Biomedical subjects

Kiki Theodorou

Publications and source records attributed to Kiki Theodorou.

4 recordsLinked to original sources

PubMed2006

Monte Carlo dosimetric evaluation of high energy vs low energy photon beams in low density tissues.

BACKGROUND AND PURPOSE: Low megavoltage photon beams are often the treatment choice in radiotherapy when low density heterogeneities are involved, because higher energies show some undesirable dosimetric effects. This work is aimed at investigating the effects of different energy selection for low density tissues. PATIENTS AND METHODS: BEAMnrc was used to simulate simple treatment set-ups in a simple and a CT reconstructed lung phantom and an air-channel phantom. The dose distribution of 6, 15 and 20 MV photon beams was studied using single, AP/PA and three-field arrangements. RESULTS: Our results showed no significant changes in the penumbra width in lung when a pair of opposed fields were used. The underdosage at the anterior/posterior tumor edge caused by the dose build-up at the lung-tumor interface reached 7% for a 5 x 5 cm AP/PA set-up. Shrinkage of the 90% isodose volume was noticed for the same set-up, which could be rectified by adding a lateral field. For the CT reconstructed phantom, the AP/PA set-up offered better tumor coverage when lower energies were used but for the three field set-up, higher energies resulted to better sparing of the lung tissue. For the air-channel set-up, adding an opposed field reduced the penumbra width. Using higher energies resulted in a 7% cold spot around the air-tissue interface for a 5 x 5 cm field. CONCLUSIONS: The choice of energy for treatment in the low density areas is not a straightforward decision but depends on a number of parameters such as the beam set-up and the dosimetric criteria. Updated calculation algorithms should be used in order to be confident for the choice of energy of treatment.

Algorithms↗

PubMed2006

An inhomogeneity correction algorithm for irregular fields of high-energy photon beams based on Clarkson integration and the 3D beam subtraction method.

A number of treatment-planning systems still use conventional correction methods for body inhomogeneities. Most of these methods (power law method, tissue-air ratio (TAR), etc.) consider only on-axis points, rectangular fields, and inhomogeneous slabs covering the whole irradiating field. A new method is proposed that overcomes the above limitations. The new method uses the principle of the Clarkson method on sector integration to take into account the position and lateral extent of the inhomogeneity with respect to the point of calculation, as well as the shape of the irradiating field. The field is divided into angular sectors, and each sector is then treated separately for the presence of inhomogeneities using a conventional correction method. Applying this method, we can predict the correction factors for Co-60 and 6-MV photon beams for irregular fields that include inhomogeneities of lower or higher densities relative to water. Validation of the predicted corrections factors was made against Monte Carlo calculations for the same geometries. The agreement between the predicted correction factors and the Monte Carlo calculations was within 1.5%. In addition, the new method was able to predict the behavior of the correction factor when the point of calculation was approaching or moving away from the interface between two materials.

Algorithms↗

PubMed2004

Analysis of the penumbra enlargement in lung versus the quality index of photon beams: a methodology to check the dose calculation algorithm.

It is well known that considerable underdosage can occur at the edges of a tumor inside the lung because of the degradation of penumbra due to lack of lateral electronic equilibrium. Although present even at smaller energies, this phenomenon is more pronounced for higher energies. Apart from Monte Carlo calculation, most of the existing Treatment Planning Systems (TPSs) cannot deal at all, or with acceptable accuracy, with this effect. A methodology has been developed for assessing the dose calculation algorithms in the lung region where lateral electronic disequilibrium exists, based on the Quality Index (QI) of the incident beam. A phantom, consisting of layers of polystyrene and lung material, has been irradiated using photon beams of 4, 6, 15, and 20 MV. The cross-plane profiles of each beam for 5x5, 10x10, and 25x10 fields have been measured at the middle of the phantom with the use of films. The penumbra (20%-80%) and fringe (50%-90%) enlargement was measured and the ratio of the widths for the lung to that of polystyrene was defined as the Correction Factor (CF). Monte Carlo calculations in the two phantoms have also been performed for energies of 6, 15, and 20 MV. Five commercial TPS's algorithms were tested for their ability to predict the penumbra and fringe enlargement. A linear relationship has been found between the QI of the beams and the CF of the penumbra and fringe enlargement for all the examined fields. Monte Carlo calculations agree very well (less than 1% difference) with the film measurements. The CF values range between 1.1 for 4 MV (QI 0.620) and 2.28 for 20 MV (QI 0.794). Three of the tested TPS's algorithms could not predict any enlargement at all for all energies and all fields and two of them could predict the penumbra enlargement to some extent. The proposed methodology can help any user or developer to check the accuracy of its algorithm for lung cases, based on a simple phantom geometry and the QI of the incident beam. This check is very important especially when higher energies are used, as the inaccuracies in existing algorithms can lead to an incorrect choice of energy for lung treatment and consequently to a failure in tumor control.

Algorithms↗

PubMed2003

A geometry based optimization algorithm for conformal external beam radiotherapy.

A geometric solution of the problem of optimal orientation of beams in conformal external radiotherapy is presented. The method uses geometric derived quantities which consider the intersection volume between organs at risk (OAR) and the beam shape. In comparison to previous geometric methods a true 3D volume computation is used which takes into account beam divergence, concave shapes, as well as treatment settings such as individual beam shaping by blocks or multi-leaf collimators. For standard dosimetric cost functions used by dose optimization algorithms a corresponding set of geometric objective functions is proposed. We compare the correlations between geometric and dosimetric cost functions for two clinical cases, a prostate and a head tumour case. A correlation is observed for the prostate case, whereas for the head case it is less pronounced due to the larger part of overlapping volumes between the beams which cannot be considered by the used objectives. In comparison to not-optimized beam directions the dose distribution is significantly better for the beam directions found by the optimization of a geometric multi-objective cost function. An optimal dose distribution can easily be achieved using the geometric model. This is shown by comparing for the two cases the dose-volume histograms (DVH) of manually optimized plans by experienced planners and the DVHs of the geometrically found optimal solutions. In comparison to the manually optimized plans the solutions found by the geometric method significantly reduce the average dose in the OARs and NT, while maintaining the same PTV coverage. The optimization requires only a few seconds and could be used to improve the performance of inverse planning algorithms in radiotherapy for the determination of the optimal direction of beams.

Algorithms↗