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Title: SU-F-T-344: Commissioning Constant Dose Rate VMAT in the Raystation Treatment Planning System for a Varian Clinac IX

Abstract

Purpose: To demonstrate the commissioning of constant dose rate volumetric modulated arc therapy (VMAT) in the Raystation treatment planning system for a Varian Clinac iX with Exact couch. Methods: Constant dose rate (CDR) VMAT is an option in the Raystation treatment planning system, enabling VMAT delivery on Varian linacs without a RapidArc upgrade. Raystation 4.7 was used to commission CDR-VMAT for a Varian Clinac iX. Raystation arc model parameters were selected to match machine deliverability characteristics. A Varian Exact couch model was added to Raystation 4.7 and commissioned for use in VMAT optimization. CDR-VMAT commissioning checks were performed on the linac, including patient-specific QA measurements for 10 test patients using both the ArcCHECK from Sun Nuclear Corporation and COMPASS from IBA Dosimetry. Multi-criteria optimization (MCO) in Raystation was used for CDR-VMAT planning. Results: Raystation 4.7 generated clinically acceptable and deliverable CDR-VMAT plans for the Varian Clinac. VMAT plans were optimized including a model of the Exact couch with both rails in the out positions. CDR-VMAT plans generated with MCO in Raystation were dosimetrically comparable to Raystation MCO-generated IMRT plans. Patient-specific QA measurements with the ArcCHECK on the couch showed good agreement with the treatment planning system prediction. Patient-specific, structure-specific, multi-statisticalmore » parameter 3D QA measurements with gantry-mounted COMPASS also showed good agreement. Conclusion: Constant dose rate VMAT was successfully modeled in Raystation 4.7 for a Varian Clinac iX, and Raystation’s multicriteria optimization generated constant dose rate VMAT plans which were deliverable and dosimetrically comparable to IMRT plans.« less

Authors:
; ; ;  [1]
  1. Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States)
Publication Date:
OSTI Identifier:
22648946
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; COMMISSIONING; DOSE RATES; LINEAR ACCELERATORS; OPTIMIZATION; PLANNING; RADIOTHERAPY; RATS

Citation Formats

Pursley, J, Gueorguiev, G, Prichard, H, and Gierga, D. SU-F-T-344: Commissioning Constant Dose Rate VMAT in the Raystation Treatment Planning System for a Varian Clinac IX. United States: N. p., 2016. Web. doi:10.1118/1.4956529.
Pursley, J, Gueorguiev, G, Prichard, H, & Gierga, D. SU-F-T-344: Commissioning Constant Dose Rate VMAT in the Raystation Treatment Planning System for a Varian Clinac IX. United States. doi:10.1118/1.4956529.
Pursley, J, Gueorguiev, G, Prichard, H, and Gierga, D. 2016. "SU-F-T-344: Commissioning Constant Dose Rate VMAT in the Raystation Treatment Planning System for a Varian Clinac IX". United States. doi:10.1118/1.4956529.
@article{osti_22648946,
title = {SU-F-T-344: Commissioning Constant Dose Rate VMAT in the Raystation Treatment Planning System for a Varian Clinac IX},
author = {Pursley, J and Gueorguiev, G and Prichard, H and Gierga, D},
abstractNote = {Purpose: To demonstrate the commissioning of constant dose rate volumetric modulated arc therapy (VMAT) in the Raystation treatment planning system for a Varian Clinac iX with Exact couch. Methods: Constant dose rate (CDR) VMAT is an option in the Raystation treatment planning system, enabling VMAT delivery on Varian linacs without a RapidArc upgrade. Raystation 4.7 was used to commission CDR-VMAT for a Varian Clinac iX. Raystation arc model parameters were selected to match machine deliverability characteristics. A Varian Exact couch model was added to Raystation 4.7 and commissioned for use in VMAT optimization. CDR-VMAT commissioning checks were performed on the linac, including patient-specific QA measurements for 10 test patients using both the ArcCHECK from Sun Nuclear Corporation and COMPASS from IBA Dosimetry. Multi-criteria optimization (MCO) in Raystation was used for CDR-VMAT planning. Results: Raystation 4.7 generated clinically acceptable and deliverable CDR-VMAT plans for the Varian Clinac. VMAT plans were optimized including a model of the Exact couch with both rails in the out positions. CDR-VMAT plans generated with MCO in Raystation were dosimetrically comparable to Raystation MCO-generated IMRT plans. Patient-specific QA measurements with the ArcCHECK on the couch showed good agreement with the treatment planning system prediction. Patient-specific, structure-specific, multi-statistical parameter 3D QA measurements with gantry-mounted COMPASS also showed good agreement. Conclusion: Constant dose rate VMAT was successfully modeled in Raystation 4.7 for a Varian Clinac iX, and Raystation’s multicriteria optimization generated constant dose rate VMAT plans which were deliverable and dosimetrically comparable to IMRT plans.},
doi = {10.1118/1.4956529},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: This study evaluated the performance of the electron Monte Carlo dose calculation algorithm in RayStation v4.0 for an Elekta machine with Agility™ treatment head. Methods: The machine has five electron energies (6–8 MeV) and five applicators (6×6 to 25×25 cm {sup 2}). The dose (cGy/MU at d{sub max}), depth dose and profiles were measured in water using an electron diode at 100 cm SSD for nine square fields ≥2×2 cm{sup 2} and four complex fields at normal incidence, and a 14×14 cm{sup 2} field at 15° and 30° incidence. The dose was also measured for three square fields ≥4×4more » cm{sup 2} at 98, 105 and 110 cm SSD. Using selected energies, the EBT3 radiochromic film was used for dose measurements in slab-shaped inhomogeneous phantoms and a breast phantom with surface curvature. The measured and calculated doses were analyzed using a gamma criterion of 3%/3 mm. Results: The calculated and measured doses varied by <3% for 116 of the 120 points, and <5% for the 4×4 cm{sup 2} field at 110 cm SSD at 9–18 MeV. The gamma analysis comparing the 105 pairs of in-water isodoses passed by >98.1%. The planar doses measured from films placed at 0.5 cm below a lung/tissue layer (12 MeV) and 1.0 cm below a bone/air layer (15 MeV) showed excellent agreement with calculations, with gamma passing by 99.9% and 98.5%, respectively. At the breast-tissue interface, the gamma passing rate is >98.8% at 12–18 MeV. The film results directly validated the accuracy of MU calculation and spatial dose distribution in presence of tissue inhomogeneity and surface curvature - situations challenging for simpler pencil-beam algorithms. Conclusion: The electron Monte Carlo algorithm in RayStation v4.0 is fully validated for clinical use for the Elekta Agility™ machine. The comprehensive validation included small fields, complex fields, oblique beams, extended distance, tissue inhomogeneity and surface curvature.« less
  • Purpose: To assess the feasibility of intensity-modulated radiotherapy for prostate cancer using photon beams from an accelerator operated without a flattening filter; and to determine potential benefits and drawbacks of using unflattened beams for this type of treatment. Methods and Materials: Intensity-modulated radiotherapy plans were generated for 10 patients with early-stage prostate cancer. For each patient, four plans were generated: with and without the flattening filter, at 6 and 18 MV. The prescription dose was 75.6 Gy to 98% of the planning target volume. The number of beams, their orientations, and optimization constraints were the same for all plans. Plansmore » were generated with Eclipse 8.0 (Varian Medical Systems). Results: All the plans developed with unflattened beams were clinically acceptable. In terms of patient dose distributions, plans with unflattened beams were similar to the corresponding plans with flattened beams. Plans with unflattened beams required fewer monitor units (MUs) per plan: on average, by a factor of 2.0 at 6 MV and 2.6 at 18 MV, assuming that removal of the flattening filter was not followed by recalibration of MUs. Conclusions: Clinically acceptable intensity-modulated radiotherapy plans for prostate cancer can be developed with unflattened beams at both 6 and 18 MV. Dosimetrically, flattened and unflattened beams generated similar treatment plans. The plans with unflattened beams required substantially fewer MUs. The reduction in the number of MUs indicates corresponding reduction in beam-on time and in the amount of radiation outside the target.« less
  • Purpose: To evaluate the neutron and photon dose equivalent rate (H{sub n,D} and H{sub G}) at the outer maze entrance and the adjacent treatment console area after the installation of a Varian Clinac 23EX accelerator with a higher beam energy than its predecessor. The evaluation was based on measurements and comparison with several empirical calculations. The effectiveness of borated polyethylene (BPE) boards, as a maze wall lining material, on neutron dose and photon dose reduction is also reported. Methods: A single energy Varian 6 MV photon linear accelerator (linac) was replaced with a Varian Clinac 23EX accelerator capable of producingmore » 18 MV photons in a vault originally designed for the former accelerator. In order to evaluate and redesign the shielding of the vault, the neutron dose equivalent H{sub n,D} was measured using an Andersson-Braun neutron Rem meter and the photon dose equivalent H{sub G} was measured using a Geiger Mueller and an ion chamber {gamma}-ray survey meter at the outer maze entrance. The measurement data were compared to semiempirical calculations such as the Kersey method, the modified Kersey method, and a newly proposed method by Falcao et al. Additional measurements were taken after BPE boards were installed on the maze walls as a neutron absorption lining material. Results: With the gantry head tilted close to the inner maze entrance and with the jaws closed, both neutron dose equivalent and photon dose equivalent reached their maximum. Compared to the measurement results, the Kersey method overestimates the neutron dose equivalent H{sub n,D} by about two to four times (calculation/measurement ratio{approx_equal}2.4-3.8). Falcao's method largely overestimates the H{sub n,D} (calculation/measurement ratio{approx_equal}3.9-5.5). The modified Kersey method has a calculation to measurement ratio about 0.6-0.9. The photon dose equivalent calculation including McGinley's capture gamma dose equivalent equation estimates about 77%-98% of the measurement. After applying BPE boards as a lining material on the inner corner of the maze wall, the H{sub n,D} and the H{sub G} at maze entrance were decreased by 41% and 59%, respectively. Conclusions: This work indicates that the Kersey method overestimates the neutron dose equivalent H{sub n,D} for a Varian Clinac 23EX accelerator. The Falcao method overestimates the H{sub n,D} partially due to the discrepancy in the International Commission on Radiological Protection (ICRP) conversion factors caused by the uncertainties of the estimated average neutron energy. The modified Kersey method gives the closest estimation of a Varian Clinac 23EX accelerator operated at 18 MV photon mode in a maze with a similar design as in the authors' study. However, it should be used with caution because of its tendency to underestimate the H{sub n,D}. A borated polyethylene lining can provide a cost effective method to reduce neutron and photon dose equivalent at the maze door for an existing linac vault, following the installation of a higher energy linac.« less
  • Purpose: To commission the Monaco Treatment Planning System for the Novalis Tx machine. Methods: The commissioning of Monte-Carlo (MC), Collapsed Cone (CC) and electron Monte-Carlo (eMC) beam models was performed through a series of measurements and calculations in medium and in water. In medium measurements relied Octavius 4D QA system with the 1000 SRS detector array for field sizes less than 4 cm × 4 cm and the 1500 detector array for larger field sizes. Heterogeneity corrections were validated using a custom built phantom. Prior to clinical implementation, an end to end testing of a Prostate and H&N VMAT plansmore » was performed. Results: Using a 0.5% uncertainty and 2 mm grid sizes, Tables I and II summarize the MC validation at 6 MV and 18 MV in both medium and water. Tables III and IV show similar comparisons for CC. Using the custom heterogeneity phantom setup of Figure 1 and IGRT guidance summarized in Figure 2, Table V lists the percent pass rate for a 2%, 2 mm gamma criteria at 6 and 18 MV for both MC and CC. The relationship between MC calculations settings of uncertainty and grid size and the gamma passing rate for a prostate and H&N case is shown in Table VI. Table VII lists the results of the eMC calculations compared to measured data for clinically available applicators and Table VIII for small field cutouts. Conclusion: MU calculations using MC are highly sensitive to uncertainty and grid size settings. The difference can be of the order of several per cents. MC is superior to CC for small fields and when using heterogeneity corrections, regardless of field size, making it more suitable for SRS, SBRT and VMAT deliveries. eMC showed good agreement with measurements down to 2 cm − 2 cm field size.« less
  • Monte Carlo modelling of a linear accelerator is the first and most important step in Monte Carlo dose calculations in radiotherapy. Monte Carlo is considered today to be the most accurate and detailed calculation method in different fields of medical physics. In this research, we developed a photon beam model for Varian Clinac iX 6 MV equipped with MilleniumMLC120 for dose calculation purposes using BEAMnrc/DOSXYZnrc Monte Carlo system based on the underlying EGSnrc particle transport code. Monte Carlo simulation for this commissioning head LINAC divided in two stages are design head Linac model using BEAMnrc, characterize this model using BEAMDPmore » and analyze the difference between simulation and measurement data using DOSXYZnrc. In the first step, to reduce simulation time, a virtual treatment head LINAC was built in two parts (patient-dependent component and patient-independent component). The incident electron energy varied 6.1 MeV, 6.2 MeV and 6.3 MeV, 6.4 MeV, and 6.6 MeV and the FWHM (full width at half maximum) of source is 1 mm. Phase-space file from the virtual model characterized using BEAMDP. The results of MC calculations using DOSXYZnrc in water phantom are percent depth doses (PDDs) and beam profiles at depths 10 cm were compared with measurements. This process has been completed if the dose difference of measured and calculated relative depth-dose data along the central-axis and dose profile at depths 10 cm is ≤ 5%. The effect of beam width on percentage depth doses and beam profiles was studied. Results of the virtual model were in close agreement with measurements in incident energy electron 6.4 MeV. Our results showed that photon beam width could be tuned using large field beam profile at the depth of maximum dose. The Monte Carlo model developed in this study accurately represents the Varian Clinac iX with millennium MLC 120 leaf and can be used for reliable patient dose calculations. In this commissioning process, the good criteria of dose difference in PDD and dose profiles were achieve using incident electron energy 6.4 MeV.« less