A Step Toward Making VMAT TBI More Prevalent: Automating the Treatment Planning Process.

PURPOSE: Our purpose was to automate the treatment planning process for total body irradiation (TBI) with volumetric modulated arc therapy (VMAT). METHODS AND MATERIALS: Two scripts were developed to facilitate autoplanning: the binary plug-in script automating the creation of optimization structures, plan generation, beam placement, and setting of the optimization constraints and the stand-alone executable performing successive optimizations. Ten patients previously treated in our clinic with VMAT TBI were used to evaluate the efficacy of the proposed autoplanning process. Paired t tests were used to compare the dosimetric indices of the produced auto plans to the manually generated clinical plans. In addition, 3 physicians were asked to evaluate the manual and autoplans for each patient in a blinded retrospective review. RESULTS: No significant differences were observed between the manual and autoplan global Dmax (P < .893), planning target volume V110% (P < .734), kidneys Dmean (P < .351), and bowel Dmax (P < .473). Significant decreases in the Dmean to the lungs and lungs-1cm (ie, lungs with 1-cm inner margin) volumes of 5.4% ± 6.4% (P < .024) and 6.8% ± 7.4% (P < .017), respectively, were obtained with the autoplans compared with the manual plans. The autoplans were selected 77% of the time by the reviewing physicians as equivalent or superior to the manual plans. The required time for treatment planning was estimated to be 2 to 3 days for the manual plans compared with approximately 3 to 5 hours for the autoplans. CONCLUSIONS: Large reductions in planning time without sacrificing plan quality were obtained using the developed autoplanning process compared with manual planning, thus reducing the required effort of the treatment planning team. Superior lung sparing with the same target coverage and similar global Dmax were observed with the autoplans as compared with the manual treatment plans. The developed scripts have been made open-source to improve access to VMAT TBI at other institutions and clinics.

Monte Carlo modeling of the influence of strong magnetic fields on the stem-effect in plastic scintillation detectors used in radiotherapy dosimetry.

PURPOSE: To investigate the impact of strong magnetic fields on the stem-effect in plastic scintillation detectors (PSDs) using Monte Carlo methods. METHODS: Prior to building the light guide model, the properties of the Cerenkov process in GEANT4 were investigated by simulating depth-dose and depth-Cerenkov emission profiles in water as functions of Cerenkov process input parameters. In addition, profile simulations were performed for magnetic field strengths ranging from 0 T to 1.5 T. A PMMA light guide was constructed in GEANT4 using data from the manufacturer and literature. Simulations were performed with the model as functions of depth and fiber-beam angle where the simulated stem-effect spectrum and the Cerenkov light ratio (CLR) were scored and compared to measured data in the literature. The light guide optical properties were iteratively adjusted until agreement between the simulated and measured data was achieved. Simulations were performed with the validated model as functions of depth and magnetic field strength and the simulated data were compared to measured data in the literature. The model was also used to evaluate the sensitivity of the CLR to the various optical properties of the light guide in different irradiation conditions. RESULTS: No significant changes in the depth-dose or depth-Cerenkov emission profiles were observed with step-size restrictions imposed by the Cerenkov process input parameters, which was attributed to the condensed history algorithm and transport parameters used in this work. Similar changes in the depth-dose and depth-Cerenkov emission profiles were observed with increasing magnetic field strength, which indicates the Cerenkov process is not adversely impacted by the presence of the magnetic field. Following optimization of the light guide optical properties, agreement within two standard deviations was observed between the simulated and measured optical data for all validation geometries considered. Agreement within one standard deviation was observed between the simulated and measured data for all depths and field strengths ≥0 T whereas discrepancies were observed for magnetic field strengths <-0.35 T. These significant differences were attributed to insufficient measurement data for this irradiation configuration during model validation. Of the light guide optical properties investigated, the fluorescence signal had the greatest impact on the CLR sensitivity to the magnetic field. CONCLUSIONS: No significant change in the Cerenkov emission per dose in water was observed for magnetic field strengths up to 1.5 T. The nominal fiber fluorescence signal was found to have a significant impact on the CLR sensitivity to varying irradiation conditions where changes up to 11.7% were observed whereas the mirror reflectivity and fiber attenuation had a modest impact with maximum CLR changes of 2.6% and 1.2% relative to 0 T, respectively. The results of this work suggest light guides with low fiber fluorescence should be used with PSDs for dosimetry measurements in magnetic fields to minimize the impact of the magnetic field on the CLR correction.

Technical note: characterization of spectral changes with measurement geometry and magnetic field strength in light guides used for scintillation dosimetry.

The purpose of this work was to characterize the stem-effect signal and the Cerenkov light ratio (CLR) in various light guides as functions of measurement geometry and magnetic field strength. Two PMMA-, two silica-, and one polystyrene-based light guides were considered in this work. Spectra measurements were performed as functions of depth, fiber-beam angle, and magnetic field strength using an optical spectrometer. All measurements were performed using a clinical linear accelerator at a nominal photon beam energy of 6 MV. Depths ranging from 1 cm to 10 cm, fiber-beam angles ranging from 90 degrees to 30 degrees, and magnetic field strengths ranging from 0 T to ± 1.40 T were investigated. The CLR was calculated from each spectrum by taking the ratio of the integral signal between 400 nm and 500 nm to the integral signal between 500 nm and 600 nm. A maximum increase of 80.5% in the stem-effect signal was observed in the magnetic field. Variations in spectral shape and, consequently, the CLR were observed for all of the fibers as functions of magnetic field strength and measurement geometry, particularly for wavelengths less than 400 nm. The plastic fibers exhibited decreases in the CLR as a function of magnetic field strength at all depths investigated, whereas the silica fibers exhibited increases in the CLR with decreasing magnetic field strength. A maximum variation of 11.1% in the CLR was observed for the polystyrene fiber due to the magnetic field. The sensitivity of the CLR to the magnetic field decreased as the fiber-beam angle decreased. The measured spectral response, shape, and CLR were found to be sensitive to the applied magnetic field strength and polarity where the variations in response were unique to each fiber.

On the accuracy and efficiency of condensed history transport in magnetic fields in GEANT4.

The purpose of this work was to investigate the accuracy and efficiency of electron transport in GEANT4 with and without a magnetic field present. Fano cavity simulations were performed in GEANT4 version 10.02 and 10.04.p01 using two multiple scattering (MSC) algorithms for two slab and one pseudo-ion chamber geometries. An iterative approach was used to optimize the transport parameters to obtain agreement with theory. Similar to previous works, the step lengths had to be severely restricted to obtain agreement with theory when using the Urban MSC model in GEANT4 v10.02. Using the Goudsmit-Saunderson MSC model with the UseSafetyPlus MSC step limitation in GEANT4 v10.04.p01 limited the maximum discrepancy from theory to 0.5%. Minor adjustments to the transport parameters were needed to obtain agreement within 0.16% of theory for all simulation configurations without a magnetic field present. The maximum deviation from theory was within 2% for all simulation configurations in the presence of a magnetic field except for two setups that exhibited discrepancies of up to 10.8%. This anomalous behavior was mitigated by forcing single scattering within the detector gas volume. Further adjustments to the transport parameters resulted in agreement with theory at the 0.21% level. Agreement with theory in the absence of a magnetic field can be obtained without significantly restricting the step size if the Goudsmit-Saunderson MSC model is used with the UseSafetyPlus MSC step limitation in GEANT4 v10.04.p01. The large discrepancies from theory observed for two simulation setups with a magnetic field present were attributed to an issue with energy loss sampling over a step when strict magnetic field transport parameters are used. This problem can be corrected by forcing single scattering within the detector gas volume; however, more work is needed to identify the cause of this anomalous behavior. This work has shown that GEANT4 can perform accurate electron transport with and without a magnetic field present without applying significant step-size reductions.

Spectral characterization of plastic scintillation detector response as a function of magnetic field strength.

The purpose of this work was to characterize intensity and spectral response changes in a plastic scintillation detector (PSD) as a function of magnetic field strength. Spectra measurements as a function of magnetic field strength were performed using an optical spectrometer. The response of both a PSD and PMMA fiber were investigated to isolate the changes in response from the scintillator and the noise signal as a function of magnetic field strength. All irradiations were performed in water at a photon beam energy of 6 MV. Magnetic field strengths of (0, ±0.35, ±0.70, ±1.05, and ±1.40) T were investigated. Four noise subtraction techniques were investigated to evaluate the impact on the resulting noise-subtracted scintillator response with magnetic field strength. The noise subtraction methods included direct spectral subtraction, the spectral method, and variants thereof. The PMMA fiber exhibited changes in response of up to 50% with magnetic field strength due to the directional light emission from [Formula: see text]erenkov radiation. The PSD showed increases in response of up to 10% when not corrected for the noise signal, which agrees with previous investigations of scintillator response in magnetic fields. Decreases in the [Formula: see text]erenkov light ratio with negative field strength were observed with a maximum change at -1.40 T of 3.2% compared to 0 T. The change in the noise-subtracted PSD response as a function of magnetic field strength varied with the noise subtraction technique used. Even after noise subtraction, the PSD exhibited changes in response of up to 5.5% over the four noise subtraction methods investigated.