scholarly journals Evaluation of parameters affecting gamma passing rate in patient‐specific QAs for multiple brain lesions IMRS treatments using ray‐station treatment planning system

Author(s):  
Elahheh Salari ◽  
E. Ishmael Parsai ◽  
Diana Shvydka ◽  
Nicholas Niven Sperling
2020 ◽  
Vol 19 ◽  
pp. 153303382094581
Author(s):  
Du Tang ◽  
Zhen Yang ◽  
Xunzhang Dai ◽  
Ying Cao

Purpose: To evaluate the performance of Delta4DVH Anatomy in patient-specific intensity-modulated radiotherapy quality assurance. Materials and Methods: Dose comparisons were performed between Anatomy doses calculated with treatment plan dose measured modification and pencil beam algorithms, treatment planning system doses, film doses, and ion chamber measured doses in homogeneous and inhomogeneous geometries. The sensitivity of Anatomy doses to machine errors and output calibration errors was also investigated. Results: For a Volumetric Modulated Arc Therapy (VMAT) plan evaluated on the Delta4 geometry, the conventional gamma passing rate was 99.6%. For a water-equivalent slab geometry, good agreements were found between dose profiles in film, treatment planning system, and Anatomy treatment plan dose measured modification and pencil beam calculations. Gamma passing rate for Anatomy treatment plan dose measured modification and pencil beam doses versus treatment planning system doses was 100%. However, gamma passing rate dropped to 97.2% and 96% for treatment plan dose measured modification and pencil beam calculations in inhomogeneous head & neck phantom, respectively. For the 10 patients’ quality assurance plans, good agreements were found between ion chamber measured doses and the planned ones (deviation: 0.09% ± 1.17%). The averaged gamma passing rate for conventional and Anatomy treatment plan dose measured modification and pencil beam gamma analyses in Delta4 geometry was 99.6% ± 0.89%, 98.54% ± 1.60%, and 98.95% ± 1.27%, respectively, higher than averaged gamma passing rate of 97.75% ± 1.23% and 93.04% ± 2.69% for treatment plan dose measured modification and pencil beam in patients’ geometries, respectively. Anatomy treatment plan dose measured modification dose profiles agreed well with those in treatment planning system for both Delta4 and patients’ geometries, while pencil beam doses demonstrated substantial disagreement in patients’ geometries when compared to treatment planning system doses. Both treatment planning system doses are sensitive to multileaf collimator and monitor unit (MU) errors for high and medium dose metrics but not sensitive to the gantry and collimator rotation error smaller than 3°. Conclusions: The new Delta4DVH Anatomy with treatment plan dose measured modification algorithm is a useful tool for the anatomy-based patient-specific quality assurance. Cautions should be taken when using pencil beam algorithm due to its limitations in handling heterogeneity and in high-dose gradient regions.


2021 ◽  
Vol 19 (11) ◽  
pp. 141-150
Author(s):  
Ahmed H. Waheeb ◽  
Zeinab Eltaher ◽  
Mohamed N. Yassin ◽  
Magdy M. Khalil

This study examined the gamma passing rate (GPR) consistency during applying different kinds of gamma analyses and dosimeters to IMRT. Methods: Import treatment protocols for QA phantom irradiation have been recalculated. A gamma analysis was used for comparing the measured and calculated dose distribution of IMRT for different gamma criteria (2%/2mm, 3%/3mm, 4%/4mm, 3%/5mm, 3%/5mm). These criteria are evaluated when 5%, 10%, or 15% of the dose distribution is suppressed. Measured and calculated dose distribution was evaluated with gamma analysis to dose difference (DD) with DTA criteria (distance to agreement). IMRT QA plans to 25 patients from various sites were formed with the Varian Eclipse treatment planning system. Results: Results indicate different diverse hardware and software combinations show varied levels of agreement with expected analysis for the same pass-rate criterion. For a dosimetry audit of the IMRT technique, an EPID detector is superior to conventional methods comparable to Gafchromic EPT3 film and 2D array due to cost, time-consuming, and set up error to get result analysis. The gamma passing rate (GPR) average is increased by increasing the low-dose threshold for different dosimetric tools. For EPID, regardless of the gamma criterion employed, the %GP does not appear to be dependent on the low-dose threshold values (5%-15%) because it indicates that fulfilment the low-dose threshold to global normalization has little effect on patient-specific QA outcomes. Conclusions: It is concluded that GPRs differ depending on gamma, dosimetric tools, and the suppressing dose ratio. To get the best results of quality assurance, each institution should thus carefully develop its procedure for gamma analysis by defining the gamma index analysis and gamma criterion using its dosimetric tools.


2019 ◽  
Vol 18 (4) ◽  
pp. 353-364
Author(s):  
Sepideh Behinaein ◽  
Ernest Osei ◽  
Johnson Darko ◽  
Paule Charland ◽  
Dylan Bassi

AbstractBackground:An increasing number of external beam treatment modalities including intensity modulated radiation therapy, volumetric modulated arc therapy (VMAT) and stereotactic radiosurgery uses very small fields for treatment planning and delivery. However, there are major challenges in small photon field dosimetry, due to the partial occlusion of the direct photon beam source’s view from the measurement point, lack of lateral charged particle equilibrium, steep dose-rate gradient and volume averaging effect of the detector response and variation of the energy fluence in the lateral direction of the beam. Therefore, experimental measurements of dosimetric parameters such as percent depth doses (PDDs), beam profiles and relative output factors (ROFs) for small fields continue to be a challenge.Materials and Methods:In this study, we used a homogeneous water phantom and the heterogeneous anthropomorphic stereotactic end-to-end verification (STEEV) head phantom for all dose measurements and calculations. PDDs, lateral dose profiles and ROFs were calculated in the Eclipse Treatment Planning System version 13·6 using the Acuros XB (AXB) and the analytical anisotropic algorithms (AAAs) in a homogenous water phantom. Monte Carlo (MC) simulations and measurements using the Exradin W1 Scintillator were also accomplished for four photon energies: 6 MV, 6FFF, 10 MV and 10FFF. Two VMAT treatment plans were generated for two different targets: one located in the brain and the other in the neck (close to the trachea) in the head phantom (CIRS, Norfolk, VA, USA). A Varian Truebeam linear accelerator (Varian, Palo Alto, CA, USA) was used for all treatment deliveries. Calculated results with AXB and AAA were compared with MC simulations and measurements.Results:The average difference of PDDs between W1 Exradin Scintillator measurements and MC simulations, AAA and AXB algorithm calculations were 1·2, 2·4 and 3·2%, respectively, for all field sizes and energies. AXB and AAA showed differences in ROF of about 0·3 and 2·9%, respectively, compared with W1 Exradin Scintillator measured values. For the target located in the brain in the head phantom, the average dose difference between W1 Exradin Scintillator and the MC simulations, AAA and AXB were 0·2, 3·2 and 2·7%, respectively, for all field sizes. Similarly, for the target located in the neck, the respective dose differences were 3·8, 5·7 and 3·5%.Conclusion:In this study, we compared dosimetric parameters such as PDD, beam profile and ROFs in water phantom and isocenter point dose measurements in an anthropomorphic head phantom representing a patient. We observed that measurements using the W1 Exradin scintillator agreed well with MC simulations and can be used efficiently for dosimetric parameters such as PDDs and dose profiles and patient-specific quality assurance measurements for small fields. In both homogenous and heterogeneous media, the AXB algorithm dose prediction agrees well with MC and measurements and was found to be superior to the AAA algorithm.


2014 ◽  
Vol 41 (6Part20) ◽  
pp. 360-360
Author(s):  
D Defoor ◽  
S Stathakis ◽  
P Mavroidis ◽  
N Papanikolaou

2021 ◽  
Vol 11 (21) ◽  
pp. 9906
Author(s):  
Joseph R. Newton ◽  
Maxwell Recht ◽  
Joseph A. Hauger ◽  
Gabriel Segarra ◽  
Chase Inglett ◽  
...  

The current practice for patient-specific quality assurance (QA) uses ion chambers or diode arrays primarily because of their ease of use and reliability. A standard routine compares the dose distribution measured in a phantom with the dose distribution calculated by the treatment planning system for the same experimental conditions. For the particular problems encountered in the treatment planning of complex radiotherapy techniques, such as small fields/segments and dynamic delivery systems, additional tests are required to verify the accuracy of dose calculations. The dose distribution verification should be throughout the total 3D dose distribution for a high dose gradient in a small, irradiated volume, instead of the standard practice of one to several planes with 2D radiochromic (GAFChromic) film. To address this issue, we have developed a 3D radiochromic dosimeter that improves the rigor of current QA techniques by providing high-resolution, complete 3D verification for a wide range of clinical applications. The dosimeter is composed of polyurethane, a radical initiator, and a leuco dye, which is radiolytically oxidized to a dye absorbing at 633 nm. Since this chemical dosimeter is single-use, it represents a significant expense. The purpose of this research is to develop a cost-effective reusable dosimeter formulation. Based on prior reusability studies, three promising dosimeter formulations were studied using small volume optical cuvettes and irradiated to known clinically relevant doses of 0.5–10 Gy. After irradiation, the change in optical density was measured in a spectrophotometer. All three formulations retained linearity of optical density response to radiation upon re-irradiations. However, only one formulation retained dose sensitivity upon at least five re-irradiations, making it ideal for further evaluation as a 3D dosimeter.


2013 ◽  
Vol 34 (4) ◽  
pp. E5 ◽  
Author(s):  
Alfredo Conti ◽  
Antonio Pontoriero ◽  
Giuseppe K. Ricciardi ◽  
Francesca Granata ◽  
Sergio Vinci ◽  
...  

Object The integration of state-of-the-art neuroimaging into treatment planning may increase the therapeutic potential of stereotactic radiosurgery. Functional neuroimaging, including functional MRI, navigated brain stimulation, and diffusion tensor imaging–based tractography, may guide the orientation of radiation beams to decrease the dose to critical cortical and subcortical areas. The authors describe their method of integrating functional neuroimaging technology into radiosurgical treatment planning using the CyberKnife radiosurgery system. Methods The records of all patients who had undergone radiosurgery for brain lesions at the CyberKnife Center of the University of Messina, Italy, between July 2010 and July 2012 were analyzed. Among patients with brain lesions in critical areas, treatment planning with the integration of functional neuroimaging was performed in 25 patients. Morphological and functional imaging data sets were coregistered using the Multiplan dedicated treatment planning system. Treatment planning was initially based on morphological data; radiation dose distribution was then corrected in relation to the functionally relevant cortical and subcortical areas. The change in radiation dose distribution was then calculated. Results The data sets could be easily and reliably integrated into the Cyberknife treatment planning. Using an inverse planning algorithm, the authors achieved an average 17% reduction in the radiation dose to functional areas. Further gain in terms of dose sparing compromised other important treatment parameters, including target coverage, conformality index, and number of monitor units. No neurological deficit due to radiation was recorded at the short-term follow-up. Conclusions Radiosurgery treatments rely on the quality of neuroimaging. The integration of functional data allows a reduction in radiation doses to functional organs at risk, including critical cortical areas, subcortical tracts, and vascular structures. The relative simplicity of integrating functional neuroimaging into radiosurgery warrants further research to implement, standardize, and identify the limits of this procedure.


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