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SBRT is an effective local treatment for patients with early-stage non-small cell lung cancer (NSCLC). This treatment is currently used in patients who have poor lung function or who decline surgery. As SBRT usually has small PTV margins, reducing the beam-on-time (BOT) is beneficial for accurate dose delivery by minimising intrafraction motion as well as improved patient comfort. Removal of the linear accelerator flattening filter can provide a higher dose rate which results in a faster treatment. In addition, the choice of photon energy can also affect the dose distribution to the target and the organs-at-risk (OAR). In this systematic review, studies analysing the choice of various photon beam energies, with a flattening filter or flattening filter free (FFF), were compared for their overall dosimetric benefit in the SBRT treatment for early-stage NSCLC. It was found that FFF treatment delivers a comparatively more conformal dose distribution, as well as a better homogeneity index and conformity index, and typically reduces BOT by between 30 and 50%. The trade-off may be a minor increase in monitor units for FFF treatment found in some studies but not others. Target conformity and OAR sparing, particularly lung doses appear better with 6MV FFF, but 10MV FFF was marginally more advantageous for skin sparing and BOT reduction. The favourable beam modality for clinical use would depend on the individual case, for which tumour size and depth, radiotherapy technique, as well as fractionation scheme need to be taken into account.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Radiocirurgia , Radioterapia de Intensidade Modulada , Carcinoma de Pequenas Células do Pulmão , Humanos , Radiocirurgia/métodos , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/patologia , Radioterapia de Intensidade Modulada/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Pulmão/patologia , Carcinoma de Pequenas Células do Pulmão/cirurgia , Dosagem RadioterapêuticaRESUMO
Objective. Clinical implementation of synthetic CT (sCT) from cone-beam CT (CBCT) for adaptive radiotherapy necessitates a high degree of anatomical integrity, Hounsfield unit (HU) accuracy, and image quality. To achieve these goals, a vision-transformer and anatomically sensitive loss functions are described. Better quantification of image quality is achieved using the alignment-invariant Fréchet inception distance (FID), and uncertainty estimation for sCT risk prediction is implemented in a scalable plug-and-play manner.Approach. Baseline U-Net, generative adversarial network (GAN), and CycleGAN models were trained to identify shortcomings in each approach. The proposed CycleGAN-Best model was empirically optimized based on a large ablation study and evaluated using classical image quality metrics, FID, gamma index, and a segmentation analysis. Two uncertainty estimation methods, Monte-Carlo Dropout (MCD) and test-time augmentation (TTA), were introduced to model epistemic and aleatoric uncertainty.Main results. FID was correlated to blind observer image quality scores with a Correlation Coefficient of -0.83, validating the metric as an accurate quantifier of perceived image quality. The FID and mean absolute error (MAE) of CycleGAN-Best was 42.11 ± 5.99 and 25.00 ± 1.97 HU, compared to 63.42 ± 15.45 and 31.80 HU for CycleGAN-Baseline, and 144.32 ± 20.91 and 68.00 ± 5.06 HU for the CBCT, respectively. Gamma 1%/1 mm pass rates were 98.66 ± 0.54% for CycleGAN-Best, compared to 86.72 ± 2.55% for the CBCT. TTA and MCD-based uncertainty maps were well spatially correlated with poor synthesis outputs.Significance. Anatomical accuracy was achieved by suppressing CycleGAN-related artefacts. FID better discriminated image quality, where alignment-based metrics such as MAE erroneously suggest poorer outputs perform better. Uncertainty estimation for sCT was shown to correlate with poor outputs and has clinical relevancy toward model risk assessment and quality assurance. The proposed model and accompanying evaluation and risk assessment tools are necessary additions to achieve clinically robust sCT generation models.
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Tomografia Computadorizada de Feixe Cônico Espiral , Incerteza , Processamento de Imagem Assistida por Computador/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador/métodosRESUMO
Metal artifacts produce incorrect Hounsfield units and impact treatment planning accuracy. This work evaluates the use of single-energy metal artifact reduction (SEMAR) algorithm for treatment planning by comparison to manual artifact overriding. CT datasets of in-house 3D-printed spine and pelvic phantoms with and without metal insert(s) and two treated patients with metal implants were analysed. CT number accuracy improved with the use of SEMAR filter: root mean square deviation (RMSD) from reference (without metal) reduced by 35.4 in spine and 98.8 in hip. The plan dose volume histograms (DVHs) and dosimetric measurements showed comparable results. SEMAR reconstruction improved planning efficiency.
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PURPOSE: In advanced radiotherapy treatments such as intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT), verification of the performance of the multileaf collimator (MLC) is an essential part of the linac QA program. The purpose of this study is to use the existing measurement methods for geometric QA of the MLCs and extend them to more comprehensive evaluation techniques, and to develop dedicated robust algorithms to quantitatively investigate the MLC performance in a fast, accurate, and efficient manner. METHODS: The behavior of leaves was investigated in the step-and-shoot mode by the analysis of integrated electronic portal imaging device (EPID) images acquired during picket fence tests at fixed gantry angles and arc delivery. The MLC was also studied in dynamic mode by the analysis of cine EPID images of a sliding gap pattern delivered in a variety of conditions including different leaf speeds, deliveries at fixed gantry angles or in arc mode, and changing the direction of leaf motion. The accuracy of the method was tested by detection of the intentionally inserted errors in the delivery patterns. RESULTS: The algorithm developed for the picket fence analysis was able to find each individual leaf position, gap width, and leaf bank skewness in addition to the deviations from expected leaf positions with respect to the beam central axis with sub-pixel accuracy. For the three tested linacs over a period of 5 months, the maximum change in the gap width was 0.5 mm, the maximum deviation from the expected leaf positions was 0.1 mm and the MLC skewness was up to 0.2°. The algorithm developed for the sliding gap analysis could determine the velocity and acceleration∕deceleration of each individual leaf as well as the gap width. There was a slight decrease in the accuracy of leaf performance with increasing leaf speeds. The analysis results were presented through several graphs. The accuracy of the method was assessed as 0.01 mm for both the gap size and peak position determination. CONCLUSIONS: This study provides fast, easy, and accurate test methods for routine QA of the MLC performance and helps in faster troubleshooting of MLC problems in both IMRT and VMAT treatments.
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Equipamentos e Provisões Elétricas , Radioterapia de Intensidade Modulada/instrumentação , Algoritmos , Controle de QualidadeRESUMO
PURPOSE: Electronic portal imaging devices (EPIDs) have been studied and used for pretreatment and in-vivo dosimetry applications for many years. The application of EPIDs for dosimetry in arc treatments requires accurate characterization of the mechanical sag of the EPID and gantry during rotation. Several studies have investigated the effects of gravity on the sag of these systems but each have limitations. In this study, an easy experiment setup and accurate algorithm have been introduced to characterize and correct for the effect of EPID and gantry sag during arc delivery. METHODS: Three metallic ball bearings were used as markers in the beam: two of them fixed to the gantry head and the third positioned at the isocenter. EPID images were acquired during a 360° gantry rotation in cine imaging mode. The markers were tracked in EPID images and a robust in-house developed MATLAB code was used to analyse the images and find the EPID sag in three directions as well as the EPID + gantry sag by comparison to the reference gantry zero image. The algorithm results were then tested against independent methods. The method was applied to compare the effect in clockwise and counter clockwise gantry rotations and different source-to-detector distances (SDDs). The results were monitored for one linear accelerator over a course of 15 months and six other linear-accelerators from two treatment centers were also investigated using this method. The generalized shift patterns were derived from the data and used in an image registration algorithm to correct for the effect of the mechanical sag in the system. The Gamma evaluation (3%, 3 mm) technique was used to investigate the improvement in alignment of cine EPID images of a fixed field, by comparing both individual images and the sum of images in a series with the reference gantry zero image. RESULTS: The mechanical sag during gantry rotation was dependent on the gantry angle and was larger in the in-plane direction, although the patterns were not identical for various linear-accelerators. The reproducibility of measurements was within 0.2 mm over a period of 15 months. The direction of gantry rotation and SDD did not affect the results by more than 0.3 mm. Results of independent tests agreed with the algorithm within the accuracy of the measurement tools. When comparing summed images, the percentage of points with Gamma index <1 increased from 85.4% to 94.1% after correcting for the EPID sag, and to 99.3% after correction for gantry + EPID sag. CONCLUSIONS: The measurement method and algorithms introduced in this study use cine-images, are highly accurate, simple, fast, and reproducible. It tests all gantry angles and provides a suitable automatic analysis and correction tool to improve EPID dosimetry and perform comprehensive linac QA for arc treatments.
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Radiometria/instrumentação , Erros de Configuração em Radioterapia/prevenção & controle , Gravação em Vídeo/instrumentação , Gravação em Vídeo/métodos , Ecrans Intensificadores para Raios X , Desenho de Equipamento , Análise de Falha de Equipamento , Dosagem Radioterapêutica , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Amorphous silicon electronic portal imaging devices (EPIDs) have been investigated and used for dosimetry in radiotherapy for several years. The presence of a phosphor scintillator layer in the structure of these EPIDs has made them sensitive to low-energy scattered and backscattered radiation. In this study, the backscattered radiation from the walls, ceiling, and floor of a linac bunker has been investigated as a possible source of inaccuracy in EPID dosimetry. EPID images acquired in integrated mode at discrete gantry angles and cine images taken during arcs were used with different field setups (18 × 18 and 10 × 10 cm2 open square fields at 150 and 105 cm source-to-detector distances) to compare the EPID response at different gantry angles. A sliding gap and a dynamic head-and-neck IMRT field and a square field with a 15 cm thick cylindrical phantom in the beam were also investigated using integrated EPID images at several gantry angles. The contribution of linac output variations at different angles was evaluated using a 2D array of ion chambers. In addition, a portable brick wall was moved to different distances from the EPID to check the effect at a single angle. The results showed an agreement of within 0.1% between the arc mode and gantry-static mode measurements, and the variation of EPID response during gantry rotation was about 1% in all measurement conditions.
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Equipamentos e Provisões Elétricas , Radiometria , Planejamento da Radioterapia Assistida por Computador , Radioterapia de Intensidade Modulada , Espalhamento de Radiação , Humanos , Imagens de Fantasmas , Fótons , Silício/químicaRESUMO
The increasing popularity of intensity-modulated arc therapy (IMAT) treatments requires specifically designed linac quality assurance (QA) programs. Gantry angle is one of the parameters that has a major effect on the outcome of IMAT treatments since dose reconstruction for patient-specific QA relies on the gantry angle; therefore, it is essential to ensure its accuracy for correct delivery of the prescribed dose. In this study, a simple measurement method and algorithm are presented for QA of gantry angle measurements based on integrated EPID images acquired at distinct gantry angles and cine EPID images during an entire 360° arc. A comprehensive study was carried out to evaluate this method, as well as to evaluate two commercially available inclinometers (NG360 and IBA GAS supplied in conjunction with popular array dosimeters Delta4 and MatriXXEvolution, respectively) by comparing their simultaneous angle measurement results with the linac potentiometer readouts at five gantry speeds. In all tested measurement systems, the average differences with the reference angle data were less than 0.3° in static mode. In arc mode, at all tested gantry speeds the average difference was less than 0.1° for the IBA GAS and the proposed EPID-based method, and 0.6° for the NG360 after correction for the inherent systematic time delay of the inclinometer. The gantry rotation speed measured by the three independent systems had an average deviation of about 0.01°/s from the nominal gantry speed.
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Equipamentos e Provisões Elétricas , Aceleradores de Partículas/instrumentação , Radiometria/instrumentação , Planejamento da Radioterapia Assistida por Computador/instrumentação , Radioterapia de Intensidade Modulada/instrumentação , Algoritmos , Humanos , Imagens de Fantasmas , Controle de Qualidade , Dosagem RadioterapêuticaRESUMO
INTRODUCTION: In radiotherapy, the presence of air gaps near a tumour can lead to underdose to the tumour. In this study, the impact of air gaps on dose to the surface was evaluated. 3D-printing was used to construct a Eurosil-4 Pink bolus customised to the patient and its dosimetric properties were compared with that of Paraffin wax bolus. METHODS: Surface dose was measured for flat sheets of Eurosil-4 Pink bolus with different thicknesses. Different air gap thicknesses were inserted between the bolus and the surface, and dose was measured for each air gap using 10 cm × 10 cm fields. This was repeated with the effective field size calculated from the patient plan. Surface dose was measured for varying angles of incidence. A customised chest phantom was used to compare dose for two customised Eurosil-4 Pink boluses, and commonly used Paraffin wax bolus. RESULTS: The surface dose was found to be highest for 1.1 cm thick bolus. The decrease in surface dose for the Eurosil-4 Pink bolus was minimal for the 10 cm × 10 cm field, but higher for the effective field size and larger angles of incidence. For instance, the dose was reduced by 6.2% as a result of 1 cm air gap for the effective field size and 60 degree angle of incidence. The doses measured using Gafchromic film under the customised Eurosil-4 Pink boluses were similar to that of the Paraffin wax bolus, and higher than prescribed dose. CONCLUSIONS: The impact of air gaps can be significant for small field sizes and oblique beams. A customised Eurosil-4 Pink bolus has promising physical and dosimetric properties to ensure sufficient dose to the tumour, even for treatments where larger impact of air gaps is suspected.
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Neoplasias , Parede Torácica , Humanos , Neoplasias/radioterapia , Parafina , Imagens de Fantasmas , Radiometria , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por ComputadorRESUMO
The use of deep learning (DL) to improve cone-beam CT (CBCT) image quality has gained popularity as computational resources and algorithmic sophistication have advanced in tandem. CBCT imaging has the potential to facilitate online adaptive radiation therapy (ART) by utilizing up-to-date patient anatomy to modify treatment parameters before irradiation. Poor CBCT image quality has been an impediment to realizing ART due to the increased scatter conditions inherent to cone-beam acquisitions. Given the recent interest in DL applications in radiation oncology, and specifically DL for CBCT correction, we provide a systematic theoretical and literature review for future stakeholders. The review encompasses DL approaches for synthetic CT generation, as well as projection domain methods employed in the CBCT correction literature. We review trends pertaining to publications from January 2018 to April 2022 and condense their major findings-with emphasis on study design and DL techniques. Clinically relevant endpoints relating to image quality and dosimetric accuracy are summarized, highlighting gaps in the literature. Finally, we make recommendations for both clinicians and DL practitioners based on literature trends and the current DL state-of-the-art methods utilized in radiation oncology.
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Aprendizado Profundo , Planejamento da Radioterapia Assistida por Computador , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imagens de Fantasmas , Radiometria/métodos , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador/métodosRESUMO
PURPOSE: Verification of the mechanical isocenter position is required as part of comprehensive quality assurance programs for stereotactic radiosurgery/radiotherapy (SRS/SRT) treatments. Several techniques have been proposed for this purpose but each of them has certain drawbacks. In this paper, a new efficient and more comprehensive method using cine-EPID images has been introduced for automatic verification of the isocenter with sufficient accuracy for stereotactic applications. METHODS: Using a circular collimator fixed to the gantry head to define the field, EPID images of a Winston-Lutz phantom were acquired in cine-imaging mode during 3600 gantry rotations. A robust MATLAB code was developed to analyze the data by finding the center of the field and the center of the ball bearing shadow in each image with sub-pixel accuracy. The distance between these two centers was determined for every image. The method was evaluated by comparison to results of a mechanical pointer and also by detection of a manual shift applied to the phantom position. The repeatability and reproducibility of the method were tested and it was also applied to detect couch and collimator wobble during rotation. RESULTS: The accuracy of the algorithm was 0.03 +/- 0.02 mm. The repeatability was less than 3 pm and the reproducibility was less than 86 microm. The time elapsed for the analysis of more than 100 cine images of Varian aS1000 and aS500 EPIDs were approximately 65 and 20 s, respectively. Processing of images taken in integrated mode took 0.1 s. The output of the analysis software is printable and shows the isocenter shifts as a function of angle in both in-plane and cross-plane directions. It gives warning messages where the shifts exceed the criteria for SRS/SRT and provides useful data for the necessary adjustments in the system including bearing system and/or room lasers. CONCLUSIONS: The comprehensive method introduced in this study uses cine-images, is highly accurate, fast, and independent of the observer. It tests all gantry angles and is suitable for pretreatment QA of the isocenter for stereotactic treatments.
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Algoritmos , Aceleradores de Partículas/instrumentação , Radiometria/instrumentação , Radiocirurgia/instrumentação , Gravação em Vídeo/instrumentação , Ecrans Intensificadores para Raios X , Dosagem Radioterapêutica , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
There have been several manual, semi-automatic and fully-automatic methods proposed for verification of the position of mechanical isocenter as part of comprehensive quality assurance programs required for linear accelerator-based stereotactic radiosurgery/radiotherapy (SRS/SRT) treatments. In this paper, a systematic review has been carried out to discuss the present methods for isocenter verification and compare their characteristics, to help physicists in making a decision on selection of their quality assurance routine.
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Radiocirurgia/métodos , Humanos , Planejamento da Radioterapia Assistida por ComputadorRESUMO
Extending cone-beam CT (CBCT) use toward dose accumulation and adaptive radiotherapy (ART) necessitates more accurate HU reproduction since cone-beam geometries are heavily degraded by photon scatter. This study proposes a novel method which aims to demonstrate how deep learning based on phantom data can be used effectively for CBCT intensity correction in patient images. Four anthropomorphic phantoms were scanned on a CBCT and conventional fan-beam CT system. Intensity correction is performed by estimating the cone-beam intensity deviations from prior information contained in the CT. Residual projections were extracted by subtraction of raw cone-beam projections from virtual CT projections. An improved version of U-net is utilized to train on a total of 2001 projection pairs. Once trained, the network could estimate intensity deviations from input patient head and neck raw projections. The results from our novel method showed that corrected CBCT images improved the (contrast-to-noise ratio) with respect to uncorrected reconstructions by a factor of 2.08. The mean absolute error and structural similarity index improved from 318 HU to 74 HU and 0.750 to 0.812 respectively. Visual assessment based on line-profile measurements and difference image analysis indicate the proposed method reduced noise and the presence of beam-hardening artefacts compared to uncorrected and manufacturer reconstructions. Projection domain intensity correction for cone-beam acquisitions of patients was shown to be feasible using a convolutional neural network trained on phantom data. The method shows promise for further improvements which may eventually facilitate dose monitoring and ART in the clinical radiotherapy workflow.
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Tomografia Computadorizada de Feixe Cônico , Redes Neurais de Computação , Artefatos , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imagens de FantasmasRESUMO
Background: Quality assurance of linear accelerators (linacs) is an important part of ensuring accurate radiotherapy treatment deliveries. The aim of this study is to investigate the role of gravity on the positional accuracy of multileaf collimator (MLC) leaves during complex radiotherapy treatments on linacs. This investigation is based on the analysis of the machine log files from five different linacs in multiple centers. Materials and Methods: Three main categories of deliveries were considered: Picket fence, volumetric modulated arc therapy (VMAT) (both delivering with continuous gantry rotation), and sliding gap tests delivered at cardinal gantry angles, to determine the error of the MLC in relation to the gantry angle. Results: Analysis of picket fence tests revealed a dependence of the error upon the gantry angle. For the majority of deliveries, the MLC showed greater error at gantry angles 270 and 90. The errors computed for the cardinal angles for sliding gap tests were all statistically different with greatest error arising at gantry angle 270 and least error at gantry 90. For picket fence, sliding gap, and VMAT cases, MLC errors were dependent on the gantry angle. Conclusions: The errors in leaf positioning were found to be dependent on the gantry angle. For sliding gap tests, the error was greater at gantry angle 270° and 90° and less when the leaf motion was perpendicular to the force of gravity.
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PURPOSE: A major problem associated with amorphous silicon (a-Si) electronic portal imaging devices (EPIDs) for transit dosimetry is the presence of a phosphor layer, which can introduce large deviations from water-equivalent behavior due to energy-dependent response and visible light scattering. In this study, an amorphous silicon EPID was modified to a direct detection configuration by removing the phosphor layer, and the accuracy of using it for transit dosimetry measurements was investigated for 6 and 18 MV treatment beams by comparison to ion-chamber in water measurements. METHODS: Solid water and copper were both evaluated as buildup materials. Using the optimum buildup thickness in each case, effects of changes in radiation field size, source to detector distance, and patient/phantom thickness were investigated by comparison to reference measurements made by an ionization chamber on the central axis. The off-axis response of the imager was also investigated by comparison of EPID image profiles to dose profiles obtained by a scanning ionization chamber in a water tank with various thicknesses of slab phantoms, and an anthropomorphic phantom in the beam using Gamma evaluation (3%, 3 mm criteria). The imaging characteristics of the direct EPID were investigated by comparison to a commercial EPID using QC3V phantom, and by taking images of an anthropomorphic pelvic phantom containing fiducial gold markers. RESULTS: Either 30 mm of solid water or 3.3 mm of copper were found to be the most suitable buildup thicknesses with solid water providing more accurate results. Using solid water buildup, the EPID response compared to the reference dosimeter within 2% for all conditions except phantom thicknesses larger than 25 cm in 6 MV beams, which was up to 6.5%. Gamma evaluation results comparing EPID profiles and reference ionization chamber profiles showed that for 6 and 18 MV beams, at least 91.8% and 90.9% of points had a Gamma <1 for all phantoms, respectively. But using copper buildup, the EPID response had more discrepancies from the ionization chamber reference measurements, including: More than 2% difference for small air gaps using 6 MV beams, up to 8% difference for phantom thicknesses larger than 25 cm in 6 MV beams, and large differences (up to 9.3%) for increasing phantom thicknesses in 18 MV beams. The percentage of points with Gamma <1 with copper buildup were at least 96.6% and 99.8% in 6 and 18 MV beams, respectively. CONCLUSIONS: The direct EPID performs as an ion-chamber detector for transit dosimetry applications in all geometries studied except for small discrepancies at 6 MV for thick phantoms. This can be ameliorated by the calibration of the EPID to dose at an intermediate phantom thickness. The major current limitation of the direct EPID is poor quality of images compared with the clinical configuration, which could be overcome by a method to interchange between imaging and dosimetry setups.
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Fósforo/química , Radiometria/métodos , Silício/química , Antropometria/métodos , Calibragem , Cobre/química , Raios gama , Humanos , Processamento de Imagem Assistida por Computador , Íons , Pelve/patologia , Imagens de Fantasmas , Dosagem Radioterapêutica , Água/químicaRESUMO
PURPOSE: Amorphous silicon EPIDs have been used for planar dose verification in IMRT treatments for many years. The support arm used to attach some types of EPIDs to linear accelerators can introduce inaccuracies to dosimetry measurements due to the presence of metallic parts in their structures. It is demonstrated that this uncertainty may be as large as approximately 6% of maximum image signal for large fields. In this study, a method has been described to quantify, model and correct for the effect of backscattered radiation from the EPID support arm (E-Arm type, Varian Medical Systems). METHODS: Measurements of a support arm backscatter kernel were made using several 1 x 1 cm2 6 MV pencil beam irradiations at a sample of positions over the sensitive area of the EPID in standard clinical setup and repeated with the EPID removed from the support arm but at the same positions. A curve-fit to the subtraction of EPID response obtained on and off the arm was used to define the backscatter kernel. The measured kernel was compared with a backscatter kernel obtained by Monte Carlo simulations with EGS/BEAM code. A backscatter dose prediction using the measured backscatter kernel was added to an existing EPID dose prediction model. The improvement in the agreement of the modified model predictions with EPID measurements for a number of open fields and IMRT beams were investigated by comparison to the original model results. RESULTS: Considering all functions tested to find the best functional fit to the data points, a broad Gaussian curve proved to be the optimum fit to the backscatter data. The best fit through the Monte Carlo simulated backscatter kernel was also found to be a Gaussian curve. The maximum decrease in normalized root mean squared deviation of the measured and modeled EPID image profiles for open fields was 13.7% for a 15 x 15 cm2 field with no decrease observed for a 3 x 3 cm2 (the smallest) field as it was not affected by the arm backscatter. Gamma evaluation (2%, 2 mm criteria) showed the improvement in agreement between the model and measurement results when the backscatter was incorporated. The average increase in Gamma pass rate was 2% for head and neck and 1.3% for prostate IMRT fields investigated in this study. CONCLUSIONS: The application of the backscatter kernel determined in this study improved the accuracy of dosimetry using a Varian EPID with E-arm for open fields of different sizes: Eight head and neck and seven prostate IMRT fields. Further improvement in the agreement between the model predictions and EPID measurements requires more sophisticated modeling of the backscatter.
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Diagnóstico por Imagem/instrumentação , Eletrônica , Modelos Teóricos , Radiometria/instrumentação , Espalhamento de Radiação , Método de Monte Carlo , Radioterapia de Intensidade Modulada , SilícioRESUMO
In radiotherapy treatments utilizing accelerator gantry rotation, gantry-mounted kilovoltage (kV) imaging systems have become integral to treatment verification. The accuracy of such verification depends on the stability of the imaging components during gantry rotation. In this study, a simple measurement method and accurate algorithm are introduced for investigation of the kV panel and source movement during gantry rotation. The method is based on images of a ball-bearing phantom combined with a Winston-Lutz phantom, and determines the movements of all the mechanical parameters of the kV imaging system relative to the reference at zero gantry angle. Analysis was performed on different linear accelerators and both gantry rotation directions. The precision of the method was tested and was less than 0.04 mm. This method is suitable to be included in the quality assurance testing of linacs to monitor the kV imaging system performance and provides additional mechanical information that previous tests cannot.
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Algoritmos , Aceleradores de Partículas , Imagens de FantasmasRESUMO
The characteristics of the focal spot of the linear accelerator (linac) play a role in determining the resulting dose distribution within the patient, and hence probability of treatment success. A direct measurement of focal spot position is not recommended by AAPM Task Group 142, but factors influenced by focal spot position, such as beam symmetry and isocentre position, are. Traditional methods of measuring focal spot position are time consuming and can only be performed at gantry 0°. The presented method has been proposed using a phantom of novel design to accurately measure the position of the focal spot relative to the collimator's axis of rotation (CAX) at any gantry angle, and to measure the intra-fraction movement of the focal spot relative to the mean position during treatment. The method was reproducible to within 0.012â¯mm/0.029â¯mm (mean/max) for the three Varian linacs tested. The focal spot position was shown to deviate from the CAX by up to 0.386â¯mm during gantry rotation. The focal spot position was more unstable at the start of treatment, with the worst performing linac having an initial displacement of up to 0.15â¯mm from its mean position before stabilizing to within 0.01â¯mm after 3â¯s. The method proposed is a beneficial addition to the quality assurance (QA) schedule of any clinic, allowing quick determination of source position and movement at any gantry angle. Measurement of focal spot allows the possibility of fine-tuning the electron beam steering system to improve the standard of the photon beam and of stereotactic treatments.
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Fracionamento da Dose de Radiação , Movimento , Aceleradores de Partículas/instrumentação , Imagens de Fantasmas , IncertezaRESUMO
In this article, production methods and applications of copper radionuclides are overviewed with special attention toward (61)Cu, due to its interesting nuclear properties. Selection of production parameters for (61)Cu including: appropriate nuclear reaction, proton beam energy, target thickness and targetry method are discussed for NRCAM 30MeV medical cyclotron. (64)Zn(p,alpha)(61)Cu was selected as the best reaction and (61)Cu was produced by 22MeV proton bombardment of a 80 microm thick natural zinc target. After 180microAh irradiation, the resultant activity of (61)Cu was 6.006Ci (12.015mCi/microAh). The chemical separation method was easy, quick and efficient (>95%) and yielded a no carrier added product with high chemical and radionuclidic purity (>99%). Detailed comparison with previous production methods confirms that our results are superior to other reports published to date.
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Radioisótopos de Cobre/química , Prótons , Zinco/efeitos da radiação , Ciclotrons , Geradores de Radionuclídeos , Zinco/químicaRESUMO
Well type chambers are used for radioactive source calibrations in brachytherapy, but do not provide radiation shielding. Routine constancy checks on a well chamber are required between periodic secondary standard laboratory calibrations to ensure consistent device performance, and ultimately to ensure accurate patient dose delivery. In this work, a method is described to provide suitable shielding for a Cs-137 rod-type point source to enable use for constancy checks. A novel plunger-type shielded housing was designed and constructed for the Cs-137 source that when combined with a suitably shielded well-chamber container minimised user exposure during constancy checks. The designed shielding proved effective, and a constancy test routine was established and used for the past 16 months. The well chamber showed consistent performance (0.12 ± 0.18 % from the baseline) and no increased exposure was reported on users' radiation badges.
Assuntos
Braquiterapia/métodos , Radioisótopos de Césio/química , Proteção Radiológica/instrumentação , Desenho de Equipamento , Padrões de ReferênciaRESUMO
Using an amorphous silicon (a-Si) EPID for transit dosimetry requires detailed characterization of its dosimetric response in a variety of conditions. In this study, a measurement-based model was developed to calibrate an a-Si EPID response to dose for transit dosimetry by comparison with a reference ionization chamber. The ionization chamber reference depth and the required additional buildup thickness for electronic portal imaging devices (EPID) transit dosimetry were determined. The combined effects of changes in radiation field size, phantom thickness, and the off-axis distance on EPID transit dosimetry were characterized. The effect of scattered radiation on out-of-field response was investigated for different field sizes and phantom thicknesses by evaluation of the differences in image profiles and in-water measured profiles. An algorithm was developed to automatically apply these corrections to EPID images based on the user-specified field size and phantom thickness. The average phantom thickness and an effective field size were used for IMRT fields, and images were acquired in cine mode in the presence of an anthropomorphic phantom. The effective field size was defined as the percentage of the jaw-defined field that was involved during the delivery. Nine head and neck dynamic IMRT fields were tested by comparison with a MatriXX two-dimensional array dosimeter using the Gamma (3%, 3 mm) evaluation. A depth of 1.5 cm was selected as the ionization chamber reference depth. An additional 2.2 mm of copper buildup was added to the EPID. Comparison of EPID and MatriXX dose images for the tested fields showed that using a 10% threshold, the average number of points with Gamma index <1 was 96.5%. The agreement in the out-of field area was shown by selection of a 2% threshold which on average resulted in 94.8% of points with a Gamma index <1. The suggested method is less complicated than previously reported techniques and can be used for all a-Si EPIDs regardless of the manufacturer.