scholarly journals Dose distribution in a radiosurgery treatment for an acoustic neuroma

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Marco Antonio Costa Cardoso ◽  
Victor Gabriel Leandro Alves ◽  
Simone Coutinho Cardoso
Keyword(s):  
Acoustic Neuroma ◽  
Dose Distribution ◽  
Linear Accelerator ◽  
Radiochromic Film ◽  
Planning System ◽  
Treatment Planning System ◽  
Radiochromic Films ◽  
Dose Volume Histograms ◽  
Dose Volume ◽  
Dose Measurements

Evaluation of the dose distribution delivered in a radiosurgery treatment of an acoustic neuroma using an adapted Alderson phantom and radiochromic film to assess absolute dose. A system was developed to perform the dose measurements, using the Alderson Rando phantom´s head carrying a modified slice, where a material reproducing the tumor was inserted. The phantom’s head with the modified slice was irradiated in a medical linear accelerator, using a procedure similar to that adopted in real cases, and radiochromic films were used to assess dose values. The suitability of the dose distribution delivered in the treatment was evaluated by comparing the Dose Volume Histograms, obtained from the Treatment Planning System (TPS) and by radiochromic film measurements. An agreement around 3% between experimental data and TPS´s calculations, showing an acceptable concordance with the planning results. The established approach of transforming 2D arrays of dose in a 3D one is satisfactory, validating it. The developed method shows to be an excellent alternative to quality control in radiosurgery using the radiochromic film to assess absolute dose.

scholarly journals Reproduction of a left-breast 3DCRT field-in-field radiation therapy planning in an anthropomorphic and anthropometric phantom

2019 ◽  
Vol 7 (2A) ◽  
Author(s):  
Luciana Batista Nogueira ◽  
Jony Marques Geraldo ◽  
Cristiane Barsanelli ◽  
Jean Carlos Aquino ◽  
Tarcísio Passos Ribeiro Campos
Keyword(s):  
Radiation Therapy ◽  
Calibration Curve ◽  
Organs At Risk ◽  
Left Breast ◽  
Planning System ◽  
Treatment Planning System ◽  
Radiochromic Films ◽  
Dose Volume Histograms ◽  
Field Radiation ◽  
Dose Measurements

The proposal of this study was to reproduce the dosimetry established by a treatment planning system (TPS) following a 3D conformational radiation therapy (3DCRT) protocol of two parallel-opposite fields applied to the left-breast in a thorax phantom, with the complementary use of the field-in-field technique. The computed tomography (CT) images of the thorax phantom were transferred to the XiO version-5 for the elaboration of the breast teletherapeutic planning with 2 Gy per day, in 25 fractions, with prescribed dose of 50 Gy. A set of ten EBT2 radiochromic films were irradiated at doses gradually. The values of RGB (Red, Green, Blue) of the films were obtained by scanning and data transformed in optical density (OD), whose values were used to construct the calibration curve. Radiochromic films were positioned outside and inside of the thorax phantom. After phantom radiation at the linear accelerator 6 MV Elekta Precise were measured the intensities of the films in RGB by software ImageJ, transformed in OD and converted in bidimensional dose distributions, applying the calibration curve. In addition, graphics and dose-volume histograms (DVH) were developed. The dose measurements in the glandular-TE in breast did not present statistically significant differences in relation to values at equivalent positions generated in the TPS. The organs at risk received doses below the reference values, according to TPS. It was possible to reproduce the dosimetry prescribed in TPS into the thorax phantom exposed to a breast conformational teletherapy. The use of the radiochromic films in dosimetry proves to be increasingly useful and shall become routine in radiotherapy services.

Dosimetric comparison of fractionated radiosurgery plans using frameless Gamma Knife ICON and CyberKnife systems with linear accelerator–based radiosurgery plans for multiple large brain metastases

2020 ◽  
Vol 132 (5) ◽  
pp. 1473-1479 ◽  
Author(s):  
Eun Young Han ◽  
He Wang ◽  
Dershan Luo ◽  
Jing Li ◽  
Xin Wang
Keyword(s):  
Brain Metastases ◽  
Gamma Knife ◽  
Linear Accelerator ◽  
Treatment Time ◽  
Target Volume ◽  
Planning System ◽  
Treatment Planning System ◽  
Normal Brain ◽  
Large Brain ◽  
The Mean

OBJECTIVEFor patients with multiple large brain metastases with at least 1 target volume larger than 10 cm3, multifractionated stereotactic radiosurgery (MF-SRS) has commonly been delivered with a linear accelerator (LINAC). Recent advances of Gamma Knife (GK) units with kilovolt cone-beam CT and CyberKnife (CK) units with multileaf collimators also make them attractive choices. The purpose of this study was to compare the dosimetry of MF-SRS plans deliverable on GK, CK, and LINAC and to discuss related clinical issues.METHODSTen patients with 2 or more large brain metastases who had been treated with MF-SRS on LINAC were identified. The median planning target volume was 18.31 cm3 (mean 21.31 cm3, range 3.42–49.97 cm3), and the median prescribed dose was 27.0 Gy (mean 26.7 Gy, range 21–30 Gy), administered in 3 to 5 fractions. Clinical LINAC treatment plans were generated using inverse planning with intensity modulation on a Pinnacle treatment planning system (version 9.10) for the Varian TrueBeam STx system. GK and CK planning were retrospectively performed using Leksell GammaPlan version 10.1 and Accuray Precision version 1.1.0.0 for the CK M6 system. Tumor coverage, Paddick conformity index (CI), gradient index (GI), and normal brain tissue receiving 4, 12, and 20 Gy were used to compare plan quality. Net beam-on time and approximate planning time were also collected for all cases.RESULTSPlans from all 3 modalities satisfied clinical requirements in target coverage and normal tissue sparing. The mean CI was comparable (0.79, 0.78, and 0.76) for the GK, CK, and LINAC plans. The mean GI was 3.1 for both the GK and the CK plans, whereas the mean GI of the LINAC plans was 4.1. The lower GI of the GK and CK plans would have resulted in significantly lower normal brain volumes receiving a medium or high dose. On average, GK and CK plans spared the normal brain volume receiving at least 12 Gy and 20 Gy by approximately 20% in comparison with the LINAC plans. However, the mean beam-on time of GK (∼ 64 minutes assuming a dose rate of 2.5 Gy/minute) plans was significantly longer than that of CK (∼ 31 minutes) or LINAC (∼ 4 minutes) plans.CONCLUSIONSAll 3 modalities are capable of treating multiple large brain lesions with MF-SRS. GK has the most flexible workflow and excellent dosimetry, but could be limited by the treatment time. CK has dosimetry comparable to that of GK with a consistent treatment time of approximately 30 minutes. LINAC has a much shorter treatment time, but residual rotational error could be a concern.

Analysis of the Physical and Radiobiological Equivalence of the Calculated and Measured Dose Distributions for Prostate Stereotactic Radiotherapy

2021 ◽  
Vol 66 (3) ◽  
pp. 68-75
Author(s):  
E. Sukhikh ◽  
L. Sukhikh ◽  
A. Vertinsky ◽  
P. Izhevsky ◽  
I. Sheino ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Dose Distribution ◽  
Three Dimensional ◽  
Anterior Wall ◽  
Dose Distributions ◽  
Stereotactic Radiation ◽  
Dose Volume Histograms ◽  
Dose Volume ◽  
Gamma Index ◽  
Measured Dose

Purpose: Carrying out the analysis of the physical and radiobiological equivalence of dose distributions obtained during the planning of hypofractionated stereotactic radiation therapy of the prostate cancer and verification using a three-dimensional cylindrical dosimeter. Material and Methods: Based on the anatomical data of twelve patients diagnosed with prostate carcinoma, stage T2N0M0 with low risk, plans were developed for stereotactic radiation therapy with volumetric modulates arc therapy (VMAT). The dose per fraction was 7,25 Gy for 5 fractions (total dose 36,25 Gy) with a normal photon energy of 10 MV. The developed plans were verified using a three-dimensional cylindrical ArcCHECK phantom. During the verification process, the three-dimensional dose distribution in the phantom was measured, based on which the values of the three-dimensional gamma index and the dose–volume histogram within each contoured anatomical structures were calculated with 3DVH software. The gamma index value γ (3 %, 2 mm, GN) at a threshold equal to 20 % of the dose maximum of the plan and the percentage of coincidence of points at least 95 % was chosen as a criterion of physical convergence of the calculated and measured dose distribution according to the recommendations of AAPM TG-218. To analyze the radiobiological equivalence of the calculated and measured dose distribution, the local control probability (TCP) and normal tissue complication probability (NTCP) criteria were used based on the calculated and measured dose–volume histograms. Contours of the target (PTV) and the anterior wall of the rectum were used for the analysis. The approach based on the concept of equivalent uniform dose (EUD) by A. Niemierko was used to calculate the values of TCP/NTCP criteria. Results: The results of physical convergence of plans for all patients on the contour of the whole body were higher than 95 % for the criteria γ (3 %, 2 mm, GN). The convergence along the PTV contour is in the range (75.5–95.2)%. The TCP and NTCP values obtained from the measured dose-volume histograms were higher than the planned values for all patients. It was found that the accelerator delivered a slightly higher dose to the PTV and the anterior wall of the rectum than originally planned. Conclusion: The capabilities of modern dosimetric equipment allow us move to the verification of treatment plans based on the analysis of TCP / NTCP radiobiological equivalence, taking into account the individual characteristics of the patient and the capabilities of radiation therapy equipment.

scholarly journals Quality Assurance of Dose Distribution of Photon Beam Planning by Anisotropic Analytical Algorithm (AAA)

2013 ◽  
Vol 4 (1) ◽  
pp. 43-49
Author(s):  
M Jahangir Alam ◽  
Syed Md Akram Hussain ◽  
Kamila Afroj ◽  
Shyam Kishore Shrivastava
Keyword(s):  
Quality Assurance ◽  
Treatment Planning ◽  
Dose Distribution ◽  
Maximum Dose ◽  
Photon Beam ◽  
Field Size ◽  
Planning System ◽  
Treatment Planning System ◽  
Anisotropic Analytical Algorithm ◽  
Analytical Algorithm

A three dimensional treatment planning system has been installed in the Oncology Center, Bangladesh. This system is based on the Anisotropic Analytical Algorithm (AAA). The aim of this study is to verify the validity of photon dose distribution which is calculated by this treatment planning system by comparing it with measured photon beam data in real water phantom. To do this verification, a quality assurance program, consisting of six tests, was performed. In this program, both the calculated output factors and dose at different conditions were compared with the measurement. As a result of that comparison, we found that the calculated output factor was in excellent agreement with the measured factors. Doses at depths beyond the depth of maximum dose calculated on-axis or off-axis in both the fields or penumbra region were found in good agreement with the measured dose under all conditions of energy, SSD and field size, for open and wedged fields. In the build up region, calculated and measured doses only agree (with a difference 2.0%) for field sizes > 5 × 5 cm2 up to 25 × 25 cm2. For smaller fields, the difference was higher than 2.0% because of the difficulty in dosimetry in that region. Dose calculation using treatment planning system based on the Anisotropic Analytical Algorithm (AAA) is accurate enough for clinical use except when calculating dose at depths above maximum dose for small field size.DOI: http://dx.doi.org/10.3329/bjmp.v4i1.14686 Bangladesh Journal of Medical Physics Vol.4 No.1 2011 43-49

Evaluation of Auto-Planning for Left-Side Breast Cancer After Breast-Conserving Surgery Based on Geometrical Relationship

2020 ◽  
Author(s):  
Yijiang Li ◽  
Han Bai ◽  
Danju Huang ◽  
Feihu Chen ◽  
Xuhong Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Correlation Coefficient ◽  
Dose Distribution ◽  
Breast Conserving Surgery ◽  
Target Volume ◽  
Planning System ◽  
Treatment Planning System ◽  
Geometric Information ◽  
Ipsilateral Lung ◽  
Geometrical Relationship

Abstract Purpose: This study aimed to evaluate (1) the performance of the Auto-Planning module embedded in the Pinnacle treatment planning system (TPS) with 30 left-side breast cancer plans and (2) the dose-distance correlations between dose-based patients and overlap volume histogram-based (OVH) patients. Method: A total of 30 patients with left-side breast cancer after breast-conserving surgery were enrolled in this study. The clinical manual-planning (MP) and the Auto-Planning (AP) plans were generated by Monaco and by the Auto-Planning module in Pinnacle respectively. The geometric information between organ at risk (OAR) and planning target volume (PTV) of each patient was described by the OVH. The AP and MP plans were ranked to compare with the geometry-based patients from OVH. The Pearson product-moment correlation coefficient (R) was used to describe the correlations between dose-based patients (APs and MPs) and geometry-based patients (OVH). Dosimetric differences between MP and AP plans were evaluated with statistical analysis. Result: The correlation coefficient (mean R = 0.71) indicated that the AP plans have a high correlation with geometry-based patients from OVH, whereas the correlation coefficient (mean R = 0.48) shows a weak correlation between MP plans and geometry-based patients. For different indicators, the dose distribution of V5Gy in the ipsilateral lung (AP: mean R = 0.82; MP: mean R = 0.58) is more relevant to geometry-based patients compared to the dose distribution of in the heart (AP: mean R = 0.4; MP: mean R = 0.19). The dosimetric comparison revealed a statistically significant improvement in ipsilateral lung V5Gy and V10Gy and in the heart V5Gy of AP plans compared to MP plans. Conclusion: The overall results of AP plans were superior to MP plans. The dose distribution in AP plans was more consistent with the distance-dose relationship described by OVH. After eliminating the interference of human factors, the AP was able to provide more stable and objective plans for radiotherapy patients.

A hybrid approach for head and neck cancer using online image guidance and offline adaptive radiotherapy planning

2019 ◽  
Vol 18 (03) ◽  
pp. 271-275 ◽  
Author(s):  
Roopam Srivastava ◽  
P.K. Sharma ◽  
K.J. Maria Das ◽  
Jayanand Manjhi
Keyword(s):  
Computed Tomography ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Dose Distribution ◽  
Treatment Plan ◽  
Planning System ◽  
Radiotherapy Planning ◽  
Treatment Planning System ◽  
Medical Systems

AbstractBackgroundThis is a prospective study to evaluate the dosimetric benefits of treatment plan adaptation for patients who had undergone repeat computed tomography (ReCT)and re-planning due to treatment-induced anatomical changes during radiotherapy.Materials and MethodsThis study involved five head and neck cancer patients who had their treatment plan modified, based on weekly thrice imaging protocol. Impact of mid-course imaging was assessed in patients using ReCT and cone beam computed tomography (CBCT)-based dose verification. Patients were imaged, apart from their initial CT, during the course of their radiation therapy with a ReCT and on board imager CBCT (Varian Medical Systems Inc., Palo Alto, CA, USA). Each CBCT/CT series was rigidly registered to the initial CT in the treatment planning system Eclipse (Varian Medical Systems Inc.) using bony landmarks. The structures were copied to the current CBCT/CT series and, where needed, manually edited slicewise. The dose distribution from the treatment plan was viewed as of the current anatomy by applying the treatment plan the CBCT/CT series, and studying the corresponding dose–volume histograms for organs at risk doses.ResultsThe reduction of parotid volumes due to weight loss was observed in all patients, which means an increase in predicted mean doses of parotid when initial CT plan was re-calculated on ReCT and CBCT (Table 1). This explains the necessity of adaptive planning. The predicted mean dose of parotid glands was increased and constraints to spinal cord and skin were exceeded, so re-planning was performed.ConclusionsThe CBCT is a useful tool to view anatomic changes in patients and get an estimate of their impact on dose distribution. Re-planning based on imaging in head and neck patients during the course of radiotherapy is mandatory to reduce side effects.

Utilising virtual bolus in superficial planning target volume dose optimisation (TomoTherapy): a phantom study

2019 ◽  
Vol 19 (1) ◽  
pp. 65-70
Author(s):  
Gim Chee Ooi ◽  
Iskandar Shahrim Bin Mustafa
Keyword(s):  
Treatment Planning ◽  
Planning Target Volume ◽  
Treatment Plan ◽  
Target Volume ◽  
The Body ◽  
Phantom Study ◽  
Planning System ◽  
Treatment Planning System ◽  
Dose Volume Histograms ◽  
Photon Fluence

AbstractAim:This is a phantom study to evaluate the dosimetry effects of using virtual bolus (VB) in TomoTherapy Treatment Planning System (TPS) optimisation for superficial planning target volume (PTV) that extends to the body surface. Without VB, the inverse-planning TPS will continuously boost the photon fluence at the surface of the superficial PTV due to lack of build-up region. VB is used during TPS optimisation only and will not be present in actual treatment delivery.Materials and methods:In this study, a dummy planning target was contoured on a cylindrical phantom which extends to the phantom surface, and VB of various combinations of thickness and density was used in treatment planning optimisation with TomoTherapy TPS. The plans were then delivered with the treatment modality TomoTherapy. Radiochromic films (Gafchromic EBT3) were calibrated and used for dose profiles measurements. TomoTherapy Planned-Adaptive software was used to analyse the delivered Dose-Volume Histograms (DVHs).Results:The use of 2 mm VB was not providing adequate build-up area and was unable to reduce the hot spots during treatment planning and actual delivery. The use of 4 mm VB was able to negate the photon fluence boosting effect by the TPS, and the actual delivery showed relatively small deviations from the treatment plan. The use of 6 mm VB caused significant dose overestimation by the TPS in the superficial regions resulting in insufficient dose coverage delivered.Findings:VB with the combination of 4 mm thickness and 1·0 g/cc density provides the most robust solution for the TomoTherapy TPS optimisation of superficial PTV.

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