Percentage Depth Dose Research Articles

Evaluating the performance of thermoplastic 3D bolus used in radiation therapy

A 3D-printed bolus is being developed to deliver accurate doses to superficial cancers. In this study, flexible thermoplastic filaments, specifically PLA, TPU, PETG, and HIPS, were fabricated into boluses and then compared to commercial bolus for the variation of the dose elevation region of photon beams. The experimental results indicate that the maximum dose depth is similar, and the consistent trend of the percentage depth dose confirms the potential usage as a build-up bolus.

Characterization of a commercial PIN diode for radiotherapy photon beam dosimetry

The dosimetric characterization of a commercial diode (BPW-34) was performed using a True Beam accelerator (Varian), with flattening filter (FF) photon beams of 6 and 15 MV and flattening filter free (FFF) of 6 MVFFF. The main performance characteristics, namely dose response, energy and dose rate dependence, field output factor, and percentage depth dose profile (PDD), were compared with those available in the literature and, whenever possible, benchmarked against the Varian Eclipse treatment planning system (TPS) predictions. Regardless of the energy, the results showed that the dose response curves are linear (R2 = 1) with nonlinearity parameters less than 0.1% and 0.3% of repeatability. Furthermore, the average dose rate effect (0.7%) is almost negligible within the range of 20–600 MU/min (6 MV, 15 MV) and 400–1400 MU/min (6 MVFFF). Despite these good results, the charge sensitivity measurements evidenced that the diode response depends slightly on the energy, being within 5% for 6 MV–15 MV. It is important to underline that all these results adhere to the standard radiotherapy dosimetry protocols. Moreover, the general output field factor measurements and the percentage depth dose profiles, which are in excellent agreement with the Eclipse TPS calculations, also demonstrated that the diode BPW-34 is a low-budget alternative radiotherapy photon beam dosimeter.

State-of-the-art silicon carbide diode dosimeters for ultra-high dose-per-pulse radiation at FLASH radiotherapy

Objective. The successful implementation of FLASH radiotherapy in clinical settings, with typical dose rates >40 Gy s−1, requires accurate real-time dosimetry. Approach. Silicon carbide (SiC) p–n diode dosimeters designed for the stringent requirements of FLASH radiotherapy have been fabricated and characterized in an ultra-high pulse dose rate electron beam. The circular SiC PiN diodes were fabricated at IMB-CNM (CSIC) in 3 μm epitaxial 4H-SiC. Their characterization was performed in PTB’s ultra-high pulse dose rate reference electron beam. The SiC diode was operated without external bias voltage. The linearity of the diode response was investigated up to doses per pulse (DPP) of 11 Gy and pulse durations ranging from 3 to 0.5 μs. Percentage depth dose measurements were performed in ultra-high dose per pulse conditions. The effect of the total accumulated dose of 20 MeV electrons in the SiC diode sensitivity was evaluated. The temperature dependence of the response of the SiC diode was measured in the range 19 °C–38 °C. The temporal response of the diode was compared to the time-resolved beam current during each electron beam pulse. A diamond prototype detector (flashDiamond) and Alanine measurements were used for reference dosimetry. Main results. The SiC diode response was independent both of DPP and of pulse dose rate up to at least 11 Gy per pulse and 4 MGy s−1, respectively, with tolerable deviation for relative dosimetry (<3%). When measuring the percentage depth dose under ultra-high dose rate conditions, the SiC diode performed comparably well to the reference flashDiamond. The sensitivity reduction after 100 kGy accumulated dose was <2%. The SiC diode was able to follow the temporal structure of the 20 MeV electron beam even for irregular pulse estructures. The measured temperature coefficient was (–0.079 ± 0.005)%/°C. Significance. The results of this study demonstrate for the first time the suitability of silicon carbide diodes for relative dosimetry in ultra-high dose rate pulsed electron beams up to a DPP of 11 Gy per pulse.

GATE Monte Carlo approach to heterogeneity dose distribution in small fields used in radiation therapy

The Accurate dosage prediction in Radiation Therapy is challenging, prompting a need for precision beyond conventional clinical Treatment Planning Systems (TPS). Monte Carlo-based methods are sought for their superior accuracy. The aim of this study is to compare dose distributions between the ACUROS algorithm and the GATE platform in various tissue densities and field sizes, focusing on smaller fields. This study was initiated with a homogeneous validation of the TrueBeam STX system, using measurements obtained from the Centre Hospitalier Interregional Edith Cavell (CHIREC) in Brussels. The validation compared dosimetric functions (Percentage Depth Dose (PDD), Dose profile (DP) and Collimator scatter fraction (CSF)) employing the GAMMA index with a 2% / 2 mm criterion tolerance. Following this, heterogeneous studies examined dose distributions between the ACUROS algorithm and the GATE platform in various tissue densities and field sizes, with a specific focus on smaller fields. Simulations were conducted using both platforms on chest phantoms with heterogeneous slabs representing bone, lung, and heart, each housing a central tumor. The impact of electronic equilibrium on tumors for different small field sizes was evaluated. Results showed a remarkable 99% agreement between measurements and GATE calculations in the homogeneous validation of the TrueBeam STX system. However, in heterogeneous studies, ACUROS consistently overestimated lung doses by up to 8% compared to GATE simulation, especially evident with a flattening filter and smaller beam sizes at density interfaces. This highlights significant dose estimation discrepancies between ACUROS and GATE, emphasizing the need for precise calculations. The findings support exploring Monte Carlo-based methods for enhanced accuracy in Radiation Therapy treatment planning.

Feasibility assessment of polycrystalline CsPbI3 relative dosimeters in photon and electron beam radiotherapy

Volumetric modulated arc therapy represents the latest technology in radiotherapy. It involves continuous modification of the multi-leaf collimator spatial distribution, dose rate, and gantry rotational speed, necessitating a dosimeter with high spatial resolution and exceptional sensitivity per unit volume. In particular, cesium-based inorganic perovskites have been studied for various applications, spanning from photoconductor solar cells to radiation detectors. These perovskites are renowned for their outstanding attributes, including thermal stability, inorganic stability, and light absorption capacity. Despite such advantageous characteristics, CsPbI3 materials have only been investigated in radiodiagnostics, with limited exploration in radiotherapy. To address this gap, this study verified the viability of CsPbI3 materials, note for their outstanding radiation detection efficiency, as dosimeters capable of measuring the radiation detection performance for radiotherapy devices. The reproducibility, linearity, and percent depth dose (PDD) were evaluated under the application of photon and electron beams in linear accelerators. The reproducibility assessment revealed impressive results, with the relative standard deviation registering at 0.53%, 0.32%, and 0.38% under electron beam energies of 6, 9, and 12 MeV and 0.45%, and 0.89% under photon beam energies of 6 and 15 MV. Moreover, the linearity test revealed an R 2 value of 0.9999, indicating high linearity, at 6, 9, and 12 MeV and at 6 and 15 MV. The PDD graphs drawn for the CsPbI3 dosimeter fabricated in this study showed that the D max points were consistent. The novel CsPbI3 dosimeter demonstrated a level of detection performance that satisfied all criteria; reproducibility, linearity, and PDD. The results collectively indicated that the CsPbI3 dosimeter can be used for dosimeters in radiotherapy devices.

Validation of Microionization Chambers in Small-field Dosimetry.

This study aims to validate the Razor Nano Chamber (RNC) and Razor Chamber (RC) dosimetric characteristics in a small field. The dosimetric parameters of the two chambers were compared. The chamber characteristics of leakage (pre and post), stability, energy dependency, dose linearity, dose rate effect, stem effect, angular dependency, ion recombination effect, and polarity effect were studied. Relative dose measurements of the percentage depth dose, profile measurement, and output factor (OF) measurements were performed for small fields. All measurements were performed in a Theratron 780E telecobalt unit and an Elekta Versa HD™ Linear Accelerator. The measured pre- and postirradiation leakage and energy dependency were within 0.5% of the acceptable limit. In the stability check, the standard error and standard error of mean were 0.047% and 0.068%, respectively, for both RNC and RC. The deviation in the angular responses of the RNC and RC ion chambers was negligible. In the ion recombination measurements, both the RNC and RC were overestimated for the 10 flattening filter-free photon beam. In small fields, there were no significant differences in the kpol values for either chamber. The RNC showed good agreement in the relative dose measurements compared to the RC. RNC and RC showed good agreement in small-field dosimetry. The RNC angular dependency and OF showed a superior response compared to the RC because of the small volume spherical shape and high spatial resolution, which gives a reduced penumbra and no volume averaging effect.

First Monte Carlo beam model for ultra-high dose rate radiotherapy with a compact electron LINAC.

FLASH radiotherapy based on ultra-high dose rate (UHDR) is actively being studied by the radiotherapy community. Dedicated UHDR electron devices are currently a mainstay for FLASH studies. To present the first Monte Carlo (MC) electron beam model for the UHDR capable Mobetron (FLASH-IQ) as a dose calculation and treatment planning platform for preclinical research and FLASH-radiotherapy (RT) clinical trials. The initial beamline geometry of the Mobetron was provided by the manufacturer, with the first-principal implementation realized in the Geant4-based GAMOS MC toolkit. The geometry and electron source characteristics, such as energy spectrum and beamline parameters, were tuned to match the central-axis percentage depth dose (PDD) and lateral profiles for the pristine beam measured during machine commissioning. The thickness of the small foil in secondary scatter affected the beam model dominantly and was fine tuned to achieve the best agreement with commissioning data. Validation of the MC beam modeling was performed by comparing the calculated PDDs and profiles with EBT-XD radiochromic film measurements for various combinations of applicators and inserts. The nominal 9 MeV electron FLASH beams were best represented by a Gaussian energy spectrum with mean energy of 9.9 MeV and variance (σ) of 0.2 MeV. Good agreement between the MC beam model and commissioning data were demonstrated with maximal discrepancy<3% for PDDs and profiles. Hundred percent gamma pass rate was achieved for all PDDs and profiles with the criteria of 2mm/3%. With the criteria of 2mm/2%, maximum, minimum and mean gamma pass rates were (100.0%, 93.8%, 98.7%) for PDDs and (100.0%, 96.7%, 99.4%) for profiles, respectively. A validated MC beam model for the UHDR capable Mobetron is presented for the first time. The MC model can be utilized for direct dose calculation or to generate beam modeling input required for treatment planning systems for FLASH-RT planning. The beam model presented in this work should facilitate translational and clinical FLASH-RT for trials conducted on the Mobetron FLASH-IQ platform.

Commissioning and Assessment of Radiation Field and Dose Inhomogeneity for a Dual X-ray Tube Cabinet Irradiator: To Ensure Accurate Dosimetry in Radiation Biology Experiments

PurposeStandardization of X-ray cabinet irradiators dose, geometry, and calibration reporting is an ongoing process. Multi-tube designs have been introduced onto the pre-clinical market and give a theoretical benefit but have not been widely assessed for use in pre-clinical irradiation conditions. The aim of this study was to report on our experience commissioning a dual x-ray source cabinet irradiator (CIXD, Xstrahl Limited, United Kingdom) and assess the dose distribution for various experimental conditions. Materials and MethodsHalf-value layer (HVL) measurement, profile measurements, and output calibration were performed with a calibrated ion chamber. Constancy measurements were performed twice daily over two weeks to assess output fluctuations. Film measurements were completed using solid water to assess percent depth dose and homogeneity within the field and within variable thickness of solid water and phosphate-buffered saline (PBS) solution. Film measurements were repeated for various arrangements of petri dishes filled with PBS or water and in a 3D printed mouse phantom. ResultsThe X-ray tubes measured in-air output was 1.27 Gy/min. The HVL was 1.7 mm Cu. The upper and lower tubes both exhibited the heel effect, but when operated simultaneously the effect was reduced. Ion chamber measurements revealed 15% dose inhomogeneity within the tray area (18 × 18 cm2). Film measurements in the petri dishes indicated minor non-uniformities with the arrangements of experimental apparatus. The mouse phantom with film agreed with ion chamber measurements for various phantom placement and orientations. ConclusionX-ray cell culture irradiation with the dual tube cabinet irradiation is efficient and robust when utilizing established dosimetric tools to confirm output and homogeneity. The conditions assumed for calibrations are often not maintained during experiments. We have confirmed that inhomogeneities are present for single tube use, however they are reduced with simultaneous tube use. Additional dosimetric monitoring should be performed for each unique irradiation setup.

Characterization of a flexible a-Si:H detector for in vivo dosimetry in therapeutic x-ray beams.

The increasing use of complex and high dose-rate treatments in radiation therapy necessitates advanced detectors to provide accurate dosimetry. Rather than relying on pre-treatment quality assurance (QA) measurements alone, many countries are now mandating the use of in vivo dosimetry, whereby a dosimeter is placed on the surface of the patient during treatment. Ideally, in vivo detectors should be flexible to conform to a patient's irregular surfaces. This study aims to characterize a novel hydrogenated amorphous silicon (a-Si:H) radiation detector for the dosimetry of therapeutic x-ray beams. The detectors are flexible as they are fabricated directly on a flexible polyimide (Kapton) substrate. The potential of this technology for application as a real-time flexible detector is investigated through a combined dosimetric and flexibility study. Measurements of fundamental dosimetric quantities were obtained including output factor (OF), dose rate dependence (DPP), energy dependence, percentage depth dose (PDD), and angular dependence. The response of the a-Si:H detectors investigated in this study are benchmarked directly against commercially available ionization chambers and solid-state diodes currently employed for QA practices. The a-Si:H detectors exhibit remarkable dose linearities in the direct detection of kV and MV therapeutic x-rays, with calibrated sensitivities ranging from (0.580±0.002) pC/cGy to (19.36±0.10) pC/cGy as a function of detector thickness, area, and applied bias. Regarding dosimetry, the a-Si:H detectors accurately obtained OF measurements that parallel commercially available detector solutions. The PDD response closely matched the expected profile as predicted via Geant4 simulations, a PTW Farmer ionization chamber and a PTW ROOS chamber. The most significant variation in the PDD performance was 5.67%, observed at a depth of 3mm for detectors operated unbiased. With an external bias, the discrepancy in PDD response from reference data was confined to±2.92% for all depths (surface to 250mm) in water-equivalent plastic. Very little angular dependence is displayed between irradiations at angles of 0° and 180°, with the most significant variation being a 7.71% decrease in collected charge at a 110° relative angle of incidence. Energy dependence and dose per pulse dependence are also reported, with results in agreement with the literature. Most notably, the flexibility of a-Si:H detectors was quantified for sample bending up to a radius of curvature of 7.98mm, where the recorded photosensitivity degraded by (-4.9±0.6)% of the initial device response when flat. It is essential to mention that this small bending radius is unlikely during in vivo patient dosimetry. In a more realistic scenario, with a bending radius of 15-20mm, the variation in detector response remained within±4%. After substantial bending, the detector's photosensitivity when returned to a flat condition was (99.1±0.5)% of the original response. This work successfully characterizes a flexible detector based on thin-film a-Si:H deposited on a Kapton substrate for applications in therapeutic x-ray dosimetry. The detectors exhibit dosimetric performances that parallel commercially available dosimeters, while also demonstrating excellent flexibility results.

Analysis of 70 - 300 MeV Proton Energy on Homogeneous and Inhomogeneous Phantoms using PHITS Monte Carlo Package

Proton therapy is a radiotherapy technique using proton particles for reach the target in a straight line and minimize damage to the surrounding tissue. Proton particles that penetrate the body will be deposited at a certain depth and produce a Bragg peak. This study aims to determine the percentage depth dose (PDD) produced by proton radiation in homogeneous and inhomogeneous phantoms. Homogeneous phantom contains water, bone, or lungs material, while inhomogeneous phantom consists of several materials, namely water, bone, and lungs. The interaction of phantom and proton radiation was simulated using the Monte Carlo-based PHITS software. The result indicate that the material density and the proton energy were influencing the dept of Bragg peak. For energy 70 MeV, the Bragg peak position for the water phantom, bone phantom, and lung phantom were 3.80 cm, 2.60 cm, and 15.8 cm. The increase of proton energy causes a deeper Bragg peak position.

On the gamma radiation response of commercially available 3D printing materials for medical dosimetry

3D printing technology has rapidly spread for decades, allowing the fabrication of medical implants and human phantoms and revolutionizing healthcare. The objective of this study is to evaluate some radiological properties of commercially available 3D printing materials as potential tissue mimicking materials. Among fifteen materials, we compared their properties with nine human tissues. In all materials and tissues, exposure and energy absorption buildup factors were calculated for photon energies between 0.015 and 15 MeV and penetration depths up to 40 mean free path. Furthermore, the Geant4 Monte Carlo toolkit (version 10.5) was used to simulate their percentage depth dose distributions. In addition, equivalent atomic numbers, effective atomic numbers, attenuation coefficients, and CT numbers have been examined. All parameters were considered in calculating the average relative error (σ), which was used as a statistical comparison tool. With σ between 6 and 7, we found that Polylactic Acid (PLA) was capable of simulating eye lenses, blood, soft tissue, lung, muscle, and brain tissues. Moreover, Polymethacrylic Acid (PMAA) material has a σ value of 4 when modeling adipose and breast tissues, respectively. Aside from that, variations in 3D printing materials’ infilling percentage can affect their CT numbers. We therefore suggest the PLA for mimicking soft tissue, muscle, brain, eye lens, lung and blood tissues, with an infill of between 92.7 and 94.3 percent. We also suggest an 89 percent infill when simulating breast tissue. Furthermore, with a 96.7 percent infill, the PMAA faithfully replicates adipose tissue. Additionally, we found that a 59 percent infill of Fe-PLA material is comparable to cortical bone. Due to the benefits of creating individualized medical phantoms and equipment, the results might be seen as an added value for both patients and clinicians.

The impact of sinusitis on dose distribution in a radiotherapy plan by in silico study.

To assess the impact of changes in sinus aeration on dose variation in nasopharyngeal cases using a single beam with various field sizes and real patient computed tomography (CT) images. The calculations were carried out on a computer equipped with an Intel Xeon (R) Gold 5118 processor operating at 2.30 GHz in 2022 at Taibah University, Al Madinah Al Munawwarah for a retrospective nasopharyngeal case. At the patient level, the impact on dose distribution was examined for different field sizes by comparing the percentage depth dose. The dose discrepancy was evaluated by comparing the dose delivered without considering the anatomical changes observed in the initial fraction to the dose adjusted to account for these changes using a 2D gamma analysis. With a criterion of 1% dose difference and 1mm distance to agreement, the gamma level for analysis was set at 95%. The study findings indicated that the observed effect diminished by approximately 50% for both 5cm x 5cm and 10cm x 10cm field sizes compared to the 3cm x 3cm size, where there was an overlap between the planning target volume and sinusitis. The study concluded that the impact of dose discrepancy was more pronounced in smaller field sizes.

Beam quality and the mystery behind the lower percentage depth dose in grid radiation therapy

Grid therapy recently has been picking momentum due to favorable outcomes in bulky tumors. This is being termed as Spatially Fractionated Radiation Therapy (SFRT) and lattice therapy. SFRT can be performed with specially designed blocks made with brass or cerrobend with repeated holes or using multi-leaf collimators where dosimetry is uncertain. The dosimetric challenge in grid therapy is the mystery behind the lower percentage depth dose (PDD) in grid fields. The knowledge about the beam quality, indexed by TPR20/10 (Tissue Phantom Ratio), is also necessary for absolute dosimetry of grid fields. Since the grid may change the quality of the primary photons, a new kq,q0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${\\mathbf{k}}_{\\mathbf{q},{\\mathbf{q}}_{0}}$$\\end{document} should be evaluated for absolute dosimetry of grid fields. A Monte Carlo (MC) approach is provided to resolving the dosimetric issues. Using 6 MV beam from a linear accelerator, MC simulation was performed using MCNPX code. Additionally, a commercial grid therapy device was used to simulate the grid fields. Beam parameters were validated with MC model for output factor, depth of maximum dose, PDDs, dose profiles, and TPR20/10. The electron and photon spectra were also compared between open and grid fields. The dmax is the same for open and grid fields. The PDD with grid is lower (~ 10%) than the open field. The difference in TPR20/10 of open and grid fields is observable (~ 5%). Accordingly, TPR20/10 is still a good index for the beam quality in grid fields and consequently choose the correct kq,q0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${\\mathbf{k}}_{\\mathbf{q},{\\mathbf{q}}_{0}}$$\\end{document} in measurements. The output factors for grid fields are 0.2 lower compared to open fields. The lower depth dose with grid therapy is due to lower depth fluence with scatter radiation but it does not impact the dosimetry as the calibration parameters are insensitive to the effective beam energies. Thus, standard dosimetry in open beam based on international protocol could be used.

Effect of bolus materials on dose deposition in deep tissues during electron beam radiotherapy.

Several materials are utilized in the production of bolus, which is essential for superficial tumor radiotherapy. This research aimed to compare the variations in dose deposition in deep tissues during electron beam radiotherapy when employing different bolus materials. Specifically, the study developed general superficial tumor models (S-T models) and postoperative breast cancer models (P-B models). Each model comprised a bolus made of water, polylactic acid (PLA), polystyrene, silica-gel or glycerol. Geant4 was employed to simulate the transportation of electron beams within the studied models, enabling the acquisition of dose distributions along the central axis of the field. A comparison was conducted to assess the dose distributions in deep tissues. In regions where the percentage depth dose (PDD) decreases rapidly, the relative doses (RDs) in the S-T models with silica-gel bolus exhibited the highest values. Subsequently, RDs for PLA, glycerol and polystyrene boluses followed in descending order. Notably, the RDs for glycerol and polystyrene boluses were consistently below 1. Within the P-B models, RDs for all four bolus materials are consistently below 1. Among them, the smallest RDs are observed with the glycerol bolus, followed by silica-gel, PLA and polystyrene bolus in ascending order. As PDDs are ~1-3% or smaller, the differences in RDs diminish rapidly until are only around 10%. For the S-T and P-B models, polystyrene and glycerol are the most suitable bolus materials, respectively. The choice of appropriate bolus materials, tailored to the specific treatment scenario, holds significant importance in safeguarding deep tissues during radiotherapy.

GEC-ESTRO survey of 106Ru eye applicator practice for ocular melanoma – Physicist survey

Aim106Ru eye plaque brachytherapy (BT, interventional radiotherapy) is an eye-preserving treatment for uveal melanoma performed in about 100 clinics worldwide. Despite this relatively low number, there is a considerable variation in clinical practice. In 2022, the BRAPHYQS and Head & Neck and Skin GEC-ESTRO working groups conducted a survey to map the current clinical practice. The survey consisted of a physicist and a physician part. This paper describes the physicist results. However, three physician questions with overlapping interest are included here as well. Materials and MethodsThe survey questions pertained to commissioning and quality control (QC) of the plaques, treatment planning, radiobiological correction, as well as more general questions on practice improvement. The questions overlapping with the physician survey were related to dose prescription and margins. ResultsSixty-five physicist responses were included. A majority of the centres do not perform an independent measurement of the absorbed dose at reference depth, percentage depth dose (PDD) and off-axis data. A lack of calibration services and suitable equipment are the main reasons. About one third of the centres indicated that they do image based treatment planning. The use of margins and dose prescription showed a large variability, despite the availability of guidelines [1]. Many respondents expressed a strong wish for improvement in a wide range of aspects of clinical practice. ConclusionThe physics survey showed a wide variability regarding quality control of the 106Ru sources and treatment planning practice.

Dose Calculation Accuracy of Beam Models in RadCalc for a 1.5 T MR-Linac

The purpose of this study is to evaluate RadCalc, an independent dose verification software, for patient-specific quality assurance (PSQA) in online adaptive planning with a magnetic resonance linear accelerator (MR-linac) of a 1.5 T. Version 7.1.4 of RadCalc to introduce the capability to establish a beam model that incorporates MR field characteristics. A total of six models were established, with one using manufacturer-provided data and the others differing in percentage depth dose (PDD) data sources. Overall, two models utilized PDD data from the treatment planning system (TPS), and three used commissioned PDD data from gantry angles of 0° and 270°. Simple tests on a virtual water phantom assessed dose-calculation accuracy, revealing percentage differences ranging from −0.5% to −20.6%. Excluding models with significant differences, clinical tests on 575 adaptive plans (prostate, liver, and breast) showed percentage differences of −0.51%, 1.12%, and 4.10%, respectively. The doses calculated using RadCalc demonstrated similar trends to those of the PSQA-based measurements. The newly released version of RadCalc enables beam modeling that considers the characteristics of the 1.5 T magnetic field. The accuracy of the software in calculating doses at 1.5 T magnetic fields has been verified, thereby making it a reliable and effective tool for PSQA in adaptive plans.

Determination of output factor for CyberKnife using scintillation dosimetry and deep learning

Objective. Small-field dosimetry is an ongoing challenge in radiotherapy quality assurance (QA) especially for radiosurgery systems such as CyberKnifeTM. The objective of this work is to demonstrate the use of a plastic scintillator imaged with a commercial camera to measure the output factor of a CyberKnife system. The output factor describes the dose on the central axis as a function of collimator size, and is a fundamental part of CyberKnife QA and integral to the data used in the treatment planning system. Approach. A self-contained device consisting of a solid plastic scintillator and a camera was build in a portable Pelicase. Photographs were analysed using classical methods and with convolutional neural networks (CNN) to predict beam parameters which were then compared to measurements. Main results. Initial results using classical image processing to determine standard QA parameters such as percentage depth dose (PDD) were unsuccessful, with 34% of points failing to meet the Gamma criterion (which measures the distance between corresponding points and the relative difference in dose) of 2 mm/2%. However, when images were processed using a CNN trained on simulated data and a green scintillator sheet, 92% of PDD curves agreed with measurements with a microdiamond detector to within 2 mm/2% and 78% to 1%/1 mm. The mean difference between the output factors measured using this system and a microdiamond detector was 1.1%. Confidence in the results was enhanced by using the algorithm to predict the known collimator sizes from the photographs which it was able to do with an accuracy of less than 1 mm. Significance. With refinement, a full output factor curve could be measured in less than an hour, offering a new approach for rapid, convenient small-field dosimetry.

Technical note: A small animal irradiation platform for investigating the dependence of the FLASH effect on electron beam parameters.

The recent rediscovery of the FLASH effect, a normal tissue sparing phenomenon observed in ultra-high dose rate (UHDR) irradiations, has instigated a surge of research endeavors aiming to close the gap between experimental observation and clinical treatment. However, the dependences of the FLASH effect and its underpinning mechanisms on beam parameters are not well known, and large-scale in vivo studies using murine models of human cancer are needed for these investigations. To commission a high-throughput, variable dose rate platform providing uniform electron fields(≥15cm diameter) at conventional (CONV) and UHDRs for in vivo investigations of the FLASH effect and its dependences on pulsed electron beam parameters. A murine whole-thoracic lung irradiation (WTLI) platform was constructed using a 1.3cm thick Cerrobend collimator forming a 15 × 1.6 cm2 slit. Control of dose and dose rate were realized by adjusting the number of monitor units and couch vertical position, respectively. Achievable doses and dose rates were investigated using Gafchromic EBT-XD film at 1cm depth in solid water and lung-density phantoms. Percent depth dose (PDD) and dose profiles at CONV and various UHDRs were also measured at depths from 0 to 2cm. A radiation survey was performed to assess radioactivation of the Cerrobend collimator by the UHDR electron beam in comparison to a precision-machined copper alternative. This platform allows for the simultaneous thoracic irradiation of at least three mice. A linear relationship between dose and number of monitor units at a given UHDR was established to guide the selection of dose, and an inverse-square relationship between dose rate and source distance was established to guide the selection of dose rate between 20 and 120Gy·s-1 . At depths of 0.5 to 1.5cm, the depth range relevant to murine lung irradiation, measured PDDs varied within±1.5%. Similar lateral dose profiles were observed at CONV and UHDRs with the dose penumbrae widening from 0.3mm at 0cm depth to 5.1mm at 2.0cm. The presence of lung-density plastic slabs had minimal effect on dose distributions as compared to measurements made with only solid water slabs. Instantaneous dose rate measurements of the activated copper collimator were up to two orders of magnitude higher than that of the Cerrobend collimator. A high-throughput, variable dose rate platform has been developed and commissioned for murine WTLI electron FLASH radiotherapy. The wide field of our UHDR-enabled linac allows for the simultaneous WTLI of at least three mice, and for the average dose rate to be modified by changing the source distance, without affecting dose distribution. The platform exhibits uniform, and comparable dose distributions at CONV and UHDRs up to 120Gy·s-1 , owing to matched and flattened 16 MeV CONV and UHDR electron beams. Considering radioactivation and exposure to staff, Cerrobend collimators are recommended above copper alternatives for electron FLASH research. This platform enables high-throughput animal irradiation, which is preferred for experiments using a large number of animals, which are required to effectively determine UHDR treatment efficacies.

Students training on virtual medical linear accelerator

At the Czech Technical University in Prague, we have installed virtual software environment simulating a radiotherapy treatment room with a medical linear accelerator (software VERT and VERT Physics by Vertual Ltd., United Kingdom). It is possible to simulate patient treatment and physics QA (quality assurance) measurements in virtual reality. This is beneficial for our students and teachers because there is no radiation present while doing the exercises and it is accessible at any time, unlike medical linear accelerators at hospitals. For our department, we have chosen the TrueBeam model by Varian Medical Systems, USA. The linear accelerator can be operated by the user in the same way as at the hospital, including the hardware pendant. There is a selection of patient treatment plans, CT images and RT structures, all of which can be visualised inside the treatment room, also during beam on, simulating the situation inside the patient while irradiating the tumour. Any DICOM files, even from another manufacturer’s linac (linear accelerator) or treatment planning system, can be imported into VERT. Apart from this, there is also an imaging interface and cone-beam CT interface showing options for patient setup. Another part of the software is a physics module with various phantoms and detectors for dosimetry as well as geometry tests. For example, a large water tank can be used for relative dosimetry of photon beams (percent depth doses and profiles), a smaller water phantom can be used for reference dosimetry or chamber cross calibration according to the TRS 398 (1) or IPEM (2) protocol. The results of measurements are based on look-up tables coming from real beam data, so dependence on the depth of measurement, field size, temperature and pressure and other parameters can be demonstrated. Moreover, it is possible to introduce many types of errors into the linac, such as jaw position, laser, or collimator miscalibration, and show how these errors propagate to patient irradiation and how they can be detected by QA tools. This paper is a short report on how this system has been used at our university and how it might be used in modern learning, pointing out its advantages and drawbacks. At the 16th Workshop on European Collaboration in Higher Education on Radiological and Nuclear Engineering and Radiation Protection (CHERNE) it was proposed that this virtual system could be used for an international student training course on medical physics in radiotherapy within the CHERNE network. This course might contain theoretical lectures with demonstrations on the virtual linac, practical exercises on the virtual linac and visits to hospitals (a photon radiotherapy centre, the Thomayer University Hospital in particular, and a proton therapy centre).

Modelling and commissioning validation of eclipse conical cone collimator for stereotactic radiosurgery using Monte Carlo simulation

Abstract Purpose: The miniaturized conical cones for stereotactic radiosurgery (SRS) make it challenging in measurement of dosimetric data needed for commissioning of treatment planning system. This study aims at validating dosimetric characteristics of conical cone collimator manufactured by Varian using Monte Carlo (MC) simulation technique. Methods &amp; Material: Percentage depth dose (PDD), tissue maximum ratio (TMR), lateral dose profile (LDP) and output factor (OF) were measured for cones with diameters of 5mm, 7·5mm, 10mm, 12·5 mm, 15 mm and 17·5 mm using EDGE detector for 6MV flattening filter-free (FFF) beam from Truebeam linac. Similarly, MC modelling of linac for 6MVFFF beam and simulation of conical cones were performed in PRIMO. Subsequently, measured beam data were validated by comparing them with results obtained from MC simulation. Results: The measured and MC-simulated PDDs or TMRs showed close agreement within 3% except for cone of 5mm diameter. Deviations between measured and simulated PDDs or TMRs were substantially higher for 5mm cone. The maximum deviations at depth of 10cm, 20cm and at range of 50% dose were found 4·05%, 7·52%, 5·52% for PDD and 4·04%, 7·03%, 5·23% for TMR with 5mm cone, respectively. The measured LDPs acquired for all the cones showed close agreement with MC LDPs except in penumbra region around 80% and 20% dose profile. Measured and MC full-width half maxima of dose profiles agreed with nominal cone size within ± 0·2 mm. Measured and MC OFs showed excellent agreement for cone sizes ≥10 mm. However, deviation consistently increases as the size of the cone gets smaller. Findings: MC model of conical cones for SRS has been presented and validated. Very good agreement was found between experimentally measured and MC-simulated data. The dosimetry dataset obtained in this study validated using MC model may be used to benchmark beam data measured for commissioning of SRS for cone planning.