Gantry Position Research Articles

SU‐E‐T‐504: Intensity‐Modulated Radiosurgery Treatments Derived by Optimizing Delivery of Sphere Packing Treatment Plans

PurposeTo minimize the number of monitor units required to deliver a sphere packing stereotactic radiosurgery (SRS) plan by eliminating overlaps of individual beam projections.MethodsAn algorithm was written in C++ to calculate SRS treatment doses using sphere packing. Three fixed beams were used to approximate each arc in a typical SRS treatment plan. For cases involving multiple isocenters, at each gantry and table angle position beams directed to individual spheres overlap to produce regions of high dose, resulting in intensity modulated beams. These high dose regions were dampened by post‐processing of the combined beam profile. The post‐process dampening involves removing the excess overlapping fluence from all but the highest contributing beam. The dampened beam profiles at each table and gantry angle position were then summed to produce the new total dose distribution.ResultsDelivery times for even the most complex multiple sphere plans can be reduced to consistent times of about 20 to 30 minutes. The total MUs required to deliver the plan can also be reduced by as much as 85% of the original plan's MUs.ConclusionRegions of high dose are removed. Dampening overlapping radiation fluence can produce the new beam profiles that have more uniform dose distributions using less MUs. This results in a treatment that requires significantly fewer intensity values than traditional IMRT or VAMT planning.

SU‐E‐T‐724: Testing the Limitations of a Photon Dose Algorithm in Commissioning

Purpose:This work is to test the limitations of a photon dose algorithm during the commissioning of a treatment planning system.Methods:Commissioning tests for a model‐based dose calculation algorithm typically involve the verification of PDD, output and dose profiles, but often those tests are performed at one SSD, one depth and one nominal gantry position. Those tests are useful to validate the modeling of radiation beams, but they may not be sufficient to detect the limitations of an algorithm. Additional tests were performed at several SSDs, various depths, oblique gantry angles and off‐axis conditions to demonstrate the accuracy and limitations of the dose calculation algorithm. Dose profiles were measured by in‐water scanning with a three‐dimensional scanning system and calculated in the TPS using a virtual water phantom.Results:Dose profiles from both the measurement and the calculation were plotted for comparison. Also plotted were the difference in absolute dose between the measurement and the calculation. For the off‐axis MLC field tests, larger discrepancies were observed at the open portion and the far edge of the field, which became greater with short SSD and deep depth. In addition, the shape of the profile appeared different for the open portion of the field. For the oblique MLC field tests, the largest difference was seen around the high‐dose shoulder of the profile. Differences in some point doses were observed to be greater than 10% of the maximum field dose.Conclusion:We have learned the limitations of the superposition dose algorithm in the XiO planning system through some specific tests, which are related to the parallel kernel approximation and the simplified energy spectra employed by the algorithm to calculate field‐size dependent fluence.

SU‐E‐T‐367: Evaluate the Dosimetric Impacts On Patient Specific Treatment Plans Due to Set Up Uncertainties During LINAC Annual QA and Commission

Purpose:To quantify the dosimetric impact on patient's specific treatment plans due to set up uncertainties during LINAC commission and annual QA and to determine the maximum set up uncertainty allowance range.Methods:A 60×60×60 cm3 solid water cube was created in Varian Eclipse TPS. Beam data profiles (crossline and diagonal) and PDDs for field sizes ranging from 2×2 cm2 to 40×40 cm2 were simulated. Three main uncertainty scenarios were purposely introduced for gantry position tilts (0–5°), source axis distance changes (100–105 cm), and iso‐center position shifts (0–5 mm) during the simulation. A gamma analysis was used to compare the correct simulated profiles with the profiles for each scenario. Two static IMRT treatment plans (H&N and GYN) with tumors at 5 cm and 15 cm depths were compared using similar set up uncertainties.Results:A gamma analysis using ±3%/±3mm with 90% passing rate criteria is included to show the passing rate for each scenario. Crossline and diagonal profiles showed a gamma passing rating of ≥ 90% at depth ≤10 cm for these scenarios: gantry tilted from 0–5°, SAD changed from 100–105 cm, and iso‐center shifted ≤ 4 mm. From 10 to 20 cm depths, all three scenarios failed with gamma passing ≤ 90% excepted for diagonal profiles at Gantry =2°, SAD =1 cm, and iso‐center =1 mm off center. Diagonal profiles showed a higher gamma passing rating compared to crossline profiles for all three scenarios. PDD differences also increased as depth increased. For patient's specific treatment plans, maximum uncertainties allowed to obtain a ≥90% gamma passing rating are: gantry tilts ±1 degree, SAD shifts ±2 cm, and iso‐center moves ±3 mm.Conclusion:This study validated AAPM TG 142 recommendations on the mechanical and dosimetry uncertainties and provided proofs on maximum acceptance tolerances for LINAC annual QA and commission.

Geometric Calibration and Image Reconstruction for a Segmented Slant-Hole Stationary Cardiac SPECT System.

A dedicated stationary cardiac single-photon emission computed tomography (SPECT) system with a novel segmented slant-hole collimator has been developed. The goal of this paper is to calibrate this new imaging geometry with a point source. Unlike the commercially available dedicated cardiac SPECT systems, which are specialized and can be used only to image the heart, our proposed cardiac system is based on a conventional SPECT system but with a segmented slant-hole collimator replacing the collimator. For a dual-head SPECT system, 2 segmented collimators, each with 7 sections, are arranged in an L-shaped configuration such that they can produce a complete cardiac SPECT image with only one gantry position. A calibration method was developed to estimate the geometric parameters of each collimator section as well as the detector rotation radius, under the assumption that the point source location is calculated using the central-section data. With a point source located off the rotation axis, geometric parameters for each collimator section can be estimated independently. The parameters estimated individually are further improved by a joint objective function that uses all collimator sections simultaneously and incorporates the collimator symmetry information. Estimation results and images reconstructed from estimated parameters are presented for both simulated and real data acquired from a prototype collimator. The calibration accuracy was validated by computer simulations with an error of about 0.1° for the slant angles and about 1 mm for the rotation radius. Reconstructions of a heart-insert phantom did not show any image artifacts of inaccurate geometric parameters. Compared with the detector's intrinsic resolution, the estimation error is small and can be ignored. Therefore, the accuracy of the calibration is sufficient for cardiac SPECT imaging.

Commissioning and quality assurance of Dynamic WaveArc irradiation.

A novel three‐dimensional unicursal irradiation technique “Dynamic WaveArc” (DWA), which employs simultaneous and continuous gantry and O‐ring rotation during dose delivery, has been implemented in Vero4DRT. The purposes of this study were to develop a commissioning and quality assurance procedure for DWA irradiation, and to assess the accuracy of the mechanical motion and dosimetric control of Vero4DRT. To determine the mechanical accuracy and the dose accuracy with DWA irradiation, 21 verification test patterns with various gantry and ring rotational directions and speeds were generated. These patterns were irradiated while recording the irradiation log data. The differences in gantry position, ring position, and accumulated MU (EG,ER, and EMU, respectively) between the planned and actual values in the log at each time point were evaluated. Furthermore, the doses delivered were measured using an ionization chamber and spherical phantom. The constancy of radiation output during DWA irradiation was examined by comparison with static beam irradiation. The mean absolute error (MAE) of EG and ER were within 0.1° and the maximum error was within 0.2°. The MAE of EMU was within 0.7 MU, and maximum error was 2.7 MU. Errors of accumulated MU were observed only around control points, changing gantry, and ring velocity. The gantry rotational range, in which EMU was greater than or equal to 2.0 MU, was not greater than 3.2%. It was confirmed that the extent of the large differences in accumulated MU was negligibly small during the entire irradiation range. The variation of relative output value for DWA irradiation was within 0.2%, and this was equivalent to conventional arc irradiation with a rotating gantry. In conclusion, a verification procedure for DWA irradiation was designed and implemented. The results demonstrated that Vero4DRT has adequate mechanical accuracy and beam output constancy during gantry and ring rotation.PACS number: 87

Quality control of VMAT synchronization using portal imaging.

For accurate delivery of volumetric‐modulated arc therapy (VMAT), the gantry position should be synchronized with the multileaf collimator (MLC) leaf positions and the dose rate. This study, therefore, aims to implement quality control (QC) of VMAT synchronization, with as few arcs as possible and with minimal data handling time, using portal imaging. A steel bar of diameter 12 mm is accurately positioned in the G–T direction, 80 mm laterally from the isocenter. An arc prescription irradiates the bar with a 16mm×220mm field during a complete 360° arc, so as to cast a shadow of the bar onto the portal imager. This results in a sinusoidal sweep of the field and shadow across the portal imager and back. The method is evaluated by simulating gantry position errors of 1°–9° at one control point, dose errors of 2 monitor units to 20 monitor units (MU) at one control point (0.3%–3% overall), and MLC leaf position errors of 1 mm ‐ 6 mm at one control point. Inhomogeneity metrics are defined to characterize the synchronization of all leaves and of individual leaves with respect to the complete set. Typical behavior is also investigated for three models of accelerator. In the absence of simulated errors, the integrated images show uniformity, and with simulated delivery errors, irregular patterns appear. The inhomogeneity metrics increase by 67% due to a 4° gantry position error, 33% due to an 8 MU (1.25%) dose error, and 70% due to a 2 mm MLC leaf position error. The method is more sensitive to errors at gantry angle 90°/270° than at 0°/180° due to the geometry of the test. This method provides fast and effective VMAT QC suitable for inclusion in a monthly accelerator QC program. The test is able to detect errors in the delivery of individual control points, with the possibility of using movie images to further investigate suspicious image features.PACS numbers: 87.55.Qr, 87.56.bd, 87.56.Fc

Dosimetric comparison of tools for intensity modulated radiation therapy with gamma analysis: a phantom study

Dosimetry of the Intensity Modulated Radiation Therapy (IMRT) is very important because of the complex dose distributions. Diode arrays are the most common and practical measurement tools for clinical usage for IMRT. Phantom selection is critical for QA process. IMRT treatment plans are recalculated for the phantom irradiation in QA. Phantoms are made in different geometrical shapes to measure the doses of different types of irradiation techniques. Comparison of measured and calculated dose distributions for IMRT can be made by using gamma analysis. In this study, 10 head-and-neck IMRT QA plans were created with Varian Eclipse 8.9 treatment planning system. Water equivalent RW3-slab phantoms, Octavius-2 phantom and PTW Seven29 2D-array were used for QA measurements. Gantry, collimator and couch positions set to 00 and QA plans were delivered to RW3 and Octavius phantoms. Then the positions set to original angles and QA plans irradiated again. Measured and calculated fluence maps were evaluated with gamma analysis for different DD and DTA criteria. The effect of different set-up conditions for RW3 and Octavius phantoms in QA plan delivery evaluated by gamma analysis. Results of gamma analysis show that using RW3-slab phantoms with setting parameters to 00 is more appropriate for IMRT QA.

Correlation of phantom-based and log file patient-specific QA with complexity scores for VMAT.

The motivation for this study was to reduce physics workload relating to patient‐specific quality assurance (QA). VMAT plan delivery accuracy was determined from analysis of pre‐ and on‐treatment trajectory log files and phantom‐based ionization chamber array measurements. The correlation in this combination of measurements for patient‐specific QA was investigated. The relationship between delivery errors and plan complexity was investigated as a potential method to further reduce patient‐specific QA workload. Thirty VMAT plans from three treatment sites — prostate only, prostate and pelvic node (PPN), and head and neck (H&N) — were retrospectively analyzed in this work. The 2D fluence delivery reconstructed from pretreatment and on‐treatment trajectory log files was compared with the planned fluence using gamma analysis. Pretreatment dose delivery verification was also carried out using gamma analysis of ionization chamber array measurements compared with calculated doses. Pearson correlations were used to explore any relationship between trajectory log file (pretreatment and on‐treatment) and ionization chamber array gamma results (pretreatment). Plan complexity was assessed using the MU/ arc and the modulation complexity score (MCS), with Pearson correlations used to examine any relationships between complexity metrics and plan delivery accuracy. Trajectory log files were also used to further explore the accuracy of MLC and gantry positions. Pretreatment 1%/1 mm gamma passing rates for trajectory log file analysis were 99.1% (98.7%–99.2%), 99.3% (99.1%–99.5%), and 98.4% (97.3%–98.8%) (median (IQR)) for prostate, PPN, and H&N, respectively, and were significantly correlated to on‐treatment trajectory log file gamma results (R=0.989,p<0.001). Pretreatment ionization chamber array (2%/2 mm) gamma results were also significantly correlated with on‐treatment trajectory log file gamma results (R=0.623,p<0.001). Furthermore, all gamma results displayed a significant correlation with MCS (R>0.57,p<0.001), but not with MU/arc. Average MLC position and gantry angle errors were 0.001±0.002mm and 0.025°±0.008° over all treatment sites and were not found to affect delivery accuracy. However, variability in MLC speed was found to be directly related to MLC position accuracy. The accuracy of VMAT plan delivery assessed using pretreatment trajectory log file fluence delivery and ionization chamber array measurements were strongly correlated with on‐treatment trajectory log file fluence delivery. The strong correlation between trajectory log file and phantom‐based gamma results demonstrates potential to reduce our current patient‐specific QA. Additionally, insight into MLC and gantry position accuracy through trajectory log file analysis and the strong correlation between gamma analysis results and the MCS could also provide further methodologies to both optimize the VMAT planning and QA process.PACS number: 87.53.Bn, 87.55.Kh, 87.55.Qr

Intelligent Synchronous Control for Gantry Position Stage

A cross-coupled proportional-integral-derivative neural network (PIDNN) control is proposed in this study for the synchronous control of a dual linear motors servo system which is installed in a gantry position stage. First, the dynamics of the field-oriented control PMLSM servo drive with a lumped uncertainty, which contains parameter variations, external disturbance and friction force, is introduced. Then, to achieve accurate trajectory tracking performance with robustness, an intelligent control approach using PIDNN is proposed for the field-oriented control PMLSM servo drive system. In the proposed approach, the on-line learning algorithms of the PIDNN are derived using back-propagation (BP) method to guarantee the convergence of the network. Finally, some experimental results are illustrated to depict the validity of the proposed control approach.

Patient dose map indications on interventional X-ray systems and validation with Gafchromic XR-RV3 film

To help avoiding secondary effects of interventional procedures like skin damage, a dose map method has been developed to provide an indication of the local dose on a surface representative of individual patient shapes. To minimise user interactions, patient envelope shapes are automatically determined depending on simple patient data information. Local doses are calculated in 1-cm² areas depending on the estimated air kerma, table and gantry positions and system settings, taking into account the table and mattress attenuations and estimated backscatter from the patient. These local doses are cumulated for each location of the patient envelope during the clinical procedure. To assess the accuracy of the method, Gafchromic XR-RV3 films have been used in several operating configurations. Good visual agreements on cumulated dose localisation were obtained within the 1-cm² precision of the map and the dose values agreed within 24.9 % accuracy. The resulting dose map method has been integrated into GE Healthcare X-Ray angiographic systems and should help in the management of the dose by the users during the procedure.

From static to dynamic 1.5T MRI-linac prototype: impact of gantry position related magnetic field variation on image fidelity

Recently, the MRI-linac prototype at UMC Utrecht was upgraded with a ring-based gantry, where all linac components are mounted on a ring around the MR scanner. Although adaptations have been made to both linac and MR magnets in order to account for mutual magnetic interference, interference problems cannot be ruled out completely. Therefore, in this paper the impact of gantry position dependent magnetic field inhomogeneity variation on the geometrical accuracy of acquired MR images is quantified. Magnetic field maps were acquired in a large field of view for static gantry positions in shimmed and un-shimmed conditions. Reproducibility of the shim settings was assessed. From the fieldmaps, a minimum gradient strength needed to acquire images with geometric distortions of, at most, 1 mm was derived. Moreover, imaging during gantry rotation was performed for a range of imaging parameters and rotation speeds. From the measurements we conclude that images with good geometric fidelity can be obtained for all static gantry positions, provided that shimming is performed for each new gantry position. This indicates that the present prototype is suitable for static IMRT scenarios. Shim settings are highly reproducible, suggesting that shimming via look-up tables is feasible. Finally, imaging during gantry rotation may produce severely distorted images at present and is likely to require advanced compensation methods such as dynamic shimming or higher order reconstruction.

SU‐E‐T‐307: Susceptibility of SBRT to Delivery Uncertainties Using RapidArc Or Dynamic IMRT

Purpose:To determine if SBRT is more susceptible to delivery uncertainties when using either RapidArc or dynamic IMRT.Methods:Systematic or random uncertainties in MLC leaf positions, gantry position and dose rate were incorporated into RapidArc (RA) and sliding‐window IMRT (SW) treatment plans for retrospective SBRT lung and liver cases, which also included the use of FFF or SRS energies and therefore higher dose rates. Initial plan comparisons included homogeneity and conformity indices. Dose distributions and dose‐value histograms of original and modified plans were compared using Gamma analysis and dose indices of planned treatment volumes (PTV) and organs at risk (OAR).Results:SBRT lung PTVs using RA were more susceptible to systematic MLC delivery errors than SW (∼6%/mm vs. ∼4%/mm), in contrast to a previous study examining hyperfractionated prostate and head‐and‐neck treatments; esophagus and cord Dmin and Dmax values changed proportionately for both techniques; RA plans were superior globally but not locally (PTV) using Gamma analyses. Uniformly distributed random variations of 2 mm for active MLC leaves had a negligible effect on all PTV dose distributions (Dmin, Dmax &lt; 0.4%). PTV coverage was affected equally when incorporating systematic gantry errors.Conclusion:RapidArc deliveries were found to be more sensitive to systematic errors in MLC leaf positions, in contrast to a previous study on hyperfractionated treatments. However, this is reasonable as both studies correlate average segmental field size or mean leaf gap with adverse dosimetric effects due to such uncertainties; mean leaf gaps for either technique in this study were similar. Gantry angle variations had similar effects on both techniques.

SU-E-T-144: Effective Analysis of VMAT QA Generated Trajectory Log Files for Medical Accelerator Predictive Maintenance

Purpose: To determine the effectiveness of SPC analysis for a model predictive maintenance process that uses accelerator generated parameter and performance data contained in trajectory log files. Methods: Each trajectory file is decoded and a total of 131 axes positions are recorded (collimator jaw position, gantry angle, each MLC, etc.). This raw data is processed and either axis positions are extracted at critical points during the delivery or positional change over time is used to determine axis velocity. The focus of our analysis is the accuracy, reproducibility and fidelity of each axis. A reference positional trace of the gantry and each MLC is used as a motion baseline for cross correlation (CC) analysis. A total of 494 parameters (482 MLC related) were analyzed using Individual and Moving Range (I/MR) charts. The chart limits were calculated using a hybrid technique that included the use of the standard 3σ limits and parameter/system specifications. Synthetic errors/changes were introduced to determine the initial effectiveness of I/MR charts in detecting relevant changes in operating parameters. The magnitude of the synthetic errors/changes was based on: TG-142 and published analysis of VMAT delivery accuracy. Results: All errors introduced were detected. Synthetic positional errors of 2mm for collimator jaw and MLC carriage exceeded the chart limits. Gantry speed and each MLC speed are analyzed at two different points in the delivery. Simulated Gantry speed error (0.2 deg/sec) and MLC speed error (0.1 cm/sec) exceeded the speed chart limits. Gantry position error of 0.2 deg was detected by the CC maximum value charts. The MLC position error of 0.1 cm was detected by the CC maximum value location charts for every MLC. Conclusion: SPC I/MR evaluation of trajectory log file parameters may be effective in providing an early warning of performance degradation or component failure for medical accelerator systems.

SU-E-T-643: A Comparison of the DTA and Gamma Index Analysis for IMRT/VMAT Plans in Rectal Carcinoma

Purpose: To investigate the variability of the global gamma index analysis for IMRT and VMAT plans in Rectal Carcinoma, assess the impact of criterion by 3mm/3% or 4mm/4% gamma index and DTA method. Methods: In ten patients, five-field IMRT plans with fixed gantry positions were compared to two dual arcs VMAT plans, each of them was optimized with Oncentra4.3 planning system, and designed by experienced planners using appropriate similar optimization parameters and dose constraints with a number of iterations to meet the clinical acceptance criteria. Plans were normalized so that at least 95% of PTV would receive the prescription dose 50 Gray in 25 fractions. Measurements of the plan dose distribution were performed and analyzed with Delta4 detector array by 3mm/3% or 4mm/4% gamma index and DTA methods. Results: All plans passed in the dose verification, for gamma criterion, an average of 93.13% of the detector points passed the 3 mm/3% for VMAT plans while in IMRT verification it was 96% (p=0.017), the lowest pass-rate were 90.2% for VMAT and 91.2% for IMRT; For 4 mm/4% gamma criterion, an average of 97.15% of the detector points passed of VMAT plans compared to 99.36% of IMRT plans (p=0.052), the lowest pass-rate were 91.5% for VMAT and 97.8% for IMRT. For DTA criterion, an average of 88.35% of the detector points passed of VMAT plans compared to 93.53% of IMRT plans(p=0.002). Conclusion: For the gamma criterion, VMAT and IMRT techniques can both achieve good dose verification with Delta4 detector array. However for the DTA criterion, it showed significant difference. Different criterions resulted in different pass-rate, further studies are needed to evaluate the methods to verify the dose distribution for VMAT/IMRT plans, so appropriate method can be chosen in clinic in the future.

SU-E-T-140: Dynamic Wave Arc Trajectory Verification Using KV X-Ray Fluoroscopy

Purpose: Purpose: This study investigates the geometric accuracy of simultaneous Gantry/Ring rotation during Dynamic Wave Arc (DWA) delivery. Methods: The Vero SBRT system consists of a 6MV LINAC mounted on an O-ring gantry that can rotate around the vertical axis (±60°), similar to couch rotation on C-arm gantries. To provide CBCT and fluoroscopy imaging functionalities, two orthogonal kV imaging units are attached to the O-ring at −45°/+45° from the beam axis.Dynamic Wave Arc maximizes Vero's motion capabilities by employing synchronized gantry and ring motion on a complex non-coplanar trajectory in combination with aperture based optimized MLC segments.Four wave arc trajectories (T1-4) were delivered using a cubic phantom with a configuration of five lead beads. O-ring gantry position information was retrieved through continuous dual-source kV X-ray image acquisition during DWA. An in-house algorithm read in the image set, extracted the projected marker positions and determined the angulation through reconstruction of the beam source position. The geometric error was quantified as the distance between the independently detected positions from kV-images and reference trajectory derived from the treatment plan in the Ring-Gantry space. Results: The average displacement between the 3D gantry/ring positions reconstructed from the fluoroscopy images and the reference trajectory was 0.346 mm (SD 0,171) for T1. A mean offset of 0.348 mm (SD 0,182) and 0.357 mm (SD 0.194) was observed for trajectory T2(2segmens) and T3(4segments), respectively. The saw shape T4 presented a mean geometric error of 0.363 (SD 0.156). The overall systematic error of 0.350 was caused by the difference between planned reference trajectory created by linear interpolation between CP, and the machine delivery following a spline curve. Conclusion: An independent geometric QA approach has been developed for DWA delivery verification, successfully applied on diverse trajectories and disclosed that the Vero system is capable of accurately follow complex trajectories.

Pilot study for compact microbeam radiation therapy using a carbon nanotube field emission micro-CT scanner.

Microbeam radiation therapy (MRT) is defined as the use of parallel, microplanar x-ray beams with an energy spectrum between 50 and 300 keV for cancer treatment and brain radiosurgery. Up until now, the possibilities of MRT have mainly been studied using synchrotron sources due to their high flux (100s Gy/s) and approximately parallel x-ray paths. The authors have proposed a compact x-ray based MRT system capable of delivering MRT dose distributions at a high dose rate. This system would employ carbon nanotube (CNT) field emission technology to create an x-ray source array that surrounds the target of irradiation. Using such a geometry, multiple collimators would shape the irradiation from this array into multiple microbeams that would then overlap or interlace in the target region. This pilot study demonstrates the feasibility of attaining a high dose rate and parallel microbeam beams using such a system. The microbeam dose distribution was generated by our CNT micro-CT scanner (100 μm focal spot) and a custom-made microbeam collimator. An alignment assembly was fabricated and attached to the scanner in order to collimate and superimpose beams coming from different gantry positions. The MRT dose distribution was measured using two orthogonal radiochromic films embedded inside a cylindrical phantom. This target was irradiated with microbeams incident from 44 different gantry angles to simulate an array of x-ray sources as in the proposed compact CNT-based MRT system. Finally, phantom translation in a direction perpendicular to the microplanar beams was used to simulate the use of multiple parallel microbeams. Microbeams delivered from 44 gantry angles were superimposed to form a single microbeam dose distribution in the phantom with a FWHM of 300 μm (calculated value was 290 μm). Also, during the multiple beam simulation, a peak to valley dose ratio of ~10 was found when the phantom translation distance was roughly 4x the beam width. The first prototype CNT-based x-ray tube dedicated to the development of compact MRT technology development was proposed and planned based on the preliminary experimental results presented here and the previous corresponding Monte Carlo simulations. The authors have demonstrated the feasibility of creating microbeam dose distributions at a high dose rate using a proposed compact MRT system. The flexibility of CNT field emission x-ray sources could possibly bring compact and low cost MRT devices to the larger research community and assist in the translational research of this promising new approach to radiation therapy.

Dual source and dual detector arrays tetrahedron beam computed tomography for image guided radiotherapy

Cone-beam computed tomography (CBCT) is an important online imaging modality for image guided radiotherapy. But suboptimal image quality and the lack of a real-time stereoscopic imaging function limit its implementation in advanced treatment techniques, such as online adaptive and 4D radiotherapy. Tetrahedron beam computed tomography (TBCT) is a novel online imaging modality designed to improve on the image quality provided by CBCT. TBCT geometry is flexible, and multiple detector and source arrays can be used for different applications. In this paper, we describe a novel dual source–dual detector TBCT system that is specially designed for LINAC radiation treatment machines. The imaging system is positioned in-line with the MV beam and is composed of two linear array x-ray sources mounted aside the electrical portal imaging device and two linear arrays of x-ray detectors mounted below the machine head. The detector and x-ray source arrays are orthogonal to each other, and each pair of source and detector arrays forms a tetrahedral volume. Four planer images can be obtained from different view angles at each gantry position at a frame rate as high as 20 frames per second. The overlapped regions provide a stereoscopic field of view of approximately 10–15 cm. With a half gantry rotation, a volumetric CT image can be reconstructed having a 45 cm field of view. Due to the scatter rejecting design of the TBCT geometry, the system can potentially produce high quality 2D and 3D images with less radiation exposure. The design of the dual source–dual detector system is described, and preliminary results of studies performed on numerical phantoms and simulated patient data are presented.

Identical Quality Assurance for Volumetric Modulated Arc Therapy in Elekta and Varian Machines.

Volumetric modulated arc therapy (VMAT) has been adopted by many clinics for its higher delivery efficiency compared to conventional intensity modulated radiotherapy techniques. Currently, the quality assurance (QA) has remained a challenge in that no identical tests are available for accelerators from different vendors. This study is the first attempt to design identical QA tests for the VMAT technique for Varian and Elekta machines. Identical procedures testing MLC positions and movements, dose rate variations, and gantry positions and movement were created for both machines. These included picket fence (PF), dose rate vs. gantry speed (DRGS) and MLC speed vs. dose rate (MLCDR) tests. Deliverable plans for these tests were made with in-house software that was deliverable for linacs from two vendors (Elekta Synergy and Varian Trilogy). The electronic portal imaging device (EPID) was used for these tests. An automated analysis method was established and software was created to quantitatively evaluate the result. The systematic gap position and width errors from PF tests were within 0.5 mm. We evaluated the detectability of this program for introduced errors down to 0.2 mm. Linear relationships existed between the introduced errors and measured errors. In the DRGS test, 99.8% and 100.0% of the intensity deviations from expected profiles were less than 3% for the Synergy and Trilogy, respectively. For the MLCDR, the intensity deviations from expected profiles less than 3% were 100.0% for Synergy and 98.1% for Trilogy. Identical test series were created and implemented for VMAT accelerators from two vendors. Test results were reported from both accelerators. Comparable results were obtained from both vendors, enabling uniform criteria to be established for VMAT quality assurance.

DICOM-RT Plan Complexity Verification for Volumetric Modulated Arc Therapy

The purpose of this study was to investigate the relationship between plan parameters verified with DICOM-RT and dosimetric results for volumetric modulated arc therapy (VMAT). We investigated three treatment locations: prostate cancer (ten cases), maxillary sinus cancer (four cases), and malignant pleura mesothelioma (four cases) with treatment plans generated by a MonacoTM treatment planning system (TPS), and delivered with an Elekta SynergyTM linear accelerator. We calculated plan parameters, including gantry and multileaf collimator (MLC) positions, Monitor Units (MU), and millimeters of MLC motion per degree of gantry rotation (mm/degree), and performed quality assurance (QA) with a DICOM-RT plan verification system. We measured the VMAT dose with a two-dimensional diode array detector. The average gamma passing rate with percent dose acceptance criteria and distance to agreement criteria of 2 mm and 2% (2 mm/2%) were 97.4%, 97.8% and 92.0% for prostate cancer, maxillary sinus cancer, and malignant pleural mesothelioma, respectively. The mean 95th percentile value for DICOM-calculated mm/degree was 4.0, 5.2, and 11.1 for prostate cancer, maxillary sinus cancer, and malignant pleural mesothelioma, respectively. The gamma passing rate showed a correlation with calculated mm/degree, with a coefficient of determination (R2) of 0.60. Higher calculated mm/degree values led to increased dosimetric errors. We conclude that dose distribution calculated by a TPS is more reliable at smaller mm/degree.

Three-Degree-of-Freedom Dynamic Model Based IT2RFNN Control for Gantry Position Stage

A three-degree-of-freedom (3-DOF) dynamic model based interval type-2 recurrent fuzzy neural network (IT2RFNN) control system is proposed in this study for a gantry position stage. To consider the effect of inter-axis mechanical coupling, a Lagrangian equation based 3-DOF dynamic model for gantry position stage is derived first. Then, to minimize the synchronous error and tracking error of the gantry position stage, the 3-DOF dynamic model based IT2RFNN control system is proposed. In this approach, the adaptive learning algorithms of the IT2RFNN on-line are derived from the Lyapunov stability theorem. Finally, some experimental results of optical inspection application are illustrated to show the validity of the proposed control approach.