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Title: SU-F-T-219: Verification of the Accuracy of a Relative Stopping Power (RSP) to Hounsfield Unit (HU) Calibration Curve Produced for Proton Treatment Planning Using EBT3-Gafchromic Film Dosimetry

Abstract

Purpose: Accuracy of a RSP-HU calibration curve produced for proton treatment planning is tested by comparing the treatment planning system dose grid to physical doses delivered on film by a Mevion S250 double-scattering proton unit. Methods: A single batch of EBT3 Gafchromic film was used for calibration and measurements. The film calibration curve was obtained using Mevion proton beam reference option 20 (15cm range, 10cm modulation). Paired films were positioned at the center of the spread out Bragg peak (SOBP) in solid water. The calibration doses were verified with an ion chamber, including background and doses from 20cGy to 350cGy. Films were scanned in a flatbed Epson-Expression 10000-XL scanner, and analyzed using the red channel. A Rando phantom was scanned with a GE LightSpeed CT Simulator. A single-field proton plan (Eclipse, Varian) was calculated to deliver 171cGy to the pelvis section (heterogeneous region), using a standard 4×4cm aperture without compensator, 7.89cm beam range, and 5.36cm SOBP. Varied depths of the calculated distal 90% isodose-line were recorded and compared. The dose distribution from film irradiated between Rando slices was compared with the calculated plans using RIT v.6.2. Results: Distal 90% isodose-line depth variation between CT scans was 2mm on average, andmore » 4mm at maximum. Fine calculation of this variation was restricted by the dose calculation grid, as well as the slice thickness. Dose differences between calibrated film measurements and calculated doses were on average 5.93cGy (3.5%), with the large majority of differences forming a normal distribution around 3.5cGy (2%). Calculated doses were almost entirely greater than those measured. Conclusion: RSP to HU calibration curve is shown to produce distal depth variation within the margin of tolerance (±4.3mm) across all potential scan energies and protocols. Dose distribution calculation is accurate to 2–4% within the SOBP, including areas of high tissue heterogeneity.« less

Authors:
; ; ;  [1]
  1. University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)
Publication Date:
OSTI Identifier:
22648836
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:
07 ISOTOPES AND RADIATION SOURCES; 60 APPLIED LIFE SCIENCES; ACCURACY; BRAGG CURVE; CALIBRATION; CAT SCANNING; FILM DOSIMETRY; IONIZATION CHAMBERS; PLANNING; PROTON BEAMS; RADIATION DOSE DISTRIBUTIONS; STOPPING POWER; VARIATIONS

Citation Formats

Schnell, E, Ferreira, C, Ahmad, S, and De La Fuente Herman, T. SU-F-T-219: Verification of the Accuracy of a Relative Stopping Power (RSP) to Hounsfield Unit (HU) Calibration Curve Produced for Proton Treatment Planning Using EBT3-Gafchromic Film Dosimetry. United States: N. p., 2016. Web. doi:10.1118/1.4956358.
Schnell, E, Ferreira, C, Ahmad, S, & De La Fuente Herman, T. SU-F-T-219: Verification of the Accuracy of a Relative Stopping Power (RSP) to Hounsfield Unit (HU) Calibration Curve Produced for Proton Treatment Planning Using EBT3-Gafchromic Film Dosimetry. United States. doi:10.1118/1.4956358.
Schnell, E, Ferreira, C, Ahmad, S, and De La Fuente Herman, T. 2016. "SU-F-T-219: Verification of the Accuracy of a Relative Stopping Power (RSP) to Hounsfield Unit (HU) Calibration Curve Produced for Proton Treatment Planning Using EBT3-Gafchromic Film Dosimetry". United States. doi:10.1118/1.4956358.
@article{osti_22648836,
title = {SU-F-T-219: Verification of the Accuracy of a Relative Stopping Power (RSP) to Hounsfield Unit (HU) Calibration Curve Produced for Proton Treatment Planning Using EBT3-Gafchromic Film Dosimetry},
author = {Schnell, E and Ferreira, C and Ahmad, S and De La Fuente Herman, T},
abstractNote = {Purpose: Accuracy of a RSP-HU calibration curve produced for proton treatment planning is tested by comparing the treatment planning system dose grid to physical doses delivered on film by a Mevion S250 double-scattering proton unit. Methods: A single batch of EBT3 Gafchromic film was used for calibration and measurements. The film calibration curve was obtained using Mevion proton beam reference option 20 (15cm range, 10cm modulation). Paired films were positioned at the center of the spread out Bragg peak (SOBP) in solid water. The calibration doses were verified with an ion chamber, including background and doses from 20cGy to 350cGy. Films were scanned in a flatbed Epson-Expression 10000-XL scanner, and analyzed using the red channel. A Rando phantom was scanned with a GE LightSpeed CT Simulator. A single-field proton plan (Eclipse, Varian) was calculated to deliver 171cGy to the pelvis section (heterogeneous region), using a standard 4×4cm aperture without compensator, 7.89cm beam range, and 5.36cm SOBP. Varied depths of the calculated distal 90% isodose-line were recorded and compared. The dose distribution from film irradiated between Rando slices was compared with the calculated plans using RIT v.6.2. Results: Distal 90% isodose-line depth variation between CT scans was 2mm on average, and 4mm at maximum. Fine calculation of this variation was restricted by the dose calculation grid, as well as the slice thickness. Dose differences between calibrated film measurements and calculated doses were on average 5.93cGy (3.5%), with the large majority of differences forming a normal distribution around 3.5cGy (2%). Calculated doses were almost entirely greater than those measured. Conclusion: RSP to HU calibration curve is shown to produce distal depth variation within the margin of tolerance (±4.3mm) across all potential scan energies and protocols. Dose distribution calculation is accurate to 2–4% within the SOBP, including areas of high tissue heterogeneity.},
doi = {10.1118/1.4956358},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: To develop a calibration curve that includes and minimizes the variations of Hounsfield Unit (HU) from a CT scanner to Relative Stopping Power (RSP) of tissues along the proton beam path. The variations are due to scanner and proton energy, technique, phantom size and placement, and tissue arrangement. Methods: A CIRS 062 M phantom with 10 plugs of known relative electron density (RED) was scanned through a 16 slice GE Discovery CT Simulator scanner. Three setup combinations of plug distributions and techniques clinically implemented for five treatment regions were scanned with energies of 100, 120, and 140 kV. Volumetricmore » HU values were measured for each plug and scan. The RSP values derived through the Bethe-Bloch formula are currently being verified with parallel-plate ionization chamber measurements in water using 80, 150, and 225 MeV proton beam. Typical treatment plans for treatment regions of brain, head-&-neck, chest, abdomen, and pelvis are being planned and dose delivered will be compared with film and Optically Stimulated Luminescence (OSL) measurements. Results: Percentage variations were determined for each variable. For tissues close to water, variations were <1% from any given parameter. Tissues far from water equivalence (lung and bone) showed the greatest sensitivity to change (7.4% maximum) with scanner energy and up to 5.3% with positioning of the phantom. No major variations were observed for proton energies within the treatment range. Conclusion: When deriving a calibration curve, attention should be placed to low and high HU values. A thorough verification process of calculated vs. water-phantom measured RSP values at different proton energies, followed by dose validation of planned vs. measured doses in phantom with film and OSL detectors are currently being undertaken.« less
  • Purpose: Perform dosimetric comparison between planned and delivered dose in the junction area, measure daily dose variation in the arc junction area for pediatric patients treated for medulloblastoma using Craniospinal axis irradiation(CSI) Material and methods Dose comparison in the junction area, daily dose variation in the arc junction area for a Rando Phantom and 5 pediatric patients treated using CSI technique were analyzed. Plans were created using the Eclipse treatment planning system. Two arcs for cranium and 1 arc for spine region were used. Planar dose matrix was created by projecting phantom and patient plan into the ArcCheck phantom. EBT3more » film was placed in the middle of ArcCheck plug to measure dose distribution in the junction areaDuring patient treatment, strip of EBT3 film was placed daily at each junction area for verification. EBT3 films were scanned using a flatbed scanner, Epson Expression 10000 XL. Film QA pro software was used to analyze film. Scanning and analysis was performed according to vendor recommendations and AAPM TG-55 report. Films were scanned and analyzed daily after each treatment and at the end of treatment course. Planar dose distributions from films were compared with planar dose distribution from treatment planning system. Results: Comparison of planned vs. measured dose distributions for patients have passing rates of 90%–100% with 3% and 3 mm gamma analysis. In some of the treatment fractions, daily setup film showed variation in dose distribution in the junction area. Conclusion: It is critical to measure dose distribution in the arc junction area and use additional quality assurance measures to verify daily setup for CSI patient where one or more junctions are present. EBT3 film prove to be a good tool to achieve this task considering flexibility associated with the film such as symmetry, self-developing and ease of use.« less
  • Purpose: Dose verification of spot-scanning proton pencil beam is performed via planar dose measurements at several depths using an ionization-chamber array, requiring repeat irradiations of each field for each depth. Here we investigate film dosimetry which has two advantages: higher resolution and efficiency from one-shot irradiation for multiple depths. Methods: Film calibration was performed using an EBT3 film at 20-cm depth of Plastic Water (CIRS, Norfolk, VA) exposed by a 10-level step wedge on a Proteus Plus proton system (IBA, Belgium). The calibration doses ranged from 25–250 cGy(RBE) for proton energies of 170–200 MeV. A uniform 1000 cm{sup 3} dosemore » cube and a clinical prostate combined with seminal-vesicle and pelvic-nodes plan were used for this study. All treatment plans were generated in the RayStation (RaySearch Lab, Sweden). The planar doses at different depths for both cases were measured with film using triple-channel dosimetry and the MatriXX PT (IBA Dosimetry, Germany). The Gamma passing rates, dose-difference maps, and profiles of 2D planar doses measured with EBT3 film and MatriXX, versus treatment planning system (TPS) calculations were analyzed and compared using the FilmQA Pro (Ashland Inc., Bridgewater, NJ). Results: The EBT3 film measurement results matched well with the TPS calculation data with an average passing rate >95% for 2%/2mm and are comparable with the MatriXX measurements (0.7%, 1.8%, 3.8% mean differences corresponding to 3%/3mm, 3%/2mm, 2%/2mm, respectively). Overall passing rates for EBT3 films appear higher than those with MatriXX detectors. Conclusion: The energy dependence of the film response could be minimized by calibration using proton beam with mixed energies. The greater efficiency of the dose verification using GafChromic EBT3 results in a potential cost trade-off between room capacity and film cost. EBT3 film may offer distinct advantages in highly intensity-modulated fields due to its higher resolution compared to 2D ionization-chamber array detectors. One of the authors has a research grant from Ashland Inc., the manufacturer of GafChromic film.« less
  • Purpose: To validate the stoichiometric calibration of the Hounsfield Unit (HU) to Stopping Power Ratio (SPR) calibration used to commission a commercial treatment planning system (TPS) for proton radiotherapy dose calculation. Methods and Materials: The water equivalent thickness (WET) of several individual pig tissues (lung, fat, muscle, liver, intestine, rib, femur), mixed tissue samples (muscle/rib, ice/femur, rib/air cavity/muscle), and an intact pig head were measured with a multi-layer ionization chamber (MLIC). A CT scan of each sample was obtained and imported into a commercial TPS. The WET calculated by the TPS for each tissue sample was compared to the measuredmore » WET value to determine the accuracy of the HU-to-SPR calibration curve used by the TPS to calculate dose. Results: The WET values calculated by the TPS showed good agreement (< 2.0%) with the measured values for bone and all soft tissues except fat (3.1% difference). For the mixed tissue samples and the intact pig head measurements, the difference in the TPS and measured WET values all agreed to within 3.5%. In addition, SPR values were calculated from the measured WET of each tissue, and compared to SPR values of reference tissues from ICRU 46 used to generate the HU-to-SPR calibration for the TPS. Conclusion: For clinical scenarios where the beam passes through multiple tissue types and its path is dominated by soft tissues, we believe using an uncertainty of 3.5% of the planned beam range is acceptable to account for uncertainties in the TPS WET determination.« less
  • Purpose: The purpose of this study was to measure the dose distributions for different Radiation Oncology Physics and Engineering Services, Australia (ROPES) type eye plaques loaded with I-125 (model 6711) seeds using GafChromic{sup ®} EBT3 films, in order to verify the dose distributions in the Plaque Simulator™ (PS) ophthalmic 3D treatment planning system. The brachytherapy module of RADCALC{sup ®} was used to independently check the dose distributions calculated by PS. Correction factors were derived from the measured data to be used in PS to account for the effect of the stainless steel ROPES plaque backing on the 3D dose distribution.Methods:more » Using GafChromic{sup ®} EBT3 films inserted in a specially designed Solid Water™ eye ball phantom, dose distributions were measured three-dimensionally both along and perpendicular to I-125 (model 6711) loaded ROPES eye plaque's central axis (CAX) with 2 mm depth increments. Each measurement was performed in full scatter conditions both with and without the stainless steel plaque backing attached to the eye plaque, to assess its effect on the dose distributions. Results were compared to the dose distributions calculated by Plaque Simulator™ and checked independently with RADCALC{sup ®}.Results: The EBT3 film measurements without the stainless steel backing were found to agree with PS and RADCALC{sup ®} to within 2% and 4%, respectively, on the plaque CAX. Also, RADCALC{sup ®} was found to agree with PS to within 2%. The CAX depth doses measured using EBT3 film with the stainless steel backing were observed to result in a 4% decrease relative to when the backing was not present. Within experimental uncertainty, the 4% decrease was found to be constant with depth and independent of plaque size. Using a constant dose correction factor of T= 0.96 in PS, where the calculated dose for the full water scattering medium is reduced by 4% in every voxel in the dose grid, the effect of the plaque backing was accurately modeled in the planning system. Off-axis profiles were also modeled in PS by taking into account the three-dimensional model of the plaque backing.Conclusions: The doses calculated by PS and RADCALC{sup ®} for uniformly loaded ROPES plaques in full and uniform scattering conditions were validated by the EBT3 film measurements. The stainless steel plaque backing was observed to decrease the measured dose by 4%. Through the introduction of a scalar correction factor (0.96) in PS, the dose homogeneity effect of the stainless steel plaque backing was found to agree with the measured EBT3 film measurements.« less