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At least 991 records · Page 55
All sourcesNASA NTRSDOE OSTI
DOE OSTI2013

Changes realized from extended bit-depth and metal artifact reduction in CT

Purpose: High-Z material in computed tomography (CT) yields metal artifacts that degrade image quality and may cause substantial errors in dose calculation. This study couples a metal artifact reduction (MAR) algorithm with enhanced 16-bit depth (vs standard 12-bit) to quantify potential gains in image quality and dosimetry. Methods: Extended CT to electron density (CT-ED) curves were derived from a tissue characterization phantom with titanium and stainless steel inserts scanned at 90-140 kVp for 12- and 16-bit reconstructions. MAR was applied to sinogram data (Brilliance BigBore CT scanner, Philips Healthcare, v.3.5). Monte Carlo simulation (MC-SIM) was performed on a simulated double hip prostheses case (Cerrobend rods embedded in a pelvic phantom) using BEAMnrc/Dosxyz (400 000 0000 histories, 6X, 10 Multiplication-Sign 10 cm{sup 2} beam traversing Cerrobend rod). A phantom study was also conducted using a stainless steel rod embedded in solid water, and dosimetric verification was performed with Gafchromic film analysis (absolute difference and gamma analysis, 2% dose and 2 mm distance to agreement) for plans calculated with Anisotropic Analytic Algorithm (AAA, Eclipse v11.0) to elucidate changes between 12- and 16-bit data. Three patients (bony metastases to the femur and humerus, and a prostate cancer case) with metal implants were reconstructed using both bit depths, with dose calculated using AAA and derived CT-ED curves. Planar dose distributions were assessed via matrix analyses and using gamma criteria of 2%/2 mm. Results: For 12-bit images, CT numbers for titanium and stainless steel saturated at 3071 Hounsfield units (HU), whereas for 16-bit depth, mean CT numbers were much larger (e.g., titanium and stainless steel yielded HU of 8066.5 {+-} 56.6 and 13 588.5 {+-} 198.8 for 16-bit uncorrected scans at 120 kVp, respectively). MC-SIM was well-matched between 12- and 16-bit images except downstream of the Cerrobend rod, where 16-bit dose was {approx}6.4% greater than 12-bit. Absolute film dosimetry in a region downstream of a stainless steel rod revealed that 16-bit calculated dose, with and without MAR, agreed more closely with film results (1%-2% less than film) as compared to 12-bit reconstructions (5.6%-6.5% less than film measurements). Gamma analysis revealed that 16-bit dose calculations were better matched to film results than 12-bit ({approx}10% higher pass rates for 16-bit). Similar results were observed in two patient cases; the largest discrepancy was observed for a femur case where 12-bit doses, both with and without MAR correction, were 6-7 Gy lower ({approx}17%-20% of the prescription dose) as compared to 16-bit dose calculations. However, when beams are not directly traversing metal, such as a prostate cancer case with bilateral hip prostheses; the impact of 16-bit reconstruction was diminished. Conclusions: These results suggest that it may be desirable to implement 16-bit MAR-corrected images for treatment planning purposes, which can provide a more accurate dosimetric approach coupled with improved visualization by suppression of CT artifacts.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

Small fields output factors measurements and correction factors determination for several detectors for a CyberKnife{sup Registered-Sign} and linear accelerators equipped with microMLC and circular cones

Purpose: The use of small photon fields is now an established practice in stereotactic radiosurgery and radiotherapy. However, due to a lack of lateral electron equilibrium and high dose gradients, it is difficult to accurately measure the dosimetric quantities required for the commissioning of such systems. Moreover, there is still no metrological dosimetric reference for this kind of beam today. In this context, the first objective of this work was to determine and to compare small fields output factors (OF) measured with different types of active detectors and passive dosimeters for three types of facilities: a CyberKnife{sup Registered-Sign} system, a dedicated medical linear accelerator (Novalis) equipped with m3 microMLC and circular cones, and an adaptive medical linear accelerator (Clinac 2100) equipped with an additional m3 microMLC. The second one was to determine the k{sub Q{sub c{sub l{sub i{sub n,Q{sub m{sub s{sub r}{sup f{sub c}{sub l}{sub i}{sub n},f{sub m}{sub s}{sub r}}}}}}}}} correction factors introduced in a recently proposed small field dosimetry formalism for different active detectors.Methods: Small field sizes were defined either by microMLC down to 6 Multiplication-Sign 6 mm{sup 2} or by circular cones down to 4 mm in diameter. OF measurements were performed with several commercially available active detectors dedicated to measurements in small fields (high resolution diodes: IBA SFD, Sun Nuclear EDGE, PTW 60016, PTW 60017; ionizing chambers: PTW 31014 PinPoint chamber, PTW 31018 microLion liquid chamber, and PTW 60003 natural diamond). Two types of passive dosimeters were used: LiF microcubes and EBT2 radiochromic films.Results: Significant differences between the results obtained by several dosimetric systems were observed, particularly for the smallest field size for which the difference in the measured OF reaches more than 20%. For passive dosimeters, an excellent agreement was observed (better than 2%) between EBT2 and LiF microcubes for all OF measurements. Moreover, it has been shown that these passive dosimeters do not require correction factors and can then be used as reference dosimeters. Correction factors for the active detectors have then been determined from the mean experimental OF measured by the passive dosimeters.Conclusions: Four sets of correction factors needed to apply the new small field dosimetry formalism are provided for several active detectors. A protocol for small photon beams OF determination based on passive dosimeters measurements has been recently proposed to French radiotherapy treatment centers.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

A Fano cavity test for Monte Carlo proton transport algorithms

Purpose: In the scope of reference dosimetry of radiotherapy beams, Monte Carlo (MC) simulations are widely used to compute ionization chamber dose response accurately. Uncertainties related to the transport algorithm can be verified performing self-consistency tests, i.e., the so-called “Fano cavity test.” The Fano cavity test is based on the Fano theorem, which states that under charged particle equilibrium conditions, the charged particle fluence is independent of the mass density of the media as long as the cross-sections are uniform. Such tests have not been performed yet for MC codes simulating proton transport. The objectives of this study are to design a new Fano cavity test for proton MC and to implement the methodology in two MC codes: Geant4 and PENELOPE extended to protons (PENH). Methods: The new Fano test is designed to evaluate the accuracy of proton transport. Virtual particles with an energy ofE{sub 0} and a mass macroscopic cross section of (Σ)/(ρ) are transported, having the ability to generate protons with kinetic energy E{sub 0} and to be restored after each interaction, thus providing proton equilibrium. To perform the test, the authors use a simplified simulation model and rigorously demonstrate that the computed cavity dose per incident fluence must equal (ΣE{sub 0})/(ρ) , as expected in classic Fano tests. The implementation of the test is performed in Geant4 and PENH. The geometry used for testing is a 10 × 10 cm{sup 2} parallel virtual field and a cavity (2 × 2 × 0.2 cm{sup 3} size) in a water phantom with dimensions large enough to ensure proton equilibrium. Results: For conservative user-defined simulation parameters (leading to small step sizes), both Geant4 and PENH pass the Fano cavity test within 0.1%. However, differences of 0.6% and 0.7% were observed for PENH and Geant4, respectively, using larger step sizes. For PENH, the difference is attributed to the random-hinge method that introduces an artificial energy straggling if step size is not small enough. Conclusions: Using conservative user-defined simulation parameters, both PENH and Geant4 pass the Fano cavity test for proton transport. Our methodology is applicable to any kind of charged particle, provided that the considered MC code is able to track the charged particle considered.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Seeing the invisible: Direct visualization of therapeutic radiation beams using air scintillation

Purpose: To assess whether air scintillation produced during standard radiation treatments can be visualized and used to monitor a beam in a nonperturbing manner. Methods: Air scintillation is caused by the excitation of nitrogen gas by ionizing radiation. This weak emission occurs predominantly in the 300–430 nm range. An electron-multiplication charge-coupled device camera, outfitted with an f/0.95 lens, was used to capture air scintillation produced by kilovoltage photon beams and megavoltage electron beams used in radiation therapy. The treatment rooms were prepared to block background light and a short-pass filter was utilized to block light above 440 nm. Results: Air scintillation from an orthovoltage unit (50 kVp, 30 mA) was visualized with a relatively short exposure time (10 s) and showed an inverse falloff (r{sup 2} = 0.89). Electron beams were also imaged. For a fixed exposure time (100 s), air scintillation was proportional to dose rate (r{sup 2} = 0.9998). As energy increased, the divergence of the electron beam decreased and the penumbra improved. By irradiating a transparent phantom, the authors also showed that Cherenkov luminescence did not interfere with the detection of air scintillation. In a final illustration of the capabilities of this new technique, the authors visualized air scintillation produced during a total skin irradiation treatment. Conclusions: Air scintillation can be measured to monitor a radiation beam in an inexpensive and nonperturbing manner. This physical phenomenon could be useful for dosimetry of therapeutic radiation beams or for online detection of gross errors during fractionated treatments.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Multi-institutional dosimetric and geometric commissioning of image-guided small animal irradiators

Purpose: To compare the dosimetric and geometric properties of a commercial x-ray based image-guided small animal irradiation system, installed at three institutions and to establish a complete and broadly accessible commissioning procedure. Methods: The system consists of a 225 kVp x-ray tube with fixed field size collimators ranging from 1 to 44 mm equivalent diameter. The x-ray tube is mounted opposite a flat-panel imaging detector, on a C-arm gantry with 360° coplanar rotation. Each institution performed a full commissioning of their system, including half-value layer, absolute dosimetry, relative dosimetry (profiles, percent depth dose, and relative output factors), and characterization of the system geometry and mechanical flex of the x-ray tube and detector. Dosimetric measurements were made using Farmer-type ionization chambers, small volume air and liquid ionization chambers, and radiochromic film. The results between the three institutions were compared. Results: At 225 kVp, with 0.3 mm Cu added filtration, the first half value layer ranged from 0.9 to 1.0 mm Cu. The dose-rate in-air for a 40 × 40 mm{sup 2} field size, at a source-to-axis distance of 30 cm, ranged from 3.5 to 3.9 Gy/min between the three institutions. For field sizes between 2.5 mm diameter and 40 × 40 mm{sup 2}, the differences between percent depth dose curves up to depths of 3.5 cm were between 1% and 4% on average, with the maximum difference being 7%. The profiles agreed very well for fields >5 mm diameter. The relative output factors differed by up to 6% for fields larger than 10 mm diameter, but differed by up to 49% for fields ≤5 mm diameter. The mechanical characteristics of the system (source-to-axis and source-to-detector distances) were consistent between all three institutions. There were substantial differences in the flex of each system. Conclusions: With the exception of the half-value layer, and mechanical properties, there were significant differences between the dosimetric and geometric properties of the three systems. This underscores the need for careful commissioning of each individual system for use in radiobiological experiments.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

Comparison of TG-43 and TG-186 in breast irradiation using a low energy electronic brachytherapy source

Purpose: The recently updated guidelines for dosimetry in brachytherapy in TG-186 have recommended the use of model-based dosimetry calculations as a replacement for TG-43. TG-186 highlights shortcomings in the water-based approach in TG-43, particularly for low energy brachytherapy sources. The Xoft Axxent is a low energy (<50 kV) brachytherapy system used in accelerated partial breast irradiation (APBI). Breast tissue is a heterogeneous tissue in terms of density and composition. Dosimetric calculations of seven APBI patients treated with Axxent were made using a model-based Monte Carlo platform for a number of tissue models and dose reporting methods and compared to TG-43 based plans. Methods: A model of the Axxent source, the S700, was created and validated against experimental data. CT scans of the patients were used to create realistic multi-tissue/heterogeneous models with breast tissue segmented using a published technique. Alternative water models were used to isolate the influence of tissue heterogeneity and backscatter on the dose distribution. Dose calculations were performed using Geant4 according to the original treatment parameters. The effect of the Axxent balloon applicator used in APBI which could not be modeled in the CT-based model, was modeled using a novel technique that utilizes CAD-based geometries. These techniques were validated experimentally. Results were calculated using two dose reporting methods, dose to water (D{sub w,m}) and dose to medium (D{sub m,m}), for the heterogeneous simulations. All results were compared against TG-43-based dose distributions and evaluated using dose ratio maps and DVH metrics. Changes in skin and PTV dose were highlighted. Results: All simulated heterogeneous models showed a reduced dose to the DVH metrics that is dependent on the method of dose reporting and patient geometry. Based on a prescription dose of 34 Gy, the average D{sub 90} to PTV was reduced by between ∼4% and ∼40%, depending on the scoring method, compared to the TG-43 result. Peak skin dose is also reduced by 10%–15% due to the absence of backscatter not accounted for in TG-43. The balloon applicator also contributed to the reduced dose. Other ROIs showed a difference depending on the method of dose reporting. Conclusions: TG-186-based calculations produce results that are different from TG-43 for the Axxent source. The differences depend strongly on the method of dose reporting. This study highlights the importance of backscatter to peak skin dose. Tissue heterogeneities, applicator, and patient geometries demonstrate the need for a more robust dose calculation method for low energy brachytherapy sources.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

SU-E-P-04: Transport Theory Learning Module in the Maple Environment

Purpose: The medical physics graduate program at the University of Miami is developing a computerized instructional module which provides an interactive mechanism for students to learn transport theory. While not essential in the medical physics curriculum, transport theory should be taught because the conceptual level of transport theory is fundamental, a substantial literature exists and ought to be accessible, and students should understand commercial software which solves the Boltzmann equation.But conventional teaching and learning of transport theory is challenging. Students may be under prepared to appreciate its methods, results, and relevance, and it is not substantially addressed in textbooks for the medical physicists. Other resources an instructor might reasonably use, while excellent, may be too briskly paced for beginning students. The purpose of this work is to render teaching of transport theory more tractable by making learning highly interactive. Methods: The module is being developed in the Maple mathematics environment by instructors and graduate students. It will refresh the students' knowledge of vector calculus and differential equations, and will develop users' intuition for phase space concepts. Scattering concepts will be developed with animated simulations using tunable parameters characterizing interactions, so that students may develop a “feel” for cross section. Transport equations for one and multiple types of radiation will be illustrated with phase space animations. Numerical methods of solution will be illustrated. Results: Attempts to teach rudiments of transport theory in radiation physics and dosimetry courses using conventional classroom techniques at the University of Miami have had small success, because classroom time is limited and the material has been hard for our students to appreciate intuitively. Conclusion: A joint effort of instructor and students to teach and learn transport theory by building an interactive description of it will lead to deeper appreciation of the transport theoretical underpinnings of dosimetry.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

SU-E-T-415: An Ionization Chamber Array with High Spatial Resolution for External Beam Radiotherapy

Purpose: To characterize an ionization chamber array technology with high spatial resolution and high charge collection efficiency for external beam radiotherapy. Methods: The prototype under test is a linear array of air vented ionization chambers developed by IBA Dosimetry, consisting of 80 pixels with 3.5mm spatial resolution and 4mm{sup 3} sensitive volume. The detector was characterized in a plastic phantom with {sup 60} Co radiation and MV X-rays from an ELEKTA Agility LINAC (with flattened and unflattened beam qualities). Bias voltage was varied in order to evaluate charge collection efficiency. A commercial array of ionization chambers (MatriXX Evolution, IBA Dosimetry) and an amorphous silicon flat panel in direct conversion configuration were used as references. Results: Repeatability (0.4%) and stability under continuous gamma irradiation (0.3%) are very good, in spite of low active volume and sensitivity (∼200pC/Gy). Charge collection efficiency is higher than 99% already at 150V with ∼2mGy dose per pulse, leading to a ±1.1% sensitivity change with dose per pulse in the range 0.09-2mGy (covering all flattened and unflattened applications). Measured dose profiles are in agreement with MatriXX for fields larger than 2×2cm{sup 2}, in which case the linear array offers a much better characterization of the penumbra region. Down to 1×1cm{sup 2}, measured profiles are in very good agreement with the flat panel. Conclusion: The array represents a valuable tool for the characterization of treatment fields in which high spatial resolution is required, together with the dosimetric performance of air vented ionization chambers. Such a technology would be particularly valuable in association with advanced treatment modalities such as rotational radiotherapy, stereotactic treatments (even with unflattened beam qualities) and proton therapy, due to the insensitivity of the chambers on dose per pulse. In the future, a two dimensional prototype based on this technology will be developed and tested. This research project has been supported by a Marie Curie Early Initial Training Network Fellowship of the European Community's Seventh Framework Programme under contract number (PITN-GA-2011-289198-.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

A revised dosimetric characterization of the model S700 electronic brachytherapy source containing an anode-centering plastic insert and other components not included in the 2006 model

Purpose: The model S700 Axxent electronic brachytherapy source by Xoft, Inc., was characterized by Rivard et al. in 2006. Since then, the source design was modified to include a new insert at the source tip. Current study objectives were to establish an accurate source model for simulation purposes, dosimetrically characterize the new source and obtain its TG-43 brachytherapy dosimetry parameters, and determine dose differences between the original simulation model and the current model S700 source design. Methods: Design information from measurements of dissected model S700 sources and from vendor-supplied CAD drawings was used to aid establishment of an updated Monte Carlo source model, which included the complex-shaped plastic source-centering insert intended to promote water flow for cooling the source anode. These data were used to create a model for subsequent radiation transport simulations in a water phantom. Compared to the 2006 simulation geometry, the influence of volume averaging close to the source was substantially reduced. A track-length estimator was used to evaluate collision kerma as a function of radial distance and polar angle for determination of TG-43 dosimetry parameters. Results for the 50 kV source were determined every 0.1 cm from 0.3 to 15 cm and every 1° from 0° to 180°. Photon spectra in water with 0.1 keV resolution were also obtained from 0.5 to 15 cm and polar angles from 0° to 165°. Simulations were run for 10{sup 10} histories, resulting in statistical uncertainties on the transverse plane of 0.04% at r = 1 cm and 0.06% at r = 5 cm. Results: The dose-rate distribution ratio for the model S700 source as compared to the 2006 model exceeded unity by more than 5% for roughly one quarter of the solid angle surrounding the source, i.e., θ ≥ 120°. The radial dose function diminished in a similar manner as for an {sup 125}I seed, with values of 1.434, 0.636, 0.283, and 0.0975 at 0.5, 2, 5, and 10 cm, respectively. The radial dose function ratio between the current and the 2006 model had a minimum of 0.980 at 0.4 cm, close to the source sheath and for large distances approached 1.014. 2D anisotropy function ratios were close to unity for 50° ≤ θ ≤ 110°, but exceeded 5% for θ < 40° at close distances to the sheath and exceeded 15% for θ > 140°, even at large distances. Photon energy fluence of the updated model as compared to the 2006 model showed a decrease in output with increasing distance; this effect was pronounced at the lowest energies. A decrease in photon fluence with increase in polar angle was also observed and was attributed to the silver epoxy component. Conclusions: Changes in source design influenced the overall dose rate and distribution by more than 2% in several regions. This discrepancy is greater than the dose calculation acceptance criteria as recommended in the AAPM TG-56 report. The effect of the design change on the TG-43 parameters would likely not result in dose differences outside of patient applicators. Adoption of this new dataset is suggested for accurate depiction of model S700 source dose distributions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Characterization of XR-RV3 GafChromic{sup ®} films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors

Purpose: To investigate the optimal use of XR-RV3 GafChromic{sup ®} films to assess patient skin dose in interventional radiology while addressing the means to reduce uncertainties in dose assessment. Methods: XR-Type R GafChromic films have been shown to represent the most efficient and suitable solution to determine patient skin dose in interventional procedures. As film dosimetry can be associated with high uncertainty, this paper presents the EURADOS WG 12 initiative to carry out a comprehensive study of film characteristics with a multisite approach. The considered sources of uncertainties include scanner, film, and fitting-related errors. The work focused on studying film behavior with clinical high-dose-rate pulsed beams (previously unavailable in the literature) together with reference standard laboratory beams. Results: First, the performance analysis of six different scanner models has shown that scan uniformity perpendicular to the lamp motion axis and that long term stability are the main sources of scanner-related uncertainties. These could induce errors of up to 7% on the film readings unless regularly checked and corrected. Typically, scan uniformity correction matrices and reading normalization to the scanner-specific and daily background reading should be done. In addition, the analysis on multiple film batches has shown that XR-RV3 films have generally good uniformity within one batch (<1.5%), require 24 h to stabilize after the irradiation and their response is roughly independent of dose rate (<5%). However, XR-RV3 films showed large variations (up to 15%) with radiation quality both in standard laboratory and in clinical conditions. As such, and prior to conducting patient skin dose measurements, it is mandatory to choose the appropriate calibration beam quality depending on the characteristics of the x-ray systems that will be used clinically. In addition, yellow side film irradiations should be preferentially used since they showed a lower dependence on beam parameters compared to white side film irradiations. Finally, among the six different fit equations tested in this work, typically used third order polynomials and more rational and simplistic equations, of the form dose inversely proportional to pixel value, were both found to provide satisfactory results. Fitting-related uncertainty was clearly identified as a major contributor to the overall film dosimetry uncertainty with up to 40% error on the dose estimate. Conclusions: The overall uncertainty associated with the use of XR-RV3 films to determine skin dose in the interventional environment can realistically be estimated to be around 20% (k = 1). This uncertainty can be reduced to within 5% if carefully monitoring scanner, film, and fitting-related errors or it can easily increase to over 40% if minimal care is not taken. This work demonstrates the importance of appropriate calibration, reading, fitting, and other film-related and scan-related processes, which will help improve the accuracy of skin dose measurements in interventional procedures.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-03: 3 Year Clinical Experience with the IBA Proton Eyeline

Purpose: Over the past 3 years, more than 50 patients with ocular disease have been treated with a prototype commercial eyeline developed by Ion Beam Applications (IBA). It is particularly crucial for the dosimetry of the machine to be accurate, precise, and reproducible because of the small treatment volumes and several surrounding critical structures. A quality assurance (QA) program has been developed in order to regularly check and record the machine’s dosimetry over time. In this study we have summarized and evaluated three years of patient and system QA data for the eyeline prototype. Methods: In order to accurately deliver the prescribed dose to the patient’s treatment site, an output model was created based on several machine parameters. This output model, along with the requested system parameters, are regularly checked and recorded by a QA program. 10 standard proton fields have been created which have regular QA performed monthly with a water tank and parallel-plate chamber, and recorded in a database. QA has additionally been performed for each patient-specific treatment field. This is to verify and evaluate the patient output model as well as the system parameters for range&modulation combinations different than the standard QA fields. Results: 140 beam measurements have been analyzed for range, modulation, and output. The range is typically within tolerance, although there are about 6 cases where the system did not perform as expected. The modulation appears to be very stable, always being within tolerance. Output for the standard QA fields are typically within 2.5% from the baseline value. The patient output measurements agree within 2.5% from the model. Conclusion: Overall the eyeline performs well within the tolerances set, and the patient output measurements agree within 2% of the model.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-171: Characterization of the New Xoft Axxent Electronic Brachytherapy Source Using PRESAGE Dosimeters

Purpose: To characterize the Xoft Axxent electronic brachytherapy source using PRESAGE™ dosimeters to obtain independent confirmation of TG-43U1 dosimetry values from previous studies and ascertain its reproducibility in HDR brachytherapy. Methods: PRESAGE™ dosimeters are solid, polyurethane-based dosimeters doped with radiochromic leucodyes that produce a linear optical-density response when exposed to radiation. Eight 1-kg dosimeters were scanned prior to irradiation on an optical-CT scanner to eliminate background signal and any optical imperfections from each dosimeter. To quantify potential imaging artifacts due to oversaturated responses in the immediate range of the source, half of the eight dosimeters were cast with a smaller channel diameter of 5.4 mm, and the other half were cast with a larger channel diameter of 15mm. During irradiation, the catheters were placed in the center of each channel. Catheters fit the 5.4mm diameters channels whereas polyurethane plugs were inserted into the larger channels to create a sturdy, immobile catheter which allowed uniform dose distributions. Two dosimeters of each 5.4mm and 15mm were irradiated at either 1517.3 cGy or 2017.5 cGy. Post-irradiation scans were performed within 48 hours of irradiation. A 3D reconstruction based on subtraction of these two images and the relative dose measurements were made using in-house software. Results: Comparing measured radial dose rates with previous results revealed smaller percent errors when PRESAGE™ irradiations were at lower maximum dose. The dosimeters showed small deviations in radial dose function, g{sub p} (r), from previous studies. Among the dosimeters irradiated at 1517.3 cGy, the g{sub p}(r) compared to previous studies fluctuated from 0.0043 to 0.3922. This suggests small fluctuations can drastically change radial dose calculations. Conclusion: The subtraction of pre-irradiation and post-irradiation scans of PRESAGE™ dosimeters using an optical-CT scanner shows promising results in determining 3D dosimetry for Xoft Axxent devices; however, further research is recommended. NIH Grant#: 5-U24-CA081647-13; ROI Grant#: 5R01CA100835.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-202: Comparison of 4D-Measurement-Guided Dose Reconstructions (MGDR) with COMPASS and OCTAVIUS 4D System

Purpose: To cross-validate the MGDR of COMPASS (IBA dosimetry, GmbH, Germany) and OCTAVIUS 4D system (PTW, Freiburg, Germany). Methods: Volumetric-modulated arc plans (5 head-and-neck and 3 prostate) collapsed to 40° gantry on the OCTAVIUS 4D phantom in QA mode on Monaco v5.0 (Elekta, CMS, Maryland Heights, MO) were delivered on a Elekta Agility linac. This study was divided into two parts: (1) error-free measurements by gantry-mounted EvolutionXX 2D array were reconstructed in COMPASS (IBA dosimetry, GmbH, Germany), and by OCTAVIUS 1500 array in Versoft v6.1 (PTW, Freiburg, Germany) to obtain the 3D doses (COM4D and OCTA4D). COM4D and OCTA4D were compared to the raw measurement (OCTA3D) at the same detector plane for which OCTAVIUS 1500 was perpendicular to 0° gantry axis while the plans were delivered at gantry 40°; (2) beam steering errors of energy (Hump=-2%) and symmetry (2T=+2%) were introduced during the delivery of 5 plans to compare the MGDR doses COM4D-Hump (COM4D-2T), OCTA4D-Hump (OCTA4D-2T), with raw doses OCTA3D-Hump (OCTA3D-2T) and with OCTA3D to assess the error reconstruction and detection ability of MGDR tools. All comparisons used Υ-criteria of 2%(local dose)/2mm and 3%/3mm. Results: Averaged Υ passing rates were 85% and 96% for COM4D,and 94% and 99% for OCTA4D at 2%/2mm and 3%/3mm criteria respectively. For error reconstruction, COM4D-Hump (COM4D-2T) showed 81% (93%) at 2%/2mm and 94% (98%) at 3%/3mm, while OCTA4D-Hump (OCTA4D-2T) showed 96% (96%) at 2%/2mm and 99% (99%) at 3%/3mm. For error detection, OCTA3D doses were compared to COM4D-Hump (COM4D-2T) showing Υ passing rates of 93% (93%) at 2%/2mm and 98% (98%), and to OCTA4D-Hump (OCTA4D -2T) showing 94% (99%) at 2%/2mm and 81% (96%) at 3%/3mm, respectively. Conclusion: OCTAVIUS MGDR showed better agreement to raw measurements in both error- and error-free comparisons. COMPASS MGDR deviated from the raw measurements possibly owing to beam modeling uncertainty.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-206: Comparison of EBT and EBT3 RadioChromic Films in Radiation Field of Parotid Cancer Radiotherapy

Purpose: The aim of the current study is to compare EBT and EBT3 RadioChromic films in dosimetry of radiotherapy fields for treatment of parotid cancer. Methods: The calibrations of EBT and EBT3 films were performed with the same setups for doses ranging from 0.2 Gy to 5 Gy using 6 MV photon beam of a Siemens Primus linac. These films were scanned in color mode (RGB) by a Microtek (1000XL) scanner and the red color channel data was extracted. Treatment planning for parotid cancer radiation therapy was performed on a RANDO phantom. Skin dose was measured at different points in the right anterior oblique (RAO) and right posterior oblique (RPO) fields by EBT and EBT3 films. Results: Dosimetry was performed with the same conditions for the two film types for calibration and in-phantom in parotid cancer radiotherapy. The measured net optical density (NOD) in EBT film was in some extent higher than that from EBT3 film. The minimum difference between these two films under calibration conditions was about 2.9% (for 0.2 Gy). However, the maximum difference was 35.5% (for 0.5 Gy). In the therapeutic fields of parotid cancer radiotherapy at different points, the measured dose from EBT film was higher than the EBT3 film. In these fields the minimum and maximum measured dose differences were 16.0% and 25.5%, respectively. Conclusion: With the same irradiation and reading conditions, EBT film demonstrates higher NOD than the EBT3 film. This effect may be related to the higher sensitivity of EBT film over EBT3 film. However, the obtained dose differences between these two films in low dose range can be due to the differences in fitting functions applied following the calibration process.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-318: Dosimetric Evaluation of ArcCHECK and 3DVH System Using Customized Polymer Gel Dosimeter

Purpose: ArcCHECK and 3DVH system (Sun Nuclear) can reconstruct the three-dimensional (3D) dose distribution and provide the DVH analysis in a patient. The aim of this study was to evaluate dosimetric accuracy of this system using customized polymer gel dosimeter, and also Gafchromic EBT3 films. Methods: Polyacrylamide-based gel contained magnesium chloride as a sensitizer (iPAGAT) was used in this study. Volumetric-modulated arc therapy (VMAT) plan was performed for the C-shape structure by the Eclipse treatment planning system (Varian) and used to irradiate the ArcCHECK by the Novalis Tx linear accelerator (Varian/BrainLAB). The cubic phantom filled with iPAGAT and EBT3 films placed in three orthogonal planes (axial, sagittal, and coronal) inserted into the I’mRT Phantom (IBA Dosimetry) simulated a patient were irradiated with the same VMAT plan. The measurement-guided 3D dose distribution was reconstructed using 3DVH software from the measured data of the ArcCHECK. The 3D dose distribution in iPAGAT was read out by Signa 1.5 T MRI system (GE), and 2D dose distribution on EBT3 was read out by color scanner (Epson). The comparison of all the dose distributions was performed with dose profiles and gamma index analysis in orthogonal planes using in-house developed software. Results: A good agreement was observed by overlaying the dose profiles of 3DVH, EBT3, and iPAGAT. The mean pass rates by gamma index analysis with 3%/3 mm criteria in orthogonal planes were 94.3% (3DVH vs EBT3), 91.1% (3DVH vs iPAGAT), and 96.4% (iPAGAT vs EBT3), respectively. Conclusion: 3D dose distribution reconstructed by ArcCHECK and 3DVH system was estimated accurately in a patient. However, slightly differences were observed between 3DVH and iPAGAT because of MRI noise, therefore further study is required to improve the accuracy of MRI based polymer gel dosimetry for the DVH analysis.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-332: Dosimetric Impact of Photon Energy and Treatment Technique When Knowledge Based Auto-Planning Is Implemented in Radiotherapy of Localized Prostate Cancer

Purpose: The aim of this study was to investigate the dosimetric impact of the combination of photon energy and treatment technique on radiotherapy of localized prostate cancer when knowledge based planning was used. Methods: A total of 16 patients with localized prostate cancer were retrospectively retrieved from database and used for this study. For each patient, four types of treatment plans with different combinations of photon energy (6X and 10X) and treatment techniques (7-field IMRT and 2-arc VMAT) were created using a prostate DVH estimation model in RapidPlan™ and Eclipse treatment planning system (Varian Medical System). For any beam arrangement, DVH objectives and weighting priorities were generated based on the geometric relationship between the OAR and PTV. Photon optimization algorithm was used for plan optimization and AAA algorithm was used for final dose calculation. Plans were evaluated in terms of the pre-defined dosimetric endpoints for PTV, rectum, bladder, penile bulb, and femur heads. A Student’s paired t-test was used for statistical analysis and p > 0.05 was considered statistically significant. Results: For PTV, V95 was statistically similar among all four types of plans, though the mean dose of 10X plans was higher than that of 6X plans. VMAT plans showed higher heterogeneity index than IMRT plans. No statistically significant difference in dosimetry metrics was observed for rectum, bladder, and penile bulb among plan types. For left and right femur, VMAT plans had a higher mean dose than IMRT plans regardless of photon energy, whereas the maximum dose was similar. Conclusion: Overall, the dosimetric endpoints were similar regardless of photon energy and treatment techniques when knowledge based auto planning was used. Given the similarity in dosimetry metrics of rectum, bladder, and penile bulb, the genitourinary and gastrointestinal toxicities should be comparable among the selections of photon energy and treatment techniques.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-344: Dynamic Electron Beam Therapy Using Multiple Apertures in a Single Cut-Out

Purpose: Few leaf electron collimators (FLEC) or electron MLCs (eMLC) are highly desirable for dynamic electron beam therapies as they produce multiple apertures within a single delivery to achieve conformal dose distributions. However, their clinical implementation has been challenging. Alternatively, multiple small apertures in a single cut-out with variable jaw sizes could be utilized in a single dynamic delivery. In this study, we investigate dosimetric characteristics of such arrangement. Methods: Monte Carlo (EGSnrc/BEAMnrc/DOSXYnrc) simulations utilized validated Varian TrueBeam phase spaces. Investigated quantities included: Energy (6 MeV), jaw size (1×1 to 22×22 cm {sup 2}; centered to aperture), applicator/cut-out (15×15 cm{sup 2}), aperture (1×1, 2×2, 3×3, 4×4 cm{sup 2}), and aperture placement (on/off central axis). Three configurations were assessed: (1) single aperture on-axis, (2) single aperture off-axis, and (3) multiple apertures. Reference was configuration (1) with standard jaw size. Aperture placement and jaw size were optimized to maintain reference dosimetry and minimize leakage through unused apertures to <5%. Comparison metrics included depth dose and orthogonal profiles. Results: Configuration (1) and (2): Jaw openings were reduced to 10×10 cm{sup 2} without affecting dosimetry (gamma 2%/1mm) regardless of on- or off-axis placement. For smaller jaw sizes, reduced surface (<2%, 5% for 1×1 cm{sup 2} aperture) and increased Bremsstrahlung (<2%, 10% for 1×1 cm{sup 2} aperture) dose was observed. Configuration (3): Optimal aperture placement was in the corners (order: 1×1, 4×4, 2×2, 3×3 cm{sup 2}) and jaw sizes were 4×4, 4×4, 7×7, and 5×5 cm{sup 2} (apertures: 1×1, 2×2, 3×3, 4×4 cm{sup 2} ). Asymmetric leakage was found from upper and lower jaws. Leakage was generally within 5% with a maximum of 10% observed for the 1×1 cm{sup 2} aperture irradiation. Conclusion: Multiple apertures in a single cut-out with variable jaw size can be used in a single dynamic delivery, providing a practical alternative to FLEC or eMLC. Future simulations will expand on all variables.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-345: Effect of DLG and MLC Transmission Value Set in the Treatment Planning System (TPS) On Dosimetric Accuracy of True Beam Hypofractionated SRT/SBRT and 2Gy/fx Prostate Rapid Arc Plans

Purpose: Due to limited commissioning time, we previously only released our True beam non-FFF mode for prostate treatment. Clinical demand now pushes us to release the non-FFF mode for SRT/SBRT treatment. When re-planning on True beam previously treated SRT/SBRT cases on iX machine we found the patient specific QA pass rate was worse than iX’s, though the 2Gy/fx prostate Result had been as good. We hypothesize that in TPS the True beam DLG and MLC transmission values, of those measured during commissioning could not yet provide accurate SRS/SBRT dosimetry. Hence this work is to investigate how the TPS DLG and transmission value affects Rapid Arc plans’ dosimetric accuracy. Methods: We increased DLG and transmission value of True beam in TPS such that their percentage differences against the measured matched those of iX’s. We re-calculated 2 SRT, 1 SBRT and 2 prostate plans, performed patient specific QA on these new plans and compared the results to the previous. Results: With DLG and transmission value set respectively 40 and 8% higher than the measured, the patient specific QA pass rate (at 3%/3mm) improved from 95.0 to 97.6% vs previous iX’s 97.8% in the case of SRT. In the case of SBRT, the pass rate improved from 75.2 to 93.9% vs previous iX’s 92.5%. In the case of prostate, the pass rate improved from 99.3 to 100%. The maximum dose difference in plans before and after adjusting DLG and transmission was approximately 1% of the prescription dose among all plans. Conclusion: The impact of adjusting DLG and transmission value on dosimetry might be the same among all Rapid Arc plans regardless hypofractionated or not. The large variation observed in patient specific QA pass rate might be due to the data analysis method in the QA software being more sensitive to hypofractionated plans.

60 APPLIED LIFE SCIENCES↗