A failure modes and effects analysis quality management framework for image-guided small animal irradiators: A change in paradigm for radiation biology.

PURPOSE: Image-guided small animal irradiators (IGSAI) are increasingly being adopted in radiation biology research. These animal irradiators, designed to deliver radiation with submillimeter accuracy, exhibit complexity similar to that of clinical radiation delivery systems, including image guidance, robotic stage motion, and treatment planning systems. However, physics expertise and resources are scarcer in radiation biology, which makes implementation of conventional prescriptive QA infeasible. In this study, we apply the failure modes and effect analysis (FMEA) popularized by the AAPM task group 100 (TG-100) report to IGSAI and radiation biological research. METHODS: Radiation biological research requires a change in paradigm where small errors to large populations of animals are more severe than grievous errors that only affect individuals. To this end, we created a new adverse effects severity table adapted to radiation biology research based on the original AAPM TG-100 severity table. We also produced a process tree which outlines the main components of radiation biology studies performed on an IGSAI, adapted from the original clinical IMRT process tree from TG-100. Using this process tree, we created and distributed a preliminary survey to eight expert IGSAI operators in four institutions. Operators rated proposed failure modes for occurrence, severity, and lack of detectability, and were invited to share their own experienced failure modes. Risk probability numbers (RPN) were calculated and used to identify the failure modes which most urgently require intervention. RESULTS: Surveyed operators indicated a number of high (RPN >125) failure modes specific to small animal irradiators. Errors due to equipment breakdown, such as loss of anesthesia or thermal control, received relatively low RPN (12-48) while errors related to the delivery of radiation dose received relatively high RPN (72-360). Errors identified could either be improved by manufacturer intervention (e.g., electronic interlocks for filter/collimator) or physics oversight (errors related to tube calibration or treatment planning system commissioning). Operators identified a number of failure modes including collision between the collimator and the stage, misalignment between imaging and treatment isocenter, inaccurate robotic stage homing/translation, and incorrect SSD applied to hand calculations. These were all relatively highly rated (90-192), indicating a possible bias in operators towards reporting high RPN failure modes. CONCLUSIONS: The first FMEA specific to radiation biology research was applied to image-guided small animal irradiators following the TG-100 methodology. A new adverse effects severity table and a process tree recognizing the need for a new paradigm were produced, which will be of great use to future investigators wishing to pursue FMEA in radiation biology research. Future work will focus on expanding scope of user surveys to users of all commercial IGSAI and collaborating with manufacturers to increase the breadth of surveyed expert operators.

The potential impact of ultrathin filter design on dosimetry and relative biological effectiveness in modern image-guided small animal irradiators.

OBJECTIVE:: Modern image-guided small animal irradiators like the Xstrahl Small Animal Radiation Research Platform (SARRP) are designed with ultrathin 0.15 mm Cu filters, which compared with more heavily filtrated traditional cabinet-style biological irradiators, produce X-ray spectra weighted toward lower energies, impacting the dosimetric properties and the relative biological effectiveness (RBE). This study quantifies the effect of ultrathin filter design on relative depth dose profiles, absolute dose output, and RBE using Monte Carlo techniques. METHODS:: The percent depth-dose and absolute dose output are calculated using kVDoseCalc and EGSnrc, respectively, while a tally based on the induction of double-strand breaks as a function of electron spectra invoked in PENELOPE is used to estimate the RBE. RESULTS:: The RBE increases by >2.4% in the ultrathin filter design compared to a traditional irradiator. Furthermore, minute variations in filter thickness have notable effects on the dosimetric properties of the X-ray beam, increasing the percent depth dose (at 2 cm in water) by + 0.4%/0.01 mm Cu and decreasing absolute dose (at 2 cm depth in water) by -1.8%/0.01 mm Cu for the SARRP. CONCLUSIONS:: These results show that modern image-guided irradiators are quite sensitive to small manufacturing variations in filter thickness, and show a small change in RBE compared to traditional X-ray irradiators. ADVANCES IN KNOWLEDGE:: We quantify the consequences of ultrathin filter design in modern image-guided biological irradiators on relative and absolute dose, and RBE. Our results show these to be small, but not insignificant, suggesting laboratories transitioning between irradiators should carefully design their radiobiological experiments.

Characterization of a plastic scintillating detector for the Small Animal Radiation Research Platform (SARRP).

PURPOSE: The purpose of this study was to characterize a small plastic scintillator developed for high resolution, real-time dosimetry of therapy and imaging x-ray beams delivered by an image-guided small animal irradiator. MATERIALS AND METHODS: A 1 mm diameter, 1 mm long polystyrene BCF-60 scintillating fiber dosimeter was characterized with 220 kVp therapy and 40, 50, 60, 70, and 80 kVp imaging beams on the Small Animal Research Platform (SARRP). Scintillator output, sensitivity (charge per unit dose), linearity, and 0.2-mm resolution beam profile measurements were performed. A validated in-house Monte Carlo (MC) model of the SARRP was used to compute detailed energy spectra at locations of dosimetry, and validated scintillator measurement with MC simulations. Mass energy-absorption coefficients from the National Institute of Standards and Technology (NIST) tables convolved with MC-derived spectra were used in conjunction with Birks ionization quenching factors to correct scintillator output. An air kerma calibration method was employed to correct scintillator output for in-air beam profile measurements with open, 5 × 5, and 3 × 3 mm2 square field sizes, and compared to MC simulations. RESULTS: Scintillator dose response showed excellent linearity (R2  ≥ 0.999) for all sensitivity measurements, including output as a function of tube current. Detector sensitivity was 2.41 µC Gy-1 for the 220 kVp therapy beam, and it ranged from 1.21 to 1.32 µC Gy-1 for the 40-80 imaging beams. Percentage difference in sensitivity between the therapy and imaging beams before sensitivity correction and after using the Birks quenching factors were 52.3% and 10.2%, respectively. Percentage differences between the therapy and imaging beam sensitivities after using the air kerma calibration method for in-air measurements was excellent and below 0.3%. In-air beam profile measurements agreed to MC simulations within a mean difference of 2.4% for the 5 × 5 and 3 × 3 mm2 field sizes, however, the scintillator showed signs of volume averaging at the penumbra edges. CONCLUSIONS: A small plastic scintillator was characterized for therapy and imaging energies of a small animal irradiator, with output corrected for using an in-house MC model of the irradiator. The characterization of the scintillator detector system for small fields presents steps toward implementing real-time measurements for quality assurance and small animal treatment and imaging dose verification.

MicroCT imaging dose to mouse organs using a validated Monte Carlo model of the small animal radiation research platform (SARRP).

The goal of this work was to establish imaging dose to mouse organs with a validated Monte Carlo (MC) model of the image-guided Small Animal Radiation Research Platform (SARRP) and to investigate the effect of scatter from the internal walls on animal therapy dose determination. A MC model of the SARRP was built in the BEAMnrc code and validated with a series of homogeneous and heterogeneous phantom measurements. A segmented microCT scan of a mouse was used in DOSXYZnrc to determine mouse organ microCT imaging doses to 15-35 g mice for the SARRP pancake (mouse lying on couch) and standard (mouse standing on couch) imaging geometries for 40-80 kVp tube voltages. Imaging dose for off-center positioning shifts and maintaining image noise across tube voltages were also calculated. Half-value layer (HVL) measurements for the 220 kVp therapy beam in the presence of the SARRP shielding cabinet were modeled in BEAMnrc and compared to the 100 cm source-to-detector distance (SDD) in the scatter free, narrow-beam geometry recommended by the American Association of Physicists in Medicine Task Group 61 (AAPM TG-61). For a 60 kVp, 0.8 mA, and 60 s scan protocol, maximum mean organ imaging doses to boney and non-boney structures were 10.5 cGy and 3.5 cGy, respectively, for an average size 20 g mouse. Current-exposure combinations above 323, 203, 147, 116, and 95 mAs for 40-80 kVp tube voltages, respectively, will increase body doses above 10 cGy. MicroCT mean body dose was 18% lower in pancake compared to standard imaging geometry. An 11% difference in measured HVL at a 50 cm SDD was found compared to MC simulated HVL for the AAPM TG-61 recommended scatter free geometry at a 100 cm SDD. This change in HVL resulted in a 0.5% change in absorbed dose to water calculations for the treatment beam.