SU-E-T-193: Using Truebeam's Research Mode to Automate Mechanical Quality Assurance.

PURPOSE: To determine the feasibility of automating mechanical quality assurance measurements on the Varian Truebeam LINAC. METHODS: Using the XML coding capability of the Varian Truebeam Research Mode, the LINAC was programmed to mimic the beams delivered for the following mechanical tests. These tests included: Field size accuracy, jaw positions for asymmetric fields, collimator rotation isocenter, and MLC positional-accuracy. Images for these beams were acquired with the EPID. The images were analyzed using an analysis code written in MATLAB. Tests for gantry and couch rotation isocenters and radiation and mechanical isocenter coincidence are being developed. RESULTS: For field-sizes ranging from 4×4cm2 to 15×15cm2 , the measured matched the nominal field sizes to within 1mm. The collimator rotation isocenter and the overall accuracy for asymmetric field matched to within 1mm. No positional error 〉1mm was seen in the 33 MLC pairs visible in the MLC positional-accuracy images. CONCLUSIONS: A large portion of the time required to make mechanical QA measurements using film is spent placing, processing, and scanning the film. Complete automation in performing these mechanical tests results in a significant time gain compared to film. A majority of the mechanical tests suggested by TG-142 have been performed using this technique, and an automated mechanical QA process has been established in our clinic.

Fundamental properties of the delivery of volumetric modulated arc therapy (VMAT) to static patient anatomy.

PURPOSE: The primary goal of this article is to formulate volumetric modulated arc therapy (VMAT) delivery problem and study interdependence between several parameters (beam dose rate, gantry angular speed, and MLC leaf speed) in the delivery of VMAT treatment plan. The secondary aim is to provide delivery solution and prove optimality (minimal beam on time) of the solution. An additional goal of this study is to investigate alternative delivery approaches to VMAT (like constant beam dose rate and constant gantry angular speed delivery). METHOD: The problem of the VMAT delivery is formulated as a control problem with machine constraints. The relationships between parameters of arc therapy delivery are derived under the constraint of treatment plan invariance and limitations on delivery parameters. The nonuniqueness of arc therapy delivery solutions is revealed from these relations. The most efficient delivery of arc therapy is then formulated as optimal control problem and solved by geometrical methods. A computer program is developed to find numerical solutions for deliveries of specific VMAT plan. RESULTS: Explicit examples of VMAT plan deliveries are computed and illustrated with graphical representations of the variability of delivery parameters. Comparison of delivery parameters with that of Varian's delivery are shown and discussed. Alternative delivery strategies such as constant gantry angular speed delivery and constant beam dose rate delivery are formulated and solutions are provided. The treatment times for all the delivery solutions are provided. CONCLUSION: The investigations derive and prove time optimal VMAT deliveries. The relationships between delivery parameters are determined. The optimal alternative delivery strategies are discussed.

An automated method for adaptive radiation therapy for prostate cancer patients using continuous fiducial-based tracking.

Electromagnetic tracking technology is primarily used for continuous prostate localization during radiotherapy, but offers potential value for evaluation of dosimetric coverage and adequacy of treatment for dynamic targets. We developed a highly automated method for daily computation of cumulative dosimetric effects of intra- and inter-fraction target motion for prostate cancer patients using fiducial-based electromagnetic tracking. A computer program utilizing real-time tracking data was written to (1) prospectively determine appropriate rotational/translational motion limits for patients treated with continuous isocenter localization; (2) retrospectively analyze dosimetric target coverage after daily treatment, and (3) visualize three-dimensional rotations and translations of the prostate with respect to the planned target volume and dose matrix. We present phantom testing and a patient case to validate and demonstrate the utility of this application. Gamma analysis of planar dose computed by our application demonstrated accuracy within 1%/1 mm. Dose computation of a patient treatment revealed high variation in minimum dose to the prostate (D(min)) over 40 fractions and a drop in the D(min) of approximately 8% between a 5 mm and a 3 mm PTV margin plan. The infrastructure has been created for patient-specific treatment evaluation using continuous tracking data. This application can be used to increase confidence in treatment delivery to targets influenced by motion.

Applicability of CORVUS pencil beam model and scatter dose model for intensity modulated neutron therapy.

Intensity modulated neutron radiotherapy (IMNRT) is currently being investigated as a mechanism to improve dose conformality in neutron radiotherapy, thereby minimizing normal tissue toxicity. This study investigates the applicability of two different dose calculation algorithms for IMNRT, a commercial system which utilizes a finite size pencil beam (FSPB) model, and an in-house planning system which uses a differential scatter air ratio (DSAR) method. Calculated dose distributions were compared with measured profiles for validation purposes. The beam-profiles matched to within +/-3% in the central region of the field. The 80-20% penumbra width as measured using an ionization chamber varied as 0.6 cm and 1.0 cm for 3 x 3 and 10 x 10 cm2 profile at a depth of 2.5 cm. The FSPB model fitted the data to a penumbra width of 0.1 cm for both 3 x 3 and 10 x 10 cm2 profiles. These results indicate that the commercial system needs further investigation. However, the in-house planning system has been validated for small irregular fields for IMNRT to an accuracy of +/-5%. Absolute dose measurements agreed with the calculated doses to within +/-3%.