Two cascaded SOAs used as intensity modulators for adaptively modulated optical OFDM signals in optical access networks

Detailed theoretical and numerical investigations of the transmission performance of adaptively modulated optical orthogonal frequency division multiplexed (AMOOFDM) signals are undertaken, for the first time, in optical amplification and chromatic dispersion (CD) compensation free single mode fiber (SMF) intensity-modulated and directdetection (IMDD) systems using two cascaded semiconductor optical amplifiers in a counterpropagating configuration as an intensity modulator (TC-SOA-CC-IM). A theoretical model describing the characteristics of this configuration is developed. Extensive performance comparisons are also made between the TC-SOA-CC and the single SOA intensity modulators. It is shown that, the TC-SOA-CC reaches its strongly saturated region using a lower input optical power much faster than the single SOA resulting in significantly reduced effective carrier lifetime and thus wide TC-SOA-CC bandwidths. It is shown that at low input optical power, we can increase the signal line rate almost 115% which will be more than twice the transmission performance offered by single SOA. In addition, the TCSOA-CC-IM is capable of supporting signal line rates higher than corresponding to the SOA-IM by using 10dB lower input optical powers. For long transmission distance, the TC-SOA-CC-IM has much stronger CD compensation capability compared to the SOA-IM. In addition the use of TC-SOA-CC-IM is more effective regarding the capability to benefit from the CD compensation for shorter distances starting at 60km SMF, whilst for the SOA-IM starting at 90km. © 2014 Optical Society of America.

Turn-on-time statistics of modulated lasers subjected to resonant weak optical feedback

We present analytical calculations of the turn-on-time probability distribution of intensity-modulated lasers under resonant weak optical feedback. Under resonant conditions, the external cavity round-trip time is taken to be equal to the modulation period. The probability distribution of the solitary laser results are modified to give reduced values of the mean turn-on-time and its variance. Numerical simulations have been carried out showing good agreement with the analytical results.

Electron intensity modulation for mixed-beam radiation therapy with an x-ray multi-leaf collimator

The current standard treatment for head and neck cancer at our institution uses intensity-modulated x-ray therapy (IMRT), which improves target coverage and sparing of critical structures by delivering complex fluence patterns from a variety of beam directions to conform dose distributions to the shape of the target volume. The standard treatment for breast patients is field-in-field forward-planned IMRT, with initial tangential fields and additional reduced-weight tangents with blocking to minimize hot spots. For these treatment sites, the addition of electrons has the potential of improving target coverage and sparing of critical structures due to rapid dose falloff with depth and reduced exit dose. In this work, the use of mixed-beam therapy (MBT), i.e., combined intensity-modulated electron and x-ray beams using the x-ray multi-leaf collimator (MLC), was explored. The hypothesis of this study was that addition of intensity-modulated electron beams to existing clinical IMRT plans would produce MBT plans that were superior to the original IMRT plans for at least 50% of selected head and neck and 50% of breast cases. Dose calculations for electron beams collimated by the MLC were performed with Monte Carlo methods. An automation system was created to facilitate communication between the dose calculation engine and the treatment planning system. Energy and intensity modulation of the electron beams was accomplished by dividing the electron beams into 2x2-cm2 beamlets, which were then beam-weight optimized along with intensity-modulated x-ray beams. Treatment plans were optimized to obtain equivalent target dose coverage, and then compared with the original treatment plans. MBT treatment plans were evaluated by participating physicians with respect to target coverage, normal structure dose, and overall plan quality in comparison with original clinical plans. The physician evaluations did not support the hypothesis for either site, with MBT selected as superior in 1 out of the 15 head and neck cases (p=1) and 6 out of 18 breast cases (p=0.95). While MBT was not shown to be superior to IMRT, reductions were observed in doses to critical structures distal to the target along the electron beam direction and to non-target tissues, at the expense of target coverage and dose homogeneity. ^

Volumetric Modulated Arc Therapy Evaluation with the Radiological Physics Center Head and Neck Phantom

Validation of treatment plan quality and dose calculation accuracy is essential for new radiotherapy techniques, including volumetric modulated arc therapy (VMAT). VMAT delivers intensity modulated radiotherapy treatments while simultaneously rotating the gantry, adding an additional level of complexity to both the dose calculation and delivery of VMAT treatments compared to static gantry IMRT. The purpose of this project was to compare two VMAT systems, Elekta VMAT and Varian RapidArc, to the current standard of care, IMRT, in terms of both treatment plan quality and dosimetric delivery accuracy using the Radiological Physics Center (RPC) head and neck (H&N) phantom. Clinically relevant treatment plans were created for the phantom using typical prescription and dose constraints for Elekta VMAT (planned with Pinnacle3 Smart Arc) and RapidArc and IMRT (both planned with Eclipse). The treatment plans were evaluated to determine if they were clinically comparable using several dosimetric criteria, including ability to meet dose objectives, hot spots, conformity index, and homogeneity index. The planned treatments were delivered to the phantom and absolute doses and relative dose distributions were measured with thermoluminescent dosimeters (TLDs) and radiochromic film, respectively. The measured and calculated doses of each treatment were compared to determine if they were clinically acceptable based upon RPC criteria of ±7% dose difference and 4 mm distance-to-agreement. Gamma analysis was used to assess dosimetric accuracy, as well. All treatment plans were able to meet the dosimetric objectives set by the RPC and had similar hot spots in the normal tissue. The Elekta VMAT plan was more homogenous but less conformal than the RapidArc and IMRT plans. When comparing the measured and calculated doses, all plans met the RPC ±7%/4 mm criteria. The percent of points passing the gamma analysis for each treatment delivery was acceptable. Treatment plan quality of the Elekta VMAT, RapidArc and IMRT treatments were comparable for consistent dose prescriptions and constraints. Additionally, the dosimetric accuracy of the Elekta VMAT and RapidArc treatments was verified to be within acceptable tolerances.

Valutazione dosimetrica e aspetti tecnici di trattamenti VMAT (Volumetric Modulated Arc Therapy) in radioterapia oncologica

La VMAT (Volumetric Modulated Arc Therapy) è una delle più recenti tecniche radioterapiche, in cui, oltre alla modulazione geometrica della fluenza del campo di radiazione come avviene nell’IMRT (Intensity Modulated Radiotherapy), sono variati durante il trattamento anche la velocità del gantry e il rateo di dose. La radiazione è erogata senza interruzioni lungo uno o più archi continui della testata dell’acceleratore, così da ridurre i tempi di trattamento in modo sostanziale rispetto all’IMRT. Nelle tecniche ad intensità modulata, ed in particolare nella VMAT, il lettino porta paziente modifica la distribuzione di dose durante gli irraggiamenti posteriori, riducendo quella al target e aumentando quella superficiale. Il presente lavoro di tesi, che ha proprio l’obiettivo di valutare questi aspetti dosimetrici in un’ottica pre-clinica, è stato svolto presso il Servizio di Fisica Sanitaria del Policlinico S.Orsola–Malpighi, Azienda Ospedaliero-Universitaria di Bologna. Le misure sono state effettuate presso le U.O. Radioterapia-Morganti e Radioterapia-Frezza f.f. della medesima Azienda Sanitaria, al fine di caratterizzare dal punto di vista dosimetrico il lettino di trattamento iBEAM evo dell’acceleratore lineare Synergy Elekta. L’attenuazione misurata in caso di incidenza perpendicolare del fascio sul lettino, in buon accordo con gli articoli di riferimento, è stata: (2.81±0.06)% per fotoni di energia di 6 MV, (1.81±0.10)% a 10 MV e (1.38±0.05)% a 15 MV. L’attenuazione massima misurata con fotoni di energia di 6 MV si è avvicinata al 4% negli irraggiamenti obliqui. Infine, è stato analizzato il confronto con statistica gamma fra distribuzione di dose pianificata e misurata prima e dopo aver modellizzato le caratteristiche del lettino nel software per l’elaborazione del piano di trattamento. Solo dopo tale operazione, i due casi VMAT analizzati (tumore dell’orofaringe e prostatico) superano i criteri più restrittivi e affidabili utilizzati nella pratica clinica.

Comparação dos efeitos secundários agudos da Radioterapia por intensidade modulada com a Radioterapia tridimensional conformada no carcinoma de próstata

Introdução: Este trabalho tem como principal objectivo comparar os efeitos secundários agudos da Radioterapia por Intensidade Modulada (IMRT) e a Radioterapia Tridimensional Conformada (3 D-CRT) no carcinoma de Próstata; Materiais e métodos: Foram observados os processos clínicos de 30 doentes e analisados os efeitos colaterais da RT ocorridos no decurso do tratamento. Resultados: A percentagem de toxicidade aguda dermatológica foi superior no grupo tratado com 3D-CRT. Nenhum doente apresentou toxicidade aguda grave. Conclusões: O tamanho reduzido da amostra e a ausência de valores estatisticamente significativos, não permite concluir a influência da técnica de RT no desenvolvimento de efeitos secundários agudos.

Comparação de diferentes técnicas de irradiação de mama em radioterapia com recurso a acelerador linear em modo de fotões

RESUMO: Introdução – A Radioterapia (RT) é uma abordagem terapêutica para tratamento de neoplasia de mama. Contudo, diferentes técnicas de irradiação (TI) podem ser usadas. Objetivos – Comparar 4 TI, considerando a irradiação dos volumes alvo (PTV) e dos órgãos de risco (OAR). Metodologia – Selecionaram-se 7 pacientes com indicação para RT de mama esquerda. Sobre tomografia computorizada foram feitos os contornos do PTV e dos OAR. Foram calculadas 4 planimetrias/paciente para as TI: conformacional externa (EBRT), intensidade modulada com 2 (IMRT2) e 5 campos (IMRT5) e arco dinâmico (DART). Resultados – Histogramas de dose volume foram comparados para todas as TI usando o software de análise estatística, IBM SPSS v20. Com IMRT5 e DART, os OAR recebem mais doses baixas. No entanto, IMRT5 apresenta melhores índices de conformidade e homogeneidade para o PTV. Conclusões – IMRT5 apresenta o melhor índice de conformidade; EBRT e IMRT2 apresentam melhores resultados que DART. Há d.e.s entre as TI, sobretudo em doses mais baixas nos OAR.

Evaluation of IMRT and VMAT techniques with and without flattening filter using pareto optimal fronts

Mestrado em Radiações Aplicadas às Tecnologias da Saúde.

Avaliação da margem do PTV em tumores ginecológicos com irradiação dos gânglios lomboaórticos, que realizaram IMRT

Mestrado em Radioterapia.

The use of non-standard CT conversion ramps for Monte Carlo verification of 6 MV prostate IMRT plans

Monte Carlo (MC) dose calculation algorithms have been widely used to verify the accuracy of intensity-modulated radiotherapy (IMRT) dose distributions computed by conventional algorithms due to the ability to precisely account for the effects of tissue inhomogeneities and multileaf collimator characteristics. Both algorithms present, however, a particular difference in terms of dose calculation and report. Whereas dose from conventional methods is traditionally computed and reported as the water-equivalent dose (Dw), MC dose algorithms calculate and report dose to medium (Dm). In order to compare consistently both methods, the conversion of MC Dm into Dw is therefore necessary. This study aims to assess the effect of applying the conversion of MC-based Dm distributions to Dw for prostate IMRT plans generated for 6 MV photon beams. MC phantoms were created from the patient CT images using three different ramps to convert CT numbers into material and mass density: a conventional four material ramp (CTCREATE) and two simplified CT conversion ramps: (1) air and water with variable densities and (2) air and water with unit density. MC simulations were performed using the BEAMnrc code for the treatment head simulation and the DOSXYZnrc code for the patient dose calculation. The conversion of Dm to Dw by scaling with the stopping power ratios of water to medium was also performed in a post-MC calculation process. The comparison of MC dose distributions calculated in conventional and simplified (water with variable densities) phantoms showed that the effect of material composition on dose-volume histograms (DVH) was less than 1% for soft tissue and about 2.5% near and inside bone structures. The effect of material density on DVH was less than 1% for all tissues through the comparison of MC distributions performed in the two simplified phantoms considering water. Additionally, MC dose distributions were compared with the predictions from an Eclipse treatment planning system (TPS), which employed a pencil beam convolution (PBC) algorithm with Modified Batho Power Law heterogeneity correction. Eclipse PBC and MC calculations (conventional and simplified phantoms) agreed well (<1%) for soft tissues. For femoral heads, differences up to 3% were observed between the DVH for Eclipse PBC and MC calculated in conventional phantoms. The use of the CT conversion ramp of water with variable densities for MC simulations showed no dose discrepancies (0.5%) with the PBC algorithm. Moreover, converting Dm to Dw using mass stopping power ratios resulted in a significant shift (up to 6%) in the DVH for the femoral heads compared to the Eclipse PBC one. Our results show that, for prostate IMRT plans delivered with 6 MV photon beams, no conversion of MC dose from medium to water using stopping power ratio is needed. In contrast, MC dose calculations using water with variable density may be a simple way to solve the problem found using the dose conversion method based on the stopping power ratio.

Comparison of different breast planning techniques and algorithms for radiation therapy treatment

This work aims at investigating the impact of treating breast cancer using different radiation therapy (RT) techniques – forwardly-planned intensity-modulated, f-IMRT, inversely-planned IMRT and dynamic conformal arc (DCART) RT – and their effects on the whole-breast irradiation and in the undesirable irradiation of the surrounding healthy tissues. Two algorithms of iPlan BrainLAB treatment planning system were compared: Pencil Beam Convolution (PBC) and commercial Monte Carlo (iMC). Seven left-sided breast patients submitted to breast-conserving surgery were enrolled in the study. For each patient, four RT techniques – f-IMRT, IMRT using 2-fields and 5-fields (IMRT2 and IMRT5, respectively) and DCART – were applied. The dose distributions in the planned target volume (PTV) and the dose to the organs at risk (OAR) were compared analyzing dose–volume histograms; further statistical analysis was performed using IBM SPSS v20 software. For PBC, all techniques provided adequate coverage of the PTV. However, statistically significant dose differences were observed between the techniques, in the PTV, OAR and also in the pattern of dose distribution spreading into normal tissues. IMRT5 and DCART spread low doses into greater volumes of normal tissue, right breast, right lung and heart than tangential techniques. However, IMRT5 plans improved distributions for the PTV, exhibiting better conformity and homogeneity in target and reduced high dose percentages in ipsilateral OAR. DCART did not present advantages over any of the techniques investigated. Differences were also found comparing the calculation algorithms: PBC estimated higher doses for the PTV, ipsilateral lung and heart than the iMC algorithm predicted.

Avaliação dos desvios no posicionamento da IMRT prostática com marcadores fiduciais versus estruturas anatómicas

Mestrado em Radioterapia

Helical tomotherapy versus 3D conformal radiotherapy in dosimetric planning for patients with localized prostate cancer

Radiotherapy is one of the therapeutics selected for localized prostate cancer, in cases where the tumour is confined to the prostate, penetrates the prostatic capsule or has reached the seminal vesicles (T1 to T3 stages). The radiation therapy can be administered through various modalities, being historically used the 3D conformal radiotherapy (3DCRT). Other modality of radiation administration is the intensity modulated radiotherapy (IMRT), that allows an increase of the total dose through modulation of the treatment beams, enabling a reduction in toxicity. One way to administer IMRT is through helical tomotherapy (TH). With this study we intent to analyze the advantages of helical tomotherapy when compared with 3DCRT, by evaluating the doses in the organs at risk (OAR) and planning target volumes (PTV).

Radioterapia adaptativa: utilização do cone-beam computed tomography para o cálculo de dose em radioterapia

Mestrado em Radiações Aplicadas às Tecnologias da Saúde - Ramo de especialização: Terapia com Radiações

Statistical analysis of quality control measurements in IMRT for head and neck and prostate cancer

Intensity Modulated Radiotherapy (IMRT) is a technique introduced to shape more precisely the dose distributions to the tumour, providing a higher dose escalation in the volume to irradiate and simultaneously decreasing the dose in the organs at risk which consequently reduces the treatment toxicity. This technique is widely used in prostate and head and neck (H&N) tumours. Given the complexity and the use of high doses in this technique it’s necessary to ensure as a safe and secure administration of the treatment, through the use of quality control programmes for IMRT. The purpose of this study was to evaluate statistically the quality control measurements that are made for the IMRT plans in prostate and H&N patients, before the beginning of the treatment, analysing their variations, the percentage of rejected and repeated measurements, the average, standard deviations and the proportion relations.