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DOE OSTI2016

SU-F-T-262: Commissioning Varian Portal Dosimetry for EPID-Based Patient Specific QA in a Non-Aria Environment

Purpose: Development of an in-house program facilitates a workflow that allows Electronic Portal Imaging Device (EPID) patient specific quality assurance (QA) measurements to be acquired and analyzed in the Portal Dosimetry Application (Varian Medical Systems, Palo Alto, CA) using a non-Aria Record and Verify (R&V) system (MOSAIQ, Elekta, Crawley, UK) to deliver beams in standard clinical treatment mode. Methods: Initial calibration of an in-house software tool includes characterization of EPID dosimetry parameters by importing DICOM images of varying delivered MUs to determine linear mapping factors in order to convert image pixel values to Varian-defined Calibrated Units (CU). Using this information, the Portal Dose Image Prediction (PDIP) algorithm was commissioned by converting images of various field sizes to output factors using the Eclipse Scripting Application Programming Interface (ESAPI) and converting a delivered configuration fluence to absolute dose units. To verify the algorithm configuration, an integrated image was acquired, exported directly from the R&V client, automatically converted to a compatible, calibrated dosimetric image, and compared to a PDIP calculated image using Varian’s Portal Dosimetry Application. Results: For two C-Series and one TrueBeam Varian linear accelerators, gamma comparisons (global 3% / 3mm) of PDIP algorithm predicted dosimetric images and images converted via the inhouse system demonstrated agreement for ≥99% of all pixels, exceeding vendor-recommended commissioning guidelines. Conclusion: Combinations of a programmatic image conversion tool and ESAPI allow for an efficient and accurate method of patient IMRT QA incorporating a 3rd party R&V system.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Dependence of Achievable Plan Quality on Treatment Technique and Planning Goal Refinement: A Head-and-Neck Intensity Modulated Radiation Therapy Application

Purpose: To develop a practical workflow for retrospectively analyzing target and normal tissue dose–volume endpoints for various intensity modulated radiation therapy (IMRT) delivery techniques; to develop technique-specific planning goals to improve plan consistency and quality when feasible. Methods and Materials: A total of 165 consecutive head-and-neck patients from our patient registry were selected and retrospectively analyzed. All IMRT plans were generated using the same dose–volume guidelines for TomoTherapy (Tomo, Accuray), TrueBeam (TB, Varian) using fixed-field IMRT (TB-IMRT) or RAPIDARC (TB-RAPIDARC), or Siemens Oncor (Siemens-IMRT, Siemens). A MATLAB-based dose–volume extraction and analysis tool was developed to export dosimetric endpoints for each patient. With a fair stratification of patient cohort, the variation of achieved dosimetric endpoints was analyzed among different treatment techniques. Upon identification of statistically significant variations, technique-specific planning goals were derived from dynamically accumulated institutional data. Results: Retrospective analysis showed that although all techniques yielded comparable target coverage, the doses to the critical structures differed. The maximum cord doses were 34.1 ± 2.6, 42.7 ± 2.1, 43.3 ± 2.0, and 45.1 ± 1.6 Gy for Tomo, TB-IMRT, TB-RAPIDARC, and Siemens-IMRT plans, respectively. Analyses of variance showed significant differences for the maximum cord doses but no significant differences for other selected structures among the investigated IMRT delivery techniques. Subsequently, a refined technique-specific dose–volume guideline for maximum cord dose was derived at a confidence level of 95%. The dosimetric plans that failed the refined technique-specific planning goals were reoptimized according to the refined constraints. We observed better cord sparing with minimal variations for the target coverage and other organ at risk sparing for the Tomo cases, and higher parotid doses for C-arm linear accelerator–based IMRT and RAPIDARC plans. Conclusion: Patient registry–based processes allowed easy and systematic dosimetric assessment of treatment plan quality and consistency. Our analysis revealed the dependence of certain dosimetric endpoints on the treatment techniques. Technique-specific refinement of planning goals may lead to improvement in plan consistency and plan quality.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Monte Carlo simulation of the dose response of a novel 2D silicon diode array for use in hybrid MRI–LINAC systems

Purpose: MRI-guided radiation therapy systems (MRIgRT) are being developed to improve online imaging during treatment delivery. At present, the operation of single point dosimeters and an ionization chamber array have been characterized in such systems. This work investigates a novel 2D diode array, named “magic plate,” for both single point calibration and 2D positional performance, the latter being a key element of modern radiotherapy techniques that will be delivered by these systems. Methods: GEANT4 Monte Carlo methods have been employed to study the dose response of a silicon diode array to 6 MV photon beams, in the presence of in-line and perpendicularly aligned uniform magnetic fields. The array consists of 121 silicon diodes (dimensions 1.5 × 1.5 × 0.38 mm{sup 3}) embedded in kapton substrate with 1 cm pitch, spanning a 10 × 10 cm{sup 2} area in total. A geometrically identical, water equivalent volume was simulated concurrently for comparison. The dose response of the silicon diode array was assessed for various photon beam field shapes and sizes, including an IMRT field, at 1 T. The dose response was further investigated at larger magnetic field strengths (1.5 and 3 T) for a 4 × 4 cm{sup 2} photon field size. Results: The magic plate diode array shows excellent correspondence (< ± 1%) to water dose in the in-line orientation, for all beam arrangements and magnetic field strengths investigated. The perpendicular orientation, however, exhibits a dose shift with respect to water at the high-dose-gradient beam edge of jaw-defined fields [maximum (4.3 ± 0.8)% over-response, maximum (1.8 ± 0.8)% under-response on opposing side for 1 T, uncertainty 1σ]. The trend is not evident in areas with in-field dose gradients typical of IMRT dose maps. Conclusions: A novel 121 pixel silicon diode array detector has been characterized by Monte Carlo simulation for its performance inside magnetic fields representative of current prototype and proposed MRI–linear accelerator systems. In the in-line orientation, the silicon dose is directly proportional to the water dose. In the perpendicular orientation, there is a shift in dose response relative to water in the highest dose gradient regions, at the edge of jaw-defined and single-segment MLC fields. The trend was not observed in-field for an IMRT beam. The array is expected to be a valuable tool in MRIgRT dosimetry.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2017

On angiography with a Thomson laser-electron X-ray generator

We consider a possibility of application of laser-electron X-ray generators for diagnosing the vessel status of internal organs. It is shown that modern lasers and linear accelerators can be used for the development of angiographic instruments of a new type with an increased spatial and temporal resolution while maintaining or reducing the radiation load on the patient and medical staff. Such improvements in diagnostic and ambient factors cannot be achieved with the use of X-ray tubes. All particular estimates and calculations have been performed for a contrast agent based on iodine compounds. (paper)

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Development and clinical evaluation of an ionization chamber array with 3.5 mm pixel pitch for quality assurance in advanced radiotherapy techniques

Purpose: To characterize a new air vented ionization chamber technology, suitable to build detector arrays with small pixel pitch and independence of sensitivity on dose per pulse. Methods: The prototype under test is a linear array of air vented ionization chambers, consisting of 80 pixels with 3.5 mm pixel pitch distance and a sensitive volume of about 4 mm{sup 3}. The detector has been characterized with {sup 60}Co radiation and MV x rays from different linear accelerators (with flattened and unflattened beam qualities). Sensitivity dependence on dose per pulse has been evaluated under MV x rays by changing both the source to detector distance and the beam quality. Bias voltage has been varied in order to evaluate the charge collection efficiency in the most critical conditions. Relative dose profiles have been measured for both flattened and unflattened distributions with different field sizes. The reference detectors were a commercial array of ionization chambers and an amorphous silicon flat panel in direct conversion configuration. Profiles of dose distribution have been measured also with intensity modulated radiation therapy (IMRT), stereotactic radiosurgery (SRS), and volumetric modulated arc therapy (VMAT) patient plans. Comparison has been done with a commercial diode array and with Gafchromic EBT3 films. Results: Repeatability and stability under continuous gamma irradiation are within 0.3%, in spite of low active volume and sensitivity (∼200 pC/Gy). Deviation from linearity is in the range [0.3%, −0.9%] for a dose of at least 20 cGy, while a worsening of linearity is observed below 10 cGy. Charge collection efficiency with 2.67 mGy/pulse is higher than 99%, leading to a ±0.9% sensitivity change in the range 0.09–2.67 mGy/pulse (covering all flattened and unflattened beam qualities). Tissue to phantom ratios show an agreement within 0.6% with the reference detector up to 34 cm depth. For field sizes in the range 2 × 2 to 15 × 15 cm{sup 2}, the output factors are in agreement with a thimble chamber within 2%, while with 25 × 25 cm{sup 2} field size, an underestimation of 4.0% was found. Agreement of field and penumbra width measurements with the flat panel is of the order of 1 mm down to 1 × 1 cm{sup 2} field size. Flatness and symmetry values measured with the 1D array and the reference detectors are comparable, and differences are always smaller than 1%. Angular dependence of the detector, when compared to measurements taken with a cylindrical chamber in the same phantom, is as large as 16%. This includes inhomogeneity and asymmetry of the design, which during plan verification are accounted for by the treatment planning system (TPS). The detector is capable to reproduce the dose distributions of IMRT and VMAT plans with a maximum deviation from TPS of 3.0% in the target region. In the case of VMAT and SRS plans, an average (maximum) deviation of the order of 1% (4%) from films has been measured. Conclusions: The investigated technology appears to be useful both for Linac QA and patient plan verification, especially in treatments with steep dose gradients and nonuniform dose rates such as VMAT and SRS. Major limitations of the present prototype are the linearity at low dose, which can be solved by optimizing the readout electronics, and the underestimation of output factors with large field sizes. The latter problem is presently not completely understood and will require further investigations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-F-CAMPUS-T-04: Variations in Nominally Identical Small Fields From Photon Jaw Reproducibility and Associated Effects On Small Field Dosimetric Parameters

Purpose: To investigate uncertainties in small field output factors and detector specific correction factors from variations in field size for nominally identical fields using measurements and Monte Carlo simulations. Methods: Repeated measurements of small field output factors are made with the Exradin W1 (plastic scintillation detector) and the PTW microDiamond (synthetic diamond detector) in beams from the Elekta Precise linear accelerator. We investigate corrections for a 0.6x0.6 cm{sup 2} nominal field size shaped with secondary photon jaws at 100 cm source to surface distance (SSD). Measurements of small field profiles are made in a water phantom at 10 cm depth using both detectors and are subsequently used for accurate detector positioning. Supplementary Monte Carlo simulations with EGSnrc are used to calculate the absorbed dose to the detector and absorbed dose to water under the same conditions when varying field size. The jaws in the BEAMnrc model of the accelerator are varied by a reasonable amount to investigate the same situation without the influence of measurements uncertainties (such as detector positioning or variation in beam output). Results: For both detectors, small field output factor measurements differ by up to 11 % when repeated measurements are made in nominally identical 0.6x0.6 cm{sup 2} fields. Variations in the FWHM of measured profiles are consistent with field size variations reported by the accelerator. Monte Carlo simulations of the dose to detector vary by up to 16 % under worst case variations in field size. These variations are also present in calculations of absorbed dose to water. However, calculated detector specific correction factors are within 1 % when varying field size because of cancellation of effects. Conclusion: Clinical physicists should be aware of potentially significant uncertainties in measured output factors required for dosimetry of small fields due to field size variations for nominally identical fields.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2022

ORNL Neutron Cross Section Measurements of 90 Zr

Nuclear criticality modeling and simulations rely on the quality of the existing evaluated nuclear data libraries such as Evaluated Nuclear Data File (ENDF)/B, the Joint Evaluated Fission and Fusion (JEFF) nuclear data library, or the Japanese Evaluated Nuclear Data Library (JENDL). In some cases, the cross-section evaluations of those libraries were found to be deficient in describing criticality benchmarks accurately. More than two decades ago, the US Nuclear Criticality Safety Program (NCSP) established a Nuclear Data (ND) task which encompassed experiments and evaluations. In response to this, the Oak Ridge National Laboratory (ORNL) formed a Nuclear Criticality and Data group which performed ND experiments, data analysis, and evaluations to produce ENDF files for the ND libraries as identified in the NCSP Five-Year Plan. Before being submitted to the ENDF library, files were processed and tested for performance by running benchmark calculations. This procedure was centralized in the ORNL group and is now often referred to as the ND pipeline. NCSP collaborates with the Joint Research Center (JRC) of the European Commission in Geel, Belgium, to perform high-resolution neutron-induced cross section measurements at the Geel Linear Accelerator (GELINA). The objective is to address emerging ND problems in criticality calculations. Difficulties with ND include insufficient neutron energy range, missing covariances, and previously unrecognized inaccuracies with experiments. New neutron total and capture cross sections of 90 Zr in the neutron energy range from 100 eV to several hundred keV were recently performed. These measured data will be used, together with existing high-resolution transmission data from a metallic 90 Zr sample, to improve representation of the cross sections.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2023

Neutron Capture and Transmission Measurements and Evaluation of 54 Fe at the RPI LINAC [Slides]

This presentation covers neutron capture and transmission measurements and evaluation of 54 Fe (Iron) at the Rensselaer Polytechnic Insitute (RPI) Linear Accelerator (LINAC). Presentation conclusions find that 54 Fe is near its conclusion, covariance matrix generation is needed for both experiments before data is made available and released (Completion by April 2023). RPI will be conducting a full Resolved Resonance Region (RRR) evaluation following release of data (Completion by September 2023). Additionally, the neutron beam imager shows promise in providing an easy way to align samples in the most intense part of the neutron beam and there will be a new evaluation that will offer improvements in crit safety, shielding, and stellar applications.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2016

SU-F-T-530: Characterization of a 60-Leaf Motorized MLC Designed for Cobalt-60 Units

Purpose: In a continuing effort to improve conformal radiation therapy with Cobalt-60 units, a 60-leaf MLC was designed, manufactured, and released to market. This work describes the physics measurements taken to characterize the clinical performance of this MLC. Methods: A 60 leaf MLC was custom designed with tungsten leaves of 4.5 cm height, single focused, achieving field size of 30×30 cm^2 when mounted on a 100cm SAD Cobalt-60 unit. Leakage and output factor measurements were performed using a single ion chamber in a solid water phantom. Penumbra and surface dose were measured using scanning chambers and diodes in a water phantom. Radiation-light coincidence measurements were performed using radiographic films. Results: With MLC mounted, measured penumbras at all depths are smaller than with jaws only. Surface doses were not significantly affected by the presence of MLC, and remained below values recommended by regulatory bodies. Light-radiation coincidences were found to be better than 3 mm for all field sizes. Leakage through the MLC was found to be strongly dependent on field size, increasing from 1.0 % for a 10×10 cm field to 2.0% for a 30×30 cm field. Such results meet the requirements of IEC 60601-2-11. The MLC was found to have significant influence on the output factor, when field size defined by MLC is significantly smaller than field size defined by jaws. Such effect is also observed on linear accelerators, but it is more pronounced on Cobalt-60 units. A 10×10 “diamond” MLC shape inside a 14×14 cm jaw showed output factor that is 5.7% higher than 10×10 cm field defined by matching MLC and jaws. Conclusion: The MLC offers clinically acceptable performance in penumbra, surface dose, and light-radiation coincidence. Several units of this MLC have recently been installed and used clinically. Validation of Cobalt-60 based IMRT with this MLC is ongoing. The authors are employees of Best Theratrnics Ltd.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Technical Note: On the impact of the incident electron beam energy on the primary dose component of flattening filter free photon beams

Purpose: For commercially available linear accelerators (Linacs), the electron energies of flattening filter free (FFF) and flattened (FF) beams are either identical or the electron energy of the FFF beam is increased to match the percentage depth dose curve (PDD) of the FF beam (in reference geometry). This study focuses on the primary dose components of FFF beams for both kinds of settings, studied on the same Linac. Methods: The measurements were conducted on a VersaHD Linac (Elekta, Crawley, UK) for both FF and FFF beams with nominal energies of 6 and 10 MV. In the clinical setting of the VersaHD, the energy of FFF{sub M} (Matched) beams is set to match the PDDs of the FF beams. In contrast the incident electron beam of the FFF{sub U} beam was set to the same energy as for the FF beam. Half value layers (HVLs) and a dual parameter beam quality specifier (DPBQS) were determined. Results: For the 6 MV FFF{sub M} beam, HVL and DPBQS values were very similar compared to those of the 6 MV FF beam, while for the 10 MV FFF{sub M} and FF beams, only %dd(10){sub x} and HVL values were comparable (differences below 1.5%). This shows that matching the PDD at one depth does not guarantee other beam quality dependent parameters to be matched. For FFF{sub U} beams, all investigated beam quality specifiers were significantly different compared to those for FF beams of the same nominal accelerator potential. The DPBQS of the 6 MV FF and FFF{sub M} beams was equal within the measurement uncertainty and was comparable to published data of a machine with similar TPR{sub 20,10} and %dd(10){sub x}. In contrast to that, the DPBQS’s two parameters of the 10 MV FFF{sub M} beam were substantially higher compared to those for the 10 MV FF beam. Conclusions: PDD-matched FF and FFF beams of both nominal accelerator potentials were observed to have similar HVL values, indicating similarity of their primary dose components. Using the DPBQS revealed that the mean attenuation coefficient was found to be the same within the uncertainty of 0.8% for 6 MV FF and 6 MV FFF{sub M} beams, while for 10 MV beams, they differed by 6.4%. This shows that the DPBQS can provide a differentiation of photon beam characteristics that would remain hidden by the use of a single beam quality specifier, such as %dd(10){sub x} or HVL.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-G-JeP2-04: Comparison Between Fricke-Type 3D Radiochromic Dosimeters for Real-Time Dose Distribution Measurements in MR-Guided Radiation Therapy

Purpose: To assess MR signal contrast for different ferrous ion compounds used in Fricke-type gel dosimeters for real-time dose measurements for MR-guided radiation therapy applications. Methods: Fricke-type gel dosimeters were prepared in 4% w/w gelatin prior to irradiation in an integrated 1.5 T MRI and 7 MV linear accelerator system (MR-Linac). 4 different ferrous ion (Fe2?) compounds (referred to as A, B, C, and D) were investigated for this study. Dosimeter D consisted of ferrous ammonium sulfate (FAS), which is conventionally used for Fricke dosimeters. Approximately half of each cylindrical dosimeter (45 mm diameter, 80 mm length) was irradiated to ∼17 Gy. MR imaging during irradiation was performed with the MR-Linac using a balanced-FFE sequence of TR/TE = 5/2.4 ms. An approximate uncertainty of 5% in our dose delivery was anticipated since the MR-Linac had not yet been fully commissioned. Results: The signal intensities (SI) increased between the un-irradiated and irradiated regions by approximately 8.6%, 4.4%, 3.2%, and 4.3% after delivery of ∼2.8 Gy for dosimeters A, B, C, and D, respectively. After delivery of ∼17 Gy, the SI had increased by 24.4%, 21.0%, 3.1%, and 22.2% compared to the un-irradiated regions. The increase in SI with respect to dose was linear for dosimeters A, B, and D with slopes of 0.0164, 0.0251, and 0.0236 Gy{sup −1} (R{sup 2} = 0.92, 0.97, and 0.96), respectively. Visually, dosimeter A had the greatest optical contrast from yellow to purple in the irradiated region. Conclusion: This study demonstrated the feasibility of using Fricke-type dosimeters for real-time dose measurements with the greatest optical and MR contrast for dosimeter A. We also demonstrated the need to investigate Fe{sup 2+} compounds beyond the conventionally utilized FAS compound in order to improve the MR signal contrast in 3D dosimeters used for MR-guided radiation therapy. This material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. LH- 102SPS.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2021

Comparison of Simulated and Experimentally Measured Detector Impulse Responses to Pulsed X-rays

The Gamma Array Simulation Toolkit (GAST) is a multi-physics software stack comprised of Geant4, MATLAB, and experimentally measured photomultiplier tube (PMT) impulse response waveforms that is used to model and inform the end-to-end performance of radiation detector systems. In order to validate the ability of GAST to predict the impulse response of a modeled detector configuration operated in current mode, experimental measurements using the Nevada National Security Site Transformational Diagnostics and Imaging 2 MeV endpoint energy electron linear accelerator (linac) with a tungsten target were performed. Seven different detector configurations consisting of unique combinations of scintillator material, size, reflectivity conditions, presence or absence of light guide, and PMT were evaluated. The resultant impulse response of each detector configuration was recorded and compared to a GAST simulation that emulated the respective linac experiment conditions. The comparison of the experimental and simulated detector impulse responses indicated that GAST can reliably predict detector impulse responses.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

TU-D-BRD-01: Image Guided SBRT II: Challenges ' Pitfalls

Stereotactic body radiation therapy (SBRT) has been effective treatment for the management of various diseases, which often delivers high radiation dose in a single or a few fractions. SBRT therefore demands precise treatment delivery to the tumor while sparing adjacent healthy tissue. Recent developments in image guidance enable target localization with increased accuracy. With such improvements in localization, image-guided SBRT has been widely adopted into clinical practice. In SBRT, high radiation dose is generally delivered with small fields. Therefore, it is crucial to accurately measure dosimetric data for the small fields during commissioning. In addition, image-guided SBRT demands accurate image localization to ensure safety and quality of patient care. Lately, the reports of AAPM TG 142 and TG 104 have been published and added recommendations for imaging devices that are integrated with the linear accelerator for SBRT. Furthermore, various challenges and potential pitfalls lie in the clinical implementation of image-guided SBRT. In this lecture, these challenges and pitfalls of image-guided SBRT will be illustrated and discussed from dosimetric, technical and clinical perspectives.Being a promising technique, image-guided SBRT has shown great potentials, and will lead to more accurate and safer SBRT treatments. Learning Objectives: To understand dosimetric challenges and pitfalls for IGRT application in SBRT. To understand major clinical challenges and pitfalls for IGRT application in SBRT. To understand major technical challenges and pitfalls for IGRT application in SBRT.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-679: Retrospective Analysis of the Sensitivity of Planar Dose Measurements To Gamma Analysis Criteria

Purpose: IMRT QA using planar dose measurements is still a widely used method for checking the accuracy of treatment plans. A pass/fail judgment is made using gamma analysis based on a single endpoint. Using more stringent criteria is a way to increase the sensitivity to planning and delivery errors. Before such implementation, it is necessary to understand how the sensitivity to different gamma criteria settings affects gamma passing rates (GPR). Methods: 752 IMRT QA measurements were re-analyzed with varying distance to agreement (DTA) and dose difference (DD) percentages using a Matlab program. Other quantifying information such as the mean dose difference in the treatment target (defined as points that are greater than 80% of maximal dose) were stored in a relational database for retrospective analysis. Results: The average and standard deviation of GPR (%) fell from 99.84 ± (0.43) to 89.61 ± (6.08) when restricting DD from 5 − 1% respectively, as compared to a drop from 99.15 ± (1.19) to 95.00 ± (4.43), when restricting the DTA from 5 − 1 mm respectively. The mean dose difference (%) in the treatment target between measured and calculated dose was −1.96 ± (0. 83), −0.09 ± (0.98), and 1.44 ± (0. 86) for each of our institution’s three matched linear accelerators (LINAC 1, 2, and 3 respectively). For plans that are approximately 2.7 sigma below the mean GPR, an average of 78.4% of those plans were measured on LINAC 1 or 3, while only 48% of the total plans were run on those machines. Conclusion: The data demonstrates that when restricting gamma criterion, such as the DD, the greatest indicator of reduced GPR in our institution is which matched LINAC the plan was measured on. While small, these differences manifest themselves to levels comparable to other treatment related differences and possibly confound the gamma analysis.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-F-T-476: Performance of the AS1200 EPID for Periodic Photon Quality Assurance

Purpose: To assess the dosimetric performance of a new amorphous silicon flat-panel electronic portal imaging device (EPID) suitable for high-intensity, flattening-filter-free delivery mode. Methods: An EPID-based QA suite was created with automation to periodically monitor photon central-axis output and two-dimensional beam profile constancy as a function of gantry angle and dose-rate. A Varian TrueBeamTM linear accelerator installed with Developer Mode was used to customize and deliver XML script routines for the QA suite using the dosimetry mode image acquisition for an aS1200 EPID. Automatic post-processing software was developed to analyze the resulting DICOM images. Results: The EPID was used to monitor photon beam output constancy (central-axis), flatness, and symmetry over a period of 10 months for four photon beam energies (6x, 15x, 6xFFF, and 10xFFF). EPID results were consistent to those measured with a standard daily QA check device. At the four cardinal gantry angles, the standard deviation of the EPID central-axis output was <0.5%. Likewise, EPID measurements were independent for the wide range of dose rates (including up to 2400 mu/min for 10xFFF) studied with a standard deviation of <0.8% relative to the nominal dose rate for each energy. Also, profile constancy and field size measurements showed good agreement with the reference acquisition of 0° gantry angle and nominal dose rate. XML script files were also tested for MU linearity and picket-fence delivery. Using Developer Mode, the test suite was delivered in <60 minutes for all 4 photon energies with 4 dose rates per energy and 5 picket-fence acquisitions. Conclusion: Dosimetry image acquisition using a new EPID was found to be accurate for standard and high-intensity photon beams over a broad range of dose rates over 10 months. Developer Mode provided an efficient platform to customize the EPID acquisitions by using custom script files which significantly reduced the time. This work was funded in part by Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Imaging of Radiation Dose for Stereotactic Radiosurgery

The distributions of radiation dose for stereotactic radiosurgery, using a modified linear accelerator (Philips SL-25 and SRS-200), have been studied by using three different dosimeters: (1) ferrous-agarose-xylenol orange (FAX) gels, (2) TLD, and (3) thick-emulsion GafChromic dye film. These dosimeters were loaded into a small volume of defect in a phantom head. A regular linac stereotactic radiosurgery treatment was then given to the phantom head for each type of dosimeter. The measured radiation dose and its distributions were found to be in good agreement with those calculated by the treatment planning computer.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

A Simple Approach to the Technical Aspects of Radiosurgery Treatments

An approach to radiosurgery treatment that can be readily adopted in most radiotherapy centers with linear accelerators is presented. In our institution, a Leksell-type of neurosurgical frame, a computed tomography scanner, locally fabricated cones, and 6 MV X-ray beams are used to perform radiosurgery treatments. Collimated arcs with dose distributions that conform to the shape of the lesion in the transverse and the sagittal planes are used. It is argued that the uncertainties in the localization of the isocenter within a lesion and the specifications of the size of the target volume do not justify high precision mechanical devices for most radiosurgery treatments.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

Sci—Fri AM: Mountain — 05: Unified Optimization and Delivery of Intensity-modulated Radiation Therapy and Volume-modulated Arc Therapy

Purpose: To study the feasibility of a unified intensity-modulated arc therapy (UIMAT) that combines IMRT and VMAT optimization and delivery in order to produce efficient and superior radiation treatment plans. Methods: Inverse planning for UIMAT was prototyped on the Pinnacle treatment planning system (Philips Medical Systems). UIMAT integrates IMRT and VMAT delivery in the same arc where IMRT was delivered with gantry speed close to zero. Optimal gantry angles for the IMRT phases were selected automatically by the inverse optimization algorithm. Optimization of the VMAT phases and IMRT phases were done simultaneously using Pinnacle's direct machine parameter optimization algorithm. Five treatment plans each for prostate, head and neck, and lung were generated using our unified technique and compared with clinical VMAT or IMRT plans. Delivery verification was performed on an ArcCheck phantom (Sun Nuclear) and delivered in clinical mode on a Varian TrueBeam linear accelerator. Results: In this prototype implementation, compared to the VMAT or IMRT plans, with the plans normalized to the same dose coverage to the planning target volumes, the UIMAT plans produced improved OAR sparing for head and neck cases, while for lung and prostate cases, the dosimetric improvements for OARs were not as significant. In this proof-of-concept work, we demonstrated that a novel radiation therapy delivery technique combining VMAT and IMRT delivery in the same arc is feasible. Initial results showed UIMAT has the potential to be superior to either standard IMRT or VMAT.

60 APPLIED LIFE SCIENCES↗