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All sourcesNASA NTRSDOE OSTI
DOE OSTI2016

HPSim, Version 1.0

HPSim is a GPU-accelerated online multi-particle beam dynamics simulation tool for ion linacs. It was originally developed for use on the Los Alamos 800-MeV proton linac. It is a “z-code” that contains typical linac beam transport elements. The linac RF-gap transformation utilizes transit-time-factors to calculate the beam acceleration therein. The space-charge effects are computed using the 2D SCHEFF (Space CHarge EFFect) algorithm, which calculates the radial and longitudinal space charge forces for cylindrically symmetric beam distributions. Other space- charge routines to be incorporated include the 3D PICNIC and a 3D Poisson solver. HPSim can simulate beam dynamics in drift tube linacs (DTLs) and coupled cavity linacs (CCLs). Elliptical superconducting cavity (SC) structures will also be incorporated into the code. The computational core of the code is written in C++ and accelerated using the NVIDIA CUDA technology. Users access the core code, which is wrapped in Python/C APIs, via Pythons scripts that enable ease-of-use and automation of the simulations. The overall linac description including the EPICS PV machine control parameters is kept in an SQLite database that also contains calibration and conversion factors required to transform the machine set points into model values used in the simulation.

Pang, Xiaoying↗
DOE OSTI2015

Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a {sup 60}Co Magnetic Resonance Image Guidance Radiation Therapy System

Purpose: This work describes a commercial treatment planning system, its technical features, and its capabilities for creating {sup 60}Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. Methods and Materials: The ViewRay treatment planning system (Oakwood Village, OH) was used to create {sup 60}Co IMRT treatment plans for 33 cancer patients with disease in the abdominal, pelvic, thorax, and head and neck regions using physician-specified patient-specific target coverage and organ at risk (OAR) objectives. Backup plans using a third-party linear accelerator (linac)-based planning system were also created. Plans were evaluated by attending physicians and approved for treatment. The {sup 60}Co and linac plans were compared by evaluating conformity numbers (CN) with 100% and 95% of prescription reference doses and heterogeneity indices (HI) for planning target volumes (PTVs) and maximum, mean, and dose-volume histogram (DVH) values for OARs. Results: All {sup 60}Co IMRT plans achieved PTV coverage and OAR sparing that were similar to linac plans. PTV conformity for {sup 60}Co was within <1% and 3% of linac plans for 100% and 95% prescription reference isodoses, respectively, and heterogeneity was on average 4% greater. Comparisons of OAR mean dose showed generally better sparing with linac plans in the low-dose range <20 Gy, but comparable sparing for organs with mean doses >20 Gy. The mean doses for all {sup 60}Co plan OARs were within clinical tolerances. Conclusions: A commercial {sup 60}Co MR-IGRT device can produce highly conformal IMRT treatment plans similar in quality to linac IMRT for a variety of disease sites. Additional work is in progress to evaluate the clinical benefit of other novel features of this MR-IGRT system.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Beam dynamics study of a 30 MeV electron linear accelerator to drive a neutron source

An experimental neutron facility based on 32 MeV/18.47 kW electron linac has been studied by means of PARMELA simulation code. Beam dynamics study for a traveling wave constant gradient electron accelerator is carried out to reach the preferential operation parameters (E = 30 MeV, P = 18 kW, dE/E < 12.47% for 99% particles). The whole linac comprises mainly E-gun, pre-buncher, buncher, and 2 accelerating columns. A disk-loaded, on-axis-coupled, 2π/3-mode type accelerating rf cavity is considered for this linac. After numerous optimizations of linac parameters, 32 MeV beam energy is obtained at the end of the linac. As high electron energy is required to produce acceptable neutron flux. The final neutron flux is estimated to be 5 × 10{sup 11} n/cm{sup 2}/s/mA. Future development will be the real design of a 30 MeV electron linac based on S band traveling wave.

43 PARTICLE ACCELERATORS↗
DOE OSTI2014

Monte Carlo based beam model using a photon MLC for modulated electron radiotherapy

Purpose: Modulated electron radiotherapy (MERT) promises sparing of organs at risk for certain tumor sites. Any implementation of MERT treatment planning requires an accurate beam model. The aim of this work is the development of a beam model which reconstructs electron fields shaped using the Millennium photon multileaf collimator (MLC) (Varian Medical Systems, Inc., Palo Alto, CA) for a Varian linear accelerator (linac). Methods: This beam model is divided into an analytical part (two photon and two electron sources) and a Monte Carlo (MC) transport through the MLC. For dose calculation purposes the beam model has been coupled with a macro MC dose calculation algorithm. The commissioning process requires a set of measurements and precalculated MC input. The beam model has been commissioned at a source to surface distance of 70 cm for a Clinac 23EX (Varian Medical Systems, Inc., Palo Alto, CA) and a TrueBeam linac (Varian Medical Systems, Inc., Palo Alto, CA). For validation purposes, measured and calculated depth dose curves and dose profiles are compared for four different MLC shaped electron fields and all available energies. Furthermore, a measured two-dimensional dose distribution for patched segments consisting of three 18 MeV segments, three 12 MeV segments, and a 9 MeV segment is compared with corresponding dose calculations. Finally, measured and calculated two-dimensional dose distributions are compared for a circular segment encompassed with a C-shaped segment. Results: For 15 × 34, 5 × 5, and 2 × 2 cm{sup 2} fields differences between water phantom measurements and calculations using the beam model coupled with the macro MC dose calculation algorithm are generally within 2% of the maximal dose value or 2 mm distance to agreement (DTA) for all electron beam energies. For a more complex MLC pattern, differences between measurements and calculations are generally within 3% of the maximal dose value or 3 mm DTA for all electron beam energies. For the two-dimensional dose comparisons, the differences between calculations and measurements are generally within 2% of the maximal dose value or 2 mm DTA. Conclusions : The results of the dose comparisons suggest that the developed beam model is suitable to accurately reconstruct photon MLC shaped electron beams for a Clinac 23EX and a TrueBeam linac. Hence, in future work the beam model will be utilized to investigate the possibilities of MERT using the photon MLC to shape electron beams.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

TH-C-12A-08: New Compact 10 MV S-Band Linear Accelerator: 3D Finite-Element Design and Monte Carlo Dose Simulations

Purpose: To design a new compact S-band linac waveguide capable of producing a 10 MV x-ray beam, while maintaining the length (27.5 cm) of current 6 MV waveguides. This will allow higher x-ray energies to be used in our linac-MRI systems with the same footprint. Methods: Finite element software COMSOL Multiphysics was used to design an accelerator cavity matching one published in an experiment breakdown study, to ensure that our modeled cavities do not exceed the threshold electric fields published. This cavity was used as the basis for designing an accelerator waveguide, where each cavity of the full waveguide was tuned to resonate at 2.997 GHz by adjusting the cavity diameter. The RF field solution within the waveguide was calculated, and together with an electron-gun phase space generated using Opera3D/SCALA, were input into electron tracking software PARMELA to compute the electron phase space striking the x-ray target. This target phase space was then used in BEAM Monte Carlo simulations to generate percent depth doses curves for this new linac, which were then used to re-optimize the waveguide geometry. Results: The shunt impedance, Q-factor, and peak-to-mean electric field ratio were matched to those published for the breakdown study to within 0.1% error. After tuning the full waveguide, the peak surface fields are calculated to be 207 MV/m, 13% below the breakdown threshold, and a d-max depth of 2.42 cm, a D10/20 value of 1.59, compared to 2.45 cm and 1.59, respectively, for the simulated Varian 10 MV linac and brehmsstrahlung production efficiency 20% lower than a simulated Varian 10 MV linac. Conclusion: This work demonstrates the design of a functional 27.5 cm waveguide producing 10 MV photons with characteristics similar to a Varian 10 MV linac.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Sci—Sat AM: Stereo — 05: The Development of Quality Assurance Methods for Trajectory based Cranial SRS Treatments

The goal of this work was to develop and validate non-planar linac beam trajectories defined by the dynamic motion of the gantry, couch, jaws, collimator and MLCs. This was conducted on the Varian TrueBeam linac by taking advantage of the linac's advanced control features in a non-clinical mode (termed developers mode). In this work, we present quality assurance methods that we have developed to test for the positional and temporal accuracy of the linac's moving components. The first QA method focuses on the coordination of couch and gantry. For this test, we developed a cylindrical phantom which has a film insert. Using this phantom we delivered a plan with dynamic motion of the couch and gantry. We found the mean absolute deviation of the entrance position from its expected value to be 0.5mm, with a standard deviation of 0.5mm. This was within the tolerances set by the machine's mechanical accuracy and the setup accuracy of the phantom. We also present an altered picket fence test which has added dynamic and simultaneous rotations of the couch and the collimator. While the test was shown to be sensitive enough to discern errors 1° and greater, we were unable to identify any errors in the coordination of the linacs collimator and couch. When operating under normal conditions, the Varian TrueBeam linac was able to pass both tests and is within tolerances acceptable for complex trajectory based treatments.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

SU-E-T-745: The Use of Electron Dense Materials for Quality Assurance Testing in a Magnetic Field

Purpose: Due to the effect of the magnetic field on the dose deposition (skewing the beam), machine quality assurance (QA) tests for the MR-linac (MRI combined with a linear accelerator) need to be redesigned. In this work we focus on the redesign of QA tests that address geometrical accuracy of the system. Methods: Using electron dense materials (e.g. copper in our experiment) the dose kernel is minimized and thereby the effect of the magnetic field on the dose distribution. This approach is supported by Monte-Carlo simulations and can be used in practice with film measurements. Two examples of QA tests are presented: beam profile and star-shot measurements. Results: The novel method was verified by performing both measurements on a conventional linac and the MR-linac with a film that was sandwiched between copper layers. Measurements were compared with a reference setup which was similar to setup used in clinical practice. On a conventional linac the experimental outcome showed good agreement between the reference and the new setup for both QA tests. The results from the MR-linac showed that the symmetry of the beam profile was restored in presence of the copper layers in the setup and that the isocenter size can be determined accurately with the introduced star-shot setup (see supporting material). Conclusion: The use of electron dense materials for QA tests was shown to be a simple and effective method to remove the effects on the dose distribution enabling assessment of geometrical accuracy of a MR-linac system. The use of high dense materials is not limited to the presented QA tests only, but has a broad applicability for beam specific QA tests in presence of a magnetic field.

43 PARTICLE ACCELERATORS↗
DOE OSTI2015

SU-F-BRB-16: A Spreadsheet Based Automatic Trajectory GEnerator (SAGE): An Open Source Tool for Automatic Creation of TrueBeam Developer Mode Robotic Trajectories

Purpose: To automate creation and delivery of robotic linac trajectories with TrueBeam Developer Mode, an open source spreadsheet-based trajectory generation tool has been developed, tested and made freely available. The computing power inherent in a spreadsheet environment plus additional functions programmed into the tool insulate users from the underlying schema tedium and allow easy calculation, parameterization, graphical visualization, validation and finally automatic generation of Developer Mode XML scripts which are directly loadable on a TrueBeam linac. Methods: The robotic control system platform that allows total coordination of potentially all linac moving axes with beam (continuous, step-and-shoot, or combination thereof) becomes available in TrueBeam Developer Mode. Many complex trajectories are either geometric or can be described in analytical form, making the computational power, graphing and programmability available in a spreadsheet environment an easy and ideal vehicle for automatic trajectory generation. The spreadsheet environment allows also for parameterization of trajectories thus enabling the creation of entire families of trajectories using only a few variables. Standard spreadsheet functionality has been extended for powerful movie-like dynamic graphic visualization of the gantry, table, MLC, room, lasers, 3D observer placement and beam centerline all as a function of MU or time, for analysis of the motions before requiring actual linac time. Results: We used the tool to generate and deliver extended SAD “virtual isocenter” trajectories of various shapes such as parameterized circles and ellipses. We also demonstrated use of the tool in generating linac couch motions that simulate respiratory motion using analytical parameterized functions. Conclusion: The SAGE tool is a valuable resource to experiment with families of complex geometric trajectories for a TrueBeam Linac. It makes Developer Mode more accessible as a vehicle to quickly translate research ideas into machine readable scripts without programming knowledge. As an open source initiative, it also enables researcher collaboration on future developments. I am a full time employee at Varian Medical Systems, Palo Alto, California.

43 PARTICLE ACCELERATORS↗
DOE OSTI2016

SU-F-T-268: A Feasibility Study of Independent Dose Verification for Vero4DRT

Purpose: Vero4DRT (Mitsubishi Heavy Industries Ltd.) has been released for a few years. The treatment planning system (TPS) of Vero4DRT is dedicated, so the measurement is the only method of dose verification. There have been no reports of independent dose verification using Clarksonbased algorithm for Vero4DRT. An independent dose verification software program of the general-purpose linac using a modified Clarkson-based algorithm was modified for Vero4DRT. In this study, we evaluated the accuracy of independent dose verification program and the feasibility of the secondary check for Vero4DRT. Methods: iPlan (Brainlab AG) was used as the TPS. PencilBeam Convolution was used for dose calculation algorithm of IMRT and X-ray Voxel Monte Carlo was used for the others. Simple MU Analysis (SMU, Triangle Products, Japan) was used as the independent dose verification software program in which CT-based dose calculation was performed using a modified Clarkson-based algorithm. In this study, 120 patients’ treatment plans were collected in our institute. The treatments were performed using the conventional irradiation for lung and prostate, SBRT for lung and Step and shoot IMRT for prostate. Comparison in dose between the TPS and the SMU was done and confidence limits (CLs, Mean ± 2SD %) were compared to those from the general-purpose linac. Results: As the results of the CLs, the conventional irradiation (lung, prostate), SBRT (lung) and IMRT (prostate) show 2.2 ± 3.5% (CL of the general-purpose linac: 2.4 ± 5.3%), 1.1 ± 1.7% (−0.3 ± 2.0%), 4.8 ± 3.7% (5.4 ± 5.3%) and −0.5 ± 2.5% (−0.1 ± 3.6%), respectively. The CLs for Vero4DRT show similar results to that for the general-purpose linac. Conclusion: The independent dose verification for the new linac is clinically available as a secondary check and we performed the check with the similar tolerance level of the general-purpose linac. This research is partially supported by Japan Agency for Medical Research and Development (AMED)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-TeP2-04: Comprehensive Machine Isocenter Evaluation with Separation of Gantry, Collimator, and Table Variables

Purpose: To develop and demonstrate application of a method that characterizes deviation of linac x-ray beams from the centroid of the volumetric radiation isocenter as a function of gantry, collimator, and table variables. Methods: A set of Winston-Lutz ball-bearing images was used to determine the gantry radiation isocenter as the midrange of deviation values resulting from gantry and collimator rotation. Also determined were displacement of table axis from gantry isocenter and recommended table axis adjustment. The method, previously reported, has been extended to include the effect of collimator walkout by obtaining measurements with 0 and 180 degree collimator rotation for each gantry angle. Twelve images were used to characterize the volumetric isocenter for the full range of available gantry, collimator, and table rotations. Results: Three Varian True Beam, two Elekta Infinity and four Versa HD linacs at five institutions were tested using identical methodology. Varian linacs exhibited substantially less deviation due to head sag than Elekta linacs (0.4 mm vs. 1.2 mm on average). One linac from each manufacturer had additional isocenter deviation of 0.3 to 0.4 mm due to jaw instability with gantry and collimator rotation. For all linacs, the achievable isocenter tolerance was dependent on adjustment of collimator position offset, transverse position steering, and alignment of the table axis with gantry isocenter, facilitated by these test results. The pattern and magnitude of table axis wobble vs. table angle was reproducible and unique to each machine. Conclusion: This new method provides a comprehensive set of isocenter deviation values including all variables. It effectively facilitates minimization of deviation between beam center and target (ball-bearing) position. This method was used to quantify the effect of jaw instability on isocenter deviation and to identify the offending jaw. The test is suitable for incorporation into a routine machine QA program. Software development was performed by Radiological Imaging Technology, Inc.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2025

Fermilab's controls development with virtual accelerator

Control Systems development is often the last thing considered when designing and building new equipment, e.g. a new detector or superconducting RF LINAC; however when the new equipment is installed, it is the first thing desired to be operational for testing. Due to frequent delays in building new equipment and project deadlines, control system development and testing is often curtailed. A way to alleviate this problem is to simulate the control system, though this will be challenging for complex systems.The Fermilab PIP-II (proton improvement plan - II) project is being constructed at Fermilab to deliver $800\,MeV$ protons of $>1\,MW$ beam power to replace the present LINAC for the remainder of the existing accelerator complex. The new LINAC consists of a warm front end (WFE), 23 superconducting RF cryomodules (of 5 types), and a beam transfer line (BTL) to the existing complex.The accelerator physics group has a parallel project to create a digital twin (DT) of the PIP-II accelerator. We have coupled the EPICS controls to this DT and are developing both the DT and EPICS software in parallel. This will allow us to develop the EPICS software framework, the HMIs, sequences, high level physics applications, and other services for use in a fully functional control system.This presentation will detail the work that we have performed to date and show demonstrations of controlling and monitoring the status of the accelerator, as well as future plans for this work.

Hanlet, Pierrick [Fermilab]↗
DOE OSTI2019

Multi-pass ERL in a ‘Dogbone’ Topology

The main thrust of a multi-pass RLA is its very efficient usage of expensive linac structures. That efficiency can be further enhanced by configuring an RLA in a ?dogbone? topology, which further ?boosts? the RF efficiency by factor of two (compare to a corresponding racetrack). However, the ?dogbone? configuration requires the beam to traverse the linac in both directions, while being accelerated. This can be facilitated by a special ?bisected? linac Optics. Here, the quadrupole gradients scale up with momentum to maintain periodic FODO structure for the lowest energy pass in the first half of the linac and then the quadrupole strengths are mirror reflected in the second linac half. The virtue of this optics is the appearance of distinct nodes in the beta beat-wave at the ends of each pass (where the droplet arcs begin), which limits the growth of initial betas at the beginning of each subsequent droplet arc. Furthermore, ?bisected? linac optics naturally supports energy recovery in the ?dogbone? topology. Here, we present a-proof-of-principle lattice design of a multi-pass ?dogbone? ERL.

Bogacz, Slawomir↗
DOE OSTI2017

Operation of the NSLS-II Injector with a Lower Booster Injection Energy

The NSLS-II injector consists of a 200 MeV linac and a 3 GeV full-energy booster synchrotron. The linac contains five traveling-wave S-band accelerating structures driven by two high-power klystrons. Optimization of the NSLS-II injector has continued since user operation started in October 2014. Beam losses have been minimized by the injector tuning and stabilization, and high level software has been developed to characterize the booster and injection parameters. However, due to the recently increased frequency of klystrons arcing which shortens the lifetime of the klystron, operation of the linac with lowered klystron output power would allow injection to be maintained with fewer trips and extended lifetime of klystrons. Apart from the energy difference, the low energy klystron operation is quite similar to the nominal 200 MeV operation. Injection trials were carried out with scaled magnet settings of the linac, linac-to- booster (LtB) transport line, and the booster. The beam was successfully injected into the booster on May 31, 2017 at the low energy mode of the 170 MeV LtB injection. Overall transfer efficiency from the linac to the storage ring is identical to the standard 200 MeV operation. The 170 MeV injection mode has been adopted in NSLS-II user operation ever since the beam study. In the most recent injector studies on June 28 and July 3, 2017, the booster injection energy was further decremented to the final target value of 100 MeV via applying the same method established in the 170 MeV operation. The ultimate value of 100 MeV is determined by the special requirement of operating the injector at single klystron while repairing the other klystron or with two klystrons with significantly reduced outputs for the purpose of maximizing klystron lifetimes.

36 MATERIALS SCIENCE↗
DOE OSTI2018

High gradient RF test results of S-band and C-band cavities for medical linear accelerators

TERA Foundation has proposed and designed hadrontherapy facilities based on novel linacs, i.e. high gradient linacs which accelerate either protons or light ions. The overall length of the linac, and therefore its cost, is almost inversely proportional to the average accelerating gradient. With the scope of studying the limiting factors for high gradient operation and to optimize the linac design, TERA, in collaboration with the CLIC Structure Development Group, has conducted a series of high gradient experiments. The main goals were to study the high gradient behavior and to evaluate the maximum gradient reached in 3 and 5.7 GHz structures to direct the design of medical accelerators based on high gradient linacs. Lastly, this paper summarizes the results of the high power tests of 3.0 and 5.7 GHz single-cell cavities.

43 PARTICLE ACCELERATORS↗
DOE OSTI2017

Experimental Platform for Ultra-high Dose Rate FLASH Irradiation of Small Animals Using a Clinical Linear Accelerator

Purpose: A key factor limiting the effectiveness of radiation therapy is normal tissue toxicity, and recent preclinical data have shown that ultra-high dose rate irradiation (>50 Gy/s, “FLASH”) potentially mitigates this effect. However, research in this field has been strongly limited by the availability of FLASH irradiators suitable for small animal experiments. We present a simple methodologic approach for FLASH electron small animal irradiation with a clinically available linear accelerator (LINAC). Methods and Materials: We investigated the FLASH irradiation potential of a Varian Clinac 21EX in both clinical mode and after tuning of the LINAC. We performed detailed FLUKA Monte Carlo and experimental dosimetric characterization at multiple experimental locations within the LINAC head. Results: Average dose rates of ≤74 Gy/s were achieved in clinical mode, and the dose rate after tuning exceeded 900 Gy/s. We obtained 220 Gy/s at 1-cm depth for a >4-cm field size with 90% homogeneity throughout a 2-cm-thick volume. Conclusions: We present an approach for using a clinical LINAC for FLASH irradiation. We obtained dose rates exceeding 200 Gy/s after simple tuning of the LINAC, with excellent dosimetric properties for small animal experiments. This will allow for increased availability of FLASH irradiation to the general research community.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

A treatment planning comparison between modulated tri-cobalt-60 teletherapy and linear accelerator–based stereotactic body radiotherapy for central early-stage non−small cell lung cancer

We evaluated the feasibility of planning stereotactic body radiotherapy (SBRT) for large central early-stage non−small cell lung cancer with a tri-cobalt-60 (tri-{sup 60}Co) system equipped with real-time magnetic resonance imaging (MRI) guidance, as compared to linear accelerator (LINAC)–based SBRT. In all, 20 patients with large central early-stage non−small cell lung cancer who were treated between 2010 and 2015 with LINAC-based SBRT were replanned using a tri-{sup 60}Co system for a prescription dose of 50 Gy in 4 fractions. Doses to organs at risk were evaluated based on established MD Anderson constraints for central lung SBRT. R{sub 100} values were calculated as the total tissue volume receiving 100% of the dose (V{sub 100}) divided by the planning target volume and compared to assess dose conformity. Dosimetric comparisons between LINAC-based and tri-{sup 60}Co SBRT plans were performed using Student's t-test and Wilcoxon Ranks test. Blinded reviews by radiation oncologists were performed to assess the suitability of both plans for clinical delivery. The mean planning target volume was 48.3 cc (range: 12.1 to 139.4 cc). Of the tri-{sup 60}Co SBRT plans, a mean 97.4% of dosimetric parameters per patient met MD Anderson dose constraints, whereas a mean 98.8% of dosimetric parameters per patient were met with LINAC-based SBRT planning (p = 0.056). R{sub 100} values were similar between both plans (1.20 vs 1.21, p = 0.79). Upon blinded review by 4 radiation oncologists, an average of 90% of the tri-{sup 60}Co SBRT plans were considered acceptable for clinical delivery compared with 100% of the corresponding LINAC-based SBRT plans (p = 0.17). SBRT planning using the tri-{sup 60}Co system with built-in MRI is feasible and achieves clinically acceptable plans for most central lung patients, with similar target dose conformity and organ at risk dosimetry. The added benefit of real-time MRI-guided therapy may further optimize tumor targeting while improving normal tissue sparing, which warrants further investigation in a prospective feasibility clinical trial.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

Commissioning of the Varian TrueBeam linear accelerator: A multi-institutional study

Purpose: Latest generation linear accelerators (linacs), i.e., TrueBeam (Varian Medical Systems, Palo Alto, CA) and its stereotactic counterpart, TrueBeam STx, have several unique features, including high-dose-rate flattening-filter-free (FFF) photon modes, reengineered electron modes with new scattering foil geometries, updated imaging hardware/software, and a novel control system. An evaluation of five TrueBeam linacs at three different institutions has been performed and this work reports on the commissioning experience. Methods: Acceptance and commissioning data were analyzed for five TrueBeam linacs equipped with 120 leaf (5 mm width) MLCs at three different institutions. Dosimetric data and mechanical parameters were compared. These included measurements of photon beam profiles (6X, 6XFFF, 10X, 10XFFF, 15X), photon and electron percent depth dose (PDD) curves (6, 9, 12 MeV), relative photon output factors (Scp), electron cone factors, mechanical isocenter accuracy, MLC transmission, and dosimetric leaf gap (DLG). End-to-end testing and IMRT commissioning were also conducted. Results: Gantry/collimator isocentricity measurements were similar (0.27-0.28 mm), with overall couch/gantry/collimator values of 0.46-0.68 mm across the three institutions. Dosimetric data showed good agreement between machines. The average MLC DLGs for 6, 10, and 15 MV photons were 1.33 {+-} 0.23, 1.57 {+-} 0.24, and 1.61 {+-} 0.26 mm, respectively. 6XFFF and 10XFFF modes had average DLGs of 1.16 {+-} 0.22 and 1.44 {+-} 0.30 mm, respectively. MLC transmission showed minimal variation across the three institutions, with the standard deviation <0.2% for all linacs. Photon and electron PDDs were comparable for all energies. 6, 10, and 15 MV photon beam quality, %dd(10){sub x} varied less than 0.3% for all linacs. Output factors (Scp) and electron cone factors agreed within 0.27%, on average; largest variations were observed for small field sizes (1.2% coefficient of variation, 10 MV, 2 Multiplication-Sign 2 cm{sup 2}) and small cone sizes (<1% coefficient of variation, 6 Multiplication-Sign 6 cm{sup 2} cone), respectively. Conclusions: Overall, excellent agreement was observed in TrueBeam commissioning data. This set of multi-institutional data can provide comparison data to others embarking on TrueBeam commissioning, ultimately improving the safety and quality of beam commissioning.

43 PARTICLE ACCELERATORS↗
DOE OSTI2014

SU-C-19A-05: Treatment Chairs for Modern Radiation Therapy Treatments

Purpose: Treating patients in a seated position has potential advantages including improved comfort, increased lung volume, and reduced respiratory motion. We compared chair designs for head and neck, thoracic and breast patients for use with either IGRT linacs or a proposed low-cost fixed horizontal beam-line machine. Methods: Three treatment chairs were designed and constructed. Two of the chairs are based on a massage-chair, with the patient angled slightly forwards and knee rests used to minimize intra-fraction slouch. The third chair design is more conventional; the patient is angled backwards, with indexed positioning devices and the ability to attach thermoplastic masks. Patient geometries, including PTV location and patient sizes, were extracted from 137 CTs of past patients were used to model the probability of collision between the patient and the linac for various seated positions. All chairs were designed around the weight limits for couches on our linacs. At the time of writing we have just received IRB approval for imaging studies to evaluate comfort, and intra- and interfraction reproducibility. Results: The geometric analysis showed that head and neck patients and thoracic patients could be treated without collision. However, there is very limited space between the patient and the treatment/imaging devices, so careful design of the chair is essential. The position of the treatment target and extended arm positioning means that this is a particular concern for thoracic and breast patients. This was demonstrated for one of the prototype chairs designed for breast treatment where the arm holders would collide with the kV detector. The extra clearance of a dedicated fixed-beam linac would overcome these difficulties. Intra- and inter-fraction reproducibility results will be presented at the meeting. Conclusion: To take advantage of the clinical advantages of seated treatments, appropriate treatment chairs are needed. A dedicate fixed-beam linac may enable more options. This work was partially funded by Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗