Engineering Papers⌕ Search

SEARCH · Engineering Papers

Results for “SWEDEN”

Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12
All sourcesNASA NTRSDOE OSTI
DOE OSTI2015

SU-E-T-150: Brachytherapy QA Employing a High Resolution Liquid Filled Ionisation Chamber Array: Initial Experience and Limitations

Purpose: Verifying a complex 3D brachytherapy dose distribution by measurement is non-trivial. Ideally a photon detector array should be independent of energy and angle, have high spatial resolution and be robust for routine clinical use. Methods: An iridium-192 source was used. A PMMA jig was constructed comprising an outer slab and a central insert with eight milled channels for 1.33mm (outer diameter) steel needles, see figure. All calculations were performed using an empty CT study reconstructing eight virtual needles (QA-CT), using the v2 source model (Elekta AG, Sweden). A high resolution liquid filled ionisation chamber array SRS1000, together with Verisoft software v6.0 (PTW Freiburg, Germany), was used to perform measurements of plans of increasing complexity to evaluate its suitability for device- and patient-specific QA. The dimension of backscatter material was investigated. The patient plan dwell time distribution was entered manually into the QA-CT and the dose distribution was calculated. Results: Our measurements indicate that the array is independent of energy and angle. The resulting measured dose values are linearly interpolated to 2025 values. Shifts of 1mm of the entire needle are readily detectable. Individual dwell position shifts (2.5mm) are also readily measurable. Moreover a dwell time increase of 1 second both in the edge and central region are detectable. Conclusion: The high resolution SRS1000 array is a powerful instrument for brachytherapy QA enabling 977 simultaneous measurements to be performed. Our measurements suggest 60mm of RW3 backscatter material upstream and downstream are sufficient. Local percentage difference analysis is useful for device based QA, normalized relative percentage difference is arguably better for patient specific QA. Automated transfer of patient plan dwell time distribution to the QA plan is required to enable a comprehensive patient QA study to be performed. Moreover the described measurement technique can be used for commissioning new brachytherapy applicators.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-194: Commissioning of Monaco Treatment Planning System On An Elekta VersaHD Linear Accelerator

Purpose: The Monaco treatment planning system (TPS) uses a Monte-Carlo algorithm based dose computation engine to model the photon beams of a linear accelerator. The aim is to perform verification of Monaco TPS beam modeling of a Elekta VersaHD linac with 6MV, 6MV FFF, 10 MV, 10MV FFF, 18MV photon beams and 160 multileaf collimators (MLC) with a projected width of 5-mm at the isocenter. Methods: A series of dosimetric tests were performed to validate Monaco calculated beams including point dose measurement in water with and without heterogeneity and 2-dimensional dose distributions on a Delta4 bi-planar diode dosimeter array (Scandidos, Uppsala, Sweden). 3D conformal beams of different field sizes, source-to-surface distances, wedges, and gantry angles were delivered onto a phantom consisting of several plastic water and Styrofoam slabs. Point dose measurements were verified with a PTW 31013 Semiflex 0.3 cc ionization chamber (PTW, Freiburg, Germany). In addition, 8 step and shoot intensity modulated radiotherapy (IMRT) and volumetric modulated arc radiotherapy (VMAT) beams included in the Monaco TPS commissioning suite were verified against measurements on Delta4 to test and fine tune parameters in the beam model. IMRT verification was computed using gamma analysis with dose difference and distance-to-agreement criteria of 3%/3mm with a dose threshold of 10%. Results: Point dose measurements agreed within 2% in the homogeneous phantom and within 3% in the heterogeneous phantom for all photon energies. IMRT beams yielded a passing percentage of 99.1±1.1% in the gamma analysis which is well above the institutional passing threshold of 90%. Conclusion: Monaco TPS commissioning was successfully performed for all the photon energies on the Elekta VersaHD linac prior to clinical usage.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-286: Dose Verification of Spot-Scanning Proton Beam Using GafChromic EBT3 Film

Purpose: Dose verification of spot-scanning proton pencil beam is performed via planar dose measurements at several depths using an ionization-chamber array, requiring repeat irradiations of each field for each depth. Here we investigate film dosimetry which has two advantages: higher resolution and efficiency from one-shot irradiation for multiple depths. Methods: Film calibration was performed using an EBT3 film at 20-cm depth of Plastic Water (CIRS, Norfolk, VA) exposed by a 10-level step wedge on a Proteus Plus proton system (IBA, Belgium). The calibration doses ranged from 25–250 cGy(RBE) for proton energies of 170–200 MeV. A uniform 1000 cm{sup 3} dose cube and a clinical prostate combined with seminal-vesicle and pelvic-nodes plan were used for this study. All treatment plans were generated in the RayStation (RaySearch Lab, Sweden). The planar doses at different depths for both cases were measured with film using triple-channel dosimetry and the MatriXX PT (IBA Dosimetry, Germany). The Gamma passing rates, dose-difference maps, and profiles of 2D planar doses measured with EBT3 film and MatriXX, versus treatment planning system (TPS) calculations were analyzed and compared using the FilmQA Pro (Ashland Inc., Bridgewater, NJ). Results: The EBT3 film measurement results matched well with the TPS calculation data with an average passing rate >95% for 2%/2mm and are comparable with the MatriXX measurements (0.7%, 1.8%, 3.8% mean differences corresponding to 3%/3mm, 3%/2mm, 2%/2mm, respectively). Overall passing rates for EBT3 films appear higher than those with MatriXX detectors. Conclusion: The energy dependence of the film response could be minimized by calibration using proton beam with mixed energies. The greater efficiency of the dose verification using GafChromic EBT3 results in a potential cost trade-off between room capacity and film cost. EBT3 film may offer distinct advantages in highly intensity-modulated fields due to its higher resolution compared to 2D ionization-chamber array detectors. One of the authors has a research grant from Ashland Inc., the manufacturer of GafChromic film.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-360: End-To-End Dosimetric Testing of a Versa HD Linear Accelerator with the Agility Head Modeled in Pinnacle3

Purpose: The Versa HD incorporates a variety of upgrades, primarily including the Agility head. The distinct dosimetric properties of the head from its predecessors combined with flattening-filter-free (FFF) beams require a new investigation of modeling in planning systems and verification of modeling accuracy. Methods: A model was created in Pinnacle{sup 3} v9.8 with commissioned beam data. Leaf transmission was modeled as <0.5% with maximum leaf speed of 3 cm/s. Photon spectra were tuned for FFF beams, for which profiles were modeled with arbitrary profiles rather than with cones. For verification, a variety of plans with varied parameters were devised, and point dose measurements were compared to calculated values. A phantom of several plastic water and Styrofoam slabs was scanned and imported into Pinnacle{sup 3}. Beams of different field sizes, SSD, wedges, and gantry angles were created. All available photon energies (6 MV, 10 MV, 18 MV, 6 FFF, 10 FFF) as well four clinical electron energies (6, 9, 12, and 15 MeV) were investigated. The plans were verified at a calculation point (8 cm deep for photons, variable for electrons) by measurement with a PTW Semiflex ionization chamber. In addition, IMRT testing was performed with three standard plans (step and shoot IMRT, small and large field VMAT plans). The plans were delivered on the Delta4 IMRT QA phantom (ScandiDos, Uppsala, Sweden). Results: Homogeneous point dose measurement agreed within 2% for all photon and electron beams. Open field photon measurements along the central axis at 100 cm SSD passed within 1%. Gamma passing rates were >99.5% for all plans with a 3%/3mm tolerance criteria. The IMRT QA results for the first 23 patients yielded gamma passing rates of 97.4±2.3%. Conclusion: The end-to-end testing ensured confidence in the ability of Pinnacle{sup 3} to model photon and electron beams with the Agility head.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-521: Investigation of the Uncertainties Involved in Secondary Neutron/gamma Production in Geant4/MCNP6 Monte Carlo Codes for Proton Therapy Application

Purpose: A major concern in proton therapy is the production of secondary neutrons causing secondary cancers, especially in young adults and children. Most utilized Monte Carlo codes in proton therapy are Geant4 and MCNP. However, the default versions of Geant4 and MCNP6 do not have suitable cross sections or physical models to properly handle secondary particle production in proton energy ranges used for therapy. In this study, default versions of Geant4 and MCNP6 were modified to better handle production of secondaries by adding the TENDL-2012 cross-section library. Methods: In-water proton depth-dose was measured at the “The Svedberg Laboratory” in Uppsala (Sweden). The proton beam was mono-energetic with mean energy of 178.25±0.2 MeV. The measurement set-up was simulated by Geant4 version 10.00 (default and modified version) and MCNP6. Proton depth-dose, primary and secondary particle fluence and neutron equivalent dose were calculated. In case of Geant4, the secondary particle fluence was filtered by all the physics processes to identify the main process responsible for the difference between the default and modified version. Results: The proton depth-dose curves and primary proton fluence show a good agreement between both Geant4 versions and MCNP6. With respect to the modified version, default Geant4 underestimates the production of secondary neutrons while overestimates that of gammas. The “ProtonInElastic” process was identified as the main responsible process for the difference between the two versions. MCNP6 shows higher neutron production and lower gamma production than both Geant4 versions. Conclusion: Despite the good agreement on the proton depth dose curve and primary proton fluence, there is a significant discrepancy on secondary neutron production between MCNP6 and both versions of Geant4. Further studies are thus in order to find the possible cause of this discrepancy or more accurate cross-sections/models to handle the nuclear interactions of protons with energy ranges used for therapy. NSERC-CRSNG’ CREATE Medical Physics Research Training Network compute calcul CANADA; McGill University health center research institute the fast foundation; LM acknowledges partial support by the CREATE Medical Physics Research Training Network grant of the Natural Sciences and Engineering; Research Council Grant number 432290.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-571: Newly Emerging Integrated Transmission Detector Systems Provide Online Quality Assurance of External Beam Radiation Therapy

Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patient treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream from the patient. Both systems demonstrate substantial utility for online treatment verification and QA of photon external beam radiotherapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

MO-F-CAMPUS-T-03: Continuous Dose Delivery with Gamma Knife Perfexion

Purpose: We propose continuous dose delivery techniques for stereotactic treatments delivered by Gamma Knife Perfexion using inverse treatment planning system that can be applied to various tumour sites in the brain. We test the accuracy of the plans on Perfexion’s planning system (GammaPlan) to ensure the obtained plans are viable. This approach introduces continuous dose delivery for Perefxion, as opposed to the currently employed step-and-shoot approaches, for different tumour sites. Additionally, this is the first realization of automated inverse planning on GammaPlan. Methods: The inverse planning approach is divided into two steps of identifying a quality path inside the target, and finding the best collimator composition for the path. To find a path, we select strategic regions inside the target volume and find a path that visits each region exactly once. This path is then passed to a mathematical model which finds the best combination of collimators and their durations. The mathematical model minimizes the dose spillage to the surrounding tissues while ensuring the prescribed dose is delivered to the target(s). Organs-at-risk and their corresponding allowable doses can also be added to the model to protect adjacent organs. Results: We test this approach on various tumour sizes and sites. The quality of the obtained treatment plans are comparable or better than forward plans and inverse plans that use step- and-shoot technique. The conformity indices in the obtained continuous dose delivery plans are similar to those of forward plans while the beam-on time is improved on average (see Table 1 in supporting document). Conclusion: We employ inverse planning for continuous dose delivery in Perfexion for brain tumours. The quality of the obtained plans is similar to forward and inverse plans that use conventional step-and-shoot technique. We tested the inverse plans on GammaPlan to verify clinical relevance. This research was partially supported by Elekta, Sweden (vendor of Gamma Knife Perfexion)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

First evaluation of the feasibility of MLC tracking using ultrasound motion estimation

Purpose: To quantify the performance of the Clarity ultrasound (US) imaging system (Elekta AB, Stockholm, Sweden) for real-time dynamic multileaf collimator (MLC) tracking. Methods: The Clarity calibration and quality assurance phantom was mounted on a motion platform moving with a periodic sine wave trajectory. The detected position of a 30 mm hypoechogenic sphere within the phantom was continuously reported via Clarity’s real-time streaming interface to an in-house tracking and delivery software and subsequently used to adapt the MLC aperture. A portal imager measured MV treatment field/MLC apertures and motion platform positions throughout each experiment to independently quantify system latency and geometric error. Based on the measured range of latency values, a prostate stereotactic body radiation therapy (SBRT) delivery was performed with three realistic motion trajectories. The dosimetric impact of system latency on MLC tracking was directly measured using a 3D dosimeter mounted on the motion platform. Results: For 2D US imaging, the overall system latency, including all delay times from the imaging and delivery chain, ranged from 392 to 424 ms depending on the lateral sector size. For 3D US imaging, the latency ranged from 566 to 1031 ms depending on the elevational sweep. The latency-corrected geometric root-mean squared error was below 0.75 mm (2D US) and below 1.75 mm (3D US). For the prostate SBRT delivery, the impact of a range of system latencies (400–1000 ms) on the MLC tracking performance was minimal in terms of gamma failure rate. Conclusions: Real-time MLC tracking based on a noninvasive US input is technologically feasible. Current system latencies are higher than those for x-ray imaging systems, but US can provide full volumetric image data and the impact of system latency was measured to be small for a prostate SBRT case when using a US-like motion input.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-C-202-03: A Tool for Automatic Calculation of Delivered Dose Variation for Off-Line Adaptive Therapy Using Cone Beam CT

Purpose: Monitoring the delivered dose is an important task for the adaptive radiotherapy (ART) and for determining time to re-plan. A software tool which enables automatic delivered dose calculation using cone-beam CT (CBCT) has been developed and tested. Methods: The tool consists of four components: a CBCT Colleting Module (CCM), a Plan Registration Moduel (PRM), a Dose Calculation Module (DCM), and an Evaluation and Action Module (EAM). The CCM is triggered periodically (e.g. every 1:00 AM) to search for newly acquired CBCTs of patients of interest and then export the DICOM files of the images and related registrations defined in ARIA followed by triggering the PRM. The PRM imports the DICOM images and registrations, links the CBCTs to the related treatment plan of the patient in the planning system (RayStation V4.5, RaySearch, Stockholm, Sweden). A pre-determined CT-to-density table is automatically generated for dose calculation. Current version of the DCM uses a rigid registration which regards the treatment isocenter of the CBCT to be the isocenter of the treatment plan. Then it starts the dose calculation automatically. The AEM evaluates the plan using pre-determined plan evaluation parameters: PTV dose-volume metrics and critical organ doses. The tool has been tested for 10 patients. Results: Automatic plans are generated and saved in the order of the treatment dates of the Adaptive Planning module of the RayStation planning system, without any manual intervention. Once the CTV dose deviates more than 3%, both email and page alerts are sent to the physician and the physicist of the patient so that one can look the case closely. Conclusion: The tool is capable to perform automatic dose tracking and to alert clinicians when an action is needed. It is clinically useful for off-line adaptive therapy to catch any gross error. Practical way of determining alarming level for OAR is under development.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-P-28: A Method of Maximize the Noncoplanar Beam Orientations and Assure the Beam Delivery Clearance for Stereotactic Body Radiation Therapy (SBRT)

Purpose: Develop a method to maximize the noncoplanar beam orientations and assure the beam delivery clearance for SBRT, therefore, optimize the dose conformality to the target, increase the dose sparing to the critical normal organs and reduce the hot spots in the body. Methods: A SBRT body frame (Elekta, Stockholm, Sweden) was used for patient immobilization and target localization. The SBRT body frame has CT fiducials on its side frames. After patient’s CT scan, the radiation treatment isocenter was defined and its coordinators referring to the body frame was calculated in the radiation treatment planning process. Meanwhile, initial beam orientations were designed based on the patient target and critical organ anatomy. The body frame was put on the linear accelerator couch and positioned to the calculated isocenter. Initially designed beam orientations were manually measured by tuning the body frame position on the couch, the gantry and couch angles. The finalized beam orientations were put into the treatment planning for dosimetric calculations. Results: Without patient presence, an optimal set of beam orientations were designed and validated. The radiation treatment plan was optimized and guaranteed for delivery clearance. Conclusion: The developed method is beneficial and effective in SBRT treatment planning for individual patient. It first allows maximizing the achievable noncoplanar beam orientation space, therefore, optimize the treatment plan for specific patient. It eliminates the risk that a plan needs to be modified due to the gantry and couch collision during patient setup.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-J-16: Planar KV Imaging Dose Reduction Study

Purpose: IGRT has become an indispensable tool in modern radiotherapy with kV imaging used in many departments due to superior image quality and lower dose when compared to MV imaging. Many departments use manufacturer supplied protocols for imaging which are not always optimised between image quality and radiation dose (ALARA). Methods: Whole body phantom PBU-50 (Kyoto Kagaku ltd., Japan) for imaging in radiology has been imaged on Varian iX accelerator (Varian Medical Systems, USA) with OBI 1.5 system. Manufacturer’s default protocols were adapted by modifying kV and mAs values when imaging different anatomical regions of the phantom (head, thorax, abdomen, pelvis, extremities). Images with different settings were independently reviewed by two persons and their suitability for IGRT set-up correction protocols were evaluated. The suitable images with the lowest mAs were then selected. The entrance surface dose (ESD) for manufacturer’s default protocols and modified protocols were measured with RTI Black Piranha (RTI Group, Sweden) and compared. Image quality was also measured with kVQC phantom (Standard Imaging, USA) for different protocols. The modified protocols have been applied for clinical work. Results: For most cases optimized protocols reduced the ESD on average by a factor of 3(range 0.9–8.5). Further reduction in ESD has been observed by applying bow-tie filter designed for CBCT. The largest reduction in dose (12.2 times) was observed for Thorax lateral protocol. The dose was slightly increased (by 10%) for large pelvis AP protocol. Conclusion: Manufacturer’s default IGRT protocols could be optimised to reduce the ESD to the patient without losing the necessary image quality for patient set-up correction. For patient set-up with planar kV imaging the bony anatomy is mostly used and optimization should focus on this aspect. Therefore, the current approach with anthropomorphic phantom is more advantageous in optimization over standard kV quality control phantoms and SNR metrics.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-J-22: Lung VolumeVariability Assessed by Bh-CBCT in 3D Surface Image Guided Deep InspirationBreath Hold (DIBH) Radiotherapy for Left-Sided Breast Cancer

Purpose: With the increasing use of DIBH techniques for left-sided breast cancer, 3D surface-image guided DIBH techniques have improved patient setup and facilitated DIBH radiation delivery. However, quantification of the daily separation between the heart and left breast still presents a challenge. One method of assuring separation is to ensure consistent left lung filling. With this in mind, the aim of this study is to retrospectively quantify left lung volume from weekly breath hold-CBCTs (bh-CBCT) of left-sided breast patients treated using a 3D surface imaging system. Methods: Ten patients (n=10) previously treated to the left breast using the C-Rad CatalystHD system (C-RAD AG, Uppsala Sweden) were evaluated. Patients were positioned with CatalystHD and with bh-CBCT. bh-CBCTs were acquired at the validation date, first day of treatment and at subsequent weekly intervals. Total treatment courses spanned from 3 to 5 weeks. bh-CBCT images were exported to VelocityAI and the left lung volume was segmented. Volumes were recorded and analyzed. Results: A total of 41 bh-CBCTs were contoured in VelocityAI for the 10 patients. The mean left lung volume for all patients was 1657±295cc based on validation bh-CBCT. With the subsequent lung volumes normalized to the validation lung volume, the mean relative ratios for all patients were 1.02±0.11, 0.97±0.14, 0.98±0.11, 1.02±0.01, and 0.96±0.02 for week 1, 2, 3, 4, and 5, respectively. Overall, the mean left lung volume change was ≤4.0% over a 5-week course; however left lung volume variations of up to 28% were noted in a select patient. Conclusion: With the use of the C-RAD CatalystHD system, the mean lung volume variability over a 5-week course of DIBH treatments was ≤4.0%. By minimizing left lung volume variability, heart to left breast separation maybe more consistently maintained. AN Gutierrez has a research grant from C-RAD AG.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-J-121: Dosimetric Evaluation of Active Breathing Coordinator-Response Gating System Linked to Linear Accelerator in Volumetric Modulated Arc Therapy

Purpose: To reduce internal target volume (ITV), respiratory management is a must in imaging and treatment for lung, liver, and breast cancers. We investigated the dosimetric accuracy of VMAT treatment delivery with a Response™ gating system linked to linear accelerator. Methods: The Response™ gating module designed to directly control radiation beam by breath-holding with a ABC system (Elekta AB, Stockholm, Sweden) was tested for VMAT treatments. Seven VMAT plans including three conventional and four stereotactic body radiotherapy (SBRT) cases were evaluated. Each plan was composed of two or four arcs of 6MV radiation beam with prescribed dose ranged from 1.8 to 9 Gy per fraction. Each plan was delivered continuously without gating and delivered with multiple interruptions by the ResponseTM gating module with a 20 or 30 second breath-holding period. MapCheck2 and Gafchromic EBT3 films sandwiched in MapPHAN were used to measure the delivered dose with and without gating. Films were scanned on a flatbed color scanner, and red channel was extracted for film dosimetry. Gamma analysis was performed to analyze the dosimetrical accuracy of the radiation delivery with gating. Results: The measured doses with gating remarkably agree with the planned dose distributions in the results of gamma index passing rate (within 20% isodose; >98% for 3%/3mm and >92% for 2%/2mm in MapCheck2, and >91% for 3%/3mm criteria in EBT3 film except one case which was for large target and highly modulated). No significant difference (student t-test: p-value < 0.0005) was shown between the doses delivered with and without gating. There was no indication of radiation gap or overlapping during deliver interruption in film dosimetry. Conclusion: The Response™ gating system can be safely used during VMAT treatment. The accurate performance of the gating system linked to ABC can contribute to ITV reduction for SBRT using VMAT.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-326: Diode Array Transmission Detector Systems Evaluation

Purpose: A new transmission detector, Delta4 Discover, developed by Scandidos (Uppsala, Sweden) was evaluated for external photon beam verification and quality assurance. The device is an array of 4040 diodes designed to be mounted on the linac accessory tray to measure photon field shape, position and fluence during patient treatment. Interfractional measurements are compared to a baseline measurement made during delivery quality assurance. The aim of this work is to evaluate the stability of the device and its effect on the shape and magnitude of the treatment beam. Methods: Beam profiles, percent depth dose, and beam attenuation was measured for 6, 10, and 15 MV photon beams with and without the device in place for 1×1 and 30×30 cm2 fields. Changes in profile and percent depth dose was quantified to evaluate the need to recommission the treatment beam, or account for the device with a tray factor. The stability of the radiation measurements was evaluated by measuring the deviation of each diode measurement during repeated prostate VMAT treatment delivery. Results: Photon beam profiles changed by < 1.25% in the nonpenumbra regions of the 30×30 cm2 beam. Percent depth dose curves show a 5–7% increased dose at depths < 2.5cm, but agreed within 1% at depths > 2.5cm. This indicates increased skin dose, similar to the use of a physical beam wedge. The device attenuated 6, 10, and 15 MV photon beams by 1.71±0.02%, 1.36±0.03%, and 1.17±0.03%, respectively. The diode array reproduced dosimetric measurements within 0.5% standard deviation for repeated prostate VMAT measurement. Conclusion: The device demonstrated stabile radiation measurements, while not changing the treatment beam shape in a clinically significantly manner. Use of this device can be accounted for with a tray factor, as opposed to recommissioning the treatment beam.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-F-T-374: Dosimetric Effects of Irradiation Through a Bilateral Hip Prosthesis in a MRI Linac

Purpose: To evaluate the interface effects when irradiating through a hip prosthesis in the presence of an orthogonal 1.5 T magnetic field using Monte Carlo simulations. Methods: A 20×20×38 cm virtual phantom with two 5×5×5 cm sections of bilateral titanium hip prosthesis was created in GPU-based Monte Carlo (MC) algorithm (GPUMCD, Elekta AB, Stockholm Sweden). The lateral prosthesis spacing was based on a representative patient CT scan. A treatment SAD of 143.5 cm was chosen, corresponding to the Elekta AB MRI Linac and the beam energy distribution was sampled from a histogram representing the true MRI Linac spectrum. A magnetic field of 1.5 T was applied perpendicular to the plane of irradiation. Dose was calculated, in voxels of side 1 mm, for 2×2, 5×5, and 10×10 cm treatment field sizes with normal beam incidence (gantry at 90° or 270°) and at 5° and 10° from normal, representing the range of incidence through the bilateral prosthesis. Results: With magnetic field ON (B-On) and normal beam incidence the backscatter dose at the interfaces of proximal and distal implants is reduced for all the field sizes compared to the magnetic field OFF (B-Off) case. The absolute reduction in doses at the interface was in the range of 12.93% to 13.16% for the proximal implant and 13.57% to 16.12% for the distal implant. Similarly for the oblique incidences of 5o and 10o the dose in the plane adjacent to the prosthetic implants is lower when the magnetic field is ON. Conclusion: The dosimetric effects of irradiating through a hip prosthesis in the presence of a transverse magnetic field have been determined using MC simulation. The backscatter dose reduction translates into significantly lower hot spots at the prosthetic interfaces, which are otherwise substantially high in the absence of the magnetic field. This project was supported through funding provided by ElektaTM.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-519: Is Geometry Based Setup Sufficient for All of the Head and Neck Treatment Cases?: A Feasibility Study Towards the Dose Based Setup

Purpose: This study compares the geometric-based setup (GBS) which is currently used in the clinic to a novel concept of dose-based setup (DBS) of head and neck (H&N) patients using cone beam CT (CBCT) of the day; and evaluates the clinical advantages. Methods: Ten H&N patients who underwent re-simulation and re-plan due to noticeable anatomic changes during the course of the treatments were retrospectively reviewed on dosimetric changes in the assumption of no plan modification was performed. RayStation planning system (RaySearch Laboratories AB, Sweden) was used to match (ROI fusion module) between prescribed isodoseline (IDL) in the CBCT imported along with ROIs from re-planned CT and the IDL of original plan (Dose-based setup: DBS). Then, the CBCT plan based on daily setup using the GBS (previously used for a patient) and the DBS CBCT plan recalculated in RayStation compared against the original CT-sim plan. Results: Most of patients’ tumor coverage and OAR doses got generally worsen when the CBCT plans were compared with original CT-sim plan with GBS. However, when DBS intervened, the OAR dose and tumor coverage was better than the GBS. For example, one of patients’ daily average doses of right parotid and oral cavity increased to 26% and 36%, respectively from the original plan to the GBS planning. However, it only increased by 13% and 24%, respectively with DBS. GTV D95 coverage also decreased by 16% with GBS, but only 2% decreased with DBS. Conclusion: DBS method is superior to GBS to prevent any abrupt dose changes to OARs as well as PTV/CTV or GTV at least for some H&N cases. Since it is not known when the DBS is beneficial to the GBS, a system which enables the on-line DBS may be helpful for better treatment of H&N.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-TeP1-05: Development and Clinical Introduction of Automated Radiotherapy Treatment Planning for Prostate Cancer

Purpose: To develop an automated radiotherapy treatment planning and optimization workflow for prostate cancer in order to generate clinical treatment plans. Methods: A fully automated radiotherapy treatment planning and optimization workflow was developed based on the treatment planning system Monaco (Elekta AB, Stockholm, Sweden). To evaluate our method, a retrospective planning study (n=100) was performed on patients treated for prostate cancer with 5 field intensity modulated radiotherapy, receiving a dose of 35×2Gy to the prostate and vesicles and a simultaneous integrated boost of 35×0.2Gy to the prostate only. A comparison was made between the dosimetric values of the automatically and manually generated plans. Operator time to generate a plan and plan efficiency was measured. Results: A comparison of the dosimetric values show that automatically generated plans yield more beneficial dosimetric values. In automatic plans reductions of 43% in the V72Gy of the rectum and 13% in the V72Gy of the bladder are observed when compared to the manually generated plans. Smaller variance in dosimetric values is seen, i.e. the intra- and interplanner variability is decreased. For 97% of the automatically generated plans and 86% of the clinical plans all criteria for target coverage and organs at risk constraints are met. The amount of plan segments and monitor units is reduced by 13% and 9% respectively. Automated planning requires less than one minute of operator time compared to over an hour for manual planning. Conclusion: The automatically generated plans are highly suitable for clinical use. The plans have less variance and a large gain in time efficiency has been achieved. Currently, a pilot study is performed, comparing the preference of the clinician and clinical physicist for the automatic versus manual plan. Future work will include expanding our automated treatment planning method to other tumor sites and develop other automated radiotherapy workflows.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TH-EF-BRB-06: Implementation of a Modulated-Arc Total Body Irradiation (TBI) Technique Using the RayStation Treatment Planning System

Purpose: To develop a clinical workflow for delivering a modulated-arc total body irradiation (TBI) with RayStation scripting. This technique uses arc fields with the patient lying at floor level on a padded table and is validated through measurements taken on a custom-made TBI phantom. Methods: Treatment planning was performed for a retrospective cohort of eight patients with a diverse range of heights and body types. Each was replanned using an open-field dual arc method, with the patient in supine and prone positions on the floor of the vault. All plans were optimized using Raystation Planning 4.7.2.5 (RaySearch Laboratories, Stockholm, Sweden), with 200 cGy prescribed to the 95% of the body contour − 5mm. This results in an open-field beam that sweeps craniocaudally across the length of the patient. The technique is validated with measurements at 10 cm intervals in a custom-milled, 5 cm thick acrylic phantom. A centrally located CC13 ion chamber and a Mobile MOSFET (Best Medical Canada, Ottawa, ON) detector array were used to measure dose. Supine and prone arcs for each patient were consecutively delivered, and the aggregate dose at each point was compared to the planned dose calculated in the phantom. Results: The ion chamber measurements differed from the planned dose by an average of .5%, with a standard deviation of 2.1%. All measured data for the MOSFETS were within 10% of the corresponding planned dose except for two outlying points. The standard deviation of dose differences across the entire cohort was 4.0%. Most significant discrepancies occurred either in inhomogeneous regions with large gradients, or at inferior points where beam angle was steepest. Conclusion: We have confirmed that the planned dose is well matched to our measurements within 10% for this method of planning and delivery. We are currently incorporating this technique into our clinical workflow. This work is supported by RaySearch.

60 APPLIED LIFE SCIENCES↗