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1.
  • Sjogren, R, et al. (författare)
  • Influence of electron contamination on in vivo surface dosimetry for high-energy photon beams
  • 1998
  • Ingår i: Medical physics (Lancaster). - 0094-2405. ; 25:6, s. 916-921
  • Tidskriftsartikel (refereegranskat)abstract
    • The influence of the electron contamination at in vivo dosimetry with diodes on the patient surface has been investigated by introducing different accessories in the beam path and by changing the field size and SSD. The results show a clear correlation between the electron contamination at an effective measuring depth of the diode and the signal from the patient diode. When the electron contamination is taken into account the agreement between the diode values and the absorbed dose is greatly improved. More accurate in vivo dosimetry with less error margins is therefore possible if better predictions of the electron contamination in high-energy photon beams can be performed. (C) 1998 American Association of Physicists in Medicine. [S0094-2405(98)00606-3].
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2.
  • Sjogren, R, et al. (författare)
  • Methods for the determination of effective monitor chamber thickness
  • 1999
  • Ingår i: Medical physics (Lancaster). - 0094-2405. ; 26:9, s. 1871-1873
  • Tidskriftsartikel (refereegranskat)abstract
    • There are a number of models, both analytical and Monte Carlo, which are used to describe the fluence from the treatment head of accelerators. One common problem in these simulations is to find relevant information about details in the treatment head. A complex unit in the treatment head for which reliable data is seldom given is the monitor chamber. In this work two methods are described for obtaining this information by analyzing the increased scattering of an electron beam when the monitor chamber is introduced in the beam. It was found that the effective thickness of the electrodes in a monitor chamber can be determined with sufficient accuracy by using experimental results combined with Fermi-Eyges theory or Monte Carlo simulations. (C) 1999 American Association of Physicists in Medicine. [S0094-2405(99)01009-3].
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3.
  • Karlsson, M G, et al. (författare)
  • Treatment head design for multileaf collimated high-energy electrons
  • 1999
  • Ingår i: Medical physics (Lancaster). - 0094-2405. ; 26:10, s. 2161-2167
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper describes how a conventional treatment head can be modified for use of multileaf collimated electron beams. Automatic and dynamic beam delivery are possible for both electrons and photons by using the computer controlled multileaf collimator (MLC) for both photon and electron beams. Thereby, the electron beams can be mixed more freely into the treatment to take advantage of the specific depth modulation characteristics of electrons. The investigation was based on Monte Carlo calculations using the software package BEAM. The physical parameters used in this optimization were the beam penumbra and the virtual/effective point source position. These parameters are essential for shaping beams, beam matching and for dosimetry calculations. The optimization was carried out by modifying a number of parameters: replacing the air atmosphere in the treatment head with helium, adding a helium bag below the MLC, changing the position of the scattering foils, modifying the monitor chamber, and adjusting the position of the MLC. The beam characteristics for some of these designs were found to fulfil our criteria for clinically useful beams down to at least 9 MeV. (C) 1999 American Association of Physicists in Medicine. [S0094-2405(99)00610-0].
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5.
  • Abramian, David, 1992-, et al. (författare)
  • Evaluation of inverse treatment planning for gamma knife radiosurgery using fMRI brain activation maps as organs at risk
  • 2023
  • Ingår i: Medical physics (Lancaster). - : WILEY. - 0094-2405. ; 50:9, s. 5297-5311
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Stereotactic radiosurgery (SRS) can be an effective primary or adjuvant treatment option for intracranial tumors. However, it carries risks of various radiation toxicities, which can lead to functional deficits for the patients. Current inverse planning algorithms for SRS provide an efficient way for sparing organs at risk (OARs) by setting maximum radiation dose constraints in the treatment planning process.Purpose: We propose using activation maps from functional MRI (fMRI) to map the eloquent regions of the brain and define functional OARs (fOARs) for Gamma Knife SRS treatment planning.Methods: We implemented a pipeline for analyzing patient fMRI data, generating fOARs from the resulting activation maps, and loading them onto the GammaPlan treatment planning software. We used the Lightning inverse planner to generate multiple treatment plans from open MRI data of five subjects, and evaluated the effects of incorporating the proposed fOARs.Results: The Lightning optimizer designs treatment plans with high conformity to the specified parameters. Setting maximum dose constraints on fOARs successfully limits the radiation dose incident on them, but can have a negative impact on treatment plan quality metrics. By masking out fOAR voxels surrounding the tumor target it is possible to achieve high quality treatment plans while controlling the radiation dose on fOARs.Conclusions: The proposed method can effectively reduce the radiation dose incident on the eloquent brain areas during Gamma Knife SRS of brain tumors.
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6.
  • Adolfsson, Emelie, et al. (författare)
  • Response of lithium formate EPR dosimeters at photon energies relevant to the dosimetry of brachytherapy
  • 2010
  • Ingår i: Medical physics (Lancaster). - : American Association of Physicists in Medicine. - 0094-2405. ; 37:9, s. 4946-4959
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE:To investigate experimentally the energy dependence of the detector response of lithium formate EPR dosimeters for photon energies below 1 MeV relative to that at 60Co energies. High energy photon beams are used in calibrating dosimeters for use in brachytherapy since the absorbed dose to water can be determined with high accuracy in such beams using calibrated ion chambers and standard dosimetry protocols. In addition to any differences in mass-energy absorption properties between water and detector, variations in radiation yield (detector response) with radiation quality, caused by differences in the density of ionization in the energy imparted (LET), may exist. Knowledge of an eventual deviation in detector response with photon energy is important for attaining high accuracy in measured brachytherapy dose distributions.METHODS:Lithium formate EPR dosimeters were irradiated to known levels of air kerma in 25-250 kV x-ray beams and in 137Cs and 60Co beams at the Swedish Secondary Standards Dosimetry Laboratory. Conversions from air kerma free in air into values of mean absorbed dose to the detectors were made using EGSnrc MC simulations and x-ray energy spectra measured or calculated for the actual beams. The signals from the detectors were measured using EPR spectrometry. Detector response (the EPR signal per mean absorbed dose to the detector) relative to that for 60Co was determined for each beam quality.RESULTS:Significant decreases in the relative response ranging from 5% to 6% were seen for x-ray beams at tube voltages < or = 180 kV. No significant reduction in the relative response was seen for 137Cs and 250 kV x rays.CONCLUSIONS:When calibrated in 60Co or MV photon beams, corrections for the photon energy dependence of detector response are needed to achieve the highest accuracy when using lithium formate EPR dosimeters for measuring absorbed doses around brachytherapy sources emitting photons in the energy range of 20-150 keV such as 169Yb and electronic sources.
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7.
  • Ahnesjö, Anders, et al. (författare)
  • Application of the convolution method for calculation of output factors for therapy photon beams
  • 1992
  • Ingår i: Medical Physics. - : Wiley. - 0094-2405. ; 19:2, s. 295-301
  • Tidskriftsartikel (refereegranskat)abstract
    • The output factor for a therapy photon beam is defined as the dose per monitor unit relative to the dose per monitor unit in a reference field. Convolution models for photon dose calculations yield the dose in units normalized to the incident energy fluence with phantom scatter intrinsically modeled. Output factors calculated with the convolution method as the dose per unit energy fluence relative to the calculated dose per unit energy fluence in a reference field could deviate as much as 5% if corrections are not made for perturbations due to treatment head scatter. Significant perturbations are particles backscattered from the collimators to the monitor and photons forward scattered from the filter and collimators in the treatment head. The forward scatter adds an "unmonitored" contribution to the total energy fluence of the beam. A model is developed that describes the field size dependence of these perturbations for conversion of output factors, calculated with the convolution method, to machine output factors as an integrated part in treatment planning. The necessary machine characteristics are derived from measurements of the output in air for a limited set of field sizes. The method has been tested using five different multileaf collimated irregular fields at 6 MV and for a large set of rectangular fields at 5, 6, and 18 MV and found to predict output factors with an accuracy better than 1%.
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8.
  • Ahnesjö, Anders, et al. (författare)
  • Beam modeling and verification of a photon beam multisource model.
  • 2005
  • Ingår i: Medical Physics. - : Wiley. - 0094-2405. ; 32:6, s. 1722-37
  • Tidskriftsartikel (refereegranskat)abstract
    • Dose calculations for treatment planning of photon beam radiotherapy require a model of the beam to drive the dose calculation models. The beam shaping process involves scattering and filtering that yield radiation components which vary with collimator settings. The necessity to model these components has motivated the development of multisource beam models. We describe and evaluate clinical photon beam modeling based on multisource models, including lateral beam quality variations. The evaluation is based on user data for a pencil kernel algorithm and a point kernel algorithm (collapsed cone) used in the clinical treatment planning systems Helax-TMS and Nucletron-Oncentra. The pencil kernel implementations treat the beam spectrum as lateral invariant while the collapsed cone involves off axis softening of the spectrum. Both algorithms include modeling of head scatter components. The parameters of the beam model are derived from measured beam data in a semiautomatic process called RDH (radiation data handling) that, in sequential steps, minimizes the deviations in calculated dose versus the measured data. The RDH procedure is reviewed and the results of processing data from a large number of treatment units are analyzed for the two dose calculation algorithms. The results for both algorithms are similar, with slightly better results for the collapsed cone implementations. For open beams, 87% of the machines have maximum errors less than 2.5%. For wedged beams the errors were found to increase with increasing wedge angle. Internal, motorized wedges did yield slightly larger errors than external wedges. These results reflect the increased complexity, both experimentally and computationally, when wedges are used compared to open beams.
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9.
  • Ahnesjö, Anders, et al. (författare)
  • Modeling transmission and scatter for photon beam attenuators
  • 1995
  • Ingår i: Medical Physics. - : Wiley. - 0094-2405. ; 22:11, s. 1711-1720
  • Tidskriftsartikel (refereegranskat)abstract
    • The development of treatment planning methods in radiation therapy requires dose calculation methods that are both accurate and general enough to provide a dose per unit monitor setting for a broad variety of fields and beam modifiers. The purpose of this work was to develop models for calculation of scatter and transmission for photon beam attenuators such as compensating filters, wedges, and block trays. The attenuation of the beam is calculated using a spectrum of the beam, and a correction factor based on attenuation measurements. Small angle coherent scatter and electron binding effects on scattering cross sections are considered by use of a correction factor. Quality changes in beam penetrability and energy fluence to dose conversion are modeled by use of the calculated primary beam spectrum after passage through the attenuator. The beam spectra are derived by the depth dose effective method, i.e., by minimizing the difference between measured and calculated depth dose distributions, where the calculated distributions are derived by superposing data from a database for monoenergetic photons. The attenuator scatter is integrated over the area viewed from the calculation point of view using first scatter theory. Calculations are simplified by replacing the energy and angular-dependent cross-section formulas with the forward scatter constant r2(0) and a set of parametrized correction functions. The set of corrections include functions for the Compton energy loss, scatter attenuation, and secondary bremsstrahlung production. The effect of charged particle contamination is bypassed by avoiding use of dmax for absolute dose calibrations. The results of the model are compared with scatter measurements in air for copper and lead filters and with dose to a water phantom for lead filters for 4 and 18 MV. For attenuated beams, downstream of the buildup region, the calculated results agree with measurements on the 1.5% level. The accuracy was slightly less in situations where the scatter component is very large, as for very large fields with very short filter to detector distances. The implementation of the model into treatment planning systems is discussed.
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10.
  • Al-Hallaq, Hania A., et al. (författare)
  • AAPM task group report 302 : Surface-guided radiotherapy
  • 2022
  • Ingår i: Medical Physics. - : Wiley. - 0094-2405 .- 2473-4209. ; 49:4, s. 82-112
  • Tidskriftsartikel (refereegranskat)abstract
    • The clinical use of surface imaging has increased dramatically, with demonstrated utility for initial patient positioning, real-time motion monitoring, and beam gating in a variety of anatomical sites. The Therapy Physics Subcommittee and the Imaging for Treatment Verification Working Group of the American Association of Physicists in Medicine commissioned Task Group 302 to review the current clinical uses of surface imaging and emerging clinical applications. The specific charge of this task group was to provide technical guidelines for clinical indications of use for general positioning, breast deep-inspiration breath hold treatment, and frameless stereotactic radiosurgery. Additionally, the task group was charged with providing commissioning and on-going quality assurance (QA) requirements for surface-guided radiation therapy (SGRT) as part of a comprehensive QA program including risk assessment. Workflow considerations for other anatomic sites and for computed tomography simulation, including motion management, are also discussed. Finally, developing clinical applications, such as stereotactic body radiotherapy (SBRT) or proton radiotherapy, are presented. The recommendations made in this report, which are summarized at the end of the report, are applicable to all video-based SGRT systems available at the time of writing.
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13.
  • Andersén, Christoffer, 1991-, et al. (författare)
  • Deep learning based digitisation of prostate brachytherapy needles in ultrasound images
  • 2020
  • Ingår i: Medical physics. - : Wiley-Blackwell Publishing Inc.. - 2473-4209 .- 0094-2405. ; 47:12, s. 6414-6420
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To develop, and evaluate the performance of, a deep learning based 3D convolutional neural network (CNN) artificial intelligence (AI) algorithm aimed at finding needles in ultrasound images used in prostate brachytherapy.METHODS: Transrectal ultrasound (TRUS) image volumes from 1102 treatments were used to create a clinical ground truth (CGT) including 24422 individual needles that had been manually digitised by medical physicists during brachytherapy procedures. A 3D CNN U-net with 128x128x128 TRUS image volumes as input was trained using 17215 needle examples. Predictions of voxels constituting a needle were combined to yield a 3D linear function describing the localisation of each needle in a TRUS volume. Manual and AI digitisations were compared in terms of the root-mean-square distance (RMSD) along each needle, expressed as median and interquartile range (IQR). The method was evaluated on a dataset including 7207 needle examples. A subgroup of the evaluation data set (n=188) was created, where the needles were digitised once more by a medical physicist (G1) trained in brachytherapy. The digitisation procedure was timed.RESULTS: The RMSD between the AI and CGT was 0.55 (IQR: 0.35-0.86) mm. In the smaller subset, the RMSD between AI and CGT was similar (0.52 [IQR: 0.33-0.79] mm) but significantly smaller (p<0.001) than the difference of 0.75 (IQR: 0.49-1.20) mm between AI and G1. The difference between CGT and G1 was 0.80 (IQR: 0.48-1.18) mm, implying that the AI performed as well as the CGT in relation to G1. The mean time needed for human digitisation was 10 min 11 sec, while the time needed for the AI was negligible.CONCLUSIONS: A 3D CNN can be trained to identify needles in TRUS images. The performance of the network was similar to that of a medical physicist trained in brachytherapy. Incorporating a CNN for needle identification can shorten brachytherapy treatment procedures substantially.
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15.
  • Andersson, Jonas, 1975-, et al. (författare)
  • Estimation of patient skin dose in fluoroscopy : summary of a joint report by AAPM TG357 and EFOMP
  • 2021
  • Ingår i: Medical physics (Lancaster). - : John Wiley & Sons. - 0094-2405 .- 2473-4209. ; 48:7, s. e671-e696
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Physicians use fixed C-arm fluoroscopy equipment with many interventional radiological and cardiological procedures. The associated effective dose to a patient is generally considered low risk, as the benefit-risk ratio is almost certainly highly favorable. However, X-ray-induced skin injuries may occur due to high absorbed patient skin doses from complex fluoroscopically guided interventions (FGI). Suitable action levels for patient-specific follow-up could improve the clinical practice. There is a need for a refined metric regarding follow-up of X-ray-induced patient injuries and the knowledge gap regarding skin dose-related patient information from fluoroscopy devices must be filled. The most useful metric to indicate a risk of erythema, epilation or greater skin injury that also includes actionable information is the peak skin dose, that is, the largest dose to a region of skin.Materials and Methods: The report is based on a comprehensive review of best practices and methods to estimate peak skin dose found in the scientific literature and situates the importance of the Digital Imaging and Communication in Medicine (DICOM) standard detailing pertinent information contained in the Radiation Dose Structured Report (RDSR) and DICOM image headers for FGI devices. Furthermore, the expertise of the task group members and consultants have been used to bridge and discuss different methods and associated available DICOM information for peak skin dose estimation.Results: The report contributes an extensive summary and discussion of the current state of the art in estimating peak skin dose with FGI procedures with regard to methodology and DICOM information. Improvements in skin dose estimation efforts with more refined DICOM information are suggested and discussed.Conclusions: The endeavor of skin dose estimation is greatly aided by the continuing efforts of the scientific medical physics community, the numerous technology enhancements, the dose-controlling features provided by the FGI device manufacturers, and the emergence and greater availability of the DICOM RDSR. Refined and new dosimetry systems continue to evolve and form the infrastructure for further improvements in accuracy. Dose-related content and information systems capable of handling big data are emerging for patient dose monitoring and quality assurance tools for large-scale multihospital enterprises.
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16.
  • Andersson, Jonas, 1975-, et al. (författare)
  • Modeling ion recombination in liquid ionization chambers : Improvement and analysis of the two-dose-rate method
  • 2017
  • Ingår i: Medical physics (Lancaster). - : John Wiley & Sons. - 0094-2405. ; 44:11, s. 5977-5987
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The use of liquid ionization chambers can provide useful information to endeavors with radiation dosimetry for highly modulated beams. Liquid ionization chambers may be particularly suitable for computed tomography applications where conventional ionization chambers do not present a high enough sensitivity for the spatial resolution required to characterize common X-ray beams. Due to the sensitivity, which leads to high charge densities, liquid ionization chambers can suffer from large recombination losses leading to degradation in signal to dose rate linearity. To solve this problem, a two-dose-rate method for general recombination correction has been proposed for liquid ionization chambers. However, the valid range of recombination losses that the method can accurately account for has been found to vary depending on radiation quality. The present work provides an in-depth analysis of the performance of the two-dose-rate method. Furthermore, the soundness of applying gas theory to liquids is investigated by using the two-dose-rate method.Methods: In the present work, the two-dose-rate method for general recombination correction of liquid ionization chambers used in continuous beams is studied by employing theory for gas-filled ionization chambers. An approximate relation for the general collection efficiency containing a material-specific parameter that is traceable to liquids has been derived for theoretical and experimental investigation alongside existing theory. Furthermore, the disassociation between initial and general recombination in the method is analyzed both theoretically and experimentally.Results: The results indicate that liquids and gases share general recombination characteristics, where the liquids investigated (isooctane and tetramethylsilane) to a large extent mimic the behavior theoretically expected in gases. Furthermore, it is shown that the disassociation between initial and general recombination in the two-dose-rate method is an approximation that depends on the relation between initial recombination and the collecting electric field strength at the dose rates used.Conclusions: Due to the approximation used to separate initial and general recombination the valid range of collection efficiencies for the two-dose-rate method will not only depend on the model used to describe general recombination but also on the type of liquid and radiation beam quality. As there is no robust theory for initial recombination in liquids to apply, the valid range of general collection efficiencies for the two-dose-rate method should be experimentally evaluated for each radiation dosimetry application.
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17.
  • Andersson, Jonas, 1975-, et al. (författare)
  • On the property of measurements with the PTW microLion chamber in continuous beam
  • 2012
  • Ingår i: Medical physics (Lancaster). - : American Association of Physicists in Medicine. - 0094-2405. ; 39:8, s. 4775-4787
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The performance of liquid ionization chambers, which may prove to be useful tools in the field of radiation dosimetry, is based on several chamber and liquid specific characteristics. The present work investigates the performance of the PTW microLion liquid ionization chamber with respect to recombination losses and perturbations from ambient electric fields at various dose rates in continuous beams.Methods: In the investigation, experiments were performed using two microLion chambers, containing isooctane (C8H18) and tetramethylsilane (Si(CH3)4) as the sensitive media, and a NACP-02 monitor chamber. An initial activity of approximately 250 GBq 18F was employed as the radiation source in the experiments. The initial dose rate in each measurement series was estimated to 1.0 Gy min-1 by Monte Carlo simulations and the measurements were carried out during the decay of the radioactive source. In the investigation of general recombination losses, employing the two-dose-rate method for continuous beams, the liquid ionization chambers were operated at polarizing voltages 25, 50, 100, 150, 200 and 300 V. Furthermore, measurements were also performed at 500 V polarizing voltage in the investigation of the sensitivity of the microLion chamber to ambient electric fields.Results: The measurement results from the liquid ionization chambers, corrected for general recombination losses according to the two-dose-rate method for continuous beams, had a good agreement with the signal to dose linearity from the NACP-02 monitor chamber for general collection efficiencies above 70%. The results also displayed an agreement with the theoretical collection efficiencies according to the Greening theory, except for the liquid ionization chamber containing isooctane operated at 25 V. At lower dose rates, perturbations from ambient electric fields were found in the microLion chamber measurement results. Due to the perturbations, measurement results below an estimated dose rate of 0.2 Gy min-1 were excluded from the present investigation of the general collection efficiency. The perturbations were found to be more pronounced when the chamber polarizing voltage was increased.Conclusions: By using the two-dose-rate method for continuous beams, comparable corrected ionization currents from experiments in low- and medium energy photon beams can be achieved. However, the valid range of general collection efficiencies has been found to vary in a comparison between experiments performed in continuous beams of 120 kVp x-ray, and the present investigation of 511 keV annihilation photons. At very high dose rates in continuous beams, there are presently no methods that can be used to correct for general recombination losses and at low dose rates the microLion chamber may be perturbed by ambient electric fields. Increasing the chamber polarizing voltage, which diminishes the general recombination effect, was found to increase the microLion chamber sensitivity to ambient electric fields. Prudence is thus advised when employing the microLion chamber in radiation dosimetry, as ambient electric fields of the strength observed in the present work may be found in many common situations. Due to uncertainties in the theoretical basis for recombination losses in liquids, further studies on the underlying theories for the initial and general recombination effect are needed if liquid ionization chambers are to become a viable option in high precision radiation dosimetry.
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18.
  • Andersson, Karin M., 1989-, et al. (författare)
  • Evaluation of two commercial CT metal artifact reduction algorithms for use in proton radiotherapy treatment planning in the head and neck area
  • 2018
  • Ingår i: Medical physics (Lancaster). - : Wiley-Blackwell Publishing Inc.. - 0094-2405 .- 2473-4209. ; 45:10, s. 4329-4344
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To evaluate two commercial CT metal artifact reduction (MAR) algorithms for use in proton treatment planning in the head and neck (H&N) area.METHODS: An anthropomorphic head phantom with removable metallic implants (dental fillings or neck implant) was CT-scanned to evaluate the O-MAR (Philips) and the iMAR (Siemens) algorithms. Reference images were acquired without any metallic implants in place. Water equivalent thickness (WET) was calculated for different path directions and compared between image sets. Images were also evaluated for use in proton treatment planning for parotid, tonsil, tongue base, and neck node targets. The beams were arranged so as to not traverse any metal prior to the target, enabling evaluation of the impact on dose calculation accuracy from artifacts surrounding the metal volume. Plans were compared based on γ analysis (1 mm distance-to-agreement/1% difference in local dose) and dose volume histogram metrics for targets and organs at risk (OARs). Visual grading evaluation of 30 dental implant patient MAR images was performed by three radiation oncologists.RESULTS: In the dental fillings images, ΔWET along a low-density streak was reduced from -17.0 to -4.3 mm with O-MAR and from -16.1 mm to -2.3 mm with iMAR, while for other directions the deviations were increased or approximately unchanged when the MAR algorithms were used. For the neck implant images, ΔWET was generally reduced with MAR but residual deviations remained (of up to -2.3 mm with O-MAR and of up to -1.5 mm with iMAR). The γ analysis comparing proton dose distributions for uncorrected/MAR plans and corresponding reference plans showed passing rates >98% of the voxels for all phantom plans. However, substantial dose differences were seen in areas of most severe artifacts (γ passing rates of down to 89% for some cases). MAR reduced the deviations in some cases, but not for all plans. For a single patient case dosimetrically evaluated, minor dose differences were seen between the uncorrected and MAR plans (γ passing rate approximately 97%). The visual grading of patient images showed that MAR significantly improved image quality (P < 0.001).CONCLUSIONS: O-MAR and iMAR significantly improved image quality in terms of anatomical visualization for target and OAR delineation in dental implant patient images. WET calculations along several directions, all outside the metallic regions, showed that both uncorrected and MAR images contained metal artifacts which could potentially lead to unacceptable errors in proton treatment planning. ΔWET was reduced by MAR in some areas, while increased or unchanged deviations were seen for other path directions. The proton treatment plans created for the phantom images showed overall acceptable dose distributions differences when compared to the reference cases, both for the uncorrected and MAR images. However, substantial dose distribution differences in the areas of most severe artifacts were seen for some plans, which were reduced by MAR in some cases but not all. In conclusion, MAR could be beneficial to use for proton treatment planning; however, case-by-case evaluations of the metal artifact-degraded images are always recommended.
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20.
  • Andreassen, Björn, et al. (författare)
  • Fast IMRT with narrow high energy scanned photon beams
  • 2011
  • Ingår i: Medical physics (Lancaster). - : Wiley. - 0094-2405. ; 38:8, s. 4774-4784
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Since the first publications on intensity modulated radiation therapy (IMRT) in the early 1980s almost all efforts have been focused on fairly time consuming dynamic or segmental multileaf collimation. With narrow fast scanned photon beams, the flexibility and accuracy in beam shaping increases, not least in combination with fast penumbra trimming multileaf collimators. Previously, experiments have been performed with full range targets, generating a broad bremsstrahlung beam, in combination with multileaf collimators or material compensators. In the present publication, the first measurements with fast narrow high energy (50 MV) scanned photon beams are presented indicating an interesting performance increase even though some of the hardware used were suboptimal. Methods: Inverse therapy planning was used to calculate optimal scanning patterns to generate dose distributions with interesting properties for fast IMRT. To fully utilize the dose distributional advantages with scanned beams, it is necessary to use narrow high energy beams from a thin bremsstrahlung target and a powerful purging magnet capable of deflecting the transmitted electron beam away from the generated photons onto a dedicated electron collector. During the present measurements the scanning system, purging magnet, and electron collimator in the treatment head of the MM50 racetrack accelerator was used with 3-6 mm thick bremsstrahlung targets of beryllium. The dose distributions were measured with diodes in water and with EDR2 film in PMMA. Monte Carlo simulations with GEANT4 were used to study the influence of the electrons transmitted through the target on the photon pencil beam kernel. Results: The full width at half-maximum (FWHM) of the scanned photon beam was 34 mm measured at isocenter, below 9.5 cm of water, 1 m from the 3 mm Be bremsstrahlung target. To generate a homogeneous dose distribution in a 10 x 10 cm(2) field, the authors used a spot matrix of 100 equal intensity beam spots resulting in a uniformity of collimated 80%-20% penumbra of 9 mm at a primary electron energy of 50 MeV. For the more complex cardioid shaped dose distribution, they used 270 spots, which at a pulse repetition frequency of 200 Hz is completed every 1.36 s. Conclusions: The present measurements indicate that the use of narrow scanned photon beams is a flexible and fast method to deliver advanced intensity modulated beams. Fast scanned photon IMRT should, therefore, be a very interesting modality in the delivery of biologically optimized radiation therapy with the possibility for in vivo treatment verification with PET-CT imaging.
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24.
  • Antonovic, Laura, et al. (författare)
  • Evaluation of a lithium formate EPR dosimetry system for dose measurements around Ir-192 brachytherapy sources
  • 2009
  • Ingår i: MEDICAL PHYSICS. - : Wiley. - 0094-2405. ; 36:6, s. 2236-2247
  • Tidskriftsartikel (refereegranskat)abstract
    • A dosimetry system using lithium formate monohydrate (HCO2Li center dot H2O) as detector material and electron paramagnetic resonance (EPR) spectroscopy for readout has been used to measure absorbed dose distributions around clinical Ir-192 sources. Cylindrical tablets with diameter of 4.5 mm, height of 4.8 mm, and density of 1.26 g/cm(3) were manufactured. Homogeneity test and calibration of the dosimeters were performed in a 6 MV photon beam. Ir-192 irradiations were performed in a PMMA phantom using two different source models, the GammaMed Plus HDR and the microSelectron PDR-v1 model. Measured absorbed doses to water in the PMMA phantom were converted to the corresponding absorbed doses to water in water phantoms of dimensions used by the treatment planning systems (TPSs) using correction factors explicitly derived for this experiment. Experimentally determined absorbed doses agreed with the absorbed doses to water calculated by the TPS to within +/- 2.9%. Relative standard uncertainties in the experimentally determined absorbed doses were estimated to be within the range of 1.7%-1.3% depending on the radial distance from the source, the type of source (HDR or PDR), and the particular absorbed doses used. This work shows that a lithium formate dosimetry system is well suited for measurements of absorbed dose to water around clinical HDR and PDR Ir-192 sources. Being less energy dependent than the commonly used thermoluminescent lithium fluoride (LiF) dosimeters, lithium formate monohydrate dosimeters are well suited to measure absorbed doses in situations where the energy dependence cannot easily be accounted for such as in multiple-source irradiations to verify treatment plans. Their wide dynamic range and linear dose response over the dose interval of 0.2-1000 Gy make them suitable for measurements on sources of the strengths used in clinical applications. The dosimeter size needs, however, to be reduced for application to single-source dosimetry.
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25.
  • Arce, P., et al. (författare)
  • Report on G4-Med, a Geant4 benchmarking system for medical physics applications developed by the Geant4 Medical Simulation Benchmarking Group
  • 2021
  • Ingår i: Medical Physics. - : Wiley. - 0094-2405 .- 2473-4209. ; 48:1, s. 19-56
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Geant4 is a Monte Carlo code extensively used in medical physics for a wide range of applications, such as dosimetry, micro- and nanodosimetry, imaging, radiation protection, and nuclear medicine. Geant4 is continuously evolving, so it is crucial to have a system that benchmarks this Monte Carlo code for medical physics against reference data and to perform regression testing. Aims: To respond to these needs, we developed G4-Med, a benchmarking and regression testing system of Geant4 for medical physics. Materials and Methods: G4-Med currently includes 18 tests. They range from the benchmarking of fundamental physics quantities to the testing of Monte Carlo simulation setups typical of medical physics applications. Both electromagnetic and hadronic physics processes and models within the prebuilt Geant4 physics lists are tested. The tests included in G4-Med are executed on the CERN computing infrastructure via the use of the geant-val web application, developed at CERN for Geant4 testing. The physical observables can be compared to reference data for benchmarking and to results of previous Geant4 versions for regression testing purposes. Results: This paper describes the tests included in G4-Med and shows the results derived from the benchmarking of Geant4 10.5 against reference data. Discussion: Our results indicate that the Geant4 electromagnetic physics constructor G4EmStandardPhysics_option4 gives a good agreement with the reference data for all the tests. The QGSP_BIC_HP physics list provided an overall adequate description of the physics involved in hadron therapy, including proton and carbon ion therapy. New tests should be included in the next stage of the project to extend the benchmarking to other physical quantities and application scenarios of interest for medical physics. Conclusion: The results presented and discussed in this paper will aid users in tailoring physics lists to their particular application.
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