Biomedical subjects

Tommy Knöös

Publications and source records attributed to Tommy Knöös.

9 recordsLinked to original sources

PubMed2007

A virtual-accelerator-based verification of a Monte Carlo dose calculation algorithm for electron beam treatment planning in clinical situations.

BACKGROUND AND PURPOSE: The introduction of Monte Carlo (MC) techniques for treatment planning and also for verification purposes will have considerable impact on the radiation therapy planning process. The aim of this work was to use a virtual accelerator to study the performance of a MC-based electron dose calculation algorithm, implemented in a commercial treatment planning system. METHODS: The performance in phantoms containing air and bone as well as in patient-specific geometries (thorax wall, nose, parotid gland and spinal cord) has been studied. RESULTS: The agreement between the virtual accelerator and the MC dose calculation algorithm is generally very good. A gamma-evaluation with criteria of 0.03 Gy/3 mm (per Gy at the depth of maximum dose) shows that, even for the worst cases, only a small volume of about 1.5% has gamma>1.0. In the worst case, with the 0.02 Gy/2 mm criteria, about 92% of the volume receiving more than 0.85 Gy per 100 monitor units (MU) has gamma-values <1.0. The corresponding value for the volume receiving more than 0.10 Gy/100 MU is about 98%. For the 18 MeV spinal-cord case, where a 6 x 20 cm2 insert is used, the TPS underestimates the dose outside the primary field due to inadequate modelling of the insert. CONCLUSION: The possibility of dose calculations in typical patient cases makes the virtual accelerator a powerful tool for validation and evaluation of dose calculation algorithms present in treatment planning systems.

Algorithms↗

PubMed2006

Comparison of dose calculation algorithms for treatment planning in external photon beam therapy for clinical situations.

A study of the performance of five commercial radiotherapy treatment planning systems (TPSs) for common treatment sites regarding their ability to model heterogeneities and scattered photons has been performed. The comparison was based on CT information for prostate, head and neck, breast and lung cancer cases. The TPSs were installed locally at different institutions and commissioned for clinical use based on local procedures. For the evaluation, beam qualities as identical as possible were used: low energy (6 MV) and high energy (15 or 18 MV) x-rays. All relevant anatomical structures were outlined and simple treatment plans were set up. Images, structures and plans were exported, anonymized and distributed to the participating institutions using the DICOM protocol. The plans were then re-calculated locally and exported back for evaluation. The TPSs cover dose calculation techniques from correction-based equivalent path length algorithms to model-based algorithms. These were divided into two groups based on how changes in electron transport are accounted for ((a) not considered and (b) considered). Increasing the complexity from the relatively homogeneous pelvic region to the very inhomogeneous lung region resulted in less accurate dose distributions. Improvements in the calculated dose have been shown when models consider volume scatter and changes in electron transport, especially when the extension of the irradiated volume was limited and when low densities were present in or adjacent to the fields. A Monte Carlo calculated algorithm input data set and a benchmark set for a virtual linear accelerator have been produced which have facilitated the analysis and interpretation of the results. The more sophisticated models in the type b group exhibit changes in both absorbed dose and its distribution which are congruent with the simulations performed by Monte Carlo-based virtual accelerator.

Algorithms↗

PubMed2006

A virtual-accelerator-based verification of a Monte Carlo dose calculation algorithm for electron beam treatment planning in homogeneous phantoms.

By introducing Monte Carlo (MC) techniques to the verification procedure of dose calculation algorithms in treatment planning systems (TPSs), problems associated with conventional measurements can be avoided and properties that are considered unmeasurable can be studied. The aim of the study is to implement a virtual accelerator, based on MC simulations, to evaluate the performance of a dose calculation algorithm for electron beams in a commercial TPS. The TPS algorithm is MC based and the virtual accelerator is used to study the accuracy of the algorithm in water phantoms. The basic test of the implementation of the virtual accelerator is successful for 6 and 12 MeV (gamma < 1.0, 0.02 Gy/2 mm). For 18 MeV, there are problems in the profile data for some of the applicators, where the TPS underestimates the dose. For fields equipped with patient-specific inserts, the agreement is generally good. The exception is 6 MeV where there are slightly larger deviations. The concept of the virtual accelerator is shown to be feasible and has the potential to be a powerful tool for vendors and users.

Algorithms↗

PubMed2005

IMRT treatment planning:- a comparative inter-system and inter-centre planning exercise of the ESTRO QUASIMODO group.

BACKGROUND AND PURPOSE: The purpose of this work was a comparison of realistic IMRT plans based on the same CT-image data set and a common predefined set of dose objectives for the planning target volume and the organs at risk. This work was part of the larger European QUASIMODO IMRT verification project. MATERIALS AND METHODS: Eleven IMRT plans were produced by nine different European groups, each applying a representative set of clinically used IMRT treatment planning systems. The plans produced were to be deliverable in a clinically acceptable treatment time with the local technical equipment. All plans were characterized using a set of different quality measures such as dose-volume histograms, number of monitor units and treatment time. RESULTS: Only one plan was able to fulfil all dose objectives strictly; six plans failed some of the objectives but were still considered to be clinically acceptable; four plans were not able to reach the objectives. Additional quality scores such as the number of monitor units and treatment time showed large variations, which mainly depend on the delivery technique. CONCLUSION: The presented planning study showed that with nearly all presently available IMRT planning and delivery systems comparable dose distributions could be achieved if the planning goals are clearly defined in advance.

Anthropometry↗

PubMed2004

Measurements of output factors with different detector types and Monte Carlo calculations of stopping-power ratios for degraded electron beams.

The aim of the present study was to investigate three different detector types (a parallel-plate ionization chamber, a p-type silicon diode and a diamond detector) with regard to output factor measurements in degraded electron beams, such as those encountered in small-electron-field radiotherapy and intraoperative radiation therapy (IORT). The Monte Carlo method was used to calculate mass collision stopping-power ratios between water and the different detector materials for these complex electron beams (nominal energies of 6, 12 and 20 MeV). The diamond detector was shown to exhibit excellent properties for output factor measurements in degraded beams and was therefore used as a reference. The diode detector was found to be well suited for practical measurements of output factors, although the water-to-silicon stopping-power ratio was shown to vary slightly with treatment set-up and irradiation depth (especially for lower electron energies). Application of ionization-chamber-based dosimetry, according to international dosimetry protocols, will introduce uncertainties smaller than 0.3% into the output factor determination for conventional IORT beams if the variation of the water-to-air stopping-power ratio is not taken into account. The IORT system at our department includes a 0.3 cm thin plastic scatterer inside the therapeutic beam, which furthermore increases the energy degradation of the electrons. By ignoring the change in the water-to-air stopping-power ratio due to this scatterer, the output factor could be underestimated by up to 1.3%. This was verified by the measurements. In small-electron-beam dosimetry, the water-to-air stopping-power ratio variation with field size could mostly be ignored. For fields with flat lateral dose profiles (>3 x 3 cm2), output factors determined with the ionization chamber were found to be in close agreement with the results of the diamond detector. For smaller field sizes the lateral extension of the ionization chamber hampers its use. We therefore recommend that the readily available silicon diode detector should be used for output factor measurements in complex electron fields.

Electrons↗

PubMed2003

Dose perturbation in the presence of metallic implants: treatment planning system versus Monte Carlo simulations.

An increasing number of patients receiving radiation therapy have metallic implants such as hip prostheses. Therefore, beams are normally set up to avoid irradiation through the implant; however, this cannot always be accomplished. In such situations, knowledge of the accuracy of the used treatment planning system (TPS) is required. Two algorithms, the pencil beam (PB) and the collapsed cone (CC), are implemented in the studied TPS. Comparisons are made with Monte Carlo simulations for 6 and 18 MV. The studied materials are steel, CoCrMo, Orthinox, TiAlV and Ti. Monte Carlo simulated depth dose curves and dose profiles are compared to CC and PB calculated data. The CC algorithm shows overall a better agreement with Monte Carlo than the PB algorithm. Thus, it is recommended to use the CC algorithm to get the most accurate dose calculation both for the planning target volume and for tissues adjacent to the implants when beams are set up to pass through implants.

Algorithms↗

PubMed2003

Monte Carlo study of TLD measurements in air cavities.

Thermoluminescent dosimeters (TLDs) are used for verification of the delivered dose during IMRT treatment of head and neck carcinomas. The TLDs are put into a plastic tube, which is placed in the nasal cavities through the treated volume. In this study, the dose distribution to a phantom having a cylindrical air cavity containing a tube was calculated by Monte Carlo methods and the results were compared with data from a treatment planning system (TPS) to evaluate the accuracy of the TLD measurements. The phantom was defined in the DOSXYZnrc Monte Carlo code and calculations were performed with 6 MV fields, with the TLD tube placed at different positions within the cylindrical air cavity. A similar phantom was defined in the pencil beam based TPS. Differences between the Monte Carlo and the TPS calculations of the absorbed dose to the TLD tube were found to be small for an open symmetrical field. For a half-beam field through the air cavity, there was a larger discrepancy. Furthermore, dose profiles through the cylindrical air cavity show, as expected, that the treatment planning system overestimates the absorbed dose in the air cavity. This study shows that when using an open symmetrical field, Monte Carlo calculations of absorbed doses to a TLD tube in a cylindrical air cavity give results comparable to a pencil beam based treatment planning system.

Algorithms↗

PubMed2002

Influence of initial electron beam characteristics on monte carlo calculated absorbed dose distributions for linear accelerator electron beams.

The least known parameters in a Monte Carlo simulation of a linear accelerator treatment head are often the properties of the initial electron beam directed onto the exit vacuum window. Several initial beams with different spatial fluence distributions, angular divergences and energy spectra have been transported through the geometry of a scattering foil accelerator. The electron beam characteristics (energy spectrum and angular distribution) at the phantom surface and the subsequent relative absorbed dose distribution in a water phantom were calculated. The dose distribution was found to be insensitive to the geometrical properties of the initial beam. Furthermore, the lateral dose profiles are unaffected by the energy spectrum of the initial beam. The effect on the depth-dose curve is negligible if the initial energy spectrum is symmetric (e.g., Gaussian shaped) and its full width at half maximum (FWHM) is less than approximately 10% of the most probable energy. A larger FWHM will decrease the normalized dose gradient, but will not affect the dose in the build-up region. An asymmetric wedge shaped spectrum with a low-energy extension simultaneously increases the dose in the build-up region and decreases the dose gradient. The relationship between the energy spectral width and the normalized dose gradient is, however, smaller than published analytical expressions indicate. Some well-established energy-range relationships were shown to be accurate for most of the initial beams studied. The energy spectrum at the phantom surface was also derived from a measured depth-dose curve through different methods. The extracted spectrum depends on the beam model and the spectral reconstruction algorithm. Even though the depth-dose curve is fairly independent of initial beam characteristics, a correct description of the low-energy tail of the energy spectrum is important to obtain good agreement between measured and Monte Carlo calculated doses in the build-up region.

Electrons↗

PubMed2002

Dosimetry characteristics of degraded electron beams investigated by Monte Carlo calculations in a setup for intraoperative radiation therapy.

Degraded electron beams, as used for intraoperative radiation therapy (IORT) or similar complicated dosimetric situations, have different characteristics compared to conventional electron therapy beams. If international dosimetry protocols are applied in a direct manner to such degraded beams, uncertainties will be introduced in the absorbed dose determination. The Monte Carlo method has been used to verify experimentally determined relative absorbed dose distributions and output factors in an IORT geometry. Monte Carlo generated dose distributions are mostly within +/-2% or +/-2 mm of measured data. The simulated output variation between the IORT cones (relative output factors) are mostly within 2% of measured values. By comparing IORT and conventional electron beam characteristics (e.g. energy spectra, angular distributions and the contributions of different system components to these quantities) limitations and uncertainties of commonly used dosimetric techniques in IORT electron fields are quantified. The intraoperative treatment field contains a larger amount of scattered electrons, which leads to a broader energy spectrum as well as a wider angular distribution of electrons at the phantom surface. The dose from the scattered electrons can contribute up to 40% of the total dose at a depth of dose maximum, compared to approximately 10% for standard beams. A study of the energy spectra at the reference depth reveals that an uncertainty of the order of 1% can be introduced if ionization chamber based dosimetry is used to determine output factors for the investigated IORT system. We recommend that relative absorbed dose distributions and output factors in IORT electron beams and for similar complicated dosimetric situations should be determined with detectors having a small energy and angular dependence (e.g. diamond detectors or p-Si diodes).

Electrons↗