scholarly journals Independent verification of treatment planning system calculations

Nukleonika ◽  
2021 ◽  
Vol 66 (2) ◽  
pp. 47-53
Author(s):  
Edyta Dąbrowska-Szewczyk ◽  
Anna Zawadzka ◽  
Beata Brzozowska ◽  
Agnieszka Walewska ◽  
Paweł Kukołowicz
Keyword(s):  
Treatment Planning ◽  
Three Dimensional ◽  
Conformal Radiotherapy ◽  
Target Volume ◽  
Planning System ◽  
Treatment Planning System ◽  
Rank Test ◽  
Average Dose ◽  
Independent Verification ◽  
The Mean

Abstract Purpose According to the available international recommendations, at least one independent verification of the calculations of number of monitor unit (MU) is required for every patient treated by teleradiotherapy. The aim of this study was to estimate the differences of dose distributions calculated with two treatment planning systems: Eclipse (Varian) and Oncentra MasterPlan (Elekta). Materials and methods The analysis was performed for 280 three-dimensional conformal radiotherapy treatment (3D-CRT) plans with photon beams from Varian accelerators: CL 600C/D X6 MV (109 plans), CL 2300C/D X6 MV (43 plans), and CL 2300C/D X15 MV (128 plans). The mean doses in the planning target volume (PTV) and doses at the isocenter point obtained with Eclipse and Oncentra MasterPlan (OMP) were compared with Wilcoxon matched-pairs signed rank test. Additionally, the treatment planning system (TPS) calculations were compared with dosimetric measurements performed in the inhomogeneous phantom. Results Data were analysed for 6 MV plans and for 15 MV plans separately, independently of the treatment machine. The dose values calculated in Eclipse were significantly (p <0.001) higher compared to calculations of OMP system. The average difference of the mean dose to PTV was (1.4 ± 1.0)% for X6 MV and (2.5 ± 0.6)% for X15 MV. Average dose disparities at the isocenter point were (1.3 ± 1.9)% and (2.1 ± 1.0)% for X6 MV and X15 MV beams, respectively. The largest differences were observed in lungs, air cavities, and bone structures. Moreover the variation in dosimetric measurements was less as compared to Eclipse calculations. Conclusions OMP calculations were introduced as the independent MU verification tool with the first action level range equal to 3.5%.

scholarly journals The choice of optimal radiotherapy technique for locally advanced maxillary carcinoma using 3d treatment planning system

2004 ◽  
Vol 61 (2) ◽  
pp. 145-154 ◽  
Author(s):  
Dusan Mileusnic
Keyword(s):  
Maxillary Sinus ◽  
Treatment Planning ◽  
Locally Advanced ◽  
Three Dimensional ◽  
Conformal Radiotherapy ◽  
Target Volume ◽  
Planning System ◽  
Treatment Planning System ◽  
Parotid Glands ◽  
3D Conformal Radiotherapy

Aim. To compare the isodose distribution of three radiotherapy techniques for locally advanced maxillary sinus carcinoma and analyze the potential of three-dimensional (3D) conformal radiotherapy planning in order to determine the optimal technique for target dose delivery, and spare uninvolved healthy tissue structures. Methods. Computed tomography (CT) scans of fourteen patients with T3-T4, N0, M0 maxillary sinus carcinoma were acquired and transferred to 3D treatment planning system (3D-TPS). The target volume and uninvolved dose limiting structures were contoured on axial CT slices throughout the volume of interest combining three variants of treatment plans (techniques) for each patient: 1. A conventional two-dimensional (2D) treatment plan with classically shaped one anterior two lateral opposite fields and two types of 3D conformal radiotherapy plans were compared for each patient. 2. Three-dimensional standard (3D-S) plan one anterior + two lateral opposite coplanar fields, which outlines were shaped with multileaf collimator (MLC) according to geometric information based on 3D reconstruction of target volume and organs at risk as seen in the beam eye's view (BEV) projection. 3. Three-dimensional non-standard (3D-NS) plan: one anterior + two lateral noncoplanar fields, which outlines were shaped in the same manner as in 3D-S plans. The planning parameters for target volumes and the degree of neurooptic structures and parotid glands protection were evaluated for all three techniques. Comparison of plans and treatment techniques was assessed by isodose distribution, dose statistics and dose-volume histograms. Results. The most enhanced conformity of the dose delivered to the target volume was achieved with 3D-NS technique, and significant differences were found comparing 3D-NS vs. 2D (Dmax: p<0,05 Daver: p<0,01; Dmin: p<0,05; V90: p<0,05, and V95: p<0,01), as well as 3D-NS vs. 3D-S technique (Dmin: p<0,05; V90: p<0,05, and V95: p<0,01), while there were no differences between 2D vs. 3D-S technique. 3D-S conformal plans were significantly superior to 2D plans regarding the protection of parotid glands, and the additional improvement of dose conformity was achieved with 3D-NS technique. 3D-NS technique resulted in the decrease of Dmax for ipsilateral retina compared with 3D-S technique, while the level of Dmax for optic nerve was increased (within an acceptable range) with 3D-NS technique. Conclusion. In this study, 3D planning of radiotherapy for locally advanced maxillary sinus carcinoma with noncoplanar fields, which number did not exceed the number of fields for conventional arrangement enabled conformal delivering of the adequate dose to the target volume with the improved sparing of adjacent uninvolved healthy tissue structures.

DOSIMETRIC COMPARISON OF VMAT AND 3D CONFORMAL RADIOTHERAPY IN PREOPERATIVE RECTAL CANCER

2021 ◽  
Author(s):  
Tatjana Miladinović ◽  
◽  
Aleksandar Miladinović ◽  
Nina Pavlović ◽  
Dragoslav Nikezić ◽  
...  
Keyword(s):  
Femoral Head ◽  
Treatment Planning ◽  
Conformal Radiotherapy ◽  
Target Volume ◽  
Planning System ◽  
Treatment Planning System ◽  
Conformity Index ◽  
Rectum Cancer ◽  
Clockwise Direction ◽  
3D Crt

The standard procedure in treating rectum cancer is surgical intervention, but presurgical chemotherapy and radiotherapy lead to a lower rate of localized recidives. Our study compared the results obtained by two techniques of radiation treatment planning (RTP) in radiotherapy, which patients received in the preoperative course of rectum cancer treatment, Volumetric Modulated Arc Therapy (VMAT) and field-in-field three-dimensional conformal radiotherapy (FIF 3D-CRT). We analyzed better coverage of the planning target volume (PTV) and better protection of organs from risk (OAR): bladder, bowel, left femoral head, and right femoral head results and monitor unit (MU). Also, we analyzed the target volume coverage indicators included homogeneity index (HI), and conformity index (CI). Selected five patients were treated in University Clinical Center Kragujevac during 2020. The two types of techniques for making radiotherapy plans, mentioned above, were designed for each patient using the same CT scans. All plans were done on the treatment planning system ECLIPSE- Version 15.6 (Varian). The prescribed dose for all patients was 50 Gy in 25 fractions. The first arc was planned in the clockwise direction and the second in the counter clockwise direction. FIF 3D-CRT plans were obtained by using fields from four different directions with the same isocenter. It was obtained that VMAT plans, compared to the FIF 3D-CRT, achieved better coverage of the PTV (D95%), better heterogeneity, and conformity. Protection for OAR such as the bladder, femoral heads, and small bowel is much better than that given by FIF 3D-CRT plans. However, the number of MU calculated by FIF 3D-CRT is almost twice lower compared to VMAT.

scholarly journals Can the PTV Volume Be Used to Predict the Better Solution in Manual and Automatic Planning Using the Pinnacle Treatment Planning System for Lung Stereotactic Body Radiation Therapy?

2021 ◽  
Author(s):  
Yanhua Duan ◽  
Yan Shao ◽  
Hua Chen ◽  
Hao Wang ◽  
Hengle Gu ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Treatment Planning ◽  
Roc Analysis ◽  
Stereotactic Body Radiation Therapy ◽  
Target Volume ◽  
Planning System ◽  
Treatment Planning System ◽  
Rank Test ◽  
Stereotactic Body Radiation ◽  
Lung Sbrt

Abstract Purpose: The plan quality of the stereotactic body radiation therapy (SBRT) plan is affected by the patient’s planning target volume (PTV). The predictability of PTV volume and cut-off points were investigated to judge the suitability of manual and automatic plans for lung SBRT patients.Methods: The manual and automatic SBRT plans were retrospectively designed using the Pinnacle 16.2 treatment planning system (TPS) for 98 lung cancer patients. the suitability of manual and automatic plans for each patient is comprehensively evaluated. Receiver operating characteristic (ROC) analysis was used to investigate the predictability of PTV volume and determine the cut-off point. Once the cut-off point exists, all patients were divided into two groups according to this cut-off point. The Wilcoxon signed-rank test was performed for the dosimetric comparisons between the two groups. Results: ROC analysis showed that PTV volume (AUC [Area under curve]: 0.918, p= 0.005) has diagnostic power to predict the suitability of manual and automatic plans for lung SBRT patients. The cut-off points of 22.675cc were selected for PTV volume. Regardless of some comparable results, the CI, GI, V10, and V20 of automatic plans were found to be better than manual plans below the cut-off points, and the manual plan is superior to the automatic plan in HI, GI, heart d15cc, V10, V20 above the cut-off points.Conclusion: The PTV volume of cut-off points (22.675cc) are predictive of the suitability of manual and automatic plan using Pinnacle TPS for lung SBRT patients. Automatic plans were recommended for patients with PTV volumes less than 22.675cc, and manual plans can be tried for patients with larger PTV volumes.

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.

scholarly journals Dosimetric evaluation of a three-dimensional treatment planning system

2011 ◽  
Vol 36 (1) ◽  
pp. 15 ◽  
Author(s):  
Appasamy Murugan ◽  
XavierSidonia Valas ◽  
Kuppusamy Thayalan ◽  
Velayudham Ramasubramanian
Keyword(s):  
Treatment Planning ◽  
Three Dimensional ◽  
Planning System ◽  
Treatment Planning System

Dose assessment to the Bladder during Intracavitary Brachytherapy of the Cervix using Gafchromic films

2017 ◽  
pp. 97-105
Author(s):  
J. Avevor ◽  
S. N. A. Tagoe ◽  
J. H. Amuasi ◽  
J. J. Fletcher ◽  
I. Shirazu
Keyword(s):  
Treatment Planning ◽  
Maximum Dose ◽  
Mean Difference ◽  
Planning System ◽  
Treatment Planning System ◽  
In Vivo Dosimetry ◽  
Intracavitary Brachytherapy ◽  
Gafchromic Films ◽  
System Verification ◽  
The Mean

Intracavitary brachytherapy procedures are used for cervical cancer treatment, by the insertion of radioactive implants directly into the diseased tissues. During the treatment process, the bladder together with surrounding tissues are exposed to radiations. Clinical complications do results from high doses received by parts of the bladder during intracavitary brachytherapy of the cervix. The aim of this study is to assess the dose delivered to the bladder using Gafchromic films and compare it with the optimized dose calculated by the Brachy Prowess 4.60 Treatment Planning System (TPS) reports for empirical validation and system verification. Fletcher suite applicators were used to perform thirty (30) different clinical insertions on the constructed cervix phantom and results evaluated. The mean difference between the doses calculated by the TPS and the doses measured by the Gafchromic film for the bladder at the distance of 0.5cm from the edge of the film was 16.3 % (range -35.33 to +39.37). At a distance of 1.5cm for the bladder, the mean difference was 19.4% (range -49.48 to +30.39). The TPS calculated maximum dose was typically higher than the measured maximum dose. However, in some cases, the measured doses were found to be higher than the doses calculated by the TPS. This is due to positional inaccuracies of the sources during treatment planning. It is recommended that in vivo dosimetry be performed in addition to computation.

The Role of A Conventional Simulator in Multileaf-Plan Simulation: A Proposal

2001 ◽  
Vol 87 (2) ◽  
pp. 91-94 ◽  
Author(s):  
Carlo Capirci ◽  
Polico Cesare ◽  
Giovanni Mandoliti ◽  
Giovanni Pavanato ◽  
Marcello Gava ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Organs At Risk ◽  
Three Dimensional ◽  
Planning System ◽  
Hard Copy ◽  
Treatment Planning System ◽  
Magnification Factor ◽  
Radiographic Images ◽  
Modern Computer

Modern computer networks provide satisfying levels of data recording and verification between the treatment planning system (TPS) and the accelerators, while the main weakness of the preparation chain remains the simulation. When a conventional simulator is employed, it may adversely affect the three-dimensional treatment planning system (3DPS) process because of the difficulty to document the leaf positions on the simulator location films and on the patient's skin. With a conventional simulator, hard copies of the DRRs of each field and CT scans at isocenter level are needed. In an attempt to transfer more information displayed from a BEV perspective from the 3DPS to simulator radiographs, this study aimed to reduce the quality loss by using a 2D conventional simulator in a 3DPS process. We realized an acetate photocopy of TPS data for each field, from a BEV perspective, containing: DRR, wire frames of the PTV, organs at risk and MLC aperture. The photocopies, with an appropriate magnification factor to obtain a correct projective value (ratio 1:1) at isocenter level, are carefully placed on the radiographic images on the same hard copy which allows us to better understand possible setup errors and obliges us to correct these. The method provides reliable documentation, facilitates treatment verification, and fulfils the criteria for MLC simulation. It is accurate, simple, and very inexpensive.

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