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Title: Monte Carlo evaluation of the AAA treatment planning algorithm in a heterogeneous multilayer phantom and IMRT clinical treatments for an Elekta SL25 linear accelerator

Abstract

The Anisotropic Analytical Algorithm (AAA) is a new pencil beam convolution/superposition algorithm proposed by Varian for photon dose calculations. The configuration of AAA depends on linear accelerator design and specifications. The purpose of this study was to investigate the accuracy of AAA for an Elekta SL25 linear accelerator for small fields and intensity modulated radiation therapy (IMRT) treatments in inhomogeneous media. The accuracy of AAA was evaluated in two studies. First, AAA was compared both with Monte Carlo (MC) and the measurements in an inhomogeneous phantom simulating lung equivalent tissues and bone ribs. The algorithm was tested under lateral electronic disequilibrium conditions, using small fields (2x2 cm{sup 2}). Good agreement was generally achieved for depth dose and profiles, with deviations generally below 3% in lung inhomogeneities and below 5% at interfaces. However, the effects of attenuation and scattering close to the bone ribs were not fully taken into account by AAA, and small inhomogeneities may lead to planning errors. Second, AAA and MC were compared for IMRT plans in clinical conditions, i.e., dose calculations in a computed tomography scan of a patient. One ethmoid tumor, one orophaxynx and two lung tumors are presented in this paper. Small differences were foundmore » between the dose volume histograms. For instance, a 1.7% difference for the mean planning target volume dose was obtained for the ethmoid case. Since better agreement was achieved for the same plans but in homogeneous conditions, these differences must be attributed to the handling of inhomogeneities by AAA. Therefore, inherent assumptions of the algorithm, principally the assumption of independent depth and lateral directions in the scaling of the kernels, were slightly influencing AAA's validity in inhomogeneities. However, AAA showed a good accuracy overall and a great ability to handle small fields in inhomogeneous media compared to other pencil beam convolution algorithms.« less

Authors:
; ; ; ;  [1];  [2];  [2]
  1. Department of Radiotherapy, St-Luc University Hospital, 10 av. Hippocrate, 1200 Brussels (Belgium)
  2. (Belgium)
Publication Date:
OSTI Identifier:
20951297
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 34; Journal Issue: 5; Other Information: DOI: 10.1118/1.2727314; (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; ACCURACY; ALGORITHMS; COMPUTERIZED TOMOGRAPHY; DEPTH DOSE DISTRIBUTIONS; LINEAR ACCELERATORS; LUNGS; MONTE CARLO METHOD; NEOPLASMS; PHANTOMS; RADIATION DOSES; RADIOTHERAPY; SKELETON

Citation Formats

Sterpin, E., Tomsej, M., Smedt, B. de, Reynaert, N., Vynckier, S., Department of Medical Physics, Ghent University, Proeftuistraat 86, 9000 Ghent, and Department of Radiotherapy, St-Luc University Hospital, 10 av. Hippocrate, 1200 Brussels. Monte Carlo evaluation of the AAA treatment planning algorithm in a heterogeneous multilayer phantom and IMRT clinical treatments for an Elekta SL25 linear accelerator. United States: N. p., 2007. Web. doi:10.1118/1.2727314.
Sterpin, E., Tomsej, M., Smedt, B. de, Reynaert, N., Vynckier, S., Department of Medical Physics, Ghent University, Proeftuistraat 86, 9000 Ghent, & Department of Radiotherapy, St-Luc University Hospital, 10 av. Hippocrate, 1200 Brussels. Monte Carlo evaluation of the AAA treatment planning algorithm in a heterogeneous multilayer phantom and IMRT clinical treatments for an Elekta SL25 linear accelerator. United States. doi:10.1118/1.2727314.
Sterpin, E., Tomsej, M., Smedt, B. de, Reynaert, N., Vynckier, S., Department of Medical Physics, Ghent University, Proeftuistraat 86, 9000 Ghent, and Department of Radiotherapy, St-Luc University Hospital, 10 av. Hippocrate, 1200 Brussels. Tue . "Monte Carlo evaluation of the AAA treatment planning algorithm in a heterogeneous multilayer phantom and IMRT clinical treatments for an Elekta SL25 linear accelerator". United States. doi:10.1118/1.2727314.
@article{osti_20951297,
title = {Monte Carlo evaluation of the AAA treatment planning algorithm in a heterogeneous multilayer phantom and IMRT clinical treatments for an Elekta SL25 linear accelerator},
author = {Sterpin, E. and Tomsej, M. and Smedt, B. de and Reynaert, N. and Vynckier, S. and Department of Medical Physics, Ghent University, Proeftuistraat 86, 9000 Ghent and Department of Radiotherapy, St-Luc University Hospital, 10 av. Hippocrate, 1200 Brussels},
abstractNote = {The Anisotropic Analytical Algorithm (AAA) is a new pencil beam convolution/superposition algorithm proposed by Varian for photon dose calculations. The configuration of AAA depends on linear accelerator design and specifications. The purpose of this study was to investigate the accuracy of AAA for an Elekta SL25 linear accelerator for small fields and intensity modulated radiation therapy (IMRT) treatments in inhomogeneous media. The accuracy of AAA was evaluated in two studies. First, AAA was compared both with Monte Carlo (MC) and the measurements in an inhomogeneous phantom simulating lung equivalent tissues and bone ribs. The algorithm was tested under lateral electronic disequilibrium conditions, using small fields (2x2 cm{sup 2}). Good agreement was generally achieved for depth dose and profiles, with deviations generally below 3% in lung inhomogeneities and below 5% at interfaces. However, the effects of attenuation and scattering close to the bone ribs were not fully taken into account by AAA, and small inhomogeneities may lead to planning errors. Second, AAA and MC were compared for IMRT plans in clinical conditions, i.e., dose calculations in a computed tomography scan of a patient. One ethmoid tumor, one orophaxynx and two lung tumors are presented in this paper. Small differences were found between the dose volume histograms. For instance, a 1.7% difference for the mean planning target volume dose was obtained for the ethmoid case. Since better agreement was achieved for the same plans but in homogeneous conditions, these differences must be attributed to the handling of inhomogeneities by AAA. Therefore, inherent assumptions of the algorithm, principally the assumption of independent depth and lateral directions in the scaling of the kernels, were slightly influencing AAA's validity in inhomogeneities. However, AAA showed a good accuracy overall and a great ability to handle small fields in inhomogeneous media compared to other pencil beam convolution algorithms.},
doi = {10.1118/1.2727314},
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: This study evaluated the performance of the electron Monte Carlo dose calculation algorithm in RayStation v4.0 for an Elekta machine with Agility™ treatment head. Methods: The machine has five electron energies (6–8 MeV) and five applicators (6×6 to 25×25 cm {sup 2}). The dose (cGy/MU at d{sub max}), depth dose and profiles were measured in water using an electron diode at 100 cm SSD for nine square fields ≥2×2 cm{sup 2} and four complex fields at normal incidence, and a 14×14 cm{sup 2} field at 15° and 30° incidence. The dose was also measured for three square fields ≥4×4more » cm{sup 2} at 98, 105 and 110 cm SSD. Using selected energies, the EBT3 radiochromic film was used for dose measurements in slab-shaped inhomogeneous phantoms and a breast phantom with surface curvature. The measured and calculated doses were analyzed using a gamma criterion of 3%/3 mm. Results: The calculated and measured doses varied by <3% for 116 of the 120 points, and <5% for the 4×4 cm{sup 2} field at 110 cm SSD at 9–18 MeV. The gamma analysis comparing the 105 pairs of in-water isodoses passed by >98.1%. The planar doses measured from films placed at 0.5 cm below a lung/tissue layer (12 MeV) and 1.0 cm below a bone/air layer (15 MeV) showed excellent agreement with calculations, with gamma passing by 99.9% and 98.5%, respectively. At the breast-tissue interface, the gamma passing rate is >98.8% at 12–18 MeV. The film results directly validated the accuracy of MU calculation and spatial dose distribution in presence of tissue inhomogeneity and surface curvature - situations challenging for simpler pencil-beam algorithms. Conclusion: The electron Monte Carlo algorithm in RayStation v4.0 is fully validated for clinical use for the Elekta Agility™ machine. The comprehensive validation included small fields, complex fields, oblique beams, extended distance, tissue inhomogeneity and surface curvature.« less
  • In this work we dosimetrically evaluated the clinical implementation of a commercial Monte Carlo treatment planning software (PEREGRINE, North American Scientific, Cranberry Township, PA) intended for quality assurance (QA) of intensity modulated radiation therapy treatment plans. Dose profiles calculated in homogeneous and heterogeneous phantoms using this system were compared to both measurements and simulations using the EGSnrc Monte Carlo code for the 6 MV beam of a Varian CL21EX linear accelerator. For simple jaw-defined fields, calculations agree within 2% of the dose at d{sub max} with measurements in homogeneous phantoms with the exception of the buildup region where the calculationsmore » overestimate the dose by up to 8%. In heterogeneous lung and bone phantoms the agreement is within 3%, on average, up to 5% for a 1x1 cm{sup 2} field. We tested two consecutive implementations of the MLC model. After matching the calculated and measured MLC leakage, simulations of static and dynamic MLC-defined fields using the most recent MLC model agreed to within 2% with measurements.« less
  • Purpose: The objective of this study was to evaluate and validate the use of the Geant4 application for emission tomography (GATE) Monte Carlo simulation platform for clinical intensity modulated radiotherapy (IMRT) dosimetry studies. Methods: The first step consisted of modeling a 6 MV photon beam linear accelerator (LINAC), with its corresponding validation carried out using percent depth dose evaluation, transverse profiles, tissue phantom ratio, and output factor on water phantom. The IMRT evaluation was performed by comparing simulation and measurements in terms of absolute and relative doses using IMRT dedicated quality assurance phantoms considering seven different patient datasets. Results: Concerningmore » the LINAC simulated model validation tissue phantom ratios at 20 and 10 cm in water TPR{sub 10}{sup 20} obtained from GATE and measurements were 0.672 {+-} 0.063 and 0.675, respectively. In terms of percent depth dose and transverse profiles, error ranges were, respectively: 1.472%{+-} 0.285% and 4.827%{+-} 1.323% for field size of 4 Multiplication-Sign 4, 5 Multiplication-Sign 5, 10 Multiplication-Sign 10, 15 Multiplication-Sign 15, 20 Multiplication-Sign 20, 25 Multiplication-Sign 25, 30 Multiplication-Sign 30, and 40 Multiplication-Sign 40 cm{sup 2}. Most errors were observed at the edge of radiation fields because of higher dose gradient in these areas. Output factors showed good agreement between simulation and measurements with a maximum error of 1.22%. Finally, for IMRT simulations considering seven patient datasets, GATE provided good results with a relative error of 0.43%{+-} 0.25% on absolute dose between simulated and measured beams (measurements at the isocenter, volume 0.125 cm{sup 3}). Planar dose comparisons were also performed using gamma-index analysis. For the whole set of beams considered the mean gamma-index value was 0.497 {+-} 0.152 and 90.8%{+-} 3.6% of the evaluated dose points satisfied the 5%/ 4 mm criterion. Conclusions: These results show that GATE allows reliable simulation of complex beams in radiotherapy after an accurate LINAC modeling is validated. A simple cross-calibration procedure proposed in this work allows obtaining absolute dose values even in complex fields.« less
  • The reliability of the convolution/superposition (C/S) algorithm of the Hi-Art tomotherapy system is evaluated by using the Monte Carlo model TomoPen, which has been already validated for homogeneous phantoms. The study was performed in three stages. First, measurements with EBT Gafchromic film for a 1.25x2.5 cm{sup 2} field in a heterogeneous phantom consisting of two slabs of polystyrene separated with Styrofoam were compared to simulation results from TomoPen. The excellent agreement found in this comparison justifies the use of TomoPen as the reference for the remaining parts of this work. Second, to allow analysis and interpretation of the results inmore » clinical cases, dose distributions calculated with TomoPen and C/S were compared for a similar phantom geometry, with multiple slabs of various densities. Even in conditions of lack of lateral electronic equilibrium, overall good agreement was obtained between C/S and TomoPen results, with deviations within 3%/2 mm, showing that the C/S algorithm accounts for modifications in secondary electron transport due to the presence of a low density medium. Finally, calculations were performed with TomoPen and C/S of dose distributions in various clinical cases, from large bilateral head and neck tumors to small lung tumors with diameter of <3 cm. To ensure a ''fair'' comparison, identical dose calculation grid and dose-volume histogram calculator were used. Very good agreement was obtained for most of the cases, with no significant differences between the DVHs obtained from both calculations. However, deviations of up to 4% for the dose received by 95% of the target volume were found for the small lung tumors. Therefore, the approximations in the C/S algorithm slightly influence the accuracy in small lung tumors even though the C/S algorithm of the tomotherapy system shows very good overall behavior.« less
  • Purpose: The Monaco treatment planning system (TPS) uses a Monte-Carlo algorithm based dose computation engine to model the photon beams of a linear accelerator. The aim is to perform verification of Monaco TPS beam modeling of a Elekta VersaHD linac with 6MV, 6MV FFF, 10 MV, 10MV FFF, 18MV photon beams and 160 multileaf collimators (MLC) with a projected width of 5-mm at the isocenter. Methods: A series of dosimetric tests were performed to validate Monaco calculated beams including point dose measurement in water with and without heterogeneity and 2-dimensional dose distributions on a Delta4 bi-planar diode dosimeter array (Scandidos,more » Uppsala, Sweden). 3D conformal beams of different field sizes, source-to-surface distances, wedges, and gantry angles were delivered onto a phantom consisting of several plastic water and Styrofoam slabs. Point dose measurements were verified with a PTW 31013 Semiflex 0.3 cc ionization chamber (PTW, Freiburg, Germany). In addition, 8 step and shoot intensity modulated radiotherapy (IMRT) and volumetric modulated arc radiotherapy (VMAT) beams included in the Monaco TPS commissioning suite were verified against measurements on Delta4 to test and fine tune parameters in the beam model. IMRT verification was computed using gamma analysis with dose difference and distance-to-agreement criteria of 3%/3mm with a dose threshold of 10%. Results: Point dose measurements agreed within 2% in the homogeneous phantom and within 3% in the heterogeneous phantom for all photon energies. IMRT beams yielded a passing percentage of 99.1±1.1% in the gamma analysis which is well above the institutional passing threshold of 90%. Conclusion: Monaco TPS commissioning was successfully performed for all the photon energies on the Elekta VersaHD linac prior to clinical usage.« less