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Noise reduction by frame averaging: a numerical simulation for portal imaging systems.

We have studied the usefulness of both pre- and post-ADC frame summing for the purpose of reducing the effect of quantum noise and digitization noise in portal imaging systems. The study is based on the fluorescent-screen video-camera type of system. The study predicts the not-surprising result that provided the noise level at the ADC input is sufficiently large, the overall SNR can be increased by a factor of square root of M1M2, where M1 and M2 are the number of frames summed before and after the ADC. The study also predicts, somewhat unexpectedly, that there is an operating region in which increasing M1 actually decreases the SNR in the final image. To avoid this region M1 must be less than approximately 6 x 2(2B) (1 + -delta-1)1/2/(iaccf), where B is the number of ADC bits, -delta is the mean number of optical photons detected by the video camera per detected x-ray photon, iacc is the open-field number of detected x-ray photons per accelerator pulse per pixel, and f is the patient transmission factor. An equivalent statement is that the rms noise at the input to the ADC, sigma in, must exceed approximately 0.4q where q is the quantization interval of the ADC. It is possible that some systems operate in or close to this region. A second feature of this anomalous behavior is that the final image is not necessarily improved by increasing the number M2 of post-ADC-summed frames. For example, when sigma in/q = 0.2, there is no improvement in the overall rms error for M2 > 32.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

[Progress in optimizing dosimetry plans in stereotactic radiotherapy in the Salt Group (Saint-Anne-Lariboisière-Tenon].

We began intracranial stereotactic irradiation under the direction of O Betti 11 years ago. At the present time, we believe it is interesting to present the methodologies of the SALT (Saint-Anne-Lariboisière-Tenon) group. Up to the present time we have irradiated 693 patients using a single fraction. Arteriovenous malformations (AVMs) represented the majority (90%) of treated lesions. Irradiation protocol has little changed since 1986, and the localization of the target volume was performed in the neurosurgery department of St Anne Hospital, France. The stereotactic images (computerized tomography [CT], angiography) were sent to the radiotherapy department of Tenon Hospital through the French public digital network NUMERIS. Protocol was realized using the stereotactic ARTEMIS-3D/Dosigray TPS. The lesion volume was filled by one or more spherical or elliptical subvolumes using the "Associated Target Methodology". The interactive adjustment of subvolumes was based on the 3D graphical representations of the lesion. The direct optimization of the irradiation space was performed by managing parameters provided by the DDB (Dosimetric Data Base) such as the number of arcs, their angular position, as well as the starting and the ending point of each arc. The evaluation of the calculated dose distribution was made using quantitative parameters. The second method of optimization was based on the minibeam intensity modulation using a mathematical theory of inverse problems and singular value decomposition (SVD) analysis. At the present time, due to technical reasons, linear accelerators do not permit the modulation of intensity of arctherapy. Thus we transformed the profiles of irregular forms into rectangular profiles of modulated ponderation, with each optimized plan being evaluated before its implementation. The criteria of evaluation were derived from the differential and cumulative dose volume histograms (DVH). The DVHs permitted the evaluation of the volumes of underdosage and overdosage inside the lesion and in the healthy tissue, respectively. Using DVHs, we have defined parameters such as the conform factor and the homogeneity index. We stress that the methodology of protocol optimization is valid for single or multiple fractions as well as for intra- and extra-cranial irradiation.

Humans↗

Shielding analysis of the Microtron MT-25 bunker using the MCNP-4C code and NCRP Report 51.

A cyclic electron accelerator Microtron MT-25 will be installed in Havana, Cuba. Electrons, neutrons and gamma radiation up to 25 MeV can be produced in the MT-25. A detailed shielding analysis for the bunker is carried out using two ways: the NCRP-51 Report and the Monte Carlo Method (MCNP-4C Code). The walls and ceiling thicknesses are estimated with dose constraints of 0.5 and 20 mSv y(-1), respectively, and an area occupancy factor of 1/16. Both results are compared and a preliminary bunker design is shown.

Electrons↗

A technique for on-board CT reconstruction using both kilovoltage and megavoltage beam projections for 3D treatment verification.

The technologies with kilovoltage (kV) and megavoltage (MV) imaging in the treatment room are now available for image-guided radiation therapy to improve patient setup and target localization accuracy. However, development of strategies to efficiently and effectively implement these technologies for patient treatment remains challenging. This study proposed an aggregated technique for on-board CT reconstruction using combination of kV and MV beam projections to improve the data acquisition efficiency and image quality. These projections were acquired in the treatment room at the patient treatment position with a new kV imaging device installed on the accelerator gantry, orthogonal to the existing MV portal imaging device. The projection images for a head phantom and a contrast phantom were acquired using both the On-Board Imager kV imaging device and the MV portal imager mounted orthogonally on the gantry of a Varian Clinac 21EX linear accelerator. MV projections were converted into kV information prior to the aggregated CT reconstruction. The multilevel scheme algebraic-reconstruction technique was used to reconstruct CT images involving either full, truncated, or a combination of both full and truncated projections. An adaptive reconstruction method was also applied, based on the limited numbers of kV projections and truncated MV projections, to enhance the anatomical information around the treatment volume and to minimize the radiation dose. The effects of the total number of projections, the combination of kV and MV projections, and the beam truncation of MV projections on the details of reconstructed kV/MV CT images were also investigated.

Humans↗

Use of the Clinac-35 for tissue activation in noninvasive measurement of capillary blood flow.

Through adjustment of operating parameters responsible for the acceleration, steering, and focusing of electrons en route to the target, we have extracted a 30-MV x-ray beam from the Clinac-35 linear accelerator that is suitable for use in photon activation -15O decay studies of tissue perfusion. This beam is significantly more efficient than the "standard" 25-MV beam in producing 15O in situ through activation of tissue oxygen, thereby substantially reducing the dose to tissue required to yield a desired initial 15O activity. Production and characteristics of the higher energy beam are discussed, and data obtained from its application to measurement of capillary blood flow in animal tumors are presented and analyzed.

Animals↗

An equivalent square field formula for determining head scatter factors of rectangular fields.

A simple formula is derived for the calculation of an equivalent square field that gives the same head scatter factor as a given rectangular field. This formula is based strictly on the configuration of a medical linear accelerator treatment head. The geometric parameters used are the distances between the target and the top of each field-defining aperture. The formula accounts for both the effect of field elongation and the collimator exchange effect. This method predicts the output to within 1% accuracy for both open and wedged fields and does not require any new measured data other than the field size dependence of head scatter for a range of square field sizes. Interestingly, the formula we derived has the same format as the formula that was empirically obtained by Vadash and Bjärngard [Med. Phys. 20, 733-734 (1993)].

Biophysical Phenomena↗

Methods for the determination of effective monitor chamber thickness.

There are a number of models, both analytical and Monte Carlo, which are used to describe the fluence from the treatment head of accelerators. One common problem in these simulations is to find relevant information about details in the treatment head. A complex unit in the treatment head for which reliable data is seldom given is the monitor chamber. In this work two methods are described for obtaining this information by analyzing the increased scattering of an electron beam when the monitor chamber is introduced in the beam. It was found that the effective thickness of the electrodes in a monitor chamber can be determined with sufficient accuracy by using experimental results combined with Fermi-Eyges theory or Monte Carlo simulations.

Biophysical Phenomena↗

[Dose distributions of linac-based radiosurgery for pineal region mass].

The doses of linac convergent-beam irradiations to pineal region were measured in an anthropomorphic phantom. The feasibility of a linac accelerator as a radiosurgery tool to treat small sized intracranial masses was evaluated. The influences of some irradiation parameters on the dose distributions were discussed. Linac-based radiosurgery can result in dose distributions similar to those achieved by gamma knife, so it is another safe and effective treatment technique of neurosurgery. The smaller the aperture is and the greater the irradiation arc travel is, the larger the dose gradient will be and the better the dose distribution will be. The maximum target doses are dependent greatly upon the collimater aperture. The appropriate irradiation arc travel and margin isodose were also discussed.

Brain Neoplasms↗

[Distribution of linear accelerators in Great Britain. Use of fast electrons and their main applications].

The features of the electron beam that make it a unique therapeutic tool, are related to physical characteristic rather than to any special biological effectiveness. The advantages of the dose distribution pattern are greatest at low energies (under 20 MeV), suggesting the use of electrons for irradiation of superficial tumors with the sparing of underlying tissues. Modern clinical electron practice demands electron treatment beams offering a high degree of purity, uniformity and the steepest possible fall-off of dose beyond the treatment volume. There are approximately 135 Linacs installed in UK, and approximately half of them have electron capacity with range of energy between 4 and 15/20 MeV. Compared to photon beams, 10% of treatment load is for electrons with a maximum of 15% in very specialised centres.

Electrons↗

Neutron sources in a 24-MV medical linear accelerator.

During the assembly of the prototype Clinac 2500, a unique opportunity arose to measure the cumulative total neutron yield of the machine as the major subassemblies were added, section by section. Differentiation of the results led to an inventory of the relative strength of the several neutron sources identified. The method utilized the fact that the scattered neutron fluence in a cavity in concrete is nearly uniform throughout the space and proportional to the fast neutron source strength. When normalized to the neutron output of the guide with bend magnet vacuum chamber, the relative neutron source strengths found were target, 1.9; primary collimator, 2.4; steel filter, 0.6; tungsten filter, 1.5; and jaw system, 0.8 open and approximately 2.0 closed. There is reasonable agreement between these measurements and published estimates of the yields from the major components of the treatment head.

Humans↗

Quality assurance in the CHART clinical trial.

As part of the clinical trial of CHART (continuous hyperfractionated accelerated radiotherapy) a quality assurance programme was included. The technical part of this--which is reported in this paper--is a series of tests designed to check all aspects of treatment planning and delivery. The results of visits to the 13 participating centres--and repeat visits to some of these centres--are discussed. The main areas tested were as follows. The linear accelerator: mechanical, and optical, scales and indicators; radiation field size; flatness and symmetry. DOSIMETRY: output; wedge factor; beam energy; phantom measurements against a plan calculated by the centre. SIMULATOR: mechanical, optical scales and indicators. The results show these centres work within the tolerances chosen for most parameters. Flatness, wedge factor and energy were areas of weakness in some centres. This must be partly the cause of the spread of phantom measurements which, after removal of variations in output, still range from -7 to +6% between calculated and measured values.

Bronchial Neoplasms↗

Applications of asymmetric collimation on linear accelerators.

Frequency of use of asymmetric collimation (AC) at an academic radiation oncology center equipped with AC-capable linear accelerators was determined, and the type of use was cataloged. Records of patients beginning radiation treatment at U.C. Davis Cancer Center within a 3-month period (3/1/92 to 5/31/92) were reviewed. Forty-seven percent of 102 patients and 56% of 123 courses of treatment involved AC. Six common uses of AC were identified: beam-split field matching, planned boosts, other field size changes, adjustments to match divergent fields, matchline feathering, and opposed tangential fields. This study demonstrates that asymmetric collimation is a useful and powerful clinical treatment tool with widespread applications to radiation therapy.

Cohort Studies↗

Beam data measurements for dynamic wedges on Varian 600C (6 MV) and 2100C (6 and 10 MV) linear accelerators.

The measurement of beam data for dynamic wedge dosimetry requires the integration of radiation dose at points across the radiation field during the dose delivery. The different measurement techniques required when using a linear diode array to measure beam profiles and when using ionization chambers to measure depth doses and effective wedge factors are described. The segmented treatment tables (STTS), which specify the delivered dose as a function of jaw position, are used by the control algorithm to deliver dynamic wedge fields. The reproducibility achieved using STTS is very consistent (and the stability of the accelerators is very good) so there is no significant variation in effective wedge factor or profile shape. There is a unique set of 132 STTS for each energy and design of treatment machine, which encompasses all the dynamic wedge data. There are significant discontinuities of up to 14% in wedge factors at certain field sizes. This means that wedge factors have to be measured at small increments (0.5 cm) in field size, as it is the width of the dynamic wedge field that determines the STT used. Considerable care must be taken when implementing these data on a current generation treatment planning computer.

Algorithms↗

Magnetic repulsion of linear accelerator contaminates.

Neodymium Iron Boron (NdFeB) rare earth permanent magnets have unique properties that enable them to fit easily onto the accessory mount of a clinical linear accelerator to partially sweep away electron contamination produced by the treatment head and block trays and thus increase skin sparing. Using such magnets the central axis entrance surface dose has been reduced by 11% for a 20 x 30 cm field size from 32% to 21% of maximum dose by the magnetic device. A reduction of 14% from 32% to 18% was seen for a 20 x 20 cm field size with a 6 mm perspex block tray positioned above the magnet. The magnetic device is light weight and thus clinically usable.

Biophysical Phenomena↗

Description of the TBI procedure for bone-marrow transplantation at the University of Tübingen.

The TBI is performed with 8 MV X-rays of a linear accelerator. The procedure is divided into a lateral and a.p./p.a. segment with a weighting factor of 5/6 and 1/6 respectively. For the lateral segment no compensators are employed. Only the upper part of the arms are used to shield the lungs. In the a.p./p.a. segment two or three fields have to be used on account of the small FSD. Here head and neck are shielded depending on the overdosage in the lateral segment. The dose given to the lungs is limited by mantlefield-technique to 10.5 Gy. The total midline dose amounts to 12 Gy and is applicated on three days with two fractions per day.

Bone Marrow Transplantation↗

[Heavy ion radiation induced inactivation of human bronchial epithelial cells].

OBJECTIVE: To observe the cell inactivating effects of Li, C and F ions. METHOD: Li(Z = 3), C(Z = 6) and F(Z = 9) ion beams, with LETs of 100 keV/micron, 300 keV/micron and 1000 keV/micron, respectively were produced by HI-13 tandem accelerator at the Department of Nuclear Physics, China Institute of Atomic Energy. The human bronchial epithelium cell line (BEAS-2B) was irradiated with the designed doses ranging from 0.5 Gy to 6.0 Gy. After irradiation, the cells were cultured at 1000/flask and the survival fractions were calculated. RESULT: The cell survival fraction (SF, non-unit) have negative exponential relations with dose(D, Gy) as shown by the fitted equations: SF = EXP(-D/1.28)(Li); SF = EXP(-D/1.18)(C); SF = EXP(-D/2.09)(F), respectively. The sensitive parameters (D0, Gy) of radiation were D0 = 1.28; D0 = 1.18; D0 = 2.09, respectively. The patterns of cell survival were fitted to single target model. The relative biological effectiveness (RBE) for Li, C and F ions were 2.54, 2.67, 1.55, respectively, compared with D0 of gamma-ray irradiation. The inactivation cross sections for these ions were 12.5, 40.6 and 76.5 microns2 respectively. CONCLUSION: The effectiveness of radiation induced by heavy ions of Li, C and F was more serious than that of 60Co gamma-ray, and more than one particle traversal are needed to kill a cell on the average.

Bronchi↗

[Monte Carlo simulation of a dynamic multileaf collimator:implementation and applications].

A model for the simulation of the accelerator heads of two identical linear accelerators was designed at the University Hospital of Tübingen, using the BEAM program developed at the National Research Council of Canada. Both linear accelerators are equipped with multileaf collimators (MLCs) and backup jaws (y-direction) with curved leaf-ends. The accelerator models were divided into two parts. The first part consisted of target, primary collimator, flattening filter, monitor chamber, and mirror. After the Monte Carlo simulation of these parts, the phase-space characteristics below the mirror were stored in a file and used as source for the second part of the accelerator head (jaw, MLC). The electron source was assumed to deliver a gaussian energy spectrum, with parallel direction to the beam axis. With this electron source, there was good agreement between the measured and simulated depth dose curves in water, with difference < 2%. A new module was created for the BEAM program to simulate backup jaws, while the standard MLCQ module from BEAM was used to simulate a MLC with curved leaf-ends. As a result, MLCs and backup jaws with curved leaf-ends make the shoulder of the y-profile higher than the straight-end MLCs.

Computer Simulation↗

Single-use MOSFET radiation dosimeters for the quality assurance of megavoltage photon beams.

We investigated the applicability of single-use MOSFET detectors as quality-assurance devices. Using ten accelerators available at our institution, we performed output measurements in both water and solid phantoms under photon irradiation. The MOSFET detectors performed well within the manufacturer's specifications, with average deviations of 2.1% and 0.7% for the 6 and 18 MV beams, respectively. The strength of the detector's design, including its wireless set-up, factory calibration and direct read-out, makes the system an acceptable independent quality-assurance device for use in verifying machine output within an accuracy of +/-5%. The MOSFET detectors provide a quick check of machine output, which can be efficacious in detecting gross errors in machine calibrations.

Particle Accelerators↗