Photon spectral characteristics of dissimilar 6 MV linear accelerators

Enhanced dynamic wedge output factors for Varian 2300CD and the case for a reference database

Dose inhomogeneity in treatment planning can be compensated using physical wedges. Enhanced dynamic wedges (EDW) were introduced by Varian to overcome some of the shortcomings of physical wedges. The objectives of this study were to measure EDW output factors for 6 MV and 20 MV photon energies for a Varian 2300CD. Secondly, to review the literature in terms of published enhanced dynamic wedge output factors (EDWOF) for different Varian models and thereby add credence to the case of the validity of reference databases. The enhanced dynamic wedge output factors were measured for the Varian 2300CD for both 6MV and 20 MV photon energies. Twelve papers with published EDWOF for different Varian linac models were found in the literature. Comparing our results with the published mean, we found an excellent agreement for 6 MV EDWOF, with the percentage differences ranging from 0.01% to 0.57%, with a mean of 0.03%. The coefficient of variation of published EDWOF ranged from 0.17% to 0.85% and 0.1% to 0.9% for the for 6 MV and 18 MV photon energies, respectively. This paper provides the first published EDWOF for 20 MV photon energy. In addition, we have provided the first compendium of EDWOFs for different Varian linac models. The consistency of value across models and institution provide further support that a standard dataset of basic photon and electron dosimetry could be established as a guide for future commissioning, beam modeling, and quality assurance purposes.

A new transmission methodology for quality assurance in radiotherapy based on radiochromic film measurements

Despite individual quality assurance (QA) being recommended for complex techniques in radiotherapy (RT) treatment, the possibility of errors in dose delivery during therapeutic application has been verified. Therefore, it is fundamentally important to conduct in vivo QA during treatment. This work presents an in vivo transmission quality control methodology, using radiochromic film (RCF) coupled to the linear accelerator (linac) accessory holder. This QA methodology compares the dose distribution measured by the film in the linac accessory holder with the dose distribution expected by the treatment planning software. The calculated dose distribution is obtained in the coronal and central plane of a phantom with the same dimensions of the acrylic support used for positioning the film but in a source-to-detector distance (SDD) of 100 cm, as a result of transferring the IMRT plan in question with all the fields positioned with the gantry vertically, that is, perpendicular to the phantom. To validate this procedure, first of all a Monte Carlo simulation using PENELOPE code was done to evaluate the differences between the dose distributions measured by the film in a SDD of 56.8 cm and 100 cm. After that, several simple dose distribution tests were evaluated using the proposed methodology, and finally a study using IMRT treatments was done. In the Monte Carlo simulation, the mean percentage of points approved in the gamma function comparing the dose distribution acquired in the two SDDs were 99.92% ± 0.14%. In the simple dose distribution tests, the mean percentage of points approved in the gamma function were 99.85% ± 0.26% and the mean percentage differences in the normalization point doses were -1.41%. The transmission methodology was approved in 24 of 25 IMRT test irradiations. Based on these results, it can be concluded that the proposed methodology using RCFs can be applied for in vivo QA in RT treatments.

An improved physics-based approach for unfolding megavoltage bremsstrahlung spectra using transmission analysis

PURPOSE

To develop a physics-based approach to improve the accuracy and robustness of the ill-conditioned problem of unfolding megavoltage bremsstrahlung spectra from transmission data.

METHODS

Spectra are specified using a rigorously-benchmarked functional form. Since ion chambers are the typical detector used in transmission measurements, the energy response of a Farmer chamber is calculated using the EGSnrc Monte Carlo code, and the effect of approximating the energy response on the accuracy of the unfolded spectra is studied. A proposal is introduced to enhance spectral sensitivity by combining transmission data measured with multiple detectors of different energy response and by combining data from multiple attenuating materials. Monte Carlo methods are developed to correct for nonideal exponential attenuation (e.g., scatter effects and secondary attenuation). The performance of the proposed methods is evaluated for a diverse set of validated clinical spectra (3.5-25 MV) using analytical transmission data with simulated experimental noise.

RESULTS

The approximations commonly used in previous studies for the ion-chamber energy response lead to significant errors in the unfolded spectra. Of the configurations studied, the one with best spectral sensitivity is to measure four full transmission curves using separate low-Z and high-Z attenuators in conjunction with two detectors of different energy response (the authors propose a Farmer-type ion chamber, once with a low-Z, and once with a high-Z buildup cap material), then to feed the data simultaneously to the unfolding algorithm. Deviations from ideal exponential attenuation are as much as 1.5% for the smallest transmission signals, and the proposed methods properly correct for those deviations. The transmission data with enhanced spectral sensitivity, combined with the accurate and flexible spectral functional form, lead to robust unfolding without requiring a priori knowledge of the spectrum. Compared with the commonly-used methods, the accuracy is improved for the unfolded spectra and for the unfolded mean incident electron kinetic energy by at least factors of three and four, respectively. With simulated experimental noise and a lowest transmission of 1%, the unfolded energy fluence spectra agree with the original spectra with a normalized root-mean-square deviation, %Δ(ψ), of 2.3%. The unfolded mean incident electron kinetic energies agree, on average, with the original values within 1.4%. A lowest transmission of only 10% still allows unfolding with %Δ(ψ) of 3.3%.

CONCLUSIONS

In the presence of realistic experimental noise, the proposed approach significantly improves the accuracy and robustness of the spectral unfolding problem for all therapy and MV imaging beams of clinical interest.