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At least 1,045 records · Page 58
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DOE OSTI2016

SU-F-T-327: Total Body Irradiation In-Vivo Dose Measurements Using Optically Stimulated Luminescence (OSL) NanoDots and Farmer Type Ion Chamber

Purpose: This study was performed to analyze the agreement between optically stimulated luminescence (OSL) nanoDots measured doses and 0.6 cc Farmer type ionization chamber measured doses during total body irradiation (TBI). Methods: In-vivo dose measurements using OSL nanoDots and Farmer chamber were done in a total of twelve patients who received TBI at our center by bilateral parallel-opposed beams technique. In this technique, the patient is kept inside the TBI box which is filled with rice bags and irradiated using two bilateral parallel opposed beams of 40×40 cm{sup 2} size with 45° collimator rotation at an SSD of 333.5 cm in an Elekta Synergy linear accelerator. All patients received a dose of 2 Gy in single fraction as conditioning regimen. The beams were equally weighted at the midplane of the box. The nanoDots were placed over forehead, right and left neck, right and left lung, umbilicus, right and left abdomen, medial part of thigh, knee and toe. A 0.6 cc Farmer chamber was placed in between the thighs of the patient. Measured doses are reported along with the statistical comparisons using paired sample t-test. Results: For the above sites the mean doses were 212.2±21.1, 218.2±7.6, 218.7±9.3, 215.6±9.5, 217.5±11.5, 214.5±7.7, 218.3±6.8, 221.5±15, 229.1±11.0, 220.5±7.7 and 223.3±5.1 cGy respectively. For all OSL measurements the mean dose was 218.6±11.8 cGy. Farmer chamber measurements yielded a mean dose of 208.8±15.6 cGy. Statistical analysis revealed that there was no significant difference between OSL measured doses in forehead, right and left neck, right and left lung, umbilicus, right and left abdomen and toe and Farmer chamber measured doses (0.72≤p≤0.06). However the mean OSL doses at thigh and knee were statistically different (p<0.05) from the Farmer chamber measurements. Conclusion: OSL measurements were found to be in agreement with Farmer type ionization chamber measurements in in-vivo dosimetry of TBI.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-333: Deliverability Considerations in Modulated Photon Radiotherapy (XMRT)

Purpose: Modulated Photon Radiotherapy (XMRT), which simultaneously optimizes photon beamlet energy (6 and 18 MV) and fluence, has shown dosimetric improvements for fluence map optimization (FMO) when compared to conventional single-energy intensity modulated radiotherapy. However, generating deliverable multi-leaf collimator (MLC) sequences for XMRT needs to be explored. Therefore, two problems were investigated: 1) The ability to generate MLC-sequenced fluence maps from FMO XMRT solutions for a prostate case 2) The impact of fluence smoothening constraints imposed in the FMO on the deliverability and dose distribution. Methods: XMRT FMO solutions for a clinical prostate case employing standard dosimetric constraints, prescriptions, and a seven coplanar beam arrangement were generated. Smoothening constraints in the FMO utilized a sum of positive gradients approach. Sequenced maps were generated using an in-house optimization algorithm (MLCSO). The maximum leaf speed, minimum leaf separation, and transmission through MLC leaves were set to 2.5 mm/s, 1 mm, and 1%, respectively. The resulting sequenced maps for each field were compared with the original FMO solutions through gamma analysis (0.5%/0.5 mm) and root mean square error (RMSE). This comparison was done for both the smoothed and unsmoothed XMRT solutions. Results: Average RMSE and gamma agreement of 0.44, 93%and 0.36, 95% were obtained for unsmoothed 6 and 18 MV contributions from XMRT sequenced maps. The sequenced maps with smoothening constraints had better agreement with their respective optimal fluences, with RMSEs of 0 and gamma pass rates of 100% for all comparisons. This improved smoothening led to increased dose to critical structures (rectum, bladder, and femoral heads); however solutions were still clinically acceptable. Conclusion: For a clinical prostate case, XMRT FMO fluence maps were suitable for conversion into deliverable MLC sequences. Imposing smoothening constraints during FMO resulted in improved sequenced maps, though with a slight increase in dose to the critical structures.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-386: Analysis of Three QA Methods for Predicting Dose Deviation Pass Percentage for Lung SBRT VMAT Plans

Purpose: To investigate the significance of using pinpoint ionization chambers (IC) and RadCalc (RC) in determining the quality of lung SBRT VMAT plans with low dose deviation pass percentage (DDPP) as reported by ScandiDos Delta4 (D4). To quantify the relationship between DDPP and point dose deviations determined by IC (ICDD), RadCalc (RCDD), and median dose deviation reported by D4 (D4DD). Methods: Point dose deviations and D4 DDPP were compiled for 45 SBRT VMAT plans. Eighteen patients were treated on Varian Truebeam linear accelerators (linacs); the remaining 27 were treated on Elekta Synergy linacs with Agility collimators. A one-way analysis of variance (ANOVA) was performed to determine if there were any statistically significant differences between D4DD, ICDD, and RCDD. Tukey’s test was used to determine which pair of means was statistically different from each other. Multiple regression analysis was performed to determine if D4DD, ICDD, or RCDD are statistically significant predictors of DDPP. Results: Median DDPP, D4DD, ICDD, and RCDD were 80.5% (47.6%–99.2%), −0.3% (−2.0%–1.6%), 0.2% (−7.5%–6.3%), and 2.9% (−4.0%–19.7%), respectively. The ANOVA showed a statistically significant difference between D4DD, ICDD, and RCDD for a 95% confidence interval (p < 0.001). Tukey’s test revealed a statistically significant difference between two pairs of groups, RCDD-D4DD and RCDD-ICDD (p < 0.001), but no difference between ICDD-D4DD (p = 0.485). Multiple regression analysis revealed that ICDD (p = 0.04) and D4DD (p = 0.03) are statistically significant predictors of DDPP with an adjusted r{sup 2} of 0.115. Conclusion: This study shows ICDD predicts trends in D4 DDPP; however this trend is highly variable as shown by our low r{sup 2}. This work suggests that ICDD can be used as a method to verify DDPP in delivery of lung SBRT VMAT plans. RCDD may not validate low DDPP discovered in D4 QA for small field SBRT treatments.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-402: The Effect of Extremely Narrow MLC Leaf Width On the Plan Quality of VMAT for Prostate Cancer

Purpose: To investigate the effect of multi-leaf collimators (MLCs) with leaf width of 1.25 mm on the plan quality of volumetric modulated arc therapy (VMAT) for prostate cancer. Methods: A total of 20 patients with prostate cancer were retrospectively selected. Using a high definition MLC (HD MLC), primary and boost VMAT plans with two full arcs were generated for each patient (original plan). After that, by shifting patient CT images by 1.25 mm in the cranio-caudal direction between the 1st and the 2nd arc, we simulated fluences made with MLCs with leaf width of 1.25 mm. After shifting, primary and boost plans were generated for each patient (shifted plan). A sum plan was generated by summation of the primary and boost plan for each patient. Dose-volumetric parameters were calculated and compared. Results: Both homogeneity index (HI) and conformity index (CI) of the shifted plans were better than those of the original plans in primary plans (HI = 0.044 vs. 0.040 with p < 0.001 and CI = 1.056 vs. 1.044 with p = 0.006). Similarly, the shifted plans for boost target volume showed better homogeneity and conformity than did the original plans (HI = 0.042 vs. 0.037 with p = 0.006 and CI = 1.015 vs. 1.009 with p < 0.001). The total body volumes of the original plans irradiated by the prescription dose were larger than those of the shifted plans in sum plans (60.9 cc vs. 49.0 cc with p = 0.007). Conclusion: Use of extremely narrow MLCs could increase dose homogeneity and conformity of the target volume for prostate VMAT. This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No. 2015R1C1A1A02036331).

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-429: Craniospinal Irradiation by VMAT Technique: Impact of FFF Beam and High Resolution MLC On Plan Quality

Purpose: Objective of this study was to evaluate the impact of using flattening filter free (FFF) beam with 0.5 cm multileaf collimator (MLC) leaves over conventional flattened beam with 1 cm leaf width MLC on the treatment plan quality in cranio-spinal irradiation (CSI). Methods: For five medulloblastoma cases (3 males and 2 females), who were previously treated by volumetric modulated arc therapy (VMAT) technique using conventional flattened beam shaped by 1 cm width MLC leaves, four test plans were generated and compared against the delivered plan. These retrospective plans consisted of four different combinations of flattened and FFF beams from Elekta’s Agility treatment head with 0.5 cm width MLC leaves. Sparing of organs at risks (OAR) in terms of dose to 5%, 50%, 75% and 90% volumes, mean and maximum dose were evaluated. Results: All plans satisfied the planning objective of covering 95% of PTV by at least 95% of prescription dose. Marginal variation of dose spillage was observed between different VMAT plans at very low dose range (1–5 Gy). Variation in dose statistics for PTVs and OARs were within 1% or 1 Gy. Amongst the five plans, the plan with flattened beam with 1 cm MLC had the highest number of MUs, 2.13 times higher than the plan with Agility MLC with FFF beam that had the least number of MUs. No statistically significant difference (p≥0.05) was observed between the reference plan and the retrospectively generated plans in terms of PTV coverage, cold spot, hot spot and organ at risk doses. Conclusion: In the treatment of CSI cases by VMAT technique, FFF beams and/or finer width MLC did not exhibit advantage over the flattened beams or wider MLC in terms of plan quality except for reduction in MUs.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-434: Development of a Fan-Beam Optical Scanner Using CMOS Array for Small Field Dosimetry

Purpose: To design and construct a second generation optical computed tomography (OCT) system using a fan-beam with a CMOS array detector for the 3D dosimetry with polymer gel and radiochromic solid dosimeters. The system was specifically designed for the small field dosimetry. Methods: The optical scanner used a fan-beam laser, which was produced from a collimated red laser beam (λ=620 nm) with a 15-degree laser-line generating lens. The fan-beam was sent through an index-matching bath which holds the sample stage and a sample. The emerging laser light was detected with a 2.54 cm-long CMOS array detector (512 elements). The sample stage rotated through the full 360 degree projection angles at 0.9-degree increments. Each projection was normalized to the unirradiated sample at the projection angle to correct for imperfections in the dosimeter. A larger sample could be scanned by using a motorized mirror and linearly translating the CMOS detector. The height of the sample stage was varied for a full 3D scanning. The image acquisition and motor motion was controlled by a computer. The 3D image reconstruction was accomplished by a fan-beam reconstruction algorithm. All the software was developed inhouse with MATLAB. Results: The scanner was used on both PRESAGE and PAGAT gel dosimeters. Irreconcilable refraction errors were seen with PAGAT because the fan beam laser line refracted away from the detector when the field was highly varying in 3D. With PRESAGE, this type of error was not seen. Conclusion: We could acquire tomographic images of dose distributions by the new OCT system with both polymer gel and radiochromic solid dosimeters. Preliminary results showed that the system was more suited for radiochromic solid dosimeters since the radiochromic dosimeters exhibited minimal refraction and scattering errors. We are currently working on improving the image quality by thorough characterization of the OCT system.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-463: Light-Field Based Dynalog Verification

Purpose: To independently verify leaf positions in so-called dynalog files for a Varian iX linac with a Millennium 120 MLC. This verification provides a measure of confidence that the files can be used directly as part of a more extensive intensity modulated radiation therapy / volumetric modulated arc therapy QA program. Methods: Initial testing used white paper placed at the collimator plane and a standard hand-held digital camera to image the light and shadow of a static MLC field through the paper. Known markings on the paper allow for image calibration. Noise reduction was attempted with removal of ‘inherent noise’ from an open-field light image through the paper, but the method was found to be inconsequential. This is likely because the environment could not be controlled to the precision required for the sort of reproducible characterization of the quantum noise needed in order to meaningfully characterize and account for it. A multi-scale iterative edge detection algorithm was used for localizing the leaf ends. These were compared with the planned locations from the treatment console. Results: With a very basic setup, the image of the central bank A leaves 15–45, which are arguably the most important for beam modulation, differed from the planned location by [0.38±0.28] mm. Similarly, for bank B leaves 15–45 had a difference of [0.42±0.28] mm Conclusion: It should be possible to determine leaf position accurately with not much more than a modern hand-held camera and some software. This means we can have a periodic and independent verification of the dynalog file information. This is indicated by the precision already achieved using a basic setup and analysis methodology. Currently, work is being done to reduce imaging and setup errors, which will bring the leaf position error down further, and allow meaningful analysis over the full range of leaves.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-480: Evaluation of the Role of Varian Machine Performance Check (MPC) in Our Daily QA Routine

Purpose: (A) To assess the role of Varian MPC in our daily QA routine, and (B) evaluate the accuracy and precision of MPC. Methods: The MPC was performed weekly, for five months, on a Varian TrueBeam for five photon (6x, 10x, 15x, 6xFFF, and 10xFFF) and electron (6e, 9e, 12e, 16e, and 20e) energies. Output results were compared to those determined with an ionization chamber (TN30001, PTW-Freiburg) in plastic and a daily check device (DQA3, Sun Nuclear). Consistency of the Mechanical measurements over five months was analyzed and compared to monthly IsoCal results. Results: The MPC randomly showed large deviations (3–7%) that disappeared upon reacquisition. The MPC output closely matched monthly ion chamber and DQA3 measurements. The maximum and mean absolute difference between monthly and MPC was 1.18% and 0.28±0.21% for all energies. The maximum and mean absolute difference between DQA3 and MPC was 3.26% and 0.85±0.61%. The results suggest the MPC is comparable to the DQA3 for measuring output. The DQA3 provides wedge output, flatness, symmetry, and energy constancy checks, which are missing from the current implementation of the MPC. However, the MPC provides additional mechanical tests, such as size of the radiation isocenter (0.33±0.02 mm) and its coincidence with MV and kV isocenters (0.17±0.05 and 0.21±0.03 mm). It also provides positional accuracy of individual jaws (maximum σ, 0.33mm), all the MLC leaves (0.08mm), gantry (0.05°) and collimator (0.13°) rotation angles, and couch positioning (0.11mm) accuracy. MPC mechanical tests could replace our current daily on-board imaging QA routine and provide some additional QA not currently performed. Conclusion: MPC has the potential to be a valuable tool that facilitates reliable daily QA including many mechanical tests that are not currently performed. This system can add to our daily QA, but further development would be needed to fully replace our current Daily QA device.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-493: An Investigation Into the Feasibility of Using PipsPro Software with Film for Linac QA

Purpose: To determine the feasibility of using radiochromic and radiographic film with Pipspro software for quality assurance of linear accelerators with no on-board imaging. Methods: The linear accelerator being used is a Varian Clinac 21EX. All IGRT is performed using the BrainLab ExacTrac system. Because of the lack of on board imaging, certain monthly and annual TG-142 quality assurance tests are more difficult to perform and analyze to a high degree of accuracy. Pipspro was not designed to be used with hard film, and to our knowledge its use with film had not been investigated. The film used will be GafChromic EBT3 film and Kodak EDR2 film, scanned with an Epson V700 scanner. The following routine tests will be attempted: MLC picket fence, light vs. radiation field coincidence, starshots, and MLC transmission. Results: The only tests that gave accurate and reliable results were the couch, gantry, and collimator starshots. Typical MV and kV images are acquired with a much higher level of contrast between the irradiated and non-irradiated areas when compared to film. Pipspro relies on this level of contrast to be able to automatically detect the fiducial points from its phantom devices, leaf edges for picket fence and transmission tests, and jaw edges for light vs. radiation field tests. Because of this, certain tests gave erroneous results and others were not able to be performed in the software at all, with either type of film. The number of monitor units delivered to the film, the experimental setup, and the scan settings was not able to rectify the problem. Conclusion: For linear accelerators with no on-board imaging, it is not recommended to use hard film with PipsPro to perform TG-142 quality assurance tests. Other software or methods should instead be investigated.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-521: Flattening-Filter-Free Beam Parameters Comparison From Different Linac Machine Types

Purpose: Novel linac machines, TrueBeam (TB) and Elekta Versa have updated head designing and software control system, include flattening-filter-free (FFF) photon and electron beams. Later on FFF beams were also introduced on C-Series machines. In this work FFF beams for same energy 6MV but from different machine versions were studied with reference to beam data parameters. Methods: The 6MV-FFF percent depth doses, profile symmetry and flatness, dose rate tables, and multi-leaf collimator (MLC) transmission factors were measured during commissioning process of both C-series and Truebeam machines. The scanning and dosimetric data for 6MV-FFF beam from Truebeam and C-Series linacs was compared. A correlation of 6MV-FFF beam from Elekta Versa with that of Varian linacs was also found. Results: The scanning files were plotted for both qualitative and quantitative analysis. The dosimetric leaf gap (DLG) for C-Series 6MV-FFF beam is 1.1 mm. Published values for Truebeam dosimetric leaf gap is 1.16 mm. 6MV MLC transmission factor varies between 1.3 % and 1.4 % in two separate measurements and measured DLG values vary between 1.32 mm and 1.33 mm on C-Series machine. MLC transmission factor from C-Series machine varies between 1.5 % and 1.6 %. Some of the measured data values from C-Series FFF beam are compared with Truebeam representative data. 6MV-FFF beam parameter values like dmax, OP factors, beam symmetry and flatness and additional parameters for C-Series and Truebeam liancs will be presented and compared in graphical form and tabular data form if selected. Conclusion: The 6MV flattening filter (FF) beam data from C-Series & Truebeam and 6MV-FFF beam data from Truebeam has already presented. This particular analysis to compare 6MV-FFF beam from C-Series and Truebeam provides opportunity to better elaborate FFF mode on novel machines. It was found that C-Series and Truebeam 6MV-FFF dosimetric and beam data was quite similar.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-533: Study of Dosimetric Properties of Cadmium Free Alloy Used in Compensator Based IMRT

Purpose: To study the dosimetric properties of cadmium free alloy which is used in compensator based IMRT. Methods: A mixture of 30% of lead,52% of bismuth and 18% of tin was used to prepare alloy. We prepared slabs of different thicknesses ranging from 0.71 cm to 6.14 cm. Density of alloy was measured by Archimedes’ principle using SI-234 Denver instrument and water as buoyant liquid. Transmission, linear attenuation coefficient (µ), tissue phantom ration (TPR), beam hardening, surface dose (Ds), percentage depth dose (PDD) and effect of scatter were measured and analyze for different field size and different thickness of compensator for 6 MV photon beam. Measurements were carried out at 100 cm SSD and 160 cm SSD. Results: Density of alloy was found to be 9.5456 gm/cm3. Melting point of alloy is 90–95 °C. For a field size of 10×10 cm2 µ was 0.4253 cm-1 at 100 cm SSD. Calculated TPR was found to be within 3 % of measured TPR. Ds was found to be decreasing with increasing thickness of compensator. 1cm, 1.98 cm and 4.16 cm thick compensator slab decreased surface dose by 4.2%, 6.1% and 9.5% respectively for a field size of 10×10cm2 at 100 cm SSD. As field size increases Ds increases for a given compensator thickness. This is due to increase in amount of scattered dose from wider collimator opening. For smaller field size, PDDs are increased from 3.0% to 5.5% of open beam PDDs as compensator thickness increases from 1 cm to 6.14 cm at a depth of 10 cm in water. For larger field size variation in PDDs is not significant. Conclusion: High degree of modulation can be achieved from this compensator material, which is essential in compensator based IMRT. Dosimetric properties analyzed in this study establish this alloy as a reliable, cost effective, reusable compensator material.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-549: Validation of a Method for in Vivo 3D Dose Reconstruction for SBRT Using a New Transmission Detector

Purpose: Recently, there has been increased clinical use of stereotactic body radiation therapy (SBRT). SBRT treatments will strongly benefit from in vivo patient dose verification, as any errors in delivery can be more detrimental to the radiobiology of the patient as compared to conventional therapy. In vivo dose measurements, a commercially available quality assurance platform which is able to correlate the delivered dose to the patient’s anatomy and take into account tissue inhomogeneity, is the COMPASS system (IBA Dosimetry, Germany) using a new transmission detector (Dolphin, IBA Dosimetry). In this work, we evaluate a method for in vivo 3D dose reconstruction for SBRT using a new transmission detector, which was developed for in vivo dose verification for intensity-modulated radiation therapy (IMRT). Methods: We evaluated the accuracy of measurement for SBRT using simple small fields (2×2−10×10 cm2), a multileaf collimator (MLC) test pattern, and clinical cases. The dose distributions from the COMPASS were compared with those of EDR2 films (Kodak, USA) and the Monte Carlo simulations (MC). For clinical cases, we compared MC using dose-volume-histograms (DVHs) and dose profiles. Results: The dose profiles from the COMPASS for small fields and the complicated MLC test pattern agreed with those of EDR2 films, and MC within 3%. This showed the COMPASS with Dolphin system showed good spatial resolution and can measure small fields which are required for SBRT. Those results also suggest that COMPASS with Dolphin is able to detect MLC leaf position errors for SBRT. In clinical cases, the COMPASS with Dolphin agreed well with MC. The Dolphin detector, which consists of ionization chambers, provided stable measurement. Conclusion: COMPASS with Dolphin detector showed a useful in vivo 3D dose reconstruction for SBRT. The accuracy of the results indicates that this approach is suitable for clinical implementation.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-552: A One-Year Evaluation of the QABeamChecker+ for Use with the CyberKnife System

Purpose: By attaching an adapter plate with fiducial markers to the QA BeamChecker+ (Standard Imaging, Inc., Middleton, WI), the output of the CyberKnife can be accurately, efficiently, and consistently evaluated. The adapter plate, known as the Cutting Board, allows for automated alignment of the QABC+ using the CK’s stereoscopic kV image-based treatment localization system (TLS). Described herein is an evaluation of the system following a year of clinical utilization. Methods: Based on a CT scan of the QABC+ and CB, a treatment plan is generated which delivers a beam to each of the 5 plane-parallel ionization chambers. Following absolute calibration of the CK, the QA plan is delivered, and baseline measurements are acquired (and automatically corrected for temperature and pressure). This test was performed at the beginning of each treatment day for a year. A calibration evaluation (using a water-equivalent slab and short thimble chamber) is performed every four weeks, or whenever the QABC+ detects a deviation of more than 1.0%. Results: During baseline evaluation, repeat measurements (n=10) were performed, with an average output of 0.25% with an SD of 0.11%. As a test of the reposition of the QABC+ and CB, ten additional measurements were performed where between each acquisition, the entire system was removed and re-positioned using the TLS. The average output deviation was 0.30% with a SD of 0.13%. During the course of the year, 187 QABC+ measurements and 13 slab-based measurements were performed. The output measurements of the QABC+ correlated well with slab-based measurements (R2=0.909). Conclusion: By using the QABC+ and CB, daily output was evaluated accurately, efficiently, and consistently. From setup to break-down (including analysis), this test required 5 minutes instead of approximately 15 using traditional techniques (collimator-mounted ionization chambers). Additionally, by automatically saving resultant output deviation to a database, trend analysis was simplified. Spectrum Medical Physics, LLC of Greenville, SC has a consulting contract with Standard Imaging of Middleton, WI.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-554: Dark Current Effect On CyberKnife Beam Dosimetry

Purpose: All RF linear accelerators produce dark current to varying degrees when an accelerating voltage and RF input is applied in the absence of electron gun injection. This study is to evaluate how dark current from the linear accelerator of CyberKnife affect the dose in the reference dosimetry. Methods: The G4 CyberKnife system with 6MV photon beam was used in this study. Using the ion chamber and the diode detector, the dose was measured in water with varying time delay between acquiring charges and staring beam-on after applying high-voltage into the linear accelerator. The dose was measured after the time delay with over the range of 0 to 120 seconds in the accelerating high-voltage mode without beam-on, applying 0, 10, 50, 100, and 200 MUs. For the measurements, the collimator of 60 mm was used and the detectors were placed at the depths of 10 cm with the source-to-surface distance of 80 cm. Results: The dark current was constant over time regardless of MU. The dose due to the dark current increased over time linearly with the R-squared value of 0.9983 up to 4.4 cGy for the time 120 seconds. In the dose rate setting of 720 MU/min, the relative dose when applying the accelerating voltage without beam-on was increased over time up to 0.6% but it was less than the leakage radiation resulted from the accelerated head. As the reference dosimetry condition, when 100 MU was delivered after 10 seconds time delay, the relative dose increased by 0.7% but 6.7% for the low MU (10 MU). Conclusion: In the dosimetry using CyberKnife system, the constant dark current affected to the dose. Although the time delay in the accelerating high-voltage mode without beam-on is within 10 seconds, the dose less than 100 cGy can be overestimated more than 1%.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2016

SU-F-T-558: ArcCheck for Patient Specific QA in Stereotactic Ablative Radiotherapy

Purpose: Stereotactic Ablative Radiotherapy (SABR) is one of the most preferred treatment techniques for early stage lung cancer. This technique has been extended to other treatment sites like Spine, Liver, Scapula, Sternum etc., This has resulted in increased physics QA time on machine. In this study, we’ve tested the feasibility of using ArcCheck as an alternative method to replace film dosimetry. Methods: Twelve patients with varied diagnosis of Lung, Liver, scapula, sternum and Spine undergoing SABR were selected for this study. Pre-treatment QA was performed for all the patients which include ionization chamber and film dosimetry. The required gamma criteria for each SABR plan to pass QA and proceed to treatment is 95% (3%,1mm). In addition to this routine process, the treatment plans were exported on to an ArcCheck phantom. The planned and measured dose from the ArcCheck device were compared using four different gamma criteria: 2%,2 mm, 3%,2 mm, 3%,1 mm and 3%, 3 mm. In addition to this, we’ve also introduced errors to gantry, collimator and couch angle to assess sensitivity of the ArcCheck with potential delivery errors. Results: The ArcCheck mean passing rates for all twelve cases were 76.1%±9.7% for gamma criteria 3%,1 mm, 89.5%±5.3% for 2%,2 mm, 92.6%±4.2% for 3%,2 mm, and 97.6%±2.4% for 3%,3 mm gamma criteria. When SABR spine cases are excluded, we observe ArcCheck passing rates higher than 95% for all the studied cases with 3%, 3mm, and ArcCheck results in acceptable agreement with the film gamma results. Conclusion: Our ArcCheck results at 3%, 3 mm were found to correlate well with our non-SABR spine routine patient specific QA results (3%,1 mm). We observed significant reduction in QA time on using ArcCheck for SABR QA. This study shows that ArcCheck could replace film dosimetry for all sites except SABR spine.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-561: Energy Dependence of a Scintillation Detector

Purpose: To investigate the response and dose rate dependence of a scintillation detector over a wide energy range. Methods: The energy dependence of W1 scintillation detector was tested with: 1) 50–225 keV beams generated by an animal irradiator, 2) a Leksell Gamma Knife Perfexion Co-60 source, 3) 6MV, 6FFF, 10FFF and 15MV photon beams, and 4) 6–20MeV electron beams from a linac. Calibrated linac beams were used to deliver 100 cGy to the detector at dmax in water under reference conditions. The gamma-knife measurement was performed in solid water (100 cGy with 16mm collimator). The low energy beams were calibrated with an ion chamber in air (TG-61), and the scintillation detector was placed at the same location as the ionization chamber during calibration. For the linac photon and electron beams, dose rate dependence was tested for 100–2400 and 100–800 MU/min. Results: The scintillation detector demonstrated strong energy dependence in the range of 50–225keV. The measured values were lower than the delivered dose and increased as the energy increased. Therapeutic photon beams showed energy independence with variations less than 1%. Therapeutic electron beams displayed the same sensitivity of ∼2–3% at their corresponding dmax depths. The change in dose-rate of photon and electron beams within the therapeutic energy range did not affect detector output (<0.5%). Measurements acquired with the gamma knife showed that the output data agreed with the delivered dose up to 3%. Conclusion: W1 scintillation detector output has a strong energy dependence in the diagnostic and orthovoltage energy range. Therapeutic photon beams exhibited energy independence with no observable dose-rate dependence. This study may aid in the implementation of a scintillation detector in QA programs by providing energy calibration factors.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2016

SU-F-T-586: Pre-Treatment QA of InCise2 MLC Plans On a Cyberknife-M6 Using the Delta4 System in SBRT

Purpose: Performing pre-treatment quality assurance (QA) with the Delta4 system (ScandiDos Inc., Madison, WI) is well established for linac-based radiotherapy. This is not true when using a Cyberknife (Accuray Inc., Sunnyvale, CA) where, typically film-based QA is applied. The goal of this work was to test the feasibility to use the Delta4 system for pre-treatment QA for stereotactic body radiation therapy (SBRT) using a Cyberknife-M6 equipped with the InCise2 multileaf collimator (MLC). Methods: In order to perform measurements without accelerator pulse signal, the Tomotherapy option within the Delta4 software was used. Absolute calibration of the Delta4 phantom was performed using a 10×10 cm{sup 2} field shaped by the InCise2 MLC of the Cyberknife-M6. Five fiducials were attached to the Delta4 phantom in order to be able to track the phantom before and during measurements. For eight SBRT treatment plans (two liver, two prostate, one lung, three bone metastases) additional verification plans were recalculated on the Delta4 phantom using MultiPlan. Dicom data was exported from MultiPlan and was adapted in order to be compatible with the Delta4 software. The measured and calculated dose distributions were compared using the gamma analysis of the Delta4 system. Results: All eight SBRT plans were successfully measured with the aid of the Delta4 system. In the mean, 98.0±1.9%, 95.8±4.1% and 88.40±11.4% of measured dose points passed the gamma analysis using a global dose deviation criterion of 3% (100% corresponds to the dose maximum) and a distance-to-agreement criterion of 3 mm, 2 mm and 1 mm, respectively, and a threshold of 20%. Conclusion: Pre-treatment QA of SBRT plans using the Delta4 system on a Cyberknife-M6 is feasible. Measured dose distributions of SBRT plans showed clinically acceptable agreement with the corresponding calculated dose distributions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-593: Technical Treatment Accuracy in a Clinic of Fractionated Stereotactic Radiosurgery

Purpose: The purpose of this study is to estimate technical treatment accuracy in fractionated stereotactic radiosurgery (fSRS) using extend system (ES) of Gamma Knife (GK). Methods: The fSRS with GK relies on a patient specific re-locatable immobilization system. The reference treatment position is estimated using a digital probe and a repositioning check tool (RCT). The “calibration values” of RCT apertures were compared with measured values on RCT-QA tool to evaluate the standard error (SE) associated with RCT measurements. A treatment plan with single “4 mm collimator shot” was created to deliver a radiation dose of 5 Gy at the predefined plane of a newly designed in-house head-neck phantom. The plan was investigated using radiochromic EBT3 films. The stereotactic CT imaging of a designed mini CT phantom and distortion study of MR imaging, were combined to calculate imaging SE. The focal precision check for GK machine tolerance was performed using a central diode test tool. Results: Twenty observations of RCT and digital probe, shown the SE of +/−0.0186mm and +/−0.0002mm respectively. A mean positional shift of 0.2752mm (σ=0.0696mm) was observed for twenty similar treatment settings of head-neck phantom. The difference between radiological and predefined exposure point was 0.4650mm and 0.4270mm; for two independent experiments. The imaging studies showed a combined SE of +/− 0.1055mm. Twenty frequent runs of a diode test tool showed the tolerance SE of +/−0.0096mm. If, the measurements are considered to be at 95% of confidence level, an expanded uncertainty was evaluated as +/− 0.2371mm with our system. The positional shift, when combined with an expanded uncertainty, a trivial variation of 0.07mm (max) was observed in comparing resultant radiological precision through film investigations. Conclusion: The study proposes an expression of “technical treatment accuracy” within “known uncertainties” is rational in the estimation of routine fSRS quality. The research work is supported by the research section of “All India Institute of Medical Sciences” - New Delhi, India under project no A-247.

60 APPLIED LIFE SCIENCES↗