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Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

The Radiation Planning Assistant (RPA) is a system developed for the fully automated creation of radiotherapy treatment plans, including volume-modulated ...

University of Texas MD Anderson Cancer Center

To investigate the dosimetric impact of the heterogeneity dose calculation Acuros (Transpire Inc., Gig Harbor, WA), a grid-based Boltzmann equation solver (GBBS), for brachytherapy in a cohort of cervical cancer patients.

Impact of heterogeneity-based dose calculation using a deterministic grid-based Boltzmann equation solver for intracavitary brachytherapy.

The purpose of this study was to verify the dosimetric performance of Acuros XB (AXB), a grid-based Boltzmann solver, in intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT).

Experimental validation of deterministic Acuros XB algorithm for IMRT and VMAT dose calculations with the Radiological Physics Center's head and neck phantom.

A dose calculation verification system (VS) was acquired and commissioned as a second check on the treatment planning system (TPS). This system reads DICOM CT datasets, RT plans, RT structures, and RT dose from the TPS and automatically, using its own collapsed cone superposition/convolution algorithm, computes dose on the same CT dataset. The system was commissioned by extracting basic beam parameters for simple field geometries and dose verification for complex treatments. Percent depth doses (PDD) and profiles were extracted for field sizes using jaw settings 3 × 3 cm2 - 40 × 40 cm2 and compared to measured data, as well as our TPS model. Smaller fields of 1 × 1 cm2 and 2 × 2 cm2 generated using the multileaf collimator (MLC) were analyzed in the same fashion as the open fields. In addition, 40 patient plans consisting of both IMRT and VMAT were computed and the following comparisons were made: 1) TPS to the VS, 2) VS to measured data, and 3) TPS to measured data where measured data is both ion chamber (IC) and film measurements. Our results indicated for all field sizes using jaw settings PDD errors for the VS on average were less than 0.87%, 1.38%, and 1.07% for 6x, 15x, and 18x, respectively, relative to measured data. PDD errors for MLC field sizes were less than 2.28%, 1.02%, and 2.23% for 6x, 15x, and 18x, respectively. The infield profile analysis yielded results less than 0.58% for 6x, 0.61% for 15x, and 0.77% for 18x for the VS relative to measured data. Analysis of the penumbra region yields results ranging from 66.5% points, meeting the DTA criteria to 100% of the points for smaller field sizes for all energies. Analysis of profile data for field sizes generated using the MLC saw agreement with infield DTA analysis ranging from 68.8%-100% points passing the 1.5%/1.5 mm criteria. Results from the dose verification for IMRT and VMAT beams indicated that, on average, the ratio of TPS to IC and VS to IC measurements was 100.5 ± 1.9% and 100.4 ± 1.3%, respectively, while our TPS to VS was 100.1 ± 1.0%. When comparing the TPS and VS to film measurements, the average percentage pixels passing a 3%/3mm criteria based gamma analysis were 96.6 ± 4.2% and 97 ± 5.6%, respectively. When the VS was compared to the TPS, on average 98.1 ± 5.3% of pixels passed the gamma analysis. Based upon these preliminary results, the VS system should be able to calculate dose adequately as a verification tool of our TPS.

Commissioning results of an automated treatment planning verification system.

To investigate the inter- and intra-fraction motion associated with the use of a low-cost tape immobilization technique as an alternative to thermoplastic immobilization masks for whole-brain treatments. The results of this study may be of interest to clinical staff with severely limited resources (e.g., in low-income countries) and also when treating patients who cannot tolerate standard immobilization masks. Setup reproducibility of eight healthy volunteers was assessed for two different immobilization techniques. (a) One strip of tape was placed across the volunteer's forehead and attached to the sides of the treatment table. (b) A second strip was added to the first, under the chin, and secured to the table above the volunteer's head. After initial positioning, anterior and lateral photographs were acquired. Volunteers were positioned five times with each technique to allow calculation of inter-fraction reproducibility measurements. To estimate intra-fraction reproducibility, 5-minute anterior and lateral videos were taken for each technique per volunteer. An in-house software was used to analyze the photos and videos to assess setup reproducibility. The maximum intra-fraction displacement for all volunteers was 2.8 mm. Intra-fraction motion increased with time on table. The maximum inter-fraction range of positions for all volunteers was 5.4 mm. The magnitude of inter-fraction and intra-fraction motion found using the "1-strip" and "2-strip" tape immobilization techniques was comparable to motion restrictions provided by a thermoplastic mask for whole-brain radiotherapy. The results suggest that tape-based immobilization techniques represent an economical and useful alternative to the thermoplastic mask.

Kelly Kisling

Department of Radiation Physics

University of Texas MD Anderson Cancer Center

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System