Relative to solid water, electron fluence correction factors at the depth of dose maximum in bone... more Relative to solid water, electron fluence correction factors at the depth of dose maximum in bone, lung, aluminum, and copper for nominal electron beam energies of 9 MeV and 15 MeV of the Clinac 18 accelerator have been determined experimentally and by Monte Carlo calculation. Thermoluminescent dosimeters were used to measure depth doses in these materials. The measured relative dose at dmax in the various materials versus that of solid water, when irradiated with the same number of monitor units, has been used to calculate the ratio of electron fluence for the various materials to that of solid water. The beams of the Clinac 18 were fully characterized using the EGS4/BEAM system. EGSnrc with the relativistic spin option turned on was used to optimize the primary electron energy at the exit window, and to calculate depth doses in the five phantom materials using the optimized phase-space data. Normalizing all depth doses to the dose maximum in solid water stopping power ratio corrected, measured depth doses and calculated depth doses differ by less than +/- 1% at the depth of dose maximum and by less than 4% elsewhere. Monte Carlo calculated ratios of doses in each material to dose in LiF were used to convert the TLD measurements at the dose maximum into dose at the center of the TLD in the phantom material. Fluence perturbation correction factors for a LiF TLD at the depth of dose maximum deduced from these calculations amount to less than 1% for 0.15 mm thick TLDs in low Z materials and are between 1% and 3% for TLDs in Al and Cu phantoms. Electron fluence ratios of the studied materials relative to solid water vary between 0.83+/-0.01 and 1.55+/-0.02 for materials varying in density from 0.27 g/cm3 (lung) to 8.96 g/cm3 (Cu). The difference in electron fluence ratios derived from measurements and calculations ranges from -1.6% to +0.2% at 9 MeV and from -1.9% to +0.2% at 15 MeV and is not significant at the 1sigma level. Excluding the data for Cu, electron fluence correction factors for open electron beams are approximately proportional to the electron density of the phantom material and only weakly dependent on electron beam energy.
One of the major drawbacks of the current radiochromic film dosimetry protocols is the postirradi... more One of the major drawbacks of the current radiochromic film dosimetry protocols is the postirradiation waiting time. In this article, the authors study the postirradiation time evolution of the absorption spectrum of radiochromic EBT-2 GAFCHROMIC film model. Postirradiation scanning times range from 3 min to 5 days and a dose range extends from 0 to 6 Gy. The authors compare the results of absorption spectra measurements for the latest GAFCHROMIC EBT-2 film model to the absorption spectra of the previous EBT GAFCHROMIC film model. The authors also describe a method that can establish the time error constraints on the postirradiation scanning time that will still provide an acceptable dose error for clinical applications if the protocol employing the shorter postirradiation scanning time is implemented in the clinic. The two film models experience the very same dose change in net absorbance with sensitivity of the latest EBT-2 model GAFCHROMIC film being slightly lower than its predecessor. The authors show that for two postirradiation scanning times of 30 min and 24 h, the 1% dose error can be achieved if the scanning time window is less than +/- 5 min and +/- 2 h, respectively. By comparing the resultant change in net absorbance between the latest EBT-2 and previous EBT GAFCHROMIC film models, the authors conclude that the addition of the yellow marker dye to the sensitive layer does not affect dosimetric properties of the latest film model. The authors also describe a procedure by which one can establish an acceptable time window around chosen postirradiation scanning time protocol that would provide an acceptable dose error for practical purposes.
A radiochromic film based dosimetry system for high dose rate (HDR) Iridium-192 brachytherapy sou... more A radiochromic film based dosimetry system for high dose rate (HDR) Iridium-192 brachytherapy source was described. A comparison between calibration curves established in water and Solid Water™ was provided. Pieces of EBT-2 model GAFCHROMIC™ film were irradiated in both water and Solid Water™ with HDR (192)Ir brachytherapy source in a dose range from 0 to 50 Gy. Responses of EBT-2 GAFCHROMIC™ film were compared for irradiations in water and Solid Water™ by scaling the dose between media through Monte Carlo calculated conversion factor for both setups. To decrease uncertainty in dose delivery due to positioning of the film piece with respect to the radiation source, traceable calibration irradiations were performed in a parallel-opposed beam setup. The EBT-2 GAFCHROMIC™ film based dosimetry system described in this work can provide an overall one-sigma dose uncertainty of 4.12% for doses above 1 Gy. The ratio of dose delivered to the sensitive layer of the film in water to the dose delivered to the sensitive layer of the film in Solid Water™ was calculated using Monte Carlo simulations to be 0.9941 ± 0.0007. A radiochromic film based dosimetry system using only the green color channel of a flatbed document scanner showed superior precision if used alone in a dose range that extends up to 50 Gy, which greatly decreases the complexity of work. In addition, Solid Water™ material was shown to be a viable alternative to water in performing radiochromic film based dosimetry with HDR (192)Ir brachytherapy sources.
ABSTRACT Purpose: To develop a flexible software package, on low cost hardware with the aim of in... more ABSTRACT Purpose: To develop a flexible software package, on low cost hardware with the aim of integrating new patient specific treatment planning with Monte Carlo dose calculation suitable for large‐scale prospective and retrospective treatment planning studies.Programming Philosophy: The McGill Monte Carlo Treatment Planning system (MMCTP) is designed as a software environment for the research development of patient specific treatment planning. The design includes a workstation GUI for treatment planning tools, and anonymous access to standard low cost hardware for MC dose calculation. Results: Before using MMCTP, treatment plans are converted into the so‐called McGill RT format. This new file structure was designed for saving patient plans on the workstation. The current MMCTP features are: (a) DICOM and RTOG imports; (b) transverse/sagittal/coronal slice viewing for contours, CT scans, dose distributions; (c) contouring tools; (d) colour‐wash and isodose line display; (e) DVH analysis, and dose matrix comparison tools; (f) external beam editing; (g) thumbnail CT navigation tool; (h) EGS/Beam calculation and XVMC patient transport for photon and electron beams. MMCTP uses a two‐step process to generate MC dose distributions. The MC module controls egs/Beam and XVMC calculations. Input files, prepared from the beam geometry, are uploaded and run on the cluster using shell commands. Upon completion of XVMC, the GUI downloads individual dose files. Conclusion: The MMCTP GUI provides a flexible research platform for the development of patient specific MC treatment planning for photon and electron external beam radiation therapy. MMCTP uses an internal storage format that is flexible in that it allows for multi‐instance multi‐modality image information useful in the planning process. The visualization, dose matrix operation and DVH tools offer extensive possibility for plan analysis and comparison to plans imported from commercial treatment planning systems through well‐documented image storage protocols such as DICOM.
ABSTRACT Purpose: To evaluate accuracy and reproducibility of a radiochromic film-based protocol ... more ABSTRACT Purpose: To evaluate accuracy and reproducibility of a radiochromic film-based protocol to measure computer tomography dose index (CTDI) as a part of annual QA on CT scanners and kV CBCT systems attached to linear accelerators.
ABSTRACT We investigated the effect of the EBT3 GafChromicTM film model absorbed dose energy resp... more ABSTRACT We investigated the effect of the EBT3 GafChromicTM film model absorbed dose energy response when used for percent depth dose (PDD) measurements in low-energy photon beams. We measured PDDs in water from a Xoft 50 kVp source using EBT3 film, and compared them to PDD measurements acquired with a PTW-TN34013 parallel-plate ionization chamber. For the x-ray source, we simulated spectra using the EGSnrc (BEAMnrc) Monte Carlo code, and calculated Half Value Layer (HVL) at different distances from the source in water. Pieces of EBT3 film were irradiated in air and calibration curves were created in terms of air-kerma in air ((Kair)air) for different beam qualities. Pieces of EBT3 film were positioned at distances of 2-6 cm from the Xoft source in a water phantom using a custom-made holder, and irradiated at the same time. As scatter is incorporated in the measured film signal in water, measured (Kair)wat was subsequently converted into absorbed dose to water by the ratio of mass energy absorption coefficients following the AAPM TG-61 dosimetry protocol. Our results show that film calibration curves obtained at beam qualities near the effective energy of the Xoft 50 kVp source in water lead to variation in absorbed dose energy dependence of the response of around 3%. However, if the calibration curve was established at MV beam quality, the error in absorbed dose could be as large as 15%. We observed agreement within 1% between PDD measurements using EBT3 film model (using a calibration curve obtained at 80 kVp, HVL=2.18 mm Al, Eeff=29.5 keV) and the parallel-plate ionization chamber. Accurate dose measurements using radiochromic films at low photon energies require that the radiochromic film dosimetry system be calibrated at corresponding low energies, as large absorbed dose errors are expected for calibrations performed at MV beam qualities.
ABSTRACT The purpose of the study was evaluating accuracy and reproducibility of a radiochromic f... more ABSTRACT The purpose of the study was evaluating accuracy and reproducibility of a radiochromic film-based protocol to measure computer tomography dose index (CTDI) as a part of annual QA on CT scanners and kV-CBCT systems attached to linear accelerators. Energy dependence of Gafchromic XR-QA2 ® film model was tested over imaging beam qualities (50 – 140 kVp). Film pieces were irradiated in air to known values of air-kerma (up to 10 cGy). Calibration curves for each beam quality were created (Film reflectance change Vs. Air-kerma in air). Film responses for same air-kerma values were compared. Film strips were placed into holes of a CTDI phantom and irradiated for several clinical scanning protocols. Film reflectance change was converted into dose to water and used to calculate CTDIvol values. Measured and tabulated CTDIvol values were compared. Average variations of ±5.2% in the mean film reflectance change were observed in the energy range of 80 to 140 keV, and 11.1% between 50 and 140 keV. Measured CTDI values were in average 10% lower than tabulated CTDI values for CT-simulators, and 44% higher for CBCT systems. Results presented a mean variation for the same machine and protocol of 2.6%. Variation of film response is within ±5% resulting in ±15% systematic error in dose estimation if a single calibration curve is used. Relatively large discrepancy between measured and tabulated CTDI values strongly support the trend towards replacing CTDI value with equilibrium dose measurement in the center of cylindrical phantom, as suggested by TG- 111.
In the past, film dosimetry was developed into a powerful tool for external beam radiotherapy tre... more In the past, film dosimetry was developed into a powerful tool for external beam radiotherapy treatment verification and quality assurance. The objective of this work was the development and clinical testing of the EBT3 model GafChromic film based brachytherapy quality assurance (QA) system. Retrospective dosimetry study was performed to test a patient-specific QA system for preoperative endorectal brachytherapy that uses a radiochromic film dosimetry system. A dedicated phantom for brachytherapy applicator used for rectal cancer treatment was fabricated enabling us to compare calculated-to-measured dose distributions. Starting from the same criteria used for external beam intensity-modulated radiation therapy QA (3%, 3 mm), passing criteria for high- and low-dose gradient regions were subsequently determined. Finally, we investigated the QA system's sensitivity to controlled source positional errors on selected patient plans. In low-dose gradient regions, measured dose distribu...
The TrueBeam linear accelerator platform has a developer's mode which permits the user dynami... more The TrueBeam linear accelerator platform has a developer's mode which permits the user dynamic control over many of the machine's mechanical and radiation systems. Using this research tool, synchronous couch and gantry motion can be programmed to simulate isocentric treatment with a shortened SAD, with benefits such as smaller projected MLC leaf widths and an increased dose rate. In this work, water tank measurements were used to commission a virtual linear accelerator with an 85 cm SAD in Eclipse, from which several arc-based radiotherapy treatments were generated, including an inverse optimized VMAT delivery. For each plan, the pertinent treatment delivery information was extracted from control points specified in the Eclipse-exported DICOM files using the pydicom package in Python, allowing construction of an XML control file. The dimensions of the jaws and MLC positions, defined for an 85 cm SAD in Eclipse, were scaled for delivery on a conventional SAD linear accelerator, and translational couch motion was added as a function of gantry angle to simulate delivery at 85 cm SAD. Ionization chamber and Gafchromic film measurements were used to compare the radiation delivery to dose calculations in Eclipse. With the exception of the VMAT delivery, ionization chamber measurements agreed withinmore » 3.3% of the Eclipse calculations. For the VMAT delivery, the ionization chamber was located in an inhomogeneous region, but gamma evaluation of the Gafchromic film plane resulted in a 94.5% passing rate using criteria of 3 mm/3%. The results indicate that Eclipse calculation infrastructure can be used.« less
ABSTRACT Purpose: To evaluate accuracy and reproducibility of a radiochromic film-based protocol ... more ABSTRACT Purpose: To evaluate accuracy and reproducibility of a radiochromic film-based protocol to measure computer tomography dose index (CTDI) as a part of annual QA on CT scanners and kV CBCT systems attached to linear accelerators.
ABSTRACT The purpose of the study was evaluating accuracy and reproducibility of a radiochromic f... more ABSTRACT The purpose of the study was evaluating accuracy and reproducibility of a radiochromic film-based protocol to measure computer tomography dose index (CTDI) as a part of annual QA on CT scanners and kV-CBCT systems attached to linear accelerators. Energy dependence of Gafchromic XR-QA2 ® film model was tested over imaging beam qualities (50 – 140 kVp). Film pieces were irradiated in air to known values of air-kerma (up to 10 cGy). Calibration curves for each beam quality were created (Film reflectance change Vs. Air-kerma in air). Film responses for same air-kerma values were compared. Film strips were placed into holes of a CTDI phantom and irradiated for several clinical scanning protocols. Film reflectance change was converted into dose to water and used to calculate CTDIvol values. Measured and tabulated CTDIvol values were compared. Average variations of ±5.2% in the mean film reflectance change were observed in the energy range of 80 to 140 keV, and 11.1% between 50 and 140 keV. Measured CTDI values were in average 10% lower than tabulated CTDI values for CT-simulators, and 44% higher for CBCT systems. Results presented a mean variation for the same machine and protocol of 2.6%. Variation of film response is within ±5% resulting in ±15% systematic error in dose estimation if a single calibration curve is used. Relatively large discrepancy between measured and tabulated CTDI values strongly support the trend towards replacing CTDI value with equilibrium dose measurement in the center of cylindrical phantom, as suggested by TG- 111.
The TrueBeam linear accelerator platform has a developer's mode which permits the user dynami... more The TrueBeam linear accelerator platform has a developer's mode which permits the user dynamic control over many of the machine's mechanical and radiation systems. Using this research tool, synchronous couch and gantry motion can be programmed to simulate isocentric treatment with a shortened SAD, with benefits such as smaller projected MLC leaf widths and an increased dose rate. In this work, water tank measurements were used to commission a virtual linear accelerator with an 85 cm SAD in Eclipse, from which several arc-based radiotherapy treatments were generated, including an inverse optimized VMAT delivery. For each plan, the pertinent treatment delivery information was extracted from control points specified in the Eclipse-exported DICOM files using the pydicom package in Python, allowing construction of an XML control file. The dimensions of the jaws and MLC positions, defined for an 85 cm SAD in Eclipse, were scaled for delivery on a conventional SAD linear accelerator, and translational couch motion was added as a function of gantry angle to simulate delivery at 85 cm SAD. Ionization chamber and Gafchromic film measurements were used to compare the radiation delivery to dose calculations in Eclipse. With the exception of the VMAT delivery, ionization chamber measurements agreed withinmore » 3.3% of the Eclipse calculations. For the VMAT delivery, the ionization chamber was located in an inhomogeneous region, but gamma evaluation of the Gafchromic film plane resulted in a 94.5% passing rate using criteria of 3 mm/3%. The results indicate that Eclipse calculation infrastructure can be used.« less
International braz j urol : official journal of the Brazilian Society of Urology
Biochemical failure has been defined as 3 consecutive increases in PSA following curative treatme... more Biochemical failure has been defined as 3 consecutive increases in PSA following curative treatment of prostate cancer. The appropriate management in such cases is controversial. The most usual treatment has been early introduction of hormones. Such patients will live for many years and hormone therapy causes important secondary effects and increases costs. The guideline in our Department of Radiotherapy has been to follow up, with no initial therapy, cases with low PSA and short PSA doubling time. The present study reports this experience. 528 patients with localized prostate cancer were treated by radical approach between 1992 and 1999, with external radiotherapy, with or without adjuvant hormone therapy. After a median follow-up of 77 months, there were 207 (39%) cases with biochemical failure, 78 of which were followed without therapy after the identification of biochemical failure. All of them were asymptomatic patients and had negative radiographic examinations or did not have...
Purpose: To investigate the feasibility of decomposition of differential uptake volume histograms... more Purpose: To investigate the feasibility of decomposition of differential uptake volume histograms (UVH) derived from FDG‐PET and CT data for uncovering tumor sub‐volumes as a novel approach for defining biological target volumes (BTV) for use in radiotherapytreatment planning. Methods: For a cohort of 27 histopathologically proven non‐small cell lungcarcinoma(NSCLC) patients, background uptake values were sampled within contra‐lateral healthy lung over PET slices containing tumor and then scaled by the ratio of tissue densities between healthy lung and tumor derived from CT data. Signal‐to‐background uptake values within volumes of interest encompassing the tumor were scored from which differential uptake volume histograms were constructed. These were subsequently decomposed into the minimum number of analytical functions that yielded acceptable net fits, as assessed by chi2 values. Results: Based on the assumption that each function used to decompose the UVH may correspond to a single sub‐volume comprising the volume of interest sampled, at least four sub‐volumes consistently evolved for our patient population. Furthermore, if crossing points between adjacent functions are interpreted as threshold values that differentiate sub‐volumes, average threshold values between the four sub‐volumes were found to be 0.80±0.21, 1.56±0.48, and 2.96±1.04 for adenocarcinomas, 0.89±0.48, 1.60±0.40, and 2.85±0.75 for large cell carcinomas, and 0.84±0.31, 1.70±0.58, and 3.72±1.68 for squamous cell carcinomas. Conclusions: Our study suggests that FDG‐based PET data could be used to identify biological sub‐volumes within tumor in NSCLC patients. Significant fluctuations in threshold values throughout the patient cohort can be explained as a consequence of large variability in physiological status of the tumor volume for each patient at the time of the PET/CT scan. This further suggests that BTV threshold values may be rather patient‐specific, and could be determined by creation and curve fitting of differential uptake volume histograms on a patient‐specific basis.
Relative to solid water, electron fluence correction factors at the depth of dose maximum in bone... more Relative to solid water, electron fluence correction factors at the depth of dose maximum in bone, lung, aluminum, and copper for nominal electron beam energies of 9 MeV and 15 MeV of the Clinac 18 accelerator have been determined experimentally and by Monte Carlo calculation. Thermoluminescent dosimeters were used to measure depth doses in these materials. The measured relative dose at dmax in the various materials versus that of solid water, when irradiated with the same number of monitor units, has been used to calculate the ratio of electron fluence for the various materials to that of solid water. The beams of the Clinac 18 were fully characterized using the EGS4/BEAM system. EGSnrc with the relativistic spin option turned on was used to optimize the primary electron energy at the exit window, and to calculate depth doses in the five phantom materials using the optimized phase-space data. Normalizing all depth doses to the dose maximum in solid water stopping power ratio corrected, measured depth doses and calculated depth doses differ by less than +/- 1% at the depth of dose maximum and by less than 4% elsewhere. Monte Carlo calculated ratios of doses in each material to dose in LiF were used to convert the TLD measurements at the dose maximum into dose at the center of the TLD in the phantom material. Fluence perturbation correction factors for a LiF TLD at the depth of dose maximum deduced from these calculations amount to less than 1% for 0.15 mm thick TLDs in low Z materials and are between 1% and 3% for TLDs in Al and Cu phantoms. Electron fluence ratios of the studied materials relative to solid water vary between 0.83+/-0.01 and 1.55+/-0.02 for materials varying in density from 0.27 g/cm3 (lung) to 8.96 g/cm3 (Cu). The difference in electron fluence ratios derived from measurements and calculations ranges from -1.6% to +0.2% at 9 MeV and from -1.9% to +0.2% at 15 MeV and is not significant at the 1sigma level. Excluding the data for Cu, electron fluence correction factors for open electron beams are approximately proportional to the electron density of the phantom material and only weakly dependent on electron beam energy.
One of the major drawbacks of the current radiochromic film dosimetry protocols is the postirradi... more One of the major drawbacks of the current radiochromic film dosimetry protocols is the postirradiation waiting time. In this article, the authors study the postirradiation time evolution of the absorption spectrum of radiochromic EBT-2 GAFCHROMIC film model. Postirradiation scanning times range from 3 min to 5 days and a dose range extends from 0 to 6 Gy. The authors compare the results of absorption spectra measurements for the latest GAFCHROMIC EBT-2 film model to the absorption spectra of the previous EBT GAFCHROMIC film model. The authors also describe a method that can establish the time error constraints on the postirradiation scanning time that will still provide an acceptable dose error for clinical applications if the protocol employing the shorter postirradiation scanning time is implemented in the clinic. The two film models experience the very same dose change in net absorbance with sensitivity of the latest EBT-2 model GAFCHROMIC film being slightly lower than its predecessor. The authors show that for two postirradiation scanning times of 30 min and 24 h, the 1% dose error can be achieved if the scanning time window is less than +/- 5 min and +/- 2 h, respectively. By comparing the resultant change in net absorbance between the latest EBT-2 and previous EBT GAFCHROMIC film models, the authors conclude that the addition of the yellow marker dye to the sensitive layer does not affect dosimetric properties of the latest film model. The authors also describe a procedure by which one can establish an acceptable time window around chosen postirradiation scanning time protocol that would provide an acceptable dose error for practical purposes.
A radiochromic film based dosimetry system for high dose rate (HDR) Iridium-192 brachytherapy sou... more A radiochromic film based dosimetry system for high dose rate (HDR) Iridium-192 brachytherapy source was described. A comparison between calibration curves established in water and Solid Water™ was provided. Pieces of EBT-2 model GAFCHROMIC™ film were irradiated in both water and Solid Water™ with HDR (192)Ir brachytherapy source in a dose range from 0 to 50 Gy. Responses of EBT-2 GAFCHROMIC™ film were compared for irradiations in water and Solid Water™ by scaling the dose between media through Monte Carlo calculated conversion factor for both setups. To decrease uncertainty in dose delivery due to positioning of the film piece with respect to the radiation source, traceable calibration irradiations were performed in a parallel-opposed beam setup. The EBT-2 GAFCHROMIC™ film based dosimetry system described in this work can provide an overall one-sigma dose uncertainty of 4.12% for doses above 1 Gy. The ratio of dose delivered to the sensitive layer of the film in water to the dose delivered to the sensitive layer of the film in Solid Water™ was calculated using Monte Carlo simulations to be 0.9941 ± 0.0007. A radiochromic film based dosimetry system using only the green color channel of a flatbed document scanner showed superior precision if used alone in a dose range that extends up to 50 Gy, which greatly decreases the complexity of work. In addition, Solid Water™ material was shown to be a viable alternative to water in performing radiochromic film based dosimetry with HDR (192)Ir brachytherapy sources.
ABSTRACT Purpose: To develop a flexible software package, on low cost hardware with the aim of in... more ABSTRACT Purpose: To develop a flexible software package, on low cost hardware with the aim of integrating new patient specific treatment planning with Monte Carlo dose calculation suitable for large‐scale prospective and retrospective treatment planning studies.Programming Philosophy: The McGill Monte Carlo Treatment Planning system (MMCTP) is designed as a software environment for the research development of patient specific treatment planning. The design includes a workstation GUI for treatment planning tools, and anonymous access to standard low cost hardware for MC dose calculation. Results: Before using MMCTP, treatment plans are converted into the so‐called McGill RT format. This new file structure was designed for saving patient plans on the workstation. The current MMCTP features are: (a) DICOM and RTOG imports; (b) transverse/sagittal/coronal slice viewing for contours, CT scans, dose distributions; (c) contouring tools; (d) colour‐wash and isodose line display; (e) DVH analysis, and dose matrix comparison tools; (f) external beam editing; (g) thumbnail CT navigation tool; (h) EGS/Beam calculation and XVMC patient transport for photon and electron beams. MMCTP uses a two‐step process to generate MC dose distributions. The MC module controls egs/Beam and XVMC calculations. Input files, prepared from the beam geometry, are uploaded and run on the cluster using shell commands. Upon completion of XVMC, the GUI downloads individual dose files. Conclusion: The MMCTP GUI provides a flexible research platform for the development of patient specific MC treatment planning for photon and electron external beam radiation therapy. MMCTP uses an internal storage format that is flexible in that it allows for multi‐instance multi‐modality image information useful in the planning process. The visualization, dose matrix operation and DVH tools offer extensive possibility for plan analysis and comparison to plans imported from commercial treatment planning systems through well‐documented image storage protocols such as DICOM.
ABSTRACT Purpose: To evaluate accuracy and reproducibility of a radiochromic film-based protocol ... more ABSTRACT Purpose: To evaluate accuracy and reproducibility of a radiochromic film-based protocol to measure computer tomography dose index (CTDI) as a part of annual QA on CT scanners and kV CBCT systems attached to linear accelerators.
ABSTRACT We investigated the effect of the EBT3 GafChromicTM film model absorbed dose energy resp... more ABSTRACT We investigated the effect of the EBT3 GafChromicTM film model absorbed dose energy response when used for percent depth dose (PDD) measurements in low-energy photon beams. We measured PDDs in water from a Xoft 50 kVp source using EBT3 film, and compared them to PDD measurements acquired with a PTW-TN34013 parallel-plate ionization chamber. For the x-ray source, we simulated spectra using the EGSnrc (BEAMnrc) Monte Carlo code, and calculated Half Value Layer (HVL) at different distances from the source in water. Pieces of EBT3 film were irradiated in air and calibration curves were created in terms of air-kerma in air ((Kair)air) for different beam qualities. Pieces of EBT3 film were positioned at distances of 2-6 cm from the Xoft source in a water phantom using a custom-made holder, and irradiated at the same time. As scatter is incorporated in the measured film signal in water, measured (Kair)wat was subsequently converted into absorbed dose to water by the ratio of mass energy absorption coefficients following the AAPM TG-61 dosimetry protocol. Our results show that film calibration curves obtained at beam qualities near the effective energy of the Xoft 50 kVp source in water lead to variation in absorbed dose energy dependence of the response of around 3%. However, if the calibration curve was established at MV beam quality, the error in absorbed dose could be as large as 15%. We observed agreement within 1% between PDD measurements using EBT3 film model (using a calibration curve obtained at 80 kVp, HVL=2.18 mm Al, Eeff=29.5 keV) and the parallel-plate ionization chamber. Accurate dose measurements using radiochromic films at low photon energies require that the radiochromic film dosimetry system be calibrated at corresponding low energies, as large absorbed dose errors are expected for calibrations performed at MV beam qualities.
ABSTRACT The purpose of the study was evaluating accuracy and reproducibility of a radiochromic f... more ABSTRACT The purpose of the study was evaluating accuracy and reproducibility of a radiochromic film-based protocol to measure computer tomography dose index (CTDI) as a part of annual QA on CT scanners and kV-CBCT systems attached to linear accelerators. Energy dependence of Gafchromic XR-QA2 ® film model was tested over imaging beam qualities (50 – 140 kVp). Film pieces were irradiated in air to known values of air-kerma (up to 10 cGy). Calibration curves for each beam quality were created (Film reflectance change Vs. Air-kerma in air). Film responses for same air-kerma values were compared. Film strips were placed into holes of a CTDI phantom and irradiated for several clinical scanning protocols. Film reflectance change was converted into dose to water and used to calculate CTDIvol values. Measured and tabulated CTDIvol values were compared. Average variations of ±5.2% in the mean film reflectance change were observed in the energy range of 80 to 140 keV, and 11.1% between 50 and 140 keV. Measured CTDI values were in average 10% lower than tabulated CTDI values for CT-simulators, and 44% higher for CBCT systems. Results presented a mean variation for the same machine and protocol of 2.6%. Variation of film response is within ±5% resulting in ±15% systematic error in dose estimation if a single calibration curve is used. Relatively large discrepancy between measured and tabulated CTDI values strongly support the trend towards replacing CTDI value with equilibrium dose measurement in the center of cylindrical phantom, as suggested by TG- 111.
In the past, film dosimetry was developed into a powerful tool for external beam radiotherapy tre... more In the past, film dosimetry was developed into a powerful tool for external beam radiotherapy treatment verification and quality assurance. The objective of this work was the development and clinical testing of the EBT3 model GafChromic film based brachytherapy quality assurance (QA) system. Retrospective dosimetry study was performed to test a patient-specific QA system for preoperative endorectal brachytherapy that uses a radiochromic film dosimetry system. A dedicated phantom for brachytherapy applicator used for rectal cancer treatment was fabricated enabling us to compare calculated-to-measured dose distributions. Starting from the same criteria used for external beam intensity-modulated radiation therapy QA (3%, 3 mm), passing criteria for high- and low-dose gradient regions were subsequently determined. Finally, we investigated the QA system's sensitivity to controlled source positional errors on selected patient plans. In low-dose gradient regions, measured dose distribu...
The TrueBeam linear accelerator platform has a developer's mode which permits the user dynami... more The TrueBeam linear accelerator platform has a developer's mode which permits the user dynamic control over many of the machine's mechanical and radiation systems. Using this research tool, synchronous couch and gantry motion can be programmed to simulate isocentric treatment with a shortened SAD, with benefits such as smaller projected MLC leaf widths and an increased dose rate. In this work, water tank measurements were used to commission a virtual linear accelerator with an 85 cm SAD in Eclipse, from which several arc-based radiotherapy treatments were generated, including an inverse optimized VMAT delivery. For each plan, the pertinent treatment delivery information was extracted from control points specified in the Eclipse-exported DICOM files using the pydicom package in Python, allowing construction of an XML control file. The dimensions of the jaws and MLC positions, defined for an 85 cm SAD in Eclipse, were scaled for delivery on a conventional SAD linear accelerator, and translational couch motion was added as a function of gantry angle to simulate delivery at 85 cm SAD. Ionization chamber and Gafchromic film measurements were used to compare the radiation delivery to dose calculations in Eclipse. With the exception of the VMAT delivery, ionization chamber measurements agreed withinmore » 3.3% of the Eclipse calculations. For the VMAT delivery, the ionization chamber was located in an inhomogeneous region, but gamma evaluation of the Gafchromic film plane resulted in a 94.5% passing rate using criteria of 3 mm/3%. The results indicate that Eclipse calculation infrastructure can be used.« less
ABSTRACT Purpose: To evaluate accuracy and reproducibility of a radiochromic film-based protocol ... more ABSTRACT Purpose: To evaluate accuracy and reproducibility of a radiochromic film-based protocol to measure computer tomography dose index (CTDI) as a part of annual QA on CT scanners and kV CBCT systems attached to linear accelerators.
ABSTRACT The purpose of the study was evaluating accuracy and reproducibility of a radiochromic f... more ABSTRACT The purpose of the study was evaluating accuracy and reproducibility of a radiochromic film-based protocol to measure computer tomography dose index (CTDI) as a part of annual QA on CT scanners and kV-CBCT systems attached to linear accelerators. Energy dependence of Gafchromic XR-QA2 ® film model was tested over imaging beam qualities (50 – 140 kVp). Film pieces were irradiated in air to known values of air-kerma (up to 10 cGy). Calibration curves for each beam quality were created (Film reflectance change Vs. Air-kerma in air). Film responses for same air-kerma values were compared. Film strips were placed into holes of a CTDI phantom and irradiated for several clinical scanning protocols. Film reflectance change was converted into dose to water and used to calculate CTDIvol values. Measured and tabulated CTDIvol values were compared. Average variations of ±5.2% in the mean film reflectance change were observed in the energy range of 80 to 140 keV, and 11.1% between 50 and 140 keV. Measured CTDI values were in average 10% lower than tabulated CTDI values for CT-simulators, and 44% higher for CBCT systems. Results presented a mean variation for the same machine and protocol of 2.6%. Variation of film response is within ±5% resulting in ±15% systematic error in dose estimation if a single calibration curve is used. Relatively large discrepancy between measured and tabulated CTDI values strongly support the trend towards replacing CTDI value with equilibrium dose measurement in the center of cylindrical phantom, as suggested by TG- 111.
The TrueBeam linear accelerator platform has a developer's mode which permits the user dynami... more The TrueBeam linear accelerator platform has a developer's mode which permits the user dynamic control over many of the machine's mechanical and radiation systems. Using this research tool, synchronous couch and gantry motion can be programmed to simulate isocentric treatment with a shortened SAD, with benefits such as smaller projected MLC leaf widths and an increased dose rate. In this work, water tank measurements were used to commission a virtual linear accelerator with an 85 cm SAD in Eclipse, from which several arc-based radiotherapy treatments were generated, including an inverse optimized VMAT delivery. For each plan, the pertinent treatment delivery information was extracted from control points specified in the Eclipse-exported DICOM files using the pydicom package in Python, allowing construction of an XML control file. The dimensions of the jaws and MLC positions, defined for an 85 cm SAD in Eclipse, were scaled for delivery on a conventional SAD linear accelerator, and translational couch motion was added as a function of gantry angle to simulate delivery at 85 cm SAD. Ionization chamber and Gafchromic film measurements were used to compare the radiation delivery to dose calculations in Eclipse. With the exception of the VMAT delivery, ionization chamber measurements agreed withinmore » 3.3% of the Eclipse calculations. For the VMAT delivery, the ionization chamber was located in an inhomogeneous region, but gamma evaluation of the Gafchromic film plane resulted in a 94.5% passing rate using criteria of 3 mm/3%. The results indicate that Eclipse calculation infrastructure can be used.« less
International braz j urol : official journal of the Brazilian Society of Urology
Biochemical failure has been defined as 3 consecutive increases in PSA following curative treatme... more Biochemical failure has been defined as 3 consecutive increases in PSA following curative treatment of prostate cancer. The appropriate management in such cases is controversial. The most usual treatment has been early introduction of hormones. Such patients will live for many years and hormone therapy causes important secondary effects and increases costs. The guideline in our Department of Radiotherapy has been to follow up, with no initial therapy, cases with low PSA and short PSA doubling time. The present study reports this experience. 528 patients with localized prostate cancer were treated by radical approach between 1992 and 1999, with external radiotherapy, with or without adjuvant hormone therapy. After a median follow-up of 77 months, there were 207 (39%) cases with biochemical failure, 78 of which were followed without therapy after the identification of biochemical failure. All of them were asymptomatic patients and had negative radiographic examinations or did not have...
Purpose: To investigate the feasibility of decomposition of differential uptake volume histograms... more Purpose: To investigate the feasibility of decomposition of differential uptake volume histograms (UVH) derived from FDG‐PET and CT data for uncovering tumor sub‐volumes as a novel approach for defining biological target volumes (BTV) for use in radiotherapytreatment planning. Methods: For a cohort of 27 histopathologically proven non‐small cell lungcarcinoma(NSCLC) patients, background uptake values were sampled within contra‐lateral healthy lung over PET slices containing tumor and then scaled by the ratio of tissue densities between healthy lung and tumor derived from CT data. Signal‐to‐background uptake values within volumes of interest encompassing the tumor were scored from which differential uptake volume histograms were constructed. These were subsequently decomposed into the minimum number of analytical functions that yielded acceptable net fits, as assessed by chi2 values. Results: Based on the assumption that each function used to decompose the UVH may correspond to a single sub‐volume comprising the volume of interest sampled, at least four sub‐volumes consistently evolved for our patient population. Furthermore, if crossing points between adjacent functions are interpreted as threshold values that differentiate sub‐volumes, average threshold values between the four sub‐volumes were found to be 0.80±0.21, 1.56±0.48, and 2.96±1.04 for adenocarcinomas, 0.89±0.48, 1.60±0.40, and 2.85±0.75 for large cell carcinomas, and 0.84±0.31, 1.70±0.58, and 3.72±1.68 for squamous cell carcinomas. Conclusions: Our study suggests that FDG‐based PET data could be used to identify biological sub‐volumes within tumor in NSCLC patients. Significant fluctuations in threshold values throughout the patient cohort can be explained as a consequence of large variability in physiological status of the tumor volume for each patient at the time of the PET/CT scan. This further suggests that BTV threshold values may be rather patient‐specific, and could be determined by creation and curve fitting of differential uptake volume histograms on a patient‐specific basis.
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Papers by François Deblois