Purpose: The dosimetric accuracy of the recently released Acuros XB advanced dose calculation algorithm (Varian Medical Systems, Palo Alto, CA) is investigated for single radiation fields incident on homogeneous and heterogeneous geometries, as well as for two arc (VMAT) cases and compared against the analytical anisotropic algorithm (AAA), the collapsed cone convolution superposition algorithm (CCCS) and Monte Carlo (MC) calculations for the same geometries. Methods and Materials: Small open fields ranging from 1 × 1 cm 2 to 5 × 5 cm 2 were used for part of this study. The fields were incident on phantoms containing lung, air, and bone inhomogeneities. The dosimetric accuracy of Acuros XB, AAA and CCCS in the presence of the inhomogeneities was compared against BEAMnrc/DOSXYZnrc calculations that were considered as the benchmark. Furthermore, two clinical cases of arc deliveries were used to test the accuracy of the dose calculation algorithms against MC. Results: Open field tests in a homogeneous phantom showed good agreement between all dose calculation algorithms and MC. The dose agreement was +/−1.5% for all field sizes and energies. Dose calculation in heterogenous phantoms showed that the agreement between Acuros XB and CCCS was within 2% in the case of lung and bone. AAA calculations showed deviation of approximately 5%. In the case of the air heterogeneity, the differences were larger for all calculations algorithms. The calculation in the patient CT for a lung and bone (paraspinal targets) showed that all dose calculation algorithms predicted the dose in the middle of the target accurately; however, small differences (2%-5%) were observed at the low dose region. Overall, when compared to MC, the Acuros XB and CCCS had better agreement than AAA. Conclusions: The Acuros XB calculation algorithm in the newest version of the Eclipse treatment planning system is an improvement over the existing AAA algorithm. The results are comparable to CCCS and MC calculations especially for both stylized and clinical cases. Dose discrepancies were observed for extreme cases in the presence of air inhomogeneities.
Purpose: To evaluate a novel reference chamber (Stealth Chamber by IBA) through experimental data and Monte Carlo simulations for 6 and 15 MV photon energies. Methods: Monte Carlo simulations in a water phantom for field sizes ranging from 3×3 and 25×25 cm 2 were performed for both energies with and without the Monte Carlo model of the Stealth Chamber in the beam path, and compared to commissioning beam data. Percent depth doses (PDDs), profiles, and gamma analysis of the simulations were performed along with an energy spectrum analysis of the phase-space files generated during the simulation. Experimental data were acquired in water with IBA three-dimensional (3D) blue phantom in a set-up identical to the one used in the Monte Carlo simulations. PDD comparisons for fields ranging from 1×1 to 25×25 cm 2 were performed for photon energies. Profile comparison for fields ranging from 1×1 to 25×25 cm 2 were executed for the depths of dmax, 5, 10 and 20 cm. Criteria of 1%, 1 mm to compare PDDs and profiles were used. Transmission measurements with the Stealth Chamber and a Matrixx detector from IBA were investigated. Measurements for 6 and 15 MV with fields ranging from 3×3 to 25×25 cm 2 dimensions were acquired in an open field with and without the Stealth Chamber in the path of the beam. Profiles and gamma analysis with a 1%, 1 mm gamma analysis criterion were performed. Results: Monte Carlo simulations of the PDDs and profiles demonstrate the agreement between both simulations. Furthermore, the gamma analysis (1%, 1 mm) result of the comparison of both planes has 100% of the points passing the criteria. The spectral distribution analysis of the phase spaces for an open field with and without the chamber reveals the agreement between both simulations. Experimental measurements of PDDs and profiles have been conducted and reveal the comparability of relative dosimetric data acquired with the Stealth Chamber and our gold standard the CC13 chamber. Transmission data measured with an ion chamber array (Matrixx) showed the small attenuation caused by the use of the Stealth Chamber. Conclusion: Simulations and experimental results from this investigation indicate the benefits associated with chamber positioning and time expended during the acquisition of the relative measurements of PDDs and profiles for the beam commissioning of photon beams when the Stealth Chamber is used as a reference chamber to perform these tasks. The results demonstrate that relative profiles and PDDs scanned with the Stealth Chamber in place are consistent with those made using a CC13 chamber within a 1% and 1 mm criterion.
Purpose: This research, investigates the viability of using the Electronic portal imaging device (EPID) coupled with the treatment planning system (TPS), to calculate the doses delivered and verify agreement with the treatment plan. The results of QA analysis using the EPID, Delta 4 and fluence calculations using the multi-leaf collimator (MLC) dynalog files on 10 IMRT patients are presented in this study.Methods: EPID Fluence Images in integrated mode and Dynalog files for each field were acquired for 10 IMRT (6MV) patients and processed through an in house MatLab program to create an opening density matrix (ODM) which was used as the input fluence for dose calculation with the TPS (Pinnacle 3 , Philips). The EPID used in this study was the aSi1000 Varian on a Novalis TX linac equipped with high definition MLC. The resulting dose distributions were then exported to VeriSoft (PTW) where a 3D gamma was calculated using 3 mm-3% criteria. The Scandidos Delta 4 phantom was also used to measure a 2D dose distribution for all 10 patients and a 2D gamma was calculated for each patient using the Delta 4 software. Results:The average 3D gamma for all 10 patients using the EPID images was 98.2% ± 2.6%. The average 3D gamma using the dynalog files was 94.6% ± 4.9%. The average 2D gamma from the Delta 4 was 98.1% ± 2.5%. The minimum 3D gamma for the EPID and dynalog reconstructed dose distributions was found on the same patient which had a very large PTV, requiring the jaws to open to the maximum field size. Conclusion:Use of the EPID, combined with a TPS is a viable method for QA of IMRT plans. A larger ODM size can be implemented to accommodate larger field sizes. An adaptation of this process to Volumetric Arc Therapy (VMAT) is currently under way.
Purpose: To study the perturbation due to the use of a novel Reference Ion Chamber designed to measure small field dosimetry (KermaX Plus C by IBA). Methods: Using the Phase‐space files for TrueBeam photon beams available by Varian in IAEA‐compliant format for 6 and 15 MV. Monte Carlo simulations were performed using BEAMnrc and DOSXYZnrc to investigate the perturbation introduced by a reference chamber into the PDDs and profiles measured in water tank. Field sizes ranging from 1×1, 2×2,3×3, 5×5 cm2 were simulated for both energies with and without a 0.5 mm foil of Aluminum which is equivalent to the attenuation equivalent of the reference chamber specifications in a water phantom of 30×30×30 cm3 and a pixel resolution of 2 mm. The PDDs, profiles, and gamma analysis of the simulations were performed as well as a energy spectrum analysis of the phase‐space files generated during the simulation. Results: Examination of the energy spectrum analysis performed shown a very small increment of the energy spectrum at the build‐up region but no difference is appreciated after dmax. The PDD, profiles and gamma analysis had shown a very good agreement among the simulations with and without the Al foil, with a gamma analysis with a criterion of 2% and 2mm resulting in 99.9% of the points passing this criterion. Conclusion: This work indicates the potential benefits of using the KermaX Plus C as reference chamber in the measurement of PDD and Profiles for small fields since the perturbation due to in the presence of the chamber the perturbation is minimal and the chamber can be considered transparent to the photon beam.
Purpose: To develop a 2nd dose validation software for helical TomoTherapy, study the sensitivity of the commission data variation on the final dosimetry impact, and inter‐fraction setup uncertainty effect for patient quality assurance. Method and Materials: A 2nd dose validation software for helical TomoTherapy, called MU‐Tomo, has been developed to independently validates point dose upon archived patient documents, initial coordinates and planned dose of point of calculation, and common dosimetric functions. MU‐Tomo has been validated with a hundred cancer cases (30 prostate, 26 head&neck, 18 lung, 17 pelvis, and 9 brain patients). Sensitivity studies were performed by oscillating fluctuation regions of off‐axis profiles, shifting, and rotating profiles. Daily setup shifts were quantified into systematic and random shifts to evaluate dosimetric variations, separately. Results: For dose validation, 98% of dose differences are within ±5% with mean 0.20%±2.06%. Sensitivity studies show linear response by oscillating OARy, 15 times larger dose variation by shifting OARy than OARx, and less than 1.5% difference by rotating OARx in ±6° and more than 5% in ±1° by rotating OARy. Systematic variations are up to −10.02%±3.00%. Mean random variations are up to −5.65%±1.90%. ANOVA analyses show significant differences among patient random dosimetric variations and systematic dosimetric variations between head&neck‐brain group and body group. Variations are not significantly correlated with treatment fraction number with the Pearson correlation analysis. The overall random dosimetric impacts to each patient are ‐ 0.0053%±1.11%. Conclusion: MU‐Tomo, has been developed for TomoTherapy dose validation. Sensitivity studies on fifty patients have been evaluated that OARy profiles are more sensitive than OARx in dose calculation. Dosimetric consequences due to inter‐fractional setup shifts on a hundred helical tomotherapy patients were assessed. Conflict of Interest: This project was supported in part by Oncology Data Systems, Inc., Oklahoma City, OK, USA.
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