SU-E-T-467: Monte Carlo Dosimetric Study of the New Flexisource Co-60 High Dose Rate Source.

PubMed

Vijande, J; Granero, D; Perez-Calatayud, J; Ballester, F

2012-06-01

Recently, a new HDR 60Co brachytherapy source, Flexisource Co-60, has been developed (Nucletron B.V.). This study aims to obtain quality dosimetric data for this source for its use in clinical practice as required by AAPM and ESTRO. Penelope2008 and GEANT4 Monte Carlo codes were used to dosimetrically characterize this source. Water composition and mass density was that recommended by AAPM. Due to the high energy of the 60Co, dose for small distances cannot be approximated by collisional kerma. Therefore, we have considered absorbed dose to water for r<0.75 cm and collisional kerma from 0.75 0.8 cm and up to 2% closer to the source. Using Penelope2008 and GEANT4, an average of Î> = 1.085±0.003 cGy/(h U) (with k = 1, Type A uncertainties) was obtained. Dose rate constant, radial dose function and anisotropy functions for the Flexisource Co-60 are compared with published data for other Co-60 sources. Dosimetric data are provided for the new Flexisource Co-60 source not studied previously in the literature. Using the data provided by this study in the treatment planning systems, it can be used in clinical practice. This project has been funded by Nucletron BV. © 2012 American Association of Physicists in Medicine.

Assessment of hepatic function decline after stereotactic body radiation therapy for primary liver cancer.

PubMed

Toesca, Diego A S; Osmundson, Evan C; von Eyben, Rie; Shaffer, Jenny L; Koong, Albert C; Chang, Daniel T

This study aims to determine how the albumin-bilirubin (ALBI) score compares with the Child-Pugh (CP) score for assessing liver function following stereotactic body radiation therapy (SBRT). In total, 60 patients, 40 with hepatocellular carcinoma (HCC) and 20 with cholangiocarcinoma (CCA), were treated with SBRT. Liver function panels were obtained before and at 1, 3, 6, and 12 months after SBRT. Laboratory values were censored after locoregional recurrence, further liver-directed therapies, or liver transplant. A significant decline in hepatic function occurred after SBRT for HCC patients only (P = .001 by ALBI score; P < .0001 by CP score). By converting radiation doses to biologically equivalent doses by using a standard linear quadratic model using α/β of 10, the strongest dosimetric predictor of liver function decline for HCC was the volume of normal liver irradiated by a dose of 40 Gy when assessing liver function by the ALBI score (P = .07), and the volume of normal liver irradiated by a dose of 20 Gy by using the CP score (P= .0009). For CCA patients, the volume of normal liver irradiated by a dose of 40 Gy remained the strongest dosimetric predictor when using the ALBI score (P = .002), but no dosimetric predictor was significant using the CP score. Hepatic function decline correlated with worse overall survival for HCC (by ALBI, P = .0005; by CP, P < .0001) and for CCA (by ALBI, P = NS; by CP, P = .008). ALBI score was similarly able to predict hepatic function decline compared with CP score, and both systems correlated with survival. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Contrasting analytical and data-driven frameworks for radiogenomic modeling of normal tissue toxicities in prostate cancer.

PubMed

Coates, James; Jeyaseelan, Asha K; Ybarra, Norma; David, Marc; Faria, Sergio; Souhami, Luis; Cury, Fabio; Duclos, Marie; El Naqa, Issam

2015-04-01

We explore analytical and data-driven approaches to investigate the integration of genetic variations (single nucleotide polymorphisms [SNPs] and copy number variations [CNVs]) with dosimetric and clinical variables in modeling radiation-induced rectal bleeding (RB) and erectile dysfunction (ED) in prostate cancer patients. Sixty-two patients who underwent curative hypofractionated radiotherapy (66 Gy in 22 fractions) between 2002 and 2010 were retrospectively genotyped for CNV and SNP rs5489 in the xrcc1 DNA repair gene. Fifty-four patients had full dosimetric profiles. Two parallel modeling approaches were compared to assess the risk of severe RB (Grade⩾3) and ED (Grade⩾1); Maximum likelihood estimated generalized Lyman-Kutcher-Burman (LKB) and logistic regression. Statistical resampling based on cross-validation was used to evaluate model predictive power and generalizability to unseen data. Integration of biological variables xrcc1 CNV and SNP improved the fit of the RB and ED analytical and data-driven models. Cross-validation of the generalized LKB models yielded increases in classification performance of 27.4% for RB and 14.6% for ED when xrcc1 CNV and SNP were included, respectively. Biological variables added to logistic regression modeling improved classification performance over standard dosimetric models by 33.5% for RB and 21.2% for ED models. As a proof-of-concept, we demonstrated that the combination of genetic and dosimetric variables can provide significant improvement in NTCP prediction using analytical and data-driven approaches. The improvement in prediction performance was more pronounced in the data driven approaches. Moreover, we have shown that CNVs, in addition to SNPs, may be useful structural genetic variants in predicting radiation toxicities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A general method for the definition of margin recipes depending on the treatment technique applied in helical tomotherapy prostate plans.

PubMed

Sevillano, David; Mínguez, Cristina; Sánchez, Alicia; Sánchez-Reyes, Alberto

2016-01-01

To obtain specific margin recipes that take into account the dosimetric characteristics of the treatment plans used in a single institution. We obtained dose-population histograms (DPHs) of 20 helical tomotherapy treatment plans for prostate cancer by simulating the effects of different systematic errors (Σ) and random errors (σ) on these plans. We obtained dosimetric margins and margin reductions due to random errors (random margins) by fitting the theoretical results of coverages for Gaussian distributions with coverages of the planned D99% obtained from the DPHs. The dosimetric margins obtained for helical tomotherapy prostate treatments were 3.3 mm, 3 mm, and 1 mm in the lateral (Lat), anterior-posterior (AP), and superior-inferior (SI) directions. Random margins showed parabolic dependencies, yielding expressions of 0.16σ(2), 0.13σ(2), and 0.15σ(2) for the Lat, AP, and SI directions, respectively. When focusing on values up to σ = 5 mm, random margins could be fitted considering Gaussian penumbras with standard deviations (σp) equal to 4.5 mm Lat, 6 mm AP, and 5.5 mm SI. Despite complex dose distributions in helical tomotherapy treatment plans, we were able to simplify the behaviour of our plans against treatment errors to single values of dosimetric and random margins for each direction. These margins allowed us to develop specific margin recipes for the respective treatment technique. The method is general and could be used for any treatment technique provided that DPHs can be obtained. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Dosimetric evaluation of Plastic Water Diagnostic-Therapy.

PubMed

Ramaseshan, Ramani; Kohli, Kirpal; Cao, Fred; Heaton, Robert K

2008-04-29

High-precision radiotherapy planning and quality assurance require accurate dosimetric and geometric phantom measurements. Phantom design requires materials with mechanical strength and resilience, and dosimetric properties close to those of water over diagnostic and therapeutic ranges. Plastic Water Diagnostic Therapy (PWDT: CIRS, Norfolk, VA) is a phantom material designed for water equivalence in photon beams from 0.04 MeV to 100 MeV; the material has also good mechanical properties. The present article reports the results of computed tomography (CT) imaging and dosimetric studies of PWDT to evaluate the suitability of the material in CT and therapy energy ranges. We characterized the water equivalence of PWDT in a series of experiments in which the basic dosimetric properties of the material were determined for photon energies of 80 kVp, 100 kVp, 250 kVp, 4 MV, 6 MV, 10 MV, and 18 MV. Measured properties included the buildup and percentage depth dose curves for several field sizes, and relative dose factors as a function of field size. In addition, the PWDT phantom underwent CT imaging at beam qualities ranging from 80 kVp to 140 kVp to determine the water equivalence of the phantom in the diagnostic energy range. The dosimetric quantities measured with PWDT agreed within 1.5% of those determined in water and Solid Water (Gammex rmi, Middleton, WI). Computed tomography imaging of the phantom was found to generate Hounsfield numbers within 0.8% of those generated using water. The results suggest that PWDT material is suitable both for regular radiotherapy quality assurance measurements and for intensity-modulated radiation therapy (IMRT) verification work. Sample IMRT verification results are presented.

Polyethylene Naphthalate Scintillator: A Novel Detector for the Dosimetry of Radioactive Ophthalmic Applicators

PubMed Central

Flühs, Dirk; Flühs, Andrea; Ebenau, Melanie; Eichmann, Marion

2015-01-01

Background Dosimetric measurements in small radiation fields with large gradients, such as eye plaque dosimetry with β or low-energy photon emitters, require dosimetrically almost water-equivalent detectors with volumes of <1 mm3 and linear responses over several orders of magnitude. Polyvinyltoluene-based scintillators fulfil these conditions. Hence, they are a standard for such applications. However, they show disadvantages with regard to certain material properties and their dosimetric behaviour towards low-energy photons. Purpose, Materials and Methods Polyethylene naphthalate, recently recognized as a scintillator, offers chemical, physical and basic dosimetric properties superior to polyvinyltoluene. Its general applicability as a clinical dosimeter, however, has not been shown yet. To prove this applicability, extensive measurements at several clinical photon and electron radiation sources, ranging from ophthalmic plaques to a linear accelerator, were performed. Results For all radiation qualities under investigation, covering a wide range of dose rates, a linearity of the detector response to the dose was shown. Conclusion Polyethylene naphthalate proved to be a suitable detector material for the dosimetry of ophthalmic plaques, including low-energy photon emitters and other small radiation fields. Due to superior properties, it has the potential to replace polyvinyltoluene as the standard scintillator for such applications. PMID:27171681

Quantifying the effect of air gap, depth, and range shifter thickness on TPS dosimetric accuracy in superficial PBS proton therapy.

PubMed

Shirey, Robert J; Wu, Hsinshun Terry

2018-01-01

This study quantifies the dosimetric accuracy of a commercial treatment planning system as functions of treatment depth, air gap, and range shifter thickness for superficial pencil beam scanning proton therapy treatments. The RayStation 6 pencil beam and Monte Carlo dose engines were each used to calculate the dose distributions for a single treatment plan with varying range shifter air gaps. Central axis dose values extracted from each of the calculated plans were compared to dose values measured with a calibrated PTW Markus chamber at various depths in RW3 solid water. Dose was measured at 12 depths, ranging from the surface to 5 cm, for each of the 18 different air gaps, which ranged from 0.5 to 28 cm. TPS dosimetric accuracy, defined as the ratio of calculated dose relative to the measured dose, was plotted as functions of depth and air gap for the pencil beam and Monte Carlo dose algorithms. The accuracy of the TPS pencil beam dose algorithm was found to be clinically unacceptable at depths shallower than 3 cm with air gaps wider than 10 cm, and increased range shifter thickness only added to the dosimetric inaccuracy of the pencil beam algorithm. Each configuration calculated with Monte Carlo was determined to be clinically acceptable. Further comparisons of the Monte Carlo dose algorithm to the measured spread-out Bragg Peaks of multiple fields used during machine commissioning verified the dosimetric accuracy of Monte Carlo in a variety of beam energies and field sizes. Discrepancies between measured and TPS calculated dose values can mainly be attributed to the ability (or lack thereof) of the TPS pencil beam dose algorithm to properly model secondary proton scatter generated in the range shifter. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Dosimetric property of mineral extracted from calamari and exposed to gamma rays

NASA Astrophysics Data System (ADS)

Cruz-Zaragoza, E.; Roman-Lopez, J.; Cruz, L. Pérez; Furetta, C.; Chiaravalle, E.; Mangiacotti, M.; Marchesani, G.

2013-07-01

Dosimetric property of polymineral fraction, quartz mainly, obtained from calamari was investigated. The commercial calamari samples from China and Sud Africa were collected in the markets of Italy. All polymineral debris were extracted and isolated from the whole body of calamari. The surface of the polymineral samples was analyzed by using the Scanning Electron Microscopy (SEM) and their chemical composition was determined using Energy Dispersive Spectroscopy (EDS). The polymineral was exposed to gamma rays (60Co) at different doses (0.5-80 Gy) to determine dosimetric property. Thermoluminescent (TL) glow curves showed two peaks centered at around 98-100 °C and 128-138 °C temperature range. The glow curves have been analyzed by using a deconvolution program. A linear dose response between 0.5 to 20 Gy was observed. The TL response of the samples as a function of the time storage, fading, presented a reduction of about 36-40 % at the end of 24 h. The reproducibility of the TL response after ten cycles of irradiation-readout showed an acceptable standard deviation in dosimetry. The polimineral fraction obtained from calamari shows an interesting dosimetric property and it may be useful for dosimetry in gamma radiation field.

2D dose distribution images of a hybrid low field MRI-γ detector

NASA Astrophysics Data System (ADS)

Abril, A.; Agulles-Pedrós, L.

2016-07-01

The proposed hybrid system is a combination of a low field MRI and dosimetric gel as a γ detector. The readout system is based on the polymerization process induced by the gel radiation. A gel dose map is obtained which represents the functional part of hybrid image alongside with the anatomical MRI one. Both images should be taken while the patient with a radiopharmaceutical is located inside the MRI system with a gel detector matrix. A relevant aspect of this proposal is that the dosimetric gel has never been used to acquire medical images. The results presented show the interaction of the 99mTc source with the dosimetric gel simulated in Geant4. The purpose was to obtain the planar γ 2D-image. The different source configurations are studied to explore the ability of the gel as radiation detector through the following parameters; resolution, shape definition and radio-pharmaceutical concentration.

Dosimetric characterization of the M−15 high‐dose‐rate Iridium−192 brachytherapy source using the AAPM and ESTRO formalism

PubMed Central

Thanh, Minh‐Tri Ho; Munro, John J.

2015-01-01

The Source Production & Equipment Co. (SPEC) model M−15 is a new Iridium−192 brachytherapy source model intended for use as a temporary high‐dose‐rate (HDR) brachytherapy source for the Nucletron microSelectron Classic afterloading system. The purpose of this study is to characterize this HDR source for clinical application by obtaining a complete set of Monte Carlo calculated dosimetric parameters for the M‐15, as recommended by AAPM and ESTRO, for isotopes with average energies greater than 50 keV. This was accomplished by using the MCNP6 Monte Carlo code to simulate the resulting source dosimetry at various points within a pseudoinfinite water phantom. These dosimetric values next were converted into the AAPM and ESTRO dosimetry parameters and the respective statistical uncertainty in each parameter also calculated and presented. The M−15 source was modeled in an MCNP6 Monte Carlo environment using the physical source specifications provided by the manufacturer. Iridium−192 photons were uniformly generated inside the iridium core of the model M−15 with photon and secondary electron transport replicated using photoatomic cross‐sectional tables supplied with MCNP6. Simulations were performed for both water and air/vacuum computer models with a total of 4×109 sources photon history for each simulation and the in‐air photon spectrum filtered to remove low‐energy photons below δ=10%keV. Dosimetric data, including D(r,θ),gL(r),F(r,θ),Φan(r), and φ¯an, and their statistical uncertainty were calculated from the output of an MCNP model consisting of an M−15 source placed at the center of a spherical water phantom of 100 cm diameter. The air kerma strength in free space, SK, and dose rate constant, Λ, also was computed from a MCNP model with M−15 Iridium−192 source, was centered at the origin of an evacuated phantom in which a critical volume containing air at STP was added 100 cm from the source center. The reference dose rate, D˙(r0,θ0)≡D˙(1cm,π/2), is found to be 4.038±0.064 cGy mCi−1 h−1. The air kerma strength, SK, is reported to be 3.632±0.086 cGy cm2 mCi−1 g−1, and the dose rate constant, Λ, is calculated to be 1.112±0.029 cGy h−1 U−1. The normalized dose rate, radial dose function, and anisotropy function with their uncertainties were computed and are represented in both tabular and graphical format in the report. A dosimetric study was performed of the new M−15 Iridium−192 HDR brachytherapy source using the MCNP6 radiation transport code. Dosimetric parameters, including the dose‐rate constant, radial dose function, and anisotropy function, were calculated in accordance with the updated AAPM and ESTRO dosimetric parameters for brachytherapy sources of average energy greater than 50 keV. These data therefore may be applied toward the development of a treatment planning program and for clinical use of the source. PACS numbers: 87.56.bg, 87.53.Jw PMID:26103489

Dose-Volume Effects on Patient-Reported Acute Gastrointestinal Symptoms During Chemoradiation Therapy for Rectal Cancer

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

Chen, Ronald C.; Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

2012-07-15

Purpose: Research on patient-reported outcomes (PROs) in rectal cancer is limited. We examined whether dose-volume parameters of the small bowel and large bowel were associated with patient-reported gastrointestinal (GI) symptoms during 5-fluorouracil (5-FU)-based chemoradiation treatment for rectal cancer. Methods and Materials: 66 patients treated at the Brigham and Women's Hospital or Massachusetts General Hospital between 2006 and 2008 were included. Weekly during treatment, patients completed a questionnaire assessing severity of diarrhea, urgency, pain, cramping, mucus, and tenesmus. The association between dosimetric parameters and changes in overall GI symptoms from baseline through treatment was examined by using Spearman's correlation. Potential associationsmore » between these parameters and individual GI symptoms were also explored. Results: The amount of small bowel receiving at least 15 Gy (V15) was significantly associated with acute symptoms (p = 0.01), and other dosimetric parameters ranging from V5 to V45 also trended toward association. For the large bowel, correlations between dosimetric parameters and overall GI symptoms at the higher dose levels from V25 to V45 did not reach statistical significance (p = 0.1), and a significant association was seen with rectal pain from V15 to V45 (p < 0.01). Other individual symptoms did not correlate with small bowel or large bowel dosimetric parameters. Conclusions: The results of this study using PROs are consistent with prior studies with physician-assessed acute toxicity, and they identify small bowel V15 as an important predictor of acute GI symptoms during 5-FU-based chemoradiation treatment. A better understanding of the relationship between radiation dosimetric parameters and PROs may allow physicians to improve radiation planning to optimize patient outcomes.« less

WE-AB-202-01: Evaluating the Toxicity Reduction with CT-Ventilation Functional Avoidance Radiation Therapy

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

Vinogradskiy, Y; Miyasaka, Y; Kadoya, N

Purpose: CT-ventilation is an exciting new imaging modality that uses 4DCTs to calculate lung ventilation. Studies have proposed to use 4DCT-ventilation imaging for functional avoidance radiotherapy which implies designing treatment plans to spare functional portions of the lung. Although retrospective studies have been performed to evaluate the dosimetric gains to functional lung; no work has been done to translate the dosimetric gains to an improvement in pulmonary toxicity. The purpose of our work was to evaluate the potential reduction in toxicity for 4DCT-ventilation based functional avoidance. Methods: 70 lung cancer patients with 4DCT imaging were used for the study. CT-ventilationmore » maps were calculated using the patient’s 4DCT, deformable image registrations, and a density-change-based algorithm. Radiation pneumonitis was graded using imaging and clinical information. Log-likelihood methods were used to fit a normal-tissue-complication-probability (NTCP) model predicting grade 2+ radiation pneumonitis as a function of doses (mean and V20) to functional lung (>15% ventilation). For 20 patients a functional plan was generated that reduced dose to functional lung while meeting RTOG 0617-based constraints. The NTCP model was applied to the functional plan to determine the reduction in toxicity with functional planning Results: The mean dose to functional lung was 16.8 and 17.7 Gy with the functional and clinical plans respectively. The corresponding grade 2+ pneumonitis probability was 26.9% with the clinically-used plan and 24.6% with the functional plan (8.5% reduction). The V20-based grade 2+ pneumonitis probability was 23.7% with the clinically-used plan and reduced to 19.6% with the functional plan (20.9% reduction). Conclusion: Our results revealed a reduction of 9–20% in complication probability with functional planning. To our knowledge this is the first study to apply complication probability to convert dosimetric results to toxicity improvement. The results presented in the current work provide seminal data for prospective clinical trials in functional avoidance. YV discloses funding from State of Colorado. TY discloses National Lung Cancer Partnership; Young Investigator Research grant.« less

Dosimetric results in treatments of neuroblastoma and neuroendocrine tumors with {sup 131}I-metaiodobenzylguanidine with implications for the activity to administer

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

Mínguez, Pablo, E-mail: pablo.minguezgabina@osakidetza.net; Flux, Glenn; Genollá, José

2015-07-15

Purpose: The aim was to investigate whole-body and red marrow absorbed doses in treatments of neuroblastoma (NB) and adult neuroendocrine tumors (NETs) with {sup 131}I-metaiodobenzylguanidine and to propose a simple method for determining the activity to administer when dosimetric data for the individual patient are not available. Methods: Nine NB patients and six NET patients were included, giving in total 19 treatments as four patients were treated twice. Whole-body absorbed doses were determined from dose-rate measurements and planar gamma-camera imaging. For six NB and five NET treatments, red marrow absorbed doses were also determined using the blood-based method. Results: Dosimetricmore » data from repeated administrations in the same patient were consistent. In groups of NB and NET patients, similar whole-body residence times were obtained, implying that whole-body absorbed dose per unit of administered activity could be reasonably well described as a power function of the patient mass. For NB, this functional form was found to be consistent with dosimetric data from previously published studies. The whole-body to red marrow absorbed dose ratio was similar among patients, with values of 1.4 ± 0.6–1.7 ± 0.7 (1 standard deviation) in NB treatments and between 1.5 ± 0.6 and 1.7 ± 0.7 (1 standard deviation) in NET treatments. Conclusions: The consistency of dosimetric results between administrations for the same patient supports prescription of the activity based on dosimetry performed in pretreatment studies, or during the first administration in a fractionated schedule. The expressions obtained for whole-body absorbed doses per unit of administered activity as a function of patient mass for NB and NET treatments are believed to be a useful tool to estimate the activity to administer at the stage when the individual patient biokinetics has not yet been measured.« less

Dosimetric property of mineral extracted from calamari and exposed to gamma rays

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

Cruz-Zaragoza, E.; Roman-Lopez, J.; Cruz, L. Perez

2013-07-03

Dosimetric property of polymineral fraction, quartz mainly, obtained from calamari was investigated. The commercial calamari samples from China and Sud Africa were collected in the markets of Italy. All polymineral debris were extracted and isolated from the whole body of calamari. The surface of the polymineral samples was analyzed by using the Scanning Electron Microscopy (SEM) and their chemical composition was determined using Energy Dispersive Spectroscopy (EDS). The polymineral was exposed to gamma rays ({sup 60}Co) at different doses (0.5-80 Gy) to determine dosimetric property. Thermoluminescent (TL) glow curves showed two peaks centered at around 98-100 Degree-Sign C and 128-138more » Degree-Sign C temperature range. The glow curves have been analyzed by using a deconvolution program. A linear dose response between 0.5 to 20 Gy was observed. The TL response of the samples as a function of the time storage, fading, presented a reduction of about 36-40 % at the end of 24 h. The reproducibility of the TL response after ten cycles of irradiation-readout showed an acceptable standard deviation in dosimetry. The polimineral fraction obtained from calamari shows an interesting dosimetric property and it may be useful for dosimetry in gamma radiation field.« less

Dosimetric impact of geometric errors due to respiratory motion prediction on dynamic multileaf collimator-based four-dimensional radiation delivery

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

Vedam, S.; Docef, A.; Fix, M.

2005-06-15

The synchronization of dynamic multileaf collimator (DMLC) response with respiratory motion is critical to ensure the accuracy of DMLC-based four dimensional (4D) radiation delivery. In practice, however, a finite time delay (response time) between the acquisition of tumor position and multileaf collimator response necessitates predictive models of respiratory tumor motion to synchronize radiation delivery. Predicting a complex process such as respiratory motion introduces geometric errors, which have been reported in several publications. However, the dosimetric effect of such errors on 4D radiation delivery has not yet been investigated. Thus, our aim in this work was to quantify the dosimetric effectsmore » of geometric error due to prediction under several different conditions. Conformal and intensity modulated radiation therapy (IMRT) plans for a lung patient were generated for anterior-posterior/posterior-anterior (AP/PA) beam arrangements at 6 and 18 MV energies to provide planned dose distributions. Respiratory motion data was obtained from 60 diaphragm-motion fluoroscopy recordings from five patients. A linear adaptive filter was employed to predict the tumor position. The geometric error of prediction was defined as the absolute difference between predicted and actual positions at each diaphragm position. Distributions of geometric error of prediction were obtained for all of the respiratory motion data. Planned dose distributions were then convolved with distributions for the geometric error of prediction to obtain convolved dose distributions. The dosimetric effect of such geometric errors was determined as a function of several variables: response time (0-0.6 s), beam energy (6/18 MV), treatment delivery (3D/4D), treatment type (conformal/IMRT), beam direction (AP/PA), and breathing training type (free breathing/audio instruction/visual feedback). Dose difference and distance-to-agreement analysis was employed to quantify results. Based on our data, the dosimetric impact of prediction (a) increased with response time, (b) was larger for 3D radiation therapy as compared with 4D radiation therapy, (c) was relatively insensitive to change in beam energy and beam direction, (d) was greater for IMRT distributions as compared with conformal distributions, (e) was smaller than the dosimetric impact of latency, and (f) was greatest for respiration motion with audio instructions, followed by visual feedback and free breathing. Geometric errors of prediction that occur during 4D radiation delivery introduce dosimetric errors that are dependent on several factors, such as response time, treatment-delivery type, and beam energy. Even for relatively small response times of 0.6 s into the future, dosimetric errors due to prediction could approach delivery errors when respiratory motion is not accounted for at all. To reduce the dosimetric impact, better predictive models and/or shorter response times are required.« less

Synthesis and characterization of CaF2:Dy nanophosphor for dosimetric application

NASA Astrophysics Data System (ADS)

Bhadane, Mahesh S.; Patil, B. J.; Dahiwale, S. S.; Kulkarni, M. S.; Bhatt, B. C.; Bhoraskar, V. N.; Dhole, S. D.

2015-06-01

In this work, nanoparticles (NPs) of dysprosium doped calcium fluoride (CaF2:Dy) 1 mol % has been prepared using simple chemical co-precipitation method and its thermoluminescence (TL) dosimetric properties were studied. The synthesized nanoparticle sample was characterized by X-ray diffraction (XRD) and the particle size of face centered cubic phase NPs was found around 30 nm. The shape, morphology and size were also observed by scanning electron microscopy (SEM). From gamma irradiated CaF2:Dy TL curves, it was observed that the total areas of all the glow peak intensities are dramatically changed with increase in annealing temperature. Further, TL glow curve of the CaF2:Dy at 183 °C annealed at 400 °C, showed very sharp linear response in the dose range from 1 Gy to 750 Gy. This linear response of CaF2:Dy nanophosphor as a function of gamma dose is very useful from radiation dosimetric point of view.

Dosimetric properties of high energy current (HEC) detector in keV x-ray beams.

PubMed

Zygmanski, Piotr; Shrestha, Suman; Elshahat, Bassem; Karellas, Andrew; Sajo, Erno

2015-04-07

We introduce a new x-ray radiation detector. The detector employs high-energy current (HEC) formed by secondary electrons consisting predominantly of photoelectrons and Auger electrons, to directly convert x-ray energy to detector signal without externally applied power and without amplification. The HEC detector is a multilayer structure composed of thin conducting layers separated by dielectric layers with an overall thickness of less than a millimeter. It can be cut to any size and shape, formed into curvilinear surfaces, and thus can be designed for a variety of QA applications. We present basic dosimetric properties of the detector as function of x-ray energy, depth in the medium, area and aspect ratio of the detector, as well as other parameters. The prototype detectors show similar dosimetric properties to those of a thimble ionization chamber, which operates at high voltage. The initial results obtained for kilovoltage x-rays merit further research and development towards specific medical applications.

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

Purwaningsih, Anik

Dosimetric data for a brachytherapy source should be known before it used for clinical treatment. Iridium-192 source type H01 was manufactured by PRR-BATAN aimed to brachytherapy is not yet known its dosimetric data. Radial dose function and anisotropic dose distribution are some primary keys in brachytherapy source. Dose distribution for Iridium-192 source type H01 was obtained from the dose calculation formalism recommended in the AAPM TG-43U1 report using MCNPX 2.6.0 Monte Carlo simulation code. To know the effect of cavity on Iridium-192 type H01 caused by manufacturing process, also calculated on Iridium-192 type H01 if without cavity. The result ofmore » calculation of radial dose function and anisotropic dose distribution for Iridium-192 source type H01 were compared with another model of Iridium-192 source.« less

SU-F-T-660: Evaluating the Benefit of Using Dual-Function Fiducial Markers for In-Situ Delivery of Radiosenistizing Gold Nanoparticles During Image-Guided Radiotherapy

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

AlMansour, S; Chin, J; Sajo, E

Purpose: Dual-function fiducials loaded with radiosensitizers, like gold nanoparticles (GNP), offer an innovative approach for ensuring geometric accuracy during image-guided radiotherapy (IGRT) and significantly increasing therapeutic efficacy due to controlled in-situ release of the radiosensitizers. This study retrospectively investigates the dosimetric benefit of using up to two such dual-function fiducial markers instead of traditional single function fiducials during IGRT. Methods: A computational code was developed to investigate the dosimetric benefit for 10 real patient tumor volumes of up to 6.5 cm diameter. The intra-tumoral space-time biodistribution of the GNP was modeled as in previous studies based on Fick’s second law.more » The corresponding dose-enhancement for each tumor voxel due to the GNP was also calculated for clinical 6MV beam configurations. Various loading concentrations (25–50 mg/g) were studied, as a function of GNP size, to determine potential for clinically significant dose enhancement. The time between initial implantation of dual-function fiducials to the beginning of radiotherapy was assumed to be 14 days as typical for many clinics. Results: A single dual-function fiducial could achieve at least a DEF of 1.2 for patients with tumors less than 1.4 cm diameter after 14 days. Replacing two single function fiducials with dual-function ones at the same locations achieved at least the required minimal DEF for tumors that are 2 cm diameter in 3 patients. The results also revealed dosimetrically better fiducial locations which could enable significant DEF when using one or two dual function fiducials. 2 nm sizes showed the most feasibility. Conclusion: The results highlight the potential of tumor sub-volume radiation boosting using GNP released from fiducials, and the ability to customize the DEF throughout the tumor by using two dual-function fiducials, varying the initial concentration and nanoparticle size. The results demonstrate potential for employing dual-function fiducials in the development of GNP-aided radiotherapy.« less

Impacts of gantry angle dependent scanning beam properties on proton PBS treatment

NASA Astrophysics Data System (ADS)

Lin, Yuting; Clasie, Benjamin; Lu, Hsiao-Ming; Flanz, Jacob; Shen, Tim; Jee, Kyung-Wook

2017-01-01

While proton beam models in treatment planning systems are generally assumed invariant with respect to the beam deliveries at different gantry angles. Physical properties of scanning pencil beams can change. The gantry angle dependent properties include the delivered charge to the monitor unit chamber, the spot position and the spot shape. The aim of this study is to investigate the extent of the changes and their dosimetric impacts using historical pencil beam scanning (PBS) treatment data. Online beam delivery records at the time of the patient-specific qualify assurance were retrospectively collected for a total of 34 PBS fields from 28 patients treated at our institution. For each field, proton beam properties at two different gantry angles (the planned and zero gantry angles) were extracted by a newly-developed machine log analysis method and used to reconstruct the delivered dose distributions in the cubic water phantom geometry. The reconstructed doses at the two different angles and a planar dose measurement by a 2D ion-chamber array were compared and the dosimetric impacts of the gantry angle dependency were accessed by a 3D γ-index analysis. In addition, the pencil beam spot size was independently characterized as a function of the gantry angle and the beam energy. The dosimetric effects of the perturbed beam shape were also investigated. Comparisons of spot-by-spot beam positions between both gantry angles show a mean deviation of 0.4 and 0.7 mm and a standard deviation of 0.3 and 0.6 mm for x and y directions, respectively. The delivered giga-protons per spot show a percent mean difference and a standard deviation of 0.01% and 0.3%, respectively, from each planned spot weight. These small deviations lead to an excellent agreement in dose comparisons with an average γ passing rate of 99.1%. When each calculation for both planned and zero gantry angles was compared to the measurement, a high correlation in γ values was also observed, also indicating the dosimetric differences are small when a field is delivered at different gantry angles. Utilizing the online beam delivery records, the gantry angle dependencies of the PBS beam delivery were assessed and quantified. The study confirms the variations of the physical properties to be sufficiently small within the clinical tolerances without taking into account the gantry angle variation.

SU-C-210-01: Are Clinically Relevant Dosimetric Endpoints Significantly Better with Gating of Lung SBRT Vs. ITV-Based Treatment?: Results of a Large Cohort Investigation Analyzing Predictive Dosimetric Indicators as a Function of Tumor Volume and Motion Amplitude

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

Kim, J; Zhao, B; Ajlouni, M

2015-06-15

Purpose: To quantitatively compare patient internal target volume (ITV)-based plans with retrospectively generated gated plans to evaluate potential dosimetric improvements in lung toxicity from gated radiotherapy. Methods: Evaluation was conducted for 150 stereotactic body radiation therapy (SBRT) treatment plans for 128 early-stage (T1–T3, <5cm) NSCLC patients. PTV margins were: ITV+5 mm (ITV-plan) and GTV+5 mm (Gated-plan). ITV-based and gated treatment plans were compared on the same free-breathing CT. ITV-based plan constraints were used to re-optimize and recalculate new gated plans. Plans were generated for 3 fractionation regimens: 3×18Gy, 4×12Gy (original), and 5×10Gy. Physical dose was converted to equivalent dose inmore » 2Gy fractions (EQD2), which was used to determine mean lung dose (MLD) and percent volume of lung receiving ≥20Gy (V20). MLD and V20 differences between gating and ITV-based plans were analyzed as a function of both three-dimensional (3D) motion and tumor volume. The low dose region, V5, was also evaluated. Results: MLD and V20 differences between gated and ITV-based plans were larger for lower (1.48±1.32Gy and 1.44±1.29%) than for upper lobe tumors (0.89±0.74Gy and 0.92±0.71%) due to smaller tumor motion (2.9±3.4mm) compared to lower lobe tumors (8.1±6.1mm). Average differences of <1–2% were noted in V5 between ITV and gated plans. Dosimetric differences between gating and ITV-based methods increased with increasing tumor motion and decreasing tumor volume. Overall, average MLD (8.04±3.92Gy) and V20 (8.29±4.33%) values for ITV-based plans were already well below clinical guidelines, even for the 3×18Gy dose scheme, for which largest differences were noted relative to gated plans. Similar results were obtained for 5×10Gy and 4×12Gy regimens. Conclusion: Clinically relevant improvement in pulmonary toxicity, based on predictors of radiation pneumonitis (MLD and V20) was not generally observed, though improvement for tumors with 3D motion >15 mm, mainly concentrated in peripheral lower lobe tumors, may be considered clinically relevant. Work supported in part by a grant from Varian Medical systems, Palo Alto, CA.« less

Biological-based and physical-based optimization for biological evaluation of prostate patient's plans

NASA Astrophysics Data System (ADS)

Sukhikh, E.; Sheino, I.; Vertinsky, A.

2017-09-01

Modern modalities of radiation treatment therapy allow irradiation of the tumor to high dose values and irradiation of organs at risk (OARs) to low dose values at the same time. In this paper we study optimal radiation treatment plans made in Monaco system. The first aim of this study was to evaluate dosimetric features of Monaco treatment planning system using biological versus dose-based cost functions for the OARs and irradiation targets (namely tumors) when the full potential of built-in biological cost functions is utilized. The second aim was to develop criteria for the evaluation of radiation dosimetry plans for patients based on the macroscopic radiobiological criteria - TCP/NTCP. In the framework of the study four dosimetric plans were created utilizing the full extent of biological and physical cost functions using dose calculation-based treatment planning for IMRT Step-and-Shoot delivery of stereotactic body radiation therapy (SBRT) in prostate case (5 fractions per 7 Gy).

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

Katsuta, Y; Tohoku University Graduate School of Medicine, Sendal, Miyagi; Kadoya, N

Purpose: In this study, we developed a system to calculate three dimensional (3D) dose that reflects dosimetric error caused by leaf miscalibration for head and neck and prostate volumetric modulated arc therapy (VMAT) without additional treatment planning system calculation on real time. Methods: An original system called clarkson dose calculation based dosimetric error calculation to calculate dosimetric error caused by leaf miscalibration was developed by MATLAB (Math Works, Natick, MA). Our program, first, calculates point doses at isocenter for baseline and modified VMAT plan, which generated by inducing MLC errors that enlarged aperture size of 1.0 mm with clarkson dosemore » calculation. Second, error incuced 3D dose was generated with transforming TPS baseline 3D dose using calculated point doses. Results: Mean computing time was less than 5 seconds. For seven head and neck and prostate plans, between our method and TPS calculated error incuced 3D dose, the 3D gamma passing rates (0.5%/2 mm, global) are 97.6±0.6% and 98.0±0.4%. The dose percentage change with dose volume histogram parameter of mean dose on target volume were 0.1±0.5% and 0.4±0.3%, and with generalized equivalent uniform dose on target volume were −0.2±0.5% and 0.2±0.3%. Conclusion: The erroneous 3D dose calculated by our method is useful to check dosimetric error caused by leaf miscalibration before pre treatment patient QA dosimetry checks.« less

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.

Correlation between gamma index passing rate and clinical dosimetric difference for pre-treatment 2D and 3D volumetric modulated arc therapy dosimetric verification.

PubMed

Jin, X; Yan, H; Han, C; Zhou, Y; Yi, J; Xie, C

2015-03-01

To investigate comparatively the percentage gamma passing rate (%GP) of two-dimensional (2D) and three-dimensional (3D) pre-treatment volumetric modulated arc therapy (VMAT) dosimetric verification and their correlation and sensitivity with percentage dosimetric errors (%DE). %GP of 2D and 3D pre-treatment VMAT quality assurance (QA) with different acceptance criteria was obtained by ArcCHECK® (Sun Nuclear Corporation, Melbourne, FL) for 20 patients with nasopharyngeal cancer (NPC) and 20 patients with oesophageal cancer. %DE were calculated from planned dose-volume histogram (DVH) and patients' predicted DVH calculated by 3DVH® software (Sun Nuclear Corporation). Correlation and sensitivity between %GP and %DE were investigated using Pearson's correlation coefficient (r) and receiver operating characteristics (ROCs). Relatively higher %DE on some DVH-based metrics were observed for both patients with NPC and oesophageal cancer. Except for 2%/2 mm criterion, the average %GPs for all patients undergoing VMAT were acceptable with average rates of 97.11% ± 1.54% and 97.39% ± 1.37% for 2D and 3D 3%/3 mm criteria, respectively. The number of correlations for 3D was higher than that for 2D (21 vs 8). However, the general correlation was still poor for all the analysed metrics (9 out of 26 for 3D 3%/3 mm criterion). The average area under the curve (AUC) of ROCs was 0.66 ± 0.12 and 0.71 ± 0.21 for 2D and 3D evaluations, respectively. There is a lack of correlation between %GP and %DE for both 2D and 3D pre-treatment VMAT dosimetric evaluation. DVH-based dose metrics evaluation obtained from 3DVH will provide more useful analysis. Correlation and sensitivity of %GP with %DE for VMAT QA were studied for the first time.

Correlation between gamma index passing rate and clinical dosimetric difference for pre-treatment 2D and 3D volumetric modulated arc therapy dosimetric verification

PubMed Central

Jin, X; Yan, H; Han, C; Zhou, Y; Yi, J

2015-01-01

Objective: To investigate comparatively the percentage gamma passing rate (%GP) of two-dimensional (2D) and three-dimensional (3D) pre-treatment volumetric modulated arc therapy (VMAT) dosimetric verification and their correlation and sensitivity with percentage dosimetric errors (%DE). Methods: %GP of 2D and 3D pre-treatment VMAT quality assurance (QA) with different acceptance criteria was obtained by ArcCHECK® (Sun Nuclear Corporation, Melbourne, FL) for 20 patients with nasopharyngeal cancer (NPC) and 20 patients with oesophageal cancer. %DE were calculated from planned dose–volume histogram (DVH) and patients' predicted DVH calculated by 3DVH® software (Sun Nuclear Corporation). Correlation and sensitivity between %GP and %DE were investigated using Pearson's correlation coefficient (r) and receiver operating characteristics (ROCs). Results: Relatively higher %DE on some DVH-based metrics were observed for both patients with NPC and oesophageal cancer. Except for 2%/2 mm criterion, the average %GPs for all patients undergoing VMAT were acceptable with average rates of 97.11% ± 1.54% and 97.39% ± 1.37% for 2D and 3D 3%/3 mm criteria, respectively. The number of correlations for 3D was higher than that for 2D (21 vs 8). However, the general correlation was still poor for all the analysed metrics (9 out of 26 for 3D 3%/3 mm criterion). The average area under the curve (AUC) of ROCs was 0.66 ± 0.12 and 0.71 ± 0.21 for 2D and 3D evaluations, respectively. Conclusions: There is a lack of correlation between %GP and %DE for both 2D and 3D pre-treatment VMAT dosimetric evaluation. DVH-based dose metrics evaluation obtained from 3DVH will provide more useful analysis. Advances in knowledge: Correlation and sensitivity of %GP with %DE for VMAT QA were studied for the first time. PMID:25494412

Monte Carlo calculated TG-60 dosimetry parameters for the {beta}{sup -} emitter {sup 153}Sm brachytherapy source

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

Sadeghi, Mahdi; Taghdiri, Fatemeh; Hamed Hosseini, S.

Purpose: The formalism recommended by Task Group 60 (TG-60) of the American Association of Physicists in Medicine (AAPM) is applicable for {beta} sources. Radioactive biocompatible and biodegradable {sup 153}Sm glass seed without encapsulation is a {beta}{sup -} emitter radionuclide with a short half-life and delivers a high dose rate to the tumor in the millimeter range. This study presents the results of Monte Carlo calculations of the dosimetric parameters for the {sup 153}Sm brachytherapy source. Methods: Version 5 of the (MCNP) Monte Carlo radiation transport code was used to calculate two-dimensional dose distributions around the source. The dosimetric parameters ofmore » AAPM TG-60 recommendations including the reference dose rate, the radial dose function, the anisotropy function, and the one-dimensional anisotropy function were obtained. Results: The dose rate value at the reference point was estimated to be 9.21{+-}0.6 cGy h{sup -1} {mu}Ci{sup -1}. Due to the low energy beta emitted from {sup 153}Sm sources, the dose fall-off profile is sharper than the other beta emitter sources. The calculated dosimetric parameters in this study are compared to several beta and photon emitting seeds. Conclusions: The results show the advantage of the {sup 153}Sm source in comparison with the other sources because of the rapid dose fall-off of beta ray and high dose rate at the short distances of the seed. The results would be helpful in the development of the radioactive implants using {sup 153}Sm seeds for the brachytherapy treatment.« less

Evaluation of a Proposed Biodegradable 188Re Source for Brachytherapy Application

PubMed Central

Khorshidi, Abdollah; Ahmadinejad, Marjan; Hamed Hosseini, S.

2015-01-01

Abstract This study aimed to evaluate dosimetric characteristics based on Monte Carlo (MC) simulations for a proposed beta emitter bioglass 188Re seed for internal radiotherapy applications. The bioactive glass seed has been developed using the sol-gel technique. The simulations were performed for the seed using MC radiation transport code to investigate the dosimetric factors recommended by the AAPM Task Group 60 (TG-60). Dose distributions due to the beta and photon radiation were predicted at different radial distances surrounding the source. The dose rate in water at the reference point was calculated to be 7.43 ± 0.5 cGy/h/μCi. The dosimetric factors consisting of the reference point dose rate, D(r0,θ0), the radial dose function, g(r), the 2-dimensional anisotropy function, F(r,θ), the 1-dimensional anisotropy function, φan(r), and the R90 quantity were estimated and compared with several available beta-emitting sources. The element 188Re incorporated in bioactive glasses produced by the sol-gel technique provides a suitable solution for producing new materials for seed implants applied to brachytherapy applications in prostate and liver cancers treatment. Dose distribution of 188Re seed was greater isotropic than other commercially attainable encapsulated seeds, since it has no end weld to attenuate radiation. The beta radiation-emitting 188Re source provides high doses of local radiation to the tumor tissue and the short range of the beta particles limit damage to the adjacent normal tissue. PMID:26181543

The Application of Elliptic Cylindrical Phantom in Brachytherapy Dosimetric Study of HDR 192Ir Source

NASA Astrophysics Data System (ADS)

Ahn, Woo Sang; Park, Sung Ho; Jung, Sang Hoon; Choi, Wonsik; Do Ahn, Seung; Shin, Seong Soo

2014-06-01

The purpose of this study is to determine the radial dose function of HDR 192Ir source based on Monte Carlo simulation using elliptic cylindrical phantom, similar to realistic shape of pelvis, in brachytherapy dosimetric study. The elliptic phantom size and shape was determined by analysis of dimensions of pelvis on CT images of 20 patients treated with brachytherapy for cervical cancer. The radial dose function obtained using the elliptic cylindrical water phantom was compared with radial dose functions for different spherical phantom sizes, including the Williamsion's data loaded into conventional planning system. The differences in the radial dose function for the different spherical water phantoms increase with radial distance, r, and the largest differences in the radial dose function appear for the smallest phantom size. The radial dose function of the elliptic cylindrical phantom significantly decreased with radial distance in the vertical direction due to different scatter condition in comparison with the Williamson's data. Considering doses to ICRU rectum and bladder points, doses to reference points can be underestimated up to 1-2% at the distance from 3 to 6 cm. The radial dose function in this study could be used as realistic data for calculating the brachytherapy dosimetry for cervical cancer.

Differences in Radiation Dosimetry and Anorectal Function Testing Imply That Anorectal Symptoms May Arise From Different Anatomic Substrates

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

Smeenk, Robert Jan, E-mail: r.smeenk@rther.umcn.nl; Hopman, Wim P.M.; Hoffmann, Aswin L.

2012-01-01

Purpose: To explore the influence of functional changes and dosimetric parameters on specific incontinence-related anorectal complaints after prostate external beam radiotherapy and to estimate dose-effect relations for the anal wall and rectal wall. Methods and Materials: Sixty patients, irradiated for localized prostate cancer, underwent anorectal manometry and barostat measurements to evaluate anal pressures, rectal capacity, and rectal sensory functions. In addition, 30 untreated men were analyzed as a control group. In 36 irradiated patients, the anal wall and rectal wall were retrospectively delineated on planning computed tomography scans, and dosimetric parameters were retrieved from the treatment plans. Functional and dosimetricmore » parameters were compared between patients with and without complaints, focusing on urgency, incontinence, and frequency. Results: After external beam radiotherapy, reduced anal pressures and tolerated rectal volumes were observed, irrespective of complaints. Patients with urgency and/or incontinence showed significantly lower anal resting pressures (mean 38 and 39 vs. 49 and 50 mm Hg) and lower tolerated rectal pressures (mean 28 and 28 vs. 33 and 34 mm Hg), compared to patients without these complaints. In patients with frequency, almost all rectal parameters were reduced. Several dosimetric parameters to the anal wall and rectal wall were predictive for urgency (e.g., anal D{sub mean}>38Gy), whereas some anal wall parameters correlated to incontinence and no dose-effect relation for frequency was found. Conclusions: Anorectal function deteriorates after external beam radiotherapy. Different incontinence-related complaints show specific anorectal dysfunctions, suggesting different anatomic and pathophysiologic substrates: urgency and incontinence seem to originate from both anal wall and rectal wall, whereas frequency seems associated with rectal wall dysfunction. Also, dose-effect relations differed between these complaints. This implies that anal wall and rectal wall should be considered separate organs in radiotherapy planning.« less

Functional liver image guided hepatic therapy (FLIGHT) with hepatobiliary iminodiacetic acid (HIDA) scans.

PubMed

Long, David E; Tann, Mark; Huang, Ke Colin; Bartlett, Gregory; Galle, James O; Furukawa, Yukie; Maluccio, Mary; Cox, John A; Kong, Feng-Ming Spring; Ellsworth, Susannah G

2018-05-01

Hepatobiliary iminodiacetic acid (HIDA) scans provide global and regional assessments of liver function that can serve as a road map for functional avoidance in stereotactic body radiation therapy (SBRT) planning. Functional liver image guided hepatic therapy (FLIGHT), an innovative planning technique, is described and compared with standard planning using functional dose-volume histograms. Thresholds predicting for decompensation during follow up are evaluated. We studied 17 patients who underwent HIDA scans before SBRT. All SBRT cases were replanned using FLIGHT. The following dosimetric endpoints were compared for FLIGHT versus standard SBRT planning: functional residual capacity <15 Gy (FRC 15 HIDA), mean liver dose (MLD), equivalent uniform dose (EUD), and functional EUD (FEUD). Receiver operating characteristics curves were used to evaluate whether baseline HIDA values, standard cirrhosis scoring, and/or dosimetric data predicted clinical decompensation. Compared with standard planning, FLIGHT significantly improved FRC 15 HIDA (mean improvement: 5.3%) as well as MLD, EUD, and FEUD (P < .05). Considerable interindividual variations in the extent of benefit were noted. Decompensation during follow-up was associated with baseline global HIDA <2.915%/min/m 2 , FRC 15 HIDA <2.11%/min/m 2 , and MELD ≥11 (P < .05). FLIGHT with HIDA-based parameters may complement blood chemistry-based assessments of liver function and facilitate individualized, adaptive liver SBRT planning. Copyright © 2018. Published by Elsevier Inc.

ESR detection of irradiated carob pods (Ceratoniasiliqua L) and its dosimetric feature

NASA Astrophysics Data System (ADS)

Tuner, Hasan; Polat, Mustafa

2017-12-01

Un-irradiated carob powder exhibited a weak ESR singlet at g = 2.0041 ± 0.0006 with peak-to-peak linewidth (ΔHpp) of 0.33 ± 0.01 mT. Irradiated carob powder exhibited an ESR spectrum consisting many resonance lines and similar to ESR spectrum of sugar in all aspects. A linear function of the absorbed radiation dose was found to describe best the dose-response curves of the ESR signal intensity Ipp. It is concluded that due to the similarity of carob powder ESR spectrum to the irradiated sugar and the fact that it is widely consumed, carob powder has the potential to be used as a retrospective and/or accidental dosimetric material.

SU-E-T-490: Independent Three-Dimensional (3D) Dose Verification of VMAT/SBRT Using EPID and Cloud Computing

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

Ding, A; Han, B; Bush, K

Purpose: Dosimetric verification of VMAT/SBRT is currently performed on one or two planes in a phantom with either film or array detectors. A robust and easy-to-use 3D dosimetric tool has been sought since the advent of conformal radiation therapy. Here we present such a strategy for independent 3D VMAT/SBRT plan verification system by a combined use of EPID and cloud-based Monte Carlo (MC) dose calculation. Methods: The 3D dosimetric verification proceeds in two steps. First, the plan was delivered with a high resolution portable EPID mounted on the gantry, and the EPID-captured gantry-angle-resolved VMAT/SBRT field images were converted into fluencemore » by using the EPID pixel response function derived from MC simulations. The fluence was resampled and used as the input for an in-house developed Amazon cloud-based MC software to reconstruct the 3D dose distribution. The accuracy of the developed 3D dosimetric tool was assessed using a Delta4 phantom with various field sizes (square, circular, rectangular, and irregular MLC fields) and different patient cases. The method was applied to validate VMAT/SBRT plans using WFF and FFF photon beams (Varian TrueBeam STX). Results: It was found that the proposed method yielded results consistent with the Delta4 measurements. For points on the two detector planes, a good agreement within 1.5% were found for all the testing fields. Patient VMAT/SBRT plan studies revealed similar level of accuracy: an average γ-index passing rate of 99.2± 0.6% (3mm/3%), 97.4± 2.4% (2mm/2%), and 72.6± 8.4 % ( 1mm/1%). Conclusion: A valuable 3D dosimetric verification strategy has been developed for VMAT/SBRT plan validation. The technique provides a viable solution for a number of intractable dosimetry problems, such as small fields and plans with high dose gradient.« less

Dosimetric characterization of the (60)Co BEBIG Co0.A86 high dose rate brachytherapy source using PENELOPE.

PubMed

Guerrero, Rafael; Almansa, Julio F; Torres, Javier; Lallena, Antonio M

2014-12-01

(60)Co sources are being used as an alternative to (192)Ir sources in high dose rate brachytherapy treatments. In a recent document from AAPM and ESTRO, a consensus dataset for the (60)Co BEBIG (model Co0.A86) high dose rate source was prepared by using results taken from different publications due to discrepancies observed among them. The aim of the present work is to provide a new calculation of the dosimetric characteristics of that (60)Co source according to the recommendations of the AAPM and ESTRO report. Radial dose function, anisotropy function, air-kerma strength, dose rate constant and absorbed dose rate in water have been calculated and compared to the results of previous works. Simulations using the two different geometries considered by other authors have been carried out and the effect of the cable density and length has been studied. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

NOTE: Development of modified voxel phantoms for the numerical dosimetric reconstruction of radiological accidents involving external sources: implementation in SESAME tool

NASA Astrophysics Data System (ADS)

Courageot, Estelle; Sayah, Rima; Huet, Christelle

2010-05-01

Estimating the dose distribution in a victim's body is a relevant indicator in assessing biological damage from exposure in the event of a radiological accident caused by an external source. When the dose distribution is evaluated with a numerical anthropomorphic model, the posture and morphology of the victim have to be reproduced as realistically as possible. Several years ago, IRSN developed a specific software application, called the simulation of external source accident with medical images (SESAME), for the dosimetric reconstruction of radiological accidents by numerical simulation. This tool combines voxel geometry and the MCNP(X) Monte Carlo computer code for radiation-material interaction. This note presents a new functionality in this software that enables the modelling of a victim's posture and morphology based on non-uniform rational B-spline (NURBS) surfaces. The procedure for constructing the modified voxel phantoms is described, along with a numerical validation of this new functionality using a voxel phantom of the RANDO tissue-equivalent physical model.

Development of modified voxel phantoms for the numerical dosimetric reconstruction of radiological accidents involving external sources: implementation in SESAME tool.

PubMed

Courageot, Estelle; Sayah, Rima; Huet, Christelle

2010-05-07

Estimating the dose distribution in a victim's body is a relevant indicator in assessing biological damage from exposure in the event of a radiological accident caused by an external source. When the dose distribution is evaluated with a numerical anthropomorphic model, the posture and morphology of the victim have to be reproduced as realistically as possible. Several years ago, IRSN developed a specific software application, called the simulation of external source accident with medical images (SESAME), for the dosimetric reconstruction of radiological accidents by numerical simulation. This tool combines voxel geometry and the MCNP(X) Monte Carlo computer code for radiation-material interaction. This note presents a new functionality in this software that enables the modelling of a victim's posture and morphology based on non-uniform rational B-spline (NURBS) surfaces. The procedure for constructing the modified voxel phantoms is described, along with a numerical validation of this new functionality using a voxel phantom of the RANDO tissue-equivalent physical model.

Contura Multi-Lumen Balloon breast brachytherapy catheter: comparative dosimetric findings of a phase 4 trial.

PubMed

Arthur, Douglas W; Vicini, Frank A; Todor, Dorin A; Julian, Thomas B; Cuttino, Laurie W; Mukhopadhyay, Nitai D

2013-06-01

Final dosimetric findings of a completed, multi-institutional phase 4 registry trial using the Contura Multi-Lumen Balloon (MLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer are presented. Three dosimetric plans with identical target coverage were generated for each patient for comparison: multilumen multidwell (MLMD); central-lumen multidwell (CLMD); and central-lumen single-dwell (CLSD) loading of the Contura catheter. For this study, a successful treatment plan achieved ideal dosimetric goals and included the following: ≥ 95% of the prescribed dose (PD) covering ≥ 95% of the target volume (TV); maximum skin dose ≤ 125% of the PD; maximum rib dose ≤ 145% of the PD; and V150 ≤50 cc and V200 ≤ 10 cc. Between January 2008 and February 2011, 23 institutions participated. A total of 318 patients were available for dosimetric review. Using the Contura MLB, all dosimetric criteria were met in 78.93% of cases planned with MLMD versus 55.38% with the CLMD versus 37.66% with the CLSD (P ≤.0001). Evaluating all patients with the full range of skin to balloon distance represented, median maximum skin dose was reduced by 12% and median maximum rib dose by 13.9% when using MLMD-based dosimetric plans compared to CLSD. The dosimetric benefit of MLMD was further demonstrated in the subgroup of patients where skin thickness was <5 mm, where MLMD use allowed a 38% reduction in median maximum skin dose over CLSD. For patients with rib distance <5 mm, the median maximum rib dose reduction was 27%. Use of the Contura MLB catheter produced statistically significant improvements in dosimetric capabilities between CLSD and CLMD treatments. This device approach demonstrates the ability not only to overcome the barriers of limited skin thickness and close rib proximity, but to consistently achieve a higher standard of dosimetric planning goals. Copyright © 2013 Elsevier Inc. All rights reserved.

Contura Multi-Lumen Balloon Breast Brachytherapy Catheter: Comparative Dosimetric Findings of a Phase 4 Trial

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

Arthur, Douglas W., E-mail: darthur@mcvh-vcu.edu; Vicini, Frank A.; Todor, Dorin A.

2013-06-01

Purpose: Final dosimetric findings of a completed, multi-institutional phase 4 registry trial using the Contura Multi-Lumen Balloon (MLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer are presented. Methods and Materials: Three dosimetric plans with identical target coverage were generated for each patient for comparison: multilumen multidwell (MLMD); central-lumen multidwell (CLMD); and central-lumen single-dwell (CLSD) loading of the Contura catheter. For this study, a successful treatment plan achieved ideal dosimetric goals and included the following: ≥95% of the prescribed dose (PD) covering ≥95% of the target volume (TV); maximum skin dose ≤125%more » of the PD; maximum rib dose ≤145% of the PD; and V150 ≤50 cc and V200 ≤10 cc. Results: Between January 2008 and February 2011, 23 institutions participated. A total of 318 patients were available for dosimetric review. Using the Contura MLB, all dosimetric criteria were met in 78.93% of cases planned with MLMD versus 55.38% with the CLMD versus 37.66% with the CLSD (P≤.0001). Evaluating all patients with the full range of skin to balloon distance represented, median maximum skin dose was reduced by 12% and median maximum rib dose by 13.9% when using MLMD-based dosimetric plans compared to CLSD. The dosimetric benefit of MLMD was further demonstrated in the subgroup of patients where skin thickness was <5 mm, where MLMD use allowed a 38% reduction in median maximum skin dose over CLSD. For patients with rib distance <5 mm, the median maximum rib dose reduction was 27%. Conclusions: Use of the Contura MLB catheter produced statistically significant improvements in dosimetric capabilities between CLSD and CLMD treatments. This device approach demonstrates the ability not only to overcome the barriers of limited skin thickness and close rib proximity, but to consistently achieve a higher standard of dosimetric planning goals.« less

SU-D-18A-06: Variation of Controlled Breath Hold From CT Simulation to Treatment and Its Dosimetric Impact for Left-Sided Breast Radiotherapy with a Real-Time Optical Tracking System

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

Mittauer, K; Deraniyagala, R; Li, J

2014-06-01

Purpose: Different breath-hold (BH) maneuvers (abdominal breathing vs. chest breathing) during CT simulation and treatment can lead to chest wall positional variation. The purpose of this study is to quantify the variation of active breathing control (ABC)-assisted BH and estimate its dosimetric impact for left-sided whole-breast radiotherapy with a real-time optical tracking system (OTS). Methods: Seven breast cancer patients were included. An in-house OTS tracked an infrared (IR) marker affixed over the xiphoid process of the patient at CT simulation and throughout the treatment course to measure BH variations. Correlation between the IR marker and the breast was studied formore » dosimetric purposes. The positional variations of 860 BHs were retrospectively incorporated into treatment plans to assess their dosimetric impact on breast and cardiac organs (heart and left anterior descending artery [LAD]). Results: The mean intrafraction variations were 2.8 mm, 2.7 mm, and 1.6 mm in the anteroposterior (AP), craniocaudal (CC), and mediolateral (ML) directions, respectively. Mean stability in any direction was within 1.5 mm. A general trend of BH undershoot at treatment relative to CT simulation was observed with an average of 4.4 mm, 3.6 mm, and 0.1 mm in the AP, CC, and ML directions, respectively. Undershoot up to 12.6 mm was observed for individual patients. The difference between the planned and delivered dose to breast targets was negligible. The average planned/delivered mean heart doses, mean LAD doses, and max LAD doses were 1.4/2.1, 7.4/15.7, and 18.6/31.0 Gy, respectively. Conclusion: Systematic undershoot was observed in ABC-assisted BHs from CT simulation to treatment. Its dosimetric impact on breast coverage was minimized with image guidance, but the benefits of cardiac organ sparing were degraded. A real-time tracking system can be used in junction with the ABC device to improve BH reproducibility.« less

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

Teng, C; Janssens, G; Ainsley, C

Purpose: Proton dose distribution is sensitive to tumor regression and tissue and normal anatomy changes. Replanning is sometimes necessary during treatment to ensure continue tumor coverage or avoid overtreatment of organs at risk (OARs). We investigated action thresholds for replanning and identified both dosimetric and non-dosimetric metrics that would predict a need for replan. Methods: All consecutive lung cancer patients (n = 188) who received definitive proton radiotherapy and had more than two evaluation CT scans at the Roberts Proton Therapy Center (Philadelphia, USA) from 2011 to 2015 were included in this study. The cohort included a variety of tumormore » sizes, locations, histology, beam angles, as well as radiation-induced tumor and lung change. Dosimetric changes during therapy were characterized by changes in the dose volume distribution of PTV, ITV, and OARs (heart, cord, esophagus, brachial plexus and lungs). Tumor and lung change were characterized by changes in sizes, and in the distribution of Hounsfield numbers and water equivalent thickness (WET) along the beam path. We applied machine learning tools to identify both dosimetric and non-dosimetric metrics that predicted a replan. Results: Preliminary data showed that clinical indicators (n = 54) were highly correlated; thus, a simple indicator may be derived to guide the action threshold for replanning. Additionally, tumor regression alone could not predict dosimetric changes in OARs; it required further information about beam angles and tumor locations. Conclusion: Both dosimetric and non-dosimetric factors are predictive of the need for replanning during proton treatment.« less

Hot pixel generation in active pixel sensors: dosimetric and micro-dosimetric response

NASA Technical Reports Server (NTRS)

Scheick, Leif; Novak, Frank

2003-01-01

The dosimetric response of an active pixel sensor is analyzed. heavy ions are seen to damage the pixel in much the same way as gamma radiation. The probability of a hot pixel is seen to exhibit behavior that is not typical with other microdose effects.

Dosimetric Verification of IMRT Treatment Plans Using an Electronic Portal Imaging Device

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

Kruszyna, Marta

This paper presents the procedures and results of dosimetric verification using an Electronic Portal Imaging Device as a tool for pre-treatment dosimetry in IMRT technique at the Greater Poland Cancer Centre in Poznan, Poland. The evaluation of dosimetric verification for various organ, during a 2 year period is given.

Assessment and quantification of patient set-up errors in nasopharyngeal cancer patients and their biological and dosimetric impact in terms of generalized equivalent uniform dose (gEUD), tumour control probability (TCP) and normal tissue complication probability (NTCP).

PubMed

Boughalia, A; Marcie, S; Fellah, M; Chami, S; Mekki, F

2015-06-01

The aim of this study is to assess and quantify patients' set-up errors using an electronic portal imaging device and to evaluate their dosimetric and biological impact in terms of generalized equivalent uniform dose (gEUD) on predictive models, such as the tumour control probability (TCP) and the normal tissue complication probability (NTCP). 20 patients treated for nasopharyngeal cancer were enrolled in the radiotherapy-oncology department of HCA. Systematic and random errors were quantified. The dosimetric and biological impact of these set-up errors on the target volume and the organ at risk (OARs) coverage were assessed using calculation of dose-volume histogram, gEUD, TCP and NTCP. For this purpose, an in-house software was developed and used. The standard deviations (1SDs) of the systematic set-up and random set-up errors were calculated for the lateral and subclavicular fields and gave the following results: ∑ = 0.63 ± (0.42) mm and σ = 3.75 ± (0.79) mm, respectively. Thus a planning organ at risk volume (PRV) margin of 3 mm was defined around the OARs, and a 5-mm margin used around the clinical target volume. The gEUD, TCP and NTCP calculations obtained with and without set-up errors have shown increased values for tumour, where ΔgEUD (tumour) = 1.94% Gy (p = 0.00721) and ΔTCP = 2.03%. The toxicity of OARs was quantified using gEUD and NTCP. The values of ΔgEUD (OARs) vary from 0.78% to 5.95% in the case of the brainstem and the optic chiasm, respectively. The corresponding ΔNTCP varies from 0.15% to 0.53%, respectively. The quantification of set-up errors has a dosimetric and biological impact on the tumour and on the OARs. The developed in-house software using the concept of gEUD, TCP and NTCP biological models has been successfully used in this study. It can be used also to optimize the treatment plan established for our patients. The gEUD, TCP and NTCP may be more suitable tools to assess the treatment plans before treating the patients.

Impact of head morphology on local brain specific absorption rate from exposure to mobile phone radiation.

PubMed

Adibzadeh, Fatemeh; Bakker, Jurriaan F; Paulides, Margarethus M; Verhaart, René F; van Rhoon, Gerard C

2015-01-01

Among various possible health effects of mobile phone radiation, the risk of inducing cancer has the strongest interest of laymen and health organizations. Recently, the Interphone epidemiological study investigated the association between the estimated Radio Frequency (RF) dose from mobile phones and the risk of developing a brain tumor. Their dosimetric analysis included over 100 phone models but only two homogeneous head phantoms. So, the potential impact of individual morphological features on global and local RF absorption in the brain was not investigated. In this study, we performed detailed dosimetric simulations for 20 head models and quantified the variation of RF dose in different brain regions as a function of head morphology. Head models were exposed to RF fields from generic mobile phones at 835 and 1900 MHz in the "tilted" and "cheek" positions. To evaluate the local RF dose variation, we used and compared two different post-processing methods, that is, averaging specific absorption rate (SAR) over Talairach regions and over sixteen predefined 1 cm(3) cube-shaped field-sensors. The results show that the variation in the averaged SAR among the heads can reach up to 16.4 dB at a 1 cm(3) cube inside the brain (field-sensor method) and alternatively up to 15.8 dB in the medulla region (Talairach method). In conclusion, we show head morphology as an important uncertainty source for dosimetric studies of mobile phones. Therefore, any dosimetric analysis dealing with RF dose at a specific region in the brain (e.g., tumor risk analysis) should be based upon real morphology. © 2014 Wiley Periodicals, Inc.

Sci—Thur PM: Planning and Delivery — 04: Respiratory margin derivation and verification in partial breast irradiation

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

Quirk, S; Conroy, L; Smith, WL

Partial breast irradiation (PBI) following breast-conserving surgery is emerging as an effective means to achieve local control and reduce irradiated breast volume. Patients are planned on a static CT image; however, treatment is delivered while the patient is free-breathing. Respiratory motion can degrade plan quality by reducing target coverage and/or dose homogeneity. A variety of methods can be used to determine the required margin for respiratory motion in PBI. We derive geometric and dosimetric respiratory 1D margin. We also verify the adequacy of the typical 5 mm respiratory margin in 3D by evaluating plan quality for increasing respiratory amplitudes (2–20more » mm). Ten PBI plans were used for dosimetric evaluation. A database of volunteer respiratory data, with similar characteristics to breast cancer patients, was used for this study. We derived a geometric 95%-margin of 3 mm from the population respiratory data. We derived a dosimetric 95%-margin of 2 mm by convolving 1D dose profiles with respiratory probability density functions. The 5 mm respiratory margin is possibly too large when 1D coverage is assessed and could lead to unnecessary normal tissue irradiation. Assessing margins only for coverage may be insufficient; 3D dosimetric assessment revealed degradation in dose homogeneity is the limiting factor, not target coverage. Hotspots increased even for the smallest respiratory amplitudes, while target coverage only degraded at amplitudes greater than 10 mm. The 5 mm respiratory margin is adequate for coverage, but due to plan quality degradation, respiratory management is recommended for patients with respiratory amplitudes greater than 10 mm.« less

Improvements in Critical Dosimetric Endpoints Using the Contura Multilumen Balloon Breast Brachytherapy Catheter to Deliver Accelerated Partial Breast Irradiation: Preliminary Dosimetric Findings of a Phase IV Trial

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

Arthur, Douglas W., E-mail: darthur@mcvh-vcu.ed; Vicini, Frank A.; Todor, Dorin A.

2011-01-01

Purpose: Dosimetric findings in patients treated with the Contura multilumen balloon (MLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) on a multi-institutional Phase IV registry trial are presented. Methods and Materials: Computed tomography-based three-dimensional planning with dose optimization was performed. For the trial, new ideal dosimetric goals included (1) {>=}95% of the prescribed dose (PD) covering {>=}90% of the target volume, (2) a maximum skin dose {<=}125% of the PD, (3) maximum rib dose {<=}145% of the PD, and (4) the V150 {<=}50 cc and V200 {<=}10 cc. The ability to concurrently achieve these dosimetric goals usingmore » the Contura MLB was analyzed. Results: 144 cases were available for review. Using the MLB, all dosimetric criteria were met in 76% of cases. Evaluating dosimetric criteria individually, 92% and 89% of cases met skin and rib dose criteria, respectively. In 93% of cases, ideal target volume coverage goals were met, and in 99%, dose homogeneity criteria (V150 and V200) were satisfied. When skin thickness was {>=}5 mm to <7 mm, the median skin dose was limited to 120.1% of the PD, and when skin thickness was <5 mm, the median skin dose was 124.2%. When rib distance was <5 mm, median rib dose was reduced to 136.5% of the PD. When skin thickness was <7 mm and distance to rib was <5 mm, median skin and rib doses were jointly limited to 120.6% and 142.1% of the PD, respectively. Conclusion: The Contura MLB catheter provided the means of achieving the imposed higher standard of dosimetric goals in the majority of clinical scenarios encountered.« less

Role of intracanalicular volumetric and dosimetric parameters on hearing preservation after vestibular schwannoma radiosurgery

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

Massager, Nicolas; Nissim, Ouzi; Delbrouck, Carine

2006-04-01

Purpose: To analyze the relationship between hearing preservation after gamma knife radiosurgery (GKR) for vestibular schwannoma (VS) and some volumetric and dosimetric parameters of the intracanalicular components of VS. Methods and Materials: This study included 82 patients with a VS treated by GKR; all patients had no NF2 disease, a Gardner-Robertson hearing class 1-4 before treatment, a marginal dose of 12 Gy, and a radiologic and audiologic follow-up {>=}1 year post-GKR. The volume of both the entire tumor and the intracanalicular part of the tumor and the mean and integrated dose of these two volumes were correlated to the auditorymore » outcomes of patients. Results: At last hearing follow-up, 52 patients had no hearing worsening, and 30 patients had an increase of {>=}1 class on Gardner-Robertson classification. We found that hearing preservation after GKR is significantly correlated with the intracanalicular tumor volume, as well as with the integrated dose delivered to the intracanalicular tumor volume. Conclusions: Some volumetric and dosimetric parameters of the intracanalicular part of the tumor influence hearing preservation after GKR of VS. Consequently, we advise the direct treatment of patients with preserved functional hearing and a VS including a small intracanalicular volume.« less

Study of the Phototransference in GR-200 Dosimetric Material and its Convenience for Dose Re-estimation

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

Baly, L.; Otazo, M. R.; Molina, D.

2006-09-08

A study of the phototransference of charges from deep to dosimetric traps in GR-200 material is presented and its convenience for dose re-estimation in the dose range between 2 and 100mSv is also analyzed. The recovering coefficient (RC) defined as the ratio between the phototransferred thermoluminescence (PTTL) and the original thermoluminescence (TL) of the dosimetric trap was used to evaluate the ratio of phototransferred charges from deep traps and the original charges in the dosimetric traps. The results show the convenience of this method for dose re-estimation for this material in the selected range of doses.

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

Depauw, N; Patel, S; MacDonald, S

Purpose: Deep inspiration breath-hold techniques (DIBH) have been shown to carry significant dosimetric advantages in conventional radiotherapy of left-sided breast cancer. The purpose of this study is to evaluate the use of DIBH techniques for post-mastectomy radiation therapy (PMRT) using proton pencil beam scanning (PBS). Method: Ten PMRT patients, with or without breast implant, underwent two helical CT scans: one with free breathing and the other with deep inspiration breath-hold. A prescription of 50.4 Gy(RBE) to the whole chest wall and lymphatics (axillary, supraclavicular, and intramammary nodes) was considered. PBS plans were generated for each patient’s CT scan using Astroid,more » an in-house treatment planning system, with the institution conventional clinical PMRT parameters; that is, using a single en-face field with a spot size varying from 8 mm to 14 mm as a function of energy. Similar optimization parameters were used in both plans in order to ensure appropriate comparison. Results: Regardless of the technique (free breathing or DIBH), the generated plans were well within clinical acceptability. DIBH allowed for higher target coverage with better sparing of the cardiac structures. The lung doses were also slightly improved. While the use of DIBH techniques might be of interest, it is technically challenging as it would require a fast PBS delivery, as well as the synchronization of the beam delivery with a gating system, both of which are not currently available at the institution. Conclusion: DIBH techniques display some dosimetric advantages over free breathing treatment for PBS PMRT patients, which warrants further investigation. Plans will also be generated with smaller spot sizes (2.5 mm to 5.5 mm and 5 mm to 9 mm), corresponding to new generation machines, in order to further quantify the dosimetric advantages of DIBH as a function of spot size.« less

Tooth Retrospective Dosimetry Using Electron Paramagnetic Resonance: Influence of Irradiated Dental Composites

PubMed Central

Desmet, Céline M.; Djurkin, Andrej; Dos Santos-Goncalvez, Ana Maria; Dong, Ruhong; Kmiec, Maciej M.; Kobayashi, Kyo; Rychert, Kevin; Beun, Sébastien; Leprince, Julian G.; Leloup, Gaëtane; Levêque, Philippe; Gallez, Bernard

2015-01-01

In the aftermath of a major radiological accident, the medical management of overexposed individuals will rely on the determination of the dose of ionizing radiations absorbed by the victims. Because people in the general population do not possess conventional dosimeters, after the fact dose reconstruction methods are needed. Free radicals are induced by radiations in the tooth enamel of victims, in direct proportion to dose, and can be quantified using Electron Paramagnetic Resonance (EPR) spectrometry, a technique that was demonstrated to be very appropriate for mass triage. The presence of dimethacrylate based restorations on teeth can interfere with the dosimetric signal from the enamel, as free radicals could also be induced in the various composites used. The aim of the present study was to screen irradiated composites for a possible radiation-induced EPR signal, to characterize it, and evaluate a possible interference with the dosimetric signal of the enamel. We investigated the most common commercial composites, and experimental compositions, for a possible class effect. The effect of the dose was studied between 10 Gy and 100 Gy using high sensitivity X-band spectrometer. The influence of this radiation-induced signal from the composite on the dosimetric signal of the enamel was also investigated using a clinical L-Band EPR spectrometer, specifically developed in the EPR center at Dartmouth College. In X-band, a radiation-induced signal was observed for high doses (25-100 Gy); it was rapidly decaying, and not detected after only 24h post irradiation. At 10 Gy, the signal was in most cases not measurable in the commercial composites tested, with the exception of 3 composites showing a significant intensity. In L-band study, only one irradiated commercial composite influenced significantly the dosimetric signal of the tooth, with an overestimation about 30%. In conclusion, the presence of the radiation-induced signal from dental composites should not significantly influence the dosimetry for early dose assessment. PMID:26125565

High-resolution digital dosimetric system for spatial characterization of radiation fields using a thermoluminescent CaF/sub 2/:Dy crystal

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

Atari, N.A.; Svensson, G.K.

1986-05-01

A high-resolution digital dosimetric system has been developed for the spatial characterization of radiation fields. The system comprises the following: 0.5-mm-thick, 25-mm-diam CaF/sub 2/:Dy thermoluminescent crystal; intensified charge coupled device video camera; video cassette recorder; and a computerized image processing subsystem. The optically flat single crystal is used as a radiation imaging device and the subsequent thermally stimulated phosphorescence is viewed by the intensified camera for further processing and analysis. Parameters governing the performance characteristics of the system were measured. A spatial resolution limit of 31 +- 2 ..mu..m (1sigma) corresponding to 16 +- 1 line pair/mm measured at themore » 4% level of the modulation transfer function has been achieved. The full width at half maximum of the line spread function measured independently by the slit method or derived from the edge response function was found to be 69 +- 4 ..mu..m (1sigma). The high resolving power, speed of readout, good precision, wide dynamic range, and the large image storage capacity make the system suitable for the digital mapping of the relative distribution of absorbed doses for various small radiation fields and the edges of larger fields.« less

High-resolution digital dosimetric system for spatial characterization of radiation fields using a thermoluminescent CaF2:Dy crystal

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

Atari, N.A.; Svensson, G.K.

1986-05-01

A high-resolution digital dosimetric system has been developed for the spatial characterization of radiation fields. The system comprises the following: 0.5-mm-thick, 25-mm-diam CaF2:Dy thermoluminescent crystal; intensified charge coupled device video camera; video cassette recorder; and a computerized image processing subsystem. The optically flat single crystal is used as a radiation imaging device and the subsequent thermally stimulated phosphorescence is viewed by the intensified camera for further processing and analysis. Parameters governing the performance characteristics of the system were measured. A spatial resolution limit of 31 +/- 2 microns (1 sigma) corresponding to 16 +/- 1 line pairs/mm measured at themore » 4% level of the modulation transfer function has been achieved. The full width at half maximum of the line spread function measured independently by the slit method or derived from the edge response function was found to be 69 +/- 4 microns (1 sigma). The high resolving power, speed of readout, good precision, wide dynamic range, and the large image storage capacity make the system suitable for the digital mapping of the relative distribution of absorbed doses for various small radiation fields and the edges of larger fields.« less

Dosimetric audit in brachytherapy

PubMed Central

Bradley, D A; Nisbet, A

2014-01-01

Dosimetric audit is required for the improvement of patient safety in radiotherapy and to aid optimization of treatment. The reassurance that treatment is being delivered in line with accepted standards, that delivered doses are as prescribed and that quality improvement is enabled is as essential for brachytherapy as it is for the more commonly audited external beam radiotherapy. Dose measurement in brachytherapy is challenging owing to steep dose gradients and small scales, especially in the context of an audit. Several different approaches have been taken for audit measurement to date: thimble and well-type ionization chambers, thermoluminescent detectors, optically stimulated luminescence detectors, radiochromic film and alanine. In this work, we review all of the dosimetric brachytherapy audits that have been conducted in recent years, look at current audits in progress and propose required directions for brachytherapy dosimetric audit in the future. The concern over accurate source strength measurement may be essentially resolved with modern equipment and calibration methods, but brachytherapy is a rapidly developing field and dosimetric audit must keep pace. PMID:24807068

Helical Tomotherapy vs. Intensity-Modulated Proton Therapy for Whole Pelvis Irradiation in High-Risk Prostate Cancer Patients: Dosimetric, Normal Tissue Complication Probability, and Generalized Equivalent Uniform Dose Analysis

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

Widesott, Lamberto, E-mail: widesott@yahoo.it; Pierelli, Alessio; Fiorino, Claudio

2011-08-01

Purpose: To compare intensity-modulated proton therapy (IMPT) and helical tomotherapy (HT) treatment plans for high-risk prostate cancer (HRPCa) patients. Methods and Materials: The plans of 8 patients with HRPCa treated with HT were compared with IMPT plans with two quasilateral fields set up (-100{sup o}; 100{sup o}) and optimized with the Hyperion treatment planning system. Both techniques were optimized to simultaneously deliver 74.2 Gy/Gy relative biologic effectiveness (RBE) in 28 fractions on planning target volumes (PTVs)3-4 (P + proximal seminal vesicles), 65.5 Gy/Gy(RBE) on PTV2 (distal seminal vesicles and rectum/prostate overlapping), and 51.8 Gy/Gy(RBE) to PTV1 (pelvic lymph nodes). Normalmore » tissue calculation probability (NTCP) calculations were performed for the rectum, and generalized equivalent uniform dose (gEUD) was estimated for the bowel cavity, penile bulb and bladder. Results: A slightly better PTV coverage and homogeneity of target dose distribution with IMPT was found: the percentage of PTV volume receiving {>=}95% of the prescribed dose (V{sub 95%}) was on average >97% in HT and >99% in IMPT. The conformity indexes were significantly lower for protons than for photons, and there was a statistically significant reduction of the IMPT dosimetric parameters, up to 50 Gy/Gy(RBE) for the rectum and bowel and 60 Gy/Gy(RBE) for the bladder. The NTCP values for the rectum were higher in HT for all the sets of parameters, but the gain was small and in only a few cases statistically significant. Conclusions: Comparable PTV coverage was observed. Based on NTCP calculation, IMPT is expected to allow a small reduction in rectal toxicity, and a significant dosimetric gain with IMPT, both in medium-dose and in low-dose range in all OARs, was observed.« less

On the half-life of luminescence signals in dosimetric applications: A unified presentation

NASA Astrophysics Data System (ADS)

Pagonis, V.; Kitis, G.; Polymeris, G. S.

2018-06-01

Luminescence signals from natural and man-made materials are widely used in dosimetric and dating applications. In general, there are two types of half-lives of luminescence signals which are of importance to experimental and modeling work in this research area. The first type of half-life is the time required for the population of the trapped charge in a single trap to decay to half its initial value. The second type of half-life is the time required for the luminescence intensity to drop to half of its initial value. While there a handful of analytical expressions available in the literature for the first type of half-life, there are no corresponding analytical expressions for the second type. In this work new analytical expressions are derived for the half-life of luminescence signals during continuous wave optical stimulation luminescence (CW-OSL) or isothermal luminescence (ITL) experiments. The analytical expressions are derived for several commonly used luminescence models which are based on delocalized transitions involving the conduction band: first and second order kinetics, empirical general order kinetics (GOK), mixed order kinetics (MOK) and the one-trap one-recombination center (OTOR) model. In addition, half-life expressions are derived for a different type of luminescence model, which is based on localized transitions in a random distribution of charges. The new half-life expressions contain two parts. The first part is inversely proportional to the thermal or optical excitation rate, and depends on the experimental conditions and on the cross section of the relevant luminescence process. The second part is characteristic of the optical and/or thermal properties of the material, as expressed by the parameters in the model. A new simple and quick method for analyzing luminescence signals is developed, and examples are given of applying the new method to a variety of dosimetric materials. The new test allows quick determination of whether a set of experimentally measured luminescence signals originate in a single trap, or in multiple traps.

Dosimetric characteristics of a new unshielded silicon diode and its application in clinical photon and electron beams.

PubMed

Griessbach, Irmgard; Lapp, Markus; Bohsung, Jörg; Gademann, Günther; Harder, Dietrich

2005-12-01

Shielded p-silicon diodes, frequently applied in general photon-beam dosimetry, show certain imperfections when applied in the small photon fields occurring in stereotactic or intensity modulated radiotherapy (IMRT), in electron beams and in the buildup region of photon beam dose distributions. Using as a study object the shielded p-silicon diode PTW 60008, well known for its reliable performance in general photon dosimetry, we have identified these imperfections as effects of electron scattering at the metallic parts of the shielding. In order to overcome these difficulties a new, unshielded diode PTW 60012 has been designed and manufactured by PTW Freiburg. By comparison with reference detectors, such as thimble and plane-parallel ionization chambers and a diamond detector, we could show the absence of these imperfections. An excellent performance of the new unshielded diode for the special dosimetric tasks in small photon fields, electron beams and build-up regions of photon beams has been observed. The new diode also has an improved angular response. However, due to its over-response to low-energy scattered photons, its recommended range of use does not include output factor measurements in large photon fields, although this effect can be compensated by a thin auxiliary lead shield.

Pencil Beam Scanning Proton Therapy for Rhabdomyosarcoma of the Biliary Tract.

PubMed

Pater, Luke; Turpin, Brian; Mascia, Anthony

2017-10-05

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma of childhood with 250-350 cases diagnosed annually in the United States. Biliary tract rhabdomyosarcoma is rare, representing <1% of the RMS cases. Due to its location, resection is clinically challenging, and functional complications exist and persist from biliary obstruction. The anatomical location of this tumor presents both opportunities and challenges for pencil beam scanning proton therapy. Proton therapy offers a dosimetric and clinical advantage by sparing the healthy liver, stomach, contra-lateral kidney and bowel. Motion management and anatomical variations, such as intestinal filling or weight loss, requiring routine dosimetric evaluation and possible adaptive treatment planning, present challenges for the use of proton therapy. By taking advantage of the superior dose distribution of proton radiation, assessing the impact of tumor and anatomy motion, and performing regular dose evaluations, biliary tract RMS is an ideal diagnosis for pencil beam scanning proton therapy.

Investigation of 3D diamond detector dosimetric characteristics

NASA Astrophysics Data System (ADS)

Kanxheri, K.; Alunni Solestizi, L.; Biasini, M.; Caprai, M.; Dipilato, A. C.; Iacco, M.; Ionica, M.; Lagomarsino, S.; Menichelli, M.; Morozzi, A.; Passeri, D.; Sciortino, S.; Talamonti, C.; Zucchetti, C.; Servoli, L.

2018-06-01

Recently, a polycrystalline chemical vapor deposited (pCVD) 3D diamond detector with graphitic in bulk electrodes, fabricated using a pulsed laser technique has been evaluated for photon beam radiation dosimetry during in-air exposure. The same 3D diamond detector, has now been investigated to evaluate its performance under clinically relevant conditions putting the detector inside a Polymethylmethacrylate (PMMA) phantom, to obtain higher precision dosimetric measurements. The detector leakage current was of the order of ± 25 pA or less for bias voltages up to ‑100 V. The 3D detector was tested for time stability and repeatability showing excellent performance with less than 0.6% signal variation. It also showed a linear response for low dose rates with a deviation from linearity of 2%. It was also possible to verify the detector response as a function of the depth in PMMA up to 18 cm.

Estimation of electromagnetic dosimetric values from non-ionizing radiofrequency fields in an indoor commercial airplane environment.

PubMed

Aguirre, Erik; Arpón, Javier; Azpilicueta, Leire; López, Peio; de Miguel, Silvia; Ramos, Victoria; Falcone, Francisco

2014-12-01

In this article, the impact of topology as well as morphology of a complex indoor environment such as a commercial aircraft in the estimation of dosimetric assessment is presented. By means of an in-house developed deterministic 3D ray-launching code, estimation of electric field amplitude as a function of position for the complete volume of a commercial passenger airplane is obtained. Estimation of electromagnetic field exposure in this environment is challenging, due to the complexity and size of the scenario, as well as to the large metallic content, giving rise to strong multipath components. By performing the calculation with a deterministic technique, the complete scenario can be considered with an optimized balance between accuracy and computational cost. The proposed method can aid in the assessment of electromagnetic dosimetry in the future deployment of embarked wireless systems in commercial aircraft.

Improvements in critical dosimetric endpoints using the Contura multilumen balloon breast brachytherapy catheter to deliver accelerated partial breast irradiation: preliminary dosimetric findings of a phase iv trial.

PubMed

Arthur, Douglas W; Vicini, Frank A; Todor, Dorin A; Julian, Thomas B; Lyden, Maureen R

2011-01-01

Dosimetric findings in patients treated with the Contura multilumen balloon (MLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) on a multi-institutional Phase IV registry trial are presented. Computed tomography-based three-dimensional planning with dose optimization was performed. For the trial, new ideal dosimetric goals included (1) ≥95% of the prescribed dose (PD) covering ≥90% of the target volume, (2) a maximum skin dose ≤125% of the PD, (3) maximum rib dose ≤145% of the PD, and (4) the V150 ≤50 cc and V200 ≤10 cc. The ability to concurrently achieve these dosimetric goals using the Contura MLB was analyzed. 144 cases were available for review. Using the MLB, all dosimetric criteria were met in 76% of cases. Evaluating dosimetric criteria individually, 92% and 89% of cases met skin and rib dose criteria, respectively. In 93% of cases, ideal target volume coverage goals were met, and in 99%, dose homogeneity criteria (V150 and V200) were satisfied. When skin thickness was ≥5 mm to <7 mm, the median skin dose was limited to 120.1% of the PD, and when skin thickness was <5 mm, the median skin dose was 124.2%. When rib distance was <5 mm, median rib dose was reduced to 136.5% of the PD. When skin thickness was <7 mm and distance to rib was <5 mm, median skin and rib doses were jointly limited to 120.6% and 142.1% of the PD, respectively. The Contura MLB catheter provided the means of achieving the imposed higher standard of dosimetric goals in the majority of clinical scenarios encountered. Copyright © 2011 Elsevier Inc. All rights reserved.

TU-CD-BRB-01: Normal Lung CT Texture Features Improve Predictive Models for Radiation Pneumonitis

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

Krafft, S; The University of Texas Graduate School of Biomedical Sciences, Houston, TX; Briere, T

2015-06-15

Purpose: Existing normal tissue complication probability (NTCP) models for radiation pneumonitis (RP) traditionally rely on dosimetric and clinical data but are limited in terms of performance and generalizability. Extraction of pre-treatment image features provides a potential new category of data that can improve NTCP models for RP. We consider quantitative measures of total lung CT intensity and texture in a framework for prediction of RP. Methods: Available clinical and dosimetric data was collected for 198 NSCLC patients treated with definitive radiotherapy. Intensity- and texture-based image features were extracted from the T50 phase of the 4D-CT acquired for treatment planning. Amore » total of 3888 features (15 clinical, 175 dosimetric, and 3698 image features) were gathered and considered candidate predictors for modeling of RP grade≥3. A baseline logistic regression model with mean lung dose (MLD) was first considered. Additionally, a least absolute shrinkage and selection operator (LASSO) logistic regression was applied to the set of clinical and dosimetric features, and subsequently to the full set of clinical, dosimetric, and image features. Model performance was assessed by comparing area under the curve (AUC). Results: A simple logistic fit of MLD was an inadequate model of the data (AUC∼0.5). Including clinical and dosimetric parameters within the framework of the LASSO resulted in improved performance (AUC=0.648). Analysis of the full cohort of clinical, dosimetric, and image features provided further and significant improvement in model performance (AUC=0.727). Conclusions: To achieve significant gains in predictive modeling of RP, new categories of data should be considered in addition to clinical and dosimetric features. We have successfully incorporated CT image features into a framework for modeling RP and have demonstrated improved predictive performance. Validation and further investigation of CT image features in the context of RP NTCP modeling is warranted. This work was supported by the Rosalie B. Hite Fellowship in Cancer research awarded to SPK.« less

Linking log files with dosimetric accuracy--A multi-institutional study on quality assurance of volumetric modulated arc therapy.

PubMed

Pasler, Marlies; Kaas, Jochem; Perik, Thijs; Geuze, Job; Dreindl, Ralf; Künzler, Thomas; Wittkamper, Frits; Georg, Dietmar

2015-12-01

To systematically evaluate machine specific quality assurance (QA) for volumetric modulated arc therapy (VMAT) based on log files by applying a dynamic benchmark plan. A VMAT benchmark plan was created and tested on 18 Elekta linacs (13 MLCi or MLCi2, 5 Agility) at 4 different institutions. Linac log files were analyzed and a delivery robustness index was introduced. For dosimetric measurements an ionization chamber array was used. Relative dose deviations were assessed by mean gamma for each control point and compared to the log file evaluation. Fourteen linacs delivered the VMAT benchmark plan, while 4 linacs failed by consistently terminating the delivery. The mean leaf error (±1SD) was 0.3±0.2 mm for all linacs. Large MLC maximum errors up to 6.5 mm were observed at reversal positions. Delivery robustness index accounting for MLC position correction (0.8-1.0) correlated with delivery time (80-128 s) and depended on dose rate performance. Dosimetric evaluation indicated in general accurate plan reproducibility with γ(mean)(±1 SD)=0.4±0.2 for 1 mm/1%. However single control point analysis revealed larger deviations and attributed well to log file analysis. The designed benchmark plan helped identify linac related malfunctions in dynamic mode for VMAT. Log files serve as an important additional QA measure to understand and visualize dynamic linac parameters. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Dosimetric assessment of the PRESAGE dosimeter for a proton pencil beam

NASA Astrophysics Data System (ADS)

Wuu, C.-S.; Xu, Y.; Qian, X.; Adamovics, J.; Cascio, E.; Lu, H.-M.

2013-06-01

The objective of this study is to assess the feasibility of using PRESAGE dosimeters for proton pencil beam dosimetry. Two different formulations of phantom materials were tested for their suitability in characterizing a single proton pencil beam. The dosimetric response of PRESAGE was found to be linear up to 4Gy. First-generation optical CT scanner, OCTOPUSTM was used to implement dose distributions for proton pencil beams since it provides most accurate readout. Percentage depth dose curves and beam profiles for two proton energy, 110 MeV, and 93 MeV, were used to evaluate the dosimetric performance of two PRESAGE phantom formulas. The findings from this study show that the dosimetric properties of the phantom materials match with basic physics of proton beams.

Realistic respiratory motion margins for external beam partial breast irradiation

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

Conroy, Leigh; Quirk, Sarah; Department of Physics and Astronomy, University of Calgary, Calgary, Alberta T2N 1N4

Purpose: Respiratory margins for partial breast irradiation (PBI) have been largely based on geometric observations, which may overestimate the margin required for dosimetric coverage. In this study, dosimetric population-based respiratory margins and margin formulas for external beam partial breast irradiation are determined. Methods: Volunteer respiratory data and anterior–posterior (AP) dose profiles from clinical treatment plans of 28 3D conformal radiotherapy (3DCRT) PBI patient plans were used to determine population-based respiratory margins. The peak-to-peak amplitudes (A) of realistic respiratory motion data from healthy volunteers were scaled from A = 1 to 10 mm to create respiratory motion probability density functions. Dosemore » profiles were convolved with the respiratory probability density functions to produce blurred dose profiles accounting for respiratory motion. The required margins were found by measuring the distance between the simulated treatment and original dose profiles at the 95% isodose level. Results: The symmetric dosimetric respiratory margins to cover 90%, 95%, and 100% of the simulated treatment population were 1.5, 2, and 4 mm, respectively. With patient set up at end exhale, the required margins were larger in the anterior direction than the posterior. For respiratory amplitudes less than 5 mm, the population-based margins can be expressed as a fraction of the extent of respiratory motion. The derived formulas in the anterior/posterior directions for 90%, 95%, and 100% simulated population coverage were 0.45A/0.25A, 0.50A/0.30A, and 0.70A/0.40A. The differences in formulas for different population coverage criteria demonstrate that respiratory trace shape and baseline drift characteristics affect individual respiratory margins even for the same average peak-to-peak amplitude. Conclusions: A methodology for determining population-based respiratory margins using real respiratory motion patterns and dose profiles in the AP direction was described. It was found that the currently used respiratory margin of 5 mm in partial breast irradiation may be overly conservative for many 3DCRT PBI patients. Amplitude alone was found to be insufficient to determine patient-specific margins: individual respiratory trace shape and baseline drift both contributed to the dosimetric target coverage. With respiratory coaching, individualized respiratory margins smaller than the full extent of motion could reduce planning target volumes while ensuring adequate coverage under respiratory motion.« less

Assessment and quantification of patient set-up errors in nasopharyngeal cancer patients and their biological and dosimetric impact in terms of generalized equivalent uniform dose (gEUD), tumour control probability (TCP) and normal tissue complication probability (NTCP)

PubMed Central

Marcie, S; Fellah, M; Chami, S; Mekki, F

2015-01-01

Objective: The aim of this study is to assess and quantify patients' set-up errors using an electronic portal imaging device and to evaluate their dosimetric and biological impact in terms of generalized equivalent uniform dose (gEUD) on predictive models, such as the tumour control probability (TCP) and the normal tissue complication probability (NTCP). Methods: 20 patients treated for nasopharyngeal cancer were enrolled in the radiotherapy–oncology department of HCA. Systematic and random errors were quantified. The dosimetric and biological impact of these set-up errors on the target volume and the organ at risk (OARs) coverage were assessed using calculation of dose–volume histogram, gEUD, TCP and NTCP. For this purpose, an in-house software was developed and used. Results: The standard deviations (1SDs) of the systematic set-up and random set-up errors were calculated for the lateral and subclavicular fields and gave the following results: ∑ = 0.63 ± (0.42) mm and σ = 3.75 ± (0.79) mm, respectively. Thus a planning organ at risk volume (PRV) margin of 3 mm was defined around the OARs, and a 5-mm margin used around the clinical target volume. The gEUD, TCP and NTCP calculations obtained with and without set-up errors have shown increased values for tumour, where ΔgEUD (tumour) = 1.94% Gy (p = 0.00721) and ΔTCP = 2.03%. The toxicity of OARs was quantified using gEUD and NTCP. The values of ΔgEUD (OARs) vary from 0.78% to 5.95% in the case of the brainstem and the optic chiasm, respectively. The corresponding ΔNTCP varies from 0.15% to 0.53%, respectively. Conclusion: The quantification of set-up errors has a dosimetric and biological impact on the tumour and on the OARs. The developed in-house software using the concept of gEUD, TCP and NTCP biological models has been successfully used in this study. It can be used also to optimize the treatment plan established for our patients. Advances in knowledge: The gEUD, TCP and NTCP may be more suitable tools to assess the treatment plans before treating the patients. PMID:25882689

Dosimetric study of GZP6 60 Co high dose rate brachytherapy source.

PubMed

Lei, Qin; Xu, Anjian; Gou, Chengjun; Wen, Yumei; He, Donglin; Wu, Junxiang; Hou, Qing; Wu, Zhangwen

2018-05-28

The purpose of this study was to obtain dosimetric parameters of GZP6 60 Co brachytherapy source number 3. The Geant4 MC code has been used to obtain the dose rate distribution following the American Association of Physicists in Medicine (AAPM) TG-43U1 dosimetric formalism. In the simulation, the source was centered in a 50 cm radius water phantom. The cylindrical ring voxels were 0.1 mm thick for r ≤ 1 cm, 0.5 mm for 1 cm < r ≤ 5 cm, and 1 mm for r > 5 cm. The kerma-dose approximation was performed for r > 0.75 cm to increase the simulation efficiency. Based on the numerical results, the dosimetric datasets were obtained. These results were compared with the available data of the similar 60 Co high dose rate sources and the detailed dosimetric characterization was discussed. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Evaluation of the dosimetric properties of a synthetic single crystal diamond detector in high energy clinical proton beams.

PubMed

Mandapaka, A K; Ghebremedhin, A; Patyal, B; Marinelli, Marco; Prestopino, G; Verona, C; Verona-Rinati, G

2013-12-01

To investigate the dosimetric properties of a synthetic single crystal diamond Schottky diode for accurate relative dose measurements in large and small field high-energy clinical proton beams. The dosimetric properties of a synthetic single crystal diamond detector were assessed by comparison with a reference Markus parallel plate ionization chamber, an Exradin A16 microionization chamber, and Exradin T1a ion chamber. The diamond detector was operated at zero bias voltage at all times. Comparative dose distribution measurements were performed by means of Fractional depth dose curves and lateral beam profiles in clinical proton beams of energies 155 and 250 MeV for a 14 cm square cerrobend aperture and 126 MeV for 3, 2, and 1 cm diameter circular brass collimators. ICRU Report No. 78 recommended beam parameters were used to compare fractional depth dose curves and beam profiles obtained using the diamond detector and the reference ionization chamber. Warm-up∕stability of the detector response and linearity with dose were evaluated in a 250 MeV proton beam and dose rate dependence was evaluated in a 126 MeV proton beam. Stem effect and the azimuthal angle dependence of the diode response were also evaluated. A maximum deviation in diamond detector signal from the average reading of less than 0.5% was found during the warm-up irradiation procedure. The detector response showed a good linear behavior as a function of dose with observed deviations below 0.5% over a dose range from 50 to 500 cGy. The detector response was dose rate independent, with deviations below 0.5% in the investigated dose rates ranging from 85 to 300 cGy∕min. Stem effect and azimuthal angle dependence of the diode signal were within 0.5%. Fractional depth dose curves and lateral beam profiles obtained with the diamond detector were in good agreement with those measured using reference dosimeters. The observed dosimetric properties of the synthetic single crystal diamond detector indicate that its behavior is proton energy independent and dose rate independent in the investigated energy and dose rate range and it is suitable for accurate relative dosimetric measurements in large as well as in small field high energy clinical proton beams.

WE-D-BRE-02: BEST IN PHYSICS (THERAPY) - Radiogenomic Modeling of Normal Tissue Toxicities in Prostate Cancer Patients Receiving Hypofractionated Radiotherapy

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

Coates, J; Jeyaseelan, K; Ybarra, N

2014-06-15

Purpose: It has been realized that inter-patient radiation sensitivity variability is a multifactorial process involving dosimetric, clinical, and genetic factors. Therefore, we explore a new framework to integrate physical, clinical, and biological data denoted as radiogenomic modeling. In demonstrating the feasibility of this work, we investigate the association of genetic variants (copy number variations [CNVs] and single nucleotide polymorphisms [SNPs]) with radiation induced rectal bleeding (RB) and erectile dysfunction (ED) while taking into account dosimetric and clinical variables in prostate cancer patients treated with curative irradiation. Methods: A cohort of 62 prostate cancer patients who underwent hypofractionated radiotherapy (66 Gymore » in 22 fractions) was retrospectively genotyped for CNV and SNP rs25489 in the xrcc1 DNA repair gene. Dosevolume metrics were extracted from treatment plans of 54 patients who had complete dosimetric profiles. Treatment outcomes were considered to be a Result of functional mapping of radiogenomic input variables according to a logit transformation. Model orders were estimated using resampling by leave-one out cross-validation (LOO-CV). Radiogenomic model performance was evaluated using area under the ROC curve (AUC) and LOO-CV. For continuous univariate dosimetric and clinical variables, Spearmans rank coefficients were calculated and p-values reported accordingly. In the case of binary variables, Chi-squared statistics and contingency table calculations were used. Results: Ten patients were found to have three copies of xrcc1 CNV (RB: χ2=14.6 [p<0.001] and ED: χ2=4.88[p=0.0272]) and twelve had heterozygous rs25489 SNP (RB: χ2=0.278[p=0.599] and ED: χ2=0.112[p=0.732]). LOO-CV identified penile bulb D60 as the only significant QUANTEC predictor (rs=0.312 [p=0.0145]) for ED. Radiogenomic modeling yielded statistically significant, cross-validated NTCP models for RB (rs=0.243[p=0.0443], AUC=0.665) and ED (rs=0.276[p=0.0217], AUC=0.754). Conclusion: The radiogenomic modeling approach presented herein has been shown to identify NTCP models which have increased predictive power. Furthermore, CNVs appears to be useful genetic variants when added to dosimetric NTCP models. This work was partially supported by CIHR grant MOP-114910.« less

Verification of intensity modulated radiation therapy beams using a tissue equivalent plastic scintillator dosimetry system

NASA Astrophysics Data System (ADS)

Petric, Martin Peter

This thesis describes the development and implementation of a novel method for the dosimetric verification of intensity modulated radiation therapy (IMRT) fields with several advantages over current techniques. Through the use of a tissue equivalent plastic scintillator sheet viewed by a charge-coupled device (CCD) camera, this method provides a truly tissue equivalent dosimetry system capable of efficiently and accurately performing field-by-field verification of IMRT plans. This work was motivated by an initial study comparing two IMRT treatment planning systems. The clinical functionality of BrainLAB's BrainSCAN and Varian's Helios IMRT treatment planning systems were compared in terms of implementation and commissioning, dose optimization, and plan assessment. Implementation and commissioning revealed differences in the beam data required to characterize the beam prior to use with the BrainSCAN system requiring higher resolution data compared to Helios. This difference was found to impact on the ability of the systems to accurately calculate dose for highly modulated fields, with BrainSCAN being more successful than Helios. The dose optimization and plan assessment comparisons revealed that while both systems use considerably different optimization algorithms and user-control interfaces, they are both capable of producing substantially equivalent dose plans. The extensive use of dosimetric verification techniques in the IMRT treatment planning comparison study motivated the development and implementation of a novel IMRT dosimetric verification system. The system consists of a water-filled phantom with a tissue equivalent plastic scintillator sheet built into the top surface. Scintillation light is reflected by a plastic mirror within the phantom towards a viewing window where it is captured using a CCD camera. Optical photon spread is removed using a micro-louvre optical collimator and by deconvolving a glare kernel from the raw images. Characterization of this new dosimetric verification system indicates excellent dose response and spatial linearity, high spatial resolution, and good signal uniformity and reproducibility. Dosimetric results from square fields, dynamic wedged fields, and a 7-field head and neck IMRT treatment plan indicate good agreement with film dosimetry distributions. Efficiency analysis of the system reveals a 50% reduction in time requirements for field-by-field verification of a 7-field IMRT treatment plan compared to film dosimetry.

A novel geometry-dosimetry label fusion method in multi-atlas segmentation for radiotherapy: a proof-of-concept study

NASA Astrophysics Data System (ADS)

Chang, Jina; Tian, Zhen; Lu, Weiguo; Gu, Xuejun; Chen, Mingli; Jiang, Steve B.

2017-05-01

Multi-atlas segmentation (MAS) has been widely used to automate the delineation of organs at risk (OARs) for radiotherapy. Label fusion is a crucial step in MAS to cope with the segmentation variabilities among multiple atlases. However, most existing label fusion methods do not consider the potential dosimetric impact of the segmentation result. In this proof-of-concept study, we propose a novel geometry-dosimetry label fusion method for MAS-based OAR auto-contouring, which evaluates the segmentation performance in terms of both geometric accuracy and the dosimetric impact of the segmentation accuracy on the resulting treatment plan. Differently from the original selective and iterative method for performance level estimation (SIMPLE), we evaluated and rejected the atlases based on both Dice similarity coefficient and the predicted error of the dosimetric endpoints. The dosimetric error was predicted using our previously developed geometry-dosimetry model. We tested our method in MAS-based rectum auto-contouring on 20 prostate cancer patients. The accuracy in the rectum sub-volume close to the planning tumor volume (PTV), which was found to be a dosimetric sensitive region of the rectum, was greatly improved. The mean absolute distance between the obtained contour and the physician-drawn contour in the rectum sub-volume 2 mm away from PTV was reduced from 3.96 mm to 3.36 mm on average for the 20 patients, with the maximum decrease found to be from 9.22 mm to 3.75 mm. We also compared the dosimetric endpoints predicted for the obtained contours with those predicted for the physician-drawn contours. Our method led to smaller dosimetric endpoint errors than the SIMPLE method in 15 patients, comparable errors in 2 patients, and slightly larger errors in 3 patients. These results indicated the efficacy of our method in terms of considering both geometric accuracy and dosimetric impact during label fusion. Our algorithm can be applied to different tumor sites and radiation treatments, given a specifically trained geometry-dosimetry model.

A novel geometry-dosimetry label fusion method in multi-atlas segmentation for radiotherapy: a proof-of-concept study.

PubMed

Chang, Jina; Tian, Zhen; Lu, Weiguo; Gu, Xuejun; Chen, Mingli; Jiang, Steve B

2017-05-07

Multi-atlas segmentation (MAS) has been widely used to automate the delineation of organs at risk (OARs) for radiotherapy. Label fusion is a crucial step in MAS to cope with the segmentation variabilities among multiple atlases. However, most existing label fusion methods do not consider the potential dosimetric impact of the segmentation result. In this proof-of-concept study, we propose a novel geometry-dosimetry label fusion method for MAS-based OAR auto-contouring, which evaluates the segmentation performance in terms of both geometric accuracy and the dosimetric impact of the segmentation accuracy on the resulting treatment plan. Differently from the original selective and iterative method for performance level estimation (SIMPLE), we evaluated and rejected the atlases based on both Dice similarity coefficient and the predicted error of the dosimetric endpoints. The dosimetric error was predicted using our previously developed geometry-dosimetry model. We tested our method in MAS-based rectum auto-contouring on 20 prostate cancer patients. The accuracy in the rectum sub-volume close to the planning tumor volume (PTV), which was found to be a dosimetric sensitive region of the rectum, was greatly improved. The mean absolute distance between the obtained contour and the physician-drawn contour in the rectum sub-volume 2 mm away from PTV was reduced from 3.96 mm to 3.36 mm on average for the 20 patients, with the maximum decrease found to be from 9.22 mm to 3.75 mm. We also compared the dosimetric endpoints predicted for the obtained contours with those predicted for the physician-drawn contours. Our method led to smaller dosimetric endpoint errors than the SIMPLE method in 15 patients, comparable errors in 2 patients, and slightly larger errors in 3 patients. These results indicated the efficacy of our method in terms of considering both geometric accuracy and dosimetric impact during label fusion. Our algorithm can be applied to different tumor sites and radiation treatments, given a specifically trained geometry-dosimetry model.

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

Sheng, Y; Ge, Y; Yuan, L

Purpose: To investigate the impact of outliers on knowledge modeling in radiation therapy, and develop a systematic workflow for identifying and analyzing geometric and dosimetric outliers using pelvic cases. Methods: Four groups (G1-G4) of pelvic plans were included: G1 (37 prostate cases), G2 (37 prostate plus lymph node cases), and G3 (37 prostate bed cases) are all clinical IMRT cases. G4 are 10 plans outside G1 re-planned with dynamic-arc to simulate dosimetric outliers. The workflow involves 2 steps: 1. identify geometric outliers, assess impact and clean up; 2. identify dosimetric outliers, assess impact and clean up.1. A baseline model wasmore » trained with all G1 cases. G2/G3 cases were then individually added to the baseline model as geometric outliers. The impact on the model was assessed by comparing leverage statistic of inliers (G1) and outliers (G2/G3). Receiver-operating-characteristics (ROC) analysis was performed to determine optimal threshold. 2. A separate baseline model was trained with 32 G1 cases. Each G4 case (dosimetric outliers) was then progressively added to perturb this model. DVH predictions were performed using these perturbed models for remaining 5 G1 cases. Normal tissue complication probability (NTCP) calculated from predicted DVH were used to evaluate dosimetric outliers’ impact. Results: The leverage of inliers and outliers was significantly different. The Area-Under-Curve (AUC) for differentiating G2 from G1 was 0.94 (threshold: 0.22) for bladder; and 0.80 (threshold: 0.10) for rectum. For differentiating G3 from G1, the AUC (threshold) was 0.68 (0.09) for bladder, 0.76 (0.08) for rectum. Significant increase in NTCP started from models with 4 dosimetric outliers for bladder (p<0.05), and with only 1 dosimetric outlier for rectum (p<0.05). Conclusion: We established a systematic workflow for identifying and analyzing geometric and dosimetric outliers, and investigated statistical metrics for detecting. Results validated the necessity for outlier detection and clean-up to enhance model quality in clinical practice. Research Grant: Varian master research grant.« less

SESAME: a software tool for the numerical dosimetric reconstruction of radiological accidents involving external sources and its application to the accident in Chile in December 2005.

PubMed

Huet, C; Lemosquet, A; Clairand, I; Rioual, J B; Franck, D; de Carlan, L; Aubineau-Lanièce, I; Bottollier-Depois, J F

2009-01-01

Estimating the dose distribution in a victim's body is a relevant indicator in assessing biological damage from exposure in the event of a radiological accident caused by an external source. This dose distribution can be assessed by physical dosimetric reconstruction methods. Physical dosimetric reconstruction can be achieved using experimental or numerical techniques. This article presents the laboratory-developed SESAME--Simulation of External Source Accident with MEdical images--tool specific to dosimetric reconstruction of radiological accidents through numerical simulations which combine voxel geometry and the radiation-material interaction MCNP(X) Monte Carlo computer code. The experimental validation of the tool using a photon field and its application to a radiological accident in Chile in December 2005 are also described.

Dosimetric effects of patient rotational setup errors on prostate IMRT treatments

NASA Astrophysics Data System (ADS)

Fu, Weihua; Yang, Yong; Li, Xiang; Heron, Dwight E.; Saiful Huq, M.; Yue, Ning J.

2006-10-01

The purpose of this work is to determine dose delivery errors that could result from systematic rotational setup errors (ΔΦ) for prostate cancer patients treated with three-phase sequential boost IMRT. In order to implement this, different rotational setup errors around three Cartesian axes were simulated for five prostate patients and dosimetric indices, such as dose-volume histogram (DVH), tumour control probability (TCP), normal tissue complication probability (NTCP) and equivalent uniform dose (EUD), were employed to evaluate the corresponding dosimetric influences. Rotational setup errors were simulated by adjusting the gantry, collimator and horizontal couch angles of treatment beams and the dosimetric effects were evaluated by recomputing the dose distributions in the treatment planning system. Our results indicated that, for prostate cancer treatment with the three-phase sequential boost IMRT technique, the rotational setup errors do not have significant dosimetric impacts on the cumulative plan. Even in the worst-case scenario with ΔΦ = 3°, the prostate EUD varied within 1.5% and TCP decreased about 1%. For seminal vesicle, slightly larger influences were observed. However, EUD and TCP changes were still within 2%. The influence on sensitive structures, such as rectum and bladder, is also negligible. This study demonstrates that the rotational setup error degrades the dosimetric coverage of target volume in prostate cancer treatment to a certain degree. However, the degradation was not significant for the three-phase sequential boost prostate IMRT technique and for the margin sizes used in our institution.

Comparison of dosimetric and radiobiological parameters on plans for prostate stereotactic body radiotherapy using an endorectal balloon for different dose-calculation algorithms and delivery-beam modes

NASA Astrophysics Data System (ADS)

Kang, Sang-Won; Suh, Tae-Suk; Chung, Jin-Beom; Eom, Keun-Yong; Song, Changhoon; Kim, In-Ah; Kim, Jae-Sung; Lee, Jeong-Woo; Cho, Woong

2017-02-01

The purpose of this study was to evaluate the impact of dosimetric and radiobiological parameters on treatment plans by using different dose-calculation algorithms and delivery-beam modes for prostate stereotactic body radiation therapy using an endorectal balloon. For 20 patients with prostate cancer, stereotactic body radiation therapy (SBRT) plans were generated by using a 10-MV photon beam with flattening filter (FF) and flattening-filter-free (FFF) modes. The total treatment dose prescribed was 42.7 Gy in 7 fractions to cover at least 95% of the planning target volume (PTV) with 95% of the prescribed dose. The dose computation was initially performed using an anisotropic analytical algorithm (AAA) in the Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA) and was then re-calculated using Acuros XB (AXB V. 11.0.34) with the same monitor units and multileaf collimator files. The dosimetric and the radiobiological parameters for the PTV and organs at risk (OARs) were analyzed from the dose-volume histogram. An obvious difference in dosimetric parameters between the AAA and the AXB plans was observed in the PTV and rectum. Doses to the PTV, excluding the maximum dose, were always higher in the AAA plans than in the AXB plans. However, doses to the other OARs were similar in both algorithm plans. In addition, no difference was observed in the dosimetric parameters for different delivery-beam modes when using the same algorithm to generate plans. As a result of the dosimetric parameters, the radiobiological parameters for the two algorithm plans presented an apparent difference in the PTV and the rectum. The average tumor control probability of the AAA plans was higher than that of the AXB plans. The average normal tissue complication probability (NTCP) to rectum was lower in the AXB plans than in the AAA plans. The AAA and the AXB plans yielded very similar NTCPs for the other OARs. In plans using the same algorithms, the NTCPs for delivery-beam modes showed no differences. This study demonstrated that the dosimetric and the radiobiological parameters for the PTV and the rectum affected the dose-calculation algorithms for prostate SBRT using an endorectal balloon. However, the dosimetric and the radiobiological parameters in the AAA and the AXB plans for other OARs were similar. Furthermore, difference between the dosimetric and the radiobiological parameters for different delivery-beam modes were not found when the same algorithm was used to generate the treatment plan.

WE-A-BRD-01: Innovation in Radiation Therapy Planning I: Knowledge Guided Treatment Planning

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

Wu, Q; Olsen, L

2014-06-15

Intensity modulated radiation therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) offer the capability of normal tissues and organs sparing. However, the exact amount of sparing is often unknown until the plan is complete. This lack of prior guidance has led to the iterative, trial and-error approach in current planning practice. Even with this effort the search for patient-specific optimal organ sparing is still strongly influenced by planner's experience. While experience generally helps in maximizing the dosimetric advantages of IMRT/VMAT, there have been several reports showing unnecessarily high degree of plan quality variability at individual institutions and amongst different institutions,more » even with a large amount of experience and the best available tools. Further, when physician and physicist evaluate a plan, the dosimetric quality of the plan is often compared with a standard protocol that ignores individual patient anatomy and tumor characteristic variations. In recent years, developments of knowledge models for clinical IMRT/VMAT planning guidance have shown promising clinical potentials. These knowledge models extract past expert clinical experience into mathematical models that predict dose sparing references at patient-specific level. For physicians and planners, these references provide objective values that reflect best achievable dosimetric constraints. For quality assurance, applying patient-specific dosimetry requirements will enable more quantitative and objective assessment of protocol compliance for complex IMRT planning. Learning Objectives: Modeling and representation of knowledge for knowledge-guided treatment planning. Demonstrations of knowledge-guided treatment planning with a few clinical caanatomical sites. Validation and evaluation of knowledge models for cost and quality effective standardization of plan optimization.« less

Local tissue air ratio in an anatomic phantom for 60Co total body irradiation.

PubMed

Vrtar, M; Purisić, A

1991-07-01

Tissue-air ratio (TAR), as the basic dosimetric function, is not ideally applicable to all important locations in total body irradiation (TBI) dosimetry because it generally refers to central ray measurements. We therefore introduced the local TAR which depends on the specific distribution of the scattering centres around the location of interest. Local TAR measurements were performed in an anatomic water phantom, produced by a sculptor, representing a patient during TBI in the real treatment position. A comparison has been made between TAR values, defined on the beam's ray at different locations in the anatomic phantom and cubic phantoms of different size. The local TAR values in the anatomic phantom, having more realistic outer surface curvatures, are lower by a few percent in most locations. We consider these values more accurate and better applicable to TBI conditions than those obtained in cubic water phantoms, even if the volume of the phantom is adapted to the particular side of the body.

Four-dimensional dose evaluation using deformable image registration in radiotherapy for liver cancer

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

Hoon Jung, Sang; Min Yoon, Sang; Ho Park, Sung

2013-01-15

Purpose: In order to evaluate the dosimetric impact of respiratory motion on the dose delivered to the target volume and critical organs during free-breathing radiotherapy, a four-dimensional dose was evaluated using deformable image registration (DIR). Methods: Four-dimensional computed tomography (4DCT) images were acquired for 11 patients who were treated for liver cancer. Internal target volume-based treatment planning and dose calculation (3D dose) were performed using the end-exhalation phase images. The four-dimensional dose (4D dose) was calculated based on DIR of all phase images from 4DCT to the planned image. Dosimetric parameters from the 4D dose, were calculated and compared withmore » those from the 3D dose. Results: There was no significant change of the dosimetric parameters for gross tumor volume (p > 0.05). The increase D{sub mean} and generalized equivalent uniform dose (gEUD) for liver were by 3.1%{+-} 3.3% (p= 0.003) and 2.8%{+-} 3.3% (p= 0.008), respectively, and for duodenum, they were decreased by 15.7%{+-} 11.2% (p= 0.003) and 15.1%{+-} 11.0% (p= 0.003), respectively. The D{sub max} and gEUD for stomach was decreased by 5.3%{+-} 5.8% (p= 0.003) and 9.7%{+-} 8.7% (p= 0.003), respectively. The D{sub max} and gEUD for right kidney was decreased by 11.2%{+-} 16.2% (p= 0.003) and 14.9%{+-} 16.8% (p= 0.005), respectively. For left kidney, D{sub max} and gEUD were decreased by 11.4%{+-} 11.0% (p= 0.003) and 12.8%{+-} 12.1% (p= 0.005), respectively. The NTCP values for duodenum and stomach were decreased by 8.4%{+-} 5.8% (p= 0.003) and 17.2%{+-} 13.7% (p= 0.003), respectively. Conclusions: The four-dimensional dose with a more realistic dose calculation accounting for respiratory motion revealed no significant difference in target coverage and potentially significant change in the physical and biological dosimetric parameters in normal organs during free-breathing treatment.« less

SU-F-T-342: Dosimetric Constraint Prediction Guided Automatic Mulit-Objective Optimization for Intensity Modulated Radiotherapy

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

Song, T; Zhou, L; Li, Y

Purpose: For intensity modulated radiotherapy, the plan optimization is time consuming with difficulties of selecting objectives and constraints, and their relative weights. A fast and automatic multi-objective optimization algorithm with abilities to predict optimal constraints and manager their trade-offs can help to solve this problem. Our purpose is to develop such a framework and algorithm for a general inverse planning. Methods: There are three main components contained in this proposed multi-objective optimization framework: prediction of initial dosimetric constraints, further adjustment of constraints and plan optimization. We firstly use our previously developed in-house geometry-dosimetry correlation model to predict the optimal patient-specificmore » dosimetric endpoints, and treat them as initial dosimetric constraints. Secondly, we build an endpoint(organ) priority list and a constraint adjustment rule to repeatedly tune these constraints from their initial values, until every single endpoint has no room for further improvement. Lastly, we implement a voxel-independent based FMO algorithm for optimization. During the optimization, a model for tuning these voxel weighting factors respecting to constraints is created. For framework and algorithm evaluation, we randomly selected 20 IMRT prostate cases from the clinic and compared them with our automatic generated plans, in both the efficiency and plan quality. Results: For each evaluated plan, the proposed multi-objective framework could run fluently and automatically. The voxel weighting factor iteration time varied from 10 to 30 under an updated constraint, and the constraint tuning time varied from 20 to 30 for every case until no more stricter constraint is allowed. The average total costing time for the whole optimization procedure is ∼30mins. By comparing the DVHs, better OAR dose sparing could be observed in automatic generated plan, for 13 out of the 20 cases, while others are with competitive results. Conclusion: We have successfully developed a fast and automatic multi-objective optimization for intensity modulated radiotherapy. This work is supported by the National Natural Science Foundation of China (No: 81571771)« less

Dosimetric effects of rotational offsets in stereotactic body radiation therapy (SBRT) for lung cancer

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

Yang, Yun; Catalano, Suzanne; Kelsey, Chris R.

2014-04-01

To quantitatively evaluate dosimetric effects of rotational offsets in stereotactic body radiation therapy (SBRT) for lung cancer. Overall, 11 lung SBRT patients (8 female and 3 male; mean age: 75.0 years) with medially located tumors were included. Treatment plans with simulated rotational offsets of 1°, 3°, and 5° in roll, yaw, and pitch were generated and compared with the original plans. Both clockwise and counterclockwise rotations were investigated. The following dosimetric metrics were quantitatively evaluated: planning target volume coverage (PTV V{sub 100%}), max PTV dose (PTV D{sub max}), percentage prescription dose to 0.35 cc of cord (cord D{sub 0.35} {submore » cc}), percentage prescription dose to 0.35 cc and 5 cc of esophagus (esophagus D{sub 0.35} {sub cc} and D{sub 5} {sub cc}), and volume of the lungs receiving at least 20 Gy (lung V{sub 20}). Statistical significance was tested using Wilcoxon signed rank test at the significance level of 0.05. Overall, small differences were found in all dosimetric matrices at all rotational offsets: 95.6% of differences were < 1% or < 1 Gy. Of all rotational offsets, largest change in PTV V{sub 100%}, PTV D{sub max}, cord D{sub 0.35} {sub cc}, esophagus D{sub 0.35} {sub cc}, esophagus D{sub 5} {sub cc}, and lung V{sub 20} was − 8.36%, − 6.06%, 11.96%, 8.66%, 6.02%, and − 0.69%, respectively. No significant correlation was found between any dosimetric change and tumor-to-cord/esophagus distances (R{sup 2} range: 0 to 0.44). Larger dosimetric changes and intersubject variations were observed at larger rotational offsets. Small dosimetric differences were found owing to rotational offsets up to 5° in lung SBRT for medially located tumors. Larger intersubject variations were observed at larger rotational offsets.« less

SU-F-T-05: Dosimetric Evaluation and Validation of Newlydeveloped Well Chamber for Use in the Calibration of Brachytherapy Sources

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

Saminathan, S; Godson, H; Ponmalar, R

2016-06-15

Purpose: To evaluate the dosimetric characteristics of newly developed well type ionization chamber and to validate the results with the commercially available calibrated well chambers that are being used for the calibration of brachytherapy sources. Methods: The newly developed well type ionization chamber (BDS 1000) has been designed for the convenient use in brachytherapy which is open to atmospheric condition. The chamber has a volume of 240 cm3 and weight of 2.5 Kg. The calibration of the radioactive source with activities from 0.01 mCi to 20 Ci can be carried out using this chamber. The dosimetric parameters such as leakagemore » current, stability, scattering effect, ion collection efficiency, reference air kerma rate and nominal response with energy were carried out with the BDS 1000 well type ion chamber. The evaluated dosimetric characteristics of BDS1000 well chamber were validated with two other commercially available well chambers (HDR 1000 plus and BTC/3007). Results: The measured leakage current observed was negligible for the newly developed BDS 1000 well type ion chamber. The ion collection efficiency was close to 1 and the response of the chamber was found to be very stable. The determined sweet spot was at 42 mm from bottom of the chamber insert. The reference air kerma rate was found to be 4.634 × 105 Gym2hr-1A-1 for the BDS 1000 well chamber. The overall dosimetric characteristics of BDS 1000 well chamber was in good agreement with the dosimetric properties of other two well chambers. Conclusion: The dosimetric study shows that the newly developed BDS 1000 well type ionization chamber is high sensitive and reliable chamber for reference air kerma strength calibration. The results obtained confirm that this chamber can be used for the calibration of HDR and LDR brachytherapy sources.« less

On the use of advanced numerical models for the evaluation of dosimetric parameters and the verification of exposure limits at workplaces.

PubMed

Catarinucci, L; Tarricone, L

2009-12-01

With the next transposition of the 2004/40/EC Directive, employers will become responsible for the electromagnetic field level at the workplace. To make this task easier, the scientific community is compiling practical guidelines to be followed. This work aims at enriching such guidelines, especially for the dosimetric issues. More specifically, some critical aspects related to the application of numerical dosimetric techniques for the verification of the safety limit compliance have been highlighted. In particular, three different aspects have been considered: the dosimetric parameter dependence on the shape and the inner characterisation of the exposed subject as well as on the numerical algorithm used, and the correlation between reference limits and basic restriction. Results and discussions demonstrate how, even by using sophisticated numerical techniques, in some cases a complex interpretation of the result is mandatory.

Comparison of the dose distribution obtained from dosimetric systems with intensity modulated radiotherapy planning system in the treatment of prostate cancer

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

Gökçe, M., E-mail: mgokce@adu.edu.tr; Uslu, D. Koçyiğit; Ertunç, C.

The aim of this study is to compare Intensity Modulated Radiation Therapy (IMRT) plan of prostate cancer patients with different dose verification systems in dosimetric aspects and to compare these systems with each other in terms of reliability, applicability and application time. Dosimetric control processes of IMRT plan of three prostate cancer patients were carried out using thermoluminescent dosimeter (TLD), ion chamber (IC) and 2D Array detector systems. The difference between the dose values obtained from the dosimetric systems and treatment planning system (TPS) were found to be about % 5. For the measured (TLD) and calculated (TPS) doses %3more » percentage differences were obtained for the points close to center while percentage differences increased at the field edges. It was found that TLD and IC measurements will increase the precision and reliability of the results of 2D Array.« less

CyberArc: a non-coplanar-arc optimization algorithm for CyberKnife

NASA Astrophysics Data System (ADS)

Kearney, Vasant; Cheung, Joey P.; McGuinness, Christopher; Solberg, Timothy D.

2017-07-01

The goal of this study is to demonstrate the feasibility of a novel non-coplanar-arc optimization algorithm (CyberArc). This method aims to reduce the delivery time of conventional CyberKnife treatments by allowing for continuous beam delivery. CyberArc uses a 4 step optimization strategy, in which nodes, beams, and collimator sizes are determined, source trajectories are calculated, intermediate radiation models are generated, and final monitor units are calculated, for the continuous radiation source model. The dosimetric results as well as the time reduction factors for CyberArc are presented for 7 prostate and 2 brain cases. The dosimetric quality of the CyberArc plans are evaluated using conformity index, heterogeneity index, local confined normalized-mutual-information, and various clinically relevant dosimetric parameters. The results indicate that the CyberArc algorithm dramatically reduces the treatment time of CyberKnife plans while simultaneously preserving the dosimetric quality of the original plans.

CyberArc: a non-coplanar-arc optimization algorithm for CyberKnife.

PubMed

Kearney, Vasant; Cheung, Joey P; McGuinness, Christopher; Solberg, Timothy D

2017-06-26

The goal of this study is to demonstrate the feasibility of a novel non-coplanar-arc optimization algorithm (CyberArc). This method aims to reduce the delivery time of conventional CyberKnife treatments by allowing for continuous beam delivery. CyberArc uses a 4 step optimization strategy, in which nodes, beams, and collimator sizes are determined, source trajectories are calculated, intermediate radiation models are generated, and final monitor units are calculated, for the continuous radiation source model. The dosimetric results as well as the time reduction factors for CyberArc are presented for 7 prostate and 2 brain cases. The dosimetric quality of the CyberArc plans are evaluated using conformity index, heterogeneity index, local confined normalized-mutual-information, and various clinically relevant dosimetric parameters. The results indicate that the CyberArc algorithm dramatically reduces the treatment time of CyberKnife plans while simultaneously preserving the dosimetric quality of the original plans.

Radiation-Related Treatment Effects across the Age Spectrum: Differences and Similarities or What The Old and Young Can Learn From Each Other

PubMed Central

Krasin, Matthew J.; Constine, Louis S.; Friedman, Debra; Marks, Lawrence B.

2010-01-01

Radiation related effects in children and adults limit the delivery of effective radiation doses and result in long-term morbidity affecting function and quality of life. Improvements in our understanding of the etiology and biology of these effects, including the influence of clinical variables, dosimetric factors, and the underlying biologic processes has made treatment safer and more efficacious. However, the approach to studying and understanding these effects differs between children and adults. By using the pulmonary and skeletal organ systems as examples, comparisons are made across the age spectrum for radiation related effects including pneumonitis, pulmonary fibrosis, osteonecrosis and fracture. Methods for dosimetric analysis, incorporation of imaging and biology as well a length of follow-up are compared, contrasted and discussed for both organ systems in children and adults. Better understanding of each age specific approach and how it differs may improve our ability to study late effects of radiation across the ages PMID:19959028

Correlation of Clinical and Dosimetric Factors With Adverse Pulmonary Outcomes in Children After Lung Irradiation

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

Venkatramani, Rajkumar, E-mail: rvenkatramani@chla.usc.edu; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California; Kamath, Sunil

Purpose: To identify the incidence and the risk factors for pulmonary toxicity in children treated for cancer with contemporary lung irradiation. Methods and Materials: We analyzed clinical features, radiographic findings, pulmonary function tests, and dosimetric parameters of children receiving irradiation to the lung fields over a 10-year period. Results: We identified 109 patients (75 male patients). The median age at irradiation was 13.8 years (range, 0.04-20.9 years). The median follow-up period was 3.4 years. The median prescribed radiation dose was 21 Gy (range, 0.4-64.8 Gy). Pulmonary toxic chemotherapy included bleomycin in 58.7% of patients and cyclophosphamide in 83.5%. The followingmore » pulmonary outcomes were identified and the 5-year cumulative incidence after irradiation was determined: pneumonitis, 6%; chronic cough, 10%; pneumonia, 35%; dyspnea, 11%; supplemental oxygen requirement, 2%; radiographic interstitial lung disease, 40%; and chest wall deformity, 12%. One patient died of progressive respiratory failure. Post-irradiation pulmonary function tests available from 44 patients showed evidence of obstructive lung disease (25%), restrictive disease (11%), hyperinflation (32%), and abnormal diffusion capacity (12%). Thoracic surgery, bleomycin, age, mean lung irradiation dose (MLD), maximum lung dose, prescribed dose, and dosimetric parameters between V{sub 22} (volume of lung exposed to a radiation dose ≥22 Gy) and V{sub 30} (volume of lung exposed to a radiation dose ≥30 Gy) were significant for the development of adverse pulmonary outcomes on univariate analysis. MLD, maximum lung dose, and V{sub dose} (percentage of volume of lung receiving the threshold dose or greater) were highly correlated. On multivariate analysis, MLD was the sole significant predictor of adverse pulmonary outcome (P=.01). Conclusions: Significant pulmonary dysfunction occurs in children receiving lung irradiation by contemporary techniques. MLD rather than prescribed dose should be used to perform risk stratification of patients receiving lung irradiation.« less

Errors in radiation oncology: A study in pathways and dosimetric impact

PubMed Central

Drzymala, Robert E.; Purdy, James A.; Michalski, Jeff

2005-01-01

As complexity for treating patients increases, so does the risk of error. Some publications have suggested that record and verify (R&V) systems may contribute in propagating errors. Direct data transfer has the potential to eliminate most, but not all, errors. And although the dosimetric consequences may be obvious in some cases, a detailed study does not exist. In this effort, we examined potential errors in terms of scenarios, pathways of occurrence, and dosimetry. Our goal was to prioritize error prevention according to likelihood of event and dosimetric impact. For conventional photon treatments, we investigated errors of incorrect source‐to‐surface distance (SSD), energy, omitted wedge (physical, dynamic, or universal) or compensating filter, incorrect wedge or compensating filter orientation, improper rotational rate for arc therapy, and geometrical misses due to incorrect gantry, collimator or table angle, reversed field settings, and setup errors. For electron beam therapy, errors investigated included incorrect energy, incorrect SSD, along with geometric misses. For special procedures we examined errors for total body irradiation (TBI, incorrect field size, dose rate, treatment distance) and LINAC radiosurgery (incorrect collimation setting, incorrect rotational parameters). Likelihood of error was determined and subsequently rated according to our history of detecting such errors. Dosimetric evaluation was conducted by using dosimetric data, treatment plans, or measurements. We found geometric misses to have the highest error probability. They most often occurred due to improper setup via coordinate shift errors or incorrect field shaping. The dosimetric impact is unique for each case and depends on the proportion of fields in error and volume mistreated. These errors were short‐lived due to rapid detection via port films. The most significant dosimetric error was related to a reversed wedge direction. This may occur due to incorrect collimator angle or wedge orientation. For parallel‐opposed 60° wedge fields, this error could be as high as 80% to a point off‐axis. Other examples of dosimetric impact included the following: SSD, ~2%/cm for photons or electrons; photon energy (6 MV vs. 18 MV), on average 16% depending on depth, electron energy, ~0.5cm of depth coverage per MeV (mega‐electron volt). Of these examples, incorrect distances were most likely but rapidly detected by in vivo dosimetry. Errors were categorized by occurrence rate, methods and timing of detection, longevity, and dosimetric impact. Solutions were devised according to these criteria. To date, no one has studied the dosimetric impact of global errors in radiation oncology. Although there is heightened awareness that with increased use of ancillary devices and automation, there must be a parallel increase in quality check systems and processes, errors do and will continue to occur. This study has helped us identify and prioritize potential errors in our clinic according to frequency and dosimetric impact. For example, to reduce the use of an incorrect wedge direction, our clinic employs off‐axis in vivo dosimetry. To avoid a treatment distance setup error, we use both vertical table settings and optical distance indicator (ODI) values to properly set up fields. As R&V systems become more automated, more accurate and efficient data transfer will occur. This will require further analysis. Finally, we have begun examining potential intensity‐modulated radiation therapy (IMRT) errors according to the same criteria. PACS numbers: 87.53.Xd, 87.53.St PMID:16143793

Pixel response-based EPID dosimetry for patient specific QA.

PubMed

Han, Bin; Ding, Aiping; Lu, Minghui; Xing, Lei

2017-01-01

Increasing use of high dose rate, flattening filter free (FFF), and/or small-sized field beams presents a significant challenge to the medical physics community. In this work, we develop a strategy of using a high spatial resolution and high frame rate amorphous silicon flat panel electronic portal imaging device (EPID) for dosimetric measurements of these challenging cases, as well as for conventional external beam therapy. To convert a series of raw EPID-measured radiation field images into water-based dose distribution, a pixel-to-pixel dose-response function of the EPID specific to the linac is essential. The response function was obtained by using a Monte Carlo simulation of the photon transport in the EPID with a comprehensive calibration. After the raw image was converted into the primary incident photon fluence, the fluence was further convolved into a water-based dose distribution of the dynamic field by using a pregenerated pencil-beam kernel. The EPID-based dosimetric measurement technique was validated using beams with and without flattening filter of all energies available in Varian TrueBeam STx™. Both regularly and irregularly shaped fields measured using a PTW 729 ion chamber array in plastic water phantom. The technique was also applied to measure the distribution for a total of 23 treatment plans of different energies to evaluate the accuracy of the proposed approach. The EPID measurements of square fields of 4 × 4 cm 2 to 20 × 20 cm 2 , circular fields of 2-15 cm diameters, rectangular fields of various sizes, and irregular MLC fields were in accordance with measurements using a Farmer chamber and/or ion chamber array. The 2D absolute dose maps generated from EPID raw images agreed with ion chamber measurements to within 1.5% for all fields. For the 23 patient cases examined in this work, the average γ-index passing rate were found to be 99.2 ± 0.6%, 97.4 ± 2.4%, and 72.6 ± 8.4%, respectively, for criterions of 3 mm/3%, 2 mm/2%, and 1 mm/1%. The high spatial resolution and high frame rate EPID provides an accurate and efficient dosimetric tool for QA of modern radiation therapy. Accurate absolute 2D dose maps can be generated from the system for an independent dosimetric verification of treatment delivery. © 2016 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Application of dual-energy CT to suppression of metal artefact caused by pedicle screw fixation in radiotherapy: a feasibility study using original phantom

NASA Astrophysics Data System (ADS)

Wang, Tianyuan; Ishihara, Takeaki; Kono, Atsushi; Yoshida, Naoki; Akasaka, Hiroaki; Mukumoto, Naritoshi; Yada, Ryuichi; Ejima, Yasuo; Yoshida, Kenji; Miyawaki, Daisuke; Kakutani, Kenichiro; Nishida, Kotaro; Negi, Noriyuki; Minami, Toshiaki; Aoyama, Yuuichi; Takahashi, Satoru; Sasaki, Ryohei

2017-08-01

The objective of the present study was the determination of the potential dosimetric benefits of using metal-artefact-suppressed dual-energy computed tomography (DECT) images for cases involving pedicle screw implants in spinal sites. A heterogeneous spinal phantom was designed for the investigation of the dosimetric effect of the pedicle-screw-related artefacts. The dosimetric comparisons were first performed using a conventional two-directional opposed (AP-PA) plan, and then a volumetric modulated arc therapy (VMAT) plan, which are both used for the treatment of spinal metastases in our institution. The results of Acuros® XB dose-to-medium (Dm) and dose-to-water (Dw) calculations using different imaging options were compared with experimental measurements including the chamber and film dosimetries in the spinal phantom. A dual-energy composition image with a weight factor of  -0.2 and a dual-energy monochromatic image (DEMI) with an energy level of 180 keV were found to have superior abilities for artefact suppression. The Dm calculations revealed greater dosimetric effects of the pedicle screw-related artefacts compared to the Dw calculations. The results of conventional single-energy computed tomography showed that, although the pedicle screws were made from low-Z titanium alloy, the metal artefacts still have dosimetric effects, namely, an average (maximum) Dm error of 4.4% (5.6%) inside the spinal cord for a complex VMAT treatment plan. Our findings indicate that metal-artefact suppression using the proposed DECT (DEMI) approach is promising for improving the dosimetric accuracy near the implants and inside the spinal cord (average (maximum) Dm error of 1.1% (2.0%)).

Patient feature based dosimetric Pareto front prediction in esophageal cancer radiotherapy.

PubMed

Wang, Jiazhou; Jin, Xiance; Zhao, Kuaike; Peng, Jiayuan; Xie, Jiang; Chen, Junchao; Zhang, Zhen; Studenski, Matthew; Hu, Weigang

2015-02-01

To investigate the feasibility of the dosimetric Pareto front (PF) prediction based on patient's anatomic and dosimetric parameters for esophageal cancer patients. Eighty esophagus patients in the authors' institution were enrolled in this study. A total of 2928 intensity-modulated radiotherapy plans were obtained and used to generate PF for each patient. On average, each patient had 36.6 plans. The anatomic and dosimetric features were extracted from these plans. The mean lung dose (MLD), mean heart dose (MHD), spinal cord max dose, and PTV homogeneity index were recorded for each plan. Principal component analysis was used to extract overlap volume histogram (OVH) features between PTV and other organs at risk. The full dataset was separated into two parts; a training dataset and a validation dataset. The prediction outcomes were the MHD and MLD. The spearman's rank correlation coefficient was used to evaluate the correlation between the anatomical features and dosimetric features. The stepwise multiple regression method was used to fit the PF. The cross validation method was used to evaluate the model. With 1000 repetitions, the mean prediction error of the MHD was 469 cGy. The most correlated factor was the first principal components of the OVH between heart and PTV and the overlap between heart and PTV in Z-axis. The mean prediction error of the MLD was 284 cGy. The most correlated factors were the first principal components of the OVH between heart and PTV and the overlap between lung and PTV in Z-axis. It is feasible to use patients' anatomic and dosimetric features to generate a predicted Pareto front. Additional samples and further studies are required improve the prediction model.

TU-C-17A-10: Patient Features Based Dosimetric Pareto Front Prediction In Esophagus Cancer Radiotherapy

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

Wang, J; Zhao, K; Peng, J

2014-06-15

Purpose: The purpose of this study is to study the feasibility of the dosimetric pareto front (PF) prediction based on patient anatomic and dosimetric parameters for esophagus cancer patients. Methods: Sixty esophagus patients in our institution were enrolled in this study. A total 2920 IMRT plans were created to generated PF for each patient. On average, each patient had 48 plans. The anatomic and dosimetric features were extracted from those plans. The mean lung dose (MLD), mean heart dose (MHD), spinal cord max dose and PTV homogeneous index (PTVHI) were recorded for each plan. The principal component analysis (PCA) wasmore » used to extract overlap volume histogram (OVH) features between PTV and other critical organs. The full dataset was separated into two parts include the training dataset and the validation dataset. The prediction outcomes were the MHD and MLD for the current study. The spearman rank correlation coefficient was used to evaluate the correlation between the anatomical features and dosimetric features. The PF was fit by the the stepwise multiple regression method. The cross-validation method was used to evaluation the model. Results: The mean prediction error of the MHD was 465 cGy with 100 repetitions. The most correlated factors were the first principal components of the OVH between heart and PTV, and the overlap between heart and PTV in Z-axis. The mean prediction error of the MLD was 195 cGy. The most correlated factors were the first principal components of the OVH between lung and PTV, and the overlap between lung and PTV in Z-axis. Conclusion: It is feasible to use patients anatomic and dosimetric features to generate a predicted PF. Additional samples and further studies were required to get a better prediction model.« less

Patient feature based dosimetric Pareto front prediction in esophageal cancer radiotherapy

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

Wang, Jiazhou; Zhao, Kuaike; Peng, Jiayuan

2015-02-15

Purpose: To investigate the feasibility of the dosimetric Pareto front (PF) prediction based on patient’s anatomic and dosimetric parameters for esophageal cancer patients. Methods: Eighty esophagus patients in the authors’ institution were enrolled in this study. A total of 2928 intensity-modulated radiotherapy plans were obtained and used to generate PF for each patient. On average, each patient had 36.6 plans. The anatomic and dosimetric features were extracted from these plans. The mean lung dose (MLD), mean heart dose (MHD), spinal cord max dose, and PTV homogeneity index were recorded for each plan. Principal component analysis was used to extract overlapmore » volume histogram (OVH) features between PTV and other organs at risk. The full dataset was separated into two parts; a training dataset and a validation dataset. The prediction outcomes were the MHD and MLD. The spearman’s rank correlation coefficient was used to evaluate the correlation between the anatomical features and dosimetric features. The stepwise multiple regression method was used to fit the PF. The cross validation method was used to evaluate the model. Results: With 1000 repetitions, the mean prediction error of the MHD was 469 cGy. The most correlated factor was the first principal components of the OVH between heart and PTV and the overlap between heart and PTV in Z-axis. The mean prediction error of the MLD was 284 cGy. The most correlated factors were the first principal components of the OVH between heart and PTV and the overlap between lung and PTV in Z-axis. Conclusions: It is feasible to use patients’ anatomic and dosimetric features to generate a predicted Pareto front. Additional samples and further studies are required improve the prediction model.« less

Dosimetric effects of endorectal balloons on intensity-modulated radiation therapy plans for prostate cancer

NASA Astrophysics Data System (ADS)

Kim, Jae-Sung; Chung, Jin-Beom; Kim, In-Ah; Eom, Keun-Yong

2013-10-01

We used an endorectal balloon (ERB) for prostate immobilization during intensity-modulated radiotherapy (IMRT) for prostate cancer treatment. To investigate the dosimetric effects of ERB-filling materials, we changed the ERB Hounsfield unit (HU) from 0 to 1000 HU in 200-HU intervals to simulate the various ERB fillings; 0 HU simulated a water-filled ERB, and 1000 HU simulated the densest material-filled ERB. Dosimetric data (coverage, homogeneity, conformity, maximal dose, and typical volume dose) for the tumor and the organs at risk (OARs) were evaluated in prostate IMRT treatment plans with 6-MV and 15-MV beams. The tumor coverage appeared to differ by approximately 1%, except for the clinical target volume (CTV) V100% and the planning target volume (PTV) V100%. The largest difference for the various ERB fillings was observed in the PTV V100%. In spite of increasing HU, the prostate IMRT plans at both energies had relatively low dosimetric effects on the PTV and the CTV. However, the maximal and the typical volume doses (D25%, D30%, and D50%) to the rectal wall and the bladder increased with increasing HU. For an air-filled ERB, the maximal doses to the rectal wall and the monitor units were lower than the corresponding values for the water-filled and the densest material-filled ERBs. An air-filled ERB spared the rectal wall because of its dosimetric effect. Thus, we conclude that the use of an air-filled ERB provides a dosimetric benefit to the rectal wall without a loss of target coverage and is an effective option for prostate IMRT treatment.

Treatment plan comparison of linac step and shoot, tomotherapy, rapidarc, and proton therapy for prostate cancer by using the dosimetrical and the biological indices

NASA Astrophysics Data System (ADS)

Lee, Suk; Cao, Yuan Jie; Chang, Kyung Hwan; Shim, Jang Bo; Kim, Kwang Hyeon; Lee, Nam Kwon; Park, Young Je; Kim, Chul Yong; Cho, Sam Ju; Lee, Sang Hoon; Min, Chul Kee; Kim, Woo Chul; Cho, Kwang Hwan; Huh, Hyun Do; Lim, Sangwook; Shin, Dongho

2015-07-01

The purpose of this study was to use various dosimetrical indices to determine the best intensitymodulated radiation therapy (IMRT) modality - for treating patients with prostate cancer. Ten patients with prostate cancer were included in this study. IMRT plans were designed to include different modalities, including the linac step and shoot, tomotherapy, RapidArc, and proton systems. Various dosimetrical indices, like the prescription isodose to target volume (PITV) ratio, conformity index (CI), homogeneity index (HI), target coverage index (TCI), modified dose homogeneity index (MHI), conformation number (CN), critical organ scoring index (COSI), and quality factor (QF), were determined to compare the different treatment plans. Biological indices, such as the generalized equivalent uniform dose (gEUD) based the tumor control probability (TCP), and the normal tissue complication probability (NTCP), were also calculated and used to compare the treatment plans. The RapidArc plan attained better PTV coverage, as evidenced by its superior PITV, CI, TCI, MHI, and CN values. Regarding organ at risks (OARs), proton therapy exhibited superior dose sparing for the rectum and the bowel in low dose volumes, whereas the tomotherapy and RapidArc plans achieved better dose sparing in high dose volumes. The QF scores showed no significant difference among these plans (p = 0.701). The average TCPs for prostate tumors in the RapidArc, linac and proton plans were higher than the average TCP for Tomotherapy (98.79%, 98.76%, and 98.75% vs. 98.70%, respectively). Regarding the rectum NTCP, RapidArc showed the most favorable result (0.09%) whereas linac resulted in the best bladder NTCP (0.08%).

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

Zhang, J; Li, X; Liu, G

Purpose: We compare and investigate the dosimetric impacts on pencil beam scanning (PBS) proton treatment plans generated with CT calibration curves from four different CT scanners and one averaged ‘global’ CT calibration curve. Methods: The four CT scanners are located at three different hospital locations within the same health system. CT density calibration curves were collected from these scanners using the same CT calibration phantom and acquisition parameters. Mass density to HU value tables were then commissioned in a commercial treatment planning system. Five disease sites were chosen for dosimetric comparisons at brain, lung, head and neck, adrenal, and prostate.more » Three types of PBS plans were generated at each treatment site using SFUD, IMPT, and robustness optimized IMPT techniques. 3D dose differences were investigated using 3D Gamma analysis. Results: The CT calibration curves for all four scanners display very similar shapes. Large HU differences were observed at both the high HU and low HU regions of the curves. Large dose differences were generally observed at the distal edges of the beams and they are beam angle dependent. Out of the five treatment sites, lung plans exhibits the most overall range uncertainties and prostate plans have the greatest dose discrepancy. There are no significant differences between the SFUD, IMPT, and the RO-IMPT methods. 3D gamma analysis with 3%, 3 mm criteria showed all plans with greater than 95% passing rate. Two of the scanners with close HU values have negligible dose difference except for lung. Conclusion: Our study shows that there are more than 5% dosimetric differences between different CT calibration curves. PBS treatment plans generated with SFUD, IMPT, and the robustness optimized IMPT has similar sensitivity to the CT density uncertainty. More patient data and tighter gamma criteria based on structure location and size will be used for further investigation.« less

The Bebig Valencia-type skin applicators: Dosimetric study and implementation of a dosimetric hybrid technique.

PubMed

Anagnostopoulos, Georgios; Andrássy, Michael; Baltas, Dimos

To determine the relative dose rate distribution in water for the Bebig 20 mm and 30 mm skin applicators and report results in a form suitable for potential clinical use. Results for both skin applicators are also provided in the form of a hybrid Task Group 43 (TG-43) dosimetry technique. Furthermore, the radiation leakage around both skin applicators from the radiation protection point of view and the impact of the geometrical source position uncertainties are studied and reported. Monte Carlo simulations were performed using the MCNP 6.1 general purpose code, which was benchmarked against published dosimetry data for the Bebig Ir2.A85-2 high-dose-rate iridium-192 source, as well as the dosimetry data for the two Elekta skin applicators. Both Bebig skin applicators were modeled, and the dose rate distributions in a water phantom were calculated. The dosimetric quantities derived according to a hybrid TG-43 dosimetry technique are provided with their corresponding uncertainty values. The air kerma rate in air was simulated in the vicinity of each skin applicator to assess the radiation leakage. Results from the Monte Carlo simulations of both skin applicators are presented in the form of figures and relative dose rate tables, and additionally with the aid of the quantities defined in the hybrid TG-43 dosimetry technique and their corresponding uncertainty values. Their output factors, flatness, and penumbra values were found comparable to the Elekta skin applicators. The radiation shielding was evaluated to be adequate. The effect of potential uncertainties in source positioning on dosimetry should be investigated as part of applicator commissioning. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Gamma dosimetric parameters in some skeletal muscle relaxants

NASA Astrophysics Data System (ADS)

Manjunatha, H. C.

2017-09-01

We have studied the attenuation of gamma radiation of energy ranging from 84 keV to 1330 keV (^{170}Tm, ^{22}Na,^{137}Cs, and ^{60}Co) in some commonly used skeletal muscle relaxants such as tubocurarine chloride, gallamine triethiodide, pancuronium bromide, suxamethonium bromide and mephenesin. The mass attenuation coefficient is measured from the attenuation experiment. In the present work, we have also proposed the direct relation between mass attenuation coefficient (μ /ρ ) and mass energy absorption coefficient (μ _{en}/ρ ) based on the nonlinear fitting procedure. The gamma dosimetric parameters such as mass energy absorption coefficient (μ _{en}/ρ ), effective atomic number (Z_{eff}), effective electron density (N_{el}), specific γ-ray constant, air kerma strength and dose rate are evaluated from the measured mass attentuation coefficient. These measured gamma dosimetric parameters are compared with the theoretical values. The measured values agree with the theoretical values. The studied gamma dosimetric values for the relaxants are useful in medical physics and radiation medicine.

SU-G-TeP3-11: Radiobiological-Cum-Dosimetric Quality Assurance of Complex Radiotherapy Plans

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

Paudel, N; Narayanasamy, G; Zhang, X

2016-06-15

Purpose: Dosimetric gamma-analysis used for QA of complex radiotherapy plans tests the dosimetric equivalence of a delivered plan with the treatment planning system (TPS) optimized plan. It does not examine whether a dosimetric difference results in any radiobiological difference. This study introduces a method to test the radiobiological and dosimetric equivalence between a delivered and the TPS optimized plan. Methods: Six head and neck and seven lung cancer VMAT or IMRT plans optimized for patient treatment were calculated and delivered to an ArcCheck phantom. ArcCheck measured dose distributions were compared with the TPS calculated dose distributions using a 2-D gamma-analysis.more » Dose volume histograms (DVHs) for various patient structures were obtained by using measured data in 3DVH software and compared against the TPS calculated DVHs using 3-D gamma analysis. DVH data were used in the Poisson model to calculate tumor control probability (TCP) for the treatment targets and in the sigmoid dose response model to calculate normal tissue complication probability (NTCP) for the normal structures. Results: Two-D and three-D gamma passing rates among six H&N patient plans differed by 0 to 2.7% and among seven lung plans by 0.1 to 4.5%. Average ± SD TCPs based on measurement and TPS were 0.665±0.018 and 0.674±0.044 for H&N, and 0.791±0.027 and 0.733±0.031 for lung plans, respectively. Differences in NTCPs were usually negligible. The differences in dosimetric results, TCPs and NTCPs were insignificant. Conclusion: The 2-D and 3-D gamma-analysis based agreement between measured and planned dose distributions may indicate their dosimetric equivalence. Small and insignificant differences in TCPs and NTCPs based on measured and planned dose distributions indicate the radiobiological equivalence between the measured and optimized plans. However, patient plans showing larger differences between 2-D and 3-D gamma-analysis can help us make a more definite conclusion through our ongoing research with a larger number of patients.« less

SU-F-T-460: Dosimetric Matching Between Trilogy Tx and TrueBeam STx

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

Choi, Y; Kwak, J; Jeong, C

Purpose: To compare the commissioned beam data for one flattening filter photon mode (6 MV) and two flattening filter-free (FFF) photon modes (6 and 10 MV-FFF) between Trilogy Tx and TrueBeam STx and evaluate the possibility of dosimetric matching Methods: Dosimetric characteristics of the new Trilogy Tx including percent depth doses (PDDs), profiles, and output factors were measured for commissioning. Linear diode array detector and ion chambers were used to measure dosimetric data. The depth of dose maximum (dmax) and PDD at 10 cm (PDD10) were evaluated: 3×3 cm{sup 2}, 10×10 cm{sup 2}, and 40×40 cm{sup 2}. The beam profilesmore » were compared and then penumbras were evaluated. As a further test of the dosimetric matching, the same VMAT plans were delivered, measured with film, and compared with TPS calculation. Results: All the measured PDDs matched well across the two units. PDD10 showed less than 0.5% variation and dmax were within 1.5 mm at the field sizes evaluated. Within the central 80% of transverse axis, profile data were almost identical. TrueBeam data resulted in a slightly greater penumbra width (up to 1.9 mm). The greatest differences of output factors were found at 40 × 40 cm{sup 2}: 2.40%, 2.03%, and 2.22% for 6 MV, 6 MV-FFF, and 10 MV-FFF, respectively. For smaller field sizes, less than 1% differences were observed. The film measurements demonstrated over 97.3% pixels passing-gamma analysis (2%/2mm). The results showed excellent agreement between measurements of two machines. Conclusion: The differences between Trilogy Tx and TrueBeam STx found could possibly affect small field and also very large field sizes in dosimetric matching considerations. These differences encountered are mostly related with the changes in the head design of the TrueBeam. Although it cannot guarantee full interchangeability of two machines, dosimetric matching by field size of 25 × 25 cm{sup 2} might be clinically acceptable.« less

Gamma Knife irradiation method based on dosimetric controls to target small areas in rat brains

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

Constanzo, Julie; Paquette, Benoit; Charest, Gabriel

2015-05-15

Purpose: Targeted and whole-brain irradiation in humans can result in significant side effects causing decreased patient quality of life. To adequately investigate structural and functional alterations after stereotactic radiosurgery, preclinical studies are needed. The purpose of this work is to establish a robust standardized method of targeted irradiation on small regions of the rat brain. Methods: Euthanized male Fischer rats were imaged in a stereotactic bed, by computed tomography (CT), to estimate positioning variations relative to the bregma skull reference point. Using a rat brain atlas and the stereotactic bregma coordinates obtained from CT images, different regions of the brainmore » were delimited and a treatment plan was generated. A single isocenter treatment plan delivering ≥100 Gy in 100% of the target volume was produced by Leksell GammaPlan using the 4 mm diameter collimator of sectors 4, 5, 7, and 8 of the Gamma Knife unit. Impact of positioning deviations of the rat brain on dose deposition was simulated by GammaPlan and validated with dosimetric measurements. Results: The authors’ results showed that 90% of the target volume received 100 ± 8 Gy and the maximum of deposited dose was 125 ± 0.7 Gy, which corresponds to an excellent relative standard deviation of 0.6%. This dose deposition calculated with GammaPlan was validated with dosimetric films resulting in a dose-profile agreement within 5%, both in X- and Z-axes. Conclusions: The authors’ results demonstrate the feasibility of standardizing the irradiation procedure of a small volume in the rat brain using a Gamma Knife.« 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.

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

Lafata, K; Ren, L; Wu, Q

Purpose: To develop a data-mining methodology based on quantum clustering and machine learning to predict expected dosimetric endpoints for lung SBRT applications based on patient-specific anatomic features. Methods: Ninety-three patients who received lung SBRT at our clinic from 2011–2013 were retrospectively identified. Planning information was acquired for each patient, from which various features were extracted using in-house semi-automatic software. Anatomic features included tumor-to-OAR distances, tumor location, total-lung-volume, GTV and ITV. Dosimetric endpoints were adopted from RTOG-0195 recommendations, and consisted of various OAR-specific partial-volume doses and maximum point-doses. First, PCA analysis and unsupervised quantum-clustering was used to explore the feature-space tomore » identify potentially strong classifiers. Secondly, a multi-class logistic regression algorithm was developed and trained to predict dose-volume endpoints based on patient-specific anatomic features. Classes were defined by discretizing the dose-volume data, and the feature-space was zero-mean normalized. Fitting parameters were determined by minimizing a regularized cost function, and optimization was performed via gradient descent. As a pilot study, the model was tested on two esophageal dosimetric planning endpoints (maximum point-dose, dose-to-5cc), and its generalizability was evaluated with leave-one-out cross-validation. Results: Quantum-Clustering demonstrated a strong separation of feature-space at 15Gy across the first-and-second Principle Components of the data when the dosimetric endpoints were retrospectively identified. Maximum point dose prediction to the esophagus demonstrated a cross-validation accuracy of 87%, and the maximum dose to 5cc demonstrated a respective value of 79%. The largest optimized weighting factor was placed on GTV-to-esophagus distance (a factor of 10 greater than the second largest weighting factor), indicating an intuitively strong correlation between this feature and both endpoints. Conclusion: This pilot study shows that it is feasible to predict dose-volume endpoints based on patient-specific anatomic features. The developed methodology can potentially help to identify patients at risk for higher OAR doses, thus improving the efficiency of treatment planning. R01-184173.« less

A computational method for estimating the dosimetric effect of intra-fraction motion on step-and-shoot IMRT and compensator plans

NASA Astrophysics Data System (ADS)

Waghorn, Ben J.; Shah, Amish P.; Ngwa, Wilfred; Meeks, Sanford L.; Moore, Joseph A.; Siebers, Jeffrey V.; Langen, Katja M.

2010-07-01

Intra-fraction organ motion during intensity-modulated radiation therapy (IMRT) treatment can cause differences between the planned and the delivered dose distribution. To investigate the extent of these dosimetric changes, a computational model was developed and validated. The computational method allows for calculation of the rigid motion perturbed three-dimensional dose distribution in the CT volume and therefore a dose volume histogram-based assessment of the dosimetric impact of intra-fraction motion on a rigidly moving body. The method was developed and validated for both step-and-shoot IMRT and solid compensator IMRT treatment plans. For each segment (or beam), fluence maps were exported from the treatment planning system. Fluence maps were shifted according to the target position deduced from a motion track. These shifted, motion-encoded fluence maps were then re-imported into the treatment planning system and were used to calculate the motion-encoded dose distribution. To validate the accuracy of the motion-encoded dose distribution the treatment plan was delivered to a moving cylindrical phantom using a programmed four-dimensional motion phantom. Extended dose response (EDR-2) film was used to measure a planar dose distribution for comparison with the calculated motion-encoded distribution using a gamma index analysis (3% dose difference, 3 mm distance-to-agreement). A series of motion tracks incorporating both inter-beam step-function shifts and continuous sinusoidal motion were tested. The method was shown to accurately predict the film's dose distribution for all of the tested motion tracks, both for the step-and-shoot IMRT and compensator plans. The average gamma analysis pass rate for the measured dose distribution with respect to the calculated motion-encoded distribution was 98.3 ± 0.7%. For static delivery the average film-to-calculation pass rate was 98.7 ± 0.2%. In summary, a computational technique has been developed to calculate the dosimetric effect of intra-fraction motion. This technique has the potential to evaluate a given plan's sensitivity to anticipated organ motion. With knowledge of the organ's motion it can also be used as a tool to assess the impact of measured intra-fraction motion after dose delivery.

Inclusion of dosimetric data as covariates in toxicity-related radiogenomic studies : A systematic review.

PubMed

Yahya, Noorazrul; Chua, Xin-Jane; Manan, Hanani A; Ismail, Fuad

2018-05-17

This systematic review evaluates the completeness of dosimetric features and their inclusion as covariates in genetic-toxicity association studies. Original research studies associating genetic features and normal tissue complications following radiotherapy were identified from PubMed. The use of dosimetric data was determined by mining the statement of prescription dose, dose fractionation, target volume selection or arrangement and dose distribution. The consideration of the dosimetric data as covariates was based on the statement mentioned in the statistical analysis section. The significance of these covariates was extracted from the results section. Descriptive analyses were performed to determine their completeness and inclusion as covariates. A total of 174 studies were found to satisfy the inclusion criteria. Studies published ≥2010 showed increased use of dose distribution information (p = 0.07). 33% of studies did not include any dose features in the analysis of gene-toxicity associations. Only 29% included dose distribution features as covariates and reported the results. 59% of studies which included dose distribution features found significant associations to toxicity. A large proportion of studies on the correlation of genetic markers with radiotherapy-related side effects considered no dosimetric parameters. Significance of dose distribution features was found in more than half of the studies including these features, emphasizing their importance. Completeness of radiation-specific clinical data may have increased in recent years which may improve gene-toxicity association studies.

Parameterization of photon beam dosimetry for a linear accelerator

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

Lebron, Sharon; Barraclough, Brendan; Lu, Bo

2016-02-15

Purpose: In radiation therapy, accurate data acquisition of photon beam dosimetric quantities is important for (1) beam modeling data input into a treatment planning system (TPS), (2) comparing measured and TPS modeled data, (3) the quality assurance process of a linear accelerator’s (Linac) beam characteristics, (4) the establishment of a standard data set for comparison with other data, etcetera. Parameterization of the photon beam dosimetry creates a data set that is portable and easy to implement for different applications such as those previously mentioned. The aim of this study is to develop methods to parameterize photon beam dosimetric quantities, includingmore » percentage depth doses (PDDs), profiles, and total scatter output factors (S{sub cp}). Methods: S{sub cp}, PDDs, and profiles for different field sizes, depths, and energies were measured for a Linac using a cylindrical 3D water scanning system. All data were smoothed for the analysis and profile data were also centered, symmetrized, and geometrically scaled. The S{sub cp} data were analyzed using an exponential function. The inverse square factor was removed from the PDD data before modeling and the data were subsequently analyzed using exponential functions. For profile modeling, one halfside of the profile was divided into three regions described by exponential, sigmoid, and Gaussian equations. All of the analytical functions are field size, energy, depth, and, in the case of profiles, scan direction specific. The model’s parameters were determined using the minimal amount of measured data necessary. The model’s accuracy was evaluated via the calculation of absolute differences between the measured (processed) and calculated data in low gradient regions and distance-to-agreement analysis in high gradient regions. Finally, the results of dosimetric quantities obtained by the fitted models for a different machine were also assessed. Results: All of the differences in the PDDs’ buildup and the profiles’ penumbra regions were less than 2 and 0.5 mm, respectively. The differences in the low gradient regions were 0.20% ± 0.20% (<1% for all) and 0.50% ± 0.35% (<1% for all) for PDDs and profiles, respectively. For S{sub cp} data, all of the absolute differences were less than 0.5%. Conclusions: This novel analytical model with minimum measurement requirements was proved to accurately calculate PDDs, profiles, and S{sub cp} for different field sizes, depths, and energies.« less

Dosimetric aspects of breast radiotherapy with three-dimensional and intensity-modulated radiotherapy helical tomotherapy planning modules

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

Yadav, Poonam; Service of Radiation Therapy, University of Wisconsin Aspirus Cancer Center, Wisconsin Rapids, WI; Yan, Yue, E-mail: yyan5@mdanderson.org

In this work, we investigated the dosimetric differences between the intensity-modulated radiotherapy (IMRT) plans and the three-dimensional (3D) helical plans based on the TomoTherapy system. A total of 15 patients with supine setup were randomly selected from the data base. For patients with lumpectomy planning target volume (PTV), regional lymph nodes were also included as part of the target. For dose sparing, the significant differences between the helical IMRT and helical 3D were only found in the heart and contralateral breast. For the dose to the heart, helical IMRT reduced the maximum point dose by 6.98 Gy compared to themore » helical 3D plan (p = 0.01). For contralateral breast, the helical IMRT plans significantly reduced the maximum point dose by 5.6 Gy compared to the helical 3D plan. However, compared to the helical 3D plan, the helical IMRT plan increased the volume for lower dose (13.08% increase in V{sub 5} {sub Gy}, p = 0.01). In general, there are no significant differences in dose sparing between helical IMRT and helical 3D plans.« less

Correlation of basic TL, OSL and IRSL properties of ten K-feldspar samples of various origins

NASA Astrophysics Data System (ADS)

Sfampa, I. K.; Polymeris, G. S.; Pagonis, V.; Theodosoglou, E.; Tsirliganis, N. C.; Kitis, G.

2015-09-01

Feldspars stand among the most widely used minerals in dosimetric methods of dating using thermoluminescence (TL), optically stimulated luminescence (OSL) and infrared stimulated luminescence (IRSL). Having very good dosimetric properties, they can in principle contribute to the dating of every site of archaeological and geological interest. The present work studies basic properties of ten naturally occurring K-feldspar samples belonging to three feldspar species, namely sanidine, orthoclase and microcline. The basic properties studied are (a) the influence of blue light and infrared stimulation on the thermoluminescence glow-curves, (b) the growth of OSL, IRSL, residual TL and TL-loss as a function of OSL and IRSL bleaching time and (c) the correlation between the OSL and IRSL signals and the energy levels responsible for the TL glow-curve. All experimental data were fitted using analytical expressions derived from a recently developed tunneling recombination model. The results show that the analytical expressions provide excellent fits to all experimental results, thus verifying the tunneling recombination mechanism in these materials and providing valuable information about the concentrations of luminescence centers.

Performance improvement of pentacosa-diynoic acid label dosimeter for radiation processing technology

NASA Astrophysics Data System (ADS)

Abdel-Fattah, A. A.; Soliman, Y. S.

2017-12-01

A radiation sensitive material, 10,12-pentacosa-diynoic acid (PCDA), was incorporated into polyvinyl butyral (PVB) films to develop indicators/dosimeters for blood and food irradiation. The present study aims to improve the dosimetric performance of these previously prepared dosimeters and to extend their shelf life by the combination of a radical scavenger, propyl gallate (PG), and a UV absorber, tinuvin-p (TP). The X-ray diffraction (XRD) patterns of the dosimeters were analysed and their dosimetric characteristics were investigated by specular reflectance in the visible spectrum range of 400-700 nm. Upon irradiation, the films turn blue exhibiting two main bands around 670 and 620 nm. Their dose-response functions were fitted by a double exponential growth, 5 parameters, equation. Irradiation temperature influences the dosimeter response at 670 nm without causing thermochromic transition up to 50 °C in poly-PCDA. The useful dose range is 5-4000 Gy depending on the wavelengths of analysis and PCDA content in the films. The overall uncertainty of dose measurement is less than 6% at 2σ.

Neutron spectrometry for radiation protection purposes

NASA Astrophysics Data System (ADS)

McDonald, J. C.; Siebert, B. R. L.; Alberts, W. G.

2002-01-01

Determination of the dose equivalent is required for radiation protection purposes, however such a determination is quite difficult for neutron radiation. In order to perform accurate dosimetric determinations, it is advantageous to acquire information about the neutron fluence spectrum in the workplace as well as the reference radiations used to calibrate dosimetric instruments. This information can then be used to select the appropriate dosimetric instrument, the optimum calibration condition or to establish correction factors that account for the differences in calibration and workplace conditions. For quite some time, neutron spectrometry has been used for these purposes. A brief review of the applications of spectrometers in radiation protection and some recommendations for further development are given here.

Construction of the TH-GEM detector components for metrology of low energy ionizing radiation

NASA Astrophysics Data System (ADS)

Silva, N. F.; Silva, T. F.; Castro, M. C.; Natal da Luz, H.; Caldas, L. V. E.

2018-03-01

The Gas Electron Multiplier (GEM) detector was originally proposed as a position sensitive detector to determine trajectories of particles prevenient from high-energy collisions. In order to study the potential of TH-GEM type detectors in dosimetric applications for low energy X-rays, specifically for the mammography standard qualities, it was proposed to construct a prototype with characteristics suitable for such use. In this work the general, structural and material parameters applicable to the necessary conditions were defined, establishing the process of construction of the components of a prototype.

Useful optical density range in film dosimetry: limitations due to noise and saturation.

PubMed

González-López, Antonio

2007-08-07

The optical density (OD) range for the scanners used in film dosimetry is limited due to saturation and noise. As the OD increases, saturation causes the rate of change of the output with respect to the input to become smaller, while at the same time noise remains fairly constant or increases. The combined effect leads to a degradation of the signal-to-noise ratio (SNR) at high optical densities. In this study, the uncertainty in the OD measurement, d(m), is expressed as a function of the optical density d. The functional relationship obtained gives the amplitude w of an interval around d in which d(m) will be found with a given probability p. The relationship w = w(d, p) is later used to determine which OD ranges fulfil a set of requirements on w and p. As an application of the procedure, the noise and saturation characteristics of a commercial film digitizer system are measured. Their contribution to the uncertainties of the dosimetric procedure is reported, and the data are used to provide an optical density range for a given uncertainty and confidence level associated with the digitizer. These data can be further combined with the data from other sources of noise such as film noise in order to estimate the final uncertainty of the dosimetric process.

Effective atomic numbers and electron density of dosimetric material

PubMed Central

Kaginelli, S. B.; Rajeshwari, T.; Sharanabasappa; Kerur, B. R.; Kumar, Anil S.

2009-01-01

A novel method for determination of mass attenuation coefficient of x-rays employing NaI (Tl) detector system and radioactive sources is described.in this paper. A rigid geometry arrangement and gating of the spectrometer at FWHM position and selection of absorber foils are all done following detailed investigation, to minimize the effect of small angle scattering and multiple scattering on the mass attenuation coefficient, μ/ρ, value. Firstly, for standardization purposes the mass attenuation coefficients of elemental foils such as Aluminum, Copper, Molybdenum, Tantalum and Lead are measured and then, this method is utilized for dosimetric interested material (sulfates). The experimental mass attenuation coefficient values are compared with the theoretical values to find good agreement between the theory and experiment within one to two per cent. The effective atomic numbers of the biological substitute material are calculated by sum rule and from the graph. The electron density of dosimetric material is calculated using the effective atomic number. The study has discussed in detail the attenuation coefficient, effective atomic number and electron density of dosimetric material/biological substitutes. PMID:20098566

Dosimetric characteristics of Novalis Tx system with high definition multileaf collimator

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

Chang Zheng; Wang Zhiheng; Wu, Q. Jackie

A new Novalis Tx system equipped with a high definition multileaf collimator (HDMLC) recently became available to perform both image-guided radiosurgery and conventional radiotherapy. It is capable of delivering a highly conformal radiation dose with three energy modes: 6 MV photon energy, 15 MV photon energy, and 6 MV photon energy in a stereotactic radiosurgery mode with 1000 MU/min dose rate. Dosimetric characteristics of the new Novalis Tx treatment unit with the HDMLC are systematically measured for commissioning. A high resolution diode detector and miniion-chamber detector are used to measure dosimetric data for a range of field sizes from 4x4more » mm to 400x400 mm. The commissioned Novalis Tx system has passed the RPC stereotactic radiosurgery head phantom irradiation test. The Novalis Tx system not only expands its capabilities with three energy modes, but also achieves better beam conformity and sharer beam penumbra with HDMLC. Since there is little beam data information available for the new Novalis Tx system, we present in this work the dosimetric data of the new modality for reference and comparison.« less

Dosimetric characterization of a bi-directional micromultileaf collimator for stereotactic applications.

PubMed

Bucciolini, M; Russo, S; Banci Buonamici, F; Pini, S; Silli, P

2002-07-01

A 6 MV photon beam from Linac SL75-5 has been collimated with a new micromultileaf device that is able to shape the field in the two orthogonal directions with four banks of leaves. This is the first clinical installation of the collimator and in this paper the dosimetric characterization of the system is reported. The dosimetric parameters required by the treatment planning system used for the dose calculation in the patient are: tissue maximum ratios, output factors, transmission and leakage of the leaves, penumbra values. Ionization chambers, silicon diode, radiographic films, and LiF thermoluminescent dosimeters have been employed for measurements of absolute dose and beam dosimetric data. Measurements with different dosimeters supply results in reasonable agreement among them and consistent with data available in literature for other models of micromultileaf collimator; that permits the use of the measured parameters for clinical applications. The discrepancies between results obtained with the different detectors (around 2%) for the analyzed parameters can be considered an indication of the accuracy that can be reached by current stereotactic dosimetry.

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

Xu, H; Guerrero, M; Prado, K

Purpose: Building up a TG-71 based electron monitor-unit (MU) calculation protocol usually involves massive measurements. This work investigates a minimum data set of measurements and its calculation accuracy and measurement time. Methods: For 6, 9, 12, 16, and 20 MeV of our Varian Clinac-Series linear accelerators, the complete measurements were performed at different depth using 5 square applicators (6, 10, 15, 20 and 25 cm) with different cutouts (2, 3, 4, 6, 10, 15 and 20 cm up to applicator size) for 5 different SSD’s. For each energy, there were 8 PDD scans and 150 point measurements for applicator factors,more » cutout factors and effective SSDs that were then converted to air-gap factors for SSD 99–110cm. The dependence of each dosimetric quantity on field size and SSD was examined to determine the minimum data set of measurements as a subset of the complete measurements. The “missing” data excluded in the minimum data set were approximated by linear or polynomial fitting functions based on the included data. The total measurement time and the calculated electron MU using the minimum and the complete data sets were compared. Results: The minimum data set includes 4 or 5 PDD’s and 51 to 66 point measurements for each electron energy, and more PDD’s and fewer point measurements are generally needed as energy increases. Using only <50% of complete measurement time, the minimum data set generates acceptable MU calculation results compared to those with the complete data set. The PDD difference is within 1 mm and the calculated MU difference is less than 1.5%. Conclusion: Data set measurement for TG-71 electron MU calculations can be minimized based on the knowledge of how each dosimetric quantity depends on various setup parameters. The suggested minimum data set allows acceptable MU calculation accuracy and shortens measurement time by a few hours.« 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

SU-F-T-433: Evaluation of a New Dose Mimicking Application for Clinical Flexibility and Reliability

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

Hoffman, D; Nair, C Kumaran; Wright, C

2016-06-15

Purpose: Clinical workflow and machine down time occasionally require patients to be temporarily treated on a system other than the initial treatment machine. A new commercial dose mimicking application provides automated cross-platform treatment planning to expedite this clinical flexibility. The aim of this work is to evaluate the feasibility of automatic plan creation and establish a robust clinical workflow for prostate and pelvis patients. Methods: Five prostate and five pelvis patients treated with helical plans were selected for re-planning with the dose mimicking application, covering both simple and complex scenarios. Two-arc VMAT and 7- and 9-field IMRT plans were generatedmore » for each case, with the objective function of achieving similar dose volume histogram from the initial helical plans. Dosimetric comparisons include target volumes and organs at risk (OARs) (rectum, bladder, small bowel, femoral heads, etc.). Dose mimicked plans were evaluated by a radiation oncologist, and patient-specific QAs were performed to validate delivery. Results: Overall plan generation and transfer required around 30 minutes of dosimetrist’s time once the dose-mimicking protocol is setup for each site. The resulting VMAT and 7- and 9-field IMRT plans achieved equivalent PTV coverage and homogeneity (D99/DRx = 97.3%, 97.2%, 97.2% and HI = 6.0, 5.8, and 5.9, respectively), compared to helical plans (97.6% and 4.6). The OAR dose discrepancies were up to 6% in rectum Dmean, but generally lower in bladder, femoral heads, bowel and penile bulb. In the context of 1–5 fractions, the radiation oncologist evaluated the dosimetric changes as not clinically significant. All delivery QAs achieved >90% pass with a 3%/3mm gamma criteria. Conclusion: The automated dose-mimicking workflow offers a strategy to avoid missing treatment fractions due to machine down time with non-clinically significant changes in dosimetry. Future work will further optimize dose mimicking plans and investigate other cross-platform treatment delivery options.« less

Optimized Varian aSi portal dosimetry: development of datasets for collective use.

PubMed

Van Esch, Ann; Huyskens, Dominique P; Hirschi, Lukas; Baltes, Christof

2013-11-04

Although much literature has been devoted to portal dosimetry with the Varian amorphous silicon (aSi) portal imager, the majority of the described methods are not routinely adopted because implementation procedures are cumbersome and not within easy reach of most radiotherapy centers. To make improved portal dosimetry solutions more generally available, we have investigated the possibility of converting optimized configurations into ready-to-use standardized datasets. Firstly, for all commonly used photon energies (6, 10, 15, 18, and 20 MV), basic beam data acquired on 20 aSi panels were used to assess the interpanel reproducibility. Secondly, a standardized portal dose image prediction (PDIP) algorithm configuration was created for every energy, using a three-step process to optimize the aSi dose response function and profile correction files for the dosimetric calibration of the imager panel. An approximate correction of the backscatter of the Exact arm was also incorporated. Thirdly, a set of validation fields was assembled to assess the accuracy of the standardized configuration. Variations in the basic beam data measured on different aSi panels very rarely exceeded 2% (2 mm) and are of the same order of magnitude as variations between different Clinacs when measuring in reference conditions in water. All studied aSi panels can hence be regarded as nearly identical. Standardized datasets were successfully created and implemented. The test package proved useful in highlighting possible problems and illustrating remaining limitations, but also in demonstrating the good overall results (95% pass rate for 3%,3 mm) that can be obtained. The dosimetric behavior of all tested aSi panels was found to be nearly identical for all tested energies. The approach of using standardized datasets was then successfully tested through the creation and evaluation of PDIP preconfigured datasets that can be used within the Varian portal dosimetry solution.

Dosimetry in radiotherapy using a-Si EPIDs: Systems, methods, and applications focusing on 3D patient dose estimation

NASA Astrophysics Data System (ADS)

McCurdy, B. M. C.

2013-06-01

An overview is provided of the use of amorphous silicon electronic portal imaging devices (EPIDs) for dosimetric purposes in radiation therapy, focusing on 3D patient dose estimation. EPIDs were originally developed to provide on-treatment radiological imaging to assist with patient setup, but there has also been a natural interest in using them as dosimeters since they use the megavoltage therapy beam to form images. The current generation of clinically available EPID technology, amorphous-silicon (a-Si) flat panel imagers, possess many characteristics that make them much better suited to dosimetric applications than earlier EPID technologies. Features such as linearity with dose/dose rate, high spatial resolution, realtime capability, minimal optical glare, and digital operation combine with the convenience of a compact, retractable detector system directly mounted on the linear accelerator to provide a system that is well-suited to dosimetric applications. This review will discuss clinically available a-Si EPID systems, highlighting dosimetric characteristics and remaining limitations. Methods for using EPIDs in dosimetry applications will be discussed. Dosimetric applications using a-Si EPIDs to estimate three-dimensional dose in the patient during treatment will be overviewed. Clinics throughout the world are implementing increasingly complex treatments such as dynamic intensity modulated radiation therapy and volumetric modulated arc therapy, as well as specialized treatment techniques using large doses per fraction and short treatment courses (ie. hypofractionation and stereotactic radiosurgery). These factors drive the continued strong interest in using EPIDs as dosimeters for patient treatment verification.

Dosimetric and clinical predictors for radiation-induced esophageal injury.

PubMed

Ahn, Sung-Ja; Kahn, Daniel; Zhou, Sumin; Yu, Xiaoli; Hollis, Donna; Shafman, Timothy D; Marks, Lawrence B

2005-02-01

To evaluate the clinical and three-dimensional dosimetric parameters associated with esophageal injury after radiotherapy (RT) for non-small-cell lung cancer. The records of 254 patients treated for non-small-cell lung cancer between 1992 and 2001 were reviewed. A variety of metrics describing the esophageal dose were extracted. The Radiation Therapy Oncology Group toxicity criteria for grading of esophageal injury were used. The median follow-up time for all patients was 43 months (range, 0.5-120 months). Logistic regression analysis, contingency table analyses, and Fisher's exact tests were used for statistical analysis. Acute toxicity occurred in 199 (78%) of 254 patients. For acute toxicity of Grade 2 or worse, twice-daily RT, age, nodal stage of N2 or worse, and most dosimetric parameters were predictive. Late toxicity occurred in 17 (7%) of 238 patients. The median and maximal time to the onset of late toxicity was 5 and 40 months after RT, respectively. Late toxicity occurred in 2%, 3%, 17%, 26%, and 100% of patients with acute Grade 0, 1, 2, 3, and 4 toxicity, respectively. For late toxicity, the severity of acute toxicity was most predictive. A variety of dosimetric parameters are predictive of acute and late esophageal injury. A strong correlation between the dosimetric parameters prevented a comparison between the predictive abilities of these metrics. The presence of acute injury was the most predictive factor for the development of late injury. Additional studies to define better the predictors of RT-induced esophageal injury are needed.

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.

Dosimetric measurements of an n-butyl cyanoacrylate embolization material for arteriovenous malformations

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

Labby, Zacariah E., E-mail: zelabby@humonc.wisc.edu; Chaudhary, Neeraj; Gemmete, Joseph J.

2015-04-15

Purpose: The therapeutic regimen for cranial arteriovenous malformations often involves both stereotactic radiosurgery and endovascular embolization. Embolization agents may contain tantalum or other contrast agents to assist the neurointerventionalists, leading to concerns regarding the dosimetric effects of these agents. This study investigated dosimetric properties of n-butyl cyanoacrylate (n-BCA) plus lipiodol with and without tantalum powder. Methods: The embolization agents were provided cured from the manufacturer with and without added tantalum. Attenuation measurements were made for the samples and compared to the attenuation of a solid water substitute using a 6 MV photon beam. Effective linear attenuation coefficients (ELAC) were derivedmore » from attenuation measurements made using a portal imager and derived sample thickness maps projected in an identical geometry. Probable dosimetric errors for calculations in which the embolized regions are overridden with the properties of water were calculated using the ELAC values. Interface effects were investigated using a parallel plate ion chamber placed at set distances below fixed samples. Finally, Hounsfield units (HU) were measured using a stereotactic radiosurgery CT protocol, and more appropriate HU values were derived from the ELAC results and the CT scanner’s HU calibration curve. Results: The ELAC was 0.0516 ± 0.0063 cm{sup −1} and 0.0580 ± 0.0091 cm{sup −1} for n-BCA without and with tantalum, respectively, compared to 0.0487 ± 0.0009 cm{sup −1} for the water substitute. Dose calculations with the embolized region set to be water equivalent in the treatment planning system would result in errors of −0.29% and −0.93% per cm thickness of n-BCA without and with tantalum, respectively. Interface effects compared to water were small in magnitude and limited in distance for both embolization materials. CT values at 120 kVp were 2082 and 2358 HU for n-BCA without and with tantalum, respectively; dosimetrically appropriate HU values were estimated to be 79 and 199 HU, respectively. Conclusions: The dosimetric properties of the embolization agents are very close to those of water for a 6 MV beam. Therefore, treating the entire intracranial space as uniform in composition will result in less than 1% dosimetric error for n-BCA emboli smaller than 3.4 cm without added tantalum and n-BCA emboli smaller than 1.1 cm with added tantalum. Furthermore, when effective embolization can be achieved by the neurointerventionalist using n-BCA without tantalum, the dosimetric impact of overriding material properties will be lessened. However, due to the high attenuation of embolization agents with and without added tantalum for diagnostic energies, artifacts may occur that necessitate additional imaging to accurately identify the spatial extent of the region to be treated.« less

TU-EF-304-04: A Heart Motion Model for Proton Scanned Beam Chest Radiotherapy

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

White, B; Kiely, J Blanco; Lin, L

Purpose: To model fast-moving heart surface motion as a function of cardiac-phase in order to compensate for the lack of cardiac-gating in evaluating accurate dose to coronary structures. Methods: Ten subjects were prospectively imaged with a breath-hold, cardiac-gated MRI protocol to determine heart surface motion. Radial and planar views of the heart were resampled into a 3-dimensional volume representing one heartbeat. A multi-resolution optical flow deformable image registration algorithm determined tissue displacement during the cardiac-cycle. The surface of the heart was modeled as a thin membrane comprised of voxels perpendicular to a pencil beam scanning (PBS) beam. The membrane’s out-of-planemore » spatial displacement was modeled as a harmonic function with Lame’s equations. Model accuracy was assessed with the root mean squared error (RMSE). The model was applied to a cohort of six chest wall irradiation patients with PBS plans generated on phase-sorted 4DCT. Respiratory motion was separated from the cardiac motion with a previously published technique. Volumetric dose painting was simulated and dose accumulated to validate plan robustness (target coverage variation accepted within 2%). Maximum and mean heart surface dose assessed the dosimetric impact of heart and coronary artery motion. Results: Average and maximum heart surface displacements were 2.54±0.35mm and 3.6mm from the end-diastole phase to the end-systole cardiac-phase respectively. An average RMSE of 0.11±0.04 showed the model to be accurate. Observed errors were greatest between the circumflex artery and mitral valve level of the heart anatomy. Heart surface displacements correspond to a 3.6±1.0% and 5.1±2.3% dosimetric impact on the maximum and mean heart surface DVH indicators respectively. Conclusion: Although heart surface motion parallel to beam’s direction was substantial, its maximum dosimetric impact was 5.1±2.3%. Since PBS delivers low doses to coronary structures relative to photon radiotherapy, it is unknown whether this variation would be clinically significant for late effects.« less

ESR dosimeter material properties of phenols compound exposed to radiotherapeutic electron beams

NASA Astrophysics Data System (ADS)

Gallo, Salvatore; Iacoviello, Giuseppina; Bartolotta, Antonio; Dondi, Daniele; Panzeca, Salvatore; Marrale, Maurizio

2017-09-01

There is a need for a sensitive dosimeter using Electron Spin Resonance spectroscopy for use in medical applications, since non-destructive read-out and dose archival could be achieved with this method. This work reports a systematic ESR investigation of IRGANOX ® 1076 exposed to clinical electron beams produced by a LINAC used for radiation therapy treatments. Recently, dosimetric features of this material were investigated for irradiation with 60Co γ -photons and neutrons in both pellet and film shape and have been found promising thanks to their high efficiency of radiation-matter energy transfer and radical stability at room temperature. Here the analysis of the dosimetric features of these ESR dosimeters exposed to clinical electron beams at energies of 7, 10 and 14 MeV, is described in terms of dependence on microwave power and modulation amplitude, response on dose, dependence on beam type, detection limits, and signal stability after irradiation. The analysis of the ESR signal as function of absorbed dose highlights that the response of this material is linear in the dose range investigated (1-13 Gy) and is independent of the beam energy. The minimum detectable dose is found to be smaller than 1 Gy. Comparison of electron stopping power values of these dosimeters with those of water and soft tissue highlights equivalence of the response to electron beams in the energy range considered. The signal intensity was monitored for 40 days after irradiation and for all energies considered and it shows negligible variations in the first 500 h after irradiation whereas after 1100 h the signal decay is only of about 4%. In conclusion, it is found that phenolic compounds possess good dosimetric features which make it useful as a sensitive dosimeter for medical applications.

Poster - 23: Dosimetric Characterization and Transferability of an Accessory Mounted Mini-Beam Collimator

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

Davis, William; Crewson, Cody; Alexander, Andrew

Objective: The dosimetric characterization of an accessory-mounted mini-beam collimator across three beam matched linear accelerators. Materials and Methods: Percent depth dose and profiles were measured for the open and mini-beam collimated fields. The average beam quality and peak-to-valley dose ratio (PVDR), the ratio of average peak dose to average valley dose, were obtained from these measurements. The open field relative output and the mini-beam collimator factor, the ratio of the mini-beam dose to open field dose at the beam center, were measured for square fields of side 2, 3, 4, and 5 cm. Mini-beam output as a function of collimatormore » inclination angle relative to the central axis was also investigated. Results and Discussion: Beam quality for both the open and mini-beam collimated fields agreed across all linacs to within ±1.0%. The PVDR was found to vary by up to ±6.6% from the mean. For the 2, 3, and 4 cm fields the average open field relative output with respect to the 5 cm field was 0.874±0.4%, 0.921±0.3%, and 0.962±0.1%. The average collimator factors were 0.450±3.9%, 0.443±3.9%, 0.438±3.9%, and 0.434±3.9%. A decrease in collimator factor greater than 7% was found for an inclination angle change of 0.09°. Conclusion: The mini-beam collimator has revealed a difference between the three linacs not apparent in the open field data, yet transferability can still be attained through thorough dosimetric characterization.« less

DOSIMETRIC CHARACTERISTICS OF GAMMA-TRON-2 (in Russian)

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

Krongauz, A.N.; Pavlova, T.G.; Frolova, A.V.

1963-01-01

Dosimetric characteristics of the Gammatron-2 during operation in a static regimen are presented. The air dose and the distribution of doses along the central ray of the beam and on the sides were determined. The protective properties of Gammatron-2 were studied. On the basis of the measurements, charts of isodoses were elaborated. (P.C.H.)

MRI-based IMRT planning for MR-linac: comparison between CT- and MRI-based plans for pancreatic and prostate cancers

NASA Astrophysics Data System (ADS)

Prior, Phil; Chen, Xinfeng; Botros, Maikel; Paulson, Eric S.; Lawton, Colleen; Erickson, Beth; Li, X. Allen

2016-05-01

The treatment planning in radiation therapy (RT) can be arranged to combine benefits of computed tomography (CT) and magnetic resonance imaging (MRI) together to maintain dose calculation accuracy and improved target delineation. Our aim is study the dosimetric impact of uniform relative electron density assignment on IMRT treatment planning with additional consideration given to the effect of a 1.5 T transverse magnetic field (TMF) in MR-Linac. A series of intensity modulated RT (IMRT) plans were generated for two representative tumor sites, pancreas and prostate, using CT and MRI datasets. Representative CT-based IMRT plans were generated to assess the impact of different electron density (ED) assignment on plan quality using CT without the presence of a 1.5 T TMF. The relative ED (rED) values used were taken from the ICRU report 46. Four types of rED assignment in the organs at risk (OARs), the planning target volumes (PTV) and in the non-specified tissue (NST) were considered. Dose was recalculated (no optimization) using a Monaco 5.09.07a research planning system employing Monte Carlo calculations with an option to include TMF. To investigate the dosimetric effect of different rED assignment, the dose-volume parameters (DVPs) obtained from these specific rED plans were compared to those obtained from the original plans based on CT. Overall, we found that uniform rED assignment results in differences in DVPs within 3% for the PTV and 5% for OAR. The presence of 1.5 T TMF on IMRT DVPs resulted in differences that were generally within 3% of the Gold St for both the pancreas and prostate. The combination of uniform rED assignment and TMF produced differences in DVPs that were within 4-5% of the Gold St. Larger differences in DVPs were observed for OARs on T2-based plans. The effects of using different rED assignments and the presence of 1.5 T TMF for pancreas and prostate IMRT plans are generally within 3% and 5% of PTV and OAR Gold St values. There are noticeable dosimetric differences between the CT- and MRI-based IMRT plans caused by a combination of anatomical changes between the two image acquisition times, uniform rED assignment and 1.5 T TMF. This work was present in part at the 2014 ASTRO annual meeting.

Optimization for high-dose-rate brachytherapy of cervical cancer with adaptive simulated annealing and gradient descent.

PubMed

Yao, Rui; Templeton, Alistair K; Liao, Yixiang; Turian, Julius V; Kiel, Krystyna D; Chu, James C H

2014-01-01

To validate an in-house optimization program that uses adaptive simulated annealing (ASA) and gradient descent (GD) algorithms and investigate features of physical dose and generalized equivalent uniform dose (gEUD)-based objective functions in high-dose-rate (HDR) brachytherapy for cervical cancer. Eight Syed/Neblett template-based cervical cancer HDR interstitial brachytherapy cases were used for this study. Brachytherapy treatment plans were first generated using inverse planning simulated annealing (IPSA). Using the same dwell positions designated in IPSA, plans were then optimized with both physical dose and gEUD-based objective functions, using both ASA and GD algorithms. Comparisons were made between plans both qualitatively and based on dose-volume parameters, evaluating each optimization method and objective function. A hybrid objective function was also designed and implemented in the in-house program. The ASA plans are higher on bladder V75% and D2cc (p=0.034) and lower on rectum V75% and D2cc (p=0.034) than the IPSA plans. The ASA and GD plans are not significantly different. The gEUD-based plans have higher homogeneity index (p=0.034), lower overdose index (p=0.005), and lower rectum gEUD and normal tissue complication probability (p=0.005) than the physical dose-based plans. The hybrid function can produce a plan with dosimetric parameters between the physical dose-based and gEUD-based plans. The optimized plans with the same objective value and dose-volume histogram could have different dose distributions. Our optimization program based on ASA and GD algorithms is flexible on objective functions, optimization parameters, and can generate optimized plans comparable with IPSA. Copyright © 2014 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

SU-F-T-165: Daily QA Analysis for Spot Scanning Beamline

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

Poenisch, F; Gillin, M; Sahoo, N

2016-06-15

Purpose: The dosimetric results of our daily quality assurance over the last 8 years for discrete pencil beam scanning proton therapy will be presented. Methods: To perform the dosimetric checks, a multi-ion chamber detector is used, which consists of an array of 5 single parallel plate ion chambers that are aligned as a cross separated by 10cm each. The Tracker is snapped into a jig, which is placed on the tabletop. Different amounts of Solid Water buildup are added to shift the dose distribution. The dosimetric checks consist of 3 parts: position check, range check and volume dose check. Results:more » The average deviation of all position-check data were 0.2±1.3%. For the range check, the average deviation was 0.1%±1.2%, which also corresponds to a range stability of better than 1 mm over all measurements. The volumetric dose output readings were all within ±1% with the exception of 2 occasions when the cable to the dose monitor was being repaired. Conclusion: Morning QA using the Tracker device gives very stable dosimetric readings but is also sensitive to mechanical and output changes in the proton therapy delivery system.« less

Performance analysis of a film dosimetric quality assurance procedure for IMRT with regard to the employment of quantitative evaluation methods.

PubMed

Winkler, Peter; Zurl, Brigitte; Guss, Helmuth; Kindl, Peter; Stuecklschweiger, Georg

2005-02-21

A system for dosimetric verification of intensity-modulated radiotherapy (IMRT) treatment plans using absolute calibrated radiographic films is presented. At our institution this verification procedure is performed for all IMRT treatment plans prior to patient irradiation. Therefore clinical treatment plans are transferred to a phantom and recalculated. Composite treatment plans are irradiated to a single film. Film density to absolute dose conversion is performed automatically based on a single calibration film. A software application encompassing film calibration, 2D registration of measurement and calculated distributions, image fusion, and a number of visual and quantitative evaluation utilities was developed. The main topic of this paper is a performance analysis for this quality assurance procedure, with regard to the specification of tolerance levels for quantitative evaluations. Spatial and dosimetric precision and accuracy were determined for the entire procedure, comprising all possible sources of error. The overall dosimetric and spatial measurement uncertainties obtained thereby were 1.9% and 0.8 mm respectively. Based on these results, we specified 5% dose difference and 3 mm distance-to-agreement as our tolerance levels for patient-specific quality assurance for IMRT treatments.

Dosimetric Evaluation of Intensity Modulated Radiotherapy and 4-Field 3-D Conformal Radiotherapy in Prostate Cancer Treatment

PubMed Central

Uysal, Bora; Beyzadeoğlu, Murat; Sager, Ömer; Dinçoğlan, Ferrat; Demiral, Selçuk; Gamsız, Hakan; Sürenkök, Serdar; Oysul, Kaan

2013-01-01

Objective: The purpose of this dosimetric study is the targeted dose homogeneity and critical organ dose comparison of 7-field Intensity Modulated Radiotherapy (IMRT) and 3-D 4-field conformal radiotherapy. Study Design: Cross sectional study. Material and Methods: Twenty patients with low and moderate risk prostate cancer treated at Gülhane Military Medical School Radiation Oncology Department between January 2009 and December 2009 are included in this study. Two seperate dosimetric plans both for 7-field IMRT and 3D-CRT have been generated for each patient to comparatively evaluate the dosimetric status of both techniques and all the patients received 7-field IMRT. Results: Dose-comparative evaluation of two techniques revealed the superiority of IMRT technique with statistically significantly lower femoral head doses along with reduced critical organ dose-volume parameters of bladder V60 (the volume receiving 60 Gy) and rectal V40 (the volume receiving 40 Gy) and V60. Conclusion: It can be concluded that IMRT is an effective definitive management tool for prostate cancer with improved critical organ sparing and excellent dose homogenization in target organs of prostate and seminal vesicles. PMID:25207069

Monte Carlo study of a new I‐125 brachytherapy prototype seed with a ceramic radionuclide carrier and radiographic marker

PubMed Central

Paixão, Lucas; Santos, Ana Maria M.; dos Santos, Adriano Márcio; Grynberg, Suely Epsztein

2012-01-01

In prostate cancer treatment, there is an increasing interest in the permanent radioactive seeds implant technique. Currently, in Brazil, the seeds are imported with high prices, which prohibit their use in public hospitals. A ceramic matrix that can be used as a radioisotope carrier and radiographic marker was developed at our institution. The ceramic matrix is distinguished by the characteristic of maintaining the radioactive material uniformly distributed in its surface. In this work, Monte Carlo simulations were performed in order to assess the dose distributions generated by this prototype seed model, with the ceramic matrix encapsulated in titanium, in the same way as the commercial 6711 seed. The obtained data was assessed, as described in the TG‐43U1 report by the American Association of Physicists in Medicine, for two seed models: (1) the most used model 6711 source — for validation and comparison, and (2) for the prototype model with the ceramic matrix. The dosimetric parameters dose rate constant, Λ, radial dose function, gL(r), and anisotropy function, F(r,θ), were derived from simulations by the Monte Carlo method using the MCNP5 code. A Λ 0.992 (±2.33%) cGyh−1U−1 was found for the prototype model. In comparison with the 6711 model, a lower dose fall‐off on transverse axis was found, as well as a lower dose anisotropy for the radius r= 0.25 cm. In general, for all distances, the prototype seed model presents a slightly larger anisotropy between 0° ≤ Θ < 50° and anisotropy similar to the 6711 model for Θ ≥ 50°. The dosimetric characteristics of the prototype model presented in this study suggest that its use is feasible. Because of the model's characteristics, seeds of lower specific activity iodine might be necessary which, on the other hand, would help to reduce costs. However, it has to be emphasized that the proposed source is a prototype, and the required (AAPM prerequisites) experimental study and tolerance manufacturer values are pending for future studies. PACS numbers: 87.53.Jw, 87.55.K PMID:22584172

Analysis of estimation of electromagnetic dosimetric values from non-ionizing radiofrequency fields in conventional road vehicle environments.

PubMed

Aguirre, Erik; Iturri, Peio Lopez; Azpilicueta, Leire; de Miguel-Bilbao, Silvia; Ramos, Victoria; Gárate, Uxue; Falcone, Francisco

2015-03-01

A high number of wireless technologies can be found operating in vehicular environments with the aim of offering different services. The dosimetric evaluation of this kind of scenarios must be performed in order to assess their compatibility with current exposure limits. In this work, a dosimetric evaluation inside a conventional car is performed, with the aid of an in-house 3D Ray Launching computational code, which has been compared with measurement results of wireless sensor networks located inside the vehicle. These results can aid in an adequate assessment of human exposure to non-ionizing radiofrequency fields, taking into account the impact of the morphology and the topology of the vehicle for current as well as for future exposure limits.

Dosimetric evaluation of lithium carbonate (Li2CO3) as a dosemeter for gamma-radiation dose measurements.

PubMed

Popoca, R; Ureña-Núñez, F

2009-06-01

This work reports the possibility of using lithium carbonate as a dosimetric material for gamma-radiation measurements. Carboxi-radical ions, CO(2)(-) and CO(3)(-), arise from the gamma irradiation of Li(2)CO(3), and these radical ions can be quantified by electron paramagnetic resonance (EPR) spectrometry. The EPR-signal response of gamma-irradiated lithium carbonate has been investigated to determine some dosimetric characteristics such as: peak-to-peak signal intensity versus gamma dose received, zero-dose response, signal fading, signal repeatability, batch homogeneity, dose rate effect and stability at different environmental conditions. Using the conventional peak-to-peak method of stable ion radicals, it is concluded that lithium carbonate could be used as a gamma dosemeter in the range of 3-100 Gy.

Considerations regarding the implementation of EPR dosimetry for the population in the vicinity of Semipalatinsk nuclear test site based on experience from other radiation accidents.

PubMed

Skvortsov, Valeriy; Ivannikov, Alexander; Tikunov, Dimitri; Stepanenko, Valeriy; Borysheva, Natalie; Orlenko, Sergey; Nalapko, Mikhail; Hoshi, Masaharu

2006-02-01

General aspects of applying the method of retrospective dose estimation by electron paramagnetic resonance spectroscopy of human tooth enamel (EPR dosimetry) to the population residing in the vicinity of the Semipalatinsk nuclear test site are analyzed and summarized. The analysis is based on the results obtained during 20 years of investigations conducted in the Medical Radiological Research Center regarding the development and practical application of this method for wide-scale dosimetrical investigation of populations exposed to radiation after the Chernobyl accident and other radiation accidents.

EXCALIBUR-at-CALIBAN: a neutron transmission experiment for {sup 238}U(n,n'{sub continuum}γ) nuclear data validation

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

Bernard, David; Leconte, Pierre; Destouches, Christophe

2015-07-01

Two recent papers justified a new experimental program to give a new basis for the validation of {sup 238}U nuclear data, namely neutron induced inelastic scattering and transport codes at neutron fission energies. The general idea is to perform a neutron transmission experiment through natural uranium material. As shown by Hans Bethe, neutron transmissions measured by dosimetric responses are linked to inelastic cross sections. This paper describes the principle and the results of such an experience called EXCALIBUR performed recently (January and October 2014) at the CALIBAN reactor facility. (authors)

Combined online and offline adaptive radiation therapy: a dosimetric feasibility study.

PubMed

Yang, Chengliang; Liu, Feng; Ahunbay, Ergun; Chang, Yu-Wen; Lawton, Colleen; Schultz, Christopher; Wang, Dian; Firat, Selim; Erickson, Beth; Li, X Allen

2014-01-01

The purpose of this work is to explore a new adaptive radiation therapy (ART) strategy, combined "online and offline" ART, that can fully account for interfraction variations similar to the existing online ART but with substantially reduced online effort. The concept for the combined ART is to perform online ART only for the fractions with obvious interfraction variations and to deliver the ART plan for that online fraction as well as the subsequent fractions until the next online fraction needs to be adapted. To demonstrate the idea, the daily computed tomographic (CT) data acquired during image guided radiation therapy (IGRT) with an in-room CT (CTVision, Siemens Healthcare, Amarillo, TX) for 6 representative patients (including 2 prostate, 1 head-and-neck, and 1 pancreatic cancer, 1 adrenal carcinoma, and 1 craniopharyngioma patients) were analyzed. Three types of plans were generated based on the following selected daily CTs: (1) IGRT repositioning plan, generated by applying the repositioning shifts to the original plan (representing the current IGRT practice); (2) Re-Opt plan, generated with full-scope optimization; and (3) ART plan, either online ART plan generated with an online ART tool (RealArt, Prowess Inc, Concord, CA) or offline ART plan generated with shifts from the online ART plan. Various dose-volume parameters were compared with measure dosimetric benefits of the ART plans based on daily dose distributions and the cumulative dose maps obtained with deformable image registration. In general, for all the cases studied, the ART (with 3-5 online ART) and Re-Opt plans provide comparable plan quality and offer significantly better target coverage and normal tissue sparing when compared with the repositioning plans. This improvement is statistically significant. The combined online and offline ART is dosimetrically equivalent to the online ART but with substantially reduced online effort, and enables immediate delivery of the adaptive plan when an obvious anatomic change is observed. Copyright © 2014 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

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

Buis, Dennis R.; Lagerwaard, Frank J.; Dirven, Clemens M.F.

Purpose: To assess the dosimetric consequences of brain arteriovenous malformation (bAVM) delineation on magnetic resonance angiography (MRA) for the purpose of stereotactic radiosurgery. Methods and Materials: Three observers contoured a bAVM in 20 patients, using digital subtraction angiography (V{sub DSA}) and three-dimensional time-of-flight MRA (V{sub MRA}). Displacement between contours was calculated. Agreement and differences between observers and imaging modalities were assessed. A standardized treatment plan with dynamic conformal arcs was generated and dosimetric coverage of all contours and the volume of normal brain tissue within the high dose region was determined. Results: The generalized reliability coefficient was 'fair' for targetmore » volume (0.79), but 'poor' for displacement (0.35). V{sub MRA} was larger than V{sub DSA} (5.0 vs. 4.0 mL, p = 0.001). No difference in displacement was found (2.8 vs. 2.5 mm, p = 0.156). Dosimetric coverage of V{sub MRA} was 62.9% (95% CI, 56.9-68.8) when V{sub DSA} was used as planning target volume, and coverage of V{sub DSA} was 83.5% (95% CI, 78.1-88.8) when V{sub MRA} was used for planning (p < 0.001). The mean volume of normal brain within the 80% isodose was larger when the bAVM was delineated on MRA (0.7 vs. 1.0 mL (p = 0.02) for targets {<=}3 mL and 3.7 vs. 7.0 mL (p = 0.01) for targets >3 mL). Conclusions: Brain arteriovenous malformations delineated on MRA are larger and more randomly displaced. However, for bAVMs {<=}3 mL, the difference in volume of normal brain tissue within the high-dose region does not seem to be clinically relevant. Therefore, MRA-images might be used as the sole imaging modality for the radiosurgical treatment of bAVMs {<=}3 mL when the bAVM is located in a noneloquent position.« less

SU-F-J-64: Comparison of Dosimetric Robustness Between Proton Therapy and IMRT Plans Following Tumor Regression for Locally Advanced Non-Small Cell Lung Cancer (NSCLC)

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

Teng, C; Ainsley, C; Teo, B

Purpose: In the light of tumor regression and normal tissue changes, dose distributions can deviate undesirably from what was planned. As a consequence, replanning is sometimes necessary during treatment to ensure continued tumor coverage or to avoid overdosing organs at risk (OARs). Proton plans are generally thought to be less robust than photon plans because of the proton beam’s higher sensitivity to changes in tissue composition, suggesting also a higher likely replanning rate due to tumor regression. The purpose of this study is to compare dosimetric deviations between forward-calculated double scattering (DS) proton plans with IMRT plans upon tumor regression,more » and assesses their impact on clinical replanning decisions. Methods: Ten consecutive locally advanced NSCLC patients whose tumors shrank > 50% in volume and who received four or more CT scans during radiotherapy were analyzed. All the patients received proton radiotherapy (6660 cGy, 180 cGy/fx). Dosimetric robustness during therapy was characterized by changes in the planning objective metrics as well as by point-by-point root-mean-squared differences for the entire PTV, ITV, and OARs (heart, cord, esophagus, brachial plexus and lungs) DVHs. Results: Sixty-four pairs of DVHs were reviewed by three clinicians, who requested a replanning rate of 16.7% and 18.6% for DS and IMRT plans, respectively, with a high agreement between providers. Robustness of clinical indicators was found to depend on the beam orientation and dose level on the DVH curve. Proton dose increased most in OARs distal to the PTV along the beam path, but these changes were primarily in the mid to low dose levels. In contrast, the variation in IMRT plans occurred primarily in the high dose region. Conclusion: Robustness of clinical indicators depends where on the DVH curves comparisons are made. Similar replanning rates were observed for DS and IMRT plans upon large tumor regression.« less

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

Kakinohana, Y; Toita, T; Kasuya, G

Purpose: To compare the dosimetric properties of radiochromic films with different orientation. Methods: A sheet of EBT3 film was cut into eight pieces with the following sizes: 15×15 cm2 (one piece), 5x15 cm{sup 2} (two) and 4×5 cm{sup 2} (five). A set of two EBT3 sheets was used at each dose level. Two sets were used changing the delivered doses (1 and 2 Gy). The 5×15 cm{sup 2} pieces were rotated by 90 degrees in relation to each other, such that one had landscape orientation and the other had portrait orientation. All 5×15 cm2 pieces were irradiated with their longmore » side aligned with the x-axis of the radiation field. The 15×15 cm{sup 2} pieces were irradiated rotated at 90 degrees to each other. Five pieces, (a total of ten from two sheets) were used to obtain a calibration curve. The irradiated films were scanned using an Epson ES-2200 scanner and were analyzed using ImageJ software. In this study, no correction was applied for the nonuniform scanner signal that is evident in the direction of the scanner lamp. Each film piece was scanned both in portrait and landscape orientations. Dosimetric comparisons of the beam profiles were made in terms of the film orientations (portrait and landscape) and scanner bed directions (perpendicular and parallel to the scanner movement). Results: In general, portrait orientation exhibited higher noise than landscape and was adversely affected to a great extent by the nonuniformity in the direction of the scanner lamp. A significant difference in the measured field widths between the perpendicular and parallel directions was found for both orientations. Conclusion: Without correction for the nonuniform scanner signal in the direction of the scanner lamp, a landscape orientation is preferable. A more detailed investigation is planned to evaluate quantitatively the effect of orientation on the dosimetric properties of a film.« less

Technical Note: Dosimetric effects of couch position variability on treatment plan quality with an MRI-guided Co-60 radiation therapy machine

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

Chow, Phillip E., E-mail: pechow@mednet.ucla.edu

2016-08-15

Purpose: Magnetic resonance imaging (MRI) guidance in radiation therapy brings real-time imaging and adaptive planning into the treatment vault where it can account for interfraction and intrafraction movement of soft tissue. The only commercially available MRI-guided radiation therapy device is a three-head {sup 60}Co and MRI system with an integrated treatment planning system (TPS). Couch attenuation of the beam of up to 20% is well modeled in the TPS. Variations in the patient’s day-to-day position introduce discrepancies in the actual couch attenuation as modeled in the treatment plan. For this reason, the authors’ institution avoids plans with beams that passmore » through or near the couch edges. This study investigates the effects of differential beam attenuation by the couch due to couch shifts in order to determine whether couch edge avoidance restrictions can be lifted. Couch shifts were simulated using a Monte Carlo treatment planning system and ion chamber measurements performed for validation. Methods: A total of 27 plans from 23 patients were investigated. Couch shifts of 1 and 2 cm were introduced in combinations of lateral and vertical directions to simulate patient position variations giving 16 shifted plans per reference plan. The 1 and 2 cm shifts were based on shifts recorded in 320 treatment fractions. Results: Following TG176 recommendations for measurement methods, couch attenuation measurements agreed with TPS modeled attenuation to within 2.1%. Planning target volume D95 changed less than 1% for 1 and 2 cm couch shifts in only the x-direction and less than 3% for all directions. Conclusions: Dosimetry of all plans tested was robust to couch shifts up to ±2 cm. In general, couch shifts resulted in clinically insignificant dosimetric deviations. It is conceivable that in certain cases with large systematic couch shifts and plans that are particularly sensitive to shifts, dosimetric changes might rise to a clinically significant level.« less

SU-F-T-189: Dosimetric Comparison of Spot-Scanning Proton Therapy Techniques for Liver Tumors Close to the Skin Surface

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

Takao, S; Matsuzaki, Y; Matsuura, T

Purpose: Spot-scanning technique has been utilized to achieve conformal dose distribution to large and complicated tumors. This technique generally does not require patient-specific devices such as aperture and compensator. The commercially available spot-scanning proton therapy (SSPT) systems, however, cannot deliver proton beams to the region shallower than 4 g/cm2. Therefore some range compensation device is required to treat superficial tumors with SSPT. This study shows dosimetric comparison of the following treatment techniques: (i) with a tabletop bolus, (ii) with a nozzle-mounted applicator, and (iii) without any devices and using intensity-modulated proton therapy (IMPT) technique. Methods: The applicator composed of amore » combination of a mini-ridge filter and a range shifter has been manufactured by Hitachi, Ltd., and the tabletop bolus was made by .decimal, Inc. Both devices have been clinically implemented in our facility. Three patients with liver tumors close to the skin surface were examined in this study. Each treatment plan was optimized so that the prescription dose of 76 Gy(RBE) or 66 Gy(RBE) would be delivered to 99% of the clinical target volume in 20 fractions. Three beams were used for tabletop bolus plan and IMPT plan, whereas two beams were used in the applicator plan because the gantry angle available was limited due to potential collision to patient and couch. The normal liver, colon, and skin were considered as organs at risk (OARs). Results: The target heterogeneity index (HI = D{sub 5}/D{sub 95}) was 1.03 on average in each planning technique. The mean dose to the normal liver was considerably less than 20 Gy(RBE) in all cases. The dose to the skin could be reduced by 20 Gy(RBE) on average in the IMPT plan compared to the applicator plan. Conclusion: It has been confirmed that all treatment techniques met the dosimetric criteria for the OARs and could be implemented clinically.« less

Impact of the vaginal applicator and dummy pellets on the dosimetry parameters of Cs-137 brachytherapy source.

PubMed

Sina, Sedigheh; Faghihi, Reza; Meigooni, Ali S; Mehdizadeh, Simin; Mosleh Shirazi, M Amin; Zehtabian, Mehdi

2011-05-19

In this study, dose rate distribution around a spherical 137Cs pellet source, from a low-dose-rate (LDR) Selectron remote afterloading system used in gynecological brachytherapy, has been determined using experimental and Monte Carlo simulation techniques. Monte Carlo simulations were performed using MCNP4C code, for a single pellet source in water medium and Plexiglas, and measurements were performed in Plexiglas phantom material using LiF TLD chips. Absolute dose rate distribution and the dosimetric parameters, such as dose rate constant, radial dose functions, and anisotropy functions, were obtained for a single pellet source. In order to investigate the effect of the applicator and surrounding pellets on dosimetric parameters of the source, the simulations were repeated for six different arrangements with a single active source and five non-active pellets inside central metallic tubing of a vaginal cylindrical applicator. In commercial treatment planning systems (TPS), the attenuation effects of the applicator and inactive spacers on total dose are neglected. The results indicate that this effect could lead to overestimation of the calculated F(r,θ), by up to 7% along the longitudinal axis of the applicator, especially beyond the applicator tip. According to the results obtained in this study, in a real situation in treatment of patients using cylindrical vaginal applicator and using several active pellets, there will be a large discrepancy between the result of superposition and Monte Carlo simulations.

Incorporation of dosimetry in the derivation of reference concentrations for ambient or workplace air: a conceptual approach.

PubMed

Oller, Adriana R; Oberdörster, Günter

2016-09-01

Dosimetric models are essential tools to refine inhalation risk assessments based on local respiratory effects. Dosimetric adjustments to account for differences in aerosol particle size and respiratory tract deposition and/or clearance among rodents, workers, and the general public can be applied to experimentally- and epidemiologically-determined points of departure (PODs) to calculate size-selected (e.g., PM 10 , inhalable aerosol fraction, respirable aerosol fraction) equivalent concentrations (e.g., HEC or Human Equivalent Concentration; REC or Rodent Equivalent Concentration). A modified POD (e.g., HEC) can then feed into existing frameworks for the derivation of occupational or ambient air concentration limits or reference concentrations. HECs that are expressed in terms of aerosol particle sizes experienced by humans but are derived from animal studies allow proper comparison of exposure levels and associated health effects in animals and humans. This can inform differences in responsiveness between animals and humans, based on the same deposited or retained doses and can also allow the use of both data sources in an integrated weight of evidence approach for hazard and risk assessment purposes. Whenever possible, default values should be replaced by substance-specific and target population-specific parameters. Assumptions and sources of uncertainty need to be clearly reported.

Incorporation of dosimetry in the derivation of reference concentrations for ambient or workplace air: a conceptual approach

PubMed Central

Oberdörster, Günter

2016-01-01

Dosimetric models are essential tools to refine inhalation risk assessments based on local respiratory effects. Dosimetric adjustments to account for differences in aerosol particle size and respiratory tract deposition and/or clearance among rodents, workers, and the general public can be applied to experimentally- and epidemiologically-determined points of departure (PODs) to calculate size-selected (e.g., PM10, inhalable aerosol fraction, respirable aerosol fraction) equivalent concentrations (e.g., HEC or Human Equivalent Concentration; REC or Rodent Equivalent Concentration). A modified POD (e.g., HEC) can then feed into existing frameworks for the derivation of occupational or ambient air concentration limits or reference concentrations. HECs that are expressed in terms of aerosol particle sizes experienced by humans but are derived from animal studies allow proper comparison of exposure levels and associated health effects in animals and humans. This can inform differences in responsiveness between animals and humans, based on the same deposited or retained doses and can also allow the use of both data sources in an integrated weight of evidence approach for hazard and risk assessment purposes. Whenever possible, default values should be replaced by substance-specific and target population-specific parameters. Assumptions and sources of uncertainty need to be clearly reported. PMID:27721518

WE-AB-209-12: Quasi Constrained Multi-Criteria Optimization for Automated Radiation Therapy Treatment Planning

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

Watkins, W.T.; Siebers, J.V.

Purpose: To introduce quasi-constrained Multi-Criteria Optimization (qcMCO) for unsupervised radiation therapy optimization which generates alternative patient-specific plans emphasizing dosimetric tradeoffs and conformance to clinical constraints for multiple delivery techniques. Methods: For N Organs At Risk (OARs) and M delivery techniques, qcMCO generates M(N+1) alternative treatment plans per patient. Objective weight variations for OARs and targets are used to generate alternative qcMCO plans. For 30 locally advanced lung cancer patients, qcMCO plans were generated for dosimetric tradeoffs to four OARs: each lung, heart, and esophagus (N=4) and 4 delivery techniques (simple 4-field arrangements, 9-field coplanar IMRT, 27-field non-coplanar IMRT, and non-coplanarmore » Arc IMRT). Quasi-constrained objectives included target prescription isodose to 95% (PTV-D95), maximum PTV dose (PTV-Dmax)< 110% of prescription, and spinal cord Dmax<45 Gy. The algorithm’s ability to meet these constraints while simultaneously revealing dosimetric tradeoffs was investigated. Statistically significant dosimetric tradeoffs were defined such that the coefficient of determination between dosimetric indices which varied by at least 5 Gy between different plans was >0.8. Results: The qcMCO plans varied mean dose by >5 Gy to ipsilateral lung for 24/30 patients, contralateral lung for 29/30 patients, esophagus for 29/30 patients, and heart for 19/30 patients. In the 600 plans computed without human interaction, average PTV-D95=67.4±3.3 Gy, PTV-Dmax=79.2±5.3 Gy, and spinal cord Dmax was >45 Gy in 93 plans (>50 Gy in 2/600 plans). Statistically significant dosimetric tradeoffs were evident in 19/30 plans, including multiple tradeoffs of at least 5 Gy between multiple OARs in 7/30 cases. The most common statistically significant tradeoff was increasing PTV-Dmax to reduce OAR dose (15/30 patients). Conclusion: The qcMCO method can conform to quasi-constrained objectives while revealing significant variations in OAR doses including mean dose reductions >5 Gy. Clinical implementation will facilitate patient-specific decision making based on achievable dosimetry as opposed to accept/reject models based on population derived objectives.« less

Preliminary study for small animal preclinical hadrontherapy facility

NASA Astrophysics Data System (ADS)

Russo, G.; Pisciotta, P.; Cirrone, G. A. P.; Romano, F.; Cammarata, F.; Marchese, V.; Forte, G. I.; Lamia, D.; Minafra, L.; Bravatá, V.; Acquaviva, R.; Gilardi, M. C.; Cuttone, G.

2017-02-01

Aim of this work is the study of the preliminary steps to perform a particle treatment of cancer cells inoculated in small animals and to realize a preclinical hadrontherapy facility. A well-defined dosimetric protocol was developed to explicate the steps needed in order to perform a precise proton irradiation in small animals and achieve a highly conformal dose into the target. A precise homemade positioning and holding system for small animals was designed and developed at INFN-LNS in Catania (Italy), where an accurate Monte Carlo simulation was developed, using Geant4 code to simulate the treatment in order to choose the best animal position and perform accurately all the necessary dosimetric evaluations. The Geant4 application can also be used to realize dosimetric studies and its peculiarity consists in the possibility to introduce the real target composition in the simulation using the DICOM micro-CT image. This application was fully validated comparing the results with the experimental measurements. The latter ones were performed at the CATANA (Centro di AdroTerapia e Applicazioni Nucleari Avanzate) facility at INFN-LNS by irradiating both PMMA and water solid phantom. Dosimetric measurements were performed using previously calibrated EBT3 Gafchromic films as a detector and the results were compared with the Geant4 simulation ones. In particular, two different types of dosimetric studies were performed: the first one involved irradiation of a phantom made up of water solid slabs where a layer of EBT3 was alternated with two different slabs in a sandwich configuration, in order to validate the dosimetric distribution. The second one involved irradiation of a PMMA phantom made up of a half hemisphere and some PMMA slabs in order to simulate a subcutaneous tumour configuration, normally used in preclinical studies. In order to evaluate the accordance between experimental and simulation results, two different statistical tests were made: Kolmogorov test and gamma index test. This work represents the first step towards the realization of a preclinical hadrontherapy facility at INFN-LNS in Catania for the future in vivo studies.

SU-F-T-107: Correlations Between Dosimetric Indices of Pharyngeal Constrictors and Proximal Esophagus with Associated Patient-Reported Outcomes Six Months After Radiation Therapy for Head and Neck Cancer

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

Chera, B; Price, A; Kostich, M

Purpose: To compare the correlations between different dosimetric indices derived from the pharyngeal constrictor muscles and proximal esophagus with patient-reported difficulty in swallowing 6 months post radiotherapy using a novel patient reported outcome version of CTCAE (PRO-CTCAE). Methods: Forty-three patients with oropharyngeal squamous cell carcinoma were treated on a prospective multi-institutional study. All patients received de-intensified 60 Gy intensity modulated radiotherapy. We investigated correlations of individual patient dosimetric data of the superior (SPC), middle (MPC), inferior (IPC) pharyngeal constrictor muscles, the superior esophagus (SES), and the inferior esophagus (IES) to their self-reported 6 month post-treatment swallowing difficulty responses. Mild (≥more » Grade 1) swallowing difficulty responses were used as the clinical endpoint indicating response. The predictive efficacy of Dmean and dose-volume (VD) points were assessed through the area under the Receiver Operating Characteristic curve (ROC) and Odds Ratio (OR). Results: The SES and SPC had more favorable area under the curves (AUC) for the Dmean (0.62 and 0.70) while the Dmean to the IPC, MPC, and IES produced suboptimal AUCs (0.42, 0.48, and 0.52). Additionally, over the range of VD, the V54 and V55 for the SES and SPC demonstrated the highest AUCs: AUC(SES) = 0.76–0.73 and AUC(SPC) = 0.72–0.69, respectively. The IES, IPC, and MPC had worse AUC results over the range of VD. An optimal OR can be found when V54 = 96% for the SPC, where OR = 3.96 (1.07–14.62). Conclusion: The V45 and V55 of the SES and SPC had the highest correlation to the clinical endpoint compared to the commonly used dosimetric index, Dmean for both the esophagus and constrictor muscles. The reported dosimetric data demonstrates that new dosimetric indices may need to be considered in the setting of dose de-escalation and self-reported outcomes.« less

Dosimetric comparison between proton beam therapy and photon radiation therapy for locally advanced esophageal squamous cell carcinoma.

PubMed

Hirano, Yasuhiro; Onozawa, Masakatsu; Hojo, Hidehiro; Motegi, Atsushi; Zenda, Sadatomo; Hotta, Kenji; Moriya, Shunsuke; Tachibana, Hidenobu; Nakamura, Naoki; Kojima, Takashi; Akimoto, Tetsuo

2018-02-09

The purpose of this study was to perform a dosimetric comparison between proton beam therapy (PBT) and photon radiation therapy in patients with locally advanced esophageal squamous cell carcinoma (ESCC) who were treated with PBT in our institution. In addition, we evaluated the correlation between toxicities and dosimetric parameters, especially the doses to normal lung or heart tissue, to clarify the clinical advantage of PBT over photon radiation therapy. A total of 37 consecutive patients with Stage III thoracic ESCC who had received PBT with or without concurrent chemotherapy between October 2012 and December 2015 were evaluated in this study. The dose distributions of PBT were compared with those of dummy 3-dimensional conformal radiation therapy (3DCRT) and Intensity Modulated Radiation Therapy (IMRT), focusing especially on the doses to organs at risk, such as normal lung and heart tissue. Of the 37 patients, the data from 27 patients were analyzed. Among these 27 patients, four patients (15%) developed grade 2 pericardial effusion as a late toxicity. None of the patients developed grade 3 or worse acute or late pulmonary and cardiac toxicities. When the dosimetric parameters between PBT and planned 3DCRT were compared, all the PBT domestic variables for the lung dose except for lung V10 GyE and V15 GyE were significantly lower than those for the dummy 3DCRT plans, and the PBT domestic variables for the heart dose were also significantly lower than those for the dummy 3DCRT plans. When the PBT and IMRT plans were compared, all the PBT domestic variables for the doses to the lung and heart were significantly lower than those for the dummy IMRT plans. Regarding the correlation between the grades of toxicities and the dosimetric parameters, no significant correlation was seen between the occurrence of grade 2 pericardial effusion and the dose to the heart. When the dosimetric parameters of the dose distributions for the treatment of patients with locally advanced stage III ESCC were compared between PBT and 3DCRT or IMRT, PBT enabled a significant reduction in the dose to the lung and heart, compared with 3DCRT or IMRT.

Adaptive optimization by 6 DOF robotic couch in prostate volumetric IMRT treatment: rototranslational shift and dosimetric consequences

PubMed Central

Placidi, Lorenzo; Azario, Luigi; Mattiucci, Gian Carlo; Greco, Francesca; Damiani, Andrea; Mantini, Giovanna; Frascino, Vincenzo; Piermattei, Angelo; Valentini, Vincenzo; Balducci, Mario

2015-01-01

The purpose of this study was to investigate the magnitude and dosimetric relevance of translational and rotational shifts on IGRT prostate volumetric‐modulated arc therapy (VMAT) using Protura six degrees of freedom (DOF) Robotic Patient Positioning System. Patients with cT3aN0M0 prostate cancer, treated with VMAT simultaneous integrated boost (VMAT‐SIB), were enrolled. PTV2 was obtained adding 0.7 cm margin to seminal vesicles base (CTV2), while PTV1 adding to prostate (CTV1) 0.7 cm margin in all directions, except 1.2 cm, as caudal margin. A daily CBCT was acquired before dose delivery. The translational and rotational displacements were corrected through Protura Robotic Couch, collected and applied to the simulation CT to obtain a translated CT (tCT) and a rototranslated CT (rtCT) on which we recalculated the initial treatment plan (TP). We analyzed the correlation between dosimetric coverage, organs at risk (OAR) sparing, and translational or rotational displacements. The dosimetric impact of a rototranslational correction was calculated. From October 2012 to September 2013, a total of 263 CBCT scans from 12 patients were collected. Translational shifts were <5mm in 81% of patients and the rotational shifts were <2∘ in 93% of patient scans. The dosimetric analysis was performed on 172 CBCT scans and calculating 344 VMAT‐TP. Two significant linear correlations were observed between yaw and the V20 femoral heads and between pitch rotation and V50 rectum (p<0.001); rototranslational correction seems to impact more on PTV2 than on PTV1, especially when margins are reduced. Rotational errors are of dosimetric significance in sparing OAR and in target coverage. This is relevant for femoral heads and rectum because of major distance from isocenter, and for seminal vesicles because of irregular shape. No correlation was observed between translational and rotational errors. A study considering the intrafractional error and the deformable registration is ongoing. PACS number: 87.55.de PMID:26699314

EXPERIMENTAL EVALUATION OF DOSIMETRIC CHARACTERIZATION OF GAFCHROMIC EBT3 AND EBT-XD FILMS FOR CLINICAL CARBON ION BEAMS.

PubMed

Yonai, Shunsuke; Arai, Chinatsu; Shimoyama, Kaoru; Fournier-Bidoz, Nathalie

2018-02-03

Radiochromic film is a very useful tool for 2D dosimetric measurements in radiotherapy because it is self-developing and has very high-spatial resolution. However, considerable care has to be taken in ion beam radiotherapy owing to the quenching effect of high-linear energy transfer (LET) radiation. In this study, the dose responses of GAFchromic EBT3 and EBT-XD films were experimentally investigated using the clinical carbon ion beam at the Heavy Ion Medical Accelerator in Chiba. Results showed that the relations between absorbed dose and net optical density could be expressed well using an equation proposed by Reinhardt (2015). The quenching effect was evaluated by determining their relative efficiencies for photon irradiation as a function of LET. A correction equation derived in this study allowed the absorbed dose to be determined in the small irradiation field used for carbon ion radiotherapy eye treatments. This study contributes to establishing an absolute dosimetry procedure for heavy ion beams using radiochromic film. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Cell irradiation setup and dosimetry for radiobiological studies at ELBE

NASA Astrophysics Data System (ADS)

Zeil, K.; Beyreuther, E.; Lessmann, E.; Wagner, W.; Pawelke, J.

2009-07-01

The radiation source ELBE delivers different types of secondary radiation, which is used for cell irradiation studies in radiobiological research. Thereby an important issue is the determination of the biological effectiveness of photon radiation as a function of photon energy by using low-energetic, monochromatic channeling radiation (10-100 keV) and high-energetic bremsstrahlung (up to 40 MV). Radiobiological studies at the research facility ELBE demand special technical and dosimetric prerequisites. Therefore, a cell irradiation system (CIS) has been designed, constructed and installed at the beam line. The CIS allows automatic irradiation of a larger cell sample number and the compensation of spatial inhomogeneity of the dose distribution within the beam spot. The recently introduced GafChromic ® EBT radiochromic film model has been used to verify the cell irradiation dose deposition achieving a dose uncertainty of <5%. Both, the installed cell irradiation system and the developed dosimetric procedure based on the use of the EBT film have been experimentally tested at ELBE. The biological effectiveness of 34 MV bremsstrahlung with respect to 200 kV X-rays from a conventional X-ray tube has been determined. An RBE value of 0.75 has been measured in good agreement with literature.

Dosimetric treatment course simulation based on a statistical model of deformable organ motion

NASA Astrophysics Data System (ADS)

Söhn, M.; Sobotta, B.; Alber, M.

2012-06-01

We present a method of modeling dosimetric consequences of organ deformation and correlated motion of adjacent organ structures in radiotherapy. Based on a few organ geometry samples and the respective deformation fields as determined by deformable registration, principal component analysis (PCA) is used to create a low-dimensional parametric statistical organ deformation model (Söhn et al 2005 Phys. Med. Biol. 50 5893-908). PCA determines the most important geometric variability in terms of eigenmodes, which represent 3D vector fields of correlated organ deformations around the mean geometry. Weighted sums of a few dominating eigenmodes can be used to simulate synthetic geometries, which are statistically meaningful inter- and extrapolations of the input geometries, and predict their probability of occurrence. We present the use of PCA as a versatile treatment simulation tool, which allows comprehensive dosimetric assessment of the detrimental effects that deformable geometric uncertainties can have on a planned dose distribution. For this, a set of random synthetic geometries is generated by a PCA model for each simulated treatment course, and the dose of a given treatment plan is accumulated in the moving tissue elements via dose warping. This enables the calculation of average voxel doses, local dose variability, dose-volume histogram uncertainties, marginal as well as joint probability distributions of organ equivalent uniform doses and thus of TCP and NTCP, and other dosimetric and biologic endpoints. The method is applied to the example of deformable motion of prostate/bladder/rectum in prostate IMRT. Applications include dosimetric assessment of the adequacy of margin recipes, adaptation schemes, etc, as well as prospective ‘virtual’ evaluation of the possible benefits of new radiotherapy schemes.

Influence of Free Radicals Signal from Dental Resins on the Radio-Induced Signal in Teeth in EPR Retrospective Dosimetry

PubMed Central

Dos Santos-Goncalvez, Ana Maria; Beun, Sébastien; Leprince, Julian G.; Leloup, Gaëtane; Gallez, Bernard

2013-01-01

In case of radiological accident, retrospective dosimetry is needed to reconstruct the absorbed dose of overexposed individuals not wearing personal dosimeters at the onset of the incident. In such a situation, emergency mass triage will be required. In this context, it has been shown that Electron Paramagnetic Resonance (EPR) spectroscopy would be a rapid and sensitive method, on the field deployable system, allowing dose evaluation of a great number of people in a short time period. This methodology uses tooth enamel as a natural dosimeter. Ionising radiations create stable free radicals in the enamel, in a dose dependent manner, which can be detected by EPR directly in the mouth with an appropriate resonator. Teeth are often subject to restorations, currently made of synthetic dimethacrylate-based photopolymerizable composites. It is known that some dental composites give an EPR signal which is likely to interfere with the dosimetric signal from the enamel. So far, no information was available about the occurrence of this signal in the various composites available on the market, the magnitude of the signal compared to the dosimetric signal, nor its evolution with time. In this study, we conducted a systematic characterization of the signal (intensity, kinetics, interference with dosimetric signal) on 19 most widely used composites for tooth restoration, and on 14 experimental resins made with the most characteristic monomers found in commercial composites. Although a strong EPR signal was observed in every material, a rapid decay of the signal was noted. Six months after the polymerization, the signal was negligible in most composites compared to a 3 Gy dosimetric signal in a tooth. In some cases, a stable atypical signal was observed, which was still interfering with the dosimetric signal. PMID:23704875

The use of megavoltage CT (MVCT) images for dose recomputations

NASA Astrophysics Data System (ADS)

Langen, K. M.; Meeks, S. L.; Poole, D. O.; Wagner, T. H.; Willoughby, T. R.; Kupelian, P. A.; Ruchala, K. J.; Haimerl, J.; Olivera, G. H.

2005-09-01

Megavoltage CT (MVCT) images of patients are acquired daily on a helical tomotherapy unit (TomoTherapy, Inc., Madison, WI). While these images are used primarily for patient alignment, they can also be used to recalculate the treatment plan for the patient anatomy of the day. The use of MVCT images for dose computations requires a reliable CT number to electron density calibration curve. In this work, we tested the stability of the MVCT numbers by determining the variation of this calibration with spatial arrangement of the phantom, time and MVCT acquisition parameters. The two calibration curves that represent the largest variations were applied to six clinical MVCT images for recalculations to test for dosimetric uncertainties. Among the six cases tested, the largest difference in any of the dosimetric endpoints was 3.1% but more typically the dosimetric endpoints varied by less than 2%. Using an average CT to electron density calibration and a thorax phantom, a series of end-to-end tests were run. Using a rigid phantom, recalculated dose volume histograms (DVHs) were compared with plan DVHs. Using a deformed phantom, recalculated point dose variations were compared with measurements. The MVCT field of view is limited and the image space outside this field of view can be filled in with information from the planning kVCT. This merging technique was tested for a rigid phantom. Finally, the influence of the MVCT slice thickness on the dose recalculation was investigated. The dosimetric differences observed in all phantom tests were within the range of dosimetric uncertainties observed due to variations in the calibration curve. The use of MVCT images allows the assessment of daily dose distributions with an accuracy that is similar to that of the initial kVCT dose calculation.

Dosimetric treatment course simulation based on a statistical model of deformable organ motion.

PubMed

Söhn, M; Sobotta, B; Alber, M

2012-06-21

We present a method of modeling dosimetric consequences of organ deformation and correlated motion of adjacent organ structures in radiotherapy. Based on a few organ geometry samples and the respective deformation fields as determined by deformable registration, principal component analysis (PCA) is used to create a low-dimensional parametric statistical organ deformation model (Söhn et al 2005 Phys. Med. Biol. 50 5893-908). PCA determines the most important geometric variability in terms of eigenmodes, which represent 3D vector fields of correlated organ deformations around the mean geometry. Weighted sums of a few dominating eigenmodes can be used to simulate synthetic geometries, which are statistically meaningful inter- and extrapolations of the input geometries, and predict their probability of occurrence. We present the use of PCA as a versatile treatment simulation tool, which allows comprehensive dosimetric assessment of the detrimental effects that deformable geometric uncertainties can have on a planned dose distribution. For this, a set of random synthetic geometries is generated by a PCA model for each simulated treatment course, and the dose of a given treatment plan is accumulated in the moving tissue elements via dose warping. This enables the calculation of average voxel doses, local dose variability, dose-volume histogram uncertainties, marginal as well as joint probability distributions of organ equivalent uniform doses and thus of TCP and NTCP, and other dosimetric and biologic endpoints. The method is applied to the example of deformable motion of prostate/bladder/rectum in prostate IMRT. Applications include dosimetric assessment of the adequacy of margin recipes, adaptation schemes, etc, as well as prospective 'virtual' evaluation of the possible benefits of new radiotherapy schemes.

Dosimetric Considerations in Respiratory-Gated Deep Inspiration Breath-Hold for Left Breast Irradiation.

PubMed

Walston, Steve; Quick, Allison M; Kuhn, Karla; Rong, Yi

2017-02-01

To present our clinical workflow of incorporating AlignRT for left breast deep inspiration breath-hold treatments and the dosimetric considerations with the deep inspiration breath-hold protocol. Patients with stage I to III left-sided breast cancer who underwent lumpectomy or mastectomy were considered candidates for deep inspiration breath-hold technique for their external beam radiation therapy. Treatment plans were created on both free-breathing and deep inspiration breath-hold computed tomography for each patient to determine whether deep inspiration breath-hold was beneficial based on dosimetric comparison. The AlignRT system was used for patient setup and monitoring. Dosimetric measurements and their correlation with chest wall excursion and increase in left lung volume were studied for free-breathing and deep inspiration breath-hold plans. Deep inspiration breath-hold plans had significantly increased chest wall excursion when compared with free breathing. This change in geometry resulted in reduced mean and maximum heart dose but did not impact lung V 20 or mean dose. The correlation between chest wall excursion and absolute reduction in heart or lung dose was found to be nonsignificant, but correlation between left lung volume and heart dose showed a linear association. It was also identified that higher levels of chest wall excursion may paradoxically increase heart or lung dose. Reduction in heart dose can be achieved for many left-sided breast and chest wall patients using deep inspiration breath-hold. Chest wall excursion as well as left lung volume did not correlate with reduction in heart dose, and it remains to be determined what metric will provide the most optimal and reliable dosimetric advantage.

Subungual squamous cell carcinoma: A case study

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

Neill, Cory J., E-mail: coryjneill@gmail.com

The purpose of this case study is to describe a dosimetric delivery of radiation to a superficial disease process involving the skin and bone of the distal finger. A 76-year-old male patient presented with a subungual squamous cell carcinoma (SCC) of the left distal index finger with bony involvement. The patient refused conventional surgical treatment but agreed to external beam radiation therapy (EBRT). There is a gap in the current literature describing how to successfully immobilize fingers and which EBRT modality is dosimetrically advantageous in treating them. The construction of a simple immobilization method with the patient in a reproduciblemore » position is described. The use of photons and electrons were compared ultimately showing photons to be dosimetrically advantageous. Long-term efficacy of the treatment was not evaluated because of patient noncompliance.« less

DARTAB: a program to combine airborne radionuclide environmental exposure data with dosimetric and health effects data to generate tabulations of predicted health impacts

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

Begovich, C.L.; Eckerman, K.F.; Schlatter, E.C.

1981-08-01

The DARTAB computer code combines radionuclide environmental exposure data with dosimetric and health effects data to generate tabulations of the predicted impact of radioactive airborne effluents. DARTAB is independent of the environmental transport code used to generate the environmental exposure data and the codes used to produce the dosimetric and health effects data. Therefore human dose and risk calculations need not be added to every environmental transport code. Options are included in DARTAB to permit the user to request tabulations by various topics (e.g., cancer site, exposure pathway, etc.) to facilitate characterization of the human health impacts of the effluents.more » The DARTAB code was written at ORNL for the US Environmental Protection Agency, Office of Radiation Programs.« less

Comparison of dose accuracy between 2D array detectors and Epid for IMRT of nasopharynx cancer

NASA Astrophysics Data System (ADS)

Altiparmak, Duygu; Coban, Yasin; Merih, Adil; Avci, Gulhan Guler; Yigitoglu, Ibrahim

2017-02-01

The aim of this study is to perform the dosimetric controls of nasopharynx cancer patient's intensity modulated radiation therapy (IMRT) treatment plans that generated by treatment planing system (TPS) with using two different equipments and also to make comparison in terms of their reliability and practicability. This study has been performed at Radiation Oncology Department, Medicine Faculty in Gaziosmanpasa University by using the VARIAN CLINAC DHX linear accelerator which is operated in the range of 6 MV. Selected 10 nasopharynx patients planned in TPS (Eclipce V13.0) and approved for treatment by medical physicists and radiation oncologists. These plans recalculated on EPID and mapcheck which are 2D dosimetric equipments to obtain dose maps. To compare these two dosimetric equipments gamma analysis method has been preferred. Achieved data is presented and discussed.

Dosimetric variations due to interfraction organ deformation in cervical cancer brachytherapy.

PubMed

Kobayashi, Kazuma; Murakami, Naoya; Wakita, Akihisa; Nakamura, Satoshi; Okamoto, Hiroyuki; Umezawa, Rei; Takahashi, Kana; Inaba, Koji; Igaki, Hiroshi; Ito, Yoshinori; Shigematsu, Naoyuki; Itami, Jun

2015-12-01

We quantitatively estimated dosimetric variations due to interfraction organ deformation in multi-fractionated high-dose-rate brachytherapy (HDRBT) for cervical cancer using a novel surface-based non-rigid deformable registration. As the number of consecutive HDRBT fractions increased, simple addition of dose-volume histogram parameters significantly overestimated the dose, compared with distribution-based dose addition. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Validation of a personalized dosimetric evaluation tool (Oedipe) for targeted radiotherapy based on the Monte Carlo MCNPX code

NASA Astrophysics Data System (ADS)

Chiavassa, S.; Aubineau-Lanièce, I.; Bitar, A.; Lisbona, A.; Barbet, J.; Franck, D.; Jourdain, J. R.; Bardiès, M.

2006-02-01

Dosimetric studies are necessary for all patients treated with targeted radiotherapy. In order to attain the precision required, we have developed Oedipe, a dosimetric tool based on the MCNPX Monte Carlo code. The anatomy of each patient is considered in the form of a voxel-based geometry created using computed tomography (CT) images or magnetic resonance imaging (MRI). Oedipe enables dosimetry studies to be carried out at the voxel scale. Validation of the results obtained by comparison with existing methods is complex because there are multiple sources of variation: calculation methods (different Monte Carlo codes, point kernel), patient representations (model or specific) and geometry definitions (mathematical or voxel-based). In this paper, we validate Oedipe by taking each of these parameters into account independently. Monte Carlo methodology requires long calculation times, particularly in the case of voxel-based geometries, and this is one of the limits of personalized dosimetric methods. However, our results show that the use of voxel-based geometry as opposed to a mathematically defined geometry decreases the calculation time two-fold, due to an optimization of the MCNPX2.5e code. It is therefore possible to envisage the use of Oedipe for personalized dosimetry in the clinical context of targeted radiotherapy.

Transformation of Physical DVHs to Radiobiologically Equivalent Ones in Hypofractionated Radiotherapy Analyzing Dosimetric and Clinical Parameters: A Practical Approach for Routine Clinical Practice in Radiation Oncology

PubMed Central

Thrapsanioti, Zoi; Karanasiou, Irene; Platoni, Kalliopi; Efstathopoulos, Efstathios P.; Matsopoulos, George; Dilvoi, Maria; Patatoukas, George; Chaldeopoulos, Demetrios; Kelekis, Nikolaos; Kouloulias, Vassilis

2013-01-01

Purpose. The purpose of this study was to transform DVHs from physical to radiobiological ones as well as to evaluate their reliability by correlations of dosimetric and clinical parameters for 50 patients with prostate cancer and 50 patients with breast cancer, who were submitted to Hypofractionated Radiotherapy. Methods and Materials. To achieve this transformation, we used both the linear-quadratic model (LQ model) and the Niemierko model. The outcome of radiobiological DVHs was correlated with acute toxicity score according to EORTC/RTOG criteria. Results. Concerning the prostate radiotherapy, there was a significant correlation between RTOG acute rectal toxicity and D 50 (P < 0.001) and V 60 (P = 0.001) dosimetric parameters, calculated for α/β = 10 Gy. Moreover, concerning the breast radiotherapy there was a significant correlation between RTOG skin toxicity and V ≥60 dosimetric parameter, calculated for both α/β = 2.3 Gy (P < 0.001) and α/β = 10 Gy (P < 0.001). The new tool seems reliable and user-friendly. Conclusions. Our proposed model seems user-friendly. Its reliability in terms of agreement with the presented acute radiation induced toxicity was satisfactory. However, more patients are needed to extract safe conclusions. PMID:24348743

Radiation-induced complications in prostate cancer patients treated with radiotherapy

NASA Astrophysics Data System (ADS)

Azuddin, A. Yusof; Rahman, I. Abdul; Siah, N. J.; Mohamed, F.; Saadc, M.; Ismail, F.

2014-09-01

The purpose of the study is to determine the relationship between radiation-induced complications with dosimetric and radiobiological parameters for prostate cancer patients that underwent the conformal radiotherapy treatment. 17 prostate cancer patients that have been treated with conformal radiotherapy were retrospectively analysed. The dosimetric data was retrieved in the form of dose-volume histogram (DVH) from Radiotherapy Treatment Planning System. The DVH was utilised to derived Normal Tissue Complication Probability (NTCP) in radiobiological data. Follow-up data from medical records were used to grade the occurrence of acute gastrointestinal (GI) and genitourinary (GU) complications using Radiation Therapy Oncology Group (RTOG) scoring system. The chi-square test was used to determine the relationship between radiation-induced complication with dosimetric and radiobiological parameters. 8 (47%) and 7 (41%) patients were having acute GI and GU complications respectively. The acute GI complication can be associated with V60rectum, rectal mean dose and NTCPrectum with p-value of 0.016, 0.038 and 0.049 respectively. There are no significant relationships of acute GU complication with dosimetric and radiobiological variables. Further study can be done by increase the sample size and follow up duration for deeper understanding of the factors that effecting the GU and GI complication in prostate cancer radiotherapy.

A voxel-based mouse for internal dose calculations using Monte Carlo simulations (MCNP).

PubMed

Bitar, A; Lisbona, A; Thedrez, P; Sai Maurel, C; Le Forestier, D; Barbet, J; Bardies, M

2007-02-21

Murine models are useful for targeted radiotherapy pre-clinical experiments. These models can help to assess the potential interest of new radiopharmaceuticals. In this study, we developed a voxel-based mouse for dosimetric estimates. A female nude mouse (30 g) was frozen and cut into slices. High-resolution digital photographs were taken directly on the frozen block after each section. Images were segmented manually. Monoenergetic photon or electron sources were simulated using the MCNP4c2 Monte Carlo code for each source organ, in order to give tables of S-factors (in Gy Bq-1 s-1) for all target organs. Results obtained from monoenergetic particles were then used to generate S-factors for several radionuclides of potential interest in targeted radiotherapy. Thirteen source and 25 target regions were considered in this study. For each source region, 16 photon and 16 electron energies were simulated. Absorbed fractions, specific absorbed fractions and S-factors were calculated for 16 radionuclides of interest for targeted radiotherapy. The results obtained generally agree well with data published previously. For electron energies ranging from 0.1 to 2.5 MeV, the self-absorbed fraction varies from 0.98 to 0.376 for the liver, and from 0.89 to 0.04 for the thyroid. Electrons cannot be considered as 'non-penetrating' radiation for energies above 0.5 MeV for mouse organs. This observation can be generalized to radionuclides: for example, the beta self-absorbed fraction for the thyroid was 0.616 for I-131; absorbed fractions for Y-90 for left kidney-to-left kidney and for left kidney-to-spleen were 0.486 and 0.058, respectively. Our voxel-based mouse allowed us to generate a dosimetric database for use in preclinical targeted radiotherapy experiments.

Influence of the irradiation temperature on the dosimetric and high temperature TL peaks of Al2O3:C.

PubMed

Molnar, G; Benabdesselam, M; Borossay, J; Iacconi, P; Lapraz, D; Akselrod, M

2002-01-01

The TL glow curves of Al2O3:C crystals have been investigated as a function of the irradiation temperature. The nature of the observed TL peaks has been studied by optical annealing. The filling of traps was found strongly dependent on the irradiation temperature in the case of UV exposure, which has been explained by the temperature dependence of the photoionisation of F centres. This latter phenomenon could have a part in the luminescence quenching and UV bleaching of F centres.

X-Ray Attenuation and Absorption for Materials of Dosimetric Interest

National Institute of Standards and Technology Data Gateway

SRD 126 X-Ray Attenuation and Absorption for Materials of Dosimetric Interest (Web, free access)   Tables and graphs of the photon mass attenuation coefficient and the mass energy-absorption coefficient are presented for all of the elements Z = 1 to 92, and for 48 compounds and mixtures of radiological interest. The tables cover energies of the photon (x-ray, gamma ray, bremsstrahlung) from 1 keV to 20 MeV.

Potential dosimetric benefit of dose-warping based 4D planning compared to conventional 3D planning in liver stereotactic body radiotherapy (SBRT)

NASA Astrophysics Data System (ADS)

Yeo, U. J.; Taylor, M. L.; Kron, T.; Pham, D.; Siva, S.; Franich, R. D.

2013-06-01

Respiratory motion induces dosimetric uncertainties for thoracic and abdominal cancer radiotherapy (RT) due to deforming and moving anatomy. This study investigates the extent of dosimetric differences between conventional 3D treatment planning and path-integrated 4D treatment planning in liver stereotactic body radiotherapy (SBRT). Respiratory-correlated 4DCT image sets with 10 phases were acquired for patients with liver tumours. Path-integrated 4D dose accumulation was performed using dose-warping techniques based on deformable image registration. Dose-volume histogram analysis demonstrated that the 3D planning approach overestimated doses to targets by up to 24% and underestimated dose to normal liver by ~4.5%, compared to the 4D planning methodology. Therefore, 4D planning has the potential to quantify such issues of under- and/or over-dosage and improve treatment accuracy.

The work of the ICRP dose calculational task group: Issues in implementation of the ICRP dosimetric methodology

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

Eckerman, K.F.

Committee 2 of the International Commission on Radiological Protection (ICRP) has had efforts underway to provide the radiation protection community with age-dependent dose coefficients, i.e.g, the dose per unit intake. The Task Group on Dose Calculations, chaired by the author, is responsible for the computation of these coefficients. The Task Group, formed in 1974 to produce ICRP Publication 30, is now international in its membership and its work load has been distributed among the institutions represented on the task group. This paper discusses: (1) recent advances in biokinetic modeling; (2) the recent changes in the dosimetric methodology; (3) the novelmore » computational problems with some of the ICRP quantities; and (4) quality assurance issues which the Task Group has encountered. Potential future developments of the dosimetric framework which might strengthen the relationships with the emerging understanding of radiation risk will also be discussed.« less

Geometric and dosimetric evaluations of atlas-based segmentation methods of MR images in the head and neck region.

PubMed

Kieselmann, Jennifer Petra; Kamerling, Cornelis Philippus; Burgos, Ninon; Menten, Martin J; Fuller, Clifton David; Nill, Simeon; Cardoso, M Jorge; Oelfke, Uwe

2018-06-08

Owing to its excellent soft-tissue contrast, magnetic resonance (MR) imaging has found an increased application in radiation therapy (RT). Harnessing these properties for treatment planning, automated segmentation methods can alleviate the manual workload burden to the clinical workflow. We investigated atlas-based segmentation methods of organs at risk (OARs) in the head and neck (H&N) region: one approach selecting the most similar atlas from a library of segmented images and two multi-atlas approaches. The latter were based on weighted majority voting and an iterative atlas-fusion approach called STEPS. We built the atlas library from pre-treatment T1-weighted MR images of 12 patients with manual contours of the parotids, spinal cord and mandible, delineated by a clinician. Following a leave-one-out cross-validation strategy, we measured geometric accuracy calculating Dice similarity coefficients (DSC), standard and 95% Hausdorff distances (HD and HD95), as well as the mean surface distance (MSD), whereby the manual contours served as the gold standard. To benchmark the algorithm, we determined the inter-expert variability (IEV) between three experts. To investigate the dosimetric effect of segmentation inaccuracies, we implemented an auto-planning strategy within the treatment planning system Monaco (Elekta AB, Stockholm, Sweden). For each set of auto-segmented volumes of interest (VOIs), we generated a plan for a 9-beam step and shoot intensity modulated RT treatment, designed according to our institution's clinical H\\&N protocol. Superimposing the dose distributions on the gold standard VOIs, we calculated dose differences to OARs caused by contouring differences between auto-segmented and gold standard VOIs. We investigated the correlation between geometric and dosimetric differences. The mean DSC was larger than 0.8 and the mean MSD smaller than 2mm for the multi-atlas approaches, resulting in a geometric accuracy comparable to previously published results and within the range of the IEV. While dosimetric differences could be as large as 23% of the clinical goal, treatment plans fulfilled all imposed clinical goals for the gold standard OARs. Correlations between geometric and dosimetric measures were low with R²<0.5. The geometric accuracy and ability to achieve clinically acceptable treatment plans indicate the suitability of using atlas-based contours for RT treatment planning purposes. The low correlations between geometric and dosimetric measures indicate that geometric measures alone are not sufficient to predict the dosimetric impact of segmentation inaccuracies on treatment planning for the data utilised in this study. Creative Commons Attribution license.

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

Using measurable dosimetric quantities to characterize the inter-structural tradeoff in inverse planning

NASA Astrophysics Data System (ADS)

Liu, Hongcheng; Dong, Peng; Xing, Lei

2017-08-01

Traditional inverse planning relies on the use of weighting factors to balance the conflicting requirements of different structures. Manual trial-and-error determination of weighting factors has long been recognized as a time-consuming part of treatment planning. The purpose of this work is to develop an inverse planning framework that parameterizes the dosimetric tradeoff among the structures with physically meaningful quantities to simplify the search for clinically sensible plans. In this formalism, instead of using weighting factors, the permissible variation range of the prescription dose or dose volume histogram (DVH) of the involved structures are used to characterize the ‘importance’ of the structures. The inverse planning is then formulated into a convex feasibility problem, called the dosimetric variation-controlled model (DVCM), whose goal is to generate plans with dosimetric or DVH variations of the structures consistent with the pre-specified values. For simplicity, the dosimetric variation range for a structure is extracted from a library of previous cases which possess similar anatomy and prescription. A two-phase procedure (TPP) is designed to solve the model. The first phase identifies a physically feasible plan to satisfy the prescribed dosimetric variation, and the second phase automatically improves the plan in case there is room for further improvement. The proposed technique is applied to plan two prostate cases and two head-and-neck cases and the results are compared with those obtained using a conventional CVaR approach and with a moment-based optimization scheme. Our results show that the strategy is able to generate clinically sensible plans with little trial and error. In all cases, the TPP generates a very competitive plan as compared to those obtained using the alternative approaches. Particularly, in the planning of one of the head-and-neck cases, the TPP leads to a non-trivial improvement in the resultant dose distribution—the fractional volumes receiving a dose above 20 Gy for the spinal cord are reduced by more than 40% when compared to the alternative schemes, while maintaining the same PTV coverage. With physically more meaningful modeling of the inter-structural tradeoff, the reported technique enables us to substantially reduce the need for trial-and-error adjustment of the model parameters. The new formalism also opens new opportunities for incorporating prior knowledge to facilitate the treatment planning process.

Visualization of a variety of possible dosimetric outcomes in radiation therapy using dose-volume histogram bands.

PubMed

Trofimov, Alexei; Unkelbach, Jan; DeLaney, Thomas F; Bortfeld, Thomas

2012-01-01

Dose-volume histograms (DVH) are the most common tool used in the appraisal of the quality of a clinical treatment plan. However, when delivery uncertainties are present, the DVH may not always accurately describe the dose distribution actually delivered to the patient. We present a method, based on DVH formalism, to visualize the variability in the expected dosimetric outcome of a treatment plan. For a case of chordoma of the cervical spine, we compared 2 intensity modulated proton therapy plans. Treatment plan A was optimized based on dosimetric objectives alone (ie, desired target coverage, normal tissue tolerance). Plan B was created employing a published probabilistic optimization method that considered the uncertainties in patient setup and proton range in tissue. Dose distributions and DVH for both plans were calculated for the nominal delivery scenario, as well as for scenarios representing deviations from the nominal setup, and a systematic error in the estimate of range in tissue. The histograms from various scenarios were combined to create DVH bands to illustrate possible deviations from the nominal plan for the expected magnitude of setup and range errors. In the nominal scenario, the DVH from plan A showed superior dose coverage, higher dose homogeneity within the target, and improved sparing of the adjacent critical structure. However, when the dose distributions and DVH from plans A and B were recalculated for different error scenarios (eg, proton range underestimation by 3 mm), the plan quality, reflected by DVH, deteriorated significantly for plan A, while plan B was only minimally affected. In the DVH-band representation, plan A produced wider bands, reflecting its higher vulnerability to delivery errors, and uncertainty in the dosimetric outcome. The results illustrate that comparison of DVH for the nominal scenario alone does not provide any information about the relative sensitivity of dosimetric outcome to delivery uncertainties. Thus, such comparison may be misleading and may result in the selection of an inferior plan for delivery to a patient. A better-informed decision can be made if additional information about possible dosimetric variability is presented; for example, in the form of DVH bands. Copyright © 2012 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Mediastinal irradiation in a patient affected by lung carcinoma after heart transplantation: Helical tomotherapy versus three dimensional conformal radiotherapy.

PubMed

Giugliano, Francesca M; Iorio, Vincenzo; Cammarota, Fabrizio; Toledo, Diego; Senese, Rossana; Francomacaro, Ferdinando; Muto, Matteo; Muto, Paolo

2016-04-26

Patients who have undergone solid organ transplants are known to have an increased risk of neoplasia compared with the general population. We report our experience using mediastinal irradiation with helical tomotherapy versus three-dimensional conformal radiation therapy to treat a patient with lung carcinoma 15 years after heart transplantation. Our dosimetric evaluation showed no particular difference between the techniques, with the exception of some organs. Mediastinal irradiation after heart transplantation is feasible and should be considered after evaluation of the risk. Conformal radiotherapy or intensity-modulated radiotherapy appears to be the appropriate treatment in heart-transplanted oncologic patients.

Bolus-dependent dosimetric effect of positioning errors for tangential scalp radiotherapy with helical tomotherapy

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

Lobb, Eric, E-mail: eclobb2@gmail.com

2014-04-01

The dosimetric effect of errors in patient position is studied on-phantom as a function of simulated bolus thickness to assess the need for bolus utilization in scalp radiotherapy with tomotherapy. A treatment plan is generated on a cylindrical phantom, mimicking a radiotherapy technique for the scalp utilizing primarily tangential beamlets. A planning target volume with embedded scalplike clinical target volumes (CTVs) is planned to a uniform dose of 200 cGy. Translational errors in phantom position are introduced in 1-mm increments and dose is recomputed from the original sinogram. For each error the maximum dose, minimum dose, clinical target dose homogeneitymore » index (HI), and dose-volume histogram (DVH) are presented for simulated bolus thicknesses from 0 to 10 mm. Baseline HI values for all bolus thicknesses were in the 5.5 to 7.0 range, increasing to a maximum of 18.0 to 30.5 for the largest positioning errors when 0 to 2 mm of bolus is used. Utilizing 5 mm of bolus resulted in a maximum HI value of 9.5 for the largest positioning errors. Using 0 to 2 mm of bolus resulted in minimum and maximum dose values of 85% to 94% and 118% to 125% of the prescription dose, respectively. When using 5 mm of bolus these values were 98.5% and 109.5%. DVHs showed minimal changes in CTV dose coverage when using 5 mm of bolus, even for the largest positioning errors. CTV dose homogeneity becomes increasingly sensitive to errors in patient position as bolus thickness decreases when treating the scalp with primarily tangential beamlets. Performing a radial expansion of the scalp CTV into 5 mm of bolus material minimizes dosimetric sensitivity to errors in patient position as large as 5 mm and is therefore recommended.« less

Intensity Modulated Radiation Therapy for Early-Stage Primary Gastric Diffuse Large B-Cell Lymphoma: Dosimetric Analysis, Clinical Outcome, and Quality of Life

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

Liu, Xin; Fang, Hui; Tian, Yuan

Purpose: To evaluate the dosimetric superiority, efficacy, toxicity, and quality of life (QOL) data of intensity modulated radiation therapy (IMRT) in patients with primary gastric diffuse large B-cell lymphoma (PG-DLBCL). Methods and Materials: Forty-six consecutive patients with early-stage PG-DLBCL underwent IMRT after chemotherapy. The majority of patients (61.5%) were subclassified as the non-germinal center B cell–like subtype. Dosimetric parameters of the planning target volume (PTV) and organs at risk were assessed. Survival rates were depicted with the Kaplan-Meier method and compared with the log-rank test. Quality of life was evaluated using the QLQ-C30-STO22 questionnaires at the last follow-up contact. Results: Themore » median PTV mean dose was 41.6 Gy. Only 0.73% of the PTV received <95% of the prescribed dose, indicating excellent target coverage. The median kidney V20 and liver V30 were 14.1% and 16.1%, respectively. The 5-year overall survival (OS), progression-free survival, and locoregional control rates for all patients were 80.4%, 75.0%, and 93.2%, respectively. Stage, lactate dehydrogenase level, and immunophenotype were significant prognostic factors for OS, and only stage was a significant factor for locoregional control. Consolidation IMRT in patients with complete response after chemotherapy resulted in significantly better OS and progression-free survival than salvage IMRT in patients with non-complete response. Two of 8 patients who had chronic liver disease experienced grade 4 or grade 5 acute hepatic failure after 4 to 5 cycles of rituximab-based chemotherapy and IMRT (40 Gy). No other serious acute or late toxicity was observed. The long-term global and functional QOL scales were excellent, with negligible symptom scales. Conclusions: Intensity modulated radiation therapy yielded excellent target coverage and critical tissue sparing and achieved favorable outcomes with acceptable toxicity and good long-term QOL in early-stage PG-DLBCL.« less

Dosimetric comparisons of carbon ion treatment plans for 1D and 2D ripple filters with variable thicknesses

NASA Astrophysics Data System (ADS)

Printz Ringbæk, Toke; Weber, Uli; Santiago, Alina; Simeonov, Yuri; Fritz, Peter; Krämer, Michael; Wittig, Andrea; Bassler, Niels; Engenhart-Cabillic, Rita; Zink, Klemens

2016-06-01

A ripple filter (RiFi)—also called mini-ridge filter—is a passive energy modulator used in particle beam treatments that broadens the Bragg peak (BP) as a function of its maximum thickness. The number of different energies requested from the accelerator can thus be reduced, which significantly reduces the treatment time. A new second generation RiFi with 2D groove shapes was developed using rapid prototyping, which optimizes the beam-modulating material and enables RiFi thicknesses of up to 6 mm. Carbon ion treatment plans were calculated using the standard 1D 3 mm thick RiFi and the new 4 and 6 mm 2D RiFis for spherical planning target volumes (PTVs) in water, eight stage I non-small cell lung cancer cases, four skull base chordoma cases and three prostate cancer cases. TRiP98 was used for treatment planning with facility-specific base data calculated with the Monte Carlo code SHIELD-HIT12A. Dose-volume-histograms, spatial dose distributions and dosimetric indexes were used for plan evaluation. Plan homogeneity and conformity of thinner RiFis were slightly superior to thicker RiFis but satisfactory results were obtained for all RiFis investigated. For the 6 mm RiFi, fine structures in the dose distribution caused by the larger energy steps were observed at the PTV edges, in particular for superficial and/or very small PTVs but performances for all RiFis increased with penetration depth due to straggling and scattering effects. Plans with the new RiFi design yielded for the studied cases comparable dosimetric results to the standard RiFi while the 4 and 6 mm RiFis lowered the irradiation time by 25-30% and 45-49%, respectively.

Dosimetric properties of a Solid Water High Equivalency (SW557) phantom for megavoltage photon beams.

PubMed

Araki, Fujio

2017-07-01

The dosimetric properties of the recently developed SW557 phantom have been investigated by comparison with those of the existing SW457 phantom in megavoltage photon beams. The electron fluence ratio φ pl w , and chamber ionization ratio k pl , of water to SW457 and water to SW557 for 4-15MV photons were calculated as a function of depth using Monte Carlo simulations, and compared with measured values. Values of φ pl w for SW457 were in the range of 1.004-1.014 for 4MV, and 1.014-1.018 for 15MV photons. The φ pl w for SW557 ranged from 1.005 to 1.008 for 4MV and from 1.010 to 1.015 for 15MV photons and the variation of φ pl w with depth for each beam energy was within ±0.5%. Values of k pl were obtained with a PTW 30013 Farmer-type ionization chamber. The k pl for SW457 ranged from 0.997 to 1.011 for 4-15MV photons. Values of k pl for SW557 were almost unity for 4 and 6MV photons, while in the case of 10 and 15MV photons they were less than 1.006, excepting the build-up region. The measured and calculated k pl values of water to SW557 were in the range of 0.997-1.002 and 1.000-1.006, respectively, for 4-15MV photons, at a depth of 10cm with a source-to-axis distance of 100cm. The measured and calculated k pl values were in agreement within their uncertainty ranges. As a water-equivalent phantom, SW557 can be used with a dosimetric difference within±0.6%, for 4-15MV photons, and is more water-equivalent than SW457 in megavoltage photon beams. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

A deformable head and neck phantom with in-vivo dosimetry for adaptive radiotherapy quality assurance

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

Graves, Yan Jiang; Smith, Arthur-Allen; Mcilvena, David

Purpose: Patients’ interfractional anatomic changes can compromise the initial treatment plan quality. To overcome this issue, adaptive radiotherapy (ART) has been introduced. Deformable image registration (DIR) is an important tool for ART and several deformable phantoms have been built to evaluate the algorithms’ accuracy. However, there is a lack of deformable phantoms that can also provide dosimetric information to verify the accuracy of the whole ART process. The goal of this work is to design and construct a deformable head and neck (HN) ART quality assurance (QA) phantom with in vivo dosimetry. Methods: An axial slice of a HN patientmore » is taken as a model for the phantom construction. Six anatomic materials are considered, with HU numbers similar to a real patient. A filled balloon inside the phantom tissue is inserted to simulate tumor. Deflation of the balloon simulates tumor shrinkage. Nonradiopaque surface markers, which do not influence DIR algorithms, provide the deformation ground truth. Fixed and movable holders are built in the phantom to hold a diode for dosimetric measurements. Results: The measured deformations at the surface marker positions can be compared with deformations calculated by a DIR algorithm to evaluate its accuracy. In this study, the authors selected a Demons algorithm as a DIR algorithm example for demonstration purposes. The average error magnitude is 2.1 mm. The point dose measurements from the in vivo diode dosimeters show a good agreement with the calculated doses from the treatment planning system with a maximum difference of 3.1% of prescription dose, when the treatment plans are delivered to the phantom with original or deformed geometry. Conclusions: In this study, the authors have presented the functionality of this deformable HN phantom for testing the accuracy of DIR algorithms and verifying the ART dosimetric accuracy. The authors’ experiments demonstrate the feasibility of this phantom serving as an end-to-end ART QA phantom.« less

Serum Transforming Growth Factor-β1 Change After Neoadjuvant Chemoradiation Therapy Is Associated With Postoperative Pulmonary Complications in Esophageal Cancer Patients Undergoing Combined Modality Therapy

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

Lu, Shao-Lun; Hsu, Feng-Ming; Tsai, Chiao-Ling

Purpose: Our aim was to investigate the association of clinical factors, dosimetric parameters, and biomarkers with postoperative pulmonary complications (PPCs) in patients with locally advanced esophageal squamous cell carcinoma (ESCC) treated by neoadjuvant concurrent chemoradiation therapy (CCRT) under strict pulmonary dose constraints and esophagectomy. Methods and Materials: We prospectively enrolled 112 patients undergoing trimodality treatment (including radiation therapy [40 Gy], concurrent taxane-/5-fluorouracil-based regimens, and radical esophagectomy) for ESCC. A PPC was defined as pneumonia or acute respiratory distress syndrome within 30 days after surgery. Serum samples were collected before and within 1 month after CCRT. The association of serum biomarkers with PPCs wasmore » detected by proximity ligation assay (PLA) and verified by enzyme-linked immunosorbent assay. Associations of clinical factors, lung dosimetric parameters, and biomarkers with PPC were tested statistically. Results: Thirty-three patients (29.5%) had PPCs. None of the dosimetric parameters was associated with PPCs. Preoperative functional vital capacity (FVC) was significantly associated with PPCs (P=.004). Of the 15 PLA-screened biomarkers, posttreatment transforming growth factor-β1 (TGF-β1) was borderline significantly associated with PPCs (P=.087). Patients with PPCs had significantly larger pre-CCRT to post-CCRT decrease in serum TGF-β1 concentration (−11,310 vs −5332 pg/mL, P=.005) and higher pre-CCRT to post-CCRT percent decline in serum TGF-β1 concentration (−37.4% vs −25.0%, P=.009) than patients without PPCs. On multivariate analysis, preoperative FVC (P=.003) and decrease in TGF-β1 >7040 pg/mL (P=.014) were independent factors associated with PPCs. Conclusions: Preoperative FVC and decrease in serum TGF-β1 level after dose-limited CCRT to the lung are associated with the development of PPCs.« less

Ir-192 HDR transit dose and radial dose function determination using alanine/EPR dosimetry

NASA Astrophysics Data System (ADS)

Guzmán Calcina, Carmen S.; de Almeida, Adelaide; Oliveira Rocha, José R.; Abrego, Felipe Chen; Baffa, Oswaldo

2005-03-01

Source positioning close to the tumour in high dose rate (HDR) brachytherapy is not instantaneous. An increment of dose will be delivered during the movement of the source in the trajectory to its static position. This increment is the transit dose, often not taken into account in brachytherapeutic treatment planning. The transit dose depends on the prescribed dose, number of treatment fractions, velocity and activity of the source. Combining all these factors, the transit dose can be 5% higher than the prescribed absorbed dose value (Sang-Hyun and Muller-Runkel, 1994 Phys. Med. Biol. 39 1181 8, Nath et al 1995 Med. Phys. 22 209 34). However, it cannot exceed this percentage (Nath et al 1995). In this work, we use the alanine-EPR (electron paramagnetic resonance) dosimetric system using analysis of the first derivative of the signal. The transit dose was evaluated for an HDR system and is consistent with that already presented for TLD dosimeters (Bastin et al 1993 Int. J. Radiat. Oncol. Biol. Phys. 26 695 702). Also using the same dosimetric system, the radial dose function, used to evaluate the geometric dose degradation around the source, was determined and its behaviour agrees better with those obtained by Monte Carlo simulations (Nath et al 1995, Williamson and Nath 1991 Med. Phys. 18 434 48, Ballester et al 1997 Med. Phys. 24 1221 8, Ballester et al 2001 Phys. Med. Biol. 46 N79 90) than with TLD measurements (Nath et al 1990 Med. Phys. 17 1032 40).

Ir-192 HDR transit dose and radial dose function determination using alanine/EPR dosimetry.

PubMed

Calcina, Carmen S Guzmán; de Almeida, Adelaide; Rocha, José R Oliveira; Abrego, Felipe Chen; Baffa, Oswaldo

2005-03-21

Source positioning close to the tumour in high dose rate (HDR) brachytherapy is not instantaneous. An increment of dose will be delivered during the movement of the source in the trajectory to its static position. This increment is the transit dose, often not taken into account in brachytherapeutic treatment planning. The transit dose depends on the prescribed dose, number of treatment fractions, velocity and activity of the source. Combining all these factors, the transit dose can be 5% higher than the prescribed absorbed dose value (Sang-Hyun and Muller-Runkel, 1994 Phys. Med. Biol. 39 1181-8, Nath et al 1995 Med. Phys. 22 209-34). However, it cannot exceed this percentage (Nath et al 1995). In this work, we use the alanine-EPR (electron paramagnetic resonance) dosimetric system using analysis of the first derivative of the signal. The transit dose was evaluated for an HDR system and is consistent with that already presented for TLD dosimeters (Bastin et al 1993 Int. J. Radiat. Oncol. Biol. Phys. 26 695-702). Also using the same dosimetric system, the radial dose function, used to evaluate the geometric dose degradation around the source, was determined and its behaviour agrees better with those obtained by Monte Carlo simulations (Nath et al 1995, Williamson and Nath 1991 Med. Phys. 18 434-48, Ballester et al 1997 Med. Phys. 24 1221-8, Ballester et al 2001 Phys. Med. Biol. 46 N79-90) than with TLD measurements (Nath et al 1990 Med. Phys. 17 1032-40).

Four-dimensional computed tomography based respiratory-gated radiotherapy with respiratory guidance system: analysis of respiratory signals and dosimetric comparison.

PubMed

Lee, Jung Ae; Kim, Chul Yong; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Lee, Suk; Kim, Young Bum

2014-01-01

To investigate the effectiveness of respiratory guidance system in 4-dimensional computed tomography (4 DCT) based respiratory-gated radiation therapy (RGRT) by comparing respiratory signals and dosimetric analysis of treatment plans. The respiratory amplitude and period of the free, the audio device-guided, and the complex system-guided breathing were evaluated in eleven patients with lung or liver cancers. The dosimetric parameters were assessed by comparing free breathing CT plan and 4 DCT-based 30-70% maximal intensity projection (MIP) plan. The use of complex system-guided breathing showed significantly less variation in respiratory amplitude and period compared to the free or audio-guided breathing regarding the root mean square errors (RMSE) of full inspiration (P = 0.031), full expiration (P = 0.007), and period (P = 0.007). The dosimetric parameters including V(5 Gy), V(10 Gy), V(20 Gy), V(30 Gy), V(40 Gy), and V(50 Gy) of normal liver or lung in 4 DCT MIP plan were superior over free breathing CT plan. The reproducibility and regularity of respiratory amplitude and period were significantly improved with the complex system-guided breathing compared to the free or the audio-guided breathing. In addition, the treatment plan based on the 4D CT-based MIP images acquired with the complex system guided breathing showed better normal tissue sparing than that on the free breathing CT.

Dosimetric verification of gated delivery of electron beams using a 2D ion chamber array

PubMed Central

Yoganathan, S. A.; Das, K. J. Maria; Raj, D. Gowtham; Kumar, Shaleen

2015-01-01

The purpose of this study was to compare the dosimetric characteristics; such as beam output, symmetry and flatness between gated and non-gated electron beams. Dosimetric verification of gated delivery was carried for all electron beams available on Varian CL 2100CD medical linear accelerator. Measurements were conducted for three dose rates (100 MU/min, 300 MU/min and 600 MU/min) and two respiratory motions (breathing period of 4s and 8s). Real-time position management (RPM) system was used for the gated deliveries. Flatness and symmetry values were measured using Imatrixx 2D ion chamber array device and the beam output was measured using plane parallel ion chamber. These detector systems were placed over QUASAR motion platform which was programmed to simulate the respiratory motion of target. The dosimetric characteristics of gated deliveries were compared with non-gated deliveries. The flatness and symmetry of all the evaluated electron energies did not differ by more than 0.7 % with respect to corresponding non-gated deliveries. The beam output variation of gated electron beam was less than 0.6 % for all electron energies except for 16 MeV (1.4 %). Based on the results of this study, it can be concluded that Varian CL2100 CD is well suitable for gated delivery of non-dynamic electron beams. PMID:26170552

Patient-specific dosimetric endpoints based treatment plan quality control in radiotherapy.

PubMed

Song, Ting; Staub, David; Chen, Mingli; Lu, Weiguo; Tian, Zhen; Jia, Xun; Li, Yongbao; Zhou, Linghong; Jiang, Steve B; Gu, Xuejun

2015-11-07

In intensity modulated radiotherapy (IMRT), the optimal plan for each patient is specific due to unique patient anatomy. To achieve such a plan, patient-specific dosimetric goals reflecting each patient's unique anatomy should be defined and adopted in the treatment planning procedure for plan quality control. This study is to develop such a personalized treatment plan quality control tool by predicting patient-specific dosimetric endpoints (DEs). The incorporation of patient specific DEs is realized by a multi-OAR geometry-dosimetry model, capable of predicting optimal DEs based on the individual patient's geometry. The overall quality of a treatment plan is then judged with a numerical treatment plan quality indicator and characterized as optimal or suboptimal. Taking advantage of clinically available prostate volumetric modulated arc therapy (VMAT) treatment plans, we built and evaluated our proposed plan quality control tool. Using our developed tool, six of twenty evaluated plans were identified as sub-optimal plans. After plan re-optimization, these suboptimal plans achieved better OAR dose sparing without sacrificing the PTV coverage, and the dosimetric endpoints of the re-optimized plans agreed well with the model predicted values, which validate the predictability of the proposed tool. In conclusion, the developed tool is able to accurately predict optimally achievable DEs of multiple OARs, identify suboptimal plans, and guide plan optimization. It is a useful tool for achieving patient-specific treatment plan quality control.

Development of patient-specific phantoms for verification of stereotactic body radiation therapy planning in patients with metallic screw fixation

NASA Astrophysics Data System (ADS)

Oh, Dongryul; Hong, Chae-Seon; Ju, Sang Gyu; Kim, Minkyu; Koo, Bum Yong; Choi, Sungback; Park, Hee Chul; Choi, Doo Ho; Pyo, Hongryull

2017-01-01

A new technique for manufacturing a patient-specific dosimetric phantom using three-dimensional printing (PSDP_3DP) was developed, and its geometrical and dosimetric accuracy was analyzed. External body contours and structures of the spine and metallic fixation screws (MFS) were delineated from CT images of a patient with MFS who underwent stereotactic body radiation therapy for spine metastasis. Contours were converted into a STereoLithography file format using in-house program. A hollow, four-section PSDP was designed and manufactured using three types of 3DP to allow filling with a muscle-equivalent liquid and insertion of dosimeters. To evaluate the geometrical accuracy of PSDP_3DP, CT images were obtained and compared with patient CT data for volume, mean density, and Dice similarity coefficient for contours. The dose distribution in the PSDP_3DP was calculated by applying the same beam parameters as for the patient, and the dosimetric characteristics of the PSDP_3DP were compared with the patient plan. The registered CT of the PSDP_3DP was well matched with that of the real patient CT in the axial, coronal, and sagittal planes. The physical accuracy and dosimetric characteristics of PSDP_3DP were comparable to those of a real patient. The ability to manufacture a PSDP representing an extreme patient condition was demonstrated.

TU-CD-304-03: Dosimetric Verification and Preliminary Comparison of Dynamic Wave Arc for SBRT Treatments

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

Burghelea, M; BRAINLAB AG, Munich; Babes Bolyai University, Cluj-Napoca

2015-06-15

Purpose: To evaluate the potential dosimetric benefits and verify the delivery accuracy of Dynamic Wave Arc, a novel treatment delivery approach for the Vero SBRT system. Methods: Dynamic Wave Arc (DWA) combines simultaneous movement of gantry/ring with inverse planning optimization, resulting in an uninterrupted non-coplanar arc delivery technique. Thirteen SBRT complex cases previously treated with 8–10 conformal static beams (CRT) were evaluated in this study. Eight primary centrally-located NSCLC (prescription dose 4×12Gy or 8×7.5Gy) and five oligometastatic cases (2×2 lesions, 10×5Gy) were selected. DWA and coplanar VMAT plans, partially with dual arcs, were generated for each patient using identical objectivemore » functions for target volumes and OARs on the same TPS (RayStation, RaySearch Laboratories). Dosimetric differences and delivery time among these three planning schemes were evaluated. The DWA delivery accuracy was assessed using the Delta4 diode array phantom (ScandiDos AB). The gamma analysis was performed with the 3%/3mm dose and distance-to-agreement criteria. Results: The target conformity for CRT, VMAT and DWA were 0.95±0.07, 0.96±0.04 and 0.97±0.04, while the low dose spillage gradient were 5.52±1.36, 5.44±1.11, and 5.09±0.98 respectively. Overall, the bronchus, esophagus and spinal cord maximum doses were similar between VMAT and DWA, but highly reduced compared with CRT. For the lung cases, the mean dose and V20Gy were lower for the arc techniques compares with CRT, while for the liver cases, the mean dose and the V30Gy presented slightly higher values. The average delivery time of VMAT and DWA were 2.46±1.10 min and 4.25±1.67 min, VMAT presenting shorter treatment time in all cases. The DWA dosimetric verification presented an average gamma index passing rate of 95.73±1.54% (range 94.2%–99.8%). Conclusion: Our preliminary data indicated that the DWA is deliverable with clinically acceptable accuracy and has the potential to further improve the plan quality. This collaborative work was supported by the Flemish government through the Hercules foundation and corporate funding from BrainLab AG. The first and the sixth author are financially supported by Brainlab AG. The other authors have no conflict of interest.« less

Dosimetric evaluation of nanotargeted (188)Re-liposome with the MIRDOSE3 and OLINDA/EXM programs.

PubMed

Chang, Chih-Hsien; Chang, Ya-Jen; Lee, Te-Wei; Ting, Gann; Chang, Kwo-Ping

2012-06-01

The OLINDA/EXM computer code was created as a replacement for the widely used MIRDOSE3 code for radiation dosimetry in nuclear medicine. A dosimetric analysis with these codes was performed to evaluate nanoliposomes as carriers of radionuclides ((188)Re-liposomes) in colon carcinoma-bearing mice. Pharmacokinetic data for (188)Re-N, N-bis (2-mercaptoethyl)-N',N'-diethylethylenediamine ((188)Re-BMEDA) and (188)Re-liposome were obtained for estimation of absorbed doses in normal organs. Radiation dose estimates for normal tissues were calculated using the MIRDOSE3 and OLINDA/EXM programs for a colon carcinoma solid tumor mouse model. Mean absorbed doses derived from(188)Re-BMEDA and (188)Re-liposome in normal tissues were generally similar as calculated by MIRDOSE3 and OLINDA/EXM programs. One notable exception to this was red marrow, wherein MIRDOSE3 resulted in higher absorbed doses than OLINDA/EXM (1.53- and 1.60-fold for (188)Re-BMEDA and (188)Re-liposome, respectively). MIRDOSE3 and OLINDA have very similar residence times and organ doses. Bone marrow doses were estimated by designating cortical bone rather than bone marrow as a source organ. The bone marrow doses calculated by MIRDOSE3 are higher than those by OLINDA. If the bone marrow is designated as a source organ, the doses estimated by MIRDOSE3 and OLINDA programs will be very similar.

Experimental Platform for Ultra-high Dose Rate FLASH Irradiation of Small Animals Using a Clinical Linear Accelerator

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

Schüler, Emil; Trovati, Stefania; King, Gregory

Purpose: A key factor limiting the effectiveness of radiation therapy is normal tissue toxicity, and recent preclinical data have shown that ultra-high dose rate irradiation (>50 Gy/s, “FLASH”) potentially mitigates this effect. However, research in this field has been strongly limited by the availability of FLASH irradiators suitable for small animal experiments. We present a simple methodologic approach for FLASH electron small animal irradiation with a clinically available linear accelerator (LINAC). Methods and Materials: We investigated the FLASH irradiation potential of a Varian Clinac 21EX in both clinical mode and after tuning of the LINAC. We performed detailed FLUKA Monte Carlomore » and experimental dosimetric characterization at multiple experimental locations within the LINAC head. Results: Average dose rates of ≤74 Gy/s were achieved in clinical mode, and the dose rate after tuning exceeded 900 Gy/s. We obtained 220 Gy/s at 1-cm depth for a >4-cm field size with 90% homogeneity throughout a 2-cm-thick volume. Conclusions: We present an approach for using a clinical LINAC for FLASH irradiation. We obtained dose rates exceeding 200 Gy/s after simple tuning of the LINAC, with excellent dosimetric properties for small animal experiments. This will allow for increased availability of FLASH irradiation to the general research community.« less

Responses of selected neutron monitors to cosmic radiation at aviation altitudes.

PubMed

Yasuda, Hiroshi; Yajima, Kazuaki; Sato, Tatsuhiko; Takada, Masashi; Nakamura, Takashi

2009-06-01

Cosmic radiation exposure of aircraft crew, which is generally evaluated by numerical simulations, should be verified by measurements. From the perspective of radiological protection, the most contributing radiation component at aviation altitude is neutrons. Measurements of cosmic neutrons, however, are difficult in a civilian aircraft because of the limitations of space and electricity; a small, battery-operated dosimeter is required whereas larger-size instruments are generally used to detect neutrons with a broad range of energy. We thus examined the applicability of relatively new transportable neutron monitors for use in an aircraft. They are (1) a conventional rem meter with a polyethylene moderator (NCN1), (2) an extended energy-range rem meter with a tungsten-powder mixed moderator (WENDI-II), and (3) a recoil-proton scintillation rem meter (PRESCILA). These monitors were installed onto the racks of a business jet aircraft that flew two times near Japan. Observed data were compared to model calculations using a PHITS-based Analytical Radiation Model in the Atmosphere (PARMA). Excellent agreement between measured and calculated values was found for the WENDI-II. The NCN1 showed approximately half of predicted values, which were lower than those expected from its response function. The observations made with PRESCILA showed much higher than expected values; which is attributable to the presence of cosmic-ray protons and muons. These results indicate that careful attention must be paid to the dosimetric properties of a detector employed for verification of cosmic neutron dose.

A dosimetric phantom study of thoracic radiotherapy based on three-dimensional modeling of mediastinal lymph nodes

PubMed Central

Zhang, Ji-Bin; Zhao, Li-Rong; Cui, Tian-Xiang; Chen, Xie-Wan; Yang, Qiao; Zhou, Yi-Bing; Chen, Zheng-Tang; Zhang, Shao-Xiang; Sun, Jian-Guo

2018-01-01

The aim of the present study was to investigate the optimal strategy and dosimetric measurement of thoracic radiotherapy based on three-dimensional (3D) modeling of mediastinal lymph nodes (MLNs). A 3D model of MLNs was constructed from a Chinese Visible Human female dataset. Image registration and fusion between reconstructed MLNs and original chest computed tomography (CT) images was conducted in the Eclipse™ treatment planning system (TPS). There were three plans, including 3D conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT), which were designed based on 10 cases of simulated lung lesions (SLLs) and MLNs. The quality of these plans was evaluated via examining indexes, including conformity index (CI), homogeneity index and clinical target volume (CTV) coverage. Dose-volume histogram analysis was performed on SLL, MLNs and organs at risk (OARs). A Chengdu Dosimetric Phantom (CDP) was then drilled at specific MLNs according to 20 patients with thoracic tumors and of a medium-build. These plans were repeated on fused MLNs and CDP CT images in the Eclipse™ TPS. Radiation doses at the SLLs and MLNs of the CDP were measured and compared with calculated doses. The established 3D MLN model demonstrated the spatial location of MLNs and adjacent structures. Precise image registration and fusion were conducted between reconstructed MLNs and the original chest CT or CDP CT images. IMRT demonstrated greater values in CI, CTV coverage and OAR (lungs and spinal cord) protection, compared with 3D-CRT and VMAT (P<0.05). The deviation between the measured and calculated doses was within ± 10% at SLL, and at the 2R and 7th MLN stations. In conclusion, the 3D MLN model can benefit plan optimization and dosimetric measurement of thoracic radiotherapy, and when combined with CDP, it may provide a tool for clinical dosimetric monitoring. PMID:29556300

SU-E-T-651: Quantification of Dosimetric Accuracy of Respiratory Gated Stereotactic Body Radiation Therapy

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

Thiyagarajan, Rajesh; Vikraman, S; Maragathaveni, S

2015-06-15

Purpose: To quantify the dosimetric accuracy of respiratory gated stereotactic body radiation therapy delivery using dynamic thorax phantom. Methods: Three patients with mobile target (2 lung, 1liver) were chosen. Retrospective 4DCT image sets were acquired for using Varian RPM system. An in-house MATLAB program was designed for MIP, MinIP and AvgIP generation. ITV was contoured on MIP image set for lung patients and on MinIP for liver patient. Dynamic IMRT plans were generated on selected phase bin image set in Eclipse (v10.0) planning system. CIRS dynamic thorax phantom was used to perform the dosimetric quality assurance. Patient breathing pattern filemore » from RPM system was converted to phantom compatible file by an in-house MATLAB program. This respiratory pattern fed to the CIRS dynamic thorax phantom. 4DCT image set was acquired for this phantom using patient breathing pattern. Verification plans were generated using patient gating window and delivered on the phantom. Measurements were carried out using with ion chamber and EBT2 film. Exposed films were analyzed and evaluated in FilmQA software. Results: The stability of gated output in comparison with un-gated output was within 0.5%. The Ion chamber measured and TPS calculated dose compared for all the patients. The difference observed was 0.45%, −0.52% and −0.54 for Patient 1, Patient2 and Patient 3 respectively.Gamma value evaluated from EBT film shows pass rates from 92.41% to 99.93% for 3% dose difference and 3mm distance to agreement criteria. Conclusion: Dosimetric accuracy of respiratory gated SBRT delivery for lung and liver was dosimetrically acceptable. The Ion chamber measured dose was within 0.203±0.5659% of the expected dose. Gamma pass rates were within 96.63±3.84% of the expected dose.« less

Clinical and Dosimetric Predictors of Radiation Pneumonitis in a Large Series of Patients Treated With Stereotactic Body Radiation Therapy to the Lung

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

Baker, Ryan; Han Gang; Sarangkasiri, Siriporn

2013-01-01

Purpose: To report clinical and dosimetric factors predictive of radiation pneumonitis (RP) in patients receiving lung stereotactic body radiation therapy (SBRT) from a series of 240 patients. Methods and Materials: Of the 297 isocenters treating 263 patients, 240 patients (n=263 isocenters) had evaluable information regarding RP. Age, gender, current smoking status and pack-years, O{sub 2} use, Charlson Comorbidity Index, prior lung radiation therapy (yes/no), dose/fractionation, V{sub 5}, V{sub 13}, V{sub 20}, V{sub prescription}, mean lung dose, planning target volume (PTV), total lung volume, and PTV/lung volume ratio were recorded. Results: Twenty-nine patients (11.0%) developed symptomatic pneumonitis (26 grade 2, 3more » grade 3). The mean V{sub 20} was 6.5% (range, 0.4%-20.2%), and the average mean lung dose was 5.03 Gy (0.547-12.2 Gy). In univariable analysis female gender (P=.0257) and Charlson Comorbidity index (P=.0366) were significantly predictive of RP. Among dosimetric parameters, V{sub 5} (P=.0186), V{sub 13} (P=.0438), and V{sub prescription} (where dose = 60 Gy) (P=.0128) were significant. There was only a trend toward significance for V{sub 20} (P=.0610). Planning target volume/normal lung volume ratio was highly significant (P=.0024). In multivariable analysis the clinical factors of female gender, pack-years smoking, and larger gross internal tumor volume and PTV were predictive (P=.0094, .0312, .0364, and .052, respectively), but no dosimetric factors were significant. Conclusions: Rate of symptomatic RP was 11%. Our mean lung dose was <600 cGy in most cases and V20 <10%. In univariable analysis, dosimetric factors were predictive, while tumor size (or tumor/lung volume ratio) played a role in multivariable and univariable and analysis, respectively.« less

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

Chang, J; Gu, X; Lu, W

Purpose: A novel distance-dose weighting method for label fusion was developed to increase segmentation accuracy in dosimetrically important regions for prostate radiation therapy. Methods: Label fusion as implemented in the original SIMPLE (OS) for multi-atlas segmentation relies iteratively on the majority vote to generate an estimated ground truth and DICE similarity measure to screen candidates. The proposed distance-dose weighting puts more values on dosimetrically important regions when calculating similarity measure. Specifically, we introduced distance-to-dose error (DDE), which converts distance to dosimetric importance, in performance evaluation. The DDE calculates an estimated DE error derived from surface distance differences between the candidatemore » and estimated ground truth label by multiplying a regression coefficient. To determine the coefficient at each simulation point on the rectum, we fitted DE error with respect to simulated voxel shift. The DEs were calculated by the multi-OAR geometry-dosimetry training model previously developed in our research group. Results: For both the OS and the distance-dose weighted SIMPLE (WS) results, the evaluation metrics for twenty patients were calculated using the ground truth segmentation. The mean difference of DICE, Hausdorff distance, and mean absolute distance (MAD) between OS and WS have shown 0, 0.10, and 0.11, respectively. In partial MAD of WS which calculates MAD within a certain PTV expansion voxel distance, the lower MADs were observed at the closer distances from 1 to 8 than those of OS. The DE results showed that the segmentation from WS produced more accurate results than OS. The mean DE error of V75, V70, V65, and V60 were decreased by 1.16%, 1.17%, 1.14%, and 1.12%, respectively. Conclusion: We have demonstrated that the method can increase the segmentation accuracy in rectum regions adjacent to PTV. As a result, segmentation using WS have shown improved dosimetric accuracy than OS. The WS will provide dosimetrically important label selection strategy in multi-atlas segmentation. CPRIT grant RP150485.« less

Dosimetric quality endpoints for low-dose-rate prostate brachytherapy using biological effective dose (bed) vs. conventional dose

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

Singh, Rachana; Al-Hallaq, Hania; Pelizzari, Charles A.

2003-12-31

The purpose of this study was to compare conventional low-dose-rate prostate brachytherapy dosimetric quality parameters with their biological effective dose (BED) counterparts. To validate a model for transformation from conventional dose to BED, the postimplant plans of 31 prostate brachytherapy patients were evaluated using conventional dose-volume histogram (DVH) quality endpoints and analogous BED-DVH endpoints. Based on CT scans obtained 4 weeks after implantation, DVHs were computed and standard dosimetric endpoints V100 (volume receiving 100% of the prescribed dose), V150, V200, HI (1-[V150/V100]), and D90 (dose that 90% of the target volume received) were obtained for quality analysis. Using known andmore » reported transformations, dose grids were transformed to BED-early ({alpha}/{beta} = 10 Gy) and BED-late ({alpha}/{beta} = 3 Gy) grids, and the same dosimetric endpoints were analyzed. For conventional, BED-early and BED-late DVHs, no differences in V100 were seen (0.896, 0.893, and 0.894, respectively). However, V150 and V200 were significantly higher for both BED-early (0.582 and 0.316) and BED-late (0.595 and 0.337), compared with the conventional (0.539 and 0.255) DVHs. D90 was significantly lower for the BED-early (103.1 Gy) and BED-late transformations (106.9 Gy) as compared with the conventional (119.5 Gy) DVHs. The conventional prescription parameter V100 is the same for the corresponding BED-early and BED-late transformed DVHs. The toxicity parameters V150 and V200 are slightly higher using the BED transformations, suggesting that the BED doses are somewhat higher than predicted using conventional DVHs. The prescription/quality parameter D90 is slightly lower, implying that target coverage is lower than predicted using conventional DVHs. This methodology can be applied to analyze BED dosimetric endpoints to improve clinical outcome and reduce complications of prostate brachytherapy.« less

Cardiac risk index as a simple geometric indicator to select patients for the heart-sparing radiotherapy of left-sided breast cancer.

PubMed

Sung, KiHoon; Choi, Young Eun; Lee, Kyu Chan

2017-06-01

This is a dosimetric study to identify a simple geometric indicator to discriminate patients who meet the selection criterion for heart-sparing radiotherapy (RT). The authors proposed a cardiac risk index (CRI), directly measurable from the CT images at the time of scanning. Treatment plans were regenerated using the CT data of 312 consecutive patients with left-sided breast cancer. Dosimetric analysis was performed to estimate the risk of cardiac mortality using cardiac dosimetric parameters, such as the relative heart volumes receiving ≥25 Gy (heart V 25 ). For each CT data set, in-field heart depth (HD) and in-field heart width (HW) were measured to generate the geometric parameters, including maximum HW (HW max ) and maximum HD (HD max ). Seven geometric parameters were evaluated as candidates for CRI. Receiver operating characteristic (ROC) curve analyses were used to examine the overall discriminatory power of the geometric parameters to select high-risk patients (heart V 25  ≥ 10%). Seventy-one high-risk (22.8%) and 241 low-risk patients (77.2%) were identified by dosimetric analysis. The geometric and dosimetric parameters were significantly higher in the high-risk group. Heart V 25 showed the strong positive correlations with all geometric parameters examined (r > 0.8, p < 0.001). The product of HD max and HW max (CRI) revealed the largest area under the curve (AUC) value (0.969) and maintained 100% sensitivity and 88% specificity at the optimal cut-off value of 14.58 cm 2 . Cardiac risk index proposed as a simple geometric indicator to select high-risk patients provides useful guidance for clinicians considering optimal implementation of heart-sparing RT. © 2016 The Royal Australian and New Zealand College of Radiologists.

A dosimetric uncertainty analysis for photon-emitting brachytherapy sources: Report of AAPM Task Group No. 138 and GEC-ESTRO

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

DeWerd, Larry A.; Ibbott, Geoffrey S.; Meigooni, Ali S.

2011-02-15

This report addresses uncertainties pertaining to brachytherapy single-source dosimetry preceding clinical use. The International Organization for Standardization (ISO) Guide to the Expression of Uncertainty in Measurement (GUM) and the National Institute of Standards and Technology (NIST) Technical Note 1297 are taken as reference standards for uncertainty formalism. Uncertainties in using detectors to measure or utilizing Monte Carlo methods to estimate brachytherapy dose distributions are provided with discussion of the components intrinsic to the overall dosimetric assessment. Uncertainties provided are based on published observations and cited when available. The uncertainty propagation from the primary calibration standard through transfer to the clinicmore » for air-kerma strength is covered first. Uncertainties in each of the brachytherapy dosimetry parameters of the TG-43 formalism are then explored, ending with transfer to the clinic and recommended approaches. Dosimetric uncertainties during treatment delivery are considered briefly but are not included in the detailed analysis. For low- and high-energy brachytherapy sources of low dose rate and high dose rate, a combined dosimetric uncertainty <5% (k=1) is estimated, which is consistent with prior literature estimates. Recommendations are provided for clinical medical physicists, dosimetry investigators, and source and treatment planning system manufacturers. These recommendations include the use of the GUM and NIST reports, a requirement of constancy of manufacturer source design, dosimetry investigator guidelines, provision of the lowest uncertainty for patient treatment dosimetry, and the establishment of an action level based on dosimetric uncertainty. These recommendations reflect the guidance of the American Association of Physicists in Medicine (AAPM) and the Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) for their members and may also be used as guidance to manufacturers and regulatory agencies in developing good manufacturing practices for sources used in routine clinical treatments.« less

SU-F-BRB-15: Dosimetric Study of Radiation Therapy for Head/Neck Patients with Metallic Dental Fixtures

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

Lu, L; Allan, E; Putten, M Van

Purpose: To investigate the dose contributions of scattered electrons from dental amalgams during head and neck radiotherapy, and to evaluate the protective role of dosimetric dental stents during treatment to prevent oral mucositis. Methods: A phantom was produced to accurately simulate the oral cavity and head. The oral cavity consisted of a tissue equivalent upper and lower jaw and complete set of teeth. A set of 4 mm ethylene copolymer dosimetric stents was made for the upper and lower teeth. Five removable gold caps were fitted to apposing right molars, and the phantom was crafted to accomodate horizontal and verticalmore » film for 2D dosimetry and NanoDot dosimeter for recording point doses. The head was simulated using a small cylindrical glass water bath. CT simulation was performed on the phantom with and without metal fittings and, in each case, with and without the dental stent. The CT image sets were imported into Eclipse treatment planning system for contouring and treatment planning, and a 9-field IMRT treatment plan was developed for each scenario. These plans were delivered using a Varian TrueBeam linear accelerator. Doses were recorded using GafChromic EBT2 films and NanoDot dosimeters. Results: The measurements revealed a 43% relative increase in dose measured adjacent to the metal fixtures in the horizontal plane without the use of the dental stent. This equates to a total dose of 100 Gy to the oral mucosa during a standard course of definitive radiotherapy. To our knowledge, this is the first dosimetric analysis of dental stents using an anatomically realistic phantom and modern beam arrangement. Conclusion: These results support the use of dosimetric dental stents in head and neck radiotherapy for patients with metallic dental fixtures as a way to effectively reduce dose to nearby mucosal surfaces and, hence, reduce the risk and severity of mucositis.« less

The dilemma of parotid gland and pharyngeal constrictor muscles preservation—Is daily online image guidance required? A dosimetric analysis

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

Duffy, Olivia; Forde, Elizabeth; Leech, Michelle, E-mail: leechm@tcd.ie

With margin reduction common in head and neck radiotherapy, it is critical that the dosimetric effects of setup deviations are quantified. With past studies focusing on the quantification of positional and volumetric changes of organs at risk (OARs), this study aimed to measure the dose delivered to these the parotid gland (PG) and pharyngeal constrictor muscles (PCMs) using cone beam computed tomography (CBCT). Furthermore, this investigation sought to establish a potential time trend of change in dose delivered to target volumes secondary to ascertaining the need for daily image guidance (IG) to reduce the dose burden to these important OARs.more » Intensity modulated radiotherapy (IMRT) plans for 5 locally advanced head and neck patients' plans were created and mapped to weekly CBCTs. Each plan was recalculated without heterogeneity correction allowing for dosimetric comparison. Dosimetric endpoints recorded to assess the effect of positional variation were as per ICRU 83 and included D{sub 95} and D{sub 98} for the target volumes, mean dose (MD) and V{sub 30} {sub Gy} for the PGs, and V{sub 50} {sub Gy} and MD for the PCMs. Results were deemed statistically significant if p < 0.05. No significant time trends were established for these OARs. A significant decrease in V{sub 50} {sub Gy} was observed for all PCMs (p < 0.001) on all CBCTs relative to the original plan. Regarding target volumes, a highly significant decrease in MD (MD = 20 Gy, CI: −20.310 to −19.820) in D{sub 98} of the high-dose planning target volume (PTV [70 Gy]; PTVD{sub 98%} = 70 Gy) for case 3 was found (p ≤ 0.001). A nonpredictable, yet significant dosimetric effect was found. A clinically acceptable balance must be achieved between OAR dosimetry and target coverage as can be achieved by frequent IG.« less

Dosimetric characterization of optically stimulated luminescence dosimeter with therapeutic photon beams for use in clinical radiotherapy measurements.

PubMed

Ponmalar, Retna; Manickam, Ravikumar; Ganesh, K M; Saminathan, Sathiyan; Raman, Arun; Godson, Henry Finlay

2017-01-01

The modern radiotherapy techniques impose new challenges for dosimetry systems with high precision and accuracy in in vivo and in phantom dosimetric measurements. The knowledge of the basic characterization of a dosimetric system before patient dose verification is crucial. This incites the investigation of the potential use of nanoDot optically stimulated luminescence dosimeter (OSLD) for application in radiotherapy with therapeutic photon beams. Measurements were carried out with nanoDot OSLDs to evaluate the dosimetric characteristics such as dose linearity, dependency on field size, dose rate, energy and source-to-surface distance (SSD), reproducibility, fading effect, reader stability, and signal depletion per read out with cobalt-60 (60 Co) beam, 6 and 18 MV therapeutic photon beams. The data acquired with OSLDs were validated with ionization chamber data where applicable. Good dose linearity was observed for doses up to 300 cGy and above which supralinear behavior. The standard uncertainty with field size observed was 1.10% ± 0.4%, 1.09% ± 0.34%, and 1.2% ± 0.26% for 6 MV, 18 MV, and 60 Co beam, respectively. The maximum difference with dose rate was 1.3% ± 0.4% for 6 MV and 1.4% ± 0.4% for 18 MV photon beams. The largest variation in SSD was 1.5% ± 1.2% for 60 Co, 1.5% ± 0.9% for 6 MV, and 1.5% ± 1.3% for 18 MV photon beams. The energy dependence of OSL response at 18 MV and 60 Co with 6 MV beam was 1.5% ± 0.7% and 1.7% ± 0.6%, respectively. In addition, good reproducibility, stability after the decay of transient signal, and predictable fading were observed. The results obtained in this study indicate the efficacy and suitability of nanoDot OSLD for dosimetric measurements in clinical radiotherapy.

WE-AB-209-02: A New Inverse Planning Framework with Principle-Based Modeling of Inter-Structural Dosimetric Tradeoffs

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

Liu, H; Dong, P; Xing, L

Purpose: Traditional radiotherapy inverse planning relies on the weighting factors to phenomenologically balance the conflicting criteria for different structures. The resulting manual trial-and-error determination of the weights has long been recognized as the most time-consuming part of treatment planning. The purpose of this work is to develop an inverse planning framework that parameterizes the inter-structural dosimetric tradeoff among with physically more meaningful quantities to simplify the search for a clinically sensible plan. Methods: A permissible dosimetric uncertainty is introduced for each of the structures to balance their conflicting dosimetric requirements. The inverse planning is then formulated as a convex feasibilitymore » problem, which aims to generate plans with acceptable dosimetric uncertainties. A sequential procedure (SP) is derived to decompose the model into three submodels to constrain the uncertainty in the planning target volume (PTV), the critical structures, and all other structures to spare, sequentially. The proposed technique is applied to plan a liver case and a head-and-neck case and compared with a conventional approach. Results: Our results show that the strategy is able to generate clinically sensible plans with little trial-and-error. In the case of liver IMRT, the fractional volumes to liver and heart above 20Gy are found to be 22% and 10%, respectively, which are 15.1% and 33.3% lower than that of the counterpart conventional plan while maintaining the same PTV coverage. The planning of the head and neck IMRT show the same level of success, with the DVHs for all organs at risk and PTV very competitive to a counterpart plan. Conclusion: A new inverse planning framework has been established. With physically more meaningful modeling of the inter-structural tradeoff, the technique enables us to substantially reduce the need for trial-and-error adjustment of the model parameters and opens new opportunities of incorporating prior knowledge to facilitate the treatment planning process.« less

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

Comparing a volume based template approach and ultrasound guided freehand approach in multicatheter interstitial accelerated partial breast irradiation.

PubMed

Koh, Vicky Y; Buhari, Shaik A; Tan, Poh Wee; Tan, Yun Inn; Leong, Yuh Fun; Earnest, Arul; Tang, Johann I

2014-06-01

Currently, there are two described methods of catheter insertion for women undergoing multicatheter interstitial accelerated partial breast irradiation (APBI). These are a volume based template approach (template) and a non-template ultrasound guidance freehand approach (non-template). We aim to compare dosimetric endpoints between the template and non-template approach. Twenty patients, who received adjuvant multicatheter interstitial APBI between August 2008 to March 2010 formed the study cohort. Dosimetric planning was based on the RTOG 04-13 protocol. For standardization, the planning target volume evaluation (PTV-Eval) and organs at risk were contoured with the assistance of the attending surgeon. Dosimetric endpoints include D90 of the PTV-Eval, Dose Homogeneity Index (DHI), V200, maximum skin dose (MSD), and maximum chest wall dose (MCD). A median of 18 catheters was used per patient. The dose prescribed was 34 Gy in 10 fractions BID over 5 days. The average breast volume was 846 cm(3) (526-1384) for the entire cohort and there was no difference between the two groups (p = 0.6). Insertion time was significantly longer for the non-template approach (mean 150 minutes) compared to the template approach (mean: 90 minutes) (p = 0.02). The planning time was also significantly longer for the non-template approach (mean: 240 minutes) compared to the template approach (mean: 150 minutes) (p < 0.01). The template approach yielded a higher D90 (mean: 95%) compared to the non-template approach (mean: 92%) (p < 0.01). There were no differences in DHI (p = 0.14), V200 (p = 0.21), MSD (p = 0.7), and MCD (p = 0.8). Compared to the non-template approach, the template approach offered significant shorter insertion and planning times with significantly improved dosimetric PTV-Eval coverage without significantly compromising organs at risk dosimetrically.

A dosimetric uncertainty analysis for photon-emitting brachytherapy sources: Report of AAPM Task Group No. 138 and GEC-ESTRO

PubMed Central

DeWerd, Larry A.; Ibbott, Geoffrey S.; Meigooni, Ali S.; Mitch, Michael G.; Rivard, Mark J.; Stump, Kurt E.; Thomadsen, Bruce R.; Venselaar, Jack L. M.

2011-01-01

This report addresses uncertainties pertaining to brachytherapy single-source dosimetry preceding clinical use. The International Organization for Standardization (ISO) Guide to the Expression of Uncertainty in Measurement (GUM) and the National Institute of Standards and Technology (NIST) Technical Note 1297 are taken as reference standards for uncertainty formalism. Uncertainties in using detectors to measure or utilizing Monte Carlo methods to estimate brachytherapy dose distributions are provided with discussion of the components intrinsic to the overall dosimetric assessment. Uncertainties provided are based on published observations and cited when available. The uncertainty propagation from the primary calibration standard through transfer to the clinic for air-kerma strength is covered first. Uncertainties in each of the brachytherapy dosimetry parameters of the TG-43 formalism are then explored, ending with transfer to the clinic and recommended approaches. Dosimetric uncertainties during treatment delivery are considered briefly but are not included in the detailed analysis. For low- and high-energy brachytherapy sources of low dose rate and high dose rate, a combined dosimetric uncertainty <5% (k=1) is estimated, which is consistent with prior literature estimates. Recommendations are provided for clinical medical physicists, dosimetry investigators, and source and treatment planning system manufacturers. These recommendations include the use of the GUM and NIST reports, a requirement of constancy of manufacturer source design, dosimetry investigator guidelines, provision of the lowest uncertainty for patient treatment dosimetry, and the establishment of an action level based on dosimetric uncertainty. These recommendations reflect the guidance of the American Association of Physicists in Medicine (AAPM) and the Groupe Européen de Curiethérapie–European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) for their members and may also be used as guidance to manufacturers and regulatory agencies in developing good manufacturing practices for sources used in routine clinical treatments. PMID:21452716

A planning comparison of 3-dimensional conformal multiple static field, conformal arc, and volumetric modulated arc therapy for the delivery of stereotactic body radiotherapy for early stage lung cancer.

PubMed

Dickey, Mike; Roa, Wilson; Drodge, Suzanne; Ghosh, Sunita; Murray, Brad; Scrimger, Rufus; Gabos, Zsolt

2015-01-01

The primary objective of this study was to compare dosimetric variables as well as treatment times of multiple static fields (MSFs), conformal arcs (CAs), and volumetric modulated arc therapy (VMAT) techniques for the treatment of early stage lung cancer using stereotactic body radiotherapy (SBRT). Treatments of 23 patients previously treated with MSF of 48Gy to 95% of the planning target volume (PTV) in 4 fractions were replanned using CA and VMAT techniques. Dosimetric parameters of the Radiation Therapy Oncology Group (RTOG) 0915 trial were evaluated, along with the van׳t Riet conformation number (CN), monitor units (MUs), and actual and calculated treatment times. Paired t-tests for noninferiority were used to compare the 3 techniques. CA had significant dosimetric improvements over MSF for the ratio of the prescription isodose volume to PTV (R100%, p < 0.0001), the maximum dose 2cm away from the PTV (D2cm, p = 0.005), and van׳t Riet CN (p < 0.0001). CA was not statistically inferior to MSF for the 50% prescription isodose volume to PTV (R50%, p = 0.05). VMAT was significantly better than CA for R100% (p < 0.0001), R50% (p < 0.0001), D2cm (p = 0.006), and CN (p < 0.0001). CA plans had significantly shorter treatment times than those of VMAT (p < 0.0001). Both CA and VMAT planning showed significant dosimetric improvements and shorter treatment times over those of MSF. VMAT showed the most favorable dosimetry of all 3 techniques; however, the dosimetric effect of tumor motion was not evaluated. CA plans were significantly faster to treat, and minimize the interplay of tumor motion and dynamic multileaf collimator (MLC) motion effects. Given these results, CA has become the treatment technique of choice at our facility. Copyright © 2015 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

A dosimetric uncertainty analysis for photon-emitting brachytherapy sources: report of AAPM Task Group No. 138 and GEC-ESTRO.

PubMed

DeWerd, Larry A; Ibbott, Geoffrey S; Meigooni, Ali S; Mitch, Michael G; Rivard, Mark J; Stump, Kurt E; Thomadsen, Bruce R; Venselaar, Jack L M

2011-02-01

This report addresses uncertainties pertaining to brachytherapy single-source dosimetry preceding clinical use. The International Organization for Standardization (ISO) Guide to the Expression of Uncertainty in Measurement (GUM) and the National Institute of Standards and Technology (NIST) Technical Note 1297 are taken as reference standards for uncertainty formalism. Uncertainties in using detectors to measure or utilizing Monte Carlo methods to estimate brachytherapy dose distributions are provided with discussion of the components intrinsic to the overall dosimetric assessment. Uncertainties provided are based on published observations and cited when available. The uncertainty propagation from the primary calibration standard through transfer to the clinic for air-kerma strength is covered first. Uncertainties in each of the brachytherapy dosimetry parameters of the TG-43 formalism are then explored, ending with transfer to the clinic and recommended approaches. Dosimetric uncertainties during treatment delivery are considered briefly but are not included in the detailed analysis. For low- and high-energy brachytherapy sources of low dose rate and high dose rate, a combined dosimetric uncertainty <5% (k=1) is estimated, which is consistent with prior literature estimates. Recommendations are provided for clinical medical physicists, dosimetry investigators, and source and treatment planning system manufacturers. These recommendations include the use of the GUM and NIST reports, a requirement of constancy of manufacturer source design, dosimetry investigator guidelines, provision of the lowest uncertainty for patient treatment dosimetry, and the establishment of an action level based on dosimetric uncertainty. These recommendations reflect the guidance of the American Association of Physicists in Medicine (AAPM) and the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) for their members and may also be used as guidance to manufacturers and regulatory agencies in developing good manufacturing practices for sources used in routine clinical treatments.

Implementation of tetrahedral-mesh geometry in Monte Carlo radiation transport code PHITS

NASA Astrophysics Data System (ADS)

Furuta, Takuya; Sato, Tatsuhiko; Han, Min Cheol; Yeom, Yeon Soo; Kim, Chan Hyeong; Brown, Justin L.; Bolch, Wesley E.

2017-06-01

A new function to treat tetrahedral-mesh geometry was implemented in the particle and heavy ion transport code systems. To accelerate the computational speed in the transport process, an original algorithm was introduced to initially prepare decomposition maps for the container box of the tetrahedral-mesh geometry. The computational performance was tested by conducting radiation transport simulations of 100 MeV protons and 1 MeV photons in a water phantom represented by tetrahedral mesh. The simulation was repeated with varying number of meshes and the required computational times were then compared with those of the conventional voxel representation. Our results show that the computational costs for each boundary crossing of the region mesh are essentially equivalent for both representations. This study suggests that the tetrahedral-mesh representation offers not only a flexible description of the transport geometry but also improvement of computational efficiency for the radiation transport. Due to the adaptability of tetrahedrons in both size and shape, dosimetrically equivalent objects can be represented by tetrahedrons with a much fewer number of meshes as compared its voxelized representation. Our study additionally included dosimetric calculations using a computational human phantom. A significant acceleration of the computational speed, about 4 times, was confirmed by the adoption of a tetrahedral mesh over the traditional voxel mesh geometry.

Implementation of tetrahedral-mesh geometry in Monte Carlo radiation transport code PHITS.

PubMed

Furuta, Takuya; Sato, Tatsuhiko; Han, Min Cheol; Yeom, Yeon Soo; Kim, Chan Hyeong; Brown, Justin L; Bolch, Wesley E

2017-06-21

A new function to treat tetrahedral-mesh geometry was implemented in the particle and heavy ion transport code systems. To accelerate the computational speed in the transport process, an original algorithm was introduced to initially prepare decomposition maps for the container box of the tetrahedral-mesh geometry. The computational performance was tested by conducting radiation transport simulations of 100 MeV protons and 1 MeV photons in a water phantom represented by tetrahedral mesh. The simulation was repeated with varying number of meshes and the required computational times were then compared with those of the conventional voxel representation. Our results show that the computational costs for each boundary crossing of the region mesh are essentially equivalent for both representations. This study suggests that the tetrahedral-mesh representation offers not only a flexible description of the transport geometry but also improvement of computational efficiency for the radiation transport. Due to the adaptability of tetrahedrons in both size and shape, dosimetrically equivalent objects can be represented by tetrahedrons with a much fewer number of meshes as compared its voxelized representation. Our study additionally included dosimetric calculations using a computational human phantom. A significant acceleration of the computational speed, about 4 times, was confirmed by the adoption of a tetrahedral mesh over the traditional voxel mesh geometry.

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.

FLUKA simulation studies on in-phantom dosimetric parameters of a LINAC-based BNCT

NASA Astrophysics Data System (ADS)

Ghal-Eh, N.; Goudarzi, H.; Rahmani, F.

2017-12-01

The Monte Carlo simulation code, FLUKA version 2011.2c.5, has been used to estimate the in-phantom dosimetric parameters for use in BNCT studies. The in-phantom parameters of a typical Snyder head, which are necessary information prior to any clinical treatment, have been calculated with both FLUKA and MCNPX codes, which exhibit a promising agreement. The results confirm that FLUKA can be regarded as a good alternative for the MCNPX in BNCT dosimetry simulations.

LabVIEW-based control and acquisition system for the dosimetric characterization of a silicon strip detector.

PubMed

Ovejero, M C; Pérez Vega-Leal, A; Gallardo, M I; Espino, J M; Selva, A; Cortés-Giraldo, M A; Arráns, R

2017-02-01

The aim of this work is to present a new data acquisition, control, and analysis software system written in LabVIEW. This system has been designed to obtain the dosimetry of a silicon strip detector in polyethylene. It allows the full automation of the experiments and data analysis required for the dosimetric characterization of silicon detectors. It becomes a useful tool that can be applied in the daily routine check of a beam accelerator.

ICRP Publication 137: Occupational Intakes of Radionuclides: Part 3.

PubMed

Paquet, F; Bailey, M R; Leggett, R W; Lipsztein, J; Marsh, J; Fell, T P; Smith, T; Nosske, D; Eckerman, K F; Berkovski, V; Blanchardon, E; Gregoratto, D; Harrison, J D

2017-12-01

The 2007 Recommendations of the International Commission on Radiological Protection (ICRP, 2007) introduced changes that affect the calculation of effective dose, and implied a revision of the dose coefficients for internal exposure, published previously in the Publication 30 series (ICRP, 1979, 1980, 1981, 1988) and Publication 68 (ICRP, 1994). In addition, new data are now available that support an update of the radionuclide-specific information given in Publications 54 and 78 (ICRP, 1988a, 1997b) for the design of monitoring programmes and retrospective assessment of occupational internal doses. Provision of new biokinetic models, dose coefficients, monitoring methods, and bioassay data was performed by Committee 2, Task Group 21 on Internal Dosimetry, and Task Group 4 on Dose Calculations. A new series, the Occupational Intakes of Radionuclides (OIR) series, will replace the Publication 30 series and Publications 54, 68, and 78. OIR Part 1 has been issued (ICRP, 2015), and describes the assessment of internal occupational exposure to radionuclides, biokinetic and dosimetric models, methods of individual and workplace monitoring, and general aspects of retrospective dose assessment. OIR Part 2 (ICRP, 2016), this current publication and upcoming publications in the OIR series (Parts 4 and 5) provide data on individual elements and their radioisotopes, including information on chemical forms encountered in the workplace; a list of principal radioisotopes and their physical half-lives and decay modes; the parameter values of the reference biokinetic model; and data on monitoring techniques for the radioisotopes encountered most commonly in workplaces. Reviews of data on inhalation, ingestion, and systemic biokinetics are also provided for most of the elements. Dosimetric data provided in the printed publications of the OIR series include tables of committed effective dose per intake (Sv Bq−1 intake) for inhalation and ingestion, tables of committed effective dose per content (Sv Bq−1 measurement) for inhalation, and graphs of retention and excretion data per Bq intake for inhalation. These data are provided for all absorption types and for the most common isotope(s) of each element. The electronic annex that accompanies the OIR series of publications contains a comprehensive set of committed effective and equivalent dose coefficients, committed effective dose per content functions, and reference bioassay functions. Data are provided for inhalation, ingestion, and direct input to blood. This third publication in the series provides the above data for the following elements: ruthenium (Ru), antimony (Sb), tellurium (Te), iodine (I), caesium (Cs), barium (Ba), iridium (Ir), lead (Pb), bismuth (Bi), polonium (Po), radon (Rn), radium (Ra), thorium (Th), and uranium (U).

ICRP Publication 134: Occupational Intakes of Radionuclides: Part 2.

PubMed

Paquet, F; Bailey, M R; Leggett, R W; Lipsztein, J; Fell, T P; Smith, T; Nosske, D; Eckerman, K F; Berkovski, V; Ansoborlo, E; Giussani, A; Bolch, W E; Harrison, J D

2016-12-01

The 2007 Recommendations of the International Commission on Radiological Protection (ICRP, 2007) introduced changes that affect the calculation of effective dose, and implied a revision of the dose coefficients for internal exposure, published previously in the Publication 30 series (ICRP, 1979, 1980, 1981, 1988b) and Publication 68 (ICRP, 1994b). In addition, new data are available that support an update of the radionuclide-specific information given in Publications 54 and 78 (ICRP, 1988a, 1997b) for the design of monitoring programmes and retrospective assessment of occupational internal doses. Provision of new biokinetic models, dose coefficients, monitoring methods, and bioassay data was performed by Committee 2, Task Group 21 on Internal Dosimetry, and Task Group 4 on Dose Calculations. A new series, the Occupational Intakes of Radionuclides (OIR) series, will replace the Publication 30 series and Publications 54, 68, and 78. Part 1 of the OIR series has been issued (ICRP, 2015), and describes the assessment of internal occupational exposure to radionuclides, biokinetic and dosimetric models, methods of individual and workplace monitoring, and general aspects of retrospective dose assessment. The following publications in the OIR series (Parts 2–5) will provide data on individual elements and their radioisotopes, including information on chemical forms encountered in the workplace; a list of principal radioisotopes and their physical half-lives and decay modes; the parameter values of the reference biokinetic model; and data on monitoring techniques for the radioisotopes encountered most commonly in workplaces. Reviews of data on inhalation, ingestion, and systemic biokinetics are also provided for most of the elements. Dosimetric data provided in the printed publications of the OIR series include tables of committed effective dose per intake (Sv per Bq intake) for inhalation and ingestion, tables of committed effective dose per content (Sv per Bq measurement) for inhalation, and graphs of retention and excretion data per Bq intake for inhalation. These data are provided for all absorption types and for the most common isotope(s) of each element. The electronic annex that accompanies the OIR series of reports contains a comprehensive set of committed effective and equivalent dose coefficients, committed effective dose per content functions, and reference bioassay functions. Data are provided for inhalation, ingestion, and direct input to blood. The present publication provides the above data for the following elements: hydrogen (H), carbon (C), phosphorus (P), sulphur (S), calcium (Ca), iron (Fe), cobalt (Co), zinc (Zn), strontium (Sr), yttrium (Y), zirconium (Zr), niobium (Nb), molybdenum (Mo), and technetium (Tc).

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

Yu, Juan; Beltran, Chris J., E-mail: beltran.chris@mayo.edu; Herman, Michael G.

Purpose: To quantitatively and systematically assess dosimetric effects induced by spot positioning error as a function of spot spacing (SS) on intensity-modulated proton therapy (IMPT) plan quality and to facilitate evaluation of safety tolerance limits on spot position. Methods: Spot position errors (PE) ranging from 1 to 2 mm were simulated. Simple plans were created on a water phantom, and IMPT plans were calculated on two pediatric patients with a brain tumor of 28 and 3 cc, respectively, using a commercial planning system. For the phantom, a uniform dose was delivered to targets located at different depths from 10 tomore » 20 cm with various field sizes from 2{sup 2} to 15{sup 2} cm{sup 2}. Two nominal spot sizes, 4.0 and 6.6 mm of 1 σ in water at isocenter, were used for treatment planning. The SS ranged from 0.5 σ to 1.5 σ, which is 2–6 mm for the small spot size and 3.3–9.9 mm for the large spot size. Various perturbation scenarios of a single spot error and systematic and random multiple spot errors were studied. To quantify the dosimetric effects, percent dose error (PDE) depth profiles and the value of percent dose error at the maximum dose difference (PDE [ΔDmax]) were used for evaluation. Results: A pair of hot and cold spots was created per spot shift. PDE[ΔDmax] is found to be a complex function of PE, SS, spot size, depth, and global spot distribution that can be well defined in simple models. For volumetric targets, the PDE [ΔDmax] is not noticeably affected by the change of field size or target volume within the studied ranges. In general, reducing SS decreased the dose error. For the facility studied, given a single spot error with a PE of 1.2 mm and for both spot sizes, a SS of 1σ resulted in a 2% maximum dose error; a SS larger than 1.25 σ substantially increased the dose error and its sensitivity to PE. A similar trend was observed in multiple spot errors (both systematic and random errors). Systematic PE can lead to noticeable hot spots along the field edges, which may be near critical structures. However, random PE showed minimal dose error. Conclusions: Dose error dependence for PE was quantitatively and systematically characterized and an analytic tool was built to simulate systematic and random errors for patient-specific IMPT. This information facilitates the determination of facility specific spot position error thresholds.« less

Determination of dosimetric quantities in pediatric abdominal computed tomography scans*

PubMed Central

Jornada, Tiago da Silva; da Silva, Teógenes Augusto

2014-01-01

Objective Aiming at contributing to the knowledge on doses in computed tomography (CT), this study has the objective of determining dosimetric quantities associated with pediatric abdominal CT scans, comparing the data with diagnostic reference levels (DRL). Materials and methods The study was developed with a Toshiba Asteion single-slice CT scanner and a GE BrightSpeed multi-slice CT unit in two hospitals. Measurements were performed with a pencil-type ionization chamber and a 16 cm-diameter polymethylmethacrylate trunk phantom. Results No significant difference was observed in the values for weighted air kerma index (CW), but the differences were relevant in values for volumetric air kerma index (CVOL), air kerma-length product (PKL,CT) and effective dose. Conclusion Only the CW values were lower than the DRL, suggesting that dose optimization might not be necessary. However, PKL,CT and effective dose values stressed that there still is room for reducing pediatric radiation doses. The present study emphasizes the importance of determining all dosimetric quantities associated with CT scans. PMID:25741103

JCCRER Project 2.3 -- Deterministic effects of occupational exposure to radiation. Phase 1: Feasibility study; Final report

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

Okladnikova, N.; Pesternikova, V.; Sumina, M.

1998-12-01

Phase 1 of Project 2.3, a short-term collaborative Feasibility Study, was funded for 12 months starting on 1 February 1996. The overall aim of the study was to determine the practical feasibility of using the dosimetric and clinical data on the MAYAK worker population to study the deterministic effects of exposure to external gamma radiation and to internal alpha radiation from inhaled plutonium. Phase 1 efforts were limited to the period of greatest worker exposure (1948--1954) and focused on collaboratively: assessing the comprehensiveness, availability, quality, and suitability of the Russian clinical and dosimetric data for the study of deterministic effects;more » creating an electronic data base containing complete clinical and dosimetric data on a small, representative sample of MAYAK workers; developing computer software for the testing of a currently used health risk model of hematopoietic effects; and familiarizing the US team with the Russian diagnostic criteria and techniques used in the identification of Chronic Radiation Sickness.« less

Investigation of pulsed IMRT and VMAT for re-irradiation treatments: dosimetric and delivery feasibilities

NASA Astrophysics Data System (ADS)

Lin, Mu-Han; Price, Robert A., Jr.; Li, Jinsheng; Kang, Shengwei; Li, Jie; Ma, C.-M.

2013-11-01

Many tumor cells demonstrate hyperradiosensitivity at doses below ˜50 cGy. Together with the increased normal tissue repair under low dose rate, the pulsed low dose rate radiotherapy (PLDR), which separates a daily fractional dose of 200 cGy into 10 pulses with 3 min interval between pulses (˜20 cGy/pulse and effective dose rate 6.7 cGy min-1), potentially reduces late normal tissue toxicity while still providing significant tumor control for re-irradiation treatments. This work investigates the dosimetric and technical feasibilities of intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT)-based PLDR treatments using Varian Linacs. Twenty one cases (12 real re-irradiation cases) including treatment sites of pancreas, prostate, pelvis, lung, head-and-neck, and breast were recruited for this study. The lowest machine operation dose rate (100 MU min-1) was employed in the plan delivery. Ten-field step-and-shoot IMRT and dual-arc VMAT plans were generated using the Eclipse TPS with routine planning strategies. The dual-arc plans were delivered five times to achieve a 200 cGy daily dose (˜20 cGy arc-1). The resulting plan quality was evaluated according to the heterogeneity and conformity indexes (HI and CI) of the planning target volume (PTV). The dosimetric feasibility of retaining the hyperradiosensitivity for PLDR was assessed based on the minimum and maximum dose in the target volume from each pulse. The delivery accuracy of VMAT and IMRT at the 100 MU min-1 machine operation dose rate was verified using a 2D diode array and ion chamber measurements. The delivery reproducibility was further investigated by analyzing the Dynalog files of repeated deliveries. A comparable plan quality was achieved by the IMRT (CI 1.10-1.38 HI 1.04-1.10) and the VMAT (CI 1.08-1.26 HI 1.05-1.10) techniques. The minimum/maximum PTV dose per pulse is 7.9 ± 5.1 cGy/33.7 ± 6.9 cGy for the IMRT and 12.3 ± 4.1 cGy/29.2 ± 4.7 cGy for the VMAT. Six out of the 186 IMRT pulses (fields) were found to exceed 50 cGy maximum PTV dose per pulse while the maximum PTV dose per pulse was within 40 cGy for all the VMAT pulses (arcs). However, for VMAT plans, the dosimetric quality of the entire treatment plan was less superior for the breast cases and large irregular targets. The gamma passing rates for both techniques at the 100 MU min-1 dose rate were at least 94.1% (3%/3 mm) and the point dose measurements agreed with the planned values to within 2.2%. The average root mean square error of the leaf position was 0.93 ± 0.83 mm for IMRT and 0.53 ± 0.48 mm for VMAT based on the Dynalog file analysis. The RMS error of the leaf position was nearly identical for the repeated deliveries of the same plans. In general, both techniques are feasible for PLDR treatments. VMAT was more advantageous for PLDR with more uniform target dose per pulse, especially for centrally located tumors. However, for large, irregular and/or peripheral tumors, IMRT could produce more favorable PLDR plans. By taking the biological benefit of PLDR delivery and the dosimetric benefit of IMRT and VMAT, the proposed methods have a great potential for those previously-irradiated recurrent patients.

FASH and MASH: female and male adult human phantoms based on polygon mesh surfaces: II. Dosimetric calculations

NASA Astrophysics Data System (ADS)

Kramer, R.; Cassola, V. F.; Khoury, H. J.; Vieira, J. W.; de Melo Lima, V. J.; Robson Brown, K.

2010-01-01

Female and male adult human phantoms, called FASH (Female Adult meSH) and MASH (Male Adult meSH), have been developed in the first part of this study using 3D animation software and anatomical atlases to replace the image-based FAX06 and the MAX06 voxel phantoms. 3D modelling methods allow for phantom development independent from medical images of patients, volunteers or cadavers. The second part of this study investigates the dosimetric implications for organ and tissue equivalent doses due to the anatomical differences between the new and the old phantoms. These differences are mainly caused by the supine position of human bodies during scanning in order to acquire digital images for voxel phantom development. Compared to an upright standing person, in image-based voxel phantoms organs are often coronally shifted towards the head and sometimes the sagittal diameter of the trunk is reduced by a gravitational change of the fat distribution. In addition, volumes of adipose and muscle tissue shielding internal organs are sometimes too small, because adaptation of organ volumes to ICRP-based organ masses often occurs at the expense of general soft tissues, such as adipose, muscle or unspecified soft tissue. These effects have dosimetric consequences, especially for partial body exposure, such as in x-ray diagnosis, but also for whole body external exposure and for internal exposure. Using the EGSnrc Monte Carlo code, internal and external exposure to photons and electrons has been simulated with both pairs of phantoms. The results show differences between organ and tissue equivalent doses for the upright standing FASH/MASH and the image-based supine FAX06/MAX06 phantoms of up to 80% for external exposure and up to 100% for internal exposure. Similar differences were found for external exposure between FASH/MASH and REGINA/REX, the reference voxel phantoms of the International Commission on Radiological Protection. Comparison of effective doses for external photon exposure showed good agreement between FASH/MASH and REGINA/REX, but large differences between FASH/MASH and the mesh-based RPI_AM and the RPI_AF phantoms, developed at the Rensselaer Polytechnic Institute (RPI).

SU-E-T-297: Dosimetric Assessment of An Air-Filled Balloon Applicator in HDR Vaginal Cuff Brachytherapy Using the Monte Carlo Method

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

Jiang, H; Lee, Y; Pokhrel, D

2015-06-15

Purpose: As an alternative to cylindrical applicators, air inflated balloon applicators have been introduced into HDR vaginal cuff brachytherapy treatment to achieve sufficient dose to vagina mucosa as well as to spare rectum and bladder. In general, TG43 formulae based treatment planning systems do not take into account tissue inhomogeneity, and air in the balloon applicator can cause higher delivered dose to mucosa than treatment plan reported. We investigated dosimetric effect of air in balloon applicator using the Monte Carlo method. Methods: The thirteen-catheter Capri applicator with a Nucletron Ir-192 seed was modeled for various balloon diameters (2cm to 3.5cm)more » using the MCNP Monte Carlo code. Ir-192 seed was placed in both central and peripheral catheters to replicate real patient situations. Existence of charged particle equilibrium (CPE) with air balloon was evaluated by comparing kerma and dose at various distances (1mm to 70mm) from surface of air-filled applicator. Also mucosa dose by an air-filled applicator was compared with by a water-filled applicator to evaluate dosimetry accuracy of planning system without tissue inhomogeneity correction. Results: Beyond 1mm from air/tissue interface, the difference between kerma and dose was within 2%. CPE (or transient CPE) condition was deemed existent, and in this region no electron transport was necessary in Monte Carlo simulations. At 1mm or less, the deviation of dose from kerma became more apparent. Increase of dose to mucosa depended on diameter of air balloon. The increment of dose to mucosa was 2.5% and 4.3% on average for 2cm and 3.5cm applicators, respectively. Conclusion: After introduction of air balloon applicator, CPE fails only at the proximity of air/tissue interface. Although dose to mucosa is increased, there is no significant dosimetric difference (<5%) between air and water filled applicators. Tissue inhomogeneity correction is not necessary for air-filled applicators.« less

Effect of MLC leaf position, collimator rotation angle, and gantry rotation angle errors on intensity-modulated radiotherapy plans for nasopharyngeal carcinoma

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

Bai, Sen; Li, Guangjun; Wang, Maojie

The purpose of this study was to investigate the effect of multileaf collimator (MLC) leaf position, collimator rotation angle, and accelerator gantry rotation angle errors on intensity-modulated radiotherapy plans for nasopharyngeal carcinoma. To compare dosimetric differences between the simulating plans and the clinical plans with evaluation parameters, 6 patients with nasopharyngeal carcinoma were selected for simulation of systematic and random MLC leaf position errors, collimator rotation angle errors, and accelerator gantry rotation angle errors. There was a high sensitivity to dose distribution for systematic MLC leaf position errors in response to field size. When the systematic MLC position errors weremore » 0.5, 1, and 2 mm, respectively, the maximum values of the mean dose deviation, observed in parotid glands, were 4.63%, 8.69%, and 18.32%, respectively. The dosimetric effect was comparatively small for systematic MLC shift errors. For random MLC errors up to 2 mm and collimator and gantry rotation angle errors up to 0.5°, the dosimetric effect was negligible. We suggest that quality control be regularly conducted for MLC leaves, so as to ensure that systematic MLC leaf position errors are within 0.5 mm. Because the dosimetric effect of 0.5° collimator and gantry rotation angle errors is negligible, it can be concluded that setting a proper threshold for allowed errors of collimator and gantry rotation angle may increase treatment efficacy and reduce treatment time.« less

LiMgPO 4:Tb,B - A new sensitive OSL phosphor for dosimetry

NASA Astrophysics Data System (ADS)

Dhabekar, Bhushan; Menon, S. N.; Alagu Raja, E.; Bakshi, A. K.; Singh, A. K.; Chougaonkar, M. P.; Mayya, Y. S.

2011-08-01

Optically Stimulated Luminescence (OSL) technique has emerged as a serious competitor to Thermally Stimulated Luminescence (TSL) technique in various dosimetric applications, especially after the development of crystalline alumina (Al 2O 3:C) doped with carbon. Since then, several attempts are being made to develop other possible materials for OSL based dosimetric applications. Efforts conducted in our laboratory in this direction have led to the development of a new phosphor, Lithium Magnesium Phosphate doped with terbium and boron (LiMgPO 4:Tb,B). This phosphor is prepared by solid-state diffusion method involving conventional air furnaces with operating temperature 1000 °C and easily amenable to large scale production without compromising primary dosimetric advantages. In this work we present some of the dosimetric OSL characteristics of this phosphor. The phosphor exhibits a main TSL peak at 250 °C. The phosphor also emits OSL, when the irradiated phosphor is stimulated with 470 nm light with the OSL sensitivity 1.3 times that of commercially available Al 2O 3:C. Photoluminescence (PL) emission spectrum consists of sharp lines characteristics of Tb 3+ emission. The OSL discs made out of this phosphor are reusable up to at least 50 cycles, the phosphor exhibits dose linearity up to 1 kGy. Minimum detectable dose is found to be 20 μGy and fading of the OSL signal is found to be about 16% in four days, after which the OSL signal stabilizes.

Toxicity and dosimetric analysis of non-small cell lung cancer patients undergoing radiotherapy with 4DCT and image-guided intensity modulated radiotherapy: a regional centre's experience.

PubMed

Livingston, Gareth C; Last, Andrew J; Shakespeare, Thomas P; Dwyer, Patrick M; Westhuyzen, Justin; McKay, Michael J; Connors, Lisa; Leader, Stephanie; Greenham, Stuart

2016-09-01

For patients receiving radiotherapy for locally advance non-small cell lung cancer (NSCLC), the probability of experiencing severe radiation pneumonitis (RP) appears to rise with an increase in radiation received by the lungs. Intensity modulated radiotherapy (IMRT) provides the ability to reduce planned doses to healthy organs at risk (OAR) and can potentially reduce treatment-related side effects. This study reports toxicity outcomes and provides a dosimetric comparison with three-dimensional conformal radiotherapy (3DCRT). Thirty curative NSCLC patients received radiotherapy using four-dimensional computed tomography and five-field IMRT. All were assessed for early and late toxicity using common terminology criteria for adverse events. All plans were subsequently re-planned using 3DCRT to the same standard as the clinical plans. Dosimetric parameters for lungs, oesophagus, heart and conformity were recorded for comparison between the two techniques. IMRT plans achieved improved high-dose conformity and reduced OAR doses including lung volumes irradiated to 5-20 Gy. One case each of oesophagitis and erythema (3%) were the only Grade 3 toxicities. Rates of Grade 2 oesophagitis were 40%. No cases of Grade 3 RP were recorded and Grade 2 RP rates were as low as 3%. IMRT provides a dosimetric benefit when compared to 3DCRT. While the clinical benefit appears to increase with increasing target size and increasing complexity, IMRT appears preferential to 3DCRT in the treatment of NSCLC.

Retrospective evaluation of dosimetric quality for prostate carcinomas treated with 3D conformal, intensity modulated and volumetric modulated arc radiotherapy

PubMed Central

Crowe, Scott B; Kairn, Tanya; Middlebrook, Nigel; Hill, Brendan; Christie, David R H; Knight, Richard T; Kenny, John; Langton, Christian M; Trapp, Jamie V

2013-01-01

Introduction This study examines and compares the dosimetric quality of radiotherapy treatment plans for prostate carcinoma across a cohort of 163 patients treated across five centres: 83 treated with three-dimensional conformal radiotherapy (3DCRT), 33 treated with intensity modulated radiotherapy (IMRT) and 47 treated with volumetric modulated arc therapy (VMAT). Methods Treatment plan quality was evaluated in terms of target dose homogeneity and organs at risk (OAR), through the use of a set of dose metrics. These included the mean, maximum and minimum doses; the homogeneity and conformity indices for the target volumes; and a selection of dose coverage values that were relevant to each OAR. Statistical significance was evaluated using two-tailed Welch's T-tests. The Monte Carlo DICOM ToolKit software was adapted to permit the evaluation of dose metrics from DICOM data exported from a commercial radiotherapy treatment planning system. Results The 3DCRT treatment plans offered greater planning target volume dose homogeneity than the other two treatment modalities. The IMRT and VMAT plans offered greater dose reduction in the OAR: with increased compliance with recommended OAR dose constraints, compared to conventional 3DCRT treatments. When compared to each other, IMRT and VMAT did not provide significantly different treatment plan quality for like-sized tumour volumes. Conclusions This study indicates that IMRT and VMAT have provided similar dosimetric quality, which is superior to the dosimetric quality achieved with 3DCRT. PMID:26229621

Resolving the limitations of using glycine as EPR dosimeter in the intermediate level of gamma dose

NASA Astrophysics Data System (ADS)

Aboelezz, E.; Hassan, G. M.

2018-04-01

The dosimetric properties of the simplest amino acid "glycine"- using EPR technique- were investigated in comparison to reference standard alanine dosimeter. The EPR spectrum of glycine at room temperature is complex, but immediately after irradiation, it appears as a triplet hyperfine structure probably due to the dominant contribution of the (•CH2COO-) radical. The dosimetric peak of glycine is at g-factor 2.0026 ± 0.0015 and its line width is 9 G at large modulation amplitude (7 G). The optimum microwave was studied and was found to be as alanine 8 mW; the post-irradiation as well as the dose rate effects were discussed. Dosimetric peak intensity of glycine fades rapidly to be about one quarter of its original value during 20 days for dried samples and it stabilizes after that. The dose response study in an intermediate range (2-1000 Gy) reveals that the glycine SNR is about 2 times more than that of alanine pellets when measured immediately after irradiation and 4 times more than that of glycine itself after 22 days of irradiation. The effect of energy dependence was studied and interpreted theoretically by calculation of mass energy absorption coefficient. The calculated combined uncertainties for glycine and alanine are nearly the same and were found to be 2.42% and 2.33%, respectively. Glycine shows interesting dosimetric properties in the range of ionizing radiation doses investigated.

Integrated beam orientation and scanning-spot optimization in intensity-modulated proton therapy for brain and unilateral head and neck tumors.

PubMed

Gu, Wenbo; O'Connor, Daniel; Nguyen, Dan; Yu, Victoria Y; Ruan, Dan; Dong, Lei; Sheng, Ke

2018-04-01

Intensity-Modulated Proton Therapy (IMPT) is the state-of-the-art method of delivering proton radiotherapy. Previous research has been mainly focused on optimization of scanning spots with manually selected beam angles. Due to the computational complexity, the potential benefit of simultaneously optimizing beam orientations and spot pattern could not be realized. In this study, we developed a novel integrated beam orientation optimization (BOO) and scanning-spot optimization algorithm for intensity-modulated proton therapy (IMPT). A brain chordoma and three unilateral head-and-neck patients with a maximal target size of 112.49 cm 3 were included in this study. A total number of 1162 noncoplanar candidate beams evenly distributed across 4π steradians were included in the optimization. For each candidate beam, the pencil-beam doses of all scanning spots covering the PTV and a margin were calculated. The beam angle selection and spot intensity optimization problem was formulated to include three terms: a dose fidelity term to penalize the deviation of PTV and OAR doses from ideal dose distribution; an L1-norm sparsity term to reduce the number of active spots and improve delivery efficiency; a group sparsity term to control the number of active beams between 2 and 4. For the group sparsity term, convex L2,1-norm and nonconvex L2,1/2-norm were tested. For the dose fidelity term, both quadratic function and linearized equivalent uniform dose (LEUD) cost function were implemented. The optimization problem was solved using the Fast Iterative Shrinkage-Thresholding Algorithm (FISTA). The IMPT BOO method was tested on three head-and-neck patients and one skull base chordoma patient. The results were compared with IMPT plans created using column generation selected beams or manually selected beams. The L2,1-norm plan selected spatially aggregated beams, indicating potential degeneracy using this norm. L2,1/2-norm was able to select spatially separated beams and achieve smaller deviation from the ideal dose. In the L2,1/2-norm plans, the [mean dose, maximum dose] of OAR were reduced by an average of [2.38%, 4.24%] and[2.32%, 3.76%] of the prescription dose for the quadratic and LEUD cost function, respectively, compared with the IMPT plan using manual beam selection while maintaining the same PTV coverage. The L2,1/2 group sparsity plans were dosimetrically superior to the column generation plans as well. Besides beam orientation selection, spot sparsification was observed. Generally, with the quadratic cost function, 30%~60% spots in the selected beams remained active. With the LEUD cost function, the percentages of active spots were in the range of 35%~85%.The BOO-IMPT run time was approximately 20 min. This work shows the first IMPT approach integrating noncoplanar BOO and scanning-spot optimization in a single mathematical framework. This method is computationally efficient, dosimetrically superior and produces delivery-friendly IMPT plans. © 2018 American Association of Physicists in Medicine.

Dosimetric Comparison of Helical Tomotherapy and Dynamic Conformal Arc Therapy in Stereotactic Radiosurgery for Vestibular Schwannomas

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

Lee, Tsair-Fwu, E-mail: tflee@cc.kuas.edu.t; Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Chao, Pei-Ju

2011-04-01

The dosimetric results of stereotactic radiosurgery (SRS) for vestibular schwannoma (VS) performed using dynamic conformal arc therapy (DCAT) with the Novalis system and helical TomoTherapy (HT) were compared using plan quality indices. The HT plans were created for 10 consecutive patients with VS previously treated with SRS using the Novalis system. The dosimetric indices used to compare the techniques included the conformity index (CI) and homogeneity index (HI) for the planned target volume (PTV), the comprehensive quality index (CQI) for nine organs at risk (OARs), gradient score index (GSI) for the dose drop-off outside the PTV, and plan quality indexmore » (PQI), which was verified using the plan quality discerning power (PQDP) to incorporate 3 plan indices, to evaluate the rival plans. The PTV ranged from 0.27-19.99 cm{sup 3} (median 3.39 cm{sup 3}), with minimum required PTV prescribed doses of 10-16 Gy (median 12 Gy). Both systems satisfied the minimum required PTV prescription doses. HT conformed better to the PTV (CI: 1.51 {+-} 0.23 vs. 1.94 {+-} 0.34; p < 0.01), but had a worse drop-off outside the PTV (GSI: 40.3 {+-} 10.9 vs. 64.9 {+-} 13.6; p < 0.01) compared with DCAT. No significant difference in PTV homogeneity was observed (HI: 1.08 {+-} 0.03 vs. 1.09 {+-} 0.02; p = 0.20). HT had a significantly lower maximum dose in 4 OARs and significant lower mean dose in 1 OAR; by contrast, DCAT had a significantly lower maximum dose in 1 OAR and significant lower mean dose in 2 OARs, with the CQI of the 9 OARs = 0.92 {+-} 0.45. Plan analysis using PQI (HT 0.37 {+-} 0.12 vs. DCAT 0.65 {+-} 0.08; p < 0.01), and verified using the PQDP, confirmed the dosimetric advantage of HT. However, the HT system had a longer beam-on time (33.2 {+-} 7.4 vs. 4.6 {+-} 0.9 min; p < 0.01) and consumed more monitor units (16772 {+-} 3803 vs. 1776 {+-} 356.3; p < 0.01). HT had a better dose conformity and similar dose homogeneity but worse dose gradient than DCAT. Plan analysis confirmed the dosimetric advantage of HT, although not all indices revealed a better outcome for HT. Whether this dosimetric advantage translates into a clinical benefit deserves further investigation.« less

The internal dosimetry code PLEIADES.

PubMed

Fell, T P; Phipps, A W; Smith, T J

2007-01-01

The International Commission on Radiological Protection (ICRP) has published dose coefficients for the ingestion or inhalation of radionuclides in a series of reports covering intakes by workers and members of the public, including children and pregnant or lactating women. The calculation of these coefficients divides naturally into two distinct parts-the biokinetic and dosimetric. This paper describes in detail the methods used to solve the biokinetic problem in the generation of dose coefficients on behalf of the ICRP, as implemented in the Health Protection Agency's internal dosimetry code PLEIADES. A summary of the dosimetric treatment is included.

The spectral applications of Beer-Lambert law for some biological and dosimetric materials

NASA Astrophysics Data System (ADS)

Içelli, Orhan; Yalçin, Zeynel; Karakaya, Vatan; Ilgaz, Işıl P.

2014-08-01

The aim of this study is to conduct quantitative and qualitative analysis of biological and dosimetric materials which contain organic and inorganic materials and to make the determination by using the spectral theorem Beer-Lambert law. Beer-Lambert law is a system of linear equations for the spectral theory. It is possible to solve linear equations with a non-zero coefficient matrix determinant forming linear equations. Characteristic matrix of the linear equation with zero determinant is called point spectrum at the spectral theory.

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

Sanchez-Nieto, Beatriz, E-mail: bsanchez@fis.puc.cl; Goset, Karen C.; Caviedes, Ivan

Purpose: To propose multivariate predictive models for changes in pulmonary function tests ({Delta}PFTs) with respect to preradiotherapy (pre-RT) values in patients undergoing RT for breast cancer and lymphoma. Methods and Materials: A prospective study was designed to measure {Delta}PFTs of patients undergoing RT. Sixty-six patients were included. Spirometry, lung capacity (measured by helium dilution), and diffusing capacity of carbon monoxide tests were used to measure lung function. Two lung definitions were considered: paired lung vs. irradiated lung (IL). Correlation analysis of dosimetric parameters (mean lung dose and the percentage of lung volume receiving more than a threshold dose) and {Delta}PFTsmore » was carried out to find the best dosimetric predictor. Chemotherapy, age, smoking, and the selected dose-volume parameter were considered as single and interaction terms in a multivariate analysis. Stability of results was checked by bootstrapping. Results: Both lung definitions proved to be similar. Modeling was carried out for IL. Acute and late damage showed the highest correlations with volumes irradiated above {approx}20 Gy (maximum R{sup 2} = 0.28) and {approx}40 Gy (maximum R{sup 2} = 0.21), respectively. RT alone induced a minor and transitory restrictive defect (p = 0.013). Doxorubicin-cyclophosphamide-paclitaxel (Taxol), when administered pre-RT, induced a late, large restrictive effect, independent of RT (p = 0.031). Bootstrap values confirmed the results. Conclusions: None of the dose-volume parameters was a perfect predictor of outcome. Thus, different predictor models for {Delta}PFTs were derived for the IL, which incorporated other nondosimetric parameters mainly through interaction terms. Late {Delta}PFTs seem to behave more serially than early ones. Large restrictive defects were demonstrated in patients pretreated with doxorubicin-cyclophosphamide-paclitaxel.« less

External dose-rate conversion factors of radionuclides for air submersion, ground surface contamination and water immersion based on the new ICRP dosimetric setting.

PubMed

Yoo, Song Jae; Jang, Han-Ki; Lee, Jai-Ki; Noh, Siwan; Cho, Gyuseong

2013-01-01

For the assessment of external doses due to contaminated environment, the dose-rate conversion factors (DCFs) prescribed in Federal Guidance Report 12 (FGR 12) and FGR 13 have been widely used. Recently, there were significant changes in dosimetric models and parameters, which include the use of the Reference Male and Female Phantoms and the revised tissue weighting factors, as well as the updated decay data of radionuclides. In this study, the DCFs for effective and equivalent doses were calculated for three exposure settings: skyshine, groundshine and water immersion. Doses to the Reference Phantoms were calculated by Monte Carlo simulations with the MCNPX 2.7.0 radiation transport code for 26 mono-energy photons between 0.01 and 10 MeV. The transport calculations were performed for the source volume within the cut-off distances practically contributing to the dose rates, which were determined by a simplified calculation model. For small tissues for which the reduction of variances are difficult, the equivalent dose ratios to a larger tissue (with lower statistical errors) nearby were employed to make the calculation efficient. Empirical response functions relating photon energies, and the organ equivalent doses or the effective doses were then derived by the use of cubic-spline fitting of the resulting doses for 26 energy points. The DCFs for all radionuclides considered important were evaluated by combining the photon emission data of the radionuclide and the empirical response functions. Finally, contributions of accompanied beta particles to the skin equivalent doses and the effective doses were calculated separately and added to the DCFs. For radionuclides considered in this study, the new DCFs for the three exposure settings were within ±10 % when compared with DCFs in FGR 13.

External dose-rate conversion factors of radionuclides for air submersion, ground surface contamination and water immersion based on the new ICRP dosimetric setting

PubMed Central

Yoo, Song Jae; Jang, Han-Ki; Lee, Jai-Ki; Noh, Siwan; Cho, Gyuseong

2013-01-01

For the assessment of external doses due to contaminated environment, the dose-rate conversion factors (DCFs) prescribed in Federal Guidance Report 12 (FGR 12) and FGR 13 have been widely used. Recently, there were significant changes in dosimetric models and parameters, which include the use of the Reference Male and Female Phantoms and the revised tissue weighting factors, as well as the updated decay data of radionuclides. In this study, the DCFs for effective and equivalent doses were calculated for three exposure settings: skyshine, groundshine and water immersion. Doses to the Reference Phantoms were calculated by Monte Carlo simulations with the MCNPX 2.7.0 radiation transport code for 26 mono-energy photons between 0.01 and 10 MeV. The transport calculations were performed for the source volume within the cut-off distances practically contributing to the dose rates, which were determined by a simplified calculation model. For small tissues for which the reduction of variances are difficult, the equivalent dose ratios to a larger tissue (with lower statistical errors) nearby were employed to make the calculation efficient. Empirical response functions relating photon energies, and the organ equivalent doses or the effective doses were then derived by the use of cubic-spline fitting of the resulting doses for 26 energy points. The DCFs for all radionuclides considered important were evaluated by combining the photon emission data of the radionuclide and the empirical response functions. Finally, contributions of accompanied beta particles to the skin equivalent doses and the effective doses were calculated separately and added to the DCFs. For radionuclides considered in this study, the new DCFs for the three exposure settings were within ±10 % when compared with DCFs in FGR 13. PMID:23542764

Inhalation dose assessment of indoor radon progeny using biokinetic and dosimetric modeling and its application to Jordanian population.

PubMed

Al-Jundi, J; Li, W B; Abusini, M; Tschiersch, J; Hoeschen, C; Oeh, U

2011-06-01

High indoor radon concentrations in Jordan result in internal exposures of the residents due to the inhalation of radon and its short-lived progeny. It is therefore important to quantify the annual effective dose and further the radiation risk to the radon exposure. This study describes the methodology and the biokinetic and dosimetric models used for calculation of the inhalation doses exposed to radon progeny. The regional depositions of aerosol particles in the human respiratory tract were firstly calculated. For the attached progeny, the activity median aerodynamic diameters of 50 nm, 230 nm and 2500 nm were chosen to represent the nucleation, accumulation and coarse modes of the aerosol particles, respectively. For the unattached progeny, the activity median thermodynamic diameter of 1 nm was chosen to represent the free progeny nuclide in the room air. The biokinetic models developed by the International Commission on Radiological Protection (ICRP) were used to calculate the nuclear transformations of radon progeny in the human body, and then the dosimetric model was applied to estimate the organ equivalent doses and the effective doses with the specific effective energies derived from the mathematical anthropomorphic phantoms. The dose conversion coefficient estimated in this study was 15 mSv WLM(-1) which was in the range of the values of 6-20 mSv WLM(-1) reported by other investigators. Implementing the average indoor radon concentration in Jordan, the annual effective doses were calculated to be 4.1 mSv y(-1) and 0.08 mSv y(-1) due to the inhalation of radon progeny and radon gas, respectively. The total annual effective dose estimated for Jordanian population was 4.2 mSv y(-1). This high annual effective dose calculated by the dosimetric approach using ICRP biokinetic and dosimetric models resulted in an increase of a factor of two in comparison to the value by epidemiological study. This phenomenon was presented by the ICRP in its new published statement on radon. Copyright © 2011 Elsevier Ltd. All rights reserved.

Dosimetric impact of cylinder size in high-dose rate vaginal cuff brachytherapy (VCBT) for primary endometrial cancer.

PubMed

Zhang, Hualin; Gopalakrishnan, Mahesh; Lee, Plato; Kang, Zhuang; Sathiaseelan, Vythialingam

2016-09-08

The purpose of this study was to evaluate the dosimetric impact of cylinder size in high-dose-rate (HDR) vaginal cuff brachytherapy (VCBT). Sample plans of HDR VCBT in a list of cylinders ranging from 2.5 to 4 cm in diameter at 0.5 cm incre-ment were created and analyzed. The doses were prescribed either at the 0.5cm depth with 5.5 Gy for 4 fractions or at the cylinder surface with 8.8 Gy for 4 frac-tions, in various treatment lengths. A 0.5 cm shell volume called PTV_Eval was contoured for each plan and served as the target volume for dosimetric evaluation. The cumulative and differential dose volume histograms (c-DVH and d-DVH), mean doses (D-mean) and the doses covering 90% (D90), 10% (D10), and 5% (D5) of PTV_Eval were calculated. In the 0.5 cm depth regimen, the DVH curves were found to have shifted toward the lower dose zone when a larger cylinder was used, but in the surface regimen the DVH curves shifted toward the higher dose zone as the cylinder size increased. The D-means of the both regimens were between 6.9 and 7.8 Gy and dependent on the cylinder size but independent of the treatment length. A 0.5 cm variation of diameter could result in a 4% change of D-mean. Average D90s were 5.7 (ranging from 5.6 to 5.8 Gy) and 6.1 Gy (from 5.7 to 6.4 Gy), respectively, for the 0.5 cm and surface regimens. Average D10 and D5 were 9.2 and 11 Gy, respectively, for the 0.5 cm depth regimen, and 8.9 and 9.7 Gy, respectively, for the surface regimen. D-mean, D90, D10, and D5 for other prescription doses could be calculated from the lookup tables of this study. Results indicated that the cylinder size has moderate dosimetric impact, and that both regimens are comparable in dosimetric quality. © 2016 The Authors.

Dosimetric challenges of small animal irradiation with a commercial X-ray unit.

PubMed

Kuess, Peter; Bozsaky, Eva; Hopfgartner, Johannes; Seifritz, Gerhard; Dörr, Wolfgang; Georg, Dietmar

2014-12-01

A commercial X-ray unit was recently installed at the Medical University Vienna for partial and whole body irradiation of small experimental animals. For 200 kV X-rays the dose deviations with respect to the reference dose measured in the geometrical center of the potential available field size was investigated for various experimental setup plates used for mouse irradiations. Furthermore, the HVL was measured in mm Al and mm Cu at 200 kV for two types of filtration. Three different setup constructions for small animal irradiation were dosimetrically characterized, covering field sizes from 9×20 mm2 to 210×200 mm2. Different types of detectors were investigated. Additionally LiF:MG,Ti TLD chips were used for mouse in-vivo dosimetry. The use of an additional 0.5 mm Cu filter reduced the deviation of the dose between each irradiation position on the setup plates. Multiple animals were irradiated at the same time using an individual setup plate for each experimental purpose. The dose deviations of each irradiation position to the center was measured to be ±4% or better. The depth dose curve measured in a solid water phantom was more pronounced for smaller field sizes. The comparison between estimated dose and measured dose in a PMMA phantom regarding the dose decline yielded in a difference of 3.9% at 20 mm depth. In-vivo measurements in a mouse snouts irradiation model confirmed the reference dosimetry, accomplished in PMMA phantoms, in terms of administered dose and deviation within different points of measurement. The outlined experiments dealt with a wide variety of dosimetric challenges during the installation of a new X-ray unit in the laboratory. The depth dose profiles measured for different field sizes were in good agreement with literature data. Different field sizes and spatial arrangement of the animals (depending on each purpose) provide additional challenges for the dosimetric measurements. Thorough dosimetric commissioning has to be performed before a new experimental setup is approved for biological experiments. Copyright © 2014. Published by Elsevier GmbH.

Dosimetric Predictors of Duodenal Toxicity After Intensity Modulated Radiation Therapy for Treatment of the Para-aortic Nodes in Gynecologic Cancer

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

Verma, Jonathan; Sulman, Erik P.; Jhingran, Anuja

Purpose: To determine the incidence of duodenal toxicity in patients receiving intensity modulated radiation therapy (IMRT) for treatment of para-aortic nodes and to identify dosimetric parameters predictive of late duodenal toxicity. Methods and Materials: We identified 105 eligible patients with gynecologic malignancies who were treated with IMRT for gross metastatic disease in the para-aortic nodes from January 1, 2005, through December 31, 2009. Patients were treated to a nodal clinical target volume to 45 to 50.4 Gy with a boost to 60 to 66 Gy. The duodenum was contoured, and dosimetric data were exported for analysis. Duodenal toxicity was scoredmore » according to Radiation Therapy Oncology Group criteria. Univariate Cox proportional hazards analysis and recursive partitioning analysis were used to determine associations between dosimetric variables and time to toxicity and to identify the optimal threshold that separated patients according to risk of toxicity. Results: Nine of the 105 patients experienced grade 2 to grade 5 duodenal toxicity, confirmed by endoscopy in all cases. The 3-year actuarial rate of any duodenal toxicity was 11.7%. A larger volume of the duodenum receiving 55 Gy (V55) was associated with higher rates of duodenal toxicity. The 3-year actuarial rates of duodenal toxicity with V55 above and below 15 cm{sup 3} were 48.6% and 7.4%, respectively (P<.01). In Cox univariate analysis of dosimetric variables, V55 was associated with duodenal toxicity (P=.029). In recursive partitioning analysis, V55 less than 13.94% segregated all patients with duodenal toxicity. Conclusions: Dose-escalated IMRT can safely and effectively treat para-aortic nodal disease in gynecologic malignancies, provided that care is taken to limit the dose to the duodenum to reduce the risk of late duodenal toxicity. Limiting V55 to below 15 cm{sup 3} may reduce the risk of duodenal complications. In cases where the treatment cannot be delivered within these constraints, consideration should be given to other treatment approaches such as resection or initial chemotherapy.« less

SU-F-E-06: Dosimetric Characterization of Small Photons Beams of a Novel Linear Accelerator

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

Almonte, A; Polanco, G; Sanchez, E

2016-06-15

Purpose: The aim of the present contribution was to measure the main dosimetric quantities of small fields produced by UNIQUE and evaluate its matching with the corresponding dosimetric data of one 21EX conventional linear accelerator (Varian) in operation at the same center. The second step was to evaluate comparative performance of the EDGE diode detector and the PinPoint micro-ionization chamber for dosimetry of small fields. Methods: UNIQUE is configured with MLC (120 leaves with 0.5 cm leaf width) and a single low photon energy of 6 MV. Beam data were measured with scanning EDGE diode detector (volume of 0.019 mm{supmore » 3}), a PinPoint micro-ionization chamber (PTW) and for larger fields (≥ 4×4cm{sup 2}) a PTW Semi flex chamber (0.125 cm{sup 3}) was used. The scanning system used was the 3D cylindrical tank manufactured by Sun Nuclear, Inc. The measurement of PDD and profiles were done at 100 cm SSD and 1.5 depth; the relative output factors were measured at 10 cm depth. Results: PDD and the profile data showed less than 1% variation between the two linear accelerators for fields size between 2×2 cm{sup 2} and 5×5cm{sup 2}. Output factor differences was less than 1% for field sizes between 3×3 cm{sup 2} and 10×10 cm{sup 2} and less of 1.5 % for fields of 1.5×1.5 cm{sup 2} and 2×2 cm{sup 2} respectively. The dmax value of the EDGE diode detector, measured from the PDD, was 8.347 mm for 0.5×0,5cm{sup 2} for UNIQUE. The performance of EDGE diode detector was comparable for all measurements in small fields. Conclusion: UNIQUE linear accelerator show similar dosimetrics characteristics as conventional 21EX Varian linear accelerator for small, medium and large field sizes.EDGE detector show good performance by measuring dosimetrics quantities in small fields typically used in IMRT and radiosurgery treatments.« less

SU-D-204-04: Correlations Between Dosimetric Indices and Follow-Up Data for Salivary Glands Six Months After Radiation Therapy for Head and Neck Cancer

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

Chera, B; Price, A; Kostich, M

Purpose: To investigate the correlation between different dosimetric indices of salivary glands (as separate or combined structures) to patient-reported dry mouth 6 months post radiotherapy using the novel patient reported outcome version of the CTCAE (PRO-CTCAE). Methods: Forty-three patients with oropharyngeal squamous cell carcinoma were treated on a prospective multi-institutional study. All patients received de-intensified 60 Gy intensity modulated radiotherapy. Dosimetric constraints were used for the salivary glands (e.g. mean dose to the contralateral-parotid < 26 Gy). We investigated correlations of individual patient dosimetric data of the parotid and submandibular glands (as separate or combined structures) to their self-reported 6more » month post-treatment dry mouth responses. Moderate dry mouth responses were most prevalent and were used as the clinical endpoint indicating response. The correlation of Dmean, Dmax and a range of dosevolume (VD) points were assessed through the area under the Receiver Operating Characteristic curve (ROC) and Odds Ratios (OR). Results: Patients reporting non/mild dry mouth response (N=22) had average Dmean = 19.6 ± 6.2Gy to the contralateral-parotid compared to an average Dmean = 28.0 ± 8.3Gy and an AUC = 0.758 for the patients reporting moderate/severe/very severe dry mouth (N=21). Analysis of the range of VD’s for patients who had reported dry mouth showed that for the contralateral-parotid the indices V18 through V22 had the highest area under the curves (AUC) (0.762 – 0.772) compared to a more traditional dosimetric index V30, which had an AUC = 0.732. The highest AUC was observed for the combination of contralateral parotid and contralateral submandibular glands, for which V16 through V28 had AUC = 0.801 – 0.834. Conclusion: Patients who report moderate/severe/very severe dry mouth 6 months post radiotherapy had on average higher Dmean. The V16-V28 of the combination of the contralateral glands showed the highest correlation with the clinical endpoint.« less

A comparative study of standard intensity-modulated radiotherapy and RapidArc planning techniques for ipsilateral and bilateral head and neck irradiation

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

Pursley, Jennifer, E-mail: jpursley@mgh.harvard.edu; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA; Damato, Antonio L.

The purpose of this study was to investigate class solutions using RapidArc volumetric-modulated arc therapy (VMAT) planning for ipsilateral and bilateral head and neck (H&N) irradiation, and to compare dosimetric results with intensity-modulated radiotherapy (IMRT) plans. A total of 14 patients who received ipsilateral and 10 patients who received bilateral head and neck irradiation were retrospectively replanned with several volumetric-modulated arc therapy techniques. For ipsilateral neck irradiation, the volumetric-modulated arc therapy techniques included two 360° arcs, two 360° arcs with avoidance sectors around the contralateral parotid, two 260° or 270° arcs, and two 210° arcs. For bilateral neck irradiation, themore » volumetric-modulated arc therapy techniques included two 360° arcs, two 360° arcs with avoidance sectors around the shoulders, and 3 arcs. All patients had a sliding-window-delivery intensity-modulated radiotherapy plan that was used as the benchmark for dosimetric comparison. For ipsilateral neck irradiation, a volumetric-modulated arc therapy technique using two 360° arcs with avoidance sectors around the contralateral parotid was dosimetrically comparable to intensity-modulated radiotherapy, with improved conformity (conformity index = 1.22 vs 1.36, p < 0.04) and lower contralateral parotid mean dose (5.6 vs 6.8 Gy, p < 0.03). For bilateral neck irradiation, 3-arc volumetric-modulated arc therapy techniques were dosimetrically comparable to intensity-modulated radiotherapy while also avoiding irradiation through the shoulders. All volumetric-modulated arc therapy techniques required fewer monitor units than sliding-window intensity-modulated radiotherapy to deliver treatment, with an average reduction of 35% for ipsilateral plans and 67% for bilateral plans. Thus, for ipsilateral head and neck irradiation a volumetric-modulated arc therapy technique using two 360° arcs with avoidance sectors around the contralateral parotid is recommended. For bilateral neck irradiation, 2- or 3-arc techniques are dosimetrically comparable to intensity-modulated radiotherapy, but more work is needed to determine the optimal approaches by disease site.« less

SU-F-BRA-14: Optimization of Dosimetric Guidelines for Accelerated Partial Breast Irradiation (APBI) Using the Strut-Adjusted Volume Implant (SAVI)

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

Mooney, K; Altman, M; Garcia-Ramirez, J

Purpose: Treatment planning guidelines for accelerated partial breast irradiation (ABPI) using the strut-adjusted volume implant (SAVI) are inconsistent between the manufacturer and NSABP B-39/RTOG 0413 protocol. Furthermore neither set of guidelines accounts for different applicator sizes. The purpose of this work is to establish guidelines specific to the SAVI that are based on clinically achievable dose distributions. Methods: Sixty-two consecutive patients were implanted with a SAVI and prescribed to receive 34 Gy in 10 fractions twice daily using high dose-rate (HDR) Ir-192 brachytherapy. The target (PTV-EVAL) was defined per NSABP. The treatments were planned and evaluated using a combination ofmore » dosimetric planning goals provided by the NSABP, the manufacturer, and our prior clinical experience. Parameters evaluated included maximum doses to skin and ribs, and volumes of PTV-EVAL receiving 90%, 95%, 100%, 150%, and 200% of the prescription (V90, etc). All target parameters were evaluated for correlation with device size using the Pearson correlation coefficient. Revised dosimetric guidelines for target coverage and heterogeneity were determined from this population. Results: Revised guidelines for minimum target coverage (ideal in parentheses): V90≥95%(97%), V95≥90%(95%), V100≥88%(91%). The only dosimetric parameters that were significantly correlated (p<0.05) with device size were V150 and V200. Heterogeneity criteria were revised for the 6–1 Mini/6-1 applicators to V150≤30cc and V200≤15cc, and unchanged for the other sizes. Re-evaluation of patient plans showed 90% (56/62) met the revised minimum guidelines and 76% (47/62) met the ideal guidelines. All and 56/62 patients met our institutional guidelines for maximum skin and rib dose, respectively. Conclusions: We have optimized dosimetric guidelines for the SAVI applicators, and found that implementation of these revised guidelines for SAVI treatment planning yielded target coverage exceeding that required by existing guidelines while preserving heterogeneity constraints and minimizing dose to organs at risk.« less

SU-E-T-313: Dosimetric Deviation of Misaligned Beams for a 6 MV Photon Linear Accelerator Using Monte Carlo Simulations

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

Kim, S

2015-06-15

Purpose: To quantify the dosimetric variations of misaligned beams for a linear accelerator by using Monte Carlo (MC) simulations. Method and Materials: Misaligned beams of a Varian 21EX Clinac were simulated to estimate the dosimetric effects. All the linac head components for a 6 MV photon beam were implemented in BEAMnrc/EGSnrc system. For incident electron beam parameters, 6 MeV with 0.1 cm full-width-half-max Gaussian beam was used. A phase space file was obtained below the jaw per each misalignment condition of the incident electron beam: (1) The incident electron beams were tilted by 0.5, 1.0 and 1.5 degrees on themore » x-axis from the central axis. (2) The center of the incident electron beam was off-axially moved toward +x-axis by 0.1, 0.2, and 0.3 cm away from the central axis. Lateral profiles for each misaligned beam condition were acquired at dmax = 1.5 cm and 10 cm depth in a rectangular water phantom. Beam flatness and symmetry were calculated by using the lateral profile data. Results: The lateral profiles were found to be skewed opposite to the angle of the incident beam for the tilted beams. For the displaced beams, similar skewed lateral profiles were obtained with small shifts of penumbra on the +x-axis. The variations of beam flatness were 3.89–11.18% and 4.12–42.57% for the tilted beam and the translated beam, respectively. The beam symmetry was separately found to be 2.95 −9.93% and 2.55–38.06% separately. It was found that the percent increase of the flatness and the symmetry values are approximated 2 to 3% per 0.5 degree tilt or per 1 mm displacement. Conclusion: This study quantified the dosimetric effects of misaligned beams using MC simulations. The results would be useful to understand the magnitude of the dosimetric deviations for the misaligned beams.« less

A comparative study of standard intensity-modulated radiotherapy and RapidArc planning techniques for ipsilateral and bilateral head and neck irradiation.

PubMed

Pursley, Jennifer; Damato, Antonio L; Czerminska, Maria A; Margalit, Danielle N; Sher, David J; Tishler, Roy B

2017-01-01

The purpose of this study was to investigate class solutions using RapidArc volumetric-modulated arc therapy (VMAT) planning for ipsilateral and bilateral head and neck (H&N) irradiation, and to compare dosimetric results with intensity-modulated radiotherapy (IMRT) plans. A total of 14 patients who received ipsilateral and 10 patients who received bilateral head and neck irradiation were retrospectively replanned with several volumetric-modulated arc therapy techniques. For ipsilateral neck irradiation, the volumetric-modulated arc therapy techniques included two 360° arcs, two 360° arcs with avoidance sectors around the contralateral parotid, two 260° or 270° arcs, and two 210° arcs. For bilateral neck irradiation, the volumetric-modulated arc therapy techniques included two 360° arcs, two 360° arcs with avoidance sectors around the shoulders, and 3 arcs. All patients had a sliding-window-delivery intensity-modulated radiotherapy plan that was used as the benchmark for dosimetric comparison. For ipsilateral neck irradiation, a volumetric-modulated arc therapy technique using two 360° arcs with avoidance sectors around the contralateral parotid was dosimetrically comparable to intensity-modulated radiotherapy, with improved conformity (conformity index = 1.22 vs 1.36, p < 0.04) and lower contralateral parotid mean dose (5.6 vs 6.8Gy, p < 0.03). For bilateral neck irradiation, 3-arc volumetric-modulated arc therapy techniques were dosimetrically comparable to intensity-modulated radiotherapy while also avoiding irradiation through the shoulders. All volumetric-modulated arc therapy techniques required fewer monitor units than sliding-window intensity-modulated radiotherapy to deliver treatment, with an average reduction of 35% for ipsilateral plans and 67% for bilateral plans. Thus, for ipsilateral head and neck irradiation a volumetric-modulated arc therapy technique using two 360° arcs with avoidance sectors around the contralateral parotid is recommended. For bilateral neck irradiation, 2- or 3-arc techniques are dosimetrically comparable to intensity-modulated radiotherapy, but more work is needed to determine the optimal approaches by disease site. Copyright © 2017 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Volumetric‐modulated arc therapy planning using multicriteria optimization for localized prostate cancer

PubMed Central

Ghandour, Sarah; Matzinger, Oscar

2015-01-01

The purpose of this work is to evaluate the volumetric‐modulated arc therapy (VMAT) multicriteria optimization (MCO) algorithm clinically available in the RayStation treatment planning system (TPS) and its ability to reduce treatment planning time while providing high dosimetric plan quality. Nine patients with localized prostate cancer who were previously treated with 78 Gy in 39 fractions using VMAT plans and rayArc system based on the direct machine parameter optimization (DMPO) algorithm were selected and replanned using the VMAT‐MCO system. First, the dosimetric quality of the plans was evaluated using multiple conformity metrics that account for target coverage and sparing of healthy tissue, used in our departmental clinical protocols. The conformity and homogeneity index, number of monitor units, and treatment planning time for both modalities were assessed. Next, the effects of the technical plan parameters, such as constraint leaf motion CLM (cm/°) and maximum arc delivery time T (s), on the accuracy of delivered dose were evaluated using quality assurance passing rates (QAs) measured using the Delta4 phantom from ScandiDos. For the dosimetric plan's quality analysis, the results show that the VMAT‐MCO system provides plans comparable to the rayArc system with no statistical difference for V95% (p<0.01), D1% (p<0.01), CI (p<0.01), and HI (p<0.01) of the PTV, bladder (p<0.01), and rectum (p<0.01) constraints, except for the femoral heads and healthy tissues, for which a dose reduction was observed using MCO compared with rayArc (p<0.01). The technical parameter study showed that a combination of CLM equal to 0.5 cm/degree and a maximum delivery time of 72 s allowed the accurate delivery of the VMAT‐MCO plan on the Elekta Versa HD linear accelerator. Planning evaluation and dosimetric measurements showed that VMAT‐MCO can be used clinically with the advantage of enhanced planning process efficiency by reducing the treatment planning time without impairing dosimetric quality. PACS numbers: 87.55.D, 87.55.de, 87.55.Qr PMID:26103500

Characterization of aluminum oxide doped with carbon and magnesium for radiation detection

NASA Astrophysics Data System (ADS)

Rodriguez, Matthew Gorman

Scope and Method of Study. A general characterization of the dosimetric properties of Al2O3:C,Mg. This included the thermoluminescence (TL) optically stimulated luminescence (OSL), radioluminescence (RL) and scintillation characteristics of Al2O3:C,Mg compared to Al2O3:C. Findings and Conclusions. The presence of aggregate defects as well as an increased F+-center concentration leads to the behavior of Al2O3:C,Mg being far more complex than Al2O3:C. The main TL peak is shifted to a lower temperature and narrower when compared to the main TL peak of Al 2O3:C. The OSL curves of Al2O3:C,Mg decay faster than Al2O3:C. Al2O3:C,Mg shows smaller dependence on the RL sensitivity as a function of dose, thus reducing the dynamic behavior of the RL signal associated with Al2O 3:C. Al2O3:C,Mg also has fast luminescence centers with lifetimes <100 ns. Finally, Annealing Al2O 3:C,Mg to 900°C would appear to increase the number of F+ and F recombination centers while destroying the aggregate defects present in the material.

[Dosimetric system for assessing doses received by people occupationally exposed to external sources of ionizing radiation].

PubMed

Brodecki, Marcin; Domienik, Joanna U; Zmyślony, Marek

2012-01-01

The current system of dosimetric quantities has been defined by the International Commission on Radiological Protection (ICRP) and the International Commission on Radiation Units and Measurements (ICRU). Complexity of the system implies the physical nature of ionizing radiation, resulting from the presence of different types of radiation of different ionization capabilities, as well as the individual radiation sensitivity of biological material exposed. According to the latest recommendations, there are three types of dosimeter quantities relevant to radiation protection and radiological assessment of occupational exposure. These are the basic quantities, safety quantities and operational quantities. Dose limits for occupational exposure relate directly to the protection quantities, i.e. the equivalent dose and effective dose, while these quantities are practically unmeasurable in real measurement conditions. For this reason, in the system of dosimetric quantities directly measurable operating volumes were defined. They represent equivalents of the protection quantities that allow for a reliable assessment of equivalent and effective dose by conducting routine monitoring of occupational exposure. This paper presents the characteristics of these quantities, their relationships and importance in assessing individual effects of radiation. Also the methods for their implementation in personal and environmental dosimetry were showcased. The material contained in the article is a compendium of essential information about dosimetric quantities with reference to the contemporary requirements of the law, including the changed annual occupational exposure limit for the lens of the eye. The material is especially addressed to those responsible for dosimetry monitoring in the workplace, radiation protection inspectors and occupational health physicians.

Volumetric modulated arc radiotherapy sparing the thyroid gland for early-stage glottic cancer: A dosimetrical analysis.

PubMed

Kim, Eun Seok; Yeo, Seung-Gu

2014-06-01

Previous studies on advanced radiotherapy (RT) techniques for early stage glottic cancer have focused on sparing the carotid artery. However, the aim of the present study was to evaluate the dosimetric advantages of volumetric modulated arc therapy (VMAT) in terms of sparing the thyroid gland in early-stage glottic cancer patients. In total, 15 cT1N0M0 glottic cancer patients treated with definitive RT using VMAT were selected, and for dosimetric comparison, a conventional RT plan comprising opposed-lateral wedged fields was generated for each patient. The carotid artery, thyroid gland and spinal cord were considered organs at risk. The prescription dose was 63 Gy at 2.25 Gy per fraction. For the thyroid gland and carotid artery, all compared parameters were significantly lower with VMAT compared with conventional RT. For the thyroid gland, the median reduction rates of the mean dose (D mean ), the volume receiving ≥30% of the prescription dose (V 30 ) and the V 50 were 32.6, 40.9 and 46.0%, respectively. The D mean was 14.7±2.6 Gy when using VMAT compared with 22.2±3.9 Gy when using conventional RT. The differences between the techniques in terms of planning target volume coverage and dose homogeneity were not significant. When considering a recent normal tissue complication probability model, which indicated the mean thyroid gland dose as the most significant predictor of radiation-induced hypothyroidism, the dosimetric advantage shown in this study may be valuable in reducing hypothyroidism following RT for early stage glottic cancer patients.

SU-E-J-52: Dosimetric Benefit of Adaptive Re-Planning in Lung Cancer Stereotactic Body Radiotherapy (SBRT)

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

Jia, J; Tian, Z; Gu, X

Purpose: To investigate the dosimetric benefit of adaptive re-planning for lung stereotactic body radiotherapy(SBRT). Methods: Five lung cancer patients with SBRT treatment were retrospectively investigated. Our in-house supercomputing online re-planning environment (SCORE) was used to realize the re-planning process. First a deformable image registration was carried out to transfer contours from treatment planning CT to each treatment CBCT. Then an automatic re-planning using original plan DVH guided fluence-map optimization is performed to get a new plan for the up-to-date patient geometry. We compared the re-optimized plan to the original plan projected on the up-to-date patient geometry in critical dosimetric parameters,more » such as PTV coverage, spinal cord maximum and volumetric constraint dose, esophagus maximum and volumetric constraint dose. Results: The average volume of PTV covered by prescription dose for all patients was improved by 7.56% after the adaptive re-planning. The volume of the spinal cord receiving 14.5Gy and 23Gy (V14.5, V23) decreased by 1.48% and 0.68%, respectively. For the esophagus, the volume receiving 19.5Gy (V19.5) reduced by 1.37%. Meanwhile, the maximum dose dropped off by 2.87% for spinal cord and 4.80% for esophagus. Conclusion: Our experimental results demonstrate that adaptive re-planning for lung SBRT has the potential to minimize the dosimetric effect of inter-fraction deformation and thus improve target coverage while reducing the risk of toxicity to nearby normal tissues.« less

Dosimetric effects of polyethylene glycol surface coatings on gold nanoparticle radiosensitization

NASA Astrophysics Data System (ADS)

Koger, B.; Kirkby, C.

2017-11-01

One of the main appeals of using gold nanoparticles (GNPs) as radiosensitizers is that their surface coatings can be altered to manipulate their pharmacokinetic properties. However, Monte Carlo studies of GNP dosimetry tend to neglect these coatings, potentially changing the dosimetric results. This study quantifies the dosimetric effects of including a polyethylene glycol (PEG) surface coating on GNPs over both nanoscopic and microscopic ranges. Two dosimetric scales were explored using PENELOPE Monte Carlo simulations. In microscopic simulations, 500-1000 GNPs, with and without coatings, were placed in cavities of side lengths 0.8-4 µm, and the reduction of dose deposited to surrounding medium within these volumes due to the coating was quantified. Including PEG surface coatings of up to 20 nm thickness resulted in reductions of up to 7.5%, 4.0%, and 2.0% for GNP diameters of 10, 20, and 50 nm, respectively. Nanoscopic simulations observed the dose falloff in the first 500 nm surrounding a single GNP both with and without surface coatings of various thicknesses. Over the first 500 nm surrounding a single GNP, the presence of a PEG surface coating reduced dose by 5-26%, 8-28%, 8-30%, and 8-34% for 2, 10, 20, and 50 nm diameter GNPs, respectively, for various energies and coating thicknesses. Reductions in dose enhancement due to the inclusion of a GNP surface coating are non-negligible and should be taken into consideration when investigating GNP dose enhancement. Further studies should be carried out to investigate the biological effects of these coatings.

Dosimetric and clinical predictors of radiation-induced lung toxicity in esophageal carcinoma.

PubMed

Zhu, Shu-Chai; Shen, Wen-Bin; Liu, Zhi-Kun; Li, Juan; Su, Jing-Wei; Wang, Yu-Xiang

2011-01-01

Radiation-induced lung toxicity occurs frequently in patients with esophageal carcinoma. This study aims to evaluate the clinical and three-dimensional dosimetric parameters associated with lung toxicity after radiotherapy for esophageal carcinoma. The records of 56 patients treated for esophageal carcinoma were reviewed. The Radiation Therapy Oncology Group criteria for grading of lung toxicity were followed. Spearman's correlation test, the chi-square test and logistic regression analyses were used for statistical analysis. Ten of the 56 patients developed acute toxicity. The toxicity grades were grade 2 in 7 patients and grade 3 in 3 patients; none of the patients developed grade 4 or worse toxicity. One case of toxicity occurred during radiotherapy and 9 occurred 2 weeks to 3 months after radiotherapy. The median time was 2.0 months after radiotherapy. Fourteen patients developed late irradiated lung injury, 3 after 3.5 months, 7 after 9 months, and 4 after 14 months. Radiographic imaging demonstrated patchy consolidation (n = 5), atelectasis with parenchymal distortion (n = 6), and solid consolidation (n = 3). For acute toxicity, the irradiated esophageal volume, number of fields, and most dosimetric parameters were predictive. For late toxicity, chemotherapy combined with radiotherapy and other dosimetric parameters were predictive. No obvious association between the occurrence of acute and late injury was observed. The percent of lung tissue receiving at least 25 Gy (V25), the number of fields, and the irradiated length of the esophagus can be used as predictors of the risk of acute toxicity. Lungs V30, as well as chemotherapy combined with radiotherapy, are predictive of late lung injury.

Projected Improvements in Accelerated Partial Breast Irradiation Using a Novel Breast Stereotactic Radiotherapy Device: A Dosimetric Analysis.

PubMed

Snider, James W; Mutaf, Yildirim; Nichols, Elizabeth; Hall, Andrea; Vadnais, Patrick; Regine, William F; Feigenberg, Steven J

2017-01-01

Accelerated partial breast irradiation has caused higher than expected rates of poor cosmesis. At our institution, a novel breast stereotactic radiotherapy device has demonstrated dosimetric distributions similar to those in brachytherapy. This study analyzed comparative dose distributions achieved with the device and intensity-modulated radiation therapy accelerated partial breast irradiation. Nine patients underwent computed tomography simulation in the prone position using device-specific immobilization on an institutional review board-approved protocol. Accelerated partial breast irradiation target volumes (planning target volume_10mm) were created per the National Surgical Adjuvant Breast and Bowel Project B-39 protocol. Additional breast stereotactic radiotherapy volumes using smaller margins (planning target volume_3mm) were created based on improved immobilization. Intensity-modulated radiation therapy and breast stereotactic radiotherapy accelerated partial breast irradiation plans were separately generated for appropriate volumes. Plans were evaluated based on established dosimetric surrogates of poor cosmetic outcomes. Wilcoxon rank sum tests were utilized to contrast volumes of critical structures receiving a percentage of total dose ( Vx). The breast stereotactic radiotherapy device consistently reduced dose to all normal structures with equivalent target coverage. The ipsilateral breast V20-100 was significantly reduced ( P < .05) using planning target volume_10mm, with substantial further reductions when targeting planning target volume_3mm. Doses to the chest wall, ipsilateral lung, and breast skin were also significantly lessened. The breast stereotactic radiotherapy device's uniform dosimetric improvements over intensity-modulated accelerated partial breast irradiation in this series indicate a potential to improve outcomes. Clinical trials investigating this benefit have begun accrual.

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.

Fractionated stereotactic radiotherapy: a method to evaluate geometric and dosimetric uncertainties using radiochromic films.

PubMed

Coscia, Gianluca; Vaccara, Elena; Corvisiero, Roberta; Cavazzani, Paolo; Ruggieri, Filippo Grillo; Taccini, Gianni

2009-07-01

In the authors' hospital, stereotactic radiotherapy treatments are performed with a Varian Clinac 600C equipped with a BrainLAB m3 micro-multileaf-collimator generally using the dynamic conformal arc technique. Patient immobilization during the treatment is achieved with a fixation mask supplied by BrainLAB, made with two reinforced thermoplastic sheets fitting the patient's head. With this work the authors propose a method to evaluate treatment geometric accuracy and, consequently, to determine the amount of the margin to keep in the CTV-PTV expansion during the treatment planning. The reproducibility of the isocenter position was tested by simulating a complete treatment on the anthropomorphic phantom Alderson Rando, inserting in between two phantom slices a high sensitivity Gafchromic EBT film, properly prepared and calibrated, and repeating several treatment sessions, each time removing the fixing mask and replacing the film inside the phantom. The comparison between the dose distributions measured on films and computed by TPS, after a precise image registration procedure performed by a commercial piece of software (FILMQA, 3cognition LLC (Division of ISP), Wayne, NJ), allowed the authors to measure the repositioning errors, obtaining about 0.5 mm in case of central spherical PTV and about 1.5 mm in case of peripheral irregular PTV. Moreover, an evaluation of the errors in the registration procedure was performed, giving negligible values with respect to the quantities to be measured. The above intrinsic two-dimensional estimate of treatment accuracy has to be increased for the error in the third dimension, but the 2 mm margin the authors generally use for the CTV-PTV expansion seems adequate anyway. Using the same EBT films, a dosimetric verification of the treatment planning system was done. Measured dose values are larger or smaller than the nominal ones depending on geometric irradiation conditions, but, in the authors' experimental conditions, always within 4%.

Monte Carlo skin dose simulation in intraoperative radiotherapy of breast cancer using spherical applicators.

PubMed

Moradi, F; Ung, N M; Khandaker, M U; Mahdiraji, G A; Saad, M; Abdul Malik, R; Bustam, A Z; Zaili, Z; Bradley, D A

2017-07-28

The relatively new treatment modality electronic intraoperative radiotherapy (IORT) is gaining popularity, irradiation being obtained within a surgically produced cavity being delivered via a low-energy x-ray source and spherical applicators, primarily for early stage breast cancer. Due to the spatially dramatic dose-rate fall off with radial distance from the source and effects related to changes in the beam quality of the low keV photon spectra, dosimetric account of the Intrabeam system is rather complex. Skin dose monitoring in IORT is important due to the high dose prescription per treatment fraction. In this study, modeling of the x-ray source and related applicators were performed using the Monte Carlo N-Particle transport code. The dosimetric characteristics of the model were validated against measured data obtained using an ionization chamber and EBT3 film as dosimeters. By using a simulated breast phantom, absorbed doses to the skin for different combinations of applicator size (1.5-5 cm) and treatment depth (0.5-3 cm) were calculated. Simulation results showed overdosing of the skin (>30% of prescribed dose) at a treatment depth of 0.5 cm using applicator sizes larger than 1.5 cm. Skin doses were significantly increased with applicator size, insofar as delivering 12 Gy (60% of the prescribed dose) to skin for the largest sized applicator (5 cm diameter) and treatment depth of 0.5 cm. It is concluded that the recommended 0.5-1 cm distance between the skin and applicator surface does not guarantee skin safety and skin dose is generally more significant in cases with the larger applicators. • Intrabeam x-ray source and spherical applicators were simulated and skin dose was calculated. • Skin dose for constant skin to applicator distance strongly depends on applicator size. • Use of larger applicators generally results in higher skin dose. • The recommended 0.5-1 cm skin to applicator distance does not guarantee skin safety.

Dosimetric calculations for uranium miners for epidemiological studies.

PubMed

Marsh, J W; Blanchardon, E; Gregoratto, D; Hofmann, W; Karcher, K; Nosske, D; Tomásek, L

2012-05-01

Epidemiological studies on uranium miners are being carried out to quantify the risk of cancer based on organ dose calculations. Mathematical models have been applied to calculate the annual absorbed doses to regions of the lung, red bone marrow, liver, kidney and stomach for each individual miner arising from exposure to radon gas, radon progeny and long-lived radionuclides (LLR) present in the uranium ore dust and to external gamma radiation. The methodology and dosimetric models used to calculate these organ doses are described and the resulting doses for unit exposure to each source (radon gas, radon progeny and LLR) are presented. The results of dosimetric calculations for a typical German miner are also given. For this miner, the absorbed dose to the central regions of the lung is dominated by the dose arising from exposure to radon progeny, whereas the absorbed dose to the red bone marrow is dominated by the external gamma dose. The uncertainties in the absorbed dose to regions of the lung arising from unit exposure to radon progeny are also discussed. These dose estimates are being used in epidemiological studies of cancer in uranium miners.

Photon small-field measurements with a CMOS active pixel sensor.

PubMed

Spang, F Jiménez; Rosenberg, I; Hedin, E; Royle, G

2015-06-07

In this work the dosimetric performance of CMOS active pixel sensors for the measurement of small photon beams is presented. The detector used consisted of an array of 520  × 520 pixels on a 25 µm pitch. Dosimetric parameters measured with this sensor were compared with data collected with an ionization chamber, a film detector and GEANT4 Monte Carlo simulations. The sensor performance for beam profiles measurements was evaluated for field sizes of 0.5  × 0.5 cm(2). The high spatial resolution achieved with this sensor allowed the accurate measurement of profiles, beam penumbrae and field size under lateral electronic disequilibrium. Field size and penumbrae agreed within 5.4% and 2.2% respectively with film measurements. Agreements with ionization chambers better than 1.0% were obtained when measuring tissue-phantom ratios. Output factor measurements were in good agreement with ionization chamber and Monte Carlo simulation. The data obtained from this imaging sensor can be easily analyzed to extract dosimetric information. The results presented in this work are promising for the development and implementation of CMOS active pixel sensors for dosimetry applications.

Poster — Thur Eve — 74: Distributed, asynchronous, reactive dosimetric and outcomes analysis using DICOMautomaton

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

Clark, Haley; BC Cancer Agency, Surrey, B.C.; BC Cancer Agency, Vancouver, B.C.

2014-08-15

Many have speculated about the future of computational technology in clinical radiation oncology. It has been advocated that the next generation of computational infrastructure will improve on the current generation by incorporating richer aspects of automation, more heavily and seamlessly featuring distributed and parallel computation, and providing more flexibility toward aggregate data analysis. In this report we describe how a recently created — but currently existing — analysis framework (DICOMautomaton) incorporates these aspects. DICOMautomaton supports a variety of use cases but is especially suited for dosimetric outcomes correlation analysis, investigation and comparison of radiotherapy treatment efficacy, and dose-volume computation. Wemore » describe: how it overcomes computational bottlenecks by distributing workload across a network of machines; how modern, asynchronous computational techniques are used to reduce blocking and avoid unnecessary computation; and how issues of out-of-date data are addressed using reactive programming techniques and data dependency chains. We describe internal architecture of the software and give a detailed demonstration of how DICOMautomaton could be used to search for correlations between dosimetric and outcomes data.« less

On the identity of the last known stable radical in X-irradiated sucrose

NASA Astrophysics Data System (ADS)

Kusakovskij, Jevgenij; De Cooman, Hendrik; Sagstuen, Einar; Callens, Freddy; Vrielinck, Henk

2017-04-01

Identification of radiation-induced radicals in relatively simple molecules is a prerequisite for the understanding of reaction pathways of the radiation chemistry of complex systems. Sucrose presents an additional practical interest as a versatile radiation dosimetric system. In this work, we present a periodic density functional theory study aimed to identify the fourth stable radical species in this carbohydrate. The proposed model is a fragment suspended in the lattice by hydrogen bonds with an unpaired electron at the original C5' carbon of the fructose unit. It requires a double scission of the ring accompanied by substantial chemical and geometric reorganization.

SU-E-T-299: Dosimetric Characterization of Small Field in Small Animal Irradiator with Radiochromic Films

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

Han, S; Kim, K; Jung, H

Purpose: The small animal irradiator has been used with small animals to optimize new radiation therapy as preclinical studies. The small animal was irradiated by whole- or partial-body exposure. In this study, the dosimetric characterizations of small animal irradiator were carried out in small field using Radiochromic films Material & Methods: The study was performed in commercial animal irradiator (XRAD-320, Precision x-ray Inc, North Brantford) with Radiochromic films (EBT2, Ashland Inc, Covington). The calibration curve was generated between delivery dose and optical density (red channel) and the films were scanned by and Epson 1000XL scanner (Epson America Inc., Long Beach,more » CA).We evaluated dosimetric characterization of irradiator using various filter supported by manufacturer in 260 kV. The various filters were F1 (2.0mm Aluminum (HVL = about 1.0mm Cu) and F2 (0.75mm Tin + 0.25mm Copper + 1.5mm Aluminum (HVL = about 3.7mm Cu). According to collimator size (3, 5, 7, 10 mm, we calculated percentage depth dose (PDD) and the surface –source distance(SSD) was 17.3 cm considering dose rate. Results: The films were irradiated in 260 kV, 10mA and we increased exposure time 5sec. intervals from 5sec. to 120sec. The calibration curve of films was fitted with cubic function. The correlation between optical density and dose was Y=0.1405 X{sup 3}−2.916 X{sup 2}+25.566 x+2.238 (R{sup 2}=0.994). Based on the calibration curve, we calculated PDD in various filters depending on collimator size. When compared PDD of specific depth (3mm) considering animal size, the difference by collimator size was 4.50% in free filter and F1 was 1.53% and F2 was within 2.17%. Conclusion: We calculated PDD curve in small animal irradiator depending on the collimator size and the kind of filter using the radiochromic films. The various PDD curve was acquired and it was possible to irradiate various dose using these curve.« less

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.

SU-F-T-518: Development and Characterization of a Gated Treatment System Implemented with An In-House Optical Tracking System and the Elekta Response Interface

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

Barraclough, B; Park, J; Li, F

2016-06-15

Purpose: To report the development and characterization of the first in-house gating system implemented with an optical tracking system (OTS) and the Elekta Response™ interface. Methods: The Response™ connects a patient tracking system with a linac, enabling the tracking system to control radiation delivery. The developed system uses an in-house OTS to monitor patient breathing. The OTS consists of two infrared-based cameras, tracking markers affixed on patient. It achieves gated or breath-held (BH) treatment by calling beam ON/OFF functions in the Response™ dynamic-link library (DLL). A 4D motion phantom was used to evaluate its dosimetric and time delay characteristics. Twomore » FF- and two FFF-IMRT beams were delivered in non-gated, BH and gated mode. The sinusoidal gating signal had a 6 sec period and 15 mm amplitude. The duty cycle included 10%, 20%, 30% and 50%. The BH signal was adapted from the sinusoidal wave by inserting 15 sec BHs. Each delivery was measured with a 2D diode array (MapCHECK™) and compared with the non-gated delivery using gamma analysis (3%). The beam ON/OFF time was captured using the service graphing utility of the linac. Results: The gated treatments were successfully delivered except the 10% duty cycle. The BH delivery had perfect agreement (100%) with non-gated delivery; the agreement of gated delivery decreased from 99% to 88% as duty cycle reduced from 50% to 20%. The beam on/off delay was on average 0.25/0.06 sec. The delivery time for the 50%, 30% and 20% duty cycle increased by 29%, 71% and 139%, respectively. No dosimetric or time delay difference was noticed between FF- and FFF-IMRT beams. Conclusion: The in-house gating system was successfully developed with dosimetric and time delay characteristics in line with published results for commercial systems. It will be an important platform for further research and clinical development of gated treatment.« less

Initial characterization, dosimetric benchmark and performance validation of Dynamic Wave Arc.

PubMed

Burghelea, Manuela; Verellen, Dirk; Poels, Kenneth; Hung, Cecilia; Nakamura, Mitsuhiro; Dhont, Jennifer; Gevaert, Thierry; Van den Begin, Robbe; Collen, Christine; Matsuo, Yukinori; Kishi, Takahiro; Simon, Viorica; Hiraoka, Masahiro; de Ridder, Mark

2016-04-29

Dynamic Wave Arc (DWA) is a clinical approach designed to maximize the versatility of Vero SBRT system by synchronizing the gantry-ring noncoplanar movement with D-MLC optimization. The purpose of this study was to verify the delivery accuracy of DWA approach and to evaluate the potential dosimetric benefits. DWA is an extended form of VMAT with a continuous varying ring position. The main difference in the optimization modules of VMAT and DWA is during the angular spacing, where the DWA algorithm does not consider the gantry spacing, but only the Euclidian norm of the ring and gantry angle. A preclinical version of RayStation v4.6 (RaySearch Laboratories, Sweden) was used to create patient specific wave arc trajectories for 31 patients with various anatomical tumor regions (prostate, oligometatstatic cases, centrally-located non-small cell lung cancer (NSCLC) and locally advanced pancreatic cancer-LAPC). DWA was benchmarked against the current clinical approaches and coplanar VMAT. Each plan was evaluated with regards to dose distribution, modulation complexity (MCS), monitor units and treatment time efficiency. The delivery accuracy was evaluated using a 2D diode array that takes in consideration the multi-dimensionality of DWA during dose reconstruction. In centrally-located NSCLC cases, DWA improved the low dose spillage with 20 %, while the target coverage was increased with 17 % compared to 3D CRT. The structures that significantly benefited from using DWA were proximal bronchus and esophagus, with the maximal dose being reduced by 17 % and 24 %, respectively. For prostate and LAPC, neither technique seemed clearly superior to the other; however, DWA reduced with more than 65 % of the delivery time over IMRT. A steeper dose gradient outside the target was observed for all treatment sites (p < 0.01) with DWA. Except the oligometastatic cases, where the DWA-MCSs indicate a higher modulation, both DWA and VMAT modalities provide plans of similar complexity. The average ɣ (3 % /3 mm) passing rate for DWA plans was 99.2 ± 1 % (range from 96.8 to 100 %). DWA proven to be a fully functional treatment technique, allowing additional flexibility in dose shaping, while preserving dosimetrically robust delivery and treatment times comparable with coplanar VMAT.

SU-D-BRB-02: Patient-Specific Rectal Toxicity Predictor Based Plan Quality Control for Prostate Stereotactic Body Radiation Therapy (SBRT)

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

Song, T; Zhou, L; Li, Y

2015-06-15

Purpose: To develop a patient-specific rectal toxicity predictor guided plan quality control tool for prostate SBRT plans. Methods: For prostate SBRT cases, four segments of rectal walls including peri-prostatic anterior rectal wall, peri-prostatic lateral rectal walls, peri-prostatic posterior rectal wall and rectum superior to prostate are identified as organs at risk and the circumference of rectal wall receiving more than 39 Gy (CRW39) and 24 Gy (CRW24) are rectal toxicity predictors. In this new geometry-dosimetry model, a patient geometry descriptor, differential circumference of rectal wall (dCRW) is used as model input geometry parameters and plan dosimetric endpoints CRW39 and CRW24more » are output dosimetric parameters. Linear models are built to correlate dCRW to both CRW39 and CRW24 and established with both a linear regression method and a modified bagging ensemble machine learning method. 27 SBRT prostate cases are retrospectively studied from a dose-escalated clinical trial research. 20 prescribed 50 Gy SBRT cases are recruited to train the model and the other rescaled 7 cases are used to evaluated model feasibility and accuracy. Results: Each solved linear coefficient sequence related to CRW39 or CRW24 is a one-dimensional decreasing function of the distance from the PTV boundary, indicating that the different locations of each rectal circumference have different contributions to each particular dosimetric endpoint. The fitting errors for those trained 20 prostate SBRT cases are small with mean values of 2.39%, 2.45% relative to the endpoint values for SBRT rectal toxicity predictor CRW39 and CRW24 respectively. 1 out of 7 evaluation plans is identified as poor quality plan. After re-planning, the CRW39 and CRW24 can be reduced by 3.34% and 3%, without sacrificing PTV coverage. Conclusion: The proposed patient geometry-plan toxicity predictor model for SBRT plans can be successfully applied to plan quality control for prostate SBRT cases.« less

Thyroid V30 Predicts Radiation-Induced Hypothyroidism in Patients Treated With Sequential Chemo-Radiotherapy for Hodgkin's Lymphoma

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

Cella, Laura; Department of Diagnostic Imaging and Radiation Oncology, Federico II University School of Medicine, Naples; Conson, Manuel

Purpose: Hypothyroidism (HT) is a frequent late side effect of Hodgkin's lymphoma (HL) therapy. The purpose of this study is to determine dose-volume constraints that correlate with functional impairment of the thyroid gland in HL patients treated with three-dimensional radiotherapy. Methods and Materials: A total of 61 consecutive patients undergoing antiblastic chemotherapy and involved field radiation treatment (median dose, 32 Gy; range, 30-36 Gy) for HL were retrospectively considered. Their median age was 28 years (range, 14-70 years). Blood levels of thyroid-stimulating hormone (TSH), free triiodo-thyronine (FT3), free thyroxine (FT4), and thyroglobulin antibody (ATG) were recorded basally and at differentmore » times after the end of therapy. For the thyroid gland, normal tissue complication probability (NTCP), dosimetric parameters, and the percentage of thyroid volume exceeding 10, 20, and 30 Gy (V10, V20, and V30) were calculated in all patients. To evaluate clinical and dosimetric factors possibly associated with HT, univariate and multivariate logistic regression analyses were performed. Results: Eight of 61 (13.1%) patients had HT before treatment and were excluded from further evaluation. At a median follow-up of 32 months (range, 6-99 months), 41.5% (22/53) of patients developed HT after treatment. Univariate analyses showed that all dosimetric factors were associated with HT (p < 0.05). On multivariate analysis, the thyroid V30 value was the single independent predictor associated with HT (p = 0.001). This parameter divided the patients into low- vs. high-risk groups: if V30 was {<=} 62.5%, the risk of developing HT was 11.5%, and if V30 was >62.5%, the risk was 70.8% (p < 0.0001). A Cox regression curve stratified by two levels of V30 value was created (odds ratio, 12.6). Conclusions: The thyroid V30 predicts the risk of developing HT after sequential chemo-radiotherapy and defines a useful constraint to consider for more accurate HL treatment planning.« less

SU-F-T-89: Investigation of Simultaneous Optimization of Photon and Electron Apertures for Mixed Beam Radiotherapy Based On An Academic Case

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

Mueller, S; Joosten, A; Fix, MK

Purpose: To estimate the dosimetric potential of mixed beam radiotherapy (MBRT) by using a single process optimizing the shape and weight of photon and electron apertures simultaneously based on Monte Carlo beamlet dose distributions. Methods: A simulated annealing based direct aperture optimization capable to perform simultaneous optimization was developed to generate treatment plans for MERT, photon-IMRT and MBRT. Both photon and electron apertures are collimated with the photon-MLC and are delivered in a segmented manner. For dosimetric comparison and for investigating the dependency on the number of apertures, photon-IMRT, MERT and MBRT plans were generated for an academic case consistingmore » of a water phantom containing two shallow PTVs differing in the maximal depth of 5 and 7 cm, respectively and two OARs in distal and lateral direction to the PTVs. Results: For the superficial PTV, the dose homogeneity (V95%–V107%) and the mean dose (in percent of the prescribed dose) to the distal and the lateral OARs of the MBRT plan (94.9%, 16.9%, 17.8%) are superior or comparable to those for the MERT (74%, 18.4%, 15.4%) and the photon-IMRT plan (89.4%, 20.8%, 24.7%). For the enlarged PTV, the dosimetric superiority of MBRT compared to MERT and photon-IMRT is even more pronounced. Furthermore, an MBRT plan with 12 electron and 10 photon apertures lead to an objective function value 38% lower than that of a photon-IMRT plan with 40 apertures. Conclusion: The results of simultaneous optimization for MBRT are promising with regards to further OAR sparing and improved dose coverage to the PTV compared to photon-IMRT and MERT. Especially superficial targets with deeper subparts (>5 cm) could substantially benefit. Moreover, MBRT seems to be a possible solution of two downsides of photon-IMRT, namely the extended low dose bath and the requirement of numerous apertures. This work was supported by Varian Medical Systems. This work was supported by Varian Medical Systems.« less

Dosimetric Characteristics of Wedged Fields

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

Sidhu, N.P.S.; Breitman, Karen

2015-01-15

The beam characteristics of the wedged fields in the nonwedged planes (planes normal to the wedged planes) were studied for 6 MV and 15 MV x-ray beams. A method was proposed for determining the maximum field length of a wedged field that can be used in the nonwedged plane without introducing undesirable alterations in the dose distributions of these fields. The method requires very few measurements. The relative wedge factors of 6 MV and 15 MV X-rays were determined for wedge filters of nominal wedge angles of 15°, 30°, 45°, and 60° as a function of depth and field size.more » For a 6 MV beam the relative wedge factors determined for a field size of 10 × 10 cm{sup 2} for 30°, 45°, and 60° wedge filters can be used for various field sizes ranging from 4 cm{sup 2} to 20 cm{sup 2} (except for the 60° wedge for which the maximum field size that can be used is 15 × 20 cm{sup 2}) without introducing errors in the dosimetric calculations of more than 0.5% for depths up to 20 cm and 1% for depths up to 30 cm. For the 15° wedge filter the relative wedge factor for a field size of 10 × 10 cm{sup 2} can be used over the same range of field sizes by introducing slightly higher error, 0.5% for depths up to 10 cm and 1% for depths up to 30 cm. For a 15 MV beam the maximum magnitude of the relative wedge factors for 45° and 60° lead wedges is of the order of 1%, and it is not important clinically to apply a correction of that magnitude. For a 15 MV beam the relative wedge factors determined for a field size of 6 × 6 cm{sup 2} for the 15° and 30° steel wedges can be used over a range of field sizes from 4 cm{sup 2} to 20 cm{sup 2} without causing dosimetric errors greater than 0.5% for depths up to 10 cm.« less

Evaluation of dosimetric properties of shielding disk used in intraoperative electron radiotherapy: A Monte Carlo study.

PubMed

Robatjazi, Mostafa; Baghani, Hamid Reza; Mahdavic, Seied Rabi; Felici, Giuseppe

2018-05-01

A shielding disk is used for IOERT procedures to absorb radiation behind the target and protect underlying healthy tissues. Setup variation of shielding disk can affect the corresponding in-vivo dose distribution. In this study, the changes of dosimetric parameters due to the disk setup variations is evaluated using EGSnrc Monte Carlo (MC) code. The results can help treatment team to decide about the level of accuracy in the setup procedure and delivered dose to the target volume during IOERT. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

Morrison, Hali, E-mail: hamorris@ualberta.ca; Meno

Purpose: To estimate the total dosimetric uncertainty at the tumor apex for ocular brachytherapy treatments delivered using 16 mm Collaborative Ocular Melanoma Study (COMS) and Super9 plaques loaded with {sup 125}I seeds in order to determine the size of the apex margin that would be required to ensure adequate dosimetric coverage of the tumor. Methods: The total dosimetric uncertainty was assessed for three reference tumor heights: 3, 5, and 10 mm, using the Guide to the expression of Uncertainty in Measurement/National Institute of Standards and Technology approach. Uncertainties pertaining to seed construction, source strength, plaque assembly, treatment planning calculations, tumormore » height measurement, plaque placement, and plaque tilt for a simple dome-shaped tumor were investigated and quantified to estimate the total dosimetric uncertainty at the tumor apex. Uncertainties in seed construction were determined using EBT3 Gafchromic film measurements around single seeds, plaque assembly uncertainties were determined using high resolution microCT scanning of loaded plaques to measure seed positions in the plaques, and all other uncertainties were determined from the previously published studies and recommended values. All dose calculations were performed using PLAQUESIMULATOR v5.7.6 ophthalmic treatment planning system with the inclusion of plaque heterogeneity corrections. Results: The total dosimetric uncertainties at 3, 5, and 10 mm tumor heights for the 16 mm COMS plaque were 17.3%, 16.1%, and 14.2%, respectively, and for the Super9 plaque were 18.2%, 14.4%, and 13.1%, respectively (all values with coverage factor k = 2). The apex margins at 3, 5, and 10 mm tumor heights required to adequately account for these uncertainties were 1.3, 1.3, and 1.4 mm, respectively, for the 16 mm COMS plaque, and 1.8, 1.4, and 1.2 mm, respectively, for the Super9 plaque. These uncertainties and associated margins are dependent on the dose gradient at the given prescription depth, thus resulting in the changing uncertainties and margins with depth. Conclusions: The margins determined in this work can be used as a guide for determining an appropriate apex margin for a given treatment, which can be chosen based on the tumor height. The required margin may need to be increased for more complex scenarios (mushroom shaped tumors, tumors close to the optic nerve, oblique muscle related tilt, etc.) than the simple dome-shaped tumor examined and should be chosen on a case-by-case basis. The sources of uncertainty contributing most significantly to the total dosimetric uncertainty are seed placement within the plaques, treatment planning calculations, tumor height measurement, and plaque tilt. This work presents an uncertainty-based, rational approach to estimating an appropriate apex margin.« less

An experimental palladium-103 seed (OptiSeedexp) in a biocompatible polymer without a gold marker: characterization of dosimetric parameters including the interseed effect.

PubMed

Abboud, F; Scalliet, P; Vynckier, S

2008-12-01

Permanent implantation of 125I (iodine) or 103Pd (palladium) sources is a popular treatment option in the management of early stage prostate cancer. New sources are being developed, some of which are being marketed for different clinical applications. A new technique of adjuvant stereotactic permanent seed breast implant, similar to that used in the treatment of prostate cancer, has been proposed by [N. Jansen et al., Int. J. Radiat. Oncol. Biol. Phys. 67, 1052-1058 (2007)] with encouraging results. The presence of artifacts from the metallic seeds, however, can disturb follow-up imaging. The development of plastic seeds has reduced these artifacts. This paper presents a feasibility study of the advantages of palladium-103 seeds, encapsulated with a biocompatible polymer, for future clinical applications, and on the effect of the gold marker on the dosimetric characteristics of such seeds. Experimental palladium seeds, OptiSeedexp, were manufactured by International Brachytherapy (IBt), Seneffe, Belgium, from a biocompatible polymer, including the marker. Apart from the absence of a gold marker, the studied seed has an identical design to the OptiSeed103 [Phys. Med. Biol. 50, 1493-1504 (2005)]; [Appl. Radiat. Isot. 63, 311-321 (2005)]. Polymer encapsulation was preferred by IBt in order to reduce the quantity of radioactive material needed for a given dose rate and to reduce the anisotropy of the radiation field around the seed. In addition, this design is intended to decrease the interseed effects that can occur as a result of the marker and the encapsulation. Dosimetric measurements were performed using LiF thermoluminescent dosimeters (1 mm3) in solid water phantoms (WT1). Measured data were compared to Monte Carlo simulated data in solid water using the MCNP code, version 4C. Updated cross sections [Med. Phys. 30, 701-711 (2003)] were used. As the measured and calculated data were in agreement, Monte Carlo calculations were then performed in liquid water to obtain relevant dosimetric data as required by TG-43U1 recommendations. Comparison of the results with previous studies of OptiSeed103 [Phys. Med. Biol. 50, 1493-1504 (2005)]; [Appl. Radiat. Isot. 63, 311-321 (2005)], and of InterSource103 [Appl. Radiat. Isot. 57, 805-811 (2002)] showed very good agreement for the dose rate constant and for the radial dose function. With respect to the anisotropy function, the relative dose (anisotropy value relative to 90 degrees) from the polymer seed at a distance of 3 cm was close to unity (105%) at 0 degrees, whereas the relative values for the OptiSeed103 with a gold marker and the titanium-encapsulated InterSource103 seed decreased to 70% and 40%, respectively. The interseed effect from one seed was negligible and in the order of calculation uncertainty, making calculation of the dose rate distribution of the studied seeds, according to TG43U1 recommendations, more accurate and closer to reality. This feasibility study shows that due to the low energy of palladium-103, the negligible interseed effect and the reduced artifacts in postimplant medical imaging, this experimental plastic seed would be a good source for breast brachytherapy. This feasibility study was carried out in collaboration with IBt and will be continued with a study of its visibility in different tissues.

An experimental palladium-103 seed (OptiSeed{sup exp}) in a biocompatible polymer without a gold marker: Characterization of dosimetric parameters including the interseed effect

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

Abboud, F.; Scalliet, P.; Vynckier, S.

Permanent implantation of {sup 125}I (iodine) or {sup 103}Pd (palladium) sources is a popular treatment option in the management of early stage prostate cancer. New sources are being developed, some of which are being marketed for different clinical applications. A new technique of adjuvant stereotactic permanent seed breast implant, similar to that used in the treatment of prostate cancer, has been proposed by [N. Jansen et al., Int. J. Radiat. Oncol. Biol. Phys. 67, 1052-1058 (2007)] with encouraging results. The presence of artifacts from the metallic seeds, however, can disturb follow-up imaging. The development of plastic seeds has reduced thesemore » artifacts. This paper presents a feasibility study of the advantages of palladium-103 seeds, encapsulated with a biocompatible polymer, for future clinical applications, and on the effect of the gold marker on the dosimetric characteristics of such seeds. Experimental palladium seeds, OptiSeed{sup exp}, were manufactured by International Brachytherapy (IBt), Seneffe, Belgium, from a biocompatible polymer, including the marker. Apart from the absence of a gold marker, the studied seed has an identical design to the OptiSeed{sup 103}[Phys. Med. Biol. 50, 1493-1504 (2005)]; [Appl. Radiat. Isot. 63, 311-321 (2005)]. Polymer encapsulation was preferred by IBt in order to reduce the quantity of radioactive material needed for a given dose rate and to reduce the anisotropy of the radiation field around the seed. In addition, this design is intended to decrease the interseed effects that can occur as a result of the marker and the encapsulation. Dosimetric measurements were performed using LiF thermoluminescent dosimeters (1 mm{sup 3}) in solid water phantoms (WT1). Measured data were compared to Monte Carlo simulated data in solid water using the MCNP code, version 4C. Updated cross sections [Med. Phys. 30, 701-711 (2003)] were used. As the measured and calculated data were in agreement, Monte Carlo calculations were then performed in liquid water to obtain relevant dosimetric data as required by TG-43U1 recommendations. Comparison of the results with previous studies of OptiSeed{sup 103}[Phys. Med. Biol. 50, 1493-1504 (2005)]; [Appl. Radiat. Isot. 63, 311-321 (2005)], and of InterSource{sup 103}[Appl. Radiat. Isot. 57, 805-811 (2002)] showed very good agreement for the dose rate constant and for the radial dose function. With respect to the anisotropy function, the relative dose (anisotropy value relative to 90 degree sign ) from the polymer seed at a distance of 3 cm was close to unity (105%) at 0 degree sign , whereas the relative values for the OptiSeed{sup 103} with a gold marker and the titanium-encapsulated InterSource{sup 103} seed decreased to 70% and 40%, respectively. The interseed effect from one seed was negligible and in the order of calculation uncertainty, making calculation of the dose rate distribution of the studied seeds, according to TG43U1 recommendations, more accurate and closer to reality. This feasibility study shows that due to the low energy of palladium-103, the negligible interseed effect and the reduced artifacts in postimplant medical imaging, this experimental plastic seed would be a good source for breast brachytherapy. This feasibility study was carried out in collaboration with IBt and will be continued with a study of its visibility in different tissues.« less

Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans

PubMed Central

McKenzie, Elizabeth M.; Balter, Peter A.; Stingo, Francesco C.; Jones, Jimmy; Followill, David S.; Kry, Stephen F.

2014-01-01

Purpose: The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. Methods: The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Results: Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference in the performance of any device between gamma criteria of 2%/2 mm, 3%/3 mm, and 5%/3 mm. Finally, optimal cutoffs (e.g., percent of pixels passing gamma) were determined for each device and while clinical practice commonly uses a threshold of 90% of pixels passing for most cases, these results showed variability in the optimal cutoff among devices. Conclusions: IMRT QA devices have differences in their ability to accurately detect dosimetrically acceptable and unacceptable plans. Field-by-field analysis with a MapCheck device and use of the MapCheck with a MapPhan phantom while delivering at planned rotational gantry angles resulted in a significantly poorer ability to accurately sort acceptable and unacceptable plans compared with the other techniques examined. Patient-specific IMRT QA techniques in general should be thoroughly evaluated for their ability to correctly differentiate acceptable and unacceptable plans. Additionally, optimal agreement thresholds should be identified and used as common clinical thresholds typically worked very poorly to identify unacceptable plans. PMID:25471949

Accounting for shared and unshared dosimetric uncertainties in the dose response for ultrasound-detected thyroid nodules after exposure to radioactive fallout.

PubMed

Land, Charles E; Kwon, Deukwoo; Hoffman, F Owen; Moroz, Brian; Drozdovitch, Vladimir; Bouville, André; Beck, Harold; Luckyanov, Nicholas; Weinstock, Robert M; Simon, Steven L

2015-02-01

Dosimetic uncertainties, particularly those that are shared among subgroups of a study population, can bias, distort or reduce the slope or significance of a dose response. Exposure estimates in studies of health risks from environmental radiation exposures are generally highly uncertain and thus, susceptible to these methodological limitations. An analysis was published in 2008 concerning radiation-related thyroid nodule prevalence in a study population of 2,994 villagers under the age of 21 years old between August 1949 and September 1962 and who lived downwind from the Semipalatinsk Nuclear Test Site in Kazakhstan. This dose-response analysis identified a statistically significant association between thyroid nodule prevalence and reconstructed doses of fallout-related internal and external radiation to the thyroid gland; however, the effects of dosimetric uncertainty were not evaluated since the doses were simple point "best estimates". In this work, we revised the 2008 study by a comprehensive treatment of dosimetric uncertainties. Our present analysis improves upon the previous study, specifically by accounting for shared and unshared uncertainties in dose estimation and risk analysis, and differs from the 2008 analysis in the following ways: 1. The study population size was reduced from 2,994 to 2,376 subjects, removing 618 persons with uncertain residence histories; 2. Simulation of multiple population dose sets (vectors) was performed using a two-dimensional Monte Carlo dose estimation method; and 3. A Bayesian model averaging approach was employed for evaluating the dose response, explicitly accounting for large and complex uncertainty in dose estimation. The results were compared against conventional regression techniques. The Bayesian approach utilizes 5,000 independent realizations of population dose vectors, each of which corresponds to a set of conditional individual median internal and external doses for the 2,376 subjects. These 5,000 population dose vectors reflect uncertainties in dosimetric parameters, partly shared and partly independent, among individual members of the study population. Risk estimates for thyroid nodules from internal irradiation were higher than those published in 2008, which results, to the best of our knowledge, from explicitly accounting for dose uncertainty. In contrast to earlier findings, the use of Bayesian methods led to the conclusion that the biological effectiveness for internal and external dose was similar. Estimates of excess relative risk per unit dose (ERR/Gy) for males (177 thyroid nodule cases) were almost 30 times those for females (571 cases) and were similar to those reported for thyroid cancers related to childhood exposures to external and internal sources in other studies. For confirmed cases of papillary thyroid cancers (3 in males, 18 in females), the ERR/Gy was also comparable to risk estimates from other studies, but not significantly different from zero. These findings represent the first reported dose response for a radiation epidemiologic study considering all known sources of shared and unshared errors in dose estimation and using a Bayesian model averaging (BMA) method for analysis of the dose response.

Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans.

PubMed

McKenzie, Elizabeth M; Balter, Peter A; Stingo, Francesco C; Jones, Jimmy; Followill, David S; Kry, Stephen F

2014-12-01

The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference in the performance of any device between gamma criteria of 2%/2 mm, 3%/3 mm, and 5%/3 mm. Finally, optimal cutoffs (e.g., percent of pixels passing gamma) were determined for each device and while clinical practice commonly uses a threshold of 90% of pixels passing for most cases, these results showed variability in the optimal cutoff among devices. IMRT QA devices have differences in their ability to accurately detect dosimetrically acceptable and unacceptable plans. Field-by-field analysis with a MapCheck device and use of the MapCheck with a MapPhan phantom while delivering at planned rotational gantry angles resulted in a significantly poorer ability to accurately sort acceptable and unacceptable plans compared with the other techniques examined. Patient-specific IMRT QA techniques in general should be thoroughly evaluated for their ability to correctly differentiate acceptable and unacceptable plans. Additionally, optimal agreement thresholds should be identified and used as common clinical thresholds typically worked very poorly to identify unacceptable plans.

TH-E-BRF-02: 4D-CT Ventilation Image-Based IMRT Plans Are Dosimetrically Comparable to SPECT Ventilation Image-Based Plans

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

Kida, S; University of Tokyo Hospital, Bunkyo, Tokyo; Bal, M

Purpose: An emerging lung ventilation imaging method based on 4D-CT can be used in radiotherapy to selectively avoid irradiating highly-functional lung regions, which may reduce pulmonary toxicity. Efforts to validate 4DCT ventilation imaging have been focused on comparison with other imaging modalities including SPECT and xenon CT. The purpose of this study was to compare 4D-CT ventilation image-based functional IMRT plans with SPECT ventilation image-based plans as reference. Methods: 4D-CT and SPECT ventilation scans were acquired for five thoracic cancer patients in an IRB-approved prospective clinical trial. The ventilation images were created by quantitative analysis of regional volume changes (amore » surrogate for ventilation) using deformable image registration of the 4D-CT images. A pair of 4D-CT ventilation and SPECT ventilation image-based IMRT plans was created for each patient. Regional ventilation information was incorporated into lung dose-volume objectives for IMRT optimization by assigning different weights on a voxel-by-voxel basis. The objectives and constraints of the other structures in the plan were kept identical. The differences in the dose-volume metrics have been evaluated and tested by a paired t-test. SPECT ventilation was used to calculate the lung functional dose-volume metrics (i.e., mean dose, V20 and effective dose) for both 4D-CT ventilation image-based and SPECT ventilation image-based plans. Results: Overall there were no statistically significant differences in any dose-volume metrics between the 4D-CT and SPECT ventilation imagebased plans. For example, the average functional mean lung dose of the 4D-CT plans was 26.1±9.15 (Gy), which was comparable to 25.2±8.60 (Gy) of the SPECT plans (p = 0.89). For other critical organs and PTV, nonsignificant differences were found as well. Conclusion: This study has demonstrated that 4D-CT ventilation image-based functional IMRT plans are dosimetrically comparable to SPECT ventilation image-based plans, providing evidence to use 4D-CT ventilation imaging for clinical applications. Supported in part by Free to Breathe Young Investigator Research Grant and NIH/NCI R01 CA 093626. The authors thank Philips Radiation Oncology Systems for the Pinnacle3 treatment planning systems.« less

Agreement Between Institutional Measurements and Treatment Planning System Calculations for Basic Dosimetric Parameters as Measured by the Imaging and Radiation Oncology Core-Houston

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

Kerns, James R.; Followill, David S.; Imaging and Radiation Oncology Core-Houston, The University of Texas Health Science Center-Houston, Houston, Texas

Purpose: To compare radiation machine measurement data collected by the Imaging and Radiation Oncology Core at Houston (IROC-H) with institutional treatment planning system (TPS) values, to identify parameters with large differences in agreement; the findings will help institutions focus their efforts to improve the accuracy of their TPS models. Methods and Materials: Between 2000 and 2014, IROC-H visited more than 250 institutions and conducted independent measurements of machine dosimetric data points, including percentage depth dose, output factors, off-axis factors, multileaf collimator small fields, and wedge data. We compared these data with the institutional TPS values for the same points bymore » energy, class, and parameter to identify differences and similarities using criteria involving both the medians and standard deviations for Varian linear accelerators. Distributions of differences between machine measurements and institutional TPS values were generated for basic dosimetric parameters. Results: On average, intensity modulated radiation therapy–style and stereotactic body radiation therapy–style output factors and upper physical wedge output factors were the most problematic. Percentage depth dose, jaw output factors, and enhanced dynamic wedge output factors agreed best between the IROC-H measurements and the TPS values. Although small differences were shown between 2 common TPS systems, neither was superior to the other. Parameter agreement was constant over time from 2000 to 2014. Conclusions: Differences in basic dosimetric parameters between machine measurements and TPS values vary widely depending on the parameter, although agreement does not seem to vary by TPS and has not changed over time. Intensity modulated radiation therapy–style output factors, stereotactic body radiation therapy–style output factors, and upper physical wedge output factors had the largest disagreement and should be carefully modeled to ensure accuracy.« less

Correlation of dosimetric parameters obtained with the analytical anisotropic algorithm and toxicity of chest chemoradiation in lung carcinoma

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

Cartier, Lysian; Auberdiac, Pierre; Khodri, Mustapha

The purpose of this study was to analyze and revisit toxicity related to chest chemoradiotherapy and to correlate these side effects with dosimetric parameters obtained using analytical anisotropic algorithm (AAA) in locally unresectable advanced lung cancer. We retrospectively analyzed data from 47 lung cancer patients between 2005 and 2008. All received conformal 3D radiotherapy using high-energy linear accelerator plus concomitant chemotherapy. All treatment planning data were transferred into Eclipse 8.05 (Varian Medical Systems, Palo Alto, CA) and dosimetric calculations were performed using AAA. Thirty-three patients (70.2%) developed acute pneumopathy after radiotherapy (grades 1 and 2). One patient (2.1%) presented withmore » grade 3 pneumopathy. Thirty-one (66%) presented with grades 1-2 lung fibrosis, and 1 patient presented with grade 3 lung fibrosis. Thirty-four patients (72.3%) developed grade 1-2 acute oesophagic toxicity. Four patients (8.5%) presented with grades 3 and 4 dysphagia, necessitating prolonged parenteral nutrition. Median prescribed dose was 64 Gy (range 50-74) with conventional fractionation (2 Gy per fraction). Dose-volume constraints were respected with a median V20 of 23.5% (maximum 34%) and a median V30 of 17% (maximum 25%). The median dose delivered to healthy contralateral lung was 13.1 Gy (maximum 18.1 Gy). At univariate analysis, larger planning target volume and V20 were significantly associated with the probability of grade {>=}2 radiation-induced pneumopathy (p = 0.022 and p = 0.017, respectively). No relation between oesophagic toxicity and clinical/dosimetric parameters could be established. Using AAA, the present results confirm the predictive value of the V20 for lung toxicity as already demonstrated with the conventional pencil beam convolution approach.« less

CURRENT STATUS OF INDIVIDUAL DOSIMETRIC MONITORING IN UKRAINE.

PubMed

Chumak, V; Deniachenko, N; Makarovska, O; Mihailescu, L-C; Prykhodko, A; Voloskyi, V; Vanhavere, F

2016-09-01

About 50 000 workers are being occupationally exposed to radiation in Ukraine. Individual dosimetric monitoring (IDM) is provided by 77 dosimetry services and laboratories of very different scale with a number of monitored workers ranging from several persons to ∼9000. In the present work, the current status of personal dosimetry in Ukraine was studied. The First National Intercomparison (FNI) of the IDM labs was accompanied by a survey of the laboratory operation in terms of coverage, types of dosimetry provided, instrumentation and methodologies used, metrological support, data recording, etc. Totally, 34 laboratories responded to the FNI call, and 18 services with 19 different personal dosimetry systems took part in the intercomparison exercise providing 24 dosimeters each for blind irradiation to photons of 6 different qualities (ISO N-series X-rays, S-Cs and S-Co sources) in a dose range of 5-60 mSv. Performance of the dosimetry labs was evaluated according to ISO 14146 criteria of matching trumpet curves with H0 = 0.2 mSv. The test revealed that 8 of the 19 systems meet ISO 14146 criteria in full, 5 other labs show marginal performance and 6 laboratories demonstrated catastrophic quality of dosimetric results. Altogether, 18 participating labs provide dosimetric monitoring to 37 477 workers (about three-fourths of all occupationally exposed workers), usually on monthly (nuclear industry) or quarterly (rest of applications) basis. Of this number, 20 664 persons (55 %) receive completely adequate individual monitoring, and the number of personnel receiving IDM of inadequate quality counts 3054 persons. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Examining the relationship between pre- and postimplant geometry in prostate low-dose-rate brachytherapy and its correlation with dosimetric quality using the similarity concept.

PubMed

Todor, Dorin A; Anscher, Mitchell S; Karlin, Jeremy D; Hagan, Michael P

2014-01-01

This is a retrospective study in which we define multiple metrics for similarity and then inquire on the relationship between similarity and currently used dosimetric quantities describing preimplant and postimplant plans. We analyzed a unique cohort of 94 consecutively performed prostate seed implant patients, associated with excellent dosimetric and clinical outcomes. For each patient, an ultrasound (US) preimplant and two CT postimplant (Day 0 and Day 30) studies were available. Measures for similarity were created and computed using feature vectors based on two classes of moments: first, invariant to rotation and translation, and the second polar-radius moments invariant to rotation, translation, and scaling. Both similarity measures were calibrated using controlled perturbations (random and systematic) of seed positions and contours in different size implants, thus producing meaningful numerical threshold values used in the clinical analysis. An important finding is that similarity, for both seed distributions and contours, improves significantly when scaling invariance is added to translation and rotation. No correlation between seed and contours similarity was found. In the setting of preplanned prostate seed implants using preloaded needles, based on our data, similarity between preimplant and postimplant plans does not correlate with either minimum dose to 90% of the volume of the prostate or analogous similarity metrics for prostate contours. We have developed novel tools and metrics, which will allow practitioners to better understand the relationship between preimplant and postimplant plans. Geometrical similarity between a preplan and an actual implant, although useful, does not seem to be necessary to achieve minimum dose to 90% of the volume of the prostate-good dosimetric implants. Copyright © 2014 American Brachytherapy Society. All rights reserved.

Dosimetric impact of tumor bed delineation variability based on 4DCT scan for external-beam partial breast irradiation.

PubMed

Guo, Bing; Li, Jianbin; Wang, Wei; Li, Fengxiang; Guo, Yanluan; Li, Yankang; Liu, Tonghai

2015-01-01

This study sought to evaluate the dosimetric impact of tumor bed delineation variability (based on clips, seroma or both clips and seroma) during external-beam partial breast irradiation (EB-PBI) planned utilizing four-dimensional computed tomography (4DCT) scans. 4DCT scans of 20 patients with a seroma clarity score (SCS) 3~5 and ≥5 surgical clips were included in this study. The combined volume of the tumor bed formed using clips, seroma, or both clips and seroma on the 10 phases of 4DCT was defined as the internal gross target volume (termed IGTVC, IGTVS and IGTVC+S, respectively). A 1.5-cm margin was added by defining the planning target volume (termed PTVC, PTVS and PTVC+S, respectively). Three treatment plans were established using the 4DCT images (termed EB-PBIC, EB-PBIS, EB-PBIC+S, respectively). The results showed that the volume of IGTVC+S was significantly larger than that of IGTVCand IGTVS. Similarly, the volume of PTVC+S was markedly larger than that of PTVC and PTVS. However, the PTV coverage for EB-PBIC+S was similar to that of EB-PBIC and EB-PBIS, and there were no significant differences in the homogeneity index or conformity index between the three treatment plans (P=0.878, 0.086). The EB-PBIS plan resulted in the lowest ipsilateral normal breast and ipsilateral lung doses compared with the EB-PBIC and EB-PBIC+S plans. To conclude, the volume variability delineated based on clips, seroma or both clips and seroma resulted in dosimetric variability for organs at risk, but did not show a marked influence on the dosimetric distribution.

Dosimetric impact of tumor bed delineation variability based on 4DCT scan for external-beam partial breast irradiation

PubMed Central

Guo, Bing; Li, Jianbin; Wang, Wei; Li, Fengxiang; Guo, Yanluan; Li, Yankang; Liu, Tonghai

2015-01-01

This study sought to evaluate the dosimetric impact of tumor bed delineation variability (based on clips, seroma or both clips and seroma) during external-beam partial breast irradiation (EB-PBI) planned utilizing four-dimensional computed tomography (4DCT) scans. 4DCT scans of 20 patients with a seroma clarity score (SCS) 3~5 and ≥5 surgical clips were included in this study. The combined volume of the tumor bed formed using clips, seroma, or both clips and seroma on the 10 phases of 4DCT was defined as the internal gross target volume (termed IGTVC, IGTVS and IGTVC+S, respectively). A 1.5-cm margin was added by defining the planning target volume (termed PTVC, PTVS and PTVC+S, respectively). Three treatment plans were established using the 4DCT images (termed EB-PBIC, EB-PBIS, EB-PBIC+S, respectively). The results showed that the volume of IGTVC+S was significantly larger than that of IGTVCand IGTVS. Similarly, the volume of PTVC+S was markedly larger than that of PTVC and PTVS. However, the PTV coverage for EB-PBIC+S was similar to that of EB-PBIC and EB-PBIS, and there were no significant differences in the homogeneity index or conformity index between the three treatment plans (P=0.878, 0.086). The EB-PBIS plan resulted in the lowest ipsilateral normal breast and ipsilateral lung doses compared with the EB-PBIC and EB-PBIC+S plans. To conclude, the volume variability delineated based on clips, seroma or both clips and seroma resulted in dosimetric variability for organs at risk, but did not show a marked influence on the dosimetric distribution. PMID:26885108

Dosimetric verification in water of a Monte Carlo treatment planning tool for proton, helium, carbon and oxygen ion beams at the Heidelberg Ion Beam Therapy Center

NASA Astrophysics Data System (ADS)

Tessonnier, T.; Böhlen, T. T.; Ceruti, F.; Ferrari, A.; Sala, P.; Brons, S.; Haberer, T.; Debus, J.; Parodi, K.; Mairani, A.

2017-08-01

The introduction of ‘new’ ion species in particle therapy needs to be supported by a thorough assessment of their dosimetric properties and by treatment planning comparisons with clinically used proton and carbon ion beams. In addition to the latter two ions, helium and oxygen ion beams are foreseen at the Heidelberg Ion Beam Therapy Center (HIT) as potential assets for improving clinical outcomes in the near future. We present in this study a dosimetric validation of a FLUKA-based Monte Carlo treatment planning tool (MCTP) for protons, helium, carbon and oxygen ions for spread-out Bragg peaks in water. The comparisons between the ions show the dosimetric advantages of helium and heavier ion beams in terms of their distal and lateral fall-offs with respect to protons, reducing the lateral size of the region receiving 50% of the planned dose up to 12 mm. However, carbon and oxygen ions showed significant doses beyond the target due to the higher fragmentation tail compared to lighter ions (p and He), up to 25%. The Monte Carlo predictions were found to be in excellent geometrical agreement with the measurements, with deviations below 1 mm for all parameters investigated such as target and lateral size as well as distal fall-offs. Measured and simulated absolute dose values agreed within about 2.5% on the overall dose distributions. The MCTP tool, which supports the usage of multiple state-of-the-art relative biological effectiveness models, will provide a solid engine for treatment planning comparisons at HIT.

Three-dimensional dosimetric considerations from different point A definitions in cervical cancer low-dose-rate brachytherapy

PubMed Central

Chen, Ting; Kim, Leonard H.; Nelson, Carl; Gabel, Molly; Narra, Venkat; Haffty, Bruce; Yue, Ning J.

2013-01-01

Purpose To investigate the dosimetric difference due to the different point A definitions in cervical cancer low-dose-rate (LDR) intracavitary brachytherapy. Material and methods Twenty CT-based LDR brachytherapy plans of 11 cervical patients were retrospectively reviewed. Two plans with point As following the modified Manchester system which defines point A being 2 cm superior to the cervical os along the tandem and 2 cm lateral (Aos), and the American Brachytherapy Society (ABS) guideline definition in which the point A is 2 cm superior to the vaginal fornices instead of os (Aovoid) were generated. Using the same source strength, two plans prescribed the same dose to Aos and Aovoid. Dosimetric differences between plans including point A dose rate, treatment volume encompassed by the prescription isodose line (TV), and dose rate of 2 cc of the rectum and bladder to the prescription dose were measured. Results On average Aovoid was 8.9 mm superior to Aos along the tandem direction with a standard deviation of 5.4 mm. With the same source strength and arrangement, Aos dose rate was 19% higher than Aovoid dose rate. The average TV(Aovoid) was 118.0 cc, which was 30% more than the average TV(Aos) of 93.0 cc. D2cc/D(Aprescribe) increased from 51% to 60% for rectum, and increased from 89% and 106% for bladder, if the prescription point changed from Aos to Aovoid. Conclusions Different point A definitions lead to significant dose differences. Careful consideration should be given when changing practice from one point A definition to another, to ensure dosimetric and clinical equivalency from the previous clinical experiences. PMID:24474971

Dosimetric impact of an air passage on intraluminal brachytherapy for bronchus cancer

PubMed Central

Okamoto, Hiroyuki; Wakita, Akihisa; Nakamura, Satoshi; Nishioka, Shie; Aikawa, Ako; Kato, Toru; Abe, Yoshihisa; Kobayashi, Kazuma; Inaba, Koji; Murakami, Naoya; Itami, Jun

2016-01-01

The brachytherapy dose calculations used in treatment planning systems (TPSs) have conventionally been performed assuming homogeneous water. Using measurements and a Monte Carlo simulation, we evaluated the dosimetric impact of an air passage on brachytherapy for bronchus cancer. To obtain the geometrical characteristics of an air passage, we analyzed the anatomical information from CT images of patients who underwent intraluminal brachytherapy using a high-dose-rate 192Ir source (MicroSelectron V2r®, Nucletron). Using an ionization chamber, we developed a measurement system capable of measuring the peripheral dose with or without an air cavity surrounding the catheter. Air cavities of five different radii (0.3, 0.5, 0.75, 1.25 and 1.5 cm) were modeled by cylindrical tubes surrounding the catheter. A Monte Carlo code (GEANT4) was also used to evaluate the dosimetric impact of the air cavity. Compared with dose calculations in homogeneous water, the measurements and GEANT4 indicated a maximum overdose of 5–8% near the surface of the air cavity (with the maximum radius of 1.5 cm). Conversely, they indicated a minimum overdose of ~1% in the region 3–5 cm from the cavity surface for the smallest radius of 0.3 cm. The dosimetric impact depended on the size and the distance of the air passage, as well as the length of the treatment region. Based on dose calculations in water, the TPS for intraluminal brachytherapy for bronchus cancer had an unexpected overdose of 3–5% for a mean radius of 0.75 cm. This study indicates the need for improvement in dose calculation accuracy with respect to intraluminal brachytherapy for bronchus cancer. PMID:27605630

Dosimetric verification for intensity-modulated arc therapy plans by use of 2D diode array, radiochromic film and radiosensitive polymer gel.

PubMed

Hayashi, Naoki; Malmin, Ryan L; Watanabe, Yoichi

2014-05-01

Several tools are used for the dosimetric verification of intensity-modulated arc therapy (IMAT) treatment delivery. However, limited information is available for composite on-line evaluation of these tools. The purpose of this study was to evaluate the dosimetric verification of IMAT treatment plans using a 2D diode array detector (2D array), radiochromic film (RCF) and radiosensitive polymer gel dosimeter (RPGD). The specific verification plans were created for IMAT for two prostate cancer patients by use of the clinical treatment plans. Accordingly, the IMAT deliveries were performed with the 2D array on a gantry-mounting device, RCF in a cylindrical acrylic phantom, and the RPGD in two cylindrical phantoms. After the irradiation, the planar dose distributions from the 2D array and the RCFs, and the 3D dose distributions from the RPGD measurements were compared with the calculated dose distributions using the gamma analysis method (3% dose difference and 3-mm distance-to-agreement criterion), dose-dependent dose difference diagrams, dose difference histograms, and isodose distributions. The gamma passing rates of 2D array, RCFs and RPGD for one patient were 99.5%, 96.5% and 93.7%, respectively; the corresponding values for the second patient were 97.5%, 92.6% and 92.9%. Mean percentage differences between the RPGD measured and calculated doses in 3D volumes containing PTVs were -0.29 ± 7.1% and 0.97 ± 7.6% for the two patients, respectively. In conclusion, IMAT prostate plans can be delivered with high accuracy, although the 3D measurements indicated less satisfactory agreement with the treatment plans, mainly due to the dosimetric inaccuracy in low-dose regions of the RPGD measurements.

CBCT-based volumetric and dosimetric variation evaluation of volumetric modulated arc radiotherapy in the treatment of nasopharyngeal cancer patients

PubMed Central

2013-01-01

Objective To investigate the anatomic and dosimetric variations of volumetric modulated arc therapy (VMAT) in the treatment of nasopharyngeal cancer (NPC) patients based on weekly cone beam CT (CBCT). Materials and methods Ten NPC patients treated by VMAT with weekly CBCT for setup corrections were reviewed retrospectively. Deformed volumes of targets and organs at risk (OARs) in the CBCT were compared with those in the planning CT. Delivered doses were recalculated based on weekly CBCT and compared with the planned doses. Results No significant volumetric changes on targets, brainstem, and spinal cord were observed. The average volumes of right and left parotid measured from the fifth CBCT were about 4.4 and 4.5 cm3 less than those from the first CBCT, respectively. There were no significant dose differences between average planned and delivered doses for targets, brainstem and spinal cord. For right parotid, the delivered mean dose was 10.5 cGy higher (p = 0.004) than the planned value per fraction, and the V26 and V32 increased by 7.5% (p = 0.002) and 7.4% (p = 0.01), respectively. For the left parotid, the D50 (dose to the 50% volume) was 8.8 cGy higher (p = 0.03) than the planned values per fraction, and the V26 increased by 8.8% (p = 0.002). Conclusion Weekly CBCTs were applied directly to study the continuous volume changes and resulting dosimetric variations of targets and OARs for NPC patients undergoing VMAT. Significant volumetric and dosimetric variations were observed for parotids. Replanning after 30 Gy will benefit the protection on parotids. PMID:24289312

Human respiratory tract model for radiological protection: a revision of the ICRP Dosimetric Model for the Respiratory System.

PubMed

Bair, W J

1989-01-01

In 1984, the International Commission on Radiological Protection (ICRP) appointed a task group of Committee 2 to review and revise, as necessary, the ICRP Dosimetric Model for the Respiratory System. The model was originally published in 1966, modified slightly in Publication No. 19, and again in Publication No. 30 (in 1979). The task group concluded that research during the past 20 y suggested certain deficiencies in the ICRP Dosimetric Model for the Respiratory System. Research has also provided sufficient information for a revision of the model. The task group's approach has been to review, in depth, morphology and physiology of the respiratory tract; deposition of inhaled particles in the respiratory tract; clearance of deposited materials; and the nature and specific sites of damage to the respiratory tract caused by inhaled radioactive substances. This review has led to a redefinition of the regions of the respiratory tract for dosimetric purposes. The redefinition has a morphologic and physiological basis and is consistent with observed deposition and clearance of particles and with resultant pathology. Regions, as revised, are the extrathoracic (E-T) region, comprising the nasal and oral regions, the pharynx, larynx, and upper part of the trachea; the fast-clearing thoracic region (T[f]), comprising the remainder of the trachea and bronchi; and the slow-clearing thoracic region (T[s]), comprising the bronchioles, alveoli, and thoracic lymph nodes. A task group report will include models for calculating radiation doses to these regions of the respiratory tract following inhalation of representative alpha-, beta-, and gamma-emitting particulate and gaseous radionuclides. The models may be implemented as a package of computer codes available to a wide range of users. This should facilitate application of the revised human respiratory tract model to worldwide radiation protection needs.

Radiation protection aspects of EMITEL Encyclopaedia of Medical Physics.

PubMed

Stoeva, M; Tabakov, S; Lewis, C; Tabakova, V; Thurston, J; Smith, P

2015-07-01

The Encyclopaedia of Medical Physics EMITEL was developed under the EU pilot project European Medical Imaging Technology e-Encyclopaedia for Lifelong Learning. This large reference material includes 3400 articles on 2100 pages supported by thousands of illustrations. All materials are available free at the website, www.emitel2.eu. The articles are grouped in seven categories--physics of: X-ray diagnostic radiology, nuclear medicine, radiotherapy, magnetic resonance imaging, ultrasound imaging, radiation protection and general terms. The radiation protection part of EMITEL includes 450 articles. These were organised in several sub-groups including: nuclear and atomic physics; ionizing radiation interactions and biological effects; radiation detection and measurement; dosimetric quantities and units; and general radiation protection and international bodies. EMITEL project was developed over 3 y and attracted as contributors 250+ senior specialists from 35 countries. After its successful launching, EMITEL is actively used by thousands of professionals around the world. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Dosimetric impact of a change in breathing period on VMAT stereotactic ablative body radiotherapy

NASA Astrophysics Data System (ADS)

Olding, T.; Alexander, KM

2017-05-01

The dosimetric impact of a change in breathing period during treatment was assessed for a volumetric modulated arc therapy (VMAT) stereotactic ablative radiotherapy (SABR) lung plan optimized according to our centre’s planning protocol. Plan delivery was evaluated at three breathing rates ranging from 7 to 23 breaths-per-minute (BPM) against the planning anatomy (15 BPM) calculated dose. Dynamic ion chamber, EBT3 film and Fricke-xylenol orange-gelatin (FXG) gel measurements were acquired using a motion phantom with appropriate inserts for each dosimeter. The results show good agreement between measured and calculated plan dose within the internal gross tumour volume (IGTV) target.

Dosimetric characteristics of LKB:Cu,P solid TL detector

NASA Astrophysics Data System (ADS)

Hashim, S.; Alajerami, Y. S. M.; Ghoshal, S. K.; Saleh, M. A.; Saripan, M. I.; Kadir, A. B. A.; Bradley, D. A.; Alzimami, K.

2014-11-01

The dosimetric characteristics of newly developed borate glass dosimeter modified with lithium and potassium carbonate (LKB) and co-doped with CuO and NH4H2PO4 are reported. Broad peaks in the absence of any sharp peak confirms the amorphous nature of the prepared glass. A simple glow curve of Cu doped sample is observed with a single prominent peak (Tm) at 220 °C. The TL intensity response shows an enhancement of ~100 times due to the addition of CuO (0.1 mol%) to LKB compound. A further enhancement of the intensity by a factor of 3 from the addition of 0.25 mol% NH4H2PO4 as a co-dopant impurity is attributed to the creation of extra electron traps with consequent increase in energy transfer of radiation recombination centers. The TL yield performance of LKB:Cu,P with Zeff ≈8.92 is approximately seventeen times less sensitive compared to LiF:Mg,Ti (TLD-100). The proposed dosimeter shows good linearity up to 103 Gy, minimal fading and photon energy independence. These attractive features offered by our dosimeter is expected to pave the way towards dosimetric applications.

Prevention of Transfusion-Associated Graft-versus-Host Disease by Irradiation: Technical Aspect of a New Ferrous Sulphate Dosimetric System

PubMed Central

Del Lama, Lucas Sacchini; de Góes, Evamberto Garcia; Petchevist, Paulo César Dias; Moretto, Edson Lara; Borges, José Carlos; Covas, Dimas Tadeu; de Almeida, Adelaide

2013-01-01

Irradiation of whole blood and blood components before transfusion is currently the only accepted method to prevent Transfusion-Associated Graft-Versus-Host-Disease (TA-GVHD). However, choosing the appropriate technique to determine the dosimetric parameters associated with blood irradiation remains an issue. We propose a dosimetric system based on the standard Fricke Xylenol Gel (FXG) dosimeter and an appropriate phantom. The modified dosimeter was previously calibrated using a 60Co teletherapy unit and its validation was accomplished with a 137Cs blood irradiator. An ionization chamber, standard FXG, radiochromic film and thermoluminescent dosimeters (TLDs) were used as reference dosimeters to determine the dose response and dose rate of the 60Co unit. The dose distributions in a blood irradiator were determined with the modified FXG, the radiochromic film, and measurements by TLD dosimeters. A linear response for absorbed doses up to 54 Gy was obtained with our system. Additionally, the dose rate uncertainties carried out with gel dosimetry were lower than 5% and differences lower than 4% were noted when the absorbed dose responses were compared with ionization chamber, film and TLDs. PMID:23762345

Dosimetric properties of dysprosium doped calcium magnesium borate glass subjected to Co-60 gamma ray

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

Omar, R. S., E-mail: ratnasuffhiyanni@gmail.com; Wagiran, H., E-mail: husin@utm.my; Saeed, M. A.

Thermoluminescence (TL) dosimetric properties of dysprosium doped calcium magnesium borate (CMB:Dy) glass are presented. This study is deemed to understand the application of calcium as the modifier in magnesium borate glass with the presence of dysprosium as the activator to be performed as TL dosimeter (TLD). The study provides fundamental knowledge of a glass system that may lead to perform new TL glass dosimetry application in future research. Calcium magnesium borate glass systems of (70-y) B{sub 2}O{sub 3} − 20 CaO – 10 MgO-(y) Dy{sub 2}O{sub 3} with 0.05  mol % ≤ y ≤ 0.7  mol % of dyprosium weremore » prepared by melt-quenching technique. The amorphous structure and TL properties of the prepared samples were determined using powder X-ray diffraction (XRD) and TL reader; model Harshaw 4500 respectively. The samples were irradiated to Co-60 gamma source at a dose of 50 Gy. Dosimetric properties such as annealing procedure, time temperature profile (TTP) setting, optimization of Dy{sub 2}O{sub 3} concentration of 0.5 mol % were determined for thermoluminescence dosimeter (TLD) reader used.« less

Physics-aspects of dose accuracy in high dose rate (HDR) brachytherapy: source dosimetry, treatment planning, equipment performance and in vivo verification techniques

PubMed Central

Bradley, David; Nisbet, Andrew

2012-01-01

This study provides a review of recent publications on the physics-aspects of dosimetric accuracy in high dose rate (HDR) brachytherapy. The discussion of accuracy is primarily concerned with uncertainties, but methods to improve dose conformation to the prescribed intended dose distribution are also noted. The main aim of the paper is to review current practical techniques and methods employed for HDR brachytherapy dosimetry. This includes work on the determination of dose rate fields around brachytherapy sources, the capability of treatment planning systems, the performance of treatment units and methods to verify dose delivery. This work highlights the determinants of accuracy in HDR dosimetry and treatment delivery and presents a selection of papers, focusing on articles from the last five years, to reflect active areas of research and development. Apart from Monte Carlo modelling of source dosimetry, there is no clear consensus on the optimum techniques to be used to assure dosimetric accuracy through all the processes involved in HDR brachytherapy treatment. With the exception of the ESTRO mailed dosimetry service, there is little dosimetric audit activity reported in the literature, when compared with external beam radiotherapy verification. PMID:23349649

Dosimetric characteristics of fabricated silica fibre for postal radiotherapy dose audits

NASA Astrophysics Data System (ADS)

Fadzil, M. S. Ahmad; Ramli, N. N. H.; Jusoh, M. A.; Kadni, T.; Bradley, D. A.; Ung, N. M.; Suhairul, H.; Mohd Noor, N.

2014-11-01

Present investigation aims to establish the dosimetric characteristics of a novel fabricated flat fibre TLD system for postal radiotherapy dose audits. Various thermoluminescence (TL) properties have been investigated for five sizes of 6 mol% Ge-doped optical fibres. Key dosimetric characteristics including reproducibility, linearity, fading and energy dependence have been established. Irradiations were carried out using a linear accelerator (linac) and a Cobalt-60 machine. For doses from 0.5 Gy up to 10 Gy, Ge-doped flat fibres exhibit linearity between TL yield and dose, reproducible to better than 8% standard deviation (SD) following repeat measurements (n = 3). For photons generated at potentials from 1.25 MeV to 10 MV an energy-dependent response is noted, with a coefficient of variation (CV) of less than 40% over the range of energies investigated. For 6.0 mm length flat fibres 100 μm thick × 350 pm wide, the TL fading loss following 30 days of storage at room temperature was < 8%. The Ge-doped flat fibre system represents a viable basis for use in postal radiotherapy dose audits, corrections being made for the various factors influencing the TL yield.

First biological and dosimetric results of the free flyer biostack experiment AO015 on LDEF

NASA Technical Reports Server (NTRS)

Reitz, G.; Buecker, H.; Facius, R.; Horneck, G.; Schaeffer, M.; Schott, J. U.; Bayonove, J.; Beaujean, R.; Benton, E. V.; Delpoux, M.

1991-01-01

The main objectives of the Biostack Experiment are to study the effectiveness of the structured components of the cosmic radiation to bacterial spores, plant seeds, and animal cysts for a long duration spaceflight and to get dosimetric data such as particle fluences and spectra and total doses for the Long Duration Exposure Facility orbit. The configuration of the experiment packages allows the localization of the trajectory of the particles in each biological layer and to correlate the potential biological impairment or injury with the physical characteristics of the responsible particle. Although the Biostack Experiment was designed for a long duration flight of only nine months, most of the biological systems show a high hatching or germination rate. Some of the first observations are an increase of the mutation rate of embryonic lethals in the second generation of Arabidopsis seeds, somatic mutations, and a reduction of growth rates of corn plants and a reduction of life span of Artemia salina shrimps. The different passive detector systems are also in a good shape and give access to a proper dosimetric analysis. The results are summarized, and some aspects of future analysis are shown.

Dosimetric evaluation of a MOSFET detector for clinical application in photon therapy.

PubMed

Kohno, Ryosuke; Hirano, Eriko; Nishio, Teiji; Miyagishi, Tomoko; Goka, Tomonori; Kawashima, Mitsuhiko; Ogino, Takashi

2008-01-01

Dosimetric characteristics of a metal oxide-silicon semiconductor field effect transistor (MOSFET) detector are studied with megavoltage photon beams for patient dose verification. The major advantages of this detector are its size, which makes it a point dosimeter, and its ease of use. In order to use the MOSFET detector for dose verification of intensity-modulated radiation therapy (IMRT) and in-vivo dosimetry for radiation therapy, we need to evaluate the dosimetric properties of the MOSFET detector. Therefore, we investigated the reproducibility, dose-rate effect, accumulated-dose effect, angular dependence, and accuracy in tissue-maximum ratio measurements. Then, as it takes about 20 min in actual IMRT for the patient, we evaluated fading effect of MOSFET response. When the MOSFETs were read-out 20 min after irradiation, we observed a fading effect of 0.9% with 0.9% standard error of the mean. Further, we applied the MOSFET to the measurement of small field total scatter factor. The MOSFET for dose measurements of small field sizes was better than the reference pinpoint chamber with vertical direction. In conclusion, we assessed the accuracy, reliability, and usefulness of the MOSFET detector in clinical applications such as pinpoint absolute dosimetry for small fields.

Recent advances in intensity modulated radiotherapy and proton therapy for esophageal cancer.

PubMed

Xi, Mian; Lin, Steven H

2017-07-01

Radiotherapy is an important component of the standard of care for esophageal cancer. In the past decades, significant improvements in the planning and delivery of radiation techniques have led to better dose conformity to the target volume and improved normal tissue sparing. Areas covered: This review focuses on the advances in radiotherapy techniques and summarizes the availably dosimetric and clinical outcomes of intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy, proton therapy, and four-dimensional radiotherapy for esophageal cancer, and discusses the challenges and future development of proton therapy. Expert commentary: Although three-dimensional conformal radiotherapy is the standard radiotherapy technique in esophageal cancer, the retrospectively comparative studies strongly suggest that the dosimetric advantage of IMRT over three-dimensional conformal radiotherapy can translate into improved clinical outcomes, despite the lack of prospective randomized evidence. As a novel form of conventional IMRT technique, volumetric modulated arc therapy can produce equivalent or superior dosimetric quality with significantly higher treatment efficiency in esophageal cancer. Compared with photon therapy, proton therapy has the potential to achieve further clinical improvement due to their physical properties; however, prospective clinical data, long-term results, and cost-effectiveness are needed.

Physics-aspects of dose accuracy in high dose rate (HDR) brachytherapy: source dosimetry, treatment planning, equipment performance and in vivo verification techniques.

PubMed

Palmer, Antony; Bradley, David; Nisbet, Andrew

2012-06-01

This study provides a review of recent publications on the physics-aspects of dosimetric accuracy in high dose rate (HDR) brachytherapy. The discussion of accuracy is primarily concerned with uncertainties, but methods to improve dose conformation to the prescribed intended dose distribution are also noted. The main aim of the paper is to review current practical techniques and methods employed for HDR brachytherapy dosimetry. This includes work on the determination of dose rate fields around brachytherapy sources, the capability of treatment planning systems, the performance of treatment units and methods to verify dose delivery. This work highlights the determinants of accuracy in HDR dosimetry and treatment delivery and presents a selection of papers, focusing on articles from the last five years, to reflect active areas of research and development. Apart from Monte Carlo modelling of source dosimetry, there is no clear consensus on the optimum techniques to be used to assure dosimetric accuracy through all the processes involved in HDR brachytherapy treatment. With the exception of the ESTRO mailed dosimetry service, there is little dosimetric audit activity reported in the literature, when compared with external beam radiotherapy verification.

A voxel-based investigation for MRI-only radiotherapy of the brain using ultra short echo times

NASA Astrophysics Data System (ADS)

Edmund, Jens M.; Kjer, Hans M.; Van Leemput, Koen; Hansen, Rasmus H.; Andersen, Jon AL; Andreasen, Daniel

2014-12-01

Radiotherapy (RT) based on magnetic resonance imaging (MRI) as the only modality, so-called MRI-only RT, would remove the systematic registration error between MR and computed tomography (CT), and provide co-registered MRI for assessment of treatment response and adaptive RT. Electron densities, however, need to be assigned to the MRI images for dose calculation and patient setup based on digitally reconstructed radiographs (DRRs). Here, we investigate the geometric and dosimetric performance for a number of popular voxel-based methods to generate a so-called pseudo CT (pCT). Five patients receiving cranial irradiation, each containing a co-registered MRI and CT scan, were included. An ultra short echo time MRI sequence for bone visualization was used. Six methods were investigated for three popular types of voxel-based approaches; (1) threshold-based segmentation, (2) Bayesian segmentation and (3) statistical regression. Each approach contained two methods. Approach 1 used bulk density assignment of MRI voxels into air, soft tissue and bone based on logical masks and the transverse relaxation time T2 of the bone. Approach 2 used similar bulk density assignments with Bayesian statistics including or excluding additional spatial information. Approach 3 used a statistical regression correlating MRI voxels with their corresponding CT voxels. A similar photon and proton treatment plan was generated for a target positioned between the nasal cavity and the brainstem for all patients. The CT agreement with the pCT of each method was quantified and compared with the other methods geometrically and dosimetrically using both a number of reported metrics and introducing some novel metrics. The best geometrical agreement with CT was obtained with the statistical regression methods which performed significantly better than the threshold and Bayesian segmentation methods (excluding spatial information). All methods agreed significantly better with CT than a reference water MRI comparison. The mean dosimetric deviation for photons and protons compared to the CT was about 2% and highest in the gradient dose region of the brainstem. Both the threshold based method and the statistical regression methods showed the highest dosimetrical agreement. Generation of pCTs using statistical regression seems to be the most promising candidate for MRI-only RT of the brain. Further, the total amount of different tissues needs to be taken into account for dosimetric considerations regardless of their correct geometrical position.

Dependence of Achievable Plan Quality on Treatment Technique and Planning Goal Refinement: A Head-and-Neck Intensity Modulated Radiation Therapy Application

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

Qi, X. Sharon, E-mail: xqi@mednet.ucla.edu; Ruan, Dan; Lee, Steve P.

2015-03-15

Purpose: To develop a practical workflow for retrospectively analyzing target and normal tissue dose–volume endpoints for various intensity modulated radiation therapy (IMRT) delivery techniques; to develop technique-specific planning goals to improve plan consistency and quality when feasible. Methods and Materials: A total of 165 consecutive head-and-neck patients from our patient registry were selected and retrospectively analyzed. All IMRT plans were generated using the same dose–volume guidelines for TomoTherapy (Tomo, Accuray), TrueBeam (TB, Varian) using fixed-field IMRT (TB-IMRT) or RAPIDARC (TB-RAPIDARC), or Siemens Oncor (Siemens-IMRT, Siemens). A MATLAB-based dose–volume extraction and analysis tool was developed to export dosimetric endpoints for eachmore » patient. With a fair stratification of patient cohort, the variation of achieved dosimetric endpoints was analyzed among different treatment techniques. Upon identification of statistically significant variations, technique-specific planning goals were derived from dynamically accumulated institutional data. Results: Retrospective analysis showed that although all techniques yielded comparable target coverage, the doses to the critical structures differed. The maximum cord doses were 34.1 ± 2.6, 42.7 ± 2.1, 43.3 ± 2.0, and 45.1 ± 1.6 Gy for Tomo, TB-IMRT, TB-RAPIDARC, and Siemens-IMRT plans, respectively. Analyses of variance showed significant differences for the maximum cord doses but no significant differences for other selected structures among the investigated IMRT delivery techniques. Subsequently, a refined technique-specific dose–volume guideline for maximum cord dose was derived at a confidence level of 95%. The dosimetric plans that failed the refined technique-specific planning goals were reoptimized according to the refined constraints. We observed better cord sparing with minimal variations for the target coverage and other organ at risk sparing for the Tomo cases, and higher parotid doses for C-arm linear accelerator–based IMRT and RAPIDARC plans. Conclusion: Patient registry–based processes allowed easy and systematic dosimetric assessment of treatment plan quality and consistency. Our analysis revealed the dependence of certain dosimetric endpoints on the treatment techniques. Technique-specific refinement of planning goals may lead to improvement in plan consistency and plan quality.« less

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-CAMPUS-I-05: Internal Dosimetric Calculations for Several Imaging Radiopharmaceuticals in Preclinical Studies and Quantitative Assessment of the Mouse Size Impact On Them. Realistic Monte Carlo Simulations Based On the 4D-MOBY Model

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

Kostou, T; Papadimitroulas, P; Kagadis, GC

2014-06-15

Purpose: Commonly used radiopharmaceuticals were tested to define the most important dosimetric factors in preclinical studies. Dosimetric calculations were applied in two different whole-body mouse models, with varying organ size, so as to determine their impact on absorbed doses and S-values. Organ mass influence was evaluated with computational models and Monte Carlo(MC) simulations. Methods: MC simulations were executed on GATE to determine dose distribution in the 4D digital MOBY mouse phantom. Two mouse models, 28 and 34 g respectively, were constructed based on realistic preclinical exams to calculate the absorbed doses and S-values of five commonly used radionuclides in SPECT/PETmore » studies (18F, 68Ga, 177Lu, 111In and 99mTc).Radionuclide biodistributions were obtained from literature. Realistic statistics (uncertainty lower than 4.5%) were acquired using the standard physical model in Geant4. Comparisons of the dosimetric calculations on the two different phantoms for each radiopharmaceutical are presented. Results: Dose per organ in mGy was calculated for all radiopharmaceuticals. The two models introduced a difference of 0.69% in their brain masses, while the largest differences were observed in the marrow 18.98% and in the thyroid 18.65% masses.Furthermore, S-values of the most important target-organs were calculated for each isotope. Source-organ was selected to be the whole mouse body.Differences on the S-factors were observed in the 6.0–30.0% range. Tables with all the calculations as reference dosimetric data were developed. Conclusion: Accurate dose per organ and the most appropriate S-values are derived for specific preclinical studies. The impact of the mouse model size is rather high (up to 30% for a 17.65% difference in the total mass), and thus accurate definition of the organ mass is a crucial parameter for self-absorbed S values calculation.Our goal is to extent the study for accurate estimations in small animal imaging, whereas it is known that there is a large variety in the anatomy of the organs.« less

SU-G-206-16: Investigation of Dosimetric Consequence Via Cone-Beam CT Based Dose Reconstruction in Hepatocellular Carcinoma Radiotherapy

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

Huang, P; Gang, Y; Qin, S

2016-06-15

Purpose: Many patients with technically unresectable or medically inoperable hepatocellular carcinoma (HCC) had hepatic dosimetric variations as a result of inter-fraction anatomical deformation. This study was conducted to assess the hepatic dosimetric consequences via reconstructing weekly dose in HCC patients receiving three dimensional conformal radiation therapy. Methods: Twenty-one HCC patients with 21 planning CT (pCT) scans and 63 weekly Cone-beam CT (CBCT) scans were enrolled in this investigation. Among them, six patients had been diagnosed of radiation induced liver disease (RILD) and the other fifteen patients had good prognosis after treatment. And each patient had three weekly CBCT before re-planning.more » In reconstructing CBCT-based weekly dose, we registered pCT to CBCT to provide the correct Hounsfield units for the CBCT using gradient-based deformable image registration (DIR), and this modified CBCT (mCBCT) were introduced to enable dose calculation.To obtain the weekly dosimetric consequences, the initial plan beam configurations and dose constraints were re-applied to mCBCT for performing dose calculation, and the mCBCT were extrapolated to 25 fractions. Besides, the manually delineated contour was propagated automatically onto the mCBCT of the new patient by exploiting the deformation vectors field, and the reconstructed weekly dose was mapped back to pCT to understand the dose distribution difference. Also, weekly dosimetric variations were compared with the hepatic radiation tolerance in terms of D50 and Dmean. Results: Among the twenty-one patients, the three weekly D50 increased by 0.7Gy, 5.1Gy and 6.1Gy, respectively, and Dmean increased by 0.9%, 4.7% and 5.5%, respectively. For patients with RILD, the average values of the third weekly D50 and Dmean were both high than hepatic radiation tolerance, while the values of patients without RILD were below. Conclusion: The planned dose on pCT was not a real dose to the liver, and the liver overdose increased the risk of RILD. The author would like to express great thanks to Lei Xing, Daniel S Kapp and Yong Yang in the Stanford University School of Medicine for their valuable suggestions to this work. This work is supported by NSFC(61471226), China Postdoctoral Science Foundation (2015T80739,2014M551949) and research funding from Shandong Province (JQ201516).« less

MO-A-BRC-00: TG167: Clinical Recommendations for Innovative Brachytherapy Devices and Applicators

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

NONE

Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence-based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved. The physicist’s role, along with physician colleagues, in this process is highlighted for innovative products or applications and includes evaluation of 1)more » dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use, 2) risks and benefits from regulatory and safety perspectives, and 3) resource assessment and preparedness. Further, calibration methods should be traceable to a primary standards dosimetry laboratory such as NIST in the U.S. or to other primary standards dosimetry laboratory located elsewhere. Clinical users should follow standards as approved by their country’s regulatory agencies that approved such a brachytherapy device. Integration of this system into the medical source calibration infrastructure of secondary standard dosimetry laboratories such as the ADCLs is encouraged before a source is introduced into widespread routine clinical use. The AAPM and GEC-ESTRO have developed guidelines for the safe and consistent application of brachytherapy using innovative brachytherapy devices and applications. The current report covers regulatory approvals, calibration, dose calculations, radiobiological issues, and overall safety concerns that should be addressed during the commissioning stage preceding clinical use. These guidelines are based on review of requirements of the U.S. NRC, FDA, Department of Transportation, International Electrotechnical Commission Medical Electrical Equipment Standard 60601, European Commission for CE Marking, and institutional review boards and radiation safety committees. Learning Objectives: Understand the necessary dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use. Evaluate risks and benefits from regulatory and safety perspectives. Identify necessary resources and create a plan for clinical introduction of innovative brachytherapy device or applications. Consultant for Theragenics Corp.; R. Nath, Consultant to Theragenics Corp.« less

MO-A-BRC-02: TG167 Report - Detailed Description

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

Rivard, M.

Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence-based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved. The physicist’s role, along with physician colleagues, in this process is highlighted for innovative products or applications and includes evaluation of 1)more » dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use, 2) risks and benefits from regulatory and safety perspectives, and 3) resource assessment and preparedness. Further, calibration methods should be traceable to a primary standards dosimetry laboratory such as NIST in the U.S. or to other primary standards dosimetry laboratory located elsewhere. Clinical users should follow standards as approved by their country’s regulatory agencies that approved such a brachytherapy device. Integration of this system into the medical source calibration infrastructure of secondary standard dosimetry laboratories such as the ADCLs is encouraged before a source is introduced into widespread routine clinical use. The AAPM and GEC-ESTRO have developed guidelines for the safe and consistent application of brachytherapy using innovative brachytherapy devices and applications. The current report covers regulatory approvals, calibration, dose calculations, radiobiological issues, and overall safety concerns that should be addressed during the commissioning stage preceding clinical use. These guidelines are based on review of requirements of the U.S. NRC, FDA, Department of Transportation, International Electrotechnical Commission Medical Electrical Equipment Standard 60601, European Commission for CE Marking, and institutional review boards and radiation safety committees. Learning Objectives: Understand the necessary dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use. Evaluate risks and benefits from regulatory and safety perspectives. Identify necessary resources and create a plan for clinical introduction of innovative brachytherapy device or applications. Consultant for Theragenics Corp.; R. Nath, Consultant to Theragenics Corp.« less

MO-A-BRC-01: TG167 Report - Introduction

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

Nath, R.

Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence-based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved. The physicist’s role, along with physician colleagues, in this process is highlighted for innovative products or applications and includes evaluation of 1)more » dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use, 2) risks and benefits from regulatory and safety perspectives, and 3) resource assessment and preparedness. Further, calibration methods should be traceable to a primary standards dosimetry laboratory such as NIST in the U.S. or to other primary standards dosimetry laboratory located elsewhere. Clinical users should follow standards as approved by their country’s regulatory agencies that approved such a brachytherapy device. Integration of this system into the medical source calibration infrastructure of secondary standard dosimetry laboratories such as the ADCLs is encouraged before a source is introduced into widespread routine clinical use. The AAPM and GEC-ESTRO have developed guidelines for the safe and consistent application of brachytherapy using innovative brachytherapy devices and applications. The current report covers regulatory approvals, calibration, dose calculations, radiobiological issues, and overall safety concerns that should be addressed during the commissioning stage preceding clinical use. These guidelines are based on review of requirements of the U.S. NRC, FDA, Department of Transportation, International Electrotechnical Commission Medical Electrical Equipment Standard 60601, European Commission for CE Marking, and institutional review boards and radiation safety committees. Learning Objectives: Understand the necessary dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use. Evaluate risks and benefits from regulatory and safety perspectives. Identify necessary resources and create a plan for clinical introduction of innovative brachytherapy device or applications. Consultant for Theragenics Corp.; R. Nath, Consultant to Theragenics Corp.« less

Comparative dosimetric evaluation of nanotargeted (188)Re-(DXR)-liposome for internal radiotherapy.

PubMed

Chang, Chih-Hsien; Stabin, Michael G; Chang, Ya-Jen; Chen, Liang-Cheng; Chen, Min-Hua; Chang, Tsui-Jung; Lee, Te-Wei; Ting, Gann

2008-12-01

A dosimetric analysis was performed to evaluate nanoliposomes as carriers of radionuclides ((188)Re-liposomes) and radiochemotherapeutic drugs [(188)Re-doxorubicin (DXR)-liposomes] in internal radiotherapy for colon carcinoma, as evaluated in mice. Pharmacokinetic data for (188)Re-N, N-bis (2-mercaptoethyl)-N',N'-diethylethylenediamine (BMEDA), (188)Re-liposome, and (188)Re-DXR-liposome were obtained for the estimation of absorbed doses in tumors and normal organs. Two colon carcinoma mouse models were employed: subcutaneous growing solid tumor and malignant ascites pervading tumor models. Radiation-dose estimates for normal tissues and tumors were calculated by using the OLINDA/EXM program. An evaluation of a recommended maximum administered activity (MAA) for the nanotargeted drugs was also made. Mean absorbed doses derived from (188)Re-liposome and (188)Re-DXR-liposome in normal tissues were generally similar to those from (188)Re-BMEDA in intraperitoneal and intravenous administration. Tissue-absorbed dose in the liver was 0.24-0.40 and 0.17-0.26 (mGy/MBq) and in red marrow was 0.033-0.050 and 0.038-0.046 (mGy/MBq), respectively, for (188)Re-liposome and (188)Re-DXR-liposome. Tumor-absorbed doses for the nanotargeted (188)Re-liposome and (188)Re-DXR-liposome were higher than those of (188)Re-BMEDA for both routes of administration (4-26-fold). Dose to red marrow defined the recommended MAA. Our results suggest that radionuclide and chemoradiotherapeutic passive targeting delivery, using nanoliposomes as the carrier, is feasible and promising in systemic-targeted radionuclide therapy.

Development of a four-axis moving phantom for patient-specific QA of surrogate signal-based tracking IMRT.

PubMed

Mukumoto, Nobutaka; Nakamura, Mitsuhiro; Yamada, Masahiro; Takahashi, Kunio; Akimoto, Mami; Miyabe, Yuki; Yokota, Kenji; Kaneko, Shuji; Nakamura, Akira; Itasaka, Satoshi; Matsuo, Yukinori; Mizowaki, Takashi; Kokubo, Masaki; Hiraoka, Masahiro

2016-12-01

The purposes of this study were two-fold: first, to develop a four-axis moving phantom for patient-specific quality assurance (QA) in surrogate signal-based dynamic tumor-tracking intensity-modulated radiotherapy (DTT-IMRT), and second, to evaluate the accuracy of the moving phantom and perform patient-specific dosimetric QA of the surrogate signal-based DTT-IMRT. The four-axis moving phantom comprised three orthogonal linear actuators for target motion and a fourth one for surrogate motion. The positional accuracy was verified using four laser displacement gauges under static conditions (±40 mm displacements along each axis) and moving conditions [eight regular sinusoidal and fourth-power-of-sinusoidal patterns with peak-to-peak motion ranges (H) of 10-80 mm and a breathing period (T) of 4 s, and three irregular respiratory patterns with H of 1.4-2.5 mm in the left-right, 7.7-11.6 mm in the superior-inferior, and 3.1-4.2 mm in the anterior-posterior directions for the target motion, and 4.8-14.5 mm in the anterior-posterior direction for the surrogate motion, and T of 3.9-4.9 s]. Furthermore, perpendicularity, defined as the vector angle between any two axes, was measured using an optical measurement system. The reproducibility of the uncertainties in DTT-IMRT was then evaluated. Respiratory motions from 20 patients acquired in advance were reproduced and compared three-dimensionally with the originals. Furthermore, patient-specific dosimetric QAs of DTT-IMRT were performed for ten pancreatic cancer patients. The doses delivered to Gafchromic films under tracking and moving conditions were compared with those delivered under static conditions without dose normalization. Positional errors of the moving phantom under static and moving conditions were within 0.05 mm. The perpendicularity of the moving phantom was within 0.2° of 90°. The differences in prediction errors between the original and reproduced respiratory motions were -0.1 ± 0.1 mm for the lateral direction, -0.1 ± 0.2 mm for the superior-inferior direction, and -0.1 ± 0.1 mm for the anterior-posterior direction. The dosimetric accuracy showed significant improvements, of 92.9% ± 4.0% with tracking versus 69.8% ± 7.4% without tracking, in the passing rates of γ with the criterion of 3%/1 mm (p < 0.001). Although the dosimetric accuracy of IMRT without tracking showed a significant negative correlation with the 3D motion range of the target (r = - 0.59, p < 0.05), there was no significant correlation for DTT-IMRT (r = 0.03, p = 0.464). The developed four-axis moving phantom had sufficient accuracy to reproduce patient respiratory motions, allowing patient-specific QA of the surrogate signal-based DTT-IMRT under realistic conditions. Although IMRT without tracking decreased the dosimetric accuracy as the target motion increased, the DTT-IMRT achieved high dosimetric accuracy.

Sensitivity of postplanning target and OAR coverage estimates to dosimetric margin distribution sampling parameters

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

Xu Huijun; Gordon, J. James; Siebers, Jeffrey V.

2011-02-15

Purpose: A dosimetric margin (DM) is the margin in a specified direction between a structure and a specified isodose surface, corresponding to a prescription or tolerance dose. The dosimetric margin distribution (DMD) is the distribution of DMs over all directions. Given a geometric uncertainty model, representing inter- or intrafraction setup uncertainties or internal organ motion, the DMD can be used to calculate coverage Q, which is the probability that a realized target or organ-at-risk (OAR) dose metric D{sub v} exceeds the corresponding prescription or tolerance dose. Postplanning coverage evaluation quantifies the percentage of uncertainties for which target and OAR structuresmore » meet their intended dose constraints. The goal of the present work is to evaluate coverage probabilities for 28 prostate treatment plans to determine DMD sampling parameters that ensure adequate accuracy for postplanning coverage estimates. Methods: Normally distributed interfraction setup uncertainties were applied to 28 plans for localized prostate cancer, with prescribed dose of 79.2 Gy and 10 mm clinical target volume to planning target volume (CTV-to-PTV) margins. Using angular or isotropic sampling techniques, dosimetric margins were determined for the CTV, bladder and rectum, assuming shift invariance of the dose distribution. For angular sampling, DMDs were sampled at fixed angular intervals {omega} (e.g., {omega}=1 deg., 2 deg., 5 deg., 10 deg., 20 deg.). Isotropic samples were uniformly distributed on the unit sphere resulting in variable angular increments, but were calculated for the same number of sampling directions as angular DMDs, and accordingly characterized by the effective angular increment {omega}{sub eff}. In each direction, the DM was calculated by moving the structure in radial steps of size {delta}(=0.1,0.2,0.5,1 mm) until the specified isodose was crossed. Coverage estimation accuracy {Delta}Q was quantified as a function of the sampling parameters {omega} or {omega}{sub eff} and {delta}. Results: The accuracy of coverage estimates depends on angular and radial DMD sampling parameters {omega} or {omega}{sub eff} and {delta}, as well as the employed sampling technique. Target |{Delta}Q|<1% and OAR |{Delta}Q|<3% can be achieved with sampling parameters {omega} or {omega}{sub eff}=20 deg., {delta}=1 mm. Better accuracy (target |{Delta}Q|<0.5% and OAR |{Delta}Q|<{approx}1%) can be achieved with {omega} or {omega}{sub eff}=10 deg., {delta}=0.5 mm. As the number of sampling points decreases, the isotropic sampling method maintains better accuracy than fixed angular sampling. Conclusions: Coverage estimates for post-planning evaluation are essential since coverage values of targets and OARs often differ from the values implied by the static margin-based plans. Finer sampling of the DMD enables more accurate assessment of the effect of geometric uncertainties on coverage estimates prior to treatment. DMD sampling with {omega} or {omega}{sub eff}=10 deg. and {delta}=0.5 mm should be adequate for planning purposes.« less

Sensitivity of postplanning target and OAR coverage estimates to dosimetric margin distribution sampling parameters.

PubMed

Xu, Huijun; Gordon, J James; Siebers, Jeffrey V

2011-02-01

A dosimetric margin (DM) is the margin in a specified direction between a structure and a specified isodose surface, corresponding to a prescription or tolerance dose. The dosimetric margin distribution (DMD) is the distribution of DMs over all directions. Given a geometric uncertainty model, representing inter- or intrafraction setup uncertainties or internal organ motion, the DMD can be used to calculate coverage Q, which is the probability that a realized target or organ-at-risk (OAR) dose metric D, exceeds the corresponding prescription or tolerance dose. Postplanning coverage evaluation quantifies the percentage of uncertainties for which target and OAR structures meet their intended dose constraints. The goal of the present work is to evaluate coverage probabilities for 28 prostate treatment plans to determine DMD sampling parameters that ensure adequate accuracy for postplanning coverage estimates. Normally distributed interfraction setup uncertainties were applied to 28 plans for localized prostate cancer, with prescribed dose of 79.2 Gy and 10 mm clinical target volume to planning target volume (CTV-to-PTV) margins. Using angular or isotropic sampling techniques, dosimetric margins were determined for the CTV, bladder and rectum, assuming shift invariance of the dose distribution. For angular sampling, DMDs were sampled at fixed angular intervals w (e.g., w = 1 degree, 2 degrees, 5 degrees, 10 degrees, 20 degrees). Isotropic samples were uniformly distributed on the unit sphere resulting in variable angular increments, but were calculated for the same number of sampling directions as angular DMDs, and accordingly characterized by the effective angular increment omega eff. In each direction, the DM was calculated by moving the structure in radial steps of size delta (=0.1, 0.2, 0.5, 1 mm) until the specified isodose was crossed. Coverage estimation accuracy deltaQ was quantified as a function of the sampling parameters omega or omega eff and delta. The accuracy of coverage estimates depends on angular and radial DMD sampling parameters omega or omega eff and delta, as well as the employed sampling technique. Target deltaQ/ < l% and OAR /deltaQ/ < 3% can be achieved with sampling parameters omega or omega eef = 20 degrees, delta =1 mm. Better accuracy (target /deltaQ < 0.5% and OAR /deltaQ < approximately 1%) can be achieved with omega or omega eff = 10 degrees, delta = 0.5 mm. As the number of sampling points decreases, the isotropic sampling method maintains better accuracy than fixed angular sampling. Coverage estimates for post-planning evaluation are essential since coverage values of targets and OARs often differ from the values implied by the static margin-based plans. Finer sampling of the DMD enables more accurate assessment of the effect of geometric uncertainties on coverage estimates prior to treatment. DMD sampling with omega or omega eff = 10 degrees and delta = 0.5 mm should be adequate for planning purposes.

WE-EF-303-05: Development and Commissioning of Real-Time Imaging Function for Respiratory-Gated Spot-Scanning Proton Beam Therapy

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

Miyamoto, N; Takao, S; Matsuura, T

2015-06-15

Purpose: To realize real-time-image gated proton beam therapy (RGPT) for treating mobile tumors. Methods: The rotating gantry of spot scanning proton beam therapy has been designed to equip two x-ray fluoroscopy devices that enable real-time imaging of the internal fiducial markers during respiration. Three-dimensional position of the fiducial marker located near the tumor can be calculated from the fluoroscopic images obtained from orthogonal directions and therapeutic beam is gated only when the fiducial marker is within the predefined gating window. Image acquisition rate can be selected from discrete value ranging from 0.1 Hz to 30 Hz. In order to confirmmore » the effectiveness of RGPT and apply it clinically, clinical commissioning was conducted. Commissioning tests were categorized to main three parts including geometric accuracy, temporal accuracy and dosimetric evaluation. Results: Developed real-time imaging function has been installed and its basic performances have been confirmed. In the evaluation of geometric accuracy, coincidence of three-dimensional treatment room coordinate system and imaging coordinate system was confirmed to be less than 1 mm. Fiducial markers (gold sphere and coil) were able to be tracked in simulated clinical condition using an anthropomorphic chest phantom. In the evaluation of temporal accuracy, latency from image acquisition to gate on/off signal was about 60 msec in typical case. In dosimetric evaluation, treatment beam characteristics including beam irradiation position and dose output were stable in gated irradiation. Homogeneity indices to the mobile target were 0.99 (static), 0.89 (w/o gating, motion is parallel to direction of scan), 0.75 (w/o gating, perpendicular), 0.98 (w/ gating, parallel) and 0.93 (w/ gating, perpendicular). Dose homogeneity to the mobile target can be maintained in RGPT. Conclusion: Real-time imaging function utilizing x-ray fluoroscopy has been developed and commissioned successfully in order to realize RGPT. Funding Support: This research was partially supported by Japan Society for the Promotion of Science (JSPS) through the FIRST Program. Conflict of Interest: Prof. Shirato has research fund from Hitachi Ltd, Mitsubishi Heavy Industries Ltd and Shimadzu Corporation.« less

Effect of high-dose stereotactic body radiation therapy on liver function in the treatment of primary and metastatic liver malignancies using the Child-Pugh score classification system.

PubMed

Dyk, Pawel; Weiner, Ashley; Badiyan, Shahed; Myerson, Robert; Parikh, Parag; Olsen, Jeffrey

2015-01-01

The purpose of this study was to evaluate liver function after high-dose liver stereotactic body radiation therapy (SBRT) in the treatment of metastatic and primary malignancies of the liver using the Child-Pugh score classification system. This was a retrospective analysis of 46 patients treated with SBRT for metastatic and primary malignancies of the liver. Patient, disease, prior treatment, and SBRT dosimetric factors were analyzed to correlate with decline in Child-Pugh class after liver SBRT. Median follow-up was 11.0 months for patients alive at last follow-up. Twenty-three patients (50%) had primary liver malignancies. Median delivered dose was 55 Gy in 5 fractions (range, 36-60 Gy in 3-6 fractions) to 1 lesion (range, 1-4 lesions) measuring 4.0 cm (range, 1.3-12.4 cm). Forty-one patients (89%) received ≥50 Gy in 3 to 6 fractions. Child-Pugh score classification was A in 42 patients (91%). Seven patients (15%) received adjuvant chemotherapy or targeted therapy. Twenty-nine patients (63%) experienced an intrahepatic recurrence after treatment. Ten patients (22%) experienced a decline in Child-Pugh class at a median of 1.6 months (range, 0.2-6 months). Eighty percent experienced a one-category decline. Only the V20, V25, V30, and V50 were correlated with decline in Child-Pugh class on univariate analysis, with V25 being most significant (P = .027). A V25 >32% was associated with a 42% incidence of Child-Pugh class decline compared with 9% for V25 ≤32 (P = .029). For primary liver malignancies, a V25 >36% was associated with a 4-fold increase in the incidence of Child-Pugh class decline (60% vs 15%, P = .021). Approximately one-quarter of patients experience a decline in Child-Pugh class after high-dose liver SBRT. The V25 may be an important dosimetric parameter predicting decline in liver function after treatment. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

TL and OSL properties of beta irradiated Y2O3 nanocrystal

NASA Astrophysics Data System (ADS)

Shivaramu, N. J.; Lakshminarasappa, B. N.; Nagabhushana, K. R.; Tatumi, S. H.; Rocca, R. R.; Singh, Fouran

2017-05-01

Nanocrystalline yttrium oxide (Y2O3) is synthesized by low temperature sol-gel technique and synthesized material is annealed at 900°C. The annealed β-rayed Y2O3 two TL glows with prominent peak at 407 K and weak glow peak at 643 K were observed in all irradiated samples. It is found that TL glow peaks intensity linearly increases with increase in β-dose from 0.813 - 40.625 Gy. The TL kinetic parameters are calculated using glow curve deconvoluted (GCD) method. The TL glows exhibits general order kinetics. Intense optical stimulated luminescence (OSL) is observed in the Y2O3 sample. These material exhibits linearity and reproducibility and hence, it suggests that this material may be used as dosimetric applications.

Thermographic analysis of waveguide-irradiated insect pupae

NASA Astrophysics Data System (ADS)

Olsen, Richard G.; Hammer, Wayne C.

1982-01-01

Pupae of the insect Tenebrio molitor L. were thermographically imaged during waveguide irradiation through longitudinal slots. T. molitor pupae have been subjects of microwave-induced teratology for a number of years, but until now the smallness of the insect has prevented detailed dosimetry. High-resolution thermographic imaging equipment was used to obtain the magnitude and spatial distribution of absorbed microwave energy at three frequencies, 1.3, 5.95, and 10 GHz. The detail of the thermal images obtained is sufficient to show the differential heating of structures as small as a single insect leg. Results show that the electrical properties of the head, thorax, and abdomen are sufficiently different to seriously impair the usefulness of any theoretical dosimetric model of homogeneous composition. Some general features of correlation with a slab model in waveguide are given.

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.

Hippocampal dosimetry correlates with the change in neurocognitive function after hippocampal sparing during whole brain radiotherapy: a prospective study.

PubMed

Tsai, Ping-Fang; Yang, Chi-Cheng; Chuang, Chi-Cheng; Huang, Ting-Yi; Wu, Yi-Ming; Pai, Ping-Ching; Tseng, Chen-Kan; Wu, Tung-Ho; Shen, Yi-Liang; Lin, Shinn-Yn

2015-12-10

Whole brain radiotherapy (WBRT) has been the treatment of choice for patients with brain metastases. However, change/decline of neurocognitive functions (NCFs) resulting from impaired hippocampal neurogenesis might occur after WBRT. It is reported that conformal hippocampal sparing would provide the preservation of NCFs. Our study aims to investigate the hippocampal dosimetry and to demonstrate the correlation between hippocampal dosimetry and neurocognitive outcomes in patients receiving hippocampal sparing during WBRT (HS-WBRT). Forty prospectively recruited cancer patients underwent HS-WBRT for therapeutic or prophylactic purposes. Before receiving HS-WBRT, all participants received a battery of baseline neurocognitive assessment, including memory, executive functions and psychomotor speed. The follow-up neurocognitive assessment at 4 months after HS-WBRT was also performed. For the delivery of HS-WBRT, Volumetric Modulated Arc Therapy (VMAT) with two full arcs and two non-coplanar partial arcs was employed. For each treatment planning, dose volume histograms were generated for left hippocampus, right hippocampus, and the composite hippocampal structure respectively. Biologically equivalent doses in 2-Gy fractions (EQD2) assuming an alpha/beta ratio of 2 Gy were computed. To perform analyses addressing the correlation between hippocampal dosimetry and the change in scores of NCFs, pre- and post-HS-WBRT neurocognitive assessments were available in 24 patients in this study. Scores of NCFs were quite stable before and after HS-WBRT in terms of hippocampus-dependent memory. Regarding verbal memory, the corresponding EQD2 values of 0, 10, 50, 80 % irradiating the composite hippocampal structure with <12.60 Gy, <8.81, <7.45 Gy and <5.83 Gy respectively were significantly associated with neurocognitive preservation indicated by the immediate recall of Word List Test of Wechsler Memory Scale-III. According to logistic regression analyses, it was noted that dosimetric parameters specific to left sided hippocampus exerted an influence on immediate recall of verbal memory (adjusted odds ratio, 4.08; p-value, 0.042, predicting patients' neurocognitive decline after receiving HS-WBRT). Functional preservation by hippocampal sparing during WBRT is indeed achieved in our study. Providing that modern VMAT techniques can reduce the dose irradiating bilateral hippocampi below dosimetric threshold, patients should be recruited in prospective trials of hippocampal sparing during cranial irradiation to accomplish neurocognitive preservation while maintaining intracranial control. Current Controlled Trials NCT02504788.

Determination of dosimetric and kinetic features of gamma irradiated solid calcium ascorbate dihydrate using ESR spectroscopy

NASA Astrophysics Data System (ADS)

Tuner, H.

2013-01-01

Effects of gamma radiation on solid calcium ascorbate dihydrate were studied using electron spin resonance (ESR) spectroscopy. Irradiated samples were found to present two specific ESR lines with shoulder at low and high magnetic field sides. Structural and kinetic features of the radicalic species responsible for experimental ESR spectrum were explored through the variations of the signal intensities with applied microwave power, variable temperature, high-temperature annealing and room temperature storage time studies. Dosimetric potential of the sample was also determined using spectrum area and measured signal intensity measurements. It was concluded that three radicals with different spectroscopic and kinetic features were produced upon gamma irradiation.

Dosimetric and clinical experience in eye proton treatment at INFN-LNS

NASA Astrophysics Data System (ADS)

Cirrone, G. A. P.; Cuttone, G.; Di Rosa, F.; Lojacono, P.; Mongelli, V.; Lo Nigro, S.; Ott, J.; Patti, I. V.; Pittera, S.; Privitera, G.; Raffaele, L.; Reibaldi, A.; Russo, G.; Salamone, V.; Sabini, M. G.; Spatola, C.; Valastro, L. M.

2009-05-01

After six years of activity 155 patients have been treated inside the CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) facility. CATANA is the first and unique proton therapy facility in which the 62 MeV proton beams, accelerated by a Superconducting Cyclotron, are used for the radio-therapeutic treatments of choroidal and iris melanomas. Inside CATANA new absolute and relative dosimetric techniques have been developed in order to achieve the best results in terms of treatment precision and dose release accuracy. The follow-up results for 42 patients demonstrated the efficacy of high energy protons in the radiotherapeutic field and encouraged us in our activity in the battle against cancer

The dose-response of Harshaw TLD-700H.

PubMed

Velbeck, K J; Luo, L Z; Ramlo, M J; Rotunda, J E

2006-01-01

Harshaw TLD-700H (7LiF:Mg,Cu,P) was previously characterised for low- to high-dose ranges from 1 microGy to 20 Gy. This paper describes the studies and results of dose-response and linearity at much higher doses. TLD-700H is a near perfect dosimetric material with near tissue equivalence, flat energy response, and the ability to measure beta, gamma and X rays. These new results extend the applicability of Harshaw TLD-700H into more dosimetric measurement environments. The simple glow curve structure provides insignificant fade, eliminating special oven preparation methods experienced by other materials. The work presented in this paper quantifies the performance of Harshaw TLD-700H in extended ranges.

A computer simulated phantom study of tomotherapy dose optimization based on probability density functions (PDF) and potential errors caused by low reproducibility of PDF.

PubMed

Sheng, Ke; Cai, Jing; Brookeman, James; Molloy, Janelle; Christopher, John; Read, Paul

2006-09-01

Lung tumor motion trajectories measured by four-dimensional CT or dynamic MRI can be converted to a probability density function (PDF), which describes the probability of the tumor at a certain position, for PDF based treatment planning. Using this method in simulated sequential tomotherapy, we study the dose reduction of normal tissues and more important, the effect of PDF reproducibility on the accuracy of dosimetry. For these purposes, realistic PDFs were obtained from two dynamic MRI scans of a healthy volunteer within a 2 week interval. The first PDF was accumulated from a 300 s scan and the second PDF was calculated from variable scan times from 5 s (one breathing cycle) to 300 s. Optimized beam fluences based on the second PDF were delivered to the hypothetical gross target volume (GTV) of a lung phantom that moved following the first PDF The reproducibility between two PDFs varied from low (78%) to high (94.8%) when the second scan time increased from 5 s to 300 s. When a highly reproducible PDF was used in optimization, the dose coverage of GTV was maintained; phantom lung receiving 10%-20% prescription dose was reduced by 40%-50% and the mean phantom lung dose was reduced by 9.6%. However, optimization based on PDF with low reproducibility resulted in a 50% underdosed GTV. The dosimetric error increased nearly exponentially as the PDF error increased. Therefore, although the dose of the tumor surrounding tissue can be theoretically reduced by PDF based treatment planning, the reliability and applicability of this method highly depend on if a reproducible PDF exists and is measurable. By correlating the dosimetric error and PDF error together, a useful guideline for PDF data acquisition and patient qualification for PDF based planning can be derived.

An Improved Method of Heterogeneity Compensation for the Convolution / Superposition Algorithm

NASA Astrophysics Data System (ADS)

Jacques, Robert; McNutt, Todd

2014-03-01

Purpose: To improve the accuracy of convolution/superposition (C/S) in heterogeneous material by developing a new algorithm: heterogeneity compensated superposition (HCS). Methods: C/S has proven to be a good estimator of the dose deposited in a homogeneous volume. However, near heterogeneities electron disequilibrium occurs, leading to the faster fall-off and re-buildup of dose. We propose to filter the actual patient density in a position and direction sensitive manner, allowing the dose deposited near interfaces to be increased or decreased relative to C/S. We implemented the effective density function as a multivariate first-order recursive filter and incorporated it into GPU-accelerated, multi-energetic C/S implementation. We compared HCS against C/S using the ICCR 2000 Monte-Carlo accuracy benchmark, 23 similar accuracy benchmarks and 5 patient cases. Results: Multi-energetic HCS increased the dosimetric accuracy for the vast majority of voxels; in many cases near Monte-Carlo results were achieved. We defined the per-voxel error, %|mm, as the minimum of the distance to agreement in mm and the dosimetric percentage error relative to the maximum MC dose. HCS improved the average mean error by 0.79 %|mm for the patient volumes; reducing the average mean error from 1.93 %|mm to 1.14 %|mm. Very low densities (i.e. < 0.1 g / cm3) remained problematic, but may be solvable with a better filter function. Conclusions: HCS improved upon C/S's density scaled heterogeneity correction with a position and direction sensitive density filter. This method significantly improved the accuracy of the GPU based algorithm reaching the accuracy levels of Monte Carlo based methods with performance in a few tenths of seconds per beam. Acknowledgement: Funding for this research was provided by the NSF Cooperative Agreement EEC9731748, Elekta / IMPAC Medical Systems, Inc. and the Johns Hopkins University. James Satterthwaite provided the Monte Carlo benchmark simulations.

WE-AB-209-09: Optimization of Rotational Arc Station Parameter Optimized Radiation Therapy

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

Dong, P; Xing, L; Ungun, B

Purpose: To develop a fast optimization method for station parameter optimized radiation therapy (SPORT) and show that SPORT is capable of improving VMAT in both plan quality and delivery efficiency. Methods: The angular space from 0° to 360° was divided into 180 station points (SPs). A candidate aperture was assigned to each of the SPs based on the calculation results using a column generation algorithm. The weights of the apertures were then obtained by optimizing the objective function using a state-of-the-art GPU based Proximal Operator Graph Solver (POGS) within seconds. Apertures with zero or low weight were thrown out. Tomore » avoid being trapped in a local minimum, a stochastic gradient descent method was employed which also greatly increased the convergence rate of the objective function. The above procedure repeated until the plan could not be improved any further. A weighting factor associated with the total plan MU also indirectly controlled the complexities of aperture shapes. The number of apertures for VMAT and SPORT was confined to 180. The SPORT allowed the coexistence of multiple apertures in a single SP. The optimization technique was assessed by using three clinical cases (prostate, H&N and brain). Results: Marked dosimetric quality improvement was demonstrated in the SPORT plans for all three studied cases. Prostate case: the volume of the 50% prescription dose was decreased by 22% for the rectum. H&N case: SPORT improved the mean dose for the left and right parotids by 15% each. Brain case: the doses to the eyes, chiasm and inner ears were all improved. SPORT shortened the treatment time by ∼1 min for the prostate case, ∼0.5 min for brain case, and ∼0.2 min for the H&N case. Conclusion: The superior dosimetric quality and delivery efficiency presented here indicates that SPORT is an intriguing alternative treatment modality.« less

A computer simulated phantom study of tomotherapy dose optimization based on probability density functions (PDF) and potential errors caused by low reproducibility of PDF

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

Sheng, Ke; Cai Jing; Brookeman, James

2006-09-15

Lung tumor motion trajectories measured by four-dimensional CT or dynamic MRI can be converted to a probability density function (PDF), which describes the probability of the tumor at a certain position, for PDF based treatment planning. Using this method in simulated sequential tomotherapy, we study the dose reduction of normal tissues and more important, the effect of PDF reproducibility on the accuracy of dosimetry. For these purposes, realistic PDFs were obtained from two dynamic MRI scans of a healthy volunteer within a 2 week interval. The first PDF was accumulated from a 300 s scan and the second PDF wasmore » calculated from variable scan times from 5 s (one breathing cycle) to 300 s. Optimized beam fluences based on the second PDF were delivered to the hypothetical gross target volume (GTV) of a lung phantom that moved following the first PDF. The reproducibility between two PDFs varied from low (78%) to high (94.8%) when the second scan time increased from 5 s to 300 s. When a highly reproducible PDF was used in optimization, the dose coverage of GTV was maintained; phantom lung receiving 10%-20% prescription dose was reduced by 40%-50% and the mean phantom lung dose was reduced by 9.6%. However, optimization based on PDF with low reproducibility resulted in a 50% underdosed GTV. The dosimetric error increased nearly exponentially as the PDF error increased. Therefore, although the dose of the tumor surrounding tissue can be theoretically reduced by PDF based treatment planning, the reliability and applicability of this method highly depend on if a reproducible PDF exists and is measurable. By correlating the dosimetric error and PDF error together, a useful guideline for PDF data acquisition and patient qualification for PDF based planning can be derived.« less

Accounting for Shared and Unshared Dosimetric Uncertainties in the Dose Response for Ultrasound-Detected Thyroid Nodules after Exposure to Radioactive Fallout

PubMed Central

Hoffman, F. Owen; Moroz, Brian; Drozdovitch, Vladimir; Bouville, André; Beck, Harold; Luckyanov, Nicholas; Weinstock, Robert M.; Simon, Steven L.

2015-01-01

Dosimetic uncertainties, particularly those that are shared among subgroups of a study population, can bias, distort or reduce the slope or significance of a dose response. Exposure estimates in studies of health risks from environmental radiation exposures are generally highly uncertain and thus, susceptible to these methodological limitations. An analysis was published in 2008 concerning radiation-related thyroid nodule prevalence in a study population of 2,994 villagers under the age of 21 years old between August 1949 and September 1962 and who lived downwind from the Semi-palatinsk Nuclear Test Site in Kazakhstan. This dose-response analysis identified a statistically significant association between thyroid nodule prevalence and reconstructed doses of fallout-related internal and external radiation to the thyroid gland; however, the effects of dosimetric uncertainty were not evaluated since the doses were simple point “best estimates”. In this work, we revised the 2008 study by a comprehensive treatment of dosimetric uncertainties. Our present analysis improves upon the previous study, specifically by accounting for shared and unshared uncertainties in dose estimation and risk analysis, and differs from the 2008 analysis in the following ways: 1. The study population size was reduced from 2,994 to 2,376 subjects, removing 618 persons with uncertain residence histories; 2. Simulation of multiple population dose sets (vectors) was performed using a two-dimensional Monte Carlo dose estimation method; and 3. A Bayesian model averaging approach was employed for evaluating the dose response, explicitly accounting for large and complex uncertainty in dose estimation. The results were compared against conventional regression techniques. The Bayesian approach utilizes 5,000 independent realizations of population dose vectors, each of which corresponds to a set of conditional individual median internal and external doses for the 2,376 subjects. These 5,000 population dose vectors reflect uncertainties in dosimetric parameters, partly shared and partly independent, among individual members of the study population. Risk estimates for thyroid nodules from internal irradiation were higher than those published in 2008, which results, to the best of our knowledge, from explicitly accounting for dose uncertainty. In contrast to earlier findings, the use of Bayesian methods led to the conclusion that the biological effectiveness for internal and external dose was similar. Estimates of excess relative risk per unit dose (ERR/Gy) for males (177 thyroid nodule cases) were almost 30 times those for females (571 cases) and were similar to those reported for thyroid cancers related to childhood exposures to external and internal sources in other studies. For confirmed cases of papillary thyroid cancers (3 in males, 18 in females), the ERR/Gy was also comparable to risk estimates from other studies, but not significantly different from zero. These findings represent the first reported dose response for a radiation epidemiologic study considering all known sources of shared and unshared errors in dose estimation and using a Bayesian model averaging (BMA) method for analysis of the dose response. PMID:25574587

Uranium mining industry views on ICRP statement on radon.

PubMed

Takala, J

2012-01-01

In 2009, the International Commission on Radiological Protection issued a statement on radon which stated that the dose conversion factor for radon progeny would likely double, and the calculation of risk from radon should move to a dosimetric approach, rather than the longstanding epidemiological approach. Through the World Nuclear Association, whose members represent over 90% of the world's uranium production, industry has been examining this issue with a goal of offering expertise and knowledge to assist with the practical implementation of these evolutionary changes to evaluating the risk from radon progeny. Industry supports the continuing use of the most current epidemiological data as a basis for risk calculation, but believes that further examination of these results is needed to better understand the level of conservatism in the potential epidemiological-based risk models. With regard to adoption of the dosimetric approach, industry believes that further work is needed before this is a practical option. In particular, this work should include a clear demonstration of the validation of the dosimetric model which includes how smoking is handled, the establishment of a practical measurement protocol, and the collection of relevant data for modern workplaces. Industry is actively working to address the latter two items. Copyright © 2012. Published by Elsevier Ltd.

Effect of the embolization material in the dose calculation for stereotactic radiosurgery of arteriovenous malformations

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

Galván de la Cruz, Olga Olinca; Lárraga-Gutiérrez, José Manuel, E-mail: jlarraga@innn.edu.mx; Laboratorio de Física Médica, Instituto Nacional de Neurología y Neurocirugía

2013-07-01

It is reported in the literature that the material used in an embolization of an arteriovenous malformation (AVM) can attenuate the radiation beams used in stereotactic radiosurgery (SRS) up to 10% to 15%. The purpose of this work is to assess the dosimetric impact of this attenuating material in the SRS treatment of embolized AVMs, using Monte Carlo simulations assuming clinical conditions. A commercial Monte Carlo dose calculation engine was used to recalculate the dose distribution of 20 AVMs previously planned with a pencil beam dose calculation algorithm. Dose distributions were compared using the following metrics: average, minimal and maximummore » dose of AVM, and 2D gamma index. The effect in the obliteration rate was investigated using radiobiological models. It was found that the dosimetric impact of the embolization material is less than 1.0 Gy in the prescription dose to the AVM for the 20 cases studied. The impact in the obliteration rate is less than 4.0%. There is reported evidence in the literature that embolized AVMs treated with SRS have low obliteration rates. This work shows that there are dosimetric implications that should be considered in the final treatment decisions for embolized AVMs.« less

Can reduction of uncertainties in cervix cancer brachytherapy potentially improve clinical outcome?

PubMed

Nesvacil, Nicole; Tanderup, Kari; Lindegaard, Jacob C; Pötter, Richard; Kirisits, Christian

2016-09-01

The aim of this study was to quantify the impact of different types and magnitudes of dosimetric uncertainties in cervix cancer brachytherapy (BT) on tumour control probability (TCP) and normal tissue complication probability (NTCP) curves. A dose-response simulation study was based on systematic and random dose uncertainties and TCP/NTCP models for CTV and rectum. Large patient cohorts were simulated assuming different levels of dosimetric uncertainties. TCP and NTCP were computed, based on the planned doses, the simulated dose uncertainty, and an underlying TCP/NTCP model. Systematic uncertainties of 3-20% and random uncertainties with a 5-30% standard deviation per BT fraction were analysed. Systematic dose uncertainties of 5% lead to a 1% decrease/increase of TCP/NTCP, while random uncertainties of 10% had negligible impact on the dose-response curve at clinically relevant dose levels for target and OAR. Random OAR dose uncertainties of 30% resulted in an NTCP increase of 3-4% for planned doses of 70-80Gy EQD2. TCP is robust to dosimetric uncertainties when dose prescription is in the more flat region of the dose-response curve at doses >75Gy. For OARs, improved clinical outcome is expected by reduction of uncertainties via sophisticated dose delivery and treatment verification. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The dosimetric effects of tissue heterogeneities in intensity-modulated radiation therapy (IMRT) of the head and neck

NASA Astrophysics Data System (ADS)

Al-Hallaq, H. A.; Reft, C. S.; Roeske, J. C.

2006-03-01

The dosimetric effects of bone and air heterogeneities in head and neck IMRT treatments were quantified. An anthropomorphic RANDO phantom was CT-scanned with 16 thermoluminescent dosimeter (TLD) chips placed in and around the target volume. A standard IMRT plan generated with CORVUS was used to irradiate the phantom five times. On average, measured dose was 5.1% higher than calculated dose. Measurements were higher by 7.1% near the heterogeneities and by 2.6% in tissue. The dose difference between measurement and calculation was outside the 95% measurement confidence interval for six TLDs. Using CORVUS' heterogeneity correction algorithm, the average difference between measured and calculated doses decreased by 1.8% near the heterogeneities and by 0.7% in tissue. Furthermore, dose differences lying outside the 95% confidence interval were eliminated for five of the six TLDs. TLD doses recalculated by Pinnacle3's convolution/superposition algorithm were consistently higher than CORVUS doses, a trend that matched our measured results. These results indicate that the dosimetric effects of air cavities are larger than those of bone heterogeneities, thereby leading to a higher delivered dose compared to CORVUS calculations. More sophisticated algorithms such as convolution/superposition or Monte Carlo should be used for accurate tailoring of IMRT dose in head and neck tumours.

Cosmic radiation dose measurements from the RaD-X flight campaign

NASA Astrophysics Data System (ADS)

Mertens, Christopher J.; Gronoff, Guillaume P.; Norman, Ryan B.; Hayes, Bryan M.; Lusby, Terry C.; Straume, Tore; Tobiska, W. Kent; Hands, Alex; Ryden, Keith; Benton, Eric; Wiley, Scott; Gersey, Brad; Wilkins, Richard; Xu, Xiaojing

2016-10-01

The NASA Radiation Dosimetry Experiment (RaD-X) stratospheric balloon flight mission obtained measurements for improving the understanding of cosmic radiation transport in the atmosphere and human exposure to this ionizing radiation field in the aircraft environment. The value of dosimetric measurements from the balloon platform is that they can be used to characterize cosmic ray primaries, the ultimate source of aviation radiation exposure. In addition, radiation detectors were flown to assess their potential application to long-term, continuous monitoring of the aircraft radiation environment. The RaD-X balloon was successfully launched from Fort Sumner, New Mexico (34.5°N, 104.2°W) on 25 September 2015. Over 18 h of flight data were obtained from each of the four different science instruments at altitudes above 20 km. The RaD-X balloon flight was supplemented by contemporaneous aircraft measurements. Flight-averaged dosimetric quantities are reported at seven altitudes to provide benchmark measurements for improving aviation radiation models. The altitude range of the flight data extends from commercial aircraft altitudes to above the Pfotzer maximum where the dosimetric quantities are influenced by cosmic ray primaries. The RaD-X balloon flight observed an absence of the Pfotzer maximum in the measurements of dose equivalent rate.

Dosimetric characterization with 62 MeV protons of a silicon-segmented detector for 2D dose verifications in radiotherapy

NASA Astrophysics Data System (ADS)

Talamonti, C.; Bucciolini, M.; Marrazzo, L.; Menichelli, D.; Bruzzi, M.; Cirrone, G. A. P.; Cuttone, G.; LoJacono, P.

2008-10-01

Due to the features of the modern radiotherapy techniques, namely intensity modulated radiation therapy and proton therapy, where high spatial dose gradients are often present, detectors to be employed for 2D dose verifications have to satisfy very narrow requirements. In particular they have to show high spatial resolution. In the framework of the European Integrated Project—Methods and Advanced Equipment for Simulation and Treatment in Radio-Oncology (MAESTRO, no. LSHC-CT-2004-503564), a dosimetric detector adequate for 2D pre-treatment dose verifications was developed. It is a modular detector, based on a monolithic silicon-segmented sensor, with an n-type implantation on an epitaxial p-type layer. Each pixel element is 2×2 mm 2 and the distance center-to-center is 3 mm. The sensor is composed of 21×21 pixels. In this paper, we report the dosimetric characterization of the system with a proton beam. The sensor was irradiated with 62 MeV protons for clinical treatments at INFN-Laboratori Nazionali del Sud (LNS) Catania. The studied parameters were repeatability of a same pixel, response linearity versus absorbed dose, and dose rate and dependence on field size. The obtained results are promising since the performances are within the project specifications.

Effect of annealing temperature and dopant concentration on the thermoluminescence sensitivity in LiF:Mg,Cu,Ag material.

PubMed

Yahyaabadi, Akram; Torkzadeh, Falamarz; Rezaei Ochbelagh, Dariush; Hosseini Pooya, Seyed Mahdi

2018-04-24

LiF:Mg,Cu,Ag is a new dosimetry material that is similar to LiF:Mg,Cu,P in terms of dosimetric properties. The effect of the annealing temperature in the range of 200 to 350°C on the thermoluminescence (TL) sensitivity and the glow curve structure of this material at different concentrations of silver (Ag) was investigated. It has been demonstrated that the optimum values of the annealing temperature and the Ag concentration are 240°C and 0.1 mol% for better sensitivity, respectively. The TL intensity decreases at annealing temperatures lower than 240°C or higher than 240°C, reaching a minimum at 300°C and then again increases for various Ag concentrations. It was observed that the glow curve structure altered and the area under the low temperature peak as well as the area under the main dosimetric peak decreased with increasing annealing temperature. The position of the main dosimetric peak moved in the direction of higher temperatures, but at 320 and 350°C annealing temperatures, it shifted to lower temperatures. It was also observed that the TL sensitivity could partially be recovered by a combined annealing procedure. Copyright © 2018 John Wiley & Sons, Ltd.

Stereotactic multibeam radiation therapy system in a PACS environment

NASA Astrophysics Data System (ADS)

Fresne, Francoise; Le Gall, G.; Barillot, Christian; Gibaud, Bernard; Manens, Jean-Pierre; Toumoulin, Christine; Lemoine, Didier; Chenal, C.; Scarabin, Jean-Marie

1991-05-01

A Multibeam radiation therapy treatment is a non-invasive technique devoted to treat a lesion within the cerebral medium by focusing photon-beams on the same target from a high number of entrance points. We present here a computer assisted dosimetric planning procedure which includes: (1) an analysis module to define the target volume by using 2D and 3D displays, (2) a planing module to issue a treatment strategy including the dosimetric simulations and (3) a treatment module setting up the parameters to order the robotized treatment system (i.e. chair- framework, radiation unit machine). Another important feature of this system is its connection to the PACS system SIRENE settled in the University hospital of Rennes which makes possible the archiving and the communication of the multimodal images (CT, MRI, Angiography) used by this application. The corporate use of stereotactic methods and the multimodality imagery ensures spatial coherence and makes the target definition and the cognition of the structures environment more accurate. The dosimetric planning suited to the spatial reference (i.e. the stereotactic frame) guarantees an optimal distribution of the dose computed by an original 3D volumetric algorithm. The robotic approach of the treatment stage has consisted to design a computer driven chair-framework cluster to position the target volume at the radiation unit isocenter.

A detailed dosimetric comparison between manual and inverse plans in HDR intracavitary/interstitial cervical cancer brachytherapy.

PubMed

Trnková, Petra; Baltas, Dimos; Karabis, Andreas; Stock, Markus; Dimopoulos, Johannes; Georg, Dietmar; Pötter, Richard; Kirisits, Christian

2010-12-01

The purpose of this study was to compare two inverse planning algorithms for cervical cancer brachytherapy and a conventional manual treatment planning according to the MUW (Medical University of Vienna) protocol. For 20 patients, manually optimized, and, inversely optimized treatment plans with Hybrid Inverse treatment Planning and Optimization (HIPO) and with Inverse Planning Simulated Annealing (IPSA) were created. Dosimetric parameters, absolute volumes of normal tissue receiving reference doses, absolute loading times of tandem, ring and interstitial needles, Paddick and COIN conformity indices were evaluated. HIPO was able to achieve a similar dose distribution to manual planning with the restriction of high dose regions. It reduced the loading time of needles and the overall treatment time. The values of both conformity indices were the lowest. IPSA was able to achieve acceptable dosimetric results. However, it overloaded the needles. This resulted in high dose regions located in the normal tissue. The Paddick index for the volume of two times prescribed dose was outstandingly low. HIPO can produce clinically acceptable treatment plans with the elimination of high dose regions in normal tissue. Compared to IPSA, it is an inverse optimization method which takes into account current clinical experience gained from manual treatment planning.

A detailed dosimetric comparison between manual and inverse plans in HDR intracavitary/interstitial cervical cancer brachytherapy

PubMed Central

Baltas, Dimos; Karabis, Andreas; Stock, Markus; Dimopoulos, Johannes; Georg, Dietmar; Pötter, Richard; Kirisits, Christian

2011-01-01

Purpose The purpose of this study was to compare two inverse planning algorithms for cervical cancer brachytherapy and a conventional manual treatment planning according to the MUW (Medical University of Vienna) protocol. Material and methods For 20 patients, manually optimized, and, inversely optimized treatment plans with Hybrid Inverse treatment Planning and Optimization (HIPO) and with Inverse Planning Simulated Annealing (IPSA) were created. Dosimetric parameters, absolute volumes of normal tissue receiving reference doses, absolute loading times of tandem, ring and interstitial needles, Paddick and COIN conformity indices were evaluated. Results HIPO was able to achieve a similar dose distribution to manual planning with the restriction of high dose regions. It reduced the loading time of needles and the overall treatment time. The values of both conformity indices were the lowest. IPSA was able to achieve acceptable dosimetric results. However, it overloaded the needles. This resulted in high dose regions located in the normal tissue. The Paddick index for the volume of two times prescribed dose was outstandingly low. Conclusions HIPO can produce clinically acceptable treatment plans with the elimination of high dose regions in normal tissue. Compared to IPSA, it is an inverse optimization method which takes into account current clinical experience gained from manual treatment planning. PMID:27853479

Outcomes and Control Rates for I-125 Plaque Brachytherapy for Uveal Melanoma: A Community-Based Institutional Experience

PubMed Central

Cook, Taylor

2014-01-01

Purpose. To evaluate our community-based institutional experience with plaque brachytherapy for uveal melanomas with a focus on local control rates, factors impacting disease progression, and dosimetric parameters impacting treatment toxicity. Methods and Materials. Our institution was retrospectively reviewed from 1996 to 2011; all patients who underwent plaque brachytherapy for uveal melanoma were included. Follow-up data were collected regarding local control, distant metastases, and side effects from treatment. Analysis was performed on factors impacting treatment outcomes and treatment toxicity. Results. A total of 107 patients underwent plaque brachytherapy, of which 88 had follow-up data available. Local control at 10 years was 94%. Freedom from progression (FFP) and overall survival at 10 years were 83% and 79%, respectively. On univariate analysis, there were no tumor or dosimetric treatment characteristics that were found to have a prognostic impact on FFP. Brachytherapy treatment was well tolerated, with clinically useful vision (>20/200) maintained in 64% of patients. Statistically significant dosimetric relationships were established with cataract, glaucoma, and retinopathy development (greatest P = 0.05). Conclusions. Treatment with plaque brachytherapy demonstrates excellent outcomes in a community-based setting. It is well tolerated and should remain a standard of care for COMS medium sized tumors. PMID:24734198

Cosmic Radiation Dose Measurements from the RaD-X Flight Campaign

NASA Technical Reports Server (NTRS)

Mertens, Christopher J.; Gronoff, Guillaume P.; Norman, Ryan B.; Hayes, Bryan M.; Lusby, Terry C.; Straume, Tore; Tobiska, W. Kent; Hands, Alex; Ryden, Keith; Benton, Eric;

Inter-patient image registration algorithms to disentangle regional dose bioeffects.

PubMed

Monti, Serena; Pacelli, Roberto; Cella, Laura; Palma, Giuseppe

2018-03-20

Radiation therapy (RT) technological advances call for a comprehensive reconsideration of the definition of dose features leading to radiation induced morbidity (RIM). In this context, the voxel-based approach (VBA) to dose distribution analysis in RT offers a radically new philosophy to evaluate local dose response patterns, as an alternative to dose-volume-histograms for identifying dose sensitive regions of normal tissue. The VBA relies on mapping patient dose distributions into a single reference case anatomy which serves as anchor for local dosimetric evaluations. The inter-patient elastic image registrations (EIRs) of the planning CTs provide the deformation fields necessary for the actual warp of dose distributions. In this study we assessed the impact of EIR on the VBA results in thoracic patients by identifying two state-of-the-art EIR algorithms (Demons and B-Spline). Our analysis demonstrated that both the EIR algorithms may be successfully used to highlight subregions with dose differences associated with RIM that substantially overlap. Furthermore, the inclusion for the first time of covariates within a dosimetric statistical model that faces the multiple comparison problem expands the potential of VBA, thus paving the way to a reliable voxel-based analysis of RIM in datasets with strong correlation of the outcome with non-dosimetric variables.

Breast conserving treatment for breast cancer: dosimetric comparison of sequential versus simultaneous integrated photon boost.

PubMed

Van Parijs, Hilde; Reynders, Truus; Heuninckx, Karina; Verellen, Dirk; Storme, Guy; De Ridder, Mark

2014-01-01

Breast conserving surgery followed by whole breast irradiation is widely accepted as standard of care for early breast cancer. Addition of a boost dose to the initial tumor area further reduces local recurrences. We investigated the dosimetric benefits of a simultaneously integrated boost (SIB) compared to a sequential boost to hypofractionate the boost volume, while maintaining normofractionation on the breast. For 10 patients 4 treatment plans were deployed, 1 with a sequential photon boost, and 3 with different SIB techniques: on a conventional linear accelerator, helical TomoTherapy, and static TomoDirect. Dosimetric comparison was performed. PTV-coverage was good in all techniques. Conformity was better with all SIB techniques compared to sequential boost (P = 0.0001). There was less dose spilling to the ipsilateral breast outside the PTVboost (P = 0.04). The dose to the organs at risk (OAR) was not influenced by SIB compared to sequential boost. Helical TomoTherapy showed a higher mean dose to the contralateral breast, but less than 5 Gy for each patient. SIB showed less dose spilling within the breast and equal dose to OAR compared to sequential boost. Both helical TomoTherapy and the conventional technique delivered acceptable dosimetry. SIB seems a safe alternative and can be implemented in clinical routine.

Impact of organ shape variations on margin concepts for cervix cancer ART.

PubMed

Seppenwoolde, Yvette; Stock, Markus; Buschmann, Martin; Georg, Dietmar; Bauer-Novotny, Kwei-Yuang; Pötter, Richard; Georg, Petra

2016-09-01

Target and organ movement motivate adaptive radiotherapy for cervix cancer patients. We investigated the dosimetric impact of margin concepts with different levels of complexity on both organ at risk (OAR) sparing and PTV coverage. Weekly CT and daily CBCT scans were delineated for 10 patients. The dosimetric impact of organ shape variations were evaluated for four (isotropic) margin concepts: two static PTVs (PTV 6mm and PTV 15mm ), a PTV based on ITV of the planning CT and CBCTs of the first treatment week (PTV ART ITV ) and an adaptive PTV based on a library approach (PTV ART Library ). Using static concepts, OAR doses increased with large margins, while smaller margins compromised target coverage. ART PTVs resulted in comparable target coverage and better sparing of bladder (V40Gy: 15% and 7% less), rectum (V40Gy: 18 and 6cc less) and bowel (V40Gy: 106 and 15cc less) compared to PTV 15mm . Target coverage evaluation showed that for elective fields a static 5mm margin sufficed. PTV ART Library achieved the best dosimetric results. However when weighing clinical benefit against workload, ITV margins based on repetitive movement evaluation during the first week also provide improvements over static margin concepts. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

An alternative method for immediate dose estimation using CaSO4:Dy based TLD badges

NASA Astrophysics Data System (ADS)

Singh, A. K.; Menon, S. N.; Dhabekar, Bhushan; Kadam, Sonal; Chougaonkar, M. P.; Babu, D. A. R.

2014-11-01

CaSO4:Dy based Thermoluminescence dosimeters (TLDs) are being used in country wide personnel monitoring program in India. The TL glow curve of CaSO4:Dy consists of a dosimetric peak at 220 °C and a low temperature peak at 120 °C which is unstable at room temperature. The TL integral counts in CaSO4:Dy reduces by 15% in seven days after irradiation due to the thermal fading of 120 °C TL peak. As the dosimetric procedure involves total integrated counts for dose conversion, the dosimeters are typically read about a week after receiving. However in the event of a suspected over exposure, where urgent processing is expected, this poses limitation. Post irradiation annealing treatment is used in such cases of immediate readout of cards. In this paper we report a new and easier to use technique based on optical bleaching for the urgent processing of TLD cards. Optical bleaching with green LED (∼555 nm photons) of 25,000 lux for one and half hour removes the low temperature TL peak without affecting the dosimetric peak. This method can be used for immediate dose estimation using CaSO4:Dy based TLD badges.

Breast Conserving Treatment for Breast Cancer: Dosimetric Comparison of Sequential versus Simultaneous Integrated Photon Boost

PubMed Central

Reynders, Truus; Heuninckx, Karina; Verellen, Dirk; Storme, Guy; De Ridder, Mark

2014-01-01

Background. Breast conserving surgery followed by whole breast irradiation is widely accepted as standard of care for early breast cancer. Addition of a boost dose to the initial tumor area further reduces local recurrences. We investigated the dosimetric benefits of a simultaneously integrated boost (SIB) compared to a sequential boost to hypofractionate the boost volume, while maintaining normofractionation on the breast. Methods. For 10 patients 4 treatment plans were deployed, 1 with a sequential photon boost, and 3 with different SIB techniques: on a conventional linear accelerator, helical TomoTherapy, and static TomoDirect. Dosimetric comparison was performed. Results. PTV-coverage was good in all techniques. Conformity was better with all SIB techniques compared to sequential boost (P = 0.0001). There was less dose spilling to the ipsilateral breast outside the PTVboost (P = 0.04). The dose to the organs at risk (OAR) was not influenced by SIB compared to sequential boost. Helical TomoTherapy showed a higher mean dose to the contralateral breast, but less than 5 Gy for each patient. Conclusions. SIB showed less dose spilling within the breast and equal dose to OAR compared to sequential boost. Both helical TomoTherapy and the conventional technique delivered acceptable dosimetry. SIB seems a safe alternative and can be implemented in clinical routine. PMID:25162031

[Technique of complex mammary irradiation: Mono-isocentric 3D conformational radiotherapy and helical tomotherapy].

PubMed

Vandendorpe, B; Guilbert, P; Champagne, C; Antoni, T; Nguyen, T D; Gaillot-Petit, N; Servagi Vernat, S

2017-12-01

To evaluate the dosimetric contribution of helical tomotherapy for breast cancers compared with conformal radiotherapy in mono-isocentric technique. For 23 patients, the dosimetric results in mono-isocentric 3D conformational radiotherapy did not satisfy the constraints either of target volumes nor organs at risk. A prospective dosimetric comparison between mono-isocentric 3D conformational radiotherapy and helical tomotherapy was therefore carried out. The use of helical tomotherapy showed a benefit in these 23 patients, with either an improvement in the conformity index or homogeneity, but with an increase in low doses. Of the 23 patients, two had pectus excavatum, five had past thoracic irradiation and two required bilateral irradiation. The other 14 patients had a combination of morphology and/or indication of lymph node irradiation. For these patients, helical tomotherapy was therefore preferred to mono-isocentric 3D conformational radiotherapy. Tomotherapy appears to provide better homogeneity and tumour coverage. This technique of irradiation may be justified in the case of morphological situations such as pectus exavatum and in complex clinical situations. In other cases, conformal radiotherapy in mono-isocentric technique remains to be favoured. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

New Technique for Developing a Proton Range Compensator With Use of a 3-Dimensional Printer

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

Ju, Sang Gyu, E-mail: sg.ju@samsung.com; Kim, Min Kyu; Hong, Chae-Seon

2014-02-01

Purpose: A new system for manufacturing a proton range compensator (RC) was developed by using a 3-dimensional printer (3DP). The physical accuracy and dosimetric characteristics of the new RC manufactured by 3DP (RC{sub 3}DP) were compared with those of a conventional RC (RC{sub C}MM) manufactured by a computerized milling machine (CMM). Methods and Materials: An RC for brain tumor treatment with a scattered proton beam was calculated with a treatment planning system, and the resulting data were converted into a new format for 3DP using in-house software. The RC{sub 3}DP was printed with ultraviolet curable acrylic plastic, and an RC{submore » C}MM was milled into polymethylmethacrylate using a CMM. The inner shape of both RCs was scanned by using a 3D scanner and compared with TPS data by applying composite analysis (CA; with 1-mm depth difference and 1 mm distance-to-agreement criteria) to verify their geometric accuracy. The position and distal penumbra of distal dose falloff at the central axis and field width of the dose profile at the midline depth of spread-out Bragg peak were measured for the 2 RCs to evaluate their dosimetric characteristics. Both RCs were imaged on a computed tomography scanner to evaluate uniformity of internal density. The manufacturing times for both RCs were compared to evaluate the production efficiency. Results: The pass rates for the CA test were 99.5% and 92.5% for RC{sub 3}DP and RC{sub C}MM, respectively. There was no significant difference in dosimetric characteristics and uniformity of internal density between the 2 RCs. The net fabrication times of RC{sub 3}DP and RC{sub C}MM were about 18 and 3 hours, respectively. Conclusions: The physical accuracy and dosimetric characteristics of RC{sub 3}DP were comparable with those of the conventional RC{sub C}MM, and significant system minimization was provided.« less

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-F-T-224: Importance of Timely Review of Daily Cone-Beam CTs: Dosimetric Evaluation of Rejected CBCTs for Head and Neck Patients

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

Andrews, M; Yu, N; Joshi, N

Purpose: To dosimetrically evaluate the importance of timely reviewing daily CBCTs for patients with head and neck cancer. Methods: After each fraction daily cone-beam CT (CBCT) for head and neck patients are reviewed by physicians prior to next treatment. Physician rejected image registrations of CBCT were identified and analyzed for 17 patients. These CBCT images were rigidly fused with planning CT images and the contours from the planning CT were transferred to CBCTs. Because of limited extension in the superior-inferior dimension contours with partial volumes in CBCTs were discarded. The treatment isocenter was placed by applying the clinically recorded shiftsmore » to the volume isocenter of the CBCT. Dose was recalculated at the shifted isocenter using a homogeneous dose calculation algorithm. Dosimetrically relevant changes defined as greater than 5% deviation from the clinically accepted plans but with homogeneous dose calculation were evaluated for the high dose (HD), intermediate dose (ID), and low dose (LD) CTVs, spinal cord, larynx, oropharynx, parotids, and submandibular glands. Results: Among seventeen rejected CBCTS, HD-CTVs, ID-CTVs, and LD-CTVs were completely included in the CBCTs for 17, 1, and 15 patients, respectively. The prescription doses to the HD-CTV, ID-CTV, and LD-CTV were received by < 95% of the CTV volumes in 5/17, 1/1, and 5/15 patients respectively. For the spinal cord, the maximum doses (D0.03cc) were increased > 5% in 13 of 17 patients. For the oropharynx, larynx, parotid, and submandibular glands, the mean dose of these organs at risk was increased > 5% in 7/17, 8/12, 11/16 and 6/16 patients, respectively. Conclusion: Timely review daily CBCTs for head and neck patients under daily CBCT guidance is important, and uncorrected setup errors can translate to dosimetrically relevant dose increases in organsat- risk and dose decreases in the clinical target volumes.« less

Dosimetric impact of an air passage on intraluminal brachytherapy for bronchus cancer.

PubMed

Okamoto, Hiroyuki; Wakita, Akihisa; Nakamura, Satoshi; Nishioka, Shie; Aikawa, Ako; Kato, Toru; Abe, Yoshihisa; Kobayashi, Kazuma; Inaba, Koji; Murakami, Naoya; Itami, Jun

2016-11-01

The brachytherapy dose calculations used in treatment planning systems (TPSs) have conventionally been performed assuming homogeneous water. Using measurements and a Monte Carlo simulation, we evaluated the dosimetric impact of an air passage on brachytherapy for bronchus cancer. To obtain the geometrical characteristics of an air passage, we analyzed the anatomical information from CT images of patients who underwent intraluminal brachytherapy using a high-dose-rate 192 Ir source (MicroSelectron V2r®, Nucletron). Using an ionization chamber, we developed a measurement system capable of measuring the peripheral dose with or without an air cavity surrounding the catheter. Air cavities of five different radii (0.3, 0.5, 0.75, 1.25 and 1.5 cm) were modeled by cylindrical tubes surrounding the catheter. A Monte Carlo code (GEANT4) was also used to evaluate the dosimetric impact of the air cavity. Compared with dose calculations in homogeneous water, the measurements and GEANT4 indicated a maximum overdose of 5-8% near the surface of the air cavity (with the maximum radius of 1.5 cm). Conversely, they indicated a minimum overdose of ~1% in the region 3-5 cm from the cavity surface for the smallest radius of 0.3 cm. The dosimetric impact depended on the size and the distance of the air passage, as well as the length of the treatment region. Based on dose calculations in water, the TPS for intraluminal brachytherapy for bronchus cancer had an unexpected overdose of 3-5% for a mean radius of 0.75 cm. This study indicates the need for improvement in dose calculation accuracy with respect to intraluminal brachytherapy for bronchus cancer. © The Author 2016. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

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

NASA Astrophysics Data System (ADS)

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

2018-06-01

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

SU-E-T-448: Heightened Apical Positivity of 2-Year Post-Radiotherapy Biopsies Is Not Related to Suboptimal Dosimetry

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

Studenski, M; Stoyanova, R; Abramowitz, M

2015-06-15

Purpose: Previous research has demonstrated that following radiation therapy for prostate cancer, there is a relative increase in positive biopsies in the apex versus the rest of the prostate. The increase could be due to: 1) Inter-fraction apex motion or deformation, 2) Intra-fraction apex motion or deformation, 3) Suboptimal dose coverage in the apex, 4) Tissue composition in the apex and/or 5) Prostate size. In this initial study, the potential for suboptimal dose coverage in the apex was assessed by splitting the prostate planning target volume into the apex (inferior third) and remainder. Methods: 69 patients were selected from 303more » patients treated on a clinical radiotherapy trial for prostate cancer. These patients were selected as they had both a localized (sextant template) 2-year post-treatment biopsy and 3D dose information. Of these patients, 10 had positive biopsies in the apex, 8 in the remainder and 11 in both locations. For all patients, the following dosimetric data was acquired from the apex dose volume histogram: Dmean, Dmax, Dmin, D95% and V100%. Unpaired, one-tailed t-tests were used to test for statistical significance (p < 0.05) between all dosimetric parameters for patients with positive versus negative apical biopsies. Additionally, D95% for the apex was plotted against D95% of the remainder. Results: There was no statistical difference for the selected apical dosimetric parameters for patients with positive versus negative biopsies (p-values > 0.05). No correlation was found between D95% (normalized to the prescription dose) for the apex and remainder (R{sup 2} = 0.0116). Conclusion: No correlation was found between positive apical biopsy and suboptimal dosimetric coverage. Current research is looking into inter-fraction apex motion and deformation as a potential source of the increased apical failure using daily CBCT images.« less

The dosimetric impact of gadolinium-based contrast media in GBM brain patient plans for a MRI-Linac

NASA Astrophysics Data System (ADS)

Bilal Ahmad, Syed; Paudel, Moti Raj; Sarfehnia, Arman; Kim, Anthony; Pang, Geordi; Ruschin, Mark; Sahgal, Arjun; Keller, Brian M.

2017-08-01

Dosimetric effects of gadolinium based contrast media (Gadovist) were evaluated for the Elekta MRI linear accelerator using the research version of the Monaco treatment planning system (TPS). In order to represent a gadolinium uptake, the contrast was manually assigned to a phantom as well as to the gross tumour volume (GTV) of 6 glioblastoma multiforme (GBM) patients. A preliminary estimate of the dose enhancement, due to gadolinium, was performed using the phantom irradiated with a single beam. A more complicated assessment was performed for the GBM patients using a 7 field IMRT technique. The material table in Monaco was modified in order to identify the presence of a non-biological material. The dose distribution was modelled using GPUMCD (MC algorithm in Monaco) for an unmodified (or default) material table (DMT) as well as for a modified (or custom) material table (CMT) for both the phantom and patients. Various concentrations ranging between 8 and 157 mg ml-1 were used to represent the gadolinium uptake in the patient’s GTV. It was assumed that the gadolinium concentration remained the same for the entire course of radiation treatment. Results showed that at the tissue-Gadovist interface, inside the phantom, dose scored using the DMT was 7% lower compared to that using the CMT for 157 mg ml-1 concentration of gadolinium. Dosimetric differences in the case of the patient study were measured using the DVH parameters. D 50% was higher by 6% when the DMT was used compared to the CMT for dose modelling for a gadolinium concentration of 157 mg ml-1. This difference decreased gradually with decreasing concentration of gadolinium. It was concluded that dosimetric differences can be quantified in Monaco if the tumour-gadolinium concentration is more than 23 mg ml-1. If the gadolinium concentration is lower than 23 mg ml-1, then a correction for the presence of gadolinium may not be necessary in the TPS.

TH-E-BRE-05: Analysis of Dosimetric Characteristics in Two Leaf Motion Calculator Algorithms for Sliding Window IMRT

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

Wu, L; Huang, B; Rowedder, B

Purpose: The Smart leaf motion calculator (SLMC) in Eclipse treatment planning system is an advanced fluence delivery modeling algorithm as it takes into account fine MLC features including inter-leaf leakage, rounded leaf tips, non-uniform leaf thickness, and the spindle cavity etc. In this study, SLMC and traditional Varian LMC (VLMC) algorithms were investigated, for the first time, in dosimetric characteristics and delivery accuracy of sliding window (SW) IMRT. Methods: The SW IMRT plans of 51 cancer cases were included to evaluate dosimetric characteristics and dose delivery accuracy from leaf motion calculated by SLMC and VLMC, respectively. All plans were deliveredmore » using a Varian TrueBeam Linac. The DVH and MUs of the plans were analyzed. Three patient specific QA tools - independent dose calculation software IMSure, Delta4 phantom, and EPID portal dosimetry were also used to measure the delivered dose distribution. Results: Significant differences in the MUs were observed between the two LMCs (p≤0.001).Gamma analysis shows an excellent agreement between the planned dose distribution calculated by both LMC algorithms and delivered dose distribution measured by three QA tools in all plans at 3%/3 mm, leading to a mean pass rate exceeding 97%. The mean fraction of pixels with gamma < 1 of SLMC is slightly lower than that of VLMC in the IMSure and Delta4 results, but higher in portal dosimetry (the highest spatial resolution), especially in complex cases such as nasopharynx. Conclusion: The study suggests that the two LMCs generates the similar target coverage and sparing patterns of critical structures. However, SLMC is modestly more accurate than VLMC in modeling advanced MLC features, which may lead to a more accurate dose delivery in SW IMRT. Current clinical QA tools might not be specific enough to differentiate the dosimetric discrepancies at the millimeter level calculated by these two LMC algorithms. NIH/NIGMS grant U54 GM104944, Lincy Endowed Assistant Professorship.« less

Co-registration of cone beam CT and planning CT in head and neck IMRT dose estimation: a feasible adaptive radiotherapy strategy

PubMed Central

Yip, C; Thomas, C; Michaelidou, A; James, D; Lynn, R; Lei, M

2014-01-01

Objective: To investigate if cone beam CT (CBCT) can be used to estimate the delivered dose in head and neck intensity-modulated radiotherapy (IMRT). Methods: 15 patients (10 without replan and 5 with replan) were identified retrospectively. Weekly CBCT was co-registered with original planning CT. Original high-dose clinical target volume (CTV1), low-dose CTV (CTV2), brainstem, spinal cord, parotids and external body contours were copied to each CBCT and modified to account for anatomical changes. Corresponding planning target volumes (PTVs) and planning organ-at-risk volumes were created. The original plan was applied and calculated using modified per-treatment volumes on the original CT. Percentage volumetric, cumulative (planned dose delivered prior to CBCT + adaptive dose delivered after CBCT) and actual delivered (summation of weekly adaptive doses) dosimetric differences between each per-treatment and original plan were calculated. Results: There was greater volumetric change in the parotids with an average weekly difference of between −4.1% and −27.0% compared with the CTVs/PTVs (−1.8% to −5.0%). The average weekly cumulative dosimetric differences were as follows: CTV/PTV (range, −3.0% to 2.2%), ipsilateral parotid volume receiving ≥26 Gy (V26) (range, 0.5–3.2%) and contralateral V26 (range, 1.9–6.3%). In patients who required replan, the average volumetric reductions were greater: CTV1 (−2.5%), CTV2 (−6.9%), PTV1 (−4.7%), PTV2 (−11.5%), ipsilateral (−10.4%) and contralateral parotids (−12.1%), but did not result in significant dosimetric changes. Conclusion: The dosimetric changes during head and neck simultaneous integrated boost IMRT do not necessitate adaptive radiotherapy in most patients. Advances in knowledge: Our study shows that CBCT could be used for dose estimation during head and neck IMRT. PMID:24288402

WE-G-BRA-04: Common Errors and Deficiencies in Radiation Oncology Practice

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

Kry, S; Dromgoole, L; Alvarez, P

Purpose: Dosimetric errors in radiotherapy dose delivery lead to suboptimal treatments and outcomes. This work reviews the frequency and severity of dosimetric and programmatic errors identified by on-site audits performed by the IROC Houston QA center. Methods: IROC Houston on-site audits evaluate absolute beam calibration, relative dosimetry data compared to the treatment planning system data, and processes such as machine QA. Audits conducted from 2000-present were abstracted for recommendations, including type of recommendation and magnitude of error when applicable. Dosimetric recommendations corresponded to absolute dose errors >3% and relative dosimetry errors >2%. On-site audits of 1020 accelerators at 409 institutionsmore » were reviewed. Results: A total of 1280 recommendations were made (average 3.1/institution). The most common recommendation was for inadequate QA procedures per TG-40 and/or TG-142 (82% of institutions) with the most commonly noted deficiency being x-ray and electron off-axis constancy versus gantry angle. Dosimetrically, the most common errors in relative dosimetry were in small-field output factors (59% of institutions), wedge factors (33% of institutions), off-axis factors (21% of institutions), and photon PDD (18% of institutions). Errors in calibration were also problematic: 20% of institutions had an error in electron beam calibration, 8% had an error in photon beam calibration, and 7% had an error in brachytherapy source calibration. Almost all types of data reviewed included errors up to 7% although 20 institutions had errors in excess of 10%, and 5 had errors in excess of 20%. The frequency of electron calibration errors decreased significantly with time, but all other errors show non-significant changes. Conclusion: There are many common and often serious errors made during the establishment and maintenance of a radiotherapy program that can be identified through independent peer review. Physicists should be cautious, particularly in areas highlighted herein that show a tendency for errors.« less

Dosimetric and Late Radiation Toxicity Comparison Between Iodine-125 Brachytherapy and Stereotactic Radiation Therapy for Juxtapapillary Choroidal Melanoma

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

Krema, Hatem, E-mail: htmkrm19@yahoo.com; Heydarian, Mostafa; Beiki-Ardakani, Akbar

2013-07-01

Purpose: To compare the dose distributions and late radiation toxicities for {sup 125}I brachytherapy (IBT) and stereotactic radiation therapy (SRT) in the treatment of juxtapapillary choroidal melanoma. Methods: Ninety-four consecutive patients with juxtapapillary melanoma were reviewed: 30 have been treated with IBT and 64 with SRT. Iodine-125 brachytherapy cases were modeled with plaque simulator software for dosimetric analysis. The SRT dosimetric data were obtained from the Radionics XKnife RT3 software. Mean doses at predetermined intraocular points were calculated. Kaplan-Meier estimates determined the actuarial rates of late toxicities, and the log–rank test compared the estimates. Results: The median follow-up was 46more » months in both cohorts. The 2 cohorts were balanced with respect to pretreatment clinical and tumor characteristics. Comparisons of radiation toxicity rates between the IBT and SRT cohorts yielded actuarial rates at 50 months for cataracts of 62% and 75% (P=.1), for neovascular glaucoma 8% and 47% (P=.002), for radiation retinopathy 59% and 89% (P=.0001), and for radiation papillopathy 39% and 74% (P=.003), respectively. Dosimetric comparisons between the IBT and SRT cohorts yielded mean doses of 12.8 and 14.1 Gy (P=.56) for the lens center, 17.6 and 19.7 Gy (P=.44) for the lens posterior pole, 13.9 and 10.8 Gy (P=.30) for the ciliary body, 61.9 and 69.7 Gy (P=.03) for optic disc center, and 48.9 and 60.1 Gy (P<.0001) for retina at 5-mm distance from tumor margin, respectively. Conclusions: Late radiation-induced toxicities were greater with SRT, which is secondary to the high-dose exposure inherent to the technique as compared with IBT. When technically feasible, IBT is preferred to treat juxtapapillary choroidal melanoma.« less

The dosimetric impact of gadolinium-based contrast media in GBM brain patient plans for a MRI-Linac.

PubMed

Ahmad, Syed Bilal; Paudel, Moti Raj; Sarfehnia, Arman; Kim, Anthony; Pang, Geordi; Ruschin, Mark; Sahgal, Arjun; Keller, Brian M

2017-08-01

Dosimetric effects of gadolinium based contrast media (Gadovist) were evaluated for the Elekta MRI linear accelerator using the research version of the Monaco treatment planning system (TPS). In order to represent a gadolinium uptake, the contrast was manually assigned to a phantom as well as to the gross tumour volume (GTV) of 6 glioblastoma multiforme (GBM) patients. A preliminary estimate of the dose enhancement, due to gadolinium, was performed using the phantom irradiated with a single beam. A more complicated assessment was performed for the GBM patients using a 7 field IMRT technique. The material table in Monaco was modified in order to identify the presence of a non-biological material. The dose distribution was modelled using GPUMCD (MC algorithm in Monaco) for an unmodified (or default) material table (DMT) as well as for a modified (or custom) material table (CMT) for both the phantom and patients. Various concentrations ranging between 8 and 157 mg ml -1 were used to represent the gadolinium uptake in the patient's GTV. It was assumed that the gadolinium concentration remained the same for the entire course of radiation treatment. Results showed that at the tissue-Gadovist interface, inside the phantom, dose scored using the DMT was 7% lower compared to that using the CMT for 157 mg ml -1 concentration of gadolinium. Dosimetric differences in the case of the patient study were measured using the DVH parameters. D 50% was higher by 6% when the DMT was used compared to the CMT for dose modelling for a gadolinium concentration of 157 mg ml -1 . This difference decreased gradually with decreasing concentration of gadolinium. It was concluded that dosimetric differences can be quantified in Monaco if the tumour-gadolinium concentration is more than 23 mg ml -1 . If the gadolinium concentration is lower than 23 mg ml -1 , then a correction for the presence of gadolinium may not be necessary in the TPS.

Assessment of dosimetric impact of system specific geometric distortion in an MRI only based radiotherapy workflow for prostate

NASA Astrophysics Data System (ADS)

Gustafsson, C.; Nordström, F.; Persson, E.; Brynolfsson, J.; Olsson, L. E.

2017-04-01

Dosimetric errors in a magnetic resonance imaging (MRI) only radiotherapy workflow may be caused by system specific geometric distortion from MRI. The aim of this study was to evaluate the impact on planned dose distribution and delineated structures for prostate patients, originating from this distortion. A method was developed, in which computer tomography (CT) images were distorted using the MRI distortion field. The displacement map for an optimized MRI treatment planning sequence was measured using a dedicated phantom in a 3 T MRI system. To simulate the distortion aspects of a synthetic CT (electron density derived from MR images), the displacement map was applied to CT images, referred to as distorted CT images. A volumetric modulated arc prostate treatment plan was applied to the original CT and the distorted CT, creating a reference and a distorted CT dose distribution. By applying the inverse of the displacement map to the distorted CT dose distribution, a dose distribution in the same geometry as the original CT images was created. For 10 prostate cancer patients, the dose difference between the reference dose distribution and inverse distorted CT dose distribution was analyzed in isodose level bins. The mean magnitude of the geometric distortion was 1.97 mm for the radial distance of 200-250 mm from isocenter. The mean percentage dose differences for all isodose level bins, were  ⩽0.02% and the radiotherapy structure mean volume deviations were  <0.2%. The method developed can quantify the dosimetric effects of MRI system specific distortion in a prostate MRI only radiotherapy workflow, separated from dosimetric effects originating from synthetic CT generation. No clinically relevant dose difference or structure deformation was found when 3D distortion correction and high acquisition bandwidth was used. The method could be used for any MRI sequence together with any anatomy of interest.

Assessment of dosimetric impact of system specific geometric distortion in an MRI only based radiotherapy workflow for prostate.

PubMed

Gustafsson, C; Nordström, F; Persson, E; Brynolfsson, J; Olsson, L E

2017-04-21

Dosimetric errors in a magnetic resonance imaging (MRI) only radiotherapy workflow may be caused by system specific geometric distortion from MRI. The aim of this study was to evaluate the impact on planned dose distribution and delineated structures for prostate patients, originating from this distortion. A method was developed, in which computer tomography (CT) images were distorted using the MRI distortion field. The displacement map for an optimized MRI treatment planning sequence was measured using a dedicated phantom in a 3 T MRI system. To simulate the distortion aspects of a synthetic CT (electron density derived from MR images), the displacement map was applied to CT images, referred to as distorted CT images. A volumetric modulated arc prostate treatment plan was applied to the original CT and the distorted CT, creating a reference and a distorted CT dose distribution. By applying the inverse of the displacement map to the distorted CT dose distribution, a dose distribution in the same geometry as the original CT images was created. For 10 prostate cancer patients, the dose difference between the reference dose distribution and inverse distorted CT dose distribution was analyzed in isodose level bins. The mean magnitude of the geometric distortion was 1.97 mm for the radial distance of 200-250 mm from isocenter. The mean percentage dose differences for all isodose level bins, were  ⩽0.02% and the radiotherapy structure mean volume deviations were  <0.2%. The method developed can quantify the dosimetric effects of MRI system specific distortion in a prostate MRI only radiotherapy workflow, separated from dosimetric effects originating from synthetic CT generation. No clinically relevant dose difference or structure deformation was found when 3D distortion correction and high acquisition bandwidth was used. The method could be used for any MRI sequence together with any anatomy of interest.

The impact of emphysema on dosimetric parameters for stereotactic body radiotherapy of the lung

PubMed Central

Ochiai, Satoru; Nomoto, Yoshihito; Yamashita, Yasufumi; Inoue, Tomoki; Murashima, Shuuichi; Hasegawa, Daisuke; Kurita, Yoshie; Watanabe, Yui; Toyomasu, Yutaka; Kawamura, Tomoko; Takada, Akinori; Noriko; Kobayashi, Shigeki; Sakuma, Hajime

2016-01-01

The purpose of this study was to evaluate the impact of emphysematous changes in lung on dosimetric parameters in stereotactic body radiation therapy (SBRT) for lung tumor. A total of 72 treatment plans were reviewed, and dosimetric factors [including homogeneity index (HI) and conformity index (CI)] were evaluated. Emphysematous changes in lung were observed in 43 patients (60%). Patients were divided into three groups according to the severity of emphysema: no emphysema (n = 29), mild emphysema (n = 22) and moderate to severe emphysema groups (n = 21). The HI (P < 0.001) and the CI (P = 0.029) were significantly different in accordance with the severity of emphysema in one-way analysis of variance (ANOVA). The HI value was significantly higher in the moderate to severe emphysema group compared with in the no emphysema (Tukey, P < 0.001) and mild emphysema groups (P = 0.002). The CI value was significantly higher in the moderate to severe emphysema group compared with in the no emphysema group (P = 0.044). In multiple linear regression analysis, the severity of emphysema (P < 0.001) and the mean material density of the lung within the PTV (P < 0.001) were significant factors for HI, and the mean density of the lung within the PTV (P = 0.005) was the only significant factor for CI. The mean density of the lung within the PTV was significantly different in accordance with the severity of emphysema (one-way ANOVA, P = 0.008) and the severity of emphysema (P < 0.001) was one of the significant factors for the density of the lung within the PTV in multiple linear regression analysis. Our results suggest that emphysematous changes in the lung significantly impact on several dosimetric parameters in SBRT, and they should be carefully evaluated before treatment planning. PMID:27380802

SU-E-T-332: Dosimetric Impact of Photon Energy and Treatment Technique When Knowledge Based Auto-Planning Is Implemented in Radiotherapy of Localized Prostate Cancer

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

Liu, Z; Kennedy, A; Larsen, E

2015-06-15

Purpose: The aim of this study was to investigate the dosimetric impact of the combination of photon energy and treatment technique on radiotherapy of localized prostate cancer when knowledge based planning was used. Methods: A total of 16 patients with localized prostate cancer were retrospectively retrieved from database and used for this study. For each patient, four types of treatment plans with different combinations of photon energy (6X and 10X) and treatment techniques (7-field IMRT and 2-arc VMAT) were created using a prostate DVH estimation model in RapidPlan™ and Eclipse treatment planning system (Varian Medical System). For any beam arrangement,more » DVH objectives and weighting priorities were generated based on the geometric relationship between the OAR and PTV. Photon optimization algorithm was used for plan optimization and AAA algorithm was used for final dose calculation. Plans were evaluated in terms of the pre-defined dosimetric endpoints for PTV, rectum, bladder, penile bulb, and femur heads. A Student’s paired t-test was used for statistical analysis and p > 0.05 was considered statistically significant. Results: For PTV, V95 was statistically similar among all four types of plans, though the mean dose of 10X plans was higher than that of 6X plans. VMAT plans showed higher heterogeneity index than IMRT plans. No statistically significant difference in dosimetry metrics was observed for rectum, bladder, and penile bulb among plan types. For left and right femur, VMAT plans had a higher mean dose than IMRT plans regardless of photon energy, whereas the maximum dose was similar. Conclusion: Overall, the dosimetric endpoints were similar regardless of photon energy and treatment techniques when knowledge based auto planning was used. Given the similarity in dosimetry metrics of rectum, bladder, and penile bulb, the genitourinary and gastrointestinal toxicities should be comparable among the selections of photon energy and treatment techniques.« less

Statistic and dosimetric criteria to assess the shift of the prescribed dose for lung radiotherapy plans when integrating point kernel models in medical physics: are we ready?

PubMed

Chaikh, Abdulhamid; Balosso, Jacques

2016-12-01

To apply the statistical bootstrap analysis and dosimetric criteria's to assess the change of prescribed dose (PD) for lung cancer to maintain the same clinical results when using new generations of dose calculation algorithms. Nine lung cancer cases were studied. For each patient, three treatment plans were generated using exactly the same beams arrangements. In plan 1, the dose was calculated using pencil beam convolution (PBC) algorithm turning on heterogeneity correction with modified batho (PBC-MB). In plan 2, the dose was calculated using anisotropic analytical algorithm (AAA) and the same PD, as plan 1. In plan 3, the dose was calculated using AAA with monitor units (MUs) obtained from PBC-MB, as input. The dosimetric criteria's include MUs, delivered dose at isocentre (Diso) and calculated dose to 95% of the target volume (D95). The bootstrap method was used to assess the significance of the dose differences and to accurately estimate the 95% confidence interval (95% CI). Wilcoxon and Spearman's rank tests were used to calculate P values and the correlation coefficient (ρ). Statistically significant for dose difference was found using point kernel model. A good correlation was observed between both algorithms types, with ρ>0.9. Using AAA instead of PBC-MB, an adjustment of the PD in the isocentre is suggested. For a given set of patients, we assessed the need to readjust the PD for lung cancer using dosimetric indices and bootstrap statistical method. Thus, if the goal is to keep on with the same clinical results, the PD for lung tumors has to be adjusted with AAA. According to our simulation we suggest to readjust the PD by 5% and an optimization for beam arrangements to better protect the organs at risks (OARs).

SU-F-BRE-04: Construction of 3D Printed Patient Specific Phantoms for Dosimetric Verification Measurements

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

Ehler, E; Higgins, P; Dusenbery, K

2014-06-15

Purpose: To validate a method to create per patient phantoms for dosimetric verification measurements. Methods: Using a RANDO phantom as a substitute for an actual patient, a model of the external features of the head and neck region of the phantom was created. A phantom was used instead of a human for two reasons: to allow for dosimetric measurements that would not be possible in-vivo and to avoid patient privacy issues. Using acrylonitrile butadiene styrene thermoplastic as the building material, a hollow replica was created using the 3D printer filled with a custom tissue equivalent mixture of paraffin wax, magnesiummore » oxide, and calcium carbonate. A traditional parallel-opposed head and neck plan was constructed. Measurements were performed with thermoluminescent dosimeters in both the RANDO phantom and in the 3D printed phantom. Calculated and measured dose was compared at 17 points phantoms including regions in high and low dose regions and at the field edges. On-board cone beam CT was used to localize both phantoms within 1mm and 1° prior to radiation. Results: The maximum difference in calculated dose between phantoms was 1.8% of the planned dose (180 cGy). The mean difference between calculated and measured dose in the anthropomorphic phantom and the 3D printed phantom was 1.9% ± 2.8% and −0.1% ± 4.9%, respectively. The difference between measured and calculated dose was determined in the RANDO and 3D printed phantoms. The differences between measured and calculated dose in each respective phantom was within 2% for 12 of 17 points. The overlap of the RANDO and 3D printed phantom was 0.956 (Jaccard Index). Conclusion: A custom phantom was created using a 3D printer. Dosimetric calculations and measurements showed good agreement between the dose in the RANDO phantom (patient substitute) and the 3D printed phantom.« less

SU-G-TeP1-05: Development and Clinical Introduction of Automated Radiotherapy Treatment Planning for Prostate Cancer

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

Winkel, D; Bol, GH; Asselen, B van

Purpose: To develop an automated radiotherapy treatment planning and optimization workflow for prostate cancer in order to generate clinical treatment plans. Methods: A fully automated radiotherapy treatment planning and optimization workflow was developed based on the treatment planning system Monaco (Elekta AB, Stockholm, Sweden). To evaluate our method, a retrospective planning study (n=100) was performed on patients treated for prostate cancer with 5 field intensity modulated radiotherapy, receiving a dose of 35×2Gy to the prostate and vesicles and a simultaneous integrated boost of 35×0.2Gy to the prostate only. A comparison was made between the dosimetric values of the automatically andmore » manually generated plans. Operator time to generate a plan and plan efficiency was measured. Results: A comparison of the dosimetric values show that automatically generated plans yield more beneficial dosimetric values. In automatic plans reductions of 43% in the V72Gy of the rectum and 13% in the V72Gy of the bladder are observed when compared to the manually generated plans. Smaller variance in dosimetric values is seen, i.e. the intra- and interplanner variability is decreased. For 97% of the automatically generated plans and 86% of the clinical plans all criteria for target coverage and organs at risk constraints are met. The amount of plan segments and monitor units is reduced by 13% and 9% respectively. Automated planning requires less than one minute of operator time compared to over an hour for manual planning. Conclusion: The automatically generated plans are highly suitable for clinical use. The plans have less variance and a large gain in time efficiency has been achieved. Currently, a pilot study is performed, comparing the preference of the clinician and clinical physicist for the automatic versus manual plan. Future work will include expanding our automated treatment planning method to other tumor sites and develop other automated radiotherapy workflows.« less

SU-G-BRA-15: Dosimetric Evaluation of Dynamic Tumor Tracking Radiation Therapy Using Digital Phantom: A Study On Margin and Desired Accuracy of Tracking

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

Uchida, T; Osanai, M; Homma, N

2016-06-15

Purpose: Dynamic tumor tracking radiation therapy can potentially reduce internal margin without prolongation of irradiation time. However, dynamic tumor tracking technique requires an extra margin (tracking margin, TM) for the uncertainty of tumor localization, prediction, and beam repositioning. The purpose of this study was to evaluate a dosimetric impact caused by TM. Methods: We used 4D XCAT to create 9 digital phantom datasets of different tumor size and motion range: tumor diameter TD=(1, 3, 5) cm and motion range MR=(1, 2, 3) cm. For each dataset, respiratory gating (30%–70% phase) and tumor tracking treatment plans were created using 8-field 3D-CRTmore » by 4D dose calculation implemented in RayStation. The dose constraint was based on RTOG0618. For the tracking plan, TMs of (0, 2.5, 5) mm were considered by surrounding a normal setup margin: SM=5 mm. We calculated V20 of normal lung to evaluate the dosimetric impact for each case, and estimated an equivalent TM that affects the same impact on V20 obtained by the gated plan. Results: The equivalent TMs for (TD=1 cm, MR=2 cm), (TD=1 cm, MR=3 cm), (TD=5 cm, MR=2 cm), and (TD=5 cm, MR=3 cm) were estimated as 1.47 mm, 3.95 mm, 1.04 mm, and 2.13 mm, respectively. The larger the tumor size, the equivalent TM became smaller. On the other hand, the larger the motion range, the equivalent TM was found to be increased. Conclusion: Our results showed the equivalent TM changes depending on tumor size and motion range. The tracking plan with TM less than the equivalent TM achieves a dosimetric impact better than the gated plan in less treatment time. This study was partially supported by JSPS Kakenhi and Varian Medical Systems.« less

Dosimetric Implications of Residual Tracking Errors During Robotic SBRT of Liver Metastases

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

Chan, Mark; Tuen Mun Hospital, Hong Kong; Grehn, Melanie

Purpose: Although the metric precision of robotic stereotactic body radiation therapy in the presence of breathing motion is widely known, we investigated the dosimetric implications of breathing phase–related residual tracking errors. Methods and Materials: In 24 patients (28 liver metastases) treated with the CyberKnife, we recorded the residual correlation, prediction, and rotational tracking errors from 90 fractions and binned them into 10 breathing phases. The average breathing phase errors were used to shift and rotate the clinical tumor volume (CTV) and planning target volume (PTV) for each phase to calculate a pseudo 4-dimensional error dose distribution for comparison with themore » original planned dose distribution. Results: The median systematic directional correlation, prediction, and absolute aggregate rotation errors were 0.3 mm (range, 0.1-1.3 mm), 0.01 mm (range, 0.00-0.05 mm), and 1.5° (range, 0.4°-2.7°), respectively. Dosimetrically, 44%, 81%, and 92% of all voxels differed by less than 1%, 3%, and 5% of the planned local dose, respectively. The median coverage reduction for the PTV was 1.1% (range in coverage difference, −7.8% to +0.8%), significantly depending on correlation (P=.026) and rotational (P=.005) error. With a 3-mm PTV margin, the median coverage change for the CTV was 0.0% (range, −1.0% to +5.4%), not significantly depending on any investigated parameter. In 42% of patients, the 3-mm margin did not fully compensate for the residual tracking errors, resulting in a CTV coverage reduction of 0.1% to 1.0%. Conclusions: For liver tumors treated with robotic stereotactic body radiation therapy, a safety margin of 3 mm is not always sufficient to cover all residual tracking errors. Dosimetrically, this translates into only small CTV coverage reductions.« less

Individualized Margins in 3D Conformal Radiotherapy Planning for Lung Cancer: Analysis of Physiological Movements and Their Dosimetric Impacts

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

Germain, Francois; Beaulieu, Luc; Fortin, Andre

2008-04-01

In conformal radiotherapy planning for lung cancer, respiratory movements are not taken into account when a single computed tomography (CT) scan is performed. This study examines tumor movements to design individualized margins to account for these movements and evaluates their dosimetric impacts on planning volume. Fifteen patients undergoing CT-based planning for radical radiotherapy for localized lung cancer formed the study cohort. A reference plan was constructed based on reference gross, clinical, and planning target volumes (rGTV, rCTV, and rPTV, respectively). The reference plans were compared with individualized plans using individualized margins obtained by using 5 serial CT scans to generatemore » individualized target volumes (iGTV, iCTV, and iPTV). Three-dimensional conformal radiation therapy was used for plan generation using 6- and 23-MV photon beams. Ten plans for each patient were generated and dose-volume histograms (DVHs) were calculated. Comparisons of volumetric and dosimetric parameters were performed using paired Student t-tests. Relative to the rGTV, the total volume occupied by the superimposed GTVs increased progressively with each additional CT scans. With the use of all 5 scans, the average increase in GTV was 52.1%. For the plans with closest dosimetric coverage, target volume was smaller (iPTV/rPTV ratio 0.808) but lung irradiation was only slightly decreased. Reduction in the proportion of lung tissue that received 20 Gy or more outside the PTV (V20) was observed both for 6-MV plans (-0.73%) and 23-MV plans (-0.65%), with p = 0.02 and p = 0.04, respectively. In conformal RT planning for the treatment of lung cancer, the use of serial CT scans to evaluate respiratory motion and to generate individualized margins to account for these motions produced only a limited lung sparing advantage.« less

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

Su, M; Sura, S

Purpose: To evaluate dosimetric impact of two axillary nodes (AX) boost techniques: (1) posterior-oblique optimized field boost (POB), (2) traditional posterior-anterior boost (PAB) with field optimization (O-PAB), for a postmastectomy breast patient with positive axillary lymph nodes. Methods: Five patients, 3 left and 2 right chest walls, were included in this study. All patients were simulated in 5mm CT slice thickness. Supraclavicular (SC) and level I/II/III AX were contoured based on the RTOG atlas guideline. Five treatment plans, (1) tangential chest wall, (2) oblique SC including AX, (3) PAB, O-PAB and POB, were created for each patient. Three plan sumsmore » (PS) were generated by sum one of (3) plan with plan (1) and (2). The field optimization was done through PS dose distribution, which included a field adjustment, a fractional dose, a calculation location and a gantry angle selection for POB. A dosimetric impact was evaluated by comparing a SC and AX coverage, a PS maximum dose, an irradiated area percentage volume received dose over 105% prescription dose (V105), an ipsi-laterial mean lung dose (MLD), an ipsi-laterial mean humeral head dose (MHHD), a mean heart dose (MHD) (for left case only) and their DVH amount these three technique. Results: O-PAB, POB and PAB dosimetric results showed that there was no significant different on SC and AX coverage (p>0.43) and MHD (p>0.16). The benefit of sparing lung irradiation from PAB to O-PAB to POB was significant (p<0.004). PAB showed a highest PS maximum dose (p<0.005), V105 (p<0.023) and MLD (compared with OPAB, p=0.055). MHHD showed very sensitive to the patient arm positioning and anatomy. O-PAB convinced a lower MHHD than PAB (p=0.03). Conclusion: 3D CT contouring plays main role in accuracy radiotherapy. Dosimetric advantage of POB and O-PAB was observed for a better normal tissue irradiation sparing.« less

External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison

PubMed Central

Melchert, Corinna; Kovács, György

2016-01-01

Purpose This study aims to compare the dosimetric data of local tumor's bed dose escalation (boost) with photon beams (external beam radiation therapy – EBRT) versus high-dose-rate interstitial brachytherapy (HDR-BT) after breast-conserving treatment in women with early-stage breast cancer. Material and methods We analyzed the treatment planning data of 136 irradiated patients, treated between 2006 and 2013, who underwent breast-conserving surgery and adjuvant whole breast irradiation (WBI; 50.4 Gy) and boost (HDR-BT: 10 Gy in one fraction [n = 36]; EBRT: 10 Gy in five fractions [n = 100]). Organs at risk (OAR; heart, ipsilateral lung, skin, most exposed rib segment) were delineated. Dosimetric parameters were calculated with the aid of dose-volume histograms (DVH). A non-parametric test was performed to compare the two different boost forms. Results There was no difference for left-sided cancers regarding the maximum dose to the heart (HDR-BT 29.8% vs. EBRT 29.95%, p = 0.34). The maximum doses to the other OAR were significantly lower for HDR-BT (Dmax lung 47.12% vs. 87.7%, p < 0.01; rib 61.17% vs. 98.5%, p < 0.01; skin 57.1% vs. 94.75%, p < 0.01; in the case of right-sided breast irradiation, dose of the heart 6.00% vs. 16.75%, p < 0.01). Conclusions Compared to EBRT, local dose escalation with HDR-BT presented a significant dose reduction to the investigated OAR. Only left-sided irradiation showed no difference regarding the maximum dose to the heart. Reducing irradiation exposure to OAR could result in a reduction of long-term side effects. Therefore, from a dosimetric point of view, an interstitial boost complementary to WBI via EBRT seems to be more advantageous in the adjuvant radiotherapy of breast cancer. PMID:27648082

Dosimetric predictors of acute hematologic toxicity in cervical cancer patients treated with concurrent cisplatin and intensity-modulated pelvic radiotherapy

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

Mell, Loren K.; Kochanski, Joel D.; Department of Radiation and Cellular Oncology, University of Illinois at Chicago, Chicago, IL

Purpose: To identify dosimetric parameters associated with acute hematologic toxicity (HT) and chemotherapy delivery in cervical cancer patients undergoing concurrent chemotherapy and intensity-modulated pelvic radiotherapy. Methods and Materials: We analyzed 37 cervical cancer patients receiving concurrent cisplatin (40 mg/m{sup 2}/wk) and intensity-modulated pelvic radiotherapy. Pelvic bone marrow (BM) was contoured for each patient and divided into three subsites: lumbosacral spine, ilium, and lower pelvis. The volume of each region receiving 10, 20, 30, and {>=}40 Gy (V{sub 1}, V{sub 2}, V{sub 3}, and V{sub 4}, respectively) was calculated. HT was graded according to Radiation Therapy Oncology Group system. Multivariate regressionmore » models were used to test associations between dosimetric parameters and HT and chemotherapy delivery. Results: Increased pelvic BM V{sub 1} (BM-V{sub 1}) was associated with an increased Grade 2 or worse leukopenia and neutropenia (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.24-3.53; p = 0.006; and OR, 1.41; 95% CI, 1.02-1.94; p = 0.037, respectively). Patients with BM-V{sub 1} {>=}90% had higher rates of Grade 2 or worse leukopenia and neutropenia than did patients with BM-V{sub 1} <90% (11.1% vs. 73.7%, p < 0.01; and 5.6% vs. 31.6%, p = 0.09) and were more likely to have chemotherapy held on univariate (16.7% vs. 47.4%, p = 0.08) and multivariate (OR, 32.2; 95% CI, 1.67-622; p = 0.02) analysis. No associations between HT and V{sub 3} and V{sub 4} were observed. Dosimetric parameters involving the lumbosacral spine and lower pelvis had stronger associations with HT than did those involving the ilium. Conclusion: The volume of pelvic BM receiving low-dose radiation is associated with HT and chemotherapy delivery in cervical cancer patients undergoing concurrent chemoradiotherapy.« less

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.

Single-fraction flattening filter–free volumetric modulated arc therapy for lung cancer: Dosimetric results and comparison with flattened beams technique

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

Barbiero, Sara; Specialty School in Medical Physics, University of Pisa, Pisa; Rink, Alexandra

2016-01-01

Purpose: To report on single-fraction stereotactic body radiotherapy (RT) (SBRT) with flattening filter (FF)–free (FFF) volumetric modulated arc therapy (VMAT) for lung cancer and to compare dosimetric results with VMAT with FF. Methods and materials: Overall, 25 patients were treated with 6-MV FFF VMAT (Varian TrueBeam STx LINAC) to a prescribed dose of 24 Gy in a single fraction. Treatment plans were recreated using FF VMAT. Dose-volume indices, monitor units (MU), and treatment times were compared between FFF and FF VMAT techniques. Results: Dose constraints to PTV, spinal cord, and lungs were reached in FFF and FF plans. In FFFmore » plans, average conformity index was 1.13 (95% CI: 1.07 to1.38). Maximum doses to spinal cord, heart, esophagus, and trachea were 2.9 Gy (95% CI: 0.4 to 6.7 Gy), 0.8 Gy (95% CI: 0 to 3.6 Gy), 3.3 Gy (95% CI: 0.02 to 13.9 Gy), and 1.5 Gy (95% CI: 0 to 4.9 Gy), respectively. Average V7 Gy, V7.4 Gy, and mean dose to the healthy lung were 126.5 cc (95% CI: 41.3 to 248.9 cc), 107.3 cc (95% CI: 18.7 to 232.8 cc), and 1.1 Gy (95% CI: 0.3 to 2.2 Gy), respectively. No statistically significant differences were found in dosimetric results and MU between FF and FFF treatments. Treatment time was reduced by an average factor of 2.31 (95% CI: 2.15 to 2.43) from FF treatments to FFF, and the difference was statistically significant. Conclusions: FFF VMAT for lung SBRT provides equivalent dosimetric results to the target and organs at risk as FF VMAT while significantly reducing treatment time.« less

Monte Carlo skin dose simulation in intraoperative radiotherapy of breast cancer using spherical applicators

NASA Astrophysics Data System (ADS)

Moradi, F.; Ung, N. M.; Khandaker, M. U.; Mahdiraji, G. A.; Saad, M.; Malik, R. Abdul; Bustam, A. Z.; Zaili, Z.; Bradley, D. A.

2017-08-01

The relatively new treatment modality electronic intraoperative radiotherapy (IORT) is gaining popularity, irradiation being obtained within a surgically produced cavity being delivered via a low-energy x-ray source and spherical applicators, primarily for early stage breast cancer. Due to the spatially dramatic dose-rate fall off with radial distance from the source and effects related to changes in the beam quality of the low keV photon spectra, dosimetric account of the Intrabeam system is rather complex. Skin dose monitoring in IORT is important due to the high dose prescription per treatment fraction. In this study, modeling of the x-ray source and related applicators were performed using the Monte Carlo N-Particle transport code. The dosimetric characteristics of the model were validated against measured data obtained using an ionization chamber and EBT3 film as dosimeters. By using a simulated breast phantom, absorbed doses to the skin for different combinations of applicator size (1.5-5 cm) and treatment depth (0.5-3 cm) were calculated. Simulation results showed overdosing of the skin (>30% of prescribed dose) at a treatment depth of 0.5 cm using applicator sizes larger than 1.5 cm. Skin doses were significantly increased with applicator size, insofar as delivering 12 Gy (60% of the prescribed dose) to skin for the largest sized applicator (5 cm diameter) and treatment depth of 0.5 cm. It is concluded that the recommended 0.5-1 cm distance between the skin and applicator surface does not guarantee skin safety and skin dose is generally more significant in cases with the larger applicators. Highlights: • Intrabeam x-ray source and spherical applicators were simulated and skin dose was calculated. • Skin dose for constant skin to applicator distance strongly depends on applicator size. • Use of larger applicators generally results in higher skin dose. • The recommended 0.5-1 cm skin to applicator distance does not guarantee skin safety.

SU-F-T-157: Physics Considerations Regarding Dosimetric Accuracy of Analytical Dose Calculations for Small Field Proton Therapy: A Monte Carlo Study

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

Geng, C; Nanjing University of Aeronautics and Astronautics, Nanjing; Daartz, J

Purpose: To evaluate the accuracy of dose calculations by analytical dose calculation methods (ADC) for small field proton therapy in a gantry based passive scattering facility. Methods: 50 patients with intra-cranial disease were evaluated in the study. Treatment plans followed standard prescription and optimization procedures of proton stereotactic radiosurgery. Dose distributions calculated with the Monte Carlo (MC) toolkit TOPAS were used to represent delivered treatments. The MC dose was first adjusted using the output factor (OF) applied clinically. This factor is determined from the field size and the prescribed range. We then introduced a normalization factor to measure the differencemore » in mean dose between the delivered dose (MC dose with OF) and the dose calculated by ADC for each beam. The normalization was determined by the mean dose of the center voxels of the target area. We compared delivered dose distributions and those calculated by ADC in terms of dose volume histogram parameters and beam range distributions. Results: The mean target dose for a whole treatment is generally within 5% comparing delivered dose (MC dose with OF) and ADC dose. However, the differences can be as great as 11% for shallow and small target treated with a thick range compensator. Applying the normalization factor to the MC dose with OF can reduce the mean dose difference to less than 3%. Considering range uncertainties, the generally applied margins (3.5% of the prescribed range + 1mm) to cover uncertainties in range might not be sufficient to guarantee tumor coverage. The range difference for R90 (90% distal dose falloff) is affected by multiple factors, such as the heterogeneity index. Conclusion: This study indicates insufficient accuracy calculating proton doses using ADC. Our results suggest that uncertainties of target doses are reduced using MC techniques, improving the dosimetric accuracy for proton stereotactic radiosurgery. The work was supported by NIH/NCI under CA U19 021239. CG was partially supported by the Chinese Scholarship Council (CSC) and the National Natural Science Foundation of China (Grant No. 11475087).« less

Pilot Pharmacokinetic and Dosimetric Studies of 18F-FPPRGD2: A PET Radiopharmaceutical Agent for Imaging αvβ3 Integrin Levels

PubMed Central

Goris, Michael L.; Iagaru, Andrei H.; Kardan, Arash; Burton, Lindee; Berganos, Rhona; Chang, Edwin; Liu, Shuanglong; Shen, Bin; Chin, Frederick T.; Chen, Xiaoyuan; Gambhir, Sanjiv S.

2011-01-01

Purpose: To assess the safety, biodistribution, and dosimetric properties of the positron emission tomography (PET) radiopharmaceutical agent fluorine 18 (18F) FPPRGD2 (2-fluoropropionyl labeled PEGylated dimeric RGD peptide [PEG3-E{c(RGDyk)}2]), which is based on the dimeric arginine-glycine–aspartic acid (RGD) peptide sequence and targets αvβ3 integrin, in the first volunteers imaged with this tracer. Materials and Methods: The protocol was approved by the institutional review board, and written informed consent was obtained from all participants. Five healthy volunteers underwent whole-body combined PET–computed tomography 0.5, 1.0, 2.0, and 3.0 hours after tracer injection (mean dose, 9.5 mCi ± 3.4 [standard deviation] [351.5 MBq ± 125.8]; mean specific radioactivity, 1200 mCi/mmol ± 714 [44.4 GBq/mmol ± 26.4]). During this time, standard vital signs, electrocardiographic (ECG) readings, and blood sample values (for chemistry, hematologic, and liver function tests) were checked at regular intervals and 1 and 7 days after the injection. These data were used to evaluate tracer biodistribution and dosimetric properties, time-activity curves, and the stability of laboratory values. Significant changes in vital signs and laboratory values were evaluated by using a combination of population-averaged generalized estimating equation regression and exact paired Wilcoxon tests. Results: The administration of 18F-FPPRGD2 was well tolerated, with no marked effects on vital signs, ECG readings, or laboratory values. The tracer showed the same pattern of biodistribution in all volunteers: primary clearance through the kidneys (0.360 rem/mCi ± 0.185 [0.098 mSv/MBq ± 0.050]) and bladder (0.862 rem/mCi ± 0.436 [0.233 mSv/MBq ± 0.118], voiding model) and uptake in the spleen (0.250 rem/mCi ± 0.168 [0.068 mSv/MBq ± 0.046]) and large intestine (0.529 rem/mCi ± 0.236 [0.143 mSv/MBq ± 0.064]). The mean effective dose of 18F-FPPRGD2 was 0.1462 rem/mCi ± 0.0669 (0.0396 mSv/MBq ± 0.0181). With an injected dose of 10 mCi (370 MBq) and a 1-hour voiding interval, a patient would be exposed to an effective radiation dose of 1.5 rem (15 mSv). Above the diaphragm, there was minimal uptake in the brain ventricles, salivary glands, and thyroid gland. Time-activity curves showed rapid clearance from the vasculature, with a mean 26% ± 17 of the tracer remaining in the circulation at 30 minutes and most of the activity occurring in the plasma relative to cells (mean whole blood–plasma ratio, 0.799 ± 0.096). Conclusion: 18F-FPPRGD2 has desirable pharmacokinetic and biodistribution properties. The primary application is likely to be PET evaluation of oncologic patients—especially those with brain, breast, or lung cancer. Specific indications may include tumor staging, identifying patients who would benefit from antiangiogenesis therapy, and separating treatment responders from nonresponders early. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101139/-/DC1 PMID:21502381

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

Zhang, J; Li, X; Ding, X

Purpose: We investigate the spot characteristic and dose profiles properties from a compact gantry proton therapy system. This compact design features a dedicated pencil beam scanning nozzle with the scanning magnet located upstream of the final 60 degree bending magnet. Due to the unique beam line design, uncertainty has been raised in the virtual source-to-axis distance (SAD). We investigate its potential clinical impact through measurements and simulation. Methods: A scintillator camera based detector was used to measure spot characteristics and position accuracy. An ion chamber array device was used to measure planar dose profile. Dose profile in-air simulation was performedmore » using in-house built MATLAB program based on additional spot parameters directly from measurements. Spot characteristics such as position and in-air sigma values were used to general simulated 2D elliptical Gaussian spots. The virtual SAD distance changes in the longitudinal direction were also simulated. Planar dose profiles were generated by summation of simulated spots at the isocenter, 15 cm above the isocenter, and 15 cm below the isocenter for evaluation of potential clinical dosimetric impact. Results: We found that the virtual SAD varies depending on the spot location on the longitudinal axis. Measurements have shown that the variable SAD changes from 7 to 12 meters from one end to the other end of the treatment field in the longitudinal direction. The simulation shows that the planer dose profiles differences between the fixed SAD and variable SAD are within 3% from the isocenter profile and the lateral penumbras are within 1 mm difference. Conclusion: Our measurements and simulations show that there are minimum effects on the spot characteristics and dose profiles for this up-stream scanning compact system proton system. Further treatment planning study is needed with the variable virtual SAD accounted for in the planning system to show minimum dosimetric impact.« less

Single-Isocenter Multiple-Target Stereotactic Radiosurgery: Risk of Compromised Coverage

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

Roper, Justin, E-mail: justin.roper@emory.edu; Department of Biostatistics and Bioinformatics, Winship Cancer Institute of Emory University, Atlanta, Georgia; Chanyavanich, Vorakarn

2015-11-01

Purpose: To determine the dosimetric effects of rotational errors on target coverage using volumetric modulated arc therapy (VMAT) for multitarget stereotactic radiosurgery (SRS). Methods and Materials: This retrospective study included 50 SRS cases, each with 2 intracranial planning target volumes (PTVs). Both PTVs were planned for simultaneous treatment to 21 Gy using a single-isocenter, noncoplanar VMAT SRS technique. Rotational errors of 0.5°, 1.0°, and 2.0° were simulated about all axes. The dose to 95% of the PTV (D95) and the volume covered by 95% of the prescribed dose (V95) were evaluated using multivariate analysis to determine how PTV coverage was relatedmore » to PTV volume, PTV separation, and rotational error. Results: At 0.5° rotational error, D95 values and V95 coverage rates were ≥95% in all cases. For rotational errors of 1.0°, 7% of targets had D95 and V95 values <95%. Coverage worsened substantially when the rotational error increased to 2.0°: D95 and V95 values were >95% for only 63% of the targets. Multivariate analysis showed that PTV volume and distance to isocenter were strong predictors of target coverage. Conclusions: The effects of rotational errors on target coverage were studied across a broad range of SRS cases. In general, the risk of compromised coverage increased with decreasing target volume, increasing rotational error and increasing distance between targets. Multivariate regression models from this study may be used to quantify the dosimetric effects of rotational errors on target coverage given patient-specific input parameters of PTV volume and distance to isocenter.« less

Methods for prostate stabilization during transperineal LDR brachytherapy.

PubMed

Podder, Tarun; Sherman, Jason; Rubens, Deborah; Messing, Edward; Strang, John; Ng, Wan-Sing; Yu, Yan

2008-03-21

In traditional prostate brachytherapy procedures for a low-dose-rate (LDR) radiation seed implant, stabilizing needles are first inserted to provide some rigidity and support to the prostate. Ideally this will provide better seed placement and an overall improved treatment. However, there is much speculation regarding the effectiveness of using regular brachytherapy needles as stabilizers. In this study, we explored the efficacy of two types of needle geometries (regular brachytherapy needle and hooked needle) and several clinically feasible configurations of the stabilization needles. To understand and assess the prostate movement during seed implantation, we collected in vivo data from patients during actual brachytherapy procedures. In vitro experimentation with tissue-equivalent phantoms allowed us to further understand the mechanics behind prostate stabilization. We observed superior stabilization with the hooked needles compared to the regular brachytherapy needles (more than 40% in bilateral parallel needle configuration). Prostate movement was also reduced significantly when regular brachytherapy needles were in an angulated configuration as compared to the parallel configuration (more than 60%). When the hooked needles were angulated for stabilization, further reduction in prostate displacement was observed. In general, for convenience of dosimetric planning and to avoid needle collision, all needles are desired to be in a parallel configuration. In this configuration, hooked needles provide improved stabilization of the prostate. On the other hand, both regular and hooked needles appear to be equally effective in reducing prostate movement when they are in angulated configurations, which will be useful in seed implantation using a robotic system. We have developed nonlinear spring-damper model for the prostate movement which can be used for adapting dosimetric planning during brachytherapy as well as for developing more realistic haptic devices and training simulators.

Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 08: Retrospective Dose Accumulation Workflow in Head and Neck Cancer Patients Using RayStation 4.5.2

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

Wong, Olive; Chan, Biu; Moseley, Joanne

Purpose: We have developed a semi-automated dose accumulation workflow for Head and Neck Cancer (HNC) patients to evaluate volumetric and dosimetric changes that take place during radiotherapy. This work will be used to assess how dosimetric changes affect both toxicity and disease control, hence inform the feasibility and design of a prospective HNC adaptive trial. Methods: RayStation 4.5.2 features deformable image registration (DIR), where structures already defined on the planning CT image set can be deformably mapped onto cone-beam computed tomography (CBCT) images, accounting for daily treatment set-up shifts and changes in patient anatomy. The daily delivered dose can bemore » calculated on each CBCT and mapped back to the planning CT to allow dose accumulation. The process is partially automated using Python scripts developed in collaboration with RaySearch. Results: To date we have performed dose accumulation on 18 HNC patients treated at our institution during 2013–2015 under REB approval. Our semi-automated process establishes clinical feasibility. Generally, dose accumulation for the entire treatment course of one case takes 60–120 minutes: importing all CBCTs requires 20–30 minutes as each patient has 30 to 40 treated fractions; image registration and dose accumulation require 60–90 minutes. This is in contrast to the process without automated scripts where dose accumulation alone would take 3–5 hours. Conclusions: We have developed a reliable workflow for retrospective dose tracking in HNC using RayStation. The process has been validated for HNC patients treated on both Elekta and Varian linacs with CBCTs acquired on XVI and OBI platforms respectively.« less

First BNCT treatment of a skin melanoma in Argentina: dosimetric analysis and clinical outcome.

PubMed

González, S J; Bonomi, M R; Santa Cruz, G A; Blaumann, H R; Calzetta Larrieu, O A; Menéndez, P; Jiménez Rebagliati, R; Longhino, J; Feld, D B; Dagrosa, M A; Argerich, C; Castiglia, S G; Batistoni, D A; Liberman, S J; Roth, B M C

2004-11-01

A Phase I/II protocol for treating cutaneuos melanomas with BNCT was designed in Argentina by the Comisión Nacional de Energía Atómica and the medical center Instituto Roffo. The first of a cohort of thirty planned patients was treated on October 9, 2003. This article depicts the protocol-based procedure and describes the first clinical case, treatment regime and planning, patient irradiation, retrospective dosimetric analysis and clinical outcome. Considering the low acute skin toxicity and the complete response in 21 of the 25 subcutaneous melanoma nodules treated, a second irradiation was performed in a different location of the extremity of the same patient. The corresponding clinical outcome is still under evaluation.

Ionizing radiation fluxes and dose measurements during the Kosmos 1887 satellite flight.

PubMed

Charvat, J; Spurny, F; Kopecka, B; Votockova, I

1990-01-01

The results of dosimetric experiments performed during the flight of Kosmos 1887 biosatellite are presented. Two kinds of measurements were performed on the external surface of the satellite. First, the fluences and spectra of low energy charged particles were established. It was found that most of the particles registered by means of solid state nuclear track detectors are helium nuclei. Tracks of oxygen nuclei and some heavier charged particles were also observed. Thermoluminescent detectors were used to establish absorbed doses in open space on the satellite's surface and behind thin shielding. It was found that these doses were rather high; nevertheless, their decrease with shielding thickness is very rapid. Dosimetric and other consequences of the results obtained are analyzed and discussed.

Comparison between infrared optical and stereoscopic X-ray technologies for patient setup in image guided stereotactic radiotherapy.

PubMed

Tagaste, Barbara; Riboldi, Marco; Spadea, Maria F; Bellante, Simone; Baroni, Guido; Cambria, Raffaella; Garibaldi, Cristina; Ciocca, Mario; Catalano, Gianpiero; Alterio, Daniela; Orecchia, Roberto

2012-04-01

To compare infrared (IR) optical vs. stereoscopic X-ray technologies for patient setup in image-guided stereotactic radiotherapy. Retrospective data analysis of 233 fractions in 127 patients treated with hypofractionated stereotactic radiotherapy was performed. Patient setup at the linear accelerator was carried out by means of combined IR optical localization and stereoscopic X-ray image fusion in 6 degrees of freedom (6D). Data were analyzed to evaluate the geometric and dosimetric discrepancy between the two patient setup strategies. Differences between IR optical localization and 6D X-ray image fusion parameters were on average within the expected localization accuracy, as limited by CT image resolution (3 mm). A disagreement between the two systems below 1 mm in all directions was measured in patients treated for cranial tumors. In extracranial sites, larger discrepancies and higher variability were observed as a function of the initial patient alignment. The compensation of IR-detected rotational errors resulted in a significantly improved agreement with 6D X-ray image fusion. On the basis of the bony anatomy registrations, the measured differences were found not to be sensitive to patient breathing. The related dosimetric analysis showed that IR-based patient setup caused limited variations in three cases, with 7% maximum dose reduction in the clinical target volume and no dose increase in organs at risk. In conclusion, patient setup driven by IR external surrogates localization in 6D featured comparable accuracy with respect to procedures based on stereoscopic X-ray imaging. Copyright © 2012 Elsevier Inc. All rights reserved.

Development of the 3DHZETRN code for space radiation protection

NASA Astrophysics Data System (ADS)

Wilson, John; Badavi, Francis; Slaba, Tony; Reddell, Brandon; Bahadori, Amir; Singleterry, Robert

Space radiation protection requires computationally efficient shield assessment methods that have been verified and validated. The HZETRN code is the engineering design code used for low Earth orbit dosimetric analysis and astronaut record keeping with end-to-end validation to twenty percent in Space Shuttle and International Space Station operations. HZETRN treated diffusive leakage only at the distal surface limiting its application to systems with a large radius of curvature. A revision of HZETRN that included forward and backward diffusion allowed neutron leakage to be evaluated at both the near and distal surfaces. That revision provided a deterministic code of high computational efficiency that was in substantial agreement with Monte Carlo (MC) codes in flat plates (at least to the degree that MC codes agree among themselves). In the present paper, the 3DHZETRN formalism capable of evaluation in general geometry is described. Benchmarking will help quantify uncertainty with MC codes (Geant4, FLUKA, MCNP6, and PHITS) in simple shapes such as spheres within spherical shells and boxes. Connection of the 3DHZETRN to general geometry will be discussed.

[Basic principles and results of brachytherapy in gynecological oncology].

PubMed

Kanaev, S V; Turkevich, V G; Baranov, S B; Savel'eva, V V

2014-01-01

The fundamental basics of contact radiation therapy (brachytherapy) for gynecological cancer are presented. During brachytherapy the principles of conformal radiotherapy should be implemented, the aim of which is to sum the maximum possible dose of radiation to the tumor and decrease the dose load in adjacent organs and tissues, which allows reducing the frequency of radiation damage at treatment of primary tumors. It is really feasible only on modern technological level, thanks to precision topometry preparation, optimal computer dosimetrical and radiobiological planning of each session and radiotherapy in general. Successful local and long-term results of the contact radiation therapy for cancer of cervix and endometrium are due to optimal anatomical and topometrical ratio of the tumor localization, radioactive sources, and also physical and radiobiological laws of distribution and effects of ionizing radiation, the dose load accounting rules.

Characterization of a cable-free system based on p-type MOSFET detectors for "in vivo" entrance skin dose measurements in interventional radiology.

PubMed

Falco, Maria Daniela; D'Andrea, Marco; Strigari, Lidia; D'Alessio, Daniela; Quagliani, Francesco; Santoni, Riccardo; Bosco, Alessia Lo

2012-08-01

During radiological interventional procedures (RIP) the skin of a patient under examination may undergo a prolonged x-ray exposure, receiving a dose as high as 5 Gy in a single session. This paper describes the use of the OneDose(TM) cable-free system based on p-type MOSFET detectors to determine the entrance skin dose (ESD) at selected points during RIP. At first, some dosimetric characteristics of the detector, such as reproducibility, linearity, and fading, have been investigated using a C-arc as a source of radiation. The reference setting (RS) was: 80 kV energy, 40 cm × 40 cm field of view (FOV), current-time product of 50 mAs and source to skin distance (SSD) of 50 cm. A calibrated PMX III solid state detector was used as the reference detector and Gafchromic(®) films have been used as an independent dosimetric system to test the entire procedure. A calibration factor for the RS and correction factors as functions of tube voltage and FOV size have been determined. Reproducibility ranged from 4% at low doses (around 10 cGy as measured by the reference detector) to about 1% for high doses (around 2 Gy). The system response was found to be linear with respect to both dose measured with the PMX III and tube voltage. The fading test has shown that the maximum deviation from the optimal reading conditions (3 min after a single irradiation) was 9.1% corresponding to four irradiations in one hour read 3 min after the last exposure. The calibration factor in the RS has shown that the system response at the kV energy range is about four times larger than in the MV energy range. A fifth order and fourth order polynomial functions were found to provide correction factors for tube voltage and FOV size, respectively, in measurement settings different than the RS. ESDs measured with the system after applying the proper correction factors agreed within one standard deviation (SD) with the corresponding ESDs measured with the reference detector. The ESDs measured with Gafchromic(®) films were in agreement within one SD compared to the ESDs measured using the OneDose(TM) system, as well. The global uncertainty associated to the OneDose(TM) system established in our experiments, ranged from 7% to 10%, depending on the duration of the RIP due to fading. These values are much lower than the uncertainty commonly accepted for general diagnostic practices (20%) and of about the same size of the uncertainty recommended for practices with high risk of deterministic side effects (7%). The OneDose(TM) system has shown a high sensitivity in the kV energy range and has been found capable of measuring the entrance skin dose in RIP.

Multicentre validation of IMRT pre-treatment verification: comparison of in-house and external audit.

PubMed

Jornet, Núria; Carrasco, Pablo; Beltrán, Mercè; Calvo, Juan Francisco; Escudé, Lluís; Hernández, Victor; Quera, Jaume; Sáez, Jordi

2014-09-01

We performed a multicentre intercomparison of IMRT optimisation and dose planning and IMRT pre-treatment verification methods and results. The aims were to check consistency between dose plans and to validate whether in-house pre-treatment verification results agreed with those of an external audit. Participating centres used two mock cases (prostate and head and neck) for the intercomparison and audit. Compliance to dosimetric goals and total number of MU per plan were collected. A simple quality index to compare the different plans was proposed. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit. While for the prostate case, all centres fulfilled the dosimetric goals and plan quality was homogeneous, that was not the case for the head and neck case. The number of MU did not correlate with the plan quality index. Pre-treatment verifications results of the external audit did not agree with those of the in-house measurements for two centres: being within tolerance for in-house measurements and unacceptable for the audit or the other way round. Although all plans fulfilled dosimetric constraints, plan quality is highly dependent on the planner expertise. External audits are an excellent tool to detect errors in IMRT implementation and cannot be replaced by intercomparison using results obtained by centres. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation.

PubMed

Jaberi, Ramin; Siavashpour, Zahra; Aghamiri, Mahmoud Reza; Kirisits, Christian; Ghaderi, Reza

2017-12-01

Intra-fractional organs at risk (OARs) deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT). The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT) of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR) brachytherapy with tandem-ovoid applicators were selected for this study. Second computed tomography scan was done for each patient after finishing brachytherapy treatment with applicators in situ. Artificial neural networks (ANNs) based models were used to predict intra-fractional OARs dose-volume histogram parameters variations and propose a new final plan. A model was developed to estimate the intra-fractional organs dose variations during gynaecological intracavitary brachytherapy. Also, ANNs were used to modify the final brachytherapy treatment plan to compensate dosimetrically for changes in 'organs-applicators', while maintaining target dose at the original level. There are semi-automatic and fast responding models that can be used in the routine clinical workflow to reduce individually IGABT uncertainties. These models can be more validated by more patients' plans to be able to serve as a clinical tool.

Green synthesis of silver nanoparticles aimed at improving theranostics

NASA Astrophysics Data System (ADS)

Vedelago, José; Gomez, Cesar G.; Valente, Mauro; Mattea, Facundo

2018-05-01

Nowadays, the combination of diagnosis and therapy, known as theranostics, is one of the keys for an optimal treatment for cancer diseases. Theranostics can be significantly improved by incorporating metallic nanoparticles that are specifically delivered and accumulated in cancerous tissue. In this context, precise knowledge about dosimetric effects in nanoparticle-infused tissues as well as the detection and processing of emerging radiation are extremely important issues. In the last years the first studies on theranostic nanomaterials in gel dosimetry have been presented but there is still a broad field of study to explore. Most of gel dosimetric materials are extremely sensible to modifications in their composition, the addition of enhancers, metallic or inorganic charges can alter their stability and dosimetric properties; therefore, thorough studies must be made before the incorporation of any type of modifier. In this work, the synthesis of metallic nanoparticles suitable for gel dosimetry for x-ray applications is presented. A green synthesis process of silver nanoparticles coated with porcine skin gelatin by thermal reduction of silver nitrate is presented. Nanoparticles were obtained and purified for their application in gel dosimetry. Also, nanoparticles size distribution, reaction yield and the preliminar application as theranostic agents were tested in Fricke gel dosimetry in the keV range. The obtained nanoparticles were successfully used in theranostic applications acting as fluorescent agents and dose enhancers in X-ray beam irradiation simultaneously.

Prevention of Radiochemotherapy-Induced Esophagitis With Glutamine: Results of a Pilot Study

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

Algara, Manuel; Universitat Pompeu Fabra, Barcelona; Rodriguez, Nuria

2007-10-01

Purpose: To assess the usefulness of oral glutamine to prevent radiochemotherapy-induced esophagitis in patients with lung cancer, and to determine the dosimetric parameter predictive of esophagitis. Methods and Materials: Seventy-five patients were enrolled; 34.7% received sequential radiochemotherapy, and 65.3% received concomitant radiochemotherapy. Every patient received prophylactic glutamine powder in doses of 10 g/8 h. Prescribed radiation doses were 45-50 Gy to planning target volume (PTV)1 (gross tumor volume plus wide margins) and 65-70 Gy to PTV2 (reduced margins). The primary endpoint was the incidence of Grade 2 or greater acute esophagitis. Results: No patient experienced glutamine intolerance or glutamine-related toxicity.more » Seventy-three percent of patients who received sequential chemotherapy and 49% of those who received concomitant chemotherapy did not present any form of esophagitis. V50 was the dosimetric parameter with better correlation between esophagitis and its duration. A V50 of {<=}30% had a 22% risk of esophagitis Grade {>=}2, which increased to 71% with a V50 of >30% (p = 0.0009). Conclusions: The use of oral glutamine may have an important role in the prevention of esophageal complications of concomitant radiochemotherapy in lung cancer patients. However, randomized trials are needed to corroborate that effect. V50 is the dosimetric parameter with better correlation with esophagitis grade and duration.« less

Comprehensive Australasian multicentre dosimetric intercomparison: issues, logistics and recommendations.

PubMed

Ebert, M A; Harrison, K M; Cornes, D; Howlett, S J; Joseph, D J; Kron, T; Hamilton, C S; Denham, J W

2009-02-01

The present paper describes the logistics of the 2004-2008 Australasian Level III Dosimetry Intercomparison. Dosimetric intercomparisons (or 'audits') can be used in radiotherapy to evaluate the accuracy and quality of radiation delivery. An intercomparison was undertaken in New Zealand and Australia to evaluate the feasibility and logistics of ongoing dosimetric intercomparisons that evaluate all steps in the radiotherapy treatment process, known as a 'Level III' intercomparison. The study commenced in 2002 with the establishment of a study team, definition of the study protocol, acquisition of appropriate equipment and recruitment of participating radiotherapy centres. Measurements were undertaken between October 2004 and March 2008, and included collation of data on time, costs and logistics of the study. Forty independent Australian and New Zealand radiotherapy centres agreed to participate. Measurement visits were made to 37 of these centres. Data is presented on the costs of the study and the level of support required. The study involved the participation of 16 staff at the study centre who invested over 4000 hours in the study, and of over 200 professionals at participating centres. Recommendations are provided for future phantom-based intercomparisons. It is hoped that the present paper will be of benefit to any centres or groups contemplating similar activities by identifying the processes involved in establishing the study, the potential hazards and pitfalls, and expected resource requirements.

Modern dosimetric tools for 60Co irradiation at high containment laboratories

PubMed Central

Twardoski, Barri; Feldmann, Heinz; Bloom, Marshall E.; Ward, Joe

2011-01-01

Purpose To evaluate an innovative photo-fluorescent film as a routine dosimetric tool during 60Co irradiations at a high containment biological research laboratory, and to investigate whether manufacturer-provided chamber exposure rates can be used to accurately administer a prescribed dose to biological specimens. Materials and methods Photo-fluorescent, lithium fluoride film dosimeters and National Institutes of Standards and Technology (NIST) transfer dosimeters were co-located in a self-shielded 60Co irradiator and exposed to γ-radiation with doses ranging from 5–85 kGy. Film dose-response relationships were developed for varying temperatures simulating conditions present when irradiating infectious biological specimens. Dose measurement results from NIST transfer dosimeters were compared to doses predicted using manufacturer-provided irradiator chamber exposure rates. Results The film dosimeter exhibited a photo-fluorescent response signal that was consistent and nearly linear in relationship to γ-radiation exposure over a wide dose range. The dosimeter response also showed negligible effects from dose fractionization and humidity. Significant disparities existed between manufacturer-provided chamber exposure rates and actual doses administered. Conclusion This study demonstrates the merit of utilizing dosimetric tools to validate the process of exposing dangerous and exotic biological agents to γ-radiation at high containment laboratories. The film dosimeter used in this study can be utilized to eliminate potential for improperly administering γ-radiation doses. PMID:21961968

A dosimetric comparison of {sup 169}Yb versus {sup 192}Ir for HDR prostate brachytherapy

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

Lymperopoulou, G.; Papagiannis, P.; Sakelliou, L.

2005-12-15

For the purpose of evaluating the use of {sup 169}Yb for prostate High Dose Rate brachytherapy (HDR), a hypothetical {sup 169}Yb source is assumed with the exact same design of the new microSelectron source replacing the {sup 192}Ir active core by pure {sup 169}Yb metal. Monte Carlo simulation is employed for the full dosimetric characterization of both sources and results are compared following the AAPM TG-43 dosimetric formalism. Monte Carlo calculated dosimetry results are incorporated in a commercially available treatment planning system (SWIFT{sup TM}), which features an inverse treatment planning option based on a multiobjective dose optimization engine. The qualitymore » of prostate HDR brachytherapy using the real {sup 192}Ir and hypothetical {sup 169}Yb source is compared in a comprehensive analysis of different prostate implants in terms of the multiobjective dose optimization solutions as well as treatment quality indices such as Dose Volume Histograms (DVH) and the Conformal Index (COIN). Given that scattering overcompensates for absorption in intermediate photon energies and distances in the range of interest to prostate HDR brachytherapy, {sup 169}Yb proves at least equivalent to {sup 192}Ir irrespective of prostate volume. This has to be evaluated in view of the shielding requirements for the {sup 169}Yb energies that are minimal relative to that for {sup 192}Ir.« less

Development of a phantom and a methodology for evaluation of depth kerma and kerma index for dental cone beam computed tomography.

PubMed

Batista, W O; Navarro, M V T; Maia, A F

2013-12-01

Basically, all modalities of diagnostic radiology require phantoms suitable for dosimetric evaluations. New technologies frequently arise unaccompanied of tools for dosimetric evaluations and quality control. In this study, a low-cost phantom and a consequent proposed methodology for dosimetric evaluations in cone beam computed tomography (CBCT) were presented. The developed phantom has typical dimensions of the human face, was built in polymethyl methacrylate and filled with water. Three devices with different technological concepts were evaluated and a proposed index, kerma index-height product (PKIH), was defined as an option to the use of air kerma-area product. The results of this study show relatively uniform kerma profiles for scanners with field of views (FOVs) of large diameters and non-uniform for FOVs of small diameters. With regard to the values obtained for the kerma indexes, much higher values were found for the equipment FOVs with small diameter compared with the values of the two other equipment that have larger diameters. The results indicate that (1) there is a need for special phantoms for use in CBCT, (2) the use of P(KA) in the evaluation of protocols on different equipment can lead to false interpretations and (3) the new index is a suitable alternative for the use of P(KA) in CBCT.

Comparison of four commercial devices for RapidArc and sliding window IMRT QA

PubMed Central

Chandraraj, Varatharaj; Manickam, Ravikumar; Esquivel, Carlos; Supe, Sanjay S.; Papanikolaou, Nikos

2011-01-01

For intensity‐modulated radiation therapy, evaluation of the measured dose against the treatment planning calculated dose is essential in the context of patient‐specific quality assurance. The complexity of volumetric arc radiotherapy delivery attributed to its dynamic and synchronization nature require new methods and potentially new tools for the quality assurance of such techniques. In the present study, we evaluated and compared the dosimetric performance of EDR2 film and three other commercially available quality assurance devices: IBA I'MatriXX array, PTW Seven29 array and the Delta 4 array. The evaluation of these dosimetric systems was performed for RapidArc and IMRT deliveries using a Varian NovalisTX linear accelerator. The plans were generated using the Varian Eclipse treatment planning system. Our results showed that all four QA techniques yield equivalent results. All patient QAs passed our institutional clinical criteria of gamma index based on a 3% dose difference and 3 mm distance to agreement. In addition, the Bland‐Altman analysis was performed which showed that all the calculated gamma values of all three QA devices were within 5% from those of the film. The results showed that the four QA systems used in this patient‐specific IMRT QA analysis are equivalent. We concluded that the dosimetric systems under investigation can be used interchangeably for routine patient specific QA. PACS numbers: 87.55.Qr, 87.56.Fc

Dosimetric characterization of a new directional low-dose rate brachytherapy source.

PubMed

Aima, Manik; DeWerd, Larry A; Mitch, Michael G; Hammer, Clifford G; Culberson, Wesley S

2018-05-24

CivaTech Oncology Inc. (Durham, NC) has developed a novel low-dose rate (LDR) brachytherapy source called the CivaSheet. TM The source is a planar array of discrete elements ("CivaDots") which are directional in nature. The CivaDot geometry and design are considerably different than conventional LDR cylindrically symmetric sources. Thus, a thorough investigation is required to ascertain the dosimetric characteristics of the source. This work investigates the repeatability and reproducibility of a primary source strength standard for the CivaDot and characterizes the CivaDot dose distribution by performing in-phantom measurements and Monte Carlo (MC) simulations. Existing dosimetric formalisms were adapted to accommodate a directional source, and other distinguishing characteristics including the presence of gold shield x-ray fluorescence were addressed in this investigation. Primary air-kerma strength (S K ) measurements of the CivaDots were performed using two free-air chambers namely, the Variable-Aperture Free-Air Chamber (VAFAC) at the University of Wisconsin Medical Radiation Research Center (UWMRRC) and the National Institute of Standards and Technology (NIST) Wide-Angle Free-Air Chamber (WAFAC). An intercomparison of the two free-air chamber measurements was performed along with a comparison of the different assumed CivaDot energy spectra and associated correction factors. Dose distribution measurements of the source were performed in a custom polymethylmethacrylate (PMMA) phantom using Gafchromic TM EBT3 film and thermoluminescent dosimeter (TLD) microcubes. Monte Carlo simulations of the source and the measurement setup were performed using MCNP6 radiation transport code. The CivaDot S K was determined using the two free-air chambers for eight sources with an agreement of better than 1.1% for all sources. The NIST measured CivaDot energy spectrum intensity peaks were within 1.8% of the MC-predicted spectrum intensity peaks. The difference in the net source-specific correction factor determined for the CivaDot free-air chamber measurements for the NIST WAFAC and UW VAFAC was 0.7%. The dose-rate constant analog was determined to be 0.555 cGy h -1 U -1 . The average difference observed in the estimated CivaDot dose-rate constant analog using measurements and MCNP6-predicted value (0.558 cGy h -1 U -1 ) was 0.6% ± 2.3% for eight CivaDot sources using EBT3 film, and -2.6% ± 1.7% using TLD microcube measurements. The CivaDot two-dimensional dose-to-water distribution measured in phantom was compared to the corresponding MC predictions at six depths. The observed difference using a pixel-by-pixel subtraction map of the measured and the predicted dose-to-water distribution was generally within 2-3%, with maximum differences up to 5% of the dose prescribed at the depth of 1 cm. Primary S K measurements of the CivaDot demonstrated good repeatability and reproducibility of the free-air chamber measurements. Measurements of the CivaDot dose distribution using the EBT3 film stack phantom and its subsequent comparison to Monte Carlo-predicted dose distributions were encouraging, given the overall uncertainties. This work will aid in the eventual realization of a clinically viable dosimetric framework for the CivaSheet based on the CivaDot dose distribution. © 2018 American Association of Physicists in Medicine.

Investigation of clinical and dosimetric factors associated with postoperative pulmonary complications in esophageal cancer patients treated with concurrent chemoradiotherapy followed by surgery.

PubMed

Wang, Shu-lian; Liao, Zhongxing; Vaporciyan, Ara A; Tucker, Susan L; Liu, Helen; Wei, Xiong; Swisher, Stephen; Ajani, Jaffer A; Cox, James D; Komaki, Ritsuko

2006-03-01

To assess the association of clinical and especially dosimetric factors with the incidence of postoperative pulmonary complications among esophageal cancer patients treated with concurrent chemoradiation therapy followed by surgery. Data from 110 esophageal cancer patients treated between January 1998 and December 2003 were analyzed retrospectively. All patients received concurrent chemoradiotherapy followed by surgery; 72 patients also received irinotecan-based induction chemotherapy. Concurrent chemotherapy was 5-fluorouracil-based and in 97 cases included taxanes. Radiotherapy was delivered to a total dose of 41.4-50.4 Gy at 1.8-2.0 Gy per fraction with a three-dimensional conformal technique. Surgery (three-field, Ivor-Lewis, or transhiatal esophagectomy) was performed 27-123 days (median, 45 days) after completion of radiotherapy. The following dosimetric parameters were generated from the dose-volume histogram (DVH) for total lung: lung volume, mean dose to lung, relative and absolute volumes of lung receiving more than a threshold dose (relative V(dose) and absolute V(dose)), and absolute volume of lung receiving less than a threshold dose (volume spared, or VS(dose)). Occurrence of postoperative pulmonary complications, defined as pneumonia or acute respiratory distress syndrome (ARDS) within 30 days after surgery, was the endpoint for all analyses. Fisher's exact test was used to investigate the relationship between categorical factors and incidence of postoperative pulmonary complications. Logistic analysis was used to analyze the relationship between continuous factors (e.g., V(dose) or VS(dose)) and complication rate. Logistic regression with forward stepwise inclusion of factors was used to perform multivariate analysis of those factors having univariate significance (p < 0.05). The Mann-Whitney test was used to compare length of hospital stay in patients with and without lung complications and to compare lung volumes, VS5 values, and absolute and relative V5 values in male vs. female patients. Pearson correlation analysis was used to determine correlations between dosimetric factors. Eighteen (16.4%) of the 110 patients developed postoperative pulmonary complications. Two of these died of progressive pneumonia. Hospitalizations were significantly longer for patients with postoperative pulmonary complications than for those without (median, 15 days vs. 11 days, p = 0.003). On univariate analysis, female gender (p = 0.017), higher mean lung dose (p = 0.036), higher relative volume of lung receiving > or = 5 Gy (V5) (p = 0.023), and smaller volumes of lung spared from doses > or = 5-35 Gy (VS5-VS35) (p < 0.05) were all significantly associated with an increased incidence of postoperative pulmonary complications. No other clinical factors were significantly associated with the incidence of postoperative pulmonary complications in this cohort. On multivariate analysis, the volume of lung spared from doses > or = 5 Gy (VS5) was the only significant independent factor associated with postoperative pulmonary complications (p = 0.005). Dosimetric factors but not clinical factors were found to be strongly associated with the incidence of postoperative pulmonary complications in this cohort of esophageal cancer patients treated with concurrent chemoradiation plus surgery. The volume of the lung spared from doses of > or = 5 Gy was the only independent dosimetric factor in multivariate analysis. This suggests that ensuring an adequate volume of lung unexposed to radiation might reduce the incidence of postoperative pulmonary complications.

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.

Dose escalation in permanent brachytherapy for prostate cancer: dosimetric and biological considerations

NASA Astrophysics Data System (ADS)

Li, X. Allen; Wang, Jian Z.; Stewart, Robert D.; Di Biase, Steven J.

2003-09-01

No prospective dose escalation study for prostate brachytherapy (PB) with permanent implants has been reported. In this work, we have performed a dosimetric and biological analysis to explore the implications of dose escalation in PB using 125I and 103Pd implants. The concept of equivalent uniform dose (EUD), proposed originally for external-beam radiotherapy (EBRT), is applied to low dose rate brachytherapy. For a given 125I or 103Pd PB, the EUD for tumour that corresponds to a dose distribution delivered by EBRT is calculated based on the linear quadratic model. The EUD calculation is based on the dose volume histogram (DVH) obtained retrospectively from representative actual patient data. Tumour control probabilities (TCPs) are also determined in order to compare the relative effectiveness of different dose levels. The EUD for normal tissue is computed using the Lyman model. A commercial inverse treatment planning algorithm is used to investigate the feasibility of escalating the dose to prostate with acceptable dose increases in the rectum and urethra. The dosimetric calculation is performed for five representative patients with different prostate sizes. A series of PB dose levels are considered for each patient using 125I and 103Pd seeds. It is found that the PB prescribed doses (minimum peripheral dose) that give an equivalent EBRT dose of 64.8, 70.2, 75.6 and 81 Gy with a fraction size of 1.8 Gy are 129, 139, 150 and 161 Gy for 125I and 103, 112, 122 and 132 Gy for 103Pd implants, respectively. Estimates of the EUD and TCP for a series of possible prescribed dose levels (e.g., 145, 160, 170 and 180 Gy for 125I and 125, 135, 145 and 155 for 103Pd implants) are tabulated. The EUD calculation was found to depend strongly on DVHs and radiobiological parameters. The dosimetric calculations suggest that the dose to prostate can be escalated without a substantial increase in both rectal and urethral dose. For example, increasing the PB prescribed dose from 145 to 180 Gy increases EUD for the rectum by only 3%. Our studies indicate that the dose to urethra can be kept within 100-120% of the prescription dose for all the dose levels studied. In conclusion, dose escalation in permanent implant for localized prostate cancer may be advantageous. It is dosimetrically possible to increase dose to prostate without a substantial increase in the dose to the rectum and urethra. Based on the results of our studies, a prospective dose escalation trial for prostate permanent implants has been initiated at our institution.

A comprehensive and efficient daily quality assurance for PBS proton therapy

NASA Astrophysics Data System (ADS)

Actis, O.; Meer, D.; König, S.; Weber, D. C.; Mayor, A.

2017-03-01

There are several general recommendations for quality assurance (QA) measures, which have to be performed at proton therapy centres. However, almost each centre uses a different therapy system. In particular, there is no standard procedure for centres employing pencil beam scanning and each centre applies a specific QA program. Gantry 2 is an operating therapy system which was developed at PSI and relies on the most advanced technological innovations. We developed a comprehensive daily QA program in order to verify the main beam characteristics to assure the functionality of the therapy delivery system and the patient safety system. The daily QA program entails new hardware and software solutions for a highly efficient clinical operation. In this paper, we describe a dosimetric phantom used for verifying the most critical beam parameters and the software architecture developed for a fully automated QA procedure. The connection between our QA software and the database allows us to store the data collected on a daily basis and use it for trend analysis over longer periods of time. All the data presented here have been collected during a time span of over two years, since the beginning of the Gantry 2 clinical operation in 2013. Our procedure operates in a stable way and delivers the expected beam quality. The daily QA program takes only 20 min. At the same time, the comprehensive approach allows us to avoid most of the weekly and monthly QA checks and increases the clinical beam availability.

TLD linearity vs. beam energy and modality.

PubMed

Troncalli, Andrew J; Chapman, Jane

2002-01-01

Thermoluminescent dosimetry (TLD) is considered to be a valuable dosimetric tool in determining patient dose. Lithium fluoride doped with magnesium and titanium (TLD-100) is widely used, as it does not display widely divergent energy dependence. For many years, we have known that TLD-100 shows supralinearity to dose. In a radiotherapy clinic, there are multiple energies and modality beams. This work investigates whether individual linearity corrections must be used for each beam or whether a single correction can be applied to all beams. The response of TLD as a function of dose was measured from 25 cGy to 1000 cGy on both electrons and photons from 6 to 18 MeV. This work shows that, within our measurement uncertainty, TLD-100 exhibits supralinearity at all megavoltage energies and modalities.

ESR response of phenol compounds for dosimetry of gamma photon beams

NASA Astrophysics Data System (ADS)

Marrale, M.; Longo, A.; Panzeca, S.; Gallo, S.; Principato, F.; Tomarchio, E.; Parlato, A.; Buttafava, A.; Dondi, D.; Zeffiro, A.

2014-11-01

In the present paper we investigate the features of IRGANOX® 1076 phenols as a material for electron spin resonance (ESR) dosimetry. We experimentally analyzed the ESR response of pellets of IRGANOX® 1076 phenols irradiated with 60Co photons. The best experimental parameters (modulation amplitude and microwave power) for dosimetric applications have been obtained. The dependence of ESR signal as function of γ dose is found to be linear in the dose range studied (12-60 Gy) and the lowest measurable dose is found to be of the order of 1 Gy. The signal after irradiation is very stable in the first thirty days. From the point of view of the tissue equivalence, these materials have mass energy absorption coefficient values comparable with those of soft tissue.

The impact of active breathing control on internal mammary lymph node coverage and normal tissue exposure in breast cancer patients planned for left-sided postmastectomy radiation therapy.

PubMed

Barry, Aisling; Rock, Kathy; Sole, Claudio; Rahman, Mohammad; Pintilie, Melania; Lee, Grace; Fyles, Anthony; Koch, C Anne

The purpose of this study was to evaluate the impact of the active breathing control (ABC) technique on IMN coverage and organs at risk in patients planned for postmastectomy radiation therapy (PMRT), with the inclusion of the internal mammary lymph nodes (IMNs). The effect of body mass index (BMI) on recorded dosimetric parameters was examined in the same patient cohort. Fifty left-sided postmastectomy patients with breast cancer who underwent free-breathing (FB) and ABC-Elekta CT simulation scans were selected at random from an institutional breast cancer database between 2008 and 2014. The ABC plans were directly compared with FB plans from the same patient. The IMN planning target volume coverage met dosimetric criteria for coverage of receiving more than 90% of the prescribed dose (V90) >90%, although it decreased with ABC compared with FB (94.5% vs 98%, P < .001). Overall, ABC significantly reduced doses to all measured heart and left anterior descending coronary artery parameters, ipsilateral lung V20, and mean lung dose compared with FB (P < .001). There was no difference seen between the ABC and FB plans with respect to the dose to contralateral lung or contralateral breast. There was no correlation identified between BMI and any of the dosimetric parameters recorded from the ABC and FB plans. Our results suggest that ABC reduces IMN coverage in left-sided breast cancer patients planned for PMRT; however, dosimetric criteria for IMN coverage were still met, suggesting that this is not likely to be clinically significant. ABC led to significant sparing of organs at risk compared with FB conditions and was not affected by BMI. Collectively, the results support the use of ABC for breast cancer patients undergoing left-sided PMRT requiring regional nodal irradiation that includes the IMNs. Further prospective clinical studies are required to determine the impact of these results on late normal tissue effects. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

SU-E-T-27: A Dosimetric Evaluation of Boney Anatomy Versus Fiducial Marker Alignment for the Treatment of Prostate Cancer Using Scanned Beam Proton Therapy

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

Freund, D; Ding, X; Zhang, J

Purpose: In prostate proton radiotherapy, three fiducial markers are used for patient daily alignment. However fiducial alignment can change beamline heterogeneity in proton therapy. The purpose of this study is to determine the difference in fiducial and boney anatomy alignment for patient treatment. Methods and materials: Prostate cancer patients who received proton treatment were included in this study. 3 fiducial markers were implanted before the initial CT. All the patients were re-CT’d every 2 weeks to check the fiducial marker position reproducibility as well as dosimetric consistence of target coverage. In geometry study, re-CT were fused to the initial CTmore » base on the boney anatomy and the average fiducial marker displacement was measured the centers of the fiducials. Dosimetrically, the initial plan was recalculated directly to re-CT image set based on the boney alignment and fiducial alignment to determine the difference from daily treatment. Prostate coverage and hotspots were evaluated using the dose to 98% of the CTV (D98) and dose to 2% (D2), respectively. Results: The shift from the initial 6 patient CT image sets resulted in an average change in the fiducial location of 5.70 +/− 3 mm. Dosimetric comparison from a single patient revealed that differences from the planned dose resulted from both boney and fiducial alignment. Planned clinical treatment volume coverage resulted in a D98 of 70.44Gy and D2 of 70.84Gy compared to a D98 of 70.13Gy and D2 70.94Gy for boney alignment and a D98 of 70.08Gy and D2 71.18Gy for fiducial alignment respectively. Conclusion: This study demonstrates that with boney anatomy alignment there is little change to CTV coverage and only slightly worse CTV coverage and hotspot production with fiducial alignment. An increase patient cohort and further investigation is necessary to determine the whether boney alignment can help better control dose heterogeneity.« less

Multidimensional dosimetry of {sup 106}Ru eye plaques using EBT3 films and its impact on treatment planning

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

Heilemann, G., E-mail: gerd.heilemann@meduniwien.ac.at; Kostiukhina, N.; Nesvacil, N.

2015-10-15

Purpose: The purpose of this study was to establish a method to perform multidimensional radiochromic film measurements of {sup 106}Ru plaques and to benchmark the resulting dose distributions against Monte Carlo simulations (MC), microdiamond, and diode measurements. Methods: Absolute dose rates and relative dose distributions in multiple planes were determined for three different plaque models (CCB, CCA, and COB), and three different plaques per model, using EBT3 films in an in-house developed polystyrene phantom and the MCNP6 MC code. Dose difference maps were generated to analyze interplaque variations for a specific type, and for comparing measurements against MC simulations. Furthermore,more » dose distributions were validated against values specified by the manufacturer (BEBIG) and microdiamond and diode measurements in a water scanning phantom. Radial profiles were assessed and used to estimate dosimetric margins for a given combination of representative tumor geometry and plaque size. Results: Absolute dose rates at a reference depth of 2 mm on the central axis of the plaque show an agreement better than 5% (10%) when comparing film measurements (MCNP6) to the manufacturer’s data. The reproducibility of depth-dose profile measurements was <7% (2 SD) for all investigated detectors and plaque types. Dose difference maps revealed minor interplaque deviations for a specific plaque type due to inhomogeneities of the active layer. The evaluation of dosimetric margins showed that for a majority of the investigated cases, the tumor was not completely covered by the 100% isodose prescribed to the tumor apex if the difference between geometrical plaque size and tumor base ≤4 mm. Conclusions: EBT3 film dosimetry in an in-house developed phantom was successfully used to characterize the dosimetric properties of different {sup 106}Ru plaque models. The film measurements were validated against MC calculations and other experimental methods and showed a good agreement with data from BEBIG well within published tolerances. The dosimetric information as well as interplaque comparison can be used for comprehensive quality assurance and for considerations in the treatment planning of ophthalmic brachytherapy.« less

Dosimetric comparison between model 9011 and 6711 sources in prostate implants

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

Zhang, Hualin, E-mail: zhang248@iupui.edu; Arizona Oncology Services, Phoenix, AZ; Beyer, David

2013-07-01

The purpose of this work is to evaluate the model 9011 iodine-125 ({sup 125}I) in prostate implants by comparing dosimetric coverage provided by the 6711 vs 9011 source implants. Postimplant dosimetry was performed in 18 consecutively implanted patients with prostate cancer. Two were implanted with the 9011 source and 16 with the 6711 source. For purposes of comparison, each implant was then recalculated assuming use of the other source. The same commercially available planning system was used and the specific source data for both 6711 and 9011 products were entered. The results of these calculations are compared side by sidemore » in the terms of the isodose values covering 100% (D100) and 90% (D90) of prostate volume, and the percentages of volumes of prostate, bladder, rectum, and urethra covered by 200% (V200), 150% (V150), 100% (V100), 50% (V50), and 20% (V20) of the prescribed dose as well. The 6711 source data overestimate coverage by 6.4% (ranging from 4.9% to 6.9%; median 6.6%) at D100 and by 6.6% (ranging from 6.2% to 6.8%; median 6.6%) at D90 compared with actual 9011 data. Greater discrepancies of up to 67% are seen at higher dose levels: average reduction for V100 is 2.7% (ranging from 0.6% to 7.7%; median 2.3%), for V150 is 14.6% (ranging from 6.1% to 20.5%; median 15.3%), for V200 is 14.9% (ranging from 4.8% to 19.1%; median 16%); similarly seen in bladder, rectal, and urethral coverage. This work demonstrates a clear difference in dosimetric behavior between the 9011 and 6711 sources. Using the 6711 source data for 9011 source implants would create a pronounced error in dose calculation. This study provides evidence that the 9011 source can provide the same dosimetric quality as the 6711 source, if properly used; however, the 6711 source data should not be considered as a surrogate for the 9011 source implants.« less

SU-E-T-233: Cyberknife Versus Linac IMRT for Dose Comparision in Hypofractionated Hemi Larynx Irradiation of Early Stage True Vocal Cord Cancer: A Dosimetric Study

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

Ding, C; Lee, P; Jiang, S

2015-06-15

Purpose: To compare dosimetric data of patients treated for early-stage larynx cancer on Cyberknife and Linac IMRT. Methods: Nine patients were treated with Cyberknife to a dose of 45 Gy in 10 fractions of the involved hemilarynx. The prescription dose provided at least 95% of PTV coverage. After Cyberknife treatment, the CT images and contours were sent to Pinnacle treatment planning system for IMRT planning on a regular SBRT linac with same dose prescription and constrains. Dose to target and normal tissue, including the arytenoids, cord, carotid arteries, thyroid, and skin, were analyzed using dose volume histograms. Results: For Cyberknifemore » plan, the conformity indices are within 1.11–1.33. The average dose to the contralateral arytenoids for Cyberknife plans was 28.9±6.5Gy), which is lower than the same mean dose for IMRT plans (34.0±5.2 Gy). The average maximum dose to the ipsilateral and contralateral carotid artery were 20.6 ±9.1 Gy and 10.2±6.0 Gy respectively for Cybeknife comparing with 22.1±8.0 Gy and 12.0±5.1 Gy for IMRT. The mean dose to the thyroid was 3.6±2.2 Gy for Cyberknife and 3.4±2.4 Gy for IMRT. As shown in DVH, the Cyberknife can deliver less dose to the normal tissue which is close to target area comparing with IMRT Plans. However, IMRT plan’s can give more sparing for the critical organs which is far away from the target area. Conclusion: We have compared the dosimetric parameters of Cyberknife and linac IMRT plans for patients with early-stage larynx cancer. Both Cyberknife and IMRT plans can achieve conformal dose distribution to the target area. Cyberknife was able to reduce normal tissue dose in high doses region while IMRT plans can reduce the dose of the normal tissue at the low dose region. These dosimetric parameters can be used to guide future prospective protocols using SBRT for larynx cancer.« less

SU-E-J-110: Dosimetric Analysis of Respiratory Motion Based On Four-Dimensional Dose Accumulation in Liver Stereotactic Body Radiotherapy

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

Kang, S; Kim, D; Kim, T

2015-06-15

Purpose: Respiratory motion in thoracic and abdominal region could lead to significant underdosing of target and increased dose to healthy tissues. The aim of this study is to evaluate the dosimetric effect of respiratory motion in conventional 3D dose by comparing 4D deformable dose in liver stereotactic body radiotherapy (SBRT). Methods: Five patients who had previously treated liver SBRT were included in this study. Four-dimensional computed tomography (4DCT) images with 10 phases for all patients were acquired on multi-slice CT scanner (Siemens, Somatom definition). Conventional 3D planning was performed using the average intensity projection (AIP) images. 4D dose accumulation wasmore » calculated by summation of dose distribution for all phase images of 4DCT using deformable image registration (DIR) . The target volume and normal organs dose were evaluated with the 4D dose and compared with those from 3D dose. And also, Index of achievement (IOA) which assesses the consistency between planned dose and prescription dose was used to compare target dose distribution between 3D and 4D dose. Results: Although the 3D dose calculation considered the moving target coverage, significant differences of various dosimetric parameters between 4D and 3D dose were observed in normal organs and PTV. The conventional 3D dose overestimated dose to PTV, however, there was no significant difference for GTV. The average difference of IOA which become ‘1’ in an ideal case was 3.2% in PTV. The average difference of liver and duodenum was 5% and 16% respectively. Conclusion: 4D dose accumulation which can provide dosimetric effect of respiratory motion has a possibility to predict the more accurate delivered dose to target and normal organs and improve treatment accuracy. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid-career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded by the Ministry of Science, ICT&Future Planning (MSIP) of Korea.« less

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

Lee, S; Ellis, R; Traughber, B

Purpose: Treating gynecological cancers with interstitial high-dose-rate (HDR) brachytherapy requires precise reconstruction of catheter positions to obtain accurate dosimetric plans. In this study, we investigated the degree of reproducibility of dosimetric plans for Syed HDR brachytherapy. Methods: We randomly selected five patients having cervix-vaginal cancer who were recently treated in our clinic with interstitial HDR brachytherapy with a prescription dose of 25–30 Gy in five fractions. Interstitial needles/catheters were placed under fluoroscopic guidance and intra-operative 3T MRI scan was performed to confirm the desired catheter placement for adequate target volume coverage. A CT scan was performed and fused with themore » MRI for delineating high-risk CTV (HR-CTV), intermediate-risk CTV (IR-CTV) and OARs. HDR treatment plans were generated using Oncentra planning software. A single plan was used for all five fractions of treatment for each patient. For this study, we took the original clinical plan and removed all the reconstructed catheters from the plan keeping the original contours unchanged. Then, we manually reconstructed all the catheters and entered the same dwell time from the first original clinical plan. The dosimetric parameters studied were: D90 for HR-CTV and IR-CV, and D2cc for bladder, rectum, sigmoid and bowel. Results: The mean of absolute differences in dosimetric coverage (D90) were (range): 1.3% (1.0–2.0%) and 2.0% (0.9–3.6%) for HR-CTV and IR-CTV, respectively. In case of OARs, the mean of absolute variations in D2cc were (range): 4.7% (0.7–8.9%) for bladder, 1.60% (0.3–3.2%) for rectum, 1.6% (0–3.9%) for sigmoid, and 1.8% (0–5.1%) for bowel. Conclusion: Overall, the reproducibility of interstitial HDR plans was within clinically acceptable limit. Observed maximum variation in D2cc for bladder. If number of catchers and dwell points were relatively low or any one catheter was heavily loaded, then reproducibility of the plan was more sensitive to the accuracy of catheter reconstruction.« less

Monitoring Dosimetric Impact of Weight Loss With Kilovoltage (KV) Cone Beam CT (CBCT) During Parotid-Sparing IMRT and Concurrent Chemotherapy

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

Ho, Kean Fatt, E-mail: hokeanfatt@hotmail.com; Marchant, Tom; Moore, Chris

2012-03-01

Purpose: Parotid-sparing head-and-neck intensity-modulated radiotherapy (IMRT) can reduce long-term xerostomia. However, patients frequently experience weight loss and tumor shrinkage during treatment. We evaluate the use of kilovoltage (kV) cone beam computed tomography (CBCT) for dose monitoring and examine if the dosimetric impact of such changes on the parotid and critical neural structures warrants replanning during treatment. Methods and materials: Ten patients with locally advanced oropharyngeal cancer were treated with contralateral parotid-sparing IMRT concurrently with platinum-based chemotherapy. Mean doses of 65 Gy and 54 Gy were delivered to clinical target volume (CTV)1 and CTV2, respectively, in 30 daily fractions. CBCT wasmore » prospectively acquired weekly. Each CBCT was coregistered with the planned isocenter. The spinal cord, brainstem, parotids, larynx, and oral cavity were outlined on each CBCT. Dose distributions were recalculated on the CBCT after correcting the gray scale to provide accurate Hounsfield calibration, using the original IMRT plan configuration. Results: Planned contralateral parotid mean doses were not significantly different to those delivered during treatment (p > 0.1). Ipsilateral and contralateral parotids showed a mean reduction in volume of 29.7% and 28.4%, respectively. There was no significant difference between planned and delivered maximum dose to the brainstem (p = 0.6) or spinal cord (p = 0.2), mean dose to larynx (p = 0.5) and oral cavity (p = 0.8). End-of-treatment mean weight loss was 7.5 kg (8.8% of baseline weight). Despite a {>=}10% weight loss in 5 patients, there was no significant dosimetric change affecting the contralateral parotid and neural structures. Conclusions: Although patient weight loss and parotid volume shrinkage was observed, overall, there was no significant excess dose to the organs at risk. No replanning was felt necessary for this patient cohort, but a larger patient sample will be investigated to further confirm these results. Nevertheless, kilovoltage CBCT is a valuable tool for patient setup verification and monitoring of dosimetric variation during radiotherapy.« less

SU-E-J-39: Dosimetric Benefit of Implanted Marker-Based CBCT Setup for Definitive Prostatic Radiotherapy

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

Zhen, H; Wu, Z; Bluemenfeld, P

Purpose Daily setup for definitive prostatic radiotherapy is challenged by suboptimal visibility of the prostate boundary and daily variation of rectum shape and position. For patients with improved bowel preparation, we conducted a dosimetric comparison between prostate implanted marker (IM)-based daily setup and anterior rectal wall (ARW)-based setup, with the hypothesis that the former leads to adequate target coverage with better rectal sparing. Methods Five IMRT/VMAT prostate cases with implanted markers were selected for analysis. Daily CBCT showed improvement of the rectal volume compared to planning CT. For each patient, the prostate and rectum were contoured on three CBCT imagesmore » (fraction 5/15/25) with subsequent physician review. The CBCTs were then registered to a planning CT using IM-based registration. The deviation of ARW positions from planning CT to CBCT were analyzed at various sup-inf levels (−1.8 cm to 1.8 cm from level of prostate center). To estimate the potential dosimetric impact from ARW-based setup, the treatment plans were recalculated using A-P shifts ranging from −1mm to +6mm. Clinically important rectum DVH values including Dmax, D3cc and Dmean were computed. Results For the studied patients, we observed on average 32% rectum volume reduction from planning CT to CBCT. As a Results, the ARW on average shifts posteriorly by −1mm to +5mm, depending on the sup-inf level of observation, with larger shifts observed at more superior levels. Recalculation shows that when ARW shifts 1mm posteriorly, ARW-based CBCT setup leads to a 1.0%, 4.2%, and 3.2% increase in rectum Dmax, D3cc, and Dmean, respectively, compared to IM-based setup. The dosimetric deviations increase to 4.7%, 25.8% and 24.7% when ARW shifts 6mm posteriorly. No significant prostate-only dose difference was observed. Conclusion For patients with improved bowel preparation, IM-based CBCT setup leads to accurate prostate coverage along with significantly lower rectal dose, compared to ARW-based setup.« less

Cardiac dosimetric evaluation of deep inspiration breath-hold level variances using computed tomography scans generated from deformable image registration displacement vectors

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

Harry, Taylor; Department of Radiation Medicine, Oregon Health and Science University, Portland, OR; Department of Nuclear Engineering and Radiation Health Physics, Oregon State University, Corvallis, OR

There is a reduction in cardiac dose for left-sided breast radiotherapy during treatment with deep inspiration breath-hold (DIBH) when compared with treatment with free breathing (FB). Various levels of DIBH may occur for different treatment fractions. Dosimetric effects due to this and other motions are a major component of uncertainty in radiotherapy in this setting. Recent developments in deformable registration techniques allow displacement vectors between various temporal and spatial patient representations to be digitally quantified. We propose a method to evaluate the dosimetric effect to the heart from variable reproducibility of DIBH by using deformable registration to create new anatomicalmore » computed tomography (CT) scans. From deformable registration, 3-dimensional deformation vectors are generated with FB and DIBH. The obtained deformation vectors are scaled to 75%, 90%, and 110% and are applied to the reference image to create new CT scans at these inspirational levels. The scans are then imported into the treatment planning system and dose calculations are performed. The average mean dose to the heart was 2.5 Gy (0.7 to 9.6 Gy) at FB, 1.2 Gy (0.6 to 3.8 Gy, p < 0.001) at 75% inspiration, 1.1 Gy (0.6 to 3.1 Gy, p = 0.004) at 90% inspiration, 1.0 Gy (0.6 to 3.0 Gy) at 100% inspiration or DIBH, and 1.0 Gy (0.6 to 2.8 Gy, p = 0.019) at 110% inspiration. The average mean dose to the left anterior descending artery (LAD) was 19.9 Gy (2.4 to 46.4 Gy), 8.6 Gy (2.0 to 43.8 Gy, p < 0.001), 7.2 Gy (1.9 to 40.1 Gy, p = 0.035), 6.5 Gy (1.8 to 34.7 Gy), and 5.3 Gy (1.5 to 31.5 Gy, p < 0.001), correspondingly. This novel method enables numerous anatomical situations to be mimicked and quantifies the dosimetric effect they have on a treatment plan.« less

SU-F-J-179: Commissioning Dosimetric Data of a New 2.5 Megavoltage Imaging Beam from a TrueBeam Linear

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

Ding, G

2016-06-15

Purpose: Recently a new 2.5 megavoltage imaging beam has become available in a TrueBeam linear accelerator for image guidance. There is limited information available related to the beam characteristics. Commissioning dosimetric data of the new imaging is necessary for configuration of the beam in a treatment planning system in order to calculate imaging doses to patients resulting from this new imaging beam. The purpose of this study is to provide measured commissioning data recommended for a beam configuration in a treatment planning system. Methods: A recently installed TrueBeam linear accelerator is equipped with a new low energy photon beam withmore » a nominal energy of 2.5 MV which provides better image quality in addition to other therapeutic megavoltage beams. Dosimetric characteristics of the 2.5 MV are measured for commissioning. An ionization chamber was used to measure dosimetric data including depth-dose curves and dose profiles at different depths for field sizes ranging from 5×5 cm{sup 2} to 40×40 cm{sup 2}. Results: Although the new 2.5 MV beam is a flattening-filter-free (FFF) beam, its dose profiles are much flatter compared to a 6 MV FFF beam. The dose decrease at 20 cm away from the central axis is less than 30% for a 40×40 cm{sup 2} field. This moderately lower dose at off-axis distances benefits the imaging quality. The values of percentage depth-dose (PDD) curves are 53% and 63% for 10×10 cm{sup 2} and 40×40 cm{sup 2} fields respectively. The measured beam output is 0.85 cGy/MU for a reference field size at depth 5 cm obtained according to the AAPM TG-51 protocol. Conclusion: This systematically measured commissioning data is useful for configuring the new imaging beam in a treatment planning system for patient imaging dose calculations resulting from the application of this 2.5 MV beam which is commonly set as a default in imaging procedures.« less

Predictors of Radiation Pneumonitis in Patients Receiving Intensity Modulated Radiation Therapy for Hodgkin and Non-Hodgkin Lymphoma

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

Pinnix, Chelsea C., E-mail: ccpinnix@mdanderson.org; Smith, Grace L.; Milgrom, Sarah

Purpose: Few studies to date have evaluated factors associated with the development of radiation pneumonitis (RP) in patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), especially in patients treated with contemporary radiation techniques. These patients represent a unique group owing to the often large radiation target volumes within the mediastinum and to the potential to receive several lines of chemotherapy that add to pulmonary toxicity for relapsed or refractory disease. Our objective was to determine the incidence and clinical and dosimetric risk factors associated with RP in lymphoma patients treated with intensity modulated radiation therapy (IMRT) at a singlemore » institution. Methods and Materials: We retrospectively reviewed clinical charts and radiation records of 150 consecutive patients who received mediastinal IMRT for HL and NHL from 2009 through 2013. Clinical and dosimetric predictors associated with RP according to Radiation Therapy Oncology Group (RTOG) acute toxicity criteria were identified in univariate analysis using the Pearson χ{sup 2} test and logistic multivariate regression. Results: Mediastinal radiation was administered as consolidation therapy in 110 patients with newly diagnosed HL or NHL and in 40 patients with relapsed or refractory disease. The overall incidence of RP (RTOG grades 1-3) was 14% in the entire cohort. Risk of RP was increased for patients who received radiation for relapsed or refractory disease (25%) versus those who received consolidation therapy (10%, P=.019). Several dosimetric parameters predicted RP, including mean lung dose of >13.5 Gy, V{sub 20} of >30%, V{sub 15} of >35%, V{sub 10} of >40%, and V{sub 5} of >55%. The likelihood ratio χ{sup 2} value was highest for V{sub 5} >55% (χ{sup 2} = 19.37). Conclusions: In using IMRT to treat mediastinal lymphoma, all dosimetric parameters predicted RP, although small doses to large volumes of lung had the greatest influence. Patients with relapsed or refractory lymphoma who received salvage chemotherapy and hematopoietic stem cell transplantation were at higher risk for symptomatic RP.« less

SU-E-T-217: Comprehensive Dosimetric Evaluation On 3D-CRT, IMRT and Non-Coplanar Arc Treatment for Prone Accelerated Partial Breast Irradiation (APBI)

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

Chiu, T; Yan, Y; Ramirez, E

2015-06-15

Purpose: Accelerated partial breast irradiation (APBI) is an effective treatment for early stage breast-cancer. Irradiation in a prone position can mitigate breast motion and spare heart and lung. In this study, a comprehensive study is performed to evaluate various treatment techniques for prone APBI treatment including: 3D-CRT, IMRT, co-planar and non-coplanar partial arcs treatment. Methods: In this treatment planning study, a left breast patient treated in prone position in our clinic was imported into Varian Eclipse TPS. Six beams tangential to chest wall were used in both 3D-CRT and IMRT plans. These six beams were coplanar in a transactional planemore » achieved by both gantry and couch rotation. A 60-beam IMRT plan was also created to explore the maximum benefit of co-planar IMRT. Within deliverable couch rotation range (±30°), partial arc treatment plans with one and up to ten couch positions were generated for comparison. For each plan, 30Gy in 6 fractions was prescribed to 95% PTV volume. Critical dosimetric parameters, such as conformity index, mean, maximum, and volume dose of organ at risk, are evaluated. Results: The conformity indexes (CI) are 3.53, 3.17, 2.21 and 1.08 respectively to 3D-CRT, 6-beam IMRT, 60-beam IMRT, and two-partial-arcs coplanar plans. However, arc plans increase heart dose. CI for non-coplanar arc plans decreases from 1.19 to 1.10 when increases couch positions. Maximum dose in ipsilateral lung (1.98 to 1.13 Gy), and heart (0.62 to 0.43 Gy) are steadily decreased with the increased number of non-coplanar arcs. Conclusions: The dosimetric evaluation results show that partial arc plans have improved CIs compared to conventional 3D-CRT and IMRT plans. Increasing number of partial arcs decreases lung and heart dose. The dosimetric benefit obtained from non-coplanar arcs should be considered with treatment delivery time.« less

An Automated Treatment Plan Quality Control Tool for Intensity-Modulated Radiation Therapy Using a Voxel-Weighting Factor-Based Re-Optimization Algorithm.

PubMed

Song, Ting; Li, Nan; Zarepisheh, Masoud; Li, Yongbao; Gautier, Quentin; Zhou, Linghong; Mell, Loren; Jiang, Steve; Cerviño, Laura

2016-01-01

Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be satisfied when the TPS-QC tool generated re-optimized plans without sacrificing other dosimetric endpoints. In addition to its feasibility and accuracy, the proposed TPS-QC tool is also user-friendly and easy to operate, both of which are necessary characteristics for clinical use.

SU-F-T-461: Dosimetric Evaluation of Indigenous Farmer Type Chamber FAR65- GB for Reference Dosimetry of FFF MV Photon Beam

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

Patwe, P; Mhatre, V; Dandekar, P

Purpose: Indigenous Farmer type chamber FAR 65 GB is a reference class 0.6 cc ion chamber. It can be used for dosimetric evaluation of photon and high energy electron beams. We studied dosimetric characteristics of the chamber for 6MV and 10MV Flattening filter free FFF photon beams available on trueBEAM STx Linac. Methods: The study was carried out on trueBEAM STx Linac having 6 and 10 MV FFF photon beam with maximum dose rate 1400 and 2400 MU per min respectively. The dosimetric device to be evaluated is Rosalina Instruments FAR 65-GB Ion Chamber with active volume 0.65 cc, totalmore » active length 23.1cm, inner diameter of cylinder 6.2mm, wall thickness 0.4mm, inner electrode diameter 1mm. Inner and outer electrodes are made from Aluminium 2.7 gm per cc and graphite 1.82 gm per cc respectively. The ion chamber was placed along central axis of beam at 10cm depth and irradiated for 10cm × 10cm field size at SAD of 100 cm in plastic phantom. We studied Precision, Dose Linearity, Dose Rate dependence, directional dependence, Recombination effect. Recombination effect was determined using standard two-voltage method. Results: 1. Measurements were reproducible std deviation of 0.0105 and type A uncertainty 0.003265 under same set of reference conditions 2. Chamber exhibit dose linearity over a wider dose range. 3. Chamber shows dose rate independence for all available dose rate range. 4. Response of chamber with the angle of incidence of radiation is constant. 5. Recombination correction factors were 1.01848 and 1.02537 for dose rate 1400 and 2400 MU per min resp. Conclusion: Our study reveals that the chamber is prone to saturation effect at dose rate of 2400 MU per min. FAR 65-GB can be used for reference dosimetry of FFF MV photon beam with proper calculation of recombination effect.« less

SU-E-T-25: A Dosimetric Comparison of Three-Dimension Conformal and Intensity-Modulated Radiation Therapy in Esophageal Cancer

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

Gallardo, N; Maneru, F; Fuentemilla, N

2015-06-15

Purpose: dosimetric comparison of 3DCRT and IMRT in 9 esophageal cancer. The aim of this paper is to know which of these two techniques is dosimetrically more favorable dosimetrically at both the CTV coverage and dose obtained in the relevant organs at risk, in this case, lungs and heart, as the spinal cord received in all cases below 45 Gy. Methods: we chose 9 patients from our center (CHN) with the same type of esophageal cancer and in which the prescribed dose was the same, 54 Gy. For these treatments we have used the same fields and the same anglesmore » (AP (0 °), OPD (225°–240°) and OPI (125°–135°)).All plans have been implemented using Eclipse (version 11.0) with AAA( Analytical Anisotropic Algorithm )(Version 11.0.31). Results: To analyze the coverage of the CTV, we have evaluated the D99% and found that the average dose received by 99% of CTV with IMRT is 53.8 ± 0.4 Gy (99.6% of the prescribed dose) and the mean value obtained with 3DCRT is 52.3 ± 0.6 Gy (96.8% of the prescribed dose).The last data analyzed was the D2% of PTV, a fact that gives us information on the maximum dose received by our PTV. D2% of the PTV for IMRT planning is 55.4 ± 0.4 Gy (102.6% of the prescribed dose) and with 3DCRT is 56.8 ± 0.7 Gy (105.2% of the prescribed dose).All parameters analyzed at risk organs (V30, V40, V45 and V50 for the case of heart and V5, V10, V15 and V20 for the case of the lungs) provide us irradiated volume percentages lower in IMRT than 3DCRT. Conclusion: IMRT provides a considerable improvement in the coverage of the CTV and the doses to organs at risk.« less

SU-E-CAMPUS-I-02: Estimation of the Dosimetric Error Caused by the Voxelization of Hybrid Computational Phantoms Using Triangle Mesh-Based Monte Carlo Transport

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

Lee, C; Badal, A

Purpose: Computational voxel phantom provides realistic anatomy but the voxel structure may result in dosimetric error compared to real anatomy composed of perfect surface. We analyzed the dosimetric error caused from the voxel structure in hybrid computational phantoms by comparing the voxel-based doses at different resolutions with triangle mesh-based doses. Methods: We incorporated the existing adult male UF/NCI hybrid phantom in mesh format into a Monte Carlo transport code, penMesh that supports triangle meshes. We calculated energy deposition to selected organs of interest for parallel photon beams with three mono energies (0.1, 1, and 10 MeV) in antero-posterior geometry. Wemore » also calculated organ energy deposition using three voxel phantoms with different voxel resolutions (1, 5, and 10 mm) using MCNPX2.7. Results: Comparison of organ energy deposition between the two methods showed that agreement overall improved for higher voxel resolution, but for many organs the differences were small. Difference in the energy deposition for 1 MeV, for example, decreased from 11.5% to 1.7% in muscle but only from 0.6% to 0.3% in liver as voxel resolution increased from 10 mm to 1 mm. The differences were smaller at higher energies. The number of photon histories processed per second in voxels were 6.4×10{sup 4}, 3.3×10{sup 4}, and 1.3×10{sup 4}, for 10, 5, and 1 mm resolutions at 10 MeV, respectively, while meshes ran at 4.0×10{sup 4} histories/sec. Conclusion: The combination of hybrid mesh phantom and penMesh was proved to be accurate and of similar speed compared to the voxel phantom and MCNPX. The lowest voxel resolution caused a maximum dosimetric error of 12.6% at 0.1 MeV and 6.8% at 10 MeV but the error was insignificant in some organs. We will apply the tool to calculate dose to very thin layer tissues (e.g., radiosensitive layer in gastro intestines) which cannot be modeled by voxel phantoms.« less

SU-E-J-84: Quantitative Dosimetry Assessment of the Impact of Image Artifacts of Metal Implants in Spinal SABR Treatment

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

Chen, T; Zhang, M; Hanft, S

2015-06-15

Purpose: Metal rods are frequently used to stabilize the spine in patients with metastatic disease. The high Z material causes imaging artifacts in the surrounding tissue in CT scans, which introduces dosimetric uncertainty when inhomogeneity correction is enabled for radiation treatment planning. The purpose of this study is to quantify the dosimetric deviations caused by the imaging artifacts and to evaluate the effectiveness of using Hounsfield units (HU) overwriting to reduce dosimetric uncertainties. Methods: We retrospectively reviewed treatment plans for 4 patients with metal implants who received stereotactic ablative radiation therapy (SABR) for metastatic disease to the spine on Tomotherapymore » HiArt. For all four patients, the region of imaging artifact surrounding the metal implants was contoured and the pixel HU’s were overwritten to be water equivalent. We then generated adaptive treatment plans for these patients using the MVCT pretreatment set up images and batched beamlets in the original treatment plans. The dosimetry deviation between the adaptive and original plans were compared and quantitatively analyzed. Results: For three out of four patient, the major OAR (spinal cord) dose (0.35cc or 10% according to protocols and fractionation) increased (2.7%, 5.5%, 0%, 3.9%, mean=3.0±2.3%, p=0.04), and the PTV dose (D90 or D95 as per prescription) increased for all four patients ( 2%, 5%, 0.7%, 3.6%, mean=2.8±1.9%, p=0.03) in the adaptive plan with HU overwriting. The average point dose deviation of the Tomotherapy DQA for the same patients was −1.0±1.0%. For plans without HU overwriting, the dose deviation from the treatment plan will increase. Conclusion: The metal implant and the imaging artifacts may cause a significant dosimetric impact on radiation treatment plans for spinal disease. The dose to the PTV and the spinal cord was under-calculated in treatment plans without considering the imaging artifacts. HU overwriting can reduce the dosimetry un-certainty.« less

SU-E-J-21: Setup Variability of Colorectal Cancer Patients Treated in the Prone Position and Dosimetric Comparison with the Supine Position

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

Kim, A; Foster, J; Chu, W

2015-06-15

Purpose: Many cancer centers treat colorectal patients in the prone position on a belly board to minimize dose to the small bowel. That may potentially Result in patient setup instability with corresponding impact on dose delivery accuracy for highly conformal techniques such as IMRT/VMAT. Two aims of this work are 1) to investigate setup accuracy of rectum patients treated in the prone position on a belly board using CBCT and 2) to evaluate dosimetric impact on bladder and small bowel of treating rectum patients in supine vs. prone position. Methods: For the setup accuracy study, 10 patients were selected. Weeklymore » CBCTs were acquired and matched to bone. The CBCT-determined shifts were recorded. For the dosimetric study, 7 prone-setup patients and 7 supine-setup patients were randomly selected from our clinical database. Various clinically relevant dose volume histogram values were recorded for the small bowel and bladder. Results: The CBCT-determined rotational shifts had a wide variation. For the dataset acquired at the time of this writing, the ranges of rotational setup errors for pitch, roll, and yaw were [−3.6° 4.7°], [−4.3° 3.2°], and [−1.4° 1.4°]. For the dosimetric study: the small bowel V(45Gy) and mean dose for the prone position was 5.6±12.1% and 18.4±6.2Gy (ranges indicate standard deviations); for the supine position the corresponding dose values were 12.9±15.8% and 24.7±8.8Gy. For the bladder, the V(30Gy) and mean dose for prone position were 68.7±12.7% and 38.4±3.3Gy; for supine position these dose values were 77.1±13.7% and 40.7±3.1Gy. Conclusion: There is evidence of significant rotational instability in the prone position. The OAR dosimetry study indicates that there are some patients that may still benefit from the prone position, though many patients can be safely treated supine.« less

SU-E-T-119: Dosimetric and Mechanical Characteristics of Elekta Infinity LINAC with Agility MLC

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

Park, J; Xu, Q; Xue, J

2014-06-01

Purpose: Elekta Infinity is the one of the latest generation LINAC with unique features. Two Infinity LINACs are recently commissioned at our institution. The dosimetric and mechanical characteristics of the machines are presented. Methods: Both Infinity LINACs with Agility MLC (160 leaves with 0.5 cm leaf width) are configured with five electron energies (6, 9, 12, 15, and 18 MeV) and two photon energies (6 and 15 MV). One machine has additional photon energy (10 MV). The commissioning was performed by following the manufacturer's specifications and AAPM TG recommendations. Beam data of both electron and photon beams are measured withmore » scanning ion chambers and linear diode array. Machines are adjusted to have the dosimetrically equivalent characteristics. Results: The commissioning of mechanical and imaging system meets the tolerances by TG recommendations. The PDD{sub 10} of various field sizes for 6 and 15 MV shows < 0.5% difference between two machines. For each electron beams, R{sub 80} matches with < 0.4 mm difference. The symmetry and flatness agree within 0.8% and 0.9% differences for photon beams, respectively. For electron beams, the differences of the symmetry and flatness are within 1.2% and 0.8%, respectively. The mean inline penumbras for 6, 10, and 15 MV are respectively 5.1±0.24, 5.6±0.07, and 5.9±0.10 mm for 10x10 cm at 10 cm depth. The crossline penumbras are larger than inline penumbras by 2.2, 1.4, and 1.0 mm, respectively. The MLC transmission factor with interleaf leakage is 0.5 % for all photon energies. Conclusion: The dosimetric and mechanical characteristics of two Infinity LINACs show good agreements between them. Although the Elekta Infinity has been used in many institutions, the detailed characteristics of the machine have not been reported. This study provides invaluable information to understand the Infinity LINAC and to compare the quality of commissioning data for other LINACs.« less

SU-E-J-127: Real-Time Dosimetric Assessment for Adaptive Head-And-Neck Treatment Via A GPU-Based Deformable Image Registration Framework

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

Qi, S; Neylon, J; Chen, A

2014-06-01

Purposes: To systematically monitor anatomic variations and their dosimetric consequences during head-and-neck (H'N) radiation therapy using a GPU-based deformable image registration (DIR) framework. Methods: Eleven H'N IMRT patients comprised the subject population. The daily megavoltage CT and weekly kVCT scans were acquired for each patient. The pre-treatment CTs were automatically registered with their corresponding planning CT through an in-house GPU-based DIR framework. The deformation of each contoured structure was computed to account for non-rigid change in the patient setup. The Jacobian determinant for the PTVs and critical structures was used to quantify anatomical volume changes. Dose accumulation was performed tomore » determine the actual delivered dose and dose accumulation. A landmark tool was developed to determine the uncertainty in the dose distribution due to registration error. Results: Dramatic interfraction anatomic changes leading to dosimetric variations were observed. During the treatment courses of 6–7 weeks, the parotid gland volumes changed up to 34.7%, the center-of-mass displacement of the two parotids varied in the range of 0.9–8.8mm. Mean doses were within 5% and 3% of the planned mean doses for all PTVs and CTVs, respectively. The cumulative minimum/mean/EUD doses were lower than the planned doses by 18%, 2%, and 7%, respectively for the PTV1. The ratio of the averaged cumulative cord maximum doses to the plan was 1.06±0.15. The cumulative mean doses assessed by the weekly kVCTs were significantly higher than the planned dose for the left-parotid (p=0.03) and right-parotid gland (p=0.006). The computation time was nearly real-time (∼ 45 seconds) for registering each pre-treatment CT to the planning CT and dose accumulation with registration accuracy (for kVCT) at sub-voxel level (<1.5mm). Conclusions: Real-time assessment of anatomic and dosimetric variations is feasible using the GPU-based DIR framework. Clinical implementation of this technology may enable timely plan adaption and potentially lead to improved outcome.« less

Monte Carlo simulation for Neptun 10 PC medical linear accelerator and calculations of output factor for electron beam

PubMed Central

Bahreyni Toossi, Mohammad Taghi; Momennezhad, Mehdi; Hashemi, Seyed Mohammad

2012-01-01

Aim Exact knowledge of dosimetric parameters is an essential pre-requisite of an effective treatment in radiotherapy. In order to fulfill this consideration, different techniques have been used, one of which is Monte Carlo simulation. Materials and methods This study used the MCNP-4Cb to simulate electron beams from Neptun 10 PC medical linear accelerator. Output factors for 6, 8 and 10 MeV electrons applied to eleven different conventional fields were both measured and calculated. Results The measurements were carried out by a Wellhofler-Scanditronix dose scanning system. Our findings revealed that output factors acquired by MCNP-4C simulation and the corresponding values obtained by direct measurements are in a very good agreement. Conclusion In general, very good consistency of simulated and measured results is a good proof that the goal of this work has been accomplished. PMID:24377010

Analysis Techniques for Microwave Dosimetric Data.

DTIC Science & Technology

1985-10-01

the number of steps in the frequency list . 0062 C ----------------------------------------------------------------------- 0063 CALL FILE2() 0064...starting frequency, 0061 C the step size, and the number of steps in the frequency list . 0062 C

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

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

Tucker, Susan L.; Liu, H. Helen; Wang, Shulian

Purpose: The aim of this study was to investigate the effect of radiation dose distribution in the lung on the risk of postoperative pulmonary complications among esophageal cancer patients. Methods and Materials: We analyzed data from 110 patients with esophageal cancer treated with concurrent chemoradiotherapy followed by surgery at our institution from 1998 to 2003. The endpoint for analysis was postsurgical pneumonia or acute respiratory distress syndrome. Dose-volume histograms (DVHs) and dose-mass histograms (DMHs) for the whole lung were used to fit normal-tissue complication probability (NTCP) models, and the quality of fits were compared using bootstrap analysis. Results: Normal-tissue complicationmore » probability modeling identified that the risk of postoperative pulmonary complications was most significantly associated with small absolute volumes of lung spared from doses {>=}5 Gy (VS5), that is, exposed to doses <5 Gy. However, bootstrap analysis found no significant difference between the quality of this model and fits based on other dosimetric parameters, including mean lung dose, effective dose, and relative volume of lung receiving {>=}5 Gy, probably because of correlations among these factors. The choice of DVH vs. DMH or the use of fractionation correction did not significantly affect the results of the NTCP modeling. The parameter values estimated for the Lyman NTCP model were as follows (with 95% confidence intervals in parentheses): n = 1.85 (0.04, {infinity}), m = 0.55 (0.22, 1.02), and D {sub 5} = 17.5 Gy (9.4 Gy, 102 Gy). Conclusions: In this cohort of esophageal cancer patients, several dosimetric parameters including mean lung dose, effective dose, and absolute volume of lung receiving <5 Gy provided similar descriptions of the risk of postoperative pulmonary complications as a function of Radiation dose distribution in the lung.« less

Radiodine therapy of the autonomous thyroid nodule in patients with or without visible extranodular activity

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

Clerc, J.; Dagousset, F.; Izembart, M.

1995-02-01

Patients with an autonomously functioning throid nodule (ATN) may present with various clinical, biochemical and scintigraphic features. To optimize 1 dose planning and treatment timing in these patients, relationships between dosimetric data and clinical follow-up events must be established. The authors retrospectively reviewed the records of 88 patients who received 1 (intended dose of 80 Gy) for an ATN, of whom 39 had evidence of extranodular activity (ENA) and 76 presented with overt thyrotoxicosis. In all of the patients, dosage calculation was monitored to estimate precisely both beta and gamma absorbed doses received by the ATN and the nodule-free lobe.more » The mean duration of follow-up was 75 mo (max 180) and always included biochemical thyroid tests. Finally, they compared the dosimetric profiles of four dosage schemes which had been normalized by simulation to ensure that the same absorbed dose threshold value was always delivered to the ATN. About 75% of the patients were cured at 6 mo for a mean 305 MBq administered. The absorbed doses delivered to the nodule-free lobe to the ATN, mainly in the form of beta irradiation. Life-table estimates for hypothyroidism and death were 9.6% and 22% at 75 mo, respectively. Hypothyroidism mainly developed in patients with nonsuppressed TSH levels but regardless of ENA, which often accounted for multifocal disease. The authors suggest that fixed doses bordering on 370 MBq are advisable in younger individuals and in patients with mild thyrotoxocosis, while 555 MBq-740 MBq can be administered in other patients and that ENA indicates multifocal autonomy in patients with toxic ATN and is a further indication for radioiodine treatment which should be begun as soon as possible to avoid the development of cardiac complications. 27 refs., 5 tabs.« less

Beam hardening and partial beam hardening of the bowtie filter: Effects on dosimetric applications in CT

NASA Astrophysics Data System (ADS)

Lopez-Rendon, X.; Zhang, G.; Bosmans, H.; Oyen, R.; Zanca, F.

2014-03-01

Purpose: To estimate the consequences on dosimetric applications when a CT bowtie filter is modeled by means of full beam hardening versus partial beam hardening. Method: A model of source and filtration for a CT scanner as developed by Turner et. al. [1] was implemented. Specific exposures were measured with the stationary CT X-ray tube in order to assess the equivalent thickness of Al of the bowtie filter as a function of the fan angle. Using these thicknesses, the primary beam attenuation factors were calculated from the energy dependent photon mass attenuation coefficients and used to include beam hardening in the spectrum. This was compared to a potentially less computationally intensive approach, which accounts only partially for beam hardening, by giving the photon spectrum a global (energy independent) fan angle specific weighting factor. Percentage differences between the two methods were quantified by calculating the dose in air after passing several water equivalent thicknesses representative for patients having different BMI. Specifically, the maximum water equivalent thickness of the lateral and anterior-posterior dimension and of the corresponding (half) effective diameter were assessed. Results: The largest percentage differences were found for the thickest part of the bowtie filter and they increased with patient size. For a normal size patient they ranged from 5.5% at half effective diameter to 16.1% for the lateral dimension; for the most obese patient they ranged from 7.7% to 19.3%, respectively. For a complete simulation of one rotation of the x-ray tube, the proposed method was 12% faster than the complete simulation of the bowtie filter. Conclusion: The need for simulating the beam hardening of the bow tie filter in Monte Carlo platforms for CT dosimetry will depend on the required accuracy.

Dosimetric and Clinical Analysis of Spatial Distribution of the Radiation Dose in Gamma Knife Radiosurgery for Vestibular Schwannoma

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

Massager, Nicolas, E-mail: nmassage@ulb.ac.be; Neurosurgery-Department, Hospital Erasme, Brussels; Lonneville, Sarah

2011-11-15

Objectives: We investigated variations in the distribution of radiation dose inside (dose inhomogeneity) and outside (dose falloff) the target volume during Gamma Knife (GK) irradiation of vestibular schwannoma (VS). We analyzed the relationship between some parameters of dose distribution and the clinical and radiological outcome of patients. Methods and Materials: Data from dose plans of 203 patients treated for a vestibular schwannoma by GK C using same prescription dose (12 Gy at the 50% isodose) were collected. Four different dosimetric indexes were defined and calculated retrospectively in all plannings on the basis of dose-volume histograms: Paddick conformity index (PI), gradientmore » index (GI), homogeneity index (HI), and unit isocenter (UI). The different measures related to distribution of the radiation dose were compared with hearing and tumor outcome of 203 patients with clinical and radiological follow-up of minimum 2 years. Results: Mean, median, SD, and ranges of the four indexes of dose distribution analyzed were calculated; large variations were found between dose plans. We found a high correlation between the target volume and PI, GI, and UI. No significant association was found between the indexes of dose distribution calculated in this study and tumor control, tumor volume shrinkage, hearing worsening, loss of functional hearing, or complete hearing loss at last follow-up. Conclusions: Parameters of distribution of the radiation dose during GK radiosurgery for VS can be highly variable between dose plans. The tumor and hearing outcome of patients treated is not significantly related to these global indexes of dose distribution inside and around target volume. In GK radiosurgery for VS, the outcome seems more to be influenced by local radiation dose delivered to specific structures or volumes than by global dose gradients.« less

EpiBrainRad: an epidemiologic study of the neurotoxicity induced by radiotherapy in high grade glioma patients.

PubMed

Durand, Thomas; Jacob, Sophie; Lebouil, Laura; Douzane, Hassen; Lestaevel, Philippe; Rahimian, Amithys; Psimaras, Dimitri; Feuvret, Loïc; Leclercq, Delphine; Brochet, Bruno; Tamarat, Radia; Milliat, Fabien; Benderitter, Marc; Vayatis, Nicolas; Noël, Georges; Hoang-Xuan, Khê; Delattre, Jean-Yves; Ricard, Damien; Bernier, Marie-Odile

2015-12-18

Radiotherapy is one of the most important treatments of primary and metastatic brain tumors. Unfortunately, it can involve moderate to severe complications among which leukoencephalopathy is very frequent and implies cognitive deficits such as memory, attention and executive dysfunctions. However, the incidence of this complication is not well established and the risk factors and process are poorly understood. The main objective of the study is to improve knowledge on radio-induced leukoencephalopathy based on pluridisciplinar approaches combining cognitive, biologic, imagery and dosimetric investigations. The EpiBrainRad study is a prospective cohort study including newly diagnosed high grade gliomas patients treated by radiotherapy and concomitant-adjuvant temozolomide chemotherapy. Patients are included between their surgery and first day of radio-chemotherapy, and the follow-up lasts for 3 years after treatment. Cognitive functioning assessments, specific blood biomarkers measures and magnetic resonance imagery are performed at different moment during the follow-up, and a specific dosimetric assessment of organs involved in the beam fields is performed. Firstly, leukoencephalopathy incidence rate will be estimated in this population. Secondly, correlations between cognitive impairments and dosimetry, biomarkers ranges and anomalies on imagery will be analyzed in order to better understand the onset and evolution of cognitive decrement associated with radiotherapy. Furthermore, a new cognitive test, quickly and easily performed, will be studied to determine its sensibility to detect leukoencephalopathy decrement. With an original multidisciplinary approach, the EpiBrainRad study aims to improve knowledge on radio-induced leukoencephalopathy in order to improve its early diagnosis and prevention. The main challenge is to preserve quality-of-life after cancer treatments which imply to study the incidence of radiation-induced complications and their associated risk factors. NCT02544178.

Characterization of a novel two dimensional diode array the "magic plate" as a radiation detector for radiation therapy treatment.

PubMed

Wong, J H D; Fuduli, I; Carolan, M; Petasecca, M; Lerch, M L F; Perevertaylo, V L; Metcalfe, P; Rosenfeld, A B

2012-05-01

Intensity modulated radiation therapy (IMRT) utilizes the technology of multileaf collimators to deliver highly modulated and complex radiation treatment. Dosimetric verification of the IMRT treatment requires the verification of the delivered dose distribution. Two dimensional ion chamber or diode arrays are gaining popularity as a dosimeter of choice due to their real time feedback compared to film dosimetry. This paper describes the characterization of a novel 2D diode array, which has been named the "magic plate" (MP). It was designed to function as a 2D transmission detector as well as a planar detector for dose distribution measurements in a solid water phantom for the dosimetric verification of IMRT treatment delivery. The prototype MP is an 11 × 11 detector array based on thin (50 μm) epitaxial diode technology mounted on a 0.6 mm thick Kapton substrate using a proprietary "drop-in" technology developed by the Centre for Medical Radiation Physics, University of Wollongong. A full characterization of the detector was performed, including radiation damage study, dose per pulse effect, percent depth dose comparison with CC13 ion chamber and build up characteristics with a parallel plane ion chamber measurements, dose linearity, energy response and angular response. Postirradiated magic plate diodes showed a reproducibility of 2.1%. The MP dose per pulse response decreased at higher dose rates while at lower dose rates the MP appears to be dose rate independent. The depth dose measurement of the MP agrees with ion chamber depth dose measurements to within 0.7% while dose linearity was excellent. MP showed angular response dependency due to the anisotropy of the silicon diode with the maximum variation in angular response of 10.8% at gantry angle 180°. Angular dependence was within 3.5% for the gantry angles ± 75°. The field size dependence of the MP at isocenter agrees with ion chamber measurement to within 1.1%. In the beam perturbation study, the surface dose increased by 12.1% for a 30 × 30 cm(2) field size at the source to detector distance (SDD) of 80 cm whilst the transmission for the MP was 99%. The radiation response of the magic plate was successfully characterized. The array of epitaxial silicon based detectors with "drop-in" packaging showed properties suitable to be used as a simplified multipurpose and nonperturbing 2D radiation detector for radiation therapy dosimetric verification.

Optimization of rotational arc station parameter optimized radiation therapy.

PubMed

Dong, P; Ungun, B; Boyd, S; Xing, L

2016-09-01

To develop a fast optimization method for station parameter optimized radiation therapy (SPORT) and show that SPORT is capable of matching VMAT in both plan quality and delivery efficiency by using three clinical cases of different disease sites. The angular space from 0° to 360° was divided into 180 station points (SPs). A candidate aperture was assigned to each of the SPs based on the calculation results using a column generation algorithm. The weights of the apertures were then obtained by optimizing the objective function using a state-of-the-art GPU based proximal operator graph solver. To avoid being trapped in a local minimum in beamlet-based aperture selection using the gradient descent algorithm, a stochastic gradient descent was employed here. Apertures with zero or low weight were thrown out. To find out whether there was room to further improve the plan by adding more apertures or SPs, the authors repeated the above procedure with consideration of the existing dose distribution from the last iteration. At the end of the second iteration, the weights of all the apertures were reoptimized, including those of the first iteration. The above procedure was repeated until the plan could not be improved any further. The optimization technique was assessed by using three clinical cases (prostate, head and neck, and brain) with the results compared to that obtained using conventional VMAT in terms of dosimetric properties, treatment time, and total MU. Marked dosimetric quality improvement was demonstrated in the SPORT plans for all three studied cases. For the prostate case, the volume of the 50% prescription dose was decreased by 22% for the rectum and 6% for the bladder. For the head and neck case, SPORT improved the mean dose for the left and right parotids by 15% each. The maximum dose was lowered from 72.7 to 71.7 Gy for the mandible, and from 30.7 to 27.3 Gy for the spinal cord. The mean dose for the pharynx and larynx was reduced by 8% and 6%, respectively. For the brain case, the doses to the eyes, chiasm, and inner ears were all improved. SPORT shortened the treatment time by ∼1 min for the prostate case, ∼0.5 min for brain case, and ∼0.2 min for the head and neck case. The dosimetric quality and delivery efficiency presented here indicate that SPORT is an intriguing alternative treatment modality. With the widespread adoption of digital linac, SPORT should lead to improved patient care in the future.

Optimization of rotational arc station parameter optimized radiation therapy

PubMed Central

Dong, P.; Ungun, B.; Boyd, S.; Xing, L.

2016-01-01

Purpose: To develop a fast optimization method for station parameter optimized radiation therapy (SPORT) and show that SPORT is capable of matching VMAT in both plan quality and delivery efficiency by using three clinical cases of different disease sites. Methods: The angular space from 0° to 360° was divided into 180 station points (SPs). A candidate aperture was assigned to each of the SPs based on the calculation results using a column generation algorithm. The weights of the apertures were then obtained by optimizing the objective function using a state-of-the-art GPU based proximal operator graph solver. To avoid being trapped in a local minimum in beamlet-based aperture selection using the gradient descent algorithm, a stochastic gradient descent was employed here. Apertures with zero or low weight were thrown out. To find out whether there was room to further improve the plan by adding more apertures or SPs, the authors repeated the above procedure with consideration of the existing dose distribution from the last iteration. At the end of the second iteration, the weights of all the apertures were reoptimized, including those of the first iteration. The above procedure was repeated until the plan could not be improved any further. The optimization technique was assessed by using three clinical cases (prostate, head and neck, and brain) with the results compared to that obtained using conventional VMAT in terms of dosimetric properties, treatment time, and total MU. Results: Marked dosimetric quality improvement was demonstrated in the SPORT plans for all three studied cases. For the prostate case, the volume of the 50% prescription dose was decreased by 22% for the rectum and 6% for the bladder. For the head and neck case, SPORT improved the mean dose for the left and right parotids by 15% each. The maximum dose was lowered from 72.7 to 71.7 Gy for the mandible, and from 30.7 to 27.3 Gy for the spinal cord. The mean dose for the pharynx and larynx was reduced by 8% and 6%, respectively. For the brain case, the doses to the eyes, chiasm, and inner ears were all improved. SPORT shortened the treatment time by ∼1 min for the prostate case, ∼0.5 min for brain case, and ∼0.2 min for the head and neck case. Conclusions: The dosimetric quality and delivery efficiency presented here indicate that SPORT is an intriguing alternative treatment modality. With the widespread adoption of digital linac, SPORT should lead to improved patient care in the future. PMID:27587028

Optimization of rotational arc station parameter optimized radiation therapy

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

Dong, P.; Ungun, B.

Purpose: To develop a fast optimization method for station parameter optimized radiation therapy (SPORT) and show that SPORT is capable of matching VMAT in both plan quality and delivery efficiency by using three clinical cases of different disease sites. Methods: The angular space from 0° to 360° was divided into 180 station points (SPs). A candidate aperture was assigned to each of the SPs based on the calculation results using a column generation algorithm. The weights of the apertures were then obtained by optimizing the objective function using a state-of-the-art GPU based proximal operator graph solver. To avoid being trappedmore » in a local minimum in beamlet-based aperture selection using the gradient descent algorithm, a stochastic gradient descent was employed here. Apertures with zero or low weight were thrown out. To find out whether there was room to further improve the plan by adding more apertures or SPs, the authors repeated the above procedure with consideration of the existing dose distribution from the last iteration. At the end of the second iteration, the weights of all the apertures were reoptimized, including those of the first iteration. The above procedure was repeated until the plan could not be improved any further. The optimization technique was assessed by using three clinical cases (prostate, head and neck, and brain) with the results compared to that obtained using conventional VMAT in terms of dosimetric properties, treatment time, and total MU. Results: Marked dosimetric quality improvement was demonstrated in the SPORT plans for all three studied cases. For the prostate case, the volume of the 50% prescription dose was decreased by 22% for the rectum and 6% for the bladder. For the head and neck case, SPORT improved the mean dose for the left and right parotids by 15% each. The maximum dose was lowered from 72.7 to 71.7 Gy for the mandible, and from 30.7 to 27.3 Gy for the spinal cord. The mean dose for the pharynx and larynx was reduced by 8% and 6%, respectively. For the brain case, the doses to the eyes, chiasm, and inner ears were all improved. SPORT shortened the treatment time by ∼1 min for the prostate case, ∼0.5 min for brain case, and ∼0.2 min for the head and neck case. Conclusions: The dosimetric quality and delivery efficiency presented here indicate that SPORT is an intriguing alternative treatment modality. With the widespread adoption of digital linac, SPORT should lead to improved patient care in the future.« less

Radiobiologically optimized couch shift: A new localization paradigm using cone-beam CT for prostate radiotherapy

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

Huang, Yimei, E-mail: yhuang2@hfhs.org; Gardner, Stephen J.; Wen, Ning

2015-10-15

Purpose: To present a novel positioning strategy which optimizes radiation delivery by utilizing radiobiological response knowledge and evaluate its use during prostate external beam radiotherapy. Methods: Five patients with low or intermediate risk prostate cancer were evaluated retrospectively in this IRB-approved study. For each patient, a VMAT plan with one 358° arc was generated on the planning CT (PCT) to deliver 78 Gy in 39 fractions. Five representative pretreatment cone beam CTs (CBCT) were selected for each patient. The CBCT images were registered to PCT by a human observer, which consisted of an initial automated registration with three degrees-of-freedom, followedmore » by manual adjustment for agreement at the prostate/rectal wall interface. To determine the optimal treatment position for each CBCT, a search was performed centering on the observer-matched position (OM-position) utilizing a score function based on radiobiological and dosimetric indices (EUD{sub prostate}, D99{sub prostate}, NTCP{sub rectum}, and NTCP{sub bladder}) for the prostate, rectum, and bladder. We termed the optimal treatment position the radiobiologically optimized couch shift position (ROCS-position). Results: The dosimetric indices, averaged over the five patients’ treatment plans, were (mean ± SD) 79.5 ± 0.3 Gy (EUD{sub prostate}), 78.2 ± 0.4 Gy (D99{sub prostate}), 11.1% ± 2.7% (NTCP{sub rectum}), and 46.9% ± 7.6% (NTCP{sub bladder}). The corresponding values from CBCT at the OM-positions were 79.5 ± 0.6 Gy (EUD{sub prostate}), 77.8 ± 0.7 Gy (D99{sub prostate}), 12.1% ± 5.6% (NTCP{sub rectum}), and 51.6% ± 15.2% (NTCP{sub bladder}), respectively. In comparison, from CBCT at the ROCS-positions, the dosimetric indices were 79.5 ± 0.6 Gy (EUD{sub prostate}), 77.3 ± 0.6 Gy (D99{sub prostate}), 8.0% ± 3.3% (NTCP{sub rectum}), and 46.9% ± 15.7% (NTCP{sub bladder}). Excessive NTCP{sub rectum} was observed on Patient 5 (19.5% ± 6.6%) corresponding to localization at OM-position, compared to the planned value of 11.7%. This was mitigated with radiobiologically optimized localization, resulting in a reduced NTCP{sub rectum} value of 11.3% ± 3.5%. Overall, the treatment position optimization resulted in similar target dose coverage with reduced risk to rectum. Conclusions: These encouraging results illustrate the potential advantage of applying radiobiologically optimized correction for online image-guided radiotherapy of prostate patients.« less

Dosimetric response for crystalline and nanostructured aluminium oxide to a high-current pulse electron beam.

PubMed

Nikiforov, S V; Kortov, V S

2014-11-01

The main thermoluminescent (TL) and dosimetric properties of the detectors based on anion-defective crystalline and nanostructured aluminium oxide after exposure to a high-current pulse electron beam are studied. TL peaks associated with deep-trapping centres are registered. It is shown that the use of deep-trap TL at 200-600°С allows registering absorbed doses up to 750 kGy for single-crystalline detectors and those up to 6 kGy for nanostructured ones. A wide range of the doses registered, high reproducibility of the TL signal and low fading contribute to a possibility of using single-crystalline and nanostructured aluminium oxide for the dosimetry of high-current pulse electron beams. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

Wei Xiong; Liu, H. Helen; Tucker, Susan L.

Purpose: To identify clinical and dosimetric factors influencing the risk of pericardial effusion (PCE) in patients with inoperable esophageal cancer treated with definitive concurrent chemotherapy and radiation therapy (RT). Methods and Materials: Data for 101 patients with inoperable esophageal cancer treated with concurrent chemotherapy and RT from 2000 to 2003 at our institution were analyzed. The PCE was confirmed from follow-up chest computed tomography scans and radiologic reports, with freedom from PCE computed from the end of RT. Log-rank tests were used to identify clinical and dosimetric factors influencing freedom from PCE. Dosimetric factors were calculated from the dose-volume histogrammore » for the whole heart and pericardium. Results: The crude rate of PCE was 27.7% (28 of 101). Median time to onset of PCE was 5.3 months (range, 1.0-16.7 months) after RT. None of the clinical factors investigated was found to significantly influence the risk of PCE. In univariate analysis, a wide range of dose-volume histogram parameters of the pericardium and heart were associated with risk of PCE, including mean dose to the pericardium, volume of pericardium receiving a dose greater than 3 Gy (V3) to greater than 50 Gy (V50), and heart volume treated to greater than 32-38 Gy. Multivariate analysis selected V30 as the only parameter significantly associated with risk of PCE. Conclusions: High-dose radiation to the pericardium may strongly increase the risk of PCE. Such a risk may be reduced by minimizing the dose-volume of the irradiated pericardium and heart.« less

Impact of Chemotherapy on Normal Tissue Complication Probability Models of Acute Hematologic Toxicity in Patients Receiving Pelvic Intensity Modulated Radiation Therapy

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

Bazan, Jose G.; Luxton, Gary; Kozak, Margaret M.

Purpose: To determine how chemotherapy agents affect radiation dose parameters that correlate with acute hematologic toxicity (HT) in patients treated with pelvic intensity modulated radiation therapy (P-IMRT) and concurrent chemotherapy. Methods and Materials: We assessed HT in 141 patients who received P-IMRT for anal, gynecologic, rectal, or prostate cancers, 95 of whom received concurrent chemotherapy. Patients were separated into 4 groups: mitomycin (MMC) + 5-fluorouracil (5FU, 37 of 141), platinum ± 5FU (Cis, 32 of 141), 5FU (26 of 141), and P-IMRT alone (46 of 141). The pelvic bone was contoured as a surrogate for pelvic bone marrow (PBM) andmore » divided into subsites: ilium, lower pelvis, and lumbosacral spine (LSS). The volumes of each region receiving 5-40 Gy were calculated. The endpoint for HT was grade ≥3 (HT3+) leukopenia, neutropenia or thrombocytopenia. Normal tissue complication probability was calculated using the Lyman-Kutcher-Burman model. Logistic regression was used to analyze association between HT3+ and dosimetric parameters. Results: Twenty-six patients experienced HT3+: 10 of 37 (27%) MMC, 14 of 32 (44%) Cis, 2 of 26 (8%) 5FU, and 0 of 46 P-IMRT. PBM dosimetric parameters were correlated with HT3+ in the MMC group but not in the Cis group. LSS dosimetric parameters were well correlated with HT3+ in both the MMC and Cis groups. Constrained optimization (0« less

Multi-centre audit of VMAT planning and pre-treatment verification.

PubMed

Jurado-Bruggeman, Diego; Hernández, Victor; Sáez, Jordi; Navarro, David; Pino, Francisco; Martínez, Tatiana; Alayrach, Maria-Elena; Ailleres, Norbert; Melero, Alejandro; Jornet, Núria

2017-08-01

We performed a multi-centre intercomparison of VMAT dose planning and pre-treatment verification. The aims were to analyse the dose plans in terms of dosimetric quality and deliverability, and to validate whether in-house pre-treatment verification results agreed with those of an external audit. The nine participating centres encompassed different machines, equipment, and methodologies. Two mock cases (prostate and head and neck) were planned using one and two arcs. A plan quality index was defined to compare the plans and different complexity indices were calculated to check their deliverability. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit (global 3D gamma, absolute dose differences, 10% of maximum dose threshold). Log-file analysis was performed to look for delivery errors. All centres fulfilled the dosimetric goals but plan quality and delivery complexity were heterogeneous and uncorrelated, depending on the manufacturer and the planner's methodology. Pre-treatment verifications results were within tolerance in all cases for gamma 3%-3mm evaluation. Nevertheless, differences between the external audit and in-house measurements arose due to different equipment or methodology, especially for 2%-2mm criteria with differences up to 20%. No correlation was found between complexity indices and verification results amongst centres. All plans fulfilled dosimetric constraints, but plan quality and complexity did not correlate and were strongly dependent on the planner and the vendor. In-house measurements cannot completely replace external audits for credentialing. Copyright © 2017 Elsevier B.V. All rights reserved.

WE-D-BRD-01: Innovation in Radiation Therapy Delivery: Advanced Digital Linac Features

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

Xing, L; Wong, J; Li, R

2014-06-15

Last few years has witnessed significant advances in linac technology and therapeutic dose delivery method. Digital linacs equipped with high dose rate FFF beams have been clinically implemented in a number of hospitals. Gated VMAT is becoming increasingly popular in treating tumors affected by respiratory motion. This session is devoted to update the audience with these technical advances and to present our experience in clinically implementing the new linacs and dose delivery methods. Topics to be covered include, technical features of new generation of linacs from different vendors, dosimetric characteristics and clinical need for FFF-beam based IMRT and VMAT, respiration-gatedmore » VMAT, the concept and implementation of station parameter optimized radiation therapy (SPORT), beam level imaging and onboard image guidance tools. Emphasis will be on providing fundamental understanding of the new treatment delivery and image guidance strategies, control systems, and the associated dosimetric characteristics. Commissioning and acceptance experience on these new treatment delivery technologies will be reported. Clinical experience and challenges encountered during the process of implementation of the new treatment techniques and future applications of the systems will also be highlighted. Learning Objectives: Present background knowledge of emerging digital linacs and summarize their key geometric and dosimetric features. SPORT as an emerging radiation therapy modality specifically designed to take advantage of digital linacs. Discuss issues related to the acceptance and commissioning of the digital linacs and FFF beams. Describe clinical utility of the new generation of digital linacs and their future applications.« less

Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation

PubMed Central

Jaberi, Ramin; Aghamiri, Mahmoud Reza; Kirisits, Christian; Ghaderi, Reza

2017-01-01

Purpose Intra-fractional organs at risk (OARs) deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT). The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Material and methods Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT) of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR) brachytherapy with tandem-ovoid applicators were selected for this study. Second computed tomography scan was done for each patient after finishing brachytherapy treatment with applicators in situ. Artificial neural networks (ANNs) based models were used to predict intra-fractional OARs dose-volume histogram parameters variations and propose a new final plan. Results A model was developed to estimate the intra-fractional organs dose variations during gynaecological intracavitary brachytherapy. Also, ANNs were used to modify the final brachytherapy treatment plan to compensate dosimetrically for changes in ‘organs-applicators’, while maintaining target dose at the original level. Conclusions There are semi-automatic and fast responding models that can be used in the routine clinical workflow to reduce individually IGABT uncertainties. These models can be more validated by more patients’ plans to be able to serve as a clinical tool. PMID:29441094

SU-E-T-618: Dosimetric Comparison of Manual and Beam Angle Optimization of Gantry Angles in IMRT for Cervical Cancer

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

Lin, X; Sun, T; Liu, T

2014-06-01

Purpose: To evaluate the dosimetric characteristics of intensity-modulated radiotherapy (IMRT) treatment plan with beam angle optimization. Methods: Ten post-operation patients with cervical cancer were included in this analysis. Two IMRT plans using seven beams were designed in each patient. A standard coplanar equi-space beam angles were used in the first plan (plan 1), whereas the selection of beam angle was optimized by beam angle optimization algorithm in Varian Eclipse treatment planning system for the same number of beams in the second plan (plan 2). Two plans were designed for each patient with the same dose-volume constraints and prescription dose. Allmore » plans were normalized to the mean dose to PTV. The dose distribution in the target, the dose to the organs at risk and total MU were compared. Results: For conformity and homogeneity in PTV, no statistically differences were observed in the two plans. For the mean dose in bladder, plan 2 were significantly lower than plan 1(p<0.05). No statistically significant differences were observed between two plans for the mean doses in rectum, left and right femur heads. Compared with plan1, the average monitor units reduced 16% in plan 2. Conclusion: The IMRT plan based on beam angle optimization for cervical cancer could reduce the dose delivered to bladder and also reduce MU. Therefore there were some dosimetric advantages in the IMRT plan with beam angle optimization for cervical cancer.« less

Effective atomic numbers and electron densities of some human tissues and dosimetric materials for mean energies of various radiation sources relevant to radiotherapy and medical applications

NASA Astrophysics Data System (ADS)

Kurudirek, Murat

2014-09-01

Effective atomic numbers, Zeff, and electron densities, neff, are convenient parameters used to characterise the radiation response of a multi-element material in many technical and medical applications. Accurate values of these physical parameters provide essential data in medical physics. In the present study, the effective atomic numbers and electron densities have been calculated for some human tissues and dosimetric materials such as Adipose Tissue (ICRU-44), Bone Cortical (ICRU-44), Brain Grey/White Matter (ICRU-44), Breast Tissue (ICRU-44), Lung Tissue (ICRU-44), Soft Tissue (ICRU-44), LiF TLD-100H, TLD-100, Water, Borosilicate Glass, PAG (Gel Dosimeter), Fricke (Gel Dosimeter) and OSL (Aluminium Oxide) using mean photon energies, Em, of various radiation sources. The used radiation sources are Pd-103, Tc-99, Ra-226, I-131, Ir-192, Co-60, 30 kVp, 40 kVp, 50 kVp (Intrabeam, Carl Zeiss Meditec) and 6 MV (Mohan-6 MV) sources. The Em values were then used to calculate Zeff and neff of the tissues and dosimetric materials for various radiation sources. Different calculation methods for Zeff such as the direct method, the interpolation method and Auto-Zeff computer program were used and agreements and disagreements between the used methods have been presented and discussed. It has been observed that at higher Em values agreement is quite satisfactory (Dif.<5%) between the adopted methods.

Calculations of dose distributions using a neural network model

NASA Astrophysics Data System (ADS)

Mathieu, R.; Martin, E.; Gschwind, R.; Makovicka, L.; Contassot-Vivier, S.; Bahi, J.

2005-03-01

The main goal of external beam radiotherapy is the treatment of tumours, while sparing, as much as possible, surrounding healthy tissues. In order to master and optimize the dose distribution within the patient, dosimetric planning has to be carried out. Thus, for determining the most accurate dose distribution during treatment planning, a compromise must be found between the precision and the speed of calculation. Current techniques, using analytic methods, models and databases, are rapid but lack precision. Enhanced precision can be achieved by using calculation codes based, for example, on Monte Carlo methods. However, in spite of all efforts to optimize speed (methods and computer improvements), Monte Carlo based methods remain painfully slow. A newer way to handle all of these problems is to use a new approach in dosimetric calculation by employing neural networks. Neural networks (Wu and Zhu 2000 Phys. Med. Biol. 45 913-22) provide the advantages of those various approaches while avoiding their main inconveniences, i.e., time-consumption calculations. This permits us to obtain quick and accurate results during clinical treatment planning. Currently, results obtained for a single depth-dose calculation using a Monte Carlo based code (such as BEAM (Rogers et al 2003 NRCC Report PIRS-0509(A) rev G)) require hours of computing. By contrast, the practical use of neural networks (Mathieu et al 2003 Proceedings Journées Scientifiques Francophones, SFRP) provides almost instant results and quite low errors (less than 2%) for a two-dimensional dosimetric map.

Dosimetric differences between intraoperative and postoperative plans using Cs-131 in transrectal ultrasound–guided brachytherapy for prostatic carcinoma

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

Jones, Andrew, E-mail: aojones@geisinger.edu; Treas, Jared; Yavoich, Brian

2014-01-01

The aim of the study was to investigate the differences between intraoperative and postoperative dosimetry for transrectal ultrasound–guided transperineal prostate implants using cesium-131 ({sup 131}Cs). Between 2006 and 2010, 166 patients implanted with {sup 131}Cs had both intraoperative and postoperative dosimetry studies. All cases were monotherapy and doses of 115 were prescribed to the prostate. The dosimetric properties (D{sub 90}, V{sub 150}, and V{sub 100} for the prostate) of the studies were compared. Two conformity indices were also calculated and compared. Finally, the prostate was automatically sectioned into 6 sectors (anterior and posterior sectors at the base, midgland, and apex)more » and the intraoperative and postoperative dosimetry was compared in each individual sector. Postoperative dosimetry showed statistically significant changes (p < 0.01) in every dosimetric value except V{sub 150}. In each significant case, the postoperative plans showed lower dose coverage. The conformity indexes also showed a bimodal frequency distribution with the index indicating poorer dose conformity in the postoperative plans. Sector analysis revealed less dose coverage postoperatively in the base and apex sectors with an increase in dose to the posterior midgland sector. Postoperative dosimetry overall and in specific sectors of the prostate differs significantly from intraoperative planning. Care must be taken during the intraoperative planning stage to ensure complete dose coverage of the prostate with the understanding that the final postoperative dosimetry will show less dose coverage.« less

Effect of heterogeneity correction on dosimetric parameters of radiotherapy planning for thoracic esophageal cancer

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

Nakayama, Masao, E-mail: naka2008@med.kobe-u.ac.jp; Yoshida, Kenji; Nishimura, Hideki

2014-04-01

The present study aimed to investigate the effect of heterogeneity correction (HC) on dosimetric parameters in 3-dimensional conformal radiotherapy planning for patients with thoracic esophageal cancer. We retrospectively analyzed 20 patients. Two treatment plans were generated for each patient using a superposition algorithm on the Xio radiotherapy planning system. The first plan was calculated without HC. The second was a new plan calculated with HC, using identical beam geometries and maintaining the same number of monitor units as the first. With regard to the planning target volume (PTV), the overall mean differences in the prescription dose, maximum dose, mean dose,more » and dose that covers 95% of the PTV between the first and second plans were 1.10 Gy (1.8%), 1.35 Gy (2.2%), 1.10 Gy (1.9%), and 0.56 Gy (1.0%), respectively. With regard to parameters related to the organs at risk (OARs), the mean differences in the absolute percentages of lung volume receiving greater than 5, 10, 20, and 30 Gy (lung V{sub 5}, V{sub 10}, V{sub 20}, and V{sub 30}) between the first and second plans were 7.1%, 2.7%, 0.4%, and 0.5%, respectively. These results suggest that HC might have a more pronounced effect on the percentages of lung volume receiving lower doses (e.g., V{sub 5} and V{sub 10}) than on the dosimetric parameters related to the PTV and other OARs.« less

Dosimetric and Clinical Outcomes With Intensity Modulated Radiation Therapy After Chemotherapy for Patients With Early-Stage Diffuse Large B-cell Lymphoma of Waldeyer Ring

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

Xu, Yong-Gang; Qi, Shu-Nan; Wang, Shu-Lian

Purpose: To assess the dosimetric benefit, prognosis, and toxicity of intensity modulated radiation therapy (IMRT) for early-stage, diffuse large B-cell lymphoma of Waldeyer ring (WR-DLBCL). Methods and Materials: Sixty-one patients with early-stage WR-DLBCL who received chemotherapy followed by IMRT were retrospectively reviewed. Dosimetric parameters for the target volume and critical normal structures were evaluated, and survival was calculated. Linear regression analysis was used to assess the effect of the mean dose (D{sub mean}) to the parotid glands on xerostomia. Results: The median conformity index and homogeneity index of the planning target volume (PTV) were 0.83 and 0.90, respectively, demonstrating verymore » good coverage of the target volume. The mean dose to the parotid glands was 24.9 Gy. The 5-year overall survival (OS), progression-free survival (PFS), and locoregional control (LRC) were 94.7%, 93.1%, and 98.3%, respectively. Early and late toxicities were mild, and no patient experienced late grade ≥3 toxicities. The D{sub mean} to the parotid glands had a linear correlation with late grade ≥2 xerostomia. Conclusions: IMRT after chemotherapy can provide excellent dose conformity and achieve favorable survival and LRC with mild toxicities in patients with early-stage WR-DLBCL. Dose constraints for the parotid glands should be limited to <24 Gy for early-stage WR-DLBCL.« less

Calculations of dose distributions using a neural network model.

PubMed

Mathieu, R; Martin, E; Gschwind, R; Makovicka, L; Contassot-Vivier, S; Bahi, J

2005-03-07

The main goal of external beam radiotherapy is the treatment of tumours, while sparing, as much as possible, surrounding healthy tissues. In order to master and optimize the dose distribution within the patient, dosimetric planning has to be carried out. Thus, for determining the most accurate dose distribution during treatment planning, a compromise must be found between the precision and the speed of calculation. Current techniques, using analytic methods, models and databases, are rapid but lack precision. Enhanced precision can be achieved by using calculation codes based, for example, on Monte Carlo methods. However, in spite of all efforts to optimize speed (methods and computer improvements), Monte Carlo based methods remain painfully slow. A newer way to handle all of these problems is to use a new approach in dosimetric calculation by employing neural networks. Neural networks (Wu and Zhu 2000 Phys. Med. Biol. 45 913-22) provide the advantages of those various approaches while avoiding their main inconveniences, i.e., time-consumption calculations. This permits us to obtain quick and accurate results during clinical treatment planning. Currently, results obtained for a single depth-dose calculation using a Monte Carlo based code (such as BEAM (Rogers et al 2003 NRCC Report PIRS-0509(A) rev G)) require hours of computing. By contrast, the practical use of neural networks (Mathieu et al 2003 Proceedings Journees Scientifiques Francophones, SFRP) provides almost instant results and quite low errors (less than 2%) for a two-dimensional dosimetric map.

Characterization of the a-Si EPID in the unity MR-linac for dosimetric applications.

PubMed

Torres-Xirau, I; Olaciregui-Ruiz, I; Baldvinsson, G; Mijnheer, B J; van der Heide, U A; Mans, A

2018-01-09

Electronic portal imaging devices (EPIDs) are frequently used in external beam radiation therapy for dose verification purposes. The aim of this study was to investigate the dose-response characteristics of the EPID in the Unity MR-linac (Elekta AB, Stockholm, Sweden) relevant for dosimetric applications under clinical conditions. EPID images and ionization chamber (IC) measurements were used to study the effects of the magnetic field, the scatter generated in the MR housing reaching the EPID, and inhomogeneous attenuation from the MR housing. Dose linearity and dose rate dependencies were also determined. The magnetic field strength at EPID level did not exceed 10 mT, and dose linearity and dose rate dependencies proved to be comparable to that on a conventional linac. Profiles of fields, delivered with and without the magnetic field, were indistinguishable. The EPID center had an offset of 5.6 cm in the longitudinal direction, compared to the beam central axis, meaning that large fields in this direction will partially fall outside the detector area and not be suitable for verification. Beam attenuation by the MRI scanner and the table is gantry angle dependent, presenting a minimum attenuation of 67% relative to the 90° measurement. Repeatability, observed over two months, was within 0.5% (1 SD). In order to use the EPID for dosimetric applications in the MR-linac, challenges related to the EPID position, scatter from the MR housing, and the inhomogeneous, gantry angle-dependent attenuation of the beam will need to be solved.

Predictive factors for acute radiation pneumonitis in postoperative intensity modulated radiation therapy and volumetric modulated arc therapy of esophageal cancer.

PubMed

Zhao, Yaqin; Chen, Lu; Zhang, Shu; Wu, Qiang; Jiang, Xiaoqin; Zhu, Hong; Wang, Jin; Li, Zhiping; Xu, Yong; Zhang, Ying Jie; Bai, Sen; Xu, Feng

2015-01-01

Radiation pneumonitis (RP) is a common side reaction in radiotherapy for esophageal cancer. There are few reports about RP in esophageal cancer patients receiving postoperative intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). This study aims to analyze clinical or dosimetric factors associated with RP, and provides data for radiotherapy planning. We reviewed 68 postoperative esophageal cancer patients who were treated with radiotherapy at the West China Hospital from October 2010 to November 2012 to identify any correlation between the clinical or dosimetric parameters and acute radiation pneumonitis (ARP) or severe acute radiation pneumonitis (SARP) by t-test, chi-square test, and logistic regression analysis. Of the 68 patients, 33 patients (48.5%) developed ARP, 13 of which (19.1%) developed SARP. Of these 33 patients, 8 (11.8%), 12 (17.6%), 11 (16.2%), and 2 (2.9%) patients were grade 1, 2, 3, and 4 ARP, respectively. Univariate analysis showed that lung infection during radiotherapy, use of VMAT, mean lung dose (MLD), and dosimetric parameters (e.g. V20, V30) are significantly correlated with RP. Multivariate analysis found that lung infection during radiotherapy, MLD ≥ 12 Gy, and V30 ≥ 13% are significantly correlated with an increased risk of RP. Lung infection during radiotherapy and low radiation dose volume distribution were predictive factors associated with RP and should be accounted for during radiation planning.

Dosimetric impact of applicator displacement during high dose rate (HDR) Cobalt-60 brachytherapy for cervical cancer: A planning study

NASA Astrophysics Data System (ADS)

Yong, J. S.; Ung, N. M.; Jamalludin, Z.; Malik, R. A.; Wong, J. H. D.; Liew, Y. M.; Ng, K. H.

2016-02-01

We investigated the dosimetric impact of applicator displacement on dose specification during high dose rate (HDR) Cobalt-60 (Co-60) brachytherapy for cervical cancer through a planning study. Eighteen randomly selected HDR full insertion plans were restrospectively studied. The tandem and ovoids were virtually shifted translationally and rotationally in the x-, y- and z-axis directions on the treatment planning system. Doses to reference points and volumes of interest in the plans with shifted applicators were compared with the original plans. The impact of dose displacement on 2D (point-based) and 3D (volume-based) treatment planning techniques was also assessed. A ±2 mm translational y-axis applicator shift and ±4° rotational x-axis applicator shift resulted in dosimetric changes of more than 5% to organs at risk (OAR) reference points. Changes to the maximum doses to 2 cc of the organ (D2cc) in 3D planning were statistically significant and higher than the reference points in 2D planning for both the rectum and bladder (p<0.05). Rectal D2cc was observed to be the most sensitive to applicator displacement among all dose metrics. Applicator displacement that is greater than ±2 mm translational y-axis and ±4° rotational x-axis resulted in significant dose changes to the OAR. Thus, steps must be taken to minimize the possibility of applicator displacement during brachytherapy.

Characterization of the a-Si EPID in the unity MR-linac for dosimetric applications

NASA Astrophysics Data System (ADS)

Torres-Xirau, I.; Olaciregui-Ruiz, I.; Baldvinsson, G.; Mijnheer, B. J.; van der Heide, U. A.; Mans, A.

2018-01-01

Electronic portal imaging devices (EPIDs) are frequently used in external beam radiation therapy for dose verification purposes. The aim of this study was to investigate the dose-response characteristics of the EPID in the Unity MR-linac (Elekta AB, Stockholm, Sweden) relevant for dosimetric applications under clinical conditions. EPID images and ionization chamber (IC) measurements were used to study the effects of the magnetic field, the scatter generated in the MR housing reaching the EPID, and inhomogeneous attenuation from the MR housing. Dose linearity and dose rate dependencies were also determined. The magnetic field strength at EPID level did not exceed 10 mT, and dose linearity and dose rate dependencies proved to be comparable to that on a conventional linac. Profiles of fields, delivered with and without the magnetic field, were indistinguishable. The EPID center had an offset of 5.6 cm in the longitudinal direction, compared to the beam central axis, meaning that large fields in this direction will partially fall outside the detector area and not be suitable for verification. Beam attenuation by the MRI scanner and the table is gantry angle dependent, presenting a minimum attenuation of 67% relative to the 90° measurement. Repeatability, observed over two months, was within 0.5% (1 SD). In order to use the EPID for dosimetric applications in the MR-linac, challenges related to the EPID position, scatter from the MR housing, and the inhomogeneous, gantry angle-dependent attenuation of the beam will need to be solved.

WE-G-BRA-04: The Development of a Virtual Reality Dosimetry Training Platform for Physics Training.

PubMed

Beavis, A; Ward, J

2012-06-01

Recently there has been a great deal of interest in the application of Simulation methodologies for training. We have previously developed a Virtual Environment for Radiotherapy Training, VERT, which simulates a fully interactive and functional Linac. Patient and plan data can be accessed across a DICOM interface, allowing the treatment process to be simulated. Here we present a newly developed range of Physics equipment, which allows the user to undertake realistic QC processes. Five devices are available: 1) scanning water phantom, 2) 'solid water' QC block/ion chamber, 3) light/ radiation field coincidence phantom, 4) laser alignment phantom and 5) water based calibration phantom with reference class and 'departmental' ion chamber. The devices were created to operate realistically and function as expected, each has an associated control screen which provides control and feedback information. The dosimetric devices respond appropriately to the beam qualities available on the Linac. Geometrical characteristics of the Linac, e.g. isocentre integrity, laser calibration and jaw calibrations can have random errors introduced in order to enable the user learn and observe fault conditions. In the calibration module appropriate factors for temperature and pressure must be set to correct for ambient, simulated, room conditions. The dosimetric devices can be used to characterise the Linac beams. Depth doses with Dmax of 15mm/29mm and d10 of 67%/77% respectively for 10cm square 6/15MV beams were measured. The Quality Indices (TPR20/10 ratios) can be measured as 0.668 and 0.761 respectively. At a simple level the tools can be used to demonstrate beam divergence or the effect of the inverse square law; They are also designed to be used to simulate the calibration of a new ion chamber. We have developed a novel set of tools that allow education of Physics processes via simulation training in our virtual environment. Both Authors are Founders and Directors of Vertual Ltd, a spin-out company that exists to commericalise the results of the research work presented in this abstract. © 2012 American Association of Physicists in Medicine.

SU-E-T-133: Dosimetric Impact of Scan Orientation Relative to Target Motion During Spot Scanning Proton Therapy

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

Stoker, J; Summers, P; Li, X

2014-06-01

Purpose: This study seeks to evaluate the dosimetric effects of intra-fraction motion during spot scanning proton beam therapy as a function of beam-scan orientation and target motion amplitude. Method: Multiple 4DCT scans were collected of a dynamic anthropomorphic phantom mimicking respiration amplitudes of 0 (static), 0.5, 1.0, and 1.5 cm. A spot-scanning treatment plan was developed on the maximum intensity projection image set, using an inverse-planning approach. Dynamic phantom motion was continuous throughout treatment plan delivery.The target nodule was designed to accommodate film and thermoluminescent dosimeters (TLD). Film and TLDs were uniquely labeled by location within the target. The phantommore » was localized on the treatment table using the clinically available orthogonal kV on-board imaging device. Film inserts provided data for dose uniformity; TLDs provided a 3% precision estimate of absolute dose. An inhouse script was developed to modify the delivery order of the beam spots, to orient the scanning direction parallel or perpendicular to target motion.TLD detector characterization and analysis was performed by the Imaging and Radiation Oncology Core group (IROC)-Houston. Film inserts, exhibiting a spatial resolution of 1mm, were analyzed to determine dose homogeneity within the radiation target. Results: Parallel scanning and target motions exhibited reduced target dose heterogeneity, relative to perpendicular scanning orientation. The average percent deviation in absolute dose for the motion deliveries relative to the static delivery was 4.9±1.1% for parallel scanning, and 11.7±3.5% (p<<0.05) for perpendicularly oriented scanning. Individual delivery dose deviations were not necessarily correlated to amplitude of motion for either scan orientation. Conclusions: Results demonstrate a quantifiable difference in dose heterogeneity as a function of scan orientation, more so than target amplitude. Comparison to the analyzed planar dose of a single field hint that multiple-field delivery alters intra-fraction beam-target motion synchronization and may mitigate heterogeneity, though further study is warranted.« less

SU-D-19A-05: The Dosimetric Impact of Using Xoft Axxent® Electronic Brachytherapy Source TG-43 Dosimetry Parameters for Treatment with the Xoft 30 Mm Diameter Vaginal Applicator

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

Simiele, S; Micka, J; Culberson, W

2014-06-01

Purpose: A full TG-43 dosimetric characterization has not been performed for the Xoft Axxent ® electronic brachytherapy source (Xoft, a subsidiary of iCAD, San Jose, CA) within the Xoft 30 mm diameter vaginal applicator. Currently, dose calculations are performed using the bare-source TG-43 parameters and do not account for the presence of the applicator. This work focuses on determining the difference between the bare-source and sourcein- applicator TG-43 parameters. Both the radial dose function (RDF) and polar anisotropy function (PAF) were computationally determined for the source-in-applicator and bare-source models to determine the impact of using the bare-source dosimetry data. Methods:more » MCNP5 was used to model the source and the Xoft 30 mm diameter vaginal applicator. All simulations were performed using 0.84p and 0.03e cross section libraries. All models were developed based on specifications provided by Xoft. The applicator is made of a proprietary polymer material and simulations were performed using the most conservative chemical composition. An F6 collision-kerma tally was used to determine the RDF and PAF values in water at various dwell positions. The RDF values were normalized to 2.0 cm from the source to accommodate the applicator radius. Source-in-applicator results were compared with bare-source results from this work as well as published baresource results. Results: For a 0 mm source pullback distance, the updated bare-source model and source-in-applicator RDF values differ by 2% at 3 cm and 4% at 5 cm. The largest PAF disagreements were observed at the distal end of the source and applicator with up to 17% disagreement at 2 cm and 8% at 8 cm. The bare-source model had RDF values within 2.6% of the published TG-43 data and PAF results within 7.2% at 2 cm. Conclusion: Results indicate that notable differences exist between the bare-source and source-in-applicator TG-43 simulated parameters. Xoft Inc. provided partial funding for this work.« less

Investigation of the effective atomic numbers of dosimetric materials for electrons, protons and alpha particles using a direct method in the energy region 10 keV-1 GeV: a comparative study.

PubMed

Kurudirek, Murat; Aksakal, Oğuz; Akkuş, Tuba

2015-11-01

A direct method has been used for the first time, to compute effective atomic numbers (Z eff) of water, air, human tissues, and some organic and inorganic compounds, for total electron proton and alpha particle interaction in the energy region 10 keV-1 GeV. The obtained values for Z eff were then compared to those obtained using an interpolation procedure. In general, good agreement has been observed for electrons, and the difference (%) in Z eff between the results of the direct and the interpolation method was found to be <10 % for all materials, in the energy range from 10 keV to 1 MeV. More specifically, results of the two methods were found to agree well (Dif. <10 %) for air, calcium fluoride, kapton polyimide film, paraffin wax and plastic scintillator in the entire energy region with respect to the total electron interaction. On the other hand, values for Z eff calculated using both methods for protons and alpha particles generally agree with each other in the high-energy region above 10 MeV.

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

Dosimetric comparison of stopping power calibration with dual-energy CT and single-energy CT in proton therapy treatment planning

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

Zhu, Jiahua; Penfold, Scott N., E-mail: scott.penfold@adelaide.edu.au

Purpose: The accuracy of proton dose calculation is dependent on the ability to correctly characterize patient tissues with medical imaging. The most common method is to correlate computed tomography (CT) numbers obtained via single-energy CT (SECT) with proton stopping power ratio (SPR). CT numbers, however, cannot discriminate between a change in mass density and change in chemical composition of patient tissues. This limitation can have consequences on SPR calibration accuracy. Dual-energy CT (DECT) is receiving increasing interest as an alternative imaging modality for proton therapy treatment planning due to its ability to discriminate between changes in patient density and chemicalmore » composition. In the current work we use a phantom of known composition to demonstrate the dosimetric advantages of proton therapy treatment planning with DECT over SECT. Methods: A phantom of known composition was scanned with a clinical SECT radiotherapy CT-simulator. The phantom was rescanned at a lower X-ray tube potential to generate a complimentary DECT image set. A set of reference materials similar in composition to the phantom was used to perform a stoichiometric calibration of SECT CT number to proton SPRs. The same set of reference materials was used to perform a DECT stoichiometric calibration based on effective atomic number. The known composition of the phantom was used to assess the accuracy of SPR calibration with SECT and DECT. Intensity modulated proton therapy (IMPT) treatment plans were generated with the SECT and DECT image sets to assess the dosimetric effect of the imaging modality. Isodose difference maps and root mean square (RMS) error calculations were used to assess dose calculation accuracy. Results: SPR calculation accuracy was found to be superior, on average, with DECT relative to SECT. Maximum errors of 12.8% and 2.2% were found for SECT and DECT, respectively. Qualitative examination of dose difference maps clearly showed the dosimetric advantages of DECT imaging, compared to SECT imaging for IMPT dose calculation for the case investigated. Quantitatively, the maximum dose calculation error in the SECT plan was 7.8%, compared to a value of 1.4% in the DECT plan. When considering the high dose target region, the root mean square (RMS) error in dose calculation was 2.1% and 0.4% for SECT and DECT, respectively. Conclusions: DECT-based proton treatment planning in a commercial treatment planning system was successfully demonstrated for the first time. DECT is an attractive imaging modality for proton therapy treatment planning owing to its ability to characterize density and chemical composition of patient tissues. SECT and DECT scans of a phantom of known composition have been used to demonstrate the dosimetric advantages obtainable in proton therapy treatment planning with DECT over the current approach based on SECT.« less

Radiation Dose-Volume Effects and the Penile Bulb

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

Roach, Mack, E-mail: mroach@radonc.ucsf.ed; Nam, Jiho; Gagliardi, Giovanna

2010-03-01

The dose, volume, and clinical outcome data for penile bulb are reviewed for patients treated with external-beam radiotherapy. Most, but not all, studies find an association between impotence and dosimetric parameters (e.g., threshold doses) and clinical factors (e.g., age, comorbid diseases). According to the data available, it is prudent to keep the mean dose to 95% of the penile bulb volume to <50 Gy. It may also be prudent to limit the D70 and D90 to 70 Gy and 50 Gy, respectively, but coverage of the planning target volume should not be compromised. It is acknowledged that the penile bulbmore » may not be the critical component of the erectile apparatus, but it seems to be a surrogate for yet to be determined structure(s) critical for erectile function for at least some techniques.« less

Type testing the Model 6600 plus automatic TLD reader.

PubMed

Velbeck, K J; Luo, L Z; Streetz, K L

2006-01-01

The Harshaw Model 6600 Plus is a reader with a capacity for 200 TLD cards or 800 extremity cards. The new unit integrates more functionality, and significantly automates the QC and calibration process compared to the Model 6600. The Model 6600 Plus was tested against the IEC 61066 (1991-2012) procedures using Harshaw TLD-700H and TLD-600H, LiF:Mg,Cu,P based TLD Cards. An overview of the type testing procedures is presented. These include batch homogeneity, detection threshold, reproducibility, linearity, self-irradiation, residue, light effects on dosemeter, light leakage to reader, voltage and frequency, dropping and reader stability. The new TLD reader was found to meet all the IEC criteria by large margins and appears well suited for whole body, extremity and environmental dosimetry applications, with a high degree of dosimetric performance.

Radiation-induced damage analysed by luminescence methods in retrospective dosimetry and emergency response.

PubMed

Woda, Clemens; Bassinet, Céline; Trompier, François; Bortolin, Emanuela; Della Monaca, Sara; Fattibene, Paola

2009-01-01

The increasing risk of a mass casualty scenario following a large scale radiological accident or attack necessitates the development of appropriate dosimetric tools for emergency response. Luminescence dosimetry has been reliably applied for dose reconstruction in contaminated settlements for several decades and recent research into new materials carried close to the human body opens the possibility of estimating individual doses for accident and emergency dosimetry using the same technique. This paper reviews the luminescence research into materials useful for accident dosimetry and applications in retrospective dosimetry. The properties of the materials are critically discussed with regard to the requirements for population triage. It is concluded that electronic components found within portable electronic devices, such as e.g. mobile phones, are at present the most promising material to function as a fortuitous dosimeter in an emergency response.

Voss with Pille TLD reader

NASA Image and Video Library

2001-06-26

ISS002-E-7814 (26 June 2001) --- James S. Voss, Expedition Two flight engineer, sets up the Human Research Facility's (HRF) Dosimetric Mapping (DOSMAP) Power Distribution Unit (PDU) in Destiny. The image was taken with a digital still camera.

Space charge dosimeters for extremely low power measurements of radiation in shipping containers

DOEpatents

Britton, Jr., Charles L.; Buckner, Mark A [Oak Ridge, TN; Hanson, Gregory R [Clinton, TN; Bryan, William L [Knoxville, TN

2011-05-03

Methods and apparatus are described for space charge dosimeters for extremely low power measurements of radiation in shipping containers. A method includes insitu polling a suite of passive integrating ionizing radiation sensors including reading-out dosimetric data from a first passive integrating ionizing radiation sensor and a second passive integrating ionizing radiation sensor, where the first passive integrating ionizing radiation sensor and the second passive integrating ionizing radiation sensor remain situated where the dosimetric data was integrated while reading-out. Another method includes arranging a plurality of ionizing radiation sensors in a spatially dispersed array; determining a relative position of each of the plurality of ionizing radiation sensors to define a volume of interest; collecting ionizing radiation data from at least a subset of the plurality of ionizing radiation sensors; and triggering an alarm condition when a dose level of an ionizing radiation source is calculated to exceed a threshold.

Space charge dosimeters for extremely low power measurements of radiation in shipping containers

DOEpatents

Britton, Jr; Charles, L [Alcoa, TN; Buckner, Mark A [Oak Ridge, TN; Hanson, Gregory R [Clinton, TN; Bryan, William L [Knoxville, TN

2011-04-26

Methods and apparatus are described for space charge dosimeters for extremely low power measurements of radiation in shipping containers. A method includes in situ polling a suite of passive integrating ionizing radiation sensors including reading-out dosimetric data from a first passive integrating ionizing radiation sensor and a second passive integrating ionizing radiation sensor, where the first passive integrating ionizing radiation sensor and the second passive integrating ionizing radiation sensor remain situated where the dosimetric data was integrated while reading-out. Another method includes arranging a plurality of ionizing radiation sensors in a spatially dispersed array; determining a relative position of each of the plurality of ionizing radiation sensors to define a volume of interest; collecting ionizing radiation data from at least a subset of the plurality of ionizing radiation sensors; and triggering an alarm condition when a dose level of an ionizing radiation source is calculated to exceed a threshold.

The calculation of mass attenuation coefficients of well-known thermoluminescent dosimetric compounds at wide energy range

NASA Astrophysics Data System (ADS)

Ermis, Elif Ebru

2017-02-01

The photon mass attenuation coefficients of LiF, BaSO4, CaCO3 and CaSO4 thermoluminescent dosimetric compounds at 100; 300; 500; 600; 800; 1,000; 1,500; 2,000; 3,000 and 5,000 keV gamma-ray energies were calculated. For this purpose, FLUKA Monte Carlo (MC) program which is one of the well-known MC codes was used in this study. Furthermore, obtained results were analyzed by means of ROOT program. National Institute of Standards and Technology (NIST) values were also used to compare the obtained theoretical values because the mass attenuation values of the used compounds could not found in the literature. Calculated mass attenuation coefficients were highly in accordance with the NIST values. As a consequence, FLUKA was successful in calculating the mass attenuation coefficients of the most used thermoluminescent compound.

LETTER TO THE EDITOR: Response to 'Patient dose measurements in radiological practices'

NASA Astrophysics Data System (ADS)

Zoetelief, J.; Wambersie, A.

2006-06-01

A lack of suitable dosimetric quantities for application in diagnostic radiology is noted by Dr Moores. It is concluded by Dr Moores that it is not possible to adhere to the basic principles of the International Commission on Radiation Units and Measurements (ICRU) regarding patient dosimetry in diagnostic radiology due to the extremely wide variety of quantities and units employed. The conclusion of the ICRU on similar observations, however, was that there is a need for harmonization of quantities and terminology for dosimetry in diagnostic and interventional radiology and they established a Report Committee with the aim of formulating an ICRU report on 'dosimetric procedures in diagnostic radiology'. The report produced by this committee entitled 'Patient dosimetry for x rays used in medical imaging' was accepted for publication in December 2005 and is currently at press, and may serve to improve the current situation with regard to patient dose measurement in diagnostic and interventional radiology.

Feasibility of 3D printed air slab diode caps for small field dosimetry.

PubMed

Perrett, Benjamin; Charles, Paul; Markwell, Tim; Kairn, Tanya; Crowe, Scott

2017-09-01

Commercial diode detectors used for small field dosimetry introduce a field-size-dependent over-response relative to an ideal, water-equivalent dosimeter due to high density components in the body of the detector. An air gap above the detector introduces a field-size-dependent under-response, and can be used to offset the field-size-dependent detector over-response. Other groups have reported experimental validation of caps containing air gaps for use with several types of diodes in small fields. This paper examines two designs for 3D printed diode air caps for the stereotactic field diode (SFD)-a cap containing a sealed air cavity, and a cap with an air cavity at the face of the SFD. Monte Carlo simulations of both designs were performed to determine dimensions for an air cavity to introduce the desired dosimetric correction. Various parameter changes were also simulated to estimate the dosimetric uncertainties introduced by 3D printing. Cap layer dimensions, cap density changes due to 3D printing, and unwanted air gaps were considered. For the sealed design the optimal air gap size for water-equivalent cap material was 0.6 mm, which increased to 1.0 mm when acrylonitrile butadiene styrene in the cap was simulated. The unsealed design had less variation, a 0.4 mm air gap is optimal in both situations. Unwanted air pockets in the bore of the cap and density changes introduced by the 3D printing process can potentially introduce significant dosimetric effects. These effects may be limited by using fine print resolutions and minimising the volume of cap material.

Acute anal toxicity after whole pelvic radiotherapy in patients with asymptomatic haemorrhoids: identification of dosimetric and patient factors.

PubMed

Jang, H; Baek, J G; Yoo, S-J

2015-06-01

Patients with asymptomatic haemorrhoids are known to be less tolerant of radiation doses lower than known tolerance doses. In the present study, the authors sought to identify the risk factors of acute haemorrhoid aggravation after whole pelvic radiotherapy (WPRT). The records of 33 patients with cervical, rectal or prostate cancer with asymptomatic haemorrhoids, which were confirmed by colonoscopy before the start of radiotherapy (RT), were reviewed. Acute anal symptoms, such as anal pain and bleeding, were observed up to 1 month after RT completion. Dosimetric and patient factors were analysed, and subgroup analyses were performed. The median induction dose for acute anal symptoms was 34.1 Gy (range, 28.8-50.4 Gy). Post-operative treatment intent showed more acute anal toxicity of patient factors (p = 0.04). In subgroup analysis, post-operative treatment intent and concurrent chemoradiotherapy were found to be related to acute anal symptoms (p < 0.01). Of the dosimetric factors, V10 tended to be related to acute anal symptoms (p = 0.08). This study indicates that asymptomatic haemorrhoid may deteriorate after low-dose radiation and that patient factors, such as treatment intent and concurrent chemotherapy, probably influence anal toxicity. In patients with asymptomatic haemorrhoids, WPRT requires careful dosimetry and clinical attention. The tolerance of anal canal tends to be ignored in patients with pelvic cancer who are undergoing WPRT. However, patients with asymptomatic haemorrhoids may be troubled by low radiation doses, and further studies are required.

Evaluation of the 2-(1-Hexyloxyethyl)-2-devinyl pyropheophorbide (HPPH) mediated photodynamic therapy by macroscopic singlet oxygen modeling.

PubMed

Penjweini, Rozhin; Kim, Michele M; Liu, Baochang; Zhu, Timothy C

2016-12-01

Photodynamic therapy (PDT) is known as a non-invasive treatment modality that is based on photochemical reactions between oxygen, photosensitizer, and a special wavelength of light. However, a dosimetric predictor for PDT outcome is still elusive because current dosimetric quantities do not account for the differences in the PDT oxygen consumption rate for different fluence rates. In this study, we evaluate several dose metrics, total fluence, photobleaching ratio, PDT dose, and mean reacted singlet oxygen (mean [ 1 O 2 ] rx ) for predicting the PDT outcome and a clinically relevant tumor re-growth endpoint. For this reason, radiation-induced fibrosarcoma (RIF) mice tumors are treated with 2-(1-Hexyloxyethyl)-2-devinyl pyropheophorbide (HPPH) and different in-air fluences (30 J/cm 2 , 50 J/cm 2 , 135 J/cm 2 , 250 J/cm 2 , and 350 J/cm 2 ) and in-air fluence rates (20, 50, 75, 150 mW/cm 2 ). Explicit measurements of HPPH and oxygen concentration as well as tissue optical properties are performed pre- and post-treatment. Then, this information is incorporated into a macroscopic model to calculate the photobleaching, PDT dose, and mean [ 1 O 2 ] rx . Changes in tumor volume are tracked following the treatment and compared with the dose metrics. The correlation demonstrates that mean [ 1 O 2 ] rx  serves as a better dosimetric quantity for predicting treatment outcome and a clinically relevant tumor re-growth endpoint. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Propagation of registration uncertainty during multi-fraction cervical cancer brachytherapy

NASA Astrophysics Data System (ADS)

Amir-Khalili, A.; Hamarneh, G.; Zakariaee, R.; Spadinger, I.; Abugharbieh, R.

2017-10-01

Multi-fraction cervical cancer brachytherapy is a form of image-guided radiotherapy that heavily relies on 3D imaging during treatment planning, delivery, and quality control. In this context, deformable image registration can increase the accuracy of dosimetric evaluations, provided that one can account for the uncertainties associated with the registration process. To enable such capability, we propose a mathematical framework that first estimates the registration uncertainty and subsequently propagates the effects of the computed uncertainties from the registration stage through to the visualizations, organ segmentations, and dosimetric evaluations. To ensure the practicality of our proposed framework in real world image-guided radiotherapy contexts, we implemented our technique via a computationally efficient and generalizable algorithm that is compatible with existing deformable image registration software. In our clinical context of fractionated cervical cancer brachytherapy, we perform a retrospective analysis on 37 patients and present evidence that our proposed methodology for computing and propagating registration uncertainties may be beneficial during therapy planning and quality control. Specifically, we quantify and visualize the influence of registration uncertainty on dosimetric analysis during the computation of the total accumulated radiation dose on the bladder wall. We further show how registration uncertainty may be leveraged into enhanced visualizations that depict the quality of the registration and highlight potential deviations from the treatment plan prior to the delivery of radiation treatment. Finally, we show that we can improve the transfer of delineated volumetric organ segmentation labels from one fraction to the next by encoding the computed registration uncertainties into the segmentation labels.

The conversion of exposures due to radon into the effective dose: the epidemiological approach.

PubMed

Beck, T R

2017-11-01

The risks and dose conversion coefficients for residential and occupational exposures due to radon were determined with applying the epidemiological risk models to ICRP representative populations. The dose conversion coefficient for residential radon was estimated with a value of 1.6 mSv year -1 per 100 Bq m -3 (3.6 mSv per WLM), which is significantly lower than the corresponding value derived from the biokinetic and dosimetric models. The dose conversion coefficient for occupational exposures with applying the risk models for miners was estimated with a value of 14 mSv per WLM, which is in good accordance with the results of the dosimetric models. To resolve the discrepancy regarding residential radon, the ICRP approaches for the determination of risks and doses were reviewed. It could be shown that ICRP overestimates the risk for lung cancer caused by residential radon. This can be attributed to a wrong population weighting of the radon-induced risks in its epidemiological approach. With the approach in this work, the average risks for lung cancer were determined, taking into account the age-specific risk contributions of all individuals in the population. As a result, a lower risk coefficient for residential radon was obtained. The results from the ICRP biokinetic and dosimetric models for both, the occupationally exposed working age population and the whole population exposed to residential radon, can be brought in better accordance with the corresponding results of the epidemiological approach, if the respective relative radiation detriments and a radiation-weighting factor for alpha particles of about ten are used.

Comparison of TG-43 dosimetric parameters of brachytherapy sources obtained by three different versions of MCNP codes.

PubMed

Zaker, Neda; Zehtabian, Mehdi; Sina, Sedigheh; Koontz, Craig; Meigooni, Ali S

2016-03-08

Monte Carlo simulations are widely used for calculation of the dosimetric parameters of brachytherapy sources. MCNP4C2, MCNP5, MCNPX, EGS4, EGSnrc, PTRAN, and GEANT4 are among the most commonly used codes in this field. Each of these codes utilizes a cross-sectional library for the purpose of simulating different elements and materials with complex chemical compositions. The accuracies of the final outcomes of these simulations are very sensitive to the accuracies of the cross-sectional libraries. Several investigators have shown that inaccuracies of some of the cross section files have led to errors in 125I and 103Pd parameters. The purpose of this study is to compare the dosimetric parameters of sample brachytherapy sources, calculated with three different versions of the MCNP code - MCNP4C, MCNP5, and MCNPX. In these simulations for each source type, the source and phantom geometries, as well as the number of the photons, were kept identical, thus eliminating the possible uncertainties. The results of these investigations indicate that for low-energy sources such as 125I and 103Pd there are discrepancies in gL(r) values. Discrepancies up to 21.7% and 28% are observed between MCNP4C and other codes at a distance of 6 cm for 103Pd and 10 cm for 125I from the source, respectively. However, for higher energy sources, the discrepancies in gL(r) values are less than 1.1% for 192Ir and less than 1.2% for 137Cs between the three codes.

SU-C-213-06: Dosimetric Verification of 3D Printed Electron Bolus

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

Rasmussen, K; Corbett, M; Pelletier, C

2015-06-15

Purpose: To determine the dosimetric effect of 3D printed bolus in an anthropomorphic phantom. Methods: Conformable bolus material was generated for an anthropomorphic phantom from a DICOM volume. The bolus generated was a uniform expansion of 5mm applied to the nose region of the phantom, as this is a difficult area to uniformly apply bolus clinically. A Printrbot metal 3D Printer using PLA plastic generated the bolus. A 9MeV anterior beam with a 5cm cone was used to deliver dose to the nose of the phantom. TLD measurements were compared to predicted values at the phantom surface. Film planes weremore » analyzed for the printed bolus, a standard 5mm bolus sheet placed on the phantom, and the phantom with no bolus applied to determine depth and dose distributions. Results: TLDs measured within 2.5% of predicted value for the 3D bolus. Film demonstrated a more uniform dose distribution in the nostril region for the 3d printed bolus than the standard bolus. This difference is caused by the air gap created around the nostrils by the standard bolus, creating a secondary build-up region. Both demonstrated a 50% central axis dose shift of 5mm relative to the no bolus film. HU for the bolus calculated the PLA electron density to be ∼1.1g/cc. Physical density was measured to be 1.3g/cc overall. Conclusion: 3D printed PLA bolus demonstrates improved dosimetric performance to standard bolus for electron beams with complex phantom geometry.« less

Fast 3D dosimetric verifications based on an electronic portal imaging device using a GPU calculation engine.

PubMed

Zhu, Jinhan; Chen, Lixin; Chen, Along; Luo, Guangwen; Deng, Xiaowu; Liu, Xiaowei

2015-04-11

To use a graphic processing unit (GPU) calculation engine to implement a fast 3D pre-treatment dosimetric verification procedure based on an electronic portal imaging device (EPID). The GPU algorithm includes the deconvolution and convolution method for the fluence-map calculations, the collapsed-cone convolution/superposition (CCCS) algorithm for the 3D dose calculations and the 3D gamma evaluation calculations. The results of the GPU-based CCCS algorithm were compared to those of Monte Carlo simulations. The planned and EPID-based reconstructed dose distributions in overridden-to-water phantoms and the original patients were compared for 6 MV and 10 MV photon beams in intensity-modulated radiation therapy (IMRT) treatment plans based on dose differences and gamma analysis. The total single-field dose computation time was less than 8 s, and the gamma evaluation for a 0.1-cm grid resolution was completed in approximately 1 s. The results of the GPU-based CCCS algorithm exhibited good agreement with those of the Monte Carlo simulations. The gamma analysis indicated good agreement between the planned and reconstructed dose distributions for the treatment plans. For the target volume, the differences in the mean dose were less than 1.8%, and the differences in the maximum dose were less than 2.5%. For the critical organs, minor differences were observed between the reconstructed and planned doses. The GPU calculation engine was used to boost the speed of 3D dose and gamma evaluation calculations, thus offering the possibility of true real-time 3D dosimetric verification.

Effect of heterogeneity correction on dosimetric parameters of radiotherapy planning for thoracic esophageal cancer.

PubMed

Nakayama, Masao; Yoshida, Kenji; Nishimura, Hideki; Miyawaki, Daisuke; Uehara, Kazuyuki; Okamoto, Yoshiaki; Okayama, Takanobu; Sasaki, Ryohei

2014-01-01

The present study aimed to investigate the effect of heterogeneity correction (HC) on dosimetric parameters in 3-dimensional conformal radiotherapy planning for patients with thoracic esophageal cancer. We retrospectively analyzed 20 patients. Two treatment plans were generated for each patient using a superposition algorithm on the Xio radiotherapy planning system. The first plan was calculated without HC. The second was a new plan calculated with HC, using identical beam geometries and maintaining the same number of monitor units as the first. With regard to the planning target volume (PTV), the overall mean differences in the prescription dose, maximum dose, mean dose, and dose that covers 95% of the PTV between the first and second plans were 1.10Gy (1.8%), 1.35Gy (2.2%), 1.10Gy (1.9%), and 0.56Gy (1.0%), respectively. With regard to parameters related to the organs at risk (OARs), the mean differences in the absolute percentages of lung volume receiving greater than 5, 10, 20, and 30Gy (lung V5, V10, V20, and V30) between the first and second plans were 7.1%, 2.7%, 0.4%, and 0.5%, respectively. These results suggest that HC might have a more pronounced effect on the percentages of lung volume receiving lower doses (e.g., V5 and V10) than on the dosimetric parameters related to the PTV and other OARs. © 2013 Published by American Association of Medical Dosimetrists on behalf of American Association of Medical Dosimetrists.

Dosimetric Factors Associated With Long-Term Dysphagia After Definitive Radiotherapy for Squamous Cell Carcinoma of the Head and Neck

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

Caudell, Jimmy J.; Schaner, Philip E.; Desmond, Renee A.

2010-02-01

Purpose: Intensification of radiotherapy and chemotherapy for head-and-neck cancer may lead to increased rates of dysphagia. Dosimetric predictors of objective findings of long-term dysphagia were sought. Methods and Materials: From an institutional database, 83 patients were identified who underwent definitive intensity-modulated radiotherapy for squamous cell carcinoma of the head and neck, after exclusion of those who were treated for a second or recurrent head-and-neck primary lesion, had locoregional recurrence at any time, had less than 12 months of follow-up, or had postoperative radiotherapy. Dosimetric parameters were analyzed relative to three objective endpoints as a surrogate for severe long-term dysphagia: percutaneousmore » endoscopic gastrostomy (PEG) tube dependence at 12 months, aspiration on modified barium swallow, or pharyngoesophageal stricture requiring dilation. Results: Mean dose greater than 41 Gy and volume receiving 60 Gy (V{sub 60}) greater than 24% to the larynx were significantly associated with PEG tube dependence and aspiration. V{sub 60} greater than 12% to the inferior pharyngeal constrictor was also significantly associated with increased PEG tube dependence and aspiration. V{sub 65} greater than 33% to the superior pharyngeal constrictor or greater than 75% to the middle pharyngeal constrictor was associated with pharyngoesophageal stricture requiring dilation. Conclusions: Doses to the larynx and pharyngeal constrictors predicted long-term swallowing complications, even when controlled for other clinical factors. The addition of these structures to intensity-modulated radiotherapy optimization may reduce the incidence of dysphagia, although cautious clinical validation is necessary.« less

Dosimetry applications in GATE Monte Carlo toolkit.

PubMed

Papadimitroulas, Panagiotis

2017-09-01

Monte Carlo (MC) simulations are a well-established method for studying physical processes in medical physics. The purpose of this review is to present GATE dosimetry applications on diagnostic and therapeutic simulated protocols. There is a significant need for accurate quantification of the absorbed dose in several specific applications such as preclinical and pediatric studies. GATE is an open-source MC toolkit for simulating imaging, radiotherapy (RT) and dosimetry applications in a user-friendly environment, which is well validated and widely accepted by the scientific community. In RT applications, during treatment planning, it is essential to accurately assess the deposited energy and the absorbed dose per tissue/organ of interest, as well as the local statistical uncertainty. Several types of realistic dosimetric applications are described including: molecular imaging, radio-immunotherapy, radiotherapy and brachytherapy. GATE has been efficiently used in several applications, such as Dose Point Kernels, S-values, Brachytherapy parameters, and has been compared against various MC codes which are considered as standard tools for decades. Furthermore, the presented studies show reliable modeling of particle beams when comparing experimental with simulated data. Examples of different dosimetric protocols are reported for individualized dosimetry and simulations combining imaging and therapy dose monitoring, with the use of modern computational phantoms. Personalization of medical protocols can be achieved by combining GATE MC simulations with anthropomorphic computational models and clinical anatomical data. This is a review study, covering several dosimetric applications of GATE, and the different tools used for modeling realistic clinical acquisitions with accurate dose assessment. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Dosimetric evaluation of a novel high dose rate (HDR) intraluminal / interstitial brachytherapy applicator for gastrointestinal and bladder cancers

PubMed Central

Aghamiri, Seyyed Mahmoud Reza; Najarian, Siamak; Jaberi, Ramin

2010-01-01

High dose rate (HDR) brachytherapy is one of the accepted treatment modalities in gastro‐intestinal tract and bladder carcinomas. Considering the shortcoming of contact brachytherapy routinely used in gastrointestinal tract in treatment of big tumors or invasive method of bladder treatment, an intraluminal applicator with the capability of insertion into the tumor depth seems to be useful. This study presents some dosimetric evaluations to introduce this applicator to the clinical use. The radiation attenuation characteristics of the applicator were evaluated by means of two dosimetric methods including well‐type chamber and radiochromic film. The proposed 110 cm long applicator has a flexible structure made of stainless steel for easy passage through lumens and a needle tip to drill into big tumors. The 2 mm diameter of the applicator is thick enough for source transition, while easy passage through any narrow lumen such as endoscope or cystoscope working channel is ensured. Well‐chamber results showed an acceptably low attenuation of this steel springy applicator. Performing absolute dosimetry resulted in a correlation coefficient of R=0.9916(p‐value≈10−7) between standard interstitial applicator and the one proposed in this article. This study not only introduces a novel applicator with acceptable attenuation but also proves the response independency of the GAFCHROMIC EBT films to energy. By applying the dose response of the applicator in the treatment planning software, it can be used as a new intraluminal / interstitial applicator. PACS number: 87.53.Bn, 87.53.Jw, 29.40.Cs

Dosimetric predictors of radiation-induced pericardial effusion in esophageal cancer.

PubMed

Ogino, Ichiro; Watanabe, Shigenobu; Sakamaki, Kentaro; Ogino, Yuka; Kunisaki, Chikara; Kimura, Kazuo

2017-07-01

To evaluate the dose-volume parameters of the pericardium and heart in order to reduce the risk of radiation-induced pericardial effusion (PE) and symptomatic PE (SPE) in esophageal cancer patients treated with concurrent chemoradiotherapy. In 86 of 303 esophageal cancer patients, follow-up CT was obtained at least 24 months after concurrent chemoradiotherapy. Correlations between clinical factors, including risk factors for cardiac disease, dosimetric factors, and the incidence of PE and SPE after radiotherapy were analyzed using Cox proportional hazard regression analysis. Significant dosimetric factors with the highest hazard ratios were investigated using zones separated according to their distance from esophagus. PE developed in 49 patients. Univariate analysis showed the mean heart dose, heart V 5 -V 55 , mean pericardium dose, and pericardium V 5 -V 50 to all significantly affect the incidence of PE. Additionally, body surface area was correlated with the incidence of PE in multivariate analysis. Grade 3 and 4 SPE developed in 5 patients. The pericardium V 50 and pericardium D 10 significantly affected the incidence of SPE. The pericardium V 50 in patients with SPE ranged from 17.1 to 21.7%. Factors affecting the incidence of SPE were the V 50 of the pericardium zones within 3 cm and 4 cm of the esophagus. A wide range of radiation doses to the heart and pericardium were related to the incidence of PE. A pericardium V 50  ≤ 17% is important to avoid symptomatic PE in esophageal cancer patients treated with concurrent chemoradiotherapy.

Inverse planning in three-dimensional conformal and intensity-modulated radiotherapy of mid-thoracic oesophageal cancer.

PubMed

Wu, V W C; Sham, J S T; Kwong, D L W

2004-07-01

The aim of this study is to demonstrate the use of inverse planning in three-dimensional conformal radiation therapy (3DCRT) of oesophageal cancer patients and to evaluate its dosimetric results by comparing them with forward planning of 3DCRT and inverse planning of intensity-modulated radiotherapy (IMRT). For each of the 15 oesophageal cancer patients in this study, the forward 3DCRT, inverse 3DCRT and inverse IMRT plans were produced using the FOCUS treatment planning system. The dosimetric results and the planner's time associated with each of the treatment plans were recorded for comparison. The inverse 3DCRT plans showed similar dosimetric results to the forward plans in the planning target volume (PTV) and organs at risk (OARs). However, they were inferior to that of the IMRT plans in terms of tumour control probability and target dose conformity. Furthermore, the inverse 3DCRT plans were less effective in reducing the percentage lung volume receiving a dose below 25 Gy when compared with the IMRT plans. The inverse 3DCRT plans delivered a similar heart dose as in the forward plans, but higher dose than the IMRT plans. The inverse 3DCRT plans significantly reduced the operator's time by 2.5 fold relative to the forward plans. In conclusion, inverse planning for 3DCRT is a reasonable alternative to the forward planning for oesophageal cancer patients with reduction of the operator's time. However, IMRT has the better potential to allow further dose escalation and improvement of tumour control.

Dosimetric Effects of Air Pockets Around High-Dose Rate Brachytherapy Vaginal Cylinders

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

Richardson, Susan, E-mail: srichardson@radonc.wustl.ed; Palaniswaamy, Geethpriya; Grigsby, Perry W.

2010-09-01

Purpose: Most physicians use a single-channel vaginal cylinder for postoperative endometrial cancer brachytherapy. Recent published data have identified air pockets between the vaginal cylinders and the vaginal mucosa. The purpose of this research was to evaluate the incidence, size, and dosimetric effects of these air pockets. Methods and Materials: 25 patients receiving postoperative vaginal cuff brachytherapy with a high-dose rate vaginal cylinders were enrolled in this prospective data collection study. Patients were treated with 6 fractions of 200 to 400 cGy per fraction prescribed at 5 mm depth. Computed tomography simulation for brachytherapy treatment planning was performed for each fraction.more » The quantity, volume, and dosimetric impact of the air pockets surrounding the cylinder were quantified. Results: In 25 patients, a total of 90 air pockets were present in 150 procedures (60%). Five patients had no air pockets present during any of their treatments. The average number of air pockets per patient was 3.6, with the average total air pocket volume being 0.34 cm{sup 3} (range, 0.01-1.32 cm{sup 3}). The average dose reduction to the vaginal mucosa at the air pocket was 27% (range, 9-58%). Ten patients had no air pockets on their first fraction but air pockets occurred in subsequent fractions. Conclusion: Air pockets between high-dose rate vaginal cylinder applicators and the vaginal mucosa are present in the majority of fractions of therapy, and their presence varies from patient to patient and fraction to fraction. The existence of air pockets results in reduced radiation dose to the vaginal mucosa.« less

Patient-specific dosimetry calculations using mathematic models of different anatomic sizes during therapy with 111In-DTPA-D-Phe1-octreotide infusions after catheterization of the hepatic artery.

PubMed

Kontogeorgakos, Dimitrios K; Dimitriou, Panagiotis A; Limouris, Georgios S; Vlahos, Lambros J

2006-09-01

The aim of the study was to provide dosimetric data on intrahepatic (111)In-diethylenetriaminepentaacetic acid (DTPA)-D-Phe(1)-octreotide therapy for neuroendocrine tumors with overexpression of somatostatin receptors. A dosimetric protocol was designed to estimate the absorbed dose to the tumor and healthy tissue in a course of 48 treatments for 12 patients, who received a mean activity of 5.4 +/- 1.7 GBq per session. The patient-specific dosimetry calculations, based on quantitative biplanar whole-body scintigrams, were performed using a Monte Carlo simulation program for 3 male and 3 female mathematic models of different anatomic sizes. Thirty minutes and 2, 6, 24, and 48 h after the radionuclide infusion, blood-sample data were collected for estimation of the red marrow radiation burden. The mean absorbed doses per administered activity (mGy/MBq) by the critical organs liver, spleen, kidneys, bladder wall, and bone marrow were 0.14 +/- 0.04, 1.4 +/- 0.6, 0.41 +/- 0.08, 0.094 +/- 0.013, and (3.5 +/- 0.8) x 10(-3), respectively; the tumor absorbed dose ranged from 2.2 to 19.6 mGy/MBq, strongly depending on the lesion size and tissue type. The results of the present study quantitatively confirm the therapeutic efficacy of transhepatic administration; the tumor-to-healthy-tissue uptake ratio was enhanced, compared with the results after antecubital infusions. Planning of treatment was also optimized by use of the patient-specific dosimetric protocol.

Patterns of care for brachytherapy in Europe: updated results for Spain.

PubMed

Guedea, Ferran; López-Torrecilla, José; Londres, Bradley; Ventura, Montse; Bilbao, Pedro; Borràs, Josep M

2012-01-01

The aim of this follow-up pattern of care study was to evaluate current clinical practices, staffing and equipment, and to compare these results to a study performed 5 years previously. This descriptive, pattern of care study was carried out via an online questionnaire. The survey was sent to a total of 95 cancer care centres in Spain. Seventy-three centres (76.8%) responded to the survey. More than half (57.5%) of responding centres offered brachytherapy (BT). A mean of 120 patients/centre were treated by BT in 2007. The most common localisations were the endometrium (29.6% of cases), prostate (29.6%), cervix uteri (14.6%), breast (12.6%), head and neck (3.6%) and vagina (2.5%). Other sites accounted for less than 2% of cases each. Most centres that offered BT (33/40 = 82.5%) were equipped with a dedicated BT operating room. The most commonly reported dosimetric method was CT dosimetry (31 of 40 centres = 77.5%), followed by plain film (30/40 = 75%), ultrasound (26/40 = 65%), MRI (8/40 = 20%), in vivo (7/40 = 17.5%) and PET-CT (5/40 = 12.5%) dosimetry. The three most common treatment sites (gynaecological, breast and prostate) remain unchanged from 2002, with prostate treatments showing large increase. Advanced dosimetric techniques (MRI, PET-CT and CT-dosimetry) continue to gain adherents. Some centres treat small numbers of patients, a finding that deserves more attention in terms of cost and quality of care. Although BT remains strong in Spain, it could be further strengthened by making modern dosimetric techniques and treatments more widely available.

Dosimetric Quantities for Computed Tomography Examinations of Paediatric Patients on the Thoracic and Abdominal Regions

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

Flores-M, E.; Gamboa de Buen, I.; Buenfil, A. E.

Computed Tomography (CT) is a high dose X ray imaging procedure and its use has rapidly increased in the last two decades fueled by the development of helical CT. The aim of this study is to present values of the dosimetric quantities for CT paediatric examinations of thoracic and abdominal regions. The protocols studied were those of chest, lung-mediastine, chest-abdomen, pulmonary high resolution and mediastine-abdomen, which are the more common examinations performed at ''Hospital Infantil de Mexico Federico Gomez'' in the thoracic-abdominal region. The measurements were performed on a Siemens SOMATOM Sensation 16 CT Scanner and the equipment used wasmore » a CT pencil ionization chamber, connected to an electrometer. This system was calibrated for RQT9 CT beam quality. A PMMA head phantom with diameter of 16 cm and length of 15 cm was also used. The dosimetric quantities measured were the weighted air kerma index (C{sub w}), the volumetric dose index (C{sub vol}) and the CT air kerma-length product. It was found that the pulmonary high resolution examination presented the highest values for the C{sub w}(31.1 mGy) and C{sub vol}(11.1 mGy). The examination with the lowest values of these two quantities was the chest-abdomen protocol with 10.5 mGy for C{sub w} and 5.5 mGy for C{sub vol}. However, this protocol presented the highest value for P{sub KL,CT}(282.2 mGy cm) when considering the average clinical length of the examinations.« less

Dosimetric impact of contouring and image registration variability on dynamic 125I prostate brachytherapy.

PubMed

Westendorp, Hendrik; Surmann, Kathrin; van de Pol, Sandrine M G; Hoekstra, Carel J; Kattevilder, Robert A J; Nuver, Tonnis T; Moerland, Marinus A; Slump, Cornelis H; Minken, André W

The quality of permanent prostate brachytherapy can be increased by addition of imaging modalities in the intraoperative procedure. This addition involves image registration, which inherently has inter- and intraobserver variabilities. We sought to quantify the inter- and intraobserver variabilities in geometry and dosimetry for contouring and image registration and analyze the results for our dynamic 125 I brachytherapy procedure. Five observers contoured 11 transrectal ultrasound (TRUS) data sets three times and 11 CT data sets one time. The observers registered 11 TRUS and MRI data sets to cone beam CT (CBCT) using fiducial gold markers. Geometrical and dosimetrical inter- and intraobserver variabilities were assessed. For the contouring study, structures were subdivided into three parts along the craniocaudal axis. We analyzed 165 observations. Interobserver geometrical variability for prostate was 1.1 mm, resulting in a dosimetric variability of 1.6% for V 100 and 9.3% for D 90 . The geometric intraobserver variability was 0.6 mm with a V 100 of 0.7% and D 90 of 1.1%. TRUS-CBCT registration showed an interobserver variability in V 100 of 2.0% and D 90 of 3.1%. Intraobserver variabilities were 0.9% and 1.6%, respectively. For MRI-CBCT registration, V 100 and D 90 were 1.3% and 2.1%. Intraobserver variabilities were 0.7% and 1.1% for the same. Prostate dosimetry is affected by interobserver contouring and registration variability. The observed variability is smaller than underdosages that are adapted during our dynamic brachytherapy procedure. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.