Feasibility of magnetic resonance imaging-guided liver stereotactic body radiation therapy: A comparison between modulated tri-cobalt-60 teletherapy and linear accelerator-based intensity modulated radiation therapy.

PubMed

Kishan, Amar U; Cao, Minsong; Wang, Pin-Chieh; Mikaeilian, Argin G; Tenn, Stephen; Rwigema, Jean-Claude M; Sheng, Ke; Low, Daniel A; Kupelian, Patrick A; Steinberg, Michael L; Lee, Percy

2015-01-01

The purpose of this study was to investigate the dosimetric feasibility of liver stereotactic body radiation therapy (SBRT) using a teletherapy system equipped with 3 rotating (60)Co sources (tri-(60)Co system) and a built-in magnetic resonance imager (MRI). We hypothesized tumor size and location would be predictive of favorable dosimetry with tri-(60)Co SBRT. The primary study population consisted of 11 patients treated with SBRT for malignant hepatic lesions whose linear accelerator (LINAC)-based SBRT plans met all mandatory Radiation Therapy Oncology Group (RTOG) 1112 organ-at-risk (OAR) constraints. The secondary study population included 5 additional patients whose plans did not meet the mandatory constraints. Patients received 36 to 60 Gy in 3 to 5 fractions. Tri-(60)Co system SBRT plans were planned with ViewRay system software. All patients in the primary study population had tri-(60)Co SBRT plans that passed all RTOG constraints, with similar planning target volume coverage and OAR doses to LINAC plans. Mean liver doses and V10Gy to the liver, although easily meeting RTOG 1112 guidelines, were significantly higher with tri-(60)Co plans. When the 5 additional patients were included in a univariate analysis, the tri-(60)Co SBRT plans were still equally able to pass RTOG constraints, although they did have inferior ability to pass more stringent liver and kidney constraints (P < .05). A multivariate analysis found the ability of a tri-(60)Co SBRT plan to meet these constraints depended on lesion location and size. Patients with smaller or more peripheral lesions (as defined by distance from the aorta, chest wall, liver dome, and relative lesion volume) were significantly more likely to have tri-(60)Co plans that spared the liver and kidney as well as LINAC plans did (P < .05). It is dosimetrically feasible to perform liver SBRT with a tri-(60)Co system with a built-in MRI. Patients with smaller or more peripheral lesions are more likely to have optimal liver and kidney sparing, with the added benefit of MRI guidance, when receiving tri-(60)Co-based SBRT. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Multileaf collimator-based linear accelerator radiosurgery: five-year efficiency analysis.

PubMed

Lawson, Joshua D; Fox, Tim; Waller, Anthony F; Davis, Lawrence; Crocker, Ian

2009-03-01

In 1989, Emory University initiated a linear accelerator (linac) radiosurgery program using circular collimators. In 2001, the program converted to a multileaf collimator. Since then, the treatment parameters of each patient have been stored in the record-and-verify system. Three major changes have occurred in the radiosurgery program in the past 6 years: in 2002, treatment was changed from static conformal beams to dynamic conformal arc (DCA) therapy, and all patients were imaged before treatment. Beginning in 2005, a linac was used, with the opportunity to treat at higher dose rates (600-1,000 monitor units/min). The aim of this study was to analyze the time required to deliver radiosurgery and the factors affecting treatment delivery. Benchmark data are provided for centers contemplating initiating linac radiosurgery programs. Custom software was developed to mine the record-and-verify system database and automatically perform a chart review on patients who underwent stereotactic radiosurgery from March 2001 to October 2006. The software extracted 510 patients who underwent stereotactic radiosurgery, and the following information was recorded for each patient: treatment technique, treatment time (from initiation of imaging, if done, to completion of therapy), number of isocenters, number of fields, total monitor units, and dose rate. Of the 510 patients, 395 were treated with DCA therapy and 115 with static conformal beams. The average number of isocenters treated was 1.06 (range, 1-4). The average times to deliver treatment were 24.1 minutes for patients who underwent DCA therapy and 19.3 minutes for those treated with static conformal beams, reflecting the lack of imaging in the latter patients. Eighty percent of patients were treated in <30 minutes. For the patients who underwent DCA therapy, the times required to treat 1, 2, 3, and 4 isocenters were 23.9, 24.8, 33.1, and 37.8 minutes, respectively. Average beam-on time for these patients was 11.4 minutes. There has been no significant reduction in treatment delivery with the use of 1,000 monitor units/min, reflecting the fact that beam-on time is not the major determinant of overall treatment time. Multileaf collimator-based linac radiosurgery can be delivered efficiently in <30 minutes in the vast majority of patients. Given the limited treatment room utilization required for stereotactic radiosurgery treatments, this study calls into question the need for a dedicated radiosurgery unit for even busy treatment centers.

Simultaneous optimization of the cavity heat load and trip rates in linacs using a genetic algorithm

DOE PAGES

Terzić, Balša; Hofler, Alicia S.; Reeves, Cody J.; ...

2014-10-15

In this paper, a genetic algorithm-based optimization is used to simultaneously minimize two competing objectives guiding the operation of the Jefferson Lab's Continuous Electron Beam Accelerator Facility linacs: cavity heat load and radio frequency cavity trip rates. The results represent a significant improvement to the standard linac energy management tool and thereby could lead to a more efficient Continuous Electron Beam Accelerator Facility configuration. This study also serves as a proof of principle of how a genetic algorithm can be used for optimizing other linac-based machines.

Hippocampal dose during Linac-based stereotactic radiotherapy for brain metastases: An observational study.

PubMed

Fiorentino, Alba; Tebano, Umberto; Sicignano, Gianluisa; Ricchetti, Francesco; Di Paola, Gioacchino; Aiello, Dario; Giaj-Levra, Niccolò; Mazzola, Rosario; Fersino, Sergio; Ruggieri, Ruggero; Alongi, Filippo

2017-09-23

Aim of the present study is to evaluate homolateral and contralateral hippocampus (H-H, C-H, respectively) dose during Fractionated Stereotactic Radiotherapy (FSRT) or Radiosurgery (SRS) for brain metastases (BM). Patients with BM<5, size≤30mm, KPS≥80 and a life expectancy>3months, were considered for SRS/FSRT (total dose 15-30Gy, 1-5 fractions). For each BM, a Flattening Filter Free (FFF) Volumetric Modulated Arc Therapy (VMAT) plan was generated with one or two arcs. Hippocampi were not considered during optimizations phase and were contoured and evaluated retrospectively in terms of dose: the Dmedian, Dmean, D0.1cc and the V1Gy, V2Gy, V5Gy and V10Gy were analyzed. From April 2014 to December 2015, 81 BM were treated with FFF-FSRT/SRS. For the H-H, the average values of Dmedian, Dmean and D0.1cc were 1.5Gy, 1.54Gy and 2.2Gy, respectively, while the V1Gy, V2Gy, V5Gy and V10Gy values were 25%, 8.9%, 8.9% and 2.1%, respectively. For the C-H, the average Dmedian, Dmean and D0.1cc were 0.7Gy, 0.7Gy, 0.9Gy, respectively, while the average values of V1Gy, V2Gy, V5Gy and V10Gy were 18%, 10.2%, 2.8% and 1.4%, respectively. Tumor dimension, tumor cranial-caudal length and the distance between BM and H-H were correlated to Dmedian, Dmean and D0.1cc. For C-H, only the distance from PTV was correlated with a dose reduction. During FFF-FSRT/SRS, hippocampus received a negligible dose. Despite its clinical significance is still under evaluation, in patients with a long life expectancy, H-H should be considered during Linac-based FSRT/SRS. Copyright © 2017. Published by Elsevier Ltd.

Clinical Positioning Accuracy for Multisession Stereotactic Radiotherapy With the Gamma Knife Perfexion

PubMed Central

Young, Lori A.; Phillips, Mark H.; Cheung, Michael; Halasz, Lia M.; Rockhill, Jason K.

2017-01-01

Multisession stereotactic radiation therapy is increasingly being seen as a preferred option for intracranial diseases in close proximity to critical structures and for larger target volumes. The objective of this study is to investigate the reproducibility of the Extend system from Elekta. A retrospective review was conducted for all patients treated with multisession Gamma Knife between July 2010 and June 2015, including both malignant and benign lesions. Eighty-four patients were treated in this 5-year span. The average residual daily setup uncertainty was 0.48 (0.19) mm. We compare measurements of setup uncertainty from the Extend system to measurements performed with a linac-based approach previously used in our center. The Extend system has significantly reduced setup uncertainty for fractionated intracranial treatments at our institution. Positive results were observed in a small population of edentulous patients. The Extend system compares favorably with other approaches to delivering intracranial stereotactic radiotherapy and is a robust, simple-to-use, and precise method for treating multisession intracranial lesions. PMID:28514899

SU-E-T-406: Use of TrueBeam Developer Mode and API to Increase the Efficiency and Accuracy of Commissioning Measurements for the Varian EDGE Stereotactic Linac

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

Gardner, S; Gulam, M; Song, K

2014-06-01

Purpose: The Varian EDGE machine is a new stereotactic platform, combining Calypso and VisionRT localization systems with a stereotactic linac. The system includes TrueBeam DeveloperMode, making possible the use of XML-scripting for automation of linac-related tasks. This study details the use of DeveloperMode to automate commissioning tasks for Varian EDGE, thereby improving efficiency and measurement consistency. Methods: XML-scripting was used for various commissioning tasks,including couch model verification,beam-scanning,and isocenter verification. For couch measurements, point measurements were acquired for several field sizes (2×2,4×4,10×10cm{sup 2}) at 42 gantry angles for two couch-models. Measurements were acquired with variations in couch position(rails in/out,couch shifted inmore » each of motion axes) compared to treatment planning system(TPS)-calculated values,which were logged automatically through advanced planning interface(API) scripting functionality. For beam scanning, XML-scripts were used to create custom MLC-apertures. For isocenter verification, XML-scripts were used to automate various Winston-Lutz-type tests. Results: For couch measurements, the time required for each set of angles was approximately 9 minutes. Without scripting, each set required approximately 12 minutes. Automated measurements required only one physicist, while manual measurements required at least two physicists to handle linac positions/beams and data recording. MLC apertures were generated outside of the TPS,and with the .xml file format, double-checking without use of TPS/operator console was possible. Similar time efficiency gains were found for isocenter verification measurements Conclusion: The use of XML scripting in TrueBeam DeveloperMode allows for efficient and accurate data acquisition during commissioning. The efficiency improvement is most pronounced for iterative measurements, exemplified by the time savings for couch modeling measurements(approximately 10 hours). The scripting also allowed for creation of the files in advance without requiring access to TPS. The API scripting functionality enabled efficient creation/mining of TPS data. Finally, automation reduces the potential for human error in entering linac values at the machine console,and the script provides a log of measurements acquired for each session. This research was supported in part by a grant from Varian Medical Systems, Palo Alto, CA.« less

Stereotactic radiosurgery for trigeminal neuralgia: a systematic review.

PubMed

Tuleasca, Constantin; Régis, Jean; Sahgal, Arjun; De Salles, Antonio; Hayashi, Motohiro; Ma, Lijun; Martínez-Álvarez, Roberto; Paddick, Ian; Ryu, Samuel; Slotman, Ben J; Levivier, Marc

2018-04-27

OBJECTIVES The aims of this systematic review are to provide an objective summary of the published literature specific to the treatment of classical trigeminal neuralgia with stereotactic radiosurgery (RS) and to develop consensus guideline recommendations for the use of RS, as endorsed by the International Society of Stereotactic Radiosurgery (ISRS). METHODS The authors performed a systematic review of the English-language literature from 1951 up to December 2015 using the Embase, PubMed, and MEDLINE databases. The following MeSH terms were used in a title and abstract screening: "radiosurgery" AND "trigeminal." Of the 585 initial results obtained, the authors performed a full text screening of 185 studies and ultimately found 65 eligible studies. Guideline recommendations were based on level of evidence and level of consensus, the latter predefined as at least 85% agreement among the ISRS guideline committee members. RESULTS The results for 65 studies (6461 patients) are reported: 45 Gamma Knife RS (GKS) studies (5687 patients [88%]), 11 linear accelerator (LINAC) RS studies (511 patients [8%]), and 9 CyberKnife RS (CKR) studies (263 patients [4%]). With the exception of one prospective study, all studies were retrospective. The mean maximal doses were 71.1-90.1 Gy (prescribed at the 100% isodose line) for GKS, 83.3 Gy for LINAC, and 64.3-80.5 Gy for CKR (the latter two prescribed at the 80% or 90% isodose lines, respectively). The ranges of maximal doses were as follows: 60-97 Gy for GKS, 50-90 Gy for LINAC, and 66-90 Gy for CKR. Actuarial initial freedom from pain (FFP) without medication ranged from 28.6% to 100% (mean 53.1%, median 52.1%) for GKS, from 17.3% to 76% (mean 49.3%, median 43.2%) for LINAC, and from 40% to 72% (mean 56.3%, median 58%) for CKR. Specific to hypesthesia, the crude rates (all Barrow Neurological Institute Pain Intensity Scale scores included) ranged from 0% to 68.8% (mean 21.7%, median 19%) for GKS, from 11.4% to 49.7% (mean 27.6%, median 28.5%) for LINAC, and from 11.8% to 51.2% (mean 29.1%, median 18.7%) for CKR. Other complications included dysesthesias, paresthesias, dry eye, deafferentation pain, and keratitis. Hypesthesia and paresthesia occurred as complications only when the anterior retrogasserian portion of the trigeminal nerve was targeted, whereas the other listed complications occurred when the root entry zone was targeted. Recurrence rates ranged from 0% to 52.2% (mean 24.6%, median 23%) for GKS, from 19% to 63% (mean 32.2%, median 29%) for LINAC, and from 15.8% to 33% (mean 25.8%, median 27.2%) for CKR. Two GKS series reported 30% and 45.3% of patients who were pain free without medication at 10 years. CONCLUSIONS The literature is limited in its level of evidence, with only one comparative randomized trial (1 vs 2 isocenters) reported to date. At present, one can conclude that RS is a safe and effective therapy for drug-resistant trigeminal neuralgia. A number of consensus statements have been made and endorsed by the ISRS.

SU-F-T-611: Critical Analysis and Efficacy of Linac Based (Beam Modulator) and Cyberknife Treatment Plans for Acoustic Neuroma/schwannoma

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

KP, Karrthick; Kataria, T; Thiyagarajan, R

Purpose: To study the critical analysis and efficacy of Linac and Cyberknife (CK) treatment plans for acoustic neuroma/schwannoma. Methods: Twelve of acoustic neuroma/schwannoma patients were taken for these study that. Treatment plans were generated in Multiplan treatment planning system (TPS) for CK using 5,7.5 and 10mm diameter collimators. Target volumes were in the range of 0.280 cc to 9.256 cc. Prescription dose (Rx) ranges from 1150cGy to 1950cGy delivered over 1 to 3 Fractions. For same patients stereotactic Volumetric modulated arc plans were generated using Elekta Linac with MLC thickness of 4mm in Monaco TPS. Appropriate calculation algorithms and gridmore » size were used with same Rx and organ at risk (OAR) constrains for both Linac and CK plans. Treatment plans were developed to achieve at least 95% of the target volume to receive the Rx. The dosimetric indices such as conformity index (CI), coverage, OAR dose and volume receiving 50% of Rx (V50%) were used to evaluate the plans. Results: Target volumes ranges from 0.280 cc to 3.5cc shows the CI of 1.16±0.109 and 1.53±0.360 for cyberknife and Linac plans respectively. For small volume targets, the OARs were well spared in CK plans. There are no significant differences in CI and OAR doses were observed between CK and Linac plans that have the target volume >3.5 cc. Perhaps the V50% were lesser in CK plans, and found to be 12.8± 8.4 and 22.8 ± 15.0 for CK and Linac respectively. Conclusion: The analysis shows the importance of collimator size for small volume targets. The target volumes >3.5 cc can be treated in Linac as comparable with CK. For targets <3.5cc CK plans showed superior plan quality with better CI and OAR sparing than the Linac based plans. Further studies may require evaluating the clinical advantage of CK robotic system.« less

SU-E-T-270: Optimized Shielding Calculations for Medical Linear Accelerators (LINACs).

PubMed

Muhammad, W; Lee, S; Hussain, A

2012-06-01

The purpose of radiation shielding is to reduce the effective equivalent dose from a medical linear accelerator (LINAC) to a point outside the room to a level determined by individual state/international regulations. The study was performed to design LINAC's room for newly planned radiotherapy centers. Optimized shielding calculations were performed for LINACs having maximum photon energy of 20 MV based on NCRP 151. The maximum permissible dose limits were kept 0.04 mSv/week and 0.002 mSv/week for controlled and uncontrolled areas respectively by following ALARA principle. The planned LINAC's room was compared to the already constructed (non-optimized) LINAC's room to evaluate the shielding costs and the other facilities those are directly related to the room design. In the evaluation process it was noted that the non-optimized room size (i.e., 610 × 610 cm 2 or 20 feet × 20 feet) is not suitable for total body irradiation (TBI) although the machine installed inside was having not only the facility of TBI but the license was acquired. By keeping this point in view, the optimized INAC's room size was kept 762 × 762 cm 2. Although, the area of the optimized rooms was greater than the non-planned room (i.e., 762 × 762 cm 2 instead of 610 × 610 cm 2), the shielding cost for the optimized LINAC's rooms was reduced by 15%. When optimized shielding calculations were re-performed for non-optimized shielding room (i.e., keeping room size, occupancy factors, workload etc. same), it was found that the shielding cost may be lower to 41 %. In conclusion, non- optimized LINAC's room can not only put extra financial burden on the hospital but also can cause of some serious issues related to providing health care facilities for patients. © 2012 American Association of Physicists in Medicine.

Stereotactic radiosurgery for vestibular schwannoma: International Stereotactic Radiosurgery Society (ISRS) Practice Guideline.

PubMed

Tsao, May N; Sahgal, Arjun; Xu, Wei; De Salles, Antonio; Hayashi, Motohiro; Levivier, Marc; Ma, Lijun; Martinez, Roberto; Régis, Jean; Ryu, Sam; Slotman, Ben J; Paddick, Ian

2017-01-01

The aim of this systematic review was to develop International Stereotactic Radiosurgery Society (ISRS) consensus guideline statements for vestibular schwannoma. A systematic review of the literature was performed up to April 2015. A total of 55 full-text articles were included in the analysis. All studies were retrospective, except for 2 prospective quality of life studies. Five-year tumour control rates with Gamma Knife radiosurgery (RS), single fraction linac RS, or fractionated (either hypofractionated or conventional fractionation) stereotactic radiation therapy (FSRT) were similar at 81-100%. The single fraction RS series (linac or Gamma Knife) with tumour marginal doses between 12 and 14 Gy revealed 5-year tumour control rates of 90-99%, hearing preservation rates of 41-79%, facial nerve preservation rates of 95-100% and trigeminal preservation rates of 79-99%.There were 6 non-randomized studies comparing single fraction RS versus FSRT. There was no statistically significant difference in tumour control; HR=1.66 (95% CI 0.81, 3.42), p =0.17, facial nerve function; HR = 0.67 (95% CI 0.30, 1.49), p =0.33, trigeminal nerve function; HR = 0.80 (95% CI 0.41, 1.56), p =0.51, and hearing preservation; HR = 1.10 (95% CI 0.72, 1.68), p =0.65 comparing single fraction RS with FSRT.Nine quality of life reports yielded conflicting results as to which modality (surgery, observation, or radiation) was associated with better quality of life outcomes. There are no randomized trials to help guide management of patients with vestibular schwannoma. Within the limitations of the retrospective series, a number of consensus statements were made.

Stereotactic radiosurgery for vestibular schwannoma: International Stereotactic Radiosurgery Society (ISRS) Practice Guideline

PubMed Central

Sahgal, Arjun; Xu, Wei; De Salles, Antonio; Hayashi, Motohiro; Levivier, Marc; Ma, Lijun; Martinez, Roberto; Régis, Jean; Ryu, Sam; Slotman, Ben J.; Paddick, Ian

2017-01-01

Objectives The aim of this systematic review was to develop International Stereotactic Radiosurgery Society (ISRS) consensus guideline statements for vestibular schwannoma. Methods A systematic review of the literature was performed up to April 2015. Results A total of 55 full-text articles were included in the analysis. All studies were retrospective, except for 2 prospective quality of life studies. Five-year tumour control rates with Gamma Knife radiosurgery (RS), single fraction linac RS, or fractionated (either hypofractionated or conventional fractionation) stereotactic radiation therapy (FSRT) were similar at 81-100%. The single fraction RS series (linac or Gamma Knife) with tumour marginal doses between 12 and 14 Gy revealed 5-year tumour control rates of 90-99%, hearing preservation rates of 41-79%, facial nerve preservation rates of 95-100% and trigeminal preservation rates of 79-99%. There were 6 non-randomized studies comparing single fraction RS versus FSRT. There was no statistically significant difference in tumour control; HR=1.66 (95% CI 0.81, 3.42), p =0.17, facial nerve function; HR = 0.67 (95% CI 0.30, 1.49), p =0.33, trigeminal nerve function; HR = 0.80 (95% CI 0.41, 1.56), p =0.51, and hearing preservation; HR = 1.10 (95% CI 0.72, 1.68), p =0.65 comparing single fraction RS with FSRT. Nine quality of life reports yielded conflicting results as to which modality (surgery, observation, or radiation) was associated with better quality of life outcomes. Conclusions There are no randomized trials to help guide management of patients with vestibular schwannoma. Within the limitations of the retrospective series, a number of consensus statements were made. PMID:29296459

Poster — Thur Eve — 46: Monte Carlo model of the Novalis Classic 6MV stereotactic linear accelerator using the GATE simulation platform

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

Wiebe, J; Department of Physics and Astronomy, University of Calgary, Calgary, AB; Ploquin, N

2014-08-15

Monte Carlo (MC) simulation is accepted as the most accurate method to predict dose deposition when compared to other methods in radiation treatment planning. Current dose calculation algorithms used for treatment planning can become inaccurate when small radiation fields and tissue inhomogeneities are present. At our centre the Novalis Classic linear accelerator (linac) is used for Stereotactic Radiosurgery (SRS). The first MC model to date of the Novalis Classic linac was developed at our centre using the Geant4 Application for Tomographic Emission (GATE) simulation platform. GATE is relatively new, open source MC software built from CERN's Geometry and Tracking 4more » (Geant4) toolkit. The linac geometry was modeled using manufacturer specifications, as well as in-house measurements of the micro MLC's. Among multiple model parameters, the initial electron beam was adjusted so that calculated depth dose curves agreed with measured values. Simulations were run on the European Grid Infrastructure through GateLab. Simulation time is approximately 8 hours on GateLab for a complete head model simulation to acquire a phase space file. Current results have a majority of points within 3% of the measured dose values for square field sizes ranging from 6×6 mm{sup 2} to 98×98 mm{sup 2} (maximum field size on the Novalis Classic linac) at 100 cm SSD. The x-ray spectrum was determined from the MC data as well. The model provides an investigation into GATE'S capabilities and has the potential to be used as a research tool and an independent dose calculation engine for clinical treatment plans.« less

SU-E-T-355: A Comparative Study of Robotic and Linac-Based Stereotactitc Body Radiation Therapy for Lumbar Spinal Tumors

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

Bossart, E; Monterroso, M; Couto, M

Purpose: Dosimetrically compare CyberKnife (CK) and linac-based (LB) stereotactic body radiotherapy (SBRT) plans for lumbar spine. Methods: Ten patient plans with lumbar spine tumors treated with CK were selected and retrospectively optimized using three techniques: CK, volumetric modulated arc (VMAT, three arcs), and 9-field-intensity modulated radiotherapy (IMRT). For the LB plans, the target volume was expanded by 1mm to accommodate additional uncertainty in patient positioning. All plans were optimized to a prescription dose of 27Gy in 3 fractions covering 90% of the PTV. If the dose constraints to the cauda equina (cauda) were not met, the prescription dose was loweredmore » to 24Gy. Parameters evaluated included Paddick Conformity-Index (CI) and Gradient-Index (GI). A two-tailed paired t-test was used to establish statistically significant differences in cauda doses. Results: Target volumes for LB plans were on average 38% larger. In terms of the indices, the closer the index values to unity the steeper the dose falloff and the higher the dose conformity to the target. The results showed that LB plans were in general statistically superior to CK plans. The IMRT plan showed the best average gradient index of 2.995, with VMAT and CK GI values of 3.699 and 5.476, respectively. Similarly, the same trend occurs with the average CI results: 0.821, 0.814, and 0.758, corresponding to IMRT, VMAT, and CK. Notably, in one CK plan the target dose was reduced to 24Gy to meet cauda constraints. Additionally, there was a statistically significant dose difference for the cauda between the CK and LB plans. Conclusion: This study demonstrates that LB plans for lumbar spine SBRT can be as effective or even better than CK plans. Despite the expansion of the target volume, the LB plans did not demonstrate dosimetric inferiority. The LB plans Resultin 2-to-3 fold decrease of treatment time.« less

Inverse planning in the age of digital LINACs: station parameter optimized radiation therapy (SPORT)

NASA Astrophysics Data System (ADS)

Xing, Lei; Li, Ruijiang

2014-03-01

The last few years have seen a number of technical and clinical advances which give rise to a need for innovations in dose optimization and delivery strategies. Technically, a new generation of digital linac has become available which offers features such as programmable motion between station parameters and high dose-rate Flattening Filter Free (FFF) beams. Current inverse planning methods are designed for traditional machines and cannot accommodate these features of new generation linacs without compromising either dose conformality and/or delivery efficiency. Furthermore, SBRT is becoming increasingly important, which elevates the need for more efficient delivery, improved dose distribution. Here we will give an overview of our recent work in SPORT designed to harness the digital linacs and highlight the essential components of SPORT. We will summarize the pros and cons of traditional beamlet-based optimization (BBO) and direct aperture optimization (DAO) and introduce a new type of algorithm, compressed sensing (CS)-based inverse planning, that is capable of automatically removing the redundant segments during optimization and providing a plan with high deliverability in the presence of a large number of station control points (potentially non-coplanar, non-isocentric, and even multi-isocenters). We show that CS-approach takes the interplay between planning and delivery into account and allows us to balance the dose optimality and delivery efficiency in a controlled way and, providing a viable framework to address various unmet demands of the new generation linacs. A few specific implementation strategies of SPORT in the forms of fixed-gantry and rotational arc delivery are also presented.

The impact of MRI steady-state sequences as an additional assessment modality in vestibular schwannoma patients after LINAC stereotactic radiotherapy or radiosurgery.

PubMed

Sauer, Julian P; Kinfe, Thomas M; Pintea, Bogdan; Schäfer, Andreas; Boström, Jan P

2018-05-23

Data concerning the clinical usefulness of steady-state sequences (SSS) for vestibular schwannomas (VS) after linear accelerator (LINAC) stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT) are scarce. The aim of the study was to investigate whether SSS provide an additional useful follow-up (FU) tool to the established thin-layered T1 sequences with contrast enhancement. Pre- and post-treatment SSS were identified in 45 consecutive VS patients (2012-2016) with a standardized FU protocol including SSS at 2-3 months and 6 months/yearly in our prospective database and were retrospectively re-evaluated. The SSS were used throughout for the segmentation of the cochlea and partly of the trigeminal nerve in the treatment planning. Data analysis included signal conversion in SSS and possible correlation with neuro-otological outcome and volumetric assessment after a certain time interval. The series included 42 SRS and 3 SRT patients (31 female/14 male; mean age 59.3 years, range: 25-81 years). An SSS signal conversion was observed in 20 tumors (44.4%) within a mean time of 11 months (range: 7-15 months). Mean FU time was 26 months (median of 4 FU visits) and demonstrated tumor volume shrinkage in 29 cases (64.4%) correlating with FU time (p = 0.07). The incidence rate of combined shrinkage and signal conversion (48.3%) compared to those without signal conversion (51.7%) did not differ significantly (p = 0.49). In case of an early signal conversion at the first FU, a weak statistical significance (p = 0.05) for a higher shrinkage rate of VS with signal conversion was found. Side effects in cases with signal conversion (9/20, 45%) were more frequently than without signal conversion (6/25, 24%) without reaching statistical significance (p = 0.13). Our data confirmed the usefulness of SSS for anatomical segmentation of VS in LINAC-SRS/SRT treatment planning and add data supporting their potential as an adjunctive FU option in VS patients.

Recirculating linacs for a neutrino factory - Arc optics design and optimization

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

Alex Bogacz; Valeri Lebedev

2001-10-21

A conceptual lattice design for a muon accelerator based on recirculating linacs (Nucl. Instr. and Meth. A 472 (2001) 499, these proceedings) is presented here. The challenge of accelerating and transporting a large phase space of short-lived muons is answered here by presenting a proof-of-principle lattice design for a recirculating linac accelerator. It is the centerpiece of a chain of accelerators consisting of a 3GeV linac and two consecutive recirculating linear accelerators, which facilitates acceleration starting after ionization cooling at 190MeV/c and proceeding to 50GeV. Beam transport issues for large-momentum-spread beams are accommodated by appropriate lattice design choices. The resultingmore » arc optics is further optimized with a sextupole correction to suppress chromatic effects contributing to the emittance dilution. The presented proof-of-principle design of the arc optics with horizontal separation of multi-pass beams can be extended to all passes in both recirculating linacs.« less

Recirculating linacs for a neutrino factory - Arc optics design and optimization

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

Valeri Lebedev; S. Bogacz

2001-10-25

A conceptual lattice design for a muon accelerator based on recirculating linacs (Nucl. Instr. and Meth. A 472 (2001) 499, these proceedings) is presented here. The challenge of accelerating and transporting a large phase space of short-lived muons is answered here by presenting a proof-of-principle lattice design for a recirculating linac accelerator. It is the centerpiece of a chain of accelerators consisting of a 3 GeV linac and two consecutive recirculating linear accelerators, which facilitates acceleration starting after ionization cooling at 190 MeV/c and proceeding to 50 GeV. Beam transport issues for large-momentum-spread beams are accommodated by appropriate lattice designmore » choices. The resulting arc optics is further optimized with a sextupole correction to suppress chromatic effects contributing to the emittance dilution. The presented proof-of-principle design of the arc optics with horizontal separation of multi-pass beams can be extended to all passes in both recirculating linacs.« less

TH-C-BRC-03: Emerging Linac Based SRS/SBRT Technologies with Modulated Arc Delivery

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

Ren, L.

2016-06-15

The delivery techniques for SRS/SBRT have been under rapid developments in recent years, which pose new challenges to medical physicists ranging from planning and quality assurance to imaging and motion management. This educational course will provide a general overview of the latest delivery techniques in SRS/SBRT, and discuss the clinical processes to address the challenges of each technique with special emphasis on dedicated gamma-ray based device, robotic x-band linac-based system and conventional C-arm s-band linac-based SRS systems. (1). Gamma-ray based SRS/SRT: This is the gold standard of intracranial SRS. With the advent of precision imaging guidance and frameless patient positioningmore » capabilities, novel stereoscopic CBCT and automatic dose adaption solution are introduced to the Gamma-ray based SRS for the first time. The first North American system has been approved by the US regulatory for patient treatments in the spring of 2016. (2). Robotic SRS/SBRT system: A number of technological milestones have been developed in the past few years, including variable aperture collimator, sequential optimization technique, and the time reduction technique. Recently, a new robotic model allows the option of a multi-leaf collimator. These technological advances have reduced the treatment time and improved dose conformity significantly and could potentially expand the application of radiosurgery for the treatment of targets not previously suitable for robotic SRS/SBRT or fractionated stereotactic radiotherapy. These technological advances have created new demanding mandates on hardware and patient quality assurance (QA) tasks, as well as the need for updating/educating the physicists in the community on these requirements. (3). Conventional Linac based treatments: Modulated arc therapy (MAT) has gained wide popularities in Linac-based treatments in recent years due to its high delivery efficiency and excellent dose conformities. Recently, MAT has been introduced to deliver highly conformal radiosurgery treatments to multiple targets simultaneously via a single isocenter to replace the conventional multi-iso multi-plan treatments. It becomes important to understand the advantages and limitations of this technique, and the pitfalls for implementing this technique in clinical practice. The planning process of single-iso multi-target MAT will be described, and its plan quality and delivery efficiency will be compared with multi-iso plans. The QA process for verifying such complex plans will be illustrated, and pitfalls in imaging and patient set up will be discussed. Overall, this session will focus on the following areas: 1) Update on the emerging technology in current SRS/SBRT delivery. 2) New developments in treatment planning and Quality Assurance program. 3) Imaging guidance and motion management. Learning Objectives: To understand the SRS/SBRT principles and its clinical applications, and gain knowledge on the emerging technologies in SRS/SBRT. To review planning concepts and useful tips in treatment planning. To learn about the imaging guidance procedures and the quality assurance program in SRS/SBRT. National Institutes of Health, Varian Medical System; L. Ren, The presenter is funded by National Institutes of Health and Varian Medical System.« less

Development of a novel optimization tool for electron linacs inspired by artificial intelligence techniques in video games

NASA Astrophysics Data System (ADS)

Meier, E.; Biedron, S. G.; LeBlanc, G.; Morgan, M. J.

2011-03-01

This paper reports the results of an advanced algorithm for the optimization of electron beam parameters in Free Electron Laser (FEL) Linacs. In the novel approach presented in this paper, the system uses state of the art developments in video games to mimic an operator's decisions to perform an optimization task when no prior knowledge, other than constraints on the actuators is available. The system was tested for the simultaneous optimization of the energy spread and the transmission of the Australian Synchrotron Linac. The proposed system successfully increased the transmission of the machine from 90% to 97% and decreased the energy spread of the beam from 1.04% to 0.91%. Results of a control experiment performed at the new FERMI@Elettra FEL is also reported, suggesting the adaptability of the scheme for beam-based control.

TH-EF-BRB-03: Significant Cord and Esophagus Dose Reduction by 4π Non-Coplanar Spine Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery

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

Yu, V; Tran, A; Nguyen, D

Purpose: To demonstrate significant organ-at-risk (OAR) sparing achievable with 4π non-coplanar radiotherapy on spine SBRT and SRS patients. Methods: Twenty-five stereotactic spine cases previously treated with VMAT (n = 23) or IMRT (n = 2) were included in this study. A computer-aided-design model of a Linac with a 3D-scanned human surface was utilized to determine the feasible beam space throughout the 4π steradian and beam specific source-to-target-distances (STD) required for collision avoidance. 4π radiotherapy plans integrating beam orientation and fluence map optimization were then created using a column-generation algorithm. Twenty optimal beams were selected for each case. To evaluate themore » tradeoff between dosimetric benefit and treatment complexity, 4π plans including only isocentrically deliverable beams were also created. Beam angles of all standard and isocentric 4π plans were imported into Eclipse to recalculate the dose using the same calculation engine as the clinical plans for unbiased comparison. OAR and PTV dose statistics for the clinical, standard-4π, and isocentric-4π plans were compared. Results: Comparing standard-4π to clinical plans, particularly significant average percent reduction in the [mean, maximum] dose of the cord and esophagus of [41%, 21.7%], and [38.7%, 36.4%] was observed, along with global decrease in all other OAR dose statistics. The average cord volume receiving more than 50% prescription dose was substantially decreased by 76%. In addition, improved PTV coverage was demonstrated with a maximum dose reduction of 0.93% and 1.66% increase in homogeneity index (D95/D5). All isocentric-4π plans achieved dosimetric performance equivalent to that of the standard-4π plans with higher delivery complexity. Conclusion: 4π radiotherapy significantly improves stereotactic spine treatment dosimetry. With the substantial OAR dose sparing, PTV dose escalation is considerably safer. Isocentric-4π is sufficient to achieve the dosimetric gain. The successful implementation of 4π using an FDA approved planning system paves the way for a prospective clinical trial. Varian Medical Systems, NIH R43CA183390 and R01CA188300, NSF graduate research fellowship DGE-1144087.« less

High gradient RF test results of S-band and C-band cavities for medical linear accelerators

NASA Astrophysics Data System (ADS)

Degiovanni, A.; Bonomi, R.; Garlasché, M.; Verdú-Andrés, S.; Wegner, R.; Amaldi, U.

2018-05-01

TERA Foundation has proposed and designed hadrontherapy facilities based on novel linacs, i.e. high gradient linacs which accelerate either protons or light ions. The overall length of the linac, and therefore its cost, is almost inversely proportional to the average accelerating gradient. With the scope of studying the limiting factors for high gradient operation and to optimize the linac design, TERA, in collaboration with the CLIC Structure Development Group, has conducted a series of high gradient experiments. The main goals were to study the high gradient behavior and to evaluate the maximum gradient reached in 3 and 5.7 GHz structures to direct the design of medical accelerators based on high gradient linacs. This paper summarizes the results of the high power tests of 3.0 and 5.7 GHz single-cell cavities.

Radiosurgery for cerebral arteriovenous malformation during pregnancy: A case report focusing on fetal exposure to radiation

PubMed Central

Nagayama, Kazuki; Kurita, Hiroki; Tonari, Ayako; Takayama, Makoto; Shiokawa, Yoshiaki

2010-01-01

Introduction: We present the case of a pregnant woman who underwent linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) and we discuss the fetal exposure to radiation. Clinical Presentation: A 20-year-old woman at 18 weeks of gestation presented with right cerebral hemorrhage and underwent urgent evacuation of the hematoma. She recovered well after surgery, but cerebral angiography after the surgery revealed a small deeply seated arteriovenous malformation (AVM) in the right frontal lobe extending to the right basal ganglia. Methods and Results: We examined the diffuse AVM and treated it with LINAC-based SRS at 24 weeks of gestation. Before SRS, the fetus was exposed to a radiation dose of 8.26 mGy, which was estimated by conducting an experiment using an adult RANDO phantom, and a radiophotoluminescent (RPL) glass rod dosimeter (GRD) system. The patient underwent Caesarean delivery at 36 weeks of gestation and gave birth to a healthy baby. Conclusion: The exposure of fetus to radiation during SRS was exceedingly low. SRS can be used as an alternative treatment to microsurgery for resolving small deeply seated AVMs even in pregnant patients. PMID:22028762

Beam dynamics study of a 30 MeV electron linear accelerator to drive a neutron source

NASA Astrophysics Data System (ADS)

Kumar, Sandeep; Yang, Haeryong; Kang, Heung-Sik

2014-02-01

An experimental neutron facility based on 32 MeV/18.47 kW electron linac has been studied by means of PARMELA simulation code. Beam dynamics study for a traveling wave constant gradient electron accelerator is carried out to reach the preferential operation parameters (E = 30 MeV, P = 18 kW, dE/E < 12.47% for 99% particles). The whole linac comprises mainly E-gun, pre-buncher, buncher, and 2 accelerating columns. A disk-loaded, on-axis-coupled, 2π/3-mode type accelerating rf cavity is considered for this linac. After numerous optimizations of linac parameters, 32 MeV beam energy is obtained at the end of the linac. As high electron energy is required to produce acceptable neutron flux. The final neutron flux is estimated to be 5 × 1011 n/cm2/s/mA. Future development will be the real design of a 30 MeV electron linac based on S band traveling wave.

The MRI-Linear Accelerator Consortium: Evidence-Based Clinical Introduction of an Innovation in Radiation Oncology Connecting Researchers, Methodology, Data Collection, Quality Assurance, and Technical Development.

PubMed

Kerkmeijer, Linda G W; Fuller, Clifton D; Verkooijen, Helena M; Verheij, Marcel; Choudhury, Ananya; Harrington, Kevin J; Schultz, Chris; Sahgal, Arjun; Frank, Steven J; Goldwein, Joel; Brown, Kevin J; Minsky, Bruce D; van Vulpen, Marco

2016-01-01

An international research consortium has been formed to facilitate evidence-based introduction of MR-guided radiotherapy (MR-linac) and to address how the MR-linac could be used to achieve an optimized radiation treatment approach to improve patients' survival, local, and regional tumor control and quality of life. The present paper describes the organizational structure of the clinical part of the MR-linac consortium. Furthermore, it elucidates why collaboration on this large project is necessary, and how a central data registry program will be implemented.

High gradient RF test results of S-band and C-band cavities for medical linear accelerators

DOE PAGES

Degiovanni, A.; Bonomi, R.; Garlasche, M.; ...

2018-02-09

TERA Foundation has proposed and designed hadrontherapy facilities based on novel linacs, i.e. high gradient linacs which accelerate either protons or light ions. The overall length of the linac, and therefore its cost, is almost inversely proportional to the average accelerating gradient. With the scope of studying the limiting factors for high gradient operation and to optimize the linac design, TERA, in collaboration with the CLIC Structure Development Group, has conducted a series of high gradient experiments. The main goals were to study the high gradient behavior and to evaluate the maximum gradient reached in 3 and 5.7 GHz structuresmore » to direct the design of medical accelerators based on high gradient linacs. Lastly, this paper summarizes the results of the high power tests of 3.0 and 5.7 GHz single-cell cavities.« less

High gradient RF test results of S-band and C-band cavities for medical linear accelerators

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

Degiovanni, A.; Bonomi, R.; Garlasche, M.

TERA Foundation has proposed and designed hadrontherapy facilities based on novel linacs, i.e. high gradient linacs which accelerate either protons or light ions. The overall length of the linac, and therefore its cost, is almost inversely proportional to the average accelerating gradient. With the scope of studying the limiting factors for high gradient operation and to optimize the linac design, TERA, in collaboration with the CLIC Structure Development Group, has conducted a series of high gradient experiments. The main goals were to study the high gradient behavior and to evaluate the maximum gradient reached in 3 and 5.7 GHz structuresmore » to direct the design of medical accelerators based on high gradient linacs. Lastly, this paper summarizes the results of the high power tests of 3.0 and 5.7 GHz single-cell cavities.« less

SU-F-T-615: Comparison of Plan Quality for Linac-Based Stereotactic Radiosurgery (SRS) Using Single- and Multi-Isocenter Techniques

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

Chang, J; Dept of Radiation Oncology, NewYork Hospital/Weill Cornell Medical College, New York, NY; Wernicke, A

2016-06-15

Purpose: To compare the plan quality of linear accelerator (linac)-based stereotactic radiosurgery (SRS) using single-isocenter volumetric arc therapy (SI-VMAT), restricted single-isocenter dynamic-arc (RSI-DARC), and multi-isocenter DARC (MI-DARC) techniques. Methods: Fifteen SRS cases were randomly selected and re-planned using the SI-VMAT (Pinnacle), RSI-DARC (iPlanNet) and MI-DARC (iPlanNet). The number of planning target volumes (PTVs) for each plan ranged from 1 to 6. For SI-VMAT, a single isocenter and 3-4 VMAT beams are used for all PTVs, while for MI-DARC, each PTV has its own isocetner with 3 DARC beams. RSI-DARC uses one isocnter with 3-6 DARC beams to irradiate all PTVsmore » within 2.5-cm radius. Both SI-DARC and RSI-DARC plans were optimized manually. The prescription dose was 20 Gy to each PTV. The maximal dose was 25 Gy for RSI-DARC and MI-DARC, but could not be controlled for SI-VMAT due to the nature of VMAT planning. Plan quality indexes including PTV coverage, mean dose of PTV (PTVmean) and tissue (Tmean), V12Gy, conformity index (CI), and V10Gy/VPTV were calculated and compared. Results: Full PTV coverage was achieved for all three techniques. Using the MI-DARC plans as the gold standard, the PTVmean of the SI-VMAT plans was 12.5%±8.3% (mean±standard deviation) higher, in comparison to 0.7%±1.4% for the RSI-DARC plans. Similar trend was observed for other indexes including V12Gy (39.4%±27.3% vs. 9.3%±7.8%), Tmean (35.0%±26.8% vs. 2.8%±3.4%), and V10Gy/VPTV (42.2%±31.5% vs. 9.9%±8.2%). CI is comparable (6.2%±14.2% vs. 6.3%±7.2%). Assuming the treatment time is proportional to the number of isocenters, the reduction of the treatment time in comparison to MI-DARC was 70% for SI-VMAT and 42% for RSI-DARC. Conclusion: Although the SI-VMAT can save a considerable amount of treatment time, the plan indexes also significantly deviates from the gold standard, MI-DARC. RSI-DARC, on the other hand, provides a good compromise between the treatment time and plan quality.« less

SU-F-T-604: Dosimetric Evaluation of Intracranial Stereotactic Radiotherapy Plans On a LINAC

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

Sheth, N; Tabibian, A; Rose, J

2016-06-15

Purpose: To evaluate the dosimetry of cranial stereotactic radiotherapy (SRT) plans of varying techniques on linac that meets appropriate TG-142 tolerances using 1 cm leaf width multileaf collimator (MLC). Methods: Seventeen spherical targets were generated in the center of a head phantom with diameters ranging 8 mm to 40 mm. SRT plans used 100° non-coplanar arcs and 5 couch angles with 35° spacing. The field size was target plus 1 mm margin. Four plans were created for each target: symmetrical jaws blocking for 5 arcs with 0° collimator (J1C), symmetrical jaws blocking with 5 clockwise arcs with 0° collimator andmore » 5 counter-clockwise arcs with 45° collimator (J2C), MLC blocking for 5 dynamic conformal arcs with 0° collimator (M1C), and MLC blocking for 5 clockwise dynamic conformal arcs with 0° collimators and 5 counter-clockwise dynamic conformal arcs with 45° collimator (M2C).Conformity was evaluated using a ratio of Rx to target volume (PITV). Heterogeneity was determined using a ratio of maximum dose to Rx dose. Falloff was scored using CGIg: difference of effective radii of spheres equal to half and full Rx volumes. Results: All plans met RTOG SRS criteria for conformity and heterogeneity. The mean PITV was 1.52±0.07, 1.49±0.08, 1.39±0.05, and 1.37±0.04 for J1C, J2C, M1C, and M2C plans respectively. The mean CGIg was 75.35±15.79, 74.19±16.66, 77.14±15.12, and 76.28±15.78 for J1C, J2C, M1C, and M2C plans respectively. The mean MDPD was 1.25±0.00 for all techniques. Conclusion: Clinically acceptable SRT plans for spherical targets were created on a linac with 1 cm MLC. Adding two collimator angles and MLC to arcs each improved conformity. The MLC improved the dose falloff while two collimator angles degraded it. This technique can expand the availability of SRT to patients especially to those who cannot travel to a facility with a dedicated stereotactic radiosurgery machine.« less

Radiogenic Side Effects After Hypofractionated Stereotactic Photon Radiotherapy of Choroidal Melanoma in 212 Patients Treated Between 1997 and 2007

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

Dunavoelgyi, Roman; Dieckmann, Karin; Gleiss, Andreas

2012-05-01

Purpose: To evaluate side effects of hypofractionated stereotactic photon radiotherapy for patients with choroidal melanoma. Patients and Methods: Two hundred and twelve patients with choroidal melanoma unsuitable for ruthenium-106 brachytherapy or local resection were treated stereotactically at the Medical University of Vienna between 1997 and 2007 with a Linac with 6-MV photon beams in five fractions with 10, 12, or 14 Gy per fraction. Examinations for radiogenic side effects were performed at baseline and every 3 months in the first 2 years, then every 6 months until 5 years and then once a year thereafter until 10 years after radiotherapy.more » Adverse side effects were assessed using slit-lamp examination, funduscopy, gonioscopy, tonometry, and, if necessary, fundus photography and fluorescein angiography. Evaluations of incidence of side effects are based on an actuarial analysis. Results: One hundred and eighty-nine (89.2%) and 168 (79.2%) of the tumors were within 3 mm of the macula and the optic disc, respectively. The five most common radiotherapy side effects were retinopathy and optic neuropathy (114 cases and 107 cases, respectively), cataract development (87 cases), neovascular glaucoma (46 cases), and corneal epithelium defects (41 cases). In total, 33.6%, 38.5%, 51.2%, 75.5%, and 77.6% of the patients were free of any radiation retinopathy, optic neuropathy, cataract, neovascular glaucoma, or corneal epithelium defects 5 years after radiotherapy, respectively. Conclusion: In centrally located choroidal melanoma hypofractionated stereotactic photon radiotherapy shows a low to moderate rate of adverse long-term side effects comparable with those after proton beam radiotherapy. Future fractionation schemes should seek to further reduce adverse side effects rate while maintaining excellent local tumor control.« less

SU-E-T-624: Quantitative Evaluation of 2D Versus 3D Dosimetry for Stereotactic Volumetric Modulated Arc Delivery Using COMPASS

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

Vikraman, S; Karrthick, K; Rajesh, T

2014-06-15

Purpose: The purpose of this study was to evaluate quantitatively 2D versus 3D dosimetry for stereotactic volumetric modulated arc delivery using COMPASS with 2D array. Methods: Twenty-five patients CT images and RT structures of different sites like brain, head and neck, thorax, abdomen and spine were taken from Multiplan planning system for this study. All these patients underwent radical stereotactic treatment in Cyberknife. For each patient, linac based VMAT stereotactic plans were generated in Monaco TPS v 3.1 using Elekta Beam Modulator MLC. Dose prescription was in the range of 5-20Gy/fraction.TPS calculated VMAT plan delivery accuracy was quantitatively evaluated withmore » COMPASS measured dose and calculated dose based on DVH metrics. In order to ascertain the potential of COMPASS 3D dosimetry for stereotactic plan delivery, 2D fluence verification was performed with MatriXX using Multicube. Results: For each site, D{sub 9} {sub 5} was achieved with 100% of prescription dose with maximum 0.05SD. Conformity index (CI) was observed closer to 1.15 in all cases. Maximum deviation of 2.62 % was observed for D{sub 9} {sub 5} when compared TPS versus COMPASS measured. Considerable deviations were observed in head and neck cases compare to other sites. The maximum mean and standard deviation for D{sub 9} {sub 5}, average target dose and average gamma were -0.78±1.72, -1.10±1.373 and 0.39±0.086 respectively. Numbers of pixels passing 2D fluence verification were observed as a mean of 99.36% ±0.455 SD with 3% dose difference and 3mm DTA. For critical organs in head and neck cases, significant dose differences were observed in 3D dosimetry while the target doses were matched well within limit in both 2D and 3D dosimetry. Conclusion: The quantitative evaluations of 2D versus 3D dosimetry for stereotactic volumetric modulated plans showed the potential of highlighting the delivery errors. This study reveals that COMPASS 3D dosimetry is an effective tool for patient specific quality assurance compared to 2D fluence verification.« less

MO-G-201-04: Knowledge-Based Planning for Single-Isocenter Stereotactic Radiosurgery to Multiple Brain Metastases

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

Ziemer, B; Shiraishi, S; Hattangadi-Gluth, J

Purpose: Single-isocenter, linac-based SRS for multiple brain metastases (multi-mets) can deliver highly conformal radiation doses and reduce overall patient treatment time compared to other therapy techniques. This study aims to quantify the dosimetric benefits of knowledge-based planning (KBP) for multi-met treatments. Methods: Using a previously-published KBP methodology (an artificial neural network (ANN) trained on single-target linac-based SRS plans), 3D dose distribution predictions for multi-met patients were obtained by treating each brain lesion as a solitary target and subsequently combining individual predictions into a single distribution using a dose-weighted geometric averaging to obtain the best results in the inter-target space. 17more » previously-treated multi-met plans, with target numbers ranging from N=2–5, were used to validate the ANN predictions and subsequent KBP auto-planning routine. The fully-deliverable KBP plans were developed by converting dose distribution predictions into patient-specific optimization objectives while maintaining identical target normalizations (typically PTV V100%=D98%). Plan quality improvements were quantified by the difference between SRS quality metrics (QMs): δdQM=QM(clinical)-QM(KBP). QMs of interest were: gradient measure (GM), conformity index (CI), brain V10 and V5, brainstem D0.1cc and heterogeneity index (HI). Finally, overall plan quality was judged via blinded plan comparison by SRS-specializing physicians. Results: Two clinical plans were found to be significant outliers wherein plan quality was dramatically worse than KBP. Despite indicating KBP superiority, these were removed from the QM analysis to prevent skewing the results. In the remaining cases, clinical and KBP QMs were nearly identical with modest improvements in the KBP sample: δGM=0.12±0.56mm, δCI=−0.01±0.04, Brain δV10=0.8±2.6cc, brain δV5=6.3 ±10.7cc, brainstem δD0.1cc=0.06±1.19Gy and δHI= −0.04±0.05. Ultimately, 13/17 KBP plans were deemed superior to the manual plans in blinded physician review. Conclusion: The results demonstrate that KBP-driven automated planning in linac-based single-isocenter treatments for multiple brain metastases is indistinguishable from, or even better than, traditional manual planning. J. Hattangadi: Research Grant; Varian Medical Systems; K.L. Moore: Research Grant: Varian Medical Systems.« less

An electron linac-based system for BNCT of shallow tumors

NASA Astrophysics Data System (ADS)

Farhad Masoudi, S.; Ghiasi, Hedieh; Harif, Maryam; Rasouli, Fatemeh S.

2018-07-01

Although BNCT has been in existence since the 1950s, it continues to be of special significant and interest for wide groups of researchers. Recent studies, focused on investigating appropriate neutron sources as alternatives for nuclear reactors, revealed the high potential of electron linac-based facilities to improve the efficiency of this treatment method. The present simulation study has been devoted to both designing an optimized and geometrically simple target to be used as a photoneutron source based on an electron linac and designing a configuration composed of arrangement of materials to generate an appropriate beam for BNCT of shallow tumors considering the widely accepted criteria for pre-clinical survey. It has been found that the behavior of photoneutrons' current and their average energy on the surface of the target is independent of the incident energy. Accordingly, we managed to present a formula to predict the average energy of photoneutrons knowing the electron energy to an acceptable approximation avoiding Monte Carlo simulations. Considering the conflict between the beam intensity and its purity in the whole beam designing process, an optimized beam shaping assembly for electron linac of 18 MeV/ mA has been proposed. These results in essence confirm the ability of these sources for BNCT of shallow tumors and are therefore encouraging for further studies. Furthermore, the results show that this configuration, which the corresponding beam fulfills all the medical requirements, is also usable for electron linacs of other energies. This can be of high importance in practical point of view.

Quantitative evaluation of 3D dosimetry for stereotactic volumetric‐modulated arc delivery using COMPASS

PubMed Central

Manigandan, Durai; Karrthick, Karukkupalayam Palaniappan; Sambasivaselli, Raju; Senniandavar, Vellaingiri; Ramu, Mahendran; Rajesh, Thiyagarajan; Lutz, Muller; Muthukumaran, Manavalan; Karthikeyan, Nithyanantham; Tejinder, Kataria

2014-01-01

The purpose of this study was to evaluate quantitatively the patient‐specific 3D dosimetry tool COMPASS with 2D array MatriXX detector for stereotactic volumetric‐modulated arc delivery. Twenty‐five patients CT images and RT structures from different sites (brain, head & neck, thorax, abdomen, and spine) were taken from CyberKnife Multiplan planning system for this study. All these patients underwent radical stereotactic treatment in CyberKnife. For each patient, linac based volumetric‐modulated arc therapy (VMAT) stereotactic plans were generated in Monaco TPS v3.1 using Elekta Beam Modulator MLC. Dose prescription was in the range of 5–20 Gy per fraction. Target prescription and critical organ constraints were tried to match the delivered treatment plans. Each plan quality was analyzed using conformity index (CI), conformity number (CN), gradient Index (GI), target coverage (TC), and dose to 95% of volume (D95). Monaco Monte Carlo (MC)‐calculated treatment plan delivery accuracy was quantitatively evaluated with COMPASS‐calculated (CCA) dose and COMPASS indirectly measured (CME) dose based on dose‐volume histogram metrics. In order to ascertain the potential of COMPASS 3D dosimetry for stereotactic plan delivery, 2D fluence verification was performed with MatriXX using MultiCube phantom. Routine quality assurance of absolute point dose verification was performed to check the overall delivery accuracy. Quantitative analyses of dose delivery verification were compared with pass and fail criteria of 3 mm and 3% distance to agreement and dose differences. Gamma passing rate was compared with 2D fluence verification from MatriXX with MultiCube. Comparison of COMPASS reconstructed dose from measured fluence and COMPASS computed dose has shown a very good agreement with TPS calculated dose. Each plan was evaluated based on dose volume parameters for target volumes such as dose at 95% of volume (D95) and average dose. For critical organs dose at 20% of volume (D20), dose at 50% of volume (D50), and maximum point doses were evaluated. Comparison was carried out using gamma analysis with passing criteria of 3 mm and 3%. Mean deviation of 1.9%±1% was observed for dose at 95% of volume (D95) of target volumes, whereas much less difference was noticed for critical organs. However, significant dose difference was noticed in two cases due to the smaller tumor size. Evaluation of this study revealed that the COMPASS 3D dosimetry is efficient and easy to use for patient‐specific QA of VMAT stereotactic delivery. 3D dosimetric QA with COMPASS provides additional degrees of freedom to check the high‐dose modulated stereotactic delivery with very high precision on patient CT images. PACS numbers: 87.55.Qr, 87.56.Fc PMID:25679152

Optimization of solenoid based low energy beam transport line for high current H+ beams

NASA Astrophysics Data System (ADS)

Pande, R.; Singh, P.; Rao, S. V. L. S.; Roy, S.; Krishnagopal, S.

2015-02-01

A 20 MeV, 30 mA CW proton linac is being developed at BARC, Mumbai. This linac will consist of an ECR ion source followed by a Radio Frequency Quadrupole (RFQ) and Drift tube Linac (DTL). The low energy beam transport (LEBT) line is used to match the beam from the ion source to the RFQ with minimum beam loss and increase in emittance. The LEBT is also used to eliminate the unwanted ions like H2+ and H3+ from entering the RFQ. In addition, space charge compensation is required for transportation of such high beam currents. All this requires careful design and optimization. Detailed beam dynamics simulations have been done to optimize the design of the LEBT using the Particle-in-cell code TRACEWIN. We find that with careful optimization it is possible to transport a 30 mA CW proton beam through the LEBT with 100% transmission and minimal emittance blow up, while at the same time suppressing unwanted species H2+ and H3+ to less than 3.3% of the total beam current.

Development of a Standardized Cranial Phantom for Training and Optimization of Functional Stereotactic Operations.

PubMed

Krüger, Marie T; Coenen, Volker A; Egger, Karl; Shah, Mukesch; Reinacher, Peter C

2018-06-13

In recent years, simulations based on phantom models have become increasingly popular in the medical field. In the field of functional and stereotactic neurosurgery, a cranial phantom would be useful to train operative techniques, such as stereo-electroencephalography (SEEG), to establish new methods as well as to develop and modify radiological techniques. In this study, we describe the construction of a cranial phantom and show examples for it in stereotactic and functional neurosurgery and its applicability with different radiological modalities. We prepared a plaster skull filled with agar. A complete operation for deep brain stimulation (DBS) was simulated using directional leads. Moreover, a complete SEEG operation including planning, implantation of the electrodes, and intraoperative and postoperative imaging was simulated. An optimally customized cranial phantom is filled with 10% agar. At 7°C, it can be stored for approximately 4 months. A DBS and an SEEG procedure could be realistically simulated. Lead artifacts can be studied in CT, X-ray, rotational fluoroscopy, and MRI. This cranial phantom is a simple and effective model to simulate functional and stereotactic neurosurgical operations. This might be useful for teaching and training of neurosurgeons, establishing operations in a new center and for optimization of radiological examinations. © 2018 S. Karger AG, Basel.

Lung density change after SABR: A comparative study between tri-Co-60 magnetic resonance-guided system and linear accelerator

PubMed Central

Kim, Eunji; Wu, Hong-Gyun; Park, Jong Min; Kim, Jung-in; Kim, Hak Jae

2018-01-01

Radiation-induced lung damage is an important treatment-related toxicity after lung stereotactic ablative radiotherapy (SABR). After implementing a tri-60Co magnetic-resonance image guided system, ViewRayTM, we compared the associated early radiological lung density changes to those associated with a linear accelerator (LINAC). Eight patients treated with the tri-60Co system were matched 1:1 with patients treated with LINAC. Prescription doses were 52 Gy or 60 Gy in four fractions, and lung dose-volumetric parameters were calculated from each planning system. The first two follow-up computed tomography (CT) were co-registered with the planning CT through deformable registration software, and lung density was measured by isodose levels. Tumor size was matched between the two groups, but the planning target volume of LINAC was larger than that of the tri-60Co system (p = 0.036). With regard to clinically relevant dose-volumetric parameters in the lungs, the ipsilateral lung mean dose, V10Gy and V20Gy were significantly poorer in tri-60Co plans compared to LINAC plans (p = 0.012, 0.036, and 0.017, respectively). Increased lung density was not observed in the first follow-up scan compared to the planning scan. A significant change of lung density was shown in the second follow-up scan and there was no meaningful difference between the tri-60Co system and LINAC for all dose regions. In addition, no patient developed clinical radiation pneumonitis until the second follow-up scan. Therefore, there was no significant difference in the early radiological lung damage between the tri-60Co system and LINAC for lung SABR despite of the inferior plan quality of the tri-60Co system compared to that of LINAC. Further studies with a longer follow-up period are needed to confirm our findings. PMID:29608606

Differences in Clinical Results After LINAC-Based Single-Dose Radiosurgery Versus Fractionated Stereotactic Radiotherapy for Patients With Vestibular Schwannomas

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

Combs, Stephanie E., E-mail: Stephanie.Combs@med.uni-heidelberg.d; Welzel, Thomas; Schulz-Ertner, Daniela

2010-01-15

Purpose: To evaluate the outcomes of patients with vestibular schwannoma (VS) treated with fractionated stereotactic radiotherapy (FSRT) vs. those treated with stereotactic radiosurgery (SRS). Methods and Materials: This study is based on an analysis of 200 patients with 202 VSs treated with FSRT (n = 172) or SRS (n = 30). Patients with tumor progression and/or progression of clinical symptoms were selected for treatment. In 165 out of 202 VSs (82%), RT was performed as the primary treatment for VS, and for 37 VSs (18%), RT was conducted for tumor progression after neurosurgical intervention. For patients receiving FSRT, a medianmore » total dose of 57.6 Gy was prescribed, with a median fractionation of 5 x 1.8 Gy per week. For patients who underwent SRS, a median single dose of 13 Gy was prescribed to the 80% isodose. Results: FSRT and SRS were well tolerated. Median follow-up time was 75 months. Local control was not statistically different for both groups. The probability of maintaining the pretreatment hearing level after SRS with doses of <=13 Gy was comparable to that of FSRT. The radiation dose for the SRS group (<=13 Gy vs. >13 Gy) significantly influenced hearing preservation rates (p = 0.03). In the group of patients treated with SRS doses of <=13 Gy, cranial nerve toxicity was comparable to that of the FSRT group. Conclusions: FSRT and SRS are both safe and effective alternatives for the treatment of VS. Local control rates are comparable in both groups. SRS with doses of <=13 Gy is a safe alternative to FSRT. While FSRT can be applied safely for the treatment of VSs of all sizes, SRS should be reserved for smaller lesions.« less

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

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

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

2011-03-15

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

Evaluation of a magnetic resonance guided linear accelerator for stereotactic radiosurgery treatment.

PubMed

Wen, Ning; Kim, Joshua; Doemer, Anthony; Glide-Hurst, Carri; Chetty, Indrin J; Liu, Chang; Laugeman, Eric; Xhaferllari, Ilma; Kumarasiri, Akila; Victoria, James; Bellon, Maria; Kalkanis, Steve; Siddiqui, M Salim; Movsas, Benjamin

2018-06-01

The purpose of this study was to investigate the systematic localization accuracy, treatment planning capability, and delivery accuracy of an integrated magnetic resonance imaging guided Linear Accelerator (MR-Linac) platform for stereotactic radiosurgery. The phantom for the end-to-end test comprises three different compartments: a rectangular MR/CT target phantom, a Winston-Lutz cube, and a rectangular MR/CT isocenter phantom. Hidden target tests were performed at gantry angles of 0, 90, 180, and 270 degrees to quantify the systematic accuracy. Five patient plans with a total of eleven lesions were used to evaluate the dosimetric accuracy. Single-isocenter IMRT treatment plans using 10-15 coplanar beams were generated to treat the multiple metastases. The end-to-end localization accuracy of the system was 1.0 ± 0.1 mm. The conformity index, homogeneity index and gradient index of the plans were 1.26 ± 0.22, 1.22 ± 0.10, and 5.38 ± 1.44, respectively. The average absolute point dose difference between measured and calculated dose was 1.64 ± 1.90%, and the mean percentage of points passing the 3%/1 mm gamma criteria was 96.87%. Our experience demonstrates that excellent plan quality and delivery accuracy was achievable on the MR-Linac for treating multiple brain metastases with a single isocenter. Copyright © 2018 Elsevier B.V. All rights reserved.

TH-C-BRC-02: A Review of Emerging Technologies in Robotic SRS/SBRT Delivery

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

Wang, L.

The delivery techniques for SRS/SBRT have been under rapid developments in recent years, which pose new challenges to medical physicists ranging from planning and quality assurance to imaging and motion management. This educational course will provide a general overview of the latest delivery techniques in SRS/SBRT, and discuss the clinical processes to address the challenges of each technique with special emphasis on dedicated gamma-ray based device, robotic x-band linac-based system and conventional C-arm s-band linac-based SRS systems. (1). Gamma-ray based SRS/SRT: This is the gold standard of intracranial SRS. With the advent of precision imaging guidance and frameless patient positioningmore » capabilities, novel stereoscopic CBCT and automatic dose adaption solution are introduced to the Gamma-ray based SRS for the first time. The first North American system has been approved by the US regulatory for patient treatments in the spring of 2016. (2). Robotic SRS/SBRT system: A number of technological milestones have been developed in the past few years, including variable aperture collimator, sequential optimization technique, and the time reduction technique. Recently, a new robotic model allows the option of a multi-leaf collimator. These technological advances have reduced the treatment time and improved dose conformity significantly and could potentially expand the application of radiosurgery for the treatment of targets not previously suitable for robotic SRS/SBRT or fractionated stereotactic radiotherapy. These technological advances have created new demanding mandates on hardware and patient quality assurance (QA) tasks, as well as the need for updating/educating the physicists in the community on these requirements. (3). Conventional Linac based treatments: Modulated arc therapy (MAT) has gained wide popularities in Linac-based treatments in recent years due to its high delivery efficiency and excellent dose conformities. Recently, MAT has been introduced to deliver highly conformal radiosurgery treatments to multiple targets simultaneously via a single isocenter to replace the conventional multi-iso multi-plan treatments. It becomes important to understand the advantages and limitations of this technique, and the pitfalls for implementing this technique in clinical practice. The planning process of single-iso multi-target MAT will be described, and its plan quality and delivery efficiency will be compared with multi-iso plans. The QA process for verifying such complex plans will be illustrated, and pitfalls in imaging and patient set up will be discussed. Overall, this session will focus on the following areas: 1) Update on the emerging technology in current SRS/SBRT delivery. 2) New developments in treatment planning and Quality Assurance program. 3) Imaging guidance and motion management. Learning Objectives: To understand the SRS/SBRT principles and its clinical applications, and gain knowledge on the emerging technologies in SRS/SBRT. To review planning concepts and useful tips in treatment planning. To learn about the imaging guidance procedures and the quality assurance program in SRS/SBRT. National Institutes of Health, Varian Medical System; L. Ren, The presenter is funded by National Institutes of Health and Varian Medical System.« less

TH-C-BRC-01: An Overview of Emerging Technologies in SRS/SBRT Delivery

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

Ma, L.

2016-06-15

The delivery techniques for SRS/SBRT have been under rapid developments in recent years, which pose new challenges to medical physicists ranging from planning and quality assurance to imaging and motion management. This educational course will provide a general overview of the latest delivery techniques in SRS/SBRT, and discuss the clinical processes to address the challenges of each technique with special emphasis on dedicated gamma-ray based device, robotic x-band linac-based system and conventional C-arm s-band linac-based SRS systems. (1). Gamma-ray based SRS/SRT: This is the gold standard of intracranial SRS. With the advent of precision imaging guidance and frameless patient positioningmore » capabilities, novel stereoscopic CBCT and automatic dose adaption solution are introduced to the Gamma-ray based SRS for the first time. The first North American system has been approved by the US regulatory for patient treatments in the spring of 2016. (2). Robotic SRS/SBRT system: A number of technological milestones have been developed in the past few years, including variable aperture collimator, sequential optimization technique, and the time reduction technique. Recently, a new robotic model allows the option of a multi-leaf collimator. These technological advances have reduced the treatment time and improved dose conformity significantly and could potentially expand the application of radiosurgery for the treatment of targets not previously suitable for robotic SRS/SBRT or fractionated stereotactic radiotherapy. These technological advances have created new demanding mandates on hardware and patient quality assurance (QA) tasks, as well as the need for updating/educating the physicists in the community on these requirements. (3). Conventional Linac based treatments: Modulated arc therapy (MAT) has gained wide popularities in Linac-based treatments in recent years due to its high delivery efficiency and excellent dose conformities. Recently, MAT has been introduced to deliver highly conformal radiosurgery treatments to multiple targets simultaneously via a single isocenter to replace the conventional multi-iso multi-plan treatments. It becomes important to understand the advantages and limitations of this technique, and the pitfalls for implementing this technique in clinical practice. The planning process of single-iso multi-target MAT will be described, and its plan quality and delivery efficiency will be compared with multi-iso plans. The QA process for verifying such complex plans will be illustrated, and pitfalls in imaging and patient set up will be discussed. Overall, this session will focus on the following areas: 1) Update on the emerging technology in current SRS/SBRT delivery. 2) New developments in treatment planning and Quality Assurance program. 3) Imaging guidance and motion management. Learning Objectives: To understand the SRS/SBRT principles and its clinical applications, and gain knowledge on the emerging technologies in SRS/SBRT. To review planning concepts and useful tips in treatment planning. To learn about the imaging guidance procedures and the quality assurance program in SRS/SBRT. National Institutes of Health, Varian Medical System; L. Ren, The presenter is funded by National Institutes of Health and Varian Medical System.« less

TH-C-BRC-00: Emerging Technologies in SRS/SBRT Delivery

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

NONE

2016-06-15

The delivery techniques for SRS/SBRT have been under rapid developments in recent years, which pose new challenges to medical physicists ranging from planning and quality assurance to imaging and motion management. This educational course will provide a general overview of the latest delivery techniques in SRS/SBRT, and discuss the clinical processes to address the challenges of each technique with special emphasis on dedicated gamma-ray based device, robotic x-band linac-based system and conventional C-arm s-band linac-based SRS systems. (1). Gamma-ray based SRS/SRT: This is the gold standard of intracranial SRS. With the advent of precision imaging guidance and frameless patient positioningmore » capabilities, novel stereoscopic CBCT and automatic dose adaption solution are introduced to the Gamma-ray based SRS for the first time. The first North American system has been approved by the US regulatory for patient treatments in the spring of 2016. (2). Robotic SRS/SBRT system: A number of technological milestones have been developed in the past few years, including variable aperture collimator, sequential optimization technique, and the time reduction technique. Recently, a new robotic model allows the option of a multi-leaf collimator. These technological advances have reduced the treatment time and improved dose conformity significantly and could potentially expand the application of radiosurgery for the treatment of targets not previously suitable for robotic SRS/SBRT or fractionated stereotactic radiotherapy. These technological advances have created new demanding mandates on hardware and patient quality assurance (QA) tasks, as well as the need for updating/educating the physicists in the community on these requirements. (3). Conventional Linac based treatments: Modulated arc therapy (MAT) has gained wide popularities in Linac-based treatments in recent years due to its high delivery efficiency and excellent dose conformities. Recently, MAT has been introduced to deliver highly conformal radiosurgery treatments to multiple targets simultaneously via a single isocenter to replace the conventional multi-iso multi-plan treatments. It becomes important to understand the advantages and limitations of this technique, and the pitfalls for implementing this technique in clinical practice. The planning process of single-iso multi-target MAT will be described, and its plan quality and delivery efficiency will be compared with multi-iso plans. The QA process for verifying such complex plans will be illustrated, and pitfalls in imaging and patient set up will be discussed. Overall, this session will focus on the following areas: 1) Update on the emerging technology in current SRS/SBRT delivery. 2) New developments in treatment planning and Quality Assurance program. 3) Imaging guidance and motion management. Learning Objectives: To understand the SRS/SBRT principles and its clinical applications, and gain knowledge on the emerging technologies in SRS/SBRT. To review planning concepts and useful tips in treatment planning. To learn about the imaging guidance procedures and the quality assurance program in SRS/SBRT. National Institutes of Health, Varian Medical System; L. Ren, The presenter is funded by National Institutes of Health and Varian Medical System.« less

Development of a combined feed forward-feedback system for an electron Linac

NASA Astrophysics Data System (ADS)

Meier, E.; Biedron, S. G.; LeBlanc, G.; Morgan, M. J.; Wu, J.

2009-10-01

This paper describes the results of an advanced control algorithm for the stabilization of electron beam energy in a Linac. The approach combines a conventional Proportional-Integral (PI) controller with a neural network (NNET) feed forward algorithm; it utilizes the robustness of PI control and the ability of a feed forward system in order to exert control over a wider range of frequencies. The NNET is trained to recognize jitter occurring in the phase and voltage of one of the klystrons, based on a record of these parameters, and predicts future energy deviations. A systematic approach is developed to determine the optimal NNET parameters that are then applied to the Australian Synchrotron Linac. The system's capability to fully cancel multi-frequency jitter is demonstrated. The NNET system is then augmented with the PI algorithm, and further jitter attenuation is achieved when the NNET is not operating optimally.

Solenoid Fringe Field Effects for the Neutrino Factory Linac - MAD-X Investigation

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

M. Aslaninejad,C. Bontoiu,J. Pasternak,J. Pozimski,Alex Bogacz

2010-05-01

International Design Study for the Neutrino Factory (IDS-NF) assumes the first stage of muon acceleration (up to 900 MeV) to be implemented with a solenoid based Linac. The Linac consists of three styles of cryo-modules, containing focusing solenoids and varying number of SRF cavities for acceleration. Fringe fields of the solenoids and the focusing effects in the SRF cavities have significant impact on the transverse beam dynamics. Using an analytical formula, the effects of fringe fields are studied in MAD-X. The resulting betatron functions are compared with the results of beam dynamics simulations using OptiM code.

Feasibility of an online adaptive replanning method for cranial frameless intensity-modulated radiosurgery

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

Calvo, Juan Francisco, E-mail: jfcdrr@gmail.com; San José, Sol; Garrido, LLuís

2013-10-01

To introduce an approach for online adaptive replanning (i.e., dose-guided radiosurgery) in frameless stereotactic radiosurgery, when a 6-dimensional (6D) robotic couch is not available in the linear accelerator (linac). Cranial radiosurgical treatments are planned in our department using intensity-modulated technique. Patients are immobilized using thermoplastic mask. A cone-beam computed tomography (CBCT) scan is acquired after the initial laser-based patient setup (CBCT{sub setup}). The online adaptive replanning procedure we propose consists of a 6D registration-based mapping of the reference plan onto actual CBCT{sub setup}, followed by a reoptimization of the beam fluences (“6D plan”) to achieve similar dosage as originally wasmore » intended, while the patient is lying in the linac couch and the original beam arrangement is kept. The goodness of the online adaptive method proposed was retrospectively analyzed for 16 patients with 35 targets treated with CBCT-based frameless intensity modulated technique. Simulation of reference plan onto actual CBCT{sub setup}, according to the 4 degrees of freedom, supported by linac couch was also generated for each case (4D plan). Target coverage (D99%) and conformity index values of 6D and 4D plans were compared with the corresponding values of the reference plans. Although the 4D-based approach does not always assure the target coverage (D99% between 72% and 103%), the proposed online adaptive method gave a perfect coverage in all cases analyzed as well as a similar conformity index value as was planned. Dose-guided radiosurgery approach is effective to assure the dose coverage and conformity of an intracranial target volume, avoiding resetting the patient inside the mask in a “trial and error” way so as to remove the pitch and roll errors when a robotic table is not available.« less

Beam dynamic simulation and optimization of the CLIC positron source and the capture linac

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

Bayar, C., E-mail: cafer.bayar@cern.ch; CERN, Geneva; Doebert, S., E-mail: Steffen.Doebert@cern.ch

2016-03-25

The CLIC Positron Source is based on the hybrid target composed of a crystal and an amorphous target. Simulations have been performed from the exit of the amorphous target to the end of pre-injector linac which captures and accelerates the positrons to an energy of 200 MeV. Simulations are performed by the particle tracking code PARMELA. The magnetic field of the AMD is represented in PARMELA by simple coils. Two modes are applied in this study. The first one is accelerating mode based on acceleration after the AMD. The second one is decelerating mode based on deceleration in the first acceleratingmore » structure. It is shown that the decelerating mode gives a higher yield for the e{sup +} beam in the end of the Pre-Injector Linac.« less

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

PubMed

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

2010-09-01

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

Hypofractionated stereotactic radiotherapy (HFSRT) for who grade I anterior clinoid meningiomas (ACM).

PubMed

Demiral, Selcuk; Dincoglan, Ferrat; Sager, Omer; Gamsiz, Hakan; Uysal, Bora; Gundem, Esin; Elcim, Yelda; Dirican, Bahar; Beyzadeoglu, Murat

2016-11-01

While microsurgical resection plays a central role in the management of ACMs, extensive surgery may be associated with substantial morbidity particularly for tumors in intimate association with critical structures. In this study, we evaluated the use of HFSRT in the management of ACM. A total of 22 patients with ACM were treated using HFSRT. Frameless image guided volumetric modulated arc therapy (VMAT) was performed with a 6 MV linear accelerator (LINAC). The total dose was 25 Gy delivered in five fractions over five consecutive treatment days. Local control (LC) and progression free survival (PFS) rates were calculated using the Kaplan-Meier method. Common Terminology Criteria for Adverse Events, version 4.0 was used in toxicity grading. Out of the total 22 patients, outcomes of 19 patients with at least 36 months of periodic follow-up were assessed. Median patient age was 40 years old (range 24-77 years old). Median follow-up time was 53 months (range 36-63 months). LC and PFS rates were 100 and 89.4 % at 1 and 3 years, respectively. Only two patients (10.5 %) experienced clinical deterioration during the follow-up period. LINAC-based HFSRT offers high rates of LC and PFS for patients with ACMs.

WE-D-BRD-01: Innovation in Radiation Therapy Delivery: Advanced Digital Linac Features

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

Xing, L; Wong, J; Li, R

2014-06-15

Last few years has witnessed significant advances in linac technology and therapeutic dose delivery method. Digital linacs equipped with high dose rate FFF beams have been clinically implemented in a number of hospitals. Gated VMAT is becoming increasingly popular in treating tumors affected by respiratory motion. This session is devoted to update the audience with these technical advances and to present our experience in clinically implementing the new linacs and dose delivery methods. Topics to be covered include, technical features of new generation of linacs from different vendors, dosimetric characteristics and clinical need for FFF-beam based IMRT and VMAT, respiration-gatedmore » VMAT, the concept and implementation of station parameter optimized radiation therapy (SPORT), beam level imaging and onboard image guidance tools. Emphasis will be on providing fundamental understanding of the new treatment delivery and image guidance strategies, control systems, and the associated dosimetric characteristics. Commissioning and acceptance experience on these new treatment delivery technologies will be reported. Clinical experience and challenges encountered during the process of implementation of the new treatment techniques and future applications of the systems will also be highlighted. Learning Objectives: Present background knowledge of emerging digital linacs and summarize their key geometric and dosimetric features. SPORT as an emerging radiation therapy modality specifically designed to take advantage of digital linacs. Discuss issues related to the acceptance and commissioning of the digital linacs and FFF beams. Describe clinical utility of the new generation of digital linacs and their future applications.« less

Electron beam energy and bunch length feed forward control studies using an artificial neural network at the Linac coherent light source

NASA Astrophysics Data System (ADS)

Meier, E.; Biedron, S. G.; LeBlanc, G.; Morgan, M. J.; Wu, J.

2009-11-01

This paper describes the results of an advanced control algorithm for the stabilization of electron beam energy in a Linac. The approach combines a conventional Proportional-Integral (PI) controller with a neural network (NNET) feed forward algorithm; it utilizes the robustness of PI control and the ability of a feed forward system in order to exert control over a wider range of frequencies. The NNET is trained to recognize jitter occurring in the phase and voltage of one of the klystrons, based on a record of these parameters, and predicts future energy deviations. A systematic approach is developed to determine the optimal NNET parameters that are then applied to the Australian Synchrotron Linac. The system's capability to fully cancel multi-frequency jitter is demonstrated. The NNET system is then augmented with the PI algorithm, and further jitter attenuation is achieved when the NNET is not operating optimally.

SU-E-T-320: Dosimetric Evaluation of Intracranial Stereotactic Radiotherapy Plans Using Jaws-Only Collimation On a LINAC

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

Mistry, N; Kim, A; Schaum, J

2015-06-15

Purpose: To evaluate the dosimetry of cranial stereotactic radiotherapy (SRT) plans using jaws-only collimation on linac that meets appropriate TG-142 tolerances. Methods: Seventeen spherical targets were generated in the center of a head phantom with diameters ranging from 8 mm to 40 mm. Plans balanced treatment time with dose gradient and conformity using 13 static fields and 3 couch angles: 9 non-opposed and coplanar fields and 4 non-coplanar fields. The symmetrical jaws field size was target diameter plus 2 mm. The prescription (Rx) was 7 Gy per fraction to the 80% isodose line. Two plans were created for each target:more » one kept the collimator at 0° (C0), one adjusted the collimator angle 40° for each field to create a 360° sweep over the 9 coplanar fields (CR).Conformity of the Rx to the target was evaluated using a ratio of Rx to target volume (PITV). Heterogeneity was determined using a ratio of maximum dose to Rx dose. Falloff was scored using CGIg: the difference of effective radii of spheres equal to half and full Rx volumes. Results: All plans met RTOG SRS criteria for conformity and heterogeneity. The use of collimator rotation improved conformity by 3.2% on average, the mean PITV was 1.7±0.1 for C0 plans and 1.6±0.1 for CR. Mean heterogeneity was 1.25±0.0 for both C0 and CR. The mean CGIg was 75.9±16.4 for C0 plans and 74.4±17.0 for CR; with a mean dose falloff degradation of 2.5% by CR. Conclusion: Clinically acceptable SRT plans for spherical targets were created using jaws-only collimation with static fields. The addition of sweeping collimator rotation improves conformity at the expense of gradient. This technique can expand the availability of SRT to patients especially to those who cannot travel to a facility with a dedicated stereotactic radiosurgery machine.« less

Demonstration of cathode emittance dominated high bunch charge beams in a DC gun-based photoinjector

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

Gulliford, Colwyn, E-mail: cg248@cornell.edu; Bartnik, Adam, E-mail: acb20@cornell.edu; Bazarov, Ivan

We present the results of transverse emittance and longitudinal current profile measurements of high bunch charge (≥100 pC) beams produced in the DC gun-based Cornell energy recovery linac photoinjector. In particular, we show that the cathode thermal and core beam emittances dominate the final 95% and core emittances measured at 9–9.5 MeV. Additionally, we demonstrate excellent agreement between optimized 3D space charge simulations and measurement, and show that the quality of the transverse laser distribution limits the optimal simulated and measured emittances. These results, previously thought achievable only with RF guns, demonstrate that DC gun based photoinjectors are capable of deliveringmore » beams with sufficient single bunch charge and beam quality suitable for many current and next generation accelerator projects such as Energy Recovery Linacs and Free Electron Lasers.« less

Irradiation Design for an Experimental Murine Model

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

Ballesteros-Zebadua, P.; Moreno-Jimenez, S.; Suarez-Campos, J. E.

2010-12-07

In radiotherapy and stereotactic radiosurgery, small animal experimental models are frequently used, since there are still a lot of unsolved questions about the biological and biochemical effects of ionizing radiation. This work presents a method for small-animal brain radiotherapy compatible with a dedicated 6MV Linac. This rodent model is focused on the research of the inflammatory effects produced by ionizing radiation in the brain. In this work comparisons between Pencil Beam and Monte Carlo techniques, were used in order to evaluate accuracy of the calculated dose using a commercial planning system. Challenges in this murine model are discussed.

TH-CD-BRA-09: Towards Absolute Dose Measurement in MRI-Linac and Gamma-Knife: Design and Construction of An MR-Compatible Water Calorimeter

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

Entezari, N; Sarfehnia, A; Renaud, J

Purpose: The purpose of this work is to design and optimize a portable Water Calorimeter (WC) for use in a commercial MRI-linac and Gamma-knife in addition to conventional radiotherapy linacs. Water calorimeters determine absorbed dose to water at a point by measuring radiation-induced temperature rise of the volume (the two are related by the medium specific heat capacity). In this formalism, one important correction factor is heat transfer correction k-ht. It compensates for heat gain/loss due to conductive and convective effects, and is numerically calculated as ratio of temperature rise in the absence of heat loss to that in themore » presence of heat loss. Operating at 4°C ensures convection is minimal. Methods: A commercial finite element software was used to evaluate several WC designs with different insulation materials and thicknesses; channels allowing coolant to travel around WC (to sustain WC at 4°C) were modeled, and worst-case scenario variation in the temperature of the coolant was simulated for optimization purposes (2.6 mK/s). Additionally, several calorimeter vessel design parameters (front/back glass thickness/separation, diameter) were also simulated and optimized. Optimization is based on minimizing long term calorimeter drift (24h) as well as variation and magnitude of k-ht. Results: The final selected WC design reached a modest drift of 11µK/s after 15h for the worst-case coolant temperature variation. This design consists of coolant channels being encompassed on both sides by cryogel insulation. For the MRI-linac beam, glass thickness plays the largest effect on k-ht with variation of upto 0.6% in the first run for thicknesses ranging between 0.5–1.7mm. Subsequent runs vary only within 0.1% with glass thickness. Other factors such as vessel radius and top/bottom glass separation have sub 0.1% effects on k-ht. Conclusion: An MR-safe 4°C stagnant WC appropriate for dosimetry in MRI-linac and Gamma-Knife was designed, optimized, and construction is nearly completed. NSERC Discovery Grant RGPIN-435608.« less

Failure mode and effects analysis and fault tree analysis of surface image guided cranial radiosurgery.

PubMed

Manger, Ryan P; Paxton, Adam B; Pawlicki, Todd; Kim, Gwe-Ya

2015-05-01

Surface image guided, Linac-based radiosurgery (SIG-RS) is a modern approach for delivering radiosurgery that utilizes optical stereoscopic imaging to monitor the surface of the patient during treatment in lieu of using a head frame for patient immobilization. Considering the novelty of the SIG-RS approach and the severity of errors associated with delivery of large doses per fraction, a risk assessment should be conducted to identify potential hazards, determine their causes, and formulate mitigation strategies. The purpose of this work is to investigate SIG-RS using the combined application of failure modes and effects analysis (FMEA) and fault tree analysis (FTA), report on the effort required to complete the analysis, and evaluate the use of FTA in conjunction with FMEA. A multidisciplinary team was assembled to conduct the FMEA on the SIG-RS process. A process map detailing the steps of the SIG-RS was created to guide the FMEA. Failure modes were determined for each step in the SIG-RS process, and risk priority numbers (RPNs) were estimated for each failure mode to facilitate risk stratification. The failure modes were ranked by RPN, and FTA was used to determine the root factors contributing to the riskiest failure modes. Using the FTA, mitigation strategies were formulated to address the root factors and reduce the risk of the process. The RPNs were re-estimated based on the mitigation strategies to determine the margin of risk reduction. The FMEA and FTAs for the top two failure modes required an effort of 36 person-hours (30 person-hours for the FMEA and 6 person-hours for two FTAs). The SIG-RS process consisted of 13 major subprocesses and 91 steps, which amounted to 167 failure modes. Of the 91 steps, 16 were directly related to surface imaging. Twenty-five failure modes resulted in a RPN of 100 or greater. Only one of these top 25 failure modes was specific to surface imaging. The riskiest surface imaging failure mode had an overall RPN-rank of eighth. Mitigation strategies for the top failure mode decreased the RPN from 288 to 72. Based on the FMEA performed in this work, the use of surface imaging for monitoring intrafraction position in Linac-based stereotactic radiosurgery (SRS) did not greatly increase the risk of the Linac-based SRS process. In some cases, SIG helped to reduce the risk of Linac-based RS. The FMEA was augmented by the use of FTA since it divided the failure modes into their fundamental components, which simplified the task of developing mitigation strategies.

TH-EF-BRB-10: Dosimetric Validation of a Trajectory Based Cranial SRS Treatment Technique On a Varian TrueBeam Linac

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

Wilson, B; Vancouver Cancer Centre, Vancouver, BC; Gete, E

2016-06-15

Purpose: This work investigates the dosimetric accuracy of a trajectory based delivery technique in which an optimized radiation beam is delivered along a Couch-Gantry trajectory that is formed by simultaneous rotation of the linac gantry and the treatment couch. Methods: Nine trajectory based cranial SRS treatment plans were created using in-house optimization software. The plans were calculated for delivery on the TrueBeam STx linac with 6MV photon beam. Dose optimization was performed along a user-defined trajectory using MLC modulation, dose rate modulation and jaw tracking. The pre-defined trajectory chosen for this study is formed by a couch rotation through itsmore » full range of 180 degrees while the gantry makes four partial arc sweeps which are 170 degrees each. For final dose calculation, the trajectory based plans were exported to the Varian Eclipse Treatment Planning System. The plans were calculated on a homogeneous cube phantom measuring 18.2×18.2×18.2 cm3 with the analytical anisotropic algorithm (AAA) using a 1mm3 calculation voxel. The plans were delivered on the TrueBeam linac via the developer’s mode. Point dose measurements were performed on 9 patients with the IBA CC01 mini-chamber with a sensitive volume of 0.01 cc. Gafchromic film measurements along the sagittal and coronal planes were performed on three of the 9 treatment plans. Point dose values were compared with ion chamber measurements. Gamma analysis comparing film measurement and AAA calculations was performed using FilmQA Pro. Results: The AAA calculations and measurements were in good agreement. The point dose difference between AAA and ion chamber measurements were within 2.2%. Gamma analysis test pass rates (2%, 2mm passing criteria) for the Gafchromic film measurements were >95%. Conclusion: We have successfully tested TrueBeam’s ability to deliver accurate trajectory based treatments involving simultaneous gantry and couch rotation with MLC and dose rate modulation along the trajectory.« less

Hypofractionated stereotactic radiotherapy in five daily fractions for post-operative surgical cavities in brain metastases patients with and without prior whole brain radiation.

PubMed

Al-Omair, Ameen; Soliman, Hany; Xu, Wei; Karotki, Aliaksandr; Mainprize, Todd; Phan, Nicolas; Das, Sunit; Keith, Julia; Yeung, Robert; Perry, James; Tsao, May; Sahgal, Arjun

2013-12-01

Our purpose was to report efficacy of hypofractionated cavity stereotactic radiotherapy (HCSRT) in patients with and without prior whole brain radiotherapy (WBRT). 32 surgical cavities in 30 patients (20 patients/21 cavities had no prior WBRT and 10 patients/11 cavities had prior WBRT) were treated with image-guided linac stereotactic radiotherapy. 7 of the 10 prior WBRT patients had "resistant" local disease given prior surgery, post-operative WBRT and a re-operation, followed by salvage HCSRT. The clinical target volume was the post-surgical cavity, and a 2-mm margin applied as planning target volume. The median total dose was 30 Gy (range: 25-37.5 Gy) in 5 fractions. In the no prior and prior WBRT cohorts, the median follow-up was 9.7 months (range: 3.0-23.6) and 15.3 months (range: 2.9-39.7), the median survival was 23.6 months and 39.7 months, and the 1-year cavity local recurrence progression- free survival (LRFS) was 79 and 100%, respectively. At 18 months the LRFS dropped to 29% in the prior WBRT cohort. Grade 3 radiation necrosis occurred in 3 prior WBRT patients. We report favorable outcomes with HCSRT, and well selected patients with prior WBRT and "resistant" disease may have an extended survival favoring aggressive salvage HCSRT at a moderate risk of radiation necrosis.

Early experiences of planning stereotactic radiosurgery using 3D printed models of eyes with uveal melanomas

PubMed Central

Furdová, Alena; Sramka, Miron; Thurzo, Andrej; Furdová, Adriana

2017-01-01

Objective The objective of this study was to determine the use of 3D printed model of an eye with intraocular tumor for linear accelerator-based stereotactic radiosurgery. Methods The software for segmentation (3D Slicer) created virtual 3D model of eye globe with tumorous mass based on tissue density from computed tomography and magnetic resonance imaging data. A virtual model was then processed in the slicing software (Simplify3D®) and printed on 3D printer using fused deposition modeling technology. The material that was used for printing was polylactic acid. Results In 2015, stereotactic planning scheme was optimized with the help of 3D printed model of the patient’s eye with intraocular tumor. In the period 2001–2015, a group of 150 patients with uveal melanoma (139 choroidal melanoma and 11 ciliary body melanoma) were treated. The median tumor volume was 0.5 cm3 (0.2–1.6 cm3). The radiation dose was 35.0 Gy by 99% of dose volume histogram. Conclusion The 3D printed model of eye with tumor was helpful in planning the process to achieve the optimal scheme for irradiation which requires high accuracy of defining the targeted tumor mass and critical structures. PMID:28203052

Radiosurgery with photons or protons for benign and malignant tumours of the skull base: a review.

PubMed

Amichetti, Maurizio; Amelio, Dante; Minniti, Giuseppe

2012-12-14

Stereotactic radiosurgery (SRS) is an important treatment option for intracranial lesions. Many studies have shown the effectiveness of photon-SRS for the treatment of skull base (SB) tumours; however, limited data are available for proton-SRS.Several photon-SRS techniques, including Gamma Knife, modified linear accelerators (Linac) and CyberKnife, have been developed and several studies have compared treatment plan characteristics between protons and photons.The principles of classical radiobiology are similar for protons and photons even though they differ in terms of physical properties and interaction with matter resulting in different dose distributions.Protons have special characteristics that allow normal tissues to be spared better than with the use of photons, although their potential clinical superiority remains to be demonstrated.A critical analysis of the fundamental radiobiological principles, dosimetric characteristics, clinical results, and toxicity of proton- and photon-SRS for SB tumours is provided and discussed with an attempt of defining the advantages and limits of each radiosurgical technique.

Radiosurgery with photons or protons for benign and malignant tumours of the skull base: a review

PubMed Central

2012-01-01

Stereotactic radiosurgery (SRS) is an important treatment option for intracranial lesions. Many studies have shown the effectiveness of photon-SRS for the treatment of skull base (SB) tumours; however, limited data are available for proton-SRS. Several photon-SRS techniques, including Gamma Knife, modified linear accelerators (Linac) and CyberKnife, have been developed and several studies have compared treatment plan characteristics between protons and photons. The principles of classical radiobiology are similar for protons and photons even though they differ in terms of physical properties and interaction with matter resulting in different dose distributions. Protons have special characteristics that allow normal tissues to be spared better than with the use of photons, although their potential clinical superiority remains to be demonstrated. A critical analysis of the fundamental radiobiological principles, dosimetric characteristics, clinical results, and toxicity of proton- and photon-SRS for SB tumours is provided and discussed with an attempt of defining the advantages and limits of each radiosurgical technique. PMID:23241206

Optimization of the RF cavity heat load and trip rates for CEBAF at 12 GeV

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

Zhang, He; Roblin, Yves R.; Freyberger, Arne P.

2017-05-01

The Continuous Electron Beam Accelerator Facility at JLab has 200 RF cavities in the north linac and the south linac respectively after the 12 GeV upgrade. The purpose of this work is to simultaneously optimize the heat load and the trip rate for the cavities and to reconstruct the pareto-optimal front in a timely manner when some of the cavities are turned down. By choosing an efficient optimizer and strategically creating the initial gradients, the pareto-optimal front for no more than 15 cavities down can be re-established within 20 seconds.

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

PubMed

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

2002-07-01

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

Advanced Accelerators for Medical Applications

NASA Astrophysics Data System (ADS)

Uesaka, Mitsuru; Koyama, Kazuyoshi

We review advanced accelerators for medical applications with respect to the following key technologies: (i) higher RF electron linear accelerator (hereafter “linac”); (ii) optimization of alignment for the proton linac, cyclotron and synchrotron; (iii) superconducting magnet; (iv) laser technology. Advanced accelerators for medical applications are categorized into two groups. The first group consists of compact medical linacs with high RF, cyclotrons and synchrotrons downsized by optimization of alignment and superconducting magnets. The second group comprises laser-based acceleration systems aimed of medical applications in the future. Laser plasma electron/ion accelerating systems for cancer therapy and laser dielectric accelerating systems for radiation biology are mentioned. Since the second group has important potential for a compact system, the current status of the established energy and intensity and of the required stability are given.

Design of Linear Accelerator (LINAC) tanks for proton therapy via Particle Swarm Optimization (PSO) and Genetic Algorithm (GA) approaches

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

Castellano, T.; De Palma, L.; Laneve, D.

2015-07-01

A homemade computer code for designing a Side- Coupled Linear Accelerator (SCL) is written. It integrates a simplified model of SCL tanks with the Particle Swarm Optimization (PSO) algorithm. The computer code main aim is to obtain useful guidelines for the design of Linear Accelerator (LINAC) resonant cavities. The design procedure, assisted via the aforesaid approach seems very promising, allowing future improvements towards the optimization of actual accelerating geometries. (authors)

A novel electron gun for inline MRI-linac configurations.

PubMed

Constantin, Dragoş E; Holloway, Lois; Keall, Paul J; Fahrig, Rebecca

2014-02-01

This work introduces a new electron gun geometry capable of robust functioning in the presence of a high strength external magnetic field for axisymmetric magnetic resonance imaging (MRI)-linac configurations. This allows an inline MRI-linac to operate without the need to isolate the linear accelerator (linac) using a magnetic shield. This MRI-linac integration approach not only leaves the magnet homogeneity unchanged but also provides the linac flexibility to move along the magnet axis of symmetry if the source to target distance needs to be adjusted. Simple electron gun geometry modifications of a Varian 600 C electron gun are considered and solved in the presence of an external magnetic field in order to determine a set of design principles for the new geometry. Based on these results, a new gun geometry is proposed and optimized in the fringe field of a 0.5 T open bore MRI magnet (GE Signa SP). A computer model for the 6 MeV Varian 600 C linac is used to determine the capture efficiency of the new electron gun-linac system in the presence of the fringe field of the same MRI scanner. The behavior of the new electron gun plus the linac system is also studied in the fringe fields of two other magnets, a 1.0 T prototype open bore magnet and a 1.5 T GE Conquest scanner. Simple geometrical modifications of the original electron gun geometry do not provide feasible solutions. However, these tests show that a smaller transverse cathode diameter with a flat surface and a slightly larger anode diameter could alleviate the current loss due to beam interactions with the anode in the presence of magnetic fields. Based on these findings, an initial geometry resembling a parallel plate capacitor with a hole in the anode is proposed. The optimization procedure finds a cathode-anode distance of 5 mm, a focusing electrode angle of 5°, and an anode drift tube length of 17.1 mm. Also, the linac can be displaced with ± 15 cm along the axis of the 0.5 T magnet without capture efficiency reduction below the experimental value in zero field. In this range of linac displacements, the electron beam generated by the new gun geometry is more effectively injected into the linac in the presence of an external magnetic field, resulting in approximately 20% increase of the target current compared to the original gun geometry behavior at zero field. The new gun geometry can generate and accelerate electron beams in external magnetic fields without current loss for fields higher than 0.11 T. The new electron-gun geometry is robust enough to function in the fringe fields of the other two magnets with a target current loss of no more than 16% with respect to the current obtained with no external magnetic fields. In this work, a specially designed electron gun was presented which can operate in the presence of axisymmetric strong magnetic fringe fields of MRI magnets. Computer simulations show that the electron gun can produce high quality beams which can be injected into a straight through linac such as Varian 600 C and accelerated with more efficiency in the presence of the external magnetic fields. Also, the new configuration allows linac displacements along the magnet axis in a range equal to the diameter of the imaging spherical volume of the magnet under consideration. The new electron gun-linac system can function in the fringe field of a MRI magnet if the field strength at the cathode position is higher than 0.11 T. The capture efficiency of the linac depends on the magnetic field strength and the field gradient. The higher the gradient the better the capture efficiency. The capture efficiency does not degrade more than 16%.

A novel electron gun for inline MRI-linac configurations

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

Constantin, Dragoş E., E-mail: dragos.constantin@varian.com; Fahrig, Rebecca; Holloway, Lois

2014-02-15

Purpose: This work introduces a new electron gun geometry capable of robust functioning in the presence of a high strength external magnetic field for axisymmetric magnetic resonance imaging (MRI)-linac configurations. This allows an inline MRI-linac to operate without the need to isolate the linear accelerator (linac) using a magnetic shield. This MRI-linac integration approach not only leaves the magnet homogeneity unchanged but also provides the linac flexibility to move along the magnet axis of symmetry if the source to target distance needs to be adjusted. Methods: Simple electron gun geometry modifications of a Varian 600C electron gun are considered andmore » solved in the presence of an external magnetic field in order to determine a set of design principles for the new geometry. Based on these results, a new gun geometry is proposed and optimized in the fringe field of a 0.5 T open bore MRI magnet (GE Signa SP). A computer model for the 6 MeV Varian 600C linac is used to determine the capture efficiency of the new electron gun-linac system in the presence of the fringe field of the same MRI scanner. The behavior of the new electron gun plus the linac system is also studied in the fringe fields of two other magnets, a 1.0 T prototype open bore magnet and a 1.5 T GE Conquest scanner. Results: Simple geometrical modifications of the original electron gun geometry do not provide feasible solutions. However, these tests show that a smaller transverse cathode diameter with a flat surface and a slightly larger anode diameter could alleviate the current loss due to beam interactions with the anode in the presence of magnetic fields. Based on these findings, an initial geometry resembling a parallel plate capacitor with a hole in the anode is proposed. The optimization procedure finds a cathode-anode distance of 5 mm, a focusing electrode angle of 5°, and an anode drift tube length of 17.1 mm. Also, the linac can be displaced with ±15 cm along the axis of the 0.5 T magnet without capture efficiency reduction below the experimental value in zero field. In this range of linac displacements, the electron beam generated by the new gun geometry is more effectively injected into the linac in the presence of an external magnetic field, resulting in approximately 20% increase of the target current compared to the original gun geometry behavior at zero field. The new gun geometry can generate and accelerate electron beams in external magnetic fields without current loss for fields higher than 0.11 T. The new electron-gun geometry is robust enough to function in the fringe fields of the other two magnets with a target current loss of no more than 16% with respect to the current obtained with no external magnetic fields. Conclusions: In this work, a specially designed electron gun was presented which can operate in the presence of axisymmetric strong magnetic fringe fields of MRI magnets. Computer simulations show that the electron gun can produce high quality beams which can be injected into a straight through linac such as Varian 600C and accelerated with more efficiency in the presence of the external magnetic fields. Also, the new configuration allows linac displacements along the magnet axis in a range equal to the diameter of the imaging spherical volume of the magnet under consideration. The new electron gun-linac system can function in the fringe field of a MRI magnet if the field strength at the cathode position is higher than 0.11 T. The capture efficiency of the linac depends on the magnetic field strength and the field gradient. The higher the gradient the better the capture efficiency. The capture efficiency does not degrade more than 16%.« less

A novel electron gun for inline MRI-linac configurations

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

Constantin, Dragoş E., E-mail: dragos.constantin@varian.com; Fahrig, Rebecca; Holloway, Lois

Purpose: This work introduces a new electron gun geometry capable of robust functioning in the presence of a high strength external magnetic field for axisymmetric magnetic resonance imaging (MRI)-linac configurations. This allows an inline MRI-linac to operate without the need to isolate the linear accelerator (linac) using a magnetic shield. This MRI-linac integration approach not only leaves the magnet homogeneity unchanged but also provides the linac flexibility to move along the magnet axis of symmetry if the source to target distance needs to be adjusted. Methods: Simple electron gun geometry modifications of a Varian 600C electron gun are considered andmore » solved in the presence of an external magnetic field in order to determine a set of design principles for the new geometry. Based on these results, a new gun geometry is proposed and optimized in the fringe field of a 0.5 T open bore MRI magnet (GE Signa SP). A computer model for the 6 MeV Varian 600C linac is used to determine the capture efficiency of the new electron gun-linac system in the presence of the fringe field of the same MRI scanner. The behavior of the new electron gun plus the linac system is also studied in the fringe fields of two other magnets, a 1.0 T prototype open bore magnet and a 1.5 T GE Conquest scanner. Results: Simple geometrical modifications of the original electron gun geometry do not provide feasible solutions. However, these tests show that a smaller transverse cathode diameter with a flat surface and a slightly larger anode diameter could alleviate the current loss due to beam interactions with the anode in the presence of magnetic fields. Based on these findings, an initial geometry resembling a parallel plate capacitor with a hole in the anode is proposed. The optimization procedure finds a cathode-anode distance of 5 mm, a focusing electrode angle of 5°, and an anode drift tube length of 17.1 mm. Also, the linac can be displaced with ±15 cm along the axis of the 0.5 T magnet without capture efficiency reduction below the experimental value in zero field. In this range of linac displacements, the electron beam generated by the new gun geometry is more effectively injected into the linac in the presence of an external magnetic field, resulting in approximately 20% increase of the target current compared to the original gun geometry behavior at zero field. The new gun geometry can generate and accelerate electron beams in external magnetic fields without current loss for fields higher than 0.11 T. The new electron-gun geometry is robust enough to function in the fringe fields of the other two magnets with a target current loss of no more than 16% with respect to the current obtained with no external magnetic fields. Conclusions: In this work, a specially designed electron gun was presented which can operate in the presence of axisymmetric strong magnetic fringe fields of MRI magnets. Computer simulations show that the electron gun can produce high quality beams which can be injected into a straight through linac such as Varian 600C and accelerated with more efficiency in the presence of the external magnetic fields. Also, the new configuration allows linac displacements along the magnet axis in a range equal to the diameter of the imaging spherical volume of the magnet under consideration. The new electron gun-linac system can function in the fringe field of a MRI magnet if the field strength at the cathode position is higher than 0.11 T. The capture efficiency of the linac depends on the magnetic field strength and the field gradient. The higher the gradient the better the capture efficiency. The capture efficiency does not degrade more than 16%.« less

Investigating a multi-purpose target for electron linac based photoneutron sources for BNCT of deep-seated tumors

NASA Astrophysics Data System (ADS)

Masoudi, S. Farhad; Rasouli, Fatemeh S.

2015-08-01

Recent studies in BNCT have focused on investigating appropriate neutron sources as alternatives for nuclear reactors. As the most prominent facilities, the electron linac based photoneutron sources benefit from two consecutive reactions, (e, γ) and (γ, n). The photoneutron sources designed so far are composed of bipartite targets which involve practical problems and are far from the objective of achieving an optimized neutron source. This simulation study deals with designing a compact, optimized, and geometrically simple target for a photoneutron source based on an electron linac. Based on a set of MCNPX simulations, tungsten is found to have the potential of utilizing as both photon converter and photoneutron target. Besides, it is shown that an optimized dimension for such a target slows-down the produced neutrons toward the desired energy range while keeping them economy, which makes achieving the recommended criteria for BNCT of deep-tumors more available. This multi-purpose target does not involve complicated designing, and can be considered as a significant step toward finding application of photoneutron sources for in-hospital treatments. In order to shape the neutron beam emitted from such a target, the beam is planned to pass through an optimized arrangement of materials composed of moderators, filters, reflector, and collimator. By assessment with the recommended in-air parameters, it is shown that the designed beam provides high intensity of desired neutrons, as well as low background contamination. The last section of this study is devoted to investigate the performance of the resultant beam in deep tissue. A typical simulated liver tumor, located within a phantom of human body, was subjected to the irradiation of the designed spectrum. The dosimetric results, including evaluated depth-dose curves and carried out in-phantom parameters show that the proposed configuration establishes acceptable agreement between the appropriate neutron intensity, and penetrating deep in tissue in a reasonable treatment time.

The Atomic, Molecular and Optical Science instrument at the Linac Coherent Light Source

DOE PAGES

Ferguson, Ken R.; Bucher, Maximilian; Bozek, John D.; ...

2015-05-01

The Atomic, Molecular and Optical Science (AMO) instrument at the Linac Coherent Light Source (LCLS) provides a tight soft X-ray focus into one of three experimental endstations. The flexible instrument design is optimized for studying a wide variety of phenomena requiring peak intensity. There is a suite of spectrometers and two photon area detectors available. An optional mirror-based split-and-delay unit can be used for X-ray pump–probe experiments. Recent scientific highlights illustrate the imaging, time-resolved spectroscopy and high-power density capabilities of the AMO instrument.

Three independent one-dimensional margins for single-fraction frameless stereotactic radiosurgery brain cases using CBCT

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

Zhang, Qinghui; Chan, Maria F.; Burman, Chandra

2013-12-15

Purpose: Setting a proper margin is crucial for not only delivering the required radiation dose to a target volume, but also reducing the unnecessary radiation to the adjacent organs at risk. This study investigated the independent one-dimensional symmetric and asymmetric margins between the clinical target volume (CTV) and the planning target volume (PTV) for linac-based single-fraction frameless stereotactic radiosurgery (SRS).Methods: The authors assumed a Dirac delta function for the systematic error of a specific machine and a Gaussian function for the residual setup errors. Margin formulas were then derived in details to arrive at a suitable CTV-to-PTV margin for single-fractionmore » frameless SRS. Such a margin ensured that the CTV would receive the prescribed dose in 95% of the patients. To validate our margin formalism, the authors retrospectively analyzed nine patients who were previously treated with noncoplanar conformal beams. Cone-beam computed tomography (CBCT) was used in the patient setup. The isocenter shifts between the CBCT and linac were measured for a Varian Trilogy linear accelerator for three months. For each plan, the authors shifted the isocenter of the plan in each direction by ±3 mm simultaneously to simulate the worst setup scenario. Subsequently, the asymptotic behavior of the CTV V{sub 80%} for each patient was studied as the setup error approached the CTV-PTV margin.Results: The authors found that the proper margin for single-fraction frameless SRS cases with brain cancer was about 3 mm for the machine investigated in this study. The isocenter shifts between the CBCT and the linac remained almost constant over a period of three months for this specific machine. This confirmed our assumption that the machine systematic error distribution could be approximated as a delta function. This definition is especially relevant to a single-fraction treatment. The prescribed dose coverage for all the patients investigated was 96.1%± 5.5% with an extreme 3-mm setup error in all three directions simultaneously. It was found that the effect of the setup error on dose coverage was tumor location dependent. It mostly affected the tumors located in the posterior part of the brain, resulting in a minimum coverage of approximately 72%. This was entirely due to the unique geometry of the posterior head.Conclusions: Margin expansion formulas were derived for single-fraction frameless SRS such that the CTV would receive the prescribed dose in 95% of the patients treated for brain cancer. The margins defined in this study are machine-specific and account for nonzero mean systematic error. The margin for single-fraction SRS for a group of machines was also derived in this paper.« less

Multidisciplinary treatment of brain metastases derived from clear cell renal cancer incorporating stereotactic radiosurgery.

PubMed

Samlowski, Wolfram E; Majer, Martin; Boucher, Kenneth M; Shrieve, Annabelle F; Dechet, Christopher; Jensen, Randy L; Shrieve, Dennis C

2008-11-01

Brain metastases are a frequent complication in patients with metastatic clear cell renal cancer. Survival after whole-brain radiotherapy (WBRT) is disappointing. A retrospective analysis of multimodality treatment was performed in patients who had received linear accelerator (LINAC)-based stereotactic radiosurgery (SRS). Thirty-two patients underwent SRS-based treatment for 71 metastatic foci between 2000 and 2006. All patients had a Karnofsky performance status >or=70 and all 32 patients had extracranial metastatic disease (Radiation Therapy Oncology Group recursive partitioning analysis [RPA] Class 2). Survival was calculated from the time of diagnosis of brain metastases. The minimum potential follow-up was 1 year after SRS. Univariate and multivariate analysis of potential prognostic factors affecting survival was performed. Twenty-six patients required only 1 SRS treatment (84%) to achieve central nervous system (CNS) control, whereas 5 patients received 2 to 3 treatments (16%). The median survival of renal cancer patients from the diagnosis of brain metastases was 10.1 months (95% confidence interval, 6.4-14.8 months). One-year and 3-year survival rates were 43% and 16%, respectively. The addition of surgery or WBRT did not appear to prolong survival. Immunotherapy after control of brain metastases with SRS appeared to result in significantly improved survival. Survival was also found to be strongly influenced by prognostic stratification of metastatic disease using Motzer or modified risk criteria. The results of the current study demonstrated that SRS-based treatment of patients with up to 5 brain metastases from clear cell renal cancer is feasible and results in excellent CNS control. Survival beyond 3 years from the time of diagnosis of brain metastases was achievable in 16% of patients and was associated with the use of systemic immunotherapy with interleukin-2 and interferon but not antiangiogenic agents.

Hypofractionated Stereotactic Radiotherapy in Five Daily Fractions for Post-Operative Surgical Cavities in Brain Metastases Patients with and without Prior Whole Brain Radiation

PubMed Central

Al-Omair, Ameen; Soliman, Hany; Xu, Wei; Karotki, Aliaksandr; Mainprize, Todd; Phan, Nicolas; Das, Sunit; Keith, Julia; Yeung, Robert; Perry, James; Tsao, May; Sahgal, Arjun

2013-01-01

Our purpose was to report efficacy of hypofractionated cavity stereotactic radiotherapy (HCSRT) in patients with and without prior whole brain radiotherapy (WBRT). 32 surgical cavities in 30 patients (20 patients/21 cavities had no prior WBRT and 10 patients/11 cavities had prior WBRT) were treated with image-guided linac stereotactic radiotherapy. 7 of the 10 prior WBRT patients had “resistant” local disease given prior surgery, post-operative WBRT and a re-operation, followed by salvage HCSRT. The clinical target volume was the post-surgical cavity, and a 2-mm margin applied as planning target volume. The median total dose was 30 Gy (range: 25-37.5 Gy) in 5 fractions. In the no prior and prior WBRT cohorts, the median follow-up was 9.7 months (range: 3.0-23.6) and 15.3 months (range: 2.9-39.7), the median survival was 23.6 months and 39.7 months, and the 1-year cavity local recurrence progression-free survival (LRFS) was 79 and 100%, respectively. At 18 months the LRFS dropped to 29% in the prior WBRT cohort. Grade 3 radiation necrosis occurred in 3 prior WBRT patients. We report favorable outcomes with HCSRT, and well selected patients with prior WBRT and “resistant” disease may have an extended survival favoring aggressive salvage HCSRT at a moderate risk of radiation necrosis. PMID:23617283

Stereotactic Fractionated Radiotherapy and LINAC Radiosurgery in the Treatment of Vestibular Schwannoma-Report About Both Stereotactic Methods From a Single Institution

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

Kopp, Christine, E-mail: Christine.Kopp@lrz.tu-muenchen.de; Fauser, Claudius; Mueller, Axel

2011-08-01

Purpose: To evaluate tumor control and side effects associated with radiosurgery (RS) and stereotactic fractionated radiotherapy (SFR) for vestibular schwannomas (VSs) in a group of patients treated at the same institution. Methods and Materials: Between May 1997 and June 2007, 115 consecutive cases of VS were treated in our department. The SFR group (47 patients), including larger tumors (maximum diameter >1.5 cm), received a total dose of 54 Gy at 1.8 Gy per fraction. The RS group (68 patients, maximum diameter <1.5 cm) received a total dose of 12 Gy at the 100% isodose. Evaluation included serial imaging tests (magneticmore » resonance imaging) and neurologic and functional hearing examinations. Results: The tumor control rate was 97.9% in the SFR group for a mean follow-up time of 32.1 months and 98.5% in the RS group for a mean follow-up time of 30.1 months. Hearing function was preserved after RS in 85% of the patients and after SFR in 79%. Facial and trigeminal nerve function remained mostly unaffected after SFR. After RS, new trigeminal neuropathy occurred in 9 of 68 patients (13%). Conclusions: A high tumor control rate and low number of side effects are registered after SFR and RS of VS. These results confirm that considering tumor diameter, both RS and SFR are good treatment modalities for VS.« less

Role of functional imaging in treatment plan optimization of stereotactic body radiation therapy for liver cancer.

PubMed

De Bari, Berardino; Jumeau, Raphael; Deantonio, Letizia; Adib, Salim; Godin, Sarah; Zeverino, Michele; Moeckli, Raphael; Bourhis, Jean; Prior, John O; Ozsahin, Mahmut

2016-10-13

We report the first known instance of the clinical use of 99mTc-mebrofenin hepatobiliary scintigraphy (HBS) for the optimization of radiotherapy treatment planning and for the follow-up of acute toxicity in a patient undergoing stereotactic body radiation therapy for hepatocellular carcinoma. In our experience, HBS allowed the identification and the sparing of more functioning liver areas, thus potentially reducing the risk of radiation-induced liver toxicity.

SU-C-17A-07: The Development of An MR Accelerator-Enabled Planning-To-Delivery Technique for Stereotactic Palliative Radiotherapy Treatment of Spinal Metastases

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

Hoogcarspel, S J; Kontaxis, C; Velden, J M van der

2014-06-01

Purpose: To develop an MR accelerator-enabled online planning-todelivery technique for stereotactic palliative radiotherapy treatment of spinal metastases. The technical challenges include; automated stereotactic treatment planning, online MR-based dose calculation and MR guidance during treatment. Methods: Using the CT data of 20 patients previously treated at our institution, a class solution for automated treatment planning for spinal bone metastases was created. For accurate dose simulation right before treatment, we fused geometrically correct online MR data with pretreatment CT data of the target volume (TV). For target tracking during treatment, a dynamic T2-weighted TSE MR sequence was developed. An in house developedmore » GPU based IMRT optimization and dose calculation algorithm was used for fast treatment planning and simulation. An automatically generated treatment plan developed with this treatment planning system was irradiated on a clinical 6 MV linear accelerator and evaluated using a Delta4 dosimeter. Results: The automated treatment planning method yielded clinically viable plans for all patients. The MR-CT fusion based dose calculation accuracy was within 2% as compared to calculations performed with original CT data. The dynamic T2-weighted TSE MR Sequence was able to provide an update of the anatomical location of the TV every 10 seconds. Dose calculation and optimization of the automatically generated treatment plans using only one GPU took on average 8 minutes. The Delta4 measurement of the irradiated plan agreed with the dose calculation with a 3%/3mm gamma pass rate of 86.4%. Conclusions: The development of an MR accelerator-enabled planning-todelivery technique for stereotactic palliative radiotherapy treatment of spinal metastases was presented. Future work will involve developing an intrafraction motion adaptation strategy, MR-only dose calculation, radiotherapy quality-assurance in a magnetic field, and streamlining the entire treatment process on an MR accelerator.« less

Assessment of Alternative RF Linac Structures for APT

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

None

The APT program has been examining both normal and superconducting variants of the APT linac for the past two years. A decision on which of the two will be the selected technology will depend upon several considerations including the results of ongoing feasibility experiments, the performance and overall attractiveness of each of the design concepts, and an assessment of the system-level features of both alternatives. The primary objective of the Assessment of Alternative RF Linac Structures for APT study reported herein was to assess and compare, at the system-level, the performance, capital and life cycle costs, reliability/availability/maintainability (RAM) and manufacturingmore » schedules of APT RF linear accelerators based upon both superconducting and normal conducting technologies. A secondary objective was to perform trade studies to explore opportunities for system optimization, technology substitution and alternative growth pathways and to identify sensitivities to design uncertainties.« less

Automatic online and real-time tumour motion monitoring during stereotactic liver treatments on a conventional linac by combined optical and sparse monoscopic imaging with kilovoltage x-rays (COSMIK)

NASA Astrophysics Data System (ADS)

Bertholet, Jenny; Toftegaard, Jakob; Hansen, Rune; Worm, Esben S.; Wan, Hanlin; Parikh, Parag J.; Weber, Britta; Høyer, Morten; Poulsen, Per R.

2018-03-01

The purpose of this study was to develop, validate and clinically demonstrate fully automatic tumour motion monitoring on a conventional linear accelerator by combined optical and sparse monoscopic imaging with kilovoltage x-rays (COSMIK). COSMIK combines auto-segmentation of implanted fiducial markers in cone-beam computed tomography (CBCT) projections and intra-treatment kV images with simultaneous streaming of an external motion signal. A pre-treatment CBCT is acquired with simultaneous recording of the motion of an external marker block on the abdomen. The 3-dimensional (3D) marker motion during the CBCT is estimated from the auto-segmented positions in the projections and used to optimize an external correlation model (ECM) of internal motion as a function of external motion. During treatment, the ECM estimates the internal motion from the external motion at 20 Hz. KV images are acquired every 3 s, auto-segmented, and used to update the ECM for baseline shifts between internal and external motion. The COSMIK method was validated using Calypso-recorded internal tumour motion with simultaneous camera-recorded external motion for 15 liver stereotactic body radiotherapy (SBRT) patients. The validation included phantom experiments and simulations hereof for 12 fractions and further simulations for 42 fractions. The simulations compared the accuracy of COSMIK with ECM-based monitoring without model updates and with model updates based on stereoscopic imaging as well as continuous kilovoltage intrafraction monitoring (KIM) at 10 Hz without an external signal. Clinical real-time tumour motion monitoring with COSMIK was performed offline for 14 liver SBRT patients (41 fractions) and online for one patient (two fractions). The mean 3D root-mean-square error for the four monitoring methods was 1.61 mm (COSMIK), 2.31 mm (ECM without updates), 1.49 mm (ECM with stereoscopic updates) and 0.75 mm (KIM). COSMIK is the first combined kV/optical real-time motion monitoring method used clinically online on a conventional accelerator. COSMIK gives less imaging dose than KIM and is in addition applicable when the kV imager cannot be deployed such as during non-coplanar fields.

Complications Following Linear Accelerator Based Stereotactic Radiation for Cerebral Arteriovenous Malformations

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

Skjoth-Rasmussen, Jane, E-mail: jane@skjoeth-rasmussen.d; Roed, Henrik; Ohlhues, Lars

2010-06-01

Purpose: Primarily, gamma knife centers are predominant in publishing results on arteriovenous malformations (AVM) treatments including reports on risk profile. However, many patients are treated using a linear accelerator-most of these at smaller centers. Because this setting is different from a large gamma knife center, the risk profile at Linac departments could be different from the reported experience. Prescribed radiation doses are dependent on AVM volume. This study details results from a medium sized Linac department center focusing on risk profiles. Method and Materials: A database was searched for all patients with AVMs. We included 50 consecutive patients with amore » minimum of 24 months follow-up (24-51 months). Results: AVM occlusion was verified in 78% of patients (39/50). AVM occlusion without new deficits (excellent outcome) was obtained in 44%. Good or fair outcome (AVM occlusion with mild or moderate new deficits) was seen in 30%. Severe complications after AVM occlusion occurred in 4% with a median interval of 15 months after treatment (range, 1-26 months). Conclusions: We applied an AVM grading score developed at the Mayo Clinic to predict probable outcome after radiosurgery in a large patient population treated with Gamma knife. A cutoff above and below a score of 1.5 could not discriminate between the likelihood of having an excellent outcome (approximately 45%). The chance of having an excellent or good outcome was slightly higher in patients with an AVM score below 1.5 (64% vs. 57%).« less

Complications following linear accelerator based stereotactic radiation for cerebral arteriovenous malformations.

PubMed

Skjøth-Rasmussen, Jane; Roed, Henrik; Ohlhues, Lars; Jespersen, Bo; Juhler, Marianne

2010-06-01

Primarily, gamma knife centers are predominant in publishing results on arteriovenous malformations (AVM) treatments including reports on risk profile. However, many patients are treated using a linear accelerator-most of these at smaller centers. Because this setting is different from a large gamma knife center, the risk profile at Linac departments could be different from the reported experience. Prescribed radiation doses are dependent on AVM volume. This study details results from a medium sized Linac department center focusing on risk profiles. A database was searched for all patients with AVMs. We included 50 consecutive patients with a minimum of 24 months follow-up (24-51 months). AVM occlusion was verified in 78% of patients (39/50). AVM occlusion without new deficits (excellent outcome) was obtained in 44%. Good or fair outcome (AVM occlusion with mild or moderate new deficits) was seen in 30%. Severe complications after AVM occlusion occurred in 4% with a median interval of 15 months after treatment (range, 1-26 months). We applied an AVM grading score developed at the Mayo Clinic to predict probable outcome after radiosurgery in a large patient population treated with Gamma knife. A cutoff above and below a score of 1.5 could not discriminate between the likelihood of having an excellent outcome (approximately 45%). The chance of having an excellent or good outcome was slightly higher in patients with an AVM score below 1.5 (64% vs. 57%). Copyright 2010 Elsevier Inc. All rights reserved.

Evaluation of stability of stereotactic space defined by cone-beam CT for the Leksell Gamma Knife Icon.

PubMed

AlDahlawi, Ismail; Prasad, Dheerendra; Podgorsak, Matthew B

2017-05-01

The Gamma Knife Icon comes with an integrated cone-beam CT (CBCT) for image-guided stereotactic treatment deliveries. The CBCT can be used for defining the Leksell stereotactic space using imaging without the need for the traditional invasive frame system, and this allows also for frameless thermoplastic mask stereotactic treatments (single or fractionated) with the Gamma Knife unit. In this study, we used an in-house built marker tool to evaluate the stability of the CBCT-based stereotactic space and its agreement with the standard frame-based stereotactic space. We imaged the tool with a CT indicator box using our CT-simulator at the beginning, middle, and end of the study period (6 weeks) for determining the frame-based stereotactic space. The tool was also scanned with the Icon's CBCT on a daily basis throughout the study period, and the CBCT images were used for determining the CBCT-based stereotactic space. The coordinates of each marker were determined in each CT and CBCT scan using the Leksell GammaPlan treatment planning software. The magnitudes of vector difference between the means of each marker in frame-based and CBCT-based stereotactic space ranged from 0.21 to 0.33 mm, indicating good agreement of CBCT-based and frame-based stereotactic space definition. Scanning 4-month later showed good prolonged stability of the CBCT-based stereotactic space definition. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Beam dynamics validation of the Halbach Technology FFAG Cell for Cornell-BNL Energy Recovery Linac

NASA Astrophysics Data System (ADS)

Méot, F.; Tsoupas, N.; Brooks, S.; Trbojevic, D.

2018-07-01

The Cornell-BNL Electron Test Accelerator (CBETA), a 150 MeV energy recovery linac (ERL) now in construction at Cornell, employs a fixed-field alternating gradient optics return loop: a single beam line comprised of FFAG cells, which accepts four recirculated energies. CBETA FFAG cell uses Halbach permanent magnet technology, its design studies have covered an extended period of time supported by extensive particle dynamics simulations using computed 3-D field map models. This approach is discussed, and illustrated here, based on the final stage in these beam dynamics studies, namely the validation of a ultimate, optimized design of the Halbach cell.

Fractionated stereotactic radiotherapy boost for gynecologic tumors: An alternative to brachytherapy?

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

Molla, Meritxell; Escude, Lluis D.; Nouet, Philippe

2005-05-01

Purpose: A brachytherapy (BT) boost to the vaginal vault is considered standard treatment for many endometrial or cervical cancers. We aimed to challenge this treatment standard by using stereotactic radiotherapy (SRT) with a linac-based micromultileaf collimator technique. Methods and Materials: Since January 2002, 16 patients with either endometrial (9) or cervical (7) cancer have been treated with a final boost to the areas at higher risk for relapse. In 14 patients, the target volume included the vaginal vault, the upper vagina, the parametria, or (if not operated) the uterus (clinical target volume [CTV]). In 2 patients with local relapse, themore » CTV was the tumor in the vaginal stump. Margins of 6-10 mm were added to the CTV to define the planning target volume (PTV). Hypofractionated dynamic-arc or intensity-modulated radiotherapy techniques were used. Postoperative treatment was delivered in 12 patients (2 x 7 Gy to the PTV with a 4-7-day interval between fractions). In the 4 nonoperated patients, a dose of 4 Gy/fraction in 5 fractions with 2 to 3 days' interval was delivered. Patients were immobilized in a customized vacuum body cast and optimally repositioned with an infrared-guided system developed for extracranial SRT. To further optimize daily repositioning and target immobilization, an inflated rectal balloon was used during each treatment fraction. In 10 patients, CT resimulation was performed before the last boost fraction to assess for repositioning reproducibility via CT-to-CT registration and to estimate PTV safety margins around the CTV. Finally, a comparative treatment planning study between BT and SRT was performed in 2 patients with an operated endometrial Stage I cancer. Results: No patient developed severe acute urinary or low-intestinal toxicity. No patient developed urinary late effects (>6 months). One patient with a vaginal relapse previously irradiated to the pelvic region presented with Grade 3 rectal bleeding 18 months after retreatment. A second patient known to suffer from irritable bowel syndrome presented with Grade 1 abdominal pain after treatment. The estimated PTV margins around the CTV were 9-10 mm with infrared marker registration. External SRT succeeded in improving dose homogeneity to the PTV and in reducing the maximum dose to the rectum, when compared to BT. Conclusion: These results suggest that the use of external SRT to deliver a final boost to the areas at higher risk for relapse in endometrial or cervical cancer is feasible, well tolerated, and may well be considered an acceptable alternative to BT.« less

TU-FG-201-01: 18-Month Clinical Experience of a Linac Daily Quality Assurance (QA) Solution Using Only EPID and OBI

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

Cai, B; Sun, B; Yaddanapudi, S

Purpose: To describe the clinical use of a Linear Accelerator (Linac) DailyQA system with only EPID and OBI. To assess the reliability over an 18-month period and improve the robustness of this system based on QA failure analysis. Methods: A DailyQA solution utilizing an in-house designed phantom, combined EPID and OBI image acquisitions, and a web-based data analysis and reporting system was commissioned and used in our clinic to measure geometric, dosimetry and imaging components of a Varian Truebeam Linac. During an 18-month period (335 working days), the Daily QA results, including the output constancy, beam flatness and symmetry, uniformity,more » TPR20/10, MV and KV imaging quality, were collected and analyzed. For output constancy measurement, an independent monthly QA system with an ionization chamber (IC) and annual/incidental TG51 measurements with ADCL IC were performed and cross-compared to Daily QA system. Thorough analyses were performed on the recorded QA failures to evaluate the machine performance, optimize the data analysis algorithm, adjust the tolerance setting and improve the training procedure to prevent future failures. Results: A clinical workflow including beam delivery, data analysis, QA report generation and physics approval was established and optimized to suit daily clinical operation. The output tests over the 335 working day period cross-correlated with the monthly QA system within 1.3% and TG51 results within 1%. QA passed with one attempt on 236 days out of 335 days. Based on the QA failures analysis, the Gamma criteria is revised from (1%, 1mm) to (2%, 1mm) considering both QA accuracy and efficiency. Data analysis algorithm is improved to handle multiple entries for a repeating test. Conclusion: We described our 18-month clinical experience on a novel DailyQA system using only EPID and OBI. The long term data presented demonstrated the system is suitable and reliable for Linac daily QA.« less

Poster — Thur Eve — 72: Clinical Subtleties of Flattening-Filter-Free Beams

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

Corns, Robert; Thomas, Steven; Huang, Vicky

2014-08-15

Flattening-filter-free (fff) beams offer superior dose rates, reducing treatment times for important techniques that utilize small field sizes, such as stereotactic ablative radiotherapy (SABR). The impact of ion collection efficiency (P{sub ion}) on the percent depth dose (PDD) has been discussed at length in the literature. Relative corrections of the order of l%–2% are possible. In the process of commissioning 6fff and 10fff beams, we identified a number of other important details that influence commissioning. We looked at the absolute dose difference between corrected and uncorrected PDD. We discovered a curve with a broad maximum between 10 and 20 cm.more » We wondered about the consequences of this PDD correction on the absolute dose calibration of the linac because the TG-51 protocol does not correct the PDD curve. The quality factor k{sub Q} depends on the PDD, so in principle, a correction to the PDD will alter the absolute calibration of the linac. Finally, there are other clinical tables, such as TMR, which are derived from PDD. Attention to details on how this computation is performed is important because different corrections are possible depending the method of calculation.« less

Towards fast online intrafraction replanning for free-breathing stereotactic body radiation therapy with the MR-linac.

PubMed

Kontaxis, C; Bol, G H; Stemkens, B; Glitzner, M; Prins, F M; Kerkmeijer, L G W; Lagendijk, J J W; Raaymakers, B W

2017-08-21

The hybrid MRI-radiotherapy machines, like the MR-linac (Elekta AB, Stockholm, Sweden) installed at the UMC Utrecht (Utrecht, The Netherlands), will be able to provide real-time patient imaging during treatment. In order to take advantage of the system's capabilities and enable online adaptive treatments, a new generation of software should be developed, ranging from motion estimation to treatment plan adaptation. In this work we present a proof of principle adaptive pipeline designed for high precision stereotactic body radiation therapy (SBRT) suitable for sites affected by respiratory motion, like renal cell carcinoma (RCC). We utilized our research MRL treatment planning system (MRLTP) to simulate a single fraction 25 Gy free-breathing SBRT treatment for RCC by performing inter-beam replanning for two patients and one volunteer. The simulated pipeline included a combination of (pre-beam) 4D-MRI and (online) 2D cine-MR acquisitions. The 4DMRI was used to generate the mid-position reference volume, while the cine-MRI, via an in-house motion model, provided three-dimensional (3D) deformable vector fields (DVFs) describing the anatomical changes during treatment. During the treatment fraction, at an inter-beam interval, the mid-position volume of the patient was updated and the delivered dose was accurately reconstructed on the underlying motion calculated by the model. Fast online replanning, targeting the latest anatomy and incorporating the previously delivered dose was then simulated with MRLTP. The adaptive treatment was compared to a conventional mid-position SBRT plan with a 3 mm planning target volume margin reconstructed on the same motion trace. We demonstrate that our system produced tighter dose distributions and thus spared the healthy tissue, while delivering more dose to the target. The pipeline was able to account for baseline variations/drifts that occurred during treatment ensuring target coverage at the end of the treatment fraction.

Dosimetry for Small Fields in Stereotactic Radiosurgery Using Gafchromic MD-V2-55 Film, TLD-100 and Alanine Dosimeters

PubMed Central

Massillon-JL, Guerda; Cueva-Prócel, Diego; Díaz-Aguirre, Porfirio; Rodríguez-Ponce, Miguel; Herrera-Martínez, Flor

2013-01-01

This work investigated the suitability of passive dosimeters for reference dosimetry in small fields with acceptable accuracy. Absorbed dose to water rate was determined in nine small radiation fields with diameters between 4 and 35 mm in a Leksell Gamma Knife (LGK) and a modified linear accelerator (linac) for stereotactic radiosurgery treatments. Measurements were made using Gafchromic film (MD-V2-55), alanine and thermoluminescent (TLD-100) dosimeters and compared with conventional dosimetry systems. Detectors were calibrated in terms of absorbed dose to water in 60Co gamma-ray and 6 MV x-ray reference (10×10 cm2) fields using an ionization chamber calibrated at a standards laboratory. Absorbed dose to water rate computed with MD-V2-55 was higher than that obtained with the others dosimeters, possibly due to a smaller volume averaging effect. Ratio between the dose-rates determined with each dosimeter and those obtained with the film was evaluated for both treatment modalities. For the LGK, the ratio decreased as the dosimeter size increased and remained constant for collimator diameters larger than 8 mm. The same behaviour was observed for the linac and the ratio increased with field size, independent of the dosimeter used. These behaviours could be explained as an averaging volume effect due to dose gradient and lack of electronic equilibrium. Evaluation of the output factors for the LGK collimators indicated that, even when agreement was observed between Monte Carlo simulation and measurements with different dosimeters, this does not warrant that the absorbed dose to water rate in the field was properly known and thus, investigation of the reference dosimetry should be an important issue. These results indicated that alanine dosimeter provides a high degree of accuracy but cannot be used in fields smaller than 20 mm diameter. Gafchromic film can be considered as a suitable methodology for reference dosimetry. TLD dosimeters are not appropriate in fields smaller than 10 mm diameters. PMID:23671677

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

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

Small field detector correction factors: effects of the flattening filter for Elekta and Varian linear accelerators

PubMed Central

Liu, Paul Z.Y.; Lee, Christopher; McKenzie, David R.; Suchowerska, Natalka

2016-01-01

Flattening filter‐free (FFF) beams are becoming the preferred beam type for stereotactic radiosurgery (SRS) and stereotactic ablative radiation therapy (SABR), as they enable an increase in dose rate and a decrease in treatment time. This work assesses the effects of the flattening filter on small field output factors for 6 MV beams generated by both Elekta and Varian linear accelerators, and determines differences between detector response in flattened (FF) and FFF beams. Relative output factors were measured with a range of detectors (diodes, ionization chambers, radiochromic film, and microDiamond) and referenced to the relative output factors measured with an air core fiber optic dosimeter (FOD), a scintillation dosimeter developed at Chris O'Brien Lifehouse, Sydney. Small field correction factors were generated for both FF and FFF beams. Diode measured detector response was compared with a recently published mathematical relation to predict diode response corrections in small fields. The effect of flattening filter removal on detector response was quantified using a ratio of relative detector responses in FFF and FF fields for the same field size. The removal of the flattening filter was found to have a small but measurable effect on ionization chamber response with maximum deviations of less than ±0.9% across all field sizes measured. Solid‐state detectors showed an increased dependence on the flattening filter of up to ±1.6%. Measured diode response was within ±1.1% of the published mathematical relation for all fields up to 30 mm, independent of linac type and presence or absence of a flattening filter. For 6 MV beams, detector correction factors between FFF and FF beams are interchangeable for a linac between FF and FFF modes, providing that an additional uncertainty of up to ±1.6% is accepted. PACS number(s): 87.55.km, 87.56.bd, 87.56.Da PMID:27167280

Towards fast online intrafraction replanning for free-breathing stereotactic body radiation therapy with the MR-linac

NASA Astrophysics Data System (ADS)

Kontaxis, C.; Bol, G. H.; Stemkens, B.; Glitzner, M.; Prins, F. M.; Kerkmeijer, L. G. W.; Lagendijk, J. J. W.; Raaymakers, B. W.

2017-09-01

The hybrid MRI-radiotherapy machines, like the MR-linac (Elekta AB, Stockholm, Sweden) installed at the UMC Utrecht (Utrecht, The Netherlands), will be able to provide real-time patient imaging during treatment. In order to take advantage of the system’s capabilities and enable online adaptive treatments, a new generation of software should be developed, ranging from motion estimation to treatment plan adaptation. In this work we present a proof of principle adaptive pipeline designed for high precision stereotactic body radiation therapy (SBRT) suitable for sites affected by respiratory motion, like renal cell carcinoma (RCC). We utilized our research MRL treatment planning system (MRLTP) to simulate a single fraction 25 Gy free-breathing SBRT treatment for RCC by performing inter-beam replanning for two patients and one volunteer. The simulated pipeline included a combination of (pre-beam) 4D-MRI and (online) 2D cine-MR acquisitions. The 4DMRI was used to generate the mid-position reference volume, while the cine-MRI, via an in-house motion model, provided three-dimensional (3D) deformable vector fields (DVFs) describing the anatomical changes during treatment. During the treatment fraction, at an inter-beam interval, the mid-position volume of the patient was updated and the delivered dose was accurately reconstructed on the underlying motion calculated by the model. Fast online replanning, targeting the latest anatomy and incorporating the previously delivered dose was then simulated with MRLTP. The adaptive treatment was compared to a conventional mid-position SBRT plan with a 3 mm planning target volume margin reconstructed on the same motion trace. We demonstrate that our system produced tighter dose distributions and thus spared the healthy tissue, while delivering more dose to the target. The pipeline was able to account for baseline variations/drifts that occurred during treatment ensuring target coverage at the end of the treatment fraction.

Advanced Accelerators for Medical Applications

NASA Astrophysics Data System (ADS)

Uesaka, Mitsuru; Koyama, Kazuyoshi

We review advanced accelerators for medical applications with respect to the following key technologies: (i) higher RF electron linear accelerator (hereafter "linac"); (ii) optimization of alignment for the proton linac, cyclotron and synchrotron; (iii) superconducting magnet; (iv) laser technology. Advanced accelerators for medical applications are categorized into two groups. The first group consists of compact medical linacs with high RF, cyclotrons and synchrotrons downsized by optimization of alignment and superconducting magnets. The second group comprises laserbased acceleration systems aimed of medical applications in the future. Laser plasma electron/ion accelerating systems for cancer therapy and laser dielectric accelerating systems for radiation biology are mentioned. Since the second group has important potential for a compact system, the current status of the established energy and intensity and of the required stability are given.

The role of technology in clinical trials using stereotactic body radiotherapy

PubMed Central

Romero, Alejandra Méndez; Heijmen, Ben J M

2017-01-01

Stereotactic body radiotherapy is a highly technology-driven treatment modality. The wider availability of in-room imaging and advanced radiotherapy delivery techniques has led to more institutions offering stereotactic ablative therapy (SABR). While some technological challenges remain, the crucial point for the next generation of SABR clinical trials is that today's technology is used correctly and close to its optimal potential for accuracy. The credentialing procedure of SABR needs to be extensive, but this investment will benefit the trial itself, the patients and the professionals involved. PMID:28055252

An Overview of the MaRIE X-FEL and Electron Radiography LINAC RF Systems

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

Bradley, Joseph Thomas III; Rees, Daniel Earl; Scheinker, Alexander

The purpose of the Matter-Radiation Interactions in Extremes (MaRIE) facility at Los Alamos National Laboratory is to investigate the performance limits of materials in extreme environments. The MaRIE facility will utilize a 12 GeV linac to drive an X-ray Free-Electron Laser (FEL). Most of the same linac will also be used to perform electron radiography. The main linac is driven by two shorter linacs; one short linac optimized for X-FEL pulses and one for electron radiography. The RF systems have historically been the one of the largest single component costs of a linac. We will describe the details of themore » different types of RF systems required by each part of the linacs. Starting with the High Power RF system, we will present our methodology for the choice of RF system peak power and pulselength with respect to klystron parameters, modulator parameters, performance requirements and relative costs. We will also present an overview of the Low Level RF systems that are proposed for MaRIE and briefly describe their use with some proposed control schemes.« less

SU-G-BRC-10: Feasibility of a Web-Based Monte Carlo Simulation Tool for Dynamic Electron Arc Radiotherapy (DEAR)

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

Rodrigues, A; Wu, Q; Sawkey, D

Purpose: DEAR is a radiation therapy technique utilizing synchronized motion of gantry and couch during delivery to optimize dose distribution homogeneity and penumbra for treatment of superficial disease. Dose calculation for DEAR is not yet supported by commercial TPSs. The purpose of this study is to demonstrate the feasibility of using a web-based Monte Carlo (MC) simulation tool (VirtuaLinac) to calculate dose distributions for a DEAR delivery. Methods: MC simulations were run through VirtuaLinac, which is based on the GEANT4 platform. VirtuaLinac utilizes detailed linac head geometry and material models, validated phase space files, and a voxelized phantom. The inputmore » was expanded to include an XML file for simulation of varying mechanical axes as a function of MU. A DEAR XML plan was generated and used in the MC simulation and delivered on a TrueBeam in Developer Mode. Radiographic film wrapped on a cylindrical phantom (12.5 cm radius) measured dose at a depth of 1.5 cm and compared to the simulation results. Results: A DEAR plan was simulated using an energy of 6 MeV and a 3×10 cm{sup 2} cut-out in a 15×15 cm{sup 2} applicator for a delivery of a 90° arc. The resulting data were found to provide qualitative and quantitative evidence that the simulation platform could be used as the basis for DEAR dose calculations. The resulting unwrapped 2D dose distributions agreed well in the cross-plane direction along the arc, with field sizes of 18.4 and 18.2 cm and penumbrae of 1.9 and 2.0 cm for measurements and simulations, respectively. Conclusion: Preliminary feasibility of a DEAR delivery using a web-based MC simulation platform has been demonstrated. This tool will benefit treatment planning for DEAR as a benchmark for developing other model based algorithms, allowing efficient optimization of trajectories, and quality assurance of plans without the need for extensive measurements.« less

Dosimetric and delivery efficiency investigation for treating hepatic lesions with a MLC-equipped robotic radiosurgery-radiotherapy combined system.

PubMed

Jin, Lihui; Price, Robert A; Wang, Lu; Meyer, Joshua; Fan, James Jiajin; Ma, Chang Ming Charlie

2016-02-01

The CyberKnife M6 (CK-M6) Series introduced a multileaf collimator (MLC) for extending its capability from stereotactic radiosurgery/stereotactic radiotherapy (SBRT) to conventionally fractionated radiotherapy. This work is to investigate the dosimetric quality of plans that are generated using MLC-shaped beams on the CK-M6, as well as their delivery time, via comparisons with the intensity modulated radiotherapy plans that were clinically used on a Varian Linac for treating hepatic lesions. Nine patient cases were selected and divided into three groups with three patients in each group: (1) the group-one patients were treated conventionally (25 fractions); (2) the group-two patients were treated with SBRT-like hypofractionation (5 fractions); and (3) the group-three patients were treated similar to group-one patients, but with two planning target volumes (PTVs) and two different prescription dose levels correspondingly. The clinically used plans were generated on the eclipse treatment planning system (TPS) and delivered on a Varian Linac (E-V plans). The multiplan (MP) TPS was used to replan these clinical cases with the MLC as the beam device for the CK-M6 (C-M plans). After plans were normalized to the same PTV dose coverage, comparisons between the C-M and E-V plans were performed based on D(99%) (percentage of prescription dose received by 99% of the PTV), D(0.1cm(3)) (the percentage of prescription dose to 0.1 cm(3) of the PTV), and doses received by critical structures. Then, the delivery times for the C-M plans will be obtained, which are the MP TPS generated estimations assuming having an imaging interval of 60 s. The difference in D(99%) between C-M and E-V plans is +0.6% on average (+ or - indicating a higher or lower dose from C-M plans than from E-V plans) with a range from -4.1% to +3.8%, and the difference in D(0.1cm(3)) was -1.0% on average with a range from -5.1% to +2.9%. The PTV conformity index (CI) for the C-M plans ranges from 1.07 to 1.29 with a mean of 1.19, slightly inferior to the E-V plans, in which the CI ranges from 1.00 to 1.15 with a mean of 1.07. Accounting for all nine patients in three groups, 45% of the critical structures received a lower mean dose for the C-M plans as compared with the E-V plans, and similarly, 48% received a lower maximum dose. Furthermore, the average difference of the mean critical structure dose between the C-M and E-V plans over all critical structures for all patients showed only +2.10% relative to the prescription dose and the similar comparison finds the average difference of the maximum critical structure dose of only +1.24%. The estimated delivery times for the C-M plans on the CK-M6 range from 18 to 24 minutes while they are from 7 to 13.7 min for the E-V plans on the Varian Linac. For treating hepatic lesions, for the C-M plans that are comparable to E-V plans in quality, the times needed to deliver these C-M plans on the CK-M6 are longer than the delivery time for the E-V plans on the Varian Linac, but may be clinically acceptable.

SU-F-T-582: Small Field Dosimetry in Radiosurgery Collimators with a Stealth Chamber

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

Azcona, J; Barbes, B

2016-06-15

Purpose: The extraction of a reference signal for measuring small fields in scanning mode can be problematic. In this work we describe the use of a transmission chamber in small field dosimetry for radiosurgery collimators and compare TMR curves obtained with stereotactic diode and microionization chamber. Methods: Four radiosurgery cones of diameters 5, 10, 12.5, and 15mm supplied by Elekta Medical were commissioned in a 6MV FFF beam from an Elekta Versa linac. A transmission chamber manufactured by IBA (Stealth chamber) was attached to the lower part of the collimators and used for PDD and profile measurements in scanning modemore » with a Scanditronix stereotactic diode. It was also used for centering the stereotactic diode in the water tank to measure TMR and output factors, by integrating the signal. TMR measurements for all collimators and the OF for the largest collimator were also acquired on a polystyrene PTW 29672 phantom with a PTW PinPoint 3D chamber 0.016 cm3 volume. Results: Measured TMR with diode and microionization chamber agreed very well with differences larger than 1% only for depths above 15cm, except the smaller collimator, for which differences were always smaller than 2%. Calculated TMR were significantly different (up to 7%) from measured TMR. The differences are attributed to the change in response of the diode with depth, because the effective field aperture varies with depth. Furthermore, neglecting the ratio of phantom-scatter factors in the conversion formula also contributes to this difference. OF measured with diode and chamber showed a difference of 3.5%. Conclusion: The transmission chamber overcomes the problem of extracting a reference signal and is of great help for small field commissioning. Calculating TMR from PDD is strongly discouraged. Good agreement was found when comparing measurements of TMR with stereotactic diode in water with measurements with microionization chamber in polystyrene.« less

Feasibility study on the use of uranium in photoneutron target and BSA optimization for Linac based BNCT

NASA Astrophysics Data System (ADS)

Rahmani, Faezeh; Shahriari, Majid; Minoochehr, Abdolhamid; Nedaie, Hasan

2011-06-01

A hybrid photoneutron target including natural uranium has been studied for a 20 MeV linear electron accelerator (Linac) based Boron Neutron Capture Therapy (BNCT) facility. In this study the possibility of using uranium to increase the neutron intensity has been investigated by focusing on the time dependence behavior of the build-up and decay of the delayed gamma rays from fission fragments and activation products through photo-fission reactions in the BSA (Beam Shaping Assembly) configuration design. Delayed components of neutrons and photons were calculated. The obtained BSA parameters are in agreement with the IAEA recommendation and compared to the hybrid photoneutron target without U. The epithermal flux in the suggested design is 2.67E9 (n/cm 2s/mA).

SU-F-T-647: Linac-Based Stereotactic Radiosurgery (SRS) in the Treatment of Trigeminal Neuralgia: Detailed Description of SRS Procedural Technique and Reported Clinical Outcomes

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

Pokhrel, D; Sood, S; Badkul, R

Purpose: SRS is an effective non-invasive alternative treatment modality with minimal-toxicity used to treat patients with medically/surgically refractory trigeminal neuralgia root(TNR) or those who may not tolerate surgical intervention. We present our linac-based SRS procedure for TNR treatment and simultaneously report our clinical outcomes. Methods: Twenty-eight TNR-patients treated with frame-based SRS at our institution (2009–2015) with a single-fraction point-dose of 60-80Gy to TNR were included in this IRB-approved study. Experienced neurosurgeon and radiation oncologist delineated the TNR on 1.0mm thin 3D-FIESTA-MRI that was co-registered with 0.7mm thin planning-CT. Treatment plans were generated in iPlan (BrainLAB) with a 4-mm diameter conemore » using 79 arcs with differential-weighting for Novalis-TX 6MV-SRS(1000MU/min) beam and optimized to minimize brainstem dose. Winston-Lutz test was performed before each treatment delivery with sub-millimeter isocenter accuracy. Quality assurance of frame placement was maintained by helmet-bobble-measurement before simulation-CT and before patient setup at treatment couch. OBI-CBCT scan was performed for patient setup verification without applying shifts. On clinical follow up, treatment response was assessed using Barrow Neurological Institute Pain Intensity Score(BNI-score:I–V). Results: 26/28 TNR-patients (16-males/10-females) who were treated with following single-fraction point-dose to isocenter: 80Gy(n=22),75Gy(n=1),70Gy(n=2) and 60Gy(n=1, re-treatment) were followed up. Median follow-up interval was 8.5-months (ranged:1–48.5months). Median age was 70-yr (ranged:43–93-yr). Right/left TNR ratio was 15/11. Delivered total # of average MUs was 19034±1204. Average beam-on-time: 19.0±1.3min. Brainstem max-dose and dose to 0.5cc were 13.3±2.4Gy (ranged:8.1–16.5Gy) and 3.6±0.4Gy (ranged:3.0–4.9Gy). On average, max-dose to optic-apparatus was ≤1.2Gy. Mean value of max-dose to eyes/lens was 0.26Gy/0.11Gy. Overall, 20-patients (77%) responded to treatment: 5(19%) achieved complete pain relief without medication (BNI score: I); 5(19%) had no-pain, decreased medication (BNI-score:II); 2(7.7%) had no-pain, but, continued medication (BNI-score:IIIA), and 8(30.8%) had pain that was well controlled by medication (BNI-score: IIIB). Six-patients (23.0%) did not respond to treatment (BNI-score:IV–V). Neither cranial nerve deficit nor radio-necrosis of temporal lobe was clinically observed. Conclusion: Linac-based SRS for medically/surgically refractory TNR provided an effective treatment option for pain resolution/control with very minimal if any normal tissue toxicity. Longer follow up of these patients is anticipated/needed to confirm our observations.« less

A collimated detection system for assessing leakage dose from medical linear accelerators at the patient plane.

PubMed

Lonski, P; Taylor, M L; Franich, R D; Kron, T

2014-03-01

Leakage radiation from linear accelerators can make a significant contribution to healthy tissue dose in patients undergoing radiotherapy. In this work thermoluminescent dosimeters (LiF:Mg,Cu,P TLD chips) were used in a focused lead cone loaded with TLD chips for the purpose of evaluating leakage dose at the patient plane. By placing the TLDs at one end of a stereotactic cone, a focused measurement device is created; this was tested both in and out of the primary beam of a Varian 21-iX linac using 6 MV photons. Acrylic build up material of 1.2 cm thickness was used inside the cone and measurements made with either one or three TLD chips at a given distance from the target. Comparing the readings of three dosimeters in one plane inside the cone offered information regarding the orientation of the cone relative to a radiation source. Measurements in the patient plane with the linac gantry at various angles demonstrated that leakage dose was approximately 0.01% of the primary beam out of field when the cone was pointed directly towards the target and 0.0025% elsewhere (due to scatter within the gantry). No specific 'hot spots' (e.g., insufficient shielding or gaps at abutments) were observed. Focused cone measurements facilitate leakage dose measurements from the linac head directly at the patient plane and allow one to infer the fraction of leakage due to 'direct' photons (along the ray-path from the bremsstrahlung target) and that due to scattered photons.

Poster — Thur Eve — 55: An automated XML technique for isocentre verification on the Varian TrueBeam

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

Asiev, Krum; Mullins, Joel; DeBlois, François

2014-08-15

Isocentre verification tests, such as the Winston-Lutz (WL) test, have gained popularity in the recent years as techniques such as stereotactic radiosurgery/radiotherapy (SRS/SRT) treatments are more commonly performed on radiotherapy linacs. These highly conformal treatments require frequent monitoring of the geometrical accuracy of the isocentre to ensure proper radiation delivery. At our clinic, the WL test is performed by acquiring with the EPID a collection of 8 images of a WL phantom fixed on the couch for various couch/gantry angles. This set of images is later analyzed to determine the isocentre size. The current work addresses the acquisition process. Amore » manual WL test acquisition performed by and experienced physicist takes in average 25 minutes and is prone to user manipulation errors. We have automated this acquisition on a Varian TrueBeam STx linac (Varian, Palo Alto, USA). The Varian developer mode allows the execution of custom-made XML script files to control all aspects of the linac operation. We have created an XML-WL script that cycles through each couch/gantry combinations taking an EPID image at each position. This automated acquisition is done in less than 4 minutes. The reproducibility of the method was verified by repeating the execution of the XML file 5 times. The analysis of the images showed variation of the isocenter size less than 0.1 mm along the X, Y and Z axes and compares favorably to a manual acquisition for which we typically observe variations up to 0.5 mm.« less

Beam dynamics validation of the Halbach Technology FFAG Cell for Cornell-BNL Energy Recovery Linac

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

Meot, Francois; Tsoupas, N.; Brooks, S.

The Cornell-BNL Electron Test Accelerator (CBETA), a 150 MeV energy recovery linac (ERL) now in construction at Cornell, employs a fixed-field alternating gradient optics return loop: a single beam line comprised of FFAG cells, which accepts four recirculated energies. CBETA FFAG cell uses Halbach permanent magnet technology, its design studies have covered an extended period of time supported by extensive particle dynamics simulations using computed 3-D field map models. As a result, this approach is discussed, and illustrated here, based on the final stage in these beam dynamics studies, namely the validation of a ultimate, optimized design of the Halbachmore » cell.« less

Beam dynamics validation of the Halbach Technology FFAG Cell for Cornell-BNL Energy Recovery Linac

DOE PAGES

Meot, Francois; Tsoupas, N.; Brooks, S.; ...

2018-04-16

The Cornell-BNL Electron Test Accelerator (CBETA), a 150 MeV energy recovery linac (ERL) now in construction at Cornell, employs a fixed-field alternating gradient optics return loop: a single beam line comprised of FFAG cells, which accepts four recirculated energies. CBETA FFAG cell uses Halbach permanent magnet technology, its design studies have covered an extended period of time supported by extensive particle dynamics simulations using computed 3-D field map models. As a result, this approach is discussed, and illustrated here, based on the final stage in these beam dynamics studies, namely the validation of a ultimate, optimized design of the Halbachmore » cell.« less

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

Chang, Chiou-Shiung, E-mail: et000417@gmail.com; Department of Radiation Oncology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan; Hwang, Jing-Min

Stereotactic radiosurgery (SRS) is a well-established technique that is replacing whole-brain irradiation in the treatment of intracranial lesions, which leads to better preservation of brain functions, and therefore a better quality of life for the patient. There are several available forms of linear accelerator (LINAC)–based SRS, and the goal of the present study is to identify which of these techniques is best (as evaluated by dosimetric outcomes statistically) when the target is located adjacent to brainstem. We collected the records of 17 patients with lesions close to the brainstem who had previously been treated with single-fraction radiosurgery. In all, 5more » different lesion catalogs were collected, and the patients were divided into 2 distance groups—1 consisting of 7 patients with a target-to-brainstem distance of less than 0.5 cm, and the other of 10 patients with a target-to-brainstem distance of ≥ 0.5 and < 1 cm. Comparison was then made among the following 3 types of LINAC-based radiosurgery: dynamic conformal arcs (DCA), intensity-modulated radiosurgery (IMRS), and volumetric modulated arc radiotherapy (VMAT). All techniques included multiple noncoplanar beams or arcs with or without intensity-modulated delivery. The volume of gross tumor volume (GTV) ranged from 0.2 cm{sup 3} to 21.9 cm{sup 3}. Regarding the dose homogeneity index (HI{sub ICRU}) and conformity index (CI{sub ICRU}) were without significant difference between techniques statistically. However, the average CI{sub ICRU} = 1.09 ± 0.56 achieved by VMAT was the best of the 3 techniques. Moreover, notable improvement in gradient index (GI) was observed when VMAT was used (0.74 ± 0.13), and this result was significantly better than those achieved by the 2 other techniques (p < 0.05). For V{sub 4} {sub Gy} of brainstem, both VMAT (2.5%) and IMRS (2.7%) were significantly lower than DCA (4.9%), both at the p < 0.05 level. Regarding V{sub 2} {sub Gy} of normal brain, VMAT plans had attained 6.4 ± 5%; this was significantly better (p < 0.05) than either DCA or IMRS plans, at 9.2 ± 7% and 8.2 ± 6%, respectively. Owing to the multiple arc or beam planning designs of IMRS and VMAT, both of these techniques required higher MU delivery than DCA, with the averages being twice as high (p < 0.05). If linear accelerator is only 1 modality can to establish for SRS treatment. Based on statistical evidence retrospectively, we recommend VMAT as the optimal technique for delivering treatment to tumors adjacent to brainstem.« less

A Project of Boron Neutron Capture Therapy System based on a Proton Linac Neutron Source

NASA Astrophysics Data System (ADS)

Kiyanagi, Yoshikai; Asano, Kenji; Arakawa, Akihiro; Fukuchi, Shin; Hiraga, Fujio; Kimura, Kenju; Kobayashi, Hitoshi; Kubota, Michio; Kumada, Hiroaki; Matsumoto, Hiroshi; Matsumoto, Akira; Sakae, Takeji; Saitoh, Kimiaki; Shibata, Tokushi; Yoshioka, Masakazu

At present, the clinical trials of Boron Neutron Capture Therapy (BNCT) are being performed at research reactor facilities. However, an accelerator based BNCT has a merit that it can be built in a hospital. So, we just launched a development project for the BNCT based on an accelerator in order to establish and to spread the BNCT as an effective therapy in the near future. In the project, a compact proton linac installed in a hospital will be applied as a neutron source, and energy of the proton beam is planned to be less than about 10 MeV to reduce the radioactivity. The BNCT requires epithermal neutron beam with an intensity of around 1x109 (n/cm2/sec) to deliver the therapeutic dose to a deeper region in a body and to complete the irradiation within an hour. From this condition, the current of the proton beam required is estimated to be a few mA on average. Enormous heat deposition in the target is a big issue. We are aiming at total optimization of the accelerator based BNCT from the linac to the irradiation position. Here, the outline of the project is introduced and the moderator design is presented.

Dosimetric Comparison of Intensity-Modulated Stereotactic Radiotherapy With Other Stereotactic Techniques for Locally Recurrent Nasopharyngeal Carcinoma

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

Kung, Shiris Wai Sum; Wu, Vincent Wing Cheung; Kam, Michael Koon Ming, E-mail: kamkm@yahoo.co

2011-01-01

Purpose: Locally recurrent nasopharyngeal carcinoma (NPC) patients can be salvaged by reirradiation with a substantial degree of radiation-related complications. Stereotactic radiotherapy (SRT) is widely used in this regard because of its rapid dose falloff and high geometric precision. The aim of this study was to examine whether the newly developed intensity-modulated stereotactic radiotherapy (IMSRT) has any dosimetric advantages over three other stereotactic techniques, including circular arc (CARC), static conformal beam (SmMLC), and dynamic conformal arc (mARC), in treating locally recurrent NPC. Methods and Materials: Computed tomography images of 32 patients with locally recurrent NPC, previously treated with SRT, were retrievedmore » from the stereotactic planning system for contouring and computing treatment plans. Treatment planning of each patient was performed for the four treatment techniques: CARC, SmMLC, mARC, and IMSRT. The conformity index (CI) and homogeneity index (HI) of the planning target volume (PTV) and doses to the organs at risk (OARs) and normal tissue were compared. Results: All four techniques delivered adequate doses to the PTV. IMSRT, SmMLC, and mARC delivered reasonably conformal and homogenous dose to the PTV (CI <1.47, HI <0.53), but not for CARC (p < 0.05). IMSRT presented with the smallest CI (1.37) and HI (0.40). Among the four techniques, IMSRT spared the greatest number of OARs, namely brainstem, temporal lobes, optic chiasm, and optic nerve, and had the smallest normal tissue volume in the low-dose region. Conclusion: Based on the dosimetric comparison, IMSRT was optimal for locally recurrent NPC by delivering a conformal and homogenous dose to the PTV while sparing OARs.« less

A photon source model based on particle transport in a parameterized accelerator structure for Monte Carlo dose calculations.

PubMed

Ishizawa, Yoshiki; Dobashi, Suguru; Kadoya, Noriyuki; Ito, Kengo; Chiba, Takahito; Takayama, Yoshiki; Sato, Kiyokazu; Takeda, Ken

2018-05-17

An accurate source model of a medical linear accelerator is essential for Monte Carlo (MC) dose calculations. This study aims to propose an analytical photon source model based on particle transport in parameterized accelerator structures, focusing on a more realistic determination of linac photon spectra compared to existing approaches. We designed the primary and secondary photon sources based on the photons attenuated and scattered by a parameterized flattening filter. The primary photons were derived by attenuating bremsstrahlung photons based on the path length in the filter. Conversely, the secondary photons were derived from the decrement of the primary photons in the attenuation process. This design facilitates these sources to share the free parameters of the filter shape and be related to each other through the photon interaction in the filter. We introduced two other parameters of the primary photon source to describe the particle fluence in penumbral regions. All the parameters are optimized based on calculated dose curves in water using the pencil-beam-based algorithm. To verify the modeling accuracy, we compared the proposed model with the phase space data (PSD) of the Varian TrueBeam 6 and 15 MV accelerators in terms of the beam characteristics and the dose distributions. The EGS5 Monte Carlo code was used to calculate the dose distributions associated with the optimized model and reference PSD in a homogeneous water phantom and a heterogeneous lung phantom. We calculated the percentage of points passing 1D and 2D gamma analysis with 1%/1 mm criteria for the dose curves and lateral dose distributions, respectively. The optimized model accurately reproduced the spectral curves of the reference PSD both on- and off-axis. The depth dose and lateral dose profiles of the optimized model also showed good agreement with those of the reference PSD. The passing rates of the 1D gamma analysis with 1%/1 mm criteria between the model and PSD were 100% for 4 × 4, 10 × 10, and 20 × 20 cm 2 fields at multiple depths. For the 2D dose distributions calculated in the heterogeneous lung phantom, the 2D gamma pass rate was 100% for 6 and 15 MV beams. The model optimization time was less than 4 min. The proposed source model optimization process accurately produces photon fluence spectra from a linac using valid physical properties, without detailed knowledge of the geometry of the linac head, and with minimal optimization time. © 2018 American Association of Physicists in Medicine.

MO-F-CAMPUS-T-04: Implementation of a Standardized Monthly Quality Check for Linac Output Management in a Large Multi-Site Clinic

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

Xu, H; Yi, B; Prado, K

2015-06-15

Purpose: This work is to investigate the feasibility of a standardized monthly quality check (QC) of LINAC output determination in a multi-site, multi-LINAC institution. The QC was developed to determine individual LINAC output using the same optimized measurement setup and a constant calibration factor for all machines across the institution. Methods: The QA data over 4 years of 7 Varian machines over four sites, were analyzed. The monthly output constancy checks were performed using a fixed source-to-chamber-distance (SCD), with no couch position adjustment throughout the measurement cycle for all the photon energies: 6 and 18MV, and electron energies: 6, 9,more » 12, 16 and 20 MeV. The constant monthly output calibration factor (Nconst) was determined by averaging the machines’ output data, acquired with the same monthly ion chamber. If a different monthly ion chamber was used, Nconst was then re-normalized to consider its different NDW,Co-60. Here, the possible changes of Nconst over 4 years have been tracked, and the precision of output results based on this standardized monthly QA program relative to the TG-51 calibration for each machine was calculated. Any outlier of the group was investigated. Results: The possible changes of Nconst varied between 0–0.9% over 4 years. The normalization of absorbed-dose-to-water calibration factors corrects for up to 3.3% variations of different monthly QA chambers. The LINAC output precision based on this standardized monthly QC relative to the TG-51 output calibration is within 1% for 6MV photon energy and 2% for 18MV and all the electron energies. A human error in one TG-51 report was found through a close scrutiny of outlier data. Conclusion: This standardized QC allows for a reasonably simplified, precise and robust monthly LINAC output constancy check, with the increased sensitivity needed to detect possible human errors and machine problems.« less

FEM design and simulation of a short, 10 MV, S-band Linac with Monte Carlo dose simulations.

PubMed

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

2015-04-01

Current commercial 10 MV Linac waveguides are 1.5 m. The authors' current 6 MV linear accelerator-magnetic resonance imager (Linac-MR) system fits in typical radiotherapy vaults. To allow 10 MV treatments with the Linac-MR and still fit within typical vaults, the authors design a 10 MV Linac with an accelerator waveguide of the same length (27.5 cm) as current 6 MV Linacs. The first design stage is to design a cavity such that a specific experimental measurement for breakdown is applicable to the cavity. This is accomplished through the use of finite element method (FEM) simulations to match published shunt impedance, Q factor, and ratio of peak to mean-axial electric field strength from an electric breakdown study. A full waveguide is then designed and tuned in FEM simulations based on this cavity design. Electron trajectories are computed through the resulting radio frequency fields, and the waveguide geometry is modified by shifting the first coupling cavity in order to optimize the electron beam properties until the energy spread and mean energy closely match values published for an emulated 10 MV Linac. Finally, Monte Carlo dose simulations are used to compare the resulting photon beam depth dose profile and penumbra with that produced by the emulated 10 MV Linac. The shunt impedance, Q factor, and ratio of peak to mean-axial electric field strength are all matched to within 0.1%. A first coupling cavity shift of 1.45 mm produces an energy spectrum width of 0.347 MeV, very close to the published value for the emulated 10 MV of 0.315 MeV, and a mean energy of 10.53 MeV, nearly identical to the published 10.5 MeV for the emulated 10 MV Linac. The depth dose profile produced by their new Linac is within 1% of that produced by the emulated 10 MV spectrum for all depths greater than 1.5 cm. The penumbra produced is 11% narrower, as measured from 80% to 20% of the central axis dose. The authors have successfully designed and simulated an S-band waveguide of length of 27.5 cm capable of producing a 10 MV photon beam. This waveguide operates well within the breakdown threshold determined for the cavity geometry used. The designed Linac produces depth dose profiles similar to those of the emulated 10 MV Linac (waveguide-length of 1.5 m) but yields a narrower penumbra.

The LCLS Project

NASA Astrophysics Data System (ADS)

Paterson, James M.

2000-04-01

The Linac Coherent Light Source (LCLS) is a linac driven FEL which uses a 1km electron linac (the last third of the SLAC linac) and a 100m long undulator to produce 1.5 angstrom X-rays of extremely high peak brightness. This radiation is fully tranversely coherent and is in sub-picosecond long pulses. The LCLS Project is a four year R&D program to solidify the design, to develop required technologies, to optimize the cost and performance and to study the potential experimental programs using these unique beam characteristics. The program is conducted by a multi-institutional collaboration consisting of SLAC as the lead laboratory, along with ANL, BNL, LLNL, LANL and UCLA.The LCLS design and the R&D programs are described.

Stereotactic radiosurgery of brain metastases.

PubMed

Specht, Hanno M; Combs, Stephanie E

2016-09-01

Brain metastases are a common problem in solid malignancies and still represent a major cause of morbidity and mortality. With the ongoing improvement in systemic therapies, the expectations on the efficacy of brain metastases directed treatment options are growing. As local therapies against brain metastases continue to evolve, treatment patterns have shifted from a palliative "one-treatment-fits-all" towards an individualized, patient adapted approach. In this article we review the evidence for stereotactic radiation treatment based on the current literature. Stereotactic radiosurgery (SRS) as a local high precision approach for the primary treatment of asymptomatic brain metastases has gained wide acceptance. It leads to lasting tumor control with only minor side effects compared to whole brain radiotherapy, since there is only little dose delivered to the healthy brain. The same holds true for hypofractionated stereotactic radiotherapy (HFSRT) for large metastases or for lesions close to organs at risk (e.g. the brainstem). New treatment indications such as neoadjuvant SRS followed by surgical resection or postoperative local therapy to the resection cavity show promising data and are also highlighted in this manuscript. With the evolution of local treatment options, optimal patient selection becomes more and more crucial. This article aims to aid decision making by outlining prognostic factors, treatment techniques and indications and common dose prescriptions.

TH-EF-BRB-08: Robotic Motion Compensation for Radiation Therapy: A 6DOF Phantom Study

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

Belcher, AH; Liu, X; Wiersma, R

Purpose: The high accuracy of frame-based stereotactic radiosurgery (SRS), which uses a rigid frame fixed to the patient’s skull, is offset by potential drawbacks of poor patient compliance and clinical workflow restrictions. Recent research into frameless SRS has so far resulted in reduced accuracy. In this study, we investigate the use of a novel 6 degree-of-freedom (6DOF) robotic head motion cancellation system that continuously detects and compensates for patient head motions during a SRS delivery. This approach has the potential to reduce invasiveness while still achieving accuracies better or equal to traditional frame-based SRS. Methods: A 6DOF parallel kinematics roboticsmore » stage was constructed, and controlled using an inverse kinematics-based motion compensation algorithm. A 6DOF stereoscopic infrared (IR) marker tracking system was used to monitor real-time motions at sub-millimeter and sub-degree levels. A novel 6DOF calibration technique was first applied to properly orient the camera coordinate frame to match that of the LINAC and robotic control frames. Simulated head motions were measured by the system, and the robotic stage responded to these 6DOF motions automatically, returning the reflective marker coordinate frame to its original position. Results: After the motions were introduced to the system in the phantom-based study, the robotic stage automatically and rapidly returned the phantom to LINAC isocenter. When errors exceeded the compensation lower threshold of 0.25 mm or 0.25 degrees, the system registered the 6DOF error and generated a cancellation trajectory. The system responded in less than 0.5 seconds and returned all axes to less than 0.1 mm and 0.1 degree after the 6DOF compensation was performed. Conclusion: The 6DOF real-time motion cancellation system was found to be effective at compensating for translational and rotational motions to current SRS requirements. This system can improve frameless SRS by automatically returning patients to isocenter with high 6DOF accuracy.« less

Guaranteed epsilon-optimal treatment plans with the minimum number of beams for stereotactic body radiation therapy

NASA Astrophysics Data System (ADS)

Yarmand, Hamed; Winey, Brian; Craft, David

2013-09-01

Stereotactic body radiation therapy (SBRT) is characterized by delivering a high amount of dose in a short period of time. In SBRT the dose is delivered using open fields (e.g., beam’s-eye-view) known as ‘apertures’. Mathematical methods can be used for optimizing treatment planning for delivery of sufficient dose to the cancerous cells while keeping the dose to surrounding organs at risk (OARs) minimal. Two important elements of a treatment plan are quality and delivery time. Quality of a plan is measured based on the target coverage and dose to OARs. Delivery time heavily depends on the number of beams used in the plan as the setup times for different beam directions constitute a large portion of the delivery time. Therefore the ideal plan, in which all potential beams can be used, will be associated with a long impractical delivery time. We use the dose to OARs in the ideal plan to find the plan with the minimum number of beams which is guaranteed to be epsilon-optimal (i.e., a predetermined maximum deviation from the ideal plan is guaranteed). Since the treatment plan optimization is inherently a multi-criteria-optimization problem, the planner can navigate the ideal dose distribution Pareto surface and select a plan of desired target coverage versus OARs sparing, and then use the proposed technique to reduce the number of beams while guaranteeing epsilon-optimality. We use mixed integer programming (MIP) for optimization. To reduce the computation time for the resultant MIP, we use two heuristics: a beam elimination scheme and a family of heuristic cuts, known as ‘neighbor cuts’, based on the concept of ‘adjacent beams’. We show the effectiveness of the proposed technique on two clinical cases, a liver and a lung case. Based on our technique we propose an algorithm for fast generation of epsilon-optimal plans.

Trajectory modulated prone breast irradiation: a LINAC-based technique combining intensity modulated delivery and motion of the couch.

PubMed

Fahimian, Benjamin; Yu, Victoria; Horst, Kathleen; Xing, Lei; Hristov, Dimitre

2013-12-01

External beam radiation therapy (EBRT) provides a non-invasive treatment alternative for accelerated partial breast irradiation (APBI), however, limitations in achievable dose conformity of current EBRT techniques have been correlated to reported toxicity. To enhance the conformity of EBRT APBI, a technique for conventional LINACs is developed, which through combined motion of the couch, intensity modulated delivery, and a prone breast setup, enables wide-angular coronal arc irradiation of the ipsilateral breast without irradiating through the thorax and contralateral breast. A couch trajectory optimization technique was developed to determine the trajectories that concurrently avoid collision with the LINAC and maintain the target within the MLC apertures. Inverse treatment planning was performed along the derived trajectory. The technique was experimentally implemented by programming the Varian TrueBeam™ STx in Developer Mode. The dosimetric accuracy of the delivery was evaluated by ion chamber and film measurements in phantom. The resulting optimized trajectory was shown to be necessarily non-isocentric, and contain both translation and rotations of the couch. Film measurements resulted in 93% of the points in the measured two-dimensional dose maps passing the 3%/3mm Gamma criterion. Preliminary treatment plan comparison to 5-field 3D-conformal, IMRT, and VMAT demonstrated enhancement in conformity, and reduction of the normal tissue V50% and V100% parameters that have been correlated with EBRT toxicity. The feasibility of wide-angular intensity modulated partial breast irradiation using motion of the couch has been demonstrated experimentally on a standard LINAC for the first time. For patients eligible for a prone setup, the technique may enable improvement of dose conformity and associated dose-volume parameters correlated with toxicity. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Beam Dynamics Simulation of Photocathode RF Electron Gun at the PBP-CMU Linac Laboratory

NASA Astrophysics Data System (ADS)

Buakor, K.; Rimjaem, S.

2017-09-01

Photocathode radio-frequency (RF) electron guns are widely used at many particle accelerator laboratories due to high quality of produced electron beams. By using a short-pulse laser to induce the photoemission process, the electrons are emitted with low energy spread. Moreover, the photocathode RF guns are not suffered from the electron back bombardment effect, which can cause the limited electron current and accelerated energy. In this research, we aim to develop the photocathode RF gun for the linac-based THz radiation source. Its design is based on the existing gun at the PBP-CMU Linac Laboratory. The gun consists of a one and a half cell S-band standing-wave RF cavities with a maximum electric field of about 60 MV/m at the centre of the full cell. We study the beam dynamics of electrons traveling through the electromagnetic field inside the RF gun by using the particle tracking program ASTRA. The laser properties i.e. transverse size and injecting phase are optimized to obtain low transverse emittance. In addition, the solenoid magnet is applied for beam focusing and emittance compensation. The proper solenoid magnetic field is then investigated to find the optimum value for proper emittance conservation condition.

Clinical Implementation of a Model-Based In Vivo Dose Verification System for Stereotactic Body Radiation Therapy-Volumetric Modulated Arc Therapy Treatments Using the Electronic Portal Imaging Device.

PubMed

McCowan, Peter M; Asuni, Ganiyu; Van Uytven, Eric; VanBeek, Timothy; McCurdy, Boyd M C; Loewen, Shaun K; Ahmed, Naseer; Bashir, Bashir; Butler, James B; Chowdhury, Amitava; Dubey, Arbind; Leylek, Ahmet; Nashed, Maged

2017-04-01

To report findings from an in vivo dosimetry program implemented for all stereotactic body radiation therapy patients over a 31-month period and discuss the value and challenges of utilizing in vivo electronic portal imaging device (EPID) dosimetry clinically. From December 2013 to July 2016, 117 stereotactic body radiation therapy-volumetric modulated arc therapy patients (100 lung, 15 spine, and 2 liver) underwent 602 EPID-based in vivo dose verification events. A developed model-based dose reconstruction algorithm calculates the 3-dimensional dose distribution to the patient by back-projecting the primary fluence measured by the EPID during treatment. The EPID frame-averaging was optimized in June 2015. For each treatment, a 3%/3-mm γ comparison between our EPID-derived dose and the Eclipse AcurosXB-predicted dose to the planning target volume (PTV) and the ≥20% isodose volume were performed. Alert levels were defined as γ pass rates <85% (lung and liver) and <80% (spine). Investigations were carried out for all fractions exceeding the alert level and were classified as follows: EPID-related, algorithmic, patient setup, anatomic change, or unknown/unidentified errors. The percentages of fractions exceeding the alert levels were 22.6% for lung before frame-average optimization and 8.0% for lung, 20.0% for spine, and 10.0% for liver after frame-average optimization. Overall, mean (± standard deviation) planning target volume γ pass rates were 90.7% ± 9.2%, 87.0% ± 9.3%, and 91.2% ± 3.4% for the lung, spine, and liver patients, respectively. Results from the clinical implementation of our model-based in vivo dose verification method using on-treatment EPID images is reported. The method is demonstrated to be valuable for routine clinical use for verifying delivered dose as well as for detecting errors. Copyright © 2017 Elsevier Inc. All rights reserved.

Clinical Implementation of a Model-Based In Vivo Dose Verification System for Stereotactic Body Radiation Therapy–Volumetric Modulated Arc Therapy Treatments Using the Electronic Portal Imaging Device

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

McCowan, Peter M., E-mail: pmccowan@cancercare.mb.ca; Asuni, Ganiyu; Van Uytven, Eric

Purpose: To report findings from an in vivo dosimetry program implemented for all stereotactic body radiation therapy patients over a 31-month period and discuss the value and challenges of utilizing in vivo electronic portal imaging device (EPID) dosimetry clinically. Methods and Materials: From December 2013 to July 2016, 117 stereotactic body radiation therapy–volumetric modulated arc therapy patients (100 lung, 15 spine, and 2 liver) underwent 602 EPID-based in vivo dose verification events. A developed model-based dose reconstruction algorithm calculates the 3-dimensional dose distribution to the patient by back-projecting the primary fluence measured by the EPID during treatment. The EPID frame-averaging was optimized in Junemore » 2015. For each treatment, a 3%/3-mm γ comparison between our EPID-derived dose and the Eclipse AcurosXB–predicted dose to the planning target volume (PTV) and the ≥20% isodose volume were performed. Alert levels were defined as γ pass rates <85% (lung and liver) and <80% (spine). Investigations were carried out for all fractions exceeding the alert level and were classified as follows: EPID-related, algorithmic, patient setup, anatomic change, or unknown/unidentified errors. Results: The percentages of fractions exceeding the alert levels were 22.6% for lung before frame-average optimization and 8.0% for lung, 20.0% for spine, and 10.0% for liver after frame-average optimization. Overall, mean (± standard deviation) planning target volume γ pass rates were 90.7% ± 9.2%, 87.0% ± 9.3%, and 91.2% ± 3.4% for the lung, spine, and liver patients, respectively. Conclusions: Results from the clinical implementation of our model-based in vivo dose verification method using on-treatment EPID images is reported. The method is demonstrated to be valuable for routine clinical use for verifying delivered dose as well as for detecting errors.« less

Linear accelerator-based stereotactic radiosurgery for brainstem metastases: the Dana-Farber/Brigham and Women's Cancer Center experience.

PubMed

Kelly, Paul J; Lin, Yijie Brittany; Yu, Alvin Y C; Ropper, Alexander E; Nguyen, Paul L; Marcus, Karen J; Hacker, Fred L; Weiss, Stephanie E

2011-09-01

To review the safety and efficacy of linear accelerator-based stereotactic radiosurgery (SRS) for brainstem metastases. We reviewed all patients with brain metastases treated with SRS at DF/BWCC from 2001 to 2009 to identify patients who had SRS to a single brainstem metastasis. Overall survival and freedom-from-local failure rates were calculated from the date of SRS using the Kaplan-Meier method. Prognostic factors were evaluated using the log-rank test and Cox proportional hazards model. A total of 24 consecutive patients with brainstem metastases had SRS. At the time of SRS, 21/24 had metastatic lesions elsewhere within the brain. 23/24 had undergone prior WBRT. Primary diagnoses included eight NSCLC, eight breast cancer, three melanoma, three renal cell carcinoma and two others. Median dose was 13 Gy (range, 8-16). One patient had fractionated SRS 5 Gy ×5. Median target volume was 0.2 cc (range, 0.02-2.39). The median age was 57 years (range, 42-92). Follow-up information was available in 22/24 cases. At the time of analysis, 18/22 patients (82%) had died. The median overall survival time was 5.3 months (range, 0.8-21.1 months). The only prognostic factor that trended toward statistical significance for overall survival was the absence of synchronous brain metastasis at the time of SRS; 1-year overall survival was 31% with versus 67% without synchronous brain metastasis (log rank P = 0.11). Non-significant factors included primary tumor histology and status of extracranial disease (progressing vs. stable/absent). Local failure occurred in 4/22 cases (18%). Actuarial freedom from local failure for all cases was 78.6% at 1 year. RTOG grade 3 toxicities were recorded in two patients (ataxia, confusion). Linac-based SRS for small volume brainstem metastases using a median dose of 13 Gy is associated with acceptable local control and low morbidity.

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

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

Emam, I; Hosini, M

2015-06-15

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

Long-term follow-up of patients with surgical intractable acromegaly after linear accelerator radiosurgery.

PubMed

Yan, Jiun-Lin; Chang, Chen-Nen; Chuang, Chi-Cheng; Hsu, Peng-Wei; Lin, Jen-Der; Wei, Kuo-Chen; Lee, Shi-Tseng; Tseng, Jen-Kan; Pai, Ping-Ching; Chen, Yao-Liang

2013-07-01

Radiotherapy is a crucial treatment for acromegalic patients with growth hormone (GH)-secreting pituitary tumors. However, its effect takes time. We retrospectively reviewed the long-term outcome of linear accelerator stereotactic radiosurgery (LINAC SRS) for patients with acromegaly from the perspective of biochemical remission and associated factors. Twenty-two patients presenting with residual or recurrent (GH)-secreting functional pituitary tumor between 1994 and 2004 who received LINAC SRS were enrolled and followed up for at least 3 years. Residual or recurrent tumor was defined as persistent elevated GH or insulin-like growth factor-1 (IGF-1) level and image-confirmed tumor after previous surgical treatment. Biochemical remission was defined as fasting GH less than 2.5 ng/mL with normal sex-and-age adjusted IGF-1. The mean follow-up period was 94.7 months (range 36-161 months). Overall mean biochemical remission time was 53 months (median 30 months). Biochemical control was achieved in 15 patients (68.2%) over the follow up period. One patient experienced recurrence after SRS and underwent another operation. Initial GH at diagnosis and pre-SRS GH correlated with biochemical control (p = 0.005 and p < 0.0001, respectively). Further evaluation demonstrated that biochemical control stabilized after 7.5 years. Overall post-SRS hormone deficit persisted in five patients (22.7%). In comparison to other radiosurgery modalities, LINAC radiosurgery also provides a satisfactory outcome. SRS has maximum effect over the first 2 years and stabilizes after 7.5 years. Moreover, SRS elicits long-term biochemical effects and requires longer follow-up for better biochemical remission. Copyright © 2012. Published by Elsevier B.V.

Radiotherapy for Vestibular Schwannomas: A Critical Review

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

Murphy, Erin S., E-mail: murphye3@ccf.or; Suh, John H.

2011-03-15

Vestibular schwannomas are slow-growing tumors of the myelin-forming cells that cover cranial nerve VIII. The treatment options for patients with vestibular schwannoma include active observation, surgical management, and radiotherapy. However, the optimal treatment choice remains controversial. We have reviewed the available data and summarized the radiotherapeutic options, including single-session stereotactic radiosurgery, fractionated conventional radiotherapy, fractionated stereotactic radiotherapy, and proton beam therapy. The comparisons of the various radiotherapy modalities have been based on single-institution experiences, which have shown excellent tumor control rates of 91-100%. Both stereotactic radiosurgery and fractionated stereotactic radiotherapy have successfully improved cranial nerve V and VII preservation tomore » >95%. The mixed data regarding the ideal hearing preservation therapy, inherent biases in patient selection, and differences in outcome analysis have made the comparison across radiotherapeutic modalities difficult. Early experience using proton therapy for vestibular schwannoma treatment demonstrated local control rates of 84-100% but disappointing hearing preservation rates of 33-42%. Efforts to improve radiotherapy delivery will focus on refined dosimetry with the goal of reducing the dose to the critical structures. As future randomized trials are unlikely, we suggest regimented pre- and post-treatment assessments, including validated evaluations of cranial nerves V, VII, and VIII, and quality of life assessments with long-term prospective follow-up. The results from such trials will enhance the understanding of therapy outcomes and improve our ability to inform patients.« less

Heuristic knowledge-based planning for single-isocenter stereotactic radiosurgery to multiple brain metastases.

PubMed

Ziemer, Benjamin P; Sanghvi, Parag; Hattangadi-Gluth, Jona; Moore, Kevin L

2017-10-01

Single-isocenter, volumetric-modulated arc therapy (VMAT) stereotactic radiosurgery (SRS) for multiple brain metastases (multimets) can deliver highly conformal dose distributions and reduce overall patient treatment time compared to other techniques. However, treatment planning for multimet cases is highly complex due to variability in numbers and sizes of brain metastases, as well as their relative proximity to organs-at-risk (OARs). The purpose of this study was to automate the VMAT planning of multimet cases through a knowledge-based planning (KBP) approach that adapts single-target SRS dose predictions to multiple target predictions. Using a previously published artificial neural network (ANN) KBP system trained on single-target, linac-based SRS plans, 3D dose distribution predictions for multimet patients were obtained by treating each brain lesion as a solitary target and subsequently combining individual dose predictions into a single distribution. Spatial dose distributions di(r→) for each of the i = 1…N lesions were merged using the combination function d(r→)=∑iNdin(r→)1/n. The optimal value of n was determined by minimizing root-mean squared (RMS) difference between clinical multimet plans and predicted dose per unit length along the line profile joining each lesion in the clinical cohort. The gradient measure GM=[3/4π]1/3V50%1/3-V100%1/3 is the primary quality metric for SRS plan evaluation at our institution and served as the main comparative metric between clinical plans and the KBP results. A total of 41 previously treated multimet plans, with target numbers ranging from N = 2-10, were used to validate the ANN predictions and subsequent KBP auto-planning routine. Fully deliverable KBP plans were developed by converting predicted dose distribution into patient-specific optimization objectives for the clinical treatment planning system (TPS). Plan parity was maintained through identical arc configuration and target normalization. Overall plan quality improvements were quantified by calculating the difference between SRS quality metrics (QMs): ΔQM = QM clinical  - QM KBP . In addition to GM, investigated QMs were: volume of brain receiving ≥ 10 Gy (V 10 Gy ), volume of brain receiving ≥ 5 Gy (ΔV 5 Gy ), heterogeneity index (HI), dose to 0.1 cc of the brainstem (D 0.1 cc ), dose to 1% of the optic chiasm (D 1% ), and interlesion dose (D IL ). In addition to this quantitative analysis, overall plan quality was assessed via blinded plan comparison of the manual and KBP treatment plans by SRS-specializing physicians. A dose combination factor of n = 8 yielded an integrated dose profile RMS difference of 2.9% across the 41-patient cohort. Multimet dose predictions exhibited ΔGM = 0.07 ± 0.10 cm against the clinical sample, implying either further normal tissue sparing was possible or that dose predictions were slightly overestimating achievable dose gradients. The latter is the more likely explanation, as this bias vanished when dose predictions were converted to deliverable KBP plans ΔGM = 0.00 ± 0.08 cm. Remaining QMs were nearly identical or showed modest improvements in the KBP sample. Equivalent QMs included: ΔV 10 Gy  = 0.37 ± 3.78 cc, ΔHI = 0.02 ± 0.08 and ΔD IL  = -2.22 ± 171.4 cGy. The KBP plans showed a greater degree of normal tissue sparing as indicated by brain ΔV 5 Gy  = 4.11± 24.05 cc, brainstem ΔD 0.1 cc  = 42.8 ± 121.4 cGy, and chiasm ΔD 1%  = 50.8 ± 83.0 cGy. In blinded review by SRS-specializing physicians, KBP-generated plans were deemed equivalent or superior in 32/41(78.1%) of the cases. Heuristic KBP-driven automated planning in linac-based, single-isocenter treatments for multiple brain metastases maintained or exceeded overall plan quality. © 2017 American Association of Physicists in Medicine.

SU-F-T-559: High-Resolution Scintillating Fiber Array for In-Vivo Real-Time SRS and SBRT Patient QA

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

Knewtson, T; Pokhrel, S; University of Tennessee Health Science Center, Memphis, TN

2016-06-15

Purpose: A high-resolution scintillating fiber detector was built for in-vivo real-time patient specific quality assurance (QA). The detector is designed for stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) to monitor treatment delivery and detect real-time deviations from planned dose to increase patient safety and treatment accuracy. Methods: The detector consists of two high-density scintillating fiber arrays layered to form an X-Y grid which can be attached to the accessory tray of a medical linac for SBRT and cone SRS treatment QA. Fiber arrays consist of 128 scintillating fibers embedded within a precision-machined, high-transmission polymer substrate with 0.8mm pitch. Themore » fibers are coupled on both ends to high-sensitivity photodetectors and the output is recorded through a high-speed analog-to-digital converter to capture the linac pulse sequence as treatment delivery progresses. The detector has a software controlled 360 degree rotational system to capture angular beam projections for high-resolution beam profile reconstruction. Results: The detector was validated using SRS cone sizes from 6mm to 34mm and MLC defined field sizes from 5×5mm2 to 100×100mm2. The detector output response is linear with dose and is dose rate independent. Each field can be reconstructed accurately with a spatial resolution of 0.8mm and the current beam output is displayed every 50msec. Dosimetric errors of 1% with respect to the treatment plan can be identified and clinically significant deviations from the expected treatment can be displayed in real-time to alert the therapists. Conclusion: The high resolution detector is capable of reconstructing beam profiles in real-time with submillimeter resolution and 1% dose resolution. This system has the ability to project in-vivo both spatial and dosimetric errors during SBRT and SRS treatments when only a non-clinically significant fraction of the intended dose was delivered. The device has the potential to establish new standards for in-vivo patient specific QA.« less

Verification of the linac isocenter for stereotactic radiosurgery using cine-EPID imaging and arc delivery

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

Rowshanfarzad, Pejman; Sabet, Mahsheed; O' Connor, Daryl J.

2011-07-15

Purpose:Verification of the mechanical isocenter position is required as part of comprehensive quality assurance programs for stereotactic radiosurgery/radiotherapy (SRS/SRT) treatments. Several techniques have been proposed for this purpose but each of them has certain drawbacks. In this paper, a new efficient and more comprehensive method using cine-EPID images has been introduced for automatic verification of the isocenter with sufficient accuracy for stereotactic applications. Methods: Using a circular collimator fixed to the gantry head to define the field, EPID images of a Winston-Lutz phantom were acquired in cine-imaging mode during 360 deg. gantry rotations. A robust matlab code was developed tomore » analyze the data by finding the center of the field and the center of the ball bearing shadow in each image with sub-pixel accuracy. The distance between these two centers was determined for every image. The method was evaluated by comparison to results of a mechanical pointer and also by detection of a manual shift applied to the phantom position. The repeatability and reproducibility of the method were tested and it was also applied to detect couch and collimator wobble during rotation. Results:The accuracy of the algorithm was 0.03 {+-} 0.02 mm. The repeatability was less than 3 {mu}m and the reproducibility was less than 86 {mu}m. The time elapsed for the analysis of more than 100 cine images of Varian aS1000 and aS500 EPIDs were {approx}65 and 20 s, respectively. Processing of images taken in integrated mode took 0.1 s. The output of the analysis software is printable and shows the isocenter shifts as a function of angle in both in-plane and cross-plane directions. It gives warning messages where the shifts exceed the criteria for SRS/SRT and provides useful data for the necessary adjustments in the system including bearing system and/or room lasers. Conclusions: The comprehensive method introduced in this study uses cine-images, is highly accurate, fast, and independent of the observer. It tests all gantry angles and is suitable for pretreatment QA of the isocenter for stereotactic treatments.« less

FEM design and simulation of a short, 10 MV, S-band Linac with Monte Carlo dose simulations

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

Baillie, Devin; Aubin, J. St.; Steciw, S., E-mail: ssteciw@ualberta.ca

2015-04-15

Purpose: Current commercial 10 MV Linac waveguides are 1.5 m. The authors’ current 6 MV linear accelerator–magnetic resonance imager (Linac–MR) system fits in typical radiotherapy vaults. To allow 10 MV treatments with the Linac–MR and still fit within typical vaults, the authors design a 10 MV Linac with an accelerator waveguide of the same length (27.5 cm) as current 6 MV Linacs. Methods: The first design stage is to design a cavity such that a specific experimental measurement for breakdown is applicable to the cavity. This is accomplished through the use of finite element method (FEM) simulations to match publishedmore » shunt impedance, Q factor, and ratio of peak to mean-axial electric field strength from an electric breakdown study. A full waveguide is then designed and tuned in FEM simulations based on this cavity design. Electron trajectories are computed through the resulting radio frequency fields, and the waveguide geometry is modified by shifting the first coupling cavity in order to optimize the electron beam properties until the energy spread and mean energy closely match values published for an emulated 10 MV Linac. Finally, Monte Carlo dose simulations are used to compare the resulting photon beam depth dose profile and penumbra with that produced by the emulated 10 MV Linac. Results: The shunt impedance, Q factor, and ratio of peak to mean-axial electric field strength are all matched to within 0.1%. A first coupling cavity shift of 1.45 mm produces an energy spectrum width of 0.347 MeV, very close to the published value for the emulated 10 MV of 0.315 MeV, and a mean energy of 10.53 MeV, nearly identical to the published 10.5 MeV for the emulated 10 MV Linac. The depth dose profile produced by their new Linac is within 1% of that produced by the emulated 10 MV spectrum for all depths greater than 1.5 cm. The penumbra produced is 11% narrower, as measured from 80% to 20% of the central axis dose. Conclusions: The authors have successfully designed and simulated an S-band waveguide of length of 27.5 cm capable of producing a 10 MV photon beam. This waveguide operates well within the breakdown threshold determined for the cavity geometry used. The designed Linac produces depth dose profiles similar to those of the emulated 10 MV Linac (waveguide-length of 1.5 m) but yields a narrower penumbra.« less

WE-G-17A-09: Novel Magnetic Shielding Design for Inline and Perpendicular Integrated 6 MV Linac and 1.0 T MRI Systems

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

Li, X; Ma, B; Kuang, Y

2014-06-15

Purpose: The influence of fringe magnetic fields delivered by magnetic resonance imaging (MRI) on the beam generation and transportation in Linac is still a major challenge for the integration of linear accelerator and MRI (Linac-MRI). In this study, we investigated an optimal magnetic shielding design for Linac-MRI and further characterized the beam trajectory in electron gun. Methods: Both inline and perpendicular configurations were analyzed in this study. The configurations, comprising a Linac-MRI with a 100cm SAD and an open 1.0 T superconductive magnet, were simulated by the 3D finite element method (FEM). The steel shielding around the Linac was includedmore » in the 3D model, the thickness of which was varied from 1mm to 20mm, and magnetic field maps were acquired with and without additional shielding. The treatment beam trajectory in electron gun was evaluated using OPERA 3d SCALA with and without shielding cases. Results: When Linac was not shielded, the uniformity of diameter sphere volume (DSV) (30cm) was about 5 parts per million (ppm) and the fringe magnetic fields in electron gun were more than 0.3 T. With shielding, the magnetic fields in electron gun were reduced to less than 0.01 T. For the inline configuration, the radial magnetic fields in the Linac were about 0.02T. A cylinder steel shield used (5mm thick) altered the uniformity of DSV to 1000 ppm. For the perpendicular configuration, the Linac transverse magnetic fields were more than 0.3T, which altered the beam trajectory significantly. A 8mm-thick cylinder steel shield surrounding the Linac was used to compensate the output losses of Linac, which shifted the magnetic fields' uniformity of DSV to 400 ppm. Conclusion: For both configurations, the Linac shielding was used to ensure normal operation of the Linac. The effect of magnetic fields on the uniformity of DSV could be modulated by the shimming technique of the MRI magnet. NIH/NIGMS grant U54 GM104944, Lincy Endowed Assistant Professorship.« less

Compact Short-Pulsed Electron Linac Based Neutron Sources for Precise Nuclear Material Analysis

NASA Astrophysics Data System (ADS)

Uesaka, M.; Tagi, K.; Matsuyama, D.; Fujiwara, T.; Dobashi, K.; Yamamoto, M.; Harada, H.

2015-10-01

An X-band (11.424GHz) electron linac as a neutron source for nuclear data study for the melted fuel debris analysis and nuclear security in Fukushima is under development. Originally we developed the linac for Compton scattering X-ray source. Quantitative material analysis and forensics for nuclear security will start several years later after the safe settlement of the accident is established. For the purpose, we should now accumulate more precise nuclear data of U, Pu, etc., especially in epithermal (0.1-10 eV) neutrons. Therefore, we have decided to modify and install the linac in the core space of the experimental nuclear reactor "Yayoi" which is now under the decommission procedure. Due to the compactness of the X-band linac, an electron gun, accelerating tube and other components can be installed in a small space in the core. First we plan to perform the time-of-flight (TOF) transmission measurement for study of total cross sections of the nuclei for 0.1-10 eV energy neutrons. Therefore, if we adopt a TOF line of less than 10m, the o-pulse length of generated neutrons should be shorter than 100 ns. Electronenergy, o-pulse length, power, and neutron yield are ~30 MeV, 100 ns - 1 micros, ~0.4 kW, and ~1011 n/s (~103 n/cm2/s at samples), respectively. Optimization of the design of a neutron target (Ta, W, 238U), TOF line and neutron detector (Ce:LiCAF) of high sensitivity and fast response is underway. We are upgrading the electron gun and a buncher to realize higher current and beam power with a reasonable beam size in order to avoid damage of the neutron target. Although the neutron flux is limited in case of the X-band electron linac based source, we take advantage of its short pulse aspect and availability for nuclear data measurement with a short TOF system. First, we form a tentative configuration in the current experimental room for Compton scattering in 2014. Then, after the decommissioning has been finished, we move it to the "Yayoi" room and perform the operation and measurement.

BEAM DYNAMICS SIMULATIONS FOR A DC GUN BASED INJECTOR FOR PERL.

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

ZHOU,F.; BEN-ZVI,I.; WANG,X.J.

2001-06-18

The National Synchrotron Light Source (NSLS) at Brookhaven National Laboratory (BNL) is considering an upgrade based on the Photoinjected Energy Recovering Linac (PERL). The various injector schemes for this machine are being extensively investigated at BNL. One of the possible options is photocathode DC gun. The schematic layout of a PERL DC gun based injector and its preliminary beam dynamics are presented in this paper. The transverse and longitudinal emittance of photo-electron beam were optimized for a DC field 500 kV.

Magnetic shielding investigation for a 6 MV in-line linac within the parallel configuration of a linac-MR system.

PubMed

Santos, D M; St Aubin, J; Fallone, B G; Steciw, S

2012-02-01

In our current linac-magnetic resonance (MR) design, a 6 MV in-line linac is placed along the central axis of the MR's magnet where the MR's fringe magnetic fields are parallel to the overall electron trajectories in the linac waveguide. Our previous study of this configuration comprising a linac-MR SAD of 100 cm and a 0.5 T superconducting (open, split) MR imager. It showed the presence of longitudinal magnetic fields of 0.011 T at the electron gun, which caused a reduction in target current to 84% of nominal. In this study, passive and active magnetic shielding was investigated to recover the linac output losses caused by magnetic deflections of electron trajectories in the linac within a parallel linac-MR configuration. Magnetic materials and complex shield structures were used in a 3D finite element method (FEM) magnetic field model, which emulated the fringe magnetic fields of the MR imagers. The effects of passive magnetic shielding was studied by surrounding the electron gun and its casing with a series of capped steel cylinders of various inner lengths (26.5-306.5 mm) and thicknesses (0.75-15 mm) in the presence of the fringe magnetic fields from a commercial MR imager. In addition, the effects of a shield of fixed length (146.5 mm) with varying thicknesses were studied against a series of larger homogeneous magnetic fields (0-0.2 T). The effects of active magnetic shielding were studied by adding current loops around the electron gun and its casing. The loop currents, separation, and location were optimized to minimize the 0.011 T longitudinal magnetic fields in the electron gun. The magnetic field solutions from the FEM model were added to a validated linac simulation, consisting of a 3D electron gun (using OPERA-3d/scala) and 3D waveguide (using comsol Multiphysics and PARMELA) simulations. PARMELA's target current and output phase-space were analyzed to study the linac's output performance within the magnetic shields. The FEM model above agreed within 1.5% with the manufacturer supplied fringe magnetic field isoline data. When passive magnetic shields are used, the target current is recoverable to greater than 99% of nominal for shield thicknesses greater than 0.75 mm. The optimized active shield which resulted in 100% target current recovery consists of two thin current rings 110 mm in diameter with 625 and 430 A-turns in each ring. With the length of the passive shield kept constant, the thickness of the shield had to be increased to achieve the same target current within the increased longitudinal magnetic fields. A ≥99% original target current is recovered with passive shield thicknesses >0.75 mm. An active shield consisting of two current rings of diameter of 110 mm with 625 and 430 A-turns fully recovers the loss that would have been caused by the magnetic fields. The minimal passive or active shielding requirements to essentially fully recover the current output of the linac in our parallel-configured linac-MR system have been determined and are easily achieved for practical implementation of the system.

Targeting of the Subthalamic Nucleus for Deep Brain Stimulation: A Survey Among Parkinson Disease Specialists.

PubMed

Hamel, Wolfgang; Köppen, Johannes A; Alesch, François; Antonini, Angelo; Barcia, Juan A; Bergman, Hagai; Chabardes, Stephan; Contarino, Maria Fiorella; Cornu, Philippe; Demmel, Walter; Deuschl, Günther; Fasano, Alfonso; Kühn, Andrea A; Limousin, Patricia; McIntyre, Cameron C; Mehdorn, H Maximilian; Pilleri, Manuela; Pollak, Pierre; Rodríguez-Oroz, Maria C; Rumià, Jordi; Samuel, Michael; Timmermann, Lars; Valldeoriola, Francesc; Vesper, Jan; Visser-Vandewalle, Veerle; Volkmann, Jens; Lozano, Andres M

2017-03-01

Deep brain stimulation within or adjacent to the subthalamic nucleus (STN) represents the most common stereotactic procedure performed for Parkinson disease. Better STN imaging is often regarded as a requirement for improving stereotactic targeting. However, it is unclear whether there is consensus about the optimal target. To obtain an expert opinion on the site regarded optimal for "STN stimulation," movement disorder specialists were asked to indicate their preferred position for an active contact on hard copies of the Schaltenbrand and Wahren atlas depicting the STN in all 3 planes. This represented an idealized setting, and it mimicked optimal imaging for direct target definition in a perfectly delineated STN. The suggested targets were heterogeneous, although some clustering was observed in the dorsolateral STN and subthalamic area. In particular, in the anteroposterior direction, the intended targets differed to a great extent. Most of the indicated targets are thought to also result in concomitant stimulation of structures adjacent to the STN, including the zona incerta, fields of Forel, and internal capsule. This survey illustrates that most sites regarded as optimal for STN stimulation are close to each other, but there appears to be no uniform perception of the optimal anatomic target, possibly influencing surgical results. The anatomic sweet zone for STN stimulation needs further specification, as this information is likely to make magnetic resonance imaging-based target definition less variable when applied to individual patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Design of 6 MeV X-band electron linac for dual-head gantry radiotherapy system

NASA Astrophysics Data System (ADS)

Shin, Seung-wook; Lee, Seung-Hyun; Lee, Jong-Chul; Kim, Huisu; Ha, Donghyup; Ghergherehchi, Mitra; Chai, Jongseo; Lee, Byung-no; Chae, Moonsik

2017-12-01

A compact 6 MeV electron linac is being developed at Sungkyunkwan University, in collaboration with the Korea atomic energy research institute (KAERI). The linac will be used as an X-ray source for a dual-head gantry radiotherapy system. X-band technology has been employed to satisfy the size requirement of the dual-head gantry radiotherapy machine. Among the several options available, we selected a pi/2-mode, standing-wave, side-coupled cavity. This choice of radiofrequency (RF) cavity design is intended to enhance the shunt impedance of each cavity in the linac. An optimum structure of the RF cavity with a high-performance design was determined by applying a genetic algorithm during the optimization procedure. This paper describes the detailed design process for a single normal RF cavity and the entire structure, including the RF power coupler and coupling cavity, as well as the beam dynamics results.

Beam dynamics in THz dielectric-loaded waveguides for the AXSIS project

NASA Astrophysics Data System (ADS)

Vinatier, T.; Assmann, R. W.; Dorda, U.; Lemery, F.; Marchetti, B.

2017-07-01

In this paper, we investigate with ASTRA simulations the beam dynamics in dielectric-loaded waveguides driven by THz pulses, used as linac structure for the AXSIS project. We show that the bunch properties at the linac exit are very sensitive to the phase velocity of the THz pulse and are limited by the strong phase slippage of the bunch respective to it. We also show that the bunch properties are optimized when low frequencies (< 300 GHz) are used inside the linac, and that the longitudinal focal point can be put several tens of cm away from the linac exit thanks to ballistic bunching. However, a strong asymmetry in the bunch transverse sizes remains for which a solution is still to be found. Work supported by the European Research Council under the European Union’s Seventh Framework Programme (FP/2007-2013)/ERC Grant Agreement n. 609920.

Stereotactic radiosurgery alone for multiple brain metastases? A review of clinical and technical issues

PubMed Central

Ruschin, Mark; Ma, Lijun; Verbakel, Wilko; Larson, David; Brown, Paul D.

2017-01-01

Abstract Over the past three decades several randomized trials have enabled evidence-based practice for patients presenting with limited brain metastases. These trials have focused on the role of surgery or stereotactic radiosurgery (SRS) with or without whole brain radiation therapy (WBRT). As a result, it is clear that local control should be optimized with surgery or SRS in patients with optimal prognostic factors presenting with up to 4 brain metastases. The routine use of adjuvant WBRT remains debatable, as although greater distant brain control rates are observed, there is no impact on survival, and modern outcomes suggest adverse effects from WBRT on patient cognition and quality of life. With dramatic technologic advances in radiation oncology facilitating the adoption of SRS into mainstream practice, the optimal management of patients with multiple brain metastases is now being put forward. Practice is evolving to SRS alone in these patients despite a lack of level 1 evidence to support a clinical departure from WBRT. The purpose of this review is to summarize the current state of the evidence for patients presenting with limited and multiple metastases, and to present an in-depth analysis of the technology and dosimetric issues specific to the treatment of multiple metastases. PMID:28380635

SU-F-T-451: Doses to Organs-At-Risk in the Presence and Absence of a 1.5 T Magnetic Field for NSCLC Patients Undergoing SABR

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

Al-Ward, S; Kim, A; McCann, C

2016-06-15

Purpose: To determine whether the electron return effect (ERE) has deleterious effects on lung SABR plans optimized in the presence of an orthogonal 1.5 T magnetic field. Methods: Data from five NSCLC-SABR patients were used. The Dose was modeled with a 2.5 mm dose grid in the presence and absence of a magnetic field using the Monaco (Elekta) TPS with the Monte Carlo GPUMCD (v5.1) algorithm. For each patient, two plans were generated, one using our conventional Elekta Agility linac beam model and another using the Elekta MRI Linac (MRL) model. Both plans were generated on the average CT usingmore » similar dose constraints and a 5 mm PTV. The optimization was performed using our clinic’s planning criteria, with normalization of the targets such that their V99% was equal to 99%. The OAR DVHs were compared for each patient. Results: The DVH plots revealed that there were limited differences when optimizing plans in the presence or absence of the magnetic field. The mean of the absolute differences, between the two planning types, in the equivalent uniform doses (EUDs) for the OARs were: 0.3 Gy (range of 0.0 - 1.0 Gy) for the esophagus, 0.6 Gy (range of 0.1 – 1.9 Gy) for the heart, 0.5 Gy (range of 0.2 – 0.8 Gy) for the lungs, and 0.6 Gy (range of 0.2 – 1.5 Gy) for the spinal canal. Regarding the maximum doses to the serial organs, the mean of the differences were 3.0 Gy (esophagus) and 0.9 Gy (spinal canal). No trends in the differences were observed. Conclusion: This study has demonstrated that there were no major differences between plans optimized using a conventional linac and those optimized using an MRI linac with an orthogonal 1.5 T magnetic field. This is attributed to the consideration of the ERE in the optimization. This project was made possible with the financial support of Elekta.« less

Stereotactic radiotherapy for early lung cancer: Evidence-based approach and future directions

PubMed Central

Chehade, Samer; Palma, David A.

2015-01-01

Aim To review key studies evaluating stereotactic radiotherapy in the setting of early-stage non-small cell lung cancer (NSCLC) for inoperable or high-risk patients, and discuss areas of ongoing research and clinical trials. Background The use of stereotactic radiotherapy for the treatment of early stage non-small cell lung cancer (NSCLC) has increased rapidly over the past decade. Numerous studies have reported outcomes for patients treated with SBRT who are unfit for surgical resection, or at high risk of surgical complications. Materials and methods A narrative review. Results The preponderance of evidence suggests that SBRT is associated with excellent local control (∼90% at 3 years) and a favorable toxicity profile. In patients with higher operative risks, such as the elderly and patients with severe COPD, SBRT may provide a less-toxic treatment than surgery with similar oncologic outcomes. Ongoing studies are evaluating the use of SBRT for locally advanced or oligometastatic NSCLC. Conclusions A large body of evidence now exists to support the use of SBRT for early-stage NSCLC. Decisions regarding the optimal choice of treatment should be individualized, and made in the context of a multidisciplinary team. PMID:26696779

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

Liang, Bin; Li, Yongbao; Liu, Bo

Purpose: CyberKnife system is initially equipped with fixed circular cones for stereotactic radiosurgery. Two dose calculation algorithms, Ray-Tracing and Monte Carlo, are available in the supplied treatment planning system. A multileaf collimator system was recently introduced in the latest generation of system, capable of arbitrarily shaped treatment field. The purpose of this study is to develop a model based dose calculation algorithm to better handle the lateral scatter in an irregularly shaped small field for the CyberKnife system. Methods: A pencil beam dose calculation algorithm widely used in linac based treatment planning system was modified. The kernel parameters and intensitymore » profile were systematically determined by fitting to the commissioning data. The model was tuned using only a subset of measured data (4 out of 12 cones) and applied to all fixed circular cones for evaluation. The root mean square (RMS) of the difference between the measured and calculated tissue-phantom-ratios (TPRs) and off-center-ratio (OCR) was compared. Three cone size correction techniques were developed to better fit the OCRs at the penumbra region, which are further evaluated by the output factors (OFs). The pencil beam model was further validated against measurement data on the variable dodecagon-shaped Iris collimators and a half-beam blocked field. Comparison with Ray-Tracing and Monte Carlo methods was also performed on a lung SBRT case. Results: The RMS between the measured and calculated TPRs is 0.7% averaged for all cones, with the descending region at 0.5%. The RMSs of OCR at infield and outfield regions are both at 0.5%. The distance to agreement (DTA) at the OCR penumbra region is 0.2 mm. All three cone size correction models achieve the same improvement in OCR agreement, with the effective source shift model (SSM) preferred, due to their ability to predict more accurately the OF variations with the source to axis distance (SAD). In noncircular field validation, the pencil beam calculated results agreed well with the film measurement of both Iris collimators and the half-beam blocked field, fared much better than the Ray-Tracing calculation. Conclusions: The authors have developed a pencil beam dose calculation model for the CyberKnife system. The dose calculation accuracy is better than the standard linac based system because the model parameters were specifically tuned to the CyberKnife system and geometry correction factors. The model handles better the lateral scatter and has the potential to be used for the irregularly shaped fields. Comprehensive validations on MLC equipped system are necessary for its clinical implementation. It is reasonably fast enough to be used during plan optimization.« less

Optimization of S/B in the detection of nuclear fission signatures via different accelerator pulsing modes

NASA Astrophysics Data System (ADS)

Brown, C.; Gozani, T.; Shaw, T.; Stevenson, J.

2011-10-01

In the search for concealed special nuclear materials (SNM) there are a number of fission specific signatures that can be measured. These include prompt and delayed neutron and gamma ray signatures. Here the focus will be on the delayed gamma signature with the assumption that a pulsed electron linac with a constant peak current will be used to generate bremsstrahlung radiation and induce photofission in 235U. In this case, the signal to background ratio (S/B) will depend on the choice of linac frequency, pulse mode, and "active" background due to linac activation products. The linac frequency is simply the rate at which it produces short bursts of radiation, typically 2-4 μs in duration. There are two pulse modes, micro-pulsing, and macro-pulsing. In the micro-pulsing mode, the linac runs continuously at its set frequency and data is collected between bursts. In the macro-pulsing mode, the linac is turned on for a given length of time, on the order of seconds, and then turned off for a period of time typically equal to the length of time it was turned on. Counting takes place during the time the linac is off and stops when the linac is turned on for another cycle. The time dependence of the delayed gamma population can be approximated by the use of 5 time groups with half-lives of 0.29, 1.7, 13, 100, and 940 s, respectively. Each group has its own relative population, which together with its half-life determines what time frame the group contributes most to the measured signal. For example, a group with a short half-life will contribute more signal to a short cycle macro pulsed measurement than it would to a macro pulse measurement with a very long cycle. An analytical expression can be derived that calculates the maximum obtainable signal (delayed gamma photons per fission gamma ray) in either a micro- or macro-pulsed measurement. Using this information along with the observed active background present in a given situation (which can constrain the micro-pulsing parameters), the preferred mode of operation can be chosen to maximize S/B and the detection sensitivity. The principles and experimental application of the optimization process will be shown.

Design study of a radio-frequency quadrupole for high-intensity beams

NASA Astrophysics Data System (ADS)

Bahng, Jungbae; Kim, Eun-San; Choi, Bong-Hyuk

2017-07-01

The Rare isotope Accelerator Of Newness (RAON) heavy-ion accelerator has been designed for the Rare Isotope Science Project (RISP) in Korea. The RAON will produce heavy-ion beams from 660-MeV-proton to 200-MeV/u-uranium with continuous wave (CW) power of 400 kW to support research in various scientific fields. Its system consists of an ECR ion source, LEBTs with 10 keV/u, CW RFQ accelerator with 81.25 MHz and 500 keV/u, a MEBT system, and a SC linac. In detail, the driver linac system consists of a Quarter Wave Resonator (QWR) section with 81.25 MHz and a Half Wave Resonator (HWR) section with 162.5 MHz, Linac-1, and a Spoke Cavity section with 325 MHz, Linac-2. These linacs have been designed to optimize the beam parameters to meet the required design goals. At the same time, a light-heavy ion accelerator with high-intensity beam, such as proton, deuteron, and helium beams, is required for experiments. In this paper, we present the design study of the high intensity RFQ for a deuteron beam with energies from 30 keV/u to 1.5 MeV/u and currents in the mA range. This system is composed of an Penning Ionization Gauge ion source, short LEBT with a RF deflector, and shared SC Linac. In order to increase acceleration efficiency in a short length with low cost, the 2nd harmonic of 162.5 MHz is applied as the operation frequency in the D+ RFQ design. The D+ RFQ is designed with 4.97 m, 1.52 bravery factor. Since it operates with 2nd harmonic frequency, the beam should be 50% of the duty factor while the cavity should be operated in CW mode, to protect the downstream linac system. We focus on avoiding emittance growth by the space-charge effect and optimizing the RFQ to achieve a high transmission and low emittance growth. Both the RFQ beam dynamics study and RFQ cavity design study for two and three dimensions will be discussed. Supported by Korea University Future Research Grant

Frameless robotically targeted stereotactic brain biopsy: feasibility, diagnostic yield, and safety.

PubMed

Bekelis, Kimon; Radwan, Tarek A; Desai, Atman; Roberts, David W

2012-05-01

Frameless stereotactic brain biopsy has become an established procedure in many neurosurgical centers worldwide. Robotic modifications of image-guided frameless stereotaxy hold promise for making these procedures safer, more effective, and more efficient. The authors hypothesized that robotic brain biopsy is a safe, accurate procedure, with a high diagnostic yield and a safety profile comparable to other stereotactic biopsy methods. This retrospective study included 41 patients undergoing frameless stereotactic brain biopsy of lesions (mean size 2.9 cm) for diagnostic purposes. All patients underwent image-guided, robotic biopsy in which the SurgiScope system was used in conjunction with scalp fiducial markers and a preoperatively selected target and trajectory. Forty-five procedures, with 50 supratentorial targets selected, were performed. The mean operative time was 44.6 minutes for the robotic biopsy procedures. This decreased over the second half of the study by 37%, from 54.7 to 34.5 minutes (p < 0.025). The diagnostic yield was 97.8% per procedure, with a second procedure being diagnostic in the single nondiagnostic case. Complications included one transient worsening of a preexisting deficit (2%) and another deficit that was permanent (2%). There were no infections. Robotic biopsy involving a preselected target and trajectory is safe, accurate, efficient, and comparable to other procedures employing either frame-based stereotaxy or frameless, nonrobotic stereotaxy. It permits biopsy in all patients, including those with small target lesions. Robotic biopsy planning facilitates careful preoperative study and optimization of needle trajectory to avoid sulcal vessels, bridging veins, and ventricular penetration.

Towards optimized anesthesia protocols for stereotactic surgery in rats: Analgesic, stress and general health effects of injectable anesthetics. A comparison of a recommended complete reversal anesthesia with traditional chloral hydrate monoanesthesia.

PubMed

Hüske, Christin; Sander, Svenja Esther; Hamann, Melanie; Kershaw, Olivia; Richter, Franziska; Richter, Angelika

2016-07-01

Although injectable anesthetics are still widely used in laboratory rodents, scientific data concerning pain and distress during and after stereotactic surgery are rare. However, optimal anesthesia protocols have a high impact on the quality of the derived data. We therefore investigated the suitability of recommended injectable anesthesia with a traditionally used monoanesthesia for stereotactic surgery in view of optimization and refinement in rats. The influence of the recommended complete reversal anesthesia (MMF; 0.15mg/kg medetomidine, 2mg/kg midazolam, 0.005mg/kg fentanyl; i.m.) with or without reversal and of chloral hydrate (430mg/kg, 3.6%, i.p.) on various physiological, biochemical and behavioral parameters (before, during, after surgery) was analyzed. Isoflurane was also included in stress parameter analysis. In all groups, depth of anesthesia was sufficient for stereotactic surgery with no animal losses. MMF caused transient exophthalmos, myositis at the injection site and increased early postoperative pain scores. Reversal induced agitation, restlessness and hypothermia. Even the low concentrated chloral hydrate led to peritonitis and multifocal liver necrosis, corresponding to increased stress hormone levels and loss in body weight. Increased stress response was also exerted by isoflurane anesthesia. Pronounced systemic toxicity of chloral hydrate strongly questions its further use in rodent anesthesia. In view of undesired effects of MMF and isoflurane, thorough consideration of anesthesia protocols for particular research projects is indispensable. Reversal should be restricted to emergency situations. Our data support further refinement of the current protocols and the importance of sham operated controls. Copyright © 2016 Elsevier B.V. All rights reserved.

Dosimetric and delivery efficiency investigation for treating hepatic lesions with a MLC-equipped robotic radiosurgery–radiotherapy combined system

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

Jin, Lihui, E-mail: lihui.jin@fccc.edu; Price, Robert A.; Wang, Lu

Purpose: The CyberKnife M6 (CK-M6) Series introduced a multileaf collimator (MLC) for extending its capability from stereotactic radiosurgery/stereotactic radiotherapy (SBRT) to conventionally fractionated radiotherapy. This work is to investigate the dosimetric quality of plans that are generated using MLC-shaped beams on the CK-M6, as well as their delivery time, via comparisons with the intensity modulated radiotherapy plans that were clinically used on a Varian Linac for treating hepatic lesions. Methods: Nine patient cases were selected and divided into three groups with three patients in each group: (1) the group-one patients were treated conventionally (25 fractions); (2) the group-two patients weremore » treated with SBRT-like hypofractionation (5 fractions); and (3) the group-three patients were treated similar to group-one patients, but with two planning target volumes (PTVs) and two different prescription dose levels correspondingly. The clinically used plans were generated on the ECLIPSE treatment planning system (TPS) and delivered on a Varian Linac (E-V plans). The multiplan (MP) TPS was used to replan these clinical cases with the MLC as the beam device for the CK-M6 (C-M plans). After plans were normalized to the same PTV dose coverage, comparisons between the C-M and E-V plans were performed based on D{sub 99%} (percentage of prescription dose received by 99% of the PTV), D{sub 0.1cm{sup 3}} (the percentage of prescription dose to 0.1 cm{sup 3} of the PTV), and doses received by critical structures. Then, the delivery times for the C-M plans will be obtained, which are the MP TPS generated estimations assuming having an imaging interval of 60 s. Results: The difference in D{sub 99%} between C-M and E-V plans is +0.6% on average (+ or − indicating a higher or lower dose from C-M plans than from E-V plans) with a range from −4.1% to +3.8%, and the difference in D{sub 0.1cm{sup 3}} was −1.0% on average with a range from −5.1% to +2.9%. The PTV conformity index (CI) for the C-M plans ranges from 1.07 to 1.29 with a mean of 1.19, slightly inferior to the E-V plans, in which the CI ranges from 1.00 to 1.15 with a mean of 1.07. Accounting for all nine patients in three groups, 45% of the critical structures received a lower mean dose for the C-M plans as compared with the E-V plans, and similarly, 48% received a lower maximum dose. Furthermore, the average difference of the mean critical structure dose between the C-M and E-V plans over all critical structures for all patients showed only +2.10% relative to the prescription dose and the similar comparison finds the average difference of the maximum critical structure dose of only +1.24%. The estimated delivery times for the C-M plans on the CK-M6 range from 18 to 24 minutes while they are from 7 to 13.7 min for the E-V plans on the Varian Linac. Conclusions: For treating hepatic lesions, for the C-M plans that are comparable to E-V plans in quality, the times needed to deliver these C-M plans on the CK-M6 are longer than the delivery time for the E-V plans on the Varian Linac, but may be clinically acceptable.« less

Dosimetric verification and clinical evaluation of a new commercially available Monte Carlo-based dose algorithm for application in stereotactic body radiation therapy (SBRT) treatment planning

NASA Astrophysics Data System (ADS)

Fragoso, Margarida; Wen, Ning; Kumar, Sanath; Liu, Dezhi; Ryu, Samuel; Movsas, Benjamin; Munther, Ajlouni; Chetty, Indrin J.

2010-08-01

Modern cancer treatment techniques, such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), have greatly increased the demand for more accurate treatment planning (structure definition, dose calculation, etc) and dose delivery. The ability to use fast and accurate Monte Carlo (MC)-based dose calculations within a commercial treatment planning system (TPS) in the clinical setting is now becoming more of a reality. This study describes the dosimetric verification and initial clinical evaluation of a new commercial MC-based photon beam dose calculation algorithm, within the iPlan v.4.1 TPS (BrainLAB AG, Feldkirchen, Germany). Experimental verification of the MC photon beam model was performed with film and ionization chambers in water phantoms and in heterogeneous solid-water slabs containing bone and lung-equivalent materials for a 6 MV photon beam from a Novalis (BrainLAB) linear accelerator (linac) with a micro-multileaf collimator (m3 MLC). The agreement between calculated and measured dose distributions in the water phantom verification tests was, on average, within 2%/1 mm (high dose/high gradient) and was within ±4%/2 mm in the heterogeneous slab geometries. Example treatment plans in the lung show significant differences between the MC and one-dimensional pencil beam (PB) algorithms within iPlan, especially for small lesions in the lung, where electronic disequilibrium effects are emphasized. Other user-specific features in the iPlan system, such as options to select dose to water or dose to medium, and the mean variance level, have been investigated. Timing results for typical lung treatment plans show the total computation time (including that for processing and I/O) to be less than 10 min for 1-2% mean variance (running on a single PC with 8 Intel Xeon X5355 CPUs, 2.66 GHz). Overall, the iPlan MC algorithm is demonstrated to be an accurate and efficient dose algorithm, incorporating robust tools for MC-based SBRT treatment planning in the routine clinical setting.

TH-A-9A-05: Initial Setup Accuracy Comparison Between Frame-Based and Frameless Stereotactic Radiosurgery

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

Tseng, T; Sheu, R; Todorov, B

2014-06-15

Purpose: To evaluate initial setup accuracy for stereotactic radiosurgery (SRS) between Brainlab frame-based and frameless immobilization system, also to discern the magnitude frameless system has on setup parameters. Methods: The correction shifts from the original setup were compared for total 157 SRS cranial treatments (69 frame-based vs. 88 frameless). All treatments were performed on a Novalis linac with ExacTrac positioning system. Localization box with isocenter overlay was used for initial setup and correction shift was determined by ExacTrac 6D auto-fusion to achieve submillimeter accuracy for treatment. For frameless treatments, mean time interval between simulation and treatment was 5.7 days (rangemore » 0–13). Pearson Chi-Square was used for univariate analysis. Results: The correctional radial shifts (mean±STD, median) for the frame and frameless system measured by ExacTrac were 1.2±1.2mm, 1.1mm and 3.1±3.3mm, 2.0mm, respectively. Treatments with frameless system had a radial shift >2mm more often than those with frames (51.1% vs. 2.9%; p<.0001). To achieve submillimeter accuracy, 85.5% frame-based treatments did not require shift and only 23.9% frameless treatment could succeed with initial setup. There was no statistical significant system offset observed in any direction for either system. For frameless treatments, those treated ≥ 3 days from simulation had statistically higher rates of radial shifts between 1–2mm and >2mm compared to patients treated in a shorter amount of time from simulation (34.3% and 56.7% vs. 28.6% and 33.3%, respectively; p=0.006). Conclusion: Although image-guided positioning system can also achieve submillimeter accuracy for frameless system, users should be cautious regarding the inherent uncertainty of its capability of immobilization. A proper quality assurance procedure for frameless mask manufacturing and a protocol for intra-fraction imaging verification will be crucial for frameless system. Time interval between simulation and treatment was influential to initial setup accuracy. A shorter time frame for frameless SRS treatment could be helpful in minimizing uncertainties in localization.« less

TU-H-BRC-05: Stereotactic Radiosurgery Optimized with Orthovoltage Beams

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

Fagerstrom, J; Culberson, W; Bender, E

2016-06-15

Purpose: To achieve improved stereotactic radiosurgery (SRS) dose distributions using orthovoltage energy fluence modulation with inverse planning optimization techniques. Methods: A pencil beam model was used to calculate dose distributions from the institution’s orthovoltage unit at 250 kVp. Kernels for the model were derived using Monte Carlo methods as well as measurements with radiochromic film. The orthovoltage photon spectra, modulated by varying thicknesses of attenuating material, were approximated using open-source software. A genetic algorithm search heuristic routine was used to optimize added tungsten filtration thicknesses to approach rectangular function dose distributions at depth. Optimizations were performed for depths of 2.5,more » 5.0, and 7.5 cm, with cone sizes of 8, 10, and 12 mm. Results: Circularly-symmetric tungsten filters were designed based on the results of the optimization, to modulate the orthovoltage beam across the aperture of an SRS cone collimator. For each depth and cone size combination examined, the beam flatness and 80–20% and 90–10% penumbrae were calculated for both standard, open cone-collimated beams as well as for the optimized, filtered beams. For all configurations tested, the modulated beams were able to achieve improved penumbra widths and flatness statistics at depth, with flatness improving between 33 and 52%, and penumbrae improving between 18 and 25% for the modulated beams compared to the unmodulated beams. Conclusion: A methodology has been described that may be used to optimize the spatial distribution of added filtration material in an orthovoltage SRS beam to result in dose distributions at depth with improved flatness and penumbrae compared to standard open cones. This work provides the mathematical foundation for a novel, orthovoltage energy fluence-modulated SRS system.« less

RFI-Based Ion Linac Systems

NASA Astrophysics Data System (ADS)

Swenson, Donald A.

A new company, Ion Linac Systems, Inc., has been formed to promote the development, manufacture, and marketing of intense, RFI-based, Ion Linac Systems. The Rf Focused Interdigital (RFI) linac structure was invented by the author while at Linac Systems, LLC. The first step, for the new company, will be to correct a flaw in an existing RFI-based linac system and to demonstrate "good transmission" through the system. The existing system, aimed at the BNCT medical application, is designed to produce a beam of 2.5 MeV protons with an average beam current of 20 mA. In conjunction with a lithium target, it will produce an intense beam of epithermal neutrons. This system is very efficient, requiring only 180 kW of rf power to produce a 50 kW proton beam. In addition to the BNCT medical application, the RFI-based systems should represent a powerful neutron generator for homeland security, defence applications, cargo container inspection, and contraband detection. The timescale to the demonstration of "good transmission" is early fall of this year. Our website is www.ionlinacs.com.

TU-FG-201-07: Development of SRS Conical Collimator Collision Prediction Software for Radiation Treatment Safety

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

Gutti, V; Morrow, A; Kim, S

Purpose: Stereotactic radiosurgery (SRS) treatments using conical collimators can potentially result in gantry collision with treatment table due to limited collision-clear spaces. An in-house software was developed to help the SRS treatment planner mitigate potential SRS conical collimator (Varian Medical System, Palo Alto, CA) collisions with the treatment table. This software was designed to remove treatment re-planning secondary to unexpected collisions. Methods: A BrainLAB SRS ICT Frameless Extension used for SRS treatments in our clinic was mathematically modelled using surface points registered to the 3D co-ordinate space of the couch extension. The surface points are transformed based on the treatmentmore » isocenter point and potential collisions are determined in 3D space for couch and gantry angle combinations. The distance between the SRS conical collimators and LINAC isocenter is known. The collision detection model was programmed in MATLAB (Mathwork, Natick, MA) to display graphical plots of the calculations, and the plotted data is used to avoid the gantry and couch angle combinations that would likely result in a collision. We have utilized the cone collision tool for 23 SRS cone treatment plans (8 retrospective and 15 prospective for 10 patients). Results: Twenty one plans strongly agreed with the software tool prediction for collision. However, in two plans, a collision was observed with a 0.5 cm margin when the software predicted no collision. Therefore, additional margins were added to the clearance criteria in the program to achieve a lower risk of actual collisions. Conclusion: Our in-house developed collision check software successfully avoided SRS cone re-planning by 91.3% due to a reduction in cone collisions with the treatment table. Future developments to our software will include a CT image data set based collision prediction model as well as a beam angle optimization tool to avoid normal critical tissues as well as previously treated lesions.« less

Injector Beam Dynamics for a High-Repetition Rate 4th-Generation Light Source

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

Papadopoulos, C. F.; Corlett, J.; Emma, P.

2013-05-20

We report on the beam dynamics studies and optimization methods for a high repetition rate (1 MHz) photoinjector based on a VHF normal conducting electron source. The simultaneous goals of beamcompression and reservation of 6-dimensional beam brightness have to be achieved in the injector, in order to accommodate a linac driven FEL light source. For this, a parallel, multiobjective optimization algorithm is used. We discuss the relative merits of different injector design points, as well as the constraints imposed on the beam dynamics by technical considerations such as the high repetition rate.

rf conditioning and breakdown analysis of a traveling wave linac with collinear load cells

NASA Astrophysics Data System (ADS)

Chen, Qushan; Hu, Tongning; Qin, Bin; Xiong, Yongqian; Fan, Kuanjun; Pei, Yuanji

2018-04-01

Huazhong University of Science and Technology (HUST) has built a compact linac-based terahertz free electron laser (THz-FEL) prototype. In order to achieve compact structure, the linac uses collinear load cells instead of conventional output coupler to absorb remanent power at the end of linac. The new designed structure is confronted with rf breakdown problem after a long time conditioning process, so we tried to figure out the breakdown site in the linac. Without transmitted signal, we propose two methods to analyze the breakdown site mainly based on the forward and the reflected power signals. One method focuses on the time relationship of the two signals while the other focuses on the amplitude. Both the two methods indicate the breakdown events happened at the end of the linac and more likely in the first or the second load cell.

LIGHT SOURCE: Physical design of a 10 MeV LINAC for polymer radiation processing

NASA Astrophysics Data System (ADS)

Feng, Guang-Yao; Pei, Yuan-Ji; Wang, Lin; Zhang, Shan-Cai; Wu, Cong-Feng; Jin, Kai; Li, Wei-Min

2009-06-01

In China, polymer radiation processing has become one of the most important processing industries. The radiation processing source may be an electron beam accelerator or a radioactive source. Physical design of an electron beam facility applied for radiation crosslinking is introduced in this paper because of it's much higher dose rate and efficiency. Main part of this facility is a 10 MeV travelling wave electron linac with constant impedance accelerating structure. A start to end simulation concerning the linac is reported in this paper. The codes Opera-3d, Poisson-superfish and Parmela are used to describe electromagnetic elements of the accelerator and track particle distribution from the cathode to the end of the linac. After beam dynamic optimization, wave phase velocities in the structure have been chosen to be 0.56, 0.9 and 0.999 respectively. Physical parameters about the main elements such as DC electron gun, iris-loaded periodic structure, solenoids, etc, are presented. Simulation results proves that it can satisfy the industrial requirement. The linac is under construction. Some components have been finished. Measurements proved that they are in a good agreement with the design values.

TU-F-CAMPUS-J-05: Fast Volumetric MRI On An MRI-Linac Enables On-Line QA On Dose Deposition in the Patient

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

Crijns, S; Glitzner, M; Kontaxis, C

Purpose: The introduction of the MRI-linac in radiotherapy brings MRI-guided treatment with daily plan adaptions within reach. This paradigm demands on-line QA. With its ability to perform continuous volumetric imaging in an outstanding soft-tissue contrast, the MRI- linac promises to elucidate the dose deposition process during a treatment session. Here we study for a prostate case how dynamic MRI combined with linac machine parameters and a fast dose-engine can be used for on-line dose accumulation. Methods: Prostate imaging was performed in healthy volunteer on a 1.5T MR-scanner (Philips, Best, NL) according to a clinical MR-sim protocol, followed by 10min ofmore » dynamic imaging (FLASH, 4s/volume, FOV 40×40×12cm{sup 3}, voxels 3×3×3mm{sup 3}, TR/TE/α=3.5ms/1.7ms/5°). An experienced radiation oncologist made delineations, considering the prostate CTV. Planning was performed on a two-compartment pseudoCT (air/water density) according to clinical constraints (77Gy in PTV) using a Monte-Carlo (MC) based TPS that accounts for magnetic fields. Delivery of one fraction (2.2Gy) was simulated on an emulator for the Axesse linac (Elekta, Stockholm, SE). Machine parameters (MLC settings, gantry angle, dose rate, etc.) were recorded at 25Hz. These were re-grouped per dynamic volume and fed into the MC-engine to calculate a dose delivered for each of the dynamics. Deformations derived from non-rigid registration of each dynamic against the first allowed dose accumulation on a common reference grid. Results: The DVH parameters on the PTV compared to the optimized plan showed little changes. Local deformations however resulted in local deviations, primarily around the air/rectum interface. This clearly indicates the potential of intra-fraction adaptations based on the accumulated dose. Application in each fraction helps to track the influence of plan adaptations to the eventual dose distribution. Calculation times were about twice the delivery time. Conclusion: The current Result paves the way to perform on-line treatment delivery QA on the MRI-linac in the near future.« less

SU-D-BRA-03: Analysis of Systematic Errors with 2D/3D Image Registration for Target Localization and Treatment Delivery in Stereotactic Radiosurgery

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

Xu, H; Chetty, I; Wen, N

Purpose: Determine systematic deviations between 2D/3D and 3D/3D image registrations with six degrees of freedom (6DOF) for various imaging modalities and registration algorithms on the Varian Edge Linac. Methods: The 6DOF systematic errors were assessed by comparing automated 2D/3D (kV/MV vs. CT) with 3D/3D (CBCT vs. CT) image registrations from different imaging pairs, CT slice thicknesses, couch angles, similarity measures, etc., using a Rando head and a pelvic phantom. The 2D/3D image registration accuracy was evaluated at different treatment sites (intra-cranial and extra-cranial) by statistically analyzing 2D/3D pre-treatment verification against 3D/3D localization of 192 Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy treatmentmore » fractions for 88 patients. Results: The systematic errors of 2D/3D image registration using kV-kV, MV-kV and MV-MV image pairs using 0.8 mm slice thickness CT images were within 0.3 mm and 0.3° for translations and rotations with a 95% confidence interval (CI). No significant difference between 2D/3D and 3D/3D image registrations (P>0.05) was observed for target localization at various CT slice thicknesses ranging from 0.8 to 3 mm. Couch angles (30, 45, 60 degree) did not impact the accuracy of 2D/3D image registration. Using pattern intensity with content image filtering was recommended for 2D/3D image registration to achieve the best accuracy. For the patient study, translational error was within 2 mm and rotational error was within 0.6 degrees in terms of 95% CI for 2D/3D image registration. For intra-cranial sites, means and std. deviations of translational errors were −0.2±0.7, 0.04±0.5, 0.1±0.4 mm for LNG, LAT, VRT directions, respectively. For extra-cranial sites, means and std. deviations of translational errors were - 0.04±1, 0.2±1, 0.1±1 mm for LNG, LAT, VRT directions, respectively. 2D/3D image registration uncertainties for intra-cranial and extra-cranial sites were comparable. Conclusion: The Varian Edge radiosurgery 6DOF-based system, can perform 2D/3D image registration with high accuracy for target localization in image-guided stereotactic radiosurgery. The work was supported by a Research Scholar Grant, RSG-15-137-01-CCE from the American Cancer Society.« less

SU-F-T-555: Accurate Stereotactic Cone TMRs Converted from PDDs Scanned with Ray Trace

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

Li, H; Zhong, H; Qin, Y

Purpose: To investigate whether the accuracy of TMRs for stereotactic cones converted from PDDs scanned with Ray Trace can be improved, when compared against the TMRs converted from the traditional PDDs. Methods: Ray Trace measurement in Sun Nuclear 3D Scanner is for accurate scan of small field PDDs. The system detects the center of field at two depths, for example, at 3 and 20 cm in our study, and then performs scan along the line passing the two centers. With both Ray Trace and the traditional method, PDDs for conical cones of 4, 5, 7.5, 10, 12.5, 15, and 17.5more » mm diameter (jaws set to 5×5 cm) were obtained for 6X FFF and 10X FFF energies on a Varian Edge linac, using Edge detectors. The formalism of converting PDD to TMR given in Khan’s book (4th Edition, p.161) was applied. Sp values at dmax were obtained by measuring cone Scp and Sc. Continuous direct measurement of TMR by filling/draining water to/from the tank and spot measurement by moving the tank and detector were also performed with the same equipment, using 100 cm SDD. Results: For 6XFFF energy and all the cones, TMRs converted from Ray Trace were very close to the continuous and spot measurement, while TMRs converted from traditional PDDs had larger deviation. Along the central axis beyond dmax, 1.7% of TMR data points calculated from Ray Trace had more 3% deviation from measurement, with maximal deviation of 5.2%. Whereas, 34% of TMR points calculated from traditional PDDs had more than 3% deviation, with maximum of 5.7%. In this initial study, Ray Trace scans for 10XFFF beam were noisy, further measurement is warranted. Conclusion: The Ray Trace could improve the accuracy of PDDs measurement and the calculated TMRs for stereotactic cones, which was within 3% of the measured TMRs.« less

Multi-dimensional dosimetric verification of stereotactic radiotherapy for uveal melanoma using radiochromic EBT film.

PubMed

Sturtewagen, Eva; Fuss, Martina; Paelinck, Leen; De Wagter, Carlos; Georg, Dietmar

2008-01-01

Since 1997, linac based stereotactic radiotherapy (SRT) of uveal melanoma has been continuously developed at the Department of Radiotherapy, Medical University Vienna. The aim of the present study was (i) to test a new type of radiochromic film (Gafchromic EBT) for dosimetric verification of class solutions for these treatments and (ii) to verify treatment plan acceptance criteria, which are based on gamma values statisitcs. An EPSON Expression 1680 Pro flat bed scanner was utilized for film reading. To establish a calibration curve, films were cut in squares of 2 x 2 cm2, positioned at 5 cm depth in a solid water phantom and were irradiated with different dose levels (0.5 and 5 Gy) in a 5 x 5 cm2 field at 6 MV. A previously developed solid phantom (polystyrene) was used with overall dimensions corresponding to an average human head. EBT films were placed at four different depths (10, 20, 25 and 30 mm) and all films were irradiated simultaneously. Four different treatment plans were verified that resemble typical clinical situations. These plans differed in irradiation technique (conformal mMLC or circular arc SRT) and in tumour size (PTV of 1 or 2.5 cm3). In-house developed software was applied to calculate gamma (gamma) index values and to perform several statistical operations (e.g. gamma-area histograms). At depths of 10 mm gamma1%, (gamma-value where 1% of the points have an equal or higher value in the region of interest) were between 1-3 and maximum gamma > 1 (% of gamma-values > 1 in the region of interest) areas were almost 30%. At larger depths, i.e. more close to the isocenter, gamma 1% was < 1 and gamma > 1 areas were mostly < 5%. Average gamma values were about 0.5. Besides the compromised accuracy in the buildup region, previously defined IMRT acceptance criteria [Stock et al., Phys. Med Biol. 50 (2005) 399-411] could be applied as well to SRT. Radiochromic EBT films, in combination with a flat-bed scanner, were found to be an ideal multidimensional dosimetric tool for treatment plan quality assurance. EBT films are a suitable and reliable dosimetric tool that could replace traditionally used radiographic films. The presented acceptance criteria for SRT treatment plans might be used as a benchmarking data-set for other stereotactic applications and/or other equipment (planning system and delivery hardware) combinations.

Deep brain stimulation for Parkinson's disease: defining the optimal location within the subthalamic nucleus.

PubMed

Bot, Maarten; Schuurman, P Richard; Odekerken, Vincent J J; Verhagen, Rens; Contarino, Fiorella Maria; De Bie, Rob M A; van den Munckhof, Pepijn

2018-05-01

Individual motor improvement after deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) varies considerably. Stereotactic targeting of the dorsolateral sensorimotor part of the STN is considered paramount for maximising effectiveness, but studies employing the midcommissural point (MCP) as anatomical reference failed to show correlation between DBS location and motor improvement. The medial border of the STN as reference may provide better insight in the relationship between DBS location and clinical outcome. Motor improvement after 12 months of 65 STN DBS electrodes was categorised into non-responding, responding and optimally responding body-sides. Stereotactic coordinates of optimal electrode contacts relative to both medial STN border and MCP served to define theoretic DBS 'hotspots'. Using the medial STN border as reference, significant negative correlation (Pearson's correlation -0.52, P<0.01) was found between the Euclidean distance from the centre of stimulation to this DBS hotspot and motor improvement. This hotspot was located at 2.8 mm lateral, 1.7 mm anterior and 2.5 mm superior relative to the medial STN border. Using MCP as reference, no correlation was found. The medial STN border proved superior compared with MCP as anatomical reference for correlation of DBS location and motor improvement, and enabled defining an optimal DBS location within the nucleus. We therefore propose the medial STN border as a better individual reference point than the currently used MCP on preoperative stereotactic imaging, in order to obtain optimal and thus less variable motor improvement for individual patients with PD following STN DBS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Physics design of APT linac with normal conducting rf cavities

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

Nath, S.; Billen, J.H.; Stovall, J.E.

The accelerator based production of tritium calls for a high-power, cw proton linac. Previous designs for such a linac use a radiofrequency quadrupole (RFQ), followed by a drift-tube linac (DTL) to an intermediate energy and a coupled-cavity linc (CCL) to the final energy. The Los Alamos design uses a high-energy (6.7 MeV) RFQ followed by the newly developed coupled-cavity drift-tube linac (CCDTL) and a CCL. This design accommodates external electromagnetic quadrupole lenses which provide a strong uniform focusing lattice from the end of the RFQ to the end of the CCL. The cell lengths in linacs of traditional design aremore » typically graded as a function of particle velocity. By making groups of cells symmetric in both the CCDTL and CCL, the cavity design as well as mechanical design and fabrication is simplified without compromising the performance. At higher energies, there are some advantages of using superconducting rf cavities. Currently, such schemes are under vigorous study. This paper describes the linac design based on normal conducting cavities and presents simulation results.« less

Design and testing of focusing magnets for a compact electron linac

NASA Astrophysics Data System (ADS)

Chen, Qushan; Qin, Bin; Liu, Kaifeng; Liu, Xu; Fu, Qiang; Tan, Ping; Hu, Tongning; Pei, Yuanji

2015-10-01

Solenoid field errors have great influence on electron beam qualities. In this paper, design and testing of high precision solenoids for a compact electron linac is presented. We proposed an efficient and practical method to solve the peak field of the solenoid for relativistic electron beams based on the reduced envelope equation. Beam dynamics involving space charge force were performed to predict the focusing effects. Detailed optimization methods were introduced to achieve an ultra-compact configuration as well as high accuracy, with the help of the POISSON and OPERA packages. Efforts were attempted to restrain system errors in the off-line testing, which showed the short lens and the main solenoid produced a peak field of 0.13 T and 0.21 T respectively. Data analysis involving central and off axes was carried out and demonstrated that the testing results fitted well with the design.

Investigations on KONUS beam dynamics using the pre-stripper drift tube linac at GSI

NASA Astrophysics Data System (ADS)

Xiao, C.; Du, X. N.; Groening, L.

2018-04-01

Interdigital H-mode (IH) drift tube linacs (DTLs) based on KONUS beam dynamics are very sensitive to the rf-phases and voltages at the gaps between tubes. In order to design these DTLs, a deep understanding of the underlying longitudinal beam dynamics is mandatory. The report presents tracking simulations along an IH-DTL using the PARTRAN and BEAMPATH codes together with MATHCAD and CST. Simulation results illustrate that the beam dynamics design of the pre-stripper IH-DTL at GSI is sensitive to slight deviations of rf-phase and gap voltages with impact to the mean beam energy at the DTL exit. Applying the existing geometrical design, rf-voltages, and rf-phases of the DTL were re-adjusted. In simulations this re-optimized design can provide for more than 90% of transmission of an intense 15 emA beam keeping the reduction of beam brilliance below 25%.

A New Predictive Tool for Optimization of the Treatment of Brain Metastases from Colorectal Cancer After Stereotactic Radiosurgery.

PubMed

Rades, Dirk; Dahlke, Markus; Gebauer, Niklas; Bartscht, Tobias; Hornung, Dagmar; Trang, Ngo Thuy; Phuong, Pham Cam; Khoa, Mai Trong; Gliemroth, Jan

2015-10-01

To develop a predictive tool for survival after stereotactic radiosurgery of brain metastases from colorectal cancer. Out of nine factors analyzed for survival, those showing significance (p<0.05) or a trend (p≤0.06) were included. For each factor, 0 (worse survival) or 1 (better survival) point was assigned. Total scores represented the sum of the factor scores. Performance status (p=0.010) and interval from diagnosis of colorectal cancer until radiosurgery (p=0.026) achieved significance, extracranial metastases showed a trend (p=0.06). These factors were included in the tool. Total scores were 0-3 points. Six-month survival rates were 17% for patients with 0, 25% for those with 1, 67% for those with 2 and 100% for those with 3 points; 12-month rates were 0%, 0%, 33% and 67%, respectively. Two groups were created: 0-1 and 2-3 points. Six- and 12-month survival rates were 20% vs. 78% and 0% vs. 44% (p=0.002), respectively. This tool helps optimize the treatment of patients after stereotactic radiosurgery for brain metastases from colorectal cancer. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Adaptive Liver Stereotactic Body Radiation Therapy: Automated Daily Plan Reoptimization Prevents Dose Delivery Degradation Caused by Anatomy Deformations

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

Leinders, Suzanne M.; Delft University of Technology, Delft; Breedveld, Sebastiaan

Purpose: To investigate how dose distributions for liver stereotactic body radiation therapy (SBRT) can be improved by using automated, daily plan reoptimization to account for anatomy deformations, compared with setup corrections only. Methods and Materials: For 12 tumors, 3 strategies for dose delivery were simulated. In the first strategy, computed tomography scans made before each treatment fraction were used only for patient repositioning before dose delivery for correction of detected tumor setup errors. In adaptive second and third strategies, in addition to the isocenter shift, intensity modulated radiation therapy beam profiles were reoptimized or both intensity profiles and beam orientationsmore » were reoptimized, respectively. All optimizations were performed with a recently published algorithm for automated, multicriteria optimization of both beam profiles and beam angles. Results: In 6 of 12 cases, violations of organs at risk (ie, heart, stomach, kidney) constraints of 1 to 6 Gy in single fractions occurred in cases of tumor repositioning only. By using the adaptive strategies, these could be avoided (<1 Gy). For 1 case, this needed adaptation by slightly underdosing the planning target volume. For 2 cases with restricted tumor dose in the planning phase to avoid organ-at-risk constraint violations, fraction doses could be increased by 1 and 2 Gy because of more favorable anatomy. Daily reoptimization of both beam profiles and beam angles (third strategy) performed slightly better than reoptimization of profiles only, but the latter required only a few minutes of computation time, whereas full reoptimization took several hours. Conclusions: This simulation study demonstrated that replanning based on daily acquired computed tomography scans can improve liver stereotactic body radiation therapy dose delivery.« less

High-dose MVCT image guidance for stereotactic body radiation therapy

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

Westerly, David C.; Schefter, Tracey E.; Kavanagh, Brian D.

Purpose: Stereotactic body radiation therapy (SBRT) is a potent treatment for early stage primary and limited metastatic disease. Accurate tumor localization is essential to administer SBRT safely and effectively. Tomotherapy combines helical IMRT with onboard megavoltage CT (MVCT) imaging and is well suited for SBRT; however, MVCT results in reduced soft tissue contrast and increased image noise compared with kilovoltage CT. The goal of this work was to investigate the use of increased imaging doses on a clinical tomotherapy machine to improve image quality for SBRT image guidance. Methods: Two nonstandard, high-dose imaging modes were created on a tomotherapy machinemore » by increasing the linear accelerator (LINAC) pulse rate from the nominal setting of 80 Hz, to 160 Hz and 300 Hz, respectively. Weighted CT dose indexes (wCTDIs) were measured for the standard, medium, and high-dose modes in a 30 cm solid water phantom using a calibrated A1SL ion chamber. Image quality was assessed from scans of a customized image quality phantom. Metrics evaluated include: contrast-to-noise ratios (CNRs), high-contrast spatial resolution, image uniformity, and percent image noise. In addition, two patients receiving SBRT were localized using high-dose MVCT scans. Raw detector data collected after each scan were used to reconstruct standard-dose images for comparison. Results: MVCT scans acquired using a pitch of 1.0 resulted in wCTDI values of 2.2, 4.7, and 8.5 cGy for the standard, medium, and high-dose modes respectively. CNR values for both low and high-contrast materials were found to increase with the square root of dose. Axial high-contrast spatial resolution was comparable for all imaging modes at 0.5 lp/mm. Image uniformity was improved and percent noise decreased as the imaging dose increased. Similar improvements in image quality were observed in patient images, with decreases in image noise being the most notable. Conclusions: High-dose imaging modes are made possible on a clinical tomotherapy machine by increasing the LINAC pulse rate. Increasing the imaging dose results in increased CNRs; making it easier to distinguish the boundaries of low contrast objects. The imaging dose levels observed in this work are considered acceptable at our institution for SBRT treatments delivered in 3-5 fractions.« less

High-dose MVCT image guidance for stereotactic body radiation therapy.

PubMed

Westerly, David C; Schefter, Tracey E; Kavanagh, Brian D; Chao, Edward; Lucas, Dan; Flynn, Ryan T; Miften, Moyed

2012-08-01

Stereotactic body radiation therapy (SBRT) is a potent treatment for early stage primary and limited metastatic disease. Accurate tumor localization is essential to administer SBRT safely and effectively. Tomotherapy combines helical IMRT with onboard megavoltage CT (MVCT) imaging and is well suited for SBRT; however, MVCT results in reduced soft tissue contrast and increased image noise compared with kilovoltage CT. The goal of this work was to investigate the use of increased imaging doses on a clinical tomotherapy machine to improve image quality for SBRT image guidance. Two nonstandard, high-dose imaging modes were created on a tomotherapy machine by increasing the linear accelerator (LINAC) pulse rate from the nominal setting of 80 Hz, to 160 Hz and 300 Hz, respectively. Weighted CT dose indexes (wCTDIs) were measured for the standard, medium, and high-dose modes in a 30 cm solid water phantom using a calibrated A1SL ion chamber. Image quality was assessed from scans of a customized image quality phantom. Metrics evaluated include: contrast-to-noise ratios (CNRs), high-contrast spatial resolution, image uniformity, and percent image noise. In addition, two patients receiving SBRT were localized using high-dose MVCT scans. Raw detector data collected after each scan were used to reconstruct standard-dose images for comparison. MVCT scans acquired using a pitch of 1.0 resulted in wCTDI values of 2.2, 4.7, and 8.5 cGy for the standard, medium, and high-dose modes respectively. CNR values for both low and high-contrast materials were found to increase with the square root of dose. Axial high-contrast spatial resolution was comparable for all imaging modes at 0.5 lp∕mm. Image uniformity was improved and percent noise decreased as the imaging dose increased. Similar improvements in image quality were observed in patient images, with decreases in image noise being the most notable. High-dose imaging modes are made possible on a clinical tomotherapy machine by increasing the LINAC pulse rate. Increasing the imaging dose results in increased CNRs; making it easier to distinguish the boundaries of low contrast objects. The imaging dose levels observed in this work are considered acceptable at our institution for SBRT treatments delivered in 3-5 fractions.

TU-AB-BRC-10: Modeling of Radiotherapy Linac Source Terms Using ARCHER Monte Carlo Code: Performance Comparison of GPU and MIC Computing Accelerators

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

Liu, T; Lin, H; Xu, X

Purpose: (1) To perform phase space (PS) based source modeling for Tomotherapy and Varian TrueBeam 6 MV Linacs, (2) to examine the accuracy and performance of the ARCHER Monte Carlo code on a heterogeneous computing platform with Many Integrated Core coprocessors (MIC, aka Xeon Phi) and GPUs, and (3) to explore the software micro-optimization methods. Methods: The patient-specific source of Tomotherapy and Varian TrueBeam Linacs was modeled using the PS approach. For the helical Tomotherapy case, the PS data were calculated in our previous study (Su et al. 2014 41(7) Medical Physics). For the single-view Varian TrueBeam case, we analyticallymore » derived them from the raw patient-independent PS data in IAEA’s database, partial geometry information of the jaw and MLC as well as the fluence map. The phantom was generated from DICOM images. The Monte Carlo simulation was performed by ARCHER-MIC and GPU codes, which were benchmarked against a modified parallel DPM code. Software micro-optimization was systematically conducted, and was focused on SIMD vectorization of tight for-loops and data prefetch, with the ultimate goal of increasing 512-bit register utilization and reducing memory access latency. Results: Dose calculation was performed for two clinical cases, a Tomotherapy-based prostate cancer treatment and a TrueBeam-based left breast treatment. ARCHER was verified against the DPM code. The statistical uncertainty of the dose to the PTV was less than 1%. Using double-precision, the total wall time of the multithreaded CPU code on a X5650 CPU was 339 seconds for the Tomotherapy case and 131 seconds for the TrueBeam, while on 3 5110P MICs it was reduced to 79 and 59 seconds, respectively. The single-precision GPU code on a K40 GPU took 45 seconds for the Tomotherapy dose calculation. Conclusion: We have extended ARCHER, the MIC and GPU-based Monte Carlo dose engine to Tomotherapy and Truebeam dose calculations.« less

DESIGN OF A GAMMA-RAY SOURCE BASED ON INVERSE COMPTON SCATTERING AT THE FAST SUPERCONDUCTING LINAC

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

Mihalcea, D.; Jacobson, B.; Murokh, A.

2016-10-10

A watt-level average-power gamma-ray source is currently under development at the Fermilab Accelerator Science & Technology (FAST) facility. The source is based on the Inverse Compton Scattering of a high-brightness 300-MeV beam against a high-power laser beam circulating in an optical cavity. The back scattered gamma rays are expected to have photon energies up to 1.5 MeV. This paper discusses the optimization of the source, its performances, and the main challenges ahead.

SU-F-T-305: Clinical Effects of Dosimetric Leaf Gap (DLG) Values Between Matched Varian Truebeam (TB) Linacs

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

Mihailidis, D; Mallah, J; Zhu, D

2016-06-15

Purpose: The dosimetric leaf gap (DLG) is an important parameter to be measured for dynamic beam delivery of modern linacs, like the Varian Truebeam (TB). The clinical effects of DLG-values on IMRT and/or VMAT commissioning of two “matched” TB linacs will be presented.Methods and Materials: The DLG values on two TB linacs were measured for all energy modalities (filtered and FFF-modes) as part of the dynamic delivery mode commissioning (IMRT and/or VMAT. After the standard beam data was modeled in eclipse treatment planning system (TPS) and validated, IMRT validation was performed based on TG1191 benchmark, IROC Head-Neck (H&N) phantom andmore » sample of clinical cases, all measured on both linacs. Although there was a single-set of data entered in the TPS, a noticeable difference was observed for the DLG-values between the linacs. The TG119, IROC phantom and selected patient plans were furnished with DLG-values of TB1 for both linacs and the delivery was performed on both TB linacs for comparison. Results: The DLG values of TB1 was first used for both linacs to perform the testing comparisons. The QA comparison of TG119 plans revealed a great dependence of the results to the DLG-values used for the linac for all energy modalities studied, especially when moving from 3%/3mm to 2%/2mm γ-analysis. Conclusion: The DLG-values have a definite influence on the dynamic dose, delivery that increases with the plan complexity. We recommend that the measured DLG-values are assigned to each of the “matched” linacs, even if a single set of beam data describes multiple linacs. The user should perform a detail test of the dynamic delivery of each linac based on end-to-end benchmark suites like TG119 and IROC phantoms.1Ezzel G., et al., “IMRT commissioning: Multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119.” Med. Phys. 36:5359–5373 (2009). partly supported by CAMC Cancer Center and Alliance Oncology.« less

Status Of the ILC Main Linac Design

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

Saini, Arun; Kapin, Valery; Solyak, Nikolay

2017-05-01

International Linear collider (ILC) is a proposed accelerator facility which is primarily based on two 11-km long superconducting main linacs. In this paper we present recent updates on the main linac design and discuss changes made in order to meet specification outlined in the technical design report (TDR).

A novel electron accelerator for MRI-Linac radiotherapy.

PubMed

Whelan, Brendan; Gierman, Stephen; Holloway, Lois; Schmerge, John; Keall, Paul; Fahrig, Rebecca

2016-03-01

MRI guided radiotherapy is a rapidly growing field; however, current electron accelerators are not designed to operate in the magnetic fringe fields of MRI scanners. As such, current MRI-Linac systems require magnetic shielding, which can degrade MR image quality and limit system flexibility. The purpose of this work was to develop and test a novel medical electron accelerator concept which is inherently robust to operation within magnetic fields for in-line MRI-Linac systems. Computational simulations were utilized to model the accelerator, including the thermionic emission process, the electromagnetic fields within the accelerating structure, and resulting particle trajectories through these fields. The spatial and energy characteristics of the electron beam were quantified at the accelerator target and compared to published data for conventional accelerators. The model was then coupled to the fields from a simulated 1 T superconducting magnet and solved for cathode to isocenter distances between 1.0 and 2.4 m; the impact on the electron beam was quantified. For the zero field solution, the average current at the target was 146.3 mA, with a median energy of 5.8 MeV (interquartile spread of 0.1 MeV), and a spot size diameter of 1.5 mm full-width-tenth-maximum. Such an electron beam is suitable for therapy, comparing favorably to published data for conventional systems. The simulated accelerator showed increased robustness to operation in in-line magnetic fields, with a maximum current loss of 3% compared to 85% for a conventional system in the same magnetic fields. Computational simulations suggest that replacing conventional DC electron sources with a RF based source could be used to develop medical electron accelerators which are robust to operation in in-line magnetic fields. This would enable the development of MRI-Linac systems with no magnetic shielding around the Linac and reduce the requirements for optimization of magnetic fringe field, simplify design of the high-field magnet, and increase system flexibility.

A novel electron accelerator for MRI-Linac radiotherapy

PubMed Central

Whelan, Brendan; Gierman, Stephen; Holloway, Lois; Schmerge, John; Keall, Paul; Fahrig, Rebecca

2016-01-01

Purpose: MRI guided radiotherapy is a rapidly growing field; however, current electron accelerators are not designed to operate in the magnetic fringe fields of MRI scanners. As such, current MRI-Linac systems require magnetic shielding, which can degrade MR image quality and limit system flexibility. The purpose of this work was to develop and test a novel medical electron accelerator concept which is inherently robust to operation within magnetic fields for in-line MRI-Linac systems. Methods: Computational simulations were utilized to model the accelerator, including the thermionic emission process, the electromagnetic fields within the accelerating structure, and resulting particle trajectories through these fields. The spatial and energy characteristics of the electron beam were quantified at the accelerator target and compared to published data for conventional accelerators. The model was then coupled to the fields from a simulated 1 T superconducting magnet and solved for cathode to isocenter distances between 1.0 and 2.4 m; the impact on the electron beam was quantified. Results: For the zero field solution, the average current at the target was 146.3 mA, with a median energy of 5.8 MeV (interquartile spread of 0.1 MeV), and a spot size diameter of 1.5 mm full-width-tenth-maximum. Such an electron beam is suitable for therapy, comparing favorably to published data for conventional systems. The simulated accelerator showed increased robustness to operation in in-line magnetic fields, with a maximum current loss of 3% compared to 85% for a conventional system in the same magnetic fields. Conclusions: Computational simulations suggest that replacing conventional DC electron sources with a RF based source could be used to develop medical electron accelerators which are robust to operation in in-line magnetic fields. This would enable the development of MRI-Linac systems with no magnetic shielding around the Linac and reduce the requirements for optimization of magnetic fringe field, simplify design of the high-field magnet, and increase system flexibility. PMID:26936713

BEAM OPTIMIZATION STUDY FOR AN X-RAY FEL OSCILLATOR AT THE LCLS-II

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

Qin, Weilun; Huang, S.; Liu, K.X.

2016-06-01

The 4 GeV LCLS-II superconducting linac with high repetition beam rate enables the possibility to drive an X-Ray FEL oscillator at harmonic frequencies *. Compared to the regular LCLS-II machine setup, the oscillator mode requires a much longer bunch length with a relatively lower current. Also a flat longitudinal phase space distribution is critical to maintain the FEL gain since the X-ray cavity has extremely narrow bandwidth. In this paper, we study the longitudinal phase space optimization including shaping the initial beam from the injector and optimizing the bunch compressor and dechirper parameters. We obtain a bunch with a flatmore » energy chirp over 400 fs in the core part with current above 100 A. The optimization was based on LiTrack and Elegant simulations using LCLS-II beam parameters.« less

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

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

Li, H; Mutic, S; Green, O

2016-06-15

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

Fast and robust online adaptive planning in stereotactic MR-guided adaptive radiation therapy (SMART) for pancreatic cancer.

PubMed

Bohoudi, O; Bruynzeel, A M E; Senan, S; Cuijpers, J P; Slotman, B J; Lagerwaard, F J; Palacios, M A

2017-12-01

To implement a robust and fast stereotactic MR-guided adaptive radiation therapy (SMART) online strategy in locally advanced pancreatic cancer (LAPC). SMART strategy for plan adaptation was implemented with the MRIdian system (ViewRay Inc.). At each fraction, OAR (re-)contouring is done within a distance of 3cm from the PTV surface. Online plan re-optimization is based on robust prediction of OAR dose and optimization objectives, obtained by building an artificial neural network (ANN). Proposed limited re-contouring strategy for plan adaptation (SMART 3CM ) is evaluated by comparing 50 previously delivered fractions against a standard (re-)planning method using full-scale OAR (re-)contouring (FULLOAR). Plan quality was assessed using PTV coverage (V 95% , D mean , D 1cc ) and institutional OAR constraints (e.g. V 33Gy ). SMART 3CM required a significant lower number of optimizations than FULLOAR (4 vs 18 on average) to generate a plan meeting all objectives and institutional OAR constraints. PTV coverage with both strategies was identical (mean V 95% =89%). Adaptive plans with SMART 3CM exhibited significant lower intermediate and high doses to all OARs than FULLOAR, which also failed in 36% of the cases to adhere to the V 33Gy dose constraint. SMART 3CM approach for LAPC allows good OAR sparing and adequate target coverage while requiring only limited online (re-)contouring from clinicians. Copyright © 2017 Elsevier B.V. All rights reserved.

Doubling The Intensity Of An ERL Based Light Source

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

Andrew Hutton

2005-05-01

A light source based on an Energy Recovered Linac (ERL) [1] consists of a superconducting linac and a transfer line that includes wigglers and undulators to produce the synchrotron light. The transfer line brings the electron bunches back to the beginning of the linac so that their energy can be recovered when they traverse the linac a second time, {lambda}/2 out of RF phase. There is another interesting condition when the length of the transfer line is (n {+-} 1/4) {lambda}. In this case, the electrons drift through on the zero RF crossing, and make a further pass around themore » transfer line, effectively doubling the circulating current in the wigglers and undulators. On the third pass through the linac, they will be decelerated and their energy recovered. The longitudinal focusing at the zero crossing is a problem, but it can be canceled if the drifting beam sees a positive energy gradient for the first half of the linac and a negative gradient for the second half (or vice versa). This paper presents a proposal to use a double chicane at the center of the linac to provide this focusing inversion for the drifting beam while leaving the accelerating and decelerating beams on crest. [1] G. R. Neil, et al, Phys. Rev. Let. 84, 662 2000« less

Technical Note: Dose gradients and prescription isodose in orthovoltage stereotactic radiosurgery

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

Fagerstrom, Jessica M., E-mail: fagerstrom@wisc.edu; Bender, Edward T.; Culberson, Wesley S.

Purpose: The purpose of this work is to examine the trade-off between prescription isodose and dose gradients in orthovoltage stereotactic radiosurgery. Methods: Point energy deposition kernels (EDKs) describing photon and electron transport were calculated using Monte Carlo methods. EDKs were generated from 10  to 250 keV, in 10 keV increments. The EDKs were converted to pencil beam kernels and used to calculate dose profiles through isocenter from a 4π isotropic delivery from all angles of circularly collimated beams. Monoenergetic beams and an orthovoltage polyenergetic spectrum were analyzed. The dose gradient index (DGI) is the ratio of the 50% prescription isodosemore » volume to the 100% prescription isodose volume and represents a metric by which dose gradients in stereotactic radiosurgery (SRS) may be evaluated. Results: Using the 4π dose profiles calculated using pencil beam kernels, the relationship between DGI and prescription isodose was examined for circular cones ranging from 4 to 18 mm in diameter and monoenergetic photon beams with energies ranging from 20 to 250 keV. Values were found to exist for prescription isodose that optimize DGI. Conclusions: The relationship between DGI and prescription isodose was found to be dependent on both field size and energy. Examining this trade-off is an important consideration for designing optimal SRS systems.« less

Dynamic imperfections and optimized feedback design in the Compact Linear Collider main linac

NASA Astrophysics Data System (ADS)

Eliasson, Peder

2008-05-01

The Compact Linear Collider (CLIC) main linac is sensitive to dynamic imperfections such as element jitter, injected beam jitter, and ground motion. These effects cause emittance growth that, in case of ground motion, has to be counteracted by a trajectory feedback system. The feedback system itself will, due to jitter effects and imperfect beam position monitors (BPMs), indirectly cause emittance growth. Fast and accurate simulations of both the direct and indirect effects are desirable, but due to the many elements of the CLIC main linac, simulations may become very time consuming. In this paper, an efficient way of simulating linear (or nearly linear) dynamic effects is described. The method is also shown to facilitate the analytic determination of emittance growth caused by the different dynamic imperfections while using a trajectory feedback system. Emittance growth expressions are derived for quadrupole, accelerating structure, and beam jitter, for ground motion, and for noise in the feedback BPMs. Finally, it is shown how the method can be used to design a feedback system that is optimized for the optics of the machine and the ground motion spectrum of the particular site. This feedback system gives an emittance growth rate that is approximately 10 times lower than that of traditional trajectory feedbacks. The robustness of the optimized feedback system is studied for a number of additional imperfections, e.g., dipole corrector imperfections and faulty knowledge about the machine optics, with promising results.

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

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

Na, Y; Black, P; Wuu, C

2016-06-15

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

Project for the development of the linac based NCT facility in University of Tsukuba.

PubMed

Kumada, H; Matsumura, A; Sakurai, H; Sakae, T; Yoshioka, M; Kobayashi, H; Matsumoto, H; Kiyanagi, Y; Shibata, T; Nakashima, H

2014-06-01

A project team headed by University of Tsukuba launched the development of a new accelerator based BNCT facility. In the project, we have adopted Radio-Frequency Quadrupole (RFQ)+Drift Tube Linac (DTL) type linac as proton accelerators. Proton energy generated from the linac was set to 8MeV and average current was 10mA. The linac tube has been constructed by Mitsubishi Heavy Industry Co. For neutron generator device, beryllium is selected as neutron target material; high intensity neutrons are generated by the reaction with beryllium and the 80kW proton beam. Our team chose beryllium as the neutron target material. At present beryllium target system is being designed with Monte-Carlo estimations and heat analysis with ANSYS. The neutron generator consists of moderator, collimator and shielding. It is being designed together with the beryllium target system. We also acquired a building in Tokai village; the building has been renovated for use as BNCT treatment facility. It is noteworthy that the linac tube had been installed in the facility in September 2012. In BNCT procedure, several medical devices are required for BNCT treatment such as treatment planning system, patient positioning device and radiation monitors. Thus these are being developed together with the linac based neutron source. For treatment planning system, we are now developing a new multi-modal Monte-Carlo treatment planning system based on JCDS. The system allows us to perform dose estimation for BNCT as well as particle radiotherapy and X-ray therapy. And the patient positioning device can navigate a patient to irradiation position quickly and properly. Furthermore the device is able to monitor movement of the patient׳s position during irradiation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Beam dynamics pre-design with KONUS principle for the DTL of SPPC p-Linac

NASA Astrophysics Data System (ADS)

Liu, Jing; Li, Haipeng; Lu, Yuanrong; Su, Jiancang; Liu, Xiaolong; Fu, Qi

2018-04-01

As the Higgs bosons were observed on the LHC in 2012, a two-stage particle collider program named CEPC-SPPC is proposed for precise measurement of Higgs properties and exploring the new physics models. In order to deliver a 2.1-TeV proton beam into the Super Proton-Proton Collider (SPPC), the injector chain will use a 1.2-GeV proton linac (p-Linac) and three synchrotrons of p-RCS, MSS and SS. This paper focuses on the preliminary conceptual design of the DTL within the p-Linac and mainly concerns about the beam dynamics studies. Taking advantages of the KONUS principle and LORASR code, a 325 MHz, 50.65 MeV DTL design which is composed of three tanks in 15.6 m will be presented. The whole DTL contains 129 gaps for beam acceleration, one quadruple doublet which is behind the buncher and eight quadruple triplets of which three are located after each tank, respectively. The aims of this pre-study are to optimize the acceleration electric field distribution together with the focusing magnetic field parameters, enhance the beam transmission quality of beam envelopes, particle distribution and energy spread, then improve the DTL performance in terms of transmission efficiency and so on. The results of the analyses show that the DTL pre-design achieves 16.8 times high energy gain and meets all the p-Linac requirements well.

Inverse Compton scattering X-ray source yield optimization with a laser path folding system inserted in a pre-existent RF linac

NASA Astrophysics Data System (ADS)

Chaleil, A.; Le Flanchec, V.; Binet, A.; Nègre, J. P.; Devaux, J. F.; Jacob, V.; Millerioux, M.; Bayle, A.; Balleyguier, P.; Prazeres, R.

2016-12-01

An inverse Compton scattering source is under development at the ELSA linac of CEA, Bruyères-le-Châtel. Ultra-short X-ray pulses are produced by inverse Compton scattering of 30 ps-laser pulses by relativistic electron bunches. The source will be able to operate in single shot mode as well as in recurrent mode with 72.2 MHz pulse trains. Within this framework, an optical multipass system that multiplies the number of emitted X-ray photons in both regimes has been designed in 2014, then implemented and tested on ELSA facility in the course of 2015. The device is described from both geometrical and timing viewpoints. It is based on the idea of folding the laser optical path to pile-up laser pulses at the interaction point, thus increasing the interaction probability. The X-ray output gain measurements obtained using this system are presented and compared with calculated expectations.

First Test Results of the bERLinPro 2-cell Booster Cavities

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

Burrill, Andrew; Anders, W.; Frahm, A.

2015-09-01

The bERLinPro Energy Recovery Linac (ERL) is currently being built at Helmholtz-Zentrum Berlin in order to study the physics of operating a high-current, a 100 mA, 50 MeV ERL utilizing all SRF cavity technology. This machine will utilize three unique SRF cryomodules for the photoinjector, booster and linac cryomodules respectively. The focus of this paper will be on the cavities contained within the booster cryomodule. Here there will be three 2-cell SRF cavities, based on the original design by Cornell University, but optimized to meet the needs of the project. All of the cavity fabrication, processing and testing was carriedmore » out at Jefferson Laboratory, where 4 cavities were produced, and the 3 cavities with the best RF performance were fitted with helium vessels for installation in the cryomodule. This paper will report on the test results of the cavities as measured in the vertical testing dewar at JLab after fabrication and again after outfitting with the helium vessels.« less

Design of thermal neutron beam based on an electron linear accelerator for BNCT.

PubMed

Zolfaghari, Mona; Sedaghatizadeh, Mahmood

2016-12-01

An electron linear accelerator (Linac) can be used for boron neutron capture therapy (BNCT) by producing thermal neutron flux. In this study, we used a Varian 2300 C/D Linac and MCNPX.2.6.0 code to simulate an electron-photoneutron source for use in BNCT. In order to decelerate the produced fast neutrons from the photoneutron source, which optimize the thermal neutron flux, a beam-shaping assembly (BSA) was simulated. After simulations, a thermal neutron flux with sharp peak at the beam exit was obtained in the order of 3.09×10 8 n/cm 2 s and 6.19×10 8 n/cm 2 s for uranium and enriched uranium (10%) as electron-photoneutron sources respectively. Also, in-phantom dose analysis indicates that the simulated thermal neutron beam can be used for treatment of shallow skin melanoma in time of about 85.4 and 43.6min for uranium and enriched uranium (10%) respectively. Copyright © 2016. Published by Elsevier Ltd.

Robotic real-time translational and rotational head motion correction during frameless stereotactic radiosurgery

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

Liu, Xinmin; Belcher, Andrew H.; Grelewicz, Zachary

Purpose: To develop a control system to correct both translational and rotational head motion deviations in real-time during frameless stereotactic radiosurgery (SRS). Methods: A novel feedback control with a feed-forward algorithm was utilized to correct for the coupling of translation and rotation present in serial kinematic robotic systems. Input parameters for the algorithm include the real-time 6DOF target position, the frame pitch pivot point to target distance constant, and the translational and angular Linac beam off (gating) tolerance constants for patient safety. Testing of the algorithm was done using a 4D (XY Z + pitch) robotic stage, an infrared headmore » position sensing unit and a control computer. The measured head position signal was processed and a resulting command was sent to the interface of a four-axis motor controller, through which four stepper motors were driven to perform motion compensation. Results: The control of the translation of a brain target was decoupled with the control of the rotation. For a phantom study, the corrected position was within a translational displacement of 0.35 mm and a pitch displacement of 0.15° 100% of the time. For a volunteer study, the corrected position was within displacements of 0.4 mm and 0.2° over 98.5% of the time, while it was 10.7% without correction. Conclusions: The authors report a control design approach for both translational and rotational head motion correction. The experiments demonstrated that control performance of the 4D robotic stage meets the submillimeter and subdegree accuracy required by SRS.« less

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

Benedict, Stanley H.; Bova, Frank J.; Clark, Brenda

This article is a tribute to the pioneering medical physicists over the last 50 years who have participated in the research, development, and commercialization of stereotactic radiosurgery (SRS) and stereotactic radiotherapy utilizing a wide range of technology. The authors have described the evolution of SRS through the eyes of physicists from its beginnings with the Gamma Knife in 1951 to proton and charged particle therapy; modification of commercial linacs to accommodate high precision SRS setups; the multitude of accessories that have enabled fine tuning patients for relocalization, immobilization, and repositioning with submillimeter accuracy; and finally the emerging technology of SBRT.more » A major theme of the article is the expanding role of the medical physicist from that of advisor to the neurosurgeon to the current role as a primary driver of new technology that has already led to an adaptation of cranial SRS to other sites in the body, including, spine, liver, and lung. SRS continues to be at the forefront of the impetus to provide technological precision for radiation therapy and has demonstrated a host of downstream benefits in improving delivery strategies for conventional therapy as well. While this is not intended to be a comprehensive history, and the authors could not delineate every contribution by all of those working in the pursuit of SRS development, including physicians, engineers, radiobiologists, and the rest of the therapy and dosimetry staff in this important and dynamic radiation therapy modality, it is clear that physicists have had a substantial role in the development of SRS and theyincreasingly play a leading role in furthering SRS technology.« less

Image fusion pitfalls for cranial radiosurgery.

PubMed

Jonker, Benjamin P

2013-01-01

Stereotactic radiosurgery requires imaging to define both the stereotactic space in which the treatment is delivered and the target itself. Image fusion is the process of using rotation and translation to bring a second image set into alignment with the first image set. This allows the potential concurrent use of multiple image sets to define the target and stereotactic space. While a single magnetic resonance imaging (MRI) sequence alone can be used for delineation of the target and fiducials, there may be significant advantages to using additional imaging sets including other MRI sequences, computed tomography (CT) scans, and advanced imaging sets such as catheter-based angiography, diffusor tension imaging-based fiber tracking and positon emission tomography in order to more accurately define the target and surrounding critical structures. Stereotactic space is usually defined by detection of fiducials on the stereotactic head frame or mask system. Unfortunately MRI sequences are susceptible to geometric distortion, whereas CT scans do not face this problem (although they have poorer resolution of the target in most cases). Thus image fusion can allow the definition of stereotactic space to proceed from the geometrically accurate CT images at the same time as using MRI to define the target. The use of image fusion is associated with risk of error introduced by inaccuracies of the fusion process, as well as workflow changes that if not properly accounted for can mislead the treating clinician. The purpose of this review is to describe the uses of image fusion in stereotactic radiosurgery as well as its potential pitfalls.

Risk Factors Associated With Symptomatic Radiation Pneumonitis After Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer.

PubMed

Shi, Shiming; Zeng, Zhaochong; Ye, Luxi; Huang, Yan; He, Jian

2017-06-01

Radiation pneumonitis is the most frequent acute pulmonary toxicity following stereotactic body radiation therapy for lung cancer. Here, we investigate clinical and dosimetric factors associated with symptomatic radiation pneumonitis in patients with stage I non-small cell lung cancer treated with stereotactic body radiation therapy. A total of 67 patients with stage I non-small cell lung cancer who received stereotactic body radiation therapy at our institution were enrolled, and their clinicopathological parameters and dosimetric parameters were recorded and analyzed. The median follow-up period was 26.4 months (range: 7-48 months). In univariate analysis, tumor size ( P = .041), mean lung dose ( P = .028), V2.5 ( P = .024), V5 ( P = .014), V10 ( P = .004), V20 ( P = .024), V30 ( P = .020), V40 ( P = .040), and V50 ( P = 0.040) were associated with symptomatic radiation pneumonitis. In multivariable logistic regression analysis, V10 ( P = .049) was significantly associated with symptomatic radiation pneumonitis. In conclusion, this study found that tumor size, mean lung dose, and V2.5 to V50 were risk factors markedly associated with symptomatic radiation pneumonitis. Our data suggested that lung V10 was the most significant factor, and optimizing lung V10 may reduce the risk of symptomatic radiation pneumonitis. For both central and peripheral stage I lung cancer, rate of radiation pneumonitis ≥grade 2 was low after stereotactic body radiation therapy with appropriate fraction dose.

Comparison of WBRT alone, SRS alone, and their combination in the treatment of one or more brain metastases: Review and meta-analysis.

PubMed

Khan, Muhammad; Lin, Jie; Liao, Guixiang; Li, Rong; Wang, Baiyao; Xie, Guozhu; Zheng, Jieling; Yuan, Yawei

2017-07-01

Whole brain radiotherapy has been a standard treatment of brain metastases. Stereotactic radiosurgery provides more focal and aggressive radiation and normal tissue sparing but worse local and distant control. This meta-analysis was performed to assess and compare the effectiveness of whole brain radiotherapy alone, stereotactic radiosurgery alone, and their combination in the treatment of brain metastases based on randomized controlled trial studies. Electronic databases (PubMed, MEDLINE, Embase, and Cochrane Library) were searched to identify randomized controlled trial studies that compared treatment outcome of whole brain radiotherapy and stereotactic radiosurgery. This meta-analysis was performed using the Review Manager (RevMan) software (version 5.2) that is provided by the Cochrane Collaboration. The data used were hazard ratios with 95% confidence intervals calculated for time-to-event data extracted from survival curves and local tumor control rate curves. Odds ratio with 95% confidence intervals were calculated for dichotomous data, while mean differences with 95% confidence intervals were calculated for continuous data. Fixed-effects or random-effects models were adopted according to heterogeneity. Five studies (n = 763) were included in this meta-analysis meeting the inclusion criteria. All the included studies were randomized controlled trials. The sample size ranged from 27 to 331. In total 202 (26%) patients with whole brain radiotherapy alone, 196 (26%) patients receiving stereotactic radiosurgery alone, and 365 (48%) patients were in whole brain radiotherapy plus stereotactic radiosurgery group. No significant survival benefit was observed for any treatment approach; hazard ratio was 1.19 (95% confidence interval: 0.96-1.43, p = 0.12) based on three randomized controlled trials for whole brain radiotherapy only compared to whole brain radiotherapy plus stereotactic radiosurgery and hazard ratio was 1.03 (95% confidence interval: 0.82-1.29, p = 0.81) for stereotactic radiosurgery only compared to combined approach. Local control was best achieved when whole brain radiotherapy was combined with stereotactic radiosurgery. Hazard ratio 2.05 (95% confidence interval: 1.36-3.09, p = 0.0006) and hazard ratio 1.84 (95% confidence interval: 1.26-2.70, p = 0.002) were obtained from comparing whole brain radiotherapy only and stereotactic radiosurgery only to whole brain radiotherapy + stereotactic radiosurgery, respectively. No difference in adverse events for treatment difference; odds ratio 1.16 (95% confidence interval: 0.77-1.76, p = 0.48) and odds ratio 0.92 (95% confidence interval: 0.59-1.42, p = 71) for whole brain radiotherapy + stereotactic radiosurgery versus whole brain radiotherapy only and whole brain radiotherapy + stereotactic radiosurgery versus stereotactic radiosurgery only, respectively. Adding stereotactic radiosurgery to whole brain radiotherapy provides better local control as compared to whole brain radiotherapy only and stereotactic radiosurgery only with no difference in radiation related toxicities.

Stereotactic Body Radiotherapy in the Management of Oligometastatic Disease.

PubMed

Ahmed, Kamran A; Torres-Roca, Javier F

2016-01-01

The treatment of oligometastatic disease has become common as imaging techniques have advanced and the management of systemic disease has improved. Use of highly targeted, hypofractionated regimens of stereotactic body radiotherapy (SBRT) is now a primary management option for patients with oligometastatic disease. The properties of SBRT are summarized and the results of retrospective and prospective studies of SBRT use in the management of oligometastases are reviewed. Future directions of SBRT, including optimizing dose and fractionation schedules, are also discussed. SBRT can deliver highly conformal, dosed radiation treatments for ablative tumors in a few treatment sessions. Phase 1/2 trials and retrospective institutional results support use of SBRT as a treatment option for oligometastatic disease metastasized to the lung, liver, and spine, and SBRT offers adequate toxicity profiles with good rates of local control. Future directions will involve optimizing dose and fractionation schedules for select histologies to improve rates of local control while limiting toxicity to normal structures. SBRT offers an excellent management option for patients with oligometastases. However, additional research is still needed to optimize dose and fractionation schedules.

SU-E-T-11: A Cloud Based CT and LINAC QA Data Management System

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

Wiersma, R; Grelewicz, Z; Belcher, A

Purpose: The current status quo of QA data management consists of a mixture of paper-based forms and spreadsheets for recording the results of daily, monthly, and yearly QA tests for both CT scanners and LINACs. Unfortunately, such systems suffer from a host of problems as, (1) records can be easily lost or destroyed, (2) data is difficult to access — one must physically hunt down records, (3) poor or no means of historical data analysis, and (4) no remote monitoring of machine performance off-site. To address these issues, a cloud based QA data management system was developed and implemented. Methods:more » A responsive tablet interface that optimizes clinic workflow with an easy-to-navigate interface accessible from any web browser was implemented in HTML/javascript/CSS to allow user mobility when entering QA data. Automated image QA was performed using a phantom QA kit developed in Python that is applicable to any phantom and is currently being used with the Gammex ACR, Las Vegas, Leeds, and Catphan phantoms for performing automated CT, MV, kV, and CBCT QAs, respectively. A Python based resource management system was used to distribute and manage intensive CPU tasks such as QA phantom image analysis or LaTeX-to-PDF QA report generation to independent process threads or different servers such that website performance is not affected. Results: To date the cloud QA system has performed approximately 185 QA procedures. Approximately 200 QA parameters are being actively tracked by the system on a monthly basis. Electronic access to historical QA parameter information was successful in proactively identifying a Linac CBCT scanner’s performance degradation. Conclusion: A fully comprehensive cloud based QA data management system was successfully implemented for the first time. Potential machine performance issues were proactively identified that would have been otherwise missed by a paper or spreadsheet based QA system.« less

Radiosurgery alone for 5 or more brain metastases: expert opinion survey.

PubMed

Knisely, Jonathan P S; Yamamoto, Masaaki; Gross, Cary P; Castrucci, William A; Jokura, Hidefumi; Chiang, Veronica L S

2010-12-01

Oligometastatic brain metastases may be treated with stereotactic radiosurgery (SRS) alone, but no consensus exists as to when SRS alone would be appropriate. A survey was conducted at 2 radiosurgery meetings to determine which factors SRS practitioners emphasize in recommending SRS alone, and what physician characteristics are associated with recommending SRS alone for ≥ 5 metastases. All physicians attending the 8th Biennial Congress and Exhibition of the International Stereotactic Radiosurgery Society in June 2007 and the 18th Annual Meeting of the Japanese Society of Stereotactic Radiosurgery in July 2009 were asked to complete a questionnaire ranking 14 clinical factors on a 5-point Likert-type scale (ranging from 1 = not important to 5 = very important) to determine how much each factor might influence a decision to recommend SRS alone for brain metastases. Results were condensed into a single dichotomous outcome variable of "influential" (4-5) versus "not influential" (1-3). Respondents were also asked to complete the statement: "In general, a reasonable number of brain metastases treatable by SRS alone would be, at most, ___." The characteristics of physicians willing to recommend SRS alone for ≥ 5 metastases were assessed. Chi-square was used for univariate analysis, and logistic regression for multivariate analysis. The final study sample included 95 Gamma Knife and LINAC-using respondents (54% Gamma Knife users) in San Francisco and 54 in Sendai (48% Gamma Knife users). More than 70% at each meeting had ≥ 5 years experience with SRS. Sixty-five percent in San Francisco and 83% in Sendai treated ≥ 30 cases annually with SRS. The highest number of metastases considered reasonable to treat with SRS alone in both surveys was 50. In San Francisco, the mean and median numbers of metastases considered reasonable to treat with SRS alone were 6.7 and 5, while in Sendai they were 11 and 10. In the San Francisco sample, the clinical factors identified to be most influential in decision making were Karnofsky Performance Scale score (78%), presence/absence of mass effect (76%), and systemic disease control (63%). In Sendai, the most influential factors were the size of the metastases (78%), the Karnofsky Performance Scale score (70%), and metastasis location (68%). In San Francisco, 55% of respondents considered treating ≥ 5 metastases and 22% considered treating ≥ 10 metastases "reasonable." In Sendai, 83% of respondents considered treating ≥ 5 metastases and 57% considered treating ≥ 10 metastases "reasonable." In both groups, private practitioners, neurosurgeons, and Gamma Knife users were statistically significantly more likely to treat ≥ 5 metastases with SRS alone. Although there is no clear consensus for how many metastases are reasonable to treat with SRS alone, more than half of the radiosurgeons at 2 international meetings were willing to extend the use of SRS as an initial treatment for ≥ 5 brain metastases. Given the substantial variation in clinicians' approaches to SRS use, further research is required to identify patient characteristics associated with optimal SRS outcomes.

Dosimetric impact of a change in breathing period on VMAT stereotactic ablative body radiotherapy

NASA Astrophysics Data System (ADS)

Olding, T.; Alexander, KM

2017-05-01

The dosimetric impact of a change in breathing period during treatment was assessed for a volumetric modulated arc therapy (VMAT) stereotactic ablative radiotherapy (SABR) lung plan optimized according to our centre’s planning protocol. Plan delivery was evaluated at three breathing rates ranging from 7 to 23 breaths-per-minute (BPM) against the planning anatomy (15 BPM) calculated dose. Dynamic ion chamber, EBT3 film and Fricke-xylenol orange-gelatin (FXG) gel measurements were acquired using a motion phantom with appropriate inserts for each dosimeter. The results show good agreement between measured and calculated plan dose within the internal gross tumour volume (IGTV) target.

Outcomes of Pituitary Radiation for Cushing's Disease.

PubMed

Ironside, Natasha; Chen, Ching-Jen; Lee, Cheng-Chia; Trifiletti, Daniel M; Vance, Mary Lee; Sheehan, Jason P

2018-06-01

Achievement of biochemical remission with preservation of normal pituitary function is the goal of treatment for Cushing's disease. For patients with persistent or recurrent Cushing's disease after transsphenoidal resection, radiation therapy may be a safe and effective treatment. Stereotactic radiosurgery is favored over conventional fractionated external beam radiation. Hormonal recurrence rates range from 0% to 36% at 8 years after treatment. Tumor control rates are high. New pituitary hormone deficiency is the most common adverse effect after stereotactic radiosurgery and external beam radiation. The effects of radiation planning optimization and use of adjuvant medication on endocrine remission rates warrant investigation. Copyright © 2018 Elsevier Inc. All rights reserved.

TH-AB-BRA-12: Experimental Results From the First High-Field Inline MRI-Linac

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

Keall, P; Dong, B; Zhang, K

Purpose: The pursuit of real-time image guided radiotherapy using optimal tissue contrast has seen the development of several hybrid MRI-treatment systems, high field and low field, and inline and perpendicular configurations. As part of a new MRI-Linac program, an MRI scanner was integrated with a linear accelerator to enable investigations of a coupled inline MRI-Linac system. This work describes our experimental results from the first high-field inline MRI-Linac. Methods: A 1.5 Tesla magnet (Sonata, Siemens) was located in a purpose built RF cage enabling shielding from and close proximity to a linear accelerator with inline orientation. A portable linear acceleratormore » (Linatron, Varian) was installed together with a multi-leaf collimator (Millennium, Varian) to provide dynamic field collimation and the whole assembly built onto a stainless-steel rail system. A series of MRI-Linac experiments was performed to investigate: (1) image quality with beam on measured using a macropodine (kangaroo) ex vivo phantom; (2) the noise as a function of beam state measured using a 6-channel surface coil array and; (3) electron focusing measured using GafChromic film. Results: (1) The macropodine phantom image quality with the beam on was almost identical to that with the beam off. (2) Noise measured with a surface RF coil produced a 25% elevation of background noise when the radiation beam was on. (3) Film measurements demonstrated electron focusing occurring at the center of the radiation field. Conclusion: The first high-field MRI-Linac has been built and experimentally characterized. This system has allowed us to establish the efficacy of a high field in-line MRI-Linac and study a number of the technical challenges and solutions. Supported by the Australian National Health and Medical Research Council, the Australian Research Council, the Australian Cancer Research Foundation and the Health and Hospitals Fund.« less

Technical Note: Experimental results from a prototype high-field inline MRI-linac

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

Liney, G. P., E-mail: gary.liney@sswahs.nsw.gov.au

Purpose: The pursuit of real-time image guided radiotherapy using optimal tissue contrast has seen the development of several hybrid magnetic resonance imaging (MRI)-treatment systems, high field and low field, and inline and perpendicular configurations. As part of a new MRI-linac program, an MRI scanner was integrated with a linear accelerator to enable investigations of a coupled inline MRI-linac system. This work describes results from a prototype experimental system to demonstrate the feasibility of a high field inline MR-linac. Methods: The magnet is a 1.5 T MRI system (Sonata, Siemens Healthcare) was located in a purpose built radiofrequency (RF) cage enablingmore » shielding from and close proximity to a linear accelerator with inline (and future perpendicular) orientation. A portable linear accelerator (Linatron, Varian) was installed together with a multileaf collimator (Millennium, Varian) to provide dynamic field collimation and the whole assembly built onto a stainless-steel rail system. A series of MRI-linac experiments was performed to investigate (1) image quality with beam on measured using a macropodine (kangaroo) ex vivo phantom; (2) the noise as a function of beam state measured using a 6-channel surface coil array; and (3) electron contamination effects measured using Gafchromic film and an electronic portal imaging device (EPID). Results: (1) Image quality was unaffected by the radiation beam with the macropodine phantom image with the beam on being almost identical to the image with the beam off. (2) Noise measured with a surface RF coil produced a 25% elevation of background intensity when the radiation beam was on. (3) Film and EPID measurements demonstrated electron focusing occurring along the centerline of the magnet axis. Conclusions: A proof-of-concept high-field MRI-linac has been built and experimentally characterized. This system has allowed us to establish the efficacy of a high field inline MRI-linac and study a number of the technical challenges and solutions.« less

Alignment of multiradiation isocenters for megavoltage photon beam

PubMed Central

Zhang, Yin; Ding, Kai; Cowan, Garth; Tryggestad, Erik; Armour, Elwood

2015-01-01

The accurate measurement of the linear accelerator (linac) radiation isocenter is critical, especially for stereotactic treatment. Traditional quality assurance (QA) procedure focuses on the measurement of single radiation isocenter, usually of 6 megavoltage (MV) photon beams. Single radiation isocenter is also commonly assumed in treatment planning systems (TPS). Due to different flattening filters and bending magnet and steering parameters, the radiation isocenter of one energy mode can deviate from another if no special effort was devoted. We present the first experience of the multiradiation isocenters alignment on an Elekta linac, as well as its corresponding QA procedure and clinical impact. An 8 mm ball‐bearing (BB) phantom was placed at the 6 MV radiation isocenter using an Elekta isocenter search algorithm, based on portal images. The 3D radiation isocenter shifts of other photon energy modes relative to the 6 MV were determined. Beam profile scanning for different field sizes was used as an independent method to determine the 2D multiradiation isocenters alignment. To quantify the impact of radiation isocenter offset on targeting accuracy, the 10 MV radiation isocenter was manually offset from that for 6 MV by adjusting the bending magnet current. Because our table isocenter was mechanically aligned to the 6 MV radiation isocenter, the deviation of the table isocentric rotation from the "shifted" 10 MV radiation isocenter after bending magnet adjustment was assessed. Winston‐Lutz test was also performed to confirm the overall radiation isocenter positioning accuracy for all photon energies. The portal image method showed the radiation isocenter of the 10 MV flattening filter‐free mode deviated from others before beam parameter adjustment. After the adjustment, the deviation was greatly improved from 0.96 to 0.35 mm relative to the 6 MV radiation isocenter. The same finding was confirmed by the profile‐scanning method. The maximum deviation of the table isocentric rotation from the 10 MV radiation isocenter was observed to linearly increase with the offset between 6 and 10 MV radiation isocenter; 1 mm radiation isocenter offset can translate to almost 2 mm maximum deviation of the table isocentric rotation from the 10 MV radiation isocenter. The alignment of the multiradiation isocenters is particularly important for high‐precision radiotherapy. Our study provides the medical physics community with a quantitative measure of the multiradiation isocenters alignment. A routine QA method should be considered, to examine the radiation isocenters alignment during the linac acceptance. PACS number: 87.55.Qr, 87.56.bd, 87.56.Fc PMID:26699586

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

NASA Astrophysics Data System (ADS)

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

2017-09-01

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

Digitally Controlled Four Harmonic Buncher for FSU LINAC

NASA Astrophysics Data System (ADS)

Moerland, Daniel S.; Wiedenhoever, Ingo; Baby, Lagy T.; Caussyn, David; Spingler, David

2012-03-01

Florida State University's John D. Fox Superconducting Accelerator Laboratory is operating a Tandem-Linac system for heavy ion beams at energies of 5-10 MeV/u. Recently, the accelerator has been used as the driver for the radioactive beam facility RESOLUT, which poses new demands on its high-intensity performance and time-resolution. These demands motivated us to optimize the RF bunching system and to switch the bunch frequency from 48.5 to 12.125 MHz. We installed a four-harmonic resonant transformer to create 3-4 kV potential oscillations across a pair of wire-mesh grids. This setup is modulating the energy of the beam injected into the tandem accelerator, with the aim to create short bunches of beam particles. Asawtooth-like wave-form is created using the Fourier series method, by combining the basis sinusoidal wave of 12.125MHz and its 3 higher order harmonics, in a manner similar to the systems used at ATLAS [1] and other RF-accelerators. A new aspect of our setup is the use of a digital 1GHz function generator, which allows us to optimize and stabilize the synthesized waveform. The control system was realized using labview and integrated into the recently updated controls of the accelerator. We characterize the bunching quality achievedand discuss the optimization of the bunching wave-form. The bunching system has been successfully used in a number of Linac-experiments performed during 2011.[4pt][1] S. Sharamentov, J. Bogaty, B.E. Clifft, R. Pardo, UPGRADE OF THE ATLAS POSITIVE ION INJECTOR BUNCHING SYSTEM, Proceedings of 2005 Particle Accelerator Conference, Knoxville, Tennessee

Automatic pose correction for image-guided nonhuman primate brain surgery planning

NASA Astrophysics Data System (ADS)

Ghafurian, Soheil; Chen, Antong; Hines, Catherine; Dogdas, Belma; Bone, Ashleigh; Lodge, Kenneth; O'Malley, Stacey; Winkelmann, Christopher T.; Bagchi, Ansuman; Lubbers, Laura S.; Uslaner, Jason M.; Johnson, Colena; Renger, John; Zariwala, Hatim A.

2016-03-01

Intracranial delivery of recombinant DNA and neurochemical analysis in nonhuman primate (NHP) requires precise targeting of various brain structures via imaging derived coordinates in stereotactic surgeries. To attain targeting precision, the surgical planning needs to be done on preoperative three dimensional (3D) CT and/or MR images, in which the animals head is fixed in a pose identical to the pose during the stereotactic surgery. The matching of the image to the pose in the stereotactic frame can be done manually by detecting key anatomical landmarks on the 3D MR and CT images such as ear canal and ear bar zero position. This is not only time intensive but also prone to error due to the varying initial poses in the images which affects both the landmark detection and rotation estimation. We have introduced a fast, reproducible, and semi-automatic method to detect the stereotactic coordinate system in the image and correct the pose. The method begins with a rigid registration of the subject images to an atlas and proceeds to detect the anatomical landmarks through a sequence of optimization, deformable and multimodal registration algorithms. The results showed similar precision (maximum difference of 1.71 in average in-plane rotation) to a manual pose correction.

Vector-model-supported optimization in volumetric-modulated arc stereotactic radiotherapy planning for brain metastasis

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

Liu, Eva Sau Fan; Department of Health Technology and Informatics, The Hong Kong Polytechnic University; Wu, Vincent Wing Cheung

Long planning time in volumetric-modulated arc stereotactic radiotherapy (VMA-SRT) cases can limit its clinical efficiency and use. A vector model could retrieve previously successful radiotherapy cases that share various common anatomic features with the current case. The prsent study aimed to develop a vector model that could reduce planning time by applying the optimization parameters from those retrieved reference cases. Thirty-six VMA-SRT cases of brain metastasis (gender, male [n = 23], female [n = 13]; age range, 32 to 81 years old) were collected and used as a reference database. Another 10 VMA-SRT cases were planned with both conventional optimization and vector-model-supported optimization, followingmore » the oncologists' clinical dose prescriptions. Planning time and plan quality measures were compared using the 2-sided paired Wilcoxon signed rank test with a significance level of 0.05, with positive false discovery rate (pFDR) of less than 0.05. With vector-model-supported optimization, there was a significant reduction in the median planning time, a 40% reduction from 3.7 to 2.2 hours (p = 0.002, pFDR = 0.032), and for the number of iterations, a 30% reduction from 8.5 to 6.0 (p = 0.006, pFDR = 0.047). The quality of plans from both approaches was comparable. From these preliminary results, vector-model-supported optimization can expedite the optimization of VMA-SRT for brain metastasis while maintaining plan quality.« less

SU-D-BRA-02: Motion Assessment During Open Face Mask SRS Using CBCT and Surface Monitoring

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

Williams, BB; Fox, CJ; Hartford, AC

Purpose: To assess the robustness of immobilization using open-face mask technology for linac-based stereotactic radiosurgery (SRS) with multiple non-coplanar arcs via repeated CBCT acquisition, with comparison to contemporaneous optical surface tracking data. Methods: 25 patients were treated in open faced masks with cranial SRS using 3–4 non-coplanar arcs. Repeated CBCT imaging was performed to verify the maintenance of proper patient positioning during treatment. Initial patient positioning was performed based on prescribed shifts and optical surface tracking. Positioning refinements employed rigid 3D-matching of the planning CT and CBCT images and were implemented via automated 6DOF couch control. CBCT imaging was repeatedmore » following the treatment of all non-transverse beams with associated couch kicks. Detected patient translations and rotations were recorded and automatically corrected. Optical surface tracking was applied throughout the treatments to monitor motion, and this contemporaneous patient positioning data was recorded to compare against CBCT data and 6DOF couch adjustments. Results: Initial patient positions were refined on average by translations of 3±1mm and rotations of ±0.9-degrees. Optical surface tracking corroborated couch corrections to within 1±1mm and ±0.4-degrees. Following treatment of the transverse and subsequent superior-oblique beam, average translations of 0.6±0.4mm and rotations of ±0.4-degrees were reported via CBCT, with optical surface tracking in agreement to within 1.1±0.6mm and ±0.6-degrees. Following treatment of the third beam, CBCT indicated additional translations of 0.4±0.2mm and rotations of ±0.3-degrees. Cumulative couch corrections resulted in 0.7 ± 0.4mm average magnitude translations and rotations of ±0.4-degrees. Conclusion: Based on CBCT measurements of patients during SRS, the open face mask maintained patient positioning to within 1.5mm and 1-degree with >95% confidence. Patient positioning determined by optical surface tracking agreed with CBCT assessment to within 1±1mm and ±0.6-degree rotations. These data support the use of 1–2mm PTV margins and repeated CBCT to maintain stereotactic positioning tolerances.« less

Image fusion pitfalls for cranial radiosurgery

PubMed Central

Jonker, Benjamin P.

2013-01-01

Stereotactic radiosurgery requires imaging to define both the stereotactic space in which the treatment is delivered and the target itself. Image fusion is the process of using rotation and translation to bring a second image set into alignment with the first image set. This allows the potential concurrent use of multiple image sets to define the target and stereotactic space. While a single magnetic resonance imaging (MRI) sequence alone can be used for delineation of the target and fiducials, there may be significant advantages to using additional imaging sets including other MRI sequences, computed tomography (CT) scans, and advanced imaging sets such as catheter-based angiography, diffusor tension imaging-based fiber tracking and positon emission tomography in order to more accurately define the target and surrounding critical structures. Stereotactic space is usually defined by detection of fiducials on the stereotactic head frame or mask system. Unfortunately MRI sequences are susceptible to geometric distortion, whereas CT scans do not face this problem (although they have poorer resolution of the target in most cases). Thus image fusion can allow the definition of stereotactic space to proceed from the geometrically accurate CT images at the same time as using MRI to define the target. The use of image fusion is associated with risk of error introduced by inaccuracies of the fusion process, as well as workflow changes that if not properly accounted for can mislead the treating clinician. The purpose of this review is to describe the uses of image fusion in stereotactic radiosurgery as well as its potential pitfalls. PMID:23682338

Dosimetric feasibility of magnetic resonance imaging-guided tri-cobalt 60 preoperative intensity modulated radiation therapy for soft tissue sarcomas of the extremity.

PubMed

Kishan, Amar U; Cao, Minsong; Mikaeilian, Argin G; Low, Daniel A; Kupelian, Patrick A; Steinberg, Michael L; Kamrava, Mitchell

2015-01-01

The purpose of this study was to investigate the dosimetric differences of delivering preoperative intensity modulated radiation therapy (IMRT) to patients with soft tissue sarcomas of the extremity (ESTS) with a teletherapy system equipped with 3 rotating (60)Co sources and a built-in magnetic resonance imaging and with standard linear accelerator (LINAC)-based IMRT. The primary study population consisted of 9 patients treated with preoperative radiation for ESTS between 2008 and 2014 with LINAC-based static field IMRT. LINAC plans were designed to deliver 50 Gy in 25 fractions to 95% of the planning target volume (PTV). Tri-(60)Co system IMRT plans were designed with ViewRay system software. Tri-(60)Co-based IMRT plans achieved equivalent target coverage and dosimetry for organs at risk (long bone, skin, and skin corridor) compared with LINAC-based IMRT plans. The maximum and minimum PTV doses, heterogeneity indices, and ratio of the dose to 50% of the volume were equivalent for both planning systems. One LINAC plan violated the maximum bone dose constraint, whereas none of the tri-(60)Co plans did. Using a tri-(60)Co system, we were able to achieve equivalent dosimetry to the PTV and organs at risk for patients with ESTS compared with LINAC-based IMRT plans. The tri-(60)Co system may be advantageous over current treatment platforms by allowing PTV reduction and by elimination of the additional radiation dose associated with daily image guidance, but this needs to be evaluated prospectively. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Poster - 53: Improving inter-linac DMLC IMRT dose precision by fine tuning of MLC leaf calibration

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

Nakonechny, Keith; Tran, Muoi; Sasaki, David

Purpose: To develop a method to improve the inter-linac precision of DMLC IMRT dosimetry. Methods: The distance between opposing MLC leaf banks (“gap size”) can be finely tuned on Varian linacs. The dosimetric effect due to small deviations from the nominal gap size (“gap error”) was studied by introducing known errors for several DMLC sliding gap sizes, and for clinical plans based on the TG119 test cases. The plans were delivered on a single Varian linac and the relationship between gap error and the corresponding change in dose was measured. The plans were also delivered on eight Varian 2100 seriesmore » linacs (at two institutions) in order to quantify the inter-linac variation in dose before and after fine tuning the MLC calibration. Results: The measured dose differences for each field agreed well with the predictions of LoSasso et al. Using the default MLC calibration, the variation in the physical MLC gap size was determined to be less than 0.4 mm between all linacs studied. The dose difference between the linacs with the largest and smallest physical gap was up to 5.4% (spinal cord region of the head and neck TG119 test case). This difference was reduced to 2.5% after fine tuning the MLC gap calibration. Conclusions: The inter-linac dose precision for DMLC IMRT on Varian linacs can be improved using a simple modification of the MLC calibration procedure that involves fine adjustment of the nominal gap size.« less

SU-F-T-235: Optical Scan Based Collision Avoidance Using Multiple Stereotactic Cameras During Simulation

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

Cardan, R; Popple, R; Dobelbower, M

Purpose: To demonstrate the ability to quickly generate an accurate collision avoidance map using multiple stereotactic cameras during simulation. Methods: Three Kinect stereotactic cameras were placed in the CT simulation room and optically calibrated to the DICOM isocenter. Immediately before scanning, the patient was optically imaged to generate a 3D polygon mesh, which was used to calculate the collision avoidance area using our previously developed framework. The mesh was visually compared to the CT scan body contour to ensure accurate coordinate alignment. To test the accuracy of the collision calculation, the patient and machine were physically maneuvered in the treatmentmore » room to calculated collision boundaries. Results: The optical scan and collision calculation took 38.0 seconds and 2.5 seconds to complete respectively. The collision prediction accuracy was determined using a receiver operating curve (ROC) analysis, where the true positive, true negative, false positive and false negative values were 837, 821, 43, and 79 points respectively. The ROC accuracy was 93.1% over the sampled collision space. Conclusion: We have demonstrated a framework which is fast and accurate for predicting collision avoidance for treatment which can be determined during the normal simulation process. Because of the speed, the system could be used to add a layer of safety with a negligible impact on the normal patient simulation experience. This information could be used during treatment planning to explore the feasible geometries when optimizing plans. Research supported by Varian Medical Systems.« less

Generation of stable subfemtosecond hard x-ray pulses with optimized nonlinear bunch compression

DOE PAGES

Huang, Senlin; Ding, Yuantao; Huang, Zhirong; ...

2014-12-15

In this paper, we propose a simple scheme that leverages existing x-ray free-electron laser hardware to produce stable single-spike, subfemtosecond x-ray pulses. By optimizing a high-harmonic radio-frequency linearizer to achieve nonlinear compression of a low-charge (20 pC) electron beam, we obtain a sharp current profile possessing a few-femtosecond full width at half maximum temporal duration. A reverse undulator taper is applied to enable lasing only within the current spike, where longitudinal space charge forces induce an electron beam time-energy chirp. Simulations based on the Linac Coherent Light Source parameters show that stable single-spike x-ray pulses with a duration less thanmore » 200 attoseconds can be obtained.« less

Linear accelerator stereotactic radiosurgery for trigeminal neuralgia.

PubMed

Varela-Lema, Leonor; Lopez-Garcia, Marisa; Maceira-Rozas, Maria; Munoz-Garzon, Victor

2015-01-01

Stereotactic radiosurgery is accepted as an alternative for patients with refractory trigeminal neuralgia, but existing evidence is fundamentally based on the Gamma Knife, which is a specific device for intracranial neurosurgery, available in few facilities. Over the last decade it has been shown that the use of linear accelerators can achieve similar diagnostic accuracy and equivalent dose distribution. To assess the effectiveness and safety of linear-accelerator stereotactic radiosurgery for the treatment of patients with refractory trigeminal neuralgia. We carried out a systematic search of the literature in the main electronic databases (PubMed, Embase, ISI Web of Knowledge, Cochrane, Biomed Central, IBECS, IME, CRD) and reviewed grey literature. All original studies on the subject published in Spanish, French, English, and Portuguese were eligible for inclusion. The selection and critical assessment was carried out by 2 independent reviewers based on pre-defined criteria. In view of the impossibility of carrying out a pooled analysis, data were analyzed in a qualitative way. Eleven case series were included. In these, satisfactory pain relief (BIN I-IIIb or reduction in pain = 50) was achieved in 75% to 95.7% of the patients treated. The mean time to relief from pain ranged from 8.5 days to 3.8 months. The percentage of patients who presented with recurrences after one year of follow-up ranged from 5% to 28.8%. Facial swelling or hypoesthesia, mostly of a mild-moderate grade appeared in 7.5% - 51.9% of the patients. Complete anaesthesia dolorosa was registered in only study (5.3%). Cases of hearing loss (2.5%), brainstem edema (5.8%), and neurotrophic keratoplasty (3.5%) were also isolated. The results suggest that stereotactic radiosurgery with linear accelerators could constitute an effective and safe therapeutic alternative for drug-resistant trigeminal neuralgia. However, existing studies leave important doubts as to optimal treatment doses or the therapeutic target, long-term recurrence, and do not help identify which subgroups of patients could most benefit from this technique. Paucity of literature and clear lack of clarification for clinical utilization of this technique.

Where have we been? Where are we going?

PubMed

Gildenberg, P L

1997-01-01

The field of human stereotactic and functional neurosurgery is 50 years old. It began with the pioneering work of Spiegel and Wycis, who developed an apparatus to be used in human neurosurgery designed like the Horsley-Clarke apparatus invented for animal experimentation 40 years earlier, but based on targeting by intracerebral landmarks. During the past half century, the field of stereotactic surgery has evolved from a small field involving a handful of scientists to a field dominated by a technology that is permeating all of neurosurgery. A review of the scientific programs and activities of the World Society for Stereotactic and Functional Neurosurgery reflects the changing level of activity in these fields, the waxing and waning of functional neurosurgery that is now vital and active, and the evolution of stereotactic guidance into the field of computer-assisted neurosurgery. Functional neurosurgery involves the application of human neurophysiology to the treatment of various diseases that produce malfunction of the nervous system, and remains the domain of those few neurosurgeons well versed in neurological pathophysiology. Image-based or computerized stereotactic surgery, on the other hand, is used in those procedures common to neurosurgery, and should be available to any operating neurosurgeon.

Structural Shielding Design of a 6 MV Flattening Filter Free Linear Accelerator: Indian Scenario.

PubMed

Mishra, Bibekananda; Selvam, T Palani; Sharma, P K Dash

2017-01-01

Detailed structural shielding of primary and secondary barriers for a 6 MV medical linear accelerator (LINAC) operated with flattening filter (FF) and flattening filter free (FFF) modes are calculated. The calculations have been carried out by two methods, one using the approach given in National Council on Radiation Protection (NCRP) Report No. 151 and the other based on the monitor units (MUs) delivered in clinical practice. Radiation survey of the installations was also carried out. NCRP approach suggests that the primary and secondary barrier thicknesses are higher by 24% and 26%. respectively, for a LINAC operated in FF mode to that of a LINAC operated in both FF and FFF modes with an assumption that only 20% of the workload is shared in FFF mode. Primary and secondary barrier thicknesses calculated from MUs delivered on clinical practice method also show the same trend and are higher by 20% and 19%, respectively, for a LINAC operated in FF mode to that of a LINAC operated in both FF and FFF modes. Overall, the barrier thickness for a LINAC operated in FF mode is higher about 20% to that of a LINAC operated in both FF and FFF modes.

Structural Shielding Design of a 6 MV Flattening Filter Free Linear Accelerator: Indian Scenario

PubMed Central

Mishra, Bibekananda; Selvam, T. Palani; Sharma, P. K. Dash

2017-01-01

Detailed structural shielding of primary and secondary barriers for a 6 MV medical linear accelerator (LINAC) operated with flattening filter (FF) and flattening filter free (FFF) modes are calculated. The calculations have been carried out by two methods, one using the approach given in National Council on Radiation Protection (NCRP) Report No. 151 and the other based on the monitor units (MUs) delivered in clinical practice. Radiation survey of the installations was also carried out. NCRP approach suggests that the primary and secondary barrier thicknesses are higher by 24% and 26%. respectively, for a LINAC operated in FF mode to that of a LINAC operated in both FF and FFF modes with an assumption that only 20% of the workload is shared in FFF mode. Primary and secondary barrier thicknesses calculated from MUs delivered on clinical practice method also show the same trend and are higher by 20% and 19%, respectively, for a LINAC operated in FF mode to that of a LINAC operated in both FF and FFF modes. Overall, the barrier thickness for a LINAC operated in FF mode is higher about 20% to that of a LINAC operated in both FF and FFF modes. PMID:28405104

Stereotactic radiosurgery versus stereotactic radiotherapy for patients with vestibular schwannoma: a Leksell Gamma Knife Society 2000 debate.

PubMed

Linskey, M E

2000-12-01

By definition, the term "radiosurgery" refers to the delivery of a therapeutic radiation dose in a single fraction, not simply the use of stereotaxy. Multiple-fraction delivery is better termed "stereotactic radiotherapy." There are compelling radiobiological principles supporting the biological superiority of single-fraction radiation for achieving an optimal therapeutic response for the slowly proliferating, late-responding, tissue of a schwannoma. It is axiomatic that complication avoidance requires precise three-dimensional conformality between treatment and tumor volumes. This degree of conformality can only be achieved through complex multiisocenter planning. Alternative radiosurgery devices are generally limited to delivering one to four isocenters in a single treatment session. Although they can reproduce dose plans similar in conformality to early gamma knife dose plans by using a similar number of isocenters, they cannot reproduce the conformality of modern gamma knife plans based on magnetic resonance image-targeted localization and five to 30 isocenters. A disturbing trend is developing in which institutions without nongamma knife radiosurgery (GKS) centers are championing and/or shifting to hypofractionated stereotactic radiotherapy for vestibular schwannomas. This trend appears to be driven by a desire to reduce complication rates to compete with modern GKS results by using complex multiisocenter planning. Aggressive advertising and marketing from some of these centers even paradoxically suggests biological superiority of hypofractionation approaches over single-dose radiosurgery for vestibular schwannomas. At the same time these centers continue to use the term radiosurgery to describe their hypofractionated radiotherapy approach in an apparent effort to benefit from a GKS "halo effect." It must be reemphasized that as neurosurgeons our primary duty is to achieve permanent tumor control for our patients and not to eliminate complications at the expense of potential late recurrence. The answer to minimizing complications while maintaining maximum tumor control is improved conformality of radiosurgery dose planning and not resorting to homeopathic radiosurgery doses or hypofractionation radiotherapy schemes.

Stereotactic radiosurgery versus stereotactic radiotherapy for patients with vestibular schwannoma: a Leksell Gamma Knife Society 2000 debate.

PubMed

Linskey, Mark E

2013-12-01

By definition, the term "radiosurgery" refers to the delivery of a therapeutic radiation dose in a single fraction, not simply the use of stereotaxy. Multiple-fraction delivery is better termed "stereotactic radiotherapy." There are compelling radiobiological principles supporting the biological superiority of single-fraction radiation for achieving an optimal therapeutic response for the slowly proliferating, late-responding, tissue of a schwannoma. It is axiomatic that complication avoidance requires precise three-dimensional conformality between treatment and tumor volumes. This degree of conformality can only be achieved through complex multiisocenter planning. Alternative radiosurgery devices are generally limited to delivering one to four isocenters in a single treatment session. Although they can reproduce dose plans similar in conformality to early gamma knife dose plans by using a similar number of isocenters, they cannot reproduce the conformality of modern gamma knife plans based on magnetic resonance image--targeted localization and five to 30 isocenters. A disturbing trend is developing in which institutions without nongamma knife radiosurgery (GKS) centers are championing and/or shifting to hypofractionated stereotactic radiotherapy for vestibular schwannomas. This trend appears to be driven by a desire to reduce complication rates to compete with modern GKS results by using complex multiisocenter planning. Aggressive advertising and marketing from some of these centers even paradoxically suggests biological superiority of hypofractionation approaches over single-dose radiosurgery for vestibular schwannomas. At the same time these centers continue to use the term radiosurgery to describe their hypofractionated radiotherapy approach in an apparent effort to benefit from a GKS "halo effect." It must be reemphasized that as neurosurgeons our primary duty is to achieve permanent tumor control for our patients and not to eliminate complications at the expense of potential late recurrence. The answer to minimizing complications while maintaining maximum tumor control is improved conformality of radiosurgery dose planning and not resorting to homeopathic radiosurgery doses or hypofractionation radiotherapy schemes.

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

Liu, Derek; Mutanga, Theodore

Purpose: An end-to-end testing methodology was designed to evaluate the overall SRS treatment fidelity, incorporating all steps in the linac-based frameless radiosurgery treatment delivery process. The study details our commissioning experience of the Steev (CIRS, Norfolk, VA) stereotactic anthropomorphic head phantom including modification, test design, and baseline measurements. Methods: Repeated MR and CT scans were performed with interchanging inserts. MR-CT fusion accuracy was evaluated and the insert spatial coincidence was verified on CT. Five non-coplanar arcs delivered a prescription dose to a 15 mm spherical CTV with 2 mm PTV margin. Following setup, CBCT-based shifts were applied as per protocol.more » Sequential measurements were performed by interchanging inserts without disturbing the setup. Spatial and dosimetric accuracy was assessed by a combination of CBCT hidden target, radiochromic film, and ion chamber measurements. To facilitate film registration, the film insert was modified in-house by etching marks. Results: MR fusion error and insert spatial coincidences were within 0.3 mm. Both CBCT and film measurements showed spatial displacements of 1.0 mm in similar directions. Both coronal and sagittal films reported 2.3 % higher target dose relative to the treatment plan. The corrected ion chamber measurement was similarly greater by 1.0 %. The 3 %/2 mm gamma pass rate was 99% for both films Conclusions: A comprehensive end-to-end testing methodology was implemented for our SRS QA program. The Steev phantom enabled realistic evaluation of the entire treatment process. Overall spatial and dosimetric accuracy of the delivery were 1 mm and 3 % respectively.« less

Monte Carlo based, patient-specific RapidArc QA using Linac log files.

PubMed

Teke, Tony; Bergman, Alanah M; Kwa, William; Gill, Bradford; Duzenli, Cheryl; Popescu, I Antoniu

2010-01-01

A Monte Carlo (MC) based QA process to validate the dynamic beam delivery accuracy for Varian RapidArc (Varian Medical Systems, Palo Alto, CA) using Linac delivery log files (DynaLog) is presented. Using DynaLog file analysis and MC simulations, the goal of this article is to (a) confirm that adequate sampling is used in the RapidArc optimization algorithm (177 static gantry angles) and (b) to assess the physical machine performance [gantry angle and monitor unit (MU) delivery accuracy]. Ten clinically acceptable RapidArc treatment plans were generated for various tumor sites and delivered to a water-equivalent cylindrical phantom on the treatment unit. Three Monte Carlo simulations were performed to calculate dose to the CT phantom image set: (a) One using a series of static gantry angles defined by 177 control points with treatment planning system (TPS) MLC control files (planning files), (b) one using continuous gantry rotation with TPS generated MLC control files, and (c) one using continuous gantry rotation with actual Linac delivery log files. Monte Carlo simulated dose distributions are compared to both ionization chamber point measurements and with RapidArc TPS calculated doses. The 3D dose distributions were compared using a 3D gamma-factor analysis, employing a 3%/3 mm distance-to-agreement criterion. The dose difference between MC simulations, TPS, and ionization chamber point measurements was less than 2.1%. For all plans, the MC calculated 3D dose distributions agreed well with the TPS calculated doses (gamma-factor values were less than 1 for more than 95% of the points considered). Machine performance QA was supplemented with an extensive DynaLog file analysis. A DynaLog file analysis showed that leaf position errors were less than 1 mm for 94% of the time and there were no leaf errors greater than 2.5 mm. The mean standard deviation in MU and gantry angle were 0.052 MU and 0.355 degrees, respectively, for the ten cases analyzed. The accuracy and flexibility of the Monte Carlo based RapidArc QA system were demonstrated. Good machine performance and accurate dose distribution delivery of RapidArc plans were observed. The sampling used in the TPS optimization algorithm was found to be adequate.

Improving treatment geometries in total skin electron therapy: Experimental investigation of linac angles and floor scatter dose contributions using Cherenkov imaging.

PubMed

Andreozzi, Jacqueline M; Brůža, Petr; Tendler, Irwin I; Mooney, Karen E; Jarvis, Lesley A; Cammin, Jochen; Li, Harold; Pogue, Brian W; Gladstone, David J

2018-06-01

The purpose of this study was to identify the optimal treatment geometry for total skin electron therapy (TSET) using a new optimization metric from Cherenkov image analysis, and to investigate the sensitivity of the Cherenkov imaging method to floor scatter effects in this unique treatment setup. Cherenkov imaging using an intensified charge coupled device (ICCD) was employed to measure the relative surface dose distribution as a 2D image in the total skin electron treatment plane. A 1.2 m × 2.2 m × 1 cm white polyethylene sheet was placed vertically at a source to surface distance (SSD) of 300 cm, and irradiated with 6 MeV high dose rate TSET beams. The linear accelerator coordinate system used stipulates 0° is the bottom of the gantry arc, and progresses counterclockwise so that gantry angle 270° produces a horizontal beam orthogonal to the treatment plane. First, all unique pairs of treatment beams were analyzed to determine the performance of the currently recommended symmetric treatment angles (±20° from the horizontal), compared to treatment geometries unconstrained to upholding gantry angle symmetry. This was performed on two medical linear accelerators (linacs). Second, the extent of the floor scatter contributions to measured surface dose at the extended SSD required for TSET were imaged using three gantry angles of incidence: 270° (horizontal), 253° (-17°), and 240° (-30°). Images of the surface dose profile at each angle were compared to the standard concrete floor when steel plates, polyvinyl chloride (PVC), and solid water were placed on the ground at the base of the treatment plane. Postprocessing of these images allowed for comparison of floor material-based scatter profiles with previously published simulation results. Analysis of the symmetric treatment geometry (270 ± 20°) and the identified optimal treatment geometry (270 + 23° and 270 - 17°) showed a 16% increase in the 90% isodose area for the latter field pair on the first linac. The optimal asymmetric pair for the second linac (270 + 25° and 270 - 17°) provided a 52% increase in the 90% isodose area when compared to the symmetric geometry. Difference images between Cherenkov images captured with test materials (steel, PVC, and solid water) and the control (concrete floor) demonstrated relative changes in the two-dimensional (2D) dose profile over a 1 × 1.9 m region of interest (ROI) that were consistent with published simulation data. Qualitative observation of the residual images demonstrates localized increases and decreases with respect to the change in floor material and gantry angle. The most significant changes occurred when the beam was most directly impinging the floor (gantry angle 240°, horizontal -30°), where the PVC floor material decreased scatter dose by 1-3% in 7.2% of the total ROI area, and the steel plate increased scatter dose by 1-3% in 7.0% of the total ROI area. An updated Cherenkov imaging method identified asymmetric, machine-dependent TSET field angle pairs that provided much larger 90% isodose areas than the commonly adopted symmetric geometry suggested by Task Group 30 Report 23. A novel demonstration of scatter dose Cherenkov imaging in the TSET field was established. © 2018 American Association of Physicists in Medicine.

Integer programming for improving radiotherapy treatment efficiency.

PubMed

Lv, Ming; Li, Yi; Kou, Bo; Zhou, Zhili

2017-01-01

Patients received by radiotherapy departments are diverse and may be diagnosed with different cancers. Therefore, they need different radiotherapy treatment plans and thus have different needs for medical resources. This research aims to explore the best method of scheduling the admission of patients receiving radiotherapy so as to reduce patient loss and maximize the usage efficiency of service resources. A mix integer programming (MIP) model integrated with special features of radiotherapy is constructed. The data used here is based on the historical data collected and we propose an exact method to solve the MIP model. Compared with the traditional First Come First Served (FCFS) method, the new method has boosted patient admission as well as the usage of linear accelerators (LINAC) and beds. The integer programming model can be used to describe the complex problem of scheduling radio-receiving patients, to identify the bottleneck resources that hinder patient admission, and to obtain the optimal LINAC-bed radio under the current data conditions. Different management strategies can be implemented by adjusting the settings of the MIP model. The computational results can serve as a reference for the policy-makers in decision making.

SU-E-T-626: Accuracy of Dose Calculation Algorithms in MultiPlan Treatment Planning System in Presence of Heterogeneities

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

Moignier, C; Huet, C; Barraux, V

Purpose: Advanced stereotactic radiotherapy (SRT) treatments require accurate dose calculation for treatment planning especially for treatment sites involving heterogeneous patient anatomy. The purpose of this study was to evaluate the accuracy of dose calculation algorithms, Raytracing and Monte Carlo (MC), implemented in the MultiPlan treatment planning system (TPS) in presence of heterogeneities. Methods: First, the LINAC of a CyberKnife radiotherapy facility was modeled with the PENELOPE MC code. A protocol for the measurement of dose distributions with EBT3 films was established and validated thanks to comparison between experimental dose distributions and calculated dose distributions obtained with MultiPlan Raytracing and MCmore » algorithms as well as with the PENELOPE MC model for treatments planned with the homogenous Easycube phantom. Finally, bones and lungs inserts were used to set up a heterogeneous Easycube phantom. Treatment plans with the 10, 7.5 or the 5 mm field sizes were generated in Multiplan TPS with different tumor localizations (in the lung and at the lung/bone/soft tissue interface). Experimental dose distributions were compared to the PENELOPE MC and Multiplan calculations using the gamma index method. Results: Regarding the experiment in the homogenous phantom, 100% of the points passed for the 3%/3mm tolerance criteria. These criteria include the global error of the method (CT-scan resolution, EBT3 dosimetry, LINAC positionning …), and were used afterwards to estimate the accuracy of the MultiPlan algorithms in heterogeneous media. Comparison of the dose distributions obtained in the heterogeneous phantom is in progress. Conclusion: This work has led to the development of numerical and experimental dosimetric tools for small beam dosimetry. Raytracing and MC algorithms implemented in MultiPlan TPS were evaluated in heterogeneous media.« less

Poster — Thur Eve — 37: Respiratory gating with an Elekta flattening filter free photon beam

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

Péloquin, S; Furstoss, C; Munger, P

2014-08-15

In cases where surgery is not possible for lung cancer treatment, stereotactic body radiation therapy (SBRT) may be an option. One problem when treating this type of cancer is the motion of the lungs caused by the patient's respiration. It is possible to reduce the impact of this movement with the use of respiratory gating. By combining respiratory gating with a flattening filter free (FFF) photon beam linac, the increased treatment time caused by a reduced beam-on time of respiratory gating methods can be compensated by the inherent increased dose rate of FFF beams. This project's aim is to createmore » hardware and software interfaces allowing free respiration gating on an Elekta Synergy-S linac specially modified to deliver 6 MV FFF photon beams. First, a printed circuit board was created for reading the signal from a Bellows Belt from Philips (a respiration monitor belt) and transmitting an On/Off signal to the accelerator. A software was also developed to visualize patient respiration. Secondly, a FFF model was created with the Pinnacle treatment planning system from Philips. Gamma (Γ) analysis (2%, 2 mm) was used to evaluate model. For fields going from 5.6 × 5.6 to 12 × 12 cm{sup 2}, central axis depth dose model fitting shows an average gamma value of 0.2 and 100% of gamma values remain under the Γ = 1 limit. For smaller fields (0.8 × 0.8 and 1.6 × 1.6 cm{sup 2}), Pinnacle has more trouble trying to fit the measurements, overestimating dose in penumbra and buildup regions.« less

Surface production dominating Cs-free H- ion source for high intensity and high energy proton accelerators

NASA Astrophysics Data System (ADS)

Ueno, Akira; Ikegami, Kiyoshi; Kondo, Yasuhiro

2004-05-01

A Cs-free negative hydrogen (H-) ion source driven by pulsed arc plasma with a LaB6 filament is being operated for the beam tests of the Japan Proton Accelerator Research Complex (J-PARC) linac. A peak H- current of 38 mA, which exceeds the requirement of the J-PARC first stage, is stably extracted from the ion source with a beam duty factor of 0.9% (360 μs×25 Hz) by principally optimizing the surface condition and shape of the plasma electrode. The sufficiently small emittance of the beam was confirmed by high transmission efficiency (around 90%) through the following 324 MHz 3 MeV J-PARC radio frequency quadrupole linac (M. Ikegami et al., Proc. 2003 Part. Accel. Conf. 2003, p. 1509). The process of the optimization, which confirms the validity of hypothesis that H- ions are produced by surface reaction on a Mo plasma electrode dominantly in the ion source, is presented.

Noncoplanar Beam Angle Class Solutions to Replace Time-Consuming Patient-Specific Beam Angle Optimization in Robotic Prostate Stereotactic Body Radiation Therapy

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

Rossi, Linda, E-mail: l.rossi@erasmusmc.nl; Breedveld, Sebastiaan; Aluwini, Shafak

Purpose: To investigate development of a recipe for the creation of a beam angle class solution (CS) for noncoplanar prostate stereotactic body radiation therapy to replace time-consuming individualized beam angle selection (iBAS) without significant loss in plan quality, using the in-house “Erasmus-iCycle” optimizer for fully automated beam profile optimization and iBAS. Methods and Materials: For 30 patients, Erasmus-iCycle was first used to generate 15-, 20-, and 25-beam iBAS plans for a CyberKnife equipped with a multileaf collimator. With these plans, 6 recipes for creation of beam angle CSs were investigated. Plans of 10 patients were used to create CSs based on themore » recipes, and the other 20 to independently test them. For these tests, Erasmus-iCycle was also used to generate intensity modulated radiation therapy plans for the fixed CS beam setups. Results: Of the tested recipes for CS creation, only 1 resulted in 15-, 20-, and 25-beam noncoplanar CSs without plan deterioration compared with iBAS. For the patient group, mean differences in rectum D{sub 1cc}, V{sub 60GyEq}, V{sub 40GyEq}, and D{sub mean} between 25-beam CS plans and 25-beam plans generated with iBAS were 0.2 ± 0.4 Gy, 0.1% ± 0.2%, 0.2% ± 0.3%, and 0.1 ± 0.2 Gy, respectively. Differences between 15- and 20-beam CS and iBAS plans were also negligible. Plan quality for CS plans relative to iBAS plans was also preserved when narrower planning target volume margins were arranged and when planning target volume dose inhomogeneity was decreased. Using a CS instead of iBAS reduced the computation time by a factor of 14 to 25, mainly depending on beam number, without loss in plan quality. Conclusions: A recipe for creation of robust beam angle CSs for robotic prostate stereotactic body radiation therapy has been developed. Compared with iBAS, computation times decreased by a factor 14 to 25. The use of a CS may avoid long planning times without losses in plan quality.« less

Process simulations for the LCLS-II cryogenic systems

NASA Astrophysics Data System (ADS)

Ravindranath, V.; Bai, H.; Heloin, V.; Fauve, E.; Pflueckhahn, D.; Peterson, T.; Arenius, D.; Bevins, M.; Scanlon, C.; Than, R.; Hays, G.; Ross, M.

2017-12-01

Linac Coherent Light Source II (LCLS-II), a 4 GeV continuous-wave (CW) superconducting electron linear accelerator, is to be constructed in the existing two mile Linac facility at the SLAC National Accelerator Laboratory. The first light from the new facility is scheduled to be in 2020. The LCLS-II Linac consists of thirty-five 1.3 GHz and two 3.9 GHz superconducting cryomodules. The Linac cryomodules require cryogenic cooling for the super-conducting niobium cavities at 2.0 K, low temperature thermal intercept at 5.5-7.5 K, and a thermal shield at 35-55 K. The equivalent 4.5 K refrigeration capacity needed for the Linac operations range from a minimum of 11 kW to a maximum of 24 kW. Two cryogenic plants with 18 kW of equivalent 4.5 K refrigeration capacity will be used for supporting the Linac cryogenic cooling requirements. The cryogenic plants are based on the Jefferson Lab’s CHL-II cryogenic plant design which uses the “Floating Pressure” design to support a wide variation in the cooling load. In this paper, the cryogenic process for the integrated LCLS-II cryogenic system and the process simulation for a 4.5 K cryoplant in combination with a 2 K cold compressor box, and the Linac cryomodules are described.

Customized, Miniature Rapid-Prototype Stereotactic Frames for Use in Deep Brain Stimulator Surgery: Initial Clinical Methodology and Experience from 263 Patients from 2002 to 2008

PubMed Central

Konrad, Peter E.; Neimat, Joseph S.; Yu, Hong; Kao, Chris C.; Remple, Michael S.; D'Haese, Pierre-François; Dawant, Benoit M.

2011-01-01

Background The microTargeting™ platform (MTP) stereotaxy system (FHC Inc., Bowdoin, Me., USA) was FDA approved in 2001 utilizing rapid-prototyping technology to create custom platforms for human stereotaxy procedures. It has also been called the STarFix (surgical targeting fixture) system since it is based on the concept of a patient- and procedure-specific surgical fixture. This is an alternative stereotactic method by which planned trajectories are incorporated into custom-built, miniature stereotactic platforms mounted onto bone fiducial markers. Our goal is to report the clinical experience with this system over a 6-year period. Methods We present the largest reported series of patients who underwent deep brain stimulation (DBS) implantations using customized rapidly prototyped stereotactic frames (MTP). Clinical experience and technical features for the use of this stereotactic system are described. Final lead location analysis using postoperative CT was performed to measure the clinical accuracy of the stereotactic system. Results Our series included 263 patients who underwent 284 DBS implantation surgeries at one institution over a 6-year period. The clinical targeting error without accounting for brain shift in this series was found to be 1.99 mm (SD 0.9). Operating room time was reduced through earlier incision time by 2 h per case. Conclusion Customized, miniature stereotactic frames, namely STarFix platforms, are an acceptable and efficient alternative method for DBS implantation. Its clinical accuracy and outcome are comparable to those associated with traditional stereotactic frame systems. PMID:21160241

Experimental benchmark of the NINJA code for application to the Linac4 H- ion source plasma

NASA Astrophysics Data System (ADS)

Briefi, S.; Mattei, S.; Rauner, D.; Lettry, J.; Tran, M. Q.; Fantz, U.

2017-10-01

For a dedicated performance optimization of negative hydrogen ion sources applied at particle accelerators, a detailed assessment of the plasma processes is required. Due to the compact design of these sources, diagnostic access is typically limited to optical emission spectroscopy yielding only line-of-sight integrated results. In order to allow for a spatially resolved investigation, the electromagnetic particle-in-cell Monte Carlo collision code NINJA has been developed for the Linac4 ion source at CERN. This code considers the RF field generated by the ICP coil as well as the external static magnetic fields and calculates self-consistently the resulting discharge properties. NINJA is benchmarked at the diagnostically well accessible lab experiment CHARLIE (Concept studies for Helicon Assisted RF Low pressure Ion sourcEs) at varying RF power and gas pressure. A good general agreement is observed between experiment and simulation although the simulated electron density trends for varying pressure and power as well as the absolute electron temperature values deviate slightly from the measured ones. This can be explained by the assumption of strong inductive coupling in NINJA, whereas the CHARLIE discharges show the characteristics of loosely coupled plasmas. For the Linac4 plasma, this assumption is valid. Accordingly, both the absolute values of the accessible plasma parameters and their trends for varying RF power agree well in measurement and simulation. At varying RF power, the H- current extracted from the Linac4 source peaks at 40 kW. For volume operation, this is perfectly reflected by assessing the processes in front of the extraction aperture based on the simulation results where the highest H- density is obtained for the same power level. In surface operation, the production of negative hydrogen ions at the converter surface can only be considered by specialized beam formation codes, which require plasma parameters as input. It has been demonstrated that this input can be provided reliably by the NINJA code.

Development of a frameless stereotactic radiosurgery system based on real-time 6D position monitoring and adaptive head motion compensation

NASA Astrophysics Data System (ADS)

Wiersma, Rodney D.; Wen, Zhifei; Sadinski, Meredith; Farrey, Karl; Yenice, Kamil M.

2010-01-01

Stereotactic radiosurgery delivers radiation with great spatial accuracy. To achieve sub-millimeter accuracy for intracranial SRS, a head ring is rigidly fixated to the skull to create a fixed reference. For some patients, the invasiveness of the ring can be highly uncomfortable and not well tolerated. In addition, placing and removing the ring requires special expertise from a neurosurgeon, and patient setup time for SRS can often be long. To reduce the invasiveness, hardware limitations and setup time, we are developing a system for performing accurate head positioning without the use of a head ring. The proposed method uses real-time 6D optical position feedback for turning on and off the treatment beam (gating) and guiding a motor-controlled 3D head motion compensation stage. The setup consists of a central control computer, an optical patient motion tracking system and a 3D motion compensation stage attached to the front of the LINAC couch. A styrofoam head cast was custom-built for patient support and was mounted on the compensation stage. The motion feedback of the markers was processed by the control computer, and the resulting motion of the target was calculated using a rigid body model. If the target deviated beyond a preset position of 0.2 mm, an automatic position correction was performed with stepper motors to adjust the head position via the couch mount motion platform. In the event the target deviated more than 1 mm, a safety relay switch was activated and the treatment beam was turned off. The feasibility of the concept was tested using five healthy volunteers. Head motion data were acquired with and without the use of motion compensation over treatment times of 15 min. On average, test subjects exceeded the 0.5 mm tolerance 86% of the time and the 1.0 mm tolerance 45% of the time without motion correction. With correction, this percentage was reduced to 5% and 2% for the 0.5 mm and 1.0 mm tolerances, respectively.

WE-AB-207B-01: Dose Tolerance for SBRT/SABR

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

Grimm, J

Purpose: Stereotactic body radiation therapy (SBRT) / stereotactic ablative body radiotherapy (SABR) is gaining popularity, but quantitative dose tolerance has still been lacking. To improve this, the April 2016 issue of Seminars in Radiation Oncology will have normal tissue complication probability (NTCP) models for 10 critical structures: optic pathway, cochlea, oral mucosa, esophagus, chestwall, aorta, bronchi, duodenum, small bowel, and spinal cord. Methods: The project included more than 1500 treatments in 1–5 fractions using CyberKnife, Gamma Knife, or LINAC, with 60 authors from 15 institutions. NTCP models were constructed from the 97 grade 2–3 complications, predominantly scored using the commonmore » terminology criteria for adverse events (CTCAEv4). Dose volume histogram (DVH) data from each institutional dataset was loaded into the DVH Evaluator software (DiversiLabs, LLC, Huntingdon Valley, Pa) for modeling. The current state of the literature for the critical structures was depicted using DVH Risk Maps: comparative graphs of dose tolerance limits that can include estimated risk levels, reported complications, DVH data for study patients, as well as high- and low-risk dose tolerance limits. Results: For relatively acceptable toxicity like grade 1–3 rib fractures and chestwall pain, the high-risk limits have 50% risk and the low-risk limits have 5% risk. Emami et al (IJROBP 1991 May 15;21(1):109–22) used 50% and 5% risk levels for all structures, whereas this effort used clinically acceptable ranges for each: in structures like aorta or spinal cord where complications must be avoided, the high- and low-risk limits have about 3% and 1% risk, respectively, in this issue of Seminars. These statistically based guidelines can help ensure plan quality for each patient. Conclusion: NTCP for SBRT is now becoming available. Hypofractionated dose tolerance can be dramatically different than extrapolations of conventional fractionation so NTCP analysis of the SBRT/SBRT data is important to ensure safe clinical practice. Dr. Grimm, designed and holds intellectual property rights to the DVH Evaluator software tool which is an FDA-cleared product in commercial use, and was used to analyze the data.« less

Reproducibility of patient positioning for fractionated extracranial stereotactic radiotherapy using a double-vacuum technique.

PubMed

Nevinny-Stickel, Meinhard; Sweeney, Reinhart A; Bale, Reto J; Posch, Andrea; Auberger, Thomas; Lukas, Peter

2004-02-01

Precise reproducible patient positioning is a prerequisite for conformal fractionated radiotherapy. A fixation system based on double-vacuum technology is presented which can be used for conventional as well as hypofractionated stereotactic extracranial radiotherapy. To form the actual vacuum mattress, the patient is pressed into the mattress with a vacuum foil which can also be used for daily repositioning and fixation. A stereotactic frame can be positioned over the region of interest on an indexed base plate. Repositioning accuracy was determined by comparing daily, pretreatment, orthogonal portal images to the respective digitally reconstructed radiographs (DRRs) in ten patients with abdominal and pelvic lesions receiving extracranial fractionated (stereotactic) radiotherapy. The three-dimensional (3-D) vectors and 95% confidence intervals (CI) were calculated from the respective deviations in the three axes. Time required for initial mold production and daily repositioning was also determined. The mean 3-D repositioning error (187 fractions) was 2.5 +/- 1.1 mm. The largest single deviation (10 mm) was observed in a patient treated in prone position. Mold production took an average of 15 min (10-30 min). Repositioning times are not necessarily longer than using no positioning aid at all. The presented fixation system allows reliable, flexible and efficient patient positioning for extracranial stereotactic radiotherapy.

Compact, inexpensive, epithermal neutron source for BNCT

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

Swenson, D. A.

1999-06-10

A new rf-focused linac structure, designed specifically to increase the acceleration efficiency and reduce the cost of linac structures in the few-MeV range, may win the role as the optimum accelerator-based epithermal neutron source for the BNCT application. This new linac structure resembles a drift tube linac (DTL) with radio frequency quadrupole (RFQ) focusing incorporated into each 'drift tube,' hence the name R lowbar f F lowbar ocused D lowbar TL, or RFD. It promises superior acceleration properties, focusing properties, and CW capabilities. We have a proposal under consideration for the development of an epithermal neutron source, based on themore » 2.5-MeV RFD linac system with an average current of 10 mA, having the following components: an ion source, a short low-energy transport system, a short RFQ linac section, an RFD linac section, an rf power system, a high-energy beam transport system, a proton beam target, and a neutron beam moderator system. We propose to develop a solid lithium target for this application in the form of a thin lithium layer on the inner surface of a truncated aluminum cone, cooled by the heavy water moderator, where the proton beam is expanded to a diameter of 3 cm and scanned along a circular path, striking the lithium layer at the cone's half-angle of 30 degrees. We propose to develop a moderator assembly designed to transmit a large fraction of the source neutrons from the target to the patient treatment port, while shifting the neutron energies to an appropriate epithermal energy spectrum and minimizing the gamma-ray dose. The status of this proposal and these plans are presented.« less

Analysis of the LSC microbunching instability in MaRIE linac reference design

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

Yampolsky, Nikolai

In this report we estimate the effect of the microbunching instability in the MaRIE XFEL linac. The reference design for the linac is described in a separate report. The parameters of the L1, L2, and L3 linacs as well as BC1 and BC2 bunch compressors were the same as in the referenced report. The beam dynamics was assumed to be linear along the accelerator (which is a reasonable assumption for estimating the effect of the microbunching instability). The parameters of the bunch also match the parameters described in the referenced report. Additionally, it was assumed that the beam radius ismore » equal to R = 100 m and does not change along linac. This assumption needs to be revisited at later studies. The beam dynamics during acceleration was accounted in the matrix formalism using a Matlab code. The input parameters for the linacs are: RF peak gradient, RF frequency, RF phase, linac length, and initial beam energy. The energy gain and the imposed chirp are calculated based on the RF parameters self-consistently. The bunch compressors are accounted in the matrix formalism as well. Each chicane is characterized by the beam energy and the R56 matrix element. It was confirmed that the linac and beam parameters described previously provide two-stage bunch compression with compression ratios of 10 and 20 resulting in the bunch of 3kA peak current.« less

Focus characterization at an X-ray free-electron laser by coherent scattering and speckle analysis

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

Sikorski, Marcin; Song, Sanghoon; Schropp, Andreas

2015-04-14

X-ray focus optimization and characterization based on coherent scattering and quantitative speckle size measurements was demonstrated at the Linac Coherent Light Source. Its performance as a single-pulse free-electron laser beam diagnostic was tested for two typical focusing configurations. The results derived from the speckle size/shape analysis show the effectiveness of this technique in finding the focus' location, size and shape. In addition, its single-pulse compatibility enables users to capture pulse-to-pulse fluctuations in focus properties compared with other techniques that require scanning and averaging.

Low incidence of chest wall pain with a risk-adapted lung stereotactic body radiation therapy approach using three or five fractions based on chest wall dosimetry.

PubMed

Coroller, Thibaud P; Mak, Raymond H; Lewis, John H; Baldini, Elizabeth H; Chen, Aileen B; Colson, Yolonda L; Hacker, Fred L; Hermann, Gretchen; Kozono, David; Mannarino, Edward; Molodowitch, Christina; Wee, Jon O; Sher, David J; Killoran, Joseph H

2014-01-01

To examine the frequency and potential of dose-volume predictors for chest wall (CW) toxicity (pain and/or rib fracture) for patients receiving lung stereotactic body radiotherapy (SBRT) using treatment planning methods to minimize CW dose and a risk-adapted fractionation scheme. We reviewed data from 72 treatment plans, from 69 lung SBRT patients with at least one year of follow-up or CW toxicity, who were treated at our center between 2010 and 2013. Treatment plans were optimized to reduce CW dose and patients received a risk-adapted fractionation of 18 Gy×3 fractions (54 Gy total) if the CW V30 was less than 30 mL or 10-12 Gy×5 fractions (50-60 Gy total) otherwise. The association between CW toxicity and patient characteristics, treatment parameters and dose metrics, including biologically equivalent dose, were analyzed using logistic regression. With a median follow-up of 20 months, 6 (8.3%) patients developed CW pain including three (4.2%) grade 1, two (2.8%) grade 2 and one (1.4%) grade 3. Five (6.9%) patients developed rib fractures, one of which was symptomatic. No significant associations between CW toxicity and patient and dosimetric variables were identified on univariate nor multivariate analysis. Optimization of treatment plans to reduce CW dose and a risk-adapted fractionation strategy of three or five fractions based on the CW V30 resulted in a low incidence of CW toxicity. Under these conditions, none of the patient characteristics or dose metrics we examined appeared to be predictive of CW pain.

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

PubMed

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

2017-01-01

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

Salvage prostate re-irradiation using high-dose-rate brachytherapy or focal stereotactic body radiotherapy for local recurrence after definitive radiation therapy.

PubMed

Mbeutcha, Aurélie; Chauveinc, Laurent; Bondiau, Pierre-Yves; Chand, Marie-Eve; Durand, Matthieu; Chevallier, Daniel; Amiel, Jean; Kee, Daniel Lam Cham; Hannoun-Lévi, Jean-Michel

2017-03-09

Optimal management of locally recurrent prostate cancer after definitive radiation therapy is still challenging. With the development of highly accurate radiotherapy devices, prostate salvage re-irradiation might generate lower toxicity rates than classical salvage therapies. We retrospectively evaluated the toxicity and the feasibility of a prostate re-irradiation after definitive radiation therapy failure. Two modalities were investigated: high-dose-rate brachytherapy (HDRB) on whole prostate gland and focal stereotactic radiotherapy (SBRT) using CyberKnife® linac. Between 2011 and 2015, 28 patients with imaged and/or biopsy-proven intra-prostatic recurrence of cancer after definitive radiation therapy underwent a salvage re-irradiation using HDRB (n = 10) or focal SBRT (n = 18). The schedule of re-irradiation was 35 Gy in 5 fractions. Biological response (defined as post-salvage radiation PSA variation) and biochemical no-evidence of disease (bNED) were evaluated in the whole cohort. For patients who had a positive biological response after salvage radiation, biochemical recurrence (BCR) and survival after salvage radiotherapy were evaluated. Post-salvage toxicities were assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.03 and were compared to baseline status. Within a median follow-up of 22.5 months (IQR = 8-42), 9 (90%) patients experienced a positive biological response after salvage HDRB and 5 (50%) remained bNED at the end of the follow-up. Among patients who initially responded to salvage HDRB, the BCR rate was 44.4% after a median interval of 19.5 months (IQR = 11.5-26). Only one patient experienced a transient grade 3 urinary complication. In the SBRT group, the median follow-up was 14.5 months (IQR = 7-23) and 10 (55.6%) out of the 18 patients remained bNED. Among the 15 patients who initially responded to salvage SBRT, 5 (33.3%) experienced a BCR. One patient experienced a transient grade 4 urinary complication. At the end of the follow-up, all evaluated patients had a urinary status grade variation ≤ +1 grade. No grade 3-4 digestive toxicity was observed. Salvage prostate re-irradiation for locally recurrent cancer is feasible and generate low toxicities rates when using with HDRB or focal SBRT. However, further investigations are necessary to confirm these findings and to determine predictive features for patients who might benefit from such an approach.

Clinical decision tool for optimal delivery of liver stereotactic body radiation therapy: Photons versus protons.

PubMed

Gandhi, Saumil J; Liang, Xing; Ding, Xuanfeng; Zhu, Timothy C; Ben-Josef, Edgar; Plastaras, John P; Metz, James M; Both, Stefan; Apisarnthanarax, Smith

2015-01-01

Stereotactic body radiation therapy (SBRT) for treatment of liver tumors is often limited by liver dose constraints. Protons offer potential for more liver sparing, but clinical situations in which protons may be superior to photons are not well described. We developed and validated a treatment decision model to determine whether liver tumors of certain sizes and locations are more suited for photon versus proton SBRT. Six spherical mock tumors from 1 to 6 cm in diameter were contoured on computed tomography images of 1 patient at 4 locations: dome, caudal, left medial, and central. Photon and proton plans were generated to deliver 50 Gy in 5 fractions to each tumor and optimized to deliver equivalent target coverage and maximal liver sparing. Using these plans, we developed a hypothesis-generating model to predict the optimal modality for maximal liver sparing based on tumor size and location. We then validated this model in 10 patients with liver tumors. Protons spared significantly more liver than photons for dome or central tumors ≥3 cm (dome: 134 ± 21 cm(3), P = .03; central: 108 ± 4 cm(3), P = .01). Our model correctly predicted the optimal SBRT modality for all 10 patients. For patients with dome or central tumors ≥3 cm, protons significantly increased the volume of liver spared (176 ± 21 cm(3), P = .01) and decreased the mean liver dose (8.4 vs 12.2 Gy, P = .01) while offering no significant advantage for tumors <3 cm at any location or for caudal and left medial tumors of any size. When feasible, protons should be considered as the radiation modality of choice for dome and central tumors >3 cm to allow maximal liver sparing and potentially reduce radiation toxicity. Protons should also be considered for any tumor >5 cm if photon plans fail to achieve adequate coverage or exceed the mean liver threshold. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Using the Malthus programme to predict the recruitment of patients to MR-linac research trials in prostate and lung cancer.

PubMed

Sanderson, Benjamin; McWilliam, Alan; Faivre-Finn, Corinne; Kirkby, Norman Francis; Jena, Rajesh; Mee, Thomas; Choudhury, Ananya

2017-01-01

In this study, we used evidence-based mathematical modelling to predict the patient cohort for MR-linac to assess its feasibility in a time of austerity. We discuss our results and the implications of evidence-based radiotherapy demand modelling tools such as Malthus on the implementation of new technology and value-based healthcare. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

SU-E-J-240: The Impact On Clinical Dose-Distributions When Using MR-Images Registered with Stereotactic CT-Images in Gamma Knife Radiosurgery

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

Benmakhlouf, H; Kraepelien, T; Forander, P

2014-06-01

Purpose: Most Gamma knife treatments are based solely on MR-images. However, for fractionated treatments and to implement TPS dose calculations that require electron densities, CT image data is essential. The purpose of this work is to assess the dosimetric effects of using MR-images registered with stereotactic CT-images in Gamma knife treatments. Methods: Twelve patients treated for vestibular schwannoma with Gamma Knife Perfexion (Elekta Instruments, Sweden) were selected for this study. The prescribed doses (12 Gy to periphery) were delivered based on the conventional approach of using stereotactic MR-images only. These plans were imported into stereotactic CT-images (by registering MR-images withmore » stereotactic CT-images using the Leksell gamma plan registration software). The dose plans, for each patient, are identical in both cases except for potential rotations and translations resulting from the registration. The impact of the registrations was assessed by an algorithm written in Matlab. The algorithm compares the dose-distributions voxel-by-voxel between the two plans, calculates the full dose coverage of the target (treated in the conventional approach) achieved by the CT-based plan, and calculates the minimum dose delivered to the target (treated in the conventional approach) achieved by the CT-based plan. Results: The mean dose difference between the plans was 0.2 Gy to 0.4 Gy (max 4.5 Gy) whereas between 89% and 97% of the target (treated in the conventional approach) received the prescribed dose, by the CT-plan. The minimum dose to the target (treated in the conventional approach) given by the CT-based plan was between 7.9 Gy and 10.7 Gy (compared to 12 Gy in the conventional treatment). Conclusion: The impact of using MR-images registered with stereotactic CT-images has successfully been compared to conventionally delivered dose plans showing significant differences between the two. Although CTimages have been implemented clinically; the effect of the registration has not been fully investigated.« less

Robotic Stereotaxy in Cranial Neurosurgery: A Qualitative Systematic Review.

PubMed

Fomenko, Anton; Serletis, Demitre

2017-12-14

Modern-day stereotactic techniques have evolved to tackle the neurosurgical challenge of accurately and reproducibly accessing specific brain targets. Neurosurgical advances have been made in synergy with sophisticated technological developments and engineering innovations such as automated robotic platforms. Robotic systems offer a unique combination of dexterity, durability, indefatigability, and precision. To perform a systematic review of robotic integration for cranial stereotactic guidance in neurosurgery. Specifically, we comprehensively analyze the strengths and weaknesses of a spectrum of robotic technologies, past and present, including details pertaining to each system's kinematic specifications and targeting accuracy profiles. Eligible articles on human clinical applications of cranial robotic-guided stereotactic systems between 1985 and 2017 were extracted from several electronic databases, with a focus on stereotactic biopsy procedures, stereoelectroencephalography, and deep brain stimulation electrode insertion. Cranial robotic stereotactic systems feature serial or parallel architectures with 4 to 7 degrees of freedom, and frame-based or frameless registration. Indications for robotic assistance are diversifying, and include stereotactic biopsy, deep brain stimulation and stereoelectroencephalography electrode placement, ventriculostomy, and ablation procedures. Complication rates are low, and mainly consist of hemorrhage. Newer systems benefit from increasing targeting accuracy, intraoperative imaging ability, improved safety profiles, and reduced operating times. We highlight emerging future directions pertaining to the integration of robotic technologies into future neurosurgical procedures. Notably, a trend toward miniaturization, cost-effectiveness, frameless registration, and increasing safety and accuracy characterize successful stereotactic robotic technologies. Copyright © 2017 by the Congress of Neurological Surgeons

Assessment of molecular markers demonstrates concordance between samples acquired via stereotactic biopsy and open craniotomy in both anaplastic astrocytomas and glioblastomas.

PubMed

Gessler, Florian; Baumgarten, Peter; Bernstock, Joshua D; Harter, Patrick; Lescher, Stephanie; Senft, Christian; Seifert, Volker; Marquardt, Gerhard; Weise, Lutz

2017-06-01

The classification, treatment and prognosis of high-grade gliomas has been shown to correlate with the expression of molecular markers (e.g. MGMT promotor methylation and IDH1 mutations). Acquisition of tumor samples may be obtained via stereotactic biopsy or open craniotomy. Between the years 2009 and 2013, 22 patients initially diagnosed with HGGs via stereotactic biopsy, that ultimately underwent open craniotomy for resection of their tumor were prospectively included in an institutional glioma database. MGMT promotor analysis was performed using methylation-specific (MS)-PCR and IDH1R132H mutation analysis was performed using immunohistochemistry. Three patients (13.7%) exhibited IDH1R132H mutations in samples obtained via stereotactic biopsy. Tissue derived from stereotaxic biopsy was demonstrated to have MGMT promotor methylation in ten patients (45.5%), while a non-methylated MGMT promotor was demonstrated in ten patients (45.5%); inconclusive results were obtained for the remaining two patients (9%) within our cohort. The initial histologic grading, IDH1R132H mutation and MGMT promotor methylation results were confirmed using samples obtained during open craniotomy in all but one patient; here inconclusive MGMT promotor analysis was obtained in contrast to that which was obtained via stereotactic biopsy. Tumor samples acquired via stereotactic biopsy provide accurate information with regard to clinically relevant molecular markers that have been shown to impact patient care decisions. The profile of markers analyzed in our cohort was nearly concordant between those samples obtained via stereotactic biopsy or open craniotomy thereby suggesting that clinical decisions may be based on the molecular profile of the tumor samples obtained via stereotactic biopsy.

Report of the eRHIC Ring-Ring Working Group

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

Aschenauer, E. C.; Berg, S.; Blaskiewicz, M.

2015-10-13

This report evaluates the ring-ring option for eRHIC as a lower risk alternative to the linac-ring option. The reduced risk goes along with a reduced initial luminosity performance. However, a luminosity upgrade path is kept open. This upgrade path consists of two branches, with the ultimate upgrade being either a ring-ring or a linac-ring scheme. The linac-ring upgrade could be almost identical to the proposed linac-ring scheme, which is based on an ERL in the RHIC tunnel. This linac-ring version has been studied in great detail over the past ten years, and its significant risks are known. On the othermore » hand, no detailed work on an ultimate performance ring-ring scenario has been performed yet, other than the development of a consistent parameter set. Pursuing the ring-ring upgrade path introduces high risks and requires significant design work that is beyond the scope of this report.« less

Design of a modulated orthovoltage stereotactic radiosurgery system.

PubMed

Fagerstrom, Jessica M; Bender, Edward T; Lawless, Michael J; Culberson, Wesley S

2017-07-01

To achieve stereotactic radiosurgery (SRS) dose distributions with sharp gradients using orthovoltage energy fluence modulation with inverse planning optimization techniques. A pencil beam model was used to calculate dose distributions from an orthovoltage unit at 250 kVp. Kernels for the model were derived using Monte Carlo methods. A Genetic Algorithm search heuristic was used to optimize the spatial distribution of added tungsten filtration to achieve dose distributions with sharp dose gradients. Optimizations were performed for depths of 2.5, 5.0, and 7.5 cm, with cone sizes of 5, 6, 8, and 10 mm. In addition to the beam profiles, 4π isocentric irradiation geometries were modeled to examine dose at 0.07 mm depth, a representative skin depth, for the low energy beams. Profiles from 4π irradiations of a constant target volume, assuming maximally conformal coverage, were compared. Finally, dose deposition in bone compared to tissue in this energy range was examined. Based on the results of the optimization, circularly symmetric tungsten filters were designed to modulate the orthovoltage beam across the apertures of SRS cone collimators. For each depth and cone size combination examined, the beam flatness and 80-20% and 90-10% penumbrae were calculated for both standard, open cone-collimated beams as well as for optimized, filtered beams. For all configurations tested, the modulated beam profiles had decreased penumbra widths and flatness statistics at depth. Profiles for the optimized, filtered orthovoltage beams also offered decreases in these metrics compared to measured linear accelerator cone-based SRS profiles. The dose at 0.07 mm depth in the 4π isocentric irradiation geometries was higher for the modulated beams compared to unmodulated beams; however, the modulated dose at 0.07 mm depth remained <0.025% of the central, maximum dose. The 4π profiles irradiating a constant target volume showed improved statistics for the modulated, filtered distribution compared to the standard, open cone-collimated distribution. Simulations of tissue and bone confirmed previously published results that a higher energy beam (≥ 200 keV) would be preferable, but the 250 kVp beam was chosen for this work because it is available for future measurements. A methodology has been described that may be used to optimize the spatial distribution of added filtration material in an orthovoltage SRS beam to result in dose distributions with decreased flatness and penumbra statistics compared to standard open cones. This work provides the mathematical foundation for a novel, orthovoltage energy fluence-modulated SRS system. © 2017 American Association of Physicists in Medicine.

OVERVIEW OF MONO-ENERGETIC GAMMA-RAY SOURCES & APPLICATIONS

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

Hartemann, F V; Albert, F; Anderson, G G

2010-05-18

Recent progress in accelerator physics and laser technology have enabled the development of a new class of tunable gamma-ray light sources based on Compton scattering between a high-brightness, relativistic electron beam and a high intensity laser pulse produced via chirped-pulse amplification (CPA). A precision, tunable Mono-Energetic Gamma-ray (MEGa-ray) source driven by a compact, high-gradient X-band linac is currently under development and construction at LLNL. High-brightness, relativistic electron bunches produced by an X-band linac designed in collaboration with SLAC NAL will interact with a Joule-class, 10 ps, diode-pumped CPA laser pulse to generate tunable {gamma}-rays in the 0.5-2.5 MeV photon energymore » range via Compton scattering. This MEGa-ray source will be used to excite nuclear resonance fluorescence in various isotopes. Applications include homeland security, stockpile science and surveillance, nuclear fuel assay, and waste imaging and assay. The source design, key parameters, and current status are presented, along with important applications, including nuclear resonance fluorescence. In conclusion, we have optimized the design of a high brightness Compton scattering gamma-ray source, specifically designed for NRF applications. Two different parameters sets have been considered: one where the number of photons scattered in a single shot reaches approximately 7.5 x 10{sup 8}, with a focal spot size around 8 {micro}m; in the second set, the spectral brightness is optimized by using a 20 {micro}m spot size, with 0.2% relative bandwidth.« less

Beam position monitor for energy recovered linac beams

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

Powers, Thomas; Evtushenko, Pavel

A method of determining the beam position in an energy recovered linac (ERL). The method makes use of in phase and quadrature (I/Q) demodulation techniques to separate the pickup signal generated by the electromagnetic fields generated by the first and second pass beam in the energy recovered linac. The method includes using analog or digital based I/Q demodulation techniques in order to measure the relative amplitude of the signals from a position sensitive beam pickup such as a button, strip line or microstripline beam position monitor.

Rib fracture following stereotactic body radiotherapy: a potential pitfall.

PubMed

Stanic, Sinisa; Boike, Thomas P; Rule, William G; Timmerman, Robert D

2011-11-01

Although the incidence of rib fractures after conventional radiotherapy is generally low (<2%), rib fractures are a relatively common complication of stereotactic body radiotherapy. For malignancy adjacent to the chest wall, the incidence of rib fractures after stereotactic body radiotherapy is as high as 10%. Unrecognized bone fractures can mimic bone metastases on bone scintigraphy, can lead to extensive workup, and can even lead to consideration of unnecessary systemic chemotherapy, as treatment decisions can be based on imaging findings alone. Nuclear medicine physicians and diagnostic radiologists should always consider rib fracture in the differential diagnosis.

Clinical implementation and rapid commissioning of an EPID based in-vivo dosimetry system.

PubMed

Hanson, Ian M; Hansen, Vibeke N; Olaciregui-Ruiz, Igor; van Herk, Marcel

2014-10-07

Using an Electronic Portal Imaging Device (EPID) to perform in-vivo dosimetry is one of the most effective and efficient methods of verifying the safe delivery of complex radiotherapy treatments. Previous work has detailed the development of an EPID based in-vivo dosimetry system that was subsequently used to replace pre-treatment dose verification of IMRT and VMAT plans. Here we show that this system can be readily implemented on a commercial megavoltage imaging platform without modification to EPID hardware and without impacting standard imaging procedures. The accuracy and practicality of the EPID in-vivo dosimetry system was confirmed through a comparison with traditional TLD in-vivo measurements performed on five prostate patients.The commissioning time required for the EPID in-vivo dosimetry system was initially prohibitive at approximately 10 h per linac. Here we present a method of calculating linac specific EPID dosimetry correction factors that allow a single energy specific commissioning model to be applied to EPID data from multiple linacs. Using this method reduced the required per linac commissioning time to approximately 30 min.The validity of this commissioning method has been tested by analysing in-vivo dosimetry results of 1220 patients acquired on seven linacs over a period of 5 years. The average deviation between EPID based isocentre dose and expected isocentre dose for these patients was (-0.7  ±  3.2)%.EPID based in-vivo dosimetry is now the primary in-vivo dosimetry tool used at our centre and has replaced nearly all pre-treatment dose verification of IMRT treatments.

Clinical implementation and rapid commissioning of an EPID based in-vivo dosimetry system

NASA Astrophysics Data System (ADS)

Hanson, Ian M.; Hansen, Vibeke N.; Olaciregui-Ruiz, Igor; van Herk, Marcel

2014-10-01

Using an Electronic Portal Imaging Device (EPID) to perform in-vivo dosimetry is one of the most effective and efficient methods of verifying the safe delivery of complex radiotherapy treatments. Previous work has detailed the development of an EPID based in-vivo dosimetry system that was subsequently used to replace pre-treatment dose verification of IMRT and VMAT plans. Here we show that this system can be readily implemented on a commercial megavoltage imaging platform without modification to EPID hardware and without impacting standard imaging procedures. The accuracy and practicality of the EPID in-vivo dosimetry system was confirmed through a comparison with traditional TLD in-vivo measurements performed on five prostate patients. The commissioning time required for the EPID in-vivo dosimetry system was initially prohibitive at approximately 10 h per linac. Here we present a method of calculating linac specific EPID dosimetry correction factors that allow a single energy specific commissioning model to be applied to EPID data from multiple linacs. Using this method reduced the required per linac commissioning time to approximately 30 min. The validity of this commissioning method has been tested by analysing in-vivo dosimetry results of 1220 patients acquired on seven linacs over a period of 5 years. The average deviation between EPID based isocentre dose and expected isocentre dose for these patients was (-0.7  ±  3.2)%. EPID based in-vivo dosimetry is now the primary in-vivo dosimetry tool used at our centre and has replaced nearly all pre-treatment dose verification of IMRT treatments.

Three-dimensional/two-dimensional multiplanar stereotactic planning system: hardware and software configuration

NASA Astrophysics Data System (ADS)

Zamorano, Lucia J.; Dujovny, Manuel; Ausman, James I.

1990-01-01

"Real time" surgical treatment planning utilizing multimodality imaging (CT, MRI, DA) has been developed to provide the neurosurgeon with 2D multiplanar and 3D views of a patient's lesion for stereotactic planning. Both diagnostic and therapeutic stereotactic procedures have been implemented utilizing workstation (SUN 1/10) and specially developed software and hardware (developed in collaboration with TOMO Medical Imaging Technology, Southfield, MI). This provides complete 3D and 2D free-tilt views as part of the system instrumentation. The 2D Multiplanar includes reformatted sagittal, coronal, paraaxial and free tilt oblique vectors at any arbitrary plane of the patient's lesion. The 3D includes features for extracting a view of the target volume localized by a process including steps of automatic segmentation, thresholding, and/or boundary detection with 3D display of the volumes of interest. The system also includes the capability of interactive playback of reconstructed 3D movies, which can be viewed at any hospital network having compatible software on strategical locations or at remote sites through data transmission and record documentation by image printers. Both 2D and 3D menus include real time stereotactic coordinate measurements and trajectory definition capabilities as well as statistical functions for computing distances, angles, areas, and volumes. A combined interactive 3D-2D multiplanar menu allows simultaneous display of selected trajectory, final optimization, and multiformat 2D display of free-tilt reformatted images perpendicular to selected trajectory of the entire target volume.

Multiple brain metastases irradiation with Eleka Axesse stereotactic system

NASA Astrophysics Data System (ADS)

Filatov, P. V.; Polovnikov, E. S.; Orlov, K. Yu.; Krutko, A. V.; Kirilova, I. A.; Moskalev, A. V.; Filatova, E. V.; Zheravin, A. A.

2017-09-01

Brain metastases are one of the factors complicating the treatment of a malignant tumor. Radiation therapy, especially radiosurgery, plays an important role in the modern treatment practice. During 2011-2016, 32 patients (from 29 to 67 years old) with multiple brain metastases underwent the treatment with SRS or SRT in our center. The number of secondary lesions varied from 2 to 11. Eight patients underwent microsurgery resection. Seven patients had recurrence after whole brain radiotherapy. Thirty patient underwent single fraction SRS and two patients with large metastases (bigger than 3 cm) underwent fractionated SRT. The treatment was done with dedicated linear accelerator stereotactic system Elekta Axesse (Elekta AB, Stockholm, Sweden). Different stereotactic fixation devices were used, namely, Leksell G frame, non-invasive HeadFIX frame, and reinforced thermoplastic mask (IMRT perforation). All treatments included a volumetric modulated arc therapy (VMAT) technique and of Inage Guided Radiation Therapy (IGRT) technique. All lesions were treated from a single isocenter, which allowed reducing the treatment time and overall dose to the patient's body. All patients suffered the treatment satisfactorily. No adverse reactions or complications were met in any case during or right after the treatment. Different stereotactic fixation devices and modern treatment techniques allowed creating an optimal, safe and comfortable way for patient treatment. The treatment time was from 15 to 50 minutes. Patient position verification after or during the treatment demonstrated good accuracy for all fixation types and low level of intrafraction motion.

Robot-assisted procedures in pediatric neurosurgery.

PubMed

De Benedictis, Alessandro; Trezza, Andrea; Carai, Andrea; Genovese, Elisabetta; Procaccini, Emidio; Messina, Raffaella; Randi, Franco; Cossu, Silvia; Esposito, Giacomo; Palma, Paolo; Amante, Paolina; Rizzi, Michele; Marras, Carlo Efisio

2017-05-01

OBJECTIVE During the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures. Nevertheless, the use of robots has been rarely reported in children. In this work, the authors describe their experience using the ROSA device (Robotized Stereotactic Assistant) in the neurosurgical management of a pediatric population. METHODS Between 2011 and 2016, 116 children underwent ROSA-assisted procedures for a variety of diseases (epilepsy, brain tumors, intra- or extraventricular and tumor cysts, obstructive hydrocephalus, and movement and behavioral disorders). Each patient received accurate preoperative planning of optimal trajectories, intraoperative frameless registration, surgical treatment using specific instruments held by the robotic arm, and postoperative CT or MR imaging. RESULTS The authors performed 128 consecutive surgeries, including implantation of 386 electrodes for stereo-electroencephalography (36 procedures), neuroendoscopy (42 procedures), stereotactic biopsy (26 procedures), pallidotomy (12 procedures), shunt placement (6 procedures), deep brain stimulation procedures (3 procedures), and stereotactic cyst aspiration (3 procedures). For each procedure, the authors analyzed and discussed accuracy, timing, and complications. CONCLUSIONS To the best their knowledge, the authors present the largest reported series of pediatric neurosurgical cases assisted by robotic support. The ROSA system provided improved safety and feasibility of minimally invasive approaches, thus optimizing the surgical result, while minimizing postoperative morbidity.

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

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

Anderson, J; Bernard, D; Liao, Y

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° arcsmore » 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.« less

Deep Brain Stimulation for Tremor Tractographic Versus Traditional (DISTINCT): Study Protocol of a Randomized Controlled Feasibility Trial.

PubMed

Sajonz, Bastian Elmar Alexander; Amtage, Florian; Reinacher, Peter Christoph; Jenkner, Carolin; Piroth, Tobias; Kätzler, Jürgen; Urbach, Horst; Coenen, Volker Arnd

2016-12-22

Essential tremor is a movement disorder that can result in profound disability affecting the quality of life. Medically refractory essential tremor can be successfully reduced by deep brain stimulation (DBS) traditionally targeting the thalamic ventral intermediate nucleus (Vim). Although this structure can be identified with magnetic resonance (MR) imaging nowadays, Vim-DBS electrodes are still implanted in the awake patient with intraoperative tremor testing to achieve satisfactory tremor control. This can be attributed to the fact that the more effective target of DBS seems to be the stimulation of fiber tracts rather than subcortical nuclei like the Vim. There is evidence that current coverage of the dentatorubrothalamic tract (DRT) results in good tremor control in Vim-DBS. Diffusion tensor MR imaging (DTI) tractography-assisted stereotactic surgery targeting the DRT would therefore not rely on multiple trajectories and intraoperative tremor testing in the awake patient, bearing the potential of more patient comfort and reduced operation-related risks. This is the first randomized controlled trial comparing DTI tractography-assisted stereotactic surgery targeting the DRT in general anesthesia with stereotactic surgery of thalamic/subthalamic region as conventionally used. This clinical pilot trial aims at demonstrating safety of DTI tractography-assisted stereotactic surgery in general anesthesia and proving its equality compared to conventional stereotactic surgery with intraoperative testing in the awake patient. The Deep Brain Stimulation for Tremor Tractographic Versus Traditional (DISTINCT) trial is a single-center investigator-initiated, randomized, controlled, observer-blinded trial. A total of 24 patients with medically refractory essential tremor will be randomized to either DTI tractography-assisted stereotactic surgery targeting the DRT in general anesthesia or stereotactic surgery of the thalamic/subthalamic region as conventionally used. The primary objective is to assess the tremor reduction, obtained by the Fahn-Tolosa-Marin Tremor Rating Scale in the 2 treatment groups. Secondary objectives include (among others) assessing the quality of life, optimal electrode contact positions, and safety of the intervention. The study protocol has been approved by the independent ethics committee of the University of Freiburg. Recruitment to the DISTINCT trial opened in September 2015 and is expected to close in June 2017. At the time of manuscript submission the trial is open to recruitment. The DISTINCT trial is the first to compare DTI tractography-assisted stereotactic surgery with target point of the DRT in general anesthesia to stereotactic surgery of the thalamic/subthalamic region as conventionally used. It can serve as a cornerstone for the evolving technique of DTI tractography-assisted stereotactic surgery. ClinicalTrials.gov NCT02491554; https://clinicaltrials.gov/ct2/show/NCT02491554 (Archived by WebCite at http://www.webcitation.org/6mezLnB9D). German Clinical Trials Register DRKS00008913; http://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00008913 (Archived by WebCite at http://www.webcitation.org/6mezCtxhS). ©Bastian Elmar Alexander Sajonz, Florian Amtage, Peter Christoph Reinacher, Carolin Jenkner, Tobias Piroth, Jürgen Kätzler, Horst Urbach, Volker Arnd Coenen. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 22.12.2016.

SU-E-T-781: Using An Electronic Portal Imaging Device (EPID) for Correlating Linac Photon Beam Energies

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

Yaddanapudi, S; Cai, B; Sun, B

2015-06-15

Purpose: Electronic portal imaging devices (EPIDs) have proven to be useful for measuring several parameters of interest in linear accelerator (linac) quality assurance (QA). The purpose of this project was to evaluate the feasibility of using EPIDs for determining linac photon beam energies. Methods: Two non-clinical Varian TrueBeam linacs (Varian Medical Systems, Palo Alto, CA) with 6MV and 10MV photon beams were used to perform the measurements. The linacs were equipped with an amorphous silicon based EPIDs (aSi1000) that were used for the measurements. We compared the use of flatness versus percent depth dose (PDD) for predicting changes in linacmore » photon beam energy. PDD was measured in 1D water tank (Sun Nuclear Corporation, Melbourne FL) and the profiles were measured using 2D ion-chamber array (IC-Profiler, Sun Nuclear) and the EPID. Energy changes were accomplished by varying the bending magnet current (BMC). The evaluated energies conformed with the AAPM TG142 tolerance of ±1% change in PDD. Results: BMC changes correlating with a ±1% change in PDD corresponded with a change in flatness of ∼1% to 2% from baseline values on the EPID. IC Profiler flatness values had the same correlation. We observed a similar trend for the 10MV beam energy changes. Our measurements indicated a strong correlation between changes in linac photon beam energy and changes in flatness. For all machines and energies, beam energy changes produced change in the uniformity (AAPM TG-142), varying from ∼1% to 2.5%. Conclusions: EPID image analysis of beam profiles can be used to determine linac photon beam energy changes. Flatness-based metrics or uniformity as defined by AAPM TG-142 were found to be more sensitive to linac photon beam energy changes than PDD. Research funding provided by Varian Medical Systems. Dr. Sasa Mutic receives compensation for providing patient safety training services from Varian Medical Systems, the sponsor of this study.« less

Dynamic simulation of motion effects in IMAT lung SBRT.

PubMed

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

2014-11-01

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

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

PubMed

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

2015-12-01

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

Improving the Diagnostic Specificity of CT for Early Detection of Lung Cancer: 4D CT-Based Pulmonary Nodule Elastometry

DTIC Science & Technology

2015-10-01

2012, patients who received stereotactic ablative radiotherapy ( SABR ) for early stage non-small cell lung cancer were included in this study. All...comparing the elasticities of malignant PNs treated with stereotactic ablative radiotherapy ( SABR ) with those of the lung. Methods: We analyzed...breath-hold images of 30 patients with malignant PNs who underwent SABR in our department. A parametric nonrigid transformation model based on multi

Technical Note: Development and performance of a software tool for quality assurance of online replanning with a conventional Linac or MR-Linac.

PubMed

Chen, Guang-Pei; Ahunbay, Ergun; Li, X Allen

2016-04-01

To develop an integrated quality assurance (QA) software tool for online replanning capable of efficiently and automatically checking radiation treatment (RT) planning parameters and gross plan quality, verifying treatment plan data transfer from treatment planning system (TPS) to record and verify (R&V) system, performing a secondary monitor unit (MU) calculation with or without a presence of a magnetic field from MR-Linac, and validating the delivery record consistency with the plan. The software tool, named ArtQA, was developed to obtain and compare plan and treatment parameters from both the TPS and the R&V system database. The TPS data are accessed via direct file reading and the R&V data are retrieved via open database connectivity and structured query language. Plan quality is evaluated with both the logical consistency of planning parameters and the achieved dose-volume histograms. Beams in between the TPS and R&V system are matched based on geometry configurations. To consider the effect of a 1.5 T transverse magnetic field from MR-Linac in the secondary MU calculation, a method based on modified Clarkson integration algorithm was developed and tested for a series of clinical situations. ArtQA has been used in their clinic and can quickly detect inconsistencies and deviations in the entire RT planning process. With the use of the ArtQA tool, the efficiency for plan check including plan quality, data transfer, and delivery check can be improved by at least 60%. The newly developed independent MU calculation tool for MR-Linac reduces the difference between the plan and calculated MUs by 10%. The software tool ArtQA can be used to perform a comprehensive QA check from planning to delivery with conventional Linac or MR-Linac and is an essential tool for online replanning where the QA check needs to be performed rapidly.

Technical Note: Development and performance of a software tool for quality assurance of online replanning with a conventional Linac or MR-Linac

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

Chen, Guang-Pei, E-mail: gpchen@mcw.edu; Ahunbay, Ergun; Li, X. Allen

Purpose: To develop an integrated quality assurance (QA) software tool for online replanning capable of efficiently and automatically checking radiation treatment (RT) planning parameters and gross plan quality, verifying treatment plan data transfer from treatment planning system (TPS) to record and verify (R&V) system, performing a secondary monitor unit (MU) calculation with or without a presence of a magnetic field from MR-Linac, and validating the delivery record consistency with the plan. Methods: The software tool, named ArtQA, was developed to obtain and compare plan and treatment parameters from both the TPS and the R&V system database. The TPS data aremore » accessed via direct file reading and the R&V data are retrieved via open database connectivity and structured query language. Plan quality is evaluated with both the logical consistency of planning parameters and the achieved dose–volume histograms. Beams in between the TPS and R&V system are matched based on geometry configurations. To consider the effect of a 1.5 T transverse magnetic field from MR-Linac in the secondary MU calculation, a method based on modified Clarkson integration algorithm was developed and tested for a series of clinical situations. Results: ArtQA has been used in their clinic and can quickly detect inconsistencies and deviations in the entire RT planning process. With the use of the ArtQA tool, the efficiency for plan check including plan quality, data transfer, and delivery check can be improved by at least 60%. The newly developed independent MU calculation tool for MR-Linac reduces the difference between the plan and calculated MUs by 10%. Conclusions: The software tool ArtQA can be used to perform a comprehensive QA check from planning to delivery with conventional Linac or MR-Linac and is an essential tool for online replanning where the QA check needs to be performed rapidly.« less

SU-E-T-468: Implementation of the TG-142 QA Process for Seven Linacs with Enhanced Beam Conformance

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

Woollard, J; Ayan, A; DiCostanzo, D

2015-06-15

Purpose: To develop a TG-142 compliant QA process for 7 Varian TrueBeam linear accelerators (linacs) with enhanced beam conformance and dosimetrically matched beam models. To ensure consistent performance of all 7 linacs, the QA process should include a common set of baseline values for use in routine QA on all linacs. Methods: The TG 142 report provides recommended tests, tolerances and frequencies for quality assurance of medical accelerators. Based on the guidance provided in the report, measurement tests were developed to evaluate each of the applicable parameters listed for daily, monthly and annual QA. These tests were then performed onmore » each of our 7 new linacs as they came on line at our institution. Results: The tolerance values specified in TG-142 for each QA test are either absolute tolerances (i.e. ±2mm) or require a comparison to a baseline value. The results of our QA tests were first used to ensure that all 7 linacs were operating within the suggested tolerance values provided in TG −142 for those tests with absolute tolerances and that the performance of the linacs was adequately matched. The QA test results were then used to develop a set of common baseline values for those QA tests that require comparison to a baseline value at routine monthly and annual QA. The procedures and baseline values were incorporated into a spreadsheets for use in monthly and annual QA. Conclusion: We have developed a set of procedures for daily, monthly and annual QA of our linacs that are consistent with the TG-142 report. A common set of baseline values was developed for routine QA tests. The use of this common set of baseline values for comparison at monthly and annual QA will ensure consistent performance of all 7 linacs.« less

Experimental model of the device for detection of nuclear cycle materials by photoneutron technology

NASA Astrophysics Data System (ADS)

Bakalyarov, A. M.; Karetnikov, M. D.; Kozlov, K. N.; Lebedev, V. I.; Meleshko, E. A.; Obinyakov, B. A.; Ostashev, I. E.; Tupikin, N. A.; Yakovlev, G. V.

2007-08-01

The inherent complexity of sea container control makes them potentially dangerous for smuggling nuclear materials. The experts believe that only active technologies based on recording the products of induced radiation from sensitive materials might solve the problem. The paper reports on the experimental model of the device on the basis of the electron LINAC U-28 for detection of nuclear materials by photonuclear technology. The preliminary numerical optimization of output units (converter, filter, collimator) for shaping the bremsstrahlung was carried out. The setup of experimental device and initial results of recording the prompt and delayed fission products are discussed.

Relocatable fixation systems in intracranial stereotactic radiotherapy. Accuracy of serial CT scans and patient acceptance in a randomized design.

PubMed

Theelen, A; Martens, J; Bosmans, G; Houben, R; Jager, J J; Rutten, I; Lambin, P; Minken, A W; Baumert, B G

2012-01-01

The goal was to provide a quantitative evaluation of the accuracy of three different fixation systems for stereotactic radiotherapy and to evaluate patients' acceptance for all fixations. A total of 16 consecutive patients with brain tumours undergoing fractionated stereotactic radiotherapy (SCRT) were enrolled after informed consent (Clinical trials.gov: NCT00181350). Fixation systems evaluated were the BrainLAB® mask, with and without custom made bite-block (fixations S and A) and a homemade neck support with bite-block (fixation B) based on the BrainLAB® frame. The sequence of measurements was evaluated in a randomized manner with a cross-over design and patients' acceptance by a questionnaire. The mean three-dimensional (3D) displacement and standard deviations were 1.16 ± 0.68 mm for fixation S, 1.92 ± 1.28 and 1.70 ± 0.83 mm for fixations A and B, respectively. There was a significant improvement of the overall alignment (3D vector) when using the standard fixation instead of fixation A or B in the craniocaudal direction (p = 0.037). Rotational deviations were significantly less for the standard fixation S in relation to fixations A (p = 0.005) and B (p = 0.03). EPI imaging with off-line correction further improved reproducibility. Five out of 8 patients preferred the neck support with the bite-block. The mask fixation system in conjunction with a bite-block is the most accurate fixation for SCRT reducing craniocaudal and rotational movements. Patients favoured the more comfortable but less accurate neck support. To optimize the accuracy of SCRT, additional regular portal imaging is warranted.

Implementation of an oblique-sectioning visualization tool for line-of-sight stereotactic neurosurgical navigation using the AVW toolkit

NASA Astrophysics Data System (ADS)

Bates, Lisa M.; Hanson, Dennis P.; Kall, Bruce A.; Meyer, Frederic B.; Robb, Richard A.

1998-06-01

An important clinical application of biomedical imaging and visualization techniques is provision of image guided neurosurgical planning and navigation techniques using interactive computer display systems in the operating room. Current systems provide interactive display of orthogonal images and 3D surface or volume renderings integrated with and guided by the location of a surgical probe. However, structures in the 'line-of-sight' path which lead to the surgical target cannot be directly visualized, presenting difficulty in obtaining full understanding of the 3D volumetric anatomic relationships necessary for effective neurosurgical navigation below the cortical surface. Complex vascular relationships and histologic boundaries like those found in artereovenous malformations (AVM's) also contribute to the difficulty in determining optimal approaches prior to actual surgical intervention. These difficulties demonstrate the need for interactive oblique imaging methods to provide 'line-of-sight' visualization. Capabilities for 'line-of- sight' interactive oblique sectioning are present in several current neurosurgical navigation systems. However, our implementation is novel, in that it utilizes a completely independent software toolkit, AVW (A Visualization Workshop) developed at the Mayo Biomedical Imaging Resource, integrated with a current neurosurgical navigation system, the COMPASS stereotactic system at Mayo Foundation. The toolkit is a comprehensive, C-callable imaging toolkit containing over 500 optimized imaging functions and structures. The powerful functionality and versatility of the AVW imaging toolkit provided facile integration and implementation of desired interactive oblique sectioning using a finite set of functions. The implementation of the AVW-based code resulted in higher-level functions for complete 'line-of-sight' visualization.

Evaluation of radiosurgery techniques–Cone-based linac radiosurgery vs tomotherapy-based radiosurgery

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

Yip, Ho Yin, E-mail: hoyinyip@yahoo.com.hk; Mui, Wing Lun A.; Lee, Joseph W.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 systemsmore » 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.« less

Improving the Diagnostic Specificity of CT for Early Detection of Lung Cancer: 4D CT-Based Pulmonary Nodule Elastometry

DTIC Science & Technology

2015-10-01

malignant PNs treated with stereotactic ablative radiotherapy ( SABR ) with those of the lung. Methods: We analyzed breath-hold images of 30...patients with malignant PNs who underwent SABR in our department. A parametric nonrigid transformation model based on multi-level B-spline guided by Sum of...and 50 of 4D CT and deep inhale and natural exhale of breath-hold CT images of 30 MPN treated with stereotactic ablative radiotherapy ( SABR ). The

TU-H-BRA-04: A Novel Superconducting Magnet Design for Optimized Patient Access and Minimal SSD for Use in a Linac-MR Hybrid

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

Yaghoobpour Tari, S; Wachowicz, K; Fallone, B

2016-06-15

Purpose: A prototype rotating hybrid MR imaging system and linac has been developed to allow for simultaneous imaging and radiation delivery parallel to B{sub 0}. However, the design of a compact magnet capable of rotation in a small vault with sufficient patient access and a typical clinical source-to-surface distance (SSD) is challenging. This work presents a novel superconducting magnet design that allows for a reduced SSD and ample patient access by moving the superconducting coils to the side of the yoke. The yoke and pole-plate structures are shaped to direct the magnetic flux appropriately. Methods: The surface of the polemore » plate for the magnet assembly is optimized. The magnetic field calculations required in this work are performed with the 3D finite element method software package Opera-3D. Each tentative design strategy is virtually modeled in this software package and externally controlled by MATLAB, with its key geometries defined as variables. The particle swarm optimization algorithm is used to optimize the variables subject to the minimization of a cost function. At each iteration, Opera-3D will solve the magnetic field solution over a field-of-view suitable for MR imaging and the degree of field uniformity will be assessed to calculate the value of the cost function associated with that iteration. Results: An optimized magnet assembly that generates a homogenous 0.2T magnetic field over an ellipsoid with large axis of 30 cm and small axes of 20 cm is obtained. Conclusion: The distinct features of this model are the minimal distance between the yoke’s top and the isocentre and the improved patient access. On the other hand, having homogeneity over an ellipsoid give us a larger field-of-view, essential for geometric accuracy of the MRI system. The increase of B{sub 0} from 0.2T in the present model to 0.5T is the subject of future work. Funding Sources: Alberta Innovates - Health Solutions (AIHS)| Disclosure and Conflict of Interest: B. Gino Fallone is a co-founder and CEO of MagnetTx Oncology Solutions (under discussions to license Alberta biplanar linac MR for commercialization).« less

Postoperative Stereotactic Body Radiation Therapy (SBRT) for Spine Metastases: A Critical Review to Guide Practice

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

Redmond, Kristin J., E-mail: kjanson3@jhmi.edu; Lo, Simon S.; Fisher, Charles

Postoperative stereotactic body radiation therapy (SBRT) for metastatic spinal tumors is increasingly being performed in clinical practice. Whereas the fundamentals of SBRT practice for intact spinal metastases are established, there are as yet no comprehensive practice guidelines for the postoperative indications. In particular, there are unique considerations for patient selection and treatment planning specific to postoperative spine SBRT that are critical for safe and effective management. The purpose of this critical review is to discuss the rationale for treatment, describe those factors affecting surgical decision making, introduce modern surgical trends, and summarize treatment outcomes for both conventional postoperative external beammore » radiation therapy and postoperative spine SBRT. Lastly, an in-depth practical discussion with respect to treatment planning and delivery considerations is provided to help guide optimal practice.« less

H- ion sources for CERN's Linac4

NASA Astrophysics Data System (ADS)

Lettry, J.; Aguglia, D.; Coutron, Y.; Chaudet, E.; Dallocchio, A.; Gil Flores, J.; Hansen, J.; Mahner, E.; Mathot, S.; Mattei, S.; Midttun, O.; Moyret, P.; Nisbet, D.; O'Neil, M.; Paoluzzi, M.; Pasquino, C.; Pereira, H.; Arias, J. Sanchez; Schmitzer, C.; Scrivens, R.; Steyaert, D.

2013-02-01

The specifications set to the Linac4 ion source are: H- ion pulses of 0.5 ms duration, 80 mA intensity and 45 keV energy within a normalized emittance of 0.25 mmmrad RMS at a repetition rate of 2 Hz. In 2010, during the commissioning of a prototype based on H- production from the plasma volume, it was observed that the powerful co-extracted electron beam inherent to this type of ion source could destroy its electron beam dump well before reaching nominal parameters. However, the same source was able to provide 80 mA of protons mixed with a small fraction of H2+ and H3+ molecular ions. The commissioning of the radio frequency quadrupole accelerator (RFQ), beam chopper and H- beam diagnostics of the Linac4 are scheduled for 2012 and its final installation in the underground building is to start in 2013. Therefore, a crash program was launched in 2010 and reviewed in 2011 aiming at keeping the original Linac4 schedule with the following deliverables: Design and production of a volume ion source prototype suitable for 20-30 mA H- and 80 mA proton pulses at 45 keV by mid-2012. This first prototype will be dedicated to the commissioning of the low energy components of the Linac4. Design and production of a second prototype suitable for 40-50 mA H- based on an external RF solenoid plasma heating and cesiated-surface production mechanism in 2013 and a third prototype based on BNL's Magnetron aiming at reliable 2 Hz and 80 mA H- operations in 2014. In order to ease the future maintenance and allow operation with Ion sources based on three different production principles, an ion source "front end" providing alignment features, pulsed gas injection, pumping units, beam tuning capabilities and pulsed bipolar high voltage acceleration was designed and is being produced. This paper describes the progress of the Linac4 ion source program, the design of the Front end and first ion source prototype. Preliminary results of the summer 2012 commissioning are presented. The outlook on the future prototype ion sources is sketched.

Notes on the design of experiments and beam diagnostics with synchrotron light detected by a gated photomultiplier for the Fermilab superconducting electron linac and for the Integrable Optics Test Accelerator (IOTA)

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

Stancari, Giulio; Romanov, Aleksandr; Ruan, Jinhao

We outline the design of beam experiments for the electron linac at the Fermilab Accelerator Science and Technology (FAST) facility and for the Integrable Optics Test Accelerator (IOTA), based on synchrotron light emitted by the electrons in bend dipoles, detected with gated microchannel-plate photomultipliers (MCP-PMTs). The system can be used both for beam diagnostics (e.g., beam intensity with full dynamic range, turn-by-turn beam vibrations, etc.) and for scientific experiments, such as the direct observation of the time structure of the radiation emitted by single electrons in a storage ring. The similarity between photon pulses and spectrum at the downstream endmore » of the electron linac and in the IOTA ring allows one to test the apparatus during commissioning of the linac.« less

Conceptual Design for the New RPI 2020 Linac

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

Adolphsen, C.; Bane, K.; Dolgashev, V.

2014-10-29

The Rensselaer Polytechnic Institute (RPI) spectrometer is an installation based on an L-band linear accelerator designed and installed many decades ago. While this installation has served many important experiments over the decades, a new more powerful and more flexible linac to serve a wider range of experiments is envisioned as an upgrade to the existing installation by 2020.

Implementation of a volumetric modulated arc therapy treatment planning solution for kidney and adrenal stereotactic body radiation therapy

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

Sonier, Marcus, E-mail: Marcus.Sonier@bccancer.bc.ca; Chu, William; Department of Radiation Oncology, University of Toronto, Toronto, ON

To develop a volumetric modulated arc therapy (VMAT) treatment planning solution in the treatment of primary renal cell carcinoma and oligometastatic adrenal lesions with stereotactic body radiation therapy. Single-arc VMAT plans (n = 5) were compared with clinically delivered step-and-shoot intensity-modulated radiotherapy (IMRT) with planning target volume coverage normalized between techniques. Target volume conformity, organ-at-risk (OAR) dose, treatment time, and monitor units were compared. A VMAT planning solution, created from a combination of arc settings and optimization constraints, auto-generated treatment plans in a single optimization. The treatment planning solution was evaluated on 15 consecutive patients receiving kidney and adrenal stereotacticmore » body radiation therapy. Treatment time was reduced from 13.0 ± 2.6 to 4.0 ± 0.9 minutes for IMRT and VMAT, respectively. The VMAT planning solution generated treatment plans with increased target homogeneity, improved 95% conformity index, and a reduced maximum point dose to nearby OARs but with increased intermediate dose to distant OARs. The conformity of the 95% isodose improved from 1.32 ± 0.39 to 1.12 ± 0.05 for IMRT and VMAT treatment plans, respectively. Evaluation of the planning solution showed clinically acceptable dose distributions for 13 of 15 cases with tight conformity of the prescription isodose to the planning target volume of 1.07 ± 0.04, delivering minimal dose to OARs. The introduction of a stereotactic body radiation therapy VMAT treatment planning solution improves the efficiency of planning and delivery time, producing treatment plans of comparable or superior quality to IMRT in the case of primary renal cell carcinoma and oligometastatic adrenal lesions.« less

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

Pantelis, Evaggelos, E-mail: vpantelis@phys.uoa.g; Medical Physics Laboratory, Medical School, University of Athens, Athens; Papadakis, Nikolaos

Purpose: To study the efficacy of the integration of functional magnetic resonance imaging (fMRI) and diffusion tensor imaging tractography data into stereotactic radiosurgery clinical practice. Methods and Materials: fMRI and tractography data sets were acquired and fused with corresponding anatomical MR and computed tomography images of patients with arteriovenous malformation (AVM), astrocytoma, brain metastasis, or hemangioma and referred for stereotactic radiosurgery. The acquired data sets were imported into a CyberKnife stereotactic radiosurgery system and used to delineate the target, organs at risk, and nearby functional structures and fiber tracts. Treatment plans with and without the incorporation of the functional structuresmore » and the fiber tracts into the optimization process were developed and compared. Results: The nearby functional structures and fiber tracts could receive doses of >50% of the maximum dose if they were excluded from the planning process. In the AVM case, the doses received by the Broadmann-17 structure and the optic tract were reduced to 700 cGy from 1,400 cGy and to 1,200 cGy from 2,000 cGy, respectively, upon inclusion into the optimization process. In the metastasis case, the motor cortex received 850 cGy instead of 1,400 cGy; and in the hemangioma case, the pyramidal tracts received 780 cGy instead of 990 cGy. In the astrocytoma case, the dose to the motor cortex bordering the lesion was reduced to 1,900 cGy from 2,100 cGy, and therefore, the biologically equivalent dose in three fractions was delivered instead. Conclusions: Functional structures and fiber tracts could receive high doses if they were not considered during treatment planning. With the aid of fMRI and tractography images, they can be delineated and spared.« less

Fiducial Marker Placement

MedlinePlus

... such as stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) , or proton therapy . Fiducial markers are small ... Proton Therapy Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT) Images related to Fiducial Marker Placement Sponsored ...

HOPI: on-line injection optimization program

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

LeMaire, J L

1977-10-26

A method of matching the beam from the 200 MeV linac to the AGS without the necessity of making emittance measurements is presented. An on-line computer program written on the PDP10 computer performs the matching by modifying independently the horizontal and vertical emittance. Experimental results show success with this method, which can be applied to any matching section.

The history of stereotactic radiosurgery and radiotherapy.

PubMed

Lasak, John M; Gorecki, John P

2009-08-01

Stereotactic neurosurgery originated from the pioneering work of Horsley and Clarke, who developed a stereotactic apparatus to study the monkey brain in 1908. Spiegel and Wycis applied this technology to the human brain in 1947, which ultimately lead to the development of multiple stereotactic neurosurgical devices during the 1950s. It was Lars Leksell of Sweden, however, who envisioned stereotactic radiosurgery. Leksell developed the gamma knife to treat intracranial lesions in a noninvasive fashion. His work stimulated worldwide interest and created the field of stereotactic radiosurgery.

Installation and Commissioning of the Super Conducting RF Linac Cryomodules for the Erlp

NASA Astrophysics Data System (ADS)

Goulden, A. R.; Bate, R.; Buckley, R. K.; Pattalwar, S. M.

2008-03-01

An Energy Recovery Linac Prototype (ERLP) is currently being constructed at Daresbury Laboratory, (UK) to promote the necessary skills in science & technology, particularly in photocathode electron gun and Superconducting RF (SRF), to enable the construction of a fourth generation light source, based on energy recovery linacs-4GLS [1]. The ERLP uses two identical cryomodules, one as a booster Linac used to accelerate the beam to 8.5 MeV, the other as an Energy Recovery Linac (ERL) module with an energy gain of 26.5 MeV. Each module consists of two 9- cell cavities operating at a frequency of 1.3 GHz and a temperature of 2 K. As there is no energy recovery in the booster it requires a peak power of 53 kW; whereas the linac module only requires 8 kW. The RF power is supplied by Inductive Output Tube (IOT) amplifiers. The maximum heat load (or the cooling power) required in the SRF system is 180 W at 2 K and is achieved in two stages: a LN2 pre-cooled Linde TCF50 liquefier produces liquid helium at 4.5 K, followed by a 2 K cold box consisting of a JT valve, recuperator and an external room temperature vacuum pumping system. This presentation reports the experience gained during, installation, commissioning and the initial operation of the cryomodules.

Dosimetric benefit of adaptive re-planning in pancreatic cancer stereotactic body radiotherapy

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

Li, Yongbao; Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA; Department of Radiation Oncology, University of California San Diego, La Jolla, CA

Stereotactic body radiotherapy (SBRT) shows promise in unresectable pancreatic cancer, though this treatment modality has high rates of normal tissue toxicity. This study explores the dosimetric utility of daily adaptive re-planning with pancreas SBRT. We used a previously developed supercomputing online re-planning environment (SCORE) to re-plan 10 patients with pancreas SBRT. Tumor and normal tissue contours were deformed from treatment planning computed tomographies (CTs) and transferred to daily cone-beam CT (CBCT) scans before re-optimizing each daily treatment plan. We compared the intended radiation dose, the actual radiation dose, and the optimized radiation dose for the pancreas tumor planning target volumemore » (PTV) and the duodenum. Treatment re-optimization improved coverage of the PTV and reduced dose to the duodenum. Within the PTV, the actual hot spot (volume receiving 110% of the prescription dose) decreased from 4.5% to 0.5% after daily adaptive re-planning. Within the duodenum, the volume receiving the prescription dose decreased from 0.9% to 0.3% after re-planning. It is noteworthy that variation in the amount of air within a patient's stomach substantially changed dose to the PTV. Adaptive re-planning with pancreas SBRT has the ability to improve dose to the tumor and decrease dose to the nearby duodenum, thereby reducing the risk of toxicity.« less

Surgical Evacuation of Spontaneous Supratentorial Lobar Intracerebral Hemorrhage: Comparison of Safety and Efficacy of Stereotactic Aspiration, Endoscopic Surgery, and Craniotomy.

PubMed

Li, Yuqian; Yang, Ruixin; Li, Zhihong; Yang, Yanping; Tian, Bo; Zhang, Xingye; Wang, Bao; Lu, Dan; Guo, Shaochun; Man, Minghao; Yang, Yang; Luo, Tao; Gao, Guodong; Li, Lihong

2017-09-01

The safety and efficacy of craniotomy, endoscopic surgery, and stereotactic aspiration for surgical evacuation of spontaneous supratentorial lobar intracerebral hemorrhage (ICH) is yet uncertain. The present study analyzed the clinical and radiographic data from 99 patients with spontaneous supratentorial lobar ICH, retrospectively, to address this issue. Patients who underwent craniotomy, endoscopy surgery, or stereotactic aspiration were assigned to the craniotomy group (n = 31), endoscopy surgery group (n = 32), or stereotactic aspiration group (n = 36), respectively. The characteristics of all the enrolled patients at the time of admission were assimilated. Also, the therapeutic effects of the three surgical procedures were evaluated based on short-term outcomes within 30 days and long-term outcomes at 6 months after the ictus. The results showed that stereotactic aspiration and endoscopic surgery were associated with a superior clinical therapeutic effect in both short-term and long-term outcomes than craniotomy for the treatment of spontaneous supratentorial lobar ICH. Notably, severely affected patients with hematoma volume > 60 mL or Glasgow Coma Scale score 4-8 may benefit more from endoscopic surgery than the two other surgical procedures. The current findings demonstrate that both stereotactic aspiration and endoscopic surgery possess an apparent advantage over craniotomy for the evacuation of spontaneous supratentorial lobar ICH. The endoscopic surgery might be more safe and effective with higher evacuation rate, better functional neurological outcomes, and lower complication and mortality rates. Copyright © 2017 Elsevier Inc. All rights reserved.

The LLRF System for the S-Band RF Plants of the FERMI Linac

NASA Astrophysics Data System (ADS)

Fabris, A.; Byrd, J.; D'Auria, G.; Doolittle, L.; Gelmetti, F.; Huang, G.; Jones, J.; Milloch, M.; Predonzani, M.; Ratti, A.; Rohlev, T.; Salom, A.; Serrano, C.; Stettler, M.

2016-04-01

Specifications on electron beam quality for the operation of a linac-based free-electron laser (FEL), as FERMI in Trieste (Italy), impose stringent requirements on the stability of the electromagnetic fields of the accelerating sections. These specifications can be met only with state-of-the-art low-level RF (LLRF) systems based on advanced digital technologies. Design considerations, construction, and performance results of the FERMI digital LLRF are presented in this paper. The stability requirements derived by simulations are better than 0.1% in amplitude and 0.1° S-band in phase. The system installed in the FERMI Linac S-band RF plants has met these specifications and is in operation on a 24-h basis as a user facility. Capabilities of the system allow planning for new developments that are also described here.

Charged-particle stereotactic radiosurgery

NASA Astrophysics Data System (ADS)

Lyman, John T.; Fabrikant, Jacob I.; Frankel, Kenneth A.

1985-05-01

Charged-particle stereotactic radiosurgery is the technique of using accelerated atomic nuclei for the irradiation of a small volume target to a high dose in a short time interval. This is contrasted with conventional radiotherapy where large volumes are treated with many small fractions of photon or electron radiation over a multi-week period. The helium-ion beam used for charged-particle stereotactic radiosurgery at the Lawrence Berkeley Laboratory 184-inch Synchrocyclotron is described. This beam is being used for the treatment of inoperable, deep, intracranial arteriovenous malformations (AVMs). Intracranial AVMs are collections of abnormal blood vessels in the brain that may represent a failure of vessels to mature properly and after a long period of slow growth they may produce clinically recognizable neurological symptoms. Based on our experience using narrow beams of helium ions for stereotactic radiosurgical treatment of AVM patients, the characteristics of the treatments are described. Improvements to the technique which are possible by the use of other charged particle beams are discussed.

Unfolding linac photon spectra and incident electron energies from experimental transmission data, with direct independent validation

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

Ali, E. S. M.; McEwen, M. R.; Rogers, D. W. O.

2012-11-15

Purpose: In a recent computational study, an improved physics-based approach was proposed for unfolding linac photon spectra and incident electron energies from transmission data. In this approach, energy differentiation is improved by simultaneously using transmission data for multiple attenuators and detectors, and the unfolding robustness is improved by using a four-parameter functional form to describe the photon spectrum. The purpose of the current study is to validate this approach experimentally, and to demonstrate its application on a typical clinical linac. Methods: The validation makes use of the recent transmission measurements performed on the Vickers research linac of National Research Councilmore » Canada. For this linac, the photon spectra were previously measured using a NaI detector, and the incident electron parameters are independently known. The transmission data are for eight beams in the range 10-30 MV using thick Be, Al and Pb bremsstrahlung targets. To demonstrate the approach on a typical clinical linac, new measurements are performed on an Elekta Precise linac for 6, 10 and 25 MV beams. The different experimental setups are modeled using EGSnrc, with the newly added photonuclear attenuation included. Results: For the validation on the research linac, the 95% confidence bounds of the unfolded spectra fall within the noise of the NaI data. The unfolded spectra agree with the EGSnrc spectra (calculated using independently known electron parameters) with RMS energy fluence deviations of 4.5%. The accuracy of unfolding the incident electron energy is shown to be {approx}3%. A transmission cutoff of only 10% is suitable for accurate unfolding, provided that the other components of the proposed approach are implemented. For the demonstration on a clinical linac, the unfolded incident electron energies and their 68% confidence bounds for the 6, 10 and 25 MV beams are 6.1 {+-} 0.1, 9.3 {+-} 0.1, and 19.3 {+-} 0.2 MeV, respectively. The unfolded spectra for the clinical linac agree with the EGSnrc spectra (calculated using the unfolded electron energies) with RMS energy fluence deviations of 3.7%. The corresponding measured and EGSnrc-calculated transmission data agree within 1.5%, where the typical transmission measurement uncertainty on the clinical linac is 0.4% (not including the uncertainties on the incident electron parameters). Conclusions: The approach proposed in an earlier study for unfolding photon spectra and incident electron energies from transmission data is accurate and practical for clinical use.« less

SU-F-T-618: Evaluation of a Mono-Isocentric Treatment Planning Software for Stereotactic Radiosurgery of Multiple Brain Metastases

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

Sham, E; Sattarivand, M; Mulroy, L

Purpose: To evaluate planning performance of an automated treatment planning software (BrainLAB; Elements) for stereotactic radiosurgery (SRS) of multiple brain metastases. Methods: Brainlab’s Multiple Metastases Elements (MME) uses single isocentric technique to treat up to 10 cranial planning target volumes (PTVs). The planning algorithm of the MME accounts for multiple PTVs overlapping with one another on the beam eyes view (BEV) and automatically selects a subset of all overlapping PTVs on each arc for sparing normal tissues in the brain. The algorithm also optimizes collimator angles, margins between multi-leaf collimators (MLCs) and PTVs, as well as monitor units (MUs) usingmore » minimization of conformity index (CI) for all targets. Planning performance was evaluated by comparing the MME-calculated treatment plan parameters with the same parameters calculated with the Volumetric Modulated Arc Therapy (VMAT) optimization on Varian’s Eclipse platform. Results: Figures 1 to 3 compare several treatment plan outcomes calculated between the MME and VMAT for 5 clinical multi-targets SRS patient plans. Prescribed target dose was volume-dependent and defined based on the RTOG recommendation. For a total number of 18 PTV’s, mean values for the CI, PITV, and GI were comparable between the MME and VMAT within one standard deviation (σ). However, MME-calculated MDPD was larger than the same VMAT-calculated parameter. While both techniques delivered similar maximum point doses to the critical cranial structures and total MU’s for the 5 patient plans, the MME required less treatment planning time by an order of magnitude compared to VMAT. Conclusion: The MME and VMAT produce similar plan qualities in terms of MUs, target dose conformation, and OAR dose sparing. While the selective use of PTVs for arc-optimization with the MME reduces significantly the total planning time in comparison to VMAT, the target dose homogeneity was also compromised due to its simplified inverse planning algorithm used.« less

Automating linear accelerator quality assurance.

PubMed

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

2015-10-01

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

SYNCHROTRON RADIATION, FREE ELECTRON LASER, APPLICATION OF NUCLEAR TECHNOLOGY, ETC.: Study on the characteristics of linac based THz light source

NASA Astrophysics Data System (ADS)

Zhu, Xiong-Wei; Wang, Shu-Hong; Chen, Sen-Yu

2009-10-01

There are many methods based on linac for THz radiation production. As one of the options for the Beijing Advanced Light, an ERL test facility is proposed for THz radiation. In this test facility, there are 4 kinds of methods to produce THz radiation: coherent synchrotron radiation (CSR), synchrotron radiation (SR), low gain FEL oscillator, and high gain SASE FEL. In this paper, we study the characteristics of the 4 kinds of THz light sources.

Stereotactic radiosurgery for trigeminal neuralgia utilizing the BrainLAB Novalis system.

PubMed

Zahra, Hadi; Teh, Bin S; Paulino, Arnold C; Yoshor, Daniel; Trask, Todd; Baskin, David; Butler, E Brian

2009-12-01

Stereotactic radiosurgery (SRS) is one of the least invasive treatments for trigeminal neuralgia (TN). To date, most reports have been about Cobalt-based treatments (i.e., Gamma Knife) with limited data on image-guided stereotactic linear accelerator treatments. We describe our initial experience of using BrainLAB Novalis stereotactic system for the radiosurgical treatment of TN. A total of 20 patients were treated between July 2004 and February 2007. Each SRS procedure was performed using the BrainLAB Novalis System. Thin cuts MRI images of 1.5 mm thickness were acquired and fused with the simulation CT of each patient. Majority of the patients received a maximum dose of 90 Gy. The median brainstem dose to 1.0 cc and 0.1 cc was 2.3 Gy and 13.5 Gy, respectively. In addition, specially acquired three-dimensional fast imaging sequence employing steady-state acquisition (FIESTA) MRI was utilized to improve target delineation of the trigeminal proximal nerve root entry zone. Barrow Neurological Index (BNI) pain scale for TN was used for assessing treatment outcome. At a median follow-up time of 14.2 months, 19 patients (95%) reported at least some improvement in pain. Eight (40%) patients were completely pain-free and stopped all medications (BNI Grade I) while another 2 (10%) patients also stopped medications but reported occasional pain (BNI Grade II). Another 2 (10%) patients reported no pain and 7 (35%) patients only occasional pain while continuing medications, BNI Grade IIIA and IIIB, respectively. Median time to pain control was 8.5 days (range: 1-70 days). No patient reported severe pain, worsening pain or any pain not controlled on their previously taken medication. Intermittent or persistent facial numbness following treatments occurred in 35% of patients. No other complications were reported. Stereotactic radiosurgery using the BrainLAB Novalis system is a safe and effective treatment for TN. This information is important as more centers are obtaining image-guided stereotactic-based linear accelerators capable of performing radiosurgery.

Calculation of Nuclear Particles Production at High-Energy Photon Beams from a Linac Operating at 6, 10 and 15 MV.

PubMed

Marchesini, Renato; Bettega, Daniela; Calzolari, Paola; Pignoli, Emanuele

2017-05-01

Production of photonuclear particles in a tissue-equivalent medium has been calculated for linacs at 6, 10 and 15 MV from Varian TrueBeam. Based on the knowledge of bremsstrahlung fluence spectra and linac photon beam parameters, numerical integration was performed on the cross sections for photoparticle production of the constituent elements of tissue (2H,12C,13C,16O,17O,18O,14N,15N). At 15 MV, at the depth of photon maximum dose, the total absorbed dose due to neutrons, protons, alphas and residual nuclei from photon reactions in tissue (5.5E-05 Gy per Gy of photons) is comparable to that due to neutrons from accelerator head. Results reasonably agree with data reported in the literature using Monte Carlo models simulating linac head components. This work suggests a simple method to estimate the dose contributed by the photon-induced nuclear particles for high-energy photon beams produced by linacs in use, as it might be relevant for late stochastic effects. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

SU-F-T-367: Using PRIMO, a PENELOPE-Based Software, to Improve the Small Field Dosimetry of Linear Accelerators

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

Benmakhlouf, H; Andreo, P; Brualla, L

2016-06-15

Purpose: To calculate output correction factors for Varian Clinac 2100iX beams for seven small field detectors and use the values to determine the small field output factors for the linacs at Karolinska university hospital. Methods: Phase space files (psf) for square fields between 0.25cm and 10cm were calculated using the PENELOPE-based PRIMO software. The linac MC-model was tuned by comparing PRIMO-estimated and experimentally determined depth doses and lateral dose-profiles for 40cmx40cm fields. The calculated psf were used as radiation sources to calculate the correction factors of IBA and PTW detectors with the code penEasy/PENELOPE. Results: The optimal tuning parameters ofmore » the MClinac model in PRIMO were 5.4 MeV incident electron energy and zero energy spread, focal spot size and beam divergence. Correction factors obtained for the liquid ion chamber (PTW-T31018) are within 1% down to 0.5 cm fields. For unshielded diodes (IBA-EFD, IBA-SFD, PTW-T60017 and PTW-T60018) the corrections are up to 2% at intermediate fields (>1cm side), becoming down to −11% for fields smaller than 1cm. The shielded diode (IBA-PFD and PTW-T60016) corrections vary with field size from 0 to −4%. Volume averaging effects are found for most detectors in the presence of 0.25cm fields. Conclusion: Good agreement was found between correction factors based on PRIMO-generated psf and those from other publications. The calculated factors will be implemented in output factor measurements (using several detectors) in the clinic. PRIMO is a userfriendly general code capable of generating small field psf and can be used without having to code own linac geometries. It can therefore be used to improve the clinical dosimetry, especially in the commissioning of linear accelerators. Important dosimetry data, such as dose-profiles and output factors can be determined more accurately for a specific machine, geometry and setup by using PRIMO and having a MC-model of the detector used.« less

SU-E-T-670: Radiotherapy Vault Shielding Evaluation Method for a Flattening Filter-Free (FFF) Linac-Practical Considerations and Recommendations

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

Mihailidis, D

2015-06-15

Purpose: To date, there isn’t formal approach for flattening filter-free (FFF) linac vault shielding evaluation, thus, we propose an extension to NCRP#151 to accommodate the recent large number of FFF linac installations.Methods and Materials: We extended the approach in NCRP#151 to design two Truebeam vaults in our new cancer center for hypofractionated treatments. Monte Carlo calculations have characterized primary, scattered, leakage and neutron radiations from FFF-modes. These calculations have shown that: a) FFF primary beam is softer on the central-axis compared to flattening filtered (FF), b) the lateral dose profile is peaked on the central axis and less integral targetmore » current is required to generate the same tumor dose with the FF beam. Thus, the TVLs for FFF mode are smaller than those of the FF mode and the scatter functions of the FF mode (NCRP#151) may not be appropriate for FFF-mode, c) the neutron source strength and fluence for 18X-FFF is smaller than 18X-FF, but it is not of a concern here, no 18X-FFF-mode is available on the linac under investigation. Results: These barrier thickness are smaller (12% reduction on the average) than those computed for conventional FF mode with same realistic primary workload since, the primary TVLs used here are smaller and the WL is smaller than the conventional (almost half reduced), keeping the TADR in tolerance. Conclusions: A comprehensive method for shielding barrier calculations based on dedicated data for FFF-mode linacs is highly desired. Meanwhile, we provide an extension to NCRP#151 to accommodate the shielding design of such installations. It is also shown that if a vault is already designed for IMRT/VMAT and SABR hypofractionated treatments with FFF-mode linac, the vault can also be used for a FFF mode linac replacement, leaving some leeway for slightly higher workload on the FFF linac.« less

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

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

Lee, Young; Ruschin, Mark

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

Coherent diffraction of single Rice Dwarf virus particles using hard X-rays at the Linac Coherent Light Source

PubMed Central

Munke, Anna; Andreasson, Jakob; Aquila, Andrew; Awel, Salah; Ayyer, Kartik; Barty, Anton; Bean, Richard J.; Berntsen, Peter; Bielecki, Johan; Boutet, Sébastien; Bucher, Maximilian; Chapman, Henry N.; Daurer, Benedikt J.; DeMirci, Hasan; Elser, Veit; Fromme, Petra; Hajdu, Janos; Hantke, Max F.; Higashiura, Akifumi; Hogue, Brenda G.; Hosseinizadeh, Ahmad; Kim, Yoonhee; Kirian, Richard A.; Reddy, Hemanth K.N.; Lan, Ti-Yen; Larsson, Daniel S.D.; Liu, Haiguang; Loh, N. Duane; Maia, Filipe R.N.C.; Mancuso, Adrian P.; Mühlig, Kerstin; Nakagawa, Atsushi; Nam, Daewoong; Nelson, Garrett; Nettelblad, Carl; Okamoto, Kenta; Ourmazd, Abbas; Rose, Max; van der Schot, Gijs; Schwander, Peter; Seibert, M. Marvin; Sellberg, Jonas A.; Sierra, Raymond G.; Song, Changyong; Svenda, Martin; Timneanu, Nicusor; Vartanyants, Ivan A.; Westphal, Daniel; Wiedorn, Max O.; Williams, Garth J.; Xavier, Paulraj Lourdu; Yoon, Chun Hong; Zook, James

2016-01-01

Single particle diffractive imaging data from Rice Dwarf Virus (RDV) were recorded using the Coherent X-ray Imaging (CXI) instrument at the Linac Coherent Light Source (LCLS). RDV was chosen as it is a well-characterized model system, useful for proof-of-principle experiments, system optimization and algorithm development. RDV, an icosahedral virus of about 70 nm in diameter, was aerosolized and injected into the approximately 0.1 μm diameter focused hard X-ray beam at the CXI instrument of LCLS. Diffraction patterns from RDV with signal to 5.9 Ångström were recorded. The diffraction data are available through the Coherent X-ray Imaging Data Bank (CXIDB) as a resource for algorithm development, the contents of which are described here. PMID:27478984

Coherent diffraction of single Rice Dwarf virus particles using hard X-rays at the Linac Coherent Light Source

DOE PAGES

Munke, Anna; Andreasson, Jakob; Aquila, Andrew; ...

2016-08-01

Single particle diffractive imaging data from Rice Dwarf Virus (RDV) were recorded using the Coherent X-ray Imaging (CXI) instrument at the Linac Coherent Light Source (LCLS). RDV was chosen as it is a well-characterized model system, useful for proof-of-principle experiments, system optimization and algorithm development. RDV, an icosahedral virus of about 70 nm in diameter, was aerosolized and injected into the approximately 0.1 μm diameter focused hard X-ray beam at the CXI instrument of LCLS. Diffraction patterns from RDV with signal to 5.9 Ångström were recorded. Here, the diffraction data are available through the Coherent X-ray Imaging Data Bank (CXIDB)more » as a resource for algorithm development, the contents of which are described here.« less

RF emittance in a low energy electron linear accelerator

NASA Astrophysics Data System (ADS)

Sanaye Hajari, Sh.; Haghtalab, S.; Shaker, H.; Kelisani, M. Dayyani

2018-04-01

Transverse beam dynamics of an 8 MeV low current (10 mA) S-band traveling wave electron linear accelerator has been studied and optimized. The main issue is to limit the beam emittance, mainly induced by the transverse RF forces. The linac is being constructed at Institute for Research in Fundamental Science (IPM), Tehran Iran Labeled as Iran's First Linac, nearly all components of this accelerator are designed and constructed within the country. This paper discusses the RF coupler induced field asymmetry and the corresponding emittance at different focusing levels, introduces a detailed beam dynamics design of a solenoid focusing channel aiming to reduce the emittance growth and studies the solenoid misalignment tolerances. In addition it has been demonstrated that a prebuncher cavity with appropriate parameters can help improving the beam quality in the transverse plane.

Coherent diffraction of single Rice Dwarf virus particles using hard X-rays at the Linac Coherent Light Source.

PubMed

Munke, Anna; Andreasson, Jakob; Aquila, Andrew; Awel, Salah; Ayyer, Kartik; Barty, Anton; Bean, Richard J; Berntsen, Peter; Bielecki, Johan; Boutet, Sébastien; Bucher, Maximilian; Chapman, Henry N; Daurer, Benedikt J; DeMirci, Hasan; Elser, Veit; Fromme, Petra; Hajdu, Janos; Hantke, Max F; Higashiura, Akifumi; Hogue, Brenda G; Hosseinizadeh, Ahmad; Kim, Yoonhee; Kirian, Richard A; Reddy, Hemanth K N; Lan, Ti-Yen; Larsson, Daniel S D; Liu, Haiguang; Loh, N Duane; Maia, Filipe R N C; Mancuso, Adrian P; Mühlig, Kerstin; Nakagawa, Atsushi; Nam, Daewoong; Nelson, Garrett; Nettelblad, Carl; Okamoto, Kenta; Ourmazd, Abbas; Rose, Max; van der Schot, Gijs; Schwander, Peter; Seibert, M Marvin; Sellberg, Jonas A; Sierra, Raymond G; Song, Changyong; Svenda, Martin; Timneanu, Nicusor; Vartanyants, Ivan A; Westphal, Daniel; Wiedorn, Max O; Williams, Garth J; Xavier, Paulraj Lourdu; Yoon, Chun Hong; Zook, James

2016-08-01

Single particle diffractive imaging data from Rice Dwarf Virus (RDV) were recorded using the Coherent X-ray Imaging (CXI) instrument at the Linac Coherent Light Source (LCLS). RDV was chosen as it is a well-characterized model system, useful for proof-of-principle experiments, system optimization and algorithm development. RDV, an icosahedral virus of about 70 nm in diameter, was aerosolized and injected into the approximately 0.1 μm diameter focused hard X-ray beam at the CXI instrument of LCLS. Diffraction patterns from RDV with signal to 5.9 Ångström were recorded. The diffraction data are available through the Coherent X-ray Imaging Data Bank (CXIDB) as a resource for algorithm development, the contents of which are described here.

Autopilot regulation for the Linac4 H- ion source

NASA Astrophysics Data System (ADS)

Voulgarakis, G.; Lettry, J.; Mattei, S.; Lefort, B.; Costa, V. J. Correia

2017-08-01

Linac4 is a 160 MeV H- linear accelerator part of the upgrade of the LHC injector chain. Its cesiated surface H- source is designed to provide a beam intensity of 40-50mA. It is operated with periodical Cs-injection at typically 30 days intervals [1] and this implies that the beam parameters will slowly evolve during operation. Autopilot is a control software package extending CERN developed Inspector framework. The aim of Autopilot is to automatize the mandatory optimization and cesiation processes and to derive performance indicators, thus keeping human intervention minimal. Autopilot has been developed by capitalizing on the experience from manually operating the source. It comprises various algorithms running in real-time, which have been devised to: • Optimize the ion source performance by regulation of H2 injection, RF power and frequency. • Describe the performance of the source with performance indicators, which can be easily understood by operators. • Identify failures, try to recover the nominal operation and send warning in case of deviation from nominal operation. • Make the performance indicators remotely available through Web pages.Autopilot is at the same level of hierarchy as an operator, in the CERN infrastructure. This allows the combination of all ion source devices, providing the required flexibility. Autopilot is executed in a dedicated server, ensuring unique and centralized control, yet allowing multiple operators to interact at runtime, always coordinating between them. Autopilot aims at flexibility, adaptability, portability and scalability, and can be extended to other components of CERN's accelerators. In this paper, a detailed description of the Autopilot algorithms is presented, along with first results of operating the Linac4 H- Ion Source with Autopilot.

Stereotactic multibeam radiation therapy system in a PACS environment

NASA Astrophysics Data System (ADS)

Fresne, Francoise; Le Gall, G.; Barillot, Christian; Gibaud, Bernard; Manens, Jean-Pierre; Toumoulin, Christine; Lemoine, Didier; Chenal, C.; Scarabin, Jean-Marie

1991-05-01

A Multibeam radiation therapy treatment is a non-invasive technique devoted to treat a lesion within the cerebral medium by focusing photon-beams on the same target from a high number of entrance points. We present here a computer assisted dosimetric planning procedure which includes: (1) an analysis module to define the target volume by using 2D and 3D displays, (2) a planing module to issue a treatment strategy including the dosimetric simulations and (3) a treatment module setting up the parameters to order the robotized treatment system (i.e. chair- framework, radiation unit machine). Another important feature of this system is its connection to the PACS system SIRENE settled in the University hospital of Rennes which makes possible the archiving and the communication of the multimodal images (CT, MRI, Angiography) used by this application. The corporate use of stereotactic methods and the multimodality imagery ensures spatial coherence and makes the target definition and the cognition of the structures environment more accurate. The dosimetric planning suited to the spatial reference (i.e. the stereotactic frame) guarantees an optimal distribution of the dose computed by an original 3D volumetric algorithm. The robotic approach of the treatment stage has consisted to design a computer driven chair-framework cluster to position the target volume at the radiation unit isocenter.

Accuracy of Intraoperative Computed Tomography during Deep Brain Stimulation Procedures: Comparison with Postoperative Magnetic Resonance Imaging

PubMed Central

Bot, Maarten; van den Munckhof, Pepijn; Bakay, Roy; Stebbins, Glenn; Verhagen Metman, Leo

2017-01-01

Objective To determine the accuracy of intraoperative computed tomography (iCT) in localizing deep brain stimulation (DBS) electrodes by comparing this modality with postoperative magnetic resonance imaging (MRI). Background Optimal lead placement is a critical factor for the outcome of DBS procedures and preferably confirmed during surgery. iCT offers 3-dimensional verification of both microelectrode and lead location during DBS surgery. However, accurate electrode representation on iCT has not been extensively studied. Methods DBS surgery was performed using the Leksell stereotactic G frame. Stereotactic coordinates of 52 DBS leads were determined on both iCT and postoperative MRI and compared with intended final target coordinates. The resulting absolute differences in X (medial-lateral), Y (anterior-posterior), and Z (dorsal-ventral) coordinates (ΔX, ΔY, and ΔZ) for both modalities were then used to calculate the euclidean distance. Results Euclidean distances were 2.7 ± 1.1 and 2.5 ± 1.2 mm for MRI and iCT, respectively (p = 0.2). Conclusion Postoperative MRI and iCT show equivalent DBS lead representation. Intraoperative localization of both microelectrode and DBS lead in stereotactic space enables direct adjustments. Verification of lead placement with postoperative MRI, considered to be the gold standard, is unnecessary. PMID:28601874

Accuracy of Intraoperative Computed Tomography during Deep Brain Stimulation Procedures: Comparison with Postoperative Magnetic Resonance Imaging.

PubMed

Bot, Maarten; van den Munckhof, Pepijn; Bakay, Roy; Stebbins, Glenn; Verhagen Metman, Leo

2017-01-01

To determine the accuracy of intraoperative computed tomography (iCT) in localizing deep brain stimulation (DBS) electrodes by comparing this modality with postoperative magnetic resonance imaging (MRI). Optimal lead placement is a critical factor for the outcome of DBS procedures and preferably confirmed during surgery. iCT offers 3-dimensional verification of both microelectrode and lead location during DBS surgery. However, accurate electrode representation on iCT has not been extensively studied. DBS surgery was performed using the Leksell stereotactic G frame. Stereotactic coordinates of 52 DBS leads were determined on both iCT and postoperative MRI and compared with intended final target coordinates. The resulting absolute differences in X (medial-lateral), Y (anterior-posterior), and Z (dorsal-ventral) coordinates (ΔX, ΔY, and ΔZ) for both modalities were then used to calculate the euclidean distance. Euclidean distances were 2.7 ± 1.1 and 2.5 ± 1.2 mm for MRI and iCT, respectively (p = 0.2). Postoperative MRI and iCT show equivalent DBS lead representation. Intraoperative localization of both microelectrode and DBS lead in stereotactic space enables direct adjustments. Verification of lead placement with postoperative MRI, considered to be the gold standard, is unnecessary. © 2017 The Author(s) Published by S. Karger AG, Basel.

Isocenter verification for linac‐based stereotactic radiation therapy: review of principles and techniques

PubMed Central

Sabet, Mahsheed; O'Connor, Daryl J.; Greer, Peter B.

2011-01-01

There have been several manual, semi‐automatic and fully‐automatic methods proposed for verification of the position of mechanical isocenter as part of comprehensive quality assurance programs required for linear accelerator‐based stereotactic radiosurgery/radiotherapy (SRS/SRT) treatments. In this paper, a systematic review has been carried out to discuss the present methods for isocenter verification and compare their characteristics, to help physicists in making a decision on selection of their quality assurance routine. PACS numbers: 87.53.Ly, 87.56.Fc, 87.56.‐v PMID:22089022

Poster - 19: Investigation of Electron Reference Dosimetry Based on Optimal Chamber Shift

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

Zhan, Lixin; Jiang, Runqing; Liu, Baochang

An addendum/revision to AAPM TG-51 electron reference dosimetry is highly expected to meet the clinical requirement with the increasing usage of new ion chambers not covered in TG-51. A recent study, Med. Phys. 41, 111701, proposed a new fitting equation for the beam quality conversion factor k’{sub Q} to a wide spectrum of chambers. In the study, an optimal Effective Point of Measurement (EPOM) from Monte Carlo calculations was recommended and the fitting parameters to k’{sub Q} was based on it. We investigated the absolute dose obtained based on the optimal EPOM method and the original TG-51 method with k’{submore » R50} determined differently. The results showed that using the Markus curve is a better choice than the well-guarded chamber fitting for an IBA PPC-05 parallel plate chamber if we need to strictly follow the AAPM TG-51 protocol. We also examined the usage of the new fitting equation with measurement performed at the physical EPOM, instead of the optimal EPOM. The former is more readily determined and more practical in clinics. Our study indicated that the k’{sub Q} fitting based on the optimal EPOM can be used to measurement at the physical EPOM with no significant clinical impact. The inclusion of Farmer chamber gradient correction P{sub gr} in k’{sub Q}, as in the mentioned study, asks for the precise positioning of chamber center at dref. It is not recommended in clinics to avoid over-correction for low electron energies, especially for an institute having matching Linacs implemented.« less

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

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

Vujicic, M; Belec, J; Heath, E

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

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

Cui, G; Trakul, N; Chang, E

Purpose: To evaluate the reproducibility of target position using moderate voluntary breath-hold during liver stereotactic ablative radiotherapy (SABR). Methods: Two patients who underwent liver SABR on a Varian TrueBeam STx linac were used for this study. Fiducial markers were placed in and around the target in the liver as surrogates for the target position and motion. GTVs were contoured by assessing tumor extent on contrast enhanced CT. The PTV was created from the GTV by adding 2 mm margins to account for the residual motion during breath-holds. A portable biofeedback system was used to facilitate the breath-hold to a reproduciblemore » position. The Varian RPM system was used for gating the linac. Proceeding each treatment, orthogonal kV pairs were taken, and alignment to nearby bony anatomy was performed. Then the breath-hold CBCT was acquired to align the fiducial markers. On-line fluoroscopy was used to fine-tune the breath-hold gating thresholds to correlate with the positions of the fiducial markers. The inter-fraction reproducibility of the target was evaluated by the offsets of the daily breath-hold CBCTs from the paired kV matches as a direct measure of the target position relative to the bony anatomy. The intra-fraction reproducibility of the target position was assessed by the gated window of the RPM marker block for each fraction. Results: The absolute mean offsets between the CBCT and paired kV matches in the vertical, longitudinal, and lateral directions were 0.06 cm, 0.10 cm, and 0.06 cm for patient 1, and 0.37 cm, 0.62 cm, and 0.09 cm for patient 2. The gated window of the RPM marker block for the breath-hold for each fraction was within 0.63 ± 0.16 cm and 0.59 ± 0.12 cm for patients 1 and 2, respectively. Conclusion: Moderate voluntary breath-hold showed good inter- and intra-fraction reproducibility of target position during liver SABR.« less

Optimization and quality assurance of an image-guided radiation therapy system for intensity-modulated radiation therapy radiotherapy

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

Tsai, Jen-San, E-mail: jen-san.tsai@verizon.net; Micaily, Bizhan; Miyamoto, Curtis

2012-10-01

To develop a quality assurance (QA) of XVI cone beam system (XVIcbs) for its optimal imaging-guided radiotherapy (IGRT) implementation, and to construe prostate tumor margin required for intensity-modulated radiation therapy (IMRT) if IGRT is unavailable. XVIcbs spatial accuracy was explored with a humanoid phantom; isodose conformity to lesion target with a rice phantom housing a soap as target; image resolution with a diagnostic phantom; and exposure validation with a Radcal ion chamber. To optimize XVIcbs, rotation flexmap on coincidency between gantry rotational axis and that of XVI cone beam scan was investigated. Theoretic correlation to image quality of XVIcbs rotationalmore » axis stability was elaborately studied. Comprehensive QA of IGRT using XVIcbs has initially been explored and then implemented on our general IMRT treatments, and on special IMRT radiotherapies such as head and neck (H and N), stereotactic radiation therapy (SRT), stereotactic radiosurgery (SRS), and stereotactic body radiotherapy (SBRT). Fifteen examples of prostate setup accounted for 350 IGRT cone beam system were analyzed. IGRT accuracy results were in agreement {+-} 1 mm. Flexmap 0.25 mm met the manufacturer's specification. Films confirmed isodose coincidence with target (soap) via XVIcbs, otherwise not. Superficial doses were measured from 7.2-2.5 cGy for anatomic diameters 15-33 cm, respectively. Image quality was susceptible to rotational stability or patient movement. IGRT using XVIcbs on general IMRT treatments such as prostate, SRT, SRS, and SBRT for setup accuracy were verified; and subsequently coordinate shifts corrections were recorded. The 350 prostate IGRT coordinate shifts modeled to Gaussian distributions show central peaks deviated off the isocenter by 0.6 {+-} 3.0 mm, 0.5 {+-} 4.5 mm in the X(RL)- and Z(SI)-coordinates, respectively; and 2.0 {+-} 3.0 mm in the Y(AP)-coordinate as a result of belly and bladder capacity variations. Sixty-eight percent of confidence was within {+-} 4.5 mm coordinates shifting. IGRT using XVIcbs is critical to IMRT for prostate and H and N, especially SRT, SRS, and SBRT. To optimize this modality of IGRT, a vigilant QA program is indispensable. Prostate IGRT reveals treatment accuracy as subject to coordinates' adjustments; otherwise a 4.5-mm margin is required to allow for full dose coverage of the clinical target volume, notwithstanding toxicity to normal tissues.« less

Nsls-II Boster

NASA Astrophysics Data System (ADS)

Gurov, S. M.; Akimov, A. V.; Akimov, V. E.; Anashin, V. V.; Anchugov, O. V.; Baranov, G. N.; Batrakov, A. M.; Belikov, O. V.; Bekhtenev, E. A.; Blum, E.; Bulatov, A. V.; Burenkov, D. B.; Cheblakov, P. B.; Chernyakin, A. D.; Cheskidov, V. G.; Churkin, I. N.; Davidsavier, M.; Derbenev, A. A.; Erokhin, A. I.; Fliller, R. P.; Fulkerson, M.; Gorchakov, K. M.; Ganetis, G.; Gao, F.; Gurov, D. S.; Hseuh, H.; Hu, Y.; Johanson, M.; Kadyrov, R. A.; Karnaev, S. E.; Karpov, G. V.; Kiselev, V. A.; Kobets, V. V.; Konstantinov, V. M.; Kolmogorov, V. V.; Korepanov, A. A.; Kramer, S.; Krasnov, A. A.; Kremnev, A. A.; Kuper, E. A.; Kuzminykh, V. S.; Levichev, E. B.; Li, Y.; Long, J. De; Makeev, A. V.; Mamkin, V. R.; Medvedko, A. S.; Meshkov, O. I.; Nefedov, N. B.; Neyfeld, V. V.; Okunev, I. N.; Ozaki, S.; Padrazo, D.; Petrov, V. V.; Petrichenkov, M. V.; Philipchenko, A. V.; Polyansky, A. V.; Pureskin, D. N.; Rakhimov, A. R.; Rose, J.; Ruvinskiy, S. I.; Rybitskaya, T. V.; Sazonov, N. V.; Schegolev, L. M.; Semenov, A. M.; Semenov, E. P.; Senkov, D. V.; Serdakov, L. E.; Serednyakov, S. S.; Shaftan, T. V.; Sharma, S.; Shichkov, D. S.; Shiyankov, S. V.; Shvedov, D. A.; Simonov, E. A.; Singh, O.; Sinyatkin, S. V.; Smaluk, V. V.; Sukhanov, A. V.; Tian, Y.; Tsukanova, L. A.; Vakhrushev, R. V.; Vobly, P. D.; Utkin, A. V.; Wang, G.; Wahl, W.; Willeke, F.; Yaminov, K. R.; Yong, H.; Zhuravlev, A.; Zuhoski, P.

The National Synchrotron Light Source II is a third generation light source, which was constructed at Brookhaven National Laboratory. This project includes a highly-optimized 3 GeV electron storage ring, linac preinjector, and full-energy synchrotron injector. Budker Institute of Nuclear Physics built and delivered the booster for NSLS-II. The commissioning of the booster was successfully completed. This paper reviews fulfilled work by participants.

Investigation of the usefulness of fluorescein sodium fluorescence in stereotactic brain biopsy.

PubMed

Thien, Ady; Han, Julian Xinguang; Kumar, Krishan; Ng, Yew Poh; Rao, Jai Prashanth; Ng, Wai Hoe; King, Nicolas Kon Kam

2018-02-01

Intraoperative frozen section assessment, to confirm acquisition of pathological tissues, is used in stereotactic brain biopsy to minimise sampling errors. Limitations include the dependence on dedicated neuro-oncology pathologists and an increase in operative duration. We investigated the use of intraoperative fluorescein sodium, and compared it to frozen section assessment, for confirming pathological tissue samples in the stereotactic biopsy of gadolinium-contrast-enhancing brain lesions. This prospective observational study consisted of 18 consecutive patients (12 men; median age, 63 years) who underwent stereotactic biopsy of gadolinium-contrast-enhancing brain lesions with intravenous fluorescein sodium administration. Twenty-three specimens were obtained and examined for the presence of fluorescence using a microscope with fluorescence visualisation capability. Positive and negative predictive values were calculated based on the fluorescence status of the biopsy samples with its corresponding intraoperative frozen section and definitive histopathological diagnosis. Nineteen specimens (83%) were fluorescent and four (17%) were non-fluorescent. All 19 fluorescent specimens were confirmed to be lesional on intraoperative frozen section assessment and were suitable for histopathological diagnosis. Three of the non-fluorescent specimens were confirmed to be lesional on intraoperative frozen section assessment. One non-fluorescent specimen was non-diagnostic on frozen section and histological assessments. The positive predictive value was 100% and the negative predictive value was 25%. Fluorescein sodium fluorescence is as accurate as frozen section assessment in confirming sampling of pathological tissue in the stereotactic biopsy of gadolinium-contrast-enhancing brain lesions. Fluorescein sodium fluorescence-guided stereotactic biopsy is a useful addition to the neurosurgical armamentarium.

Monteris AXiiiS Stereotactic Miniframe for Intracranial Biopsy: Precision, Feasibility, and Ease of Use.

PubMed

Manjila, Sunil; Knudson, Kathleen E; Johnson, Carleton; Sloan, Andrew E

2016-06-01

Stereotactic biopsy is an important and minimally invasive technique used for a variety of indications in neurosurgery. Initially, this technique required a frame, but recently there have been a number of newer, less cumbersome approaches to biopsy including robotic arms, fixed arms, and, more recently, skull-mounted miniframes. Miniframes are attractive because they are disposable and low profile. However, the relatively limited degree of freedom offered by currently available devices necessitates a preplanned burr hole, which in turn limits flexibility and multiple trajectories. The AXiiiS device is a skull-mounted, magnetic resonance imaging-compatible miniframe that provides a similar degree of freedom with a frame while maintaining a low-profile, disposable platform. To assess the image-guided trajectory alignment accuracy using AXiiiS stereotactic miniframe biopsy of intracranial lesions. The accuracy of the AXiiiS device is compared with the Navigus Trajectory Guide as platforms. After approval by our institutional review board, medical records of 10 neurosurgical patients with intracranial pathologies were chosen for AXiiiS stereotactic miniframe biopsy, and histological correlation was obtained. Ten reported cases demonstrate the precision and ease of using the AXiiiS stereotactic miniframe for biopsy of intracranial lesions in conjunction with preoperative magnetic resonance imaging. Multiple trajectories and angles have been used with precision and safety. The AXiiiS stereotactic miniframe is a feasible, safe, and disposable platform for multitrajectory intracranial biopsies. Compared with existing platforms, this novel device provides a more stable base and wider limits of trajectory angles with comparable accuracy and precision.

Single-Dose Versus Fractionated Stereotactic Radiotherapy for Brain Metastases

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

Kim, Yeon-Joo; Cho, Kwan Ho, E-mail: kwancho@ncc.re.kr; Kim, Joo-Young

2011-10-01

Purpose: To evaluate the efficacy of stereotactic radiotherapy in patients with brain metastases by comparing two different treatment regimens, single-dose radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT). Methods and Materials: Between November 2003 and December 2008, 98 patients with brain metastases were included. Fifty-eight patients were treated with SRS, and forty were treated with FSRT. Fractionated stereotactic radiotherapy was used for large lesions or lesions located near critical structures. The median doses were 20 Gy for the SRS group and 36 Gy in 6 fractions for the FSRT group. Results: With a median follow-up period of 7 months, the medianmore » survival was 7 months for all patients, with a median of 6 months for the SRS group and 8 months for the FSRT group (p = 0.89). Local progression-free survival (LPFS) rates at 6 months and 1 year were 81% and 71%, respectively, for the SRS group and 97% and 69%, respectively, for the FSRT group (p = 0.31). Despite the fact that FSRT was used for large lesions and lesions in adverse locations, LPFS was not inferior to SRS. Toxicity was more frequently observed in the SRS group than in the FSRT group (17% vs. 5%, p = 0.05). Conclusions: Because patients treated with FSRT exhibited similar survival times and LPFS rates with a lower risk of toxicity in comparison to those treated with SRS, despite the fact that FSRT was used for large lesions and lesions in adverse locations, we find that FSRT can particularly be beneficial for patients with large lesions or lesions located near critical structures. Further investigation is warranted to determine the optimal dose/fractionation.« less

SU-F-T-268: A Feasibility Study of Independent Dose Verification for Vero4DRT

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

Yamashita, M; Kokubo, M; Institute of Biomedical Research and Innovation, Kobe, Hyogo

2016-06-15

Purpose: Vero4DRT (Mitsubishi Heavy Industries Ltd.) has been released for a few years. The treatment planning system (TPS) of Vero4DRT is dedicated, so the measurement is the only method of dose verification. There have been no reports of independent dose verification using Clarksonbased algorithm for Vero4DRT. An independent dose verification software program of the general-purpose linac using a modified Clarkson-based algorithm was modified for Vero4DRT. In this study, we evaluated the accuracy of independent dose verification program and the feasibility of the secondary check for Vero4DRT. Methods: iPlan (Brainlab AG) was used as the TPS. PencilBeam Convolution was used formore » dose calculation algorithm of IMRT and X-ray Voxel Monte Carlo was used for the others. Simple MU Analysis (SMU, Triangle Products, Japan) was used as the independent dose verification software program in which CT-based dose calculation was performed using a modified Clarkson-based algorithm. In this study, 120 patients’ treatment plans were collected in our institute. The treatments were performed using the conventional irradiation for lung and prostate, SBRT for lung and Step and shoot IMRT for prostate. Comparison in dose between the TPS and the SMU was done and confidence limits (CLs, Mean ± 2SD %) were compared to those from the general-purpose linac. Results: As the results of the CLs, the conventional irradiation (lung, prostate), SBRT (lung) and IMRT (prostate) show 2.2 ± 3.5% (CL of the general-purpose linac: 2.4 ± 5.3%), 1.1 ± 1.7% (−0.3 ± 2.0%), 4.8 ± 3.7% (5.4 ± 5.3%) and −0.5 ± 2.5% (−0.1 ± 3.6%), respectively. The CLs for Vero4DRT show similar results to that for the general-purpose linac. Conclusion: The independent dose verification for the new linac is clinically available as a secondary check and we performed the check with the similar tolerance level of the general-purpose linac. This research is partially supported by Japan Agency for Medical Research and Development (AMED)« less

Volumetric Modulated Arc-Based Hypofractionated Stereotactic Radiotherapy for the Treatment of Selected Intracranial Arteriovenous Malformations: Dosimetric Report and Early Clinical Experience

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

Subramanian, Sai; Srinivas, Chilukuri; Ramalingam, K.

2012-03-01

Purpose: To evaluate, with a dosimetric and clinical feasibility study, RapidArc (a volumetric modulated arc technique) for hypofractionated stereotactic radiotherapy treatment of large arteriovenous malformations (AVMs). Methods and Materials: Nine patients were subject to multimodality imaging (magnetic resonance, computed tomography, and digital subtraction angiography) to determine nidus and target volumes, as well as involved organs at risk (optical structures, inner ear, brain stem). Plans for multiple intensity-modulated arcs with a single isocenter were optimized for a fractionation of 25 Gy in 5 fractions. All plans were optimized for 6-MV photon beams. Dose-volume histograms were analyzed to assess plan quality. Deliverymore » parameters were reported to appraise technical features of RapidArc, and pretreatment quality assurance measurements were carried out to report on quality of delivery. Results: Average size of AVM nidus was 26.2 cm{sup 3}, and RapidArc plans provided complete target coverage with minimal overdosage (V{sub 100%} = 100% and V{sub 110%} < 1%) and excellent homogeneity (<6%). Organs at risk were highly spared. The D{sub 1%} to chiasm, eyes, lenses, optic nerves, and brainstem (mean {+-} SD) was 6.4 {+-} 8.3, 1.9 {+-} 3.8, 2.3 {+-} 2.2, 0.7 {+-} 0.9, 4.4 {+-} 7.2, 12.2 {+-} 9.6 Gy, respectively. Conformity index (CI{sub 95%}) was 2.2 {+-} 0.1. The number of monitor units per gray was 277 {+-} 45, total beam-on time was 2.5 {+-} 0.3 min. Planning vs. delivery {gamma} pass rate was 98.3% {+-} 0.9%. None of the patients developed acute toxicity. With a median follow-up of 9 months, 3 patients presented with deterioration of symptoms and were found to have postradiation changes but responded symptomatically to steroids. These patients continue to do well on follow-up. One patient developed headache and seizures, which was attributed to intracranial bleed, confirmed on imaging. Conclusion: Hypofractionated stereotactic radiotherapy can be successfully delivered using the RapidArc form of volumetric arc technology for intracranial AVMs. The quality of delivery and calculated parameters are in agreement with each other and are in line with published reports for other sites.« less

Clinical impact of dosimetric changes for volumetric modulated arc therapy in log file-based patient dose calculations.

PubMed

Katsuta, Yoshiyuki; Kadoya, Noriyuki; Fujita, Yukio; Shimizu, Eiji; Matsunaga, Kenichi; Matsushita, Haruo; Majima, Kazuhiro; Jingu, Keiichi

2017-10-01

A log file-based method cannot detect dosimetric changes due to linac component miscalibration because log files are insensitive to miscalibration. Herein, clinical impacts of dosimetric changes on a log file-based method were determined. Five head-and-neck and five prostate plans were applied. Miscalibration-simulated log files were generated by inducing a linac component miscalibration into the log file. Miscalibration magnitudes for leaf, gantry, and collimator at the general tolerance level were ±0.5mm, ±1°, and ±1°, respectively, and at a tighter tolerance level achievable on current linac were ±0.3mm, ±0.5°, and ±0.5°, respectively. Re-calculations were performed on patient anatomy using log file data. Changes in tumor control probability/normal tissue complication probability from treatment planning system dose to re-calculated dose at the general tolerance level was 1.8% on planning target volume (PTV) and 2.4% on organs at risk (OARs) in both plans. These changes at the tighter tolerance level were improved to 1.0% on PTV and to 1.5% on OARs, with a statistically significant difference. We determined the clinical impacts of dosimetric changes on a log file-based method using a general tolerance level and a tighter tolerance level for linac miscalibration and found that a tighter tolerance level significantly improved the accuracy of the log file-based method. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Optimization of image quality and dose for Varian aS500 electronic portal imaging devices (EPIDs).

PubMed

McGarry, C K; Grattan, M W D; Cosgrove, V P

2007-12-07

This study was carried out to investigate whether the electronic portal imaging (EPI) acquisition process could be optimized, and as a result tolerance and action levels be set for the PIPSPro QC-3V phantom image quality assessment. The aim of the optimization process was to reduce the dose delivered to the patient while maintaining a clinically acceptable image quality. This is of interest when images are acquired in addition to the planned patient treatment, rather than images being acquired using the treatment field during a patient's treatment. A series of phantoms were used to assess image quality for different acquisition settings relative to the baseline values obtained following acceptance testing. Eight Varian aS500 EPID systems on four matched Varian 600C/D linacs and four matched Varian 2100C/D linacs were compared for consistency of performance and images were acquired at the four main orthogonal gantry angles. Images were acquired using a 6 MV beam operating at 100 MU min(-1) and the low-dose acquisition mode. Doses used in the comparison were measured using a Farmer ionization chamber placed at d(max) in solid water. The results demonstrated that the number of reset frames did not have any influence on the image contrast, but the number of frame averages did. The expected increase in noise with corresponding decrease in contrast was also observed when reducing the number of frame averages. The optimal settings for the low-dose acquisition mode with respect to image quality and dose were found to be one reset frame and three frame averages. All patients at the Northern Ireland Cancer Centre are now imaged using one reset frame and three frame averages in the 6 MV 100 MU min(-1) low-dose acquisition mode. Routine EPID QC contrast tolerance (+/-10) and action (+/-20) levels using the PIPSPro phantom based around expected values of 190 (Varian 600C/D) and 225 (Varian 2100C/D) have been introduced. The dose at dmax from electronic portal imaging has been reduced by approximately 28%, and while the image quality has been reduced, the images produced are still clinically acceptable.

Poster — Thur Eve — 64: Preliminary investigation of arc configurations for optimal sparing of normal tissue in hypofractionated stereotactic radiotherapy (HF-SRT) of multiple brain metastases using a 5mm interdigitating micro-multileaf collimator

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

Leavens, C; Wronski, M; Lee, YK

2014-08-15

Purpose: To evaluate normal tissue sparing in intra-cranial HF-SRT, comparing various arc configurations with the Synergy Beam Modulator (SynBM) and Agility linacs, the latter incorporating leaf interdigitation and backup jaws. Methods: Five patients with multiple brain metastases (BMs), (5 BMs (n=2), 3 BMs (n=3)) treated with HF-SRT using 25 Gy (n=2) or 30 Gy (n=3) in 5 fractions, were investigated. Clinical treatment plans used the SynBM. Each patient was retrospectively re-planned on Agility, employing three planning strategies: (A) one isocenter and dedicated arc for each BM; (B) a single isocenter, centrally placed with respect to BMs; (C) the isocenter andmore » arc configuration used in the SynBM plan, where closely spaced (<5cm) BMs used a dedicated isocenter and arcs. Agility plans were normalized for PTV coverage and heterogeneity. Results and Conclusion: Strategy A obtained the greatest improvements over the SynBM plan, where the maximum OAR dose, and mean dose to normal brain (averaged for all patients) were reduced by 55cGy and 25cGy, respectively. Strategy B was limited by having a single isocenter, hence less jaw shielding and increased MLC leakage. The maximum OAR dose was reduced by 13cGy, however mean dose to normal brain increased by 84cGy. Strategy C reduced the maximum OAR dose and mean dose to normal brain by 32cGy and 9cGy, respectively. The results from this study indicate that, for intra-cranial HF-SRT of multiple BMs, Agility plans are equal or better than SynBM plans. Further planning is needed to investigate dose sparing using Strategy A and the SynBM.« less

SU-F-T-250: What Does It Take to Correctly Assess the High Failure Modes of an Advanced Radiotherapy Procedure Such as Stereotactic Body Radiation Therapy?

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

Han, D; Vile, D; Rosu, M

Purpose: Assess the correct implementation of risk-based methodology of TG 100 to optimize quality management and patient safety procedures for Stereotactic Body Radiation Therapy. Methods: A detailed process map of SBRT treatment procedure was generated by a team of three physicists with varying clinical experience at our institution to assess the potential high-risk failure modes. The probabilities of occurrence (O), severity (S) and detectability (D) for potential failure mode in each step of the process map were assigned by these individuals independently on the scale from1 to 10. The risk priority numbers (RPN) were computed and analyzed. The highest 30more » potential modes from each physicist’s analysis were then compared. Results: The RPN values assessed by the three physicists ranged from 30 to 300. The magnitudes of the RPN values from each physicist were different, and there was no concordance in the highest RPN values recorded by three physicists independently. The 10 highest RPN values belonged to sub steps of CT simulation, contouring and delivery in the SBRT process map. For these 10 highest RPN values, at least two physicists, irrespective of their length of experience had concordance but no general conclusions emerged. Conclusion: This study clearly shows that the risk-based assessment of a clinical process map requires great deal of preparation, group discussions, and participation by all stakeholders. One group albeit physicists cannot effectively implement risk-based methodology proposed by TG100. It should be a team effort in which the physicists can certainly play the leading role. This also corroborates TG100 recommendation that risk-based assessment of clinical processes is a multidisciplinary team effort.« less

Performance of a Combined System Using an X-Ray FEL Oscillator and a High-Gain FEL Amplifier

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

Gupta, L.; Lindberg, R.; Kim, K. -J.

The LCLS-II at SLAC will feature a 4 GeV CW superconducting (SC) RF linac [1] that can potentially drive a 5th harmonic X-Ray FEL Oscillator (XFELO) to produce fully coherent, 1 MW photon pulses with a 5 meV bandwidth at 14.4 keV [2]. The XFELO output can serve as the input seed signal for a high-gain FEL amplifier employing fs electron beams from the normal conducting SLAC linac, thereby generating coherent, fs x-ray pulses with TW peak powers using a tapered undulator after saturation [3]. Coherent, intense output at several tens of keV will also be feasible if one considersmore » a harmonic generation scheme. Thus, one can potentially reach the 42 keV photon energy required for the MaRIE project [4] by beginning with an XFELO operating at the 3rd harmonic to produce 14.0 keV photons using a 12 GeV SCRF linac, and then subsequently using the high-gain harmonic generation scheme to generate and amplify the 3th harmonic at 42 keV [5]. We report extensive GINGER simulations that determine an optimized parameter set for the combined system.« less

Hypofractionated stereotactic radiation therapy in three to five fractions for vestibular schwannoma.

PubMed

Morimoto, Masahiro; Yoshioka, Yasuo; Kotsuma, Tadayuki; Adachi, Kana; Shiomi, Hiroya; Suzuki, Osamu; Seo, Yuji; Koizumi, Masahiko; Kagawa, Naoki; Kinoshita, Manabu; Hashimoto, Naoya; Ogawa, Kazuhiko

2013-08-01

To retrospectively examine the outcomes of hypofractionated stereotactic radiation therapy in three to five fractions for vestibular schwannomas. Twenty-five patients with 26 vestibular schwannomas were treated with hypofractionated stereotactic radiation therapy using a CyberKnife. The vestibular schwannomas of 5 patients were associated with type II neurofibromatosis. The median follow-up time was 80 months (range: 6-167); the median planning target volume was 2.6 cm(3) (0.3-15.4); and the median prescribed dose (≥D90) was 21 Gy in three fractions (18-25 Gy in three to five fractions). Progression was defined as ≥2 mm 3-dimensional post-treatment tumor enlargement excluding transient expansion. Progression or any death was counted as an event in progression-free survival rates, whereas only progression was counted in progression-free rates. The 7-year progression-free survival and progression-free rates were 78 and 95%, respectively. Late adverse events (≥3 months) with grades based on Common Terminology Criteria for Adverse Events, v4.03 were observed in 6 patients: Grade 3 hydrocephalus in one patient, Grade 2 facial nerve disorders in two and Grade 1-2 tinnitus in three. In total, 12 out of 25 patients maintained pure tone averages ≤50 dB before hypofractionated stereotactic radiation therapy, and 6 of these 12 patients (50%) maintained pure tone averages at this level at the final audiometric follow-up after hypofractionated stereotactic radiation therapy. However, gradient deterioration of pure tone average was observed in 11 of these 12 patients. The mean pure tone averages before hypofractionated stereotactic radiation therapy and at the final follow-up for the aforementioned 12 patients were 29.8 and 57.1 dB, respectively. Treating vestibular schwannomas with hypofractionated stereotactic radiation therapy in three to five fractions may prevent tumor progression with tolerable toxicity. However, gradient deterioration of pure tone average was observed.

Stereotactic radiosurgery - discharge

MedlinePlus

Gamma knife - discharge; Cyberknife - discharge; Stereotactic radiotherapy - discharge; Fractionated stereotactic radiotherapy - discharge; Cyclotrons - discharge; Linear accelerator - discharge; Lineacs - discharge; Proton beam radiosurgery - discharge

An Rf Focused Interdigital Ion Accelerating Structure

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

Swenson, D.A.

2003-08-26

An Rf Focused Interdigital (RFI) ion accelerating structure will be described. It represents an effective combination of the Wideroee (or interdigital) linac structure, used for many low frequency, heavy ion applications, and the rf electric quadrupole focusing used in the RFQ and RFD linac structures. As in the RFD linac structure, rf focusing is introduced into the RFI linac structure by configuring the drift tubes as two independent pieces operating at different electrical potentials as determined by the rf fields of the linac structure. Each piece (or electrode) of the RFI drift tube supports two fingers pointed inwards towards themore » opposite end of the drift tube forming a four-finger geometry that produces an rf quadrupole field along the axis of the linac for focusing the beam. However, because of the differences in the rf field configuration along the axis, the scheme for introducing rf focusing into the interdigital linac structure is quite different from that adopted for the RFD linac structure. The RFI linac structure promises to have significant size, efficiency, performance, and cost advantages over existing linac structures for the acceleration of low energy ion beams of all masses (light to heavy). These advantages will be reviewed. A 'cold model' of this new linac structure has been fabricated and the results of rf cavity measurements on this cold model will be presented.« less

TH-C-12A-04: Dosimetric Evaluation of a Modulated Arc Technique for Total Body Irradiation

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

Tsiamas, P; Czerminska, M; Makrigiorgos, G

2014-06-15

Purpose: A simplified Total Body Irradiation (TBI) was developed to work with minimal requirements in a compact linac room without custom motorized TBI couch. Results were compared to our existing fixed-gantry double 4 MV linac TBI system with prone patient and simultaneous AP/PA irradiation. Methods: Modulated arc irradiates patient positioned in prone/supine positions along the craniocaudal axis. A simplified inverse planning method developed to optimize dose rate as a function of gantry angle for various patient sizes without the need of graphical 3D treatment planning system. This method can be easily adapted and used with minimal resources. Fixed maximum fieldmore » size (40×40 cm2) is used to decrease radiation delivery time. Dose rate as a function of gantry angle is optimized to result in uniform dose inside rectangular phantoms of various sizes and a custom VMAT DICOM plans were generated using a DICOM editor tool. Monte Carlo simulations, film and ionization chamber dosimetry for various setups were used to derive and test an extended SSD beam model based on PDD/OAR profiles for Varian 6EX/ TX. Measurements were obtained using solid water phantoms. Dose rate modulation function was determined for various size patients (100cm − 200cm). Depending on the size of the patient arc range varied from 100° to 120°. Results: A PDD/OAR based beam model for modulated arc TBI therapy was developed. Lateral dose profiles produced were similar to profiles of our existing TBI facility. Calculated delivery time and full arc depended on the size of the patient (∼8min/ 100° − 10min/ 120°, 100 cGy). Dose heterogeneity varied by about ±5% − ±10% depending on the patient size and distance to the surface (buildup region). Conclusion: TBI using simplified modulated arc along craniocaudal axis of different size patients positioned on the floor can be achieved without graphical / inverse 3D planning.« less

Design study of high gradient, low impedance accelerating structures for the FERMI free electron laser linac upgrade

NASA Astrophysics Data System (ADS)

Shafqat, N.; Di Mitri, S.; Serpico, C.; Nicastro, S.

2017-09-01

The FERMI free-electron laser (FEL) of Elettra Sincrotrone Trieste, Italy, is a user facility driven by a 1.5 GeV 10-50 Hz S-band radiofrequency linear accelerator (linac), and it is based on an external laser seeding scheme that allows lasing at the shortest fundamental wavelength of 4 nm. An increase of the beam energy to 1.8 GeV at a tolerable breakdown rate, and an improvement of the final beam quality is desired in order to allow either lasing at 4 nm with a higher flux, or lasing at shorter wavelengths. This article presents the impedance analysis of newly designed S-band accelerating structures, for replacement of the existing backward travelling wave structures (BTWS) in the last portion of the FERMI linac. The new structure design promises higher accelerating gradient and lower impedance than those of the existing BTWS. Particle tracking simulations show that, with the linac upgrade, the beam relative energy spread, its linear and nonlinear z-correlation internal to the bunch, and the beam transverse emittances can be made smaller than the ones in the present configuration, with expected advantage to the FEL performance. The repercussion of the upgrade on the linac quadrupole magnets setting, for a pre-determined electron beam optics, is also considered.

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

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

Zhang, X; Liang, X; Penagaricano, J

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),more » 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-seated and cannot be safely treated with LINAC-GRID.« less

Dose characteristics of in-house-built collimators for stereotactic radiotherapy with a linear accelerator.

PubMed

Norrgård, F S; Sipilä, P M; Kulmala, J A; Minn, H R

1998-06-01

Dose characteristics of a stereotactic radiotherapy unit based on a standard Varian Clinac 4/100 4 MV linear accelerator, in-house-built Lipowitz collimators and the SMART stereotactic radiotherapy treatment planning software have been determined. Beam collimation is constituted from the standard collimators of the linear accelerator and a tertiary collimation consisting of a replaceable divergent Lipowitz collimator. Four collimators with isocentre diameters of 15, 25, 35 and 45 mm, respectively, were constructed. Beam characteristics were measured in air, acrylic or water with ionization chamber, photon diode, electron diode, diamond detector and film. Monte Carlo simulation was also applied. The radiation leakage under the collimators was less than 1% at 50 mm depth in water. Specific beam characteristics for each collimator were imported to SMART and dose planning with five non-coplanar converging 140 degrees arcs separated by 36 degrees angles was performed for treatment of a RANDO phantom. Dose verification was made with TLD and radiochromic film. The in-house-built collimators were found to be suitable for stereotactic radiotherapy and patient treatments with this system are in progress.

Single-fraction stereotactic body radiotherapy for spinal metastases from renal cell carcinoma.

PubMed

Balagamwala, Ehsan H; Angelov, Lilyana; Koyfman, Shlomo A; Suh, John H; Reddy, Chandana A; Djemil, Toufik; Hunter, Grant K; Xia, Ping; Chao, Samuel T

2012-12-01

Stereotactic body radiotherapy (SBRT) has emerged as an important treatment option for spinal metastases from renal cell carcinoma (RCC) as a means to overcome RCC's inherent radioresistance. The authors reviewed the outcomes of SBRT for the treatment of RCC metastases to the spine at their institution, and they identified factors associated with treatment failure. Fifty-seven patients (88 treatment sites) with RCC metastases to the spine received single-fraction SBRT. Pain relief was based on the Brief Pain Inventory and was adjusted for narcotic use according to the Radiation Therapy Oncology Group protocol 0631. Toxicity was scored according to Common Toxicity Criteria for Adverse Events version 4.0. Radiographic failure was defined as infield or adjacent (within 1 vertebral body [VB]) failure on follow-up MRI. Multivariate analyses were performed to correlate outcomes with the following variables: epidural, paraspinal, single-level, or multilevel disease (2-5 sites); neural foramen involvement; and VB fracture prior to SBRT. Kaplan-Meier analysis and Cox proportional hazards modeling were used for statistical analysis. The median follow-up and survival periods were 5.4 months (range 0.3-38 months) and 8.3 months (range 1.5-38 months), respectively. The median time to radiographic failure and unadjusted pain progression were 26.5 and 26.0 months, respectively. The median time to pain relief (from date of simulation) and duration of pain relief (from date of treatment) were 0.9 months (range 0.1-4.4 months) and 5.4 months (range 0.1-37.4 months), respectively. Multivariate analyses demonstrated that multilevel disease (hazard ratio [HR] 3.5, p = 0.02) and neural foramen involvement (HR 3.4, p = 0.02) were correlated with radiographic failure; multilevel disease (HR 2.3, p = 0.056) and VB fracture (HR 2.4, p = 0.046) were correlated with unadjusted pain progression. One patient experienced Grade 3 nausea and vomiting; no other Grade 3 or 4 toxicities were observed. Twelve treatment sites (14%) were complicated by subsequent vertebral fractures. Stereotactic body radiotherapy for RCC metastases to the spine offers fast and durable pain relief with minimal toxicity. Stereotactic body radiotherapy seems optimal for patients who have solitary or few spinal metastases. Patients with neural foramen involvement are at an increased risk for failure.

Dual mode stereotactic localization method and application

DOEpatents

Keppel, Cynthia E.; Barbosa, Fernando Jorge; Majewski, Stanislaw

2002-01-01

The invention described herein combines the structural digital X-ray image provided by conventional stereotactic core biopsy instruments with the additional functional metabolic gamma imaging obtained with a dedicated compact gamma imaging mini-camera. Before the procedure, the patient is injected with an appropriate radiopharmaceutical. The radiopharmaceutical uptake distribution within the breast under compression in a conventional examination table expressed by the intensity of gamma emissions is obtained for comparison (co-registration) with the digital mammography (X-ray) image. This dual modality mode of operation greatly increases the functionality of existing stereotactic biopsy devices by yielding a much smaller number of false positives than would be produced using X-ray images alone. The ability to obtain both the X-ray mammographic image and the nuclear-based medicine gamma image using a single device is made possible largely through the use of a novel, small and movable gamma imaging camera that permits its incorporation into the same table or system as that currently utilized to obtain X-ray based mammographic images for localization of lesions.

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

Hartemann, F V; Albert, F; Anderson, S G

Nuclear photonics is an emerging field of research requiring new tools, including high spectral brightness, tunable gamma-ray sources; high photon energy, ultrahigh-resolution crystal spectrometers; and novel detectors. This presentation focuses on the precision linac technology required for Compton scattering gamma-ray light sources, and on the optimization of the laser and electron beam pulse format to achieve unprecedented spectral brightness. Within this context, high-gradient X-band technology will be shown to offer optimal performance in a compact package, when used in conjunction with the appropriate pulse format, and photocathode illumination and interaction laser technologies. The nascent field of nuclear photonics is enabledmore » by the recent maturation of new technologies, including high-gradient X-band electron acceleration, robust fiber laser systems, and hyper-dispersion CPA. Recent work has been performed at LLNL to demonstrate isotope-specific detection of shielded materials via NRF using a tunable, quasi-monochromatic Compton scattering gamma-ray source operating between 0.2 MeV and 0.9 MeV photon energy. This technique is called Fluorescence Imaging in the Nuclear Domain with Energetic Radiation (or FINDER). This work has, among other things, demonstrated the detection of {sup 7}Li shielded by Pb, utilizing gamma rays generated by a linac-driven, laser-based Compton scattering gamma-ray source developed at LLNL. Within this context, a new facility is currently under construction at LLNL, with the goal of generating tunable {gamma}-rays in the 0.5-2.5 MeV photon energy range, at a repetition rate of 120 Hz, and with a peak brightness in the 10{sup 20} photons/(s x mm{sup 2} x mrad{sup 2} x 0.1% bw).« less

Stereotactic Body Radiation Therapy for Oligometastatic Prostate Cancer

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

Muldermans, Jonathan L.; Romak, Lindsay B.; Kwon, Eugene D.

Purpose: To review outcomes of patients with oligometastatic prostate cancer (PCa) treated with stereotactic body radiation therapy (SBRT) and to identify variables associated with local failure. Methods and Materials: We retrospectively reviewed records of patients treated with SBRT for oligometastatic PCa. Metastasis control (ie, control of the treated lesion, MC), biochemical progression-free survival, distant progression-free survival, and overall survival were estimated with the Kaplan-Meier method. Results: Sixty-six men with 81 metastatic PCa lesions, 50 of which were castrate-resistant, were included in the analysis. Lesions were in bone (n=74), lymph nodes (n=6), or liver (n=1). Stereotactic body radiation therapy was deliveredmore » in 1 fraction to 71 lesions (88%), at a median dose of 16 Gy (range, 16-24 Gy). The remaining lesions received 30 Gy in 3 fractions (n=6) or 50 Gy in 5 fractions (n=4). Median follow-up was 16 months (range, 3-49 months). Estimated MC at 2 years was 82%. Biochemical progression-free survival, distant progression-free survival, and overall survival were 54%, 45%, and 83%, respectively. On multivariate analysis, only the dose of SBRT was significantly associated with MC; lesions treated with 16 Gy had 58% MC, and those treated with ≥18 Gy had 95% MC at 2 years (P≤.001). At 2 years, MC for lesions treated with 18 Gy (n=21) was 88%. No patient treated with ≥18 Gy in a single fraction or with any multifraction regimen had local failure. Six patients (9%) had grade 1 pain flare, and 2 (3%) had grade 2 pain flare. No grade 2 or greater late toxicities were reported. Conclusions: Stereotactic body radiation therapy for patients with oligometastatic prostate cancer provided optimal metastasis control and acceptable toxicity with doses ≥18 Gy. Biochemical progression-free survival was 54% at 16 months with the inclusion of SBRT in the treatment regimen. Stereotactic body radiation therapy should be considered in patients with castration-refractory, oligometastatic prostate cancer who have limited options for systemic therapy.« less

TU-G-BRA-01: Assessing Radiation-Induced Reductions in Regional Lung Perfusion Following Stereotactic Radiotherapy for Lung Cancer

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

McGurk, R; Green, R; Lawrence, M

2015-06-15

Purpose: The dose-dependent nature of radiation therapy (RT)-induced lung injury following hypo-fractionated stereotactic RT is unclear. We herein report preliminary results of a prospective study assessing the magnitude of RT-induced reductions in regional lung perfusion following hypo-fractionated stereotactic RT. Methods: Four patients undergoing hypo-fractionated stereotactic lung RT (SBRT: 12 Gy x 4 fractions or 10 Gy x 5 fractions) had a pre-treatment SPECT (single-photon emission computed tomography) perfusion scan providing a 3D map of regional lung perfusion. Scans were repeated 3–6 months post-treatment. Pre- and post SPECT scans were registered to the planning CT scan (and hence the 3D dosemore » data). Changes in regional perfusion (counts per cc on the pre-post scans) were computed in regions of the lung exposed to different doses of radiation (in 5 Gy intervals), thus defining a dose-response function. SPECT scans were internally normalized to the regions receiving <5 Gy. Results: At 3 months post-RT, the changes in perfusion are highly variable. At 6 months, there is a consistent dose-dependent reduction in regional perfusion. The average percent decline in regional perfusion was 10% at 15–20 Gy, 20% at 20–25 Gy, and 30% at 25–30 Gy representing a relatively linear dose response with an approximate 2% reduction per Gray for doses in excess of 10 Gy. There was a subtle increase in perfusion in the lung receiving <10 Gy. Conclusion: Hypo-fractionated stereotactic RT appears to cause a dose-dependent reduction in regional lung perfusion. There appears to be a threshold effect with no apparent perfusion loss at doses <10 Gy, though this might be in part due to the normalization technique used. Additional data is needed from a larger number of patients to better assess this issue. This sort of data can be used to assist optimizing RT treatment plans that minimize the risk of lung injury. Partly supported by the NIH (CA69579) and the Lance Armstrong Foundation.« less

Use of the CEBAF Accelerator for IR and UV Free Electron Lasers

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

Yunn, Byung; Sinclair, Charles; Leemann, Christoph

1992-08-01

The CEBAF superconducting linac is capable of accelerating electron beams suitable for driving high-power free-electron lasers. The 45 MeV injector linac with a 6 cm period wiggler can produce kilowatt output powers of infrared light (3.6-17 micrometer), while the 400 MeV north linac can produce ultraviolet light (~200 nm) at similar powers. The FELs require the addition of a high-peak intensity electron source (~ 60 A peak current) and extraction beam lines to wigglers with appropriate electron and photon optics. FEL operation is compatible with simultaneous baseline CEBAF nuclear physics operation. A design for a CEBAF-based FEL facility has beenmore » developed. The current status of the FEL project is reported.« less

10 CFR 35.645 - Periodic spot-checks for gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Periodic spot-checks for gamma stereotactic radiosurgery... § 35.645 Periodic spot-checks for gamma stereotactic radiosurgery units. (a) A licensee authorized to use a gamma stereotactic radiosurgery unit for medical use shall perform spot-checks of each gamma...

10 CFR 35.645 - Periodic spot-checks for gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Periodic spot-checks for gamma stereotactic radiosurgery... § 35.645 Periodic spot-checks for gamma stereotactic radiosurgery units. (a) A licensee authorized to use a gamma stereotactic radiosurgery unit for medical use shall perform spot-checks of each gamma...

10 CFR 35.645 - Periodic spot-checks for gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Periodic spot-checks for gamma stereotactic radiosurgery... § 35.645 Periodic spot-checks for gamma stereotactic radiosurgery units. (a) A licensee authorized to use a gamma stereotactic radiosurgery unit for medical use shall perform spot-checks of each gamma...

10 CFR 35.645 - Periodic spot-checks for gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Periodic spot-checks for gamma stereotactic radiosurgery... § 35.645 Periodic spot-checks for gamma stereotactic radiosurgery units. (a) A licensee authorized to use a gamma stereotactic radiosurgery unit for medical use shall perform spot-checks of each gamma...

10 CFR 35.645 - Periodic spot-checks for gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Periodic spot-checks for gamma stereotactic radiosurgery... § 35.645 Periodic spot-checks for gamma stereotactic radiosurgery units. (a) A licensee authorized to use a gamma stereotactic radiosurgery unit for medical use shall perform spot-checks of each gamma...

10 CFR 35.2645 - Records of periodic spot-checks for gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Records of periodic spot-checks for gamma stereotactic... MATERIAL Records § 35.2645 Records of periodic spot-checks for gamma stereotactic radiosurgery units. (a) A... and intercom systems, timer termination, treatment table retraction mechanism, and stereotactic frames...

10 CFR 35.2645 - Records of periodic spot-checks for gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Records of periodic spot-checks for gamma stereotactic... MATERIAL Records § 35.2645 Records of periodic spot-checks for gamma stereotactic radiosurgery units. (a) A... and intercom systems, timer termination, treatment table retraction mechanism, and stereotactic frames...

10 CFR 35.2645 - Records of periodic spot-checks for gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Records of periodic spot-checks for gamma stereotactic... MATERIAL Records § 35.2645 Records of periodic spot-checks for gamma stereotactic radiosurgery units. (a) A... and intercom systems, timer termination, treatment table retraction mechanism, and stereotactic frames...

Frequency choice of eRHIC SRF linac

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

Xu, W.; Ben-Zvi, I.; Roser, T.

2016-01-05

eRHIC is a FFAG lattice-based multipass ERL. The eRHIC SRF linac has been decided to change from 422 MHz 5-cell cavity to 647 MHz 5-cell cavity. There are several considerations affecting the frequency choice for a high-current multipass-ERL: the beam structure, bunch length, energy spread, beam-break-up (BBU) threshold, SRF loss considerations. Beyond the physics considerations, cost and complexity or risk is an important consideration for the frequency choice, especially when we are designing a machine to be built in a few years. Although there are some benefits of using a 422 MHz cavity for eRHIC ERL, however, there are somemore » very critical drawbacks, including lack of facilities to fabricate a 422 MHz 5-cell cavity, very few facilities to process such a cavity and no existing facility to test the cavity anywhere. As the cavity size is big and its weight is large, it is difficult to handle it during fabrication, processing and testing, and no one has experience in this area. As the cavity size is large, the cryomodule becomes big as well. All of these considerations drive the risk of building eRHIC ERL with 422 MHz cavities to a very high level. Therefore, a decision was made to change the frequency of main linac to be 647 MHz 5-cell cavities. This note will compare these two linacs: 422MHz 5-cell cavity linac and 647Mz 5-cell cavity SRF linac, from both practical point of view and physics point of view.« less

Comparison of endoscopic evacuation, stereotactic aspiration and craniotomy for the treatment of supratentorial hypertensive intracerebral haemorrhage: study protocol for a randomised controlled trial.

PubMed

Xu, Xinghua; Zheng, Yi; Chen, Xiaolei; Li, Fangye; Zhang, Huaping; Ge, Xin

2017-06-28

Hypertensive intracerebral haemorrhage (HICH) is the most common form of haemorrhagic stroke with the highest morbidity and mortality of all stroke types. The choice of surgical or conservative treatment for patients with HICH remains controversial. In recent years, minimally invasive surgeries, such as endoscopic evacuation and stereotactic aspiration, have been attempted for haematoma removal and offer promise. However, research evidence on the benefits of endoscopic evacuation or stereotactic aspiration is still insufficient. A multicentre, randomised controlled trial will be conducted to compare the efficacy of endoscopic evacuation, stereotactic aspiration and craniotomy in the treatment of supratentorial HICH. About 1350 eligible patients from 10 neurosurgical centres will be randomly assigned to an endoscopic group, a stereotactic group and a craniotomy group at a 1:1:1 ratio. Randomisation is undertaken using a 24-h randomisation service accessed by telephone or the Internet. All patients will receive the corresponding surgery based on their grouping. They will be followed-up at 1, 3 and 6 months after surgery. The primary outcome is the modified Rankin Scale at 6-month follow-up. Secondary outcomes include: haematoma clearance rate; Glasgow Coma Scale 7 days after surgery; rebleeding rate; intracranial infection rate; hospitalisation time; mortality at 1 month and 3 months after surgery; the Barthel Index and the WHO quality of life at 3 months and 6 months after surgery. The trial aims to investigate whether endoscopic evacuation and stereotactic aspiration could improve the outcome of supratentorial HICH compared with craniotomy. The trial will help to determine the best surgical method for the treatment of supratentorial HICH. ClinicalTrials.gov, ID: NCT02811614 . Registered on 20 June 2016.

The future of image-guided radiotherapy-is image everything?

PubMed

Noble, David J; Burnet, Neil G

2018-05-17

MR-based image-guided (IG) radiotherapy via all-in-one MR treatment units (MR-linacs) is one of the hottest topics in contemporary radiotherapy research. From ingenious engineering solutions to complex physical problems, researchers have developed machines with the promise of superior image quality, and all the advantages this may confer. Benefits include better tumour visualisation, online adaptation and the potential for image biomarker-based personalised RT. However, it is important to remember that the technical challenges are real. In many instances, they are skillfully managed rather than abolished, a point illustrated by the wide variety of MR-linac designs. The proposed benefits also deserve careful inspection. Better visibility of the primary tumour on an IG scan cannot be bad, but does not automatically equate to better IG, which often depends on a more generalised match to daily anatomy. MR-linac will undoubtedly be a rich milieu to search for IMBs, but these will need to be carefully validated, and similar work with CT-based biomarkers using existing, cheaper, and more widely available hardware is currently ongoing. Online adaptation is an attractive concept, but practicalities are complex, and more work is required to understand which patients will benefit from plan adaptation, and when. Finally, the issue of cost cannot be overlooked, nor can the research community's responsibilities to global healthcare inequalities. MR-linac is an exciting and ingenious technology, which merits both investment and research. It may not, however, have the future to itself.

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

NASA Astrophysics Data System (ADS)

Christophides, Damianos; Davies, Alex; Fleckney, Mark

2016-12-01

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

Cost-Effectiveness of Surgery, Stereotactic Body Radiation Therapy, and Systemic Therapy for Pulmonary Oligometastases

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

Lester-Coll, Nataniel H., E-mail: nataniel.lester-coll@yale.edu; Rutter, Charles E.; Bledsoe, Trevor J.

Introduction: Pulmonary oligometastases have conventionally been managed with surgery and/or systemic therapy. However, given concerns about the high cost of systemic therapy and improvements in local treatment of metastatic cancer, the optimal cost-effective management of these patients is unclear. Therefore, we sought to assess the cost-effectiveness of initial management strategies for pulmonary oligometastases. Methods and Materials: A cost-effectiveness analysis using a Markov modeling approach was used to compare average cumulative costs, quality adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) among 3 initial disease management strategies: video-assisted thoracic surgery (VATS) wedge resection, stereotactic body radiation therapy (SBRT), and systemicmore » therapy among 5 different cohorts of patient disease: (1) melanoma; (2) non-small cell lung cancer adenocarcinoma without an EGFR mutation (NSCLC AC); (3) NSCLC with an EGFR mutation (NSCLC EGFRm AC); (4) NSCLC squamous cell carcinoma (NSCLC SCC); and (5) colon cancer. One-way sensitivity analyses and probabilistic sensitivity analyses were performed to analyze uncertainty with regard to model parameters. Results: In the base case, SBRT was cost effective for melanoma, with costs/net QALYs of $467,787/0.85. In patients with NSCLC, the most cost-effective strategies were SBRT for AC ($156,725/0.80), paclitaxel/carboplatin for SCC ($123,799/0.48), and erlotinib for EGFRm AC ($147,091/1.90). Stereotactic body radiation therapy was marginally cost-effective for EGFRm AC compared to erlotinib with an incremental cost-effectiveness ratio of $126,303/QALY. For colon cancer, VATS wedge resection ($147,730/2.14) was the most cost-effective strategy. Variables with the greatest influence in the model were erlotinib-associated progression-free survival (EGFRm AC), toxicity (EGFRm AC), cost of SBRT (NSCLC SCC), and patient utilities (all histologies). Conclusions: Video-assisted thoracic surgery wedge resection or SBRT can be cost-effective in select patients with pulmonary oligometastases, depending on histology, efficacy, and tolerability of treatment and patient preferences.« less

Cobalt-60 Machines and Medical Linear Accelerators: Competing Technologies for External Beam Radiotherapy.

PubMed

Healy, B J; van der Merwe, D; Christaki, K E; Meghzifene, A

2017-02-01

Medical linear accelerators (linacs) and cobalt-60 machines are both mature technologies for external beam radiotherapy. A comparison is made between these two technologies in terms of infrastructure and maintenance, dosimetry, shielding requirements, staffing, costs, security, patient throughput and clinical use. Infrastructure and maintenance are more demanding for linacs due to the complex electric componentry. In dosimetry, a higher beam energy, modulated dose rate and smaller focal spot size mean that it is easier to create an optimised treatment with a linac for conformal dose coverage of the tumour while sparing healthy organs at risk. In shielding, the requirements for a concrete bunker are similar for cobalt-60 machines and linacs but extra shielding and protection from neutrons are required for linacs. Staffing levels can be higher for linacs and more staff training is required for linacs. Life cycle costs are higher for linacs, especially multi-energy linacs. Security is more complex for cobalt-60 machines because of the high activity radioactive source. Patient throughput can be affected by source decay for cobalt-60 machines but poor maintenance and breakdowns can severely affect patient throughput for linacs. In clinical use, more complex treatment techniques are easier to achieve with linacs, and the availability of electron beams on high-energy linacs can be useful for certain treatments. In summary, there is no simple answer to the question of the choice of either cobalt-60 machines or linacs for radiotherapy in low- and middle-income countries. In fact a radiotherapy department with a combination of technologies, including orthovoltage X-ray units, may be an option. Local needs, conditions and resources will have to be factored into any decision on technology taking into account the characteristics of both forms of teletherapy, with the primary goal being the sustainability of the radiotherapy service over the useful lifetime of the equipment. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Quality Assurance Results for a Commercial Radiosurgery System: A Communication.

PubMed

Ruschin, Mark; Lightstone, Alexander; Beachey, David; Wronski, Matt; Babic, Steven; Yeboah, Collins; Lee, Young; Soliman, Hany; Sahgal, Arjun

2015-10-01

The purpose of this communication is to inform the radiosurgery community of quality assurance (QA) results requiring attention in a commercial FDA-approved linac-based cone stereo-tactic radiosurgery (SRS) system. Standard published QA guidelines as per the American Association of Physics in Medicine (AAPM) were followed during the SRS system's commissioning process including end-to-end testing, cone concentricity testing, image transfer verification, and documentation. Several software and hardware deficiencies that were deemed risky were uncovered during the process and QA processes were put in place to mitigate these risks during clinical practice. In particular, the present work focuses on daily cone concentricity testing and commissioning-related findings associated with the software. Cone concentricity/alignment is measured daily using both optical light field inspection, as well as quantitative radiation field tests with the electronic portal imager. In 10 out of 36 clini-cal treatments, adjustments to the cone position had to be made to align the cone with the collimator axis to less than 0.5 mm and on two occasions the pre-adjustment measured offset was 1.0 mm. Software-related errors discovered during commissioning included incorrect transfer of the isocentre in DICOM coordinates, improper handling of non-axial image sets, and complex handling of beam data, especially for multi-target treatments. QA processes were established to mitigate the occurrence of the software errors. With proper QA processes, the reported SRS system complies with tolerances set out in established guidelines. Discussions with the vendor are ongoing to address some of the hardware issues related to cone alignment. © The Author(s) 2014.

Interleaving lattice for the Argonne Advanced Photon Source linac

NASA Astrophysics Data System (ADS)

Shin, S.; Sun, Y.; Dooling, J.; Borland, M.; Zholents, A.

2018-06-01

To realize and test advanced accelerator concepts and hardware, a beam line is being reconfigured in the linac extension area (LEA) of the Argonne Advanced Photon Source (APS) linac. A photocathode rf gun installed at the beginning of the APS linac will provide a low emittance electron beam into the LEA beam line. The thermionic rf gun beam for the APS storage ring and the photocathode rf gun beam for the LEA beam line will be accelerated through the linac in an interleaved fashion. In this paper, the design studies for interleaving lattice realization in the APS linac is described with the initial experiment result.

Solid-state pulse modulator using Marx generator for a medical linac electron-gun

NASA Astrophysics Data System (ADS)

Lim, Heuijin; Hyeok Jeong, Dong; Lee, Manwoo; Lee, Mujin; Yi, Jungyu; Yang, Kwangmo; Ro, Sung Chae

2016-04-01

A medical linac is used for the cancer treatment and consists of an accelerating column, waveguide components, a magnetron, an electron-gun, a pulse modulator, and an irradiation system. The pulse modulator based on hydrogen thyratron-switched pulse-forming network is commonly used in linac. As the improvement of the high power semiconductors in switching speed, voltage rating, and current rating, an insulated gate bipolar transistor has become the more popular device used for pulsed power systems. We propose a solid-state pulse modulator to generator high voltage by multi-stacked storage-switch stages based on the Marx generator. The advantage of our modulator comes from the use of two semiconductors to control charging and discharging of the storage capacitor at each stage and it allows to generate the pulse with various amplitudes, widths, and shapes. In addition, a gate driver for two semiconductors is designed to reduce the control channels and to protect the circuits. It is developed for providing the pulsed power to a medical linac electron-gun that requires 25 kV and 1 A as the first application. In order to improve the power efficiency and achieve the compactness modulator, a capacitor charging power supply, a Marx pulse generator, and an electron-gun heater isolated transformer are constructed and integrated. This technology is also being developed to extend the high power pulsed system with > 1 MW and also other applications such as a plasma immersed ion implantation and a micro pulse electrostatic precipitator which especially require variable pulse shape and high repetition rate > 1 kHz. The paper describes the design features and the construction of this solid-state pulse modulator. Also shown are the performance results into the linac electron-gun.

MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

PubMed

Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

2017-07-01

The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

Synthetic CT for MRI-based liver stereotactic body radiotherapy treatment planning

NASA Astrophysics Data System (ADS)

Bredfeldt, Jeremy S.; Liu, Lianli; Feng, Mary; Cao, Yue; Balter, James M.

2017-04-01

A technique for generating MRI-derived synthetic CT volumes (MRCTs) is demonstrated in support of adaptive liver stereotactic body radiation therapy (SBRT). Under IRB approval, 16 subjects with hepatocellular carcinoma were scanned using a single MR pulse sequence (T1 Dixon). Air-containing voxels were identified by intensity thresholding on T1-weighted, water and fat images. The envelope of the anterior vertebral bodies was segmented from the fat image and fuzzy-C-means (FCM) was used to classify each non-air voxel as mid-density, lower-density, bone, or marrow in the abdomen, with only bone and marrow classified within the vertebral body envelope. MRCT volumes were created by integrating the product of the FCM class probability with its assigned class density for each voxel. MRCTs were deformably aligned with corresponding planning CTs and 2-ARC-SBRT-VMAT plans were optimized on MRCTs. Fluence was copied onto the CT density grids, dose recalculated, and compared. The liver, vertebral bodies, kidneys, spleen and cord had median Hounsfield unit differences of less than 60. Median target dose metrics were all within 0.1 Gy with maximum differences less than 0.5 Gy. OAR dose differences were similarly small (median: 0.03 Gy, std:0.26 Gy). Results demonstrate that MRCTs derived from a single abdominal imaging sequence are promising for use in SBRT dose calculation.

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

Constantin, M; Sawkey, D; Johnsen, S

Purpose: To validate the physics parameters of a Monte Carlo model for patient plane leakage calculations on the 6MV Unique linac by comparing the simulations against IEC patient plane leakage measurements. The benchmarked model can further be used for shielding design optimization, to predict leakage in the proximity of intended treatment fields, reduce the system weight and cost, and improve components reliability. Methods: The treatment head geometry of the Unique linac was simulated in Geant4 (v9.4.p02 with “Opt3” standard electromagnetic physics list) based on CAD drawings of all collimation and shielding components projected from the target to the area withinmore » 2m from isocenter. A 4×4m2 scorer was inserted 1m from the target in the patient plane and multiple phase space files were recorded by performing a 40-node computing cluster simulation on the EC2 cloud. The photon energy fluence was calculated relative to the value at isocenter for a 10×10cm2 field using 10×10mm2 bins. Tungsten blocks were parked accordingly to represent MLC120. The secondary particle contamination to patient plane was eliminated by “killing” those particles prior to the primary collimator entrance using a “kill-plane”, which represented the upper head shielding components not being modeled. Both IEC patient-plane leakage and X/Y-jaws transmission were simulated. Results: The contribution of photons to energy fluence was 0.064% on average, in excellent agreement with the experimental data available at 0.5, 1.0, and 1.5m from isocenter, characterized by an average leakage of 0.045% and a maximum leakage of 0.085%. X- and Y-jaws transmissions of 0.43% and 0.44% were found in good agreement with measurements of 0.48% and 0.43%, respectively. Conclusion: A Geant4 model based on energy fluence calculations for the 6MV Unique linac was created and validated using IEC patient plane leakage measurements. The “kill-plane” has effectively eliminated electron contamination to patient plane in these simulations.« less

Sci-Sat AM: Brachy - 04: Neutron production around a radiation therapy linac bunker - monte carlo simulations and physical measurements.

PubMed

Khatchadourian, R; Davis, S; Evans, M; Licea, A; Seuntjens, J; Kildea, J

2012-07-01

Photoneutrons are a major component of the equivalent dose in the maze and near the door of linac bunkers. Physical measurements and Monte Carlo (MC) calculations of neutron dose are key for validating bunker design with respect to health regulations. We attempted to use bubble detectors and a 3 He neutron spectrometer to measure neutron equivalent dose and neutron spectra in the maze and near the door of one of our bunkers. We also ran MC simulations with MCNP5 to measure the neutron fluence in the same region. Using a point source of neutrons, a Clinac 1800 linac operating at 10 MV was simulated and the fluence measured at various locations of interest. We describe the challenges faced when measuring dose with bubble detectors in the maze and the complexity of photoneutron spectrometry with linacs operating in pulsed mode. Finally, we report on the development of a userfriendly GUI for shielding calculations based on the NCRP 151 formalism. © 2012 American Association of Physicists in Medicine.

RF transient analysis and stabilization of the phase and energy of the proposed PIP-II LINAC

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

Edelen, J. P.; Chase, B. E.

This paper describes a recent effort to develop and benchmark a simulation tool for the analysis of RF transients and their compensation in an H- linear accelerator. Existing tools in this area either focus on electron LINACs or lack fundamental details about the LLRF system that are necessary to provide realistic performance estimates. In our paper we begin with a discussion of our computational models followed by benchmarking with existing beam-dynamics codes and measured data. We then analyze the effect of RF transients and their compensation in the PIP-II LINAC, followed by an analysis of calibration errors and how amore » Newton’s Method based feedback scheme can be used to regulate the beam energy to within the specified limits.« less

Characterization of the ePix100 prototype: a front-end ASIC for second-generation LCLS integrating hybrid pixel detectors

NASA Astrophysics Data System (ADS)

Caragiulo, P.; Dragone, A.; Markovic, B.; Herbst, R.; Nishimura, K.; Reese, B.; Herrmann, S.; Hart, P.; Blaj, G.; Segal, J.; Tomada, A.; Hasi, J.; Carini, G.; Kenney, C.; Haller, G.

2014-09-01

ePix100 is the first variant of a novel class of integrating pixel ASICs architectures optimized for the processing of signals in second generation LINAC Coherent Light Source (LCLS) X-Ray cameras. ePix100 is optimized for ultra-low noise application requiring high spatial resolution. ePix ASICs are based on a common platform composed of a random access analog matrix of pixel with global shutter, fast parallel column readout, and dedicated sigma-delta analog to digital converters per column. The ePix100 variant has 50μmx50μm pixels arranged in a 352x384 matrix, a resolution of 50e- r.m.s. and a signal range of 35fC (100 photons at 8keV). In its final version it will be able to sustain a frame rate of 1kHz. A first prototype has been fabricated and characterized and the measurement results are reported here.

Photoneutron Flux Measurement via Neutron Activation Analysis in a Radiotherapy Bunker with an 18 MV Linear Accelerator

NASA Astrophysics Data System (ADS)

Çeçen, Yiğit; Gülümser, Tuğçe; Yazgan, Çağrı; Dapo, Haris; Üstün, Mahmut; Boztosun, Ismail

2017-09-01

In cancer treatment, high energy X-rays are used which are produced by linear accelerators (LINACs). If the energy of these beams is over 8 MeV, photonuclear reactions occur between the bremsstrahlung photons and the metallic parts of the LINAC. As a result of these interactions, neutrons are also produced as secondary radiation products (γ,n) which are called photoneutrons. The study aims to map the photoneutron flux distribution within the LINAC bunker via neutron activation analysis (NAA) using indium-cadmium foils. Irradiations made at different gantry angles (0°, 90°, 180° and 270°) with a total of 91 positions in the Philips SLI-25 linear accelerator treatment room and location-based distribution of thermal neutron flux was obtained. Gamma spectrum analysis was carried out with high purity germanium (HPGe) detector. Results of the analysis showed that the maximum neutron flux in the room occurred at just above of the LINAC head (1.2x105 neutrons/cm2.s) which is compatible with an americium-beryllium (Am-Be) neutron source. There was a 90% decrease of flux at the walls and at the start of the maze with respect to the maximum neutron flux. And, just in front of the LINAC door, inside the room, neutron flux was measured less than 1% of the maximum.

Beam energy tracking system on Optima XEx high energy ion implanter

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

David, Jonathan; Satoh, Shu; Wu Xiangyang

2012-11-06

The Axcelis Optima XEx high energy implanter is an RF linac-based implanter with 12 RF resonators for beam acceleration. Even though each acceleration field is an alternating, sinusoidal RF field, the well known phase-focusing principle produces a beam with a sharp quasi-monoenergetic energy spectrum. A magnetic energy filter after the linac further attenuates the low energy continuum in the energy spectrum often associated with RF acceleration. The final beam energy is a function of the phase and amplitude of the 12 resonators in the linac. When tuning a beam, the magnetic energy filter is set to the desired energy, andmore » each linac parameter is tuned to maximize the transmission through the filter. Once a beam is set up, all the parameters are stored in a recipe, which can be easily tuned and has proven to be quite repeatable. The magnetic field setting of the energy filter selects the beam energy from the RF Linac accelerator, and in-situ verification of beam energy in addition to the magnetic energy filter setting has long been desired. An independent energy tracking system was developed for this purpose, using the existing electrostatic beam scanner as a deflector to construct an in-situ electrostatic energy analyzer. This paper will describe the system and performance of the beam energy tracking system.« less

On isocentre adjustment and quality control in linear accelerator based radiosurgery with circular collimators and room lasers.

PubMed

Treuer, H; Hoevels, M; Luyken, K; Gierich, A; Kocher, M; Müller, R P; Sturm, V

2000-08-01

We have developed a densitometric method for measuring the isocentric accuracy and the accuracy of marking the isocentre position for linear accelerator based radiosurgery with circular collimators and room lasers. Isocentric shots are used to determine the accuracy of marking the isocentre position with room lasers and star shots are used to determine the wobble of the gantry and table rotation movement, the effect of gantry sag, the stereotactic collimator alignment, and the minimal distance between gantry and table rotation axes. Since the method is based on densitometric measurements, beam spot stability is implicitly tested. The method developed is also suitable for quality assurance and has proved to be useful in optimizing isocentric accuracy. The method is simple to perform and only requires a film box and film scanner for instrumentation. Thus, the method has the potential to become widely available and may therefore be useful in standardizing the description of linear accelerator based radiosurgical systems.

A non-axial superconducting magnet design for optimized patient access and minimal SAD for use in a Linac-MR hybrid: proof of concept.

PubMed

Yaghoobpour Tari, Shima; Wachowicz, Keith; Gino Fallone, B

2017-04-21

A prototype rotating hybrid magnetic resonance imaging system and linac has been developed to allow for simultaneous imaging and radiation delivery parallel to B 0 . However, the design of a compact magnet capable of rotation in a small vault with sufficient patient access and a typical clinical source-to-axis distance (SAD) is challenging. This work presents a novel superconducting magnet design as a proof of concept that allows for a reduced SAD and ample patient access by moving the superconducting coils to the side of the yoke. The yoke and pole-plate structures are shaped to direct the magnetic flux appropriately. The outer surface of the pole plate is optimized subject to the minimization of a cost function, which evaluates the uniformity of the magnetic field over an ellipsoid. The magnetic field calculations required in this work are performed with the 3D finite element method software package Opera-3D. Each tentative design strategy is virtually modeled in this software package, which is externally controlled by MATLAB, with its key geometries defined as variables. The optimization variables are the thickness of the pole plate at control points distributed over the pole plate surface. A novel design concept as a superconducting non-axial magnet is introduced, which could create a large uniform B 0 magnetic field with fewer geometric restriction. This non-axial 0.5 T superconducting magnet has a moderately reduced SAD of 123 cm and a vertical patient opening of 68 cm. This work is presented as a proof of principle to investigate the feasibility of a non-axial magnet with the coils located around the yoke, and the results encourage future design optimizations to maximize the benefits of this non-axial design.

SU-F-T-344: Commissioning Constant Dose Rate VMAT in the Raystation Treatment Planning System for a Varian Clinac IX

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

Pursley, J; Gueorguiev, G; Prichard, H

Purpose: To demonstrate the commissioning of constant dose rate volumetric modulated arc therapy (VMAT) in the Raystation treatment planning system for a Varian Clinac iX with Exact couch. Methods: Constant dose rate (CDR) VMAT is an option in the Raystation treatment planning system, enabling VMAT delivery on Varian linacs without a RapidArc upgrade. Raystation 4.7 was used to commission CDR-VMAT for a Varian Clinac iX. Raystation arc model parameters were selected to match machine deliverability characteristics. A Varian Exact couch model was added to Raystation 4.7 and commissioned for use in VMAT optimization. CDR-VMAT commissioning checks were performed on themore » linac, including patient-specific QA measurements for 10 test patients using both the ArcCHECK from Sun Nuclear Corporation and COMPASS from IBA Dosimetry. Multi-criteria optimization (MCO) in Raystation was used for CDR-VMAT planning. Results: Raystation 4.7 generated clinically acceptable and deliverable CDR-VMAT plans for the Varian Clinac. VMAT plans were optimized including a model of the Exact couch with both rails in the out positions. CDR-VMAT plans generated with MCO in Raystation were dosimetrically comparable to Raystation MCO-generated IMRT plans. Patient-specific QA measurements with the ArcCHECK on the couch showed good agreement with the treatment planning system prediction. Patient-specific, structure-specific, multi-statistical parameter 3D QA measurements with gantry-mounted COMPASS also showed good agreement. Conclusion: Constant dose rate VMAT was successfully modeled in Raystation 4.7 for a Varian Clinac iX, and Raystation’s multicriteria optimization generated constant dose rate VMAT plans which were deliverable and dosimetrically comparable to IMRT plans.« less

A non-axial superconducting magnet design for optimized patient access and minimal SAD for use in a Linac-MR hybrid: proof of concept

NASA Astrophysics Data System (ADS)

Yaghoobpour Tari, Shima; Wachowicz, Keith; Fallone, B. Gino

2017-04-01

A prototype rotating hybrid magnetic resonance imaging system and linac has been developed to allow for simultaneous imaging and radiation delivery parallel to B 0. However, the design of a compact magnet capable of rotation in a small vault with sufficient patient access and a typical clinical source-to-axis distance (SAD) is challenging. This work presents a novel superconducting magnet design as a proof of concept that allows for a reduced SAD and ample patient access by moving the superconducting coils to the side of the yoke. The yoke and pole-plate structures are shaped to direct the magnetic flux appropriately. The outer surface of the pole plate is optimized subject to the minimization of a cost function, which evaluates the uniformity of the magnetic field over an ellipsoid. The magnetic field calculations required in this work are performed with the 3D finite element method software package Opera-3D. Each tentative design strategy is virtually modeled in this software package, which is externally controlled by MATLAB, with its key geometries defined as variables. The optimization variables are the thickness of the pole plate at control points distributed over the pole plate surface. A novel design concept as a superconducting non-axial magnet is introduced, which could create a large uniform B 0 magnetic field with fewer geometric restriction. This non-axial 0.5 T superconducting magnet has a moderately reduced SAD of 123 cm and a vertical patient opening of 68 cm. This work is presented as a proof of principle to investigate the feasibility of a non-axial magnet with the coils located around the yoke, and the results encourage future design optimizations to maximize the benefits of this non-axial design.

BEAM DYNAMICS STUDIES OF A HIGH-REPETITION RATE LINAC-DRIVER FOR A 4TH GENERATION LIGHT SOURCE

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

Ventturini, M.; Corlett, J.; Emma, P.

2012-05-18

We present recent progress toward the design of a super-conducting linac driver for a high-repetition rate FEL-based soft x-ray light source. The machine is designed to accept beams generated by the APEX photo-cathode gun operating with MHz-range repetition rate and deliver them to an array of SASE and seeded FEL beamlines. We review the current baseline design and report results of beam dynamics studies.

Investigation of using shrinking method in construction of Institute for Research in Fundamental Sciences Electron Linear Accelerator TW-tube (IPM TW-Linac tube)

NASA Astrophysics Data System (ADS)

Ghasemi, F.; Abbasi Davani, F.

2015-06-01

Due to Iran's growing need for accelerators in various applications, IPM's electron Linac project has been defined. This accelerator is a 15 MeV energy S-band traveling-wave accelerator which is being designed and constructed based on the klystron that has been built in Iran. Based on the design, operating mode is π /2 and the accelerating chamber consists of two 60cm long tubes with constant impedance and a 30cm long buncher. Amongst all construction methods, shrinking method is selected for construction of IPM's electron Linac tube because it has a simple procedure and there is no need for large vacuum or hydrogen furnaces. In this paper, different aspects of this method are investigated. According to the calculations, linear ratio of frequency alteration to radius change is 787.8 MHz/cm, and the maximum deformation at the tube wall where disks and the tube make contact is 2.7μ m. Applying shrinking method for construction of 8- and 24-cavity tubes results in satisfactory frequency and quality factor. Average deviations of cavities frequency of 8- and 24-cavity tubes to the design values are 0.68 MHz and 1.8 MHz respectively before tune and 0.2 MHz and 0.4 MHz after tune. Accelerating tubes, buncher, and high power couplers of IPM's electron linac are constructed using shrinking method.

Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a ⁶⁰Co Magnetic Resonance Image Guidance Radiation Therapy System.

PubMed

Wooten, H Omar; Green, Olga; Yang, Min; DeWees, Todd; Kashani, Rojano; Olsen, Jeff; Michalski, Jeff; Yang, Deshan; Tanderup, Kari; Hu, Yanle; Li, H Harold; Mutic, Sasa

2015-07-15

This work describes a commercial treatment planning system, its technical features, and its capabilities for creating (60)Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. The ViewRay treatment planning system (Oakwood Village, OH) was used to create (60)Co IMRT treatment plans for 33 cancer patients with disease in the abdominal, pelvic, thorax, and head and neck regions using physician-specified patient-specific target coverage and organ at risk (OAR) objectives. Backup plans using a third-party linear accelerator (linac)-based planning system were also created. Plans were evaluated by attending physicians and approved for treatment. The (60)Co and linac plans were compared by evaluating conformity numbers (CN) with 100% and 95% of prescription reference doses and heterogeneity indices (HI) for planning target volumes (PTVs) and maximum, mean, and dose-volume histogram (DVH) values for OARs. All (60)Co IMRT plans achieved PTV coverage and OAR sparing that were similar to linac plans. PTV conformity for (60)Co was within <1% and 3% of linac plans for 100% and 95% prescription reference isodoses, respectively, and heterogeneity was on average 4% greater. Comparisons of OAR mean dose showed generally better sparing with linac plans in the low-dose range <20 Gy, but comparable sparing for organs with mean doses >20 Gy. The mean doses for all (60)Co plan OARs were within clinical tolerances. A commercial (60)Co MR-IGRT device can produce highly conformal IMRT treatment plans similar in quality to linac IMRT for a variety of disease sites. Additional work is in progress to evaluate the clinical benefit of other novel features of this MR-IGRT system. Copyright © 2015 Elsevier Inc. All rights reserved.

SU-G-TeP1-08: LINAC Head Geometry Modeling for Cyber Knife System

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

Liang, B; Li, Y; Liu, B

Purpose: Knowledge of the LINAC head information is critical for model based dose calculation algorithms. However, the geometries are difficult to measure precisely. The purpose of this study is to develop linac head models for Cyber Knife system (CKS). Methods: For CKS, the commissioning data were measured in water at 800mm SAD. The measured full width at half maximum (FWHM) for each cone was found greater than the nominal value, this was further confirmed by additional film measurement in air. Diameter correction, cone shift and source shift models (DCM, CSM and SSM) are proposed to account for the differences. Inmore » DCM, a cone-specific correction is applied. For CSM and SSM, a single shift is applied to the cone or source physical position. All three models were validated with an in-house developed pencil beam dose calculation algorithm, and further evaluated by the collimator scatter factor (Sc) correction. Results: The mean square error (MSE) between nominal diameter and the FWHM derived from commissioning data and in-air measurement are 0.54mm and 0.44mm, with the discrepancy increasing with cone size. Optimal shift for CSM and SSM is found to be 9mm upward and 18mm downward, respectively. The MSE in FWHM is reduced to 0.04mm and 0.14mm for DCM and CSM (SSM). Both DCM and CSM result in the same set of Sc values. Combining all cones at SAD 600–1000mm, the average deviation from 1 in Sc of DCM (CSM) and SSM is 2.6% and 2.2%, and reduced to 0.9% and 0.7% for the cones with diameter greater than 15mm. Conclusion: We developed three geometrical models for CKS. All models can handle the discrepancy between vendor specifications and commissioning data. And SSM has the best performance for Sc correction. The study also validated that a point source can be used in CKS dose calculation algorithms.« less

Inverse 4D conformal planning for lung SBRT using particle swarm optimization

NASA Astrophysics Data System (ADS)

Modiri, A.; Gu, X.; Hagan, A.; Bland, R.; Iyengar, P.; Timmerman, R.; Sawant, A.

2016-08-01

A critical aspect of highly potent regimens such as lung stereotactic body radiation therapy (SBRT) is to avoid collateral toxicity while achieving planning target volume (PTV) coverage. In this work, we describe four dimensional conformal radiotherapy using a highly parallelizable swarm intelligence-based stochastic optimization technique. Conventional lung CRT-SBRT uses a 4DCT to create an internal target volume and then, using forward-planning, generates a 3D conformal plan. In contrast, we investigate an inverse-planning strategy that uses 4DCT data to create a 4D conformal plan, which is optimized across the three spatial dimensions (3D) as well as time, as represented by the respiratory phase. The key idea is to use respiratory motion as an additional degree of freedom. We iteratively adjust fluence weights for all beam apertures across all respiratory phases considering OAR sparing, PTV coverage and delivery efficiency. To demonstrate proof-of-concept, five non-small-cell lung cancer SBRT patients were retrospectively studied. The 4D optimized plans achieved PTV coverage comparable to the corresponding clinically delivered plans while showing significantly superior OAR sparing ranging from 26% to 83% for D max heart, 10%-41% for D max esophagus, 31%-68% for D max spinal cord and 7%-32% for V 13 lung.

Inverse 4D conformal planning for lung SBRT using particle swarm optimization

PubMed Central

Modiri, A; Gu, X; Hagan, A; Bland, R; Iyengar, P; Timmerman, R; Sawant, A

2016-01-01

A critical aspect of highly potent regimens such as lung stereotactic body radiation therapy (SBRT) is to avoid collateral toxicity while achieving planning target volume (PTV) coverage. In this work, we describe four dimensional conformal radiotherapy (4D CRT) using a highly parallelizable swarm intelligence-based stochastic optimization technique. Conventional lung CRT-SBRT uses a 4DCT to create an internal target volume (ITV) and then, using forward-planning, generates a 3D conformal plan. In contrast, we investigate an inverse-planning strategy that uses 4DCT data to create a 4D conformal plan, which is optimized across the three spatial dimensions (3D) as well as time, as represented by the respiratory phase. The key idea is to use respiratory motion as an additional degree of freedom. We iteratively adjust fluence weights for all beam apertures across all respiratory phases considering OAR sparing, PTV coverage and delivery efficiency. To demonstrate proof-of-concept, five non-small-cell lung cancer SBRT patients were retrospectively studied. The 4D optimized plans achieved PTV coverage comparable to the corresponding clinically delivered plans while showing significantly superior OAR sparing ranging from 26% to 83% for Dmax heart, 10% to 41% for Dmax esophagus, 31% to 68% for Dmax spinal cord and 7% to 32% for V13 lung. PMID:27476472

SU-E-T-211: Comparison of Seven New TrueBeam Linacs with Enhanced Beam Data Conformance Using a Beam Comparison Software Tool

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

Grzetic, S; Hessler, J; Gupta, N

2015-06-15

Purpose: To develop an independent software tool to assist in commissioning linacs with enhanced beam conformance, as well as perform ongoing QA for dosimetrically equivalent linacs. Methods: Linac manufacturers offer enhanced beam conformance as an option to allow for clinics to complete commissioning efficiently, as well as implement dosimetrically equivalent linacs. The specification for enhanced conformance includes PDD as well as profiles within 80% FWHM. Recently, we commissioned seven Varian TrueBeam linacs with enhanced beam conformance. We developed a software tool in Visual Basic to allow us to load the reference beam data and compare our beam data during commissioningmore » to evaluate enhanced beam conformance. This tool also allowed us to upload our beam data used for commissioning our dosimetrically equivalent beam models to compare and tweak each of our linac beams to match our modelled data in Varian’s Eclipse TPS. This tool will also be used during annual QA of the linacs to compare our beam data to our baseline data, as required by TG-142. Results: Our software tool was used to check beam conformance for seven TrueBeam linacs that we commissioned in the past six months. Using our tool we found that the factory conformed linacs showed up to 3.82% difference in their beam profile data upon installation. Using our beam comparison tool, we were able to adjust the energy and profiles of our beams to accomplish a better than 1.00% point by point data conformance. Conclusion: The availability of quantitative comparison tools is essential to accept and commission linacs with enhanced beam conformance, as well as to beam match multiple linacs. We further intend to use the same tool to ensure our beam data conforms to the commissioning beam data during our annual QA in keeping with the requirements of TG-142.« less

Electron beam energy stabilization using a neural network hybrid controller at the Australian Synchrotron Linac.

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

Meier, E.; Morgan, M. J.; Biedron, S. G.

2009-01-01

This paper describes the implementation of a neural network hybrid controller for energy stabilization at the Australian Synchrotron Linac. The structure of the controller consists of a neural network (NNET) feed forward control, augmented by a conventional Proportional-Integral (PI) feedback controller to ensure stability of the system. The system is provided with past states of the machine in order to predict its future state, and therefore apply appropriate feed forward control. The NNET is able to cancel multiple frequency jitter in real-time. When it is not performing optimally due to jitter changes, the system can successfully be augmented by themore » PI controller to attenuate the remaining perturbations. With a view to control the energy and bunch length at the FERMI{at}Elettra Free Electron Laser (FEL), the present study considers a neural network hybrid feed forward-feedback type of control to rectify limitations related to feedback systems, such as poor response for high jitter frequencies or limited bandwidth, while ensuring robustness of control. The Australian Synchrotron Linac is equipped with a beam position monitor (BPM), that was provided by Sincrotrone Trieste from a former transport line thus allowing energy measurements and energy control experiments. The present study will consequently focus on correcting energy jitter induced by variations in klystron phase and voltage.« less

SU-F-BRB-16: A Spreadsheet Based Automatic Trajectory GEnerator (SAGE): An Open Source Tool for Automatic Creation of TrueBeam Developer Mode Robotic Trajectories

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

Etmektzoglou, A; Mishra, P; Svatos, M

Purpose: To automate creation and delivery of robotic linac trajectories with TrueBeam Developer Mode, an open source spreadsheet-based trajectory generation tool has been developed, tested and made freely available. The computing power inherent in a spreadsheet environment plus additional functions programmed into the tool insulate users from the underlying schema tedium and allow easy calculation, parameterization, graphical visualization, validation and finally automatic generation of Developer Mode XML scripts which are directly loadable on a TrueBeam linac. Methods: The robotic control system platform that allows total coordination of potentially all linac moving axes with beam (continuous, step-and-shoot, or combination thereof) becomesmore » available in TrueBeam Developer Mode. Many complex trajectories are either geometric or can be described in analytical form, making the computational power, graphing and programmability available in a spreadsheet environment an easy and ideal vehicle for automatic trajectory generation. The spreadsheet environment allows also for parameterization of trajectories thus enabling the creation of entire families of trajectories using only a few variables. Standard spreadsheet functionality has been extended for powerful movie-like dynamic graphic visualization of the gantry, table, MLC, room, lasers, 3D observer placement and beam centerline all as a function of MU or time, for analysis of the motions before requiring actual linac time. Results: We used the tool to generate and deliver extended SAD “virtual isocenter” trajectories of various shapes such as parameterized circles and ellipses. We also demonstrated use of the tool in generating linac couch motions that simulate respiratory motion using analytical parameterized functions. Conclusion: The SAGE tool is a valuable resource to experiment with families of complex geometric trajectories for a TrueBeam Linac. It makes Developer Mode more accessible as a vehicle to quickly translate research ideas into machine readable scripts without programming knowledge. As an open source initiative, it also enables researcher collaboration on future developments. I am a full time employee at Varian Medical Systems, Palo Alto, California.« less

Available evidence on re-irradiation with stereotactic ablative radiotherapy following high-dose previous thoracic radiotherapy for lung malignancies.

PubMed

De Bari, Berardino; Filippi, Andrea Riccardo; Mazzola, Rosario; Bonomo, Pierluigi; Trovò, Marco; Livi, Lorenzo; Alongi, Filippo

2015-06-01

Patients affected with intra-thoracic recurrences of primary or secondary lung malignancies after a first course of definitive radiotherapy have limited therapeutic options, and they are often treated with a palliative intent. Re-irradiation with stereotactic ablative radiotherapy (SABR) represents an appealing approach, due to the optimized dose distribution that allows for high-dose delivery with better sparing of organs at risk. This strategy has the goal of long-term control and even cure. Aim of this review is to report and discuss published data on re-irradiation with SABR in terms of efficacy and toxicity. Results indicate that thoracic re-irradiation may offer satisfactory disease control, however the data on outcome and toxicity are derived from low quality retrospective studies, and results should be cautiously interpreted. As SABR may be associated with serious toxicity, attention should be paid for an accurate patients' selection. Copyright © 2015 Elsevier Ltd. All rights reserved.

Development and reproducibility evaluation of a Monte Carlo-based standard LINAC model for quality assurance of multi-institutional clinical trials.

PubMed

Usmani, Muhammad Nauman; Takegawa, Hideki; Takashina, Masaaki; Numasaki, Hodaka; Suga, Masaki; Anetai, Yusuke; Kurosu, Keita; Koizumi, Masahiko; Teshima, Teruki

2014-11-01

Technical developments in radiotherapy (RT) have created a need for systematic quality assurance (QA) to ensure that clinical institutions deliver prescribed radiation doses consistent with the requirements of clinical protocols. For QA, an ideal dose verification system should be independent of the treatment-planning system (TPS). This paper describes the development and reproducibility evaluation of a Monte Carlo (MC)-based standard LINAC model as a preliminary requirement for independent verification of dose distributions. The BEAMnrc MC code is used for characterization of the 6-, 10- and 15-MV photon beams for a wide range of field sizes. The modeling of the LINAC head components is based on the specifications provided by the manufacturer. MC dose distributions are tuned to match Varian Golden Beam Data (GBD). For reproducibility evaluation, calculated beam data is compared with beam data measured at individual institutions. For all energies and field sizes, the MC and GBD agreed to within 1.0% for percentage depth doses (PDDs), 1.5% for beam profiles and 1.2% for total scatter factors (Scps.). Reproducibility evaluation showed that the maximum average local differences were 1.3% and 2.5% for PDDs and beam profiles, respectively. MC and institutions' mean Scps agreed to within 2.0%. An MC-based standard LINAC model developed to independently verify dose distributions for QA of multi-institutional clinical trials and routine clinical practice has proven to be highly accurate and reproducible and can thus help ensure that prescribed doses delivered are consistent with the requirements of clinical protocols. © The Author 2014. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

Optimized Orthovoltage Stereotactic Radiosurgery

NASA Astrophysics Data System (ADS)

Fagerstrom, Jessica M.

Because of its ability to treat intracranial targets effectively and noninvasively, stereotactic radiosurgery (SRS) is a prevalent treatment modality in modern radiation therapy. This work focused on SRS delivering rectangular function dose distributions, which are desirable for some targets such as those with functional tissue included within the target volume. In order to achieve such distributions, this work used fluence modulation and energies lower than those utilized in conventional SRS. In this work, the relationship between prescription isodose and dose gradients was examined for standard, unmodulated orthovoltage SRS dose distributions. Monte Carlo-generated energy deposition kernels were used to calculate 4pi, isocentric dose distributions for a polyenergetic orthovoltage spectrum, as well as monoenergetic orthovoltage beams. The relationship between dose gradients and prescription isodose was found to be field size and energy dependent, and values were found for prescription isodose that optimize dose gradients. Next, a pencil-beam model was used with a Genetic Algorithm search heuristic to optimize the spatial distribution of added tungsten filtration within apertures of cone collimators in a moderately filtered 250 kVp beam. Four cone sizes at three depths were examined with a Monte Carlo model to determine the effects of the optimized modulation compared to open cones, and the simulations found that the optimized cones were able to achieve both improved penumbra and flatness statistics at depth compared to the open cones. Prototypes of the filter designs calculated using mathematical optimization techniques and Monte Carlo simulations were then manufactured and inserted into custom built orthovoltage SRS cone collimators. A positioning system built in-house was used to place the collimator and filter assemblies temporarily in the 250 kVp beam line. Measurements were performed in water using radiochromic film scanned with both a standard white light flatbed scanner as well as a prototype laser densitometry system. Measured beam profiles showed that the modulated beams could more closely approach rectangular function dose profiles compared to the open cones. A methodology has been described and implemented to achieve optimized SRS delivery, including the development of working prototypes. Future work may include the construction of a full treatment platform.

Case report of a near medical event in stereotactic radiotherapy due to improper units of measure from a treatment planning system

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

Gladstone, D. J.; Li, S.; Jarvis, L. A.

2011-07-15

Purpose: The authors hereby notify the Radiation Oncology community of a potentially lethal error due to improper implementation of linear units of measure in a treatment planning system. The authors report an incident in which a patient was nearly mistreated during a stereotactic radiotherapy procedure due to inappropriate reporting of stereotactic coordinates by the radiation therapy treatment planning system in units of centimeter rather than in millimeter. The authors suggest a method to detect such errors during treatment planning so they are caught and corrected prior to the patient positioning for treatment on the treatment machine. Methods: Using pretreatment imaging,more » the authors found that stereotactic coordinates are reported with improper linear units by a treatment planning system. The authors have implemented a redundant, independent method of stereotactic coordinate calculation. Results: Implementation of a double check of stereotactic coordinates via redundant, independent calculation is simple and accurate. Use of this technique will avoid any future error in stereotactic treatment coordinates due to improper linear units, transcription, or other similar errors. Conclusions: The authors recommend an independent double check of stereotactic treatment coordinates during the treatment planning process in order to avoid potential mistreatment of patients.« less

Self-Shielding Analysis of the Zap-X System

PubMed Central

Schneider, M. Bret; Adler, John R.

2017-01-01

The Zap-X is a self-contained and first-of-its-kind self-shielded therapeutic radiation device dedicated to brain as well as head and neck stereotactic radiosurgery (SRS). By utilizing an S-band linear accelerator (linac) with a 2.7 megavolt (MV) accelerating potential and incorporating radiation-shielded mechanical structures, the Zap-X does not typically require a radiation bunker, thereby saving SRS facilities considerable cost. At the same time, the self-shielded features of the Zap-X are designed for more consistency of radiation protection, reducing the risk to radiation workers and others potentially exposed from a poorly designed or constructed radiotherapy vault. The hypothesis of the present study is that a radiosurgical system can be self-shielded such that it produces radiation exposure levels deemed safe to the public while operating under a full clinical workload. This study summarizes the Zap-X system shielding and found that the overall system radiation leakage values are reduced by a factor of 50 compared to the occupational radiation limit stipulated by the Nuclear Regulatory Commission (NRC) or agreement states. The goal of self-shielding is achieved under all but the most exceptional conditions for which additional room shielding or a larger restricted area in the vicinity of the Zap-X system would be required. PMID:29441251

Multisession stereotactic radiosurgery for large benign brain tumors of >3cm- early clinical outcomes

PubMed Central

Memon, Muhammad Ali; Ahmed, Usman; Saleem, Muhammad Abid; Bhatti, Amer Iqtidar; Ahmed, Naveed; Hashim, Abdul Sattar M.

2012-01-01

Objective To evaluate the clinical outcome of linear accelerator based multisession stereotactic radiosurgery (SRS) for large benign brain tumors of >3cm. Methods Between June 2009 and May 2011, 35 patients having large benign brain tumors of >3cm (≥15 cm3) were treated by multisession stereotactic radiosurgery. This retrospective study was carried out at Neurospinal & Medical Institute Karachi. There were 17 (48.6 %) males and 18(51.4 %) females. Median age was 36 years (range: 13-65 years). Median target volume was 49.4 cm3 (range: 15-184 cm3). The median marginal dose was 25 Gy (range: 20–27.5Gy) prescribed to a median 75% isodose line (range: 65-100 %). Median number of 5 fractions were used ranging 3-5 fractions. Results All the patients tolerated treatment very well. 21 (58.3%) patients had remarkable clinical improvement of neurological symptoms, 14 (38.9%) patients had stable symptoms, and only one patient had transient worsening of symptoms. No permanent neurological damage or radiation injury was seen. Radiologically, 9 (25.7%) patients achieved reduction in size of the tumor, 26(74.3 %) patients were having stable disease, and overall control rate was found to be 100 %. Median follow-up time from the end of SRS was 6.4 months (range: 1-22.5months). Conclusion Linear accelerator based multisession stereotactic radiosurgery for large benign brain tumors of >3cm is effective and well tolerated. PMID:29296340

Stereotactically Standard Areas: Applied Mathematics in the Service of Brain Targeting in Deep Brain Stimulation.

PubMed

Mavridis, Ioannis N

2017-12-11

The concept of stereotactically standard areas (SSAs) within human brain nuclei belongs to the knowledge of the modern field of stereotactic brain microanatomy. These are areas resisting the individual variability of the nuclear location in stereotactic space. This paper summarizes the current knowledge regarding SSAs. A mathematical formula of SSAs was recently invented, allowing for their robust, reproducible, and accurate application to laboratory studies and clinical practice. Thus, SSAs open new doors for the application of stereotactic microanatomy to highly accurate brain targeting, which is mainly useful for minimally invasive neurosurgical procedures, such as deep brain stimulation.

TH-AB-BRB-04: Quality Assurance for Advanced Digital Linac Implementations

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

Yu, V.

2016-06-15

Current state-of-the art digital C-arm medical linear accelerators are capable of delivering radiation treatments with high level of automation, which affords coordinated motions of gantry, couch, and multileaf collimator (MLC) with dose rate modulations. The new machine capacity has shown the potential to bring substantially improved radiation dosimetry and/or delivery efficiency to many challenging diseases. Combining an integrated beam orientation optimization algorithm with automated machine navigation, markedly improved dose conformity has been achieved using 4ρ therapy. Trajectory modulated radiation therapy (TMAT) can be used to deliver highly conformal dose to partial breast or to carve complex dose distribution for therapymore » involving extended volumes such as total marrow and total lymph node treatment. Dynamic electron arc radiotherapy (DEAR) not only overcomes the deficiencies of conventional electron therapy in dose conformity and homogeneity but also achieves so without patient-specific shields. The combination of MLC and couch tracking provides improved motion management of thoracic and abdominal tumors. A substantial body of work has been done in these technological advances for clinical translation. The proposed symposium will provide a timely review of these exciting opportunities. Learning Objectives: Recognize the potential of using digitally controlled linacs for clinically significant improvements in delivered dose distributions for various treatment sites. Identify existing approaches to treatment planning, optimization and delivery for treatment techniques utilizing the advanced functions of digital linacs and venues for further development and improvement. Understand methods for testing and validating delivery system performance. Identify tools available on current delivery systems for implementation and control for such treatments. Obtain the update in clinical applications, trials and regulatory approval. K. Sheng, NIH U19AI067769, NIH R43CA183390, NIH R01CA188300, Varian Medical Systems V. Yu, Varian Medical Systems, AAPM Summer Undergraduate Fellowship, NSF graduate fellowship S. Nill, Elekta AB. Cancer Research UK under Programme C33589/A19727, NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research.« less

Splash: a software tool for stereotactic planning of recording chamber placement and electrode trajectories.

PubMed

Sperka, Daniel J; Ditterich, Jochen

2011-01-01

While computer-aided planning of human neurosurgeries is becoming more and more common, animal researchers still largely rely on paper atlases for planning their approach before implanting recording chambers to perform invasive recordings of neural activity, which makes this planning process tedious and error-prone. Here we present SPLASh (Stereotactic PLAnning Software), an interactive software tool for the stereotactic planning of recording chamber placement and electrode trajectories. SPLASh has been developed for monkey cortical recordings and relies on a combination of structural MRIs and electronic brain atlases. Since SPLASh is based on the neuroanatomy software Caret, it should also be possible to use it for other parts of the brain or other species for which Caret atlases are available. The tool allows the user to interactively evaluate different possible placements of recording chambers and to simulate electrode trajectories.

Splash: A Software Tool for Stereotactic Planning of Recording Chamber Placement and Electrode Trajectories

PubMed Central

Sperka, Daniel J.; Ditterich, Jochen

2011-01-01

While computer-aided planning of human neurosurgeries is becoming more and more common, animal researchers still largely rely on paper atlases for planning their approach before implanting recording chambers to perform invasive recordings of neural activity, which makes this planning process tedious and error-prone. Here we present SPLASh (Stereotactic PLAnning Software), an interactive software tool for the stereotactic planning of recording chamber placement and electrode trajectories. SPLASh has been developed for monkey cortical recordings and relies on a combination of structural MRIs and electronic brain atlases. Since SPLASh is based on the neuroanatomy software Caret, it should also be possible to use it for other parts of the brain or other species for which Caret atlases are available. The tool allows the user to interactively evaluate different possible placements of recording chambers and to simulate electrode trajectories. PMID:21472085

Toward frameless stereotaxy: anatomical-vascular correlation and registration

NASA Astrophysics Data System (ADS)

Henri, Christopher J.; Cukiert, A.; Collins, D. Louis; Olivier, A.; Peters, Terence M.

1992-09-01

We present a method to correlate and register a projection angiogram with volume rendered tomographic data from the same patient. Previously, we have described how this may be accomplished using a stereotactic frame to handle the required coordinate transformations. Here we examine the efficacy of employing anatomically based landmarks as opposed to external fiducials to achieve the same results. The experiments required a neurosurgeon to identify several homologous points in a DSA image and a MRI volume which were subsequently used to compute the coordinate transformations governing the matching procedure. Correlation accuracy was assessed by comparing these results to those employing fiducial markers on a stereotactic frame, and by examining how different levels of noise in the positions of the homologous points affect the resulting coordinate transformations. Further simulations suggest that this method has potential to be used in planning stereotactic procedures without the use of a frame.

SU-D-BRB-04: Plan Quality Comparison of Intracranial Stereotactic Radiosurgery (SRS) for Gamma Knife and VMAT Treatments

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

Keeling, V; Algan, O; Ahmad, S

2015-06-15

Purpose: To compare treatment plan quality of intracranial stereotactic radiosurgery (SRS) for VMAT (RapidArc) and Gamma Knife (GK) systems. Methods: Ten patients with 24 tumors (seven with 1–2 and three with 4–6 lesions), previously treated with GK 4C (prescription doses ranging from 14–23 Gy) were re-planned for RapidArc. Identical contour sets were kept on MRI images for both plans with tissues assigned a CT number of zero. RapidArc plans were performed using 6 MV flattening-filter-free (FFF) beams with dose rate of 1400 MU/minute using two to eight arcs with the following combinations: 2 full coplanar arcs and the rest non-coplanarmore » half arcs. Beam selection was based on target depth. Areas that penetrated more than 10 cm of tissue were avoided by creating smaller arcs or using avoidance sectors in optimization. Plans were optimized with jaw tracking and a high weighting to the normal-brain-tissue and Normal-Tissue-Objective without compromising PTV coverage. Plans were calculated on a 1 mm grid size using AAA algorithm and then normalized so that 99% of each target volume received the prescription dose. Plan quality was assessed by target coverage using Paddick Conformity Index (PCI), sparing of normal-brain-tissue through analysis of V4, V8, and V12 Gy, and integral dose. Results: In all cases critical structure dose criteria were met. RapidArc had a higher PCI than GK plans for 23 out of 24 lesions. The average PCI was 0.76±0.21 for RapidArc and 0.46±0.20 for GK plans (p≤0.001), respectively. Integral dose and normal-brain-tissue doses for all criteria were lower for RapidArc in nearly all patients. The average ratio of GK to RapidArc plans was 1.28±0.27 (p=0.018), 1.31±0.25 (p=0.017), 1.81±0.43 (p=0.005), and 1.50±0.61 (p=0.006) for V4, V8, and V12 Gy, and integral dose, respectively. Conclusion: VMAT was capable of producing higher quality treatment plans than GK when using optimal beam geometries and proper optimization techniques.« less

Symposium on electron linear accelerators in honor of Richard B. Neal's 80th birthday: Proceedings

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

Siemann, R.H.

The papers presented at the conference are: (1) the construction of SLAC and the role of R.B. Neal; (2) symposium speech; (3) lessons learned from the SLC; (4) alternate approaches to future electron-positron linear colliders; (5) the NLC technical program; (6) advanced electron linacs; (7) medical uses of linear accelerators; (8) linac-based, intense, coherent X-ray source using self-amplified spontaneous emission. Selected papers have been indexed separately for inclusion in the Energy Science and Technology Database.

Accuracy of frame-based stereotactic depth electrode implantation during craniotomy for subdural grid placement.

PubMed

Munyon, Charles N; Koubeissi, Mohamad Z; Syed, Tanvir U; Lüders, Hans O; Miller, Jonathan P

2013-01-01

Frame-based stereotaxy and open craniotomy may seem mutually exclusive, but invasive electrophysiological monitoring can require broad sampling of the cortex and precise targeting of deeper structures. The purpose of this study is to describe simultaneous frame-based insertion of depth electrodes and craniotomy for placement of subdural grids through a single surgical field and to determine the accuracy of depth electrodes placed using this technique. A total of 6 patients with intractable epilepsy underwent placement of a stereotactic frame with the center of the planned cranial flap equidistant from the fixation posts. After volumetric imaging, craniotomy for placement of subdural grids was performed. Depth electrodes were placed using frame-based stereotaxy. Postoperative CT determined the accuracy of electrode placement. A total of 31 depth electrodes were placed. Mean distance of distal electrode contact from the target was 1.0 ± 0.15 mm. Error was correlated to distance to target, with an additional 0.35 mm error for each centimeter (r = 0.635, p < 0.001); when corrected, there was no difference in accuracy based on target structure or method of placement (prior to craniotomy vs. through grid, p = 0.23). The described technique for craniotomy through a stereotactic frame allows placement of subdural grids and depth electrodes without sacrificing the accuracy of a frame or requiring staged procedures.

Stereotactic Fractionated Radiotherapy in the Treatment of Juxtapapillary Choroidal Melanoma: The McGill University Experience

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

Al-Wassia, Rolina; Dal Pra, Alan; Shun, Kitty

2011-11-15

Purpose: To report our experience with linear accelerator-based stereotactic fractionated radiotherapy in the treatment of juxtapapillary choroidal melanoma. Methods and Materials: We performed a retrospective review of 50 consecutive patients diagnosed with juxtapapillary choroidal melanoma and treated with linear accelerator-based stereotactic fractionated radiotherapy between April 2003 and December 2009. Patients with small to medium sized lesions (Collaborative Ocular Melanoma Study classification) located within 2 mm of the optic disc were included. The prescribed radiation dose was 60 Gy in 10 fractions. The primary endpoints included local control, enucleation-free survival, and complication rates. Results: The median follow-up was 29 months (range,more » 1-77 months). There were 31 males and 29 females, with a median age of 69 years (range, 30-92 years). Eighty-four percent of the patients had medium sized lesions, and 16% of patients had small sized lesions. There were four cases of local progression (8%) and three enucleations (6%). Actuarial local control rates at 2 and 5 years were 93% and 86%, respectively. Actuarial enucleation-free survival rates at 2 and 5 years were 94% and 84%, respectively. Actuarial complication rates at 2 and 5 years were 33% and 88%, respectively, for radiation-induced retinopathy; 9.3% and 46.9%, respectively, for dry eye; 12% and 53%, respectively, for cataract; 30% and 90%, respectively, for visual loss [Snellen acuity (decimal equivalent), <0.1]; 11% and 54%, respectively, for optic neuropathy; and 18% and 38%, respectively, for neovascular glaucoma. Conclusions: Linear accelerator-based stereotactic fractionated radiotherapy using 60 Gy in 10 fractions is safe and has an acceptable toxicity profile. It has been shown to be an effective noninvasive treatment for juxtapapillary choroidal melanomas.« less

Combining stereotactic angiography and 3D time-of-flight magnetic resonance angiography in treatment planning for arteriovenous malformation radiosurgery.

PubMed

Bednarz, G; Downes, B; Werner-Wasik, M; Rosenwasser, R H

2000-03-15

This study was initiated to evaluate the advantages of using three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA), as an adjuvant to conventional stereotactic angiography, in obtaining three-dimensional information about an arteriovenous malformation (AVM) nidus and in optimizing radiosurgical treatment plans. Following angiography, contrast-enhanced MRI and MRA studies were obtained in 22 consecutive patients undergoing Gamma Knife radiosurgery for AVM. A treatment plan was designed, based on the angiograms and modified as necessary, using the information provided by MRA. The quantitative analysis involved calculation of the ratio of the treated volume to the MRA nidus volume (the tissue volume ratio [TVR]) for the initial and final treatment plans. In 12 cases (55%), the initial treatment plans were modified after including the MRA information in the treatment planning process. The mean TVR for the angiogram-based plans was 1.63 (range 1.17-2.17). The mean coverage of the MRA nidus by the angiogram-based plans was 93% (range 73-99%). The mean MRA nidus volume was 2.4 cc (range 0. 6-5.3 cc). The MRA-based modifications resulted in increased conformity with the mean TVR of 1.46 (range 1.20-1.74). These modifications were caused by MRA revealing irregular nidi and/or vascular components superimposed on the angiographic projections of the nidi. In a number of cases, the information from MRA was essential in defining the nidus when the projections of the angiographic outlines showed different superior and/or inferior extent of the nidus. In two cases, MRA revealed irregular nidi, correlating well with the angiograms and showed that the angiographically acceptable plans undertreated 27% of the MRA nidus in one case and 18% of the nidus in the other case. In the remaining 10 cases (45%), both MRI and MRA failed to detect the nidus due to surgical clip artifacts and the presence of embolizing glue. The 3D TOF MRA provided information on irregular AVM shape, which was not visualized by angiography alone, and it was superior to MRI for defining the AVM nidus. However, when imaging artifacts obscured the AVM nidus on MRI and MRA, angiography permitted detection of AVM. Utilizing MRA as a complementary imaging modality to angiography increased accuracy of the AVM radiosurgery and allowed for optimal dose planning.

Overtaking collision effects in a cw double-pass proton linac

DOE PAGES

Tao, Yue; Qiang, Ji; Hwang, Kilean

2017-12-22

The recirculating superconducting proton linac has the advantage of reducing the number of cavities in the accelerator and the corresponding construction and operational costs. Beam dynamics simulations were done recently in a double-pass recirculating proton linac using a single proton beam bunch. For continuous wave (cw) operation, the high-energy proton bunch during the second pass through the linac will overtake and collide with the low-energy bunch during the first pass at a number of locations of the linac. These collisions might cause proton bunch emittance growth and beam quality degradation. Here, we study the collisional effects due to Coulomb space-chargemore » forces between the high-energy bunch and the low-energy bunch. Our results suggest that these effects on the proton beam quality would be small and might not cause significant emittance growth or beam blowup through the linac. A 10 mA, 500 MeV cw double-pass proton linac is feasible without using extra hardware for phase synchronization.« less

Overtaking collision effects in a cw double-pass proton linac

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

Tao, Yue; Qiang, Ji; Hwang, Kilean

The recirculating superconducting proton linac has the advantage of reducing the number of cavities in the accelerator and the corresponding construction and operational costs. Beam dynamics simulations were done recently in a double-pass recirculating proton linac using a single proton beam bunch. For continuous wave (cw) operation, the high-energy proton bunch during the second pass through the linac will overtake and collide with the low-energy bunch during the first pass at a number of locations of the linac. These collisions might cause proton bunch emittance growth and beam quality degradation. Here, we study the collisional effects due to Coulomb space-chargemore » forces between the high-energy bunch and the low-energy bunch. Our results suggest that these effects on the proton beam quality would be small and might not cause significant emittance growth or beam blowup through the linac. A 10 mA, 500 MeV cw double-pass proton linac is feasible without using extra hardware for phase synchronization.« less

MO-FG-CAMPUS-TeP1-03: Pre-Treatment Surface Imaging Based Collision Detection

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

Wiant, D; Maurer, J; Liu, H

2016-06-15

Purpose: Modern radiotherapy increasingly employs large immobilization devices, gantry attachments, and couch rotations for treatments. All of which raise the risk of collisions between the patient and the gantry / couch. Collision detection is often achieved by manually checking each couch position in the treatment room and sometimes results in extraneous imaging if collisions are detected after image based setup has begun. In the interest of improving efficiency and avoiding extra imaging, we explore the use of a surface imaging based collision detection model. Methods: Surfaces acquired from AlignRT (VisionRT, London, UK) were transferred in wavefront format to a custommore » Matlab (Mathworks, Natick, MA) software package (CCHECK). Computed tomography (CT) scans acquired at the same time were sent to CCHECK in DICOM format. In CCHECK, binary maps of the surfaces were created and overlaid on the CT images based on the fixed relationship of the AlignRT and CT coordinate systems. Isocenters were added through a graphical user interface (GUI). CCHECK then compares the inputted surfaces to a model of the linear accelerator (linac) to check for collisions at defined gantry and couch positions. Note, CCHECK may be used with or without a CT. Results: The nominal surface image field of view is 650 mm × 900 mm, with variance based on patient position and size. The accuracy of collision detections is primarily based on the linac model and the surface mapping process. The current linac model and mapping process yield detection accuracies on the order of 5 mm, assuming no change in patient posture between surface acquisition and treatment. Conclusions: CCHECK provides a non-ionizing method to check for collisions without the patient in the treatment room. Collision detection accuracy may be improved with more robust linac modeling. Additional gantry attachments (e.g. conical collimators) can be easily added to the model.« less

Accuracy of Marketing Claims by Providers of Stereotactic Radiation Therapy

PubMed Central

Narang, Amol K.; Lam, Edwin; Makary, Martin A.; DeWeese, Theodore L.; Pawlik, Timothy M.; Pronovost, Peter J.; Herman, Joseph M.

2013-01-01

Purpose: Direct-to-consumer advertising by industry has been criticized for encouraging overuse of unproven therapies, but advertising by health care providers has not been as carefully scrutinized. Stereotactic radiation therapy is an emerging technology that has sparked controversy regarding the marketing campaigns of some manufacturers. Given that this technology is also being heavily advertised on the Web sites of health care providers, the accuracy of providers' marketing claims should be rigorously evaluated. Methods: We reviewed the Web sites of all US hospitals and private practices that provide stereotactic radiation using two leading brands of stereotactic radiosurgery technology. Centers were identified by using data from the manufacturers. Centers without Web sites were excluded. The final study population consisted of 212 centers with online advertisements for stereotactic radiation. Web sites were evaluated for advertisements that were inconsistent with advertising guidelines provided by the American Medical Association. Results: Most centers (76%) had individual pages dedicated to the marketing of their brand of stereotactic technology that frequently contained manufacturer-authored images (50%) or text (55%). Advertising for the treatment of tumors that have not been endorsed by professional societies was present on 66% of Web sites. Centers commonly claimed improved survival (22%), disease control (20%), quality of life (17%), and toxicity (43%) with stereotactic radiation. Although 40% of Web sites championed the center's regional expertise in delivering stereotactic treatments, only 15% of Web sites provided data to support their claims. Conclusion: Provider advertisements for stereotactic radiation were prominent and aggressive. Further investigation of provider advertising, its effects on quality of care, and potential oversight mechanisms is needed. PMID:23633973

Accuracy of marketing claims by providers of stereotactic radiation therapy.

PubMed

Narang, Amol K; Lam, Edwin; Makary, Martin A; Deweese, Theodore L; Pawlik, Timothy M; Pronovost, Peter J; Herman, Joseph M

2013-01-01

Direct-to-consumer advertising by industry has been criticized for encouraging overuse of unproven therapies, but advertising by health care providers has not been as carefully scrutinized. Stereotactic radiation therapy is an emerging technology that has sparked controversy regarding the marketing campaigns of some manufacturers. Given that this technology is also being heavily advertised on the Web sites of health care providers, the accuracy of providers' marketing claims should be rigorously evaluated. We reviewed the Web sites of all U.S. hospitals and private practices that provide stereotactic radiation using two leading brands of stereotactic radiosurgery technology. Centers were identified by using data from the manufacturers. Centers without Web sites were excluded. The final study population consisted of 212 centers with online advertisements for stereotactic radiation. Web sites were evaluated for advertisements that were inconsistent with advertising guidelines provided by the American Medical Association. Most centers (76%) had individual pages dedicated to the marketing of their brand of stereotactic technology that frequently contained manufacturer-authored images (50%) or text (55%). Advertising for the treatment of tumors that have not been endorsed by professional societies was present on 66% of Web sites. Centers commonly claimed improved survival (22%), disease control (20%), quality of life (17%), and toxicity (43%) with stereotactic radiation. Although 40% of Web sites championed the center's regional expertise in delivering stereotactic treatments, only 15% of Web sites provided data to support their claims. Provider advertisements for stereotactic radiation were prominent and aggressive. Further investigation of provider advertising, its effects on quality of care, and potential oversight mechanisms is needed.

Design of High Efficiency High Power Electron Accelerator Systems Based on Normal Conducting RF Technology for Energy and Environmental Applications

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

Dolgashev, Valery; Tantawi, Sami

The goal of this project was to perform engineering design studies of three extremely high efficiency electron accelerators with the following parameters [1]: 2 MeV output beam energy and 1 MW average beam power; 10 MeV output energy and 10 MW; 10 MeV output energy and 1 MW. These linacs are intended for energy and environmental applications [2]. We based our designs on normal conducting radio-frequency technology. We have successfully reached this goal where we show rf-to-beam efficiency of 96.7 %, 97.2 %, and 79.6 % for these linacs.

High gradient linac for proton therapy

NASA Astrophysics Data System (ADS)

Benedetti, S.; Grudiev, A.; Latina, A.

2017-04-01

Proposed for the first time almost 30 years ago, the research on radio frequency linacs for hadron therapy experienced a sparkling interest in the past decade. The different projects found a common ground on a relatively high rf operating frequency of 3 GHz, taking advantage of the availability of affordable and reliable commercial klystrons at this frequency. This article presents for the first time the design of a proton therapy linac, called TULIP all-linac, from the source up to 230 MeV. In the first part, we will review the rationale of linacs for hadron therapy. We then divided this paper in two main sections: first, we will discuss the rf design of the different accelerating structures that compose TULIP; second, we will present the beam dynamics design of the different linac sections.

Developing field emission electron sources based on ultrananocrystalline diamond for accelerators

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

Baryshev, Sergey V.; Jing, Chunguang; Qiu, Jiaqi

Radiofrequency (RF) electron guns work by establishing an RF electromagnetic field inside a cavity having conducting walls. Electrons from a cathode are generated in the injector and immediately become accelerated by the RF electric field, and exit the gun as a series of electron bunches. Finding simple solutions for electron injection is a long standing problem. While energies of 30-50 MeV are achievable in linear accelerators (linacs), finding an electron source able to survive under MW electric loads and provide an average current of 1-10 mA is important. Meeting these requirements would open various linac applications for industry. The naturalmore » way to simplify and integrate RF injector architectures with the electron source would be to place the source directly into the RF cavity with no need for additional heaters/lasers. Euclid TechLabs in collaboration with Argonne National Lab are prototyping a family of highly effective field emission electron sources based on a nitrogen-incorporated ultrananocrystalline diamond ((N)UNCD) platform. Determined metrics suggest that our emitters are emissive enough to meet requirements for magnetized cooling at electron-ion colliders, linac-based radioisotope production and X-ray sterilization, and others.« less

High duty factor plasma generator for CERN's Superconducting Proton Linac.

PubMed

Lettry, J; Kronberger, M; Scrivens, R; Chaudet, E; Faircloth, D; Favre, G; Geisser, J-M; Küchler, D; Mathot, S; Midttun, O; Paoluzzi, M; Schmitzer, C; Steyaert, D

2010-02-01

CERN's Linac4 is a 160 MeV linear accelerator currently under construction. It will inject negatively charged hydrogen ions into CERN's PS-Booster. Its ion source is a noncesiated rf driven H(-) volume source directly inspired from the one of DESY and is aimed to deliver pulses of 80 mA of H(-) during 0.4 ms at a 2 Hz repetition rate. The Superconducting Proton Linac (SPL) project is part of the luminosity upgrade of the Large Hadron Collider. It consists of an extension of Linac4 up to 5 GeV and is foreseen to deliver protons to a future 50 GeV synchrotron (PS2). For the SPL high power option (HP-SPL), the ion source would deliver pulses of 80 mA of H(-) during 1.2 ms and operate at a 50 Hz repetition rate. This significant upgrade motivates the design of the new water cooled plasma generator presented in this paper. Its engineering is based on the results of a finite element thermal study of the Linac4 H(-) plasma generator that identified critical components and thermal barriers. A cooling system is proposed which achieves the required heat dissipation and maintains the original functionality. Materials with higher thermal conductivity are selected and, wherever possible, thermal barriers resulting from low pressure contacts are removed by brazing metals on insulators. The AlN plasma chamber cooling circuit is inspired from the approach chosen for the cesiated high duty factor rf H(-) source operating at SNS.

Magnetic resonance imaging of the subthalamic nucleus for deep brain stimulation.

PubMed

Chandran, Arjun S; Bynevelt, Michael; Lind, Christopher R P

2016-01-01

The subthalamic nucleus (STN) is one of the most important stereotactic targets in neurosurgery, and its accurate imaging is crucial. With improving MRI sequences there is impetus for direct targeting of the STN. High-quality, distortion-free images are paramount. Image reconstruction techniques appear to show the greatest promise in balancing the issue of geometrical distortion and STN edge detection. Existing spin echo- and susceptibility-based MRI sequences are compared with new image reconstruction methods. Quantitative susceptibility mapping is the most promising technique for stereotactic imaging of the STN.

EF5 PET of Tumor Hypoxia: A Predictive Imaging Biomarker of Response to Stereotactic Ablative Radiotherapy (SABR) for Early Lung Cancer

DTIC Science & Technology

2014-09-01

Predictive Imaging Biomarker of Response to Stereotactic Ablative Radiotherapy ( SABR ) for Early Lung Cancer PRINCIPAL INVESTIGATOR: Billy W...CONTRACT NUMBER Response to Stereotactic Ablative Radiotherapy ( SABR ) for Early Lung Cancer 5b. GRANT NUMBER W81XWH-12-1-0236 5c...NOTES 14. ABSTRACT Purpose and scope: Stereotactic ablative radiotherapy ( SABR ) has become a new standard of care for early stage lung

A multi-institutional study to assess adherence to lung stereotactic body radiotherapy planning goals

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

Woerner, Andrew; Roeske, John C.; Harkenrider, Matthew M.

2015-08-15

Purpose: A multi-institutional planning study was performed to evaluate the frequency that current guidelines established by Radiation Therapy Oncology Group (RTOG) protocols and other literature for lung stereotactic body radiotherapy (SBRT) treatments are followed. Methods: A total of 300 patients receiving lung SBRT treatments in four different institutions were retrospectively reviewed. The treatments were delivered using Linac based SBRT (160 patients) or image guided robotic radiosurgery (140). Most tumors were located peripherally (250/300). Median fractional doses and ranges were 18 Gy (8–20 Gy), 12 Gy (6–15 Gy), and 10 Gy (5–12 Gy) for three, four, and five fraction treatments, respectively.more » The following planning criteria derived from RTOG trials and the literature were used to evaluate the treatment plans: planning target volumes, PTV{sub V} {sub 100} ≥ 95% and PTV{sub V} {sub 95} ≥ 99%; conformality indices, CI{sub 100%} < 1.2 and CI{sub 50%} range of 2.9–5.9 dependent on PTV; total lung-ITV: V{sub 20Gy} < 10%, V{sub 12.5Gy} < 15%, and V{sub 5Gy} < 37%; contralateral lung V{sub 5Gy} < 26%; and maximum doses for spinal cord, esophagus, trachea/bronchus, and heart and great vessels. Populations were grouped by number of fractions, and dosimetric criteria satisfaction rates (CSRs) were reported. Results: Five fraction regimens were the most common lung SBRT fractionation (46%). The median PTV was 27.2 cm{sup 3} (range: 3.8–419.5 cm{sup 3}). For all plans: mean PTV{sub V} {sub 100} was 94.5% (±5.6%, planning CSR: 69.8%), mean PTV{sub V} {sub 95} was 98.1% (±4.1%, CSR: 69.5%), mean CI{sub 100%} was 1.14 (±0.21, CSR: 79.1%, and 16.5% within minor deviation), and mean CI{sub 50%} was 5.63 (±2.8, CSR: 33.0%, and 28.0% within minor deviation). When comparing plans based on location, peripherally located tumors displayed higher PTV{sub V} {sub 100} and PTV{sub V} {sub 95} CSR (71.5% and 71.9%, respectively) than centrally located tumors (61.2% and 57.1%, respectively). Overall, the planning criteria were met for all the critical structure such as lung, heart, spinal cord, esophagus, and trachea/bronchus for at least 85% of the patients. Conclusions: Among the various parameters that were used to evaluate the SBRT plans, the CI{sub 100%} and CI{sub 50%} were the most challenging criteria to meet. Although the CSRs of organs at risk were higher among all cases, their proximity to the PTV was a significant factor.« less

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

PubMed

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

2018-05-14

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

Stereotactic core needle breast biopsy marker migration: An analysis of factors contributing to immediate marker migration.

PubMed

Jain, Ashali; Khalid, Maria; Qureshi, Muhammad M; Georgian-Smith, Dianne; Kaplan, Jonah A; Buch, Karen; Grinstaff, Mark W; Hirsch, Ariel E; Hines, Neely L; Anderson, Stephan W; Gallagher, Katherine M; Bates, David D B; Bloch, B Nicolas

2017-11-01

To evaluate breast biopsy marker migration in stereotactic core needle biopsy procedures and identify contributing factors. This retrospective study analyzed 268 stereotactic biopsy markers placed in 263 consecutive patients undergoing stereotactic biopsies using 9G vacuum-assisted devices from August 2010-July 2013. Mammograms were reviewed and factors contributing to marker migration were evaluated. Basic descriptive statistics were calculated and comparisons were performed based on radiographically-confirmed marker migration. Of the 268 placed stereotactic biopsy markers, 35 (13.1%) migrated ≥1 cm from their biopsy cavity. Range: 1-6 cm; mean (± SD): 2.35 ± 1.22 cm. Of the 35 migrated biopsy markers, 9 (25.7%) migrated ≥3.5 cm. Patient age, biopsy pathology, number of cores, and left versus right breast were not associated with migration status (P> 0.10). Global fatty breast density (P= 0.025) and biopsy in the inner region of breast (P = 0.031) were associated with marker migration. Superior biopsy approach (P= 0.025), locally heterogeneous breast density, and t-shaped biopsy markers (P= 0.035) were significant for no marker migration. Multiple factors were found to influence marker migration. An overall migration rate of 13% supports endeavors of research groups actively developing new biopsy marker designs for improved resistance to migration. • Breast biopsy marker migration is documented in 13% of 268 procedures. • Marker migration is affected by physical, biological, and pathological factors. • Breast density, marker shape, needle approach etc. affect migration. • Study demonstrates marker migration prevalence; marker design improvements are needed.

Frameless stereotactic radiosurgery with a bite-plate: our experience with brain metastases.

PubMed

Furuse, M; Aoki, T; Takagi, T; Takahashi, J A; Ishikawa, M

2008-12-01

Non-invasive frameless stereotactic radiosurgical systems have recently been developed. We report our experience of frameless stereotactic radiosurgery (SRS) with a bite-plate for brain metastases. Between February 2002 and December 2005, 147 patients with brain metastases were treated with C-arm linear accelerator-based SRS and 122 patients were followed up by our institute. An optic tracking system with infrared light-emitting diodes was used for real-time monitoring. A bite-plate with fiducial markers was applied as a first-line method for frameless SRS. Head-ring fixation was used in patients lacking teeth. Lung carcinomas (63%) were the most common primary tumors, followed by breast carcinomas (13%). Ninety patients underwent radiosurgery with a bite-plate and 32 patients underwent fixation of a head ring. Males were significantly more predominant in the head-ring group (26 men and 6 women), compared with the bite-plate group (47 men and 43 women, p < 0.01). The average age (62 years) in the bite-plate group was significantly younger than that (68 years) in the head-ring group (p < 0.01). The median survival time was 12.0 months in the bite-plate group and 8.0 months in the head-ring group (p = 0.0621). Nine patients who had brain metastases in or close to the brain stem were treated with fractionated stereotactic radiotherapy. The frameless stereotactic radiosurgical system with a bite-plate is safe and effective for the treatment of brain metastasis. Elderly male patients sometimes are edentulous and require placement of a head ring for radiosurgery.

Clinical accuracy of ExacTrac intracranial frameless stereotactic system

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

Ackerly, T.; Lancaster, C. M.; Geso, M.

2011-09-15

Purpose: In this paper, the authors assess the accuracy of the Brainlab ExacTrac system for frameless intracranial stereotactic treatments in clinical practice. Methods: They recorded couch angle and image fusion results (comprising lateral, longitudinal, and vertical shifts, and rotation corrections about these axes) for 109 stereotactic radiosurgery and 166 stereotactic radiotherapy patient treatments. Frameless stereotactic treatments involve iterative 6D image fusion corrections applied until the results conform to customizable pass criteria, theirs being 0.7 mm and 0.5 deg. for each axis. The planning CT slice thickness was 1.25 mm. It has been reported in the literature that the CT slices'more » thickness impacts the accuracy of localization to bony anatomy. The principle of invariance with respect to patient orientation was used to determine spatial accuracy. Results: The data for radiosurgery comprised 927 image pairs, of which 532 passed (pass ratio of 57.4%). The data for radiotherapy comprised 15983 image pairs, of which 10 050 passed (pass ratio of 62.9%). For stereotactic radiotherapy, the combined uncertainty of ExacTrac calibration, image fusion, and intrafraction motion was (95% confidence interval) 0.290-0.302 and 0.306-0.319 mm in the longitudinal and lateral axes, respectively. The combined uncertainty of image fusion and intrafraction motion in the anterior-posterior coordinates was 0.174-0.182 mm. For stereotactic radiosurgery, the equivalent ranges are 0.323-0.393, 0.337-0.409, and 0.231-0.281 mm. The overall spatial accuracy was 1.24 mm for stereotactic radiotherapy (SRT) and 1.35 mm for stereotactic radiosurgery (SRS). Conclusions: The ExacTrac intracranial frameless stereotactic system spatial accuracy is adequate for clinical practice, and with the same pass criteria, SRT is more accurate than SRS. They now use frameless stereotaxy exclusively at their center.« less

WE-A-304-01: Strategies and Technologies for Cranial Radiosurgery Planning: MLC-Based Linac

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

Kim, G.

2015-06-15

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Futuremore » directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.« less

Construction and commissioning of the compact energy-recovery linac at KEK

NASA Astrophysics Data System (ADS)

Akemoto, Mitsuo; Arakawa, Dai; Asaoka, Seiji; Cenni, Enrico; Egi, Masato; Enami, Kazuhiro; Endo, Kuninori; Fukuda, Shigeki; Furuya, Takaaki; Haga, Kaiichi; Hajima, Ryoichi; Hara, Kazufumi; Harada, Kentaro; Honda, Tohru; Honda, Yosuke; Honma, Teruya; Hosoyama, Kenji; Kako, Eiji; Katagiri, Hiroaki; Kawata, Hiroshi; Kobayashi, Yukinori; Kojima, Yuuji; Kondou, Yoshinari; Tanaka, Olga; Kume, Tatsuya; Kuriki, Masao; Matsumura, Hiroshi; Matsushita, Hideki; Michizono, Shinichiro; Miura, Takako; Miyajima, Tsukasa; Nagahashi, Shinya; Nagai, Ryoji; Nakai, Hirotaka; Nakajima, Hiromitsu; Nakamura, Norio; Nakanishi, Kota; Nigorikawa, Kazuyuki; Nishimori, Nobuyuki; Nogami, Takashi; Noguchi, Shuichi; Obina, Takashi; Qiu, Feng; Sagehashi, Hidenori; Sakai, Hiroshi; Sakanaka, Shogo; Sasaki, Shinichi; Satoh, Kotaro; Sawamura, Masaru; Shimada, Miho; Shinoe, Kenji; Shishido, Toshio; Tadano, Mikito; Takahashi, Takeshi; Takai, Ryota; Takenaka, Tateru; Tanimoto, Yasunori; Uchiyama, Takashi; Ueda, Akira; Umemori, Kensei; Watanabe, Ken; Yamamoto, Masahiro

2018-01-01

Energy-recovery linacs (ERLs) are promising for advanced synchrotron light sources, high-power free electron lasers (FELs), high-brightness gamma-ray sources, and electron-ion colliders. To demonstrate the critical technology of ERL-based light sources, we have designed and constructed a test accelerator, the compact ERL (cERL). Using advanced technology that includes a photocathode direct current (DC) electron gun and two types of 1.3-GHz-frequency superconducting cavities, the cERL was designed to be capable of recirculating low emittance (≤1 mm ṡ mrad) and high average-current (≥10 mA) electron beams while recovering the beam energy. During initial commissioning, the cERL demonstrated successful recirculation of high-quality beams with normalized transverse emittance of ∼0.14 mm ṡ mrad and momentum spread of ∼1.2 × 10-4 (rms) at a beam energy of 20 MeV and bunch charge below 100 fC. Energy recovery in the superconducting main linac was also demonstrated for high-average-current continuous-wave beams. These results constitute an important milestone toward realizing ERL-based light sources.

An in vivo dose verification method for SBRT-VMAT delivery using the EPID.

PubMed

McCowan, P M; Van Uytven, E; Van Beek, T; Asuni, G; McCurdy, B M C

2015-12-01

Radiation treatments have become increasingly more complex with the development of volumetric modulated arc therapy (VMAT) and the use of stereotactic body radiation therapy (SBRT). SBRT involves the delivery of substantially larger doses over fewer fractions than conventional therapy. SBRT-VMAT treatments will strongly benefit from in vivo patient dose verification, as any errors in delivery can be more detrimental to the radiobiology of the patient as compared to conventional therapy. Electronic portal imaging devices (EPIDs) are available on most commercial linear accelerators (Linacs) and their documented use for dosimetry makes them valuable tools for patient dose verification. In this work, the authors customize and validate a physics-based model which utilizes on-treatment EPID images to reconstruct the 3D dose delivered to the patient during SBRT-VMAT delivery. The SBRT Linac head, including jaws, multileaf collimators, and flattening filter, were modeled using Monte Carlo methods and verified with measured data. The simulation provides energy spectrum data that are used by their "forward" model to then accurately predict fluence generated by a SBRT beam at a plane above the patient. This fluence is then transported through the patient and then the dose to the phosphor layer in the EPID is calculated. Their "inverse" model back-projects the EPID measured focal fluence to a plane upstream of the patient and recombines it with the extra-focal fluence predicted by the forward model. This estimate of total delivered fluence is then forward projected onto the patient's density matrix and a collapsed cone convolution algorithm calculates the dose delivered to the patient. The model was tested by reconstructing the dose for two prostate, three lung, and two spine SBRT-VMAT treatment fractions delivered to an anthropomorphic phantom. It was further validated against actual patient data for a lung and spine SBRT-VMAT plan. The results were verified with the treatment planning system (TPS) (ECLIPSE AAA) dose calculation. The SBRT-VMAT reconstruction model performed very well when compared to the TPS. A stringent 2%/2 mm χ-comparison calculation gave pass rates better than 91% for the prostate plans, 88% for the lung plans, and 86% for the spine plans for voxels containing 80% or more of the prescribed dose. Patient data were 86% for the lung and 95% for the spine. A 3%/3 mm χ-comparison was also performed and gave pass rates better than 93% for all plan types. The authors have customized and validated a robust, physics-based model that calculates the delivered dose to a patient for SBRT-VMAT delivery using on-treatment EPID images. The accuracy of the results indicates that this approach is suitable for clinical implementation. Future work will incorporate this model into both offline and real-time clinical adaptive radiotherapy.

Studies on the S-band bunching system with the Hybrid Bunching-accelerating Structure

NASA Astrophysics Data System (ADS)

Pei, Shi-Lun; Gao, Bin

2018-04-01

Generally, a standard bunching system is composed of a standing-wave (SW) pre-buncher (PB), a traveling-wave (TW) buncher (B) and a standard accelerating structure. In the industrial area, the bunching system is usually simplified by eliminating the PB and integrating the B and the standard accelerating structure together to form a β-varied accelerating structure. The beam capturing efficiency for this kind of simplified system is often worse than that for the standard one. The hybrid buncher (HB) has been proved to be a successful attempt to reduce the cost but preserve the beam quality as much as possible. Here we propose to exclusively simplify the standard bunching system by integrating the PB, the B and the standard accelerating structure together to form a Hybrid Bunching-accelerating Structure (HBaS). Compared to the standard bunching system, the one based on the HBaS is more compact, and the cost is lowered to the largest extent. With almost the same beam transportation efficiency (∼70%) from the electron gun to the linac exit, the peak-to-peak (p-to-p) beam energy spread and the 1 σ emittance of the linac with the HBaS are ∼20% and ∼60% bigger than those of the linac based on the split PB/B/standard accelerating structure system. Nonetheless, the proposed HBaS can be widely applied in the industrial linacs to greatly increase the beam capturing efficiency without fairly increasing the construction cost.

The development of stereotactic body radiotherapy in the past decade: a global perspective.

PubMed

Lo, Simon S; Slotman, Ben J; Lock, Michael; Nagata, Yasushi; Guckenberger, Matthias; Siva, Shankar; Foote, Matthew; Tan, Daniel; Teh, Bin S; Mayr, Nina A; Chang, Eric L; Timmerman, Robert D; Sahgal, Arjun

2015-09-04

In the past 10 years, there has been an exponential increase in the incorporation of stereotactic body radiotherapy, also known as stereotactic ablative radiotherapy, into the armamentarium against various types of cancer in different settings worldwide. In this article in the 10th year anniversary issue of Future Oncology, representatives from the USA, Canada, Japan, Germany, The Netherlands, Australia and Singapore will provide individual perspectives of the development of stereotactic body radiotherapy in their respective countries.

Numerical simulations of stripping effects in high-intensity hydrogen ion linacs

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

Carneiro, J.-P.; /Fermilab; Mustapha, B.

2008-12-01

Numerical simulations of H{sup -} stripping losses from blackbody radiation, electromagnetic fields, and residual gas have been implemented into the beam dynamics code TRACK. Estimates of the stripping losses along two high-intensity H{sup -} linacs are presented: the Spallation Neutron Source linac currently being operated at Oak Ridge National Laboratory and an 8 GeV superconducting linac currently being designed at Fermi National Accelerator Laboratory.

CT Perfusion Imaging as an Early Biomarker of Differential Response to Stereotactic Radiosurgery in C6 Rat Gliomas

PubMed Central

Yeung, Timothy Pok Chi; Kurdi, Maher; Wang, Yong; Al-Khazraji, Baraa; Morrison, Laura; Hoffman, Lisa; Jackson, Dwayne; Crukley, Cathie; Lee, Ting-Yim; Bauman, Glenn; Yartsev, Slav

2014-01-01

Background The therapeutic efficacy of stereotactic radiosurgery for glioblastoma is not well understood, and there needs to be an effective biomarker to identify patients who might benefit from this treatment. This study investigated the efficacy of computed tomography (CT) perfusion imaging as an early imaging biomarker of response to stereotactic radiosurgery in a malignant rat glioma model. Methods Rats with orthotopic C6 glioma tumors received either mock irradiation (controls, N = 8) or stereotactic radiosurgery (N = 25, 12 Gy in one fraction) delivered by Helical Tomotherapy. Twelve irradiated animals were sacrificed four days after stereotactic radiosurgery to assess acute CT perfusion and histological changes, and 13 irradiated animals were used to study survival. Irradiated animals with survival >15 days were designated as responders while those with survival ≤15 days were non-responders. Longitudinal CT perfusion imaging was performed at baseline and regularly for eight weeks post-baseline. Results Early signs of radiation-induced injury were observed on histology. There was an overall survival benefit following stereotactic radiosurgery when compared to the controls (log-rank P<0.04). Responders to stereotactic radiosurgery showed lower relative blood volume (rBV), and permeability-surface area (PS) product on day 7 post-stereotactic radiosurgery when compared to controls and non-responders (P<0.05). rBV and PS on day 7 showed correlations with overall survival (P<0.05), and were predictive of survival with 92% accuracy. Conclusions Response to stereotactic radiosurgery was heterogeneous, and early selection of responders and non-responders was possible using CT perfusion imaging. Validation of CT perfusion indices for response assessment is necessary before clinical implementation. PMID:25329655

Endoscopic versus stereotactic procedure for pineal tumour biopsies: Comparative review of the literature and learning from a 25-year experience.

PubMed

Balossier, A; Blond, S; Touzet, G; Lefranc, M; de Saint-Denis, T; Maurage, C-A; Reyns, N

2015-01-01

Pineal tumours account for 1% to 4% of brain tumours in adults and for around 10% in children. Except in a few cases where germ cell markers are elevated, accurate histological samples are mandatory to initiate the treatment. Open surgery still has a high morbidity and is often needless. Biopsies can either be obtained by endoscopic or stereotactic procedures. Following an extensive review of the literature (PubMed 1970-2013; keywords pineal tumour, biopsy; English and French), 33 studies were analysed and relevant data compared regarding the type of procedure, diagnosis rate, cerebrospinal fluid diversion type and rate, perioperative mortality, morbidity. Endoscopic and stereotactic biopsies showed a diagnosis rate of 81.1% (20%-100%) and 93.7% (82%-100%), respectively. Endoscopic biopsies involved 21.0% of minor and 2.0% of major complications whereas stereotactic biopsies involved 6.4% of minor and 1.6% of major complications. The most frequently reported complication was haemorrhage for both endoscopic and stereotactic procedures, accounting for 4.8% and 4.3%, respectively. Mortality rate was low for both endoscopic and stereotactic procedures, equal to 0.4% and 1.3%, respectively. Local experience of stereotactic biopsies was also reported and corroborated the previous data. The difference between both procedures is not statistically significant (p>0.05) across large series (≥20patients). Nevertheless, tissue diagnosis appears less accurate with endoscopic procedures than with stereotactic procedures (81.1% versus 93.7%, weighted mean across all series). In our opinion, the neuroendoscopic approach is the best tool for managing hydrocephalus, whereas stereotactic biopsies remain the best way to obtain a tissue diagnosis with accuracy and low morbidity. Copyright © 2014. Published by Elsevier Masson SAS.

Optical spectroscopy for stereotactic biopsy of brain tumors

NASA Astrophysics Data System (ADS)

Markwardt, Niklas; von Berg, Anna; Fiedler, Sebastian; Goetz, Marcus; Haj-Hosseini, Neda; Polzer, Christoph; Stepp, Herbert; Zelenkov, Petr; Rühm, Adrian

2015-07-01

Stereotactic biopsy procedure is performed to obtain a tissue sample for diagnosis purposes. Currently, a fiber-based mechano-optical device for stereotactic biopsies of brain tumors is developed. Two different fluorophores are employed to improve the safety and reliability of this procedure: The fluorescence of intravenously applied indocyanine green (ICG) facilitates the recognition of blood vessels and thus helps minimize the risk of cerebral hemorrhages. 5- aminolevulinic-acid-induced protoporphyrin IX (PpIX) fluorescence is used to localize vital tumor tissue. ICG fluorescence detection using a 2-fiber probe turned out to be an applicable method to recognize blood vessels about 1.5 mm ahead of the fiber tip during a brain tumor biopsy. Moreover, the suitability of two different PpIX excitation wavelengths regarding practical aspects was investigated: While PpIX excitation in the violet region (at 405 nm) allows for higher sensitivity, red excitation (at 633 nm) is noticeably superior with regard to blood layers obscuring the fluorescence signal. Contact measurements on brain simulating agar phantoms demonstrated that a typical blood coverage of the tumor reduces the PpIX signal to about 75% and nearly 0% for 633 nm and 405 nm excitation, respectively. As a result, 633 nm seems to be the wavelength of choice for PpIX-assisted detection of high-grade gliomas in stereotactic biopsy.

MO-FG-BRA-07: Intrafractional Motion Effect Can Be Minimized in Tomotherapy Stereotactic Body Radiotherapy (SBRT)

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

Price, A; Chang, S; Matney, J

2016-06-15

Purpose: Tomotherapy has unique challenges in handling intrafractional motion compared to conventional LINAC. In this study, we analyzed the impact of intrafractional motion on cumulative dosimetry using actual patient motion data and investigated real time jaw/MLC compensation approaches to minimize the motion-induced dose discrepancy in Tomotherapy SBRT treatment. Methods: Intrafractional motion data recorded in two CyberKnife lung treatment cases through fiducial tracking and two LINAC prostate cases through Calypso tracking were used in this study. For each treatment site, one representative case has an average motion (6mm) and one has a large motion (10mm for lung and 15mm for prostate).more » The cases were re-planned on Tomotherapy for SBRT. Each case was planned with 3 different jaw settings: 1cm static, 2.5cm dynamic, and 5cm dynamic. 4D dose accumulation software was developed to compute dose with the recorded motions and theoretically compensate motions by modifying original jaw and MLC to track the trajectory of the tumor. Results: PTV coverage in Tomotherapy SBRT for patients with intrafractional motion depends on motion type, amplitude and plan settings. For the prostate patient with large motion, PTV coverage changed from 97.2% (motion-free) to 47.1% (target motion-included), 96.6% to 58.5% and 96.3% to 97.8% for the 1cm static jaw, 2.5cm dynamic jaw and 5cm dynamic jaw setting, respectively. For the lung patient with large motion, PTV coverage discrepancies showed a similar trend of change. When the jaw and MLC compensation program was engaged, the motion compromised PTV coverage was recovered back to >95% for all cases and plans. All organs at risk (OAR) were spared with < 5% increase from original motion-free plans. Conclusion: Tomotherapy SBRT is less motion-impacted when 5cm dynamic jaw is used. Once the motion pattern is known, the jaw and MLC compensation program can largely minimize the compromised target coverage and OAR sparing.« less

SU-C-210-02: Impact of Intrafractional Motion On TomoTherapy Stereotactic Body Radiotherapy (SBRT) 4D Dosimetry

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

Lian, J; Matney, J; Chao, E

2015-06-15

Purpose: TomoTherapy treatment has unique challenges in handling intrafractional motion compared to conventional LINAC. This study is aimed to gain a realistic and quantitative understanding of motion impact on TomoTherapy SBRT treatment of lung and prostate cancer patients. Methods: A 4D dose engine utilizing GPUs and including motion during treatment was developed for the efficient simulation of TomoTherapy delivered dosimetry. Two clinical CyberKnife lung cases with respiratory motion tracking and two prostate cases with a slower non-periodical organ motion treated by LINAC plus Calypso tracking were used in the study. For each disease site, one selected case has an averagemore » motion (6mm); the other has a large motion (10mm for lung and 15mm for prostate). SBRT of lung and prostate cases were re-planned on TomoTherapy with 12 Gyx4 fractions and 7Gyx5 fractions, respectively, all with 95% PTV coverage. Each case was planned with 4 jaw settings: 1) conventional 1cm static, 2) 2.5cm static, 3) 2.5cm dynamic, and 4) 5cm dynamic. The intrafractional rigid motion of the target was applied in the dose calculation of individual fractions of each plan and total dose was accumulated from multiple fractions. Results: For 1cm static jaw plans with motions applied, PTV coverage is related to motion type and amplitude. For SBRT patients with average motion (6mm), the PTV coverage remains > 95% for lung case and 74% for prostate case. For cases with large motion, PTV coverage drops to 61% for lung SBRT and 49% for prostate SBRT. Plans with other jaws improve uniformity of moving target, but still suffer from poor PTV coverage (< 70%). Conclusion: TomoTherapy lung SBRT is less motion-impacted when average amplitude of respiratory-induced intrafractional motion is present (6mm). When motion is large and/or non-periodic (prostate), all studied plans lead to significantly decreased target coverage in actual delivered dosimetry.« less

Robotic intrafractional US guidance for liver SABR: System design, beam avoidance, and clinical imaging.

PubMed

Schlosser, Jeffrey; Gong, Ren Hui; Bruder, Ralf; Schweikard, Achim; Jang, Sungjune; Henrie, John; Kamaya, Aya; Koong, Albert; Chang, Daniel T; Hristov, Dimitre

2016-11-01

To present a system for robotic 4D ultrasound (US) imaging concurrent with radiotherapy beam delivery and estimate the proportion of liver stereotactic ablative body radiotherapy (SABR) cases in which robotic US image guidance can be deployed without interfering with clinically used VMAT beam configurations. The image guidance hardware comprises a 4D US machine, an optical tracking system for measuring US probe pose, and a custom-designed robot for acquiring hands-free US volumes. In software, a simulation environment incorporating the LINAC, couch, planning CT, and robotic US guidance hardware was developed. Placement of the robotic US hardware was guided by a target visibility map rendered on the CT surface by using the planning CT to simulate US propagation. The visibility map was validated in a prostate phantom and evaluated in patients by capturing live US from imaging positions suggested by the visibility map. In 20 liver SABR patients treated with VMAT, the simulation environment was used to virtually place the robotic hardware and US probe. Imaging targets were either planning target volumes (PTVs, range 5.9-679.5 ml) or gross tumor volumes (GTVs, range 0.9-343.4 ml). Presence or absence of mechanical interference with LINAC, couch, and patient body as well as interferences with treated beams was recorded. For PTV targets, robotic US guidance without mechanical interference was possible in 80% of the cases and guidance without beam interference was possible in 60% of the cases. For the smaller GTV targets, these proportions were 95% and 85%, respectively. GTV size (1/20), elongated shape (1/20), and depth (1/20) were the main factors limiting the availability of noninterfering imaging positions. The robotic US imaging system was deployed in two liver SABR patients during CT simulation with successful acquisition of 4D US sequences in different imaging positions. This study indicates that for VMAT liver SABR, robotic US imaging of a relevant internal target may be possible in 85% of the cases while using treatment plans currently deployed in the clinic. With beam replanning to account for the presence of robotic US guidance, intrafractional US may be an option for 95% of the liver SABR cases.

Performance of the 2 × 4-cell superconducting linac module for the THz-FEL facility

NASA Astrophysics Data System (ADS)

Kui, Zhou; Chenglong, Lao; Dai, Wu; Xing, Luo; Jianxin, Wang; Dexin, Xiao; Lijun, Shan; Tianhui, He; Xuming, Shen; Sifen, Lin; Linde, Yang; Hanbin, Wang; Xingfan, Yang; Ming, Li; Xiangyang, Lu

2018-07-01

A high average power THz radiation facility has been developed by the China Academy of Engineering Physics. It is the first CW THz user facility based on superconducting accelerator technology in China. The superconducting linac module, which contains two 4-cell 1.3 GHz TESLA-like superconducting radio frequency cavities, is a major component of this facility. The expected electron energy gain is 6-8 MeV with a field gradient of 8-10 MV/m. The design and fabrication of the linac module is complete. This paper discusses its assembly and results from cyromodule tests and beam commissioning. At 2 K, the cryomodule works smoothly and stably. Both cavities have achieved effective field gradients of 10 MV/m. In beam loading experiments, 8 MeV, 5 mA electron beams with an energy spread less than 0.2% have been produced, which satisfies our requirements.

Electron Accelerators for Research at the Frontiers of Nuclear Physics

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

Hartline, Beverly; Grunder, Hermann

1986-10-01

Electron accelerators for the frontiers of nuclear physics must provide high duty factor (gte 80) for coincidence measurements; few-hundred-MeV through few-GeV energy for work in the nucleonic, hadronic, and confinement regimes; energy resolution of ~ 10 -4; and high current (gte 100 zA). To fulfill these requirements new machines and upgrades of existing ones are being planned or constructed. Representative microtron-based facilities are the upgrade of MAMI at the University of Mainz (West Germany), the proposed two-stage cascade microtron at the University of Illinois (U.S.A.), and the three-stage Troitsk ``polytron'' (USSR). Representative projects to add pulse stretcher rings to existingmore » linacs are the upgrades at MIT-Bates (U.S.A.) and at NIKHEF-K (Netherlands). Recent advances in superconducting rf technology, especially in cavity design and fabrication, have made large superconducting cw linacs become feasible. Recirculating superconducting cw linacs are under construc« less

Cornell-BNL Electron Energy Recovery Linac FFAG Test Accelerator (CBETA)

NASA Astrophysics Data System (ADS)

Trbojevic, Dejan; Peggs, Steve; Berg, Scott; Brooks, Stephen; Mahler, George; Meot, Francois; Tsoupas, Nicholaos; Witte, Holger; Hoffstaetter, Georg; Bazarov, Ivan; Mayes, Christopher; Patterson, Ritchie; Smolenski, Karl; Li, Yulin; Dobbins, John; BNL Team; Cornell University Team

A novel energy recovery linac (ERL) with Non-Scaling Fixed Field Alternating Gradient (NS-FFAG) racetrack is being constructed as a result of collaboration of the Cornell University with Brookhaven National Laboratory. The existing injector and superconducting linac at Cornell University are being installed together with a single NS-FFAG arcs and straight section at the opposite side of the linac to form an ERL system. The 6 MeV electron beam from injector is transferred into the 36 MeV superconducting linac and accelerated by four successive passes: from 42 to 150 MeV using the same NS-FFAG structure made of permanent magnets. After the maximum energy of 150 MeV is reached, the electron beam is brought back to the linac with opposite Radio Frequency (RF) phase and with 4 passes electron energy is recovered and brought back to the initial energy of 6 MeV. This is going to be the first 4 pass superconducting ERL and the first NS-FFAG permanent magnet structure to bring the electron beam back to the linac.

Technical Note: Evaluation of the systematic accuracy of a frameless, multiple image modality guided, linear accelerator based stereotactic radiosurgery system

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

Wen, N., E-mail: nwen1@hfhs.org; Snyder, K. C.; Qin, Y.

2016-05-15

Purpose: To evaluate the total systematic accuracy of a frameless, image guided stereotactic radiosurgery system. Methods: The localization accuracy and intermodality difference was determined by delivering radiation to an end-to-end prototype phantom, in which the targets were localized using optical surface monitoring system (OSMS), electromagnetic beacon-based tracking (Calypso®), cone-beam CT, “snap-shot” planar x-ray imaging, and a robotic couch. Six IMRT plans with jaw tracking and a flattening filter free beam were used to study the dosimetric accuracy for intracranial and spinal stereotactic radiosurgery treatment. Results: End-to-end localization accuracy of the system evaluated with the end-to-end phantom was 0.5 ± 0.2more » mm with a maximum deviation of 0.9 mm over 90 measurements (including jaw, MLC, and cone measurements for both auto and manual fusion) for single isocenter, single target treatment, 0.6 ± 0.4 mm for multitarget treatment with shared isocenter. Residual setup errors were within 0.1 mm for OSMS, and 0.3 mm for Calypso. Dosimetric evaluation based on absolute film dosimetry showed greater than 90% pass rate for all cases using a gamma criteria of 3%/1 mm. Conclusions: The authors’ experience demonstrates that the localization accuracy of the frameless image-guided system is comparable to robotic or invasive frame based radiosurgery systems.« less

Electron contamination modeling and reduction in a 1 T open bore inline MRI-linac system.

PubMed

Oborn, B M; Kolling, S; Metcalfe, P E; Crozier, S; Litzenberg, D W; Keall, P J

2014-05-01

A potential side effect of inline MRI-linac systems is electron contamination focusing causing a high skin dose. In this work, the authors reexamine this prediction for an open bore 1 T MRI system being constructed for the Australian MRI-Linac Program. The efficiency of an electron contamination deflector (ECD) in purging electron contamination from the linac head is modeled, as well as the impact of a helium gas region between the deflector and phantom surface for lowering the amount of air-generated contamination. Magnetic modeling of the 1 T MRI was used to generate 3D magnetic field maps both with and without the presence of an ECD located immediately below the MLC's. Forty-seven different ECD designs were modeled and for each the magnetic field map was imported into Geant4 Monte Carlo simulations including the linac head, ECD, and a 30 × 30 × 30 cm(3) water phantom located at isocenter. For the first generation system, the x-ray source to isocenter distance (SID) will be 160 cm, resulting in an 81.2 cm long air gap from the base of the ECD to the phantom surface. The first 71.2 cm was modeled as air or helium gas, with the latter encased between two windows of 50 μm thick high density polyethlyene. 2D skin doses (at 70 μm depth) were calculated across the phantom surface at 1 × 1 mm(2) resolution for 6 MV beams of field size of 5 × 5, 10 × 10, and 20 × 20 cm(2). The skin dose was predicted to be of similar magnitude as the generic systems modeled in previous work, 230% to 1400% of D(max) for 5 × 5 to 20 × 20 cm(2), respectively. Inclusion of the ECD introduced a nonuniformity to the MRI imaging field that ranged from ∼20 to ∼140 ppm while the net force acting on the ECD ranged from ∼151 N to ∼1773 N. Various ECD designs were 100% efficient at purging the electron contamination into the ECD magnet banks; however, a small percentage were scattered back into the beam and continued to the phantom surface. Replacing a large portion of the extended air-column between the ECD and phantom surface with helium gas is a key element as it significantly minimized the air-generated contamination. When using an optimal ECD and helium gas region, the 70 μm skin dose is predicted to increase moderately inside a small hot spot over that of the case with no magnetic field present for the jaw defined square beams examined here. These increases include from 12% to 40% of [Formula: see text] for 5 × 5 cm(2), 18% to 55% of D(max) for 10 × 10 cm(2), and from 23% to 65% of D(max) for 20 × 20 cm(2). Coupling an efficient ECD and helium gas region below the MLCs in the 160 cm isocenter MRI-linac system is predicted to ameliorate the impact electron contamination focusing has on skin dose increases. An ECD is practical as its impact on the MRI imaging distortion is correctable, and the mechanical forces acting on it manageable from an engineering point of view.

The ESS neutrino facility for CP violation discovery

NASA Astrophysics Data System (ADS)

Baussan, Eric; Bouquerel, Elian; Dracos, Marcos

2017-09-01

The comparatively large value of the neutrino mixing angle θ 13 measured in 2012 by neutrino reactor experiments has opened the possibility to observe for the first time CP violation in the leptonic sector. The measured value of θ 13 also privileges the 2nd oscillation maximum for the discovery of CP violation instead of the usually used 1st oscillation maximum. The sensitivity at the 2nd oscillation maximum is about three times higher than at the 1st oscillation maximum implying a significantly lower sensitivity to systematic errors. Measuring at the 2nd oscillation maximum necessitates a very intense neutrino beam with the appropriate energy. The world’s most intense pulsed spallation neutron source, the European Spallation Source, has a proton linac with 5 MW power and 2 GeV energy. This linac also has the potential to become the proton driver of the world’s most intense neutrino beam with very high potential for the discovery of neutrino CP violation. The physics performance of that neutrino Super Beam in conjunction with a megaton Water Cherenkov neutrino detector installed ca 1000 m down in a mine at a distance of about 500 km from ESS has been evaluated. In addition, the use of such a detector will make it possible to extent the physics program to proton decay, atmospheric neutrinos and astrophysics searches. The ESS proton linac upgrade, the accumulator ring needed for proton pulse compression, the target station optimization and the physics potential are described. In addition to the production of neutrinos, this facility will also be a copious source of muons which could be used to feed a low energy nuSTORM facility, a future neutrino factory or a muon collider. The ESS linac, under construction, will reach full operation at 5 MW by 2023 after which the upgrades for the neutrino facility could start.

Electron linear accelerator system for natural rubber vulcanization

NASA Astrophysics Data System (ADS)

Rimjaem, S.; Kongmon, E.; Rhodes, M. W.; Saisut, J.; Thongbai, C.

2017-09-01

Development of an electron accelerator system, beam diagnostic instruments, an irradiation apparatus and electron beam processing methodology for natural rubber vulcanization is underway at the Plasma and Beam Physics Research Facility, Chiang Mai University, Thailand. The project is carried out with the aims to improve the qualities of natural rubber products. The system consists of a DC thermionic electron gun, 5-cell standing-wave radio-frequency (RF) linear accelerator (linac) with side-coupling cavities and an electron beam irradiation apparatus. This system is used to produce electron beams with an adjustable energy between 0.5 and 4 MeV and a pulse current of 10-100 mA at a pulse repetition rate of 20-400 Hz. An average absorbed dose between 160 and 640 Gy is expected to be archived for 4 MeV electron beam when the accelerator is operated at 400 Hz. The research activities focus firstly on assembling of the accelerator system, study on accelerator properties and electron beam dynamic simulations. The resonant frequency of the RF linac in π/2 operating mode is 2996.82 MHz for the operating temperature of 35 °C. The beam dynamic simulations were conducted by using the code ASTRA. Simulation results suggest that electron beams with an average energy of 4.002 MeV can be obtained when the linac accelerating gradient is 41.7 MV/m. The rms transverse beam size and normalized rms transverse emittance at the linac exit are 0.91 mm and 10.48 π mm·mrad, respectively. This information can then be used as the input data for Monte Carlo simulations to estimate the electron beam penetration depth and dose distribution in the natural rubber latex. The study results from this research will be used to define optimal conditions for natural rubber vulcanization with different electron beam energies and doses. This is very useful for development of future practical industrial accelerator units.

Optimizing global liver function in radiation therapy treatment planning

NASA Astrophysics Data System (ADS)

Wu, Victor W.; Epelman, Marina A.; Wang, Hesheng; Romeijn, H. Edwin; Feng, Mary; Cao, Yue; Ten Haken, Randall K.; Matuszak, Martha M.

2016-09-01

Liver stereotactic body radiation therapy (SBRT) patients differ in both pre-treatment liver function (e.g. due to degree of cirrhosis and/or prior treatment) and radiosensitivity, leading to high variability in potential liver toxicity with similar doses. This work investigates three treatment planning optimization models that minimize risk of toxicity: two consider both voxel-based pre-treatment liver function and local-function-based radiosensitivity with dose; one considers only dose. Each model optimizes different objective functions (varying in complexity of capturing the influence of dose on liver function) subject to the same dose constraints and are tested on 2D synthesized and 3D clinical cases. The normal-liver-based objective functions are the linearized equivalent uniform dose (\\ell \\text{EUD} ) (conventional ‘\\ell \\text{EUD} model’), the so-called perfusion-weighted \\ell \\text{EUD} (\\text{fEUD} ) (proposed ‘fEUD model’), and post-treatment global liver function (GLF) (proposed ‘GLF model’), predicted by a new liver-perfusion-based dose-response model. The resulting \\ell \\text{EUD} , fEUD, and GLF plans delivering the same target \\ell \\text{EUD} are compared with respect to their post-treatment function and various dose-based metrics. Voxel-based portal venous liver perfusion, used as a measure of local function, is computed using DCE-MRI. In cases used in our experiments, the GLF plan preserves up to 4.6 % ≤ft(7.5 % \\right) more liver function than the fEUD (\\ell \\text{EUD} ) plan does in 2D cases, and up to 4.5 % ≤ft(5.6 % \\right) in 3D cases. The GLF and fEUD plans worsen in \\ell \\text{EUD} of functional liver on average by 1.0 Gy and 0.5 Gy in 2D and 3D cases, respectively. Liver perfusion information can be used during treatment planning to minimize the risk of toxicity by improving expected GLF; the degree of benefit varies with perfusion pattern. Although fEUD model optimization is computationally inexpensive and often achieves better GLF than \\ell \\text{EUD} model optimization does, the GLF model directly optimizes a more clinically relevant metric and can further improve fEUD plan quality.

Design of high-energy high-current linac with focusing by superconducting solenoids

NASA Astrophysics Data System (ADS)

Batskikh, Guennady I.; Belugin, Vladimir M.; Bondarev, Boris I.; Fedotov, Arkady P.; Durkin, Alexander P.; Ivanov, Yury D.; Mikhailov, Vladimir N.; Murin, Boris P.; Mustafin, Kharis Kh.; Shumakov, Igor V.; Uksusov, Nikolay I.

1995-09-01

The advancement of MRTI design for 1.5 GeV and 250 mA ion CW linac is presented in the report. In new linac version all the way from input to output the ions are focused by magnetic fields of superconducting solenoids. The ion limit current is far beyond the needed value. The linac focusing channel offers major advantages over the more conventional ones. The acceptance is 1.7 times as large for such focusing channel as for quadrupole one. Concurrently, a random perturbation sensitivity for such channel is one order of magnitude smaller than in quadrupole channel. These focusing channel features allow to decrease beam matched radius and increase a linac radiation purity without aperture growth. ``Regotron'' is used as high power generator in linac main part. But D&W cavities need not be divided into sections connected by RF-bridges which denuded them of high coupling factor.

Accuracy evaluation of the optical surface monitoring system on EDGE linear accelerator in a phantom study

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

Mancosu, Pietro; Fogliata, Antonella, E-mail: Antonella.Fogliata@humanitas.it; Stravato, Antonella

2016-07-01

Frameless stereotactic radiosurgery (SRS) requires dedicated systems to monitor the patient position during the treatment to avoid target underdosage due to involuntary shift. The optical surface monitoring system (OSMS) is here evaluated in a phantom-based study. The new EDGE linear accelerator from Varian (Varian, Palo Alto, CA) integrates, for cranial lesions, the common cone beam computed tomography (CBCT) and kV-MV portal images to the optical surface monitoring system (OSMS), a device able to detect real-time patient's face movements in all 6 couch axes (vertical, longitudinal, lateral, rotation along the vertical axis, pitch, and roll). We have evaluated the OSMS imagingmore » capability in checking the phantoms' position and monitoring its motion. With this aim, a home-made cranial phantom was developed to evaluate the OSMS accuracy in 4 different experiments: (1) comparison with CBCT in isocenter location, (2) capability to recognize predefined shifts up to 2° or 3 cm, (3) evaluation at different couch angles, (4) ability to properly reconstruct the surface when the linac gantry visually block one of the cameras. The OSMS system showed, with a phantom, to be accurate for positioning in respect to the CBCT imaging system with differences of 0.6 ± 0.3 mm for linear vector displacement, with a maximum rotational inaccuracy of 0.3°. OSMS presented an accuracy of 0.3 mm for displacement up to 1 cm and 1°, and 0.5 mm for larger displacements. Different couch angles (45° and 90°) induced a mean vector uncertainty < 0.4 mm. Coverage of 1 camera produced an uncertainty < 0.5 mm. Translations and rotations of a phantom can be accurately detect with the optical surface detector system.« less

Cone beam CT-based set-up strategies with and without rotational correction for stereotactic body radiation therapy in the liver.

PubMed

Bertholet, Jenny; Worm, Esben; Høyer, Morten; Poulsen, Per

2017-06-01

Accurate patient positioning is crucial in stereotactic body radiation therapy (SBRT) due to a high dose regimen. Cone-beam computed tomography (CBCT) is often used for patient positioning based on radio-opaque markers. We compared six CBCT-based set-up strategies with or without rotational correction. Twenty-nine patients with three implanted markers received 3-6 fraction liver SBRT. The markers were delineated on the mid-ventilation phase of a 4D-planning-CT. One pretreatment CBCT was acquired per fraction. Set-up strategy 1 used only translational correction based on manual marker match between the CBCT and planning CT. Set-up strategy 2 used automatic 6 degrees-of-freedom registration of the vertebrae closest to the target. The 3D marker trajectories were also extracted from the projections and the mean position of each marker was calculated and used for set-up strategies 3-6. Translational correction only was used for strategy 3. Translational and rotational corrections were used for strategies 4-6 with the rotation being either vertebrae based (strategy 4), or marker based and constrained to ±3° (strategy 5) or unconstrained (strategy 6). The resulting set-up error was calculated as the 3D root-mean-square set-up error of the three markers. The set-up error of the spinal cord was calculated for all strategies. The bony anatomy set-up (2) had the largest set-up error (5.8 mm). The marker-based set-up with unconstrained rotations (6) had the smallest set-up error (0.8 mm) but the largest spinal cord set-up error (12.1 mm). The marker-based set-up with translational correction only (3) or with bony anatomy rotational correction (4) had equivalent set-up error (1.3 mm) but rotational correction reduced the spinal cord set-up error from 4.1 mm to 3.5 mm. Marker-based set-up was substantially better than bony-anatomy set-up. Rotational correction may improve the set-up, but further investigations are required to determine the optimal correction strategy.

A Multidisciplinary Evaluation of a Web-based eLearning Training Programme for SAFRON II (TROG 13.01): a Multicentre Randomised Study of Stereotactic Radiotherapy for Lung Metastases.

PubMed

Pham, D; Hardcastle, N; Foroudi, F; Kron, T; Bressel, M; Hilder, B; Chesson, B; Oates, R; Montgomery, R; Ball, D; Siva, S

2016-09-01

In technically advanced multicentre clinical trials, participating centres can benefit from a credentialing programme before participating in the trial. Education of staff in participating centres is an important aspect of a successful clinical trial. In the multicentre study of fractionated versus single fraction stereotactic ablative body radiotherapy in lung oligometastases (TROG 13.01), knowledge transfer of stereotactic ablative body radiotherapy techniques to the local multidisciplinary team is intended as part of the credentialing process. In this study, a web-based learning platform was developed to provide education and training for the multidisciplinary trial teams at geographically distinct sites. A web-based platform using eLearning software consisting of seven training modules was developed. These modules were based on extracranial stereotactic theory covering the following discrete modules: Clinical background; Planning technique and evaluation; Planning optimisation; Four-dimensional computed tomography simulation; Patient-specific quality assurance; Cone beam computed tomography and image guidance; Contouring organs at risk. Radiation oncologists, medical physicists and radiation therapists from hospitals in Australia and New Zealand were invited to participate in this study. Each discipline was enrolled into a subset of modules (core modules) and was evaluated before and after completing each module. The effectiveness of the eLearning training will be evaluated based on (i) knowledge retention after participation in the web-based training and (ii) confidence evaluation after participation in the training. Evaluation consisted of a knowledge test and confidence evaluation using a Likert scale. In total, 130 participants were enrolled into the eLearning programme: 81 radiation therapists (62.3%), 27 medical physicists (20.8%) and 22 radiation oncologists (16.9%). There was an average absolute improvement of 14% in test score (P < 0.001) after learning. This score improvement compared with initial testing was also observed in the long-term testing (>4 weeks) after completing the modules (P < 0.001). For most there was significant increase in confidence (P < 0.001) after completing all the modules. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

SU-F-J-149: Beam and Cryostat Scatter Characteristics of the Elekta MR-Linac

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

Duglio, M; Towe, S; Roberts, D

2016-06-15

Purpose: The Elekta MR-Linac combines a digital linear accelerator system with a 1.5T Philips MRI machine. This study aimed to determine key characteristic information regarding the MR-Linac beam and in particular it evaluated the effect of the MR cryostat on the out of field scatter dose. Methods: Tissue phantom ratios, profiles and depth doses were acquired in plastic water with an IC-profiler or with an MR compatible water tank using multiple system configurations (Full (B0= 1.5T), Full (B0=0T) and No cryostat). Additionally, an in-house CAD based Monte Carlo code based on Penelope was used to provide comparative data. Results: Withmore » the cryostat in place and B0=0T, the measured TPR for the MR Linac system was 0.702, indicating an energy of around 7MV. Without the cryostat, the measured TPR was 0.669. For the Full (B0=0T) case, out of field dose at a depth of 10 cm in the isocentric plane, 5 cm from the field edge was 0.8%, 3.1% and 5.4% for 3×3 cm{sup 2}, 10×10 cm{sup 2} and 20×20 cm{sup 2} fields respectively.The out of field dose (averaged between 5 cm and 10 cm beyond the field edges) in the “with cryostat” case is 0.78% (absolute difference) higher than without the cryostat for clinically relevant field sizes (i.e. 10×10 cm{sup 2}) and comparable to measured conventional 6MV treatment beams at a depth of 10 cm (within 0.1% between 5 cm and 6 cm from field edge). At dose maximum and at 5 cm from the field edge, the “with cryostat” out of field scatter for a 10×10 cm{sup 2} field is 1.5% higher than “without cryostat', with a modest increase (0.9%) compared to Agility 6MV in the same conditions. Conclusion: The study has presented typical characteristics of the MR-Linac beam and determined that out of field dose is comparable to conventional treatment beams. All authors are employed by Elekta Ltd., who are developing an MR-Linac.« less

Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a {sup 60}Co Magnetic Resonance Image Guidance Radiation Therapy System

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

Wooten, H. Omar, E-mail: hwooten@radonc.wustl.edu; Green, Olga; Yang, Min

2015-07-15

Purpose: This work describes a commercial treatment planning system, its technical features, and its capabilities for creating {sup 60}Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. Methods and Materials: The ViewRay treatment planning system (Oakwood Village, OH) was used to create {sup 60}Co IMRT treatment plans for 33 cancer patients with disease in the abdominal, pelvic, thorax, and head and neck regions using physician-specified patient-specific target coverage and organ at risk (OAR) objectives. Backup plans using a third-party linear accelerator (linac)-based planning system were also created. Plans were evaluated bymore » attending physicians and approved for treatment. The {sup 60}Co and linac plans were compared by evaluating conformity numbers (CN) with 100% and 95% of prescription reference doses and heterogeneity indices (HI) for planning target volumes (PTVs) and maximum, mean, and dose-volume histogram (DVH) values for OARs. Results: All {sup 60}Co IMRT plans achieved PTV coverage and OAR sparing that were similar to linac plans. PTV conformity for {sup 60}Co was within <1% and 3% of linac plans for 100% and 95% prescription reference isodoses, respectively, and heterogeneity was on average 4% greater. Comparisons of OAR mean dose showed generally better sparing with linac plans in the low-dose range <20 Gy, but comparable sparing for organs with mean doses >20 Gy. The mean doses for all {sup 60}Co plan OARs were within clinical tolerances. Conclusions: A commercial {sup 60}Co MR-IGRT device can produce highly conformal IMRT treatment plans similar in quality to linac IMRT for a variety of disease sites. Additional work is in progress to evaluate the clinical benefit of other novel features of this MR-IGRT system.« less

10 CFR 35.655 - Five-year inspection for teletherapy and gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Five-year inspection for teletherapy and gamma stereotactic radiosurgery units. 35.655 Section 35.655 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic...

10 CFR 35.655 - Five-year inspection for teletherapy and gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Five-year inspection for teletherapy and gamma stereotactic radiosurgery units. 35.655 Section 35.655 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic...

10 CFR 35.655 - Five-year inspection for teletherapy and gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Five-year inspection for teletherapy and gamma stereotactic radiosurgery units. 35.655 Section 35.655 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic...

10 CFR 35.655 - Five-year inspection for teletherapy and gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Five-year inspection for teletherapy and gamma stereotactic radiosurgery units. 35.655 Section 35.655 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic...

10 CFR 35.655 - Five-year inspection for teletherapy and gamma stereotactic radiosurgery units.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Five-year inspection for teletherapy and gamma stereotactic radiosurgery units. 35.655 Section 35.655 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic...

Superconducting heavy ion injector linac

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

Shepard, K.W.

1985-01-01

A conceptual design for a very low velocity (.007 < v/c < .07) superconducting heavy-ion linac is reviewed. This type of linac may have significant cost and performance advantages over room-temperature linacs, at least for applications requiring modest beam currents. Some general features of the design of very-low velocity superconducting accelerating structures are discussed and a design for a 48.5 MHz, v/c = .009 structure, together with the status of a niobium prototype, is discussed in detail. Preliminary results of a beam dynamics study indicate that the low velocity linac may be able to produce heavy-ion beams with time-energy spreadsmore » of a few keV-nsec. 11 refs, 4 figs.« less

SU-E-T-453: Optimization of Dose Gradient for Gamma Knife Radiosurgery.

PubMed

Sheth, N; Chen, Y; Yang, J

2012-06-01

The goals of stereotactic radiosurgery (SRS) are the ablation of target tissue and sparing of critical normal tissue. We develop tools to aid in the selection of collimation and prescription (Rx) isodose line to optimize the dose gradient for single isocenter intracranial stereotactic radiosurgery (SRS) with GammaKnife 4C utilizing the updated physics data in GammaPlan v10.1. Single isocenter intracranial SRS plans were created to treat the center of a solid water anthropomorphism head phantom for each GammaKnife collimator (4 mm, 8 mm, 14 mm, and 18 mm). The dose gradient, defined as the difference of effective radii of spheres equal to half and full Rx volumes, and Rx treatment volume was analyzed for isodoses from 99% to 20% of Rx. The dosimetric data on Rx volume and dose gradient vs. Rx isodose for each collimator was compiled into an easy to read nomogram as well as plotted graphically. The 4, 8, 14, and 18 mm collimators have the sharpest dose gradient at the 64%, 70%, 76%, and 77% Rx isodose lines, respectively. This corresponds to treating 4.77 mm, 8.86 mm, 14.78 mm, and 18.77 mm diameter targets with dose gradients radii of 1.06 mm, 1.63 mm, 2.54 mm, and 3.17 mm, respectively. We analyzed the dosimetric data for the most recent version of GammaPlan treatment planning software to develop tools that when applied clinically will aid in the selection of a collimator and Rx isodose line for optimal dose gradient and target coverage for single isocenter intracranial SRS with GammaKnife 4C. © 2012 American Association of Physicists in Medicine.

Electron linac for medical isotope production with improved energy efficiency and isotope recovery

DOEpatents

Noonan, John; Walters, Dean; Virgo, Matt; Lewellen, John

2015-09-08

A method and isotope linac system are provided for producing radio-isotopes and for recovering isotopes. The isotope linac is an energy recovery linac (ERL) with an electron beam being transmitted through an isotope-producing target. The electron beam energy is recollected and re-injected into an accelerating structure. The ERL provides improved efficiency with reduced power requirements and provides improved thermal management of an isotope target and an electron-to-x-ray converter.

Stereotactic ablative radiotherapy after concomitant chemoradiotherapy in non-small cell lung cancer: A TITE-CRM phase 1 trial.

PubMed

Doyen, Jérôme; Poudenx, Michel; Gal, Jocelyn; Otto, Josiane; Guerder, Caroline; Naghavi, Arash O; Gérard, Anais; Leysalle, Axel; Cohen, Charlotte; Padovani, Bernard; Ianessi, Antoine; Schiappa, Renaud; Chamorey, Emmanuel; Bondiau, Pierre-Yves

2018-05-01

Platinum based chemoradiotherapy is the standard of care for inoperable non-small cell lung cancer (NSCLC). With evidence that NSCLC can have a dose dependent response with stereotactic ablative radiotherapy (SABR), we hypothesize that a SABR boost on residual tumor treated with chemoradiotherapy could increase treatment efficacy. The purpose of this study was to determine feasibility of such an approach. A prospective phase I trial was performed including 26 patients. Time-to-event continual reassessment method (TITE-CRM) was used for dose escalation which ranged from 3 × 7 to 3 × 12 Gy for the stereotactic boost, after 46 Gy (2 Gy per day) of chemoradiotherapy. Median follow-up was of 37.1 months (1.7-60.7), and 3, 4, 3, 3, 9 and 4 patients were included at the dose levels 1, 2, 3, 4, 5 and 6, respectively. During chemoradiotherapy, 9 patients experienced grade 3 toxicity. After stereotactic radiotherapy, 1 patient experienced an esophageal fistula (with local relapse) at the 3 × 11 Gy level, and 1 patient died from hemoptysis at the 3 × 12 Gy level. The 2-year rate of local control, locoregional free survival, metastasis-free survival, and overall survival was 70.3%, 55.5%, 44.5% and 50.8%, respectively. In the treatment of NSCLC with chemoradiotherapy followed by a stereotactic boost, the safe recommended dose in our protocol was a boost dose of 3 × 11 Gy. Copyright © 2018 Elsevier B.V. All rights reserved.

SU-E-T-551: Monitor Unit Optimization in Stereotactic Body Radiation Therapy for Stage I Lung Cancer

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

Huang, B-T; Lu, J-Y

2015-06-15

Purpose: The study aims to reduce the monitor units (MUs) in the stereotactic body radiation therapy (SBRT) treatment for lung cancer by adjusting the optimizing parameters. Methods: Fourteen patients suffered from stage I Non-Small Cell Lung Cancer (NSCLC) were enrolled. Three groups of parameters were adjusted to investigate their effects on MU numbers and organs at risk (OARs) sparing: (1) the upper objective of planning target volume (UOPTV); (2) strength setting in the MU constraining objective; (3) max MU setting in the MU constraining objective. Results: We found that the parameters in the optimizer influenced the MU numbers in amore » priority, strength and max MU dependent manner. MU numbers showed a decreasing trend with the UOPTV increasing. MU numbers with low, medium and high priority for the UOPTV were 428±54, 312±48 and 258±31 MU/Gy, respectively. High priority for UOPTV also spared the heart, cord and lung while maintaining comparable PTV coverage than the low and medium priority group. It was observed that MU numbers tended to decrease with the strength increasing and max MU setting decreasing. With maximum strength, the MU numbers reached its minimum while maintaining comparable or improved dose to the normal tissues. It was also found that the MU numbers continued to decline at 85% and 75% max MU setting but no longer to decrease at 50% and 25%. Combined with high priority for UOPTV and MU constraining objectives, the MU numbers can be decreased as low as 223±26 MU/Gy. Conclusion:: The priority of UOPTV, MU constraining objective in the optimizer impact on the MU numbers in SBRT treatment for lung cancer. Giving high priority to the UOPTV, setting the strength to maximum value and the max MU to 50% in the MU objective achieves the lowest MU numbers while maintaining comparable or improved OAR sparing.« less

Quadrupole Alignment and Trajectory Correction for Future Linear Colliders: SLC Tests of a Dispersion-Free Steering Algorithm

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

Assmann, R

2004-06-08

The feasibility of future linear colliders depends on achieving very tight alignment and steering tolerances. All proposals (NLC, JLC, CLIC, TESLA and S-BAND) currently require a total emittance growth in the main linac of less than 30-100% [1]. This should be compared with a 100% emittance growth in the much smaller SLC linac [2]. Major advances in alignment and beam steering techniques beyond those used in the SLC are necessary for the next generation of linear colliders. In this paper, we present an experimental study of quadrupole alignment with a dispersion-free steering algorithm. A closely related method (wakefield-free steering) takesmore » into account wakefield effects [3]. However, this method can not be studied at the SLC. The requirements for future linear colliders lead to new and unconventional ideas about alignment and beam steering. For example, no dipole correctors are foreseen for the standard trajectory correction in the NLC [4]; beam steering will be done by moving the quadrupole positions with magnet movers. This illustrates the close symbiosis between alignment, beam steering and beam dynamics that will emerge. It is no longer possible to consider the accelerator alignment as static with only a few surveys and realignments per year. The alignment in future linear colliders will be a dynamic process in which the whole linac, with thousands of beam-line elements, is aligned in a few hours or minutes, while the required accuracy of about 5 pm for the NLC quadrupole alignment [4] is a factor of 20 higher than in existing accelerators. The major task in alignment and steering is the accurate determination of the optimum beam-line position. Ideally one would like all elements to be aligned along a straight line. However, this is not practical. Instead a ''smooth curve'' is acceptable as long as its wavelength is much longer than the betatron wavelength of the accelerated beam. Conventional alignment methods are limited in accuracy by errors in the survey and the fiducials. Beam-based alignment methods ideally only depend upon the BPM resolution and generally provide much better precision. Many of those techniques are described in other contributions to this workshop. In this paper we describe our experiences with a dispersion-free steering algorithm for linacs. This algorithm was first suggested by Raubenheimer and Ruth in 1990 [5]. It h as been studied in simulations for NLC [5], TESLA [6], the S-BAND proposal [7] and CLIC [8]. The dispersion-free steering technique can be applied to the whole linac at once and returns the alignment (or trajectory) that minimizes the dispersive emittance growth of the beam. Thus it allows an extremely fast alignment of the beam-line. As we will show dispersion-free steering is only sensitive to quadrupole misalignments. Wakefield-free steering [3] as mentioned before is a closely related technique that minimizes the emittance growth caused by both dispersion and wakefields. Due to hardware limitations (i.e. insufficient relative range of power supplies) we could not study this method experimentally in the SLC. However, its systematics are very similar to those of dispersion-free steering. The studies of dispersion-free steering which are presented made extensive use of the unique potential of the SLC as the only operating linear collider. We used it to study the performance and problems of advanced beam-based optimization tools in a real beam-line environment and on a large scale. We should mention that the SLC has utilized beam-based alignment for years [9], using the difference of electron and positron trajectories. This method, however, cannot be used in future linear colliders. The goal of our work is to demonstrate the performance of advanced beam-based alignment techniques in linear colliders and to anticipate possible reality-related problems. Those can then be solved in the design state for the next generation of linear colliders.« less

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

Clendenin, James E

The International Committee supported the proposal of the Chairman of the XVIII International Linac Conference to issue a new Compendium of linear accelerators. The last one was published in 1976. The Local Organizing Committee of Linac96 decided to set up a sub-committee for this purpose. Contrary to the catalogues of the High Energy Accelerators which compile accelerators with energies above 1 GeV, we have not defined a specific limit in energy. Microtrons and cyclotrons are not in this compendium. Also data from thousands of medical and industrial linacs has not been collected. Therefore, only scientific linacs are listed in themore » present compendium. Each linac found in this research and involved in a physics context was considered. It could be used, for example, either as an injector for high energy accelerators, or in nuclear physics, materials physics, free electron lasers or synchrotron light machines. Linear accelerators are developed in three continents only: America, Asia, and Europe. This geographical distribution is kept as a basis. The compendium contains the parameters and status of scientific linacs. Most of these linacs are operational. However, many facilities under construction or design studies are also included. A special mention has been made at the end for the studies of future linear colliders.« less

Fiducial marker placement using endobronchial ultrasound and navigational bronchoscopy for stereotactic radiosurgery: an alternative strategy.

PubMed

Harley, Daniel P; Krimsky, William S; Sarkar, Saiyad; Highfield, David; Aygun, Cengis; Gurses, Burak

2010-02-01

Stereotactic radiosurgery is being increasingly used to treat patients with early-stage non-small cell lung cancers (NSCLC) who are not candidates for surgical resection. Stereotactic radiosurgery usually needs fiducial markers (FMs) for the tracking process. FMs have generally been placed using percutaneous computed axial tomography scan guidance. We report the results of FM placement using endobronchial ultrasound (EBUS) in 43 patients. A multidisciplinary tumor board evaluates NSCLC patients before they are offered stereotactic radiosurgery. In patients selected for stereotactic radiosurgery, FMs were inserted into peripheral, central, and mediastinal tumors using EBUS and, in selected patients, navigational bronchoscopy. Patients underwent repeat computed axial tomography chest scans 2 weeks later to ensure stability of the FMs before beginning stereotactic radiosurgery. Included were 43 consecutive patients (21 men, 22 women; mean age, 74.4 years). Forty-two (98%) had NSC carcinomas (5 recurrences); 1 had a carcinoid tumor. Twenty-two tumors were located in the left lung, 19 in the right lung, 1 at the carina, and 1 pretracheal. Two to 5 FMs were placed in and around all tumor masses using EBUS and, for peripheral lesions, EBUS combined with navigational bronchoscopy. Thirty patients had no displacement of FMs. In the 13 who had displaced 1 or more FMs, the ability to use the remaining FMs for stereotactic radiosurgery was unimpaired. EBUS and navigational bronchoscopy are safe and effective methods to position FMs for preparing patients with both central and peripheral lung cancers for stereotactic radiosurgery. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Crossbar H-mode drift-tube linac design with alternative phase focusing for muon linac

NASA Astrophysics Data System (ADS)

Otani, M.; Futatsukawa, K.; Hasegawa, K.; Kitamura, R.; Kondo, Y.; Kurennoy, S.

2017-07-01

We have developed a Crossbar H-mode (CH) drift-tube linac (DTL) design with an alternative phase focusing (APF) scheme for a muon linac, in order to measure the anomalous magnetic moment and electric dipole moment (EDM) of muons at the Japan Proton Accelerator Research Complex (J-PARC). The CH-DTL accelerates muons from β = v/c = 0.08 to 0.28 at an operational frequency of 324 MHz. The design and results are described in this paper.

Design and characterization of the ePix10k: a high dynamic range integrating pixel ASIC for LCLS detectors

NASA Astrophysics Data System (ADS)

Caragiulo, P.; Dragone, A.; Markovic, B.; Herbst, R.; Nishimura, K.; Reese, B.; Herrmann, S.; Hart, P.; Blaj, G.; Segal, J.; Tomada, A.; Hasi, J.; Carini, G.; Kenney, C.; Haller, G.

2015-05-01

ePix10k is a variant of a novel class of integrating pixel ASICs architectures optimized for the processing of signals in second generation LINAC Coherent Light Source (LCLS) X-Ray cameras. The ASIC is optimized for high dynamic range application requiring high spatial resolution and fast frame rates. ePix ASICs are based on a common platform composed of a random access analog matrix of pixel with global shutter, fast parallel column readout, and dedicated sigma-delta analog to digital converters per column. The ePix10k variant has 100um×100um pixels arranged in a 176×192 matrix, a resolution of 140e- r.m.s. and a signal range of 3.5pC (10k photons at 8keV). In its final version it will be able to sustain a frame rate of 2kHz. A first prototype has been fabricated and characterized. Performance in terms of noise, linearity, uniformity, cross-talk, together with preliminary measurements with bump bonded sensors are reported here.

Wakefields in SLAC linac collimators

DOE PAGES

Novokhatski, A.; Decker, F. -J.; Smith, H.; ...

2014-12-02

When a beam travels near collimator jaws, it gets an energy loss and a transverse kick due to the backreaction of the beam field diffracted from the jaws. The effect becomes very important for an intense short bunch when a tight collimation of the background beam halo is required. In the Linac Coherent Light Source at SLAC a collimation system is used to protect the undulators from radiation due to particles in the beam halo. The halo is most likely formed from gun dark current or dark current in some of the accelerating sections. However, collimators are also responsible formore » the generation of wake fields. The wake field effect from the collimators not only brings an additional energy jitter and change in the trajectory of the beam, but it also rotates the beam on the phase plane, which consequently leads to a degradation of the performance of the Free Electron Laser at the Linac Coherent Light Source. In this paper, we describe a model of the wake field radiation in the SLAC linac collimators. We use the results of a numerical simulation to illustrate the model. Based on the model, we derive simple formulas for the bunch energy loss and the average kick. We also present results from experimental measurements that confirm our model.« less

Dosimetric comparison between intra-cavitary breast brachytherapy techniques for accelerated partial breast irradiation and a novel stereotactic radiotherapy device for breast cancer: GammaPod™

NASA Astrophysics Data System (ADS)

Ödén, Jakob; Toma-Dasu, Iuliana; Yu, Cedric X.; Feigenberg, Steven J.; Regine, William F.; Mutaf, Yildirim D.

2013-07-01

The GammaPod™ device, manufactured by Xcision Medical Systems, is a novel stereotactic breast irradiation device. It consists of a hemispherical source carrier containing 36 Cobalt-60 sources, a tungsten collimator with two built-in collimation sizes, a dynamically controlled patient support table and a breast immobilization cup also functioning as the stereotactic frame for the patient. The dosimetric output of the GammaPod™ was modelled using a Monte Carlo based treatment planning system. For the comparison, three-dimensional (3D) models of commonly used intra-cavitary breast brachytherapy techniques utilizing single lumen and multi-lumen balloon as well as peripheral catheter multi-lumen implant devices were created and corresponding 3D dose calculations were performed using the American Association of Physicists in Medicine Task Group-43 formalism. Dose distributions for clinically relevant target volumes were optimized using dosimetric goals set forth in the National Surgical Adjuvant Breast and Bowel Project Protocol B-39. For clinical scenarios assuming similar target sizes and proximity to critical organs, dose coverage, dose fall-off profiles beyond the target and skin doses at given distances beyond the target were calculated for GammaPod™ and compared with the doses achievable by the brachytherapy techniques. The dosimetric goals within the protocol guidelines were fulfilled for all target sizes and irradiation techniques. For central targets, at small distances from the target edge (up to approximately 1 cm) the brachytherapy techniques generally have a steeper dose fall-off gradient compared to GammaPod™ and at longer distances (more than about 1 cm) the relation is generally observed to be opposite. For targets close to the skin, the relative skin doses were considerably lower for GammaPod™ than for any of the brachytherapy techniques. In conclusion, GammaPod™ allows adequate and more uniform dose coverage to centrally and peripherally located targets with an acceptable dose fall-off and lower relative skin dose than the brachytherapy techniques considered in this study.

Compact x-ray source based on burst-mode inverse Compton scattering at 100 kHz

DOE PAGES

Graves, W.  S.; Bessuille, J.; Brown, P.; ...

2014-12-01

A design for a compact x-ray light source (CXLS) with flux and brilliance orders of magnitude beyond existing laboratory scale sources is presented. The source is based on inverse Compton scattering of a high brightness electron bunch on a picosecond laser pulse. The accelerator is a novel high-efficiency standingwave linac and rf photoinjector powered by a single ultrastable rf transmitter at X-band rf frequency. The high efficiency permits operation at repetition rates up to 1 kHz, which is further boosted to 100 kHz by operating with trains of 100 bunches of 100 pC charge, each separated by 5 ns. Themore » entire accelerator is approximately 1 meter long and produces hard x rays tunable over a wide range of photon energies. The colliding laser is a Yb:YAG solid-state amplifier producing 1030 nm, 100 mJ pulses at the same 1 kHz repetition rate as the accelerator. The laser pulse is frequency-doubled and stored for many passes in a ringdown cavity to match the linac pulse structure. At a photon energy of 12.4 keV, the predicted x-ray flux is 5 × 10¹¹ photons/second in a 5% bandwidth and the brilliance is 2 × 10¹² photons/(sec mm² mrad² 0.1%) in pulses with rms pulse length of 490 fs. The nominal electron beam parameters are 18 MeV kinetic energy, 10 microamp average current, 0.5 microsecond macropulse length, resulting in average electron beam power of 180 W. Optimization of the x-ray output is presented along with design of the accelerator, laser, and x-ray optic components that are specific to the particular characteristics of the Compton scattered x-ray pulses.« less

THz-pump and X-ray-probe sources based on an electron linac

NASA Astrophysics Data System (ADS)

Setiniyaz, Sadiq; Park, Seong Hee; Kim, Hyun Woo; Vinokurov, Nikolay A.; Jang, Kyu-Ha; Lee, Kitae; Baek, In Hyung; Jeong, Young Uk

2017-11-01

We describe a compact THz-pump and X-ray-probe beamline, based on an electron linac, for ultrafast time-resolved diffraction applications. Two high-energy electron (γ > 50) bunches, 5 ns apart, impinge upon a single-foil or multifoil radiator and generate THz radiation and X-rays simultaneously. The THz pulse from the first bunch is synchronized to the X-ray beam of the second bunch by using an adjustable optical delay of a THz pulse. The peak power of THz radiation from the multifoil radiator is estimated to be 0.14 GW for a 200 pC well-optimized electron bunch. GEANT4 simulations show that a carbon foil with a thickness of 0.5-1.0 mm has the highest yield of 10-20 keV hard X-rays for a 25 MeV beam, which is approximately 103 photons/(keV pC-electrons) within a few degrees of the polar angle. A carbon multifoil radiator with 35 foils (25 μm thick each) can generate close to 103 hard X-rays/(keV pC-electrons) within a 2° acceptance angle. With 200 pC charge and a 100 Hz repetition rate, we can generate 107 X-rays per 1 keV energy bin per second or 105 X-rays per 1 keV energy bin per pulse. The longitudinal time profile of an X-ray pulse ranges from 400 to 600 fs depending on the acceptance angle. The broadening of the time duration of an X-ray pulse is observed owing to its diverging effect. A double-crystal monochromator will be used to select and transport the desired X-rays to the sample. The heating of the radiators by an electron beam is negligible because of the low beam current.

SU-E-T-245: Detection of the Photon Target Damage in Varian Linac Based On Periodical Quality Assurance Measurements

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

Gao, S; Balter, P; Wang, X

2015-06-15

Purpose: To determine the best dosimetric metric measured by our routine QA devices for diagnosing photon target failure on a Varian C-series linac. Methods: We have retrospectively reviewed and analyzed the dosimetry data from a Varian linac with a target degradation that was undiagnosed for one year. A failure in the daily QA symmetry tests was the first indication of an issue. The beam was steered back to a symmetric shape and water scans indicated the beam energy had changed but stayed within the manufacturer’s specifications and agreed reasonably with our treatment planning system data. After the problem was identifiedmore » and the target was replaced, we retrospectively analyzed our QA data including diagonals normalized flatness (F-DN) from the daily device (DQA3), profiles from an ionization chamber array (IC Profiler), as well as profiles and PDDs from a 3D water Scanner (3DS). These metrics were cross-compared to determine which was the best early indicator of target degradation. Results: A 3% change in FDN measured by the DQA3 was found to be an early indicator of target degradation. It is more sensitive than changes in output, symmetry, flatness or PDD. All beam shape metrics (flatness at dmax and 10 cm depth, and F-DN) indicated an energy increase while the PDD indicated an energy decrease. This disagreement between the beam-shape based energy metrics (F-DN and flatness) and PDD based energy metric may indicate target failure as opposed to an energy change resulting from changes in the incident electron energy. Conclusion: Photon target degradation has been identified as a failure mode for linacs. The manufacturer’s test for this condition is highly invasive and requires machine down time. We have demonstrated that the condition could be caught early based upon data acquired during routine QA activities, such as the F-DN.« less

Consequences of air around an ionization chamber: Are existing solid phantoms suitable for reference dosimetry on an MR-linac?

PubMed

Hackett, S L; van Asselen, B; Wolthaus, J W H; Kok, J G M; Woodings, S J; Lagendijk, J J W; Raaymakers, B W

2016-07-01

A protocol for reference dosimetry for the MR-linac is under development. The 1.5 T magnetic field changes the mean path length of electrons in an air-filled ionization chamber but has little effect on the electron trajectories in a surrounding phantom. It is therefore necessary to correct the response of an ionization chamber for the influence of the magnetic field. Solid phantoms are used for dosimetry measurements on the MR-linac, but air is present between the chamber wall and phantom insert. This study aimed to determine if this air influences the ion chamber measurements on the MR-linac. The absolute response of the chamber and reproducibility of dosimetry measurements were assessed on an MR-linac in solid and water phantoms. The sensitivity of the chamber response to the distribution of air around the chamber was also investigated. Measurements were performed on an MR-linac and replicated on a conventional linac for five chambers. The response of three waterproof chambers was measured with air and with water between the chamber and the insert to measure the influence of the air volume on absolute chamber response. The distribution of air around the chamber was varied indirectly by rotating each chamber about the longitudinal chamber axis in a solid phantom and a water phantom (waterproof chambers only) and measuring the angular dependence of the chamber response, and varied directly by displacing the chamber in the phantom insert using a paper shim positioned at different orientations between the chamber casing and the insert. The responses of the three waterproof chambers measured on the MR-linac were 0.7%-1.2% higher with water than air in the chamber insert. The responses of the chambers on the conventional linac changed by less than 0.3% when air in the insert was replaced with water. The angular dependence of the chambers ranged from 0.6% to 1.9% in the solid phantom on the MR-linac but was less than 0.5% in water on the MR-linac and less than 0.3% in the solid phantom on the conventional linac. Inserting a shim around the chamber induced changes of the chamber response in a magnetic field of up to 2.2%, but the change in chamber response on the conventional linac was less than 0.3%. The interaction between the magnetic field and secondary electrons in the air around the chamber reduces the charge collected from 0.7% to 1.2%. The large angular dependence of ion chambers measured in the plastic phantom in a magnetic field appears to arise from a change of air distribution as the chamber is moved within the insert, rather than an intrinsic isotropy of the chamber sensitivity to radiation. It is recommended that reference dosimetry measurements on the MR-linac can be performed only in water, rather than in existing plastic phantoms.

Design of high-energy high-current linac with focusing by superconducting solenoids

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

Batskikh, Guennady I.; Belugin, Vladimir M.; Bondarev, Boris I.

1995-09-15

The advancement of MRTI design for 1.5 GeV and 250 mA ion CW linac is presented in the report. In new linac version all the way from input to output the ions are focused by magnetic fields of superconducting solenoids. The ion limit current is far beyond the needed value. The linac focusing channel offers major advantages over the more conventional ones. The acceptance is 1.7 times as large for such focusing channel as for quadrupole one. Concurrently, a random perturbation sensitivity for such channel is one order of magnitude smaller than in quadrupole channel. These focusing channel features allowmore » to decrease beam matched radius and increase a linac radiation purity without aperture growth. ''Regotron'' is used as high power generator in linac main part. But D and W cavities need not be divided into sections connected by RF-bridges which denuded them of high coupling factor.« less

Design of high-energy high-current linac with focusing by superconducting solenoids

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

Batskikh, G.I.; Belugin, V.M.; Bondarev, B.I.

1995-10-01

The advancement of MRTI design for 1.5 GeV and 250 mA ion CW linac was presented in a previous report. In this new linac version all the way from input to output the ions are focused by magnetic fields of superconducting solenoids. The ion limit current is far beyond the needed value. The linac focusing channel offers major advantages over the more conventional ones. The acceptance is 1.7 times as large for such focusing channel as for quadrupole one. Concurrently, a random perturbation sensitivity for such channel is one order of magnitude smaller than in quadrupole channel. These focusing channelmore » features allow to decrease beam matched radius and increase a linac radiation purity without aperture growth. {open_quotes}Regotron{close_quotes} is used as high power generator in linac main part. But D&W cavities need not be divided into sections connected by RF-bridges which denuded them of high coupling factor.« less

Modeling of Radiotherapy Linac Source Terms Using ARCHER Monte Carlo Code: Performance Comparison for GPU and MIC Parallel Computing Devices

NASA Astrophysics Data System (ADS)

Lin, Hui; Liu, Tianyu; Su, Lin; Bednarz, Bryan; Caracappa, Peter; Xu, X. George

2017-09-01

Monte Carlo (MC) simulation is well recognized as the most accurate method for radiation dose calculations. For radiotherapy applications, accurate modelling of the source term, i.e. the clinical linear accelerator is critical to the simulation. The purpose of this paper is to perform source modelling and examine the accuracy and performance of the models on Intel Many Integrated Core coprocessors (aka Xeon Phi) and Nvidia GPU using ARCHER and explore the potential optimization methods. Phase Space-based source modelling for has been implemented. Good agreements were found in a tomotherapy prostate patient case and a TrueBeam breast case. From the aspect of performance, the whole simulation for prostate plan and breast plan cost about 173s and 73s with 1% statistical error.

A singular value decomposition linear programming (SVDLP) optimization technique for circular cone based robotic radiotherapy.

PubMed

Liang, Bin; Li, Yongbao; Wei, Ran; Guo, Bin; Xu, Xuang; Liu, Bo; Li, Jiafeng; Wu, Qiuwen; Zhou, Fugen

2018-01-05

With robot-controlled linac positioning, robotic radiotherapy systems such as CyberKnife significantly increase freedom of radiation beam placement, but also impose more challenges on treatment plan optimization. The resampling mechanism in the vendor-supplied treatment planning system (MultiPlan) cannot fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy. The SVDLP approach initializes the input beams by simulating the process of covering the entire target volume with equivalent beam tapers. The requirements on dosimetry distribution are modeled as hard and soft constraints, and the sparsity of the treatment plan is achieved by compressive sensing. The proposed linear programming (LP) model optimizes beam weights by minimizing the deviation of soft constraints subject to hard constraints, with a constraint on the l 1 norm of the beam weight. A singular value decomposition (SVD) based acceleration technique was developed for the LP model. Based on the degeneracy of the influence matrix, the model is first compressed into lower dimension for optimization, and then back-projected to reconstruct the beam weight. After beam weight optimization, the number of beams is reduced by removing the beams with low weight, and optimizing the weights of the remaining beams using the same model. This beam reduction technique is further validated by a mixed integer programming (MIP) model. The SVDLP approach was tested on a lung case. The results demonstrate that the SVD acceleration technique speeds up the optimization by a factor of 4.8. Furthermore, the beam reduction achieves a similar plan quality to the globally optimal plan obtained by the MIP model, but is one to two orders of magnitude faster. Furthermore, the SVDLP approach is tested and compared with MultiPlan on three clinical cases of varying complexities. In general, the plans generated by the SVDLP achieve steeper dose gradient, better conformity and less damage to normal tissues. In conclusion, the SVDLP approach effectively improves the quality of treatment plan due to the use of the complete beam search space. This challenging optimization problem with the complete beam search space is effectively handled by the proposed SVD acceleration.

A singular value decomposition linear programming (SVDLP) optimization technique for circular cone based robotic radiotherapy

NASA Astrophysics Data System (ADS)

Liang, Bin; Li, Yongbao; Wei, Ran; Guo, Bin; Xu, Xuang; Liu, Bo; Li, Jiafeng; Wu, Qiuwen; Zhou, Fugen

2018-01-01

With robot-controlled linac positioning, robotic radiotherapy systems such as CyberKnife significantly increase freedom of radiation beam placement, but also impose more challenges on treatment plan optimization. The resampling mechanism in the vendor-supplied treatment planning system (MultiPlan) cannot fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy. The SVDLP approach initializes the input beams by simulating the process of covering the entire target volume with equivalent beam tapers. The requirements on dosimetry distribution are modeled as hard and soft constraints, and the sparsity of the treatment plan is achieved by compressive sensing. The proposed linear programming (LP) model optimizes beam weights by minimizing the deviation of soft constraints subject to hard constraints, with a constraint on the l 1 norm of the beam weight. A singular value decomposition (SVD) based acceleration technique was developed for the LP model. Based on the degeneracy of the influence matrix, the model is first compressed into lower dimension for optimization, and then back-projected to reconstruct the beam weight. After beam weight optimization, the number of beams is reduced by removing the beams with low weight, and optimizing the weights of the remaining beams using the same model. This beam reduction technique is further validated by a mixed integer programming (MIP) model. The SVDLP approach was tested on a lung case. The results demonstrate that the SVD acceleration technique speeds up the optimization by a factor of 4.8. Furthermore, the beam reduction achieves a similar plan quality to the globally optimal plan obtained by the MIP model, but is one to two orders of magnitude faster. Furthermore, the SVDLP approach is tested and compared with MultiPlan on three clinical cases of varying complexities. In general, the plans generated by the SVDLP achieve steeper dose gradient, better conformity and less damage to normal tissues. In conclusion, the SVDLP approach effectively improves the quality of treatment plan due to the use of the complete beam search space. This challenging optimization problem with the complete beam search space is effectively handled by the proposed SVD acceleration.

Electron beam energy chirp control with a rectangular corrugated structure at the Linac Coherent Light Source

DOE PAGES

Zhang, Zhen; Bane, Karl; Ding, Yuantao; ...

2015-01-30

In this study, electron beam energy chirp is an important parameter that affects the bandwidth and performance of a linac-based, free-electron laser. In this paper we study the wakefields generated by a beam passing between at metallic plates with small corrugations, and then apply such a device as a passive dechirper for the Linac Coherent Light Source (LCLS) energy chirp control with a multi-GeV and femtosecond electron beam. Similar devices have been tested in several places at relatively low energies (~100 MeV) and with relatively long bunches (> 1ps). In the parameter regime of the LCLS dechirper, with the corrugationmore » size similar to the gap between the plates, the analytical solutions of the wakefields are no longer applicable, and we resort to a field matching program to obtain the wakes. Based on the numerical calculations, we fit the short-range, longitudinal wakes to simple formulas, valid over a large, useful parameter range. Finally, since the transverse wakefields - both dipole and quadrupole-are strong, we compute and include them in beam dynamics simulations to investigate the error tolerances when this device is introduced in the LCLS.« less

Present status of the low energy linac-based slow positron beam and positronium spectrometer in Saclay

NASA Astrophysics Data System (ADS)

Liszkay, L.; Comini, P.; Corbel, C.; Debu, P.; Grandemange, P.; Pérez, P.; Rey, J.-M.; Reymond, J.-M.; Ruiz, N.; Sacquin, Y.; Vallage, B.

2014-04-01

A new slow positron beamline featuring a large acceptance positronium lifetime spectrometer has been constructed and tested at the linac-based slow positron source at IRFU CEA Saclay, France. The new instrument will be used in the development of a dense positronium target cloud for the GBAR experiment. The GBAR project aims at precise measurement of the gravitational acceleration of antihydrogen in the gravitational field of the Earth. Beyond application in fundamental science, the positron spectrometer will be used in materials research, for testing thin porous films and layers by means of positronium annihilation. The slow positron beamline is being used as a test bench to develop further instrumentation for positron annihilation spectroscopy (Ps time-of-flight, pulsed positron beam). The positron source is built on a low energy linear electron accelerator (linac). The 4.3 MeV electron energy used is well below the photoneutron threshold, making the source a genuine on-off device, without remaining radioactivity. The spectrometer features large BGO (Bismuth Germanate) scintillator detectors, with sufficiently large acceptance to detect all ortho-positronium annihilation lifetime components (annihilation in vacuum and in nanopores).

Development of quantitative analysis method for stereotactic brain image: assessment of reduced accumulation in extent and severity using anatomical segmentation.

PubMed

Mizumura, Sunao; Kumita, Shin-ichiro; Cho, Keiichi; Ishihara, Makiko; Nakajo, Hidenobu; Toba, Masahiro; Kumazaki, Tatsuo

2003-06-01

Through visual assessment by three-dimensional (3D) brain image analysis methods using stereotactic brain coordinates system, such as three-dimensional stereotactic surface projections and statistical parametric mapping, it is difficult to quantitatively assess anatomical information and the range of extent of an abnormal region. In this study, we devised a method to quantitatively assess local abnormal findings by segmenting a brain map according to anatomical structure. Through quantitative local abnormality assessment using this method, we studied the characteristics of distribution of reduced blood flow in cases with dementia of the Alzheimer type (DAT). Using twenty-five cases with DAT (mean age, 68.9 years old), all of whom were diagnosed as probable Alzheimer's disease based on NINCDS-ADRDA, we collected I-123 iodoamphetamine SPECT data. A 3D brain map using the 3D-SSP program was compared with the data of 20 cases in the control group, who age-matched the subject cases. To study local abnormalities on the 3D images, we divided the whole brain into 24 segments based on anatomical classification. We assessed the extent of an abnormal region in each segment (rate of the coordinates with a Z-value that exceeds the threshold value, in all coordinates within a segment), and severity (average Z-value of the coordinates with a Z-value that exceeds the threshold value). This method clarified orientation and expansion of reduced accumulation, through classifying stereotactic brain coordinates according to the anatomical structure. This method was considered useful for quantitatively grasping distribution abnormalities in the brain and changes in abnormality distribution.

Stereotactic robot-assisted MRI-guided laser thermal ablation of radiation necrosis in the posterior cranial fossa: technical note.

PubMed

Chan, Alvin Y; Tran, Diem Kieu T; Gill, Amandip S; Hsu, Frank P K; Vadera, Sumeet

2016-10-01

Laser interstitial thermal therapy (LITT) is a minimally invasive procedure used to treat a variety of intracranial lesions. Utilization of robotic assistance with stereotactic procedures has gained attention due to potential for advantages over conventional techniques. The authors report the first case in which robot-assisted MRI-guided LITT was used to treat radiation necrosis in the posterior fossa, specifically within the cerebellar peduncle. The use of a stereotactic robot allowed the surgeon to perform LITT using a trajectory that would be extremely difficult with conventional arc-based techniques. A 60-year-old man presented with facial weakness and brainstem symptoms consistent with radiation necrosis. He had a history of anaplastic astrocytoma that was treated with CyberKnife radiosurgery 1 year prior to presentation, and he did well for 11 months until his symptoms recurred. The location and form of the lesion precluded excision but made the patient a suitable candidate for LITT. The location and configuration of the lesion required a trajectory for LITT that was too low for arc-based stereotactic navigation, and thus the ROSA robot (Medtech) was used. Using preoperative MRI acquisitions, the lesion in the posterior fossa was targeted. Bone fiducials were used to improve accuracy in registration, and the authors obtained an intraoperative CT image that was then fused with the MR image by the ROSA robot. They placed the laser applicator and then ablated the lesion under real-time MR thermometry. There were no complications, and the patient tolerated the procedure well. Postoperative 2-month MRI showed complete resolution of the lesion, and the patient had some improvement in symptoms.

TH-CD-202-12: Online Inter-Beam Replanning Based On Real-Time Dose Reconstruction

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

Kamerling, CP; Fast, MF; Ziegenhein, P

Purpose: This work provides a proof-of-concept study for online replanning during treatment delivery for step-and-shoot prostate SBRT, based on real-time dose reconstruction. Online replanning is expected to improve the trade-off between target coverage and organ-at-risk dose in the presence of intra-fractional motion. Methods: We have implemented an online replanning workflow on top of our previously reported real-time dose reconstruction software which connects to an Elekta research linac. The treatment planning system DynaPlan was extended to (1) re-optimize and sequence treatment plans (in clockwise beam order) before each beam, based on actual delivered dose, in a timeframe limited by the gantrymore » rotation between subsequent beams, and (2) send the respective segments to the delivery control software DynaTrack which starts/continues treatment immediately.To investigate the impact of a reduced safety margin, we have created and delivered (on a linac emulator) a conventional CTV+5/3mm (I) and a reduced CTV+1mm margin (II) treatment plan for a prostate patient. We have assessed CTV coverage with and without inter-beam replanning, all exposed to a gradual target shift of 0–5mm in posterior and inferior direction from start until the end of delivery. Results: For the reconstructed conventional plan (I), D98 for CTV was 100% of D98 of the planned dose. For the reconstructed margin-reduced plan (II), D98 for CTV was 95% of the planned D98 without replanning, but could be recovered to 99% by replanning for each beam. Plan (II) with replanning resulted in a decrease for bladder V90% by 88% and an increase to rectum V90% by 9% compared to the conventional plan (I). Dose calculation/accumulation was performed in <15ms per MLC aperture, replanning in <15s per beam. Conclusion: We have shown that online inter-beam replanning is technically feasible and potentially allows for a margin reduction. Future investigation considering motion-robust replanning optimization parameters is in progress. We acknowledge support of the MLC research from Elekta AB. This work is supported by Cancer Research UK under Programme C33589/A19908. Research at ICR is also supported by Cancer Research UK under Programme C33589/A19727 and NHS funding to the NIHR Biomedical Research Centre at RMH and ICR.« less

Low-cost phantom for stereotactic breast biopsy training.

PubMed

Larrison, Matthew; DiBona, Alex; Hogg, David E

2006-10-01

This article reports on the construction of a low-cost phantom to be used for training technologists, residents, and radiologists to perform stereotactic breast biopsy. The model is adaptable to a variety of biopsy devices and realistically simulates the aspects of stereotactic breast biopsy. We believe our model provides an excellent alternative to more expensive commercial products.

Image-based in vivo assessment of targeting accuracy of stereotactic brain surgery in experimental rodent models

NASA Astrophysics Data System (ADS)

Rangarajan, Janaki Raman; Vande Velde, Greetje; van Gent, Friso; de Vloo, Philippe; Dresselaers, Tom; Depypere, Maarten; van Kuyck, Kris; Nuttin, Bart; Himmelreich, Uwe; Maes, Frederik

2016-11-01

Stereotactic neurosurgery is used in pre-clinical research of neurological and psychiatric disorders in experimental rat and mouse models to engraft a needle or electrode at a pre-defined location in the brain. However, inaccurate targeting may confound the results of such experiments. In contrast to the clinical practice, inaccurate targeting in rodents remains usually unnoticed until assessed by ex vivo end-point histology. We here propose a workflow for in vivo assessment of stereotactic targeting accuracy in small animal studies based on multi-modal post-operative imaging. The surgical trajectory in each individual animal is reconstructed in 3D from the physical implant imaged in post-operative CT and/or its trace as visible in post-operative MRI. By co-registering post-operative images of individual animals to a common stereotaxic template, targeting accuracy is quantified. Two commonly used neuromodulation regions were used as targets. Target localization errors showed not only variability, but also inaccuracy in targeting. Only about 30% of electrodes were within the subnucleus structure that was targeted and a-specific adverse effects were also noted. Shifting from invasive/subjective 2D histology towards objective in vivo 3D imaging-based assessment of targeting accuracy may benefit a more effective use of the experimental data by excluding off-target cases early in the study.

Development of mini linac-based positron source and an efficient positronium convertor for positively charged antihydrogen production

NASA Astrophysics Data System (ADS)

Muranaka, T.; Debu, P.; Dupré, P.; Liszkay, L.; Mansoulie, B.; Pérez, P.; Rey, J. M.; Ruiz, N.; Sacquin, Y.; Crivelli, P.; Gendotti, U.; Rubbia, A.

2010-04-01

We have installed in Saclay a facility for an intense positron source in November 2008. It is based on a compact 5.5 MeV electron linac connected to a reaction chamber with a tungsten target inside to produce positrons via pair production. The expected production rate for fast positrons is 5·1011 per second. The study of moderation of fast positrons and the construction of a slow positron trap are underway. In parallel, we have investigated an efficient positron-positronium convertor using porous silica materials. These studies are parts of a project to produce positively charged antihydrogen ions aiming to demonstrate the feasibility of a free fall antigravity measurement of neutral antihydrogen.

IRIDE: Interdisciplinary research infrastructure based on dual electron linacs and lasers

NASA Astrophysics Data System (ADS)

Ferrario, M.; Alesini, D.; Alessandroni, M.; Anania, M. P.; Andreas, S.; Angelone, M.; Arcovito, A.; Arnesano, F.; Artioli, M.; Avaldi, L.; Babusci, D.; Bacci, A.; Balerna, A.; Bartalucci, S.; Bedogni, R.; Bellaveglia, M.; Bencivenga, F.; Benfatto, M.; Biedron, S.; Bocci, V.; Bolognesi, M.; Bolognesi, P.; Boni, R.; Bonifacio, R.; Boscherini, F.; Boscolo, M.; Bossi, F.; Broggi, F.; Buonomo, B.; Calo, V.; Catone, D.; Capogni, M.; Capone, M.; Cassou, K.; Castellano, M.; Castoldi, A.; Catani, L.; Cavoto, G.; Cherubini, N.; Chirico, G.; Cestelli-Guidi, M.; Chiadroni, E.; Chiarella, V.; Cianchi, A.; Cianci, M.; Cimino, R.; Ciocci, F.; Clozza, A.; Collini, M.; Colo, G.; Compagno, A.; Contini, G.; Coreno, M.; Cucini, R.; Curceanu, C.; Curciarello, F.; Dabagov, S.; Dainese, E.; Davoli, I.; Dattoli, G.; De Caro, L.; De Felice, P.; De Leo, V.; Dell Agnello, S.; Della Longa, S.; Delle Monache, G.; De Spirito, M.; Di Cicco, A.; Di Donato, C.; Di Gioacchino, D.; Di Giovenale, D.; Di Palma, E.; Di Pirro, G.; Dodaro, A.; Doria, A.; Dosselli, U.; Drago, A.; Dupraz, K.; Escribano, R.; Esposito, A.; Faccini, R.; Ferrari, A.; Filabozzi, A.; Filippetto, D.; Fiori, F.; Frasciello, O.; Fulgentini, L.; Gallerano, G. P.; Gallo, A.; Gambaccini, M.; Gatti, C.; Gatti, G.; Gauzzi, P.; Ghigo, A.; Ghiringhelli, G.; Giannessi, L.; Giardina, G.; Giannini, C.; Giorgianni, F.; Giovenale, E.; Giulietti, D.; Gizzi, L.; Guaraldo, C.; Guazzoni, C.; Gunnella, R.; Hatada, K.; Iannone, M.; Ivashyn, S.; Jegerlehner, F.; Keeffe, P. O.; Kluge, W.; Kupsc, A.; Labate, L.; Levi Sandri, P.; Lombardi, V.; Londrillo, P.; Loreti, S.; Lorusso, A.; Losacco, M.; Lukin, A.; Lupi, S.; Macchi, A.; Magazù, S.; Mandaglio, G.; Marcelli, A.; Margutti, G.; Mariani, C.; Mariani, P.; Marzo, G.; Masciovecchio, C.; Masjuan, P.; Mattioli, M.; Mazzitelli, G.; Merenkov, N. P.; Michelato, P.; Migliardo, F.; Migliorati, M.; Milardi, C.; Milotti, E.; Milton, S.; Minicozzi, V.; Mobilio, S.; Morante, S.; Moricciani, D.; Mostacci, A.; Muccifora, V.; Murtas, F.; Musumeci, P.; Nguyen, F.; Orecchini, A.; Organtini, G.; Ottaviani, P. L.; Pace, C.; Pace, E.; Paci, M.; Pagani, C.; Pagnutti, S.; Palmieri, V.; Palumbo, L.; Panaccione, G. C.; Papadopoulos, C. F.; Papi, M.; Passera, M.; Pasquini, L.; Pedio, M.; Perrone, A.; Petralia, A.; Petrarca, M.; Petrillo, C.; Petrillo, V.; Pierini, P.; Pietropaolo, A.; Pillon, M.; Polosa, A. D.; Pompili, R.; Portoles, J.; Prosperi, T.; Quaresima, C.; Quintieri, L.; Rau, J. V.; Reconditi, M.; Ricci, A.; Ricci, R.; Ricciardi, G.; Ricco, G.; Ripani, M.; Ripiccini, E.; Romeo, S.; Ronsivalle, C.; Rosato, N.; Rosenzweig, J. B.; Rossi, A. A.; Rossi, A. R.; Rossi, F.; Rossi, G.; Russo, D.; Sabatucci, A.; Sabia, E.; Sacchetti, F.; Salducco, S.; Sannibale, F.; Sarri, G.; Scopigno, T.; Sekutowicz, J.; Serafini, L.; Sertore, D.; Shekhovtsova, O.; Spassovsky, I.; Spadaro, T.; Spataro, B.; Spinozzi, F.; Stecchi, A.; Stellato, F.; Surrenti, V.; Tenore, A.; Torre, A.; Trentadue, L.; Turchini, S.; Vaccarezza, C.; Vacchi, A.; Valente, P.; Venanzoni, G.; Vescovi, S.; Villa, F.; Zanotti, G.; Zema, N.; Zobov, M.; Zomer, F.

2014-03-01

This paper describes the scientific aims and potentials as well as the preliminary technical design of IRIDE, an innovative tool for multi-disciplinary investigations in a wide field of scientific, technological and industrial applications. IRIDE will be a high intensity "particles factory", based on a combination of high duty cycle radio-frequency superconducting electron linacs and of high energy lasers. Conceived to provide unique research possibilities for particle physics, for condensed matter physics, chemistry and material science, for structural biology and industrial applications, IRIDE will open completely new research possibilities and advance our knowledge in many branches of science and technology. IRIDE is also supposed to be realized in subsequent stages of development depending on the assigned priorities.

Treatment planning, optimization, and beam delivery technqiues for intensity modulated proton therapy

NASA Astrophysics Data System (ADS)

Sengbusch, Evan R.

Physical properties of proton interactions in matter give them a theoretical advantage over photons in radiation therapy for cancer treatment, but they are seldom used relative to photons. The primary barriers to wider acceptance of proton therapy are the technical feasibility, size, and price of proton therapy systems. Several aspects of the proton therapy landscape are investigated, and new techniques for treatment planning, optimization, and beam delivery are presented. The results of these investigations suggest a means by which proton therapy can be delivered more efficiently, effectively, and to a much larger proportion of eligible patients. An analysis of the existing proton therapy market was performed. Personal interviews with over 30 radiation oncology leaders were conducted with regard to the current and future use of proton therapy. In addition, global proton therapy market projections are presented. The results of these investigations serve as motivation and guidance for the subsequent development of treatment system designs and treatment planning, optimization, and beam delivery methods. A major factor impacting the size and cost of proton treatment systems is the maximum energy of the accelerator. Historically, 250 MeV has been the accepted value, but there is minimal quantitative evidence in the literature that supports this standard. A retrospective study of 100 patients is presented that quantifies the maximum proton kinetic energy requirements for cancer treatment, and the impact of those results with regard to treatment system size, cost, and neutron production is discussed. This study is subsequently expanded to include 100 cranial stereotactic radiosurgery (SRS) patients, and the results are discussed in the context of a proposed dedicated proton SRS treatment system. Finally, novel proton therapy optimization and delivery techniques are presented. Algorithms are developed that optimize treatment plans over beam angle, spot size, spot spacing, beamlet weight, the number of delivered beamlets, and the number of delivery angles. These methods are evaluated via treatment planning studies including left-sided whole breast irradiation, lung stereotactic body radiotherapy, nasopharyngeal carcinoma, and whole brain radiotherapy with hippocampal avoidance. Improvements in efficiency and efficacy relative to traditional proton therapy and intensity modulated photon radiation therapy are discussed.

Characteristics and Treatments of Large Cystic Brain Metastasis: Radiosurgery and Stereotactic Aspiration

PubMed Central

Kim, Moinay; Cheok, Stephanie; Chung, Lawrance K.; Ung, Nolan; Thill, Kimberly; Voth, Brittany; Kwon, Do Hoon; Kim, Jeong Hoon; Kim, Chang Jin; Tenn, Stephen; Lee, Percy

2015-01-01

Brain metastasis represents one of the most common causes of intracranial tumors in adults, and the incidence of brain metastasis continues to rise due to the increasing survival of cancer patients. Yet, the development of cystic brain metastasis remains a relatively rare occurrence. In this review, we describe the characteristics of cystic brain metastasis and evaluate the combined use of stereotactic aspiration and radiosurgery in treating large cystic brain metastasis. The results of several studies show that stereotactic radiosurgery produces comparable local tumor control and survival rates as other surgery protocols. When the size of the tumor interferes with radiosurgery, stereotactic aspiration of the metastasis should be considered to reduce the target volume as well as decreasing the chance of radiation induced necrosis and providing symptomatic relief from mass effect. The combined use of stereotactic aspiration and radiosurgery has strong implications in improving patient outcomes. PMID:25977901

X-ray Laser Animated Fly-Through

ScienceCinema

None

2018-01-16

Take a tour with an electron's-eye-view through SLAC's revolutionary new X-ray laser facility with this 5 1/2 minute animation. See how the X-ray pulses are generated using the world's longest linear accelerator along with unique arrays of machinery specially designed for this one-of-a-kind tool. For more than 40 years, SLAC's two-mile-long linear accelerator (or linac) linac has produced high-energy electrons for cutting-edge physics experiments. Now, SLAC's linac has entered a new phase of its career with the creation of the Linac Coherent Light Source (LCLS).

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

Pang, Xiaoying; Rybarcyk, Larry

HPSim is a GPU-accelerated online multi-particle beam dynamics simulation tool for ion linacs. It was originally developed for use on the Los Alamos 800-MeV proton linac. It is a “z-code” that contains typical linac beam transport elements. The linac RF-gap transformation utilizes transit-time-factors to calculate the beam acceleration therein. The space-charge effects are computed using the 2D SCHEFF (Space CHarge EFFect) algorithm, which calculates the radial and longitudinal space charge forces for cylindrically symmetric beam distributions. Other space- charge routines to be incorporated include the 3D PICNIC and a 3D Poisson solver. HPSim can simulate beam dynamics in drift tubemore » linacs (DTLs) and coupled cavity linacs (CCLs). Elliptical superconducting cavity (SC) structures will also be incorporated into the code. The computational core of the code is written in C++ and accelerated using the NVIDIA CUDA technology. Users access the core code, which is wrapped in Python/C APIs, via Pythons scripts that enable ease-of-use and automation of the simulations. The overall linac description including the EPICS PV machine control parameters is kept in an SQLite database that also contains calibration and conversion factors required to transform the machine set points into model values used in the simulation.« less

Medical Application of the SARAF-Proton/Deuteron 40 MeV Superconducting Linac

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

Halfon, Shlomi

2007-11-26

The Soreq Applied Research Accelerator Facility (SARAF) is based on a superconducting linear accelerator currently being built at the Soreq research center (Israel). The SARAF is planned to generate a 2 mA 4 MeV proton beam during its first year of operation and up to 40 MeV proton or deuteron beam in 2012. The high intensity beam, together with the linac ability to adjust the ion energy provides opportunities for medical research, such as Boron Neutron Capture Therapy (BNCT) and the production of medical radioisotopes, for instance {sup 103}Pd for prostate brachytherapy.

Investigating in-field and out-of-field neutron contamination in high-energy medical linear accelerators based on the treatment factors of field size, depth, beam modifiers, and beam type.

PubMed

Biltekin, Fatih; Yeginer, Mete; Ozyigit, Gokhan

2015-07-01

We analysed the effects of field size, depth, beam modifier and beam type on the amount of in-field and out-of-field neutron contamination for medical linear accelerators (linacs). Measurements were carried out for three high-energy medical linacs of Elekta Synergy Platform, Varian Clinac DHX High Performance and Philips SL25 using bubble detectors. The photo-neutron measurements were taken in the first two linacs with 18 MV nominal energy, whereas the electro-neutrons were measured in the three linacs with 9 MeV, 10 MeV, 15 MeV and 18 MeV. The central neutron doses increased with larger field sizes as a dramatic drop off was observed in peripheral areas. Comparing with the jaws-shaped open-field of 10 × 10 cm, the motorised and physical wedges contributed to neutron contamination at central axis by 60% and 18%, respectively. The similar dose increment was observed in MLC-shaped fields. The contributions of MLCs were in the range of 55-59% and 19-22% in Elekta and Varian linacs comparing with 10 × 10 and 20 × 20 cm open fields shaped by the jaws, respectively. The neutron doses at shallow depths were found to be higher than the doses found at deeper regions. The electro-neutron dose at the 18 MeV energy was higher than the doses at the electron energies of 15 MeV and 9 MeV by a factor of 3 and 50, respectively. The photo- and electro-neutron dose should be taken into consideration in the radiation treatment with high photon and electron energies. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

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

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

Purpose: We aim to evaluate a new commercial dose mimicking inverse-planning application that was designed to provide cross-platform treatment planning, for its dosimetric quality and efficiency. The clinical benefit of this application allows patients treated on O-shaped linac to receive an equivalent plan on conventional L-shaped linac as needed for workflow or machine downtime. Methods: The dose mimicking optimization process seeks to create a similar DVH of an O-shaped linac-based plans with an alternative treatment technique (IMRT or VMAT), by maintaining target conformity, and penalizing dose falloff outside the target. Ten head and neck (HN) helical delivery plans, including simplemore » and complex cases were selected for re-planning with the dose mimicking application. All plans were generated for a 6 MV beam model, using 7-field/ 9-field IMRT and VMAT techniques. PTV coverage (D1, D99 and homogeneity index [HI]), and OARs avoidance (Dmean / Dmax) were compared. Results: The resulting dose mimicked HN plans achieved acceptable PTV coverage for HI (VMAT 7.0±2.3, 7-fld 7.3±2.4, and 9-fld 7.0±2.4), D99 (98.0%±0.7%, 97.8%±0.7%, and 98.0%±0.7%), as well as D1 (106.4%±2.1%, 106.5%±2.2%, and 106.4%±2.1%), respectively. The OAR dose discrepancy varied: brainstem (2% to 4%), cord (3% to 6%), esophagus (−4% to −8%), larynx (−4% to 2%), and parotid (4% to 14%). Mimicked plans would typically be needed for 1–5 fractions of a treatment course, and we estimate <1% variance would be introduced in target coverage while maintaining comparable low dose to OARs. All mimicked plans were approved by independent physician and passed patient specific QA within our established tolerance. Conclusion: Dose mimicked plans provide a practical alternative for responding to clinical workflow issues, and provide reliability for patient treatment. The quality of dose mimicking for HN patients highly depends on the delivery technique, field numbers and angles, as well as user selection of structures.« less

Consequences of air around an ionization chamber: Are existing solid phantoms suitable for reference dosimetry on an MR-linac?

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

Hackett, S. L., E-mail: S.S.Hackett@umcutrecht.nl

Purpose: A protocol for reference dosimetry for the MR-linac is under development. The 1.5 T magnetic field changes the mean path length of electrons in an air-filled ionization chamber but has little effect on the electron trajectories in a surrounding phantom. It is therefore necessary to correct the response of an ionization chamber for the influence of the magnetic field. Solid phantoms are used for dosimetry measurements on the MR-linac, but air is present between the chamber wall and phantom insert. This study aimed to determine if this air influences the ion chamber measurements on the MR-linac. The absolute responsemore » of the chamber and reproducibility of dosimetry measurements were assessed on an MR-linac in solid and water phantoms. The sensitivity of the chamber response to the distribution of air around the chamber was also investigated. Methods: Measurements were performed on an MR-linac and replicated on a conventional linac for five chambers. The response of three waterproof chambers was measured with air and with water between the chamber and the insert to measure the influence of the air volume on absolute chamber response. The distribution of air around the chamber was varied indirectly by rotating each chamber about the longitudinal chamber axis in a solid phantom and a water phantom (waterproof chambers only) and measuring the angular dependence of the chamber response, and varied directly by displacing the chamber in the phantom insert using a paper shim positioned at different orientations between the chamber casing and the insert. Results: The responses of the three waterproof chambers measured on the MR-linac were 0.7%–1.2% higher with water than air in the chamber insert. The responses of the chambers on the conventional linac changed by less than 0.3% when air in the insert was replaced with water. The angular dependence of the chambers ranged from 0.6% to 1.9% in the solid phantom on the MR-linac but was less than 0.5% in water on the MR-linac and less than 0.3% in the solid phantom on the conventional linac. Inserting a shim around the chamber induced changes of the chamber response in a magnetic field of up to 2.2%, but the change in chamber response on the conventional linac was less than 0.3%. Conclusions: The interaction between the magnetic field and secondary electrons in the air around the chamber reduces the charge collected from 0.7% to 1.2%. The large angular dependence of ion chambers measured in the plastic phantom in a magnetic field appears to arise from a change of air distribution as the chamber is moved within the insert, rather than an intrinsic isotropy of the chamber sensitivity to radiation. It is recommended that reference dosimetry measurements on the MR-linac can be performed only in water, rather than in existing plastic phantoms.« less

The development of magnetic field measurement system for drift-tube linac quadrupole

NASA Astrophysics Data System (ADS)

Zhou, Jianxin; Kang, Wen; Yin, Baogui; Peng, Quanling; Li, Li; Liu, Huachang; Gong, Keyun; Li, Bo; Chen, Qiang; Li, Shuai; Liu, Yiqin

2015-06-01

In the China Spallation Neutron Source (CSNS) linac, a conventional 324 MHz drift-tube linac (DTL) accelerating an H- ion beam from 3 MeV to 80 MeV has been designed and manufactured. The electromagnetic quadrupoles (EMQs) are widely used in a DTL accelerator. The main challenge of DTLQ's structure is to house a strong gradient EMQ in the much reduced space of the drift-tube (DT). To verify the DTLQ's design specifications and fabrication quality, a precision harmonic coil measurement system has been developed, which is based on the high precision movement platform, the harmonic coil with ceramic frame and the special method to make the harmonic coil and the quadrupoles coaxial. After more than one year's continuous running, the magnetic field measurement system still performs accurately and stably. The field measurement of more than one hundred DTLQ has been finished. The components and function of the measurement system, the key point of the technology and the repeatability of the measurement results are described in this paper.

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

PubMed Central

Yang, Fei; Cao, Ning; Meyer, Juergen

2016-01-01

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

WE-G-BRD-08: Motion Analysis for Rectal Cancer: Implications for Adaptive Radiotherapy On the MR-Linac

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

Kleijnen, J; Asselen, B van; Burbach, M

2015-06-15

Purpose: Purpose of this study is to find the optimal trade-off between adaptation interval and margin reduction and to define the implications of motion for rectal cancer boost radiotherapy on a MR-linac. Methods: Daily MRI scans were acquired of 16 patients, diagnosed with rectal cancer, prior to each radiotherapy fraction in one week (N=76). Each scan session consisted of T2-weighted and three 2D sagittal cine-MRI, at begin (t=0 min), middle (t=9:30 min) and end (t=18:00 min) of scan session, for 1 minute at 2 Hz temporal resolution. Tumor and clinical target volume (CTV) were delineated on each T2-weighted scan andmore » transferred to each cine-MRI. The start frame of the begin scan was used as reference and registered to frames at time-points 15, 30 and 60 seconds, 9:30 and 18:00 minutes and 1, 2, 3 and 4 days later. Per time-point, motion of delineated voxels was evaluated using the deformation vector fields of the registrations and the 95th percentile distance (dist95%) was calculated as measure of motion. Per time-point, the distance that includes 90% of all cases was taken as estimate of required planning target volume (PTV)-margin. Results: Highest motion reduction is observed going from 9:30 minutes to 60 seconds. We observe a reduction in margin estimates from 10.6 to 2.7 mm and 16.1 to 4.6 mm for tumor and CTV, respectively, when adapting every 60 seconds compared to not adapting treatment. A 75% and 71% reduction, respectively. Further reduction in adaptation time-interval yields only marginal motion reduction. For adaptation intervals longer than 18:00 minutes only small motion reductions are observed. Conclusion: The optimal adaptation interval for adaptive rectal cancer (boost) treatments on a MR-linac is 60 seconds. This results in substantial smaller PTV-margin estimates. Adaptation intervals of 18:00 minutes and higher, show little improvement in motion reduction.« less

[The beginning of stereotactic treatment of extrapyramidal disorders in Poland].

PubMed

Gościński, Igor; Moskała, Marek; Polak, Jarosław

2003-01-01

Oskar Liszka in cooperation with I. Gościński i Z. Wicentowicz in 1961 introduced in Poland Guiot-Gillingham stereotactic method of operation and then modified it in 1967. In the next years stereotactic procedures in extrapyramidal diseases were performed also in Warszawa--J. Subczyński, E. Mempel and J. Bidziński, in Białystok J. Łebkowski, in Szczecin J. Slósarek and I. Kojder, in Bydgoszcz M. Harat, in Gdańsk P. Słoniewski. Contemporary W. Koszewski and M. Zabek in Warszawa. In Lublin T. Trojanowski et al. use stereotactic radiotherapy in the treatment of angiomas of the brain.

Accuracy of magnetic resonance imaging stereotactic coordinates with the cosman-roberts-wells frame.

PubMed

Carter, D A; Parsai, E I; Ayyangar, K M

1999-01-01

Quality assessment on the accuracy of a Cosman-Roberts-Wells (CRW) magnetic resonance imaging (MRI) stereotactic ring which had nonferrous stainless steel screws and positioning posts and a localizer with petroleum jelly in the fiducials, purchased in 1994, revealed errors of greater than 4 mm with targets in phantoms. Image fusion of objects within the phantom indicated the central area was accurately depicted by CT or MRI. We then tested a newer CRW- MRI ring (MRIA-IHR with titanium screws and posts) and localizer (MRIA-2-LF with fiducials filled with copper sulfate) and found that the MRI stereotactically calculated target coordinates matched both the known position of these targets in the phantom as well as the CT stereotactically calculated coordinates within approximately 1 mm. We also describe excellent superimposition of CT and MRI stereotactically determined surfaces in a recent clinical case using the new hardware. This shows that recent modifications to the CRW-MRI stereotactic system can make it accurate for small targets, but we emphasize that all systems need to undergo ongoing local quality assessment to ensure acceptable accuracy in practice. Copyright 2000 S. Karger AG, Basel

Transport and energy selection of laser generated protons for postacceleration with a compact linac

NASA Astrophysics Data System (ADS)

Sinigardi, Stefano; Turchetti, Giorgio; Londrillo, Pasquale; Rossi, Francesco; Giove, Dario; De Martinis, Carlo; Sumini, Marco

2013-03-01

Laser accelerated proton beams have a considerable potential for various applications including oncological therapy. However, the most consolidated target normal sheath acceleration regime based on irradiation of solid targets provides an exponential energy spectrum with a significant divergence. The low count number at the cutoff energy seriously limits at present its possible use. One realistic scenario for the near future is offered by hybrid schemes. The use of transport lines for collimation and energy selection has been considered. We present here a scheme based on a high field pulsed solenoid and collimators which allows one to select a beam suitable for injection at 30 MeV into a compact linac in order to double its energy while preserving a significant intensity. The results are based on a fully 3D simulation starting from laser acceleration.

The contemporary practice of psychiatric surgery: results from a global survey of functional neurosurgeons.

PubMed

Mendelsohn, Daniel; Lipsman, Nir; Lozano, Andres M; Taira, Takaomi; Bernstein, Mark

2013-01-01

Interest in neurosurgery for psychiatric diseases (NPD) has grown globally. We previously reported the results of a survey of North American functional neurosurgeons that evaluated general attitudes towards NPD and the future directions of the field. The purpose of this study was to expand on our previous work and obtain a snapshot in time of global attitudes towards NPD among practicing functional neurosurgeons. We measure general and regional trends in functional neurosurgery and focus specifically on surgery for mind and mood, while exploring the future prospects of the field. We designed an online survey and distributed it electronically to 881 members of the following international organizations: World Society for Stereotactic and Functional Neurosurgery, European Society for Stereotactic and Functional Neurosurgery, Asian-Australasian Society for Stereotactic Functional Neurosurgery and the South and Latin American Society for Stereotactic and Functional Neurosurgery. Subsequent statistical and thematic analysis was performed on the data obtained. Of 881 surveys distributed, 106 were returned (12.8%). Eighty-two percent of functional neurosurgeon respondents were fellowship trained, with movement disorders and pain making up the majority of their practice. Psychiatric indications are the most frequently treated conditions for 34% of survey respondents, and over half of participants (51%) perform epilepsy surgery. Of the psychiatric conditions, obsessive-compulsive disorder and depression are the most common disorders treated. The majority of respondents (90%) felt optimistic about the future of NPD. Two thirds cited the reluctance of psychiatrists to refer patients as the greatest obstacle facing the field, and a majority reported that a cultural stigma surrounding psychiatric diseases exists in their community. In response to hypothetical situations involving cognitive and personality enhancement, opinions varied, but the majority opposed enhancement interventions. Regional variations were examined as well and uncovered distinct attitudinal differences depending on geographic location. Surgery for psychiatric conditions is an expanding field within functional neurosurgery. The opinions of international functional neurosurgeons were largely in line with those of their North American colleagues. Optimism regarding the future of NPD predominates, and future editions of this survey can be used to track the evolution of neurosurgeons' attitudes towards NPD and neuroenhancement. Copyright © 2013 S. Karger AG, Basel.

Stereoelectroencephalography based on the Leksell stereotactic frame and Neurotech operation planning software.

PubMed

Zhang, Guangming; Chen, Guoqiang; Meng, Dawei; Liu, Yanwu; Chen, Jianwei; Shu, Lanmei; Liu, Wenbo

2017-06-01

This study aimed to introduce a new stereoelectroencephalography (SEEG) system based on Leksell stereotactic frame (L-SEEG) as well as Neurotech operation planning software, and to investigate its safety, applicability, and reliability.L-SEEG, without the help of navigation, includes SEEG operation planning software (Neurotech), Leksell stereotactic frame, and corresponding surgical instruments. Neurotech operation planning software can be used to display three-dimensional images of the cortex and cortical vessels and to plan the intracranial electrode implantation. In 44 refractory epilepsy patients, 364 intracranial electrodes were implanted through the L-SEEG system, and the postoperative complications such as bleeding, cerebral spinal fluid (CSF) leakage, infection, and electrode-related problems were also investigated.All electrodes were implanted accurately as preoperatively planned shown by postoperative lamina computed tomography and preoperative lamina magnetic resonance imaging. There was no severe complication after intracranial electrode implantation through the L-SEEG system. There were no electrode-related problems, no CSF leakage and no infection after surgery. All the patients recovered favorably after SEEG electrode implantation, and only 1 patient had asymptomatic frontal lateral ventricle hematoma (3 mL).The L-SEEG system with Neurotech operation planning software can be used for safe, accurate, and reliable intracranial electrode implantation for SEEG.

Atlas-based system for functional neurosurgery

NASA Astrophysics Data System (ADS)

Nowinski, Wieslaw L.; Yeo, Tseng T.; Yang, Guo L.; Dow, Douglas E.

1997-05-01

This paper addresses the development of an atlas-based system for preoperative functional neurosurgery planning and training, intraoperative support and postoperative analysis. The system is based on Atlas of Stereotaxy of the Human Brain by Schaltenbrand and Wahren used for interactive segmentation and labeling of clinical data in 2D/3D, and for assisting stereotactic targeting. The atlas microseries are digitized, enhanced, segmented, labeled, aligned and organized into mutually preregistered atlas volumes 3D models of the structures are also constructed. The atlas may be interactively registered with the actual patient's data. Several other features are also provided including data reformatting, visualization, navigation, mensuration, and stereotactic path display and editing in 2D/3D. The system increases the accuracy of target definition, reduces the time of planning and time of the procedure itself. It also constitutes a research platform for the construction of more advanced neurosurgery supporting tools and brain atlases.

Spatial Distortion in MRI-Guided Stereotactic Procedures: Evaluation in 1.5-, 3- and 7-Tesla MRI Scanners.

PubMed

Neumann, Jan-Oliver; Giese, Henrik; Biller, Armin; Nagel, Armin M; Kiening, Karl

2015-01-01

Magnetic resonance imaging (MRI) is replacing computed tomography (CT) as the main imaging modality for stereotactic transformations. MRI is prone to spatial distortion artifacts, which can lead to inaccuracy in stereotactic procedures. Modern MRI systems provide distortion correction algorithms that may ameliorate this problem. This study investigates the different options of distortion correction using standard 1.5-, 3- and 7-tesla MRI scanners. A phantom was mounted on a stereotactic frame. One CT scan and three MRI scans were performed. At all three field strengths, two 3-dimensional sequences, volumetric interpolated breath-hold examination (VIBE) and magnetization-prepared rapid acquisition with gradient echo, were acquired, and automatic distortion correction was performed. Global stereotactic transformation of all 13 datasets was performed and two stereotactic planning workflows (MRI only vs. CT/MR image fusion) were subsequently analysed. Distortion correction on the 1.5- and 3-tesla scanners caused a considerable reduction in positional error. The effect was more pronounced when using the VIBE sequences. By using co-registration (CT/MR image fusion), even a lower positional error could be obtained. In ultra-high-field (7 T) MR imaging, distortion correction introduced even higher errors. However, the accuracy of non-corrected 7-tesla sequences was comparable to CT/MR image fusion 3-tesla imaging. MRI distortion correction algorithms can reduce positional errors by up to 60%. For stereotactic applications of utmost precision, we recommend a co-registration to an additional CT dataset. © 2015 S. Karger AG, Basel.

Stereotactic amygdalotomy in the management of severe aggressive behavioral disorders.

PubMed

Mpakopoulou, Maria; Gatos, Haralambos; Brotis, Alexandros; Paterakis, Konstantinos N; Fountas, Kostas N

2008-01-01

Stereotactic amygdalotomy has been utilized as a surgical treatment for severe aggressive behavioral disorders. Several clinical studies have been reported since the first description of the procedure. In the current study, the authors reviewed the literature and evaluated the surgical results, neuropsychological outcome, and complication rate in patients who had undergone stereotactic amygdalotomy for severe aggressive behavioral disorders. The PubMed database was searched using the following terms: "amygdalotomy," "amygdalectomy," "amygdaloidectomy," "psychosurgery," "aggressive disorder," and "behavioral disorder." Clinical series with more than 5 patients undergoing stereotactic amygdalotomy for aggressive or other behavioral disorders were included in this review. The surgical technique, anatomical target, improvement in psychiatric symptomatology, postoperative employment and social rehabilitation, postoperative neurocognitive function, procedure-related complications, and long-term follow-up were evaluated. Thirteen clinical studies met our inclusion criteria. Reported postoperative improvement in aggressive behavior varied between 33 and 100%. Procedure-related complication rates ranged from 0 to 42%, whereas the mortality rate was as high as 3.8%. In the majority of the reviewed clinical series, the performance of stereotactic amygdalotomy did not compromise a patient's learning, language, and intellectual capabilities. The long-term follow-up, although very limited, revealed that initially observed improvement was maintained in most cases. Stereotactic amygdalotomy can be considered a valid surgical treatment option for carefully selected patients with medically refractory aggressive behavioral disorders. Recent advances in imaging and stereotactic navigation can further improve outcome and minimize the complication rate associated with this psychosurgical procedure.

A computational model to compare different investment scenarios for mini-stereotactic frame approach to deep brain stimulation surgery.

PubMed

Lanotte, M; Cavallo, M; Franzini, A; Grifi, M; Marchese, E; Pantaleoni, M; Piacentino, M; Servello, D

2010-09-01

Deep brain stimulation (DBS) alleviates symptoms of many neurological disorders by applying electrical impulses to the brain by means of implanted electrodes, generally put in place using a conventional stereotactic frame. A new image guided disposable mini-stereotactic system has been designed to help shorten and simplify DBS procedures when compared to standard stereotaxy. A small number of studies have been conducted which demonstrate localization accuracies of the system similar to those achievable by the conventional frame. However no data are available to date on the economic impact of this new frame. The aim of this paper was to develop a computational model to evaluate the investment required to introduce the image guided mini-stereotactic technology for stereotactic DBS neurosurgery. A standard DBS patient care pathway was developed and related costs were analyzed. A differential analysis was conducted to capture the impact of introducing the image guided system on the procedure workflow. The analysis was carried out in five Italian neurosurgical centers. A computational model was developed to estimate upfront investments and surgery costs leading to a definition of the best financial option to introduce the new frame. Investments may vary from Euro 1.900 (purchasing of Image Guided [IG] mini-stereotactic frame only) to Euro 158.000.000. Moreover the model demonstrates how the introduction of the IG mini-stereotactic frame doesn't substantially affect the DBS procedure costs.

Progress update on cryogenic system for ARIEL E-linac at TRIUMF

NASA Astrophysics Data System (ADS)

Koveshnikov, A.; Bylinskii, I.; Hodgson, G.; Yosifov, D.

2014-01-01

TRIUMF is involved in a major upgrade. The Advanced Rare IsotopeE Laboratory (ARIEL) has become a fully funded project in July 2010. A 10 mA 50 MeV SRF electron linac (e-linac) operating CW at 1.3 GHz is the key component of this initiative. This machine will serve as a second independent photo-fission driver for Rare Isotope Beams (RIB) production at TRIUMF's Isotope Separator and Accelerator (ISAC) facility. The cryogens delivery system requirements are driven by the electron accelerator cryomodule design [1, 2]. Since commencement of the project in 2010 the cryogenic system of e-linac has moved from the conceptual design phase into engineering design and procurement stage. The present document summarizes the progress in cryogenic system development and construction. Current status of e-linac cryogenic system including details of LN2 storage and delivery systems, and helium subatmospheric (SA) system is presented. The first phase of e-linac consisting of two cryomodules, cryogens storage, delivery, and distribution systems, and a 600 W class liquid helium cryoplant is scheduled for installation and commissioning by year 2014.

Development of 3He LPSDs and read-out system for the SANS spectrometer at CPHS

NASA Astrophysics Data System (ADS)

Huang, T. C.; Gong, H.; Shao, B. B.; Wang, X. W.; Zhang, Y.; Pang, B. B.

2014-01-01

The Compact Pulsed Hadron Source (CPHS) is a 13-MeV proton-linac-driven neutron source under construction in Tsinghua University. Time-of-flight (TOF) small-angle neutron scattering (SANS) spectrometer is one of the first instruments to be built. It is designed to use linear position-sensitive detectors (LPSDs) of 3He gas proportional counters to cover a 1 m×1 m area. Prototypical LPSDs (Φ = 12 mm, L=1 m) have been made and read-out system is developed based on charge division. This work describes the in-house fabrication of the prototypical LPSDs and design of the read-out system including front-end electronics and data acquisition (DAQ) system. Key factors of the front-end electronics are studied and optimized with PSPICE simulation. DAQ system is designed based on VME bus architecture and FPGA Mezzanine Card (FMC) standard with high flexibility and extendibility. Preliminary experiments are carried out and the results are present and discussed.

Planning Target Volume D95 and Mean Dose Should Be Considered for Optimal Local Control for Stereotactic Ablative Radiation Therapy

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

Zhao, Lina; Zhou, Shouhao; Balter, Peter

Purpose: To identify the optimal dose parameters predictive for local/lobar control after stereotactic ablative radiation therapy (SABR) in early-stage non-small cell lung cancer (NSCLC). Methods and Materials: This study encompassed a total of 1092 patients (1200 lesions) with NSCLC of clinical stage T1-T2 N0M0 who were treated with SABR of 50 Gy in 4 fractions or 70 Gy in 10 fractions, depending on tumor location/size, using computed tomography-based heterogeneity corrections and a convolution superposition calculation algorithm. Patients were monitored by chest CT or positron emission tomography/CT and/or biopsy after SABR. Factors predicting local/lobar recurrence (LR) were determined by competing risk multivariate analysis.more » Continuous variables were divided into 2 subgroups at cutoff values identified by receiver operating characteristic curves. Results: At a median follow-up time of 31.7 months (interquartile range, 14.8-51.3 months), the 5-year time to local recurrence within the same lobe and overall survival rates were 93.8% and 44.8%, respectively. Total cumulative number of patients experiencing LR was 40 (3.7%), occurring at a median time of 14.4 months (range, 4.8-46 months). Using multivariate competing risk analysis, independent predictive factors for LR after SABR were minimum biologically effective dose (BED{sub 10}) to 95% of planning target volume (PTVD95 BED{sub 10}) ≤86 Gy (corresponding to PTV D95 physics dose of 42 Gy in 4 fractions or 55 Gy in 10 fractions) and gross tumor volume ≥8.3 cm{sup 3}. The PTVmean BED{sub 10} was highly correlated with PTVD95 BED{sub 10.} In univariate analysis, a cutoff of 130 Gy for PTVmean BED{sub 10} (corresponding to PTVmean physics dose of 55 Gy in 4 fractions or 75 Gy in 10 fractions) was also significantly associated with LR. Conclusions: In addition to gross tumor volume, higher radiation dose delivered to the PTV predicts for better local/lobar control. We recommend that both PTVD95 BED{sub 10} >86 Gy and PTVmean BED{sub 10} >130 Gy should be considered for SABR plan optimization.« less

Design and experiments of RF transverse focusing in S-Band, 1 MeV standing wave linac

NASA Astrophysics Data System (ADS)

Mondal, J.; Chandan, Shiv; Parashar, S.; Bhattacharjee, D.; Tillu, A. R.; Tiwari, R.; Jayapraksh, D.; Yadav, V.; Banerjee, S.; Choudhury, N.; Ghodke, S. R.; Dixit, K. P.; Nimje, V. T.

2015-09-01

S-Band standing wave (SW) linacs in the range of 1-10 MeV have many potential industrial applications world wide. In order to mitigate the industrial requirement it is required to reduce the overall size and weight of the system. On this context a 2856 M Hz, 1 Me V, bi-periodic on axis coupled self transverse focused SW linac has been designed and tested. The RF phase focusing is achieved by introducing an asymmetric field distribution in the first cell of the 1 MeV linac. The pulsed electron beam of 40 keV, 650 mA and 5 μs duration is injected from a LaB6 thermionic gun. This paper presents the structure design, beam dynamics simulation, fabrication and experimental results of the 1 MeV auto-focusing SW linac.

Immunotherapy Combined with Large Fractions of Radiotherapy: Stereotactic Radiosurgery for Brain Metastases—Implications for Intraoperative Radiotherapy after Resection

PubMed Central

Herskind, Carsten; Wenz, Frederik; Giordano, Frank A.

2017-01-01

Brain metastases (BM) affect approximately a third of all cancer patients with systemic disease. Treatment options include surgery, whole-brain radiotherapy, or stereotactic radiosurgery (SRS) while chemotherapy has only limited activity. In cases where patients undergo resection before irradiation, intraoperative radiotherapy (IORT) to the tumor bed may be an alternative modality, which would eliminate the repopulation of residual tumor cells between surgery and postoperative radiotherapy. Accumulating evidence has shown that high single doses of ionizing radiation can be highly efficient in eliciting a broad spectrum of local, regional, and systemic tumor-directed immune reactions. Furthermore, immune checkpoint blockade (ICB) has proven effective in treating antigenic BM and, thus, combining IORT with ICB might be a promising approach. However, it is not known if a low number of residual tumor cells in the tumor bed after resection is sufficient to act as an immunizing event opening the gate for ICB therapies in the brain. Because immunological data on tumor bed irradiation after resection are lacking, a rationale for combining IORT with ICB must be based on mechanistic insight from experimental models and clinical studies on unresected tumors. The purpose of the present review is to examine the mechanisms by which large radiation doses as applied in SRS and IORT enhance antitumor immune activity. Clinical studies on IORT for brain tumors, and on combined treatment of SRS and ICB for unresected BM, are used to assess the safety, efficacy, and immunogenicity of IORT plus ICB and to suggest an optimal treatment sequence. PMID:28791250

Immunotherapy Combined with Large Fractions of Radiotherapy: Stereotactic Radiosurgery for Brain Metastases-Implications for Intraoperative Radiotherapy after Resection.

PubMed

Herskind, Carsten; Wenz, Frederik; Giordano, Frank A

2017-01-01

Brain metastases (BM) affect approximately a third of all cancer patients with systemic disease. Treatment options include surgery, whole-brain radiotherapy, or stereotactic radiosurgery (SRS) while chemotherapy has only limited activity. In cases where patients undergo resection before irradiation, intraoperative radiotherapy (IORT) to the tumor bed may be an alternative modality, which would eliminate the repopulation of residual tumor cells between surgery and postoperative radiotherapy. Accumulating evidence has shown that high single doses of ionizing radiation can be highly efficient in eliciting a broad spectrum of local, regional, and systemic tumor-directed immune reactions. Furthermore, immune checkpoint blockade (ICB) has proven effective in treating antigenic BM and, thus, combining IORT with ICB might be a promising approach. However, it is not known if a low number of residual tumor cells in the tumor bed after resection is sufficient to act as an immunizing event opening the gate for ICB therapies in the brain. Because immunological data on tumor bed irradiation after resection are lacking, a rationale for combining IORT with ICB must be based on mechanistic insight from experimental models and clinical studies on unresected tumors. The purpose of the present review is to examine the mechanisms by which large radiation doses as applied in SRS and IORT enhance antitumor immune activity. Clinical studies on IORT for brain tumors, and on combined treatment of SRS and ICB for unresected BM, are used to assess the safety, efficacy, and immunogenicity of IORT plus ICB and to suggest an optimal treatment sequence.

Radiobiology of hypofractionated stereotactic radiotherapy: what are the optimal fractionation schedules?

PubMed Central

Shibamoto, Yuta; Miyakawa, Akifumi; Otsuka, Shinya; Iwata, Hiromitsu

2016-01-01

In hypofractionated stereotactic radiotherapy (SRT), high doses per fraction are usually used and the dose delivery pattern is different from that of conventional radiation. The daily dose is usually given intermittently over a longer time compared with conventional radiotherapy. During prolonged radiation delivery, sublethal damage repair takes place, leading to the decreased effect of radiation. In in vivo tumors, however, this decrease in effect may be counterbalanced by rapid reoxygenation. Another issue related to hypofractionated SRT is the mathematical model for dose evaluation and conversion. The linear–quadratic (LQ) model and biologically effective dose (BED) have been suggested to be incorrect when used for hypofractionation. The LQ model overestimates the effect of high fractional doses of radiation. BED is particularly incorrect when used for tumor responses in vivo, since it does not take reoxygenation into account. Correction of the errors, estimated at 5–20%, associated with the use of BED is necessary when it is used for SRT. High fractional doses have been reported to exhibit effects against tumor vasculature and enhance host immunity, leading to increased antitumor effects. This may be an interesting topic that should be further investigated. Radioresistance of hypoxic tumor cells is more problematic in hypofractionated SRT, so trials of hypoxia-targeted agents are encouraged in the future. In this review, the radiobiological characteristics of hypofractionated SRT are summarized, and based on the considerations, we would like to recommend 60 Gy in eight fractions delivered three times a week for lung tumors larger than 2 cm in diameter. PMID:27006380

Energy-Recovery Linacs for Commercial Radioisotope Production

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

Johnson, Rolland Paul

Most radioisotopes are produced by nuclear reactors or positive ion accelerators, which are expensive to construct and to operate. Photonuclear reactions using bremsstrahlung photon beams from less-expensive electron linacs can generate isotopes of critical interest, but much of the beam energy in a conventional electron linac is dumped at high energy, making unwanted radioactivation. The largest part of this radioactivation may be completely eliminated by applying energy recovery linac technology to the problem with an additional benefit that the energy cost to produce a given amount of isotope is reduced. Consequently, a Superconducting Radio Frequency (SRF) Energy Recovery Linac (ERL)more » is a path to a more diverse and reliable domestic supply of short-lived, high-value, high-demand isotopes at a cost lower than that of isotopes produced by reactors or positive-ion accelerators. A Jefferson Lab approach to this problem involves a thin photon production radiator, which allows the electron beam to recirculate through rf cavities so the beam energy can be recovered while the spent electrons are extracted and absorbed at a low enough energy to minimize unwanted radioactivation. The thicker isotope photoproduction target is not in the beam. MuPlus, with Jefferson Lab and Niowave, proposed to extend this ERL technology to the commercial world of radioisotope production. In Phase I we demonstrated that 1) the ERL advantage for producing radioisotopes is at high energies (~100 MeV), 2) the range of acceptable radiator thickness is narrow (too thin and there is no advantage relative to other methods and too thick means energy recovery is too difficult), 3) using optics techniques developed under an earlier STTR for collider low beta designs greatly improves the fraction of beam energy that can be recovered (patent pending), 4) many potentially useful radioisotopes can be made with this ERL technique that have never before been available in significant commercial quantities. We developed a plan for the Phase II project that started with a Conceptual Design Report (CDR) based on the results of the Phase I studies and concluded with a Technical Design Report (TDR) for a facility to make isotopes that are most attractive based on market analyses.« less

Interlock system for machine protection of the KOMAC 100-MeV proton linac

NASA Astrophysics Data System (ADS)

Song, Young-Gi

2015-02-01

The 100-MeV proton linear accelerator of the Korea Multi-purpose Accelerator Complex (KOMAC) has been developed. The beam service started this year after performing the beam commissioning. If the very sensitive and essential equipment is to be protected during machine operation, a machine interlock system is required, and the interlock system has been implemented. The purpose of the interlock system is to shut off the beam when the radio-frequency (RF) and ion source are unstable or a beam loss occurs. The interlock signal of the KOMAC linac includes a variety of sources, such as the beam loss, RF and high-voltage converter modulator faults, and fast closing valves of the vacuum window at the beam lines and so on. This system consists of a hardware-based interlock system using analog circuits and a software-based interlock system using an industrial programmable logic controller (PLC). The hardware-based interlock system has been fabricated, and the requirement has been satisfied with the results being within 10 µs. The software logic interlock system using the PLC has been connected to the framework of with the experimental physics and industrial control system (EPICS) to integrate a variety of interlock signals and to control the machine components when an interlock occurs. This paper will describe the design and the construction of the machine interlock system for the KOMAC 100-MeV linac.

Design of a CW high charge state heavy ion RFQ for SSC-LINAC

NASA Astrophysics Data System (ADS)

Liu, G.; Lu, Y. R.; He, Y.; Wang, Z.; Xiao, C.; Gao, S. L.; Yang, Y. Q.; Zhu, K.; Yan, X. Q.; Chen, J. E.; Yuan, Y. J.; Zhao, H. W.

2013-02-01

The new linac injector SSC-LINAC has been proposed to replace the existing Separator Sector Cyclotron (SSC). This effort is to improve the beam efficiency of the Heavy Ion Research Facility of Lanzhou (HIRFL). As a key component of the linac, a continuous-wave (CW) mode high charge state heavy ion radio-frequency quadrupole (RFQ) accelerator has been designed. It accelerates ions with the ratio of mass to charge up to 7 from 3.728 keV/u to 143 keV/u. The requirements of CW mode operation and the transportation of intense beam have been considered as the greatest challenges. The design is based on 238U34+ beams, whose current is 0.5 pmA (0.5 particle mili-ampere, which is the measured 17 emA electric current divided by charge state of heavy ions). It achieves the transmission efficiency of 94% with 2508.46 mm long vanes in simulation. To improve the transmission efficiency and quality of the beams, the phase advance has been taken into account to analyze the reasons of beam loss and emittance growth. Parametric resonance and beam mismatch have been carefully avoided by adjusting the structure parameters. The parameter-sensitivity of the design is checked by transportation simulations of various input beams. To verify the applicability of machining, the effects of different vane manufacturing methods on beam dynamics are presented in this paper.

Beam dynamics pre-study for the RFQ of SPPC p-Linac

NASA Astrophysics Data System (ADS)

Liu, Jing; Lu, Yuanrong; Li, Haipeng; Su, Jiancang; Liu, Xiaolong

2018-02-01

A proton-proton collider at center-of-mass energy of more than 70 TeV is the second stage of the CEPC-SPPC program. As proposed, the SPPC injector chain will use a 1.2 GeV p-Linac and three synchrotrons of 10 GeV p-RCS, 180 GeV MSS and 2.1 TeV SS. Peking University is responsible for the preliminary conceptual design of the room temperature part of SPPC p-Linac. This paper is focusing on the beam dynamics studies performed with respect to the 325 MHz RFQ. As the first accelerator structure after the ion source and the front-end of the whole SPPC, RFQ plays an important role in the beam initial transverse focusing and longitudinal bunching. Based on the New Four Section Procedure strategy, as well as the matched and Equipartitioning design method, a 3 MeV RFQ designed by Parmteq code will be introduced. The cavity length of RFQ is 3.6 m and the transmission efficiency is 98%. In this design scheme, the 40 mA proton beam from the 50 keV ion source is accelerated to 3 MeV in 3.8 m length, which achieves a sixty times energy gain. The results of the analyses show that the RFQ design is reliable and meets all the SPPC p-Linac requirements well.

Overview of High Power Vacuum Dry RF Load Designs

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

Krasnykh, Anatoly

2015-08-27

A specific feature of RF linacs based on the pulsed traveling wave (TW) mode of operation is that only a portion of the RF energy is used for the beam acceleration. The residual RF energy has to be terminated into an RF load. Higher accelerating gradients require higher RF sources and RF loads, which can stably terminate the residual RF power. RF feeders (from the RF source though the accelerating section to the load) are vacuumed to transmit multi-megawatt high power RF. This overview will outline vacuumed RF loads only. A common method to terminate multi-MW RF power is tomore » use circulated water (or other liquid) as an absorbing medium. A solid dielectric interface (a high quality ceramic) is required to separate vacuum and liquid RF absorber mediums. Using such RF load approaches in TW linacs is troubling because there is a fragile ceramic window barrier and a failure could become catastrophic for linac vacuum and RF systems. Traditional loads comprising of a ceramic disk have limited peak and average power handling capability and are therefore not suitable for high gradient TW linacs. This overview will focus on ''vacuum dry'' or ''all-metal'' loads that do not employ any dielectric interface between vacuum and absorber. The first prototype is an original design of RF loads for the Stanford Two-Mile Accelerator.« less

Comparison of doses received by the hippocampus in patients treated with single isocenter– vs multiple isocenter–based stereotactic radiation therapy to the brain for multiple brain metastases

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

Algan, Ozer, E-mail: oalgan@ouhsc.edu; Giem, Jared; Young, Julie

To investigate the doses received by the hippocampus and normal brain tissue during a course of stereotactic radiation therapy using a single isocenter (SI)–based or multiple isocenter (MI)–based treatment planning in patients with less than 4 brain metastases. In total, 10 patients with magnetic resonance imaging (MRI) demonstrating 2-3 brain metastases were included in this retrospective study, and 2 sets of stereotactic intensity-modulated radiation therapy (IMRT) treatment plans (SI vs MI) were generated. The hippocampus was contoured on SPGR sequences, and doses received by the hippocampus and the brain were calculated and compared between the 2 treatment techniques. A totalmore » of 23 lesions in 10 patients were evaluated. The median tumor volume, the right hippocampus volume, and the left hippocampus volume were 3.15, 3.24, and 2.63 mL, respectively. In comparing the 2 treatment plans, there was no difference in the planning target volume (PTV) coverage except in the tail for the dose-volume histogram (DVH) curve. The only statistically significant dosimetric parameter was the V{sub 100}. All of the other measured dosimetric parameters including the V{sub 95}, V{sub 99}, and D{sub 100} were not significantly different between the 2 treatment planning techniques. None of the dosimetric parameters evaluated for the hippocampus revealed any statistically significant difference between the MI and SI plans. The total brain doses were slightly higher in the SI plans, especially in the lower dose region, although this difference was not statistically different. The use of SI-based treatment plan resulted in a 35% reduction in beam-on time. The use of SI treatments for patients with up to 3 brain metastases produces similar PTV coverage and similar normal tissue doses to the hippocampus and the brain when compared with MI plans. SI treatment planning should be considered in patients with multiple brain metastases undergoing stereotactic treatment.« less