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At least 343 records · Page 19

Diaboloidal mirrors: algebraic solution and surface shape approximations

A new type of optical element that can focus a cylindrical wave to a point focus (or vice versa) is analytically described. Such waves are, for example, produced in a beamline where light is collimated in one direction and then doubly focused by a single optic. A classical example in X-ray optics is the collimated two-crystal monochromator, with toroidal mirror refocusing. The element here replaces the toroid, and in such a system provides completely aberration free, point-to-point imaging of rays from the on-axis source point. We present an analytic solution for the mirror shape in its laboratory coordinate system with zero slope at the centre, and approximate solutions, based on bending an oblique circular cone and a bent right circular cylinder, that may facilitate fabrication and metrology.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Progress on HL-LHC Nb 3 Sn Magnets

The high-luminosity Large Hadron Collider (HL-LHC) project aims at allowing to increase the collisions in the LHC by a factor of ten in the decade 2025-2035. One essential element is the superconducting magnet around the interaction region points, where the large aperture magnets will be installed to allow to further reduce the beam size in the interaction point. The core of this upgrade is the Nb 3 Sn triplet, made up of 150-mm aperture quadrupoles in the range of 7-8 m. The project is being shared between the European Organization for Nuclear Research and the US Accelerator Upgrade Program, based on the same design, and on the two strand technologies. The project is ending the short model phase, and entering the prototype construction. We will report on the main results of the short model program, including the quench performance and field quality. A second important element is the 11 T dipole that replaces a standard dipole making space for additional collimators. The magnet is also ending the model development and entering the prototype phase. A critical point in the design of this magnet is the large current density, allowing increase of the field from 8 to 11 T with the same coil cross section as in the LHC dipoles. This is also the first two-in-one Nb 3 Sn magnet developed so far. We will report the main results on the test and the critical aspects.

75 CONDENSED MATTER PHYSICS, SUPERCONDUCTIVITY AND↗

Individual and Simultaneous Imaging of ⁹⁹mTc and ¹⁷⁷Lu With a Preclinical Broad Energy-Spectrum CZT-Based SPECT

Radiopharmaceutical therapy has demonstrated a high efficacy in the treatment of various tumor types. One of the radionuclides already used in the clinic is 177Lu, a beta emitter that also emits several photons imageable with SPECT. Quantitative imaging of 177Lu is critical for developing new radiopharmaceuticals. Energy resolution is an important factor when imaging multiple photon emissions. Solid-state detectors offer a superior performance over scintillators, that are commonly used in commercially-available preclinical SPECT scanners. This study demonstrates the feasibility of 99m Tc and 177Lu quantitative imaging in mouse phantoms, individually and simultaneously, with a SPECT prototype built with four CdZnTe (CZT) detector heads and a custom-designed and energy-optimized parallel-hole tungsten collimator. With a custom implementation of the one-step late (OSL) image reconstruction algorithm, the system is capable of imaging energies from ~70 keV to 250 keV. Above 250 keV, images were significantly affected by septal penetration, consistent with the collimator design. A recovery coefficient within 25% was obtained for activities as low as 2 kBq/mL for 99m Tc and 45% for 177Lu. Compared to a commercial NaI-based preclinical SPECT (VECTor4/CT), our prototype showed a superior energy resolution (< 5% at 140 keV), a similar uniformity with a high-compact design.

Encarnação, Pedro M C C↗

New results from sub-3 MeV Compton spectrometer experiments

We report that our team at Los Alamos National Laboratory has successfully employed Compton spectrometers to measure the X-ray spectra of both continuous and flash radiographic sources. In this method, a collimated beam of X-rays incident on a converter foil ejects Compton electrons. A collimator may be inserted into the entrance of the spectrometer to narrow the angular acceptance of the forward-scattered electrons, which then enter the magnetic field region of the spectrometer. The position of the electrons at the magnet’s focal plane is proportional to the square root of their momentum, allowing the X-ray spectrum to be reconstructed. A new samarium-cobalt spectrometer with an energy range of 50 keV to 4 MeV has been fielded at two facilities. Finally, the X-ray generating machines produced intense photon beams (> 4 rad at 1 m) with spectral endpoints below 3 MeV. Recent experimental results will be presented.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Technical Note: Enhancing the surface dose using a weak longitudinal magnetic field

Purpose: The surface dose in radiotherapy is subject to the physical properties of the radiation beam and collimator. The purpose of this work is to investigate the manipulation of surface dose using magnetic fields produced with a resistive magnet. Better understanding of the feasibility and mechanisms of altered surface dose could have important clinical applications where the surface dose must be increased for therapeutic goals, or reduced to enhance the therapeutic benefit. Methods: A resistive magnet capable of generating a peak magnetic field up to 0.24 T was integrated with a cobalt treatment unit. The magnetic fringe field of the magnet was small due to the self-shielding built within the magnet. The magnetic field at the beam collimation jaws of the cobalt irradiator was less than 10 G. The surface dose and depth dose were measured for varying magnetic field strengths. Results: The resistive magnet was able to alter the dose in the buildup region of the {sup 60}Co depth dose significantly, and the magnitude of dose enhancement was directly related to the strength of the longitudinal magnetic field. Peak magnetic fields as low as 0.08 T were able to affect the surface dose. At a peak field of 0.24 T, the authors measured a surface dose enhancement of 2.8-fold. Conclusions: Surface dose enhancement using resistive magnets is feasible. Further experimental study is needed to understand the origin of the scattered electrons that contribute to the increase in surface dose.

07 ISOTOPE AND RADIATION SOURCES↗

SU-F-T-178: Optimized Design of a Diamond Detector Specifically Dedicated to the Dose Distribution Measurements in Clinical Proton Pencil Beams

Purpose: In proton-therapy, pencil beam scanning (PBS) dosimetry presents a real challenge due to the small size of the beam (about 3 to 8 mm in FWHM), the pulsed high dose rate (up to 100 Gy/s) and the proton energy variation (about 30 MeV to 250 MeV). In the framework of French INSERM DEDIPRO project, a specifically dedicated single crystal diamond dosimeter (SCDDo) was developed with the objective of obtaining accurate measurements of the dose distribution in PBS modality. Methods: Monte Carlo simulations with MCNPX were performed. A small proton beam of 5 mm in FWHM was simulated as well as diamond devices with various size, thickness and holder composition. The calculated doses-to-diamond were compared with the doses-to-water in order to reduce the perturbation effects. Monte-Carlo simulations lead to an optimized SCDDo design for small proton beams dosimetry. Following the optimized design, SCDDos were mounted in water-equivalent holders with electrical connection adapted to standard electrometer. First, SCDDos performances (stability, repeatability, signal-to-background ratio…) were evaluated with conventional photon beams. Then, characterizations (dose linearity, dose rate dependence…) with wide proton beams were performed at proton-therapy center (IC-CPO) from Curie Institute (France) with the passive proton delivery technique, in order to confirm dosimetric requirements. Finally, depth-dose distributions were measured in a water tank, for native and modulated Bragg Peaks with the collimator of 12 cm, and compared to a commercial PPC05 parallel-plate ionization chamber reference detector. Lateral-dose profiles were also measured with the collimator of 5 mm, and compared to a commercial SFD diode. Results: The results show that SCDDo design does not disturb the dose distributions. Conclusion: The experimental dose distributions with the SCDDo are in good agreement with the commercial detectors and no energy dependence was observed with this device configuration.

07 ISOTOPE AND RADIATION SOURCES↗

SU-F-T-347: An Absolute Dose-Volume Constraint Based Deterministic Optimization Framework for Multi-Co60 Source Focused Radiotherapy

Purpose: Treatment plan optimization in multi-Co60 source focused radiotherapy with multiple isocenters is challenging, because dose distribution is normalized to maximum dose during optimization and evaluation. The objective functions are traditionally defined based on relative dosimetric distribution. This study presents an alternative absolute dose-volume constraint (ADC) based deterministic optimization framework (ADC-DOF). Methods: The initial isocenters are placed on the eroded target surface. Collimator size is chosen based on the area of 2D contour on corresponding axial slice. The isocenter spacing is determined by adjacent collimator sizes. The weights are optimized by minimizing the deviation from ADCs using the steepest descent technique. An iterative procedure is developed to reduce the number of isocenters, where the isocenter with lowest weight is removed without affecting plan quality. The ADC-DOF is compared with the genetic algorithm (GA) using the same arbitrary shaped target (254cc), with a 15mm margin ring structure representing normal tissues. Results: For ADC-DOF, the ADCs imposed on target and ring are (D100>10Gy, D50,10, 0<12Gy, 15Gy and 20Gy) and (D40<10Gy). The resulting D100, 50, 10, 0 and D40 are (9.9Gy, 12.0Gy, 14.1Gy and 16.2Gy) and (10.2Gy). The objectives of GA are to maximize 50% isodose target coverage (TC) while minimize the dose delivered to the ring structure, which results in 97% TC and 47.2% average dose in ring structure. For ADC-DOF (GA) techniques, 20 out of 38 (10 out of 12) initial isocenters are used in the final plan, and the computation time is 8.7s (412.2s) on an i5 computer. Conclusion: We have developed a new optimization technique using ADC and deterministic optimization. Compared with GA, ADC-DOF uses more isocenters but is faster and more robust, and achieves a better conformity. For future work, we will focus on developing a more effective mechanism for initial isocenter determination.

60 APPLIED LIFE SCIENCES↗

SU-F-T-371: Development of a Linac Monte Carlo Model to Calculate Surface Dose

Purpose: To generate and validate a linac Monte Carlo (MC) model for surface dose prediction. Methods: BEAMnrc V4-2.4.0 was used to model 6 and 18 MV photon beams for a commercially available linac. DOSXYZnrc V4-2.4.0 calculated 3D dose distributions in water. Percent depth dose (PDD) and beam profiles were extracted for comparison to measured data. Surface dose and at depths in the buildup region was measured with radiochromic film at 100 cm SSD for 4 × 4 cm{sup 2} and 10 × 10 cm{sup 2} collimator settings for open and MLC collimated fields. For the 6 MV beam, films were placed at depths ranging from 0.015 cm to 2 cm and for 18 MV, 0.015 cm to 3.5 cm in Solid Water™. Films were calibrated for both photon energies at their respective dmax. PDDs and profiles were extracted from the film and compared to the MC data. The MC model was adjusted to match measured PDD and profiles. Results: For the 6 MV beam, the mean error(ME) in PDD between film and MC for open fields was 1.9%, whereas it was 2.4% for MLC. For the 18 MV beam, the ME in PDD for open fields was 2% and was 3.5% for MLC. For the 6 MV beam, the average root mean square(RMS) deviation for the central 80% of the beam profile for open fields was 1.5%, whereas it was 1.6% for MLC. For the 18 MV beam, the maximum RMS for open fields was 3%, and was 3.1% for MLC. Conclusion: The MC model of a linac agreed to within 4% of film measurements for depths ranging from the surface to dmax. Therefore, the MC linac model can predict surface dose for clinical applications. Future work will focus on adjusting the linac MC model to reduce RMS error and improve accuracy.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-F-T-375: Optimization of a New Co-60 Machine for Intensity Modulated Radiation Therapy: A Monte Carlo Characterization Study

Purpose: To provide a wide range of dose output for intensity modulation purposes while minimizing the beam penumbra for a new rotating cobalt therapy system. The highest dose rate needs to be maximized as well. Methods: The GEPTS Monte Carlo system is used to calculate the dose distribution from each tested Co-60 head for a wide range of field sizes (1×1 to 40×40 cm2). This includes the transport of photons (and secondary electrons) from the source through the collimation system (primary collimator, Y and × jaws, and MLCs) and finally in the water phantom. Photon transport includes Compton scattering (with electron binding effect), Rayleigh scattering, Photoelectric effect (with detailed simulation of fluorescence x-rays). Calculations are done for different system designs to reduce geometric penumbra and provide dose output modulation. Results: Taking into account different clinical requirements, the choice of a movable head (SAD = 70 to 80 cm) is made. The 120-leaf MLC (6-cm thick) entrance is at 32 cm from the bottom of the source (to reduce penumbra while allowing larger patient clearance). Three system designs (refereed here as S1–3) were simulated with different effective source sizes (2mm, 10mm and 17mm diameter). The effective point source is at mid-height of the 25-mm-long source. Using a 12000-Ci source, the designed Co-60 head can deliver a wide range of dose outputs (0.5 − 4 Gy/mn). A dose output of 2.2 Gy/mn can be delivered for a 10cm × 10cm field size with 1-cm penumbra using a 10mm effective source. Conclusion: A new 60Co-based VMAT machine is designed to meet different clinical requirements in term of dose output and beam penumbra. Outcomes from this study can be used for the design of 60Co machines for which a renewed interest is seen.

60 APPLIED LIFE SCIENCES↗

SU-F-T-384: Step and Shoot IMRT, VMAT and Autoplan VMAT Nasopharnyx Plan Robustness to Linear Accelerator Delivery Errors

Purpose: To identify the robustness of different treatment techniques in respect to simulated linac errors on the dose distribution to the target volume and organs at risk for step and shoot IMRT (ssIMRT), VMAT and Autoplan generated VMAT nasopharynx plans. Methods: A nasopharynx patient dataset was retrospectively replanned with three different techniques: 7 beam ssIMRT, one arc manual generated VMAT and one arc automatically generated VMAT. Treatment simulated uncertainties: gantry, collimator, MLC field size and MLC shifts, were introduced into these plans at increments of 5,2,1,−1,−2 and −5 (degrees or mm) and recalculated in Pinnacle. The mean and maximum doses were calculated for the high dose PTV, parotids, brainstem, and spinal cord and then compared to the original baseline plan. Results: Simulated gantry angle errors have <1% effect on the PTV, ssIMRT is most sensitive. The small collimator errors (±1 and ±2 degrees) impacted the mean PTV dose by <2% for all techniques, however for the ±5 degree errors mean target varied by up to 7% for the Autoplan VMAT and 10% for the max dose to the spinal cord and brain stem, seen in all techniques. The simulated MLC shifts introduced the largest errors for the Autoplan VMAT, with the larger MLC modulation presumably being the cause. The most critical error observed, was the MLC field size error, where even small errors of 1 mm, caused significant changes to both the PTV and the OAR. The ssIMRT is the least sensitive and the Autoplan the most sensitive, with target errors of up to 20% over and under dosages observed. Conclusion: For a nasopharynx patient the plan robustness observed is highest for the ssIMRT plan and lowest for the Autoplan generated VMAT plan. This could be caused by the more complex MLC modulation seen for the VMAT plans. This project is supported by a grant from NSW Cancer Council.

60 APPLIED LIFE SCIENCES↗

SU-F-T-488: Comparison of the TG-51 and TG-51 Addendum Calibration Protocols

Purpose: To quantify differences between the TG51 and TG51 addendum calibration protocols. Methods: Beam energies of 6X, 6XSRS, 10X, 15X, 23X, 6XFFF, and 10XFFF were calibrated following both the TG51 and TG51 addendum protocols using both a Farmer and a scanning ionization chamber with traceable absorbed dose-to-water calibrations. For the TG51 addendum procedure, the collimating jaws were positioned to define a 10×10cm{sup 2} radiation field, a lead foil was only used for kQ measurements of FFF energies, and a volume-averaging correction was applied based on crossline and inline dose profiles. For the TG51 procedure, the collimating jaws were set to 10×10cm{sup 2} according to the digital readout, and a lead foil was used for kQ measurements of energies greater than 10MV. Results: For beam energies with a flattening filter, absorbed dose-to-water determined by the two protocols differed by 0.1%–0.3%. For FFF beam energies, differences between the protocols were up to 0.2% and 0.8% for the scanning and Farmer ionization chambers, respectively. Differences between the protocols were due to kQ determination, volume-averaging correction, and measurement of raw ionization. Differences in kQ values between the two protocols were up to 0.4% and 0.2% for the scanning and Farmer ionization chambers, respectively. Volume-averaging corrections were less than 0.1% for the scanning ionization chamber, and up to 0.4% and 0.6% for the Farmer ionization chamber in beams with a flattening filter and FFF beams, respectively. Raw ionization measurements differed up to 0.3%±0.07% due to differences in jaw settings. Conclusion: The TG51 and TG51 addendum calibration protocols differed less than 0.3% for the scanning ionization chamber. For the Farmer chamber in FFF energies, volume-averaging corrections of up to 0.6% contributed to calibration differences of up to 0.8%. Failure to verify the radiation field size can produce calibration differences of up to 0.3%.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-F-T-504: Non-Divergent Planning Method for Craniospinal Irradiation

Purpose: Traditional Craniospinal Irradiation (CSI) planning techniques require careful field placement to allow optimal divergence and field overlap at depth, and measurement of skin gap. The result of this is a necessary field overlap resulting in dose heterogeneity in the spinal canal. A novel, nondivergent field matching method has been developed to allow simple treatment planning and delivery without the need to measure skin gap. Methods: The CSI patient was simulated in the prone, and a plan was developed. Bilateral cranial fields were designed with couch and collimator rotation to eliminate divergence with the upper spine field and minimize anterior divergence into the lenses. Spinal posterior-to-anterior fields were designed with the couch rotated to 90 degrees to allow gantry rotation to eliminate divergence at the match line, and the collimator rotated to 90 degrees to allow appropriate field blocking with the MLCs. A match line for the two spinal fields was placed and the gantry rotated to equal angles in opposite directions about the match line. Jaw positions were then defined to allow 1mm overlap at the match line to avoid cold spots. A traditional CSI plan was generated using diverging spinal fields, and a comparison between the two techniques was generated. Results: The non-divergent treatment plan was able to deliver a highly uniform dose to the spinal cord with a cold spot of only 95% and maximum point dose of 115.8%, as compared to traditional plan cold spots of 87% and hot spots of 132% of the prescription dose. Conclusion: A non-divergent method for planning CSI patients has been developed and clinically implemented. Planning requires some geometric manipulation in order to achieve an adequate dose distribution, however, it can help to manage cold spots and simplify the shifts needed between spinal fields.

60 APPLIED LIFE SCIENCES↗

SU-F-T-524: Investigation of the Dosimertric Benefits of Interchangeable Source Size of a Novel Rotating Gamma System

Purpose: Tremendous technological developments were made for conformal therapy techniques with linear accelerators, while less attention was paid to cobalt-60 units. The aim of the current study is to explore the dosimetric benefits of a novel rotating gamma ray system enhanced with interchangeable source sizes and multi-leaf collimator (MLC). Material and Methods: CybeRT is a novel rotating gamma ray machine with a ring gantry that ensures an iso-center accuracy of less than 0.3 mm. The new machine has a 70cm source axial distance allowing for improved penumbra compared to conventional machines. MCBEAM was used to simulate Cobalt-60 beams from the CybeRT head, while the MCPLAN code was used for modeling the MLC and for phantom/patient dose calculation. The CybeRT collimation will incorporate a system allowing for interchanging source sizes. In this work we have created phase space files for 1cm and 2cm source sizes. Evaluation of the system was done by comparing CybeRT beams with the 6MV beams in a water phantom and in patient geometry. Treatment plans were compared based on isodose distributions and dose volume histograms. Results: Profiles for the 1cm source were comparable to that from 6MV in the order of 6mm for 10×10 cm{sup 2} field size at the depth of maximum dose. This could ascribe to Cobalt-60 beams producing lowerenergy secondary electrons. Although, the 2cm source have a larger penumbra however it could be still used for large targets with proportionally increased dose rate. For large lung targets, the difference between cobalt and 6MV plans is clinically insignificant. Our preliminary results showed that interchanging source sizes will allow cobalt beams for volumetric arc therapy of both small lesions and large tumors. Conclusion: The CybeRT system will be a cost effective machine capable of performing advanced radiation therapy treatments of both small tumors and large target volumes.

60 APPLIED LIFE SCIENCES↗

SU-F-T-538: CyberKnife with MLC for Treatment of Large Volume Tumors: A Feasibility Study

Purpose: CyberKnife is a well-documented modality for SRS and SBRT treatments. Typical tumors are small and 1–5 fractions are usually used. We determined the feasibility of using CyberKnife, with an InCise multileaf collimator option, for larger tumors undergoing standard dose and fractionation. The intent was to understand the limitation of using this modality for other external beam radiation treatments. Methods: Five tumors from different anatomical sites with volumes from 127.8 cc to 1,320.5 cc were contoured and planned on a Multiplan V5.1 workstation. The target average diameter ranged from 7 cm to 13 cm. The dose fractionation was 1.8–2.0 Gy/fraction and 25–45 fractions for total doses of 45–81 Gy. The sites planned were: pancreas, head and neck, prostate, anal, and esophagus. The plans were optimized to meet conventional dose constraints based on various RTOG protocols for conventional fractionation. Results: The Multiplan treatment planning system successfully generated clinically acceptable plans for all sites studied. The resulting dose distributions achieved reasonable target coverage, all greater than 95%, and satisfactory normal tissue sparing. Treatment times ranged from 9 minutes to 38 minutes, the longest being a head and neck plan with dual targets receiving different doses and with multiple adjacent critical structures. Conclusion: CyberKnife, with the InCise multileaf collimation option, can achieve acceptable dose distributions in large volume tumors treated with conventional dose and fractionation. Although treatment times are greater than conventional accelerator time; target coverage and dose to critical structures can be kept within a clinically acceptable range. While time limitations exist, when necessary CyberKnife can provide an alternative to traditional treatment modalities for large volume tumors.

60 APPLIED LIFE SCIENCES↗

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

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 grid 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.

60 APPLIED LIFE SCIENCES↗

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

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) using 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.

60 APPLIED LIFE SCIENCES↗

SU-F-T-637: Single-Isocenter Versus Multiple-Isocenter VMAT SRS for Unusual Multiple Metastasis Case with Two Widely Separated Lesions

Purpose: Single-isocenter (SI) volumetric modulated arc therapy has been shown to be an effective and efficient approach to multiple metastasis radiosurgery. However, certain extreme cases raise the question of whether multiple-isocenter (MI) approaches can still generate superior plans. In this study, we ask this question with respect to a clinical case with two very widely separated lesions. Methods: A patient with two widely separated (d = 12cm) tumors was treated with SI-VMAT SRS using 10MV flattening filter free (FFF) beam with high-definition multi-leaf collimator (HD-MLC, 2.5/5mm) in two non-coplanar arcs using concentric rings to enforce steep gradient. Because of lesion positioning with respect to collimator angle selection, lesions were treated by 5mm leaves. We re-planned the case with a congruent arc arrangement but separate isocenter for each lesion. In this manner, lesions were treated by 2.5mm leaves. Conformity index (CI), V50%, and mean brain dose were compared. Results: Neither conformity (CI-SI = 1.12, CI-MI = 1.08) nor V50% (V50%-SI =8.82cc, V50%-MI =8.81cc) were improved by utilizing a separate isocenter for each lesion. Mean brain dose was slightly reduced (dmean-SI = 118.4 cGy, dmean-MI = 88.7 cGy) by using multiple isocenters. Conclusion: For this case with a lesion at the apex of the brain and another distantly located at the base of skull, employing a separate isocenter for each target did not meaningfully improve plan quality. Single-isocenter VMAT has been shown feasible and equivalent to multiple-isocenter VMAT for multiple metastasis cases in general. In this extreme case, single- and multiple- isocenter VMAT were also equivalent. If rotational setup errors are appropriately corrected, the increased delivery efficiency of the single-isocenter approach renders it preferable to the multiple isocenter approach. Dr’s Thomas, Popple, and Fiveash have all received honoraria from Varian Medical Systems for discussing their experiences with stereotactic radiosurgery.

60 APPLIED LIFE SCIENCES↗

SU-F-T-658: Out-Of-Field Dose Comparison for TrueBeam Low Energy Beams for Extended Distances: Measurement Vs Monte Carlo Simulation

Purpose: Patient dose far from the treatment field is comprised of scatter from within the patient, and treatment head leakage. We quantify the treatment head leakage for TrueBeam linear accelerator for 6X and 6X-FFF beams by comparing measurements to Monte Carlo simulations for a variety of jaw sizes and collimator rotations. This work is conceptually similar to that of Kry et al. (Medical Physics 2006; 33: 4405), who considered a Clinac linear accelerator. Methods: Measurements were made using an EXRADIN A101 ion chamber positioned in the patient plane, at distances up to 100 cm from isocenter. Simulations were done using VirtuaLinac, the GEANT4-based Monte Carlo model of the TrueBeam treatment head, and an in-house (U. Virginia) GEANT4-based code. In-house code modelled an ion chamber with build-up, based on a CT scan of the chamber. VirtuaLinac included a detailed model of the treatment head shielding, and was run on the Amazon Web Services cloud to generate spherical phase space files surrounding the treatment head. These phase space files were imported into the in-house code. Results: Initial comparisons between measurements and simulation showed an excess of dose in the in-plane direction, away from the gantry, in the simulations. This was traced to an incomplete model of the shielding—specifically, the component holding the primary collimator was smaller in the model than in the TrueBeam. Modifications were made to VirtuaLinac to more closely match the engineering drawings. In the in-plane direction, the lowest out of field dose was away from gantry (negative abscissa values) at around 60 cm from isocenter, for fields smaller than 10×10 cm2. Out of field dose decreased with decreasing jaw size. Flattening-filter free beam produced out-of-field doses as low as 65% of those with flattened beam. Conclusion: Doses determined from simulation and measurement were in close agreement. Funding support from the Jefferson Trust Foundation.

60 APPLIED LIFE SCIENCES↗