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Title: An independent dose calculation algorithm for MLC-based stereotactic radiotherapy

Abstract

We have developed an algorithm to calculate dose in a homogeneous phantom for radiotherapy fields defined by multi-leaf collimator (MLC) for both static and dynamic MLC delivery. The algorithm was developed to supplement the dose algorithms of the commercial treatment planning systems (TPS). The motivation for this work is to provide an independent dose calculation primarily for quality assurance (QA) and secondarily for the development of static MLC field based inverse planning. The dose calculation utilizes a pencil-beam kernel. However, an explicit analytical integration results in a closed form for rectangular-shaped beamlets, defined by single leaf pairs. This approach reduces spatial integration to summation, and leads to a simple method of determination of model parameters. The total dose for any static or dynamic MLC field is obtained by summing over all individual rectangles from each segment which offers faster speed to calculate two-dimensional dose distributions at any depth in the phantom. Standard beam data used in the commissioning of the TPS was used as input data for the algorithm. The calculated results were compared with the TPS and measurements for static and dynamic MLC. The agreement was very good (<2.5%) for all tested cases except for very small static MLCmore » sizes of 0.6 cmx0.6 cm (<6%) and some ion chamber measurements in a high gradient region (<4.4%). This finding enables us to use the algorithm for routine QA as well as for research developments.« less

Authors:
; ; ;  [1];  [2];  [3];  [2]
  1. Department of Radiation Oncology, Mannheim Medical Center, University of Heidelberg, Mannheim, 68167 (Germany)
  2. (United States)
  3. (Germany)
Publication Date:
OSTI Identifier:
20951291
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 34; Journal Issue: 5; Other Information: DOI: 10.1118/1.2717385; (c) 2007 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; ALGORITHMS; BEAMS; COLLIMATORS; COMMISSIONING; DOSIMETRY; IONIZATION CHAMBERS; KERNELS; PHANTOMS; QUALITY ASSURANCE; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Lorenz, Friedlieb, Killoran, Joseph H., Wenz, Frederik, Zygmanski, Piotr, Department of Radiation Oncology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, Department of Radiation Oncology, Mannheim Medical Center, University of Heidelberg, Mannheim, 68167, and Department of Radiation Oncology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115. An independent dose calculation algorithm for MLC-based stereotactic radiotherapy. United States: N. p., 2007. Web. doi:10.1118/1.2717385.
Lorenz, Friedlieb, Killoran, Joseph H., Wenz, Frederik, Zygmanski, Piotr, Department of Radiation Oncology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, Department of Radiation Oncology, Mannheim Medical Center, University of Heidelberg, Mannheim, 68167, & Department of Radiation Oncology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115. An independent dose calculation algorithm for MLC-based stereotactic radiotherapy. United States. doi:10.1118/1.2717385.
Lorenz, Friedlieb, Killoran, Joseph H., Wenz, Frederik, Zygmanski, Piotr, Department of Radiation Oncology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, Department of Radiation Oncology, Mannheim Medical Center, University of Heidelberg, Mannheim, 68167, and Department of Radiation Oncology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115. Tue . "An independent dose calculation algorithm for MLC-based stereotactic radiotherapy". United States. doi:10.1118/1.2717385.
@article{osti_20951291,
title = {An independent dose calculation algorithm for MLC-based stereotactic radiotherapy},
author = {Lorenz, Friedlieb and Killoran, Joseph H. and Wenz, Frederik and Zygmanski, Piotr and Department of Radiation Oncology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115 and Department of Radiation Oncology, Mannheim Medical Center, University of Heidelberg, Mannheim, 68167 and Department of Radiation Oncology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115},
abstractNote = {We have developed an algorithm to calculate dose in a homogeneous phantom for radiotherapy fields defined by multi-leaf collimator (MLC) for both static and dynamic MLC delivery. The algorithm was developed to supplement the dose algorithms of the commercial treatment planning systems (TPS). The motivation for this work is to provide an independent dose calculation primarily for quality assurance (QA) and secondarily for the development of static MLC field based inverse planning. The dose calculation utilizes a pencil-beam kernel. However, an explicit analytical integration results in a closed form for rectangular-shaped beamlets, defined by single leaf pairs. This approach reduces spatial integration to summation, and leads to a simple method of determination of model parameters. The total dose for any static or dynamic MLC field is obtained by summing over all individual rectangles from each segment which offers faster speed to calculate two-dimensional dose distributions at any depth in the phantom. Standard beam data used in the commissioning of the TPS was used as input data for the algorithm. The calculated results were compared with the TPS and measurements for static and dynamic MLC. The agreement was very good (<2.5%) for all tested cases except for very small static MLC sizes of 0.6 cmx0.6 cm (<6%) and some ion chamber measurements in a high gradient region (<4.4%). This finding enables us to use the algorithm for routine QA as well as for research developments.},
doi = {10.1118/1.2717385},
journal = {Medical Physics},
number = 5,
volume = 34,
place = {United States},
year = {Tue May 15 00:00:00 EDT 2007},
month = {Tue May 15 00:00:00 EDT 2007}
}
  • Purpose: To evaluate performance of three commercially available treatment planning systems for stereotactic body radiation therapy (SBRT) of lung cancer using the following algorithms: Boltzmann transport equation based algorithm (AcurosXB AXB), convolution based algorithm Anisotropic Analytic Algorithm (AAA); and Monte Carlo based algorithm (XVMC). Methods: A total of 10 patients with early stage non-small cell peripheral lung cancer were included. The initial clinical plans were generated using the XVMC based treatment planning system with a prescription of 54Gy in 3 fractions following RTOG0613 protocol. The plans were recalculated with the same beam parameters and monitor units using AAA and AXBmore » algorithms. A calculation grid size of 2mm was used for all algorithms. The dose distribution, conformity, and dosimetric parameters for the targets and organs at risk (OAR) are compared between the algorithms. Results: The average PTV volume was 19.6mL (range 4.2–47.2mL). The volume of PTV covered by the prescribed dose (PTV-V100) were 93.97±2.00%, 95.07±2.07% and 95.10±2.97% for XVMC, AXB and AAA algorithms, respectively. There was no significant difference in high dose conformity index; however, XVMC predicted slightly higher values (p=0.04) for the ratio of 50% prescription isodose volume to PTV (R50%). The percentage volume of total lungs receiving dose >20Gy (LungV20Gy) were 4.03±2.26%, 3.86±2.22% and 3.85±2.21% for XVMC, AXB and AAA algorithms. Examination of dose volume histograms (DVH) revealed small differences in targets and OARs for most patients. However, the AAA algorithm was found to predict considerable higher PTV coverage compared with AXB and XVMC algorithms in two cases. The dose difference was found to be primarily located at the periphery region of the target. Conclusion: For clinical SBRT lung treatment planning, the dosimetric differences between three commercially available algorithms are generally small except at target periphery. XVMC and AXB algorithms are recommended for accurate dose estimation at tissue boundaries.« less
  • Purpose: Intra-fractional tumor motion due to respiration may potentially compromise dose delivery for SBRT of lung tumors. Even sufficient margins are used to ensure there is no geometric miss of target volume, there is potential dose blurring effect may present due to motion and could impact the tumor coverage if motions are larger. In this study we investigated dose blurring effect of open fields as well as Lung SBRT patients planned using 2 non-coplanar dynamic conformal arcs(NCDCA) and few conformal beams(CB) calculated with Monte Carlo (MC) based algorithm utilizing phantom with 2D-diode array(MapCheck) and ion-chamber. Methods: SBRT lung patients weremore » planned on Brainlab-iPlan system using 4D-CT scan and ITV were contoured on MIP image set and verified on all breathing phase image sets to account for breathing motion and then 5mm margin was applied to generate PTV. Plans were created using two NCDCA and 4-5 CB 6MV photon calculated using XVMC MC-algorithm. 3 SBRT patients plans were transferred to phantom with MapCheck and 0.125cc ion-chamber inserted in the middle of phantom to calculate dose. Also open field 3×3, 5×5 and 10×10 were calculated on this phantom. Phantom was placed on motion platform with varying motion from 5, 10, 20 and 30 mm with duty cycle of 4 second. Measurements were carried out for open fields as well 3 patients plans at static and various degree of motions. MapCheck planar dose and ion-chamber reading were collected and compared with static measurements and computed values to evaluate the dosimetric effect on tumor coverage due to motion. Results: To eliminate complexity of patients plan 3 simple open fields were also measured to see the dose blurring effect with the introduction of motion. All motion measured ionchamber values were normalized to corresponding static value. For open fields 5×5 and 10×10 normalized central axis ion-chamber values were 1.00 for all motions but for 3×3 they were 1 up to 10mm motion and 0.97 and 0.87 for 20 and 30mm motion respectively. For SBRT plans central axis dose values were within 1% upto 10mm motions but decreased to average of 5% for 20mm and 8% for 30mm motion. Mapcheck comparison with static showed penumbra enlargement due to motion blurring at the edges of the field for 3×3,5×5,10×10 pass rates were 88% to 12%, 100% to 43% and 100% to 63% respectively as motion increased from 5 to 30mm. For SBRT plans MapCheck mean pass rate were decreased from 73.8% to 39.5% as motion increased from 5mm to 30mm. Conclusion: Dose blurring effect has been seen in open fields as well as SBRT lung plans using NCDCA with CB which worsens with increasing respiratory motion and decreasing field size(tumor size). To reduce this effect larger margins and appropriate motion reduction techniques should be utilized.« less
  • Purpose: In current IMRT and VMAT settings, the use of sophisticated dose calculation procedure is inevitable in order to account complex treatment field created by MLCs. As a consequence, independent volumetric dose verification procedure is time consuming which affect the efficiency of clinical workflow. In this study, the authors present an efficient Pencil Beam based dose calculation algorithm that minimizes the computational procedure while preserving the accuracy. Methods: The computational time of Finite Size Pencil Beam (FSPB) algorithm is proportional to the number of infinitesimal identical beamlets that constitute the arbitrary field shape. In AB-FSPB, the dose distribution from eachmore » beamlet is mathematically modelled such that the sizes of beamlets to represent arbitrary field shape are no longer needed to be infinitesimal nor identical. In consequence, it is possible to represent arbitrary field shape with combinations of different sized and minimal number of beamlets. Results: On comparing FSPB with AB-FSPB, the complexity of the algorithm has been reduced significantly. For 25 by 25 cm2 squared shaped field, 1 beamlet of 25 by 25 cm2 was sufficient to calculate dose in AB-FSPB, whereas in conventional FSPB, minimum 2500 beamlets of 0.5 by 0.5 cm2 size were needed to calculate dose that was comparable to the Result computed from Treatment Planning System (TPS). The algorithm was also found to be GPU compatible to maximize its computational speed. On calculating 3D dose of IMRT (∼30 control points) and VMAT plan (∼90 control points) with grid size 2.0 mm (200 by 200 by 200), the dose could be computed within 3∼5 and 10∼15 seconds. Conclusion: Authors have developed an efficient Pencil Beam type dose calculation algorithm called AB-FSPB. The fast computation nature along with GPU compatibility has shown performance better than conventional FSPB. This completely enables the implantation of AB-FSPB in the clinical environment for independent volumetric dose verification.« less
  • Purpose: To retrospectively analyze the clinical outcomes of stereotactic body radiotherapy (SBRT) for patients with Stages 1A and 1B non-small-cell lung cancer. Methods and Materials: We reviewed the records of patients with non-small-cell lung cancer treated with curative intent between Dec 2001 and May 2007. All patients had histopathologically or cytologically confirmed disease, increased levels of tumor markers, and/or positive findings on fluorodeoxyglucose positron emission tomography. Staging studies identified their disease as Stage 1A or 1B. Performance status was 2 or less according to World Health Organization guidelines in all cases. The prescribed dose of 50 Gy total in fivemore » fractions, calculated by using a superposition algorithm, was defined for the periphery of the planning target volume. Results: One hundred twenty-one patients underwent SBRT during the study period, and 63 were eligible for this analysis. Thirty-eight patients had Stage 1A (T1N0M0) and 25 had Stage 1B (T2N0M0). Forty-nine patients were not appropriate candidates for surgery because of chronic pulmonary disease. Median follow-up of these 49 patients was 31 months (range, 10-72 months). The 3-year local control, disease-free, and overall survival rates in patients with Stages 1A and 1B were 93% and 96% (p = 0.86), 76% and 77% (p = 0.83), and 90% and 63% (p = 0.09), respectively. No acute toxicity was observed. Grade 2 or higher radiation pneumonitis was experienced by 3 patients, and 1 of them had fatal bacterial pneumonia. Conclusions: The SBRT at 50 Gy total in five fractions to the periphery of the planning target volume calculated by using a superposition algorithm is feasible. High local control rates were achieved for both T2 and T1 tumors.« less
  • Purpose: To evaluate outcome after image-guided stereotactic body radiotherapy (SBRT) for early-stage non-small-cell lung cancer (NSCLC) and pulmonary metastases. Methods and Materials: A total of 124 patients with 159 pulmonary lesions (metastases n = 118; NSCLC, n = 41; Stage IA, n = 13; Stage IB, n = 19; T3N0, n = 9) were treated with SBRT. Patients were treated with hypofractionated schemata (one to eight fractions of 6-26 Gy); biologic effective doses (BED) to the clinical target volume (CTV) were calculated based on four-dimensional (4D) dose calculation. The position of the pulmonary target was verified using volume imaging beforemore » all treatments. Results: With mean/median follow-up of 18/14 months, actuarial local control was 83% at 36 months with no difference between NSCLC and metastases. The dose to the CTV based on 4D dose calculation was closely correlated with local control: local control rates were 89% and 62% at 36 months for >100 Gy and <100 Gy BED (p = 0.0001), respectively. Actuarial freedom from regional and systemic progression was 34% at 36 months for primary NSCLC group; crude rate of regional failure was 15%. Three-year overall survival was 37% for primary NSCLC and 16% for metastases; no dose-response relationship for survival was observed. Exacerbation of comorbidities was the most frequent cause of death for primary NSCLC. Conclusions: Doses of >100 Gy BED to the CTV based on 4D dose calculation resulted in excellent local control rates. This cutoff dose is not specific to the treatment technique and protocol of our study and may serve as a general recommendation.« less