No presente trabalho serão apresentados testes de comissionamento e de avaliação da utilização do portal dosimetry, da Varian, no controle de qualidade dos planejamentos de radioterapia de intensidade modulada. Os testes de comissionamento foram realizados para caracterizar o portal dosimetry em termos dosimétricos e para avaliar a sua possível aplicação em radioterapia. Esses testes demonstraram que o portal dosimetry possui todas as características necessárias para ser utilizado em dosimetria na radioterapia tais como linearidade da resposta com a dose, independência com a taxa de dose, reprodutibilidade, dentre outras. A avaliação da utilização do portal dosimetry no controle de qualidade de IMRT foi realizada em duas etapas: avaliação da capacidade do dispositivo em detectar erros propositalmente introduzidos em fluências simples e em fluências complexas. Foram introduzidos erros de magnitude conhecida em áreas determinadas das fluências e foi realizado o controle de qualidade dessas fluências com o portal dosimetry e com mais três sistemas dosimétricos: câmara de ionização, filme e matriz de câmaras de ionização. Os dados obtidos com o portal foram comparados com os dos outros dispositivos e todos foram capazes de identificar os erros introduzidos de maneira satisfatória, sendo os valores, normalizados para a fluência original, obtidos com o dosímetro portal indênticos aos da câmara de ionização e aos da matriz de câmaras de ionização (seven29) e diferindo em até 2% dos valores obtidos com os filmes. As fluências medidas com o portal dosimetry foram avaliadas em termos quantitativos e qualitativos. Os índices da função gama fornecidos pelo software de análise do portal dosimetry não apresentaram regras definidas de comportamento em relação aos erros introduzidos e por essa razão a análise qualitativa se mostrou indispensável nos casos avaliados. / In this paper we present commissioning testing and evaluation of the use of Varians portal dosimetry in the quality assurance of intensity-modulated radiotherapy. The commissioning tests were performed to characterize the portal dosimetry in terms dosimetric and to assess the its possible application in radiotherapy. These tests demonstrated that portal dosimetry has all the characteristics to be used for dosimetry in radiotherapy such as linear response with dose, the independence of dose rate, reproducibility, and others. The evaluation of the use of portal dosimetry in quality control of IMRT was performed in two steps: assessing the ability of the device to detect errors deliberately introduced in simple and complex fluences. Errors of known magnitude were introduced in certain areas of fluences and was carried out quality control of these fluences with portal dosimetry and three dosimetric systems: ionization chamber, film and array of ionization chambers. The data obtained from the portal were compared with those of other devices and all were able to identify errors introduced satisfactorily, the values, normalized to the original fluence, obtained with the portal dosimetry were similar to the ionization chamber and the array of ion chambers (seven29) and differing in up to 2% of the values obtained with the films. The fluences measured with the portal dosimetry were evaluated both quantitatively and qualitatively. The index of the gamma function provided by software analysis of portal dosimetry showed no defined rules of behavior in relation to the errors introduced and for this reason the qualitative analysis has proved indispensable in cases evaluated.

No presente trabalho serão apresentados testes de comissionamento e de avaliação da utilização do portal dosimetry, da Varian, no controle de qualidade dos planejamentos de radioterapia de intensidade modulada. Os testes de comissionamento foram realizados para caracterizar o portal dosimetry em termos dosimétricos e para avaliar a sua possível aplicação em radioterapia. Esses testes demonstraram que o portal dosimetry possui todas as características necessárias para ser utilizado em dosimetria na radioterapia tais como linearidade da resposta com a dose, independência com a taxa de dose, reprodutibilidade, dentre outras. A avaliação da utilização do portal dosimetry no controle de qualidade de IMRT foi realizada em duas etapas: avaliação da capacidade do dispositivo em detectar erros propositalmente introduzidos em fluências simples e em fluências complexas. Foram introduzidos erros de magnitude conhecida em áreas determinadas das fluências e foi realizado o controle de qualidade dessas fluências com o portal dosimetry e com mais três sistemas dosimétricos: câmara de ionização, filme e matriz de câmaras de ionização. Os dados obtidos com o portal foram comparados com os dos outros dispositivos e todos foram capazes de identificar os erros introduzidos de maneira satisfatória, sendo os valores, normalizados para a fluência original, obtidos com o dosímetro portal indênticos aos da câmara de ionização e aos da matriz de câmaras de ionização (seven29) e diferindo em até 2% dos valores obtidos com os filmes. As fluências medidas com o portal dosimetry foram avaliadas em termos quantitativos e qualitativos. Os índices da função gama fornecidos pelo software de análise do portal dosimetry não apresentaram regras definidas de comportamento em relação aos erros introduzidos e por essa razão a análise qualitativa se mostrou indispensável nos casos avaliados. / In this paper we present commissioning testing and evaluation of the use of Varians portal dosimetry in the quality assurance of intensity-modulated radiotherapy. The commissioning tests were performed to characterize the portal dosimetry in terms dosimetric and to assess the its possible application in radiotherapy. These tests demonstrated that portal dosimetry has all the characteristics to be used for dosimetry in radiotherapy such as linear response with dose, the independence of dose rate, reproducibility, and others. The evaluation of the use of portal dosimetry in quality control of IMRT was performed in two steps: assessing the ability of the device to detect errors deliberately introduced in simple and complex fluences. Errors of known magnitude were introduced in certain areas of fluences and was carried out quality control of these fluences with portal dosimetry and three dosimetric systems: ionization chamber, film and array of ionization chambers. The data obtained from the portal were compared with those of other devices and all were able to identify errors introduced satisfactorily, the values, normalized to the original fluence, obtained with the portal dosimetry were similar to the ionization chamber and the array of ion chambers (seven29) and differing in up to 2% of the values obtained with the films. The fluences measured with the portal dosimetry were evaluated both quantitatively and qualitatively. The index of the gamma function provided by software analysis of portal dosimetry showed no defined rules of behavior in relation to the errors introduced and for this reason the qualitative analysis has proved indispensable in cases evaluated.

No description available.

Radiation therapy is continuously increasing in complexity due to technological innovation in delivery techniques, necessitating thorough dosimetric verification. Comparing accurately predicted portal dose images to measured images obtained during patient treatment can determine if a particular treatment was delivered correctly. The goal of this thesis was to create a method to predict portal dose images that was versatile and accurate enough to use in a clinical setting. All measured images in this work were obtained with an amorphous silicon electronic portal imaging device (a-Si EPID), but the technique is applicable to any planar imager. A detailed, physics-motivated fluence model was developed to characterize fluence exiting the linear accelerator head. The model was further refined using results from Monte Carlo simulations and schematics of the linear accelerator. The fluence incident on the EPID was converted to a portal dose image through a superposition of Monte Carlo-generated, monoenergetic dose kernels specific to the a-Si EPID. Predictions of clinical IMRT fields with no patient present agreed with measured portal dose images within 3% and 3 mm. The dose kernels were applied ignoring the geometrically divergent nature of incident fluence on the EPID. A computational investigation into this parallel dose kernel assumption determined its validity under clinically relevant situations. Introducing a patient or phantom into the beam required the portal image prediction algorithm to account for patient scatter and attenuation. Primary fluence was calculated by attenuating raylines cast through the patient CT dataset, while scatter fluence was determined through the superposition of pre-calculated scatter fluence kernels. Total dose in the EPID was calculated by convolving the total predicted incident fluence with the EPID-specific dose kernels. The algorithm was tested on water slabs with square fields, agreeing with measurement within 3% and 3 mm. The method was then applied to five prostate and six head-and-neck IMRT treatment courses (~1900 clinical images). Deviations between the predicted and measured images were quantified. The portal dose image prediction model developed in this thesis work has been shown to be accurate, and it was demonstrated to be able to verify patients’ delivered radiation treatments.

Radiation therapy is continuously increasing in complexity due to technological innovation in delivery techniques, necessitating thorough dosimetric verification. Comparing accurately predicted portal dose images to measured images obtained during patient treatment can determine if a particular treatment was delivered correctly. The goal of this thesis was to create a method to predict portal dose images that was versatile and accurate enough to use in a clinical setting. All measured images in this work were obtained with an amorphous silicon electronic portal imaging device (a-Si EPID), but the technique is applicable to any planar imager. A detailed, physics-motivated fluence model was developed to characterize fluence exiting the linear accelerator head. The model was further refined using results from Monte Carlo simulations and schematics of the linear accelerator. The fluence incident on the EPID was converted to a portal dose image through a superposition of Monte Carlo-generated, monoenergetic dose kernels specific to the a-Si EPID. Predictions of clinical IMRT fields with no patient present agreed with measured portal dose images within 3% and 3 mm. The dose kernels were applied ignoring the geometrically divergent nature of incident fluence on the EPID. A computational investigation into this parallel dose kernel assumption determined its validity under clinically relevant situations. Introducing a patient or phantom into the beam required the portal image prediction algorithm to account for patient scatter and attenuation. Primary fluence was calculated by attenuating raylines cast through the patient CT dataset, while scatter fluence was determined through the superposition of pre-calculated scatter fluence kernels. Total dose in the EPID was calculated by convolving the total predicted incident fluence with the EPID-specific dose kernels. The algorithm was tested on water slabs with square fields, agreeing with measurement within 3% and 3 mm. The method was then applied to five prostate and six head-and-neck IMRT treatment courses (~1900 clinical images). Deviations between the predicted and measured images were quantified. The portal dose image prediction model developed in this thesis work has been shown to be accurate, and it was demonstrated to be able to verify patients’ delivered radiation treatments.

<p>Intensity-Modulated Radiation Treatment (IMRT) requires patient-specific quality assurance measurements, which can benefit from the convenience of using an Electronic Portal Imaging Device (EPID) for dose verification. However, EPIDs have limitations stemming from the non-uniform backscatter due to the support-arm as well as from scatter, glare, and an increased sensitivity to low-energy photons. None of these effects is typically accounted for in a treatment planning system (TPS) model, resulting in errors in calculated EPID response of up to 6%. This work addresses the non-uniform backscatter by directly incorporating a support-arm backscatter region into the TPS geometry. The shape of the backscatter region is adjusted iteratively until the TPS-calculated flood-field planar dose matches the flood-field EPID image The scatter, glare and increased low-energy response are addressed by using a radially-dependent Point-Spread Function (Kernel). The kernel is fitted using a least-squares method so that it best reproduces the EPID-acquired image for a checkerboard field. The backscatter-correction method is implemented for a Varian Clinac equipped with a 40 cm x 30 cm (512 x 384 pixel) EPID and a Pinnacle³ TPS and tested for several rectangular and IMRT fields. The scatter, glare and energy-response correction kernel is implemented and tested for a simulated checkerboard field and a simulated IMRT field. Agreement between the EPID-measured image and TPS-calculated planar dose map is seen to improve from 6% to 2% when the backscatter region is added to the Pinnacle³ model. Agreement between the simulated EPID images and simulated TPS images is improved from 14% to approx. 1% when the radially-dependent kernel is used. Simultaneous application of both the backscatter region and Point-Spread Function is a promising direction for future investigations.</p> / Master of Science (MSc)

Electronic Portal Image Devices (EPID) são dispositivos eletrônicos que foram criados originalmente para aquisição de imagens portais. Atualmente eles também têm sido estudados para reconstrução de dose no plano do eixo central (paralelo ao EPID) na modalidade transit (modalidade que considera um material atenuador entre a fonte e o EPID). Neste trabalho foi determinado um algoritmo de reconstrução de dose para relacionar mapas bidimensionais de dose localizados dentro de geometrias que simularam uma situação clínica em radioterapia de forma simplificada. Para tal foram feitas simulações Monte Carlo utilizando o pacote de simulação PENELOPE de maneira que um cubo composto de água representou o corpo do paciente e um paralelepípedo retângulo composto de água representou o EPID. Definiu-se primeiramente a geometria controle e os parâmetros de irradiação controle e então foram feitas simulações para determinar a equação de reconstrução de dose referencial. Uma vez determinada essa equação, foram feitas novas simulações variando o tamanho de campo, espessura do objeto simulador do corpo, distância entre a fonte e a superfície de entrada do objeto simulador do corpo (DFS) e distância entre a superfície de saída do objeto simulador do corpo e o centro do objeto simulador do EPID (DSDE). Os arquivos de saída dessas simulações alimentaram o programa contendo o algoritmo de reconstrução de dose, feito em MATLAB®. Após a aplicação do programa, comparou-se a matriz que representa o mapa bidimensional localizado dentro do objeto simulador do corpo com a matriz localizada no mesmo local, reconstruída a partir da matriz que representa o objeto simulador do EPID. Os resultados encontrados neste trabalho mostram que a equação de reconstrução de dose e o algoritmo de reconstrução de dose propostos são válidos com desvios padrão menor que 1,6%. / Electronic Portal Image Devices (EPID) were originally created to acquire portal images, but they have also been studied for dose reconstruction in the central axis plane (parallel to the EPID) in transit mode (mode which considers an attenuator material between the source and the EPID). In this work we determined a dose reconstruction algorithm that relate two-dimensional dose maps located within geometries that simulated a clinical situation in simplified form. For this, simulations were performed using the simulation package PENELOPE so that a cube composed of water represented the patients body and a rectangle parallelepiped composed of water represented the EPID. We defined a control geometry and control irradiation parameters first, then simulations were performed to determine the referential dose reconstruction equation. Once determined this equation, new simulations were performed varying the field size, the body phantom thickness, the distance between the source and the body phantom entrance surface (DFS) and the distance between the body phantom exit surface and the EPID phantom center. The output files of these simulations fed the program containing the dose reconstruction algorithm, wrote in MATLAB®. After the program application, we compared the matrix that represents the two-dimensional map located within the body phantom with the matrix located at the same site, reconstructed from the matrix that represents the EPID phantom. The results in this work show that the dose reconstruction equation and the dose reconstruction algorithm proposed are valid with less than 1,6% standard deviation.

Electronic Portal Image Devices (EPID) são dispositivos eletrônicos que foram criados originalmente para aquisição de imagens portais. Atualmente eles também têm sido estudados para reconstrução de dose no plano do eixo central (paralelo ao EPID) na modalidade transit (modalidade que considera um material atenuador entre a fonte e o EPID). Neste trabalho foi determinado um algoritmo de reconstrução de dose para relacionar mapas bidimensionais de dose localizados dentro de geometrias que simularam uma situação clínica em radioterapia de forma simplificada. Para tal foram feitas simulações Monte Carlo utilizando o pacote de simulação PENELOPE de maneira que um cubo composto de água representou o corpo do paciente e um paralelepípedo retângulo composto de água representou o EPID. Definiu-se primeiramente a geometria controle e os parâmetros de irradiação controle e então foram feitas simulações para determinar a equação de reconstrução de dose referencial. Uma vez determinada essa equação, foram feitas novas simulações variando o tamanho de campo, espessura do objeto simulador do corpo, distância entre a fonte e a superfície de entrada do objeto simulador do corpo (DFS) e distância entre a superfície de saída do objeto simulador do corpo e o centro do objeto simulador do EPID (DSDE). Os arquivos de saída dessas simulações alimentaram o programa contendo o algoritmo de reconstrução de dose, feito em MATLAB®. Após a aplicação do programa, comparou-se a matriz que representa o mapa bidimensional localizado dentro do objeto simulador do corpo com a matriz localizada no mesmo local, reconstruída a partir da matriz que representa o objeto simulador do EPID. Os resultados encontrados neste trabalho mostram que a equação de reconstrução de dose e o algoritmo de reconstrução de dose propostos são válidos com desvios padrão menor que 1,6%. / Electronic Portal Image Devices (EPID) were originally created to acquire portal images, but they have also been studied for dose reconstruction in the central axis plane (parallel to the EPID) in transit mode (mode which considers an attenuator material between the source and the EPID). In this work we determined a dose reconstruction algorithm that relate two-dimensional dose maps located within geometries that simulated a clinical situation in simplified form. For this, simulations were performed using the simulation package PENELOPE so that a cube composed of water represented the patients body and a rectangle parallelepiped composed of water represented the EPID. We defined a control geometry and control irradiation parameters first, then simulations were performed to determine the referential dose reconstruction equation. Once determined this equation, new simulations were performed varying the field size, the body phantom thickness, the distance between the source and the body phantom entrance surface (DFS) and the distance between the body phantom exit surface and the EPID phantom center. The output files of these simulations fed the program containing the dose reconstruction algorithm, wrote in MATLAB®. After the program application, we compared the matrix that represents the two-dimensional map located within the body phantom with the matrix located at the same site, reconstructed from the matrix that represents the EPID phantom. The results in this work show that the dose reconstruction equation and the dose reconstruction algorithm proposed are valid with less than 1,6% standard deviation.