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Hajare R, Ali MB, Sreelakshmi KK, Kumar MA, Kalita R, Mahantshetty UM. Implementation and Validation of Anisotropic Analytical Algorithm in Eclipse Treatment Planning System for Indigenous Telecobalt Machine (Bhabhatron II). J Med Phys 2022; 47:50-56. [PMID: 35548036 PMCID: PMC9084584 DOI: 10.4103/jmp.jmp_95_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/04/2022] Open
Abstract
Background The photon dose calculation model anisotropic analytical algorithm (AAA) available with eclipse integrated treatment planning system (TPS) (Varian) supports telecobalt dose calculation from Version 13.6 onward. Formerly, pencil beam convolution (PBC) was used for modeling telecobalt machines. Eclipse TPS no longer supports PBC dose calculation algorithm in v13.6 and above. The AAA dose calculation model is a three-dimensional PBC/superposition algorithm. Its configuration is based on Monte-Carlo-determined basic physical parameters that are tailored to measured clinical beam data. Aim The study investigated the feasibility of clinical implementation of AAA in Eclipse TPS for Bhabhatron II. Materials and Methods The indigenous telecobalt machine, Bhabhatron II, was configured as a generic machine because an inbuilt machine model for the same was not available in Varian Eclipse TPS algorithm library. In such a scenario, it was necessary to evaluate and validate dosimetric parameters of the TPS because improper tailoring would cause errors in dose calculations. Beam data measurements of the machine were carried out which were used for configuration of the algorithm. Result After successful configuration, a variety of plans created in TPS were executed on the machine and subsequently evaluated. Conclusion From this study, we concluded that AAA-based dose calculation in TPS is very well suited for accurate dose calculations for telecobalt machine and can be implemented for clinical use.
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Affiliation(s)
- Raghavendra Hajare
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - Md. Basit Ali
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - K K Sreelakshmi
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India,Address for correspondence: Ms. K K Sreelakshmi, Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Aganampudi, Gajuwaka Mandalam, Visakhapatnam - 530 053, Andhra Pradesh, India. E-mail:
| | - M Anil Kumar
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - Rituraj Kalita
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - Umesh M Mahantshetty
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
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Rajamanickam T, Muthu S, Murugan P, Dinesan C, Mekala C, Senthilnathan K, Arunai Nambi Raj N, Ramesh Babu P. An Assessment of Dosimetric Characteristics of Inline 2.5 Mega Voltage Unflattened Imaging X-Ray Beam. Asian Pac J Cancer Prev 2019; 20:2531-2539. [PMID: 31450929 PMCID: PMC6852810 DOI: 10.31557/apjcp.2019.20.8.2531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose: The aim of this work is to study the dosimetric parameters of newly introduced 2.5 MV imaging x-ray beam used as inline imaging to do setup verification of the patient undergoing radiation therapy. As this x-ray beam is in megavoltage range but comprises of a lower energy spectrum. It is essential to study the pros and cons of 2.5 MV imaging x-ray beam for clinical use. Methods: The mean energy was calculated using the NIST XCOM table through MAC. Profile analysis was done using RFA to understand the percentage depth dose, degree of unflatteness, symmetry, penumbra and out of field dose. Dose to skin for the 2.5 MV x-ray beam was analysed for field sizes 10x10 cm2, 20x20 cm2, 30x30 cm2. Leakage measurements for treatment head and at the patient plane were done using IEC 819/98 protocol. Finally, the spatial resolution and contrast were analyzed with and without patient scatter medium. Results: The MAC at 15 cm off-axis was found to be lower than that at the CAX. Similarly, there was a decrease in mean energy from 0.47 MV to 0.37 MV at 15 cm off-axis. The reduction of mean energy towards off-axis is lower than the other high energy MV x-ray beams. The tuned absolute dose of 1 cGy/MU is consistent and within < ±1 %. The relative output factors were found to be in correlation with Co-60. The beam quality of 2.5 MV x-ray beam was found to be 0.4771. The profile parameters like the degree of unflatness of the 2.5 x-ray beam were studied at 85 %, 90 %, 95 % lateral distances, and the penumbra at different depth and field sizes are higher than the 6 MV treatment beam. In addition, out of field dose also drastically increases to a maximum of up to 30 % laterally at 5cm at deeper depths. The skin dose increases from 48.51 % to 88.15 % from 6 MV to 2.5 MV x-ray beam for the field size 10x10 cm2. Also, the skin dose increases from 88.15 % to 91.78 % from the field size 10x10 cm2 to 30x30 cm2. Although the measured leakage radiation for 2.5 MV x-ray beam at the patient plane and other than patient planes are with the tolerance limit, an increase in exposure towards gantry side compared to other areas around treatment head and the patient plane may lead to more skin dose to head and chest while imaging pelvis region. The MLC transmission of 2.5 MV x-ray beam such as inter, intra and edge effect are 0.40 %, 0.37 % and 11% respectively. The spatial resolution of 2.0, 1.25 and 0.9 LP/mm was observed for KV, 2.5MV, and 6 MV x-ray beams. The spatial resolution and contrast of 2.5 MV x-ray beam are superior to 6 MV x-ray beam and inferior to KV x-rays. Conclusions: The 2.5 MV x-ray imaging beam is analysed in view of beam characteristics and radiation safety to understand the above-studied concepts while using this imaging beam in a clinical situation. In future, if 2.5MV x-ray beam is used for treatment purpose with increased dose rate, the above-studied notions can be incorporated prior to implementation.
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Affiliation(s)
- Tamilarasan Rajamanickam
- Department of Radiation Oncology, Sri Shankara Cancer Hospital & Research Centre, Bengaluru, Karnataka, India.,Department of Physics, SAS, Vellore Institute of Technology, Vellore, Tamil Nadu, India.
| | - Sivakumar Muthu
- Department of Radiation Oncology, Sri Shankara Cancer Hospital & Research Centre, Bengaluru, Karnataka, India
| | - Perumal Murugan
- Department of Radiation Oncology, Sri Shankara Cancer Hospital & Research Centre, Bengaluru, Karnataka, India
| | - Chinnaiah Dinesan
- Department of Radiation Oncology, Sri Shankara Cancer Hospital & Research Centre, Bengaluru, Karnataka, India
| | - Chandrasekaran Mekala
- Principal Clinical Scientist and Stereotactic Lead, University Hospital Southampton NHS FT, Tremona Rd, Southampton SO16 6YD, UK
| | | | - Narayanasamy Arunai Nambi Raj
- Centre for Biomaterials, Cellular and Molecular Theranostics, Vellore Institute of Technology, Vellore, Tamil Nadu, India
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Grover S, Gudi S, Gandhi AK, Puri PM, Olson AC, Rodin D, Balogun O, Dhillon PK, Sharma DN, Rath GK, Shrivastava SK, Viswanathan AN, Mahantshetty U. Radiation Oncology in India: Challenges and Opportunities. Semin Radiat Oncol 2016; 27:158-163. [PMID: 28325242 DOI: 10.1016/j.semradonc.2016.11.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Rising cancer incidence and mortality in India emphasize the need to address the increasing burden of this disease and the stark inequities in access to radiotherapy and other essential medical treatments. State-of-the-art technology is available within the private sector and a few hospitals in the public sector, but 75% of patients in the public sector in India do not have access to timely radiotherapy. This inequity in access to radiotherapy in the public sector is amplified in rural areas, where most of India׳s population lives. A long-term government commitment to machine purchase and human resource development in the public sector is needed to improve access. A number of innovative initiatives to improve cancer treatment and access have emerged that could support such an investment. These include local production of equipment, twinning programs between institutions in high- and low-income countries to exchange knowledge and expertise, and nongovernmental and state-sponsored schemes to sponsor and support patients in their cancer journey. Strengthening of cancer registries and regulatory bodies with authority to enforce minimum standards is also required to improve care. The more uniform and frequent availability of high-quality radiotherapy can improve cancer outcomes and may be regarded as a marker of a comprehensive and equitable system of health care delivery.
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Affiliation(s)
- Surbhi Grover
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA.
| | | | - Ajeet Kumar Gandhi
- Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
| | - Priya M Puri
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Adam C Olson
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC; Hubert Yeargan Center for Global Health, Duke University, Durham, NC
| | - Danielle Rodin
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Onyi Balogun
- Department of Radiation Oncology, Weill Cornell Medical College, NY
| | - Preet K Dhillon
- Public Health Foundation of India, National Capital Region, India
| | | | | | | | - Akila N Viswanathan
- Johns Hopkins Radiation Oncology and Molecular Radiation Sciences, Baltimore, MD
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Langhans M, Echner G, Runz A, Baumann M, Xu M, Ueltzhöffer S, Häring P, Schlegel W. Development, physical properties and clinical applicability of a mechanical Multileaf Collimator for the use in Cobalt-60 radiotherapy. Phys Med Biol 2015; 60:3375-87. [PMID: 25831017 DOI: 10.1088/0031-9155/60/8/3375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
According to the Directory of Radiotherapy Centres (DIRAC) there are 2348 Cobalt-60 (Co-60) teletherapy units worldwide, most of them in low and middle income countries, compared to 11046 clinical accelerators. To improve teletherapy with Co-60, a mechanical Multi-Leaf Collimator (MLC) was developed, working with pneumatic pressure and thus independent of electricity supply. Instead of tungsten, brass was used as leaf material to make the mechanical MLC more affordable. The physical properties and clinical applicability of this mechanical MLC are presented here. The leakage strongly depends on the fieldsize of the therapy unit due to scatter effects. The maximum transmission through the leaves measured 2.5 cm from the end-to-end gap, within a field size of 20 cm × 30 cm defined by jaws of the therapy unit at 80 cm SAD, amounts 4.2%, normalized to an open 10 cm × 10 cm field, created by the mechanical MLC. Within a precollimated field size of 12.5 cm × 12.5 cm, the end-to-end leakage is 6.5% normalized to an open 10 cm × 10 cm field as well. This characteristic is clinically acceptable considering the criteria for non-IMRT MLCs of the International Electrotechnical Commission (IEC 60601-2-1). The penumbra for a 10 cm × 10 cm field was measured to be 9.14 mm in plane and 8.38 mm cross plane. The clinical applicability of the designed mechanical MLC was affirmed by measurements relating to all relevant clinical properties such as penumbra, leakage, output factors and field widths. Hence this novel device presents an apt way forward to make radiotherapy with conformal fields possible in low-infrastructure environments, using gantry based Co-60 therapy units.
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Affiliation(s)
- Marco Langhans
- Department of Medical Physics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany. Department of Radiation Therapy, Radiologie Vechta, Marienstraße 13, 49377 Vechta, Germany
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Sahani G, Dutt Sharma S, Dash Sharma PK, Sharma DN, Hussain SA. Monte Carlo simulation based study of a proposed multileaf collimator for a telecobalt machine. Med Phys 2013; 40:021705. [DOI: 10.1118/1.4773308] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kumar R, Kar D, Sharma S, Mayya Y. Design, implementation and validation of a motorized wedge filter for a telecobalt machine (Bhabhatron-II). Phys Med 2012; 28:54-60. [DOI: 10.1016/j.ejmp.2011.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 02/28/2011] [Accepted: 03/03/2011] [Indexed: 10/18/2022] Open
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