Dose-volume histogram quality assurance for linac-based treatment planning systems.

Dose-volume histograms provide key information to radiation oncologists when they assess the adequacy of a patient treatment plan in radiation therapy. It is important therefore that all clinically relevant data be accurate. In this article we present the first quality assurance routine involving a direct comparison of planning system results with the results obtained from independent hand calculations. Given a known three-dimensional (3-D) structure such as a parallelepiped, a simple beam arrangement, and known physics beam data, a time-efficient and reproducible method for verifying the accuracy of volumetric statistics (DVH) from a radiation therapy treatment planning system (TPS) can be employed rapidly, satisfying the QA requirements for (TPS) commissioning, upgrades, and annual checks. Using this method, the maximum disagreement was only 1.7% for 6 MV and 1.3% for 18 MV photon energies. The average accuracy was within 0.6% for 6 MV and 0.4% for 18 MV for all depth-dose results. A 2% disagreement was observed with the treatment planning system DVH from defined volume comparison to the known structure dimensions.

Code of Ethics for the American Association of Physicists in Medicine: report of Task Group 109.

A comprehensive Code of Ethics for the members of the American Association of Physicists in Medicine (AAPM) is presented as the report of Task Group 109 which consolidates previous AAPM ethics policies into a unified document. The membership of the AAPM is increasingly diverse. Prior existing AAPM ethics polices were applicable specifically to medical physicists, and did not encompass other types of members such as health physicists, regulators, corporate affiliates, physicians, scientists, engineers, those in training, or other health care professionals. Prior AAPM ethics policies did not specifically address research, education, or business ethics. The Ethics Guidelines of this new Code of Ethics have four major sections: professional conduct, research ethics, education ethics, and business ethics. Some elements of each major section may be duplicated in other sections, so that readers interested in a particular aspect of the code do not need to read the entire document for all relevant information. The prior Complaint Procedure has also been incorporated into this Code of Ethics. This Code of Ethics (PP 24-A) replaces the following AAPM policies: Ethical Guidelines for Vacating a Position (PP 4-B); Ethical Guidelines for Reviewing the Work of Another Physicist (PP 5-C); Guidelines for Ethical Practice for Medical Physicists (PP 8-D); and Ethics Complaint Procedure (PP 21-A). The AAPM Board of Directors approved this Code or Ethics on July 31, 2008.

Ion chamber measurements of transverse gamma knife beam profiles.

A microchamber, PTW Pinpoint 31006, was used to measure transverse beam profiles for an Elekta Gamma Knife, Model B, and compared with profiles measured with film dosimetry. The microchamber sensitive volume has a diameter of 2 mm, which is smaller than the gamma knife beams, and a length of 5 mm. The chamber was mounted in a custom cassette in a spherical plastic phantom, supplied by Elekta, and oriented in a sagittal plane with the 2-mm dimension at right angles to the transverse plane. The phantom was manually moved across the beam, using the gamma knife x-coordinate trunnions, to measure the profiles. Profiles were also measured with V-film placed in a cassette mounted in the spherical plastic phantom. The films were scanned with a Scanditronix film scanner and converted to dose with a density to dose calibration curve. The results were superimposed for comparison. The beam width at the 50% intensity was measured from the film profiles to give the dimensions of the beams in the orthagonal planes. The ion chamber measurements are compared with the film results for the transverse, x profiles. Good agreement between the film and ion chamber transverse profiles is observed.

Superimposition of beams to vary shot size in gamma knife stereotactic radiosurgery.

The Leksell Gamma Knife [Elekta Corp] uses helmets as collimators to produce four standard beam sizes. The nominal beam diameters are 18, 14, 8, and 4 mm. During computer treatment planning for gamma knife stereotactic radiosurgery, the size of the treated volume may differ from the standard beam sizes. To maintain conformality of the isodose curves to the treated volume, beam sizes may be superimposed during computer treatment planning to produce beam diameters that are intermediate to the standard beams. A study of superimposed gamma knife beams was performed to confirm the accuracy of this method and to verify the accuracy of the GammaPlan treatment planning computer. Superimposed beams were simulated on the Elekta treatment planning computer, GammaPlan, version 4.12, and tested by film measurements of beam profiles for single helmet sizes and superimposed shots with various beam weightings. The weighting for each beam size is varied to attain the beam size diameter desired. The beams were defined at the 50% isodose line. The profiles of the superimposed beams were obtained and compared with the single helmet shots. The uniformity of the resulting beams was measured. The results show a linear relationship between beam size and beam weighting for the superimposed beams. The film measurements confirm the computer calculations.