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Title: SU-F-T-79: Monte Carlo Investigation of Optimizing Parameters for Modulated Electron Arc Therapy

Abstract

Purpose: Electron arc therapy provides excellent dose distributions for treating superficial tumors along curved surfaces. However this modality has not received widespread application due to the lack of needed advancement in electron beam delivery, accurate electron dose calculation and treatment plan optimization. The aim of the current work is to investigate possible parameters that can be optimized for electron arc (eARC) therapy. Methods: The MCBEAM code was used to generate phase space files for 6 and 12MeV electron beam energies from a Varian trilogy machine. An Electron Multi-leaf collimator eMLC of 2cm thickness positioned at 82 cm source collimated distance was used in the study. Dose distributions for electron arcs were calculated inside a cylindrical phantom using the MCSIM code. The Cylindrical phantom was constructed with 0.2cm voxels and a 15cm diameter. Electron arcs were delivered with two different approaches. The first approach was to deliver the arc as segments of very small field widths. In this approach we also tested the impact of the segment size and the arc increment angle. The second approach is to deliver the arc as a sum of large fields each covering the whole target as seen from the beam eye view. Results: Inmore » considering 90 % as the prescription isodose line, the first approach showed a region of buildup proceeding before the prescription zone. This build up is minimizing with the second approach neglecting need for bolus. The second approach also showed less x-ray contamination. In both approaches the variation of the segment size changed the size and location of the prescription isodose line. The optimization process for eARC could involve interplay between small and large segments to achieve desired coverage. Conclusion: An advanced modulation of eARCs will allow for tailored dose distribution for superficial curved target as with challenging scalp cases.« less

Authors:
; ;  [1]; ;  [2]
  1. Azhar university, Nasr City, Cairo (Egypt)
  2. Fox Chase Cancer Center, Philadelphia, PA (United States)
Publication Date:
OSTI Identifier:
22642327
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; COLLIMATORS; ELECTRON BEAMS; MONTE CARLO METHOD; NEOPLASMS; OPTIMIZATION; PHANTOMS; PHASE SPACE; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; RADIOTHERAPY; THICKNESS

Citation Formats

Al Ashkar, E, Eraba, K, Imam, M, Eldib, A, and Ma, C. SU-F-T-79: Monte Carlo Investigation of Optimizing Parameters for Modulated Electron Arc Therapy. United States: N. p., 2016. Web. doi:10.1118/1.4956215.
Al Ashkar, E, Eraba, K, Imam, M, Eldib, A, & Ma, C. SU-F-T-79: Monte Carlo Investigation of Optimizing Parameters for Modulated Electron Arc Therapy. United States. doi:10.1118/1.4956215.
Al Ashkar, E, Eraba, K, Imam, M, Eldib, A, and Ma, C. 2016. "SU-F-T-79: Monte Carlo Investigation of Optimizing Parameters for Modulated Electron Arc Therapy". United States. doi:10.1118/1.4956215.
@article{osti_22642327,
title = {SU-F-T-79: Monte Carlo Investigation of Optimizing Parameters for Modulated Electron Arc Therapy},
author = {Al Ashkar, E and Eraba, K and Imam, M and Eldib, A and Ma, C},
abstractNote = {Purpose: Electron arc therapy provides excellent dose distributions for treating superficial tumors along curved surfaces. However this modality has not received widespread application due to the lack of needed advancement in electron beam delivery, accurate electron dose calculation and treatment plan optimization. The aim of the current work is to investigate possible parameters that can be optimized for electron arc (eARC) therapy. Methods: The MCBEAM code was used to generate phase space files for 6 and 12MeV electron beam energies from a Varian trilogy machine. An Electron Multi-leaf collimator eMLC of 2cm thickness positioned at 82 cm source collimated distance was used in the study. Dose distributions for electron arcs were calculated inside a cylindrical phantom using the MCSIM code. The Cylindrical phantom was constructed with 0.2cm voxels and a 15cm diameter. Electron arcs were delivered with two different approaches. The first approach was to deliver the arc as segments of very small field widths. In this approach we also tested the impact of the segment size and the arc increment angle. The second approach is to deliver the arc as a sum of large fields each covering the whole target as seen from the beam eye view. Results: In considering 90 % as the prescription isodose line, the first approach showed a region of buildup proceeding before the prescription zone. This build up is minimizing with the second approach neglecting need for bolus. The second approach also showed less x-ray contamination. In both approaches the variation of the segment size changed the size and location of the prescription isodose line. The optimization process for eARC could involve interplay between small and large segments to achieve desired coverage. Conclusion: An advanced modulation of eARCs will allow for tailored dose distribution for superficial curved target as with challenging scalp cases.},
doi = {10.1118/1.4956215},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: Modulated electron radiotherapy (MERT) has been proposed as a mean of delivering conformal dose to shallow tumors while sparing distal structures and surrounding tissues. In intraoperative radiotherapy (IORT) utilizing Mobetron, an applicator is placed as closely as possible to the suspected cancerous tissues to be treated. In this study we investigate the characteristics of Mobetron electron beams collimated by an in-house prospective electron multileaf collimator (eMLC) and its feasibility for MERT. Methods: IntraOp Mobetron™ dedicated to perform radiotherapy during surgery was used in the study. It provides several energies (6, 9 and 12 MeV). Dosimetry measurements were performed tomore » obtain percentage depth dose curves (PDD) and profiles for a 10-cm diameter applicator using the PTW MP3/XS 3D-scanning system and the semiflex ion chamber. MCBEAM/MCSIM Monte Carlo codes were used for the treatment head simulation and phantom dose calculation. The design of an electron beam collimation by an eMLC attached to the Mobetron head was also investigated using Monte Carlo simulations. Isodose distributions resulting from eMLC collimated beams were compared to that collimated using cutouts. The design for our Mobetron eMLC is based on our previous experiences with eMLCs designed for clinical linear accelerators. For Mobetron the eMLC is attached to the end of a spacer-mounted rectangular applicator at 50 cm SSD. Steel will be used as the leaf material because other materials would be toxic and will not be suitable for intraoperative applications. Results: Good agreement (within 2%) was achieved between measured and calculated PDD curves and profiles for all available energies. Dose distributiosn provided by the eMLC showed reasonable agreement (∼3%/1mm) with those obtained by conventional cutouts. Conclusion: Monte Carlo simulations are capable of modeling Mobetron electron beams with a reliable accuracy. An eMLC attached to the Mobteron treatment head will allow better treatment options with those machines.« less
  • Energy modulated electron therapy (EMET) based on Monte Carlo dose calculation is a promising technique that enhances the treatment planning and delivery of superficially located tumors. This study investigated the application of EMET using a novel few-leaf electron collimator (FLEC) in head and neck and breast sites in comparison with three-dimensional conventional radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) techniques. Treatment planning was performed for two parotid cases and one breast case. Four plans were compared for each case: 3D-CRT, IMRT, 3D-CRT in conjunction with EMET (EMET-CRT), and IMRT in conjunction with EMET (EMET-IMRT), all of which weremore » performed and calculated with Monte Carlo techniques. For all patients, dose volume histograms (DVHs) were obtained for all organs of interest and the DVHs were used as a means of comparing the plans. Homogeneity and conformity of dose distributions were calculated, as well as a sparing index that compares the effect of the low isodose lines. In addition, the whole-body dose equivalent (WBDE) was estimated for each plan. Adding EMET delivered with the FLEC to 3D-CRT improves sparing of normal tissues. For the two head and neck cases, the mean dose to the contralateral parotid and brain stem was reduced relative to IMRT by 43% and 84%, and by 57% and 71%, respectively. Improved normal tissue sparing was quantified as an increase in sparing index of 47% and 30% for the head and neck and the breast cases, respectively. Adding EMET to either 3D-CRT or IMRT results in preservation of target conformity and dose homogeneity. When adding EMET to the treatment plan, the WBDE was reduced by between 6% and 19% for 3D-CRT and by between 21% and 33% for IMRT, while WBDE for EMET-CRT was reduced by up to 72% when compared with IMRT. FLEC offers a practical means of delivering modulated electron therapy. Although adding EMET delivered using the FLEC results in perturbation of target conformity when compared to IMRT, it significantly improves normal tissue sparing while offering enhanced target conformity to the 3D-CRT planning. The addition of EMET systematically leads to a reduction in WBDE especially when compared with IMRT.« less
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