An EPID-based method for comprehensive verification of gantry, EPID and the MLC carriage positional accuracy in Varian linacs during arc treatments

Background

]In modern radiotherapy, it is crucial to monitor the performance of all linac components including gantry, collimation system and electronic portal imaging device (EPID) during arc deliveries. In this study, a simple EPID-based measurement method has been introduced in conjunction with an algorithm to investigate the stability of these systems during arc treatments with the aim of ensuring the accuracy of linac mechanical performance.

The Varian EPID sag, gantry sag, changes in source-to-detector distance (SDD), EPID and collimator skewness, EPID tilt, and the sag in MLC carriages as a result of linac rotation were separately investigated by acquisition of EPID images of a simple phantom comprised of 5 ball-bearings during arc delivery. A fast and robust software package was developed for automated analysis of image data. Twelve Varian linacs of different models were investigated.

The average EPID sag was within 1 mm for all tested linacs. All machines showed less than 1 mm gantry sag. Changes in SDD values were within 1.7 mm except for three linacs of one centre which were within 9 mm. Values of EPID skewness and tilt were negligible in all tested linacs. The maximum sag in MLC leaf bank assemblies was around 1 mm. The EPID sag showed a considerable improvement in TrueBeam linacs.

The methodology and software developed in this study provide a simple tool for effective investigation of the behaviour of linac components with gantry rotation. It is reproducible and accurate and can be easily performed as a routine test in clinics.

Volumetric modulated arc therapy and breath-hold in image-guided locoregional left-sided breast irradiation

PURPOSE: To investigate the effects of using volumetric modulated arc therapy (VMAT) and/or voluntary moderate deep inspiration breath-hold (vmDIBH) in the radiation therapy (RT) of left-sided breast cancer including the regional lymph nodes.

MATERIALS AND METHODS: For 13 patients, four treatment combinations were compared; 3D-conformal RT (i.e., forward IMRT) in free-breathing 3D-CRT(FB), 3D-CRT(vmDIBH), 2 partial arcs VMAT(FB), and VMAT(vmDIBH). Prescribed dose was 42.56 Gy in 16 fractions. For 10 additional patients, 3D-CRT and VMAT in vmDIBH only were also compared.

RESULTS: Dose conformity, PTV coverage, ipsilateral and total lung doses were significantly better for VMAT plans compared to 3D-CRT. Mean heart dose (D(mean,heart)) reduction in 3D-CRT(vmDIBH) was between 0.9 and 8.6 Gy, depending on initial D(mean,heart) (in 3D-CRT(FB) plans). VMAT(vmDIBH) reduced the D(mean,heart) further when D(mean,heart) was still >3.2 Gy in 3D-CRT(vmDIBH). Mean contralateral breast dose was higher for VMAT plans (2.7 Gy) compared to 3DCRT plans (0.7 Gy).

CONCLUSIONS: VMAT and 3D-CRT(vmDIBH) significantly reduced heart dose for patients treated with locoregional RT of left-sided breast cancer. When Dmean,heart exceeded 3.2 Gy in 3D-CRT(vmDIBH) plans, VMAT(vmDIBH) resulted in a cumulative heart dose reduction. VMAT also provided better target coverage and reduced ipsilateral lung dose, at the expense of a small increase in the dose to the contralateral breast.

The Reliability of the Arc-Length Method in the Analysis of Mode-Jumping Problems

The Arc-Length Method is a solution procedure that enables a generic non-linear problem to pass limit points. Some examples are provided of mode-jumping problems solutions using a commercial nite element package, and other investigations are carried out on a simple structure of which the numerical solution can be compared with an analytical one. It is shown that Arc-Length Method is not reliable when bifurcations are present in the primary equilibrium path; also the presence of very sharp snap-backs or special boundary conditions may cause convergence diÆculty at limit points. An improvement to the predictor used in the incremental procedure is suggested, together with a reliable criteria for selecting either solution of the quadratic arc-length constraint. The gap that is sometimes observed between the experimantal load level of mode-jumping and its arc-length prediction is explained through an example.

Comparative Raman Study of Carbon Nanotubes Prepared by D.C. Arc Discharge and Catalytic Methods

The Raman spectra of carbon nanotubes prepared by catalytic (C-CNT) and d.c. arc discharge (D-CNT) methods are reported. A previously unnoticed third-order Raman peak at ca. 4248 cm-1 was observed in the Raman spectrum of D-CNT. The Raman features of D-CNT and C-CNT are similar to those of highly oriented pyrolytic graphite (HOPG) and active carbon, respectively. The data also suggest that the increase in disorder in D-CNT compared with HOPG is due to structural defects in D-CNT. © 1997 by John Wiley & Sons, Ltd.