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TH-A-BRC-03: AAPM TG218: Measurement Methods and Tolerance Levels for Patient-Specific IMRT Verification QA

AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance - Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline of possible dosimetry protocols. The report will be reviewed by the AAPM Working Group on Recommendations for Radiotherapy External Beam Quality Assurance and then by the AAPM Science Council before publication in Medical Physics Survey of possible calibration protocols for calibration of Gamma Stereotactic Radiosurgery (GSR) devices Overview of modern Quality Assurance techniques for GSR AAPM TG-218 Tolerance Levels and Methodologies for IMRT Verification QA - Moyed Miften Patient-specific IMRT QA measurement is a process designed to identify discrepancies between calculated and delivered doses. Error tolerance limits are not well-defined or consistently applied across centers. The AAPM TG-218 report has been prepared to improve the understanding and consistency of this process by providing recommendations for methodologies and tolerance limits in patient-specific IMRT QA. Learning Objectives: Review measurement methods and methodologies for absolute dose verification Provide recommendations on delivery methods, data interpretation, the use of analysis routines and choice of tolerance limits for IMRT QA Sonja Dieterich has a research agreement with Sun Nuclear Inc. Steven Goetsch is a part-time consultant for Elekta.

60 APPLIED LIFE SCIENCES↗

TH-B-BRC-00: How to Identify and Resolve Potential Clinical Errors Before They Impact Patients Treatment: Lessons Learned

Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient’s treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures. During treatment, there might be errors on machine that needs attention. External reviews of some of the treatment delivery components by independent reviewers, like IROC, can detect errors, but may not be timely. The goal of this session is to help junior clinical physicists identify potential errors as well as the approach of quality assurance to perform a root cause analysis to find and eliminate an error and to continually monitor for errors. A compilation of potential errors will be presented by examples of the thought process required to spot the error and determine the root cause. Examples may include unusual machine operation, erratic electrometer reading, consistent lower electron output, variation in photon output, body parts inadvertently left in beam, unusual treatment plan, poor normalization, hot spots etc. Awareness of the possibility and detection of error in any link of the treatment process chain will help improve the safe and accurate delivery of radiation to patients. Four experts will discuss how to identify errors in four areas of clinical treatment. D. Followill, NIH grant CA 180803.

60 APPLIED LIFE SCIENCES↗

TH-B-BRC-01: How to Identify and Resolve Potential Clinical Errors

Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient’s treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures. During treatment, there might be errors on machine that needs attention. External reviews of some of the treatment delivery components by independent reviewers, like IROC, can detect errors, but may not be timely. The goal of this session is to help junior clinical physicists identify potential errors as well as the approach of quality assurance to perform a root cause analysis to find and eliminate an error and to continually monitor for errors. A compilation of potential errors will be presented by examples of the thought process required to spot the error and determine the root cause. Examples may include unusual machine operation, erratic electrometer reading, consistent lower electron output, variation in photon output, body parts inadvertently left in beam, unusual treatment plan, poor normalization, hot spots etc. Awareness of the possibility and detection of error in any link of the treatment process chain will help improve the safe and accurate delivery of radiation to patients. Four experts will discuss how to identify errors in four areas of clinical treatment. D. Followill, NIH grant CA 180803.

60 APPLIED LIFE SCIENCES↗

TH-B-BRC-02: Troubleshooting Issues with Linear Accelerator

Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient’s treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures. During treatment, there might be errors on machine that needs attention. External reviews of some of the treatment delivery components by independent reviewers, like IROC, can detect errors, but may not be timely. The goal of this session is to help junior clinical physicists identify potential errors as well as the approach of quality assurance to perform a root cause analysis to find and eliminate an error and to continually monitor for errors. A compilation of potential errors will be presented by examples of the thought process required to spot the error and determine the root cause. Examples may include unusual machine operation, erratic electrometer reading, consistent lower electron output, variation in photon output, body parts inadvertently left in beam, unusual treatment plan, poor normalization, hot spots etc. Awareness of the possibility and detection of error in any link of the treatment process chain will help improve the safe and accurate delivery of radiation to patients. Four experts will discuss how to identify errors in four areas of clinical treatment. D. Followill, NIH grant CA 180803.

60 APPLIED LIFE SCIENCES↗

TH-B-BRC-03: Measurement and Calibration Discrepancy: Advanced Warning Guidance

Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient’s treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures. During treatment, there might be errors on machine that needs attention. External reviews of some of the treatment delivery components by independent reviewers, like IROC, can detect errors, but may not be timely. The goal of this session is to help junior clinical physicists identify potential errors as well as the approach of quality assurance to perform a root cause analysis to find and eliminate an error and to continually monitor for errors. A compilation of potential errors will be presented by examples of the thought process required to spot the error and determine the root cause. Examples may include unusual machine operation, erratic electrometer reading, consistent lower electron output, variation in photon output, body parts inadvertently left in beam, unusual treatment plan, poor normalization, hot spots etc. Awareness of the possibility and detection of error in any link of the treatment process chain will help improve the safe and accurate delivery of radiation to patients. Four experts will discuss how to identify errors in four areas of clinical treatment. D. Followill, NIH grant CA 180803.

60 APPLIED LIFE SCIENCES↗

TH-CD-BRA-03: Direct Measurement of Magnetic Field Correction Factors, KQB, for Application in Future Codes of Practice for Reference Dosimetry

Purpose: With an MR-linac, radiation is delivered in the presence of a magnetic field. Modifications in the codes of practice (CoPs) for reference dosimetry are required to incorporate the effect of the magnetic field. Methods: In most CoPs the absorbed dose is determined using the well-known kQ formalism as the product of the calibration coefficient, the corrected electrometer reading and kQ, to account for the difference in beam quality. To keep a similar formalism a single correction factor is introduced which replaces kQ, and which corrects for beam quality and B-field, kQ,B. In this study we propose a method to determine kQ,B under reference conditions in the MRLinac without using a primary standard, as the product of:- the ratio between detector readings without and with B-field (kB),- the ratio between doses in the point of measurement with and without B-field (rho),- kQ in the absence of the B-field in the MRLinac beam (kQmrl0,Q0),The ratio of the readings, which covers the change in detector reading due to the different electron trajectories in the detector, was measured with a waterproof ionization chamber (IBA-FC65g) in a water phantom in the MRLinac without and with B-field. The change in dose-to-water in the point of measurement due to the B-field was determined with a Monte Carlo based TPS. Results: For the presented approach, the measured ratio of readings is 0.956, the calculated ratio of doses in the point of measurement is 0.995. Based on TPR20,10 measurements kQ was calculated as 0.989 using NCS-18. This yields a value of 0.9408 for kQ,B. Conclusion: The presented approach to determine kQ,B agrees with a method based on primary standards within 0.4% with an uncertainty of 1% (1 std.uncert). It differs from a similar approach using a PMMA-phantom and an NE2571 chamber with 1.3%.

60 APPLIED LIFE SCIENCES↗

Fast Scanning Diamond Detector for Electron Beam Profile Monitoring

The first prototype of a fast scanning diamond beam profile detector (DBPD) suitable for invasive high power CW electron beam core profile measurements in transmittance mode was developed. It consists of a multi-strip solid state diamond detector to scan with high speed (up to 1 m/s) and precision (about 5 μm) through the core of an electron beam. The diamond sensor was made from a thin polycrystalline diamond (PCD) plate with highly B-doped diamond conductive strips both grown by CVD. Transient currents from the multi-strip detector were measured with fast digitizing electrometers. Successful operation of the DBPD was demonstrated for pulsed (5 Hz) and CW (78 kHz) CeC beams, including the detector’s ability to withstand a 20 sec insertion into the CW CeC beam core. The X-Y beam spatial profile was measured in one scan. Thermal modelling demonstrated a manageable thermal impact even from a relatively long insertion of the diamond sensor into the CW CeC core and very short (0.2 s) insertion into the CW LEReC beam core. Electrical impedance modelling of the detector and vacuum chamber assembly demonstrated minimal impact on beam line impedance with diamond sensor insertion.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Apparatus for simultaneous ion counting and current recording in mass spectrometry

Ion counting system is coupled to the last dynode of an Allen-type electron multiplier on the mass analyzer of a double focusing mass spectrometer. This leaves the anode available for an electrometer, making possible simultaneous measurements. Coupling is achieved by a ferrite core transformer and associated circuitry.

Kohl, F. J.↗

Experiment D010: Ion sensing attitude control

The feasibility of an attitude control system that uses environmental positive ions and an electrostatic detection system to measure spacecraft pitch and yaw is studied. The secondary objective was to measure the spatial and temporal variations of ambient positively charged particles along the orbital path of the Gemini 10 and 12 spacecrafts. The results proved that the use of a horizon detector in conjunction with pitch and yaw sensors would facilitate complete description of the spacecraft position and attitude. Furthermore, with the addition of a servosystem, the unit could be used as a complete automatic attitude-control system that would be applicable from the lowest satellite altitudes up to at least 10 earth radii. Also, results established that the charge density along the trajectory of the satellite could be determined by transmission of output voltages from the individual electrometers.

Sagalyn, R. C.↗

Experimental determination of cosmic ray charged particle intensity profiles in the atmosphere

Absolute cosmic-ray free air ionization and charged particle fluxes and dose rates throughout the atmosphere were measured on a series of balloon flights that commenced in 1968. Argon-filled ionization chambers equipped with solid-state electrometers, with different gas pressures and steel wall thicknesses, and a pair of aluminum-wall Gm counters have provided the basic data. These data are supplemented by measurements with air-filled and tissue equivalent ionization chambers and a scintillation spectrometer. Laboratory experiments together with analyses of the theoretical aspects of the detector responses to cosmic radiation indicate that these profiles can be determined to an overall accuracy of + or - 5 percent.

Lowder, W. M.↗

An investigation of geometry and noise corrections to San Marco-C neutral atmospheric composition experiment data

The problem of the calculation of ambient densities from San Marco-C neutral atmospheric composition experiment data is considered. A brief description is given of the data measurement method, followed by a description of both the theoretical and experimental data curves. Geometry, electrometer distortions, and noise effects are then studied in terms of their effects on the ideal data form. From these considerations two data reduction methods are evolved. The first is an iterative integration technique that exploits the symmetry of the experimental data about the minimum angle of attack. For the analysis of geometry effects, a second method using interval averaging was developed and studied.

Curtis, S. A.↗

Instrumentation for measuring low-level currents/voltages

Instrumentation consists of high-output resistance voltage measuring amplifier (electrometer) and current-to-frequency converter (current digitizer) coupled to set of timers and counters. Digital display of time-averaged signals with amplitudes varying over 11 decades is possible.

Richmond, R. G.↗

Average plasma environment at geosynchronous orbit

The average plasma environment at geosynchronous orbit (GSO) is derived from a whole year's worth of plasma data obtained by the UCSD electrostatic electrometer on board ATS 5. The result is primarily intended for use as a general reference for engineers designing a large spacecraft to be flown at GSO. A simple mathematical formula using a 3rd order polynomial is found to be adequate for representing the yearly averaged particle energy spectrum from 70 to 41,000 eV under different geomagnetic conditions. Furthermore, correlation analyses with the geomagnetic planetary index Kp and with the auroral electrojet index AE were carried out in the hope that the ground observations of the geomagnetic field variations can be used to predict the plasma variations in space. Unfortunately, the results indicate that such forecasting is not feasible by use of these two popular geomagnetic parameters alone.

Su, S. Y.↗

Retarding potential analyzer for the Pioneer-Venus Orbiter Mission

The retarding potential analyzer on the Pioneer-Venus Orbiter Mission has been designed to measure most of the thermal plasma parameters within and near the Venusian ionosphere. Parameters include total ion concentration, concentrations of the more abundant ions, ion temperatures, ion drift velocity, electron temperature, and low-energy (0-50 eV) electron distribution function. To accomplish these measurements on a spinning vehicle with a small telemetry bit rate, several functions, including decision functions not previously used in RPA's, have been developed and incorporated into this instrument. The more significant functions include automatic electrometer ranging with background current compensation; digital, quadratic retarding potential step generation for the ion and low-energy electron scans; a current sampling interval of 2 ms throughout all scans; digital logic inflection point detection and data selection; and automatic ram direction detection. Extensive numerical simulation and plasma chamber tests have been conducted to verify adequacy of the design for the Pioneer Mission.

Knudsen, W. C.↗

Pioneer Venus Orbiter Electron Temperature Probe

The Orbiter Electron Temperature Probe (OETP) instrumentation and measurement technique has been designed to perform in-situ measurements of electron temperature and electron and ion density in the ionosphere of Venus. Adaptive sweep voltage circuitry continuously tracks the changing electron temperature and spacecraft potential while auto-ranging electrometers adjust their gain in response to the changing plasma density. Control signals used in the instrument to achieve this automatic tracking provide a continuous monitor of the ionospheric parameters without telemetering each volt-ampere curve. Internal data storage permits high data rate sampling of selected raw characteristic curves for low rate transmission to earth. These curves are used to verify or correct the inflight processed data. Sample in orbit measurements are presented to demonstrate instrument performance.

Krehbiel, J. P.↗