Recent progress in radiation therapy has been greatly enhanced in many facilities by the development of new machines for treatment, improved computer technology for radiotherapy treatment planning systems (RTPs), increased accuracy of radiation therapy such as stereotactic irradiation, and intensity-modulated radiation therapy (IMRT). Quality control (QC) of the isocenter, which has consisted of gantry rotation and limiting the radiation field, is important for greater accuracy of these radiation therapy technologies. Starshot analyses using computed radiography (CR) for evaluation of the isocenter were employed in this study. Devices to support CR were created, and a method of automatically analyzing images obtained by the starshot technique, which calculated the error (distance) from the isocenter and the incident beam angle, were developed. In terms of the accuracy of our method, the average maximum error was 0.33 mm (less than 2 pixels: 0.35 mm), the average absolute error and incident beam angle errors were 0.3 mm and 0.4 degrees at maximum and at one standard deviation (SD), respectively. In this study, the processing times were 16 sec at minimum, 152 sec at maximum, 18 sec at most frequencies, and 23.6 sec on average. In conclusion, it was considered that our newly developed method for analyzing star-shot images using CR enabled immediate, quantitative evaluation of the isocenter.
Respiratory-gated (RG) radiotherapy is useful for minimizing the irradiated volume of normal tissues resulting from the shifting of internal structures caused by respiratory movement. The present study was conducted to evaluate the treatment field in RG radiotherapy using a phantom system simulating patient respiration. A phantom system consisting of a 3-cm ball-shaped dummy tumor and film placed in a cork lung phantom was used (THK Co., Ltd.). RG radiotherapy was employed in the expiratory phase. The phantom movement distance was set to 2 cm, and the gating signals from a respiratory-gating system (AZ-733V, Anzai Medical) were varied. The settings used for irradiation were an X-ray energy of 6 MV (PRIMUS, Toshiba Medical Systems), treatment field of 5 cm × 7 cm, and X-ray dose of 100 MU. Images were acquired using an electric portal-imaging device (EPID, OPTIVUE 500), and the X-ray dose distribution was measured by the film method. In images acquired using the EPID, the tumor margins became less clear when the gating signals were increased, and the ITVs were determined to be 3.6 cm, 3.7 cm, 4.2 cm, and 5.1 cm at gating rates of 10%, 25%, 50%, and no gate, respectively. With regard to the X-ray dose distribution measured by the film method, the dose profile in the cephalocaudal direction was shifted toward the expiratory phase, and the degree of shift became greater when the gating signals were increased. In addition, the optimal treatment fields in the cephalocaudal direction were determined to be 5.2 cm, 5.2 cm, 5.6 cm, and 7.0 cm at gating rates of 10%, 25%, 50%, and no gating, respectively. Although RG radiotherapy is useful for improving the accuracy of radiotherapy, the characteristics of the RG radiotherapy technique and the radiotherapy system must be clearly understood when this method is to be employed in clinical practice. Image-guided radiotherapy (IGRT) is now assuming a central role in radiotherapy, and properly identifying internal margins is an important issue for ensuring optimal treatment. The results of this study confirmed that it is necessary to ensure the optimal treatment field in radiotherapy of the trunk and that it is essential to confirm tumor position on the basis of image evaluation.
To more easily estimate accurate values of collimator scatter facor, Sc , we suggest a two-component saturation model that accounts for scatter from the primary collimator and flattening filter and from the collimator jaws. This model, which assumes an exponential distribution of scatter intensity, was tested by in-air measurements using a mini-phantom for 4 MV and 10 MV X-rays of a Clinac 2100 C/D linear accelerator. The results showed a good fit of this model to our measured data (R2>0.9993). When the measured value was divided into the primary collimator/flattening filter component and the collimator jaw component, as expected, the former component showed a rapid and full saturation curve with increased field size, while the latter showed an almost linearly increasing curve. Therefore, we think that this saturation model is useful for the estimation of Sc and is applicable to monitor unit calculation for an asymmetric field.
The purpose of this study was to develop an efficient method of determining gate-on and -off timing in respiration-gated radiotherapy. Gate-on and -off timing in a breathing cycle were defined as the respiratory signal level for the start of irradiation (Ls) in the expiration phase and that for the end of irradiation (Le) in the inspiration phase, respectively. Thirty subjects participated in this study. The diaphragm was used as the tracking target, and time-dependent changes in the position of the target were measured together with those in the respiratory signal level. For each subject, the following maps were created by varying the combination of Ls and Le: absolute target displacement (ATD) map, relative target displacement (RTD) map, and gate-on duty cycle (GDC) map. By classifying respiratory signal waveforms, three respiratory types were derived (A: the length of end-expiration level >40% of a breathing cycle, B: the length of end-expiration level ≤40% and that of end-inspiration level >20% of a breathing cycle, and C: the length of end-expiration level ≤40% and that of end-inspiration level ≤20% of a breathing cycle). For each respiratory type, average RTD and GDC maps were created. We presented an algorithm to obtain the optimal Ls and Le using the RTD (or ATD) and GDC maps, and this algorithm was verified by demonstrating that, in determining Ls and Le for a subject, the average RTD and GDC maps corresponding to the subject's respiratory type could be used effectively.
We proposed a formula for the enhanced dynamic wedge (EDW) factor in the half-field (HF) that combined the formula proposed by Liu et al. in 1998 and their formula in 2003. When the EDW was used for irradiation to the tangent line of the HF breast, the values calculated by our formula and the measured values were consistent within 0.5%. We showed that our proposed formula was useful, easy to use, and more accurate than the conventional formula. The purpose of this study was to examine the available range of the wedge factor of symmetrical and asymmetric EDW calculated by our formula. As a result of the examination, the values calculated by our formula and the measured values were consistent within 2% except for highly asymmetric EDW. We created a spreadsheet to calculate the wedge factor easily and accurately. We will examine the reason why the calculated and measured values were greater than 2%, and improve our formula so that it can be used in a wider range.
High-resolution film dosimetry has been used for several decades to check and to measure two-dimensional dose distributions. However, in recent years, the automatic processor has been replaced by the spread of computed radiography, or has been little used hospitals. In this study, we measured the off-center ratio (OCR) of the open field, after an irradiating radiation beam was delivered to the imaging plate (IP) under conditions in which the IP was exposed to a fixed amount of light with fading, and compared these data with the OCR measured by an ionization-chamber dosimeter, which is the standard method used for measuring radiation dose. Profile measurement using IP could be achieved by performing light fading, even at a range of more than 100 MU. Further, by using a metallic filter, we succeeded in demonstrating that the profile measurement of IP in an open irradiation field could approximate the values of those obtained by an ionization chamber dosimeter. This method can serve as a simple, easy-to-use method for evaluating the QA of dose distribution in radiation therapy.