A procedure to determine the radiation isocenter size in a linear accelerator

Measurement of radiation isocenter is a fundamental part of commissioning and quality assurance (QA) for a linear accelerator (linac). In this work we present an automated procedure for the analysis of the stars-shots employed in the radiation isocenter determination. Once the star-shot film has been developed and digitized, the resulting image is analyzed by scanning concentric circles centered around the intersection of the lasers that had been previously marked on the film. The center and the radius of the minimum circle intersecting the central rays are determined with an accuracy and precision better than 1% of the pixel size. The procedure is applied to the position and size determination of the radiation isocenter by means of the analysis of star-shots, placed in different planes with respect to the gantry, couch and collimator rotation axes.     

Dosimetry and mechanical accuracy of the first rotating gamma system installed in North America

The purpose of this paper is to present the dosimetry and mechanical accuracy of the first rotating gamma system (RGS) installed in North America for stereotactic radiosurgery. The data were obtained during the installation, acceptance test procedure, and commissioning of the unit. The RGS unit installed at UC Davis Cancer Center (RGSu) has modifications on the source and collimator bodies from the earlier version of the Chinese RGS (RGSc). The differences between these two RGSs are presented. The absolute dose at the focal point was measured in a 16-cm-diam acrylic phantom using a small volume chamber, which was calibrated at the University of Wisconsin Accredited Dosimetry Calibration Laboratory (UW-ADCL). The dose in acrylic was then converted to a dose in water. A collimator output factor from each of the four different collimator sizes ranging from 4, 8, 14, and 18 mm was measured with (1) a smaller volume chamber and (2) approximately 3.0 mm x 3.0 mm x 1.0 mm TLD chips in the same acrylic phantom. The Gafchromic films were used for the dose profile, collimator output factor, and mechanical/radiation field isocentricity measurements. The TLD chips were processed in-house whereas Gafchromic films were processed both at the UW-ADCL and in-house. The timer error, timer accuracy, and timer linearity were also determined. The dose profiles were found to be similar between RGSc and RGSu. The 4 mm collimator output factor of the RGSu was approximately 0.6, similar to that from RGSc, in comparison to 0.8 in the report for a Leksell Model U Gamma-Knife. The mechanical/radiation field isocentricity for RGSc and RGSu is found to be similar and is within 0.3 mm in both X and Y directions. In the Z direction, the beam center of the RGSu is shifted toward the sources by 0.75 mm from the mechanical isocenter whereas no data are available for RGSc. Little dosimetric difference is found between RGSu and RGSc. It is reported that RGSc has the same dosimetric and mechanical characteristics as the Model U Gamma-Knife. Therefore, RGSu should be capable of achieving stereotactic radiosurgery with the same degree of dosimetric and mechanical accuracy as with the Gamma-Knife.     

An MLC-based linac QA procedure for the characterization of radiation isocenter and room lasers' position

We have designed and implemented a new stereotactic linac QA test with stereotactic precision. The test is used to characterize gantry sag, couch wobble, cone placement, MLC offsets, and room lasers' positions relative to the radiation isocenter. Two MLC star patterns, a cone pattern, and the laser line patterns are recorded on the same imaging medium. Phosphor plates are used as imaging medium due to their sensitivity to red light. The red light of room lasers erases some of the irradiation information stored on the phosphor plates enabling accurate and direct measurements for the position of room lasers and radiation isocenter. Using film instead of the phosphor plate as imaging medium is possible, however, it is less practical. The QA method consists of irradiating four phosphor plates that record the gantry sag between the 0 degrees and 180 degrees gantry angles, the position and stability of couch rotational axis, the sag between the 90 degrees and 270 degrees gantry angles, the accuracy of cone placement on the collimator, the MLC offsets from the collimator rotational axis, and the position of laser lines relative to the radiation isocenter. The estimated accuracy of the method is +/- 0.2 mm. The observed reproducibility of the method is about +/- 0.1 mm. The total irradiation/ illumination time is about 10 min per image. Data analysis, including the phosphor plate scanning, takes less than 5 min for each image. The method characterizes the radiation isocenter geometry with the high accuracy required for the stereotactic radiosurgery. In this respect, it is similar to the standard ball test for stereotactic machines. However, due to the usage of the MLC instead of the cross-hair/ball, it does not depend on the cross-hair/ball placement errors with respect to the lasers and it provides more information on the mechanical integrity of the linac/couch/laser system. Alternatively, it can be used as a highly accurate QA procedure for the nonstereotactic machines. Noteworthy is its ability to characterize the MLC position accuracy, which is an important factor in IMRT delivery.     

Application of radiosurgery principles to a target in the breast: a dosimetric study

PURPOSE: To investigate the technical and physical feasibility of using a radiosurgery-like technique to irradiate a small target within the breast with a single fraction. MATERIAL AND METHODS: During diagnostic biopsy, a tantalum surgical clip is placed in the lesion identified at mammography. Transverse CT scans over the entire breast are obtained, as the patient lies prone on a special table that allows the breast to hang down. The clip is used as a reference point to define the isocenter of the radiation treatment. RESULTS: The clip is visible on port films taken with a 4 MV beam, allowing the isocenter to be set to its planned location. No movement of the hanging breast is visually detected. The possible beam directions are enclosed by a 220 degrees horizontal x 180 degrees vertical angular interval. Dosimetry of two "radiosurgical" examples, (A) seven fixed horizontal beams and (B) six 45 degrees arcs and a 90 degrees sagittal arc using a 4 MV x-ray beam with a 32 mm diameter collimator, are discussed. Both field arrangements produce adequate tumor coverage: the minimum target dose is 83% of the dose maximum in the fixed beam arrangement and 86% in the multiarc setup. In arrangement A the lung and other tissues external to the breast receive dose only from scattered radiation. In arrangement B the maximum lung dose is less than 5% of the dose to isocenter. CONCLUSION: From a dosimetric point of view both described techniques are feasible, and the radiosurgery-like treatment is executable.     

Effects of finite angular steps and extent of profile data on the calculation of rotational x-ray dose distributions

Computer algorithms for rotational therapy beams, in most cases, perform dose calculations by summing stored fixed beam data at finite angular steps. Such an algorithm, based on the Bentley beam model, was evaluated by comparing calculations with measured data for an 18-MV x-ray beam. Measurements were made in a specially constructed cylindrical water phantom of 15-cm radius using a 0.1-cm3 ionization chamber for an arc of 180 degrees and for a field size of 7.2 X 7.2 cm2 at 100-cm source-axis distance. This study revealed that the Bentley beam model, with fixed beams summed every 10 degrees, predicts the dose in the treatment volume, centered about the isocenter, with an accuracy of approximately 2%. However, dose at depths between the phantom surface and the treatment volume could be underestimated by as much as 10% (3% of isocenter). This was shown to be partially due to the truncated tails of the off-axis profiles in the Bentley model, which extend only 8 mm outside the edge of the radiation field, and the large angular increment of integration (10 degrees). Using beam profiles extending to 4 cm outside the edge of the radiation field and angular steps of 5 degrees or less for summation of fixed beams reduced errors to less than 5%. Therefore, extended beam profiles and smaller angular steps for summing fixed beams are recommended for photon rotation calculation when increased accuracy is required.     

Computer-aided analysis of star shot films for high-accuracy radiation therapy treatment units

As mechanical stability of radiation therapy treatment devices has gone beyond sub-millimeter levels, there is a rising demand for simple yet highly accurate measurement techniques to support the routine quality control of these devices. A combination of using high-resolution radiosensitive film and computer-aided analysis could provide an answer. One generally known technique is the acquisition of star shot films to determine the mechanical stability of rotations of gantries and the therapeutic beam. With computer-aided analysis, mechanical performance can be quantified as a radiation isocenter radius size. In this work, computer-aided analysis of star shot film is further refined by applying an analytical solution for the smallest intersecting circle problem, in contrast to the gradient optimization approaches used until today. An algorithm is presented and subjected to a performance test using two different types of radiosensitive film, the Kodak EDR2 radiographic film and the ISP EBT2 radiochromic film. Artificial star shots with a priori known radiation isocenter size are used to determine the systematic errors introduced by the digitization of the film and the computer analysis. The estimated uncertainty on the isocenter size measurement with the presented technique was 0.04 mm (2σ) and 0.06 mm (2σ) for radiographic and radiochromic films, respectively. As an application of the technique, a study was conducted to compare the mechanical stability of O-ring gantry systems with C-arm-based gantries. In total ten systems of five different institutions were included in this study and star shots were acquired for gantry, collimator, ring, couch rotations and gantry wobble. It was not possible to draw general conclusions about differences in mechanical performance between O-ring and C-arm gantry systems, mainly due to differences in the beam-MLC alignment procedure accuracy. Nevertheless, the best performing O-ring system in this study, a BrainLab/MHI Vero system, and the best performing C-arm system, a Varian Truebeam system, showed comparable mechanical performance: gantry isocenter radius of 0.12 and 0.09?mm, respectively, ring/couch rotation of below 0.10 mm for both systems and a wobble of 0.06 and 0.18 mm, respectively. The methodology described in this work can be used to monitor mechanical performance constancy of high-accuracy treatment devices, with means available in a clinical radiation therapy environment.     

Algorithm for dosimetry of multiarc linear-accelerator stereotactic radiosurgery.

Treatment planning for multiarc radiosurgery is an inherently complex three-dimensional dosimetry problem. Characteristics of small-field x-ray beams suggest that major simplification of the dose computation algorithm is possible without significant loss of accuracy compared to calculations based on large-field algorithms. The simplification makes it practical to efficiently implement accurate multiplanar dosimetry calculations on a desktop computer. An algorithm is described that is based on data from fixed-beam tissue-maximum-ratio (TMR) and profile measurements at isocenter. The profile for each fixed beam is scaled geometrically according to distance from the x-ray source. Beam broadening due to scatter is taken into account by a simple formula that interpolates the full width at half maximum (FWHM) between profiles at isocenter at different depths in phantom. TMR and profile data for two representative small-field collimators (10- and 25-mm projected diameter) were obtained by TLD and film measurements in a phantom. The accuracy of the calculational method and the associated computer program were verified by TLD and film measurements of noncoplanar multiarc irradiations from these collimators on a 4-MV linear accelerator. Comparison of film measurements in two orthogonal planes showed close agreement with calculations in the shape of the dose distribution. Maximal separation of measured and calculated 90%, 80%, and 50% isodose curves was less than or equal to 0.5 mm for all planes and collimators. All TLD and film measurements of dose to isocenter agreed with calculations to within 2%.     

Development of a QA phantom and automated analysis tool for geometric quality assurance of on-board MV and kV x-ray imaging systems

The medical linear accelerator (linac) integrated with a kilovoltage (kV) flat-panel imager has been emerging as an important piece of equipment for image-guided radiation therapy. Due to the sagging of the linac head and the flexing of the robotic arms that mount the x-ray tube and flat-panel detector, geometric nonidealities generally exist in the imaging geometry no matter whether it is for the two-dimensional projection image or three-dimensional cone-beam computed tomography. Normally, the geometric parameters are established during the commissioning and incorporated in correction software in respective image formation or reconstruction. A prudent use of an on-board imaging system necessitates a routine surveillance of the geometric accuracy of the system like the position of the x-ray source, imager position and orientation, isocenter, rotation trajectory, and source-to-imager distance. Here we describe a purposely built phantom and a data analysis software for monitoring these important parameters of the system in an efficient and automated way. The developed tool works equally well for the megavoltage (MV) electronic portal imaging device and hence allows us to measure the coincidence of the isocenters of the MV and kV beams of the linac. This QA tool can detect an angular uncertainty of 0.1 degrees of the x-ray source. For spatial uncertainties, such as the source position, the imager position, or the kV/MV isocenter misalignment, the demonstrated accuracy of this tool was better than 1.6 mm. The developed tool provides us with a simple, robust, and objective way to probe and monitor the geometric status of an imaging system in a fully automatic process and facilitate routine QA workflow in a clinic.     

Design and evaluation of a variable aperture collimator for conformal radiotherapy of small animals using a microCT scanner

Treatment of small animals with radiation has in general been limited to planar fields shaped with lead blocks, complicating spatial localization of dose and treatment of deep-seated targets. In order to advance laboratory radiotherapy toward what is accomplished in the clinic, we have constructed a variable aperture collimator for use in shaping the beam of microCT scanner. This unit can image small animal subjects at high resolution, and is capable of delivering therapeutic doses in reasonable exposure times. The proposed collimator consists of two stages, each containing six trapezoidal brass blocks that move along a frame in a manner similar to a camera iris producing a hexagonal aperture of variable size. The two stages are offset by 30 degrees and adjusted for the divergence of the x-ray beam so as to produce a dodecagonal profile at isocenter. Slotted rotating driving plates are used to apply force to pins in the collimator blocks and effect collimator motion. This device has been investigated through both simulation and measurement. The collimator aperture size varied from 0 to 8.5 cm as the driving plate angle increased from 0 to 41 degrees. The torque required to adjust the collimator varied from 0.5 to 5 N x m, increasing with increasing driving plate angle. The transmission profiles produced by the scanner at isocenter exhibited a penumbra of approximately 10% of the collimator aperture width. Misalignment between the collimator assembly and the x-ray source could be identified on the transmission images and corrected by adjustment of the collimator location. This variable aperture collimator technology is therefore a feasible and flexible solution for adjustable shaping of radiation beams for use in small animal radiotherapy as well as other applications in which beam shaping is desired.     

Modeling skin collimation using the electron pencil beam redefinition algorithm

Skin collimation is an important tool for electron beam therapy that is used to minimize the penumbra when treating near critical structures, at extended treatment distances, with bolus, or using arc therapy. It is usually made of lead or lead alloy material that conforms to and is placed on patient surface. Presently, commercially available treatment-planning systems lack the ability to model skin collimation and to accurately calculate dose in its presence. The purpose of the present work was to evaluate the use of the pencil beam redefinition algorithm (PBRA) in calculating dose in the presence of skin collimation. Skin collimation was incorporated into the PBRA by terminating the transport of electrons once they enter the skin collimator. Both fixed- and arced-beam dose calculations for arced-beam geometries were evaluated by comparing them with measured dose distributions for 10- and 15-MeV beams. Fixed-beam dose distributions were measured in water at 88-cm source-to-surface distance with an air gap of 32 cm. The 6 x 20-cm2 field (dimensions projected to isocenter) had a 10-mm thick lead collimator placed on the surface of the water with its edge 5 cm inside the field's edge located at +10 cm. Arced-beam dose distributions were measured in a 13.5-cm radius polystyrene circular phantom. The beam was arced 90 degrees (-45 degrees to +45 degrees), and 10-mm thick lead collimation was placed at +/- 30 degrees. For the fixed beam at 10 MeV, the PBRA- calculated dose agreed with measured dose to within 2.0-mm distance to agreement (DTA) in the regions of high-dose gradient and 2.0% in regions of low dose gradient. At 15 MeV, the PBRA agreed to within a 2.0-mm DTA in the regions of high-dose gradient; however, the PBRA underestimated the dose by as much as 5.3% over small regions at depths less than 2 cm because it did not model electrons scattered from the edge of the skin collimation. For arced beams at 10 MeV, the agreement was 1-mm DTA in the high-dose gradient regions, and 2% in the low-dose gradient regions. For arced beams at 15 MeV, the agreement was 1 mm in the high-dose gradient regions, and in the low-dose gradient region at depth less than 2 cm, as much as 5% dose difference was observed. This study demonstrated the ease with which skin collimation can be incorporated into the PBRA. The good agreement of PBRA calculated with measured dose shows that the PBRA is likely sufficiently accurate for clinical use in the presence of skin collimation for electron arc therapy. To further improve the accuracy of the PBRA in regions having significant electrons scattered from the edge of the skin collimation would require transporting the electrons through the lead skin collimation near its edges.     

Using Monte Carlo methods to commission electron beams: a feasibility study

The purpose of this study was to investigate the feasibility of using Monte Carlo methods to assist in the commissioning of electron beams for a medical linear accelerator. The EGS4/BEAM code system was used to model an installed linear accelerator at this institution. Following an initial tuning of the input parameters, dosimetry data normally measured during the machine commissioning was calculated using the Monte Carlo code. All commissioning data was calculated for 6- and 12-MeV electron beams, and a subset of the commissioning data was calculated for the 20-MeV electron beams. On central axis, calculated percentage depth dose, cross-beam profiles, cone-insert ratios, and air-gap factors were generally within 2% of Dmax or 1 mm of the measured commissioning data; however, calculated open-cone ratios were not within 2%, in most cases. Calculated off-axis dose profiles for small fields were generally within the 2% (1-mm) criteria; however, calculated dose profiles for larger (open cone) fields frequently failed the 2% (1-mm) criteria. The remaining discrepancies between Monte Carlo calculations and measurement could be due to flaws in the Monte Carlo code, inaccuracies in the simulation geometry, the approximation of the initial source configuration, or a combination of the above. Although agreement between Monte Carlo calculated and measured doses was impressive and similar to previously published comparisons, our results did not prove our hypothesis that Monte Carlo calculations can generate electron commissioning data that is accurate within 2% of Dmax or 0.1 cm over the entire range of clinical treatment parameters. Although we believe that this hypothesis can be proved, it remains a challenge for the medical physics community. We intend to pursue this further by developing systematic methods for isolating causes of these differences.     

基于加速器的锥形束CT系统机械精度的精确测量方法及其实现

目的:设计并实现一种锥形束CT（CBCT）机械精度的检测方法,可对CBCT的机械性能参数进行精确测量和分析（重复性在0.5 mm以内,测量误差在0.5 mm内,耗时数分钟）。方法:系统硬件包括双目红外相机、定位小球、注册笔和水平注册仪。双目红外相机可输出定位小球中心的空间坐标,利用定位小球中心位置坐标可计算出加速器机械等中心坐标,利用CBCT拍出的定位小球图像可计算出CBCT影像中心与加速器机械等中心的偏差,利用注册笔可计算出CBCT平板角度偏差。结果:在某医院加速器配备的CBCT上运用本方法进行3次测试和分析,得到加速器机械等中心坐标、CBCT影像等中心坐标、两等中心距离误差和CBCT平板打开垂直度等数据。结论:本研究提出的检测CBCT机械精度的方法操作过程较简单,结果精准,可重复性高,将复杂的质控过程数字化、自动化和简单化,给CBCT的日常质量检测带来非常大的便利,也为相关技术人员以及医护人员在临床上安全应用CBCT提供指导。 【关键词】锥形束CT;红外双目相机;定位小球;机械等中心;影像等中心     

Commissioning and clinical implementation of a mega-voltage cone beam CT system for treatment localization

The improvement in conformal radiotherapy techniques with steep dose gradients has allowed for the delivery of higher doses to a tumor volume while maintaining the sparing of surrounding normal tissue. In this situation, verification of patient setup and evaluation of internal organ motion just prior to radiation delivery is a crucial step. To this end, several volumetric image-guided techniques have been developed for patient localization, such as the Siemens MVision mega-voltage cone beam CT (MV-CBCT) system. In this work, the commissioning and clinical implementation of the MVision system is presented. The geometry and gain calibration procedures for the system are described, and guidelines for quality assurance procedures are provided. Different MV-CBCT clinical protocols, ranging from daily to weekly image-guidance, which includes image acquisition, reconstruction, registration with planning CT, and treatment couch offsets corrections, were commissioned. The image quality characteristics of the MVision system were measured and assessed qualitatively and quantitatively, including the image noise and uniformity, low-contrast resolution, and spatial resolution. Furthermore, the image reconstruction and registration software was evaluated. Data show that a 2 cm large object with 1% electron density contrast can be detected with the MVision system with 10 cGy at isocenter and that the registration software is accurate within 2 mm in the anterior-posterior, left-right, and superior-inferior directions.     

Characteristics and quality assurance of a dedicated open 0.23 T MRI for radiation therapy simulation

A commercially available open MRI unit is under routine use for radiation therapy simulation. The effects of a gradient distortion correction (GDC) program used to post process the images were assessed by comparison with the known geometry of a phantom. The GDC reduced the magnitude of the distortions at the periphery of the axial images from 12 mm to 2 mm horizontally along the central axis and distortions exceeding 20 mm were reduced to as little as 2 mm at the image periphery. Coronal and sagittal scans produced similar results. Coalescing these data into distortion as a function of radial distance, we found that for radial distances of <10 cm, the distortion after GDC was <2 mm and for radial distances up to 20 cm, the distortion was <5 mm. The dosimetric errors resulting from homogeneous dose calculations with this level of distortion of the external contour is <2%. A set of triangulation lasers has been added to establish a virtual isocenter for convenient setup and marking of patients and phantoms. Repeated measurements of geometric phantoms over several months showed variations in position between the virtual isocenter and the magnetic isocenter were constrained to <2 mm. Additionally, the interscan variations of 12 randomly selected points in space defined by a rectangular grid phantom was found to be within the intraobserver error of approximately 1 mm in the coronal, sagittal, and transverse planes. Thus, the open MRI has sufficient geometric accuracy for most radiation therapy planning and is temporally stable.     

Electron dose rate and photon contamination in electron arc therapy

The electron dose rate at the depth of dose maximum dmax and the photon contamination are discussed as a function of several parameters of the rotational electron beam. A pseudoarc technique with an angular increment of 10 degrees and a constant number of monitor units per each stationary electron field was used in our experiments. The electron dose rate is defined as the electron dose at a given point in phantom divided by the number of monitor units given for any one stationary electron beam. For a given depth of isocenter di the electron dose rates at dmax are linearly dependent on the nominal field width w, while for a given w the dose rates are inversely proportional to di. The dose rates for rotational electron beams with different di are related through the inverse square law provided that the two beams have (di,w) combinations which give the same characteristic angle beta. The photon dose at the isocenter depends on the arc angle alpha, field width w, and isocenter depth di. For constant w and di the photon dose at isocenter is proportional to alpha, for constant alpha and w it is proportional to di, and for constant alpha and di it is inversely proportional to w. The w and di dependence implies that for the same alpha the photon dose at the isocenter is inversely proportional to the electron dose rate at dmax.     

Helical tomotherapy radiation leakage and shielding considerations

Leakage radiation and room shielding considerations increase significantly for intensity-modulated radiation therapy (IMRT) treatments due to the increased beam-on time to deliver modulated fields. Tomotherapy, with its slice by slice approach to IMRT, further exacerbates this increase. Accordingly, additional shielding is used in tomotherapy machines to reduce unwanted radiation. The competing effects of the high modulation and the enhanced shielding were studied. The overall room leakage radiation levels are presented for the continuous gantry rotations, which are always used during treatments. The measured leakage at 4 m from the isocenter is less than 3 x 10(-4) relative to calibration output. Primary radiation exposure levels were investigated as well. The effect of forward-directed leakage through the beam-collimation system was studied, as this is the leakage dose the patient would receive in the course of a treatment. A 12-min treatment was calculated to produce only 1% patient leakage dose to the periphery region. Longer treatment times might yield less patient dose if the field width selected is correspondingly narrower. A method for estimating the worst-case leakage dose a patient would receive is presented.     

Performance evaluation of a multi-slice CT system

Our purpose in this study was to characterize the performance of a recently introduced multi-slice CT scanner (LightSpeed QX/i, Version 1.0, General Electric Medical Systems) in comparison to a single-slice scanner from the same manufacturer (HiSpeed CT/i, Version 4.0). To facilitate this comparison, a refined definition of pitch is introduced which accommodates multi-slice CT systems, yet maintains the existing relationships between pitch, patient dose, and image quality. The following performance parameters were assessed: radiation and slice sensitivity profiles, low-contrast and limiting spatial resolution, image uniformity and noise, CT number and geometric accuracy, and dose. The multi-slice system was tested in axial (1, 2, or 4 images per gantry rotation) and HQ (Pitch = 0.75) and HS (Pitch = 1.5) helical modes. Axial and helical acquisition speed and limiting spatial resolution (0.8-s exposure) were improved on the multi-slice system. Slice sensitivity profiles, image noise, CT number accuracy and uniformity, and low-contrast resolution were similar. In some HS-helical modes, helical artifacts and geometric distortion were more pronounced with a different appearance. Radiation slice profiles and doses were larger on the multi-slice system at all scan widths. For a typical abdomen and pelvis exam, the central and surface body doses for 5-mm helical scans were higher on the multi-slice system by approximately 50%. The increase in surface CTDI values (with respect to the single-slice system) was greatest for the 4 x 1.25-mm detector configuration (190% for head, 240% for body) and least for the 4 x 5-mm configuration (53% for head, 76% for body). Preliminary testing of version 1.1 software demonstrated reduced doses on the multi-slice scanner, where the increase in body surface CTDI values (with respect to the single-slice system) was 105% for the 4 x 1.25-mm detector configuration and 10% for the 4 x 5-mm configuration. In summary, the axial and HQ-helical modes of the multi-slice system provided excellent image quality and a substantial reduction in exam time and tube loading, although at varying degrees of increased dose relative to the single-slice scanner.     

Measurement of LINAC 90 degrees head leakage radiation TVL values

One of the key components in modern LINAC room shielding design is the amount of 90 degrees head leakage radiation levels. With the general clinical acceptance of intensity-modulated radiation therapy (IMRT) technique, accurate knowledge of this quantity has become even more important. Measurement of 90 degrees head leakage radiation of medical linear accelerators can be technically challenging due to the low dose rate causing poor signal-to-noise ratios in most detectors. 90 degrees leakage tenth-value layer (TVL) values in concrete have not been reported for the Elekta linear accelerators. This report describes our measurements of 90 degrees leakage TVL values for 6, 10, and 18 MV x-ray beams for an Elekta Precise Treatment System. A large-volume (1000 cm3) unpressurized ionization chamber and a high sensitivity electrometer, together with a separate chamber bias power supply, were used in these measurements in order to maximize the signal-to-noise ratio. A lead enclosure, of minimum thickness 10 cm, was constructed inside the treatment room to house the ion chamber to reduce the influence of room-scattered radiation. A square aperture of 10 X 10 cm2 area was left in the shield and aimed towards the accelerator head. Measurements were performed with the chamber placed at approximately 2 m from the accelerator isocenter. Concrete slabs with individual dimensions of approximately 40 X 40 cm2 cross-sectional area and 5 cm thickness were placed between the accelerator head and the ion chamber for these measurements. The measurements were performed with total concrete thickness of up to 80 cm, so that values up to the third TVL were measured. These measurements showed thatthe first concrete TVL values are 22, 23, and 28 cm (8.6, 9.1, and 10.5 in.) for 6, 10, and 18 MV beams, while the average of the first 3 TVL's were 25, 26, and 29 cm (9.9, 10.2, and 11.5 in.). Measured values agreed to within 10% of previously reported values for Varian linear accelerators for equivalent radiation beam qualities.     

Compact multileaf collimator for conformal and intensity modulated fast neutron therapy: electromechanical design and validation

The electromechanical properties of a 120-leaf, high-resolution, computer-controlled, fast neutron multileaf collimator (MLC) are presented. The MLC replaces an aging, manually operated multirod collimator. The MLC leaves project 5 mm in the isocentric plane perpendicular to the beam axis. A taper is included on the leaves matching beam divergence along one axis. The 5-mm leaf projection width is chosen to give high-resolution conformality across the entire field. The maximum field size provided is 30 x 30 cm2. To reduce the interleaf transmission a 0.254-mm blocking step is included. End-leaf steps totaling 0.762 mm are also provided allowing opposing leaves to close off within the primary radiation beam. The neutron MLC also includes individual 45 degrees and 60 degrees automated universal tungsten wedges. The automated high-resolution neutron collimation provides an increase in patient throughput capacity, enables a new modality, intensity modulated neutron therapy, and limits occupational radiation exposure by providing remote operation from a shielded console area.