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Guyer G, Mueller S, Mackeprang PH, Frei D, Volken W, Aebersold DM, Loessl K, Manser P, Fix MK. Delivery time reduction for mixed photon-electron radiotherapy by using photon MLC collimated electron arcs. Phys Med Biol 2023; 68:215009. [PMID: 37816376 DOI: 10.1088/1361-6560/ad021a] [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: 06/28/2023] [Accepted: 10/10/2023] [Indexed: 10/12/2023]
Abstract
Objective. Electron arcs in mixed-beam radiotherapy (Arc-MBRT) consisting of intensity-modulated electron arcs with dynamic gantry rotation potentially reduce the delivery time compared to mixed-beam radiotherapy containing electron beams with static gantry angle (Static-MBRT). This study aims to develop and investigate a treatment planning process (TPP) for photon multileaf collimator (pMLC) based Arc-MBRT.Approach. An existing TPP for Static-MBRT plans is extended to integrate electron arcs with a dynamic gantry rotation and intensity modulation using a sliding window technique. The TPP consists of a manual setup of electron arcs, and either static photon beams or photon arcs, shortening of the source-to-surface distance for the electron arcs, initial intensity modulation optimization, selection of a user-defined number of electron beam energies based on dose contribution to the target volume and finally, simultaneous photon and electron intensity modulation optimization followed by full Monte Carlo dose calculation. Arc-MBRT plans, Static-MBRT plans, and photon-only plans were created and compared for four breast cases. Dosimetric validation of two Arc-MBRT plans was performed using film measurements.Main results. The generated Arc-MBRT plans are dosimetrically similar to the Static-MBRT plans while outperforming the photon-only plans. The mean heart dose is reduced by 32% on average in the MBRT plans compared to the photon-only plans. The estimated delivery times of the Arc-MBRT plans are similar to the photon-only plans but less than half the time of the Static-MBRT plans. Measured and calculated dose distributions agree with a gamma passing rate of over 98% (3% global, 2 mm) for both delivered Arc-MBRT plans.Significance. A TPP for Arc-MBRT is successfully developed and Arc-MBRT plans showed the potential to improve the dosimetric plan quality similar as Static-MBRT while maintaining short delivery times of photon-only treatments. This further facilitates integration of pMLC-based MBRT into clinical practice.
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Affiliation(s)
- Gian Guyer
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Silvan Mueller
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Paul-Henry Mackeprang
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Daniel Frei
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Werner Volken
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Daniel M Aebersold
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Kristina Loessl
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Peter Manser
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Michael K Fix
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
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Fix MK, Frei D, Mueller S, Guyer G, Loebner HA, Volken W, Manser P. Auto-commissioning of a Monte Carlo electron beam model with application to photon MLC shaped electron fields. Phys Med Biol 2023; 68. [PMID: 36716491 DOI: 10.1088/1361-6560/acb755] [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: 09/30/2022] [Accepted: 01/30/2023] [Indexed: 02/01/2023]
Abstract
Objective.Presently electron beam treatments are delivered using dedicated applicators. An alternative is the usage of the already installed photon multileaf collimator (pMLC) enabling efficient electron treatments. Currently, the commissioning of beam models is a manual and time-consuming process. In this work an auto-commissioning procedure for the Monte Carlo (MC) beam model part representing the beam above the pMLC is developed for TrueBeam systems with electron energies from 6 to 22 MeV.Approach.The analytical part of the electron beam model includes a main source representing the primary beam and a jaw source representing the head scatter contribution each consisting of an electron and a photon component, while MC radiation transport is performed for the pMLC. The auto-commissioning of this analytical part relies on information pre-determined from MC simulations, in-air dose profiles and absolute dose measurements in water for different field sizes and source to surface distances (SSDs). For validation calculated and measured dose distributions in water were compared for different field sizes, SSDs and beam energies for eight TrueBeam systems. Furthermore, a sternum case in an anthropomorphic phantom was considered and calculated and measured dose distributions were compared at different SSDs.Main results.Instead of the manual commissioning taking up to several days of calculation time and several hours of user time, the auto-commissioning is carried out in a few minutes. Measured and calculated dose distributions agree generally within 3% of maximum dose or 2 mm. The gamma passing rates for the sternum case ranged from 96% to 99% (3% (global)/2 mm criteria, 10% threshold).Significance.The auto-commissioning procedure was successfully implemented and applied to eight TrueBeam systems. The newly developed user-friendly auto-commissioning procedure allows an efficient commissioning of an MC electron beam model and eases the usage of advanced electron radiotherapy utilizing the pMLC for beam shaping.
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Affiliation(s)
- M K Fix
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - D Frei
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - S Mueller
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - G Guyer
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - H A Loebner
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - W Volken
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - P Manser
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
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Ronga MG, Cavallone M, Patriarca A, Leite AM, Loap P, Favaudon V, Créhange G, De Marzi L. Back to the Future: Very High-Energy Electrons (VHEEs) and Their Potential Application in Radiation Therapy. Cancers (Basel) 2021; 13:4942. [PMID: 34638424 PMCID: PMC8507836 DOI: 10.3390/cancers13194942] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/14/2022] Open
Abstract
The development of innovative approaches that would reduce the sensitivity of healthy tissues to irradiation while maintaining the efficacy of the treatment on the tumor is of crucial importance for the progress of the efficacy of radiotherapy. Recent methodological developments and innovations, such as scanned beams, ultra-high dose rates, and very high-energy electrons, which may be simultaneously available on new accelerators, would allow for possible radiobiological advantages of very short pulses of ultra-high dose rate (FLASH) therapy for radiation therapy to be considered. In particular, very high-energy electron (VHEE) radiotherapy, in the energy range of 100 to 250 MeV, first proposed in the 2000s, would be particularly interesting both from a ballistic and biological point of view for the establishment of this new type of irradiation technique. In this review, we examine and summarize the current knowledge on VHEE radiotherapy and provide a synthesis of the studies that have been published on various experimental and simulation works. We will also consider the potential for VHEE therapy to be translated into clinical contexts.
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Affiliation(s)
- Maria Grazia Ronga
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
- Thales AVS Microwave & Imaging Sub-Systems, 78141 Vélizy-Villacoublay, France
| | - Marco Cavallone
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
| | - Annalisa Patriarca
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
| | - Amelia Maia Leite
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
- INSERM LITO U1288, Campus Universitaire, Institut Curie, PSL Research University, University Paris Saclay, 91898 Orsay, France
| | - Pierre Loap
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
| | - Vincent Favaudon
- INSERM U 1021-CNRS UMR 3347, Campus Universitaire, Institut Curie, PSL Research University, University Paris Saclay, 91898 Orsay, France;
| | - Gilles Créhange
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
| | - Ludovic De Marzi
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
- INSERM LITO U1288, Campus Universitaire, Institut Curie, PSL Research University, University Paris Saclay, 91898 Orsay, France
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Ryu D, Kim JI, Lee S, Ye SJ, Park JM. Remote afterloading patient-specific brachytherapy with liquid radioisotope for irradiation of extensive scalp lesions: A Monte Carlo study. Med Phys 2019; 46:3227-3234. [PMID: 31049969 DOI: 10.1002/mp.13561] [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: 11/25/2018] [Revised: 03/15/2019] [Accepted: 04/25/2019] [Indexed: 11/11/2022] Open
Abstract
PURPOSE The aim of this study is to propose a remote afterloading patient-specific brachytherapy technique for total scalp irradiation by utilizing liquid radioisotope as well as a three-dimensional (3D) printer and to find an optimal radioisotope for the suggested technique. METHODS We designed a brachytherapy device composed of liquid radioisotope tank, tube, patient-specific applicator, and a thin flexible pouch. The liquid radioisotope tank, tube, and the flexible pouch are interconnected one another to constitute a closed loop system. The pouch is located inside the solid patient-specific applicator; therefore, when the liquid radioisotope is injected into the pouch, the pouch is inflated and fills the space inside the applicator. The 3D-printed patient-specific applicator keeps the uniform thickness of the liquid radioisotope conforming patient's contour. To investigate an optimum condition for the suggested system, we performed Monte Carlo simulation with the GEANT4 simulation toolkit. To find the optimal radioisotope, percent depth doses (PDDs) of P-32, Sr-89, Y-90, and I-125 solutions were acquired in a rectangular parallelepiped phantom. For the selected radiation source, PDDs as well as dose rates in spherical phantoms with radii of 7.7 cm (infant head size) and 9.1 cm (adult head size) were acquired. RESULTS To deliver prescription doses at 4-mm depth regions (scalp region), 1-mm-thick Y-90 and 5-mm-thick I-125 in liquid form were found to be feasible for the suggested technique. For both spherical phantoms with radii of 7.7 and 9.1 cm, when delivering 2 Gy at the 4-mm depth region with the 1-mm-thick Y-90 and 5-mm-thick I-125 sources, 53.3 and 3.8 Gy were delivered at the surface regions, respectively (delivery time = 111.1 and 3.5 min with 1 GBq/ml solutions). The PDDs of Y-90 and I-125 became less than 1% at depths greater than 8 and 50 mm, respectively. CONCLUSIONS The remote afterloading patient-patient specific brachytherapy with I-125 or Y-90 in liquid form seems feasible for total scalp irradiation.
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Affiliation(s)
- Dongmin Ryu
- Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Seoul National University Graduate School of Convergence Science and Technology, Seoul, 16229, Republic of Korea
| | - Jung-In Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, 03080, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, 03080, Republic of Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, 03080, Republic of Korea
| | - Sangmin Lee
- Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Seoul National University Graduate School of Convergence Science and Technology, Seoul, 16229, Republic of Korea
| | - Sung-Joon Ye
- Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Seoul National University Graduate School of Convergence Science and Technology, Seoul, 16229, Republic of Korea
| | - Jong Min Park
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, 03080, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, 03080, Republic of Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, 03080, Republic of Korea.,Robotics Research Laboratory for Extreme Environments, Advanced Institutes of Convergence Technology, Suwon, 16229, Republic of Korea
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Mueller S, Fix MK, Joosten A, Henzen D, Frei D, Volken W, Kueng R, Aebersold DM, Stampanoni MFM, Manser P. Simultaneous optimization of photons and electrons for mixed beam radiotherapy. ACTA ACUST UNITED AC 2017; 62:5840-5860. [DOI: 10.1088/1361-6560/aa70c5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Eldib A, Jin L, Martin J, Fan J, Li J, Chibani O, Veltchev I, Price R, Galloway T, Ma CMC. Investigating the dosimetric benefits of modulated electron radiation therapy (MERT) for partial scalp patients. Biomed Phys Eng Express 2017. [DOI: 10.1088/2057-1976/aa70ab] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Lloyd SAM, Gagne IM, Bazalova-Carter M, Zavgorodni S. Validation of Varian TrueBeam electron phase-spaces for Monte Carlo simulation of MLC-shaped fields. Med Phys 2016; 43:2894-2903. [PMID: 27277038 DOI: 10.1118/1.4949000] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE This work evaluates Varian's electron phase-space sources for Monte Carlo simulation of the TrueBeam for modulated electron radiation therapy (MERT) and combined, modulated photon and electron radiation therapy (MPERT) where fields are shaped by the photon multileaf collimator (MLC) and delivered at 70 cm SSD. METHODS Monte Carlo simulations performed with EGSnrc-based BEAMnrc/DOSXYZnrc and penelope-based PRIMO are compared against diode measurements for 5 × 5, 10 × 10, and 20 × 20 cm(2) MLC-shaped fields delivered with 6, 12, and 20 MeV electrons at 70 cm SSD (jaws set to 40 × 40 cm(2)). Depth dose curves and profiles are examined. In addition, EGSnrc-based simulations of relative output as a function of MLC-field size and jaw-position are compared against ion chamber measurements for MLC-shaped fields between 3 × 3 and 25 × 25 cm(2) and jaw positions that range from the MLC-field size to 40 × 40 cm(2). RESULTS Percent depth dose curves generated by BEAMnrc/DOSXYZnrc and PRIMO agree with measurement within 2%, 2 mm except for PRIMO's 12 MeV, 20 × 20 cm(2) field where 90% of dose points agree within 2%, 2 mm. Without the distance to agreement, differences between measurement and simulation are as large as 7.3%. Characterization of simulated dose parameters such as FWHM, penumbra width and depths of 90%, 80%, 50%, and 20% dose agree within 2 mm of measurement for all fields except for the FWHM of the 6 MeV, 20 × 20 cm(2) field which falls within 2 mm distance to agreement. Differences between simulation and measurement exist in the profile shoulders and penumbra tails, in particular for 10 × 10 and 20 × 20 cm(2) fields of 20 MeV electrons, where both sets of simulated data fall short of measurement by as much as 3.5%. BEAMnrc/DOSXYZnrc simulated outputs agree with measurement within 2.3% except for 6 MeV MLC-shaped fields. Discrepancies here are as great as 5.5%. CONCLUSIONS TrueBeam electron phase-spaces available from Varian have been implemented in two distinct Monte Carlo simulation packages to produce dose distributions and outputs that largely reflect measurement. Differences exist in the profile shoulders and penumbra tails for the 20 MeV phase-space off-axis and in the outputs for the 6 MeV phase-space.
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Affiliation(s)
- Samantha A M Lloyd
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8P 3P6 5C2, Canada
| | - Isabelle M Gagne
- Department of Medical Physics, BC Cancer Agency-Vancouver Island Centre, Victoria, British Columbia V8R 6V5, Canada and Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8W 3P6 5C2, Canada
| | - Magdalena Bazalova-Carter
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8W 3P6 5C2, Canada
| | - Sergei Zavgorodni
- Department of Medical Physics, BC Cancer Agency-Vancouver Island Centre, Victoria, British Columbia V8R 6V5, Canada and Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8W 3P6 5C2, Canada
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