A method to analyze 2-dimensional daily radiotherapy portal images from an on-line fiber-optic imaging system.

On-line radiotherapy imaging systems allow convenient treatment verification and generate a wealth of data. Quantitative analysis of data will provide important information about the nature of treatment variations. Using an inhouse fiber-optic imaging system to acquire daily portal images for five patients, we have developed a method to analyze the cumulative positional variation of blocks in the 2-dimensional images. For each beam arrangement used to treat a particular patient, a reference portal image was established. All other images for that patient were registered with respect to the anatomical landmarks visible on the reference image. Two-dimensional frequency distributions describing the overlap of the blocks during the course of treatment were then calculated and superimposed on the reference image. Results of the analysis show positional and quantitative information about the daily variation in block placement, and appeared to be site-dependent. Long term verification studies using on-line imaging systems will be important in the understanding of treatment uncertainties.

Portal dose images. II: Patient dose estimation.

Due to the many sources of uncertainties in radiotherapy, conventional treatment planning can only provide a nominal presentation of the dose delivered to the patient. Provided that large setup errors can be detected and corrected, we propose that measured and calculated portal dose images can be used to improve estimation of patient dose. The iterative approach described in this paper requires an accurate method of dose calculations, 3-dimensional CT data that closely represents the patient and the measured portal dose image. From the CT data, a portal dose image is calculated for comparison with the measured one. The differences are then used to modify the original CT data so that a new image can be calculated. The process is repeated until the calculated and measured images agree to satisfaction. At that point, the internal dose is calculated using the modified CT data. If the method is successful, daily portal dose images could be used to cumulatively estimate patient dose throughout the course of treatment. This manuscript describes 60Co simulation results to demonstrate the feasibility of the approach.

On-line radiotherapy imaging with an array of fiber-optic image reducers.

In the optical approach for on-line radiotherapy imaging, a large metal sheet-fluorescent screen combination is used to convert the radiation intensity distribution into a visible light image. Data are then captured via a mirror with a camera located out of the beam. Although usable portal images can be acquired, presence of the large mirror renders the system impractical in many treatment geometries. We have overcome this limitation by replacing the mirror with an array of 16 by 16 bundles of plastic fiber-optic image reducers. Each bundle, in turn, is made up of 16 by 16 individual optical fibers. The total of 256 by 256 fibers spans an input area of 40 cm by 40 cm with each individual fiber viewing an area of 1.6 mm by 1.6 mm. Within a height of 12 cm, each fiber is reduced to an area of 0.1 mm by 0.1 mm. The reduced portal image is then turned and "piped" to a final 3.0 cm by 3.0 cm output area. For data acquisition and digitization, the fiber output is directly coupled to the sensor of a TV camera interfaced to a small computer via a 512 by 512 frame grabber. In this initial evaluation, the imaging system has been characterized in terms of its line spread function, noise and resistance to radiation damage. Adequate phantom and patient images are presented.