Dosimetric characterization of a microDiamond detector in clinical scanned carbon ion beams

Purpose: To investigate for the first time the dosimetric properties of a new commercial synthetic diamond detector (PTW microDiamond) in high-energy scanned clinical carbon ion beams generated by a synchrotron at the CNAO facility. Methods: The detector response was evaluated in a water phantom with actively scanned carbon ion beams ranging from 115 to 380 MeV/u (30-250 mm Bragg peak depth in water). Homogeneous square fields of 3×3 and 6×6 cm2 were used. Short- and medium-term (2 months) detector response stability, dependence on beam energy as well as ion type (carbon ions and protons), linearity with dose, and directional and dose-rate dependence were investigated. The depth dose curve of a 280 MeV/u carbon ion beam, scanned over a 3×3 cm² area, was measured with the microDiamond detector and compared to that measured using a PTW Advanced Markus ionization chamber, and also simulated using FLUKA Monte Carlo code. The detector response in two spread-out-Bragg-peaks (SOBPs), respectively, centered at 9 and 21 cm depths in water and calculated using the treatment planning system (TPS) used at CNAO, was measured. Results: A negligible drift of detector sensitivity within the experimental session was seen, indicating that no detector preirradiation was needed. Short-term response reproducibility around 1% (1 standard deviation) was found. Only 2% maximum variation of microDiamond sensitivity was observed among all the evaluated proton and carbon ion beam energies. The detector response showed a good linear behavior. Detector sensitivity was found to be dose-rate independent, with a variation below 1.3% in the evaluated dose-rate range. A very good agreement between measured and simulated Bragg curves with both microDiamond and Advanced Markus chamber was found, showing a negligible LET dependence of the tested detector. A depth dose curve was also measured by positioning the microDiamond with its main axis oriented orthogonally to the beam direction. A strong distortion in Bragg peak measurement was observed, confirming manufacturer recommendation on avoiding such configuration. Very good results were obtained for SOBP measurements, with a difference below 1% between measured and TPS-calculated doses. The stability of detector sensitivity in the observation period was within the experimental uncertainty. Conclusions: Dosimetric characterization of a PTW microDiamond detector in high-energy scanned carbon ion beams was performed. The results of the present study showed that this detector is suitable for dosimetry of clinical carbon ion beams, with a negligible LET and dose-rate dependence

Modulated electron radiation therapy: an investigation on fast beam models and radiation-tolerant solutions for automated motion control of a few leaf electron collimator

The purpose of this study was to address two specific issues related with the clinical application of Modulated Electron Radiation Therapy (MERT). The first was to investigate radiation-tolerant solutions for automated motion control of a Few Leaf Electron Collimator. Secondly, we implemented a fast, Monte Carlo-based, parameterized beam model for characterization of the electron beam in modulated deliveries.Two approaches were investigated for the implementation of a radiation-tolerant position feedback system: (i) the use of CMOS-based optical encoders protected by a prototype shield and (ii) the use of an analog device, such as a potentiometer, whose radiation tolerance is significantly higher. The two approaches were implemented and their performance tested. Results indicated that the optical encoders could not be safely used under radiation even with the presence of a shield. The analog position feedback system showed to be a viable solution. Future work will be focused towards the direction of implementing an analog position feedback system suitable for clinical use.The MC-based, parameterized beam model is based on the idea of deriving the scattered electron beam characteristics directly on the exit plane of the linear accelerator by the use of source scatter fluence kernels. Primary beam characteristics are derived by fast Monte Carlo simulations. The novelty of the method is that arbitrary rectangular fields can be recreated fast by superposition of the appropriate source kernels directly on the output plane. Depth, profile dose distributions and dose output, were derived for three field sizes (8 x 8, 2 x 2 and 2 x 8 cm^2) and energies of 6 MeV and 20 MeV electron beams by the beam model and compared with full Monte Carlo simulations. The primary beam showed excellent agreement in all cases. Scattered particles agreed well for the larger field sizes of 8 x 8 and 2 x 8 cm^2, while discrepancies were encountered for scattered particles for the smaller field size of 2 x 2 cm^2. Sources of errors were identified and future work will focus on the improvement of the beam model.L'objectif primaire du projet est d'explorer des solutions de radiation dures pour le contrôle dynamique d'un collimateur d'électrons à lames dans le contexte de la radiothérapie par modulation d'électrons. De plus, un modèle de faisceau paramétrique basé sur la méthode Monte-Carlo (MC) a été implémenté pour la caractérisation du faisceau d'électrons durant les traitements modulés. Deux approches ont été étudiées pour le développement d'un système de positionnement à boucle rétroactif pour la radiation dure : (i) des encodeurs optique CMOS protégés par un bouclier prototype (ii) et des composantes analogues telles que les potentiomètres avec une tolérance de radiation relativement élevée. La comparaison des deux méthodes montre que les encodeurs optiques ne peuvent subir de radiation, même en présence d'un bouclier adapté. De ce fait, pour l'utilisation clinique, les solutions basées sur les composantes analogues sont plus prometteuses et doivent être étudiées en détails à l'avenir.Le model MC de faisceau paramétrique vise la caractérisation du faisceau d'électrons diffusé directement sur la surface de sortie de l'accélérateur linéaire à l'aide de noyaux de fluence pour la diffusion des sources. Les caractéristiques primaires du faisceau sont obtenues par les méthodes de MC rapides. La nouveauté de la méthode réside dans la reproduction rapide de champs rectangulaires par la superposition de noyaux appropriés directement sur la surface de sortie. Profondeur, distribution dosimétrique de profil, et résultat de dose, sont calculés à partir de trois champs (8 x 8, 2 x 2, 2 x 8 cm^2) et des énergies de 6 MeV et 20 MeV, et sont comparés aux simulations MC. Le faisceau primaire montre une excellente cohérence dans tout les cas. Les résultats pour les particules diffusées étaient consistants pour les deux méthodes dans le cas de champs plus larges (8 x 8 et 2 x 8 cm^2) alors que des divergences ont été notées pour les petits champs (2 x 2 cm^2). Les sources d'erreurs ont été identifiées et la recherche ultérieure visera donc l'amélioration du modèle de faisceau

On the correction, perturbation and modification of small field detectors in relative dosimetry

The purpose of this study was to derive a complete set of correction and perturbation factors for output factors (OF) and dose profiles. Modern small field detectors were investigated including a plastic scintillator (Exradin W1, SI), a liquid ionization chamber (microLion 31018, PTW), an unshielded diode (Exradin D1V, SI) and a synthetic diamond (microDiamond 60019, PTW). A Monte Carlo (MC) beam model was commissioned for use in small fields following two commissioning procedures: (1) using intermediate and moderately small fields (down to 2 7 2 cm2) and (2) using only small fields (0.5 7 0.5 cm2-2 7 2 cm2). In the latter case the detectors were explicitly modelled in the dose calculation. The commissioned model was used to derive the correction and perturbation factors with respect to a small point in water as suggested by the Alfonso formalism. In MC calculations the design of two detectors was modified in order to minimize or eliminate the corrections needed. The results of this study indicate that a commissioning process using large fields does not lead to an accurate estimation of the source size, even if a 2 7 2 cm2 field is included. Furthermore, the detector should be explicitly modelled in the calculations. On the output factors, the scintillator W1 needed the smallest correction (+0.6%), followed by the microDiamond (+1.3%). Larger corrections were observed for the microLion (+2.4%) and diode D1V (-2.4%). On the profiles, significant corrections were observed out of the field on the gradient and tail regions. The scintillator needed the smallest corrections (-4%), followed by the microDiamond (-11%), diode D1V (+13%) and microLion (-15%). The major perturbations reported were due to volume averaging and high density materials that surround the active volumes. These effects presented opposite trends in both OF and profiles. By decreasing the radius of the microLion to 0.85 mm we could modify the volume averaging effect in order to achieve a discrepancy less than 1% for OF and 5% for profiles compared to water. Similar results were observed for the diode D1V if the radius was increased to 1 mm.Peer reviewed: YesNRC publication: Ye

On the correction, perturbation and modification of small field detectors in relative dosimetry

The purpose of this study was to derive a complete set of correction and perturbation factors for output factors (OF) and dose profiles. Modern small field detectors were investigated including a plastic scintillator (Exradin W1, SI), a liquid ionization chamber (microLion 31018, PTW), an unshielded diode (Exradin D1V, SI) and a synthetic diamond (microDiamond 60019, PTW). A Monte Carlo (MC) beam model was commissioned for use in small fields following two commissioning procedures: (1) using intermediate and moderately small fields (down to 2 7 2 cm2) and (2) using only small fields (0.5 7 0.5 cm2-2 7 2 cm2). In the latter case the detectors were explicitly modelled in the dose calculation. The commissioned model was used to derive the correction and perturbation factors with respect to a small point in water as suggested by the Alfonso formalism. In MC calculations the design of two detectors was modified in order to minimize or eliminate the corrections needed. The results of this study indicate that a commissioning process using large fields does not lead to an accurate estimation of the source size, even if a 2 7 2 cm2 field is included. Furthermore, the detector should be explicitly modelled in the calculations. On the output factors, the scintillator W1 needed the smallest correction (+0.6%), followed by the microDiamond (+1.3%). Larger corrections were observed for the microLion (+2.4%) and diode D1V (-2.4%). On the profiles, significant corrections were observed out of the field on the gradient and tail regions. The scintillator needed the smallest corrections (-4%), followed by the microDiamond (-11%), diode D1V (+13%) and microLion (-15%). The major perturbations reported were due to volume averaging and high density materials that surround the active volumes. These effects presented opposite trends in both OF and profiles. By decreasing the radius of the microLion to 0.85 mm we could modify the volume averaging effect in order to achieve a discrepancy less than 1% for OF and 5% for profiles compared to water. Similar results were observed for the diode D1V if the radius was increased to 1 mm.Peer reviewed: YesNRC publication: Ye

Technical Note: Evaluation of plastic scintillator detector for small field stereotactic patient-specific quality assurance

PURPOSE: To evaluate the performance of a commercial plastic scintillator detector (PSD) for small-field stereotactic patient-specific quality assurance (QA) measurements using flattening-filter-free beam. METHODS: A total of 10 spherical targets [volume range: (0.03 cc-2 cc)] were planned with two techniques: (a) dynamic conformal arc (DCA-10 plans) and (b) volumetric modulated arc therapy (VMAT-10 plans). All plans were generated using Varian Eclipse treatment planning system, and AcurosXB v.13 algorithm in 1.0 mm grid size. Additionally, 14 previously treated cranial and spine SRS plans were evaluated [6 DCA, 8 VMAT, volume range: (0.04 cc-119.02 cc)]. Plan modulation was quantified via two metrics: MU per prescription dose (MU/Rx) and Average Leaf Pair Opening (ALPO). QA was performed on the Varian Edge linear accelerator equipped with HDMLC. Three detectors were used: (a) PinPoint ion chamber (PTW; active volume 0.015 cc), (b) Exradin W1 PSD (Standard Imaging; active volume 0.002 cc), and (c) Gafchromic EBT3 film (Ashland). PinPoint chamber and PSD were positioned perpendicular to beam axis in a Lucy phantom (Standard Imaging); films were placed horizontally capturing the coronal plane. RESULTS: PSD, film, and PinPoint chamber measured average differences of 1.00 ± 1.54%, 1.30 ± 1.69%, and -0.66 ± 2.36%, respectively, compared to AcurosXB dose calculation. As the target volume decreased, PinPoint chamber measured lower doses (maximum -5.07% at 0.07 cc target), while PSD and film measured higher doses (2.87% and 2.54% at 0.03 cc target) than AcurosXB. Film agreed with the benchmark detector PSD by an average difference of 0.31 ± 1.20%, but suffered from larger uncertainty; PinPoint chamber underestimated dose by more than 4% for targets smaller than 0.2 cc. Taking PSD as the measurement standard, DCA plans achieved good QA results across all volumes studied, with an average of -0.07 ± 0.89%; for VMAT plans, PSD measured consistently higher dose (1.95 ± 1.36%) than AcurosXB. Correlation study revealed that plan modulation quantified by both MU/Rx and ALPO correlated significantly with QA results. CONCLUSION: Among all three detectors, PSD demonstrated superior performances in plans with small fields and heavy modulation. High consistency and low uncertainty made PSD a suitable detector for clinical routine SRS QA. PinPoint chamber should be avoided for targets smaller than 0.2 cc; film dosimetry can be utilized with careful evaluation of its uncertainty bracket. Compared to PSD measurements, AcurosXB calculation demonstrated high accuracy for nonmodulated small fields. The positive correlation between plan modulation and QA discrepancy calls for our attention for clinical SRS plans with high modulation

Clinical assessment of deep learning-based uncertainty maps in lung cancer segmentation

OBJECTIVE: Prior to radiation therapy planning, accurate delineation of gross tumour volume (GTVs) and organs at risk (OARs) is crucial. In the current clinical practice, tumour delineation is performed manually by radiation oncologists, which is time-consuming and prone to large inter-observer variability. With the advent of deep learning (DL) models, automated contouring has become possible, speeding up procedures and assisting clinicians. However, these tools are currently used in the clinic mostly for contouring OARs, since these systems are not reliable yet for contouring GTVs. To improve the reliability of these systems, researchers have started exploring the topic of probabilistic neural networks. However, there is still limited knowledge of the practical implementation of such networks in real clinical settings. APPROACH: In this work, we developed a 3D probabilistic system that generates DL-based uncertainty maps for lung cancer CT segmentations. We employed the Monte Carlo (MC) dropout technique to generate probabilistic and uncertainty maps, while the model calibration was evaluated by using reliability diagrams. A clinical validation was conducted in collaboration with a radiation oncologist to qualitatively assess the value of the uncertainty estimates. We also proposed two novel metrics, namely mean uncertainty (MU) and relative uncertainty volume (RUV), as potential indicators for clinicians to assess the need for independent visual checks of the DL-based segmentation. MAIN RESULTS: Our study showed that uncertainty mapping effectively identified cases of under or over-contouring. Although the overconfidence of the model, a strong correlation was observed between the clinical opinion and MU metric. Moreover, both MU and RUV revealed high AUC values in discretising between low and high uncertainty cases. SIGNIFICANCE: Our study is one of the first attempts to clinically validate uncertainty estimates in DL-based contouring. The two proposed metrics exhibited promising potential as indicators for clinicians to independently assess the quality of tumour delineation