Physical wedge as a tool for radiochromic film calibration

Reliable calibration is one of the major challenges in using radiochromic films (RCF) for radiation dosimetry. In this study the feasibility of using dose gradients produced by a physical wedge (PW) for RCF calibration was investigated. The aim was to establish an efficient and reproducible method for calibrating RCF using a PW. Film strips were used to capture the wedge dose profile for five different exposures and the acquired scans were processed to generate corresponding net optical density wedge profiles. The proposed method was compared to the benchmark calibration, following the guidelines for precise calibration using uniform dose fields. The results of the benchmark comparison presented in this paper showed that using a single film strip for measuring wedge dose profile is sufficient for estimating a reliable calibration curve within the recorded dose range. Furthermore, the PW calibration can be extrapolated or extended by using multiple gradients for the optimal coverage of the desired calibration dose range. The method outlined in this paper can be readily replicated using the equipment and expertise commonly found in a radiotherapy center. Once the dose profile and central axis attenuation coefficient of the PW are determined, they can serve as a reference for a variety of calibrations using different types and batches of film. This investigation demonstrated that the calibration curves obtained with the presented PW calibration method are within the bounds of the measurement uncertainty evaluated for the conventional uniform dose field calibration method.

Accelerating and improving radiochromic film calibration by utilizing the dose ratio in photon and proton beams

Purpose

Radiochromic films are versatile 2D dosimeters with high‐resolution and near tissue equivalence. To assure high precision and accuracy, a time‐consuming calibration process is required. To improve the time efficiency, a novel calibration method utilizing the ratio of the same dose profile measured at different monitor units (MUs) is introduced and tested in a proton and photon beam.

Methods

The calibration procedure employs the dose ratio of film measurements of the same relative profile for different absolute dose values. Hence, the ratio of the dose is constant at any point of the profile, but the ratio of the net optical densities is not constant. The key idea of the method is to optimize the calibration function until the ratio of the calculated doses is constant. The proposed method was tested in the dose range between 0.25–12 and 1–6 Gy in a proton and photon beam, respectively. A radial symmetric profile and a rectangular profile were created, both having a central plateau region of about 3 cm diameter and a dose falloff of about 1.5 cm at larger distances. The dose falloff region was used as input for the optimization method and the central plateau region served as dose reference points. Only the plateau region of the highest dose entered the optimization as an additional objective. The measured data were randomly split into differently sized training and test sets. The optimization was repeated 1000 times with random start value initialization using the same start values for the standard and the gradient method. Finally, a proton plan with four dose levels was created, which were separated spatially, to test the possibility of a full calibration within a single measurement.

Results

Parameter estimation was possible with as low as one dose ratio used for optimization in both the photon and the proton case, yet exhibiting a high sensitivity on the dose level. The root mean squared deviation (RMSD) of the dose was less than 1% when the dose ratio was in the order of 20, whereas the median RMSD of all optimizations was 1.7%. Using four dose levels for optimization resulted in a median RMSD of 1% when randomly selecting the dose levels. Having at least one dose ratio of about 20 included in the optimization considerably improved the RMSD of the calibration function. Using six or eight dose levels reduced the sensitivity on the dose level selection and the median RMSD was 0.8%. A full calibration was possible in a single measurement having four dose levels in one plan but spatially separated.

Conclusions

The number of measurements required to obtain an EBT3 film calibration function could be reduced using the proposed dose ratio method while maintaining the same accuracy as with the standard method.

A protocol for accurate radiochromic film dosimetry using Radiochromic.com

BACKGROUND

Radiochromic films have many applications in radiology and radiation therapy. Generally, the dosimetry system for radiochromic film dosimetry is composed of radiochromic films, flatbed scanner, and film analysis software. The purpose of this work is to present the effectiveness of a protocol for accurate radiochromic film dosimetry using Radiochromic.com as software for film analysis.

MATERIALS AND METHODS

Procedures for image acquisition, lot calibration, and dose calculation are explained and analyzed. Radiochromic.com enables state-of-the-art models and corrections for radiochromic film dosimetry, such as the Multigaussian model for multichannel film dosimetry, and lateral, inter-scan, and re-calibration corrections of the response.

RESULTS

The protocol presented here provides accurate dose results by mitigating the sources of uncertainty that affect radiochromic film dosimetry.

CONCLUSIONS

Appropriate procedures for film and scanner handling in combination with Radiochromic.com as software for film analysis make easy and accurate radiochromic film dosimetry feasible.

Comparison of three film analysis softwares using EBT2 and EBT3 films in radiotherapy

Introduction The purpose of the study was to compare the results of gamma value based film analysis according to the used type of self-developer film and software product. Material and methods The films were irradiated with different treatment techniques such as 3D conformal and intensity modulated radiotherapy with static and rotational delivery. Stereotactic plans with conformal and intensity modulated arc techniques, using coplanar and non-coplanar beam setup were also evaluated. The data of irradiated film were compared with the planned planar dose distribution exported from the treatment planning system. Three film analysis software programs were evaluated: PTW Mephysto (PTW), FilmQA Pro (FQP) and radiohromic.com(RC). Both EBT2 and EBT3 types of films were examined. The comparisons of dose distributions were performed with gamma analysis using 10% cut-off level. Results The results of the gamma analysis for larger fields were between 78.3% and 98.3%, 75.7% and 100%, 80.2% and 98.8% with PTW, FQP and RC, respectively. The results of evaluation in case of stereotactic measurements were 76.8%-99.2% for PTW, 95.7%-100% for FQP and 91.2%-99.9% for RC. Conclusions All the three software programs are suitable for calibrating and evaluating films, performing gamma analysis, and can be used for patient specific quality assurance measurements. There is no direct connection between gamma passing rate and absolute accuracy or software quality, it is just a feature of the software. The interpretation of own results has to be defined on an institutional level according to given workflow and preliminary results.

The Multigaussian method: a new approach to mitigating spatial heterogeneities with multichannel radiochromic film dosimetry

The main objective of multichannel radiochromic film dosimetry methods is to correct, or at least mitigate, spatial heterogeneities in the film-scanner response, especially variations in the active layer thickness. To this end, films can also be scanned prior to irradiation. In this study, the abilities of various single channel and multichannel methods to reduce spatial heterogeneities, with and without scanning before irradiation, were tested. Red, green and blue single channel models, two additive channel independent perturbation (CHIP) models and two multiplicative CHIP models were compared with the Multigaussian method. The Multigaussian method is a new approach to multichannel dosimetry, based on experimental findings. It assumes that the probability density function of the response vector formed by the pixel values of the different color channels, including irradiated and non-irradiated scans, follows a multivariate Gaussian distribution. The Multigaussian method provided more accurate doses than the other models under comparison, especially when incorporating the information of the film prior to irradiation. The relative dose differences between reference doses measured with MatriXX and film doses were examined. After applying inter-scan and lateral corrections, the lowest mean absolute errors were 0.8% and 1.0% for the Multigaussian method with and without the information of the scan before irradiation, respectively. Followed by the uniform multiplicative CHIP and red single channel models, using pixel values and net optical density, respectively, both with 1.1%.

Monte Carlo uncertainty analysis of dose estimates in radiochromic film dosimetry with single-channel and multichannel algorithms

PURPOSE

To provide a multi-stage model to calculate uncertainty in radiochromic film dosimetry with Monte-Carlo techniques. This new approach is applied to single-channel and multichannel algorithms.

MATERIAL AND METHODS

Two lots of Gafchromic EBT3 are exposed in two different Varian linacs. They are read with an EPSON V800 flatbed scanner. The Monte-Carlo techniques in uncertainty analysis provide a numerical representation of the probability density functions of the output magnitudes. From this numerical representation, traditional parameters of uncertainty analysis as the standard deviations and bias are calculated. Moreover, these numerical representations are used to investigate the shape of the probability density functions of the output magnitudes. Also, another calibration film is read in four EPSON scanners (two V800 and two 10000XL) and the uncertainty analysis is carried out with the four images.

RESULTS

The dose estimates of single-channel and multichannel algorithms show a Gaussian behavior and low bias. The multichannel algorithms lead to less uncertainty in the final dose estimates when the EPSON V800 is employed as reading device. In the case of the EPSON 10000XL, the single-channel algorithms provide less uncertainty in the dose estimates for doses higher than four Gy.

CONCLUSION

A multi-stage model has been presented. With the aid of this model and the use of the Monte-Carlo techniques, the uncertainty of dose estimates for single-channel and multichannel algorithms are estimated. The application of the model together with Monte-Carlo techniques leads to a complete characterization of the uncertainties in radiochromic film dosimetry.

The combination of the error correction methods of GAFCHROMIC EBT3 film

Purpose

The aim of this study was to combine a set of methods for use of radiochromic film dosimetry, including calibration, correction for lateral effects and a proposed triple-channel analysis. These methods can be applied to GAFCHROMIC EBT3 film dosimetry for radiation field analysis and verification of IMRT plans.

Methods

A single-film exposure was used to achieve dose calibration, and the accuracy was verified based on comparisons with the square-field calibration method. Before performing the dose analysis, the lateral effects on pixel values were corrected. The position dependence of the lateral effect was fitted by a parabolic function, and the curvature factors of different dose levels were obtained using a quadratic formula. After lateral effect correction, a triple-channel analysis was used to reduce disturbances and convert scanned images from films into dose maps. The dose profiles of open fields were measured using EBT3 films and compared with the data obtained using an ionization chamber. Eighteen IMRT plans with different field sizes were measured and verified with EBT3 films, applying our methods, and compared to TPS dose maps, to check correct implementation of film dosimetry proposed here.

Results

The uncertainty of lateral effects can be reduced to ±1 cGy. Compared with the results of Micke A et al., the residual disturbances of the proposed triple-channel method at 48, 176 and 415 cGy are 5.3%, 20.9% and 31.4% smaller, respectively. Compared with the ionization chamber results, the difference in the off-axis ratio and percentage depth dose are within 1% and 2%, respectively. For the application of IMRT verification, there were no difference between two triple-channel methods. Compared with only corrected by triple-channel method, the IMRT results of the combined method (include lateral effect correction and our present triple-channel method) show a 2% improvement for large IMRT fields with the criteria 3%/3 mm.

Technical Note: Experimental results from a prototype high-field inline MRI-linac

PURPOSE

The pursuit of real-time image guided radiotherapy using optimal tissue contrast has seen the development of several hybrid magnetic resonance imaging (MRI)-treatment systems, high field and low field, and inline and perpendicular configurations. As part of a new MRI-linac program, an MRI scanner was integrated with a linear accelerator to enable investigations of a coupled inline MRI-linac system. This work describes results from a prototype experimental system to demonstrate the feasibility of a high field inline MR-linac.

METHODS

The magnet is a 1.5 T MRI system (Sonata, Siemens Healthcare) was located in a purpose built radiofrequency (RF) cage enabling shielding from and close proximity to a linear accelerator with inline (and future perpendicular) orientation. A portable linear accelerator (Linatron, Varian) was installed together with a multileaf collimator (Millennium, Varian) to provide dynamic field collimation and the whole assembly built onto a stainless-steel rail system. A series of MRI-linac experiments was performed to investigate (1) image quality with beam on measured using a macropodine (kangaroo) ex vivo phantom; (2) the noise as a function of beam state measured using a 6-channel surface coil array; and (3) electron contamination effects measured using Gafchromic film and an electronic portal imaging device (EPID).

RESULTS

(1) Image quality was unaffected by the radiation beam with the macropodine phantom image with the beam on being almost identical to the image with the beam off. (2) Noise measured with a surface RF coil produced a 25% elevation of background intensity when the radiation beam was on. (3) Film and EPID measurements demonstrated electron focusing occurring along the centerline of the magnet axis.

CONCLUSIONS

A proof-of-concept high-field MRI-linac has been built and experimentally characterized. This system has allowed us to establish the efficacy of a high field inline MRI-linac and study a number of the technical challenges and solutions.

How flatbed scanners upset accurate film dosimetry

Film is an excellent dosimeter for verification of dose distributions due to its high spatial resolution. Irradiated film can be digitized with low-cost, transmission, flatbed scanners. However, a disadvantage is their lateral scan effect (LSE): a scanner readout change over its lateral scan axis. Although anisotropic light scattering was presented as the origin of the LSE, this paper presents an alternative cause. Hereto, LSE for two flatbed scanners (Epson 1680 Expression Pro and Epson 10000XL), and Gafchromic film (EBT, EBT2, EBT3) was investigated, focused on three effects: cross talk, optical path length and polarization. Cross talk was examined using triangular sheets of various optical densities. The optical path length effect was studied using absorptive and reflective neutral density filters with well-defined optical characteristics (OD range 0.2-2.0). Linear polarizer sheets were used to investigate light polarization on the CCD signal in absence and presence of (un)irradiated Gafchromic film. Film dose values ranged between 0.2 to 9 Gy, i.e. an optical density range between 0.25 to 1.1. Measurements were performed in the scanner's transmission mode, with red-green-blue channels. LSE was found to depend on scanner construction and film type. Its magnitude depends on dose: for 9 Gy increasing up to 14% at maximum lateral position. Cross talk was only significant in high contrast regions, up to 2% for very small fields. The optical path length effect introduced by film on the scanner causes 3% for pixels in the extreme lateral position. Light polarization due to film and the scanner's optical mirror system is the main contributor, different in magnitude for the red, green and blue channel. We concluded that any Gafchromic EBT type film scanned with a flatbed scanner will face these optical effects. Accurate dosimetry requires correction of LSE, therefore, determination of the LSE per color channel and dose delivered to the film.

Amplitude gating for a coached breathing approach in respiratory gated 10 MV flattening filter-free VMAT delivery

The purpose of this study was to investigate amplitude gating combined with a coached breathing strategy for 10 MV flattening filter‐free (FFF) volumetric‐modulated arc therapy (VMAT) on the Varian TrueBeam linac. Ten patient plans for VMAT SABR liver were created using the Eclipse treatment planning system (TPS). The verification plans were then transferred to a CT‐scanned Quasar phantom and delivered on a TrueBeam linac using a 10 MV FFF beam and Varian's real‐time position management (RPM) system for respiratory gating based on breathing amplitude. Breathing traces were acquired from ten patients using two kinds of breathing patterns: free breathing and an interrupted (~5 s pause) end of exhale coached breathing pattern. Ion chamber and Gafchromic film measurements were acquired for a gated delivery while the phantom moved under the described breathing patterns, as well as for a nongated stationary phantom delivery. The gate window was set to obtain a range of residual target motion from 2–5 mm. All gated deliveries on a moving phantom have been shown to be dosimetrically equivalent to the nongated deliveries on a static phantom, with differences in point dose measurements under 1% and average gamma 2%/2 mm agreement above 98.7%. Comparison with the treatment planning system also resulted in good agreement, with differences in point‐dose measurements under 2.5% and average gamma 3%/3 mm agreement of 97%. The use of a coached breathing pattern significantly increases the duty cycle, compared with free breathing, and allows for shorter treatment times. Patients' free‐breathing patterns contain considerable variability and, although dosimetric results for gated delivery may be acceptable, it is difficult to achieve efficient treatment delivery. A coached breathing pattern combined with a 5 mm amplitude gate, resulted in both high‐quality dose distributions and overall shortest gated beam delivery times.

PACS number: 87.55.Qr

On multichannel film dosimetry with channel-independent perturbations

PURPOSE

Different multichannel methods for film dosimetry have been proposed in the literature. Two of them are the weighted mean method and the method put forth by Micke et al. ["Multichannel film dosimetry with nonuniformity correction," Med. Phys. 38, 2523-2534 (2011)] and Mayer et al. ["Enhanced dosimetry procedures and assessment for EBT2 radiochromic film," Med. Phys. 39, 2147-2155 (2012)]. The purpose of this work was to compare their results and to develop a generalized channel-independent perturbations framework in which both methods enter as special cases.

METHODS

Four models of channel-independent perturbations were compared: weighted mean, Micke-Mayer method, uniform distribution, and truncated normal distribution. A closed-form formula to calculate film doses and the associated type B uncertainty for all four models was deduced. To evaluate the models, film dose distributions were compared with planned and measured dose distributions. At the same time, several elements of the dosimetry process were compared: film type EBT2 versus EBT3, different waiting-time windows, reflection mode versus transmission mode scanning, and planned versus measured dose distribution for film calibration and for γ-index analysis. The methods and the models described in this study are publicly accessible through IRISEU. Alpha 1.1 (http://www.iriseu.com). IRISEU. is a cloud computing web application for calibration and dosimetry of radiochromic films.

RESULTS

The truncated normal distribution model provided the best agreement between film and reference doses, both for calibration and γ-index verification, and proved itself superior to both the weighted mean model, which neglects correlations between the channels, and the Micke-Mayer model, whose accuracy depends on the properties of the sensitometric curves. With respect to the selection of dosimetry protocol, no significant differences were found between transmission and reflection mode scanning, between 75 ± 5 min and 20 ± 1 h waiting-time windows or between employing EBT2 or EBT3 films. Significantly better results were obtained when a measured dose distribution was used instead of a planned one as reference for the calibration, and when a planned dose distribution was used instead of a measured one as evaluation for the γ-analysis.

CONCLUSIONS

The truncated normal distribution model of channel-independent perturbations was found superior to the other three models under comparison and the authors propose its use for multichannel dosimetry.