Comparison of beam characteristics of a gold x-ray target and a tungsten replacement target

Monte Carlo modeling and simulations of the High Definition (HD120) micro MLC and validation against measurements for a 6 MV beam

PURPOSE

The most recent Varian(®) micro multileaf collimator (MLC), the High Definition (HD120) MLC, was modeled using the BEAMNRC Monte Carlo code. This model was incorporated into a Varian medical linear accelerator, for a 6 MV beam, in static and dynamic mode. The model was validated by comparing simulated profiles with measurements.

METHODS

The Varian(®) Trilogy(®) (2300C/D) accelerator model was accurately implemented using the state-of-the-art Monte Carlo simulation program BEAMNRC and validated against off-axis and depth dose profiles measured using ionization chambers, by adjusting the energy and the full width at half maximum (FWHM) of the initial electron beam. The HD120 MLC was modeled by developing a new BEAMNRC component module (CM), designated HDMLC, adapting the available DYNVMLC CM and incorporating the specific characteristics of this new micro MLC. The leaf dimensions were provided by the manufacturer. The geometry was visualized by tracing particles through the CM and recording their position when a leaf boundary is crossed. The leaf material density and abutting air gap between leaves were adjusted in order to obtain a good agreement between the simulated leakage profiles and EBT2 film measurements performed in a solid water phantom. To validate the HDMLC implementation, additional MLC static patterns were also simulated and compared to additional measurements. Furthermore, the ability to simulate dynamic MLC fields was implemented in the HDMLC CM. The simulation results of these fields were compared with EBT2 film measurements performed in a solid water phantom.

RESULTS

Overall, the discrepancies, with and without MLC, between the opened field simulations and the measurements using ionization chambers in a water phantom, for the off-axis profiles are below 2% and in depth-dose profiles are below 2% after the maximum dose depth and below 4% in the build-up region. On the conditions of these simulations, this tungsten-based MLC has a density of 18.7 g cm(- 3) and an overall leakage of about 1.1 ± 0.03%. The discrepancies between the film measured and simulated closed and blocked fields are below 2% and 8%, respectively. Other measurements were performed for alternated leaf patterns and the agreement is satisfactory (to within 4%). The dynamic mode for this MLC was implemented and the discrepancies between film measurements and simulations are within 4%.

CONCLUSIONS

The Varian(®) Trilogy(®) (2300 C/D) linear accelerator including the HD120 MLC was successfully modeled and simulated using the Monte Carlo BEAMNRC code by developing an independent CM, the HDMLC CM, either in static and dynamic modes.

Internal scatter, the unavoidable major component of the peripheral dose in photon-beam radiotherapy

In clinical photon beams, the dose outside the geometrical field limits is produced by photons originating from (i) head leakage, (ii) scattering at the beam collimators and the flattening filter (head scatter) and (iii) scattering from the directly irradiated region of the patient or phantom (internal scatter). While the first two components can be modified, e.g. by reinforcement of shielding components or by re-modeling the filter system, internal scatter remains an unavoidable contributor to the peripheral dose. Its relative magnitude compared to the other components, its numerical variation with beam energy, field size and off-axis distance as well as its spectral distribution are evaluated in this study. We applied a detailed Monte Carlo (MC) model of our 6/15 MV Siemens Primus linear accelerator beam head, provided with ideal head leakage shielding conditions (multi-leaf collimator without gaps) to assess the head scatter contribution. Experimental values obtained under real shielding conditions were used to evaluate the head leakage contribution. It was found that the MC-computed internal scatter doses agree with the results of our previous measurements, that internal scatter is the major contributor to the peripheral dose in the near periphery while head leakage prevails in the far periphery, and that the lateral decline of the internal scatter dose can be represented by the sum of two exponentials, with an asymptotic tenth value of 18 to 19 cm. Internal scatter peripheral doses from various elementary beams are additive, so that their sum increases approximately in proportion with field size. The ratio between normalized internal scatter doses at 6 and 15 MV is approximately 2:1. The energy fluence spectra of the internal scatter component at all points of interest outside the field have peaks near 500 keV. The fact that the energy-shifted internal scatter constitutes the major contributor to the dose in the near periphery has a general bearing for dosimetry, i.e. for energy-dependent detector responses and dose conversion factors, for the relative biological effectiveness and for second primary malignancy risk estimates in the peripheral region.

Simulation of large x-ray fields using independently measured source and geometry details

PURPOSE

Obtain an accurate simulation of the dose from the 6 and 18 MV x-ray beams from a Siemens Oncor linear accelerator by comparing simulation to measurement. Constrain the simulation by independently determining parameters of the treatment head and incident beam, in particular, the energy and spot size.

METHODS

Measurements were done with the treatment head in three different configurations: (1) The clinical configuration, (2) the flattening filter removed, and (3) the target and flattening filter removed. Parameters of the incident beam and treatment head were measured directly. Incident beam energy and spectral width were determined from the percent-depth ionization of the raw beam (as described previously), spot size was determined using a spot camera, and the densities of the flattening filters were determined by weighing them. Simulations were done with EGSnrc/BEAMnrc code. An asymmetric simulation was used, including offsets of the spot, primary collimator, and flattening filter from the collimator rotation axis.

RESULTS

Agreement between measurement and simulation was obtained to the least restrictive of 1% or 1 mm at 6 MV, both with and without the flattening filter in place, except for the buildup region. At 18 MV, the agreement was 1.5%/1.5 mm with the flattening filter in place and 1%/1 mm with it removed, except for in the buildup region. In the buildup region, the discrepancy was 2%/2 mm at 18 MV and 1.5%/1.5 mm at 6 MV with the flattening filter either removed or in place. The methodology for measuring the source and geometry parameters for the treatment head simulation is described. Except to determine the density of the flattening filter, no physical modification of the treatment head is necessary to obtain those parameters. In particular, the flattening filter does not need to be removed as was done in this work.

CONCLUSIONS

Good agreement between measured and simulated dose distributions was obtained, even in the buildup region. The simulation was tightly constrained by independent measurements of parameters of the incident beam and treatment head. The method of obtaining the input parameters is described, and can be carried out on a clinical linear accelerator.

The accuracy of EGSnrc, Geant4 and PENELOPE Monte Carlo systems for the simulation of electron scatter in external beam radiotherapy

Three widely used Monte Carlo systems were benchmarked against recently published measurements of the angular distribution of 13 MeV and 20 MeV electrons scattered from foils of different atomic numbers and thicknesses. Source and geometry were simulated in detail to calculate electron fluence profiles 118.2 cm from the exit window. Results were compared to the measured fluence profiles and the characteristic angle where the fluence drops to 1/e of its maximum value. EGSnrc and PENELOPE results, on average, agreed with measurement within 1 standard deviation experimental uncertainty, with EGSnrc estimating slightly lower scatter than measurement and PENELOPE slightly higher scatter. Geant4.9.2 overestimated the characteristic angle for the lower atomic number foils by as much as 10%. Retuning of the scatter distributions in Geant4 led to a much better agreement with measurement, close to that achieved with the other codes. The 3% differences from measurement seen with all codes for at least some of the foils would result in clinically significant errors in the fluence profiles (2%/4 mm), given accurate knowledge of the electron source and treatment head geometry used in radiotherapy. Further improvement in simulation accuracy is needed to achieve 1%/1 mm agreement with measurement for the full range of beam energies, foil atomic number and thickness used in radiotherapy. EGSnrc would achieve this accuracy with an increase in thickness of the mylar sheets in the monitor chamber, PENELOPE with a decrease in thickness.

Algorithm for X-ray scatter, beam-hardening, and beam profile correction in diagnostic (kilovoltage) and treatment (megavoltage) cone beam CT

Quantitative reconstruction of cone beam X-ray computed tomography (CT) datasets requires accurate modeling of scatter, beam-hardening, beam profile, and detector response. Typically, commercial imaging systems use fast empirical corrections that are designed to reduce visible artifacts due to incomplete modeling of the image formation process. In contrast, Monte Carlo (MC) methods are much more accurate but are relatively slow. Scatter kernel superposition (SKS) methods offer a balance between accuracy and computational practicality. We show how a single SKS algorithm can be employed to correct both kilovoltage (kV) energy (diagnostic) and megavoltage (MV) energy (treatment) X-ray images. Using MC models of kV and MV imaging systems, we map intensities recorded on an amorphous silicon flat panel detector to water-equivalent thicknesses (WETs). Scattergrams are derived from acquired projection images using scatter kernels indexed by the local WET values and are then iteratively refined using a scatter magnitude bounding scheme that allows the algorithm to accommodate the very high scatter-to-primary ratios encountered in kV imaging. The algorithm recovers radiological thicknesses to within 9% of the true value at both kV and megavolt energies. Nonuniformity in CT reconstructions of homogeneous phantoms is reduced by an average of 76% over a wide range of beam energies and phantom geometries.

Focused beam-stop array for the measurement of scatter in megavoltage portal and cone beam CT imaging

We describe a focused beam-stop array (BSA) for the measurement of object scatter in imaging systems that utilize x-ray beams in the megavoltage (MV) energy range. The BSA consists of 64 doubly truncated tungsten cone elements of 0.5 cm maximum diameter that are arranged in a regular array on an acrylic slab. The BSA is placed in the accessory tray of a medical linear accelerator at a distance of approximately 50 cm from the focal spot. We derive an expression that allows us to estimate the scatter in an image taken without the array present, given image values in a second image with the array in place. The presence of the array reduces fluence incident on the imaged object. This leads to an object-dependent underestimation bias in the scatter measurements. We apply corrections in order to address this issue. We compare estimates of the flat panel detector response to scatter obtained using the BSA to those derived from Monte Carlo simulations. We find that the two estimates agree to within 10% in terms of RMS error for 30 cm x 30 cm water slabs in the thickness range of 10-30 cm. Larger errors in the scatter estimates are encountered for thinner objects, probably owing to extrafocal radiation sources. However, RMS errors in the estimates of primary images are no more than 5% for water slab thicknesses in the range of 1-30 cm. The BSA scatter estimates are also used to correct cone beam tomographic projections. Maximum deviations of central profiles of uniform water phantoms are reduced from 193 to 19 HU after application of corrections for scatter, beam hardening, and lateral truncation that are based on the BSA-derived scatter estimate. The same corrections remove the typical cupping artifact from both phantom and patient images. The BSA proves to be a useful tool for quantifying and removing image scatter, as well as for validating models of MV imaging systems.

Photon spectral characteristics of dissimilar 6 MV linear accelerators

This work measures and compares the energy spectra of four dosimetrically matched 6 MV beams, generated from four physically different linear accelerators. The goal of this work is twofold. First, this study determines whether the spectra of dosimetrically matched beams are measurably different. This study also demonstrates that the spectra of clinical photon beams can be measured as a part of the beam data collection process for input to a three-dimensional (3D) treatment planning system. The spectra of 6 MV beams that are dosimetrically matched for clinical use were studied to determine if the beam spectra are similarly matched. Each of the four accelerators examined had a standing waveguide, but with different physical designs. The four accelerators were two Varian 2100C/Ds (one 6 MV/18 MV waveguide and one 6 MV/10 MV waveguide), one Varian 600 C with a vertically mounted waveguide and no bending magnet, and one Siemens MD 6740 with a 6 MV/10 MV waveguide. All four accelerators had percent depth dose curves for the 6 MV beam that were matched within 1.3%. Beam spectra were determined from narrow beam transmission measurements through successive thicknesses of pure aluminum along the central axis of the accelerator, made with a graphite Farmer ion chamber with a Lucite buildup cap. An iterative nonlinear fit using a Marquardt algorithm was used to find each spectrum. Reconstructed spectra show that all four beams have similar energy distributions with only subtle differences, despite the differences in accelerator design. The measured spectra of different 6 MV beams are similar regardless of accelerator design. The measured spectra show excellent agreement with those found by the auto-modeling algorithm in a commercial 3D treatment planning system that uses a convolution dose calculation algorithm. Thus, beam spectra can be acquired in a clinical setting at the time of commissioning as a part of the routine beam data collection.

Monte Carlo feasibility study of orthogonal bremsstrahlung beams for improved radiation therapy imaging

The basic characteristics of orthogonal bremsstrahlung beams are studied and the feasibility of improved contrast imaging with such a beam is evaluated. In the context of this work, orthogonal bremsstrahlung beams represent the component of the bremsstrahlung distribution perpendicular to the electron beam impinging on an accelerator target. The BEAMnrc Monte Carlo code was used to study target characteristics, energy spectra and relative fluences of orthogonal beams to optimize target design. The reliability of the simulations was verified by comparing our results with benchmark experiments. Using the results of the Monte Carlo optimization, the targets with various materials and a collimator were designed and built. The primary pencil electron beam from the research port of a Varian Clinac-18 accelerator striking on Al, Pb and C targets was used to create orthogonal beams. For these beams, diagnostic image contrast was tested by placing simple Lucite objects in the path of the beams and comparing image contrast obtained in the orthogonal direction to the one obtained in the forward direction. The simulations for various target materials and various primary electron energies showed that a width of 80% of the continuous-slowing-down approximation range (RCSDA) is sufficient to remove electron contamination in the orthogonal direction. The photon fluence of the orthogonal beam for high Z targets is larger compared to low Z targets, i.e. by a factor of 20 for W compared to Be. For a 6 MeV electron beam, the mean energy for low Z targets is calculated to be 320 keV for Al and 150 keV for Be, and for a high Z target like Pb to be 980 keV. For irradiation times of 1.2 s in an electron mode of the linac, the contrast of diagnostic images created with orthogonal beams from the Al target is superior to that in the forward direction. The image contrast and the beam profile of the bremsstrahlung beams were also studied. Both the Monte Carlo study and experiment showed an improvement of the contrast for lower Z target materials. This study confirms the feasibility, both in terms of intensity and image contrast, of orthogonal bremsstrahlung beams for radiation therapy imaging.