Biomedical subjects

S Mutic

Publications and source records attributed to S Mutic.

22 records · Page 2Linked to original sources

PubMed1998

Phantoms for IMRT dose distribution measurement and treatment verification.

BACKGROUND: The verification of intensity-modulated radiation therapy (IMRT) patient treatment dose distributions is currently based on custom-built or modified dose measurement phantoms. The only commercially available IMRT treatment planning and delivery system (Peacock, NOMOS Corp.) is supplied with a film phantom that allows accurate spatial localization of the dose distribution using radiographic film. However, measurements using other dosimeters are necessary for the thorough verification of IMRT. METHODS: We have developed a phantom to enable dose measurements using a cylindrical ionization chamber and the localization of prescription isodose curves using a matrix of thermoluminescent dosimetry (TLD) chips. The external phantom cross-section is identical to that of the commercial phantom, to allow direct comparisons of measurements. A supplementary phantom has been fabricated to verify the IMRT dose distributions for pelvis treatments. RESULTS: To date, this phantom has been used for the verification of IMRT dose distributions for head and neck and prostate cancer treatments. Designs are also presented for a phantom insert to be used with polymerizing gels (e.g., BANG-2) to obtain volumetric dose distribution measurements. CONCLUSION: The phantoms have proven useful in the quantitative evaluation of IMRT treatments.

Head and Neck Neoplasms↗

PubMed1998

Quantitative dosimetric verification of an IMRT planning and delivery system.

BACKGROUND AND PURPOSE: The accuracy of dose calculation and delivery of a commercial serial tomotherapy treatment planning and delivery system (Peacock. NOMOS Corporation) was experimentally determined. MATERIALS AND METHODS: External beam fluence distributions were optimized and delivered to test treatment plan target volumes, including three with cylindrical targets with diameters ranging from 2.0 to 6.2 cm and lengths of 0.9 through 4.8 cm, one using three cylindrical targets and two using C-shaped targets surrounding a critical structure, each with different dose distribution optimization criteria. Computer overlays of film-measured and calculated planar dose distributions were used to assess the dose calculation and delivery spatial accuracy. A 0.125 cm3 ionization chamber was used to conduct absolute point dosimetry verification. Thermoluminescent dosimetry chips, a small-volume ionization chamber and radiochromic film were used as independent checks of the ion chamber measurements. RESULTS: Spatial localization accuracy was found to be better than +/-2.0 mm in the transverse axes (with one exception of 3.0 mm) and +/-1.5 mm in the longitudinal axis. Dosimetric verification using single slice delivery versions of the plans showed that the relative dose distribution was accurate to +/-2% within and outside the target volumes (in high dose and low dose gradient regions) with a mean and standard deviation for all points of -0.05% and 1.1%, respectively. The absolute dose per monitor unit was found to vary by +/-3.5% of the mean value due to the lack of consideration for leakage radiation and the limited scattered radiation integration in the dose calculation algorithm. To deliver the prescribed dose, adjustment of the monitor units by the measured ratio would be required. CONCLUSIONS: The treatment planning and delivery system offered suitably accurate spatial registration and dose delivery of serial tomotherapy generated dose distributions. The quantitative dose comparisons were made as far as possible from abutment regions and examination of the dosimetry of these regions will also be important. Because of the variability in the dose per monitor unit and the complex nature of the calculation and delivery of serial tomotherapy, patient-specific quality assurance procedures will include a measurement of the delivered target dose.

Algorithms↗

PubMed1998

A technique for the quantitative evaluation of dose distributions.

The commissioning of a three-dimensional treatment planning system requires comparisons of measured and calculated dose distributions. Techniques have been developed to facilitate quantitative comparisons, including superimposed isodoses, dose-difference, and distance-to-agreement (DTA) distributions. The criterion for acceptable calculation performance is generally defined as a tolerance of the dose and DTA in regions of low and high dose gradients, respectively. The dose difference and DTA distributions complement each other in their useful regions. A composite distribution has recently been developed that presents the dose difference in regions that fail both dose-difference and DTA comparison criteria. Although the composite distribution identifies locations where the calculation fails the preselected criteria, no numerical quality measure is provided for display or analysis. A technique is developed to unify dose distribution comparisons using the acceptance criteria. The measure of acceptability is the multidimensional distance between the measurement and calculation points in both the dose and the physical distance, scaled as a fraction of the acceptance criteria. In a space composed of dose and spatial coordinates, the acceptance criteria form an ellipsoid surface, the major axis scales of which are determined by individual acceptance criteria and the center of which is located at the measurement point in question. When the calculated dose distribution surface passes through the ellipsoid, the calculation passes the acceptance test for the measurement point. The minimum radial distance between the measurement point and the calculation points (expressed as a surface in the dose-distance space) is termed the gamma index. Regions where gamma > 1 correspond to locations where the calculation does not meet the acceptance criteria. The determination of gamma throughout the measured dose distribution provides a presentation that quantitatively indicates the calculation accuracy. Examples of a 6 MV beam penumbra are used to illustrate the gamma index.

Gamma Rays↗

PubMed1997

Abutment region dosimetry for sequential arc IMRT delivery.

Arc-based intensity modulated radiation therapy (IMRT) planning and delivery is available as a commercial product (Nomos Corp.). The dose distribution is delivered to 1.68 cm thick regions, and the patient moved in a precise manner between treatments. Assuming accurate patient positioning, the abutment region dose distribution near the gantry isocentre is delivered with no undesired dose heterogeneities. However, for regions far from the isocentre, the dose distribution may exhibit high- or low-dose regions due to uncompensated beam divergence for arc treatments of less than 360 degrees gantry angle length. A study has been initiated to characterize abutment region dose distribution heterogeneities for sequential arc IMRT delivery. Five dose distributions were optimized, each using 8 cm diameter target volumes at different distances from the isocentre, and the arc delivery limited to 290 degrees symmetric about the vertical axis. The target lengths were sufficient to require a treatment consisting of five couch positions, yielding four abutment regions. The dose within the abutment regions was measured using film and analysed as a function of off-axis position along both the vertical and horizontal directions. Little dependence on the dose heterogeneity was seen along the horizontal axis passing through the isocentre. However, the abutment regions along the vertical axis contained 15% low and 7% high doses at 7 cm above and below the isocentre respectively. This dose heterogeneity is not predicted by the current clinical release of the treatment planning software due to limitations of the dose calculation algorithm. The intensity of dose heterogeneity is considered sufficient to warrant further study.

Humans↗