Relative Output Factors Research Articles

On the development of a comprehensive MC simulation model for the Gamma Knife Perfexion radiosurgery unit

This work presents a comprehensive Monte Carlo (MC) simulation model for the Gamma Knife Perfexion (PFX) radiosurgery unit. Model-based dosimetry calculations were benchmarked in terms of relative dose profiles (RDPs) and output factors (OFs), against corresponding EBT2 measurements. To reduce the rather prolonged computational time associated with the comprehensive PFX model MC simulations, two approximations were explored and evaluated on the grounds of dosimetric accuracy. The first consists in directional biasing of the 60Co photon emission while the second refers to the implementation of simplified source geometric models. The effect of the dose scoring volume dimensions in OF calculations accuracy was also explored. RDP calculations for the comprehensive PFX model were found to be in agreement with corresponding EBT2 measurements. Output factors of 0.819 ± 0.004 and 0.8941 ± 0.0013 were calculated for the 4 mm and 8 mm collimator, respectively, which agree, within uncertainties, with corresponding EBT2 measurements and published experimental data. Volume averaging was found to affect OF results by more than 0.3% for scoring volume radii greater than 0.5 mm and 1.4 mm for the 4 mm and 8 mm collimators, respectively. Directional biasing of photon emission resulted in a time efficiency gain factor of up to 210 with respect to the isotropic photon emission. Although no considerable effect on relative dose profiles was detected, directional biasing led to OF overestimations which were more pronounced for the 4 mm collimator and increased with decreasing emission cone half-angle, reaching up to 6% for a 5° angle. Implementation of simplified source models revealed that omitting the sources’ stainless steel capsule significantly affects both OF results and relative dose profiles, while the aluminum-based bushing did not exhibit considerable dosimetric effect. In conclusion, the results of this work suggest that any PFX simulation model should be benchmarked in terms of both RDP and OF results.

Commissioning of TrueBeam<sup>TM</sup> Medical Linear Accelerator: Quantitative and Qualitative Dosimetric Analysis and Comparison of Flattening Filter (FF) and Flattening Filter Free (FFF) Beam

Motive of the study is to present quantitative and qualitative analysis and comparison of beam data measurement with FF (flattening filter) and FFF (flattening filter free) beam in a Varian TrueBeamTM Medical Linear Accelerator. Critique of beam characterization and evolution of dosimetric properties for 6 MV, 10 MV, 15 MV FF beam and 6 MVFFF, 10 MVFFF FFF beam has been carried out. We performed the comparison of photon beam data for two standard FF photon energy 6 MV, 10 MV verses 6 MVFFF, and 10 MVFFF FFF beam. Determination and comparison of parameter involved PDD (Percentage depth dose), Depth dose profile, Symmetry, Flatness, Quality index, Relative output factor, Penumbra, Transmission factor, DLG (Dosimetric leaf gap), in addition to degree of Un-flatness and off-axis ratio of FFF beam. Outcomes of presenting study had shown that change of various parameters such as Percentage depth dose curves, Shape of the depth dose profile, Transmission, Value of quality index and significant rise in surface dose for FFF in comparison with FF beam. Differences in the output factor at lower and higher field sizes for FFF beam compared to that of FF beam were found. The maximum output factor deviation between 6 MV and 6 MVFFF was found to be 4.55%, whereas in 10 MV and 10 MVFFF was 5.71%. Beam quality TPR20/10 for FFF beam was found to be lesser in magnitude, 5.42% for 6 MVFFF whereas 4.50% for 10 MVFFF compared to 6 MV and 10 MV FF beam respectively. Jaw transmission and interleaf leakage for FFF beam were found to be lesser than FF beam. Also DLG for FFF beam was found to be lesser in magnitude comparable to that of flattened beam. This study is mainly inclined towards evaluation and comparison of the FF and FFF beam. It has been observed that, the outcome of a commissioning beam data generation fully complies with vendor specification and published literature.

Commissioning an Elekta Versa HD linear accelerator.

The purpose of this study is to report the dosimetric aspects of commissioning performed on an Elekta Versa HD linear accelerator (linac) with high‐dose‐rate flattening filter‐free (FFF) photon modes and electron modes. Acceptance and commissioning was performed on the Elekta Versa HD linac with five photon energies (6 MV, 10 MV, 18 MV, 6 MV FFF, 10 MV FFF), four electron energies (6 MeV, 9 MeV, 12 MeV, 15 MeV) and 160‐leaf (5 mm wide) multileaf collimators (MLCs). Mechanical and dosimetric data were measured and evaluated. The measurements include percent depth doses (PDDs), in‐plane and cross‐plane profiles, head scatter factor (Sc), relative photon output factors (Scp), universal wedge transmission factor, MLC transmission factors, and electron cone factors. Gantry, collimator, and couch isocentricity measurements were within 1 mm, 0.7 mm, and 0.7 mm diameter, respectively. The PDDs of 6 MV FFF and 10 MV FFF beams show deeper dmax and steeper falloff with depth than the corresponding flattened beams. While flatness values of 6 MV FFF and 10 MV FFF normalized profiles were expectedly higher than the corresponding flattened beams, the symmetry values were almost identical. The cross‐plane penumbra values were higher than the in‐plane penumbra values for all the energies. The MLC transmission values were 0.5%, 0.6%, and 0.6% for 6 MV, 10 MV, and 18 MV photon beams, respectively. The electron PDDs, profiles, and cone factors agree well with the literature. The outcome of radiation treatment is directly related to the accuracy in the dose modeled in the treatment planning system, which is based on the commissioned data. Commissioning data provided us a valuable insight into the dosimetric characteristics of the beam. This set of commissioning data can provide comparison data to others performing Versa HD commissioning, thereby improving patient safety.PACS number(s): 87.56.bd

SU‐E‐T‐190: Commissioning An Elekta VersaHD Linear Accelerator

Purpose:The purpose of this study is to report the dosimetric aspects of commissioning performed on an Elekta VersaHD linear accelerator with high dose rate flattening‐filter‐free (FFF) photon modes and electron modes.Methods:Acceptance and commissioning was performed on an Elekta VersaHD linac with 5 photon energies (6MV, 10MV, 18MV, 6FFF, 10FFF), 4 electron energies (6MeV, 9MeV, 12MeV, 15MeV) and 160 leaf (5mm wide) multi‐leaf collimators (MLCs). Mechanical and dosimetric data was measured and evaluated. The measurements include percent depth doses (PDDs), inplane and crossplane profiles, head scatter factor (Sc), relative photon output factors (Scp), universal wedge transmission factor, MLC transmission factors, and electron cone factors.Results:Gantry, collimator, couch isocentricity measurements were within 1mm, 0.7mm and 0.7mm diameter respectively. The PDDs of 6FFF and 10FFF beams show deeper dmax and steeper fall‐off with depth than the corresponding flattened beams. While flatness values of 6FFF and 10FFF normalized profiles were higher than the corresponding flattened beams, the symmetry values were almost identical. The crossplane penumbra values were higher than the inplane penumbra values for all the energies. The MLC transmission values were 0.5%, 0.6% and 0.6% for 6MV, 10MV, and 18MV photon beams. The electron PDDs, profiles and cone factors is validated by literature.Conclusion:The outcome of radiation treatment is directly related to the accuracy in the dose modeled in the treatment planning system which is based on the commissioned data. Commissioning data provided us a valuable insight into the dosimetric characteristics of the beam. This set of commissioning data can provide comparison data to others performing VersaHD commissioning thus improving patient safety.

Parameterization of electron beam output factor

Electron beam dose distribution is dependent on the beam energy and complicated trajectory of particles. Recent treatment planning systems using Monte Carlo calculation algorithm provide accurate dose calculation. However, double check of monitor units (MUs) based on an independent algorithm is still required. In this study, we have demonstrated single equation that reproduces the measured relative output factor (ROF) that can be used for MU calculation for electron radiotherapy. Electron beams generated by an iX (Varian Medical Systems) and a PRIMUS (Siemens) accelerator were investigated. For various energies of electron beams, the ROF at respective dmax were measured using diode detector in a water phantom at SSD of 100 cm. Curve fitting was performed with an exponential generalized equation ROF = α(β – e−γR) including three variables (α, β, γ) as a function of field radius and electron energy. The correlation coefficients between the ROF measured and that calculated by the equation were greater than 0.998. For ROF of Varian electron beams, the average values of all fitting formulas were applied for two of the constants; α and β. The parameter γ showed good agreement with the quadratic approximation as a function of mean energy at surface (E0). The differences between measured and calculated ROF values were within ±3% for beams with cutout radius of ≥1.5 cm for electron beams with energies from 6 MeV to 15 MeV. The proposed formula will be helpful for double-check of MUs, as it requires minimal efforts for MU calculation.

Assessment of radiochromic gel dosimeter based on Turnbull Blue dye for relative output factor measurements of the Leksell Gamma Knife® PerfexionTM

The aim of the study was to perform assessment of radiochromic gel dosimeter based on Turnbull blue dye formed by irradiation (TB gel dosimeter) for measurement of ROFs for 4 mm and 8 mm collimators for the Leksell Gamma Knife PerfexionTM. All measurements have been carried out using home-made spherical Perspex glass phantom of diameter 160 mm. TB gel dosimeters were scanned using homemade optical CT scanner. The results are compared with vendor recommended Monte Carlo calculated ROFs values of 0.814 and 0.900 for 4 mm and 8 mm collimators, respectively. The comparisons between the gel measurements and the treatment planning system (TPS) calculation are presented in the form of 2D isodoses for the central slices and 1D profile. Measured ROF 0.746 and 0.874 for 4 mm and 8 mm collimators respectively are in a reasonable agreement with vendor recommended values and measured relative dose distribution in a central slice and measured profiles of all shots show excellent correspondence with TPS.

Glass beads and Ge-doped optical fibres as thermoluminescence dosimeters for small field photon dosimetry

An investigation has been made of glass beads and optical fibres as novel dosimeters for small-field photon radiation therapy dosimetry. Commercially available glass beads of largest dimension 1.5 mm and GeO2-doped SiO2 optical fibres of 5 mm length and 120 µm diameter were characterized as thermoluminescence dosimeters. Results were compared against Monte-Carlo simulations with BEAMnrc/DOSXYZnrc, EBT3 Gafchromic film, and a high-resolution 2D-array of liquid-filled ionization chambers. Measurements included relative output factors and dose profiles for square-field sizes of 1, 2, 3, 4, and 10 cm. A customized Solid-Water® phantom was employed, and the beads and fibres were placed at defined positions along the longitudinal axis to allow accurate beam profile measurement. Output factors and the beam profile parameters were compared against those calculated by BEAMnrc/DOSXYZnrc. The output factors and field width measurements were found to be in agreement with reference measurements to within better than 3.5% for all field sizes down to 2 cm2 for both dosimetric systems, with the beads showing a discrepancy of no more than 2.8% for all field sizes. The results confirm the potential of the beads and fibres as thermoluminescent dosimeters for use in small photon radiation field sizes.

Radiation Physics of a New Electronic Brachytherapy System for Treating Skin Lesions

To commission and analyze a new low energy high dose rate electronic brachytherapy system. Half-value layer (HVL), absolute dose output, beam profiles, and insert factors of an electronic brachytherapy system (EBT) were measured and analyzed. A thimble-shaped parallel-plate ionization chamber was utilized for HVL, absolute output, and insert factor determinations. HVL measurements of the 69.5 keV beam of EBT were conducted using thin aluminum foils in narrow beam geometry. In this setup, the aluminum filters were positioned at a distance of 30 cm from tip of the EBT device and 30 cm from the ion chamber. Absolute calibration of this X-ray beam was carried out based on the AAPM Task Group 61 (TG61) report. Beam profiles and depth ionization curves were measured and analyzed using radiochromic films, a professional scanner, and a scientific software package. The relative output factors of the five standard inserts of this device (10, 15, 20, 25, and 30 mm in diameter) were determined employing the ion chamber in air. Finally, a secondary dose calculation system was developed in a spreadsheet. HVL of the X-ray beam of EBT was measured to be 1.61 mmAl. For TG61-based calibration of this low energy kV beam employing the ion chamber at the SSD of 6 cm, it was determined that for this system Pion, Ppol, backscatter factor, ratio of mass energy absorption coefficient, inverse square correction from the surface to the effective point of measurement, and end-effect are 1.009, 0.995, 1.121, 1.017, 1.061, and 0.997, respectively. Measuring the PDD of this beam was proved difficult. Per TG61 recommendations, PDD values from BJR supplement #25 were employed for translating the measured output at the surface to the depth of 3 mm in tissue. The PDD values from BJR were in agreement with those supplied by the manufacturer to within <0.5%. The absolute dose at the depth of 3 mm was therefore established to be 3.1 Gy, for when the EBT system was programmed to deliver 3 Gy. This agreement level was deemed acceptable for the low-energy and small SSD of this device. Beam profiles showed a relatively flat beam (<5%) with small (1 mm) penumbra. Insert factors varied from 0.95 to 1.01 for the five standard inserts of this EBT device in relations to the 30 mm insert output value. Radiation physics parameters of an EBT X-ray unit were measured to match those claimed by the manufacturer to an accuracy of better than 5%, except HVL. Our measured HVL was 1.61 mm Al, whereas that indicated by the manufacturer is 1.83 mm Al. This discrepancy in HVL has a 0.3% effect on the NK value used for this chamber and less than 2% impact on the PDD employed for determining the absorbed radiation dose at depth. Reproducibility of the radiation beam of this device was on the order of less than 0.3%.

Poster — Thur Eve — 43: Monte Carlo Modeling of Flattening Filter Free Beams and Studies of Relative Output Factors

Flattening filter free (FFF) beams have been adopted by many clinics and used for patient treatment. However, compared to the traditional flattened beams, we have limited knowledge of FFF beams. In this study, we successfully modeled the 6 MV FFF beam for Varian TrueBeam accelerator with the Monte Carlo (MC) method. Both the percentage depth dose and profiles match well to the Golden Beam Data (GBD) from Varian. MC simulations were then performed to predict the relative output factors. The in‐water output ratio, Scp, was simulated in water phantom and data obtained agrees well with GBD. The in‐air output ratio, Sc, was obtained by analyzing the phase space placed at isocenter, in air, and computing the ratio of water Kerma rates for different field sizes. The phantom scattering factor, Sp, can then be obtained from the traditional way of taking the ratio of Scp and Sc. We also simulated Sp using a recently proposed method based on only the primary beam dose delivery in water phantom. Because there is no concern of lateral electronic disequilibrium, this method is more suitable for small fields. The results from both methods agree well with each other. The flattened 6 MV beam was simulated and compared to 6 MV FFF. The comparison confirms that 6 MV FFF has less scattering from the Linac head and less phantom scattering contribution to the central axis dose, which will be helpful for improving accuracy in beam modeling and dose calculation in treatment planning systems.

SU‐E‐T‐476: Quality Assurance for Gamma Knife Perfexion Using the Exradin W1 Plastic Scintillation Detector

Purpose:To perform dose profile and output factor measurements for the Exradin W1 plastic scintillation detector (PSD) for the Gamma Knife Perfexion (GKP) collimators in a Lucy phantom and to compare these values to an Exradin A16 ion chamber, EBT3 radiochromic film and treatment planning system (TPS) data.Methods:We used the Exradin W1 PSD which has a small volume, near‐water equivalent sensitive element. It has also been shown to be energy independent. This new detector is manufactured and distributed by Standard Imaging, Inc. Measurements were performed for all three collimators (4 mm, 8 mm and 16 mm) for the GKP. The Lucy phantom with the PSD inserted was moved in small steps to acquire profiles in all three directions. EBT3 film was inserted in the Lucy phantom and exposed to a single shot for each collimator. Relative output factors were measured using the three detectors while profiles acquired with the PSD were compared to the ones measured with EBT3 radiochromic film.Results:Measured output factors relative to the largest collimator are as followsCollimator PS EBT3 A1616mm 1.000 1.000 1.0008mm 0.892 0.881 0.8834mm 0.795 0.793 0.727 The nominal (vendor) OFs for GKP are 1.000, 0.900, and 0.814, for collimators 16 mm, 8 mm and 4 mm, respectively. There is excellent agreement between all profiles measured with the PSD and EBT3 as well as with the TPS data provided by the vendor.Conclusion:Output factors measured with the W1 were consistent with the ones measured with EBT3 and A16 ion chamber. Measured profiles are in excellent agreement. The W1 detector seems well suited for beam QA for Gamma Knife due to its dosimetric characteristics.Sam Beddar would like to disclose a NIH/NCI SBIR Phase II grant (2R44CA153824‐02A1) with Standard Imaging, Title: “Water‐Equivalent Plastic Scintillation Detectors for Small Field Radiotherapy”

SU-E-T-364: 6X FFF and 10X FFF Portal Dosimetry Output Factor Verification: Application for SRS/SBRT

Purpose: To enhance portal dosimetry of high dose rate SRS/SBRT plan verifications with extensive imager measurement of output factors (OF). Methods: Electronic portal image dosimetry (EPID), implemented on the Varian Edge allows for acquisition of its two energies: 6X FFF and 10 FFF (1400 and 2400 MU/min, respectively) at source to imager distance (SID) =100cm without imager saturation. Square and rectangular aSi OF following EPID calibration were obtained. Data taken was similar to that obtained during beam commissioning (of almost all field sizes from 1×1 to 15×15 and 20×20 cm{sup 2}, [Trilogy] and [Edge], respectively) to construct a table using the OF tool for use in the Portal Dosimetry Prediction Algorithm (PDIP v11). The Trilogy 6x SRS 1000 MU/min EPID data were taken at 140 SID. The large number of OF were obtained for comparison to that obtained with diode detectors and ion chambers (cc13 for >3×3 field size). As Edge PDIP verification is currently ongoing, EPID measurements of three SRS/SBRT plans for the Trilogy were taken and compared to results obtained prior to these measurements. Results: The relative difference output factors of field sizes 2×2 and higher compared to commissioning data were (mean+/-SD, [range]): Edge 6X (−1.9+/−2.9%, [−5.9%,3.1%]), Edgemore » 10X (−0.7+/−1.2%, [− 3.3%,0.8%] and Trilogy (0.03+/−0.5%, [−1.4%,1.1%]) with EPID over predicting. The results for the 140 SID showed excellent agreement throughout except at the 1×1 to 1×15 and 15×1 field sizes where differences were: −10.6%, −6.0% and −5.8%. The differences were also most pronounced for the 1×1 at 100 SID. They were −7.4% and −11.5% for 6X and 10X, respectively. The Gamma (3%, 1mm) for three clinical plans improved by 8.7+/−1.8%. Conclusion: Results indicate that imager output factor measurements at any SID of high dose rate SRS/SBRT are quite reliable for portal dosimetry plan verification except for the smallest fields. This work was not funded by Varian Oncology Systems. Some authors have other work partly funded by Varian Oncology Systems.« less

TH‐E‐BRE‐09: TrueBeam Monte Carlo Absolute Dose Calculations Using Monitor Chamber Backscatter Simulations and Linac‐Logged Target Current

Purpose:To simulate and measure radiation backscattered into the monitor chamber of a TrueBeam linac; establish a rigorous framework for absolute dose calculations for TrueBeam Monte Carlo (MC) simulations through a novel approach, taking into account the backscattered radiation and the actual machine output during beam delivery; improve agreement between measured and simulated relative output factors.Methods:The ‘monitor backscatter factor’ is an essential ingredient of a well‐established MC absolute dose formalism (the MC equivalent of the TG‐51 protocol). This quantity was determined for the 6 MV, 6X FFF, and 10X FFF beams by two independent Methods: (1) MC simulations in the monitor chamber of the TrueBeam linac; (2) linac‐generated beam record data for target current, logged for each beam delivery. Upper head MC simulations used a freelyavailable manufacturer‐provided interface to a cloud‐based platform, allowing use of the same head model as that used to generate the publicly‐available TrueBeam phase spaces, without revealing the upper head design. The MC absolute dose formalism was expanded to allow direct use of target current data.Results:The relation between backscatter, number of electrons incident on the target for one monitor unit, and MC absolute dose was analyzed for open fields, as well as a jaw‐tracking VMAT plan. The agreement between the two methods was better than 0.15%. It was demonstrated that the agreement between measured and simulated relative output factors improves across all field sizes when backscatter is taken into account.Conclusion:For the first time, simulated monitor chamber dose and measured target current for an actual TrueBeam linac were incorporated in the MC absolute dose formalism. In conjunction with the use of MC inputs generated from post‐delivery trajectory‐log files, the present method allows accurate MC dose calculations, without resorting to any of the simplifying assumptions previously made in the TrueBeam MC literature. This work has been partially funded by Varian Medical Systems.

Evaluation of a synthetic single-crystal diamond detector for relative dosimetry measurements on a CyberKnife.

To evaluate a new commercial PTW-60019 microDiamond (PTW, Freiburg, Germany) synthetic single-crystal diamond detector for relative dosimetry measurements on a clinical CyberKnife™ VSI (Accuray Inc., Sunnyvale, CA) system. Relative output factors (ROFs) were measured for collimator diameters from 5 to 60 mm, and compared with diode [PTW-60017, PTW-60018 and IBA Dosimetry (Schwarzenbruck, Germany) SFD] and ionization chamber (PTW-31014 PinPoint and PTW-31010 Semiflex) measurements. Beam profiles were measured at a range of depths, and collimator sizes, with the detector stem oriented both parallel and perpendicular to the central axis (CAX). Percentage depth-dose (PDD) curves were obtained for the 60-mm collimator and compared with natural Diamond Detector (PTW-60003) and ionization chamber curves to evaluate energy dependence. Penumbral broadening was noted on profile measurements made with the microDiamond oriented with the stem parallel to the CAX, in comparison with diodes. Oriented perpendicular to the CAX, the profile penumbra was sharper, but stem effects could not be ruled out. The PDD measurements were within 0.5% of ionization chamber measurements, indicating insignificant dose-rate dependence. The ROF for the microDiamond fell between diode and ionization chamber results. Published Monte Carlo-derived CyberKnife-specific factors were applied to the PTW-60017, PTW-60018 and PTW-31014 ROFs, and the microDiamond factors agreed within 2.0% of the mean of these. Over a range of small field relative dosimetry measurements, the microDiamond detector shows excellent spatial resolution, dose-rate independence and water equivalence. The microDiamond is a suitable tool for commissioning stereotactic systems.

Multi‐institutional dosimetric and geometric commissioning of image‐guided small animal irradiators

To compare the dosimetric and geometric properties of a commercial x-ray based image-guided small animal irradiation system, installed at three institutions and to establish a complete and broadly accessible commissioning procedure. The system consists of a 225 kVp x-ray tube with fixed field size collimators ranging from 1 to 44 mm equivalent diameter. The x-ray tube is mounted opposite a flat-panel imaging detector, on a C-arm gantry with 360° coplanar rotation. Each institution performed a full commissioning of their system, including half-value layer, absolute dosimetry, relative dosimetry (profiles, percent depth dose, and relative output factors), and characterization of the system geometry and mechanical flex of the x-ray tube and detector. Dosimetric measurements were made using Farmer-type ionization chambers, small volume air and liquid ionization chambers, and radiochromic film. The results between the three institutions were compared. At 225kVp, with 0.3 mm Cu added filtration, the first half value layer ranged from 0.9 to 1.0 mm Cu. The dose-rate in-air for a 40 × 40 mm(2) field size, at a source-to-axis distance of 30 cm, ranged from 3.5 to 3.9 Gy/min between the three institutions. For field sizes between 2.5 mm diameter and 40 × 40 mm(2), the differences between percent depth dose curves up to depths of 3.5 cm were between 1% and 4% on average, with the maximum difference being 7%. The profiles agreed very well for fields >5 mm diameter. The relative output factors differed by up to 6% for fields larger than 10 mm diameter, but differed by up to 49% for fields ≤5 mm diameter. The mechanical characteristics of the system (source-to-axis and source-to-detector distances) were consistent between all three institutions. There were substantial differences in the flex of each system. With the exception of the half-value layer, and mechanical properties, there were significant differences between the dosimetric and geometric properties of the three systems. This underscores the need for careful commissioning of each individual system for use in radiobiological experiments.

The use of Valencia applicators at extended source surface distances for irregular surface contours

The use of Valencia applicators across irregular surface contours results in significant dose heterogeneities at the prescription depth. Investigations were carried out using extended source surface distances (standoff) to reduce these dose heterogeneities. Relative output factors were measured with a Roos chamber and Gafchromic EBT3 film was used to measure profiles and percentage depth doses at numerous standoff distances. The use of 20 mm standoff was found to reduce the relative difference in delivered dose across a 4 mm change in surface contour by 10.6% for the H2 applicator and 10.0% for the H3 applicator. The radiation became more penetrating with standoff and the field size larger, as expected. The results show that standoff can be used with the Valencia applicator to reduce dose heterogeneities across changes in surface contour.

A study on the use of Gafchromic™ EBT3 film for output factor measurements in kilovoltage X-ray beams

Relative output factors are used in radiation therapy for treatment planning purposes including treatments using kilovoltage X-ray beams. The output factor is the relative dose output for a particular applicator relative to a reference applicator. Due to the differences in the scatter contribution from the inside of an applicator, it is more accurate if output factors are measured for all combinations of X-ray beam energy and applicator. Previously published papers and various kilovoltage X-ray beam dosimetry protocols have discussed the validity of using various cylindrical and parallel plate ionization chambers for relative output factor measurements. In this work, we evaluated the suitability of Gafchromic™ EBT3 film for the determination of output factors for kilovoltage X-ray beams. Output factors were measured with Gafchromic™ EBT3 film for beam qualities of 50, 75, 100 and 125kVp and applicator sizes of 2, 3, 4cm diameter, 8×8 and 12×12cm(2) square applicators. The film read out was performed with a flatbed EPSON Expression10000XL scanner. The measured data was compared with benchmark data from measurements using an Advanced Markus ionisation chamber as well as comparing with ratios of published backscatter factor values. The agreement between output factors measured with EBT3 film and the ionisation chamber was generally better than 2%, with the largest difference of 3.3% occurring for the 2cm diameter field with the 50kVp X-ray beam. These differences were consistent with the estimated total uncertainty in the measurements as calculated by the ISO GUM. The agreement between the output factors measured with film and the published BSFs was generally better than 5% but differences of up to 12% occurred for the smallest field size. The results demonstrate that Gafchromic™ EBT3 film is a suitable dosimeter for output factor measurements of kilovoltage X-ray beams.

Implementation and commissioning of an integrated micro-CT/RT system with computerized independent jaw collimation

To design, construct, and commission a set of computer-controlled motorized jaws for a micro-CT∕RT system to perform conformal image-guided small animal radiotherapy. The authors designed and evaluated a system of custom-built motorized orthogonal jaws, which allows the delivery of off-axis rectangular fields on a GE eXplore CT 120 preclinical imaging system. The jaws in the x direction are independently driven, while the y-direction jaws are symmetric. All motors have backup encoders, verifying jaw positions. Mechanical performance of the jaws was characterized. Square beam profiles ranging from 2×2 to 60×60 mm2 were measured using EBT2 film in the center of a 70×70×22 mm3 solid water block. Similarly, absolute depth dose was measured in a solid water and EBT2 film stack 50×50×50 mm3. A calibrated Farmer ion chamber in a 70×70×20 mm3 solid water block was used to measure the output of three field sizes: 50×50, 40×40, and 30×30 mm2. Elliptical target plans were delivered to films to assess overall system performance. Respiratory-gated treatment was implemented on the system and initially proved using a simple sinusoidal motion phantom. All films were scanned on a flatbed scanner (Epson 1000XL) and converted to dose using a fitted calibration curve. A Monte Carlo beam model of the micro-CT with the jaws has been created using BEAMnrc for comparison with the measurements. An example image-guided partial lung irradiation in a rat is demonstrated. The averaged random error of positioning each jaw is less than 0.1 mm. Relative output factors measured with the ion chamber agree with Monte Carlo simulations within 2%. Beam profiles and absolute depth dose curves measured from the films agree with simulations within measurement uncertainty. Respiratory-gated treatments applied to a phantom moving with a peak-to-peak amplitude of 5 mm showed improved beam penumbra (80%-20%) from 3.9 to 0.8 mm. A set of computer-controlled motorized jaws for a micro-CT∕RT system were constructed with position reliably better than a tenth of a millimeter. The hardware system is ready for image-guided conformal radiotherapy for small animals with capability of respiratory-gated delivery.

Evaluation of the EDGE detector in small-field dosimetry

This study evaluates a new diode detector design for small-field dosimetry. An accurate detector that has a small volume are necessary to compile data for stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and intensity-modulated radiotherapy (IMRT). Two semiconductor diode detectors and one ionization chamber were used to measure the profiles, percent depth doses (PDDs), and relative output factors (OFs) of a Novalis 6-MV SRS beam. Profiles and PDD data were collected using 5.0-, 10.0-, 15.0-, 20.0-, 30.0-, and 50.0-mm micro multileaf collimators (mMLCs) at small fields and a 98.0 × 98.0-mm2 reference field. OFs were collected for each of the mMLCs. The EDGE diode detector, the diode detector, and the ion chamber (0.007 cc) were used in the study. Detector measurements were performed using the 3D water phantom with a source-to-surface distance of 100-cm at a depth of 1.5-cm. The measurements were analyzed using the IBA OmniPro Accept 7th version software. In addition, all data were compared to Monte Carlo simulations. The semiconductor diodes had similar OFs and PDDs for each of the mMLCs used. The Dmax values of the EDGE diode detector, measured from the PDD, ranged from 8.5 to 14.0-mm with an average of 12.4-mm. The field widths of the EDGE diode detector were found to have similar values. The performance of the EDGE diode detector was comparable for all small-field measurements. Additionally, no evidence of an energy response was observed for the EDGE detectors for a field of 98 × 98-mm2. This is particularly important when measuring the relative OF for small fields or gathering larger-sized field data for the commissioning of a treatment planning system.

GPU-based Monte Carlo radiotherapy dose calculation using phase-space sources

A novel phase-space source implementation has been designed for graphics processing unit (GPU)-based Monte Carlo dose calculation engines. Short of full simulation of the linac head, using a phase-space source is the most accurate method to model a clinical radiation beam in dose calculations. However, in GPU-based Monte Carlo dose calculations where the computation efficiency is very high, the time required to read and process a large phase-space file becomes comparable to the particle transport time. Moreover, due to the parallelized nature of GPU hardware, it is essential to simultaneously transport particles of the same type and similar energies but separated spatially to yield a high efficiency. We present three methods for phase-space implementation that have been integrated into the most recent version of the GPU-based Monte Carlo radiotherapy dose calculation package gDPM v3.0. The first method is to sequentially read particles from a patient-dependent phase-space and sort them on-the-fly based on particle type and energy. The second method supplements this with a simple secondary collimator model and fluence map implementation so that patient-independent phase-space sources can be used. Finally, as the third method (called the phase-space-let, or PSL, method) we introduce a novel source implementation utilizing pre-processed patient-independent phase-spaces that are sorted by particle type, energy and position. Position bins located outside a rectangular region of interest enclosing the treatment field are ignored, substantially decreasing simulation time with little effect on the final dose distribution. The three methods were validated in absolute dose against BEAMnrc/DOSXYZnrc and compared using gamma-index tests (2%/2 mm above the 10% isodose). It was found that the PSL method has the optimal balance between accuracy and efficiency and thus is used as the default method in gDPM v3.0. Using the PSL method, open fields of 4 × 4, 10 × 10 and 30 × 30 cm2 in water resulted in gamma passing rates of 99.96%, 99.92% and 98.66%, respectively. Relative output factors agreed within 1%. An intensity modulated radiation therapy patient plan using the PSL method resulted in a passing rate of 97%, and was calculated in 50 s (per GPU) compared to 8.4 h (per CPU) for BEAMnrc/DOSXYZnrc.

SU‐C‐105‐06: Development of a High Resolution EPID Solution for Small Field Dosimetry

Purpose: The increasing use of small beams in VMAT and SBRT presents significant challenges and calls for new tools for dosimetry measurements. The purpose of this study is to investigate a high spatial‐resolution (0.2mm) amorphous silicon flat‐panel electronic portal imaging device (EPID) for small field dosimetry. Methods: A previously‐developed EPID dosimetry system was used to measure the dose distribution of small fields from raw EPID‐measured images. The response of the EPID specific to the linac was obtained by using a Monte Carlo simulation and a comprehensive calibration of the detector. The dosimetry system was validated against measurements of field sizes greater than 3×3cm2. In the present study, the EPID‐based dosimetry measurement technique was used to obtain the relative output factor for small fields from 0.5cm to 3cm respectively created by both the jaws and the MLCs. 6MV, 10MV, and 15MV photon beams from a Varian TrueBeam were tested. The results were compared with measurements using EBT3 film, EDGE diode detector, and PinPoint ion chamber. Results: The diode measurement was considered as a reference in this study based on the expectation that its small size(0.8mm) avoids the field size‐dependent artifacts of larger detectors. For jaw‐defined fields between 2 and 3cm, measurements with all detectors agreed with diode measurements to within 2.7%. For jaw field sizes &lt;2cm, the relative output factors measured using the EPID, film and PinPointTM were lower than the diode by averages of 3.5%, 15.1% and 23.1%, respectively. For MLC fields, output factors measured with EPID, film and PinPoint were found to differ from the diode measurements by averages of +1.7%, −2.2% and −8.1%, respectively. Conclusion: The high spatial resolution EPID dosimetry system proved to be an accurate and efficient dosimetric tool for small field measurements. Accurate output factors can be measured for independent dosimetry calibration and verification.