1. |
- Dalaryd, Mårten, et al.
(författare)
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A Monte Carlo study of a flattening filter-free linear accelerator verified with measurements.
- 2010
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Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 1361-6560 .- 0031-9155. ; 55:23, s. 7333-7344
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Tidskriftsartikel (refereegranskat)abstract
- A Monte Carlo model of an Elekta Precise linear accelerator has been built and verified by measured data for a 6 and 10 MV photon beam running with and without a flattening filter in the beam line. In this study the flattening filter was replaced with a 6 mm thick copper plate, provided by the linac vendor, in order to stabilize the beam. Several studies have shown that removal of the filter improves some properties of the photon beam, which could be beneficial for radiotherapy treatments. The investigated characteristics of this new beam included output, spectra, mean energy, half value layer and the origin of scattered photons. The results showed an increased dose output per initial electron at the central axis of 1.76 and 2.66 for the 6 and 10 MV beams, respectively. The number of scattered photons from the accelerator head was reduced by (31.7 ± 0.03)% (1 SD) for the 6 MV beam and (47.6 ± 0.02)% for the 10 MV beam. The photon energy spectrum of the unflattened beam was softer compared to a conventional beam and did not vary significantly with the off-axis distance, even for the largest field size (0-20 cm off-axis).
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2. |
- Georg, Dietmar, et al.
(författare)
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Photon beam quality variations of a flattening filter free linear accelerator
- 2010
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Ingår i: Medical Physics. - : Wiley. - 0094-2405. ; 37:1, s. 49-53
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Recently, there has been an increasing interest in operating conventional linear accelerators without a flattening filter. The aim of this study was to determine beam quality variations as a function of off-axis ray angle for unflattened beams. In addition, a comparison was made with the off-axis energy variation in flattened beams. Methods: Two Elekta Precise linear accelerators were modified in order to enable radiation delivery with and without the flattening filter in the beam line. At the Medical University Vienna (Vienna, Austria), half value layer (HVL) measurements were performed for 6 and 10 MV with an in-house developed device that can be easily mounted on the gantry. At St. Luke's Hospital (Dublin, Ireland), measurements were performed at 6 MV in narrow beam geometry with the gantry tilted around 270 degrees with pinhole collimators, an attenuator, and the chamber positioned on the table. All attenuation measurements were performed with ionization chambers and a buildup cap (2 mm brass) or a PMMA mini phantom (diameter 3 cm, measurement depth 2.5 cm). Results: For flattened 6 and 10 MV photon beams from the Elekta linac the relative HVL(theta) varies by about 11% for an off-axis ray angle theta=10 degrees. These results agree within +/-2% with a previously proposed generic off-axis energy correction. For unflattened beams, the variation was less than 5% in the whole range of off-axis ray angles up to 10 degrees. The difference in relative HVL data was less than 1% for unflattened beams at 6 and 10 MV. Conclusions: Off-axis energy variation is rather small in unflattened beams and less than half the one for flattened beams. Thus, ignoring the effect of off-axis energy variation for dose calculations in unflattened beams can be clinically justified. (C) 2010 American Association of Physicists in Medicine. [DOI: 10.1118/1.3264617]
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3. |
- Kragl, Gabriele, et al.
(författare)
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Dosimetric characteristics of 6 and 10 MV unflattened photon beams
- 2009
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Ingår i: Radiotherapy and Oncology. - : Elsevier BV. - 1879-0887 .- 0167-8140. ; 93:1, s. 141-146
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To determine dosimetric properties of unflattened megavoltage photon beams. Materials and methods: Dosimetric data including depth dose, profiles, output factors and phantom scatter factors from three different beam qualities provided by Elekta Precise linacs, operated with and without flattening filter were examined. Additional measurements of leaf transmission, leakage radiation and surface dose were performed. In flattening filter free (FFF) mode a 6-mm thick copper filter was placed into the beam to stabilize it. Results: Depths of dose maxima for flattened and unflattened beams did not deviate by more than 2 mm and penumbral widths agreed within 1 mm. In FFF mode the collimator exchange effect was found to be on average 0.3% for rectangular fields. Between maximum and minimum field size head scatter factors of unflattened beams showed on average 40% and 56% less variation for 6 and 10 MV beams than conventional beams. Phantom scatter factors for FFF beams differed up to 4% from the published reference data. For field sizes smaller than 15 cm, surface doses relative to the dose at d(max) increased for unflattened beams with maximum differences of 7% at 6 MV and 25% at 10 MV for a 5 x 5 cm(2) field. For a 30 x 30 cm(2) field, relative surface dose decreased by about 10% for FFF beams. Leaf transmission on the central axis was 0.3% and 0.4% lower for unflattened 6 and 10 MV beams, respectively. Leakage radiation was reduced by 52% for 6 MV and by 65% for 10 MV unflattened beams. Conclusions: The results of the study were independently confirmed at two radiotherapy centres. Phantom scatter reference data need to be reconsidered for medical accelerators operated without a flattening filter. (C) 2009 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 93 (2009) 141-146
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4. |
- Nordström, Fredrik, et al.
(författare)
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3D geometric gel dosimetry verification of intraprostatic fiducial guided hypofractionated radiotherapy of prostate cancer
- 2010
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Ingår i: Journal of Physics: Conference Series. - : IOP Publishing. - 1742-6596. ; 250, s. 287-291
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Konferensbidrag (refereegranskat)abstract
- This pre-study is aimed to investigate the feasibility of a normoxic polyacrylamide gel (nPAG) dosimeter with implanted gold fiducials to evaluate the geometric precision, including setup correction strategies, in the delivery of hypofractionated treatments. For this purpose a phantom consisting of three parts was constructed: (1) the patient simulating volume, providing realistic scatter conditions and weight, (2) a bottle containing the active dosimetric volume and (3) the gold fiducials and the fiducial support structure. A 6.1 Gy prostate IMRT treatment was delivered to the phantom using the sliding-window technique. The phantom was positioned prior to the treatment using the implanted fiducials and kV on-board imaging. An overlay of the 95% isosurface of the TPS calculated dose distribution and the measured dose distribution using gel showed good agreement. The clinical target volume (CTV) was well centred inside the 95% isodose surface of the measured volume. It was shown for the evaluated case that the use of on-board imaging and integrated setup correction tools could be used to compensate for a deliberately introduced offset in CTV position. The study showed that MRI based nPAG gel dosimetry can be used to verify setup correction procedures using implanted gold fiducials.
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5. |
- Nordström, Fredrik, et al.
(författare)
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Control chart analysis of data from a multicenter monitor unit verification study.
- 2012
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Ingår i: Radiotherapy and Oncology. - : Elsevier BV. - 1879-0887 .- 0167-8140. ; 102:3, s. 364-370
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: This study aims to investigate the process of monitor unit verification using control charts. Control charts is a key tool within statistical process control (SPC), through which process characteristics can be visualized, usually chronologically with statistically determined limits. MATERIAL AND METHODS: Our group has developed a monitor unit verification software that has been adopted at several Swedish institutions for pre-treatment verification of radiotherapy treatments. Deviations between point dose calculations using the treatment planning systems and using the independent monitor unit verification software from 9219 treatment plans and five different institutions were included in this multicenter study. The process of monitor unit verification was divided into subprocesses. Each subprocess was analyzed using probability plots and control charts. RESULTS: Differences in control chart parameters for the investigated subprocesses were found between different treatment sites and different institutions, as well as between different treatment techniques. 19 of 37 subprocesses met the clinical specification (±5%), i.e. process capability index was equal to or above one. CONCLUSIONS: Control charts were found to be a useful tool for continuous analysis of data from the monitor unit verification software for patient specific quality control, as well as for comparisons between different institutions and treatment sites. The derived control chart limits were in agreement with AAPM TG114 guidelines on action levels.
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6. |
- Olsson, Lars E., et al.
(författare)
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Evaluation of a deep learning magnetic resonance imaging reconstruction method for synthetic computed tomography generation in prostate radiotherapy
- 2024
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Ingår i: Physics and imaging in radiation oncology. - 2405-6316. ; 29
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose: In magnetic resonance imaging (MRI) only radiotherapy computed tomography (CT) is excluded. The method relies entirely on synthetic CT images generated from MRI. This study evaluates the compatibility of a commercial synthetic CT (sCT) with an accelerated commercial deep learning reconstruction (DLR) in MRI-only prostate radiotherapy. Materials and Methods: For a group of 24 patients (cohort 1) the effects of DLR were studied in isolation. MRI data were reconstructed conventionally and with DLR from identical k-space data, and sCTs were generated for both reconstructions. The sCT quality, Hounsfield Unit (HU) and dosimetric impact were investigated. In another group of 15 patients (cohort 2) effects on sCT generation using accelerated MRI acquisition (40 % time reduction) reconstructed with DLR were investigated. Results: sCT images from both cohorts, generated from DLR MRI data, were of clinically expected image quality. The mean dose differences for targets and organs at risks in cohort 1 were <0.06 Gy, corresponding to a 0.1 % prescribed dose difference. Similar dose differences were observed in cohort 2. Gamma pass rates for cohort 1 were 100 % for criteria 3 %/3mm, 2 %/2mm and 1 %/1mm for all dose levels. Mean error and mean absolute error inside the body, between sCTs, averaged over all cohort 1 subjects, were −1.1 ± 0.6 [−2.4 0.2] and 2.9 ± 0.4 [2.3 3.9] HU, respectively. Conclusions: DLR was suitable for sCT generation with clinically negligible differences in HU and calculated dose compared to the conventional MRI reconstruction method. For sCT generation DLR enables scan time reduction, without compromised sCT quality.
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7. |
- Scherman, Jonas, et al.
(författare)
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Geometric impact and dose estimation of on-patient placement of a lightweight receiver coil in a clinical magnetic resonance imaging-only radiotherapy workflow for prostate cancer
- 2023
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Ingår i: Physics and imaging in radiation oncology. - : Elsevier BV. - 2405-6316. ; 26
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose: For pelvic magnetic resonance imaging (MRI)-only radiotherapy the use of receiver coil bridges (CB) is recommended to avoid deformation of the patient. Development in coil technology has enabled lightweight, flexible coils. In this work we evaluate the effects of a lightweight coil in a pelvic MRI-only radiotherapy workflow. Materials and Methods: Twenty-one patients, referred to prostate MRI-only radiotherapy, were included. Images were acquired with and without CB. Anatomical deformation from the on-patient coil placement was measured in the anterior-posterior (AP) and left–right (LR) direction. The change in signal-to-noise ratio (SNR) was measured in phantom and in vivo. The clinical treatment plan, created on the image with CB, was transferred and recalculated on the image without the CB. Dose metrics for the targets (planning- and clinical target volume) and organs at risks (OAR) were analyzed. Results: There was a statistically significant increase in SNR in-vivo (median 21 %, p = 0.002) when removing the CB. Anatomical differences after removing the CB in patients were −1.5 mm in AP (median change) and + 2.5 mm in LR direction. Dosimetric differences for the target structures were clinically negligible, but statistically significant. The difference in target mean doses were 0.2 % (both p = 0.004) of the prescribed dose. No dosimetric differences were observed for the OAR, except for the penile bulb. Conclusions: We concluded that anatomical change and dosimetric differences, originating from scanning without CB were minor. The CB can thereby be removed from the workflow, enabling easier patient positioning and increased SNR when using lightweight coils.
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