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At least 919 records · Page 51
All sourcesNASA NTRSDOE OSTI
DOE OSTI2015

The first clinical treatment with kilovoltage intrafraction monitoring (KIM): A real-time image guidance method

Purpose: Kilovoltage intrafraction monitoring (KIM) is a real-time image guidance method that uses widely available radiotherapy technology, i.e., a gantry-mounted x-ray imager. The authors report on the geometric and dosimetric results of the first patient treatment using KIM which occurred on September 16, 2014. Methods: KIM uses current and prior 2D x-ray images to estimate the 3D target position during cancer radiotherapy treatment delivery. KIM software was written to process kilovoltage (kV) images streamed from a standard C-arm linear accelerator with a gantry-mounted kV x-ray imaging system. A 120° pretreatment kV imaging arc was acquired to build the patient-specific 2D to 3D motion correlation. The kV imager was activated during the megavoltage (MV) treatment, a dual arc VMAT prostate treatment, to estimate the 3D prostate position in real-time. All necessary ethics, legal, and regulatory requirements were met for this clinical study. The quality assurance processes were completed and peer reviewed. Results: During treatment, a prostate position offset of nearly 3 mm in the posterior direction was observed with KIM. This position offset did not trigger a gating event. After the treatment, the prostate motion was independently measured using kV/MV triangulation, resulting in a mean difference of less than 0.6 mm and standard deviation of less than 0.6 mm in each direction. The accuracy of the marker segmentation was visually assessed during and after treatment and found to be performing well. During treatment, there were no interruptions due to performance of the KIM software. Conclusions: For the first time, KIM has been used for real-time image guidance during cancer radiotherapy. The measured accuracy and precision were both submillimeter for the first treatment fraction. This clinical translational research milestone paves the way for the broad implementation of real-time image guidance to facilitate the detection and correction of geometric and dosimetric errors, and resultant improved clinical outcomes, in cancer radiotherapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-545: MLC Distance Travelled as a Predictor for Motor Failure

Purpose: To study the frequency of Multi-Leaf Collimator (MLC) leaf failures, investigate methods to predict them and reduce linac downtime. Methods: A Varian HD120 MLC was used in our study. The hyperterminal MLC errors logged from 06/2012 to 12/2014 were collected. Along with the hyperterminal errors, the MLC motor changes and all other MLC interventions by the linear accelerator engineer were recorded. The MLC dynalog files were also recorded on a daily basis for each treatment and during linac QA. The dynalog files were analyzed to calculate root mean square errors (RMS) and cumulative MLC travel distance per motor. An in-house MatLab code was used to analyze all dynalog files, record RMS errors and calculate the distance each MLC traveled per day. Results: A total of 269 interventions were recorded over a period of 18 months. Of these, 146 included MLC motor leaf change, 39 T-nut replacements, and 84 MLC cleaning sessions. Leaves close to the middle of each side required the most maintenance. In the A bank, leaves A27 to A40 recorded 73% of all interventions, while the same leaves in the B bank counted for 52% of the interventions. On average, leaves in the middle of the bank had their motors changed approximately every 1500m of travel. Finally, it was found that the number of RMS errors increased prior to an MLC motor change. Conclusion: An MLC dynalog file analysis software was developed that can be used to log daily MLC usage. Our eighteen-month data analysis showed that there is a correlation between the distance an MLC travels, the RMS and the life of the MLC motor. We plan to use this tool to predict MLC motor failures and with proper and timely intervention, reduce the downtime of the linac during clinical hours.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2016

SU-F-T-564: 3 Year Experience of Treatment Plan QualityAssurance for Vero SBRT Patients

Purpose: To verify treatment plan monitor units from iPlan treatment planning system for Vero Stereotactic Body Radiotherapy (SBRT) treatment using both software-based and (homogeneous and heterogeneous) phantom-based approaches. Methods: Dynamic conformal arcs (DCA) were used for SBRT treatment of oligometastasis patients using Vero linear accelerator. For each plan, Monte Carlo calculated treatment plans MU (prescribed dose to water with 1% variance) is verified first by RadCalc software with 3% difference threshold. Beyond 3% differences, treatment plans were copied onto (homogeneous) Scanditronix phantom for non-lung patients and copied onto (heterogeneous) CIRS phantom for lung patients and the corresponding plan dose was measured using a cc01 ion chamber. The difference between the planed and measured dose was recorded. For the past 3 years, we have treated 180 patients with 315 targets. Out of these patients, 99 targets treatment plan RadCalc calculation exceeded 3% threshold and phantom based measurements were performed with 26 plans using Scanditronix phantom and 73 plans using CIRS phantom. Mean and standard deviation of the dose differences were obtained and presented. Results: For all patient RadCalc calculations, the mean dose difference is 0.76% with a standard deviation of 5.97%. For non-lung patient plan Scanditronix phantom measurements, the mean dose difference is 0.54% with standard deviation of 2.53%; for lung patient plan CIRS phantom measurements, the mean dose difference is −0.04% with a standard deviation of 1.09%; The maximum dose difference is 3.47% for Scanditronix phantom measurements and 3.08% for CIRS phantom measurements. Conclusion: Limitations in secondary MU check software lead to perceived large dose discrepancies for some of the lung patient SBRT treatment plans. Homogeneous and heterogeneous phantoms were used in plan quality assurance for non-lung patients and lung patients, respectively. Phantom based QA showed the relative good agreement between iPlan calculated dose and measured dose.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-635: Quantitative Study On Beam Flatness Variation with Beam Energy Change

Purpose: Beam flatness check has been proposed for beam energy check for photon beams with flattering filters. In this work, beam flatness change with beam energy was investigated quantitatively using the Monte Carlo method and its significance was compared with depth dose curve change. Methods: Monte Carlo simulations for a linear accelerator with flattering filter were performed with different initial electron energies for photon beams of 6MV and 10MV. Dose calculations in a water phantom were then perform with the phase space files obtained from the simulations. The beam flatness was calculated based on the dose profile at 10 cm depth for all the beams with different initial electron energies. The percentage depth dose (PDD) curves were also analyzed. The dose at 10cm depth (D10) and the ratio of the dose at 10cm and 20cm depth (D10/D20) and their change with the beam energy were calculated and compared with the beam flatness variation. Results: It was found that the beam flatness variation with beam energy change was more significant than the change of D10 and the ratio between D10 and D20 for both 6MV and 10MV beams. Half MeV difference on the initial electron beam energy brought in at least 20% variation on the beam flatness but only half percent change on the ratio of D10 and D20. The change of D10 or D20 alone is even less significant. Conclusion: The beam energy impact on PDD is less significant than that on the beam flatness. If the PDD is used for checking the beam energy, uncertainties of the measurement could possibly disguise its change. Beam flatness changes more significantly with beam energy and therefore it can be used for monitoring the energy change for photon beams with flattering filters. However, other factors which may affect the beam flatness should be watched as well.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Spatial variation of dosimetric leaf gap and its impact on dose delivery

Purpose: During dose calculation, the Eclipse treatment planning system (TPS) retracts the multileaf collimator (MLC) leaf positions by half of the dosimetric leaf gap (DLG) value (measured at central axis) for all leaf positions in a dynamic MLC plan to accurately model the rounded leaf ends. The aim of this study is to map the variation of DLG along the travel path of each MLC leaf pair and quantify how this variation impacts delivered dose. Methods: 6 MV DLG values were measured for all MLC leaf pairs in increments of 1.0 cm (from the line intersecting the CAX and perpendicular to MLC motion) to 13.0 cm off axis distance at dmax. The measurements were performed on two Varian linear accelerators, both employing the Millennium 120-leaf MLCs. The measurements were performed at several locations in the beam with both a Sun Nuclear MapCHECK device and a PTW pinpoint ion chamber. Results: The measured DLGs for the middle 40 MLC leaf pairs (each 0.5 cm width) at positions along a line through the CAX and perpendicular to MLC leaf travel direction were very similar, varying maximally by only 0.2 mm. The outer 20 MLC leaf pairs (each 1.0 cm width) have much lower DLG values, about 0.3–0.5 mm lower than the central MLC leaf pair, at their respective central line position. Overall, the mean and the maximum variation between the 0.5 cm width leaves and the 1.0 cm width leaf pairs are 0.32 and 0.65 mm, respectively. Conclusions: The spatial variation in DLG is caused by the variation of intraleaf transmission through MLC leaves. Fluences centered on the CAX would not be affected since DLG does not vary; but any fluences residing significantly off axis with narrow sweeping leaves may exhibit significant dose differences. This is due to the fact that there are differences in DLG between the true DLG exhibited by the 1.0 cm width outer leaves and the constant DLG value utilized by the TPS for dose calculation. Since there are large differences in DLG between the 0.5 cm width leaf pairs and 1.0 cm width leaf pairs, there is a need to correct the TPS plans, especially those with high modulation (narrow dynamic MLC gap), with 2D variation of DLG.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

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

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

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

SU-C-BRB-05: Investigation of Conformal Arc Therapy Utilizing Newly Designed Cobalt 60 Machine

Purpose: A new modernized design for cobalt 60 (Co-60) machines is being developed with a ring type gantry. In this study we investigate the beneficial outcome of the new design for conformal arc therapy for various clinical sites. The new modality was evaluated based on isodose distributions and dose volume histograms as compared to 6MV photon beams from conventional linear accelerators. Methods: Computed tomographic images of seven different SBRT patients were selected from our patient database. All of these cases were previously planned on the Eclipse treatment planning system. New plans for these patients were generated with a modified conformal arc technique using both 6MV and Co-60 beams. The conformal arc was created by the delivery of treatment fields conformal to the target cross-section at every 5 or 10 degrees. The field shape was modified or turned off when it initially passed through a critical structure. Monte Carlo codes, MCBEAM and MCPLAN, were used for the machine head simulation and phantom/patient dose calculation, respectively. In the new Co-60 machine design, the source-to-isocenter distance was 60cm and the treatment head included the Co-60 source, primary collimator, jaws and MLC. Results: For all cases investigated, conformal arc plans utilizing Co-60 beams achieved similar conformity (mean conformity index=1.19) comparing to 6MV photon beams. Isodose distributions were tailored similarly around the PTV; both Co-60 and 6MV plans met our clinical acceptance criteria for the target coverage, and the maximum and minimum target doses. The DVH for the Co-60 plans showed slightly lower doses to the critical structures although the differences were small in most cases. Conclusion: There were no significant dosimetric differences between 6MV and Co-60 plans. Our results confirmed that this new Co-60 design could be a cost-effective machine for advanced radiotherapy due to its low cost, low maintenance and high up time.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-592: Relationship Between Dose of Distribution and Area of Segment Fields Among Different Intensity-Modulated Radiotherapy Planning in Cervix Cancer

Purpose: In premise of uninfluenced to dose distribution of tumor target and organ at risk(OAR) in cervical cancer,area of segment fields was changed to increase efficacy and optimize treatment method by designing different plan of intensity modulated radiotherapy(IMRT). Methods: 12 cases of cervical cancer were confirmed in pathology and treated with step and shoot IMRT. Dose of PTV was 50Gy/25fractions. Every patient was designed 9 treatment plans of IMRT by Pinnacle 8.0m planning system,each plan was used with 9 beams of uniform distribution and fixing incidence direction(200°,240°,280°,320°,0°,40°,80°,120°and 160°respectively),and designed for delivery on Elekta Synergy linear accelerator. All plans were optimized with the direct machine parameter optimization(DMPO) algorithm using the same set of optimization objectives. Number of maximum segment field was defined at 80 and minimum MU in each segment was 5MU,and minimal segment area was 2*1cm{sup 2},2*2cm{sup 2},3*3cm{sup 2},4*4cm{sup 2},5*5cm{sup 2},6*6cm{sup 2},7*7cm{sup 2},8*8cm{sup 2}and 9*9cm{sup 2},respectively.Coverage,homogeneity and conformity of PTV,sparing of OAR, MU and number of segment were compared. Results: In this group, mean volume of PTV was 916.8±228.7 cm{sup 3}. Compared with the area of minimal segment field increased from 2*1cm{sup 2} to 9*9 cm{sup 2},the number of mean MU was decreased from 1405±170 to 490±47 and the number of segment field was reduced from 76±4 to 39±7 respectively(p<0.05). When the limit of minimal segment area was increased from 2*1cm{sup 2} to 7*7 cm{sup 2},dose distribution of PTV,OAR,CI,HI and V{sub 2} {sub 3} were not different (p>0.05),but when the minimal segment area was 8*8 cm{sup 2} and 9*9 cm{sup 2},they were changed compared with 7*7 cm{sup 2} and below(p<0.05). Conclusion: The minimal segment field of IMRT plan designed by Pinnacle 8.0m planning system in cervical carcinoma should be enlarge reasonably and minimal segment area of 7*7 cm{sup 2} was recommend.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2017

Impact of silver metallization and electron irradiation on the mechanical deformation of polyimide films

The impact of silver metallization and electron irradiation on the physical and mechanical properties of polyimide films has been studied. The metal that impregnated the structure of the polyimide substrate was 1–5 μm. The surface coatings contained 80–97% of the relative silver mirror in the visible and infrared regions. Irradiation was performed at the ELU-6 linear accelerator with an average beam electron energy of 2 MeV, an integral current of up to 1000 μA, a pulse repetition rate of 200 Hz, and a pulse duration of 5 μs. The absorbed dose in the samples was 10, 20, 30, and 40 MGy. The samples were deformed at room temperature under uniaxial tension on an Instron 5982 universal testing system. The structural changes in the composite materials that result from the impact of the physical factors were studied using an X-ray diffractometer DRON-2M in air at 293 K using CuK{sub α} radiation (λ{sub αCu} = 1.5418 Å). A substantial growth of mechanical characteristics resulting from the film metallization, as compared to the pure film, was observed. The growth of the ultimate strength by Δσ = 105 MPa and the plasticity by Δε = 75% is connected with the characteristics of the change of structure of the metallized films and the chemical etching conditions. The electron irradiation of the metallized polyimide film worsens its elastic and strength characteristics due to the formation of new phases in the form of silver oxide in the coating. The concentration of these phases increased with increasing dose, which was also the result of the violation of the ordered material structure, namely, the rupture of polyimide macromolecule bonds and the formation of new phases of silver in the coating. A mathematical model was obtained that predicts the elastic properties of silver metallized polyimide films. This model agrees with the experimental data.

75 CONDENSED MATTER PHYSICS, SUPERCONDUCTIVITY AND↗
DOE OSTI2016

Use of radiochromic film as a high-spatial resolution dosimeter by Raman spectroscopy

Purpose: Due to increasing demand for high-spatial resolution dosimetry, radiochromic films have been investigated as potential candidates but are often limited by the scanning system, e.g., flatbed optical scanner. In this study, Raman spectroscopy in conjunction with a microscope was selected as an alternative method for high-spatial resolution dosimetry of radiochromic film. Methods: Unlaminated Gafchromic™ EBT3 films were irradiated with doses between 0 and 50 Gy using 6 MV x-rays of a clinical linear accelerator. Depth profiling from the surface of unlaminated film was performed to acquire the maximum Raman intensity peaks of C≡C and C=C stretching bands of diacetylene polymer. The Raman mapping technique for a region of interest (200 × 200, 30 × 30 μm{sup 2}) was developed to reduce a large variation in a Raman spectrum produced with a sampling resolution of a few μm. The preprocessing of Raman spectra was carried out to determine a dosimetric relationship with the amount of diacetylene polymerization. Results: Due to partial diacetylene polymerization upon irradiation, two Raman peaks of C=C and C≡C stretching bands were observed around 1447 and 2060 cm{sup −1}, respectively. The maximum intensities of the two peaks were obtained by positioning a focused laser spot on the surface of unlaminated film. For the dose range of 0–50 Gy, the band heights of both C≡C and C=C peaks increase asymptotically with increasing doses and can be fit with an exponential function of two components. The relative standard deviation in Raman mapping was found to be less than ±5%. By using this technique, dose uniformity was found to be within ±2%. Conclusions: The Raman intensity for C=C and C≡C peaks increases with an increase in the amount of diacetylene polymerization due to an increase in dose. This study shows the potential of Raman spectroscopy as an alternative for absolute dosimetry verifications with a high-spatial resolution of a few μm, but these findings need to be further validated for the purpose of microdosimetry.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-121: Dosimetric Characterization of Gafchromic Film EBT3 Using Vidar DosimetryPro Advantage RED and EPSON Expression 10000XL Scanners

Purpose: The purpose of this paper is to characterize EBT3 using two types of scanner, analyzing the factors of influence of each dosimetry system. Methods: The film used in this study was GAFCHROMIC EBT3, the films were exposed at a dose range between 0Gy a 9Gy in a solid water phantom, SSD=100cm, 5cm depth and perpendicularly to the 6MV photon beam generated by a Novalis TX linear accelerator equipped with an HDMLC. A Farmer type ion chamber TN30013 (PTW) was used to determine the dose delivered to the film. The films were digitized with a scanner EPSON expression 10000XL and the VIDAR DosimetryPro Adventage RED. Software RIT113v6.1 was used for construction of the calibration curve and analysis. The film characteristics investigated were: response at different dose levels, sensitivity to orientation and side and resolution through the results of the spatial response function by analyzing a step pattern. Additionally, 20 IMRT treatment fields were measured with both scanner and compared with calculated dose using gamma index analysis (3%-3mm). Results: The OD obtained for dose level 2Gy in the orientation portrait of the film on the scanner EPSON is (0,222±0,19) and for Vidar RED (0,252±0,10) and landscape is for EPSON (0,211±0,25) and for Vidar RED (0,250±0,11) . The orientation dependence with respect to film side is about 0,09% for EPSON and about 0.03% for VIDAR. The spatial response function increase in response to the Gaussian function FWHM EPSON scanner (0.18mm) compared with VIDAR scanner function (less than 0.06mm) was observed. We analyzed 20 total plan dose distributions the number of pixels with gamma>1 (3%-3mm) was 0.7%±1.2 [0.1%; 2.82%] for EBT3-VIDAR y 2%±2.9 [0.2%; 3.5%] for EBT3-EPSON. Conclusion: VIDAR scanner shows better sensitivity. EBT3 film shows a different response between portrait and landscape orientation. Step pattern is better reproduce by VIDAR scanner.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2016

An experimental extrapolation technique using the Gafchromic EBT3 film for relative output factor measurements in small x-ray fields

Purpose: An experimental extrapolation technique is presented, which can be used to determine the relative output factors for very small x-ray fields using the Gafchromic EBT3 film. Methods: Relative output factors were measured for the Brainlab SRS cones ranging in diameters from 4 to 30 mm{sup 2} on a Novalis Trilogy linear accelerator with 6 MV SRS x-rays. The relative output factor was determined from an experimental reducing circular region of interest (ROI) extrapolation technique developed to remove the effects of volume averaging. This was achieved by scanning the EBT3 film measurements with a high scanning resolution of 1200 dpi. From the high resolution scans, the size of the circular regions of interest was varied to produce a plot of relative output factors versus area of analysis. The plot was then extrapolated to zero to determine the relative output factor corresponding to zero volume. Results: Results have shown that for a 4 mm field size, the extrapolated relative output factor was measured as a value of 0.651 ± 0.018 as compared to 0.639 ± 0.019 and 0.633 ± 0.021 for 0.5 and 1.0 mm diameter of analysis values, respectively. This showed a change in the relative output factors of 1.8% and 2.8% at these comparative regions of interest sizes. In comparison, the 25 mm cone had negligible differences in the measured output factor between zero extrapolation, 0.5 and 1.0 mm diameter ROIs, respectively. Conclusions: This work shows that for very small fields such as 4.0 mm cone sizes, a measureable difference can be seen in the relative output factor based on the circular ROI and the size of the area of analysis using radiochromic film dosimetry. The authors recommend to scan the Gafchromic EBT3 film at a resolution of 1200 dpi for cone sizes less than 7.5 mm and to utilize an extrapolation technique for the output factor measurements of very small field dosimetry.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Radiation Therapy for Hypersalivation: A Prospective Study in 50 Amyotrophic Lateral Sclerosis Patients

Purpose: This study aimed to evaluate the efficiency and the tolerance of radiation therapy (RT) on salivary glands in a large series of amyotrophic lateral sclerosis (ALS) patients with hypersalivation. Methods and Materials: Fifty ALS patients that had medically failure pretreatment were included in this prospective study. RT was delivered through a conventional linear accelerator with 6-MV photons and 2 opposed beams fields including both submandibular glands and two-thirds of both parotid glands. Total RT dose was 10 Gy in 2 fractions (n=30) or 20 Gy in 4 fractions (n=20). RT efficacy was assessed with the 9-grade Sialorrhea Scoring Scale (SSS), recently prospectively validated as the most effective and sensitive tool to measure sialorrhea in ALS patients. Results: At the end of RT, all patients had improved: 46 had a complete response (92% CR, SSS 1-3) and 4 had a partial response (8% PR, SSS 4-5). A significant lasting salivary reduction was observed 6 months after RT completion: there was 71% CR and 26% PR, and there was a significant SSS reduction versus baseline (P<10{sup −6}). There was no grade 3 to 4 toxicity, and most side effects (34%) occurred during RT. Nine patients (18%) underwent a second salivary gland RT course, with a 3-months mean delay from the first RT, resulting in a SSS decrease (−77%). Both RT dose regimens induced a significant SSS decrease with no significant toxicity. There were, however, more patients with CR/PR in the 20-Gy protocol (P=.02), and 8 of 9 patients (89%) receiving a second RT course had previously been treated within the 10-Gy protocol. Conclusion: Radiation therapy of 20 Gy in 4 fractions is an efficient and safe treatment for ALS patients with sialorrhea. A shorter RT course (10 Gy in 2 fractions) may be proposed in patients in poor medical condition.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

SU-E-T-749: Thorough Calibration of MOSFET Dosimeters

Purpose: To improve the accuracy of the MOSFET calibration procedure by performing the measurement several times and calculating the average value of the calibration factor for various photon and electron energies. Methods: The output of three photon and six electron beams of Varian Trilogy linear accelerator SN 5878 was calibrated. Five reinforced standard sensitivity MOSFET dosimeters were placed in the calibration jig and connected to the Reader Module. As the backscatter material was used 7 cm of Virtual Water. The MOSFET dosimeters were covered with 1.5 cm thick bolus for the regular and SRS 6 MV beams, 3 cm bolus for 15 MV beam, 1.5 cm bolus for 6 MeV electron beam, and 2 cm bolus for the electron energies of 9, 12, 15, 18, and 22 MeV. The dosimeters were exposed to 100 MU, and the calibration factor was determined using the mobileMOSFET software. To improve the accuracy of calibration, this procedure was repeated ten times and the calibration factors were averaged. Results: As the number of calibrations was increasing the variability of calibration factors of different dosimeters was decreasing. After ten calibrations, the calibration factors for all five dosimeters were within 1% of one another for all energies, except 6 MV SRS photons and 6 MeV electrons, for which the variability was 2%. Conclusions: The described process results in calibration factors which are almost independent of modality or energy. Once calibrated, the dosimeters may be used for in-vivo dosimetry or for daily verification of the beam output. Measurement of the radiation dose under bolus and scatter to the eye are examples of frequent use of calibrated MOSFET dosimeters. The calibration factor determined for full build-up is used under these circumstances. To the best of our knowledge, such thorough procedure for calibrating MOSFET dosimeters has not been reported previously. Best Medical Canada provided MOSFET dosimeters for this project.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Multileaf collimator performance monitoring and improvement using semiautomated quality control testing and statistical process control

Purpose: High-quality radiation therapy using highly conformal dose distributions and image-guided techniques requires optimum machine delivery performance. In this work, a monitoring system for multileaf collimator (MLC) performance, integrating semiautomated MLC quality control (QC) tests and statistical process control tools, was developed. The MLC performance monitoring system was used for almost a year on two commercially available MLC models. Control charts were used to establish MLC performance and assess test frequency required to achieve a given level of performance. MLC-related interlocks and servicing events were recorded during the monitoring period and were investigated as indicators of MLC performance variations. Methods: The QC test developed as part of the MLC performance monitoring system uses 2D megavoltage images (acquired using an electronic portal imaging device) of 23 fields to determine the location of the leaves with respect to the radiation isocenter. The precision of the MLC performance monitoring QC test and the MLC itself was assessed by detecting the MLC leaf positions on 127 megavoltage images of a static field. After initial calibration, the MLC performance monitoring QC test was performed 3–4 times/week over a period of 10–11 months to monitor positional accuracy of individual leaves for two different MLC models. Analysis of test results was performed using individuals control charts per leaf with control limits computed based on the measurements as well as two sets of specifications of ±0.5 and ±1 mm. Out-of-specification and out-of-control leaves were automatically flagged by the monitoring system and reviewed monthly by physicists. MLC-related interlocks reported by the linear accelerator and servicing events were recorded to help identify potential causes of nonrandom MLC leaf positioning variations. Results: The precision of the MLC performance monitoring QC test and the MLC itself was within ±0.22 mm for most MLC leaves and the majority of the apparent leaf motion was attributed to beam spot displacements between irradiations. The MLC QC test was performed 193 and 162 times over the monitoring period for the studied units and recalibration had to be repeated up to three times on one of these units. For both units, rate of MLC interlocks was moderately associated with MLC servicing events. The strongest association with the MLC performance was observed between the MLC servicing events and the total number of out-of-control leaves. The average elapsed time for which the number of out-of-specification or out-of-control leaves was within a given performance threshold was computed and used to assess adequacy of MLC test frequency. Conclusions: A MLC performance monitoring system has been developed and implemented to acquire high-quality QC data at high frequency. This is enabled by the relatively short acquisition time for the images and automatic image analysis. The monitoring system was also used to record and track the rate of MLC-related interlocks and servicing events. MLC performances for two commercially available MLC models have been assessed and the results support monthly test frequency for widely accepted ±1 mm specifications. Higher QC test frequency is however required to maintain tighter specification and in-control behavior.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2018

Application of Geant4 Monte Carlo simulation in dose calculations for small radiosurgical fields

The Geant4 toolkit was used to develop a Monte Carlo (MC)-based engine for accurate dose calculations in small radiation field sizes. The Geant4 toolkit (version 10.1.p02) was used to simulate 6-MV photon beam of a Varian2100C linear accelerator that is being used for stereotactic radiosurgery (SRS) treatment with small radiation fields. Geometric models of 3 in-house designed radiosurgical divergent cones, with the diameters of their projections at the isocenter being 10, 20, and 30 mm, were simulated. The accuracy of the MC simulation technique was examined by reproducing several different simulated dosimetric parameters of the primary beams with the experimental data. The dose distributions are first checked for single beams for each cone, then standard multiple field (SMF) techniques are applied. A sample set of DICOM files from computed tomography (CT) scan imaging of a patient's head was converted to the Geant4 geometry format to implement MC-based engine for a clinical test. To validate the accuracy of the MC-based calculations for SMF arrangements, the isodose lines from MC simulation in water phantom were compared with the measured isodose lines using EBT3 Gafchromic film in Solid Water phantoms. Agreements between measured and simulated depth dose values and beam profiles for SRS cones were generally within 2%/2 mm. For output factors, the largest discrepancy was observed for 10 mm SRS cone, which was 1.7%. For SMF techniques, in SRS cones, the MC simulation and EBT3 Gafchromic film dosimetry were in acceptable agreement (5%/5 mm). Excellent agreement between the results of the MC-based and measured dose values for both single and SMF techniques in SRS cones indicates the ability of the Geant4 toolkit to be applied as the platform for treatment planning of advanced radiotherapy techniques.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

SU-G-TeP4-08: Automating the Verification of Patient Treatment Parameters

Purpose: To automate the daily verification of each patient’s treatment by utilizing the trajectory log files (TLs) written by the Varian TrueBeam linear accelerator while reducing the number of false positives including jaw and gantry positioning errors, that are displayed in the Treatment History tab of Varian’s Chart QA module. Methods: Small deviations in treatment parameters are difficult to detect in weekly chart checks, but may be significant in reducing delivery errors, and would be critical if detected daily. Software was developed in house to read TLs. Multiple functions were implemented within the software that allow it to operate via a GUI to analyze TLs, or as a script to run on a regular basis. In order to determine tolerance levels for the scripted analysis, 15,241 TLs from seven TrueBeams were analyzed. The maximum error of each axis for each TL was written to a CSV file and statistically analyzed to determine the tolerance for each axis accessible in the TLs to flag for manual review. The software/scripts developed were tested by varying the tolerance values to ensure veracity. After tolerances were determined, multiple weeks of manual chart checks were performed simultaneously with the automated analysis to ensure validity. Results: The tolerance values for the major axis were determined to be, 0.025 degrees for the collimator, 1.0 degree for the gantry, 0.002cm for the y-jaws, 0.01cm for the x-jaws, and 0.5MU for the MU. The automated verification of treatment parameters has been in clinical use for 4 months. During that time, no errors in machine delivery of the patient treatments were found. Conclusion: The process detailed here is a viable and effective alternative to manually checking treatment parameters during weekly chart checks.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

A practical and theoretical definition of very small field size for radiotherapy output factor measurements

Purpose: This work introduces the concept of very small field size. Output factor (OPF) measurements at these field sizes require extremely careful experimental methodology including the measurement of dosimetric field size at the same time as each OPF measurement. Two quantifiable scientific definitions of the threshold of very small field size are presented. Methods: A practical definition was established by quantifying the effect that a 1 mm error in field size or detector position had on OPFs and setting acceptable uncertainties on OPF at 1%. Alternatively, for a theoretical definition of very small field size, the OPFs were separated into additional factors to investigate the specific effects of lateral electronic disequilibrium, photon scatter in the phantom, and source occlusion. The dominant effect was established and formed the basis of a theoretical definition of very small fields. Each factor was obtained using Monte Carlo simulations of a Varian iX linear accelerator for various square field sizes of side length from 4 to 100 mm, using a nominal photon energy of 6 MV. Results: According to the practical definition established in this project, field sizes ≤15 mm were considered to be very small for 6 MV beams for maximal field size uncertainties of 1 mm. If the acceptable uncertainty in the OPF was increased from 1.0% to 2.0%, or field size uncertainties are 0.5 mm, field sizes ≤12 mm were considered to be very small. Lateral electronic disequilibrium in the phantom was the dominant cause of change in OPF at very small field sizes. Thus the theoretical definition of very small field size coincided to the field size at which lateral electronic disequilibrium clearly caused a greater change in OPF than any other effects. This was found to occur at field sizes ≤12 mm. Source occlusion also caused a large change in OPF for field sizes ≤8 mm. Based on the results of this study, field sizes ≤12 mm were considered to be theoretically very small for 6 MV beams. Conclusions: Extremely careful experimental methodology including the measurement of dosimetric field size at the same time as output factor measurement for each field size setting and also very precise detector alignment is required at field sizes at least ≤12 mm and more conservatively≤15 mm for 6 MV beams. These recommendations should be applied in addition to all the usual considerations for small field dosimetry, including careful detector selection.

61 RADIATION PROTECTION AND DOSIMETRY↗