A brief look at model-based dose calculation principles, practicalities, and promise.

Model-based dose calculation algorithms (MBDCAs) have recently emerged as potential successors to the highly practical, but sometimes inaccurate TG-43 formalism for brachytherapy treatment planning. So named for their capacity to more accurately calculate dose deposition in a patient using information from medical images, these approaches to solve the linear Boltzmann radiation transport equation include point kernel superposition, the discrete ordinates method, and Monte Carlo simulation. In this overview, we describe three MBDCAs that are commercially available at the present time, and identify guidance from professional societies and the broader peer-reviewed literature intended to facilitate their safe and appropriate use.

Transit dose contributions to intracavitary and interstitial PDR brachytherapy treatments.

The objective of this study was to determine the magnitude of transit dose contributions to the planned dose in common intracavitary and interstitial brachytherapy treatments delivered using a pulsed dose rate (PDR) remote afterloader. The total transit dose arises from the travel of the radiation source into (entry) and out of (exit) the applicator, and between the dwell positions (inter-dwell). In this paper, we used a well-type ionization chamber to measure the transit dose component for a PDR afterloader and compared the results against measurements for a high dose rate (HDR) afterloader.

Compensator thickness verification using an a-Si EPID.

Electronic portal imaging devices (EPIDs) are being increasingly employed to make therapy verification and dose measurements in the clinic. In this work, we investigate the use of an amorphous silicon (a-Si) EPID to verify the accuracy of compensator fabrication and mounting. Compensator thickness estimates on a two-dimensional grid were calculated from the primary component of transmission obtained by subtracting a modeled scatter component from the total transmission measured with the EPID.

Quality assurance measurements of a-Si EPID performance.

The performance stability of a Varian aS500 amorphous silicon (a-Si) electronic portal imaging device (EPID) was monitored over an 18-month period using a variety of standard quality assurance (QA) tests. The tests were selected to provide ongoing information about image quality and dose response from the time of EPID acceptance into clinical service. To evaluate imaging performance, we made spatial resolution and contrast measurements using both PortalVision and QC-3V phantoms for 6- and 15-MV photon beams at repetition rates of 100, 300, and 400 MU/min in standard scanning mode.

Compensator quality control with an amorphous silicon EPID.

The calibration and quality control of compensators is conventionally performed with an ion chamber in a water-equivalent phantom. In our center, the compensator factor and four off-axis fluence ratios are measured to verify the central axis beam modulation and orientation of the compensator. Here we report the investigation of an alternative technique for compensator quality control using an amorphous silicon electronic portal imaging device (a-Si EPID).