Calculated Percentage Depth Dose Research Articles

Sensitivity Analysis of a 6 MeV Photon Beam Monte Carlo Model.

This study aimed to optimize efficiency in Monte Carlo (MC) simulation using sensitivity analysis of a beam model. The BEAMnrc-based model of 6 MV beam of a Siemens Primus linac was developed. For sensitivity analysis, the effect of the electron source, treatment head, and virtual phantom specifications on calculated percent depth dose (PDD) and lateral dose profiles was evaluated. The optimum mean energy (E) and the full width at half maximum (FWHM) of the intensity distribution of the electron beam were calculated as 6.7 MeV and 3 mm, respectively. Increasing E from 6.1 to 6.7 MeV, increased the PDD in the fall-off region by 4.70% and decreased the lateral profile by 8.76%. Changing the FWHM had a significant effect on the buildup region of PDD and the horns and out-of-field regions of the lateral profile. Increasing the collimators opening by 0.5 mm, PDD increased by 2.13% and the central and penumbra regions of profiles decreased by 1.98% and 11.40% respectively. Collimator properties such as thickness and density were effective in changing the penumbra (11.32% for 0.25 cm increment) and the out-of-field (22.82% for 3 g/cm3) regions of the lateral profiles. Analysis of a 6 MV model showed that PDD profiles were more sensitive to changes in energy than to FWHM of the electron source. The lateral profiles were sensitive to E, FWHM, and collimator opening. The density of the collimator affected only the out-of-field region of lateral profiles. The findings of this study may be used to make benchmarking of an MC beam model more efficient.

Commissioning of a three-dimensional arc-based technique for total body irradiation.

The purpose of this study is to describe the commissioning of a novel three‐dimensional arc‐based technique for total body irradiation (TBI) treatments. The development and implementation of this technique allowed our institution to transition from a bilateral two‐dimensional (2D) technique to a methodology based on volumetric dose calculation. The methodology described in this work is a derivation from the MATBI technique, with the static fields being replaced by four contiguous arc‐fields for each anterior and posterior incidence. The reduced number of fields we employed makes it possible to reach a satisfactory dose uniformity through manual optimization in a straightforward process. We use the Eclipse anisotropic analytical algorithm (AAA) algorithm, commissioned with preconfigured beam data for a 6 MV photon beam, at standard SSD (100 cm). A thorough evaluation of the accuracy of the AAA algorithm at an extended distance (approximately 200 cm) was carried out. For the evaluation, we compared measured and calculated percentage depth–dose and profiles that included open‐field, penumbra, and out‐of‐field regions. The analysis was performed for both static and arc fields, taking into consideration unshielded fields and also in the presence of lung shielding blocks. End‐to‐end tests were carried out for our institutional template plan by two means: with a 2D ion chamber array detector in solid phantom and using Gafchromic films in an anthropomorphic phantom. The results obtained in this work demonstrate that the Eclipse AAA algorithm commissioned for standard treatments can be safely used with our TBI planning technique. Moreover, this technique proved to be a highly efficient path to replace conventional treatment techniques, providing a homogeneous dose distribution, dosimetric robustness, and shorter treatment times. In addition, as inherited from the MATBI technique, our methodology can be implemented in small treatment rooms, with no need for ancillary equipment.

Application of the phase-space distribution approach of Monte Carlo for radiation contamination dose estimation from the (n,γ), (γ,n) nuclear reactions and linac leakage photons in the megavoltage radiotherapy facility.

The aim of this study was to characterize the radiation contamination inside and outside the megavoltage radiotherapy room. Radiation contamination components in the 18MV linac room are the secondary neutron, prompt gamma ray, electron and linac leakage radiation. An 18MV linac modeled in a typical bunker employing the MCNPX code of Monte Carlo. For fast calculation, phase-space distribution (PSD) file modeling was applied and the calculations were conducted for the radiation contamination components dose and spectra at 6 locations inside and outside the bunker. The results showed that the difference of measured and calculated percent depth-dose (PDD) and photo beam-profile (PBP) datasets were lower than acceptable values. At isocenter, the obtained photon dose and neutron fluence were 2.4×10-14 Gy/initial e° and 2.22×10-8 n°/cm2, respectively. Then, neutron apparent source strength (QN) value was found as 1.34×1012 n°/Gy X at isocenter and the model verified to photon and neutron calculations. A surface at 2cm below the flattening filter was modeled as phase-space (PS) file for PDD and PBP calculations. Then by use of a spherical cell in the center of the linac target as a PS surface, contaminant radiations dose, fluence and spectra were estimated at 6 locations in a considerably short time, using the registered history of all particles and photons in the 13GB PSD file as primary source in the second step. Designing the PSD file in MC modeling helps user to solve the problems with complex geometry and physics precisely in a shorter run-time.

Assessment of portal image resolution improvement using an external aluminum target and polystyrene electron filter

BackgroundIn this study, an external 8 mm thick aluminum target was installed on the upper accessory tray mount of a medical linear accelerator head. The purpose of this study was to determine the effects of the external aluminum target beam (Al-target beam) on the portal image quality by analyzing the spatial and contrast resolutions. In addition, the image resolutions with the Al-target beams were compared with those of conventional 6 megavoltage (MV) images.MethodsThe optimized Al-target beam was calculated using Monte Carlo simulations. To validate the simulations, the percentage depth dose and lateral profiles were measured and compared with the modeled dose distributions. A PTW resolution phantom was used for imaging to assess the image resolution. The spatial resolution was quantified by determining the modulation transfer function. The contrast resolution was determined by a fine contrast difference between the 27 measurement areas. The spatial and contrast resolutions were compared with the those of conventional portal images.ResultsThe measured and calculated percentage depth dose of the Al-target beam were consistent within 1.6%. The correspondence of measured and modelled profiles was evaluated by gamma analysis (3%, 3 mm) and all gamma values inside the field were less than one. The critical spatial frequencies (f50) of the images obtained with the Al-target beam and conventional imaging beam were 0.745 lp/mm and 0.451 lp/mm, respectively. The limiting spatial frequencies (f10) for the Al-target beam image and the conventional portal image were 2.39 lp/mm and 1.82 lp/mm, respectively. The Al-target beam resolved the smaller and lower contrast objects better than that of the MV photon beam.ConclusionThe Al-target beams generated by the simple target installation method provided better spatial and contrast resolutions than those of the conventional 6 MV imaging beam.

A Monte Carlo-based dosimetric characterization of Esteya® , an electronic surface brachytherapy unit.

The purpose of this work is threefold: First, to obtain the phase space of an electronic brachytherapy (eBT) system designed for surface skin treatments. Second, to explore the use of some efficiency enhancing (EFEN) strategies in the determination of the phase space. Third, to use the phase space previously obtained to perform a dosimetric characterization of the Esteya eBT system. The Monte Carlo study of the 69.5 kVp x-ray beam of the Esteya® unit (Elekta Brachytherapy, Veenendaal, The Netherlands) was performed with PENELOPE2014. The EFEN strategies included the use of variance reduction techniques and mixed Class II simulations, where transport parameters were fine-tuned. Four source models were studied varying the most relevant parameters characterizing the electron beam impinging the target: the energy spectrum (mono-energetic or Gaussian shaped), and the electron distribution over the focal spot (uniform or Gaussian shaped). Phase spaces obtained were analyzed to detect differences in the calculated data due to the EFEN strategy or the source configuration. Depth dose curves and absorbed dose profiles were obtained for each source model and compared to experimental data previously published. In our EFEN strategy, the interaction forcing variance reduction (VRIF) technique increases efficiency by a factor ~20. Tailoring the transport parameters values (C1 and C2) does not increase the efficiency in a significant way. Applying a universal cutoff energy EABS of 10 keV saves 84% of CPU time while showing negligible impact on the calculated results. Disabling the electron transport by imposing an electron energy cutoff of 70 keV (except for the target) saves an extra 8% (losing in the process 1.2% of the photons). The Gaussian energy source (FWHM = 10%, centered at the nominal kVp, homogeneous electron distribution) shows characteristic K-lines in its energy spectrum, not observed experimentally. The average photon energy using an ideal source (mono-energetic, homogeneous electron distribution) was 36.19 ± 0.09 keV, in agreement with the published measured data of 36.2 ± 0.2 keV. The use of a Gaussian-distributed electron source (mono-energetic) increases the penumbra by 50%, which is closer to the measurement results. The maximum discrepancy of the calculated percent depth dose with the corresponding measured values is 4.5% (at the phantom surface, less than 2% beyond 1 mm depth) and 5% (for the 80% of the field) in the dose profile. Our results agree with the findings published by other authors and are consistent within the expected Type A and B uncertainties. Our results agree with the published measurement results within the reported uncertainties. The observed differences in PDD, dose profiles, and photon spectrum come from three main sources of uncertainty: intermachine variations, measurements, and Monte Carlo calculations. It has been observed that a mono-energetic source with a Gaussian electron distribution over the focal spot is a suitable choice to reproduce the experimental data.

Novel Monte Carlo dose calculation algorithm for robotic radiosurgery with multi leaf collimator: Dosimetric evaluation

PurposeAt introduction in 2014, dose calculation for the first MLC on a robotic SRS/SBRT platform was limited to a correction-based Finite-Size Pencil Beam (FSPB) algorithm. We report on the dosimetric accuracy of a novel Monte Carlo (MC) dose calculation algorithm for this MLC, included in the Precision™ treatment planning system. MethodsA phantom was built of one slab (5.0 cm) of lung-equivalent material (0.09…0.29 g/cc) enclosed by 3.5 cm (above) and 5 cm (below) slabs of solid water (1.045 g/cc). This was irradiated using rectangular (15.4 × 15.4 mm2 to 53.8 × 53.7 mm2) and two irregular MLC-fields. Radiochromic film (EBT3) was positioned perpendicular to the slabs and parallel to the beam. Calculated dose distributions were compared to film measurements using line scans and 2D gamma analysis. ResultsMeasured and MC calculated percent depth dose curves showed a characteristic dose drop within the low-density region, which was not correctly reproduced by FSPB. Superior average gamma pass rates (2%/1 mm) were found for MC (91.2 ± 1.5%) compared to FSPB (55.4 ± 2.7%). However, MC calculations exhibited localized anomalies at mass density transitions around 0.15 g/cc, which were traced to a simplification in electron transport. Absence of these anomalies was confirmed in a modified build of the MC engine, which increased gamma pass rates to 96.6 ± 1.2%. ConclusionsThe novel MC algorithm greatly improves dosimetric accuracy in heterogeneous tissue, potentially expanding the clinical use of robotic radiosurgery with MLC. In-depth, independent validation is paramount to identify and reduce the residual uncertainties in any software solution.

Impact of Silicone gel breast prosthesis on photon beam therapy of recurrence carcinoma post mastectomy

AbstractIntroduction Silicone gel breast implants are used for breast reconstruction post mastectomy. In the event of cancer recurrence, the radiation oncologists are forced to irradiate through the prosthesis device. Due to prosthesis higher atomic number dose perturbations occur during treatment. This study determined the influence of silicone gel thickness on the photon beam distribution. Materials and MethodsA Varian linear accelerator, water phantom (dimensions 30 × 30 × 30 cm3), silicone gel breast prosthesis and Omni-Pro Accept software were used in the study. With the gantry positioned at at a source-to-surface distance (SSD) of 100 cm, the collimators were adjusted to a field size of 10 × 10 cm2 and the 6 MeV photon beam was used. Omni-Pro Accept software was used to plot the percentage depth dose curves and the beam profiles. The results obtained with a Monte Carlo Nuclear Particle (MCNP) Code were validated with the measurement data. The beam profile and percentage depth dose curves were also measured for silicone gel thicknesses (4, 6, 8, 10, 12, 14 and 16 cm) and width 16.5 cm aligned 1 cm below the surface of the water.ResultsThe measured and calculated percentage depth dose (PDD) ratio was 0.03. The measured and calculated beam profiles were 0.5% and 0.9% respectively. For the silicone gel prosthesis, the depth dose values at 0.5 cm below the prosthesis were 2.8%.ConclusionDose perturbations below the breast prosthesis are insignificant, breast prosthesis are safe in the event of carcinoma recurrences.

Monte Carlo study and design of system for implementation of Rotational Total Skin Electron Irradiation technique

Total skin electron irradiation technique is used in treatment of the mycosis fungoid. The implementation of this technique requires non-standard measurements and complex dosimetry methods. Depending on the linear accelerator (Linac) type, bunker size, room dimensions and dosimetry equipment, the design of instruments for appropriate set up and implementation of TSEI in different radiation therapy centers varies. The studies which have been done in this article provide an introduction to the implementing of this method for the first time in Iran and its results can be used for the centers with similar specifications in the world. This article determined the electron beam characteristic of TSEI for the only electron accelerator, located at the radiation center of the Seyed Alshohada Hospital of Isfahan (NEPTUN 10PC), by performing Monte Carlo simulations and using EGSnrc-based codes (BEAMnrc and DOSXYZnrc). For the best uniformity of the vertical profile, the optimal angle of gantry was defined at SSD=350 cm. The effect of the degrader plane that is located at a distance of 20 cm from the patient surface, was evaluated on the amount of energy reduction of the beam, the opening of the electron beam field and the homogeneity of the dose distribution. The transversal dose distribution from the whole treatment with Stanford technique (six dual fields) and Rotational technique was simulated in a CT-based anthropomorphic phantom. Also, the percentage depth dose in the head, neck, thorax, abdomen and legs was obtained for both methods. The simulation results show that the 20̂ angle between the horizontal and the beam central axis is optimal in order to provide the best vertical dose uniformity. The mean energy decreases from 6.1 MeV (the exit window) to 3 MeV (the treatment surface) by placing a degrader with 0.8 cm thickness in front of the treatment plane. FWHM of the angular distribution of the electron beam increased from 15̂ at SSD=100 cm to more than 30̂ on the treatment surface by traversing the PMMA degrader. The MC calculated percentage depth dose curves in different organs of anthropomorphic phantom for RTSEI indicates that the depth of maximum dose is on the surface of the phantom and Isodose curve of 80% is formed at a depth less than 4 mm. the results also show, with the degrader plane in front of the patient, the degree of homogeneity of the dose distribution for both Stanford and rotational techniques is the same.

Investigation of the use of external aluminium targets for portal imaging in a medical accelerator using Geant4 Monte Carlo simulation

To install a low-Z target on the wedge tray mount of a medical linear accelerator to create a new image beam and to confirm image contrast enhancement. Experimental low-energy photon beams were produced with the linac running in the 6 MeV electron mode and with a low-Z target installed on the wedge tray mount [denoted 6 MeV (low-Z target)]. Geant4 Monte Carlo simulation was performed to analyse the energy spectrum and image contrast of a 6 MeV (low-Z target) beam. This study modelled the 6 MeV (low-Z target) beam and the 6 MV (megavoltage) radiotherapy photon beam and verified model validity by measurement. In addition, a contrast phantom was modelled to quantitatively compare the image contrasts of the 6 MeV (low-Z target) beam and the 6 MV radiotherapy photon beam. A low-Z target was fabricated to generate low-energy photons (25-150 keV) from incident electrons, and a portal image of the Alderson RANDO phantom was acquired using a clinical linear accelerator for qualitative analysis. The measured and calculated percentage depth dose of the 6 MV photon and 6 MeV (Al) beams were consistent within 1.5 and 1.6%, respectively, and calculated lateral profiles of the 6 MV photon beam and the 6 MeV (Al) beam were consistent with the measured results within 1.5 and 1.9%, respectively. Although low-energy photons (25-150 keV) of the 6 MV photon beam were only 0.3%, the Be, C, and Al low-Z targets, but not the Ti target, generated 34.4 to 38.5% low-energy photons. In 5 to 20 cm water phantoms, contrast of the 6 MeV (Al) beam was approximately 1.16 times greater than that of the 6 MV beam. The contrasts of 6 MeV (Al) and 6 MV photon beams in the 20 cm water phantom were ~34% lower than those in the 5 cm water phantom. 6 MeV (Al)/CR (computed radiography) images of the human body phantom were more vivid and detailed than 6 MV/EPID (electronic portal imaging device) and 6 MeV (Al)/EPID images. The experimental beam with a low-Z target, which was simply installed on the wedge tray mount of the radiotherapy linear accelerator, generated significantly more low-energy photons than the 6 MV radiotherapy photon beam, and provided better quality portal images. Advances in knowledge: This study shows that, unlike the existing low-Z beam studies, a low-Z target can be installed outside the head of a linear accelerator to improve portal image quality.

Geant4 beam model for boron neutron capture therapy: investigation of neutron dose components.

Boron neutron capture therapy (BNCT) is a biochemically-targeted type of radiotherapy, selectively delivering localized dose to tumour cells diffused in normal tissue, while minimizing normal tissue toxicity. BNCT is based on thermal neutron capture by stable [Formula: see text]B nuclei resulting in emission of short-ranged alpha particles and recoil [Formula: see text]Li nuclei. The purpose of the current work was to develop and validate a Monte Carlo BNCT beam model and to investigate contribution of individual dose components resulting of neutron interactions. A neutron beam model was developed in Geant4 and validated against published data. The neutron beam spectrum, obtained from literature for a cyclotron-produced beam, was irradiated to a water phantom with boron concentrations of 100 μg/g. The calculated percentage depth dose curves (PDDs) in the phantom were compared with published data to validate the beam model in terms of total and boron depth dose deposition. Subsequently, two sensitivity studies were conducted to quantify the impact of: (1) neutron beam spectrum, and (2) various boron concentrations on the boron dose component. Good agreement was achieved between the calculated and measured neutron beam PDDs (within 1%). The resulting boron depth dose deposition was also in agreement with measured data. The sensitivity study of several boron concentrations showed that the calculated boron dose gradually converged beyond 100 μg/g boron concentration. This results suggest that 100μg/g tumour boron concentration may be optimal and above this value limited increase in boron dose is expected for a given neutron flux.

Validation of Monte Carlo simulation of 6 MV photon beam produced by Varian Clinac 2100 linear accelerator using BEAMnrc code and DOSXYZnrc code

The Monte Carlo model for the photon-beam output from the Varian Clinac 2100 linear accelerator was validated to compare the calculated to measured PDD and beam dose profiles The Monte Carlo calculation method is considered to be the most accurate method for dose calculation in radiotherapy. The objective of this study is to build a Monte Carlo geometry of Varian Clinac 2100 linear accelerator as realistically as possible. The Monte Carlo codes used in this work were the BEAMnrc code to simulate the photons beam and the DOSXYZnrc code to examinate the absorbed dose in the water phantom. We have calculated percentage depth dose (PDD) and beam profiles of the 6 MV photon beam for the 6 × 6 cm2, 10 × 10 cm2 and 15 × 15 cm2 field sizes. We have used the gamma index technique for the quantitative evaluation to compare the measured and calculated distributions. Good agreement was found between calculated PDD and beam profile compared to measured data. The comparison was evaluated using the gamma index method and the criterions were 3% for dose difference and 3 mm for distance to agreement. The gamma index acceptance rate was more than 97% of both distribution comparisons PDDs and dose profiles and our results were more developed and accurate. The Varian Clinac 2100 linear accelerator was accurately modeled using Monte Carlo codes: BEAMnrc and DOSXYZnrc codes package.

Energy spectra considerations for synchrotron radiotherapy trials on the ID17 bio-medical beamline at the European Synchrotron Radiation Facility.

The aim of this study was to validate the kilovoltage X-ray energy spectrum on the ID17 beamline at the European Synchrotron Radiation Facility (ESRF). The purpose of such validation was to provide an accurate energy spectrum as the input to a computerized treatment planning system, which will be used in synchrotron microbeam radiotherapy trials at the ESRF. Calculated and measured energy spectra on ID17 have been reported previously but recent additions and safety modifications to the beamline for veterinary trials warranted a fresh investigation. The authors used an established methodology to compare X-ray attenuation measurements in copper sheets (referred to as half value layer measurements in the radiotherapy field) with the predictions of a theoretical model. A cylindrical ionization chamber in air was used to record the relative attenuation of the X-ray beam intensity by increasing thicknesses of high-purity copper sheets. The authors measured the half value layers in copper for two beamline configurations, which corresponded to differing spectral conditions. The authors obtained good agreement between the measured and predicted half value layers for the two beamline configurations. The measured first half value layer was 1.754 ± 0.035 mm Cu and 1.962 ± 0.039 mm Cu for the two spectral conditions, compared with theoretical predictions of 1.763 ± 0.039 mm Cu and 1.984 ± 0.044 mm Cu, respectively. The calculated mean energies for the two conditions were 105 keV and 110 keV and there was not a substantial difference in the calculated percentage depth dose curves in water between the different spectral conditions. The authors observed a difference between their calculated energy spectra and the spectra previously reported by other authors, particularly at energies greater than 100 keV. The validation of the beam spectrum by the copper half value layer measurements means the authors can provide an accurate spectrum as an input to a treatment planning system for the forthcoming veterinary trials of microbeam radiotherapy to spontaneous tumours in cats and dogs.

SU-E-T-299: Dosimetric Characterization of Small Field in Small Animal Irradiator with Radiochromic Films

Purpose: The small animal irradiator has been used with small animals to optimize new radiation therapy as preclinical studies. The small animal was irradiated by whole- or partial-body exposure. In this study, the dosimetric characterizations of small animal irradiator were carried out in small field using Radiochromic films Material & Methods: The study was performed in commercial animal irradiator (XRAD-320, Precision x-ray Inc, North Brantford) with Radiochromic films (EBT2, Ashland Inc, Covington). The calibration curve was generated between delivery dose and optical density (red channel) and the films were scanned by and Epson 1000XL scanner (Epson America Inc., Long Beach, CA).We evaluated dosimetric characterization of irradiator using various filter supported by manufacturer in 260 kV. The various filters were F1 (2.0mm Aluminum (HVL = about 1.0mm Cu) and F2 (0.75mm Tin + 0.25mm Copper + 1.5mm Aluminum (HVL = about 3.7mm Cu). According to collimator size (3, 5, 7, 10 mm, we calculated percentage depth dose (PDD) and the surface –source distance(SSD) was 17.3 cm considering dose rate. Results: The films were irradiated in 260 kV, 10mA and we increased exposure time 5sec. intervals from 5sec. to 120sec. The calibration curve of films was fitted with cubic function. The correlation between optical density and dose was Y=0.1405 X3−2.916 X2+25.566 x+2.238 (R2=0.994). Based on the calibration curve, we calculated PDD in various filters depending on collimator size. When compared PDD of specific depth (3mm) considering animal size, the difference by collimator size was 4.50% in free filter and F1 was 1.53% and F2 was within 2.17%. Conclusion: We calculated PDD curve in small animal irradiator depending on the collimator size and the kind of filter using the radiochromic films. The various PDD curve was acquired and it was possible to irradiate various dose using these curve.

SU‐E‐T‐253: Development of a GDPM Monte Carlo Based Quality Assurance Tool for Cyberknife

Purpose:To develop a 3D quality assurance (QA) tool for Cyberknife plans using a GPU‐based Monte Carlo dose calculation package, gDPM. The developed QA tool will be used as a secondary check for Cyberknife treatment planning software (TPS) reported dose distributions.Methods:Phase space files of the 5, 7.5, 10, 15, and 60 mm iris cones were downloaded from IAEA phase‐space database. From the 60mm iris cone phase space file, we were able to generate raw phase space files for all other cones using a particle rejection method. The particles in the raw phase space files were binned with respect to the radial position and energy for commissioning. During the commissioning process, gDPM calculated percent depth dose and off‐center ratios which were compared to those measured in the Blue Phantom. The off‐axis data was measured with an SAD setup at depths of 15, 50, 100, 200, and 300 mm. At the commissioning stage, an optimization problem was solved to adjust the binned particles weights to minimize the difference between the calculated and measured ones. Commissioning validations will be performed by measuring point dose data of patient specific plans delivered to water phantoms. With commissioned phase space files, 3D patient‐specific dose distributions will be calculated and compared against TPS reported dose.Results:Beyond the initial buildup region, the root mean square difference between the calculated and measured percent depth dose differences was less than 0.5%. The full‐width half‐max data from the off‐axis ratio calculations was found to be within 0.1 mm of the measured data.Conclusion:Our current work showed excellent agreement between the gDPM calculated dose and the measured data for all cone sizes and types for the Cyberknife system. Implementation of a fast and accurate QA tool for patient specific plans will be feasible with this tool.

SU-E-T-110: Development of An Independent, Monte Carlo, Dose Calculation, Quality Assurance Tool for Clinical Trials

Purpose: To develop a comprehensive end-to-end test for Varian's TrueBeam linear accelerator for head and neck IMRT using a custom phantom designed to utilize multiple dosimetry devices. Purpose: To commission a multiple-source Monte Carlo model of Elekta linear accelerator beams of nominal energies 6MV and 10MV. Methods: A three source, Monte Carlo model of Elekta 6 and 10MV therapeutic x-ray beams was developed. Energy spectra of two photon sources corresponding to primary photons created in the target and scattered photons originating in the linear accelerator head were determined by an optimization process that fit the relative fluence of 0.25 MeV energy bins to the product of Fatigue-Life and Fermi functions to match calculated percent depth dose (PDD) data with that measured in a water tank for a 10×10cm2 field. Off-axis effects were modeled by a 3rd degree polynomial used to describe the off-axis half-value layer as a function of off-axis angle and fitting the off-axis fluence to a piecewise linear function to match calculated dose profiles with measured dose profiles for a 40×40cm2 field. The model was validated by comparing calculated PDDs and dose profiles for field sizes ranging from 3×3cm2 to 30×30cm2 to those obtained from measurements. A benchmarking study compared calculated data to measurements for IMRT plans delivered to anthropomorphic phantoms. Results: Along the central axis of the beam 99.6% and 99.7% of all data passed the 2%/2mm gamma criterion for 6 and 10MV models, respectively. Dose profiles at depths of dmax, through 25cm agreed with measured data for 99.4% and 99.6% of data tested for 6 and 10MV models, respectively. A comparison of calculated dose to film measurement in a head and neck phantom showed an average of 85.3% and 90.5% of pixels passing a 3%/2mm gamma criterion for 6 and 10MV models respectively. Conclusion: A Monte Carlo multiple-source model for Elekta 6 and 10MV therapeutic x-ray beams has been developed as a quality assurance tool for clinical trials.

Feasibility of using intermediate x‐ray energies for highly conformal extracranial radiotherapy

To investigate the feasibility of using intermediate energy 2 MV x-rays for extracranial robotic intensity modulated radiation therapy. Two megavolts flattening filter free x-rays were simulated using the Monte Carlo code MCNP (v4c). A convolution/superposition dose calculation program was tuned to match the Monte Carlo calculation. The modeled 2 MV x-rays and actual 6 MV flattened x-rays from existing Varian Linacs were used in integrated beam orientation and fluence optimization for a head and neck, a liver, a lung, and a partial breast treatment. A column generation algorithm was used for the intensity modulation and beam orientation optimization. Identical optimization parameters were applied in three different planning modes for each site: 2, 6 MV, and dual energy 2/6 MV. Excellent agreement was observed between the convolution/superposition and the Monte Carlo calculated percent depth dose profiles. For the patient plans, overall, the 2/6 MV x-ray plans had the best dosimetry followed by 2 MV only and 6 MV only plans. Between the two single energy plans, the PTV coverage was equivalent but 2 MV x-rays improved organs-at-risk sparing. For the head and neck case, the 2 MV plan reduced lips, mandible, tongue, oral cavity, brain, larynx, left and right parotid gland mean doses by 14%, 8%, 4%, 14%, 24%, 6%, 30% and 16%, respectively. For the liver case, the 2 MV plan reduced the liver and body mean doses by 17% and 18%, respectively. For the lung case, lung V 20, V 10, and V5 were reduced by 13%, 25%, and 30%, respectively. V 10 of heart with 2 MV plan was reduced by 59%. For the partial breast treatment, the 2 MV plan reduced the mean dose to the ipsilateral and contralateral lungs by 27% and 47%, respectively. The mean body dose was reduced by 16%. The authors showed the feasibility of using flattening filter free 2 MV x-rays for extracranial treatments as evidenced by equivalent or superior dosimetry compared to 6 MV plans using the same inverse noncoplanar intensity modulated planning method.

SU‐E‐T‐159: Development of An Independent, Monte Carlo, Dose Calculation, Quality Assurance Tool for Clinical Trials

Purpose: To commission a multiple‐source Monte Carlo model of Elekta linear accelerator beams of nominal energies 6MV and 10MV. Methods: A three source, Monte Carlo model of Elekta 6 and 10MV therapeutic x‐ray beams was developed in a two‐step process. Energy spectra of each of three sources, a primary source corresponding to photons created in the target, an extra‐focal source corresponding to photons originating from scattered events in the linac head, and an electron contamination source, were determined. The two photon sources were determined by an optimization process that fit the relative fluence of 0.25 MeV energy bins to the product of Fatigue‐Life and Fermi functions to match calculated percent depth dose (PDD) data with that measured in water for a 10×10cm2 field. Off‐axis effects were modeled by fitting the off‐axis fluence to a piece‐wise linear function through optimization of relative fluence to match calculated dose profiles with measured dose profiles for a 40×40cm2 field. A 3rd degree polynomial was used to describe the off‐axis half‐value layer as a function of off‐axis angle. The model was then commissioned by comparing calculated PDDs and dose profiles for field sizes ranging from 3×3cm2 to 30×30cm2 to those obtained from measurements. Results: Agreement between calculated and measured data was evaluated using 2%/2mm global gamma criterion for field sizes of 3×3, 5×5, 10×10, 15×15, 20×20, and 30×30cm2. Along the central axis of the beam 99.5% and 99.6% of all data passed the criterion for 6 and 10MV models, respectively. Dose profiles at depths of dmax, 5, 10, 20, and 25cm agreed with measured data for 95.4% and 99.2% of data tested for 6 and 10MV models, respectively. Conclusion: A Monte Carlo multiple‐source model for Elekta 6 and 10MV therapeutic x‐ray beams has been developed as a quality assurance tool for clinical trials. This work was supported by Public Health Service grants CA010953, CA081647, and CA21661 awarded by the National Cancer Institute, United States Department of Health and Human Services.

Poster - Thur Eve - 23: Statistical analysis and verification of the percentage depth dose calculation based on the tissue maximum ratio in external beam radiotherapy.

The aim of this study is to perform a statistical analysis to verify the calculated percentage depth dose (PDD) based on the tissue maximum ratio (TMR) with the PDD measurements taken in water. 6 and 15 MV photon beams produced by a Varian linear 2100 C/D accelerator were used. PDDs and TMRs were measured at various depths and field sizes (5 × 5, 10 × 10, 15 × 15, 20 × 20 and 30 × 30 cm2 ) using a PTW 31006 ionization chamber and a scanning water tank. By comparing the calculated and measured PDD results, it was seen that for larger field sizes the deviation between the calculated and measured PDD was smaller. Deviations between the calculated and measured results were found to be higher in the build-up regions of the 6 and 15 MV photon beams. For the statistical analyses, t-tests were performed using the measured and calculated PDDs for each field size but showed insignificant deviations for the 6 and 15 MV photon beams. The mean t-test values are 0.952 and 0.970 for the 6 and 15 MV photon beams, respectively. The difference between the calculated and measured PDD is within the acceptable range according to the ICRU reports (ICRU Report No. 24, 1976). We conclude that accurate calculation of the PDD using the measured TMR data is possible, which is useful as the PDD cannot be measured directly.

SU-E-T-479: Skin Dose from Flattening Filter Free Beams: A Monte Carlo Investigation.

Flattening filter free (FFF) beams in radiotherapy have advantages such as shorter treatment delivery time and lower out-of-field dose compared with conventional flattened beams. This study investigates in detail the skin dose induced by FFF beams from a TrueBeam accelerator (Varian Medical Systems, Palo Alto, CA) using Monte Carlo method. Phase space files generated using real geometry of a TrueBeam accelerator above the jaws, were used as the input radiation source files in beam simulation for various field sizes using BEAMnrc. Phase space files for various field sizes were generated at the phantom surface. DOSXYZnrc was used for dose calculations in phantom and in patient using the generated phase space files as source input files. The calculated percentage depth dose curves and profiles in water agreed with measurements within ± 2% for the high dose region and ±2 mm in the penumbra. The peak fluence of a 6 MV FFF beam with the same electron beam incident on the target is about 3 times that of a flattened beam . The mean energy of a 6 MV FFF beam is 0.92-0.95 MeV while it is 1.18-1.30 MeV for the flattened beam. Due to the mean energy difference, the dose in a 6 MV FFF beam is about 6% (of the maximum dose, or 12% of local dose) higher at depth of 1 mm compared with a flattened beam. Due to the lower mean photon energy, in an FFF beam the surface (skin) dose is slightly higher compared to the conventional flattened beam of the same field size.

SU-E-T-402: Modulated Electron Radiotherapy Dose Delivery Using Photon Multileaf Collimators

Purpose: Different designs of multileaf collimators (MLC) have been investigated for dose delivery for energy and intensity modulated electron radiotherapy (MERT). This work aims at verifying MERT dose delivery accuracy on clinical accelerators, Siemens Artiste and Varian Clinac iX, equipped with conventional photon multileaf collimators (pMLC). Method and Materials:Expensive measurements and Monte Carlo (MC) simulations were performed to acquire the electron beam data for Monte Carlo-based MERT treatment planning. The calculated percentage depth dose (PDD) and dose profiles were benchmarked with measurements. Differences of electron beam characteristics for fields shaped by the Artiste and Clinac iX pMLC were examined, demonstrating their strengths and weaknesses in MERT dose delivery. Results: MC simulated PDDs and dose profiles for electron energies, 6, 9, 12, 15 (Artiste) and 16 (Clinac iX) MeV with fields shaped by either applicators or MLCs agreed well (2%/2mm) with ion chamber measurements. For pMLC-shaped fields, no significant changes in PDDs were observed as SSD varied from 61 cm to 85 cm while the flatness and penumbra of dose profiles showed obvious deterioration as SSD increased. In comparison, the Clinac iX pMLC resulted in flatter electron beams with smaller penumbra than those collimated the Artiste pMLC most likely due to the differences of the pMLC locations. Conclusions: Both Siemens Artiste and Varian Clinac iX are capable of delivering energy and intensity modulated electron dose distributions efficiently using their existing pMLC. The electron beam properties shaped by pMLCs were better suited for MERT at smaller SSDs (with smaller gaps between the pMLC and the patient surface). For the same SSD, the Clinac iX pMLC manifested superior beam flatness and penumbra compared to the Artiste pMLC.