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At least 631 records · Page 35
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DOE OSTI2014

Sci—Fri PM: Dosimetry—04: Radiation out-of-field dose in the treatment of pediatric central nervous system malignancies

Children diagnosed with central nervous system (CNS) malignancies often receive radiotherapy, which can cause radiogenic late effects. In order to identify and reduce the risk of these late effects, we must understand the radiation doses that these children receive. Modern treatment planning systems accurately estimate the absorbed dose within the treatment fields but poorly estimate the dose outside them. The purpose of our study was to measure the out-of-field dose for children receiving localized radiotherapy for CNS cancer and apply an analytical model for estimating dose as a function of distance from the field edge. Radiation fields designed for a 12-year-old boy treated in our clinic were applied to an anthropomorphic phantom containing more than 200 thermoluminescent dosimeters. A double-Gaussian function of absorbed dose versus distance from the field edge (i.e., 50% isodose line) was applied, and parameters were allowed to vary and were fit to the model by minimizing the root mean square deviation, RMSD. The fitted model accurately predicted the dose from distances of 4 cm to 50 cm (RMSD = 0.54 cGy/Gy), but the model was not useful in estimating dose for distances less than 4 cm because of wide variation in measured dose, and the double-Gaussian model failed by systematically underestimating the dose beyond 50 cm. In conclusion, the double-Gaussian model may be applicable for points at distances from the field edge between 4 cm and 50 cm, where most children's radiosensitive tissues are located, but for points beyond 50 cm, an improvement should be investigated.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Sci—Fri PM: Dosimetry—05: Megavoltage electron backscatter: EGSnrc results versus 21 experiments

The accuracy of electron backscatter calculations at megavoltage energies is important for many medical physics applications. In this study, EGSnrc calculations of megavoltage electron backscatter (1–22 MeV) are performed and compared to the data from 21 experiments published between 1954 and 1993 for 25 single elements with atomic numbers from 3 to 92. Typical experimental uncertainties are 15%. For EGSnrc simulations, an ideal detector is assumed, and the most accurate electron physics options are employed, for a combined statistical and systematic uncertainty of 3%. The quantities compared are the backscatter coefficient and the energy spectra (in the backward hemisphere and at specific detector locations). For the backscatter coefficient, the overall agreement is within ±2% in the absolute value of the backscatter coefficient (in per cent), and within 11% of the individual backscatter values. EGSnrc results are systematically on the higher end of the spread of the experimental data, which could be partially from systematic experimental errors discussed in the literature. For the energy spectra, reasonable agreement between simulations and experiments is observed, although there are significant variations in the experimental data. At the lower end of the spectra, simulations are higher than some experimental data, which could be due to reduced experimental sensitivity to lower energy electrons and/or over-estimation by EGSnrc for backscattered secondary electrons. In conclusion, overall good agreement is observed between EGSnrc backscatter calculations and experimental measurements for megavoltage electrons. There is a need for high quality experimental data for the energy spectra of backscattered electrons.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Application of a radiophotoluminescent glass dosimeter to nonreference condition dosimetry in the postal dose audit system

Purpose: The purpose of this study was to obtain a set of correction factors of the radiophotoluminescent glass dosimeter (RGD) output for field size changes and wedge insertions. Methods: Several linear accelerators were used for irradiation of the RGDs. The field sizes were changed from 5 × 5 cm to 25 × 25 cm for 4, 6, 10, and 15 MV x-ray beams. The wedge angles were 15°, 30°, 45°, and 60°. In addition to physical wedge irradiation, nonphysical (dynamic/virtual) wedge irradiations were performed. Results: The obtained data were fitted with a single line for each energy, and correction factors were determined. Compared with ionization chamber outputs, the RGD outputs gradually increased with increasing field size, because of the higher RGD response to scattered low-energy photons. The output increase was about 1% per 10 cm increase in field size, with a slight difference dependent on the beam energy. For both physical and nonphysical wedged beam irradiation, there were no systematic trends in the RGD outputs, such as monotonic increase or decrease depending on the wedge angle change if the authors consider the uncertainty, which is approximately 0.6% for each set of measured points. Therefore, no correction factor was needed for all inserted wedges. Based on this work, postal dose audits using RGDs for the nonreference condition were initiated in 2010. The postal dose audit results between 2010 and 2012 were analyzed. The mean difference between the measured and stated doses was within 0.5% for all fields with field sizes between 5 × 5 cm and 25 × 25 cm and with wedge angles from 15° to 60°. The standard deviations (SDs) of the difference distribution were within the estimated uncertainty (1SD) except for the 25 × 25 cm field size data, which were not reliable because of poor statistics (n = 16). Conclusions: A set of RGD output correction factors was determined for field size changes and wedge insertions. The results obtained from recent postal dose audits were analyzed, and the mean differences between the measured and stated doses were within 0.5% for every field size and wedge angle. The SDs of the distribution were within the estimated uncertainty, except for one condition that was not reliable because of poor statistics.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Organ localization: Toward prospective patient-specific organ dosimetry in computed tomography

Purpose: With increased focus on radiation dose from medical imaging, prospective radiation dose estimates are becoming increasingly desired. Using available populations of adult and pediatric patient phantoms, radiation dose calculations can be catalogued and prospectively applied to individual patients that best match certain anatomical characteristics. In doing so, the knowledge of organ size and location is a required element. Here, the authors develop a predictive model of organ locations and volumes based on an analysis of adult and pediatric computed tomography (CT) data. Methods: Fifty eight adult and 69 pediatric CT datasets were segmented and utilized in the study. The maximum and minimum points of the organs were recorded with respect to the axial distance from the tip of the sacrum. The axial width, midpoint, and volume of each organ were calculated. Linear correlations between these three organ parameters and patient age, BMI, weight, and height were determined. Results: No statistically significant correlations were found in adult patients between the axial width, midpoint, and volume of the organs versus the patient age or BMI. Slight, positive linear trends were found for organ midpoint versus patient weight (max r{sup 2} = 0.382, mean r{sup 2} = 0.236). Similar trends were found for organ midpoint versus height (max r{sup 2} = 0.439, mean r{sup 2} = 0.200) and for organ volume versus height (max r{sup 2} = 0.410, mean r{sup 2} = 0.153). Gaussian fits performed on probability density functions of the adult organs resulted in r{sup 2}-values ranging from 0.96 to 0.996. The pediatric patients showed much stronger correlations overall. Strong correlations were observed between organ axial midpoint versus age, height, and weight (max r{sup 2} = 0.842, mean r{sup 2} = 0.790; max r{sup 2} = 0.949, mean r{sup 2} = 0.894; and max r{sup 2} = 0.870, mean r{sup 2} = 0.847, respectively). Moderate linear correlations were also observed for organ axial width versus height (max r{sup 2} = 0.772, mean r{sup 2} = 0.562) and for organ volume versus height (max r{sup 2} = 0.781, mean r{sup 2} = 0.601). Conclusions: Adult patients exhibited small variations in organ volume and location with respect to height and weight, but no meaningful correlation existed between these parameters and age or BMI. Once adulthood is reached, organ morphology and positioning seem to remain static. However, clear trends are evident between pediatric organ locations versus age, height, and weight. Such information can be incorporated into a matching methodology that may provide the highest probability of representing the anatomy of a patient undergoing a clinical exam to prospectively estimate the radiation dose.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Accuracy of Monte Carlo simulations compared to in-vivo MDCT dosimetry

Purpose: The purpose of this study was to assess the accuracy of a Monte Carlo simulation-based method for estimating radiation dose from multidetector computed tomography (MDCT) by comparing simulated doses in ten patients to in-vivo dose measurements. Methods: MD Anderson Cancer Center Institutional Review Board approved the acquisition of in-vivo rectal dose measurements in a pilot study of ten patients undergoing virtual colonoscopy. The dose measurements were obtained by affixing TLD capsules to the inner lumen of rectal catheters. Voxelized patient models were generated from the MDCT images of the ten patients, and the dose to the TLD for all exposures was estimated using Monte Carlo based simulations. The Monte Carlo simulation results were compared to the in-vivo dose measurements to determine accuracy. Results: The calculated mean percent difference between TLD measurements and Monte Carlo simulations was −4.9% with standard deviation of 8.7% and a range of −22.7% to 5.7%. Conclusions: The results of this study demonstrate very good agreement between simulated and measured doses in-vivo. Taken together with previous validation efforts, this work demonstrates that the Monte Carlo simulation methods can provide accurate estimates of radiation dose in patients undergoing CT examinations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Optical cone beam tomography of Cherenkov-mediated signals for fast 3D dosimetry of x-ray photon beams in water

Purpose: To test the use of a three-dimensional (3D) optical cone beam computed tomography reconstruction algorithm, for estimation of the imparted 3D dose distribution from megavoltage photon beams in a water tank for quality assurance, by imaging the induced Cherenkov-excited fluorescence (CEF). Methods: An intensified charge-coupled device coupled to a standard nontelecentric camera lens was used to tomographically acquire two-dimensional (2D) projection images of CEF from a complex multileaf collimator (MLC) shaped 6 MV linear accelerator x-ray photon beam operating at a dose rate of 600 MU/min. The resulting projections were used to reconstruct the 3D CEF light distribution, a potential surrogate of imparted dose, using a Feldkamp–Davis–Kress cone beam back reconstruction algorithm. Finally, the reconstructed light distributions were compared to the expected dose values from one-dimensional diode scans, 2D film measurements, and the 3D distribution generated from the clinical Varian ECLIPSE treatment planning system using a gamma index analysis. A Monte Carlo derived correction was applied to the Cherenkov reconstructions to account for beam hardening artifacts. Results: 3D light volumes were successfully reconstructed over a 400 × 400 × 350 mm{sup 3} volume at a resolution of 1 mm. The Cherenkov reconstructions showed agreement with all comparative methods and were also able to recover both inter- and intra-MLC leaf leakage. Based upon a 3%/3 mm criterion, the experimental Cherenkov light measurements showed an 83%–99% pass fraction depending on the chosen threshold dose. Conclusions: The results from this study demonstrate the use of optical cone beam computed tomography using CEF for the profiling of the imparted dose distribution from large area megavoltage photon beams in water.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

SU-E-J-69: Iterative Deconvolution of the Initial Photon Fluence for EPID Dosimetry: A Monte Carlo Based Study

Purpose: Developing a fast and accurate calculation model to reconstruct the applied photon fluence from an external photon radiation therapy treatment based on an image recorded by an electronic portal image device (EPID). Methods: To reconstruct the initial photon fluence the 2D EPID image was corrected for scatter from the patient/phantom and EPID to generate the transmitted primary photon fluence. This was done by an iterative deconvolution using precalculated point spread functions (PSF). The transmitted primary photon fluence was then backprojected through the patient/phantom geometry considering linear attenuation to receive the initial photon fluence applied for the treatment.The calculation model was verified using Monte Carlo simulations performed with the EGSnrc code system. EPID images were produced by calculating the dose deposition in the EPID from a 6 MV photon beam irradiating a water phantom with air and bone inhomogeneities and the ICRP anthropomorphic voxel phantom. Results: The initial photon fluence was reconstructed using a single PSF and position dependent PSFs which depend on the radiological thickness of the irradiated object. Appling position dependent point spread functions the mean uncertainty of the reconstructed initial photon fluence could be reduced from 1.13 % to 0.13 %. Conclusion: This study presents a calculation model for fluence reconstruction from EPID images. The{sup Result} show a clear advantage when position dependent PSF are used for the iterative reconstruction. The basic work of a reconstruction method was established and further evaluations must be made in an experimental study.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-09: A Clinical Implementation and Optimized Dosimetry Study of Freiberg Flap Skin Surface Treatment in High Dose Rate Brachytherapy

Purpose: This case study was designated to confirm the optimized plan was used to treat skin surface of left leg in three stages. 1. To evaluate dose distribution and plan quality by alternating of the source loading catheters pattern in flexible Freiberg Flap skin surface (FFSS) applicator. 2. To investigate any impact on Dose Volume Histogram (DVH) of large superficial surface target volume coverage. 3. To compare the dose distribution if it was treated with electron beam. Methods: The Freiburg Flap is a flexible mesh style surface mold for skin radiation or intraoperative surface treatments. The Freiburg Flap consists of multiple spheres that are attached to each other, holding and guiding up to 18 treatment catheters. The Freiburg Flap also ensures a constant distance of 5mm from the treatment catheter to the surface. Three treatment trials with individual planning optimization were employed: 18 channels, 9 channels of FF and 6 MeV electron beam. The comparisons were highlighted in target coverage, dose conformity and dose sparing of surrounding tissues. Results: The first 18 channels brachytherapy plan was generated with 18 catheters inside the skin-wrapped up flap (Figure 1A). A second 9 catheters plan was generated associated with the same calculation points which were assigned to match prescription for target coverage as 18 catheters plan (Figure 1B). The optimized inverse plan was employed to reduce the dose to adjacent structures such as tibia or fibula. The comparison of DVH’s was depicted on Figure 2. External beam of electron RT plan was depicted in Figure 3. Overcall comparisons among these three were illustrated in Conclusion: The 9-channel Freiburg flap flexible skin applicator offers a reasonably acceptable plan without compromising the coverage. Electron beam was discouraged to use to treat curved skin surface because of low target coverage and high dose in adjacent tissues.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-379: Evaluation of An EPID-Based System for Daily Dosimetry Check by Comparison with a Widely-Used Ionization Chamber-Based Device

Purpose: To examine the feasibility of using Varian’s EPID-based Machine Performance Check (MPC) system to track daily machine output through comparison with Sun Nuclear’s DailyQA3 (DQA) device. Methods: Daily machine outputs for two photon energies (6 and 16MV) and five electron energies (6, 9, 12, 16, 20MeV) were measured for one month using both MPC and DQA. Baselines measurements for MPC were taken at the start of the measurement series, while DQA baselines were set at an earlier date. In order to make absolute comparisons with MPC, all DQA readings were referenced to the average of the first three DQA readings in that series, minimizing systematic differences between the measurement techniques due to baseline differences. In addition to daily output measurements, weekly averages were also calculated and compared. Finally, the electron energy dependence of each measurement technique was examined by comparing energy-specific measurements to the average electron output of all energies each day. Results: For 6 and 16MV photons, the largest absolute percent differences between MPC and DQA were 0.60% and 0.73%, respectively. Weekly averages were within 0.17% and 0.23%, respectively. For all five electron energies, the greatest absolute percent differences between MPC and DQA for each energy ranged from 0.49%–0.83%. Weekly averages ranged from 0.07%–0.28%. DQA energy-specific electron readings matched the average electron output within 0.29% for all days and all energies. MPC energy-specific readings matched the average within 0.21% for 9–20MeV. However, 6MeV showed a larger distribution about the average with four days showing a difference greater than 0.30% and a maximum difference of 0.51%. Conclusion: MPC output measurements correlated well with the widely-used DQA3 for most beam energies, making it a reliable back up technique for daily output monitoring. However, MPC may display an energy dependence for lower electrons energies, requiring additional investigation.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

SU-E-T-414: Experimental Correction of High-Z Electrode Effect in Mini-Ionization Chambers for Small Beam Dosimetry

Purpose: To correct for the over-response of mini-ionization chambers with high-Z central electrodes. The hypothesis is that by applying a negative/reverse voltage, it is possible to suppress the signal generated in the high-Z central electrode by low-energy photons. Methods: The mini-ionization chambers used in the experiments were a PTW-31014, PTW-31006 and IBA-CC01. The PTW-31014 has an aluminum central electrode while the PTW-31006 and IBA-CC01 have a steel one. Total scatter factors (Scp) were measured for a 6 MV photon beam down to a square field size of 0.5 cm. The measurements were performed in water at 10 cm depth with SAD of 100 cm. The Scp were measured with the dosimeters with +400V bias voltage. In the case of the PTW-31006 and IBA-CC01, the measurements were repeated with −400V bias voltage. Also, the field factors in water were calculated with Monte Carlo simulations for comparison. Results: The measured Scp at +400V with the PTW-31006 and IBA-CC01 detectors were in agreement within 0.2% down to a field size of 1.5 cm. Both dosimeters shown a systematic difference about 2.5% with the Scp measured with the PTW-31014 and the Monte Carlo calculated field factors. The measured Scp at −400V with the PTW-31006 and IBA-CC01 detectors were in close agreement with the PTW-31014 measured Scp and the field factors within 0.3 and 1.0%, respectively. In the case of the IBA-CC01 it was found a good agreement (1%) down to field size of 1.0 cm. All the dosimeters shown differences up to 17% between the measured Scp and the field factor for the 0.5 cm field size. Conclusion: By applying a negative/reverse voltage to the mini-ionization chambers with high-Z central electrode it was possible to correct for their over-response to low energy photons.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

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 ↗
DOE OSTI2015

WE-D-210-04: Radiation-Induced Polymerization of Ultrasound Contrast Agents in View of Non-Invasive Dosimetry in External Beam Radiation Therapy

Purpose: Ultrasound contrast agents (UCA’s) based on gas-filled microbubbles encapsulated by an amphiphilic shell are well established as safe and effective echo-enhancers in diagnostic imaging. In view of an alternative application of UCA’s, we investigated the use of targeted microbubbles as radiation sensors for external beam radiation therapy. As radiation induces permanent changes in the microbubble’s physico-chemical properties, a robust measure of these changes can provide a direct or indirect estimate of the applied radiation dose. For instance, by analyzing the ultrasonic dispersion characteristics of microbubble distributions before and after radiation treatment, an estimate of the radiation dose at the location of the irradiated volume can be made. To increase the radiation sensitivity of microbubbles, polymerizable diacetylene molecules can be incorporated into the shell. This study focuses on characterizing the acoustic response and quantifying the chemical modifications as a function of radiation dose. Methods: Lipid/diacetylene microbubbles were irradiated with a 6 MV photon beam using dose levels in the range of 0–150 Gy. The acoustic response of the microbubbles was monitored by ultrasonic through-transmission measurements in the range of 500 kHz to 20 MHz, thereby providing the dispersion relations of the phase velocity, attenuation and nonlinear coefficient. In addition, the radiation-induced chemical modifications were quantified using UV-VIS spectroscopy. Results: UV-VIS spectroscopy measurements indicate that ionizing radiation induces the polymerization of diacetylenes incorporated in the microbubble shell. The polymer yield strongly depends on the shell composition and the radiation-dose. The acoustic response is inherently related to the visco-elastic properties of the shell and is strongly influenced by the shell composition and the physico-chemical changes in the environment. Conclusion: Diacetylene-containing microbubbles are polymerizable under influence of ionizing radiation and are a promising design concept within the development of a novel non-invasive in-vivo radiation dosimeter for external beam radiation therapy. This work was funded by the Research Foundation - Flanders (FWO)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Technical Note: Motion-perturbation method applied to dosimetry of dynamic MLC target tracking—A proof-of-concept

Purpose: Previous studies show that dose to a moving target can be estimated using 4D measurement-guided dose reconstruction based on a process called virtual motion simulation, or VMS. A potential extension of VMS is to estimate dose during dynamic multileaf collimator (MLC)-tracking treatments. The authors introduce a modified VMS method and quantify its performance as proof-of-concept for tracking applications. Methods: Direct measurements with a moving biplanar diode array were used to verify accuracy of the VMS dose estimates. A tracking environment for variably sized circular MLC apertures was simulated by sending preprogrammed control points to the MLC while simultaneously moving the accelerator treatment table. Sensitivity of the method to simulated tracking latency (0–700 ms) was also studied. Potential applicability of VMS to fast changing beam apertures was evaluated by modeling, based on the demonstrated dependence of the cumulative dose on the temporal dose gradient. Results: When physical and virtual latencies were matched, the agreement rates (2% global/2 mm gamma) between the VMS and the biplanar dosimeter were above 96%. When compared to their own reference dose (0 induced latency), the agreement rates for VMS and biplanar array track closely up to 200 ms of induced latency with 10% low-dose cutoff threshold and 300 ms with 50% cutoff. Time-resolved measurements suggest that even in the modulated beams, the error in the cumulative dose introduced by the 200 ms VMS time resolution is not likely to exceed 0.5%. Conclusions: Based on current results and prior benchmarks of VMS accuracy, the authors postulate that this approach should be applicable to any MLC-tracking treatments where leaf speeds do not exceed those of the current Varian accelerators.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

A new technique to characterize CT scanner bow-tie filter attenuation and applications in human cadaver dosimetry simulations

Purpose: To present a noninvasive technique for directly measuring the CT bow-tie filter attenuation with a linear array x-ray detector. Methods: A scintillator based x-ray detector of 384 pixels, 307 mm active length, and fast data acquisition (model X-Scan 0.8c4-307, Detection Technology, FI-91100 Ii, Finland) was used to simultaneously detect radiation levels across a scan field-of-view. The sampling time was as short as 0.24 ms. To measure the body bow-tie attenuation on a GE Lightspeed Pro 16 CT scanner, the x-ray tube was parked at the 12 o’clock position, and the detector was centered in the scan field at the isocenter height. Two radiation exposures were made with and without the bow-tie in the beam path. Each readout signal was corrected for the detector background offset and signal-level related nonlinear gain, and the ratio of the two exposures gave the bow-tie attenuation. The results were used in the GEANT4 based simulations of the point doses measured using six thimble chambers placed in a human cadaver with abdomen/pelvis CT scans at 100 or 120 kV, helical pitch at 1.375, constant or variable tube current, and distinct x-ray tube starting angles. Results: Absolute attenuation was measured with the body bow-tie scanned at 80–140 kV. For 24 doses measured in six organs of the cadaver, the median or maximum difference between the simulation results and the measurements on the CT scanner was 8.9% or 25.9%, respectively. Conclusions: The described method allows fast and accurate bow-tie filter characterization.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-P-21: Study of Dosimetry Accuracy of Small Passively Scattered Proton Beam Fields

Purpose: To study the accuracy of the dose distribution of very small irregular fields of passively scattered proton beams calculated by the analytical pencil beam model of the Eclipse treatment planning system (TPS). Methods: An irregular field with a narrow region (width < 1 cm) that was used for the treatment of a small volume adjacent to a previously treated area were chosen for this investigation. Point doses at different locations inside the field were measured with a small volume ion chamber (A26, Standard Imaging). 2-D dose distributions were measured using a 2-D ion chamber array (MatriXX, IBA). All the measurements were done in plastic water phantom. The measured dose distributions were compared with the verification plan dose calculated in a water like phantom for the patient treatment field without the use of the compensator. Results: Point doses measured with the ion chamber in the narrowest section of the field were found to differ as much as 10% from the Eclipse calculated dose at some of the points. The 2-D dose distribution measured with the MatriXX which was validated by comparison with limited film measurement, at the proximal 95%, center of the spread out Bragg Peak and distal 90% depths agreed reasonably well with the TPS calculated dose distribution with more than 92% of the pixels passing the 2% / 2 mm dose distance agreement. Conclusion: The dose calculated by the pencil beam model of the Eclipse TPS for narrow irregular fields may not be accurate within 5% at some locations of the field, especially at the points close to the field edge due to the limitation of the dose calculation model. Overall accuracy of the calculated 2-D dose distribution was found to be acceptable for the 2%/2 mm dose/distance agreement with the measurement.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-J-127: Multi-Institutional Evaluation of Setup, Organ Deformation, Precision Dosimetry in Total Marrow Irradiation

Purpose: Totals Marrow Irradiation (TMI) is a highly focused radiation delivery to the human skeleton structure therefore requiring a high amount of precision and accuracy for a quality treatment. Not much is known on how the patient position varies across multiple treatment fractions and how that positioning impacts the dose delivery. Currently TMI is studied as an international collaboration with multiple centers around the world; however, many of these centers used different pretreatment techniques. The goal of this work is to measure the accuracy of patient positioning, its impact on dose delivery and compare the impact of each technique for multiple institutions. Methods: Using Tomotherapy pretreatment MVCTs and the planning KVCTs measurements are made of the 3D setup uncertainties of the TMI treatment. Then, using the dose and plan files of the treatment impact of patient position on dose can be measured. Measurement of organ deformation and center of mass change were done using the Velocity AI program from Varian. We are looking at four the boney targets (skull, spine, pelvis, and femur) and three key sensitive tissues (eyes, lungs, kidneys). Results: Position measurements have been made for 3 different institutions using 3 different pre-treatment techniques. Comparing the translation motion we can observe the greatest change in the Y and Z direction of patient set up. For intra-fractional motion the shoulder and clavicle represent the greatest potential for motion and therefore most likely to have a dose change. Conclusion: All centers use different techniques for their treatment and this study shows that these techniques do not produce the same pretreatment results. We hope to expand this study further. Currently we have 3 centers participating in this study with more centers joining every day.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-09: In Phantom Full-Implant Validation of Plastic Scintillation Detectors for in Vivo Dosimetry During Low Dose Rate Brachytherapy

Purpose: To validate in a water phantom the use of plastic scintillation detectors to measure dose to the urethra and the rectal wall during a clinically realistic low dose rate (LDR) brachytherapy implant. Methods: A template was designed to replicate a clinically realistic LDR brachytherapy prostate implant inside a water phantom. Twenty-two catheters were inserted, including one mimicking the urethra and another the rectal wall. The needles inserted in the remaining 20 catheters were composed of thin-walled nylon tubes in which I-125 radioactive seeds (Air Kerma Strengths of (0.328±0.020)U) were abutted together with plastic spacers to replicate a typical loading. A plastic scintillation detector (PSD) with a 5-mm long × 1-mm diameter sensitive element was first placed inside the urethra and 1-second measurements were performed for 60s after each needle implant. Measurements were also performed at multiple positions along the urethra once all the needles were inserted. The procedure was then repeated with the PSD placed at the rectal wall. Results: Individual dose-rates ranging from 0.07µGy/s to 1.5µGy/s were measured after each needle implant. The average absolute relative differences were (6.2±3.6)% and (6.9±6.5)% to the values calculated with the TG-43 formalism, for the urethra and rectal wall respectively. These results are within expectations from the error uncertainty budget once accounting for uncertainties in seeds’ strength and positioning. Interestingly, the PSD allowed for unplanned error detection as the study was performed. Finally, the measured dose after the full implant at different positions along the mimicked organs at risk were in agreement with TG-43 values for all of the positions tested. Conclusion: Plastic scintillation detectors could be used as in vivo detectors for LDR brachytherapy as they would provide accurate dose information after each needle implant as well as along the organs at risk at the end of the implant.

60 APPLIED LIFE SCIENCES↗