Department of Radiation Oncology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Zap Surgical Systems, Inc, San Carlos, California, USA.
Med Phys. 2021 Oct;48(10):6121-6136. doi: 10.1002/mp.15091. Epub 2021 Aug 18.
This study reports a single-institution experience with beam data acquisition and film-based validation for a novel self-shielded sterotactic radiosurgery unit and investigates detector dependency on field output factors (OFs), off-axis ratios (OARs), and percent depth dose (PDD) measurements within the context of small-field dosimetry.
The delivery platform for this unit consists of a 2.7-MV S-band linear accelerator mounted on coupled gimbals that rotate around a common isocenter (source-to-axis distance [SAD] = 450 mm), allowing for more than 260 noncoplanar beam angles. Beam collimation is achieved via a tungsten collimator wheel with eight circular apertures ranging from 4 mm to 25 mm in diameter. Three diodes (PTW 60012 Diode E, PTW 60018 SRS Diode, and Sun Nuclear EDGE) and a synthetic diamond detector (PTW 60019 micro Diamond [µD] detector) were used for OAR, PDD, and OF measurements. OFs were also acquired with a PTW 31022 PinPoint ionization chamber. Beam scanning was performed using a 3D water tank at depths of 7, 50, 100, 200, and 250 mm with a source-to-surface distance of 450 mm. OFs were measured at the depth of maximum dose (d = 7 mm) with the SAD at 450 mm. Gafchromic EBT3 film was used to validate OF and profile measurements and as a reference detector for estimating correction factors for active detector OFs. Deviations in field size, penumbra, and PDDs across the different detectors were quantified.
Relative OFs (ROFs) for the diodes were within 1.4% for all collimators except for 5 and 7.5 mm, for which SRS Diode measurements were higher by 1.6% and 2.6% versus Diode E. The µD ROFs were within 1.4% of the diode measurements. PinPoint ROFs were lower by >10% for the 4-mm and 5-mm collimators versus the Diode E and µD. Corrections to OFs using EBT3 film as a reference were within 1.2% for all diodes and the µD detector for collimators 10 mm and greater and within 2.0%, 2.8%, and 1.1% for the 7.5-, 5-, and 4-mm collimators, respectively. The maximum difference in full width at half maximum (FWHM) between the Diode E and the other active detectors was for the 25-mm collimator and was 0.09 mm (µD), 0.16 mm (SRS Diode), and 0.65 mm (EDGE). Differences seen in PDDs beyond the depth of d were <1% across the three diodes and the µD. FWHM and penumbra measurements made using EBT3 film were within 1.34% and 3.26%, respectively, of the processed profile data entered into the treatment planning system.
Minimal differences were seen in OAR and PDD measurements acquired with the diodes and the µD. ROFs measured with the three diodes were within 2.6% and within 1.4% versus the µD. Gafchromic Film measurements provided independent verification of the OAR and OF measurements. Estimated corrections to OFs using film as a reference were <1.6% for the Diode E, EDGE, and µD detector.
本研究报告了一种新型自屏蔽立体定向放射外科单元的光束数据采集和基于胶片的验证的单机构经验,并研究了探测器在小场剂量学中对场输出因子(OFs)、离轴比(OARs)和百分深度剂量(PDD)测量的依赖性。
该单元的输送平台由安装在耦合万向架上的 2.7MV S 波段直线加速器组成,可绕公共等中心(源轴距[SAD]为 450mm)旋转,允许超过 260 个非共面光束角度。光束准直通过带有八个圆形孔径的钨合金准直器轮实现,孔径直径从 4mm 到 25mm 不等。三个二极管(PTW 60012 二极管 E、PTW 60018 SRS 二极管和 Sun Nuclear EDGE)和一个合成钻石探测器(PTW 60019 微钻石[µD]探测器)用于 OAR、PDD 和 OF 测量。PTW 31022 PinPoint 电离室也用于获取 OFs。使用 3D 水箱在源皮距为 450mm 时在 7、50、100、200 和 250mm 的深度进行光束扫描。在 SAD 为 450mm 时,在最大剂量深度(d=7mm)处测量 OFs。Gafchromic EBT3 胶片用于验证 OF 和轮廓测量,并作为用于估计有源探测器 OF 校正因子的参考探测器。量化了不同探测器的场大小、半影和 PDD 的差异。
对于所有准直器,二极管的相对 OFs(ROFs)除 5mm 和 7.5mm 外,均在 1.4%以内,对于 SRS 二极管测量,其值比 Diode E 高 1.6%和 2.6%。µD ROFs 在 1.4%以内的二极管测量值。与 Diode E 和 µD 相比,PinPoint 对于 4mm 和 5mm 准直器的 OFs 低>10%。使用 EBT3 胶片作为参考的 OF 校正值在 10mm 及以上的所有二极管和 µD 探测器中均在 1.2%以内,对于 7.5mm、5mm 和 4mm 准直器,分别在 2.0%、2.8%和 1.1%以内。Diode E 和其他有源探测器之间的最大半峰全宽(FWHM)差异为 25mm 准直器,为 0.09mm(µD)、0.16mm(SRS 二极管)和 0.65mm(EDGE)。在三个二极管和 µD 中,超过 d 深度的 PDD 差异<1%。使用 EBT3 胶片进行的 FWHM 和半影测量值分别为处理后的轮廓数据输入治疗计划系统的 1.34%和 3.26%。
二极管和 µD 采集的 OAR 和 PDD 测量值差异较小。三个二极管测量的 ROFs 分别在 2.6%和 1.4%以内,与 µD 相比。使用胶片作为参考的 OF 校正值在 1.6%以内,适用于 Diode E、EDGE 和 µD 探测器。Gafchromic 胶片测量值为 OAR 和 OF 测量提供了独立验证。使用胶片作为参考的 OF 校正值<1.6%,适用于 Diode E、EDGE 和 µD 探测器。