How much does film sensitivity increase at depth for larger field sizes?
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Biomedical subjects
Publications and source records attributed to J R Sykes.
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Advances in external beam therapy technology have made routine, efficient conformal therapy a reality. With it comes the increasing need for online treatment verification, which is only achievable at present through the use of electronic portal imaging devices (EPIDs). For a large radiotherapy centre, the provision of one EPID per treatment machine proves extremely expensive. This paper details modifications to the design of a commercial fluoroscopic EPID (the SRI-100) to produce a portable system, capable of providing quick, high quality imaging on more than one treatment machine. We describe the necessary hardware and software changes made to the system, as well as the variety of mechanical and quality control checks performed for testing the stability and quality of the imaging. The modified system has been found to be both electronically and mechanically robust, with associated image quality, scaling, distortion and movement similar to other EPIDs in the department. Although the modification was designed specifically to allow for the acquisition of images from multiple treatment machines, it may also enable the operation of the EPID for other uses such as total body irradiation (TBI) treatment verification and a further range of quality control procedures on the linear accelerator itself.
The implementation of intensity modulated radiotherapy by dynamic multileaf collimator control involves the use of interpreter software which creates leaf trajectory plans for each leaf pair. Interpreter software for use with an Elekta SL15 linear accelerator and dedicated multileaf collimator has been written and tested. In practice the ideal trajectory plans often predict contact between leaves from opposing leaf banks, but this is prohibited by control software on the Elekta system as it could lead to mechanical damage. If the modulation within the geometric limits of a shaped field is not to be compromised then strategies to avoid leaf contact result in additional unwanted doses outside the geometric edge. The magnitude of any such additional dose can be reduced to acceptable levels by a technique which we have called rectangular edge synchronization. The performance of interpreter software which incorporates rectangular edge synchronization has been compared with that of potentially more efficient software which does not. The option containing the rectangular edge synchronization algorithm was shown to work consistently well at high monitor unit rates, and without incurring leaf contacts, under a wide range of test conditions. It therefore provides a sound basis for using intensity modulation to replace mechanical wedges, to simulate customized patient shape compensators, or to implement the results of inverse treatment planning processes that require superimposed intensity modulated beams.
The tongue and groove effect is an underdosing effect which can occur in certain applications of multileaf collimators. It results from the need to overlap adjacent leaves of a multileaf collimator in order to limit leakage between leaves. The applications in which the effect can occur are the abutment of fields where the beam edges are defined by the leaf edge and the production of intensity-modulated fields by dynamic collimation. The effect has been measured for the 'worst case' when just two MLC fields are matched along leaf edges which have overlapping steps. Measurements of the dose have been made at d(max) and also at a more clinically relevant depth of 87 mm in Perspex for beam energies of 6 MV, 8 MV and 20 MV on two Philips SL series accelerators. Dose distributions were recorded on radiographic film which was subsequently digitized for analysis. The dose reduction of the tongue and groove effect was found to be 15-28% and spread over a width of 3.8 to 4.2 mm. This is somewhat shallower and wider than would be expected from a simple, idealized model of the effect which would predict a dose reduction of 80% over a width of 1 mm.
Functional magnetic resonance imaging (fMRI) has been performed on a standard 1 T system using a pulse sequence developed to utilize blood oxygen level dependent (BOLD) contrast and an off-line analysis routine using correlation techniques. The sequence and the data analysis routine have been validated by reproducing the conventional hand movement paradigm studies reported by numerous other workers. Our work has then been extended to investigate cerebral foci for a tonic pain stimulus and the cortical representation of oesophageal stimulation. Both these studies relate to paradigms where the expected BOLD signal is significantly less than that encountered for motor or visual cortex paradigms. The results show good agreement with other modalities (positron emission tomography, magnetoencephalography and cortical evoked potentials). Performing fMRI at 1 T is slightly controversial. However, our successful study of demanding paradigms, using a standard clinical 1 T imaging system, has important implications for many other users operating at this field strength.
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