Search results for: IMRT

Authors: A. Taqaddas

Abstract:

Purpose: This E-survey was carried out to facilitate the implementation and Education of VMAT (Volumetric Modulated Arc Therapy) in Radiotherapy-RT departments and reasons for not using IMRT (Intensity Modulated Radiotherapy). VMAT Skills in demand were also identified. Method: E-Survey was distributed to NHS hospitals across UK by email. Thirty NHS and related centres in England, 21 in Scotland, 3 in Ireland and 1 in Wales were contacted. This Survey was intended for those working in RT and Medical Physics and who were responsible for Treatment Planning and training. Results: This E-survey have indicated pathways adopted by staff to acquire VMAT skills, strategies to efficiently implement VMAT in RT departments and for obtaining VMAT Education. Conclusion: Despite poor survey response this survey has managed to highlight requirements for education and implementation of VMAT that are also applicable to IMRT. Other RT centres in world can also find these results useful.

Keywords: IMRT, Radiotherapy, Treatment Planning, VMAT.

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Authors: Jayesh K., Ganesh T., Suganthi D., Mohan R., Rakesh C. J., Sarojkumar D. M., Jacob S. J.

Abstract:

Prior to the use of detectors, characteristics comparison study was performed and baseline established. In patient specific QA, the portal dosimetry mean values of area gamma, average gamma and maximum gamma were 1.02, 0.31 and 1.31 with standard deviation of 0.33, 0.03 and 0.14 for IMRT and the corresponding values were 1.58, 0.48 and 1.73 with standard deviation of 0.31, 0.06 and 0.66 for VMAT. With ImatriXX 2-D array system, on an average 99.35% of the pixels passed the criteria of 3%-3 mm gamma with standard deviation of 0.24 for dynamic IMRT. For VMAT, the average value was 98.16% with a standard deviation of 0.86. The results showed that both the systems can be used in patient specific QA measurements for IMRT and VMAT. The values obtained with the portal dosimetry system were found to be relatively more consistent compared to those obtained with ImatriXX 2-D array system.

Keywords: Gamma, IMRT, QA, TPS, VMAT.

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Authors: Ravi Kiran Pothamsetty, Radha Rani Ghosh, Baby Paul Thaliath

Abstract:

Radiation therapy has undergone many advancements and evloved from 2D to 3D. Recently, with rapid pace of drug discoveries, cutting edge technology, and clinical trials has made innovative advancements in computer technology and treatment planning and upgraded to intensity modulated radiotherapy (IMRT) which delivers in homogenous dose to tumor and normal tissues. The present study was a hospital-based experience comparing two different conformal radiotherapy techniques for brain tumors. This analytical study design has been conducted at Regional Cancer Centre, India from January 2014 to January 2015. Ten patients have been selected after inclusion and exclusion criteria. All the patients were treated on Artiste Siemens Linac Accelerator. The tolerance level for maximum dose was 6.0 Gyfor lenses and 54.0 Gy for brain stem, optic chiasm and optical nerves as per RTOG criteria. Mean and standard deviation values of PTV98%, PTV 95% and PTV 2% in IMRT were 93.16±2.9, 95.01±3.4 and 103.1±1.1 respectively; for 3DCRT were 91.4±4.7, 94.17±2.6 and 102.7±0.39 respectively. PTV max dose (%) in IMRT and 3D-CRT were 104.7±0.96 and 103.9±1.0 respectively. Maximum dose to the tumor can be delivered with IMRT with acceptable toxicity limits. Variables such as expertise, location of tumor, patient condition, and TPS influence the outcome of the treatment.

Keywords: IMRT, 3D CRT, Brain, tumors, OARs, RTOG.

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Authors: A. Taqaddas

Abstract:

Purpose: Planning and dosimetry of different VMAT algorithms (SmartArc, Ergo++, Autobeam) is compared with IMRT for Head and Neck Cancer patients. Modelling was performed to rule out the causes of discrepancies between planned and delivered dose. Methods: Five HNC patients previously treated with IMRT were re-planned with SmartArc (SA), Ergo++ and Autobeam. Plans were compared with each other and against IMRT and evaluated using DVHs for PTVs and OARs, delivery time, monitor units (MU) and dosimetric accuracy. Modelling of control point (CP) spacing, Leaf-end Separation and MLC/Aperture shape was performed to rule out causes of discrepancies between planned and delivered doses. Additionally estimated arc delivery times, overall plan generation times and effect of CP spacing and number of arcs on plan generation times were recorded. Results: Single arc SmartArc plans (SA4d) were generally better than IMRT and double arc plans (SA2Arcs) in terms of homogeneity and target coverage. Double arc plans seemed to have a positive role in achieving improved Conformity Index (CI) and better sparing of some Organs at Risk (OARs) compared to Step and Shoot IMRT (ss-IMRT) and SA4d. Overall Ergo++ plans achieved best CI for both PTVs. Dosimetric validation of all VMAT plans without modelling was found to be lower than ss-IMRT. Total MUs required for delivery were on average 19%, 30%, 10.6% and 6.5% lower than ss-IMRT for SA4d, SA2d (Single arc with 2⁰ Gantry Spacing), SA2Arcs and Autobeam plans respectively. Autobeam was most efficient in terms of actual treatment delivery times whereas Ergo++ plans took longest to deliver. Conclusion: Overall SA single arc plans on average achieved best target coverage and homogeneity for both PTVs. SA2Arc plans showed improved CI and some OARs sparing. Very good dosimetric results were achieved with modelling. Ergo++ plans achieved best CI. Autobeam resulted in fastest treatment delivery times.

Keywords: Dosimetry, Intensity Modulated Radiotherapy, Optimization Algorithms, Volumetric Modulated Arc Therapy.

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Authors: M. Umar Farooq, T. Ahmad Afridi, M. Zia-Ul-Islam Arsalan, U. Hussain Haider, S. Ullah

Abstract:

Cancer, a leading fatal disease worldwide, can be treated with various techniques including radiation therapy. It involves the use of ionizing radiation to target cancer cells. On basis of source placement, radiation therapy is of two types i.e., Brachytherapy and External Beam Radiotherapy (EBRT). EBRT has evolved from 2-D conventional therapy to 3-D Conformal radiotherapy (3D-CRT) and then Intensity-Modulated Radiotherapy (IMRT). IMRT improves dose conformity and sparing of organs at risk. Volumetric Modulated Arc Therapy (VMAT) is a modern technique that uses treatment delivery in arcs with rotation of the gantry. In this report, a dosimetry comparison was performed between IMRT and VMAT. This study was conducted in the Radiotherapy Department of the Institute of Nuclear Medicine and Oncology Lahore (INMOL). Ten patients with Prostate Carcinoma were selected for this study to compare the methods. Simulation of these patients was done with help of a CT Simulator. All target volumes and organs were delineated by the oncologists. Then suitable fields/arcs were applied which cover volumes effectively. This was followed by the optimization of plans for both techniques for every patient. Finally, a comparison of evaluating parameters e.g., Conformity Index (CI), Volume Coverage, Homogeneity Index (HI), Organ Doses, and MUs (Monitor Units) was performed. We obtained better results of target conformity indices from VMAT (CI = 1.16) than IMRT (CI = 1.24). VMAT was better in organ sparing too. Also, VMAT shows fewer MUs (733 MUs) as compared to IMRT (2149 MUs). From this study, it is concluded that VMAT is a better treatment technique than IMRT. This technique will enhance treatment efficiency as it takes less time in obtaining the required results. Also, a very less scatter dose will be delivered to the patient.

Keywords: 2-D Conventional Radiotherapy, 3-D Conformal Radiotherapy, Intensity Modulated Radiotherapy, Prostate Carcinoma, Radiotherapy, Volumetric Modulated Arc Therapy.

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Authors: Todsaporn Fuangrod, Daryl J. O'Connor, Boyd MC McCurdy, Peter B. Greer

Abstract:

An electronic portal image device (EPID) has become a method of patient-specific IMRT dose verification for radiotherapy. Research studies have focused on pre and post-treatment verification, however, there are currently no interventional procedures using EPID dosimetry that measure the dose in real time as a mechanism to ensure that overdoses do not occur and underdoses are detected as soon as is practically possible. As a result, an EPID-based real time dose verification system for dynamic IMRT was developed and was implemented with MATLAB/Simulink. The EPID image acquisition was set to continuous acquisition mode at 1.4 images per second. The system defined the time constraint gap, or execution gap at the image acquisition time, so that every calculation must be completed before the next image capture is completed. In addition, the <=-evaluation method was used for dose comparison, with two types of comparison processes; individual image and cumulative dose comparison monitored. The outputs of the system are the <=-map, the percent of <=<1, and mean-<= versus time, all in real time. Two strategies were used to test the system, including an error detection test and a clinical data test. The system can monitor the actual dose delivery compared with the treatment plan data or previous treatment dose delivery that means a radiation therapist is able to switch off the machine when the error is detected.

Keywords: real-time dose verification, EPID dosimetry, simulation, dynamic IMRT

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Authors: Pradip Deb

Abstract:

Quantitative radiobiological models can be used to assess the optimum clinical outcome from sophisticated therapeutic modalities by calculating tumor control probability (TCP) and normal tissue complication probability (NTCP). In this study two 3D-CRT and an IMRT treatment plans were developed with an initial prescription dose of 60 Gy in 2 Gy/fraction to prostate. Sensitivity of TCP and Complication free tumor control probability (P+) to the different values of α/β ratio was investigated for various prescription doses planned to be delivered in either a fixed number of fractions (I) or in a fixed dose per fraction (II) in each of the three different treatment plans. High dose/fraction and high α/β value result in comparatively smaller P+ and IMRT plans resulted in the highest P+, mainly due to the decrease in NTCP. If α/β is lower than expected, better tumor control can be achieved by increasing dose/fraction but decreasing the number of fractions.

Keywords: Linear Quadratic Model, TCP, NTCP, α/β ratio.

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Authors: Xi Pei, Ruifen Cao, Hui Liu, Chufeng Jin, Mengyun Cheng, Huaqing Zheng, Yican Wu, FDS Team

Abstract:

In intensity modulated radiation therapy (IMRT) treatment planning, beam angles are usually preselected on the basis of experience and intuition. Therefore, getting an appropriate beam configuration needs a very long time. Based on the present situation, the paper puts forward beam orientation optimization using ant colony optimization (ACO). We use ant colony optimization to select the beam configurations, after getting the beam configuration using Conjugate Gradient (CG) algorithm to optimize the intensity profiles. Combining with the information of the effect of pencil beam, we can get the global optimal solution accelerating. In order to verify the feasibility of the presented method, a simulated and clinical case was tested, compared with dose-volume histogram and isodose line between target area and organ at risk. The results showed that the effect was improved after optimizing beam configurations. The optimization approach could make treatment planning meet clinical requirements more efficiently, so it had extensive application perspective.

Keywords: intensity modulated radiation therapy, ant colonyoptimization, Conjugate Gradient algorithm

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