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At least 1,135 records · Page 63
All sourcesNASA NTRSDOE OSTI
DOE OSTI2013

A BrachyPhantom for verification of dose calculation of HDR brachytherapy planning system

Purpose: To develop a calibration phantom for {sup 192}Ir high dose rate (HDR) brachytherapy units that renders possible the direct measurement of absorbed dose to water and verification of treatment planning system.Methods: A phantom, herein designated BrachyPhantom, consists of a Solid Water™ 8-cm high cylinder with a diameter of 14 cm cavity in its axis that allows the positioning of an A1SL ionization chamber with its reference measuring point at the midheight of the cylinder's axis. Inside the BrachyPhantom, at a 3-cm radial distance from the chamber's reference measuring point, there is a circular channel connected to a cylindrical-guide cavity that allows the insertion of a 6-French flexible plastic catheter from the BrachyPhantom surface. The PENELOPE Monte Carlo code was used to calculate a factor, P{sub sw}{sup lw}, to correct the reading of the ionization chamber to a full scatter condition in liquid water. The verification of dose calculation of a HDR brachytherapy treatment planning system was performed by inserting a catheter with a dummy source in the phantom channel and scanning it with a CT. The CT scan was then transferred to the HDR computer program in which a multiple treatment plan was programmed to deliver a total dose of 150 cGy to the ionization chamber. The instrument reading was then converted to absorbed dose to water using the N{sub gas} formalism and the P{sub sw}{sup lw} factor. Likewise, the absorbed dose to water was calculated using the source strength, S{sub k}, values provided by 15 institutions visited in this work.Results: A value of 1.020 (0.09%, k= 2) was found for P{sub sw}{sup lw}. The expanded uncertainty in the absorbed dose assessed with the BrachyPhantom was found to be 2.12% (k= 1). To an associated S{sub k} of 27.8 cGy m{sup 2} h{sup −1}, the total irradiation time to deliver 150 cGy to the ionization chamber point of reference was 161.0 s. The deviation between the absorbed doses to water assessed with the BrachyPhantom and those calculated by the treatment plans and using the S{sub k} values did not exceed ±3% and ±1.6%, respectively.Conclusions: The BrachyPhantom may be conveniently used for quality assurance and/or verification of HDR planning system with a priori threshold level to spot problems of 2% and ±3%, respectively, and in the long run save time for the medical physicist.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

Experimental validation of a kilovoltage x-ray source model for computing imaging dose

Purpose: To introduce and validate a kilovoltage (kV) x-ray source model and characterization method to compute absorbed dose accrued from kV x-rays. Methods: The authors propose a simplified virtual point source model and characterization method for a kV x-ray source. The source is modeled by: (1) characterizing the spatial spectral and fluence distributions of the photons at a plane at the isocenter, and (2) creating a virtual point source from which photons are generated to yield the derived spatial spectral and fluence distribution at isocenter of an imaging system. The spatial photon distribution is determined by in-air relative dose measurements along the transverse (x) and radial (y) directions. The spectrum is characterized using transverse axis half-value layer measurements and the nominal peak potential (kVp). This source modeling approach is used to characterize a Varian{sup ®} on-board-imager (OBI{sup ®}) for four default cone-beam CT beam qualities: beams using a half bowtie filter (HBT) with 110 and 125 kVp, and a full bowtie filter (FBT) with 100 and 125 kVp. The source model and characterization method was validated by comparing dose computed by the authors’ inhouse software (kVDoseCalc) to relative dose measurements in a homogeneous and a heterogeneous block phantom comprised of tissue, bone, and lung-equivalent materials. Results: The characterized beam qualities and spatial photon distributions are comparable to reported values in the literature. Agreement between computed and measured percent depth-dose curves is ⩽2% in the homogeneous block phantom and ⩽2.5% in the heterogeneous block phantom. Transverse axis profiles taken at depths of 2 and 6 cm in the homogeneous block phantom show an agreement within 4%. All transverse axis dose profiles in water, in bone, and lung-equivalent materials for beams using a HBT, have an agreement within 5%. Measured profiles of FBT beams in bone and lung-equivalent materials were higher than their computed counterparts resulting in an agreement within 2.5%, 5%, and 8% within solid water, bone, and lung, respectively. Conclusions: The proposed virtual point source model and characterization method can be used to compute absorbed dose in both the homogeneous and heterogeneous block phantoms within of 2%–8% of measured values, depending on the phantom and the beam quality. The authors’ results also provide experimental validation for their kV dose computation software, kVDoseCalc.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

Practical aspects and uncertainty analysis of biological effective dose (BED) regarding its three-dimensional calculation in multiphase radiotherapy treatment plans

Purpose: There is a growing interest in the radiation oncology community to use the biological effective dose (BED) rather than the physical dose (PD) in treatment plan evaluation and optimization due to its stronger correlation with radiobiological effects. Radiotherapy patients may receive treatments involving a single only phase or multiple phases (e.g., primary and boost). Since most treatment planning systems cannot calculate the analytical BED distribution in multiphase treatments, an approximate multiphase BED expression, which is based on the total physical dose distribution, has been used. The purpose of this paper is to reveal the mathematical properties of the approximate BED formulation, relative to the true BED. Methods: The mathematical properties of the approximate multiphase BED equation are analyzed and evaluated. In order to better understand the accuracy of the approximate multiphase BED equation, the true multiphase BED equation was derived and the mathematical differences between the true and approximate multiphase BED equations were determined. The magnitude of its inaccuracies under common clinical circumstances was also studied. All calculations were performed on a voxel-by-voxel basis using the three-dimensional dose matrices. Results: Results showed that the approximate multiphase BED equation is accurate only when the dose-per-fractions (DPFs) in both the first and second phases are equal, which occur when the dose distribution does not significantly change between the phases. In the case of heterogeneous dose distributions, which significantly vary between the phases, there are fewer occurrences of equal DPFs and hence the inaccuracy of the approximate multiphase BED is greater. These characteristics are usually seen in the dose distributions being delivered to organs at risk rather than to targets. Conclusions: The finding of this study indicates that the true multiphase BED equation should be implemented in the treatment planning systems due to the inconsistent accuracy of the approximate multiphase BED equation in most of the clinical situations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

On the suitability of ultrathin detectors for absorbed dose assessment in the presence of high-density heterogeneities

Purpose: The aim of this study was to evaluate the suitability of several detectors for the determination of absorbed dose in bone. Methods: Three types of ultrathin LiF-based thermoluminescent dosimeters (TLDs)—two LiF:Mg,Cu,P-based (MCP-Ns and TLD-2000F) and a{sup 7}Li-enriched LiF:Mg,Ti-based (MTS-7s)—as well as EBT2 Gafchromic films were used to measure percentage depth-dose distributions (PDDs) in a water-equivalent phantom with a bone-equivalent heterogeneity for 6 and 18 MV and a set of field sizes ranging from 5×5 cm{sup 2} to 20×20 cm{sup 2}. MCP-Ns, TLD-2000F, MTS-7s, and EBT2 have active layers of 50, 20, 50, and 30 μm, respectively. Monte Carlo (MC) dose calculations (PENELOPE code) were used as the reference and helped to understand the experimental results and to evaluate the potential perturbation of the fluence in bone caused by the presence of the detectors. The energy dependence and linearity of the TLDs’ response was evaluated. Results: TLDs exhibited flat energy responses (within 2.5%) and linearity with dose (within 1.1%) within the range of interest for the selected beams. The results revealed that all considered detectors perturb the electron fluence with respect to the energy inside the bone-equivalent material. MCP-Ns and MTS-7s underestimated the absorbed dose in bone by 4%–5%. EBT2 exhibited comparable accuracy to MTS-7s and MCP-Ns. TLD-2000F was able to determine the dose within 2% accuracy. No dependence on the beam energy or field size was observed. The MC calculations showed that a50 μm thick detector can provide reliable dose estimations in bone regardless of whether it is made of LiF, water or EBT’s active layer material. Conclusions: TLD-2000F was found to be suitable for providing reliable absorbed dose measurements in the presence of bone for high-energy x-ray beams.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-C-18C-04: Evaluation of Effective Dose During Ureteroscopy for Obese and Non-Obese Patients

Purpose: Ureteroscopy involves fluoroscopy which potentially results in considerable amount of radiation dose to the patient. Purpose of this study was two-fold: (a) to develop the effective dose computational model for obese and non-obese patients undergoing left and right ureteroscopy, and (b) to evaluate the utility of a commercial Monte Carlo software for dose assessment in ureteroscopy. Methods: Organ dose measurements were performed on an adult male anthropomorphic phantom, representing the non-obese patients, with 20 high-sensitivity MOSFET detectors and two 0.18cc ionization chambers placed in selected organs. Fat-equivalent paddings were placed around the abdominal region to simulate for obese patients. Effective dose (ED) was calculated using ICRP 103 tissue weighting factors and normalized to the effective dose rate in miliSivert per second (mSv/s). In addition, a commercial Monte Carlo (MC) dose estimation program was used to estimate ED for the non-obese model, with table attenuation correction applied to simulate clinical procedure. Results: For the equipment and protocols involved in this study, the MOSFETderived ED rates for the obese patient model (‘Left’: 0.0092±0.0004 mSv/s; ‘Right’: 0.0086±0.0004 mSv/s) was found to be more than twice as much as that to the non-obese patient model (‘Left’: 0.0041±0.0003 mSv/s; ‘Right’: 0.0036±0.0007 mSv/s). The MC-derived ED rates for the non-obese patient model (‘Left’: 0.0041 mSv/s; ‘Right’: 0.0036 mSv/s; with statistical uncertainty of 1%) showed a good agreement with the MOSFET method. Conclusion: The significant difference in ED rate between the obese and non-obese patient models shows the limitation of directly applying commercial softwares for obese patients and leading to considerable underestimation of ED. Although commercial softwares offer a convenient means of dose estimation, but the utility may be limited to standard-man geometry as the software does not account for table attenuation, obese patient geometry, and differences between the anthropomorphic phantom and MC mathematical phantom.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-D-BRF-02: In Situ Verification of Radiation Therapy Dose Distributions From High-Energy X-Rays Using PET Imaging

Purpose: To study the possibility of in situ verification of radiation therapy dose distributions using PET imaging based on the activity distribution of 11C and 15O produced via photonuclear reactions in patient irradiated by 45MV x-rays. Methods: The method is based on the photonuclear reactions in the most elemental composition {sup 12}C and {sup 16}O in body tissues irradiated by bremsstrahlung photons with energies up to 45 MeV, resulting primarily in {sup 11}C and {sup 15}O, which are positron-emitting nuclei. The induced positron activity distributions were obtained with a PET scanner in the same room of a LA45 accelerator (Top Grade Medical, Beijing, China). The experiments were performed with a brain phantom using realistic treatment plans. The phantom was scanned at 20min and 2-5min after irradiation for {sup 11}C and {sup 15}, respectively. The interval between the two scans was 20 minutes. The activity distributions of {sup 11}C and {sup 15}O within the irradiated volume can be separated from each other because the half-life is 20min and 2min for {sup 11}C and {sup 15}O, respectively. Three x-ray energies were used including 10MV, 25MV and 45MV. The radiation dose ranged from 1.0Gy to 10.0Gy per treatment. Results: It was confirmed that no activity was detected at 10 MV beam energy, which was far below the energy threshold for photonuclear reactions. At 25 MV x-ray activity distribution images were observed on PET, which needed much higher radiation dose in order to obtain good quality. For 45 MV photon beams, good quality activation images were obtained with 2-3Gy radiation dose, which is the typical daily dose for radiation therapy. Conclusion: The activity distribution of {sup 15}O and {sup 11}C could be used to derive the dose distribution of 45MV x-rays at the regular daily dose level. This method can potentially be used to verify in situ dose distributions of patients treated on the LA45 accelerator.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-J-21: Advantages of Ultra Fast Radiation Dose Delivering

Purpose: For delivering conformed dose to a moving tumor and sparing normal tissue, we presented an innovation that was combined a linear accelerator and a storage ring to generate ultra high dose rate. This innovation allows delivering prescribed dose to a moving target in such a short time period, for an example 0.1 second, during which the displacement of the target could be ignored. Methods: The advantages of this approach were evaluated based on normal tissue sparing, feasibility, accuracy, and time saving in clinical treatment. The target volume reduction with this innovation approach was demonstrated by analyzing the values of GTVs, ITVs, and PTVs obtained from 15 patients who had been diagnosed with malignant neoplasm of lung and treated with SBRT. The processes of SBRT treatment were investigated and advantages of this innovation in improving SBRT lung treatment were evaluated. Results: With the ultra-high dose rate, the target volumes could be reduced by ∼30% to 50%. The innovation combining with IGRT technique could deliver prescribed dose to moving target accurately with simpler procedures than that of adaptive approach. This new approach could reduce the time of guiding treatment by many times. The new technique make a new strategy became feasible that was to deliver the dose to a target when it moved to a desirable location, such as away from critical organs. Conclusion: Combining with IGRT technique, this innovation could significantly improve the accuracy to deliver dose to moving targets with a shorter time than conventional techniques. The innovation opens a door for new strategies to deliver dose to moving targets.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-27: A Tool for Routine Quality Assurance of Radiotherapy Dose Calculation Software

Purpose: Dose calculation software is thoroughly evaluated when it is commissioned; however, evaluation of periodic software updates is typically limited in scope due to staffing constraints and the need to quickly return the treatment planning system to clinical service. We developed a tool for quickly and comprehensively testing and documenting dose calculation software against measured data. Methods: A tool was developed using MatLab (The MathWorks, Natick, MA) for evaluation of dose calculation algorithms against measured data. Inputs to the tool are measured data, reference DICOM RT PLAN files describing the measurements, and dose calculations in DICOM format. The tool consists of a collection of extensible modules that can perform analysis of point dose, depth dose curves, and profiles using dose difference, distance-to-agreement, and the gamma-index. Each module generates a report subsection that is incorporated into a master template, which is converted to final form in portable document format (PDF). Results: After each change to the treatment planning system, a report can be generated in approximately 90 minutes. The tool has been in use for more than 5 years, spanning 5 versions of the eMC and 4 versions of the AAA. We have detected changes to the algorithms that affected clinical practice once during this period. Conclusion: Our tool provides an efficient method for quality assurance of dose calculation software, providing a complete set of tests for an update. Future work includes the addition of plan level tests, allowing incorporation of, for example, the TG-119 test suite for IMRT, and integration with the treatment planning system via an application programming interface. Integration with the planning system will permit fully-automated testing and reporting at scheduled intervals.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-161: Evaluation of Dose Calculation Based On Cone-Beam CT

Purpose: The purpose of this study is to convert pixel values in cone-beam CT (CBCT) using histograms of pixel values in the simulation CT (sim-CT) and the CBCT images and to evaluate the accuracy of dose calculation based on the CBCT. Methods: The sim-CT and CBCT images immediately before the treatment of 10 prostate cancer patients were acquired. Because of insufficient calibration of the pixel values in the CBCT, it is difficult to be directly used for dose calculation. The pixel values in the CBCT images were converted using an in-house program. A 7 fields treatment plans (original plan) created on the sim-CT images were applied to the CBCT images and the dose distributions were re-calculated with same monitor units (MUs). These prescription doses were compared with those of original plans. Results: In the results of the pixel values conversion in the CBCT images,the mean differences of pixel values for the prostate,subcutaneous adipose, muscle and right-femur were −10.78±34.60, 11.78±41.06, 29.49±36.99 and 0.14±31.15 respectively. In the results of the calculated doses, the mean differences of prescription doses for 7 fields were 4.13±0.95%, 0.34±0.86%, −0.05±0.55%, 1.35±0.98%, 1.77±0.56%, 0.89±0.69% and 1.69±0.71% respectively and as a whole, the difference of prescription dose was 1.54±0.4%. Conclusion: The dose calculation on the CBCT images achieve an accuracy of <2% by using this pixel values conversion program. This may enable implementation of efficient adaptive radiotherapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-163: Evaluation of Dose Distributions Recalculated with Per-Field Measurement Data Under the Condition of Respiratory Motion During IMRT for Liver Cancer

Purpose: The dose distributions within the real volumes of tumor targets and critical organs during internal target volume-based intensity-modulated radiation therapy (ITV-IMRT) for liver cancer were recalculated by applying the effects of actual respiratory organ motion, and the dosimetric features were analyzed through comparison with gating IMRT (Gate-IMRT) plan results. Methods: The 4DCT data for 10 patients who had been treated with Gate-IMRT for liver cancer were selected to create ITV-IMRT plans. The ITV was created using MIM software, and a moving phantom was used to simulate respiratory motion. The period and range of respiratory motion were recorded in all patients from 4DCT-generated movie data, and the same period and range were applied when operating the dynamic phantom to realize coincident respiratory conditions in each patient. The doses were recalculated with a 3 dose-volume histogram (3DVH) program based on the per-field data measured with a MapCHECK2 2-dimensional diode detector array and compared with the DVHs calculated for the Gate-IMRT plan. Results: Although a sufficient prescription dose covered the PTV during ITV-IMRT delivery, the dose homogeneity in the PTV was inferior to that with the Gate-IMRT plan. We confirmed that there were higher doses to the organs-at-risk (OARs) with ITV-IMRT, as expected when using an enlarged field, but the increased dose to the spinal cord was not significant and the increased doses to the liver and kidney could be considered as minor when the reinforced constraints were applied during IMRT plan optimization. Conclusion: Because Gate-IMRT cannot always be considered an ideal method with which to correct the respiratory motional effect, given the dosimetric variations in the gating system application and the increased treatment time, a prior analysis for optimal IMRT method selection should be performed while considering the patient's respiratory condition and IMRT plan results.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-164: Evaluation of Electron Dose Distribution Using Two Algorithms

Purpose: To appreciate the difference of electron dose distributions calculated from the Monte Carlo and Electron 3D algorithms of radiotherapy in a heterogeneous phantom. Methods: A phantom consisted of two different materials (lungs mimicked by low-density cork and others by polystyrene) with an 11x16 cm field size (SSD = 100 cm) was utilized to estimate the two-dimensional dose distributions under 6 and 18 MeV beams. On behalf of two different types of tissue, the heterogeneous phantom was comprised of 3 identical slabs in the longitudinal direction with a thickness of 1 cm for each slab and 2 with a thickness of 2.5 cm. The Monte Carlo/MCTP application package constituted of five codes was performed to simulate the electron beams of a Varian Clinac 23IX. A 20x20 cm2 type III (open walled) applicator was used in these simulations. It has been shown elsewhere that the agreement of the phase space data between the calculation results of MCTP application package and the measured data were within 2% on depth-dose and transverse profiles, as well as output factor calculations. The electron 3D algorithm owned by Pinnacle 8.0m and the MCTP application package were applied for the two-dimensional dose distributions calculation. The curves at 50% and 100%-prescribed dose were observed for 6 and 18 MeV beams, respectively. Results: The MC calculations results were compared with the electron 3D calculations in terms of two-dimensional dose distributions for 6 and 18 MeV beams showed excellent agreement except in distal boundary where it was the very junction of the high and low-density region. Conclusions: The Monte Carlo/MCTP method could be used to better reflect the dose variation caused by heterogeneous tissues. Conclusion: A case study showed that the Monte Carlo/MCTP method could be used to better reflect the dose variation caused by heterogeneous tissues.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-226: Junction Free Craniospinal Irradiation in Linear Accelerator Using Volumetric Modulated Arc Therapy : A Novel Technique Using Dose Tapering

Purpose: Spatially separated fields are required for craniospinal irradiation due to field size limitation in linear accelerator. Field junction shits are conventionally done to avoid hot or cold spots. Our study was aimed to demonstrate the feasibility of junction free irradiation plan of craniospinal irradiation (CSI) for Meduloblastoma cases treated in linear accelerator using Volumetric modulated arc therapy (VMAT) technique. Methods: VMAT was planned using multiple isocenters in Monaco V 3.3.0 and delivered in Elekta Synergy linear accelerator. A full arc brain and 40° posterior arc spine fields were planned using two isocentre for short (<1.3 meter height ) and 3 isocentres for taller patients. Unrestricted jaw movement was used in superior-inferior direction. Prescribed dose to PTV was achieved by partial contribution from adjacent beams. A very low dose gradient was generated to taper the isodoses over a long length (>10 cm) at the conventional field junction. Results: In this primary study five patients were planned and three patients were delivered using this novel technique. As the dose contribution from the adjacent beams were varied (gradient) to create a complete dose distribution, therefore there is no specific junction exists in the plan. The junction were extended from 10–14 cm depending on treatment plan. Dose gradient were 9.6±2.3% per cm for brain and 7.9±1.7 % per cm for spine field respectively. Dose delivery error due to positional inaccuracy was calculated for brain and spine field for ±1mm, ±2mm, ±3mm and ±5 mm were 1%–0.8%, 2%–1.6%, 2.8%–2.4% and 4.3%–4% respectively. Conclusion: Dose tapering in junction free CSI do not require a junction shift. Therefore daily imaging for all the field is also not essential. Due to inverse planning dose to organ at risk like thyroid kidney, heart and testis can be reduced significantly. VMAT gives a quicker delivery than Step and shoot or dynamic IMRT.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-324: The Influence of Patient Positioning Uncertainties in Proton Radiotherapy On Proton Range and Dose Distributions

Purpose: Proton radiotherapy allows radiation treatment delivery with high dose gradients. The nature of such dose distributions increases the influence of patient positioning uncertainties on their fidelity when compared to photon radiotherapy. The present work quantitatively analyzes the influence of setup uncertainties on proton range and dose distributions. Methods: 38 clinical passive scattering treatment fields for small lesions in the head were studied. Dose distributions for shifted and rotated patient positions were Monte Carlo-simulated. Proton range uncertainties at the 50% and 90%-dose falloff position were calculated considering 18 arbitrary combinations of maximal patient position shifts and rotations for two patient positioning methods. Normal tissue complication probabilities (NTCPs), equivalent uniform doses (EUDs) and tumor control probabilities (TCPs) were studied for organs at risk (OARs) and target volumes of eight patients. Results: We identified a median 1σ proton range uncertainty at the 50%-dose falloff of 2.8 mm for anatomy-based patient positioning and 1.6 mm for fiducial-based patient positioning as well as 7.2 mm and 5.8 mm for the 90%-dose falloff position respectively. These range uncertainties were correlated to heterogeneity indices (HIs) calculated for each treatment field (38% < R{sup 2} < 50%). A NTCP increase of more than 10% (absolute) was observed for less than 2.9% (anatomy-based positioning) and 1.2% (fiducial-based positioning) of the studied OARs and patient shifts. TCP decreases larger than 10% (absolute) were seen for less than 2.2% of the target volumes or non-existent. EUD changes were up to 178% for OARs and 35% for target volumes. Conclusion: The influence of patient positioning uncertainties on proton range in therapy of small lesions in the human brain and target and OAR dosimetry were studied. Observed range uncertainties were correlated with HIs. The clinical practice of using multiple compensator-smeared treatment beams selected to avoid distal OAR sparing is considered to be safe. J. L. was supported by a scholarship of the University of Vienna.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-386: A Monte Carlo Dose Calculation Framework for Electron Beams On Varian TrueBeam

Purpose: The design of the linac head is different for TrueBeam than Clinac, and there are differences in measured dose distributions in water phantoms between TrueBeam and Clinac for electron beams. Therefore, MC models for Clinac may not be applied directly to the Truebeam linac. The purpose of this study is to validate a Monte Carlo (MC) dose calculation framework for electron beams on Varian TrueBeam with phase space files provided by Varian. Methods: The particle histories from the phase space file were used as input for the down-stream simulation including jaws, applicators, and water phantom. MC packages BEAMnrc/DOSYXZnrc were used. The down-stream beam components were modeled according to manufacturer specifications and the dose distributions were compared with the measured data of standard cones. The measurements were performed in a water phantom with a p-type electron field diode (diameter 0.2cm) and ion chamber (CC13). Depth dose and orthogonal profiles at depths defined by R{sub 1} {sub 0} {sub 0}, R{sub 5} {sub 0}, Rp were compared. Results: Preliminary results for a 16 MeV phase space and 10x10, 15x15, and 20x20 cm{sup 2} applicator are presented. Simulations were run for a statistical uncertainty of <2% at depth of maximum dose for a voxel resolution of 0.5x0.5x0.2cm{sup 2}. Dose and range differences for the PDD profiles were within 2% and 1 mm, respectively. Dose differences within the central 80% of the beam width for the orthogonal profiles at depth of maximum dose were less than 2% for the 10x10, 15x15, and 20x20 cm{sup 2} applicator, respectively. Conclusion: Varian electron phase space files simulations are in agreement with measured commissioning data. These phase space files can be used in the simulation of TrueBeam linacs, and will provide reproducibility across publications. Analyses for all electron energies and standard applicators are under way and results will be included in the presentation.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-516: Measurement of the Absorbed Dose Rate in Water Under Reference Conditions in a CyberKnife Unit

Purpose: This paper aims to measure the absorbed-dose-rate in a CyberKnife unit reference-field (6cm diameter) using three ionization chambers (IC) following the new IAEA/AAPM formalism and Gafchromic film (MD-V3-55 and EBT3) protocol according to our work reported previously. Methods: The absorbed-dose-rates were measured at 90cm and 70cm SSD in a 10cmx10cm field and at 70cm SSD in a 5.4cmx5.4cm equivalent to 6cm diameter field using a linac Varian iX. All measurements were performed at 10cm depth in water. The correction factors that account for the difference between the IC response on the reference field and the CyberKnife reference field, k-(Q-msr,Q)^(f-msr,f-ref), were evaluated and Gafchromic film were calibrated using the results obtained above. Under the CyberKnife reference conditions, the factors were used to measure the absorbed-dose-rate with IC according to the new formalism and the calibrated film was irradiated in water. The film calibration curve was used to evaluate the absorbed-dose-rate in the CyberKnife unit. Results: Difference up to 2.56% is observed between dose-rate measured with IC in the reference 10cmx10cm field, depending where the chamber was calibrated, which was not reflected in the correction factor k-(Q-msr,Q)^(f-msr,f-ref ) where variations of ~0.15%-0.5% were obtained. Within measurements uncertainties, maximum difference of 1.8% on the absorbed-dose-rate in the CyberKnife reference field is observed between all IC and the films Conclusion: Absorbed-dose-rate to water was measured in a CyberKnife reference field with acceptable accuracy (combined uncertainties ~1.32%-1.73%, k=1) using three IC and films. The MD-V3-55 film as well as the new IAEA/AAPM formalism can be considered as a suitable dosimetric method to measure absorbed-dose-rate to water in small and non-standard CyberKnife fields used in clinical treatments However, the EBT3 film is not appropriated due to the high uncertainty provided (combined uncertainty ~9%, k=1) This work is partially supported by Conacyt grant 127409 and PAPIITUNAM grant IN10581.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-633: Dose Differences in Lung Cancer SBRT: The Influences of MLC Width

Purpose: The aim is to compare the plan dose distribution of lung SBRT with MLCs in different width. Methods: Cases with phase INSCLC were enrolled. 9 cases were undergone 4D-CT scanning in the supine position with both arms raised. 3D-CT images without IV contrast were afterwards acquired with 3mm thickness and used for dose calculations. ITV was generated by using the inspiration and expiration images. The ITV can be expanded by geometric set-up uncertainty (5 mm) to generate the PTV. All chest normal tissues including chest wall were contoured by doctors. A total dose of 55 Gy will be given in 5 fractions within 10–14 days with an inter fraction interval of 2–3 days. Guided by the RTOG trial 3502 protocol, 11–13 non-coplanar fields with 6MV photon were arranged. Three types of MLCs with width of 3mm, 5mm and 10mm at isocenter position, were used separately to generate a CRT plan for each case. Monte Carlo algorithm was applied to dose calculation. All plans were adjusted as possible to meet the dose constraints. Dose-volume parameters from plans as followed were compared and analysized: PTV V55Gy, COMPTV D70% (70% of normalization dose), volume A (body minus PTV), and R100% and R50% (the ratio of x% of prescription dose isoline volume to PTV volume). Results: MLCs, 3mm and 5mm wide, played the identical roles on dosimetry of the plans, excluding the parameter volume A (p<0.05). On the contrary, MLC with width of 10mm was significantly inferior to the other two types on most parameters (p<0.05). For R50%, all types contributed equally (p>0.05). Conclusion: For lung cancer SBRT, MLC width had influence to dosimetry, especially in irradiation area. Small size MLC, e.g. 3mm and 5mm, are helpful to generate a high quality treatment plan, which could meet the strict criteria for targets and OAR.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-CAMPUS-T-01: Analysis of the Precision of Patient Set-Up, and Fidelity of the Delivered Dose Distribution in Proton Therapy of Ocular Tumors

Purpose: To quantify daily set-up variations in fractionated proton therapy of ocular melanomas, and to assess the effect on the fidelity of delivered distribution to the plan. Methods: In a typical five-fraction course, daily set-up is achieved by matching the position of fiducial markers in orthogonal radiographs to the images generated by treatment planning program. A patient maintains the required gaze direction voluntarily, without the aid of fixation devices. Confirmation radiographs are acquired to assess intrafractional changes. For this study, daily radiographs were analyzed to determine the daily iso-center position and apparent gaze direction, which were then transferred to the planning system to calculate the dose delivered in individual fractions, and accumulated dose for the entire course. Dose-volume metrics were compared between the planned and accumulated distributions for the tumor and organs at risk, for representative cases that varied by location within the ocular globe. Results: The analysis of the first set of cases (3 posterior, 3 transequatorial and 4 anterior tumors) revealed varying dose deviation patterns, depending on the tumor location. For anterior and posterior tumors, the largest dose increases were observed in the lens and ciliary body, while for the equatorial tumors, macula, optic nerve and disk, were most often affected. The iso-center position error was below 1.3 mm (95%-confidence interval), and the standard deviation of daily polar and azimuthal gaze set-up were 1.5 and 3 degrees, respectively. Conclusion: We quantified interfractional and intrafractional set-up variation, and estimated their effect on the delivered dose for representative cases. Current safety margins are sufficient to maintain the target coverage, however, the dose delivered to critical structures often deviates from the plan. The ongoing analysis will further explore the patterns of dose deviation, and may help to identify particular treatment scenarios which are at a higher risk for such deviations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-F-19A-01: APBI Brachytherapy Treatment Planning: The Impact of Heterogeneous Dose Calculations

Purpose: To quantify the difference in dose to PTV-EVAL and OARs (skin and rib) as calculated by (TG43) and heterogeneous calculations (CCC). Methods: 25 patient plans (5 Contura and 20 SAVI) were selected for analysis. Clinical dose distributions were computed with a commercially available treatment planning algorithm (TG43-D-(w,w)) and then recomputed with a pre-clinical collapsed cone convolution algorithm (CCCD-( m,m)). PTV-EVAL coverage (V90%, V95%), and rib and skin maximum dose were compared via percent difference. Differences in dose to normal tissue (V150cc, V200cc of PTV-EVAL) were also compared. Changes in coverage and maximum dose to organs at risk are reported in percent change, (100*(TG43 − CCC) / TG43)), and changes in maximum dose to normal tissue are absolute change in cc (TG43 − CCC). Results: Mean differences in V90, V95, V150, and V200 for the SAVI cases were −0.2%, −0.4%, −0.03cc, and −0.14cc, respectively, with maximum differences of −0.78%, −1.7%, 1.28cc, and 1.01cc, respectively. Mean differences in the 0.1cc dose to the rib and skin were −1.4% and −0.22%, respectively, with maximum differences of −4.5% and 16%, respectively. Mean differences in V90, V95, V150, and V200 for the Contura cases were −1.2%, −2.1%, −1.8cc, and −0.59cc, respectively, with maximum differences of −2.0%, −3.16%, −2.9cc, and −0.76cc, respectively. Mean differences in the 0.1cc dose to the rib and skin were −2.6% and −3.9%, respectively, with maximum differences of −3.2% and −5.7%, respectively. Conclusion: The effects of translating clinical knowledge based on D-(w,w) to plans reported in D-(m,m) are minimal (2% or less) on average, but vary based on the type and placement of the device, source, and heterogeneity information.

60 APPLIED LIFE SCIENCES↗