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At least 1,621 records · Page 90
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DOE OSTI2014

TH-C-18A-04: Validation of Dosimetric Measurement of CT Radiation Profile Width

Purpose: The ACR now requires that the CT radiation profile width be measured at all clinically used collimations. We developed a method for measuring the profile width using dosimetry alone to allow a faster and simpler measurement of beam widths. Methods: A pencil ionization chamber is used to take two dose-length product measurements in air for a wide collimation. One of these is taken with a 1cm tungsten mask on the pencil chamber. The difference between these measurements is the calibration factor, or the DLP in air per unit length. By dividing the doselength product for any given collimation by this factor, we can rapidly determine the beam profile width.We measured the beam width for all available detector configurations and focal spot sizes on three different CT scanners from two different manufacturers. The measurements were done using film, CR cassette, and the present dosimetric method. Results: The beam widths measured dosimetrically are approximately 2% wider than those measured using film or computed radiography; this difference is believed due to off-focus or scattered radiation. After correcting for this, the dosimetric beam widths match the film and CR widths with an RMS difference of approximately 0.2mm. The measured beam widths are largely insensitive to errors in positioning of the mask, or to tilt errors in the pencil chamber. Conclusion: Using the present method, radiation profile widths can be measured quickly, with an accuracy better than 1mm.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Verification of a novel method for tube voltage constancy measurement of orthovoltage x-ray irradiators

Purpose: For orthovoltage x-ray irradiators, the tube voltage is one of the most fundamental system parameters as this directly relates to the dosimetry in radiation biology studies; however, to the best of our knowledge, there is no commercial portable quality assurance (QA) tool to directly test the constancy of the tube voltage greater than 160 kV. The purpose of this study is to establish the Beam Quality Index (BQI), a quantity strongly correlated to the tube voltage, as an alternative parameter for the verification of the tube voltage as part of the QA program of orthovoltage x-ray irradiators. Methods: A multipurpose QA meter and its associated data acquisition software were used to customize the measurement parameters to measure the BQI and collect its time-plot. BQI measurements were performed at 320 kV with four filtration levels on three orthovoltage x-ray irradiators of the same model, one of which had been recently energy-calibrated at the factory. Results: For each of the four filtration levels, the measured BQI values were in good agreement (<5%) between the three irradiators. BQI showed filtration-specificity, possibly due to the difference in beam quality. Conclusions: The BQI has been verified as a feasible alternative for monitoring the constancy of the tube voltage for orthovoltage irradiators. The time-plot of BQI offers information on the behavior of beam energy at different phases of the irradiation time line. In addition, this would provide power supply performance characteristics from initial ramp-up to plateau, and finally, the sharp drop-off at the end of the exposure.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TH-C-12A-06: Feasibility of a MLC-Based Inversely Optimized Multi-Field Grid Therapy Technique

Purpose: Grid therapy (GT), which generates highly spatially modulated dose distributions, can deliver single- or hypo-fractionated radiotherapy for large tumors without causing significant toxicities. GT may be applied in combination with immunotherapy, in light of recent preclinical data of synergetic interaction between radiotherapy and immunotherapy. However, conventional GT uses only one field, which does not have the advantage of multi-fields in 3D conformal-RT or IMRT. We have proposed a novel MLC-based, inverse-planned multi-field 3D GT technique. This study aims to test its deliverability and dosimetric accuracy. Methods: A lattice of small spheres was created as the boost volume within a large target. A simultaneous boost IMRT plan with 8-Gy to the target and 20-Gy to the boost volume was generated in the Eclipse treatment planning system (AAA v10) with a HD120 MLC. Nine beams were used, and the gantry and couch angles were selected so that the spheres were perfectly aligned in every beams eye view. The plan was mapped to a phantom with dose scaled. EBT3 films were calibrated and used to measure the delivered dose. Results: The IMRT plan generated a highly spatially modulated dose distribution in the target. D95%, D50%, D5% for the spheres and the targets in Gy were 18.5, 20.0, 21.4 and 7.9, 9.8, 16.1, respectively. D50% for a 1cm ring 1cm outside the target was 2.9-Gy. Film dosimetry showed good agreement between calculated and delivered dose, with an overall gamma passing rate of 99.6% (3%/1mm). The point dose differences for different spheres varied from 1–6%. Conclusion: We have demonstrated the deliverability and dose calculation accuracy of the MLC-based inversely optimized multi-field GT technique, which achieved a brachytherapy-like dose distribution. Single-fraction high dose can be delivered to the spheres in a large target with minimal dose to the surrounding normal tissue.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Dose-to-water conversion for the backscatter-shielded EPID: A frame-based method to correct for EPID energy response to MLC transmitted radiation

Purpose: To develop a frame-by-frame correction for the energy response of amorphous silicon electronic portal imaging devices (a-Si EPIDs) to radiation that has transmitted through the multileaf collimator (MLC) and to integrate this correction into the backscatter shielded EPID (BSS-EPID) dose-to-water conversion model. Methods: Individual EPID frames were acquired using a Varian frame grabber and iTools acquisition software then processed using in-house software developed inMATLAB. For each EPID image frame, the region below the MLC leaves was identified and all pixels in this region were multiplied by a factor of 1.3 to correct for the under-response of the imager to MLC transmitted radiation. The corrected frames were then summed to form a corrected integrated EPID image. This correction was implemented as an initial step in the BSS-EPID dose-to-water conversion model which was then used to compute dose planes in a water phantom for 35 IMRT fields. The calculated dose planes, with and without the proposed MLC transmission correction, were compared to measurements in solid water using a two-dimensional diode array. Results: It was observed that the integration of the MLC transmission correction into the BSS-EPID dose model improved agreement between modeled and measured dose planes. In particular, the MLC correction produced higher pass rates for almost all Head and Neck fields tested, yielding an average pass rate of 99.8% for 2%/2 mm criteria. A two-sample independentt-test and fisher F-test were used to show that the MLC transmission correction resulted in a statistically significant reduction in the mean and the standard deviation of the gamma values, respectively, to give a more accurate and consistent dose-to-water conversion. Conclusions: The frame-by-frame MLC transmission response correction was shown to improve the accuracy and reduce the variability of the BSS-EPID dose-to-water conversion model. The correction may be applied as a preprocessing step in any pretreatment portal dosimetry calculation and has been shown to be beneficial for highly modulated IMRT fields.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Feasibility of vibro-acoustography with a quasi-2D ultrasound array transducer for detection and localizing of permanent prostate brachytherapy seeds: A pilot ex vivo study

Purpose: Effective permanent prostate brachytherapy (PPB) requires precise placement of radioactive seeds in and around the prostate. The impetus for this research is to examine a new ultrasound-based imaging modality, vibro-acoustography (VA), which may serve to provide a high rate of PPB seed detection while also effecting enhanced prostate imaging. The authors investigate the ability of VA, implemented on a clinical ultrasound (US) scanner and equipped with a quasi-2D (Q2D) array US transducer, to detect and localize PPB seeds in excised prostate specimens. Methods: Nonradioactive brachytherapy seeds were implanted into four excised cadaver prostates. A clinical US scanner equipped with a Q2D array US transducer was customized to acquire both US and C-scan VA images at various depths. The VA images were then used to detect and localize the implanted seeds in prostate tissue. To validate the VA results, computed tomography (CT) images of the same tissue samples were obtained to serve as the reference by which to evaluate the performance of VA in PPB seed detection. Results: The results indicate that VA is capable of accurately identifying the presence and distribution of PPB seeds with a high imaging contrast. Moreover, a large ratio of the PPB seeds implanted into prostate tissue samples could be detected through acquired VA images. Using CT-based seed identification as the standard, VA was capable of detecting 74%–92% of the implanted seeds. Additionally, the angular independency of VA in detecting PPB seeds was demonstrated through a well-controlled phantom experiment. Conclusions: Q2DVA detected a substantial portion of the seeds by using a 2D array US transducer in excised prostate tissue specimens. While VA has inherent advantages associated with conventional US imaging, it has the additional advantage of permitting detection of PPB seeds independent of their orientation. These results suggest the potential of VA as a method for PPB imaging that ultimately may allow US-based real-time intraoperative dosimetry.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Poster — Thur Eve — 23: Dose and Position Quality Assurance using the RADPOS System for 4D Radiotherapy with CyberKnife

Introduction: RADPOS 4D dosimetry system consists of a microMOSFET dosimeter combined with an electromagnetic positioning sensor, which allows for performing real-time dose and position measurements simultaneously. In this report the use of RADPOS as an independent quality assurance (QA) tool during CyberKnife 4D radiotherapy treatment is described. In addition to RADPOS, GAFCHROMIC® films were used for simultaneous dose measurement. Methods: RADPOS and films were calibrated in a Solid Water® phantom at 1.5 cm depth, SAD= 80 cm, using 60 mm cone. CT based treatment plan was created for a Solid Water® breast phantom containing metal fiducials and RADPOS probe. Dose calculations were performed using iPlan pencil beam algorithm. Before the treatment delivery, GAFCHROMIC® film was inserted inside the breast phantom, next to the RADPOS probe. Then the phantom was positioned on the chest platform of the QUASAR, to which Synchrony LED optical markers were also attached. Position logging began for RADPOS and the Synchrony tracking system, the QUASAR motion was initiated and the treatment was delivered. Results: RADPOS position measurements very closely matched the LED marker positions recorded by the Synchrony camera tracking system. The RADPOS measured dose was 2.5% higher than the average film measured dose, which is within the experimental uncertainties. Treatment plan calculated dose was 4.1 and 1.6% lower than measured by RADPOS and film, respectively. This is most likely due to the inferior nature of the dose calculation algorithm. Conclusions: Our study demonstrates that RADPOS system is a useful tool for independent QA of CyberKnife treatments.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Poster — Thur Eve — 24: Commissioning and preliminary measurements using an Attix-style free air ionization chamber for air kerma measurements on the BioMedical Imaging and Therapy beamlines at the Canadian Light Source

Synchrotron facilities, including the Canadian Light Source (CLS), provide opportunities for the development of novel imaging and therapy applications. A vital step progressing these applications toward clinical trials is the availability of accurate dosimetry. In this study, a refurbished Attix-style (cylindrical) free air chamber (FAC) is tested and used for preliminary air kerma measurements on the two BioMedical Imaging and Therapy (BMIT) beamlines at the CLS. The FAC consists of a telescoping chamber that relies on a difference measurement of collected charge in expanded and collapsed configurations. At the National Research Council's X-ray facility, a Victoreen Model 480 FAC was benchmarked against two primary standard FACs. The results indicated an absolute accuracy at the 0.5% level for energies between 60 and 150 kVp. A series of measurements were conducted on the small, non-uniform X-ray beams of the 05B1-1 (∼8 – 100 keV) and 05ID-2 (∼20 – 200 keV) beamlines for a variety of energies, filtrations and beam sizes. For the 05B1-1 beam with 1.1 mm of Cu filtration, recombination corrections of less than 5 % could only be achieved for field sizes no greater than 0.5 mm × 0.6 mm (corresponding to an air kerma rate of ∼ 57 Gy/min). Ionic recombination thus presents a significant challenge to obtaining accurate air kerma rate measurements using this FAC in these high intensity beams. Future work includes measurements using a smaller aperture to sample a smaller and thus more uniform beam area, as well as experimental and Monte Carlo-based investigation of correction factors.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Poster — Thur Eve — 26: Evaluation of lens dose from anterior electron beams: comparison of Pinnacle and Gafchromic EBT3 film

The purpose of this work is twofold: 1) to measure dose profiles under lead shielding at the level of the lens for a range of clinical electron energies via film dosimetry; and, 2) to assess the validity of the Pinnacle treatment planning system (TPS) in calculating the penumbral doses under lead shielding with the heterogeneous electron algorithm. First, a film calibration curve that spanned the electron energies of interest, 6–18MeV, was created. Next, EBT3 film and lead shielding were incorporated into a solid water phantom with the film positioned 7mm below the lead and a variable thickness of bolus on top. This geometry was reproduced in the Pinnacle TPS and used to calculate dose profiles using the heterogeneous electron algorithm. The measured vs. calculated dose profiles were normalized to d{sub max} in a homogeneous phantom with no lead shielding and compared. Pinnacle consistently overestimated the dose distal to the lead shielding with significant discrepancies occurring near the edge of the lead shield reaching 25% at the edge and 35% in the open field region. The film measurements showed that a minimum lead margin of 5mm extending beyond the diameter of the lens is required to adequately shield the lens to ≤10% of the dose at d{sub max}. These measurements allow for a reasonable estimate of the dose to the lens from anterior electron beams. They also allow for clinicians to assess the extent of the lead margin required to reduce the lens dose to an acceptable amount prior to radiotherapy treatment.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Poster — Thur Eve — 32: Stereotactic Body Radiation Therapy for Peripheral Lung Lesion: Treatment Planning and Quality Assurance

Stereotactic body radiation therapy (SBRT), due to its high precision for target localizing, has become widely used to treat tumours at various locations, including the lungs. Lung SBRT program was started at our institution a year ago. Eighteen patients with peripheral lesions up to 3 cm diameter have been treated with 48 Gy in 4 fractions. Based on four-dimensional computed tomography (4DCT) simulation, internal target volume (ITV) was delineated to encompass the respiratory motion of the lesion. A margin of 5 mm was then added to create the planning target volume (PTV) for setup uncertainties. There was no expansion from gross tumour volume (GTV) to clinical target volume (CTV). Pinnacle 9.6 was used as the primary treatment planning system. Volumetric modulated arc therapy (VMAT) technique, with one or two coplanar arcs, generally worked well. For quality assurance (QA), each plan was exported to Eclipse 10 and dose calculation was repeated. Dose volume histograms (DVHs) of the targets and organs at risk (OARs) were then compared between the two treatment planning systems. Winston-Lutz tests were carried out as routine machine QA. Patient-specific QA included ArcCheck measurement with an insert, where an ionization chamber was placed at the centre to measure dose at the isocenter. For the first several patients, and subsequently for the plans with extremely strong modulation, Gafchromic film dosimetry was also employed. For each patient, a mock setup was scheduled prior to treatments. Daily pre- and post-CBCT were acquired for setup and assessment of intra-fractional motion, respectively.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Poster — Thur Eve — 38: Feasibility of a Table-Top Total Body Irradiation Technique using Robotic Couch Motion

Purpose: To develop and test the feasibility of a table-top implementation for total body irradiation (TBI) via robotic couch motion and coordinated monitor unit modulation on a standard C-arm linac geometry. Methods: To allow for collision free delivery and to maximize the effective field size, the couch was rotated to 270° IEC and dropped to 150 cm from the vertical radiation source. The robotic delivery was programmed using the TrueBeam STx Developer Mode using custom XML scripting. To assess the dosimetry of a sliding 30×20 cm{sup 2} field, irradiation on a solid water phantom of varying thickness was analyzed using EDR2 radiographic film and OSLDs. Beam modulation was achieved by dividing the couch path into multiple segments of varying dose rates and couch speeds in order to deliver 120 cGy to the midline. Results: The programmed irradiation in conjunction with coordinated couch motion was successfully delivered on a TrueBeam linac. When no beam modulation was employed, the dose difference between two different phantom sections was 17.0%. With simple beam modulation via changing dose rates and couch speeds, the desired prescription dose can be achieved at the centre of each phantom section within 1.9%. However, dose deviation at the junction was 9.2% due to the nonphysical change in the phantom thickness. Conclusions: The feasibility of robotic table-top TBI on a C-arm linac geometry was experimentally demonstrated. To achieve a more uniform dose distribution, inverse-planning allowing for a combination of dose rate modulation, jaw tracking and MLC motion is under investigation.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Poster — Thur Eve — 39: Feasibility of Commissioning HybridArc with the Delta 4 two plane diode phantom: comparisons with Gafchromic Film

HybridArc is a relatively novel radiation therapy technique which combines optimized dynamic conformai arcs (DCA) and intensity modulated radiation therapy (IMRT). HybridArc has possible dosimetry and efficiency advantages over stand alone DCA and IMRT treatments and can be readily implemented on any linac capable of DCA and IMRT, giving strong motivation to commission the modality. The Delta4 phantom (Scandidos, Uppsala, Sweden) has been used for IMRT and VMAT clinical dosimetric verification making it a candidate for HybridArc commissioning. However the HybridArc modality makes use of several non co-planar arcs which creates setup issues due to the geometry of the Delta4, resulting in possible phantom gantry collisions for plans with non-zero couch angles. An analysis was done determining the feasibility of using the Delta4 fixed at 0° couch angle compared with results obtained using Gafchromic ETB2 film (Ashland, Covington Kentucky) in an anthropomorphic phantom at the planned couch angles. A gamma index analysis of the measured and planned dose distributions was done using Delta4 and DoseLab Pro (Mobius Medical Systems, Houston Texas) software. For both arc and IMRT sub-fields there is reasonable correlation between the gamma index found from the Delta4 and Gafchromic film. All results show the feasibility of using the Delta4 for HybridArc commissioning.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Sci—Fri AM: Mountain — 01: Validation of a new formulism and the related correction factors on output factor determination for small photon fields

Small field dosimetry measurements including output factors are difficult due to lack of charged-particle equilibrium, occlusion of the radiation source, the finite size of detectors, and non-water equivalence of detector components. With available detectors significant variations could be measured that will lead to incorrect delivered dose to patients. IAEA/AAPM have provided a framework and formulation to correct the detector response in small photon fields. Monte Carlo derived correction factors for some commonly used small field detectors are now available, however validation has not been performed prior to this study. An Exradin A16 chamber, EDGE detector and SFD detector were used to perform the output factor measurement for a series of conical fields (5–30mm) on a Varian iX linear accelerator. Discrepancies up to 20%, 10% and 6% were observed for 5, 7.5 and 10 mm cones between the initial output factors measured by the EDGE detector and the A16 ion chamber, while the discrepancies for the conical fields larger than 10 mm were less than 4%. After the application of the correction, the output factors agree well with each other to within 1%. Caution is needed when determining the output factors for small photon fields, especially for fields 10 mm in diameter or smaller. More than one type of detector should be used, each with proper corrections applied to the measurement results. It is concluded that with the application of correction factors to appropriately chosen detectors, output can be measured accurately for small fields.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Sci—Fri PM: Topics — 01: A monte carlo model of a miniature low-energy x-ray tube using EGSnrc

The INTRABEAM system (Carl Zeiss, Oberkochen, Germany) is a miniature x-ray generator for use in intraoperative radiotherapy and brachytherapy. The device accelerates electrons to up to 50 keV, which are then steered down an evacuated needle probe to strike a thin gold target. For accurate dosimetry of the INTRABEAM system, it is important that the photon spectrum be well understood. Measurements based on air-kerma are heavily impacted by photon spectra, particularly for low photon energies due to the large photoelectric contribution in air mass energy absorption coefficient. While low energy photons have little clinical significance at treatment depths, they may have a large effect on air-kerma measurements. In this work, we have developed an EGSnrc-based monte carlo (MC) model of the Zeiss INTRABEAM system to study the source photon spectra and half-value layers (HVLs) of the bare probe and with various spherical applicators. HVLs were calculated using the analytical attenuation of air-kerma spectra. The calculated bare probe spectrum was compared with simulated and measured results taken from literature. Differences in the L-line energies of gold were found between the spectra predicted by EGSnrc and Geant4. This is due to M and N shell averaging during atomic transitions in EGSnrc. The calculated HVLs of the bare probe and spherical applicators are consistent with literature reported measured values.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Sci—Fri PM: Topics — 02: Evaluation of Dosimetric Variations in Partial Breast Seed Implant (PBSI) due to Patient Arm Position (Up vs. Down)

The planning for PBSI is done with the patient's ipsilateral arm raised, however, anatomical changes and variations are unavoidable as the patient resumes her daily activities, potentially resulting in significant deviations in implant geometry from the treatment plan. This study aims to quantify the impact of the ipsilateral arm position on the geometry and dosimetry of the implant at eight weeks, evaluated on post-plans using the MIM Symphony™ software (MIM Software, Cleveland, OH). The average dose metrics for the three patients treated at the TBCC thus far using rigid fusion and contour transfer for the arms up position were 76% for the CTV V100, 61% for the PTV V100, and 37% for the PTV V200; and for the arms down position 81% for the CTV V100, 64% for the PTV V100, and 42% for the PTV V200. Qualitative analysis of the post-implant CT for one of the three patients showed poor agreement between the seroma contour transferred from the pre-implant CT and the seroma visible on the post-implant CT. To obtain a clinically accurate plan for that patient, contour modifications were used, yielding improved dose metric averages for the arms-up position for all three patients of 87% for the CTV V100, 68% for the PTV V100, and 39% for the PTV V200. Overall, the data available shows that dosimetric parameters increase with the patient's arm down, both in terms of coverage and in terms of the hot spot, and accrual of more patients may confirm this in a larger population.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

A 2D ion chamber array audit of wedged and asymmetric fields in an inhomogeneous lung phantom

Purpose: The Australian Clinical Dosimetry Service (ACDS) has implemented a new method of a nonreference condition Level II type dosimetric audit of radiotherapy services to increase measurement accuracy and patient safety within Australia. The aim of this work is to describe the methodology, tolerances, and outcomes from the new audit. Methods: The ACDS Level II audit measures the dose delivered in 2D planes using an ionization chamber based array positioned at multiple depths. Measurements are made in rectilinear homogeneous and inhomogeneous phantoms composed of slabs of solid water and lung. Computer generated computed tomography data sets of the rectilinear phantoms are supplied to the facility prior to audit for planning of a range of cases including reference fields, asymmetric fields, and wedged fields. The audit assesses 3D planning with 6 MV photons with a static (zero degree) gantry. Scoring is performed using local dose differences between the planned and measured dose within 80% of the field width. The overall audit result is determined by the maximum dose difference over all scoring points, cases, and planes. Pass (Optimal Level) is defined as maximum dose difference ≤3.3%, Pass (Action Level) is ≤5.0%, and Fail (Out of Tolerance) is >5.0%. Results: At close of 2013, the ACDS had performed 24 Level II audits. 63% of the audits passed, 33% failed, and the remaining audit was not assessable. Of the 15 audits that passed, 3 were at Pass (Action Level). The high fail rate is largely due to a systemic issue with modeling asymmetric 60° wedges which caused a delivered overdose of 5%–8%. Conclusions: The ACDS has implemented a nonreference condition Level II type audit, based on ion chamber 2D array measurements in an inhomogeneous slab phantom. The powerful diagnostic ability of this audit has allowed the ACDS to rigorously test the treatment planning systems implemented in Australian radiotherapy facilities. Recommendations from audits have led to facilities modifying clinical practice and changing planning protocols.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Multiple anatomy optimization of accumulated dose

Purpose: To investigate the potential advantages of multiple anatomy optimization (MAO) for lung cancer radiation therapy compared to the internal target volume (ITV) approach. Methods: MAO aims to optimize a single fluence to be delivered under free-breathing conditions such that the accumulated dose meets the plan objectives, where accumulated dose is defined as the sum of deformably mapped doses computed on each phase of a single four dimensional computed tomography (4DCT) dataset. Phantom and patient simulation studies were carried out to investigate potential advantages of MAO compared to ITV planning. Through simulated delivery of the ITV- and MAO-plans, target dose variations were also investigated. Results: By optimizing the accumulated dose, MAO shows the potential to ensure dose to the moving target meets plan objectives while simultaneously reducing dose to organs at risk (OARs) compared with ITV planning. While consistently superior to the ITV approach, MAO resulted in equivalent OAR dosimetry at planning objective dose levels to within 2% volume in 14/30 plans and to within 3% volume in 19/30 plans for each lung V20, esophagus V25, and heart V30. Despite large variations in per-fraction respiratory phase weights in simulated deliveries at high dose rates (e.g., treating 4/10 phases during single fraction beams) the cumulative clinical target volume (CTV) dose after 30 fractions and per-fraction dose were constant independent of planning technique. In one case considered, however, per-phase CTV dose varied from 74% to 117% of prescription implying the level of ITV-dose heterogeneity may not be appropriate with conventional, free-breathing delivery. Conclusions: MAO incorporates 4DCT information in an optimized dose distribution and can achieve a superior plan in terms of accumulated dose to the moving target and OAR sparing compared to ITV-plans. An appropriate level of dose heterogeneity in MAO plans must be further investigated.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Combining tissue-phantom ratios to provide a beam-quality specifier for flattening filter free photon beams

Purpose: There are currently several commercially available radiotherapy treatment units without a flattening filter in the beam line. Unflattened photon beams have an energy and lateral fluence distribution that is different from conventional beams and, thus, their attenuation properties differ. As a consequence, for flattening filter free (FFF) beams, the relationship between the beam-quality specifier TPR{sub 20,10} and the Spencer–Attix restricted water-to-air mass collision stopping-power ratios, (L{sup -}/ρ){sub air}{sup water}, may have to be refined in order to be used with equivalent accuracy as for beams with a flattening filter. The purpose of this work was twofold. First, to study the relationship between TPR{sub 20,10} and (L{sup -}/ρ){sub air}{sup water} for FFF beams, where the flattening filter has been replaced by a metal plate as in most clinical FFF beams. Second, to investigate the potential of increasing the accuracy in determining (L{sup -}/ρ){sub air}{sup water} by adding another beam-quality metric, TPR{sub 10,5}. The relationship between (L{sup -}/ρ){sub air}{sup water} and %dd(10){sub x} for beams with and without a flattening filter was also included in this study. Methods: A total of 24 realistic photon beams (10 with and 14 without a flattening filter) from three different treatment units have been used to calculate (L{sup -}/ρ){sub air}{sup water}, TPR{sub 20,10}, and TPR{sub 10,5} using the EGSnrc Monte Carlo package. The relationship between (L{sup -}/ρ){sub air}{sup water} and the dual beam-quality specifier TPR{sub 20,10} and TPR{sub 10,5} was described by a simple bilinear equation. The relationship between the photon beam-quality specifier %dd(10){sub x} used in the AAPM’s TG-51 dosimetry protocol and (L{sup -}/ρ){sub air}{sup water} was also investigated for the beams used in this study, by calculating the photon component of the percentage depth dose at 10 cm depth with SSD 100 cm. Results: The calculated (L{sup -}/ρ){sub air}{sup water} for beams without a flattening filter was 0.3% lower, on average, than for beams with a flattening filter and comparable TPR{sub 20,10}. Using the relationship in IAEA, TRS-398 resulted in a root mean square deviation (RMSD) of 0.0028 with a maximum deviation of 0.0043 (0.39%) from Monte Carlo calculated values. For all beams in this study, the RMSD between the proposed model and the Monte Carlo calculated values was 0.0006 with a maximum deviation of 0.0013 (0.1%). Using an earlier proposed relationship [Xiong and Rogers, Med. Phys. 35, 2104–2109 (2008)] between %dd(10){sub x} and (L{sup -}/ρ){sub air}{sup water} gave a RMSD of 0.0018 with a maximum deviation of 0.0029 (0.26%) for all beams in this study (compared to RMSD 0.0015 and a maximum deviation of 0.0048 (0.47%) for the relationship used in AAPM TG-51 published by Almond et al. [Med. Phys. 26, 1847–1870 (1999)]). Conclusions: Using TPR{sub 20,10} as a beam-quality specifier, for the flattening filter free beams used in this study, gave a maximum difference of 0.39% between (L{sup -}/ρ){sub air}{sup water} predicted using IAEA TRS-398 and Monte Carlo calculations. An additional parameter for determining (L{sup -}/ρ){sub air}{sup water} has been presented. This parameter is easy to measure; it requires only an additional dose measurement at 5 cm depth with SSD 95 cm, and provides information for accurate determination of the (L{sup -}/ρ){sub air}{sup water} ratio for beams both with and without a flattening filter at the investigated energies.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

A universal dose–response curve for radiochromic films

Purpose: This paper presents a model for dose–response curves of radiochromic films. It is based on a modified version of single-hit model to take into account the growth experienced by lithium salt of pentacosa-10,12-diynoic acid polymers after irradiation. Methods: Polymer growth in radiochromic films is a critical phenomenon that can be properly described by means of percolation theory to provide an appropriate distribution function for polymer sizes. Resulting functional form is a power function featuring a critical exponent and two adjustable parameters. Moreover, these parameters act as scaling factors setting a natural scale for sensitometric curves where the dependence on channel sensitivity is removed. A unique reduced response curve is then obtained from all the color channels describing film behavior independently of film dosimetry system. Results: Resulting functional form has been successfully tested in several sensitometric curves from different Gafchromic EBT models, providing excellent agreement with experimental data in a wide dose range up to about 40 Gy and low dose uncertainty. Conclusions: The model presented in this paper describes accurately the sensitometric curves of radiochromic films in wide dose ranges covering all typical ranges used in external radiotherapy. Resulting dose uncertainty is low enough to render a reasonably good performance in clinical applications. Due to cross-correlation, only one of the adjustable parameters is totally independent and characterizes film batches.

07 ISOTOPE AND RADIATION SOURCES↗