A deformable head and neck phantom with in-vivo dosimetry for adaptive radiotherapy quality assurance.

PURPOSE: Patients' interfractional anatomic changes can compromise the initial treatment plan quality. To overcome this issue, adaptive radiotherapy (ART) has been introduced. Deformable image registration (DIR) is an important tool for ART and several deformable phantoms have been built to evaluate the algorithms' accuracy. However, there is a lack of deformable phantoms that can also provide dosimetric information to verify the accuracy of the whole ART process. The goal of this work is to design and construct a deformable head and neck (HN) ART quality assurance (QA) phantom with in vivo dosimetry. METHODS: An axial slice of a HN patient is taken as a model for the phantom construction. Six anatomic materials are considered, with HU numbers similar to a real patient. A filled balloon inside the phantom tissue is inserted to simulate tumor. Deflation of the balloon simulates tumor shrinkage. Nonradiopaque surface markers, which do not influence DIR algorithms, provide the deformation ground truth. Fixed and movable holders are built in the phantom to hold a diode for dosimetric measurements. RESULTS: The measured deformations at the surface marker positions can be compared with deformations calculated by a DIR algorithm to evaluate its accuracy. In this study, the authors selected a Demons algorithm as a DIR algorithm example for demonstration purposes. The average error magnitude is 2.1 mm. The point dose measurements from the in vivo diode dosimeters show a good agreement with the calculated doses from the treatment planning system with a maximum difference of 3.1% of prescription dose, when the treatment plans are delivered to the phantom with original or deformed geometry. CONCLUSIONS: In this study, the authors have presented the functionality of this deformable HN phantom for testing the accuracy of DIR algorithms and verifying the ART dosimetric accuracy. The authors' experiments demonstrate the feasibility of this phantom serving as an end-to-end ART QA phantom.

A comparative study of young and mature bovine cortical bone.

The mechanical properties and microstructure of young and mature bovine femur bone were investigated by optical microscopy and compression testing in the longitudinal and transverse directions for untreated, deproteinized and demineralized cases. Optical microscopy revealed that mature bone has a more established and less porous microstructure compared to young bone. Mature bone was found to be stronger in both directions for the untreated and deproteinized cases. Mature untreated bone was also found to be stiffer and less tough compared to young bone in both directions. These results are related to the increase in mineralization of mature bone and significant microstructural differences. Young bone was found to be stronger in both directions for the demineralized case, which is attributed to alterations in the collagen network with age.