Thumbnail
Access Restriction
Open

Author Chow, Phillip E.
Source United States Department of Energy Office of Scientific and Technical Information
Content type Text
Language English
Subject Keyword APPLIED LIFE SCIENCES ♦ RADIATION PROTECTION AND DOSIMETRY ♦ ATTENUATION ♦ BEAMS ♦ BIOMEDICAL RADIOGRAPHY ♦ COBALT 60 ♦ DOSIMETRY ♦ IONIZATION CHAMBERS ♦ MONTE CARLO METHOD ♦ NMR IMAGING ♦ PATIENTS ♦ PLANNING ♦ RADIOTHERAPY ♦ SIMULATION
Abstract Purpose: Magnetic resonance imaging (MRI) guidance in radiation therapy brings real-time imaging and adaptive planning into the treatment vault where it can account for interfraction and intrafraction movement of soft tissue. The only commercially available MRI-guided radiation therapy device is a three-head {sup 60}Co and MRI system with an integrated treatment planning system (TPS). Couch attenuation of the beam of up to 20% is well modeled in the TPS. Variations in the patient’s day-to-day position introduce discrepancies in the actual couch attenuation as modeled in the treatment plan. For this reason, the authors’ institution avoids plans with beams that pass through or near the couch edges. This study investigates the effects of differential beam attenuation by the couch due to couch shifts in order to determine whether couch edge avoidance restrictions can be lifted. Couch shifts were simulated using a Monte Carlo treatment planning system and ion chamber measurements performed for validation. Methods: A total of 27 plans from 23 patients were investigated. Couch shifts of 1 and 2 cm were introduced in combinations of lateral and vertical directions to simulate patient position variations giving 16 shifted plans per reference plan. The 1 and 2 cm shifts were based on shifts recorded in 320 treatment fractions. Results: Following TG176 recommendations for measurement methods, couch attenuation measurements agreed with TPS modeled attenuation to within 2.1%. Planning target volume D95 changed less than 1% for 1 and 2 cm couch shifts in only the x-direction and less than 3% for all directions. Conclusions: Dosimetry of all plans tested was robust to couch shifts up to ±2 cm. In general, couch shifts resulted in clinically insignificant dosimetric deviations. It is conceivable that in certain cases with large systematic couch shifts and plans that are particularly sensitive to shifts, dosimetric changes might rise to a clinically significant level.
ISSN 00942405
Educational Use Research
Learning Resource Type Article
Publisher Date 2016-08-15
Publisher Place United States
Journal Medical Physics
Volume Number 43
Issue Number 8


Open content in new tab

   Open content in new tab