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Sample records for helical tomotherapy beams

  1. Shielding requirements in helical tomotherapy

    NASA Astrophysics Data System (ADS)

    Baechler, S.; Bochud, F. O.; Verellen, D.; Moeckli, R.

    2007-08-01

    Helical tomotherapy is a relatively new intensity-modulated radiation therapy (IMRT) treatment for which room shielding has to be reassessed for the following reasons. The beam-on-time needed to deliver a given target dose is increased and leads to a weekly workload of typically one order of magnitude higher than that for conventional radiation therapy. The special configuration of tomotherapy units does not allow the use of standard shielding calculation methods. A conventional linear accelerator must be shielded for primary, leakage and scatter photon radiations. For tomotherapy, primary radiation is no longer the main shielding issue since a beam stop is mounted on the gantry directly opposite the source. On the other hand, due to the longer irradiation time, the accelerator head leakage becomes a major concern. An analytical model based on geometric considerations has been developed to determine leakage radiation levels throughout the room for continuous gantry rotation. Compared to leakage radiation, scatter radiation is a minor contribution. Since tomotherapy units operate at a nominal energy of 6 MV, neutron production is negligible. This work proposes a synthetic and conservative model for calculating shielding requirements for the Hi-Art II TomoTherapy unit. Finally, the required concrete shielding thickness is given for different positions of interest.

  2. Shielding requirements in helical tomotherapy.

    PubMed

    Baechler, S; Bochud, F O; Verellen, D; Moeckli, R

    2007-08-21

    Helical tomotherapy is a relatively new intensity-modulated radiation therapy (IMRT) treatment for which room shielding has to be reassessed for the following reasons. The beam-on-time needed to deliver a given target dose is increased and leads to a weekly workload of typically one order of magnitude higher than that for conventional radiation therapy. The special configuration of tomotherapy units does not allow the use of standard shielding calculation methods. A conventional linear accelerator must be shielded for primary, leakage and scatter photon radiations. For tomotherapy, primary radiation is no longer the main shielding issue since a beam stop is mounted on the gantry directly opposite the source. On the other hand, due to the longer irradiation time, the accelerator head leakage becomes a major concern. An analytical model based on geometric considerations has been developed to determine leakage radiation levels throughout the room for continuous gantry rotation. Compared to leakage radiation, scatter radiation is a minor contribution. Since tomotherapy units operate at a nominal energy of 6 MV, neutron production is negligible. This work proposes a synthetic and conservative model for calculating shielding requirements for the Hi-Art II TomoTherapy unit. Finally, the required concrete shielding thickness is given for different positions of interest.

  3. Comparison of arc-modulated cone beam therapy and helical tomotherapy for three different types of cancer

    SciTech Connect

    Ulrich, Silke; Sterzing, Florian; Nill, Simeon; Schubert, Kai; Herfarth, Klaus K.; Debus, Juergen; Oelfke, Uwe

    2009-10-15

    Purpose: Arc-modulated cone beam therapy (AMCBT) is a fast treatment technique deliverable in a single rotation with a conventional C-arm shaped linac. In this planning study, the authors assess the dosimetric properties of single-arc therapy in comparison to helical tomotherapy for three different tumor types. Methods: Treatment plans for three patients with prostate carcinoma, three patients with anal cancer, and three patients with head and neck cancer were optimized for helical tomotherapy and AMCBT. The dosimetric comparison of the two techniques is based on physical quantities derived from dose-volume histograms. Results: For prostate cancer, the quality of dose distributions calculated for AMCBT was of equal quality as that generated for tomotherapy with the additional benefits of a faster delivery and a lower integral dose. For highly complex geometries, the plan quality achievable with helical tomotherapy could not be achieved with arc-modulated cone beam therapy. Conclusions: Rotation therapy with a conventional linac in a single arc is capable to deliver a high and homogeneous dose to the target and spare organs at risk. Advantages of this technique are a fast treatment time and a lower integral dose in comparison to helical tomotherapy. For highly complex cases, e.g., with several target regions, the dose shaping capabilities of AMCBT are inferior to those of tomotherapy. However, treatment plans for AMCBT were also clinically acceptable.

  4. A Case Report on the Effect of Fan Beam Thickness in Helical Tomotherapy of Nasopharyngeal Carcinoma

    SciTech Connect

    Wu, W.C. Vincent; Mui, Wing Lun A.

    2011-04-01

    The fan beam thickness (FBT) in helical tomotherapy is defined by a pair of collimators parallel to the rotational orbit of the radiation beam and is fixed for a specific patient treatment. The aim of this case study is to evaluate the dosimetric influence of changing the FBT in the treatment of a nasopharyngeal carcinoma (NPC) patient. The subject was a T2N1M0 stage NPC patient. The planning target volumes (PTVs) of the primary nasopharyngeal tumor and the left and right cervical lymphatics were delineated along with the organs at risk (OARs) in the corresponding computed tomography slices. Three treatment plans with FBT of 1.0 cm, 2.5 cm, and 5.0 cm (FBT-10, FBT-25, and FBT-50) were generated separately based on similar dose constraints and planning parameters. The dosimetric results of the PTV and OARs were collected and compared among the 3 treatment plans. The differences in the dose parameters of the PTVs were small among the 3 plans. The FBT-10 plan demonstrated the most homogeneous PTV doses with the smallest homogeneity indices (HIs). The FBT-50 plan delivered the highest dose to the OARs and the FBT-10 plan delivered the lowest. The differences between the 2 plans were more significant in the spinal cord, optic chiasm, optic nerves, and lens. This case study demonstrated that the variation of FBT in tomotherapy affected the quality of the treatment plan mainly in the OAR doses, but not so much in the PTV. Increasing the FBT reduced the effectiveness in the sparing of OARs.

  5. Feasibility of Postmastectomy Treatment With Helical TomoTherapy

    SciTech Connect

    Ashenafi, Michael; Boyd, Robert A.; Lee, Tae K.; Lo, Kenneth K.

    2010-07-01

    Purpose: To investigate the potential of helical tomotherapy for postmastectomy radiation therapy. Methods and Materials: By use of the TomoTherapy Hi-Art II treatment-planning system (TomoTherapy Inc., Madison, WI), helical tomotherapy dose plans were developed for 5 patients and compared with the mixed-beam (electron-photon) plans with which they had been treated. The TomoTherapy plans were evaluated by use of dose-volume quantities, tumor control probability, normal tissue complication probability (NTCP), and secondary cancer complication probability (SCCP). Results: The TomoTherapy plans showed better dose homogeneity in the planning treatment volume containing the chest wall and internal mammary nodes (p = 0.001) and eliminated the need for abutting fields. For the normal tissues, the TomoTherapy plans showed a smaller fractional volume receiving 20Gy or greater for the ipsilateral lung (p = 0.05), no change in NTCP for postradiation pneumonitis, increased SCCP for each lung and both lungs together (p < 0.02), no change in the volume of the heart receiving more than 15Gy, no change in NTCP for excess cardiac mortality, and a larger mean dose and SCCP in the contralateral breast (p < 0.001). For nonspecific tissues, the volume receiving between 5Gy and 25Gy and SCCP were both larger for the TomoTherapy plans (p < 0.01). Total SCCP was larger for the TomoTherapy plans (p = 0.001). Conclusions: Overall, the TomoTherapy plans had comparable tumor control probability and NTCP to the mixed-beam plans and increased SCCP. The TomoTherapy plans showed significantly greater dose homogeneity in the chest wall, which offers the potential for improved cosmesis after treatment. These factors have resulted in TomoTherapy often being the treatment of choice for postmastectomy radiation therapy in our clinic.

  6. Quality assurance of a helical tomotherapy machine

    NASA Astrophysics Data System (ADS)

    Fenwick, J. D.; Tomé, W. A.; Jaradat, H. A.; Hui, S. K.; James, J. A.; Balog, J. P.; DeSouza, C. N.; Lucas, D. B.; Olivera, G. H.; Mackie, T. R.; Paliwal, B. R.

    2004-07-01

    Helical tomotherapy has been developed at the University of Wisconsin, and 'Hi-Art II' clinical machines are now commercially manufactured. At the core of each machine lies a ring-gantry-mounted short linear accelerator which generates x-rays that are collimated into a fan beam of intensity-modulated radiation by a binary multileaf, the modulation being variable with gantry angle. Patients are treated lying on a couch which is translated continuously through the bore of the machine as the gantry rotates. Highly conformal dose-distributions can be delivered using this technique, which is the therapy equivalent of spiral computed tomography. The approach requires synchrony of gantry rotation, couch translation, accelerator pulsing and the opening and closing of the leaves of the binary multileaf collimator used to modulate the radiation beam. In the course of clinically implementing helical tomotherapy, we have developed a quality assurance (QA) system for our machine. The system is analogous to that recommended for conventional clinical linear accelerator QA by AAPM Task Group 40 but contains some novel components, reflecting differences between the Hi-Art devices and conventional clinical accelerators. Here the design and dosimetric characteristics of Hi-Art machines are summarized and the QA system is set out along with experimental details of its implementation. Connections between this machine-based QA work, pre-treatment patient-specific delivery QA and fraction-by-fraction dose verification are discussed.

  7. Reducing the probability of radiation-induced hepatic toxicity by changing the treatment modality from helical tomotherapy to fixed-beam intensity-modulated radiotherapy

    PubMed Central

    Song, Jin Ho; Son, Seok Hyun; Kay, Chul Seung; Jang, Hong Seok

    2015-01-01

    Purpose To estimate and compare the risk of radiation-induced hepatic toxicity (RIHT) in helical tomotherapy and fixed-beam intensity-modulated radiotherapy (IMRT) for the treatment of hepatocellular carcinoma (HCC). Materials and Methods Twenty patients with unresectable HCC treated with tomotherapy were selected. We performed tomotherapy re-planning to reduce the non-target normal liver volume receiving a dose of more than 15 Gy (NTNL-V15Gy), and we created a fixed-beam IMRT plan (FB-P). We compared the dosimetric results as well as the estimated probability of RIHT among the tomotherapy initial plan (T-IP), the tomotherapy re-plan (T-RP), and the FB-P. Results Comparing the T-RP and FB-P, the homogeneity index was 0.11 better with the T-RP. However, the mean NTNL-V15Gy was 6.3% lower with the FB-P. These differences result in a decline in the probability of RIHT from 0.216 in the T-RP to 0.115 in the FB-P. In patients whose NTNL-V15Gy was higher than 43.2% with the T-RP, the probability of RIHT markedly reduced from 0.533 to 0.274. Conclusions By changing the treatment modality from tomotherapy to fixed-beam IMRT, we could reduce the liver dose and the probability of RIHT without scarifying the target coverage, especially in patients whose liver dose is high. PMID:26376679

  8. Helical tomotherapy quality assurance with ArcCHECK

    SciTech Connect

    Chapman, David; Barnett, Rob; Yartsev, Slav

    2014-07-01

    To design a quality assurance (QA) procedure for helical tomotherapy that measures multiple beam parameters with 1 delivery and uses a rotating gantry to simulate treatment conditions. The customized QA procedure was preprogrammed on the tomotherapy operator station. The dosimetry measurements were performed using an ArcCHECK diode array and an A1SL ion chamber inserted in the central holder. The ArcCHECK was positioned 10 cm above the isocenter so that the 21-cm diameter detector array could measure the 40-cm wide tomotherapy beam. During the implementation of the new QA procedure, separate comparative measurements were made using ion chambers in both liquid and solid water, the tomotherapy onboard detector array, and a MapCHECK diode array for a period of 10 weeks. There was good agreement (within 1.3%) for the beam output and cone ratio obtained with the new procedure and the routine QA measurements. The measured beam energy was comparable (0.3%) to solid water measurement during the 10-week evaluation period, excluding 2 of the 10 measurements with unusually high background. The symmetry reading was similarly compromised for those 2 weeks, and on the other weeks, it deviated from the solid water reading by ∼2.5%. The ArcCHECK phantom presents a suitable alternative for performing helical tomotherapy QA, provided the background is collected properly. The proposed weekly procedure using ArcCHECK and water phantom makes the QA process more efficient.

  9. Utility of Megavoltage Fan-Beam CT for Treatment Planning in a Head-And-Neck Cancer Patient with Extensive Dental Fillings Undergoing Helical Tomotherapy

    SciTech Connect

    Yang, Claus; Liu Tianxiao; Jennelle, Richard L.; Ryu, Janice K.; Vijayakumar, Srinivasan; Purdy, James A.; Chen, Allen M.

    2010-07-01

    The purpose of this study was to demonstrate the potential utility of megavoltage fan-beam computed tomography (MV-FBCT) for treatment planning in a patient undergoing helical tomotherapy for nasopharyngeal carcinoma in the presence of extensive dental artifact. A 28-year-old female with locally advanced nasopharyngeal carcinoma presented for radiation therapy. Due to the extensiveness of the dental artifact present in the oral cavity kV-CT scan acquired at simulation, which made treatment planning impossible on tomotherapy planning system, MV-FBCT imaging was obtained using the HI-ART tomotherapy treatment machine, with the patient in the treatment position, and this information was registered with her original kV-CT scan for the purposes of structure delineation, dose calculation, and treatment planning. To validate the feasibility of the MV-FBCT-generated treatment plan, an electron density CT phantom (model 465, Gammex Inc., Middleton, WI) was scanned using MV-FBCT to obtain CT number to density table. Additionally, both a 'cheese' phantom (which came with the tomotherapy treatment machine) with 2 inserted ion chambers and a generic phantom called Quasar phantom (Modus Medical Devices Inc., London, ON, Canada) with one inserted chamber were used to confirm dosimetric accuracy. The MV-FBCT could be used to clearly visualize anatomy in the region of the dental artifact and provide sufficient soft-tissue contrast to assist in the delineation of normal tissue structures and fat planes. With the elimination of the dental artifact, the MV-FBCT images allowed more accurate dose calculation by the tomotherapy system. It was confirmed that the phantom material density was determined correctly by the tomotherapy MV-FBCT number to density table. The ion chamber measurements agreed with the calculations from the MV-FBCT generated phantom plan within 2%. MV-FBCT may be useful in radiation treatment planning for nasopharyngeal cancer patients in the setting of extensive

  10. A Prospective Evaluation of Helical Tomotherapy

    SciTech Connect

    Bauman, Glenn ||. E-mail: glenn.bauman@lhsc.on.ca; Yartsev, Slav; Rodrigues, George ||; Lewis, Craig; Hammond, Alex; Perera, Francisco; Ash, Robert, Dar, A. Rashid |; Venkatesan, Varagur M. |; Yu, Edward; Lock, Michael; Battista, Jerry; Van Dyk, Jake ||; Baily, Laura; Coad, Terry C; Trenka, Kris C.; Warr, Barbara; Kron, Tomas

    2007-06-01

    Purpose: To report results from two clinical trials evaluating helical tomotherapy (HT). Methods and Materials: Patients were enrolled in one of two prospective trials of HT (one for palliative and one for radical treatment). Both an HT plan and a companion three-dimensional conformal radiotherapy (3D-CRT) plan were generated. Pretreatment megavoltage computed tomography was used for daily image guidance. Results: From September 2004 to January 2006, a total of 61 sites in 60 patients were treated. In all but one case, a clinically acceptable tomotherapy plan for treatment was generated. Helical tomotherapy plans were subjectively equivalent or superior to 3D-CRT in 95% of plans. Helical tomotherapy was deemed equivalent or superior in two thirds of dose-volume point comparisons. In cases of inferiority, differences were either clinically insignificant and/or reflected deliberate tradeoffs to optimize the HT plan. Overall imaging and treatment time (median) was 27 min (range, 16-91 min). According to a patient questionnaire, 78% of patients were satisfied to very satisfied with the treatment process. Conclusions: Helical tomotherapy demonstrated clear advantages over conventional 3D-CRT in this diverse patient group. The prospective trials were helpful in deploying this technology in a busy clinical setting.

  11. Helical tomotherapy quality assurance with ArcCHECK.

    PubMed

    Chapman, David; Barnett, Rob; Yartsev, Slav

    2014-01-01

    To design a quality assurance (QA) procedure for helical tomotherapy that measures multiple beam parameters with 1 delivery and uses a rotating gantry to simulate treatment conditions. The customized QA procedure was preprogrammed on the tomotherapy operator station. The dosimetry measurements were performed using an ArcCHECK diode array and an A1SL ion chamber inserted in the central holder. The ArcCHECK was positioned 10cm above the isocenter so that the 21-cm diameter detector array could measure the 40-cm wide tomotherapy beam. During the implementation of the new QA procedure, separate comparative measurements were made using ion chambers in both liquid and solid water, the tomotherapy onboard detector array, and a MapCHECK diode array for a period of 10 weeks. There was good agreement (within 1.3%) for the beam output and cone ratio obtained with the new procedure and the routine QA measurements. The measured beam energy was comparable (0.3%) to solid water measurement during the 10-week evaluation period, excluding 2 of the 10 measurements with unusually high background. The symmetry reading was similarly compromised for those 2 weeks, and on the other weeks, it deviated from the solid water reading by ~2.5%. The ArcCHECK phantom presents a suitable alternative for performing helical tomotherapy QA, provided the background is collected properly. The proposed weekly procedure using ArcCHECK and water phantom makes the QA process more efficient. Copyright © 2014 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  12. Helical Tomotherapy for Parotid Gland Tumors

    SciTech Connect

    Lee, Tae Kyu; Rosen, Isaac I.; Gibbons, John P.; Fields, Robert S.; Hogstrom, Kenneth R.

    2008-03-01

    Purpose: To investigate helical tomotherapy (HT) intensity-modulated radiotherapy (IMRT) as a postoperative treatment for parotid gland tumors. Methods and Materials: Helical tomotherapy plans were developed for 4 patients previously treated with segmental multileaf collimator (SMLC) IMRT. A primary planning target volume (PTV64) and two secondary PTVs (PTV60, PTV54) were defined. The clinical goals from the SMLC plans were applied as closely as possible to the HT planning. The SMLC plans included bolus, whereas HT plans did not. Results: In general, the HT plans showed better target coverage and target dose homogeneity. The minimum doses to the desired coverage volume were greater, on average, in the HT plans for all the targets. Minimum PTV doses were larger, on average, in the HT plans by 4.6 Gy (p = 0.03), 4.8 Gy (p = 0.06), and 4.9 Gy (p = 0.06) for PTV64, PTV60, and PTV54, respectively. Maximum PTV doses were smaller, on average, by 2.9 Gy (p = 0.23), 3.2 Gy (p = 0.02), and 3.6 Gy (p = 0.03) for PTV64, PTV60, and PTV54, respectively. Average dose homogeneity index was statistically smaller in the HT plans, and conformity index was larger for PTV64 in 3 patients. Tumor control probabilities were higher for 3 of the 4 patients. Sparing of normal structures was comparable for the two techniques. There were no significant differences between the normal tissue complication probabilities for the HT and SMLC plans. Conclusions: Helical tomotherapy treatment plans were comparable to or slightly better than SMLC plans. Helical tomotherapy is an effective alternative to SMLC IMRT for treatment of parotid tumors.

  13. Rotational output and beam quality evaluations for helical tomotherapy with use of a third-party quality assurance tool.

    PubMed

    Shimizu, Hidetoshi; Sasaki, Koji; Iwata, Manabu; Kawai, Minoru; Nakashima, Kuniyasu; Kubota, Takashi; Osaki, Hikaru; Nakayama, Masashi; Yoshimoto, Manabu; Kodaira, Takeshi

    2016-01-01

    Our aim was to determine whether a third-party quality assurance (QA) tool was suitable for the measurement of rotational output and beam quality in place of on-board detector signals. A Rotational Therapy Phantom 507 (507 Phantom) was used as a QA tool. The rotational output constancy (ROC507) and the beam quality index ([Formula: see text]) were evaluated by analysis of signals from an ion chamber inserted into the 507 Phantom. On-board detector signals were obtained for comparisons with the data from the 507 Phantom. The rotational output (ROC(detector)) and beam quality (corrected cone ratio; CCR) were determined by analysis of on-board detector signals that were generated by irradiation. The tissue phantom ratio at depth 20 and 10 cm (TPR20, 10) was measured with a Farmer-type ionization chamber inserted in a plastic-slab phantom. For rotational output measurement, the correlation coefficient between ROC507 and ROC(detector) values was 0.68 (p < 0.001). ROC507 and ROC(detector) values showed a reduced coefficient of variation after magnetron replacement, which was done during the measurement period. In addition, ROC507 values were reduced significantly along with ROC(detector) values after target replacement (p < 0.001). Regarding the beam quality index, [Formula: see text] showed a change similar to CCR and an increase similar to TPR20, 10 after magnetron/target replacement. This QA tool could check for daily rotational output and detect changes in rotational output and beam quality caused by magnetron or target failure as well as when on-board detector signals were used. Without needing a tomotherapy quality assurance license, we could effectively and quantitatively estimate the rotational output and beam quality at a low cost.

  14. Optimization of helical tomotherapy treatment plans for prostate cancer

    NASA Astrophysics Data System (ADS)

    Grigorov, G.; Kron, T.; Wong, E.; Chen, J.; Sollazzo, J.; Rodrigues, G.

    2003-07-01

    Helical tomotherapy (HT) is a novel treatment approach where the ring gantry irradiation geometry of a helical CT scanner is combined with an intensity-modulated megavoltage x-ray fan beam. An inverse treatment planning system (TomoTherapy Inc., Madison) was used to optimize the treatment plans for ten randomly selected prostate patients. Five different sets of margins (2, 5, 7.5 and 10 mm uniform 3D margins and a non-uniform margin of 5 to 10 mm) were employed for the prostate (GTV2) and seminal vesicles (GTV1). The dose distribution was evaluated in targets, rectum, bladder and femoral heads. HT plans are characterized by a rapid dose fall off around the target in all directions resulting in low doses (less than 30% of the dose at ICRU reference point) to the femurs in all cases. Up to a margin of 5 mm for target structures, it was always possible to satisfy the requirements for dose delivery set by RTOG protocol P-0126. Using a 'class solution', HT plans require minimal operator interaction and result in excellent sparing of normal structures in prostate radiotherapy.

  15. Can We Spare the Pancreas and Other Abdominal Organs at Risk? A Comparison of Conformal Radiotherapy, Helical Tomotherapy and Proton Beam Therapy in Pediatric Irradiation

    PubMed Central

    Jouglar, Emmanuel; Wagner, Antoine; Delpon, Grégory; Campion, Loïc; Meingan, Philippe; Bernier, Valérie; Demoor-Goldschmidt, Charlotte; Mahé, Marc-André; Lacornerie, Thomas; Supiot, Stéphane

    2016-01-01

    Objectives Late abdominal irradiation toxicity during childhood included renal damage, hepatic toxicity and secondary diabetes mellitus. We compared the potential of conformal radiotherapy (CRT), helical tomotherapy (HT) and proton beam therapy (PBT) to spare the abdominal organs at risk (pancreas, kidneys and liver- OAR) in children undergoing abdominal irradiation. Methods We selected children with abdominal tumors who received more than 10 Gy to the abdomen. Treatment plans were calculated in order to keep the dose to abdominal OAR as low as possible while maintaining the same planned target volume (PTV) coverage. Dosimetric values were compared using the Wilcoxon signed-rank test. Results The dose distribution of 20 clinical cases with a median age of 8 years (range 1–14) were calculated with different doses to the PTV: 5 medulloblastomas (36 Gy), 3 left-sided and 2 right-sided nephroblastomas (14.4 Gy to the tumor + 10.8 Gy boost to para-aortic lymphnodes), 1 left-sided and 4 right-sided or midline neuroblastomas (21 Gy) and 5 Hodgkin lymphomas (19.8 Gy to the para-aortic lymphnodes and spleen). HT significantly reduced the mean dose to the whole pancreas (WP), the pancreatic tail (PT) and to the ipsilateral kidney compared to CRT. PBT reduced the mean dose to the WP and PT compared to both CRT and HT especially in midline and right-sided tumors. PBT decreased the mean dose to the ispilateral kidney but also to the contralateral kidney and the liver compared to CRT. Low dose to normal tissue was similar or increased with HT whereas integral dose and the volume of normal tissue receiving at least 5 and 10 Gy were reduced with PBT compared to CRT and HT. Conclusion In children undergoing abdominal irradiation therapy, proton beam therapy reduces the dose to abdominal OAR while sparing normal tissue by limiting low dose irradiation. PMID:27764132

  16. Standard and Nonstandard Craniospinal Radiotherapy Using Helical TomoTherapy

    SciTech Connect

    Parker, William; Brodeur, Marylene; Roberge, David; Freeman, Carolyn

    2010-07-01

    Purpose: To show the advantages of planning and delivering craniospinal radiotherapy with helical TomoTherapy (TomoTherapy Inc., Madison, WI) by presenting 4 cases treated at our institution. Methods and Materials: We first present a standard case of craniospinal irradiation in a patient with recurrent myxopapillary ependymoma (MPE) and follow this with 2 cases requiring differential dosing to multiple target volumes. One of these, a patient with recurrent medulloblastoma, required a lower dose to be delivered to the posterior fossa because the patient had been previously irradiated to the full dose, and the other required concurrent boosts to leptomeningeal metastases as part of his treatment for newly diagnosed MPE. The final case presented is a patient with pronounced scoliosis who required spinal irradiation for recurrent MPE. Results: The four cases presented were planned and treated successfully with Helical Tomotherapy. Conclusions: Helical TomoTherapy delivers continuous arc-based intensity-modulated radiotherapy that gives high conformality and excellent dose homogeneity for the target volumes. Increased healthy tissue sparing is achieved at higher doses albeit at the expense of larger volumes of tissue receiving lower doses. Helical TomoTherapy allows for differential dosing of multiple targets, resulting in very elegant dose distributions. Daily megavoltage computed tomography imaging allows for precision of patient positioning, permitting a reduction in planning margins and increased healthy tissue sparing in comparison with standard techniques.

  17. An absolute dose determination of helical tomotherapy accelerator, TomoTherapy High-Art II.

    PubMed

    Bailat, Claude J; Buchillier, Thierry; Pachoud, Marc; Moeckli, Raphaël; Bochud, François O

    2009-09-01

    A helical tomotherapy accelerator presents a dosimetric challenge because, to this day, there is no internationally accepted protocol for the determination of the absolute dose. Because of this reality, we investigated the different alternatives for characterizing and measuring the absolute dose of such an accelerator. We tested several dosimetric techniques with various metrological traceabilities as well as using a number of phantoms in static and helical modes. Firstly, the relationship between the reading of ionization chambers and the absorbed dose is dependent on the beam quality value of the photon beam. For high energy photons, the beam quality is specified by the tissue phantom ratio (TPR20,10) and it is therefore necessary to know the TPR20,10 to calculate the dose delivered by a given accelerator. This parameter is obtained through the ratio of the absorbed dose at 20 and 10 cm depths in water and was measured in the particular conditions of the tomotherapy accelerator. Afterward, measurements were performed using the ionization chamber (model A1SL) delivered as a reference instrument by the vendor. This chamber is traceable in absorbed dose to water in a Co-60 beam to a water calorimeter of the American metrology institute (NIST). Similarly, in Switzerland, each radiotherapy department is directly traceable to the Swiss metrology institute (METAS) in absorbed dose to water based on a water calorimeter. For our research, this traceability was obtained by using an ionization chamber traceable to METAS (model NE 2611A), which is the secondary standard of our institute. Furthermore, in order to have another fully independent measurement method, we determined the dose using alanine dosimeters provided by and traceable to the British metrology institute (NPL); they are calibrated in absorbed dose to water using a graphite calorimeter. And finally, we wanted to take into account the type of chamber routinely used in clinical practice and therefore measured the

  18. An absolute dose determination of helical tomotherapy accelerator, TomoTherapy High-Art II

    SciTech Connect

    Bailat, Claude J.; Buchillier, Thierry; Pachoud, Marc; Moeckli, Raphaeel; Bochud, Francois O.

    2009-09-15

    Purpose: A helical tomotherapy accelerator presents a dosimetric challenge because, to this day, there is no internationally accepted protocol for the determination of the absolute dose. Because of this reality, we investigated the different alternatives for characterizing and measuring the absolute dose of such an accelerator. We tested several dosimetric techniques with various metrological traceabilities as well as using a number of phantoms in static and helical modes. Methods: Firstly, the relationship between the reading of ionization chambers and the absorbed dose is dependent on the beam quality value of the photon beam. For high energy photons, the beam quality is specified by the tissue phantom ratio (TPR{sub 20,10}) and it is therefore necessary to know the TPR{sub 20,10} to calculate the dose delivered by a given accelerator. This parameter is obtained through the ratio of the absorbed dose at 20 and 10 cm depths in water and was measured in the particular conditions of the tomotherapy accelerator. Afterward, measurements were performed using the ionization chamber (model A1SL) delivered as a reference instrument by the vendor. This chamber is traceable in absorbed dose to water in a Co-60 beam to a water calorimeter of the American metrology institute (NIST). Similarly, in Switzerland, each radiotherapy department is directly traceable to the Swiss metrology institute (METAS) in absorbed dose to water based on a water calorimeter. For our research, this traceability was obtained by using an ionization chamber traceable to METAS (model NE 2611A), which is the secondary standard of our institute. Furthermore, in order to have another fully independent measurement method, we determined the dose using alanine dosimeters provided by and traceable to the British metrology institute (NPL); they are calibrated in absorbed dose to water using a graphite calorimeter. And finally, we wanted to take into account the type of chamber routinely used in clinical

  19. Initial experience in treating lung cancer with helical tomotherapy

    PubMed Central

    Yartsev, S; Dar, AR; Woodford, C; Wong, E; Bauman, G; Van Dyk, J

    2007-01-01

    Helical tomotherapy is a new form of image-guided radiation therapy that combines features of a linear accelerator and a helical computed tomography (CT) scanner. Megavoltage CT (MVCT) data allow the verification and correction of patient setup on the couch by comparison and image registration with the kilovoltage CT multi-slice images used for treatment planning. An 84-year-old male patient with Stage III bulky non-small cell lung cancer was treated on a Hi-ART II tomotherapy unit. Daily MVCT imaging was useful for setup corrections and signaled the need to adapt the delivery plan when the patient’s anatomy changed significantly. PMID:21614260

  20. Spatially fractionated radiotherapy (GRID) using helical tomotherapy.

    PubMed

    Zhang, Xin; Penagaricano, Jose; Yan, Yulong; Liang, Xiaoying; Morrill, Steven; Griffin, Robert J; Corry, Peter; Ratanatharathorn, Vaneerat

    2016-01-08

    Spatially fractionated radiotherapy (GRID) was designed to treat large tumors while sparing skin, and it is usually delivered with a linear accelerator using a commercially available block or multileaf collimator (LINAC-GRID). For deep-seated (skin to tumor distance (> 8 cm)) tumors, it is always a challenge to achieve adequate tumor dose coverage. A novel method to perform GRID treatment using helical tomotherapy (HT-GRID) was developed at our institution. Our approach allows treating patients by generating a patient-specific virtual GRID block (software-generated) and using IMRT technique to optimize the treatment plan. Here, we report our initial clinical experience using HT-GRID, and dosimetric comparison results between HT-GRID and LINAC-GRID. This study evaluates 10 previously treated patients who had deep-seated bulky tumors with complex geometries. Five of these patients were treated with HT-GRID and replanned with LINAC-GRID for comparison. Similarly, five other patients were treated with LINAC-GRID and replanned with HT-GRID for comparison. The prescription was set such that the maximum dose to the GTV is 20 Gy in a single fraction. Dosimetric parameters compared included: mean GTV dose (DGTV mean), GTV dose inhomogeneity (valley-to-peak dose ratio (VPR)), normal tissue doses (DNmean), and other organs-at-risk (OARs) doses. In addition, equivalent uniform doses (EUD) for both GTV and normal tissue were evaluated. In summary, HT-GRID technique is patient-specific, and allows adjustment of the GRID pattern to match different tumor sizes and shapes when they are deep-seated and cannot be adequately treated with LINAC-GRID. HT-GRID delivers a higher DGTV mean, EUD, and VPR compared to LINAC-GRID. HT-GRID delivers a higher DNmean and lower EUD for normal tissue compared to LINAC-GRID. HT-GRID plans also have more options for tumors with complex anatomical relationships between the GTV and the avoidance OARs (abutment or close proximity).

  1. Dosimetric verification of helical tomotherapy for total scalp irradiation

    SciTech Connect

    Hardcastle, Nicholas; Soisson, Emilie; Metcalfe, Peter; Rosenfeld, Anatoly B.; Tome, Wolfgang A.

    2008-11-15

    Total scalp irradiation is a treatment technique used for a variety of superficial malignancies. Helical tomotherapy is an effective technique used for total scalp irradiation. Recent published work has shown the TomoTherapy planning system to overestimate the superficial dose. In this study, the superficial doses for a helical tomotherapy total scalp irradiation have been measured on an anthropomorphic phantom using radiochromic and radiographic film as well as a new skin dosimeter, the MOSkin. The superficial dose was found to be accurately calculated by the TomoTherapy planning system. This is in contrast to recent reports, probably due to a combination of the smaller dose grid resolution used in planning and this particular treatment primarily consisting of beamlets tangential to the scalp. The superficial dose was found to increase from 33.6 to 41.2 Gy and 36.0 to 42.0 Gy over the first 2 mm depth in the phantom in selected regions of the PTV, measured with radiochromic film. The prescription dose was 40 Gy. The superficial dose was at the prescription dose or higher in some regions due to the bolus effect of the thermoplastic head mask and the head rest used to aid treatment setup. It is suggested that to achieve the prescription dose at the surface ({<=}2 mm depth) bolus or a custom thermoplastic helmet is used.

  2. Stereotactic Image-Guided Intensity Modulated Radiotherapy Using the HI-ART II Helical Tomotherapy System

    SciTech Connect

    Holmes, Timothy W. Hudes, Richard; Dziuba, Sylwester; Kazi, Abdul; Hall, Mark; Dawson, Dana

    2008-07-01

    The highly integrated adaptive radiation therapy (HI-ART II) helical tomotherapy unit is a new radiotherapy machine designed to achieve highly precise and accurate treatments at all body sites. The precision and accuracy of the HI-ART II is similar to that provided by stereotactic radiosurgery systems, hence the historical distinction between external beam radiotherapy and stereotactic procedures based on differing precision requirements is removed for this device. The objectives of this work are: (1) to describe stereotactic helical tomotherapy processes (SRS, SBRT); (2) to show that the precision and accuracy of the HI-ART meet the requirements defined for SRS and SBRT; and (3) to describe the clinical implementation of a stereotactic image-guided intensity modulated radiation therapy (IG-IMRT) system that incorporates optical motion management.

  3. Enhanced efficiency in helical tomotherapy quality assurance using a custom-designed water-equivalent phantom

    NASA Astrophysics Data System (ADS)

    Goddu, S. Murty; Mutic, Sasa; Pechenaya, Olga L.; Chaudhari, Summer R.; Garcia-Ramirez, Jose; Rangaraj, Dharanipathy; Klein, Eric E.; Yang, Deshan; Grigsby, James; Low, Daniel A.

    2009-10-01

    Tomotherapy is an image-guided, intensity-modulated radiation therapy system that delivers highly conformal dose distributions in a helical fashion. This system is also capable of acquiring megavoltage computed-tomography images and registering them to the planning kVCT images for accurate target localization. Quality assurance (QA) of this device is time intensive, but can be expedited by improved QA tools and procedures. A custom-designed phantom was fabricated to improve the efficiency of daily QA of our Tomotherapy machine. The phantom incorporates ionization chamber measurement points, plugs of different densities and slide-out film cartridges. The QA procedure was designed to verify in less than 30 min the vital components of the tomotherapy system: static beam quality and output, image quality, correctness of image registration and energy of the helical dose delivery. Machine output, percent depth dose and off-axis factors are simultaneously evaluated using a static 5 × 40 cm2 open field. A single phantom scan is used to evaluate image quality and registration accuracy. The phantom can also be used for patient plan-specific QA. The QA results over a period of 6 months are reported in this paper. The QA process was found to be simple, efficient and capable of simultaneously verifying several important parameters.

  4. Enhanced efficiency in helical tomotherapy quality assurance using a custom-designed water-equivalent phantom.

    PubMed

    Goddu, S Murty; Mutic, Sasa; Pechenaya, Olga L; Chaudhari, Summer R; Garcia-Ramirez, Jose; Rangaraj, Dharanipathy; Klein, Eric E; Yang, Deshan; Grigsby, James; Low, Daniel A

    2009-10-07

    Tomotherapy is an image-guided, intensity-modulated radiation therapy system that delivers highly conformal dose distributions in a helical fashion. This system is also capable of acquiring megavoltage computed-tomography images and registering them to the planning kVCT images for accurate target localization. Quality assurance (QA) of this device is time intensive, but can be expedited by improved QA tools and procedures. A custom-designed phantom was fabricated to improve the efficiency of daily QA of our Tomotherapy machine. The phantom incorporates ionization chamber measurement points, plugs of different densities and slide-out film cartridges. The QA procedure was designed to verify in less than 30 min the vital components of the tomotherapy system: static beam quality and output, image quality, correctness of image registration and energy of the helical dose delivery. Machine output, percent depth dose and off-axis factors are simultaneously evaluated using a static 5 x 40 cm(2) open field. A single phantom scan is used to evaluate image quality and registration accuracy. The phantom can also be used for patient plan-specific QA. The QA results over a period of 6 months are reported in this paper. The QA process was found to be simple, efficient and capable of simultaneously verifying several important parameters.

  5. Dynamic Jaws and Dynamic Couch in Helical Tomotherapy

    SciTech Connect

    Sterzing, Florian; Uhl, Matthias; Hauswald, Henrik; Schubert, Kai; Sroka-Perez, Gabriele; Chen Yu; Lu Weiguo; Mackie, Rock; Debus, Juergen; Herfarth, Klaus; Oliveira, Gustavo

    2010-03-15

    Purpose: To investigate the next generation of helical tomotherapy delivery with dynamic jaw and dynamic couch movements. Methods and Materials: The new technique of dynamic jaw and dynamic couch movements is described, and a comparative planning study is performed. Ten nasopharyngeal cancer patients with skull base infiltration were chosen for this comparison of longitudinal dose profiles using regular tomotherapy delivery, running-start-stop treatment, and dynamic jaw and dynamic couch delivery. A multifocal simultaneous integrated boost concept was used (70.4Gy to the primary tumor and involved lymph nodes; 57.4Gy to the bilateral cervical lymphatic drainage pathways, 32 fractions). Target coverage, conformity, homogeneity, sparing of organs at risk, integral dose, and radiation delivery time were evaluated. Results: Mean parotid dose for all different deliveries was between 24.8 and 26.1Gy, without significant differences. The mean integral dose was lowered by 6.3% by using the dynamic technique, in comparison with a 2.5-cm-field width for regular delivery and 16.7% with 5-cm-field width for regular delivery. Dynamic jaw and couch movements reduced the calculated radiation time by 66% of the time required with regular 2.5-cm-field width delivery (199 sec vs. 595 sec, p < 0.001). Conclusions: The current delivery mode of helical tomotherapy produces dose distributions with conformal avoidance of parotid glands, brain stem, and spinal cord. The new technology with dynamic jaw and couch movements improves the plan quality by reducing the dose penumbra and thereby reducing the integral dose. In addition, radiation time is reduced by 66% of the regular delivery time.

  6. Helical tomotherapy for duodenal adenocarcinoma in an elderly patient: A case report

    PubMed Central

    Lancellotta, Valentina; Russo, Giuseppe; Lupattelli, Marco; Iacco, Martina; Perrucci, Elisabetta; Zucchetti, Claudio; Falcinelli, Lorenzo; Aristei, Cynthia

    2017-01-01

    To evaluate the efficacy and feasibility of external beam radiotherapy (EBRT) for duodenal adenocarcinoma in an 84-year-old female who underwent EBRT (2.2 Gy/d for a total dose of 46.2 Gy) using helical tomotherapy (HT). Toxicity was evaluated on the National Cancer Institute’s common toxicity criteria (CTCAE 3.0). The patient completed the treatment without G3-G4 toxicity. After 22-mo follow-up, she is alive and well, in complete remission with no late side effects. HT seems to be feasible and effective for duodenal adenocarcinoma in old to very old patients. PMID:28255431

  7. Helical tomotherapy with dynamic running-start-stop delivery compared to conventional tomotherapy delivery

    SciTech Connect

    Rong, Yi; Chen, Yu; Lu, Weiguo; Shang, Lu; Zuo, Li; Chen, Quan

    2014-05-15

    Purpose: Despite superior target dose uniformity, helical tomotherapy{sup ®} (HT) may involve a trade-off between longitudinal dose conformity and beam-on time (BOT), due to the limitation of only three available jaw sizes with the conventional HT (1.0, 2.5, and 5.0 cm). The recently introduced dynamic running-start-stop (RSS) delivery allows smaller jaw opening at the superior and inferior ends of the target when a sharp penumbra is needed. This study compared the dosimetric performance of RSS delivery with the fixed jaw HT delivery. Methods: Twenty patient cases were selected and deidentified prior to treatment planning, including 16 common clinical cases (brain, head and neck (HN), lung, and prostate) and four special cases of whole brain with hippocampus avoidance (WBHA) that require a high degree of dose modulation. HT plans were generated for common clinical cases using the fixed 2.5 cm jaw width (HT2.5) and WBHA cases using 1.0 cm (HT1.0). The jaw widths for RSS were preset with a larger size (RSS5.0 vs HT2.5 and RSS2.5 vs HT1.0). Both delivery techniques were planned based on identical contours, prescriptions, and planning objectives. Dose indices for targets and critical organs were compared using dose-volume histograms, BOT, and monitor units. Results: The average BOT was reduced from 4.8 min with HT2.5 to 2.5 min with RSS5.0. Target dose homogeneity with RSS5.0 was shown comparable to HT2.5 for common clinical sites. Superior normal tissue sparing was observed in RSS5.0 for optic nerves and optic chiasm in brain and HN cases. RSS5.0 demonstrated improved dose sparing for cord and esophagus in lung cases, as well as penile bulb in prostate cases. The mean body dose was comparable for both techniques. For the WBHA cases, the target homogeneity was significantly degraded in RSS2.5 without distinct dose sparing for hippocampus, compared to HT1.0. Conclusions: Compared to the fixed jaw HT delivery, RSS combined with a larger jaw width provides faster

  8. Comparison study of the partial-breast irradiation techniques: dosimetric analysis of three-dimensional conformal radiation therapy, electron beam therapy, and helical tomotherapy depending on various tumor locations.

    PubMed

    Kim, Min-Joo; Park, So-Hyun; Son, Seok-Hyun; Cheon, Keum-Seong; Choi, Byung-Ock; Suh, Tae-Suk

    2013-01-01

    The partial-breast irradiation (PBI) technique, an alternative to whole-breast irradiation, is a beam delivery method that uses a limited range of treatment volume. The present study was designed to determine the optimal PBI treatment modalities for 8 different tumor locations. Treatment planning was performed on computed tomography (CT) data sets of 6 patients who had received lumpectomy treatments. Tumor locations were classified into 8 subsections according to breast quadrant and depth. Three-dimensional conformal radiation therapy (3D-CRT), electron beam therapy (ET), and helical tomotherapy (H-TOMO) were utilized to evaluate the dosimetric effect for each tumor location. Conformation number (CN), radical dose homogeneity index (rDHI), and dose delivered to healthy tissue were estimated. The Kruskal-Wallis, Mann-Whitney U, and Bonferroni tests were used for statistical analysis. The ET approach showed good sparing effects and acceptable target coverage for the lower inner quadrant-superficial (LIQ-S) and lower inner quadrant-deep (LIQ-D) locations. The H-TOMO method was the least effective technique as no evaluation index achieved superiority for all tumor locations except CN. The ET method is advisable for treating LIQ-S and LIQ-D tumors, as opposed to 3D-CRT or H-TOMO, because of acceptable target coverage and much lower dose applied to surrounding tissue.

  9. Comparison study of the partial-breast irradiation techniques: Dosimetric analysis of three-dimensional conformal radiation therapy, electron beam therapy, and helical tomotherapy depending on various tumor locations

    SciTech Connect

    Kim, Min-Joo; Park, So-Hyun; Son, Seok-Hyun; Cheon, Keum-Seong; Choi, Byung-Ock; Suh, Tae-Suk

    2013-10-01

    The partial-breast irradiation (PBI) technique, an alternative to whole-breast irradiation, is a beam delivery method that uses a limited range of treatment volume. The present study was designed to determine the optimal PBI treatment modalities for 8 different tumor locations. Treatment planning was performed on computed tomography (CT) data sets of 6 patients who had received lumpectomy treatments. Tumor locations were classified into 8 subsections according to breast quadrant and depth. Three-dimensional conformal radiation therapy (3D-CRT), electron beam therapy (ET), and helical tomotherapy (H-TOMO) were utilized to evaluate the dosimetric effect for each tumor location. Conformation number (CN), radical dose homogeneity index (rDHI), and dose delivered to healthy tissue were estimated. The Kruskal-Wallis, Mann-Whitney U, and Bonferroni tests were used for statistical analysis. The ET approach showed good sparing effects and acceptable target coverage for the lower inner quadrant—superficial (LIQ-S) and lower inner quadrant—deep (LIQ-D) locations. The H-TOMO method was the least effective technique as no evaluation index achieved superiority for all tumor locations except CN. The ET method is advisable for treating LIQ-S and LIQ-D tumors, as opposed to 3D-CRT or H-TOMO, because of acceptable target coverage and much lower dose applied to surrounding tissue.

  10. Verification of Calculated Skin Doses in Postmastectomy Helical Tomotherapy

    SciTech Connect

    Ito, Shima; Parker, Brent C.; Levine, Renee; Sanders, Mary Ella; Fontenot, Jonas; Gibbons, John; Hogstrom, Kenneth

    2011-10-01

    Purpose: To verify the accuracy of calculated skin doses in helical tomotherapy for postmastectomy radiation therapy (PMRT). Methods and Materials: In vivo thermoluminescent dosimeters (TLDs) were used to measure the skin dose at multiple points in each of 14 patients throughout the course of treatment on a TomoTherapy Hi.Art II system, for a total of 420 TLD measurements. Five patients were evaluated near the location of the mastectomy scar, whereas 9 patients were evaluated throughout the treatment volume. The measured dose at each location was compared with calculations from the treatment planning system. Results: The mean difference and standard error of the mean difference between measurement and calculation for the scar measurements was -1.8% {+-} 0.2% (standard deviation [SD], 4.3%; range, -11.1% to 10.6%). The mean difference and standard error of the mean difference between measurement and calculation for measurements throughout the treatment volume was -3.0% {+-} 0.4% (SD, 4.7%; range, -18.4% to 12.6%). The mean difference and standard error of the mean difference between measurement and calculation for all measurements was -2.1% {+-} 0.2% (standard deviation, 4.5%: range, -18.4% to 12.6%). The mean difference between measured and calculated TLD doses was statistically significant at two standard deviations of the mean, but was not clinically significant (i.e., was <5%). However, 23% of the measured TLD doses differed from the calculated TLD doses by more than 5%. Conclusions: The mean of the measured TLD doses agreed with TomoTherapy calculated TLD doses within our clinical criterion of 5%.

  11. Verification of calculated skin doses in postmastectomy helical tomotherapy.

    PubMed

    Ito, Shima; Parker, Brent C; Levine, Renee; Sanders, Mary Ella; Fontenot, Jonas; Gibbons, John; Hogstrom, Kenneth

    2011-10-01

    To verify the accuracy of calculated skin doses in helical tomotherapy for postmastectomy radiation therapy (PMRT). In vivo thermoluminescent dosimeters (TLDs) were used to measure the skin dose at multiple points in each of 14 patients throughout the course of treatment on a TomoTherapy Hi·Art II system, for a total of 420 TLD measurements. Five patients were evaluated near the location of the mastectomy scar, whereas 9 patients were evaluated throughout the treatment volume. The measured dose at each location was compared with calculations from the treatment planning system. The mean difference and standard error of the mean difference between measurement and calculation for the scar measurements was -1.8% ± 0.2% (standard deviation [SD], 4.3%; range, -11.1% to 10.6%). The mean difference and standard error of the mean difference between measurement and calculation for measurements throughout the treatment volume was -3.0% ± 0.4% (SD, 4.7%; range, -18.4% to 12.6%). The mean difference and standard error of the mean difference between measurement and calculation for all measurements was -2.1% ± 0.2% (standard deviation, 4.5%: range, -18.4% to 12.6%). The mean difference between measured and calculated TLD doses was statistically significant at two standard deviations of the mean, but was not clinically significant (i.e., was <5%). However, 23% of the measured TLD doses differed from the calculated TLD doses by more than 5%. The mean of the measured TLD doses agreed with TomoTherapy calculated TLD doses within our clinical criterion of 5%. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. A case study for online plan adaptation using helical tomotherapy

    PubMed Central

    Neilson, Christopher E.; Yartsev, Slav

    2012-01-01

    Helical tomotherapy's ability to provide daily megavoltage (MV) computed tomography (CT) images for patient set-up verification allows for the creation of adapted plans. As plans become more complex by introducing sharper dose gradients in an effort to spare healthy tissue, inter-fraction changes of organ position with respect to plan become a limiting factor in the correct dose delivery to the target. Tomotherapy's planned adaptive option provides the possibility to evaluate the dose distribution for each fraction and subsequently adapt the original plan to the current anatomy. In this study, 30 adapted plans were created using new contours based on the daily MVCT studies of a bladder cancer patient with considerable anatomical variations. Dose to the rectum and two planning target volumes (PTVs) were compared between the original plan, the dose that was actually delivered to the patient, and the theoretical dose from the 30 adapted plans. The adaptation simulation displayed a lower dose to 35% and 50% of the rectum compared to no adaptation at all, while maintaining an equivalent dose to the PTVs. Although online adaptation is currently too time-consuming, it has the potential to improve the effectiveness of radiotherapy. PMID:22557799

  13. Dosimetric comparisons of helical tomotherapy treatment plans and step-and-shoot intensity-modulated radiosurgery treatment plans in intracranial stereotactic radiosurgery

    SciTech Connect

    Han Chunhui . E-mail: chan@coh.org; Liu An; Schultheiss, Timothy E.; Pezner, Richard D.; Chen Yijen; Wong, Jeffrey Y.C.

    2006-06-01

    Purpose: To evaluate dose conformity, dose homogeneity, and dose gradient in helical tomotherapy treatment plans for stereotactic radiosurgery, and compare results with step-and-shoot intensity-modulated radiosurgery (IMRS) treatment plans. Methods and Materials: Sixteen patients were selected with a mean tumor size of 14.65 {+-} 11.2 cm{sup 3}. Original step-and-shoot IMRS treatment plans used coplanar fields because of the constraint of the beam stopper. Retrospective step-and-shoot IMRS plans were generated using noncoplanar fields. Helical tomotherapy treatment plans were generated using the tomotherapy planning station. Dose conformity index, dose gradient score index, and homogeneity index were used in plan intercomparisons. Results: Noncoplanar IMRS plans increased dose conformity and dose gradient, but not dose homogeneity, compared with coplanar IMRS plans. Tomotherapy plans increased dose conformity and dose gradient, yet increased dose heterogeneity compared with noncoplanar IMRS plans. The average dose conformity index values were 1.53 {+-} 0.38, 1.35 {+-} 0.15, and 1.26 {+-} 0.10 in coplanar IMRS, noncoplanar IMRS, and tomotherapy plans, respectively. The average dose homogeneity index values were 1.15 {+-} 0.05, 1.13 {+-} 0.04, and 1.18 {+-} 0.09 in coplanar IMRS, noncoplanar IMRS, and tomotherapy plans, respectively. The mean dose gradient score index values were 1.37 {+-} 19.08, 22.32 {+-} 19.20, and 43.28 {+-} 13.78 in coplanar IMRS, noncoplanar IMRS, and tomotherapy plans, respectively. The mean treatment time in tomotherapy was 42 {+-} 16 min. Conclusions: We were able to achieve better dose conformity and dose gradient in tomotherapy plans compared with step-and-shoot IMRS plans for intracranial stereotactic radiosurgery. However, tomotherapy treatment time was significantly larger than that in step-and-shoot IMRS.

  14. Independent calculation of dose distributions for helical tomotherapy using a conventional treatment planning system

    SciTech Connect

    Klüter, Sebastian Schubert, Kai; Lissner, Steffen; Sterzing, Florian; Oetzel, Dieter; Debus, Jürgen; Schlegel, Wolfgang; Oelfke, Uwe; Nill, Simeon

    2014-08-15

    Purpose: The dosimetric verification of treatment plans in helical tomotherapy usually is carried out via verification measurements. In this study, a method for independent dose calculation of tomotherapy treatment plans is presented, that uses a conventional treatment planning system with a pencil kernel dose calculation algorithm for generation of verification dose distributions based on patient CT data. Methods: A pencil beam algorithm that directly uses measured beam data was configured for dose calculation for a tomotherapy machine. Tomotherapy treatment plans were converted into a format readable by an in-house treatment planning system by assigning each projection to one static treatment field and shifting the calculation isocenter for each field in order to account for the couch movement. The modulation of the fluence for each projection is read out of the delivery sinogram, and with the kernel-based dose calculation, this information can directly be used for dose calculation without the need for decomposition of the sinogram. The sinogram values are only corrected for leaf output and leaf latency. Using the converted treatment plans, dose was recalculated with the independent treatment planning system. Multiple treatment plans ranging from simple static fields to real patient treatment plans were calculated using the new approach and either compared to actual measurements or the 3D dose distribution calculated by the tomotherapy treatment planning system. In addition, dose–volume histograms were calculated for the patient plans. Results: Except for minor deviations at the maximum field size, the pencil beam dose calculation for static beams agreed with measurements in a water tank within 2%/2 mm. A mean deviation to point dose measurements in the cheese phantom of 0.89% ± 0.81% was found for unmodulated helical plans. A mean voxel-based deviation of −0.67% ± 1.11% for all voxels in the respective high dose region (dose values >80%), and a mean local

  15. Postmastectomy radiotherapy with integrated scar boost using helical tomotherapy

    SciTech Connect

    Rong Yi; Yadav, Poonam; Welsh, James S.; Fahner, Tasha; Paliwal, Bhudatt

    2012-10-01

    The purpose of this study was to evaluate helical tomotherapy dosimetry in postmastectomy patients undergoing treatment for chest wall and positive nodal regions with simultaneous integrated boost (SIB) in the scar region using strip bolus. Six postmastectomy patients were scanned with a 5-mm-thick strip bolus covering the scar planning target volume (PTV) plus 2-cm margin. For all 6 cases, the chest wall received a total cumulative dose of 49.3-50.4 Gy with daily fraction size of 1.7-2.0 Gy. Total dose to the scar PTV was prescribed to 58.0-60.2 Gy at 2.0-2.5 Gy per fraction. The supraclavicular PTV and mammary nodal PTV received 1.7-1.9 dose per fraction. Two plans (with and without bolus) were generated for all 6 cases. To generate no-bolus plans, strip bolus was contoured and overrode to air density before planning. The setup reproducibility and delivered dose accuracy were evaluated for all 6 cases. Dose-volume histograms were used to evaluate dose-volume coverage of targets and critical structures. We observed reduced air cavities with the strip bolus setup compared with what we normally see with the full bolus. The thermoluminescence dosimeters (TLD) in vivo dosimetry confirmed accurate dose delivery beneath the bolus. The verification plans performed on the first day megavoltage computed tomography (MVCT) image verified that the daily setup and overall dose delivery was within 2% accuracy compared with the planned dose. The hotspot of the scar PTV in no-bolus plans was 111.4% of the prescribed dose averaged over 6 cases compared with 106.6% with strip bolus. With a strip bolus only covering the postmastectomy scar region, we observed increased dose uniformity to the scar PTV, higher setup reproducibility, and accurate dose delivered beneath the bolus. This study demonstrates the feasibility of using a strip bolus over the scar using tomotherapy for SIB dosimetry in postmastectomy treatments.

  16. The use of a commercial QA device for daily output check of a helical tomotherapy unit

    SciTech Connect

    Alaei, Parham; Hui, Susanta K.; Higgins, Patrick D.; Gerbi, Bruce J.

    2006-10-15

    Helical tomotherapy radiation therapy units, due to their particular design and differences from a traditional linear accelerator, require different procedures by which to perform routine quality assurance (QA). One of the principal QA tasks that should be performed daily on any radiation therapy equipment is the output constancy check. The daily output check on a Hi-Art TomoTherapy unit is commonly performed utilizing ionization chambers placed inside a solid water phantom. This provides a good check of output at one point, but does not give any information on either energy or symmetry of the beam, unless more than one point is measured. This also has the added disadvantage that it has to be done by the physics staff. To address these issues, and to simplify the process, such that it can be performed by radiation therapists, we investigated the use of a commercially available daily QA device to perform this task. The use of this device simplifies the task of daily output constancy checks and eliminates the need for continued physics involvement. This device can also be used to monitor the constancy of beam energy and cone profile and can potentially be used to detect gross errors in the couch movement or laser alignment.

  17. Integral dose in three-dimensional conformal radiotherapy, intensity-modulated radiotherapy and helical tomotherapy.

    PubMed

    Yang, R; Xu, S; Jiang, W; Xie, C; Wang, J

    2009-11-01

    To evaluate the integral dose to organs at risk (OARs), normal tissue and the whole body in three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT) and helical tomotherapy for whole pelvic radiotherapy (WPRT) in postoperative endometrial cancer patients. We selected 10 patients with endometrial cancer undergoing postoperative WPRT. Plans of 6MV-3DCRT, 18MV-3DCRT, 6MV-IMRT, 18MV-IMRT and helical tomotherapy were developed for each patient. The integral doses to OARs, normal tissue and the whole body were compared. Compared with 3DCRT, both IMRT and helical tomotherapy significantly improved dose conformity and the integral doses to OARs (8.8-29.9%, P<0.05). Compared with 6MV-3DCRT, IMRT resulted in 13.2 and 11.0% lower integral doses to normal tissue and the whole body, respectively (P=0.00), whereas no significant difference was found with helical tomotherapy. Compared directly with IMRT, helical tomotherapy reduced the integral doses to the rectum and bladder. However, the integral doses to normal tissue were 13.9 and 17.1% higher than 6MV-IMRT and 18MV-IMRT plans, respectively (P=0.00); the integral doses to pelvic bones also slightly increased with helical tomotherapy. The use of 18MV resulted in 5.8 and 2.7% lower integral doses to normal tissue and 4.8 and 2.1% lower integral doses to the whole body in the 3DCRT and IMRT plans, respectively (P=0.00). Results show that IMRT and helical tomotherapy offer better conformity and lower integral doses to OARs for postoperative WPRT of endometrial cancers compared with 3DCRT. The integral doses to normal tissue and the whole body were significantly lower with IMRT, whereas no significant difference was found with helical tomotherapy compared with 6MV-3DCRT. Compared directly with IMRT, helical tomotherapy further reduced the integral doses to the rectum and bladder, at the expense of a slightly higher integral dose to pelvic bones and normal tissue. The use of 18MV improved the

  18. Hypofractionated breast and chest wall irradiation using simultaneous in-field boost IMRT delivered via helical tomotherapy.

    PubMed

    Rong, Y; Fahner, T; Welsh, J S

    2008-12-01

    Although helical tomotherapy has been described as a means of administering accelerated partial breast irradiation, its practicality in routine whole breast irradiation as part of breast conserving therapy or chest wall irradiation has been questioned. In this technical note we describe our method of whole breast or chest wall irradiation using helical tomotherapy based image-guided, hypofractionated, simultaneous in-field boost intensity modulated radiation therapy. We have observed that excellent dose-distributions can be achieved with helical tomotherapy through a careful selection of treatment planning parameters. Dose homogeneity to the whole breast and simultaneously targeted lumpectomy region appears superior to conventional "tangents" with minimal hot or cold spots. Dose-volume histogram analysis documents effective reduction of high dose to critical sensitive structures (heart and lung) although a greater volume of these non-target organs receives low dose compared to what is typical with tangential beams. Treatment planning is efficient and is usually completed within one to two hours, although physician contouring requires more time and attention than non-IMRT approaches. Pretreatment megavoltage CT (MVCT) imaging has proved invaluable in aiding set-up and engenders greater confidence that the planned IMRT dose distributions are truly being delivered. In some situations, MVCT can provide visual feedback when a seroma or overall breast volume has changed significantly since simulation, thereby identifying cases where replanning might be prudent. Treatment is brief, typically completed in 6 to 9 minutes. Initial clinical application has confirmed the feasibility and practicality of helical tomotherapy as an efficient means of administering radiation therapy for routine breast-conserving therapy and post-mastectomy chest wall irradiation. A simultaneous in-field boost technique reduces the length of the overall course by about a week thereby adding

  19. A virtual source model for Monte Carlo simulation of helical tomotherapy.

    PubMed

    Yuan, Jiankui; Rong, Yi; Chen, Quan

    2015-01-08

    The purpose of this study was to present a Monte Carlo (MC) simulation method based on a virtual source, jaw, and MLC model to calculate dose in patient for helical tomotherapy without the need of calculating phase-space files (PSFs). Current studies on the tomotherapy MC simulation adopt a full MC model, which includes extensive modeling of radiation source, primary and secondary jaws, and multileaf collimator (MLC). In the full MC model, PSFs need to be created at different scoring planes to facilitate the patient dose calculations. In the present work, the virtual source model (VSM) we established was based on the gold standard beam data of a tomotherapy unit, which can be exported from the treatment planning station (TPS). The TPS-generated sinograms were extracted from the archived patient XML (eXtensible Markup Language) files. The fluence map for the MC sampling was created by incorporating the percentage leaf open time (LOT) with leaf filter, jaw penumbra, and leaf latency contained from sinogram files. The VSM was validated for various geometry setups and clinical situations involving heterogeneous media and delivery quality assurance (DQA) cases. An agreement of < 1% was obtained between the measured and simulated results for percent depth doses (PDDs) and open beam profiles for all three jaw settings in the VSM commissioning. The accuracy of the VSM leaf filter model was verified in comparing the measured and simulated results for a Picket Fence pattern. An agreement of < 2% was achieved between the presented VSM and a published full MC model for heterogeneous phantoms. For complex clinical head and neck (HN) cases, the VSM-based MC simulation of DQA plans agreed with the film measurement with 98% of planar dose pixels passing on the 2%/2 mm gamma criteria. For patient treatment plans, results showed comparable dose-volume histograms (DVHs) for planning target volumes (PTVs) and organs at risk (OARs). Deviations observed in this study were

  20. Novel Application of Helical Tomotherapy in Whole Skull Palliative Radiotherapy

    SciTech Connect

    Rodrigues, George Yartsev, Slav; Coad, Terry; Bauman, Glenn

    2008-01-01

    Helical tomotherapy (HT) is a radiation planning/delivery platform that combines inversely planned IMRT with on-board megavoltage imaging. A unique HT radiotherapy whole skull brain sparing technique is described in a patient with metastatic prostate cancer. An inverse HT plan and an accompanying back-up conventional lateral 6-MV parallel opposed pair (POP) plan with corresponding isodose distributions and dose-volume histograms (DVH) were created and assessed prior to initiation of therapy. Plans conforming to the planning treatment volume (PTV) with significant sparing of brain, optic nerve, and eye were created. Dose heterogeneity to the PTV target was slightly higher in the HT plan compared to the back-up POP plan. Conformal sparing of brain, optic nerve, and eye was achieved by the HT plan. Similar lens and brain stem/spinal cord doses were seen with both plans. Prospective clinical evaluation with relevant end points (quality of life, symptom relief) are required to confirm the potential benefits of highly conformal therapies applied to palliative situations such as this case.

  1. Dosimetric study and in-vivo dose verification for conformal avoidance treatment of anal adenocarcinoma using helical tomotherapy

    SciTech Connect

    Han Chunhui . E-mail: chan@coh.org; Chen Yijen; Liu An; Schultheiss, Timothy E.; Wong, Jeffrey Y.C.

    2007-04-01

    This study evaluated the efficacy of using helical tomotherapy for conformal avoidance treatment of anal adenocarcinoma. We retrospectively generated step-and-shoot intensity-modulated radiotherapy (sIMRT) plans and helical tomotherapy plans for two anal cancer patients, one male and one female, who were treated by the sIMRT technique. Dose parameters for the planning target volume (PTV) and the organs-at-risk (OARs) were compared between the sIMRT and the helical tomotherapy plans. The helical tomotherapy plans showed better dose homogeneity in the PTV, better dose conformity around the PTV, and, therefore, better sparing of nearby OARs compared with the sIMRT plans. In-vivo skin dose measurements were performed during conformal avoidance helical tomotherapy treatment of an anal cancer patient to verify adequate delivery of skin dose and sparing of OARs.

  2. [Clinical implementation of dose reconstruction and dose-guided intensity modulated radiotherapy for helical tomotherapy].

    PubMed

    Yao, Weirong; Xu, Shouping; Du Lei; Xie, Chuanbin; Ma, Lin

    2012-09-01

    To implement dose reconstruction and dose-guided intensity modulated radiotherapy for helical tomotherapy. Dose reconstruction was implemented on adaptive helical tomotherapy with the online megavoltage CT (MVCT) imaging from a patient with nasopharyngeal cancer. The differences of isodose line between actual and planned deposition were analysis in 3D distribution, on which the hot spot and cold spot were lined. The dose delivered to these areas was modulated in later fractions to keep the planned requirement. The differences between actual and planned isodose line were shown on the image visually. The modulation to the hot spot and cold spot in later fraction corrected the incorrectly delivered dose to achieve the requirement of primary plan. The dose reconstruction and dose-guided intensity modulated radiotherapy can be implemented in adaptive helical tomotherapy.

  3. Dosimetric effects of rotational output variation and x-ray target degradation on helical tomotherapy plans.

    PubMed

    Staton, Robert J; Langen, Katja M; Kupelian, Patrick A; Meeks, Sanford L

    2009-07-01

    In this study, two potential sources of IMRT delivery error have been identified for helical tomotherapy delivery using the HiART system (TomoTherapy, Inc., Madison, WI): Rotational output variation and target degradation. The HiArt system is known to have output variation, typically about +/- 2%, due to the absence of a dose servo system. On the HiArt system, x-ray target replacement is required approximately every 10-12 months due to target degradation. Near the end of target life, the target thins and causes a decrease in the beam energy and a softening of the beam profile at the lateral edges of the beam. The purpose of this study is to evaluate the dosimetric effects of rotational output variation and target degradation by modeling their effects and incorporating them into recalculated treatment plans for three clinical scenarios: Head and neck, partial breast, and prostate. Models were created to emulate both potential sources of error. For output variation, a model was created using a sine function to match the amplitude (+/- 2%), frequency, and phase of the measured rotational output variation data. A second model with a hypothetical variation of +/- 7% was also created to represent the largest variation that could exist without violating the allowable dose window in the delivery system. A measured beam profile near the end of target life was used to create a modified beam profile model for the target degradation. These models were then incorporated into the treatment plan by modifying the leaf opening times in the delivery sinogram. A new beam model was also created to mimic the change in beam energy seen near the end of target life. The plans were then calculated using a research version of the PLANNED ADAPTIVE treatment planning software from TomoTherapy, Inc. Three plans were evaluated in this study: Head and neck, partial breast, and prostate. The D50 of organs at risk, the D95 for planning target volumes (PTVs), and the local dose difference were used

  4. Ion recombination for ionization chamber dosimetry in a helical tomotherapy unit.

    PubMed

    Palmans, H; Thomas, R A S; Duane, S; Sterpin, E; Vynckier, S

    2010-06-01

    Ion recombination for ionization chambers in pulsed high-energy photon beams is a well-studied phenomenon. Despite this, the correction for ion recombination is often determined inaccurately due to the inappropriate combination of using a high polarizing voltage and the simple two-voltage method. An additional complication arises in new treatment modalities such as IMRT and tomotherapy, where the dosimetry of a superposition of many constituting fields becomes more relevant than of single static fields. For these treatment modalities, the irradiation of the ion chamber geometry can be instantaneously inhomogeneous and time dependent. This article presents a study of ion recombination in ionization chambers used for dosimetry in a helical tomotherapy beam. Models are presented for studying the recombination correction factors in a continuous beam, in pulsed large and small fields, and in helical fields. Measurements using Exradin A1SL, NE2571, and NE2611 type chambers and Monte Carlo simulations usingPENELOPE are performed in support of these models. Initial recombination and charge multiplication are found to be the same in C60o and in the pulsed high-energy photon beam for the chambers and operating voltages used in this study. Applying the two-voltage technique for the A1SL chamber at its recommended operating voltage of 300 V leads to an overestimation of the recombination. Operating at a voltage of 100 V yields larger but more accurate values for the recombination correction. The recombination correction measured for this chamber in the TomoTherapy HiArt unit is lower than the 1% applied in the routine dosimetry for this treatment unit. For a helical dose delivery with a small slice width, lateral electron scatter in the cavity makes that the recombination is smaller than for an open beam delivering the same total dose. In a Farmer type chamber, a helical delivery with a 1 cm slice field results in a time and spatially integrated volume recombination of 55% of

  5. Ion recombination for ionization chamber dosimetry in a helical tomotherapy unit.

    PubMed

    Palmans, H; Thomas, R A S; Duane, S; Sterpin, E; Vynckier, S

    2010-06-01

    Ion recombination for ionization chambers in pulsed high-energy photon beams is a well-studied phenomenon. Despite this, the correction for ion recombination is often determined inaccurately due to the inappropriate combination of using a high polarizing voltage and the simple two-voltage method. An additional complication arises in new treatment modalities such as IMRT and tomotherapy, where the dosimetry of a superposition of many constituting fields becomes more relevant than of single static fields. For these treatment modalities, the irradiation of the ion chamber geometry can be instantaneously inhomogeneous and time dependent. This article presents a study of ion recombination in ionization chambers used for dosimetry in a helical tomotherapy beam. Models are presented for studying the recombination correction factors in a continuous beam, in pulsed large and small fields, and in helical fields. Measurements using Exradin A1SL, NE2571, and NE2611 type chambers and Monte Carlo simulations using PENELOPE are performed in support of these models. Initial recombination and charge multiplication are found to be the same in 60Co and in the pulsed high-energy photon beam for the chambers and operating voltages used in this study. Applying the two-voltage technique for the A1SL chamber at its recommended operating voltage of 300 V leads to an overestimation of the recombination. Operating at a voltage of 100 V yields larger but more accurate values for the recombination correction. The recombination correction measured for this chamber in the TomoTherapy HiArt unit is lower than the 1% applied in the routine dosimetry for this treatment unit. For a helical dose delivery with a small slice width, lateral electron scatter in the cavity makes that the recombination is smaller than for an open beam delivering the same total dose. In a Farmer type chamber, a helical delivery with a 1 cm slice field results in a time and spatially integrated volume recombination of 55% of

  6. Simultaneous irradiation of the breast and regional lymph nodes in prone position using helical tomotherapy

    PubMed Central

    Kainz, K; White, J; Chen, G-P; Hermand, J; England, M; Li, X A

    2012-01-01

    Objective We investigated dosimetric advantages of using helical tomotherapy to simultaneously irradiate the breast and regional lymph nodes for patients positioned prone, and compared tomotherapy plan qualities for the prone position with those previously published for the supine position. Methods Tomotherapy plans for 11 patients (5 left breast, 6 right) simulated with the involved breast suspended downward were generated. Each target (ipsilateral breast and supraclavicular, axillary and internal mammary chain nodes) was to receive 45 Gy. Results For targets, V40.5≥99.9% and V42.8≥99.5% for all patients, where V40.5 and V42.8 denote the relative target volume receiving at least 40.5 and 42.8 Gy, respectively. The targets' maximum dose was, on average, approximately 49.5 Gy. The mean doses to the contralateral lung and heart were lower for right-breast cases (2.8 Gy lung, 2.7 Gy heart) than for left-breast cases (3.8 Gy lung, 8.7 Gy heart). Mean organ doses to the ipsilateral lung (9.3 Gy) and contralateral breast (2.3 Gy) from the prone breast tomotherapy plans were similar to those reported for conventional radiotherapy techniques. For the left breast with regional nodes, tomotherapy plans for prone-positioned patients yielded lower mean doses to the contralateral breast and heart than previously reported data for tomotherapy plans for supine-positioned patients. Conclusion Helical tomotherapy with prone breast positioning can simultaneously cover the breast and regional nodes with acceptable uniformity and can provide reduced mean dose to proximal organs at risk compared with tomotherapy with supine position. The similarity of plan quality to existing data for conventional breast radiotherapy indicates that this planning approach is appropriate, and that the risk of secondary tumour formation should not be significantly greater. PMID:22457317

  7. Treatment planning of epithelial ovarian cancers using helical tomotherapy.

    PubMed

    Swamidas, V Jamema; Mahantshetty, Umesh; Vineeta, Goel; Engineer, Reena; Deshpande, Deepak D; Sarin, Rajiv; Shrivastava, Shyam Kishore

    2009-10-07

    Whole Abdomen Radiotherapy (WAR) for epithelial ovarian cancer though effective has been used sparingly due to inadequate target coverage and poor sparing of Organ At Risk (OAR) leading to significantly higher toxicities. Newer radiation techniques have shown potential for significant improvement in the therapeutic ratio. The purpose of this study was to evaluate Helical Tomotherapy(HT) for WAR. The objective parameters were to obtain uniform and adequate target coverage with maximum OAR sparing. HT plans were generated for five patients with field-width of 5.0/2.5 cm, modulation factor of 3.5/3.0, and a pitch of 0.3. A dose of 25 Gy in 25 fractions was prescribed to the abdomen with a simultaneous boost of 45 Gy in 25 fractions to the pelvis. Dose-volume parameters and various indices were analyzed and compared. Mean volume (standard-deviation) of abdominal and pelvic PTV (planning target volume) was 6630 +/-450 cm3 and 1235 +/-98 cm3 respectively. Mean length of PTV in cranio-caudal direction was 41+/-4 cm. Volume receiving 95% and 107% of the prescription dose, (V95% and V107%) was 95.6+/-2.7% and 2.6+/-0.5% for abdominal-PTV, and 95.7+/-2.4% and 0% for pelvic-PTV respectively. Homogeneity and Conformity indices were 17.5+/-1.7, 1.2+/-0.03 for abdominal PTV, and 5.2+/-0.7, 1.1+/-0.02 for pelvic-PTV respectively. Median dose received by the kidneys, liver and bone marrow were 9.6+/-1.2 Gy, 17+/-2.7 Gy and 22+/-1.4 Gy respectively. HT achieves an excellent coverage of WAR target with simultaneous pelvic boost and better organ (kidneys and liver) sparing. HT for WAR has the potential as consolidative therapy which is being evaluated further in a phase II cohort study in epithelial ovarian cancers.

  8. Craniospinal irradiation using helical tomotherapy for central nervous system tumors.

    PubMed

    Schiopu, Sanziana R I; Habl, Gregor; Häfner, Matthias; Katayama, Sonja; Herfarth, Klaus; Debus, Juergen; Sterzing, Florian

    2017-01-17

    The aim of this study was to describe early and late toxicity, survival and local control in 45 patients with primary brain tumors treated with helical tomotherapy craniospinal irradiation (HT-CSI). From 2006 to 2014, 45 patients with central nervous system malignancies were treated with HT-CSI. The most common tumors were medulloblastoma in 20 patients, ependymoma in 10 patients, intracranial germinoma (ICG) in 7 patients, and primitive neuroectodermal tumor in 4 patients. Hematological toxicity during treatment included leukopenia Grades 1-4 (6.7%, 33.3%, 37.8% and 17.8%, respectively), anemia Grades 1-4 (44.4%, 22.2%, 22.2% and 0%, respectively) and thrombocytopenia Grades 1-4 (51.1%, 15.6%, 15.6% and 6.7%, respectively). The most common acute toxicities were nausea, vomiting, fatigue, loss of appetite, alopecia and neurotoxicity. No Grade 3 or higher late toxicity occurred. The overall 3- and 5-year survival rates were 80% and 70%, respectively. Survival for the main tumor entities included 3- and 5-year survival rates of 80% and 70%, respectively, for patients with medulloblastoma, 70% for both in patients with ependymoma, and 100% for both in patients with ICG. Relapse occurred in 11 patients (24.4%): 10 with local and 1 with multifocal relapse. One patient experienced a secondary cancer. M-status and the results of the re-evaluation at the end of treatment were significantly related to survival. Survival after HT-CSI was in line with the existing literature, and acute treatment-induced toxicity resolved quickly. Compared with conventional radiotherapy, HT offers benefits such as avoiding gaps and junctions, sparing organs, and better and more homogeneous dose distribution and coverage of the target volume.

  9. Helical tomotherapy as a means of delivering accelerated partial breast irradiation.

    PubMed

    Hui, Susanta K; Das, Rupak K; Kapatoes, Jeff; Oliviera, Gustavo; Becker, Stuart; Odau, Heath; Fenwick, John D; Patel, Rakesh; Kuske, Robert; Mehta, Minesh; Paliwal, Bhudatt; Mackie, Thomas R; Fowler, Jack F; Welsh, James S

    2004-12-01

    A novel treatment approach utilizing helical tomotherapy for partial breast irradiation for patients with early-stage breast cancer is described. This technique may serve as an alternative to high dose-rate (HDR) interstitial brachytherapy and standard linac-based approaches. Through helical tomotherapy, highly conformal irradiation of target volumes and avoidance of normal sensitive structures can be achieved. Unlike HDR brachytherapy, it is noninvasive. Unlike other linac-based techniques, it provides image-guided adaptive radiotherapy along with intensity modulation. A treatment planning CT scan was obtained as usual on a post-lumpectomy patient undergoing HDR interstitial breast brachytherapy. The patient underwent catheter placement for HDR treatment and was positioned prone on a specially designed position-supporting mattress during CT. The planning target volume (PTV) was defined as the lumpectomy bed plus a 20 mm margin. The prescription dose was 34 Gy (10 fx of 3.4 Gy) in both the CT based HDR and on the tomotherapy plan. Cumulative dose-volume histograms (DVHs) were generated and analyzed for the target, lung, heart, skin, pectoralis muscle, and chest wall for both HDR brachytherapy and helical tomotherapy. Dosimetric coverage of the target with helical tomotherapy was conformal and homogeneous. "Hot spots" (> or =150% isodose line) were present around implanted dwell positions in brachytherapy plan whereas no isodose lines higher than 109% were present in the helical tomotherapy plan. Similar dose coverage was achieved for lung, pectoralis muscle, heart, chest wall and breast skin with the two methods. We also compared our results to that obtained using conventional linac-based three dimensional (3D) conformal accelerated partial breast irradiation. Dose homogeneity is excellent with 3D conformal irradiation, and lung, heart and chest wall dose is less than for either HDR brachytherapy or helical tomotherapy but skin and pectoral muscle doses were higher

  10. Helical tomotherapy provides efficacy similar to that of intensity-modulated radiation therapy with dosimetric benefits for endometrial carcinoma

    PubMed Central

    Hsieh, Chen-Hsi; Shueng, Pei-Wei; Hsiao, Sheng-Mou; Wei, Ming-Chow; Wu, Wen-Yih; Sun, Hsu-Dong; Tien, Hui-Ju; Wang, Li-Ying; Hsieh, Yen-Ping

    2012-01-01

    Background The purpose of this study was to compare the efficacy of intensity-modulated radiotherapy (IMRT) and helical tomotherapy for endometrial cancer. Methods Between November 1, 2006 and November 31, 2010, 31 patients with histologically confirmed endometrial cancer were enrolled. All enrolled patients received total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant whole pelvic IMRT or helical tomotherapy. Results The actuarial 3-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates for the IMRT and helical tomotherapy groups were 87.5% versus 100%, 91.7% versus 51.7%, 91.7% versus 83.3%, and 91.7% versus 51.7%, respectively. The conformal index and uniformity index for IMRT versus helical tomotherapy was 1.25 versus 1.17 (P = 0.04) and 1.08 versus 1.05 (P < 0.01), respectively. Two of 31 patients with cervical stump failure were noted, one in the IMRT group and the other in the helical tomotherapy group. No acute or late grade 3 or 4 toxicities were noted, including proctitis, or genitourinary or gastrointestinal disturbances. Conclusion Helical tomotherapy is as effective as IMRT and has better uniformity and conformal indices, and critical organ-sparing properties. Prospective clinical trials are needed to evaluate the comparative efficacy of IMRT versus helical tomotherapy. PMID:23055750

  11. Intensity-Modulated Proton Therapy Versus Helical Tomotherapy in Nasopharynx Cancer: Planning Comparison and NTCP Evaluation

    SciTech Connect

    Widesott, Lamberto Pierelli, Alessio; Fiorino, Claudio; Dell'Oca, Italo; Broggi, Sara; Cattaneo, Giovanni Mauro; Di Muzio, Nadia; Fazio, Ferruccio; Calandrino, Riccardo; Schwarz, Marco

    2008-10-01

    Purpose: To compare intensity-modulated proton therapy (IMPT) and helical tomotherapy (HT) treatment plans for nasopharynx cancer using a simultaneous integrated boost approach. Methods and Materials: The data from 6 patients who had previously been treated with HT were used. A three-beam IMPT technique was optimized in the Hyperion treatment planning system, simulating a 'beam scanning' technique. HT was planned using the tomotherapy treatment planning system. Both techniques were optimized to simultaneously deliver 66 Gy in 30 fractions to planning target volume (PTV1; GTV and enlarged nodes) and 54 Gy to PTV2 subclinical, electively treated nodes. Normal tissue complication probability calculation was performed for the parotids and larynx. Results: Very similar PTVs coverage and homogeneity of the target dose distribution for IMPT and HT were found. The conformity index was significantly lower for protons than for photons (1.19 vs. 1.42, respectively). The mean dose to the ipsilateral and contralateral parotid glands decreased by 6.4 Gy and 5.6 Gy, respectively, with IMPT. The volume of mucosa and esophagus receiving {>=}20 Gy and {>=}30 Gy with IMPT was significantly lower than with HT. The average volume of larynx receiving {>=}50 Gy was significantly lower with HT, while for thyroid, it was comparable. The volume receiving {>=}30, {>=}20, and {>=}10 Gy in total body volume decreased with IMPT by 14.5%, 19.4%, and 23.1%, respectively. The normal tissue complication probability for the parotid glands was significantly lower with IMPT for all sets of parameters; however, we also estimated an almost full recovery of the contralateral parotid with HT. The normal tissue complication probability for the larynx was not significantly different between the two irradiation techniques. Conclusion: Excellent target coverage, homogeneity within the PTVs, and sparing of the organs at risk were reached with both modalities. IMPT allows for better sparing of most organs at

  12. QA for helical tomotherapy: Report of the AAPM Task Group 148a).

    PubMed

    Langen, Katja M; Papanikolaou, Niko; Balog, John; Crilly, Richard; Followill, David; Goddu, S Murty; Grant, Walter; Olivera, Gustavo; Ramsey, Chester R; Shi, Chengyu

    2010-09-01

    Helical tomotherapy is a relatively new modality with integrated treatment planning and delivery hardware for radiation therapy treatments. In view of the uniqueness of the hardware design of the helical tomotherapy unit and its implications in routine quality assurance, the Therapy Physics Committee of the American Association of Physicists in Medicine commissioned Task Group 148 to review this modality and make recommendations for quality assurance related methodologies. The specific objectives of this Task Group are: (a) To discuss quality assurance techniques, frequencies, and tolerances and (b) discuss dosimetric verification techniques applicable to this unit. This report summarizes the findings of the Task Group and aims to provide the practicing clinical medical physicist with the insight into the technology that is necessary to establish an independent and comprehensive quality assurance program for a helical tomotherapy unit. The emphasis of the report is to describe the rationale for the proposed QA program and to provide example tests that can be performed, drawing from the collective experience of the task group members and the published literature. It is expected that as technology continues to evolve, so will the test procedures that may be used in the future to perform comprehensive quality assurance for helical tomotherapy units. © 2010 American Association of Physicists in Medicine.

  13. QA for helical tomotherapy: report of the AAPM Task Group 148.

    PubMed

    Langen, Katja M; Papanikolaou, Niko; Balog, John; Crilly, Richard; Followill, David; Goddu, S Murty; Grant, Walter; Olivera, Gustavo; Ramsey, Chester R; Shi, Chengyu

    2010-09-01

    Helical tomotherapy is a relatively new modality with integrated treatment planning and delivery hardware for radiation therapy treatments. In view of the uniqueness of the hardware design of the helical tomotherapy unit and its implications in routine quality assurance, the Therapy Physics Committee of the American Association of Physicists in Medicine commissioned Task Group 148 to review this modality and make recommendations for quality assurance related methodologies. The specific objectives of this Task Group are: (a) To discuss quality assurance techniques, frequencies, and tolerances and (b) discuss dosimetric verification techniques applicable to this unit. This report summarizes the findings of the Task Group and aims to provide the practicing clinical medical physicist with the insight into the technology that is necessary to establish an independent and comprehensive quality assurance program for a helical tomotherapy unit. The emphasis of the report is to describe the rationale for the proposed QA program and to provide example tests that can be performed, drawing from the collective experience of the task group members and the published literature. It is expected that as technology continues to evolve, so will the test procedures that may be used in the future to perform comprehensive quality assurance for helical tomotherapy units.

  14. Total marrow irradiation using Helical TomoTherapy

    NASA Astrophysics Data System (ADS)

    Garcia-Fernandez, Lourdes Maria

    Clinical dose response data of human tumours are limited or restricted to a radiation dose range determined by the level of toxicity to the normal tissues. This is the case for the most common disseminated plasma cell neoplasm, multiple myeloma, where the maximum dose deliverable to the entire bony skeleton using a standard total body irradiation (TBI) technique is limited to about 12 Gy. This study is part of scientific background of a phase I/II dose escalation clinical trial for multiple myeloma using image-guided intensity modulated radiotherapy (IG-IMRT) to deliver high dose to the entire volume of bone marrow with Helical TomoTherapy (HT). This relatively new technology can deliver highly conformal dose distributions to complex target shapes while reducing the dose to critical normal tissues. In this study tools for comparing and predicting the effectiveness of different approaches to total marrow irradiation (TMI) using HT were provided. The expected dose response for plasma cell neoplasms was computed and a radiobiological evaluation of different treatment cohorts in a dose escalating study was performed. Normal tissue complication probability (NTCP) and tumour control probability (TCP) models were applied to an actual TMI treatment plan for a patient and the implications of using different longitudinal field widths were assessed. The optimum dose was ˜39 Gy for which a predicted tumour control of 95% (+/-3%) was obtained, with a predicted 3% (0, 8%) occurrence of radiation pneumonitis. Tissue sparing was seen by using smaller field widths only in the organs of the head. This suggests it would be beneficial to use the small fields in the head only since using small fields for the whole treatment would lead to long treatment times. In TMI it may be necessary to junction two longitudinally adjacent treatment volumes to form a contiguous planning target volume PTV. For instance, this is the case when a different SUP-INF spatial resolution is required or when

  15. Measurement and correction of leaf open times in helical tomotherapy

    SciTech Connect

    Sevillano, David; Minguez, Cristina; Sanchez, Alicia; Sanchez-Reyes, Alberto

    2012-11-15

    Purpose: The binary multileaf collimator (MLC) is one of the most important components in helical tomotherapy (HT), as it modulates the dose delivered to the patient. However, methods to ensure MLC quality in HT treatments are lacking. The authors obtained data on the performance of the MLC in treatments administered in their department in order to assess possible delivery errors due to the MLC. Correction methods based on their data are proposed. Methods: Twenty sinograms from treatments delivered using both of the authors HT systems were measured and analyzed by recording the fluence collected by the imaging detector. Planned and actual sinograms were compared using distributions of leaf open time (LOT) errors, as well as differences in fluence reconstructed at each of the 51 projections into which the treatment planning system divides each rotation for optimization purposes. They proposed and applied a method based on individual leaf error correction and the increase in projection time to prevent latency effects when LOT is close to projection time. In order to analyze the dosimetric impact of the corrections, inphantom measurements were made for four corrected treatments. Results: The LOTs measured were consistent with those planned. Most of the mean errors in LOT distributions were within 1 ms with standard deviations of over 4 ms. Reconstructed fluences showed good results, with over 90% of points passing the 3% criterion, except in treatments with a short mean LOT, where the percentage of passing points was as low as 66%. Individual leaf errors were as long as 4 ms in some cases. Corrected sinograms improved error distribution, with standard deviations of over 3 ms and increased percentages of points passing 3% in the fluence per angle analysis, especially in treatments with a short mean LOT and those that were more subject to latency effects. The minimum percentage of points within 3% increased to 86%. In-phantom measurements of the corrected treatments

  16. Helical Tomotherapy for Simultaneous Multitarget Radiotherapy for Pulmonary Metastasis

    SciTech Connect

    Kim, Ji Yoon; Kay, Chul Seung; Kim, Yeon Sil; Jang, Jeong Won; Bae, Si Hyun; Choi, Jong Yeong; Yoon, Seung Kyu; Kim, Ki Joon

    2009-11-01

    Purpose: To retrospectively evaluate our experience with tomotherapy for simultaneous multitarget radiotherapy in patients with pulmonary metastases. Methods and Materials: Thirty-one patients were treated with tomotherapy for pulmonary metastases. We defined gross tumor volume (GTV) in computed tomography scans, and the margin of the planning target volume was 1 to 1.5 cm from the GTV. The median doses prescribed were 50 Gy and 40 Gy delivered in 10 fractions over 2 weeks to the 95% isodose volume of the GTV and planning target volume, respectively. Prior to each treatment, online corrections were made in the three axes, and rotation was done after registration of the megavoltage and simulation computed tomography scans. Survival was calculated from the completion of tomotherapy, using the Kaplan-Meier method and log rank test. Results: The overall survival rate at 12 months was 60.5%, and the median survival time was 16.0 months. A rating of 1 or below on the Eastern Cooperative Oncology Group scale, a breast or colon cancer as the primary cancer, primary lesions that were completely controlled, and a response maintained at 3 months after tomotherapy were shown by univariate analysis to be statistically significant favorable prognostic factors. Progression-free survival rates at 1 and 2 years were 39.6% and 27.7%, respectively. The posttreatment failure rate was 64.5%, the local failure rate was 9.7%, the regional failure rate was 51.6%, and the synchronous local and regional failure rate was 3.2%. Grades I and II radiation-related toxicity levels were observed in 41.9% and 16.0% of patients, respectively. There were no treatment-related deaths. Conclusions: Tomotherapy could be offered to patients as a safe and effective treatment in select patients with lung metastases. However, large-scale, prospective clinical trials should be done to confirm our results.

  17. Investigation of dose homogeneity for loose helical tomotherapy delivery in the context of breath-hold radiation therapy

    NASA Astrophysics Data System (ADS)

    Kim, Bryan; Kron, Tomas; Battista, Jerry; Van Dyk, Jake

    2005-05-01

    Loose helical delivery is a potential solution to account for respiration-driven tumour motion in helical tomotherapy (HT). In this approach, a treatment is divided into a set of interlaced 'loose' helices commencing at different gantry angles. Each loose helix covers the entire target length in one gantry rotation during a single breath-hold. The dosimetric characteristics of loose helical delivery were investigated by delivering a 6 MV photon beam in a HT-like manner. Multiple scenarios of conventional 'tight' HT and loose helical deliveries were modelled in treatment planning software, and carried out experimentally with Kodak EDR2 film. The advantage of loose helical delivery lies in its ability to produce a more homogeneous dose distribution by eliminating the 'thread' effect—an inherent characteristic of HT, which results in dose modulations away from the axis of gantry rotation. However, loose helical delivery was also subjected to undesirable dose modulations in the direction of couch motion (termed 'beating' effect), when the ratio between the number of beam projections per gantry rotation (n) and pitch factor (p) was a non-integer. The magnitude of dose modulations decreased with an increasing n/p ratio. The results suggest that for the current HT unit (n = 51), dose modulations could be kept under 5% by selecting a pitch factor smaller than 7. A pitch factor of this magnitude should be able to treat a target up to 30 cm in length. Loose helical delivery should increase the total session time only by a factor of 2, while the planning time should stay the same since the total number of beam projections remains unchanged. Considering its dosimetric advantage and clinical practicality, loose helical delivery is a promising solution for the future HT treatments of respiration-driven targets.

  18. Independent verification of transferred delivery sinogram between two dosimetrically matched helical tomotherapy machines: a protocol for patient-specific quality assurance.

    PubMed

    Yaddanapudi, Sridhar; Oddiraju, Swetha; Rodriguez, Vivian; Green, Olga L; Low, Daniel A; Rangaraj, Dharanipathy; Mutic, Sasa; Goddu, S Murty

    2012-09-07

    The purpose of this study was to independently verify the transferred delivery sinogram between two dosimetrically matched helical tomotherapy machines with the goal of eliminating redundant quality assurance (QA) measurements on the second machine. The equivalence of the two machines was evaluated based on both geometric and dosimetric beam characteristics, including measuring open field per cent depth doses (PDD), longitudinal and transverse profiles and helical delivery of clinical patient treatment plans measured in phantoms. QA of 56 patient plans was studied. The delivery sinogram on the secondary machine was computed by accounting for the differences in the MLC characteristics of the two machines. Computed sinograms were compared against the transferred sinograms by tomotherapy's data management system for the same 56 patient plans. The PDD, transverse and longitudinal dose profiles agreed within ±1% between the two machines. Ionization chamber and planar dose measurements with the Iba MatriXX device on both machines for the 56 patients were found to be within ±3% of the doses computed by the tomotherapy treatment planning system. For all 56 patients, the differences between computed sinograms and DMS-converted sinograms were within ±2%. The matched tomotherapy machines had similar beam characteristics. The sinogram-based QA was validated using point and planar dose measurements and found to be acceptable for clinical use.

  19. Independent verification of transferred delivery sinogram between two dosimetrically matched helical tomotherapy machines: a protocol for patient-specific quality assurance

    NASA Astrophysics Data System (ADS)

    Yaddanapudi, Sridhar; Oddiraju, Swetha; Rodriguez, Vivian; Green, Olga L.; Low, Daniel A.; Rangaraj, Dharanipathy; Mutic, Sasa; Goddu, S. Murty

    2012-09-01

    The purpose of this study was to independently verify the transferred delivery sinogram between two dosimetrically matched helical tomotherapy machines with the goal of eliminating redundant quality assurance (QA) measurements on the second machine. The equivalence of the two machines was evaluated based on both geometric and dosimetric beam characteristics, including measuring open field per cent depth doses (PDD), longitudinal and transverse profiles and helical delivery of clinical patient treatment plans measured in phantoms. QA of 56 patient plans was studied. The delivery sinogram on the secondary machine was computed by accounting for the differences in the MLC characteristics of the two machines. Computed sinograms were compared against the transferred sinograms by tomotherapy's data management system for the same 56 patient plans. The PDD, transverse and longitudinal dose profiles agreed within ±1% between the two machines. Ionization chamber and planar dose measurements with the Iba MatriXX device on both machines for the 56 patients were found to be within ±3% of the doses computed by the tomotherapy treatment planning system. For all 56 patients, the differences between computed sinograms and DMS-converted sinograms were within ±2%. The matched tomotherapy machines had similar beam characteristics. The sinogram-based QA was validated using point and planar dose measurements and found to be acceptable for clinical use.

  20. Helical Tomotherapy-Based STAT RT: Dosimetric Evaluation for Clinical Implementation of a Rapid Radiation Palliation Program

    SciTech Connect

    McIntosh, Alyson; Dunlap, Neal; Sheng, Ke; Geezey, Constance; Turner, Benton; Blackhall, Leslie; Weiss, Geoffrey; Lappinen, Eric; Larner, James M.; Read, Paul W.

    2010-01-01

    Helical tomotherapy-based STAT radiation therapy (RT) uses an efficient software algorithm for rapid intensity-modulated treatment planning, enabling conformal radiation treatment plans to be generated on megavoltage computed tomography (MVCT) scans for CT simulation, treatment planning, and treatment delivery in one session. We compared helical tomotherapy-based STAT RT dosimetry with standard linac-based 3D conformal plans and standard helical tomotherapy-based intensity-modulated radiation therapy (IMRT) dosimetry for palliative treatments of whole brain, a central obstructive lung mass, multilevel spine disease, and a hip metastasis. Specifically, we compared the conformality, homogeneity, and dose with regional organs at risk (OARs) for each plan as an initial step in the clinical implementation of a STAT RT rapid radiation palliation program. Hypothetical planning target volumes (PTVs) were contoured on an anthropomorphic phantom in the lung, spine, brain, and hip. Treatment plans were created using three planning techniques: 3D conformal on Pinnacle{sup 3}, helical tomotherapy, and helical tomotherapy-based STAT RT. Plan homogeneity, conformality, and dose to OARs were analyzed and compared. STAT RT and tomotherapy improved conformality indices for spine and lung plans (CI spine = 1.21, 1.17; CI lung = 1.20, 1.07, respectively) in comparison with standard palliative anteroposterior/posteroanterior (AP/PA) treatment plans (CI spine = 7.01, CI lung = 7.30), with better sparing of heart, esophagus, and spinal cord. For palliative whole-brain radiotherapy, STAT RT and tomotherapy reduced maximum and mean doses to the orbits and lens (maximum/mean lens dose: STAT RT = 2.94/2.65 Gy, tomotherapy = 3.13/2.80 Gy, Lateral opposed fields = 7.02/3.65 Gy), with an increased dose to the scalp (mean scalp dose: STAT RT = 16.19 Gy, tomotherapy = 15.61 Gy, lateral opposed fields = 14.01 Gy). For bony metastatic hip lesions, conformality with both tomotherapy techniques (CI

  1. The impact of linac output variations on dose distributions in helical tomotherapy

    PubMed Central

    Flynn, R T; Kissick, M W; Mehta, M P; Olivera, G H; Jeraj, R; Mackie, T R

    2009-01-01

    It has been suggested for quality assurance purposes that linac output variations for helical tomotherapy (HT) be within ±2% of the long-term average. Due to cancellation of systematic uncertainty and averaging of random uncertainty over multiple beam directions, relative uncertainties in the dose distribution can be significantly lower than those in linac output. The sensitivity of four HT cases with respect to linac output uncertainties was assessed by scaling both modelled and measured systematic and random linac output uncertainties until a dose uncertainty acceptance criterion failed. The dose uncertainty acceptance criterion required the delivered dose to have at least a 95% chance of being within 2% of the planned dose in all of the voxels in the treatment volume. For a random linac output uncertainty of 5% of the long-term mean, the maximum acceptable amplitude of the modelled, sinusoidal, systematic component of the linac output uncertainty for the four cases was 1.8%. Although the measured linac output variations represented values that were outside of the ±2% tolerance, the acceptance criterion did not fail for any of the four cases until the measured linac output variations were scaled by a factor of almost three. Thus the ±2% tolerance in linac output variations for HT is a more conservative tolerance than necessary. PMID:18184996

  2. Simultaneous Multitarget Irradiation Using Helical Tomotherapy for Advanced Hepatocellular Carcinoma With Multiple Extrahepatic Metastases

    SciTech Connect

    Jang, Jeong Won Kay, Chul Seung You, Chan Ran; Kim, Chang Wook; Bae, Si Hyun.; Choi, Jong Young; Yoon, Seung Kew; Han, Chi Wha; Jung, Hyun Suk; Choi, Ihl Bong

    2009-06-01

    Purpose: The prognosis of hepatocellular carcinoma (HCC) patients with extrahepatic metastases is extremely poor. Helical tomotherapy, an image-guided, intensity-modulated radiotherapy system, can allow for simultaneous and precise targeting of multiple cancerous lesions, while sparing normal tissues. This study evaluated the feasibility and outcome of tomotherapy for advanced HCC with metastases. Patients and Methods: A total of 42 consecutive HCC patients with metastases were treated with tomotherapy using the Hi-Art system. A total of 152 intra- and extrahepatic lesions (3.5 lesions/patient) were treated simultaneously, with a dose of 51.03 Gy (range, 30-57.61) in 10 fractions. Transarterial chemolipiodolization using epirubicin (50 mg) and cisplatin (60 mg) was repeated in patients with intrahepatic HCC (mean size, 9.0 cm) after tomotherapy. Results: An objective response (complete response and partial response) was achieved in 45.2% of patients with intrahepatic tumors, 68.4% of patients with pulmonary lesions, 60.0% of patients with lymph node/adrenal lesions, and 66.7% of patients with soft-tissue metastases. The complete response rate for those with pulmonary and lymph node/adrenal metastases was 26.3% and 5.0%, respectively. The overall survival rate at 1 and 2 years was 50.1% and 14.9%, respectively, with a median survival of 12.3 months. The actuarial in-field tumor control rate for {<=}1 year was 79.0%. No cases of Grade 4-5 acute toxicity occurred. Conclusion: The results of this study have shown that helical tomotherapy is safe and feasible without major toxicities for the treatment of advanced HCC and results in excellent tumor control and a potential survival benefit. This approach is expected to be a useful palliative option for selected HCC patients with metastases.

  3. Pediatric Craniospinal Axis Irradiation With Helical Tomotherapy: Patient Outcome and Lack of Acute Pulmonary Toxicity

    SciTech Connect

    Penagaricano, Jose; Moros, Eduardo; Corry, Peter; Saylors, Robert; Ratanatharathorn, Vaneerat

    2009-11-15

    Purpose: To present the patient outcomes and risk of symptomatic acute radiation pneumonitis (ARP) in 18 pediatric patients treated with helical tomotherapy to their craniospinal axis for a variety of neoplasms. Methods and Materials: A total of 18 patients received craniospinal axis irradiation with helical tomotherapy. The median age was 12 years (range, 2.5-21). The follow-up range was 3-48 months (median, 16.5). Of the 18 patients, 15 received chemotherapy in the neoadjuvant, adjuvant, or concomitant setting. Chemotherapy was tailored to the particular histologic diagnosis; 10 of 18 patients underwent surgical removal of the gross primary tumor. The patients were followed and evaluated for ARP starting at 3-6 months after completion of craniospinal axis irradiation. ARP was graded using the Common Toxicity Criteria, version 3. Results: At the last follow-up visit, 14, 2, and 2 patients were alive without disease, alive with disease, and dead of disease, respectively. The cause-specific survival rate was 89% (16 of 18), disease-free survival rate was 78% (14 of 18), and overall survival rate was 89% (16 of 18). No patient had treatment failure at the cribriform plate. No patient developed symptoms of ARP. Conclusion: Craniospinal axis irradiation using helical tomotherapy yielded encouraging patient outcomes and acute toxicity profiles. Although large volumes of the lung received low radiation doses, no patient developed symptoms of ARP during the follow-up period.

  4. Adaptive Radiation Therapy for Localized Mesothelioma with Mediastinal Metastasis Using Helical Tomotherapy

    SciTech Connect

    Renaud, James; Yartsev, Slav Dar, A. Rashid; Van Dyk, Jake

    2009-10-01

    The purpose of this study was to compare 2 adaptive radiotherapy strategies with helical tomotherapy. A patient having mesothelioma with mediastinal nodes was treated using helical tomotherapy with pretreatment megavoltage CT (MVCT) imaging. Gross tumor volumes (GTVs) were outlined on every MVCT study. Two alternatives for adapting the treatment were investigated: (1) keeping the prescribed dose to the targets while reducing the dose to the OARs and (2) escalating the target dose while maintaining the original level of healthy tissue sparing. Intensity modulated radiotherapy (step-and-shoot IMRT) and 3D conformal radiotherapy (3DCRT) plans for the patient were generated and compared. The primary lesion and nodal mass regressed by 16.2% and 32.5%, respectively. Adapted GTVs and reduced planning target volume (PTV) margins of 4 mm after 22 fractions decrease the planned mean lung dose by 19.4%. For dose escalation, the planned prescribed doses may be increased from 50.0 to 58.7 Gy in PTV{sub 1} and from 60.0 to 70.5 Gy in PTV{sub 2}. The step-and-shoot IMRT plan was better in sparing healthy tissue but did not provide target coverage as well as the helical tomotherapy plan. The 3DCRT plan resulted in a prohibitively high planned dose to the spinal cord. MVCT studies provide information both for setup correction and plan adaptation. Improved healthy tissue sparing and/or dose escalation can be achieved by adaptive planning.

  5. Surface dose for five telecobalt machines, 6MV photon beam from four linear accelerators and a Hi-Art Tomotherapy.

    PubMed

    Kinhikar, Rajesh A

    2008-10-01

    The purpose of this study was to estimate the surface dose for five telecobalt machines (four from Best Theratronics Limited, Canada, one from Panacea Medical Technologies, India), 6 MV photon beam (static) from four linear accelerators (three Varian linear accelerators and one Siemens) and Hi-Art Tomotherapy unit. The surface dose was measured with Thermoluminescent dosimeters in phantom slabs. For Tomotherapy 6 MV beam the surface dose was estimated as 32% while it was 35%, 33%, and 36% for Clinac 6EX, Clinac 2100CD, and Clinac 2100C linear accelerators, respectively. Similarly, the surface dose for 6 MV photon beam from Primus linear accelerator was estimated as 35%. Surface doses from telecobalt machines Equinox-80, Elite-80, Th-780C, Th-780, and Bhabhatron-II was found to be 30%, 29.1%, 27.8%, 29.3%, and 29.9% for 10 cm x 10 field size, respectively. Measured surface dose from all four linear accelerators were in good agreement with that of the Tomotherapy. The surface dose measurements were useful for Tomotherapy to predict the superficial dose during helical IMRT treatments.

  6. Analysis of peripheral doses for base of tongue treatment by linear accelerator and helical TomoTherapy IMRT.

    PubMed

    Bennett, Brian Richard; Lamba, Michael A S; Elson, Howard R

    2010-06-21

    The purpose of this study was to compare the peripheral doses to various organs from a typical head and neck intensity-modulated radiation therapy (IMRT) treatment delivered by linear accelerator (linac) and helical TomoTherapy. Multiple human CT data sets were used to segment critical structures and organs at risk, fused and adjusted to an anthropomorphic phantom. Eighteen contours were designated for thermoluminescent dosimeter (TLD) placement. Following the RTOG IMRT Protocol 0522, treatment of the primary tumor and involved nodes (PTV70) and subclinical disease sites (PTV56) was planned utilizing IMRT to 70Gy and 56 Gy. Clinically acceptable treatment plans were produced for linac and TomoTherapy treatments. TLDs were placed and each treatment plan was delivered to the anthropomorphic phantom four times. Within 2.5 cm (one helical TomoTherapy field width) superior and inferior to the field edges, normal tissue doses were on average 45% lower using linear accelerator. Beyond 2.5 cm, the helical TomoTherapy normal tissue dose was an average of 52% lower. The majority of points proved to be statistically different using the Student's t-test with p > 0.05. Using one method of calculation, probability of a secondary malignancy was 5.88% for the linear accelerator and 4.08% for helical TomoTherapy. Helical TomoTherapy delivers more dose than a linac immediately above and below the treatment field, contributing to the higher peripheral doses adjacent to the field. At distances beyond one field width (where leakage is dominant), helical TomoTherapy doses are lower than linear accelerator doses.

  7. Performance characterization of megavoltage computed tomography imaging on a helical tomotherapy unit

    SciTech Connect

    Meeks, Sanford L.; Harmon, Joseph F. Jr.; Langen, Katja M.; Willoughby, Twyla R.; Wagner, Thomas H.; Kupelian, Patrick A.

    2005-08-15

    Helical tomotherapy is an innovative means of delivering IGRT and IMRT using a device that combines features of a linear accelerator and a helical computed tomography (CT) scanner. The HI-ART II can generate CT images from the same megavoltage x-ray beam it uses for treatment. These megavoltage CT (MVCT) images offer verification of the patient position prior to and potentially during radiation therapy. Since the unit uses the actual treatment beam as the x-ray source for image acquisition, no surrogate telemetry systems are required to register image space to treatment space. The disadvantage to using the treatment beam for imaging, however, is that the physics of radiation interactions in the megavoltage energy range may force compromises between the dose delivered and the image quality in comparison to diagnostic CT scanners. The performance of the system is therefore characterized in terms of objective measures of noise, uniformity, contrast, and spatial resolution as a function of the dose delivered by the MVCT beam. The uniformity and spatial resolutions of MVCT images generated by the HI-ART II are comparable to that of diagnostic CT images. Furthermore, the MVCT scan contrast is linear with respect to the electron density of material imaged. MVCT images do not have the same performance characteristics as state-of-the art diagnostic CT scanners when one objectively examines noise and low-contrast resolution. These inferior results may be explained, at least partially, by the low doses delivered by our unit; the dose is 1.1 cGy in a 20 cm diameter cylindrical phantom. In spite of the poorer low-contrast resolution, these relatively low-dose MVCT scans provide sufficient contrast to delineate many soft-tissue structures. Hence, these images are useful not only for verifying the patient's position at the time of therapy, but they are also sufficient for delineating many anatomic structures. In conjunction with the ability to recalculate radiotherapy doses on

  8. Secondary Cutaneous Involvement in Follicular Diffuse Lymphoma Treated with Helical Tomotherapy

    PubMed Central

    Dar, A. Rashid; Jordan, Kevin

    2017-01-01

    Non-Hodgkin’s lymphoma is a complex heterogeneous group of disease entities that involves nodal and extranodal tissues. Cutaneous involvement can occur either as a primary or secondary in course of disease. Radiation therapy with either total body or localized treatments is often used for local control and symptom relief, depending on the target volume. We describe a 60-year-old male with a remote history of stage IA left neck follicular lymphoma treated with radiation 20 years ago and previous relapses aggressively treated by chemotherapy. Treatment to a large volume of back and posterior shoulders on a helical tomotherapy radiotherapy system is reported. The skin lesions responded completely with no toxicity. Palliative radiotherapy to a fairly large and complex volume of skin with modest dose avoiding underlying critical tissues on tomotherapy is feasible, well tolerated with an excellent durable response, without compromising future chemotherapy and stem cell transplant for systemic relapse. PMID:28944110

  9. Comparison of Elekta VMAT with helical tomotherapy and fixed field IMRT: Plan quality, delivery efficiency and accuracy

    SciTech Connect

    Rao Min; Yang Wensha; Chen Fan; Sheng Ke; Ye Jinsong; Mehta, Vivek; Shepard, David; Cao Daliang

    2010-03-15

    Purpose: Helical tomotherapy (HT) and volumetric modulated arc therapy (VMAT) are arc-based approaches to IMRT delivery. The objective of this study is to compare VMAT to both HT and fixed field IMRT in terms of plan quality, delivery efficiency, and accuracy. Methods: Eighteen cases including six prostate, six head-and-neck, and six lung cases were selected for this study. IMRT plans were developed using direct machine parameter optimization in the Pinnacle{sup 3} treatment planning system. HT plans were developed using a Hi-Art II planning station. VMAT plans were generated using both the Pinnacle{sup 3} SmartArc IMRT module and a home-grown arc sequencing algorithm. VMAT and HT plans were delivered using Elekta's PreciseBeam VMAT linac control system (Elekta AB, Stockholm, Sweden) and a TomoTherapy Hi-Art II system (TomoTherapy Inc., Madison, WI), respectively. Treatment plan quality assurance (QA) for VMAT was performed using the IBA MatriXX system while an ion chamber and films were used for HT plan QA. Results: The results demonstrate that both VMAT and HT are capable of providing more uniform target doses and improved normal tissue sparing as compared with fixed field IMRT. In terms of delivery efficiency, VMAT plan deliveries on average took 2.2 min for prostate and lung cases and 4.6 min for head-and-neck cases. These values increased to 4.7 and 7.0 min for HT plans. Conclusions: Both VMAT and HT plans can be delivered accurately based on their own QA standards. Overall, VMAT was able to provide approximately a 40% reduction in treatment time while maintaining comparable plan quality to that of HT.

  10. SU-E-P-37: Helical Tomotherapy to LINAC Plan Conversion Utilizing RayStation Fallback Planning

    SciTech Connect

    Zhang, X; Penagaricano, J; Liang, X; Morrill, S; Corry, P; Griffin, R; Paudel, N; Ratanatharathorn, V

    2015-06-15

    Purpose: RayStation Fallback (RSF) plan was developed to switch patient’s treatment from Helical Tomotherapy (HT) to Varian TrueBeam. Helical Tomotherapy plans were compared with the corresponding RSF plans by looking at the following dosimetric parameters: PTV coverage (Dmean and D95), Paddick conformity index (CI), uniformity index (UI=(D98-D2)/Drx) and organ-at-risk (OAR) doses. Methods: Five patients with five tumor sites including larynx, head and neck, esophagus, lung, and prostate previously treated with HT were re-planned using RSF treatment planning station(TPS) to best match the HT treatment plans. IMRT technique with nine fields 6 MV X-ray beams and a static multi-leaf collimator (MLC) were used for RSF plans without any additional attempt to further optimize the RSF plans. Results: A physician evaluated and confirmed the clinical acceptability of the RSF plans. Both HT and RSF plans gave comparable PTV coverage with a maximum percentage difference for D95 of 0.7%. HT plans had a better CIs ranging from 2%–15% higher conformity compared to RSF plans. HT plans also had better UIs for all tumor sites except the esophagus. The UIs were 1.6% to 8.9% lower for HT plans compared to RSF plans. Both HT and RSF plans gave comparable and acceptable OAR doses. However, the integral dose was 1%–15% higher for HT plans compared to RSF plans. Conclusion: RSF plans were simple and fast to generate. In the study cases of 5 various tumor sites, RSF efficiently created clinically acceptable plans without further optimization. However, further optimization for any IMRT plan can be done if clinically warranted. The absolute differences in CI and UI were small between RSF and HT plans.

  11. A dosimetric selectivity intercomparison of HDR brachytherapy, IMRT and helical tomotherapy in prostate cancer radiotherapy.

    PubMed

    Hermesse, Johanne; Biver, Sylvie; Jansen, Nicolas; Lenaerts, Eric; De Patoul, Nathalie; Vynckier, Stefaan; Coucke, Philippe; Scalliet, Pierre; Nickers, Philippe

    2009-11-01

    Dose escalation in order to improve the biochemical control in prostate cancer requires the application of irradiation techniques with high conformality. The dosimetric selectivity of three radiation modalities is compared: high-dose-rate brachytherapy (HDR-BT), intensity-modulated radiation radiotherapy (IMRT), and helical tomotherapy (HT). Ten patients with prostate adenocarcinoma treated by a 10-Gy HDR-BT boost after external-beam radiotherapy were investigated. For each patient, HDR-BT, IMRT and HT theoretical treatment plans were realized using common contour sets. A 10-Gy dose was prescribed to the planning target volume (PTV). The PTVs and critical organs' dose-volume histograms obtained were compared using Student's t-test. HDR-BT delivers spontaneously higher mean doses to the PTV with smaller cold spots compared to IMRT and HT. 33% of the rectal volume received a mean HDR-BT dose of 3.86 + or - 0.3 Gy in comparison with a mean IMRT dose of 6.57 + or - 0.68 Gy and a mean HT dose of 5.58 + or - 0.71 Gy (p < 0.0001). HDR-BT also enables to better spare the bladder. The hot spots inside the urethra are greater with HDR-BT. The volume of healthy tissue receiving 10% of the prescribed dose is reduced at least by a factor of 8 with HDR-BT (p < 0.0001). HDR-BT offers better conformality in comparison with HT and IMRT and reduces the volume of healthy tissue receiving a low dose.

  12. SU-E-T-761: TOMOMC, A Monte Carlo-Based Planning VerificationTool for Helical Tomotherapy

    SciTech Connect

    Chibani, O; Ma, C

    2015-06-15

    Purpose: Present a new Monte Carlo code (TOMOMC) to calculate 3D dose distributions for patients undergoing helical tomotherapy treatments. TOMOMC performs CT-based dose calculations using the actual dynamic variables of the machine (couch motion, gantry rotation, and MLC sequences). Methods: TOMOMC is based on the GEPTS (Gama Electron and Positron Transport System) general-purpose Monte Carlo system (Chibani and Li, Med. Phys. 29, 2002, 835). First, beam models for the Hi-Art Tomotherpy machine were developed for the different beam widths (1, 2.5 and 5 cm). The beam model accounts for the exact geometry and composition of the different components of the linac head (target, primary collimator, jaws and MLCs). The beams models were benchmarked by comparing calculated Pdds and lateral/transversal dose profiles with ionization chamber measurements in water. See figures 1–3. The MLC model was tuned in such a way that tongue and groove effect, inter-leaf and intra-leaf transmission are modeled correctly. See figure 4. Results: By simulating the exact patient anatomy and the actual treatment delivery conditions (couch motion, gantry rotation and MLC sinogram), TOMOMC is able to calculate the 3D patient dose distribution which is in principal more accurate than the one from the treatment planning system (TPS) since it relies on the Monte Carlo method (gold standard). Dose volume parameters based on the Monte Carlo dose distribution can also be compared to those produced by the TPS. Attached figures show isodose lines for a H&N patient calculated by TOMOMC (transverse and sagittal views). Analysis of differences between TOMOMC and TPS is an ongoing work for different anatomic sites. Conclusion: A new Monte Carlo code (TOMOMC) was developed for Tomotherapy patient-specific QA. The next step in this project is implementing GPU computing to speed up Monte Carlo simulation and make Monte Carlo-based treatment verification a practical solution.

  13. Early Clinical Experience and Outcome of Helical Tomotherapy for Multiple Metastatic Lesions

    SciTech Connect

    Lee, Ik Jae; Seong, Jinsil; Lee, Chang Geol; Kim, Yong Bae; Keum, Ki Chang; Suh, Chang Ok; Kim, Gwi Eon; Cho, Jaeho

    2009-04-01

    Purpose: To evaluate the feasibility of synchronous treatment of multiple metastatic lesions by helical tomotherapy. Methods and Materials: Forty-two patients with multiple metastatic lesions were treated by helical tomotherapy from April 2006 to February 2007. Among these patients, 21 had metastatic bone disease. Subjective pain response was assessed using the visual analogue scales, and morbidity was evaluated by Common Terminology Criteria for Adverse Events v3.0. The correlation between the percentage of red bone marrow in the radiation field and the severity of leukocytopenia was analyzed. Results: The median age was 57 years. Radiation dose to the gross tumor volume was 30-84 Gy, with a median fractional size of 3 Gy. Mean treatment time was 16 min and 1 sec. Treatment time and fraction size were modified because of poor performance status or hematologic toxicity in two patients. With regard to palliative effects for bone metastasis, 16 patients (76.2%) experienced positive pain relief. Four patients had Grade III leukocytopenia, and three had Grade IV leukocytopenia. In the multivariate logistic regression, red marrow percentage was the independent risk factor most associated with Grade III/IV leukocytopenia (p = 0.014). The tolerance cutoff point of red bone marrow was 26.8%, with a sensitivity and specificity of 85.7% and 85.7%, respectively. Conclusions: Helical tomotherapy was effective for symptom palliation and was feasible for patients with multiple metastatic diseases. The volume of red bone marrow, as well as performance status, must be taken into account to determine optimal treatment.

  14. Image-guided total marrow and total lymphatic irradiation using helical tomotherapy

    SciTech Connect

    Schultheiss, Timothy E. . E-mail: Schultheiss@coh.org; Wong, Jeffrey; Liu, An; Olivera, Gustavo; Somlo, George

    2007-03-15

    Purpose: To develop a treatment technique to spare normal tissue and allow dose escalation in total body irradiation (TBI). We have developed intensity-modulated radiotherapy techniques for the total marrow irradiation (TMI), total lymphatic irradiation, or total bone marrow plus lymphatic irradiation using helical tomotherapy. Methods and Materials: For TBI, we typically use 12 Gy in 10 fractions delivered at an extended source-to-surface distance (SSD). Using helical tomotherapy, it is possible to deliver equally effective doses to the bone marrow and lymphatics while sparing normal organs to a significant degree. In the TMI patients, whole body skeletal bone, including the ribs and sternum, comprise the treatment target. In the total lymphatic irradiation, the target is expanded to include the spleen and major lymph node areas. Sanctuary sites for disease (brain and testes) are included when clinically indicated. Spared organs include the lungs, esophagus, parotid glands, eyes, oral cavity, liver, kidneys, stomach, small and large intestine, bladder, and ovaries. Results: With TBI, all normal organs received the TBI dose; with TMI, total lymphatic irradiation, and total bone marrow plus lymphatic irradiation, the visceral organs are spared. For the first 6 patients treated with TMI, the median dose to organs at risk averaged 51% lower than would be achieved with TBI. By putting greater weight on the avoidance of specific organs, greater sparing was possible. Conclusion: Sparing of normal tissues and dose escalation is possible using helical tomotherapy. Late effects such as radiation pneumonitis, veno-occlusive disease, cataracts, neurocognitive effects, and the development of second tumors should be diminished in severity and frequency according to the dose reduction realized for the organs at risk.

  15. Schedule for CT image guidance in treating prostate cancer with helical tomotherapy

    PubMed Central

    Beldjoudi, G; Yartsev, S; Bauman, G; Battista, J; Van Dyk, J

    2010-01-01

    The aim of this study was to determine the effect of reducing the number of image guidance sessions and patient-specific target margins on the dose distribution in the treatment of prostate cancer with helical tomotherapy. 20 patients with prostate cancer who were treated with helical tomotherapy using daily megavoltage CT (MVCT) imaging before treatment served as the study population. The average geometric shifts applied for set-up corrections, as a result of co-registration of MVCT and planning kilovoltage CT studies over an increasing number of image guidance sessions, were determined. Simulation of the consequences of various imaging scenarios on the dose distribution was performed for two patients with different patterns of interfraction changes in anatomy. Our analysis of the daily set-up correction shifts for 20 prostate cancer patients suggests that the use of four fractions would result in a population average shift that was within 1 mm of the average obtained from the data accumulated over all daily MVCT sessions. Simulation of a scenario in which imaging sessions are performed at a reduced frequency and the planning target volume margin is adapted provided significantly better sparing of organs at risk, with acceptable reproducibility of dose delivery to the clinical target volume. Our results indicate that four MVCT sessions on helical tomotherapy are sufficient to provide information for the creation of personalised target margins and the establishment of the new reference position that accounts for the systematic error. This simplified approach reduces overall treatment session time and decreases the imaging dose to the patient. PMID:19505966

  16. Concurrent Chemoradiotherapy With Helical Tomotherapy for Oropharyngeal Cancer: A Preliminary Result

    SciTech Connect

    Shueng, Pei-Wei; Wu, Le-Jung; Chen, Shiou-Yi

    2010-07-01

    Purpose: To review the experience with and evaluate the treatment plan for helical tomotherapy for the treatment of oropharyngeal cancer. Methods and Materials: Between November 1, 2006 and January 31, 2009, 10 histologically confirmed oropharyngeal cancer patients were enrolled. All patients received definitive concurrent chemoradiation with helical tomotherapy. The prescription dose to the gross tumor planning target volume, the high-risk subclinical area, and the low-risk subclinical area was 70Gy, 63Gy, and 56Gy, respectively. During radiotherapy, all patients were treated with cisplatin, 30mg/m{sup 2}, plus 5-fluorouracil (425mg/m{sup 2})/leucovorin (30mg/m{sup 2}) intravenously weekly. Toxicity of treatment was scored according to the Common Terminology Criteria for Adverse Events, version 3.0. Several parameters, including maximal or median dose to critical organs, uniformity index, and conformal index, were evaluated from dose-volume histograms. Results: The mean survival was 18 months (range, 7-22 months). The actuarial overall survival, disease-free survival, locoregional control, and distant metastasis-free rates at 18 months were 67%, 70%, 80%, and 100%, respectively. The average for uniformity index and conformal index was 1.05 and 1.26, respectively. The mean of median dose for right side and left side parotid glands was 23.5 and 23.9Gy, respectively. No Grade 3 toxicity for dermatitis and body weight loss and only one instance of Grade 3 mucositis were noted. Conclusion: Helical tomotherapy achieved encouraging clinical outcomes in patients with oropharyngeal carcinoma. Treatment toxicity was acceptable, even in the setting of concurrent chemotherapy. Long-term follow-up is needed to confirm these preliminary findings.

  17. A novel method to correct for pitch and yaw patient setup errors in helical tomotherapy

    SciTech Connect

    Boswell, Sarah A.; Jeraj, Robert; Ruchala, Kenneth J.; Olivera, Gustavo H.; Jaradat, Hazim A.; James, Joshua A.; Gutierrez, Alonso; Pearson, Dave; Frank, Gary; Mackie, T. Rock

    2005-06-15

    An accurate means of determining and correcting for daily patient setup errors is important to the cancer outcome in radiotherapy. While many tools have been developed to detect setup errors, difficulty may arise in accurately adjusting the patient to account for the rotational error components. A novel, automated method to correct for rotational patient setup errors in helical tomotherapy is proposed for a treatment couch that is restricted to motion along translational axes. In tomotherapy, only a narrow superior/inferior section of the target receives a dose at any instant, thus rotations in the sagittal and coronal planes may be approximately corrected for by very slow continuous couch motion in a direction perpendicular to the scanning direction. Results from proof-of-principle tests indicate that the method improves the accuracy of treatment delivery, especially for long and narrow targets. Rotational corrections about an axis perpendicular to the transverse plane continue to be implemented easily in tomotherapy by adjustment of the initial gantry angle.

  18. Independent quality assurance of a helical tomotherapy machine using the dose magnifying glass

    SciTech Connect

    Wong, J. H. D.; Hardcastle, N.; Tome, W. A.; and others

    2011-04-15

    Purpose: Helical tomotherapy is a complex delivery technique, integrating CT image guidance and intensity modulated radiotherapy in a single system. The integration of the CT detector ring on the gantry not only allows patient position verification but is also often used to perform various QA procedures. This convenience lacks the rigor of a machine-independent QA process. Methods: In this article, a Si strip detector, known as the Dose Magnifying Glass (DMG), was used to perform machine-independent QA measurements of the multileaf collimator alignment, leaf open time threshold, and leaf fluence output factor (LFOF). Results: The DMG measurements showed good agreements with EDR2 film for the MLC alignment test while the CT detector agrees well with DMG measurements for leaf open time threshold and LFOF measurements. The leaf open time threshold was found to be approximately 20 ms. The LFOF measured with the DMG agreed within error with the CT detector measured LFOF. Conclusions: The DMG with its 0.2 mm spatial resolution coupled to TERA ASIC allowed real-time high temporal resolution measurements of the tomotherapy leaf movement. In conclusion, DMG was shown to be a suitable tool for machine-independent QA of a tomotherapy unit.

  19. On-line rapid palliation using helical tomotherapy: a prospective feasibility study.

    PubMed

    MacPherson, Miller; Montgomery, Lynn; Fox, Greg; Carty, Kathy; Gerig, Lee; MacRae, Rob; Grimard, Laval; Clark, Brenda G; Samant, Rajiv

    2008-04-01

    Rapid delivery of radiation therapy is expected to benefit patients requiring palliation. We investigated the feasibility of employing a helical tomotherapy unit to scan, plan, and deliver a radiation treatment in a single radiation therapy appointment. Eleven patients each had an MVCT scan acquired, a plan created, and delivery completed while the patient was on the treatment couch. Timelines for each step of the process were recorded for each patient, and compared with the conventional process for similar patients. Preliminary results show that patients routinely can be treated within a 1 hour appointment for the first fraction.

  20. Helical Tomotherapy Versus Single-Arc Intensity-Modulated Arc Therapy: A Collaborative Dosimetric Comparison Between Two Institutions

    SciTech Connect

    Rong Yi; Tang, Grace; Welsh, James S.; Mohiuddin, Majid M.; Paliwal, Bhudatt; Yu, Cedric X.

    2011-09-01

    Purpose: Both helical tomotherapy (HT) and single-arc intensity-modulated arc therapy (IMAT) deliver radiation using rotational beams with multileaf collimators. We report a dual-institution study comparing dosimetric aspects of these two modalities. Methods and Materials: Eight patients each were selected from the University of Maryland (UMM) and the University of Wisconsin Cancer Center Riverview (UWR), for a total of 16 cases. Four cancer sites including brain, head and neck (HN), lung, and prostate were selected. Single-arc IMAT plans were generated at UMM using Varian RapidArc (RA), and HT plans were generated at UWR using Hi-Art II TomoTherapy. All 16 cases were planned based on the identical anatomic contours, prescriptions, and planning objectives. All plans were swapped for analysis at the same time after final approval. Dose indices for targets and critical organs were compared based on dose-volume histograms, the beam-on time, monitor units, and estimated leakage dose. After the disclosure of comparison results, replanning was done for both techniques to minimize diversity in optimization focus from different operators. Results: For the 16 cases compared, the average beam-on time was 1.4 minutes for RA and 4.8 minutes for HT plans. HT provided better target dose homogeneity (7.6% for RA and 4.2% for HT) with a lower maximum dose (110% for RA and 105% for HT). Dose conformation numbers were comparable, with RA being superior to HT (0.67 vs. 0.60). The doses to normal tissues using these two techniques were comparable, with HT showing lower doses for more critical structures. After planning comparison results were exchanged, both techniques demonstrated improvements in dose distributions or treatment delivery times. Conclusions: Both techniques created highly conformal plans that met or exceeded the planning goals. The delivery time and total monitor units were lower in RA than in HT plans, whereas HT provided higher target dose uniformity.

  1. Parotid Gland Sparing With Helical Tomotherapy in Head-and-Neck Cancer

    SciTech Connect

    Voordeckers, Mia; Farrag, Ashraf; Everaert, Hendrik; Tournel, Koen; Storme, Guy; Verellen, Dirk; De Ridder, Mark

    2012-10-01

    Purpose: This study evaluated the ability of helical tomotherapy to spare the function of the parotid glands in patients with head-and-neck cancer by analyzing dose-volume histograms, salivary gland scintigraphy, and quality of life assessment. Methods and Materials: Data from 76 consecutive patients treated with helical tomotherapy (Hi-Art Tomotherapy) at University Hospital Brussel were analyzed. During planning, priority was given to planning target volume (PTV) coverage: {>=}95% of the dose must be delivered to {>=}95% of the PTV. Elective nodal regions received 54 Gy (1.8 Gy/fraction). A dose of 70.5 Gy (2.35 Gy/fraction) was prescribed to the primary tumor and pathologic lymph nodes (simultaneous integrated boost scheme). Objective scoring of salivary excretion was performed by salivary gland scintigraphy. Subjective scoring of salivary gland function was evaluated by the European Organization for Research and Treatment of Cancer quality of life questionnaires Quality of Life Questionnaire-C30 (QLQ-C30) and Quality of Life Questionnaire-Head and Neck 35 (H and N35). Results: Analysis of dose-volume histograms (DVHs) showed excellent coverage of the PTV. The volume of PTV receiving 95% of the prescribed dose (V95%) was 99.4 (range, 96.3-99.9). DVH analysis of parotid gland showed a median value of the mean parotid dose of 32.1 Gy (range, 17.5-70.3 Gy). The median parotid volume receiving a dose <26 Gy was 51.2%. Quality of life evaluation demonstrated an initial deterioration of almost all scales and items in QLQ-C30 and QLQ-H and N35. Most items improved in time, and some reached baseline values 18 months after treatment. Conclusion: DVH analysis, scintigraphic evaluation of parotid function, and quality of life assessment of our patient group showed that helical tomotherapy makes it possible to preserve parotid gland function without compromising disease control. We recommend mean parotid doses of <34 Gy and doses <26 Gy to a maximum 47% of the parotid

  2. Phase II Study of Preoperative Helical Tomotherapy With a Simultaneous Integrated Boost for Rectal Cancer

    SciTech Connect

    Engels, Benedikt; Tournel, Koen; Everaert, Hendrik; Hoorens, Anne; Sermeus, Alexandra; Christian, Nicolas; Storme, Guy; Verellen, Dirk; De Ridder, Mark

    2012-05-01

    Purpose: The addition of concomitant chemotherapy to preoperative radiotherapy is considered the standard of care for patients with cT3-4 rectal cancer. The combined treatment modality increases the complete response rate and local control (LC), but has no impact on survival or the incidence of distant metastases. In addition, it is associated with considerable toxicity. As an alternative strategy, we explored prospectively, preoperative helical tomotherapy with a simultaneous integrated boost (SIB). Methods and Materials: A total of 108 patients were treated with intensity-modulated and image-guided radiotherapy using the Tomotherapy Hi-Art II system. A dose of 46 Gy, in daily fractions of 2 Gy, was delivered to the mesorectum and draining lymph nodes, without concomitant chemotherapy. Patients with an anticipated circumferential resection margin (CRM) of less than 2 mm, based on magnetic resonance imaging, received a SIB to the tumor up to a total dose of 55.2 Gy. Acute and late side effects were scored using the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. Results: A total of 102 patients presented with cT3-4 tumors; 57 patients entered the boost group and 51 the no-boost group. One patient in the no-boost group developed a radio-hypersensitivity reaction, resulting in a complete tumor remission, a Grade 3 acute and Grade 5 late enteritis. No other Grade {>=}3 acute toxicities occurred. With a median follow-up of 32 months, Grade {>=}3 late gastrointestinal and urinary toxicity were observed in 6% and 4% of the patients, respectively. The actuarial 2-year LC, progression-free survival and overall survival were 98%, 79%, and 93%. Conclusions: Preoperative helical tomotherapy displays a favorable acute toxicity profile in patients with cT3-4 rectal cancer. A SIB can be safely administered in patients with a narrow CRM and resulted in a promising LC.

  3. Helical tomotherapy to LINAC plan conversion utilizing RayStation Fallback planning.

    PubMed

    Zhang, Xin; Penagaricano, Jose; Narayanasamy, Ganesh; Corry, Peter; Liu, TianXiao; Sanjay, Maraboyina; Paudel, Nava; Morrill, Steven

    2017-01-01

    RaySearch RayStation Fallback (FB) planning module can generate an equivalent backup radiotherapy treatment plan facilitating treatment on other linear accelerators. FB plans were generated from the RayStation FB module by simulating the original plan target and organ at risk (OAR) dose distribution and delivered in various backup linear accelerators. In this study, helical tomotherapy (HT) backup plans used in Varian TrueBeam linear accelerator were generated with the RayStation FB module. About 30 patients, 10 with lung cancer, 10 with head and neck (HN) cancer, and 10 with prostate cancer, who were treated with HT, were included in this study. Intensity-modulated radiotherapy Fallback plans (FB-IMRT) were generated for all patients, and three-dimensional conformal radiotherapy Fallback plans (FB-3D) were only generated for lung cancer patients. Dosimetric comparison study evaluated FB plans based on dose coverage to 95% of the PTV volume (R95), PTV mean dose (Dmean), Paddick's conformity index (CI), and dose homogeneity index (HI). The evaluation results showed that all IMRT plans were statistically comparable between HT and FB-IMRT plans except that PTV HI was worse in prostate, and PTV R95 and HI were worse in HN multitarget plans for FB-IMRT plans. For 3D lung cancer plans, only the PTV R95 was statistically comparable between HT and FB-3D plans, PTV Dmean was higher, and CI and HI were worse compared to HT plans. The FB plans using a TrueBeam linear accelerator generally offer better OAR sparing compared to HT plans for all the patients. In this study, all cases of FB-IMRT plans and 9/10 cases of FB-3D plans were clinically acceptable without further modification and optimization once the FB plans were generated. However, the statistical differences between HT and FB-IMRT/3D plans might not be of any clinically significant. One FB-3D plan failed to simulate the original plan without further optimization. © 2017 The Authors. Journal of Applied Clinical

  4. Comparing step-and-shoot IMRT with dynamic helical tomotherapy IMRT plans for head-and-neck cancer

    SciTech Connect

    Vulpen, Marco van . E-mail: M.vanVulpen@azu.nl; Field, Colin; Raaijmakers, Cornelis P.J.; Parliament, Matthew B.; Terhaard, Chris H.J.; MacKenzie, Marc A.; Scrimger, Rufus; Lagendijk, Jan J.W.; Fallone, B. Gino

    2005-08-01

    Purpose: The goal of this planning study was to compare step-and-shoot intensity-modulated radiotherapy (IMRT) plans with helical dynamic IMRT plans for oropharynx patients on the basis of dose distribution. Methods and Materials: Five patients with oropharynx cancer had been previously treated by step-and-shoot IMRT at University Medical Centre Utrecht, The Netherlands, applying five fields and approximately 60-90 segments. Inverse planning was carried out using Plato, version 2.6.2. For each patient, an inverse IMRT plan was also made using Tomotherapy Hi-Art System, version 2.0, and using the same targets and optimization goals. Statistical analysis was performed by a paired t test. Results: All tomotherapy plans compared favorably with the step-and-shoot plans regarding sparing of the organs at risk and keeping an equivalent target dose homogeneity. Tomotherapy plans in particular realized sharper dose gradients compared with the step-and-shoot plans. The mean dose to all parotid glands (n = 10) decreased on average 6.5 Gy (range, -4 to 14; p = 0.002). The theoretical reduction in normal tissue complication probabilities in favor of the tomotherapy plans depended on the parotid normal tissue complication probability model used (range, -3% to 32%). Conclusion: Helical tomotherapy IMRT plans realized sharper dose gradients compared with the clinically applied step-and shoot plans. They are expected to be able to reduce the parotid normal tissue complication probability further, keeping a similar target dose homogeneity.

  5. Helical tomotherapy optimized planning parameters for nasopharyngeal cancer

    NASA Astrophysics Data System (ADS)

    Yawichai, K.; Chitapanarux, I.; Wanwilairat, S.

    2016-03-01

    Helical TomoTherapy(HT) planning depends on optimize parameters including field width (FW), pitch factor (PF) and modulation factor (MF). These optimize parameters are effect to quality of plans and treatment time. The aim of this study was to find the optimized parameters which compromise between plan quality and treatment times. Six nasopharyngeal cancer patients were used. For each patient data set, 18 treatment plans consisted of different optimize parameters combination (FW=5.0, 2.5, 1.0 cm; PF=0.43, 0.287, 0.215; MF2.0, 3.0) were created. The identical optimization procedure followed ICRU83 recommendations. The average D50 of both parotid glands and treatment times per fraction were compared for all plans. The study show treatment plan with FW1.0 cm showed the lowest average D50 of both parotid glands. The treatment time increased inversely to FW. The FW1.0 cm the average treatment time was 4 times longer than FW5.0 cm. PF was very little influence on the average D50 of both parotid glands. Finally, MF increased from 2.0 to 3.0 the average D50 of both parotid glands was slightly decreased. However, the average treatment time was increased 22.28%. For routine nasopharyngeal cancer patients with HT, we suggest the planning optimization parameters consist of FW=5.0 cm, PF=0.43 and MF=2.0.

  6. Dosimetric comparison of helical tomotherapy and dynamic conformal arc therapy in stereotactic radiosurgery for vestibular schwannomas.

    PubMed

    Lee, Tsair-Fwu; Chao, Pei-Ju; Wang, Chang-Yu; Lan, Jen-Hong; Huang, Yu-Je; Hsu, Hsuan-Chih; Sung, Chieh-Cheng; Su, Te-Jen; Lian, Shi-Long; Fang, Fu-Min

    2011-01-01

    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 index (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(3) (median 3.39 cm(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

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

    SciTech Connect

    Lee, Tsair-Fwu; Chao, Pei-Ju; Wang, Chang-Yu; Lan, Jen-Hong; Huang, Yu-Je; Hsu, Hsuan-Chih; Sung, Chieh-Cheng; Su, Te-Jen; Lian, Shi-Long; Fang, Fu-Min

    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 index (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

  8. An Attempted Substitute Study of Total Skin Electron Therapy Technique by Using Helical Photon Tomotherapy with Helical Irradiation of the Total Skin Treatment: A Phantom Result

    PubMed Central

    Lin, Chi-Ta; Tien, Hui-Ju; Yeh, Hsin-Pei

    2013-01-01

    An anthropomorphic phantom was used to investigate a treatment technique and analyze the dose distributions for helical irradiation of the total skin (HITS) by helical tomotherapy (HT). Hypothetical bolus of thicknesses of 0, 10, and 15 mm was added around the phantom body to account for the dose homogeneity and setup uncertainty. A central core structure was assigned as a “complete block” to force the dose tangential delivery. HITS technique with prescribed dose (D p) of 36 Gy in 36 fractions was generated. The radiochromic EBT2 films were used for the dose measurements. The target region with 95.0% of the D p received by more than 95% of the PTV was obtained. The calculated mean doses for the organs at risk (OARs) were 4.69, 3.10, 3.20, and 2.94 Gy for the lung, heart, liver, and kidneys, respectively. The measurement doses on a phantom surface for a plan with 10 mm hypothetical bolus and bolus thicknesses of 0, 1, 2, and 3 mm are 89.5%, 111.4%, 116.9%, and 117.7% of D p, respectively. HITS can provide an accurate and uniform treatment dose in the skin with limited doses to OARs and is safe to replace a total skin electron beam regimen. PMID:23984313

  9. An attempted substitute study of total skin electron therapy technique by using helical photon tomotherapy with helical irradiation of the total skin treatment: a phantom result.

    PubMed

    Lin, Chi-Ta; Shiau, An-Cheng; Tien, Hui-Ju; Yeh, Hsin-Pei; Shueng, Pei-Wei; Hsieh, Chen-Hsi

    2013-01-01

    An anthropomorphic phantom was used to investigate a treatment technique and analyze the dose distributions for helical irradiation of the total skin (HITS) by helical tomotherapy (HT). Hypothetical bolus of thicknesses of 0, 10, and 15 mm was added around the phantom body to account for the dose homogeneity and setup uncertainty. A central core structure was assigned as a "complete block" to force the dose tangential delivery. HITS technique with prescribed dose (D p ) of 36 Gy in 36 fractions was generated. The radiochromic EBT2 films were used for the dose measurements. The target region with 95.0% of the D p received by more than 95% of the PTV was obtained. The calculated mean doses for the organs at risk (OARs) were 4.69, 3.10, 3.20, and 2.94 Gy for the lung, heart, liver, and kidneys, respectively. The measurement doses on a phantom surface for a plan with 10 mm hypothetical bolus and bolus thicknesses of 0, 1, 2, and 3 mm are 89.5%, 111.4%, 116.9%, and 117.7% of D p , respectively. HITS can provide an accurate and uniform treatment dose in the skin with limited doses to OARs and is safe to replace a total skin electron beam regimen.

  10. Treatment of Single or Multiple Brain Metastases by Hypofractionated Stereotactic Radiotherapy Using Helical Tomotherapy

    PubMed Central

    Nagai, Aiko; Shibamoto, Yuta; Yoshida, Masanori; Wakamatsu, Koichi; Kikuchi, Yuzo

    2014-01-01

    This study investigated the clinical outcomes of a 4-fraction stereotactic radiotherapy (SRT) study using helical tomotherapy for brain metastases. Between August 2009 and June 2013, 54 patients with a total of 128 brain metastases underwent SRT using tomotherapy. A total dose of 28 or 28.8 Gy at 80% isodose was administered in 4 fractions for all tumors. The mean gross tumor volume (GTV) was 1.9 cc. Local control (LC) rates at 6, 12, and 18 months were 96%, 91%, and 88%, respectively. The 12-month LC rates for tumors with GTV ≤0.25, >0.25 and ≤1, and >1 cc were 98%, 82%, and 93%, respectively; the rates were 92% for tumors >3 cc and 100% for >10 cc. The 6-month rates for freedom from distant brain failure were 57%, 71%, and 55% for patients with 1, 2, and ≥3 brain metastases, respectively. No differences were significant. No major complications were observed. The 4-fraction SRT protocol provided excellent tumor control with minimal toxicity. Distant brain failure was not so frequent, even in patients with multiple tumors. The results of the current study warrant a prospective randomized study comparing single-fraction stereotactic radiosurgery (SRS) with SRT in this patient population. PMID:24758932

  11. A quality assurance tool for helical tomotherapy using a step-wedge phantom and the on-board MVCT detector.

    PubMed

    Althof, Vincent; van Haaren, Paul; Westendorp, Rik; Nuver, Tonnis; Kramer, Dinant; Ikink, Marijke; Bel, Arjen; Minken, Andre

    2012-01-05

    The purpose of this study was to develop and evaluate filmless quality assurance (QA) tools for helical tomotherapy by using the signals from the on-board megavoltage computed tomography (MVCT) detector and applying a dedicated step-wedge phantom. The step-wedge phantom is a 15 cm long step-like aluminum block positioned on the couch. The phantom was moved through the slit beam and MVCT detector signals were analyzed. Two QA procedures were developed, with gantry fixed at 0°: 1) step-wedge procedure: to check beam energy consistency, field width, laser alignment with respect to the virtual isocenter, couch movement, and couch velocity; and 2) completion procedure: to check the accuracy of a field abutment made by the tomotherapy system after a treatment interruption. The procedures were designed as constancy tool and were validated by measurement of deliberately induced variations and comparison with a reference method. Two Hi-Art II machines were monitored over a period of three years using the step-wedge procedures. The data acquisition takes 5 minutes. The analysis is fully automated and results are available directly after acquisition. Couch speed deviations up to 2% were induced. The mean absolute difference between expected and measured couch speed was 0.2% ± 0.2% (1 standard deviation SD). Field width was varied around the 10 mm nominal size, between 9.7 and 11.1 mm, in steps of 0.2 mm. Mean difference between the step-wedge analysis and the reference method was < 0.01 mm ± 0.03 mm (1 SD). Laser (mis)alignment relative to a reference situation was detected with 0.3 mm precision (1SD). The step-wedge profile was fitted to a PDD in water. The PDD ratio D20/D10, measured at depths of 20 cm and 10 cm, was used to check beam energy consistency. Beam energy variations were induced. Mean difference between step-wedge and water PDD ratios was 0.2% ± 0.3% (1SD). The completion procedure was able to reveal abutment mismatches with a mean error of -0.6 mm ± 0.2 mm

  12. SU-E-T-657: Quantitative Assessment of Plan Robustness for Helical Tomotherapy for Head and Neck Cancer Radiotherapy

    SciTech Connect

    Matney, J; Lian, J; Chera, B; Marks, L; Das, S; Chao, E

    2015-06-15

    Introduction: Geometric uncertainties in daily patient setup can lead to variations in the planned dose, especially when using highly conformal techniques such as helical Tomotherapy. To account for the potential effect of geometric uncertainty, our clinical practice is to expand critical structures by 3mm expansion into planning risk volumes (PRV). The PRV concept assumes the spatial dose cloud is insensitive to patient positioning. However, no tools currently exist to determine if a Tomotherapy plan is robust to the effects of daily setup variation. We objectively quantified the impact of geometric uncertainties on the 3D doses to critical normal tissues during helical Tomotherapy. Methods: Using a Matlab-based program created and validated by Accuray (Madison, WI), the planned Tomotherapy delivery sinogram recalculated dose on shifted CT datasets. Ten head and neck patients were selected for analysis. To simulate setup uncertainty, the patient anatomy was shifted ±3mm in the longitudinal, lateral and vertical axes. For each potential shift, the recalculated doses to various critical normal tissues were compared to the doses delivered to the PRV in the original plan Results: 18 shifted scenarios created from Tomotherapy plans for three patients with head and neck cancers were analyzed. For all simulated setup errors, the maximum doses to the brainstem, spinal cord, parotids and cochlea were no greater than 0.6Gy of the respective original PRV maximum. Despite 3mm setup shifts, the minimum dose delivered to 95% of the CTVs and PTVs were always within 0.4Gy of the original plan. Conclusions: For head and neck sites treated with Tomotherapy, the use of a 3mm PRV expansion provide a reasonable estimate of the dosimetric effects of 3mm setup uncertainties. Similarly, target coverage appears minimally effected by a 3mm setup uncertainty. Data from a larger number of patients will be presented. Future work will include other anatomical sites.

  13. Clinical benefits of new immobilization system for hypofractionated radiotherapy of intrahepatic hepatocellular carcinoma by helical tomotherapy.

    PubMed

    Hu, Yong; Zhou, Yong-Kang; Chen, Yi-Xing; Shi, Shi-Ming; Zeng, Zhao-Chong

    2017-01-01

    A comprehensive clinical evaluation was conducted, assessing the Body Pro-Lok immobilization and positioning system to facilitate hypofractionated radiotherapy of intrahepatic hepatocellular carcinoma (HCC), using helical tomotherapy to improve treatment precision. Clinical applications of the Body Pro-Lok system were investigated (as above) in terms of interfractional and intrafractional setup errors and compressive abdominal breath control. To assess interfractional setup errors, a total of 42 patients who were given 5 to 20 fractions of helical tomotherapy for intrahepatic HCC were analyzed. Overall, 15 patients were immobilized using simple vacuum cushion (group A), and the Body Pro-Lok system was used in 27 patients (group B), performing megavoltage computed tomography (MVCT) scans 196 times and 435 times, respectively. Pretreatment MVCT scans were registered to the planning kilovoltage computed tomography (KVCT) for error determination, and group comparisons were made. To establish intrafractional setup errors, 17 patients with intrahepatic HCC were selected at random for immobilization by Body Pro-Lok system, undergoing MVCT scans after helical tomotherapy every week. A total of 46 MVCT re-scans were analyzed for this purpose. In researching breath control, 12 patients, randomly selected, were immobilized by Body Pro-Lok system and subjected to 2-phase 4-dimensional CT (4DCT) scans, with compressive abdominal control or in freely breathing states, respectively. Respiratory-induced liver motion was then compared. Mean interfractional setup errors were as follows: (1) group A: X, 2.97 ± 2.47mm; Y, 4.85 ± 4.04mm; and Z, 3.77 ± 3.21mm; pitch, 0.66 ± 0.62°; roll, 1.09 ± 1.06°; and yaw, 0.85 ± 0.82°; and (2) group B: X, 2.23 ± 1.79mm; Y, 4.10 ± 3.36mm; and Z, 1.67 ± 1.91mm; pitch, 0.45 ± 0.38°; roll, 0.77 ± 0.63°; and yaw, 0.52 ± 0.49°. Between-group differences were statistically significant in 6 directions (p < 0.05). Mean intrafractional setup

  14. Helical tomotherapy of spinal chordomas: French Multicentric, retrospective study of a cohort of 30 cases.

    PubMed

    Bobin, Maxime; Zacharatou, Christina; Sargos, Paul; Brouste, Véronique; Lisbona, Albert; Mahé, Marc-André; Noël, Georges; Halley, Amandine; Feuvret, Loïc; Gras, Louis; Hoppe, Stéphanie; de Figueiredo, Bénédicte Henriques; Kantor, Guy

    2017-01-31

    To evaluate the efficacy and toxicity of helical tomotherapy (HT) in the management of spine chordomas when proton therapy is unavailable or non-feasible. Between 2007 and 2013, 30 patients with biopsy-proven chordomas were treated by HT in five French institutions. Information regarding local control (LC), overall survival (OS), progression-free survival (PFS) and metastasis-free survival (MFS) was collected. Clinical efficacy, toxicity and treatment quality were evaluated. Two-year actuarial LC, OS, PFS and MFS were 69.9%, 96.7%, 61.2% and 76.4%, respectively. HT treatments were well tolerated and no Grade 4-5 toxicities were observed. HT permitted the delivery of a mean dose of 68 Gy while respecting organ at risk (OAR) dose constraints, in particular in the spinal cord and cauda equina. This multicentric, retrospective study demonstrated the feasibility of HT in the treatment of spine chordomas, in the absence of hadron therapy.

  15. High-dose Helical Tomotherapy With Concurrent Full-dose Chemotherapy for Locally Advanced Pancreatic Cancer

    SciTech Connect

    Chang, Jee Suk; Wang, Michael L.C.; Koom, Woong Sub; Yoon, Hong In; Chung, Yoonsun; Song, Si Young; Seong, Jinsil

    2012-08-01

    Purpose: To improve poor therapeutic outcome of current practice of chemoradiotherapy (CRT), high-dose helical tomotherapy (HT) with concurrent full-dose chemotherapy has been performed on patients with locally advanced pancreatic cancer (LAPC), and the results were analyzed. Methods and Materials: We retrospectively reviewed 39 patients with LAPC treated with radiotherapy using HT (median, 58.4 Gy; range, 50.8-59.9 Gy) and concomitant chemotherapy between 2006 and 2009. Radiotherapy was directed to the primary tumor with a 0.5-cm margin without prophylactic nodal coverage. Twenty-nine patients (79%) received full-dose (1000 mg/m{sup 2}) gemcitabine-based chemotherapy during HT. After completion of CRT, maintenance chemotherapy was administered to 37 patients (95%). Results: The median follow-up was 15.5 months (range, 3.4-43.9) for the entire cohort, and 22.5 months (range, 12.0-43.9) for the surviving patients. The 1- and 2-year local progression-free survival rates were 82.1% and 77.3%, respectively. Eight patients (21%) were converted to resectable status, including 1 with a pathological complete response. The median overall survival and progression-free survival were 21.2 and 14.0 months, respectively. Acute toxicities were acceptable with no gastrointestinal (GI) toxicity higher than Grade 3. Severe late GI toxicity ({>=}Grade 3) occurred in 10 patients (26%); 1 treatment-related death from GI bleeding was observed. Conclusion: High-dose helical tomotherapy with concurrent full-dose chemotherapy resulted in improved local control and long-term survival in patients with LAPC. Future studies are needed to widen the therapeutic window by minimizing late GI toxicity.

  16. Helical Tomotherapy Planning for Left-Sided Breast Cancer Patients With Positive Lymph Nodes: Comparison to Conventional Multiport Breast Technique

    SciTech Connect

    Goddu, S. Murty Chaudhari, Summer; Mamalui-Hunter, Maria; Pechenaya, Olga L.; Pratt, David; Mutic, Sasa; Zoberi, Imran; Jeswani, Sam; Powell, Simon N.; Low, Daniel A.

    2009-03-15

    Purpose: To evaluate the feasibility of using helical tomotherapy for locally advanced left-sided breast cancer. Methods and Materials: Treatment plans were generated for 10 left-sided breast cancer patients with positive lymph nodes comparing a multiport breast (three-dimensional) technique with the tomotherapy treatment planning system. The planning target volumes, including the chest wall/breast, supraclavicular, axillary, and internal mammary lymph nodes, were contoured. The treatment plans were generated on the tomotherapy treatment planning system to deliver 50.4 Gy to the planning target volume. To spare the contralateral tissues, directional blocking was applied to the right breast and right lung. The optimization goals were to protect the lungs, heart, and right breast. Results: The tomotherapy plans increased the minimal dose to the planning target volume (minimal dose received by 99% of target volume = 46.2 {+-} 1.3 Gy vs. 27.9 {+-} 17.1 Gy) while improving the dose homogeneity (dose difference between the minimal dose received by 5% and 95% of the planning target volume = 7.5 {+-} 1.8 Gy vs. 37.5 {+-} 26.9 Gy). The mean percentage of the left lung volume receiving {>=}20 Gy in the tomotherapy plans decreased from 32.6% {+-} 4.1% to 17.6% {+-} 3.5%, while restricting the right-lung mean dose to <5 Gy. However, the mean percentage of volume receiving {>=}5 Gy for the total lung increased from 25.2% {+-} 4.2% for the three-dimensional technique to 46.9% {+-} 8.4% for the tomotherapy plan. The mean volume receiving {>=}35 Gy for the heart decreased from 5.6% {+-} 4.8% to 2.2% {+-} 1.5% in the tomotherapy plans. However, the mean heart dose for tomotherapy delivery increased from 7.5 {+-} 3.4 Gy to 12.2 {+-} 1.8 Gy. Conclusion: The tomotherapy plans provided better dose conformity and homogeneity than did the three-dimensional plans for treatment of left-sided breast tumors with regional lymph node involvement, while allowing greater sparing of the heart and

  17. Helical tomotherapy planning for left-sided breast cancer patients with positive lymph nodes: comparison to conventional multiport breast technique.

    PubMed

    Goddu, S Murty; Chaudhari, Summer; Mamalui-Hunter, Maria; Pechenaya, Olga L; Pratt, David; Mutic, Sasa; Zoberi, Imran; Jeswani, Sam; Powell, Simon N; Low, Daniel A

    2009-03-15

    To evaluate the feasibility of using helical tomotherapy for locally advanced left-sided breast cancer. Treatment plans were generated for 10 left-sided breast cancer patients with positive lymph nodes comparing a multiport breast (three-dimensional) technique with the tomotherapy treatment planning system. The planning target volumes, including the chest wall/breast, supraclavicular, axillary, and internal mammary lymph nodes, were contoured. The treatment plans were generated on the tomotherapy treatment planning system to deliver 50.4 Gy to the planning target volume. To spare the contralateral tissues, directional blocking was applied to the right breast and right lung. The optimization goals were to protect the lungs, heart, and right breast. The tomotherapy plans increased the minimal dose to the planning target volume (minimal dose received by 99% of target volume = 46.2 +/- 1.3 Gy vs. 27.9 +/- 17.1 Gy) while improving the dose homogeneity (dose difference between the minimal dose received by 5% and 95% of the planning target volume = 7.5 +/- 1.8 Gy vs. 37.5 +/- 26.9 Gy). The mean percentage of the left lung volume receiving >or=20 Gy in the tomotherapy plans decreased from 32.6% +/- 4.1% to 17.6% +/- 3.5%, while restricting the right-lung mean dose to <5 Gy. However, the mean percentage of volume receiving >or=5 Gy for the total lung increased from 25.2% +/- 4.2% for the three-dimensional technique to 46.9% +/- 8.4% for the tomotherapy plan. The mean volume receiving >or=35 Gy for the heart decreased from 5.6% +/- 4.8% to 2.2% +/- 1.5% in the tomotherapy plans. However, the mean heart dose for tomotherapy delivery increased from 7.5 +/- 3.4 Gy to 12.2 +/- 1.8 Gy. The tomotherapy plans provided better dose conformity and homogeneity than did the three-dimensional plans for treatment of left-sided breast tumors with regional lymph node involvement, while allowing greater sparing of the heart and left lung from doses associated with increased complications.

  18. A motion phantom study on helical tomotherapy: the dosimetric impacts of delivery technique and motion

    NASA Astrophysics Data System (ADS)

    Kanagaki, Brian; Read, Paul W.; Molloy, Janelle A.; Larner, James M.; Sheng, Ke

    2007-01-01

    Helical tomotherapy (HT) can potentially be used for lung cancer treatment including stereotactic radiosurgery because of its advanced image guidance and its ability to deliver highly conformal dose distributions. However, previous theoretical and simulation studies reported that the effect of respiratory motion on statically planned tomotherapy treatments may cause substantial differences between the calculated and actual delivered radiation isodose distribution, particularly when the treatment is hypofractionated. In order to determine the dosimetric effects of motion upon actual HT treatment delivery, phantom film dosimetry measurements were performed under static and moving conditions using a clinical HT treatment unit. The motion phantom system was constructed using a programmable motor, a base, a moving platform and a life size lung heterogeneity phantom with wood inserts representing lung tissue with a 3.0 cm diameter spherical tumour density equivalent insert. In order to determine the effects of different motion and tomotherapy delivery parameters, treatment plans were created using jaw sizes of 1.04 cm and 2.47 cm, with incremental gantry rotation periods between the minimum allowed (10 s) and the maximum allowed (60 s). The couch speed varied from 0.009 cm s-1 to 0.049 cm s-1, and delivered to a phantom under static and dynamic conditions with peak-to-peak motion amplitudes of 1.2 cm and 2 cm and periods of 3 and 5 s to simulate human respiratory motion of lung tumours. A cylindrical clinical target volume (CTV) was contoured to tightly enclose the tumour insert. 2.0 Gy was prescribed to 95% of the CTV. Two-dimensional dose was measured by a Kodak EDR2 film. Dynamic phantom doses were then quantitatively compared to static phantom doses in terms of axial dose profiles, cumulative dose volume histograms (DVH), percentage of CTV receiving the prescription dose and the minimum dose received by 95% of the CTV. The larger motion amplitude resulted in more

  19. Fractionated Helical Tomotherapy as an alternative to radiosurgery in patients unwilling to undergo additional radiosurgery for recurrent brain metastases

    PubMed Central

    Sanghera, P; Lightstone, A W; Hyde, D E; Davey, P

    2010-01-01

    Our clinic routinely treats brain metastases with stereotactic radiosurgery using a 6 megavoltage (MV) linear accelerator, cones, and a surgically attached head frame. Four patients declined repeat radiosurgery for new lesions due to their previous discomfort and a fifth patient could not complete radiosurgery because of uncontrolled nausea. Instead patients were treated with Helical Tomotherapy (HT). This report discusses the spatial dose distribution of HT as measured in a head phantom and the clinical course of these five patients. The planning target volume (PTV) was a 3 mm geometric expansion of the gross tumour volume (GTV). The prescribed dose to the PTV was 27 Gy in five daily fractions with the distribution optimised to deliver 30 Gy to the GTV. Patients were immobilised with a mask and the lesions were targeted by MV computerised tomography, an inherent feature of the system. One patient died six weeks later from systemic disease; the remaining patients survived eight to 16 months. No patient experienced an exacerbation of neurological symptoms following Helical Tomotherapy. These results suggest that fractionated Helical Tomotherapy for brain metastases may be a viable alternative to radiosurgery in patients unable or unwilling to undergo that procedure. PMID:20139253

  20. SU-E-J-203: Reconstruction of the Treatment Area by Use of Sinogram in Helical Tomotherapy

    SciTech Connect

    Haga, A; Nakagawa, K; Ida, S; Sakata, D; Magome, T; Nakano, M; Masutani, Y; Maurer, C; Ruchala, K; Chao, E; Casey, D

    2014-06-01

    Purpose: TomoTherapy (Accuray Co.) has an image-guided radiotherapy system with megavoltage (MV) X-ray source and the on-board imaging device. With the MV computed tomography (MVCT), it became feasible to perform the efficient daily-3D registration of the patient position before each treatment delivery. This system also allows one to acquire the delivery sinogram during the actual treatment, which partly includes the information of the irradiated object. In this study, we try to develop the image reconstruction during treatment in helical Tomotherapy. Methods: Sinogram data were acquired during helical Tomotherapy delivery using an arc-shaped detector array that consists of 738 xenon-gas filled detector cells. In preprocessing, these were normalized by full air-scan data. A software program was developed that reconstructs 3D images during treatment with corrections as; (1) the regions outside the field were masked not to be added in the backprojection (a masking correction), and (2) each voxel of the reconstructed image was divided by the number of the X-ray passing through its voxel (a ray-passing correction). Results: Without masking and ray-passing corrections, the image reconstruction was failed. The masking correction made the image clear, however, the streak artifact was accompanied. The ray-passing correction reduced this artifact. Although the SNR (the ratio of mean to standard deviation in homogeneous region) and the contrast of the reconstructed image were slightly improved with the ray-passing correction, the masking correction only is enough for the visualization purpose. Conclusion: The visualization of the treatment area was feasible by use of the sinogram in helical Tomotherapy. This proposed method can be utilized in the treatment verification. This work was partly supported by JSPS KAKENHI 24234567. No COI, but the data in this paper were prepared by collaborators in Accuray.

  1. Megavoltage Computed Tomography Image Guidance With Helical Tomotherapy in Patients With Vertebral Tumors: Analysis of Factors Influencing Interobserver Variability

    SciTech Connect

    Levegruen, Sabine; Poettgen, Christoph; Abu Jawad, Jehad; Berkovic, Katharina; Hepp, Rodrigo; Stuschke, Martin

    2013-02-01

    Purpose: To evaluate megavoltage computed tomography (MVCT)-based image guidance with helical tomotherapy in patients with vertebral tumors by analyzing factors influencing interobserver variability, considered as quality criterion of image guidance. Methods and Materials: Five radiation oncologists retrospectively registered 103 MVCTs in 10 patients to planning kilovoltage CTs by rigid transformations in 4 df. Interobserver variabilities were quantified using the standard deviations (SDs) of the distributions of the correction vector components about the observers' fraction mean. To assess intraobserver variabilities, registrations were repeated after {>=}4 weeks. Residual deviations after setup correction due to uncorrectable rotational errors and elastic deformations were determined at 3 craniocaudal target positions. To differentiate observer-related variations in minimizing these residual deviations across the 3-dimensional MVCT from image resolution effects, 2-dimensional registrations were performed in 30 single transverse and sagittal MVCT slices. Axial and longitudinal MVCT image resolutions were quantified. For comparison, image resolution of kilovoltage cone-beam CTs (CBCTs) and interobserver variability in registrations of 43 CBCTs were determined. Results: Axial MVCT image resolution is 3.9 lp/cm. Longitudinal MVCT resolution amounts to 6.3 mm, assessed as full-width at half-maximum of thin objects in MVCTs with finest pitch. Longitudinal CBCT resolution is better (full-width at half-maximum, 2.5 mm for CBCTs with 1-mm slices). In MVCT registrations, interobserver variability in the craniocaudal direction (SD 1.23 mm) is significantly larger than in the lateral and ventrodorsal directions (SD 0.84 and 0.91 mm, respectively) and significantly larger compared with CBCT alignments (SD 1.04 mm). Intraobserver variabilities are significantly smaller than corresponding interobserver variabilities (variance ratio [VR] 1.8-3.1). Compared with 3-dimensional

  2. Reference dosimetry for helical tomotherapy: Practical implementation and a multicenter validation

    SciTech Connect

    De Ost, B.; Schaeken, B.; Vynckier, S.; Sterpin, E.; Van den Weyngaert, D.

    2011-11-15

    Purpose: The aim of this study was to implement a protocol for reference dosimetry in tomotherapy and to validate the beam output measurements with an independent dosimetry system. Methods: Beam output was measured at the reference depth of 10 cm in water for the following three cases: (1) a 5 x 10 cm{sup 2} static machine specific reference field (MSR), (2) a rotational 5 x 10 cm{sup 2} field without modulation and no tabletop in the beam, (3) a plan class specific reference (PCSR) field defined as a rotational homogeneous dose delivery to a cylindrical shaped target volume: plan with modulation and table-top movement. The formalism for reference dosimetry of small and nonstandard fields [Med.Phys.35: 5179-5186, 2008] and QA recommendations [Med.Phys.37: 4817-4853, 2010] were adopted in the dose measurement protocol. All ionization chamber measurements were verified independently using alanine/EPR dosimetry. As a pilot study, the beam output was measured on tomotherapy Hi-art systems at three other centers and directly compared to the centers specifications and to alanine dosimetry. Results: For the four centers, the mean static output at a depth of 10 cm in water and SAD = 85 cm, measured with an A1SL chamber following the TG-148 report was 6.238 Gy/min {+-} 0.058 (1 SD); the rotational output was 6.255 Gy/min {+-} 0.069 (1 SD). The dose stated by the center was found in good agreement with the measurements of the visiting team: D{sub center}/D{sub visit} = 1.000 {+-} 0.003 (1 SD). The A1SL chamber measurements were all in good agreement with Alanine/EPR dosimetry. Going from the static reference field to the rotational/non modulated field the dose rate remains constant within 0.2% except for one center where a deviation of 1.3% was detected. Conclusions: Following the TG-148 report, beam output measurements in water at the reference depth using a local protocol, as developed at different centers, was verified. The measurements were found in good agreement with

  3. An automatic dose verification system for adaptive radiotherapy for helical tomotherapy

    NASA Astrophysics Data System (ADS)

    Mo, Xiaohu; Chen, Mingli; Parnell, Donald; Olivera, Gustavo; Galmarini, Daniel; Lu, Weiguo

    2014-03-01

    Purpose: During a typical 5-7 week treatment of external beam radiotherapy, there are potential differences between planned patient's anatomy and positioning, such as patient weight loss, or treatment setup. The discrepancies between planned and delivered doses resulting from these differences could be significant, especially in IMRT where dose distributions tightly conforms to target volumes while avoiding organs-at-risk. We developed an automatic system to monitor delivered dose using daily imaging. Methods: For each treatment, a merged image is generated by registering the daily pre-treatment setup image and planning CT using treatment position information extracted from the Tomotherapy archive. The treatment dose is then computed on this merged image using our in-house convolution-superposition based dose calculator implemented on GPU. The deformation field between merged and planning CT is computed using the Morphon algorithm. The planning structures and treatment doses are subsequently warped for analysis and dose accumulation. All results are saved in DICOM format with private tags and organized in a database. Due to the overwhelming amount of information generated, a customizable tolerance system is used to flag potential treatment errors or significant anatomical changes. A web-based system and a DICOM-RT viewer were developed for reporting and reviewing the results. Results: More than 30 patients were analysed retrospectively. Our in-house dose calculator passed 97% gamma test evaluated with 2% dose difference and 2mm distance-to-agreement compared with Tomotherapy calculated dose, which is considered sufficient for adaptive radiotherapy purposes. Evaluation of the deformable registration through visual inspection showed acceptable and consistent results, except for cases with large or unrealistic deformation. Our automatic flagging system was able to catch significant patient setup errors or anatomical changes. Conclusions: We developed an automatic dose

  4. Implant breast reconstruction followed by radiotherapy: Can helical tomotherapy become a standard irradiation treatment?

    SciTech Connect

    Massabeau, Carole; Fournier-Bidoz, Nathalie; Wakil, Georges; Castro Pena, Pablo; Viard, Romain; Zefkili, Sofia; Reyal, Fabien; Campana, Francois; Fourquet, Alain; Kirova, Youlia M.

    2012-01-01

    To evaluate the benefits and limitations of helical tomotherapy (HT) for loco-regional irradiation of patients after a mastectomy and immediate implant-based reconstruction. Ten breast cancer patients with retropectoral implants were randomly selected for this comparative study. Planning target volumes (PTVs) 1 (the volume between the skin and the implant, plus margin) and 2 (supraclavicular, infraclavicular, and internal mammary nodes, plus margin) were 50 Gy in 25 fractions using a standard technique and HT. The extracted dosimetric data were compared using a 2-tailed Wilcoxon matched-pair signed-rank test. Doses for PTV1 and PTV2 were significantly higher with HT (V95 of 98.91 and 97.91%, respectively) compared with the standard technique (77.46 and 72.91%, respectively). Similarly, the indexes of homogeneity were significantly greater with HT (p = 0.002). HT reduced ipsilateral lung volume that received {>=}20 Gy (16.7 vs. 35%), and bilateral lungs (p = 0.01) and neighboring organs received doses that remained well below tolerance levels. The heart volume, which received 25 Gy, was negligible with both techniques. HT can achieve full target coverage while decreasing high doses to the heart and ipsilateral lung. However, the low doses to normal tissue volumes need to be reduced in future studies.

  5. Image-guided radiation therapy based on helical tomotherapy in prostate cancer: minimizing toxicity.

    PubMed

    Acevedo-Henao, Catalina M; Lopez Guerra, Jose L; Matute, Raul; Puebla, Fernando; Russo, Moises; Rivin, Eleonor; Sanchez-Reyes, Alberto; Ortiz, M José; Azinovic, Ignacio

    2014-01-01

    We report the clinical results and prognostic factors of image-guided radiation therapy (RT) with helical tomotherapy (HT) for localized and recurrent prostate cancer (PC). We evaluated 70 patients with PC (primary diagnosis, n = 48; adjuvant, n = 5; salvage, n = 17) treated with HT from May 2006 through January 2011. The dose prescribed to the prostate/surgical bed ranged between 60 and 78 Gy. Potential risk factors for genitourinary (GU) and gastrointestinal (GI) toxicity were assessed. The median age was 68 years (range 51-87 years). The median follow-up was 37 months (range 3-74 months). The rates of acute grade 2 GI and GU toxicities were 10 and 13%, respectively. Only 1 patient experienced acute grade 3 GU toxicity. The rates of late grade ≥ 2 GI and GU toxicities were 1% each. Multivariate analysis showed an association between rectum mean dose > median (39 Gy) and bladder median dose > median (46 Gy) with a higher grade of acute GI (p = 0.017) and GU (p = 0.019) toxicity, respectively. Additionally, older age was associated with late GU toxicity (p = 0.026). Toxicity with HT is low and is associated with higher median/mean doses in organs at risk as well as with older age. A prospective validation would be necessary to confirm these results. © 2014 S. Karger GmbH, Freiburg.

  6. Intra-fraction respiratory motion and baseline drift during breast Helical Tomotherapy.

    PubMed

    Ricotti, Rosalinda; Ciardo, Delia; Fattori, Giovanni; Leonardi, Maria Cristina; Morra, Anna; Dicuonzo, Samantha; Rojas, Damaris Patricia; Pansini, Floriana; Cambria, Raffaella; Cattani, Federica; Gianoli, Chiara; Spinelli, Chiara; Riboldi, Marco; Baroni, Guido; Orecchia, Roberto; Jereczek-Fossa, Barbara Alicja

    2017-01-01

    To investigate the intra-fraction breast motion during long-lasting treatments of breast cancer with Helical Tomotherapy by means of an optical tracking system. A set of seven radio-transparent passive markers was placed on the thoraco-abdominal surface of twenty breast cancer patients and tracked by an infrared tracking system. A continuous non-invasive monitoring of intra-fraction motion from patient setup verification and correction to the end of radiation delivery was thus obtained. The measured displacements were analysed in terms of cyclic respiratory motion and slow baseline drift. The average monitoring time per patient was 15.57min. The breathing amplitude of the chest was less than 2mm, on average, along all anatomical directions. The baseline drift of the body led to more significant setup uncertainties than the respiratory motion. The main intra-fraction baseline drifts were in posterior and inferior directions and occurred within the first eight minutes of monitoring. Considering the intra-fraction motion only, the resultant clinical-to-planning target volume safety margins are highly patient-specific and largely anisotropic. The non-respiratory motion occurring during prolonged treatments induces notable uncertainties. Non-invasive continuous monitoring of patient setup variations including baseline drifts is recommended in order to minimize dosimetric deviations, which might jeopardize the therapeutic ratio between target coverage and the sparing of organs at risk. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. A study of longitudinal tumor motion in helical tomotherapy using a cylindrical phantom.

    PubMed

    Klein, Michael; Gaede, Stewart; Yartsev, Slav

    2013-03-04

    Tumor motion during radiation treatment on a helical tomotherapy unit may create problems due to interplay with motion of the multileaf collimator, gantry rotation, and patient couch translation through the gantry. This study evaluated this interplay effect for typical clinical parameters using a cylindrical phantom consisting of 1386 diode detectors placed on a respiratory motion platform. All combinations of radiation field widths (1, 2.5, and 5 cm) and gantry rotation periods (16, 30, and 60 s) were considered for sinusoidal motions with a period of 4 s and amplitudes of 5, 6, 7, 8, 9, and 10 mm, as well as real patient breathing pattern. Gamma comparisons with 2% dose difference and 2 mm distance to agreement and dose profiles were used for evaluation. The required motion margins were determined for each set of parameters. The required margin size increased with decreasing field width and increasing tumor motion amplitude, but was not affected by rotation period. The plans with the smallest field width of 1 cm have required motion margins approximately equal to the amplitude of motion (± 25%), while those with the largest field width of 5 cm had required motion margins approximately equal to 20% of the motion amplitude (± 20%). For tumor motion amplitudes below 6 mm and field widths above 1 cm, the required additional motion margins were very small, at a maximum of 2.5 mm for sinusoidal breathing patterns and 1.2 mm for the real patient breathing pattern.

  8. Tumor cell survival dependence on helical tomotherapy, continuous arc and segmented dose delivery

    NASA Astrophysics Data System (ADS)

    Yang, Wensha; Wang, Li; Larner, James; Read, Paul; Benedict, Stan; Sheng, Ke

    2009-11-01

    The temporal pattern of radiation delivery has been shown to influence the tumor cell survival fractions for the same radiation dose. To study the effect more specifically for state of the art rotational radiation delivery modalities, 2 Gy of radiation dose was delivered to H460 lung carcinoma, PC3 prostate cancer cells and MCF-7 breast tumor cells by helical tomotherapy (HT), seven-field LINAC (7F), and continuous dose delivery (CDD) over 2 min that simulates volumetric rotational arc therapy. Cell survival was measured by the clonogenic assay. The number of viable H460 cell colonies was 23.2 ± 14.4% and 27.7 ± 15.6% lower when irradiated by CDD compared with HT and 7F, respectively, and the corresponding values were 36.8 ± 18.9% and 35.3 ± 18.9% lower for MCF7 cells (p < 0.01). The survival of PC3 was also lower when irradiated by CDD than by HT or 7F but the difference was not as significant (p = 0.06 and 0.04, respectively). The higher survival fraction from HT delivery was unexpected because 90% of the 2 Gy was delivered in less than 1 min at a significantly higher dose rate than the other two delivery techniques. The results suggest that continuous dose delivery at a constant dose rate results in superior in vitro tumor cell killing compared with prolonged, segmented or variable dose rate delivery.

  9. Dosimetric comparison of stereotactic body radiotherapy for spinal metastasis in cyberknife and helical tomotherapy

    NASA Astrophysics Data System (ADS)

    Kang, Young-nam; Kay, Chul Seung; Son, Seok Hyun; Choi, Byung Ock; Jung, Ji-Young; Shin, Hun-Joo; Kay, Chul Seung; Son, Seok Hyun; Kim, Myong Ho; Seo, Jae-Hyuk; Lee, Gi Woong

    2012-12-01

    This study seeks to evaluate the stereotactic body radiation therapy (SBRT) dosimetric benefit of cyberknife (CK) and helical tomotherapy (HT) for spinal tumor patients in regards to successful plan acceptance and lower dosage to critical structures. This study used dose volume histogram (DVH) compared the two systems quantitatively, by using several indices for the dosimetric comparisons, including the conformity index (CI) and homogeneity index (HI) for the planned target volume (PTV). We planned L3 (n = 2), L5 (n = 1), T12 (n = 1), C3 (n = 1), and T5 (n = 1) spinal tumors case with planning target volumes ranging from 3.55-17.95 cc. Prescription doses were 1600 ˜ 2000 cGy per single fraction. CK prescribed 80 ˜ 85% in PTV and HT 90 ˜ 95%, respectively. The dosimetric data were compared between the two treatment systems by calculating the CI, HI, and maximum doses to the OARs based on the treatment plans, generated for each site. Regarding the homogeneity of PTV, both plans gave satisfactory results, and no significant differences were observed. The partial volume tolerance dose (received dose of 10 Gy at a spinal cord volume 10%) to the spinal cord in 16 ˜ 18 Gy single fraction was satisfactory. We found that both planning systems satisfied the required PTV prescription, but better dose conformity and better dose homogeneity with a poorer dose gradient were achieved with HT then with CK.

  10. Helical Tomotherapy Planning for Lung Cancer Based on Ventilation Magnetic Resonance Imaging

    SciTech Connect

    Cai Jing; McLawhorn, Robert; Altes, Tallisa A.; Lange, Eduard de; Read, Paul W.; Larner, James M.; Benedict, Stanley H.; Sheng Ke

    2011-01-01

    To investigate the feasibility of lung ventilation-based treatment planning, computed tomography and hyperpolarized (HP) helium-3 (He-3) magnetic resonance imaging (MRI) ventilation images of 6 subjects were coregistered for intensity-modulated radiation therapy planning in Tomotherapy. Highly-functional lungs (HFL) and less-functional lungs (LFL) were contoured based on their ventilation image intensities, and a cylindrical planning-target-volume was simulated at locations adjacent to both HFL and LFL. Annals of an anatomy-based plan (Plan 1) and a ventilation-based plan (Plan 2) were generated. The following dosimetric parameters were determined and compared between the 2 plans: percentage of total/HFL volume receiving {>=}20 Gy, 15 Gy, 10 Gy, and 5 Gy (TLV{sub 20}, HFLV{sub 20}, TLV{sub 15}, HFLV{sub 15}, TLV{sub 10}, HFLV{sub 10}, TLV{sub 5}, HFLV{sub 5}), mean total/HFL dose (MTLD/HFLD), maximum doses to all organs at risk (OARs), and target dose conformality. Compared with Plan 1, Plan 2 reduced mean HFLD (mean reduction, 0.8 Gy), MTLD (mean reduction, 0.6 Gy), HFLV{sub 20} (mean reduction, 1.9%), TLV{sub 20} (mean reduction, 1.5%), TLV{sub 15} (mean reduction, 1.7%), and TLV{sub 10} (mean reduction, 2.1%). P-values of the above comparisons are less than 0.05 using the Wilcoxon signed rank test. For HFLV{sub 15}, HFLV{sub 10}, TLV{sub 5}, and HTLV{sub 5}, Plan 2 resulted in lower values than plan 1 but the differences are not significant (P-value range, 0.063-0.219). Plan 2 did not significantly change maximum doses to OARs (P-value range, 0.063-0.563) and target conformality (P = 1.000). HP He-3 MRI of patients with lung disease shows a highly heterogeneous ventilation capacity that can be utilized for functional treatment planning. Moderate but statistically significant improvements in sparing functional lungs were achieved using helical tomotherapy plans.

  11. Acute Toxicity From Breast Cancer Radiation Using Helical Tomotherapy With a Simultaneous Integrated Boost.

    PubMed

    Wojcieszynski, Andrzej P; Olson, Anna K; Rong, Yi; Kimple, Randall J; Yadav, Poonam

    2016-04-01

    To evaluate 2 simultaneous integrated boost treatment planning techniques using helical tomotherapy for breast conserving therapy with regard to acute skin toxicity and dosimetry. Thirty-two patients were studied. The original approach was for 16 patients and incorporated a directional block of the ipsilateral lung and breast. An additional 16 patients were planned for using a modified approach that incorporates a full block of the ipsilateral lung exclusive of 4 cm around the breast. Dose-volume histograms of targets and critical structures were evaluated. Skin toxicity monitoring was performed throughout treatment and follow-up using the Common Terminology Criteria for Adverse Events. Treatment was well tolerated with patients receiving a median dose of 59.36 Gy. Of the 16 patients in both groups, 8 had grade 2 erythema immediately after radiation. On 3-week follow-up, 10 and 7 patients in the original and modified groups showed grade 1 erythema. On 3- and 6-month follow-up, both groups had minimal erythema, with all patients having either grade 0 or 1 symptoms. No grade 2 or 3 toxicities were reported. Mean treatment time was 7.5 and 10.4 minutes using the original and modified methods. Adequate dose coverage was achieved using both methods (V95 = 99.5% and 98%). Mean dose to the heart was 10.5 and 1.8 Gy, respectively (P < .01). For right-sided tumors, the original and modified plans yielded a mean of 8.8 and 1.1 Gy (P < .01) versus 11.7 and 2.4 Gy for left-sided tumors (P < .01). The mean dose to the ipsilateral lung was also significantly lower in the modified plans (11.8 vs. 5.0 Gy, P < .01). Tomotherapy is capable of delivering homogeneous treatment plans to the whole breast and lumpectomy cavity using simultaneous integrated boost treatment. Using the treatment methods described herein, extremely low doses to critical structures can be achieved without compromising acute skin toxicity. © The Author(s) 2015.

  12. Dosimetric evaluation of a three-phase adaptive radiotherapy for nasopharyngeal carcinoma using helical tomotherapy

    SciTech Connect

    Fung, Winky Wing Ki; Wu, Vincent Wing Cheung; Teo, Peter Man Lung

    2012-04-01

    helical tomotherapy of NPC.

  13. Salivary gland-sparing helical tomotherapy for head and neck cancer: Preserved salivary function on quantitative salivary gland scintigraphy after tomotherapy.

    PubMed

    Kreps, S; Berges, O; Belin, L; Zefkili, S; Petras, S; Giraud, P

    2016-09-01

    Prospective evaluation of salivary gland preservation, overall survival and local recurrence-free survival after head and neck cancer treated by helical tomotherapy (HT). From March 2007 to February 2009, 30 patients with head and neck cancer were treated by HT. The salivary excretion fraction (SEF) was assessed by technetium salivary gland scintigraphy before, and 6, 12 and 18 months after HT to define salivary gland preservation rates. Patients were reviewed every 3 months to assess clinical toxicity. The median follow-up was 4.3 years. The mean dose to the ipsilateral parotid gland (IPG) was 25.4Gy. Good preservation of parotid gland function was observed in 84% of the 19 patients evaluated by scintigraphy at 18 months. The 5-year local recurrence-free survival (LRFS) was 100% among the 6 patients who received a dose of more than 26Gy to the parotid gland. The 28-month LRFS was 33% in the group that received a dose of less than 20Gy versus 91% in the group that received a dose of more than 20Gy to the IPG. Helical tomotherapy reduced the incidence and severity of xerostomia. A mean dose to the parotid between 20 and 26Gy allowed preservation of salivary function without compromising treatment efficacy. However, parotid-sparing HT requiring a mean dose less than 20Gy is associated with an increased risk of recurrence. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Dosimetric Comparison of Helical Tomotherapy and Linac-IMRT Treatment Plans for Head and Neck Cancer Patients

    SciTech Connect

    Zhang Xin; Penagaricano, Jose; Moros, Eduardo G.; Corry, Peter M.; Yan Yulong; Ratanatharathorn, Vaneerat

    2010-01-01

    The rapid development and clinical implementation of external beam radiation treatment technologies continues. The existence of various commercially available technologies for intensity-modulated radiation therapy (IMRT) has stimulated interest in exploring the differential potential advantage one may have compared with another. Two such technologies, Hi-Art Helical Tomotherapy (HT) and conventional medical linear accelerator-based IMRT (LIMRT) have been shown to be particularly suitable for the treatment of head and neck cancers. In this study, 23 patients who were diagnosed with stages 3 or 4 head and neck cancers, without evidence of distance metastatic disease, were treated in our clinic. Treatment plans were developed for all patients simultaneously on the HT planning station and on the Pinnacle treatment planning system for step-and-shoot IMRT. Patients were treated only on the HT unit, with the LIMRT plan serving as a backup in case the HT system might not be available. All plans were approved for clinical use by a physician. The prescription was that patients receive at least 95% of the planning target volume (PTV), which is 66 Gy at 2.2 Gy per fraction. Several dosimetric parameters were computed: PTV dose coverage; PTV volume conformity index; the normalized total dose (NTD), where doses were converted to 2 Gy per fraction to organs at risk (OAR); and PTV dose homogeneity. Both planning systems satisfied our clinic's PTV prescription requirements. The results suggest that HT plans had, in general, slightly better dosimetric characteristics, especially regarding PTV dose homogeneity and normal tissue sparing. However, for both techniques, doses to OAR were well below the currently accepted normal tissue tolerances. Consequently, factors other than the dosimetric parameters studied here may have to be considered when making a choice between IMRT techniques.

  15. Dosimetric Study and Verification of Total Body Irradiation Using Helical Tomotherapy and its Comparison to Extended SSD Technique

    SciTech Connect

    Zhuang, Audrey H.; Liu An; Schultheiss, Timothy E.; Wong, Jeffrey Y.C.

    2010-01-01

    The American College of Radiology practice guideline for total body irradiation (TBI) requires a back-up treatment delivery system. This study investigates the development of helical tomotherapy (HT) for delivering TBI and compares it with conventional extended source-to-surface distance (X-SSD) technique. Four patients' head-to-thigh computed tomographic images were used in this study, with the target defined as the body volume without the left and right lungs. HT treatment plans with the standard TBI prescription (1.2 Gy/fx, 10 fractions) were generated and verified on phantoms. To compare HT plans with X-SSD treatment, the dose distribution of X-SSD technique was simulated using the Eclipse software. The average dose received by 90% of the target volume was 12.3 Gy (range, 12.2-12.4 Gy) for HT plans and 10.3 Gy (range, 10.08-10.58 Gy) for X-SSD plans (p < 0.001). The left and right lung median doses were 5.44 Gy and 5.40 Gy, respectively, for HT plans and 8.34 Gy and 8.95 Gy, respectively, for X-SSD treatment. The treatment planning time was comparable between the two methods. The beam delivery time of HT treatment was longer than X-SSD treatment. In conclusion, HT-based TBI plans have better dose coverage to the target and better dose sparing to the lungs compared with X-SSD technique, which applies dose compensators, lung blocks, and electron boosts. This study demonstrates that HT is possible for delivering TBI. Clinical validation of the feasibility of this approach would be of interest in the future.

  16. 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.

  17. Prospective Phase I-II Trial of Helical Tomotherapy With or Without Chemotherapy for Postoperative Cervical Cancer Patients

    SciTech Connect

    Schwarz, Julie K.; Wahab, Sasa; Grigsby, Perry W.

    2011-12-01

    Purpose: To investigate, in a prospective trial, the acute and chronic toxicity of patients with cervical cancer treated with surgery and postoperative intensity-modulated radiotherapy (RT) delivered using helical tomotherapy, with or without the administration of concurrent chemotherapy. Patients and Methods: A total of 24 evaluable patients entered the study between March 2006 and August 2009. The indications for postoperative RT were tumor size, lymphovascular space invasion, and the depth of cervical stromal invasion in 15 patients; 9 patients underwent postoperative RT because of surgically positive lymph nodes. All patients underwent pelvic RT delivered with helical tomotherapy and intracavitary high-dose-rate brachytherapy. Treatment consisted of concurrent weekly platinum in 17, sequential carboplatin/Taxol in 1, and RT alone in 6. The patients were monitored for acute and chronic toxicity using the Common Toxicity Criteria, version 3.0. Results: The median follow-up was 24 months (range, 4-49). At the last follow-up visit, 23 patients were alive and disease free. Of the 24 patients, 12 (50%) experienced acute Grade 3 gastrointestinal toxicity (anorexia in 5, diarrhea in 4, and nausea in 3). One patient developed acute Grade 4 genitourinary toxicity (vesicovaginal fistula). For patients treated with concurrent chemotherapy, the incidence of acute Grade 3 and 4 hematologic toxicity was 71% and 24%, respectively. For patients treated without concurrent chemotherapy, the incidence of acute Grade 3 and 4 hematologic toxicity was 29% and 14%, respectively. Two long-term toxicities occurred (vesicovaginal fistula at 25 months and small bowel obstruction at 30 months). The overall and progression-free survival rate at 3 years for all patients was 100% and 89%, respectively. Conclusion: The results of our study have shown that postoperative external RT for cervical cancer delivered with helical tomotherapy and high-dose-rate brachytherapy and with or without

  18. Treatment of nasopharyngeal carcinoma using simultaneous modulated accelerated radiation therapy via helical tomotherapy: a phase II study

    PubMed Central

    Du, Lei; Zhang, Xin Xin; Feng, Lin Chun; Chen, Jing; Yang, Jun; Liu, Hai Xia; Xu, Shou Ping; Xie, Chuan Bin

    2016-01-01

    Abstract Background The aim of the study was to evaluate short-term safety and efficacy of simultaneous modulated accelerated radiation therapy (SMART) delivered via helical tomotherapy in patients with nasopharyngeal carcinoma (NPC). Methods Between August 2011 and September 2013, 132 newly diagnosed NPC patients were enrolled for a prospective phase II study. The prescription doses delivered to the gross tumor volume (pGTVnx) and positive lymph nodes (pGTVnd), the high risk planning target volume (PTV1), and the low risk planning target volume (PTV2), were 67.5 Gy (2.25 Gy/F), 60 Gy (2.0 Gy/F), and 54 Gy (1.8 Gy/F), in 30 fractions, respectively. Acute toxicities were evaluated according to the established RTOG/EORTC criteria. This group of patients was compared with the 190 patients in the retrospective P70 study, who were treated between September 2004 and August 2009 with helical tomotherapy, with a dose of 70-74 Gy/33F/6.5W delivered to pGTVnx and pGTVnd. Results The median follow-up was 23.7 (12–38) months. Acute radiation related side-effects were mainly problems graded as 1 or 2. Only a small number of patients suffered from grade 4 leucopenia (4.5%) or thrombocytopenia (2.3%). The local relapse-free survival (LRFS), nodal relapse-free survival (NRFS), local-nodal relapse-free survival (LNRFS), distant metastasis-free survival (DMFS) and overall survival (OS) were 96.7%, 95.5%, 92.2%, 92.7% and 93.2%, at 2 years, respectively, with no significant difference compared with the P70 study. Conclusions Smart delivered via the helical tomotherapy technique appears to be associated with an acceptable acute toxicity profile and favorable short-term outcomes for patients with NPC. Long-term toxicities and patient outcomes are under investigation. PMID:27247555

  19. Feasibility of Helical Tomotherapy for Debulking Irradiation Before Stem Cell Transplantation in Malignant Lymphoma

    SciTech Connect

    Chargari, Cyrus; Vernant, Jean-Paul; Tamburini, Jerome; Zefkili, Sofia; Fayolle, Maryse; Campana, Francois; Fourquet, Alain; Kirova, Youlia M.

    2011-11-15

    Purpose: Preliminary clinical experience has suggested that radiation therapy (RT) may be effectively incorporated into conditioning therapy before transplant for patients with refractory/relapsed malignant lymphoma. We investigated the feasibility of debulking selective lymph node irradiation before autologous and/or allogeneic stem cell transplantation (SCT) using helical tomotherapy (HT). Methods and Materials: Six consecutive patients with refractory malignant lymphoma were referred to our institution for salvage HT before SCT. All patients had been previously heavily treated but had bulky residual tumor despite chemotherapy (CT) intensification. Two patients had received previous radiation therapy. HT delivered 30-40 Gy in the involved fields (IF), using 6 MV photons, 2 Gy per daily fraction. Total duration of treatment was 28 to 35 days. Results: Using HT, doses to critical organs (heart, lungs, esophagu, and parotids) were significantly decreased and highly conformational irradiation could be delivered to all clinical target volumes. HT delivery was technically possible, even in patients with lesions extremely difficult to irradiate in other conditions or in patients with previous radiation therapy. No Grade 2 or higher toxicity occurred. Four months after the end of HT, 5 patients experienced complete clinical, radiologic, and metabolic response and were subsequently referred for SCT. Conclusions: By more effectively sparing critical organs, HT may contribute to improving the tolerance of debulking irradiation before allograft. Quality of life may be preserved, and doses to the heart may be decreased. This is particularly relevant in heavily treated patients who are at risk for subsequent heart disease. These preliminary results require further prospective assessment.

  20. Split-Field Helical Tomotherapy With or Without Chemotherapy for Definitive Treatment of Cervical Cancer

    SciTech Connect

    Chang, Albert J.; Richardson, Susan; Grigsby, Perry W.; Schwarz, Julie K.

    2012-01-01

    Objective: The objective of this study was to investigate the chronic toxicity, response to therapy, and survival outcomes of patients with cervical cancer treated with definitive pelvic irradiation delivered by helical tomotherapy (HT), with or without concurrent chemotherapy. Methods and Materials: There were 15 patients with a new diagnosis of cervical cancer evaluated in this study from April 2006 to February 2007. The clinical stages of their disease were Stage Ib1 in 3 patients, Ib2 in 3, IIa in 2, IIb in 4, IIIb in 2, and IVa in 1 patient. Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) simulation was performed in all patients. All patients received pelvic irradiation delivered by HT and high-dose-rate (HDR) brachytherapy. Four patients also received para-aortic irradiation delivered by HT. Thirteen patients received concurrent chemotherapy. Patients were monitored for chronic toxicity using the Common Terminology Criteria for Adverse Events version 3.0 criteria. Results: The median age of the cohort was 51 years (range, 29-87 years), and the median follow-up for all patients alive at time of last follow-up was 35 months. The median overall radiation treatment time was 54 days. One patient developed a chronic Grade 3 GI complication. No other Grade 3 or 4 complications were observed. At last follow-up, 3 patients had developed a recurrence, with 1 patient dying of disease progression. The 3-year progression-free and cause-specific survival estimates for all patients were 80% and 93%, respectively. Conclusion: Intensity-modulated radiation therapy delivered with HT and HDR brachytherapy with or without chemotherapy for definitive treatment of cervical cancer is feasible, with acceptable levels of chronic toxicity.

  1. Effectiveness and toxicity of helical tomotherapy for patients with locally recurrent nasopharyngeal carcinoma.

    PubMed

    Puebla, F; Lopez Guerra, J L; Garcia Ramirez, J M; Matute, R; Marrone, I; Miguez, C; Sevillano, D; Sanchez-Reyes, A; Rivin Del Campo, E; Praena-Fernandez, J M; Azinovic, I

    2015-11-01

    We assessed therapeutic outcomes of reirradiation with helical tomotherapy (HT) for locoregional recurrent nasopharyngeal carcinoma (LRNPC) patients. Treatment outcomes were evaluated retrospectively in 17 consecutive LRNPC patients receiving HT between 2006 and 2012. Median age was 57 years and most patients (n = 13) were male. Simultaneous systemic therapy was applied in 5 patients. Initial treatment covered the gross tumor volume with a median dose of 70 Gy (60-81.6 Gy). Reirradiation was confined to the local relapse region with a median dose of 63 Gy (50-70.2 Gy), resulting in a median cumulative dose of 134 Gy (122-148.2 Gy). The median time interval between initial and subsequent treatment was 42 months (11-126). The median follow-up for the entire cohort was 23 and 35 months for survivors. Three patients (18 %) developed both local and distant recurrences and only one patient (6 %) suffered from isolated local recurrence. Two-year actuarial DFS and LC rates were 74 and 82 %, respectively. Two-year OS rate was 79 %. Acute and late grade 2 toxicities were observed in 8 patients (47 %). No patient experienced late grade ≥3 toxicity. Late toxicity included fibrosis of skin, hypoacusia, dysphagia, and xerostomia. Patients with higher Karnofsky performance status scores associated with a lower risk of mortality (HR 0.85, p = 0.015). Reirradiation with HT in patients with LRNPC is feasible and yields encouraging results in terms of local control and overall survival with acceptable toxicity.

  2. SU-E-T-371: Validation of Organ Doses Delivered During Craniospinal Irradiation with Helical Tomotherapy

    SciTech Connect

    Perez-Andujar, A; Chen, J; Garcia, A; Haas-Kogan, D

    2014-06-01

    Purpose: New techniques have been developed to deliver more conformal treatments to the craniospinal axis. One concern, however, is the widespread low dose delivered and implications for possible late effects. The purpose of this work is for the first time to validate the organ doses calculated by the treatment planning system (TPS), including out-of-field doses for a pediatric craniospinal treatment (CSI). Methods: A CSI plan prescribed to 23.4 Gy and a posterior fossa boost plan to 30.6 Gy (total dose 54.0 Gy) was developed for a pediatric anthropomorphic phantom representing a 13 yearold- child. For the CSI plan, the planning target volumes (PTV) consisted of the brain and spinal cord with 2 mm and 5 mm expansions, respectively. Organs at risk (OAR) were contoured and included in the plan optimization. The plans were delivered on a helical tomotherapy unit. Thermoluminescent dosimeters (TLDs) were used to measure the dose at 54 positions within the PTV and OARs. Results: For the CSI treatment, the mean percent difference between TPS dose calculations and measurements was 5% for the PTV and 10% for the OARs. For the boost, the average was 3% for the PTV. The percent difference for the OARs, which lie outside the field and received a small fraction of the prescription dose, varied from 15% to 200%. However in terms of absolute dose, the average difference between measurement and TPS per treatment Gy was 2 cGy/Gy and 3 mGy/Gy for the CSI and boost plans, respectively. Conclusion: There was good agreement between doses calculated by the TPS and measurements for the CSI treatment. Higher percent differences were observed for out-of-field doses in the boost plan, but absolute dose differences were very small compared to the prescription dose. These findings can help in the estimation of late effects after radiotherapy for pediatric patients.

  3. Dosimetric verification of dose calculation algorithm in the lung during total marrow irradiation using helical tomotherapy.

    PubMed

    Konstanty, Ewelina; Malicki, Julian; Łagodowska, Katarzyna; Kowalik, Anna

    2017-01-01

    Treatment of proliferative diseases of the hematopoietic system involves, in most cases, chemotherapy combined with radiation therapy, which is intended to provide adequate immunosuppressant. Conventionally, total body irradiation (TBI) was used; however, total marrow irradiation (TMI) performed with helical tomotherapy (HT) has been proposed as an alternative, with the aim of delivering the highest dose in the target area (skeleton bone). The purpose of this study is to evaluate the accuracy of the dose calculation algorithm for the lung in TMI delivered with HT. Thermoluminescent detectors (TLD-100 Harshaw) were used to measure delivered doses. Doses were calculated for 95 selected points in the central lung (53 TLDs) and near the rib bones (42 TLDs) in the anthropomorphic phantom. A total of 12 Gy were delivered (6 fractions of 2 Gy/fraction). HT-TMI technique reduces the dose delivered to the lungs in a phantom model to levels that are much lower than those reported for TBI delivered by a conventional linear accelerator. The mean calculated lung dose was 5.6 Gy versus a mean measured dose of 5.7 ± 2.4 Gy. The maximum and minimum measured doses were, respectively, 11.3 Gy (chest wall) and 2.8 Gy (central lung). At most of the 95 points, the measured dose was lower than the calculated dose, with the largest differences observed in the region located between the target volume and the adjacent lung tissue. The mean measured dose was lower than the calculated dose in both primary locations: -3.7% in the 42 rib-adjacent detectors and -3.0% in the 53 central lung TLDs. Our study has shown that the measured doses may be lower than those calculated by the HT-TMI calculation algorithm. Although these differences between calculated and measured doses are not clinically relevant, this finding merits further investigation.

  4. The role of helical tomotherapy in the treatment of bone plasmacytoma

    SciTech Connect

    Chargari, Cyrus; Hijal, Tarek; Bouscary, Didier; Caussa, Lucas; Dendale, Remi; Zefkili, Sofia; Fourquet, Alain; Kirova, Youlia M.

    2012-04-01

    We evaluated the early clinical outcome of patients with solitary bone plasmacytoma (SP) or a solitary lesion of multiple myeloma (MM) treated with helical tomotherapy (HT) compared with 3D conformal radiotherapy (3D-CRT), in terms of target coverage and exposure of critical organs. Ten patients with SP and 3 patients with a solitary lesion of MM underwent radiation therapy (RT) delivered by HT, to a dose of 40 Gy in 20 fractions. Treatment planning was then performed with 3D-CRT and the dosimetric parameters of both techniques were compared. Patients were also assessed for response to treatment and acute toxicities. With a median follow-up of 13 months, 78% of patients with pain before RT had resolution of their symptoms. Coverage of target lesion was adequate with both techniques in 12 of 13 patients. Target coverage was significantly lower for HT (V{sub 95%} = 98.55% vs. 97.15%; p = 0.04, for 3D-CRT and HT, respectively). Target overdoses were also lower with HT (V{sub 105%} = 2.01% vs. 0.19%; p= 0.16), although nonsignificant. Finally, there were no significant differences in organs-at-risk irradiation between both techniques. The early treatment tolerance was excellent, with no toxicity higher than grade I. RT of SP and MM with a solitary lesion can be safely delivered with HT, with no major acute side effects and good symptomatic control. Finally, HT provides a dosimetry similar to that of 3D-CRT in terms of organs-at-risk sparing and target volume coverage.

  5. Treatment and Dosimetric Advantages Between VMAT, IMRT, and Helical TomoTherapy in Prostate Cancer

    SciTech Connect

    Tsai, Chiao-Ling; Wu, Jian-Kuen; Chao, Hsiao-Ling; Tsai, Yi-Chun; Cheng, Jason Chia-Hsien

    2011-10-01

    We investigated the possible treatment and dosimetric advantage of volumetric modulated arc therapy (VMAT) over step-and-shoot intensity-modulated radiation therapy (step-and-hhoot IMRT) and helical tomotherapy (HT). Twelve prostate cancer patients undergoing VMAT to the prostate were included. Three treatment plans (VMAT, step-and-shoot IMRT, HT) were generated for each patient. The doses to clinical target volume and 95% of planning target volume were both {>=}78 Gy. Target coverage, conformity index, dose to rectum/bladder, monitor units (MU), treatment time, equivalent uniform dose (EUD), normal tissue complication probability (NTCP) of targets, and rectum/bladder were compared between techniques. HT provided superior conformity and significantly less rectal volume exposed to 65 Gy and 40 Gy, as well as EUD/NTCP of rectum than step-and-shoot IMRT, whereas VMAT had a slight dosimetric advantage over step-and-shoot IMRT. Notably, significantly lower MUs were needed for VMAT (309.7 {+-} 35.4) and step-and-shoot IMRT (336.1 {+-} 16.8) than for HT (3368 {+-} 638.7) (p < 0.001). The treatment time (minutes) was significantly shorter for VMAT (2.6 {+-} 0.5) than step-and-shoot IMRT (3.8 {+-} 0.3) and HT (3.8 {+-} 0.6) (p < 0.001). Dose verification of VMAT using point dose and film dosimetry met the accepted criteria. VMAT and step-and-shoot IMRT have comparable dosimetry, but treatment efficiency is significantly higher for VMAT than for step-and-shoot IMRT and HT.

  6. Voxel-Based Dose Reconstruction for Total Body Irradiation With Helical TomoTherapy

    SciTech Connect

    Chao Ming; Penagaricano, Jose; Yan Yulong; Moros, Eduardo G.; Corry, Peter; Ratanatharathorn, Vaneerat

    2012-04-01

    Purpose: We have developed a megavoltage CT (MVCT)-based dose reconstruction strategy for total body irradiation (TBI) with helical TomoTherapy (HT) using a deformable registration model to account for the patient's interfraction changes. The proposed technique serves as an efficient tool for delivered dose verification and, potentially, plan adaptation. Methods and Materials: Four patients with acute myelogenous leukemia treated with TBI using HT were selected for this study. The prescription was 12 Gy, 2 Gy/fraction, twice per day, given at least 6 h apart. The original plan achieved coverage of 80% of the clinical target volume (CTV) by the 12 Gy isodose surface. MVCTs were acquired prior to each treatment. Regions of interest were contoured on each MVCT. The dose for each fraction was calculated based on the MVCT using the HT planned adaptive station. B-spline deformable registration was conducted to establish voxel-to-voxel correspondence between the MVCT and the planning CT. The resultant deformation vector was employed to map the reconstructed dose from each fraction to the same point as the plan dose, and a voxel-to-voxel summed dose from all six fractions was obtained. The reconstructed dose distribution and its dosimetric parameters were compared with those of the original treatment plan. Results: While changes in CTV contours occurred in all patients, the reconstructed dose distribution showed that the dose-volume histogram for CTV coverage was close (<1.5%) to that of the original plan. For sensitive structures, the differences between the reconstructed and the planned doses were less than 3.0%. Conclusion: Voxel-based dose reconstruction strategy that takes into account interfraction anatomical changes using MVCTs is a powerful tool for treatment verification of the delivered doses. This proposed technique can also be applied to adaptive TBI therapy using HT.

  7. Aichi Cancer Center Initial Experience of Intensity Modulated Radiation Therapy for Nasopharyngeal Cancer Using Helical Tomotherapy

    SciTech Connect

    Kodaira, Takeshi Tomita, Natsuo; Tachibana, Hiroyuki; Nakamura, Tatsuya; Nakahara, Rie; Inokuchi, Haruo; Fuwa, Nobukazu

    2009-03-15

    Purpose: To assess the feasibility of helical tomotherapy (HT) for patients with nasopharyngeal carcinoma. Methods and Materials: From June 2006 to June 2007, 20 patients with nasopharyngeal carcinoma were treated with HT with (n = 18) or without (n = 2) systemic chemotherapy. The primary tumor and involved lymph node (PTV1) were prescribed 70 Gy and the prophylactic region 54 Gy at D95, respectively. The majority of patients received 2 Gy per fraction for PTV1 in 35 fractions. Parotid function was evaluated using quantitative scintigraphy at pretreatment, and posttreatment at 3 months and 1 year later. Results: The median patient age was 53 years, ranging from 15 to 83. Our cohort included 5, 8, 4, 2, and 1 patients with disease Stages IIB, III, IVA, IVB, and IVC, respectively. Histopathological record revealed two for World Health Organization Type I and 18 for Type 2 or 3. The median duration time for treatment preparation was 9.5 days, and all plans were thought to be acceptable regarding dose constraints of both the planning target volume and organ at risk. All patients completed their treatment procedure of intensity-modulated radiation therapy (IMRT). All patients achieved clinical remission after IMRT. The majority of patients had Grade 3 or higher toxicity of skin, mucosa, and neutropenia. At the median follow-up of 10.9 months, two patients recurred, and one patient died from cardiac disease. Parotid gland function at 1 year after completion of IMRT was significantly improved compared with that at 3 months. Conclusion: HT was clinically effective in terms of IMRT planning and utility for patients with nasopharyngeal cancer.

  8. Accelerated large volume irradiation with dynamic Jaw/Dynamic Couch Helical Tomotherapy

    PubMed Central

    2012-01-01

    Background Helical Tomotherapy (HT) has unique capacities for the radiotherapy of large and complicated target volumes. Next generation Dynamic Jaw/Dynamic Couch HT delivery promises faster treatments and reduced exposure of organs at risk due to a reduced dose penumbra. Methods Three challenging clinical situations were chosen for comparison between Regular HT delivery with a field width of 2.5 cm (Reg 2.5) and 5.0 cm (Reg 5.0) and DJDC delivery with a maximum field width of 5.0 cm (DJDC 5.0): Hemithoracic Irradiation, Whole Abdominal Irradiation (WAI) and Total Marrow Irradiation (TMI). For each setting, five CT data sets were chosen, and target coverage, conformity, integral dose, dose exposure of organs at risk (OAR) and treatment time were calculated. Results Both Reg 5.0 and DJDC 5.0 achieved a substantial reduction in treatment time while maintaining similar dose coverage. Treatment time could be reduced from 10:57 min to 3:42 min / 5:10 min (Reg 5.0 / DJDC 5.0) for Hemithoracic Irradiation, from 18:03 min to 8:02 min / 8:03 min for WAI and to 18:25 min / 18:03 min for TMI. In Hemithoracic Irradiation, OAR exposure was identical in all modalities. For WAI, Reg 2.5 resulted in lower exposure of liver and bone. DJDC plans showed a small but significant increase of ∼ 1 Gy to the kidneys, the parotid glans and the thyroid gland. While Reg 5.0 and DJDC were identical in terms of OAR exposure, integral dose was substantially lower with DJDC, caused by a smaller dose penumbra. Conclusions Although not clinically available yet, next generation DJDC HT technique is efficient in improving the treatment time while maintaining comparable plan quality. PMID:23146914

  9. Mesothelioma at era of helical tomotherapy: results of two institutions in combining chemotherapy, surgery and radiotherapy.

    PubMed

    Sylvestre, Alma; Mahé, Marc-André; Lisbona, Albert; Zefkili, Sofia; Savignoni, Alexia; Bonnette, Pierre; Barthes, Françoise Le Pimpec; Paris, Edouard; Perigaud, Christian; Yassa, Michael; Giraud, Philippe

    2011-12-01

    There is a scarce clinical experience about adjuvant helical tomotherapy (HT) in patients affected by malignant pleural mesothelioma (MPM) even though it appears as a useful technique to treat complex volume as the pleural cavity, and seems to have better dose distribution than the "classic" intensity modulated radiotherapy (IMRT). Twenty-four patients received adjuvant radiotherapy (RT) by HT from August 1st, 2007 to December 1st, 2009 at Curie Institute (Paris) and René Gauducheau Cancer Center (Nantes). Thirteen patients had neoadjuvant chemotherapy. Extrapleural pleuropneumonectomy (EPP) was done in 23 patients. Median dose to PTV was 50Gy [48.7-55.9Gy] (2Gy/fraction). Acute and long term toxicities, disease free survival (DFS), overall survival (OS) and relapses are presented. Average follow up after RT was 7 months. The disease was staged mostly as T2-T3, N1-N2. Nineteen patients had epithelial type histology. Most patients tolerated radiotherapy with grade 1-2 side effects: redness of the skin, light cough or dyspnea, fatigue, nausea and odynophagia, mild increase of the post-operative thoracic pain. Grade 3 pneumonitis was suspected in 2 patients. Two grade 5 pneumonitis were also suspected. Eleven patients had a follow up of more than 6 months and no long term side effects related with HT were noted. At 24 months, 51.8% of patients were free of disease. Thirty percent of patients relapsed, with 2 patients presenting local relapses. Two patients died from recurrence. With limited follow up, HT has comparable toxicity to those observed with traditional IMRT. Higher radiation dose and good coverage results in excellent local control. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Comparison of coplanar and noncoplanar intensity-modulated radiation therapy and helical tomotherapy for hepatocellular carcinoma

    PubMed Central

    2010-01-01

    Background To compare the differences in dose-volume data among coplanar intensity modulated radiotherapy (IMRT), noncoplanar IMRT, and helical tomotherapy (HT) among patients with hepatocellular carcinoma (HCC) and portal vein thrombosis (PVT). Methods Nine patients with unresectable HCC and PVT underwent step and shoot coplanar IMRT with intent to deliver 46 - 54 Gy to the tumor and portal vein. The volume of liver received 30Gy was set to keep less than 30% of whole normal liver (V30 < 30%). The mean dose to at least one side of kidney was kept below 23 Gy, and 50 Gy as for stomach. The maximum dose was kept below 47 Gy for spinal cord. Several parameters including mean hepatic dose, percent volume of normal liver with radiation dose at X Gy (Vx), uniformity index, conformal index, and doses to organs at risk were evaluated from the dose-volume histogram. Results HT provided better uniformity for the planning-target volume dose coverage than both IMRT techniques. The noncoplanar IMRT technique reduces the V10 to normal liver with a statistically significant level as compared to HT. The constraints for the liver in the V30 for coplanar IMRT vs. noncoplanar IMRT vs. HT could be reconsidered as 21% vs. 17% vs. 17%, respectively. When delivering 50 Gy and 60-66 Gy to the tumor bed, the constraints of mean dose to the normal liver could be less than 20 Gy and 25 Gy, respectively. Conclusion Noncoplanar IMRT and HT are potential techniques of radiation therapy for HCC patients with PVT. Constraints for the liver in IMRT and HT could be stricter than for 3DCRT. PMID:20492727

  11. Investigation of Pitch and Jaw Width to Decrease Delivery Time of Helical Tomotherapy Treatments for Head and Neck Cancer

    SciTech Connect

    Moldovan, Monica; Fontenot, Jonas D.; Gibbons, John P.; Lee, Tae Kyu; Rosen, Isaac I.; Fields, Robert S.; Hogstrom, Kenneth R.

    2011-01-01

    Helical tomotherapy plans using a combination of pitch and jaw width settings were developed for 3 patients previously treated for head and neck cancer. Three jaw widths (5, 2.5, and 1 cm) and 4 pitches (0.86, 0.43, 0.287, and 0.215) were used with a (maximum) modulation factor setting of 4. Twelve plans were generated for each patient using an identical optimization procedure (e.g., number of iterations, objective weights, and penalties, etc.), based on recommendations from TomoTherapy (Madison, WI). The plans were compared using isodose plots, dose volume histograms, dose homogeneity indexes, conformity indexes, radiobiological models, and treatment times. Smaller pitches and jaw widths showed better target dose homogeneity and sparing of normal tissue, as expected. However, the treatment time increased inversely proportional to the jaw width, resulting in delivery times of 24 {+-} 1.9 min for the 1-cm jaw width. Although treatment plans produced with the 2.5-cm jaw were dosimetrically superior to plans produced with the 5-cm jaw, subsequent calculations of tumor control probabilities and normal tissue complication probabilities suggest that these differences may not be radiobiologically meaningful. Because treatment plans produced with the 5-cm jaw can be delivered in approximately half the time of plans produced with the 2.5-cm jaw (5.1 {+-} 0.6 min vs. 9.5 {+-} 1.1 min), use of the 5-cm jaw in routine treatment planning may be a viable approach to decreasing treatment delivery times from helical tomotherapy units.

  12. Investigation of pitch and jaw width to decrease delivery time of helical tomotherapy treatments for head and neck cancer.

    PubMed

    Moldovan, Monica; Fontenot, Jonas D; Gibbons, John P; Lee, Tae Kyu; Rosen, Isaac I; Fields, Robert S; Hogstrom, Kenneth R

    2011-01-01

    Helical tomotherapy plans using a combination of pitch and jaw width settings were developed for 3 patients previously treated for head and neck cancer. Three jaw widths (5, 2.5, and 1 cm) and 4 pitches (0.86, 0.43, 0.287, and 0.215) were used with a (maximum) modulation factor setting of 4. Twelve plans were generated for each patient using an identical optimization procedure (e.g., number of iterations, objective weights, and penalties, etc.), based on recommendations from TomoTherapy (Madison, WI). The plans were compared using isodose plots, dose volume histograms, dose homogeneity indexes, conformity indexes, radiobiological models, and treatment times. Smaller pitches and jaw widths showed better target dose homogeneity and sparing of normal tissue, as expected. However, the treatment time increased inversely proportional to the jaw width, resulting in delivery times of 24 ± 1.9 min for the 1-cm jaw width. Although treatment plans produced with the 2.5-cm jaw were dosimetrically superior to plans produced with the 5-cm jaw, subsequent calculations of tumor control probabilities and normal tissue complication probabilities suggest that these differences may not be radiobiologically meaningful. Because treatment plans produced with the 5-cm jaw can be delivered in approximately half the time of plans produced with the 2.5-cm jaw (5.1 ± 0.6 min vs. 9.5 ± 1.1 min), use of the 5-cm jaw in routine treatment planning may be a viable approach to decreasing treatment delivery times from helical tomotherapy units. Copyright © 2011 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  13. Effect of CT contrast on volumetric arc therapy planning (RapidArc and helical tomotherapy) for head and neck cancer.

    PubMed

    Liu, Alan J; Vora, Nayana; Suh, Steve; Liu, An; Schultheiss, Timothy E; Wong, Jeffrey Y C

    2015-01-01

    The objectives of the study were to evaluate the effect of intravenous contrast in the dosimetry of helical tomotherapy and RapidArc treatment for head and neck cancer and determine if it is acceptable during the computed tomography (CT) simulation to acquire only CT with contrast for treatment planning of head and neck cancer. Overall, 5 patients with head and neck cancer (4 men and 1 woman) treated on helical tomotherapy were analyzed retrospectively. For each patient, 2 consecutive CT scans were performed. The first CT set was scanned before the contrast injection and secondary study set was scanned 45 seconds after contrast. The 2 CTs were autoregistered using the same Digital Imaging and Communications in Medicine coordinates. Tomotherapy and RapidArc plans were generated on 1 CT data set and subsequently copied to the second CT set. Dose calculation was performed, and dose difference was analyzed to evaluate the influence of intravenous contrast media. The dose matrix used for comparison included mean, minimum and maximum doses of planning target volume (PTV), PTV dose coverage, and V45Gy, V30Gy, and V20Gy organ doses. Treatment planning on contrasted images generally showed a lower dose to both organs and target than plans on noncontrasted images. The doses for the points of interest placed in the organs and target rarely changed more than 2% in any patient. In conclusion, treatment planning using a contrasted image had insignificant effect on the dose to the organs and targets. In our opinion, only CT with contrast needs to be acquired during the CT simulation for head and neck cancer. Dose calculations performed on contrasted images can potentially underestimate the delivery dose slightly. However, the errors of planning on a contrasted image should not affect the result in clinically significant way. Copyright © 2015 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  14. Effect of CT contrast on volumetric arc therapy planning (RapidArc and helical tomotherapy) for head and neck cancer

    SciTech Connect

    Liu, Alan J.; Vora, Nayana; Suh, Steve; Liu, An; Schultheiss, Timothy E.; Wong, Jeffrey Y.C.

    2015-04-01

    The objectives of the study were to evaluate the effect of intravenous contrast in the dosimetry of helical tomotherapy and RapidArc treatment for head and neck cancer and determine if it is acceptable during the computed tomography (CT) simulation to acquire only CT with contrast for treatment planning of head and neck cancer. Overall, 5 patients with head and neck cancer (4 men and 1 woman) treated on helical tomotherapy were analyzed retrospectively. For each patient, 2 consecutive CT scans were performed. The first CT set was scanned before the contrast injection and secondary study set was scanned 45 seconds after contrast. The 2 CTs were autoregistered using the same Digital Imaging and Communications in Medicine coordinates. Tomotherapy and RapidArc plans were generated on 1 CT data set and subsequently copied to the second CT set. Dose calculation was performed, and dose difference was analyzed to evaluate the influence of intravenous contrast media. The dose matrix used for comparison included mean, minimum and maximum doses of planning target volume (PTV), PTV dose coverage, and V{sub 45} {sub Gy}, V{sub 30} {sub Gy}, and V{sub 20} {sub Gy} organ doses. Treatment planning on contrasted images generally showed a lower dose to both organs and target than plans on noncontrasted images. The doses for the points of interest placed in the organs and target rarely changed more than 2% in any patient. In conclusion, treatment planning using a contrasted image had insignificant effect on the dose to the organs and targets. In our opinion, only CT with contrast needs to be acquired during the CT simulation for head and neck cancer. Dose calculations performed on contrasted images can potentially underestimate the delivery dose slightly. However, the errors of planning on a contrasted image should not affect the result in clinically significant way.

  15. Poster - Thur Eve - 72: Conversion of helical tomotherapy plans into clinically favourable step-and-shoot IMRT plans deliverable on a c-arm linac.

    PubMed

    Studinski, Rcn; Alexander, A; La Russa, D

    2012-07-01

    The treatment planning software SharePlan is designed to convert dose distributions generated by the TomoTherapy planning station into step-and-shoot IMRT plans deliverable on a c-arm linear accelerator. Five anal canal patients who were planned for TomoTherapy treatments were exported into a SharePlan system and plans were generated for delivery on an Elekta Synergy unit. A total of 80 plans were generated for those five patients, with either seven, nine, eleven or twenty-one gantry angles and different priorities between focusing on matching either the target doses or healthy tissue sparing of the TomoTherapy plan. The plans generated by SharePlan, while often not matching target coverage at prescription, matched well the TomoTherapy coverage at 95% and 105% of the prescription dose. Organ at risk dose, when heavily emphazied in the SharePlan calculations matched or bettered the TomoTherapy dose due to the placement of the beams and the sharper sup-inf fall off of the dose distribution on a linac. For one of the patients, it was possible to produce a better DVH with SharePlan than the original TomoTherapy plan for those reasons. The TomoTherapy plans boasted significantly shorter delivery times than the plans generated with SharePlan. © 2012 American Association of Physicists in Medicine.

  16. Helical Tomotherapy Delivery of an IMRT Boost in Lieu of Interstitial Brachytherapy in the Setting of Gynecologic Malignancy: Feasibility and Dosimetric Comparison

    SciTech Connect

    Gielda, Benjamin T.; Shah, Anand P.; Marsh, James C.; Smart, Joseph P.; Bernard, Damian; Rotmensch, Jacob; Griem, Katherine L.

    2011-07-01

    Interstitial brachytherapy is an important means by which to improve local control in gynecologic malignancy when intracavitary brachytherapy is untenable. Patients unable to receive brachytherapy have traditionally received conventional external beam radiation alone with modest results. We investigated the ability of Tomotherapy (Tomotherapy Inc., Madison, WI) to replace interstitial brachytherapy. Six patients were selected. The planning CT of each patient was contoured with the planning target volume (PTV), bladder, rectum, femoral heads, and bowel. Identical contour sets were exported to Tomotherapy and Nucletron PLATO (Nucletron B.V., Veenendaal, The Netherlands). With Tomotherapy, the PTV was prescribed 31 Gy in 5 fractions to 90% of the volume. With PLATO, 600 cGy x 5 fractions was prescribed to the surface of the PTV. Dose delivered was normalized to 2 Gy fractions (EQD2) and added to a hypothetical homogenous 45-Gy pelvic dose. Tomotherapy achieved a D90 of 87 Gy EQD2 versus 86 Gy with brachytherapy. PTV dose was more homogeneous with tomotherapy. The dose to the most at-risk 2 mL of bladder and rectum with Tomotherapy was of 78 and 71 Gy EQD2 versus 81 and 75 Gy with brachytherapy. Tomotherapy delivered more dose to the femoral heads (mean 1.23 Gy per fraction) and bowel. Tomotherapy was capable of replicating the peripheral dose achieved with brachytherapy, without the PTV hotspots inherent to interstitial brachytherapy. Similar maximum doses to bowel and bladder were achieved with both methods. Excessive small bowel and femoral head toxicity may result if previous pelvic irradiation is not planned accordingly. Significant challenges related to interfraction and intrafraction motion must be overcome if treatment of this nature is to be contemplated.

  17. Peripheral Dose Heterogeneity Due to the Thread Effect in Total Marrow Irradiation With Helical Tomotherapy

    SciTech Connect

    Takahashi, Yutaka; Verneris, Michael R.; Dusenbery, Kathryn E.; Wilke, Christopher T.; Storme, Guy; Weisdorf, Daniel J.; Hui, Susanta K.

    2013-11-15

    Purpose: To report potential dose heterogeneity leading to underdosing at different skeletal sites in total marrow irradiation (TMI) with helical tomotherapy due to the thread effect and provide possible solutions to reduce this effect. Methods and Materials: Nine cases were divided into 2 groups based on patient size, defined as maximum left-to-right arm distance (mLRD): small mLRD (≤47 cm) and large mLRD (>47 cm). TMI treatment planning was conducted by varying the pitch and modulation factor while a jaw size (5 cm) was kept fixed. Ripple amplitude, defined as the peak-to-trough dose relative to the average dose due to the thread effect, and the dose–volume histogram (DVH) parameters for 9 cases with various mLRD was analyzed in different skeletal regions at off-axis (eg, bones of the arm or femur), at the central axis (eg, vertebrae), and planning target volume (PTV), defined as the entire skeleton plus 1-cm margin. Results: Average ripple amplitude for a pitch of 0.430, known as one of the magic pitches that reduce thread effect, was 9.2% at 20 cm off-axis. No significant differences in DVH parameters of PTV, vertebrae, or femur were observed between small and large mLRD groups for a pitch of ≤0.287. Conversely, in the bones of the arm, average differences in the volume receiving 95% and 107% dose (V95 and V107, respectively) between large and small mLRD groups were 4.2% (P=.016) and 16% (P=.016), respectively. Strong correlations were found between mLRD and ripple amplitude (rs=.965), mLRD and V95 (rs=−.742), and mLRD and V107 (rs=.870) of bones of the arm. Conclusions: Thread effect significantly influences DVH parameters in the bones of the arm for large mLRD patients. By implementing a favorable pitch value and adjusting arm position, peripheral dose heterogeneity could be reduced.

  18. Helical tomotherapy in the treatment of pediatric malignancies: a preliminary report of feasibility and acute toxicity

    PubMed Central

    2011-01-01

    Background Radiation therapy plays a central role in the management of many childhood malignancies and Helical Tomotherapy (HT) provides potential to decrease toxicity by limiting the radiation dose to normal structures. The aim of this article was to report preliminary results of our clinical experience with HT in pediatric malignancies. Methods In this study 66 consecutive patients younger than 14 years old, treated with HT at our center between January 2006 and April 2010, have been included. We performed statistical analyses to assess the relationship between acute toxicity, graded according to the RTOG criteria, and several clinical and treatment characteristics such as a dose and irradiation volume. Results The median age of patients was 5 years. The most common tumor sites were: central nervous system (57%), abdomen (17%) and thorax (6%). The most prevalent histological types were: medulloblastoma (16 patients), neuroblastoma (9 patients) and rhabdomyosarcoma (7 patients). A total of 52 patients were treated for primary disease and 14 patients were treated for recurrent tumors. The majority of the patients (72%) were previously treated with chemotherapy. The median prescribed dose was 51 Gy (range 10-70 Gy). In 81% of cases grade 1 or 2 acute toxicity was observed. There were 11 cases (16,6%) of grade 3 hematological toxicity, two cases of grade 3 skin toxicity and one case of grade 3 emesis. Nine patients (13,6%) had grade 4 hematological toxicity. There were no cases of grade 4 non-hematological toxicities. On the univariate analysis, total dose and craniospinal irradiation (24 cases) were significantly associated with severe toxicity (grade 3 or more), whereas age and chemotherapy were not. On the multivariate analysis, craniospinal irradiation was the only significant independent risk factor for grade 3-4 toxicity. Conclusion HT in pediatric population is feasible and safe treatment modality. It is characterized by an acceptable level of acute toxicity

  19. Helical tomotherapy and volumetric modulated arc therapy: New therapeutic arms in the breast cancer radiotherapy

    PubMed Central

    Lauche, Olivier; Kirova, Youlia M; Fenoglietto, Pascal; Costa, Emilie; Lemanski, Claire; Bourgier, Celine; Riou, Olivier; Tiberi, David; Campana, Francois; Fourquet, Alain; Azria, David

    2016-01-01

    AIM To analyse clinical and dosimetric results of helical tomotherapy (HT) and volumetric modulated arc therapy (VMAT) in complex adjuvant breast and nodes irradiation. METHODS Seventy-three patients were included (31 HT and 42 VMAT). Dose were 63.8 Gy (HT) and 63.2 Gy (VMAT) in the tumour bed, 52.2 Gy in the breast, 50.4 Gy in supraclavicular nodes (SCN) and internal mammary chain (IMC) with HT and 52.2 Gy and 49.3 Gy in IMC and SCN with VMAT in 29 fractions. Margins to particle tracking velocimetry were greater in the VMAT cohort (7 mm vs 5 mm). RESULTS For the HT cohort, the coverage of clinical target volumes was as follows: Tumour bed: 99.4% ± 2.4%; breast: 98.4% ± 4.3%; SCN: 99.5% ± 1.2%; IMC: 96.5% ± 13.9%. For the VMAT cohort, the coverage was as follows: Tumour bed: 99.7% ± 0.5%, breast: 99.3% ± 0.7%; SCN: 99.6% ± 1.4%; IMC: 99.3% ± 3%. For ipsilateral lung, Dmean and V20 were 13.6 ± 1.2 Gy, 21.1% ± 5% (HT) and 13.6 ± 1.4 Gy, 20.1% ± 3.2% (VMAT). Dmean and V30 of the heart were 7.4 ± 1.4 Gy, 1% ± 1% (HT) and 10.3 ± 4.2 Gy, 2.5% ± 3.9% (VMAT). For controlateral breast Dmean was 3.6 ± 0.2 Gy (HT) and 4.6 ± 0.9 Gy (VMAT). Acute skin toxicity grade 3 was 5% in the two cohorts. CONCLUSION HT and VMAT in complex adjuvant breast irradiation allow a good coverage of target volumes with an acceptable acute tolerance. A longer follow-up is needed to assess the impact of low doses to healthy tissues. PMID:27648167

  20. Analysis of modulation factor to shorten the delivery time in helical tomotherapy.

    PubMed

    Shimizu, Hidetoshi; Sasaki, Koji; Tachibana, Hiroyuki; Tomita, Natsuo; Makita, Chiyoko; Nakashima, Kuniyasu; Yokoi, Kazushi; Kubota, Takashi; Yoshimoto, Manabu; Iwata, Tohru; Kodaira, Takeshi

    2017-05-01

    A low modulation factor (MF) maintaining a good dose distribution contributes to the shortening of the delivery time and efficiency of the treatment plan in helical tomotherapy. The purpose of this study was to reduce the delivery time using initial values and the upper limit values of MF. First, patients with head and neck cancer (293 cases) or prostate cancer (181 cases) treated between June 2011 and July 2015 were included in the analysis of MF values. The initial MF value (MFinitial ) was defined as the average MFactual value, and the upper limit of the MF value (MFUL ) was defined according the following equation: MFUL = 2 × standard deviation of MFactual value + the average MFactual Next, a treatment plan was designed for patients with head and neck cancer (62 cases) and prostate cancer (13 cases) treated between December 2015 and June 2016. The average MFactual value for the nasopharynx, oropharynx, hypopharynx, and prostate cases decreased from 2.1 to 1.9 (p = 0.0006), 1.9 to 1.6 (p < 0.0001), 2.0 to 1.7 (p < 0.0001), and 1.8 to 1.6 (p = 0.0004) by adapting the MFinitial and the MFUL values, respectively. The average delivery time for the nasopharynx, oropharynx, hypopharynx, and prostate cases also decreased from 19.9 s cm(-1) to 16.7 s cm(-1) (p < 0.0001), 15.0 s cm(-1) to 13.9 s cm(-1) (p = 0.025), 15.1 s cm(-1) to 13.8 s cm(-1) (p = 0.015), and 23.6 s cm(-1) to 16.9 s cm(-1) (p = 0.008) respectively. The delivery time was shortened by the adaptation of MFinitial and MFUL values with a reduction in the average MFactual for head and neck cancer and prostate cancer cases. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  1. SU-E-T-337: Dosimetric Study of TMI Using Helical Tomotherapy

    SciTech Connect

    Phurailatpam, R; Swamidas, J; Sastri, J; Josi, K; Mathankar, M; Paul, S; Sawant, M; Moundekar, P

    2015-06-15

    Purpose: The purpose of this study is to evaluate the dosimtry of TMI using Helical Tomotherapy (HT). Methods: Whole body CT data sets of 4 patients (median age : range:12–37 years) with 5mm slice thickness were used for planning in HT (TPS version 4.2.3). The contouring of the target and organ at risks (OAR) were delineated ( Oncentra Master Plan v 4.1). Two plans were generated using 5cm and 2.5 cm field widths.The modulation factor and pitch was 3 and 0.3 respectively. Dose to PTV, OARs and the dose homogeneity were evaluated. The doses obtained were compared with the existimg literature. Dose delivery verification was carried out by point dose and 2D array measurements with ion chamber and Arc check dosimetry (Sun NuclearTM) system repectively. The prescribed dose was 14.4 Gy in 8 fractions. Results: The mean PTV volume was 7341.28cc (sd=2353) The dose homogeneity index of PTV was 12.03(sd=2.98) for 2.5cm-FW and 14.61 (sd=1.33) for 5cm-FW.The conformation number for 2.5 and 5 cm plans are 0.6328(sd=0.09) and 0.5915 (sd=0.0376) respectively. The mean dose(Gy) to the OARs were as follows for 2.5cm-FW : eyes, lens, lungs, kidneys, heart, liver,thyroid and testes for are 4.12,1.9,6.61,4.04,4.85,6.06,7.17 and 1.27. The mean dose(Gy) to the OARs were as follows for 5cm-FW :eyes, lens, lungs, kidneys, heart, liver,thyroid and testes for are 4.45,3.14,6.79,4.02,5.01,6.01,10.8 and 1.33. The mean variation of the point dose as compared to the expected dose was within 2% and the gamma analysis was at 91%. Conclusion: It was concluded that 5cm field width plans produces optimal dose volume parameters with deliverable treatment time. From this initial dissymmetric study, it was concluded that the treatment planning and the dose delivery verification was feasible considering the complexity of the TMI.

  2. The sensitivity of ArcCHECK-based gamma analysis to manufactured errors in helical tomotherapy radiation delivery.

    PubMed

    Templeton, Alistair K; Chu, James C H; Turian, Julius V

    2015-01-08

    Three-dimensional measurement arrays are an efficient means of acquiring a distribution of data for patient plan delivery QA. However, the tie between plan integrity and traditional gamma-based analysis of these data are not clear. This study explores the sensitivity of such analysis by creating errors in Helical Tomotherapy delivery and measuring the passing rates with an ArcCHECK cylindrical diode array. Errors were introduced in each of the couch speed, leaf open time, and gantry starting position in increasing magnitude while the resulting gamma passing rates were tabulated. The error size required to degrade the gamma passing rate to 90% or below was on average a 3% change in couch speed, 5° in gantry synchronization, or a 5 ms in leaf closing speed for a 3%/3 mm Van Dyk gamma analysis. This varied with plan type, with prostate plans exhibiting less sensitivity than head and neck plans and with gamma analysis criteria, but in all cases the error magnitudes were large compared to actual machine tolerances. These findings suggest that the sensitivity of ArcCHECK-based gamma analysis to single-mode errors in tomotherapy plans is dependent upon plan and analysis type and at traditional passing thresholds unable to detect small defects in the plan.

  3. SU-E-P-30: Clinical Applications of Spatially Fractionated Radiation Therapy (GRID) Using Helical Tomotherapy

    SciTech Connect

    Zhang, X; Liang, X; Penagaricano, J; Morrill, S; Corry, P; Paudel, N; Vaneerat, V Ratanatharathorn; Yan, Y; Griffin, R

    2015-06-15

    Purpose: To present the first clinical applications of Helical Tomotherapy-based spatially fractionated radiotherapy (HT-GRID) for deep seated tumors and associated dosimetric study. Methods: Ten previously treated GRID patients were selected (5 HT-GRID and 5 LINAC-GRID using a commercially available GRID block). Each case was re-planned either in HT-GRID or LINAC-GRID for a total of 10 plans for both techniques using same prescribed dose of 20 Gy to maximum point dose of GRID GTV. For TOMO-GRID, a programmable virtual TOMOGRID template mimicking a GRID pattern was generated. Dosimetric parameters compared included: GRID GTV mean dose (Dmean) and equivalent uniform dose (EUD), GRID GTV dose inhomogeneity (Ratio(valley/peak)), normal tissue Dmean and EUD, and other organs-at-risk(OARs) doses. Results: The median tumor volume was 634 cc, ranging from 182 to 4646 cc. Median distance from skin to the deepest part of tumor was 22cm, ranging from 8.9 to 38cm. The median GRID GTV Dmean and EUD was 10.65Gy (9.8–12.5Gy) and 7.62Gy (4.31–11.06Gy) for HT-GRID and was 6.73Gy (4.44–8.44Gy) and 3.95Gy (0.14–4.2Gy) for LINAC-GRID. The median Ratio(valley/peak) was 0.144(0.05–0.29) for HT-GRID and was 0.055(0.0001–0.14) for LINAC-GRID. For normal tissue in HT-GRID, the median Dmean and EUD was 1.24Gy (0.34–2.54Gy) and 5.45 Gy(3.45–6.89Gy) and was 0.61 Gy(0.11–1.52Gy) and 6Gy(4.45–6.82Gy) for LINAC-GRID. The OAR doses were comparable between the HT-GRID and LINAC-GRID. However, in some cases it was not possible to avoid a critical structure in LINAC-GRID; while HT-GRID can spare more tissue doses for certain critical structures. Conclusion: HT-GRID delivers higher GRID GTV Dmean, EUD and Ratio(valley/peak) compared to LINAC-GRID. HT-GRID delivers higher Dmean and lower EUD for normal tissue compared to LINAC-GRID. TOMOGRID template can be highly patient-specific and allows adjustment of the GRID pattern to different tumor sizes and shapes when they are deeply

  4. Preliminary Results of Helical Tomotherapy in Patients with Complex-Shaped Meningiomas Close to the Optic Pathway

    SciTech Connect

    Schiappacasse, Luis Cendales, Ricardo; Sallabanda, Kita; Schnitman, Franco; Samblas, Jose

    2011-01-01

    Meningiomas are the most common benign intracranial tumor. Meningiomas close to the optic pathway represent a treatment challenge both for surgery and radiotherapy. The aim of this article is to describe early results of helical tomotherapy treatment in complex-shaped meningiomas close to the optic pathway. Twenty-eight patients were consecutively treated. All patients were immobilized with a thermoplastic head mask and planned with the aid of a magnetic resonance imaging-computed tomography fusion. All treatments included daily image guidance. Pretreatment symptoms and acute toxicity were recorded. Median age was 57.5 years, and 92.8% patients had Eastern Cooperative Oncology Group performance status scale {<=}1. The most common localizations were the sella turcica, followed by the cavernous sinus and the sphenoid. The most common symptoms were derived from cranial nerve deficits. Tomotherapy was administered as primary treatment in 35.7% of patients, as an adjuvant treatment in 32.4%, and as a rescue treatment after postsurgical progression in 32.1% patients. Most patients were either inoperable or Simpson IV. Total dose varied between 5000 and 5400 cGy; fractionation varied between 180 and 200 cGy. Median dose to the planning target volume was 51.7 Gy (range, 50.2-55.9 Gy). Median coverage index was 0.89 (range, 0.18-0.97). Median homogeneity index was 1.05 (range, 1-1.12). Acute transient toxicity was grade 1 and included headache in 35.7% patients, ocular pain/dryness in 28.5%, and radiation dermatitis in 25%. Thus far, with a maximal follow-up of 3 years, no late effects have been seen and all patients have a radiological stabilization of the disease. Helical tomotherapy offered a safe and effective therapeutic alternative for patients with inoperable or subtotally resected complex-shaped meningiomas close to the optic pathway. Acceptable coverage and homogeneity indexes were achieved with appropriate values for maximal doses delivered to the eyes, lenses

  5. Dosimetric consequences of uncorrected setup errors in helical Tomotherapy treatments of breast-cancer patients.

    PubMed

    Goddu, S Murty; Yaddanapudi, Sridhar; Pechenaya, Olga L; Chaudhari, Summer R; Klein, Eric E; Khullar, Divya; El Naqa, Issam; Mutic, Sasa; Wahab, Sasha; Santanam, Lakshmi; Zoberi, Imran; Low, Daniel A

    2009-10-01

    The Tomotherapy Hi-Art II system allows acquisition of pre-treatment MVCT images to correct patient position. This work evaluates the dosimetric impact of uncorrected setup errors in breast-cancer radiation therapy. Breast-cancer patient-positioning errors were simulated by shifting the patient computed-tomography (CT) dataset relative to the planned photon fluence and re-computing the dose distributions. To properly evaluate the superficial region, film measurements were compared against the Tomotherapy treatment planning system (TPS) calculations. A simulation of the integrated dose distribution was performed to evaluate the setup error impact over the course of treatment. Significant dose differences were observed for 11-mm shifts in the anterolateral and 3-mm shifts in the posteromedial directions. The results of film measurements in the superficial region showed that the TPS overestimated the dose by 14% at a 1-mm depth, improving to 3% at depths >or=5mm. Significant dose reductions in PTV were observed in the dose distributions simulated over the course of treatment. Tomotherapy's rotational delivery provides sufficient photon fluence extending beyond the skin surface to allow an up to 7-mm uncorrected setup error in the anterolateral direction. However, the steep dose falloff that conforms to the lung surface leads to compromised dose distributions with uncorrected posteromedial shifts. Therefore, daily image guidance and consequent patient repositioning is warranted for breast-cancer patients.

  6. SU-E-T-290: Dosimetric Verification of Helical Tomotherapy against Experimental Measurements for Head and Neck Treatments.

    PubMed

    Lopez-Vilanova, N; Bueno, M; Sevillano, D; Minguez, C; Ginjaume, M; Sanchez-Reyes, A; Duch, M

    2012-06-01

    To verify a Tomotherapy plan for a typical head and neck treatment against experimental measurements. The treatment plan for a head and neck case was generated by the Tomotherapy treatment planning system (TPS) to deliver ∼70 Gy in 33 sessions to the contoured PTV. The plan was calculated on a CIRS ATOM anthropomorphic phantom that provides a grid spacing of 3×3 cm(2) holes to accommodate thermoluminescent detectors (TLD). The plan was verified against experimental measurements carried out by (7) LiF:Mg,Ti (TLD-700) TLD. Up to 20 locations were selected within the irradiated region and three detectors were used simultaneously at each point to decrease the statistical uncertainty. TLD locations were labeled in the planning system and dose comparisons between TPS prediction and experimental measurements were performed in terms of absolute dose to water for a single fraction. We examined the dose from (i) the corresponding 3.5MV Tomo-scan alone and (ii) the complete treatment. TLD-700 were found to fulfill the requirements of reproducibility, linearity and flat energy response in a previous study. In particular, TLD energy response was previously checked for 6 MV flattening filter free and conventional radiation beams under reference conditions. Doses derived from the TPS were in most cases in good agreement (4% on average) with TLD dose measurements within TLD statistical uncertainties (about 3%). Larger discrepancies up to 7% were found for points close to complex tissue inhomogeneities, such as bony structures. Dose from the scanning procedure alone is about 1 % of the dose per fraction. This work indicates that dose delivery plans created with Tomotherapy TPS are accurate for head and neck tumor localizations. © 2012 American Association of Physicists in Medicine.

  7. Dosimetric Evaluation of Intensity-Modulated Radiotherapy, Volumetric Modulated Arc Therapy, and Helical Tomotherapy for Hippocampal-Avoidance Whole Brain Radiotherapy

    PubMed Central

    Rong, Yi; Evans, Josh; Xu-Welliver, Meng; Pickett, Cadron; Jia, Guang; Chen, Quan; Zuo, Li

    2015-01-01

    Background Whole brain radiotherapy (WBRT) is a vital tool in radiation oncology and beyond, but it can result in adverse health effects such as neurocognitive decline. Hippocampal Avoidance WBRT (HA-WBRT) is a strategy that aims to mitigate the neuro-cognitive side effects of whole brain radiotherapy treatment by sparing the hippocampi while delivering the prescribed dose to the rest of the brain. Several competing modalities capable of delivering HA-WBRT, include: Philips Pinnacle step-and-shoot intensity modulated radiotherapy (IMRT), Varian RapidArc volumetric modulated arc therapy (RapidArc), and helical TomoTherapy (TomoTherapy). Methods In this study we compared these methods using 10 patient datasets. Anonymized planning CT (computerized tomography) scans and contour data based on fused MRI images were collected. Three independent planners generated treatment plans for the patients using three modalities, respectively. All treatment plans met the RTOG 0933 criteria for HA-WBRT treatment. Results In dosimetric comparisons between the three modalities, TomoTherapy has a significantly superior homogeneity index of 0.15 ± 0.03 compared to the other two modalities (0.28 ± .04, p < .005 for IMRT and 0.22 ± 0.03, p < .005 for RapidArc). RapidArc has the fastest average delivery time of 2.5 min compared to the other modalities (15 min for IMRT and 18 min for TomoTherapy). Conclusion TomoTherapy is considered to be the preferred modality for HA-WBRT due to its superior dose distribution. When TomoTherapy is not available or treatment time is a concern, RapidArc can provide sufficient dose distribution meeting RTOG criteria and efficient treatment delivery. PMID:25894615

  8. Hippocampal-Sparing Whole-Brain Radiotherapy: A 'How-To' Technique Using Helical Tomotherapy and Linear Accelerator-Based Intensity-Modulated Radiotherapy

    SciTech Connect

    Gondi, Vinai; Tolakanahalli, Ranjini; Mehta, Minesh P.; Tewatia, Dinesh; Rowley, Howard; Kuo, John S.; Khuntia, Deepak; Tome, Wolfgang A.

    2010-11-15

    Purpose: Sparing the hippocampus during cranial irradiation poses important technical challenges with respect to contouring and treatment planning. Herein we report our preliminary experience with whole-brain radiotherapy using hippocampal sparing for patients with brain metastases. Methods and Materials: Five anonymous patients previously treated with whole-brain radiotherapy with hippocampal sparing were reviewed. The hippocampus was contoured, and hippocampal avoidance regions were created using a 5-mm volumetric expansion around the hippocampus. Helical tomotherapy and linear accelerator (LINAC)-based intensity-modulated radiotherapy (IMRT) treatment plans were generated for a prescription dose of 30 Gy in 10 fractions. Results: On average, the hippocampal avoidance volume was 3.3 cm{sup 3}, occupying 2.1% of the whole-brain planned target volume. Helical tomotherapy spared the hippocampus, with a median dose of 5.5 Gy and maximum dose of 12.8 Gy. LINAC-based IMRT spared the hippocampus, with a median dose of 7.8 Gy and maximum dose of 15.3 Gy. On a per-fraction basis, mean dose to the hippocampus (normalized to 2-Gy fractions) was reduced by 87% to 0.49 Gy{sub 2} using helical tomotherapy and by 81% to 0.73 Gy{sub 2} using LINAC-based IMRT. Target coverage and homogeneity was acceptable with both IMRT modalities, with differences largely attributed to more rapid dose fall-off with helical tomotherapy. Conclusion: Modern IMRT techniques allow for sparing of the hippocampus with acceptable target coverage and homogeneity. Based on compelling preclinical evidence, a Phase II cooperative group trial has been developed to test the postulated neurocognitive benefit.

  9. Hippocampal-Sparing Whole Brain Radiotherapy: A “How-To” Technique, Utilizing Helical Tomotherapy and LINAC-based Intensity Modulated Radiotherapy

    PubMed Central

    Gondi, Vinai; Tolakanahalli, Ranjini; Mehta, Minesh P.; Tewatia, Dinesh; Rowley, Howard; Kuo, John S.; Khuntia, Deepak; Tomé, Wolfgang A.

    2010-01-01

    Purpose Sparing the hippocampus during cranial irradiation poses important technical challenges with respect to contouring and treatment planning. Herein, we report our preliminary experience with whole-brain radiotherapy using hippocampal sparing for patients with brain metastases. Materials/Methods 5 anonymous patients previously treated with whole-brain radiotherapy with hippocampal sparing were reviewed. The hippocampus was contoured, and hippocampal avoidance regions were created using a 5mm volumetric expansion around the hippocampus. Helical tomotherapy and LINAC-based IMRT treatment plans were generated for a prescription dose of 30 Gy in 10 fractions. Results On average, the hippocampal avoidance volume was 3.3 cm3, occupying 2.1% of the whole brain planned target volume. Helical tomotherapy spared the hippocampus, with a median dose of 5.5 Gy and maximum dose of 12.8 Gy. LINAC-based IMRT spared the hippocampus, with a median dose of 7.8 Gy and maximum dose of 15.3 Gy. On a per-fraction basis, mean dose to the hippocampus (normalized to 2-Gy fractions) was reduced by 87% to 0.49 Gy2 using helical tomotherapy and by 81% to 0.73 Gy2 using LINAC-based IMRT. Target coverage and homogeneity was acceptable with both IMRT modalities, with differences largely attributed to more rapid dose fall-off with helical tomotherapy. Conclusion Modern IMRT techniques allow for sparing of the hippocampus with acceptable target coverage and homogeneity. Based on compelling preclinical evidence, a phase II cooperative group trial has been developed to test the postulated neurocognitive benefit. PMID:20598457

  10. High-dose-rate prostate brachytherapy in a patient with bilateral hip prostheses planned using megavoltage computed tomography images acquired with a helical tomotherapy unit.

    PubMed

    Holly, Rick; Myrehaug, Sten; Kamran, Asim; Sankreacha, Raxa; Morton, Gerard

    2009-01-01

    The presence of hip prostheses results in significant image artifacts making delineation of anatomy for planning difficult with traditional kilovoltage CT images. This report presents the use of megavoltage computed tomography (MVCT) imaging acquired with a helical tomotherapy unit to plan a high-dose-rate (HDR) prostate brachytherapy treatment for a patient with bilateral hip prostheses. A 77-year-old man presented with a localized clinical Stage T3a, Gleason 7 prostate cancer. Past history was also significant for bilateral hip prostheses. Staging workup included a negative bone scan and CT of abdomen and pelvis. The pelvic CT exhibited significant streak artifacts obscuring the prostate. HDR monotherapy with adjuvant androgen deprivation therapy was proposed. On the day of the implant and after catheter insertion, MVCT imaging of the pelvic area of the patient was obtained using a commercial helical tomotherapy unit. The MVCT images were transferred to Nucletron PLATO (v14.3.2) for planning with optimization of catheter dwell positions and times. MVCT images acquired with the helical tomotherapy unit allow good visualization of bony anatomy and of the hip prosthesis. No reconstruction streak artifacts are visible in the images as seen in the diagnostic kilovoltage CT images. Sufficient soft tissue contrast exists to allow delineation of the bladder and rectum. The absence of streak artifacts provides good quantification of Hounsfield number in the region surrounding the hip prosthesis and allows for good dose quantification. MVCT images obtained using the commercial helical tomotherapy unit have been shown to provide good soft tissue contrast and no streak artifacts when planning a patient for prostate HDR brachytherapy having bilateral prosthetic hip replacements. The rectum and bladder can be clearly seen in the MVCT images and contoured independently. Prostate delineation is assumed from the position of the brachytherapy catheters.

  11. Efficacy of the Dynamic Jaw Mode in Helical Tomotherapy With Static Ports for Breast Cancer

    PubMed Central

    Manabe, Yoshihiko; Hayashi, Akihiro; Murai, Taro; Takaoka, Taiki; Hattori, Yukiko; Iwata, Hiromitsu; Takenaka, Ran; Shibamoto, Yuta

    2015-01-01

    The recently developed dynamic jaw technology of tomotherapy can reduce craniocaudal dose spread without much prolonging the treatment time. This study aimed to investigate the efficacy of the dynamic jaw mode for tomotherapy of breast cancer. Static tomotherapy plans of the whole breast and supraclavicular regional lymph nodes, and plans for the whole breast only were generated in 25 patients with left-sided breast cancer. Plans with a field width of 2.5 or 5 cm with the dynamic or fixed jaw modes were made for each patient. The prescribed dose was 50 Gy in 25 fractions. In whole breast and supraclavicular nodal radiotherapy, dose distributions and homogeneity of the planning target volume (PTV) with the dynamic jaw mode were slightly inferior to those with the fixed jaw mode with a 5-cm field width (P < .05). However, lung low-dose volumes and mean doses of the larynx, thyroid, skin, and all the healthy tissues combined were smaller with the dynamic jaw mode than with the fixed jaw mode with a 5-cm field width (P < .001). In whole breast radiotherapy, mean doses of the skin and healthy tissues were lower with the dynamic jaw mode than with the fixed jaw mode with a 5-cm field width (P < .001) without significant differences in PTV dose distributions, homogeneity, and conformity. The dynamic jaw mode provided better sparing of organs at risks with minimal disturbance of dose–volume indices of PTV. Considering the treatment time, the 5-cm-field dynamic jaw mode is more efficient than the 2.5-cm fixed jaw mode. PMID:25398681

  12. Efficacy of the Dynamic Jaw Mode in Helical Tomotherapy With Static Ports for Breast Cancer.

    PubMed

    Sugie, Chikao; Manabe, Yoshihiko; Hayashi, Akihiro; Murai, Taro; Takaoka, Taiki; Hattori, Yukiko; Iwata, Hiromitsu; Takenaka, Ran; Shibamoto, Yuta

    2015-08-01

    The recently developed dynamic jaw technology of tomotherapy can reduce craniocaudal dose spread without much prolonging the treatment time. This study aimed to investigate the efficacy of the dynamic jaw mode for tomotherapy of breast cancer. Static tomotherapy plans of the whole breast and supraclavicular regional lymph nodes, and plans for the whole breast only were generated in 25 patients with left-sided breast cancer. Plans with a field width of 2.5 or 5 cm with the dynamic or fixed jaw modes were made for each patient. The prescribed dose was 50 Gy in 25 fractions. In whole breast and supraclavicular nodal radiotherapy, dose distributions and homogeneity of the planning target volume (PTV) with the dynamic jaw mode were slightly inferior to those with the fixed jaw mode with a 5-cm field width (P < .05). However, lung low-dose volumes and mean doses of the larynx, thyroid, skin, and all the healthy tissues combined were smaller with the dynamic jaw mode than with the fixed jaw mode with a 5-cm field width (P < .001). In whole breast radiotherapy, mean doses of the skin and healthy tissues were lower with the dynamic jaw mode than with the fixed jaw mode with a 5-cm field width (P < .001) without significant differences in PTV dose distributions, homogeneity, and conformity. The dynamic jaw mode provided better sparing of organs at risks with minimal disturbance of dose-volume indices of PTV. Considering the treatment time, the 5-cm-field dynamic jaw mode is more efficient than the 2.5-cm fixed jaw mode.

  13. Helical tomotherapy and larynx sparing in advanced oropharyngeal carcinoma: a dosimetric study.

    PubMed

    Gielda, Benjamin T; Millunchick, Cheryl H; Smart, Joseph P; Marsh, James C; Turian, Julius V; Coleman, Joy L

    2010-01-01

    Intensity-modulated radiation therapy (IMRT) is gaining acceptance as a standard treatment technique for advanced squamous cell carcinoma (SCC) of the oropharynx. Dose to the uninvolved larynx and surrounding structures can pose a problem in patients with significant neck disease, potentially compromising laryngeal function and quality of life. Tomotherapy may allow greater laryngeal sparing. Seven patients with stage IV SCC of the oropharynx were replanned using Tomotherapy version 3.1. All contours/planning target volumes (PTVs) from the original plans were preserved, with the exception of the larynx, which was drawn to include all soft tissue encompassed by the thyroid/cricoid cartilage. A simultaneous integrated boost technique was used with PTV 1, 2, and 3 receiving 69.96, 59.40, and 54.00 Gy, respectively in 33 fractions. Dosimetry was evaluated via the Pinnacle treatment planning system (TPS). Equivalent uniform dose (EUD) was calculated from the dose volume histogram (DVH) using the general method with "a" = 5.0. Mean larynx dose for all patients was 24.4 Gy. Mean EUD to the larynx was 34.2 Gy. Homogeneity was adequate; average maximum dose was 109.7% of the highest prescription. All other organs at risk (OAR) were adequately spared. Tomotherapy can spare the uninvolved larynx in the setting of advanced SCC of the oropharynx to levels that are similar to or better than those reported with other techniques. Sparing is achieved without compromising target coverage or other OAR sparing. The clinical benefit of this sparing remains to be determined in a prospective study.

  14. Helical Tomotherapy and Larynx Sparing in Advanced Oropharyngeal Carcinoma: A Dosimetric Study

    SciTech Connect

    Gielda, Benjamin T.; Millunchick, Cheryl H.; Smart, Joseph P.; Marsh, James C.; Turian, Julius V.; Coleman, Joy L.

    2010-10-01

    Intensity-modulated radiation therapy (IMRT) is gaining acceptance as a standard treatment technique for advanced squamous cell carcinoma (SCC) of the oropharynx. Dose to the uninvolved larynx and surrounding structures can pose a problem in patients with significant neck disease, potentially compromising laryngeal function and quality of life. Tomotherapy may allow greater laryngeal sparing. Seven patients with stage IV SCC of the oropharynx were replanned using Tomotherapy version 3.1. All contours/planning target volumes (PTVs) from the original plans were preserved, with the exception of the larynx, which was drawn to include all soft tissue encompassed by the thyroid/cricoid cartilage. A simultaneous integrated boost technique was used with PTV 1, 2, and 3 receiving 69.96, 59.40, and 54.00 Gy, respectively in 33 fractions. Dosimetry was evaluated via the Pinnacle treatment planning system (TPS). Equivalent uniform dose (EUD) was calculated from the dose volume histogram (DVH) using the general method with 'a' = 5.0. Mean larynx dose for all patients was 24.4 Gy. Mean EUD to the larynx was 34.2 Gy. Homogeneity was adequate; average maximum dose was 109.7% of the highest prescription. All other organs at risk (OAR) were adequately spared. Tomotherapy can spare the uninvolved larynx in the setting of advanced SCC of the oropharynx to levels that are similar to or better than those reported with other techniques. Sparing is achieved without compromising target coverage or other OAR sparing. The clinical benefit of this sparing remains to be determined in a prospective study.

  15. Clinical Evaluation of an Immbolization System for Stereotactic Body Radiotherapy Using Helical Tomotherapy

    SciTech Connect

    Gutierrez, Alonso N.; Stathakis, Sotirios; Crownover, Richard; Esquivel, Carlos; Shi Chengyu; Papanikolaou, Niko

    2011-07-01

    In this study, a clinical evaluation of the Body Pro-Lok{sup TM} System combined with the TomoTherapy megavoltage computed tomography (MVCT) was performed for lung and liver stereotactic body radiotherapy (SBRT) to reduce interfractional setup uncertainty. Twenty patients treated with 3-5 fractions of SBRT were analyzed retrospectively. The Body Pro-Lok{sup TM} system was used in both CT simulation and during patient treatment setup. Patients were immobilized with a vacuum cushion placed posteriorly over the thoracic region, an abdominal compression plate, and a knee and foot sponge. Pretreatment MVCT scans of the TomoTherapy HI-ART II unit were fused with the planning kVCT before delivery of each fraction to determine the interfractional setup error. A total of 84 shifts were analyzed to assess the interfractional setup accuracy. Results showed that the mean interfractional setup errors and standard deviations were -0.9 {+-} 3.1 mm, 1.2 {+-} 5.5 mm, and 6.5 {+-} 2.6 mm for lateral (IEC-X), longitudinal (IEC-Y), and vertical (IEC-Z) variations, respectively. The maximum motion was 17.1 mm in the longitudinal direction. When all 3 translational coordinates were analyzed, a mean composite displacement vector of 8.2 {+-} 2.0 mm (range 4.1-11.7 mm) was obtained for all patients. Based on the findings, image-guided SBRT using the Body Pro-Lok{sup TM} system in conjunction with the MVCT of TomoTherapy is capable of minimizing interfractional setup error and improving treatment accuracy.

  16. Helical and Static-port Tomotherapy Using the Newly-developed Dynamic Jaws Technology for Lung Cancer.

    PubMed

    Manabe, Yoshihiko; Shibamoto, Yuta; Sugie, Chikao; Hayashi, Akihiro; Murai, Taro; Yanagi, Takeshi

    2015-10-01

    With the newly developed dynamic jaws technology, radiation dose for the cranio-caudal edges of a target can be lowered in the treatment with tomotherapy. We compared dynamic-jaw- and fixed-jaw-mode plans for lung cancer. In 35 patients, four plans using the 2.5-cm dynamic-, 2.5-cm fixed-, 5.0-cm dynamic-, and 5.0-cm fixed-jaw modes were generated. For 10 patients with upper lobe stage I lung cancer, the helical tomotherapy mode was used. Fifty-six Gy in 8 fractions was prescribed as a minimum coverage dose for 95% of the target (D95%). For 25 patients with locally advanced lung cancer, plans using four static ports (TomoDirect® mode) were made. Sixty Gy in 30 daily fractions for the primary tumor and swollen lymph nodes and 51 Gy in 30 fractions for prophylactic lymph node areas were prescribed as median doses. The mean conformity index of the planning target volume were similar among the four plans. The mean V5 Gy of the lung for 2.5-cm dynamic-, 2.5-cm fixed-, 5.0-cm dynamic-, and 5.0-cm fixed-jaw mode plans were 18.5%, 21.8%, 20.1%, and 29.4%, respectively (p < 0.0001), for patients with stage I lung cancer, and 37.3%, 38.7%, 40.4%, and 44.0%, respectively (p < 0.0001), for patients with locally advanced lung cancer. The mean V5 Gy of the whole body was 1,826, 2,143, 1,983, and 2,939 ml, respectively (p < 0.0001), for patients with stage I lung cancer and 4,849, 5,197, 5,220, and 6,154 ml, respectively (p < 0.0001), for patients with locally advanced lung cancer. Treatment time was reduced by 21-39% in 5.0-cm dynamic-jaw plans compared to 2.5-cm plans. Regarding dose distribution, 2.5-cm dynamic-jaw plans were the best, and 5.0-cm dynamic-jaw plans were comparable to 2.5-cm fixed-jaw plans with shorter treatment times. The dynamic-jaw mode should be used instead of the conventional fixed-jaw mode in tomotherapy for lung cancer.

  17. SU-F-BRB-13: Correlation of Improved Target and Organ-At-Risk Dosimetric Quantities and Clinical Outcomes for Helical Tomotherapy Treated Mesothelioma

    SciTech Connect

    Qi, S; Kishan, A; Alexander, S; Lee, P; Selch, M; Kupelian, P; Steiberg, M; Low, D

    2015-06-15

    Purpose: We have observed improved local control probability (LCP) for adjuvant mesothelioma radiotherapy following pleurectomy/decortication using Tomotherapy compared to the conventional 3D technique (p<0.05). This work assesses the correlation between the improved clinical outcomes against dosimetry quantities. Methods: Thirty-eight mesothelioma cases consecutively treated at our clinic were retrospectively analyzed. Sixteen patients were treated using 3D technique planned on the Eclipse for c-arm accelerators prior to 7/2012; the other 22 cases were treated on Tomotherapy using helical IMRT after 7/2012. Typical 3D plans consisting of 15 MV AP/PA photon fields prescribed to 10 cm depth followed by matching electron fields with energy ranging from 8–16 MeV. Tomotherapy plans were designed using 2.5cm jaw, 0.287 pitch with directional blocking of the contralateral lung. The same prescription of 45 Gy (1.8GyX25) was used for both techniques. The dosimetry metrics for the critical structures: ipsilateral-/contralateral-lung, heart, cord, esophagus, etc were compared between two techniques. Results: Superior LCP is closely associated with improved target coverage. Tomotherapy plans yielded dramatically better target coverage and less dose heterogeneity despite of more advanced/larger disease. The averaged PTV volumes were 2287.3±569.9 (Tomotherapy) vs. 1904.8±312.3cc (3D); V100s were: 91.1±4.0 (%) vs. 47.8±12.7 (%) with heterogeneity indices of 1.20±0.1 vs.1.37±0.38 and for the Tomotherapy and 3D plans, respectively. Compared to the 3D technique, we observed significant lower maximum cord doses (p<0.001), lower mean esophagus doses (p<0.002), and lower heart mean doses when tumor was left-sided (p=0.002). For ipsilateral-/contralateral-lungs, however, the mean doses and V20, V5 of Tomotherapy plans were significantly higher than the 3D plans (p<0.01) regardless which sides of lung were treated. However, rates of radiation pneumonitis were no different

  18. [Preliminary results of whole breast helical tomotherapy with simultaneous integrated boost in the adjuvant treatment of breast cancer].

    PubMed

    Liem, X; Chira, C; Fourquet, A; Campana, F; Peurien, D; Fournier-Bidoz, N; Kirova, Y M

    2014-01-01

    To evaluate the dosimetry and acute toxicity of helical tomotherapy for locoregional irradiation of patients after breast-conserving surgery. Twenty breast cancer patients with breast-conserving surgery treated by helical tomotherapy have been studied. The median age was 49 (min: 25, max: 69). The whole breast, tumour bed and lymph nodes were prescribed 52.2 Gy, 63.8 Gy and 50.4 Gy, all in 29 fractions. The dose per fraction was 2.2 Gy to the boost, 1.8 Gy to the breast and 1.74 Gy to the lymph node volumes. The reproducibility was analysed by recording the daily shifts in x, y and z directions and roll rotation. All toxicities were described using the Common Terminology Criteria for Adverse Effects v3.0. Twenty-two tumours were irradiated. Six-eight percent were located in the inner quadrant. In 90 % of patients supraclavicular and internal mammary nodes were treated. The coverage of planning target volumes (PTV) was as follows: PTV boost: V107 = 0.3 % ± 0.5 SD, V95 = 98.4 % ± 1.9 SD; PTV breast: -V107 = 7.8 % ± 17.3 SD, V95 = 96.8 % ± 2.2 SD; PTV LN: V107 = 2.5 % ± 4.2 SD, V95 = 92.7 % ± 13.2 SD. The mean V20 of the homolateral lung was 18.9 % ± 3.5 SD. For left side lesion, the mean V30 of the heart was 0.9 % ± 0.8 SD. The mean V5 was: V5 homolateral lung: 73.1 % ± 11.8 ET, controlateral lung: 38.9 % ± 21, heart (left side breast): 57.3 % ± 21, controlateral breast: 15.5 % ± 9.6. Median shifts were as follow: x-axis -0.04 mm (IC 95: -0.4 +0.38), y-axis -0.37 mm ± 5.51 (IC 95: -0.88 +0.14), z-axis 2.90 mm ± 5.42 (IC 95:+2.4+3.4) and roll rotation 0.22 ± 1.10 (IC 95: -0.1+0.32). The treatment tolerance was acceptable with 1 definitive interruption couple of fractions before the end and 3 temporal interruptions for skin toxicity. No grade 3 or 4 toxicity. Ninety-five percent of patients experienced skin toxicity: 45 % grade 2. There were 3 cases of oesophagitis. The median follow-up of presented series is 9.7 months and all of the patients are free

  19. Theory of helical electron beams in gyrotrons

    SciTech Connect

    Kuftin, A.N.; Lygin, V.K.; Manuilov, V.N.; Raisky, B.V.; Solujanova, E.A.; Tsimring, S.E.

    1993-04-01

    Helical electron beams (HEB) with disturbed axial symmetry of currents density and HEB with locking electrons in magnetic trap are described. The theory of magnetron injection gun (MIG) in space-charge limited current is developed. Systems on permanent magnets forming HEB are considered. 30 refs., 12 figs., 5 tabs.

  20. Helical Tomotherapy With Simultaneous Integrated Boost After Laparoscopic Staging in Patients With Cervical Cancer: Analysis of Feasibility and Early Toxicity

    SciTech Connect

    Marnitz, Simone; Koehler, Christhardt; Burova, Elena; Wlodarczyk, Waldemar; Jahn, Ulrich; Gruen, Arne; Budach, Volker; Stromberger, Carmen

    2012-02-01

    Purpose: To demonstrate the feasibility and safety of the simultaneous integrated boost technique for dose escalation in combination with helical tomotherapy in patients with cervical cancer. Methods and Materials: Forty patients (International Federation of Gynecology and Obstetrics Stage IB1 pN1-IVA) underwent primary chemoradiation with helical tomotherapy. Before therapy, 29/40 patients underwent laparoscopic pelvic and para-aortic lymphadenectomy. In 21%, 31%, and 3% of the patients, pelvic, pelvic and para-aortic, and skip metastases in the para-aortic region could be confirmed. All patients underwent radiation with 1.8-50.4 Gy to the tumor region and the pelvic (para-aortic) lymph node region (planning target volume-A), and a simultaneous boost with 2.12-59.36 Gy to the boost region (planning target volume-B). The boost region was defined using titan clips during laparoscopic staging. In all other patients, standardized borders for the planning target volume-B were defined. High-dose-rate brachytherapy was performed in 39/40 patients. The mean biologic effective dose to the macroscopic tumor ranged from 87.5 to 97.5 Gy. Chemotherapy consisted of weekly cisplatin 40 mg/m{sup 2}. Dose-volume histograms and acute gastrointestinal, genitourinary, and hematologic toxicity were evaluated. Results: The mean treatment time was 45 days. The mean doses to the small bowel, rectum, and bladder were 28.5 {+-} 6.1 Gy, 47.9 {+-} 3.8 Gy, and 48 {+-} 3 Gy, respectively. Hematologic toxicity Grade 3 occurred in 20% of patients, diarrhea Grade 2 in 5%, and diarrhea Grade 3 in 2.5%. There was no Grade 3 genitourinary toxicity. All patients underwent curettage 3 months after chemoradiation, which confirmed complete pathologic response in 38/40 patients. Conclusions: The concept of simultaneous integrated boost for dose escalation in patients with cervical cancer is feasible, with a low rate of acute gastrointestinal and genitourinary toxicity. Whether dose escalation can be

  1. Sparing of the Neural Stem Cell Compartment During Whole-Brain Radiation Therapy: A Dosimetric Study Using Helical Tomotherapy

    SciTech Connect

    Marsh, James C.; Godbole, Rohit H.; Herskovic, Arnold M.; Gielda, Benjamin T.; Turian, Julius V.

    2010-11-01

    Purpose: To assess the feasibility of dosimetrically sparing the hippocampus and neural stem cell (NSC) compartment during whole-brain radiotherapy (WBRT) and prophylactic cranial irradiation (PCI). Methods and Materials: We contoured the brain/brainstem on fused magnetic resonance /computed tomography images as the planning target volume (PTV) in 10 patients, excluding the hippocampus and NSC compartment as organs at risk. PCI and WBRT helical tomotherapy plans were prepared for each patient, with 1.0-cm field width, a pitch of 0.285, and a modulation factor of 2.5. We attempted to maximally spare the hippocampus and NSC compartment while treating the rest of the brain to 30 Gy in 15 fractions (PCI) or 35 Gy in 14 fractions (WBRT) with a V{sub 100} of {>=}95%. Plan quality was assessed by calculating mean dose, equivalent uniform dose (EUD), and biologically equivalent dose (BED) for organs at risk and the percent volume of the PTV receiving the prescribed dose of V{sub 100}. Results: In the PCI plans, mean doses/EUD/BED for the hippocampus and NSC compartment were 11.5 Gy/13.1 Gy/15.7 Gy{sub 2} (BED assuming alpha/beta ratio of 2Gy) and 11.5 Gy/13.1 Gy/12.3 Gy{sub 10} (BED assuming alpha/beta ratio of 10Gy), respectively. In the WBRT plans, mean doses/EUD/BED for the hippocampus and NSC compartment were 11.8 Gy/14.8 Gy/16.8 Gy{sub 2} and 11.8 Gy/14.8 Gy/12.8 Gy{sub 10}, respectively. The mean V{sub 95} for the rest of the brain (PTV) was 96.9% for both the PCI and WBRT plans. Mean PCI and WBRT treatment times were 15.93 min (range, 14.28 min-17.50 min) and 20.18 min (range, 18.43 min-22.32 min), respectively. Conclusions: It is dosimetrically feasible to spare the hippocampus and NSC compartment using helical tomotherapy during the administration of whole-brain irradiation.

  2. Prostate treatment with helical TomoTherapy in patients with bilateral hip prostheses—Two case studies

    SciTech Connect

    Kling, Justin; Patel, Kamal M.

    2013-04-01

    Prostate cancer patients with bilateral hip prostheses require additional planning and treatment considerations. Visualization of the organs at risk (OAR) and the planning target volume (PTV) is hindered by the large amount of artifact streaking between the metallic implants. The density of this area must be accounted for when using heterogeneity correction. Fusion of a megavolt computed tomography (MVCT) to the planning CT aids in viewing the prostate, bladder, and rectum, and implantation of 6 fiducial markers along the posterior border of the prostate helps with the delineation between it and the rectum. When planning, the amount of beam entry angles is limited because of the position of the prostheses and prevents the use of any lateral beams. Therefore, TomoTherapy presents an effective option for these patients because of the ability to use a directional block, which prevents any primary beams from entering through the bilateral hip prostheses (but the beams may exit through the structures), use of MVCT for daily localization, and delivery of radiation with intensity modulation allows for effective sparing of the OAR.

  3. Dose calculation software for helical tomotherapy, utilizing patient CT data to calculate an independent three-dimensional dose cube

    SciTech Connect

    Thomas, Simon J.; Eyre, Katie R.; Tudor, G. Samuel J.; Fairfoul, Jamie

    2012-01-15

    Purpose: Treatment plans for the TomoTherapy unit are produced with a planning system that is integral to the unit. The authors have produced an independent dose calculation system, to enable plans to be recalculated in three dimensions, using the patient's CT data. Methods: Software has been written using MATLAB. The DICOM-RT plan object is used to determine the treatment parameters used, including the treatment sinogram. Each projection of the sinogram is segmented and used to calculate dose at multiple calculation points in a three-dimensional grid using tables of measured beam data. A fast ray-trace algorithm is used to determine effective depth for each projection angle at each calculation point. Calculations were performed on a standard desktop personal computer, with a 2.6 GHz Pentium, running Windows XP. Results: The time to perform a calculation, for 3375 points averaged 1 min 23 s for prostate plans and 3 min 40 s for head and neck plans. The mean dose within the 50% isodose was calculated and compared with the predictions of the TomoTherapy planning system. When the modified CT (which includes the TomoTherapy couch) was used, the mean difference for ten prostate patients, was -0.4% (range -0.9% to +0.3%). With the original CT (which included the CT couch), the mean difference was -1.0% (range -1.7% to 0.0%). The number of points agreeing with a gamma 3%/3 mm averaged 99.2% with the modified CT, 96.3% with the original CT. For ten head and neck patients, for the modified and original CT, respectively, the mean difference was +1.1% (range -0.4% to +3.1%) and 1.1% (range -0.4% to +3.0%) with 94.4% and 95.4% passing a gamma 4%/4 mm. The ability of the program to detect a variety of simulated errors has been tested. Conclusions: By using the patient's CT data, the independent dose calculation performs checks that are not performed by a measurement in a cylindrical phantom. This enables it to be used either as an additional check or to replace phantom

  4. Muon Beam Helical Cooling Channel Design

    SciTech Connect

    Johnson, Rolland; Ankenbrandt, Charles; Flanagan, G; Kazakevich, G M; Marhauser, Frank; Neubauer, Michael; Roberts, T; Yoshikawa, C; Derbenev, Yaroslav; Morozov, Vasiliy; Kashikhin, V S; Lopes, Mattlock; Tollestrup, A; Yonehara, Katsuya; Zloblin, A

    2013-06-01

    The Helical Cooling Channel (HCC) achieves effective ionization cooling of the six-dimensional (6d) phase space of a muon beam by means of a series of 21st century inventions. In the HCC, hydrogen-pressurized RF cavities enable high RF gradients in strong external magnetic fields. The theory of the HCC, which requires a magnetic field with solenoid, helical dipole, and helical quadrupole components, demonstrates that dispersion in the gaseous hydrogen energy absorber provides effective emittance exchange to enable longitudinal ionization cooling. The 10-year development of a practical implementation of a muon-beam cooling device has involved a series of technical innovations and experiments that imply that an HCC of less than 300 m length can cool the 6d emittance of a muon beam by six orders of magnitude. We describe the design and construction plans for a prototype HCC module based on oxygen-doped hydrogen-pressurized RF cavities that are loaded with dielectric, fed by magnetrons, and operate in a superconducting helical solenoid magnet.

  5. Dosimetric comparison of three different treatment modalities for total scalp irradiation: the conventional lateral photon-electron technique, helical tomotherapy, and volumetric-modulated arc therapy.

    PubMed

    Song, Jin Ho; Jung, Ji-Young; Park, Hyung-Wook; Lee, Gi Woong; Chae, Soo-Min; Kay, Chul Seung; Son, Seok Hyun

    2015-07-01

    The aim of this study was to compare lateral photon-electron (LPE), helical tomotherapy (HT), and volumetric-modulated arc therapy (VMAT) plans for total scalp irradiation. We selected a single adult model case and compared the dosimetric results for the three plans. All plans mainly used 6-MV photon beams, and the prescription dose was 60 Gy in 30 fractions. First, we compared the LPE, HT and VMAT plans, with all plans including a 1-cm bolus. We also compared HT plans with and without the bolus. The conformity indices for LPE, HT and VMAT were 1.73, 1.35 and 1.49, respectively. The HT plan showed the best conformity and the LPE plan showed the worst. However, the plans had similar homogeneity indexes. The dose to the hippocampus was the highest in the VMAT plan, with a mean of 6.7 Gy, compared with 3.5 Gy in the LPE plan and 4.8 Gy in the HT plan. The doses to the optical structures were all within the clinically acceptable range. The beam-on time and monitor units were highest in the HT plan. The HT plans with and without a bolus showed similar target coverage and organ-at-risk (OAR) sparing. The HT plan showed the best target coverage and conformity, with low doses to the brain and hippocampus. This plan also had the advantage of not necessarily requiring a bolus. Although the VMAT plan showed better conformity than the LPE plan and acceptable OAR sparing, the dose to the hippocampus should be considered when high doses are prescribed.

  6. A Dosimetric Comparison of Accelerated Partial Breast Irradiation Techniques: Multicatheter Interstitial Brachytherapy, Three-Dimensional Conformal Radiotherapy, and Supine Versus Prone Helical Tomotherapy

    SciTech Connect

    Patel, Rakesh R. . E-mail: patel@humonc.wisc.edu; Becker, Stewart J.; Das, Rupak K.; Mackie, Thomas R.

    2007-07-01

    Purpose: To compare dosimetrically four different techniques of accelerated partial breast irradiation (APBI) in the same patient. Methods and Materials: Thirteen post-lumpectomy interstitial brachytherapy (IB) patients underwent imaging with preimplant computed tomography (CT) in the prone and supine position. These CT scans were then used to generate three-dimensional conformal radiotherapy (3D-CRT) and prone and supine helical tomotherapy (PT and ST, respectively) APBI plans and compared with the treated IB plans. Dose-volume histogram analysis and the mean dose (NTD{sub mean}) values were compared. Results: Planning target volume coverage was excellent for all methods. Statistical significance was considered to be a p value <0.05. The mean V100 was significantly lower for IB (12% vs. 15% for PT, 18% for ST, and 26% for 3D-CRT). A greater significant differential was seen when comparing V50 with mean values of 24%, 43%, 47%, and 52% for IB, PT, ST, and 3D-CRT, respectively. The IB and PT were similar and delivered an average lung NTD{sub mean} dose of 1.3 Gy{sub 3} and 1.2 Gy{sub 3}, respectively. Both of these methods were statistically significantly lower than the supine external beam techniques. Overall, all four methods yielded similar low doses to the heart. Conclusions: The use of IB and PT resulted in greater normal tissue sparing (especially ipsilateral breast and lung) than the use of supine external beam techniques of 3D-CRT or ST. However, the choice of APBI technique must be tailored to the patient's anatomy, lumpectomy cavity location, and overall treatment goals.

  7. Implementation of HybridArc treatment technique in preoperative radiotherapy of rectal cancer: dose patterns in target lesions and organs at risk as compared to helical Tomotherapy and RapidArc

    PubMed Central

    2012-01-01

    Purpose HybridArc is a novel treatment technique blending aperture-enhanced optimized arcs with discrete IMRT-elements, allowing selection of arcs with a set of static IMRT-beams. This study compared this new technique to helical Tomotherapy, and RapidArc, in preoperative radiotherapy of rectal cancer. Material and methods Twelve rectal cancer patients treated consecutively with Tomotherapy Hi-Art II system were simulated with HybridArc and RapidArc. Treatment plans were designed to deliver homogeneous dose of 46.0Gy to mesorectum and draining lymph nodes, with a simultaneous-integrated-boost to the primary tumor up to a total dose of 55.2Gy. Planning objectives were 95% of prescribed dose to 95% of PTVs, while minimizing the volume of small bowel receiving more than 15Gy (V15) and the mean bladder dose. Dose gradient towards simultaneous-integrated-boost (GI), calculated by dividing the volume receiving more then 52.4Gy (95% of PTV55.2Gy)to the volume of PTV55.2Gy, was kept below 1.5. Mean beam-on time and amount of MUs were also analyzed. Results PTV swere adequately covered by all plans. Significant advantage was found for Tomotherapy in sparing small bowel (V15 = 112.7cm3SD73.4cm3) compared to RapidArc (133.4cm3SD75.3cm3) and HybridArc (143.7cm3SD74.4cm3) (p < 0.01). The mean bladder dose was better with RapidArc (20.6GySD2.2Gy) compared to HybridArc (24.2Gy SD4.3Gy) and Tomotherapy (23.0GySD4.7Gy) (p < 0.01). The mean beam-on time was significantly lower (p < 0.01) for HybridArc (2.7min SD0.8) and RapidArc (2.5min SD0.5) compared to Tomotherapy (11.0min SD0.7). The total amount of MUs was significantly (p < 0.01) lower for RapidArc (547SD44)compared to HybridArc (949 SD153). Conclusions HybridArc is a feasible solution for preoperative RT with a simultaneous-integrated-boost in rectal cancer patients. It achieved similar PTV coverage with significant lower beam-on time, but less efficient in sparing small bowel and bladder compared to

  8. Conditioner for a helically transported electron beam

    SciTech Connect

    Wang, C.

    1992-05-01

    The kinetic theory is developed to investigate a conditioner for a helically imported electron beam. Linear expressions for axial velocity spread are derived. Numerical simulation is used to check the theoretical results and examine nonlinear aspects of the conditioning process. The results show that in the linear regime the action of the beam conditioner on a pulsed beam mainly depends on the phase at which the beam enters the conditioner and depends only slightly on the operating wavelength. In the nonlinear regime, however, the action of the conditioner strongly depends on the operating wavelength and only slightly upon the entrance phase. For a properly chosen operating wavelength, a little less than the electron's relativistic cyclotron wavelength, the conditioner can decrease the axial velocity spread of a pulsed beam down to less than one-third of its initial value.

  9. Conditioner for a helically transported electron beam

    SciTech Connect

    Wang, C.

    1992-05-01

    The kinetic theory is developed to investigate a conditioner for a helically imported electron beam. Linear expressions for axial velocity spread are derived. Numerical simulation is used to check the theoretical results and examine nonlinear aspects of the conditioning process. The results show that in the linear regime the action of the beam conditioner on a pulsed beam mainly depends on the phase at which the beam enters the conditioner and depends only slightly on the operating wavelength. In the nonlinear regime, however, the action of the conditioner strongly depends on the operating wavelength and only slightly upon the entrance phase. For a properly chosen operating wavelength, a little less than the electron`s relativistic cyclotron wavelength, the conditioner can decrease the axial velocity spread of a pulsed beam down to less than one-third of its initial value.

  10. Dosimetric effects of swelling or shrinking tissue during helical tomotherapy breast irradiation: A phantom study.

    PubMed

    Klepper, Rudolf; Höfel, Sebastian; Botha, Ulrike; Köhler, Peter; Zwicker, Felix

    2014-07-08

    During radiation therapy of the female breast, the actual target volume compared to the planning target volume may change due to swelling or shrinking of the tissue. Under- or overdosage is to be expected, especially when performing IMRT or tomotherapy techniques. The objective of this study is to develop a model-based quantification of these dose effects, with a particular focus on the changes in the surface dose. A cylindrical phantom was used as an artificial surrogate of the human torso. By adding and removing Superflab layers of various thicknesses, both radial breast swelling and shrinking could be simulated. The effects on dose distribution were evaluated using film dosimetry. The results were compared to dose calculations. To estimate the true surface doses, we subtracted the influence of the film material on air measurements. During a swelling of 5, 10, and 15 mm, the planning target volume was consistently underdosed by 2%, 5%, and 7% of the prescribed dose, respectively. Swelling led to reduced dose values of up to 72%, 55%, and 50% at the outer edge of the actual target volume. The measured surface dose decreased successively from 31% to 23%. During shrinking, the dose in the planning target volume increased successively from 100% to 106%. The measured surface doses increased from 29% to 36%. The calculated dose values agreed with the measured values within error limits. During radiotherapy of the female breast, new planning appears to be essential for radial tissue swelling of 5 mm or more because of severe underdosing. Shrinking leads to moderate overdosing and an increased surface dose. In addition, caution is advised when removing bolus material with respect to the planned situation.

  11. Dosimetric effects of swelling or shrinking tissue during helical tomotherapy breast irradiation. A phantom study.

    PubMed

    Klepper, Rudolf; Höfel, Sebastian; Botha, Ulrike; Köhler, Peter; Zwicker, Felix

    2014-07-01

    During radiation therapy of the female breast, the actual target volume compared to the planning target volume may change due to swelling or shrinking of the tissue. Under- or overdosage is to be expected, especially when performing IMRT or tomotherapy techniques. The objective of this study is to develop a model-based quantification of these dose effects, with a particular focus on the changes in the surface dose. A cylindrical phantom was used as an artificial surrogate of the human torso. By adding and removing Superflab layers of various thicknesses, both radial breast swelling and shrinking could be simulated. The effects on dose distribution were evaluated using film dosimetry. The results were compared to dose calculations. To estimate the true surface doses, we subtracted the influence of the film material on air measurements. During a swelling of 5, 10, and 15 mm, the planning target volume was consistently underdosed by 2%, 5%, and 7% of the prescribed dose, respectively. Swelling led to reduced dose values of up to 72%, 55%, and 50% at the outer edge of the actual target volume. The measured surface dose decreased successively from 31% to 23%. During shrinking, the dose in the planning target volume increased successively from 100% to 106%. The measured surface doses increased from 29% to 36%. The calculated dose values agreed with the measured values within error limits. During radiotherapy of the female breast, new planning appears to be essential for radial tissue swelling of 5 mm or more because of severe underdosing. Shrinking leads to moderate overdosing and an increased surface dose. In addition, caution is advised when removing bolus material with respect to the planned situation. PACS numbers: 87.53.Bn, 87.55.dk, 87.55.D.

  12. Dosimetric Comparison of 6 MV and 15 MV Single Arc Rapidarc to Helical TomoTherapy for the Treatment of Pancreatic Cancer

    SciTech Connect

    Cai Jing; Yue Jinbo; McLawhorn, Robert; Yang Wensha; Wijesooriya, Krishni; Dunlap, Neal E.; Sheng Ke; Yin Fangfang; Benedict, Stanley H.

    2011-10-01

    We conducted a planning study to compare Varian's RapidArc (RA) and helical TomoTherapy (HT) for the treatment of pancreatic cancer. Three intensity-modulated radiotherapy (IMRT) plans were generated for 8 patients with pancreatic cancer: one using HT with 6-MV beam (Plan{sub HT6}), one using single-arc RA with 6-MV beam (Plan{sub RA6}), and one using single-arc RA with 15-MV beam (Plan{sub RA15}). Dosimetric indices including high/low conformality index (CI{sub 100%}/CI{sub 50%}), heterogeneity index (HI), monitor units (MUs), and doses to organs at risk (OARs) were compared. The mean CI{sub 100%} was statistically equivalent with respect to the 2 treatment techniques, as well as beam energy (0.99, 1.01, and 1.02 for Plan{sub HT6}, Plan{sub RA6}, and Plan{sub RA156,} respectively). The CI{sub 50%} and HI were improved in both RA plans over the HT plan. The RA plans significantly reduced MU (MU{sub RA6} = 697, MU{sub RA15} = 548) compared with HT (MU{sub HT6} = 6177, p = 0.008 in both cases). The mean maximum cord dose was decreased from 29.6 Gy in Plan{sub HT6} to 21.6 Gy (p = 0.05) in Plan{sub RA6} and 21.7 Gy (p = 0.04) in Plan{sub RA15}. The mean bowel dose decreased from 17.2 Gy in Plan{sub HT6} to 15.2 Gy (p = 0.03) in Plan{sub RA6} and 15.0 Gy (p = 0.03) Plan{sub RA15}. The mean liver dose decreased from 8.4 Gy in Plan{sub HT6} to 6.3 Gy (p = 0.04) in Plan{sub RA6} and 6.2 Gy in Plan{sub RA15}. Variations of the mean dose to the duodenum, kidneys, and stomach were statistically insignificant. RA and HT can both deliver conformal dose distributions to target volumes while limiting the dose to surrounding OARs in the treatment of pancreatic cancer. Dosimetric advantages might be gained by using RA over HT by reducing the dose to OARs and total MUs used for treatment.

  13. Phase I Trial of Simultaneous In-Field Boost With Helical Tomotherapy for Patients With One to Three Brain Metastases

    SciTech Connect

    Rodrigues, George; Yartsev, Slav; Yaremko, Brian; Perera, Francisco; Dar, A. Rashid; Hammond, Alex; Lock, Michael; Yu, Edward; Ash, Robert; Caudrelier, Jean-Michelle; Khuntia, Deepak; Bailey, Laura; Bauman, Glenn

    2011-07-15

    Purpose: Stereotactic radiosurgery is an alternative to surgical resection for selected intracranial lesions. Integrated image-guided intensity-modulated-capable radiotherapy platforms such as helical tomotherapy (HT) could potentially replace traditional radiosurgery apparatus. The present study's objective was to determine the maximally tolerated dose of a simultaneous in-field boost integrated with whole brain radiotherapy for palliative treatment of patients with one to three brain metastases using HT. Methods and Materials: The inclusion/exclusion criteria and endpoints were consistent with the Radiation Therapy Oncology Group 9508 radiosurgery trial. The cohorts were constructed with a 3 + 3 design; however, additional patients were enrolled in the lower dose tolerable cohorts during the toxicity assessment periods. Whole brain radiotherapy (30 Gy in 10 fractions) was delivered with a 5-30-Gy (total lesion dose of 35-60 Gy in 10 fractions) simultaneous in-field boost delivered to the brain metastases. The maximally tolerated dose was determined by the frequency of neurologic Grade 3-5 National Cancer Institute Common Toxicity Criteria, version 3.0, dose-limiting toxicity events within each Phase I cohort. Results: A total of 48 patients received treatment in the 35-Gy (n = 3), 40-Gy (n = 16), 50-Gy (n = 15), 55-Gy (n = 8), and 60-Gy (n = 6) cohorts. No patients experienced dose-limiting toxicity events in any of the trial cohorts. The 3-month RECIST assessments available for 32 of the 48 patients demonstrated a complete response in 2, a partial response in 16, stable disease in 6, and progressive disease in 8 patients. Conclusion: The delivery of 60 Gy in 10 fractions to one to three brain metastases synchronously with 30 Gy whole brain radiotherapy was achieved without dose-limiting central nervous system toxicity as assessed 3 months after treatment. This approach is being tested in a Phase II efficacy trial.

  14. Patterns of CT lung injury and toxicity after stereotactic radiotherapy delivered with helical tomotherapy in early stage medically inoperable NSCLC

    PubMed Central

    Agolli, L; Portalone, L; Migliorino, M R; Lopergolo, M G; Monaco, A; Dognini, J; Pressello, M C; Bracci, S; Donato, V

    2015-01-01

    Objective: To evaluate toxicity and patterns of radiologic lung injury on CT images after hypofractionated image-guided stereotactic body radiotherapy (SBRT) delivered with helical tomotherapy (HT) in medically early stage inoperable non-small-cell lung cancer (NSCLC). Methods: 28 elderly patients (31 lesions) with compromised pulmonary reserve were deemed inoperable and enrolled to undergo SBRT. Patterns of lung injury based on CT appearance were assessed at baseline and during follow up. Acute (6 months or less) and late (more than 6 months) events were classified as radiation pneumonitis and radiation fibrosis (RF), respectively. Results: After a median follow-up of 12 months (range, 4–20 months), 31 and 25 lesions were examined for acute and late injuries, respectively. Among the former group, 25 (80.6%) patients showed no radiological changes. The CT appearance of RF revealed modified conventional, mass-like and scar-like patterns in three, four and three lesions, respectively. No evidence of late lung injury was demonstrated in 15 lesions. Five patients developed clinical pneumonitis (four patients, grade 2 and one patient, grade 3, respectively), and none of whom had CT findings at 3 months post-treatment. No instance of symptomatic RF was detected. The tumour response rate was 84% (complete response + partial response). Local control was 83% at 1 year. Conclusion: Our findings show that HT-SBRT can be considered an effective treatment with a mild toxicity profile in medically inoperable patients with early stage NSCLC. No specific pattern of lung injury was demonstrated. Advances in knowledge: Our study is among the few showing that HT-SBRT represents a safe and effective option in patients with early stage medically inoperable NSCLC, and that it is not associated with a specific pattern of lung injury. PMID:25645106

  15. Comparison of the effectiveness of different immobilization systems in different body regions using daily megavoltage CT in helical tomotherapy

    PubMed Central

    Cheng, K-F

    2014-01-01

    Objective: Effective immobilization is crucial for the accurate delivery of radiotherapy. This study aimed to compare the effectiveness of the commonly used immobilization systems for different body regions using megavoltage CT (MVCT). Methods: Daily treatment set-up data from 212 patients treated by helical tomotherapy (Accuray, Sunnyvale, CA) in 6 body regions (52 head and neck, 41 chest, 38 abdomen, 36 pelvis, 18 breast and 27 cranium) were obtained. Based on a verification tool using the pre-treatment MVCT, set-up corrections for each patient were recorded. Mean systematic and random errors of lateral, longitudinal, vertical and roll directions and three-dimensional vectors were compared between immobilization systems of each region. Results: Smaller set-up deviations were observed in the Orfit system (Orfit Industries NV, Wijnegem, Belgium) of the head and neck region, while the performance of immobilization systems for the chest, abdomen and pelvis regions was similar. Larger differences were noted in the breast group, where the prone BodyFIX® system (Medical Intelligence, Medizintechnik GmbH, Schwabmünchen, Germany) was less stable than the supine VacLok® system (CIVCO Medical Solutions, Orange City, IA). Conclusion: Differences were found between the immobilization systems in the head and neck region, in which the Orfit system was relatively more effective, whereas the VacLok and BodyFIX systems performed similarly in the chest, abdomen and pelvis regions. For the breast case, the supine position with VacLok was much more stable than the prone breast technique. The results provided references for the estimation of clinical target volume–planning target volume margins. Advances in knowledge: This is the first article on comprehensive comparisons performed in immobilization systems for main body regions that provides some practical recommendations. PMID:24398111

  16. Helical Tomotherapy Versus Conventional Intensity-Modulated Radiation Therapy for Primary Chemoradiation in Cervical Cancer Patients: An Intraindividual Comparison

    SciTech Connect

    Marnitz, Simone; Lukarski, Dusko; Koehler, Christhardt; Wlodarczyk, Waldemar; Ebert, Andreas; Budach, Volker; Schneider, Achim; Stromberger, Carmen

    2011-10-01

    Purpose: To compare intensity-modulated radiotherapy (IMRT) delivered by helical tomotherapy (HT) with conventional IMRT for primary chemoradiation in cervical cancer patients. Methods and Materials: Twenty cervical cancer patients undergoing primary chemoradiation received radiation with HT; 10 patients underwent pelvic irradiation (PEL) and 10 extended-field irradiation (EXT). For treatment planning, the simultaneously integrated boost (SIB) concept was applied. Tumor, pelvic, with or without para-aortic lymph nodes were defined as planning target volume A (PTV-A) with a prescribed dose of 1.8/50.4 Gy (28 fractions). The SIB dose for the parametrium (PTV-B), was 2.12/59.36 Gy. The lower target constraints were 95% of the prescribed dose in 95% of the target volume, and the upper dose constraint was 107%. The irradiated small-bowel volumes were kept as low as possible. For every HT plan, a conventional IMRT plan was calculated and compared with regard to dose-volume histogram, conformity index and conformity number, and homogeneity index. Results: Both techniques allowed excellent target volume coverage and sufficient SB sparing. Conformity index and conformity number results for both PTV-A and PTV-B, homogeneity index for PTV-B, and SB sparing for V45, V50, Dmax, and D1% were significantly better with HT. SB sparing was significantly better for conventional IMRT at low doses (V10). Conclusions: Both HT and conventional IMRT provide optimal treatment of cervical cancer patients. The HT technique was significantly favored with regard to target conformity, homogeneity, and SB sparing. Randomized trials are needed to assess the oncological outcome, toxicity, and clinical relevance of these differences.

  17. Pre-treatment and in-vivo dosimetry of Helical Tomotherapy treatment plans using the Dosimetry Check system

    NASA Astrophysics Data System (ADS)

    Mezzenga, E.; Cagni, E.; Botti, A.; Orlandi, M.; Iori, M.

    2014-04-01

    Dosimetry Check (DC) is the world's first commercially available software that provides patient-specific pre-treatment (PTD) and in-vivo transit (IVD) dose quality assurance of static and rotational intensity-modulated radiotherapy treatments. To investigate the feasibility of replacing pre-treatment verification with in vivo dosimetry for Helical Tomotherapy (HT), the commissioning and the application of the DC software was realised. Dose distributions were reconstructed from Mega Voltage Computed Tomography (MVCT) detectors, inside phantoms or patients for a total number of 6 treatment plans. Planned, reconstructed MVCT dose and measurements using ionisation chambers and a matrix detector inserted in cylindrical and octagonal phantoms, respectively, were compared at the isocenter and in two dimensions using the γ2D and γ10-index (3% / 3 mm). The dose reconstruction PTD and IVD methods of DC software provided, compared to detector measurements and for three Quality Assurance (QA) plans, similar point dose deviations and γ2D-index passing rates: (0.4 ± 0.1)% vs. (-1.4 ± 1.6)%, and (96.8 ± 0.9)% vs. (98.9 ± 0.6)%, respectively. In terms of γ10-index passing rate, PTD and IVD modalities reached mean values of (99.3 ± 0.1)% and (97.2 ± 1.9)%, respectively. Also for the remaining three clinical plans, similar results were reached for IVD with γ10-index passing rate reaching mean values of (95.9 ± 3.4)%. Therefore, either the PTD and the IVD verification modalities proved to be a very promising tool for the patient-specific QA of HT Plans.

  18. kVCT, MVCT, and hybrid CT image studies-Treatment planning and dose delivery equivalence on helical tomotherapy.

    PubMed

    Martin, Spencer; Yartsev, Slav

    2010-06-01

    To determine the equivalence of radiation therapy treatment planning and delivery for various imaging options on helical tomotherapy. Seven treatment plans using identical anatomy and planning parameters were created based on the following CT studies: Standard kilovoltage CT (kVCT); 2, 4, and 6 mm spacing megavoltage CT (MVCT); and 2, 4, and 6 mm hybrid MVCT/kVCT studies. In addition, two kVCT based plans were created to explore the effect of the choice of dose calculation grid for optimization. Calculated and measured dose distributions were compared via volumetric and dosimetric analysis at the planning stage, point dose measurements with ion chamber, along with EDR2 film data for gamma function analysis for distance to agreement of 3 mm and dose differences of 3%, 5%, and 7% using both the commercially available "cheese" phantom and the new QUASAR Verification (QVer) phantom. Plans created for each imaging option showed residual error increasing as image slice spacing increased and critical structure size decreased. With the exception of the low dose area in hybrid studies, point dose measurements were within the calculated/measured dose acceptance criteria of 5% on both the QVer and cheese phantoms. Gamma analysis for the original kVCT plan delivery showed an average of 98.5%±0.5% and 98.8%±0.3% of dose pixels passing kVCT study treatment and delivery quality assurance procedures, respectively. The QVer phantom allows for delivery quality assurance with simultaneous use of two films and more convenient gamma function assessment but shows some measurement discrepancy up to 10% compared to the cheese phantom. The kVCT, MVCT, and kVCT/MVCT hybrid studies showed considerable agreement at both planning and delivery stages. The choice of calculation grid is more important when dealing with smaller anatomical structures. © 2010 American Association of Physicists in Medicine.

  19. Hypofractionated helical tomotherapy using 2.5-2.6 Gy daily fractions for localized prostate cancer.

    PubMed

    Lopez Guerra, Jose Luis; Isa, Nicolas; Matute, Raul; Russo, Moises; Puebla, Fernando; Kim, Michelle Miran; Sanchez-Reyes, Alberto; Beltran, Cesar; Jaen, Javier; Bourgier, Celine; Marsiglia, Hugo

    2013-04-01

    The purpose of this study is to evaluate the tolerability of hypofractionated helical tomotherapy (HT) in the treatment of localized prostate cancer. We evaluated 48 patients with primary adenocarcinoma of the prostate (cT1-T3N0M0) who were treated with hypofractionated HT from August 2008 through July 2011. Hypofractionated regimens included: 68.04 Gy at 2.52 Gy/fraction, 70 Gy at 2.5 Gy/fraction, and 70.2 Gy at 2.6 Gy/fraction. Genitourinary (GU) and gastrointestinal (GI) toxicity was scored using the Radiation Therapy Oncology Group scoring system. Thirty-two patients were treated with 68.04 Gy, 5 patients with 70 Gy, and 11 with 70.2 Gy. The median age at diagnosis was 69 years (range 49-87) and the median follow-up 11 months (range 7-40). Grade 2 acute GI toxicity occurred in 9 patients (19 %). No grade 3 or higher acute GI toxicity was observed. Grade 2 and 3 acute GU toxicities occurred in 19 and 6 % of patients, respectively. The incidence of late grade 2 GI and GU toxicity was 4 and 2 %, respectively. No grade 3 or higher late toxicities were observed. Multivariate analysis showed that patients treated at 2.6 Gy/fraction or those who received a total radiation dose ≥70 Gy had higher rates of grade ≥2 acute GU toxicity (P = 0.004 and P = 0.048, respectively). Hypofractionated HT in the treatment of localized prostate cancer is well tolerated with no grade 3 or higher early or late GI and GU toxicities. Further research is needed to assess definitive late toxicity and tumor control.

  20. Helical tomotherapy versus conventional intensity-modulated radiation therapy for primary chemoradiation in cervical cancer patients: an intraindividual comparison.

    PubMed

    Marnitz, Simone; Lukarski, Dusko; Köhler, Christhardt; Wlodarczyk, Waldemar; Ebert, Andreas; Budach, Volker; Schneider, Achim; Stromberger, Carmen

    2011-10-01

    To compare intensity-modulated radiotherapy (IMRT) delivered by helical tomotherapy (HT) with conventional IMRT for primary chemoradiation in cervical cancer patients. Twenty cervical cancer patients undergoing primary chemoradiation received radiation with HT; 10 patients underwent pelvic irradiation (PEL) and 10 extended-field irradiation (EXT). For treatment planning, the simultaneously integrated boost (SIB) concept was applied. Tumor, pelvic, with or without para-aortic lymph nodes were defined as planning target volume A (PTV-A) with a prescribed dose of 1.8/50.4 Gy (28 fractions). The SIB dose for the parametrium (PTV-B), was 2.12/59.36 Gy. The lower target constraints were 95% of the prescribed dose in 95% of the target volume, and the upper dose constraint was 107%. The irradiated small-bowel volumes were kept as low as possible. For every HT plan, a conventional IMRT plan was calculated and compared with regard to dose-volume histogram, conformity index and conformity number, and homogeneity index. Both techniques allowed excellent target volume coverage and sufficient SB sparing. Conformity index and conformity number results for both PTV-A and PTV-B, homogeneity index for PTV-B, and SB sparing for V45, V50, Dmax, and D1% were significantly better with HT. SB sparing was significantly better for conventional IMRT at low doses (V10). Both HT and conventional IMRT provide optimal treatment of cervical cancer patients. The HT technique was significantly favored with regard to target conformity, homogeneity, and SB sparing. Randomized trials are needed to assess the oncological outcome, toxicity, and clinical relevance of these differences. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Helical Muon Beam Cooling Channel Engineering Design

    SciTech Connect

    Kashikhin, V.S.; Lopes, M.L.; Romanov, G.V.; Tartaglia, M.A.; Yonehara, K.; Yu, M.; Zlobin, A.V.; Flanagan, G.; Johnson, R.P.; Kazakevich, G.M.; Marhauser, F.; /MUONS Inc., Batavia

    2012-05-01

    The Helical Cooling Channel (HCC), a novel technique for six-dimensional (6D) ionization cooling of muon beams, has shown considerable promise based on analytic and simulation studies. However, the implementation of this revolutionary method of muon cooling requires new techniques for the integration of hydrogen-pressurized, high-power RF cavities into the low-temperature superconducting magnets of the HCC. We present the progress toward a conceptual design for the integration of 805 MHz RF cavities into a 10 T Nb{sub 3}Sn based HCC test section. We include discussions on the pressure and thermal barriers needed within the cryostat to maintain operation of the magnet at 4.2 K while operating the RF and energy absorber at a higher temperature. Additionally, we include progress on the Nb{sub 3}Sn helical solenoid design.

  2. Helical muon beam cooling channel engineering design

    SciTech Connect

    Johnson, Rolland

    2015-08-07

    The Helical Cooling Channel (HCC) achieves effective ionization cooling of the six-dimensional (6d) phase space of a muon beam by means of a series of 21st century inventions. In the HCC, hydrogen-pressurized RF cavities enable high RF gradients in strong external magnetic fields. The theory of the HCC, which requires a magnetic field with solenoid, helical dipole, and helical quadrupole components, demonstrates that dispersion in the gaseous hydrogen energy absorber provides effective emittance exchange to enable longitudinal ionization cooling. The 10-year development of a practical implementation of a muon-beam cooling device has involved a series of technical innovations and experiments that imply that an HCC of less than 300 m length can cool the 6d emittance of a muon beam by six orders of magnitude. We describe the design and construction plans for a prototype HCC module based on oxygen-doped hydrogen-pressurized RF cavities that are loaded with dielectric, fed by magnetrons, and operate in a superconducting helical solenoid magnet. The first phase of this project saw the development of a conceptual design for the integration of 805 MHz RF cavities into a 10 T Nb3Sn-based HS test section. Two very novel ideas are required to realize the design. The first idea is the use of dielectric inserts in the RF cavities to make them smaller for a given frequency so that the cavities and associated plumbing easily fit inside the magnet cryostat. Calculations indicate that heat loads will be tolerable, while RF breakdown of the dielectric inserts will be suppressed by the pressurized hydrogen gas. The second new idea is the use of a multi-layer Nb3Sn helical solenoid. The technology demonstrations for the two aforementioned key components of a 10T, 805 MHz HCC were begun in this project. The work load in the Fermilab Technical Division made it difficult to test a multi-layer Nb3Sn solenoid as originally planned. Instead, a complementary

  3. Superposition of helical beams by using a Michelson interferometer.

    PubMed

    Gao, Chunqing; Qi, Xiaoqing; Liu, Yidong; Weber, Horst

    2010-01-04

    Orbital angular momentum (OAM) of a helical beam is of great interests in the high density optical communication due to its infinite number of eigen-states. In this paper, an experimental setup is realized to the information encoding and decoding on the OAM eigen-states. A hologram designed by the iterative method is used to generate the helical beams, and a Michelson interferometer with two Porro prisms is used for the superposition of two helical beams. The experimental results of the collinear superposition of helical beams and their OAM eigen-states detection are presented.

  4. Respiratory gating and 4-D tomotherapy

    SciTech Connect

    Zhang Tiezhi

    2004-12-01

    Helical tomotherapy is a new intensity-modulated radiotherapy (IMRT) delivery process developed at the University of Wisconsin and TomoTherapy Inc. Tomotherapy may be of advantage in lung cancer treatment due to its rotational delivery mode. As with conventional IMRT delivery, however, intrafraction respiratory motion during a tomotherapy treatment causes unnecessary radiation to the healthy tissue. Possible solutions to these problems associated with intrafraction motion have been studied in this thesis. A spirometer is useful for monitoring breathing because of its direct correlation with lung volume changes. However, its inherent drift prevents its application in long-term breathing monitoring. With calibration and stabilization algorithms, a spirometer is able to provide accurate, long-term lung volume change measurements. Such a spirometer system is most suited for deep inspiration breath-hold (DIBH) treatments. An improved laser-spirometer combined system has also been developed for target tracking in 4-D treatment. Spirometer signals are used to calibrate the displacement measurements into lung volume changes, thereby eliminating scaling errors from daily setup variations. The laser displacement signals may also be used to correct spirometer drifts during operation. A new 4-D treatment technique has been developed to account for intrafraction motion in treatment planning. The patient's breathing and the beam delivery are synchronized, and the target motion/deformation is incorporated into treatment plan optimization. Results show that this new 4D treatment technique significantly reduces motion effects and provides improved patient tolerance.

  5. Skin-sparing Helical Tomotherapy vs 3D-conformal Radiotherapy for Adjuvant Breast Radiotherapy: In Vivo Skin Dosimetry Study

    SciTech Connect

    Capelle, Lisa; Warkentin, Heather; MacKenzie, Marc; Joseph, Kurian; Gabos, Zsolt; Pervez, Nadeem; Tankel, Keith; Chafe, Susan; Amanie, John; Ghosh, Sunita; Parliament, Matthew; Abdulkarim, Bassam

    2012-08-01

    Purpose: We investigated whether treatment-planning system (TPS)-calculated dose accurately reflects skin dose received for patients receiving adjuvant breast radiotherapy (RT) with standard three-dimensional conformal RT (3D-CRT) or skin-sparing helical tomotherapy (HT). Methods and Materials: Fifty patients enrolled in a randomized controlled trial investigating acute skin toxicity from adjuvant breast RT with 3D-CRT compared to skin-sparing HT, where a 5-mm strip of ipsilateral breast skin was spared. Thermoluminescent dosimetry or optically stimulated luminescence measurements were made in multiple locations and were compared to TPS-calculated doses. Skin dosimetric parameters and acute skin toxicity were recorded in these patients. Results: With HT there was a significant correlation between calculated and measured dose in the medial and lateral ipsilateral breast (r = 0.67, P<.001; r = 0.44, P=.03, respectively) and the medial and central contralateral breast (r = 0.73, P<.001; r = 0.88, P<.001, respectively). With 3D-CRT there was a significant correlation in the medial and lateral ipsilateral breast (r = 0.45, P=.03; r = 0.68, P<.001, respectively); the medial and central contralateral breast (r = 0.62, P=.001; r = 0.86, P<.001, respectively); and the mid neck (r = 0.42, P=.04, respectively). On average, HT-calculated dose overestimated the measured dose by 14%; 3D-CRT underestimated the dose by 0.4%. There was a borderline association between highest measured skin dose and moist desquamation (P=.05). Skin-sparing HT had greater skin homogeneity (homogeneity index of 1.39 vs 1.65, respectively; P=.005) than 3D-CRT plans. HT plans had a lower skin{sub V50} (1.4% vs 5.9%, respectively; P=.001) but higher skin{sub V40} and skin{sub V30} (71.7% vs 64.0%, P=.02; and 99.0% vs 93.8%, P=.001, respectively) than 3D-CRT plans. Conclusion: The 3D-CRT TPS more accurately reflected skin dose than the HT TPS, which tended to overestimate dose received by 14% in patients

  6. Surface imaging, laser positioning or volumetric imaging for breast cancer with nodal involvement treated by helical TomoTherapy.

    PubMed

    Crop, Frederik; Pasquier, David; Baczkiewic, Amandine; Doré, Julie; Bequet, Lena; Steux, Emeline; Gadroy, Anne; Bouillon, Jacqueline; Florence, Clement; Muszynski, Laurence; Lacour, Mathilde; Lartigau, Eric

    2016-09-08

    A surface imaging system, Catalyst (C-Rad), was compared with laser-based positioning and daily mega voltage computed tomography (MVCT) setup for breast patients with nodal involvement treated by helical TomoTherapy. Catalyst-based positioning performed better than laser-based positioning. The respective modalities resulted in a standard deviation (SD), 68% confidence interval (CI) of positioning of left-right, craniocaudal, anterior-posterior, roll: 2.4 mm, 2.7 mm, 2.4 mm, 0.9° for Catalyst positioning, and 6.1 mm, 3.8 mm, 4.9 mm, 1.1° for laser-based positioning, respectively. MVCT-based precision is a combination of the interoperator variability for MVCT fusion and the patient movement during the time it takes for MVCT and fusion. The MVCT fusion interoperator variability for breast patients was evaluated at one SD left-right, craniocaudal, ant-post, roll as: 1.4 mm, 1.8 mm, 1.3 mm, 1.0°. There was no statistically significant difference between the automatic MVCT registration result and the manual adjustment; the automatic fusion results were within the 95% CI of the mean result of 10 users, except for one specific case where the patient was positioned with large yaw. We found that users add variability to the roll correction as the automatic registration was more consistent. The patient position uncertainty confidence interval was evaluated as 1.9 mm, 2.2 mm, 1.6 mm, 0.9° after 4 min, and 2.3 mm, 2.8 mm, 2.2 mm, 1° after 10 min. The combination of this patient movement with MVCT fusion interoperator variability results in total standard deviations of patient posi-tion when treatment starts 4 or 10 min after initial positioning of, respectively: 2.3 mm, 2.8 mm, 2.0 mm, 1.3° and 2.7 mm, 3.3 mm, 2.6 mm, 1.4°. Surface based positioning arrives at the same precision when taking into account the time required for MVCT imaging and fusion. These results can be used on a patient-per-patient basis to decide which positioning system performs the best after the

  7. Skin-sparing helical tomotherapy vs 3D-conformal radiotherapy for adjuvant breast radiotherapy: in vivo skin dosimetry study.

    PubMed

    Capelle, Lisa; Warkentin, Heather; Mackenzie, Marc; Joseph, Kurian; Gabos, Zsolt; Pervez, Nadeem; Tankel, Keith; Chafe, Susan; Amanie, John; Ghosh, Sunita; Parliament, Matthew; Abdulkarim, Bassam

    2012-08-01

    We investigated whether treatment-planning system (TPS)-calculated dose accurately reflects skin dose received for patients receiving adjuvant breast radiotherapy (RT) with standard three-dimensional conformal RT (3D-CRT) or skin-sparing helical tomotherapy (HT). Fifty patients enrolled in a randomized controlled trial investigating acute skin toxicity from adjuvant breast RT with 3D-CRT compared to skin-sparing HT, where a 5-mm strip of ipsilateral breast skin was spared. Thermoluminescent dosimetry or optically stimulated luminescence measurements were made in multiple locations and were compared to TPS-calculated doses. Skin dosimetric parameters and acute skin toxicity were recorded in these patients. With HT there was a significant correlation between calculated and measured dose in the medial and lateral ipsilateral breast (r = 0.67, P<.001; r = 0.44, P=.03, respectively) and the medial and central contralateral breast (r = 0.73, P<.001; r = 0.88, P<.001, respectively). With 3D-CRT there was a significant correlation in the medial and lateral ipsilateral breast (r = 0.45, P=.03; r = 0.68, P<.001, respectively); the medial and central contralateral breast (r = 0.62, P=.001; r = 0.86, P<.001, respectively); and the mid neck (r = 0.42, P=.04, respectively). On average, HT-calculated dose overestimated the measured dose by 14%; 3D-CRT underestimated the dose by 0.4%. There was a borderline association between highest measured skin dose and moist desquamation (P=.05). Skin-sparing HT had greater skin homogeneity (homogeneity index of 1.39 vs 1.65, respectively; P=.005) than 3D-CRT plans. HT plans had a lower skin(V50) (1.4% vs 5.9%, respectively; P=.001) but higher skin(V40) and skin(V30) (71.7% vs 64.0%, P=.02; and 99.0% vs 93.8%, P=.001, respectively) than 3D-CRT plans. The 3D-CRT TPS more accurately reflected skin dose than the HT TPS, which tended to overestimate dose received by 14% in patients receiving adjuvant breast RT. Copyright © 2012 Elsevier Inc. All

  8. Dosimetric assessment of static and helical TomoTherapy in the clinical implementation of breast cancer treatments.

    PubMed

    Reynders, Truus; Tournel, Koen; De Coninck, Peter; Heymann, Steve; Vinh-Hung, Vincent; Van Parijs, Hilde; Duchateau, Michaël; Linthout, Nadine; Gevaert, Thierry; Verellen, Dirk; Storme, Guy

    2009-10-01

    Investigation of the use of TomoTherapy and TomoDirect versus conventional radiotherapy for the treatment of post-operative breast carcinoma. This study concentrates on the evaluation of the planning protocol for the TomoTherapy and TomoDirect TPS, dose verification and the implementation of in vivo dosimetry. Eight patients with different breast cancer indications (left/right tumor, axillary nodes involvement (N+)/no nodes (N0), tumorectomy/mastectomy) were enrolled. TomoTherapy, TomoDirect and conventional plans were generated for prone and supine positions leading to six or seven plans per patient. Dose prescription was 42Gy in 15 fractions over 3weeks. Dose verification of a TomoTherapy plan is performed using TLDs and EDR2 film inside a home-made wax breast phantom fixed on a rando-alderson phantom. In vivo dosimetry was performed with TLDs. It is possible to create clinically acceptable plans with TomoTherapy and TomoDirect. TLD calibration protocol with a water equivalent phantom is accurate. TLD verification with the phantom shows measured over calculated ratios within 2.2% (PTV). An overresponse of the TLDs was observed in the low dose regions (<0.1Gy). The film measurements show good agreement for high and low dose regions inside the phantom. A sharp gradient can be created to the thoracic wall. In vivo dosimetry with TLDs was clinically feasible. The TomoTherapy and TomoDirect modalities can deliver dose distributions which the radiotherapist judges to be equal to or better than conventional treatment of breast carcinoma according to the organ to be protected.

  9. NOTE: The effect of tomotherapy imaging beam output instabilities on dose calculation

    NASA Astrophysics Data System (ADS)

    Duchateau, Michael; Tournel, Koen; Verellen, Dirk; Van de Vondel, Iwein; Reynders, Truus; Linthout, Nadine; Gevaert, Thierry; de Coninck, Peter; Depuydt, Tom; Storme, Guy

    2010-06-01

    A radiotherapy treatment plan is based on an anatomical 'snapshot' of the patient acquired during the preparation stage using a kVCT (kilovolt computed tomography) scanner. Anatomical changes will occur during the treatment course, in some cases requiring a new treatment plan to deliver the prescribed dose. With the introduction of 3D volumetric on-board imaging devices, it became feasible to use the produced images for dose recalculation. However, the use of these on-board imaging devices in clinical routine for the calculation of dose depends on the stability of the images. In this study the validation of tomotherapy MVCT (megavolt computed tomography) produced images, for the purpose of dose recalculation by the Planned Adaptive software, has been performed. To investigate the validity of MVCT images for dose calculation, a treatment plan was created based on kVCT-acquired images of a solid water phantom. During a period of 4 months, MVCT images of the phantom have been acquired and were used by the planned adaptive software to recalculate the initial kVCT-based dose on the MVCT images. The influence of the adapted IVDTs (image value-to-density tables) has been investigated as well as the effect of image acquisition with or without preceding airscan. Output fluctuations and/or instabilities of the imaging beam result in MV images of different quality yielding different results when used for dose calculation. It was shown that the output of the imaging beam is not stable, leading to differences of nearly 3% between the original kV-based dose and the recalculated MV-based dose, for solid water only. MVCT images can be used for dose calculation purposes bearing in mind that the output beam is liable to fluctuations. The acquisition of an IVDT together with the MVCT image set, that is going to be used for dose calculation, is highly recommended.

  10. Re-irradiation of recurrent head and neck carcinomas: comparison of robust intensity modulated proton therapy treatment plans with helical tomotherapy

    PubMed Central

    2013-01-01

    Background To test the hypothesis that the therapeutic ratio of intensity-modulated photon therapy using helical tomotherapy (HT) for retreatment of head and neck carcinomas can be improved by robust intensity-modulated proton therapy (IMPT). Methods Comparative dose planning with robust IMPT was performed for 7 patients retreated with HT. Results On average, HT yielded dose gradients steeper in a distance ≤ 7.5 mm outside the target (p<0.0001, F-test) and more conformal high dose regions down to the 50% isodose than IMPT. Both methods proved comparably robust against set-up errors of up to 2 mm, and normal tissue exposure was satisfactory. The mean body dose was smaller with IMPT. Conclusions IMPT was found not to be uniformly superior to HT and the steeper average dose fall-off around the target volume is an argument pro HT under the methodological implementations used. However, looking at single organs at risk, the normal tissue sparing of IMPT can surpass tomotherapy for an individual patient. Therefore, comparative dose planning is recommended, if both methods are available. PMID:23601204

  11. Image-Guided Total-Marrow Irradiation Using Helical Tomotherapy in Patients With Multiple Myeloma and Acute Leukemia Undergoing Hematopoietic Cell Transplantation

    SciTech Connect

    Wong, Jeffrey Y.C. Rosenthal, Joseph; Liu An; Schultheiss, Timothy; Forman, Stephen; Somlo, George

    2009-01-01

    Purpose: Total-body irradiation (TBI) has an important role in patients undergoing hematopoietic cell transplantation (HCT), but is associated with significant toxicities. Targeted TBI using helical tomotherapy results in reduced doses to normal organs, which predicts for reduced toxicities compared with standard TBI. Methods and Materials: Thirteen patients with multiple myeloma were treated in an autologous tandem transplantation Phase I trial with high-dose melphalan, followed 6 weeks later by total-marrow irradiation (TMI) to skeletal bone. Dose levels were 10, 12, 14, and 16 Gy at 2 Gy daily/twice daily. In a separate allogeneic HCT trial, 8 patients (5 with acute myelogenous leukemia, 1 with acute lymphoblastic leukemia, 1 with non-Hodgkin's lymphoma, and 1 with multiple myeloma) were treated with TMI plus total lymphoid irradiation plus splenic radiotherapy to 12 Gy (1.5 Gy twice daily) combined with fludarabine/melphalan. Results: For the 13 patients in the tandem autologous HCT trial, median age was 54 years (range, 42-66 years). Median organ doses were 15-65% that of the gross target volume dose. Primarily Grades 1-2 acute toxicities were observed. Six patients reported no vomiting; 9 patients, no mucositis; 6 patients, no fatigue; and 8 patients, no diarrhea. For the 8 patients in the allogeneic HCT trial, median age was 52 years (range, 24-61 years). Grades 2-3 nausea, vomiting, mucositis, and diarrhea were observed. In both trials, no Grade 4 nonhematologic toxicity was observed, and all patients underwent successful engraftment. Conclusions: This study shows that TMI using helical tomotherapy is clinically feasible. The reduced acute toxicities observed compare favorably with those seen with standard TBI. Initial results are encouraging and warrant further evaluation as a method to dose escalate with acceptable toxicity or to offer TBI-containing regimens to patients unable to tolerate standard approaches.

  12. Radiobiologic comparison of helical tomotherapy, intensity modulated radiotherapy, and conformal radiotherapy in treating lung cancer accounting for secondary malignancy risks

    SciTech Connect

    Komisopoulos, Georgios; Mavroidis, Panayiotis; Rodriguez, Salvador; Stathakis, Sotirios; Papanikolaou, Nikos; Nikiforidis, Georgios C.; Sakellaropoulos, Georgios C.

    2014-01-01

    The aim of the present study is to examine the importance of using measures to predict the risk of inducing secondary malignancies in association with the clinical effectiveness of treatment plans in terms of tumor control and normal tissue complication probabilities. This is achieved by using radiobiologic parameters and measures, which may provide a closer association between clinical outcome and treatment delivery. Overall, 4 patients having been treated for lung cancer were examined. For each of them, 3 treatment plans were developed based on the helical tomotherapy (HT), multileaf collimator-based intensity modulated radiation therapy (IMRT), and 3-dimensional conformal radiation therapy (CRT) modalities. The different plans were evaluated using the complication-free tumor control probability (p{sub +}), the overall probability of injury (p{sub I}), the overall probability of control/benefit (p{sub B}), and the biologically effective uniform dose (D{sup ¯¯}). These radiobiologic measures were used to develop dose-response curves (p-D{sup ¯¯} diagram), which can help to evaluate different treatment plans when used in conjunction with standard dosimetric criteria. The risks for secondary malignancies in the heart and the contralateral lung were calculated for the 3 radiation modalities based on the corresponding dose-volume histograms (DVHs) of each patient. Regarding the overall evaluation of the different radiation modalities based on the p{sub +} index, the average values of the HT, IMRT, and CRT are 67.3%, 61.2%, and 68.2%, respectively. The corresponding average values of p{sub B} are 75.6%, 70.5%, and 71.0%, respectively, whereas the average values of p{sub I} are 8.3%, 9.3%, and 2.8%, respectively. Among the organs at risk (OARs), lungs show the highest probabilities for complications, which are 7.1%, 8.0%, and 1.3% for the HT, IMRT, and CRT modalities, respectively. Similarly, the biologically effective prescription doses (D{sub B}{sup ¯¯}) for the

  13. Radiobiologic comparison of helical tomotherapy, intensity modulated radiotherapy, and conformal radiotherapy in treating lung cancer accounting for secondary malignancy risks.

    PubMed

    Komisopoulos, Georgios; Mavroidis, Panayiotis; Rodriguez, Salvador; Stathakis, Sotirios; Papanikolaou, Nikos; Nikiforidis, Georgios C; Sakellaropoulos, Georgios C

    2014-01-01

    The aim of the present study is to examine the importance of using measures to predict the risk of inducing secondary malignancies in association with the clinical effectiveness of treatment plans in terms of tumor control and normal tissue complication probabilities. This is achieved by using radiobiologic parameters and measures, which may provide a closer association between clinical outcome and treatment delivery. Overall, 4 patients having been treated for lung cancer were examined. For each of them, 3 treatment plans were developed based on the helical tomotherapy (HT), multileaf collimator-based intensity modulated radiation therapy (IMRT), and 3-dimensional conformal radiation therapy (CRT) modalities. The different plans were evaluated using the complication-free tumor control probability (p+), the overall probability of injury (pI), the overall probability of control/benefit (pB), and the biologically effective uniform dose (D¯¯). These radiobiologic measures were used to develop dose-response curves (p-D¯¯ diagram), which can help to evaluate different treatment plans when used in conjunction with standard dosimetric criteria. The risks for secondary malignancies in the heart and the contralateral lung were calculated for the 3 radiation modalities based on the corresponding dose-volume histograms (DVHs) of each patient. Regarding the overall evaluation of the different radiation modalities based on the p+ index, the average values of the HT, IMRT, and CRT are 67.3%, 61.2%, and 68.2%, respectively. The corresponding average values of pB are 75.6%, 70.5%, and 71.0%, respectively, whereas the average values of pI are 8.3%, 9.3%, and 2.8%, respectively. Among the organs at risk (OARs), lungs show the highest probabilities for complications, which are 7.1%, 8.0%, and 1.3% for the HT, IMRT, and CRT modalities, respectively. Similarly, the biologically effective prescription doses (DB¯¯) for the HT, IMRT, and CRT modalities are 64.0, 60.9, and 60.8Gy

  14. Helical Channel Design and Technology for Cooling of Muon Beams

    NASA Astrophysics Data System (ADS)

    Yonehara, K.; Derbenev, Y. S.; Johnson, R. P.

    2010-11-01

    Novel magnetic helical channel designs for capture and cooling of bright muon beams are being developed using numerical simulations based on new inventions such as helical solenoid (HS) magnets and hydrogen-pressurized RF (HPRF) cavities. We are close to the factor of a million six-dimensional phase space (6D) reduction needed for muon colliders. Recent experimental and simulation results are presented.

  15. Helical channel design and technology for cooling of muon beams

    SciTech Connect

    Yonehara, K; Derbenev, Y.S.; Johnson, R.P.; /MUONS Inc., Batavia

    2010-08-01

    Novel magnetic helical channel designs for capture and cooling of bright muon beams are being developed using numerical simulations based on new inventions such as helical solenoid (HS) magnets and hydrogen-pressurized RF (HPRF) cavities. We are close to the factor of a million six-dimensional phase space (6D) reduction needed for muon colliders. Recent experimental and simulation results are presented.

  16. Helical Channel Design and Technology for Cooling of Muon Beams

    SciTech Connect

    Yonehara, K.; Derbenev, Y. S.; Johnson, R. P.

    2010-11-04

    Novel magnetic helical channel designs for capture and cooling of bright muon beams are being developed using numerical simulations based on new inventions such as helical solenoid (HS) magnets and hydrogen-pressurized RF (HPRF) cavities. We are close to the factor of a million six-dimensional phase space (6D) reduction needed for muon colliders. Recent experimental and simulation results are presented.

  17. Helical electron-beam microbunching by harmonic coupling in a helical undulator.

    PubMed

    Hemsing, E; Musumeci, P; Reiche, S; Tikhoplav, R; Marinelli, A; Rosenzweig, J B; Gover, A

    2009-05-01

    Microbunching of a relativistic electron beam into a helix is examined analytically and in simulation. Helical microbunching is shown to occur naturally when an e beam interacts resonantly at the harmonics of the combined field of a helical magnetic undulator and an axisymmetric input laser beam. This type of interaction is proposed as a method to generate a strongly prebunched e beam for coherent emission of light with orbital angular momentum at virtually any wavelength. The results from the linear microbunching theory show excellent agreement with three-dimensional numerical simulations.

  18. Comparing the quality of passively-scattered proton and photon tomotherapy plans for brain and head and neck disease sites.

    PubMed

    Kainz, Kristofer; Firat, Selim; Wilson, J Frank; Schultz, Christopher; Siker, Malika; Wang, Andrew; Olson, Dan; Li, X Allen

    2015-03-21

    We compare the quality of photon IMRT (helical tomotherapy) with classic proton plans for brain, head and neck tumors, in terms of target dose uniformity and conformity along with organ-at-risk (OAR) sparing. Plans were created for twelve target volumes among eight cases. All patients were originally planned and treated using helical tomotherapy. Proton plans were generated using a passively-scattered beam model with a maximum range of 32 g cm(-2) (225 MeV), range modulation in 0.5 g cm(-2) increments and range compensators with 4.8 mm milling tool diameters. All proton plans were limited to two to four beams. Plan quality was compared using uniformity index (UI), conformation number (CN) and a EUD-based plan quality index (fEUD). For 11 of the 12 targets, UI was improved for the proton plan; on average, UI was 1.05 for protons versus 1.08 for tomotherapy. For 7 of the 12 targets, the tomotherapy plan exhibited more favorable CN. For proximal OARs, the improved dose conformity to the target volume from tomotherapy led to a lower maximum dose. For distal OARs, the maximum dose was much lower for proton plans. For 6 of the 8 cases, near-total avoidance for distal OARs provided by protons leads to improved fEUD. However, if distal OARs are excluded in the fEUD calculation, the proton plans exhibit better fEUD in only 3 of the 8 cases. The distal OAR sparing and target dose uniformity are generally better with passive-scatter proton planning than with photon tomotherapy; proton therapy may be preferred if the clinician deems those attributes critical. However, tomotherapy may serve equally as well as protons for cases where superior target dose conformity from tomotherapy leads to plan quality nearly identical to or better than protons and for cases where distal OAR sparing is not concerning.

  19. Comprehensive dosimetric planning comparison for early-stage, non-small cell lung cancer with SABR: fixed-beam IMRT versus VMAT versus TomoTherapy.

    PubMed

    Xhaferllari, Ilma; El-Sherif, Omar; Gaede, Stewart

    2016-09-01

    Volumetric-modulated arc therapy (VMAT) is emerging as a leading technology in treating early-stage, non-small cell lung cancer (NSCLC) with stereotactic ablative radiotherapy (SABR). However, two other modalities capable of delivering intensity-modulated radiation therapy (IMRT) include fixed-beam and helical TomoTherapy (HT). This study aims to provide an extensive dosimetric comparison among these various IMRT techniques for treating early-stage NSCLC with SABR. Ten early-stage NSCLC patients were retrospectively optimized using three fixed-beam techniques via nine to eleven beams (high and low modulation step-and-shoot (SS), and sliding window (SW)), two VMAT techniques via two partial arcs (SmartArc (SA) and RapidArc (RA)), and three HT techniques via three different fan beam widths (1 cm, 2.5 cm, and 5 cm) for 80 plans total. Fixed-beam and VMAT plans were generated using flattening filter-free beams. SS and SA, HT treatment plans, and SW and RA were optimized using Pinnacle v9.1, Tomoplan v.3.1.1, and Eclipse (Acuros XB v11.3 algorithm), respectively. Dose-volume histogram statistics, dose conformality, and treatment delivery efficiency were analyzed. VMAT treatment plans achieved significantly lower values for contralateral lung V5Gy(p≤0.05) compared to the HT plans, and significantly lower mean lung dose (p<0.006) compared to HT 5 cm treatment plans. In the comparison between the VMAT techniques, a significant reduction in the total monitor units (p=0.05) was found in the SA plans, while a significant decrease was observed in the dose falloff parameter, D2cm, (p=0.05), for the RA treatments. The maximum cord dose was significantly reduced (p=0.017) in grouped RA&SA plans compared to SS. Estimated treatment time was significantly higher for HT and fixed-beam plans compared to RA&SA (p<0.001). Although, a significant difference was not observed in the RA vs. SA (p=0.393). RA&SA outperformed HT in all parameters measured. Despite an increase in dose to the

  20. Comprehensive dosimetric planning comparison for early-stage, non-small cell lung cancer with SABR: fixed-beam IMRT versus VMAT versus TomoTherapy.

    PubMed

    Xhaferllari, Ilma; El-Sherif, Omar; Gaede, Stewart

    2016-09-08

    Volumetric-modulated arc therapy (VMAT) is emerging as a leading technology in treating early-stage, non-small cell lung cancer (NSCLC) with stereotactic ablative radiotherapy (SABR). However, two other modalities capable of deliver-ing intensity-modulated radiation therapy (IMRT) include fixed-beam and helical TomoTherapy (HT). This study aims to provide an extensive dosimetric compari-son among these various IMRT techniques for treating early-stage NSCLC with SABR. Ten early-stage NSCLC patients were retrospectively optimized using three fixed-beam techniques via nine to eleven beams (high and low modulation step-and-shoot (SS), and sliding window (SW)), two VMAT techniques via two partial arcs (SmartArc (SA) and RapidArc (RA)), and three HT techniques via three different fan beam widths (1 cm, 2.5 cm, and 5 cm) for 80 plans total. Fixed-beam and VMAT plans were generated using flattening filter-free beams. SS and SA, HT treatment plans, and SW and RA were optimized using Pinnacle v9.1, Tomoplan v.3.1.1, and Eclipse (Acuros XB v11.3 algorithm), respectively. Dose-volume histogram statistics, dose conformality, and treatment delivery efficiency were analyzed. VMAT treatment plans achieved significantly lower values for contralat-eral lung V5Gy (p ≤ 0.05) compared to the HT plans, and significantly lower mean lung dose (p < 0.006) compared to HT 5 cm treatment plans. In the comparison between the VMAT techniques, a significant reduction in the total monitor units (p = 0.05) was found in the SA plans, while a significant decrease was observed in the dose falloff parameter, D2cm, (p = 0.05), for the RA treatments. The maximum cord dose was significantly reduced (p = 0.017) in grouped RA&SA plans com-pared to SS. Estimated treatment time was significantly higher for HT and fixed-beam plans compared to RA&SA (p < 0.001). Although, a significant difference was not observed in the RA vs. SA (p = 0.393). RA&SA outperformed HT in all parameters measured. Despite an

  1. Experimental observation of helical microbunching of a relativistic electron beam

    SciTech Connect

    Hemsing, E.; Knyazik, A.; O'Shea, F.; Marinelli, A.; Musumeci, P.; Williams, O.; Rosenzweig, J. B.; Tochitsky, S.

    2012-02-27

    Experimental observation of the microbunching of a relativistic electron beam at the second harmonic interaction frequency of a helical undulator is presented. The microbunching signal is observed from the coherent transition radiation of the electron beam and indicates experimental evidence of a dominantly helical electron beam density distribution. This result is in agreement with theoretical and numerical predictions and provides a proof-of-principle demonstration of proposed schemes designed to generate light with orbital angular momentum in high-gain free-electron lasers.

  2. A case study comparing the relative benefit of optimizing beam weights, wedge angles, beam orientations and tomotherapy in stereotactic radiotherapy of the brain

    NASA Astrophysics Data System (ADS)

    Oldham, M.; Khoo, V. S.; Rowbottom, C. G.; Bedford, J. L.; Webb, S.

    1998-08-01

    A treatment-planning case study has been performed on a patient with a medium-sized, convex brain tumour. The study involved the application of advanced treatment-plan optimization techniques to improve on the dose distribution of the `standard plan' used to treat the patient. The standard plan was created according to conventional protocol at the Royal Marsden NHS Trust, and consisted of a three-field (one open and two wedged) non-coplanar arrangement, with field shaping to the beam's-eye view of the planning target volume (PTV). Three optimized treatment plans were created corresponding to (i) the optimization of the beam weights and wedge angles of the standard plan, (ii) the optimization of the beam orientations, beam weights and wedge angles of the standard plan, and (iii) a full fluence tomotherapy optimization of 1 cm wide (at isocentre), arcs. (i) and (ii) were created on the VOXELPLAN research 3D treatment-planning system, using in-house developed optimization algorithms, and (iii) was created on the PEACOCK tomotherapy planning system. The downhill-simplex optimization algorithm is used, in conjuction with `threshold-dose' cost-function terms enabling the algorithm to optimize specific regions of the dose-volume histogram (DVH) curve. The `beam-cost plot' tool is presented as a visual aid to the selection of beneficial beam directions. The methods and pitfalls in the transfer of plans and patient data between the two planning systems are discussed. Each optimization approach was evaluated, relative to the standard plan, on the basis of DVH and dose statistics in the PTV and organs at risk (OARs). All three optimization approaches were able to improve on the dose distribution of the standard plan. The magnitude of the improvement was greater for the optimized beam-orientation and tomotherapy plans (up to 15% and 30% for the maximum and mean OAR doses). A smaller improvement

  3. A Phase II Study of Stereotactic Body Radiation Therapy for Low-Intermediate-High-Risk Prostate Cancer Using Helical Tomotherapy: Dose-Volumetric Parameters Predicting Early Toxicity

    PubMed Central

    Macias, Victor A.; Blanco, Manuel L.; Barrera, Inmaculada; Garcia, Rafael

    2014-01-01

    Endpoint: To assess early urinary (GU) and rectal (GI) toxicities after helical tomotherapy Stereotactic body radiation therapy (SBRT), and to determine their predictive factors. Methods: Since May 2012, 45 prostate cancer patients were treated with eight fractions of 5.48 (low risk, 29%) or 5.65 Gy (intermediate-high risk, 71%) on alternative days over 2.5 weeks. The exclusion criteria were Gleason score 9–10, PSA >40 ng/mL, cT3b-4, IPSS ≥20, and history of acute urinary retention. During the follow-up, a set of potential prognostic factors was correlated with urinary or rectal toxicity. Results: The median follow-up was 13.8 months (2–25 months). There were no grade ≥3 toxicities. Acute grade 2 GU complications were found in a 22.7% of men, but in 2.3% of patients at 1 month, 0% at 6 months, and 0% at 12 months. The correspondent figures for grade 2 GI toxicities were 20.4% (acute), 2.3% (1 month), 3.6% (6 months), and 5% (12 months). Acute GI toxicity was significantly correlated with the rectal volume (>15 cm3) receiving 28 Gy, only when expressed as absolute volume. The age (>72 years old) was a predictor of GI toxicity after 1 month of treatment. No correlation was found, however, between urinary toxicity and the other analyzed variables. IPSS increased significantly at the time of the last fraction and within the first month, returning to the baseline at sixth month. Urinary-related quality of life (IPSS question 8 score), it was not significantly worsen during radiotherapy returning to the baseline levels 1 month after the treatment. At 12 months follow-up patient’s perception of their urinary function improved significantly in comparison with the baseline. Conclusion: Our scheme of eight fractions on alternative days delivered using helical tomotherapy is well tolerated. We recommend using actual volume instead of percentual volume in the treatment planning, and not to exceed 15 cm3 of rectal volume receiving

  4. Hypofractionated breast cancer radiotherapy. Helical tomotherapy in supine position or classic 3D-conformal radiotherapy in prone position: which is better?

    PubMed

    Cammarota, Fabrizio; Giugliano, Francesca Maria; Iadanza, Luciano; Cutillo, Luisa; Muto, Matteo; Toledo, Diego; Ravo, Vincenzo; Falivene, Sara; Muto, Paolo

    2014-03-01

    We propose a comparative dosimetric study of whole-breast hypofractionated radiation therapy using helical tomotherapy (HT) in supine position and 3-D conformal radiotherapy (3D-CRT) in prone position. Twelve patients undergoing breast-conserving therapy were retrospectively selected from October to December 2012. Specific dose-volume parameters were selected for the study. The target coverage was adequate in all patients for both techniques. Significant differences in lung dose distribution were observed: maximum dose (mean value over the 12 plans) was 23.41 Gy in HT plans and 6.65 Gy in 3D-CRT; V20 (i.e. the lung volume receiving 20 Gy) was 0.31% in HT plans and 0.0% in 3D-CRT plans. The mean dose to the heart was 5.57 Gy and 0.93 Gy, respectively. The differences between the two techniques were significant (p<0.05) only for some parameters. We noted better results in the prone position, but with HT, dose constraints were mentioned for the whole set of considered organs.

  5. Metastatic brain cancer: prediction of response to whole-brain helical tomotherapy with simultaneous intralesional boost for metastatic disease using quantitative MR imaging features

    NASA Astrophysics Data System (ADS)

    Sharma, Harish; Bauman, Glenn; Rodrigues, George; Bartha, Robert; Ward, Aaron

    2014-03-01

    The sequential application of whole brain radiotherapy (WBRT) and more targeted stereotactic radiosurgery (SRS) is frequently used to treat metastatic brain tumors. However, SRS has side effects related to necrosis and edema, and requires separate and relatively invasive localization procedures. Helical tomotherapy (HT) allows for a SRS-type simultaneous infield boost (SIB) of multiple brain metastases, synchronously with WBRT and without separate stereotactic procedures. However, some patients' tumors may not respond to HT+SIB, and would be more appropriately treated with radiosurgery or conventional surgery despite the additional risks and side effects. As a first step toward a broader objective of developing a means for response prediction to HT+SIB, the goal of this study was to investigate whether quantitative measurements of tumor size and appearance (including first- and second-order texture features) on a magnetic resonance imaging (MRI) scan acquired prior to treatment could be used to differentiate responder and nonresponder patient groups after HT+SIB treatment of metastatic disease of the brain. Our results demonstrated that smaller lesions may respond better to this form of therapy; measures of appearance provided limited added value over measures of size for response prediction. With further validation on a larger data set, this approach may lead to a means for prediction of individual patient response based on pre-treatment MRI, supporting appropriate therapy selection for patients with metastatic brain cancer.

  6. Assessing the Role of Volumetric Modulated Arc Therapy (VMAT) Relative to IMRT and Helical Tomotherapy in the Management of Localized, Locally Advanced, and Post-Operative Prostate Cancer

    SciTech Connect

    Davidson, Melanie T.M.; Blake, Samuel J.; Batchelar, Deidre L.; Cheung, Patrick; Mah, Katherine

    2011-08-01

    Purpose: To quantify differences in treatment delivery efficiency and dosimetry between step-and-shoot intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and helical tomotherapy (HT) for prostate treatment. Methods and Materials: Twenty-five prostate cancer patients were selected retrospectively for this planning study. Treatment plans were generated for: prostate alone (n = 5), prostate + seminal vesicles (n = 5), prostate + seminal vesicles + pelvic lymph nodes (n = 5), prostate bed (n = 5), and prostate bed + pelvic lymph nodes (n = 5). Target coverage, dose homogeneity, integral dose, monitor units (MU), and sparing of organs at risk (OAR) were compared across techniques. Time required to deliver each plan was measured. Results: The dosimetric quality of IMRT, VMAT, and HT plans were comparable for target coverage (planning target volume V95%, clinical target volume V100% all >98.7%) and sparing of organs at risk (OAR) for all treatment groups. Although HT resulted in a slightly higher integral dose and mean doses to the OAR, it yielded a lower maximum dose to all OAR examined. VMAT resulted in reductions in treatment times over IMRT (mean = 75%) and HT (mean = 70%). VMAT required 15-38% fewer monitor units than IMRT over all treatment volumes, with the reduction per fraction ranging from 100-423 MU from the smallest to largest volumes. Conclusions: VMAT improves efficiency of delivery for equivalent dosimetric quality as IMRT and HT across various prostate cancer treatment volumes in the intact and postoperative settings.

  7. Automatic registration of megavoltage to kilovoltage CT images in helical tomotherapy: An evaluation of the setup verification process for the special case of a rigid head phantom

    SciTech Connect

    Boswell, Sarah; Tome, Wolfgang; Jeraj, Robert; Jaradat, Hazim; Mackie, T. Rock

    2006-11-15

    Precise daily target localization is necessary to achieve highly conformal radiation delivery. In helical tomotherapy, setup verification may be accomplished just prior to delivering each fraction by acquiring a megavoltage CT scan of the patient in the treatment position. This daily image set may be manually or automatically registered to the image set on which the treatment plan was calculated, in order to determine any needed adjustments. The system was tested by acquiring 104 MVCT scans of an anthropomorphic head phantom to which translational displacements had been introduced with respect to the planning image set. Registration results were compared against an independent, optically guided positioning system. The total experimental uncertainty was within approximately 1 mm. Although the registration of phantom images is not fully analogous to the registration of patient images, this study confirms that the system is capable of phantom localization with sub-voxel accuracy. In seven registration problems considered, expert human observers were able to perform manual registrations with comparable or inferior accuracy to automatic registration by mutual information. The time to compute an automatic registration is considerably shorter than the time required for manual registration. However, human evaluation of automatic results is necessary in order to identify occasional outliers, and to ensure that the registration is clinically acceptable, especially in the case of deformable patient anatomy.

  8. Helical Tomotherapy-Based STAT Stereotactic Body Radiation Therapy: Dosimetric Evaluation for a Real-Time SBRT Treatment Planning and Delivery Program

    SciTech Connect

    Dunlap, Neal; McIntosh, Alyson; Sheng Ke; Yang Wensha; Turner, Benton; Shoushtari, Asal; Sheehan, Jason; Jones, David R.; Lu Weigo; Ruchala, Keneth; Olivera, Gustavo; Parnell, Donald; Larner, James L.; Benedict, Stanley H.; Read, Paul W.

    2010-01-01

    Stereotactic body radiation therapy (SBRT) treatments have high-dose gradients and even slight patient misalignment from the simulation to treatment could lead to target underdosing or organ at risk (OAR) overdosing. Daily real-time SBRT treatment planning could minimize the risk of geographic miss. As an initial step toward determining the clinical feasibility of developing real-time SBRT treatment planning, we determined the calculation time of helical TomoTherapy-based STAT radiation therapy (RT) treatment plans for simple liver, lung, and spine SBRT treatments to assess whether the planning process was fast enough for practical clinical implementation. Representative SBRT planning target volumes for hypothetical liver, peripheral lung, and thoracic spine lesions and adjacent OARs were contoured onto a planning computed tomography scan (CT) of an anthropomorphic phantom. Treatment plans were generated using both STAT RT 'full scatter' and conventional helical TomoTherapy 'beamlet' algorithms. Optimized plans were compared with respect to conformality index (CI), heterogeneity index (HI), and maximum dose to regional OARs to determine clinical equivalence and the number of required STAT RT optimization iterations and calculation times were determined. The liver and lung dosimetry for the STAT RT and standard planning algorithms were clinically and statistically equivalent. For the liver lesions, 'full scatter' and 'beamlet' algorithms showed a CI of 1.04 and 1.04 and HI of 1.03 and 1.03, respectively. For the lung lesions, 'full scatter' and 'beamlet' algorithms showed a CI of 1.05 and 1.03 and HI of 1.05and 1.05, respectively. For spine lesions, 'full scatter' and 'beamlet' algorithms showed a CI of 1.15 and 1.14 and HI of 1.22 and 1.14, respectively. There was no difference between treatment algorithms with respect to maximum doses to the OARs. The STAT RT iteration time with current treatment planning systems is 45 sec, and the treatment planning required 3

  9. Dose-volume histogram comparison between static 5-field IMRT with 18-MV X-rays and helical tomotherapy with 6-MV X-rays.

    PubMed

    Hayashi, Akihiro; Shibamoto, Yuta; Hattori, Yukiko; Tamura, Takeshi; Iwabuchi, Michio; Otsuka, Shinya; Sugie, Chikao; Yanagi, Takeshi

    2015-03-01

    We treated prostate cancer patients with static 5-field intensity-modulated radiation therapy (IMRT) using linac 18-MV X-rays or tomotherapy with 6-MV X-rays. As X-ray energies differ, we hypothesized that 18-MV photon IMRT may be better for large patients and tomotherapy may be more suitable for small patients. Thus, we compared dose-volume parameters for the planning target volume (PTV) and organs at risk (OARs) in 59 patients with T1-3 N0M0 prostate cancer who had been treated using 5-field IMRT. For these same patients, tomotherapy plans were also prepared for comparison. In addition, plans of 18 patients who were actually treated with tomotherapy were analyzed. The evaluated parameters were homogeneity indicies and a conformity index for the PTVs, and D2 (dose received by 2% of the PTV in Gy), D98, Dmean and V10-70 Gy (%) for OARs. To evaluate differences by body size, patients with a known body mass index were grouped by that index ( <21; 21-25; and >25 kg/m(2)). For the PTV, all parameters were higher in the tomotherapy plans compared with the 5-field IMRT plans. For the rectum, V10 Gy and V60 Gy were higher, whereas V20 Gy and V30 Gy were lower in the tomotherapy plans. For the bladder, all parameters were higher in the tomotherapy plans. However, both plans were considered clinically acceptable. Similar trends were observed in 18 patients treated with tomotherapy. Obvious trends were not observed for body size. Tomotherapy provides equivalent dose distributions for PTVs and OARs compared with 18-MV 5-field IMRT. Tomotherapy could be used as a substitute for high-energy photon IMRT for prostate cancer regardless of body size.

  10. Monte Carlo computed machine-specific correction factors for reference dosimetry of TomoTherapy static beam for several ion chambers.

    PubMed

    Sterpin, E; Mackie, T R; Vynckier, S

    2012-07-01

    To determinekQmsr,Qofmsr,fo correction factors for machine-specific reference (msr) conditions by Monte Carlo (MC) simulations for reference dosimetry of TomoTherapy static beams for ion chambers Exradin A1SL, A12; PTW 30006, 31010 Semiflex, 31014 PinPoint, 31018 microLion; NE 2571. For the calibration of TomoTherapy units, reference conditions specified in current codes of practice like IAEA/TRS-398 and AAPM/TG-51 cannot be realized. To cope with this issue, Alfonso et al. [Med. Phys., - (2008)] described a new formalism introducing msr factors kQmsr,Qofmsr,fo for reference dosimetry, applicable to static TomoTherapy beams. In this study, those factors were computed directly using MC simulations for Q0 corresponding to a simplified (60) Co beam in TRS-398 reference conditions (at 10 cm depth). The msr conditions were a 10 × 5 cm(2) TomoTherapy beam, source-surface distance of 85 cm and 10 cm depth. The chambers were modeled according to technical drawings using the egs++ package and the MC simulations were run with the egs_chamber user code. Phase-space files used as the source input were produced using PENELOPE after simulation of a simplified (60) Co beam and the TomoTherapy treatment head modeled according to technical drawings. Correlated sampling, intermediate phase-space storage, and photon cross-section enhancement variance reduction techniques were used. The simulations were stopped when the combined standard uncertainty was below 0.2%. ComputedkQmsr,Qofmsr,fo values were all close to one, in a range from 0.991 for the PinPoint chamber to 1.000 for the Exradin A12 with a statistical uncertainty below 0.2%. Considering a beam quality Q defined as the TPR20,10 for a 6 MV Elekta photon beam (0.661), the additional correction kQmsr,Qfmsr,fref to kQ,Qo defined in Alfonso et al. [Med. Phys., - (2008)] formalism was in a range from 0.997 to 1.004. The MC computed factors in this study are in agreement with measured factors for chamber types already studied in

  11. Monte Carlo computed machine-specific correction factors for reference dosimetry of TomoTherapy static beam for several ion chambers.

    PubMed

    Sterpin, E; Mackie, T R; Vynckier, S

    2012-07-01

    To determine k(Q(msr),Q(o) ) (f(msr),f(o) ) correction factors for machine-specific reference (msr) conditions by Monte Carlo (MC) simulations for reference dosimetry of TomoTherapy static beams for ion chambers Exradin A1SL, A12; PTW 30006, 31010 Semiflex, 31014 PinPoint, 31018 microLion; NE 2571. For the calibration of TomoTherapy units, reference conditions specified in current codes of practice like IAEA∕TRS-398 and AAPM∕TG-51 cannot be realized. To cope with this issue, Alfonso et al. [Med. Phys. 35, 5179-5186 (2008)] described a new formalism introducing msr factors k(Q(msr),Q(o) ) (f(msr),f(o) ) for reference dosimetry, applicable to static TomoTherapy beams. In this study, those factors were computed directly using MC simulations for Q(0) corresponding to a simplified (60)Co beam in TRS-398 reference conditions (at 10 cm depth). The msr conditions were a 10 × 5 cm(2) TomoTherapy beam, source-surface distance of 85 cm and 10 cm depth. The chambers were modeled according to technical drawings using the egs++ package and the MC simulations were run with the egs_chamber user code. Phase-space files used as the source input were produced using PENELOPE after simulation of a simplified (60)Co beam and the TomoTherapy treatment head modeled according to technical drawings. Correlated sampling, intermediate phase-space storage, and photon cross-section enhancement variance reduction techniques were used. The simulations were stopped when the combined standard uncertainty was below 0.2%. Computed k(Q(msr),Q(o) ) (f(msr),f(o) ) values were all close to one, in a range from 0.991 for the PinPoint chamber to 1.000 for the Exradin A12 with a statistical uncertainty below 0.2%. Considering a beam quality Q defined as the TPR(20,10) for a 6 MV Elekta photon beam (0.661), the additional correction k(Q(msr,)Q) (f(msr,)f(ref) ) to k(Q,Q(o) ) defined in Alfonso et al. [Med. Phys. 35, 5179-5186 (2008)] formalism was in a range from 0.997 to 1.004. The MC computed factors

  12. Multi-institutional Feasibility Study of a Fast Patient Localization Method in Total Marrow Irradiation With Helical Tomotherapy: A Global Health Initiative by the International Consortium of Total Marrow Irradiation

    SciTech Connect

    Takahashi, Yutaka; Vagge, Stefano; Agostinelli, Stefano; Han, Eunyoung; Matulewicz, Lukasz; Schubert, Kai; Chityala, Ravishankar; Ratanatharathorn, Vaneerat; Tournel, Koen; Penagaricano, Jose A.; Florian, Sterzing; Mahe, Marc-Andre; Verneris, Michael R.; Weisdorf, Daniel J.; and others

    2015-01-01

    Purpose: To develop, characterize, and implement a fast patient localization method for total marrow irradiation. Methods and Materials: Topographic images were acquired using megavoltage computed tomography (MVCT) detector data by delivering static orthogonal beams while the couch traversed through the gantry. Geometric and detector response corrections were performed to generate a megavoltage topogram (MVtopo). We also generated kilovoltage topograms (kVtopo) from the projection data of 3-dimensional CT images to reproduce the same geometry as helical tomotherapy. The MVtopo imaging dose and the optimal image acquisition parameters were investigated. A multi-institutional phantom study was performed to verify the image registration uncertainty. Forty-five MVtopo images were acquired and analyzed with in-house image registration software. Results: The smallest jaw size (front and backup jaws of 0) provided the best image contrast and longitudinal resolution. Couch velocity did not affect the image quality or geometric accuracy. The MVtopo dose was less than the MVCT dose. The image registration uncertainty from the multi-institutional study was within 2.8 mm. In patient localization, the differences in calculated couch shift between the registration with MVtopo-kVtopo and MVCT-kVCT images in lateral, cranial–caudal, and vertical directions were 2.2 ± 1.7 mm, 2.6 ± 1.4 mm, and 2.7 ± 1.1 mm, respectively. The imaging time in MVtopo acquisition at the couch speed of 3 cm/s was <1 minute, compared with ≥15 minutes in MVCT for all patients. Conclusion: Whole-body MVtopo imaging could be an effective alternative to time-consuming MVCT for total marrow irradiation patient localization.

  13. Multi-institutional Feasibility Study of a Fast Patient Localization Method in Total Marrow Irradiation With Helical Tomotherapy: A Global Health Initiative by the International Consortium of Total Marrow Irradiation

    PubMed Central

    Takahashi, Yutaka; Vagge, Stefano; Agostinelli, Stefano; Han, Eunyoung; Matulewicz, Lukasz; Schubert, Kai; Chityala, Ravishankar; Ratanatharathorn, Vaneerat; Tournel, Koen; Penagaricano, Jose A.; Florian, Sterzing; Mahe, Marc-Andre; Verneris, Michael R.; Weisdorf, Daniel J.; Corvo, Renzo; Dusenbery, Kathryn E.; Storme, Guy; Hui, Susanta K.

    2014-01-01

    Purpose To develop, characterize, and implement a fast patient localization method for total marrow irradiation. Methods and Materials Topographic images were acquired using megavoltage computed tomography (MVCT) detector data by delivering static orthogonal beams while the couch traversed through the gantry. Geometric and detector response corrections were performed to generate a megavoltage topogram (MVtopo). We also generated kilovoltage topograms (kVtopo) from the projection data of 3-dimensional CT images to reproduce the same geometry as helical tomotherapy. The MVtopo imaging dose and the optimal image acquisition parameters were investigated. A multi-institutional phantom study was performed to verify the image registration uncertainty. Forty-five MVtopo images were acquired and analyzed with in-house image registration software. Results The smallest jaw size (front and backup jaws of 0) provided the best image contrast and longitudinal resolution. Couch velocity did not affect the image quality or geometric accuracy. The MVtopo dose was less than the MVCT dose. The image registration uncertainty from the multi-institutional study was within 2.8 mm. In patient localization, the differences in calculated couch shift between the registration with MVtopo-kVtopo and MVCT-kVCT images in lateral, cranial–caudal, and vertical directions were 2.2 ± 1.7 mm, 2.6 ± 1.4 mm, and 2.7 ± 1.1 mm, respectively. The imaging time in MVtopo acquisition at the couch speed of 3 cm/s was <1 minute, compared with ≥15 minutes in MVCT for all patients. Conclusion Whole-body MVtopo imaging could be an effective alternative to time-consuming MVCT for total marrow irradiation patient localization. PMID:25442340

  14. Helical tractor beam: analytical solution of Rayleigh particle dynamics.

    PubMed

    Carretero, Luis; Acebal, Pablo; Garcia, Celia; Blaya, Salvador

    2015-08-10

    We analyze particle dynamics in an optical force field generated by helical tractor beams obtained by the interference of a cylindrical beam with a topological charge and a co-propagating temporally de-phased plane wave. We show that, for standard experimental conditions, it is possible to obtain analytical solutions for the trajectories of particles in such force field by using of some approximations. These solutions show that, in contrast to other tractor beams described before, the intensity becomes a key parameter for the control of particle trajectories. Therefore, by tuning the intensity value the particle can describe helical trajectories upstream and downstream, a circular trajectory in a fixed plane, or a linear displacement in the propagation direction. The approximated analytical solutions show good agreement to the corresponding numerical solutions of the exact dynamical differential equations.

  15. Electron cyclotron beam measurement system in the Large Helical Device

    SciTech Connect

    Kamio, S. Takahashi, H.; Kubo, S.; Shimozuma, T.; Yoshimura, Y.; Igami, H.; Ito, S.; Kobayashi, S.; Mizuno, Y.; Okada, K.; Osakabe, M.; Mutoh, T.

    2014-11-15

    In order to evaluate the electron cyclotron (EC) heating power inside the Large Helical Device vacuum vessel and to investigate the physics of the interaction between the EC beam and the plasma, a direct measurement system for the EC beam transmitted through the plasma column was developed. The system consists of an EC beam target plate, which is made of isotropic graphite and faces against the EC beam through the plasma, and an IR camera for measuring the target plate temperature increase by the transmitted EC beam. This system is applicable to the high magnetic field (up to 2.75 T) and plasma density (up to 0.8 × 10{sup 19} m{sup −3}). This system successfully evaluated the transmitted EC beam profile and the refraction.

  16. Helical Tomotherapy of the breast: can thermoplastic immobilization improve the reproducibility of the treatment setup and the accuracy of the delivered dose?

    PubMed

    Agostinelli, S; Garelli, S; Bellini, A; Pupillo, F; Guenzi, M; Bosetti, D; Blandino, G; Taccini, G

    2015-02-01

    To evaluate the impact of thermoplastic mask immobilization in the setup reproducibility and delivered dose for Helical Tomotherapy (HT) of the breast/chest wall. 16 patients treated with Accuray Hi-Art HT for breast-cancer were considered. Patients were positioned supine with arms extended above the head using Civco Wing Board (WB) system. In 50% of patients an Orfit thermoplastic mask was added in order to improve immobilization. Before each treatment fraction a megavoltage CT (MVCT) scan was taken and registered to the planning CT by experienced medical staff. The impact of thermoplastic mask was investigated analysing MVCT shift-roll data and MVCT dose distribution using Planned Adaptive software. In the analysed cases, the addition of thermoplastic mask had minor impact on the lateral, longitudinal and roll data distribution. Variance of vertical shifts was significantly reduced in the WB + Orfit group. Van Herk's margins were not affected by addition of thermoplastic immobilization. In both groups, target coverage (V95) and maximum dose (D1) were almost identical to planned values. D1 of organs at risk were not significantly different in the two groups. Analysis of shift-roll data shows no improvement in the group of patients immobilized with the addition of thermoplastic mask. Van Herk's margin is quite large (7-10 mm) in both groups evidencing the need to perform daily setup correction. The adapted dose distribution complies well with the planned one, showing that if MVCT is used before each treatment fraction, a 3 mm margin (setup component) for CTVs expansion could be adequate. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. Superiority of helical tomotherapy on liver sparing and dose escalation in hepatocellular carcinoma: a comparison study of three-dimensional conformal radiotherapy and intensity-modulated radiotherapy

    PubMed Central

    Zhao, Qianqian; Wang, Renben; Zhu, Jian; Jin, Linzhi; Zhu, Kunli; Xu, Xiaoqing; Feng, Rui; Jiang, Shumei; Qi, Zhonghua; Yin, Yong

    2016-01-01

    Background and purpose To compare the difference of liver sparing and dose escalation between three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and helical tomotherapy (HT) for hepatocellular carcinoma. Patients and methods Sixteen unresectable HCC patients were enrolled in this study. First, some evaluation factors of 3DCRT, IMRT, and HT plans were calculated with prescription dose at 50 Gy/25 fractions. Then, the doses were increased using HT or IMRT independently until either the plans reached 70 Gy or any normal tissue reached the dose limit according to quantitative analysis of normal tissue effects in the clinic criteria. Results The conformal index of 3DCRT was lower than that of IMRT (P<0.001) or HT (P<0.001), and the homogeneity index of 3DCRT was higher than that of IMRT (P<0.001) or HT (P<0.001). HT took the longest treatment time (P<0.001). For V50% (fraction of normal liver treated to at least 50% of the isocenter dose) of the normal liver, there was a significant difference: 3DCRT > IMRT > HT (P<0.001). HT had a lower Dmean (mean dose) and V20 (Vn, the percentage of organ volume receiving ≥n Gy) of liver compared with 3DCRT (P=0.005 and P=0.005, respectively) or IMRT (P=0.508 and P=0.007, respectively). Dmean of nontarget normal liver and V30 of liver were higher for 3DCRT than IMRT (P=0.005 and P=0.005, respectively) or HT (P=0.005 and P=0.005, respectively). Seven patients in IMRT (43.75%) and nine patients in HT (56.25%) reached the isodose 70 Gy, meeting the dose limit of the organs at risk. Conclusion HT may provide significantly better liver sparing and allow more patients to achieve higher prescription dose in HCC radiotherapy. PMID:27445485

  18. Treatment-Related Pneumonitis and Acute Esophagitis in Non-Small-Cell Lung Cancer Patients Treated With Chemotherapy and Helical Tomotherapy

    SciTech Connect

    Song, Chang Hoon; Pyo, Hongryull; Moon, Sung Ho; Kim, Tae Hyun; Kim, Dae Woong; Cho, Kwan Ho

    2010-11-01

    Purpose: To assess clinical outcomes and complications in patients with non-small-cell lung cancer (NSCLC) treated with helical tomotherapy (HT) with or without chemotherapy. Methods and Materials: Data from 37 NSCLC patients treated between January 2007 and August 2008 were analyzed retrospectively. Twenty-eight patients had Stage III disease. Concurrent and neoadjuvant chemotherapy was given to 24 and 14 patients, respectively. Radiotherapy was delivered to a total dose of 60-70.4 Gy at 2.0-2.4 Gy per fraction to the gross tumor volume and 50-64 Gy at 1.8-2.0 Gy per fraction to the planning target volume. Results: With a median follow-up of 18 months (range, 6-27 months), 2-year local control and overall survival rates were 63% and 56% for all 37 patients, respectively, and were 78% and 75% for the patients with Stage III disease who received concurrent chemoradiotherapy alone. Acute esophagitis and treatment-related pneumonitis (TRP) {>=}Grade 3 occurred in 5 and 7 patients, respectively. Four patients died of treatment-related death (TRD) after HT. In univariate analysis, poor performance status, total lung V{sub 5}, contralateral lung (CL) V{sub 5}, and V{sub 10} were associated with TRD. Only CL V{sub 5} remained significant in the multivariate analysis (p = 0.029). Conclusions: HT with chemotherapy has shown promising clinical outcomes, esophagitis, and TRPs. However, HT has produced a somewhat high rate of fatal pulmonary complications. Our data suggest that CL V{sub 5} should be considered and kept as low as possible (<60%) in addition to the conventional dosimetric factors.

  19. 11C-choline PET/CT based helical tomotherapy as treatment approach for bone metastases in recurrent prostate cancer patients.

    PubMed

    Incerti, Elena; Gangemi, Vincenzo; Mapelli, Paola; Deantoni, Chiara Lucrezia; Giovacchini, Giampiero; Fallanca, Federico; Fodor, Andrei; Ciarmiello, Andrea; Baldari, Sergio; Gianolli, Luigi; Di Muzio, Nadia; Picchio, Maria

    2017-09-19

    To evaluate the efficacy of 11C-choline PET/CT (CHO-PET/CT) based helical tomotherapy (HTT) as a therapeutic approach for bone metastases in recurrent prostate cancer (PCa) patients. METHODS This retrospective study includes 20 PCa patients (median age: 67; range: 51-80 years) presenting biochemical relapse after primary treatment who underwent CHO-PET/CT based HTT on positive bone metastases from December 2007 to June 2014. The effectiveness of HTT assessed with biochemical response at 3/6/12 months, biochemical relapse free survival (bRFS) and overall survival (OS) at 2 years. Toxicity has been also considered and assessed according to Common Terminology Criteria for Adverse Events (CTCAE). RESULTS All patients presented a relapse at the time of CHO-PET/CT at bone metastases. In addition 15/20 (75%) also at lymph nodes (LNs) level (total lesions= 54). All patients underwent HTT on bone metastases and 19/20 concomitantly on prostatic bed and LNs. The median follow-up from CHO-PET/CT was 2 years (range: 1-7 years). At 3 months, after the beginning of HTT treatment, complete or partial biochemical response occurred in 79% of patients, at 6 months in 82% and at 12 months in 63% of patients. bRFS and OS at 2 years were 50% and 55% of patients, respectively. Patients presented mostly grade 1 or 2 toxicity according to CTCAE. The only grade 3 late toxicity has been observed in one patient. CONCLUSIONS CHO-PET/CT based HTT is a suitable therapeutic approach in patients with recurrent PCa presenting bone metastases with a medium-low toxicity. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. Conversion of the helical tomotherapy plans to the step-and-shoot IMRT plans for patients with hip prosthesis during radiotherapy for prostate cancer.

    PubMed

    Olmińska, Maria; Piotrowski, Tomasz; Litoborska, Joanna; Pawałowski, Bartosz; Jodda, Agata

    2016-01-01

    To evaluate the SharePlan software in conversion of helical tomotherapy (HT) to a step and shoot IMRT (sIMRT) for patients with high-risk prostate cancer and hip prosthesis. Analysis was performed for 16 consecutive patients treated on HT. The HT plans were converted to sIMRT plans. 3DCRT, sliding window IMRT (dIMRT) and VMAT plans for a c-arm linear accelerator (CLA) were created manually. The doses in planning target volume (PTV), bladder, rectum, bowels, femoral heads and hip prosthesis were compared using: (i) a qualitative analysis of doses in averaged dose-volume histograms, (ii) a quantitative, ranking procedure performed for each patient separately, and (iii) statistical testing based on the Friedman ANOVA and Nemenyi method. For the bladder, rectum, and femoral head, the best dose distributions were observed for HT and sIMRT and then for dIMRT, VMAT, and finally for 3DCRT (p-values were, respectively, 0.002, 0.004 and p = 0.024). For the bowels, 3DCRT was significantly different from the rest of the techniques (p = 0.009). For the hip prosthesis, the differences were only between 3DCRT and HT/sIMRT (p = 0.038). The SharePlan is an efficient tool for the conversion of HT plans for patients with prostate cancer and hip prosthesis. Dose distributions in sIMRT and in HT plans are similar and are generally better than in CLA plans. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2012-01-05

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

  2. Bowel sparing in pediatric cranio-spinal radiotherapy: a comparison of combined electron and photon and helical TomoTherapy techniques to a standard photon method

    SciTech Connect

    Harron, Elizabeth; Lewis, Joanne

    2012-07-01

    The aim of this study was to compare the dose to organs at risk (OARs) from different craniospinal radiotherapy treatment approaches available at the Northern Centre for Cancer Care (NCCC), with a particular emphasis on sparing the bowel. Method: Treatment plans were produced for a pediatric medulloblastoma patient with inflammatory bowel disease using 3D conformal 6-MV photons (3DCP), combined 3D 6-MV photons and 18-MeV electrons (3DPE), and helical photon TomoTherapy (HT). The 3DPE plan was a modification of the standard 3DCP technique, using electrons to treat the spine inferior to the level of the diaphragm. The plans were compared in terms of the dose-volume data to OARs and the nontumor integral dose. Results: The 3DPE plan was found to give the lowest dose to the bowel and the lowest nontumor integral dose of the 3 techniques. However, the coverage of the spine planning target volume (PTV) was least homogeneous using this technique, with only 74.6% of the PTV covered by 95% of the prescribed dose. HT was able to achieve the best coverage of the PTVs (99.0% of the whole-brain PTV and 93.1% of the spine PTV received 95% of the prescribed dose), but delivered a significantly higher integral dose. HT was able to spare the heart, thyroid, and eyes better than the linac-based techniques, but other OARs received a higher dose. Conclusions: Use of electrons was the best method for reducing the dose to the bowel and the integral dose, at the expense of compromised spine PTV coverage. For some patients, HT may be a viable method of improving dose homogeneity and reducing selected OAR doses.

  3. SmartArc-based volumetric modulated arc therapy for endometrial cancer: a dosimetric comparison with helical tomotherapy and intensity-modulated radiation therapy

    PubMed Central

    2013-01-01

    Background The purpose of the present study was to investigate the feasibility of using volumetric modulated arc therapy with SmartArc (VMAT-S) to achieve radiation delivery efficiency higher than that of intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT) when treating endometrial cancer, while maintaining plan quality. Methods Nine patients with endometrial cancer were retrospectively studied. Three plans per patient were generated for VMAT-S, IMRT and HT. The dose distributions for the planning target volume (PTV), organs at risk (OARs) and normal tissue were compared. The monitor units (MUs) and treatment delivery time were also evaluated. Results The average homogeneity index was 1.06, 1.10 and 1.07 for the VMAT-S, IMRT and HT plans, respectively. The V40 for the rectum, bladder and pelvis bone decreased by 9.0%, 3.0% and 3.0%, respectively, in the VMAT-S plan relative to the IMRT plan. The target coverage and sparing of OARs were comparable between the VMAT-S and HT plans. The average MU was 823, 1105 and 8403 for VMAT-S, IMRT and HT, respectively; the average delivery time was 2.6, 8.6 and 9.5 minutes, respectively. Conclusions For endometrial cancer, the VMAT-S plan provided comparable quality with significantly shorter delivery time and fewer MUs than with the IMRT and HT plans. In addition, more homogeneous PTV coverage and superior sparing of OARs in the medium to high dose region were observed in the VMAT-S relative to the IMRT plan. PMID:24175929

  4. Feasibility of Helical Tomotherapy in Stereotactic Body Radiation Therapy for Centrally Located Early Stage Non-Small-Cell Lung Cancer or Lung Metastases

    SciTech Connect

    Chi, Alexander; Jang, Si Young; Welsh, James S.; Nguyen, Nam P.; Ong, Evan; Gobar, Lisa; Komaki, Ritsuko

    2011-11-01

    Purpose: To investigate the ability of helical tomotherapy (HT) to spare critical organs immediately adjacent to the tumor target in stereotactic body radiation therapy (SBRT) for centrally located lung lesions. Methods and Materials: HT SBRT plans for 10 patients with centrally located lesions or lesions immediately adjacent to a critical structure were generated. A total of 70 Gy in 10 fractions was prescribed to the planning target volume (PTV) to satisfy a target volume coverage of {>=}95% PTV receiving 70 Gy and an established set of dose constraints for the organs at risk (OARs). Quality assurance (QA) of the HT plans was performed with both ion chamber and film measurements. Results: The PTV coverage criteria was met with 95% of the PTV receiving 70.68 {+-} 0.33 Gy for all cases even though the OARs immediately adjacent to the PTV ranged from 0.38 to 0.85 cm away. The mean lung dose (MLD), and V{sub 20} were 7.15 {+-} 1.44 Gy, and 11.93 {+-} 3.24 % for the total lung, respectively. The dose parameters of MLD, V{sub 5}, V{sub 10}, and V{sub 20} for the contralateral lung were significantly lower than those for the ipsilateral lung (p < 0.05). An average dose fall off from the PTV periphery to the edge of the immediately adjacent OAR was 47.6% over an average distance of 4.87 mm. Comparison of calculated and measured doses with the ion chamber showed an average of 1.85% point dose error, whereas an average mean gamma and the area with a gamma larger than 1 of 0.20 and 0.94% were observed, respectively. Conclusion: HT allows the sparing of critical structures immediately adjacent to the tumor target, thus making SBRT for these centrally located lesions feasible.

  5. Dosimetric comparison of postoperative whole pelvic radiotherapy for endometrial cancer using three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and helical tomotherapy.

    PubMed

    Yang, Ruijie; Xu, Shouping; Jiang, Weijuan; Wang, Junjie; Xie, Chuanbin

    2010-01-01

    The use of Intensity-modulated radiotherapy (IMRT) and Helical tomotherapy (HT) is increasing in gynecological cancer patients. No published studies have performed a dosimetric evaluation of whole pelvic radiotherapy (WPRT) using HT for postoperative endometrial cancer. The purpose of this study was to perform a direct dosimetric comparison of three-dimensional conformal radiotherapy (3D-CRT), IMRT and HT plans for WPRT in postoperative endometrial cancer patients, and to evaluate the integral dose to organs at risk (OARs) and normal tissue. We selected ten patients with endometrial cancer undergoing postoperative WPRT. Plans for 3D-CRT, IMRT and HT were developed for each patient. All plans were normalized to deliver 50 Gy to 95% of the PTV. The dosimetry and integral dose to OARs and normal tissue were compared. The significance of differences was tested using a paired two-tailed Student t-test. IMRT were superior to 3D-CRT in dose conformity (conformity index: 0.87 vs. 0.61, p = 0.00) and integral dose to OARs and normal tissue, although a greater volume of normal tissue receiving dose below 10 Gy was observed. The results were similar in HT except that the integral dose to normal tissue increased slightly. Compared directly with IMRT, HT showed better dose homogeneity and lower integral dose to rectum and bladder, but the integral dose to pelvic bones and normal tissue slightly increased. In postoperative WPRT of endometrial cancer, IMRT and HT result in better conformity and lower integral dose to OARs compared with 3D-CRT. The integral dose to normal tissue did not increase significantly in IMRT, although a greater volume of normal tissue is irradiated to the dose below 10 Gy. HT further improves the dose homogeneity and integral dose to rectum and bladder, at the expense of a slightly higher integral dose to pelvic bones and normal tissue.

  6. Investigation of electron beam transport in a helical undulator

    SciTech Connect

    Jeong, Y.U.; Lee, B.C.; Kim, S.K.

    1995-12-31

    Lossless transport of electrons through the undulator is essential for CW operation of the FELs driven by recirculating electrostatic accelerators. We calculate the transport ratio of an electron beam in a helical undulator by using a 3-D simulation code and compare the results with the experimental results. The energy and the current of the electron beam are 400 keV and 2 A, respectively. The 3-D distribution of the magnetic field of a practical permanent-magnet helical undulator is measured and is used in the calculations. The major parameters of the undutlator are : period = 32 mm, number of periods = 20, number of periods in adiabatic region = 3.5, magnetic field strength = 1.3 kG. The transport ratio is very sensitive to the injection condition of the electron beam such as the emittance, the diameter, the divergence, etc.. The injection motion is varied in the experiments by changing the e-gun voltage or the field strength of the focusing magnet located at the entrance of the undulator. It is confirmed experimentally and with simulations that most of the beam loss occurs at the adiabatic region of the undulator regardless of the length of the adiabatic region The effect of axial guiding magnetic field on the beam finish is investigated. According to the simulations, the increase of the strength of axial magnetic field from 0 to 1 kG results in the increase of the transport ratio from 15 % to 95%.

  7. Observation of an optical vortex beam from a helical undulator in the XUV region.

    PubMed

    Kaneyasu, Tatsuo; Hikosaka, Yasumasa; Fujimoto, Masaki; Iwayama, Hiroshi; Hosaka, Masahito; Shigemasa, Eiji; Katoh, Masahiro

    2017-09-01

    The observation of an optical vortex beam at 60 nm wavelength, produced as the second-harmonic radiation from a helical undulator, is reported. The helical wavefront of the optical vortex beam was verified by measuring the interference pattern between the vortex beam from a helical undulator and a normal beam from another undulator. Although the interference patterns were slightly blurred owing to the relatively large electron beam emittance, it was possible to observe the interference features thanks to the helical wavefront of the vortex beam. The experimental results were well reproduced by simulation.

  8. Dose as a Function of Lung Volume and Planned Treatment Volume in Helical Tomotherapy Intensity-Modulated Radiation Therapy-Based Stereotactic Body Radiation Therapy for Small Lung Tumors

    SciTech Connect

    Baisden, Joseph M.; Romney, Davis A.; Reish, Andrew G.; Cai Jing; Sheng Ke; Jones, David R.; Benedict, Stanley H.; Read, Paul W.; Larner, James M. . E-mail: JML2P@virginia.edu

    2007-07-15

    Purpose: To evaluate the limitations of Hi-Art Helical Tomotherapy (Middleton, WI) stereotactic body radiotherapy (SBRT) for lung lesions, and to provide an initial report on patients treated with this method. Stereotactic body radiotherapy was shown to be an effective, well-tolerated treatment for early-stage, non-small-cell lung carcinoma (NSCLC). The Radiation Therapy Oncology Group (RTOG) 0236 protocol is currently evaluating three-dimensional conformal SBRT that delivers 60 Gy in three fractions. Methods and Materials: Inverse treatment planning for hypothetical lung gross tumor volumes (GTV) and planned treatment volume (PTV) expansions were performed. We tested the hypothesis that the maximum acceptable dose (MAD) to be delivered to the lesion by SBRT could be predicted by PTV and lung volume. Dose constraints on normal tissue were as designated by the RTOG protocol. Inverse planning was performed to find the maximum tolerated SBRT dose up to 60 Gy. Results: Regression analysis of the data obtained indicated a linear relationship between MAD, PTV, and lung volume. This generated two equations which may be useful predictive tools. Seven patients with Stage I and II NSCLC treated at University of Virginia with this method tolerated the treatment extremely well, and suffered no greater than grade I toxicity, with no evidence of disease recurrence in follow-up from 2-20 months. Conclusions: Helical tomotherapy SBRT for lung lesions is well-tolerated. In addition, the likely MAD for patients considered for this type of treatment can be predicted by PTV and lung volume.

  9. Measurements of Beam Ion Loss from the Compact Helical System

    SciTech Connect

    D. S. Darrow, M. Isobe, Takashi Kondo, M. Sasao, and the CHS Group National Institute for Fusion Science, Toki, Gifu, Japan

    2010-02-03

    Beam ion loss from the Compact Helical System (CHS) has been measured with a scintillator-type probe. The total loss to the probe, and the pitch angle and gyroradius distributions of that loss, have been measured as various plasma parameters were scanned. Three classes of beam ion loss were observed at the probe position: passing ions with pitch angles within 10o of those of transition orbits, ions on transition orbits, and ions on trapped orbits, typically 15o or more from transition orbits. Some orbit calculations in this geometry have been performed in order to understand the characteristics of the loss. Simulation of the detector signal based upon the following of orbits from realistic beam deposition profiles is not able to reproduce the pitch angle distribution of the losses measured. Consequently it is inferred that internal plasma processes, whether magnetohydrodynamic modes, radial electric fields, or plasma turbulence, move previously confined beam ions to transition orbits, resulting in their loss.

  10. Generating polarization vortices by using helical beams and a Twyman Green interferometer.

    PubMed

    Fu, Shiyao; Gao, Chunqing; Shi, Yang; Dai, Kunjian; Zhong, Lei; Zhang, Shikun

    2015-04-15

    A stable interferometric arrangement consisting of a polarizing beam splitter, a reflector, and a right-angle prism is designed to transform helical beams into polarization vortices. The computer-generated holograms are loaded on the liquid crystal spatial light modulator (LC-SLM) in order to generate different helical beams. Then the helical beams are transformed into polarization vortices with different kinds of intensity distribution successfully.

  11. Do We Need Daily Image-Guided Radiotherapy by Megavoltage Computed Tomography in Head and Neck Helical Tomotherapy? The Actual Delivered Dose to the Spinal Cord

    SciTech Connect

    Duma, Marciana Nona; Kampfer, Severin; Schuster, Tibor; Aswathanarayana, Nandana; Fromm, Laura-Sophie; Molls, Michael; Andratschke, Nicolaus; Geinitz, Hans

    2012-09-01

    Purpose: To quantify the actual delivered dose to the cervical spinal cord with different image-guided radiotherapy (IGRT) approaches during head and neck (HN) cancer helical tomotherapy. Methods and Materials: Twenty HN patients (HNpts) treated with bilateral nodal irradiation were analyzed. Daily megavoltage computed tomography MVCT) scans were performed for setup purposes. The maximum dose on the planning CT scan (plan-Dmax) and the magnitude and localization of the actual delivered Dmax (a-Dmax) were analyzed for four scenarios: daily image-guided radiotherapy (dIGRT), twice weekly IGRT (2 Multiplication-Sign WkIGRT), once weekly IGRT (1 Multiplication-Sign WkIGRT), and no IGRT at all (non-IGRT). The spinal cord was recontoured on 236 MVCTs for each scenario (total, 944 fractions), and the delivered dose was recalculated for each fraction (fx) separately. Results: Fifty-one percent of the analyzed fx for dIGRT, 56% of the analyzed fx for the 2 Multiplication-Sign WkIGRT, 62% of the analyzed fx for the 1 Multiplication-Sign WkIGRT, and 63% of the analyzed fx for the non-IGRT scenarios received a higher a-Dmax than the plan-Dmax. The median increase of dose in these fx was 3.3% more for dIGRT, 5.8% more for 2 Multiplication-Sign WkIGRT, 10.0% more for 1 Multiplication-Sign WkIGRT, and 9.5% more for non-IGRT than the plan-Dmax. The median spinal cord volumes receiving a higher dose than the plan-Dmax were 0.02 cm{sup 3} for dIGRT, 0.11 cm{sup 3} for 2 Multiplication-Sign WkIGRT, 0.31 cm{sup 3} for 1 Multiplication-Sign WkIGRT, and 0.22 cm{sup 3} for non-IGRT. Differences between the dIGRT and all other scenarios were statistically significant (p < 0.05). Conclusions: Compared to the Dmax of the initial plan, daily IGRT had the smallest increase in dose. Furthermore, daily IGRT had the lowest proportion of fractions and the smallest volumes affected by a dose that was higher than the planned dose. For patients treated with doses close to the tolerance dose of the

  12. Dosimetric effect of small bowel oral contrast on conventional radiation therapy, linear accelerator-based intensity modulated radiation therapy, and helical tomotherapy plans for rectal cancer.

    PubMed

    Joseph, Kurian; Liu, Derek; Severin, Diane; Dickey, Mike; Polkosnik, Lee-Anne; Warkentin, Heather; Mihai, Alina; Ghosh, Sunita; Field, Colin

    2015-01-01

    This study evaluated the dosimetric effect of small bowel oral contrast on conventional radiation therapy, linear accelerator-based intensity modulated radiation therapy (IMRT), and helical tomotherapy (HT) treatment plans. Thirteen patients with rectal cancer underwent computed tomography (CT) simulation with oral contrast (CCT) in preparation for chemoradiation therapy. The contrast in the small bowel was contoured, and a noncontrast CT scan (NCCT) was simulated by reassigning a CT number of 0 Hounsfield units to the contrast volume. Conventional, IMRT, and HT plans were generated with the CCT. The plan generated on the CCT was then recalculated on the NCCT, maintaining the same number of monitor units for each field, and the plans were not renormalized. Dosimetric parameters representing coverage of the planning target volume with 45 Gy (D98%, D95%, D50%, and D2%) and sparing of the bladder and peritoneal cavity (D50%, D30%, and D10%) were recorded. The ratio of dose calculated in the presence of contrast to dose with contrast edited out was recorded for each parameter. A paired Student t test was used for comparison of plans. For conventional plans, there was <0.1% variance in the dose ratio for all volumes of interest. For IMRT plans, there was a 1% decrease in the mean dose ratio, and the range of dose ratios for all volumes was greater than that for HT or conventional plans. For HT plans, for all volumes of interest, the mean dose ratio was <0.2%, and the range for all patients was <1%. For all IMRT dosimetric parameters, the difference was in the order of 1% of the mean dose (P < .05). The dose difference was not statistically significant for the conventional or HT plans. The use of CCT during CT simulation has no clinically significant effect on dose calculations for conventional, IMRT, and HT treatment plans and may not require replacement of the contrast with a CT number of 0 Hounsfield units. Copyright © 2015 American Society for Radiation Oncology

  13. Helical tomotherapy for whole-brain irradiation with integrated boost to multiple brain metastases: evaluation of dose distribution characteristics and comparison with alternative techniques.

    PubMed

    Levegrün, Sabine; Pöttgen, Christoph; Wittig, Andrea; Lübcke, Wolfgang; Abu Jawad, Jehad; Stuschke, Martin

    2013-07-15

    To quantitatively evaluate dose distribution characteristics achieved with helical tomotherapy (HT) for whole-brain irradiation (WBRT) with integrated boost (IB) to multiple brain metastases in comparison with alternative techniques. Dose distributions for 23 patients with 81 metastases treated with WBRT (30 Gy/10 fractions) and IB (50 Gy) were analyzed. The median number of metastases per patient (N(mets)) was 3 (range, 2-8). Mean values of the composite planning target volume of all metastases per patient (PTV(mets)) and of the individual metastasis planning target volume (PTV(ind met)) were 8.7 ± 8.9 cm(3) (range, 1.3-35.5 cm(3)) and 2.5 ± 4.5 cm(3) (range, 0.19-24.7 cm(3)), respectively. Dose distributions in PTV(mets) and PTV(ind met) were evaluated with respect to dose conformity (conformation number [CN], RTOG conformity index [PITV]), target coverage (TC), and homogeneity (homogeneity index [HI], ratio of maximum dose to prescription dose [MDPD]). The dependence of dose conformity on target size and N(mets) was investigated. The dose distribution characteristics were benchmarked against alternative irradiation techniques identified in a systematic literature review. Mean ± standard deviation of dose distribution characteristics derived for PTV(mets) amounted to CN = 0.790 ± 0.101, PITV = 1.161 ± 0.154, TC = 0.95 ± 0.01, HI = 0.142 ± 0.022, and MDPD = 1.147 ± 0.029, respectively, demonstrating high dose conformity with acceptable homogeneity. Corresponding numbers for PTV(ind met) were CN = 0.708 ± 0.128, PITV = 1.174 ± 0.237, TC = 0.90 ± 0.10, HI = 0.140 ± 0.027, and MDPD = 1.129 ± 0.030, respectively. The target size had a statistically significant influence on dose conformity to PTV(mets) (CN = 0.737 for PTV(mets) ≤4.32 cm(3) vs CN = 0.848 for PTV(mets) >4.32 cm(3), P=.006), in contrast to N(mets). The achieved dose conformity to PTV(mets), assessed by both CN and PITV, was in all investigated volume strata well within the best quartile of

  14. Treatment outcomes and patterns of radiologic appearance after hypofractionated image-guided radiotherapy delivered with helical tomotherapy (HHT) for lung tumours.

    PubMed

    Arcangeli, Stefano; Falcinelli, Lorenzo; Bracci, Stefano; Greco, Alessandro; Monaco, Alessia; Dognini, Jessica; Chiostrini, Cinzia; Bellavita, Rita; Aristei, Cynthia; Donato, Vittorio

    2017-03-01

    To evaluate treatment outcomes and patterns of CT lung injury after hypofractionated image-guided radiotherapy delivered with helical tomotherapy (HHT) in a series of inoperable lung lesions. 68 patients who were medically inoperable (69 lesions) without evidence of viable extrathoracic disease were included. Dose prescription was driven by tumour location (hilar/pericentral vs peripheral) and/or target volume. 52% of the lesions received a biological equivalent dose (BED10) ≥100 Gy. Assessment of tumour response was based on the Response Evaluation Criteria in Solid Tumours 1.1 criteria coupled with fluorine-18 fludeoxyglucose/positron emission tomography-CT. Toxicity monitoring was focused on treatment-related pulmonary adverse events according to the Common Terminology Criteria for Adverse Events v. 4.0. Acute and late events were classified as radiation pneumonitis (RP) and radiation fibrosis (RF), respectively. Survival curves were calculated using the Kaplan-Meier method. Univariate and multivariate analyses of survival were performed using the Cox proportional hazards model. After a median follow-up of 12 months (range, 3-31 months), no instances of ≥Grade 4 RP was documented, and clinically severe (Grade 3) RP occurred in 5.8% of the patients. 2 (3%) patients developed a late severe (≥Grade 3) symptomatic RF. No specific pattern of CT lung injury was demonstrated, in both acute and late settings. Median overall survival (OS) and progression-free survival (PFS) for the entire population were 30.8 and 14.1 months, respectively. At multivariate analysis (MVA), BED10 ≥ 100 Gy and KPS ≥ 90 emerged as significant prognostic factors for OS (p = 0.01 and p = 0.001, respectively), and BED10 ≥ 100 Gy for PFS (p = 0.02). Our findings show that HHT adjusted for tumour location and/or target volume is an effective treatment with an acceptable toxicity profile in patients who are medically inoperable with lung tumours and is not

  15. Out-of-field doses from pediatric craniospinal irradiations using 3D-CRT, IMRT, helical tomotherapy and electron-based therapy.

    PubMed

    De Saint-Hubert, Marijke; Verellen, Dirk; Poels, Kenneth; Crijns, Wouter; Magliona, Federica; Depuydt, Tom; Vanhavere, Filip; Struelens, Lara

    2017-04-11

    Medulloblastoma treatment involves irradiation of the entire central nervous system, i.e craniospinal irradiation (CSI). This is associated with significant exposure of large volumes of healthy tissue with a growing concern regarding treatment associated side effects. The current study compares out-of-field organ doses in children receiving CSI with three-dimensional-conformal radiotherapy (3D-CRT), intensity modulated radiotherapy (IMRT), helical tomotherapy (HT) and an electron-based technique, including as well radiation doses resulting from imaging performed during treatment. An extensive phantom study is performed, using an anthropomorphic phantom corresponding to a 5-year old child, in which organ absorbed doses are measured using thermoluminescent detectors (TLDs). Additionally the study evaluates and explores tools for calculating out-of-field patient doses using the treatment planning system (TPS) and analytical models. In our study, 3D-CRT resulted in very high doses to a limited number of organs while it was able to spare organs such as the lungs and breast when compared to IMRT and HT. Both IMRT and HT spread the dose over more organs and were able to spare heart, thyroid, bladder, uterus and testes when compared to 3D-CRT. The electron-based technique considerably decreased the out-of-field doses in deep seated organs but cannot avoid nearby out-of-field organs such as lungs, ribs, adrenals, kidneys and uterus. Daily imaging dose is small compared to the treatment dose burden. TPS error for out-of-field doses was most pronounced for organs further away from the target nevertheless no systematic underestimation was observed for any of the studied TPS systems. Finally analytical modeling was most optimal for 3D-CRT although the number of organs that can be modeled was limited. To conclude none of the techniques studied was able to spare doses in all organs. Nevertheless the electron-based technique showed most promising for out-of-field organ dose

  16. Out-of-field doses from pediatric craniospinal irradiations using 3D-CRT, IMRT, helical tomotherapy and electron-based therapy

    NASA Astrophysics Data System (ADS)

    De Saint-Hubert, Marijke; Verellen, Dirk; Poels, Kenneth; Crijns, Wouter; Magliona, Federica; Depuydt, Tom; Vanhavere, Filip; Struelens, Lara

    2017-07-01

    Medulloblastoma treatment involves irradiation of the entire central nervous system, i.e. craniospinal irradiation (CSI). This is associated with the significant exposure of large volumes of healthy tissue and there is growing concern regarding treatment-associated side effects. The current study compares out-of-field organ doses in children receiving CSI through 3D-conformal radiotherapy (3D-CRT), intensity modulated radiotherapy (IMRT), helical tomotherapy (HT) and an electron-based technique, and includes radiation doses resulting from imaging performed during treatment. An extensive phantom study is performed, using an anthropomorphic phantom corresponding to a five year old child, in which organ absorbed doses are measured using thermoluminescent detectors. Additionally, the study evaluates and explores tools for calculating out-of-field patient doses using the treatment planning system (TPS) and analytical models. In our study, 3D-CRT resulted in very high doses to a limited number of organs, while it was able to spare organs such as the lungs and breast when compared to IMRT and HT. Both IMRT and HT spread the dose over more organs and were able to spare the heart, thyroid, bladder, uterus and testes when compared to 3D-CRT. The electron-based technique considerably decreased the out-of-field doses in deep-seated organs but could not avoid nearby out-of-field organs such as the lungs, ribs, adrenals, kidneys and uterus. The daily imaging dose is small compared to the treatment dose burden. The TPS error for out-of-field doses was most pronounced for organs further away from the target; nevertheless, no systematic underestimation was observed for any of the studied TPS systems. Finally, analytical modeling was most optimal for 3D-CRT although the number of organs that could be modeled was limited. To conclude, none of the techniques studied was capable of sparing all organs from out-of-field doses. Nevertheless, the electron-based technique showed the most

  17. Experimental Validation of Monte Carlo Simulations Based on a Virtual Source Model for TomoTherapy in a RANDO Phantom.

    PubMed

    Yuan, Jiankui; Zheng, Yiran; Wessels, Barry; Lo, Simon S; Ellis, Rodney; Machtay, Mitchell; Yao, Min

    2016-12-01

    A virtual source model for Monte Carlo simulations of helical TomoTherapy has been developed previously by the authors. The purpose of this work is to perform experiments in an anthropomorphic (RANDO) phantom with the same order of complexity as in clinical treatments to validate the virtual source model to be used for quality assurance secondary check on TomoTherapy patient planning dose. Helical TomoTherapy involves complex delivery pattern with irregular beam apertures and couch movement during irradiation. Monte Carlo simulation, as the most accurate dose algorithm, is desirable in radiation dosimetry. Current Monte Carlo simulations for helical TomoTherapy adopt the full Monte Carlo model, which includes detailed modeling of individual machine component, and thus, large phase space files are required at different scoring planes. As an alternative approach, we developed a virtual source model without using the large phase space files for the patient dose calculations previously. In this work, we apply the simulation system to recompute the patient doses, which were generated by the treatment planning system in an anthropomorphic phantom to mimic the real patient treatments. We performed thermoluminescence dosimeter point dose and film measurements to compare with Monte Carlo results. Thermoluminescence dosimeter measurements show that the relative difference in both Monte Carlo and treatment planning system is within 3%, with the largest difference less than 5% for both the test plans. The film measurements demonstrated 85.7% and 98.4% passing rate using the 3 mm/3% acceptance criterion for the head and neck and lung cases, respectively. Over 95% passing rate is achieved if 4 mm/4% criterion is applied. For the dose-volume histograms, very good agreement is obtained between the Monte Carlo and treatment planning system method for both cases. The experimental results demonstrate that the virtual source model Monte Carlo system can be a viable option for the

  18. Fast, low-dose patient localization on TomoTherapy via topogram registration.

    PubMed

    Moore, Kevin L; Palaniswaamy, Geethpriya; White, Benjamin; Goddu, S Murty; Low, Daniel A

    2010-08-01

    To investigate a protocol which efficiently localizes TomoTherapy patients with a scout imaging (topogram) mode that can be used with or instead of 3D megavoltage computed tomography (MVCT) imaging. The process presented here is twofold: (a) The acquisition of the topogram using the TomoTherapy MV imaging system and (b) the generation of a digitally reconstructed topogram (DRT) derived from a standard kV CT simulation data set. The unique geometric characteristics of the current TomoTherapy imaging system were explored both theoretically and by acquiring topograms of anthropomorphic phantoms and comparing these images to DRT images. The performance of the MV topogram imaging system in terms of image quality, dose incurred to the patient, and acquisition time was investigated using ionization chamber and radiographic film measurements. The time required to acquire a clinically usable topogram, limited by the maximum couch speed of 4.0 cm s(-1), was 12.5 s for a 50 cm long field. The patient dose was less than 1% of that delivered by a helical MVCT scan. Further refinements within the current TomoTherapy system, most notably decreasing the imaging beam repetition rate during MV topogram acquisition, would further reduce the topogram dose to less than 25 microGy per scan without compromising image quality. Topogram localization on TomoTherapy is a fast and low-dose alternative to 3D MVCT localization. A protocol designed that exclusively utilized MV topograms would result in a 30-fold reduction in imaging time and a 100-fold reduction in dose from localization scans using the current TomoTherapy workflow.

  19. Note: A helical velocity selector for continuous molecular beams

    NASA Astrophysics Data System (ADS)

    Szewc, Carola; Collier, James D.; Ulbricht, Hendrik

    2010-10-01

    We report on a modern realization of the classic helical velocity selector for gas phase particle beams. The device operates stably under high vacuum conditions at rotational frequencies limited only by commercial dc motor capabilities. Tuning the rotational frequency allows selective scanning over a broad velocity band. The width of the selected velocity distributions at full-width-half-maximum is as narrow as a few percent of the selected mean velocity and independent of the rotational speed of the selector. The selector generates low vibrational noise amplitudes comparable to mechanically damped state-of-the-art turbo-molecular pumps and is therefore compatible with vibration sensitive experiments like molecule interferometry.

  20. Note: A helical velocity selector for continuous molecular beams.

    PubMed

    Szewc, Carola; Collier, James D; Ulbricht, Hendrik

    2010-10-01

    We report on a modern realization of the classic helical velocity selector for gas phase particle beams. The device operates stably under high vacuum conditions at rotational frequencies limited only by commercial dc motor capabilities. Tuning the rotational frequency allows selective scanning over a broad velocity band. The width of the selected velocity distributions at full-width-half-maximum is as narrow as a few percent of the selected mean velocity and independent of the rotational speed of the selector. The selector generates low vibrational noise amplitudes comparable to mechanically damped state-of-the-art turbo-molecular pumps and is therefore compatible with vibration sensitive experiments like molecule interferometry.

  1. Note: A helical velocity selector for continuous molecular beams

    SciTech Connect

    Szewc, Carola; Collier, James D.; Ulbricht, Hendrik

    2010-10-15

    We report on a modern realization of the classic helical velocity selector for gas phase particle beams. The device operates stably under high vacuum conditions at rotational frequencies limited only by commercial dc motor capabilities. Tuning the rotational frequency allows selective scanning over a broad velocity band. The width of the selected velocity distributions at full-width-half-maximum is as narrow as a few percent of the selected mean velocity and independent of the rotational speed of the selector. The selector generates low vibrational noise amplitudes comparable to mechanically damped state-of-the-art turbo-molecular pumps and is therefore compatible with vibration sensitive experiments like molecule interferometry.

  2. The frequency split method for helical cone-beam reconstruction.

    PubMed

    Shechter, G; Köhler, Th; Altman, A; Proksa, R

    2004-08-01

    A new approximate method for the utilization of redundant data in helical cone-beam CT is presented. It is based on the observation that the original WEDGE method provides excellent image quality if only little more than 180 degrees data are used for back-projection, and that significant low-frequency artifacts appear if a larger amount of redundant data are used. This degradation is compensated by the frequency split method: The low-frequency part of the image is reconstructed using little more than 180 degrees of data, while the high frequency part is reconstructed using all data. The resulting algorithm shows no cone-beam artifacts in a simulation of a 64-row scanner. It is further shown that the frequency split method hardly degrades the signal-to-noise ratio of the reconstructed images and that it behaves robustly in the presence of motion.

  3. Studies of a gas-filled helical muon beam cooling channel

    SciTech Connect

    Yonehara, K.; Derbenev, Y.; Johnson, R.P.; Roberts, T.J.; /MUONS Inc., Batavia

    2006-06-01

    A helical cooling channel (HCC) can quickly reduce the six dimensional phase space of muon beams for muon colliders, neutrino factories, and intense muon sources. The HCC is composed of solenoidal, helical dipole, and helical quadrupole magnetic fields to provide the focusing and dispersion needed for emittance exchange as the beam follows an equilibrium helical orbit through a continuous homogeneous absorber. The beam dynamics of a gas-filled helical muon beam cooling channel is studied by using Monte Carlo simulations. The results verify the cooling theory [1] of the helical magnet. The cooling performance has been improved by correcting chromatic aberration and the non-linear effects caused by the ionization energy loss process. With these improvements, a simulated cooling channel of 160 meters length has achieved a reduction of 6-dimensional (6D) phase space by a factor of 50,000.

  4. Helical Tomotherapy for Whole-Brain Irradiation With Integrated Boost to Multiple Brain Metastases: Evaluation of Dose Distribution Characteristics and Comparison With Alternative Techniques

    SciTech Connect

    Levegrün, Sabine; Pöttgen, Christoph; Wittig, Andrea; Lübcke, Wolfgang; Abu Jawad, Jehad; Stuschke, Martin

    2013-07-15

    Purpose: To quantitatively evaluate dose distribution characteristics achieved with helical tomotherapy (HT) for whole-brain irradiation (WBRT) with integrated boost (IB) to multiple brain metastases in comparison with alternative techniques. Methods and Materials: Dose distributions for 23 patients with 81 metastases treated with WBRT (30 Gy/10 fractions) and IB (50 Gy) were analyzed. The median number of metastases per patient (N{sub mets}) was 3 (range, 2-8). Mean values of the composite planning target volume of all metastases per patient (PTV{sub mets}) and of the individual metastasis planning target volume (PTV{sub ind} {sub met}) were 8.7 ± 8.9 cm{sup 3} (range, 1.3-35.5 cm{sup 3}) and 2.5 ± 4.5 cm{sup 3} (range, 0.19-24.7 cm{sup 3}), respectively. Dose distributions in PTV{sub mets} and PTV{sub ind} {sub met} were evaluated with respect to dose conformity (conformation number [CN], RTOG conformity index [PITV]), target coverage (TC), and homogeneity (homogeneity index [HI], ratio of maximum dose to prescription dose [MDPD]). The dependence of dose conformity on target size and N{sub mets} was investigated. The dose distribution characteristics were benchmarked against alternative irradiation techniques identified in a systematic literature review. Results: Mean ± standard deviation of dose distribution characteristics derived for PTV{sub mets} amounted to CN = 0.790 ± 0.101, PITV = 1.161 ± 0.154, TC = 0.95 ± 0.01, HI = 0.142 ± 0.022, and MDPD = 1.147 ± 0.029, respectively, demonstrating high dose conformity with acceptable homogeneity. Corresponding numbers for PTV{sub ind} {sub met} were CN = 0.708 ± 0.128, PITV = 1.174 ± 0.237, TC = 0.90 ± 0.10, HI = 0.140 ± 0.027, and MDPD = 1.129 ± 0.030, respectively. The target size had a statistically significant influence on dose conformity to PTV{sub mets} (CN = 0.737 for PTV{sub mets} ≤4.32 cm{sup 3} vs CN = 0.848 for PTV{sub mets} >4.32 cm{sup 3}, P=.006), in contrast to N{sub mets}. The achieved

  5. Resonant excitation of whistler waves by a helical electron beam

    NASA Astrophysics Data System (ADS)

    An, X.; Van Compernolle, B.; Bortnik, J.; Thorne, R. M.; Chen, L.; Li, W.

    2016-03-01

    Chorus-like whistler mode waves that are known to play a fundamental role in driving radiation belt dynamics are excited on the Large Plasma Device by the injection of a helical electron beam into a cold plasma. The mode structure of the excited whistler wave is identified using a phase correlation technique showing that the waves are excited through a combination of Landau resonance, cyclotron resonance, and anomalous cyclotron resonance. The dominant wave mode excited through cyclotron resonance is quasi-parallel propagating, whereas wave modes excited through Landau resonance and anomalous cyclotron resonance propagate at oblique angles that are close to the resonance cone. An analysis of the linear wave growth rates captures the major observations in the experiment. The results have important implications for the generation process of whistler waves in the Earth's inner magnetosphere.

  6. Gaussian laser beam transformation into an optical vortex beam by helical lens

    NASA Astrophysics Data System (ADS)

    Janicijevic, Ljiljana; Topuzoski, Suzana

    2016-01-01

    In this article, we investigate the Fresnel diffraction characteristics of the hybrid optical element which is a combination of a spiral phase plate (SPP) with topological charge p and a thin lens with focal length f, named the helical lens (HL). As incident a Gaussian laser beam is treated, having its waist a distance ζ from the HL plane and its axis passing through the centre of the HL. It is shown that the SPP introduces a phase singularity of pth order to the incident beam, while the lens transforms the beam characteristic parameters. The output light beam is analyzed in detail: its characteristic parameters and focusing properties, amplitude and intensity distributions and the vortex rings profiles, and radii, at any z distance behind the HL plane, as well as in the near and far field.

  7. Application of Monte Carlo methods in tomotherapy and radiation biophysics

    NASA Astrophysics Data System (ADS)

    Hsiao, Ya-Yun

    Helical tomotherapy is an attractive treatment for cancer therapy because highly conformal dose distributions can be achieved while the on-board megavoltage CT provides simultaneous images for accurate patient positioning. The convolution/superposition (C/S) dose calculation methods typically used for Tomotherapy treatment planning may overestimate skin (superficial) doses by 3-13%. Although more accurate than C/S methods, Monte Carlo (MC) simulations are too slow for routine clinical treatment planning. However, the computational requirements of MC can be reduced by developing a source model for the parts of the accelerator that do not change from patient to patient. This source model then becomes the starting point for additional simulations of the penetration of radiation through patient. In the first section of this dissertation, a source model for a helical tomotherapy is constructed by condensing information from MC simulations into series of analytical formulas. The MC calculated percentage depth dose and beam profiles computed using the source model agree within 2% of measurements for a wide range of field sizes, which suggests that the proposed source model provides an adequate representation of the tomotherapy head for dose calculations. Monte Carlo methods are a versatile technique for simulating many physical, chemical and biological processes. In the second major of this thesis, a new methodology is developed to simulate of the induction of DNA damage by low-energy photons. First, the PENELOPE Monte Carlo radiation transport code is used to estimate the spectrum of initial electrons produced by photons. The initial spectrum of electrons are then combined with DNA damage yields for monoenergetic electrons from the fast Monte Carlo damage simulation (MCDS) developed earlier by Semenenko and Stewart (Purdue University). Single- and double-strand break yields predicted by the proposed methodology are in good agreement (1%) with the results of published

  8. Magnetic resonance imaging for adaptive cobalt tomotherapy: A proposal.

    PubMed

    Kron, Tomas; Eyles, David; John, Schreiner L; Battista, Jerry

    2006-10-01

    Magnetic resonance imaging (MRI) provides excellent soft tissue contrast for oncology applications. We propose to combine a MRI scanner with a helical tomotherapy (HT) system to enable daily target imaging for improved conformal radiation dose delivery to a patient. HT uses an intensity-modulated fan-beam that revolves around a patient, while the patient slowly advances through the plane of rotation, yielding a helical beam trajectory. Since the use of a linear accelerator to produce radiation may be incompatible with the pulsed radiofrequency and the high and pulsed magnetic fields required for MRI, it is proposed that a radioactive Cobalt-60 ((60)Co) source be used instead to provide the radiation. An open low field (0.25 T) MRI system is proposed where the tomotherapy ring gantry is located between two sets of Helmholtz coils that can generate a sufficiently homogenous main magnetic field.It is shown that the two major challenges with the design, namely acceptable radiation dose rate (and therefore treatment duration) and moving parts in strong magnetic field, can be addressed. The high dose rate desired for helical tomotherapy delivery can be achieved using two radiation sources of 220TBq (6000Ci) each on a ring gantry with a source to axis-of-rotation distance of 75 cm. In addition to this, a dual row multi-leaf collimator (MLC) system with 15 mm leaf width at isocentre and relatively large fan beam widths between 15 and 30 mm per row shall be employed. In this configuration, the unit would be well-suited for most pelvic radiotherapy applications where the soft tissue contrast of MRI will be particularly beneficial. Non-magnetic MRI compatible materials must be used for the rotating gantry. Tungsten, which is non-magnetic, can be used for primary collimation of the fan-beam as well as for the MLC, which allows intensity modulated radiation delivery. We propose to employ a low magnetic Cobalt compound, sycoporite (CoS) for the Cobalt source material itself

  9. SU-E-T-197: Helical Cranial-Spinal Treatments with a Linear Accelerator

    SciTech Connect

    Anderson, J; Bernard, D; Liao, Y; Templeton, A; Turian, J; Chu, J

    2014-06-01

    Purpose: Craniospinal irradiation (CSI) of systemic disease requires a high level of beam intensity modulation to reduce dose to bone marrow and other critical structures. Current helical delivery machines can take 30 minutes or more of beam-on time to complete these treatments. This pilot study aims to test the feasibility of performing helical treatments with a conventional linear accelerator using longitudinal couch travel during multiple gantry revolutions. Methods: The VMAT optimization package of the Eclipse 10.0 treatment planning system was used to optimize pseudo-helical CSI plans of 5 clinical patient scans. Each gantry revolution was divided into three 120° arcs with each isocenter shifted longitudinally. Treatments requiring more than the maximum 10 arcs used multiple plans with each plan after the first being optimized including the dose of the others (Figure 1). The beam pitch was varied between 0.2 and 0.9 (couch speed 5- 20cm/revolution and field width of 22cm) and dose-volume histograms of critical organs were compared to tomotherapy plans. Results: Viable pseudo-helical plans were achieved using Eclipse. Decreasing the pitch from 0.9 to 0.2 lowered the maximum lens dose by 40%, the mean bone marrow dose by 2.1% and the maximum esophagus dose by 17.5%. (Figure 2). Linac-based helical plans showed dose results comparable to tomotherapy delivery for both target coverage and critical organ sparing, with the D50 of bone marrow and esophagus respectively 12% and 31% lower in the helical linear accelerator plan (Figure 3). Total mean beam-on time for the linear accelerator plan was 8.3 minutes, 54% faster than the tomotherapy average for the same plans. Conclusions: This pilot study has demonstrated the feasibility of planning pseudo-helical treatments for CSI targets using a conventional linac and dynamic couch movement, and supports the ongoing development of true helical optimization and delivery.

  10. Orbital angular momentum of helical necklace beams in colloid-based nonlinear optical metamaterials (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Walasik, Wiktor T.; Silahli, Salih Z.; Litchinitser, Natalia M.

    2016-09-01

    Colloidal metamaterials are a robust and flexible platform for engineering of optical nonlinearities and studies of light filamentation. To date, nonlinear propagation and modulation instability of Gaussian beams and optical vortices carrying orbital angular momentum were studied in such media. Here, we investigate the propagation of necklace beams and the conservation of the orbital angular momentum in colloidal media with saturable nonlinearity. We study various scenarios leading to generation of helical necklace beams or twisted beams, depending on the radius, power, and charge of the input vortex beam. Helical beams are build of two separate solitary beams with circular cross-sections that spiral around their center of mass as a result of the equilibrium between the attraction force of in-phase solitons and the centrifugal force associated with the rotational movement. A twisted beam is a single beam with an elliptical cross-section that rotates around it's own axis. We show that the orbital angular momentum is converted into the rotational motion at different rates for helical and twisted beams. While earlier studies reported that solitary beams are expelled form the initial vortex ring along straight trajectories tangent to the vortex ring, we show that depending on the charge and the power of the initial beam, these trajectories can diverge from the tangential direction and may be curvilinear. These results provide a detailed description of necklace beam dynamics in saturable nonlinear media and may be useful in studies of light filamentation in liquids and light propagation in highly scattering colloids and biological samples.

  11. Superposition and detection of two helical beams for optical orbital angular momentum communication

    NASA Astrophysics Data System (ADS)

    Liu, Yi-Dong; Gao, Chunqing; Gao, Mingwei; Qi, Xiaoqing; Weber, Horst

    2008-07-01

    A loop-like system with a Dove prism is used to generate a collinear superposition of two helical beams with different azimuthal quantum numbers in this manuscript. After the generation of the helical beams distributed on the circle centered at the optical axis by using a binary amplitude grating, the diffractive field is separated into two polarized ones with the same distribution. Rotated by the Dove prism in the loop-like system in counter directions and combined together, the two fields will generate the collinear superposition of two helical beams in certain direction. The experiment shows consistency with the theoretical analysis. This method has potential applications in optical communication by using orbital angular momentum of laser beams (optical vortices).

  12. Investigations of electron helicity in optically active molecules using polarized beams of electrons and positrons

    NASA Technical Reports Server (NTRS)

    Gidley, D. W.; Rich, A.; Van House, J. C.; Zitzewitz, P. W.

    1981-01-01

    A positronium-formation experiment with a high sensitivity to a possible relation between the helicity of beta particles emitted in nuclear beta decay and the optical asymmetry of biological molecules is presented. The experiment is based on a mechanism in which the electrons in optically active molecules possess a helicity of less than 0.001, too weak to detect in radiolysis experiments, the sign of which depends on the chirality of the isomer. A helicity-dependent asymmetry is sought in the formation of the triplet ground state of positronium when a low-energy beam of polarized positrons of reversible helicity interacts with an optically active substance coating a channel electron multiplier. Asymmetries between positronium decays observed at positive and negative helicities for the same substance can thus be determined with a sensitivity of 0.0001, which represents a factor of 100 improvement over previous positronium experiments.

  13. Single-slice reconstruction method for helical cone-beam differential phase-contrast CT.

    PubMed

    Fu, Jian; Chen, Liyuan

    2014-01-01

    X-ray phase-contrast computed tomography (PC-CT) can provide the internal structure information of biomedical specimens with high-quality cross-section images and has become an invaluable analysis tool. Here a simple and fast reconstruction algorithm is reported for helical cone-beam differential PC-CT (DPC-CT), which is called the DPC-CB-SSRB algorithm. It combines the existing CB-SSRB method of helical cone-beam absorption-contrast CT with the differential nature of DPC imaging. The reconstruction can be performed using 2D fan-beam filtered back projection algorithm with the Hilbert imaginary filter. The quality of the results for large helical pitches is surprisingly good. In particular, with this algorithm comparable quality is obtained using helical cone-beam DPC-CT data with a normalized pitch of 10 to that obtained using the traditional inter-row interpolation reconstruction with a normalized pitch of 2. This method will push the future medical helical cone-beam DPC-CT imaging applications.

  14. Fraunhofer diffraction of Laguerre-Gaussian laser beam by helical axicon

    NASA Astrophysics Data System (ADS)

    Topuzoski, S.

    2014-11-01

    In this article we present a theoretical study for Fraunhofer diffraction of a Laguerre-Gaussian laser beam with “0” radial mode number and “l” azimuthal mode number (LG0l) by helical axicon. Analytical expressions describing the diffracted wave field amplitude and intensity distributions in the back focal plane of a convergent lens are derived in a form of product of a Gauss-doughnut function and a sum of hypergeometric Kummer functions. Also, the diffracted LG beam by axicon only, as well as by spiral phase plate only, and the diffracted Gaussian beam by helical axicon, are described mathematically in the back focal plane of a convergent lens. Different possibilities for obtaining output vortex beam with reduced or increased topological charge compared to that of the incident beam, or for obtaining chargeless beam are analyzed.

  15. A Comprehensive Assessment by Tumor Site of Patient Setup Using Daily MVCT Imaging From More Than 3,800 Helical Tomotherapy Treatments

    SciTech Connect

    Schubert, Leah K. Westerly, David C.; Tome, Wolfgang A.; Mehta, Minesh P.; Soisson, Emilie T.; Mackie, Thomas R.; Ritter, Mark A.; Khuntia, Deepak; Harari, Paul M.; Paliwal, Bhudatt R.

    2009-03-15

    Purpose: To assess patient setup corrections based on daily megavoltage CT (MVCT) imaging for four anatomic treatment sites treated on tomotherapy. Method and Materials: Translational and rotational setup corrections, based on registration of daily MVCT to planning CT images, were analyzed for 1,179 brain and head and neck (H and N), 1,414 lung, and 1,274 prostate treatment fractions. Frequencies of three-dimensional vector lengths, overall distributions of setup corrections, and patient-specific distributions of random and systematic setup errors were analyzed. Results: Brain and H and N had lower magnitude positioning corrections and smaller variations in translational setup errors but were comparable in roll rotations. Three-dimensional vector translational shifts of larger magnitudes occurred more frequently for lung and prostate than for brain and H and N treatments, yet this was not observed for roll rotations. The global systematic error for prostate was 4.7 mm in the vertical direction, most likely due to couch sag caused by large couch extension distances. Variations in systematic errors and magnitudes of random translational errors ranged from 1.6 to 2.6 mm for brain and H and N and 3.2 to 7.2 mm for lung and prostate, whereas roll rotational errors ranged from 0.8{sup o} to 1.2{sup o} for brain and H and N and 0.5{sup o} to 1.0{sup o} for lung and prostate. Conclusions: Differences in setup were observed between brain, H and N, lung, and prostate treatments. Patient setup can be improved if daily imaging is performed. This analysis can assess the utilization of daily image guidance and allows for further investigation into improved anatomic site-specific and patient-specific treatments.

  16. Formation and nonlinear dynamics of the squeezed state of a helical electron beam with additional deceleration

    SciTech Connect

    Egorov, E. N. Koronovskii, A. A.; Kurkin, S. A.; Hramov, A. E.

    2013-11-15

    Results of numerical simulations and analysis of the formation and nonlinear dynamics of the squeezed state of a helical electron beam in a vircator with a magnetron injection gun as an electron source and with additional electron deceleration are presented. The ranges of control parameters where the squeezed state can form in such a system are revealed, and specific features of the system dynamics are analyzed. It is shown that the formation of a squeezed state of a nonrelativistic helical electron beam in a system with electron deceleration is accompanied by low-frequency longitudinal dynamics of the space charge.

  17. Accuracy of TomoTherapy treatments for superficial target volumes.

    PubMed

    Cheek, Dennis; Gibbons, John P; Rosen, Isaac I; Hogstrom, Kenneth R

    2008-08-01

    Helical tomotherapy is a technique for delivering intensity modulated radiation therapy treatments using a continuously rotating linac. In this approach, fan beams exiting the linac are dynamically modulated in synchrony with the motion of the gantry and couch. Helical IMRT deliveries have been applied to treating surface lesions, and the purpose of this study was to evaluate the accuracy of dose calculated by the TomoTherapy HiArt treatment planning system for superficial planning target volumes (PTVs). TomoTherapy treatment plans were developed for three superficial PTVs (2-, 4-, and 6-cm deep radially by 90 degrees azimuthally by 4-cm longitudinally) contoured on a 27-cm diameter cylindrical white opaque, high-impact polystyrene phantom. The phantom included removable transverse and sagittal film cassettes that contained bare Kodak EDR2 films cut such that their edges matched the phantom surface (+/-0.05 cm). The phantom was aligned to the machine's isocenter (+/-0.05 cm) and was irradiated according to the treatment plans. Films were scanned with a Vidar film digitizer, and optical densities were converted to dose using a calibration determined from a 6 MV perpendicular film exposure. This perpendicular calibration required that axial film doses (parallel irradiation) be scaled by 1.02 so that mid-arc depth doses matched those measured in the sagittal plane (perpendicular irradiation). All film readings were scaled by 0.935 to correct for over-response due to phantom Cerenkov light. Measured dose distributions were registered to calculated ones and compared. Calculated doses overpredicted measured doses by as much as 9.5% of the prescribed dose at depths less than 1 cm. At depths greater than 1 cm, calculated dose distributions showed agreement to measurement within 5% in the high-dose region and within 0.2 cm distance-to-agreement in the dose falloff regions. In the low-dose region posterior to the PTVs (<10% of the prescribed dose), the dose algorithm

  18. Encouraging Early Clinical Outcomes With Helical Tomotherapy-Based Image-Guided Intensity-Modulated Radiation Therapy for Residual, Recurrent, and/or Progressive Benign/Low-Grade Intracranial Tumors: A Comprehensive Evaluation

    SciTech Connect

    Gupta, Tejpal

    2012-02-01

    Purpose: To report early clinical outcomes of helical tomotherapy (HT)-based image-guided intensity-modulated radiation therapy (IMRT) in brain tumors of varying shape, size, and location. Materials and Methods: Patients with residual, recurrent, and/or progressive low-grade intracranial and skull-base tumors were treated on a prospective protocol of HT-based IMRT and followed clinicoradiologically. Standardized metrics were used for plan evaluation and outcome analysis. Results: Twenty-seven patients with 30 lesions were treated to a median radiotherapy dose of 54 Gy in 30 fractions. All HT plans resulted in excellent target volume coverage with steep dose-gradients. The mean (standard deviation) dose homogeneity index and conformity index was 0.07 (0.05) and 0.71 (0.08) respectively. At first response assessment, 20 of 30 lesions were stable, whereas 9 showed partial regression. One patient with a recurrent clival chordoma though neurologically stable showed imaging-defined progression, whereas another patient with stable disease on serial imaging had sustained neurologic worsening. With a median follow-up of 19 months (interquartile range, 11-26 months), the 2-year clinicoradiological progression-free survival and overall survival was 93.3% and 100% respectively. Conclusions: Careful selection of radiotherapy technique is warranted for benign/low-grade brain tumors to achieve durable local control with minimum long-term morbidity. Large or complex-shaped tumors benefit most from IMRT. Our early clinical experience of HT-based IMRT for brain tumors has been encouraging.

  19. 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

    SciTech Connect

    Widesott, Lamberto; Pierelli, Alessio; Fiorino, Claudio; Lomax, Antony J.; Amichetti, Maurizio; Cozzarini, Cesare; Soukup, Martin; Schneider, Ralf; Hug, Eugen; Di Muzio, Nadia; Calandrino, Riccardo; Schwarz, Marco

    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). Normal 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.

  20. Iterative image reconstruction for limited-angle inverse helical cone-beam computed tomography.

    PubMed

    Yu, Wei; Zeng, Li

    2016-01-01

    Helical trajectory satisfying the condition of exact reconstruction, has been widely utilized in the commercial computed tomography (CT). While limited by the scanning environment in some practical applications, the conventional helical cone-beam CT imaging is hard to complete, thus, developing an imaging system suited for long-object may be valuable. Three-dimensional C-arm CT is an innovative imaging technique which has been greatly concerned. Since there is a high degree of freedom of C-arm, more flexible image acquisition trajectories for 3D imaging can be achieved. In this work, a fast iterative reconstruction algorithm based on total variation minimization is developed for a trajectory of limited-angle inverse helical cone-beam CT, which can be applied to detect long-object without slip-ring technology. The experimental results show that the developed algorithm can yield reconstructed images of low noise level and high image quality.

  1. Investigation of Fully Three-Dimensional Helical RF Field Effects on TWT Beam/Circuit Interaction

    NASA Technical Reports Server (NTRS)

    Kory, Carol L.

    2000-01-01

    A fully three-dimensional (3D), time-dependent, helical traveling wave-tube (TWT) interaction model has been developed using the electromagnetic particle-in-cell (PIC) code MAFIA. The model includes a short section of helical slow-wave circuit with excitation fed by RF input/output couplers, and electron beam contained by periodic permanent magnet (PPM) focusing. All components of the model are simulated in three dimensions allowing the effects of the fully 3D helical fields on RF circuit/beam interaction to be investigated for the first time. The development of the interaction model is presented, and predicted TWT performance using 2.5D and 3D models is compared to investigate the effect of conventional approximations used in TWT analyses.

  2. Tomotherapy and stereotactic radiosurgery

    NASA Astrophysics Data System (ADS)

    Soisson, Emilie T.

    Currently, at the University of Wisconsin-Madison, a linear accelerator equipped with circular collimators and a floor stand is used for stereotactic radiosurgery (SRS) delivery. In the interest of providing a more efficient delivery option for patients with multiple brain metastases, a Tomotherapy-based radiosurgery program was developed to serve as an intensity modulated compliment to our existing delivery method. The unique advantage of Tomotherapy over other radiotherapy delivery units is the on board megavoltage CT that can be used for both stereotactic localization and treatment planning. As such, a workflow was designed in which the planning image is acquired on the treatment unit itself and, instead using a patient-frame based coordinate system for stereotactic localization, volumetric imaging is used to precisely locate the target at the time of treatment. Localization and delivery accuracy was found to be comparable to conventional approaches and well within stated tolerances. A Tomotherapy-specific treatment planning technique was also developed using the Tomotherapy treatment planning system that reliably produces plans that achieve both conformal target coverage and sufficiently steep dose falloff into surrounding normal brain. Tomotherapy plans have been compared to conventional circular collimator based plans for both the treatment of brain metastases and arteriovenous malformations in terms of both target conformity and dose to normal brain. To determine the effect of plan differences on patient outcome, clinical data was used to predict the resulting risk of treatment induced symptomatic brain necrosis for both conventional and Tomotherapy based plans. Overall, it was determined that plans generated using the described planning technique are acceptable for radiosurgery. In addition, delivery time for complex cases is comparable to or improved over conventional isocentric approaches. Finally, this work explores the impact of future product

  3. Quantum-Path Signatures in Attosecond Helical Beams Driven by Optical Vortices

    SciTech Connect

    Hernandez-Garcıa, C; San Roman, J; Plaja, L; Picon, A.

    2015-09-17

    High-order harmonic generation (HHG) driven by beams carrying orbital angular momentum (OAM) has been recently demonstrated as a unique process to generate spatio-temporal coherent XUV/x-ray radiation with attosecond helical structure. We explore the details of the mapping of the driving vortex to its harmonic spectrum. In particular we show that the geometry of the harmonic vortices is complex, arising from the superposition of the contribution from the short and long quantum paths responsible of HHG. Transversal phase matching and quantum path interferences provide an explanation of the dramatic changes in the XUV vortex structure generated at different relative positions of the target respect to the laser beam focus. Finally, we show how to take advantage of transversal phase matching to select helical attosecond beams generated from short or long quantum paths, exhibiting positive or negative temporal chirp respectively.

  4. Dosimetric and radiobiological comparison of helical tomotherapy, forward-planned intensity-modulated radiotherapy and two-phase conformal plans for radical radiotherapy treatment of head and neck squamous cell carcinomas.

    PubMed

    Chatterjee, S; Willis, N; Locks, S M; Mott, J H; Kelly, C G

    2011-12-01

    The usual radical radiotherapy treatment prescribed for head and neck squamous cell carcinoma (HNSCC) is 70 Gy (in 2 Gy per fraction equivalent) administered to the high-risk target volume (TV). This can be planned using either a forward-planned photon-electron junction technique (2P) or a single-phase (1P) forward-planned technique developed in-house. Alternatively, intensity-modulated radiotherapy (IMRT) techniques, including helical tomotherapy (HT), allow image-guided inversely planned treatments. This study was designed to compare these three planning techniques with regards to TV coverage and the dose received by organs at risk. We compared the dose-volume histograms and conformity indices (CI) of the three planning processes in five patients with HNSCC. The tumour control probability (TCP), normal tissue complication probability (NTCP) and uncomplicated tumour control probability (UCP) were calculated for each of the 15 plans. In addition, we explored the radiobiological rationality of a dose-escalation strategy. The CI for the high-risk clinical TV (CTV1) in the 5 patients were 0.78, 0.76, 0.82, 0.72 and 0.81 when HT was used; 0.58, 0.56, 0.47, 0.35 and 0.60 for the single-phase forward-planned technique and 0.46, 0.36, 0.29, 0.22 and 0.49 for the two-phase technique. The TCP for CTV1 with HT were 79.2%, 85.2%, 81.1%, 83.0% and 53.0%; for single-phase forward-planned technique, 76.5%, 86.9%, 73.4%, 81.8% and 31.8% and for the two-phase technique, 38.2%, 86.2%, 42.7%, 0.0% and 3.4%. Dose escalation using HT confirmed the radiobiological advantage in terms of TCP. TCP for the single-phase plans was comparable to that of HT plans, whereas that for the two-phase technique was lower. Centres that cannot provide IMRT for the radical treatment of all patients could implement the single-phase technique as standard to attain comparable TCP. However, IMRT produced better UCP, thereby enabling the exploration of dose escalation.

  5. Which technique for radiation is most beneficial for patients with locally advanced cervical cancer? Intensity modulated proton therapy versus intensity modulated photon treatment, helical tomotherapy and volumetric arc therapy for primary radiation - an intraindividual comparison.

    PubMed

    Marnitz, Simone; Wlodarczyk, Waldemar; Neumann, Oliver; Koehler, Christhardt; Weihrauch, Mirko; Budach, Volker; Cozzi, Luca

    2015-04-17

    To compare highly sophisticated intensity-modulated radiotherapy (IMRT) delivered by either helical tomotherapy (HT), RapidArc (RA), IMRT with protons (IMPT) in patients with locally advanced cervical cancer. Twenty cervical cancer patients were irradiated using either conventional IMRT, VMAT or HT; ten received pelvic (PEL) and ten extended field irradiation (EFRT). The dose to the planning-target volume A (PTV_A: cervix, uterus, pelvic ± para-aortic lymph nodes) was 1.8/50.4 Gy. The SIB dose for the parametrium (PTV_B), was 2.12/59.36 Gy. MRI-guided brachytherapy was administered with 5 fractions up to 25 Gy. For EBRT, the lower target constraints were 95% of the prescribed dose in 95% of the target volume. The irradiated small bowel (SB) volumes were kept as low as possible. For every patient, target parameters as well as doses to the organs at risk (SB, bladder, rectum) were evaluated intra-individually for IMRT, HT, VMAT and IMPT. All techniques provided excellent target volume coverage, homogeneity, conformity. With IMPT, there was a significant reduction of the mean dose (Dmean) of the SB from 30.2 ± 4.0 Gy (IMRT); 27.6 ± 5.6 Gy (HT); 34.1 ± 7.0 (RA) to 18.6 ± 5.9 Gy (IMPT) for pelvic radiation and 26.3 ± 3.2 Gy (IMRT); 24.0 ± 4.1 (HT); 25.3 ± 3.7 (RA) to 13.8 ± 2.8 Gy (IMPT) for patients with EFRT, which corresponds to a reduction of 38-52% for the Dmean (SB). Futhermore, the low dose bath (V10Gy) to the small bowel was reduced by 50% with IMPT in comparison to all photon techniques. Furthermore, Dmean to the bladder and rectum was decresed by 7-9 Gy with IMPT in patents with pelvic radiation and EFRT. All modern techniques (were proved to be dosimetrically adequate regarding coverage, conformity and homogeneity of the target. Protons offered the best sparing of small bowel and rectum and therefore could contribute to a significant reduction of acute and late toxicity in cervical cancer treatment.

  6. Comparison of Effects Between Central and Peripheral Stage I Lung Cancer Using Image-Guided Stereotactic Body Radiotherapy via Helical Tomotherapy.

    PubMed

    He, Jian; Huang, Yan; Shi, Shiming; Hu, Yong; Zeng, Zhaochong

    2015-12-01

    Lung cancer is a common malignant tumor with high morbidity and mortality. Here we compared the effects and outcome between central and peripheral stage I lung cancer using image-guided stereotactic body radiotherapy. From June 2011 to July 2013, a total of 33 patients with stage I lung cancer were enrolled. A total of 50 Gy in 10 fractions or 60 Gy in 10 fractions was delivered in the central arm (n = 18), while 50 Gy in 5 fractions in the peripheral arm (n = 15). Statistical analyses were performed using logistic regression analysis and Kaplan-Meier method. The mean follow-up time was 38.1 months. Three-month, 1-, 2-, and 3-year overall response rates were 66.7%, 83.3%, 61.1%, and 72.2% and 66.7%, 80%, 80%, and 80% in the central and peripheral arms, respectively. Three-year local control rates (94.4% vs 93.3%, P = .854), regional control rates (94.4% vs 86.7%, P = .412), and distant control rates (64.2% vs 61.7%, P = .509) had no differences between the central and the peripheral arms. Grade 2 radiation pneumonitis was observed in 6 of 18 patients in the central arm and in 1 of 15 patients in the peripheral arm (P = .92). Grade 2 radiation esophagitis was 5.7% in the central arm, while none occurred in the peripheral arm (P = .008). Five (15.1%) of all patients felt slight fatigue during radiotherapy. Other major complications were not observed. In conclusion, helical image-guided stereotactic body radiotherapy for central stage I lung cancer is safe and effective compared to peripheral stage I lung cancer.

  7. WE-G-18A-06: Sinogram Restoration in Helical Cone-Beam CT

    SciTech Connect

    Little, K; Riviere, P La

    2014-06-15

    Purpose: To extend CT sinogram restoration, which has been shown in 2D to reduce noise and to correct for geometric effects and other degradations at a low computational cost, from 2D to a 3D helical cone-beam geometry. Methods: A method for calculating sinogram degradation coefficients for a helical cone-beam geometry was proposed. These values were used to perform penalized-likelihood sinogram restoration on simulated data that were generated from the FORBILD thorax phantom. Sinogram restorations were performed using both a quadratic penalty and the edge-preserving Huber penalty. After sinogram restoration, Fourier-based analytical methods were used to obtain reconstructions. Resolution-variance trade-offs were investigated for several locations within the reconstructions for the purpose of comparing sinogram restoration to no restoration. In order to compare potential differences, reconstructions were performed using different groups of neighbors in the penalty, two analytical reconstruction methods (Katsevich and single-slice rebinning), and differing helical pitches. Results: The resolution-variance properties of reconstructions restored using sinogram restoration with a Huber penalty outperformed those of reconstructions with no restoration. However, the use of a quadratic sinogram restoration penalty did not lead to an improvement over performing no restoration at the outer regions of the phantom. Application of the Huber penalty to neighbors both within a view and across views did not perform as well as only applying the penalty to neighbors within a view. General improvements in resolution-variance properties using sinogram restoration with the Huber penalty were not dependent on the reconstruction method used or the magnitude of the helical pitch. Conclusion: Sinogram restoration for noise and degradation effects for helical cone-beam CT is feasible and should be able to be applied to clinical data. When applied with the edge-preserving Huber penalty

  8. On the Helical Fields Guiding Near-Relativistic Electron Beams in the Heliosphere

    NASA Astrophysics Data System (ADS)

    Rust, David M.; Haggerty, D. K.; Georgoulis, M. K.; Stenborg, G.

    2009-05-01

    Wavelet processing of the LASCO images of the solar corona brings out many subtle details that are easily missed in the intensity images. Specifically, wavelet processing can enhance the edges on large and small scales making it easier to detect and define helical features. We used the processed LASCO images obtained during the period 1997 -2001 to study the structure and motions of nearly radial streamers extending from coronal holes adjacent to flaring active regions. Some of the streamers show outward-propagating twist. These helical fields extend into the heliosphere where they would reach 1 AU with a path length generally greater than the 1.2 AU of idealized fields following the Parker spiral. We focused on the regions from our earlier work (Rust et al., ApJ 687, 635, 2008) on flares associated with beams of near-relativistic electrons detected at 1 AU with the ACE spacecraft. Our study shows that the electron beam's typical delay of about 10 min in arriving at 1 AU may be due to their following a helical path from Sun to Earth. According to the reconnection jet model, the helical component may be introduced to open fields by earlier events involving reconnections with emerging, twisted flux ropes. Our study implies that the escaping electrons may be accelerated at the same time as the trapped electrons that produce X-ray flare emissions. NASA supported this work with grant NNG 05GM69G.

  9. Studies of a Gas-filled Helical Muon Beam Cooling Channel

    SciTech Connect

    R.P. Johnson; K. Paul; T.J. Roberts; Y.S. Derbenev; K. Yonehara

    2006-06-26

    A helical cooling channel (HCC) can quickly reduce the six dimensional phase space of muon beams for muon colliders, neutrino factories, and intense muon sources. The HCC is composed of solenoidal, helical dipole, and helical quadrupole magnetic fields to provide the focusing and dispersion needed for emittance exchange as the beam follows an equilibrium helical orbit through a continuous homogeneous absorber. We consider liquid helium and liquid hydrogen absorbers in HCC segments that alternate with RF accelerating sections and we also consider gaseous hydrogen absorber in pressurized RF cavities imbedded in HCC segments. In the case of liquid absorber, the possibility of using superconducting RF in low magnetic field regions between the HCC segments may provide a cost effective solution to the high repetition rate needed for an intense neutrino factory or high average luminosity muon collider. In the gaseous hydrogen absorber case, the pressurized RF cavities can be operated at low temperature to improve their efficiency for higher repetition rates. Numerical simulations are used to optimize and compare the liquid and gaseous HCC techniques.

  10. Beam-helicity asymmetries in double-charged-pion photoproduction on the proton.

    PubMed

    Strauch, S; Berman, B L; Adams, G; Ambrozewicz, P; Anghinolfi, M; Asavapibhop, B; Asryan, G; Audit, G; Avakian, H; Bagdasaryan, H; Baillie, N; Ball, J P; Baltzell, N A; Barrow, S; Batourine, V; Battaglieri, M; Beard, K; Bedlinskiy, I; Bektasoglu, M; Bellis, M; Benmouna, N; Bennhold, C; Biselli, A S; Boiarinov, S; Bouchigny, S; Bradford, R; Branford, D; Briscoe, W J; Brooks, W K; Bültmann, S; Burkert, V D; Butuceanu, C; Calarco, J R; Careccia, S L; Carman, D S; Carnahan, B; Chen, S; Cole, P L; Coleman, A; Coltharp, P; Cords, D; Corvisiero, P; Crabb, D; Crannell, H; Cummings, J P; Degtyarenko, P V; Denizli, H; Dennis, L; De Sanctis, E; Deur, A; Devita, R; Dharmawardane, K V; Dhuga, K S; Djalali, C; Dodge, G E; Donnelly, J; Doughty, D; Dragovitsch, P; Dugger, M; Dytman, S; Dzyubak, O P; Egiyan, H; Egiyan, K S; Elouadrhiri, L; Empl, A; Eugenio, P; Fatemi, R; Fedotov, G; Feldman, G; Feuerbach, R J; Fix, A; Forest, T A; Funsten, H; Gavalian, G; Gilfoyle, G P; Giovanetti, K L; Girod, F X; Goetz, J T; Gothe, R W; Griffioen, K A; Guidal, M; Guler, N; Guo, L; Gyurjyan, V; Hadjidakis, C; Hakobyan, R S; Hardie, J; Heddle, D; Hersman, F W; Hicks, K; Hleiqawi, I; Holtrop, M; Hu, J; Huertas, M; Hyde-Wright, C E; Ilieva, Y; Ireland, D G; Ishkhanov, B S; Ito, M M; Jenkins, D; Jo, H S; Joo, K; Juengst, H G; Kellie, J D; Khandaker, M; Kim, K Y; Kim, K; Kim, W; Klein, A; Klein, F J; Klimenko, A V; Klusman, M; Kossov, M; Kramer, L H; Kubarovsky, V; Kuhn, J; Kuhn, S E; Lachniet, J; Laget, J M; Langheinrich, J; Lawrence, D; Lee, T; Lima, A C S; Livingston, K; Lukashin, K; Manak, J J; Marchand, C; McAleer, S; McKinnon, B; McNabb, J W C; Mecking, B A; Mestayer, M D; Meyer, C A; Mibe, T; Mikhailov, K; Minehart, R; Mirazita, M; Miskimen, R; Mokeev, V; Morrow, S A; Muccifora, V; Mueller, J; Mutchler, G S; Nadel-Turonski, P; Napolitano, J; Nasseripour, R; Niccolai, S; Niculescu, G; Niculescu, I; Niczyporuk, B B; Niyazov, R A; Nozar, M; O'rielly, G V; Osipenko, M; Ostrovidov, A I; Park, K; Pasyuk, E; Paterson, C; Philips, S A; Pierce, J; Pivnyuk, N; Pocanic, D; Pogorelko, O; Polli, E; Pozdniakov, S; Preedom, B M; Price, J W; Prok, Y; Protopopescu, D; Qin, L M; Raue, B A; Riccardi, G; Ricco, G; Ripani, M; Ritchie, B G; Roberts, W; Ronchetti, F; Rosner, G; Rossi, P; Rowntree, D; Rubin, P D; Sabatié, F; Salgado, C; Santoro, J P; Sapunenko, V; Schumacher, R A; Serov, V S; Shafi, A; Sharabian, Y G; Shaw, J; Skabelin, A V; Smith, E S; Smith, L C; Sober, D I; Stavinsky, A; Stepanyan, S S; Stepanyan, S; Stokes, B E; Stoler, P; Strakovsky, I I; Suleiman, R; Taiuti, M; Taylor, S; Tedeschi, D J; Thoma, U; Thompson, R; Tkabladze, A; Tkachenko, S; Todor, L; Tur, C; Ungaro, M; Vineyard, M F; Vlassov, A V; Wang, K; Weinstein, L B; Weygand, D P; Williams, M; Wolin, E; Wood, M H; Yegneswaran, A; Yun, J; Zana, L; Zhang, J

    2005-10-14

    Beam-helicity asymmetries for the two-pion-photoproduction reaction gammap-->ppi(+)pi(-) have been studied for the first time in the resonance region for center-of-mass energies between 1.35 and 2.30 GeV. The experiment was performed at Jefferson Lab with the CEBAF Large Acceptance Spectrometer using circularly polarized tagged photons incident on an unpolarized hydrogen target. Beam-helicity-dependent angular distributions of the final-state particles were measured. The large cross-section asymmetries exhibit strong sensitivity to the kinematics and dynamics of the reaction. The data are compared with the results of various phenomenological model calculations, and show that these models currently do not provide an adequate description for the behavior of this new observable.

  11. Collective instabilities of the electron beam in magnetic fields of a helical undulator and solenoid

    NASA Astrophysics Data System (ADS)

    Artamonov, A. S.; Inozemtsev, N. I.

    1989-03-01

    The collective instabilities of a continuous electron beam propagating in the magnetic fields of a helical undulator and solenoid are analyzed theoretically in the framework of a one-dimensional model. Modulation of charge density is investigated along with modulation of the transverse velocity of the electrons by an electromagnetic wave. A dispersion equation describing the collective-excitation spectrum is obtained, and analyzed in the hydrodynamic approximation for two-, three-, and four-wave interaction.

  12. A synthetic diagnostic for beam emission spectroscopy in the helically symmetric experiment stellarator

    SciTech Connect

    Dobbins, T. J. Kumar, S. T. A.; Anderson, D. T.

    2016-11-15

    The Helically Symmetric Experiment (HSX) has a number of active spectroscopy diagnostics. Due to the relatively large beam width compared to the plasma minor radius, it is difficult to achieve good spatial resolution at the core of the HSX plasma. This is due to the fact that the optical sightline cuts through many flux surfaces with varying field vectors within the beam. In order to compare the experimental results with theoretical models it is important to accurately model the beam width effects. A synthetic diagnostic has been developed for this purpose. This synthetic diagnostic calculates the effect of spot size and beam width on the measurements of quantities of interest, including radial electric field, flow velocity, and Stark polarization.

  13. Determining helicity and topological structure of coherent vortex beam from laser speckle

    NASA Astrophysics Data System (ADS)

    R. V, Vinu; Singh, Rakesh Kumar

    2016-09-01

    We propose and experimentally demonstrate a technique to quantitatively determine the topological structure of the vortex beam coaxially launched into the random scattering media with another non-vortex beam of the orthogonal polarization component. The proposed technique applies the coherent superposition of the random electromagnetic fields and a priori knowledge of correlation of one of the random fields to determine the polarization correlation of the other. The polarization correlation of the random field is used to determine the topological charge and phase structure of the vortex beam from the laser speckle. The application of the proposed technique is demonstrated by determining the helicity and topological charge of the vortex beam for three different cases.

  14. Sampling conditions of 3D parallel and fan-beam x-ray CT with application to helical tomography

    NASA Astrophysics Data System (ADS)

    Desbat, Laurent; Roux, Sébastien; Grangeat, Pierre; Koenig, Anne

    2004-06-01

    We give the sampling conditions of the 3D fan-beam x-ray transform (3DFBXRT). The motivation of this work lies in the fact that helical tomography with a single detector line is simply a sampling of this transform under the helical constraint. We give a precise description of the geometry of the essential support of the 3DFBXRT Fourier transform and show how to derive efficient sampling schemes. We then give efficient sampling schemes in parallel helical tomography. We present numerical experiments showing that efficient sampling on hexagonal interlaced schemes yields better reconstructions than the standard schemes in both parallel helical tomography (using QDO) and 3DFBXRT. We discuss the practical drawbacks and advantages of these efficient schemes and the possible extension to fan-beam helical CT.

  15. Sampling conditions of 3D parallel and fan-beam x-ray CT with application to helical tomography.

    PubMed

    Desbat, Laurent; Roux, Sébastien; Grangeat, Pierre; Koenig, Anne

    2004-06-07

    We give the sampling conditions of the 3D fan-beam x-ray transform (3DFBXRT). The motivation of this work lies in the fact that helical tomography with a single detector line is simply a sampling of this transform under the helical constraint. We give a precise description of the geometry of the essential support of the 3DFBXRT Fourier transform and show how to derive efficient sampling schemes. We then give efficient sampling schemes in parallel helical tomography. We present numerical experiments showing that efficient sampling on hexagonal interlaced schemes yields better reconstructions than the standard schemes in both parallel helical tomography (using QDO) and 3DFBXRT. We discuss the practical drawbacks and advantages of these efficient schemes and the possible extension to fan-beam helical CT.

  16. A theoretically exact reconstruction algorithm for helical cone-beam differential phase-contrast computed tomography.

    PubMed

    Li, Jing; Sun, Yi; Zhu, Peiping

    2013-08-21

    Differential phase-contrast computed tomography (DPC-CT) reconstruction problems are usually solved by using parallel-, fan- or cone-beam algorithms. For rod-shaped objects, the x-ray beams cannot recover all the slices of the sample at the same time. Thus, if a rod-shaped sample is required to be reconstructed by the above algorithms, one should alternately perform translation and rotation on this sample, which leads to lower efficiency. The helical cone-beam CT may significantly improve scanning efficiency for rod-shaped objects over other algorithms. In this paper, we propose a theoretically exact filter-backprojection algorithm for helical cone-beam DPC-CT, which can be applied to reconstruct the refractive index decrement distribution of the samples directly from two-dimensional differential phase-contrast images. Numerical simulations are conducted to verify the proposed algorithm. Our work provides a potential solution for inspecting the rod-shaped samples using DPC-CT, which may be applicable with the evolution of DPC-CT equipments.

  17. Linked and knotted beams of light, conservation of helicity and the flow of null electromagnetic fields

    NASA Astrophysics Data System (ADS)

    Irvine, William T. M.

    2010-09-01

    Maxwell's equations allow for some remarkable solutions consisting of pulsed beams of light which have linked and knotted field lines. The preservation of the topological structure of the field lines in these solutions has previously been ascribed to the fact that the electric and magnetic helicities, a measure of the degree of linking and knotting between field lines, are conserved. Here we show that the elegant evolution of the field is due to the stricter condition that the electric and magnetic fields be everywhere orthogonal. The field lines then satisfy a 'frozen field' condition and evolve as if they were unbreakable filaments embedded in a fluid. The preservation of the orthogonality of the electric and magnetic field lines is guaranteed for null, shear-free fields such as the ones considered here by a theorem of Robinson. We calculate the flow field of a particular solution and find it to have the form of a Hopf fibration moving at the speed of light in a direction opposite to the propagation of the pulsed light beam, a familiar structure in this type of solution. The difference between smooth evolution of individual field lines and conservation of electric and magnetic helicities is illustrated by considering a further example in which the helicities are conserved, but the field lines are not everywhere orthogonal. The field line configuration at time t = 0 corresponds to a nested family of torus knots but unravels upon evolution.

  18. Status of the heavy ion beam probe system in the Large Helical Device

    SciTech Connect

    Nishiura, M.; Ido, T.; Shimizu, A.; Nakano, H.; Kato, T.; Kato, S.; Hamada, Y.; Shevelko, V. P.; Janev, R. K.; Wada, M.

    2008-02-15

    A heavy ion beam probe (HIBP) system has been installed into the Large Helical Device (LHD) to measure the spatial profile of the plasma potential and density fluctuations. The optimization of the HIBP system, especially the beam injector, is described. The negative ion beam is required for the MeV beam production in a tandem accelerator. A sputter-type heavy negative ion source has been developed as an intense Au{sup -} beam source to produce Au{sup +} beams with energy in the MeV range. The extraction electrodes and the Einzel lens system of the ion source have been designed taking into account the beam optics, and installed into the real machine. Throughout the plasma diagnostics on LHD experiments, the consumptions of vaporized caesium and gold target are being characterized for practical operations. In addition, the experimental charge fractions are compared with the theoretical fractions for understanding the charge-changing behavior of Au{sup -} ions and optimizing the fraction of Au{sup +} ions at the exit of the tandem accelerator of the HIBP system.

  19. Ion Compensation for Space Charge in the Helical Electron Beams of Gyrotrons

    NASA Astrophysics Data System (ADS)

    Manuilov, V. N.; Semenov, V. E.

    2016-06-01

    We solve analytically the problem about ion compensation for the space charge of a helical electron beam in a gyrotron operated in the long-pulse regime. Elementary processes, which take place during ionization of residual gas in the tube under typical pressures of 10-6-10-7 mm Hg, are considered. It is shown that distribution of the space charge is affected mainly by the electrons of the initial beam and slow-moving ions produced by ionization of the residual gas. Steady-state density of ions in the operating space of the gyrotron after the end of the transitional processes is found, as well as the electron density profile in the channel of electron beam transportation. The results obtained allow us to evaluate the pitch-factor variations caused by partial compensations for the potential "sagging" in the gyrotron cavity, thus being useful for analysis of starting currents, efficiency, and mode competition in high-power gyrotrons.

  20. Assessment of three-dimensional set-up errors using megavoltage computed tomography (MVCT) during image-guided intensity-modulated radiation therapy (IMRT) for craniospinal irradiation (CSI) on helical tomotherapy (HT).

    PubMed

    Gupta, Tejpal; Upasani, Maheshkumar; Master, Zubin; Patil, Anita; Phurailatpam, Reena; Nojin, Siji; Kannan, Sadhana; Godasastri, Jayant; Jalali, Rakesh

    2015-02-01

    The purpose of this study was to assess three-dimensional (3D) set-up errors using megavoltage computed tomography (MVCT) during image-guided intensity-modulated radiation therapy (IMRT) for supine craniospinal irradiation (CSI) on helical tomotherapy (HT). Patients were immobilized in a customized 4-clamp thermoplastic head mask with or without whole-body vacuum cradle. Set-up was based primarily on a set of cranial fiducial markers. MVCT scans were acquired and co-registered with planning scan separately at three different levels (brain, upper, and lower spine) at every fraction. Only translational displacements were analysed, wherein positive sign denotes deviation in anterior, left, and superior direction; while negative sign denotes deviation in posterior, right, and inferior direction. Mean displacements, systematic, and random errors of the study population were calculated at all three levels separately. Local residual uncertainty of the upper and lower spine was also derived assuming perfect co-registration of the skull. Set-up margins for clinical target volume (CTV) to planning target volume (PTV) were derived at these three levels separately using published margin recipes. Data from 1868 co-registrations in 674 fractions on 33 patients was included. The mean displacements in the lateral, longitudinal, and vertical directions were -1.21, -1.36, and 1.38 mm; -1.25, -0.34, and 0.65 mm; and -1.47, -2.78, and 0.22 mm for the brain; upper spine; and lumbar spine respectively. The corresponding 3D vector of displacement was 2.28; 1.45; and 3.15 mm respectively. There was a distinct systematic trend towards increasing inaccuracy from the brain towards the lower spine. Using Stroom's formula, the minimum recommended CTV to PTV margins in absence of daily image-guidance were 6.5; 7.0; and 9.5 mm for the brain; upper spine; and lower spine respectively. This increased to 7.5; 8.5; and 11.5 mm using van Herk's formula. Subset and sensitivity analyses

  1. Modeling activities on the negative-ion-based Neutral Beam Injectors of the Large Helical Device

    SciTech Connect

    Agostinetti, P.; Antoni, V.; Chitarin, G.; Pilan, N.; Serianni, G.; Veltri, P.; Cavenago, M.; Nakano, H.; Takeiri, Y.; Tsumori, K.

    2011-09-26

    At the National Institute for Fusion Science (NIFS) large-scaled negative ion sources have been widely used for the Neutral Beam Injectors (NBIs) mounted on the Large Helical Device (LHD), which is the world-largest superconducting helical system. These injectors have achieved outstanding performances in terms of beam energy, negative-ion current and optics, and represent a reference for the development of heating and current drive NBIs for ITER.In the framework of the support activities for the ITER NBIs, the PRIMA test facility, which includes a RF-drive ion source with 100 keV accelerator (SPIDER) and a complete 1 MeV Neutral Beam system (MITICA) is under construction at Consorzio RFX in Padova.An experimental validation of the codes has been undertaken in order to prove the accuracy of the simulations and the soundness of the SPIDER and MITICA design. To this purpose, the whole set of codes have been applied to the LHD NBIs in a joint activity between Consorzio RFX and NIFS, with the goal of comparing and benchmarking the codes with the experimental data. A description of these modeling activities and a discussion of the main results obtained are reported in this paper.

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

    PubMed Central

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

    2007-01-01

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

  3. Dosimetric comparison of helical tomothearpy and linac-based IMRT in whole abdomen radiotherapy

    NASA Astrophysics Data System (ADS)

    Kang, Young-nam; Kim, Dae-Hyun; Jang, Hong Seok; Song, Jin Ho; Choi, Byung Ock; Cho, Seok Goo; Jung, Ji-Young; Kay, Chul Seung

    2012-10-01

    Recent advances in radiotherapy techniques have allowed a significant improvement in the therapeutic ratio of whole abdominal irradiation (WAI) through linear-accelerator (Linac) based intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT). IMRT has been shown to reduce the dose to organs at risk (OAR) while adequately treating the tumor volume. HT operates by adjusting 51 beam directions, couch speed, pitch and shapes of a binary multileaf collimator (MLC), with the purpose of clinically increasing the befit to the patient. We incorporated helical tomotherapy as a new modality for WAI for the treatment of non-Hodgkin's lymphoma patients whose disease involved the intestine and the mesenteric lymph nodes. Excellent tumor coverage with effective sparing of normal organ sparings, and homogeneous dose distribution could be achieved. This study dosimetrically compared HT and linac-based IMRT by using several indices, including the conformity index (CI) and the homogeneity index (HI) for the planning target volume (PTV), as well as the, max dose and the mean dose and the quality index (QI) for five organs at risk (OARs). The HI and the CI were used to compare the quality of target coverage while the QI was used compare the dosimetric performans for OAR systems. The target coverages between the two systems were similar, but the most QIs were lower than 1, what means that HT is batter at sparing OARs than IMRT. Tomotherapy enabled excellent target coverage, effective sparing of normal tissues, and homogeneous dose distribution without severe acute toxicity.

  4. Single-fraction spine SBRT end-to-end testing on TomoTherapy, Vero, TrueBeam, and CyberKnife treatment platforms using a novel anthropomorphic phantom.

    PubMed

    Gallo, John J; Kaufman, Isaac; Powell, Rachel; Pandya, Shalini; Somnay, Archana; Bossenberger, Todd; Ramirez, Ezequiel; Reynolds, Robert; Solberg, Timothy; Burmeister, Jay

    2015-01-08

    Spine SBRT involves the delivery of very high doses of radiation to targets adjacent to the spinal cord and is most commonly delivered in a single fraction. Highly conformal planning and accurate delivery of such plans is imperative for successful treatment without catastrophic adverse effects. End-to-end testing is an important practice for evaluating the entire treatment process from simulation through treatment delivery. We performed end-to-end testing for a set of representative spine targets planned and delivered using four different treatment planning systems (TPSs) and delivery systems to evaluate the various capabilities of each. An anthropomorphic E2E SBRT phantom was simulated and treated on each system to evaluate agreement between measured and calculated doses. The phantom accepts ion chambers in the thoracic region and radiochromic film in the lumbar region. Four representative targets were developed within each region (thoracic and lumbar) to represent different presentations of spinal metastases and planned according to RTOG 0631 constraints. Plans were created using the TomoTherapy TPS for delivery using the Hi·Art system, the iPlan TPS for delivery using the Vero system, the Eclipse TPS for delivery using the TrueBeam system in both flattened and flattening filter free (FFF), and the MultiPlan TPS for delivery using the CyberKnife system. Delivered doses were measured using a 0.007 cm3 ion chamber in the thoracic region and EBT3 GAFCHROMIC film in the lumbar region. Films were scanned and analyzed using an Epson Expression 10000XL flatbed scanner in conjunction with FilmQAPro2013. All treatment platforms met all dose constraints required by RTOG 0631. Ion chamber measurements in the thoracic targets delivered an overall average difference of 1.5%. Specifically, measurements agreed with the TPS to within 2.2%, 3.2%, 1.4%, 3.1%, and 3.0% for all three measureable cases on TomoTherapy, Vero, TrueBeam (FFF), TrueBeam (flattened), and Cyber

  5. Filmless methods for quality assurance of Tomotherapy using ArcCHECK.

    PubMed

    Yang, B; Wong, W K R; Geng, H; Lam, W W; Ho, Y W; Kwok, W M; Cheung, K Y; Yu, S K

    2017-01-01

    Tomotherapy delivers an intensity-modulated radiation therapy (IMRT) treatment by the synchronization of gantry rotation, multileaf collimator (MLC), and couch movement. This dynamic nature makes the quality assurance (QA) important and challenging. The purpose of this study is to develop some methodologies using an ArcCHECK for accurate QA measurements of the gantry angle and speed, MLC synchronization and leaf open time, couch translation per gantry rotation, couch speed and uniformity, and constancy of longitudinal beam profile for a Tomotherapy unit. Four test plans recommended by AAPM Task Group 148 (TG148) and the manufacturer were chosen for this study. Helical and static star shot tests are used for checking the leaves opened at the expected gantry angles. Another helical test is to verify the couch traveled the expected distance per gantry rotation. The final test is for checking the couch speed constancy with a static gantry. ArcCHECK can record the detector signal every 50 ms as a movie file, and has a virtual inclinometer for gantry angle measurement. These features made the measurement of gantry angle and speed, MLC synchronization and leaf open time, and longitudinal beam profile possible. A shaping parameter was defined for facilitating the location of the beam center during the plan delivery, which was thereafter used to calculate the couch translation per gantry rotation and couch speed. The full width at half maximum (FWHM) was calculated for each measured longitudinal beam profile and then used to evaluate the couch speed uniformity. Furthermore, a mean longitudinal profile was obtained for constancy check of field width. The machine trajectory log data were also collected for comparison. Inhouse programs were developed in MATLAB to process both the ArcCHECK and machine log data. The deviation of our measurement results from the log data for gantry angle was calculated to be less than 0.4°. The percentage differences between measured and planned

  6. Comparing efficiency and accuracy of the kinoform and the helical axicon as Bessel-Gauss beam generators.

    PubMed

    Arrizón, Victor; Ruiz, Ulises; Aguirre-Olivas, Dilia; Sánchez-de-la-Llave, David; Ostrovsky, Andrey S

    2014-03-01

    We compare two phase optical elements that are employed to generate approximate Bessel-Gauss beams of arbitrary order. These elements are the helical axicon (HA) and the kinoform of the desired Bessel-Gauss beam. The HA generates a Bessel beam (BB) by free propagation, and the kinoform is employed in a Fourier spatial filtering optical setup. As the main result, it is obtained that the error in the BBs generated with the kinoform is smaller than the error in the beams obtained with the HA. On the other hand, it is obtained that the efficiencies of the methods are approximately 1.0 (HA) and 0.7 (kinoform).

  7. Beam-helicity asymmetry I⊙ in the photoproduction of π0-pairs off the deuteron

    NASA Astrophysics Data System (ADS)

    Oberle, Markus

    2012-12-01

    Beam-helicity asymmetries have been measured at the MAMI accelerator in Mainz for the photoproduction of neutral pion pairs in the reactions γp → pπ0π0 and γd → (n)pπ0π0, γd → (p)nπ0π0 off free protons and off quasi-free nucleons bound in the deuteron for incident photon energies up to 1.4 GeV. A circularly polarized photon beam was produced off a longitudinally polarized electron beam using bremsstrahlung processes. The photons were tagged with the Glasgow magnetic spectrometer. Decay photons from the π0 mesons, recoil protons, and recoil neutrons were detected in the 4π covering detector system composed of the Crystal Ball and TAPS electromagnetic calorimeters. The free and quasi-free results are in almost perfect agreement. The measured asymmetries for reactions off protons and neutrons are very similar, in contrary to expectations. The results are compared to the predictions from the Two-Pion-MAID reaction model.

  8. Exact Reconstruction From Uniformly Attenuated Helical Cone-Beam Projections in SPECT

    SciTech Connect

    Gullberg, Grant T; Huang, Qiu; You, Jiangsheng; Zeng, Gengsheng L.

    2008-12-18

    In recent years the development of cone-beam reconstruction algorithms has been an active research area in x-ray computed tomography (CT), and significant progress has been made in the advancement of algorithms. Theoretically exact and computationally efficient analytical algorithms can be found in the literature. However, in single photon emission computed tomography (SPECT), published cone-beam reconstruction algorithms are either approximate or involve iterative methods. The SPECT reconstruction problem is more complicated due to degradations in the imaging detection process, one of which is the effect of attenuation of gamma ray photons. Attenuation should be compensated for to obtain quantitative results. In this paper, an analytical reconstruction algorithm for uniformly attenuated cone-beam projection data is presented for SPECT imaging. The algorithm adopts the DBH method, a procedure consisting of differentiation and backprojection followed by a finite inverse cosh-weighted Hilbert transform. The significance of the proposed approach is that a selected region of interest can be reconstructed even with a detector with a reduced field of view. The algorithm is designed for a general trajectory. However, to validate the algorithm, a numerical study was performed using a helical trajectory. The implementation is efficient and the simulation result is promising.

  9. High-quality electron beams from a helical inverse free-electron laser accelerator.

    PubMed

    Duris, J; Musumeci, P; Babzien, M; Fedurin, M; Kusche, K; Li, R K; Moody, J; Pogorelsky, I; Polyanskiy, M; Rosenzweig, J B; Sakai, Y; Swinson, C; Threlkeld, E; Williams, O; Yakimenko, V

    2014-09-15

    Compact, table-top sized accelerators are key to improving access to high-quality beams for use in industry, medicine and academic research. Among laser-based accelerating schemes, the inverse free-electron laser (IFEL) enjoys unique advantages. By using an undulator magnetic field in combination with a laser, GeV m(-1) gradients may be sustained over metre-scale distances using laser intensities several orders of magnitude less than those used in laser wake-field accelerators. Here we show for the first time the capture and high-gradient acceleration of monoenergetic electron beams from a helical IFEL. Using a modest intensity (~10(13) W cm(-2)) laser pulse and strongly tapered 0.5 m long undulator, we demonstrate >100 MV m(-1) accelerating gradient, >50 MeV energy gain and excellent output beam quality. Our results pave the way towards compact, tunable GeV IFEL accelerators for applications such as driving soft X-ray free-electron lasers and producing γ-rays by inverse Compton scattering.

  10. High-quality electron beams from a helical inverse free-electron laser accelerator

    NASA Astrophysics Data System (ADS)

    Duris, J.; Musumeci, P.; Babzien, M.; Fedurin, M.; Kusche, K.; Li, R. K.; Moody, J.; Pogorelsky, I.; Polyanskiy, M.; Rosenzweig, J. B.; Sakai, Y.; Swinson, C.; Threlkeld, E.; Williams, O.; Yakimenko, V.

    2014-09-01

    Compact, table-top sized accelerators are key to improving access to high-quality beams for use in industry, medicine and academic research. Among laser-based accelerating schemes, the inverse free-electron laser (IFEL) enjoys unique advantages. By using an undulator magnetic field in combination with a laser, GeV m-1 gradients may be sustained over metre-scale distances using laser intensities several orders of magnitude less than those used in laser wake-field accelerators. Here we show for the first time the capture and high-gradient acceleration of monoenergetic electron beams from a helical IFEL. Using a modest intensity (~1013 W cm-2) laser pulse and strongly tapered 0.5 m long undulator, we demonstrate >100 MV m-1 accelerating gradient, >50 MeV energy gain and excellent output beam quality. Our results pave the way towards compact, tunable GeV IFEL accelerators for applications such as driving soft X-ray free-electron lasers and producing γ-rays by inverse Compton scattering.

  11. Recent Progress in the Negative-Ion-Based Neutral Beam Injectors in Large Helical Device

    SciTech Connect

    Takeiri, Y.; Tsumori, K.; Ikeda, K.; Osakabe, M.; Nagaoka, K.; Oka, Y.; Asano, E.; Kondo, T.; Sato, M.; Shibuya, M.; Komada, S.; Kaneko, O.

    2009-03-12

    Negative-ion-based neutral beam injection (negative-NBI) system has been operated for 10 years in Large Helical Device (LHD). The injection power has been increased year by year, according to the improvement of the negative ion sources. Up to now, every injector achieves the designed injection energy and power of 180 keV-5 MW with hydrogen beams, and the total injection power exceeds 16 MW with three injectors. In the multi-round aperture grounded grid (GG), the diameter of a round aperture has been enlarged for higher GG transparency. Then, the GG heat load is reduced, as well as in the multi-slotted GG, and the voltage holding ability in the beam acceleration was improved. As a result, the beam energy is raised and the injection power is increased. To improve the anisotropic property of the beamlet convergence condition between the perpendicular and the parallel directions to the slots in the multi-slotted GG, a round-shape aperture of the steering grid (SG) has been changed to a racetrack shape. As a result, the difference of the beamlet conversion condition is much mitigated, and the injection efficiency (port-transmission efficiency) is improved, leading to 188 keV-6.4 MW injection. The Cs consumption is observed to be proportional to the tungsten evaporation from filaments. The Cs behavior is investigated with optical emission spectroscopy. During the beam extraction, the Cs recycling is dominated by Cs on the backplate, which is evaporated into the plasma by the backstreaming positive ions, and the wall surfaces should be loss regions for the supplied Cs.

  12. Recent Progress in the Negative-Ion-Based Neutral Beam Injectors in Large Helical Device

    NASA Astrophysics Data System (ADS)

    Takeiri, Y.; Tsumori, K.; Ikeda, K.; Osakabe, M.; Nagaoka, K.; Oka, Y.; Asano, E.; Kondo, T.; Sato, M.; Shibuya, M.; Komada, S.; Kaneko, O.

    2009-03-01

    Negative-ion-based neutral beam injection (negative-NBI) system has been operated for 10 years in Large Helical Device (LHD). The injection power has been increased year by year, according to the improvement of the negative ion sources. Up to now, every injector achieves the designed injection energy and power of 180 keV-5 MW with hydrogen beams, and the total injection power exceeds 16 MW with three injectors. In the multi-round aperture grounded grid (GG), the diameter of a round aperture has been enlarged for higher GG transparency. Then, the GG heat load is reduced, as well as in the multi-slotted GG, and the voltage holding ability in the beam acceleration was improved. As a result, the beam energy is raised and the injection power is increased. To improve the anisotropic property of the beamlet convergence condition between the perpendicular and the parallel directions to the slots in the multi-slotted GG, a round-shape aperture of the steering grid (SG) has been changed to a racetrack shape. As a result, the difference of the beamlet conversion condition is much mitigated, and the injection efficiency (port-transmission efficiency) is improved, leading to 188 keV-6.4 MW injection. The Cs consumption is observed to be proportional to the tungsten evaporation from filaments. The Cs behavior is investigated with optical emission spectroscopy. During the beam extraction, the Cs recycling is dominated by Cs on the backplate, which is evaporated into the plasma by the backstreaming positive ions, and the wall surfaces should be loss regions for the supplied Cs.

  13. Beam-helicity asymmetries in double-pion photoproduction off the proton.

    PubMed

    Krambrich, D; Zehr, F; Fix, A; Roca, L; Aguar, P; Ahrens, J; Annand, J R M; Arends, H J; Beck, R; Bekrenev, V; Boillat, B; Braghieri, A; Branford, D; Briscoe, W J; Brudvik, J; Cherepnya, S; Codling, R; Downie, E J; Dexler, P; Glazier, D I; Grabmayr, P; Gregor, R; Heid, E; Hornidge, D; Jahn, O; Kashevarov, V L; Knezevic, A; Kondratiev, R; Korolija, M; Kotulla, M; Krusche, B; Kulbardis, A; Lang, M; Lisin, V; Livingston, K; Lugert, S; MacGregor, I J D; Manley, D M; Martinez, M; McGeorge, J C; Mekterovic, D; Metag, V; Nefkens, B M K; Nikolaev, A; Pedroni, P; Pheron, F; Polonski, A; Prakhov, S N; Price, J W; Rosner, G; Rost, M; Rostomyan, T; Schumann, S; Sober, D; Starostin, A; Supek, I; Tarbert, C M; Thomas, A; Unverzagt, M; Walcher, Th; Watts, D P

    2009-07-31

    Beam-helicity asymmetries have been measured at the MAMI accelerator in Mainz in the three isospin channels gamma[over -->]p-->pi(+)pi(0)n, gamma[over -->]p-->pi(0)pi(0)p, and gamma[over -->]p-->pi(+)pi(-)p. The circularly polarized photons, produced from bremsstrahlung of longitudinally polarized electrons, were tagged with the Glasgow magnetic spectrometer. Charged pions and the decay photons of pi(0) mesons were detected in a 4pi electromagnetic calorimeter which combined the Crystal Ball detector with the TAPS detector. The precisely measured asymmetries are very sensitive to details of the production processes and are thus key observables in the modeling of the reaction dynamics.

  14. Limited-angle reverse helical cone-beam CT for pipeline with low rank decomposition

    NASA Astrophysics Data System (ADS)

    Wu, Dong; Zeng, Li

    2014-10-01

    In this paper, tomographic imaging of pipeline in service by cone-beam computed tomography (CBCT) is studied. With the developed scanning strategy and image model, the quality of reconstructed image is improved. First, a limited-angle reverse helical scanning strategy based on C-arm computed tomography (C-arm CT) is developed for the projection data acquisition of pipeline in service. Then, an image model which considering the resemblance among slices of pipeline is developed. Finally, split Bregman method based algorithm is implemented in solving the model aforementioned. Preliminary results of simulation experiments show that the projection data acquisition strategy and reconstruction method are efficient and feasible, and our method is superior to Feldkamp-Davis-Kress (FDK) algorithm and simultaneous algebraic reconstruction technique (SART).

  15. 2D potential measurements by applying automatic beam adjustment system to heavy ion beam probe diagnostic on the Large Helical Device

    SciTech Connect

    Shimizu, A. Ido, T.; Kato, S.; Hamada, Y.; Kurachi, M.; Makino, R.; Nishiura, M.; Nishizawa, A.

    2014-11-15

    Two-dimensional potential profiles in the Large Helical Device (LHD) were measured with heavy ion beam probe (HIBP). To measure the two-dimensional profile, the probe beam energy has to be changed. However, this task is not easy, because the beam transport line of LHD-HIBP system is very long (∼20 m), and the required beam adjustment consumes much time. To reduce the probe beam energy adjustment time, an automatic beam adjustment system has been developed. Using this system, required time to change the probe beam energy is dramatically reduced, such that two-dimensional potential profiles were able to be successfully measured with HIBP by changing the probe beam energy shot to shot.

  16. SU-E-T-393: Investigation of Hot Spots in Tomotherapy 3D Conformal Breast Plan

    SciTech Connect

    Chen, Q; Siebers, J; Khandelwal, S

    2014-06-01

    Purpose: The purpose of this study is to determine the root-cause of hotspots inherent to Tomotherapy static beam 3D conformal radiotherapy (3DCRT) for breast treatment. ASTRO (ref here) recommends that IMRT be avoided for breast treatments. Despite Tomotherapy's inherent IMRT-like optimization and delivery, our experience at a Tomotherapy-only site has been that Tomotherapy 3DCRT fail to produce a clinically acceptable plan for 79% of our breast patients. Hot-spots have been one of the major obstacles. Methods: Eight lumpectomy patients were planned according to RTOG-1005 specification. Two or four tangential beams were used for 3DCRT breast planning. To spare the contralateral breast and ipsilateral lung, part of the PTV was not covered by the primary beam, yielding adjacent hot-spots. We hypothesize that the planning system creates hotspots adjacent to the cold spots to yield scatter radiation dose compensation in the blocked region. Various phantom and patient setup were used to test the hypothesis. Results: Hot spots outside of PTV in the range of 135% - 174% were observed for patient plan. It is confirmed that the PTV partial block causes the adjacent hot spot. The root cause is the optimizer quadratic objective function over- weighs improving the cold spot. The IMRT flexibility offered by Tomotherapy is counter-productive in static-beam 3DCRT breast treatment. For phantom case, as the Modulation-Factor increases from 1.1 to 5, the hot spot increases from 110% to 300%. Limiting the 3DCRT intensity modulation is shown to produce clinically acceptable plan. Conclusion: Most of the hot spots in Tomotherapy 3DCRT breast plan originate from the planning-system optimizer attempting to cover PTV cold spots rather than from the beam energy. Altering the objective function could improve clinical acceptability of static beam Tomotherapy 3DCRT.

  17. 2D spatial profile measurements of potential fluctuation with heavy ion beam probe on the Large Helical Device

    NASA Astrophysics Data System (ADS)

    Shimizu, A.; Ido, T.; Nishiura, M.; Kato, S.; Ogawa, K.; Takahashi, H.; Igami, H.; Yoshimura, Y.; Kubo, S.; Shimozuma, T.

    2016-11-01

    Two-dimensional spatial profiles of potential fluctuation were measured with the heavy ion beam probe (HIBP) in the Large Helical Device (LHD). For 2D spatial profile measurements, the probe beam energy has to be changed, which requires the adjustment of many deflectors in the beam transport line to optimize the beam trajectory, since the transport line of LHD-HIBP system is long. The automatic beam adjustment system was developed, which allows us to adjust the beam trajectory easily. By analyzing coherence between potential fluctuation and magnetic probe signal, the noise level of the mode power spectrum of the potential fluctuation can be reduced. By using this method, the 2D spatial profile of potential fluctuation profile was successfully obtained.

  18. Improving the output voltage waveform of an intense electron-beam accelerator based on helical type Blumlein pulse forming line

    NASA Astrophysics Data System (ADS)

    Cheng, Xin-Bing; Liu, Jin-Liang; Zhang, Hong-Bo; Feng, Jia-Huai; Qian, Bao-Liang

    2010-07-01

    The Blumlein pulse forming line (BPFL) consisting of an inner coaxial pulse forming line (PFL) and an outer coaxial PFL is widely used in the field of pulsed power, especially for intense electron-beam accelerators (IEBA). The output voltage waveform determines the quality and characteristics of the output beam current of the IEBA. Comparing with the conventional BPFL, an IEBA based on a helical type BPFL can increase the duration of the output voltage in the same geometrical volume. However, for the helical type BPFL, the voltage waveform on a matched load may be distorted which influences the electron-beam quality. In this paper, an IEBA based on helical type BPFL is studied theoretically. Based on telegrapher equations of the BPFL, a formula for the output voltage of IEBA is obtained when the transition section is taken into account, where the transition section is between the middle cylinder of BPFL and the load. From the theoretical analysis, it is found that the wave impedance and transit time of the transition section influence considerably the main pulse voltage waveform at the load, a step is formed in front of the main pulse, and a sharp spike is also formed at the end of the main pulse. In order to get a well-shaped square waveform at the load and to improve the electron-beam quality of such an accelerator, the wave impedance of the transition section should be equal to that of the inner PFL of helical type BPFL and the transit time of the transition section should be designed as short as possible. Experiments performed on an IEBA with the helical type BPFL show reasonable agreement with theoretical analysis.

  19. Handling data redundancy in helical cone beam reconstruction with a cone-angle-based window function and its asymptotic approximation

    SciTech Connect

    Tang Xiangyang; Hsieh Jiang

    2007-06-15

    A cone-angle-based window function is defined in this manuscript for image reconstruction using helical cone beam filtered backprojection (CB-FBP) algorithms. Rather than defining the window boundaries in a two-dimensional detector acquiring projection data for computed tomographic imaging, the cone-angle-based window function deals with data redundancy by selecting rays with the smallest cone angle relative to the reconstruction plane. To be computationally efficient, an asymptotic approximation of the cone-angle-based window function is also given and analyzed in this paper. The benefit of using such an asymptotic approximation also includes the avoidance of functional discontinuities that cause artifacts in reconstructed tomographic images. The cone-angle-based window function and its asymptotic approximation provide a way, equivalent to the Tam-Danielsson-window, for helical CB-FBP reconstruction algorithms to deal with data redundancy, regardless of where the helical pitch is constant or dynamically variable during a scan. By taking the cone-parallel geometry as an example, a computer simulation study is conducted to evaluate the proposed window function and its asymptotic approximation for helical CB-FBP reconstruction algorithm to handle data redundancy. The computer simulated Forbild head and thorax phantoms are utilized in the performance evaluation, showing that the proposed cone-angle-based window function and its asymptotic approximation can deal with data redundancy very well in cone beam image reconstruction from projection data acquired along helical source trajectories. Moreover, a numerical study carried out in this paper reveals that the proposed cone-angle-based window function is actually equivalent to the Tam-Danielsson-window, and rigorous mathematical proofs are being investigated.

  20. Doppler-shift spectra of Hα lines from negative-ion-based neutral beams for large helical device neutral beam injection

    NASA Astrophysics Data System (ADS)

    Oka, Y.; Ikeda, K.; Takeiri, Y.; Tsumori, K.; Kaneko, O.; Nagaoka, K.; Osakabe, M.; Asano, E.; Kondo, T.; Sato, M.; Shibuya, M.; Grisham, L.; Umeda, N.; Honda, A.; Ikeda, Y.; Yamamoto, T.

    2006-03-01

    The velocity spectra of the negative-ion-(H-) based neutral beams are studied in high-performance large-area ion sources during injection into large helical device fusion plasmas. We are conducting systematic observations in standard neutral beam injection to correlate beam spectra with source operating conditions. Almost all of the transmitted beam power was at full acceleration energy (˜170keV). The small stripping beam component which was produced in the extraction gap was evaluated to be about 9%-22% by amplitude of the measured spectra for the sources in beam lines 1 and 2. H- production uniformity from the spectrum profile was 86%-90% for three sources. For the longest pulse injection during 74 and 128 s, a full energy component tended to decrease with time, while the accelerator gap stripping tail tended to increase slightly with time, which is attributed to beam-induced outgassing in the accelerator. A higher conductance multislot ground grid accelerator appeared to show little growth in the accelerator gap beam stripping during long pulses compared to the conventional multiaperture ground grid. The beam uniformity appeared to vary in part with the Cs uniformity on the plasma grid.

  1. Extending Three-Dimensional Weighted Cone Beam Filtered Backprojection (CB-FBP) Algorithm for Image Reconstruction in Volumetric CT at Low Helical Pitches

    PubMed Central

    Hsieh, Jiang; Nilsen, Roy A.; McOlash, Scott M.

    2006-01-01

    A three-dimensional (3D) weighted helical cone beam filtered backprojection (CB-FBP) algorithm (namely, original 3D weighted helical CB-FBP algorithm) has already been proposed to reconstruct images from the projection data acquired along a helical trajectory in angular ranges up to [0, 2 π]. However, an overscan is usually employed in the clinic to reconstruct tomographic images with superior noise characteristics at the most challenging anatomic structures, such as head and spine, extremity imaging, and CT angiography as well. To obtain the most achievable noise characteristics or dose efficiency in a helical overscan, we extended the 3D weighted helical CB-FBP algorithm to handle helical pitches that are smaller than 1: 1 (namely extended 3D weighted helical CB-FBP algorithm). By decomposing a helical over scan with an angular range of [0, 2π + Δβ] into a union of full scans corresponding to an angular range of [0, 2π], the extended 3D weighted function is a summation of all 3D weighting functions corresponding to each full scan. An experimental evaluation shows that the extended 3D weighted helical CB-FBP algorithm can improve noise characteristics or dose efficiency of the 3D weighted helical CB-FBP algorithm at a helical pitch smaller than 1: 1, while its reconstruction accuracy and computational efficiency are maintained. It is believed that, such an efficient CB reconstruction algorithm that can provide superior noise characteristics or dose efficiency at low helical pitches may find its extensive applications in CT medical imaging. PMID:23165031

  2. SU-E-T-303: Dosimetric Comparison of a LINAC Fallback Plan Generated From Tomotherapy System

    SciTech Connect

    Yang, C; Chen, Y

    2015-06-15

    Purpose: Quantitatively evaluate the Multi Criteria Optimization (MCO) based MLC step and shoot (sMLC) fallback plan derived from Tomotherapy of multiple lesions lung SBRT Methods: Inter-comparison of various IMRT planning systems tends to be difficult due to the vendor-specific functionalities. The methodology of defining dose constraints and beam geometries is challenging. Raysearch™ planning system offers an alternative replanning to deliver same intensity map from Tomotherapy without modifying original fluence. This intuitive comparison comes from the final fluence map converted without any embedded system dependent dose optimization. This planner independent approach could be utilized to study the merits of individual machines. The term “fallback” was utilized to (A) transfer plans in among treatment delivery systems; (B) maintain acceptable plan qualities; and (C) minimize the biological dose impact due to machine breakdown. The Tomotherapy specific DICOM RT dose and plan are retrieved into Raystation’s pre-defined sMLC protocol. Based on specific machine characteristics, same fluence maps were converted to generate equivalent deliverable segments. Therefore, the treatment plans were evaluated among two planning tools, Tomotherapy and MCO based sMLC delivery plans. Results: By converting the fluence map with the pre-defined machine characteristics, the 9-fields fallback plan has similar ITV coverage compared to the original Tomotherapy plan. ITV average doses, the D95 consisted of 0.9% variation. The total lung doses of fallback plan drifted from 17.4% to 30.5% which represents the limitations of the static beam delivery. D2 of fallback spinal cord increased from 22.4% to 36.4% but still within tolerances. Ipsilateral lung changed from 11.0% to 22.6%. Low dose region between ITVs presented increased dose to the normal lung tissues. Conclusion: Acceptable fallback plan for Tomotherapy SBRT has similar ITVs coverage, but lack of the normal tissues

  3. Clinical challenges in the implementation of a tomotherapy service for head and neck cancer patients in a regional UK radiotherapy centre

    PubMed Central

    Chatterjee, S; Mott, J H; Smyth, G; Dickson, S; Dobrowsky, W; Kelly, C G

    2011-01-01

    Objective Intensity-modulated radiotherapy (IMRT) is increasingly being used to treat head and neck cancer cases. Methods We discuss the clinical challenges associated with the setting up of an image guided intensity modulated radiotherapy service for a subset of head and neck cancer patients, using a recently commissioned helical tomotherapy (HT) Hi Art (Tomotherapy Inc, WI) machine in this article. We also discuss the clinical aspects of the tomotherapy planning process, treatment and image guidance experiences for the first 10 head and neck cancer cases. The concepts of geographical miss along with tomotherapy-specific effects, including that of field width and megavoltage CT (MVCT) imaging strategy, have been highlighted using the first 10 head and neck cases treated. Results There is a need for effective streamlining of all aspects of the service to ensure compliance with cancer waiting time targets. We discuss how patient toxicity audits are crucial to guide refinement of the newly set-up planning dose constraints. Conclusion This article highlights the important clinical issues one must consider when setting up a head and neck IMRT, image-guided radiotherapy service. It shares some of the clinical challenges we have faced during the setting up of a tomotherapy service. Implementation of a clinical tomotherapy service requires a multidisciplinary team approach and relies heavily on good team working and effective communication between different staff groups. PMID:21159810

  4. Using a Bessel light beam as an ultrashort period helical undulator

    NASA Astrophysics Data System (ADS)

    Jiang, B. C.; Zhang, Q. L.; Chen, J. H.; Zhao, Z. T.

    2017-07-01

    An undulator is a critical component to produce synchrotron radiation and a free electron laser. When a Bessel light beam carrying the orbit angular momentum copropagates with an electron beam bunch, a net transverse deflection force will be subjected to the latter one. As a result of dephasing effect, the deflection force will oscillate and act as an undulator. For such a laser based undulator, the period length can reach submillimeter level, which will greatly reduce the electron energy for the required x-ray production.

  5. Beam-helicity asymmetry in photon and pion electroproduction in the Δ(1232)-resonance region at Q2 = 0.35(GeV/c)2

    NASA Astrophysics Data System (ADS)

    Bensafa, I. K.; Achenbach, P.; Ases Antelo, M.; Ayerbe, C.; Baumann, D.; Böhm, R.; Bosnar, D.; Burtin, E.; Defaÿ, X.; D'Hose, N.; Ding, M.; Distler, M. O.; Doria, L.; Fonvieille, H.; Friedrich, J. M.; Friedrich, J.; García Llongo, J.; Janssens, P.; Jover Mañas, G.; Kohl, M.; Laveissière, G.; Lloyd, M.; Makek, M.; Marroncle, J.; Merkel, H.; Merle, P.; Müller, U.; Nungesser, L.; Pasquini, B.; Pérez Benito, R.; Pochodzalla, J.; Potokar, M.; Rosner, G.; Sánchez Majos, S.; Seimetz, M.; Širca, S.; Spitzenberg, T.; Tamas, G.; van de Vyver, R.; van Hoorebeke, L.; Walcher, Th.; Weis, M.

    2007-04-01

    The beam-helicity asymmetry has been measured simultaneously for the reactions stackrel{{rightarrow}}{{e}} p→ epγ and stackrel{{rightarrow}}{{e}} p→ epπ 0 in the Δ(1232)-resonance region at Q 2 = 0.35( GeV/ c)2. The experiment was performed at MAMI with a longitudinally polarized beam and an out-of-plane detection of the proton. The results are compared with calculations based on dispersion relations for virtual Compton scattering and with the MAID model for pion electroproduction. There is an overall good agreement between experiment and theoretical calculations. The remaining discrepancies may be ascribed to an imperfect parametrization of some γ (*) N→ πN multipoles, mainly contributing to the non-resonant background. The beam-helicity asymmetry in both channels ( γ and π 0) shows a good sensitivity to these multipoles and should allow future improvement in their parametrization.

  6. A motion-compensated scheme for helical cone-beam reconstruction in cardiac CT angiography

    SciTech Connect

    Stevendaal, U. van; Berg, J. von; Lorenz, C.; Grass, M.

    2008-07-15

    Since coronary heart disease is one of the main causes of death all over the world, cardiac computed tomography (CT) imaging is an application of very high interest in order to verify indications timely. Due to the cardiac motion, electrocardiogram (ECG) gating has to be implemented into the reconstruction of the measured projection data. However, the temporal and spatial resolution is limited due to the mechanical movement of the gantry and due to the fact that a finite angular span of projections has to be acquired for the reconstruction of each voxel. In this article, a motion-compensated reconstruction method for cardiac CT is described, which can be used to increase the signal-to-noise ratio or to suppress motion blurring. Alternatively, it can be translated into an improvement of the temporal and spatial resolution. It can be applied to the entire heart in common and to high contrast objects moving with the heart in particular, such as calcified plaques or devices like stents. The method is based on three subsequent steps: As a first step, the projection data acquired in low pitch helical acquisition mode together with the ECG are reconstructed at multiple phase points. As a second step, the motion-vector field is calculated from the reconstructed images in relation to the image in a reference phase. Finally, a motion-compensated reconstruction is carried out for the reference phase using those projections, which cover the cardiac phases for which the motion-vector field has been determined.

  7. Cobalt-60 tomotherapy: Clinical treatment planning and phantom dose delivery studies

    SciTech Connect

    Dhanesar, Sandeep; Darko, Johnson; Joshi, Chandra P.; Kerr, Andrew; John Schreiner, L.

    2013-08-15

    Purpose: Investigations have shown that a Cobalt-60 (Co-60) radioactive source has the potential to play a role in intensity modulated radiation therapy (IMRT). In this paper, Co-60 tomotherapy's conformal dose delivery potential is evaluated by delivering conformal dose plans on a cylindrical homogeneous phantom containing clinical structures similar to those found in a typical head and neck (H and N) cancer. Also, the clinical potential of Co-60 tomotherapy is investigated by generating 2D clinical treatment plans for H and N and prostate anatomical regions. These plans are compared with the 6 MV based treatment plans for modalities such as linear accelerator-based tomotherapy and broad beam IMRT, and 15 MV based 3D conformal radiation therapy (3DCRT).Methods: For experimental validation studies, clinical and nonclinical conformal dose patterns were delivered on circular, homogeneous phantoms containing GafChromic film. For clinical planning study, dose calculations were performed with the EGSnrc Monte Carlo program, where a Theratronics 780C Co-60 unit and a 6 MV linear accelerator were modeled with a MIMiC binary multileaf collimator. An inhouse inverse treatment planning system was used to optimize tomotherapy plans using the same optimization parameters for both Co-60 and 6 MV beams. The IMRT and 3DCRT plans for the clinical cases were generated entirely in the Eclipse treatment planning system based on inhouse IMRT and 3DCRT site specific protocols.Results: The doses delivered to the homogeneous phantoms agreed with the calculations, indicating that it is possible to deliver highly conformal doses with the Co-60 unit. The dose distributions for Co-60 tomotherapy clinical plans for both clinical cases were similar to those obtained with 6 MV based tomotherapy and IMRT, and much more conformal compared to 3DCRT plans. The dose area histograms showed that the Co-60 plans achieve the dose objectives for the targets and organs at risk.Conclusions: These results

  8. Abutment region dosimetry for serial tomotherapy.

    PubMed

    Low, D A; Mutic, S; Dempsey, J F; Markman, J; Goddu, S M; Purdy, J A

    1999-08-01

    A commercial intensity modulated radiation therapy system (Corvus, NOMOS Corp.) is presently used in our clinic to generate optimized dose distributions delivered using a proprietary dynamic multileaf collimator (DMLC) (MIMiC) composed of 20 opposed leaf pairs. On our accelerator (Clinac 600C/D, Varian Associates, Inc.) each MIMiC leaf projects to either 1.00 x 0.84 or 1.00 x 1.70 cm2 (depending on the treatment plan and termed 1 cm or 2 cm mode, respectively). The MIMiC is used to deliver serial (axial) tomotherapy treatment plans, in which the beam is delivered to a nearly cylindrical volume as the DMLC is rotated about the patient. For longer targets, the patient is moved (indexed) between treatments a distance corresponding to the projected leaf width. The treatment relies on precise indexing and a method was developed to measure the precision of indexing devices. A treatment planning study of the dosimetric effects of incorrect patient indexing and concluded that a dose heterogeneity of 10% mm(-1) resulted. Because the results may be sensitive to the dose model accuracy, we conducted a measurement-based investigation of the consequences of incorrect indexing using our accelerator. Although the indexing provides an accurate field abutment along the isocenter, due to beam divergence, hot and cold spots will be produced below and above isocenter, respectively, when less than 300 degree arcs were used. A preliminary study recently determined that for a 290 degree rotation in 1 cm mode, 15% cold and 7% hot spots were delivered to 7 cm above and below isocenter, respectively. This study completes the earlier work by investigating the dose heterogeneity as a function of position relative to the axis of rotation, arc length, and leaf width. The influence of random daily patient positioning errors is also investigated. Treatment plans were generated using 8.0 cm diameter cylindrical target volumes within a homogeneous rectilinear film phantom. The plans included both 1

  9. A new experiment to investigate the origin of optical activity using a low energy positron beam of controlled helicity. [molecular biology

    NASA Technical Reports Server (NTRS)

    Gidley, D. W.; Rich, A.; Van House, J. C.; Zitzewitz, P. W.

    1981-01-01

    Previous experiments undertaken in search of a correlation between the origin of optical activity in biological molecules and the helicity of beta particles emitted in nuclear beta decay have not provided any useful results. A description is presented of an experiment in which a low energy polarized positron beam of controlled helicity interacts with an optically active material to form positronium in vacuum. Advantages of the current study compared to the previous experiments are mainly related to a much greater sensitivity. Initially, it will be possible to detect a helicity-dependent asymmetry in triplet positronium formation of 1 part in 10,000. Improvements to better than 1 part in 100,000 should be attainable.

  10. A new experiment to investigate the origin of optical activity using a low energy positron beam of controlled helicity. [molecular biology

    NASA Technical Reports Server (NTRS)

    Gidley, D. W.; Rich, A.; Van House, J. C.; Zitzewitz, P. W.

    1981-01-01

    Previous experiments undertaken in search of a correlation between the origin of optical activity in biological molecules and the helicity of beta particles emitted in nuclear beta decay have not provided any useful results. A description is presented of an experiment in which a low energy polarized positron beam of controlled helicity interacts with an optically active material to form positronium in vacuum. Advantages of the current study compared to the previous experiments are mainly related to a much greater sensitivity. Initially, it will be possible to detect a helicity-dependent asymmetry in triplet positronium formation of 1 part in 10,000. Improvements to better than 1 part in 100,000 should be attainable.

  11. Plasmonic gold helices for the visible range fabricated by oxygen plasma purification of electron beam induced deposits

    NASA Astrophysics Data System (ADS)

    Haverkamp, Caspar; Höflich, Katja; Jäckle, Sara; Manzoni, Anna; Christiansen, Silke

    2017-02-01

    Electron beam induced deposition (EBID) currently provides the only direct writing technique for truly three-dimensional nanostructures with geometrical features below 50 nm. Unfortunately, the depositions from metal-organic precursors suffer from a substantial carbon content. This hinders many applications, especially in plasmonics where the metallic nature of the geometric surfaces is mandatory. To overcome this problem a post-deposition treatment with oxygen plasma at room temperature was investigated for the purification of gold containing EBID structures. Upon plasma treatment, the structures experience a shrinkage in diameter of about 18 nm but entirely keep their initial shape. The proposed purification step results in a core-shell structure with the core consisting of mainly unaffected EBID material and a gold shell of about 20 nm in thickness. These purified structures are plasmonically active in the visible wavelength range as shown by dark field optical microscopy on helical nanostructures. Most notably, electromagnetic modeling of the corresponding scattering spectra verified that the thickness and quality of the resulting gold shell ensures an optical response equal to that of pure gold nanostructures.

  12. Measurement of the beam-helicity asymmetry I⊙ in the photoproduction of pairs off protons and off neutrons

    NASA Astrophysics Data System (ADS)

    Oberle, M.; Ahrens, J.; Annand, J. R. M.; Arends, H. J.; Bantawa, K.; Bartolome, P. A.; Beck, R.; Bekrenev, V.; Berghäuser, H.; Braghieri, A.; Branford, D.; Briscoe, W. J.; Brudvik, J.; Cherepnya, S.; Demissie, B.; Dieterle, M.; Downie, E. J.; Drexler, P.; Fil'kov, L. V.; Fix, A.; Glazier, D. I.; Heid, E.; Hornidge, D.; Howdle, D.; Huber, G. M.; Jahn, O.; Jaegle, I.; Jude, T. C.; Käser, A.; Kashevarov, V. L.; Keshelashvili, I.; Kondratiev, R.; Korolija, M.; Kruglov, S. P.; Krusche, B.; Kulbardis, A.; Lisin, V.; Livingston, K.; MacGregor, I. J. D.; Maghrbi, Y.; Mancell, J.; Manley, D. M.; Marinides, Z.; Martinez, M.; McGeorge, J. C.; McNicoll, E.; Mekterovic, D.; Metag, V.; Micanovic, S.; Middleton, D. G.; Mushkarenkov, A.; Nefkens, B. M. K.; Nikolaev, A.; Novotny, R.; Ostrick, M.; Oussena, B.; Pedroni, P.; Pheron, F.; Polonski, A.; Prakhov, S. N.; Robinson, J.; Rosner, G.; Rostomyan, T.; Schumann, S.; Sikora, M. H.; Sober, D. I.; Starostin, A.; Supek, I.; Thiel, M.; Thomas, A.; Unverzagt, M.; Watts, D. P.; Werthmüller, D.; Witthauer, L.; Zehr, F.

    2014-03-01

    Beam-helicity asymmetries have been measured at the MAMI accelerator in Mainz for the photoproduction of mixed-charge pion pairs in the reactions off free protons and and off quasi-free nucleons bound in the deuteron for incident photon energies up to 1.4GeV. Circularly polarized photons were produced from bremsstrahlung of longitudinally polarized electrons and tagged with the Glasgow-Mainz magnetic spectrometer. The charged pions, recoil protons, recoil neutrons, and decay photons from mesons were detected in the electromagnetic calorimeter composed of the Crystal Ball and TAPS detectors. Using a complete kinematic reconstruction of the final state, excellent agreement was found between the results for free and quasi-free protons, suggesting that the quasi-free neutron results are also a close approximation of the free-neutron asymmetries. A comparison of the results to the predictions of the Two-Pion-MAID reaction model shows that the reaction mechanisms are still not well understood, in particular at low incident photon energies in the second nucleon-resonance region.

  13. Plasmonic gold helices for the visible range fabricated by oxygen plasma purification of electron beam induced deposits.

    PubMed

    Haverkamp, Caspar; Höflich, Katja; Jäckle, Sara; Manzoni, Anna; Christiansen, Silke

    2017-02-03

    Electron beam induced deposition (EBID) currently provides the only direct writing technique for truly three-dimensional nanostructures with geometrical features below 50 nm. Unfortunately, the depositions from metal-organic precursors suffer from a substantial carbon content. This hinders many applications, especially in plasmonics where the metallic nature of the geometric surfaces is mandatory. To overcome this problem a post-deposition treatment with oxygen plasma at room temperature was investigated for the purification of gold containing EBID structures. Upon plasma treatment, the structures experience a shrinkage in diameter of about 18 nm but entirely keep their initial shape. The proposed purification step results in a core-shell structure with the core consisting of mainly unaffected EBID material and a gold shell of about 20 nm in thickness. These purified structures are plasmonically active in the visible wavelength range as shown by dark field optical microscopy on helical nanostructures. Most notably, electromagnetic modeling of the corresponding scattering spectra verified that the thickness and quality of the resulting gold shell ensures an optical response equal to that of pure gold nanostructures.

  14. The effect and stability of MVCT images on adaptive TomoTherapy.

    PubMed

    Yadav, Poonam; Tolakanahalli, Ranjini; Rong, Yi; Paliwal, Bhudatt R

    2010-07-02

    Use of helical TomoTherapy-based MVCT imaging for adaptive planning is becoming increasingly popular. Treatment planning and dose calculations based on MVCT require an image value to electron density calibration to remain stable over the course of treatment time. In this work, we have studied the dosimetric impact on TomoTherapy treatment plans due to variation in image value to density table (IVDT) curve as a function of target degradation. We also have investigated the reproducibility and stability of the TomoTherapy MVCT image quality over time. Multiple scans of the TomoTherapy "Cheese" phantom were performed over a period of five months. Over this period, a difference of 4.7% in the HU values was observed in high-density regions while there was no significant variation in the image values for the low densities of the IVDT curve. Changes in the IVDT curves before and after target replacement were measured. Two clinical treatment sites, pelvis and prostate, were selected to study the dosimetric impact of this variation. Dose was recalculated on the MVCTs with the planned fluence using IVDT curves acquired before and after target change. For the cases studied, target replacement resulted in an overall difference of less than 5%, which can be significant for hypo-fractionated cases. Hence, it is recommended to measure the IVDT curves on a monthly basis and after any major repairs/replacements.

  15. A dosimetric comparison between CyberKnife and tomotherapy treatment plans for single brain metastasis.

    PubMed

    Greto, Daniela; Pallotta, Stefania; Masi, Laura; Talamonti, Cinzia; Marrazzo, Livia; Doro, Raffaella; Saieva, Calogero; Scoccianti, Silvia; Desideri, Isacco; Livi, Lorenzo

    2017-05-01

    Radiosurgery (RS) is a well-established treatment in selected patients with brain metastasis. The aim of this study is to compare the differences between CyberKnife (CK) and TomoTherapy (HT) treatment plans of RS of single brain metastasis (BM) to define when HT should be used in cases beyond Cyberknife-when both systems are readily available for the radiation oncologist. Nineteen patients with single brain metastasis treated with CK were re-planned for radiosurgery using TomoTherapy Hi-ART system. Two planning approaches have been used for TomoTherapy plans: the classical one (HT) and the improved conformity (icHT) that produces dose distributions more similar to those of RS plans. PTV coverage, Conformity Index (CI), Paddick Conformity Index (nCI), Homogeneity Index (HI), Gradient Index (GI), and beam on time of CK, HT, and icHT plans were evaluated and compared. A good coverage was found for CK, HT, and icHT plans. A difference between mean HI of CK and icHT plans was observed (p = 0.007). Better dose gradients compared to both icHT and HT modalities were observed in CK plans. icHT modality showed improved mean CI respect to HT modality, similar to that obtained in CK plans. CK plans show higher conformity and lower GI than icHT and HT plans. TomoTherapy demonstrates the advantage of being a device capable to reach different clinical objectives depending on the different planning modality employed. CyberKnife and TomoTherapy are both optimal RS devices, the choice to use one over another has to be clinically guided.

  16. Tomotherapy-like versus VMAT-like treatments: a multicriteria comparison for a prostate geometry.

    PubMed

    Pardo-Montero, Juan; Fenwick, John D

    2012-12-01

    To perform a methodological comparison of volumetric modulated arc therapy (VMAT)-like and tomotherapy-like techniques for a prostate geometry, exploring the dependence on machine, delivery, and optimization parameters of cost function values optimized for each technique. A gradient-descent algorithm is used to optimize tomotherapy-like treatments, while VMAT-like optimization is carried out using a direct-aperture simulated annealing algorithm with 180 control points equispaced at 2° angles. Dose distributions are linked to fluences via a three-dimensional double-gaussian pencil beam model. Plans are optimized for a prostate geometry, outlined according to the CHHiP protocol. The cost function used for optimization contains ten simple functions, each of which describes a single planning objective. These functions are split into three structure groups according to whether they are used to control PTV, rectal or bladder dose levels. Different optimizations have been performed by varying the relative weights of each of these structure groups, exploring in this way a three-dimensional Pareto front. Plan quality is studied according to the value of the optimized cost function and the relative Euclidean distance between the components of the cost function and those of the nearest plan lying on a reference Pareto front obtained for tomotherapy-like plans generated using a 1 cm fan-beam width and 1/3 pitch. The quality of tomotherapy-like optimization depends on the fan-beam width, s, and rotation pitch, p, used to deliver the treatment. These values together define the effective longitudinal resolution with which fluence can be modulated, and lower cost function values are obtained for treatments optimized with tighter pitches and narrower fan-beam widths (higher modulation resolution). On the other hand, the cost function values of VMAT-like optimizations depends on the optimization running time, leaf displacement constraints, and number of arcs employed, as well as on

  17. A diagnostic tool for basic daily quality assurance of a Tomotherapy Hi*Art machine.

    PubMed

    Van de Vondel, Iwein; Tournel, Koen; Verellen, Dirk; Duchateau, Michael; Lelie, Steven; Storme, Guy

    2009-10-15

    To investigate and evaluate the use of an in-house developed diagnostic software tool using the imaging detector data for a quick daily quality assurance check of the output (dose) and lateral profile (cone) of a tomotherapy Hi*Art system. The Hi*Art treatment system is a radiation therapy machine for delivering intensity modulated radiation therapy (IMRT) in a helical fashion with an integrated CT scanner used for improved patient positioning before treatment. Since the system was developed specifically for IMRT, flat fields can be obtained by modulating the beam and therefore the flattening filter could be omitted. Because of this, the field has a cone-like profile in both lateral and transversal directions. Patients are treated in a helical fashion with a tight pitch and a constant gantry rotation speed, while modulation is performed by a binary MLC. Consequently dose output per time-unit (dose rate) as well as the shape of the cone-profile are very important for correct patient treatment and should be closely monitored. However, using the company-provided initial tools and conventional dosimetry, this can be a time consuming daily procedure. The aim of this work is to develop a fast, automated method of quality assurance based on the detector signal. A software tool called "tomocheck" running on the operation station has been developed to evaluate the output (dose rate) and the lateral cone profile (energy) of the Hi*Art system, comparing actual output and cone profile with a reference (previously approved against ionization chamber measurements). This is done by using the data of the 640 on-board detector array that are directly retrieved and processed after a specific QA procedure. The detector file consists of the CT detector data and the three monitoring dose chamber readings over a time period of 200 sec. To evaluate the method, the system was benchmarked against ionization chamber measurements and classical IMRT QA methods. Action levels (final status

  18. Azo-polymer film twisted to form a helical surface relief by illumination with a circularly polarized Gaussian beam.

    PubMed

    Masuda, Keigo; Nakano, Shogo; Barada, Daisuke; Kumakura, Mitsutaka; Miyamoto, Katsuhiko; Omatsu, Takashige

    2017-05-29

    A helical surface relief can be created in an azo-polymer film simply by illuminating circularly polarized light with spin angular momentum and without any orbital angular momentum. The helicity of the surface relief is determined by the sign of the spin angular momentum. The illumination of circularly polarized light induces orbital motion of the azo-polymer to shape the helical surface relief as an intermediate form; a subsequent transformation to a non-helical bump-shaped relief with a central peak creates a final form with additional exposure time. The mechanism for the formation of such a helical surface relief was also theoretically analyzed using the formula for the optical radiation force in a homogeneous and isotropic material.

  19. TomoTherapy MLC verification using exit detector data

    SciTech Connect

    Chen Quan; Westerly, David; Fang Zhenyu; Sheng, Ke; Chen Yu

    2012-01-15

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

  20. A study of tungsten spectra using large helical device and compact electron beam ion trap in NIFS

    NASA Astrophysics Data System (ADS)

    Morita, S.; Dong, C. F.; Goto, M.; Kato, D.; Murakami, I.; Sakaue, H. A.; Hasuo, M.; Koike, F.; Nakamura, N.; Oishi, T.; Sasaki, A.; Wang, E. H.

    2013-07-01

    Tungsten spectra have been observed from Large Helical Device (LHD) and Compact electron Beam Ion Trap (CoBIT) in wavelength ranges of visible to EUV. The EUV spectra with unresolved transition array (UTA), e.g., 6g-4f, 5g-4f, 5f-4d and 5p-4d transitions for W+24-+33, measured from LHD plasmas are compared with those measured from CoBIT with monoenergetic electron beam (≤2keV). The tungsten spectra from LHD are well analyzed based on the knowledge from CoBIT tungsten spectra. The C-R model code has been developed to explain the UTA spectra in details. Radial profiles of EUV spectra from highly ionized tungsten ions have been measured and analyzed by impurity transport simulation code with ADPAK atomic database code to examine the ionization balance determined by ionization and recombination rate coefficients. As the first trial, analysis of the tungsten density in LHD plasmas is attempted from radial profile of Zn-like WXLV (W44+) 4p-4s transition at 60.9Å based on the emission rate coefficient calculated with HULLAC code. As a result, a total tungsten ion density of 3.5×1010cm-3 at the plasma center is reasonably obtained. In order to observe the spectra from tungsten ions in lower-ionized charge stages, which can give useful information on the tungsten influx in fusion plasmas, the ablation cloud of the impurity pellet is directly measured with visible spectroscopy. A lot of spectra from neutral and singly ionized tungsten are observed and some of them are identified. A magnetic forbidden line from highly ionized tungsten ions has been examined and Cd-like WXXVII (W26+) at 3893.7Å is identified as the ground-term fine-structure transition of 4f23H5-3H4. The possibility of α particle diagnostic in D-T burning plasmas using the magnetic forbidden line is discussed.

  1. Evaluation of PTW Seven29 for tomotherapy patient-specific quality assurance and comparison with ScandiDos Delta(4).

    PubMed

    Myers, Pamela; Stathakis, Sotirios; Gutiérrez, Alonso N; Esquivel, Carlos; Mavroidis, Panayiotis; Papanikolaou, Niko

    2012-04-01

    For routine quality assurance of helical tomotherapy plans, an alternative method, as opposed to the TomoTherapy suggested cylindrical solid water phantom with film and ionization chamber, is proposed using the PTW Seven29 2D-ARRAY inserted in a dedicated octagonal phantom, called Octavius. First, the sensitivity of the array to pitch was studied by varying the pitch during planning to 0.287, 0.433, 1.0, and 2.0. For each pitch selected, the dependence on field size was investigated by generating plans with field widths (FWs) of 1.06 cm, 2.49 cm, and 5.02 cm, for a total of 12 plans. Secondly, a total of 15 patient QA plans were delivered using helical tomotherapy with the Delta(4) and Seven29/Octavius for comparison. Using the clinical gamma criteria, 3% and 3 mm, all FW and pitch plans had a passing percentage of >90%. For patient QA plans, the average gamma pass percentage was 97.0% (94.4-99.8%) for the Delta(4) and 97.6% (92.5-100.0%) for the Seven29/Octavius. Both the Seven29/Octavius and Delta(4) performed to a high standard of measurement accuracy and had a 90% or greater gamma percent for all plans and were considered clinically acceptable.

  2. Evaluation of PTW Seven29 for tomotherapy patient-specific quality assurance and comparison with ScandiDos Delta4

    PubMed Central

    Myers, Pamela; Stathakis, Sotirios; Gutiérrez, Alonso N.; Esquivel, Carlos; Mavroidis, Panayiotis; Papanikolaou, Niko

    2012-01-01

    For routine quality assurance of helical tomotherapy plans, an alternative method, as opposed to the TomoTherapy suggested cylindrical solid water phantom with film and ionization chamber, is proposed using the PTW Seven29 2D-ARRAY inserted in a dedicated octagonal phantom, called Octavius. First, the sensitivity of the array to pitch was studied by varying the pitch during planning to 0.287, 0.433, 1.0, and 2.0. For each pitch selected, the dependence on field size was investigated by generating plans with field widths (FWs) of 1.06 cm, 2.49 cm, and 5.02 cm, for a total of 12 plans. Secondly, a total of 15 patient QA plans were delivered using helical tomotherapy with the Delta4 and Seven29/Octavius for comparison. Using the clinical gamma criteria, 3% and 3 mm, all FW and pitch plans had a passing percentage of >90%. For patient QA plans, the average gamma pass percentage was 97.0% (94.4–99.8%) for the Delta4 and 97.6% (92.5-100.0%) for the Seven29/Octavius. Both the Seven29/Octavius and Delta4 performed to a high standard of measurement accuracy and had a 90% or greater gamma percent for all plans and were considered clinically acceptable. PMID:22557796

  3. Tomographic patient registration and conformal avoidance tomotherapy

    NASA Astrophysics Data System (ADS)

    Aldridge, Jennifer Stacy

    Development of tomotherapy has led to the emergence of several processes, providing the basis for many unique investigative opportunities. These processes include setup verification, tomographic verification, megavoltage dose reconstruction, and conformal avoidance tomotherapy. Setup verification and conformal avoidance tomotherapy, in particular, are two closely intertwined matters. In order to avoid critical structures located within or adjacent to indistinct tumor regions, accurate patient positioning from fraction to fraction must be ensured. With tomographic patient registration, a higher level of assurance is offered than with traditional positioning methods. Translational and rotational offsets are calculated directly from projection data using cross- correlation or fast Fourier transforms. Experiments assessing the algorithm's ability to calculate individual offsets were conducted using the University of Wisconsin's Tomotherapy Benchtop. These experiments indicate statistical errors within +/-1 mm for offsets up to approximately 20 mm, with maximum offset errors of about +/-2 mm for displacements up to 35 mm. The angular offset component is within +/-2°. To evaluate the registration process as a whole, experimental results from a few multi-parameter examples are also analyzed. With the development of tomographic patient registration in projection space, efforts to promote further sparing of critical structures are justified. Conformal avoidance tomotherapy has as its objective to treat an indistinct tumor region while conformally avoiding any normal critical structures in that region. To demonstrate the advantages of conformal avoidance tomotherapy, conventional and tomotherapy treatments are contrasted for both nasopharyngeal and breast carcinoma cases. For initial research efforts, computed tomography data sets of a human male and female were obtained via the ``Visible Human Project''. Since these data sets are on the order of hundreds of megabytes, both

  4. SU-E-T-349: Verification of a Monte Carlo Simulation Tool as a Second Check for TomoTherapy Treatment Planning

    SciTech Connect

    Yuan, J; Zheng, Y; Sohn, J; Wessels, B; Chen, Q

    2014-06-01

    Purpose: To verify a virtual source model used in Monte Carlo (MC) TomoTherapy simulations and to provide a tool for the dose distribution second check for TomoTherapy treatment planning. Methods: Published studies adopted the full MC model to simulate helical TomoTherapy which use phase space files (PSFs) at different scoring planes to facilitate patient dose calculations. We have developed a simple virtual source model (VSM) based on the commissioning data of helical TomoTherapy unit which can be exported from the treatment planning station (TPS). To calculate the patient dose distribution, TPS-generated sinograms are extracted from archived patient XML files and fluence maps are created by incorporating the openclose leaf time with leaf filter, jaw penumbra, and leaf latency. The VSM has been validated for various geometrical set-ups including open fields, heterogeneous media and clinical DQA cases. Results: Good agreement was obtained between our VSM and a published full MC model for the test case of heterogeneous media. For the complex clinical head and neck (HN) case, the MC simulation of the DQA plan agreed with the film measurement with 98% of planar dose pixels passing the 2%/2 mm gamma value test. For the patient treatment plan itself, the MC simulation showed comparable DVHs for the planning target volumes (PTVs) and organs-at-risk (OARs). Deviations observed were consistent with literature. Conclusion: The proposed VSM can be used in the MC method to accurately simulate the patient dose distributions for helical TomoTherapy.

  5. Preliminary Retrospective Analysis of Daily Tomotherapy Output Constancy Checks Using Statistical Process Control

    PubMed Central

    Menghi, Enrico; Marcocci, Francesco; Bianchini, David

    2016-01-01

    The purpose of this study was to retrospectively evaluate the results from a Helical TomoTherapy Hi-Art treatment system relating to quality controls based on daily static and dynamic output checks using statistical process control methods. Individual value X-charts, exponentially weighted moving average charts, and process capability and acceptability indices were used to monitor the treatment system performance. Daily output values measured from January 2014 to January 2015 were considered. The results obtained showed that, although the process was in control, there was an out-of-control situation in the principal maintenance intervention for the treatment system. In particular, process capability indices showed a decreasing percentage of points in control which was, however, acceptable according to AAPM TG148 guidelines. Our findings underline the importance of restricting the acceptable range of daily output checks and suggest a future line of investigation for a detailed process control of daily output checks for the Helical TomoTherapy Hi-Art treatment system. PMID:26848962

  6. Monte Carlo-based simulation of dynamic jaws tomotherapy

    SciTech Connect

    Sterpin, E.; Chen, Y.; Chen, Q.; Lu, W.; Mackie, T. R.; Vynckier, S.

    2011-09-15

    Purpose: Original TomoTherapy systems may involve a trade-off between conformity and treatment speed, the user being limited to three slice widths (1.0, 2.5, and 5.0 cm). This could be overcome by allowing the jaws to define arbitrary fields, including very small slice widths (<1 cm), which are challenging for a beam model. The aim of this work was to incorporate the dynamic jaws feature into a Monte Carlo (MC) model called TomoPen, based on the MC code PENELOPE, previously validated for the original TomoTherapy system. Methods: To keep the general structure of TomoPen and its efficiency, the simulation strategy introduces several techniques: (1) weight modifiers to account for any jaw settings using only the 5 cm phase-space file; (2) a simplified MC based model called FastStatic to compute the modifiers faster than pure MC; (3) actual simulation of dynamic jaws. Weight modifiers computed with both FastStatic and pure MC were compared. Dynamic jaws simulations were compared with the convolution/superposition (C/S) of TomoTherapy in the ''cheese'' phantom for a plan with two targets longitudinally separated by a gap of 3 cm. Optimization was performed in two modes: asymmetric jaws-constant couch speed (''running start stop,'' RSS) and symmetric jaws-variable couch speed (''symmetric running start stop,'' SRSS). Measurements with EDR2 films were also performed for RSS for the formal validation of TomoPen with dynamic jaws. Results: Weight modifiers computed with FastStatic were equivalent to pure MC within statistical uncertainties (0.5% for three standard deviations). Excellent agreement was achieved between TomoPen and C/S for both asymmetric jaw opening/constant couch speed and symmetric jaw opening/variable couch speed, with deviations well within 2%/2 mm. For RSS procedure, agreement between C/S and measurements was within 2%/2 mm for 95% of the points and 3%/3 mm for 98% of the points, where dose is greater than 30% of the prescription dose (gamma analysis

  7. SU-E-T-372: Dosimetric Comparison of Craniospinal Irradiation Using Different Tomotherapy Techniques

    SciTech Connect

    Zhang, X; Penagaricano, J; Han, E; Liang, X; Morrill, S; Hardee, M; Gupta, S; Vaneerat, R

    2014-06-01

    Purpose: TomoHDA can treat with fixed jaws, dynamic jaws, and fixed gantry using either 3DCRT or IMRT. This study compares PTV coverage, OAR sparing, and beam-on-time (BOT) among these techniques for craniospinal irradiation (CSI). Methods: This study includes ten CSI patients treated to 23.4 Gy/13 fractions with Hi-Art 3.0 unit (HT-IMRT fixed 5 cm jaw). New plans were regenerated with 5 cm jaw for TomoHDA Hi-Art 5.0 using dynamic jaw (HD-IMRT), TomoDirect-IMRT (TD-IMRT), and Helical Tomotherapy 3DCRT (HT-3DCRT using 5 cm and 2.5 cm jaws with various pitches). Studied parameters include PTV mean dose, D95 (dose covering 95% of PTV), Paddick's conformity index (CI) and homogeneity index (HI – standard deviation of PTV dose/average PTV dose), BOT, and average OAR doses. Results: PTV coverage from these techniques were comparable (p>0.05). The main differences were in OAR sparing; HDIMRT reduced more OAR doses for lenses, bladder and rectum compared to HT-IMRT. For the sparing of visceral organs: liver, lung, heart, and kidneys, the three IMRT techniques gave comparable results. HD-IMRT gave best heart sparing; HT-IMRT best kidney sparing. Liver and lung doses were best reduced by TD-IMRT. All three IMRT techniques gave comparable BOT. OARs sparing was achieved for jaw size of 2.5 cm. HI was also improved but with doubling of BOT. Increasing the pitch number from 0.2 to 0.43 produced no significant improvement in OAR sparing but CI and HI did improve. Conclusion: HT-3DCRT, HT-IMRT, HD-IMRT or TD-IMRT techniques give comparable PTV coverage but the three IMRT plans better spared OARs compared with 3DCRT plans. Dynamic jaw plan is superior to fixed jaw plan to spare more OAR doses at field edge. TD-IMRT cannot reduce BOT for CSI patient but for sparing certain OAR, TD-IMRT may be used to avoid the beam going through the structures of interest.

  8. MO-D-213-04: The Proximity to the Skin of PTV Affects PTV Coverage and Skin Dose for TomoTherapy

    SciTech Connect

    Reynolds, T; Higgins, P; Watanabe, Y

    2015-06-15

    Purpose: The proximity to the skin surface of the PTV for the patients with skin disease could be a concern in terms of the PTV coverage and actual surface dose (SD). IMRT optimization algorithms increase the beam intensity close to the skin in order to compensate for lack of scattering material, leading to enhanced SD but potential hot spots. This study aims to investigate the effect of PTV proximity to the skin on planning and measured SD Methods: All measurements were done for 6 MV X-ray beam of Helical TomoTherapy. An anthropomorphic phantom was scanned in a CT simulator in a routine manner with thermoplastic mask immobilization. PTVs were created with varying distances to the skin of 0 mm -(PTV1), 1 mm- (PTV2), 2 mm-(PTV3) and 3 mm-(PTV4). Also, a 5 mm bolus was used with PTV1 (PTV5). All planning constraints were kept the same in all studies (hard constraint: 95% of the prescription dose covered 95% of the PTV). Gafchromic film (EBT3) was placed under the mask on the phantom surface, and the resulting dose was estimated using RIT software. Results: Optimizing the dose using different PTVs lead to average planned target doses of 10.8, 10.3, 10.2, 10.3 and 10.0 Gy, with maximum doses 12.2, 11.2, 11.1, 11.1 and 10.0 Gy for PTV1, PTV2, PTV3, PTV4 and PTV5, respectively. EBT3 measurements indicated a significant decrease of SD with skin distance by 12.7% (PTV1), 21.9% (PTV2), 24.8% (PTV3) and 28.4% (PTV4) comparing to prescription dose. Placement of a 5 mm bolus on the phantom surface resulted in a SD close to prescribed (+0.5%). Conclusion: This work provides a clear demonstration of the relationship between the skin dose and the PTV to the skin distance. The results indicate the necessity of a bolus even for TomoTherapy when high skin dose is required.

  9. Helicity scalings

    NASA Astrophysics Data System (ADS)

    Plunian, F.; Lessinnes, T.; Carati, D.; Stepanov, R.

    2011-12-01

    Using a helical shell model of turbulence, Chen et al. (2003) showed that both helicity and energy dissipate at the Kolmogorov scale, independently from any helicity input. This is in contradiction with a previous paper by Ditlevsen & Giuliani (2001) in which, using a GOY shell model of turbulence, they found that helicity dissipates at a scale larger than the Kolmogorov scale, and does depend on the helicity input. In a recent paper by Lessinnes et al. (2011), we showed that this discrepancy is due to the fact that in the GOY shell model only one helical mode (+ or -) is present at each scale instead of both modes in the helical shell model. Then, using the GOY model, the near cancellation of the helicity flux between the + and - modes cannot occur at small scales, as it should be in true turbulence. We review the main results with a focus on the numerical procedure needed to obtain accurate statistics.

  10. Half-body irradiation with tomotherapy for pain palliation in metastatic breast cancer.

    PubMed

    Furlan, Carlo; Trovo, Marco; Drigo, Annalisa; Capra, Elvira; Trovo, Mauro Gaetano

    2014-01-01

    Half-body irradiation (HBI) is the fastest and most effective tool against uncontrolled pain from widespread bone metastases but is somewhat toxic. To assess the feasibility of lower HBI with helical tomotherapy in patients with metastatic breast cancer in terms of acute toxicity and delay in chemotherapy administration. Thirteen breast cancer patients with multiple painful bone metastases to the lower half of the body were enrolled in this prospective trial. Eight patients were receiving chemotherapy. Target volume included all bones from the L3-L4 interface to the femoral shafts. Radiation consisted of 8 Gy in one fraction, delivered with helical tomotherapy. Patients were premedicated only with oral steroids. Pain intensity was scored using the Numeric Rating Scale from 0 to 10. Toxicity was scored using the Common Terminology Criteria for Adverse Events, version 3.0. Quality of life was scored with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, before and 21 days after the radiation course. This trial was approved by the local review board. Median follow-up was at seven months (range 2-12 months). All but two patients had pain relief in the radiated field. Six patients stopped their analgesic drug consumption. Toxicity was acceptable: two Grade 3 hematologic toxicities were registered (anemia and leukopenia). Grade 1-2 toxicities were hematologic = 13, fever = 3, nausea = 2, and diarrhea = 1. Three of the eight patients had a delay in chemotherapy administration because of leukopenia or anemia. Twelve patients answered to European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, and an improved quality of life was documented in eight cases. Lower HBI delivered with helical tomotherapy resulted in a well-tolerated regimen, without significant delay in chemotherapy schedule. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All

  11. The Evolution of External Beam Radiation Therapy (EBRT) from a Technological Perspective.

    NASA Astrophysics Data System (ADS)

    Detorie, Nicholas

    2008-03-01

    Since the discovery of x-rays by Roentgen in 1895 ionizing radiations have been used as a treatment for cancer. Such treatments have been based on either implantation of radioactive materials at the site of disease or by aiming external radiation beams at the diseased site. This later method is referred to as teletherapy because the beams originate from a location outside of the body distant from the disease site itself. A brief review of the basic radiation biology will be given to illustrate the rationale for therapeutic use of ionizing radiations and the effects of beam energy and beam type- particulate or photon. The remainder of the presentation will focus on the technological teletherapy developments supported by the required physical properties of the beams and their associated characteristics that make them suitable for patient treatments. Chronological highlights will include the following sources or devices: superficial x-rays, orthovaltage x-rays, megavoltage x-rays and Cobalt 60 photons, electron beams, neutron beams, negative pi mesons, protons, and heavy ions. The presentation will illustrate how the physical beam properties have been incorporated into modern radiation treatment devices, many of which are equipped with radiation imaging capability. Such devices include: linacs equipped with multileaf collimators for beam shaping and intensity modulation, the Gamma Knife for precise and accurate irradiation of brain tumors or arterial-venous malformations (AVM), the robotic arm based Cyber Knife, and the Helical Tomotherapy unit.

  12. The concept and challenges of TomoTherapy accelerators

    NASA Astrophysics Data System (ADS)

    Bailat, Claude J.; Baechler, Sébastien; Moeckli, Raphael; Pachoud, Marc; Pisaturo, Olivier; Bochud, François O.

    2011-08-01

    A currently used intensity-modulated radiotherapy system is the TomoTherapy® Hi-Art® accelerator (Tomotherapy Inc., Madison, WI, USA), which started clinical treatments at the beginning of the new millennium. The innovative idea behind tomotherapy units is to marry an x-ray computed tomography unit with a linear particle accelerator. This concept has answered some of the needs of the medical physicist community, but epidemiological evaluations are still needed in order to compare the technique with other modalities. This paper summarizes the basic concepts of tomotherapy units as well as current challenges and implications for users.

  13. A simple derivation and analysis of a helical cone beam tomographic algorithm for long object imaging via a novel definition of region of interest.

    PubMed

    Hu, Jicun; Tam, Kwok; Johnson, Roger H

    2004-01-21

    We derive and analyse a simple algorithm first proposed by Kudo et al (2001 Proc. 2001 Meeting on Fully 3D Image Reconstruction in Radiology and Nuclear Medicine (Pacific Grove, CA) pp 7-10) for long object imaging from truncated helical cone beam data via a novel definition of region of interest (ROI). Our approach is based on the theory of short object imaging by Kudo et al (1998 Phys. Med. Biol. 43 2885-909). One of the key findings in their work is that filtering of the truncated projection can be divided into two parts: one, finite in the axial direction, results from ramp filtering the data within the Tam window. The other, infinite in the z direction, results from unbounded filtering of ray sums over PI lines only. We show that for an ROI defined by PI lines emanating from the initial and final source positions on a helical segment, the boundary data which would otherwise contaminate the reconstruction of the ROI can be completely excluded. This novel definition of the ROI leads to a simple algorithm for long object imaging. The overscan of the algorithm is analytically calculated and it is the same as that of the zero boundary method. The reconstructed ROI can be divided into two regions: one is minimally contaminated by the portion outside the ROI, while the other is reconstructed free of contamination. We validate the algorithm with a 3D Shepp-Logan phantom and a disc phantom.

  14. Development of A Novel Image Guidance Alternative for Patient Localization using Topographic Images for TomoTherapy

    NASA Astrophysics Data System (ADS)

    Qi, X. Sharon; White, Benjamin; Low, Daniel A.

    2014-03-01

    To develop a faster and lower dose topogram based image registration for TomoTherapy as an alternative image guidance tool to volumetric megavoltage computed tomography (MVCT). Topogram procedures were performed for an anthropomorphic thorax phantom on a TomoTherapy HD unit (Accuray Inc., Sunnyvale, CA) using couch speeds from 1-4 cm/s and gantry angles of 0 and 90 degrees, other scanning parameters are: 1 mm imaging jaw, compression factor of 1, 30 seconds scanning duration with all multileaf collimators (MLCs) open. The raw exit detector data was exported after each scan. The topogram was reconstructed from a fan beam source for TomoTherapy beam and detector geometry at a SSD of 85 cm. A reference image, so called Digitally Reconstructed Topogram (DRT) was created by integrating the trajectories through the kVCT simulation with the topogram geometry. Image registration was performed by visually aligning the bony structure in topogram to the DRT. Image resolution was determined by the radius of curvature for the detector array, source to axis distance, source to detector distance, detector spacing, and number of detectors. The localization errors were 1.5, 2.5 mm in medio-lateral and anterior-posterior direction, larger errors in cranial-caudal direction was observed for faster couch speeds (i.e., >=3cm/s). The topographic imaging time was 30 sec (versus 3-5 minutes for MVCT thorax scan) with imaging dose less than 1% of MVCT scan. Topograms with appropriate couch speed provide reliable patient localization images while significantly reducing pre-treatment imaging time. Topogram can be used as an alternative and/or additional patient alignment tool to MVCT on TomoTherapy.

  15. Self-consistent analysis of radiation and relativistic electron beam dynamics in a helical wiggler using Lienard-Wiechert fields

    SciTech Connect

    Tecimer, M.; Elias, L.R.

    1995-12-31

    Lienard-Wiechert (LW) fields, which are exact solutions of the Wave Equation for a point charge in free space, are employed to formulate a self-consistent treatment of the electron beam dynamics and the evolution of the generated radiation in long undulators. In a relativistic electron beam the internal forces leading to the interaction of the electrons with each other can be computed by means of retarded LW fields. The resulting electron beam dynamics enables us to obtain three dimensional radiation fields starting from an initial incoherent spontaneous emission, without introducing a seed wave at start-up. Based on the formalism employed here, both the evolution of the multi-bucket electron phase space dynamics in the beam body as well as edges and the relative slippage of the radiation with respect to the electrons in the considered short bunch are naturally embedded into the simulation model. In this paper, we present electromagnetic radiation studies, including multi-bucket electron phase dynamics and angular distribution of radiation in the time and frequency domain produced by a relativistic short electron beam bunch interacting with a circularly polarized magnetic undulator.

  16. B-Spline registration based on new concept of an intelligent masking procedure and GPU computations for the head and neck adaptive tomotherapy.

    PubMed

    Piotrowski, T; Ryczkowski, A; Kazmierska, J

    2012-06-01

    The deformable image registration (DIR) procedure has been optimized for helical tomotherapy. The data on registration shifts obtained on matching planning image with pre-treatment megavoltage CT are used in our software for acceleration of the first step (rigid registration) of the DIR procedure and for implementation of the B-Spline algorithm with intelligent masking. Priorities of the masks were automatically calculated based on disagreement detected during rigid registration. Evaluation tasks included: (a) comparison of accuracy and rate for schemes of pre-registered and non-registered images; (b) qualification of the effectiveness of the intelligent masking process, and (c) determination of acceleration of achievable with GPU computing. A specially designed head and neck phantom used for evaluation included structures with controlled changes of position, volume, density, and shape. Re-contouring procedures were performed with an Adaptive Planning software (Tomotherapy Inc.). No statistical difference was observed in accuracy of DIR based on structure position match on the tomotherapy unit and non pre-registered images (p > 0.7). Using pre-registered data reduces the total time required for execution of the elastic registration procedure by 5%. These data are also necessary for intelligent masking procedure during B-Spine registration. Intelligent masking procedure increases accuracy of the registration for a masked structure (p < 0.04) without decreasing the accuracy in non-masked tissues and additionally reduces the total time by 13%. GPU computations speed up procedure 30 times. GPU computing of the DIR in current status of our investigation could be realized in a relatively short time after pre-treatment imaging. The proposed approach can be used in the routine assessment of anatomic changes occurring in healthy tissue during the course of radiotherapy. Further developments will be concentrated on the full integration of DIR computations in the imaging and

  17. SU-E-T-370: Evaluating Plan Quality and Dose Delivery Accuracy of Tomotherapy SBRT Treatments for Lung Cancer

    SciTech Connect

    Blake, S; Thwaites, D; Hansen, C; Deshpande, S; Phan, P; Franji, I; Holloway, L

    2015-06-15

    Purpose: This study evaluated the plan quality and dose delivery accuracy of stereotactic body radiotherapy (SBRT) helical Tomotherapy (HT) treatments for lung cancer. Results were compared with those previously reported by our group for flattening filter (FF) and flattening filter free (FFF) VMAT treatments. This work forms part of an ongoing multicentre and multisystem planning and dosimetry audit on FFF beams for lung SBRT. Methods: CT datasets and DICOM RT structures delineating the target volume and organs at risk for 6 lung cancer patients were selected. Treatment plans were generated using the HT treatment planning system. Tumour locations were classified as near rib, near bronchial tree or in free lung with prescribed doses of 48Gy/4fr, 50Gy/5fr and 54Gy/3fr respectively. Dose constraints were specified by a modified RTOG0915 protocol used for an Australian SBRT phase II trial. Plan quality was evaluated using mean PTV dose, PTV volume receiving 100% of the prescribed dose (V100%), target conformity (CI=VD100%/VPTV) and low dose spillage (LDS=VD50%/VPTV). Planned dose distributions were compared to those measured using an ArcCheck phantom. Delivery accuracy was evaluated using a gamma-index pass rate of 95% with 3% (of max dose) and 3mm criteria. Results: Treatment plans for all patients were clinically acceptable in terms of quality and accuracy of dose delivery. The following DVH metrics are reported as averages (SD) of all plans investigated: mean PTV dose was 115.3(2.4)% of prescription, V100% was 98.8(0.9)%, CI was 1.14(0.03) and LDS was 5.02(0.37). The plans had an average gamma-index passing rate of 99.3(1.3)%. Conclusion: The results reported in this study for HT agree within 1 SD to those previously published by our group for VMAT FF and FFF lung SBRT treatments. This suggests that HT delivers lung SBRT treatments of comparable quality and delivery accuracy as VMAT using both FF and FFF beams.

  18. Reference dosimetry on TomoTherapy: an addendum to the 1990 UK MV dosimetry code of practice

    NASA Astrophysics Data System (ADS)

    Thomas, S. J.; Aspradakis, M. M.; Byrne, J. P.; Chalmers, G.; Duane, S.; Rogers, J.; Thomas, R. A. S.; Tudor, G. S. J.; Twyman, N.

    2014-03-01

    The current UK code of practice for high-energy photon therapy dosimetry (Lillicrap et al 1990 Phys. Med. Biol. 35 1355-60) gives instructions for measuring absorbed dose to water under reference conditions for megavoltage photons. The reference conditions and the index used to specify beam quality require that a machine be able to set a 10 cm × 10 cm field at the point of measurement. TomoTherapy machines have a maximum collimator setting of 5 cm × 40 cm at a source to axis distance of 85 cm, making it impossible for users of these machines to follow the code. This addendum addresses the specification of reference irradiation geometries, the choice of ionization chambers and the determination of dosimetry corrections, the derivation of absorbed dose to water calibration factors and choice of appropriate chamber correction factors, for carrying out reference dosimetry measurements on TomoTherapy machines. The preferred secondary standard chamber remains the NE2611 chamber, which with its associated secondary standard electrometer, is calibrated at the NPL through the standard calibration service for MV photon beams produced on linear accelerators with conventional flattening filters. Procedures are given for the derivation of a beam quality index specific to the TomoTherapy beam that can be used in the determination of a calibration coefficient for the secondary standard chamber from its calibration certificate provided by the NPL. The recommended method of transfer from secondary standard to field instrument is in a static beam, at a depth of 5 cm, by sequential substitution or by simultaneous side by side irradiation in either a water phantom or a water-equivalent solid phantom. Guidance is given on the use of a field instrument in reference fields.

  19. Two new DOSXYZnrc sources for 4D Monte Carlo simulations of continuously variable beam configurations, with applications to RapidArc, VMAT, TomoTherapy and CyberKnife

    NASA Astrophysics Data System (ADS)

    Lobo, Julio; Antoniu Popescu, I.

    2010-08-01

    We present two new Monte Carlo sources for the DOSXYZnrc code, which can be used to compute dose distributions due to continuously variable beam configurations. These sources support a continuously rotating gantry and collimator, dynamic multileaf collimator (MLC) motion, variable monitor unit (MU) rate, couch rotation and translation in any direction, arbitrary isocentre motion with respect to the patient and variable source-to-axis distance (SAD). These features make them applicable to Monte Carlo simulations for RapidArc™, Elekta VMAT, TomoTherapy™ and CyberKnife™. Unique to these sources is the synchronization between the motion in the DOSXYZnrc geometry and the motion within the linac head, represented by a shared library (either a BEAMnrc accelerator with dynamic component modules, or an external library). The simulations are achieved in single runs, with no intermediate phase space files.

  20. Measurement of the beam-helicity asymmetry I⊙ in the photoproduction of π0-pairs off the proton and off the neutron

    NASA Astrophysics Data System (ADS)

    Oberle, M.; Krusche, B.; Ahrens, J.; Annand, J. R. M.; Arends, H. J.; Bantawa, K.; Bartolome, P. A.; Beck, R.; Bekrenev, V.; Berghäuser, H.; Braghieri, A.; Branford, D.; Briscoe, W. J.; Brudvik, J.; Cherepnya, S.; Demissie, B.; Dieterle, M.; Downie, E. J.; Drexler, P.; Fil'kov, L. V.; Fix, A.; Glazier, D. I.; Heid, E.; Hornidge, D.; Howdle, D.; Huber, G. M.; Jahn, O.; Jaegle, I.; Jude, T. C.; Käser, A.; Kashevarov, V. L.; Keshelashvili, I.; Kondratiev, R.; Korolija, M.; Kruglov, S. P.; Kulbardis, A.; Lisin, V.; Livingston, K.; MacGregor, I. J. D.; Maghrbi, Y.; Mancell, J.; Manley, D. M.; Marinides, Z.; Martinez, M.; McGeorge, J. C.; McNicoll, E.; Mekterovic, D.; Metag, V.; Micanovic, S.; Middleton, D. G.; Mushkarenkov, A.; Nefkens, B. M. K.; Nikolaev, A.; Novotny, R.; Ostrick, M.; Oussena, B.; Pedroni, P.; Pheron, F.; Polonski, A.; Prakhov, S. N.; Robinson, J.; Rosner, G.; Rostomyan, T.; Schumann, S.; Sikora, M. H.; Sober, D. I.; Starostin, A.; Supek, I.; Thiel, M.; Thomas, A.; Unverzagt, M.; Watts, D. P.; Werthmüller, D.; Witthauer, L.; Zehr, F.

    2013-04-01

    Beam-helicity asymmetries have been measured at the MAMI accelerator in Mainz for the photoproduction of neutral pion pairs in the reactions γ→ p → pπ0π0 and γ→ d → (n) pπ0π0, γ→ d → (p) nπ0π0 off free protons and off quasi-free nucleons bound in the deuteron for incident photon energies up to 1.4 GeV. Circularly polarized photons were produced from bremsstrahlung of longitudinally polarized electrons and tagged with the Glasgow magnetic spectrometer. Decay photons from the π0 mesons, recoil protons, and recoil neutrons were detected in the 4π covering electromagnetic calorimeter composed of the Crystal Ball and TAPS detectors. After kinematic reconstruction of the final state, excellent agreement was found between the results for free and quasi-free protons. This demonstrates that the free-nucleon behavior of such observables can be extracted from measurements with quasi-free nucleons, which is the only possibility for the neutron. Contrary to expectations, the measured asymmetries are very similar for reactions off protons and neutrons. The results are compared to the predictions from the Two-Pion MAID reaction model and (for the proton) also to the Bonn-Gatchina coupled channel analysis.

  1. Diffraction of a finite-radius plane wave and a Gaussian beam by a helical axicon and a spiral phase plate.

    PubMed

    Kotlyar, Victor V; Kovalev, Alexey A; Skidanov, Roman V; Moiseev, Oleg Yu; Soifer, Victor A

    2007-07-01

    We derive what we believe to be new analytical relations to describe the Fraunhofer diffraction of the finite-radius plane wave by a helical axicon (HA) and a spiral phase plate (SPP). The solutions are deduced in the form of a series of the Bessel functions for the HA and a finite sum of the Bessel functions for the SPP. The solution for the HA changes to that for the SPP if the axicon parameter is set equal to zero. We also derive what we believe to be new analytical relations to describe the Fresnel and Fraunhofer diffraction of the Gaussian beam by a HA are derived. The solutions are deduced in the form of a series of the hypergeometric functions. We have fabricated by photolithography a binary diffractive optical element (a HA with number n=10) able to produce in the focal plane of a spherical lens an optical vortex, which was then used to perform rotation of several polystyrene beads of diameter 5 microm.

  2. Beam-target helicity asymmetry for γ→n→→π-p in the N* resonance region

    DOE PAGES

    Ho, D.; Peng, P.; Bass, C.; ...

    2017-06-16

    In this paper, we report the first beam-target double-polarization asymmetries in themore » $$\\gamma + n(p) \\rightarrow \\pi^- + p(p)$$ reaction spanning the nucleon resonance region from invariant mass $W$= $1500$ to $2300$ MeV. Circularly polarized photons and longitudinally polarized deuterons in $HD$ have been used with the CLAS detector at Jefferson Lab. The exclusive final state has been extracted using three very different analysis techniques that show excellent agreement, and these have been used to deduce the $E$ polarization observable for an effective neutron target. These results have been incorporated into new partial wave analyses, and have led to revised values for several $$\\gamma nN^*$$ resonance photo-couplings.« less

  3. Beam-Target Helicity Asymmetry for γ → n → →π-p in the N* Resonance Region

    NASA Astrophysics Data System (ADS)

    Ho, D.; Peng, P.; Bass, C.; Collins, P.; D'Angelo, A.; Deur, A.; Fleming, J.; Hanretty, C.; Kageya, T.; Khandaker, M.; Klein, F. J.; Klempt, E.; Laine, V.; Lowry, M. M.; Lu, H.; Nepali, C.; Nikonov, V. A.; O'Connell, T.; Sandorfi, A. M.; Sarantsev, A. V.; Schumacher, R. A.; Strakovsky, I. I.; Švarc, A.; Walford, N. K.; Wei, X.; Whisnant, C. S.; Workman, R. L.; Zonta, I.; Adhikari, K. P.; Adikaram, D.; Akbar, Z.; Amaryan, M. J.; Anefalos Pereira, S.; Avakian, H.; Ball, J.; Bashkanov, M.; Battaglieri, M.; Batourine, V.; Bedlinskiy, I.; Biselli, A.; Briscoe, W. J.; Burkert, V. D.; Carman, D. S.; Celentano, A.; Charles, G.; Chetry, T.; Ciullo, G.; Clark, L.; Colaneri, L.; Cole, P. L.; Contalbrigo, M.; Crede, V.; Dashyan, N.; De Sanctis, E.; De Vita, R.; Djalali, C.; Dupre, R.; El Alaoui, A.; El Fassi, L.; Elouadrhiri, L.; Eugenio, P.; Fedotov, G.; Fegan, S.; Fersch, R.; Filippi, A.; Fradi, A.; Ghandilyan, Y.; Gilfoyle, G. P.; Girod, F. X.; Glazier, D. I.; Gleason, C.; Gohn, W.; Golovatch, E.; Gothe, R. W.; Griffioen, K. A.; Guidal, M.; Guo, L.; Hakobyan, H.; Harrison, N.; Hattawy, M.; Hicks, K.; Holtrop, M.; Hughes, S. M.; Ilieva, Y.; Ireland, D. G.; Ishkhanov, B. S.; Isupov, E. L.; Jenkins, D.; Jiang, H.; Jo, H. S.; Joo, K.; Joosten, S.; Keller, D.; Khachatryan, G.; Kim, A.; Kim, W.; Klein, A.; Kubarovsky, V.; Kuleshov, S. V.; Lanza, L.; Lenisa, P.; Livingston, K.; MacGregor, I. J. D.; Markov, N.; McKinnon, B.; Mineeva, T.; Mokeev, V.; Montgomery, R. A.; Movsisyan, A.; Munoz Camacho, C.; Murdoch, G.; Niccolai, S.; Niculescu, G.; Osipenko, M.; Paolone, M.; Paremuzyan, R.; Park, K.; Pasyuk, E.; Phelps, W.; Pogorelko, O.; Price, J. W.; Procureur, S.; Protopopescu, D.; Ripani, M.; Riser, D.; Ritchie, B. G.; Rizzo, A.; Rosner, G.; Sabatié, F.; Salgado, C.; Sharabian, Y. G.; Skorodumina, Iu.; Smith, G. D.; Sober, D. I.; Sokhan, D.; Sparveris, N.; Strauch, S.; Tian, Ye; Torayev, B.; Ungaro, M.; Voskanyan, H.; Voutier, E.; Watts, D. P.; Wood, M. H.; Zachariou, N.; Zhang, J.; Zhao, Z. W.; CLAS Collaboration

    2017-06-01

    We report the first beam-target double-polarization asymmetries in the γ +n (p )→π-+p (p ) reaction spanning the nucleon resonance region from invariant mass W =1500 to 2300 MeV. Circularly polarized photons and longitudinally polarized deuterons in solid hydrogen deuteride (HD) have been used with the CEBAF Large Acceptance Spectrometer (CLAS) at Jefferson Lab. The exclusive final state has been extracted using three very different analyses that show excellent agreement, and these have been used to deduce the E polarization observable for an effective neutron target. These results have been incorporated into new partial wave analyses and have led to significant revisions for several γ n N* resonance photocouplings.

  4. Synthesis of Current-Voltage Characteristics of 670 GHz Gyrotron Magnetron Injection Gun and Calculation of the Helical Electron Beam Parameters at the Leading Edge of a High-Voltage Pulse

    NASA Astrophysics Data System (ADS)

    Manuilov, V. N.; Glyavin, M. Yu.

    2013-02-01

    A method of synthesis of current-voltage characteristics (CVC) and calculation of the parameters of a helical electron beam (HEB) at the leading edge of the accelerating voltage pulse for gyrotron electron guns is proposed. These data can be used for a study of the gyrotron startup scenario with the mode competition taken into account. As an example, the results of calculations for a pulsed gyrotron with a frequency of 670 GHz are presented.

  5. SU-E-I-15: Quantitative Evaluation of Dose Distributions From Axial, Helical and Cone-Beam CT Imaging by Measurement Using a Two-Dimensional Diode-Array Detector

    SciTech Connect

    Chacko, M; Aldoohan, S; Sonnad, J; Ahmad, S; Ali, I

    2015-06-15

    Purpose: To evaluate quantitatively dose distributions from helical, axial and cone-beam CT clinical imaging techniques by measurement using a two-dimensional (2D) diode-array detector. Methods: 2D-dose distributions from selected clinical protocols used for axial, helical and cone-beam CT imaging were measured using a diode-array detector (MapCheck2). The MapCheck2 is composed from solid state diode detectors that are arranged in horizontal and vertical lines with a spacing of 10 mm. A GE-Light-Speed CT-simulator was used to acquire axial and helical CT images and a kV on-board-imager integrated with a Varian TrueBeam-STx machine was used to acquire cone-beam CT (CBCT) images. Results: The dose distributions from axial, helical and cone-beam CT were non-uniform over the region-of-interest with strong spatial and angular dependence. In axial CT, a large dose gradient was measured that decreased from lateral sides to the middle of the phantom due to large superficial dose at the side of the phantom in comparison with larger beam attenuation at the center. The dose decreased at the superior and inferior regions in comparison to the center of the phantom in axial CT. An asymmetry was found between the right-left or superior-inferior sides of the phantom which possibly to angular dependence in the dose distributions. The dose level and distribution varied from one imaging technique into another. For the pelvis technique, axial CT deposited a mean dose of 3.67 cGy, helical CT deposited a mean dose of 1.59 cGy, and CBCT deposited a mean dose of 1.62 cGy. Conclusions: MapCheck2 provides a robust tool to measure directly 2D-dose distributions for CT imaging with high spatial resolution detectors in comparison with ionization chamber that provides a single point measurement or an average dose to the phantom. The dose distributions measured with MapCheck2 consider medium heterogeneity and can represent specific patient dose.

  6. Technical Note: FreeCT_wFBP: A robust, efficient, open-source implementation of weighted filtered backprojection for helical, fan-beam CT

    PubMed Central

    Hoffman, John; Young, Stefano; Noo, Frédéric

    2016-01-01

    Purpose: With growing interest in quantitative imaging, radiomics, and CAD using CT imaging, the need to explore the impacts of acquisition and reconstruction parameters has grown. This usually requires extensive access to the scanner on which the data were acquired and its workflow is not designed for large-scale reconstruction projects. Therefore, the authors have developed a freely available, open-source software package implementing a common reconstruction method, weighted filtered backprojection (wFBP), for helical fan-beam CT applications. Methods: FreeCT_wFBP is a low-dependency, GPU-based reconstruction program utilizing c for the host code and Nvidia CUDA C for GPU code. The software is capable of reconstructing helical scans acquired with arbitrary pitch-values, and sampling techniques such as flying focal spots and a quarter-detector offset. In this work, the software has been described and evaluated for reconstruction speed, image quality, and accuracy. Speed was evaluated based on acquisitions of the ACR CT accreditation phantom under four different flying focal spot configurations. Image quality was assessed using the same phantom by evaluating CT number accuracy, uniformity, and contrast to noise ratio (CNR). Finally, reconstructed mass-attenuation coefficient accuracy was evaluated using a simulated scan of a FORBILD thorax phantom and comparing reconstructed values to the known phantom values. Results: The average reconstruction time evaluated under all flying focal spot configurations was found to be 17.4 ± 1.0 s for a 512 row × 512 column × 32 slice volume. Reconstructions of the ACR phantom were found to meet all CT Accreditation Program criteria including CT number, CNR, and uniformity tests. Finally, reconstructed mass-attenuation coefficient values of water within the FORBILD thorax phantom agreed with original phantom values to within 0.0001 mm2/g (0.01%). Conclusions: FreeCT_wFBP is a fast, highly configurable reconstruction package for

  7. Technical Note: FreeCT_wFBP: A robust, efficient, open-source implementation of weighted filtered backprojection for helical, fan-beam CT.

    PubMed

    Hoffman, John; Young, Stefano; Noo, Frédéric; McNitt-Gray, Michael

    2016-03-01

    With growing interest in quantitative imaging, radiomics, and CAD using CT imaging, the need to explore the impacts of acquisition and reconstruction parameters has grown. This usually requires extensive access to the scanner on which the data were acquired and its workflow is not designed for large-scale reconstruction projects. Therefore, the authors have developed a freely available, open-source software package implementing a common reconstruction method, weighted filtered backprojection (wFBP), for helical fan-beam CT applications. FreeCT_wFBP is a low-dependency, GPU-based reconstruction program utilizing c for the host code and Nvidia CUDA C for GPU code. The software is capable of reconstructing helical scans acquired with arbitrary pitch-values, and sampling techniques such as flying focal spots and a quarter-detector offset. In this work, the software has been described and evaluated for reconstruction speed, image quality, and accuracy. Speed was evaluated based on acquisitions of the ACR CT accreditation phantom under four different flying focal spot configurations. Image quality was assessed using the same phantom by evaluating CT number accuracy, uniformity, and contrast to noise ratio (CNR). Finally, reconstructed mass-attenuation coefficient accuracy was evaluated using a simulated scan of a FORBILD thorax phantom and comparing reconstructed values to the known phantom values. The average reconstruction time evaluated under all flying focal spot configurations was found to be 17.4 ± 1.0 s for a 512 row × 512 column × 32 slice volume. Reconstructions of the ACR phantom were found to meet all CT Accreditation Program criteria including CT number, CNR, and uniformity tests. Finally, reconstructed mass-attenuation coefficient values of water within the FORBILD thorax phantom agreed with original phantom values to within 0.0001 mm(2)/g (0.01%). FreeCT_wFBP is a fast, highly configurable reconstruction package for third-generation CT available under

  8. Application of failure mode and effects analysis (FMEA) to pretreatment phases in tomotherapy.

    PubMed

    Broggi, Sara; Cantone, Marie Claire; Chiara, Anna; Di Muzio, Nadia; Longobardi, Barbara; Mangili, Paola; Veronese, Ivan

    2013-09-06

    The aim of this paper was the application of the failure mode and effects analysis (FMEA) approach to assess the risks for patients undergoing radiotherapy treatments performed by means of a helical tomotherapy unit. FMEA was applied to the preplanning imaging, volume determination, and treatment planning stages of the tomotherapy process and consisted of three steps: 1) identification of the involved subprocesses; 2) identification and ranking of the potential failure modes, together with their causes and effects, using the risk probability number (RPN) scoring system; and 3) identification of additional safety measures to be proposed for process quality and safety improvement. RPN upper threshold for little concern of risk was set at 125. A total of 74 failure modes were identified: 38 in the stage of preplanning imaging and volume determination, and 36 in the stage of planning. The threshold of 125 for RPN was exceeded in four cases: one case only in the phase of preplanning imaging and volume determination, and three cases in the stage of planning. The most critical failures appeared related to (i) the wrong or missing definition and contouring of the overlapping regions, (ii) the wrong assignment of the overlap priority to each anatomical structure, (iii) the wrong choice of the computed tomography calibration curve for dose calculation, and (iv) the wrong (or not performed) choice of the number of fractions in the planning station. On the basis of these findings, in addition to the safety strategies already adopted in the clinical practice, novel solutions have been proposed for mitigating the risk of these failures and to increase patient safety.

  9. Effects of changing modulation and pitch parameters on tomotherapy delivery quality assurance plans.

    PubMed

    Binny, Diana; Lancaster, Craig M; Harris, Selina; Sylvander, Steven R

    2015-09-08

    This study was aimed at investigating delivery quality assurance (DQA) discrepancies observed for helical tomotherapy plans. A selection of tomotherapy plans that initially failed the DQA process was chosen for this investigation. These plans failed the fluence analysis as assessed using gamma criteria (3%, 3 mm) with radiographic film. Each of these plans was modified (keeping the planning constraints the same), beamlets rebatched and reoptimized. By increasing and decreasing the modulation factor, the fluence in a circumferential plane as measured with a diode array was assessed. A subset of these plans was investigated using varied pitch values. Metrics for each plan that were examined were point doses, fluences, leaf opening times, planned leaf sinograms, and uniformity indices. In order to ensure that the treatment constraints remained the same, the dose-volume histograms (DVHs) of all the modulated plans were compared to the original plan. It was observed that a large increase in the modulation factor did not significantly improve DVH uniformity, but reduced the gamma analysis pass rate. This also increased the treatment delivery time by slowing down the gantry rotation speed which then increases the maximum to mean non-zero leaf open time ratio. Increasing and decreasing the pitch value did not substantially change treatment time, but the delivery accuracy was adversely affected. This may be due to many other factors, such as the complexity of the treatment plan and site. Patient sites included in this study were head and neck, right breast, prostate, abdomen, adrenal, and brain. The impact of leaf timing inaccuracies on plans was greater with higher modulation factors. Point-dose measurements were seen to be less susceptible to changes in pitch and modulation factors. The initial modulation factor used by the optimizer, such that the TPS generated 'actual' modulation factor within the range of 1.4 to 2.5, resulted in an improved deliverable plan.

  10. Effects of changing modulation and pitch parameters on tomotherapy delivery quality assurance plans.

    PubMed

    Binny, Diana; Lancaster, Craig M; Harris, Selina; Sylvander, Steven R

    2015-09-01

    This study was aimed at investigating delivery quality assurance (DQA) discrepancies observed for helical tomotherapy plans. A selection of tomotherapy plans that initially failed the DQA process was chosen for this investigation. These plans failed the fluence analysis as assessed using gamma criteria (3%, 3 mm) with radiographic film. Each of these plans was modified (keeping the planning constraints the same), beamlets rebatched and reoptimized. By increasing and decreasing the modulation factor, the fluence in a circumferential plane as measured with a diode array was assessed. A subset of these plans was investigated using varied pitch values. Metrics for each plan that were examined were point doses, fluences, leaf opening times, planned leaf sinograms, and uniformity indices. In order to ensure that the treatment constraints remained the same, the dose-volume histograms (DVHs) of all the modulated plans were compared to the original plan. It was observed that a large increase in the modulation factor did not significantly improve DVH uniformity, but reduced the gamma analysis pass rate. This also increased the treatment delivery time by slowing down the gantry rotation speed which then increases the maximum to mean non-zero leaf open time ratio. Increasing and decreasing the pitch value did not substantially change treatment time, but the delivery accuracy was adversely affected. This may be due to many other factors, such as the complexity of the treatment plan and site. Patient sites included in this study were head and neck, right breast, prostate, abdomen, adrenal, and brain. The impact of leaf timing inaccuracies on plans was greater with higher modulation factors. Point-dose measurements were seen to be less susceptible to changes in pitch and modulation factors. The initial modulation factor used by the optimizer, such that the TPS generated 'actual' modulation factor within the range of 1.4 to 2.5, resulted in an improved deliverable plan. PACS

  11. Minimum detection windows, PI-line existence and uniqueness for helical cone-beam scanning of variable pitch.

    PubMed

    Ye, Yangbo; Zhu, Jiehua; Wang, Ge

    2004-03-01

    The goal of this paper is to study Cone-beam CT scanning along a helix of variable pitch. First the rationale and applications in medical imaging of variable pitch CT reconstruction are explained. Then formulas for the minimum detection window are derived. The main part of the paper proves a necessary and sufficient condition for the existence and uniqueness of PI-lines inside this variable pitch helix. These results are necessary steps toward an exact reconstruction algorithm for helix scanning of variable pitch, generalizing Katsevich's formula on constant pitch exact reconstruction. It is shown through an example that, when the derivative of the pitch function is not convex, or when the pitch function passes a inflection point and begins to slow down, PI-lines may be not unique near the rim of the helix cylinder. The conclusion is that the restriction on the pitch function is weaker, if the object is placed well within the helix cylinder and far from its rim, in order to preserve the uniqueness of PI-lines. If the object is near the rim, the restriction condition on the allowable pitch functions becomes stronger.

  12. Adaptive planning using megavoltage fan-beam CT for radiation therapy with testicular shielding

    SciTech Connect

    Yadav, Poonam; Kozak, Kevin; Tolakanahalli, Ranjini; Ramasubramanian, V.; Paliwal, Bhudatt R.; Welsh, James S.; Rong, Yi

    2012-07-01

    This study highlights the use of adaptive planning to accommodate testicular shielding in helical tomotherapy for malignancies of the proximal thigh. Two cases of young men with large soft tissue sarcomas of the proximal thigh are presented. After multidisciplinary evaluation, preoperative radiation therapy was recommended. Both patients were referred for sperm banking and lead shields were used to minimize testicular dose during radiation therapy. To minimize imaging artifacts, kilovoltage CT (kVCT) treatment planning was conducted without shielding. Generous hypothetical contours were generated on each 'planning scan' to estimate the location of the lead shield and generate a directionally blocked helical tomotherapy plan. To ensure the accuracy of each plan, megavoltage fan-beam CT (MVCT) scans were obtained at the first treatment and adaptive planning was performed to account for lead shield placement. Two important regions of interest in these cases were femurs and femoral heads. During adaptive planning for the first patient, it was observed that the virtual lead shield contour on kVCT planning images was significantly larger than the actual lead shield used for treatment. However, for the second patient, it was noted that the size of the virtual lead shield contoured on the kVCT image was significantly smaller than the actual shield size. Thus, new adaptive plans based on MVCT images were generated and used for treatment. The planning target volume was underdosed up to 2% and had higher maximum doses without adaptive planning. In conclusion, the treatment of the upper thigh, particularly in young men, presents several clinical challenges, including preservation of gonadal function. In such circumstances, adaptive planning using MVCT can ensure accurate dose delivery even in the presence of high-density testicular shields.

  13. Adaptive planning using megavoltage fan-beam CT for radiation therapy with testicular shielding.

    PubMed

    Yadav, Poonam; Kozak, Kevin; Tolakanahalli, Ranjini; Ramasubramanian, V; Paliwal, Bhudatt R; Welsh, James S; Rong, Yi

    2012-01-01

    This study highlights the use of adaptive planning to accommodate testicular shielding in helical tomotherapy for malignancies of the proximal thigh. Two cases of young men with large soft tissue sarcomas of the proximal thigh are presented. After multidisciplinary evaluation, preoperative radiation therapy was recommended. Both patients were referred for sperm banking and lead shields were used to minimize testicular dose during radiation therapy. To minimize imaging artifacts, kilovoltage CT (kVCT) treatment planning was conducted without shielding. Generous hypothetical contours were generated on each "planning scan" to estimate the location of the lead shield and generate a directionally blocked helical tomotherapy plan. To ensure the accuracy of each plan, megavoltage fan-beam CT (MVCT) scans were obtained at the first treatment and adaptive planning was performed to account for lead shield placement. Two important regions of interest in these cases were femurs and femoral heads. During adaptive planning for the first patient, it was observed that the virtual lead shield contour on kVCT planning images was significantly larger than the actual lead shield used for treatment. However, for the second patient, it was noted that the size of the virtual lead shield contoured on the kVCT image was significantly smaller than the actual shield size. Thus, new adaptive plans based on MVCT images were generated and used for treatment. The planning target volume was underdosed up to 2% and had higher maximum doses without adaptive planning. In conclusion, the treatment of the upper thigh, particularly in young men, presents several clinical challenges, including preservation of gonadal function. In such circumstances, adaptive planning using MVCT can ensure accurate dose delivery even in the presence of high-density testicular shields.

  14. Multibeam tomotherapy: A new treatment unit devised for multileaf collimation, intensity-modulated radiation therapy

    SciTech Connect

    Achterberg, Nils; Mueller, Reinhold G.

    2007-10-15

    A fully integrated system for treatment planning, application, and verification for automated multileaf collimator (MLC) based, intensity-modulated, image-guided, and adaptive radiation therapy (IMRT, IGRT and ART, respectively) is proposed. Patient comfort, which was the major development goal, will be achieved through a new unit design and short treatment times. Our device for photon beam therapy will consist of a new dual energy linac with five fixed treatment heads positioned evenly along one plane but one electron beam generator only. A minimum of moving parts increases technical reliability and reduces motion times to a minimum. Motion is allowed solely for the MLCs, the robotic patient table, and the small angle gantry rotation of {+-}36 deg. . Besides sophisticated electron beam guidance, this compact setup can be built using existing modules. The flattening-filter-free treatment heads are characterized by reduced beam-on time and contain apertures restricted in one dimension to the area of maximum primary fluence output. In the case of longer targets, this leads to a topographic intensity modulation, thanks to the combination of 'step and shoot' MLC delivery and discrete patient couch motion. Owing to the limited number of beam directions, this multislice cone beam serial tomotherapy is referred to as 'multibeam tomotherapy.' Every patient slice is irradiated by one treatment head at any given moment but for one subfield only. The electron beam is then guided to the next head ready for delivery, while the other heads are preparing their leaves for the next segment. The 'Multifocal MLC-positioning' algorithm was programmed to enable treatment planning and optimize treatment time. We developed an overlap strategy for the longitudinally adjacent fields of every beam direction, in doing so minimizing the field match problem and the effects of possible table step errors. Clinical case studies show for the same or better planning target volume coverage, better

  15. Multibeam tomotherapy: a new treatment unit devised for multileaf collimation, intensity-modulated radiation therapy.

    PubMed

    Achterberg, Nils; Müller, Reinhold G

    2007-10-01

    A fully integrated system for treatment planning, application, and verification for automated multileaf collimator (MLC) based, intensity-modulated, image-guided, and adaptive radiation therapy (IMRT, IGRT and ART, respectively) is proposed. Patient comfort, which was the major development goal, will be achieved through a new unit design and short treatment times. Our device for photon beam therapy will consist of a new dual energy linac with five fixed treatment heads positioned evenly along one plane but one electron beam generator only. A minimum of moving parts increases technical reliability and reduces motion times to a minimum. Motion is allowed solely for the MLCs, the robotic patient table, and the small angle gantry rotation of +/- 36 degrees. Besides sophisticated electron beam guidance, this compact setup can be built using existing modules. The flattening-filter-free treatment heads are characterized by reduced beam-on time and contain apertures restricted in one dimension to the area of maximum primary fluence output. In the case of longer targets, this leads to a topographic intensity modulation, thanks to the combination of "step and shoot" MLC delivery and discrete patient couch motion. Owing to the limited number of beam directions, this multislice cone beam serial tomotherapy is referred to as "multibeam tomotherapy." Every patient slice is irradiated by one treatment head at any given moment but for one subfield only. The electron beam is then guided to the next head ready for delivery, while the other heads are preparing their leaves for the next segment. The "Multifocal MLC-positioning" algorithm was programmed to enable treatment planning and optimize treatment time. We developed an overlap strategy for the longitudinally adjacent fields of every beam direction, in doing so minimizing the field match problem and the effects of possible table step errors. Clinical case studies show for the same or better planning target volume coverage, better

  16. Effect of Breast Volume on Treatment Reproducibility on a Tomotherapy Unit in the Treatment of Breast Cancer

    SciTech Connect

    Offerman, Shannon; Lamba, Michael; Lavigne, Ruth

    2011-06-01

    Purpose: To determine whether the volume of a patient's breast is correlated with reliable daily setup in treatment of breast cancer with a helical tomotherapy treatment unit. Methods and Materials: Thirty-six consecutive patients with breast cancer were treated on a helical tomotherapy unit. During simulation, kilovoltage CT images were obtained for treatment planning. These were fused with daily megavoltage CT scans, and after setup based on skin marks and laser alignment the necessary shifts were carried out. The magnitude of daily shifts (in millimeters) was retrospectively obtained from the daily image fusions, and the breast volume was obtained from the treatment plan. A total of 873 fusion scans were reviewed. Random error for absolute and directional daily shifts was evaluated for correlation to volume. Variation over time was also evaluated. Results: Mean (SD) random shift for all patients in the lateral, longitudinal, and vertical directions was 2.7 (2.0), 3.1 (1.5), and 3.2 (2.6) mm, respectively. Mean (SD) absolute distance shifted was 6.0 (3.5) mm. There was no significant correlation between mean absolute or mean directional daily shift and breast volume (0.08, 0.08, 0.22, and 0.07, respectively). There was no correlation between setup variation and time. Conclusions: In this cohort, there was no correlation between breast volume and degree of daily shift. There was no correlation between time course and setup variation. Therefore, setup variation does not improve or degrade with repeated treatment setups.

  17. 4D-Imaging of the Lung: Reproducibility of Lesion Size and Displacement on Helical CT, MRI, and Cone Beam CT in a Ventilated Ex Vivo System

    SciTech Connect

    Biederer, Juergen Dinkel, Julien; Remmert, Gregor; Jetter, Siri; Nill, Simeon; Moser, Torsten; Bendl, Rolf; Thierfelder, Carsten; Fabel, Michael; Oelfke, Uwe; Bock, Michael; Plathow, Christian; Bolte, Hendrik; Welzel, Thomas; Hoffmann, Beata; Hartmann, Guenter; Schlegel, Wolfgang; Debus, Juergen; Heller, Martin

    2009-03-01

    Purpose: Four-dimensional (4D) imaging is a key to motion-adapted radiotherapy of lung tumors. We evaluated in a ventilated ex vivo system how size and displacement of artificial pulmonary nodules are reproduced with helical 4D-CT, 4D-MRI, and linac-integrated cone beam CT (CBCT). Methods and Materials: Four porcine lungs with 18 agarose nodules (mean diameters 1.3-1.9 cm), were ventilated inside a chest phantom at 8/min and subject to 4D-CT (collimation 24 x 1.2 mm, pitch 0.1, slice/increment 24x10{sup 2}/1.5/0.8 mm, pitch 0.1, temporal resolution 0.5 s), 4D-MRI (echo-shared dynamic three-dimensional-flash; repetition/echo time 2.13/0.72 ms, voxel size 2.7 x 2.7 x 4.0 mm, temporal resolution 1.4 s) and linac-integrated 4D-CBCT (720 projections, 3-min rotation, temporal resolution {approx}1 s). Static CT without respiration served as control. Three observers recorded lesion size (RECIST-diameters x/y/z) and axial displacement. Interobserver- and interphase-variation coefficients (IO/IP VC) of measurements indicated reproducibility. Results: Mean x/y/z lesion diameters in cm were equal on static and dynamic CT (1.88/1.87; 1.30/1.39; 1.71/1.73; p > 0.05), but appeared larger on MRI and CBCT (2.06/1.95 [p < 0.05 vs. CT]; 1.47/1.28 [MRI vs. CT/CBCT p < 0.05]; 1.86/1.83 [CT vs. CBCT p < 0.05]). Interobserver-VC for lesion sizes were 2.54-4.47% (CT), 2.29-4.48% (4D-CT); 5.44-6.22% (MRI) and 4.86-6.97% (CBCT). Interphase-VC for lesion sizes ranged from 2.28% (4D-CT) to 10.0% (CBCT). Mean displacement in cm decreased from static CT (1.65) to 4D-CT (1.40), CBCT (1.23) and MRI (1.16). Conclusions: Lesion sizes are exactly reproduced with 4D-CT but overestimated on 4D-MRI and CBCT with a larger variability due to limited temporal and spatial resolution. All 4D-modalities underestimate lesion displacement.

  18. 4D-Imaging of the lung: reproducibility of lesion size and displacement on helical CT, MRI, and cone beam CT in a ventilated ex vivo system.

    PubMed

    Biederer, Juergen; Dinkel, Julien; Remmert, Gregor; Jetter, Siri; Nill, Simeon; Moser, Torsten; Bendl, Rolf; Thierfelder, Carsten; Fabel, Michael; Oelfke, Uwe; Bock, Michael; Plathow, Christian; Bolte, Hendrik; Welzel, Thomas; Hoffmann, Beata; Hartmann, Günter; Schlegel, Wolfgang; Debus, Jürgen; Heller, Martin; Kauczor, Hans-Ulrich

    2009-03-01

    Four-dimensional (4D) imaging is a key to motion-adapted radiotherapy of lung tumors. We evaluated in a ventilated ex vivo system how size and displacement of artificial pulmonary nodules are reproduced with helical 4D-CT, 4D-MRI, and linac-integrated cone beam CT (CBCT). Four porcine lungs with 18 agarose nodules (mean diameters 1.3-1.9 cm), were ventilated inside a chest phantom at 8/min and subject to 4D-CT (collimation 24 x 1.2 mm, pitch 0.1, slice/increment 24 x 10(2)/1.5/0.8 mm, pitch 0.1, temporal resolution 0.5 s), 4D-MRI (echo-shared dynamic three-dimensional-flash; repetition/echo time 2.13/0.72 ms, voxel size 2.7 x 2.7 x 4.0 mm, temporal resolution 1.4 s) and linac-integrated 4D-CBCT (720 projections, 3-min rotation, temporal resolution approximately 1 s). Static CT without respiration served as control. Three observers recorded lesion size (RECIST-diameters x/y/z) and axial displacement. Interobserver- and interphase-variation coefficients (IO/IP VC) of measurements indicated reproducibility. Mean x/y/z lesion diameters in cm were equal on static and dynamic CT (1.88/1.87; 1.30/1.39; 1.71/1.73; p > 0.05), but appeared larger on MRI and CBCT (2.06/1.95 [p < 0.05 vs. CT]; 1.47/1.28 [MRI vs. CT/CBCT p < 0.05]; 1.86/1.83 [CT vs. CBCT p < 0.05]). Interobserver-VC for lesion sizes were 2.54-4.47% (CT), 2.29-4.48% (4D-CT); 5.44-6.22% (MRI) and 4.86-6.97% (CBCT). Interphase-VC for lesion sizes ranged from 2.28% (4D-CT) to 10.0% (CBCT). Mean displacement in cm decreased from static CT (1.65) to 4D-CT (1.40), CBCT (1.23) and MRI (1.16). Lesion sizes are exactly reproduced with 4D-CT but overestimated on 4D-MRI and CBCT with a larger variability due to limited temporal and spatial resolution. All 4D-modalities underestimate lesion displacement.

  19. The AGS synchrotron with four helical magnets

    SciTech Connect

    Tsoupas N.; Huang, H.; Roser, T.; MacKay, W.W.; Trbojevic, D.

    2012-05-20

    The idea of using two partial helical magnets was applied successfully to the AGS synchrotron to preserve the proton beam polarization. In this paper we explore in details the idea of using four helical magnets placed symmetrically in the AGS ring. The placement of four helical magnets in the AGS ring provides many advantages over the present setup of the AGS which uses two partial helical magnets. First, the symmetric placement of the four helical magnets allows for a better control of the AGS optics with reduced values of the beta functions especially near beam injection, second, the vertical spin direction during beam injection and extraction is closer to vertical, and third, it provides for a larger 'spin tune gap', which allows the vertical and horizontal tunes to be placed, and prevent the horizontal and vertical intrinsic spin resonances of the AGS to occur during the acceleration cycle. Although the same spin gap can be obtained with a single or two partial helices, the required high field strength of a single helix makes its use impractical, and that of the double helix rather difficult. In this paper we will provide results on the spin tune and on the optics of the AGS with four partial helical magnets, and compare these results with the present setup of the AGS that uses two partial helical magnets.

  20. Validation of GPU based TomoTherapy dose calculation engine.

    PubMed

    Chen, Quan; Lu, Weiguo; Chen, Yu; Chen, Mingli; Henderson, Douglas; Sterpin, Edmond

    2012-04-01

    The graphic processing unit (GPU) based TomoTherapy convolution/superposition(C/S) dose engine (GPU dose engine) achieves a dramatic performance improvement over the traditional CPU-cluster based TomoTherapy dose engine (CPU dose engine). Besides the architecture difference between the GPU and CPU, there are several algorithm changes from the CPU dose engine to the GPU dose engine. These changes made the GPU dose slightly different from the CPU-cluster dose. In order for the commercial release of the GPU dose engine, its accuracy has to be validated. Thirty eight TomoTherapy phantom plans and 19 patient plans were calculated with both dose engines to evaluate the equivalency between the two dose engines. Gamma indices (Γ) were used for the equivalency evaluation. The GPU dose was further verified with the absolute point dose measurement with ion chamber and film measurements for phantom plans. Monte Carlo calculation was used as a reference for both dose engines in the accuracy evaluation in heterogeneous phantom and actual patients. The GPU dose engine showed excellent agreement with the current CPU dose engine. The majority of cases had over 99.99% of voxels with Γ(1%, 1 mm) < 1. The worst case observed in the phantom had 0.22% voxels violating the criterion. In patient cases, the worst percentage of voxels violating the criterion was 0.57%. For absolute point dose verification, all cases agreed with measurement to within ±3% with average error magnitude within 1%. All cases passed the acceptance criterion that more than 95% of the pixels have Γ(3%, 3 mm) < 1 in film measurement, and the average passing pixel percentage is 98.5%-99%. The GPU dose engine also showed similar degree of accuracy in heterogeneous media as the current TomoTherapy dose engine. It is verified and validated that the ultrafast TomoTherapy GPU dose engine can safely replace the existing TomoTherapy cluster based dose engine without degradation in dose accuracy.

  1. A Dosimetric Comparison of Tomotherapy and Volumetric Modulated Arc Therapy in the Treatment of High-Risk Prostate Cancer With Pelvic Nodal Radiation Therapy

    SciTech Connect

    Pasquier, David; Cavillon, Fabrice; Lacornerie, Thomas; Touzeau, Claire; Tresch, Emmanuelle; Lartigau, Eric

    2013-02-01

    Purpose: To compare the dosimetric results of volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) in the treatment of high-risk prostate cancer with pelvic nodal radiation therapy. Methods and Materials: Plans were generated for 10 consecutive patients treated for high-risk prostate cancer with prophylactic whole pelvic radiation therapy (WPRT) using VMAT and HT. After WPRT, a sequential boost was delivered to the prostate. Plan quality was assessed according to the criteria of the International Commission on Radiation Units and Measurements 83 report: the near-minimal (D98%), near-maximal (D2%), and median (D50%) doses; the homogeneity index (HI); and the Dice similarity coefficient (DSC). Beam-on time, integral dose, and several organs at risk (OAR) dosimetric indexes were also compared. Results: For WPRT, HT was able to provide a higher D98% than VMAT (44.3 {+-} 0.3 Gy and 43.9 {+-} 0.5 Gy, respectively; P=.032) and a lower D2% than VMAT (47.3 {+-} 0.3 Gy and 49.1 {+-} 0.7 Gy, respectively; P=.005), leading to a better HI. The DSC was better for WPRT with HT (0.89 {+-} 0.009) than with VMAT (0.80 {+-} 0.02; P=.002). The dosimetric indexes for the prostate boost did not differ significantly. VMAT provided better rectum wall sparing at higher doses (V70, V75, D2%). Conversely, HT provided better bladder wall sparing (V50, V60, V70), except at lower doses (V20). The beam-on times for WPRT and prostate boost were shorter with VMAT than with HT (3.1 {+-} 0.1 vs 7.4 {+-} 0.6 min, respectively; P=.002, and 1.5 {+-} 0.05 vs 3.7 {+-} 0.3 min, respectively; P=.002). The integral dose was slightly lower for VMAT. Conclusion: VMAT and HT provided very similar and highly conformal plans that complied well with OAR dose-volume constraints. Although some dosimetric differences were statistically significant, they remained small. HT provided a more homogeneous dose distribution, whereas VMAT enabled a shorter delivery time.

  2. Dosimetric variances anticipated from breathing- induced tumor motion during tomotherapy treatment delivery.

    PubMed

    Chaudhari, S R; Goddu, S M; Rangaraj, D; Pechenaya, O L; Lu, W; Kintzel, E; Malinowski, K; Parikh, P J; Bradley, J D; Low, D A

    2009-04-21

    In their classic paper, Yu et al (1998 Phys. Med. Biol. 43 91) investigated the interplay between tumor motion caused by breathing and dynamically collimated, intensity-modulated radiation delivery. The paper's analytic model assumed an idealized, sinusoidal pattern of motion. In this work, we investigate the effect of tumor motion based on patients' breathing patterns for typical tomotherapy treatments with field widths of 1.0 and 2.5 cm. The measured breathing patterns of 52 lung- and upper-abdominal-cancer patients were used to model a one-dimensional motion. A convolution of the measured beam-dose profiles with the motion model was used to compute the dose-distribution errors, and the positive and negative dose errors were recorded for each simulation. The dose errors increased with increasing motion magnitude, until the motion was similar in magnitude to the field width. For the 1.0 cm and 2.5 cm field widths, the maximum dose-error magnitude exceeded 10% in some simulations, even with breathing-motion magnitudes as small as 5 mm and 10 mm, respectively. Dose errors also increased slightly with increasing couch speed. We propose that the errors were due to subtle drifts in the amplitude and frequency of breathing motion, as well as changes in baseline (exhalation) position, causing both over- and under-dosing of the target. The results of this study highlight potential breathing-motion-induced dose delivery errors in tomotherapy. However, for conventionally fractionated treatments, the dose delivery errors may not be co-located and may average out over many fractions, although this may not be true for hypofractionated treatments.

  3. Dosimetric variances anticipated from breathing- induced tumor motion during tomotherapy treatment delivery

    NASA Astrophysics Data System (ADS)

    Chaudhari, S. R.; Goddu, S. M.; Rangaraj, D.; Pechenaya, O. L.; Lu, W.; Kintzel, E.; Malinowski, K.; Parikh, P. J.; Bradley, J. D.; Low, D. A.

    2009-04-01

    In their classic paper, Yu et al (1998 Phys. Med. Biol. 43 91) investigated the interplay between tumor motion caused by breathing and dynamically collimated, intensity-modulated radiation delivery. The paper's analytic model assumed an idealized, sinusoidal pattern of motion. In this work, we investigate the effect of tumor motion based on patients' breathing patterns for typical tomotherapy treatments with field widths of 1.0 and 2.5 cm. The measured breathing patterns of 52 lung- and upper-abdominal-cancer patients were used to model a one-dimensional motion. A convolution of the measured beam-dose profiles with the motion model was used to compute the dose-distribution errors, and the positive and negative dose errors were recorded for each simulation. The dose errors increased with increasing motion magnitude, until the motion was similar in magnitude to the field width. For the 1.0 cm and 2.5 cm field widths, the maximum dose-error magnitude exceeded 10% in some simulations, even with breathing-motion magnitudes as small as 5 mm and 10 mm, respectively. Dose errors also increased slightly with increasing couch speed. We propose that the errors were due to subtle drifts in the amplitude and frequency of breathing motion, as well as changes in baseline (exhalation) position, causing both over- and under-dosing of the target. The results of this study highlight potential breathing-motion-induced dose delivery errors in tomotherapy. However, for conventionally fractionated treatments, the dose delivery errors may not be co-located and may average out over many fractions, although this may not be true for hypofractionated treatments.

  4. Tomotherapy as a tool in image-guided radiation therapy (IGRT): current clinical experience and outcomes

    PubMed Central

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

    2007-01-01

    Modern radiotherapy is characterised by a better target definition through medical imaging accompanied by significantly improved radiation delivery methods, most notably Intensity-Modulate Radiation Therapy (IMRT). However, the treatment can only be as accurate as the positioning of patients for their daily radiotherapy fraction. It is in this context that a number of imaging modalities - ranging from ultrasound to on-board kilovoltage imaging and computed tomography (CT) - have found their way into the treatment room where they verify accurate patient positioning prior to or even during delivery of radiation. Helical tomotherapy (HT) combines IMRT delivery with in-built image guidance using megavoltage CT scanning. This paper discusses the initial experience of different centres with IGRT using HT illustrated by a number of clinical examples from the installation in London in Ontario, Canada, one of the world’s first HT sites. We found that HT allows the delivery of highly conformal radiation dose distributions combined with adequate daily image acquisition. An important feature of this unit is its seamless integration, which also includes a customised inverse treatment planning system and a quality assurance module for individual patients. PMID:21614258

  5. Decay of magnetic helicity producing polarized Alfven waves

    SciTech Connect

    Yoshida, Z.; Mahajan, S.M.

    1994-02-01

    When a super-Alfvenic electron beam propagates along an ambient magnetic field, the left-hand circularly polarized Alfven wave is Cherenkov-emitted (two stream instability). This instability results in a spontaneous conversion of the background plasma helicity to the wave helicity. The background helicity induces a frequency (energy) shift in the eigenmodes, which changes the critical velocity for Cherenkov emission, and it becomes possible for a sub-Alfvenic electron beam to excite a nonsingular Alfven mode.

  6. Helical Electron Avoidance Radiation Therapy (HEART) for Breast Cancer Treatment

    DTIC Science & Technology

    2005-04-01

    electron beams. Our end point is to test the technical feasibilities of generating helical electrons and its applications for breast cancer treatments . We...therapy", Int. J. Rad. Oncol. 48(2000) No. 3, 219. Summary 9 The BC99087 project "Helical Electron Beam Avoidance Radiation Therapy for Breast Cancer Treatments " completed

  7. Preliminary results of tomotherapy for treatment of inoperable recurrent non-small cell lung cancer at bronchial stump site after right pneumonectomy.

    PubMed

    Jang, Hong Seok; Moon, Seong Kwon

    2015-01-01

    This study aimed to prospectively investigate the clinical outcomes of curative radical helical tomotherapy (HT) applied to recurrent non-small cell lung cancer (NSCLC) at the bronchial stump site after right pneumonectomy. After right pneumonectomy, the heart shifted right laterally. The chambers of the heart closed with a recurrent mass at the bronchial stump were the right atrium and left atrium due to right shifting of the heart. The unfavorable bronchial stump recurrent cancer-heart geometry due to a right shift of the heart might serve as a reliable predictor of cardiac morbidity for aggressive radiotherapy. The 23 patients received HT for the recurrent NSCLC at the bronchial stump site after right pneumonectomy between 2008 and 2011. The median age of the patients was 65 years (range 56-74). We prescribed 95% volume of the primary planning target volume (PTV) to a total dose of 69 Gy in 30 fractions, and 95% of the secondary PTV to a total dose of 54 Gy in 30 fractions with reduction of the 50% volume of the heart < 20 Gy. The median conformal index in the 23 plans was 1.21. The mean fraction of primary PTV receiving more than 95% of the prescribed dose was 97.8%. The mean V45, V50, V60 of the heart were 10.5%, 6.5%, 0.2%, respectively. The median follow-up after tomotherapy was 19.86 months. Median survival was 20 months. The 2-year OS was 39.1%. The relatively high dose tomotherapy alone for patients with a recurrent bronchial stump mass which was proximal to the heart demonstrated favorable clinical results without severe heart or pulmonary complications.

  8. Preliminary results of tomotherapy for treatment of inoperable recurrent non-small cell lung cancer at bronchial stump site after right pneumonectomy

    PubMed Central

    Moon, Seong Kwon

    2015-01-01

    Aim of the study This study aimed to prospectively investigate the clinical outcomes of curative radical helical tomotherapy (HT) applied to recurrent non-small cell lung cancer (NSCLC) at the bronchial stump site after right pneumonectomy. After right pneumonectomy, the heart shifted right laterally. The chambers of the heart closed with a recurrent mass at the bronchial stump were the right atrium and left atrium due to right shifting of the heart. The unfavorable bronchial stump recurrent cancer-heart geometry due to a right shift of the heart might serve as a reliable predictor of cardiac morbidity for aggressive radiotherapy. Material and methods The 23 patients received HT for the recurrent NSCLC at the bronchial stump site after right pneumonectomy between 2008 and 2011. The median age of the patients was 65 years (range 56–74). Results We prescribed 95% volume of the primary planning target volume (PTV) to a total dose of 69 Gy in 30 fractions, and 95% of the secondary PTV to a total dose of 54 Gy in 30 fractions with reduction of the 50% volume of the heart < 20 Gy. The median conformal index in the 23 plans was 1.21. The mean fraction of primary PTV receiving more than 95% of the prescribed dose was 97.8%. The mean V45, V50, V60 of the heart were 10.5%, 6.5%, 0.2%, respectively. The median follow-up after tomotherapy was 19.86 months. Median survival was 20 months. The 2-year OS was 39.1%. Conclusions The relatively high dose tomotherapy alone for patients with a recurrent bronchial stump mass which was proximal to the heart demonstrated favorable clinical results without severe heart or pulmonary complications. PMID:26199573

  9. Adjustable phase planar helical undulator

    NASA Astrophysics Data System (ADS)

    Carr, Roger G.; Lidia, Steve

    1993-11-01

    We present here the design description of a new type of planar helical undulator, which we are constructing for the SPEAR storage ring at the Stanford Synchrotron Radiation Laboratory. It comprises four rows of pure permanent magnet blocks, one row in each quadrant about the axis defined by the electron beam. Rows may be translated longitudinally with respect to each other to change the helicity of the magnetic field they create at the position of the beam. They may also be translated longitudinally to vary the energy of the x-rays emitted, unlike designs where this function is performed by varying the gap between the rows. This work includes numerical calculations of the fields, electron trajectories, and x-ray spectra, including off-axis effects.

  10. Elliptical Muon Helical Cooling Channel Coils

    SciTech Connect

    Kahn, S. A.; Flanagan, G.; Lopes, M. L.; Yonehara, K.

    2013-09-01

    A helical cooling channel (HCC) consisting of a pressurized gas absorber imbedded in a magnetic channel that provides solenoid, helical dipole and helical quadrupole fields has shown considerable promise in providing six-dimensional phase space reduction for muon beams. The most effective approach to implementing the desired magnetic field is a helical solenoid (HS) channel composed of short solenoid coils arranged in a helical pattern. The HS channel along with an external solenoid allows the B$_z$ and B$_{\\phi}$ components along the reference orbit to be set to any desired values. To set dB$_{\\phi}$/dr to the desired value for optimum focusing requires an additional variable to tune. We shall show that using elliptical shaped coils in the HS channel allows the flexibility to achieve the desired dB$_{\\phi}$/dr on the reference orbit without significant change to B$_z$ and B$_{\\phi}$.

  11. Helical tomotherapy setup variations in canine nasal tumor patients immobilized with a bite block.

    PubMed

    Kubicek, Lyndsay N; Seo, Songwon; Chappell, Richard J; Jeraj, Robert; Forrest, Lisa J

    2012-01-01

    The purpose of our study was to compare setup variation in four degrees of freedom (vertical, longitudinal, lateral, and roll) between canine nasal tumor patients immobilized with a mattress and bite block, versus a mattress alone. Our secondary aim was to define a clinical target volume (CTV) to planning target volume (PTV) expansion margin based on our mean systematic error values associated with nasal tumor patients immobilized by a mattress and bite block. We evaluated six parameters for setup corrections: systematic error, random error, patient-patient variation in systematic errors, the magnitude of patient-specific random errors (root mean square [RMS]), distance error, and the variation of setup corrections from zero shift. The variations in all parameters were statistically smaller in the group immobilized by a mattress and bite block. The mean setup corrections in the mattress and bite block group ranged from 0.91 mm to 1.59 mm for the translational errors and 0.5°. Although most veterinary radiation facilities do not have access to Image-guided radiotherapy (IGRT), we identified a need for more rigid fixation, established the value of adding IGRT to veterinary radiation therapy, and define the CTV-PTV setup error margin for canine nasal tumor patients immobilized in a mattress and bite block.

  12. Efficacy of stereotactic radiotherapy for brain metastases using dynamic jaws technology in the helical tomotherapy system

    PubMed Central

    Hayashi, Akihiro; Manabe, Yoshihiko; Sugie, Chikao; Takaoka, Taiki; Yanagi, Takeshi; Oguri, Tetsuya; Matsuo, Masayuki; Mori, Yoshimasa; Shibamoto, Yuta

    2016-01-01

    Objective: Dynamic jaws (DJ) are expected to be useful in stereotactic radiotherapy (SRT) for brain metastases (BM). The efficacy and optimal dose fractionation were investigated. Methods: In a planning study, 63 treatment plans were generated for the following 3 conditions: 1.0-cm fixed jaws (FJ), 2.5-cm FJ and 2.5-cm DJ. In a clinical study, 30 Gy/3 fr, 35 Gy/5 fr or 37.5 Gy/5 fr were prescribed depending on tumour size. Clinical results of groups treated with 2.5-cm DJ plans and 1.0-cm FJ were compared. Results: In the planning study, the treatment times in 2.5-cm DJ and FJ plans were less than that in 1.0-cm FJ plans (p < 0.001). The brain doses in 1.0-cm FJ plans and 2.5-cm DJ plans were smaller than those in 2.5-cm FJ plans (p < 0.05). In the clinical study, 34 patients with 68 BM were treated with SRT. Of those, 15 patients with 34 BM were treated with 2.5-cm DJ plans and 19 patients with 34 BM were treated with 1.0-cm FJ plans. The overall survival and local tumour control (LC) rates were 52 and 93% at 12 months, respectively. The DJ system achieved favourable LC and 29% shorter treatment time compared with the FJ system (p < 0.001). Grade 2 or 3 necrosis occurred more frequently in patients with 15 cc or larger tumour volumes (p = 0.05). Conclusion: DJ technology enables treatment time to be reduced without worsening the dose distribution and clinical efficacy. The prescribed doses in this study may be acceptable for patients with small tumour volumes. Advances in knowledge: DJ technology enables treatment time to be reduced without worsening the dose. PMID:27556639

  13. Optimization of the Helical Orbits in the Tevatron

    SciTech Connect

    Alexahin, Y.; /Fermilab

    2007-06-01

    To avoid multiple head-on collisions the proton and antiproton beams in the Tevatron move along separate helical orbits created by 7 horizontal and 8 vertical electrostatic separators. Still the residual long-range beam-beam interactions can adversely affect particle motion at all stages from injection to collision. With increased intensity of the beams it became necessary to modify the orbits in order to mitigate the beam-beam effect on both antiprotons and protons. This report summarizes the work done on optimization of the Tevatron helical orbits, outlines the applied criteria and presents the achieved results.

  14. SU-E-J-174: Adaptive PET-Based Dose Painting with Tomotherapy

    SciTech Connect

    Darwish, N; Mackie, T; Thomadsen, B

    2014-06-01

    Purpose: PET imaging can be converted into dose prescription directly. Due to the variability of the intensity of PET the image, PET prescription maybe superior over uniform dose prescription. Furthermore, unlike the case in image reconstruction of not knowing the image solution in advance, the prescribed dose is known from a PET image a priori. Therefore, optimum beam orientations are derivable. Methods: We can assume the PET image to be the prescribed dose and invert it to determine the energy fluence. The same method used to reconstruct tissue images from projections could be used to solve the inverse problem of determining beam orientations and modulation patterns from a dose prescription [10]. Unlike standard tomographic reconstruction of images from measured projection profiles, the inversion of the prescribed dose results in photon fluence which may be negative and therefore unphysical. Two-dimensional modulated beams can be modelled in terms of the attenuated or exponential radon transform of the prescribed dose function (assumed to be the PET image in this case), an application of a Ram-Lak filter, and inversion by backprojection. Unlike the case in PET processing, however, the filtered beam obtained from the inversion represents a physical photon fluence. Therefore, a positivity constraint for the fluence (setting negative fluence to zero) must be applied (Brahme et al 1982, Bortfeld et al 1990) Results: Truncating the negative profiles from the PET data results in an approximation of the derivable energy fluence. Backprojection of the deliverable fluence is an approximation of the dose delivered. The deliverable dose is comparable to the original PET image and is similar to the PET image. Conclusion: It is possible to use the PET data or image as a direct indicator of deliverable fluence for cylindrical radiotherapy systems such as TomoTherapy.

  15. Lung SBRT: dosimetric and delivery comparison of RapidArc, TomoTherapy, and IMR.

    PubMed

    Weyh, Ashleigh; Konski, Andre; Nalichowski, Adrian; Maier, Jordan; Lack, Danielle

    2013-07-08

    This study seeks to compare fixed-field intensity-modulated radiation therapy (FF IMRT), RapidArc (RA), and helical tomotherapy (HT) to discover the optimal treatment modality to deliver SBRT to the peripheral lung. Eight patients with peripheral primary lung cancer were reviewed. Plans were prescribed a dose of 48 Gy and optimized similarly with heterogeneity corrections. Plan quality was assessed using conformality index (CI100%), homogeneity index (HI), the ratio of the 50% isodose volume to PTV (R50%) to assess intermediate dose spillage, and normal tissue constraints. Delivery efficiency was evaluated using treatment time and MUs. Dosimetric accuracy was assessed using gamma index (3% dose difference, 3 mm DTA, 10% threshold), and measured with a PTW ARRAY seven29 and OCTAVIUS phantom. CI100%, HI, and R50% were lowest for HT compared to seven-field coplanar IMRT and two-arc coplanar RA (p < 0.05). Normal tissue constraints were met for all modalities, except maximum rib dose due to close proximity to the PTV. RA reduced delivery time by 60% compared to HT, and 40% when compared to FF IMRT. RA also reduced the mean MUs by 77% when compared to HT, and by 22% compared to FF IMRT. All modalities can be delivered accurately, with mean QA pass rates over 97%. For peripheral lung SBRT treatments, HT performed better dosimetrically, reducing maximum rib dose, as well as improving dose conformity and uniformity. RA and FF IMRT plan quality was equivalent to HT for patients with minimal or no overlap of the PTV with the chest wall, but was reduced for patients with a larger overlap. RA and IMRT were equivalent, but the reduced treatment times of RA make it a more efficient modality.

  16. Helicity content and tokamak applications of helicity

    SciTech Connect

    Boozer, A.H.

    1986-05-01

    Magnetic helicity is approximately conserved by the turbulence associated with resistive instabilities of plasmas. To generalize the application of the concept of helicity, the helicity content of an arbitrary bounded region of space will be defined. The definition has the virtues that both the helicity content and its time derivative have simple expressions in terms of the poloidal and toroidal magnetic fluxes, the average toroidal loop voltage and the electric potential on the bounding surface, and the volume integral of E-B. The application of the helicity concept to tokamak plasmas is illustrated by a discussion of so-called MHD current drive, an example of a stable tokamak q profile with q less than one in the center, and a discussion of the possibility of a natural steady-state tokamak due to the bootstrap current coupling to tearing instabilities.

  17. Dosimetric effect on pediatric conformal treatment plans using dynamic jaw with Tomotherapy HDA

    SciTech Connect

    Han, Eun Young; Kim, Dong-Wook; Zhang, Xin; Penagaricano, Jose; Liang, Xiaoying; Hardee, Matthew; Morrill, Steve; Ratanatharathorn, Vaneerat

    2015-10-01

    It is important to minimize the radiation dose delivered to healthy tissues in pediatric cancer treatment because of the risk of secondary malignancies. Tomotherapy HDA provides a dynamic jaw (DJ) delivery mode that creates a sharper penumbra at the craniocaudal ends of a target in addition to a fixed jaw (FJ) delivery mode. The purpose of this study was to evaluate its dosimetric effect on the pediatric cancer cases. We included 6 pediatric cases in this study. The dose profiles and plan statistics—target dose conformity, uniformity, organ-at-risk (OAR) mean dose, beam-on time, and integral dose—were compared for each case. Consequently, the target dose coverage and uniformity were similar for different jaw settings. The OAR dose sparing depended on its relative location to the target and disease sites. For example, in the head and neck cancer cases, the brain stem dose using DJ 2.5 was reduced by more than two-fold (2.4 Gy vs. 6.3 Gy) than that obtained with FJ 2.5. The integral dose with DJ 2.5 decreased by more than 9% compared with that with FJ 2.5. Thus, using dynamic jaw in pediatric cases could be critical to reduce a probability of a secondary malignancy.

  18. The AGS with four helical magnets

    SciTech Connect

    Tsoupas, N.; Huang, H.; MacKay, W.W.; Roser, T.; Trbojevic, D.

    2010-02-25

    The idea of using multiple partial helical magnets was applied successfully to the AGS synchrotron, to preserve the proton beam polarization. In this paper we explore in details the idea of using four helical magnets placed symmetrically in the AGS ring. This modification provides many advantages over the present setup of the AGS that uses two partial helical magnets. First, it provides a larger 'spin tune gap' for the placement of the vertical betatron tune of the AGS during acceleration, second, the vertical spin direction during the beam injection and extraction is closer to vertical, third, the symmetric placement of the snakes allows for a better control of the AGS optics, and for reduced values of the beta and eta functions, especially near injection, fourth, the optical properties of the helical magnets also favor the placement of the horizontal betatron tune in the 'spin tune gap', thus eliminating the horizontal spin resonances. In this paper we provide results on the spin tune and on the optics of the AGS with four partial helical magnets, and we compare these results with the present setup of the AGS that uses two partial helical magnets.

  19. Helical dipole magnets for polarized protons in RHIC

    SciTech Connect

    Syphers, M.; Courant, E.; Fischer, W.

    1997-07-01

    Superconducting helical dipole magnets will be used in the Brookhaven Relativistic Heavy Ion Collider (RHIC) to maintain polarization of proton beams and to perform localized spin rotations at the two major experimental detector regions. Requirements for the helical dipole system are discussed, and magnet prototype work is reported.

  20. A Helical Cooling Channel System for Muon Colliders

    SciTech Connect

    Katsuya Yonehara, Rolland Johnson, Michael Neubauer, Yaroslav Derbenev

    2010-03-01

    Fast muon beam six dimensional (6D) phase space cooling is essential for muon colliders. The Helical Cooling Channel (HCC) uses hydrogen-pressurized RF cavities imbedded in a magnet system with solenoid, helical dipole, and helical quadrupole components that provide the continuous dispersion needed for emittance exchange and effective 6D beam cooling. A series of HCC segments, each with sequentially smaller aperture, higher magnetic field, and higher RF frequency to match the beam size as it is cooled, has been optimized by numerical simulation to achieve a factor of 105 emittance reduction in a 300 m long channel with only a 40% loss of beam. Conceptual designs of the hardware required for this HCC system and the status of the RF studies and HTS helical solenoid magnet prototypes are described.

  1. Superconducting helical solenoid systems for muon cooling experiment at Fermilab

    SciTech Connect

    Kashikhin, Vladimir S.; Andreev, Nikolai; Johnson, Rolland P.; Kashikhin, Vadim V.; Lamm, Michael J.; Romanov, Gennady; Yonehara, Katsuya; Zlobin, Alexander V.; /Fermilab

    2007-08-01

    Novel configurations of superconducting magnet system for Muon Beam Cooling Experiment is under design at Fermilab. The magnet system has to generate longitudinal and transverse dipole and quadrupole helical magnetic fields providing a muon beam motion along helical orbit. It was found that such complicated field configuration can be formed by a set of circular coils shifted in transverse directions in such a way that their centers lay on the center of the helical beam orbit. Closed beam orbit configurations were also proposed and investigated. This paper describes the magnetic and mechanical designs and parameters of such magnetic system based on a NbTi Rutherford type cable. The helical solenoid fabrication, assembly and quench protection issues are presented.

  2. Design of Helical Cooling Channel for Muon Collider

    SciTech Connect

    Yonehara, Katsuya; /Fermilab

    2010-07-30

    Fast muon beam six dimensional (6D) phase space cooling is essential for muon colliders. The Helical Cooling Channel (HCC) uses hydrogen-pressurized RF cavities imbedded in a magnet system with solenoid, helical dipole, and helical quadrupole components that provide the continuous dispersion needed for emittance exchange and effective 6D beam cooling. A series of HCC segments, each with sequentially smaller aperture, higher magnetic field, and higher RF frequency to match the beam size as it is cooled, has been optimized by numerical simulation to achieve a factor of 10{sup 5} emittance reduction in a 300 m long channel with only a 40% loss of beam. Conceptual designs of the hardware required for this HCC system and the status of the RF studies and HTS helical solenoid magnet prototypes are described.

  3. Artificial multiple helices: polarization and EM properties

    NASA Astrophysics Data System (ADS)

    Wongkasem, N.; Kamtongdee, C.; Akyurtlu, A.; Marx, K. A.

    2010-07-01

    Polarization and electromagnetic properties in artificial multiple helix structures are investigated. It was found that on increasing the numbers of helical backbones, resulting in higher values of chirality index, a unique beam splitting behavior is observed. These split left and right circularly polarized waves provide opposite refractive index broad passbands, propagating within the structure with very low loss.

  4. Shearing wind helicity and thermal wind helicity

    NASA Astrophysics Data System (ADS)

    Han, Y.; Wu, R. S.; Fang, J.

    2006-07-01

    Helicity is defined as H = V . omega, where V and omega are the velocity and vorticity vectors, respectively. Many works have pointed out that the larger the helicity is, the longer the life cycle of the weather system is. However, the direct relationship of the helicity to the evolution of the weather system is not quite clear. In this paper, the concept of helicity is generalized as shearing wind helicity (SWH). Dynamically, it is found that the average SWH is directly related to the increase of the average cyclonic rotation of the weather system. Physically, it is also pointed out that the SWH, as a matter of fact, is the sum of the torsion terms and the divergence term in the vorticity equation. Thermal wind helicity (TWH), as a derivative of SWH, is also discussed here because it links the temperature field and the vertical wind field. These two quantities may be effective for diagnosing a weather system. This paper applies these two quantities in cylindrical coordinates to study the development of Hurricane Andrew to validate their practical use. Through analyzing the hurricane, it is found that TWH can well describe the characteristics of the hurricane such as the strong convection and release of latent heat. SWH is not only a good quantity for diagnosing the weather system, but also an effective one for diagnosing the development of the hurricane.

  5. Breathing-Synchronized Delivery: A Potential Four-Dimensional Tomotherapy Treatment Technique

    SciTech Connect

    Zhang Tiezhi . E-mail: tiezhi.zhang@beaumont.edu; Lu Weiguo; Olivera, Gustavo H.; Keller, Harry; Jeraj, Robert; Manon, Rafael; Mehta, Minesh; Mackie, Thomas R.; Paliwal, Bhudatt

    2007-08-01

    Purpose: To introduce a four-dimensional (4D) tomotherapy treatment technique with improved motion control and patient tolerance. Methods and Materials: Computed tomographic images at 10 breathing phases were acquired for treatment planning. The full exhalation phase was chosen as the planning phase, and the CT images at this phase were used as treatment-planning images. Region of interest delineation was the same as in traditional treatment planning, except that no breathing motion margin was used in clinical target volume-planning target volume expansion. The correlation between delivery and breathing phases was set assuming a constant gantry speed and a fixed breathing period. Deformable image registration yielded the deformation fields at each phase relative to the planning phase. With the delivery/breathing phase correlation and voxel displacements at each breathing phase, a 4D tomotherapy plan was obtained by incorporating the motion into inverse treatment plan optimization. A combined laser/spirometer breathing tracking system has been developed to monitor patient breathing. This system is able to produce stable and reproducible breathing signals representing tidal volume. Results: We compared the 4D tomotherapy treatment planning method with conventional tomotherapy on a static target. The results showed that 4D tomotherapy can achieve dose distributions on a moving target similar to those obtained with conventional delivery on a stationary target. Regular breathing motion is fully compensated by motion-incorporated breathing-synchronized delivery planning. Four-dimensional tomotherapy also has close to 100% duty cycle and does not prolong treatment time. Conclusion: Breathing-synchronized delivery is a feasible 4D tomotherapy treatment technique with improved motion control and patient tolerance.

  6. Re-Shielding of Cobalt-60 Teletherapy Rooms for Tomotherapy and Conventional Linear Accelerators using Monte Carlo Simulations

    NASA Astrophysics Data System (ADS)

    Çeçen, Yiğit; Yazgan, Çağrı

    2017-09-01

    Purpose. Nearly all Cobalt-60 teletherapy machines were removed around the world during the last two decades. The remaining ones are being used for experimental purposes. However, the rooms of these teletherapy machines are valuable because of lack of space in radiotherapy clinics. In order to place a new technology treatment machine in one of these rooms, one should re-shield the room since it was designed only for 1.25 MeV gamma beams on average. Mostly, the vendor of the new machine constructs the new shielding of the room using their experience. However, every radiotherapy room has different surrounding work areas and it would be wise to shield the room considering these special conditions. Also, the shield design goal of the clinic may be much lower than the International Atomic Energy Agency (IAEA) or the local association accepts. The study shows re-shielding of a Cobalt-60 room, specific to the clinic, using Monte Carlo simulations. Materials & Methods: First, a 6 MV Tomotherapy machine, then a 10 MV conventional linear accelerator (LINAC) was placed inside the Cobalt-60 teletherapy room. The photon flux outside the room was simulated using Monte Carlo N-Particle (MCNP6.1) code before and after re-shielding. For the Tomotherapy simulation, flux distributions around the machine were obtained from the vendor and implemented as the source of the model. The LINAC model was more generic with the 10 MeV electron source, the tungsten target, first and secondary collimators. The aim of the model was to obtain the maximum (40x40 cm2) open field at the isocenter. Two different simulations were carried out for gantry angles 90o and 270o. The LINAC was placed in the room such that the primary walls were A' (Gantry 270o) and C' (Gantry 90o) (figure 1). The second part of the study was to model the re-shielding of the room for Tomotherapy and for the conventional LINAC, separately. The aim was to investigate the recommended shielding by the vendors. Left side of the room

  7. Beam-Target Helicity Asymmetry for γ[over →]n[over →]→π^{-}p in the N^{*} Resonance Region.

    PubMed

    Ho, D; Peng, P; Bass, C; Collins, P; D'Angelo, A; Deur, A; Fleming, J; Hanretty, C; Kageya, T; Khandaker, M; Klein, F J; Klempt, E; Laine, V; Lowry, M M; Lu, H; Nepali, C; Nikonov, V A; O'Connell, T; Sandorfi, A M; Sarantsev, A V; Schumacher, R A; Strakovsky, I I; Švarc, A; Walford, N K; Wei, X; Whisnant, C S; Workman, R L; Zonta, I; Adhikari, K P; Adikaram, D; Akbar, Z; Amaryan, M J; Anefalos Pereira, S; Avakian, H; Ball, J; Bashkanov, M; Battaglieri, M; Batourine, V; Bedlinskiy, I; Biselli, A; Briscoe, W J; Burkert, V D; Carman, D S; Celentano, A; Charles, G; Chetry, T; Ciullo, G; Clark, L; Colaneri, L; Cole, P L; Contalbrigo, M; Crede, V; Dashyan, N; De Sanctis, E; De Vita, R; Djalali, C; Dupre, R; El Alaoui, A; El Fassi, L; Elouadrhiri, L; Eugenio, P; Fedotov, G; Fegan, S; Fersch, R; Filippi, A; Fradi, A; Ghandilyan, Y; Gilfoyle, G P; Girod, F X; Glazier, D I; Gleason, C; Gohn, W; Golovatch, E; Gothe, R W; Griffioen, K A; Guidal, M; Guo, L; Hakobyan, H; Harrison, N; Hattawy, M; Hicks, K; Holtrop, M; Hughes, S M; Ilieva, Y; Ireland, D G; Ishkhanov, B S; Isupov, E L; Jenkins, D; Jiang, H; Jo, H S; Joo, K; Joosten, S; Keller, D; Khachatryan, G; Kim, A; Kim, W; Klein, A; Kubarovsky, V; Kuleshov, S V; Lanza, L; Lenisa, P; Livingston, K; MacGregor, I J D; Markov, N; McKinnon, B; Mineeva, T; Mokeev, V; Montgomery, R A; Movsisyan, A; Munoz Camacho, C; Murdoch, G; Niccolai, S; Niculescu, G; Osipenko, M; Paolone, M; Paremuzyan, R; Park, K; Pasyuk, E; Phelps, W; Pogorelko, O; Price, J W; Procureur, S; Protopopescu, D; Ripani, M; Riser, D; Ritchie, B G; Rizzo, A; Rosner, G; Sabatié, F; Salgado, C; Sharabian, Y G; Skorodumina, Iu; Smith, G D; Sober, D I; Sokhan, D; Sparveris, N; Strauch, S; Tian, Ye; Torayev, B; Ungaro, M; Voskanyan, H; Voutier, E; Watts, D P; Wood, M H; Zachariou, N; Zhang, J; Zhao, Z W

    2017-06-16

    We report the first beam-target double-polarization asymmetries in the γ+n(p)→π^{-}+p(p) reaction spanning the nucleon resonance region from invariant mass W=1500 to 2300 MeV. Circularly polarized photons and longitudinally polarized deuterons in solid hydrogen deuteride (HD) have been used with the CEBAF Large Acceptance Spectrometer (CLAS) at Jefferson Lab. The exclusive final state has been extracted using three very different analyses that show excellent agreement, and these have been used to deduce the E polarization observable for an effective neutron target. These results have been incorporated into new partial wave analyses and have led to significant revisions for several γnN^{*} resonance photocouplings.

  8. SU-E-T-182: Delivery Verification of Tomotherapy Treatments Using Exit Detector Sinograms: A Phantom Study.

    PubMed

    Rodriguez, V; Richardson, S; Ghosh, T; Kashani, R; Goddu, S

    2012-06-01

    The objective of this study was to use a liquid water female body phantom to investigate the feasibility of using helical Tomotherapy's exit detector data sinograms (EDDS) for quality assurance of Tomotherapy treatments. Delivery Verification software (DV-Tool), described by Kapatoes et al., uses EDDS and daily mega-voltage-CT images for delivery sinogram reconstruction and subsequent dose computations. These dose distributions should reflect variations in patient's anatomy and machine delivery. Phantom was used to verify the robustness of the DV-Tool for machine consistency over 2months, and sensitivity to weight loss and setup errors. Weight loss simulations were done by removing layers of bolus from the phantom's pelvis. Setup errors were simulated by performing known table shifts before the treatment. Two treatment plans simulating a breast and gynecological treatment plans were used for these evaluations. Reconstructed doses and dose volume histograms (DVHs) were analyzed in comparison to the plan DVHs by scaling the reconstructed PTV mean dose (PTV-MD) to match the plan. PTV-MD differences before and after machine output adjustments were evaluated. Machine consistency check of gynecological plan revealed that the deviations were greater (±5%) during the week prior to target replacement. After output adjustments, the deviations for breast and gynecological plans agreed within ±1.0% and ±2.5%, respectively. Weight loss on the gynecological plan showed a correlation (R2=0.998) between lost thickness and increasing PTV-MD by approximately 5%/cm. Setup errors on the breast plan showed broadening shoulder of the PTV DVH for shifts greater than 5mm. Volume at 20Gy for the right lung increased by 6% for 10mm shifts in both x and z directions. The DV-Tool is sensitive to simulated weight loss, setup errors, and machine output. Exit detector data and the DV-Tool have great potential for monitoring patient's delivered treatments. However, clinical workflow needs to

  9. Emerging double helical nanostructures

    NASA Astrophysics Data System (ADS)

    Zhao, Meng-Qiang; Zhang, Qiang; Tian, Gui-Li; Wei, Fei

    2014-07-01

    As one of the most important and land-mark structures found in nature, a double helix consists of two congruent single helices with the same axis or a translation along the axis. This double helical structure renders the deoxyribonucleic acid (DNA) the crucial biomolecule in evolution and metabolism. DNA-like double helical nanostructures are probably the most fantastic yet ubiquitous geometry at the nanoscale level, which are expected to exhibit exceptional and even rather different properties due to the unique organization of the two single helices and their synergistic effect. The organization of nanomaterials into double helical structures is an emerging hot topic for nanomaterials science due to their promising exceptional unique properties and applications. This review focuses on the state-of-the-art research progress for the fabrication of double-helical nanostructures based on `bottom-up' and `top-down' strategies. The relevant nanoscale, mesoscale, and macroscopic scale fabrication methods, as well as the properties of the double helical nanostructures are included. Critical perspectives are devoted to the synthesis principles and potential applications in this emerging research area. A multidisciplinary approach from the scope of nanoscience, physics, chemistry, materials, engineering, and other application areas is still required to the well-controlled and large-scale synthesis, mechanism, property, and application exploration of double helical nanostructures.

  10. A Helical Stairway Project

    ERIC Educational Resources Information Center

    Farmer, Tom

    2008-01-01

    We answer a geometric question that was raised by the carpenter in charge of erecting helical stairs in a 10-story hospital. The explanation involves the equations of lines, planes, and helices in three-dimensional space. A brief version of the question is this: If A and B are points on a cylinder and the line segment AB is projected radially onto…

  11. Emerging double helical nanostructures.

    PubMed

    Zhao, Meng-Qiang; Zhang, Qiang; Tian, Gui-Li; Wei, Fei

    2014-08-21

    As one of the most important and land-mark structures found in nature, a double helix consists of two congruent single helices with the same axis or a translation along the axis. This double helical structure renders the deoxyribonucleic acid (DNA) the crucial biomolecule in evolution and metabolism. DNA-like double helical nanostructures are probably the most fantastic yet ubiquitous geometry at the nanoscale level, which are expected to exhibit exceptional and even rather different properties due to the unique organization of the two single helices and their synergistic effect. The organization of nanomaterials into double helical structures is an emerging hot topic for nanomaterials science due to their promising exceptional unique properties and applications. This review focuses on the state-of-the-art research progress for the fabrication of double-helical nanostructures based on 'bottom-up' and 'top-down' strategies. The relevant nanoscale, mesoscale, and macroscopic scale fabrication methods, as well as the properties of the double helical nanostructures are included. Critical perspectives are devoted to the synthesis principles and potential applications in this emerging research area. A multidisciplinary approach from the scope of nanoscience, physics, chemistry, materials, engineering, and other application areas is still required to the well-controlled and large-scale synthesis, mechanism, property, and application exploration of double helical nanostructures.

  12. Monte Carlo simulations of patient dose perturbations in rotational-type radiotherapy due to a transverse magnetic field: A tomotherapy investigation

    SciTech Connect

    Yang, Y. M.; Geurts, M.; Smilowitz, J. B.; Bednarz, B. P.; Sterpin, E.

    2015-02-15

    Purpose: Several groups are exploring the integration of magnetic resonance (MR) image guidance with radiotherapy to reduce tumor position uncertainty during photon radiotherapy. The therapeutic gain from reducing tumor position uncertainty using intrafraction MR imaging during radiotherapy could be partially offset if the negative effects of magnetic field-induced dose perturbations are not appreciated or accounted for. The authors hypothesize that a more rotationally symmetric modality such as helical tomotherapy will permit a systematic mediation of these dose perturbations. This investigation offers a unique look at the dose perturbations due to homogeneous transverse magnetic field during the delivery of Tomotherapy{sup ®} Treatment System plans under varying degrees of rotational beamlet symmetry. Methods: The authors accurately reproduced treatment plan beamlet and patient configurations using the Monte Carlo code GEANT4. This code has a thoroughly benchmarked electromagnetic particle transport physics package well-suited for the radiotherapy energy regime. The three approved clinical treatment plans for this study were for a prostate, head and neck, and lung treatment. The dose heterogeneity index metric was used to quantify the effect of the dose perturbations to the target volumes. Results: The authors demonstrate the ability to reproduce the clinical dose–volume histograms (DVH) to within 4% dose agreement at each DVH point for the target volumes and most planning structures, and therefore, are able to confidently examine the effects of transverse magnetic fields on the plans. The authors investigated field strengths of 0.35, 0.7, 1, 1.5, and 3 T. Changes to the dose heterogeneity index of 0.1% were seen in the prostate and head and neck case, reflecting negligible dose perturbations to the target volumes, a change from 5.5% to 20.1% was observed with the lung case. Conclusions: This study demonstrated that the effect of external magnetic fields can

  13. Analysis of Daily Setup Variation With Tomotherapy Megavoltage Computed Tomography

    SciTech Connect

    Zhou Jining Uhl, Barry; Dewit, Kelly; Young, Mark; Taylor, Brian; Fei Dingyu; Lo, Y-C

    2010-04-01

    The purpose of this study was to evaluate different setup uncertainties for various anatomic sites with TomoTherapy (registered) pretreatment megavoltage computed tomography (MVCT) and to provide optimal margin guidelines for these anatomic sites. Ninety-two patients with tumors in head and neck (HN), brain, lung, abdominal, or prostate regions were included in the study. MVCT was used to verify patient position and tumor target localization before each treatment. With the anatomy registration tool, MVCT provided real-time tumor shift coordinates relative to the positions where the simulation CT was performed. Thermoplastic facemasks were used for HN and brain treatments. Vac-Lok{sup TM} cushions were used to immobilize the lower extremities up to the thighs for prostate patients. No respiration suppression was administered for lung and abdomen patients. The interfractional setup variations were recorded and corrected before treatment. The mean interfractional setup error was the smallest for HN among the 5 sites analyzed. The average 3D displacement in lateral, longitudinal, and vertical directions for the 5 sites ranged from 2.2-7.7 mm for HN and lung, respectively. The largest movement in the lung was 2.0 cm in the longitudinal direction, with a mean error of 6.0 mm and standard deviation of 4.8 mm. The mean interfractional rotation variation was small and ranged from 0.2-0.5 deg., with the standard deviation ranging from 0.7-0.9 deg. Internal organ displacement was also investigated with a posttreatment MVCT scan for HN, lung, abdomen, and prostate patients. The maximum 3D intrafractional displacement across all sites was less than 4.5 mm. The interfractional systematic errors and random errors were analyzed and the suggested margins for HN, brain, prostate, abdomen, and lung in the lateral, longitudinal, and vertical directions were between 4.2 and 8.2 mm, 5.0 mm and 12.0 mm, and 1.5 mm and 6.8 mm, respectively. We suggest that TomoTherapy (registered

  14. Evaluation of radiosurgery techniques--cone-based linac radiosurgery vs tomotherapy-based radiosurgery.

    PubMed

    Yip, Ho Yin; Mui, Wing Lun A; Lee, Joseph W Y; Fung, Winky Wing Ki; Chan, Jocelyn M T; Chiu, G; Law, Maria Y Y

    2013-01-01

    Performances of radiosurgery of intracranial lesions between cone-based Linac system and Tomotherapy-based system were compared in terms of dosimetry and time. Twelve patients with single intracranial lesion treated with cone-based Linac radiosurgery system from 2005 to 2009 were replanned for Tomotherapy-based radiosurgery treatment. The conformity index, homogeneity index (HI), and gradient score index (GSI) of each case was calculated. The Wilcoxon matched-pair test was used to compare the 3 indices between both systems. The cases with regular target (n = 6) and those with irregular target (n = 6) were further analyzed separately. The estimated treatment time between both systems was also compared. Significant differences were found in HI (p = 0.05) and in GSI (p = 0.03) for the whole group. Cone-based radiosurgery was better in GSI whereas Tomotherapy-based radiosurgery was better in HI. Cone-based radiosurgery was better in conformity index (p = 0.03) and GSI (p = 0.03) for regular targets, whereas Tomotherapy-based radiosurgery system performed significantly better in HI (p = 0.03) for irregular targets. The estimated total treatment time for Tomotherapy-based radiosurgery ranged from 24 minutes to 35 minutes, including 15 minutes of pretreatment megavoltage computed tomography (MVCT) and image registration, whereas that for cone-based radiosurgery ranged from 15 minutes for 1 isocenter to 75 minutes for 5 isocenters. As a rule of thumb, Tomotherapy-based radiosurgery system should be the first-line treatment for irregular lesions because of better dose homogeneity and shorter treatment time. Cone-based Linac radiosurgery system should be the treatment of choice for regular targets because of the better dose conformity, rapid dose fall-off, and reasonable treatment time. Copyright © 2013 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  15. Evaluation of radiosurgery techniques–Cone-based linac radiosurgery vs tomotherapy-based radiosurgery

    SciTech Connect

    Yip, Ho Yin; Mui, Wing Lun A.; Lee, Joseph W.Y.; Fung, Winky Wing Ki; Chan, Jocelyn M.T.; Chiu, G.; Law, Maria Y.Y.

    2013-07-01

    Performances of radiosurgery of intracranial lesions between cone-based Linac system and Tomotherapy-based system were compared in terms of dosimetry and time. Twelve patients with single intracranial lesion treated with cone-based Linac radiosurgery system from 2005 to 2009 were replanned for Tomotherapy-based radiosurgery treatment. The conformity index, homogeneity index (HI), and gradient score index (GSI) of each case was calculated. The Wilcoxon matched-pair test was used to compare the 3 indices between both systems. The cases with regular target (n = 6) and those with irregular target (n = 6) were further analyzed separately. The estimated treatment time between both systems was also compared. Significant differences were found in HI (p = 0.05) and in GSI (p = 0.03) for the whole group. Cone-based radiosurgery was better in GSI whereas Tomotherapy-based radiosurgery was better in HI. Cone-based radiosurgery was better in conformity index (p = 0.03) and GSI (p = 0.03) for regular targets, whereas Tomotherapy-based radiosurgery system performed significantly better in HI (p = 0.03) for irregular targets. The estimated total treatment time for Tomotherapy-based radiosurgery ranged from 24 minutes to 35 minutes, including 15 minutes of pretreatment megavoltage computed tomography (MVCT) and image registration, whereas that for cone-based radiosurgery ranged from 15 minutes for 1 isocenter to 75 minutes for 5 isocenters. As a rule of thumb, Tomotherapy-based radiosurgery system should be the first-line treatment for irregular lesions because of better dose homogeneity and shorter treatment time. Cone-based Linac radiosurgery system should be the treatment of choice for regular targets because of the better dose conformity, rapid dose fall-off, and reasonable treatment time.

  16. SU-E-T-485: Investigation of a Synthetic Diamond Detector for Tomotherapy Dosimetry

    SciTech Connect

    Knill, C; Nalichowski, A; Halford, R; Zakjevskii, V; Zhuang, L; Snyder, M; Burmeister, J

    2014-06-01

    Purpose: Tomotherapy treatments are characterized by rotational deliveries of flattening-filter free fields resulting in high-gradient dose distributions. Small volume, rotationally independent detectors are needed for accurate dosimetry. PTWs microDiamond detector, with its small sensitive volume (0.004mm{sup 3}), could potentially be an ideal detector for Tomotherapy. The microDiamond detector was tested against a small volume Exradin A1SL ion chamber for Tomotherapy open-field and IMRT commissioning measurements. Methods: Custom detector holders were fabricated to allow A1SL and microDiamond measurements in the Tomotherapy Cheese phantom and a square solid water phantom. The microDiamond rotational dependence within the Tomotherapy phantom was tested by incrementally rotating the detector in between static-gantry angle Tomotherapy irradiations. Longitudinal Tomotherapy profiles, for all field sizes, were measured with the microDiamond and A1SL detectors at 1.5cm depth in the square phantom, and compared to film. Detector axes were aligned parallel to table motion. Per TG-119 recommendations, both detectors were calibrated to known doses in phantoms and used to measure high-dose points in TG-119 H and N and Prostate plans. The measurements were compared to the treatment planning system and subsequently compared to published TG-119 confidence limits. Results: The microDiamond angular dependence was less than 0.5%. The average difference between the detectors and film-measured longitudinal profile 80–20% penumbras were 0.03+/-0.04mm and 1.36+/-0.22mm for the microDiamond and A1SL, respectively. The average difference between the detector and filmmeasured field sizes were 0.07+/-0.01mm and 0.09+/-0.02mm for the microDiamond and A1SL, respectively. The measured confidence limits were 0.023 and 0.015 for microDiamond and A1SL, respectively. TG-119 reported a confidence limit of 0.034. Conclusion: The microDiamond measured open-field longitudinal Tomotherapy profiles

  17. Generation of optical vortices in layered helical waveguides

    SciTech Connect

    Alexeyev, C. N.; Fadeyeva, T. A.; Lapin, B. P.; Yavorsky, M. A.

    2011-06-15

    We study the possibility of changing the topological charge of incident beams by layered helical structures consisting of planar layers. We show that such structures can effectively change the topological charge of the incoming beam by unity. The problem of the fundamental mode and optical vortex passage through such a layered helical waveguide of a finite length is solved. The spectral characteristics of these processes are obtained. It is shown that such a waveguide can operate as a broadband compact generator of optical vortices from both regular and singular beams.

  18. SU-E-T-331: To Evaluate Planning Quality of SBRT with Multiple Lung Metastases Generated with Pinnacle and Tomotherapy

    SciTech Connect

    Chen, Y; Zhang, Y; Zhang, Y; Doxsee, K; Yang, C

    2014-06-01

    Purpose: To evaluate planning quality of SBRT with multiple lung metastases generated with Pinnacle and Tomotherapy Methods: Nine randomly selected patients diagnosed with non small-cell lung cancer with multiple lesions were planned with Pinnacle (version 9.2) and Tomotherapy (version 4.2). Coplanar and non-coplanar plans were generated on Pinnacle. A total dose of 60 Gy was prescribed to 95% of PTV in 3 fractions. Single isocenter was used. Nine static beams were used for Pinnacle plans. Planning outcomes such as minimum and mean dose, V{sub 9} {sub 5}, D{sub 9} {sub 5} (95% of target volume receives prescription dose), D{sub 5}, and D{sub 1} to PTV, maximum dose to heart, esophagus, cord, trachea, brachial plexus, rib, chest wall, and liver, mean dose to liver, total lung, right and left lung, volume of chest wall receives 30 Gy, volume of lungs receives 5 Gy and 20Gy, conformity index (CI = PIV / PTV) and heterogeneity index (HI = D{sub 5} / D{sub 9} {sub 5}) were reported for evaluation. Results: The mean volume of PTV was 37.77 ± 23.4 cm3. D{sub 9} {sub 5} of PTV with Tomo, coplanar, non-coplanar was 60.2 ± 0.3 Gy, 58.6 ± 1.2 Gy, and 59.1 ± 0.7 Gy, respectively. Mean dose to PTV was lower for Tomo (p < 0.0001), so were D{sub 5} (p < 0.0001) and D{sub 1} (p = 0.001). CI was better with Tomo (p < 0.0001), so was HI (p < 0.0001). Maximum dose to other critical organs were also lower exclusively with Tomo plans. Treatment time was recorded only for Tomo plans (73.0 ± 20.6 min). Conclusion: With 51 beam angles, Tomo plans could generally achieve better tumor coverage while sparing more critical structures for multiple lung lesions study. Non-coplanar also has better tumor coverage with lower dose to critical organs such as lungs, liver, chest wall and cord compare to coplanar plans.

  19. Design of Helical Solenoid Combined with RF Cavity

    SciTech Connect

    Kashikhin, Vladimir; Andreev, Nicolai; Kashikhin, Vadim; Lamm, Michael; Makarov, Alexander; Romanov, Gennady; Yonehara, Katsuya; Yu, Miao; Zlobin, Alexander; /Fermilab

    2010-05-01

    Helical Solenoids (HS) were proposed for a muon beam ionization cooling. There are substantial energy losses, up to 30 MeV/m, during the passing of the muon beam through the absorber. The main issue of such a system is the muon beam energy recovery. A conventional RF cavity is too large to be placed inside HS. In the paper the results of a dielectric-filled RF cavity design is presented. The proposed RF cavity has a helical configuration. Helical Cooling Channel (HCC) module design which includes high pressure vessel, RF cavity, and superconducting HS is presented. The parameters of these module sub-systems are discussed, and the results of muon beam tracking in combined magnetic and electric 3D fields are shown.

  20. Squeezed helical elastica.

    PubMed

    Bouzar, Lila; Müller, Martin Michael; Gosselin, Pierre; Kulić, Igor M; Mohrbach, Hervé

    2016-11-01

    We theoretically study the conformations of a helical semi-flexible filament confined to a flat surface. This squeezed helix exhibits a variety of unexpected shapes resembling circles, waves or spirals depending on the material parameters. We explore the conformation space in detail and show that the shapes can be understood as the mutual elastic interaction of conformational quasi-particles. Our theoretical results are potentially useful to determine the material parameters of such helical filaments in an experimental setting.

  1. Broadband circularly polarizing dichroism with high efficient plasmonic helical surface.

    PubMed

    Hu, Jingpei; Zhao, Xiaonan; Li, Ruibin; Zhu, Aijiao; Chen, Linghua; Lin, Yu; Cao, Bing; Zhu, Xiaojun; Wang, Chinhua

    2016-05-16

    We propose and experimentally demonstrate a broadband and high efficient circularly polarizing dichroism using a simple single-cycle and single-helical plasmonic surface array arranged in square lattice. Two types of helical surface structures (partially or completely covered with a gold film) are investigated. It is shown that the circular polarization dichroism in the mid-IR range (3µm - 5µm) can reach 80% (when the surface is partially covered with gold) or 65% (when the surface is completely covered with gold) with a single-cycle and single-helical surface. Experimental fabrications of the proposed helical plasmonic surface are implemented with direct 3D laser writing followed by electron beam evaporation deposition of gold. The experimental evaluations of the circular polarization dichroism are in excellent agreement with the simulation. The proposed helical surface structure is of advantages of easy-fabrication, high-dichroism and scalable to other frequencies as a high efficient broadband circular polarizer.

  2. Long-term dosimetric stability of multiple TomoTherapy delivery systems.

    PubMed

    Smilowitz, Jennifer B; Dunkerley, David; Hill, Patrick M; Yadav, Poonam; Geurts, Mark W

    2017-05-01

    The dosimetric stability of six TomoTherapy units was analyzed to investigate changes in performance over time and with system upgrades. Energy and output were tracked using monitor chamber signal, onboard megavoltage computed tomography (MVCT) detector profile, and external ion chamber measurements. The systems (and monitoring periods) include three Hi-Art (67, 61, and 65 mos.), two TomoHDA (31 and 26 mos.), and one Radixact unit (11 mos.), representing approximately 10 years of clinical use. The four newest systems use the Dose Control Stability (DCS) system and Fixed Target Linear Accelerator (linac) (FTL). The output stability is reported as deviation from reference monitor chamber signal for all systems and/or from an external chamber signal. The energy stability was monitored using relative (center versus off-axis) MVCT detector signal (beam profile) and/or the ratio of chamber measurements at 2 depths. The clinical TomoHDA data were used to benchmark the Radixact stability, which has the same FTL but runs at a higher dose rate. The output based on monitor chamber data of all systems is very stable. The standard deviation of daily output on the non-DCS systems was 0.94-1.52%. As expected, the DCS systems had improved standard deviation: 0.004-0.06%. The beam energy was also very stable for all units. The standard deviation in profile flatness was 0.23-0.62% for rotating target systems and 0.04-0.09% for FTL. Ion chamber output and PDD ratios supported these results. The output stability on the Radixact system during extended treatment delivery (20, 30, and 40 min) was comparable to a clinical TomoHDA system. For each system, results are consistent between different measurement tools and techniques, proving not only the dosimetric stability, but also these quality parameters can be confirmed with various metrics. The replacement history over extended time periods of the major dosimetric components of the different delivery systems (target, linac, and magnetron

  3. Helical plasma thruster

    SciTech Connect

    Beklemishev, A. D.

    2015-10-15

    A new scheme of plasma thruster is proposed. It is based on axial acceleration of rotating magnetized plasmas in magnetic field with helical corrugation. The idea is that the propellant ionization zone can be placed into the local magnetic well, so that initially the ions are trapped. The E × B rotation is provided by an applied radial electric field that makes the setup similar to a magnetron discharge. Then, from the rotating plasma viewpoint, the magnetic wells of the helically corrugated field look like axially moving mirror traps. Specific shaping of the corrugation can allow continuous acceleration of trapped plasma ions along the magnetic field by diamagnetic forces. The accelerated propellant is expelled through the expanding field of magnetic nozzle. By features of the acceleration principle, the helical plasma thruster may operate at high energy densities but requires a rather high axial magnetic field, which places it in the same class as the VASIMR{sup ®} rocket engine.

  4. Helical screw viscometer

    NASA Astrophysics Data System (ADS)

    Aubert, J. H.; Chapman, R. N.; Kraynik, A. M.

    1983-06-01

    A helical screw viscometer for the measurement of the viscosity of Newtonian and nonNewtonian fluids is comprised of an elongated cylindrical container closed by end caps defining a circular cylindrical cavity within the container, a cylindrical rotor member having a helical screw or ribbon flight carried by the other periphery thereof rotatably carried within the cavity. The fluid to be measured is confined in the cavity filling the space between the rotor and the container wall. The rotor member is supported by axle members journaled in the end caps, one axle extending through one end cap and connectable to a drive source. A pair of longitudinally spaced ports are provided through the wall of the container in communication with the cavity and a differential pressure meter is connected between the ports for measuring the pressure drop caused by the rotation of the helical screw rotor acting on the confined fluid for computing viscosity.

  5. Helical plasma thruster

    NASA Astrophysics Data System (ADS)

    Beklemishev, A. D.

    2015-10-01

    A new scheme of plasma thruster is proposed. It is based on axial acceleration of rotating magnetized plasmas in magnetic field with helical corrugation. The idea is that the propellant ionization zone can be placed into the local magnetic well, so that initially the ions are trapped. The E × B rotation is provided by an applied radial electric field that makes the setup similar to a magnetron discharge. Then, from the rotating plasma viewpoint, the magnetic wells of the helically corrugated field look like axially moving mirror traps. Specific shaping of the corrugation can allow continuous acceleration of trapped plasma ions along the magnetic field by diamagnetic forces. The accelerated propellant is expelled through the expanding field of magnetic nozzle. By features of the acceleration principle, the helical plasma thruster may operate at high energy densities but requires a rather high axial magnetic field, which places it in the same class as the VASIMR® rocket engine.

  6. Mathisson's helical motions demystified

    NASA Astrophysics Data System (ADS)

    Costa, L. Filipe; Natário, José; Zilhão, Miguel

    2012-07-01

    The motion of spinning test particles in general relativity is described by Mathisson-Papapetrou-Dixon equations, which are undetermined up to a spin supplementary condition, the latter being today still an open question. The Mathisson-Pirani (MP) condition is known to lead to rather mysterious helical motions which have been deemed unphysical, and for this reason discarded. We show that these assessments are unfounded and originate from a subtle (but crucial) misconception. We discuss the kinematical explanation of the helical motions, and dynamically interpret them through the concept of hidden momentum, which has an electromagnetic analogue. We also show that, contrary to previous claims, the frequency of the helical motions coincides exactly with the zitterbewegung frequency of the Dirac equation for the electron.

  7. Helical screw viscometer

    DOEpatents

    Aubert, J.H.; Chapman, R.N.; Kraynik, A.M.

    1983-06-30

    A helical screw viscometer for the measurement of the viscosity of Newtonian and non-Newtonian fluids comprising an elongated cylindrical container closed by end caps defining a circular cylindrical cavity within the container, a cylindrical rotor member having a helical screw or ribbon flight carried by the outer periphery thereof rotatably carried within the cavity whereby the fluid to be measured is confined in the cavity filling the space between the rotor and the container wall. The rotor member is supported by axle members journaled in the end caps, one axle extending through one end cap and connectable to a drive source. A pair of longitudinally spaced ports are provided through the wall of the container in communication with the cavity and a differential pressure meter is connected between the ports for measuring the pressure drop caused by the rotation of the helical screw rotor acting on the confined fluid for computing viscosity.

  8. RF Modeling of a Helical Kicker for Fast Chopping

    SciTech Connect

    Awida, Mohamed; Chen, Alex; Khabiboulline, Timergali; Saewert, Gregory; Yakovlev, Vyacheslav

    2015-06-01

    High intensity proton particle accelerators that supports several simultaneous physics experiments requires sharing the beam. A bunch by bunch beam chopper system located after the Radio Frequency Quadrupole (RFQ) is required in this case to structure the beam in the proper bunch format required by the several experiments. The unused beam will need to be kicked out of the beam path and is disposed in a beam dumb. In this paper, we report on the RF modeling results of a proposed helical kicker. Two beam kickers constitutes the proposed chopper. The beam sequence is formed by kicking in or out the beam bunches from the streamline. The chopper was developed for Project X Injection Experiment (PXIE).

  9. Helical-D pinch

    SciTech Connect

    Schaffer, M.J.

    1997-08-01

    A stabilized pinch configuration is described, consisting of a D-shaped plasma cross section wrapped tightly around a guiding axis. The {open_quotes}helical-D{close_quotes} geometry produces a very large axial (toroidal) transform of magnetic line direction that reverses the pitch of the magnetic lines without the need of azimuthal (poloidal) plasma current. Thus, there is no need of a {open_quotes}dynamo{close_quotes} process and its associated fluctuations. The resulting configuration has the high magnetic shear and pitch reversal of the reversed field pinch (RFP). (Pitch = P = qR, where R = major radius). A helical-D pinch might demonstrate good confinement at q << 1.

  10. Helical spring holder assembly

    NASA Technical Reports Server (NTRS)

    Newman, Wyatt S. (Inventor)

    1987-01-01

    A helically-threaded spring holder on which a helically wound spring is mounted has a groove formed in one side of the thread at the end where the spring engages the spring holder. The groove relieves the portion of the side in which it is formed from restricting the spring against axial movement during deflection of the spring. The circumferential length of this groove is chosen to establish the number of spring coils which can be deflected without contacting the side of the thread. The end of the thread is also made rigid to prevent flexing thereof during maximal elongation of the spring.

  11. Epicyclic Helical Channels for Parametric Resonance Ionization Cooling

    SciTech Connect

    Andrei Afanaciev, Alex Bogacz, Yaroslav Derbenev, Kevin Beard, Valentin Ivanov, Rolland Johnson, Guimei Wang, Katsuya Yonehara

    2009-05-01

    In order to achieve cooling of muons in addition to 6D helical cooling channel (HCC) [1], we develop a technique based on a parametric resonance. The use of parametric resonances requires alternating dispersion, minimized at locations of thin absorbers, but maximized in between in order to compensate for chromatic aberrations [2]. These solutions can be combined in an Epicyclic Helical Cooling Channel (EHCC) that meets requirements of alternating dispersion of beam periodic orbit with best conditions for maintenance of stable beam transport in a continuous solenoid-type field [3]. We discuss here basic features and new simulation results for EHCC.

  12. 3D Dose Verification Using Tomotherapy CT Detector Array

    SciTech Connect

    Sheng Ke; Jones, Ryan; Yang Wensha; Saraiya, Siddharth; Schneider, Bernard; Chen Quan; Sobering, Geoff; Olivera, Gustavo; Read, Paul

    2012-02-01

    Purpose: To evaluate a three-dimensional dose verification method based on the exit dose using the onboard detector of tomotherapy. Methods and Materials: The study included 347 treatment fractions from 24 patients, including 10 prostate, 5 head and neck (HN), and 9 spinal stereotactic body radiation therapy (SBRT) cases. Detector sonograms were retrieved and back-projected to calculate entrance fluence, which was then forward-projected on the CT images to calculate the verification dose, which was compared with ion chamber and film measurement in the QA plans and with the planning dose in patient plans. Results: Root mean square (RMS) errors of 2.0%, 2.2%, and 2.0% were observed comparing the dose verification (DV) and the ion chamber measured point dose in the phantom plans for HN, prostate, and spinal SBRT patients, respectively. When cumulative dose in the entire treatment is considered, for HN patients, the error of the mean dose to the planning target volume (PTV) varied from 1.47% to 5.62% with a RMS error of 3.55%. For prostate patients, the error of the mean dose to the prostate target volume varied from -5.11% to 3.29%, with a RMS error of 2.49%. The RMS error of maximum doses to the bladder and the rectum were 2.34% (-4.17% to 2.61%) and 2.64% (-4.54% to 3.94%), respectively. For the nine spinal SBRT patients, the RMS error of the minimum dose to the PTV was 2.43% (-5.39% to 2.48%). The RMS error of maximum dose to the spinal cord was 1.05% (-2.86% to 0.89%). Conclusions: An excellent agreement was observed between the measurement and the verification dose. In the patient treatments, the agreement in doses to the majority of PTVs and organs at risk is within 5% for the cumulative treatment course doses. The dosimetric error strongly depends on the error in multileaf collimator leaf opening time with a sensitivity correlating to the gantry rotation period.

  13. Helicity and celestial magnetism

    NASA Astrophysics Data System (ADS)

    Moffatt, H. K.

    2016-06-01

    This informal article discusses the central role of magnetic and kinetic helicity in relation to the evolution of magnetic fields in geophysical and astrophysical contexts. It is argued that the very existence of magnetic fields of the intensity and scale observed is attributable in large part to the chirality of the background turbulence or random-wave field of flow, the simplest measure of this chirality being non-vanishing helicity. Such flows are responsible for the generation of large-scale magnetic fields which themselves exhibit magnetic helicity. In the geophysical context, the turbulence has a `magnetostrophic' character in which the force balance is primarily that between buoyancy forces, Coriolis forces and Lorentz forces associated with the dynamo-generated magnetic field; the dominant nonlinearity here arises from the convective transport of buoyant elements erupting from the `mushy zone' at the inner core boundary. At the opposite extreme, in a highly conducting low-density plasma, the near-invariance of magnetic field topology (and of associated helicity) presents the challenging problem of `magnetic relaxation under topological constraints', of central importance both in astrophysical contexts and in controlled-fusion plasma dynamics. These problems are reviewed and open issues, particularly concerning saturation mechanisms, are reconsidered.

  14. The Helicity of Vortex Filaments.

    NASA Astrophysics Data System (ADS)

    Petrich, Dean; Tao, Louis

    1996-03-01

    The helicity, defined by H = int dV v \\cdot nabla × v, is a conserved quantity of the three-dimensional Euler equations. Traditionally the helicity has been viewed as a measure of the topology of vortex lines, but it is shown that the helicity measures their geometry as well as their topology (J.D. Bekenstein, Physics Letters B), 282 (1992) 44-49.. The existence of helicity-preserving reconnection events is discussed.

  15. Helical dipole partial Siberian snake for the AGS

    NASA Astrophysics Data System (ADS)

    Takano, J.; Ahrens, L. A.; Alforque, R.; Bai, M.; Brown, K.; Courant, E. D.; Ganetis, G.; Gardner, C. J.; Glenn, J. W.; Hattori, T.; Huang, H.; Jain, A.; Luccio, A. U.; MacKay, W. W.; Okamura, M.; Roser, T.; Tsoupas, N.; Tepikian, S.; Tuozzolo, J.; Wood, J.; Zelenski, A.; Zeno, K.

    2006-11-01

    Overcoming depolarization resonances in medium class synchrotrons (3 to 50 GeV) is one of the key issues in accelerating a highly polarized proton beam up to very high energies. Since such synchrotrons, including the Alternating Gradient Synchrotron (AGS) and the J-PARC Main Ring, generally do not have sufficiently long straight sections to accommodate full Siberian snakes with reasonable beam excursions, the practical solution is to use partial Siberian snakes that rotate the particle spin about a horizontal axis by a fraction of 180 degrees. For the AGS, we designed and installed a new partial Siberian snake consisting of a helical dipole magnet with a double pitch structure. The helical structure reduced the amount of transverse coupling as compared to that achieved by the previous solenoidal partial snake. This coupling led to partial depolarization at certain energies from horizontal betatron oscillations. The helical magnetic field in the snake magnet was calculated using a 3D magnetic field code TOSCA, and was optimized by segmenting the helical pitch and varying the lengths of the segments. Fabrication errors were checked and verified to be within required tolerances. Finally, the transverse field was measured by rotating harmonic coils. After installation, we achieved a 37.5% improvement in polarization - from 40% with the old solenoid to 55% with the new helical snake, thereby demonstrating that the helical partial snake is an effective device to suppress depolarization resonances in medium-sized synchrotrons.

  16. Adjuvant Radiotherapy for Gastric Cancer: A Dosimetric Comparison of 3-Dimensional Conformal Radiotherapy, Tomotherapy (registered) and Conventional Intensity Modulated Radiotherapy Treatment Plans

    SciTech Connect

    Dahele, Max; Skinner, Matthew; Schultz, Brenda; Cardoso, Marlene; Bell, Chris; Ung, Yee C.

    2010-07-01

    Some patients with gastric cancer benefit from post-operative chemo-radiotherapy, but adequately irradiating the planning target volume (PTV) whilst avoiding organs at risk (OAR) can be difficult. We evaluate 3-dimensional conformal radiotherapy (CRT), conventional intensity-modulated radiotherapy (IMRT) and helical tomotherapy (TT). TT, 2 and 5-field (F) CRT and IMRT treatment plans with the same PTV coverage were generated for 5 patients and compared. Median values are reported. The volume of left/right kidney receiving at least 20Gy (V20) was 57/51% and 51/60% for 2 and 5F-CRT, and 28/14% for TT and 27/19% for IMRT. The volume of liver receiving at least 30Gy (V30) was 45% and 62% for 2 and 5F-CRT, and 37% for TT and 35% for IMRT. With TT, 98% of the PTV received 95-105% of the prescribed dose, compared with 45%, 34% and 28% for 2F-CRT, 5F-CRT and IMRT respectively. Using conventional metrics, conventional IMRT can achieve comparable PTV coverage and OAR sparing to TT, but at the expense of PTV dose heterogeneity. Both irradiate large volumes of normal tissue to low doses. Additional studies are needed to demonstrate the clinical impact of these technologies.

  17. Generation of hybrid sinograms for the recovery of kV-CT images with metal artifacts for helical tomotherapy

    SciTech Connect

    Jeon, Hosang; Park, Dahl; Kim, Wontaek; Ki, Yongkan; Kim, Yong Ho; Lee, Ju Hye; Kim, Dongwon; Youn, Hanbean; Nam, Jiho; Lee, Jayoung; Kim, Ho Kyung

    2015-08-15

    Purpose: The overall goal of this study is to restore kilovoltage computed tomography (kV-CT) images which are disfigured by patients’ metal prostheses. By generating a hybrid sinogram that is a combination of kV and megavoltage (MV) projection data, the authors suggest a novel metal artifact-reduction (MAR) method that retains the image quality to match that of kV-CT and simultaneously restores the information of metal prostheses lost due to photon starvation. Methods: CT projection data contain information about attenuation coefficients and the total length of the attenuation. By normalizing raw kV projections with their own total lengths of attenuation, mean attenuation projections were obtained. In the same manner, mean density projections of MV-CT were obtained by the normalization of MV projections resulting from the forward projection of density-calibrated MV-CT images with the geometric parameters of the kV-CT device. To generate the hybrid sinogram, metal-affected signals of the kV sinogram were identified and replaced by the corresponding signals of the MV sinogram following a density calibration step with kV data. Filtered backprojection was implemented to reconstruct the hybrid CT image. To validate the authors’ approach, they simulated four different scenarios for three heads and one pelvis using metallic rod inserts within a cylindrical phantom. Five inserts describing human body elements were also included in the phantom. The authors compared the image qualities among the kV, MV, and hybrid CT images by measuring the contrast-to-noise ratio (CNR), the signal-to-noise ratio (SNR), the densities of all inserts, and the spatial resolution. In addition, the MAR performance was compared among three existing MAR methods and the authors’ hybrid method. Finally, for clinical trials, the authors produced hybrid images of three patients having dental metal prostheses to compare their MAR performances with those of the kV, MV, and three existing MAR methods. Results: The authors compared the image quality and MAR performance of the hybrid method with those of other imaging modalities and the three MAR methods, respectively. The total measured mean of the CNR (SNR) values for the nonmetal inserts was determined to be 14.3 (35.3), 15.3 (37.8), and 25.5 (64.3) for the kV, MV, and hybrid images, respectively, and the spatial resolutions of the hybrid images were similar to those of the kV images. The measured densities of the metal and nonmetal inserts in the hybrid images were in good agreement with their true densities, except in cases of extremely low densities, such as air and lung. Using the hybrid method, major streak artifacts were suitably removed and no secondary artifacts were introduced in the resultant image. In clinical trials, the authors verified that kV and MV projections were successfully combined and turned into the resultant hybrid image with high image contrast, accurate metal information, and few metal artifacts. The hybrid method also outperformed the three existing MAR methods with regard to metal information restoration and secondary artifact prevention. Conclusions: The authors have shown that the hybrid method can restore the overall image quality of kV-CT disfigured by severe metal artifacts and restore the information of metal prostheses lost due to photon starvation. The hybrid images may allow for the improved delineation of structures of interest and accurate dose calculations for radiation treatment planning for patients with metal prostheses.

  18. Tomotherapy treatment plan quality assurance: The impact of applied criteria on passing rate in gamma index method

    SciTech Connect

    Bresciani, Sara; Di Dia, Amalia; Maggio, Angelo; Cutaia, Claudia; Miranti, Anna; Infusino, Erminia; Stasi, Michele

    2013-12-15

    Purpose: Pretreatment patient plan verification with gamma index (GI) metric analysis is standard procedure for intensity modulated radiation therapy (IMRT) treatment. The aim of this paper is to evaluate the variability of the local and global gamma index obtained during standard pretreatment quality assurance (QA) measurements for plans performed with Tomotherapy unit. The QA measurements were performed with a 3D diode array, using variable passing criteria: 3%/3 mm, 2%/2 mm, 1%/1 mm, each with both local and global normalization.Methods: The authors analyzed the pretreatment QA results for 73 verifications; 37 were prostate cancer plans, 16 were head and neck plans, and 20 were other clinical sites. All plans were treated using the Tomotherapy Hi-Art System. Pretreatment QA plans were performed with the commercially available 3D diode array ArcCHECK™. This device has 1386 diodes arranged in a helical geometry spaced 1 cm apart. The dose measurements were acquired on the ArcCHECK™ and then compared with the calculated dose using the standard gamma analysis method. The gamma passing rate (%GP), defined as the percentage of points satisfying the condition GI < 1, was calculated for different criteria (3%/3 mm, 2%/2 mm, 1%/1 mm) and for both global and local normalization. In the case of local normalization method, the authors set three dose difference threshold (DDT) values of 2, 3, and 5 cGy. Dose difference threshold is defined as the minimum absolute dose error considered in the analysis when using local normalization. Low-dose thresholds (TH) of 5% and 10% were also applied and analyzed.Results: Performing a paired-t-test, the authors determined that the gamma passing rate is independent of the threshold values for all of the adopted criteria (5%TH vs 10%TH, p > 0.1). Our findings showed that mean %GPs for local (or global) normalization for the entire study group were 93% (98%), 84% (92%), and 66% (61%) for 3%/3 mm, 2%/2 mm, and 1%/1 mm criteria

  19. A robust procedure for verifying TomoTherapy Hi-Art™ source models for small fields

    NASA Astrophysics Data System (ADS)

    Hundertmark, B.; Sterpin, E.; Mackie, T.

    2011-06-01

    The dosimetric measurement and modeling of small radiation treatment fields (<2 × 2 cm2) are difficult to perform and prone to error. Measurements of small fields are often adversely influenced by the properties of the detectors used to make them. The dosimetric properties of small fields have been difficult to accurately model due to the effects of source occlusion caused by the collimating jaws. In this study, small longitudinal slice widths (SWs) of the TomoTherapy® Hi-Art® machine are characterized by performing dosimetric measurements topographically. By using a static gantry, opening the central 16 MLC leaves during the irradiations, and symmetrically scanning detectors 10 cm through each longitudinal SW, integral doses to a 'TomoTherapy equivalent' 10 × 10 cm2 area are topographically measured. To quantify the effects of source occlusion for TomoTherapy, a quantity referred to as the integral scanned dose to slice width ratio (D/SW) is introduced. (D/SW) ratios are measured for SWs ranging from 0.375 to 5 cm in size using ion chambers and a radiographic film. The measurements of the (D/SW) ratio are shown to be insensitive to the detectors used in this study. The (D/SW) ratios for TomoTherapy have values of unity in the range of SW sizes from 5 cm to approximately 2 cm. For SWs smaller than 2 cm in size, the source-occlusion effect substantially reduces the measured machine output and the value of the (D/SW) ratios. The topographic measurement method presented provides a way to directly evaluate the accuracy of the small-field source model parameters used in dose calculation algorithms. As an example, the electron source spot size of a Penelope Monte Carlo (MC) model of TomoTherapy was varied to match computed and measured (D/SW) ratios. It was shown that the MC results for small SW sizes were sensitive to that particular parameter.

  20. SU-D-201-03: During-Treatment Delivery Monitoring System for TomoTherapy

    SciTech Connect

    Chen, Q; Read, P

    2016-06-15

    Purpose: Multiple error pathways can lead to delivery errors during the treatment course that cannot be caught with pre-treatment QA. While in vivo solutions are being developed for linacs, no such solution exists for tomotherapy. The purpose of this study is to develop a near real-time system for tomotherapy that can monitor the delivery and dose accumulation process during the treatment-delivery, which enable the user to assess the impact of delivery variations and/or errors and to interrupt the treatment if necessary. Methods: A program running on a tomotherapy planning station fetches the raw DAS data during treatment. Exit detector data is extracted as well as output, gantry angle, and other machine parameters. For each sample, the MLC open-close state is determined. The delivered plan is compared with the original plan via a Monte Carlo dose engine which transports fluence deviations from a pre-treatment Monte Carlo run. A report containing the difference in fluence, dose and DVH statistics is created in html format. This process is repeated until the treatment is completed. Results: Since we only need to compute the dose for the difference in fluence for a few projections each time, dose with 2% statistical uncertainty can be computed in less than 1 second on a 4-core cpu. However, the current bottleneck in this near real-time system is the repeated fetching and processing the growing DAS data file throughout the delivery. The frame rate drops from 10Hz at the beginning of treatment to 5Hz after 3 minutes and to 2Hz after 10 minutes. Conclusion: A during-treatment delivery monitor system has been built to monitor tomotherapy treatments. The system improves patient safety by allowing operators to assess the delivery variations and errors during treatment delivery and adopt appropriate actions.

  1. Helically Coiled Graphene Nanoribbons.

    PubMed

    Daigle, Maxime; Miao, Dandan; Lucotti, Andrea; Tommasini, Matteo; Morin, Jean-François

    2017-03-07

    Graphene is a zero-gap, semiconducting 2D material that exhibits outstanding charge-transport properties. One way to open a band gap and make graphene useful as a semiconducting material is to confine the electron delocalization in one dimension through the preparation of graphene nanoribbons (GNR). Although several methods have been reported so far, solution-phase, bottom-up synthesis is the most promising in terms of structural precision and large-scale production. Herein, we report the synthesis of a well-defined, helically coiled GNR from a polychlorinated poly(m-phenylene) through a regioselective photochemical cyclodehydrochlorination (CDHC) reaction. The structure of the helical GNR was confirmed by (1) H NMR, FT-IR, XPS, TEM, and Raman spectroscopy. This Riemann surface-like GNR has a band gap of 2.15 eV and is highly emissive in the visible region, both in solution and the solid state.

  2. Analysis of Helical Waveguide.

    DTIC Science & Technology

    1985-12-23

    tube Efficiency Helix structure Backward wave oscillation Gain 19. ABSTRACT (Continue on reverse if necessary and identofy by block number) The...4,vailabilitY CCdes -vai aidIorDist spec a ." iii "- -. .5- S.. . ANALYSIS OF HELICAL WAVEGUIDE I. INTRODUCTION High power (- 10 kW) and broadband ...sys- tems. The frequency range of interest is 60-100 GHz. In this frequency range, the conventional slow wave circuits such as klystrons and TWTs have

  3. Helically linked mirror arrangement

    SciTech Connect

    Ranjan, P.

    1986-08-01

    A scheme is described for helical linking of mirror sections, which endeavors to combine the better features of toroidal and mirror devices by eliminating the longitudinal loss of mirror machines, having moderately high average ..beta.. and steady state operation. This scheme is aimed at a device, with closed magnetic surfaces having rotational transform for equilibrium, one or more axisymmetric straight sections for reduced radial loss, a simple geometrical axis for the links and an overall positive magnetic well depth for stability. We start by describing several other attempts at linking of mirror sections, made both in the past and the present. Then a description of our helically linked mirror scheme is given. This example has three identical straight sections connected by three sections having helical geometric axes. A theoretical analysis of the magnetic field and single-particle orbits in them leads to the conclusion that most of the passing particles would be confined in the device and they would have orbits independent of pitch angle under certain conditions. Numerical results are presented, which agree well with the theoretical results as far as passing particle orbits are concerned.

  4. Magnetic helicity in astrophysical dynamos

    NASA Astrophysics Data System (ADS)

    Candelaresi, Simon

    2012-09-01

    The broad variety of ways in which magnetic helicity affects astrophysical systems, in particular dynamos, is discussed. The so-called alpha effect is responsible for the growth of large-scale magnetic fields. The conservation of magnetic helicity, however, quenches the alpha effect, in particular for high magnetic Reynolds numbers. Predictions from mean-field theories state particular power law behavior of the saturation strength of the mean fields, which we confirm in direct numerical simulations. The loss of magnetic helicity in the form of fluxes can alleviate the quenching effect, which means that large-scale dynamo action is regained. Physically speaking, galactic winds or coronal mass ejections can have fundamental effects on the amplification of galactic and solar magnetic fields. The gauge dependence of magnetic helicity is shown to play no effect in the steady state where the fluxes are represented in form of gauge-independent quantities. This we demonstrate in the Weyl-, resistive- and pseudo Lorentz-gauge. Magnetic helicity transport, however, is strongly affected by the gauge choice. For instance the advecto-resistive gauge is more efficient in transporting magnetic helicity into small scales, which results in a distinct spectrum compared to the resistive gauge. The topological interpretation of helicity as linking of field lines is tested with respect to the realizability condition, which imposes a lower bound for the spectral magnetic energy in presence of magnetic helicity. It turns out that the actual linking does not affect the relaxation process, unlike the magnetic helicity content. Since magnetic helicity is not the only topological variable, I conduct a search for possible others, in particular for non-helical structures. From this search I conclude that helicity is most of the time the dominant restriction in field line relaxation. Nevertheless, not all numerical relaxation experiments can be described by the conservation of magnetic helicity

  5. Far-field measurements of vortex beams interacting with nanoholes

    PubMed Central

    Zambrana-Puyalto, Xavier; Vidal, Xavier; Fernandez-Corbaton, Ivan; Molina-Terriza, Gabriel

    2016-01-01

    We measure the far-field intensity of vortex beams going through nanoholes. The process is analyzed in terms of helicity and total angular momentum. It is seen that the total angular momentum is preserved in the process, and helicity is not. We compute the ratio between the two transmitted helicity components, γm,p. We observe that this ratio is highly dependent on the helicity (p) and the angular momentum (m) of the incident vortex beam in consideration. Due to the mirror symmetry of the nanoholes, we are able to relate the transmission properties of vortex beams with a certain helicity and angular momentum, with the ones with opposite helicity and angular momentum. Interestingly, vortex beams