In recent years, small fields have come to play a key role in advanced radiotherapy, yet protocols to perform dosimetry under small field conditions are still in their infancy. In 2008, the IAEA and AAPM published a formalism [Med. Phys. 35, 5179-5186] recommending the use of point-dose correction factors. This thesis uses Monte Carlo simulations to demonstrate that the values of these correction factors depend strongly on both detector design and field size, as well as other variables such as detector off-axis position and detector azimuthal angle. Mass density is found to be the principal determinant of detector water non-equivalence. Furthermore, it is shown that it is possible to compensate for the mass-density of a detector cavity by incorporating additional components of contrasting mass-density into that detector’s design. For small cavities, such design modifications enable the detector’s small- to large- field response ratio to be matched to that of a “point-like” water-structure: ideal detector performance can be achieved across a variety of irradiation conditions. For existing commercial detectors, a Dose Area Product (DAP) formalism is also developed and shown to be much more robust than the point-dose correction factor approach. In conclusion, correction factor values for existing detector designs depend on a host of variables and their calculation typically relies on the use of time-intensive Monte Carlo methods. This thesis indicates that future moves towards density-compensated detector designs or DAP-based protocols can simplify the methodology of small field dosimetry.

As propriedades dosimétricas de um feixe de radiação utilizado em Radioterapia estão diretamente ligadas ao espectro de energia produzido pela unidade de tratamento. Dessa forma, o desenvolvimento de metodologias que permitam avaliar de forma simples e acurada os espectros de feixes clínicos pode auxiliar no estabelecimento da qualidade dos tratamentos realizados. Baseado nisso, este trabalho teve como objetivo o desenvolvimento de uma metodologia acurada e de baixo custo para a determinação dos espectros primários dos campos de radiação utilizados em radioterapia a partir de medidas de transmissão em atenuadores de alumínio, cobre chumbo e acrílico, utilizando o método da transformada inversa de Laplace. Simulação Monte Carlo com o código PENELOPE, apresentou-se como uma ferramenta indispensável na avaliação dos resultados obtidos para os diferentes materiais e na validação dos espectros reconstruídos por meio da simulação de parâmetros dosimétricos que caracterizam o feixe. Um programa em linguagem FORTRAN foi elaborado para o cálculo da transformada inversa de Laplace e os dados obtidos foram investigados em função de parâmetros do programa e do ajuste realizado para a curva de transmissão. A diferença máxima de 4,4% para o feixe clínico de 6 MV e de 4,2% para o feixe de 10 MV, entre os valores experimentais de PDP e simulados com o espectro reconstruído, utilizando o alumínio como material atenuador, confirmam a acurácia da metodologia na reconstrução de feixes radioterápicos produzidos em aceleradores clínicos. / The dosimetric properties of a radiation beam used in radiotherapy are directly related to the energy spectrum produced by the treatment unit. Therefore, the development of methodologies to evaluate in a simple and accurate way the spectra of clinical beams can help establishing the quality of the treatment. Based on this, the purpose of this work was to develop an accurate and low cost methodology for the determination of the primary spectra of radiation fields used in radiotherapy from measurements of transmission in attenuators of aluminum, copper, lead and acrylics and using the method of the inverse Laplace transform. Monte Carlo simulation with PENELOPE code was an essential tool in evaluating the results obtained for different materials and validating the spectra reconstructed by the simulation of dosimetric parameters that characterize the beam. A program in FORTRAN was developed to calculate the inverse Laplace transform and the data obtained were evaluated in regard the parameters of the program and the fitting used for the transmission curve. The maximum difference of 4.4% for the clinical beam of 6 MV and 4.2% for the beam of 10 MV, between the experimental and simulated PDP with the reconstructed spectrum, using aluminum as the attenuator material, confirm the accuracy of the methodology of spectra reconstruction of radiotherapy beams produced by clinical accelerators.

Megavoltage computed tomography (MVCT) and megavoltage cone beam computed tomography can be used for visualizing anatomical structures prior to radiation therapy treatments to assist in patient setup and target localization. These systems provide images using the same beam used for patient treatment, however their image contrast is limited by the low detective quantum efficiency (DQE) of the detectors currently available. By using higher DQE thick, segmented cadmium tungstate detectors we can improve the system contrast. This in turn would permit enhanced soft tissue visualization, allowing MVCT to be more useful. This thesis describes the evaluation of a prototype MVCT system that uses thick, segmented detectors. The system was found to be able to easily visualize a 15 mm diameter 1.5% contrast target with 2 cGy of radiation dose delivered. This system could become the basis for improved commercial MVCT systems. / Medical Physics

No description available.

As propriedades dosimétricas de um feixe de radiação utilizado em Radioterapia estão diretamente ligadas ao espectro de energia produzido pela unidade de tratamento. Dessa forma, o desenvolvimento de metodologias que permitam avaliar de forma simples e acurada os espectros de feixes clínicos pode auxiliar no estabelecimento da qualidade dos tratamentos realizados. Baseado nisso, este trabalho teve como objetivo o desenvolvimento de uma metodologia acurada e de baixo custo para a determinação dos espectros primários dos campos de radiação utilizados em radioterapia a partir de medidas de transmissão em atenuadores de alumínio, cobre chumbo e acrílico, utilizando o método da transformada inversa de Laplace. Simulação Monte Carlo com o código PENELOPE, apresentou-se como uma ferramenta indispensável na avaliação dos resultados obtidos para os diferentes materiais e na validação dos espectros reconstruídos por meio da simulação de parâmetros dosimétricos que caracterizam o feixe. Um programa em linguagem FORTRAN foi elaborado para o cálculo da transformada inversa de Laplace e os dados obtidos foram investigados em função de parâmetros do programa e do ajuste realizado para a curva de transmissão. A diferença máxima de 4,4% para o feixe clínico de 6 MV e de 4,2% para o feixe de 10 MV, entre os valores experimentais de PDP e simulados com o espectro reconstruído, utilizando o alumínio como material atenuador, confirmam a acurácia da metodologia na reconstrução de feixes radioterápicos produzidos em aceleradores clínicos. / The dosimetric properties of a radiation beam used in radiotherapy are directly related to the energy spectrum produced by the treatment unit. Therefore, the development of methodologies to evaluate in a simple and accurate way the spectra of clinical beams can help establishing the quality of the treatment. Based on this, the purpose of this work was to develop an accurate and low cost methodology for the determination of the primary spectra of radiation fields used in radiotherapy from measurements of transmission in attenuators of aluminum, copper, lead and acrylics and using the method of the inverse Laplace transform. Monte Carlo simulation with PENELOPE code was an essential tool in evaluating the results obtained for different materials and validating the spectra reconstructed by the simulation of dosimetric parameters that characterize the beam. A program in FORTRAN was developed to calculate the inverse Laplace transform and the data obtained were evaluated in regard the parameters of the program and the fitting used for the transmission curve. The maximum difference of 4.4% for the clinical beam of 6 MV and 4.2% for the beam of 10 MV, between the experimental and simulated PDP with the reconstructed spectrum, using aluminum as the attenuator material, confirm the accuracy of the methodology of spectra reconstruction of radiotherapy beams produced by clinical accelerators.

No description available.

<p>A bench-top dual cone-beam computed tomography (CBCT) system was developed consisting of two orthogonally placed 40x30 cm<super>2</super> flat-panel detectors and two conventional X-ray tubes with two individual high-voltage generators sharing the same rotational axis. The X-ray source to detector distance is 150 cm and X-ray source to rotational axis distance is 100 cm for both subsystems. The objects are scanned through 200° of rotation. The dual CBCT (DCBCT) system utilized 110° of projection data from one detector and 90° from the other while the two individual single CBCTs utilized 200° data from each detector. The system performance was characterized in terms of uniformity, contrast, spatial resolution, noise power spectrum and CT number linearity. The uniformity, within the axial slice and along the longitudinal direction, and noise power spectrum were assessed by scanning a water bucket; the contrast and CT number linearity were measured using the Catphan phantom; and the spatial resolution was evaluated using a tungsten wire phantom. A skull phantom and a ham were also scanned to provide qualitative evaluation of high- and low-contrast resolution. Each measurement was compared between dual and single CBCT systems.</p><p>Compared with single CBCT, the DCBCT presented: 1) a decrease in uniformity by 1.9% in axial view and 1.1% in the longitudinal view, as averaged for four energies (80, 100, 125 and 150 kVp); 2) comparable or slightly better contrast to noise ratio (CNR) for low-contrast objects and comparable contrast for high-contrast objects; 3) comparable spatial resolution; 4) comparable CT number linearity with R<super>2</super> &#8805; 0.99 for all four tested energies; 5) lower noise power spectrum in magnitude. DCBCT images of the skull phantom and the ham demonstrated both high-contrast resolution and good soft-tissue contrast.</p><p>One of the major challenges for clinical implementation of four-dimensional (4D) CBCT is the long scan time. To investigate the 4D imaging capabilities of the DCBCT system, motion phantom studies were conducted to validate the efficiency by comparing 4D images generated from 4D-DCBCT and 4D-CBCT. First, a simple sinusoidal profile was used to confirm the scan time reduction. Next, both irregular sinusoidal and patient-derived profiles were used to investigate the advantage of temporally correlated orthogonal projections due to a reduced scan time. Normalized mutual information (NMI) between 4D-DCBCT and 4D-CBCT was used for quantitative evaluation.</p><p>For the simple sinusoidal profile, the average NMI for ten phases between two single 4D-CBCTs was 0.336, indicating the maximum NMI that can be achieved for this study. The average NMIs between 4D-DCBCT and each single 4D-CBCT were 0.331 and 0.320. For both irregular sinusoidal and patient-derived profiles, 4D-DCBCT generated phase images with less motion blurring when compared with single 4D-CBCT.</p><p>For dual kV energy imaging, we acquired 80kVp projections and 150 kVp projections, with an additional 0.8 mm tin filtration. The virtual monochromatic (VM) technique was implemented, by first decomposing these projections into acrylic and aluminum basis material projections to synthesize VM projections, which were then used to reconstruct VM CBCTs. The effect of the VM CBCT on metal artifact reduction was evaluated with an in-house titanium-BB phantom. The optimal VM energy to maximize CNR for iodine contrast and minimize beam hardening in VM CBCT was determined using a water phantom containing two iodine concentrations. The linearly-mixed (LM) technique was implemented by linearly combining the low- (80kVp) and high-energy (150kVp) CBCTs. The dose partitioning between low- and high-energy CBCTs was varied (20%, 40%, 60% and 80% for low-energy) while keeping total dose approximately equal to single-energy CBCTs, measured using an ion chamber. Noise levels and CNRs for four tissue types were investigated for dual-energy LM CBCTs in comparison with single-energy CBCTs at 80, 100, 125 and 150kVp.</p><p>The VM technique showed a substantial reduction of metal artifacts at 100 keV with a 40% reduction in the background standard deviation compared with a 125 kVp single-energy scan of equal dose. The VM energy to maximize CNR for both iodine concentrations and minimize beam hardening in the metal-free object was 50 keV and 60 keV, respectively. The difference in average noise levels measured in the phantom background was 1.2% for dual-energy LM CBCTs and equivalent-dose single-energy CBCTs. CNR values in the LM CBCTs of any dose partitioning were better than those of 150 kVp single-energy CBCTs. The average CNRs for four tissue types with 80% dose fraction at low-energy showed 9.0% and 4.1% improvement relative to 100 kVp and 125 kVp single-energy CBCTs, respectively. CNRs for low contrast objects improved as dose partitioning was more heavily weighted towards low-energy (80kVp) for LM CBCTs.</p><p>For application of the dual-energy technique in the kilovoltage (kV) and megavoltage (MV) range, we acquired both MV projections (from gantry angle of 0° to 100°) and kV projections (90° to 200°) with the current orthogonal kV/MV imaging hardware equipped in modern linear accelerators, as gantry rotated a total of 110°. A selected range of overlap projections between 90° to 100° were then decomposed into two material projections using experimentally determined parameters from orthogonally stacked aluminum and acrylic step-wedges. Given attenuation coefficients of aluminum and acrylic at a predetermined energy, one set of VM projections could be synthesized from two corresponding sets of decomposed projections. Two linear functions were generated using projection information at overlap angles to convert kV and MV projections at non-overlap angles to approximate VM projections for CBCT reconstruction. The CNRs were calculated for different inserts in VM CBCTs of a CatPhan phantom with various selected energies and compared with those in kV and MV CBCTs. The effect of overlap projection number on CNR was evaluated. Additionally, the effect of beam orientation was studied by scanning the CatPhan sandwiched with two 5 cm solid-water phantoms on both lateral sides and an electronic density phantom with two metal bolt inserts.</p><p>Proper selection of VM energy (30keV and 40keV for low-density polyethylene (LDPE), polymethylpentene (PMP), 2MeV for Delrin) provided comparable or even better CNR results as compared with kV or MV CBCT. An increased number of overlap between kV and MV projections demonstrated only marginal improvements of CNR for different inserts (with the exception of LDPE) and therefore one projection overlap was found to be sufficient for the CatPhan study. It was also evident that the optimal CBCT image quality was achieved when MV beams penetrated through the heavy attenuation direction of the object. </p><p>In conclusion, the performance of a bench-top DCBCT imaging system has been characterized and is comparable to that of a single CBCT. The 4D-DCBCT provides an efficient 4D imaging technique for motion management. The scan time is reduced by approximately a factor of two. The temporally correlated orthogonal projections improved the image blur across 4D phase images. Dual-energy CBCT imaging techniques were implemented to synthesize VM CBCT and LM CBCTs. VM CBCT was effective at achieving metal artifact reduction. Depending on the dose-partitioning scheme, LM CBCT demonstrated the potential to improve CNR for low contrast objects compared with single-energy CBCT acquired with equivalent dose. A novel technique was developed to generate VM CBCTs from kV/MV projections. This technique has the potential to improve CNR at selected VM energies and to suppress artifacts at appropriate beam orientations.</p> / Dissertation