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At least 1,657 records · Page 92
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DOE OSTI2015

SU-E-T-89: Accuracy of Absolute Three-Dimensional Dose Distribution Measurement Using the Delta4

Purpose: In this study, we investigated the accuracy of the absolute dose distribution measurement using the Delta4 phantom compared to the measurements using a ionization chamber and EDR2 film Methods: Several conventional and intensity-modulated radiation therapy plans were used to compare the dose distribution measured using the Delta4 phantom to the absolute point dose using the chamber and the relative two-dimensional dose distribution using the EDR2 film. For the absolute dose distribution evaluation, the measurements using the Delta4, the chamber and the film were performed in similar measurement geometry. For point dose measurement using the chamber, an acrylic slab phantom with the PTW Semiflex chamber was inserted into the Delta4 phantom, alternative to the Delta4 main unit. Similarly, for dose distribution measurement using the film, the EDR2 film sandwiched with two acrylic slab phantoms were inserted to the phantom. Dose difference and gamma analysis were done for point dose and relative dose distribution comparisons, respectively. Results: The point dose measurements show slight negative systematic dose difference of −0.5 ± 0.1% and −1.0 ± 0.4% in the conventional and the IMRT plans, respectively. The additional measurement for direction dependency for Delta4 shows similar negative systematic dose difference even the phantom analysis software consider the directional dependency. The pass rate of the gamma evaluation was 77.7 ± 5.8% and 88.8±3.3% in the conventional and the IMRT plans, respectively. Conclusions: The Delta4 phantom shows a 1%-systematic dose difference derived from directional dependency and lower resolution compared to the film. Thus it is necessary to comprehensively evaluate the phantom to verify the IMRT/VMAT plans. Especially, the dosimetry tool is needed to have high resolution and high measurement accuracy in IMRT/VMAT-SBRT plan with small fields using intensity modulation in which the analysis area is limited and the higher correspondence between calculation and measurement is needed.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-124: Anthropomorphic Phantoms for Confirmation of Linear Accelerator Based Small Animal Irradiation

Purpose: To document the support of radiobiological small animal research by a modern radiation oncology facility. This study confirms that a standard, human use linear accelerator can cover the range of experiments called for by researchers performing animal irradiation. A number of representative, anthropomorphic murine phantoms were made. The phantoms confirmed the small field photon and electron beams dosimetry validated the use of the linear accelerator for rodents. Methods: Laser scanning a model, CAD design and 3D printing produced the phantoms. The phantoms were weighed and CT scanned to judge their compatibility to real animals. Phantoms were produced to specifically mimic lung, gut, brain, and othotopic lesion irradiations. Each phantom was irradiated with the same protocol as prescribed to the live animals. Delivered dose was measured with small field ion chambers, MOS/FETs or TLDs. Results: The density of the phantom material compared to density range across the real mice showed that the printed material would yield sufficiently accurate measurements when irradiated. The whole body, lung and gut irradiations were measured within 2% of prescribed doses with A1SL ion chamber. MOSFET measurements of electron irradiations for the orthotopic lesions allowed refinement of the measured small field output factor to better than 2% and validated the immunology experiment of irradiating one lesion and sparing another. Conclusion: Linacs are still useful tools in small animal bio-radiation research. This work demonstrated a strong role for the clinical accelerator in small animal research, facilitating standard whole body dosing as well as conformal treatments down to 1cm field. The accuracy of measured dose, was always within 5%. The electron irradiations of the phantom brain and flank tumors needed adjustment; the anthropomorphic phantoms allowed refinement of the initial output factor measurements for these fields which were made in a large block of solid water.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-125: Application of Jaw-Tracking Function in VMAT for Upper Thoracic Esophageal Cancer

Purpose: To explore the effect of the Jaw-tracking with RapidArc(JT-RapidArc) plans for upper thoracic esophageal cancer. Methods: Treatment planning was designed by using RapidArc and JT-RapidArc techniques for 11 consecutive patients. The dose-volume histogram parameters of PTV and the organs at risk(OAR), conformity index(CI), heterogeneity index(HI), low dose volume of normal tissue(B-P) and monitor units(MUs) were compared between the different techniques. Results: JT-RapidArc plans provided the better coverage of PTV1(64) D98 and HI(P<0.05), lower MLD, D2 of PTV1(64) and PTV2(54), but no statistically difference in CI(P>0.05), which comparison with RapidArc plans. Plans with JT- RapidArc had lower Lung of V5, V10, V13, V20, V30, MLD(P<0.05); heart of V20, MLD(P<0.05); and B-P of V5, V10, V15, V20, V30(P<0.05); but no significantly different in Spinal cord and SC-PRV as compared with RapidArc plans. JT-RapidArc plans increaseed the MUs by 1%(P>0.05) as compared with RapidArc plans. Conclusion: All of the plans had met the requirements of clinical dosimetry. JT-RapidArc plans as compared with RapidArc plans, showing better part of target coverage, part of OARS(lung and heart) and heart and B-P sparing, which MUs was slightly increased. This work was sponsored by Shantou University Medical College Clinical Research Enhancement Initiative(NO.201424)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-153: Burst-Mode Modulated Arc Therapy with Flattening-Filter-Free Beams Versus Flattening-Filtered Beams

Purpose: To compare the dosimetry and delivery of burst-mode modulated arc radiotherapy using flattening-filter-free (FFF) and flattening-filtered (FF) beams. Methods: Burst-mode modulated arc therapy (mARC, Siemens) plans were generated for six prostate cases with FFF and FF beam models, using the Elekta Monaco v. 5.00 planning system. One 360-degree arc was used for five cases, and for one case two 360-degree coplanar arcs were used. The maximum number of optimization points (OPs) per arc was set to 91, and OPs with less than 4 MU were disregarded. All plans were delivered on the Siemens Artiste linear accelerator with 6MV FF (300 MU/min) and comparable-energy FFF (2000 MU/min, labeled as 7UF) beams. Results: For all cases studied, the plans with FFF beams exhibited DVHs for the PTV, rectum, and bladder that were nearly identical to those for the plans with FF beams. The FFF plan yielded reduced dose to the right femoral head for 5 cases, and lower mean dose to the left femoral head for 4 cases. For all but the two-arc case, the FFF and FF plans resulted in an identical number of segments. The total number of MUs was slightly lower for the FF plans for five cases. The total delivery time per fraction was substantially lower for the FFF plans, ranging from 25 to 50 percent among all cases, as compared to the FF plans. Conclusion: For mARC plans, FFF and FF beams provided comparable PTV coverage and rectum and bladder sparing. For the femoral heads, the mean dose was slightly lower in most cases when using the FFF beam. Although the flat beam plans typically required slightly fewer MUs, FFF beams required substantially less time to deliver a plan of similar quality. This work was supported by Siemens Medical Solutions and the MCW Cancer Center Fotsch Foundation.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-154: Calculation of Tissue Dose Point Kernels Using GATE Monte Carlo Simulation Toolkit to Compare with Water Dose Point Kernel

Purpose: the objective of this study was to assess utilizing water dose point kernel (DPK)instead of tissue dose point kernels in convolution algorithms.to the best of our knowledge, in providing 3D distribution of absorbed dose from a 3D distribution of the activity, the human body is considered equivalent to water. as a Result tissue variations are not considered in patient specific dosimetry. Methods: In this study Gate v7.0 was used to calculate tissue dose point kernel. the beta emitter radionuclides which have taken into consideration in this simulation include Y-90, Lu-177 and P-32 which are commonly used in nuclear medicine. the comparison has been performed for dose point kernels of adipose, bone, breast, heart, intestine, kidney, liver, lung and spleen versus water dose point kernel. Results: In order to validate the simulation the Result of 90Y DPK in water were compared with published results of Papadimitroulas et al (Med. Phys., 2012). The results represented that the mean differences between water DPK and other soft tissues DPKs range between 0.6 % and 1.96% for 90Y, except for lung and bone, where the observed discrepancies are 6.3% and 12.19% respectively. The range of DPK difference for 32P is between 1.74% for breast and 18.85% for bone. For 177Lu, the highest difference belongs to bone which is equal to 16.91%. For other soft tissues the least discrepancy is observed in kidney with 1.68%. Conclusion: In all tissues except for lung and bone, the results of GATE for dose point kernel were comparable to water dose point kernel which demonstrates the appropriateness of applying water dose point kernel instead of soft tissues in the field of nuclear medicine.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-182: Clinical Implementation of TG71-Based Electron MU Calculation and Comparison with a Commercial Secondary Calculation

Purpose: The TG-71 report was published in 2014 to present standardized methodologies for MU calculations and determination of dosimetric quantities. This work explores the clinical implementation of a TG71-based electron MU calculation algorithm and compares it with a recently released commercial secondary calculation program–Mobius3D (Mobius Medical System, LP). Methods: TG-71 electron dosimetry data were acquired, and MU calculations were performed based on the recently published TG-71 report. The formalism in the report for extended SSD using air-gap corrections was used. The dosimetric quantities, such PDD, output factor, and f-air factors were incorporated into an organized databook that facilitates data access and subsequent computation. The Mobius3D program utilizes a pencil beam redefinition algorithm. To verify the accuracy of calculations, five customized rectangular cutouts of different sizes–6×12, 4×12, 6×8, 4×8, 3×6 cm{sup 2}–were made. Calculations were compared to each other and to point dose measurements for electron beams of energy 6, 9, 12, 16, 20 MeV. Each calculation / measurement point was at the depth of maximum dose for each cutout in a 10×10 cm{sup 2} or 15×15cm{sup 2} applicator with SSDs 100cm and 110cm. Validation measurements were made with a CC04 ion chamber in a solid water phantom for electron beams of energy 9 and 16 MeV. Results: Differences between the TG-71 and the commercial system relative to measurements were within 3% for most combinations of electron energy, cutout size, and SSD. A 5.6% difference between the two calculation methods was found only for the 6MeV electron beam with 3×6 cm{sup 2}cutout in the 10×10{sup 2}cm applicator at 110cm SSD. Both the TG-71 and the commercial calculations show good consistency with chamber measurements: for 5 cutouts, <1% difference for 100cm SSD, and 0.5–2.7% for 110cm SSD. Conclusions: Based on comparisons with measurements, a TG71-based computation method and a Mobius3D program produce reasonably accurate MU calculations for electron-beam therapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-207: Comparison of Integrated Tissue Air Ratio (ITAR) to Traditional TAR for Kilovoltage Pencil-Beams

Purpose: Clinically viable depth dose determination in kilovoltage pencil-beams is a great challenge that resulted in a published dosimetry method called ITAR, which involves measurement of air kerma and attenuation with a detector in a low scatter environment coupled with MCNP scatter calculations. The objective of this work is to compare ITAR to traditional TAR using inherently water-proof microchambers that have only recently become commercially available. Methods: An Exradin A26 microchamber was centered 150 mm from a 100 kVp x-ray source with 2 mm aluminum HVL. Depth dose in water from 16 to 24 mm in 2 mm increments was determined by: (1) placing blocks of Plastic Water LR near the source to minimize scatter and using previously published conversion coefficients [ITAR method] and (2) submerging the detector in a water tank with 2 mm thick Plastic Water LR walls and jogging the tank with motor controllers while keeping the detector position fixed [traditional TAR method]. Each method was repeated four to five times. For each repetition, dose was measured free in-air to normalize the data for exponential regression. Results: Traditional TAR indicated higher depth dose than ITAR; differences ranged from 2.1% at 24 mm depth to 2.5% at 16 mm depth. However, the results of traditional TAR did not include a correction for Pq,cham because it is unknown for this detector type in these conditions. It is estimated that the component of Pq,cham due to the effect of water displacement alone is ∼0.94, but Pq,cham is likely several percent larger than 0.94 due to the energy dependency of the microchamber in the presence of low energy scatter that is not present during in-air calibration. Conclusion: The ITAR method remains preferable for clinical depth dose determination in kilovoltage pencil-beams due to Pq,cham being unknown for suitable detectors in relevant conditions. All four of the authors are either current full time employees, which include stock option grants, or consultants of Oraya Therapeutics Inc.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-224: Considerations for the Proper Treatment of Multiple Cranial Metastases with Single Isocenter Volumetric Modulated Arc Therapy

Purpose: To investigate some limitations of single isocenter VMAT for cranial multiple met cases. Methods: A single isocenter VMAT plan (Varian, Eclipse AAA10 commissioned down to 1 cm) was designed for two 7mm diameter spherical targets in a rectangular Solid Water (Gammex) phantom. The targets were separated by a distance of 6cm and the isocenter was centered in one of the targets. The plan was delivered (Varian, Truebeam STx) three separate times with different artificial couch angle errors of 0, 0.5 and 1 degree. The coronal dose distributions were measured with calibrated EBT3 film placed at mid-phantom. EBT3 film dosimetry was also performed on the delivery of separate multiple arc vmat plans to targets below 6mm in diameter. Results: Measurements of the sup/inf dose profiles through the high dose distributions show no movement of the central axis high dose region and shifts of the high dose region intended for the off-axis target. For the 1 degree rotation error, the high dose region was shifted 1.04mm from the target. This corresponds to the shift expected from triangulation (60mmxTan(1deg)=1.047mm). Furthermore, a streak of 10% interleaf leakage dose was observed and is likely a Result of the off axis target traveling a wide path such that a long length of MLC is exposed for the whole arc. The calculated dose was about 10% to 15% low compared to that measured on film for a 5mm diameter target. Conclusion: Judicious use of additional margin for off axis targets or limits on the span of multiple mets treated with one isocenter is recommended. The magnitude of the margin should be based on the rotational errors evaluated for the positioning system and the distance of the target from the isocenter. A lower limit of lesion size that can be accurately treated with VMAT should be determined.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-245: Detection of the Photon Target Damage in Varian Linac Based On Periodical Quality Assurance Measurements

Purpose: To determine the best dosimetric metric measured by our routine QA devices for diagnosing photon target failure on a Varian C-series linac. Methods: We have retrospectively reviewed and analyzed the dosimetry data from a Varian linac with a target degradation that was undiagnosed for one year. A failure in the daily QA symmetry tests was the first indication of an issue. The beam was steered back to a symmetric shape and water scans indicated the beam energy had changed but stayed within the manufacturer’s specifications and agreed reasonably with our treatment planning system data. After the problem was identified and the target was replaced, we retrospectively analyzed our QA data including diagonals normalized flatness (F-DN) from the daily device (DQA3), profiles from an ionization chamber array (IC Profiler), as well as profiles and PDDs from a 3D water Scanner (3DS). These metrics were cross-compared to determine which was the best early indicator of target degradation. Results: A 3% change in FDN measured by the DQA3 was found to be an early indicator of target degradation. It is more sensitive than changes in output, symmetry, flatness or PDD. All beam shape metrics (flatness at dmax and 10 cm depth, and F-DN) indicated an energy increase while the PDD indicated an energy decrease. This disagreement between the beam-shape based energy metrics (F-DN and flatness) and PDD based energy metric may indicate target failure as opposed to an energy change resulting from changes in the incident electron energy. Conclusion: Photon target degradation has been identified as a failure mode for linacs. The manufacturer’s test for this condition is highly invasive and requires machine down time. We have demonstrated that the condition could be caught early based upon data acquired during routine QA activities, such as the F-DN.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

SU-E-T-246: Detector Selection for Small Field Measurements, a Comparative Study

Purpose: To compare commercially available detectors for small field dosimetry. Methods: PTW (Freiburg, Germany) diode E, PTW microDiamond, and SunNuclear (Melbourne, FL) Edge detector were used to measure output factors, PDD, and profiles on a Varian iX linear accelerator (Varian Medical Systems, Palo Alto, CA) using 6MV and 18MV photon beams. The water tank was set to 100cm SSD. Centering profiles at 5cm and 20cm depth confirmed an offset <0.1mm. High resolution PDD (0.1mm) aligned the collecting volume at water surface. For setup and linearity verification, PDD and profiles were matched to annual measurements, which were performed with an A1SL ion chamber.Scans were taken for 6X and 18X, for 10cmx10cm, 10cmx2cm, 10cmx1cm, and 10cmx0.5cm fields. Profiles were measured at Dmax (6X=1.5cm, 18X=3.5cm), 5cm, 10cm, and 20cm depths. All fields used 10cmx10cm jaws with the MLC defining the field in the X-direction. PDDs used 2mm step size and 0.2s discrete collecting time. Profiles used 1mm step size and a 0.4s discrete collecting time. Results: The PTW diode E and Edge detector exhibit centering stability, but all detectors require vertical shifts from Vendor defined vertical alignment. Output factor measurements reveal good agreement between detectors. The Edge detector demonstrates the sharpest penumbra and the closest consistent match to ion chamber measurements in the out of field regions for 6MV (3.2%). Each detector provides comparable curve quality for PDDs, with a maximum difference across detectors giving a standard deviation of 0.6% at 30cm depth, 18X, and 10cmx0.5cm. Profiles match closely across all detectors, depths, energies, and field sizes. The microDiamond detector produces the largest penumbra width, largest deviation from ion chamber dose in the tail region for 6MV, and exhibits centering instability. Conclusion: Based on our findings, the Edge detector was chosen for stereotactic measurements. The PTW diode E is an acceptable alternative.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-267: Development of the Compact Graphite Calorimetry System for the High Energy Photon Beam

Purpose: Graphite calorimeter systems are used for the absolute photon dosimetry. But many electronics are demanded in order to measure the tiny temperature changes. Minimizing the control system is needed to make a portable graphite calorimeter. Methods: A Domen-type graphite calorimetry system is constructing to measure the absorbed dose of the high energy photon beam. The graphite calorimeter divided into three parts, Core, Jacket, and Shield. In order to measure the temperature rising of the core due to the radiation accurately, the temperatures of the jacket and the shield should be controlled properly. A commercial temperature controller (Model 350, Lake Shore Cryogenics) was used to minimize the size of control system for making a portable graphite calorimetry system at the cost of the measurement uncertainty. The PID control of the jacket is conducted by the software (LabView) and Model 350 maintain the temperature of shield. Results: Our design value of the heat deposition power in the core is 0.04 mW for the dose rate of 3 Gy/min where the temperature sensitivity of the graphite is 1.4 mK/Gy. While the residuals of the Steinhart-hart equation fitting for the core thermistor were less than 0.1 mK, the temperature resolution of Model 350 is 1 mK. The temperature of the shield was kept within the 5 mK when the room temperature variation was about 0.5 K. Conclusion: The resolution of Model 350 for the temperature measurement and control is not good enough as the control system for the compact graphite calorimetry system. But The performance of Model 350 is good enough to maintain the temperature of the shield constantly. The Model 350 will be replaced by the AC resistance bridge (Model 372, Lake Shore Cryogenics) for the core temperature measurement and the jacket control.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

SU-E-T-280: Dose Evaluation in Using CT Density Versus Relative Stopping Power for Pencil Beam Planning and Treating IROC Proton Phantom

Purpose: The purpose of this study is to evaluate any effects of converted CT density variation in treatment planning system (TPS) of spot scanning proton therapy with an IROC proton prostate phantom at our new ProteusOne Proton Therapy Center. Methods: A proton prostate phantom was requested from the Imaging and Radiation Oncology Core Houston (IROC), The University of Texas MD Anderson Cancer Center, Houston, TX, where GAF Chromic films and couples of thermo luminescent dosemeter (TLD) capsules in target and adjacent structures were embedded for imaging and dose monitoring. Various material such as PVC, PBT HI polystyrene as dosimetry inserts and acrylic were within phantom. Relative stopping power (SP) were provided. However our treatment planning system (TPS) doesn’t require SP instead relative density was converted relative to water in TPS. Phantom was irradiated and the results were compared with IROC measurements. The range of relative density was converted from SP into relative density of water as a new assigned material and tested. Results: The summary of TLD measurements of the prostate and femoral heads were well within 2% of the TPS and met the criteria established by IROC. The film at coronal plane was found to be shift in superior-inferior direction due to locking position of cylinder insert was off and was corrected. The converted CT density worked precisely to correlated relative stopping power. Conclusion: The proton prostate phantom provided by IROC is a useful methodology to evaluate our new commissioned proton pencil beam and TPS within certain confidence in proton therapy. The relative stopping power was converted into relative physical density relatively to water and the results were satisfied.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-293: Dosimetric Analysis of Microscopic Disease in SBRT for Lung Cancers

Purpose: To evaluate the dosimetry of microscopic disease (MD) region of lung cancer in stereotactic body radiation therapy (SBRT). Methods: For simplicity, we assume organ moves along one dimension. The probability distribution function of tumor position was calculated according to the breathing cycle. The dose to the MD region was obtained through accumulating the treatment planning system calculated doses at different positions in a breathing cycle. A phantom experiment was then conducted to validate the calculated results using a motion phantom (The CIRS ‘Dynamic’ Thorax Phantom). The simulated breathing pattern used a cos4(x) curve with an amplitude of 10mm. A 3-D conformal 7-field plan with 6X energy was created and the dose was calculated in the average intensity projection (AIP) simulation CT images. Both films (EBT2) and optically stimulated luminescence (OSL) detectors were inserted in the target of the phantom to measure the dose during radiation delivery (Varian Truebeam) and results were compared to planning dose parameters. Results: The Gamma analysis (3%/3mm) between measured dose using EBT2 film and calculated dose using AIP was 80.5%, indicating substantial dosimetric differences. While the Gamma analysis (3%/3mm) between measured dose using EBT2 and accumulated dose using 4D-CT was 98.9%, indicating the necessity of dose accumulation using 4D-CT. The measured doses using OSL and theoretically calculated doses using probability distribution function at the corresponding position were comparable. Conclusion: Use of static dose calculation in the treatment planning system could substantially underestimate the actually delivered dose in the MD region for a moving target. Funding Supported by NSFC, No.81372436.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-297: Dosimetric Assessment of An Air-Filled Balloon Applicator in HDR Vaginal Cuff Brachytherapy Using the Monte Carlo Method

Purpose: As an alternative to cylindrical applicators, air inflated balloon applicators have been introduced into HDR vaginal cuff brachytherapy treatment to achieve sufficient dose to vagina mucosa as well as to spare rectum and bladder. In general, TG43 formulae based treatment planning systems do not take into account tissue inhomogeneity, and air in the balloon applicator can cause higher delivered dose to mucosa than treatment plan reported. We investigated dosimetric effect of air in balloon applicator using the Monte Carlo method. Methods: The thirteen-catheter Capri applicator with a Nucletron Ir-192 seed was modeled for various balloon diameters (2cm to 3.5cm) using the MCNP Monte Carlo code. Ir-192 seed was placed in both central and peripheral catheters to replicate real patient situations. Existence of charged particle equilibrium (CPE) with air balloon was evaluated by comparing kerma and dose at various distances (1mm to 70mm) from surface of air-filled applicator. Also mucosa dose by an air-filled applicator was compared with by a water-filled applicator to evaluate dosimetry accuracy of planning system without tissue inhomogeneity correction. Results: Beyond 1mm from air/tissue interface, the difference between kerma and dose was within 2%. CPE (or transient CPE) condition was deemed existent, and in this region no electron transport was necessary in Monte Carlo simulations. At 1mm or less, the deviation of dose from kerma became more apparent. Increase of dose to mucosa depended on diameter of air balloon. The increment of dose to mucosa was 2.5% and 4.3% on average for 2cm and 3.5cm applicators, respectively. Conclusion: After introduction of air balloon applicator, CPE fails only at the proximity of air/tissue interface. Although dose to mucosa is increased, there is no significant dosimetric difference (<5%) between air and water filled applicators. Tissue inhomogeneity correction is not necessary for air-filled applicators.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-305: Dosimetric Comparison of Cyberknife Versus Linac Based VMAT Stereotactic Treatment Planning for Localised Prostate Cancer

Purpose: The purpose of this study was to compare dosimetric indices of Cyberknife versus Linac for localised prostate cancer Methods: In this study, twenty patients were taken from Cyberknife Multiplan TPS v 4.6.0. All these patients underwent hypo fractionated boost treatment for localised prostate cancer in Cyberknife with the prescription dose of 18Gy in 3 fractions. For each patient VMAT stereotactic plans were generated in Monaco TPS v 5.0 using Elekta beam modulator MLC machine for 6MV photon beam. The plans quality were evaluated by comparing dosimetry indices such that D95, D90, D5 for target volume and V100, V80, V50, V30 for critical organs. The p values were calculated for target and OAR to ascertain the significant differences. Results: For each case, D95 of target coverage was achieved with 100% prescription dose with p value of 0.9998. The p value for D90, D5 and V100 for linac and Cyberknife plans was 0.9938, 0.9918 and 0.9838 respectively. For rectum, rectum-PTV and bladder doses were significantly less in Cyberknife compared to linac plans. For rectum, rectum-PTV and bladder at V100 the p value is 0.2402, 0.002, and 0.1615 respectively. Other indices V80, V50 and V30 were comparable in both plans. Conclusion: This study demonstrated that both linac and Cyberknife plans were shown adequate target coverage, while in Cyberknife the treatment time is longer and more MUs to be delivered. However, better conformity, lesser doses to the critical organs and dose gradient outside target for localised prostate treatment were achieved in Cyberknife plans due to multiple non coplanar beam arrangements.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-314: Dosimetric Effect of Smooth Drilling On Proton Compensators in Prostate Patients

Purpose: To evaluate the dosimetric effect of smooth drilling of proton compensators in proton prostate plans when compared to typical plunge drilling settings. Methods: Twelve prostate patients were planned in Eclipse treatment planning system using three different drill settings Smooth, Plunge drill A, and Plunge drill B. The differences between A and B were: spacing X[cm]: 0.4(A), 0.1(B), spacing Y[cm]: 0.35(A), 0.1(B), row offset [cm]: 0.2(A), 0(B). Planning parameters were kept consistent between the different plans, which utilized two opposed lateral beams arrangement. Mean differences absolute dosimetry in OAR constraints are presented. Results: The smooth drilled compensator based plans yielded equivalent target coverage to the plans generated with drill settings A and B. Overall, the smooth compensators reduced dose to the majority of organs at risk compared to settings A and B. Constraints were reduced for the following OAR: Rectal V75 by 2.12 and 2.48%, V70 by 2.45 and 2.91%, V65 by 2.85 and 3.37%, V50 by 2.3 and 5.1%, Bladder V65 by 4.49 and 3.67%, Penial Bulb mean by 3.7 and 4.2Gy, and the maximum plan dose 5.3 and 7.4Gy for option A vs smooth and option B vs smooth respectively. The femoral head constraint (V50<5%) was met by all plans, but it was not consistently lower for the smooth drilling plan. Conclusion: Smooth drilled compensators provide equivalent target coverage and overall slightly cooler plans to the majority of organs at risk; it also minimizes the potential dosimetric impacts caused by patient positioning uncertainty.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-350: Effective Point of Measurement and Total Perturbation Correction P for Parallel-Plate Ion Chambers in High-Energy Photon Beams

Purpose: This paper aims to determine the effective point of measurement and the total perturbation correction p of parallel-plate chambers for clinical photon dosimetry. Methods: The effective point of measurement (EPOM) was calculated using the EGSnrc Monte Carlo code system with the EGSnrc user code egs- chamber. Depth dose curves of the ionization chambers were calculated in a water phantom for several high energy photon spectra (4, 6, 10, 15, 18 MV-X). Different normalization criterions (normalization to the maximum of the depth dose curve and normalization to the value in 10 cm depth) have been applied. The EPOM was determined by shifting the normalized depth dose curve of a small water voxel against the depth ionization curve until the disagreement (calculated by the root mean square deviation) reaches a minimum. In addition, the total perturbation correction p was calculated by the ratio of the dose to water and the product of the dose determined in the chamber and the water to air stopping power ratio. Results: The EPOM varied slightly depending on the chosen normalization criterion. For all chambers the necessary shift of the EPOM decreased linearly with increasing beam quality specifier TPR{sub 20/10}. For the Roos and NACP chamber, the results were positive suggesting that the chambers need to be shifted towards the focus. For the Markus chamber, the required shift was negative and for the Advanced Markus chamber partly negative and partly positive. The total perturbation correction p was almost independent of the depth. Only for regions below 1 cm the perturbation correction deviated significantly from unity. Conclusion: In the present study, the effective point of measurement and the total perturbation correction p was determined for four parallel-plate ionization chambers and five clinical relevant photon spectra. Applying the calculated EPOM, the residual perturbation correction p was mostly depth independent.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-354: Efficient and Enhanced QA Testing of Linear Accelerators Using a Real-Time Beam Monitor

Purpose: To investigate the feasibility of performing routine QA tests of linear accelerators (Linac) using the Integral Quality Monitoring (IQM) system. The system, consisting of a 1-D sensitivity gradient large area ion-chamber mounted at the collimator, allows automatic collection and analysis of beam data. Methods: The IQM was investigated to perform several QA constancy tests, similar to those recommended by AAPM TG142, of a Linac including: beam output, MLC calibration, beam symmetry, relative dose factor (RDF), dose linearity, output as a function of gantry angle and dose rate. All measurements by the IQM system accompanied a reference measurement using a conventional dosimetry system and were performed on an Elekta Infinity Linac with Agility MLC. The MLC calibration check is done using a Picket-Fence type 2×10cm{sup 2} field positioned at different off-axis locations along the chamber gradient. Beam symmetry constancy values are established by signals from an 4×4cm{sup 2} aperture located at various off-axis positions; the sensitivity of the test was determined by the changes in the signals in response to a tilt in the beam. The data for various square field sizes were used to develop a functional relationship with RDF. Results: The IQM tracked the beam output well within 1% of the reference ion-chamber readings. The Picket-Fence type field test detected a 1mm shift error of one MLC bank. The system was able to detect 2.5% or greater beam asymmetry. The IQM results for all other QA tests were found to agree with the reference values to within 0.5%. Conclusion: It was demonstrated that the IQM system can effectively monitor the Linac performance parameters for the purpose of routine QA constancy tests. With minimum user interactions a comprehensive set of tests can be performed efficiently, allowing frequent monitoring of the Linac. The presenting author’s salary is funded by the manufacturer of the QA device. All the other authors have financial interests with the commercialization of this QA device.

07 ISOTOPE AND RADIATION SOURCES↗