Search NASA⌕ Search

SEARCH · Search NASA

Results for “LINAC”

Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,045 records · Page 58
All sourcesNASA NTRSDOE OSTI
DOE OSTI2013

Correcting radiation survey data to account for increased leakage during intensity modulated radiotherapy treatments

Purpose: Intensity modulated radiotherapy (IMRT) treatments require more beam-on time and produce more linac head leakage to deliver similar doses to conventional, unmodulated, radiotherapy treatments. It is necessary to take this increased leakage into account when evaluating the results of radiation surveys around bunkers that are, or will be, used for IMRT. The recommended procedure of applying a monitor-unit based workload correction factor to secondary barrier survey measurements, to account for this increased leakage when evaluating radiation survey measurements around IMRT bunkers, can lead to potentially costly overestimation of the required barrier thickness. This study aims to provide initial guidance on the validity of reducing the value of the correction factor when applied to different radiation barriers (primary barriers, doors, maze walls, and other walls) by evaluating three different bunker designs.Methods: Radiation survey measurements of primary, scattered, and leakage radiation were obtained at each of five survey points around each of three different radiotherapy bunkers and the contribution of leakage to the total measured radiation dose at each point was evaluated. Measurements at each survey point were made with the linac gantry set to 12 equidistant positions from 0° to 330°, to assess the effects of radiation beam direction on the results.Results: For all three bunker designs, less than 0.5% of dose measured at and alongside the primary barriers, less than 25% of the dose measured outside the bunker doors and up to 100% of the dose measured outside other secondary barriers was found to be caused by linac head leakage.Conclusions: Results of this study suggest that IMRT workload corrections are unnecessary, for survey measurements made at and alongside primary barriers. Use of reduced IMRT workload correction factors is recommended when evaluating survey measurements around a bunker door, provided that a subset of the measurements used in this study are repeated for the bunker in question. Reduction of the correction factor for other secondary barrier survey measurements is not recommended unless the contribution from leakage is separately evaluated.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Characteristics of flattening filter free beams at low monitor unit settings

Purpose: Newer linear accelerators (linacs) have been equipped to deliver flattening filter free (FFF) beams. When FFF beams are used for step-and-shoot intensity-modulated radiotherapy (IMRT), the stability of delivery of small numbers of monitor units (MU) is important. The authors developed automatic measurement techniques to evaluate the stability of the dose profile, dose linearity, and consistency. Here, the authors report the performance of the Artiste™ accelerator (Siemens, Erlangen, Germany) in delivering low-MU FFF beams.Methods: A 6 MV flattened beam (6X) with 300 MU/min dose rate and FFF beams of 7 (7XU) and 11 MV (11XU), each with a 500 MU/min dose rate, were measured at 1, 2, 3, 5, 8, 10, and 20 MU settings. For the 2000 MU/min dose rate, the 7 (7XUH) and 11 MV (11XUH) beams were set at 10, 15, 20, 25, and 30 MU because of the limits of the minimum MU settings. Beams with 20 × 20 and 10 × 10 cm{sup 2} field sizes were alternately measured ten times in intensity modulated (IM) mode, with which Siemens linacs regulate beam delivery for step-and-shoot IMRT. The in- and crossplane beam profiles were measured using a Profiler™ Model 1170 (Sun Nuclear Corporation, Melbourne, FL) in multiframe mode. The frames of 20 × 20 cm{sup 2} beams were identified at the off-axis profile. The 6X beam profile was normalized at the central axis. The 7 and 11 MV FFF beam profiles were rescaled to set the dose at the central axis at 145% and 170%, respectively. Point doses were also measured using a Farmer-type ionization chamber and water-equivalent solid phantom to evaluate the linearity and consistency of low-MU beam delivery. The values displayed on the electrometer were recognized with a USB-type camera and read with open-source optical character recognition software.Results: The symmetry measurements of the 6X, 7XU, and 11XU beam profiles were better than 2% for beams ≥2 MU and improved with increasing MU. The variations in flatness of FFF beams ≥2 MU were ±5%. The standard deviation of the symmetry and flatness also decreased with increasing MU. The linearity of the 6X beam was ±1% and ±2% for the beams of ≥5 and ≥3 MU, respectively. The 7XU and 11XU beams of ≥2 MU showed linearity with ±2% except the 7XU beam of 8 MU (+2.9%). The profiles of the FFF beams with 2000 and 500 MU/min dose rate were similar.Conclusions: The characteristics of low-MU beams delivered in IM mode were evaluated using an automatic measurement system developed in this study. The authors demonstrated that the profiles of FFF beams of the Artiste™ linac were highly stable, even at low MU. The linearity of dose output was also stable for beams ≥2 MU.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

Evaluation of an aSi-EPID with flattening filter free beams: Applicability to the GLAaS algorithm for portal dosimetry and first experience for pretreatment QA of RapidArc

Purpose: To demonstrate the feasibility of portal dosimetry with an amorphous silicon mega voltage imager for flattening filter free (FFF) photon beams by means of the GLAaS methodology and to validate it for pretreatment quality assurance of volumetric modulated arc therapy (RapidArc).Methods: The GLAaS algorithm, developed for flattened beams, was applied to FFF beams of nominal energy of 6 and 10 MV generated by a Varian TrueBeam (TB). The amorphous silicon electronic portal imager [named mega voltage imager (MVI) on TB] was used to generate integrated images that were converted into matrices of absorbed dose to water. To enable GLAaS use under the increased dose-per-pulse and dose-rate conditions of the FFF beams, new operational source-detector-distance (SDD) was identified to solve detector saturation issues. Empirical corrections were defined to account for the shape of the profiles of the FFF beams to expand the original methodology of beam profile and arm backscattering correction. GLAaS for FFF beams was validated on pretreatment verification of RapidArc plans for three different TB linacs. In addition, the first pretreatment results from clinical experience on 74 arcs were reported in terms of γ analysis.Results: MVI saturates at 100 cm SDD for FFF beams but this can be avoided if images are acquired at 150 cm for all nominal dose rates of FFF beams. Rotational stability of the gantry-imager system was tested and resulted in a minimal apparent imager displacement during rotation of 0.2 ± 0.2 mm at SDD = 150 cm. The accuracy of this approach was tested with three different Varian TrueBeam linacs from different institutes. Data were stratified per energy and machine and showed no dependence with beam quality and MLC model. The results from clinical pretreatment quality assurance, provided a gamma agreement index (GAI) in the field area for six and ten FFF beams of (99.8 ± 0.3)% and (99.5 ± 0.6)% with distance to agreement and dose difference criteria set to 3 mm/3% with 2 mm/2% thresholds, GAI resulted (95.7.0 ± 2.3)% and (97.2 ± 2.1)%.Conclusions: The GLAaS methodology, introduced in clinical practice for conventional flattened photon beams for machine, IMRT, and RapidArc quality assurance, was successfully adapted for FFF beams of Varian TrueBeam Linac. The detector saturation effects could be eliminated if the portal images acquired at 150 cm for all nominal dose rates of FFF beams.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

A line-source method for aligning on-board and other pinhole SPECT systems

Purpose: In order to achieve functional and molecular imaging as patients are in position for radiation therapy, a robotic multipinhole SPECT system is being developed. Alignment of the SPECT system—to the linear accelerator (LINAC) coordinate frame and to the coordinate frames of other on-board imaging systems such as cone-beam CT (CBCT)—is essential for target localization and image reconstruction. An alignment method that utilizes line sources and one pinhole projection is proposed and investigated to achieve this goal. Potentially, this method could also be applied to the calibration of the other pinhole SPECT systems.Methods: An alignment model consisting of multiple alignment parameters was developed which maps line sources in three-dimensional (3D) space to their two-dimensional (2D) projections on the SPECT detector. In a computer-simulation study, 3D coordinates of line-sources were defined in a reference room coordinate frame, such as the LINAC coordinate frame. Corresponding 2D line-source projections were generated by computer simulation that included SPECT blurring and noise effects. The Radon transform was utilized to detect angles (α) and offsets (ρ) of the line-source projections. Alignment parameters were then estimated by a nonlinear least squares method, based on the α and ρ values and the alignment model. Alignment performance was evaluated as a function of number of line sources, Radon transform accuracy, finite line-source width, intrinsic camera resolution, Poisson noise, and acquisition geometry. Experimental evaluations were performed using a physical line-source phantom and a pinhole-collimated gamma camera attached to a robot.Results: In computer-simulation studies, when there was no error in determining angles (α) and offsets (ρ) of the measured projections, six alignment parameters (three translational and three rotational) were estimated perfectly using three line sources. When angles (α) and offsets (ρ) were provided by the Radon transform, estimation accuracy was reduced. The estimation error was associated with rounding errors of Radon transform, finite line-source width, Poisson noise, number of line sources, intrinsic camera resolution, and detector acquisition geometry. Statistically, the estimation accuracy was significantly improved by using four line sources rather than three and by thinner line-source projections (obtained by better intrinsic detector resolution). With five line sources, median errors were 0.2 mm for the detector translations, 0.7 mm for the detector radius of rotation, and less than 0.5° for detector rotation, tilt, and twist. In experimental evaluations, average errors relative to a different, independent registration technique were about 1.8 mm for detector translations, 1.1 mm for the detector radius of rotation (ROR), 0.5° and 0.4° for detector rotation and tilt, respectively, and 1.2° for detector twist.Conclusions: Alignment parameters can be estimated using one pinhole projection of line sources. Alignment errors are largely associated with limited accuracy of the Radon transform in determining angles (α) and offsets (ρ) of the line-source projections. This alignment method may be important for multipinhole SPECT, where relative pinhole alignment may vary during rotation. For pinhole and multipinhole SPECT imaging on-board radiation therapy machines, the method could provide alignment of SPECT coordinates with those of CBCT and the LINAC.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Three independent one-dimensional margins for single-fraction frameless stereotactic radiosurgery brain cases using CBCT

Purpose: Setting a proper margin is crucial for not only delivering the required radiation dose to a target volume, but also reducing the unnecessary radiation to the adjacent organs at risk. This study investigated the independent one-dimensional symmetric and asymmetric margins between the clinical target volume (CTV) and the planning target volume (PTV) for linac-based single-fraction frameless stereotactic radiosurgery (SRS).Methods: The authors assumed a Dirac delta function for the systematic error of a specific machine and a Gaussian function for the residual setup errors. Margin formulas were then derived in details to arrive at a suitable CTV-to-PTV margin for single-fraction frameless SRS. Such a margin ensured that the CTV would receive the prescribed dose in 95% of the patients. To validate our margin formalism, the authors retrospectively analyzed nine patients who were previously treated with noncoplanar conformal beams. Cone-beam computed tomography (CBCT) was used in the patient setup. The isocenter shifts between the CBCT and linac were measured for a Varian Trilogy linear accelerator for three months. For each plan, the authors shifted the isocenter of the plan in each direction by ±3 mm simultaneously to simulate the worst setup scenario. Subsequently, the asymptotic behavior of the CTV V{sub 80%} for each patient was studied as the setup error approached the CTV-PTV margin.Results: The authors found that the proper margin for single-fraction frameless SRS cases with brain cancer was about 3 mm for the machine investigated in this study. The isocenter shifts between the CBCT and the linac remained almost constant over a period of three months for this specific machine. This confirmed our assumption that the machine systematic error distribution could be approximated as a delta function. This definition is especially relevant to a single-fraction treatment. The prescribed dose coverage for all the patients investigated was 96.1%± 5.5% with an extreme 3-mm setup error in all three directions simultaneously. It was found that the effect of the setup error on dose coverage was tumor location dependent. It mostly affected the tumors located in the posterior part of the brain, resulting in a minimum coverage of approximately 72%. This was entirely due to the unique geometry of the posterior head.Conclusions: Margin expansion formulas were derived for single-fraction frameless SRS such that the CTV would receive the prescribed dose in 95% of the patients treated for brain cancer. The margins defined in this study are machine-specific and account for nonzero mean systematic error. The margin for single-fraction SRS for a group of machines was also derived in this paper.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

Monte Carlo simulation of a quantum noise limited Čerenkov detector based on air-spaced light guiding taper for megavoltage x-ray imaging

Purpose: Electronic Portal Imaging Devices (EPIDs) have been widely used in radiation therapy and are still needed on linear accelerators (Linacs) equipped with kilovoltage cone beam CT (kV-CBCT) or MRI systems. Our aim is to develop a new high quantum efficiency (QE) Čerenkov Portal Imaging Device (CPID) that is quantum noise limited at dose levels corresponding to a single Linac pulse. Methods: Recently a new concept of CPID for MV x-ray imaging in radiation therapy was introduced. It relies on Čerenkov effect for x-ray detection. The proposed design consisted of a matrix of optical fibers aligned with the incident x-rays and coupled to an active matrix flat panel imager (AMFPI) for image readout. A weakness of such design is that too few Čerenkov light photons reach the AMFPI for each incident x-ray and an AMFPI with an avalanche gain is required in order to overcome the readout noise for portal imaging application. In this work the authors propose to replace the optical fibers in the CPID with light guides without a cladding layer that are suspended in air. The air between the light guides takes on the role of the cladding layer found in a regular optical fiber. Since air has a significantly lower refractive index (∼1 versus 1.38 in a typical cladding layer), a much superior light collection efficiency is achieved. Results: A Monte Carlo simulation of the new design has been conducted to investigate its feasibility. Detector quantities such as quantum efficiency (QE), spatial resolution (MTF), and frequency dependent detective quantum efficiency (DQE) have been evaluated. The detector signal and the quantum noise have been compared to the readout noise. Conclusions: Our studies show that the modified new CPID has a QE and DQE more than an order of magnitude greater than that of current clinical systems and yet a spatial resolution similar to that of current low-QE flat-panel based EPIDs. Furthermore it was demonstrated that the new CPID does not require an avalanche gain in the AMFPI and is quantum noise limited at dose levels corresponding to a single Linac pulse.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

SU-E-J-126: Respiratory Gating Quality Assurance: A Simple Method to Achieve Millisecond Temporal Resolution

Purpose: Low temporal latency between a gating on/off signal and a linac beam on/off during respiratory gating is critical for patient safety. Although, a measurement of temporal lag is recommended by AAPM Task Group 142 for commissioning and annual quality assurance, there currently exists no published method. Here we describe a simple, inexpensive, and reliable method to precisely measure gating lag at millisecond resolutions. Methods: A Varian Real-time Position Management™ (RPM) gating simulator with rotating disk was modified with a resistive flex sensor (Spectra Symbol) attached to the gating box platform. A photon diode was placed at machine isocenter. Output signals of the flex sensor and diode were monitored with a multichannel oscilloscope (Tektronix™ DPO3014). Qualitative inspection of the gating window/beam on synchronicity were made by setting the linac to beam on/off at end-expiration, and the oscilloscope's temporal window to 100 ms to visually examine if the on/off timing was within the recommended 100-ms tolerance. Quantitative measurements were made by saving the signal traces and analyzing in MatLab™. The on and off of the beam signal were located and compared to the expected gating window (e.g. 40% to 60%). Four gating cycles were measured and compared. Results: On a Varian TrueBeam™ STx linac with RPM gating software, the average difference in synchronicity at beam on and off for four cycles was 14 ms (3 to 30 ms) and 11 ms (2 to 32 ms), respectively. For a Varian Clinac™ 21EX the average difference at beam on and off was 127 ms (122 to 133 ms) and 46 ms (42 to 49 ms), respectively. The uncertainty in the synchrony difference was estimated at ±6 ms. Conclusion: This new gating QA method is easy to implement and allows for fast qualitative inspection and quantitative measurements for commissioning and TG-142 annual QA measurements.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

SU-E-J-156: Preclinical Inverstigation of Dynamic Tumor Tracking Using Vero SBRT Linear Accelerator: Motion Phantom Dosimetry Study

Purpose: Following the ‘end-to-end testing’ paradigm of Dynamic Target Tracking option in our Image-Guided dedicated SBRT VeroTM linac, we verify the capability of the system to deliver planned dose to moving targets in the heterogeneous thorax phantom (CIRSTM). The system includes gimbaled C-band linac head, robotic 6 degree of freedom couch and a tumor tracking method based on predictive modeling of target position using fluoroscopically tracked implanted markers and optically tracked infrared reflecting external markers. Methods: 4DCT scan of the motion phantom with the VisicoilTM implanted marker in the close vicinity of the target was acquired, the ‘exhale’=most prevalent phase was used for planning (iPlan by BrainLabTM). Typical 3D conformal SBRT treatment plans aimed to deliver 6-8Gy/fx to two types of targets: a)solid water-equivalent target 3cm in diameter; b)single VisicoilTM marker inserted within lung equivalent material. The planning GTV/CTV-to-PTV margins were 2mm, the block margins were 3 mm. The dose calculated by MonteCarlo algorithm with 1% variance using option Dose-to-water was compared to the ion chamber (CC01 by IBA Dosimetry) measurements in case (a) and GafchromicTM EBT3 film measurements in case (b). During delivery, the target 6 motion patterns available as a standard on CIRSTM motion phantom were investigated: in case (a), the target was moving along the designated sine or cosine4 3D trajectory; in case (b), the inserted marker was moving sinusoidally in 1D. Results: The ion chamber measurements have shown the agreement with the planned dose within 1% under all the studied motion conditions. The film measurements show 98.1% agreement with the planar calculated dose (gamma criteria: 3%/3mm). Conclusion: We successfully verified the capability of the SBRT VeroTM linac to perform real-time tumor tracking and accurate dose delivery to the target, based on predictive modeling of the correlation between implanted marker motion and external surrogate of breathing motion.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-209: Independent Dose Calculation in FFF Modulated Fields with Pencil Beam Kernels Obtained by Deconvolution

Purpose: To obtain the pencil beam kernels that characterize a megavoltage photon beam generated in a FFF linac by experimental measurements, and to apply them for dose calculation in modulated fields. Methods: Several Kodak EDR2 radiographic films were irradiated with a 10 MV FFF photon beam from a Varian True Beam (Varian Medical Systems, Palo Alto, CA) linac, at the depths of 5, 10, 15, and 20cm in polystyrene (RW3 water equivalent phantom, PTW Freiburg, Germany). The irradiation field was a 50 mm diameter circular field, collimated with a lead block. Measured dose leads to the kernel characterization, assuming that the energy fluence exiting the linac head and further collimated is originated on a point source. The three-dimensional kernel was obtained by deconvolution at each depth using the Hankel transform. A correction on the low dose part of the kernel was performed to reproduce accurately the experimental output factors. The kernels were used to calculate modulated dose distributions in six modulated fields and compared through the gamma index to their absolute dose measured by film in the RW3 phantom. Results: The resulting kernels properly characterize the global beam penumbra. The output factor-based correction was carried out adding the amount of signal necessary to reproduce the experimental output factor in steps of 2mm, starting at a radius of 4mm. There the kernel signal was in all cases below 10% of its maximum value. With this correction, the number of points that pass the gamma index criteria (3%, 3mm) in the modulated fields for all cases are at least 99.6% of the total number of points. Conclusion: A system for independent dose calculations in modulated fields from FFF beams has been developed. Pencil beam kernels were obtained and their ability to accurately calculate dose in homogeneous media was demonstrated.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-386: A Monte Carlo Dose Calculation Framework for Electron Beams On Varian TrueBeam

Purpose: The design of the linac head is different for TrueBeam than Clinac, and there are differences in measured dose distributions in water phantoms between TrueBeam and Clinac for electron beams. Therefore, MC models for Clinac may not be applied directly to the Truebeam linac. The purpose of this study is to validate a Monte Carlo (MC) dose calculation framework for electron beams on Varian TrueBeam with phase space files provided by Varian. Methods: The particle histories from the phase space file were used as input for the down-stream simulation including jaws, applicators, and water phantom. MC packages BEAMnrc/DOSYXZnrc were used. The down-stream beam components were modeled according to manufacturer specifications and the dose distributions were compared with the measured data of standard cones. The measurements were performed in a water phantom with a p-type electron field diode (diameter 0.2cm) and ion chamber (CC13). Depth dose and orthogonal profiles at depths defined by R{sub 1} {sub 0} {sub 0}, R{sub 5} {sub 0}, Rp were compared. Results: Preliminary results for a 16 MeV phase space and 10x10, 15x15, and 20x20 cm{sup 2} applicator are presented. Simulations were run for a statistical uncertainty of <2% at depth of maximum dose for a voxel resolution of 0.5x0.5x0.2cm{sup 2}. Dose and range differences for the PDD profiles were within 2% and 1 mm, respectively. Dose differences within the central 80% of the beam width for the orthogonal profiles at depth of maximum dose were less than 2% for the 10x10, 15x15, and 20x20 cm{sup 2} applicator, respectively. Conclusion: Varian electron phase space files simulations are in agreement with measured commissioning data. These phase space files can be used in the simulation of TrueBeam linacs, and will provide reproducibility across publications. Analyses for all electron energies and standard applicators are under way and results will be included in the presentation.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Poster — Thur Eve — 38: Feasibility of a Table-Top Total Body Irradiation Technique using Robotic Couch Motion

Purpose: To develop and test the feasibility of a table-top implementation for total body irradiation (TBI) via robotic couch motion and coordinated monitor unit modulation on a standard C-arm linac geometry. Methods: To allow for collision free delivery and to maximize the effective field size, the couch was rotated to 270° IEC and dropped to 150 cm from the vertical radiation source. The robotic delivery was programmed using the TrueBeam STx Developer Mode using custom XML scripting. To assess the dosimetry of a sliding 30×20 cm{sup 2} field, irradiation on a solid water phantom of varying thickness was analyzed using EDR2 radiographic film and OSLDs. Beam modulation was achieved by dividing the couch path into multiple segments of varying dose rates and couch speeds in order to deliver 120 cGy to the midline. Results: The programmed irradiation in conjunction with coordinated couch motion was successfully delivered on a TrueBeam linac. When no beam modulation was employed, the dose difference between two different phantom sections was 17.0%. With simple beam modulation via changing dose rates and couch speeds, the desired prescription dose can be achieved at the centre of each phantom section within 1.9%. However, dose deviation at the junction was 9.2% due to the nonphysical change in the phantom thickness. Conclusions: The feasibility of robotic table-top TBI on a C-arm linac geometry was experimentally demonstrated. To achieve a more uniform dose distribution, inverse-planning allowing for a combination of dose rate modulation, jaw tracking and MLC motion is under investigation.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Poster — Thur Eve — 55: An automated XML technique for isocentre verification on the Varian TrueBeam

Isocentre verification tests, such as the Winston-Lutz (WL) test, have gained popularity in the recent years as techniques such as stereotactic radiosurgery/radiotherapy (SRS/SRT) treatments are more commonly performed on radiotherapy linacs. These highly conformal treatments require frequent monitoring of the geometrical accuracy of the isocentre to ensure proper radiation delivery. At our clinic, the WL test is performed by acquiring with the EPID a collection of 8 images of a WL phantom fixed on the couch for various couch/gantry angles. This set of images is later analyzed to determine the isocentre size. The current work addresses the acquisition process. A manual WL test acquisition performed by and experienced physicist takes in average 25 minutes and is prone to user manipulation errors. We have automated this acquisition on a Varian TrueBeam STx linac (Varian, Palo Alto, USA). The Varian developer mode allows the execution of custom-made XML script files to control all aspects of the linac operation. We have created an XML-WL script that cycles through each couch/gantry combinations taking an EPID image at each position. This automated acquisition is done in less than 4 minutes. The reproducibility of the method was verified by repeating the execution of the XML file 5 times. The analysis of the images showed variation of the isocenter size less than 0.1 mm along the X, Y and Z axes and compares favorably to a manual acquisition for which we typically observe variations up to 0.5 mm.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Monitoring external beam radiotherapy using real-time beam visualization

Purpose: To characterize the performance of a novel radiation therapy monitoring technique that utilizes a flexible scintillating film, common optical detectors, and image processing algorithms for real-time beam visualization (RT-BV). Methods: Scintillating films were formed by mixing Gd{sub 2}O{sub 2}S:Tb (GOS) with silicone and casting the mixture at room temperature. The films were placed in the path of therapeutic beams generated by medical linear accelerators (LINAC). The emitted light was subsequently captured using a CMOS digital camera. Image processing algorithms were used to extract the intensity, shape, and location of the radiation field at various beam energies, dose rates, and collimator locations. The measurement results were compared with known collimator settings to validate the performance of the imaging system. Results: The RT-BV system achieved a sufficient contrast-to-noise ratio to enable real-time monitoring of the LINAC beam at 20 fps with normal ambient lighting in the LINAC room. The RT-BV system successfully identified collimator movements with sub-millimeter resolution. Conclusions: The RT-BV system is capable of localizing radiation therapy beams with sub-millimeter precision and tracking beam movement at video-rate exposure.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

Radiotherapy beyond cancer: Target localization in real-time MRI and treatment planning for cardiac radiosurgery

Purpose: Atrial fibrillation (AFib) is the most common cardiac arrhythmia that affects millions of patients world-wide. AFib is usually treated with minimally invasive, time consuming catheter ablation techniques. While recently noninvasive radiosurgery to the pulmonary vein antrum (PVA) in the left atrium has been proposed for AFib treatment, precise target location during treatment is challenging due to complex respiratory and cardiac motion. A MRI linear accelerator (MRI-Linac) could solve the problems of motion tracking and compensation using real-time image guidance. In this study, the authors quantified target motion ranges on cardiac magnetic resonance imaging (MRI) and analyzed the dosimetric benefits of margin reduction assuming real-time motion compensation was applied. Methods: For the imaging study, six human subjects underwent real-time cardiac MRI under free breathing. The target motion was analyzed retrospectively using a template matching algorithm. The planning study was conducted on a CT of an AFib patient with a centrally located esophagus undergoing catheter ablation, representing an ideal case for cardiac radiosurgery. The target definition was similar to the ablation lesions at the PVA created during catheter treatment. Safety margins of 0 mm (perfect tracking) to 8 mm (untracked respiratory motion) were added to the target, defining the planning target volume (PTV). For each margin, a 30 Gy single fraction IMRT plan was generated. Additionally, the influence of 1 and 3 T magnetic fields on the treatment beam delivery was simulated using Monte Carlo calculations to determine the dosimetric impact of MRI guidance for two different Linac positions. Results: Real-time cardiac MRI showed mean respiratory target motion of 10.2 mm (superior–inferior), 2.4 mm (anterior–posterior), and 2 mm (left–right). The planning study showed that increasing safety margins to encompass untracked respiratory motion leads to overlapping structures even in the ideal scenario, compromising either normal tissue dose constraints or PTV coverage. The magnetic field caused a slight increase in the PTV dose with the in-line MRI-Linac configuration. Conclusions: The authors’ results indicate that real-time tracking and motion compensation are mandatory for cardiac radiosurgery and MRI-guidance is feasible, opening the possibility of treating cardiac arrhythmia patients completely noninvasively.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-C-BRD-03: Closing the Loop On Virtual IMRT QA

Purpose: To develop an algorithm that predicts a priori IMRT QA passing rates. Methods: 416 IMRT plans from all treatment sites were planned in Eclipse version 11 and delivered using a dynamic sliding window technique on Clinac iX or TrueBeam linacs (Varian Medical Systems, Palo Alto, CA). The 3%/3mm and 2%/2mm local distance to agreement (DTA) were recorded during clinical operations using a commercial 2D diode array (MapCHECK 2, Sun Nuclear, Melbourne, FL). Each plan was characterized by 37 metrics that describe different failure modes between the calculated and measured dose. Machine-learning algorithms (MLAs) were trained to learn the relation between the plan characteristics and each passing rate. Minimization of the cross validated error, together with maximum a posteriori estimation (MAP), were used to choose the model parameters. Results: 3%/3mm local DTA can be predicted with an error smaller than 3% for 98% of the plans. For the remaining 2% of plans, the residual error was within 5%. For 2%/2mm local DTA passing rates, 96% percent of the plans were successfully predicted with an error smaller than 5%. All high-risk plans that failed the 2%/2mm local criteria were correctly identified by the algorithm. The most important metric to describe the passing rates was determined to be the MU per Gray (modulation factor). Conclusions: Logs files and independent dose calculations have been suggested as possible substitutes for measurement based IMRT QA. However, none of these methods answer the fundamental question of whether a plan can be delivered with a clinically acceptable error given the limitations of the linacs and the treatment planning system. Predicting the IMRT QA passing rates a priori closes that loop. For additional robustness, virtual IMRT QA can be combined with Linac QA and log file analysis to confirm appropriate delivery.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-53: A New Method for Characterizing the Stability of the Treatment Couch Isocentre

Purpose: In this work we propose a new method for characterizing the accuracy of a linear accelerator treatment couch’s isocentre. This is accomplished by a direct determination of the coordinates of the center of rotation as a function of rotation angle. Methods: A phantom consisting of five metallic BBs arranged in a plane was constructed. The phantom was positioned on the treatment couch such that the plane of the BBs was horizontal, while the central BB was aligned with the linac isocentre. With the gantry in the vertical position, the couch was rotated through its full range of rotation while EPID images were acquired every 10 degrees. For each rotation angle, the coordinates of the rotation center were calculated from the displacement of each of the four off-center BBs identified on a pair of EPID images taken between successive rotations. The accuracy of the couch isocentre was evaluated from the distribution of the rotation center coordinates. Our results were compared with film based star-shot measurements of the couch isocentre. Results: The measured couch center of rotation consisted of a cloud of points clustered around the linac isocentre within < 0.7 mm distance. The deviations of these points from the linac isocentre were in the range of 0.01 to 0.20 mm in the cross-plane direction, and 0.10 to 0.61 mm in the in-plane direction, with mean values of 0.09 mm and 0.32 mm. These results were consistent with the results obtained from the star-shot method. Conclusion: A new method for determining the location and accuracy of the couch center of rotation has been successfully implemented. This method gives explicit values of the location and the stability of the couch isocentre, and it can be extended to gantry and collimator rotations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-545: MLC Distance Travelled as a Predictor for Motor Failure

Purpose: To study the frequency of Multi-Leaf Collimator (MLC) leaf failures, investigate methods to predict them and reduce linac downtime. Methods: A Varian HD120 MLC was used in our study. The hyperterminal MLC errors logged from 06/2012 to 12/2014 were collected. Along with the hyperterminal errors, the MLC motor changes and all other MLC interventions by the linear accelerator engineer were recorded. The MLC dynalog files were also recorded on a daily basis for each treatment and during linac QA. The dynalog files were analyzed to calculate root mean square errors (RMS) and cumulative MLC travel distance per motor. An in-house MatLab code was used to analyze all dynalog files, record RMS errors and calculate the distance each MLC traveled per day. Results: A total of 269 interventions were recorded over a period of 18 months. Of these, 146 included MLC motor leaf change, 39 T-nut replacements, and 84 MLC cleaning sessions. Leaves close to the middle of each side required the most maintenance. In the A bank, leaves A27 to A40 recorded 73% of all interventions, while the same leaves in the B bank counted for 52% of the interventions. On average, leaves in the middle of the bank had their motors changed approximately every 1500m of travel. Finally, it was found that the number of RMS errors increased prior to an MLC motor change. Conclusion: An MLC dynalog file analysis software was developed that can be used to log daily MLC usage. Our eighteen-month data analysis showed that there is a correlation between the distance an MLC travels, the RMS and the life of the MLC motor. We plan to use this tool to predict MLC motor failures and with proper and timely intervention, reduce the downtime of the linac during clinical hours.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

SU-E-T-679: Retrospective Analysis of the Sensitivity of Planar Dose Measurements To Gamma Analysis Criteria

Purpose: IMRT QA using planar dose measurements is still a widely used method for checking the accuracy of treatment plans. A pass/fail judgment is made using gamma analysis based on a single endpoint. Using more stringent criteria is a way to increase the sensitivity to planning and delivery errors. Before such implementation, it is necessary to understand how the sensitivity to different gamma criteria settings affects gamma passing rates (GPR). Methods: 752 IMRT QA measurements were re-analyzed with varying distance to agreement (DTA) and dose difference (DD) percentages using a Matlab program. Other quantifying information such as the mean dose difference in the treatment target (defined as points that are greater than 80% of maximal dose) were stored in a relational database for retrospective analysis. Results: The average and standard deviation of GPR (%) fell from 99.84 ± (0.43) to 89.61 ± (6.08) when restricting DD from 5 − 1% respectively, as compared to a drop from 99.15 ± (1.19) to 95.00 ± (4.43), when restricting the DTA from 5 − 1 mm respectively. The mean dose difference (%) in the treatment target between measured and calculated dose was −1.96 ± (0. 83), −0.09 ± (0.98), and 1.44 ± (0. 86) for each of our institution’s three matched linear accelerators (LINAC 1, 2, and 3 respectively). For plans that are approximately 2.7 sigma below the mean GPR, an average of 78.4% of those plans were measured on LINAC 1 or 3, while only 48% of the total plans were run on those machines. Conclusion: The data demonstrates that when restricting gamma criterion, such as the DD, the greatest indicator of reduced GPR in our institution is which matched LINAC the plan was measured on. While small, these differences manifest themselves to levels comparable to other treatment related differences and possibly confound the gamma analysis.

61 RADIATION PROTECTION AND DOSIMETRY↗