RESUMO
PURPOSE: The purpose of this study was to investigate influence of different scanning speeds on measurements of photon beam flatness and symmetry. METHODS: Commissioning and quality assurance of linear accelerators require extensive beam measurements. To increase efficacy, we evaluated flatness, symmetry and penumbra of 6MV photon beam using the Varian-TrueBeamTM system. Scanning speeds were 0.3, 0.5, 0.75, 1, 1.5, and 2.5cm/s. Measurements were performed in water phantom (BluePhantom2 , IBA-Dosimetry) at depths of maximum dose, 5,10, and 20cm, for 10×10 cm field size. For each scanning speed and depth, measurements were repeated five times to give results sufficient statistical significance, in both crossline and inline directions. Beam flatness was calculated using variation over mean (80%), whereas symmetry was calculated using point difference quotient (IEC) algorithm. After filed scanning chamber (Wellhofer) was fully stopped, system was paused for stabilization time of 15s to avoid buildup of ripples. RESULTS: It was noticed for all measurements that minimum and maximum flatness and symmetry were recorded when scanning speeds were 0.3cm and 2.5cm, respectively. For depth of maximum dose, maximum flatness and symmetry were 0.82% and 100.58% (crossplane), and 0.94% and 100.96% (inplane). The average was 0.76% and 100.38% (SD 0.04 and 0.12) for crossplane; 0.89% and 100.87% (SD 0.04 and 0.06) for inplane measurements. As the scanning depth increased, flatness and symmetry increased, but SD for all measurements was within the same range (0.04-0.07 and 0.04-0.12). The maximum absolute difference for flatness and symmetry for maximum and minimum speed were 0.16% and 0.34%.However, for scanning speeds from 0.5-1cm/s, results were almost identical with maximum SD 0.03 for both flatness and symmetry. Use of different scanning speeds did not influence penumbra; SD was 0 for all measurements. CONCLUSIONS: This study reveals small influence of scanning speed within predefined range. Consequently, difference in measurements does not have clinical significance.
RESUMO
PURPOSE: It is well established that using image guidance for prostate motion allows reduction of margin, dose escalation, decreased toxicity and recently improved outcomes. However, current methods only account for translational motion, not rotational variations. The purpose of this study is to assess whether rotations in anatomy lead to significant changes in the delivered dose for prostate patients. METHODS: Under an IRB approved protocol, 11 consecutive patients underwent prostate IMRT using IGRT with implanted metal-oxide semiconductor field-effect transistors (MOSFETs); the Dose Verification System (DVS) manufactured by Sicel Technologies. Two dosimeters were implanted per patient. From conebeam CT (CBCT) registration, corrections were applied to all translational errors. For rotations larger than 3 degrees, patient were repositioned and realigned to attempt to correct the rotation. Both translational and rotational errors based on the CBCT were documented. The daily DVS readings were compared to CBCT rotations about each axis (pitch, roll and yaw) and the root-mean square (RMS) rotation. RESULTS: 372 CBCT images were acquired. The correlation between rotation and DVS measurement was analyzed using linear regression. The R2 value for pitch was 0.059 and 0.144 for each dosimeter, respectively. For roll, the R2 values were 0.049 and 0.001. For yaw, the values were <0.001. For the RMS rotation, R2 was 0.034 and 0.038. As it could confound results, the angular dependence of the dosimeters was measured during commissioning and found that it was approximately 0.5% for 5 degree rotations. CONCLUSIONS: We did not find any significant correlation between prostate rotation around any axis and discrepancy in DVS reading. These results show that rotations seen clinically do not have a substantial effect on the dose delivered to the prostate. Further studies will attempt to determine at what angle rotations begin to affect the dose distribution, if at all.
RESUMO
PURPOSE: To quantify the variation in CT number generated by the Simulix Evolution CBCT with changes in scan length and phantom thickness. METHODS: Three phantoms were used in this study: CIRS Model 610 AAPM CT Phantom, Gammex 467 Tissue Characterization Phantom, and Catphan 600 phantom. The AAPM Phantom was used to assess the variation of HU with phantom thickness. Scans were acquired with two field size settings (full- and half-beam) with and without a 3.5 cm thick ring. The Catphan and Gammex phantoms were used to assess the Simulix's capability of producing a consistent CT-to-ED conversion table with different scan lengths, ranging from 1 cm (very thin) to 20 cm (clinical use). The data were also compared to data acquired with our in-house CT Sim (GE HiLite LightSpeed 16 slice). RESULTS: The AAPM phantom scans with and without the ring yielded an average difference in HU of 145 HU (full-beam) and 74 HU (half-beam) for each of five inserts. The HU for Cortical Bone (SB3) [largest Gammex electron density insert; 1.69] ranged from 923 to 1170 HU for the 4 cm and 1 cm scan lengths, respectively. The HU for Teflon [largest Catphan electron density insert; 1.867] ranged from 657 to 951 for the 20 cm and 1 cm scan lengths, respectively. The HU for air in Catphan ranged from -749 to -905, and the HU for LDPE [electron density 0.944] ranged from -82 to -42, for the 20 cm and 1 cm scan lengths, respectively. CONCLUSIONS: Results show a large variability in the calculated CT number with differences in phantom thickness, as evidenced by the results with the AAPM phantom. In addition, there appears to be a dependence on scan length, attributed to increased scatter contribution. Further tests will be done to evaluate the appropriateness of the use of the Simulix CBCT unit for heterogeneity corrected external beam treatment planning. The author has received no funding during the course of this research.