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Title: SU-F-T-160: Commissioning of a Single-Room Double-Scattering Proton Therapy System

Abstract

Purpose: To report the detailed commissioning experience for a compact double-scattering Mevion S250 proton therapy system at a University Cancer Center site. Methods: The commissioning of the proton therapy system mainly consisted of ensuring integrity of mechanical and imaging system, beam data collection, and commissioning of a treatment planning system (TPS). First, mechanical alignment and imaging were tested including safety, interlocks, positional accuracy of couch and gantry, image quality, mechanical and imaging isocenter and so on. Second, extensive beam data (outputs, PDDs, and profiles) were collected and analyzed through effective sampling of range (R) and modulation width (M) from 24 beam options. Three different output (cGy/MU) prediction models were also commissioned as primary and secondary MU calculation tool. Third, the Varian Eclipse TPS was commissioned through five sets of data collections (in-water Bragg peak scans, in-air longitudinal fluence scans, in-air lateral profiles, in-air half-beam profiles, and an HU-to-stopping-power conversion curve) and accuracy of TPS calculation was tested using in-water scans and dose measurements with a 2D array detector with block and range compensator. Finally, an anthropomorphic phantom was scanned and heterogeneity effects were tested by inserting radiochromic films in the phantom and PET activation scans for range verification in conjunctionmore » with end-to-end test. Results: Beam characteristics agreed well with the vendor specifications; however, minor mismatches in R and M were found in some measurements during the beam data collection. These were reflected into the TPS commissioning such that the TPS could accurately predict the R and M within tolerance levels. The output models had a good agreement with measured outputs (<3% error). The end-to-end test using the film and PET showed reasonably the TPS predicted dose, R and M in heterogeneous medium. Conclusion: The proton therapy system was successfully commissioned and was released for clinical use.« less

Authors:
; ; ; ; ; ;  [1];  [2]
  1. University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)
  2. Carti, Inc., Little Rock, AR (United States)
Publication Date:
OSTI Identifier:
22642401
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:
61 RADIATION PROTECTION AND DOSIMETRY; 60 APPLIED LIFE SCIENCES; BIOMEDICAL RADIOGRAPHY; BRAGG CURVE; COMMISSIONING; EDUCATIONAL FACILITIES; FORECASTING; IMAGES; POSITRON COMPUTED TOMOGRAPHY; PROTON BEAMS; RADIOTHERAPY; STOPPING POWER

Citation Formats

Jin, H, Ahmad, S, Chen, Y, Lau, A, Islam, M, Ferreira, C, Ferguson, S, and Keeling, V. SU-F-T-160: Commissioning of a Single-Room Double-Scattering Proton Therapy System. United States: N. p., 2016. Web. doi:10.1118/1.4956296.
Jin, H, Ahmad, S, Chen, Y, Lau, A, Islam, M, Ferreira, C, Ferguson, S, & Keeling, V. SU-F-T-160: Commissioning of a Single-Room Double-Scattering Proton Therapy System. United States. doi:10.1118/1.4956296.
Jin, H, Ahmad, S, Chen, Y, Lau, A, Islam, M, Ferreira, C, Ferguson, S, and Keeling, V. 2016. "SU-F-T-160: Commissioning of a Single-Room Double-Scattering Proton Therapy System". United States. doi:10.1118/1.4956296.
@article{osti_22642401,
title = {SU-F-T-160: Commissioning of a Single-Room Double-Scattering Proton Therapy System},
author = {Jin, H and Ahmad, S and Chen, Y and Lau, A and Islam, M and Ferreira, C and Ferguson, S and Keeling, V},
abstractNote = {Purpose: To report the detailed commissioning experience for a compact double-scattering Mevion S250 proton therapy system at a University Cancer Center site. Methods: The commissioning of the proton therapy system mainly consisted of ensuring integrity of mechanical and imaging system, beam data collection, and commissioning of a treatment planning system (TPS). First, mechanical alignment and imaging were tested including safety, interlocks, positional accuracy of couch and gantry, image quality, mechanical and imaging isocenter and so on. Second, extensive beam data (outputs, PDDs, and profiles) were collected and analyzed through effective sampling of range (R) and modulation width (M) from 24 beam options. Three different output (cGy/MU) prediction models were also commissioned as primary and secondary MU calculation tool. Third, the Varian Eclipse TPS was commissioned through five sets of data collections (in-water Bragg peak scans, in-air longitudinal fluence scans, in-air lateral profiles, in-air half-beam profiles, and an HU-to-stopping-power conversion curve) and accuracy of TPS calculation was tested using in-water scans and dose measurements with a 2D array detector with block and range compensator. Finally, an anthropomorphic phantom was scanned and heterogeneity effects were tested by inserting radiochromic films in the phantom and PET activation scans for range verification in conjunction with end-to-end test. Results: Beam characteristics agreed well with the vendor specifications; however, minor mismatches in R and M were found in some measurements during the beam data collection. These were reflected into the TPS commissioning such that the TPS could accurately predict the R and M within tolerance levels. The output models had a good agreement with measured outputs (<3% error). The end-to-end test using the film and PET showed reasonably the TPS predicted dose, R and M in heterogeneous medium. Conclusion: The proton therapy system was successfully commissioned and was released for clinical use.},
doi = {10.1118/1.4956296},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: The Mevion S250 proton therapy unit is equipped with a 6D-robotic couch and IGRT system (Verity). The patient alignment process allows corrections in six degrees of freedom: translation (x,y,z), pitch, roll, and yaw (θ,ϑ,ψ). Geometric accuracy of couch corrections and imaging vs. radiation isocenter coincidence were quantified before clinical implementation. Methods: A commercial phantom with sixteen 2mm tungsten BBs was rigidly couch-mounted and imaged with CT. Seventeen rigid translations/rotations of known magnitude were digitally applied to the original CT image using commercial software, validated with Varian OBI system. For each altered image, phantom was mounted on robotic couch inmore » original position, then Verity 2D:2D match (PA-LLAT) was performed using DRRs from altered images. Corrections were recorded and applied, phantom was imaged a second time and residual corrections recorded. Physical measurements verified that applied couch corrections coincided with both physical couch shifts/rotations and known CT image translations/rotations. Additionally, image vs. radiation isocenter coicidence was quantified over couch treatment angles (±90° from setup position) using radiochromic film and an image-guided couch star-shot. Posterior-anterior and left-lateral kV radiographs were taken before each beam was delivered to verify imaging/radiation isocentricity. Results: Verity suggested couch corrections and known CT shifts/rotations agreed within ±1mm (average: Δ lat=0.5mm; Δ vert=0.4mm; Δ long=0.3mm) and ± 0.4° (average: Δ pitch=0.24° Δ roll=0.01°; Δ yaw=0.10°). Physical couch measurements and Verity applied corrections agreed within ± 1mm (average: Δlat=0.5mm; Δvert=0.4mm; Δlong=0.2mm) and ±0.2° (average: Δpitch=0.03°; Δ roll=0.04°; Δ yaw=0.04°). The directionality of all translations and rotations were qualitatively verified. The image vs. radiation isocenter coincidence was <1mm and radiation-isocenter precision was <1mm over the 180° of couch motion, as indicated by film analysis. Conclusion: The Verity IGRT software and 6D-couch combination on the Mevion S250 was verified as accurate within 1mm and 0.5°. This complies with the TG-142 standards for a stereotactic radiotherapy IGRT system. Rob Cessac is employed as Product Manager for Mevion Medical Systems.« less
  • Purpose: The purpose of this investigation is to determine if a single set of beam data, described by a minimal set of equations and fitting variables, can be used to commission different installations of a proton double-scattering system in a commercial pencil-beam dose calculation algorithm. Methods: The beam model parameters required to commission the pencil-beam dose calculation algorithm (virtual and effective SAD, effective source size, and pristine-peak energy spread) are determined for a commercial double-scattering system. These parameters are measured in a first room and parameterized as function of proton energy and nozzle settings by fitting four analytical equations tomore » the measured data. The combination of these equations and fitting values constitutes the golden beam data (GBD). To determine the variation in dose delivery between installations, the same dosimetric properties are measured in two additional rooms at the same facility, as well as in a single room at another facility. The difference between the room-specific measurements and the GBD is evaluated against tolerances that guarantee the 3D dose distribution in each of the rooms matches the GBD-based dose distribution within clinically reasonable limits. The pencil-beam treatment-planning algorithm is commissioned with the GBD. The three-dimensional dose distribution in water is evaluated in the four treatment rooms and compared to the treatment-planning calculated dose distribution. Results: The virtual and effective SAD measurements fall between 226 and 257 cm. The effective source size varies between 2.4 and 6.2 cm for the large-field options, and 1.0 and 2.0 cm for the small-field options. The pristine-peak energy spread decreases from 1.05% at the lowest range to 0.6% at the highest. The virtual SAD as well as the effective source size can be accurately described by a linear relationship as function of the inverse of the residual energy. An additional linear correction term as function of RM-step thickness is required for accurate parameterization of the effective SAD. The GBD energy spread is given by a linear function of the exponential of the beam energy. Except for a few outliers, the measured parameters match the GBD within the specified tolerances in all of the four rooms investigated. For a SOBP field with a range of 15 g/cm{sup 2} and an air gap of 25 cm, the maximum difference in the 80%–20% lateral penumbra between the GBD-commissioned treatment-planning system and measurements in any of the four rooms is 0.5 mm. Conclusions: The beam model parameters of the double-scattering system can be parameterized with a limited set of equations and parameters. This GBD closely matches the measured dosimetric properties in four different rooms.« less
  • Purpose: To quantitatively evaluate dosimetric consequence of spot size variations and validate beam-matching criteria for commissioning a pencil beam model for multiple treatment rooms. Methods: A planning study was first conducted by simulating spot size variations to systematically evaluate dosimetric impact of spot size variations in selected cases, which was used to establish the in-air spot size tolerance for beam matching specifications. A beam model in treatment planning system was created using in-air spot profiles acquired in one treatment room. These spot profiles were also acquired from another treatment room for assessing the actual spot size variations between the twomore » treatment rooms. We created twenty five test plans with targets of different sizes at different depths, and performed dose measurement along the entrance, proximal and distal target regions. The absolute doses at those locations were measured using ionization chambers at both treatment rooms, and were compared against the calculated doses by the beam model. Fifteen additional patient plans were also measured and included in our validation. Results: The beam model is relatively insensitive to spot size variations. With an average of less than 15% measured in-air spot size variations between two treatment rooms, the average dose difference was −0.15% with a standard deviation of 0.40% for 55 measurement points within target region; but the differences increased to 1.4%±1.1% in the entrance regions, which are more affected by in-air spot size variations. Overall, our single-room based beam model in the treatment planning system agreed with measurements in both rooms < 0.5% within the target region. For fifteen patient cases, the agreement was within 1%. Conclusion: We have demonstrated that dosimetrically equivalent machines can be established when in-air spot size variations are within 15% between the two treatment rooms.« less
  • Purpose: The out-of-beam dose is important for understanding the peripheral dose in radiation therapy. In proton radiotherapy, the study of out-of-beam dose is scarce and the treatment planning system (TPS) based on pencil beam algorithm cannot accurately predict the out-of-beam dose. This study investigates the out-of-beam dose for the single-room Mevion S250 double scattering proton therapy system using experimentally measured and treatment planning software generated data. The results are compared with those reported for conventional photon beam therapy. However, this study does not incorporate the neutron contribution in the scattered dose. Methods: A total of seven proton treatment plans weremore » generated using Varian Eclipse TPS for three different sites (brain, lung, and pelvis) in an anthropomorphic phantom. Three field sizes of 5×5, 10×10, and 20×20 cm{sup 2} (lung only) with typical clinical range (13.3–22.8 g/cm{sup 2}) and modulation widths (5.3–14.0 g/cm{sup 2}) were used. A single beam was employed in each treatment plan to deliver a dose of 181.8 cGy (200.0 cGy (RBE)) to the selected target. The out-of-beam dose was measured at 2.0, 5.0, 10.0, and 15.0 cm from the beam edge in the phantom using a thimble chamber (PTW TN31010). Results: The out-of-beam dose generally increased with field size, range, and volume irradiated. For all the plans, the scattered dose sharply fell off with distance. At 2.0 cm, the out-of-beam dose ranged from 0.35% to 2.16% of the delivered dose; however, the dose was clinically negligible (<0.3%) at a distance of 5.0 cm and greater. In photon therapy, the slightly greater out-of-beam dose was reported (TG36; 4%, 2%, and 1% for 2.0, 5.0, and 10.0 cm, respectively, using 6 MV beam). Conclusion: The measured out-of-beam dose in proton therapy excluding neutron contribution was observed higher than the TPS calculated dose and comparable to that of photon beam therapy.« less
  • Purpose: To describe a summary of the clinical commissioning of the discrete spot scanning proton beam at the Proton Therapy Center, Houston (PTC-H). Methods: Discrete spot scanning system is composed of a delivery system (Hitachi ProBeat), an electronic medical record (Mosaiq V 1.5), and a treatment planning system (TPS) (Eclipse V 8.1). Discrete proton pencil beams (spots) are used to deposit dose spot by spot and layer by layer for the proton distal ranges spanning from 4.0 to 30.6 g/cm{sup 2} and over a maximum scan area at the isocenter of 30x30 cm{sup 2}. An arbitrarily chosen reference calibration conditionmore » has been selected to define the monitor units (MUs). Using radiochromic film and ion chambers, the authors have measured spot positions, the spot sizes in air, depth dose curves, and profiles for proton beams with various energies in water, and studied the linearity of the dose monitors. In addition to dosimetric measurements and TPS modeling, significant efforts were spent in testing information flow and recovery of the delivery system from treatment interruptions. Results: The main dose monitors have been adjusted such that a specific amount of charge is collected in the monitor chamber corresponding to a single MU, following the IAEA TRS 398 protocol under a specific reference condition. The dose monitor calibration method is based on the absolute dose per MU, which is equivalent to the absolute dose per particle, the approach used by other scanning beam institutions. The full width at half maximum for the spot size in air varies from approximately 1.2 cm for 221.8 MeV to 3.4 cm for 72.5 MeV. The measured versus requested 90% depth dose in water agrees to within 1 mm over ranges of 4.0-30.6 cm. The beam delivery interlocks perform as expected, guarantying the safe and accurate delivery of the planned dose. Conclusions: The dosimetric parameters of the discrete spot scanning proton beam have been measured as part of the clinical commissioning program, and the machine is found to function in a safe manner, making it suitable for patient treatment.« less