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Previous work has shown that PRESAGE® can be used successfully to perform 3D dosimetric measurements of complex radiotherapy treatments. However, measurements near the sample edges are known to be difficult to achieve. This is an issue when the doses at air-material interfaces are of interest, for example when investigating the electron return effect (ERE) present in treatments delivered by magnetic resonance (MR)-linac systems. To study this effect, a set of 3.5 cm-diameter cylindrical PRESAGE® samples was uniformly irradiated with multiple dose fractions, using either a conventional linac or an MR-linac. The samples were imaged between fractions using an optical-CT, to read out the corresponding accumulated doses. A calibration between TPS-predicted dose and optical-CT pixel value was determined for individual dosimeters as a function of radial distance from the axis of rotation. This data was used to develop a correction that was applied to four additional samples of PRESAGE® of the same formulation, irradiated with 3D-CRT and IMRT treatment plans, to recover significantly improved 3D measurements of dose. An alternative strategy was also tested, in which the outer surface of the sample was physically removed prior to irradiation. Results show that for the formulation studied here, PRESAGE® samples have a central region that responds uniformly and an edge region of 6–7 mm where there is gradual increase in dosimeter response, rising to an over-response of 24%–36% at the outer boundary. This non-uniform dose response increases in both extent and magnitude over time. Both mitigation strategies investigated were successful. In our four exemplar studies, we show how discrepancies at edges are reduced from 13%–37% of the maximum dose to between 2 and 8%. Quantitative analysis shows that the 3D gamma passing rates rise from 90.4, 69.3, 63.7 and 43.6% to 97.3, 99.9, 96.7 and 98.9% respectively. [ABSTRACT FROM AUTHOR]

We present a novel technical concept of a two-dimensional binary multileaf collimator (2D-bMLC) especially designed for fast dose delivery in rotational IMRT. The 2D-bMLC consists of individually controlled absorber channels, which are arranged side by side forming a 2D collimator aperture. In each channel three separate tungsten modules are arranged behind each other. To open and close an element, the central module is shifted between two positions. The purpose of this work is the presentation of the 2D-bMLC concept and its dosimetric evaluation. To determine the dosimetric properties, we designed a Monte Carlo model of an exemplary 2D-bMLC, consisting of 30 × 30 elements. A virtual source model of a flattening filter-free 7MV linac was used to characterize the linac phase space. A primary radiation efficiency factor of 43% was calculated for the open 2D-bMLC by dividing the integral dose scored for a 2D-bMLC field by the integral dose scored for an open fieldwith the same dimensions. The leakage calculated for the closed collimator was below 0.5%. Following the primary photon fluence distribution, the bixel intensity decreases with the distance of the element to the central axis of the treatment machine. From the collimator field's center toward its borders, the geometric bixel widths increase in a symmetric and predictable manner by up to 4%. The increase is explained by the specific design of the 2D-bMLC. Abutting element beams exhibit a slight tongue-and-groove effect if opened sequentially. This effect as well as the primary radiation efficiency is basically affected by the source size and the dimensions of the collimator elements. We successfully established and evaluated a dosimetric model of the 2D-bMLC. The results are promising, and we will therefore investigate on real patient plans, if the concept could be advantageous for fast rotational IMRT treatments. [ABSTRACT FROM AUTHOR]

In this work, the image quality of a novel megavoltage cone-beam-computed tomography (CBCT) scanner is compared to three other image-guided radiation therapy devices by analysing images of different-sized quality assurance phantoms. The following devices are compared in terms of image uniformity, signal-to-noise ratio, contrast-to-noise ratio (CNR), electron density to HU conversion, presampling modulation transfer function (MTFpre) and combined spatial resolution and noise (Q-factor): (i) the Siemens Artiste kilovoltage (kV) (121 kV) CBCT device, (ii) the Artiste treatment beam line (TBL), 6 MV, (iii) the Tomotherapy (3.5 MV) fan-beam CT and (iv) Siemens' novel approach using a carbon target for a dedicated imaging beam line (IBL), 4.2 MV. Machine settings were selected to produce the same imaging dose for all devices. For a head phantom, IBL scans display CNR values 2.6±0.3 times higher than for the TBL at the same dose level (for a CT-number range of -200 to-60 HU). kV CBCT, on the other hand, displays CNR values 7.9±0.3 times higher than the IBL. There was no significant deviation in spatial resolution between IBL, TBL and Tomotherapy in terms of 50% and 10% MTFpre. For kV CBCT, the MTFpre was significantly higher than those for other devices. In our Q-factor analysis, the IBL (14.6) scores higher than the TBL (7.9) and Tomotherapy (9.7) due to its lower noise level. The linearity of electron density to HU conversion is demonstrated for different-sized phantoms. Employing the IBL instead of the TBL significantly reduces the imaging dose by up to a factor of 5 at a constant image quality level, providing an immediate benefit for the patient. [ABSTRACT FROM AUTHOR]

Previous work has shown that PRESAGE® can be used successfully to perform 3D dosimetric measurements of complex radiotherapy treatments. However, measurements near the sample edges are known to be difficult to achieve. This is an issue when the doses at air-material interfaces are of interest, for example when investigating the electron return effect (ERE) present in treatments delivered by magnetic resonance (MR)-linac systems. To study this effect, a set of 3.5 cm-diameter cylindrical PRESAGE® samples was uniformly irradiated with multiple dose fractions, using either a conventional linac or an MR-linac. The samples were imaged between fractions using an optical-CT, to read out the corresponding accumulated doses. A calibration between TPS-predicted dose and optical-CT pixel value was determined for individual dosimeters as a function of radial distance from the axis of rotation. This data was used to develop a correction that was applied to four additional samples of PRESAGE® of the same formulation, irradiated with 3D-CRT and IMRT treatment plans, to recover significantly improved 3D measurements of dose. An alternative strategy was also tested, in which the outer surface of the sample was physically removed prior to irradiation. Results show that for the formulation studied here, PRESAGE® samples have a central region that responds uniformly and an edge region of 6–7 mm where there is gradual increase in dosimeter response, rising to an over-response of 24%–36% at the outer boundary. This non-uniform dose response increases in both extent and magnitude over time. Both mitigation strategies investigated were successful. In our four exemplar studies, we show how discrepancies at edges are reduced from 13%–37% of the maximum dose to between 2 and 8%. Quantitative analysis shows that the 3D gamma passing rates rise from 90.4, 69.3, 63.7 and 43.6% to 97.3, 99.9, 96.7 and 98.9% respectively. [ABSTRACT FROM AUTHOR]