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Title: SU-F-J-26: Performance of 2.5MV Portal Imaging in Comparison with KV X-Ray and 6MV and Flattening-Filter-Free 6MV Portal Imaging

Abstract

Purpose: To assess image quality and imaging dose of 2.5MV electronic portal imaging in comparison to kV imaging and 6MV and Flattening-Filter-Free 6MV (6MVFFF) portal imaging using a DMI imager. Methods: Quantitative assessment of image quality was performed with Leeds and Las Vegas test phantoms in conjunction with qualitative evaluation of clinical patient images for kV imaging and 2.5MV, 6MV and 6MVFFF portal imaging. High and low contrast resolutions were evaluated and imaging doses were measured using these x-rays. Phantom test was performed both in air and in solid water. Clinical patient portal images were also reviewed and qualitatively assessed for these three imaging MV energies. Results: Among the 28 objects in Las Vegas phantom, 16, 17 and 26 of them were resolved using Low Dose technique and 18, 22 and 26 were resolved using High Quality technique with 6MV, 6MVFFF and 2.5MV, respectively. The number of Leeds low contrast objects resolved by 6MV, 6MFFFF and 2.5MV was 6, 15 and 18 with Low Dose technique and 14, 17 and 18 with High Quality technique, respectively. When the test phantoms were embedded in 20cm thick solid water, the results were noticeably affected, but the performance of 2.5MV was still substantiallymore » better than 6MV and 6MVFFF. Imaging dose with 2.5MV measured at 10 cm depth was about half of that with 6MV or 6MVFFF. Clinical patient portal images were reviewed and qualitatively assessed for different sites including brain, head-and-neck, chest and pelvis. 2.5MV imaging provided more details and substantially higher contrast. Conclusion: While portal imaging with 6MVFFF provides noticeably better image quality than that with 6MV, the performance of 2.5MV portal imaging is substantially better than both 6MV and 6MVFFF in terms of high and low contrast resolutions as well as lower imaging dose. 2.5MV imaging provides near kV imaging quality.« less

Authors:
; ; ; ; ;  [1]
  1. Duke University Medical Center, Durham, NC (United States)
Publication Date:
OSTI Identifier:
22632161
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; BIOMEDICAL RADIOGRAPHY; BRAIN; CHEST; COMPARATIVE EVALUATIONS; ELECTRON DIFFRACTION; HEAD; IMAGES; NECK; PATIENTS; PELVIS; PERFORMANCE; PHANTOMS; RADIATION DOSES; REVIEWS

Citation Formats

Duan, J, Yang, Y, Faught, A, Subashi, E, Wu, Q, and Yin, F. SU-F-J-26: Performance of 2.5MV Portal Imaging in Comparison with KV X-Ray and 6MV and Flattening-Filter-Free 6MV Portal Imaging. United States: N. p., 2016. Web. doi:10.1118/1.4955934.
Duan, J, Yang, Y, Faught, A, Subashi, E, Wu, Q, & Yin, F. SU-F-J-26: Performance of 2.5MV Portal Imaging in Comparison with KV X-Ray and 6MV and Flattening-Filter-Free 6MV Portal Imaging. United States. doi:10.1118/1.4955934.
Duan, J, Yang, Y, Faught, A, Subashi, E, Wu, Q, and Yin, F. Wed . "SU-F-J-26: Performance of 2.5MV Portal Imaging in Comparison with KV X-Ray and 6MV and Flattening-Filter-Free 6MV Portal Imaging". United States. doi:10.1118/1.4955934.
@article{osti_22632161,
title = {SU-F-J-26: Performance of 2.5MV Portal Imaging in Comparison with KV X-Ray and 6MV and Flattening-Filter-Free 6MV Portal Imaging},
author = {Duan, J and Yang, Y and Faught, A and Subashi, E and Wu, Q and Yin, F},
abstractNote = {Purpose: To assess image quality and imaging dose of 2.5MV electronic portal imaging in comparison to kV imaging and 6MV and Flattening-Filter-Free 6MV (6MVFFF) portal imaging using a DMI imager. Methods: Quantitative assessment of image quality was performed with Leeds and Las Vegas test phantoms in conjunction with qualitative evaluation of clinical patient images for kV imaging and 2.5MV, 6MV and 6MVFFF portal imaging. High and low contrast resolutions were evaluated and imaging doses were measured using these x-rays. Phantom test was performed both in air and in solid water. Clinical patient portal images were also reviewed and qualitatively assessed for these three imaging MV energies. Results: Among the 28 objects in Las Vegas phantom, 16, 17 and 26 of them were resolved using Low Dose technique and 18, 22 and 26 were resolved using High Quality technique with 6MV, 6MVFFF and 2.5MV, respectively. The number of Leeds low contrast objects resolved by 6MV, 6MFFFF and 2.5MV was 6, 15 and 18 with Low Dose technique and 14, 17 and 18 with High Quality technique, respectively. When the test phantoms were embedded in 20cm thick solid water, the results were noticeably affected, but the performance of 2.5MV was still substantially better than 6MV and 6MVFFF. Imaging dose with 2.5MV measured at 10 cm depth was about half of that with 6MV or 6MVFFF. Clinical patient portal images were reviewed and qualitatively assessed for different sites including brain, head-and-neck, chest and pelvis. 2.5MV imaging provided more details and substantially higher contrast. Conclusion: While portal imaging with 6MVFFF provides noticeably better image quality than that with 6MV, the performance of 2.5MV portal imaging is substantially better than both 6MV and 6MVFFF in terms of high and low contrast resolutions as well as lower imaging dose. 2.5MV imaging provides near kV imaging quality.},
doi = {10.1118/1.4955934},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}
  • Purpose: To compare image quality metrics and dose of TrueBeam V2.0’s 2.5MV imaging beam and kV and 6MV images. Methods: To evaluate the MV image quality, the Standard Imaging QC-3 and Varian Las Vegas (LV) phantoms were imaged using the ‘quality’ and ‘low dose’ modes and then processed using RIT113 V6.3. The LEEDS phantom was used to evaluate the kV image quality. The signal to noise ratio (SNR) was also evaluated in patient images using Matlab. In addition, dose per image was evaluated at a depth of 5cm using solid water for a 28.6 cm × 28.6 cm field size,more » which is representative of the largest jaw settings at an SID of 150cm. Results: The 2.5MV images had lower dose than the 6 MV images and a contrast to noise ratio (CNR) about 1.4 times higher, when evaluated using the QC-3. When energy was held constant but dose varied, the different modes, ‘low dose’ and ‘quality’, showed less than an 8% difference in CNR. The ‘quality’ modes demonstrated better spatial resolution than the ‘low dose’; however, even with the ‘low dose’ all line pairs were distinct except for the 0.75lp/mm on the 2.5MV. The LV phantom was used to measure low contrast detectability and showed similar results to the QC-3. Several patient images all confirmed that SNR were highest in kV images followed by 2.5MV and then 6MV. Qualitatively, for anatomical areas with large variability in thickness, like lateral head and necks, 2.5MV images show more anatomy, such as shoulder position, than kV images. Conclusions: The kV images clearly provide the best image metrics per unit dose. The 2.5MV beam showed excellent contrast at a lower dose than 6MV and may be superior to kV for difficult to image areas that include large changes in anatomical thickness. P Balter: Varian, Sun Nuclear, Philips, CPRIT.« less
  • Purpose: Aim of the current study is to look plan quality, treatment beam ON time for IMRT using 6MV FB (Flatten Beam) and FFFB (Flattening Filter Free Beam) in left breast cancer cases. Methods: Ten left breast cancer patients treated with breast conserving surgical (BCS) procedure approach and adjuvant radiotherapy were selected from the department database. Simultaneous Integrated boost (SIB) technique was used to irradiate the total left breast (PTV) to a dose of 50.40Gy with concomitant enhance to the lumpectomy cavity known as gross tumour volume (GTV) to a dose of 59.40Gy in 28 fractions. Plans 6MV FB IMRTmore » and 6MV FFFB IMRT had been generated to achieve dose to 95% target volume (TV) and spare Organ at risks (OAR’s). Homogeneity index (HI), conformity index (CI), treatment monitor unit (MU),normal tissues integral dose (NTID) and low dose volume of normal tissue were compared. Results: There was no statistically huge difference among the plans with respect to target volume coverage, CI HI, Ipsilateral Lung and Breast. But statistically significant difference (p< 0.05) as observed in Heart, V5Gy of Contralateral Lung, MU’s NTID and low dose volume of normal tissue. Conclusion: 6MV FB and FFF beam produce almost equivalent plans in IMRT modality with admire to target volume coverage, HI, CI. Beam on time and NTID was determined to be much less in 6MV FFFB IMRT. FFF beam leads to a time saving treatment delivery and fewer NTID in cancer of left breast cases.« less
  • Purpose: To implement and validate a method of using electronic portal image device (EPID) for pre-treatment quality assurance (QA) of volumetric modulated arc therapy (VMAT) plans using flattering filter free (FFF) beams for stereotactic body radiotherapy (SBRT). Methods: On Varian Edge with 6MV FFF beam, open field (from 2×2 cm to 20×20 cm) EPID images were acquired with 200 monitor unit (MU) at the image device to radiation source distance of 150cm. With 10×10 open field and calibration unit (CU) provided by vendor to EPID image pixel, a dose conversion factor was determined by dividing the center dose calculated frommore » the treatment planning system (TPS) to the corresponding CU readout on the image. Water phantom measured beam profile and the output factors for various field sizes were further correlated to those of EPID images. The dose conversion factor and correction factors were then used for converting the portal images to the planner dose distributions of clinical fields. A total of 28 VMAT fields of 14 SBRT plans (8 lung, 2 prostate, 2 liver and 2 spine) were measured. With 10% low threshold cutoff, the delivered dose distributions were compared to the reference doses calculated in water phantom from the TPS. A gamma index analysis was performed for the comparison in percentage dose difference/distance-to-agreement specifications. Results: The EPID device has a linear response to the open fields with increasing MU. For the clinical fields, the gamma indices between the converted EPID dose distributions and the TPS calculated 2D dose distributions were 98.7%±1.1%, 94.0%±3.4% and 70.3%±7.7% for the criteria of 3%/3mm, 2%/2mm and 1%/1mm, respectively. Conclusion: Using a portal image device, a high resolution and high accuracy portal dosimerty was achieved for pre-treatment QA verification for SBRT VMAT plans with FFF beams.« less
  • Purpose: Varian’s electronic portal imaging device (EPID) based portal dosimetry tool is a popular and effective means of performing IMRT QA. EPIDs for older models of the TrueBeam accelerator utilize a 40cmx30cm Image Detection Unit (IDU) that saturates at the center for standard source to imager distances with high dose rate flattening filter free (FFF) beams. This makes portal dosimetry not possible and an alternative means of IMRT QA necessary. We developed a filter that would attenuate the beam to a dose rate measureable by the IDU for portal dosimetry IMRT QA. Methods: Multipurpose 304 stainless steel plates were placedmore » on an accessory tray to attenuate the beam. Profiles of an open field measured on the IDU were acquired with varying number of plates to assess the thickness needed to reduce the maximum dose rates of 6XFFF and 10XFFF beams to measurable levels. A new portal dose image prediction (PDIP) model was commissioned based on open field measurements with plates in position, and a modified beam profile was input to portal dosimetry calibration at the console to empirically correct for attenuation and scatter. The portal dosimetry tool was used to assess agreement between predicted and measured doses for open 25×25cm{sup 2} fields and intensity modulated fields using 6XFFF and 10XFFF beams. Results: Thicknesses of 2.5cm and 3.8cm of steel were required to reduce the highest dose rates to a measureable level for 6XFFF and 10XFFF, respectively. Gamma analysis using a 3%/3mm relative criterion with the filter in place and using the new PDIP model resulted in 98.2% and 93.6% of pixels passing while intensity modulated fields showed passing rates of 98.2% and 99.0%. Conclusion: Use of the filter allows for portal dosimetry to be used for IMRT QA of FFF plans in place of purchasing a second option for IMRT QA.« less
  • Purpose: Novel linac machines, TrueBeam (TB) and Elekta Versa have updated head designing and software control system, include flattening-filter-free (FFF) photon and electron beams. Later on FFF beams were also introduced on C-Series machines. In this work FFF beams for same energy 6MV but from different machine versions were studied with reference to beam data parameters. Methods: The 6MV-FFF percent depth doses, profile symmetry and flatness, dose rate tables, and multi-leaf collimator (MLC) transmission factors were measured during commissioning process of both C-series and Truebeam machines. The scanning and dosimetric data for 6MV-FFF beam from Truebeam and C-Series linacs wasmore » compared. A correlation of 6MV-FFF beam from Elekta Versa with that of Varian linacs was also found. Results: The scanning files were plotted for both qualitative and quantitative analysis. The dosimetric leaf gap (DLG) for C-Series 6MV-FFF beam is 1.1 mm. Published values for Truebeam dosimetric leaf gap is 1.16 mm. 6MV MLC transmission factor varies between 1.3 % and 1.4 % in two separate measurements and measured DLG values vary between 1.32 mm and 1.33 mm on C-Series machine. MLC transmission factor from C-Series machine varies between 1.5 % and 1.6 %. Some of the measured data values from C-Series FFF beam are compared with Truebeam representative data. 6MV-FFF beam parameter values like dmax, OP factors, beam symmetry and flatness and additional parameters for C-Series and Truebeam liancs will be presented and compared in graphical form and tabular data form if selected. Conclusion: The 6MV flattening filter (FF) beam data from C-Series & Truebeam and 6MV-FFF beam data from Truebeam has already presented. This particular analysis to compare 6MV-FFF beam from C-Series and Truebeam provides opportunity to better elaborate FFF mode on novel machines. It was found that C-Series and Truebeam 6MV-FFF dosimetric and beam data was quite similar.« less