The evaluation for the usability ofthe Varian Standard Couch modelingusing Treatment Planning System

치료계획 시스템을 이용한 Varian Standard Couch 모델링의 유용성 평가

  • Yang, yong mo (Samsung Medical Center, Department of Radiation Oncology) ;
  • Song, yong min (Samsung Medical Center, Department of Radiation Oncology) ;
  • Kim, jin man (Samsung Medical Center, Department of Radiation Oncology) ;
  • Choi, ji min (Samsung Medical Center, Department of Radiation Oncology) ;
  • Choi, byeung gi (Samsung Medical Center, Department of Radiation Oncology)
  • 양용모 (삼성서울병원 방사선종양학과) ;
  • 송용민 (삼성서울병원 방사선종양학과) ;
  • 김진만 (삼성서울병원 방사선종양학과) ;
  • 최지민 (삼성서울병원 방사선종양학과) ;
  • 최병기 (삼성서울병원 방사선종양학과)
  • Received : 2016.05.27
  • Accepted : 2016.06.23
  • Published : 2016.06.30

Abstract

Purpose : When a radiation treatment, there is an attenuation by Carbon Fiber Couch. In this study, we tried to evaluate the usability of the Varian Standard Couch(VSC) by modeling with Treatment Planning System (TPS) Materials and Methods : VSC was scanned by CBCT(Cone Beam Computed Tomography) of the Linac(Clinac IX, VARIAN, USA), following the three conditions of VSC, Side Rail OutGrid(SROG), Side Rail InGrid(SRIG), Side Rail In OutSpine Down Bar(SRIOS). After scan, the data was transferred to TPS and modeled by contouring Side Rail, Side Bar Upper, Side Bar Lower, Spine Down Bar automatically. We scanned the Cheese Phantom(Middelton, USA) using Computed Tomography(Light Speed RT 16, GE, USA) and transfer the data to TPS, and apply VSC modeled previously with TPS to it. Dose was measured at the isocenter of Ion Chamber(A1SL, Standard imaging, USA) in Cheese Phantom using 4 and 10 MV radiation for every $5^{\circ}$ gantry angle in a different filed size($3{\times}3cm^2$, $10{\times}10cm^2$) without any change of MU(=100), and then we compared the calculated dose and measured dose. Also we included dose at the $127^{\circ}$ in SRIG to compare the attenuation by Side Bar Upper. Results : The density of VSC by CBCT in TPS was $0.9g/cm^3$, and in the case of Spine Down Bar, it was $0.7g/cm^3$. The radiation was attenuated by 17.49%, 16.49%, 8.54%, and 7.59% at the Side Rail, Side Bar Upper, Side Bar Lower, and Spine Down Bar. For the accuracy of modeling, calculated dose and measured dose were compared. The average error was 1.13% and the maximum error was 1.98% at the $170^{\circ}beam$ crossing the Spine Down Bar. Conclusion : To evaluate the usability for the VSC modeled by TPS, the maximum error was 1.98% as a result of compassion between calculated dose and measured dose. We found out that VSC modeling helped expect the dose, so we think that it will be helpful for the more accurate treatment.

목 적 : 방사선 치료 시 Carbon Fiber Couch에 의한 감약이 일어난다. 본 연구에서는 치료계획 시스템(Treatment Planning System: TPS)을 이용해 Varian사의 Varian Standard Couch(VSC)를 모델링 하여 유용성을 평가하고자 한다. 대상 및 방법 : 선형가속기(Clinac IX, VARIAN, USA)의 CBCT(Cone Beam Computed Tomography)를 이용하여 VSC의3가지 조건Side Rail Out Grid(SROG), Side Rail InGrid(SRIG), Side Rail In OutSpine Down Bar(SRIOS)로 스캔 한 후 TPS(Pinnacle9.8, Philips, USA)로 전송하여 Side Rail, Side Bar Upper, Side Bar Lower, Spine Down Bar를 Automatic Contouring하여 모델링 하였다. 전산화 단층촬영(Light Speed RT 16, GE, USA)으로 스캔 한 Cheese Phantom(Middelton, USA) 을 TPS로 전송하여 모델링 한 VSC를 적용하였다. 측정 점은 Cheese Phantom내의 Ion Chamber(A1SL, Standard imaging, USA)이며 Isocenter에 위치시켜 Energy(4, 10MV), Gantry Angle($5^{\circ}$간격으로 측정), Field Size($3{\times}3cm^2$, $10{\times}10cm^2$)에 변화를 주어 각 100MU의 동일한 조건에서 얻은 계산 값과 측정값을 비교하였으며 Side Bar Upper에 의한 감약을 비교하기 위해 SRIG조건에서 $127^{\circ}$를 포함하였다. 결 과 : CBCT를 이용해 얻은 VSC의 Density를 TPS에서 확인한 결과 $0.9g/cm^3$였으며 Spine Down Bar의 경우 $0.7g/cm^3$로 나타났다.Side Rail, Side Bar Upper, Side Bar Lower, Spine Down Bar에서 각 17.49%, 16.49%, 8.54%, 7.59%의 감약이 일어났으며모델링의 정확성을 평가하기 위해 계산 값과 측정값을 비교한 결과 평균 1.13%의 오차가 보였으며 Spine Down Bar를 지나는 $170^{\circ}beam$에서 1.98%로 가장 많은오차를 보였다. 결 론 : TPS이용해 모델링 한 VSC의 유용성을 평가하기 위해계산 값과 측정값을 비교한 결과 최대1.98%의 오차를 보였다. 방사선 치료계획 시 VSC를 모델링 하여 적용한다면선량에 대한 예측이 가능해 더욱 정확한 치료를 하는데 도움이 될 것으로 사료된다.

Keywords

References

  1. De Mooy LG. The use of carbon fibers in radiotherapy. Radiother Oncol. 1991;22(2):140-142. https://doi.org/10.1016/0167-8140(91)90010-E
  2. Meara SJ, Langmack KA. An investigation into the use of carbon fibre for megavoltage radiotherapy applications. Phys Med Biol. 1998;43(5):1359-66. https://doi.org/10.1088/0031-9155/43/5/025
  3. W. Kenji Myint. Investigating treatment dose error due to beamattenuation by a carbon fibertabletop. Medical Physics. 2006;3(7):21-27
  4. Meyer J, Mills JA, Haas OC, Burnham KJ, Parvin EA. Accommodation of couch constraints for coplanar intensitymodulated radiation therapy. Radiother Oncol. 2001;61(1):23-32. https://doi.org/10.1016/S0167-8140(01)00393-0
  5. Myint WK, Niedbala M, Wilkins D, Gerig LH. Investigating treatment dose error due to beam attenuation by a carbon fiber tabletop. J Appl Clin Med Phys. 2006;7(3):21-27.
  6. Muthuswamy MS, Lam KL. A method of beam-couch intersection detection. Med Phys. 1999;26(2):229-235. https://doi.org/10.1118/1.598509
  7. McCormack S, Diffey J, Morgan A. The effect of gantry angle on megavoltage photon beam attenuation by a carbon fiber couch insert. Med Phys. 2005;32(2):483-87. https://doi.org/10.1118/1.1852792
  8. Jan K.H. seppala, Jarmo A.J. Kulmala. Increased beam attenuation and surface dose by different couch inserts of treatment tables used in megavoltage radiotherapy. Med Phys.2011;12(4):15-23
  9. Sanchez-Nieto B, Nahum AE. The delta-TCP concept: A clinically useful measure of tumor control probability.Int J Rad Oncol Biol Phys. 1999;44(2):369-380. https://doi.org/10.1016/S0360-3016(99)00029-2
  10. S. C. Vieira, R. S. Kaatee, M. L. Dirkx, and B. J. Heijmen, "Twodimensionalmeasurement f photon beam attenuation by the treatmentcouch and immobilization devices using an electronic portal imaging device,"Med. Phys. 30_11_, 2981-2987_2003_.
  11. Mihaylov IB, Corry P, Yan Y, Ratanatharathorn V, Moros EG. Modeling of carbon fiber couch attenuation properties with a commercial treatment planning system. Med Phys. 2008;35(11):4982-88. https://doi.org/10.1118/1.2982135
  12. Mijnheer BJ, Battermann JJ, Wambersie A. What degree of accuracy is required and can be achieved in photonand neutron therapy. Radiother Oncol. 1987;8(3):237-252. https://doi.org/10.1016/S0167-8140(87)80247-5