In the last 30 days

• Open/close Estimation of geometrical parameters for fan beam tomography

  G T Gullberg et al 1987 Phys. Med. Biol. 32 1581 Tag this article

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  Tomographic image quality depends on precisely determining the geometric parameters that reference the detector system to the transaxial imaging coordinate system. In addition to the projection of the centre of rotation onto the detector, fan beam geometry requires two other parameters that include the focal length and the projection of the focal point onto the detector. Heretofore no method has been developed for estimating the geometrical parameters of a fan beam detector system. A method is presented for estimating these parameters from centroids of the measured projections of a point source using the non-linear estimation algorithm due to Marquardt. The technique is applied to single photon emission computed tomography (SPECT) data from a rotating gamma camera using a fan beam collimator. The parameters can be determined very quickly in a clinical environment. The corresponding reconstructed images do not show image artefacts or loss of resolution characteristic of inaccurately determined geometric parameters.

• Open/close Two new DOSXYZnrc sources for 4D Monte Carlo simulations of continuously variable beam configurations, with applications to RapidArc, VMAT, TomoTherapy and CyberKnife

  Julio Lobo and I Antoniu Popescu 2010 Phys. Med. Biol. 55 4431 Tag this article

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  We present two new Monte Carlo sources for the DOSXYZnrc code, which can be used to compute dose distributions due to continuously variable beam configurations. These sources support a continuously rotating gantry and collimator, dynamic multileaf collimator (MLC) motion, variable monitor unit (MU) rate, couch rotation and translation in any direction, arbitrary isocentre motion with respect to the patient and variable source-to-axis distance (SAD). These features make them applicable to Monte Carlo simulations for RapidArc™, Elekta VMAT, TomoTherapy™ and CyberKnife™. Unique to these sources is the synchronization between the motion in the DOSXYZnrc geometry and the motion within the linac head, represented by a shared library (either a BEAMnrc accelerator with dynamic component modules, or an external library). The simulations are achieved in single runs, with no intermediate phase space files.

• Open/close A review of dosimetry studies on external-beam radiation treatment with respect to second cancer induction

  X George Xu et al 2008 Phys. Med. Biol. 53 R193 Tag this article

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  It has been long known that patients treated with ionizing radiation carry a risk of developing a second cancer in their lifetimes. Factors contributing to the recently renewed concern about the second cancer include improved cancer survival rate, younger patient population as well as emerging treatment modalities such as intensity-modulated radiation treatment (IMRT) and proton therapy that can potentially elevate secondary exposures to healthy tissues distant from the target volume. In the past 30 years, external-beam treatment technologies have evolved significantly, and a large amount of data exist but appear to be difficult to comprehend and compare. This review article aims to provide readers with an understanding of the principles and methods related to scattered doses in radiation therapy by summarizing a large collection of dosimetry and clinical studies. Basic concepts and terminology are introduced at the beginning. That is followed by a comprehensive review of dosimetry studies for external-beam treatment modalities including classical radiation therapy, 3D-conformal x-ray therapy, intensity-modulated x-ray therapy (IMRT and tomotherapy) and proton therapy. Selected clinical data on second cancer induction among radiotherapy patients are also covered. Problems in past studies and controversial issues are discussed. The needs for future studies are presented at the end.

• Open/close The physics, biophysics and technology of photodynamic therapy

  Brian C Wilson and Michael S Patterson 2008 Phys. Med. Biol. 53 R61 Tag this article

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  Photodynamic therapy (PDT) uses light-activated drugs to treat diseases ranging from cancer to age-related macular degeneration and antibiotic-resistant infections. This paper reviews the current status of PDT with an emphasis on the contributions of physics, biophysics and technology, and the challenges remaining in the optimization and adoption of this treatment modality. A theme of the review is the complexity of PDT dosimetry due to the dynamic nature of the three essential components—light, photosensitizer and oxygen. Considerable progress has been made in understanding the problem and in developing instruments to measure all three, so that optimization of individual PDT treatments is becoming a feasible target. The final section of the review introduces some new frontiers of research including low dose rate (metronomic) PDT, two-photon PDT, activatable PDT molecular beacons and nanoparticle-based PDT.

• Open/close Dosimetric verification and clinical evaluation of a new commercially available Monte Carlo-based dose algorithm for application in stereotactic body radiation therapy (SBRT) treatment planning

  Margarida Fragoso et al 2010 Phys. Med. Biol. 55 4445 Tag this article

  Article References Full text PDF (4.14 MB)

  Modern cancer treatment techniques, such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), have greatly increased the demand for more accurate treatment planning (structure definition, dose calculation, etc) and dose delivery. The ability to use fast and accurate Monte Carlo (MC)-based dose calculations within a commercial treatment planning system (TPS) in the clinical setting is now becoming more of a reality. This study describes the dosimetric verification and initial clinical evaluation of a new commercial MC-based photon beam dose calculation algorithm, within the iPlan v.4.1 TPS (BrainLAB AG, Feldkirchen, Germany). Experimental verification of the MC photon beam model was performed with film and ionization chambers in water phantoms and in heterogeneous solid-water slabs containing bone and lung-equivalent materials for a 6 MV photon beam from a Novalis (BrainLAB) linear accelerator (linac) with a micro-multileaf collimator (m ₃ MLC). The agreement between calculated and measured dose distributions in the water phantom verification tests was, on average, within 2%/1 mm (high dose/high gradient) and was within ±4%/2 mm in the heterogeneous slab geometries. Example treatment plans in the lung show significant differences between the MC and one-dimensional pencil beam (PB) algorithms within iPlan, especially for small lesions in the lung, where electronic disequilibrium effects are emphasized. Other user-specific features in the iPlan system, such as options to select dose to water or dose to medium, and the mean variance level, have been investigated. Timing results for typical lung treatment plans show the total computation time (including that for processing and I/O) to be less than 10 min for 1–2% mean variance (running on a single PC with 8 Intel Xeon X5355 CPUs, 2.66 GHz). Overall, the iPlan MC algorithm is demonstrated to be an accurate and efficient dose algorithm, incorporating robust tools for MC-based SBRT treatment planning in the routine clinical setting.

• Open/close RapidArc treatment verification in 3D using polymer gel dosimetry and Monte Carlo simulation

  Sofie Ceberg et al 2010 Phys. Med. Biol. 55 4885 Tag this article

  Article References Full text PDF (1.16 MB)

  The aim of this study was to verify the advanced inhomogeneous dose distribution produced by a volumetric arc therapy technique (RapidArc™) using 3D gel measurements and Monte Carlo (MC) simulations. The TPS (treatment planning system)-calculated dose distribution was compared with gel measurements and MC simulations, thus investigating any discrepancy between the planned dose delivery and the actual delivery. Additionally, the reproducibility of the delivery was investigated using repeated gel measurements. A prostate treatment plan was delivered to a 1.3 liter nPAG gel phantom using one single arc rotation and a target dose of 3.3 Gy. Magnetic resonance imaging of the gel was carried out using a 1.5 T scanner. The MC dose distributions were calculated using the VIMC-Arc code. The relative absorbed dose differences were calculated voxel-by-voxel, within the volume enclosed by the 90% isodose surface (VOI ₉₀), for the TPS versus gel and TPS versus MC. The differences between the verification methods, MC versus gel, and between two repeated gel measurements were investigated in the same way. For all volume comparisons, the mean value was within 1% and the standard deviation of the differences was within 2.5% (1SD). A 3D gamma analysis between the dose matrices were carried out using gamma criteria 3%/3 mm and 5%/5 mm (% dose difference and mm distance to agreement) within the volume enclosed by the 50% isodose surface (VOI ₅₀) and the 90% isodose surface (VOI ₉₀), respectively. All comparisons resulted in very high pass rates. More than 95% of the TPS points were within 3%/3 mm of both the gel measurement and MC simulation, both inside VOI ₅₀ and VOI ₉₀. Additionally, the repeated gel measurements showed excellent consistency, indicating reproducible delivery. Using MC simulations and gel measurements, this verification study successfully demonstrated that the RapidArc™ plan was both accurately calculated and delivered as planned.

• Open/close Derivation of the tumor position from external respiratory surrogates with periodical updating of the internal/external correlation

  E Kanoulas et al 2007 Phys. Med. Biol. 52 5443 Tag this article

  Article References Full text PDF (759 KB)

  In this work we develop techniques that can derive the tumor position from external respiratory surrogates (abdominal surface motion) through periodically updated internal/external correlation. A simple linear function is used to express the correlation between the tumor and surrogate motion. The function parameters are established during a patient setup session with the tumor and surrogate positions simultaneously measured at a 30 Hz rate. During treatment, the surrogate position, constantly acquired at 30 Hz, is used to derive the tumor position. Occasionally, a pair of radiographic images is acquired to enable the updating of the linear correlation function. Four update methods, two aggressive and two conservative, are investigated: (A1) shift line through the update point; (A2) re-fit line through the update point; (C1) re-fit line with extra weight to the update point; (C2) minimize the distances to the update point and previous line fit point. In the present study of eight lung cancer patients, tumor and external surrogate motion demonstrate a high degree of linear correlation which changes dynamically over time. It was found that occasionally updating the correlation function leads to more accurate predictions than using external surrogates alone. In the case of high imaging rates during treatment (greater than 2 Hz) the aggressive update methods (A1 and A2) are more accurate than the conservative ones (C1 and C2). The opposite is observed in the case of low imaging rates.

• Open/close Multimodality imaging of structure and function

  D W Townsend 2008 Phys. Med. Biol. 53 R1 Tag this article

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  Historically, medical devices to image either anatomical structure or functional processes have developed along somewhat independent paths. The recognition that combining images from different modalities can nevertheless offer significant diagnostic advantages gave rise to sophisticated software techniques to coregister structure and function. Recently, alternatives to retrospective software-based fusion have become available through instrumentation that combines two imaging modalities within a single device, an approach that has since been termed hardware fusion. As a result, following their recent introduction into the clinic, combined PET/CT and SPECT/CT devices are now playing an increasingly important role in the diagnosis and staging of human disease. Recently, although limited to the brain, the first clinical MR scanner with a PET insert, a technically-challenging design, has been undergoing evaluation. This review will follow the development of multimodality instrumentation for clinical use from conception to present-day technology and assess the status and future potential for such devices.

• Open/close Special section: Selected papers from the Second European Workshop on Monte Carlo Treatment Planning (MCTP2009)

  Emiliano Spezi 2010 Phys. Med. Biol. 55 Tag this article

  Article References Full text PDF (28 KB)

  Sixty years after the paper 'The Monte Carlo method' by N Metropolis and S Ulam in The Journal of the American Statistical Association (Metropolis and Ulam 1949), use of the most accurate algorithm for computer modelling of radiotherapy linear accelerators, radiation detectors and three dimensional patient dose was discussed in Wales (UK).

  The Second European Workshop on Monte Carlo Treatment Planning (MCTP2009) was held at the National Museum of Wales in Cardiff. The event, organized by Velindre NHS Trust, Cardiff University and Cancer Research Wales, lasted two and a half days, during which leading experts and contributing authors presented and discussed the latest advances in the field of Monte Carlo treatment planning (MCTP).

  MCTP2009 was highly successful, judging from the number of participants which was in excess of 140. Of the attendees, 24% came from the UK, 46% from the rest of Europe, 12% from North America and 18% from the rest of the World. Fifty-three oral presentations and 24 posters were delivered in a total of 12 scientific sessions. MCTP2009 follows the success of previous similar initiatives (Verhaegen and Seuntjens 2005, Reynaert 2007, Verhaegen and Seuntjens 2008), and confirms the high level of interest in Monte Carlo technology for radiotherapy treatment planning. The 13 articles selected for this special section (following Physics in Medicine and Biology's usual rigorous peer-review procedure) give a good picture of the high quality of the work presented at MCTP2009. The book of abstracts can be downloaded from http://www.mctp2009.org.

  I wish to thank the IOP Medical Physics and Computational Physics Groups for their financial support, Elekta Ltd and Dosisoft for sponsoring MCTP2009, and leading manufacturers such as BrainLab, Nucletron and Varian for showcasing their latest MC-based radiotherapy solutions during a dedicated technical session. I am also very grateful to the eight invited speakers who kindly accepted to give keynote presentations which contributed significantly to raising the quality of the event and capturing the interest of the medical physics community.

  I also wish to thank all those who contributed to the success of MCTP2009: the members of the local Organizing Committee and the Workshop Management Team who managed the event very efficiently, the members of the European Working Group in Monte Carlo Treatment Planning (EWG-MCTP) who acted as Guest Associate Editors for the MCTP2009 abstracts reviewing process, and all the authors who generated new, high quality work.

  Finally, I hope that you find the contents of this special section enjoyable and informative.

  Emiliano Spezi
  Chairman of MCTP2009 Organizing Committee and Guest Editor

  References

  Metropolis N and Ulam S 1949 The Monte Carlo method J. Amer. Stat. Assoc. 44 335–41

  Reynaert N 2007 First European Workshop on Monte Carlo Treatment Planning J. Phys.: Conf. Ser. 74 011001

  Verhaegen F and Seuntjens J 2005 International Workshop on Current Topics in Monte Carlo Treatment Planning Phys. Med. Biol. 50

  Verhaegen F and Seuntjens J 2008 International Workshop on Monte Carlo Techniques in Radiotherapy Delivery and Verification J. Phys.: Conf. Ser. 102 011001

• Open/close Arc-modulated radiation therapy (AMRT): a single-arc form of intensity-modulated arc therapy

  Chao Wang et al 2008 Phys. Med. Biol. 53 6291 Tag this article

  Article References Full text PDF (711 KB)

  Arc-modulated radiation therapy (AMRT) is a novel rotational intensity-modulated radiation therapy (IMRT) technique developed for a clinical linear accelerator that aims to deliver highly conformal radiation treatment using just one arc of gantry rotation. Compared to fixed-gantry IMRT and the multiple-arc intensity-modulated arc therapy (IMAT) techniques, AMRT promises the same treatment quality with a single-arc delivery. In this paper, we present a treatment planning scheme for AMRT, which addresses the challenges in inverse planning, leaf sequencing and dose calculation. The feasibility and performance of this AMRT treatment planning scheme have been verified with multiple clinical cases of various sites on Varian linear accelerators.