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Title: SU-G-TeP1-12: Random Repainting as Mitigation for Scanned Ion Beam Interplay Effects

Abstract

Purpose: Interference of dose application in scanned beam particle therapy and organ motion may lead to interplay effects with distorted dose to target volumes. Interplay effects depend on the speed and direction of the scanning beam, leading to fringed field edges (scanning parallel to organ motion direction) or over- and under-dosed regions (both directions are orthogonal). Current repainting methods can mitigate interplay effects, but are susceptible to artefacts when only a limited number of repaints are applied. In this study a random layered-repainting strategy was investigated. Methods: Mono-energetic proton beams were irradiated to a 10 ×10 cm{sup 2} scanned field at a Varian ProBeam facility. Applied dose was measured with a 2D amorphous silicon detector mounted on a motion platform (CIRS dynamic platform). Motion was considered with different cycles, directions and translations up to ±8 mm. Dose distributions were measured for a static case, regular repainting (repeated meander-like path) and random repainting. Latter was realized by randomly distributing single spot locations during irradiation for a given number of repaints. Efficiency of repainting was analyzed by comparison to the static case. A simulation tool based on treatment logs and motion information was developed to compare measurement results to expected dose distributions.more » Results: Regular repainting could reduce motion artefacts, but dose distortion was strongly dependent on motion direction. Random repainting with same number of repaints (N=4) showed superior results, independent of target movement direction, while introducing slight penalty on delivery times, caused by an increase of overall scanning travel distance. The simulation tool showed good agreement to measured results. Conclusion: The results demonstrate significant improvement in terms of dose conformity when layered repainting is applied in a randomized fashion. This allows for reduced target margins during treatment planning and limited number of repaints. A combination with e.g. respiratory gating is straight-forward. Authors are employees of Varian Medical Systems Particle Therapy GmbH.« less

Authors:
;  [1]
  1. Varian Medical Systems Particle Therapy GmbH, Troisdorf, NRW (Germany)
Publication Date:
OSTI Identifier:
22649352
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:
43 PARTICLE ACCELERATORS; ION BEAMS; LOCAL IRRADIATION; MITIGATION; PROTON BEAMS; RADIATION DOSE DISTRIBUTIONS; RANDOMNESS

Citation Formats

Bach, M, and Wulff, J. SU-G-TeP1-12: Random Repainting as Mitigation for Scanned Ion Beam Interplay Effects. United States: N. p., 2016. Web. doi:10.1118/1.4957002.
Bach, M, & Wulff, J. SU-G-TeP1-12: Random Repainting as Mitigation for Scanned Ion Beam Interplay Effects. United States. doi:10.1118/1.4957002.
Bach, M, and Wulff, J. 2016. "SU-G-TeP1-12: Random Repainting as Mitigation for Scanned Ion Beam Interplay Effects". United States. doi:10.1118/1.4957002.
@article{osti_22649352,
title = {SU-G-TeP1-12: Random Repainting as Mitigation for Scanned Ion Beam Interplay Effects},
author = {Bach, M and Wulff, J},
abstractNote = {Purpose: Interference of dose application in scanned beam particle therapy and organ motion may lead to interplay effects with distorted dose to target volumes. Interplay effects depend on the speed and direction of the scanning beam, leading to fringed field edges (scanning parallel to organ motion direction) or over- and under-dosed regions (both directions are orthogonal). Current repainting methods can mitigate interplay effects, but are susceptible to artefacts when only a limited number of repaints are applied. In this study a random layered-repainting strategy was investigated. Methods: Mono-energetic proton beams were irradiated to a 10 ×10 cm{sup 2} scanned field at a Varian ProBeam facility. Applied dose was measured with a 2D amorphous silicon detector mounted on a motion platform (CIRS dynamic platform). Motion was considered with different cycles, directions and translations up to ±8 mm. Dose distributions were measured for a static case, regular repainting (repeated meander-like path) and random repainting. Latter was realized by randomly distributing single spot locations during irradiation for a given number of repaints. Efficiency of repainting was analyzed by comparison to the static case. A simulation tool based on treatment logs and motion information was developed to compare measurement results to expected dose distributions. Results: Regular repainting could reduce motion artefacts, but dose distortion was strongly dependent on motion direction. Random repainting with same number of repaints (N=4) showed superior results, independent of target movement direction, while introducing slight penalty on delivery times, caused by an increase of overall scanning travel distance. The simulation tool showed good agreement to measured results. Conclusion: The results demonstrate significant improvement in terms of dose conformity when layered repainting is applied in a randomized fashion. This allows for reduced target margins during treatment planning and limited number of repaints. A combination with e.g. respiratory gating is straight-forward. Authors are employees of Varian Medical Systems Particle Therapy GmbH.},
doi = {10.1118/1.4957002},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: To compare multiple repainting techniques as strategies for mitigating the interplay effect in free-breathing, spot scanning proton plans. Methods: An analytic routine modeled three-dimensional dose distributions of pencil-beam proton plans delivered to a moving target. The interplay effect was studied in subsequent calculations by modeling proton delivery from a clinical synchrotron based spot scanning system and respiratory target motion, patterned from surrogate breathing traces from clinical 4DCT scans and normalized to nominal 0.5 and 1 cm amplitudes. Two distinct repainting strategies were modeled. In idealized volumetric repainting, the plan is divided up and delivered multiple times successively, with eachmore » instance only delivering a fraction of the total MU. Maximum-MU repainting involves delivering a fixed number of MU per spot and repeating a given energy layer until the prescribed MU are reached. For each of 13 patient breathing traces, the dose was computed for up to four volumetric repaints and an array of maximum-MU values. Delivery strategies were inter-compared based on target coverage, dose homogeneity, and delivery time. Results: Increasing levels of repainting generally improved plan quality and reduced dosimetric variability at the expense of longer delivery time. Motion orthogonal to the scan direction yielded substantially greater dose deviations than motion parallel to the scan direction. For a fixed delivery time, maximum-MU repainting was most effective relative to idealized volumetric repainting at small maximum-MU values. For 1 cm amplitude motion orthogonal to the scan direction, the average homogeneity metric (D5 – D95)[%] of 23.4% was reduced to 7.6% with a 168 s delivery using volumetric repainting compared with 8.7% in 157.2 s for maximum-MU repainting. The associated static target homogeneity metric was 2.5%. Conclusion: Maximum-MU repainting can provide a reasonably effective alternative to volumetric repainting for systems without the capability to switch energies rapidly.« less
  • Purpose: The impact of removing the flattening filter on absolute dosimetry based on IAEA’s TPR-398 and AAPM’s TG-51 was investigated in this study using Monte Carlo simulations. Methods: The EGSnrc software package was used for all Monte Carlo simulations performed in this work. Five different ionization chambers and nine linear accelerator heads have been modeled according to technical drawings. To generate a flattening filter free radiation field the flattening filter was replaced by a 2 mm thick aluminum layer. Dose calculation in a water phantom were performed to calculate the beam quality correction factor k{sub Q} as a function ofmore » the beam quality specifiers %dd(10){sub x}, TPR{sub 20,10} and mean photon and electron energies at the point of measurement in photon fields with (WFF) and without flattening filter (FFF). Results: The beam quality correction factor as a function of %dd(10){sub x} differs systematically between FFF and WFF beams for all investigated ionization chambers. The largest difference of 1.8% was observed for the largest investigated Farmer-type ionization chamber with a sensitive volume of 0.69 cm{sup 3}. For ionization chambers with a smaller nominal sensitive volume (0.015 – 0.3 cm{sup 3}) the deviation was less than 0.4% between WFF and FFF beams for %dd(10){sub x} > 62%. The specifier TPR{sub 20,10} revealed only a good correlation between WFF and FFF beams (< 0.3%) for low energies. Conclusion: The results confirm that %dd(10){sub x} is a suitable beam quality specifier for FFF beams with an acceptable bias. The deviation depends on the volume of the ionization chamber. Using %dd(10){sub x} to predict k{sub Q} for a large volume chamber in a FFF photon field may lead to not acceptable errors according to the results of this study. This bias may be caused by the volume effect due to the inhomogeneous photon fields of FFF linear accelerators.« less
  • Purpose: The shape of a single beam in proton PBS influences the resulting dose distribution. Spot profiles are modelled as two-dimensional Gaussian (single/ double) distributions in treatment planning systems (TPS). Impact of slight deviations from an ideal Gaussian on resulting dose distributions is typically assumed to be small due to alleviation by multiple Coulomb scattering (MCS) in tissue and superposition of many spots. Quantitative limits are however not clear per se. Methods: A set of 1250 deliberately deformed profiles with sigma=4 mm for a Gaussian fit were constructed. Profiles and fit were normalized to the same area, resembling output calibrationmore » in the TPS. Depth-dependent MCS was considered. The deviation between deformed and ideal profiles was characterized by root-mean-squared deviation (RMSD), skewness/ kurtosis (SK) and full-width at different percentage of maximum (FWxM). The profiles were convolved with different fluence patterns (regular/ random) resulting in hypothetical dose distributions. The resulting deviations were analyzed by applying a gamma-test. Results were compared to measured spot profiles. Results: A clear correlation between pass-rate and profile metrics could be determined. The largest impact occurred for a regular fluence-pattern with increasing distance between single spots, followed by a random distribution of spot weights. The results are strongly dependent on gamma-analysis dose and distance levels. Pass-rates of >95% at 2%/2 mm and 40 mm depth (=70 MeV) could only be achieved for RMSD<10%, deviation in FWxM at 20% and root of quadratic sum of SK <0.8. As expected the results improve for larger depths. The trends were well resembled for measured spot profiles. Conclusion: All measured profiles from ProBeam sites passed the criteria. Given the fact, that beam-line tuning can result shape distortions, the derived criteria represent a useful QA tool for commissioning and design of future beam-line optics.« less
  • Purpose: To predict photon percentage depth dose (PDD) from profile due to a change in flattened (FF) and flattening-filter-free (FFF) beam quality. Methods: 6MV photon beam PDDs and profiles in a 3D water tank (3DW) and profiles in an ionization chamber array (ICP) were collected for different field sizes and depths with FF and FFF beams in a Versa HD (Elekta Ltd.). The energy was adjusted by changing the bending magnet current (BMC) ±15% from the clinical beam (6MV) in 5% increments. For baseline establishment, PDDs(depth≥3cm) were parameterized with bi-exponential functions and the PDD 20 to 10cm ratios (PDD{sub 20,10})more » were calculated. Then, the FF profile at 10cm from the central axis (Pr{sub 10}) and the slope of the FFF central linear region (SFFF) were calculated. Calibration curves were established: (1) change in Pr{sub 10} and SFFF as functions of the change in PDD{sub 20,10} and (2) change in PDD(depth=3, 15 and 30cm) as function of the change in PDD{sub 20,10}. The differences between Pr{sub 10} and SFFF from baseline were calculated and, from calibration curves, changes in PDD{sub 20,10} and PDD(depth=3, 15 and 30cm) were obtained. Then, absolute PDD(depth=3, 15 and 30cm) values were input into a least-square-optimization algorithm to calculate the bi-exponential function’s optimal coefficients and generate the PDD(depths≥3cm). Results: The change in PDD{sub 20,10} relative to baseline increased (<±4%) with BMC. Pr{sub 10} increased (±6%) and SFFF decreased (±11%) with BMC. Relative differences between measured and calculated (i.e. PDD calculation from Pr{sub 10} and SFFF) PDDs were less than 1%. Results apply to FF and FFF beams measured in 3DW and ICP. Conclusion: Pr{sub 10} and SFFF are more sensitive than PDD to changes in beam energy and PDD information can be accurately generated from them. With known 3DW and ICP profile relationship, ICP can be used to obtain PDD for current photon beam.« less
  • Purpose: Stereotactic radiosurgery (SRS) outcomes are related to the delivered dose to the target and to surrounding tissue. We have commissioned a Monte Carlo based dose calculation algorithm to recalculated the delivered dose planned using pencil beam calculation dose engine. Methods: Twenty consecutive previously treated patients have been selected for this study. All plans were generated using the iPlan treatment planning system (TPS) and calculated using the pencil beam algorithm. Each patient plan consisted of 1 to 3 targets and treated using dynamically conformal arcs or intensity modulated beams. Multi-target treatments were delivered using multiple isocenters, one for each target.more » These plans were recalculated for the purpose of this study using a single isocenter. The CT image sets along with the plan, doses and structures were DICOM exported to Monaco TPS and the dose was recalculated using the same voxel resolution and monitor units. Benchmark data was also generated prior to patient calculations to assess the accuracy of the two TPS against measurements using a micro ionization chamber in solid water. Results: Good agreement, within −0.4% for Monaco and +2.2% for iPlan were observed for measurements in water phantom. Doses in patient geometry revealed up to 9.6% differences for single target plans and 9.3% for multiple-target-multiple-isocenter plans. The average dose differences for multi-target-single-isocenter plans were approximately 1.4%. Similar differences were observed for the OARs and integral dose. Conclusion: Accuracy of the beam is crucial for the dose calculation especially in the case of small fields such as those used in SRS treatments. A superior dose calculation algorithm such as Monte Carlo, with properly commissioned beam models, which is unaffected by the lack of electronic equilibrium should be preferred for the calculation of small fields to improve accuracy.« less