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Zhu L, Dong S, Sun L, Xiao Y, Zhong Y, Pan M, Wang Y. Dosimetric comparison of HyperArc and InCise MLC-based CyberKnife plans in treating single and multiple brain metastases. J Appl Clin Med Phys 2024:e14404. [PMID: 38803034 DOI: 10.1002/acm2.14404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/19/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND AND PURPOSE This study aimed to compare the dosimetric attributes of two multi-leaf collimator based techniques, HyperArc and Incise CyberKnife, in the treatment of brain metastases. MATERIAL AND METHODS 17 cases of brain metastases were selected including 6 patients of single lesion and 11 patients of multiple lesions. Treatment plans of HyperArc and CyberKnife were designed in Eclipse 15.5 and Precision 1.0, respectively, and transferred to Velocity 3.2 for comparison. RESULTS HyperArc plans provided superior Conformity Index (0.91 ± 0.06 vs. 0.77 ± 0.07, p < 0.01) with reduced dose distribution in organs at risk (Dmax, p < 0.05) and lower normal tissue exposure (V4Gy-V20Gy, p < 0.05) in contrast to CyberKnife plans, although the Gradient Indexes were similar. CyberKnife plans showed higher Homogeneity Index (1.54 ± 0.17 vs. 1.39 ± 0.09, p < 0.05) and increased D2% and D50% in the target (p < 0.05). Additionally, HyperArc plans had significantly fewer Monitor Units (MUs) and beam-on time (p < 0.01). CONCLUSION HyperArc plans demonstrated superior performance compared with MLC-based CyberKnife plans in terms of conformity and the sparing of critical organs and normal tissues, although no significant difference in GI outcomes was noted. Conversely, CyberKnife plans achieved a higher target dose and HI. The study suggests that HyperArc is more efficient and particularly suitable for treating larger lesions in brain metastases.
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Affiliation(s)
- Liying Zhu
- Radiation Oncology Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Shengnan Dong
- Radiation Oncology Center, Henan Province Hospital of TCM, Zhengzhou, China
| | - Lei Sun
- Department of Neurosurgery, CyberKnife Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yixuan Xiao
- Radiation Oncology Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yihua Zhong
- Radiation Oncology Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Mingyuan Pan
- Radiation Oncology Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yang Wang
- Radiation Oncology Center, Huashan Hospital, Fudan University, Shanghai, China
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Kazantsev P, Wesolowska P, Bokulic T, Falowska-Pietrzak O, Repnin K, Dimitriadis A, Swamidas J, Izewska J. The IAEA remote audit of small field dosimetry for testing the implementation of the TRS-483 code of practice. Med Phys 2024. [PMID: 38700987 DOI: 10.1002/mp.17109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The TRS‑483, an IAEA/AAPM International Code of Practice on dosimetry of small static photon fields, underwent testing via an IAEA coordinated research project (CRP). Alongside small field output factors (OFs) measurements using active dosimeters by CRP participants, the IAEA Dosimetry Laboratory received a mandate to formulate a remote small field dosimetry audit method using its passive dosimetry systems. PURPOSE This work aimed to develop a small field dosimetry audit methodology employing radiophotoluminescent dosimeters (RPLDs) and radiochromic films. The methodology was subsequently evaluated through a multicenter pilot study with CRP participants. METHODS The developments included designing and manufacturing a dosimeter holder set and the characterization of an RPLD system for measurements in small photon fields using the new holder. The audit included verification of small field OFs and lateral beam profiles for small fields. At first, treatment planning system (TPS) calculated OFs were checked against a reference data set that was available for conventional linacs. Second, calculated OFs were verified through the RPLD measurement of point doses in a machine-specific reference field, 4 cm × 4 cm, 2 cm × 2 cm, and 1 cm × 1 cm, corresponding size circular fields or nearest achievable field sizes. Lastly, profile checks in in-plane and cross-plane directions were done for the two smallest fields by comparing film measurements with TPS calculations at 20%, 50%, and 80% isodose levels. RESULTS RPLD correction factors for small field measurements were approximately unity. However, they influenced the dose determination's overall uncertainty in small fields, estimated at 2.30% (k = 1 level). Considering the previous experience in auditing reference beam output following the TRS-398 Code of Practice, the acceptance limit of 5% for the ratio of the dose determined by RPLD to the dose calculated by TPS, DRPLD/DTPS, was considered adequate. The multicenter pilot study included 15 participants from 14 countries (39 beams). Consistent with the previous findings, the results of the OF check against the reference data confirmed that TPSs tend to overestimate OFs for the smallest fields included in this exercise. All except three RPLD measurement results were within the acceptance limit, and the spread of results increased for smaller field sizes. The differences between the film measured and TPS calculated dose profiles were within 3 mm for most of the beams checked; deviated results revealed problems with TPS commissioning and calibration of the treatment unit collimation systems. CONCLUSION The newly developed small field dosimetry audit methodology proved effective and successfully complemented the CRP OF measurements by participants with RPLD audit results.
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Affiliation(s)
| | - Paulina Wesolowska
- International Atomic Energy Agency, Vienna, Austria
- The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Tomislav Bokulic
- International Atomic Energy Agency, Vienna, Austria
- University of Zagreb, Zagreb, Croatia
| | - Olga Falowska-Pietrzak
- International Atomic Energy Agency, Vienna, Austria
- Stockholm University, Stockholm, Sweden
| | - Kostiantyn Repnin
- International Atomic Energy Agency, Vienna, Austria
- Medical University of Vienna, Vienna, Austria
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Kakade NR, Kumar R, Sharma SD, Sapra BK. Dosimetry audit in advanced radiotherapy using in-house developed anthropomorphic head & neck phantom. Biomed Phys Eng Express 2024; 10:025022. [PMID: 38269653 DOI: 10.1088/2057-1976/ad222a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/24/2024] [Indexed: 01/26/2024]
Abstract
The treatment of head and neck (H&N) cancer presents formidable challenges due to the involvement of normal tissue and organs at risk (OARs) in the close vicinity. Ensuring the precise administration of the prescribed dose demands prior dose verification. Considering contour irregularity and heterogeneity in the H&N region, an anthropomorphic and heterogeneous H&N phantom was developed and fabricated locally for conducting the dosimetry audit in advanced radiotherapy treatments. This specialized phantom emulates human anatomy and incorporates a removable cylindrical insert housing a C-shaped planning target volume (PTV) alongside key OARs including the spinal cord, oral cavity, and bilateral parotid glands. Acrylonitrile Butadiene Styrene (ABS) was chosen for PTV and parotid fabrication, while Delrin was adopted for spinal cord fabrication. A pivotal feature of this phantom is the incorporation of thermoluminescent dosimeters (TLDs) within the PTV and OARs, enabling the measurement of delivered dose. To execute the dosimetry audit, the phantom, accompanied by dosimeters and comprehensive guidelines, was disseminated to multiple radiotherapy centers. Subsequently, hospital physicists acquired computed tomography (CT) scans to generate treatment plans for phantom irradiation. The treatment planning system (TPS) computed the anticipated dose distribution within the phantom, and post-irradiation TLD readings yielded actual dose measurements. The TPS calculated and TLD measured dose values at most of the locations inside the PTV were found comparable within ± 4%. The outcomes affirm the suitability of the developed anthropomorphic H&N phantom for precise dosimetry audits of advanced radiotherapy treatments.
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Affiliation(s)
- Nitin R Kakade
- Radiological Physics & Advisory Division, Bhabha Atomic Research Centre, Mumbai-400094, India
| | - Rajesh Kumar
- Radiological Physics & Advisory Division, Bhabha Atomic Research Centre, Mumbai-400094, India
| | - S D Sharma
- Radiological Physics & Advisory Division, Bhabha Atomic Research Centre, Mumbai-400094, India
- Homi Bhabha National Institute, Mumbai-400094, India
| | - B K Sapra
- Radiological Physics & Advisory Division, Bhabha Atomic Research Centre, Mumbai-400094, India
- Homi Bhabha National Institute, Mumbai-400094, India
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Wesolowska P, Slusarczyk-Kacprzyk W, Fillmann M, Kazantsev P, Bulski W. Results of the IAEA supported national end-to-end audit of the IMRT technique in Poland. Phys Med 2023; 116:103168. [PMID: 37984129 DOI: 10.1016/j.ejmp.2023.103168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 10/09/2023] [Accepted: 11/05/2023] [Indexed: 11/22/2023] Open
Abstract
The dosimetry audit services were established in Poland in 1991, since then new audits have been introduced. The recently developed IAEA audit methodology for IMRT H&N treatments was tested nationally. Anthropomorphic SHANE phantom (CIRS) was used to perform measurements in 8 hospitals which voluntarily participated in the study. Each participant had to complete successfully pre-visit activities to take part in an onsite visit. During the visit, auditors together with the local staff, did a CT scan using local protocol, recalculated the plan and verified all the relevant parameters and performed measurements with an ionization chamber and films in SHANE. The adoption of IAEA methodology to the national circumstances was done with no major issues. Participants plans were verified and the results of ionization chamber were all within the 5 % tolerance limit for PTV (max 4,5%) and 7 % for OAR (max 5,3%). Film global gamma results (3 %, 3 mm, 90 % acceptance limit) were within 91,5-99,7% range. The IAEA established acceptance criteria which were achievable for most tests except for CTtoRED conversion curve. The locally performed study allowed establishing new limits. The audit gave interesting results and showed that the procedure is very thorough and capable to identify issues related with suboptimal treatment preparation and delivery. The new limits for CTtoRED conversion curve were adopted for national study. Such an audit gives an opportunity to verify the quality of locally implemented procedures and should be available for Polish hospitals on a daily basis.
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Affiliation(s)
- Paulina Wesolowska
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
| | | | - Marta Fillmann
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Pavel Kazantsev
- Dosimetry Laboratory, Dosimetry and Medical Radiation Physics Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Wojciech Bulski
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Saez J, Bar-Deroma R, Bogaert E, Cayez R, Chow T, Clark CH, Esposito M, Feygelman V, Monti AF, Garcia-Miguel J, Gershkevitsh E, Goossens J, Herrero C, Hussein M, Khamphan C, Kierkels RGJ, Lechner W, Lemire M, Nevelsky A, Nguyen D, Paganini L, Pasler M, Fernando Pérez Azorín J, Ramos Garcia LI, Russo S, Shakeshaft J, Vieillevigne L, Hernandez V. Universal evaluation of MLC models in treatment planning systems based on a common set of dynamic tests. Radiother Oncol 2023; 186:109775. [PMID: 37385376 DOI: 10.1016/j.radonc.2023.109775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/19/2023] [Accepted: 06/23/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE To demonstrate the feasibility of characterising MLCs and MLC models implemented in TPSs using a common set of dynamic beams. MATERIALS AND METHODS A set of tests containing synchronous (SG) and asynchronous sweeping gaps (aSG) was distributed among twenty-five participating centres. Doses were measured with a Farmer-type ion chamber and computed in TPSs, which provided a dosimetric characterisation of the leaf tip, tongue-and-groove, and MLC transmission of each MLC, as well as an assessment of the MLC model in each TPS. Five MLC types and four TPSs were evaluated, covering the most frequent combinations used in radiotherapy departments. RESULTS Measured differences within each MLC type were minimal, while large differences were found between MLC models implemented in clinical TPSs. This resulted in some concerning discrepancies, especially for the HD120 and Agility MLCs, for which differences between measured and calculated doses for some MLC-TPS combinations exceeded 10%. These large differences were particularly evident for small gap sizes (5 and 10 mm), as well as for larger gaps in the presence of tongue-and-groove effects. A much better agreement was found for the Millennium120 and Halcyon MLCs, differences being within ± 5% and ± 2.5%, respectively. CONCLUSIONS The feasibility of using a common set of tests to assess MLC models in TPSs was demonstrated. Measurements within MLC types were very similar, but TPS dose calculations showed large variations. Standardisation of the MLC configuration in TPSs is necessary. The proposed procedure can be readily applied in radiotherapy departments and can be a valuable tool in IMRT and credentialing audits.
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Affiliation(s)
- Jordi Saez
- Hospital Clínic de Barcelona, Department of Radiation Oncology, Barcelona, Spain.
| | - Raquel Bar-Deroma
- Rambam Health Care Campus, Department of Radiotherapy, Division of Oncology, Haifa, Israel
| | - Evelien Bogaert
- Ghent University Hospital and Ghent University, Department of Radiation Oncology, Ghent, Belgium
| | - Romain Cayez
- Oscar Lambret Center, Department of Medical Physics, Lille, France
| | - Tom Chow
- Juravinski Hospital and Cancer Centre at Hamilton Health Sciences, Department of Medical Physics, Ontario, Canada
| | - Catharine H Clark
- National Physical Laboratory, Metrology for Medical Physics Centre, London TW11 0PX, UK; Radiotherapy Physics, University College London Hospital, 250 Euston Rd, London NW1 2PG, UK; Dept Medical Physics and Bioengineering, University College London, Malet Place, London WC1 6BT, UK
| | - Marco Esposito
- AUSL Toscana Centro, Medical Physics Unit, Florence, Italy; The Abdus Salam International Center for Theoretical, Trieste, Italy
| | | | - Angelo F Monti
- ASST GOM Niguarda, Department of Medical Physics, Milano, Italy
| | - Julia Garcia-Miguel
- Consorci Sanitari de Terrassa, Department of Radiation Oncology, Terrassa, Spain
| | - Eduard Gershkevitsh
- North Estonia Medical Centre, Department of Medical Physics, Tallinn, Estonia
| | - Jo Goossens
- Iridium Netwerk, Department of Medical Physics, Antwerp, Belgium
| | - Carmen Herrero
- Centro Médico de Asturias-IMOMA, Department of Medical Physics, Oviedo, Spain
| | - Mohammad Hussein
- National Physical Laboratory, Metrology for Medical Physics Centre, London TW11 0PX, UK
| | - Catherine Khamphan
- Institut du Cancer - Avignon Provence, Department of Medical Physics, Avignon, France
| | - Roel G J Kierkels
- Radiotherapiegroep, Department of Medical Physics, Arnhem/Deventer, the Netherlands
| | - Wolfgang Lechner
- Medical University of Vienna, Department of Radiation Oncology, Vienna, Austria
| | - Matthieu Lemire
- CIUSSS de l'Est-de-l'Île-de-Montréal, Service de Radio-Physique, Montréal, Canada
| | - Alexander Nevelsky
- Rambam Health Care Campus, Department of Radiotherapy, Division of Oncology, Haifa, Israel
| | | | - Lucia Paganini
- Humanitas Clinical and Research Center, Radiotherapy and Radiosurgery Department, Rozzano, Italy
| | - Marlies Pasler
- Lake Constance Radiation Oncology Center, Department of Radiation Oncology, Singen, Friedrichshafen, Germany; Radiotherapy Hirslanden, St. Gallen, Switzerland
| | - José Fernando Pérez Azorín
- Medical Physics and Radiation Protection Department, Gurutzeta-Cruces University Hospital, Barakaldo, Spain; Biocruces Health Research Institute, Barakaldo, Spain
| | | | | | - John Shakeshaft
- Gold Coast University Hospital, ICON Cancer Centre, Gold Coast, Australia
| | - Laure Vieillevigne
- Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse, Department of Medical Physics, Toulouse, France
| | - Victor Hernandez
- Hospital Sant Joan de Reus, Department of Medical Physics, Reus, Spain; Universitat Rovira i Virgili, Tarragona, Spain
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Rousseau A, Stien C, Gouriou J, Bordy JM, Boissonnat G, Chabert I, Dufreneix S, Blideanu V. End-to-end quality assurance for stereotactic radiotherapy with Fricke-Xylenol orange-Gelatin gel dosimeter and dual-wavelength cone-beam optical CT readout. Phys Med 2023; 113:102656. [PMID: 37625218 DOI: 10.1016/j.ejmp.2023.102656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/04/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023] Open
Abstract
PURPOSE The end-to-end (E2E) quality assurance (QA) test is a unique tool for validating the treatment chain undergone by patients in external radiotherapy. It should be conducted in three dimensions (3D) to get accurate results. This study aims to implement these tests with Fricke-Xylenol orange-Gelatin (FXG) gel dosimeter and a newly developed dual-wavelength reading method on the Vista16™ optical Computed Tomography (CT) scanner (ModusQA) for three treatment techniques in stereotactic radiotherapy, on Novalis (Varian) and CyberKnife (Accuray) linear accelerators. METHODS The tests were performed in head phantoms. Gel measurements were compared with planned dose distributions and measured by film and ion chamber measurements by plotting isodose curves and dose profiles, and by conducting a 3D local gamma-index analysis (2%/2mm criteria). RESULTS Gamma passing rates were higher than 95 %. Point dose differences between treatment planning and gel and ion chamber measurements at the isocenter were < 2.3 % for both treatments delivered on the Novalis accelerator, while this difference was higher than 4 % for the treatment delivered on the CyberKnife, highlighting a small overdosing of the tumor volume. A good agreement was observed between gel and film dose profiles. CONCLUSIONS This study presents the successful implementation of 3D E2E QA tests for stereotactic radiotherapy with FXG gel dosimetry and a dual-wavelength reading method on an optical CT scanner. This dosimetric method provides 3D absolute dose distributions in the 0.25 - 10 Gy dose range with a high spatial resolution and a dose uncertainty of around 2 % (k=1).
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Affiliation(s)
- Alice Rousseau
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), Palaiseau, France.
| | - Christel Stien
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), Palaiseau, France
| | - Jean Gouriou
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), Palaiseau, France
| | - Jean-Marc Bordy
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), Palaiseau, France
| | - Guillaume Boissonnat
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), Palaiseau, France
| | | | - Stéphane Dufreneix
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), Palaiseau, France; Institut de Cancérologie de l'Ouest, Angers, France
| | - Valentin Blideanu
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), Palaiseau, France
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Greer PB, Standen T, David R, Miri N, Bobrowski K, Lehmann J, Zwan B, Moore A. Remote EPID-based dosimetric auditing using DVH patient dose analysis. Phys Med Biol 2023; 68. [PMID: 36595255 DOI: 10.1088/1361-6560/aca953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022]
Abstract
Objective.The aim of this work was to develop and validate a method for remote dosimetric auditing that enables dose-volume histogram parameter comparisons of measured and planned dose in the patient CT volume.Approach. The method is derived by adapting and combining a remote electronic portal imaging (EPID) based auditing method (Virtual Epid based Standard Phantom Audit-VESPA) and a method to estimate 3D in-patient dose distributions from planar dosimetric measurements. The method was tested with a series of error-induced plans including monitor unit and multileaf collimator (MLC) positioning errors. A pilot audit study was conducted with eleven radiotherapy centres. IMRT plans from two clinical trials, a post-prostatectomy (RAVES trial) plan and a head and neck (HPV trial) plan were utilized. Clinically relevant DVH parameters for the planned dose and estimated measured dose were compared.Main results. The method was found to reproduce the induced dose errors within 0.5% and was sensitive to MLC positioning errors as small as 0.5 mm. For the RAVES plan audit all DVH results except one were within 3% and for the HPV plan audit all DVH results were within 3% except three with a maximum difference of 3.2%.Significance. The results from the audit method produce clinically meaningful DVH metrics for the audited plan and could enable an improved understanding of a centre's radiotherapy quality.
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Affiliation(s)
- P B Greer
- Calvary Mater Newcastle Hospital, Newcastle, Australia.,University of Newcastle, Newcastle, Australia
| | - T Standen
- University of Sydney, Sydney, Australia
| | - R David
- University of Newcastle, Newcastle, Australia.,Central Coast Cancer Centre, Gosford, Australia
| | - N Miri
- University of Newcastle, Newcastle, Australia
| | - K Bobrowski
- University of Wollongong, Wollongong, Australia
| | - J Lehmann
- Calvary Mater Newcastle Hospital, Newcastle, Australia.,University of Newcastle, Newcastle, Australia.,University of Sydney, Sydney, Australia
| | - B Zwan
- Central Coast Cancer Centre, Gosford, Australia
| | - A Moore
- University of Newcastle, Newcastle, Australia.,TROG Cancer Research, Newcastle, Australia
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Lechner W, Alfonso R, Arib M, Huq MS, Ismail A, Kinhikar R, Lárraga-Gutiérrez JM, Mani KR, Maphumulo N, Sauer OA, Shoeir S, Suriyapee S, Christaki K. A multi-institutional evaluation of small field output factor determination following the recommendations of IAEA/AAPM TRS-483. Med Phys 2022; 49:5537-5550. [PMID: 35717637 PMCID: PMC9541513 DOI: 10.1002/mp.15797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 03/31/2022] [Accepted: 05/25/2022] [Indexed: 11/15/2022] Open
Abstract
Purpose The aim of this work was to test the implementation of small field dosimetry following TRS‐483 and to develop quality assurance procedures for the experimental determination of small field output factors (SFOFs). Materials and methods Twelve different centers provided SFOFs determined with various detectors. Various linac models using the beam qualities 6 MV and 10 MV with flattening filter and without flattening filter were utilized to generate square fields down to a nominal field size of 0.5 cm × 0.5 cm. The detectors were positioned at 10 cm depth in water. Depending on the local situation, the source‐to‐surface distance was either set to 90 cm or 100 cm. The SFOFs were normalized to the output of the 10 cm × 10 cm field. The spread of SFOFs measured with different detectors was investigated for each individual linac beam quality and field size. Additionally, linac‐type specific SFOF curves were determined for each beam quality and the SFOFs determined using individual detectors were compared to these curves. Example uncertainty budgets were established for a solid state detector and a micro ionization chamber. Results The spread of SFOFs for each linac and field was below 5% for all field sizes. With the exception of one linac‐type, the SFOFs of all investigated detectors agreed within 10% with the respective linac‐type SFOF curve, indicating a potential inter‐detector and inter‐linac variability. Conclusion Quality assurance on the SFOF measurements can be done by investigation of the spread of SFOFs measured with multiple detectors and by comparison to linac‐type specific SFOFs. A follow‐up of a measurement session should be conducted if the spread of SFOFs is larger than 5%, 3%, and 2% for field sizes of 0.5 cm × 0.5 cm, 1 cm × 1 cm, and field sizes larger than 2 cm × 2 cm, respectively. Additionally, deviations of measured SFOFs to the linac‐type‐curves of more than 7%, 3%, and 2% for field sizes 0.5 cm × 0.5 cm, 1 cm × 1 cm, and field sizes larger than 1 cm × 1 cm, respectively, should be followed up.
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Affiliation(s)
- Wolfgang Lechner
- Department of Radiation Oncology, Division of Medical Physics, Medical University Vienna, Vienna, 1090, Austria
| | - Rodolfo Alfonso
- Department of Nuclear Engineering, Higher Institute of Technology and Applied Sciences, University of Havana, Havana, 10400, Cuba
| | - Mehenna Arib
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - M Saiful Huq
- Department of Radiation Oncology, University of Pittsburgh School of Medicine and UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - Anas Ismail
- Protection and Safety Department, Atomic Energy Commission of Syria, Damascus, PO Box 6091, Syria
| | - Rajesh Kinhikar
- Department of Medical Physics, Tata Memorial Centre, Mumbai, India 400012 & Homi Bhabha National Institute, Mumbai, 400094, India
| | - José M Lárraga-Gutiérrez
- Laboratorio de Física-Médica, Instituto Nacional de Neurología y Neurocirugía, Insurgentes sur 3877, La Fama, Tlalpan 14269, CDMX, México
| | - Karthick Raj Mani
- Department of Radiation Oncology, United Hospital Ltd., Dhaka, 1212, Bangladesh
| | - Nkosingiphile Maphumulo
- Radiation Dosimetry Section, National Metrology Institute of South Africa, Pretoria, South Africa
| | - Otto A Sauer
- Department of Radiation Oncology, University of Würzburg, 97080, Würzburg, Germany
| | | | - Sivalee Suriyapee
- Division of Radiation Oncology, Department of Radiology, Chulalongkorn University, Bangkok, Thailand
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Fadzil M, Noor N, Tamchek N, Ung N, Abdullah N, Dolah M, Bradley D. A cross-validation study of Ge-doped silica optical fibres and TLD-100 systems for high energy photon dosimetry audit under non-reference conditions. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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