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Title: SU-F-T-177: Impacts of Gantry Angle Dependent Scanning Beam Properties for Proton Treatment

Abstract

Purpose: In pencil beam scanning (PBS), the delivered spot MU, position and size are slightly different at different gantry angles. We investigated the level of delivery uncertainty at different gantry angles through a log file analysis. Methods: 34 PBS fields covering full 360 degrees gantry angle spread were collected retrospectively from 28 patients treated at our institution. All fields were delivered at zero gantry angle and the prescribed gantry angle, and measured at isocenter with the MatriXX 2D array detector at the prescribed gantry angle. The machine log files were analyzed to extract the delivered MU per spot and the beam position from the strip ionization chambers in the treatment nozzle. The beam size was separately measured as a function of gantry angle and beam energy. Using this information, the dose was calculated in a water phantom at both gantry angles and compared to the measurement using the 3D γ-index at 2mm/2%. Results: The spot-by-spot difference between the beam position in the log files from the delivery at the two gantry angles has a mean of 0.3 and 0.4 mm and a standard deviation of 0.6 and 0.7 mm for × and y directions, respectively. Similarly, the spot-by-spot difference betweenmore » the MU in the log files from the delivery at the two gantry angles has a mean 0.01% and a standard deviation of 0.7%. These small deviations lead to an excellent agreement in dose calculations with an average γ pass rate for all fields being approximately 99.7%. When each calculation is compared to the measurement, a high correlation in γ was also found. Conclusion: Using machine logs files, we verified that PBS beam delivery at different gantry angles are sufficiently small and the planned spot position and MU. This study brings us one step closer to simplifying our patient-specific QA.« less

Authors:
; ; ; ;  [1]
  1. Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)
Publication Date:
OSTI Identifier:
22642418
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; BEAM POSITION; DELIVERY; IONIZATION CHAMBERS; RADIOTHERAPY

Citation Formats

Lin, Y, Clasie, B, Lu, H, Flanz, J, and Jee, K. SU-F-T-177: Impacts of Gantry Angle Dependent Scanning Beam Properties for Proton Treatment. United States: N. p., 2016. Web. doi:10.1118/1.4956314.
Lin, Y, Clasie, B, Lu, H, Flanz, J, & Jee, K. SU-F-T-177: Impacts of Gantry Angle Dependent Scanning Beam Properties for Proton Treatment. United States. doi:10.1118/1.4956314.
Lin, Y, Clasie, B, Lu, H, Flanz, J, and Jee, K. 2016. "SU-F-T-177: Impacts of Gantry Angle Dependent Scanning Beam Properties for Proton Treatment". United States. doi:10.1118/1.4956314.
@article{osti_22642418,
title = {SU-F-T-177: Impacts of Gantry Angle Dependent Scanning Beam Properties for Proton Treatment},
author = {Lin, Y and Clasie, B and Lu, H and Flanz, J and Jee, K},
abstractNote = {Purpose: In pencil beam scanning (PBS), the delivered spot MU, position and size are slightly different at different gantry angles. We investigated the level of delivery uncertainty at different gantry angles through a log file analysis. Methods: 34 PBS fields covering full 360 degrees gantry angle spread were collected retrospectively from 28 patients treated at our institution. All fields were delivered at zero gantry angle and the prescribed gantry angle, and measured at isocenter with the MatriXX 2D array detector at the prescribed gantry angle. The machine log files were analyzed to extract the delivered MU per spot and the beam position from the strip ionization chambers in the treatment nozzle. The beam size was separately measured as a function of gantry angle and beam energy. Using this information, the dose was calculated in a water phantom at both gantry angles and compared to the measurement using the 3D γ-index at 2mm/2%. Results: The spot-by-spot difference between the beam position in the log files from the delivery at the two gantry angles has a mean of 0.3 and 0.4 mm and a standard deviation of 0.6 and 0.7 mm for × and y directions, respectively. Similarly, the spot-by-spot difference between the MU in the log files from the delivery at the two gantry angles has a mean 0.01% and a standard deviation of 0.7%. These small deviations lead to an excellent agreement in dose calculations with an average γ pass rate for all fields being approximately 99.7%. When each calculation is compared to the measurement, a high correlation in γ was also found. Conclusion: Using machine logs files, we verified that PBS beam delivery at different gantry angles are sufficiently small and the planned spot position and MU. This study brings us one step closer to simplifying our patient-specific QA.},
doi = {10.1118/1.4956314},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: To investigate the effect of spot size variation as function of gantry angle on the quality of treatment plans for pencil beam scanning proton plans. Method: Three homogeneous 26×26×7cm dose volumes with different ranges and SOBPs were delivered on the matrixxPT 2D array at gantry angles of 0 and 270 degrees. The spot size sigma varies by 1.8, 7.8, and 1.4%, for nominal energies of 215, 183, and 103 MeV (Range 29, 22, and 8cm, respectively). The resulting dose planes are compared and evaluated with the gamma index for 2%/2mm and 1%/1mm criteria. Results: Patient specific QA is performedmore » at a gantry angle of 0 degrees. However, beam sigmas vary as function of gantry angle because of the beam optics for each gantry. This will cause differences between the delivered and planned treatment plans. Delivered plans were compared and a gamma pass rate of 96.5% for criteria of 2%/2mm and 91.4% for 1%/1mm were seen for plans with a nominal energy of 183 MeV. For plans with a nominal energy of 103 MeV, gamma pass rates of 97.3% for 2%/2mm and 91.5% for 1%/1mm were seen. For plans with a nominal energy of 215 MeV the pass rate was 99.8% for 1%/1mm between the two gantry angles. Conclusion: Differences in beam sigma of up to 7.8% do not cause significant differences in the dose distribution of different spot size gammas.« less
  • Purpose: The beam monitoring equipments developed for the first PSI spot scanning proton therapy facility, Gantry 1, have been successfully used for more than 10 years. The purpose of this article is to summarize the author's experience in the beam monitoring technique for dynamic proton scanning. Methods: The spot dose delivery and verification use two independent beam monitoring and computer systems. In this article, the detector construction, electronic system, dosimetry, and quality assurance results are described in detail. The beam flux monitor is calibrated with a Faraday cup. The beam position monitoring is realized by measuring the magnetic fields ofmore » deflection magnets with Hall probes before applying the spot and by checking the beam position and width with an ionization strip chamber after the spot delivery. Results: The results of thimble ionization chamber dosimetry measurements are reproducible (with a mean deviation of less than 1% and a standard deviation of 1%). The resolution in the beam position measurement is of the order of a tenth of a millimeter. The tolerance of the beam position delivery and monitoring during scanning is less than 1.5 mm. Conclusions: The experiences gained with the successful operation of Gantry 1 represent a unique and solid background for the development of a new system, Gantry 2, in order to perform new advanced scanning techniques.« less
  • Purpose: Gantry-less proton treatment facility could lower the capital cost of proton therapy. This study investigates the dosimetric feasibility of using only coplanar pencil beam scanning (PBS) beams for those patients who had beam angles that would not have been deliverable without the gantry. Those coplanar beams are implemented on gantry-less horizontal beam-line with patients in sitting or standing positions. Methods: We have selected ten patients (seven head-and-neck, one thoracic, one abdominal and one pelvic case) with clinically delivered double scattering (DS) or PBS treatment plans with beam angles that were challenging to achieve without a gantry. After removing thesemore » beams angles, PBS plans were optimized for gantry-less intensity modulated proton therapy (IMPT) or single field optimization (SFO) with multi-criteria optimization (MCO). For head-and-neck patients who were treated by DS, we generated PBS plans with non-coplanar beams for comparison. Dose-volume-histograms (DVHs), target homogeneity index (HI), mean dose, D-2 and D-98 were reported. Robustness analysis was performed with ±2.5 mm setup errors and ±3.5% range uncertainties for three head-and-neck patients. Results: PBS-gantry-less plans provided more homogenous target coverage and significant improvements on organs-at-risk (OARs) sparing, compared to passive scattering treatments with a gantry. The PBS gantry-less treatments reduced the HI for target coverage by 1.3% to 47.2%, except for a suprasellar patient and a liver patient. The PBS-gantry-less plans reduced the D-mean of OARs by 3.6% to 67.4%. The PBS-gantry plans had similar target coverage and only marginal improvements on OAR sparing as compared to the PBS-gantry-less plans. These two PBS plans also had similar robustness relative to range uncertainties and setup errors. Conclusion: The gantry-less plans have with less mean dose to OARs and more homogeneous target coverage. Although the PBS-gantry plans have slightly improved target coverage and OARs sparing, the overall benefit of having a gantry to provide non-coplanar beams is debatable.« less
  • A proton therapy facility based on a linac injector and a slow cycling synchrotron is proposed. To achieve effective treatment of cancer, a scanning gantry is required. The flexible transmission of beam and high beam position accuracy are the most basic requirements for a gantry. The designed gantry optics and scanning system are presented. Great efforts are put into studying the sensitivity of the beam position in the isocenter to the element misalignments. It shows that quadrupole shift makes the largest contribution and special attention should be paid to it.
  • Purpose: To ascertain the necessity of a proton gantry, as compared to the feasibility of using a horizontal fixed proton beam-line for treatment with advanced technology. Methods: To calculate the percentage of patients that can be treated with a horizontal fixed beam-line instead of a gantry, we analyze the distributions of beam orientations of our proton gantry patients treated over the past 10 years. We identify three horizontal fixed beam geometries (FIXED, BEND and MOVE) with the patient in lying and/or sitting positions. The FIXED geometry includes only table/chair rotations and translations. In BEND, the beam can be bent up/downmore » for up to 20 degrees. MOVE allows for patient head/body angle adjustment. Based on the analysis, we select eight patients whose plan involves beams which are still challenging to achieve with a horizontal fixed beam. These beams are removed in the pencil beam scanning (PBS) plan optimized for the fixed beam-line (PBS-fix). We generate non-coplanar PBS-gantry plans for comparison, and perform a robustness analysis. Results: The percentage of patients with head-and-neck/brain tumors that can be treated with horizontal fixed beam is 44% in FIXED, 70% in 20-degrees BEND, and 100% in 90-degrees MOVE. For torso regions, 99% of the patients can be treated in 20-degree BEND. The target coverage is more homogeneous with PBS-fix plans compared to the clinical scattering treatment plans. The PBS-fix plans reduce the mean dose to organs-at-risk by a factor of 1.1–28.5. PBS-gantry plans are as good as PBS-fix plans, sometimes marginally better. Conclusion: The majority of the beam orientations can be realized with a horizontal fixed beam-line. Challenging non-coplanar beams can be eliminated with PBS delivery. Clinical implementation of the proposed fixed beam-line requires use of robotic patient positioning, further developments in immobilization, and image guidance. However, our results suggest that fixed beam-lines can be as effective as gantries.« less