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Commissioning and verification of the collapsed cone convolution superposition algorithm for SBRT delivery using flattening filter-free beams.

ABSTRACT: Linacs equipped with flattening filter-free (FFF) megavoltage photon beams are now commercially available. However, the commissioning of FFF beams poses challenges that are not shared with traditional flattened megavoltage X-ray beams. The planning system must model a beam that is peaked in the center and has an energy spectrum that is softer than the flattened beam. Removing the flattening filter also increases the maximum possible dose rates from 600 MU/min up to 2400 MU/min in some cases; this increase in dose rate affects the recombination correction factor, P(ion), used during absolute dose calibration with ionization chambers. We present the first reported experience of commissioning, verification, and clinical use of the collapsed cone convolution superposition (CCCS) dose calculation algorithm for commercially available flattening filter-free beams. Our commissioning data are compared to previously reported measurements and Monte Carlo studies of FFF beams. Commissioning was verified by making point-dose measurement of test plans, irradiating the RPC lung phantom, and performing patient-specific QA. The average point-dose difference between calculations and measurements of all test plans and all patient specific QA measurements is 0.80%, and the RPC phantom absolute dose differences for the two thermoluminescent dosimeters (TLDs) in the phantom planning target volume (PTV) were 1% and 2%, respectively. One hundred percent (100%) of points in the RPC phantom films passed the RPC gamma criteria of 5% and 5 mm. Our results show that the CCCS algorithm can accurately model FFF beams and calculate SBRT dose distributions using those beams.

SUBMITTER: Foster RD

PROVIDER: S-EPMC5875462 | biostudies-literature | 2014 Mar

REPOSITORIES: biostudies-literature

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Commissioning and verification of the collapsed cone convolution superposition algorithm for SBRT delivery using flattening filter-free beams.

Foster Ryan D RD Speiser Michael P MP Solberg Timothy D TD

Journal of applied clinical medical physics 20140306 2

Linacs equipped with flattening filter-free (FFF) megavoltage photon beams are now commercially available. However, the commissioning of FFF beams poses challenges that are not shared with traditional flattened megavoltage X-ray beams. The planning system must model a beam that is peaked in the center and has an energy spectrum that is softer than the flattened beam. Removing the flattening filter also increases the maximum possible dose rates from 600 MU/min up to 2400 MU/min in some cases; thi ...[more]

PMID: 24710452

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Project description:We evaluate a photon convolution-superposition algorithm used to model a fast neutron therapy beam in a commercial treatment planning system (TPS). The neutron beam modeled was the Clinical Neutron Therapy System (CNTS) fast neutron beam produced by 50 MeV protons on a Be target at our facility, and we implemented the Pinnacle3 dose calculation model for computing neutron doses. Measured neutron data were acquired by an IC30 ion chamber flowing 5 cc/min of tissue equivalent gas. Output factors and profile scans for open and wedged fields were measured according to the Pinnacle physics reference guide recommendations for photon beams in a Wellhofer water tank scanning system. Following the construction of a neutron beam model, computed doses were then generated using 100 monitor units (MUs) beams incident on a water-equivalent phantom for open and wedged square fields, as well as multileaf collimator (MLC)-shaped irregular fields. We compared Pinnacle dose profiles, central axis doses, and off-axis doses (in irregular fields) with 1) doses computed using the Prism treatment planning system, and 2) doses measured in a water phantom and having matching geometry to the computation setup. We found that the Pinnacle photon model may be used to model most of the important dosimetric features of the CNTS fast neutron beam. Pinnacle-calculated dose points among open and wedged square fields exhibit dose differences within 3.9 cGy of both Prism and measured doses along the central axis, and within 5 cGy difference of measurement in the penumbra region. Pinnacle dose point calculations using irregular treatment type fields showed a dose difference up to 9 cGy from measured dose points, although most points of comparison were below 5 cGy. Comparisons of dose points that were chosen from cases planned in both Pinnacle and Prism show an average dose difference less than 0.6%, except in certain fields which incorporate both wedges and heavy blocking of the central axis. All clinical cases planned in both Prism and Pinnacle were found to be comparable in terms of dose-volume histograms and spatial dose distribution following review by the treating clinicians. Variations were considered minor and within clinically acceptable limits by the treating clinicians. The Pinnacle TPS has sufficient computational modeling ability to adequately produce a viable neutron model for clinical use in treatment planning.

Project description:Although there are many works on evaluating dose calculations of the anisotropic analytical algorithm (AAA) using various homogeneous and heterogeneous phantoms, related work concerning dosimetry due to tangential photon beam is lacking. In this study, dosimetry predicted by the AAA and collapsed cone convolution (CCC) algorithm was evaluated using the tangential photon beam and phantom geometry. The photon beams of 6 and 15 MV with field sizes of 4 × 4 (or 7 × 7), 10 × 10 and 20 × 20 cm², produced by a Varian 21 EX linear accelerator, were used to test performances of the AAA and CCC using Monte Carlo (MC) simulation (EGSnrc-based code) as a benchmark. Horizontal dose profiles at different depths, phantom skin profiles (i.e., vertical dose profiles at a distance of 2 mm from the phantom lateral surface), gamma dose distributions, and dose-volume histograms (DVHs) of skin slab were determined. For dose profiles at different depths, the CCC agreed better with doses in the air-phantom region, while both the AAA and CCC agreed well with doses in the penumbra region, when compared to the MC. Gamma evaluations between the AAA/CCC and MC showed that deviations of 2D dose distribution occurred in both beam edges in the phantom and air-phantom interface. Moreover, the gamma dose deviation is less significant in the air-phantom interface than the penumbra. DVHs of skin slab showed that both the AAA and CCC underestimated the width of the dose drop-off region for both the 6 and 15 MV photon beams. When the gantry angle was 0°, it was found that both the AAA and CCC overestimated doses in the phantom skin profiles compared to the MC, with various photon beam energies and field sizes. The mean dose differences with doses normalized to the prescription point for the AAA and CCC were respectively: 7.6% ± 2.6% and 2.1% ± 1.3% for a 10 × 10 cm2 field, 6 MV; 16.3%± 2.1% and 6.7% ± 2.1% for a 20 × 20 cm2 field, 6 MV; 5.5% ± 1.2% and 1.7% ± 1.4% for a 10 × 10 cm2, 15 MV; 18.0% ± 1.3% and 8.3% ± 1.8% for a 20 × 20 cm², 15 MV. However, underestimations of doses in the phantom skin profile were found with small fields of 4 × 4 and 7 × 7 cm² for the 6 and 15 MV photon beams, respectively, when the gantry was turned 5° anticlockwise. As surface dose with tangential photon beam geometry is important in some radiation treatment sites such as breast, chest wall and sarcoma, it is found that neither of the treatment planning system algorithms can predict the dose well at depths shallower than 2 mm. The dosimetry data and beam and phantom geometry in this study provide a better knowledge of a dose calculation algorithm in tangential-like irradiation.

Dataset Information

Commissioning and verification of the collapsed cone convolution superposition algorithm for SBRT delivery using flattening filter-free beams.

Publications

Commissioning and verification of the collapsed cone convolution superposition algorithm for SBRT delivery using flattening filter-free beams.

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