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Luc Beaulieu

Publications and source records attributed to Luc Beaulieu.

At least 19 recordsLinked to original sources
PubMed2006

Permanent prostate implant using high activity seeds and inverse planning with fast simulated annealing algorithm: A 12-year Canadian experience.

PURPOSE: To report outcomes and toxicity of the first Canadian permanent prostate implant program. METHODS AND MATERIALS: 396 consecutive patients (Gleason < or =6, initial prostate specific antigen (PSA) < or =10 and stage T1-T2a disease) were implanted between June 1994 and December 2001. The median follow-up is of 60 months (maximum, 136 months). All patients were planned with fast-simulated annealing inverse planning algorithm with high activity seeds ([gt] 0.76 U). Acute and late toxicity is reported for the first 213 patients using a modified RTOG toxicity scale. The Kaplan-Meier biochemical failure-free survival (bFFS) is reported according to the ASTRO and Houston definitions. RESULTS: The bFFS at 60 months was of 88.5% (90.5%) according to the ASTRO (Houston) definition and, of 91.4% (94.6%) in the low risk group (initial PSA < or =10 and Gleason < or =6 and Stage < or =T2a). Risk factors statistically associated with bFFS were: initial PSA >10, a Gleason score of 7-8, and stage T2b-T3. The mean D90 was of 151 +/- 36.1 Gy. The mean V100 was of 85.4 +/- 8.5% with a mean V150 of 60.1 +/- 12.3%. Overall, the implants were well tolerated. In the first 6 months, 31.5% of the patients were free of genitourinary symptoms (GUs), 12.7% had Grade 3 GUs; 91.6% were free of gastrointestinal symptoms (GIs). After 6 months, 54.0% were GUs free, 1.4% had Grade 3 GUs; 95.8% were GIs free. CONCLUSION: The inverse planning with fast simulated annealing and high activity seeds gives a 5-year bFFS, which is comparable with the best published series with a low toxicity profile.

Aged↗
PubMed2006

Bypassing the learning curve in permanent seed implants using state-of-the-art technology.

PURPOSE: The aim of this study was to demonstrate, based on clinical postplan dose distributions, that technology can be used efficiently to eliminate the learning curve associated with permanent seed implant planning and delivery. METHODS AND MATERIALS: Dose distributions evaluated 30 days after the implant of the initial 22 consecutive patients treated with permanent seed implants at two institutions were studied. Institution 1 (I1) consisted of a new team, whereas institution 2 (I2) had performed more than 740 preplanned implantations over a 9-year period before the study. Both teams had adopted similar integrated systems based on three-dimensional (3D) transrectal ultrasonography, intraoperative dosimetry, and an automated seed delivery and needle retraction system (FIRST, Nucletron). Procedure time and dose volume histogram parameters such as D90, V100, V150, V200, and others were collected in the operating room and at 30 days postplan. RESULTS: The average target coverage from the intraoperative plan (V100) was 99.4% for I1 and 99.9% for I2. D90, V150, and V200 were 191.4 Gy (196.3 Gy), 75.3% (73.0%), and 37.5% (34.1%) for I1 (I2) respectively. None of these parameters shows a significant difference between institutions. The postplan D90 was 151.2 Gy for I1 and 167.3 Gy for I2, well above the 140 Gy from the Stock et al. analysis, taking into account differences at planning, results in a p value of 0.0676. The procedure time required on average 174.4 min for I1 and 89 min for I2. The time was found to decrease with the increasing number of patients. CONCLUSION: State-of-the-art technology enables a new brachytherapy team to obtain excellent postplan dose distributions, similar to those achieved by an experienced team with proven long-term clinical results. The cost for bypassing the usual dosimetry learning curve is time, with increasing team experience resulting in shorter treatment times.

Brachytherapy↗
PubMed2006

Measurement accuracy and cerenkov removal for high performance, high spatial resolution scintillation dosimetry.

With highly conformal radiation therapy techniques such as intensity-modulated radiation therapy, radiosurgery, and tomotherapy becoming more common in clinical practice, the use of these narrow beams requires a higher level of precision in quality assurance and dosimetry. Plastic scintillators with their water equivalence, energy independence, and dose rate linearity have been shown to possess excellent qualities that suit the most complex and demanding radiation therapy treatment plans. The primary disadvantage of plastic scintillators is the presence of Cerenkov radiation generated in the light guide, which results in an undesired stem effect. Several techniques have been proposed to minimize this effect. In this study, we compared three such techniques-background subtraction, simple filtering, and chromatic removal-in terms of reproducibility and dose accuracy as gauges of their ability to remove the Cerenkov stem effect from the dose signal. The dosimeter used in this study comprised a 6-mm(3) plastic scintillating fiber probe, an optical fiber, and a color charge-coupled device camera. The whole system was shown to be linear and the total light collected by the camera was reproducible to within 0.31% for 5-s integration time. Background subtraction and chromatic removal were both found to be suitable for precise dose evaluation, with average absolute dose discrepancies of 0.52% and 0.67%, respectively, from ion chamber values. Background subtraction required two optical fibers, but chromatic removal used only one, thereby preventing possible measurement artifacts when a strong dose gradient was perpendicular to the optical fiber. Our findings showed that a plastic scintillation dosimeter could be made free of the effect of Cerenkov radiation.

Artifacts↗
PubMed2006

Prostatic edema in 125I permanent prostate implants: dynamical dosimetry taking volume changes into account.

The purpose of this study is to determine the impact of edema on the dose delivered to the target volume. An evaluation of the edema characteristics was first made, and then a dynamical dosimetry algorithm was developed and used to compare its results to a standard clinical (static) dosimetry. Source positions and prostate contours extracted from 66 clinical cases on images taken at different points in time (planning, implant day, post-implant evaluation) were used, via the mean interseed distance, to characterize edema [initial increase (deltar0), half-life (tau)]. An algorithm was developed to take into account the edema by summing a time series of dose-volume histograms (DVHs) with a weight based on the fraction of the dose delivered during the time interval considered. The algorithm was then used to evaluate the impact of edema on the dosimetry of permanent implants by comparing its results to those of a standard clinical dosimetry. The volumetric study yielded results as follows: the initial prostate volume increase was found to be 1.58 (ranging from 1.15 to 2.48) and the edema half-life, approximately 30 days (range: 3 to 170 days). The dosimetric differences in D90 observed between the dynamic dosimetry and the clinical one for a single case were up to 15 Gy and depended on the edema half-life and the initial volume increase. The average edema half-life, 30 days, is about 3 times longer than the previously reported 9 days. Dosimetric differences up to 10% of the prescription dose are observed, which can lead to differences in the quality assertion of an implant. The study of individual patient edema resorption with time might be necessary to extract meaningful clinical correlation or biological parameters in permanent implants.

Algorithms↗
PubMed2006

Impact of interseed attenuation and tissue composition for permanent prostate implants.

The purpose is to evaluate the impact of interseed attenuation and prostate composition for prostate treatment plans with 125I permanent seed implants using the Monte Carlo (MC) method. The effect of seed density (number of seeds per prostate unit volume) is specifically investigated. The study focuses on treatment plans that were generated for clinical cases. For each plan, four different dose calculation techniques are compared: TG-43 based calculation, superposition MC, full MC with water prostate, and full MC with realistic prostate tissue. The prostate tissue description is from the ICRP report 23 (W. S. Snyer, M. J. Cook, E. S. Nasset, L. R. Karkhausen, G. P. Howells, and I. H. Tipton, "Report of the task group on reference man," Technical Report 23, International Commission on Radiological Protection, 1974). According to the comparisons, the seed density has an influence on interseed attenuation. A plan with a typical low seed density (42 0.6 mCi seeds in a 26 cm3 prostate) suffers a 1.2% drop in the CTV D90 value due to interseed attenuation. A drop of 3.0% is calculated for a higher seed density (75 0.3 mCi seeds, same prostate). The influence of the prostate composition is similar for all seed densities and prostate sizes. The difference between MC simulations in water and MC simulations in prostate tissue is between 4.4% and 4.8% for the D90 parameter. Overall, the effect on D90 is ranging from 5.8% to 12.8% when comparing clinically approved TG-43 and MC simulations in prostate tissue. The impact varies from one patient to the other and depends on the prostate size and the number of seeds. This effect can reach a significant level when reporting correlations between clinical effect and deposited dose.

Brachytherapy↗
PubMed2006

Octree indexing of DICOM images for voxel number reduction and improvement of Monte Carlo simulation computing efficiency.

The purpose of the present study is to introduce a compression algorithm for the CT (computed tomography) data used in Monte Carlo simulations. Performing simulations on the CT data implies large computational costs as well as large memory requirements since the number of voxels in such data reaches typically into hundreds of millions voxels. CT data, however, contain homogeneous regions which could be regrouped to form larger voxels without affecting the simulation's accuracy. Based on this property we propose a compression algorithm based on octrees: in homogeneous regions the algorithm replaces groups of voxels with a smaller number of larger voxels. This reduces the number of voxels while keeping the critical high-density gradient area. Results obtained using the present algorithm on both phantom and clinical data show that compression rates up to 75% are possible without losing the dosimetric accuracy of the simulation.

Algorithms↗
PubMed2006

Surface preparation and coupling in plastic scintillator dosimetry.

One way to improve the performance of scintillation dosimeters is to increase the light-collection efficiency at the coupling interfaces of the detector system. We performed a detailed study of surface preparation of scintillating fibers and their coupling with clear optical fibers to minimize light loss and increase the amount of light collected. We analyzed fiber-surface polishing with aluminum oxide sheets, coating fibers with magnesium oxide, and the use of eight different coupling agents (air, three optical gels, an optical curing agent, ultraviolet light, cyanoacrylate glue, and acetone). We prepared 10 scintillating fiber and clear optical fiber light guide samples to test different coupling methods. To test the coupling, we first cut both the scintillating fiber and the clear optical fiber. Then, we cleaned and polished both ends of both fibers. Finally, we coupled the scintillating fiber with the clear optical fiber in either a polyethylene jacket or a V-grooved support depending on the coupling agent used. To produce more light, we used an ultraviolet lamp to stimulate scintillation. A typical series of similar couplings showed a standard deviation in light-collection efficiency of 10%. This can be explained by differences in the surface preparation quality and alignment of the scintillating fiber with the clear optical fiber. Absence of surface polishing reduced the light collection by approximately 40%, and application of magnesium oxide on the proximal end of the scintillating fiber increased the amount of light collected from the optical fiber by approximately 39%. Of the coupling agents, we obtained the best results using one of the optical gels. Because a large amount of the light produced inside a scintillator is usually lost, better light-collection efficiency will result in improved sensitivity.

Artifacts↗
PubMed2006

Energy and integrated dose dependence of MOSFET dosimeter sensitivity for irradiation energies between 30 kV and 60Co.

Since metal-oxide-semiconductor field effect transistors (MOSFETs) medical applications in radiotherapy and radiology are gaining popularity, evaluating them under radiation of different energies is of major interest. This study aims at a characterization of MOSFET sensitivity with regard to total integrated dose. Sensitivity is expressed by the water calibration factor (CFw) and allows the user to associate the voltage difference reading displayed by the device to a dose value in water at the MOSFET location. The CFw of seven p-type dual-bias MOSFETs were measured for several accumulated doses. The radiation sources used were a 60Co unit ((E)gamma: 1.25 MeV), an 192Ir high dose rate unit ((E)gamma: 380 keV), and an orthovoltage unit providing two x-ray energy spectra for tube voltages of 30 kV((E)gamma:14.8 KeV) and 150 kV((E)gamma:70.1 keV). The CFw value diminishes with increasing threshold voltage, especially for low-energy radiation. It was stable for 60Co irradiations, while it decreased 6%, 5%, and 15% for beam energies of 192Ir, 150 kV, and 30 kV, respectively. The decrease rate is higher for the first half of the device lifetime. This behavior is explained by an alteration of the effective electric field applied to the MOSFET during irradiation, caused by the accumulation of holes at the Si-SiO2 interface. It is strongly dependent on the nature of the radiation, and particularly affects low x-ray energies. A frequent calibration of the device for this radiation type is essential in order to achieve adequate measurement accuracy, especially in low-energy applications, such as superficial therapy, brachytherapy, and diagnostic and interventional radiology.

Calibration↗
PubMed2005

An adaptive approach to metal artifact reduction in helical computed tomography for radiation therapy treatment planning: experimental and clinical studies.

PURPOSE: In this article, an approach to metal artifact reduction is proposed that is practical for clinical use in radiation therapy. It is based on a new interpolation scheme of the projections associated with metal implants in helical computed tomography (CT) scanners. METHODS AND MATERIALS: A three-step approach was developed consisting of an automatic algorithm for metal implant detection, a correction algorithm for helical projections, and a new, efficient algorithm for projection interpolation. The modified raw projection data are transferred back to the CT scanner device where CT slices are regenerated using the built-in reconstruction operator. The algorithm was tested on a CT calibration phantom in which the density of inserted objects are known and on clinical prostate cases with two hip prostheses. The results are evaluated using the CT number and shape of the objects. RESULTS: The validations on a CT calibration phantom with various inserts of known densities show that the algorithm improved the overall image quality by restoring the shape and the representative CT number of the objects in the image. For the clinical hip replacement cases, a large fraction of the bladder, rectum, and prostate that were not visible on the original CT slices were recovered using the algorithm. Precise contouring of the target volume was thus feasible. Without this enhancement, physicians would have drawn bigger margins to be sure to include the target and, at the same time, could have prescribed a lower dose to keep the same level of normal tissue toxicity. CONCLUSIONS: In both phantom experiment and patient studies, the algorithm resulted in significant artifact reduction with increases in the reliability of planning procedure for the case of metallic hip prostheses. This algorithm is now clinically used as a preprocessing before treatment planning for metal artifact reduction.

Algorithms↗
PubMed2005

Anatomy-based inverse planning dose optimization in HDR prostate implant: a toxicity study.

BACKGROUND AND PURPOSE: The aim of this study is to evaluate the acute and late complications in patients who have received HDR implant boost using inverse planning, and to determine dose volume correlations. PATIENTS AND METHODS: Between September 1999 and October 2002, 44 patients with locally advanced prostate cancer (PSA>/=10 ng/ml, and/or Gleason score>/=7, and/or Stage T2c or higher) were treated with 40-45 Gy external pelvic field followed by 2--3 fraction of inverse-planned HDR implant boost (6--9.5 Gy /fraction). Median follow-up time was 1.7 years with 81.8% of patients who had at least 12 months of follow up (range 8.6--42.5. Acute and late morbidity data were collected and graded according to RTOG criteria. Questionnaires were used to collect prostate related measures of quality of life, and international prostate symptom score (IPSS) before and after treatment. Dose-volume histograms for prostate, urethra, bladder, penis bulb and rectum were analyzed. RESULTS: The median patient age was 64 years. Of these, 32% were in the high risk group, and 61% in the intermediate risk group. 3 patients (7%) had no adverse prognostic factors. A single grade 3 GU acute toxicity was reported but no grade 3--4 acute GI toxicity. No grade 3--4 late GU or GI toxicity was reported. Acute (late) grade 2 urinary and rectal symptoms were reported in 31.8 (11.4%) and 4.6% (4.6%) of patients, respectively. A trend for predicting acute GU toxicity is seen for total HDR dose of more than 18 Gy (OR=3.6, 95%CI=[0.96--13.5], P=0.058). The evolution of toxicity is presented for acute and late GU/GI toxicity. Erectile dysfunction occurs in approximately 27% of patients who were not on hormonal deprivation, but may be taking sildenafil. The IPSS peaked on averaged 6 weeks post-implant and returned to the baseline at a median of 6 months. CONCLUSIONS: Inverse-planned HDR brachytherapy is a viable option to deliver higher dose to the prostate as a boost without increasing GU or rectal complication. Further HDR dose escalation to the prostate is feasible.

Adenocarcinoma↗
PubMed2005

Sliding slice: a novel approach for high accuracy and automatic 3D localization of seeds from CT scans.

We present a conceptually novel principle for 3D reconstruction of prostate seed implants. Unlike existing methods for implant reconstruction, the proposed algorithm uses raw CT data (sinograms) instead of reconstructed CT slices. Using raw CT data solves several inevitable problems related to the reconstruction from CT slices. First, the sinograms are not affected by reconstruction artifacts in the presence of metallic objects and seeds in the patient body. Second, the scanning axis is not undersampled as in the case of CT slices; as a matter of fact the scanning axis is the most densely sampled and each seed is typically represented by several hundred samples. Moreover, the shape of a single seed in a sinogram can be modeled exactly, thus facilitating the detection. All this allows very accurate 3D reconstruction of both position and the orientation of the seeds. Preliminary results indicate that the seed position can be estimated with 0.15 mm accuracy (average), while the orientation estimate accuracy is within 3 deg on average. Although the main contribution of the paper is to present a new principle of reconstruction, a preliminary implementation is also presented as a proof of concept. The implemented algorithm has been tested on a phantom and the obtained results are presented to validate the proposed approach.

Algorithms↗
PubMed2005

Plastic scintillation dosimetry: optimal selection of scintillating fibers and scintillators.

Scintillation dosimetry is a promising avenue for evaluating dose patterns delivered by intensity-modulated radiation therapy plans or for the small fields involved in stereotactic radiosurgery. However, the increase in signal has been the goal for many authors. In this paper, a comparison is made between plastic scintillating fibers and plastic scintillator. The collection of scintillation light was measured experimentally for four commercial models of scintillating fibers (BCF-12, BCF-60, SCSF-78, SCSF-3HF) and two models of plastic scintillators (BC-400, BC-408). The emission spectra of all six scintillators were obtained by using an optical spectrum analyzer and they were compared with theoretical behavior. For scintillation in the blue region, the signal intensity of a singly clad scintillating fiber (BCF-12) was 120% of that of the plastic scintillator (BC-400). For the multiclad fiber (SCSF-78), the signal reached 144% of that of the plastic scintillator. The intensity of the green scintillating fibers was lower than that of the plastic scintillator: 47% for the singly clad fiber (BCF-60) and 77% for the multiclad fiber (SCSF-3HF). The collected light was studied as a function of the scintillator length and radius for a cylindrical probe. We found that symmetric detectors with nearly the same spatial resolution in each direction (2 mm in diameter by 3 mm in length) could be made with a signal equivalent to those of the more commonly used asymmetric scintillators. With augmentation of the signal-to-noise ratio in consideration, this paper presents a series of comparisons that should provide insight into selection of a scintillator type and volume for development of a medical dosimeter.

Computer-Aided Design↗
PubMed2004

Measurements of intrafraction motion and interfraction and intrafraction rotation of prostate by three-dimensional analysis of daily portal imaging with radiopaque markers.

PURPOSE: To measure the interfraction and intrafraction motion of the prostate during the course of external beam radiotherapy using a video electronic portal imaging device and three-dimensional analysis. METHODS AND MATERIALS: Eighteen patients underwent implantation with two or three gold markers in the prostate before five-angle/11-field conformal radiotherapy. Using CT data as the positional reference, multiple daily sets of portal images, and a three-dimensional reconstruction algorithm, intrafraction translations, as well as interfraction and intrafraction rotations, were analyzed along the three principal axes (left-right [LR], superoinferior [SI], and AP). The overall mean values and standard deviations (SDs), along with random and systematic SDs, were computed for these translations and rotations. RESULTS: For 282 intrafraction translational displacements, the random SD was 0.8 mm (systematic SD, 0.2) in the LR, 1.0 mm (systematic SD, 0.4) in the SI, and 1.4 mm (systematic SD, 0.7) in the AP axes. The analysis of 348 interfraction rotations revealed random SDs of 6.1 degrees (systematic SD, 5.6 degrees ) around the LR axis, 2.8 degrees (systematic SD, 2.4 degrees ) around the SI axis, and 2.0 degrees (systematic SD, 2.2 degrees ) around the AP axis. The intrafraction rotational motion observed during 44 fractions had a random SD of 1.8 degrees (systematic SD, 1.0 degrees ) around the LR, 1.1 degrees (systematic SD, 0.8 degrees ) around the SI, and 0.6 degrees (systematic SD, 0.3 degrees ) around the AP axis. CONCLUSION: The interfraction rotations observed were more important than those reported in previous studies. Intrafraction motion was generally smaller in magnitude than interfraction motion. However, the intrafraction rotations and translations of the prostate should be taken into account when designing planning target volume margins because their magnitudes are not negligible.

Humans↗
PubMed2004

Evaluation of an automatic needle-loading system.

The purpose of this paper is to evaluate the dosimetric capabilities and the radiation protection (RP) performance of a new automatic needle-loading system for permanent prostate implants, the Isoloader (Mentor Corp.). The unit has been used in more than 100 clinical cases at our institution. The Isoloader is a computerized workstation that allows automated seed testing by a solid-state CdZnTe radiation detector and loading in surgical needles. The seeds are received in a shielded and ready-to-use cartridge. Radiation protection measurements were done on a cartridge filled with 67 (125)I seeds and during dosimetric seed verification and needle loading. The reproducibility of the detector was tested and its accuracy was determined by comparison to specified activities of six calibration seeds and to their measurements in a calibrated well-chamber (WC). Finally, the times required to complete dosimetric verification and needle loading were evaluated. The cartridge was found to be adequately shielded, since no significant amount of radiation was detected around it. Radiation during seed assay was found to be worst at the cartridge's bottom, where it has a value of 15.2 microSv/h (1.4 microSv/h at 10 cm). For the needle-loading task, measurements were performed with a typical needle (three seeds) at the shielded needle holder surface yielding 307.2 microSv/h (8.3 microSv/h at 20 cm). Seed dosimetric verification takes an average of 15 s/seed, while it takes a mean time of 50 s/needle to complete the loading task. Measurements of the six seed activities were within 0.65% of the ordered activities and 1.9% higher on average than those from the WC (min = 0.7%; max = 3.5%). The reproducibility of the measurements of the CdZnTe detector was excellent, with an average of 0.01% of deviation from a reference measurement (N = 120; = 1.9%). We therefore conclude that the Isoloader is a safe, fast, and effective needle-loading system.

Brachytherapy↗
PubMed2004

The robustness of dose distributions to displacement and migration of 125I permanent seed implants over a wide range of seed number, activity, and designs.

PURPOSE: To investigate the robustness of permanent prostate implant dosimetry for various (125)I seed activities and various seed models. The dosimetric impact of seed misplacement and seed migration (seed loss) is also taken into account using various standard dose indices. METHODS AND MATERIALS: A dose-based inverse planning algorithm is used for automated dosimetric plan creation (45-60 s per plan) and provides an unbiased way to compare the robustness of various optimal dosimetric plans. Seed misplacement and seed migration are simulated by way of Monte Carlo, based on the measured displacement distributions from clinical postimplant cases. Plans were generated for seed activities between 0.2 and 1.4 mCi (0.25 to 1.78 U) and for 11 different seed models. RESULTS: The numbers of seeds and needles are shown to decrease rapidly for a seed activity between 0.3 mCi and 0.6 mCi (0.38 and 0.76 U). The loss in V100, from 100%, because of seed misplacement is below 10% for an apparent activity ranging from 0.2 to 0.9 mCi (0.25 to 1.14 U). A minimum degradation in V100 is observed around 0.6-0.7 mCi (0.76-0.89 U). D90 increases from 150 to 170 Gy between 0.3 and 0.7 mCi (0.38 and 0.89 U) and decreases afterward to fall below 140 Gy at higher activity. V200 and D10 to the target volume both show an increase in hot spots up to 0.7 mCi, and then decrease linearly at higher activities for all seed models. V200 and D10 to the urethra remain about constant for all seed activities up to 0.8 mCi (1.02 U), at which point they start to decrease. All seed models follow this general trend. CONCLUSIONS: Plans were shown to be robust to misplacement and migration of seeds over a wide range of seed activity and for various seed models. With a properly tuned inverse planning algorithm able to ensure the dose coverage and protection for the organs at risk in the presence of placement errors (displacement and migration), the choice of a preferred seed activity, in a range up to about 0.7 mCi (0.89 U), is open. The upper part of this range offers the opportunity to significantly reduce the number of seeds and needles, thus reducing surgical trauma to the patient, saving time in an operating room planning setting, and reducing the cost of a permanent prostate implant procedure.

Algorithms↗
PubMed2004

Idealized line source configuration for permanent 125I prostate implants.

BACKGROUND AND PURPOSE: To validate the use of idealized seed orientations in conjunction with the line source formalism for post-implant dosimetry of permanent 125I prostate implants. PATIENTS AND METHODS: Post-implant, a CT scan and three fluoroscopic images were obtained for 32 patients having undergone permanent implants. From these images, the seed positions and orientations (phi,theta) were determined (1625 individual seeds). Two different dosimetric calculations were done: one using real orientations and one using idealized orientations (seeds along the axis of implantation). Dose volume histograms (DVHs) and key dosimetric parameters were compiled for the prostate, urethra, rectum, bladder and penile bulb, to evaluate the difference between the two approximations. RESULTS: The phi angle distribution (phi = 1.1 degrees; sigma phi = 22.9 degrees) and the theta angle distribution (theta= -4.29 degrees; sigma theta = 27.1 degrees) were found to be similar to the first order except for the pronounced peak of the phi angle distribution. The DVHs comparison and dosimetric parameters study reveal no significant difference between the two approximations. The difference in D90 for the prostate was only 0.02% (sigma = 0.91%) The differences were slightly higher in the case of the organs at risk, as expected from the dosimetric characteristics of the seed model used. CONCLUSIONS: The angular distributions (phi,theta) of individual seeds were determined. The dosimetric evaluation shows that line source formalism can be used in conjunction with an idealized seed configuration presented here to report prostate and organs at risk dose coverage.

Brachytherapy↗
PubMed2004

Automatic generation of anatomy-based MLC fields in aperture-based IMRT.

We have developed an algorithm to automatically generate anatomy-based MLC fields. For each beam, a first field is adjusted to the projection of the target in a beam's eye view, allowing subsequent fields to be derived from this conformal field by removing the overlapping surface of each organ at risk, respectively. The projections are based on a surface sampling of the anatomical structures. On top of the MLC mechanical constraints, verification constraints are imposed on the MLC segments, in order to get reliable dosimetry using a commercial dose calculation engine. Thus, in each direction, the aperture's cross-section must be greater than a specified threshold, in our case 2 cm. Furthermore, junctions are not tolerated in order to avoid underdosage, for instance from the tongue-and-groove effect. The use of such MLC fields simplifies the verification process. The performance of the algorithm is illustrated for head and neck, thorax and prostate cases. Only a fraction of a second of CPU time is required to perform the segmentation for each beam.

Algorithms↗