Engaging medical physics students in active and authentic learning through the use of monte-carlo simulation and inverse treatment planning.

PURPOSE: Engagement and participation of students with the learning process has been recognised as a growing problem across the higher education sector. The aim of this study was to investigate the value and impact of introducing Problem-based Learning (PBL) activities into a radiotherapy physics unit of a postgraduate medical physics course. METHODS: Computer-based problem solving activities on 1) monte-carlo modelling of a linear accelerator and 2) inverse radiotherapy treatment planning were designed and implemented into a one-semester unit on radiotherapy physics. The value and impact of the activities on the student learning were evaluated through student surveys, a focus group, and peer observation of the sessions by members of the learning design team. Student attendance and grade profile data are also reported. RESULTS: Overall the results indicated that students had a positive experience with the new problem solving activities that were implemented. Survey responses from a number of students indicated a desire for increased theoretical and technical support prior to and during activities. Another underlying theme that emerged from survey and focus group response was the perceived lack of reward in terms of marks for their efforts working on the learning activities. This may have influenced students' choices around attendance and participation. No significant changes were noted in the overall grades achieved in the unit. CONCLUSIONS: Students appreciated the more hands-on approach to learning in the form of more authentic activities that they could directly relate to clinical radiotherapy. Further work is required to update and integrate assessment into the new learning delivery model more directly.

Characterization of Gamma Knife Perfexion™ source based on Monte Carlo simulation.

This study is aimed at characterizing a single Cobalt-60 source capsule of the Gamma Knife Perfexion™ unit using the BEAMnrc Monte Carlo code. The Gamma Knife Perfexion™ source capsule was modeled using the BEAMnrc user code according to the manufacturer's technical details. The modeled parts include the source, the area around the source, and the capsule. The cylindrical source is 1 mm in diameter and 17 mm in length, with a physical density (ρ) of 8.9 × 103 kg/m3. The simulation parameters were an electron cutoff energy (ECUT) of 0.7 meV and photon cutoff energy (PCUT) of 0.01 meV. Energy fluence was calculated on a 0.25 cm diameter scoring plane located 3.1 cm from the source. Simulations were performed with and without the encapsulation of the source to investigate its effect on the spectrum and fluence of emitted gamma rays. The results showed that the influence of source encapsulation on the gamma rays is an increase in the relative number of particles in each energy bin of aggregate gamma rays by 92.36% at 0.23 meV energy and 66.12% at 1.10 meV energy. The secondary gamma rays were found to increase by 94.17% at 0.23 meV energy and 63.74% at 1.10 meV energy. The encapsulation of the source attenuated the gamma rays, which altered the spectrum. The mean energy of the beam increased, thereby exhibiting a beam-hardening effect.

Interplay effects during Enhanced Dynamic Wedge deliveries.

In this study the interplay effects for Enhanced Dynamic Wedge (EDW) treatments are experimentally investigated. Single and multiple field EDW plans for different wedge angles were delivered to a phantom and detector on a moving platform, with various periods, amplitudes for parallel and perpendicular motions. A four field 4D CT planned lung EDW treatment was delivered to a dummy tumor over four fractions. For the single field parallel case the amplitude and the period of motion both affect the interplay resulting in the appearance of a step function and penumbral cut off with the discrepancy worst where collimator-tumor speed is similar. For perpendicular motion the amplitude of tumor motion is the only dominant factor. For large wedge angle the dose discrepancy is more pronounced compared to the small wedge angle for the same field size and amplitude-period values. For a small field size i.e. 5 × 5 cm(2) the loss of wedged distribution was observed for both 60° and 15° wedge angles for parallel and perpendicular motions. Film results from 4D CT planned delivery displayed a mix of over and under dosages over 4 fractions, with the gamma pass rate of 40% for the averaged film image at 3%/1 mm DTA (Distance to Agreement). Amplitude and period of the tumor motion both affect the interplay for single and multi-field EDW treatments and for a limited (4 or 5) fraction delivery there is a possibility of non-averaging of the EDW interplay.

Validation and automation of the DYNJAWS component module of the BEAMnrc Monte Carlo code.

The purpose of this work is to validate and automate the use of DYNJAWS; a new component module (CM) in the BEAMnrc Monte Carlo (MC) user code. The DYNJAWS CM simulates dynamic wedges and can be used in three modes; dynamic, step-and-shoot and static. The step-and-shoot and dynamic modes require an additional input file defining the positions of the jaw that constitutes the dynamic wedge, at regular intervals during its motion. A method for automating the generation of the input file is presented which will allow for the more efficient use of the DYNJAWS CM. Wedged profiles have been measured and simulated for 6 and 10 MV photons at three field sizes (5 cm × 5 cm, 10 cm × 10 cm and 20 cm × 20 cm), four wedge angles (15°, 30°, 45° and 60°), at d (max) and at 10 cm depth. Results of this study show agreement between the measured and the MC profiles to within 3% of absolute dose or 3 mm distance to agreement for all wedge angles at both energies and depths. The gamma analysis suggests that dynamic mode is more accurate than the step-and-shoot mode. The DYNJAWS CM is an important addition to the BEAMnrc code and will enable the MC verification of patient treatments involving dynamic wedges.

Contrast enhancement of EPID images via difference imaging: a feasibility study.

In this study, the feasibility of difference imaging for improving the contrast of electronic portal imaging device (EPID) images is investigated. The difference imaging technique consists of the acquisition of two EPID images (with and without the placement of an additional layer of attenuating medium on the surface of the EPID) and the subtraction of one of these images from the other. The resulting difference image shows improved contrast, compared to a standard EPID image, since it is generated by lower-energy photons. Results of this study show that, firstly, this method can produce images exhibiting greater contrast than is seen in standard megavoltage EPID images and secondly, the optimal thickness of attenuating material for producing a maximum contrast enhancement may vary with phantom thickness and composition. Further studies of the possibilities and limitations of the difference imaging technique, and the physics behind it, are therefore recommended.

Modeling a complex micro-multileaf collimator using the standard BEAMnrc distribution.

PURPOSE: The component modules in the standard BEAMnrc istribution may appear to be insufficient to model micro-multileaf collimators that have trifaceted leaf ends and complex leaf profiles. This note indicates, however, that accurate Monte Carlo simulations of radiotherapy beams defined by a complex collimation device can be completed using BEAMnrc's standard VARMLC component module. METHODS: That this simple collimator model can produce spatially and dosimetrically accurate microcollimated fields is illustrated using comparisons with ion chamber and film measurements of the dose deposited by square and irregular fields incident on planar, homogeneous water phantoms. RESULTS: Monte Carlo dose calculations for on-axis and off-axis fields are shown to produce good agreement with experimental values, even on close examination of the penumbrae. CONCLUSIONS: The use of a VARMLC model of the micro-multileaf collimator, along with a commissioned model of the associated linear accelerator, is therefore recommended as an alternative to the development or use of in-house or third-party component modules for simulating stereotactic radiotherapy and radiosurgery treatments. Simulation parameters for the VARMLC model are provided which should allow other researchers to adapt and use this model to study clinical stereotactic radiotherapy treatments.

Effects of collimator backscatter in an Elekta linac by Monte Carlo simulation.

The effects of radiation backscattered from the secondary collimators into the monitor chamber in an Elekta linac (producing 6 and 10 MV photon beams) are investigated using BEAMnrc Monte Carlo simulations. The degree and effects of this backscattered radiation are assessed by evaluating the changes to the calculated dose in the monitor chamber, and by determining a correction factor for those changes. Additionally, the fluence and energy characteristics of particles entering the monitor chamber from the downstream direction are evaluated by examining BEAMnrc phase-space data. It is shown that the proportion of particles backscattered into the monitor chamber is small (< 0.35%), for all field sizes studied. However, when the backscatter plate is removed from the model linac, these backscattered particles generate a noticeable increase in dose to the monitor chamber (up to approximately 2.4% for the 6 MV beam and up to 4.4% for the 10 MV beam). With its backscatter plate in place, the Elekta linac (operating at 6 and 10 MV) is subject to negligible variation of monitor chamber dose with field size. At these energies, output variations in photon beams produced by the clinical Elekta linear accelerator can be attributed to head scatter alone. Corrections for field-size-dependence of monitor chamber dose are not necessary when running Monte Carlo simulations of the Elekta linac operating at 6 and 10 MV.

Radiotherapy treatment verification using radiological thickness measured with an amorphous silicon electronic portal imaging device: Monte Carlo simulation and experiment.

This work validates the use of an amorphous-silicon, flat-panel electronic portal imaging device (a-Si EPID) for use as a gauge of patient or phantom radiological thickness, as an alternative to dosimetry. The response of the a-Si EPID is calibrated by adapting a technique previously applied to scanning liquid ion chamber EPIDs, and the stability, accuracy and reliability of this calibration are explored in detail. We find that the stability of this calibration, between different linacs at the same centre, is sufficient to justify calibrating only one of the EPIDs every month and using the calibration data thus obtained to perform measurements on all of the other linacs. Radiological thickness is shown to provide a reliable means of relating experimental measurements to the results of BEAMnrc Monte Carlo simulations of the linac-phantom-EPID system. For these reasons we suggest that radiological thickness can be used to verify radiotherapy treatment delivery and identify changes in the treatment field, patient position and target location, as well as patient physical thickness.

Amorphous silicon EPID calibration for dosimetric applications: comparison of a method based on Monte Carlo prediction of response with existing techniques.

For EPID dosimetry, the calibration should ensure that all pixels have a similar response to a given irradiation. A calibration method (MC), using an analytical fit of a Monte Carlo simulated flood field EPID image to correct for the flood field image pixel intensity shape, was proposed. It was compared with the standard flood field calibration (FF), with the use of a water slab placed in the beam to flatten the flood field (WS) and with a multiple field calibration where the EPID was irradiated with a fixed 10x10 field for 16 different positions (MF). The EPID was used in its normal configuration (clinical setup) and with an additional 3 mm copper slab (modified setup). Beam asymmetry measured with a diode array was taken into account in MC and WS methods. For both setups, the MC method provided pixel sensitivity values within 3% of those obtained with the MF and WS methods (mean difference<1%, standard deviation<2%). The difference of pixel sensitivity between MC and FF methods was up to 12.2% (clinical setup) and 11.8% (modified setup). MC calibration provided images of open fields (5x5 to 20x20 cm2) and IMRT fields to within 3% of that obtained with WS and MF calibrations while differences with images calibrated with the FF method for fields larger than 10x10 cm2 were up to 8%. MC, WS and MF methods all provided a major improvement on the FF method. Advantages and drawbacks of each method were reviewed.

Final-state effects in neutron Compton scattering measurements on zirconium deuteride and beryllium.

We report inelastic neutron scattering measurements of the neutron Compton profile, J(y), for Be and for D in polycrystalline [Formula: see text] over a range of momentum transfers, q between 27 and [Formula: see text]. The measurements were performed using the inverse geometry spectrometer eVS which is situated at the UK pulsed spallation neutron source ISIS. We have investigated deviations from impulse approximation (IA) scattering which are generically referred to as final-state effects (FSEs) using a method described by Sears. This method allows both the magnitude and the q dependence of the FSE to be studied. Analysis of the measured data was compared with analysis of numerical simulations based on the harmonic approximation and good agreement was found for both [Formula: see text] and Be. Finally we have shown how [Formula: see text], where V is the interatomic potential, can be extracted from the antisymmetric component of J(y).