Gas desorption and electron emission coefficients were measured for 1 MeV potassium ions incident on stainless steel at grazing angles (between 80 and 88 from normal incidence) using a new gaselectron source diagnostic (GESD). Issues addressed in design and commissioning of the GESD include effects from backscattering of ions at the surface, space-charge limited emission current, and reproducibility of desorption measurements. We find that electron emission coefficients e scale as 1= cos up to angles of 86 , where e 90. Nearer grazing incidence, e is reduced below the 1= cos scaling by nuclear scattering of ions through large angles, reaching e 135 at 88. Electrons were emitted with a measured temperature of 30 eV. Gas desorption coefficients 0 were much larger, of order 0 10 4. They also varied with angle, but much more slowly than 1= cos. From this we conclude that the desorption was not entirely from adsorbed layers of gas on the surface. Two mitigation techniques were investigated: rough surfaces reduced electron emission by a factor of 10 and gas desorption by a factor of 2; a mild bake to 220 had no effect on electron emission, but decreased gas desorption by 15% near grazing incidence. We propose that gas desorption is due to electronic sputtering.

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We propose a clinical workflow of stereotactic volumetric modulated arc therapy (VMAT) for a lung tumor from planning to tumor position verification using 4D planning computed tomography (CT) and 4D cone-beam CT (CBCT). A 4D CT scanner, an Anzai belt and a BodyFix were employed to obtain 10-phase respiratory-correlated CT data for a lung patient under constrained breathing conditions. A planning target volume (PTV) was defined by adding a 5-mm margin to an internal target volume created from 10 clinical target volumes, each of which was delineated on each of the 10-phase planning CT data. A single-arc VMAT plan was created with a D95 prescription dose of 50 Gy in four fractions on the maximum exhalation phase CT images. The PTV contours were exported to a kilovoltage CBCT X-ray Volume Imaging (XVI) equipped with a linear accelerator (linac). Immediately before treatment, 10-phase 4D CBCT images were reconstructed leading to animated lung tumor imaging. Initial bone matching was performed between frame-averaged 4D planning CT and frame-averaged 4D CBCT datasets. Subsequently, the imported PTV contours and the animated moving tumor were simultaneously displayed on the XVI monitor, and a manual 4D registration was interactively performed on the monitor until the moving tumor was symmetrically positioned inside the PTV. A VMAT beam was delivered to the patient and during the delivery further 4D CBCT projection data were acquired to verify the tumor position. The entire process was repeated for each fraction. It was confirmed that the moving tumor was positioned inside the PTV during the VMAT delivery.

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We have successfully created a single arc volumetric modulated arc therapy (VMAT) plan for treating post-surgical left breast/chest wall and regional nodes using Elekta multileaf collimator (MLC). Dose volume histograms (DVHs) were compared between the VMAT plans and conventional tangential beam plans using a field-in-field technique, leading to significant DVH advantages in the VMAT plans. The difference between Elekta VMAT and Varian RapidArc due to different MLC designs was discussed in terms of the number of arcs required to cover a large target, highlighting a single arc capability of Elekta VMAT for a large target volume which may be less sensitive to unexpected organ motion during dose delivery.