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Title: SU-F-T-436: A Method to Evaluate Dosimetric Properties of SFGRT in Eclipse TPS

Abstract

Purpose: The objective was to develop a method for dose distribution calculation of spatially-fractionated-GRID-radiotherapy (SFGRT) in Eclipse treatment-planning-system (TPS). Methods: Patient treatment-plans with SFGRT for bulky tumors were generated in Varian Eclipse version11. A virtual structure based on the GRID pattern was created and registered to a patient CT image dataset. The virtual GRID structure was positioned on the iso-center level together with matching beam geometries to simulate a commercially available GRID block made of brass. This method overcame the difficulty in treatment-planning and dose-calculation due to the lack o-the option to insert a GRID block add-on in Eclipse TPS. The patient treatment-planning displayed GRID effects on the target, critical structures, and dose distribution. The dose calculations were compared to the measurement results in phantom. Results: The GRID block structure was created to follow the beam divergence to the patient CT images. The inserted virtual GRID block made it possible to calculate the dose distributions and profiles at various depths in Eclipse. The virtual GRID block was added as an option to TPS. The 3D representation of the isodose distribution of the spatially-fractionated beam was generated in axial, coronal, and sagittal planes. Physics of GRID can be different from thatmore » for fields shaped by regular blocks because the charge-particle-equilibrium cannot be guaranteed for small field openings. Output factor (OF) measurement was required to calculate the MU to deliver the prescribed dose. The calculated OF based on the virtual GRID agreed well with the measured OF in phantom. Conclusion: The method to create the virtual GRID block has been proposed for the first time in Eclipse TPS. The dosedistributions, in-plane and cross-plane profiles in PTV can be displayed in 3D-space. The calculated OF’s based on the virtual GRID model compare well to the measured OF’s for SFGRT clinical use.« less

Authors:
; ;  [1]; ; ; ;  [2]
  1. Northwestern Medicine Cancer Center, Warrenville, IL (United States)
  2. Landauer Medical Physics, Glenwood, IL and Cancer Treatment Centers of America at Southeastern Regional Medical Center, Newnan, GA (United States)
Publication Date:
OSTI Identifier:
22649029
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; BEAMS; COMPUTERIZED TOMOGRAPHY; ECLIPSE; IMAGE PROCESSING; PATIENTS; RADIATION DOSE DISTRIBUTIONS

Citation Formats

Xu, M, Tobias, R, Pankuch, M, Wei, J, Dick, J, Crawford, S, and Swanson, J. SU-F-T-436: A Method to Evaluate Dosimetric Properties of SFGRT in Eclipse TPS. United States: N. p., 2016. Web. doi:10.1118/1.4956621.
Xu, M, Tobias, R, Pankuch, M, Wei, J, Dick, J, Crawford, S, & Swanson, J. SU-F-T-436: A Method to Evaluate Dosimetric Properties of SFGRT in Eclipse TPS. United States. doi:10.1118/1.4956621.
Xu, M, Tobias, R, Pankuch, M, Wei, J, Dick, J, Crawford, S, and Swanson, J. 2016. "SU-F-T-436: A Method to Evaluate Dosimetric Properties of SFGRT in Eclipse TPS". United States. doi:10.1118/1.4956621.
@article{osti_22649029,
title = {SU-F-T-436: A Method to Evaluate Dosimetric Properties of SFGRT in Eclipse TPS},
author = {Xu, M and Tobias, R and Pankuch, M and Wei, J and Dick, J and Crawford, S and Swanson, J},
abstractNote = {Purpose: The objective was to develop a method for dose distribution calculation of spatially-fractionated-GRID-radiotherapy (SFGRT) in Eclipse treatment-planning-system (TPS). Methods: Patient treatment-plans with SFGRT for bulky tumors were generated in Varian Eclipse version11. A virtual structure based on the GRID pattern was created and registered to a patient CT image dataset. The virtual GRID structure was positioned on the iso-center level together with matching beam geometries to simulate a commercially available GRID block made of brass. This method overcame the difficulty in treatment-planning and dose-calculation due to the lack o-the option to insert a GRID block add-on in Eclipse TPS. The patient treatment-planning displayed GRID effects on the target, critical structures, and dose distribution. The dose calculations were compared to the measurement results in phantom. Results: The GRID block structure was created to follow the beam divergence to the patient CT images. The inserted virtual GRID block made it possible to calculate the dose distributions and profiles at various depths in Eclipse. The virtual GRID block was added as an option to TPS. The 3D representation of the isodose distribution of the spatially-fractionated beam was generated in axial, coronal, and sagittal planes. Physics of GRID can be different from that for fields shaped by regular blocks because the charge-particle-equilibrium cannot be guaranteed for small field openings. Output factor (OF) measurement was required to calculate the MU to deliver the prescribed dose. The calculated OF based on the virtual GRID agreed well with the measured OF in phantom. Conclusion: The method to create the virtual GRID block has been proposed for the first time in Eclipse TPS. The dosedistributions, in-plane and cross-plane profiles in PTV can be displayed in 3D-space. The calculated OF’s based on the virtual GRID model compare well to the measured OF’s for SFGRT clinical use.},
doi = {10.1118/1.4956621},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • In the authors' hospital, stereotactic radiotherapy treatments are performed with a Varian Clinac 600C equipped with a BrainLAB m3 micro-multileaf-collimator generally using the dynamic conformal arc technique. Patient immobilization during the treatment is achieved with a fixation mask supplied by BrainLAB, made with two reinforced thermoplastic sheets fitting the patient's head. With this work the authors propose a method to evaluate treatment geometric accuracy and, consequently, to determine the amount of the margin to keep in the CTV-PTV expansion during the treatment planning. The reproducibility of the isocenter position was tested by simulating a complete treatment on the anthropomorphic phantommore » Alderson Rando, inserting in between two phantom slices a high sensitivity Gafchromic EBT film, properly prepared and calibrated, and repeating several treatment sessions, each time removing the fixing mask and replacing the film inside the phantom. The comparison between the dose distributions measured on films and computed by TPS, after a precise image registration procedure performed by a commercial piece of software (FILMQA, 3cognition LLC (Division of ISP), Wayne, NJ), allowed the authors to measure the repositioning errors, obtaining about 0.5 mm in case of central spherical PTV and about 1.5 mm in case of peripheral irregular PTV. Moreover, an evaluation of the errors in the registration procedure was performed, giving negligible values with respect to the quantities to be measured. The above intrinsic two-dimensional estimate of treatment accuracy has to be increased for the error in the third dimension, but the 2 mm margin the authors generally use for the CTV-PTV expansion seems adequate anyway. Using the same EBT films, a dosimetric verification of the treatment planning system was done. Measured dose values are larger or smaller than the nominal ones depending on geometric irradiation conditions, but, in the authors' experimental conditions, always within 4%.« less
  • The aim of this study is to assess the accuracy of a convolution-based algorithm (anisotropic analytical algorithm [AAA]) implemented in the Eclipse planning system for intensity-modulated radiosurgery (IMRS) planning of small cranial targets by using a 5-mm leaf-width multileaf collimator (MLC). Overall, 24 patient-based IMRS plans for cranial lesions of variable size (0.3 to 15.1 cc) were planned (Eclipse, AAA, version 10.0.28) using fixed field-based IMRS produced by a Varian linear accelerator equipped with a 120 MLC (5-mm width on central leaves). Plan accuracy was evaluated according to phantom-based measurements performed with radiochromic film (EBT2, ISP, Wayne, NJ). Film 2Dmore » dose distributions were performed with the FilmQA Pro software (version 2011, Ashland, OH) by using the triple-channel dosimetry method. Comparison between computed and measured 2D dose distributions was performed using the gamma method (3%/1 mm). Performance of the MLC was checked by inspection of the DynaLog files created by the linear accelerator during the delivery of each dynamic field. The absolute difference between the calculated and measured isocenter doses for all the IMRS plans was 2.5% ± 2.1%. The gamma evaluation method resulted in high average passing rates of 98.9% ± 1.4% (red channel) and 98.9% ± 1.5% (blue and green channels). DynaLog file analysis revealed a maximum root mean square error of 0.46 mm. According to our results, we conclude that the Eclipse/AAA algorithm provides accurate cranial IMRS dose distributions that may be accurately delivered by a Varian linac equipped with a Millennium 120 MLC.« less
  • Purpose: Deformable registration establishes the spatial correspondence back to the reference image in order to accumulate dose. However, in prostate radiotherapy the changing shape and volume of the rectum present a challenge to accurate deformable registration and consequently calculation of delivered dose. We explored an alternative approach to calculating accumulated dose to the rectum, independent of deformable registration. Methods: This study was performed on three patients who received online image-guided radiotherapy (IGRT) with daily CBCT (XVI-system,Elekta) and target localization using intraprostatic fiducials. On each CBCT, the rectum was manually contoured and bulk density assignments were made allowing dose to bemore » calculated for each fraction. Dose-surface maps (DSM) were generated (MATLAB,Mathworks,Natick,MA) by considering the rectum as a cylinder and sampling the dose at 21-equispaced points on each CT slice. The cylinder was “cut” at the posterior-most position on each CT and unfolded to generate a DSM. These were normalised in the longitudinal direction by interpolation creating maps of 21×21 pixels. A DSM was produced for each CBCT and the dose was accumulated. Results: The mean accumulated delivered rectal surface dose was on average 7.5(+/−3.5)% lower than the planned dose. The dose difference maps consistently show that the greatest variation in dose between planned and delivered dose is away from where the rectal surface is adjacent to the prostate. Conclusion: Estimation of dose accumulation using DSM provides an alternative method for determining actual delivered dose to the rectum. The dose difference is greatest in areas away from the region where the rectal surface abuts the prostate, the region where set-up is verified. The change in size and shape of the rectum was shown to resultin a change in the accumulated dose compared to the planned dose and this will have an impact on determining the relationships between dose delivered and toxicity. We acknowledge funding from CRUK and acknowledge NHS funding to the NIHR Biomedical Research Centre for Cancer. Patients were treated within the CHHiP IGRT sub-study (CRUK/06/016, ISRCTN:97182923) funded by CRUK. RayStation was used under an evaluation agreement with RaySearch Laboratories AB.« less
  • Purpose: To quantify the dosimetric impact on patient’s specific treatment plans due to set up uncertainties during LINAC commission and annual QA and to determine the maximum set up uncertainty allowance range. Methods: A 60×60×60 cm{sup 3} solid water cube was created in Varian Eclipse TPS. Beam data profiles (crossline and diagonal) and PDDs for field sizes ranging from 2×2 cm{sup 2} to 40×40 cm{sup 2} were simulated. Three main uncertainty scenarios were purposely introduced for gantry position tilts (0–5°), source axis distance changes (100–105 cm), and iso-center position shifts (0–5 mm) during the simulation. A gamma analysis was usedmore » to compare the correct simulated profiles with the profiles for each scenario. Two static IMRT treatment plans (H&N and GYN) with tumors at 5 cm and 15 cm depths were compared using similar set up uncertainties. Results: A gamma analysis using ±3%/±3mm with 90% passing rate criteria is included to show the passing rate for each scenario. Crossline and diagonal profiles showed a gamma passing rating of ≥ 90% at depth ≤10 cm for these scenarios: gantry tilted from 0–5°, SAD changed from 100–105 cm, and iso-center shifted ≤ 4 mm. From 10 to 20 cm depths, all three scenarios failed with gamma passing ≤ 90% excepted for diagonal profiles at Gantry =2°, SAD =1 cm, and iso-center =1 mm off center. Diagonal profiles showed a higher gamma passing rating compared to crossline profiles for all three scenarios. PDD differences also increased as depth increased. For patient’s specific treatment plans, maximum uncertainties allowed to obtain a ≥90% gamma passing rating are: gantry tilts ±1 degree, SAD shifts ±2 cm, and iso-center moves ±3 mm. Conclusion: This study validated AAPM TG 142 recommendations on the mechanical and dosimetry uncertainties and provided proofs on maximum acceptance tolerances for LINAC annual QA and commission.« less