The aim of this study is to compare between proton boron fusion therapy (PBFT) and boron neutron capture therapy (BNCT) and to analyze dose escalation using a Monte Carlo simulation. We simulated a proton beam passing through the water with a boron uptake region (BUR) in MCNPX. To estimate the interaction between neutrons/protons and borons by the alpha particle, the simulation yielded with a variation of the center of the BUR location and proton energies. The variation and influence about the alpha particle were observed from the percent depth dose (PDD) and cross-plane dose profile of both the neutron and proton beams. The peak value of the maximum dose level when the boron particle was accurately labeled at the region was 192.4% among the energies. In all, we confirmed that prompt gamma rays of 478 keV and 719 keV were generated by the nuclear reactions in PBFT and BNCT, respectively. We validated the dramatic effectiveness of the alpha particle, especially in PBFT. The utility of PBFT was verified using the simulation and it has a potential for application in radiotherapy.

The purpose of this work is to evaluate the Standard Imaging Exradin W2 plastic scintillation detector (W2) for use in the types of fields used for stereotactic radiosurgery. Methods: Prior to testing the W2 in small fields, the W2 was evaluated in standard large field conditions to ensure good detector performance. These tests included energy dependence, short-term repeatability, dose-response linearity, angular dependence, temperature dependence, and dose rate dependence. Next, scan settings and calibration of the W2 were optimized to ensure high quality data acquisition. Profiles of small fields shaped by cones and multi-leaf collimator (MLCs) were measured using the W2 and IBA RAZOR diode in a scanning water tank. Output factors for cones (4-17.5 mm) and MLC fields (1, 2, 3 cm) were acquired with both detectors. Finally, the dose at isocenter for seven radiosurgery plans was measured with the W2 detector. Results: W2 exhibited acceptable warm-up behavior, short-term reproducibility, axial angular dependence, dose-rate linearity, and dose linearity. The detector exhibits a dependence upon energy, polar angle, and temperature. Scanning measurements taken with the W2 and RAZOR were in good agreement, with full-width half -maximum and penumbra widths agreeing to within 0.1 mm. The output factors measured by the W2 and RAZOR exhibited a maximum difference of 1.8%. For the seven point-dose measurements of radiosurgery plans, the W2 agreed well with our treatment planning system with a maximum deviation of 2.2%. The Čerenkov light ratio calibration method did not significantly impact the measurement of relative profiles, output factors, or point dose measurements. Conclusion:The W2 demonstrated dosimetric characteristics that are suitable for radiosurgery field measurements. The detector agreed well with the RAZOR diode for output factors and scanned profiles and showed good agreement with the treatment planning system in measurements of clinical treatment plans.

The ionization chamber volume averaging effect is a well-known issue without an elegant solution. The purpose of this study is to propose a novel convolution-based approach to address the volume averaging effect in model-based treatment planning systems (TPSs). Ionization chamber-measured beam profiles can be regarded as the convolution between the detector response function and the implicit real profiles. Existing approaches address the issue by trying to remove the volume averaging effect from the measurement. In contrast, our proposed method imports the measured profiles directly into the TPS and addresses the problem by reoptimizing pertinent parameters of the TPS beam model. In the iterative beam modeling process, the TPS-calculated beam profiles are convolved with the same detector response function. Beam model parameters responsible for the penumbra are optimized to drive the convolved profiles to match the measured profiles. Since the convolved and the measured profiles are subject to identical volume averaging effect, the calculated profiles match the real profiles when the optimization converges. The method was applied to reoptimize a CC13 beam model commissioned with profiles measured with a standard ionization chamber (Scanditronix Wellhofer, Bartlett, TN). The reoptimized beam model was validated by comparing the TPS-calculated profiles with diode-measured profiles. Its performance in intensity-modulated radiation therapy (IMRT) quality assurance (QA) for ten head-and-neck patients was compared with the CC13 beam model and a clinical beam model (manually optimized, clinically proven) using standard Gamma comparisons. The beam profiles calculated with the reoptimized beam model showed excellent agreement with diode measurement at all measured geometries. Performance of the reoptimized beam model was comparable with that of the clinical beam model in IMRT QA. The average passing rates using the reoptimized beam model increased substantially from 92.1% to 99.3% with 3%/3 mm and from 79.2% to 95.2% with 2%/2 mm when compared with the CC13 beam model. These results show the effectiveness of the proposed method. Less inter-user variability can be expected of the final beam model. It is also found that the method can be easily integrated into model-based TPS.

The management of a pregnant patient in radiation oncology is an infrequent event requiring careful consideration by both the physician and physicist. The aim of this manuscript was to highlight treatment planning techniques and detail measurements of fetal dose for a pregnant patient recently requiring treatment for a brain cancer. A 27‐year‐old woman was treated during gestational weeks 19–25 for a resected grade 3 astrocytoma to 50.4 Gy in 28 fractions, followed by an additional 9 Gy boost in five fractions. Four potential plans were developed for the patient: a 6 MV 3D‐conformal treatment plan with enhanced dynamic wedges, a 6 MV step‐and‐shoot (SnS) intensity‐modulated radiation therapy (IMRT) plan, an unflattened 6 MV SnS IMRT plan, and an Accuray TomoTherapy HDA helical IMRT treatment plan. All treatment plans used strategies to reduce peripheral dose. Fetal dose was estimated for each treatment plan using available literature references, and measurements were made using thermoluminescent dosimeters (TLDs) and an ionization chamber with an anthropomorphic phantom. TLD measurements from a full‐course radiation delivery ranged from 1.0 to 1.6 cGy for the 3D‐conformal treatment plan, from 1.0 to 1.5 cGy for the 6 MV SnS IMRT plan, from 0.6 to 1.0 cGy for the unflattened 6 MV SnS IMRT plan, and from 1.9 to 2.6 cGy for the TomoTherapy treatment plan. The unflattened 6 MV SnS IMRT treatment plan was selected for treatment for this particular patient, though the fetal doses from all treatment plans were deemed acceptable. The cumulative dose to the patient's unshielded fetus is estimated to be 1.0 cGy at most. The planning technique and distance between the treatment target and fetus both contributed to this relatively low fetal dose. Relevant treatment planning strategies and treatment delivery considerations are discussed to aid radiation oncologists and medical physicists in the management of pregnant patients.

This novel analytical model with minimum measurement requirements was proved to accurately calculate PDDs, profiles, and S(cp) for different field sizes, depths, and energies.

Although all three DRFs were found adequate to represent the response of the studied ionization chambers, the Gaussian function was favored due to its superior overall performance. The geometry dependence of the DRFs can be significant for clinical applications involving small fields such as stereotactic radiotherapy.

Daily output variations of up to ±2% were observed for a protracted time on a Varian TrueBeam® STx; these output variations were hypothesized to be the result of atmospheric communication of the sealed monitor chamber. Daily changes in output relative to baseline, measured with an ionization chamber array (DQA3) and the amorphous silicon flat panel detector (IDU) on the TrueBeam®, were compared with daily temperature-pressure corrections (P TP) determined from sensors within the DQA3. Output measurements were performed using a Farmer® ionization chamber over a 5-hour period, during which there was controlled variation in the monitor chamber temperature. The root mean square difference between percentage output change from baseline measured with the DQA3 and IDU was 0.50% over all measurements. Over a 7-month retrospective review of daily changes in output and P TP , weak correlation (R 2 = 0.30) was observed between output and P TP for the first 5 months; for the final 2 months, daily output changes were linearly correlated with changes in P TP , with a slope of 0.84 (R 2 = 0.89). Ionization measurements corrected for ambient temperature and pressure during controlled heating and cooling of the monitor chamber differed from expected values for a sealed monitor chamber by up to 4.6%, but were consistent with expectation for an aircommunicating monitor chamber within uncertainty (1.3%, k = 2). Following replacement of the depressurized monitor chamber, there has been no correlation between daily percentage change in output and P TP (R 2 = 0.09). The utility of control charts is demonstrated for earlier identification of changes in the sensitivity of a sealed monitor chamber.

The aim of this study is to perform a direct comparison of the source model for photon beams with and without flattening filter (FF) and to develop an efficient independent algorithm for planar dose calculation for FF‐free (FFF) intensity‐modulated radiotherapy (IMRT) quality assurance (QA). The source model consisted of a point source modeling the primary photons and extrafocal bivariate Gaussian functions modeling the head scatter, monitor chamber backscatter, and collimator exchange effect. The model parameters were obtained by minimizing the difference between the calculated and measured in‐air output factors (S c). The fluence of IMRT beams was calculated from the source model using a backprojection and integration method. The off‐axis ratio in FFF beams were modeled with a fourth degree polynomial. An analytical kernel consisting of the sum of three Gaussian functions was used to describe the dose deposition process. A convolution‐based method was used to account for the ionization chamber volume averaging effect when commissioning the algorithm. The algorithm was validated by comparing the calculated planar dose distributions of FFF head‐and‐neck IMRT plans with measurements performed with a 2D diode array. Good agreement between the measured and calculated S c was achieved for both FF beams (<0.25%) and FFF beams (<0.10%). The relative contribution of the head‐scattered photons reduced by 34.7% for 6 MV and 49.3% for 10 MV due to the removal of the FF. Superior agreement between the calculated and measured dose distribution was also achieved for FFF IMRT. In the gamma comparison with a 2%/2 mm criterion, the average passing rate was 96.2 ± 1.9% for 6 MV FFF and 95.5 ± 2.6% for 10 MV FFF. The efficient independent planar dose calculation algorithm is easy to implement and can be valuable in FFF IMRT QA.