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DOE OSTI2014

Poster — Thur Eve — 46: Monte Carlo model of the Novalis Classic 6MV stereotactic linear accelerator using the GATE simulation platform

Monte Carlo (MC) simulation is accepted as the most accurate method to predict dose deposition when compared to other methods in radiation treatment planning. Current dose calculation algorithms used for treatment planning can become inaccurate when small radiation fields and tissue inhomogeneities are present. At our centre the Novalis Classic linear accelerator (linac) is used for Stereotactic Radiosurgery (SRS). The first MC model to date of the Novalis Classic linac was developed at our centre using the Geant4 Application for Tomographic Emission (GATE) simulation platform. GATE is relatively new, open source MC software built from CERN's Geometry and Tracking 4 (Geant4) toolkit. The linac geometry was modeled using manufacturer specifications, as well as in-house measurements of the micro MLC's. Among multiple model parameters, the initial electron beam was adjusted so that calculated depth dose curves agreed with measured values. Simulations were run on the European Grid Infrastructure through GateLab. Simulation time is approximately 8 hours on GateLab for a complete head model simulation to acquire a phase space file. Current results have a majority of points within 3% of the measured dose values for square field sizes ranging from 6×6 mm{sup 2} to 98×98 mm{sup 2} (maximum field size on the Novalis Classic linac) at 100 cm SSD. The x-ray spectrum was determined from the MC data as well. The model provides an investigation into GATE'S capabilities and has the potential to be used as a research tool and an independent dose calculation engine for clinical treatment plans.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-160: Characterization and Monitoring of Linear Accelerator Gantry Radiation Isocenter Motion

Purpose: To characterize the motion of the radiation isocenter, over time, as a function of gantry rotation for multiple linear accelerators (linacs). Two semi-automated image-based quality control (QC) test workflows were designed to achieve this goal. Methods: The full QC-test workflow for motion characterization consisted of acquiring 16 megavoltage images at 8 gantry angles of a ball-bearing suspended off the end of the couch. Performance constancy was assessed using a shortened QC-test workflow which consisted of imaging a cube phantom placed on the couch (5 images at 4 gantry angles). Both workflows use an image processing algorithm to determine the field center and phantom position on each image and computed radiation isocenter motion as a function of gantry angle. Motion was characterized for 9 linacs of same model and performance monitored for 2 months on 3 linacs. Results: The maximum isocenter motion determined with the full-workflow for 9 linacs was within 0.38–0.79 mm. The shortened-workflow usually agreed within 0.1 mm with the full-workflow and the time required for these methods was about 4 and 15 min, respectively. For all linacs, the isocenter motion perpendicular to the gantry rotation plane followed a consistent pattern with maximum amplitude of 0.36–0.59 mm. In the gantry rotation plane, the variation among linacs was higher and the beam axis described a circle of up to 0.6 mm radius around the gantry axis of rotation (2 linacs). The radiation isocenter motion was stable as a function of time for the monitored linacs and was within ±0.1 mm of the average. Conclusion: Radiation isocenter motion parallel and perpendicular to the gantry rotation plane was characterized. In the gantry rotation plane, beam spot positioning adjustment might be used to reduce the observed radiation isocenter motion. A shortened-workflow was designed and enables performance monitoring over time.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-190: Commissioning An Elekta VersaHD Linear Accelerator

Purpose: The purpose of this study is to report the dosimetric aspects of commissioning performed on an Elekta VersaHD linear accelerator with high dose rate flattening-filter-free (FFF) photon modes and electron modes. Methods: Acceptance and commissioning was performed on an Elekta VersaHD linac with 5 photon energies (6MV, 10MV, 18MV, 6FFF, 10FFF), 4 electron energies (6MeV, 9MeV, 12MeV, 15MeV) and 160 leaf (5mm wide) multi-leaf collimators (MLCs). Mechanical and dosimetric data was measured and evaluated. The measurements include percent depth doses (PDDs), inplane and crossplane profiles, head scatter factor (Sc), relative photon output factors (Scp), universal wedge transmission factor, MLC transmission factors, and electron cone factors. Results: Gantry, collimator, couch isocentricity measurements were within 1mm, 0.7mm and 0.7mm diameter respectively. The PDDs of 6FFF and 10FFF beams show deeper dmax and steeper fall-off with depth than the corresponding flattened beams. While flatness values of 6FFF and 10FFF normalized profiles were higher than the corresponding flattened beams, the symmetry values were almost identical. The crossplane penumbra values were higher than the inplane penumbra values for all the energies. The MLC transmission values were 0.5%, 0.6% and 0.6% for 6MV, 10MV, and 18MV photon beams. The electron PDDs, profiles and cone factors is validated by literature. Conclusion: The outcome of radiation treatment is directly related to the accuracy in the dose modeled in the treatment planning system which is based on the commissioned data. Commissioning data provided us a valuable insight into the dosimetric characteristics of the beam. This set of commissioning data can provide comparison data to others performing VersaHD commissioning thus improving patient safety.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-194: Commissioning of Monaco Treatment Planning System On An Elekta VersaHD Linear Accelerator

Purpose: The Monaco treatment planning system (TPS) uses a Monte-Carlo algorithm based dose computation engine to model the photon beams of a linear accelerator. The aim is to perform verification of Monaco TPS beam modeling of a Elekta VersaHD linac with 6MV, 6MV FFF, 10 MV, 10MV FFF, 18MV photon beams and 160 multileaf collimators (MLC) with a projected width of 5-mm at the isocenter. Methods: A series of dosimetric tests were performed to validate Monaco calculated beams including point dose measurement in water with and without heterogeneity and 2-dimensional dose distributions on a Delta4 bi-planar diode dosimeter array (Scandidos, Uppsala, Sweden). 3D conformal beams of different field sizes, source-to-surface distances, wedges, and gantry angles were delivered onto a phantom consisting of several plastic water and Styrofoam slabs. Point dose measurements were verified with a PTW 31013 Semiflex 0.3 cc ionization chamber (PTW, Freiburg, Germany). In addition, 8 step and shoot intensity modulated radiotherapy (IMRT) and volumetric modulated arc radiotherapy (VMAT) beams included in the Monaco TPS commissioning suite were verified against measurements on Delta4 to test and fine tune parameters in the beam model. IMRT verification was computed using gamma analysis with dose difference and distance-to-agreement criteria of 3%/3mm with a dose threshold of 10%. Results: Point dose measurements agreed within 2% in the homogeneous phantom and within 3% in the heterogeneous phantom for all photon energies. IMRT beams yielded a passing percentage of 99.1±1.1% in the gamma analysis which is well above the institutional passing threshold of 90%. Conclusion: Monaco TPS commissioning was successfully performed for all the photon energies on the Elekta VersaHD linac prior to clinical usage.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-203: Comparison of a Commercial MRI-Linear Accelerator Based Monte Carlo Dose Calculation Algorithm and Geant4

Purpose: An MRI-linear accelerator is currently being developed by the vendor Elekta™. The treatment planning system that will be used to model dose for this unit uses a Monte Carlo dose calculation algorithm, GPUMCD, that allows for the application of a magnetic field. We tested this radiation transport code against an independent Monte-Carlo toolkit Geant4 (v.4.10.01) both with and without the magnetic field applied. Methods: The setup comprised a 6 MeV mono-energetic photon beam emerging from a point source impinging on a homogeneous water phantom at 100 cm SSD. The comparisons were drawn from the percentage depth doses (PDD) for three different field sizes (1.5 x 1.5 cm{sup 2}, 5 x 5 cm{sup 2}, 10 x 10 cm{sup 2}) and dose profiles at various depths. A 1.5 T magnetic field was applied perpendicular to the direction of the beam. The transport thresholds were kept the same for both codes. Results: All of the normalized PDDs and profiles agreed within ± 1 %. In the presence of the magnetic field, PDDs rise more quickly reducing the depth of maximum dose. Near the beam exit point in the phantom a hot spot is created due to the electron return effect. This effect is more pronounced for the larger field sizes. Profiles selected parallel to the external field show no effect, however, the ones selected perpendicular to the direction of the applied magnetic field are shifted towards the direction of the Lorentz force applied by the magnetic field on the secondary electrons. It is observed that these profiles are not symmetric which indicates a lateral build up of the dose. Conclusion: There is a good general agreement between the PDDs/profiles calculated by both algorithms thus far. We are proceeding towards clinically relevant comparisons in a heterogeneous phantom for polyenergetic beams. Funding for this work has been provided by Elekta.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-313: Dosimetric Deviation of Misaligned Beams for a 6 MV Photon Linear Accelerator Using Monte Carlo Simulations

Purpose: To quantify the dosimetric variations of misaligned beams for a linear accelerator by using Monte Carlo (MC) simulations. Method and Materials: Misaligned beams of a Varian 21EX Clinac were simulated to estimate the dosimetric effects. All the linac head components for a 6 MV photon beam were implemented in BEAMnrc/EGSnrc system. For incident electron beam parameters, 6 MeV with 0.1 cm full-width-half-max Gaussian beam was used. A phase space file was obtained below the jaw per each misalignment condition of the incident electron beam: (1) The incident electron beams were tilted by 0.5, 1.0 and 1.5 degrees on the x-axis from the central axis. (2) The center of the incident electron beam was off-axially moved toward +x-axis by 0.1, 0.2, and 0.3 cm away from the central axis. Lateral profiles for each misaligned beam condition were acquired at dmax = 1.5 cm and 10 cm depth in a rectangular water phantom. Beam flatness and symmetry were calculated by using the lateral profile data. Results: The lateral profiles were found to be skewed opposite to the angle of the incident beam for the tilted beams. For the displaced beams, similar skewed lateral profiles were obtained with small shifts of penumbra on the +x-axis. The variations of beam flatness were 3.89–11.18% and 4.12–42.57% for the tilted beam and the translated beam, respectively. The beam symmetry was separately found to be 2.95 −9.93% and 2.55–38.06% separately. It was found that the percent increase of the flatness and the symmetry values are approximated 2 to 3% per 0.5 degree tilt or per 1 mm displacement. Conclusion: This study quantified the dosimetric effects of misaligned beams using MC simulations. The results would be useful to understand the magnitude of the dosimetric deviations for the misaligned beams.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-403: Evaluation of the Beam Performance of a Varian TrueBeam Linear Accelerator Under External Device-Based Gated Delivery Conditions

Purpose: To examine the beam performance of a Varian TrueBeam linear accelerator under external device-based gated delivery conditions. Methods: Six gating cycles were used to evaluate the gating performance of a standard production TrueBeam system that was not specially tuned in any way. The system was equipped with a factory installed external gating interface (EXGI). An in-house EXGI tester box was used to simulate the input gating signals. The gating cycles were selected based on long beam-on and short beam-off times, short beam-on and long beam-off times, or equal beam on and off times to check linac performance. The beam latencies were measured as the time difference between the logic high gating signal and the first or last target pulses with an oscilloscope. Tissue-Phantom Ratio, beam flatness, and dose distributions from 5 different plans were measured using the 6 different gating durations and the un-gated irradiation. A PTW 729 2-D array was used to compare 5 plans versus the un-gated delivery with a 1%/1mm gamma index passing criteria. Results: The beam latencies of the linac were based off of 20 samples for beam-on and beam-off, for each gating cycle. The average beam-on delays were measured to be between 57 and 66msec, with a maximum of 88 msec. The beam off latencies averaged between 19 and 26msec, with a maximum of 48 msec. TPR20,10 measurements showed beam energy stability within 0.5% of the un-gated delivery. Beam flatness was better than 2.5% for all gated cycles. All but two deliveries, the open field with 4 seconds on, 1 second off, and a five field IMRT plan with 0.5 seconds on, 2.5 seconds off, had >90% passing rate. Conclusion: TrueBeam demonstrates excellent beam stability with minimal beam latencies under external device-based gated operations. Dosimetric measurements show minimal variation in beam energy, flatness, and plan delivery. Authors are employees of Varian Medical Systems, Inc.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-405: Evaluation of the Raystation Electron Monte Carlo Algorithm for Varian Linear Accelerators

Purpose: To evaluate the Raystation v4.51 Electron Monte Carlo algorithm for Varian Trilogy, IX and 2100 series linear accelerators and commission for clinical use. Methods: Seventy two water and forty air scans were acquired with a water tank in the form of profiles and depth doses, as requested by vendor. Data was imported into Rayphysics beam modeling module. Energy spectrum was modeled using seven parameters. Contamination photons were modeled using five parameters. Source phase space was modeled using six parameters. Calculations were performed in clinical version 4.51 and percent depth dose curves and profiles were extracted to be compared to water tank measurements. Sensitivity tests were performed for all parameters. Grid size and particle histories were evaluated per energy for statistical uncertainty performance. Results: Model accuracy for air profiles is poor in the shoulder and penumbra region. However, model accuracy for water scans is acceptable. All energies and cones are within 2%/2mm for 90% of the points evaluated. Source phase space parameters have a cumulative effect. To achieve distributions with satisfactory smoothness level a 0.1cm grid and 3,000,000 particle histories were used for commissioning calculations. Calculation time was approximately 3 hours per energy. Conclusion: Raystation electron Monte Carlo is acceptable for clinical use for the Varian accelerators listed. Results are inferior to Elekta Electron Monte Carlo modeling. Known issues were reported to Raysearch and will be resolved in upcoming releases. Auto-modeling is limited to open cone depth dose curves and needs expansion.

43 PARTICLE ACCELERATORS↗
DOE OSTI2015

SU-E-T-543: Measurement of Neutron Activation From Different High Energy Varian Linear Accelerators

Purpose: Linear accelerators producing photons above 10 MeV may induce photonuclear reactions in high Z components of the accelerator. These liberated neutrons can then activate the structural components of the accelerator and other materials in the beam path through neutron capture reactions. The induced activity within the accelerator may contribute to additional dose to both patients and personnel. This project seeks to determine the total activity and activity per activated isotope following irradiation in different Varian accelerators at energies above 10 MeV. Methods: A Varian 21IX accelerator was used to irradiate a 30 cm × 30 cm × 20 cm solid water phantom with 15 MV x-rays. The phantom was placed at an SSD of 100 cm and at the center of a 20 cm × 20 cm field. Activation induced gamma spectra were acquired over a 5 minute interval after 1 and 15 minutes from completion of the irradiation. All measurements were made using a CANBERRA Falcon 5000 Portable HPGe detector. The majority of measurements were made in scattering geometry with the detector situated at 90° to the incident beam, 30 cm from the side of the phantom and approximately 10 cm from the top. A 5 minute background count was acquired and automatically subtracted from all subsequent measurements. Photon spectra were acquired for both open and MLC fields. Results: Based on spectral signatures, nuclides have been identified and their activities calculated for both open and MLC fields. Preliminary analyses suggest that activities from the activation products in the microcurie range. Conclusion: Activation isotopes have been identified and their relative activities determined. These activities are only gross estimates since efficiencies have not been determined for this source-detector geometry. Current efforts are focused on accurate determination of detector efficiencies using Monte Carlo calculations.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

SU-E-T-597: Parameterization of the Photon Beam Dosimetry for a Commercial Linear Accelerator

Purpose: In radiation therapy, accurate data acquisition of photon beam dosimetric quantities is important for (1) beam modeling data input into a treatment planning system (TPS), (2) comparing measured and TPS modelled data, (3) a linear accelerator’s (linac) beam characteristics quality assurance process, and (4) establishing a standard data set for data comparison, etcetera. Parameterization of the photon beam dosimetry creates a portable data set that is easy to implement for different applications such as those previously mentioned. The aim of this study is to develop methods to parameterize photon percentage depth doses(PDD), profiles, and total scatter output factors(Scp). Methods: Scp, PDDs and profiles for different field sizes (from 2×2 to 40×40cm{sup 2}), depths and energies were measured in a linac using a three-dimensional water tank. All data were smoothed and profile data were also centered, symmetrized and geometrically scaled. The Scp and PDD data were analyzed using exponential functions. For modelling of open and wedge field profiles, each side was divided into three regions described by exponential, sigmoid and Gaussian equations. The model’s equations were chosen based on the physical principles described by these dosimetric quantities. The equations’ parameters were determined using a least square optimization method with the minimal amount of measured data necessary. The model’s accuracy was then evaluated via the calculation of absolute differences and distance–to–agreement analysis in low gradient and high gradient regions, respectively. Results: All differences in the PDDs’ buildup and the profiles’ penumbra regions were less than 2 mm and 0.5 mm, respectively. Differences in the low gradient regions were 0.20 ± 0.20% and 0.50 ± 0.35% for PDDs and profiles, respectively. For Scp data, all differences were less than 0.5%. Conclusion: This novel analytical model with minimum measurement requirements proved to accurately calculate PDDs, profiles, and Scp for different field sizes, depths and energies.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

TU-F-CAMPUS-T-01: Dose and Energy Spectra From Neutron Induced Radioactivity in Medical Linear Accelerators Following High Energy Total Body Irradiation

Purpose: To assess the risk posed by neutron induced activation of components in medical linear accelerators (linacs) following the delivery of high monitor unit 18 MV photon beams such as used in TBI. Methods: Gamma spectroscopy was used to identify radioisotopes produced in components of a Varian 21EX and an Elekta Synergy following delivery of photon beams. Dose and risk estimates for TBI were assessed using dose deliveries from an actual patient treatment. A 1 litre spherical ion chamber (PTW, Germany) has been used to measure the dose at the beam exit window and at the total body irradiation (TBI) treatment couch following large and small field beams with long beam-on times. Measurements were also made outside of the closed jaws to quantify the benefit of the attenuation provided by the jaws. Results: The radioisotopes produced in the linac head have been identified as {sup 187}W, {sup 56}Mn, {sup 24}Na and {sup 28}Al, which have half-lives from between 2.3 min to 24 hours. The dose at the beam exit window following an 18 MV 2197 MU TBI beam delivery was 12.6 µSv in ten minutes. The dose rate at the TBI treatment couch 4.8 m away is a factor of ten lower. For a typical TBI delivered in six fractions each consisting of four beams and an annual patient load of 24, the annual dose estimate for a staff member at the treatment couch for ten minutes is 750 µSv. This can be further reduced by a factor of about twelve if the jaws are closed before entering the room, resulting in a dose estimate of 65 µSv. Conclusion: The dose resulting from the activation products for a representative TBI workload at our clinic of 24 patients per year is 750 µSv, which can be further reduced to 65 µSv by closing the jaws.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

Daily QA of linear accelerators using only EPID and OBI

Purpose: As treatment delivery becomes more complex, there is a pressing need for robust quality assurance (QA) tools to improve efficiency and comprehensiveness while simultaneously maintaining high accuracy and sensitivity. This work aims to present the hardware and software tools developed for comprehensive QA of linear accelerator (LINAC) using only electronic portal imaging devices (EPIDs) and kV flat panel detectors. Methods: A daily QA phantom, which includes two orthogonally positioned phantoms for QA of MV-beams and kV onboard imaging (OBI) is suspended from the gantry accessory holder to test both geometric and dosimetric components of a LINAC and an OBI. The MV component consists of a 0.5 cm water-equivalent plastic sheet incorporating 11 circular steel plugs for transmission measurements through multiple thicknesses and one resolution plug for MV-image quality testing. The kV-phantom consists of a Leeds phantom (TOR-18 FG phantom supplied by Varian) for testing low and high contrast resolutions. In the developed process, the existing LINAC tools were used to automate daily acquisition of MV and kV images and software tools were developed for simultaneous analysis of these images. A method was developed to derive and evaluate traditional QA parameters from these images [output, flatness, symmetry, uniformity, TPR{sub 20/10}, and positional accuracy of the jaws and multileaf collimators (MLCs)]. The EPID-based daily QA tools were validated by performing measurements on a detuned 6 MV beam to test its effectiveness in detecting errors in output, symmetry, energy, and MLC positions. The developed QA process was clinically commissioned, implemented, and evaluated on a Varian TrueBeam LINAC (Varian Medical System, Palo Alto, CA) over a period of three months. Results: Machine output constancy measured with an EPID (as compared against a calibrated ion-chamber) is shown to be within ±0.5%. Beam symmetry and flatness deviations measured using an EPID and a 2D ion-chamber array agree within ±0.5% and ±1.2% for crossline and inline profiles, respectively. MLC position errors of 0.5 mm can be detected using a picket fence test. The field size and phantom positioning accuracy can be determined within 0.5 mm. The entire daily QA process takes ∼15 min to perform tests for 5 photon beams, MLC tests, and imaging checks. Conclusions: The exclusive use of EPID-based QA tools, including a QA phantom and simultaneous analysis software tools, has been demonstrated as a viable, efficient, and comprehensive process for daily evaluation of LINAC performance.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Automating linear accelerator quality assurance

Purpose: The purpose of this study was 2-fold. One purpose was to develop an automated, streamlined quality assurance (QA) program for use by multiple centers. The second purpose was to evaluate machine performance over time for multiple centers using linear accelerator (Linac) log files and electronic portal images. The authors sought to evaluate variations in Linac performance to establish as a reference for other centers. Methods: The authors developed analytical software tools for a QA program using both log files and electronic portal imaging device (EPID) measurements. The first tool is a general analysis tool which can read and visually represent data in the log file. This tool, which can be used to automatically analyze patient treatment or QA log files, examines the files for Linac deviations which exceed thresholds. The second set of tools consists of a test suite of QA fields, a standard phantom, and software to collect information from the log files on deviations from the expected values. The test suite was designed to focus on the mechanical tests of the Linac to include jaw, MLC, and collimator positions during static, IMRT, and volumetric modulated arc therapy delivery. A consortium of eight institutions delivered the test suite at monthly or weekly intervals on each Linac using a standard phantom. The behavior of various components was analyzed for eight TrueBeam Linacs. Results: For the EPID and trajectory log file analysis, all observed deviations which exceeded established thresholds for Linac behavior resulted in a beam hold off. In the absence of an interlock-triggering event, the maximum observed log file deviations between the expected and actual component positions (such as MLC leaves) varied from less than 1% to 26% of published tolerance thresholds. The maximum and standard deviations of the variations due to gantry sag, collimator angle, jaw position, and MLC positions are presented. Gantry sag among Linacs was 0.336 ± 0.072 mm. The standard deviation in MLC position, as determined by EPID measurements, across the consortium was 0.33 mm for IMRT fields. With respect to the log files, the deviations between expected and actual positions for parameters were small (<0.12 mm) for all Linacs. Considering both log files and EPID measurements, all parameters were well within published tolerance values. Variations in collimator angle, MLC position, and gantry sag were also evaluated for all Linacs. Conclusions: The performance of the TrueBeam Linac model was shown to be consistent based on automated analysis of trajectory log files and EPID images acquired during delivery of a standardized test suite. The results can be compared directly to tolerance thresholds. In addition, sharing of results from standard tests across institutions can facilitate the identification of QA process and Linac changes. These reference values are presented along with the standard deviation for common tests so that the test suite can be used by other centers to evaluate their Linac performance against those in this consortium.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Parameterization of photon beam dosimetry for a linear accelerator

Purpose: In radiation therapy, accurate data acquisition of photon beam dosimetric quantities is important for (1) beam modeling data input into a treatment planning system (TPS), (2) comparing measured and TPS modeled data, (3) the quality assurance process of a linear accelerator’s (Linac) beam characteristics, (4) the establishment of a standard data set for comparison with other data, etcetera. Parameterization of the photon beam dosimetry creates a data set that is portable and easy to implement for different applications such as those previously mentioned. The aim of this study is to develop methods to parameterize photon beam dosimetric quantities, including percentage depth doses (PDDs), profiles, and total scatter output factors (S{sub cp}). Methods: S{sub cp}, PDDs, and profiles for different field sizes, depths, and energies were measured for a Linac using a cylindrical 3D water scanning system. All data were smoothed for the analysis and profile data were also centered, symmetrized, and geometrically scaled. The S{sub cp} data were analyzed using an exponential function. The inverse square factor was removed from the PDD data before modeling and the data were subsequently analyzed using exponential functions. For profile modeling, one halfside of the profile was divided into three regions described by exponential, sigmoid, and Gaussian equations. All of the analytical functions are field size, energy, depth, and, in the case of profiles, scan direction specific. The model’s parameters were determined using the minimal amount of measured data necessary. The model’s accuracy was evaluated via the calculation of absolute differences between the measured (processed) and calculated data in low gradient regions and distance-to-agreement analysis in high gradient regions. Finally, the results of dosimetric quantities obtained by the fitted models for a different machine were also assessed. Results: All of the differences in the PDDs’ buildup and the profiles’ penumbra regions were less than 2 and 0.5 mm, respectively. The differences in the low gradient regions were 0.20% ± 0.20% (<1% for all) and 0.50% ± 0.35% (<1% for all) for PDDs and profiles, respectively. For S{sub cp} data, all of the absolute differences were less than 0.5%. Conclusions: This novel analytical model with minimum measurement requirements was proved to accurately calculate PDDs, profiles, and S{sub cp} for different field sizes, depths, and energies.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-D-201-01: A Multi-Institutional Study Quantifying the Impact of Simulated Linear Accelerator VMAT Errors for Nasopharynx

Purpose: To quantify the impact of differing magnitudes of simulated linear accelerator errors on the dose to the target volume and organs at risk for nasopharynx VMAT. Methods: Ten nasopharynx cancer patients were retrospectively replanned twice with one full arc VMAT by two institutions. Treatment uncertainties (gantry angle and collimator in degrees, MLC field size and MLC shifts in mm) were introduced into these plans at increments of 5,2,1,−1,−2 and −5. This was completed using an in-house Python script within Pinnacle3 and analysed using 3DVH and MatLab. The mean and maximum dose were calculated for the Planning Target Volume (PTV1), parotids, brainstem, and spinal cord and then compared to the original baseline plan. The D1cc was also calculated for the spinal cord and brainstem. Patient average results were compared across institutions. Results: Introduced gantry angle errors had the smallest effect of dose, no tolerances were exceeded for one institution, and the second institutions VMAT plans were only exceeded for gantry angle of ±5° affecting different sided parotids by 14–18%. PTV1, brainstem and spinal cord tolerances were exceeded for collimator angles of ±5 degrees, MLC shifts and MLC field sizes of ±1 and beyond, at the first institution. At the second institution, sensitivity to errors was marginally higher for some errors including the collimator error producing doses exceeding tolerances above ±2 degrees, and marginally lower with tolerances exceeded above MLC shifts of ±2. The largest differences occur with MLC field sizes, with both institutions reporting exceeded tolerances, for all introduced errors (±1 and beyond). Conclusion: The plan robustness for VMAT nasopharynx plans has been demonstrated. Gantry errors have the least impact on patient doses, however MLC field sizes exceed tolerances even with relatively low introduced errors and also produce the largest errors. This was consistent across both departments. The authors acknowledge funding support from the NSW Cancer Council.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-P-36: Automation of Linear Accelerator Star Shot Measurement with Advanced XML Scripting and Electronic Portal Imaging Device

Purpose: To verify a method used to automatically acquire jaw, MLC, collimator and couch star shots for a Varian TrueBeam linear accelerator utilizing Developer Mode and an Electronic Portal Imaging Device (EPID). Methods: An XML script was written to automate motion of the jaws, MLC, collimator and couch in TrueBeam Developer Mode (TBDM) to acquire star shot measurements. The XML script also dictates MV imaging parameters to facilitate automatic acquisition and recording of integrated EPID images. Since couch star shot measurements cannot be acquired using a combination of EPID and jaw/MLC collimation alone due to a fixed imager geometry, a method utilizing a 5mm wide steel ruler placed on the table and centered within a 15×15cm2 open field to produce a surrogate of the narrow field aperture was investigated. Four individual star shot measurements (X jaw, Y jaw, MLC and couch) were obtained using our proposed as well as traditional film-based method. Integrated EPID images and scanned measurement films were analyzed and compared. Results: Star shot (X jaw, Y jaw, MLC and couch) measurements were obtained in a single 5 minute delivery using the TBDM XML script method compared to 60 minutes for equivalent traditional film measurements. Analysis of the images and films demonstrated comparable isocentricity results, agreeing within 0.3mm of each other. Conclusion: The presented automatic approach of acquiring star shot measurements using TBDM and EPID has proven to be more efficient than the traditional film approach with equivalent results.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-I-02: Comparative Analysis and Constancy Check of Image Quality Parameters for Three Linear Accelerators Per TG 142 Protocol

Purpose: To compare image quality parameters and assessing the image stability of three different linear accelerators (linac) for 2D and 3D imaging modalities: planar kV, MV images and cone-beam CT (CBCT). Methods: QCkV1, QC-3 and Cathpan-600 phantoms were utilized to acquire kV, MV and CBCT images respectively on monthly basis per TG142 QA protocol for over 2 years on 21Ex, NovalisTx and TrueBeam linacs. DICOM images were analyzed with the help of QA analysis software: PIPsPro from Standard Imaging. For planar kV and MV images, planar spatial resolution, contrast to noise ratio (CNR) and noise; for CBCT, HU values were collected and analyzed. Results: Two years of monthly QA measurements were analyzed for the planar and CBCT images. Values were normalized to the mean and the standard deviations (STD) are presented. For the kV planar radiographic images the STD of spatial resolution for f30, f40, f50, CNR and noise for 21Ex are 0.006, 0.011, 0.013, 0.046, 0.026; Novalis-Tx are 0.009, 0.016, 0.016, 0.067, 0.053 ; TrueBeam are 0.007, 0.005, 0.009, 0.017, 0.016 respectively. For the MV planar radiographic images, the STD of spatial resolution for f30, f40, f50, CNR and noise for 21Ex are 0.009, 0.010, 0.008, 0.023, 0.023; for Novalix-Tx are 0.012, 0.010, 0.008, 0.029, 0.023 and for TrueBeam are 0.010, 0.010, 0.007, 0.022, 0.022 respectively. For the CBCT images, HU constancies of Air, Polystyrene, Teflon, PMP, LDPE and Delrin for 21Ex are 0.014, 0.070, 0.031, 0.053, 0.076, 0.087; for Novalis Tx are 0.019, 0.047, 0.035, 0.059, 0.077, 0.087 and for TrueBeam are 0.011, 0.044, 0.025, 0.044, 0.056, 0.020 respectively. Conclusion: These Imaging QA results demonstrated that the TrueBeam, performed better in terms of image quality stability for both kV planer and CBCT images as well as EPID MV images, however other two linacs were also satisfied TG142 guidelines.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-J-121: Dosimetric Evaluation of Active Breathing Coordinator-Response Gating System Linked to Linear Accelerator in Volumetric Modulated Arc Therapy

Purpose: To reduce internal target volume (ITV), respiratory management is a must in imaging and treatment for lung, liver, and breast cancers. We investigated the dosimetric accuracy of VMAT treatment delivery with a Response™ gating system linked to linear accelerator. Methods: The Response™ gating module designed to directly control radiation beam by breath-holding with a ABC system (Elekta AB, Stockholm, Sweden) was tested for VMAT treatments. Seven VMAT plans including three conventional and four stereotactic body radiotherapy (SBRT) cases were evaluated. Each plan was composed of two or four arcs of 6MV radiation beam with prescribed dose ranged from 1.8 to 9 Gy per fraction. Each plan was delivered continuously without gating and delivered with multiple interruptions by the ResponseTM gating module with a 20 or 30 second breath-holding period. MapCheck2 and Gafchromic EBT3 films sandwiched in MapPHAN were used to measure the delivered dose with and without gating. Films were scanned on a flatbed color scanner, and red channel was extracted for film dosimetry. Gamma analysis was performed to analyze the dosimetrical accuracy of the radiation delivery with gating. Results: The measured doses with gating remarkably agree with the planned dose distributions in the results of gamma index passing rate (within 20% isodose; >98% for 3%/3mm and >92% for 2%/2mm in MapCheck2, and >91% for 3%/3mm criteria in EBT3 film except one case which was for large target and highly modulated). No significant difference (student t-test: p-value < 0.0005) was shown between the doses delivered with and without gating. There was no indication of radiation gap or overlapping during deliver interruption in film dosimetry. Conclusion: The Response™ gating system can be safely used during VMAT treatment. The accurate performance of the gating system linked to ABC can contribute to ITV reduction for SBRT using VMAT.

60 APPLIED LIFE SCIENCES↗