Zeitschrift fur Medizinische Physik最新文献

Purpose: To investigate the accuracy of the treatment planning system (TPS) TRiP4D in reproducing doses computed by the clinically used TPS SyngoRT.

Methods: Proton and carbon ion beam models in TRiP4D were converted from SyngoRT. Cubic plans with different depths in a water-tank phantom (WP) and previously treated and experimentally verified patient plans from SyngoRT were recalculated in TRiP4D. The target mean dose deviation (ΔD_mean,T) and global gamma index (2%-2 mm for the absorbed dose and 3%-3mm for the RBE-weighted dose with 10% threshold) were evaluated.

Results: The carbon and proton absorbed dose gamma passing rates (γ-PRs) were ≥99.93% and ΔD_mean,T smaller than -0.22%. On average, the RBE-weighted dose D_mean,T was -1.26% lower for TRiP4D than SyngoRT for cubic plans. In TRiP4D, the faster analytical 'low dose approximation' (Krämer, 2006) was used, while SyngoRT used a stochastic implementation (Krämer, 2000). The average ΔD_{mean, T} could be reduced to -0.59% when applying the same biological effect calculation algorithm. However, the dose recalculation time increased by a factor of 79-477. ΔD_mean,T variation up to -2.27% and -2.79% was observed for carbon absorbed and RBE-weighted doses in patient plans. The γ-PRs were ≥93.92% and ≥91.83% for patient plans, except for one proton beam with a range shifter (γ-PR of 64.19%).

Conclusion: The absorbed dose between TRiP4D and SyngoRT were identical for both proton and carbon ion plans in the WP. Compared to SyngoRT, TRiP4D underestimated the target RBE-weighted dose; however more efficient in RBE-weighted dose calculation. Large variation for proton beam with range shifter was observed. TRiP4D will be used to evaluate doses delivered to moving targets. Uncertainties inherent to the 4D-dose reconstruction calculation are expected to be significantly larger than the dose errors reported here. For this reason, the residual differences between TRiP4D and SyngoRT observed in this study are considered acceptable. The study was approved by the Institutional Research Board of Shanghai Proton and Heavy Ion Center (approval number SPHIC-MP-2020-04, RS).

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.

Recently, 3D printing has been widely used to fabricate medical imaging phantoms. So far, various rigid 3D printable materials have been investigated for their radiological properties and efficiency in imaging phantom fabrication. However, flexible, soft tissue materials are also needed for imaging phantoms for simulating several clinical scenarios where anatomical deformations is important. Recently, various additive manufacturing technologies have been used to produce anatomical models based on extrusion techniques that allow the fabrication of soft tissue materials. To date, there is no systematic study in the literature investigating the radiological properties of silicone rubber materials/fluids for imaging phantoms fabricated directly by extrusion using 3D printing techniques. The aim of this study was to investigate the radiological properties of 3D printed phantoms made of silicone in CT imaging. To achieve this goal, the radiodensity as described as Hounsfield Units (HUs) of several samples composed of three different silicone printing materials were evaluated by changing the infill density to adjust their radiological properties. A comparison of HU values with a Gammex Tissue Characterization Phantom was performed. In addition, a reproducibility analysis was performed by creating several replicas for specific infill densities. A scaled down anatomical model derived from an abdominal CT was also fabricated and the resulting HU values were evaluated. For the three different silicone materials, a spectrum ranging from -639 to +780 HU was obtained on CT at a scan setting of 120 kVp. In addition, using different infill densities, the printed materials were able to achieve a similar radiodensity range as obtained in different tissue-equivalent inserts in the Gammex phantom (238 HU to -673 HU). The reproducibility results showed good agreement between the HU values of the replicas compared to the original samples, confirming the reproducibility of the printed materials. A good agreement was observed between the HU target values in abdominal CT and the HU values of the 3D-printed anatomical phantom in all tissues.

Performing phantom measurements for patient-specific quality assurance (PSQA) adds a significant amount of time to the adaptive radiotherapy procedure. Log file based PSQA can be used to increase the efficiency of this process. This study compared the dosimetric accuracy of high-frequency linear accelerator (Linac) log files and low-frequency log data stored in the oncology information system (OIS). Thirty patients were included, that were recently treated in the head and neck (HN), brain, and prostate region with volumetric modulated arc therapy (VMAT) and an additional ten patients treated using stereotactic body radiation therapy (SBRT) with 3D-conformal radiotherapy (3D-CRT) technique. Log data containing a single fraction were used to calculate the dose distributions. The dosimetric differences between Linac log files and OIS logs were evaluated with a gamma analysis with 2%/2 mm criterion and dose threshold of 30%. The original treatment plan was used as a reference. Moreover, DVH parameters of D_98%, D_50%, and D_2% of the planning-target volume (PTV) and dose to several organs at risk (OARs) were reported. Significant differences in dose distributions between the two log types and the original dose were observed for PTV D_98% and D_2% (r < 0.001) for HN cases, PTV D_98% (r = 0.005) for brain cases, and PTV D_50% (r = 0.015) for prostate cases. No significant differences were found between the two log types with respect to D_50%. The root mean square (RMS) error of the leaf positions of the OIS log was approximately twice the RMS error of the Linac log file for VMAT plans, but identical for 3D-CRT plans. The relationship between the gamma pass rate and the RMS error showed a moderate correlation for the Linac log files (r = -0.58, p < 0.001) and strong correlation for OIS logs (r = -0.71, p < 0.001). Furthermore, all doses calculated using Linac log files and OIS log data had a GPR >90% for an RMS error < 3.3 mm. Based on these findings, a tolerance limit of RMS error of 3.3 mm for considering OIS log based PSQA was established. Nevertheless, the OIS log data quality should be improved to achieve adequate PSQA.

Purpose: Radiochromic film (RCF) is a detector that can obtain a two-dimensional dose distribution with high resolution; it is widely used in medical and industrial fields. Several types of RCFs exist based on their application. The type of RCF mainly used for mammography dose assessment has been discontinued; however, a new type of RCF (LD-V1) has been distributed as a successor. Since the medical use of LD-V1 has rarely been studied, we investigated the response characteristics of LD-V1 in mammography.

Methods: Measurements were performed using Mo/Mo and Rh/Ag on a Senographe Pristina mammography device (GE, Fairfield, CT, USA). The reference air kerma was measured using a parallel-plate ionization chamber (PPIC) (C-MA, Applied Engineering Inc, Tokyo, Japan). Pieces of LD-V1 film model were irradiated at the same position where the reference air kerma in air was measured by the PPIC. Irradiation was performed using the time scale method based on the load on the equipment. Two methods of irradiation were considered: placing the detector in air and on the phantom. The LD-V1 was scanned five times at 72 dpi in RGB (48 bit) mode using a flatbed scanner (ES-G11000, Seiko Epson Corp, Nagano, Japan) 24 h following irradiation. The response ratio of the reference air kerma and the air kerma obtained from the LD-V1 were compared and examined for each beam quality and air kerma range.

Results and discussion: When the beam quality was altered, the response ratio varied from 0.8 to 1.2 with respect to the measurement value of the PPIC; however, some outliers were observed. Response ratios were highly variable in the low-dose range; however, as the air kerma increased, the ratios approached 1. Thus, LD-V1 does not need calibration for each beam quality used in mammography. LD-V1 enables air kerma evaluation by creating air kerma response curves under certain X-ray conditions used in mammography.

Conclusion: We suggest that the dose range be limited to 12 mGy or more to keep the response variation with beam qualities below ±20%. If further measurement is required for reducing the response variation, the dose range should be shifted to a higher dose range.

We present a multi-stage and multi-resolution deformable image registration framework for image-guidance at a small animal proton irradiation platform. The framework is based on list-mode proton radiographies acquired at different angles, which are used to deform a 3D treatment planning CT relying on normalized mutual information (NMI) or root mean square error (RMSE) in the projection domain. We utilized a mouse X-ray micro-CT expressed in relative stopping power (RSP), and obtained Monte Carlo simulations of proton images in list-mode for three different treatment sites (brain, head and neck, lung). Rigid transformations and controlled artificial deformation were applied to mimic position misalignments, weight loss and breathing changes. Results were evaluated based on the residual RMSE of RSP in the image domain including the comparison of extracted local features, i.e. between the reference micro-CT and the one transformed taking into account the calculated deformation. The residual RMSE of the RSP showed that the accuracy of the registration framework is promising for compensating rigid (>97% accuracy) and non-rigid (∼95% accuracy) transformations with respect to a conventional 3D-3D registration. Results showed that the registration accuracy is degraded when considering the realistic detector performance and NMI as a metric, whereas the RMSE in projection domain is rather insensitive. This work demonstrates the pre-clinical feasibility of the registration framework on different treatment sites and its use for small animal imaging with a realistic detector. Further computational optimization of the framework is required to enable the use of this tool for online estimation of the deformation.

Flexible form-fitting radiofrequency coils provide high signal-to-noise ratio (SNR) for magnetic resonance imaging (MRI), and in array configuration large anatomical areas of interest can be covered. We propose a modular system - "ModFlex"- of flexible lightweight 4-channel coaxial coil arrays for 3 T MRI. We investigated the performance difference between commercial reference coils and 8- and 16-channel ModFlex receive-only array systems. In vivo, six anatomical targets in four regions of interest - the neck, the ankle, the spine and the hip - were imaged with the novel coil array system. The versatility of ModFlex and the robustness of the coil characteristics for different use cases is demonstrated. We measured an SNR gain for 4 out of 6 and similar SNR for 2 out of 6 anatomical target regions as compared to commercial reference coils. Parallel imaging capabilities are comparable to standard coils in hip and neck imaging, but ModFlex outperforms standard coils in ankle and spine imaging. High SNR combined with high acceleration possibilities enables faster imaging workflows and/or high-resolution MR acquisitions. The coil's versatility is beneficial for use cases with varying subject sizes and could improve patient comfort.