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Biomedical subjects

Anders Ahnesjö

Publications and source records attributed to Anders Ahnesjö.

11 recordsLinked to original sources

Pencil kernel correction and residual error estimation for quality-index-based dose calculations.

Experimental data from 593 photon beams were used to quantify the errors in dose calculations using a previously published pencil kernel model. A correction of the kernel was derived in order to remove the observed systematic errors. The remaining residual error for individual beams was modelled through uncertainty associated with the kernel model. The methods were tested against an independent set of measurements. No significant systematic error was observed in the calculations using the derived correction of the kernel and the remaining random errors were found to be adequately predicted by the proposed method.

Biophysical Phenomena↗

The IMRT information process-mastering the degrees of freedom in external beam therapy.

The techniques and procedures for intensity-modulated radiation therapy (IMRT) are reviewed in the context of the information process central to treatment planning and delivery of IMRT. A presentation is given of the evolution of the information based radiotherapy workflow and dose delivery techniques, as well as the volume and planning concepts for relating the dose information to image based patient representations. The formulation of the dose shaping process as an optimization problem is described. The different steps in the calculation flow for determination of machine parameters for dose delivery are described starting from the formulation of optimization objectives over dose calculation to optimization procedures. Finally, the main elements of the quality assurance procedure necessary for implementing IMRT clinically are reviewed.

Animals↗

Photon pencil kernel parameterisation based on beam quality index.

BACKGROUND AND PURPOSE: New treatment techniques in radiotherapy employ increasing dose calculation complexity in treatment planning. For an adequate check of the results coming from a modern treatment planning system, clinical tools with almost the same degree of generality and accuracy as the planning system itself are needed. To fulfil this need we propose a photon pencil kernel parameterization based on a minimum of input data that can be used for phantom scatter calculations. Through scatter integration the pencil kernel model can calculate common parameters, such as TPR or phantom scatter factors, used in various dosimetric QA (quality assurance) procedures. MATERIAL AND METHODS: The proposed model originates from an already published radially parameterized pencil kernel. A depth parameterization of the pencil kernel parameters has been introduced, based on a large database containing commissioned beam data for a commercial treatment planning system. The entire pencil kernel model demands only one photon beam quality index, TPR20,10, as input. RESULTS: By comparing the dose calculation results to the extensive experimental data set in the database, it has been possible to make a thorough analysis of the resulting accuracy. The errors in calculated doses, normalized to the reference geometry, are in most cases smaller than 2%. CONCLUSIONS: The investigation shows that a pencil kernel model based only on TPR20,10 can be used for dosimetric verification purposes in megavoltage photon beams at depths below the range of contaminating electrons.

Algorithms↗

Portal dose image verification: the collapsed cone superposition method applied with different electronic portal imaging devices.

Two different commercial electronic portal imaging devices (EPIDs), one based on a liquid ion chamber matrix and the other based on a fluoroscopic CCD camera, were used to acquire readings that, through a calibration procedure, provided images proportional to the absolute dose to a virtual water slab located at the EPID plane. The transformation of the matrix ion chamber image into a portal dose image (PDI) was based on a published relationship between dose rate and ionization current. For the fluoroscopic CCD-camera-based system, the transformation was based on a deconvolution with a radial light scatter kernel. Local response variations were corrected in the images from both systems using open field fluence maps. The acquired PDIs were compared with PDIs calculated with the collapsed cone superposition method for a three-dimensional detector model in water equivalent buildup material. The calculation model was based on the beam modelling and geometrical description of the treatment unit and energy used for treatment planning in a kernel-based system. The validity of the calculation method was evaluated for several field shapes and thicknesses of patient phantoms for the matrix ion chamber at 6 MV x-rays and for the camera-based EPID at 6 and 15 MV x-rays. The agreement between predicted and measured PDIs was evaluated with dose comparisons at points of interest and gamma index calculations. The average area failing the passing criteria in dose and position deviation was analysed to validate the performance of the method. For the matrix ion chamber on average an area less than 1% fails the passing criteria of 3 mm and 3%. For the camera-based EPID, the average area is 7% and 1% for 6 and 15 MV, respectively. The overall agreement centrally in the fields was 0.1 +/- 1.6% (1 sd) for the camera-based EPID and -0.1 +/- 1.6% (1 sd) for the matrix ion chamber. Thus, an absolute dose calibrated EPID could validate the delivered dose to the patient by comparing a calculated and a measured PDI.

Algorithms↗

Evaluation of uncertainty predictions and dose output for model-based dose calculations for megavoltage photon beams.

In many radiotherapy clinics an independent verification of the number of monitor units (MU) used to deliver the prescribed dose to the target volume is performed prior to the treatment start. Traditionally this has been done by using methods mainly based on empirical factors which, at least to some extent, try to separate the influence from input parameters such as field size, depth, distance, etc. The growing complexity of modern treatment techniques does however make this approach increasingly difficult, both in terms of practical application and in terms of the reliability of the results. In the present work the performance of a model-based approach, describing the influence from different input parameters through actual modeling of the physical effects, has been investigated in detail. The investigated model is based on two components related to megavoltage photon beams; one describing the exiting energy fluence per delivered MU, and a second component describing the dose deposition through a pencil kernel algorithm solely based on a measured beam quality index. Together with the output calculations, the basis of a method aiming to predict the inherent calculation uncertainties in individual treatment setups has been developed. This has all emerged from the intention of creating a clinical dose/MU verification tool that requires an absolute minimum of commissioned input data. This evaluation was focused on irregular field shapes and performed through comparison with output factors measured at 5, 10, and 20 cm depth in ten multileaf collimated fields on four different linear accelerators with varying multileaf collimator designs. The measurements were performed both in air and in water and the results of the two components of the model were evaluated separately and combined. When compared with the corresponding measurements the resulting deviations in the calculated output factors were in most cases smaller than 1% and in all cases smaller than 1.7%. The distribution describing the calculation errors in the total dose output has a mean value of -0.04% and a standard deviation of 0.47%. In the dose calculations a previously developed correction of the pencil kernel was applied that managed to contract the error distribution considerably. A detailed analysis of the predicted uncertainties versus the observed deviations suggests that the predictions indeed can be used as a basis for creating action levels and tracking dose calculation errors in homogeneous media.

Air↗

Dose uncertainties in photon pencil kernel calculations at off-axis positions.

The purpose of this study was to investigate the specific problems associated with photon dose calculations in points located at a distance from the central beam axis. These problems are related to laterally inhomogeneous energy fluence distributions and spectral variations causing a lateral shift in the beam quality, commonly referred to as off-axis softening (OAS). We have examined how the dose calculation accuracy is affected when enabling and disabling explicit modeling of these two effects. The calculations were performed using a pencil kernel dose calculation algorithm that facilitates modeling of OAS through laterally varying kernel properties. Together with a multi-source model that provides the lateral energy fluence distribution this generates the total dose output, i.e., the dose per monitor unit, at an arbitrary point of interest. The dose calculation accuracy was evaluated through comparisons with 264 measured output factors acquired at 5, 10, and 20 cm depth in four different megavoltage photon beams. The measurements were performed up to 18 cm from the central beam axis, inside square fields of varying size and position. The results show that calculations including explicit modeling of OAS were considerably more accurate, up to 4%, than those ignoring the lateral beam quality shift. The deviations caused by simplified head scatter modeling were smaller, but near the field edges additional errors close to 1% occurred. When enabling full physics modeling in the dose calculations the deviations display a mean value of -0.1%, a standard deviation of 0.7%, and a maximum deviation of -2.2%. Finally, the results were analyzed in order to quantify and model the inherent uncertainties that are present when leaving the central beam axis. The off-axis uncertainty component showed to increase with both off-axis distance and depth, reaching 1% (1 standard deviation) at 20 cm depth.

Algorithms↗

Beam modeling and verification of a photon beam multisource model.

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.

Algorithms↗

Brachytherapy source characterization for improved dose calculations using primary and scatter dose separation.

In brachytherapy, tissue heterogeneities, source shielding, and finite patient/phantom extensions affect both the primary and scatter dose distributions. The primary dose is, due to the short range of secondary electrons, dependent only on the distribution of material located on the ray line between the source and dose deposition site. The scatter dose depends on both the direct irradiation pattern and the distribution of material in a large volume surrounding the point of interest, i.e., a much larger volume must be included in calculations to integrate many small dose contributions. It is therefore of interest to consider different methods for the primary and the scatter dose calculation to improve calculation accuracy with limited computer resources. The algorithms in present clinical use ignore these effects causing systematic dose errors in brachytherapy treatment planning. In this work we review a primary and scatter dose separation formalism (PSS) for brachytherapy source characterization to support separate calculation of the primary and scatter dose contributions. We show how the resulting source characterization data can be used to drive more accurate dose calculations using collapsed cone superposition for scatter dose calculations. Two types of source characterization data paths are used: a direct Monte Carlo simulation in water phantoms with subsequent parameterization of the results, and an alternative data path built on processing of AAPM TG43 formatted data to provide similar parameter sets. The latter path is motivated of the large amounts of data already existing in the TG43 format. We demonstrate the PSS methods using both data paths for a clinical 192Ir source. Results are shown for two geometries: a finite but homogeneous water phantom, and a half-slab consisting of water and air. The dose distributions are compared to results from full Monte Carlo simulations and we show significant improvement in scatter dose calculations when the collapsed-cone kernel-superposition algorithm is used compared to traditional table based calculations. The PSS source characterization method uses exponential fit functions derived from one-dimensional transport theory to describe both the primary and scatter dose contributions. We present data for the PSS characterization method to different 192Ir, 137Cs, and 60Cs brachytherapy sources. We also show how TG43 formatted data can be derived from our data to serve traditional treatment planning systems, as to enable for a gradual transfer to algorithms that provides improved modeling of heterogeneities in brachytherapy treatment planning.

Algorithms↗

Monte Carlo evaluation of a photon pencil kernel algorithm applied to fast neutron therapy treatment planning.

When dedicated software is lacking, treatment planning for fast neutron therapy is sometimes performed using dose calculation algorithms designed for photon beam therapy. In this work Monte Carlo derived neutron pencil kernels in water were parametrized using the photon dose algorithm implemented in the Nucletron TMS (treatment management system) treatment planning system. A rectangular fast-neutron fluence spectrum with energies 0-40 MeV (resembling a polyethylene filtered p(41)+Be spectrum) was used. Central axis depth doses and lateral dose distributions were calculated and compared with the corresponding dose distributions from Monte Carlo calculations for homogeneous water and heterogeneous slab phantoms. All absorbed doses were normalized to the reference dose at 10 cm depth for a field of radius 5.6 cm in a 30 x 40 x 20 cm3 water test phantom. Agreement to within 7% was found in both the lateral and the depth dose distributions. The deviations could be explained as due to differences in size between the test phantom and that used in deriving the pencil kernel (radius 200 cm, thickness 50 cm). In the heterogeneous phantom, the TMS, with a directly applied neutron pencil kernel, and Monte Carlo calculated absorbed doses agree approximately for muscle but show large deviations for media such as adipose or bone. For the latter media, agreement was substantially improved by correcting the absorbed doses calculated in TMS with the neutron kerma factor ratio and the stopping power ratio between tissue and water. The multipurpose Monte Carlo code FLUKA was used both in calculating the pencil kernel and in direct calculations of absorbed dose in the phantom.

Adipose Tissue↗

Accounting for high Z shields in brachytherapy using collapsed cone superposition for scatter dose calculation.

Common clinical brachytherapy treatment planning algorithms perform at best one-dimensional corrections for high Z heterogeneities that will be inaccurate for intermediate energies (60-100 keV). The development of fast methods for a three-dimensional dose calculation to account for high Z materials in this energy range is important, e.g., to fully utilize the potential of patient individualized shields using isotopes such as 241Am and 169Yb. In this work we use the collapsed cone superposition algorithm to calculate the scatter dose contribution around partly lead-shielded point sources at 60, 100, and 350 keV. Methods to scale point kernels for water into kernels for high Z materials are derived. The scaling accounts for scattered photon spectral differences between materials and thus goes beyond the common density scaling approach. Compared to Monte Carlo simulations, the results of our algorithm yield agreements on the unshielded side to within 3% at 350 and 60 keV and to within 7% at 100 keV out to distances of 8 cm from the source. The effect of the shield in the center of the unshielded region is small at 350 keV but significant and occurs at short distances at 100 and 60 keV. At 60 keV, the shield causes a dose reduction of around 10%, 1 cm from the source on the unshielded side. At 100 keV, the reverse effect is seen, the insertion of shields leading to the total dose being increased by about 10% at 1 cm. That one-dimensional algorithms are incapable of predicting these changes shows the importance of accounting for the full three-dimensional geometry in correctly determining the scatter dose contribution.

Algorithms↗

Portal dose image verification: formalism and application of the collapsed cone superposition method.

A formalism tailored for portal dose image verification is proposed to facilitate the comparison of calculated and measured portal dose distributions. Each portal image is converted into a dose proportional image and normalized to the reference beam calibration dose per monitor unit. The calculated or measured dose to a detector phantom is accordingly normalized so as to enable direct comparison. The collapsed cone kernel superposition method is adapted and evaluated for calculation of portal dose distributions in a water-equivalent detector phantom through comparisons with Monte Carlo calculations and with measurements. The deviation compared with Monte Carlo calculations for 6 and 15 MV was between +0.9% (the 0.9 quantile) and -2.1% (the 0.1 quantile) for a range of investigated geometries. Collapsed cone calculations compared with measurements for clinical fields agreed within [-1.9%, +2.4%] for 15 MV and [-0.9%, +3.2%] for 6 MV for the 0.1 and 0.9 quantiles, respectively. Hence, the absolute portal dose to a detector phantom could be calculated and verified well within the present accuracy requirements for clinical dose calculations.

Algorithms↗