg/kg), an MLCK inhibitor. In vivo intestinal permeability to fluorescein isothiocyanate (FITC)-dextran was measured. Intestinal mucosa injury was assessed histologically. Tight junction proteins ZO-1, occludin and claudin-1 was analyzed by immunofluorescent assay. Expression of MLCK and phosphorylated MLC in ileal mucosa was assessed by Western blot. Intestinal permeability was increased significantly after burn injury, which was accompanied by mucosa injury, tight junction protein alterations, and increase of both MLCK and MLC phosphorylation. Treatment with ML-9 attenuated the burn-caused increase of intestinal permeability, mucosa injury, tight junction protein alterations, and decreased MLC phosphorylation, but not MLCK expression. Conclusions/Significance The MLCK-dependent MLC phosphorylation mediates intestinal epithelial barrier dysfunction after severe burn injury. It is suggested that MLCK-dependent MLC phosphorylation may be a critical target for the therapeutic treatment of intestinal epithelial barrier disruption after severe burn injury. PMID:22529961

On the use of biomathematical models in patient-specific IMRT dose QA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhen Heming; Nelms, Benjamin E.; Tome, Wolfgang A.

2013-07-15

Purpose: To investigate the use of biomathematical models such as tumor control probability (TCP) and normal tissue complication probability (NTCP) as new quality assurance (QA) metrics.Methods: Five different types of error (MLC transmission, MLC penumbra, MLC tongue and groove, machine output, and MLC position) were intentionally induced to 40 clinical intensity modulated radiation therapy (IMRT) patient plans (20 H and N cases and 20 prostate cases) to simulate both treatment planning system errors and machine delivery errors in the IMRT QA process. The changes in TCP and NTCP for eight different anatomic structures (H and N: CTV, GTV, both parotids,more » spinal cord, larynx; prostate: CTV, rectal wall) were calculated as the new QA metrics to quantify the clinical impact on patients. The correlation between the change in TCP/NTCP and the change in selected DVH values was also evaluated. The relation between TCP/NTCP change and the characteristics of the TCP/NTCP curves is discussed.Results:{Delta}TCP and {Delta}NTCP were summarized for each type of induced error and each structure. The changes/degradations in TCP and NTCP caused by the errors vary widely depending on dose patterns unique to each plan, and are good indicators of each plan's 'robustness' to that type of error.Conclusions: In this in silico QA study the authors have demonstrated the possibility of using biomathematical models not only as patient-specific QA metrics but also as objective indicators that quantify, pretreatment, a plan's robustness with respect to possible error types.« less

Alignment reference device

DOEpatents

Patton, Gail Y.; Torgerson, Darrel D.

1987-01-01

An alignment reference device provides a collimated laser beam that minimizes angular deviations therein. A laser beam source outputs the beam into a single mode optical fiber. The output end of the optical fiber acts as a source of radiant energy and is positioned at the focal point of a lens system where the focal point is positioned within the lens. The output beam reflects off a mirror back to the lens that produces a collimated beam.

Inherent smoothness of intensity patterns for intensity modulated radiation therapy generated by simultaneous projection algorithms

NASA Astrophysics Data System (ADS)

Xiao, Ying; Michalski, Darek; Censor, Yair; Galvin, James M.

2004-07-01

The efficient delivery of intensity modulated radiation therapy (IMRT) depends on finding optimized beam intensity patterns that produce dose distributions, which meet given constraints for the tumour as well as any critical organs to be spared. Many optimization algorithms that are used for beamlet-based inverse planning are susceptible to large variations of neighbouring intensities. Accurately delivering an intensity pattern with a large number of extrema can prove impossible given the mechanical limitations of standard multileaf collimator (MLC) delivery systems. In this study, we apply Cimmino's simultaneous projection algorithm to the beamlet-based inverse planning problem, modelled mathematically as a system of linear inequalities. We show that using this method allows us to arrive at a smoother intensity pattern. Including nonlinear terms in the simultaneous projection algorithm to deal with dose-volume histogram (DVH) constraints does not compromise this property from our experimental observation. The smoothness properties are compared with those from other optimization algorithms which include simulated annealing and the gradient descent method. The simultaneous property of these algorithms is ideally suited to parallel computing technologies.

Two self-referencing methods for the measurement of beam spot position.

PubMed

Nyiri, Balazs J; Smale, Jason R; Gerig, Lee H

2012-12-01

Two quantitative methods of measuring electron beam spot position with respect to the collimator axis of rotation (CAOR) are described. Method 1 uses a cylindrical ion chamber (IC) mounted on a jig corotational with the collimator making the relationship among the chamber, jaws, and CAOR fixed and independent of collimator angle. A jaw parallel to the IC axis is set to zero and the IC position adjusted so that the IC signal is approximately 50% of the open field value, providing a large dose gradient in the region of the IC. The cGy∕MU value is measured as a function of collimator rotation, e.g., every 30°. If the beam spot does not lie on the CAOR, the signal from the ion chamber will vary with collimator rotation. Based on a measured spatial sensitivity, the distance of the beam spot from the CAOR can be calculated from the IC signal variation with rotation. The 2nd method is image based. Two stainless steel rods, 3 mm in diameter, are mounted to a jig attached to the Linac collimator. The rods, offset from the CAOR, lay in different planes normal to the CAOR, one at 158 cm SSD and the other at 70 cm SSD. As the collimator rotates the rods move tangent along an envelope circle, the centers of which are on the CAOR in their respective planes. Three images, each at a different collimator rotation, containing the shadows of both rods, are acquired on the Linac EPID. At each angle the shadow of the rods on the EPID defines lines tangent to the projection of the envelope circles. From these the authors determine the projected centers of the two circles at different heights. From the distance of these two points using the two heights and the source to EPID distance, the authors calculate the distance of the beam spot from the CAOR. Measurements with all two techniques were performed on an Elekta Linac. Measurements were performed with the beam spot in nominal clinical position and in a deliberately offset position. Measurements were also performed using the Flexmap image registration∕ball-bearing test. Within their uncertainties, both methods report the same beam spot displacement. In clinical use, a total of 203 monthly beam spot measurements on 14 different beams showed an average displacement of 0.11 mm (σ = 0.07 mm) in-plane and 0.10 mm (σ = 0.07 mm) cross-plane with maximum displacement of 0.37 mm in-plane and 0.34 mm cross-plane. The methods described provide a quantitative measure of beam spot position, are easy to use, and provide another tool for Linac setup and quality assurance. Fundamental to the techniques is that they are self-referencing-i.e., they do not require the user to independently define the CAOR.

Two self-referencing methods for the measurement of beam spot position

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nyiri, Balazs J.; Smale, Jason R.; Gerig, Lee H.

2012-12-15

Purpose: Two quantitative methods of measuring electron beam spot position with respect to the collimator axis of rotation (CAOR) are described. Methods: Method 1 uses a cylindrical ion chamber (IC) mounted on a jig corotational with the collimator making the relationship among the chamber, jaws, and CAOR fixed and independent of collimator angle. A jaw parallel to the IC axis is set to zero and the IC position adjusted so that the IC signal is approximately 50% of the open field value, providing a large dose gradient in the region of the IC. The cGy/MU value is measured as amore » function of collimator rotation, e.g., every 30 Degree-Sign . If the beam spot does not lie on the CAOR, the signal from the ion chamber will vary with collimator rotation. Based on a measured spatial sensitivity, the distance of the beam spot from the CAOR can be calculated from the IC signal variation with rotation. The 2nd method is image based. Two stainless steel rods, 3 mm in diameter, are mounted to a jig attached to the Linac collimator. The rods, offset from the CAOR, lay in different planes normal to the CAOR, one at 158 cm SSD and the other at 70 cm SSD. As the collimator rotates the rods move tangent along an envelope circle, the centers of which are on the CAOR in their respective planes. Three images, each at a different collimator rotation, containing the shadows of both rods, are acquired on the Linac EPID. At each angle the shadow of the rods on the EPID defines lines tangent to the projection of the envelope circles. From these the authors determine the projected centers of the two circles at different heights. From the distance of these two points using the two heights and the source to EPID distance, the authors calculate the distance of the beam spot from the CAOR. Measurements with all two techniques were performed on an Elekta Linac. Measurements were performed with the beam spot in nominal clinical position and in a deliberately offset position. Measurements were also performed using the Flexmap image registration/ball-bearing test. Results: Within their uncertainties, both methods report the same beam spot displacement. In clinical use, a total of 203 monthly beam spot measurements on 14 different beams showed an average displacement of 0.11 mm ({sigma}= 0.07 mm) in-plane and 0.10 mm ({sigma}= 0.07 mm) cross-plane with maximum displacement of 0.37 mm in-plane and 0.34 mm cross-plane. Conclusions: The methods described provide a quantitative measure of beam spot position, are easy to use, and provide another tool for Linac setup and quality assurance. Fundamental to the techniques is that they are self-referencing-i.e., they do not require the user to independently define the CAOR.« less

Ten Novel Mutations in Chinese Patients with Megalencephalic Leukoencephalopathy with Subcortical Cysts and a Long-Term Follow-Up Research

PubMed Central

Cao, Binbin; Yan, Huifang; Guo, Mangmang; Xie, Han; Wu, Ye; Gu, Qiang; Xiao, Jiangxi; Shang, Jing; Yang, Yanling; Xiong, Hui; Niu, Zhengping; Wu, Xiru; Jiang, Yuwu; Wang, Jingmin

2016-01-01

Objective Megalencephalic leukoencephalopathy with subcortical cysts (MLC, OMIM 604004) is a rare neurological deterioration disease. We aimed to clarify clinical and genetic features of Chinese MLC patients. Methods Clinical information and peripheral venous blood of 20 patients and their families were collected, Sanger-sequencing and Multiple Ligation-dependent Probe Amplification were performed to make genetic analysis. Splicing-site mutation was confirmed with RT-PCR. UPD was detected by haplotype analysis. Follow-up study was performed through telephone for 27 patients. Results Out of 20 patients, macrocephaly, classic MRI features, motor development delay and cognitive impairment were detected in 20(100%), 20(100%), 17(85%) and 4(20%) patients, respectively. 20(100%) were clinically diagnosed with MLC. 19(95%) were genetically diagnosed with 10 novel mutations in MLC1, MLC1 and GlialCAM mutations were identified in 15 and 4 patients, respectively. Deletion mutation from exon4 to exon9 and a homozygous point mutation due to maternal UPD of chromosome22 in MLC1 were found firstly. c.598-2A>C in MLC1 leads to the skip of exon8. c.772-1G>C in MLC1 accounting for 15.5%(9/58) alleles in Chinese patients might be a founder or a hot-spot mutation. Out of 27 patients in the follow-up study, head circumference was ranged from 56cm to 61cm in patients older than 5yeas old, with a median of 57cm. Motor development delay and cognitive impairment were detected in 22(81.5%) and 5(18.5%) patients, respectively. Motor and cognitive deterioration was found in 5 (18.5%) and 2 patients (7.4%), respectively. Improvements and MRI recovery were first found in Chinese patients. Rate of seizures (45.5%), transient motor retrogress (45.5%) and unconsciousness (13.6%) after head trauma was much higher than that after fever (18.2%, 9.1%, 0%, respectively). Significance It’s a clinical and genetic analysis and a follow-up study for largest sample of Chinese MLC patients, identifying 10 novel mutations, expanding mutation spectrums and discovering clinical features of Chinese MLC patients. PMID:27322623

Electron radiography

DOEpatents

Merrill, Frank E.; Morris, Christopher

2005-05-17

A system capable of performing radiography using a beam of electrons. Diffuser means receive a beam of electrons and diffuse the electrons before they enter first matching quadrupoles where the diffused electrons are focused prior to the diffused electrons entering an object. First imaging quadrupoles receive the focused diffused electrons after the focused diffused electrons have been scattered by the object for focusing the scattered electrons. Collimator means receive the scattered electrons and remove scattered electrons that have scattered to large angles. Second imaging quadrupoles receive the collimated scattered electrons and refocus the collimated scattered electrons and map the focused collimated scattered electrons to transverse locations on an image plane representative of the electrons' positions in the object.

A novel mechanism for the Ca(2+)-sensitizing effect of protein kinase C on vascular smooth muscle: inhibition of myosin light chain phosphatase

PubMed Central

1994-01-01

Mechanisms of Ca2+ sensitization of both myosin light chain (MLC) phosphorylation and force development by protein kinase C (PKC) were studied in permeabilized tonic smooth muscle obtained from the rabbit femoral artery. For comparison, the Ca2+ sensitizing effect of guanosine 5'-O-(gamma-thiotriphosphate) (GTP gamma S) was examined, which had been previously shown to inhibit MLC phosphatase in phasic vascular smooth muscle. We now report that PKC activators (phorbol esters, short chain synthetic diacylglycerols and a diacylglycerol kinase inhibitor) and GTP gamma S significantly increase both MLC phosphorylation and force development at constant [Ca2+]. Major phosphorylation site occurring in the presence of phorbol-12,13- dibutyrate (PDBu) or GTP gamma S at constant [Ca2+] is the same serine residue (Ser-19) as that phosphorylated by MLC kinase in response to increased Ca2+ concentrations. In an ATP- and Ca(2+)-free solution containing 1-(5-chloronaphthalene-1-sulfonyl)-1H-hexahydro-1,4- diazepine (ML-9), to avoid the kinase activity, both PDBu and GTP gamma S significantly decreased the rate of MLC dephosphorylation to half its control value. However, PDBu inhibited the relaxation rate more than did GTP gamma S. In the presence of microcystin-LR to inhibit the phosphatase activity, neither PDBu nor GTP gamma S affected MLC phosphorylation and force development. These results indicate that PKC, like activation of GTP binding protein, increases Ca2+ sensitivity of both MLC phosphorylation and force production through inhibition of MLC phosphatase. PMID:7807049

The Mathematics and Computer Science Learning Center (MLC).

ERIC Educational Resources Information Center

Abraham, Solomon T.

The Mathematics and Computer Science Learning Center (MLC) was established in the Department of Mathematics at North Carolina Central University during the fall semester of the 1982-83 academic year. The initial operations of the MLC were supported by grants to the University from the Burroughs-Wellcome Company and the Kenan Charitable Trust Fund.…

76 FR 4375 - In the Matter of Certain MLC Flash Memory Devices and Products Containing Same; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-683] In the Matter of Certain MLC Flash Memory Devices and Products Containing Same; Notice of Commission Determination Not To Review an Initial... the United States after importation of certain MLC flash memory devices and products containing same...

SU-F-T-538: CyberKnife with MLC for Treatment of Large Volume Tumors: A Feasibility Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bichay, T; Mayville, A

2016-06-15

Purpose: CyberKnife is a well-documented modality for SRS and SBRT treatments. Typical tumors are small and 1–5 fractions are usually used. We determined the feasibility of using CyberKnife, with an InCise multileaf collimator option, for larger tumors undergoing standard dose and fractionation. The intent was to understand the limitation of using this modality for other external beam radiation treatments. Methods: Five tumors from different anatomical sites with volumes from 127.8 cc to 1,320.5 cc were contoured and planned on a Multiplan V5.1 workstation. The target average diameter ranged from 7 cm to 13 cm. The dose fractionation was 1.8–2.0 Gy/fractionmore » and 25–45 fractions for total doses of 45–81 Gy. The sites planned were: pancreas, head and neck, prostate, anal, and esophagus. The plans were optimized to meet conventional dose constraints based on various RTOG protocols for conventional fractionation. Results: The Multiplan treatment planning system successfully generated clinically acceptable plans for all sites studied. The resulting dose distributions achieved reasonable target coverage, all greater than 95%, and satisfactory normal tissue sparing. Treatment times ranged from 9 minutes to 38 minutes, the longest being a head and neck plan with dual targets receiving different doses and with multiple adjacent critical structures. Conclusion: CyberKnife, with the InCise multileaf collimation option, can achieve acceptable dose distributions in large volume tumors treated with conventional dose and fractionation. Although treatment times are greater than conventional accelerator time; target coverage and dose to critical structures can be kept within a clinically acceptable range. While time limitations exist, when necessary CyberKnife can provide an alternative to traditional treatment modalities for large volume tumors.« less

A multi-institutional study of independent calculation verification in inhomogeneous media using a simple and effective method of heterogeneity correction integrated with the Clarkson method.

PubMed

Jinno, Shunta; Tachibana, Hidenobu; Moriya, Shunsuke; Mizuno, Norifumi; Takahashi, Ryo; Kamima, Tatsuya; Ishibashi, Satoru; Sato, Masanori

2018-05-21

In inhomogeneous media, there is often a large systematic difference in the dose between the conventional Clarkson algorithm (C-Clarkson) for independent calculation verification and the superposition-based algorithms of treatment planning systems (TPSs). These treatment site-dependent differences increase the complexity of the radiotherapy planning secondary check. We developed a simple and effective method of heterogeneity correction integrated with the Clarkson algorithm (L-Clarkson) to account for the effects of heterogeneity in the lateral dimension, and performed a multi-institutional study to evaluate the effectiveness of the method. In the method, a 2D image reconstructed from computed tomography (CT) images is divided according to lines extending from the reference point to the edge of the multileaf collimator (MLC) or jaw collimator for each pie sector, and the radiological path length (RPL) of each line is calculated on the 2D image to obtain a tissue maximum ratio and phantom scatter factor, allowing the dose to be calculated. A total of 261 plans (1237 beams) for conventional breast and lung treatments and lung stereotactic body radiotherapy were collected from four institutions. Disagreements in dose between the on-site TPSs and a verification program using the C-Clarkson and L-Clarkson algorithms were compared. Systematic differences with the L-Clarkson method were within 1% for all sites, while the C-Clarkson method resulted in systematic differences of 1-5%. The L-Clarkson method showed smaller variations. This heterogeneity correction integrated with the Clarkson algorithm would provide a simple evaluation within the range of -5% to +5% for a radiotherapy plan secondary check.

Carbachol-induced rabbit bladder smooth muscle contraction: roles of protein kinase C and Rho kinase.

PubMed

Wang, Tanchun; Kendig, Derek M; Smolock, Elaine M; Moreland, Robert S

2009-12-01

Smooth muscle contraction is regulated by phosphorylation of the myosin light chain (MLC) catalyzed by MLC kinase and dephosphorylation catalyzed by MLC phosphatase. Agonist stimulation of smooth muscle results in the inhibition of MLC phosphatase activity and a net increase in MLC phosphorylation and therefore force. The two pathways believed to be primarily important for inhibition of MLC phosphatase activity are protein kinase C (PKC)-catalyzed CPI-17 phosphorylation and Rho kinase (ROCK)-catalyzed myosin phosphatase-targeting subunit (MYPT1) phosphorylation. The goal of this study was to determine the roles of PKC and ROCK and their downstream effectors in regulating MLC phosphorylation levels and force during the phasic and sustained phases of carbachol-stimulated contraction in intact bladder smooth muscle. These studies were performed in the presence and absence of the PKC inhibitor bisindolylmaleimide-1 (Bis) or the ROCK inhibitor H-1152. Phosphorylation levels of Thr(38)-CPI-17 and Thr(696)/Thr(850)-MYPT1 were measured at different times during carbachol stimulation using site-specific antibodies. Thr(38)-CPI-17 phosphorylation increased concurrently with carbachol-stimulated force generation. This increase was reduced by inhibition of PKC during the entire contraction but was only reduced by ROCK inhibition during the sustained phase of contraction. MYPT1 showed high basal phosphorylation levels at both sites; however, only Thr(850) phosphorylation increased with carbachol stimulation; the increase was abolished by the inhibition of either ROCK or PKC. Our results suggest that during agonist stimulation, PKC regulates MLC phosphatase activity through phosphorylation of CPI-17. In contrast, ROCK phosphorylates both Thr(850)-MYPT1 and CPI-17, possibly through cross talk with a PKC pathway, but is only significant during the sustained phase of contraction. Last, our results demonstrate that there is a constitutively activate pool of ROCK that phosphorylates MYPT1 in the basal state, which may account for the high resting levels of MLC phosphorylation measured in rabbit bladder smooth muscle.

Effects of prostaglandin F2alpha and latanoprost on phosphoinositide turnover, myosin light chain phosphorylation and contraction in cat iris sphincter.

PubMed

Ansari, Habib R; Davis, Angela M; Kaddour-Djebbar, Ismail; Abdel-Latif, Ata A

2003-06-01

The effects of the ocular hypotensive agents prostaglandin F(2alpha) (PGF(2alpha)) and its analog latanoprost on intraocular pressure (IOP) in both animals and human have been investigated extensively in the last two decades. While there is general agreement that application of these PGs to the eye alters IOP by altering the aqueous humor outflow of the eye via the uveoscleral and trabecular meshwork pathways, the mechanism of action of these agents on IOP lowering remains unclear. There is evidence which suggests that myosin light kinase (MLC kinase) may be involved in the IOP-lowering effects of these agents. Thus, the purpose of the present work was to investigate in cat iris sphincter the effects of these PGs on the MLC kinase signaling pathway, inositol phosphates production, MLC phosphorylation and contraction, in order to gain more information about the mechanism through which these agents modulate smooth muscle function and lower IOP. [(3)H]myo-inositol phosphates production was measured by ion-exchange chromatography, MLC kinase activity was measured by incorporation of (32)Pi into MLC, and changes in muscle tension were recorded isometrically. PGF(2alpha) and latanoprost induced contraction in a concentration-dependent manner with EC(50) values of 18.6 and 29.9 nM, respectively, and increased inositol phosphates production in a concentration-dependent manner. At 1 microM, PGF(2alpha) and latanoprost increased inositol phosphates formation by 125 and 102% over basal, respectively. PGF(2alpha) and latanoprost increased MLC phosphorylation in a concentration- and time-dependent manner, at 1 microM and 5 min incubation, the PGs increased the MLC response by 181 and 176% over basal, respectively. In general, PGF(2alpha) was slightly more potent in inducing the biochemical and pharmacological responses. Wortmannin, ML-7 and ML-9, selective inhibitors of MLC kinase, inhibited significantly PGF(2alpha)- and latanoprost-induced MLC phosphorylation and contraction. These results demonstrate for the first time involvement of the MLC kinase pathway in the FP receptor function of this ocular tissue. Contraction-relaxation of smooth muscle alters the shape and stiffness of smooth muscle cells and MLC kinase, through myosin phosphorylation and dephosphorylation, has been shown to be involved in cytoskeletal remodeling, cytoskeletal alterations, and IOP lowering. In light of these reports and the findings presented here we suggest that alterations in the MLC kinase signaling pathway and its derived second messengers, which leads to changes in contraction-relaxation of the smooth muscles of the anterior segment, could facilitate aqueous humor outflow and thus contribute to the IOP-lowering effects of the FP-class PGs.

The Rho-GTPase effector ROCK regulates meiotic maturation of the bovine oocyte via myosin light chain phosphorylation and cofilin phosphorylation.

PubMed

Lee, So-Rim; Xu, Yong-Nan; Jo, Yu-Jin; Namgoong, Suk; Kim, Nam-Hyung

2015-11-01

Oocyte meiosis involves a unique asymmetric division involving spindle movement from the central cytoplasm to the cortex, followed by polar body extrusion. ROCK is a Rho-GTPase effector involved in various cellular functions in somatic cells as well as oocyte meiosis. ROCK was previously shown to promote actin organization by phosphorylating several downstream targets, including LIM domain kinase (LIMK), phosphorylated cofilin (p-cofilin), and myosin light chain (MLC). In this study, we investigated the roles of ROCK and MLC during bovine oocyte meiosis. We found that ROCK was localized around the nucleus at the oocyte's germinal-vesicle (GV) stage, but spreads to the rest of the cytoplasm in later developmental stages. On the other hand, phosphorylated MLC (p-MLC) localized at the cortex, and its abundance decreased by the metaphase-II stage. Disrupting ROCK activity, via RNAi or the chemical inhibitor Y-27632, blocked both cell cycle progression and polar body extrusion. ROCK inhibition also resulted in decreased cortical actin, p-cofilin, and p-MLC levels. Similar to the phenotype associated with inhibition of ROCK activity, inhibition of MLC kinase by the chemical inhibitor ML-7 caused defects in polar body extrusion. Collectively, our results suggest that the ROCK/MLC/actomyosin as well as ROCK/LIMK/cofilin pathways regulate meiotic spindle migration and cytokinesis during bovine oocyte maturation. © 2015 Wiley Periodicals, Inc.

Dosimetric effect of multileaf collimator leaf width on volumetric modulated arc stereotactic radiotherapy for spine tumors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Amoush, Ahmad, E-mail: aamoush@augusta.edu; Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195; Long, Huang

This work aimed to study the dosimetric effect of multileaf collimator (MLC) leaf widths in treatment plans for patients receiving volumetric modulated arc therapy (VMAT) for spine stereotactic body radiation therapy (SBRT). Thirteen patients treated with spine SBRT were retrospectively selected for this study. The patients were treated following the protocol of the Radiation Therapy Oncology Group 0631 (RTOG 0631) for spine metastasis. The prescription dose was 16 Gy in 1 fraction to 90% of the target volume (V16 > 90%). The maximum spinal cord dose of 14 Gy and 10% of the spinal cord receiving < 10 Gy (V10) were the acceptable tolerance doses. For themore » purpose of this study, 2 dual-arc VMAT plans were created for each patient using 3 different MLC leaf widths: 2.5 mm, 4 mm, and 5 mm. The compliance with the RTOG 0631 protocol, conformity index (CI), dose gradient index (DGI), and number of monitor units (MUs) were compared. The average V16Gy of the targets was 91.8 ± 1.2%, 92.2 ± 2.1%, and 91.7 ± 2.3% for 2.5-mm, 4-mm, and 5-mm leaf widths, respectively (p = 0.78). Accordingly, the average CI was 1.45 ± 0.4, 1.47 ± 0.29, and 1.47 ± 0.31 (p = 0.98), respectively. The average DGI was 0.22 ± 0.04, 0.20 ± 0.06, and 0.22 ± 0.05, respectively (p = 0.77). The average maximum dose to the spinal cord was 12.45 ± 1.0 Gy, 12.80 ± 1.0 Gy, and 12.48 ± 1.1 (p = 0.62) and V10% of the spinal cord was 3.6 ± 2.1%, 5.6 ± 2.8%, and 5.5 ± 3.0% (p = 0.11) for 2.5-mm, 4-mm, and 5-mm leaf widths, respectively. Accordingly, the average number of MUs was 4341 ± 500 MU, 5019 ± 834 MU, and 4606 ± 691 MU, respectively (p = 0.053). The use of 2.5-mm, 4-mm, and 5-mm MLCs achieved similar VMAT plan quality as recommended by the RTOG 0631. The dosimetric parameters were also comparable for the 3 MLCs. In general, any of these leaf widths can be used for spine SBRT using VMAT.« less

High contrast laser beam collimation testing using two proximately placed holographic optical elements

NASA Astrophysics Data System (ADS)

Rajkumar; Dubey, Rajiv; Debnath, Sanjit K.; Chhachhia, D. P.

2018-05-01

Accuracy in laser beam collimation is very important in systems used for precision measurements. The present work reports a technique for collimation testing of laser beams using two proximately placed holographic optical elements (HOEs). The required HOEs are designed and fabricated such that upon illumination with the test beam, they release two laterally sheared wavefronts, at desired angles from the directly transmitted beam, that superimpose each other to generate straight interference fringes. Deviation from the collimation of the test beam results in orientation of these otherwise horizontal fringes. The novelty of this setup comes from the fact that HOEs are lightweight, as well as easy to fabricate as compared to conventional wedge plates used for collimation testing, and generate high contrast fringes compared to other interferometry, holography, Talbot and Moiré based techniques in a compact manner. The proposed technique is experimentally validated by measuring the orientation of fringes by an angle of 16.4° when a collimating lens of focal length 200 mm is defocused by 600 μm. The accuracy in the setting of this collimation position is obtained to be 10 μm.

Application of Gaussian beam ray-equivalent model and back-propagation artificial neural network in laser diode fast axis collimator assembly.

PubMed

Yu, Hao; Rossi, Giammarco; Braglia, Andrea; Perrone, Guido

2016-08-10

The paper presents the development of a tool based on a back-propagation artificial neural network to assist in the accurate positioning of the lenses used to collimate the beam from semiconductor laser diodes along the so-called fast axis. After training using a Gaussian beam ray-equivalent model, the network is capable of indicating the tilt, decenter, and defocus of such lenses from the measured field distribution, so the operator can determine the errors with respect to the actual lens position and optimize the diode assembly procedure. An experimental validation using a typical configuration exploited in multi-emitter diode module assembly and fast axis collimating lenses with different focal lengths and numerical apertures is reported.

Drastic increase of myosin light chain MLC-2 in senescent skeletal muscle indicates fast-to-slow fibre transition in sarcopenia of old age.

PubMed

Gannon, Joan; Doran, Philip; Kirwan, Anne; Ohlendieck, Kay

2009-11-01

The age-dependent decline in skeletal muscle mass and function is believed to be due to a multi-factorial pathology and represents a major factor that blocks healthy aging by increasing physical disability, frailty and loss of independence in the elderly. This study has focused on the comparative proteomic analysis of contractile elements and revealed that the most striking age-related changes seem to occur in the protein family representing myosin light chains (MLCs). Comparative screening of total muscle extracts suggests a fast-to-slow transition in the aged MLC population. The mass spectrometric analysis of the myofibril-enriched fraction identified the MLC2 isoform of the slow-type MLC as the contractile protein with the most drastically changed expression during aging. Immunoblotting confirmed an increased abundance of slow MLC2, concomitant with a switch in fast versus slow myosin heavy chains. Staining of two-dimensional gels of crude extracts with the phospho-specific fluorescent dye ProQ-Diamond identified the increased MLC2 spot as a muscle protein with a drastically enhanced phosphorylation level in aged fibres. Comparative immunofluorescence microscopy, using antibodies to fast and slow myosin isoforms, confirmed a fast-to-slow transformation process during muscle aging. Interestingly, the dramatic increase in slow MLC2 expression was restricted to individual senescent fibres. These findings agree with the idea that aged skeletal muscles undergo a shift to more aerobic-oxidative metabolism in a slower-twitching fibre population and suggest the slow MLC2 isoform as a potential biomarker for fibre type shifting in sarcopenia of old age.

Design and dosimetry of small animal radiation facilities

NASA Astrophysics Data System (ADS)

Rodriguez, Manuel R.

The aim of this work was to develop an irradiation system for radiobiology studies. We designed a novel image-guided micro-irradiator capable of partial-body zebrafish embryo irradiation. The radiation source is a 50 kV photon beam from a miniature x-ray source (Xoft Inc., CA). The source is inserted in a cylindrical brass collimator, 3 cm in diameter and 3 cm in length. The collimator has a 1 mm-diameter pinhole along the longitudinal axis, which provides a well-focused beam with a sharp penumbra. A photodiode is installed at one exit of the pinhole collimator to monitor the photon dose rate. The source with the collimator is attached under a movable table. A video camera, connected to the computer, is placed above the movable table to record position of the specimens in relation to the pinhole collimator. The captured images are analyzed, and the relative distances between the specimens and the pinhole are calculated. The coordinates are sent to the computer-controlled movable table to accurately position the specimens in the beam. Monte Carlo simulations were performed to characterize dosimetric properties of the system, to determine dosimetric sensitivity, and to help in the design. The image-guidance and high precision of the movable table enable very accurate specimen position. The beam monitoring system provides accurate, fast and easy dose determination. Portability and self-shielding make this system suitable for any radiobiology laboratory. This novel micro-irradiator is appropriate for partial irradiation of zebrafish embryos; however its potential use is much wider like irradiation of cell cultures or other small specimens.

Mainland Chinese Students at an Elite Hong Kong University: Habitus-Field Disjuncture in a Transborder Context

ERIC Educational Resources Information Center

Xu, Cora Lingling

2017-01-01

Drawing on in-depth interview data from 31 mainland Chinese (MLC) students in a Hong Kong university, this article conceptualises MLC and Hong Kong higher education as two dissonant but interrelated subfields of the Chinese higher education field. The article argues that these MLC students' habitus, one that possesses rich economic, social and…

MO-H-19A-02: Investigation of Modulated Electron Arc (MeArc) Therapy for the Treatment of Scalp Tumors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eldib, A; Al-Azhar University, Cairo; Jin, L

2014-06-15

Purpose: Electron arc therapy has long been proposed as the most suitable technique for the treatment of superficial tumors that follow circularly curved surfaces. However it was challenged by unsuitability of the conventional applicators and the lack of adequate 3-D dose calculation tools for arc electron beams in the treatment planning systems (TPS). Now with the availability of an electron specific multi-leaf collimator (eMLC) and an in-house Monte Carlo (MC) based TPS, we were motivated to investigate more advanced modulated electron arc (MeARC) therapy and its beneficial outcome. Methods: We initiated the study by a film measurement conducted in amore » head and neck phantom, where we delivered electron arcs in a step and shoot manner using the light field as a guide to avoid fields abutments. This step was done to insure enough clearance for the arcs with eMLC. MCBEAM and MCPLAN MC codes were used for the treatment head simulation and phantom dose calculation, respectively. Treatment plans were generated for targets drawn in real patient CTs and head and neck phantom. We utilized beams eye view available from a commercial planning system to create beamlets having same isocenter and adjoined at the scalp surface. Then dose-deposition coefficients from those beamlets were calculated for all electron energies using MCPLAN. An in-house optimization code was then used to find the optimum weights needed from individual beamlets. Results: MeARC showed a nicely tailored dose distribution around the circular curved target on the scalp. Some hot spots were noticed and could be attributed to fields abutment problem owing to the bulging nature of electron profiles. Brain dose was shown to be at lower levels compared to photon treatment. Conclusion: MeARC was shown to be a promising modality for treating scalp cases and could be beneficial to all superficial tumors with a circular curvature.« less

SU-F-T-493: An Investigation Into the Feasibility of Using PipsPro Software with Film for Linac QA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Underwood, R

2016-06-15

Purpose: To determine the feasibility of using radiochromic and radiographic film with Pipspro software for quality assurance of linear accelerators with no on-board imaging. Methods: The linear accelerator being used is a Varian Clinac 21EX. All IGRT is performed using the BrainLab ExacTrac system. Because of the lack of on board imaging, certain monthly and annual TG-142 quality assurance tests are more difficult to perform and analyze to a high degree of accuracy. Pipspro was not designed to be used with hard film, and to our knowledge its use with film had not been investigated. The film used will bemore » GafChromic EBT3 film and Kodak EDR2 film, scanned with an Epson V700 scanner. The following routine tests will be attempted: MLC picket fence, light vs. radiation field coincidence, starshots, and MLC transmission. Results: The only tests that gave accurate and reliable results were the couch, gantry, and collimator starshots. Typical MV and kV images are acquired with a much higher level of contrast between the irradiated and non-irradiated areas when compared to film. Pipspro relies on this level of contrast to be able to automatically detect the fiducial points from its phantom devices, leaf edges for picket fence and transmission tests, and jaw edges for light vs. radiation field tests. Because of this, certain tests gave erroneous results and others were not able to be performed in the software at all, with either type of film. The number of monitor units delivered to the film, the experimental setup, and the scan settings was not able to rectify the problem. Conclusion: For linear accelerators with no on-board imaging, it is not recommended to use hard film with PipsPro to perform TG-142 quality assurance tests. Other software or methods should instead be investigated.« less

TH-AB-BRB-04: Quality Assurance for Advanced Digital Linac Implementations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, V.

2016-06-15

Current state-of-the art digital C-arm medical linear accelerators are capable of delivering radiation treatments with high level of automation, which affords coordinated motions of gantry, couch, and multileaf collimator (MLC) with dose rate modulations. The new machine capacity has shown the potential to bring substantially improved radiation dosimetry and/or delivery efficiency to many challenging diseases. Combining an integrated beam orientation optimization algorithm with automated machine navigation, markedly improved dose conformity has been achieved using 4ρ therapy. Trajectory modulated radiation therapy (TMAT) can be used to deliver highly conformal dose to partial breast or to carve complex dose distribution for therapymore » involving extended volumes such as total marrow and total lymph node treatment. Dynamic electron arc radiotherapy (DEAR) not only overcomes the deficiencies of conventional electron therapy in dose conformity and homogeneity but also achieves so without patient-specific shields. The combination of MLC and couch tracking provides improved motion management of thoracic and abdominal tumors. A substantial body of work has been done in these technological advances for clinical translation. The proposed symposium will provide a timely review of these exciting opportunities. Learning Objectives: Recognize the potential of using digitally controlled linacs for clinically significant improvements in delivered dose distributions for various treatment sites. Identify existing approaches to treatment planning, optimization and delivery for treatment techniques utilizing the advanced functions of digital linacs and venues for further development and improvement. Understand methods for testing and validating delivery system performance. Identify tools available on current delivery systems for implementation and control for such treatments. Obtain the update in clinical applications, trials and regulatory approval. K. Sheng, NIH U19AI067769, NIH R43CA183390, NIH R01CA188300, Varian Medical Systems V. Yu, Varian Medical Systems, AAPM Summer Undergraduate Fellowship, NSF graduate fellowship S. Nill, Elekta AB. Cancer Research UK under Programme C33589/A19727, NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research.« less

TH-AB-BRB-00: Research Opportunities with Digital Linear Accelerators

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

2016-06-15

Current state-of-the art digital C-arm medical linear accelerators are capable of delivering radiation treatments with high level of automation, which affords coordinated motions of gantry, couch, and multileaf collimator (MLC) with dose rate modulations. The new machine capacity has shown the potential to bring substantially improved radiation dosimetry and/or delivery efficiency to many challenging diseases. Combining an integrated beam orientation optimization algorithm with automated machine navigation, markedly improved dose conformity has been achieved using 4ρ therapy. Trajectory modulated radiation therapy (TMAT) can be used to deliver highly conformal dose to partial breast or to carve complex dose distribution for therapymore » involving extended volumes such as total marrow and total lymph node treatment. Dynamic electron arc radiotherapy (DEAR) not only overcomes the deficiencies of conventional electron therapy in dose conformity and homogeneity but also achieves so without patient-specific shields. The combination of MLC and couch tracking provides improved motion management of thoracic and abdominal tumors. A substantial body of work has been done in these technological advances for clinical translation. The proposed symposium will provide a timely review of these exciting opportunities. Learning Objectives: Recognize the potential of using digitally controlled linacs for clinically significant improvements in delivered dose distributions for various treatment sites. Identify existing approaches to treatment planning, optimization and delivery for treatment techniques utilizing the advanced functions of digital linacs and venues for further development and improvement. Understand methods for testing and validating delivery system performance. Identify tools available on current delivery systems for implementation and control for such treatments. Obtain the update in clinical applications, trials and regulatory approval. K. Sheng, NIH U19AI067769, NIH R43CA183390, NIH R01CA188300, Varian Medical Systems V. Yu, Varian Medical Systems, AAPM Summer Undergraduate Fellowship, NSF graduate fellowship S. Nill, Elekta AB. Cancer Research UK under Programme C33589/A19727, NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research.« less

Simultaneous optimization of photons and electrons for mixed beam radiotherapy

NASA Astrophysics Data System (ADS)

Mueller, S.; Fix, M. K.; Joosten, A.; Henzen, D.; Frei, D.; Volken, W.; Kueng, R.; Aebersold, D. M.; Stampanoni, M. F. M.; Manser, P.

2017-07-01

The aim of this work is to develop and investigate an inverse treatment planning process (TPP) for mixed beam radiotherapy (MBRT) capable of performing simultaneous optimization of photon and electron apertures. A simulated annealing based direct aperture optimization (DAO) is implemented to perform simultaneous optimization of photon and electron apertures, both shaped with the photon multileaf collimator (pMLC). Validated beam models are used as input for Monte Carlo dose calculations. Consideration of photon pMLC transmission during DAO and a weight re-optimization of the apertures after deliverable dose calculation are utilized to efficiently reduce the differences between optimized and deliverable dose distributions. The TPP for MBRT is evaluated for an academic situation with a superficial and an enlarged PTV in the depth, a left chest wall case including the internal mammary chain and a squamous cell carcinoma case. Deliverable dose distributions of MBRT plans are compared to those of modulated electron radiotherapy (MERT), photon IMRT and if available to those of clinical VMAT plans. The generated MBRT plans dosimetrically outperform the MERT, photon IMRT and VMAT plans for all investigated situations. For the clinical cases of the left chest wall and the squamous cell carcinoma, the MBRT plans cover the PTV similarly or more homogeneously than the VMAT plans, while OARs are spared considerably better with average reductions of the mean dose to parallel OARs and D 2% to serial OARs by 54% and 26%, respectively. Moreover, the low dose bath expressed as V 10% to normal tissue is substantially reduced by up to 45% compared to the VMAT plans. A TPP for MBRT including simultaneous optimization is successfully implemented and the dosimetric superiority of MBRT plans over MERT, photon IMRT and VMAT plans is demonstrated for academic and clinical situations including superficial targets with and without deep-seated part.

Simultaneous optimization of photons and electrons for mixed beam radiotherapy.

PubMed

Mueller, S; Fix, M K; Joosten, A; Henzen, D; Frei, D; Volken, W; Kueng, R; Aebersold, D M; Stampanoni, M F M; Manser, P

2017-06-26

The aim of this work is to develop and investigate an inverse treatment planning process (TPP) for mixed beam radiotherapy (MBRT) capable of performing simultaneous optimization of photon and electron apertures. A simulated annealing based direct aperture optimization (DAO) is implemented to perform simultaneous optimization of photon and electron apertures, both shaped with the photon multileaf collimator (pMLC). Validated beam models are used as input for Monte Carlo dose calculations. Consideration of photon pMLC transmission during DAO and a weight re-optimization of the apertures after deliverable dose calculation are utilized to efficiently reduce the differences between optimized and deliverable dose distributions. The TPP for MBRT is evaluated for an academic situation with a superficial and an enlarged PTV in the depth, a left chest wall case including the internal mammary chain and a squamous cell carcinoma case. Deliverable dose distributions of MBRT plans are compared to those of modulated electron radiotherapy (MERT), photon IMRT and if available to those of clinical VMAT plans. The generated MBRT plans dosimetrically outperform the MERT, photon IMRT and VMAT plans for all investigated situations. For the clinical cases of the left chest wall and the squamous cell carcinoma, the MBRT plans cover the PTV similarly or more homogeneously than the VMAT plans, while OARs are spared considerably better with average reductions of the mean dose to parallel OARs and D 2% to serial OARs by 54% and 26%, respectively. Moreover, the low dose bath expressed as V 10% to normal tissue is substantially reduced by up to 45% compared to the VMAT plans. A TPP for MBRT including simultaneous optimization is successfully implemented and the dosimetric superiority of MBRT plans over MERT, photon IMRT and VMAT plans is demonstrated for academic and clinical situations including superficial targets with and without deep-seated part.

Treatment planning for spinal radiosurgery : A competitive multiplatform benchmark challenge.

PubMed

Moustakis, Christos; Chan, Mark K H; Kim, Jinkoo; Nilsson, Joakim; Bergman, Alanah; Bichay, Tewfik J; Palazon Cano, Isabel; Cilla, Savino; Deodato, Francesco; Doro, Raffaela; Dunst, Jürgen; Eich, Hans Theodor; Fau, Pierre; Fong, Ming; Haverkamp, Uwe; Heinze, Simon; Hildebrandt, Guido; Imhoff, Detlef; de Klerck, Erik; Köhn, Janett; Lambrecht, Ulrike; Loutfi-Krauss, Britta; Ebrahimi, Fatemeh; Masi, Laura; Mayville, Alan H; Mestrovic, Ante; Milder, Maaike; Morganti, Alessio G; Rades, Dirk; Ramm, Ulla; Rödel, Claus; Siebert, Frank-Andre; den Toom, Wilhelm; Wang, Lei; Wurster, Stefan; Schweikard, Achim; Soltys, Scott G; Ryu, Samuel; Blanck, Oliver

2018-05-25

To investigate the quality of treatment plans of spinal radiosurgery derived from different planning and delivery systems. The comparisons include robotic delivery and intensity modulated arc therapy (IMAT) approaches. Multiple centers with equal systems were used to reduce a bias based on individual's planning abilities. The study used a series of three complex spine lesions to maximize the difference in plan quality among the various approaches. Internationally recognized experts in the field of treatment planning and spinal radiosurgery from 12 centers with various treatment planning systems participated. For a complex spinal lesion, the results were compared against a previously published benchmark plan derived for CyberKnife radiosurgery (CKRS) using circular cones only. For two additional cases, one with multiple small lesions infiltrating three vertebrae and a single vertebra lesion treated with integrated boost, the results were compared against a benchmark plan generated using a best practice guideline for CKRS. All plans were rated based on a previously established ranking system. All 12 centers could reach equality (n = 4) or outperform (n = 8) the benchmark plan. For the multiple lesions and the single vertebra lesion plan only 5 and 3 of the 12 centers, respectively, reached equality or outperformed the best practice benchmark plan. However, the absolute differences in target and critical structure dosimetry were small and strongly planner-dependent rather than system-dependent. Overall, gantry-based IMAT with simple planning techniques (two coplanar arcs) produced faster treatments and significantly outperformed static gantry intensity modulated radiation therapy (IMRT) and multileaf collimator (MLC) or non-MLC CKRS treatment plan quality regardless of the system (mean rank out of 4 was 1.2 vs. 3.1, p = 0.002). High plan quality for complex spinal radiosurgery was achieved among all systems and all participating centers in this planning challenge. This study concludes that simple IMAT techniques can generate significantly better plan quality compared to previous established CKRS benchmarks.

Automation of a Linear Accelerator Dosimetric Quality Assurance Program

NASA Astrophysics Data System (ADS)

Lebron Gonzalez, Sharon H.

According to the American Society of Radiation Oncology, two-thirds of all cancer patients will receive radiation therapy during their illness with the majority of the treatments been delivered by a linear accelerator (linac). Therefore, quality assurance (QA) procedures must be enforced in order to deliver treatments with a machine in proper conditions. The overall goal of this project is to automate the linac's dosimetric QA procedures by analyzing and accomplishing various tasks. First, the photon beam dosimetry (i.e. total scatter correction factor, infinite percentage depth dose (PDD) and profiles) were parameterized. Parameterization consists of defining the parameters necessary for the specification of a dosimetric quantity model creating a data set that is portable and easy to implement for different applications including: beam modeling data input into a treatment planning system (TPS), comparing measured and TPS modelled data, the QA of a linac's beam characteristics, and the establishment of a standard data set for comparison with other data, etcetera. Second, this parameterization model was used to develop a universal method to determine the radiation field size of flattened (FF), flattening-filter-free (FFF) and wedge beams which we termed the parameterized gradient method (PGM). Third, the parameterized model was also used to develop a profile-based method for assessing the beam quality of photon FF and FFF beams using an ionization chamber array. The PDD and PDD change was also predicted from the measured profile. Lastly, methods were created to automate the multileaf collimator (MLC) calibration and QA procedures as well as the acquisition of the parameters included in monthly and annual photon dosimetric QA. A two field technique was used for the calculation of the MLC leaf relative offsets using an electronic portal imaging device (EPID). A step-and-shoot technique was used to accurately acquire the radiation field size, flatness, symmetry, output and beam quality specifiers in a single delivery to an ionization chamber array for FF and FFF beams.

Apelin impairs myogenic response to induce diabetic nephropathy in mice.

PubMed

Zhang, Jia; Yin, Jiming; Wang, Yangjia; Li, Bin; Zeng, Xiangjun

2018-03-09

The cause of the invalid reaction of smooth muscle cells to mechanical stimulation that results in a dysfunctional myogenic response that mediates the disruption of renal blood flow (RBF) in patients with diabetes is debatable. The present study revealed that increased apelin concentration in serum of diabetic mice neutralized the myogenic response mediated by apelin receptor (APJ) and resulted in increased RBF, which promoted the progression of diabetic nephropathy. The results showed that apelin concentration, RBF, and albuminuria:creatinine ratio were all increased in kkAy mice, and increased RBF correlated positively with serum apelin both in C57 and diabetic mice. The increased RBF was accompanied by decreased phosphorylation of myosin light chain (MLC), β-arrestin, and increased endothelial NOS in glomeruli. Meanwhile, calcium, phosphorylation of MLC, and β-arrestin were decreased by high glucose and apelin treatment in cultured smooth muscle cells, as well. eNOS was increased by high glucose and increased by apelin in cultured endothelial cells (ECs). Knockdown of β-arrestin expression in smooth muscle cells cancelled phosphorylation of MLC induced by apelin. Therefore, apelin may induce the progression of diabetic nephropathy by counteracting the myogenic response in smooth muscle cells.-Zhang, J., Yin, J., Wang, Y., Li, B., Zeng, X. Apelin impairs myogenic response to induce diabetic nephropathy in mice.

Neutron range spectrometer

DOEpatents

Manglos, Stephen H.

1989-06-06

A neutron range spectrometer and method for determining the neutron energy spectrum of a neutron emitting source are disclosed. Neutrons from the source are collimnated along a collimation axis and a position sensitive neutron counter is disposed in the path of the collimated neutron beam. The counter determines positions along the collimation axis of interactions between the neutrons in the neutron beam and a neutron-absorbing material in the counter. From the interaction positions, a computer analyzes the data and determines the neutron energy spectrum of the neutron beam. The counter is preferably shielded and a suitable neutron-absorbing material is He-3. The computer solves the following equation in the analysis: ##EQU1## where: N(x).DELTA.x=the number of neutron interactions measured between a position x and x+.DELTA.x, A.sub.i (E.sub.i).DELTA.E.sub.i =the number of incident neutrons with energy between E.sub.i and E.sub.i +.DELTA.E.sub.i, and C=C(E.sub.i)=N .sigma.(E.sub.i) where N=the number density of absorbing atoms in the position sensitive counter means and .sigma. (E.sub.i)=the average cross section of the absorbing interaction between E.sub.i and E.sub.i +.DELTA.E.sub.i.

SU-E-T-187: Collimation Methods in Spot Scanning Proton Therapy: A Treatment Plan Comparison Between a Fixed Aperture and a Dynamic Collimation System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, B; Gelover, E; Wang, D

2015-06-15

Purpose: Low-energy treatments during spot scanning proton therapy (SSPT) suffer from poor conformity due to increased spot size. Collimation devices can reduce the lateral penumbra of a proton therapy dose distribution and improve the overall plan quality. The purpose of this work was to study the advantages of individual energy-layer collimation, which is unique to a recently proposed Dynamic Collimation System (DCS), in comparison to a standard, fixed aperture that allows only a single shape for all energy layers. Methods: Three brain patients previously planned and treated with SSPT were re-planned using an in-house treatment planning system capable of modelingmore » collimated and un-collimated proton beamlets. The un-collimated plans, which served as a baseline for comparison, reproduced the target coverage of the clinically delivered plans. The collimator opening for the aperture based plans included a 0.6 cm expansion of the largest cross section of the target in the Beam’s Eye View, while the DCS based plans were created by optimizing the collimator position for beam spots near the periphery of the target in each energy layer. Results: The reduction of mean dose to normal tissue adjacent to the target, as defined by a 10 mm ring, averaged 9.13% and 3.48% for the DCS and aperture plans, respectively. The conformity index, as defined by the ratio of the volume of the 50% isodose line to the target volume, yielded an average improvement of 16.42% and 8.16% for the DCS and aperture plans, respectively. Conclusion: Collimation reduces the dose to normal tissue adjacent to the target and increases dose conformity to the target region for low-energy SSPT. The ability of the DCS to provide collimation to each energy layer yields better conformity in comparison to fixed aperture plans. This work was partially funded by IBA (Ion Beam Applications S.A.)« less

The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat: a randomized trial.

PubMed

Aude, Y Wady; Agatston, Arthur S; Lopez-Jimenez, Francisco; Lieberman, Eric H; Marie Almon; Hansen, Melinda; Rojas, Gerardo; Lamas, Gervasio A; Hennekens, Charles H

2004-10-25

In the United States, obesity is a major clinical and public health problem causing diabetes, dyslipidemia, and hypertension, as well as increasing cardiovascular and total mortality. Dietary restrictions of calories and saturated fat are beneficial. However, it remains unclear whether replacement of saturated fat with carbohydrates (as in the US National Cholesterol Education Program [NCEP] diet) or protein and monounsaturated fat (as in our isocaloric modified low-carbohydrate [MLC] diet, which is lower in total carbohydrates but higher in protein, monounsaturated fat, and complex carbohydrates) is optimal. We randomized 60 participants (29 women and 31 men) to the NCEP or the MLC diet and evaluated them every 2 weeks for 12 weeks. They were aged 28 to 71 years (mean age, 44 years in the NCEP and 46 years in the MLC group). A total of 36% of participants from the NCEP group and 35% from the MLC group had a body mass index (calculated as weight in kilograms divided by the square of height in meters) greater than 27. The primary end point was weight loss, and secondary end points were blood lipid levels and waist-to-hip ratio. Weight loss was significantly greater in the MLC (13.6 lb) than in the NCEP group (7.5 lb), a difference of 6.1 lb (P = .02). There were no significant differences between the groups for total, low density, and high-density lipoprotein cholesterol, triglycerides, or the proportion of small, dense low-density lipoprotein particles. There were significantly favorable changes in all lipid levels within the MLC but not within the NCEP group. Waist-to-hip ratio was not significantly reduced between the groups (P = .27), but it significantly decreased within the MLC group (P = .009). Compared with the NCEP diet, the MLC diet, which is lower in total carbohydrates but higher in complex carbohydrates, protein, and monounsaturated fat, caused significantly greater weight loss over 12 weeks. There were no significant differences between the groups in blood lipid levels, but favorable changes were observed within the MLC diet group.

Method and apparatus for enhanced sensitivity filmless medical x-ray imaging, including three-dimensional imaging

DOEpatents

Parker, S.

1995-10-24

A filmless X-ray imaging system includes at least one X-ray source, upper and lower collimators, and a solid-state detector array, and can provide three-dimensional imaging capability. The X-ray source plane is distance z{sub 1} above upper collimator plane, distance z{sub 2} above the lower collimator plane, and distance z{sub 3} above the plane of the detector array. The object to be X-rayed is located between the upper and lower collimator planes. The upper and lower collimators and the detector array are moved horizontally with scanning velocities v{sub 1}, v{sub 2}, v{sub 3} proportional to z{sub 1}, z{sub 2} and z{sub 3}, respectively. The pattern and size of openings in the collimators, and between detector positions is proportional such that similar triangles are always defined relative to the location of the X-ray source. X-rays that pass through openings in the upper collimator will always pass through corresponding and similar openings in the lower collimator, and thence to a corresponding detector in the underlying detector array. Substantially 100% of the X-rays irradiating the object (and neither absorbed nor scattered) pass through the lower collimator openings and are detected, which promotes enhanced sensitivity. A computer system coordinates repositioning of the collimators and detector array, and X-ray source locations. The computer system can store detector array output, and can associate a known X-ray source location with detector array output data, to provide three-dimensional imaging. Detector output may be viewed instantly, stored digitally, and/or transmitted electronically for image viewing at a remote site. 5 figs.

Method and apparatus for enhanced sensitivity filmless medical x-ray imaging, including three-dimensional imaging

DOEpatents

Parker, Sherwood

1995-01-01

A filmless X-ray imaging system includes at least one X-ray source, upper and lower collimators, and a solid-state detector array, and can provide three-dimensional imaging capability. The X-ray source plane is distance z.sub.1 above upper collimator plane, distance z.sub.2 above the lower collimator plane, and distance z.sub.3 above the plane of the detector array. The object to be X-rayed is located between the upper and lower collimator planes. The upper and lower collimators and the detector array are moved horizontally with scanning velocities v.sub.1, v.sub.2, v.sub.3 proportional to z.sub.1, z.sub.2 and z.sub.3, respectively. The pattern and size of openings in the collimators, and between detector positions is proportional such that similar triangles are always defined relative to the location of the X-ray source. X-rays that pass through openings in the upper collimator will always pass through corresponding and similar openings in the lower collimator, and thence to a corresponding detector in the underlying detector array. Substantially 100% of the X-rays irradiating the object (and neither absorbed nor scattered) pass through the lower collimator openings and are detected, which promotes enhanced sensitivity. A computer system coordinates repositioning of the collimators and detector array, and X-ray source locations. The computer system can store detector array output, and can associate a known X-ray source location with detector array output data, to provide three-dimensional imaging. Detector output may be viewed instantly, stored digitally, and/or transmitted electronically for image viewing at a remote site.

SeHCAT retention values as measured with a collimated and an uncollimated gamma camera: a method comparison study.

PubMed

Wright, James W; Lovell, Lesley A; Gemmell, Howard G; McKiddie, Fergus; Staff, Roger T

2013-07-01

TauroH-23-(Se) selena-25-homocholic acid retention values are used in the diagnosis of bile acid malabsorption. The standard method for measuring values is with an uncollimated gamma camera, which can create some logistic difficulties, with other background sources of activity, which are irrelevant when a collimator is used, becoming significant. In this study we compare the retention values obtained with a collimated and an uncollimated gamma camera in phantoms and in 23 patients. Bland-Altman plots were created using the data, which showed a mean bias in retention of 0.10% in the phantom study and 0.55% in the patient study between methods. A Wilcoxon signed-rank test with the null hypothesis of zero median difference between uncollimated and collimated methods was not statistically significant to P values less than 0.05 in the patient and phantom studies. In the patient study, on using a fixed boundary of retention (10%) between positive and negative status, the status of one patient was changed from negative (12%) to positive (9%). We conclude that measurement of retention with a collimated gamma camera is similar but not identical to that of uncollimated values. The clinical significance of this shift is unclear, as the threshold of significance and the method of integrating this measure with other clinical factors into management remain unclear.

MO-G-BRE-04: Automatic Verification of Daily Treatment Deliveries and Generation of Daily Treatment Reports for a MR Image-Guided Treatment Machine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, D; Li, X; Li, H

2014-06-15

Purpose: Two aims of this work were to develop a method to automatically verify treatment delivery accuracy immediately after patient treatment and to develop a comprehensive daily treatment report to provide all required information for daily MR-IGRT review. Methods: After systematically analyzing the requirements for treatment delivery verification and understanding the available information from a novel MR-IGRT treatment machine, we designed a method to use 1) treatment plan files, 2) delivery log files, and 3) dosimetric calibration information to verify the accuracy and completeness of daily treatment deliveries. The method verifies the correctness of delivered treatment plans and beams, beammore » segments, and for each segment, the beam-on time and MLC leaf positions. Composite primary fluence maps are calculated from the MLC leaf positions and the beam-on time. Error statistics are calculated on the fluence difference maps between the plan and the delivery. We also designed the daily treatment delivery report by including all required information for MR-IGRT and physics weekly review - the plan and treatment fraction information, dose verification information, daily patient setup screen captures, and the treatment delivery verification results. Results: The parameters in the log files (e.g. MLC positions) were independently verified and deemed accurate and trustable. A computer program was developed to implement the automatic delivery verification and daily report generation. The program was tested and clinically commissioned with sufficient IMRT and 3D treatment delivery data. The final version has been integrated into a commercial MR-IGRT treatment delivery system. Conclusion: A method was developed to automatically verify MR-IGRT treatment deliveries and generate daily treatment reports. Already in clinical use since December 2013, the system is able to facilitate delivery error detection, and expedite physician daily IGRT review and physicist weekly chart review.« less

Thrombin-induced activation of RhoA in platelet shape change.

PubMed

Bodie, S L; Ford, I; Greaves, M; Nixon, G F

2001-09-14

Thrombin-induced activation of RhoA and its involvement in the regulation of myosin II light chain(20) phosphorylation (MLC-P) in alpha-toxin permeabilized platelets was investigated. Permeabilized platelets, expressing normal levels of P-selectin, displayed a Ca(2+)-dependent increase in shape change and MLC-P. Thrombin activated RhoA as measured by a rhotekin-binding assay within 30 s of stimulation under conditions of constant [Ca(2+)](i). Under the same conditions and timecourse, thrombin or GTPgammaS induced an increase in MLC-P and platelet shape change which was not dependent on an increase in [Ca(2+)](i). The thrombin- and GTPgammaS-induced MLC-P in constant [Ca(2+)](i) was inhibited by the addition of Y27632, a Rho-kinase inhibitor. This study directly demonstrates that thrombin can activate RhoA in platelets in a timecourse compatible with a role in increasing MLC-P and shape change (not involving an increase in [Ca(2+)](i)). This is also Rho-kinase-dependent. Copyright 2001 Academic Press.

Fiber optic diffraction grating maker

DOEpatents

Deason, V.A.; Ward, M.B.

1991-05-21

A compact and portable diffraction grating maker is comprised of a laser beam, optical and fiber optics devices coupling the beam to one or more evanescent beam splitters, and collimating lenses or mirrors directing the split beam at an appropriate photosensitive material. The collimating optics, the output ends of the fiber optic coupler and the photosensitive plate holder are all mounted on an articulated framework so that the angle of intersection of the beams can be altered at will without disturbing the spatial filter, collimation or beam quality, and assuring that the beams will always intersect at the position of the plate. 4 figures.

Fiber optic diffraction grating maker

DOEpatents

Deason, Vance A.; Ward, Michael B.

1991-01-01

A compact and portable diffraction grating maker comprised of a laser beam, optical and fiber optics devices coupling the beam to one or more evanescent beam splitters, and collimating lenses or mirrors directing the split beam at an appropriate photosensitive material. The collimating optics, the output ends of the fiber optic coupler and the photosensitive plate holder are all mounted on an articulated framework so that the angle of intersection of the beams can be altered at will without disturbing the spatial filter, collimation or beam quality, and assuring that the beams will always intersect at the position of the plate.

In-situ spectrophotometric probe

DOEpatents

Prather, William S.

1992-01-01

A spectrophotometric probe for in situ absorption spectra measurements comprising a first optical fiber carrying light from a remote light source, a second optical fiber carrying light to a remote spectrophotometer, the proximal ends of the first and second optical fibers parallel and coterminal, a planoconvex lens to collimate light from the first optical fiber, a reflecting grid positioned a short distance from the lens to reflect the collimated light back to the lens for focussing on the second optical fiber. The lens is positioned with the convex side toward the optical fibers. A substrate for absorbing analyte or an analyte and reagent mixture may be positioned between the lens and the reflecting grid.

Normalization of a collimated 14.7 MeV neutron source in a neutron spectrometry system for benchmark experiments

NASA Astrophysics Data System (ADS)

Ofek, R.; Tsechanski, A.; Shani, G.

1988-05-01

In the present study a method used to normalize a collimated 14.7 MeV neutron beam is introduced. It combined a measurement of the fast neutron scalar flux passing through the collimator, using a copper foil activation, with a neutron transport calculation of the foil activation per unit source neutron, carried out by the discrete-ordinates transport code DOT 4.2. The geometry of the collimated neutron beam is composed of a D-T neutron source positioned 30 cm in front of a 6 cm diameter collimator, through a 120 cm thick paraffin wall. The neutron flux emitted from the D-T source was counted by an NE-213 scintillator, simultaneously with the irradiation of the copper foil. Thus, the determination of the normalization factor of the D-T source is used for an absolute flux calibration of the NE-213 scintillator. The major contributions to the uncertainty in the determination of the normalization factor, and their origins, are discussed.

Poster - 53: Improving inter-linac DMLC IMRT dose precision by fine tuning of MLC leaf calibration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nakonechny, Keith; Tran, Muoi; Sasaki, David

Purpose: To develop a method to improve the inter-linac precision of DMLC IMRT dosimetry. Methods: The distance between opposing MLC leaf banks (“gap size”) can be finely tuned on Varian linacs. The dosimetric effect due to small deviations from the nominal gap size (“gap error”) was studied by introducing known errors for several DMLC sliding gap sizes, and for clinical plans based on the TG119 test cases. The plans were delivered on a single Varian linac and the relationship between gap error and the corresponding change in dose was measured. The plans were also delivered on eight Varian 2100 seriesmore » linacs (at two institutions) in order to quantify the inter-linac variation in dose before and after fine tuning the MLC calibration. Results: The measured dose differences for each field agreed well with the predictions of LoSasso et al. Using the default MLC calibration, the variation in the physical MLC gap size was determined to be less than 0.4 mm between all linacs studied. The dose difference between the linacs with the largest and smallest physical gap was up to 5.4% (spinal cord region of the head and neck TG119 test case). This difference was reduced to 2.5% after fine tuning the MLC gap calibration. Conclusions: The inter-linac dose precision for DMLC IMRT on Varian linacs can be improved using a simple modification of the MLC calibration procedure that involves fine adjustment of the nominal gap size.« less

A post-transcriptional compensatory pathway in heterozygous ventricular myosin light chain 2-deficient mice results in lack of gene dosage effect during normal cardiac growth or hypertrophy.

PubMed

Minamisawa, S; Gu, Y; Ross, J; Chien, K R; Chen, J

1999-04-09

Our previous study of homozygous mutants of the ventricular specific isoform of myosin light chain 2 (mlc-2v) demonstrated that mlc-2v plays an essential role in murine heart development (Chen, J., Kubalak, S. W., Minamisawa, S., Price, R. L., Becker, K. D., Hickey, R., Ross, J., Jr., and Chien, K. R. (1998) J. Biol. Chem. 273, 1252-1256). As gene dosage of some myofibrillar proteins can affect muscle function, we have analyzed heterozygous mutants in depth. Ventricles of heterozygous mutants displayed a 50% reduction in mlc-2v mRNA, yet expressed normal levels of protein both under basal conditions and following induction of cardiac hypertrophy by aortic constriction. Heterozygous mutants exhibited cardiac function comparable to that of wild-type littermate controls both prior to and following aortic constriction. There were no significant differences in contractility and responses to calcium between wild-type and heterozygous unloaded cardiomyocytes. We conclude that heterozygous mutants show neither a molecular nor a physiological cardiac phenotype either at base line or following hypertrophic stimuli. These results suggest that post-transcriptional compensatory mechanisms play a major role in maintaining the level of MLC-2v protein in murine hearts. In addition, as our mlc-2v knockout mutants were created by a knock-in of Cre recombinase into the endogenous mlc-2v locus, this study demonstrates that heterozygous mlc-2v cre knock-in mice are appropriate for ventricular specific gene targeting.

Error detection capability of a novel transmission detector: a validation study for online VMAT monitoring.

PubMed

Pasler, Marlies; Michel, Kilian; Marrazzo, Livia; Obenland, Michael; Pallotta, Stefania; Björnsgard, Mari; Lutterbach, Johannes

2017-09-01

The purpose of this study was to characterize a new single large-area ionization chamber, the integral quality monitor system (iRT, Germany), for online and real-time beam monitoring. Signal stability, monitor unit (MU) linearity and dose rate dependence were investigated for static and arc deliveries and compared to independent ionization chamber measurements. The dose verification capability of the transmission detector system was evaluated by comparing calculated and measured detector signals for 15 volumetric modulated arc therapy plans. The error detection sensitivity was tested by introducing MLC position and linac output errors. Deviations in dose distributions between the original and error-induced plans were compared in terms of detector signal deviation, dose-volume histogram (DVH) metrics and 2D γ-evaluation (2%/2 mm and 3%/3 mm). The detector signal is linearly dependent on linac output and shows negligible (<0.4%) dose rate dependence up to 460 MU min -1 . Signal stability is within 1% for cumulative detector output; substantial variations were observed for the segment-by-segment signal. Calculated versus measured cumulative signal deviations ranged from  -0.16%-2.25%. DVH, mean 2D γ-value and detector signal evaluations showed increasing deviations with regard to the respective reference with growing MLC and dose output errors; good correlation between DVH metrics and detector signal deviation was found (e.g. PTV D mean : R 2   =  0.97). Positional MLC errors of 1 mm and errors in linac output of 2% were identified with the transmission detector system. The extensive tests performed in this investigation show that the new transmission detector provides a stable and sensitive cumulative signal output and is suitable for beam monitoring during patient treatment.

Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 05: A novel respiratory motion simulation program for VMAT treatment plans: a phantom validation study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hubley, Emily; Pierce, Greg; Ploquin, Nicolas

Purpose: To develop and validate a computational method to simulate craniocaudal respiratory motion in a VMAT treatment plan. Methods: Three 4DCTs of the QUASAR respiratory motion phantom were acquired with a 2cm water-density spherical tumour embedded in cedar to simulate lung. The phantom was oscillating sinusoidally with an amplitude of 2cm and periods of 3, 4, and 5 seconds. An ITV was contoured and 5mm PTV margin was added. High and a low modulation factor VMAT plans were created for each scan. An in-house program was developed to simulate respiratory motion in the treatment plans by shifting the MLC leafmore » positions relative to the phantom. Each plan was delivered to the phantom and the dose was measured using Gafchromic film. The measured and calculated plans were compared using an absolute dose gamma analysis (3%/3mm). Results: The average gamma pass rate for the low modulation plan and high modulation plans were 91.1% and 51.4% respectively. The difference between the high and low modulation plans gamma pass rates is likely related to the different sampling frequency of the respiratory curve and the higher MLC leaf speeds in the high modulation plan. A high modulation plan has a slower gantry speed and therefore samples the breathing cycle at a coarser frequency leading to inaccuracies between the measured and planned doses. Conclusion: A simple program, including a novel method for increasing sampling frequency beyond the control point frequency, has been developed to simulate respiratory motion in VMAT plans by shifting the MLC leaf positions.« less

Error detection capability of a novel transmission detector: a validation study for online VMAT monitoring

NASA Astrophysics Data System (ADS)

Pasler, Marlies; Michel, Kilian; Marrazzo, Livia; Obenland, Michael; Pallotta, Stefania; Björnsgard, Mari; Lutterbach, Johannes

2017-09-01

The purpose of this study was to characterize a new single large-area ionization chamber, the integral quality monitor system (iRT, Germany), for online and real-time beam monitoring. Signal stability, monitor unit (MU) linearity and dose rate dependence were investigated for static and arc deliveries and compared to independent ionization chamber measurements. The dose verification capability of the transmission detector system was evaluated by comparing calculated and measured detector signals for 15 volumetric modulated arc therapy plans. The error detection sensitivity was tested by introducing MLC position and linac output errors. Deviations in dose distributions between the original and error-induced plans were compared in terms of detector signal deviation, dose-volume histogram (DVH) metrics and 2D γ-evaluation (2%/2 mm and 3%/3 mm). The detector signal is linearly dependent on linac output and shows negligible (<0.4%) dose rate dependence up to 460 MU min-1. Signal stability is within 1% for cumulative detector output; substantial variations were observed for the segment-by-segment signal. Calculated versus measured cumulative signal deviations ranged from  -0.16%-2.25%. DVH, mean 2D γ-value and detector signal evaluations showed increasing deviations with regard to the respective reference with growing MLC and dose output errors; good correlation between DVH metrics and detector signal deviation was found (e.g. PTV D mean: R 2  =  0.97). Positional MLC errors of 1 mm and errors in linac output of 2% were identified with the transmission detector system. The extensive tests performed in this investigation show that the new transmission detector provides a stable and sensitive cumulative signal output and is suitable for beam monitoring during patient treatment.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Otageri, P; Grant, E; Maricle, S

Purpose: To evaluate the effects of MLC modeling after commissioning the Varian TrueBeam LINAC in Pinnacle version 9.2. Methods: Stepand-shoot IMRT QAs were investigated when we observed our measured absolute dose results using ion chamber (Capintec PR-05P) were uncharacteristically low; about 4–5% compared to doses calculated by Pinnacle{sup 3} (Phillips, Madison, WI). This problem was predominant for large and highly modulated head and neck (HN) treatments. Intuitively we knew this had to be related to shortcomings in the MLC modeling in Pinnacle. Using film QA we were able to iteratively adjust the MLC parameters. We confirmed results by re-testing fivemore » failed IMRT QA patients; and ion chamber measurements were verified in Quasar anthropomorphic phantom. Results: After commissioning the LINAC in Pinnacle version 9.2, the MLC transmission for 6X, 10X and 15X were 2.0%, 1.7% and 2.0%, respectively, and additional Interleaf leakage for all three energies was 0.5%. These parameters were obtained from profiles scanned with an Edge detector (Sun Nuclear, Melbourne, FL) during machine commissioning. A Verification testing with radiographic EDR2 film (Kodak, Rochester, NY) measurement was performed by creating a closed MLC leaf pattern and analyzing using RIT software (RIT, Colorado Springs, CO). This reduced MLC transmission for 6X, 10X and 15X to 0.7%, 0.9% and 0.9%, respectively; while increasing additional Interleaf leakage for all three energies to 1.0%. Conclusion: Radiographic film measurements were used to correct MLC transmission values for step and shoot IMRT fields used in Pinnacle version 9.2. After adjusting the MLC parameters to correlate with the film QA, there was still very good agreement between the Pinnacle model and commissioning data. Using the same QA methodology, we were also able to improve the beam models for the Varian C-series linacs, Novalis-Tx, and TrueBeam M-120 linacs.« less

SU-F-T-372: Surface and Peripheral Dose in Compensator-Based FFF Beam IMRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, D; Feygelman, V; Moros, E

2016-06-15

Purpose: Flattening filter free (FFF) beams produce higher dose rates. Combined with compensator IMRT techniques, the dose delivery for each beam can be much shorter compared to the flattened beam MLC-based or compensator-based IMRT. This ‘snap shot’ IMRT delivery is beneficial to patients for tumor motion management. Due to softer energy, surface doses in FFF beam treatment are usually higher than those from flattened beams. Because of less scattering due to no flattening filter, peripheral doses are usually lower in FFF beam treatment. However, in compensator-based IMRT using FFF beams, the compensator is in the beam pathway. Does it introducemore » beam hardening effects and scattering such that the surface dose is lower and peripheral dose is higher compared to FFF beam MLC-based IMRT? Methods: This study applied Monte Carlo techniques to investigate the surface and peripheral doses in compensator-based IMRT using FFF beams and compared it to the MLC-based IMRT using FFF beams and flattened beams. Besides various thicknesses of copper slabs to simulate various thicknesses of compensators, a simple cone-shaped compensator was simulated to mimic a clinical application. The dose distribution in water phantom by the cone-shaped compensator was then simulated by multiple MLC defined FFF and flattened beams with various openings. After normalized to Dmax, the surface and peripheral dose was compared between the FFF beam compensator-based IMRT and FFF/flattened beam MLC-based IMRT. Results: The surface dose at the central 0.5mm depth was close between the compensator and 6FFF MLC dose distributions, and about 8% (of Dmax) higher than the flattened 6MV MLC dose. At 8cm off axis at dmax, the peripheral dose between the 6FFF and flattened 6MV MLC demonstrated similar doses, while the compensator dose was about 1% higher. Conclusion: Compensator does not reduce the surface doses but slightly increases the peripheral doses due to scatter inside compensator.« less

A SPECT Scanner for Rodent Imaging Based on Small-Area Gamma Cameras

NASA Astrophysics Data System (ADS)

Lage, Eduardo; Villena, José L.; Tapias, Gustavo; Martinez, Naira P.; Soto-Montenegro, Maria L.; Abella, Mónica; Sisniega, Alejandro; Pino, Francisco; Ros, Domènec; Pavia, Javier; Desco, Manuel; Vaquero, Juan J.

2010-10-01

We developed a cost-effective SPECT scanner prototype (rSPECT) for in vivo imaging of rodents based on small-area gamma cameras. Each detector consists of a position-sensitive photomultiplier tube (PS-PMT) coupled to a 30 x 30 Nal(Tl) scintillator array and electronics attached to the PS-PMT sockets for adapting the detector signals to an in-house developed data acquisition system. The detector components are enclosed in a lead-shielded case with a receptacle to insert the collimators. System performance was assessed using 99mTc for a high-resolution parallel-hole collimator, and for a 0.75-mm pinhole collimator with a 60° aperture angle and a 42-mm collimator length. The energy resolution is about 10.7% of the photopeak energy. The overall system sensitivity is about 3 cps/μCi/detector and planar spatial resolution ranges from 2.4 mm at 1 cm source-to-collimator distance to 4.1 mm at 4.5 cm with parallel-hole collimators. With pinhole collimators planar spatial resolution ranges from 1.2 mm at 1 cm source-to-collimator distance to 2.4 mm at 4.5 cm; sensitivity at these distances ranges from 2.8 to 0.5 cps/μCi/detector. Tomographic hot-rod phantom images are presented together with images of bone, myocardium and brain of living rodents to demonstrate the feasibility of preclinical small-animal studies with the rSPECT.

TM 4: Beam through the Main Linac Cryomodule

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bartnik, A.

2017-06-14

On May 15th 2017, the CBETA project reached the major funding milestone, “Beam through the MLC.” For this test, the team had to successfully accelerate the electron beam to 6 MeV in the Injector Cryomodule (ICM), and then to a final energy of 12 MeV in the Main Linac Cryomodule (MLC). The MLC contains six superconducting accelerating cavities; for this initial test only a single cavity was powered.

Optimal design of a high accuracy photoelectric auto-collimator based on position sensitive detector

NASA Astrophysics Data System (ADS)

Yan, Pei-pei; Yang, Yong-qing; She, Wen-ji; Liu, Kai; Jiang, Kai; Duan, Jing; Shan, Qiusha

2018-02-01

A kind of high accuracy Photo-electric auto-collimator based on PSD was designed. The integral structure composed of light source, optical lens group, Position Sensitive Detector (PSD) sensor, and its hardware and software processing system constituted. Telephoto objective optical type is chosen during the designing process, which effectively reduces the length, weight and volume of the optical system, as well as develops simulation-based design and analysis of the auto-collimator optical system. The technical indicators of auto-collimator presented by this paper are: measuring resolution less than 0.05″; a field of view is 2ω=0.4° × 0.4° measuring range is +/-5' error of whole range measurement is less than 0.2″. Measuring distance is 10m, which are applicable to minor-angle precise measuring environment. Aberration analysis indicates that the MTF close to the diffraction limit, the spot in the spot diagram is much smaller than the Airy disk. The total length of the telephoto lens is only 450mm by the design of the optical machine structure optimization. The autocollimator's dimension get compact obviously under the condition of the image quality is guaranteed.

APPARATUS FOR PRODUCING IONS OF VAPORIZABLE MATERIALS

DOEpatents

Wright, B.T.

1958-01-28

a uniform and copious supply of ions. The source comprises a hollow arc- block and means for establishing a magnetic field through the arc-block. Vaporization of the material to be ionized is produced by an electric heated filament. The arc producing structure within the arc-block consists of a cathode disposed between a pair of collimating electrodes along with an anode adjacent each collimating electrode on the side opposite the cathode. A positive potential applied to the anodes and collimating electrodes, with respect to the cathode, and the magnetic field act to accelerate the electrons from the cathode through a slit in each collimating clectrode towards the respective anode. In this manner a pair of collinear arc discharges are produced in the gas region which can be tapped for an abundant supply of ions of the material being analyzed.

Catching errors with patient-specific pretreatment machine log file analysis.

PubMed

Rangaraj, Dharanipathy; Zhu, Mingyao; Yang, Deshan; Palaniswaamy, Geethpriya; Yaddanapudi, Sridhar; Wooten, Omar H; Brame, Scott; Mutic, Sasa

2013-01-01

A robust, efficient, and reliable quality assurance (QA) process is highly desired for modern external beam radiation therapy treatments. Here, we report the results of a semiautomatic, pretreatment, patient-specific QA process based on dynamic machine log file analysis clinically implemented for intensity modulated radiation therapy (IMRT) treatments delivered by high energy linear accelerators (Varian 2100/2300 EX, Trilogy, iX-D, Varian Medical Systems Inc, Palo Alto, CA). The multileaf collimator machine (MLC) log files are called Dynalog by Varian. Using an in-house developed computer program called "Dynalog QA," we automatically compare the beam delivery parameters in the log files that are generated during pretreatment point dose verification measurements, with the treatment plan to determine any discrepancies in IMRT deliveries. Fluence maps are constructed and compared between the delivered and planned beams. Since clinical introduction in June 2009, 912 machine log file analyses QA were performed by the end of 2010. Among these, 14 errors causing dosimetric deviation were detected and required further investigation and intervention. These errors were the result of human operating mistakes, flawed treatment planning, and data modification during plan file transfer. Minor errors were also reported in 174 other log file analyses, some of which stemmed from false positives and unreliable results; the origins of these are discussed herein. It has been demonstrated that the machine log file analysis is a robust, efficient, and reliable QA process capable of detecting errors originating from human mistakes, flawed planning, and data transfer problems. The possibility of detecting these errors is low using point and planar dosimetric measurements. Copyright © 2013 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

SU-E-T-348: Verification MU Calculation for Conformal Radiotherapy with Multileaf Collimator Using Report AAPM TG 114

DOE Office of Scientific and Technical Information (OSTI.GOV)

Adrada, A; Tello, Z; Medina, L

Purpose: The purpose of this work was to develop and validate an open source independent MU dose calculation software for 3D conformal radiotherapy with multileaf high and low resolution according to the report of AAPM TG 11 Methods: Treatment plans were done using Iplan v4.5 BrainLAB TPS. A 6MV photon beam produced by Primus and Novalis linear accelerators equipped with an Optifocus MLC and HDMLC, respectively. TPS dose calculation algorithms were pencil beam and Monte Carlo. 1082 treatments plans were selected for the study. The algorithm was written in free and open source CodeBlocks C++ platform. Treatment plans were importedmore » by the software using RTP format. Equivalent size field is obtained from the positions of the leaves; the effective depth of calculation can be introduced by TPS's dosimetry report or automatically calculated starting from SSD. The inverse square law is calculated by the 3D coordinates of the isocenter and normalization point of the treatment plan. The dosimetric parameters TPR, Sc, Sp and WF are linearly interpolated. Results: 1082 plans of both machines were analyzed. The average uncertainty between the TPS and the independent calculation was −0.43% ± 2.42% [−7.90%, 7.50%]. Specifically for the Primus the variation obtained was −0.85% ± 2.53% and for the Novalis 0.00% ± 2.23%. Data show that 94.8% of the cases the uncertainty was less than or equal to 5%, while 98.9% is less than or equal to 6%. Conclusion: The developed software is appropriate for use in calculation of UM. This software can be obtained upon request.« less

A comparison of two prompt gamma imaging techniques with collimator-based cameras for range verification in proton therapy

NASA Astrophysics Data System (ADS)

Lin, Hsin-Hon; Chang, Hao-Ting; Chao, Tsi-Chian; Chuang, Keh-Shih

2017-08-01

In vivo range verification plays an important role in proton therapy to fully utilize the benefits of the Bragg peak (BP) for delivering high radiation dose to tumor, while sparing the normal tissue. For accurately locating the position of BP, camera equipped with collimators (multi-slit and knife-edge collimator) to image prompt gamma (PG) emitted along the proton tracks in the patient have been proposed for range verification. The aim of the work is to compare the performance of multi-slit collimator and knife-edge collimator for non-invasive proton beam range verification. PG imaging was simulated by a validated GATE/GEANT4 Monte Carlo code to model the spot-scanning proton therapy and cylindrical PMMA phantom in detail. For each spot, 108 protons were simulated. To investigate the correlation between the acquired PG profile and the proton range, the falloff regions of PG profiles were fitted with a 3-line-segment curve function as the range estimate. Factors including the energy window setting, proton energy, phantom size, and phantom shift that may influence the accuracy of detecting range were studied. Results indicated that both collimator systems achieve reasonable accuracy and good response to the phantom shift. The accuracy of range predicted by multi-slit collimator system is less affected by the proton energy, while knife-edge collimator system can achieve higher detection efficiency that lead to a smaller deviation in predicting range. We conclude that both collimator systems have potentials for accurately range monitoring in proton therapy. It is noted that neutron contamination has a marked impact on range prediction of the two systems, especially in multi-slit system. Therefore, a neutron reduction technique for improving the accuracy of range verification of proton therapy is needed.

Functional conservation between rodents and chicken of regulatory sequences driving skeletal muscle gene expression in transgenic chickens

PubMed Central

2010-01-01

Background Regulatory elements that control expression of specific genes during development have been shown in many cases to contain functionally-conserved modules that can be transferred between species and direct gene expression in a comparable developmental pattern. An example of such a module has been identified at the rat myosin light chain (MLC) 1/3 locus, which has been well characterised in transgenic mouse studies. This locus contains two promoters encoding two alternatively spliced isoforms of alkali myosin light chain. These promoters are differentially regulated during development through the activity of two enhancer elements. The MLC3 promoter alone has been shown to confer expression of a reporter gene in skeletal and cardiac muscle in transgenic mice and the addition of the downstream MLC enhancer increased expression levels in skeletal muscle. We asked whether this regulatory module, sufficient for striated muscle gene expression in the mouse, would drive expression in similar domains in the chicken. Results We have observed that a conserved downstream MLC enhancer is present in the chicken MLC locus. We found that the rat MLC1/3 regulatory elements were transcriptionally active in chick skeletal muscle primary cultures. We observed that a single copy lentiviral insert containing this regulatory cassette was able to drive expression of a lacZ reporter gene in the fast-fibres of skeletal muscle in chicken in three independent transgenic chicken lines in a pattern similar to the endogenous MLC locus. Reporter gene expression in cardiac muscle tissues was not observed for any of these lines. Conclusions From these results we conclude that skeletal expression from this regulatory module is conserved in a genomic context between rodents and chickens. This transgenic module will be useful in future investigations of muscle development in avian species. PMID:20184756

Myosin light chain 2-based selection of human iPSC-derived early ventricular cardiac myocytes

PubMed Central

Bizy, Alexandra; Guerrero-Serna, Guadalupe; Hu, Bin; Ponce-Balbuena, Daniela; Willis, B. Cicero; Zarzoso, Manuel; Ramirez, Rafael J.; Sener, Michelle F.; Mundada, Lakshmi V.; Klos, Matthew; Devaney, Eric J.; Vikstrom, Karen L.; Herron, Todd J.; Jalife, José

2014-01-01

Applications of human induced pluripotent stemcell derived-cardiac myocytes (hiPSC-CMs) would be strengthened by the ability to generate specific cardiac myocyte (CM) lineages. However, purification of lineage-specific hiPSC-CMs is limited by the lack of cell marking techniques. Here, we have developed an iPSC-CM marking system using recombinant adenoviral reporter constructs with atrial- or ventricular-specific myosin light chain-2 (MLC-2) promoters. MLC-2a and MLC-2v selected hiPSC-CMs were purified by fluorescence-activated cell sorting and their biochemical and electrophysiological phenotypes analyzed. We demonstrate that the phenotype of both populations remained stable in culture and they expressed the expected sarcomeric proteins, gap junction proteins and chamber-specific transcription factors. Compared to MLC-2a cells, MLC-2v selected CMs had larger action potential amplitudes and durations. In addition, by immunofluorescence, we showed that MLC-2 isoform expression can be used to enrich hiPSC-CM consistent with early atrial and ventricularmyocyte lineages. However, only the ventricular myosin light chain-2 promoter was able to purify a highly homogeneous population of iPSC-CMs. Using this approach, it is now possible to develop ventricular-specific disease models using iPSC-CMs while atrial-specific iPSC-CM cultures may require additional chamber-specific markers. PMID:24095945

Patient views through the keyhole: new perspectives on single-incision vs. multiport laparoscopic cholecystectomy

PubMed Central

Hey, Jennifer; Roberts, Keith John; Morris-Stiff, Gareth J; Toogood, Giles J

2012-01-01

Objectives Single-incision laparoscopic cholecystectomy (SILC) may be associated with less pain, shorter hospital stay and better cosmetic results than multiport laparoscopic cholecystectomy (MLC). Advocates suggest that patients prefer SILC, although research directly addressing the question of patient preferences is limited. This study aimed to assess patient preferences using currently available evidence. Methods Patients awaiting elective cholecystectomy were shown a series of postoperative images taken after SILC or MLC and asked which procedure this led them to prefer. This was repeated after patients had completed a questionnaire constructed using published objective data comparing patient-reported outcomes of SILC and MLC. Results The study was completed by 113 consecutive patients. After their initial viewing of the images, 16% of subjects preferred MLC. Younger age, lower body mass index and female sex were associated with choosing SILC. After completing the questionnaire, 88% of patients preferred MLC (P < 0.001). Patients ranked the level of risk for complications and postoperative pain above cosmetic results in determining their choice of procedure. Conclusions Patients' initial preference when presented with cosmetic appearance was for SILC. When contemporary outcome data were included, the majority chose MLC. This underlines the need to fully inform patients during the consent process and indicates that patient views of SILC may differ from the views of those introducing the technology. PMID:22404262

Myosin light chain 2-based selection of human iPSC-derived early ventricular cardiac myocytes.

PubMed

Bizy, Alexandra; Guerrero-Serna, Guadalupe; Hu, Bin; Ponce-Balbuena, Daniela; Willis, B Cicero; Zarzoso, Manuel; Ramirez, Rafael J; Sener, Michelle F; Mundada, Lakshmi V; Klos, Matthew; Devaney, Eric J; Vikstrom, Karen L; Herron, Todd J; Jalife, José

2013-11-01

Applications of human induced pluripotent stem cell derived-cardiac myocytes (hiPSC-CMs) would be strengthened by the ability to generate specific cardiac myocyte (CM) lineages. However, purification of lineage-specific hiPSC-CMs is limited by the lack of cell marking techniques. Here, we have developed an iPSC-CM marking system using recombinant adenoviral reporter constructs with atrial- or ventricular-specific myosin light chain-2 (MLC-2) promoters. MLC-2a and MLC-2v selected hiPSC-CMs were purified by fluorescence-activated cell sorting and their biochemical and electrophysiological phenotypes analyzed. We demonstrate that the phenotype of both populations remained stable in culture and they expressed the expected sarcomeric proteins, gap junction proteins and chamber-specific transcription factors. Compared to MLC-2a cells, MLC-2v selected CMs had larger action potential amplitudes and durations. In addition, by immunofluorescence, we showed that MLC-2 isoform expression can be used to enrich hiPSC-CM consistent with early atrial and ventricular myocyte lineages. However, only the ventricular myosin light chain-2 promoter was able to purify a highly homogeneous population of iPSC-CMs. Using this approach, it is now possible to develop ventricular-specific disease models using iPSC-CMs while atrial-specific iPSC-CM cultures may require additional chamber-specific markers. © 2013.

Maxi/gsc

NASA Astrophysics Data System (ADS)

Mihara, T.; Maxi Team

2010-12-01

Gas Slit Camera (GSC) is the instrument in the MAXI mission. The GSC utilizes twelve large area proportional counters (PC), a slit and slats collimator. The energy range is 2-30 keV. The GSC has two FOVs of 160 x 3 degrees. One is toward forward direction of ISS and the other is the zenithal direction. Two arches of FOV scans the sky in every 92 minutes with ISS rotation. The slats collimator makes the narrow arc FOV, and the one-dimensional position-resolution of the PC resolves the X-ray sources within the FOV. Thus the position resolution is determined by the slats collimator and a combination of the slit and the position resolution of the detector. These make the point spread function of 1.5 x 1.5 degrees. The background is 1.2 × 10^-4 c/s/cm2 /keV, which is almost the same level with Ginga/LAC. The 5-sigma sensitivity is 15 mCrab/day, which is improved to with the sqrt (t) law. It will reach the 5 sigma confusion limit of 0.5 mCrab in 900 days, if the particle-background estimation is accurate enough.

In-situ spectrophotometric probe

DOEpatents

Prather, W.S.

1992-12-15

A spectrophotometric probe is described for in situ absorption spectra measurements comprising a first optical fiber carrying light from a remote light source, a second optical fiber carrying light to a remote spectrophotometer, the proximal ends of the first and second optical fibers parallel and co-terminal, a planoconvex lens to collimate light from the first optical fiber, a reflecting grid positioned a short distance from the lens to reflect the collimated light back to the lens for focusing on the second optical fiber. The lens is positioned with the convex side toward the optical fibers. A substrate for absorbing analyte or an analyte and reagent mixture may be positioned between the lens and the reflecting grid. 5 figs.

SU-E-T-613: Dosimetric Consequences of Systematic MLC Leaf Positioning Errors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kathuria, K; Siebers, J

2014-06-01

Purpose: The purpose of this study is to determine the dosimetric consequences of systematic MLC leaf positioning errors for clinical IMRT patient plans so as to establish detection tolerances for quality assurance programs. Materials and Methods: Dosimetric consequences were simulated by extracting mlc delivery instructions from the TPS, altering the file by the specified error, reloading the delivery instructions into the TPS, recomputing dose, and extracting dose-volume metrics for one head-andneck and one prostate patient. Machine error was simulated by offsetting MLC leaves in Pinnacle in a systematic way. Three different algorithms were followed for these systematic offsets, and aremore » as follows: a systematic sequential one-leaf offset (one leaf offset in one segment per beam), a systematic uniform one-leaf offset (same one leaf offset per segment per beam) and a systematic offset of a given number of leaves picked uniformly at random from a given number of segments (5 out of 10 total). Dose to the PTV and normal tissue was simulated. Results: A systematic 5 mm offset of 1 leaf for all delivery segments of all beams resulted in a maximum PTV D98 deviation of 1%. Results showed very low dose error in all reasonably possible machine configurations, rare or otherwise, which could be simulated. Very low error in dose to PTV and OARs was shown in all possible cases of one leaf per beam per segment being offset (<1%), or that of only one leaf per beam being offset (<.2%). The errors resulting from a high number of adjacent leaves (maximum of 5 out of 60 total leaf-pairs) being simultaneously offset in many (5) of the control points (total 10–18 in all beams) per beam, in both the PTV and the OARs analyzed, were similarly low (<2–3%). Conclusions: The above results show that patient shifts and anatomical changes are the main source of errors in dose delivered, not machine delivery. These two sources of error are “visually complementary” and uncorrelated (albeit not additive in the final error) and one can easily incorporate error resulting from machine delivery in an error model based purely on tumor motion.« less

Laser-Extinction and High-Resolution Atmospheric Transmission Measurements Conducted at White Sands Missile Range, New Mexico, March 1979.

DTIC Science & Technology

1980-11-19

used is first collimated by auxiliary optics to a diameter of approximately 18 mm. The beam is then focused via the off-axis parabolic mirror shown in...RECEIVER STATIONARY OF AISZERO ~ PAR ABOLA PATH OR PATH - CHOPPER I 90cm 120 cm COLLIMATOR / COLLECTOR XMTR DMOBILE RCvR CAIBAIO C0J POSITION - ETECTOR

33 CFR 1.07-90 - Criminal penalties.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Commandant is required, the Area, Maintenance & Logistics Command (MLC), and District Commanders are..., 121 to 126 inclusive). (c) The Area, MLC, or District Commander will identify the laws or regulations...

33 CFR 1.07-90 - Criminal penalties.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Commandant is required, the Area, Maintenance & Logistics Command (MLC), and District Commanders are..., 121 to 126 inclusive). (c) The Area, MLC, or District Commander will identify the laws or regulations...

33 CFR 1.07-90 - Criminal penalties.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Commandant is required, the Area, Maintenance & Logistics Command (MLC), and District Commanders are..., 121 to 126 inclusive). (c) The Area, MLC, or District Commander will identify the laws or regulations...

33 CFR 1.07-90 - Criminal penalties.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Commandant is required, the Area, Maintenance & Logistics Command (MLC), and District Commanders are..., 121 to 126 inclusive). (c) The Area, MLC, or District Commander will identify the laws or regulations...

33 CFR 1.07-90 - Criminal penalties.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Commandant is required, the Area, Maintenance & Logistics Command (MLC), and District Commanders are..., 121 to 126 inclusive). (c) The Area, MLC, or District Commander will identify the laws or regulations...

Micro-Laser Range Finder Development: Using the Monolithic Approach

DTIC Science & Technology

1999-02-01

components can be joined together, optically aligned to form the laser cavity and then sliced to produce MLC modules . This batch process can greatly reduce...the overall fabrication costs of the µLRF system. The MLC module is ultra-compact. Its overall size is approximately 56 mm (L) x 3 mm (W) x 3 mm (H) as...MLC module is placed on a laser pallet for stiffness, mechanical stability. The laser pallet size is selected as part of the integration design

High spatial resolution technique for SPECT using a fan-beam collimator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ichihar, T.; Nambu, K.; Motomura, N.

1993-08-01

The physical characteristics of the collimator cause degradation of resolution with increasing distance from the collimator surface. A new convolutional backprojection algorithm has been derived for fanbeam SPECT data without rebinding into parallel beam geometry. The projections are filtered and then backprojected into the area within an isosceles triangle whose vertex is the focal point of the fan-beam and whose base is the fan-beam collimator face, and outside of the circle whose center is located midway between the focal point and the center of rotation and whose diameter is the distance between the focal point and the center of rotation.more » Consequently the backprojected area is close to the collimator surface. This algorithm has been implemented on a GCA-9300A SPECT system showing good results with both phantom and patient studies. The SPECT transaxial resolution was 4.6mm FWHM (reconstructed image matrix size of 256x256) at the center of SPECT FOV using UHR (ultra-high-resolution) fan beam collimators for brain study. Clinically, Tc-99m HMPAO and Tc-99m ECD brain data were reconstructed using this algorithm. The reconstruction results were compared with MRI images of the same slice position and showed significantly improved over results obtained with standard reconstruction algorithms.« less

SU-F-T-233: Evaluation of Treatment Delivery Parameters Using High Resolution ELEKTA Log Files

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kabat, C; Defoor, D; Alexandrian, A

2016-06-15

Purpose: As modern linacs have become more technologically advanced with the implementation of IGRT and IMRT with HDMLCs, a requirement for more elaborate tracking techniques to monitor components’ integrity is paramount. ElektaLog files are generated every 40 milliseconds, which can be analyzed to track subtle changes and provide another aspect of quality assurance. This allows for constant monitoring of fraction consistency in addition to machine reliability. With this in mind, it was the aim of the study to evaluate if ElektaLog files can be utilized for linac consistency QA. Methods: ElektaLogs were reviewed for 16 IMRT patient plans with >16more » fractions. Logs were analyzed by creating fluence maps from recorded values of MLC locations, jaw locations, and dose per unit time. Fluence maps were then utilized to calculate a 2D gamma index with a 2%–2mm criteria for each fraction. ElektaLogs were also used to analyze positional errors for MLC leaves and jaws, which were used to compute an overall error for the MLC banks, Y-jaws, and X-jaws by taking the root-meansquare value of the individual recorded errors during treatment. Additionally, beam on time was calculated using the number of ElektaLog file entries within the file. Results: The average 2D gamma for all 16 patient plans was found to be 98.0±2.0%. Recorded gamma index values showed an acceptable correlation between fractions. Average RMS values for MLC leaves and the jaws resulted in a leaf variation of roughly 0.3±0.08 mm and jaw variation of about 0.15±0.04 mm, both of which fall within clinical tolerances. Conclusion: The use of ElektaLog files for day-to-day evaluation of linac integrity and patient QA can be utilized to allow for reliable analysis of system accuracy and performance.« less

Evaluation of Video Image Analysis (VIA) technology to predict meat yield of sheep carcasses on-line under UK abattoir conditions.

PubMed

Rius-Vilarrasa, E; Bünger, L; Maltin, C; Matthews, K R; Roehe, R

2009-05-01

The Meat and Livestock Commission's (MLC) EUROP classification based scheme and Video Image Analysis (VIA) system were compared in their ability to predict weights of primal carcass joints. A total of 443 commercial lamb carcasses under 12 months of age and mixed gender were selected by their cold carcass weight (CCW), conformation and fat scores. Lamb carcasses were classified for conformation and fatness, scanned by the VIA system and dissected into primal joints of leg, chump, loin, breast and shoulder. After adjustment for CCW, the estimation of primal joints using MLC EUROP scores showed high coefficients of determination (R(2)) in the range of 0.82-0.99. The use of VIA always resulted in equal or higher R(2). The precision measured as root mean square error (RMSE) was 27% (leg), 13% (chump), 1% (loin), 11% (breast), 5% (shoulders) and 13% (total primals) higher using VIA than MLC carcass information. Adjustment for slaughter day and gender effects indicated that estimations of primal joints using MLC EUROP scores were more sensitive to these factors than using VIA. This was consistent with an increase in stability of the prediction model of 28%, 11%, 2%, 12%, 6% and 14% for leg, chump, loin, breast and shoulder and total primals, respectively, using VIA compared to MLC EUROP scores. Consequently, VIA was capable of improving the prediction of primal meat yields compared to the current MLC EUROP carcass classification scheme used in the UK abattoirs.

Motion-Base Simulator Evaluation of an Aircraft Using an External Vision System

NASA Technical Reports Server (NTRS)

Kramer, Lynda J.; Williams, Steven P.; Arthur, J. J.; Rehfeld, Sherri A.; Harrison, Stephanie

2012-01-01

Twelve air transport-rated pilots participated as subjects in a motion-base simulation experiment to evaluate the use of eXternal Vision Systems (XVS) as enabling technologies for future supersonic aircraft without forward facing windows. Three head-up flight display concepts were evaluated -a monochromatic, collimated Head-up Display (HUD) and a color, non-collimated XVS display with a field-of-view (FOV) equal to and also, one significantly larger than the collimated HUD. Approach, landing, departure, and surface operations were conducted. Additionally, the apparent angle-of-attack (AOA) was varied (high/low) to investigate the vertical field-of-view display requirements and peripheral, side window visibility was experimentally varied. The data showed that lateral approach tracking performance and lateral landing position were excellent regardless of AOA, display FOV, display collimation or whether peripheral cues were present. However, the data showed glide slope approach tracking appears to be affected by display size (i.e., FOV) and collimation. The monochrome, collimated HUD and color, uncollimated XVS with Full FOV display had (statistically equivalent) glide path performance improvements over the XVS with HUD FOV display. Approach path performance results indicated that collimation may not be a requirement for an XVS display if the XVS display is large enough and employs color. Subjective assessments of mental workload and situation awareness also indicated that an uncollimated XVS display may be feasible. Motion cueing appears to have improved localizer tracking and touchdown sink rate across all displays.

Thrombin-induced phosphorylation of the regulatory light chain of myosin II in cultured bovine corneal endothelial cells.

PubMed

Satpathy, M; Gallagher, P; Lizotte-Waniewski, M; Srinivas, S P

2004-10-01

Phosphorylation of the regulatory light chain of myosin II (referred to as myosin light chain or MLC) leads to a loss of barrier integrity in cellular monolayers by an increase in the contractility of the cortical actin cytoskeleton. This effect has been examined in corneal endothelial (CE) cells. Experiments were performed using cultured bovine CE cells (BCEC). MLC phosphorylation was induced by a thrombin-mediated activation of the proteinase-activated receptor-1 (PAR-1). Expression of MLC kinase (MLCK), a Ca2+/calmodulin-dependent protein kinase that phosphorylates MLC at its Ser-19 and Thr-18 residues, was determined by RT-PCR and Western blotting. Expression of PAR-1, RhoA, and Rho kinase-1 (effector of RhoA) was ascertained by RT-PCR. MLC phosphorylation was assessed by urea-glycerol gel electrophoresis followed by immunoblotting. The effects of Rho kinase-1 and PKC were characterized by using their selective inhibitors, Y-27632 and chelerythrine, respectively. Reorganization of the cytoskeleton was evaluated by the phalloidin staining of actin. [Ca2+]i was measured using Fura-2. The barrier integrity was assayed as permeability of BCEC monolayers to horseradish peroxidase (HRP; 44 kDa). RT-PCR showed expression of MLCK, PAR-1, Rho kinase-1, and RhoA. Western blotting indicated expression of the non-muscle and smooth muscle isoforms of MLCK. Exposure to thrombin induced an increase in [Ca2+]i with the peak unaffected by an absence of extracellular Ca2+. Pre-exposure to thrombin (2 U ml(-1); 2 min) led to mono- and di-phosphorylation of MLC. Under both basal conditions and in the presence of thrombin, MLC phosphorylation was prevented by chelerythrine (10 microm) and Y-27632 (<25 microm). Thrombin led to inter-endothelial gaps secondary to the disruption of the cortical actin cytoskeleton, which under resting conditions was organized as a perijunctional actomyosin ring (PAMR). These responses were blocked by pre-treatment with Y-27632. Thrombin also increased permeability to HRP, which was abolished by pre-treatment with Y-27632. Thrombin induces MLC phosphorylation in BCEC. The consequent increase in the contractility of the actin cytoskeleton produces a centripetal force resulting in inter-endothelial gaps and a breakdown of barrier integrity. These responses are PKC- and Rho kinase-dependent. [Ca2+]i increase, as well as sensitivity of the thrombin response to PKC and Rho kinase inhibitors, are consistent with the expression of PAR-1 receptors in BCEC. Thrombin-induced hyperpermeability is a model to investigate barrier dysfunction induced by MLC phosphorylation.

Small field measurements with a novel silicon position sensitive diode array.

PubMed

Manolopoulos, S; Wojnecki, C; Hugtenburg, R; Jaafar Sidek, M A; Chalmers, G; Heyes, G; Green, S

2009-02-07

DOSI, a novel dosimeter based on position sensitive detectors for particle physics experiments, was used for relative clinical dosimetry measurements in small radiotherapy fields. The device is capable of dynamic measurements in real time and provides sub-millimetre spatial resolution. The basic beam data for a stereotactic radiotherapy collimator system (BrainLAB) using 6 MV photons were measured and compared with the corresponding data acquired with a small diamond detector and a PinPoint ionization chamber. All measurements showed an excellent agreement between DOSI and the diamond detector. There was an increasing discrepancy between the relative output factors (ROF) measured with DOSI and those measured with the ionization chamber with decreasing field size, specifically for collimators with a diameter smaller than 15 mm. The percentage depth doses (PDD) were in agreement to better than 1% for all depths. The agreement on off-axis ratios (OAR) was better than 3% for all collimators, whereas the agreement on relative output factors (ROF) was at the 1% level. DOSI's fast read-out electronics made it possible for all measurements to be recorded within 45 min including time to change collimators. This should reduce the overall time for commissioning and QA measurements, an important factor especially for busy radiotherapy departments.

Dosimetric and delivery efficiency investigation for treating hepatic lesions with a MLC-equipped robotic radiosurgery-radiotherapy combined system.

PubMed

Jin, Lihui; Price, Robert A; Wang, Lu; Meyer, Joshua; Fan, James Jiajin; Ma, Chang Ming Charlie

2016-02-01

The CyberKnife M6 (CK-M6) Series introduced a multileaf collimator (MLC) for extending its capability from stereotactic radiosurgery/stereotactic radiotherapy (SBRT) to conventionally fractionated radiotherapy. This work is to investigate the dosimetric quality of plans that are generated using MLC-shaped beams on the CK-M6, as well as their delivery time, via comparisons with the intensity modulated radiotherapy plans that were clinically used on a Varian Linac for treating hepatic lesions. Nine patient cases were selected and divided into three groups with three patients in each group: (1) the group-one patients were treated conventionally (25 fractions); (2) the group-two patients were treated with SBRT-like hypofractionation (5 fractions); and (3) the group-three patients were treated similar to group-one patients, but with two planning target volumes (PTVs) and two different prescription dose levels correspondingly. The clinically used plans were generated on the eclipse treatment planning system (TPS) and delivered on a Varian Linac (E-V plans). The multiplan (MP) TPS was used to replan these clinical cases with the MLC as the beam device for the CK-M6 (C-M plans). After plans were normalized to the same PTV dose coverage, comparisons between the C-M and E-V plans were performed based on D(99%) (percentage of prescription dose received by 99% of the PTV), D(0.1cm(3)) (the percentage of prescription dose to 0.1 cm(3) of the PTV), and doses received by critical structures. Then, the delivery times for the C-M plans will be obtained, which are the MP TPS generated estimations assuming having an imaging interval of 60 s. The difference in D(99%) between C-M and E-V plans is +0.6% on average (+ or - indicating a higher or lower dose from C-M plans than from E-V plans) with a range from -4.1% to +3.8%, and the difference in D(0.1cm(3)) was -1.0% on average with a range from -5.1% to +2.9%. The PTV conformity index (CI) for the C-M plans ranges from 1.07 to 1.29 with a mean of 1.19, slightly inferior to the E-V plans, in which the CI ranges from 1.00 to 1.15 with a mean of 1.07. Accounting for all nine patients in three groups, 45% of the critical structures received a lower mean dose for the C-M plans as compared with the E-V plans, and similarly, 48% received a lower maximum dose. Furthermore, the average difference of the mean critical structure dose between the C-M and E-V plans over all critical structures for all patients showed only +2.10% relative to the prescription dose and the similar comparison finds the average difference of the maximum critical structure dose of only +1.24%. The estimated delivery times for the C-M plans on the CK-M6 range from 18 to 24 minutes while they are from 7 to 13.7 min for the E-V plans on the Varian Linac. For treating hepatic lesions, for the C-M plans that are comparable to E-V plans in quality, the times needed to deliver these C-M plans on the CK-M6 are longer than the delivery time for the E-V plans on the Varian Linac, but may be clinically acceptable.

Clinical implementation of an exit detector-based dose reconstruction tool for helical tomotherapy delivery quality assurance.

PubMed

Deshpande, Shrikant; Xing, Aitang; Metcalfe, Peter; Holloway, Lois; Vial, Philip; Geurts, Mark

2017-10-01

The aim of this study was to validate the accuracy of an exit detector-based dose reconstruction tool for helical tomotherapy (HT) delivery quality assurance (DQA). Exit detector-based DQA tool was developed for patient-specific HT treatment verification. The tool performs a dose reconstruction on the planning image using the sinogram measured by the HT exit detector with no objects in the beam (i.e., static couch), and compares the reconstructed dose to the planned dose. Vendor supplied (three "TomoPhant") plans with a cylindrical solid water ("cheese") phantom were used for validation. Each "TomoPhant" plan was modified with intentional multileaf collimator leaf open time (MLC LOT) errors to assess the sensitivity and robustness of this tool. Four scenarios were tested; leaf 32 was "stuck open," leaf 42 was "stuck open," random leaf LOT was closed first by mean values of 2% and then 4%. A static couch DQA procedure was then run five times (once with the unmodified sinogram and four times with modified sinograms) for each of the three "TomoPhant" treatment plans. First, the original optimized delivery plan was compared with the original machine agnostic delivery plan, then the original optimized plans with a known modification applied (intentional MLC LOT error) were compared to the corresponding error plan exit detector measurements. An absolute dose comparison between calculated and ion chamber (A1SL, Standard Imaging, Inc., WI, USA) measured dose was performed for the unmodified "TomoPhant" plans. A 3D gamma evaluation (2%/2 mm global) was performed by comparing the planned dose ("original planned dose" for unmodified plans and "adjusted planned dose" for each intentional error) to exit detector-reconstructed dose for all three "Tomophant" plans. Finally, DQA for 119 clinical (treatment length <25 cm) and three cranio-spinal irradiation (CSI) plans were measured with both the ArcCHECK phantom (Sun Nuclear Corp., Melbourne, FL, USA) and the exit detector DQA tool to assess the time required for DQA and similarity between two methods. The measured ion chamber dose agreed to within 1.5% of the reconstructed dose computed by the exit detector DQA tool on a cheese phantom for all unmodified "Tomophant" plans. Excellent agreement in gamma pass rate (>95%) was observed between the planned and reconstructed dose for all "Tomophant" plans considered using the tool. The gamma pass rate from 119 clinical plan DQA measurements was 94.9% ± 1.5% and 91.9% ± 4.37% for the exit detector DQA tool and ArcCHECK phantom measurements (P = 0.81), respectively. For the clinical plans (treatment length <25 cm), the average time required to perform DQA was 24.7 ± 3.5 and 39.5 ± 4.5 min using the exit detector QA tool and ArcCHECK phantom, respectively, whereas the average time required for the 3 CSI treatments was 35 ± 3.5 and 90 ± 5.2 min, respectively. The exit detector tool has been demonstrated to be faster for performing the DQA with equivalent sensitivity for detecting MLC LOT errors relative to a conventional phantom-based QA method. In addition, comprehensive MLC performance evaluation and features of reconstructed dose provide additional insight into understanding DQA failures and the clinical relevance of DQA results. © 2017 American Association of Physicists in Medicine.

Field precision machining technology of target chamber in ICF lasers

NASA Astrophysics Data System (ADS)

Xu, Yuanli; Wu, Wenkai; Shi, Sucun; Duan, Lin; Chen, Gang; Wang, Baoxu; Song, Yugang; Liu, Huilin; Zhu, Mingzhi

2016-10-01

In ICF lasers, many independent laser beams are required to be positioned on target with a very high degree of accuracy during a shot. The target chamber provides a precision platform and datum reference for final optics assembly and target collimation and location system. The target chamber consists of shell with welded flanges, reinforced concrete pedestal, and lateral support structure. The field precision machining technology of target chamber in ICF lasers have been developed based on ShenGuangIII (SGIII). The same center of the target chamber is adopted in the process of design, fabrication, and alignment. The technologies of beam collimation and datum reference transformation are developed for the fabrication, positioning and adjustment of target chamber. A supporting and rotating mechanism and a special drilling machine are developed to bore the holes of ports. An adjustment mechanism is designed to accurately position the target chamber. In order to ensure the collimation requirements of the beam leading and focusing and the target positioning, custom-machined spacers are used to accurately correct the alignment error of the ports. Finally, this paper describes the chamber center, orientation, and centering alignment error measurements of SGIII. The measurements show the field precision machining of SGIII target chamber meet its design requirement. These information can be used on similar systems.

A study of reconstruction accuracy for a cardiac SPECT system with multi-segmental collimation

NASA Astrophysics Data System (ADS)

Yu, D.-C.; Chang, W.; Pan, T.-S.

1997-06-01

To improve the geometric efficiency of cardiac SPECT imaging, the authors previously proposed to use a multi-segmental collimation with a cylindrical geometry. The proposed collimator consists of multiple parallel-hole collimators with most of the segments directed toward a small central region, where the patient's heart should be positioned. This technique provides a significantly increased detection efficiency for the central region, but at the expense of reduced efficiency for the surrounding region. The authors have used computer simulations to evaluate the implication of this technique on the accuracy of the reconstructed cardiac images. Two imaging situations were simulated: 1) the heart well placed inside the central region, and 2) the heart shifted and partially outside the central region. A neighboring high-uptake liver was simulated for both imaging situations. The images were reconstructed and corrected for attenuation with ML-EM and OS-FM methods using a complete attenuation map. The results indicate that errors caused by projection truncation are not significant and are not strongly dependent on the activity of the liver when the heart is well positioned within the central region. When the heart is partially outside the central region, hybrid emission data (a combination of high-count projections from the central region and low-count projections from the background region) can be used to restore the activity of the truncated section of the myocardium. However, the variance of the image in the section of the myocardium outside the central region is increased by 2-3 times when 10% of the collimator segments are used to image the background region.

On isocentre adjustment and quality control in linear accelerator based radiosurgery with circular collimators and room lasers.

PubMed

Treuer, H; Hoevels, M; Luyken, K; Gierich, A; Kocher, M; Müller, R P; Sturm, V

2000-08-01

We have developed a densitometric method for measuring the isocentric accuracy and the accuracy of marking the isocentre position for linear accelerator based radiosurgery with circular collimators and room lasers. Isocentric shots are used to determine the accuracy of marking the isocentre position with room lasers and star shots are used to determine the wobble of the gantry and table rotation movement, the effect of gantry sag, the stereotactic collimator alignment, and the minimal distance between gantry and table rotation axes. Since the method is based on densitometric measurements, beam spot stability is implicitly tested. The method developed is also suitable for quality assurance and has proved to be useful in optimizing isocentric accuracy. The method is simple to perform and only requires a film box and film scanner for instrumentation. Thus, the method has the potential to become widely available and may therefore be useful in standardizing the description of linear accelerator based radiosurgical systems.

Bridge Crossing Simulator

DTIC Science & Technology

2014-10-07

is counted as. Per the TDTC, a test bridge with longitudinal and/or lateral symmetry under non- eccentric loading can be considered as 1, 2, or 4...Level Run036 3 MLC70T (tracked) BA Run046 6 AB Run055 9 AB Run060 9 BA Run064 12 BA Run071 15 AB Run155 3 MLC96W ( wheeled ) AB...Run331 9 AB Run359 15 AB Run430 12 MLC96W ( wheeled ) BA Run434 12 AB Run447 3 BA Bank Condition: Side Slope, Even Strain Channels High

Focus collimator press for a collimator for gamma ray cameras

DOE Office of Scientific and Technical Information (OSTI.GOV)

York, R.N.; York, D.L.

A focus collimator press for collimators for gamma ray cameras is described comprising a pivot arm of fixed length mounted on a travelling pivot which is movable in the plane of a spaced apart work table surface in a direction toward and away from the work table. A press plate is carried at the opposite end of the fixed length pivot arm, and is maintained in registration with the same portion of the work table for pressing engagement with each undulating radiation opaque strip as it is added to the top of a collimator stack in process by movement ofmore » the travelling pivot inward toward the work table. This enables the press plate to maintain its relative position above the collimator stack and at the same time the angle of the press plate changes, becoming less acute in relation to the work table as the travelling pivot motes inwardly toward the work table. The fixed length of the pivot arm is substantially equal to the focal point of the converging apertures formed by each pair of undulating strips stacked together. Thus, the focal point of each aperture row falls substantially on the axis of the travelling pivot, and since it moves in the plane of the work table surface the focal point of each aperture row is directed to lie in the same common plane. When one of two collimator stacks made in this way is rotated 180 degrees and the two bonded together along their respective first strips, all focal points of every aperture row lie on the central axis of the completed collimator.« less

TH-EF-BRB-02: Feasibility of Optimization for Dynamic Trajectory Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fix, MK; Frei, D; Volken, W

2016-06-15

Purpose: Over the last years, volumetric modulated arc therapy (VMAT) has been widely introduced into clinical routine using a coplanar delivery technique. However, VMAT might be improved by including dynamic couch and collimator rotations, leading to dynamic trajectory radiotherapy (DTRT). In this work the feasibility and the potential benefit of DTRT was investigated. Methods: A general framework for the optimization was developed using the Eclipse Scripting Research Application Programming Interface (ESRAPI). Based on contoured target and organs at risk (OARs), the structures are extracted using the ESRAPI. Sampling potential beam directions, regularly distributed on a sphere using a Fibanocci-lattice, themore » fractional volume-overlap of each OAR and the target is determined and used to establish dynamic gantry-couch movements. Then, for each gantry-couch track the most suitable collimator angle is determined for each control point by optimizing the area between the MLC leaves and the target contour. The resulting dynamic trajectories are used as input to perform the optimization using a research version of the VMAT optimization algorithm and the ESRAPI. The feasibility of this procedure was tested for a clinically motivated head and neck case. Resulting dose distributions for the VMAT plan and for the dynamic trajectory treatment plan were compared based on DVH-parameters. Results: While the DVH for the target is virtually preserved, improvements in maximum dose for the DTRT plan were achieved for all OARs except for the inner-ear, where maximum dose remains the same. The major improvements in maximum dose were 6.5% of the prescribed dose (66 Gy) for the parotid and 5.5% for the myelon and the eye. Conclusion: The result of this work suggests that DTRT has a great potential to reduce dose to OARs with similar target coverage when compared to conventional VMAT treatment plans. This work was supported by Varian Medical Systems. This work was supported by Varian Medical Systems.« less

Computerized optimization of multiple isocentres in stereotactic convergent beam irradiation

NASA Astrophysics Data System (ADS)

Treuer, U.; Treuer, H.; Hoevels, M.; Müller, R. P.; Sturm, V.

1998-01-01

A method for the fully computerized determination and optimization of positions of target points and collimator sizes in convergent beam irradiation is presented. In conventional interactive trial and error methods, which are very time consuming, the treatment parameters are chosen according to the operator's experience and improved successively. This time is reduced significantly by the use of a computerized procedure. After the definition of target volume and organs at risk in the CT or MR scans, an initial configuration is created automatically. In the next step the target point positions and collimator diameters are optimized by the program. The aim of the optimization is to find a configuration for which a prescribed dose at the target surface is approximated as close as possible. At the same time dose peaks inside the target volume are minimized and organs at risk and tissue surrounding the target are spared. To enhance the speed of the optimization a fast method for approximate dose calculation in convergent beam irradiation is used. A possible application of the method for calculating the leaf positions when irradiating with a micromultileaf collimator is briefly discussed. The success of the procedure has been demonstrated for several clinical cases with up to six target points.

Genetics Home Reference: megalencephalic leukoencephalopathy with subcortical cysts

MedlinePlus

... is unable to correctly transport GlialCAM and MLC1 proteins to cell junctions. It is unknown how a lack of functional MLC1 or GlialCAM protein at cell junctions in the brain impairs brain development and ...

Introduction of a novel ultrahigh sensitivity collimator for brain SPECT imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Park, Mi-Ae, E-mail: miaepark@bwh.harvard.edu; Kij

Purpose: Noise levels of brain SPECT images are highest in central regions, due to preferential attenuation of photons emitted from deep structures. To address this problem, the authors have designed a novel collimator for brain SPECT imaging that yields greatly increased sensitivity near the center of the brain without loss of resolution. This hybrid collimator consisted of ultrashort cone-beam holes in the central regions and slant-holes in the periphery (USCB). We evaluated this collimator for quantitative brain imaging tasks. Methods: Owing to the uniqueness of the USCB collimation, the hole pattern required substantial variations in collimator parameters. To utilize themore » lead-casting technique, the authors designed two supporting plates to position about 37 000 hexagonal, slightly tapered pins. The holes in the supporting plates were modeled to yield the desired focal length, hole length, and septal thickness. To determine the properties of the manufactured collimator and to compute the system matrix, the authors prepared an array of point sources that covered the entire detector area. Each point source contained 32 μCi of Tc-99m at the first scan time. The array was imaged for 5 min at each of the 64 shifted locations to yield a 2-mm sampling distance, and hole parameters were calculated. The sensitivity was also measured using a point source placed along the central ray at several distances from the collimator face. High-count projection data from a five-compartment brain phantom were acquired with the three collimators on a dual-head SPECT/CT system. The authors calculated Cramer-Rao bounds on the precision of estimates of striatal and background activity concentration. In order to assess the new collimation system to detect changes in striatal activity, the authors evaluated the precision of measuring a 5% decrease in right putamen activity. The authors also reconstructed images of projection data obtained by summing data from the individual phantom compartments. Results: The sensitivity of the novel cone-beam collimator varied with distance from the detector face; it was higher than that of the fan-beam collimator by factors ranging from 2.7 to 162. Examination of the projections of the point sources revealed that only a few holes were distorted or partially blocked, indicating that the intensive manual fabrication process was very successful. Better reconstructed phantom images were obtained from the USCB+FAN collimator pair than from either LEHR or FAN collimation. For the left caudate, located near the center of the brain, the detected counts were 9.8 (8.3) times higher for UCSB compared with LEHR (FAN), averaged over 60 views. The task-specific SNR for detecting a 5% decrease in putamen uptake was 7.4 for USCB and 3.2 for LEHR. Conclusions: The authors have designed and manufactured a novel collimator for brain SPECT imaging. The sensitivity is much higher than that of a fan-beam collimator. Because of differences between the manufactured collimator and its design, reconstruction of the data requires a measured system matrix. The authors have demonstrated the potential of USCB collimation for improved precision in estimating striatal uptake. The novel collimator may be useful for early detection of Parkinson’s disease, and for monitoring therapy response and disease progression.« less

Characterization of the Shielded Neutron Source at Triangle Universities Nuclear Laboratory

NASA Astrophysics Data System (ADS)

Hobson, Chad; Finch, Sean; Howell, Calvin; Malone, Ron; Tornow, Wernew

2016-09-01

In 2015, Triangle Universities Nuclear Laboratory rebuilt its shielded neutron source (SNS) with the goal of improving neutron beam collimation and reducing neutron and gamma-ray backgrounds. Neutrons are produced via the 2H(d,n)3He reaction and then collimated by heavy shielding to form a beam. The SNS has the ability to produce both a rectangular and circular neutron beam through use of two collimators with different beam apertures. Our work characterized both the neutron beam profiles as well as the neutron and gamma-ray backgrounds at various locations around the SNS. This characterization was performed to provide researchers who use the SNS with beam parameters necessary to plan and conduct an experiment. Vertical and horizontal beam profiles were measured at two different distances from the neutron production cell by scanning a small plastic scintillator across the face of the beam at various energies for each collimator. Background neutron and gamma-ray intensities were measured using time-of-flight techniques at 10 MeV and 16 MeV with the rectangular collimator. We present results on the position and size of neutron beam as well as on the structure and magnitude of the backgrounds.

SU-F-E-20: A Mathematical Model of Linac Jaw Calibration Integrated with Collimator Walkout

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhao, Y; Corns, R; Huang, V

2016-06-15

Purpose: Accurate jaw calibration is possible, but it does not necessarily achieve good junctions because of collimator rotation walkout. We developed a mathematical model seeking to pick an origin for calibration that minimizes the collimator walkout effect. Methods: We use radioopaque markers aligned with crosshair on the EPID to determine the collimator walkout at collimator angles 0°, 90° and 270°. We can accurately calibrate jaws to any arbitrary origin near the radiation field centre. While the absolute position of an origin moves with the collimator walkout, its relative location to the crosshair is an invariant. We studied two approaches tomore » select an optimal origin. One approach seeks to bring all three origin locations (0°–90°–270°) as close as possible by minimizing the perimeter of the triangle formed by these points. The other approach focuses on the gap for 0°–90° junctions. Results: Our perimeter cost function has two variables and non-linear behaviour. Generally, it does not have zero-perimeter-length solution which leads to perfect jaw matches. The zero solution can only be achieved, if the collimator rotates about a single fixed axis. In the second approach, we can always get perfect 0°–0° and 0°–90° junctions, because we ignore the 0°–270° situation. For our TrueBeams, both techniques for selecting an origin improved junction dose inhomogeneities to less than ±6%. Conclusion: Our model considers the general jaw matching with collimator rotations and proposes two potential solutions. One solution optimizes the junction gaps by considering all three collimator angles while the other only considers 0°–90°. The first solution will not give perfect matching, but can be clinically acceptable with minimized collimator walkout effect, while the second can have perfect junctions at the expense of the 0°–270° junctions. Different clinics might choose between these two methods basing on their clinical practices.« less

Sensitivity of 3D Dose Verification to Multileaf Collimator Misalignments in Stereotactic Body Radiation Therapy of Spinal Tumor.

PubMed

Xin-Ye, Ni; Ren, Lei; Yan, Hui; Yin, Fang-Fang

2016-12-01

This study aimed to detect the sensitivity of Delt 4 on ordinary field multileaf collimator misalignments, system misalignments, random misalignments, and misalignments caused by gravity of the multileaf collimator in stereotactic body radiation therapy. (1) Two field sizes, including 2.00 cm (X) × 6.00 cm (Y) and 7.00 cm (X) × 6.00 cm (Y), were set. The leaves of X1 and X2 in the multileaf collimator were simultaneously opened. (2) Three cases of stereotactic body radiation therapy of spinal tumor were used. The dose of the planning target volume was 1800 cGy with 3 fractions. The 4 types to be simulated included (1) the leaves of X1 and X2 in the multileaf collimator were simultaneously opened, (2) only X1 of the multileaf collimator and the unilateral leaf were opened, (3) the leaves of X1 and X2 in the multileaf collimator were randomly opened, and (4) gravity effect was simulated. The leaves of X1 and X2 in the multileaf collimator shifted to the same direction. The difference between the corresponding 3-dimensional dose distribution measured by Delt 4 and the dose distribution in the original plan made in the treatment planning system was analyzed with γ index criteria of 3.0 mm/3.0%, 2.5 mm/2.5%, 2.0 mm/2.0%, 2.5 mm/1.5%, and 1.0 mm/1.0%. (1) In the field size of 2.00 cm (X) × 6.00 cm (Y), the γ pass rate of the original was 100% with 2.5 mm/2.5% as the statistical standard. The pass rate decreased to 95.9% and 89.4% when the X1 and X2 directions of the multileaf collimator were opened within 0.3 and 0.5 mm, respectively. In the field size of 7.00 (X) cm × 6.00 (Y) cm with 1.5 mm/1.5% as the statistical standard, the pass rate of the original was 96.5%. After X1 and X2 of the multileaf collimator were opened within 0.3 mm, the pass rate decreased to lower than 95%. The pass rate was higher than 90% within the 3 mm opening. (2) For spinal tumor, the change in the planning target volume V 18 under various modes calculated using treatment planning system was within 1%. However, the maximum dose deviation of the spinal cord was high. In the spinal cord with a gravity of -0.25 mm, the maximum dose deviation minimally changed and increased by 6.8% than that of the original. In the largest opening of 1.00 mm, the deviation increased by 47.7% than that of the original. Moreover, the pass rate of the original determined through Delt 4 was 100% with 3 mm/3% as the statistical standard. The pass rate was 97.5% in the 0.25 mm opening and higher than 95% in the 0.5 mm opening A, 0.25 mm opening A, whole gravity series, and 0.20 mm random opening. Moreover, the pass rate was higher than 90% with 2.0 mm/2.0% as the statistical standard in the original and in the 0.25 mm gravity. The difference in the pass rates was not statistically significant among the -0.25 mm gravity, 0.25 mm opening A, 0.20 mm random opening, and original as calculated using SPSS 11.0 software with P > .05. Different analysis standards of Delt 4 were analyzed in different field sizes to improve the detection sensitivity of the multileaf collimator position on the basis of 90% throughout rate. In stereotactic body radiation therapy of spinal tumor, the 2.0 mm/2.0% standard can reveal the dosimetric differences caused by the minor multileaf collimator position compared with the 3.0 mm/3.0% statistical standard. However, some position derivations of the misalignments that caused high dose amount to the spinal cord cannot be detected. However, some misalignments were not detected when a large number of multileaf collimator were administered into the spinal cord. © The Author(s) 2015.

SU-E-T-88: Comprehensive Automated Daily QA for Hypo- Fractionated Treatments

DOE Office of Scientific and Technical Information (OSTI.GOV)

McGuinness, C; Morin, O

2014-06-01

Purpose: The trend towards more SBRT treatments with fewer high dose fractions places increased importance on daily QA. Patient plan specific QA with 3%/3mm gamma analysis and daily output constancy checks may not be enough to guarantee the level of accuracy required for SBRT treatments. But increasing the already extensive amount of QA procedures that are required is a daunting proposition. We performed a feasibility study for more comprehensive automated daily QA that could improve the diagnostic capabilities of QA without increasing workload. Methods: We performed the study on a Siemens Artiste linear accelerator using the integrated flat panel EPID.more » We included square fields, a picket fence, overlap and representative IMRT fields to measure output, flatness, symmetry, beam center, and percent difference from the standard. We also imposed a set of machine errors: MLC leaf position, machine output, and beam steering to compare with the standard. Results: Daily output was consistent within +/− 1%. Change in steering current by 1.4% and 2.4% resulted in a 3.2% and 6.3% change in flatness. 1 and 2mm MLC leaf offset errors were visibly obvious in difference plots, but passed a 3%/3mm gamma analysis. A simple test of transmission in a picket fence can catch a leaf offset error of a single leaf by 1mm. The entire morning QA sequence is performed in less than 30 minutes and images are automatically analyzed. Conclusion: Automated QA procedures could be used to provide more comprehensive information about the machine with less time and human involvement. We have also shown that other simple tests are better able to catch MLC leaf position errors than a 3%/3mm gamma analysis commonly used for IMRT and modulated arc treatments. Finally, this information could be used to watch trends of the machine and predict problems before they lead to costly machine downtime.« less

Clinical implementation and error sensitivity of a 3D quality assurance protocol for prostate and thoracic IMRT

PubMed Central

Cotter, Christopher; Turcotte, Julie Catherine; Crawford, Bruce; Sharp, Gregory; Mah'D, Mufeed

2015-01-01

This work aims at three goals: first, to define a set of statistical parameters and plan structures for a 3D pretreatment thoracic and prostate intensity‐modulated radiation therapy (IMRT) quality assurance (QA) protocol; secondly, to test if the 3D QA protocol is able to detect certain clinical errors; and third, to compare the 3D QA method with QA performed with single ion chamber and 2D gamma test in detecting those errors. The 3D QA protocol measurements were performed on 13 prostate and 25 thoracic IMRT patients using IBA's COMPASS system. For each treatment planning structure included in the protocol, the following statistical parameters were evaluated: average absolute dose difference (AADD), percent structure volume with absolute dose difference greater than 6% (ADD6), and 3D gamma test. To test the 3D QA protocol error sensitivity, two prostate and two thoracic step‐and‐shoot IMRT patients were investigated. Errors introduced to each of the treatment plans included energy switched from 6 MV to 10 MV, multileaf collimator (MLC) leaf errors, linac jaws errors, monitor unit (MU) errors, MLC and gantry angle errors, and detector shift errors. QA was performed on each plan using a single ion chamber and 2D array of ion chambers for 2D and 3D QA. Based on the measurements performed, we established a uniform set of tolerance levels to determine if QA passes for each IMRT treatment plan structure: maximum allowed AADD is 6%; maximum 4% of any structure volume can be with ADD6 greater than 6%, and maximum 4% of any structure volume may fail 3D gamma test with test parameters 3%/3 mm DTA. Out of the three QA methods tested the single ion chamber performed the worst by detecting 4 out of 18 introduced errors, 2D QA detected 11 out of 18 errors, and 3D QA detected 14 out of 18 errors. PACS number: 87.56.Fc PMID:26699299

Surface dose investigation of the flattening filter-free photon beams.

PubMed

Wang, Yuenan; Khan, Mohammad K; Ting, Joseph Y; Easterling, Stephen B

2012-06-01

Flattening filter-free (FFF) x-rays can provide more efficient use of photons and a significant increase of dose rate compared with conventional flattened x-rays, features that are especially beneficial for stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). The available data on the entrance doses of the FFF photon beams remain limited. The purpose of this study was to investigate the entrance dose of FFF photons in the buildup region and to compare it with that of conventional flattened photons. A Varian TrueBeam linear accelerator has been in full clinical operation with 6-MV and 10-MV FFF and flattened x-ray photons. Entrance dose at the surface was measured using a parallel plate ionization chamber in a solid water phantom with buildup depth = 0~15 mm for 6X and 0~25 mm for 10X. Different field size (FS) patterns were created in the Eclipse Treatment Planning System by multileaf collimator (MLC) rather than jaws (FS = 2 × 2, 3 × 3, 4 × 4, 6 × 6, and 10 × 10 cm(2) by MLC and jaw size = 2.2 × 2.2, 3.2 × 3.2, 4.2 × 4.2, 6 × 6, and 10 × 10 cm(2)). The smallest FS was about four times larger than the ion chamber dimension. All buildup dose measurements were normalized to FS = 10 × 10 cm(2) at the depth of dose maximum (dmax). Good repeatability was demonstrated and surface dose increased linearly with FS for both flattened and FFF photons. The entrance dose of the FFF photons was modestly larger than that of the corresponding flattened photons for both 6X and 10X for different FS ranging from 2 × 2 cm(2) to 10 × 10 cm(2). The FFF photons have a higher entrance dose than that of the corresponding flattened photons for FS smaller than 10 × 10 cm(2). However, the difference is not substantial and may be clinically insignificant. Published by Elsevier Inc.

Minimizing dose variation from the interplay effect in stereotactic radiation therapy using volumetric modulated arc therapy for lung cancer.

PubMed

Kubo, Kazuki; Monzen, Hajime; Tamura, Mikoto; Hirata, Makoto; Ishii, Kentaro; Okada, Wataru; Nakahara, Ryuta; Kishimoto, Shun; Kawamorita, Ryu; Nishimura, Yasumasa

2018-03-01

It is important to improve the magnitude of dose variation that is caused by the interplay effect. The aim of this study was to investigate the impact of the number of breaths (NBs) to the dose variation for VMAT-SBRT to lung cancer. Data on respiratory motion and multileaf collimator (MLC) sequence were collected from the cases of 30 patients who underwent radiotherapy with VMAT-SBRT for lung cancer. The NBs in the total irradiation time with VMAT and the maximum craniocaudal amplitude of the target were calculated. The MLC sequence complexity was evaluated using the modulation complexity score for VMAT (MCSv). Static and dynamic measurements were performed using a cylindrical respiratory motion phantom and a micro ionization chamber. The 1 standard deviation which were obtained from 10 dynamic measurements for each patient were defined as dose variation caused by the interplay effect. The dose distributions were also verified with radiochromic film to detect undesired hot and cold dose spot. Dose measurements were also performed with different NBs in the same plan for 16 patients in 30 patients. The correlations between dose variations and parameters assessed for each treatment plan including NBs, MCSv, the MCSv/amplitude quotient (TMMCSv), and the MCSv/amplitude quotient × NBs product (IVS) were evaluated. Dose variation was decreased with increasing NBs, and NBs of >40 times maintained the dose variation within 3% in 15 cases. The correlation between dose variation and IVS which were considered NBs was shown stronger (R 2  = 0.43, P < 0.05) than TMMCSv (R 2  = 0.32, P < 0.05). The NBs is an important factor to reduce the dose variation. The patient who breathes >40 times during irradiation of two partial arcs VMAT (i.e., NBs = 16 breaths per minute) may be suitable for VMAT-SBRT for lung cancer. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

TH-AB-BRB-01: Trajectory Modulated Arc Therapy: Application to Partial Breast Irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hristov, D.

2016-06-15

Current state-of-the art digital C-arm medical linear accelerators are capable of delivering radiation treatments with high level of automation, which affords coordinated motions of gantry, couch, and multileaf collimator (MLC) with dose rate modulations. The new machine capacity has shown the potential to bring substantially improved radiation dosimetry and/or delivery efficiency to many challenging diseases. Combining an integrated beam orientation optimization algorithm with automated machine navigation, markedly improved dose conformity has been achieved using 4ρ therapy. Trajectory modulated radiation therapy (TMAT) can be used to deliver highly conformal dose to partial breast or to carve complex dose distribution for therapymore » involving extended volumes such as total marrow and total lymph node treatment. Dynamic electron arc radiotherapy (DEAR) not only overcomes the deficiencies of conventional electron therapy in dose conformity and homogeneity but also achieves so without patient-specific shields. The combination of MLC and couch tracking provides improved motion management of thoracic and abdominal tumors. A substantial body of work has been done in these technological advances for clinical translation. The proposed symposium will provide a timely review of these exciting opportunities. Learning Objectives: Recognize the potential of using digitally controlled linacs for clinically significant improvements in delivered dose distributions for various treatment sites. Identify existing approaches to treatment planning, optimization and delivery for treatment techniques utilizing the advanced functions of digital linacs and venues for further development and improvement. Understand methods for testing and validating delivery system performance. Identify tools available on current delivery systems for implementation and control for such treatments. Obtain the update in clinical applications, trials and regulatory approval. K. Sheng, NIH U19AI067769, NIH R43CA183390, NIH R01CA188300, Varian Medical Systems V. Yu, Varian Medical Systems, AAPM Summer Undergraduate Fellowship, NSF graduate fellowship S. Nill, Elekta AB. Cancer Research UK under Programme C33589/A19727, NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research.« less

SU-E-T-335: Dosimetric Investigation of An Advanced Rotating Gamma Ray System for Imaged Guided Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ma, C; Eldib, A; Chibani, O

2015-06-15

Purpose: Co-60 beams have unique dosimetric properties for cranial treatments and thoracic cancers. The conventional concern about the high surface dose is overcome by modern system designs with rotational treatment techniques. This work investigates a novel rotational Gamma ray system for image-guided, external beam radiotherapy. Methods: The CybeRT system (Cyber Medical Corp., China) consists of a ring gantry with either one or two treatment heads containing a Gamma source and a multileaf collimator (MLC). The MLC has 60 paired leaves, and the maximum field size is either 40cmx40cm (40 pairs of 0.5cm central leaves, 20 pairs of 1cm outer leaves),more » or 22cmx40cm (32 pairs of 0.25cm central leaves, 28 pairs of 0.5cm outer leaves). The treatment head(s) can swing 35° superiorly and 8° inferiorly, allowing a total of 43° non-coplanar beam incident. The treatment couch provides 6-degrees-of-freedom motion compensation and the kV cone-beam CT system has a spatial resolution of 0.4mm. Monte Carlo simulations were used to compute dose distributions and compare with measurements. A retrospective study of 98 previously treated patients was performed to compare CybeRT with existing RT systems. Results: Monte Carlo results confirmed the CybeRT design parameters including output factors and 3D dose distributions. Its beam penumbra/dose gradient was similar to or better than that of 6MV photon beams and its isocenter accuracy is 0.3mm. Co-60 beams produce lower-energy secondary electrons that exhibit better dose properties in low-density lung tissues. Because of their rapid depth dose falloff, Co-60 beams are favorable for peripheral lung tumors with half-arc arrangements to spare the opposite lung and critical structures. Superior dose distributions were obtained for head and neck, breast, spine and lung tumors. Conclusion: Because of its accurate dose delivery and unique dosimetric properties of C-60 sources, CybeRT is ideally suited for advanced SBRT as well as conventional RT. This work was partially supported by Cyber Medical Corp.« less

Improving cardiovascular health of underserved populations in the community with Life's Simple 7.

PubMed

Murphy, Marcia Pencak; Coke, Lola; Staffileno, Beth A; Robinson, Janis D; Tillotson, Robin

2015-11-01

The purpose of this nurse practitioner (NP) led initiative was to improve the cardiovascular health of two underserved populations in the community using the American Heart Association (AHA) Life's Simple 7 and My Life Check (MLC) tools. Two inner city community sites were targeted: (a) a senior center servicing African American (AA) older adults, and (b) a residential facility servicing homeless women. Preprogram health data (blood pressure, cholesterol, blood glucose levels, body mass index, and health behaviors) were collected to calculate MLC scores. Postprogram health data were obtained on participants with the lowest MLC scores who completed the program. Eight older adults completed the program with a 37.1% increase in average MLC score (6.2 vs. 8.5). Ten women completed the program with a 9.3% decrease in average MLC score (4.3 vs. 3.9). Favorable benefits were observed in the AA older adults. In contrast, similar benefits were not observed in the women, which may be because of a constellation of social, environmental, biological, and mental health factors. NPs are prepared to target community-based settings to address the health of underserved populations. Engaging key stakeholders in the planning and implementation is essential for success. ©2015 American Association of Nurse Practitioners.

IL-4 inhibits the synthesis of IFN-gamma and induces the synthesis of IgE in human mixed lymphocyte cultures.

PubMed

Vercelli, D; Jabara, H H; Lauener, R P; Geha, R S

1990-01-15

The T cell-derived lymphokine IL-4 is essential for the induction of IgE synthesis by human lymphocytes. The IgE-inducing effect of IL-4 is antagonized by IFN-gamma. The secretion of IFN-gamma is vigorously triggered in MLC. Thus, IL-4-stimulated MLC represent a suitable model to characterize the functional antagonism between IL-4 and IFN-gamma. In this report, we show that rIL-4 consistently induced IgE synthesis when added to human primary MLC. IL-4-dependent IgE production required cognate T/B cell recognition, because it was inhibited by antibodies to CD3 and MHC class II (HlA-DR) Ag. A neutralizing anti-IFN-gamma mAb dramatically enhanced IL-4-dependent IgE synthesis by MLC, indicating that endogenous IFN-gamma is a major inhibitor of IgE production. More importantly, addition of rIL-4 markedly inhibited the release of IFN-gamma in supernatants of MLC and Con A-activated PBMC. The decrease in IFN-gamma protein was accompanied by a decreased expression of IFN-gamma mRNA transcripts. The downregulation of IFN-gamma by IL-4 is likely to play an important role in the IL-4-dependent induction of IgE synthesis.

An increase or a decrease in myosin II phosphorylation inhibits macrophage motility

PubMed Central

1991-01-01

Myosin II purified from mammalian non-muscle cells is phosphorylated on the 20-kD light chain subunit (MLC20) by the Ca2+/calmodulin-dependent enzyme myosin light chain kinase (MLCK). The importance of MLC20 phosphorylation in regulating cell motility was investigated by introducing either antibodies to MLCK (MK-Ab) or a Ca2+/calmodulin- independent, constitutively active form of MLCK (MK-) into macrophages. The effects of these proteins on cell motility were then determined using a quantitative chemotaxis assay. Chemotaxis is significantly diminished in macrophages containing MK-Ab compared to macrophages containing control antibodies. Moreover, there is an inverse relationship between the number of cells that migrate and the amount of MK-Ab introduced into cells. Interestingly, there is also an inverse relationship between the number of cells that migrate and the amount of MK- introduced into cells. Other experiments demonstrated that MK-Ab decreased intracellular MLC20 phosphorylation while MK- increased MLC20 phosphorylation. MK- also increased the amount of myosin associated with the cytoskeleton. These data demonstrate that the regulation of MLCK is an important aspect of cell motility and suggest that MLC20 phosphorylation must be maintained within narrow limits during translational motility by mammalian cells. PMID:2071674

Transient up- and down-regulation of expression of myosin light chain 2 and myostatin mRNA mark the changes from stratified hyperplasia to muscle fiber hypertrophy in larvae of gilthead sea bream (Sparus aurata L.).

PubMed

Georgiou, Stella; Alami-Durante, Hélène; Power, Deborah M; Sarropoulou, Elena; Mamuris, Zissis; Moutou, Katerina A

2016-02-01

Hyperplasia and hypertrophy are the two mechanisms by which muscle develops and grows. We study these two mechanisms, during the early development of white muscle in Sparus aurata, by means of histology and the expression of structural and regulatory genes. A clear stage of stratified hyperplasia was identified early in the development of gilthead sea bream but ceased by 35 dph when hypertrophy took over. Mosaic recruitment of new white fibers began as soon as 60 dph. The genes mlc2a and mlc2b were expressed at various levels during the main phases of hyperplasia and hypertrophy. The genes myog and mlc2a were significantly up-regulated during the intensive stratified formation of new fibers and their expression was significantly correlated. Expression of mstn1 and igf1 increased at 35 dph, appeared to regulate the hyperplasia-to-hypertrophy transition, and may have stimulated the expression of mlc2a, mlc2b and col1a1 at the onset of mosaic hyperplasia. The up-regulation of mstn1 at transitional phases in muscle development indicates a dual regulatory role of myostatin in fish larval muscle growth.

Myosin light chain phosphorylation is critical for adaptation to cardiac stress.

PubMed

Warren, Sonisha A; Briggs, Laura E; Zeng, Huadong; Chuang, Joyce; Chang, Eileen I; Terada, Ryota; Li, Moyi; Swanson, Maurice S; Lecker, Stewart H; Willis, Monte S; Spinale, Francis G; Maupin-Furlowe, Julie; McMullen, Julie R; Moss, Richard L; Kasahara, Hideko

2012-11-27

Cardiac hypertrophy is a common response to circulatory or neurohumoral stressors as a mechanism to augment contractility. When the heart is under sustained stress, the hypertrophic response can evolve into decompensated heart failure, although the mechanism(s) underlying this transition remain largely unknown. Because phosphorylation of cardiac myosin light chain 2 (MLC2v), bound to myosin at the head-rod junction, facilitates actin-myosin interactions and enhances contractility, we hypothesized that phosphorylation of MLC2v plays a role in the adaptation of the heart to stress. We previously identified an enzyme that predominantly phosphorylates MLC2v in cardiomyocytes, cardiac myosin light-chain kinase (cMLCK), yet the role(s) played by cMLCK in regulating cardiac function in health and disease remain to be determined. We found that pressure overload induced by transaortic constriction in wild-type mice reduced phosphorylated MLC2v levels by ≈40% and cMLCK levels by ≈85%. To examine how a reduction in cMLCK and the corresponding reduction in phosphorylated MLC2v affect function, we generated Mylk3 gene-targeted mice and transgenic mice overexpressing cMLCK specifically in cardiomyocytes. Pressure overload led to severe heart failure in cMLCK knockout mice but not in mice with cMLCK overexpression in which cMLCK protein synthesis exceeded degradation. The reduction in cMLCK protein during pressure overload was attenuated by inhibition of ubiquitin-proteasome protein degradation systems. Our results suggest the novel idea that accelerated cMLCK protein turnover by the ubiquitin-proteasome system underlies the transition from compensated hypertrophy to decompensated heart failure as a result of reduced phosphorylation of MLC2v.

Lactobacillus farciminis treatment suppresses stress induced visceral hypersensitivity: a possible action through interaction with epithelial cell cytoskeleton contraction.

PubMed

Ait-Belgnaoui, A; Han, W; Lamine, F; Eutamene, H; Fioramonti, J; Bueno, L; Theodorou, V

2006-08-01

Stress induced increase in colonic paracellular permeability results from epithelial cell cytoskeleton contraction and is responsible for stress induced hypersensitivity to colorectal distension (CRD). The probiotic Lactobacillus farciminis releases spontaneously nitric oxide (NO) in the colonic lumen in vivo and exerts anti-inflammatory effects. This study aimed: (i) to evaluate the effects of L farciminis on stress induced hypersensitivity to CRD and increase in colonic paracellular permeability; and (ii) to ascertain whether these effects are NO mediated and related to changes in colonocyte myosin light chain phosphorylation (p-MLC). Female Wistar rats received either 10(11) CFU/day of L farciminis or saline orally over 15 days before partial restraint stress (PRS) or sham-PRS application. Visceral sensitivity to CRD and colonic paracellular permeability was assessed after PRS or sham-PRS. Haemoglobin was used as an NO scavenger. Western blotting for MLC kinase, MLC, and p-MLC were performed in colonic mucosa from L farciminis treated and control rats after PRS or sham-PRS. PRS significantly increased the number of spike bursts for CRD pressures of 30-60 mm Hg as well as colonic paracellular permeability. L farciminis treatment prevented both effects, while haemoglobin reversed the protective effects of L farciminis. p-MLC expression increased significantly from 15 to 45 minutes after PRS, and L farciminis treatment prevented this increase. L farciminis treatment prevents stress induced hypersensitivity, increase in colonic paracellular permeability, and colonocyte MLC phosphorylation. This antinociceptive effect occurs via inhibition of contraction of colonic epithelial cell cytoskeleton and the subsequent tight junction opening, and may also involve direct or indirect effects of NO produced by this probiotic.

Lactobacillus farciminis treatment suppresses stress induced visceral hypersensitivity: a possible action through interaction with epithelial cell cytoskeleton contraction

PubMed Central

Ait‐Belgnaoui, A; Han, W; Lamine, F; Eutamene, H; Fioramonti, J; Bueno, L; Theodorou, V

2006-01-01

Background Stress induced increase in colonic paracellular permeability results from epithelial cell cytoskeleton contraction and is responsible for stress induced hypersensitivity to colorectal distension (CRD). The probiotic Lactobacillus farciminis releases spontaneously nitric oxide (NO) in the colonic lumen in vivo and exerts anti‐inflammatory effects. This study aimed: (i) to evaluate the effects of L farciminis on stress induced hypersensitivity to CRD and increase in colonic paracellular permeability; and (ii) to ascertain whether these effects are NO mediated and related to changes in colonocyte myosin light chain phosphorylation (p‐MLC). Methods Female Wistar rats received either 1011 CFU/day of L farciminis or saline orally over 15 days before partial restraint stress (PRS) or sham‐PRS application. Visceral sensitivity to CRD and colonic paracellular permeability was assessed after PRS or sham‐PRS. Haemoglobin was used as an NO scavenger. Western blotting for MLC kinase, MLC, and p‐MLC were performed in colonic mucosa from L farciminis treated and control rats after PRS or sham‐PRS. Results PRS significantly increased the number of spike bursts for CRD pressures of 30–60 mm Hg as well as colonic paracellular permeability. L farciminis treatment prevented both effects, while haemoglobin reversed the protective effects of L farciminis. p‐MLC expression increased significantly from 15 to 45 minutes after PRS, and L farciminis treatment prevented this increase. Conclusion L farciminis treatment prevents stress induced hypersensitivity, increase in colonic paracellular permeability, and colonocyte MLC phosphorylation. This antinociceptive effect occurs via inhibition of contraction of colonic epithelial cell cytoskeleton and the subsequent tight junction opening, and may also involve direct or indirect effects of NO produced by this probiotic. PMID:16507583

Testing the Role of Meander Cutoff in Promoting Gene Flow across a Riverine Barrier in Ground Skinks (Scincella lateralis)

PubMed Central

Jackson, Nathan D.; Austin, Christopher C.

2013-01-01

Despite considerable attention, the long-term impact of rivers on species diversification remains uncertain. Meander loop cutoff (MLC) is one river phenomenon that may compromise a river’s diversifying effects by passively transferring organisms from one side of the river to the other. However, the ability of MLC to promote gene flow across rivers has not been demonstrated empirically. Here, we test several predictions of MLC-mediated gene flow in populations of North American ground skinks (Scincella lateralis) separated by a well-established riverine barrier, the Mississippi River: 1) individuals collected from within meander cutoffs should be more closely related to individuals across the river than on the same side, 2) individuals within meander cutoffs should contain more immigrants than individuals away from meander cutoffs, 3) immigration rates estimated across the river should be highest in the direction of the cutoff event, and 4) the distribution of alleles native to one side of the river should be better predicted by the historical rather than current path of the river. To test these predictions we sampled 13 microsatellite loci and mitochondrial DNA from ground skinks collected near three ancient meander loops. These predictions were generally supported by genetic data, although support was stronger for mtDNA than for microsatellite data. Partial support for genetic divergence of samples within ancient meander loops also provides evidence for the MLC hypothesis. Although a role for MLC-mediated gene flow was supported here for ground skinks, the transient nature of river channels and morphologies may limit the long-term importance of MLC in stemming population divergence across major rivers. PMID:23658778

System and method for the identification of radiation in contaminated rooms

DOEpatents

Coleman, Jody Rustyn; Farfan, Eduardo B.

2015-09-29

Devices and methods for the characterization of areas of radiation in contaminated rooms are provided. One such device is a collimator with a collimator shield for reducing noise when measuring radiation. A position determination system is provided that may be used for obtaining position and orientation information of the detector in the contaminated room. A radiation analysis method is included that is capable of determining the amount of radiation intensity present at known locations within the contaminated room. Also, a visual illustration system is provided that may project images onto the physical objects, which may be walls, of the contaminated room in order to identify the location of radioactive materials for decontamination.

Randomized algorithms for high quality treatment planning in volumetric modulated arc therapy

NASA Astrophysics Data System (ADS)

Yang, Yu; Dong, Bin; Wen, Zaiwen

2017-02-01

In recent years, volumetric modulated arc therapy (VMAT) has been becoming a more and more important radiation technique widely used in clinical application for cancer treatment. One of the key problems in VMAT is treatment plan optimization, which is complicated due to the constraints imposed by the involved equipments. In this paper, we consider a model with four major constraints: the bound on the beam intensity, an upper bound on the rate of the change of the beam intensity, the moving speed of leaves of the multi-leaf collimator (MLC) and its directional-convexity. We solve the model by a two-stage algorithm: performing minimization with respect to the shapes of the aperture and the beam intensities alternatively. Specifically, the shapes of the aperture are obtained by a greedy algorithm whose performance is enhanced by random sampling in the leaf pairs with a decremental rate. The beam intensity is optimized using a gradient projection method with non-monotonic line search. We further improve the proposed algorithm by an incremental random importance sampling of the voxels to reduce the computational cost of the energy functional. Numerical simulations on two clinical cancer date sets demonstrate that our method is highly competitive to the state-of-the-art algorithms in terms of both computational time and quality of treatment planning.

Traditional and MLC based dose compensator design for patients with hip prostheses undergoing pelvic radiation therapy.

PubMed

Alecu, R; Alecu, M; Loomis, T; Ochran, T; He, T

1999-01-01

Perturbations in the dose distribution caused by a hip prosthesis when treating pelvic malignancies can result in unacceptable dose inhomogeneities within the target volume. Our results, obtained by in vivo exit dose measurements with diodes, showed a 55% reduction in the dose at the exit dmax of a lateral 15 MV photon beam after passing through a bilateral cobalt-chrome alloy hip prosthesis. Such an inhomogeneous dose distribution may decrease the curability. Solutions such as treatment techniques to avoid the prosthesis are often not the best choice as the dose to the rectum may be unacceptably high. In this work an alternative method of dose compensator is presented. Two types of dose compensators were designed based on a 3-D treatment planning system and CT images of a pelvic phantom containing a hip prosthesis: one was fabricated from a polyethylene-lead slab in the representation of step fringes and placed on a tray in the path of the beam while the other was produced by the use of several fields shaped with a multileaf collimator. The calculation procedures developed by the authors for generating the compensators are described. Results of film measurements performed in a phantom with and without the compensators in place are discussed.

21 CFR 872.1840 - Dental x-ray position indicating device.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Dental x-ray position indicating device. 872.1840... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1840 Dental x-ray position indicating device. (a) Identification. A dental x-ray position indicating device is a device, such as a collimator...

21 CFR 872.1840 - Dental x-ray position indicating device.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Dental x-ray position indicating device. 872.1840... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1840 Dental x-ray position indicating device. (a) Identification. A dental x-ray position indicating device is a device, such as a collimator...

21 CFR 872.1840 - Dental x-ray position indicating device.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Dental x-ray position indicating device. 872.1840... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1840 Dental x-ray position indicating device. (a) Identification. A dental x-ray position indicating device is a device, such as a collimator...

21 CFR 872.1840 - Dental x-ray position indicating device.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Dental x-ray position indicating device. 872.1840... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1840 Dental x-ray position indicating device. (a) Identification. A dental x-ray position indicating device is a device, such as a collimator...

21 CFR 872.1840 - Dental x-ray position indicating device.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental x-ray position indicating device. 872.1840... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1840 Dental x-ray position indicating device. (a) Identification. A dental x-ray position indicating device is a device, such as a collimator...

SU-E-T-01: 2-D Characterization of DLG Among All MLC Leaf Pairs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kumaraswamy, L; Xu, Z; Podgorsak, M

Purpose: The aim of this study is to evaluate the variation of dosimetric leaf-gap (DLG) along the travel path of each MLC leaf pair. This study evaluates whether the spatial variations in DLG could cause dose differences between TPS-calculated and measured dose. Methods: The 6MV DLG values were measured for all leaf pairs in the direction of leaf motion using a 2-D diode array and 0.6cc ion chamber. These measurements were performed on two Varian Linacs, employing the Millennium 120-leaf MLC and a 2-D-DLG variation map was created via in-house software. Several test plans were created with sweeping MLC fieldsmore » using constant gaps from 2mm to 10mm and corrected for 2-D variation utilizing in-house software. Measurements were performed utilizing the MapCHECK at 5.0cm depth for plans with and without the 2-D DLG correction and compared to the TPS calculated dose via gamma analysis (3%/3mm). Results: The measured DLGs for the middle 40 MLC leaf pairs (0.5cm width) were very similar along the central superior-inferior axis, with maximum variation of 0.2mm. The outer 20 MLC leaf pairs (1.0cm width) have DLG values from 0.32mm (mean) to 0.65mm (maximum) lower than the central leaf-pair, depending on off-axis distance. Gamma pass rates for the 2mm, 4mm, and 6mm sweep plans increased by 23.2%, 28.7%, and 26.0% respectively using the 2-D-DLG correction. The most improved dose points occur in areas modulated by the 1.0cm leaf-pairs. The gamma pass rate for the 10mm sweep plan increased by only 7.7%, indicating that the 2D variation becomes less significant for dynamic plans with larger MLC gaps. Conclusion: Fluences residing significantly off-axis with narrow sweeping gaps may exhibit significant variations from planned dose due to large differences between the true DLG exhibited by the 1.0cm leaf-pairs versus the constant DLG value utilized by the TPS for dose calculation.« less

Identification of T. gondii Myosin Light Chain-1 as a Direct Target of TachypleginA-2, a Small-Molecule Inhibitor of Parasite Motility and Invasion

PubMed Central

Leung, Jacqueline M.; Tran, Fanny; Pathak, Ravindra B.; Poupart, Séverine; Heaslip, Aoife T.; Ballif, Bryan A.; Westwood, Nicholas J.; Ward, Gary E.

2014-01-01

Motility of the protozoan parasite Toxoplasma gondii plays an important role in the parasite’s life cycle and virulence within animal and human hosts. Motility is driven by a myosin motor complex that is highly conserved across the Phylum Apicomplexa. Two key components of this complex are the class XIV unconventional myosin, TgMyoA, and its associated light chain, TgMLC1. We previously showed that treatment of parasites with a small-molecule inhibitor of T. gondii invasion and motility, tachypleginA, induces an electrophoretic mobility shift of TgMLC1 that is associated with decreased myosin motor activity. However, the direct target(s) of tachypleginA and the molecular basis of the compound-induced TgMLC1 modification were unknown. We show here by “click” chemistry labelling that TgMLC1 is a direct and covalent target of an alkyne-derivatized analogue of tachypleginA. We also show that this analogue can covalently bind to model thiol substrates. The electrophoretic mobility shift induced by another structural analogue, tachypleginA-2, was associated with the formation of a 225.118 Da adduct on S57 and/or C58, and treatment with deuterated tachypleginA-2 confirmed that the adduct was derived from the compound itself. Recombinant TgMLC1 containing a C58S mutation (but not S57A) was refractory to click labelling and no longer exhibited a mobility shift in response to compound treatment, identifying C58 as the site of compound binding on TgMLC1. Finally, a knock-in parasite line expressing the C58S mutation showed decreased sensitivity to compound treatment in a quantitative 3D motility assay. These data strongly support a model in which tachypleginA and its analogues inhibit the motility of T. gondii by binding directly and covalently to C58 of TgMLC1, thereby causing a decrease in the activity of the parasite’s myosin motor. PMID:24892871

TU-AB-BRC-04: Commissioning of a New MLC Model for the GEPTS Monte Carlo System: A Model Based On the Leaf and Interleaf Effective Density

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chibani, O; Tahanout, F; Ma, C

2016-06-15

Purpose: To commission a new MLC model for the GEPTS Monte Carlo system. The model is based on the concept of leaves and interleaves effective densities Methods: GEPTS is a Monte Carlo system to be used for external beam planning verification. GEPTS incorporates detailed photon and electron transport algorithms (Med.Phys. 29, 2002, 835). A new GEPTS model for the Varian Millennium MLC is presented. The model accounts for: 1) thick (1 cm) and thin (0.5 cm) leaves, 2) tongue-and-groove design, 3) High-Transmission (HT) and Low-Transmission (LT) interleaves, and 4) rounded leaf end. Leaf (and interleaf) height is set equal tomore » 6 cm. Instead of modeling air gaps, screw holes, and complex leaf heads, “effective densities” are assigned to: 1) thin leaves, 2) thick leaves, 3) HT-, and 4) LT-interleaves. Results: The new MLC model is used to calculate dose profiles for Closed-MLC and Tongue-and-Groove fields at 5 cm depth for 6, 10 and 15 MV Varian beams. Calculations are compared with 1) Pin-point ionization chamber transmission ratios and 2) EBT3 Radiochromic films. Pinpoint readings were acquired beneath thick and thin leaves, and HT and LT interleaves. The best fit of measured dose profiles was obtained for the following parameters: Thick-leaf density = 16.1 g/cc, Thin-leaf density = 17.2 g/cc; HT Interleaf density = 12.4 g/cc, LT Interleaf density = 14.3 g/cc; Interleaf thickness = 1.1 mm. Attached figures show comparison of calculated and measured transmission ratios for the 3 energies. Note this is the only study where transmission profiles are compared with measurements for 3 different energies. Conclusion: The new MLC model reproduces transmission measurements within 0.1%. The next step is to implement the MLC model for real plans and quantify the improvement in dose calculation accuracy gained using this model for IMRT plans with high modulation factors.« less

SU-F-T-588: Asymmetries in the CyberKnife Iris 2 Collimator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cernica, G; Ji, H; McRae, D

Purpose: The Iris 2 dodecahedral collimator in the CyberKnife unit can demonstrate visible asymmetry in the shaped radiation field, as seen on routine films. Specifically some edges of the collimator project longer than others. PDDs and output factors remain unaffected by this asymmetry. An in-house program was written to analyze the impact of this asymmetry on profiles. Methods: Two years of routine chromodynamic films were retrospectively analyzed using an in-house developed program. Films were obtained on a weekly basis in a plastic phantom on the vendor-provided mount. Profiles were obtained every degree. A dodecahedron was fitted to the 50% isodosemore » line and the positions and sizes of the upper and lower hexagonal collimators were derived. The collimators’ profiles at every degree, symmetry and centering were calculated and trended over the months. Results: Asymmetries in the obtained profiles were apparent. The upper and lower collimators were off-centered (0.31 mm, p<10–8), they did not project the same field size at 80 cm (0.46 mm difference, p<10–31). Profiles as a function of angle demonstrate a periodicity, but short and long profiles are rarely 15° apart, but vary from 9° to 21°. In addition, a second, intermediate minimum is seen at every other short profile. A trend in the field size over time is noted and can be monitored to identify servicing needs. Conclusion: Despite its differences, the asymmetric Iris 2 collimator did not demonstrate large deviations in PDDs and output factors. Due to the asymmetry, the 15° apart profiles obtained at commissioning do not represent the true large and short blade profiles of the collimator. Averaging of the profiles in the commissioning process hides this difference.« less

Experimental Comparison of Knife-Edge and Multi-Parallel Slit Collimators for Prompt Gamma Imaging of Proton Pencil Beams.

PubMed

Smeets, Julien; Roellinghoff, Frauke; Janssens, Guillaume; Perali, Irene; Celani, Andrea; Fiorini, Carlo; Freud, Nicolas; Testa, Etienne; Prieels, Damien

2016-01-01

More and more camera concepts are being investigated to try and seize the opportunity of instantaneous range verification of proton therapy treatments offered by prompt gammas emitted along the proton tracks. Focusing on one-dimensional imaging with a passive collimator, the present study experimentally compared in combination with the first, clinically compatible, dedicated camera device the performances of instances of the two main options: a knife-edge slit (KES) and a multi-parallel slit (MPS) design. These two options were experimentally assessed in this specific context as they were previously demonstrated through analytical and numerical studies to allow similar performances in terms of Bragg peak retrieval precision and spatial resolution in a general context. Both collimators were prototyped according to the conclusions of Monte Carlo optimization studies under constraints of equal weight (40 mm tungsten alloy equivalent thickness) and of the specificities of the camera device under consideration (in particular 4 mm segmentation along beam axis and no time-of-flight discrimination, both of which less favorable to the MPS performance than to the KES one). Acquisitions of proton pencil beams of 100, 160, and 230 MeV in a PMMA target revealed that, in order to reach a given level of statistical precision on Bragg peak depth retrieval, the KES collimator requires only half the dose the present MPS collimator needs, making the KES collimator a preferred option for a compact camera device aimed at imaging only the Bragg peak position. On the other hand, the present MPS collimator proves more effective at retrieving the entrance of the beam in the target in the context of an extended camera device aimed at imaging the whole proton track within the patient.

SU-F-T-425: Head-Scatter Off-Axis for FFF Megavoltage Photon Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhu, T; Penjweini, R; Dimofte, A

Purpose: Head-scatter photons inside a clinical accelerator cause the output to change with collimator setting. On the central-axis, this contribution is well-described by output factor in air (or head-scatter factor). However, a few studies have examined this component at off-axis points. Methods: We define the head-scatter off-axis ratio, HOA, as the ratio of the water kerma in air due to head-scatter photons at the off-axis position x to the water kerma from direct primary photons on the central axis: HOA(cx,cy,xy) = (Q(cx,cy,x) – QP(cx,cy,x))/QP(cx,cy,0), where Q(cx, cy,x), QP(cx,cy,x) are charges measured by an ionization chamber in a miniphantom for collimatormore » setting cx × cy and cx × 3 cm, respectively, at off-axis point x. “Direct primary” is those photons that come from the source without interactions in the intervening structures. Results: We measured HOA for two energies (6XFFF and 6X) along X and Y jaw directions for various collimator settings. The shape of HOA has well defined penumbra for collimator setting larger than 10 × 10 cm2. Conclusion: The narrow gaussian component is interpreted as the source of photons scattered in the flattening filter and the primary collimator. The broad component is attributed to photons scattered in the secondary (variable) collimators. By a direct comparison between 6X and 6XFFF beams, we can confirm that the second component is indeed coming from collimator jaws and identify the parts coming from the primary collimator and the flattening filter, respectively.« less

Role of Rac1 in Escherichia coli K1 invasion of human brain microvascular endothelial cells.

PubMed

Rudrabhatla, Rajyalakshmi S; Selvaraj, Suresh K; Prasadarao, Nemani V

2006-02-01

Escherichia coli K1 invasion of human brain microvascular endothelial cells (HBMEC) requires the reorganization of host cytoskeleton at the sites of bacterial entry. Both actin and myosin constitute the cytoskeletal architecture. We have previously shown that myosin light chain (MLC) phosphorylation by MLC kinase is regulated during E. coli invasion by an upstream kinase, p21-activated kinase 1 (PAK1), which is an effector protein of Rac and Cdc42 GTPases, but not of RhoA. Here, we report that the binding of only Rac1 to PAK1 decreases in HBMEC upon infection with E. coli K1, which resulted in increased phosphorylation of MLC. Overexpression of a constitutively active (cAc) form of Rac1 in HBMEC blocked the E. coli invasion significantly, whereas overexpression of a dominant negative form had no effect. Increased PAK1 phosphorylation was observed in HBMEC expressing cAc-Rac1 with a concomitant reduction in the phosphorylation of MLC. Immunocytochemistry studies demonstrated that the inhibition of E. coli invasion into cAc-Rac1/HBMEC is due to lack of phospho-MLC recruitment to the sites of E. coli entry. Taken together the data suggest that E. coli modulates the binding of Rac1, but not Cdc42, to PAK1 during the invasion of HBMEC.

Monte Carlo study for designing a dedicated “D”-shaped collimator used in the external beam radiotherapy of retinoblastoma patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mayorga, P. A.; Departamento de Física Atómica, Molecular y Nuclear, Universidad de Granada, E-18071 Granada; Brualla, L.

2014-01-15

Purpose: Retinoblastoma is the most common intraocular malignancy in the early childhood. Patients treated with external beam radiotherapy respond very well to the treatment. However, owing to the genotype of children suffering hereditary retinoblastoma, the risk of secondary radio-induced malignancies is high. The University Hospital of Essen has successfully treated these patients on a daily basis during nearly 30 years using a dedicated “D”-shaped collimator. The use of this collimator that delivers a highly conformed small radiation field, gives very good results in the control of the primary tumor as well as in preserving visual function, while it avoids themore » devastating side effects of deformation of midface bones. The purpose of the present paper is to propose a modified version of the “D”-shaped collimator that reduces even further the irradiation field with the scope to reduce as well the risk of radio-induced secondary malignancies. Concurrently, the new dedicated “D”-shaped collimator must be easier to build and at the same time produces dose distributions that only differ on the field size with respect to the dose distributions obtained by the current collimator in use. The scope of the former requirement is to facilitate the employment of the authors' irradiation technique both at the authors' and at other hospitals. The fulfillment of the latter allows the authors to continue using the clinical experience gained in more than 30 years. Methods: The Monte Carlo codePENELOPE was used to study the effect that the different structural elements of the dedicated “D”-shaped collimator have on the absorbed dose distribution. To perform this study, the radiation transport through a Varian Clinac 2100 C/D operating at 6 MV was simulated in order to tally phase-space files which were then used as radiation sources to simulate the considered collimators and the subsequent dose distributions. With the knowledge gained in that study, a new, simpler, “D”-shaped collimator is proposed. Results: The proposed collimator delivers a dose distribution which is 2.4 cm wide along the inferior-superior direction of the eyeball. This width is 0.3 cm narrower than that of the dose distribution obtained with the collimator currently in clinical use. The other relevant characteristics of the dose distribution obtained with the new collimator, namely, depth doses at clinically relevant positions, penumbrae width, and shape of the lateral profiles, are statistically compatible with the results obtained for the collimator currently in use. Conclusions: The smaller field size delivered by the proposed collimator still fully covers the planning target volume with at least 95% of the maximum dose at a depth of 2 cm and provides a safety margin of 0.2 cm, so ensuring an adequate treatment while reducing the irradiated volume.« less

In vitro activity of nitazoxanide against some metronidazole-resistant and susceptible Trichomonas vaginalis isolates.

PubMed

Abdel-Magied, Aida A; Hammouda, Marwa M; Mosbah, Alaa; El-Henawy, Abeer A

2017-04-01

Trichomonas vaginalis cases refractory to metronidazole (MTZ) treatment had been reported. This study aimed to the assessment of in vitro metronidazole resistance among Trichomonas positive cases with treatment failure by determination of metronidazole minimal lethal concentration (MLC), and to the evaluation of the in vitro efficacy of nitazoxanide (NTZ) as compared to metronidazole (MTZ) in both resistant and susceptible isolates. Drug testing was carried out by an aerobic tube assay where suspension of Trichomonas trophozoites was exposed for 24 and 48 h to serial dilution of metronidazole and nitazoxanide. In refractory isolates n = 30, median MLC conc. for MTZ was 100 μg/ml versus 50 μg/ml for NTZ (P < .0001). After 48 h median MLC conc. for MTZ was 25 μg/ml versus 12 μg/ml for NTZ (P < .0001). NTZ against resistant isolates was twice as active as MTZ at 24 h and increased to 2.5 times at 48 h while in susceptible isolates, NTZ was twice as active as MTZ at both 24 h and 48 h. MTZ was about 8 times more active in susceptible than in resistant isolates. So, high doses of metronidazole in resistant cases will likely increase side effects. The study proved the activity of NTZ against trichomoniasis especially in cases with MTZ resistance. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

WE-DE-BRA-10: Development of a Novel Scanning Beam Low-Energy Intraoperative Radiation Therapy (SBIORT) System for Pancreatic Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wears, B; Mohiuddin, I; Flynn, R

2016-06-15

Purpose: Developing a compact collimator system and validating a 3D surface imaging module for a scanning beam low-energy x-ray radiation therapy (SBIORT) system that enables delivery of non-uniform radiation dose to targets with irregular shapes intraoperatively. Methods: SBIORT consists of a low energy x-ray source, a custom compact collimator module, a robotic arm, and a 3D surface imaging module. The 3D surface imaging system (structure sensor) is utilized for treatment planning and motion monitoring of the surgical cavity. SBIORT can deliver non-uniform dose distributions by dynamically moving the x-ray source assembly along optimal paths with various collimator apertures. The compactmore » collimator utilizes a dynamic shutter mechanism to form a variable square aperture. The accuracy and reproducibility of the collimator were evaluated using a high accuracy encoder and a high resolution camera platform. The dosimetrical characteristics of the collimator prototype were evaluated using EBT3 films with a Pantak Therapax unit. The accuracy and clinical feasibility of the 3D imaging system were evaluated using a phantom and a cadaver cavity. Results: The SBIORT collimator has a compact size: 66 mm diameter and 10 mm thickness with the maximum aperture of 20 mm. The mechanical experiment indicated the average accuracy of leaf position was 0.08 mm with a reproducibility of 0.25 mm at 95% confidence level. The dosimetry study indicated the collimator had a penumbra of 0.35 mm with a leaf transmission of 0.5%. 3D surface scans can be acquired in 5 seconds. The average difference between the acquired 3D surface and the ground truth is 1 mm with a standard deviation of 0.6 mm. Conclusion: This work demonstrates the feasibility of the compact collimator and 3D scanning system for the SBIORT. SBIORT is a way of delivering IORT with a compact system that requires minimum shielding of the procedure room. This research is supported by the University of Iowa Internal Funding Initiatives.« less

Minimal-Level Cataloging: A Look at the Issues--A Symposium.

ERIC Educational Resources Information Center

Horny, Karen L.; And Others

1986-01-01

Six articles on pros and cons of minimal-level cataloging (MLC) highlight patron access and browsability, time and cost savings, network and bibliographic utility cooperation, standards, alternatives to MLC, levels of records, online catalogs, experimental cataloging program at University of Michigan, and experiences at Kent State University…

Development of an expanded-field irradiation technique using a gimbaled x-ray head

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ono, Tomohiro; Miyabe, Yuki, E-mail: miyabe@kuhp.kyoto-u.ac.jp; Yamada, Masahiro

2014-10-15

Purpose: The Vero4DRT has a maximum field size of 150.0 × 150.0 mm. The purpose of the present study was to develop expanded-field irradiation techniques using the unique gimbaled x-ray head of the Vero4DRT and to evaluate the dosimetric characteristics thereof. Methods: Two techniques were developed. One features gimbal swing irradiation and multiple static segments consisting of four separate fields exhibiting 2.39° gimbal rotation around two orthogonal axes. The central beam axis for each piecewise-field is shifted 40 mm from the isocenters of the left–right (LR) and superior–inferior (SI) directions, and, thus, the irradiation field size is expanded to 230.8 × 230.8 mm. Adjacentmore » regions were created at the isocenter (a center-adjacent expandedfield) and 20 mm from the isocenter (an off-adjacent expandedfield). The field gaps or overlaps of combined piecewise-fields were established by adjustment of gimbal rotation and movement of the multileaf collimator (MLC). Another technique features dynamic segment irradiation in which the beam is delivered while rotating the gimbal. The dose profile is controlled by a combination of gimbal swing motion and opening and closing of the MLC. This enabled the authors to expand the irradiation field on the LR axis because the direction of MLC motion is parallel to that axis. A field 220.6 × 150.0 mm in dimensions was configured and examined. To evaluate the dosimetric characteristics of the expandedfields, films inserted into water-equivalent phantoms at depths of 50, 100, and 150 mm were irradiated and field sizes, penumbrae, flatness, and symmetry analyzed. In addition, the expanded-field irradiation techniques were applied to intensity-modulated radiation therapy (IMRT). A head-and-neck IMRT field, created using a conventional Linac (the Varian Clinac iX), was reproduced employing an expanded-field of the Vero4DRT. The simulated dose distribution for the expanded-IMRT field was compared to the measured dose distribution. Results: The field sizes, penumbrae, flatness, and symmetry of the center- and off-adjacent expanded-fields were 230.2–232.1 mm, 6.8–10.7 mm, 2.3%–5.1%, and −0.5% to −0.4%, respectively, at a depth of 100 mm. Similarly, the field sizes, penumbrae, flatness, and symmetry of dynamic segment irradiation on the LR axis were 219.2 mm, 6.0–6.2 mm, 3.4%, and −0.1%, respectively, at a depth of 100 mm. In the area of expanded-IMRT dose distribution, the passing rate of 5% dose difference was 85.8% between measurements and simulation, and the 3%/3 mm gamma passing rate was 96.4%. Conclusions: Expanded-field irradiation techniques were developed using a gimbaled x-ray head. The techniques effectively extend target areas, as required when whole-breast irradiation or head-and-neck IMRT is contemplated.« less

Dosimetric evaluation of the clinical implementation of the first commercial IMRT Monte Carlo treatment planning system at 6 MV

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heath, Emily; Seuntjens, Jan; Sheikh-Bagheri, Daryoush

2004-10-01

In this work we dosimetrically evaluated the clinical implementation of a commercial Monte Carlo treatment planning software (PEREGRINE, North American Scientific, Cranberry Township, PA) intended for quality assurance (QA) of intensity modulated radiation therapy treatment plans. Dose profiles calculated in homogeneous and heterogeneous phantoms using this system were compared to both measurements and simulations using the EGSnrc Monte Carlo code for the 6 MV beam of a Varian CL21EX linear accelerator. For simple jaw-defined fields, calculations agree within 2% of the dose at d{sub max} with measurements in homogeneous phantoms with the exception of the buildup region where the calculationsmore » overestimate the dose by up to 8%. In heterogeneous lung and bone phantoms the agreement is within 3%, on average, up to 5% for a 1x1 cm{sup 2} field. We tested two consecutive implementations of the MLC model. After matching the calculated and measured MLC leakage, simulations of static and dynamic MLC-defined fields using the most recent MLC model agreed to within 2% with measurements.« less

Experimental verification of a Monte Carlo-based MLC simulation model for IMRT dose calculations in heterogeneous media

NASA Astrophysics Data System (ADS)

Tyagi, N.; Curran, B. H.; Roberson, P. L.; Moran, J. M.; Acosta, E.; Fraass, B. A.

2008-02-01

IMRT often requires delivering small fields which may suffer from electronic disequilibrium effects. The presence of heterogeneities, particularly low-density tissues in patients, complicates such situations. In this study, we report on verification of the DPM MC code for IMRT treatment planning in heterogeneous media, using a previously developed model of the Varian 120-leaf MLC. The purpose of this study is twofold: (a) design a comprehensive list of experiments in heterogeneous media for verification of any dose calculation algorithm and (b) verify our MLC model in these heterogeneous type geometries that mimic an actual patient geometry for IMRT treatment. The measurements have been done using an IMRT head and neck phantom (CIRS phantom) and slab phantom geometries. Verification of the MLC model has been carried out using point doses measured with an A14 slim line (SL) ion chamber inside a tissue-equivalent and a bone-equivalent material using the CIRS phantom. Planar doses using lung and bone equivalent slabs have been measured and compared using EDR films (Kodak, Rochester, NY).

Analysis investigation of supporting and restraint conditions on the surface deformation of a collimator primary mirror

NASA Astrophysics Data System (ADS)

Chan, Chia-Yen; You, Zhen-Ting; Huang, Bo-Kai; Chen, Yi-Cheng; Huang, Ting-Ming

2015-09-01

For meeting the requirements of the high-precision telescopes, the design of collimator is essential. The diameter of the collimator should be larger than that of the target for the using of alignment. Special supporting structures are demanded to reduce the deformation of gravity and to control the surface deformation induced by the mounting force when inspecting large-aperture primary mirrors. By using finite element analysis, a ZERODUR® mirror of a diameter of 620 mm will be analyzed to obtain the deformation induced by the supporting structures. Zernike polynomials will also be adopted to fit the optical surface and separate corresponding aberrations. Through the studies under different boundary conditions and supporting positions of the inner ring, it is concluded that the optical performance will be excellent under a strong enough supporter.

Improvement of multi-level resistive switching characteristics in solution-processed AlO x -based non-volatile resistive memory using microwave irradiation

NASA Astrophysics Data System (ADS)

Kim, Seung-Tae; Cho, Won-Ju

2018-01-01

We fabricated a resistive random access memory (ReRAM) device on a Ti/AlO x /Pt structure with solution-processed AlO x switching layer using microwave irradiation (MWI), and demonstrated multi-level cell (MLC) operation. To investigate the effect of MWI power on the MLC characteristics, post-deposition annealing was performed at 600-3000 W after AlO x switching layer deposition, and the MLC operation was compared with as-deposited (as-dep) and conventional thermally annealing (CTA) treated devices. All solution-processed AlO x -based ReRAM devices exhibited bipolar resistive switching (BRS) behavior. We found that these devices have four-resistance states (2 bits) of MLC operation according to the modulation of the high-resistance state (HRSs) through reset voltage control. Particularly, compared to the as-dep and CTA ReRAM devices, the MWI-treated ReRAM devices showed a significant increase in the memory window and stable endurance for multi-level operation. Moreover, as the MWI power increased, excellent MLC characteristics were exhibited because the resistance ratio between each resistance state was increased. In addition, it exhibited reliable retention characteristics without deterioration at 25 °C and 85 °C for 10 000 s. Finally, the relationship between the chemical characteristics of the solution-processed AlO x switching layer and BRS-based multi-level operation according to the annealing method and MWI power was investigated using x-ray photoelectron spectroscopy.

Measured and simulated heavy-ion beam loss patterns at the CERN Large Hadron Collider

NASA Astrophysics Data System (ADS)

Hermes, P. D.; Bruce, R.; Jowett, J. M.; Redaelli, S.; Salvachua Ferrando, B.; Valentino, G.; Wollmann, D.

2016-05-01

The Large Hadron Collider (LHC) at CERN pushes forward to new regimes in terms of beam energy and intensity. In view of the combination of very energetic and intense beams together with sensitive machine components, in particular the superconducting magnets, the LHC is equipped with a collimation system to provide protection and intercept uncontrolled beam losses. Beam losses could cause a superconducting magnet to quench, or in the worst case, damage the hardware. The collimation system, which is optimized to provide a good protection with proton beams, has shown a cleaning efficiency with heavy-ion beams which is worse by up to two orders of magnitude. The reason for this reduced cleaning efficiency is the fragmentation of heavy-ion beams into isotopes with a different mass to charge ratios because of the interaction with the collimator material. In order to ensure sufficient collimation performance in future ion runs, a detailed theoretical understanding of ion collimation is needed. The simulation of heavy-ion collimation must include processes in which 82 + 208Pb ions fragment into dozens of new isotopes. The ions and their fragments must be tracked inside the magnetic lattice of the LHC to determine their loss positions. This paper gives an overview of physical processes important for the description of heavy-ion loss patterns. Loss maps simulated by means of the two tools ICOSIM [1,2] and the newly developed STIER (SixTrack with Ion-Equivalent Rigidities) are compared with experimental data measured during LHC operation. The comparison shows that the tool STIER is in better agreement.

Coordinate changes of myosin light and heavy chain isoforms during forced fiber type transitions in rabbit muscle.

PubMed

Leeuw, T; Pette, D

1996-01-01

Skeletal muscle fibers are versatile entities, capable of changing their phenotype in response to altered functional demands. In the present study, fast-to-slow fiber type transitions were induced in rabbit tibialis anterior (fA) muscles by chronic low-frequency stimulation (CLFS). The time course of changes in relative protein concentrations of fast and slow myosin light chain (MLC) isoforms and changes in their relative synthesis rates by in vivo labeling with [35S]methionine were followed during stimulation periods of up to 60 days. Generally, relative synthesis rates and protein concentrations changed in parallel; i.e., fast isoforms decreased and slow isoforms increased. MLC3f, however, which turns over at a higher rate than the other light chains, exhibited a conspicuous discrepancy between a markedly reduced relative synthesis but only a moderate decrease in protein amount during the initial 2 weeks of CLFS. Apparently, MLC3f is regulated independent of MLC1f, with protein degradation playing an important role in its regulation. The exchange of fast MLC isoforms with their slow counterparts seemed to correspond to the ultimate fast-to-slow (MHCIIa-->MHCI) transition at the MHC level. However, due to an earlier onset of the fast-to-slow transition of the regulatory light chain and the delayed fast-to-slow exchange of the alkali light chains, a spectrum of hybrid isomyosins composed of fast and slow light and heavy chains must have existed transiently in transforming fibers. Such hybrid isomyosins appeared to be restricted to MHCIIa- and MHCI-based combinations. In conclusion, fiber type specific programs that normally coordinate the expression of myofibrillar protein isoforms seem to be maintained during fiber type transitions. Possible differences in post-transcriptional regulation may result in the transient accumulation of atypical combinations of fast and slow MLC and MHC isoforms, giving rise to the appearance of hybrid fibers under the conditions of forced fiber type conversion.

Ultrasound-Guided Delivery of siRNA and a Chemotherapeutic Drug by Using Microbubble Complexes: In Vitro and In Vivo Evaluations in a Prostate Cancer Model.

PubMed

Bae, Yun Jung; Yoon, Young Il; Yoon, Tae-Jong; Lee, Hak Jong

2016-01-01

To evaluate the effectiveness of ultrasound and microbubble-liposome complex (MLC)-mediated delivery of siRNA and doxorubicin into prostate cancer cells and its therapeutic capabilities both in vitro and in vivo. Microbubble-liposome complexes conjugated with anti-human epidermal growth factor receptor type 2 (Her2) antibodies were developed to target human prostate cancer cell lines PC-3 and LNCaP. Intracellular delivery of MLC was observed by confocal microscopy. We loaded MLC with survivin-targeted small interfering RNA (siRNA) and doxorubicin, and delivered it into prostate cancer cells. The release of these agents was facilitated by ultrasound application. Cell viability was analyzed by MTT assay after the delivery of siRNA and doxorubicin. Survivin-targeted siRNA loaded MLC was delivered into the xenograft mouse tumor model. Western blotting was performed to quantify the expression of survivin in vivo. Confocal microscopy demonstrated substantial intracellular uptake of MLCs in LNCaP, which expresses higher levels of Her2 than PC-3. The viability of LNCaP cells was significantly reduced after the delivery of MLCs loaded with siRNA and doxorubicin (85.0 ± 2.9%), which was further potentiated by application of ultrasound (55.0 ± 3.5%, p = 0.009). Survivin expression was suppressed in vivo in LNCaP tumor xenograft model following the ultrasound and MLC-guided delivery of siRNA (77.4 ± 4.90% to 36.7 ± 1.34%, p = 0.027). Microbubble-liposome complex can effectively target prostate cancer cells, enabling intracellular delivery of the treatment agents with the use of ultrasound. Ultrasound and MLC-mediated delivery of survivin-targeted siRNA and doxorubicin can induce prostate cell apoptosis and block survivin expression in vitro and in vivo.

Measurement system with high accuracy for laser beam quality.

PubMed

Ke, Yi; Zeng, Ciling; Xie, Peiyuan; Jiang, Qingshan; Liang, Ke; Yang, Zhenyu; Zhao, Ming

2015-05-20

Presently, most of the laser beam quality measurement system collimates the optical path manually with low efficiency and low repeatability. To solve these problems, this paper proposed a new collimated method to improve the reliability and accuracy of the measurement results. The system accuracy controlled the position of the mirror to change laser beam propagation direction, which can realize the beam perpendicularly incident to the photosurface of camera. The experiment results show that the proposed system has good repeatability and the measuring deviation of M² factor is less than 0.6%.

Topological detector: measuring continuous dosimetric quantities with few-element detector array.

PubMed

Han, Zhaohui; Brivio, Davide; Sajo, Erno; Zygmanski, Piotr

2016-08-21

A prototype topological detector was fabricated and investigated for quality assurance of radiation producing medical devices. Unlike a typical array or flat panel detector, a topological detector, while capable of achieving a very high spatial resolution, consists of only a few elements and therefore is much simpler in construction and more cost effective. The key feature allowing this advancement is a geometry-driven design that is customized for a specific dosimetric application. In the current work, a topological detector of two elements was examined for the positioning verification of the radiation collimating devices (jaws, MLCs, and blades etc). The detector was diagonally segmented from a rectangular thin film strip (2.5 cm  ×  15 cm), giving two contiguous but independent detector elements. The segmented area was the central portion of the strip measuring 5 cm in length. Under irradiation, signals from each detector element were separately digitized using a commercial multichannel data acquisition system. The center and size of an x-ray field, which were uniquely determined by the collimator positions, were shown mathematically to relate to the difference and sum of the two signals. As a proof of concept, experiments were carried out using slit x-ray fields ranging from 2 mm to 20 mm in size. It was demonstrated that, the collimator positions can be accurately measured with sub-millimeter precisions.

Design of a radiation facility for very small specimens used in radiobiology studies

NASA Astrophysics Data System (ADS)

Rodriguez, Manuel; Jeraj, Robert

2008-06-01

A design of a radiation facility for very small specimens used in radiobiology is presented. This micro-irradiator has been primarily designed to irradiate partial bodies in zebrafish embryos 3-4 mm in length. A miniature x-ray, 50 kV photon beam, is used as a radiation source. The source is inserted in a cylindrical brass collimator that has a pinhole of 1.0 mm in diameter along the central axis to produce a pencil photon beam. The collimator with the source is attached underneath a computer-controlled movable table which holds the specimens. Using a 45° tilted mirror, a digital camera, connected to the computer, takes pictures of the specimen and the pinhole collimator. From the image provided by the camera, the relative distance from the specimen to the pinhole axis is calculated and coordinates are sent to the movable table to properly position the samples in the beam path. Due to its monitoring system, characteristic of the radiation beam, accuracy and precision of specimen positioning, and automatic image-based specimen recognition, this radiation facility is a suitable tool to irradiate partial bodies in zebrafish embryos, cell cultures or any other small specimen used in radiobiology research.

Purification, Characterization and Analysis of the Allergenic Properties of Myosin Light Chain in Procambarus clarkia.

USDA-ARS?s Scientific Manuscript database

Myosin light chain (MLC) plays a vital role in cell and muscle functions and has been identified as an allergen in close species. In this study, MLC with the molecular mass of 18kDa was purified from crayfish (Procambarus clarkii) muscle fibrils. Its physicochemical characterization showed that the...

SU-E-T-67: A Quality Assurance Procedure for VMAT Delivery Technique with Multiple Verification Metric Using TG-119 Protocol

DOE Office of Scientific and Technical Information (OSTI.GOV)

Katsuta, Y; Kadoya, N; Shimizu, E

2015-06-15

Purpose: A successful VMAT plan delivery includes precise modulations of dose rate, gantry rotational and multi-leaf collimator shapes. The purpose of this research is to construct routine QA protocol which focuses on VMAT delivery technique and to obtain a baseline including dose error, fluence distribution and mechanical accuracy during VMAT. Methods: The mock prostate, head and neck (HN) cases supplied from AAPM were used in this study. A VMAT plans were generated in Monaco TPS according to TG-119 protocol. Plans were created using 6 MV and 10 MV photon beams for each case. The phantom based measurement, fluence measurement andmore » log files analysis were performed. The dose measurement was performed using 0.6 cc ion chamber, which located at isocenter. The fluence distribution were acquired using the MapCHECK2 mounted in the MapPHAN. The trajectory log files recorded inner 20 leaf pairs and gantry angle positions at every 0.25 sec interval were exported to in-house software developed by MATLAB and determined those RMS values. Results: The dose difference is expressed as a ratio of the difference between measured and planned doses. The dose difference for 6 MV was 0.91%, for 10 MV was 0.67%. In turn, the fluence distribution using gamma criteria of 2%/2 mm with a 50% minimum dose threshold for 6 MV was 98.8%, for 10 MV was 97.5%, respectively. The RMS values of MLC for 6 MV and 10 MV were 0.32 mm and 0.37 mm, of gantry were 0.33 degree and 0.31 degree. Conclusion: In this study, QA protocol to assess VMAT delivery accuracy is constructed and results acquired in this study are used as a baseline of VMAT delivery performance verification.« less

PTV margin determination in conformal SRT of intracranial lesions

PubMed Central

Parker, Brent C.; Shiu, Almon S.; Maor, Moshe H.; Lang, Frederick F.; Liu, H. Helen; White, R. Allen; Antolak, John A.

2002-01-01

The planning target volume (PTV) includes the clinical target volume (CTV) to be irradiated and a margin to account for uncertainties in the treatment process. Uncertainties in miniature multileaf collimator (mMLC) leaf positioning, CT scanner spatial localization, CT‐MRI image fusion spatial localization, and Gill‐Thomas‐Cosman (GTC) relocatable head frame repositioning were quantified for the purpose of determining a minimum PTV margin that still delivers a satisfactory CTV dose. The measured uncertainties were then incorporated into a simple Monte Carlo calculation for evaluation of various margin and fraction combinations. Satisfactory CTV dosimetric criteria were selected to be a minimum CTV dose of 95% of the PTV dose and at least 95% of the CTV receiving 100% of the PTV dose. The measured uncertainties were assumed to be Gaussian distributions. Systematic errors were added linearly and random errors were added in quadrature assuming no correlation to arrive at the total combined error. The Monte Carlo simulation written for this work examined the distribution of cumulative dose volume histograms for a large patient population using various margin and fraction combinations to determine the smallest margin required to meet the established criteria. The program examined 5 and 30 fraction treatments, since those are the only fractionation schemes currently used at our institution. The fractionation schemes were evaluated using no margin, a margin of just the systematic component of the total uncertainty, and a margin of the systematic component plus one standard deviation of the total uncertainty. It was concluded that (i) a margin of the systematic error plus one standard deviation of the total uncertainty is the smallest PTV margin necessary to achieve the established CTV dose criteria, and (ii) it is necessary to determine the uncertainties introduced by the specific equipment and procedures used at each institution since the uncertainties may vary among locations. PACS number(s): 87.53.Kn, 87.53.Ly PMID:12132939

Multi-detector row CT colonography: effect of collimation, pitch, and orientation on polyp detection in a human colectomy specimen.

PubMed

Taylor, Stuart A; Halligan, Steve; Bartram, Clive I; Morgan, Paul R; Talbot, Ian C; Fry, Nicola; Saunders, Brian P; Khosraviani, Kirosh; Atkin, Wendy

2003-10-01

To investigate the effects of orientation, collimation, pitch, and tube current setting on polyp detection at multi-detector row computed tomographic (CT) colonography and to determine the optimal combination of scanning parameters for screening. A colectomy specimen containing 117 polyps of different sizes was insufflated and imaged with a multi-detector row CT scanner at various collimation (1.25 and 2.5 mm), pitch (3 and 6), and tube current (50, 100, and 150 mA) settings. Two-dimensional multiplanar reformatted images and three-dimensional endoluminal surface renderings from the 12 resultant data sets were examined by one observer for the presence and conspicuity of polyps. The results were analyzed with Poisson regression and logistic regression to determine the effects of scanning parameters and of specimen orientation on polyp detection. The percentage of polyps that were detected significantly increased when collimation (P =.008) and table feed (P =.03) were decreased. Increased tube current resulted in improved detection only of polyps with a diameter of less than 5 mm. Polyps of less than 5 mm were optimally depicted with a collimation of 1.25 mm, a pitch of 3, and a tube current setting of 150 mA; polyps with a diameter greater than 5 mm were adequately depicted with 1.25-mm collimation and with either pitch setting and any of the three tube current settings. Small polyps in the transverse segment (positioned at a 90 degrees angle to the z axis of scanning) were significantly less visible than those in parallel or oblique orientations (P <.001). The effective radiation dose, calculated with a Monte Carlo simulation, was 1.4-10.0 mSv. Detection of small polyps (<5 mm) with multi-detector row CT is highly dependent on collimation, pitch, and, to a lesser extent, tube current. Collimation of 1.25 mm, combined with pitch of 6 and tube current of 50 mA, provides for reliable detection of polyps 5 mm or larger while limiting the effective radiation dose. Polyps smaller than 5 mm, however, may be poorly depicted with use of these settings in the transverse colon. Copyright RSNA, 2003

Validation of Pinnacle treatment planning system for use with Novalis delivery unit.

PubMed

Faygelman, Vladimir; Hunt, Dylan; Walker, Luke; Mueller, Richard; Demarco, Mary Lou; Dilling, Thomas; Stevens, Craig; Zhang, Geoffrey

2010-06-15

For an institution that already owns the licenses, it is economically advantageous and technically feasible to use Pinnacle TPS (Philips Radiation Oncology Systems, Fitchburg, WI) with the BrainLab Novalis delivery system (BrainLAB A.G., Heimstetten, Germany). This takes advantage of the improved accuracy of the convolution algorithm in the presence of heterogeneities compared with the pencil beam calculation, which is particularly significant for lung SBRT treatments. The reference patient positioning DRRs still have to be generated by the BrainLab software from the CT images and isocenter coordinates transferred from Pinnacle. We validated this process with the end-to-end hidden target test, which showed an isocenter positioning error within one standard deviation from the previously established mean value. The Novalis treatment table attenuation is substantial (up to 6.2% for a beam directed straight up and up to 8.4% for oblique incidence) and has to be accounted for in calculations. A simple single-contour treatment table model was developed, resulting in mean differences between the measured and calculated attenuation factors of 0.0%-0.2%, depending on the field size. The maximum difference for a single incidence angle is 1.1%. The BrainLab micro-MLC (mMLC) leaf tip, although not geometrically round, can be represented in Pinnacle by an arch with satisfactory dosimetric accuracy. Subsequently, step-and-shoot (direct machine parameter optimization) IMRT dosimetric agreement is excellent. VMAT (called "SmartArc" in Pinnacle) treatments with constant gantry speed and dose rate are feasible without any modifications to the accelerator. Due to the 3 mm-wide mMLC leaves, the use of a 2 mm calculation grid is recommended. When dual arcs are used for the more complex cases, the overall dosimetric agreement for the SmartArc plans compares favorably with the previously reported results for other implementations of VMAT: gamma(3%,3mm) for absolute dose obtained with the biplanar diode array passing rates above 97% with the mean of 98.6%. However, a larger than expected dose error with the single-arc plans, confined predominantly to the isocenter region, requires further investigation.

SU-E-T-300: Spatial Variations of Multiple Off-Axial Targets for a Single Isocenter SRS Treatment Plan in ExacTrac 6D Robotic Couch System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, S; Tseng, T

2014-06-01

Purpose: To evaluate the spatial variations of multiple off-axial targets for a single isocenter stereotactic radiosurgery (SRS) treatment plan in ExacTrac 6D robotic couch system (BrainLab AG). Methods: Five metallic ball bearing (BB) markers were placed sparsely in 3D off-axial locations (non-coplanar) inside a skull phantom as the representatives of multiple targets mimicking multiple brain metastases. The locations of the BB markers were carefully chosen to minimize overlapping of each other in a port imaging detector plane. The skull phantom was immobilized by a frameless mask and CT scanned with a BrainLab Head and Neck Localizer using a GE Optimamore » MDCT scanner. The CT images were exported to iPlan software (BrainLab AG) and a multiple target PTV was drawn by combining all the contours of the BBs. The margin of the MLC opening was selected as 3 mm expansion outward. Two coplanar arc beams were placed to generate a single isocenter SRS plan to treat the PTV. The arc beams were delivered using Novalis Tx system with portal imaging acquisition mode per 10% temporal resolution. The locations of the BBs were visualized and analyzed with respect to the MLC aperture in the treatment plan similar to the Winston-Lutz test. Results: All the BBs were clearly identified inside the MLC openings. The positional errors for the BBs were overall less than 1 mm along the rotational path of the two arcs. Conclusion: This study verified that the spatial deviations of multiple off-axial targets for a single isocenter SRS treatment plan is within sub-millimeter range in ExacTrac 6D robotic couch system. Accompanied with the Winston-Lutz test, this test will quality-assure the spatial accuracies of the isocenter as well as the positions of multiple off-axial targets for the SRS treatment using a single isocenter multiple target treatment plan.« less

Apparatus for and method of performing spectroscopic analysis on an article

DOEpatents

Powell, George Louis; Hallman, Jr., Russell Louis

1999-01-01

An apparatus for and method of analyzing an article having an entrance and an exit in communication with the entrance. The apparatus comprises: a spectrometer having an emission source with a focal point; a plurality of mirrors; and a detector connected to the spectroscope. The emission source is positioned so that its focal point is substantially coextensive with the entrance of the article. The mirrors comprise: a first mirror positionable adjacent the exit of the article and a second mirror positioned relative to the other of said plurality of mirrors. The first mirror receives scattered emissions exiting the article and substantially collimates the scattered emissions. The second mirror substantially focuses the collimated emissions into a focused emission. The detector receives the focused emission from the mirrors.

Apparatus for and method of performing spectroscopic analysis on an article

DOEpatents

Powell, G.L.; Hallman, R.L. Jr.

1999-04-20

An apparatus and method are disclosed for analyzing an article having an entrance and an exit in communication with the entrance. The apparatus comprises: a spectrometer having an emission source with a focal point; a plurality of mirrors; and a detector connected to the spectroscope. The emission source is positioned so that its focal point is substantially coextensive with the entrance of the article. The mirrors comprise: a first mirror positionable adjacent the exit of the article and a second mirror positioned relative to the other of said plurality of mirrors. The first mirror receives scattered emissions exiting the article and substantially collimates the scattered emissions. The second mirror substantially focuses the collimated emissions into a focused emission. The detector receives the focused emission from the mirrors. 6 figs.

Reflector automatic acquisition and pointing based on auto-collimation theodolite.

PubMed

Luo, Jun; Wang, Zhiqian; Wen, Zhuoman; Li, Mingzhu; Liu, Shaojin; Shen, Chengwu

2018-01-01

An auto-collimation theodolite (ACT) for reflector automatic acquisition and pointing is designed based on the principle of autocollimators and theodolites. First, the principle of auto-collimation and theodolites is reviewed, and then the coaxial ACT structure is developed. Subsequently, the acquisition and pointing strategies for reflector measurements are presented, which first quickly acquires the target over a wide range and then points the laser spot to the charge coupled device zero position. Finally, experiments are conducted to verify the acquisition and pointing performance, including the calibration of the ACT, the comparison of the acquisition mode and pointing mode, and the accuracy measurement in horizontal and vertical directions. In both directions, a measurement accuracy of ±3″ is achieved. The presented ACT is suitable for automatic pointing and monitoring the reflector over a small scanning area and can be used in a wide range of applications such as bridge structure monitoring and cooperative target aiming.

Reflector automatic acquisition and pointing based on auto-collimation theodolite

NASA Astrophysics Data System (ADS)

Luo, Jun; Wang, Zhiqian; Wen, Zhuoman; Li, Mingzhu; Liu, Shaojin; Shen, Chengwu

2018-01-01

An auto-collimation theodolite (ACT) for reflector automatic acquisition and pointing is designed based on the principle of autocollimators and theodolites. First, the principle of auto-collimation and theodolites is reviewed, and then the coaxial ACT structure is developed. Subsequently, the acquisition and pointing strategies for reflector measurements are presented, which first quickly acquires the target over a wide range and then points the laser spot to the charge coupled device zero position. Finally, experiments are conducted to verify the acquisition and pointing performance, including the calibration of the ACT, the comparison of the acquisition mode and pointing mode, and the accuracy measurement in horizontal and vertical directions. In both directions, a measurement accuracy of ±3″ is achieved. The presented ACT is suitable for automatic pointing and monitoring the reflector over a small scanning area and can be used in a wide range of applications such as bridge structure monitoring and cooperative target aiming.

Particle generator

DOEpatents

Hess, Wayne P.; Joly, Alan G.; Gerrity, Daniel P.; Beck, Kenneth M.; Sushko, Peter V.; Shlyuger, Alexander L.

2005-06-28

Energy tunable solid state sources of neutral particles are described. In a disclosed embodiment, a halogen particle source includes a solid halide sample, a photon source positioned to deliver photons to a surface of the halide, and a collimating means positioned to accept a spatially defined plume of hyperthermal halogen particles emitted from the sample surface.

HRR Upgrade to mass loss calorimeter and modified Schlyter test for FR Wood

Treesearch

Mark A. Dietenberger; Charles R. Boardman

2013-01-01

Enhanced Heat Release Rate (HRR) methodology has been extended to the Mass Loss Calorimeter (MLC) and the Modified Schlyter flame spread test to evaluate fire retardant effectiveness used on wood based materials. Modifications to MLC include installation of thermopile on the chimney walls to correct systematic errors to the sensible HRR calculations to account for...