Quality assurance evaluation of spot scanning beam proton therapy with an anthropomorphic prostate phantom.

OBJECTIVE: The purpose of this study was to evaluate spot scanning proton therapy with an anthropomorphic prostate phantom at the Proton Therapy Center of The University of Texas MD Anderson Cancer Center at Houston, TX (PTCH). METHODS: An anthropomorphic prostate phantom from the Radiological Physics Center (RPC), The University of Texas MD Anderson Cancer Center, Houston, TX, was used, which contained thermoluminescent dosemeters and GAFCHROMIC(®) EBT2 film (ISP Technologies, Wayne, NJ). The phantom was irradiated by the Hitachi synchrotron (Hitachi America, Ltd, Tarrytown, NY), and the results were compared between the treatment planning system (TPS) and RPC measurements. RESULTS: RPC results show that the right/left, inferior/superior and posterior/anterior aspects of the coronal/sagittal and EBT2 film measurements were within ±7%/±4 mm of the TPS. The RPC thermoluminescent dosemeter measurements of the prostate and femoral heads were within 3% of the TPS. CONCLUSION: The RPC prostate phantom is a useful mechanism to evaluate spot scanning beam proton therapy within certain confidence levels. ADVANCES IN KNOWLEDGE: The RPC anthropomorphic prostate phantom could be used to establish quality assurance of spot scanning proton beam for patients with prostate cancer.

SU-D-BRCD-01: Evaluation of Zebra Multi-Layer Ionization Chamber System for Patient Treatment Field and Machine QA for Spot Scanning and Passive Scattering Proton Beams.

PURPOSE: To evaluate Zebra multi-layer ionization chamber system for patient treatment field and machine QA for spot scanning proton beams (SSPB) and passive scattering proton beams (PSPB). METHODS: Zebra dose measurement system (IBA Dosimetry), consisting of 180 parallel platechambers with 2 mm detector spacing, was used for measuring proton beamdepth dose curves (DDC) for spread out Bragg peaks (SOBP) and single spot pristine Bragg peaks (PBP). The measurements were performed for 100 to 250 MeV PSPB and 89.2 to 221.8 MeV SSPB using the Hitachi ProBeat synchrotron based delivery system. An in-house Matlab based analysis software was used to compare the Zebra measured DDC with those measured by the Markus chamber in a PTW water tank (MC-WT). Several verification plans in the water phantom were created for patient treatment fields using the Eclipse treatment planning system (TPS). The DDC for individual verification fields were measured using the Zebra andcomparisons were made with the TPS calculations. RESULTS: The dosedifferences between the Zebra and MC-WT measurements in the plateau regions of the DDC are within 2% for various energies of PSPB, but are larger than 2% at the sharp dose distal gradient regions. The values for distal penumbra widths, range and SOBP widths from Zebra and MC-WT measurements agree within 0.5 mm, 1.5 mm, and 2 mm, respectively. The Zebra measured values of the range of the single spots also agreed within 1 mm with their established values from other measurements. The Zebra measured DDC of verification plan of patient treatment fields showed goodagreement with those from the TPS. CONCLUSIONS: Our investigation shows that Zebra can be useful for fast and reasonably accurate measurements of the DDC of pristine and spread-out Bragg peaks of both spot scanning and passive scattering proton beams.

Poster - Thurs Eve-15: Comparison of Cobalt-60 and 6 MV linac based tomotherapy: A prostate case study.

Previous work reported by us has shown the potential for Cobalt-60 (Co-60) tomotherapy for sites with small separations such as in head and neck site. In this work we extend our investigations by comparing tomotherapy plans for the treatment of a typical prostate cancer obtained for 6 MV and Co-60 beams. Beam collimation was provided by the MIMiC® (NOMOS Corporation, Sewickly, PA) multi-leaf collimator (MLC). Both plans used 21 beam angles, each utilizing the central 10 leaf-pairs of the MLC for intensity modulation. An in-house inverse treatment planning program, based on the active-set conjugate gradient method, was used for dose-volume optimization. BEAMnrc and DOSXYZnrc Monte Carlo simulated beam and dose data, including inhomogeneity corrections, were used to calculate the optimized tomotherapy dose distributions. Prostate, rectum, and external body contours were outlined and dose-volume optimization objectives were set to deliver a minimum of 95% and a maximum of 105% of the 76 Gy dose prescription to the prostate and limiting only 20% of the rectum volume to receive ⩾ 70 Gy. A quantitative analysis of the dose distributions and dose-area histograms show that both Co-60 and 6 MV plans achieve the initial objectives for target (prostate) and organ at risk (rectum). Although the dose to the body and rectum for Co-60 is slightly higher than that for 6 MV, it satisfies the plan objectives based on the clinical dose tolerance. Our results demonstrate that Co-60 based tomotherapy can provide clinically competitive dose distributions for the treatment of prostate cancer.

Poster - Thurs Eve-42: A revision of the γ-evaluation: Initial interpretation of dose disagreements on γ-vector fields.

Gamma evaluations are a common clinical tool used as a quantitative comparison between dose-distributions, combining both dose difference and distance to agreement criteria. Because gamma evaluations permit rapid analysis of agreement between complex dose distributions, they are often a preferred comparison method for assessing delivery of conformal radiotherapy distributions. Although the comparison provides a useful measure of agreement between distributions when the index is less than one, the scalar gamma value provides little information into the clinical significance or source of disagreements of failing gamma values (i.e., when γ>1). Previously, Stock et al., have presented the gamma angle as an indicator of the relative influence of the distance to agreement versus the dose difference on gamma. We present a modification to the gamma evaluation such that the complete 3D gamma vector information is considered. The predictive nature of each vector component was investigated by simulating various dose disagreements in test distributions. Misalignment tests revealed that the mean gamma vector components indicate the offset direction and relative magnitude for all test distributions. The mean dose component of the gamma vector was prognostic of double Gaussian overdoses and underdoses in a virtual conformal delivery. The response of the vector field depends on properties distinctive to each distribution, such as the local dose gradient. Understanding how these unique properties affect the vector field may permit better diagnosis of dose disagreement sources. Other vector field properties, such as curl and divergence, may yet provide more information for interpreting the cause and significance of γ>1.