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Biomedical subjects

Jörgen Olofsson

Publications and source records attributed to Jörgen Olofsson.

8 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↗

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↗

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↗

The use of risk estimation models for the induction of secondary cancers following radiotherapy.

Theoretical predictions of cancer risk from radiotherapy may be used as a complementary criterion for the selection of successful treatment plans together with the classical approach of estimating the possible deterministic effects. However, any such attempts must take into consideration the specific features of radiation treatment. This paper explores several possible methods for estimating the risk of cancer following radiotherapy in order to investigate the influences of the fractionation and the non-uniformity of the dose to the irradiated organ. The results indicate that dose inhomogeneity plays an important role in predicting the risk for secondary cancer and therefore for predictive purposes it must be taken into account through the use of the dose volume histograms. They also suggest that the competition between cell killing and the induction of carcinogenic mutations has to be taken into consideration for more realistic risk estimations. Furthermore, more realistic parameters could be obtained if this competition is also included in analyses of epidemiological data from radiotherapy applications.

Dose-Response Relationship, Radiation↗

A practical method to calculate head scatter factors in wedged rectangular and irregular MLC shaped beams for external and internal wedges.

Factor based methods for absorbed dose or monitor unit calculations are often based on separate data sets for open and wedged beams. The determination of basic beam parameters can be rather time consuming, unless equivalent square methods are applied. When considering irregular wedged beams shaped with a multileaf collimator, parametrization methods for dosimetric quantities, e.g. output ratios or wedge factors as a function of field size and shape, become even more important. A practical method is presented to derive wedged output ratios in air (S(c,w)) for any rectangular field and for any irregular MLC shaped beam. This method was based on open field output ratios in air (S(c)) for a field with the same collimator setting, and a relation f(w) between S(c,w) and S(c). The relation f(w) can be determined from measured output ratios in air for a few open and wedged fields including the maximum wedged field size. The function f(w) and its parametrization were dependent on wedge angle and treatment head design, i.e. they were different for internal and external wedges. The proposed method was tested for rectangular wedged fields on three accelerators with internal wedges (GE, Elekta, BBC) and two accelerators with external wedges (Varian). For symmetric regular beams the average deviation between calculated and measured S(c,w) / S(c) ratios was 0.3% for external wedges and about 0.6% for internal wedges. Maximum deviations of 1.8% were obtained for elongated rectangular fields on the GE and ELEKTA linacs with an internal wedge. The same accuracy was achieved for irregular MLC shaped wedged beams on the accelerators with MLC and internal wedges (GE and Elekta), with an average deviation < 1% for the fields tested. The proposed method to determine output ratios in air for wedged beams from output ratios of open beams, combined with equivalent square approaches, can be easily integrated in empirical or semi-empirical methods for monitor unit calculations.

Algorithms↗

On empirical methods to determine scatter factors for irregular MLC shaped beams.

Multileaf collimators (MLCs) are in clinical use for more than a decade and are a well accepted tool in radiotherapy. For almost each MLC design different empirical or semianalytical methods have been presented for calculating output ratios in air for irregularly shaped beams. However, until now no clear recommendations have been given on how to handle irregular fields shaped by multileaf collimators for independent monitor unit (MU) verification. The present article compares different empirical methods, which have been proposed for independent MU verification, to determine (1) output ratios in air (Sc) and (2) phantom scatter factors (Sp) for irregular MLC shaped fields. Ten dedicated field shapes were applied to five different types of MLCs (Elekta, Siemens, Varian, Scanditronix, General Electric). All calculations based on empirical relations were compared with measurements and with calculations performed by a treatment planning system with a fluence based algorithm. For most irregular MLC shaped beams output ratios in air could be adequately modeled with an accuracy of about 1%-1.5% applying a method based on the open field aperture defined by the leaf and jaw setting combined with the equivalent square formula suggested by Vadash and Bjärngard [P. Vadash and B. E. Bjärngard, Med. Phys. 20, 733-734 (1993)]. The accuracy of this approach strongly depends on the inherent head scatter characteristics of the accelerator in use and on the irregular field under consideration. Deviations of up to 3% were obtained for fields where leaves obscure central parts of the flattening filter. Simple equivalent square methods for Sp calculations in irregular fields did not provide acceptable results (deviations mostly >3%). Sp values derived from Clarkson integration, based on published tables of phantom scatter correction factors, showed the same accuracy level as calculations performed using a pencil beam algorithm of a treatment planning system (in a homogeneous media). The separation of head scatter and phantom scatter contributions is strongly recommended for irregular MLC shaped beams as both contributions have different factors of influence. With rather simple methods Sc and Sp can be determined for independent MU calculation with an accuracy better than 1.5% for most clinical situations encountered in conformal radiotherapy.

Algorithms↗

A widely tested model for head scatter influence on photon beam output.

PURPOSE: To construct and test a semi-analytical model describing the effects on Monitor Unit (MU) verification caused by scattering in the treatment head. The implementation of the model should be accomplished using a small set of experimental data. Furthermore, the model should include a geometry dependent estimation of the resulting uncertainty. MATERIAL AND METHODS: The input required by the created model consists of basic treatment head geometry and 10 measured output factors in air (OFair) for square fields. It considers primary energy fluence, scattered radiation from an extra-focal source and from secondary collimators, as well as backscatter to the monitor chamber. Measurements and calculations were performed in open symmetric and asymmetric fields at points located both on and off the collimator axis, as well as at arbitrary treatment distances. The model has been verified for 19 photon beams in the range from 4 up to 50 MV, provided by nine different treatment units from six manufacturers. RESULTS: The presented model provided results with errors smaller than 1% (2 S.D.) in typical clinical situations for all beams tested. In more exceptional situations, i.e. combinations of unconventional treatment head designs, very elongated fields, and dosimetry points far away from the isocenter, the total uncertainty increased to approximately 2%. The spread in the results was further analysed in order to create a method for predicting the uncertainties under different treatment conditions. CONCLUSIONS: A general head scatter model that is easy to implement has been developed and can be used as the basis for computerised MU verification. The model handles all commercially available treatment units adequately and also includes an estimation of the resulting uncertainty.

Models, Theoretical↗