Engineering topics

Solberg, T

Publications and source records attributed to Solberg, T.

26 records · Page 2

DOE OSTI2015

SU-E-T-187: Collimation Methods in Spot Scanning Proton Therapy: A Treatment Plan Comparison Between a Fixed Aperture and a Dynamic Collimation System

Purpose: Low-energy treatments during spot scanning proton therapy (SSPT) suffer from poor conformity due to increased spot size. Collimation devices can reduce the lateral penumbra of a proton therapy dose distribution and improve the overall plan quality. The purpose of this work was to study the advantages of individual energy-layer collimation, which is unique to a recently proposed Dynamic Collimation System (DCS), in comparison to a standard, fixed aperture that allows only a single shape for all energy layers. Methods: Three brain patients previously planned and treated with SSPT were re-planned using an in-house treatment planning system capable of modeling collimated and un-collimated proton beamlets. The un-collimated plans, which served as a baseline for comparison, reproduced the target coverage of the clinically delivered plans. The collimator opening for the aperture based plans included a 0.6 cm expansion of the largest cross section of the target in the Beam’s Eye View, while the DCS based plans were created by optimizing the collimator position for beam spots near the periphery of the target in each energy layer. Results: The reduction of mean dose to normal tissue adjacent to the target, as defined by a 10 mm ring, averaged 9.13% and 3.48% for the DCS and aperture plans, respectively. The conformity index, as defined by the ratio of the volume of the 50% isodose line to the target volume, yielded an average improvement of 16.42% and 8.16% for the DCS and aperture plans, respectively. Conclusion: Collimation reduces the dose to normal tissue adjacent to the target and increases dose conformity to the target region for low-energy SSPT. The ability of the DCS to provide collimation to each energy layer yields better conformity in comparison to fixed aperture plans. This work was partially funded by IBA (Ion Beam Applications S.A.)

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-376: Evaluation of a New Stereotactic Diode for Small Field Dosimetry

Purpose: To evaluate the performance of a new stereotactic diode for dosimetry of small photon fields. Methods: A new stereotactic diode, consisting of an unshielded p-type silicon chip, and with improved radiation hardness energy dependence was recently developed (IBA Dosimetry, Schwarzenbruch, Germany). The diode has an active volume of 0.6 mm dia. x 0.02 mm thick. Two new diodes were evaluated, one which was pre-irradiated to 100kGy with 10 MeV electrons and another which received no prior irradiation. Sensitivity, stability, reproducibility, and linearity as a function of dose were assessed. Beam profiles and small field output factors were measured on a CyberKnife (CK) and compared with measurements using two commercially available diodes. Results: The new diodes exhibit linear behavior (within 0.6%) over a dose range 0.02 – 50 Gy; a commercially available device exhibits excursions of up to 4% over the same range. The sensitivity is 4.1 and 3.8 nC/Gy for the un-irradiated and pre-irradiated diodes, respectively. When irradiated with 150 Gy in dose increments of 5, 20 and 35 Gy, both new diodes provide a stable response within 0.5%. Output factors measured with the two new diodes are identical and compare favorably with other commercially available diodes and published data. Similarly, no differences in measured field size or penumbra were observed among the devices tested. Conclusion: The new diodes show excellent stability and sensitivity. The beam characterization in terms of output factors and beam profiles is consistent with that obtained with commercially available diodes.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-640: Proton Modulated Arc Therapy Using Scanned Pencil Beams

Purpose: Rotational proton radiotherapy would be an interesting treatment modality if it proves to produce dose distributions that conform to the target as well or better than currently available treatment modalities, while reducing the dose to the surrounding organs at risk. A treatment planning study is presented, showing how this objective can be achieved using a single or small number of scanned mono-energetic pencil beams delivered while the proton gantry rotates at the same time that they may deliver faster and more biologically effective treatments than current proton modalities.Methods Proton treatment using single- (SFO) and multi-field optimized (MFO) PBS plans are compared with PMAT plans in phantoms of different shape and uniformity as well as on a brain case. The method followed in ECLIPSE to produce PMAT plans is presented and the feasibility is discussed. Results Table 1 shows that the conformity and uniformity of the PMAT plans is of similar order than those of the SFO and MFO plans. However, in the brain case, the DVHs shown in Figure 1 indicate a significant reduction of the dose to the OARs when PMAT is used. Similarly, the use of PMAT increases the LET in the treatment area, which could translate into a more biologically effective treatment.Conclusions PMAT could provide dose distributions as conformal as current PBS plans but could also offer faster beam delivery and more biologically effective proton plans.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2015

TU-EF-304-11: Therapeutic Benefits of Collimation in Spot Scanning Proton Therapy in the Treatment of Brain Cancer

Purpose: A dynamic collimation system (DCS) based on two orthogonal pairs of mobile trimmer blades has recently been proposed to reduce the lateral penumbra in spot scanning proton therapy (SSPT). The purpose of this work is to quantify the therapeutic benefit of using the DCS for SSPT of brain cancer by comparing un-collimated and collimated treatment plans. Methods: Un-collimated and collimated brain treatment plans were created for five patients, previously treated with SSPT, using an in-house treatment planning system capable of modeling collimated and un-collimated beamlets. Un-collimated plans reproduced the clinically delivered plans in terms of target coverage and organ-at-risk (OAR) sparing, whereas collimated plans were re-optimized to improve the organ-at-risk sparing while maintaining target coverage. Physical and biological comparison metrics such as dose distribution conformity, mean and maximum doses, normal tissue complication probability (NTCP) and risk of secondary brain cancer were used to evaluate the plans. Results: The DCS systematically improved the dose distribution conformity while preserving the target coverage. The average reduction of the mean dose to the 10-mm ring surrounding the target and the healthy brain were 7.1% (95% CI: 4.2%–9.9%; p<0.01) and 14.3% (95% CI: 7.8%–20.8%; p<0.01), respectively. This yielded an average reduction of 12.0% (95% CI: 8.2%–15.7%; p<0.01) for the brain necrosis NTCP using the Flickinger model, and 14.2% (95% CI: 7.7%–20.8%; p<0.01) for the risk of secondary brain cancer. The average maximum dose reductions for the brainstem, chiasm, optic nerves, cochleae and pituitary gland when comparing un-collimated and collimated plans were 14.3%, 10.4%, 11.2%, 13.0%, 12.9% and 3.4%, respectively. Evaluating individual plans using the Lyman-Kutcher-Burman NTCP model also yielded improvements. Conclusion: The lateral penumbra reduction performed by the DCS increases the normal tissue sparing capabilities of SSPT for brain tumor treatment while preserving the target coverage. This research was financially supported by Ion Beam Applications S.A. (IBA, Louvain-La-Neuve, Belgium)

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

WE-EF-303-08: Proton Radiography Using Pencil Beam Scanning and Novel Micromegas Detectors

Purpose: While the energy of therapeutic proton beams can be adjusted to penetrate to any given depth in water, range uncertainties arise in patients due in part to imprecise knowledge of the stopping power of protons in human tissues. Proton radiography is one approach to reduce the beam range uncertainty, thereby allowing for a reduction in treatment margins and dose escalation. Methods: The authors have adapted a novel detector technology based on Micromesh Gaseous Structure (“Micromegas”) for proton therapy beams and have demonstrated fine spatial and time resolution of magnetically scanned proton pencil beams, as well as wide dynamic range for dosimetry. In this work, proton radiographs were obtained using Micromegas 2D planes positioned downstream of solid water assemblies. The position-sensitive monitor chambers in the IBA proton delivery nozzle provide the beam entrance position. Results: Radiography with Micromegas detectors and actively scanned beams provide spatial resolution of up to 300 µm and water-equivalent thickness (WET) resolution as good as 0.02% (60 µm out of 31 cm total thickness), with the dose delivered to the patient kept below 2 cGy. The spatial resolution as a function of sample rate and number of delivered protons is found to be near the theoretical Cramer-Rao lower bound. Using the CR bound, we argue that the imaging dose could be further lowered to 1 mGy, while still achieving sub-mm spatial resolution, by relatively simple instrumentation upgrades and beam delivery modifications. Conclusion: For proton radiography, high spatial and WET resolution can be achieved, with minimal additional dose to patient, by using magnetically scanned proton pencil beams and Micromegas detectors.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2014

SU-E-T-153: Establish a Comprehensive Patient-Specific Plan QA Database for Instituitional Quality Control Program

Purpose: Since the publication of TG-119, several new treatment techniques requiring new QA devices have been implemented in the clinic. To monitor and analyze our institutional QA performance, we have created a comprehensive QA database using Research Electronic Data Capture (REDCap). The database will also assist us in creating IMRT QA Analysis practice guidelines. Methods: Since Oct. 2013, 336 patient plan QA results were entered into the database. Plan parameters such as plan ID, treatment site, technique, energy, optimization constraints, modulation factor, leaf speed, leaf opening.etc were automatically extracted from the Varian Eclipse database to allow us to refine our evaluation and analysis method. Specific QA device, LINAC-related information, and measurement and analysis results were manually entered by the QA team. IMRT plans were measured using MapCHECK2 while RapidArc plans were measured using ArcCHECK. Distance-To-Agreement 3%/3mm without global maximum normalization was used. Results: The data indicates that different treatment techniques might benefit from a different site-specific action level(AL) depending on the complexity of the plan and optimization parameter used (e.g., breast IMRT QA= 97.8% and pelvis IMRT QA=93.1%). Different QA devices may also benefit from a different AL (MapCHECK2 = 94.1% while ArcCHECK = 83.0%). The relationship between the parameters and passing rate suggests that the complexity of each plan, characterized by leaf travel, leaf opening and modulation factor, affect the passing rate significantly. The database is reviewed regularly, and any abnormal point of the QA result or a trend of lower QA passing rate on a specific LINAC is further investigated. Conclusion: Establishing a comprehensive QA database provides an overview of the quality assurance program. It not only helps in answering the question “what is a reasonable and achievable standard for each institution”, but also saves time in monitoring and investigating the daily machine and QA performance.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2014

SU-E-T-287: Robustness Study of Passive-Scattering Proton Therapy in Lung: Is Range and Setup Uncertainty Calculation On the Initial CT Enough to Predict the Plan Robustness?

Purpose: Plan robustness of the passive-scattering proton therapy treatment of lung tumors has been studied previously using combined uncertainties of 3.5% in CT number and 3 mm geometric shifts. In this study, we investigate whether this method is sufficient to predict proton plan robustness by comparing to plans performed on weekly verification CT scans. Methods: Ten lung cancer patients treated with passive-scattering proton therapy were randomly selected. All plans were prescribed 6660cGy in 37 fractions. Each initial plan was calculated using +/− 3.5% range and +/− 0.3cm setup uncertainty in x, y and z directions in Eclipse TPS(Method-A). Throughout the treatment course, patients received weekly verification CT scans to assess the daily treatment variation(Method-B). After contours and imaging registrations are verified by the physician, the initial plan with the same beamline and compensator was mapped into the verification CT. Dose volume histograms (DVH) were evaluated for robustness study. Results: Differences are observed between method A and B in terms of iCTV coverage and lung dose. Method-A shows all the iCTV D95 are within +/− 1% difference, while 20% of cases fall outside +/−1% range in Method-B. In the worst case scenario(WCS), the iCTV D95 is reduced by 2.5%. All lung V5 and V20 are within +/−5% in Method-A while 15% of V5 and 10% of V20 fall outside of +/−5% in Method-B. In the WCS, Lung V5 increased by 15% and V20 increased by 9%. Method A and B show good agreement with regard to cord maximum and Esophagus mean dose. Conclusion: This study suggests that using range and setup uncertainty calculation (+/−3.5% and +/−3mm) may not be sufficient to predict the WCS. In the absence of regular verification scans, expanding the conventional uncertainty parameters(e.g., to +/−3.5% and +/−4mm) may be needed to better reflect plan actual robustness.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2014

SU-E-T-363: Experimentally Validated Pencil Beam Scanning Source Model in TOPAS

Purpose: Monte Carlo method can provide the most accurate dose calculation for pencil beam scanning (PBS) proton therapy if the proton sources and particle interaction mechanisms are correct. Methods: TOPAS 1.8, a simulation tool based on Geant4.9.6, was utilized to simulate proton spot profiles. Proton sources, placed at the phantom surface, were modelled with three two-dimensional Gaussian functions to fit measured in-air spot profiles up to 100 mm radius. Simulations were compared with profiles measured using EBT3 film in Solidwater phantoms at various depths from the surface to the end of range for 100, 115, 150, 180, 210 and 225 MeV proton beams with phantom surface locations at 270 mm upstream and at isocentre. Results: Simulation can reproduce one-dimensional integral dose versus radius within 1 mm/1% and two-dimensional profiles within 1 mm out to 0.1% of the central spot dose for all the studied depths of all energies. For two-dimensional 0.01% isodose, simulation can reproduce all 210 MeV proton beam measurements, but cannot predict the diamond-shaped isodose distributions of the 115 MeV beam. When the proton spots are scanned 100 mm off axis, no profile difference can be found between the central axis and the off axis locations for the 210 MeV beam. For the 115 MeV beam, differences of up to 2 mm are observed at the ends of the diamond-shaped 0.01% isodose contour, implying there are lower energy components in the energy spectrum which are less than 4% of the primary energy. Subsequent simulation demonstrates that adopting such an energy spectrum within the source model can improve the distance agreement by 5–6 mm for isodoses below 0.1% near the end of range of the 115 MeV proton beam. Conclusion: Excellent agreement between simulation and measurement validates our PBS source model and the particle interaction mechanism embedded in TOPAS.

07 ISOTOPE AND RADIATION SOURCES↗