Factors affecting penumbral shape and 3D dose distributions in stereotactic radiotherapy

Beam penumbra reduction of Gamma Knife machine model 4C using Monte Carlo simulation

BACKGROUND AND OBJECTIVE

In small radiation fields used in stereotactic radiosurgery penumbra is an important portion of the field size especially when critical organs at risk are located near the treatment sites. This study was aimed to reduce penumbra width (90%-50% isodose lines) of Gamma Knife (GK) machine by investigating of source to diaphragm distance (SDD) and designing compensating filter.

METHODS

Compensating filters at the end of the helmet collimators with the aim of reducing penumbra as well as reducing hot spots appeared near the edge of beam were modeled using Monte Carlo simulation code. Moreover, the SDD parameter was increased as one of the effective factors on penumbra width.

RESULTS

Results showed that single beam penumbra width using optimal design of filters was decreased by 59.49%, 42.50%, 39.02% and 34.44% with attenuation of 30.53%, 13.67%, 11.43% and 9.82% for 4, 8, 14 and 18 mm field sizes, respectively.

CONCLUSIONS

The designed filters lead to considerable reductions in single beams penumbra width as well as a noticeable reduction in maximum dose emerged near the beam edge due to the curved lateral surface of filters.

Finer leaf resolution and steeper beam edges using a virtual isocentre in concurrence to PTV-shaped collimators in standard distance - a planning study

Purpose

Investigation of a reduced source to target distance to improve organ at risk sparing during stereotactic irradiation (STX).

Methods

The authors present a planning study with perfectly target-volume adapted collimator compared with multi-leaf collimator (MLC) at reduced source to virtual isocentre distance (SVID) in contrast to normal source to isocentre distance (SID) for stereotactic applications. The role of MLC leaf width and 20–80% penumbra was examined concerning the healthy tissue sparing. Several prescription schemes and target diameters are considered.

Results

Paddick’s gradient index (GI) as well as comparison of the mean doses to spherical shells at several distances to the target is evaluated. Both emphasize the same results: the healthy tissue sparing in the high dose area around the planning target volume (PTV) is improved at reduced SVID ≤ 70 cm. The effect can be attributed more to steeper penumbra than to finer leaf resolution. Comparing circular collimators at different SVID just as MLC-shaped collimators, always the GI was reduced. Even MLC-shaped collimator at SVID 70 cm had better healthy tissue sparing than an optimal shaped circular collimator at SID 100 cm.

Regarding penumbra changes due to varying SVID, the results of the planning study are underlined by film dosimetry measurements with Agility™ MLC.

Conclusion

Penumbra requires more attention in comparing studies, especially studies using different planning systems. Reduced SVID probably allows usage of conventional MLC for STX-like irradiations.

Electronic supplementary material

The online version of this article (doi:10.1186/s13014-017-0826-8) contains supplementary material, which is available to authorized users.

Radiation damage in protein crystals is reduced with a micron-sized X-ray beam

Radiation damage is a major limitation in crystallography of biological macromolecules, even for cryocooled samples, and is particularly acute in microdiffraction. For the X-ray energies most commonly used for protein crystallography at synchrotron sources, photoelectrons are the predominant source of radiation damage. If the beam size is small relative to the photoelectron path length, then the photoelectron may escape the beam footprint, resulting in less damage in the illuminated volume. Thus, it may be possible to exploit this phenomenon to reduce radiation-induced damage during data measurement for techniques such as diffraction, spectroscopy, and imaging that use X-rays to probe both crystalline and noncrystalline biological samples. In a systematic and direct experimental demonstration of reduced radiation damage in protein crystals with small beams, damage was measured as a function of micron-sized X-ray beams of decreasing dimensions. The damage rate normalized for dose was reduced by a factor of three from the largest (15.6 μm) to the smallest (0.84 μm) X-ray beam used. Radiation-induced damage to protein crystals was also mapped parallel and perpendicular to the polarization direction of an incident 1-μm X-ray beam. Damage was greatest at the beam center and decreased monotonically to zero at a distance of about 4 μm, establishing the range of photoelectrons. The observed damage is less anisotropic than photoelectron emission probability, consistent with photoelectron trajectory simulations. These experimental results provide the basis for data collection protocols to mitigate with micron-sized X-ray beams the effects of radiation damage.

Optimal margin and edge-enhanced intensity maps in the presence of motion and uncertainty

In radiation therapy, intensity maps involving margins have long been used to counteract the effects of dose blurring arising from motion. More recently, intensity maps with increased intensity near the edge of the tumour (edge enhancements) have been studied to evaluate their ability to offset similar effects that affect tumour coverage. In this paper, we present a mathematical methodology to derive margin and edge-enhanced intensity maps that aim to provide tumour coverage while delivering minimum total dose. We show that if the tumour is at most about twice as large as the standard deviation of the blurring distribution, the optimal intensity map is a pure scaling increase of the static intensity map without any margins or edge enhancements. Otherwise, if the tumour size is roughly twice (or more) the standard deviation of motion, then margins and edge enhancements are preferred, and we present formulae to calculate the exact dimensions of these intensity maps. Furthermore, we extend our analysis to include scenarios where the parameters of the motion distribution are not known with certainty, but rather can take any value in some range. In these cases, we derive a similar threshold to determine the structure of an optimal margin intensity map.

Relative output factor measurements of a 5 mm diameter radiosurgical photon beam using polymer gel dosimetry

Besides the fine spatial resolution inherent in polymer gel-magnetic resonance imaging (MRI) dosimetry, the method also features the potential for multiple measurements of varying sensitive volume in a single experiment by integrating results in MRI voxels of finite dimensions (i.e., in plane resolution by slice thickness). This work exploits this feature of polymer gel dosimetry to propose an experimental technique for relative output factor (OF) measurements of small radiosurgical beams. Two gel vials were irradiated with a 5 and 30 mm diameter 6 MV radiosurgery beam and MR scanned with the same slice thickness and three different in plane resolutions. Using this experimental data set, 5 mm OF measurements with the PinPoint ion chamber are simulated by integrating results over a sensitive volume equal to that of the chamber. Results are found in agreement within experimental uncertainties with actual PinPoint measurements verifying the validity of the proposed experimental procedure. The polymer gel data set is subsequently utilized for OF measurements of the 5 mm beam with varying sensitive volume to discuss the magnitude of detector volume averaging effects. Seeking to correct for volume averaging, results are extrapolated to zero sensitive volume yielding a 5 mm OF measurement of (0.66+/-5%). This result compares reasonably with corresponding ionometric and radiographic film measurements of this work and corresponding, limited, data in the literature. Overall, results suggest that polymer gel dosimetry coupled with the proposed experimental procedure helps overcome not only tissue-equivalence and beam perturbation implications but also volume averaging and positioning uncertainties which constitute the main drawback in small radiosurgical beam dosimetry.

Narrow stereotactic beam profile measurements using N-vinylpyrrolidone based polymer gels and magnetic resonance imaging

In this work, polymer gel-MRI dosimetry (using VIPAR gels), radiographic film and a PinPoint ion chamber were used for profile measurements of 6 MV x-ray stereotactic beams of 5 and 10 mm diameter. The VIPAR gel-MRI method exhibited a linear dose response up to 32 Gy. VIPAR gels were found to resolve the penumbra region quite accurately, provided that the in-plane image resolution of the related T2-map is adequate (< or = 0.53 mm). T2-map slice thickness had no significant effect on beam profile data. VIPAR measurements performed with a spatial resolution of 0.13 mm provided penumbra widths (80%-20% distance) of 1.34 and 1.70 mm for the 5 and 10 mm cones respectively. These widths were found to be significantly smaller than those obtained with the film (2.23 mm for the 5 mm cone, 2.45 mm for the 10 mm cone) and PinPoint (2.25 mm for the 5 mm cone, 2.52 mm for the 10 mm cone) methods. Regarding relative depth dose measurements, good correlation between VIPAR gel and PinPoint data was observed. In conclusion, polymer gel-MRI dosimetry can provide relatively accurate profile data for very small beams used in stereotactic radiosurgery since it can overcome, to some extent, the problems related to the finite size of conventional detectors.

Study of dosimetric penumbra due to multileaf collimation on a medical linear accelerator

PURPOSE

Investigations of dosimetric penumbra produced by multileaf collimation on a medical linear accelerator are presented.

METHODS AND MATERIALS

Multileaf collimators (MLCs) can be designed with at least three different shaped leaf-end profiles: straight, divergent, and curved. Assessment of the dosimetric effects of the collimator edge profiles was implemented using a fast Fourier transform (FFT) convolution algorithm. Accelerator source intensity was considered to have a Gaussian distribution. The calculated dose profile, for a source-to-surface distance of 100 cm and at depth of 10 cm in a water phantom, was fitted to a penumbral-forming function from which the penumbral width between 80% and 20% of the central axis dose was obtained.

RESULTS

Calculation performed at various field sizes showed that curved collimator leaf-end produces a wider penumbra than the diverging collimator leaf-side. Film measurements agreed with the calculations within an uncertainty of less than 2 mm. The effect of backup jaws for the MLC and of the lower pair of diverging diaphragms on dosimetric penumbra was also investigated.

CONCLUSIONS

This study is useful for characterizing collimator edge effects and for optimizing new collimator designs.