Objective function based ranking method for selection of optimal beam angles in IMRT

We propose a novel method for the selection of optimal beam angles in Intensity Modulated Radiation Therapy (IMRT). The proposed approach uses an objective function based metric called “target-to-critical organ objective function ratio” to find out the optimal gantry angles. The beams are ranked based on this metric and are accordingly chosen for IMRT optimization. We have used the Pinnacle TPS (Philips Medical System V 16.2) for performing the IMRT optimization. In order to validate our approach, we have applied it in four clinical cases: Head and Neck, Lung, Abdomen and Prostate. Basically, for all clinical cases, two set of plans were created with same clinical objectives, namely Equal angle plan (EA Plan) and Suitable angle Plan (SA Plan). In the EA plans, the beam angles were placed in an equiangular manner starting from the gantry angle of 0°. In the corresponding SA plans, the beam angles were decided using the guidance provided by the algorithm. The reduction in OAR mean dose and max dose obtained in SA plans is about 3 to 16% and 3 to 15% respectively depending upon the treatment site while obtaining equal target coverage as compared to their EA counterparts. It takes approximately 15–25 min to find the optimal beam angles. The results obtained from the clinical cases indicate that the plan quality is considerably improved when the beam angles are optimized using the proposed method.     

The effect of rectal gas on dose distribution during prostate cancer treatment using full arc and partial arc Volumetric Modulated Arc Therapy (VMAT) treatment plans

Background/AimIn this study, we investigated the effect of rectal gas on the dose distribution of prostate cancer using a volumetric modulated arc therapy (VMAT) treatment planning.Materials and MethodsThe first is the original structure set, clinical target volume (CTV), the rectum, and the bladder used clinically. The second is a structure set (simulated gas structure set) in which the overlapping part of the rectum and PTV is overwritten with Hounsfield Unit −950 as gas. Full arc and limited gantry rotation angle with VMAT were the two arcs. The VMAT of the full arc was 181°–179° in the clockwise (CW) direction and 179°–181° in the counterclockwise (CCW) direction. Three partial arcs with a limited gantry rotation angle were created: 200°–160 °CW and 160°–200 °CCW; 220°–140 °CW and 140°–220 °CCW; and finally, 240°–120 °CW and 120°–240 °CCW. The evaluation items were dose difference, distance to agreement, and gamma analysis.ResultIn the CTV, the full arc was the treatment planning technique with the least effect of rectal gas. In the rectum, when the gantry rotation angle range was short, the pass rate tended to reduce for all evaluation indices. The bladder showed no characteristic change between the treatment planning techniques in any of the evaluation indices.ConclusionsThe VMAT treatment planning with the least effect on dose distribution caused by rectal gas was shown to be a full arc.     

EGSnrc application for IMRT planning

The aim of this study was to describe a detailed instruction of intensity modulated radiotherapy (IMRT) planning simulation using BEAMnrc-DOSXYZnrc code system (EGSnrc package) and present a new graphical user interface based on MATLAB code (The MathWorks) to combine more than one. 3ddose file which were obtained from the IMRT plan.This study was performed in four phases: the commissioning of Varian Clinac iX6 MV, the simulation of IMRT planning in EGSnrc, the creation of in-house VDOSE GUI, and the analysis of the isodose contour and dose volume histogram (DVH) curve from several beam angles. The plan paramaters in sequence and control point files were extracted from the planning data in Tan Tock Seng Hospital Singapore (multileaf collimator (MLC) leaf positions – bank A and bank B, gantry angles, coordinate of isocenters, and MU indexes).VDOSE GUI which was created in this study can display the distribution dose curve in each slice and beam angle. Dose distributions from various MLC settings and beam angles yield different dose distributions even though they used the same number of simulated particles. This was due to the differences in the MLC leaf openings in every field. The value of the relative dose error between the two dose ditributions for “body” was 51.23 %. The Monte Carlo (MC) data was normalized with the maximum dose but the analytical anisotropic algorithm (AAA) data was normalized by the dose in the isocenter.In this study, we have presented a Monte Carlo simulation framework for IMRT dose calculation using DOSXYZnrc source 21. Further studies are needed in conducting IMRT simulations using EGSnrc to minimize the different dose error and dose volume histogram deviation.     

Gantry angle dependence in IMRT pre-treatment patient-specific quality controls

Intensity Modulated Radiation Therapy (IMRT) is a complex treatment modality that requires pre-treatment patient-specific quality control (QC) in order to assess a correct treatment delivery. The aim of this work is to investigate pre-treatment patient-specific per-field QCs performed with an on-board EPID at the gantry angle of 0° and at the treatment ones, and to asses if measurements executed at 0° are able to guarantee a correct treatment.Ten patients with prostate cancer were evaluated. Two “verification” plans were created for each patient in order to calculate the dose at the EPID surface: one with all fields positioned at 0° and one with all fields at the actual treatment angles.EPID’s mechanical shifts due to gravity effects were always taken into account and corrected.0 and no-0 plans were compared using a gamma-index method (3%, 3 mm). The gamma index was found dependent on gantry angles but the difference between 0 and no-0 samples was small (?0.3% mean value) and the criteria of acceptability of the gamma method was always satisfied for every field delivered at angles different from 0.Therefore patient-specific pre-treatment QCs should be done at treatments angles, but, if periodical quality assurance is performed on dynamic MLC for different gantry angles, this requirement was shown not strictly mandatory and pre-treatment IMRTQC can be reasonably executed at 0° angles too.     

Comparative Planning of Flattening-Filter-Free and Flat Beam IMRT for Hypopharynx Cancer as a Function of Beam and Segment Number

Although highly conformal dose distributions can be achieved by IMRT planning, this often requires a large number of segments or beams, resulting in increased treatment times. While flattening-filter-free beams offer a higher dose rate, even more segments may be required to create homogeneous target coverage. Therefore, it is worthwhile to systematically investigate the dependence of plan quality on gantry angles and number of segments for flat vs. FFF beams in IMRT planning. For the practical example of hypopharynx cancer, we present a planning study of flat vs. FFF beams using three different configurations of gantry angles and different segment numbers. The two beams are very similar in physical properties, and are hence well-suited for comparative planning. Starting with a set of plans of equal quality for flat and FFF beams, we assess how far the number of segments can be reduced before the plan quality is markedly compromised, and compare monitor units and treatment times for the resulting plans. As long as a sufficiently large number of segments is permitted, all planning scenarios give good results, independently of gantry angles and flat or FFF beams. For smaller numbers of segments, plan quality decreases both for flat and FFF energies; this effect is stronger for fewer gantry angles and for FFF beams. For low segment numbers, FFF plans are generally worse than the corresponding flat beam plans, but they are less sensitive to a decrease in segment number if many gantry angles are used (18 beams); in this case the quality of flat and FFF plans remains comparable even for few segments.     

Assessment of dose error due to nylon mesh of treatment couch

PurposeThis study aims at the assessment of dose error in patients undergoing radiotherapy due to treatment couch of Co-60 teletherapy unit.Materials and methodsIn this study beam attenuation due to treatment couch of Co-60 unit was measured in air for different gantry angles and field sizes. Polymethylmethacrylate (PMMA) phantom was used to estimate the effect of depth on attenuation. Impact of couch on surface dose was also evaluated.ResultsBeam attenuation due to couch was in the range of 0.5–28% for different gantry angles with standard field size of 10 × 10 cm² with optimum position of metallic cranks. Maximum attenuation (29%) was observed with smallest field size i.e. 5 × 5 cm². Beam attenuation has been found higher in phantom as compared to that in air However, no particular trend of attenuation has been noted with varying depth of phantom. A 6% increase in surface dose has also been observed due to couch insertion for normal beam incidence. Maximum error of 80% is also note-worthy for most unfavorable situation of irradiation at 180 degree through the metallic cranks.ConclusionIt has been determined that ignoring the treatment couch and its accessories can result in dose error of 0.5–80%, depending on gantry angle, field size and position of couch accessories. Therefore, consideration of dose error due to couch during treatment planning is recommended.     

The simulation of aerial movement--I. The determination of orientation angles from film data

Quantitative mechanical analyses of human movement require the time histories of the angles which specify body configuration and orientation. When these angles are obtained from a filmed performance they may be used to evaluate the accuracy of a simulation model. This paper presents a method of determining orientation angles and their rates of change from film data. The stages used comprise the synchronization of data obtained from two camera views, the determination of three-dimensional coordinates of joint centres, the calculation of an angle from a sequence of sine and cosine values and the curve fitting of angles using quintic splines. For each stage, other possible approaches are discussed. Original procedures are presented for obtaining individual error estimates of both the film data and the calculated angles to permit the automatic fitting of quintic splines for interpolation and differentiation and for deriving the time history of an angle as a continuous function from a sequence of sine and cosine values. The method is applied to a forward somersault with 1 1/2 twists and the average error estimate of 17 orientation angles is obtained as 2.1 degrees.     

Virtual Tangential-fields Arc Therapy (ViTAT) for whole breast irradiation: Technique optimization and validation

PurposeTo test the performances of a volumetric arc technique named ViTAT (Virtual Tangential-fields Arc Therapy) mimicking tangential field irradiation for whole breast radiotherapy.MethodsViTAT plans consisted in 4 arcs whose starting/ending position were established based on gantry angle distribution of clinical plans for right and left-breast. The arcs were completely blocked excluding the first and last 20°. Different virtual bolus densities and thicknesses were preliminarily evaluated to obtain the best plan performances. For 40 patients with tumor laterality equally divided between right and left sides, ViTAT plans were optimized considering the clinical DVHs for OARs (resulting from tangential field manual planning) to constrain them: ViTAT plans were compared with the clinical tangential-fields in terms of DVH parameters for both PTV and OARs.ResultsDistal angle values were suggested in the ranges [220°,240°] for the right-breast and [115°,135°] for the left-breast cases; medial angles were [60°,40°] for the right side and [295°,315°] for the left side, limiting the risk of collision. The optimal virtual bolus had −500 HU density and 1.5 cm thickness. ViTAT plans generated dose distributions very similar to the tangential-field plans, with significantly improved PTV homogeneity. The mean doses of ipsilateral OARs were comparable between the two techniques with minor increase of the low-dose spread in the range 2–15 Gy (few % volume); contralateral OARs were slightly better spared with ViTAT.ConclusionViTAT dose distributions were similar to tangential-fields. ViTAT should allow automatic plan optimization by developing knowledge-based DVH prediction models of patients treated with tangential-fields.     

A model for light-scattering by algae in water

Algae suspended in water may absorb or scatter light. Probabilistic arguments are used to derive the intensity of light at an optical depth τ when the incident light just under the surface makes an angle to the upward vertical for which the cosine is μ₀. An approximate formula (25), which assumes that scattering angles are small, suggests that the intensity should have exponential decay due to absorption alone multiplied by a cubic function of τ.     

Protein loop modeling by using fragment assembly and analytical loop closure

Protein loops are often involved in important biological functions such as molecular recognition, signal transduction, or enzymatic action. The three dimensional structures of loops can provide essential information for understanding molecular mechanisms behind protein functions. In this article, we develop a novel method for protein loop modeling, where the loop conformations are generated by fragment assembly and analytical loop closure. The fragment assembly method reduces the conformational space drastically, and the analytical loop closure method finds the geometrically consistent loop conformations efficiently. We also derive an analytic formula for the gradient of any analytical function of dihedral angles in the space of closed loops. The gradient can be used to optimize various restraints derived from experiments or databases, for example restraints for preferential interactions between specific residues or for preferred backbone angles. We demonstrate that the current loop modeling method outperforms previous methods that employ residue‐based torsion angle maps or different loop closure strategies when tested on two sets of loop targets of lengths ranging from 4 to 12. Proteins 2010. © 2010 Wiley‐Liss, Inc.     

A study on dosimetric properties of electronic portal imaging device and its use as a quality assurance tool in Volumetric Modulated Arc Therapy

Aim

In this study, the dosimetric properties of the electronic portal imaging device were examined and the quality assurance testing of Volumetric Modulated Arc Therapy was performed.

Background

RapidArc involves the variable dose rate, leaf speed and the gantry rotation. The imager was studied for the effects like dose, dose rate, field size, leaf speed and sag during gantry rotation.

Materials and methods

A Varian RapidArc machine equipped with 120 multileaf collimator and amorphous silicon detector was used for the study. The characteristics that are variable in RapidArc treatment were studied for the portal imager. The accuracy of a dynamic multileaf collimator position at different gantry angles and during gantry rotation was examined using the picket fence test. The control of the dose rate and gantry speed was verified using a test field irradiating seven strips of the same dose with different dose rate and gantry speeds. The control over leaf speed during arc was verified by irradiating four strips of different leaf speeds with the same dose in each strip. To verify the results, the RapidArc test procedure was compared with the X-Omat film and verified for a period of 6 weeks using EPID.

Results

The effect of gantry rotation on leaf accuracy was minimal. The dose in segments showed good agreement with mean deviation of 0.8% for dose rate control and 1.09% for leaf speed control over different gantry speeds.

Conclusion

The results provided a precise control of gantry speed, dose rate and leaf speeds during RapidArc delivery and were consistent over 6 weeks.     

Comparison of three commercial dosimetric systems in detecting clinically significant VMAT delivery errors

AimTo study the sensitivity of three commercial dosimetric systems, Delta4, Multicube and Octavius4D, in detecting Volumetric Modulated Arc Therapy (VMAT) delivery errors.MethodsFourteen prostate and head and neck (H&N) VMAT plans were considered for this study. Three types of errors were introduced into the original plans: gantry angle independent and dependent MLC errors, and gantry angle dependent dose errors. The dose matrix measured by each detector system for the no-error and error introduced delivery were compared with the reference Treatment Planning System (TPS) calculated dose matrix for no-error plans using gamma (γ) analysis with 2%/2 mm tolerance criteria. The ability of the detector system in identifying the minimum error in each scenario was assessed by analysing the gamma pass rates of no error delivery and error delivery using a Wilcoxon signed-rank test. The relative sensitivity of the system was assessed by determining the slope of the gamma pass line for studied error magnitude in each error scenario.ResultsIn the gantry angle independent and dependent MLC error scenario the Delta4, Multicube and Octavius4D systems detected a minimum 2 mm error. In the gantry angle dependent dose error scenario all studied systems detected a minimum 3% and 2% error in prostate and H&N plans respectively. In the studied detector systems Multicube showed relatively less sensitivity to the errors in the majority of error scenarios.ConclusionThe studied systems identified the same magnitude of minimum errors in all considered error scenarios.     

Some notes on estimation of the basic homoteneity-coefficient of sets of phytosociological relevés

The formula for calculation of the basic homotoneity-coefficient of sets of phytosociological relevés does not give adequate values for sets of 4 or 3 relevés. Therefore an empirical correction procedure is proposed for the calculation of this coefficient for such small sets of relevés. For sets of 2 relevés the calculation of the basic homotoneity-coefficient gives values equal toSørensen’s coefficient of floristic similarity. A simplification of calculation of the basic homotoneity-coefficient for sets of more than 20 relevés is proposed.     

Design,implementation and validation of a motorized wedge filter for a telecobalt machine (Bhabhatron-II)

A universal wedge filter of 15W × 20 cm² and 60° nominal wedge angle is designed and placed between the collimating jaws and penumbra trimmers inside the treatment head. A pneumatically driven actuating mechanism toggles the wedge between the wedge IN position and wedge OUT position. The effective wedge angles were determined using an analytical formula. An accumulated wedge profile at a depth of 10 cm which was measured using a 2D profiler and dose values at depths of 10 cm and 20 cm for the same experimental setup were used as input parameters in the formula used for determining effective wedge angles. The relationship between the wedge beam weight and effective wedge angle was established. The planned wedge angles were compared with the measured wedge angles and the differences are found to be less than 2° throughout the range of field sizes. Planned doses for various field sizes and wedge angles were measured for verification and the differences were found to be less than 1.8%. This study established that the relationship between the beam weights and effective wedge angles implemented for the motorized wedge filter of medical linacs is not directly applicable for the motorized wedge filter of Telecobalt.     

Expressions for the interpretation of circular intensity differential scattering of chiral aggregates

The derivation of compact expressions of the circular intensity differential scattering (CIDS) of chiral molecules is presented in the first Born approximation of the fields. The expressions derived are valid for a suspension of scattering chiral particles free to adopt any orientation in solution. The connection is established between the preferential scattering cross section for right- vs left-circularly polarized light for a given scattering angle and the geometrical parameters of the molecule. As observed experimentally, the equations predict that the circular differential scattering patterns must show as a function of the scattering angle a series of lobes of alternating sign. In between these lobes, zeros in the differential scattering cross section occur. For the case of two dipole moments arranged in chiral fashion, an expression is derived that shows how the relative arrangement of the dipoles and their separation relative to the wavelength of light control the number and the position of the zeros. A compact expression predicting the CIDS of a sample for very small angles of scattering is derived for a system of helices whose dimensions are small compared with the wavelength of light. Finally, the presence of CIDS in a sample is related to the appearance of anomalous signals in the CD spectrum of chiral systems. Expressions and computations of the magnitudes and sign of the anomalies are presented. The expressions obtained confirm the main features of the experimental CIDS patterns of chiral molecules previously published.     

Real-time gait assessment utilizing a new way of accelerometry

Real-time registration of body segment angles is essential in artificial body position control. A new method is presented for the real-time calculation of the lower extremity angles using data obtained from pairs of two one-dimensional accelerometers. It is shown that, assuming rigid-body dynamics and simple hinge joints, relative angles (i.e. angles between segments) can be calculated without integration, thereby solving the problem of integration drift normally associated with accelerometry. During the stance phase of walking, the relative angles can be transformed to absolute angles (i.e. relative to the gravitational field direction) for the different leg segments. The feasibility of relative angle calculation is demonstrated by calculation of the knee angle of a healthy subject. Stability and resolution were demonstrated with measurements during standing. Measurements during standing up, sitting down and walking showed that shock (heel-strike) and skin movements, due to movements of the underlying muscle tissue, are the main error sources. Additional signal processing, e.g. low-pass filtering, can be used to diminish this error. The accuracy of the knee angle found is shown to be high enough to be used in a feedback controller for functional electrostimulation of the lower extremities.     

1H-NMR stereospecific assignments by conformational data-base searches

A search procedure is described for making stereospecific assignments at prochiral centers in proteins on the basis of nuclear Overhauser enhancement and coupling constant data derived from nmr experiments. A data base comprising torsion angles, associated 1H-1H coupling constants and interproton distances is searched by a computer algorithm for sets of values that match the experimental data within specified error limits. Two different data bases are used. The first is a crystallographic data base derived from 34 well-refined crystal structures; the second is a systematic data base derived from conformations of a short peptide fragment with idealized geometry by systematically varying the phi, psi, and chi 1 torsion angles. Both approaches are tested for beta-methylene groups with model data obtained from 20 crystal structures. The results for the two methods are similar though not identical, so that a combination of the two methods appears to be useful. With an appropriate choice of error estimates, around 80% of the beta-methylene groups could be assigned in the test calculations. In addition, results with experimental nmr data indicate that a similar percentage of stereospecific assignments can be made in practical situations.     

The interaction between two charged rods in an electrolyte solution

A problem on the electrostatic interaction of two homogeneously charged macromolecular rods of a finite length, submerged into an electrolyte solution was considered. An explicit expression for the energy of interaction and rotational moment as a function of the angle of rotation between the long axes of the molecules was obtained. At small angles of rotation, the expression for energy turns into the corresponding formula for parallel rods, and the rotational moment tends to zero, as it follows from geometrical considerations. The possibility is discussed whether the study is applicable to real biological systems, including liquid-crystalline dispersions of DNA.     

Cell death (apoptosis) in mouse intestine after continuous irradiation with gamma rays and with beta rays from tritiated water

Apoptosis is a pattern of cell death involving nuclear pycnosis, cytoplasmic condensation, and karyorrhexis. Apoptosis induced by continuous irradiation with gamma rays (externally given by a 137Cs source) or with beta rays (from tritiated water injected ip) was quantified in the crypts of two portions of mouse bowel, the small intestine and descending colon. The time-course change in the incidence of apoptosis after each type of radiation could be explained on the basis of the innate circadian rhythm of the cells susceptible to apoptotic death and of the excretion of tritiated water (HTO) from the body. For 6-h continuous gamma irradiation at various dose rates (0.6-480 mGy/h) and for 6 h after injection of HTO of various radioactivities (0.15-150 GBq per kg body wt), the relationships between dose and incidence of apoptosis were obtained. Survival curves were then constructed from the curves for dose vs incidence of apoptosis. For the calculation of the absorbed dose from HTO, the water content both of the mouse body and of the cells was assumed to be 70%. One megabecquerel of HTO per mouse (i.e., 40 MBq/kg body wt) gave a dose rate of 0.131 mGy/h. The mean lethal doses (D0) were calculated for gamma rays and HTO, and relative biological effectiveness values of HTO relative to gamma rays were obtained. The D0 values for continuous irradiation with gamma rays were 210 mGy for small intestine and 380 mGy for descending colon, and the respective values for HTO were 130 and 280 mGy, indicating the high radiosensitivity of target cells for apoptotic death. The relative biological effectiveness of HTO relative to 137Cs gamma rays for cell killing in both the small intestine and the descending colon in the mouse was 1.4-2.1.