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Title: Using fluence separation to account for energy spectra dependence in computing dosimetric a-Si EPID images for IMRT fields

Abstract

This study develops a method to improve the dosimetric accuracy of computed images for an amorphous silicon flat-panel imager. Radially dependent kernels derived from Monte Carlo simulations are convolved with the treatment-planning system's energy fluence. Multileaf collimator (MLC) beam hardening is accounted for by having separate kernels for open and blocked portions of MLC fields. Field-size-dependent output factors are used to account for the field-size dependence of scatter within the imager. Gamma analysis was used to evaluate open and sliding window test fields and intensity modulated patient fields. For each tested field, at least 99.6% of the points had {gamma}<1 with a 3%, 3-mm criteria. With a 2%, 2-mm criteria, between 81% and 100% of points had {gamma}<1. Patient intensity modulated test fields had 94%-100% of the points with {gamma}<1 with a 2%, 2-mm criteria for all six fields tested. This study demonstrates that including the dependencies of kernel and fluence on radius and beam hardening in the convolution improves its accuracy compared with the use of radial and beam-hardening independent kernels; it also demonstrates that the resultant accuracy of the convolution method is sufficient for pretreatment, intensity modulated patient field verification.

Authors:
; ;  [1]
  1. Department of Radiation Oncology, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia 23298 (United States)
Publication Date:
OSTI Identifier:
20853815
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 33; Journal Issue: 12; Other Information: DOI: 10.1118/1.2369468; (c) 2006 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; COLLIMATORS; COMPUTERIZED SIMULATION; DOSIMETRY; ENERGY SPECTRA; IMAGES; KERNELS; MONTE CARLO METHOD; PATIENTS; RADIOTHERAPY; SILICON

Citation Formats

Li Weidong, Siebers, Jeffrey V., and Moore, Joseph A. Using fluence separation to account for energy spectra dependence in computing dosimetric a-Si EPID images for IMRT fields. United States: N. p., 2006. Web. doi:10.1118/1.2369468.
Li Weidong, Siebers, Jeffrey V., & Moore, Joseph A. Using fluence separation to account for energy spectra dependence in computing dosimetric a-Si EPID images for IMRT fields. United States. doi:10.1118/1.2369468.
Li Weidong, Siebers, Jeffrey V., and Moore, Joseph A. Fri . "Using fluence separation to account for energy spectra dependence in computing dosimetric a-Si EPID images for IMRT fields". United States. doi:10.1118/1.2369468.
@article{osti_20853815,
title = {Using fluence separation to account for energy spectra dependence in computing dosimetric a-Si EPID images for IMRT fields},
author = {Li Weidong and Siebers, Jeffrey V. and Moore, Joseph A.},
abstractNote = {This study develops a method to improve the dosimetric accuracy of computed images for an amorphous silicon flat-panel imager. Radially dependent kernels derived from Monte Carlo simulations are convolved with the treatment-planning system's energy fluence. Multileaf collimator (MLC) beam hardening is accounted for by having separate kernels for open and blocked portions of MLC fields. Field-size-dependent output factors are used to account for the field-size dependence of scatter within the imager. Gamma analysis was used to evaluate open and sliding window test fields and intensity modulated patient fields. For each tested field, at least 99.6% of the points had {gamma}<1 with a 3%, 3-mm criteria. With a 2%, 2-mm criteria, between 81% and 100% of points had {gamma}<1. Patient intensity modulated test fields had 94%-100% of the points with {gamma}<1 with a 2%, 2-mm criteria for all six fields tested. This study demonstrates that including the dependencies of kernel and fluence on radius and beam hardening in the convolution improves its accuracy compared with the use of radial and beam-hardening independent kernels; it also demonstrates that the resultant accuracy of the convolution method is sufficient for pretreatment, intensity modulated patient field verification.},
doi = {10.1118/1.2369468},
journal = {Medical Physics},
number = 12,
volume = 33,
place = {United States},
year = {Fri Dec 15 00:00:00 EST 2006},
month = {Fri Dec 15 00:00:00 EST 2006}
}
  • Purpose: This work uses repeat images of intensity modulated radiation therapy (IMRT) fields to quantify fluence anomalies (i.e., delivery errors) that can be reliably detected in electronic portal images used for IMRT pretreatment quality assurance. Methods: Repeat images of 11 clinical IMRT fields are acquired on a Varian Trilogy linear accelerator at energies of 6 MV and 18 MV. Acquired images are corrected for output variations and registered to minimize the impact of linear accelerator and electronic portal imaging device (EPID) positioning deviations. Detection studies are performed in which rectangular anomalies of various sizes are inserted into the images. Themore » performance of detection strategies based on pixel intensity deviations (PIDs) and gamma indices is evaluated using receiver operating characteristic analysis. Results: Residual differences between registered images are due to interfraction positional deviations of jaws and multileaf collimator leaves, plus imager noise. Positional deviations produce large intensity differences that degrade anomaly detection. Gradient effects are suppressed in PIDs using gradient scaling. Background noise is suppressed using median filtering. In the majority of images, PID-based detection strategies can reliably detect fluence anomalies of {>=}5% in {approx}1 mm{sup 2} areas and {>=}2% in {approx}20 mm{sup 2} areas. Conclusions: The ability to detect small dose differences ({<=}2%) depends strongly on the level of background noise. This in turn depends on the accuracy of image registration, the quality of the reference image, and field properties. The longer term aim of this work is to develop accurate and reliable methods of detecting IMRT delivery errors and variations. The ability to resolve small anomalies will allow the accuracy of advanced treatment techniques, such as image guided, adaptive, and arc therapies, to be quantified.« less
  • Purpose: Radiation treatments are trending toward delivering higher doses per fraction under stereotactic radiosurgery and hypofractionated treatment regimens. There is a need for accurate 3D in vivo patient dose verification using electronic portal imaging device (EPID) measurements. This work presents a model-based technique to compute full three-dimensional patient dose reconstructed from on-treatment EPID portal images (i.e., transmission images). Methods: EPID dose is converted to incident fluence entering the patient using a series of steps which include converting measured EPID dose to fluence at the detector plane and then back-projecting the primary source component of the EPID fluence upstream of themore » patient. Incident fluence is then recombined with predicted extra-focal fluence and used to calculate 3D patient dose via a collapsed-cone convolution method. This method is implemented in an iterative manner, although in practice it provides accurate results in a single iteration. The robustness of the dose reconstruction technique is demonstrated with several simple slab phantom and nine anthropomorphic phantom cases. Prostate, head and neck, and lung treatments are all included as well as a range of delivery techniques including VMAT and dynamic intensity modulated radiation therapy (IMRT). Results: Results indicate that the patient dose reconstruction algorithm compares well with treatment planning system computed doses for controlled test situations. For simple phantom and square field tests, agreement was excellent with a 2%/2 mm 3D chi pass rate ≥98.9%. On anthropomorphic phantoms, the 2%/2 mm 3D chi pass rates ranged from 79.9% to 99.9% in the planning target volume (PTV) region and 96.5% to 100% in the low dose region (>20% of prescription, excluding PTV and skin build-up region). Conclusions: An algorithm to reconstruct delivered patient 3D doses from EPID exit dosimetry measurements was presented. The method was applied to phantom and patient data sets, as well as for dynamic IMRT and VMAT delivery techniques. Results indicate that the EPID dose reconstruction algorithm presented in this work is suitable for clinical implementation.« less
  • A commercial amorphous silicon electronic portal imaging device (EPID) has been studied to investigate its potential in the field of pretreatment verifications of step and shoot, intensity modulated radiation therapy (IMRT), 6 MV photon beams. The EPID was calibrated to measure absolute exit dose in a water-equivalent phantom at patient level, following an experimental approach, which does not require sophisticated calculation algorithms. The procedure presented was specifically intended to replace the time-consuming in-phantom film dosimetry. The dosimetric response was characterized on the central axis in terms of stability, linearity, and pulse repetition frequency dependence. The a-Si EPID demonstrated a goodmore » linearity with dose (within 2% from 1 monitor unit), which represent a prerequisite for the application in IMRT. A series of measurements, in which phantom thickness, air gap between the phantom and the EPID, field size and position of measurement of dose in the phantom (entrance or exit) varied, was performed to find the optimal calibration conditions, for which the field size dependence is minimized. In these conditions (20 cm phantom thickness, 56 cm air gap, exit dose measured at the isocenter), the introduction of a filter for the low-energy scattered radiation allowed us to define a universal calibration factor, independent of field size. The off-axis extension of the dose calibration was performed by applying a radial correction for the beam profile, distorted due to the standard flood field calibration of the device. For the acquisition of IMRT fields, it was necessary to employ home-made software and a specific procedure. This method was applied for the measurement of the dose distributions for 15 clinical IMRT fields. The agreement between the dose distributions, quantified by the gamma index, was found, on average, in 97.6% and 98.3% of the analyzed points for EPID versus TPS and for EPID versus FILM, respectively, thus suggesting a great potential of this EPID for IMRT dosimetric applications.« less
  • Dosimetric properties of an amorphous-silicon electronic portal imaging device (EPID) operated in a real-time acquisition mode were investigated. This mode will be essential for time-resolved dose verification of dynamic (sliding window) intensity modulated radiation therapy (IMRT) and intensity modulated arc radiation therapy (arc-IMRT). The EPID was used in continuous acquisition mode (i.e., ''cine'' mode) where individual sequential image frames are acquired in real time. The properties studied include dose linearity, reproducibility of response, and image stability. Results of using the continuous acquisition mode with several example treatments including dynamic IMRT, arc treatment, and single-arc-IMRT are compared to results using themore » well-studied integrated acquisition mode (i.e., ''frame averaging'' or ''IMRT'' mode). Real-time EPID response was also compared to real-time ion-chamber data for selected points in the deliveries. The example treatment deliveries in both continuous and integrated acquisition modes were converted to arbitrary EPID dose units via a calibration field. The summation of all acquired continuous mode images was compared using percentage dose difference to the single image acquired in the integrated mode using in-field pixels only (defined as those pixels >10% of maximum, in-field signal). Using the continuous acquisition mode, the EPID response was not linear with dose. It was found that the continuous mode dose response corresponded approximately to dropping one image per acquisition session. Reproducibility of EPID response to low monitor units (MUs) was found to be poor but greatly improved with increasing MU. Open field profiles were found to be stable in the cross-plane direction but required several frames to become stable in the in-plane direction. However, both of these issues are clinically insignificant due to arc-IMRT deliveries requiring relatively large monitor units (>100 MU). Analysis of the five IMRT, arc, and arc-IMRT tests revealed that all examples compared to within 2% of maximum dose for more than 95% of in-field pixels. The continuous acquisition mode is suited to time-resolved dosimetry applications including arc-IMRT and dynamic IMRT, giving comparable dose results to the well-studied integrated acquisition mode, although caution should be used in low MU applications. Time-resolved EPID dose information also compared well to time-resolved ion-chamber measurements.« less
  • Purpose: Verifying an algorithm to reconstruct relative initial photon fluence for clinical use. Clinical EPID and CT images were acquired to reconstruct an external photon radiation treatment field. The reconstructed initial photon fluence could be used to verify the treatment or calculate the applied dose to the patient. Methods: The acquired EPID images were corrected for scatter caused by the patient and the EPID with an iterative reconstruction algorithm. The transmitted photon fluence behind the patient was calculated subsequently. Based on the transmitted fluence the initial photon fluence was calculated using a back-projection algorithm which takes the patient geometry andmore » its energy dependent linear attenuation into account. This attenuation was gained from the acquired cone-beam CT or the planning CT by calculating a water-equivalent radiological thickness for each irradiation direction. To verify the algorithm an inhomogeneous phantom consisting of three inhomogeneities was irradiated by a static 6 MV photon field and compared to a reference flood field image. Results: The mean deviation between the reconstructed relative photon fluence for the inhomogeneous phantom and the flood field EPID image was 3% rising up to 7% for off-axis fluence. This was probably caused by the used clinical EPID calibration, which flattens the inhomogeneous fluence profile of the beam. Conclusion: In this clinical experiment the algorithm achieved good results in the center of the field while it showed high deviation of the lateral fluence. This could be reduced by optimizing the EPID calibration, considering the off-axis differential energy response. In further progress this and other aspects of the EPID, eg. field size dependency, CT and dose calibration have to be studied to realize a clinical acceptable accuracy of 2%.« less