Hui Khee Looe

Clinical performance of a transmission detector array for the permanent supervision of IMRT deliveries.

BACKGROUND AND PURPOSE Clinical evaluation of a novel dosimetric accessory serving the permanent supervision of MLC function. MATERIALS AND METHODS The DAVID system (PTW-Freiburg, Germany) is a transparent, multi-wire transmission ionization chamber, placed in the accessory holder of the treatment head. Since each of the 37 individual wires is positioned exactly below the associated leaf pair of the MLC, its signal records the opening of this leaf pair during patient treatment. RESULTS The DAVID system closes a gap in the quality assurance program, permitting the permanent in-vivo verification of IMRT plans. During dosimetric plan verification with the 2D-ARRAY (PTW-Freiburg, Germany), reference values of the 37 DAVID signals are collected, with which the DAVID readings recorded during daily patient treatment are compared. This comparison is visually displayed in the control room, and warning and alarm levels of any discrepancies can be defined. The properties of the DAVID system as a transmission device, its sensitivity to beam delivery and leaflet errors as well as its stability have been analyzed for clinically relevant examples. In a recent version, the DAVID system has been equipped with 80 wires. CONCLUSIONS The DAVID system permits the on-line detection of clinically relevant MLC discrepancies in IMRT deliveries.

The dose response functions of ionization chambers in photon dosimetry – Gaussian or non-Gaussian?

This study is concerned with the spatial resolution of air-filled ionization chambers in photon-beam dosimetry, i.e. with their dose response functions. These act as convolution kernels K(x,y), transforming true dose profiles D(x,y) into the measured signal profiles M(x,y). One-dimensional dose response functions have been experimentally determined for nine types of cylindrical ionization chambers both in their lateral and longitudinal directions, as well as across two plane-parallel chambers and for the single chambers of two 2D arrays. All these 1D dose response functions are closely described by Gaussian functions. The associated energy-dependent values of the standard deviations σ have been measured for 6 and 15 MV photons with an uncertainty of 0.02mm. At depths beyond secondary electron fluence build-up, there was no detectable depth dependence of the σ values. The general occurrence of Gaussian dose response functions, their extension beyond the geometrical boundaries of the chambers, and the energy dependence of their standard deviations can be understood by considering the underlying system of convolutions, which is the origin of the influences of secondary electron transport. Monte-Carlo simulations of the convolution kernels for a cylindrical, a square, and a flat ionization chamber and their Fourier analysis have been employed to show that the Gaussian convolution kernels are approximations to the true dose response functions, valid in the clinically relevant domain of the spatial frequency. This paper is conceived as the starting point for the deconvolution methods to be described in a further publication.

Performance parameters of a liquid filled ionization chamber array

PURPOSE In this work, the properties of the two-dimensional liquid filled ionization chamber array Octavius 1000SRS (PTW-Freiburg, Germany) for use in clinical photon-beam dosimetry are investigated. METHODS Measurements were carried out at an Elekta Synergy and Siemens Primus accelerator. For measurements of stability, linearity, and saturation effects of the 1000SRS array a Semiflex 31013 ionization chamber (PTW-Freiburg, Germany) was used as a reference. The effective point of measurement was determined by TPR measurements of the array in comparison with a Roos chamber (type 31004, PTW-Freiburg, Germany). The response of the array with varying field size and depth of measurement was evaluated using a Semiflex 31010 ionization chamber as a reference. Output factor measurements were carried out with a Semiflex 31010 ionization chamber, a diode (type 60012, PTW-Freiburg, Germany), and the detector array under investigation. The dose response function for a single detector of the array was determined by measuring 1 cm wide slit-beam dose profiles and comparing them against diode-measured profiles. Theoretical aspects of the low pass properties and of the sampling frequency of the detector array were evaluated. Dose profiles measured with the array and the diode detector were compared, and an intensity modulated radiation therapy (IMRT) field was verified using the Gamma-Index method and the visualization of line dose profiles. RESULTS The array showed a short and long term stability better than 0.1% and 0.2%, respectively. Fluctuations in linearity were found to be within ±0.2% for the vendor specified dose range. Saturation effects were found to be similar to those reported in other studies for liquid-filled ionization chambers. The detectors relative response varied with field size and depth of measurement, showing a small energy dependence accounting for maximum signal deviations of ±2.6% from the reference condition for the setup used. The σ-values of the Gaussian dose response function for a single detector of the array were found to be (0.72±0.25) mm at 6 MV and (0.74±0.25) mm at 15 MV and the corresponding low pass cutoff frequencies are 0.22 and 0.21 mm(-1), respectively. For the inner 5×5 cm2 region and the outer 11×11 cm2 region of the array the Nyquist theorem is fulfilled for maximum sampling frequencies of 0.2 and 0.1 mm(-1), respectively. An IMRT field verification with a Gamma-Index analysis yielded a passing rate of 95.2% for a 3 mm∕3% criterion with a TPS calculation as reference. CONCLUSIONS This study shows the applicability of the Octavius 1000SRS in modern dosimetry. Output factor and dose profile measurements illustrated the applicability of the array in small field and stereotactic dosimetry. The high spatial resolution ensures adequate measurements of dose profiles in regular and intensity modulated photon-beam fields.

Conversion coefficients for the estimation of effective doses in intraoral and panoramic dental radiology from dose-area product values

Conversion coefficients for the estimation of effective doses in intraoral and panoramic dental radiology from dose-area product (DAP) values were determined by measuring organ-absorbed doses and the corresponding DAP values. Measurements were performed for all standard intraoral radiological projections and standard panoramic examination at different exposure parameters. Organ-absorbed doses were measured using thermoluminescent detectors and an adult anthropomorphic phantom specially designed for dosimetric study in dental radiology. Different techniques for the calculation of effective doses were evaluated. Conversion coefficients derived from this study range from 0.008 to 0.132 microSv mGy(-1) cm(-2) for intraoral radiography and 0.055 to 0.238 microSv mGy(-1) cm(-2) for panoramic radiography.

2007 Recommendations of the ICRP Change Basis for Estimation of the Effective Dose: What is the Impact on Radiation Dose Assessment of Patient and Personnel?

PURPOSE In radiation protection regulations the algorithm for effective dose calculation is based on Publication 60 (1990) of the International Commission on Radiological Protection (ICRP). The modifications to the tissue weighting factors in Publication 103 (2007) of the ICRP will affect the present methodology of calculating the effective dose and will also have an impact on its assessment. This paper evaluates circumstances under which the application of the new model yields relevant dose differences compared to the prevailing model. MATERIALS AND METHODS Effective doses were calculated and compared from the measured organ doses according to ICRP 60 and ICRP 103, respectively. The measurements of patient doses were carried out with an anthropomorphic phantom for thoracic and coronary CT examinations. Exposure of radiological personnel was measured based on the geometry of angiographic examinations using two anthropomorphic phantoms. RESULTS The change of the weighting factor for the breast from 0.05 to 0.12 leads to a noticeable increase in the effective dose for thoracic (21 %) and coronary (31 %) CT examinations. Calculating sex-specific effective doses based on ICRP 60, the dose for coronary CT examination for women is 1.7 times higher than for men. Based on ICRP 103, the difference between female and male doses increases to a factor of 3.3. Due to the consideration of organs in the head and neck region as introduced in ICRP 103, for angiography the personnel is exposed to 24 - 50 % and 38 - 142 % higher doses with and without thyroid protection, respectively. Thereby, the official personal dosimetry will underestimate the effective dose according to ICRP 103 by a factor of 1.6 - 2.4 with thyroid protection and 1.1 - 1.4 without thyroid protection. CONCLUSION The revision of the parameters for effective dose calculation leads to higher doses and greater sex-specific differences for radiological examinations involving exposure of the breast. This effect should be considered when justifying any radiological examination. For the personnel, the new model results in higher effective doses due to increased emphasis on the organs in the head and neck region. Hence to optimize radiation protection of personnel, the use of radiation-protective shielding for this region becomes more important.

Enhanced accuracy of the permanent surveillance of IMRT deliveries by iterative deconvolution of DAVID chamber signal profiles

In vivo dosimetry systems, capable of permanently monitoring IMRT treatment deliveries throughout all fractions, are increasingly used in clinical practice. The first of these solutions is the DAVID system, a translucent multiwire ionization chamber placed in the accessory holder of the treatment head below the MLC. Each wire is exactly adjusted along the midline of its associated leaf pair, thereby generating a signal correlated with the aperture of this leaf pair. However, there is some blurring of the profile of the wire signals across the beam due to the lateral transport of scattered secondary electrons in the air gap of the DAVID chamber. This paper deals with a numerical correction by which this effect is eliminated. The true photon fluence profile is calculated from the measured signal profile by an iterative deconvolution algorithm, based upon the convolution kernel formed by the lateral wire signal profile when only one leaf pair is opened. Lateral fluence profiles are thereby obtained with increased resolution, and errors in MLC positioning are revealed with enhanced sensitivity. The needed computational time of less than 1 s has made it feasible to implement the deconvolution algorithm into the daily routine for the accurate surveillance of IMRT deliveries.

Experimental determination of the lateral dose response functions of detectors to be applied in the measurement of narrow photon-beam dose profiles.

This study aims at the experimental determination of the detector-specific 1D lateral dose response function K(x) and of its associated rotational symmetric counterpart K(r) for a set of high-resolution detectors presently used in narrow-beam photon dosimetry. A combination of slit-beam, radiochromic film, and deconvolution techniques served to accomplish this task for four detectors with diameters of their sensitive volumes ranging from 1 to 2.2 mm. The particular aim of the experiment was to examine the existence of significant negative portions of some of these response functions predicted by a recent Monte-Carlo-simulation (Looe et al 2015 Phys. Med. Biol. 60 6585-607). In a 6 MV photon slit beam formed by the Siemens Artiste collimation system and a 0.5 mm wide slit between 10 cm thick lead blocks serving as the tertiary collimator, the true cross-beam dose profile D(x) at 3 cm depth in a large water phantom was measured with radiochromic film EBT3, and the detector-affected cross-beam signal profiles M(x) were recorded with a silicon diode, a synthetic diamond detector, a miniaturized scintillation detector, and a small ionization chamber. For each detector, the deconvolution of the convolution integral M(x)  =  K(x)  ∗  D(x) served to obtain its specific 1D lateral dose response function K(x), and K(r) was calculated from it. Fourier transformations and back transformations were performed using function approximations by weighted sums of Gaussian functions and their analytical transformation. The 1D lateral dose response functions K(x) of the four types of detectors and their associated rotational symmetric counterparts K(r) were obtained. Significant negative curve portions of K(x) and K(r) were observed in the case of the silicon diode and the diamond detector, confirming the Monte-Carlo-based prediction (Looe et al 2015 Phys. Med. Biol. 60 6585-607). They are typical for the perturbation of the secondary electron field by a detector with enhanced electron density compared with the surrounding water. In the cases of the scintillation detector and the small ionization chamber, the negative curve portions of K(x) practically vanish. It is planned to use the measured functions K(x) and K(r) to deconvolve clinical narrow-beam signal profiles and to correct the output factor values obtained with various high-resolution detectors.

Dosimetric characteristics of the novel 2D ionization chamber array OCTAVIUS Detector 1500.

PURPOSE The dosimetric properties of the OCTAVIUS Detector 1500 (OD1500) ionization chamber array (PTW-Freiburg, Freiburg, Germany) have been investigated. A comparative study was carried out with the OCTAVIUS Detector 729 and OCTAVIUS Detector 1000 SRS arrays. METHODS The OD1500 array is an air vented ionization chamber array with 1405 detectors in a 27 × 27 cm(2) measurement area arranged in a checkerboard pattern with a chamber-to-chamber distance of 10 mm in each row. A sampling step width of 5 mm can be achieved by merging two measurements shifted by 5 mm, thus fulfilling the Nyquist theorem for intensity modulated dose distributions. The stability, linearity, and dose per pulse dependence were investigated using a Semiflex 31013 chamber (PTW-Freiburg, Freiburg, Germany) as a reference detector. The effective depth of measurement was determined by measuring TPR curves with the array and a Roos chamber type 31004 (PTW-Freiburg, Freiburg, Germany). Comparative output factor measurements were performed with the array, the Semiflex 31010 ionization chamber and the Diode 60012 (both PTW-Freiburg, Freiburg, Germany). The energy dependence of the OD1500 was measured by comparing the arrays readings to those of a Semiflex 31010 ionization chamber for varying mean photon energies at the depth of measurement, applying to the Semiflex chamber readings the correction factor kNR for nonreference conditions. The Gaussian lateral dose response function of a single array detector was determined by searching the convolution kernel suitable to convert the slit beam profiles measured with a Diode 60012 into those measured with the arrays central chamber. An intensity modulated dose distribution measured with the array was verified by comparing a OD1500 measurement to TPS calculations and film measurements. RESULTS The stability and interchamber sensitivity variation of the OD1500 array were within ±0.2% and ±0.58%, respectively. Dose linearity was within 1% over the range from 5 to 1000 MU. The effective point of measurement of the OD1500 for dose measurements in RW3 phantoms was determined to be (8.7 ± 0.2) mm below its front surface. Output factors showed deviations below 1% for field sizes exceeding 4 × 4 cm(2). The dose per pulse dependence was smaller than 0.4% for doses per pulse from 0.2 to 1 mGy. The energy dependence of the array did not exceed ±0.9%. The parameter σ of the Gaussian lateral dose response function was determined as σ6MV = (2.07 ± 0.02) mm for 6 MV and σ15MV = (2.09 ± 0.02) mm for 15 MV. An IMRT verification showed passing rates well above 90% for a local 3 mm/3% criterion. CONCLUSIONS The OD1500 arrays dosimetric properties showed the applicability of the array for clinical dosimetry with the possibility to increase the spatial sampling frequency and the coverage of a dose distribution with the sensitive areas of ionization chambers by merging two measurements.

Iterative 2D deconvolution of portal imaging radiographs

Portal imaging has become an integral part of modern radiotherapy techniques such as IMRT and IGRT. It serves to verify the accuracy of day-to-day patient positioning, a prerequisite for treatment success. However, image blurring attributable to different physical and geometrical effects, analysed in this work, impairs the image quality of the portal images, and anatomical structures cannot always be clearly outlined. A 2D iterative deconvolution method was developed to reduce this image blurring. The affiliated data basis was generated by the separate measurement of the components contributing to image blurring. Secondary electron transport and pixel size within the EPID, as well as geometrical penumbra due to the finite photon source size were found to be the major contributors, whereas photon scattering in the patient is less important. The underlying line-spread kernels of these components were shown to be Lorentz functions. This implies that each of these convolution kernels and also their combination can be characterized by a single characteristic, the width parameter λ of the Lorentz function. The overall resulting λ values were 0.5mm for 6 MV and 0.65 mm for 15 MV. Portal images were deconvolved using the point-spread function derived from the Lorentz function together with the experimentally determined λ values. The improvement of the portal images was quantified in terms of the modulation transfer function of a bar pattern. The resulting clinical images show a clear enhancement of sharpness and contrast.

Magnetic field influences on the lateral dose response functions of photon-beam detectors: MC study of wall-less water-filled detectors with various densities

The distortion of detector reading profiles across photon beams in the presence of magnetic fields is a developing subject of clinical photon-beam dosimetry. The underlying modification by the Lorentz force of a detectors lateral dose response function-the convolution kernel transforming the true cross-beam dose profile in water into the detector reading profile-is here studied for the first time. The three basic convolution kernels, the photon fluence response function, the dose deposition kernel, and the lateral dose response function, of wall-less cylindrical detectors filled with water of low, normal and enhanced density are shown by Monte Carlo simulation to be distorted in the prevailing direction of the Lorentz force. The asymmetric shape changes of these convolution kernels in a water medium and in magnetic fields of up to 1.5 T are confined to the lower millimetre range, and they depend on the photon beam quality, the magnetic flux density and the detectors density. The impact of this distortion on detector reading profiles is demonstrated using a narrow photon beam profile. For clinical applications it appears as favourable that the magnetic flux density dependent distortion of the lateral dose response function, as far as secondary electron transport is concerned, vanishes in the case of water-equivalent detectors of normal water density. By means of secondary electron history backtracing, the spatial distribution of the photon interactions giving rise either directly to secondary electrons or to scattered photons further downstream producing secondary electrons which contribute to the detectors signal, and their lateral shift due to the Lorentz force is elucidated. Electron history backtracing also serves to illustrate the correct treatment of the influences of the Lorentz force in the EGSnrc Monte Carlo code applied in this study.