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Commissioning and field tests of a van-mounted system for the detection of radioactive sources and Special Nuclear Material

MODES SNM project aimed to carry out technical research in order to develop a prototype for a mobile, modular detection system for radioactive sources and Special Nuclear Materials (SNM). Its main goal was to deliver a tested prototype of a modular mobile system capable of passively detecting weak or shielded radioactive sources with accuracy higher than that of currently available systems. By the end of the project all the objectives have been successfully achieved. Results from the laboratory commissioning and the field tests will be presented. (authors)

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Implementation and commissioning of an integrated micro-CT/RT system with computerized independent jaw collimation

Purpose: To design, construct, and commission a set of computer-controlled motorized jaws for a micro-CT/RT system to perform conformal image-guided small animal radiotherapy.Methods: The authors designed and evaluated a system of custom-built motorized orthogonal jaws, which allows the delivery of off-axis rectangular fields on a GE eXplore CT 120 preclinical imaging system. The jaws in the x direction are independently driven, while the y-direction jaws are symmetric. All motors have backup encoders, verifying jaw positions. Mechanical performance of the jaws was characterized. Square beam profiles ranging from 2 × 2 to 60 × 60 mm{sup 2} were measured using EBT2 film in the center of a 70 × 70 × 22 mm{sup 3} solid water block. Similarly, absolute depth dose was measured in a solid water and EBT2 film stack 50 × 50 × 50 mm{sup 3}. A calibrated Farmer ion chamber in a 70 × 70 × 20 mm{sup 3} solid water block was used to measure the output of three field sizes: 50 × 50, 40 × 40, and 30 × 30 mm{sup 2}. Elliptical target plans were delivered to films to assess overall system performance. Respiratory-gated treatment was implemented on the system and initially proved using a simple sinusoidal motion phantom. All films were scanned on a flatbed scanner (Epson 1000XL) and converted to dose using a fitted calibration curve. A Monte Carlo beam model of the micro-CT with the jaws has been created using BEAMnrc for comparison with the measurements. An example image-guided partial lung irradiation in a rat is demonstrated.Results: The averaged random error of positioning each jaw is less than 0.1 mm. Relative output factors measured with the ion chamber agree with Monte Carlo simulations within 2%. Beam profiles and absolute depth dose curves measured from the films agree with simulations within measurement uncertainty. Respiratory-gated treatments applied to a phantom moving with a peak-to-peak amplitude of 5 mm showed improved beam penumbra (80%–20%) from 3.9 to 0.8 mm.Conclusions: A set of computer-controlled motorized jaws for a micro-CT/RT system were constructed with position reliably better than a tenth of a millimeter. The hardware system is ready for image-guided conformal radiotherapy for small animals with capability of respiratory-gated delivery.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-D-BRE-02: Development and Commissioning of A Gated Spot Scanning Proton Beam Therapy System with Real-Time Tumor-Tracking

Purpose: A novel Proton Beam Therapy system has been developed by integrating Real-Time Tumor-Tracking (RTRT) and discrete spot scanning techniques. The system dedicated for spot scanning delivers significant advantages for both clinical and economical points of view. The system has the ability to control dose distribution with spot scanning beams and to gate the beams from the synchrotron to irradiate moving tumors only when the actual positions of them are within the planned position. Methods: The newly designed system consists of a synchrotron, beam transport systems, a compact and rotating gantry system with robotic couch and two orthogonal sets of X-ray fluoroscopes. The fully compact design of the system has been realized by reducing the maximum energy of the beam to 220MeV, corresponding to 30g/cm2 range and the number of circulating protons per synchrotron operation cycle, due to higher beam utilization efficiency in spot scanning. To improve the irradiation efficiency in the integration of RTRT and spot scanning, a new control system has been developed to enable multiple gated irradiation per operation cycle according to the gating signals. After the completion of the equipment installation, beam tests and commissioning has been successfully performed. Results: The basic performances and beam characteristics through the synchrotron accelerator to iso-center have been confirmed and the performance test of the irradiation nozzle and whole system has been appropriately completed. CBCT image has been checked and sufficient quality was obtained. RTRT system has been demonstrated and realized accurate dose distributions for moving targets. Conclusion: The gated spot scanning Proton Beam Therapy system with Real-Time Tumor-Tracking has been developed, successfully installed and tested. The new system enables us to deliver higher dose to the moving target tumors while sparing surrounding normal tissues and to realize the compact design of the system and facility by maximizing the efficiency of proton beam utilization. This research is granted by the Japan Society for the Promotion of Science(JSPS) through the “Funding Program for World-Leading Innovative R and D on Science and Technology(FIRST Program)”, initiated by the Council for Science and Technology Policy(CSTP)

60 APPLIED LIFE SCIENCES↗

SU-D-BRE-03: Dosimetric Impact of In-Air Spot Size Variations for Commissioning a Room-Matched Beam Model for Pencil Beam Scanning Proton Therapy

Purpose: To quantitatively evaluate dosimetric consequence of spot size variations and validate beam-matching criteria for commissioning a pencil beam model for multiple treatment rooms. Methods: A planning study was first conducted by simulating spot size variations to systematically evaluate dosimetric impact of spot size variations in selected cases, which was used to establish the in-air spot size tolerance for beam matching specifications. A beam model in treatment planning system was created using in-air spot profiles acquired in one treatment room. These spot profiles were also acquired from another treatment room for assessing the actual spot size variations between the two treatment rooms. We created twenty five test plans with targets of different sizes at different depths, and performed dose measurement along the entrance, proximal and distal target regions. The absolute doses at those locations were measured using ionization chambers at both treatment rooms, and were compared against the calculated doses by the beam model. Fifteen additional patient plans were also measured and included in our validation. Results: The beam model is relatively insensitive to spot size variations. With an average of less than 15% measured in-air spot size variations between two treatment rooms, the average dose difference was −0.15% with a standard deviation of 0.40% for 55 measurement points within target region; but the differences increased to 1.4%±1.1% in the entrance regions, which are more affected by in-air spot size variations. Overall, our single-room based beam model in the treatment planning system agreed with measurements in both rooms < 0.5% within the target region. For fifteen patient cases, the agreement was within 1%. Conclusion: We have demonstrated that dosimetrically equivalent machines can be established when in-air spot size variations are within 15% between the two treatment rooms.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-E-T-277: Raystation Electron Monte Carlo Commissioning and Clinical Implementation

Purpose: To evaluate the Raystation v4.0 Electron Monte Carlo algorithm for an Elekta Infinity linear accelerator and commission for clinical use. Methods: A total of 199 tests were performed (75 Export and Documentation, 20 PDD, 30 Profiles, 4 Obliquity, 10 Inhomogeneity, 55 MU Accuracy, and 5 Grid and Particle History). Export and documentation tests were performed with respect to MOSAIQ (Elekta AB) and RadCalc (Lifeline Software Inc). Mechanical jaw parameters and cutout magnifications were verified. PDD and profiles for open cones and cutouts were extracted and compared with water tank measurements. Obliquity and inhomogeneity for bone and air calculations were compared to film dosimetry. MU calculations for open cones and cutouts were performed and compared to both RadCalc and simple hand calculations. Grid size and particle histories were evaluated per energy for statistical uncertainty performance. Acceptability was categorized as follows: performs as expected, negligible impact on workflow, marginal impact, critical impact or safety concern, and catastrophic impact of safety concern. Results: Overall results are: 88.8% perform as expected, 10.2% negligible, 2.0% marginal, 0% critical and 0% catastrophic. Results per test category are as follows: Export and Documentation: 100% perform as expected, PDD: 100% perform as expected, Profiles: 66.7% perform as expected, 33.3% negligible, Obliquity: 100% marginal, Inhomogeneity 50% perform as expected, 50% negligible, MU Accuracy: 100% perform as expected, Grid and particle histories: 100% negligible. To achieve distributions with satisfactory smoothness level, 5,000,000 particle histories were used. Calculation time was approximately 1 hour. Conclusion: Raystation electron Monte Carlo is acceptable for clinical use. All of the issues encountered have acceptable workarounds. Known issues were reported to Raysearch and will be resolved in upcoming releases.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-E-T-584: Commissioning of the MC2 Monte Carlo Dose Computation Engine

Purpose: An automated system, MC2, was developed to convert DICOM proton therapy treatment plans into a sequence MCNPX input files, and submit these to a computing cluster. MC2 converts the results into DICOM format, and any treatment planning system can import the data for comparison vs. conventional dose predictions. This work describes the data and the efforts made to validate the MC2 system against measured dose profiles and how the system was calibrated to predict the correct number of monitor units (MUs) to deliver the prescribed dose. Methods: A set of simulated lateral and longitudinal profiles was compared to data measured for commissioning purposes and during annual quality assurance efforts. Acceptance criteria were relative dose differences smaller than 3% and differences in range (in water) of less than 2 mm. For two out of three double scattering beam lines validation results were already published. Spot checks were performed to assure proper performance. For the small snout, all available measurements were used for validation vs. simulated data. To calibrate the dose per MU, the energy deposition per source proton at the center of the spread out Bragg peaks (SOBPs) was recorded for a set of SOBPs from each option. Subsequently these were then scaled to the results of dose per MU determination based on published methods. The simulations of the doses in the magnetically scanned beam line were also validated vs. measured longitudinal and lateral profiles. The source parameters were fine tuned to achieve maximum agreement with measured data. The dosimetric calibration was performed by scoring energy deposition per proton, and scaling the results to a standard dose measurement of a 10 x 10 x 10 cm3 volume irradiation using 100 MU. Results: All simulated data passed the acceptance criteria. Conclusion: MC2 is fully validated and ready for clinical application.

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-T-585: Commissioning of Electron Monte Carlo in Eclipse Treatment Planning System for TrueBeam

Purpose: To commission electron Monte Carlo (eMC) algorithm in Eclipse Treatment Planning System (TPS) for TrueBeam Linacs, including the evaluation of dose calculation accuracy for small fields and oblique beams and comparison with the existing eMC model for Clinacs. Methods: Electron beam percent-depth-dose (PDDs) and profiles with and without applicators, as well as output factors, were measured from two Varian TrueBeam machines. Measured data were compared against the Varian TrueBeam Representative Beam Data (VTBRBD). The selected data set was transferred into Eclipse for beam configuration. Dose calculation accuracy from eMC was evaluated for open fields, small cut-out fields, and oblique beams at different incident angles. The TrueBeam data was compared to the existing Clinac data and eMC model to evaluate the differences among Linac types. Results: Our measured data indicated that electron beam PDDs from our TrueBeam machines are well matched to those from our Varian Clinac machines, but in-air profiles, cone factors and open-filed output factors are significantly different. The data from our two TrueBeam machines were well represented by the VTBRBD. Variations of TrueBeam PDDs and profiles were within the 2% /2mm criteria for all energies, and the output factors for fields with and without applicators all agree within 2%. Obliquity factor for two clinically relevant applicator sizes (10×10 and 15×15 cm{sup 2}) and three oblique angles (15, 30, and 45 degree) were measured for nominal R100, R90, and R80 of each electron beam energy. Comparisons of calculations using eMC of obliquity factors and cut-out factors versus measurements will be presented. Conclusion: eMC algorithm in Eclipse TPS can be configured using the VTBRBD. Significant differences between TrueBeam and Clinacs were found in in-air profiles and open field output factors. The accuracy of the eMC algorithm was evaluated for a wide range of cut-out factors and oblique incidence.

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-T-625: Use and Choice of Ionization Chambers for the Commissioning of Flattened and Flattening-Filter-Free Photon Beams: Determination of Recombination Correction Factor (ks)

Purpose: To evaluate the recombination effect for some ionization chambers to be used for linacs commissioning for Flattened Filter (FF) and Flattening Filter Free (FFF) photon beams. Methods: A Varian TrueBeam linac with five photon beams was used: 6, 10 and 15 MV FF and 6 and 10 MV FFF. Measurements were performed in a water tank and in a plastic water phantom with different chambers: a mini-ion chamber (IC CC01, IBA), a plane-parallel ion chamber (IC PPC05, IBA) and two Farmer chambers (NE2581 and FPC05-IBA). Measurement conditions were Source- Surface Distance of 100 cm, two field sizes (10x10 and 40x40 cm2) and five depths (1cm, maximum buildup, 5cm, 10cm and 20cm). The ion recombination factors (kS), obtained from the Jaffe's plots (voltage interval 50-400 V), were evaluated at the recommended operating voltage of +300V. Results: Dose Per Pulse (DPP) at dmax was 0.4 mGy/pulse for FF beams, 1.0 mGy/pulse and 1.9 mGy/pulse for 6MV and 10 MV FFF beams respectively. For all measurement conditions, kS ranged between 0.996 and 0.999 for IC PPC05, 0.997 and 1.008 for IC CC01. For the FPC05 IBA Farmer IC, kS varied from 1.001 to 1.011 for FF beams, from 1.004 to 1.015 for 6 MV FFF and from 1.009 to 1.025 for 10 MV FFF. Whereas, for NE2581 IC the values ranged from 1.002 to 1.009 for all energy beams and measurement conditions. Conclusion: kS depends on the chamber volume and the DPP, which in turn depends on energy beam but is independent of dose rate. Ion chambers with small active volume can be reliably used for dosimetry of FF and FFF beams even without kS correction. On the contrary, for absolute dosimetry of FFF beams by Farmer ICs it is necessary to evaluate and apply the kS correction. Partially supported by Lega Italiana Lotta contro i Tumori (LILT)

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-T-630: Commissioning for SRS Planning Systems

Purpose: This study will try to find optimal procedures to collect small fields beam data for commissioning in treatment planning systems (TPS), and to provide a protocol to collect output factors for very small field sizes: 0.5 cm × 0.5 cm to 4.0 cm × 4.0 cm.This will help in determining the correct beam configuration methods in TPS planning intensity modulated radiation therapy (IMRT), and stereotactic radiosurgery SRS using mini multileaf collimation (mMLC). Methods: Data has been collected for a mMLC linear accelerator (linac) Novalis from 0.5 cm × 0.5 cm to 10 cm × 10 cm (its maximum field size). The TPS chosen is BrainLab, Eclipse and Cyberknife. The beam data collected was modeled and imported in the TPS. Verification plans were generated in solid water to confirm the goodness of the data. 3D and IMRT plans on regular CT scans were generated and verified using Mapcheck. All 3D plans with field sizes above 4 cm × 4 cm verified excellent using a distance to agreement of 2 mm and a 2% tolerance. IMRT plans gave an error of -8%. New scans with new detectors have been taken, new field sizes were introduced, and focus has been applied on determining the dosimetric leaf gap. Results: Although this is still a work in progress, this study brings several issues to light: the importance of the correct technique in beam data collection from the correct watertank to the correct detectors. Readings for rectangular fields have to be taken especially for fields which one side is under 4 cm. Conclusion: The use of equivalent square fields will not provide correct readings for the fields with large differences between the length and the width.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-T-631: Commissioning and Comprehensive Evaluation of the ArcCHECK Cylindrical Diode Array for VMAT QA

Purpose: Commissioning and comprehensive evaluation of ArcCHECK phantom for dosimetry of VMAT QA, using 6MV photon beam with and without the flattening filter. Methods: ArcCHECK was evaluated for response dependency on linac dose rate, instantaneous dose rate, radiation field size, beam angle and couch insertion. Scatter dose characterization, consistency and symmetry of response, dosimetric accuracy of fixed aperture arcs and clinical VMAT plans were investigated. Measurements were done using TrueBeam™ STx accelerator (Console version 1.6) with a 6 MV beam with and without flattening filter. Reference dose-grids were calculated using Eclipse TPS Analytical Anisotropic Algorithm (AAA version 10.0.39). Planned doses were calculated using symmetric 2mm 3D dose grids with 4 degree angular resolution defaulted to each control point. Gamma evaluations were performed in absolute dose mode, with default normalization to maximum dose in the curved plane and a low dose threshold of 10% to restrict the analysis to clinically relevant areas. Global and local gamma indices at 3mm/3% and 2mm/2% level were computed using SNC software (version 6.0). Results: Results of gamma analysis demonstrated an overall agreement between ArcCHECK measured and TPS calculated reference doses. Field size dependency was within 0.5% of the reference. Dose-rate based dependency was well within 1% of the TPS reference and the angular dependency was ±3% of the reference, as tested for BEV angles. At the level of 3%/3mm, narrow and wide open arcs as well as clinical VMAT cases demonstrated high level of dosimetry accuracy in global gamma passing rates for both 6X and 6F beams. At the level of 2%/2mm two VMAT cases involving the narrow heavily modulated arcs demonstrated lower passing rates. Conclusion: ArcCHECK phantom with latest software and hardware upgrades is suitable for VMAT QA. For higher sensitivity of 2%/2mm gamma analysis, we intend to use it as one of the VMAT QA evaluation metrics.

07 ISOTOPE AND RADIATION SOURCES↗

Technical Note: Impact on detective quantum efficiency of edge angle determination method by International Electrotechnical Commission methodology for cardiac x-ray image detectors

Purpose: Cardiac x-ray detectors are used to acquire moving images in real-time for angiography and interventional procedures. Detective quantum efficiency (DQE) is not generally measured on these dynamic detectors; the required “for processing” image data and control of x-ray settings have not been accessible. By 2016, USA hospital physicists will have the ability to measure DQE and will likely utilize the International Electrotechnical Commission (IEC) standard for measuring DQE of dynamic x-ray imaging devices. The current IEC standard requires an image of a tilted tungsten edge test object to obtain modulation transfer function (MTF) for DQE calculation. It specifies the range of edge angles to use; however, it does not specify a preferred method to determine this angle for image analysis. The study aimed to answer the question “will my choice in method impact my results?” Four different established edge angle determination methods were compared to investigate the impact on DQE. Methods: Following the IEC standard, edge and flat field images were acquired on a cardiac flat-panel detector to calculate MTF and noise power spectrum, respectively, to determine DQE. Accuracy of the methods in determining the correct angle was ascertained using a simulated edge image with known angulations. Precision of the methods was ascertained using variability of MTF and DQE, calculated via bootstrapping. Results: Three methods provided near equal angles and the same MTF while the fourth, with an angular difference of 6%, had a MTF lower by 3% at 1.5 mm{sup −1} spatial frequency and 8% at 2.5 mm{sup −1}; corresponding DQE differences were 6% at 1.5 mm{sup −1} and 17% at 2.5 mm{sup −1}; differences were greater than standard deviations in the measurements. Conclusions: DQE measurements may vary by a significant amount, depending on the method used to determine the edge angle when following the IEC standard methodology for a cardiac x-ray detector. The most accurate and precise methods are recommended for absolute assessments and reproducible measurements, respectively.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-E-T-88: Acceptance Testing and Commissioning Measurements of a Newly Released InCiseâ„¢ Multileaf Collimator for CyberKnife M6â„¢ System

Purpose: Accuray recently released a new collimator, the InCise™ Multileaf Collimator (MLC), for clinical use with the CyberKnife M6™ System. This work reports the results of acceptance testing and commissioning measurements for this collimator. Methods: The MLC consists of 41 pairs of 2.5 mm wide leaves projecting a clinical maximum field size of 110 mm x 97.5 mm at 800 mm SAD. The leaves are made of tungsten, 90 mm in height and tilted by 0.5 degree. The manufacturer stated leaf positioning accuracy and reproducibility are 0.5 mm and 0.4 mm respectively at 800 mm SAD. The leaf over-travel is 100% with full interdigitation capability. Acceptance testing included, but are not limited to, the verification of the specifications of various parameters described above, leakage measurements and end-to-end tests. Dosimetric measurements included, but not limited to, measurements of output factors, open beam profiles, tissue-phantom ratios, beam flatness and symmetry, and patient specific QA. Results: All measurements were well within the manufacturer specifications. The values of output factors ranged from 0.804 (smallest field size of 7.6 mm x 7.5 mm) to 1.018 (largest field size of 110.0 mm x 97.5 mm). End-to-end test results for the various tracking modes are: Skull (0.27mm), fiducial (0.16mm), Xsight Spine (0.4mm), Xsight Lung (0.93 mm) and Synchrony (0.43mm). Measured maximum and average leakage was 0.37% and 0.3%, respectively. Patient-specific QA measurements with chamber were all within 5% absolute dose agreement, and film measurements all passed 2%/2mm gamma evaluation for more than 95% of measurement points. Conclusion: The presented results are the first set of data reported on the InCise™ MLC. The MLC proved to be very reliable and is currently in clinical use.

60 APPLIED LIFE SCIENCES↗

SU-E-T-191: Commissioning and Dosimetric Characteristics of Elekta Agility for Total Skin Electron Beam (TSEB) Therapy

Purpose The purpose of this work is to publish beam data from Elekta Synergy(R) linear accelerators with Agility(TM) MLC for total skin electron beam (TSEB) therapy using the HDRE1 (High Dose Rate Electron 6MeV) energy. Method & Materials The optimal gantry angles for TSEB were determined using ion chamber measurements along a vertical profile at 450cm SSD. After gantry angles were chosen, field uniformity was measured over the entire treatment area. Uniformity was measured with and without the patient support device, allowing the dosimetric effect of the support device to be determined. Beam output and PDD were measured at the calibration point (450cm SSD) for a dual beam using a parallel plate chamber in solid water. These measurements were repeated with the chamber and phantom rotated about the patient isocenter at various angles, in order to measure the contribution from oblique beams. This technique provides a precise measurement of the treatment skin dose (TSD). Lastly, ion chamber measurements were verified by film and diodes. Results The optimal gantry angle for 450 cm SSD was determined to be 90±16°. This achieved uniformity better than 96% on the vertical axis, and 92% along the horizontal axis. HDRE1 was calibrated to deliver 10 cGy/MU at standard geometry (100 cm SSD, 1.2 cm depth). Thus at TSEB geometry (450 cm SSD, 0.1 cm depth) the output of the AP dual field was measured to be 0.35 cGy/MU. The TSD of a 20 cm radius cylinder for six (equally, 60° spaced) dual fields was measured to be 1.19 cGy/MU. Percent Depth Dose data for the AP dual field and TSD are shown in Figure 2. Conclusion This paper provides a modern procedure for commissioning TSEB therapy on a linear accelerator, and clinical beam data for the Elekta Synergy(R) with Agility(TM) MLC.

60 APPLIED LIFE SCIENCES↗

SU-E-T-192: Commissioning of a Commercial 3D Dose Calculation Program

Purpose: To commission a commercial software package (CSP) that is used as secondary dose calculation check. The CSP uses an independent golden data beam model. However, some parameters can be modified to generate a customer specific model. Plan comparisons and point dose measurements were performed to test if and to what extent the beam model needed adjustment to optimize results. Methods: Beam parameter configurations were compared between the CSP and both TPS. Twelve phantom test plans ranging from simple to complex were generated in two treatment planning systems (TPS). Tests included small field, off axis, EDW, IMRT and VMAT plans. For each plan a point dose was measured to establish ground truth. Lastly, patient plans were compared for both TPS systems and the CSP. Results: Beam parameters agreed within 2%. The output factors for small fields were changed for the 15 MV beam by 2 and 1.5 % for the 1 cm and 2 cm field sizes, respectively. For the 6 MV beam output factors were adjusted by 3−0.8% for field sizes ranging from 1 to 5 cm. The MLC dynamic leaf gap was adjusted by 1.5 mm for 18 MV beam. Differences between the CSP and the TPS were noted in the built-up region. These differences affected the gamma pass rate in the surface region, however this effect is reduced with increasing number of beam angles and does not affect point dose calculations at depth. All IMRT and VMAT plans agreed with the CSP using a gamma pass rate of 95% (3%, 3mm). Conclusion: The CSP is used to verify point doses for all 3D plans generated in our clinic for the last 6 months. No point dose mismatches were encountered since the CSP was implemented. Next, the CSP will be adapted for secondary checks of all IMRT plans. KL had a beta tester agreement with Mobius Medical for an in-kind equipment and software loan.

60 APPLIED LIFE SCIENCES↗

SU-E-T-624: Portal Dosimetry Commissioning of Multiple (6) Varian TrueBeam Linacs Equipped with PortalVision DMI MV Imager

Purpose: To show that a single model for Portal Domisetry (PD) can be established for beam-matched TrueBeam™ linacs that are equipped with the DMI imager (43×43cm effective area). Methods: Our department acquired 6 new TrueBeam™s, 4 “Slim” and 2 “Edge” models. The Slims were equipped with 6 and 10MV photons, and the Edges with 6MV. MLCs differed between the Slims and Edges (Millennium 120 vs HD-MLC respectively). PD model was created from data acquired using a single linac (Slim). This includes maximum field size profile, as well as output factors and acquired measured fluence using the DMI imager. All identical linacs were beam-matched, profiles were within 1% at maximum field size at a variety of depths. The profile correction file was generated from 40×40 profile acquired at 5cm depth, 95cm SSD, and was adjusted for deviation at the field edges and corners. The PD model and profile correction was applied to all six TrueBeam™s and imagers. A variety of jaw only and sliding window (SW) MLC test fields, as well as TG-119 and clinical SW and VMAT plans were run on each linac to validate the model. Results: For 6X and 10X, field by field comparison using 3mm/3% absolute gamma criteria passed 90% or better for all cases. This was also true for composite comparisons of TG-199 and clinical plans, matching our current department criteria. Conclusion: Using a single model per photon energy for PD for the TrueBeam™ equipped with a DMI imager can produce clinically acceptable results across multiple identical and matched linacs. It is also possible to use the same PD model despite different MLCs. This can save time during commissioning and software updates.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-F-BRA-11: An Experimental Commissioning Test of Brachytherapy MBDCA Dosimetry, Based On a Commercial Radiochromic Gel/optical CT System

Purpose: To implement a 3D dose verification procedure of Model-Based Dose Calculation Algorithms (MBDCAs) for {sup 192}Ir HDR brachytherapy, based on a novel Ferrous Xylenol-orange gel (FXG) and optical CT read-out. Methods: The TruView gel was employed for absolute dosimetry in conjunction with cone-beam optical CT read-out with the VISTA scanner (both from Modus Medical Inc, London, ON, Canada). A multi-catheter skin flap was attached to a cylindrical PETE jar (d=9.6cm, h=16cm) filled with FXG, which served as both the dosimeter and the water equivalent phantom of bounded dimensions. X- ray CT image series of the jar with flap attached was imported to Oncentra Brachy v.4.5. A treatment plan consisting of 8 catheters and 56 dwell positions was generated, and Oncentra-ACE MBDCA as well as TG43 dose results were exported for further evaluation. The irradiation was carried out with a microSelecton v2 source. The FXG dose-response, measured via an electron irradiation of a second dosimeter from the same batch, was linear (R2>0.999) at least up to 12Gy. A MCNP6 input file was prepared from the DICOM-RT plan data using BrachyGuide to facilitate Monte Carlo (MC) simulation dosimetry in the actual experimental geometry. Agreement between experimental (reference) and calculated dose distributions was evaluated using the 3D gamma index (GI) method with criteria (5%-2mm applied locally) determined from uncertainty analysis. Results: The TG-43 GI failed, as expected, in the majority of voxels away from the flap (pass rate 59% for D>0.8Gy, corresponding to 10% of prescribed dose). ACE performed significantly better (corresponding pass rate 92%). The GI evaluation for the MC data (corresponding pass rate 97%) failed mainly at low dose points of increased uncertainty. Conclusion: FXG gel/optical CT is an efficient method for level-2 commissioning of brachytherapy MBDCAs. Target dosimetry is not affected from uncertainty introduced by TG43 assumptions in 192Ir skin brachytherapy. Research co-financed by the ESF and Greek funds through the Operational Program Education and Lifelong Learning Investing in Knowledge Society of the NSRF. Research Funding Program: Aristeia. Modus Medical Devices Inc. provided a TruView dosimeter batch and Nucletron, and Elekta company, provided access to Oncentra Brachy v4.5, for research purposes.

60 APPLIED LIFE SCIENCES↗

MO-F-CAMPUS-J-02: Commissioning of Radiofrequency Tracking for Gated SBRT of the Liver Using Novel Motion System

Purpose: Tracking soft tissue targets has recently been approved as a new application of the Calypso radiofrequency tracking system allowing for gated treatment of the liver based on the motion of the target volume itself. As part of the commissioning process, an end-to-end test was performed using a 3D diode array and 6D motion platform to verify the dosimetric accuracy and establish the workflow of gated SBRT treatment of the liver using Calypso. Methods: A 4DCT scan of the ScandiDos Delta4 phantom was acquired using the HexaMotion motion platform to simulate realistic breathing motion. A VMAT plan was optimized on the end of inspiration phase of the 4DCT scan and delivered to the Delta4 phantom using the Varian TrueBeam. The treatment beam was gated by Calypso to deliver dose at the end of inspiration. The expected dose was compared to the delivered dose using gamma analysis. In addition, gating limits were investigated to determine how large the gating range can be while still maintaining dosimetric accuracy. Results: The 3%/3mm and 2%/2mm gamma pass rate for the gated treatment delivery was 100% and 98.4%, respectively. When increasing the gating limits beyond the known extent of planned motion from the 4DCT, the gamma pass rates decreased as expected. The 3%/3mm gamma pass rate for a 1, 2, and 3mm increase in gating limits were measured to be 96.0%, 92.7%, and 78.8%, respectively. Conclusion: Radiofrequency tracking was shown to be an effective way to provide gated SBRT treatment of the liver. Baseline gating limits should be determined by measuring the extent of target motion during the respiratory phases used for planning. We recommend adding 1mm to the baseline limits to provide the proper balance between treatment efficiency and dosimetric accuracy.

60 APPLIED LIFE SCIENCES↗

TU-G-213-00: The International Electrotechnical Commission (IEC): What Is It and Why Should Medical Physicists Care?

The International Electrotechnical Commission (IEC) writes standards that manufacturers of electrical equipment must comply with. Medical electrical equipment, such as medical imaging, radiation therapy, and radiation dosimetry devices, fall under Technical Committee 62. Of particular interest to medical physicists are the standards developed within Subcommittees (SC) 62B, which addresses diagnostic radiological imaging equipment, and 62C, which addresses equipment for radiation therapy, nuclear medicine and dosimetry. For example, a Working Group of SC 62B is responsible for safety and quality assurance standards for CT scanners and a Working Group of SC 62C is responsible for standards that set requirements for dosimetric safety and accuracy of linacs and proton accelerators. IEC standards thus have an impact on every aspect of a medical physicist’s job, including equipment testing, shielding design, room layout, and workflow. Consequently, it is imperative that US medical physicists know about existing standards, as well as have input on those under development or undergoing revision. The structure of the IEC and current standards development work will be described in detail. The presentation will explain how US medical physicists can learn about IEC standards and contribute to their development. Learning Objectives: Learn about the structure of the IEC and the influence that IEC standards have on the design of equipment for radiology and radiation therapy. Learn about the mechanisms by which the US participates in the development and revision of standards. Understand the specific requirements of several standards having direct relevance to diagnostic and radiation therapy physicists.

60 APPLIED LIFE SCIENCES↗