Off-axis Dose Profiles Research Articles

Preliminary evaluation of a novel secondary check tool for intensity modulated radiotherapy treatment planning

PurposeTo evaluate the dosimetric accuracy of the Delta4 Insight (DI) secondary-check dosimetry system. MethodsAbsolute dosimetry in reference conditions, output factors, percent depth doses normalized and off-axis dose profiles for different field sizes calculated by DI were compared with measurements. Dose calculations for 20 clinical IMRT/VMAT plans generated in the TPS using both AAA or AcurosXB algorithms were compared with measurements. The average difference between calculated and measured point dose in high-dose region was calculated for all cases. 3D dose measurements were performed in Delta4 Phantom+ and a comparison between calculated and measured dose distributions was performed by means of the gamma analysis with 3 %/2 mm criteria. The dose distributions calculated by DI for 20 IMRT/VMAT plans were compared with those calculated by the TPS. ResultsThe absolute dosimetry computed by DI showed dose value in agreement with the measured one within 0.3 %. The average differences between measured and calculated output factors were less than 2.5 %. The average PDD differences were less than 0.6 %. An excellent agreement between calculations and off-axis measurements is found. The point doses calculated for the 20 recalculated plan showed good agreement with measurements with average differences less than 0.5 %. The average gamma pass rate values for the Delta4 Phantom + 3D dose analysis was greater than 97.%. The comparison of DI with theTPS showed good agreement for the used metrics. ConclusionsDelta4 Insight may provide a useful independent secondary dose verification system for IMRT/VMAT plans, complementing the traditional global QA protocols.

Dosimetric characteristics of the LIAC intraoperative radiotherapy beams: Assessment of sensitivity to measurement errors at the commissioning phase

Commissioning of the LIAC intraoperative electron radiotherapy (IOERT) unit relies on the vendor's SWL-LIAC software. This software simulates the percentage depth-doses (PDDs), off-axis dose profiles and relative output factors (ROFs) for all beams based on a small set of input measurements. To date, the impact of various possible measurement errors during commissioning on LIAC dosimetric characteristics has not been studied in detail. We aimed to assess the sensitivity of the dosimetric characteristics of the ‘LIAC 12 MeV’ IOERT unit beams to various measurement errors in the commissioning phase by obtaining the magnitude of the influence of each error.The required SWL-LIAC inputs (PDDs of applicator diameters 3, 7, and 10 cm and open field) were measured with intentional applicator misalignments including 1° rotation or lateral (2 mm) or vertical (±2 mm) displacements. Also, inaccurate water surface definition for the detector was simulated by using PDDs that were shifted by ±2 mm. The errors were applied one at a time. To identify the most influential errors, the computed relative dosimetric characteristics resulting from such erroneous measurement conditions were compared to the corresponding ‘error-free’ ones. The depths of 90% and 50% doses (R90 and R50, respectively) were investigated further.All the resulting errors in R90, R50, flatness, symmetry and penumbra were within 3.9 mm, 2.8 mm, 4.3%, 4.6% and 3.5 mm, respectively. The overall averages of the absolute differences in these indices from the error-free fields were 0.8 mm, 0.8 mm, 0.6%, 0.4% and 0.5 mm, respectively. Errors in water surface definition for the detector had 4.4 to 22 times greater influence on PDDs than the other errors. The corresponding values for the profiles were 1.3–5.8 times. Among the errors in applicator alignment, PDDs and profiles were more affected by rotational and vertical ‘stand-in’ applicator misalignments, respectively. The R90 and R50 values were less affected by the errors in the small (3 and 4 cm diameter) and 45° bevelled applicators.To conclude, on average, the studied errors caused relatively small changes in beam characteristics although the maximum magnitudes of the observed errors were fairly substantial. Among the investigated errors, defining the water surface inaccurately has the largest impact on the dosimetric characteristics. Overall, sensitivity to the studied errors was found to be greatest with large-diameter flat applicators and/or lower electron energies. Although individual errors in applicator alignment have less effect on dosimetric characteristics compared to water surface error, given that these errors may occur simultaneously during dosimetry, special attention should be paid to placing the applicator correctly at the surface. Special set-up aids, such as our in-house tool for aligning applicators, are therefore indicated. The findings also further highlight the need for checking the water level periodically in long-term dosimetry procedures.

Monte Carlo study of small-field dosimetry for an ELEKTA Unity MR-Linac system

This study aims to investigate the magnetic field effect in small-field dosimetry for an ELEKTA Unity MR-Linac system using Monte Carlo (MC) simulations. The EGSnrc/BEAMnrc code was used to simulate the MR-Linac treatment head. The percentage depth-doses (PDDs) and off-axis dose profiles were calculated for field sizes of 2 cm × 2 cm and 10 cm × 10 cm using the DOSXYZnrc code, while the output factors were calculated with the egs_chamber code. The dose profiles and output factors were calculated at a depth of 10 cm in water with a 143.5 cm source-axis-distance. The output factors for the detectors with different sensitive volumes were compared with previously measured values. The kQ,B was also calculated. The accuracy of the simulated beam was validated by comparing the MC-calculated PDDs and dose profiles with previously measured values, which agreed within 2% except the penumbra region. The output factors of the ion chambers decreased rapidly depending on the sensitive volumes of small fields. The output factors of the PTW-31022 agreed within 2% with those in a water slab down to a 1 cm × 1 cm field. The output factors of PTW-31021 and PTW-31022 chambers and PTW-60018 diode agreed within 2% with previously measured values. The kQ,B values for PTW-30013, PTW-31010, PTW-31021, and PTW-31022 chambers were 0.974 ± 0.14%, 0.976 ± 0.26%, 0.977 ± 0.21%, and 0.995 ± 0.36%, respectively. The calculated output factors for the detectors showed good agreement with previously measured values. The magnetic field effect was small in ionization chambers with the small cavity radius.

Independent validation of a dedicated commissioning software and investigation of the direction dependence of the field symmetry for the LIAC intraoperative electron radiotherapy accelerator

Commissioning of the LIAC intraoperative electron radiotherapy accelerator relies heavily on the manufacturer's SWL-LIAC simulation software, which substantially reduces the number of difficult-to-set-up measurements needed. The aim of this study was to independently validate the accuracy of SWL-LIAC's calculated outputs, namely, percentage depth-doses (PDDs), off-axis dose profiles and relative output factors (ROFs), against experimental data. For all the available energies (6, 8, 10, 12 MeV), PDD measurements were made for all sizes of the flat-ended applicators (3–10 cm) and several beveled applicators. Profiles and ROFs were measured for the more frequently used applicators in clinical practice and the reference 10 cm diameter applicator. Meticulous measurements were made using a p-type electron diode in a water phantom, aided by inhouse custom-made positioning tools and confirmed using radiochromic film dosimetry. The measured and calculated scans were compared using multi-criteria gamma analysis. Eighty-five percent of the calculated ROFs showed a 2% or better agreement with the measurements. The average gamma passing rate for PDDs was 100% using a 2mm/1% (global dose difference) criterion. Repeated measurements showed that the measured in-plane profiles were somewhat tilted, which was confirmed by the manufacturer. The average gamma passing rate of all profiles was 95.5% (2mm/3%); Without considering in-plane profiles, this value was 97.6%. It can be concluded that the accuracy of the SWL-LIAC calculations may be deemed acceptable for most clinical applications. However, assuming isotropic off-axis profiles is unwarranted and measuring profiles in both directions for all energies at installation and acceptance testing is indicated.

Modeling the head of PRIMUS linear accelerator for electron-mode at 10 MeV for different applicators.

ObjectiveThis study is to validate the utilization of Monte Carlo (MC) simulation to model the head of Primus linear accelerator, thereafter, using it to estimate the energy fluence distribution (EFD), the percentage depth dose (PDD), and beam profiles.Materials and MethodsThe BEAMNRC code that is based on the EGSNRC code has been used for modeling the linear accelerator head for 10 MeV electron beam with different applicator sizes (10 × 10, 15 × 15, and 20 × 20 cm2). The phase space was acquired from BEAMNRC at the end of each applicator and then used as an input file to DOSXYZNRC and BEAMDP to calculate the EFD, PDD, and beam profiles.ResultsThere were a good consistency between the outcomes of the MC simulation and measured PDD and off‐axis dose profiles that performed in a water phantom for all applicators. The PDD for the applicators proved to be favorable as a direct comparison of R100, R90, R80, and R50 yielded results of < 2 mm, while it was 6 mm in R100 for the applicator 15 × 15 cm2. The discrepancies in the surface doses (<3%) showed a quick decline in the build‐up region and differences reached 0% within the first 2.4 mm. For the beam profiles comparison, the differences ranged from 2% (2 mm) to 3% (6 mm) for all applicators.ConclusionOur examination demonstrated that the MC simulation by BEAMNRC code was accurate in modeling the Primus linear accelerator head.

3D printing for rapid prototyping of low-Z/density ionization chamber arrays.

To explore 3D printing for rapid development of prototype thin slab low-Z/density ionization chamber arrays viable for custom needs in radiotherapy dosimetry and quality assurance (QA). We designed and fabricated parallel plate ionization chambers and ionization chamber arrays using an off-the-shelf 3D printing equipment. Conductive components of the detectors were made of conductive polylactic acid (cPLA) and insulating components were made of acrylonitrile butadiene styrene (ABS). We characterized the detector responses using a Varian TrueBeam linac at 95cm SSD in slab solid water phantom at 5cm depth. We measured the current-voltage (IV) curves, the response to different energy beam lines (2.5 MV, 6 MV, 6 MV FFF) for various dose rates and compared them to responses of a commercial Exradin A12 ionization chamber. We measured off-axis ratio (OAR) for several small field static multi-leaf collimators field sizes (0.5-3cm) and compared them to OAR data obtained for commissioning of stereotactic radiotherapy. We identified the printing capability and the limitations of a low-cost off-the-shelf 3D printer for rapid prototyping of detector arrays. The design of the array with sub-millimeter size features conformed to the 3D printing capabilities. IV-curve for the array showed a strong polarity effect (8%) due to the design. Results for the parallel plate and the array compared well with A12 chamber: monitor unit (MU) dependence for the array was within a few % and the response to different energy beam lines was within 1%. Off-axis dose profiles measured with the array were comparable to dose profiles obtained in water tank and stereotactic diode after accounting for the size of the chambers. Dose error was within 2% at the center of the profile and slightly larger at the penumbra. Rapid prototyping of ion chambers by means of low-cost 3D printing is feasible with certain limitations in the design and spatial accuracy of the printed details.

Radiation leakage dose from Elekta electron collimation system.

This study provided baseline data required for a greater project, whose objective was to design a new Elekta electron collimation system having significantly lighter electron applicators with equally low out‐of field leakage dose. Specifically, off‐axis dose profiles for the electron collimation system of our uniquely configured Elekta Infinity accelerator with the MLCi2 treatment head were measured and calculated for two primary purposes: 1) to evaluate and document the out‐of‐field leakage dose in the patient plane and 2) to validate the dose distributions calculated using a BEAMnrc Monte Carlo (MC) model for out‐of‐field dose profiles. Off‐axis dose profiles were measured in a water phantom at 100 cm SSD for 1 and 2 cm depths along the in‐plane, cross‐plane, and both diagonal axes using a cylindrical ionization chamber with the 10×10 and 20×20 cm2 applicators and 7, 13, and 20 MeV beams. Dose distributions were calculated using a previously developed BEAMnrc MC model of the Elekta Infinity accelerator for the same beam energies and applicator sizes and compared with measurements. Measured results showed that the in‐field beam flatness met our acceptance criteria (±3% on major and ±4% on diagonal axes) and that out‐of‐field mean and maximum percent leakage doses in the patient plane met acceptance criteria as specified by the International Electrotechnical Commission (IEC). Cross‐plane out‐of‐field dose profiles showed greater leakage dose than in‐plane profiles, attributed to the curved edges of the upper X‐ray jaws and multileaf collimator. Mean leakage doses increased with beam energy, being 0.93% and 0.85% of maximum central axis dose for the 10×10 and 20×20 cm2 applicators, respectively, at 20 MeV. MC calculations predicted the measured dose to within 0.1% in most profiles outside the radiation field; however, excluding modeling of nontrimmer applicator components led to calculations exceeding measured data by as much as 0.2% for some regions along the in‐plane axis. Using EGSnrc LATCH bit filtering to separately calculate out‐of‐field leakage dose components (photon dose, primary electron dose, and electron dose arising from interactions in various collimating components), MC calculations revealed that the primary electron dose in the out‐of‐field leakage region was small and decreased as beam energy increased. Also, both the photon dose component and electron dose component resulting from collimator scatter dominated the leakage dose, increasing with increasing beam energy. We concluded that our custom Elekta Infinity with the MLCi2 treatment head met IEC leakage dose criteria in the patient plane. Also, accuracy of our MC model should be sufficient for our use in the design of a new, improved electron collimation system.PACS number(s): 87.56.nk, 87.10.Rt, 87.56.J

SU-F-BRA-07: Dosimetric Verification of the Valencia Skin Applicator Using Gafchromic EBT3 Film

Purpose: The Valencia applicators have recently been introduced for HDR treatment of small and shallow superficial skin lesions (< 20 mm diameter and 3-mm depth). Per AAPM TG 56, any HDR applicator internal dimensions must be verified prior to clinical use. However radiographic and tomographic imaging to validate the Valencia applicators is impractical due to the Tungsten alloy housing and flattening filter. In this study, we propose to use EBT3 film to indirectly confirm the physical integrity of the Valencia applicators. Methods: Treatment plans were created using the Oncentra MasterPlan TPS v4.5 for the H2 (20-mm dia.) and H3 (30-mm dia.) Valencia Applicators. A virtual CT phantom (2-mm slice thickness) was created with one source position in water. The published effective depth method was used for each applicator to delivery 500 cGy to a 3-mm depth using the TG-43 formalism. Film measurements (n=3) at 3-mm depth and vertical plane in solid water were performed for each applicator to verify the prescribed dose calculated by the TPS. Percent depth dose curves and off-axis profiles (phantom surface and 3-mm depth) were measured and compared to published data. Films were analyzed using an in-house written program and RIT113 v6 software. Film calibration was performed per TG-55 protocol using the Ir-192 source with NIST-traceable calibration. Results: The prescription absolute dose difference was 1% for the Valencia H2 applicator and 4% for the Valencia H3 applicator. The measured percent depth dose curves and off-axis dose profiles measured for the H2 and H2 Valencia applicators are in excellent agreement with the Granero et al. Monte Carlo results1. Conclusion: Gafchromic EBT3 film can be used to indirectly verify the internal components of special HDR skin applicators constructed from high Z materials.1Granero et al. “Design and evaluation of a HDR skin applicator with flattening filter”, Med. Phys. 35(2), 495–503, 2008

Properties of a commercial PTW-60019 synthetic diamond detector for the dosimetry of small radiotherapy beams

A CVD based radiation detector has recently become commercially available from the manufacturer PTW-Freiburg (Germany). This detector has a sensitive volume of 0.004 mm3, a nominal sensitivity of 1 nC Gy−1 and operates at 0 V. Unlike natural diamond based detectors, the CVD diamond detector reports a low dose rate dependence. The dosimetric properties investigated in this work were dose rate, angular dependence and detector sensitivity and linearity. Also, percentage depth dose, off-axis dose profiles and total scatter ratios were measured and compared against equivalent measurements performed with a stereotactic diode. A Monte Carlo simulation was carried out to estimate the CVD small beam correction factors for a 6 MV photon beam. The small beam correction factors were compared with those obtained from stereotactic diode and ionization chambers in the same irradiation conditions The experimental measurements were performed in 6 and 15 MV photon beams with the following square field sizes: 10 × 10, 5 × 5, 4 × 4, 3 × 3, 2 × 2, 1.5 × 1.5, 1 × 1 and 0.5 × 0.5 cm. The CVD detector showed an excellent signal stability (<0.2%) and linearity, negligible dose rate dependence (<0.2%) and lower response angular dependence. The percentage depth dose and off-axis dose profiles measurements were comparable (within 1%) to the measurements performed with ionization chamber and diode in both conventional and small radiotherapy beams. For the 0.5 × 0.5 cm, the measurements performed with the CVD detector showed a partial volume effect for all the dosimetric quantities measured. The Monte Carlo simulation showed that the small beam correction factors were close to unity (within 1.0%) for field sizes ≥1 cm. The synthetic diamond detector had high linearity, low angular and negligible dose rate dependence, and its response was energy independent within 1% for field sizes from 1.0 to 5.0 cm. This work provides new data showing the performance of the CVD detector compared against a high spatial resolution diode. It also presents a comparison of the CVD small beam correction factors with those of diode and ionization chamber for a 6 MV photon beam.

Determining optimization of the initial parameters in Monte Carlo simulation for linear accelerator radiotherapy

Monte Carlo (MC) method is a well known calculation algorithm which can accurately assess the dose distribution for radiotherapy. The present study investigated all the possible regions of the depth-dose or lateral profiles which may affect the fitting of the initial parameters (mean energy and the radial intensity (full width at half maximum, FWHM) of the incident electron). EGSnrc-based BEAMnrc codes were used to generate the phase space files (SSD=100cm, FS=40×40cm2) for the linac (linear accelerator, Varian 21EX, 6MV photon mode) and EGSnrc-based DOSXYZnrc code was used to calculate the dose in the region of interest. Interpolation of depth dose curves of pre-set energies was proposed as a preliminary step for optimal energy fit. A good approach for determination of the optimal mean energy is the difference comparison of the PDD curves excluding buildup region, and using D(10) as a normalization method. For FWHM fitting, due to electron disequilibrium and the larger statistical uncertainty, using horn or/and penumbra regions will give inconsistent outcomes at various depths. Difference comparisons should be performed in the flat regions of the off-axis dose profiles at various depths to optimize the FWHM parameter.

SU-E-T-289: On the Use of a Diode Array for the Commissioning of Dynamically-Wedged Asymmetric Fields Generated by Varian EDW's in the Pinnacle Treatment Planning System.

To present a validation study of enhanced dynamic wedges (EDWs) implemented into Pinnacle3 treatment planning system (TPS) using a diode array, Monte Carlo (MC) simulation, and measurements. Modeling of EDW dose distribution in the Pinnacle3 TPS is based on a combination of open-field beam data and the Varian 'Golden Segmented Treatment Table' (GSTT) unique to each photon beam. To validate the EDW models, dose profiles of 6- and 10-MV photon beams from a Clinac 2100C/D were measured in virtual water at depths from near- surface to 30 cm for a wide range of asymmetric field sizes and wedge angles using the Profiler-2 diode array system. The EDW output factors for asymmetric fields were measured in solid water using a small-volume cylindrical ionization chamber placed at a depth of 10 cm on the central axis. In addition, absolute doses on central axis at depths of 5, 10, 15 and 20 cm were measured in virtual water using a small-volume cylindrical chamber for comparison with the collapsed-cone convolution (CCC) calculations. The 6- and 10-MV photon beams emerging from the treatment head of the Clinac 2100C/D were fully simulated using the Monte Carlo code BEAMnrc and DOSXYZnrc. This code was used to calculate the central-axis percentage depth doses and dose profiles for the open and dynamically-wedged fields in a water phantom. The off-axis dose profiles of various EDWs computed with the CCC dose model and MC simulations agreed with measured EDW dose distributions to an accuracy of better than 2%/2 mm. Measured EDW output factors used for MU calculations in Pinnacle3 TPS agreed with MC predictions within 1-2%. The utility of Profiler-2 diode array system to measure dose profiles for commissioning of EDWs into the Pinnacle3 TPS has been demonstrated to have acceptable accuracy for clinical implementation.

Monte Carlo modeling and simulations of the High Definition (HD120) micro MLC and validation against measurements for a 6 MV beam

The most recent Varian(®) micro multileaf collimator (MLC), the High Definition (HD120) MLC, was modeled using the BEAMNRC Monte Carlo code. This model was incorporated into a Varian medical linear accelerator, for a 6 MV beam, in static and dynamic mode. The model was validated by comparing simulated profiles with measurements. The Varian(®) Trilogy(®) (2300C/D) accelerator model was accurately implemented using the state-of-the-art Monte Carlo simulation program BEAMNRC and validated against off-axis and depth dose profiles measured using ionization chambers, by adjusting the energy and the full width at half maximum (FWHM) of the initial electron beam. The HD120 MLC was modeled by developing a new BEAMNRC component module (CM), designated HDMLC, adapting the available DYNVMLC CM and incorporating the specific characteristics of this new micro MLC. The leaf dimensions were provided by the manufacturer. The geometry was visualized by tracing particles through the CM and recording their position when a leaf boundary is crossed. The leaf material density and abutting air gap between leaves were adjusted in order to obtain a good agreement between the simulated leakage profiles and EBT2 film measurements performed in a solid water phantom. To validate the HDMLC implementation, additional MLC static patterns were also simulated and compared to additional measurements. Furthermore, the ability to simulate dynamic MLC fields was implemented in the HDMLC CM. The simulation results of these fields were compared with EBT2 film measurements performed in a solid water phantom. Overall, the discrepancies, with and without MLC, between the opened field simulations and the measurements using ionization chambers in a water phantom, for the off-axis profiles are below 2% and in depth-dose profiles are below 2% after the maximum dose depth and below 4% in the build-up region. On the conditions of these simulations, this tungsten-based MLC has a density of 18.7 g cm(- 3) and an overall leakage of about 1.1 ± 0.03%. The discrepancies between the film measured and simulated closed and blocked fields are below 2% and 8%, respectively. Other measurements were performed for alternated leaf patterns and the agreement is satisfactory (to within 4%). The dynamic mode for this MLC was implemented and the discrepancies between film measurements and simulations are within 4%. The Varian(®) Trilogy(®) (2300 C/D) linear accelerator including the HD120 MLC was successfully modeled and simulated using the Monte Carlo BEAMNRC code by developing an independent CM, the HDMLC CM, either in static and dynamic modes.

A novel cerrobend block in the radiation therapy

This study was carried out to look for the substitute products of lead cerrobend block and determine whether the products can give more radiation dose to the tumor in the skin and superficial tumors in radiotherapy treatment. Five kinds of PbO/Er2O3/Epoxy(E-51) samples used as the cerrobend block in the electron beam radiotherapy treatment were prepared successfully by a solidified forming approach. The central axis depth dose and off-axis dose profiles in the water phantom were calculated using BEAMnrc/DOSEXYZnrc user codes. The results revealed that there were more energy deposition events induced by low energy electron beams in the surface of the water phantom. These electron beams were attributed to Compton scattering and photoemission between photons and erbium, plumbum elements. The maximum dose (Dm) and the depth at the maximum dose (Rm) were linearly dependent on the mass fraction of erbium and plumbum element in the sample. The max dose and its depth varied depending on the combined actions of new electrons and transmission electrons.

Study of the response of plastic scintillation detectors in small‐field 6 MV photon beams by Monte Carlo simulations

To investigate the response of plastic scintillation detectors (PSDs) in a 6 MV photon beam of various field sizes using Monte Carlo simulations. Three PSDs were simulated: A BC-400 and a BCF-12, each attached to a plastic-core optical fiber, and a BC-400 attached to an air-core optical fiber. PSD response was calculated as the detector dose per unit water dose for field sizes ranging from 10 x 10 down to 0.5 x 0.5 cm2 for both perpendicular and parallel orientations of the detectors to an incident beam. Similar calculations were performed for a CC01 compact chamber. The off-axis dose profiles were calculated in the 0.5 x 0.5 cm2 photon beam and were compared to the dose profile calculated for the CC01 chamber and that calculated in water without any detector. The angular dependence of the PSDs' responses in a small photon beam was studied. In the perpendicular orientation, the response of the BCF-12 PSD varied by only 0.5% as the field size decreased from 10 x 10 to 0.5 x 0.5 cm2, while the response of BC-400 PSD attached to a plastic-core fiber varied by more than 3% at the smallest field size because of its longer sensitive region. In the parallel orientation, the response of both PSDs attached to a plastic-core fiber varied by less than 0.4% for the same range of field sizes. For the PSD attached to an air-core fiber, the response varied, at most, by 2% for both orientations. The responses of all the PSDs investigated in this work can have a variation of only 1%-2% irrespective of field size and orientation of the detector if the length of the sensitive region is not more than 2 mm long and the optical fiber stems are prevented from pointing directly to the incident source.

Poster - Thur Eve - 73: Dosimetric Performance of Radionics Mini-MLC on Elekta Synergy S Linear Accelerator: A Monte Carlo Evaluation

This work contributed new information of dosimetric evaluation of Radionics mini-multileaf collimator (MMLC) attached on the head of an Elekta Synergy S linear accelerator using Monte Carlo simulations. The penumbrae, depth and lateral dose profiles of the Radionics MMLC for the 6 MV photon beams, were determined first time using the EGSnrc-based Monte Carlo codes (BEAMnrc) verified by measurements. The Monte Carlo modelled MMLC has a maximum field size of 9.6 × 12 cm2 and 3.8 mm leaf thickness at the isocenter. Monte Carlo verification was carried out using CC13 Wellhofer ionization chamber (cavity volume = 0.13 cm3) and a Wellhofer water tank for measurements. Dosimetric parameters such as the penumbrae, percentage depth doses, the in-plane and cross-plane off-axis dose profiles were measured and calculated for different field sizes and depths. Penumbra widths (80%−20%) for the reference field of 9.6 × 10.4 cm2 at the isocenter with a depth of 10 cm were 4.8 and 5.1 mm for the leaf-sides and leaf-ends, respectively. The corresponding values of penumbrae at depths of 1.5 and 5 cm were 3.6 and 4.2 mm for the leaf-sides and 3.8 and 4.5 mm for the leaf-ends. Dosimetric results based on our Monte Carlo model demonstrated excellent agreement to within 1% or 1 mm when compared to measurements. Our Monte Carlo model for the MMLC is expected to benefit the commissioning of the stereotactic radiosurgery planning for the small intracranial and extracranial lesions.

Verification of Varian enhanced dynamic wedge implementation in MasterPlan treatment planning system

This paper investigates the accuracy of the two available calculation algorithms of the Oncentra MasterPlan three‐dimensional treatment planning system (TPS) – the pencil beam method and collapsed‐cone convolution – in modeling the Varian enhanced dynamic wedge (EDW). Measurements were carried out for a dual high energy (6–15 MV) Varian DHX‐S linear accelerator using ionization chambers for beam axis measurements (wedge factors and depth doses), film dosimetry for off‐axis dose profiles measurements, and a diode matrix detector for two dimensional absolute dose distributions. Using both calculation algorithms, different configuration of symmetric and asymmetric fields varying the wedge's angle were tested. Accuracy of the treatment planning system was evaluated in terms of percentage differences between measured and calculated values for wedge factors, depth doses, and profiles. As far as the absolute dose distribution was concerned, the gamma index method (Low et al. (13) ) was used with 3% and 3 mm as acceptance criteria for dose difference and distance‐to‐agreement, respectively. Wedge factors and percentage depth doses were within 1% deviation between calculated and measured values. The comparison of measured and calculated dose profiles shows that the Van Dyk's acceptance criteria (Van Dyk et al. (14) ) are generally met; a disagreement can be noted for large wedge angles and field size limited to the low dose‐low gradient region only. The 2D absolute dose distribution analysis confirms the good accuracy of the two calculation algorithms in modeling the enhanced dynamic wedge.PACS number: 87.53.Bn, 87.55.kn, 87.56.ng

Clinical implementation of enhanced dynamic wedges into the Pinnacle treatment planning system: Monte Carlo validation and patient-specific QA

The goal of this work is to present a systematic Monte Carlo validation study on the clinical implementation of the enhanced dynamic wedges (EDWs) into the Pinnacle3 (Philips Medical Systems, Fitchburg, WI) treatment planning system (TPS) and QA procedures for patient plan verification treated with EDWs. Modeling of EDW beams in the Pinnacle3 TPS, which employs a collapsed-cone convolution superposition (CCCS) dose model, was based on a combination of measured open-beam data and the ‘Golden Segmented Treatment Table’ (GSTT) provided by Varian for each photon beam energy. To validate EDW models, dose profiles of 6 and 10 MV photon beams from a Clinac 2100 C/D were measured in virtual water at depths from near-surface to 30 cm for a wide range of field sizes and wedge angles using the Profiler 2 (Sun Nuclear Corporation, Melbourne, FL) diode array system. The EDW output factors (EDWOFs) for square fields from 4 to 20 cm wide were measured in virtual water using a small-volume Farmer-type ionization chamber placed at a depth of 10 cm on the central axis. Furthermore, the 6 and 10 MV photon beams emerging from the treatment head of Clinac 2100 C/D were fully modeled and the central-axis depth doses, the off-axis dose profiles and the output factors in water for open and dynamically wedged fields were calculated using the Monte Carlo (MC) package EGS4. Our results have shown that (1) both the central-axis depth doses and the off-axis dose profiles of various EDWs computed with the CCCS dose model and MC simulations showed good agreement with the measurements to within 2%/2 mm; (2) measured EDWOFs used for monitor-unit calculation in Pinnacle3 TPS agreed well with the CCCS and MC predictions within 2%; (3) all the EDW fields satisfied our validation criteria of 1% relative dose difference and 2 mm distance-to-agreement (DTA) with 99–100% passing rate in routine patient treatment plan verification using MapCheck 2D diode array.

Optical imaging analysis of microscopic radiation dose gradients in Gafchromic EBT film using a digital microscope

By providing superior localization and immobilization, stereotactic radiosurgery (SRS) is capable of delivering millimeter spheres of dose to intracranial targets with submillimeter precision. Several authors have proposed new SRS solutions to dramatically reduce beam penumbra to hundreds of microns. These solutions require new quality assurance methods capable of penumbra measurement at the micron scale. This article examines the capability of a digital microscope, with translation stage and associated software, to resolve dose gradients in Gafchromic EBT film at this level. To produce very steep penumbra, films were irradiated in phantom beneath pinhole collimators using lower energy x rays (100 kVp, 300 kVp, and Iridium-192) and minimal geometric penumbra contribution. For film analysis, a method was developed which improved the signal to noise ratio by finding the center of the irradiation spot, generating several radial dose profiles and averaging these to obtain the final off-axis dose profile. Optical density was converted to dose using a calibration curve. The experimentally determined off-axis dose profiles were compared with MCNP Monte Carlo simulations which replicated the irradiation geometry and served to validate our measured data. The measured 80%-20% penumbral widths were 46 microm +/- 26 microm (100 kVp, 2 mm field size), 69 microm +/- m 27 microm (300 kVp, 2 mm field size), and 241 microm +/-31 microm (Ir-192, 1 mm field size). These penumbral widths agreed with Monte Carlo simulations within experimental uncertainty. Our findings suggest that reading Gafchromic EBT films using a digital microscope with translation stage is suitable for the quality assurance of very sharp penumbra able to resolve gradients to within at least 30 microm.

Sci-Thurs PM: Delivery-03: Optical imaging of microscopic radiation dose gradients using a digital microscope.

Using superior localization and immobilization methods, stereotactic radiosurgery is capable of delivering spheres of dose as small as a few millimetres in diameter to intracranial targets. For targets abutting critical structures, the most conformal treatments minimize adverse radiation side effects and it is important, therefore, to ensure proper quality assurance prior to delivering high doses of radiation to eloquent brain locations in a single fraction. This work examines the capability of a digital microscope, with translation stage and associated software, to resolve dose gradients in Gafchromic EBT™ film at the micron level. In order to validate the microscope-film system from a radiation physics approach, films were irradiated to produce very steep penumbrae by using very small fields, lower photon energies and minimal geometric penumbra contribution. Orthovoltage film irradiations were done by placing films in phantom beneath pinhole collimators. The experimentally determined off-axis dose profiles were compared with Monte Carlo computer simulations which replicated the irradiation geometry and served to validate our measured data. The measured 80% - 20% penumbral widths were 46 μm ± 26 μm (100 kVp, 2 mm field size) and 69 μm ± 27 μm (300 kVp, 2 mm field size). In the energy range covered, the measured penumbral widths agreed with Monte Carlo computer simulations within experimental uncertainty. The effects of noise originating from both the film and the microscope system are discussed and improvements to this system suggested.

Experimental verification and clinical implementation of a commercial Monte Carlo electron beam dose calculation algorithm

This study describes the modeling and the experimental verification and clinical implementation of the alpha release of Pinnacle3 Monte Carlo (MC) electron beam dose calculation algorithm for patient-specific treatment planning. The MC electron beam modeling was performed for beam energies ranging from 6 to 18 MeV from a Siemens (Primus) linear accelerator using standard-shaped electron applicators and 100 cm source-to-surface distance (SSD). The agreement between MC calculations and measurements was, on average, within 2% and 2 mm for all applicator sizes. However, differences of the order of 3%-4% were noted in the off-axis dose profiles for the largest applicator modeled and for all energies. Output factors were calculated for standard electron cones and square cutouts inserted in the 10 x 10 cm2 applicator for different SSDs and were found to be within 4% of measured data. Experimental verification of the MC electron beam model was carried out using an ionization chamber and film in solid-water slab and anthropomorphic phantoms containing bone and lung materials. Agreement between calculated and measured dose distributions was within +/-3%. Clinical comparison was performed in four patient treatment plans with lesions in highly irregular anatomies, such as the ear, face, and breast, where custom-designed bolus and field shaping blocks were used in the patient treatments. For comparison purposes, treatment planning was also performed using the conventional pencil beam (PB) algorithm with the Pinnacle3 treatment planning system. Differences between MC and PB dose calculations for the patient treatment plans were significant, particularly in anatomies where the target was in close proximity to low density tissues, such as lung and air cavities. Concerning monitor unit calculations, the largest differences obtained between MC and PB algorithms were between 4.0% and 5.0% for two patients treated with oblique beams and involving highly irregular surfaces, i.e., breast and cheek. Clinical results are reported for overall uncertainty values (averaged over voxels with doses >50% dosemax) ranging from 2% to 0.3% and calculations were performed using cubic voxels with side 0.3 cm. Timing values ranged from 2 min to 24.5 h, depending on the field size, beam energy, number, and thickness of computed tomography slices used to define the patient's anatomy for the overall uncertainty values mentioned above.