Influence of the Planning Parameters of a New Algorithm on the Dosimetric Quality, Beam-On Time and Delivery Accuracy of Tomotherapy Plans.

BACKGROUND: This work aimed to determine the optimum VOLOTM Ultra algorithm parameters for tomotherapy treatments. METHODS: 1056 treatment plans were generated with VOLOTM Ultra for 36 patients and six anatomical locations. The impact of varying four parameters was studied: the accelerated treatment (AT), leaf open/close time (LOT) cutoff, normal tissue objective (NTO) weight, and number of iterations. The beam-on time and dosimetric metrics were quantified for the target volumes and organs at risk (OARs). Delivery quality assurance measurements were obtained for 36 plans to assess the delivery accuracy. RESULTS: The mean beam-on time for the helical tomotherapy and TomoDirect (TD) plans decreased by 26.6 ± 2.8% and 17.4 ± 4.3%, respectively, when the accelerated treatment parameter was increased from 0 to 10, at the expense of the planning target volume (PTV) coverage (2% lower D98%) and OAR dose (up to 15% increase). For TD plans, it seems preferable to systematically use an AT value of 10. Increasing the number of iterations beyond six seems unnecessary. In this study, an NTO weight of approximately 10 appears to be ideal and eliminates the need to use rings in the treatment plan. Finally, no correlation was found between the leaf open/close time cutoff and the delivery accuracy, while a leaf open/close cutoff of 60 ms seemed to degrade dosimetry quality. CONCLUSION: Optimal values for the AT, LOT cutoff, NTO weight, and number of optimization rounds were identified and should help improve the management of patients whose tomotherapy treatments are planned with VOLOTM Ultra.

RPL Neutron Dosimetry in n-γ Fields in Comparison with Polymer Detectors Type CR-39.

Previously we characterized radiophotoluminescent (RPL) detectors for measuring both fast and thermal neutrons for personal monitoring. The linear response and angular dependence, which satisfies the ISO 21909 standard makes their application possible in neutron dosimetry. The polymer CR-39 track detectors remain one of the most used dosimeters where neutron radiations are to be measured, but the visualization process is time consuming. The difference between results obtained by RPL and CR-39 has been discussed mainly for fast neutrons. The present study has also looked at thermal neutron dosimetry, where we found few results in the literature for CR-39. Our measurements demonstrate that RPL detectors can be advantageously incorporated into a dosimeter to measure thermal neutrons.

Real-time detection of fast and thermal neutrons in radiotherapy with CMOS sensors.

The peripheral dose distribution is a growing concern for the improvement of new external radiation modalities. Secondary particles, especially photo-neutrons produced by the accelerator, irradiate the patient more than tens of centimeters away from the tumor volume. However the out-of-field dose is still not estimated accurately by the treatment planning softwares. This study demonstrates the possibility of using a specially designed CMOS sensor for fast and thermal neutron monitoring in radiotherapy. The 14 microns-thick sensitive layer and the integrated electronic chain of the CMOS are particularly suitable for real-time measurements in γ/n mixed fields. An experimental field size dependency of the fast neutron production rate, supported by Monte Carlo simulations and CR-39 data, has been observed. This dependency points out the potential benefits of a real-time monitoring of fast and thermal neutron during beam intensity modulated radiation therapies.