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1.
PurposeThe work presented herein rests on the study of the Varian EPID aS500-II and the Image Acquisition system IAS3. We assessed the dosimetric performance of this EPID for measurements and quality assurance of enhanced dynamic wedge profiles and wedge factors.Materials and methodsWe evaluated the dosimeter properties using the integrated asynchronous mode of acquisition in treatments with enhanced dynamic wedges (EDW). We studied the performance, stability and the reproducibility in measurements of the transmission factors and profiles of the fields with dynamic wedges. EPID profiles were compared to the “Profiler Sun Nuclear” diode array and PTW ion chamber. Analytical functions were developed in order to correct EDW profiles. The dependence of EPID measurements on wedge direction, beam dimensions and source to EPID distance was assessed.ResultsThe backscatter produced by the “exact arm” was evaluated; EPID profiles depended on the EDW direction and on the detector source distance. Wedge factors were determined using this detector and compared to the ion chamber response, differences were all within 1 %. Two empirical correction functions were developed to produce EPID wedge profiles that correspond to diode for all wedge angles and energies depending on the wedge direction.ConclusionThe EPID is highly suited to regular measurement of EDW due to the reproducibility of the EPID-measured wedge factors and profiles.  相似文献   

2.
Objective:The dosimetric characteristics for linear accelerators with the same model, and nominal energy are known to be very similar, as long as the machines are unaltered from the manufacturer’s original specifications. In this pre-liminary study, a quantitative investigation of the similarity in the basic photon and electron dosimetry data from the Siemens Oncor linear accelerators at our hospital (Children’s Cancer Hospital, Cairo, Egypt) was reported. Methods:The output factor (OF), wedge factors (WF), percentage depth dose (PDD), and beam profile for the 6 and 10 MV photon beams were measured. Results:The measured output factors varied by less than about 1%for each field size. The dif erence between the maximum and minimum PDD values at each depth was less than about 1%. The dif erence between the beam flattnes and symetry was no more than 1%at al of-axis distances. For electron the results showed that the PDD, OF, and the beam profiles were matched within 1%dif erences. Conclusion:These results strongly suggest that it is feasible to establish one reference photon and electron dosimetry data set for the two machines and nominal energies.  相似文献   

3.
Purpose: After acquiring 4 years of experience with Dynamic Wedge, a software-driven one-dimensional (1D) compensation system, we implemented a new software version called Enhanced Dynamic Wedge (EDW). The EDW allows larger (30 cm) and asymmetric field sizes and additional angles for wedged fields. We implemented this software on four similar dual-energy accelerators that also possess upper and lower physical wedge sets. Our goal was to implement EDW with one common wedge factor (WF) table and one set of treatment-planning files.Methods and Materials: We measured WFs with an ionization chamber and isodose profiles with both film and a diode array. We used a calculation scheme that requires only entry of the wedge angle and fixed jaw value. Filters for computerized treatment planning were configured for each wedge angle. We also examined to what degree the multileaf collimation (MLC) orientation, which is orthogonal to the EDW direction, was compromised for specific treatment sites. As a comparative test, we examined the dosimetric consistency for the 8 sets of physical wedges on the four machines. Finally, we updated our DW quality assurance program for EDW.Results: The measured EDW WF was common for all four machines to within ± 1.5% and the calculation scheme held to within 1.5%. The EDW isodoses were consistent among the machines as measured by film and diode array. The treatment-planning filters provided computed isodose profiles that were nearly identical to measured profiles. Regarding MLC orientation, we found that the collimator angle needed for EDW did not compromise isodose distributions, as apparent in measured isodoses and calculated dose–volume histograms. The consistency of the physical wedges did not fare as well. Two of the lower wedge sets had Wfs and profiles different (>3%) from the other wedge sets.Conclusions: We have successfully implemented EDW on four machines using only one WF table and one set of treatment-planning filters. The EDW provides for improved treatment techniques for particular sites due to the large field sizes and additional angles available. Daily treatment efficiency has increased because of the remote capability provided by EDW.  相似文献   

4.
目的 用扩充型动态楔形板(EDW)模型比较Pinnacle3 9.0治疗计划系统(TPS)的ACA算法和Eclipse7.3 TPS的AAA、PBC算法的准确性。方法 对瓦里安21EX 6 MV X线不同射野的EDW楔形因子(WF)进行实际测量和绘制二维剂量分布曲线,与2种TPS3种算法的计算结果进行相对误差和最大偏差比较。γ通过率分析平面剂量强度分布。结果 对称野WF 的ACA 算法相对误差<2.8%,AAA算法的<1.0%,PBC算法的<1.2%;非对称野WF 的ACA 算法相对误差高达19.4%,AAA算法的<2.0%,PBC算法的<3.0%。楔形方向所有射野ACA算法最大偏差为3.0%,AAA算法的为2.7%,PBC算法的为4.0%。对称野3种算法的通过率>87%,在去除半影区后>96%;非对称野的>85%,在去除半影区后达95%。结论 AAA、PBC算法对于对称和非对称野准确度均能满足临床需要,而ACA 算法在非对称野条件下WF误差偏大,在实际临床中应尽量避免使用。  相似文献   

5.
BACKGROUND AND PURPOSE: Intensity modulated radiation therapy offers a dose distribution improvement by modulating the two-dimensional X-ray fluence. This increases the treatment complexity from the planning phase to the verification one. Pre-treatment dosimetric verifications of each treatment field are strictly necessary, films and EPIDs are generally used for this purpose. In this paper we investigated the dosimetric characteristics of a commercially available fluoroscopic EPID "I'mRT QA" (Scanditronix-Wellh?fer) (I-QA) based on charge-coupled device camera (CCD) and we present a new method for optimising the EPID's response. MATERIALS AND METHODS: I-QA is an optically sealed EPID and it is designed for on-line two-dimensional measurements of relative dose distribution. Dose profiles measured in water with diodes and dose distributions measured in water-equivalent phantoms with films were compared with those obtained with the I-QA for homogeneous and intensity modulated 6 and 18 MV photon beams. RESULTS AND CONCLUSIONS: I-QA measurements depend on the field size and on the two-dimensional energy spectrum of the beam. The incoming beam was modified positioning a series of lead and plastic (RW3) slabs above the fluorescent screen to obtain a homogeneous response of the I-QA over the whole sensitive area. The thickness of lead and RW3 sheets was optimised to get the best matching between diodes, films and the I-QA measurements for each energy. Gamma index evaluations showed a correspondence between I-QA measurements and diode ones within 3% or 2 mm for homogeneous and simple modulated fields, and within 5% or 3mm for complex modulated fields.  相似文献   

6.
The transit in vivo dosimetry performed by the Electronic Portal Imaging Device (EPID), avoids the problem of solid-state detector positioning on the patient. Moreover, the dosimetric characterization of the recent Elekta aSi EPIDs in terms of signal stability and linearity enables these detectors adaptable for the transit in vivo dosimetry with 6, 10 and 15 MV photon beams. However, the implementation of the EPID transit dosimetry requires several measurements. Recently, the present authors have developed an in vivo dosimetry method for the 3D CRT based on correlation functions defined by the ratios between the transit signal, s(t) (w,L), by the EPID and the phantom mid-plane dose, D(m)(w,L), at the Source to Axis Distance (SAD) as a function of the phantom thickness, w, and the square field dimensions, L. When the phantom mid-plane was positioned at distance d from the SAD, the ratios st(w,L)/s't(d,w,L), were used to take into account the variation of the scattered photon contributions on the EPID as a function of, d and L. The aim of this paper was the implementation of a procedure that uses generalized correlation functions obtained by nine Elekta Precise linac beams. The procedure can be used by other Elekta Precise linacs equipped with the same aSi EPIDs assuring the stabilities of the beam output factors and the EPID signals. The calibration procedure of the aSi EPID here reported avoids measurements in solid water equivalent phantoms needed to implement the in vivo dosimetry method in the radiotherapy center. A tolerance level ranging between ±5% and ±6% (depending on the type of tumor) was estimated for the comparison between the reconstructed isocenter dose, D(iso) and the computed dose D(iso,TPS) by the treatment planning system (TPS).  相似文献   

7.
BACKGROUND AND PURPOSE: Dosimetric measurements and treatment planning system (TPS) calculations in the region outside the clinical photon beams have been investigated. The aim was to estimate the calculation accuracy of a specific TPS in areas that are becoming increasingly relevant with the advent of new technologies, such as, for example, intensity modulation radiation therapy. MATERIALS AND METHODS: Measurements were performed on two different linacs to obtain, separately, the head scatter (electrons and photons), the transmission below the jaws and the phantom scatter outside the primary beam for different photon energies, distances from the field edge and field sizes. Calculations with a commercial TPS (Helax TMS) were then obtained and compared with these measurements. RESULTS: In general, reasonable agreement between calculations and measurements was obtained (1-2%), especially for photon scattering (head and phantom). Nevertheless, some discrepancies were found in the electron contamination computation, due probably to the approximations and assumptions made in the TPS calculation algorithm. CONCLUSIONS: The analyzed TPS presented good results, but for some particular clinical cases and moreover for advanced techniques such as intensity modulated radiation therapy, the calculation behaviour with respect to measurements and patient dose delivery should be carefully evaluated.  相似文献   

8.
Background: To avoid inconvenience to patients due to linear accelerator down time in busy radio-therapy departments, treatment plans can be switched between linear accelerators provided that all exhibit the same same dosimetric characteristics. In other words linear accelerators should be beam-matched. Aim: The aim of this study was to evaluate the clinical significance of beam-matching using VMAT plans. Materials and Methods: Dosimetric data with a 6MV beam from am Clinac 2100CD were taken as baseline values and other two units, a 2300CD and a Unique Performance, were factory tuned in accordance. An analysis of PDD data was performed for different field sizes to evaluate energy matching. Beam profiles for field sizes of 10×10 cm2 and 40 × 40 cm2 at depths of 1.5 cm and 10 cm were analyzed. The relative output factor and MLC dosimetric properties were compared with each machine to determine variability among the different models. Thirty patients from our database were selected, ten each for head and neck, thorax and pelvis sites. VMAT plans were created in the Eclipse treatment planning system for a Clinac 2100 CD for reference. and verification plans were created for each to compare point dose measurements. Results: The TPR 20/10 for 10 × 10 cm2 was well matched, showing no energy differences. Deviation of all point dose measurements fell within ±3%. Planar dose maps all showed greater than 95% of points with a passed area γ-value less than 1. Conclusion: Our study evaluation of beam matching with treatment planning modeling showed good agreement fior 6 MV beams across all three linear accelerators used in our clinical environment.  相似文献   

9.
BACKGROUND AND PURPOSE: The aim of this work is to set-up mailed entrance in vivo dosimetry by means of thermoluminescence dosimeters (TLDs) in the form of LiF powder in order to assess the overall accuracy of patient treatment delivery by comparing the doses delivered to patients with the doses calculated by the treatment planning system (TPS) in different institutions. PATIENTS AND METHODS: Two millimeter thick copper (for 6 MV photon beams) and 1.3 mm thick aluminium (for (60)Co gamma beams) build-up caps are developed. The characteristics of these build-up caps are tested by phantom measurements: the response of the TLD inside the build-up cap is compared to the ionisation chamber (IC) signal in the same irradiation conditions. A pilot study using the copper build-up cap is performed on 8 patients, treated with a 6 MV photon beam at the radiotherapy department of the University Hospital of Leuven. Additionally, a first run of mailed entrance in vivo dosimetry is performed by 18 radiotherapy centres in Europe. RESULTS: For 80 different phantom set-ups using copper and aluminium build-up caps, the mean TLD dose compared to the IC dose is 0.993+/-0.015 (1SD). Regarding the patient measurements in the radiotherapy department of the University Hospital of Leuven, the mean ratio of the measured entrance dose (TLD) to the entrance dose calculated by the TPS, is equal to 0.986+/-0.017 (1SD) (N=8), after correction of an error detected in one of the patient treatments. For the 18 radiotherapy centres participating in the mailed in vivo TLD study, the mean measured versus stated entrance dose for patients treated in a (60)Co and 6 MV photon beam is 1.004+/-0.021 (1SD) (N=143). CONCLUSIONS: From the results, it can be deduced that the build-up caps and the proposed calibration methodology allow the use of TLD in the form of powder to be applied in large scale in vivo dose audits.  相似文献   

10.
PURPOSE: Positioning verification is usually performed with treatment beam (MV) portal images (PI) using an electronic portal imaging device (EPID). A new alternative is the use of a low energy photon source (kV) and an additional EPID mounted to the accelerator gantry. This system may be used for PI or--with rotating gantry--as cone-beam CT (CBCT). The dose delivered to the patient by different imaging processes was measured. METHODS AND MATERIALS: A total of 15 in-vivo dose measurements were done in five patients receiving prostate IMRT. For anterior-posterior (AP) and lateral PI with MV and kV photons measurement points were inside the rectum and at the patient's skin. Dose for CBCT was measured in the rectum. Additional measurements for CBCT were done in a cylindrical CT-dose-index (CTDI) phantom to determine peripheral, central and weighted CTDI. RESULTS: The dose for AP MV PI was 57.8 mGy at the surface and 33.9 mGy in the rectum, for lateral MV PI 69.4 mGy and 31.7 mGy, respectively (5 MU/exposure). The dose for AP kV PI was 0.8 mGy at the surface and 0.2 mGy in the rectum, for lateral PI 1.1 mGy and 0. 1 mGy, respectively. For a CBCT the rectal dose was 17.2 mGy. The peripheral CTDI was 23.6 mGy and the center dose was 10.2 mGy, resulting in a weighted CTDI of 19.1 mGy in the phantom and an estimated surface dose of < or =28 mGy. CONCLUSIONS: Even taking into account an RBE (Relative Biological Effectiveness) of 2 for kV vs. MV radiation, for kV PI the delivered dose is lower and image quality is better than for MV PI. CBCT provides a 3D-image dataset and dose exposure for one scan is lower than for two MV PI, thus rendering frequent volume imaging during a fractionated course of radiotherapy possible.  相似文献   

11.
The ESTRO formalism for monitor unit (MU) calculations was evaluated and implemented to replace a previous methodology based on dosimetric data measured in a full-scatter phantom. This traditional method relies on data normalised at the depth of dose maximum (Zm), as well as on the utilisation of the BJR 25 table for the conversion of rectangular fields into equivalent square fields. The treatment planning system (TPS) was subsequently updated to reflect the new beam data normalised at a depth ZR of 10 cm. Comparisons were then carried out between the ESTRO formalism, the Clarkson-based dose calculation algorithm on the TPS (with beam data normalised at Zm and ZR), and the traditional "full-scatter" methodology. All methodologies, except for the "full-scatter" methodology, separated head-scatter from phantom-scatter effects and none of the methodologies; except for the ESTRO formalism, utilised wedge depth dose information for calculations. The accuracy of MU calculations was verified against measurements in a homogeneous phantom for square and rectangular open and wedged fields, as well as blocked open and wedged fields, at 5, 10, and 20 cm depths, under fixed SSD and isocentric geometries for 6 and 10 MV. Overall, the ESTRO Formalism showed the most accurate performance, with the root mean square (RMS) error with respect to measurements remaining below 1% even for the most complex beam set-ups investigated. The RMS error for the TPS deteriorated with the introduction of a wedge, with a worse RMS error for the beam data normalised at Zm (4% at 6 MV and 1.6% at 10 MV) than at ZR (1.-9% at 6 MV and 1.1% at 10 MV). The further addition of blocking had only a marginal impact on the accuracy of this methodology. The "full-scatter" methodology showed a loss in accuracy for calculations involving either wedges or blocking, and performed worst for blocked wedged fields (RMS errors of 7.1% at 6 MV and 5% at 10 MV). The origins of these discrepancies were quantified and the shortcomings of these MU calculation methodologies are discussed in the paper.  相似文献   

12.
Dosimetric measurements have been made of a 6 MV photon beam from a linear accelerator equipped with asymmetric jaws. The field size factors for asymmetrically set fields are compared to those for symmetrically set fields. The change of beam quality has been measured as a function of off-axis position of the asymmetric fields to assess its effect on depth dose. Additional measurements include beam penumbra and shape of isodose curves for open and wedge fields as the field opening is moved asymmetrically from the central ray.  相似文献   

13.
BACKGROUND AND PURPOSE: A dose compensation method is presented for patients with hip prosthesis based on Dynamic Multi Leaves Collimator (DMLC) planning. Calculations are done from an exit Portal Dose Image (PDI) from 6 MV Photon beam using an Electronic Portal Imaging Device (EPID) from Varian. Four different hip prostheses are used for this work. METHODS: From an exit PDI the fluence needed to yield a uniform dose distribution behind the prosthesis is calculated. To back-project the dose distribution through the phantom, the lateral scatter is removed by deconvolution with a point spread function (PSF) determined for depths from 10 to 40cm. The dose maximum, D(max), is determined from the primary plan which delivers the PDI. A further deconvolution to remove the dose glare effect in the EPID is performed as well. Additionally, this calculated fluence distribution is imported into the Treatment Planning System (TPS) for the final calculation of a DMLC plan. The fluence file contains information such as the relative central axis (CAX) position, grid size and fluence size needed for correct delivery of the DMLC plan. GafChromic EBT films positioned at 10cm depth are used as verification of uniform dose distributions behind the prostheses. As the prosthesis is positioned at the phantom surface the dose verifications are done 10cm from the prosthesis. CONCLUSION: The film measurement with 6 MV photon beam shows uniform doses within 5% for most points, but with hot/cold spots of 10% near the femoral head prostheses.  相似文献   

14.
Introduction: Aim of study is to investigate the effect of hip prosthesis on 6 and 15 MV photon beam energies. Materials and Methods: Prosthesis was kept at the level of tray position. The measurements were done on Varian Clinac-iX linac. Customized prosthesis, termed as Prosthetic Metal Implant (PMI) was made up of wrought austenitic stainless steel rod and covered with paraffin-wax. ‘Standard prosthesis’ was made up of wrought titanium alloy. The dose profiles were measured for three field sizes i.e. 5, 10 and 20 cm at 100 cm SSD for 6 and 15 MV energies. The perturbation index (PI) was also calculated. Results: Perturbation caused by standard prosthesis was approximately 50% higher than that of PMI. This result may be due to difference in dimension and not because of material composition. Variation of central axis dose might be due to the dimensions of PMI used for experiment which gave intermediate response (e.g. 102.1%, 141.0% and 117.7% for Open, Standard and PMI respectively for 10x10 cm2 field size, 10 cm depth and 15MV photon beam setup )as compared to the ‘open’ and ‘standard’ prosthesis. Percentage dose at 10 cm for 6MV photon increased rapidly with field-size for PMI. But, for 15MV photon, difference was not significant. Surface dose (Ds) for PMI remains significantly higher for smaller field. Conclusion: The perturbation index varied from 0.05 to 0.22 for the measured energies and gave an idea to the planner to assess the behavior of the prosthesis. This range is applicable for both type of implants and for all clinical field-sizes. The attenuation caused by the prosthesis was significant and this effect should be considered in the treatment planning calculations.  相似文献   

15.
目的:比较颈胸交界区食管癌放射治疗中不同射野与楔形板应用的技术。方法:采用美国CMS公司XiO V4.1.1三维治疗计划系统(TPS),比较颈胸交界区食管癌在不同治疗计划中等剂量曲线、剂量体积直方图(DVH)及其他评价指标的优劣。结果:采用先前后对穿照射(适形野或马褂野)及后程两前斜野加楔形板治疗技术的剂量分布较仅应用两前斜野加楔形板治疗技术等剂量曲线分布均匀,肺受量减小。运用马褂野较用适形野的照射方式剂量分布更加均匀且满足锁骨上淋巴结区预防照射要求;楔形板常规应用技术(仅厚端相对避免内野高剂量)的靶区剂量分布较其在三维治疗计划系统的应用技术均匀性明显不足。结论:放射治疗技术和楔形板在颈胸交界区食管癌放射治疗中的应用应做到个体化,对锁骨上淋巴结区需预防照射的患者,应采用先前后对穿照射(适形野或马褂野)加后程两前斜野及楔形板治疗技术,对锁骨上淋巴结区不需预防照射的患者,则可以用前两斜野加楔形板治疗技术。  相似文献   

16.
Physical wedges still can be used as missing tissue compensators or filters to alter the shape of isodose curves in a target volume to reach an optimal radiotherapy plan without creating a hotspot. The aim of this study was to investigate the dosimetric properties of physical wedges filters such as off-axis photon fluence, photon spectrum, output factor and half value layer. The photon beam quality of a 6 MV Primus Siemens modified by 150 and 450 physical wedges was studied with BEAMnrc Monte Carlo (MC) code. The calculated present depth dose and dose profile curves for open and wedged photon beam were in good agreement with the measurements. Increase of wedge angle increased the beam hardening and this effect was more pronounced at the heal region. Using such an accurate MC model to determine of wedge factors and implementation of it as a calculation algorithm in the future treatment planning systems is recommended.  相似文献   

17.
18.
Contralateral breast (CLB) cancer is a rare but serious concern in radiotherapy. In this study, the CLB dose was measured using MOSFET dosimeter in 49 patients who underwent breast conservation surgery treated by different radiotherapy tangential field techniques, which included enhanced dynamic wedge (EDW), physical wedge, and intensity modulated radiation therapy (IMRT). The mean percent of the prescribed dose received by the contralateral areola in treatment technique using physical wedge (Cobalt), physical wedge (Linac), EDW, and IMRT were 4.27% (SD: 0.65), 3.61% (SD: 0.60), 3.38% (SD: 0.58), and 1.65% (SD: 0.24), respectively. There was a 29% CLB dose reduction at 3 cm from the medial tangential field border with IMRT compared to other wedged tangential field techniques. The study shows that the CLB dose could be reduced with IMRT or reducing or avoiding the medial wedge in conventional tangential field planning for breast cancer.  相似文献   

19.
BACKGROUND AND PURPOSE: Although intensity modulated radiation therapy is characterized by three-dimensional dose distributions which are often superior to those obtained with conventional treatment plans, its routine clinical implementation is partially held back by the complexity of the beam verification. This is even more so when a dynamic multileaf collimator (dMLC) is used instead of a segmented beam delivery. We have therefore investigated the possibility of using a commercially available, liquid-filled electronic portal imaging device (EPID) for the pre-treatment quality assurance of dynamically delivered dose distributions. METHODS AND MATERIALS: A special acquisition mode was developed to optimize the image acquisition speed for dosimetry with the liquid-filled EPID. We investigated the accuracy of this mode for 6 and 18 MV photon beams through comparison with film and ion chamber measurements. The impact of leaf speed and pulse rate fluctuations was quantified by means of dMLC plans especially designed for this purpose. Other factors influencing the accuracy of the dosimetry (e.g. the need for build-up, remanence of the ion concentration in the liquid and bulging of the liquid at non-zero gantry angles) were studied as well. We finally compared dosimetric EPID images with the corresponding image prediction delivered without a patient in the beam. RESULTS: The dosimetric accuracy of the measured dose distribution is approximately 2% with respect to film and ion chamber measurements. The accuracy declines when leaf speed is increased beyond 2 cm/s, but is fairly insensitive to accelerator pulse rate fluctuations. The memory effect is found to be of no clinical relevance. When comparing the acquired and expected distributions, an overall agreement of 3% can be obtained, except at areas of steep dose gradients where slight positional shifts are translated into large errors. CONCLUSIONS: Accurate dosimetric images of intensity modulated beam profiles delivered with a dMLC can be obtained with a commercially available, liquid-filled EPID. The developed acquisition mode is especially suited for fast and accurate pre-treatment verification of the intensity modulated fields.  相似文献   

20.
李齐林  邓小武  陈立新 《癌症》2010,29(6):617-620
Background and Objective:The planning dose distribution of intensity-modulated radiation therapy(IMRT) has to be verified before clinical implementation.The commonly used verification method is to measure the beam fluency at 0 degree(0°) gantry angle with a 2-dimensional(2D) detector array,but not the composite dose distribution of the real delivery in the planned gantry angles.This study was to investigate the angular dependence of a 2D diode array(2D array) and the feasibility of using it to verify the co...  相似文献   

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