Purpose
Half‐beam block is a field matching technique frequently used in radiotherapy. With no setup error, a well calibrated linac, and no internal organ motion, two photon fields can be matched seamlessly dosimetry‐wise with their central axes passing the match line. However, in actual clinical situations, internal organ motion is often inevitable. This study was conducted to investigate its influence on radiation dose to patient internal points directly under the matching line.
Methods
A clinical setting is modeled as two half‐space (x<0 and x<0) radiation fields that are turned on sequentially with a time gap of integer times of the patient internal organ motion period (T0). Our point of interest moves with patient internal organs periodically and evenly in and out of the radiation fields, resulting in an average location at x=0. When the fields are delivered without any motion management, the initial phase of the point's movement is unknown. Statistical methods are used to compute the expected value (
Purpose: To examine the effectiveness of the coefficient of variation, skewness (third central moment), and kurtosis (fourth central moment) in quantifying and characterizing the target dose distribution in brain stereotactic radiosurgery (SRS) cases. Methods: Twenty‐one brain lesions in eighteen SRS patients treated using non‐coplanar dynamic conformal arcs were randomly selected. Setup errors of these patients were extracted from clinical ExacTrac data. Retrospective plans were generated based on the ExacTrac data to simulate the effects of patient positioning errors. The coefficient of variation, skewness, and kurtosis were used to analyze the dose distribution of the planning target volume (PTV). These variables were computed from the dose‐volume histogram of the PTV. For each patient, the ratios of the variables were calculated between treatment plans with and without setup errors. Results: The magnitude of patient setup errors ranged from 0.28 mm to 2.78 mm, with an average of 1.35 ±0.67 mm. The average ratio of coefficient of variation was 1.63 ±1.25, the ratio of the skewness was 1.40 ±0.41, and the ratio of the kurtosis was 1.26 ±0.33. These ratios were in accordance with the fact that when setup errors existed, the PTV dose distribution generally became broader, more asymmetric, and less uniform. The values of the skewness were negative, reflecting that upon setup errors part of the PTV fell into regions of lower doses. Anova analysis showed significant differences between the coefficient of variation (p=0.037), the skewness (p=0.02), and the kurtosis (p=0.01) with and without patient setup errors. Conclusion: The coefficient of variation, skewness, and kurtosis were introduced to PTV dose distribution analysis. It was found that those variables were good measures of the characteristics of the PTV dose distribution. They may be useful parameters in the evaluation of treatment plan quality.
Purpose: To study the effect of limited angular resolution of pencil beam calculation (PBC) on dynamic conformal arc plan (DCAP) in iPlan (BrainLab) using the ArcCHECK sytem and 3DVH software (Sun Nuclear Corporation). Methods: Four DCAPs were generated in iPlan RT Dose 4.5 treatment planning system on the ArcCHECK cylindrical phantom with central planning target volume (PTV). A cylindrical shell structure (SHELL) 2.85cm from phantom surface and 1.5 mm thickness was created to simulate the ArcCHECK diode array. Planned doses were calculated using both Monte Carlo calculation (MCC) and PBC algorithms, and exported to 3DVH software for global and target based comparisons using the 3Dgamma index. Four additional DCAPs were created and calculated on patient CT images and mapped onto the ArcCHECK phantom for measurement using a Varian TrueBeam STx. The measurements were compared against both MC and PB calculation using gamma index analysis. Results: For the ArcCHECK phantom, the dose distribution agreement quantified with 3D‐gamma index is better (average‐gamma (<γ>)=99.9%vs.79.1% and 96.8%vs45.7%, p=0.0294, 0.0286 for gamma (2mm,2%) and (1mm,1%) criteria respectively using Mann‐Whitney U test) in the PTV than in the SHELL. The measurements show better agreement with MCC than the PB (<γ>=100%vs.86.7%, 99.6%vs.72.3%, 85.5%vs.50.8%, p=0.021, 0.026, 0.029 for gamma (3mm,3%), (2mm,2%) and (1mm,1%) criteria using Mann‐Whitney U test respectively). The effect due to limited (10 degree) angular resolution of the PBC was observed, and it can be one of the possible reasons for poor agreement between measurement and PB calculation. Conclusion: The PBC of iPlan shows poor peripheral dose calculation accuracy for dynamic conformal arc plans due to limited angular resolution, but it performs well in the area close to target volume without considering heterogeneity. Since the user cannot change the 10 degree angular resolution of PBC, MCC is more appropriate for dynamic conformal arc plans.
Purpose The accuracy of Varian PerfectPitch six degree of freedom (DOF) robotic couch was examined using Varian Isocal phantom and cone‐beam CT (CBCT) system. Methods CBCT images of the Isocal phantom were taken at different pitch and roll angles. The pitch and roll angles were varied from 357 to 3 degrees in one degree increments by input from service console, generating a total of 49 combinations with couch angle (yaw) zero. The center positions of the 16 tungsten carbide BBs contained in the Isocal were determined with in‐house image processing software. Expected BBs positions at different rotation angles were determined mathematically by applying a combined translation/rotation operator to BB positions at zero pitch and roll values. A least square method was used to minimize the difference between the expected BB positions and their measured positions. In this way rotation angles were obtained and compared with input values from the console. Results A total of 49 CBCT images with voxel sizes 0.51 mm × 0.51 mm × 1 mm were used in analysis. Among the 49 calculations, the maximum rotation angle differences were 0.1 degree, 0.15 degree, and 0.09 degree, for pitch, roll, and couch rotation, respectively. The mean ± standard‐deviation angle differences were 0.028±0.001 degree, −0.043±0.003 degree, and −0.009±0.001 degree, for pitch, roll, and couch rotation, respectively. The maximum isocenter shifts were 0.3 mm, 0.5 mm, 0.4 mm in x, y, z direction respectively following IEC6127 convention. The mean isocenter shifts were 0.07±0.02 mm, −0.05±0.06 mm, and −0.12±0.02 mm in x, y and z directions. Conclusion The accuracy of the Varian PerfectPitch six DOF couch was studied with CBCTs of the Isocal phantom. The rotational errors were less than 0.15 degree and isocenter shifts were less than 0.5 mm in any direction. This accuracy is sufficient for stereotactic radiotherapy clinical applications.
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