ibo & sun nuclear - uke
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IBO & Sun Nuclear
Hans Ozimek
Neuruppin 27.- 28.03.08
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Sun Nuclear Corporation
>>Florida‟s Space Coast
• Private, founded 1984
• Experience since 1972
• Medical Physics, Nuclear Medicine,
Radon Monitoring
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Core Tools MapCHECK™ #1 Requirement: Built for IMRT QA
• Small detectors do not hide errors
• No warmup time, no waiting
• Calibration stable > 1 year
• User calibrated
#2 Requirement: Advanced features• Beam QA
• Film support: EBT & EDR2
• Anatomical structure filter
• MLC QA
• Respiratory Motion/Gating QA (XY/4D)
• EPID based analysis
• Combine feature to increase field size and data density
>> Over 50 publications, 5 years of clinical use
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Why Diodes?
IMRT fields are collections of small fields with steep dose gradients Small field beam scanning results are best with a
diode› The same is logically true with IMRT fields
Detector response for a 2cm x 2cm field
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Dose Volume Averaging
Case Study: Beam modeling error detected by
MapCHECK
Old model,
(6 mm chamber)New model
(2 mm detector)
The small diodes in MapCHECK detected the
beam modeling error in (a), where the data was
collected by a large volume ion chamber.
(a) (b)79% passed >95% passed
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MapCHECK: Current Version
TPSMeasured
Comparison
Profile / Histogram / Structure
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Anatomical Structure
Filter There is a need for more intuitive and clinically relevant
tools for IMRT QA
Relate QA “failures” to contoured BEV patient anatomy
Benefits
See if there are any „cold‟ spots in your PTV mass
See if there are any „hot‟ spots in the patient‟s critical
structures
Must account for patient isocenter, couch angle, gantry
angle when projecting structures
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How it Works 1) Select DICOM Structure & Patient Plan File
2) Select Beam
3) Accept Gantry Setup
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Structure Results
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MLC QAQuantitative Results
MLC
Analysis
1) Picket Fence Plan
2) Measure Picket Fence
3) View Results
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MLC Analysis
y = -0.2269x + 0.034
R2 = 0.9967
-60%
-40%
-20%
0%
20%
40%
60%
-2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 2 2.5
MLC gap offset [mm]
pic
ket
fen
ce A
vera
ge e
rro
r
“A 1mm MLC
error equates to
a MapCHECK
measured error
of 20%”
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MLC: Leaf by Leaf
Analysis data for each leaf pair
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MapCHECK XY/4DRespiratory Motion/Gating QA
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XY/4D Workflow
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Gantry 180
Gantry 225
Gantry 270
Gantry 315 Motion is Beam
Geometry Specific
BEV Motion Kernel
Non-Gated Gated
180
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XY/4D Interface
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XY: Increase Field Size,
Density
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XY/4D Applications Beam gating qualification
Study impact to moving targets (Structures, ITV, PTV)
Increase data density, field size
Supports:
Varian RPM
Siemens/Elekta Pressure Belt
Publications
“On the dose to a moving target while employing different IMRT delivery mechanisms”
Eric D. Ehler, Benjamin E. Nelms, Wolfgang A. ToméRadiotherapy & Oncology Journal of the ESTRO, Volume 83, Issue 1, pg. 49-56, April 2007
“Quality assurance device for four dimensional intensity modulated or stereotactic body radiation therapy and respiratory gating using patient specific intrafraction motion kernels”
Nelms, et.al.
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EPIDose Workflow
Dose
Raw
Images
Baseline
Absolute
Dose Data
TPS
Dose
QA Comparison in
MapCHECK
Physics
Modeling
Module
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From Image to Dose
TPS
EPID
140-145cm SPD
100cm SPD 100cm SPD
“Apples” to “Apples” Dose Plane
Comparisons
no buildup
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EPID Physics Modeling
Output vs. Field Size
Dose Redistribution Kernel
2D Wide Field Calibration
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EPID QA
The result?
EPIDose physics model smartly accounts for differences between EPID response and tissue dose
EPID imageEPID dose
EPID to Dose
Conversion Algorithms
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New Arrays