One of the most used irradiation techniques in modern radiation therapy is step-and-shoot IMRT. The accuracy of this technique when delivering complex dose distributions strongly depends on the size of the subfields. The aims of this study is to determine the minimum size of subfields that can be used efficiently in Step-and-Shoot IMRT, to investigate the validation process for beam delivery and treatment planning dose calculations, and to find recommendations for practical clinical implementations. Two different detectors, a CC04 ion chamber and a SFD stereotactic diode, have been used for measuring head scatter factors in air (Sc), total output factors (Scp) and dose profiles in water for a wide range of field sizes. The measurements were compared to calculations done with a pre-release version of the Nucletron MasterPlanTM v 3.1 treatment planning system that employs a novel, high resolution fluence modelling for both its pencil beam and collapsed cone dose calculation algorithms. Collimator settings were explicitly checked using FWHM film measurements with a build-up sheet of tungsten placed close to the treatment head to reduce the influence from lateral electron transport and geometrical penumbra. An analysis of the influence and sensitivity of Scp for small fields with respect to the linear accelerator source size and shape was also made. The measurements with the ionization chamber and the stereotactic diode showed good agreements with each other and with the treatment planning system calculations for field sizes larger than 2×2 cm2. For small field sizes, measurements with different detectors yielded different results. Calculations showed agreements with measurements with the smallest detector, provided careful field size calibration and commissioning of calculation parameters. Uncertainties in collimator settings and source characteristics were shown to yield large uncertainties in Scp for fields smaller than 2×2 cm2. The treatment planning system was found to properly handle small subfields but results were very sensitive to uncertainties in source size, as well as calibration and reproducibility of the collimator settings. Therefore if subfields smaller than 2×2 cm2 are to be used in IMRT extra care should be taken to determine the source characteristics and to calibrate the collimators. The volume of the detectors used for validation of such small fields and the loss of charged particle equilibrium conditions also have to be taken into consideration.

The thesis presents a comparison of four techniques used for stereotactic radiosurgery, consisting of the static conformal beam, static cone-based, proton therapy, and the Gamma Knife techniques. The comparisons involved six test cases in which phantom target lesions were created in the center of the modified anthropomorphic RandoRTM head. The phantom lesions presented in the study were extreme irregular cases that ranged in shape and volume and were near a critical structure to receive minimal dose during treatment planning. The best treatment plans from each technique for all studies were selected and the extracted data was analyzed using physical and biological parameters. Correlations between integral biological effective dose (normal brain) and normal tissue complication probability were analyzed as a function of dose conformity (PITV), and correlations between tumor control probability and integral biological effective dose (tumor) as a function of dose homogeneity (MDPD) were analyzed, as well. These parameter pairings showed strong links. The static conformal beam and the proton SOBP techniques consistently provided low PITV and MDPD values for all cases, including the most irregular and complicated cases. Higher PITV and MDPD values, typically associated with static cone-based and the Gamma Knife techniques, were due to normal tissue and tumor tissue, respectively, being irradiated at higher dose levels than the prescribed dose. For these cases, as the PITV increased, the NTCP increased, as well, due to high doses created within the normal tissue found within the prescription isodose surface.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 4 uppsatser.

Thesis (M.S.)--University of Toledo, 2008. / "In partial fulfillment of the requirements for the degree of Master of Science in Biomedical Sciences." Title from title page of PDF document. Bibliography: pages 67-72.

Diss. (sammanfattning) Stockholm : Stockholms universitet, 2008. / Härtill 7 uppsatser.

Thesis--University of Oklahoma. / Bibliography: leaves 78-79.

Thesis (M.Sc.). / Written for the Medical Physics Unit. Title from title page of PDF (viewed ). Includes bibliographical references.

Originally presented as the author's Thesis (Ph. D.)--"Otto von Guericke" Universität Magdeburg, 2003. / "Elektrotechnik"--Cover. Includes bibliographical references (p. 145-149).

Optimization and planning of radiation therapy is performed in a treatment planning system. This includes the definition of target structures to be irradiated and organs at risk to be protected, typically performed by contouring structures slice by slice in the image data. Conversions between contours and their volume representations are needed for visualizations and computations, but will however introduce a loss of information due to the sampling to a uniform voxel grid. The number of conversions performed can be large, causing errors to accumulate. The aim of this thesis is to examine volume reconstruction methods and sparse voxel representations for the purpose of volume reconstruction and representation with better accuracy than currently used algorithms in treatment planning systems. A prototype has been shown to be more accurate on contours and potentially cheaper in memory compared to the current method in RayStation in the case where contours represent non-smooth objects.

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