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1.
Megavoltage CT (MVCT) images of patients are acquired daily on a helical tomotherapy unit (TomoTherapy, Inc., Madison, WI). While these images are used primarily for patient alignment, they can also be used to recalculate the treatment plan for the patient anatomy of the day. The use of MVCT images for dose computations requires a reliable CT number to electron density calibration curve. In this work, we tested the stability of the MVCT numbers by determining the variation of this calibration with spatial arrangement of the phantom, time and MVCT acquisition parameters. The two calibration curves that represent the largest variations were applied to six clinical MVCT images for recalculations to test for dosimetric uncertainties. Among the six cases tested, the largest difference in any of the dosimetric endpoints was 3.1% but more typically the dosimetric endpoints varied by less than 2%. Using an average CT to electron density calibration and a thorax phantom, a series of end-to-end tests were run. Using a rigid phantom, recalculated dose volume histograms (DVHs) were compared with plan DVHs. Using a deformed phantom, recalculated point dose variations were compared with measurements. The MVCT field of view is limited and the image space outside this field of view can be filled in with information from the planning kVCT. This merging technique was tested for a rigid phantom. Finally, the influence of the MVCT slice thickness on the dose recalculation was investigated. The dosimetric differences observed in all phantom tests were within the range of dosimetric uncertainties observed due to variations in the calibration curve. The use of MVCT images allows the assessment of daily dose distributions with an accuracy that is similar to that of the initial kVCT dose calculation.  相似文献   

2.
Megavoltage cone-beam CT (MVCBCT), the recent addition to the family of in-room CT imaging systems for image-guided radiation therapy (IGRT), uses a conventional treatment unit equipped with a flat panel detector to obtain a three-dimensional representation of the patient in treatment position. MVCBCT has been used for more than two years in our clinic for anatomy verification and to improve patient alignment prior to dose delivery. The objective of this research is to evaluate the image acquisition dose delivered to patients for MVCBCT and to develop a simple method to reduce the additional dose resulting from routine MVCBCT imaging. Conventional CT scans of phantoms and patients were imported into a commercial treatment planning system (TPS: Phillips, Pinnacle) and an arc treatment mimicking the MVCBCT acquisition process was generated to compute the delivered acquisition dose. To validate the dose obtained from the TPS, a simple water-equivalent cylindrical phantom with spaces for MOSFETs and an ion chamber was used to measure the MVCBCT image acquisition dose. Absolute dose distributions were obtained by simulating MVCBCTs of 9 and 5 monitor units (MU) on pelvis and head and neck patients, respectively. A compensation factor was introduced to generate composite plans of treatment and MVCBCT imaging dose. The article provides a simple equation to compute the compensation factor. The developed imaging compensation method was tested on routinely used clinical plans for prostate and head and neck patients. The quantitative comparison between the calculated dose by the TPS and measurement points on the cylindrical phantom were all within 3%. The dose percentage difference for the ion chamber placed in the center of the phantom was only 0.2%. For a typical MVCBCT, the dose delivered to patients forms a small anterior-posterior gradient ranging from 0.6 to 1.2 cGy per MVCBCT MU. MVCBCT acquisitions in the pelvis and head and neck areas deliver slightly more dose than current portal imaging but render soft tissue information for positioning. Overall, the additional dose from daily 9 MU MVCBCTs of prostate patients is small compared to the treatment dose (<4%). Dose-volume histograms of compensated plans for pelvis and head and neck patients imaged daily with MVCBCT showed no additional dose to the target and small increases at low doses. The results indicate that the dose delivered for MVCBCT imaging can be precisely calculated in the TPS and therefore included in the treatment plan. This allows simple plan compensations, such as slightly reducing the treatment dose, to minimize the total dose received by critical structures from daily positioning with MVCBCT. The proposed compensation factor reduces the number of MU per treatment beam per fraction. Both the number of fractions and the beam arrangement are kept unchanged. Reducing the imaging volume in the cranio-caudal direction can further reduce the dose delivered for MVCBCT. This is a useful feature to eliminate the imaging dose to the eyes or to focus on a specific region of interest for alignment.  相似文献   

3.
Megavoltage CT provides the ability to image the patient before, during or after a radiotherapy treatment. This allows one to verify not only the placement of a patient's external boundary, but also the locations of internal anatomy. In addition, the reconstructed MVCT values are potentially useful for treatment planning inhomogeneity corrections and dose reconstruction. To this end, dosimetric calibration of the University of Wisconsin Tomotherapy Benchtop MVCT system was investigated. It was found that MVCT values correlate extremely well with electron density and that unlike kilovoltage CT, this correlation is well maintained for higher atomic number materials. Improvements of the order of 1% in the dosimetric calculations of high atomic number materials should be possible by deriving input images from MVCT as opposed to kVCT, and calibrating in terms of electron density, as opposed to physical density.  相似文献   

4.
Accurate dose calculation is essential to precision radiation treatment planning and this accuracy depends upon anatomic and tissue electron density information. Modern treatment planning inhomogeneity corrections use x-ray CT images and calibrated scales of tissue CT number to electron density to provide this information. The presence of metal in the volume scanned by an x-ray CT scanner causes metal induced image artefacts that influence CT numbers and thereby introduce errors in the radiation dose distribution calculated. This paper investigates the dosimetric improvement achieved by a previously proposed x-ray CT metal artefact suppression technique when the suppressed images of a patient with bilateral hip prostheses are used in commercial treatment planning systems for proton, electron or photon therapies. For all these beam types, this clinical image and treatment planning study reveals that the target may be severely underdosed if a metal artefact-contaminated image is used for dose calculations instead of the artefact suppressed one. Of the three beam types studied, the metal artefact suppression is most important for proton therapy dose calculations, intermediate for electron therapy and least important for x-ray therapy but still significant. The study of a water phantom having a metal rod simulating a hip prosthesis indicates that CT numbers generated after image processing for metal artefact suppression are accurate and thus dose calculations based on the metal artefact suppressed images will be of high fidelity.  相似文献   

5.
This work compares Monte Carlo (MC) dose calculations for (125)I and (103)Pd low-dose rate (LDR) brachytherapy sources performed in virtual phantoms containing a series of human soft tissues of interest for brachytherapy. The geometries are segmented (tissue type and density assignment) based on simulated single energy computed tomography (SECT) and dual energy (DECT) images, as well as the all-water TG-43 approach. Accuracy is evaluated by comparison to a reference MC dose calculation performed in the same phantoms, where each voxel's material properties are assigned with exactly known values. The objective is to assess potential dose calculation accuracy gains from DECT. A CT imaging simulation package, ImaSim, is used to generate CT images of calibration and dose calculation phantoms at 80, 120, and 140 kVp. From the high and low energy images electron density ρ(e) and atomic number Z are obtained using a DECT algorithm. Following a correction derived from scans of the calibration phantom, accuracy on Z and ρ(e) of ±1% is obtained for all soft tissues with atomic number Z ? [6,8] except lung. GEANT4 MC dose calculations based on DECT segmentation agreed with the reference within ±4% for (103)Pd, the most sensitive source to tissue misassignments. SECT segmentation with three tissue bins as well as the TG-43 approach showed inferior accuracy with errors of up to 20%. Using seven tissue bins in our SECT segmentation brought errors within ±10% for (103)Pd. In general (125)I dose calculations showed higher accuracy than (103)Pd. Simulated image noise was found to decrease DECT accuracy by 3-4%. Our findings suggest that DECT-based segmentation yields improved accuracy when compared to SECT segmentation with seven tissue bins in LDR brachytherapy dose calculation for the specific case of our non-anthropomorphic phantom. The validity of our conclusions for clinical geometry as well as the importance of image noise in the tissue segmentation procedure deserves further experimental investigation.  相似文献   

6.
The incorporation of daily images into the radiotherapy process leads to adaptive radiation therapy (ART), in which the treatment is evaluated periodically and the plan is adaptively modified for the remaining course of radiotherapy. Deformable registration between the planning image and the daily images is a key component of ART. In this paper, we report our researches on deformable registration between the planning kVCT and the daily MVCT image sets. The method is based on a fast intensity-based free-form deformable registration technique. Considering the noise and contrast resolution differences between the kVCT and the MVCT, an 'edge-preserving smoothing' is applied to the MVCT image prior to the deformable registration process. We retrospectively studied daily MVCT images from commercial TomoTherapy machines from different clinical centers. The data set includes five head-neck cases, one pelvis case, two lung cases and one prostate case. Each case has one kVCT image and 20-40 MVCT images. We registered the MVCT images with their corresponding kVCT image. The similarity measures and visual inspections of contour matches by physicians validated this technique. The applications of deformable registration in ART, including 'deformable dose accumulation', 'automatic re-contouring' and 'tumour growth/regression evaluation' throughout the course of radiotherapy are also studied.  相似文献   

7.
A formalism tailored for portal dose image verification is proposed to facilitate the comparison of calculated and measured portal dose distributions. Each portal image is converted into a dose proportional image and normalized to the reference beam calibration dose per monitor unit. The calculated or measured dose to a detector phantom is accordingly normalized so as to enable direct comparison. The collapsed cone kernel superposition method is adapted and evaluated for calculation of portal dose distributions in a water-equivalent detector phantom through comparisons with Monte Carlo calculations and with measurements. The deviation compared with Monte Carlo calculations for 6 and 15 MV was between +0.9% (the 0.9 quantile) and -2.1% (the 0.1 quantile) for a range of investigated geometries. Collapsed cone calculations compared with measurements for clinical fields agreed within [-1.9%, +2.4%] for 15 MV and [-0.9%, +3.2%] for 6 MV for the 0.1 and 0.9 quantiles, respectively. Hence, the absolute portal dose to a detector phantom could be calculated and verified well within the present accuracy requirements for clinical dose calculations.  相似文献   

8.
This study describes the modeling and the experimental verification and clinical implementation of the alpha release of Pinnacle3 Monte Carlo (MC) electron beam dose calculation algorithm for patient-specific treatment planning. The MC electron beam modeling was performed for beam energies ranging from 6 to 18 MeV from a Siemens (Primus) linear accelerator using standard-shaped electron applicators and 100 cm source-to-surface distance (SSD). The agreement between MC calculations and measurements was, on average, within 2% and 2 mm for all applicator sizes. However, differences of the order of 3%-4% were noted in the off-axis dose profiles for the largest applicator modeled and for all energies. Output factors were calculated for standard electron cones and square cutouts inserted in the 10 x 10 cm2 applicator for different SSDs and were found to be within 4% of measured data. Experimental verification of the MC electron beam model was carried out using an ionization chamber and film in solid-water slab and anthropomorphic phantoms containing bone and lung materials. Agreement between calculated and measured dose distributions was within +/-3%. Clinical comparison was performed in four patient treatment plans with lesions in highly irregular anatomies, such as the ear, face, and breast, where custom-designed bolus and field shaping blocks were used in the patient treatments. For comparison purposes, treatment planning was also performed using the conventional pencil beam (PB) algorithm with the Pinnacle3 treatment planning system. Differences between MC and PB dose calculations for the patient treatment plans were significant, particularly in anatomies where the target was in close proximity to low density tissues, such as lung and air cavities. Concerning monitor unit calculations, the largest differences obtained between MC and PB algorithms were between 4.0% and 5.0% for two patients treated with oblique beams and involving highly irregular surfaces, i.e., breast and cheek. Clinical results are reported for overall uncertainty values (averaged over voxels with doses >50% dosemax) ranging from 2% to 0.3% and calculations were performed using cubic voxels with side 0.3 cm. Timing values ranged from 2 min to 24.5 h, depending on the field size, beam energy, number, and thickness of computed tomography slices used to define the patient's anatomy for the overall uncertainty values mentioned above.  相似文献   

9.
Experimental methods are commonly used for patient-specific intensity-modulated radiotherapy (IMRT) verification. The purpose of this study was to investigate the accuracy and performance of independent dose calculation software (denoted as 'MUV' (monitor unit verification)) for patient-specific quality assurance (QA). 52 patients receiving step-and-shoot IMRT were considered. IMRT plans were recalculated by the treatment planning systems (TPS) in a dedicated QA phantom, in which an experimental 1D and 2D verification (0.3 cm(3) ionization chamber; films) was performed. Additionally, an independent dose calculation was performed. The fluence-based algorithm of MUV accounts for collimator transmission, rounded leaf ends, tongue-and-groove effect, backscatter to the monitor chamber and scatter from the flattening filter. The dose calculation utilizes a pencil beam model based on a beam quality index. DICOM RT files from patient plans, exported from the TPS, were directly used as patient-specific input data in MUV. For composite IMRT plans, average deviations in the high dose region between ionization chamber measurements and point dose calculations performed with the TPS and MUV were 1.6 +/- 1.2% and 0.5 +/- 1.1% (1 S.D.). The dose deviations between MUV and TPS slightly depended on the distance from the isocentre position. For individual intensity-modulated beams (total 367), an average deviation of 1.1 +/- 2.9% was determined between calculations performed with the TPS and with MUV, with maximum deviations up to 14%. However, absolute dose deviations were mostly less than 3 cGy. Based on the current results, we aim to apply a confidence limit of 3% (with respect to the prescribed dose) or 6 cGy for routine IMRT verification. For off-axis points at distances larger than 5 cm and for low dose regions, we consider 5% dose deviation or 10 cGy acceptable. The time needed for an independent calculation compares very favourably with the net time for an experimental approach. The physical effects modelled in the dose calculation software MUV allow accurate dose calculations in individual verification points. Independent calculations may be used to replace experimental dose verification once the IMRT programme is mature.  相似文献   

10.
The advantages of a finite range of proton beams can only be partly exploited in radiation therapy unless the range can be predicted in patient anatomy with <2 mm accuracy (for non-moving targets). Monte Carlo dose calculation aims at 1-2 mm accuracy in dose prediction, and proton-induced PET imaging aims at ~2 mm accuracy in range verification. The latter is done using Monte Carlo predicted PET images. Monte Carlo methods are based on CT images to describe patient anatomy. The dose calculation algorithm and the CT resolution/artifacts might affect dose calculation accuracy. Additionally, when using Monte Carlo for PET range verification, the biological decay model and the cross sections for positron emitter production affect predicted PET images. The goal of this work is to study the effect of uncertainties in the CT conversion on the proton beam range predicted by Monte Carlo dose calculations and proton-induced PET signals. Conversion schemes to assign density and elemental composition based on a CT image of the patient define a unique Hounsfield unit (HU) to tissue parameters relationship. Uncertainties are introduced because there is no unique relationship between HU and tissue parameters. In this work, different conversion schemes based on a stoichiometric calibration method as well as different numbers of tissue bins were considered in three head and neck patients. For Monte Carlo dose calculation, the results show close to zero (<0.5 mm) differences in range using different conversion schemes. Further, a reduction of the number of bins used to define individual tissues down to 13 did not affect the accuracy. In the case of simulated PET images we found a more pronounced sensitivity on the CT conversion scheme with a mean fall-off position variation of about 1 mm. We conclude that proton dose distributions based on Monte Carlo calculation are only slightly affected by the uncertainty on density and elemental composition introduced by unique assignment to each HU if a stoichiometric calibration is used. Calculated PET images used for range verification are more sensitive to conversion uncertainties causing an intrinsic limitation due to CT conversion alone of at least 1 mm.  相似文献   

11.
Intensity-modulated arc therapy (IMAT), a technique which combines beam rotation and dynamic multileaf collimation, has been implemented in our clinic. Dosimetric errors can be created by the inability of the planning system to accurately account for the effects of tissue inhomogeneities and physical characteristics of the multileaf collimator (MLC). The objective of this study is to explore the use of Monte Carlo (MC) simulation for IMAT dose verification. The BEAM/DOSXYZ Monte Carlo system was implemented to perform dose verification for the IMAT treatment. The implementation includes the simulation of the linac head/MLC (Elekta SL20), the conversion of patient CT images and beam arrangement for 3D dose calculation, the calculation of gantry rotation and leaf motion by a series of static beams and the development of software to automate the entire MC process. The MC calculations were verified by measurements for conventional beam settings. The agreement was within 2%. The IMAT dose distributions generated by a commercial forward planning system (RenderPlan. Elekta) were compared with those calculated by the MC package. For the cases studied, discrepancies of over 10% were found between the MC and the RenderPlan dose calculations. These discrepancies were due in part to the inaccurate dose calculation of the RenderPlan system. The computation time for the IMAT MC calculation was in the range of 20-80 min on 15 Pentium-Ill computers. The MC method was also useful in verifying the beam apertures used in the IMAT treatments.  相似文献   

12.
Cone-beam CT (CBCT) images have recently become an established modality for treatment verification in radiotherapy. However, identification of soft-tissue structures and the calculation of dose distributions based on CBCT images is often obstructed by image artefacts and poor consistency of density calibration. A robust method for voxel-by-voxel enhancement of CBCT images using a priori knowledge from the planning CT scan has been developed and implemented. CBCT scans were enhanced using a low spatial frequency grey scale shading function generated with the aid of a planning CT scan from the same patient. This circumvents the need for exact correspondence between CBCT and CT and the process is robust to the appearance of unshared features such as gas pockets. Enhancement was validated using patient CBCT images. CT numbers in regions of fat and muscle tissue in the processed CBCT were both within 1% of the values in the planning CT, as opposed to 10-20% different for the original CBCT. Visual assessment of processed CBCT images showed improvement in soft-tissue visibility, although some cases of artefact introduction were observed.  相似文献   

13.
A commercial electron dose calculation software implementation based on the macro Monte Carlo algorithm has recently been introduced. We have evaluated the performance of the system using a standard verification data set comprised of two-dimensional (2D) dose distributions in the transverse plane of a 15 X 15 cm2 field. The standard data set was comprised of measurements performed for combinations of 9-MeV and 20-MeV beam energies and five phantom geometries. The phantom geometries included bone and air heterogeneities, and irregular surface contours. The standard verification data included a subset of the data needed to commission the dose calculation. Additional required data were obtained from a dosimetrically equivalent machine. In addition, we performed 2D dose measurements in a water phantom for the standard field sizes, a 4 cm X 4 cm field, a 3 cm diameter circle, and a 5 cm X 13 cm triangle for the 6-, 9-, 12-, 15-, and 18-MeV energies of a Clinac 21EX. Output factors were also measured. Synthetic CT images and structure contours duplicating the measurement configurations were generated and transferred to the treatment planning system. Calculations for the standard verification data set were performed over the range of each of the algorithm parameters: statistical precision, grid-spacing, and smoothing. Dose difference and distance-to-agreement were computed for the calculation points. We found that the best results were obtained for the highest statistical precision, for the smallest grid spacing, and for smoothed dose distributions. Calculations for the 21EX data were performed using parameters that the evaluation of the standard verification data suggested would produce clinically acceptable results. The dose difference and distance-to-agreement were similar to that observed for the standard verification data set except for the portion of the triangle field narrower than 3 cm for the 6- and 9-MeV electron beams. The output agreed with measurements to within 2%, with the exception of the 3-cm diameter circle and the triangle for 6 MeV, which were within 5%. We conclude that clinically acceptable results may be obtained using a grid spacing that is no larger than approximately one-tenth of the distal falloff distance of the electron depth dose curve (depth from 80% to 20% of the maximum dose) and small relative to the size of heterogeneities. For judicious choices of parameters, dose calculations agree with measurements to better than 3% dose difference and 3-mm distance-to-agreement for fields with dimensions no less than about 3 cm.  相似文献   

14.
Electronic portal imaging devices (EPIDs) are mainly used for patient setup verification during treatment but other geometric properties like block shape and leaf positions are also determined. Electronic portal dosimetry allows dosimetric treatment verification. By combining geometric and dosimetric information, the data transfer between treatment planning system (TPS) and linear accelerator can be verified which in particular is important when this transfer is not carried out electronically. We have developed a pretreatment verification procedure of geometric and dosimetric treatment parameters of a 10 MV photon beam using an EPID. Measurements were performed with a CCD camera-based iView EPID, calibrated to convert a greyscale EPID image into a two-dimensional absolute dose distribution. Central field dose calculations, independent of the TPS, are made to predict dose values at a focus-EPID distance of 157.5 cm. In the same EPID image, the presence of a wedge, its direction, and the field size defined by the collimating jaws were determined. The accuracy of the procedure was determined for open and wedged fields for various field sizes. Ionization chamber measurements were performed to determine the accuracy of the dose values measured with the EPID and calculated by the central field dose calculation. The mean difference between ionization chamber and EPID dose at the center of the fields was 0.8 +/- 1.2% (1 s.d.). Deviations larger than 2.5% were found for half fields and fields with a jaw in overtravel. The mean difference between ionization chamber results and the independent dose calculation was -0.21 +/- 0.6% (1 s.d.). For all wedged fields, the presence of the wedge was detected and the mean difference in actual and measured wedge direction was 0 +/- 3 degrees (1 s.d.). The mean field size differences in X and Y directions were 0.1 +/- 0.1 cm and 0.0 +/- 0.1 cm (1 s.d.), respectively. Pretreatment monitor unit verification is possible with high accuracy and also geometric parameters can be verified using the same EPID image.  相似文献   

15.
The verification of intensity-modulated radiation therapy (IMRT) is necessary for adequate quality control of the treatment. Pretreatment verification may trace the possible differences between the planned dose and the actual dose delivered to the patient. To estimate the impact of differences between planned and delivered photon beams, a three-dimensional (3-D) dose verification method has been developed that reconstructs the dose inside a phantom. The pretreatment procedure is based on portal dose images measured with an electronic portal imaging device (EPID) of the separate beams, without the phantom in the beam and a 3-D dose calculation engine based on the Monte Carlo calculation. Measured gray scale portal images are converted into portal dose images. From these images the lateral scattered dose in the EPID is subtracted and the image is converted into energy fluence. Subsequently, a phase-space distribution is sampled from the energy fluence and a 3-D dose calculation in a phantom is started based on a Monte Carlo dose engine. The reconstruction model is compared to film and ionization chamber measurements for various field sizes. The reconstruction algorithm is also tested for an IMRT plan using 10 MV photons delivered to a phantom and measured using films at several depths in the phantom. Depth dose curves for both 6 and 10 MV photons are reconstructed with a maximum error generally smaller than 1% at depths larger than the buildup region, and smaller than 2% for the off-axis profiles, excluding the penumbra region. The absolute dose values are reconstructed to within 1.5% for square field sizes ranging from 5 to 20 cm width. For the IMRT plan, the dose was reconstructed and compared to the dose distribution with film using the gamma evaluation, with a 3% and 3 mm criterion. 99% of the pixels inside the irradiated field had a gamma value smaller than one. The absolute dose at the isocenter agreed to within 1% with the dose measured with an ionization chamber. It can be concluded that our new dose reconstruction algorithm is able to reconstruct the 3-D dose distribution in phantoms with a high accuracy. This result is obtained by combining portal dose images measured prior to treatment with an accurate dose calculation engine.  相似文献   

16.
研究在千伏级锥形束CT(CBCT)图像中不同的能量对X-ray Voxel Monte Carlo(XVMC)算法剂量计算精度的影响。采用CIRS062模体刻度CT和CBCT图像的CT值-相对电子密度表,用头颈部人体仿真模体(CDP)在相同摆位条件下分别行CT和CBCT扫描,并在CDP中模拟局部进展期鼻咽癌病例,在Monaco计划系统中设计IMRT计划,选取的能量包括6MV和15MV光子,用XVMC算法分别对CT和CBCT图像进行剂量计算,排除旋转摆位误差等其他因素带来的误差后对CT和CBCT计划的结果进行比较,并分析能量因素产生的影响。DVHs、靶区和危及器官受量的比较以及靶区剂量适型度和均匀性的比较均显示了CT和CBCT计划有较好的符合度,从多数评估指标来看,15MV能量时CT和CBCT计划的偏差更小。对CT和CBCT计划的剂量分布的比较采用γ分析,标准是2mm/2%,阈值是10%,6MV能量时各个平面的平均通过率分别是99.3%±0.47%,15MV能量时则是99.4%±0.44%。显示出CBCT图像重新进行相对电子密度刻度后用XVMC算法进行剂量计算时具有良好的精度,选用15MV能量时计算结果精度更高。  相似文献   

17.
A formalism for an independent dose verification of the Gamma Knife treatment planning is developed. It is based on the approximation that isodose distribution for a single shot is in the shape of an ellipsoid in three-dimensional space. The dose profiles for a phantom along each of the three major axes are fitted to a function which contains the terms that represent the contributions from a point source, an extrafocal scattering, and a flat background. The fitting parameters are extracted for all four helmet collimators, at various shot locations, and with different skull shapes. The 33 parameters of a patient's skull shape obtained from the Skull Scaling Instrument measurements are modeled for individual patients. The relative doses for a treatment volume in the form of 31 x 31 x 31 matrix of points are extracted from the treatment planning system, the Leksell Gamma-Plan (LGP). Our model evaluates the relative doses using the same input parameters as in the LGP, which are skull measurement data, shot location, weight, gamma-angle of the head frame, and helmet collimator size. For 29 single-shot cases, the discrepancy of dose at the focus point between the calculation and the LGP is found to be within -1% to 2%. For multi-shot cases, the value and the coordinate of the maximum dose point from the calculation agree within +/-7% and +/-3 mm with the LGP results. In general, the calculated doses agree with the LGP calculations within +/-10% for the off-center locations. Results of calculation with this method for the dimension and location of the 50% isodose line are in good agreement with results from Leksell GammaPlan. Therefore, this method can be served as a useful tool for secondary quality assurance of Gamma Knife treatment plans.  相似文献   

18.
19.
Despite the capability of energy modulated electron therapy (EMET) to achieve highly conformal dose distributions in superficial targets it has not been widely implemented due to problems inherent in electron beam radiotherapy such as planning dosimetry accuracy, and verification as well as a lack of systems for automated delivery. In previous work we proposed a novel technique to deliver EMET using an automated "few leaf electron collimator" (FLEC) that consists of four motor-driven leaves fit in a standard clinical electron beam applicator. Integrated with a Monte Carlo based optimization algorithm that utilizes patient-specific dose kernels, a treatment delivery was incorporated within the linear accelerator operation. The FLEC was envisioned to work as an accessory tool added to the clinical accelerator. In this article the design and construction of the FLEC prototype that match our compact design goals are presented. It is controlled using an in-house developed EMET controller. The structure of the software and the hardware characteristics of the EMET controller are demonstrated. Using a parallel plate ionization chamber, output measurements were obtained to validate the Monte Carlo calculations for a range of fields with different energies and sizes. Further verifications were also performed for comparing 1-D and 2-D dose distributions using energy independent radiochromic films. Comparisons between Monte Carlo calculations and measurements of complex intensity map deliveries show an overall agreement to within +/- 3%. This work confirms our design objectives of the FLEC that allow for automated delivery of EMET. Furthermore, the Monte Carlo dose calculation engine required for EMET planning was validated. The result supports the potential of the prototype FLEC for the planning and delivery of EMET.  相似文献   

20.
Kehwar TS  Huq MS 《Medical physics》2008,35(4):1214-1222
This study outlines an improved method for calculating dose per monitor unit values for irregularly shaped electron fields using the nth root percent depth dose method. This method calculates the percent depth dose and output factors for an irregularly shaped electron field directly from the measured electron beam percent depth dose curves and output factors for circular fields. The percent depth dose curves and output factors for circular fields are normalized and measured at a fixed depth of maximum dose for a reference field, respectively. When compared with the sector integral lateral buildup ratio method, the percent depth dose data calculated using the nth root method accounts more accurately for the change in lateral scatter with decreasing field size. Therefore, it provides more accurate values of dose per monitor unit at different depths for all type of field shapes and beam energies. For beam energies in the range of 6-21 MeV, the differences between measured and calculated dose per monitor unit values, at different depths, were found to be within +/- 1.0% when the nth root percent depth dose method was used for calculation and 12.6% when the sector integral lateral buildup ratio method was used. The nth root percent depth dose method was tested and compared with the sector integral lateral buildup ratio method for ten clinically used irregularly shaped inserts (cutouts). For small irregularly shaped fields, a maximum difference of 2% was found between calculated dose per monitor unit values and measurements when the nth root percent depth dose method was used; this difference changed to 7% when comparisons were made between measurements and calculations based on the sector integral lateral buildup ration method. For large irregular fields this difference was found to be within 1.5% and 3.5%, respectively.  相似文献   

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