Knill Cory, Snyder Michael, Rakowski Joseph T, Zhuang Ling, Matuszak Martha, Burmeister Jay
Department of Radiation Oncology, Karmanos Cancer Institute, Detroit, Michigan 48201 and Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, Michigan 48201.
Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, Michigan 48201.
Med Phys. 2016 May;43(5):2476. doi: 10.1118/1.4946822.
PTW's Octavius 1000 SRS array performs IMRT quality assurance (QA) measurements with liquid-filled ionization chambers (LICs) to allow closer detector spacing and higher resolution, compared to air-filled QA devices. However, reduced ion mobility in LICs relative to air leads to increased ion recombination effects and reduced collection efficiencies that are dependent on Linac pulse frequency and pulse dose. These pulse parameters are variable during an IMRT delivery, which affects QA results. In this study, (1) 1000 SRS collection efficiencies were measured as a function of pulse frequency and pulse dose, (2) two methods were developed to correct changes in collection efficiencies during IMRT QA measurements, and the effects of these corrections on QA pass rates were compared.
To obtain collection efficiencies, the OCTAVIUS 1000 SRS was used to measure open fields of varying pulse frequency, pulse dose, and beam energy with results normalized to air-filled chamber measurements. Changes in ratios of 1000 SRS to chamber measured dose were attributed to changing collection efficiencies, which were then correlated to pulse parameters using regression analysis. The usefulness of the derived corrections was then evaluated using 6 MV and 10FFF SBRT RapidArc plans delivered to the OCTAVIUS 4D system using a TrueBeam (Varian Medical Systems) linear accelerator equipped with a high definition multileaf collimator. For the first correction, matlab software was developed that calculates pulse frequency and pulse dose for each detector, using measurement and DICOM RT Plan files. Pulse information is converted to collection efficiency, and measurements are corrected by multiplying detector dose by ratios of calibration to measured collection efficiencies. For the second correction the MU/min in the daily 1000 SRS calibration was chosen to match the average MU/min of the volumetric modulated arc therapy plan. Effects of the two corrections on QA results were examined by performing 3D gamma analysis comparing predicted to measured dose, with and without corrections.
Collection efficiencies correlated linearly to pulse dose, while correlations with pulse frequency were less defined, generally increasing as pulse frequency decreased. After complex matlab corrections, average 3D gamma pass rates improved by [0.07%,0.40%,1.17%] for 6 MV and [0.29%,1.40%,4.57%] for 10FFF using [3%/3 mm,2%/2 mm,1%/1 mm] criteria. Maximum changes in gamma pass rates were [0.43%,1.63%,3.05%] for 6 MV and [1.00%,4.80%,11.2%] for 10FFF using [3%/3 mm,2%/2 mm,1%/1 mm] criteria. On average, pass rates of simple daily calibration corrections were within 1% of complex matlab corrections.
OCTAVIUS 1000 SRS ion recombination effects have little effect on 6 MV measurements. However, the effect could potentially be clinically significant for higher pulse dose unflattened beams when using tighter gamma tolerances, especially when small aperture sizes are used, as is common for SRS/SBRT. In addition, ion recombination effects are strongly correlated to changing MU/min, therefore MU/min used in daily 1000 SRS calibrations should be matched to the expected average MU/min of the IMRT plan.
与充气式质量保证设备相比,PTW公司的Octavius 1000 SRS阵列采用充液电离室(LIC)进行调强放疗(IMRT)质量保证(QA)测量,可实现更紧密的探测器间距和更高的分辨率。然而,与空气相比,LIC中离子迁移率降低会导致离子复合效应增加,收集效率降低,而收集效率取决于直线加速器的脉冲频率和脉冲剂量。在IMRT治疗过程中,这些脉冲参数是可变的,这会影响QA结果。在本研究中,(1)测量了1000 SRS的收集效率与脉冲频率和脉冲剂量的函数关系,(2)开发了两种方法来校正IMRT QA测量过程中收集效率的变化,并比较了这些校正对QA通过率的影响。
为了获得收集效率,使用OCTAVIUS 1000 SRS测量不同脉冲频率、脉冲剂量和射束能量的开放野,并将结果归一化为充气电离室测量值。1000 SRS与电离室测量剂量比值的变化归因于收集效率的变化,然后使用回归分析将其与脉冲参数相关联。然后,使用配备高清多叶准直器的TrueBeam(瓦里安医疗系统公司)直线加速器,将6 MV和10FFF SBRT RapidArc计划输送到OCTAVIUS 4D系统,评估导出校正的有效性。对于第一次校正,开发了matlab软件,该软件使用测量文件和DICOM RT计划文件计算每个探测器的脉冲频率和脉冲剂量。将脉冲信息转换为收集效率,并通过将探测器剂量乘以校准与测量收集效率的比值来校正测量值。对于第二次校正,选择每日1000 SRS校准中的每分钟监测单位(MU/min)以匹配容积调强弧形治疗计划的平均MU/min。通过进行3D伽马分析,比较有无校正情况下预测剂量与测量剂量,研究了两种校正对QA结果的影响。
收集效率与脉冲剂量呈线性相关,与脉冲频率的相关性不太明确,一般随脉冲频率降低而增加。经过复杂的matlab校正后,对于6 MV,使用[3%/3 mm、2%/2 mm、1%/1 mm]标准时,平均3D伽马通过率提高了[0.07%、0.40%、1.17%];对于10FFF,平均3D伽马通过率提高了[0.29%、1.40%、4.57%]。使用[3%/3 mm、2%/2 mm、1%/1 mm]标准时,6 MV伽马通过率的最大变化为[0.43%、1.63%、3.05%],10FFF伽马通过率的最大变化为[1.00%、4.80%、11.2%]。平均而言,简单的每日校准校正的通过率与复杂的matlab校正相差在1%以内。
OCTAVIUS 1000 SRS的离子复合效应在6 MV测量中影响较小。然而,当使用更严格的伽马容差时,对于更高脉冲剂量的非平坦射束,这种效应在临床上可能具有显著意义,特别是在使用小孔径时,这在立体定向放射治疗(SRS)/立体定向体部放射治疗(SBRT)中很常见。此外,离子复合效应与变化的MU/min密切相关,因此每日1000 SRS校准中使用的MU/min应与IMRT计划预期的平均MU/min相匹配。