Biomedical subjects

C M Ma

Publications and source records attributed to C M Ma.

At least 19 recordsLinked to original sources

PubMed2005

Dosimetry validation of treatment room shielding design.

Intensity-modulated radiation therapy (IMRT) can lead to an increase in leakage radiation. The total number of monitor units (MUs) for IMRT is typically 2-5 times that for conventional treatments [the ratio of the two is used to derive the effective modulation scaling factor (MSFeff)]. Shielding calculations for IMRT can be done by applying the MSFeff to measured exposures under conservative conditions (standard beam setup 40 cm x 40 cm field, 45 degrees collimator angle) to account for the increased leakage. In this work, we verified this approach for two existing vaults housing a Siemens Primart 6 MV linac and a Varian 21Ex 10 MV linac. We measured the cumulative exposures at various locations around the vaults for typical IMRT cases and for the standard beam setup using the same MUs. For the standard beam setup, the IMRT gantry angles and eight equally spaced angles were used. Estimations of weekly exposures for IMRT were carried out using exposure rates measured under standard beam setup and the MSFeff averaged over 20 treatment cases. The accumulated exposures under realistic IMRT conditions were 30%-50% lower than the estimated values using equally spaced gantry angles except for two locations where the real IMRT leakage was higher than the estimated value by approximately 10%. Measurements using the same gantry angles yielded similar results. Our results indicate that it is adequate to use the MSFeff and previously measured exposures to estimate the leakage increase due to IMRT for an existing vault. Different approaches should be followed when considering primary or secondary barriers since the standard beam setup is overestimating the exposures behind primary barriers compared to IMRT. In such cases, a 10 cm x 10 cm field can be used for more accurate shielding evaluation.

Computer-Aided Design↗

PubMed2005

New aristolochic acid, aristololactam and renal cytotoxic constituents from the stem and leaves of Aristolochia contorta.

Two novel phenanthrene derivatives, aristololactam IVa (1) and 9-hydroxy aristolochic acid I (2) were isolated from the stem and leaves of Anstolochia contorta Bunge, together with 17 known compounds (3-19). The structures of these compounds were determined by spectroscopic analysis. The phenanthrenes obtained were tested for cytotoxicity against renal proximal tubular epithelial cell line (HK-2). Aristololactam IVa and 7-methoxy aristololactam IV were found to have strong cytotoxic activity against HK-2 cells with a potency similar to or even stronger than those of aristolochic acid I and aristololactam I.

Aristolochia↗

PubMed2004

Modelling of electron contamination in clinical photon beams for Monte Carlo dose calculation.

The purpose of this work is to model electron contamination in clinical photon beams and to commission the source model using measured data for Monte Carlo treatment planning. In this work, a planar source is used to represent the contaminant electrons at a plane above the upper jaws. The source size depends on the dimensions of the field size at the isocentre. The energy spectra of the contaminant electrons are predetermined using Monte Carlo simulations for photon beams from different clinical accelerators. A 'random creep' method is employed to derive the weight of the electron contamination source by matching Monte Carlo calculated monoenergetic photon and electron percent depth-dose (PDD) curves with measured PDD curves. We have integrated this electron contamination source into a previously developed multiple source model and validated the model for photon beams from Siemens PRIMUS accelerators. The EGS4 based Monte Carlo user code BEAM and MCSIM were used for linac head sinulation and dose calculation. The Monte Carlo calculated dose distributions were compared with measured data. Our results showed good agreement (less than 2% or 2 mm) for 6, 10 and 18 MV photon beams.

Artifacts↗

PubMed2004

Optimization of combined electron and photon beams for breast cancer.

Recently, intensity-modulated radiation therapy and modulated electron radiotherapy have gathered a growing interest for the treatment of breast and head and neck tumours. In this work, we carried out a study to combine electron and photon beams to achieve differential dose distributions for multiple target volumes simultaneously. A Monte Carlo based treatment planning system was investigated, which consists of a set of software tools to perform accurate dose calculation, treatment optimization, leaf sequencing and plan analysis. We compared breast treatment plans generated using this home-grown optimization and dose calculation software for different treatment techniques. Five different planning techniques have been developed for this study based on a standard photon beam whole breast treatment and an electron beam tumour bed cone down. Technique 1 includes two 6 MV tangential wedged photon beams followed by an anterior boost electron field. Technique 2 includes two 6 MV tangential intensity-modulated photon beams and the same boost electron field. Technique 3 optimizes two intensity-modulated photon beams based on a boost electron field. Technique 4 optimizes two intensity-modulated photon beams and the weight of the boost electron field. Technique 5 combines two intensity-modulated photon beams with an intensity-modulated electron field. Our results show that technique 2 can reduce hot spots both in the breast and the tumour bed compared to technique 1 (dose inhomogeneity is reduced from 34% to 28% for the target). Techniques 3, 4 and 5 can deliver a more homogeneous dose distribution to the target (with dose inhomogeneities for the target of 22%, 20% and 9%, respectively). In many cases techniques 3, 4 and 5 can reduce the dose to the lung and heart. It is concluded that combined photon and electron beam therapy may be advantageous for treating breast cancer compared to conventional treatment techniques using tangential wedged photon beams followed by a boost electron field.

Breast↗

PubMed2004

Monitor unit calculation for Monte Carlo treatment planning.

In this work, we investigate a formalism for monitor unit (MU) calculation in Monte Carlo based treatment planning. By relating MU to dose measured under reference calibration conditions (central axis, depth of dose maximum in water, 10 cm x 10 cm field defined at 100 cm source-to-surface distance) our formalism determines the MU required for a treatment plan based on the prescription dose and Monte Carlo calculated dose distribution. Detailed descriptions and formulae are given for various clinical situations including conventional treatments and advanced techniques such as intensity-modulated radiotherapy (IMRT) and modulated electron radiotherapy (MERT). Analysis is made of the effects of source modelling, beam modifier simulation and patient dose calculation accuracy, all of which are important factors for absolute dose calculations using Monte Carlo simulations. We have tested the formalism through phantom measurements and the predicted MU values were consistent with measured values to within 2%. The formalism has been used for MU calculation and plan comparison for advanced treatment techniques such as MERT, extracranial stereotactic IMRT, MRI-based treatment planning and intensity-modulated laser-proton therapy studies. It is also used for absolute dose calculations using Monte Carlo simulations for treatment verification, which has become part of our comprehensive IMRT quality assurance programme.

Dose-Response Relationship, Radiation↗

PubMed2004

Modelling 6 MV photon beams of a stereotactic radiosurgery system for Monte Carlo treatment planning.

The goal of this work is to build a multiple source model to represent the 6 MV photon beams from a Cyberknife stereotactic radiosurgery system for Monte Carlo treatment planning dose calculations. To achieve this goal, the 6 MV photon beams have been characterized and modelled using the EGS4/BEAM Monte Carlo system. A dual source model has been used to reconstruct the particle phase space at a plane immediately above the secondary collimator. The proposed model consists of two circular planar sources for the primary photons and the scattered photons, respectively. The dose contribution of the contaminant electrons was found to be in the order of 10(-3) of the total maximum dose and therefore has been omitted in the source model. Various comparisons have been made to verify the dual source model against the full phase space simulated using the EGS4/BEAM system. The agreement in percent depth dose (PDD) curves and dose profiles between the phase space and the source model was generally within 2%/1 mm for various collimators (5 to 60 mm in diameter) at 80 to 100 cm source-to-surface distances (SSD). Excellent agreement (within 1%/1 mm) was also found between the dose distributions in heterogeneous lung and bone geometry calculated using the original phase space and those calculated using the source model. These results demonstrated the accuracy of the dual source model for Monte Carlo treatment planning dose calculations for the Cyberknife system.

Models, Theoretical↗

PubMed2004

Daily target localization for prostate patients based on 3D image correlation.

There are several localization techniques that have been used for prostate treatment. Recently, the potential use of a variety of CT-based equipment in the treatment room has been discussed. The goal of our study was to develop an automated procedure for daily treatment table shift calculation based on two CT data sets: simulation CT data and localization CT data. The method suggested in this study is a 3D image cross-correlation of small regions of interest (ROI) within the two data sets. The relative position of the two ROIs with respect to each other is determined by the maximum value of the normalized cross-correlation function, calculated for all possible relative locations of the two ROIs. After the best match is found the shifts are given by the vector connecting the treatment isocentre and the planning isocentre (both determined by the radio opaque fiducial markers on the patient's skin). The results have been compared with shifts calculated through manual fusion. The shift differences, averaged over 17 statistically independent shift calculations, are less then 1 mm in the lateral and longitudinal directions, and about 1 mm in the AP direction. The impact of image noise on the performance of the algorithm has been tested. The results show that the algorithm accurately adjusts for target positional changes even with Gaussian noise levels as high as 20% inserted.

Algorithms↗

PubMed2004

Clinical implementation of intensity-modulated tangential beam irradiation for breast cancer.

A Monte Carlo based intensity-modulated radiation therapy (IMRT) treatment planning system has been developed and used for breast treatment. An iterative method was used for optimization to generate IMRT plans and a step-and-shoot technique was used for beam delivery. The patient setup and incident beam directions were the same as those for conventional tangential photon treatment. The weights for the opposed beamlets in the two tangential beams were determined first by the doses at the depths of the maximum dose at both sides to minimize hot spots. The intensity of an individual beamlet pair was then optimized based on the dose at the midplane. Fine tuning was made to achieve optimal target dose uniformity and to reduce the dose to the heart when necessary. The final dose calculations were performed using the Monte Carlo method and the plans were verified by phantom measurements. The dose distributions and dose-volume-histograms of IMRT plans were compared with those of conventional plans that were generated using a commercial treatment planning system and recalculated using an in-house Monte Carlo system for the first 25 patients. The dose comparisons showed that the percentage volume receiving more than 95% of the prescription dose (V95) and the percentage volume receiving more than 100% of the prescription dose (V100) for the clinical target volume (CTV) of IMRT plans were about the same as those of conventional plans. The percentage volume receiving more than 105% of the prescription dose (V105) for the CTV was reduced from 23.1% to 7.9% on average. The percentage volume of the lung receiving more than 20 Gy dose (V20 Gy) during the entire treatment was reduced by about 10%. The percentage volume of the heart receiving more than 30 Gy dose (V30 Gy) is reduced from 3.3% to 0.3%. Further studies revealed that a less than 5 degrees change in couch angle and collimator angle at patient setup had no significant effect on the dose coverage of CTV but had significant effect on the dose to the lung and heart. The study on the effect of beam spoiler showed that it increased the dose at the buildup region by 0- 13% that varies with location. The machine output linearity and stability for small monitor unit delivery of Siemens accelerators used for this study was checked and found to be suitable for breast IMRT. The total effect of variations was calculated to be less than 1% for typical breast treatments. The beam delivery time was increased by about 2 min compared with conventional tangential treatments. The whole treatment including patient setup and beam delivery can be completed in a 15 min slot. The IMRT technique has been proven practical for breast treatment clinically. The results showed that tangential IMRT improved the dose homogeneity in the breast and reduced the dose to the lung and heart.

Algorithms↗

PubMed2003

Intensity modulated radiation therapy using laser-accelerated protons: a Monte Carlo dosimetric study.

In this paper we present Monte Carlo studies of intensity modulated radiation therapy using laser-accelerated proton beams. Laser-accelerated protons coming out of a solid high-density target have broad energy and angular spectra leading to dose distributions that cannot be directly used for therapeutic applications. Through the introduction of a spectrometer-like particle selection system that delivers small pencil beams of protons with desired energy spectra it is feasible to use laser-accelerated protons for intensity modulated radiotherapy. The method presented in this paper is a three-dimensional modulation in which the proton energy spectrum and intensity of each individual beamlet are modulated to yield a homogeneous dose in both the longitudinal and lateral directions. As an evaluation of the efficacy of this method, it has been applied to two prostate cases using a variety of beam arrangements. We have performed a comparison study between intensity modulated photon plans and those for laser-accelerated protons. For identical beam arrangements and the same optimization parameters, proton plans exhibit superior coverage of the target and sparing of neighbouring critical structures. Dose-volume histogram analysis of the resulting dose distributions shows up to 50% reduction of dose to the critical structures. As the number of fields is decreased, the proton modality exhibits a better preservation of the optimization requirements on the target and critical structures. It is shown that for a two-beam arrangement (parallel-opposed) it is possible to achieve both superior target coverage with 5% dose inhomogeneity within the target and excellent sparing of surrounding tissue.

Algorithms↗

PubMed2003

A comparative dosimetric study on tangential photon beams, intensity-modulated radiation therapy (IMRT) and modulated electron radiotherapy (MERT) for breast cancer treatment.

Recently, energy- and intensity-modulated electron radiotherapy (MERT) has garnered a growing interest for the treatment of superficial targets. In this work. we carried out a comparative dosimetry study to evaluate MERT, photon beam intensity-modulated radiation therapy (IMRT) and conventional tangential photon beams for the treatment of breast cancer. A Monte Carlo based treatment planning system has been investigated, which consists of a set of software tools to perform accurate dose calculation, treatment optimization, leaf sequencing and plan analysis. We have compared breast treatment plans generated using this home-grown treatment optimization and dose calculation software forthese treatment techniques. The MERT plans were planned with up to two gantry angles and four nominal energies (6, 9, 12 and 16 MeV). The tangential photon treatment plans were planned with 6 MV wedged photon beams. The IMRT plans were planned using both multiple-gantry 6 MV photon beams or two 6 MV tangential beams. Our results show that tangential IMRT can reduce the dose to the lung, heart and contralateral breast compared to conventional tangential wedged beams (up to 50% reduction in high dose volume or 5 Gy in the maximum dose). MERT can reduce the maximum dose to the lung by up to 20 Gy and to the heart by up to 35 Gy compared to conventional tangential wedged beams. Multiple beam angle IMRT can significantly reduce the maximum dose to the lung and heart (up to 20 Gy) but it induces low and medium doses to a large volume of normal tissues including lung, heart and contralateral breast. It is concluded that MERT has superior capabilities to achieve dose conformity both laterally and in the depth direction, which will be well suited for treating superficial targets such as breast cancer.

Breast Neoplasms↗

PubMed2003

A quality assurance phantom for IMRT dose verification.

This paper investigates a quality assurance (QA) phantom specially designed to verify the accuracy of dose distributions and monitor units (MU) calculated by clinical treatment planning optimization systems and by the Monte Carlo method for intensity-modulated radiotherapy (IMRT). The QA phantom is a PMMA cylinder of 30 cm diameter and 40 cm length with various bone and lung inserts. A procedure (and formalism) has been developed to measure the absolute dose to water in the PMMA phantom. Another cylindrical phantom of the same dimensions, but made of water, was used to confirm the results obtained with the PMMA phantom. The PMMA phantom was irradiated by 4, 6 and 15 MV photon beams and the dose was measured using an ionization chamber and compared to the results calculated by a commercial inverse planning system (CORVUS, NOMOS, Sewickley, PA) and by the Monte Carlo method. The results show that the dose distributions calculated by both CORVUS and Monte Carlo agreed to within 2% of dose maximum with measured results in the uniform PMMA phantom for both open and intensity-modulated fields. Similar agreement was obtained between Monte Carlo calculations and measured results with the bone and lung heterogeneity inside the PMMA phantom while the CORVUS results were 4% different. The QA phantom has been integrated as a routine QA procedure for the patient's IMRT dose verification at Stanford since 1999.

Equipment Design↗

PubMed2003

Particle selection for laser-accelerated proton therapy feasibility study.

In this paper we present calculations for the design of a particle selection system for laser-accelerated proton therapy. Laser-accelerated protons coming from a thin high-density foil have broad energy and angular spectra leading to dose distributions that cannot be directly used for therapeutic applications. Our solution to this problem is a compact particle selection and collimation device that delivers small pencil beams of protons with desired energy spectra. We propose a spectrometer-like particle selection and beam modulation system in which the magnetic field will be used to spread the protons spatially according to their energies and emitting angles. Subsequently, an aperture will be used to select the protons within a therapeutic window of energy (energy modulation). It will be shown that for the effective proton spatial differentiation, the primary collimation device should be used, which will collimate protons to the desired angular distribution and limit the spatial mixing of different energy protons once they have traveled through the magnetic system. Due to the angular proton distribution, the spatial mixing of protons of different energies will always be present and it will result in a proton energy spread with the width depending on the energy. For 250 MeV protons, the width (from the maximum to the minimum energy) is found to be 50 MeV for the magnetic field configuration used in our calculations. As the proton energy decreases, its energy width decreases as well, and for 80 MeV protons it equals 9 MeV. The presence of the energy width in the proton energy distribution will modify the depth dose curves needed for the energy modulation calculation. The matching magnetic field setup will ensure the refocusing of the selected protons and the final beam will be collimated by the secondary collimator. The calculations presented in this article show that the dose rate that the selection system can yield is on the order of D=260 Gy/min for a field size of 1 x 1 cm2.

Equipment Design↗

PubMed2003

Dose correlation for thoracic motion in radiation therapy of breast cancer.

This work investigates the dose correlation for deformed objects due to thoracic motion for radiotherapy treatment of breast cancer. An analytical model has been developed to reconstruct patient anatomy based on the assumption that the body will expand or compress proportionally during respiration. The patient geometry at any phase during a breathing pattern is reconstructed using the CT data taken at the inspiration and expiration phases and the breathing level which can be related to the measured chest wall motion. A correlation between the voxels in the inspiration (or expiration) geometry and the voxels in the reconstructed geometry at any phase of the breathing pattern is established so that the dose can be accumulated during a treatment. The method has been implemented for treatment planning dose calculation by interfacing with a Monte Carlo code. The patient geometry files for different phases of the breathing pattern are generated and the three-dimensional dose data are obtained from the Monte Carlo simulations. The final dose distribution is reconstructed from the dose data at different breathing phases based on patient's breathing pattern associated with chest wall movements.

Artifacts↗

PubMed2003

Commissioning 6 MV photon beams of a stereotactic radiosurgery system for Monte Carlo treatment planning.

The goal of this work is to implement a beam commissioning procedure to generate a multiple source model using a set of standard measurement data for possible Monte Carlo treatment planning in the clinic for a Cyberknife stereotactic radiosurgery system. The required measurement data include the central axis depth dose curve (PDD), the dose profile at dmax(= 1.5 cm) of 60 mm cone at 80 cm source-to-surface distance (SSD), and the cone output factors for cones of 5 mm to 60 mm at 80 cm source-to-axis distance (SAD). The employed dual source model has the same structure as the one that has been studied in our previous work while most of the parameters of each source are extracted from the measurement data rather than the beam phase space. The energy spectra will be extracted from the central axis PDD, the fluence distributions will be deconvoluted from the dose profile at dmax, and the source distributions will be determined from the measured cone output factors. Monte Carlo dose calculations in various water phantoms have been performed to verify the beam commissioning procedure. The agreement between the measurements and the commissioning results was within 2%/1 mm for the central axis PDDs and the dose profiles at various depths when an IC-3 chamber was used and within 2% for the cone output factors for various collimator sizes of 5 to 60 mm. Largest difference (9.5%) was observed for the 7.5 mm cone when an IC-10 chamber was used. The large differences can be attributed to the volumetric averaging effect of the IC-10 chamber, whose dimension is comparable to the field of the small cones. The overall agreement between the measurements and the commissioning results is clinically acceptable, which implies that our commissioning tool is adequate for clinical applications of Monte Carlo dose calculations for the Cyberknife stereotactic radiosurgery system.

Monte Carlo Method↗

PubMed2002

A Monte Carlo dose calculation tool for radiotherapy treatment planning.

A Monte Carlo user code, MCDOSE, has been developed for radiotherapy treatment planning (RTP) dose calculations. MCDOSE is designed as a dose calculation module suitable for adaptation to host RTP systems. MCDOSE can be used for both conventional photon/electron beam calculation and intensity modulated radiotherapy (IMRT) treatment planning. MCDOSE uses a multiple-source model to reconstruct the treatment beam phase space. Based on Monte Carlo simulated or measured beam data acquired during commissioning, source-model parameters are adjusted through an automated procedure. Beam modifiers such as jaws, physical and dynamic wedges, compensators, blocks, electron cut-outs and bolus are simulated by MCDOSE together with a 3D rectilinear patient geometry model built from CT data. Dose distributions calculated using MCDOSE agreed well with those calculated by the EGS4/DOSXYZ code using different beam set-ups and beam modifiers. Heterogeneity correction factors for layered-lung or layered-bone phantoms as calculated by both codes were consistent with measured data to within 1%. The effect of energy cut-offs for particle transport was investigated. Variance reduction techniques were implemented in MCDOSE to achieve a speedup factor of 10-30 compared to DOSXYZ.

Computer Simulation↗

PubMed2002

A Monte Carlo investigation of fluence profiles collimated by an electron specific MLC during beam delivery for modulated electron radiation therapy.

Modulated electron radiation therapy (MERT) is able to deliver conformal dose to shallow tumors while significantly reducing dose to distal structures and surrounding tissues. An electron specific multileaf collimator (eMLC) has been proposed and constructed as an effective means of delivering electron beams for MERT. The aim of this work is to apply the Monte Carlo method to investigate the fluence profiles collimated by the eMLC in order to achieve accurate beam delivery for MERT. In this work, the EGS4/BEAM code was used to simulate the eMLC collimated electron beams of 6-20 MeV generated from a Varian Clinac 2100C linear accelerator. An attempt was made to describe the fluence profiles with an analytic Sigmoid function. The function parameters were determined by the fittings of the Monte Carlo simulated fluence profiles. How the function parameters depend on the eMLC aperture size, the off-axis location, and the electron beam energy has been investigated. It has been found that the eMLC collimated fluence profiles are dependent on beam energy, while almost independent of leaf location or dimension of MLC aperture. There is little difference in the fluence profiles collimated by the leaf side and the leaf end for the straight-edged leaves. It is possible that these energy-dependent Sigmoid functions can serve as operators to account for the energy dependence of the eMLC collimated fluence profiles. These operators can be incorporated into the inverse planning algorithm to derive desired dose distributions using a set of electron beams of variable energy and field size suitable for delivery by the eMLC.

Computer Simulation↗

PubMed2002

Particle in cell simulation of laser-accelerated proton beams for radiation therapy.

In this article we present the results of particle in cell (PIC) simulations of laser plasma interaction for proton acceleration for radiation therapy treatments. We show that under optimal interaction conditions protons can be accelerated up to relativistic energies of 300 MeV by a petawatt laser field. The proton acceleration is due to the dragging Coulomb force arising from charge separation induced by the ponderomotive pressure (light pressure) of high-intensity laser. The proton energy and phase space distribution functions obtained from the PIC simulations are used in the calculations of dose distributions using the GEANT Monte Carlo simulation code. Because of the broad energy and angular spectra of the protons, a compact particle selection and beam collimation system will be needed to generate small beams of polyenergetic protons for intensity modulated proton therapy.

Computer Simulation↗

PubMed2001

Induction of tumor necrosis factor receptor type 2 gene expression by tumor necrosis factor-alpha in rat primary astrocytes.

Using reverse transcription-polymerase chain reaction (RT-PCR) technique, the messenger RNA (mRNA) for tumor necrosis factor receptor type 2 (TNF-R2, 75/80 kDa) was detected in rat primary astrocytes, with much lower level of expression when compared to that for tumor necrosis factor receptor type 1 (TNF-R1, 55/60 kDa). Upon exposure to TNF-alpha (100 U/ml), the TNF-R2 mRNA level was greatly enhanced at 8 h, while TNF-R1 mRNA remained unchanged even after 24 h. The induction of TNF-R2 gene expression by TNF-alpha was dose-dependent and seemed to be unique to TNF-alpha, as interleukin-6 (IL-6) had no significant effect on TNF-R2 expression. Since TNF-R2 was reported to mediate mitogenic and gene-inducing effects in many other cell types, it is likely that the reported proliferative effect of TNF-alpha on astrocytes was also mediated by this TNF receptor subtype. Upon exposure to TNF-alpha or lipopolysaccharide (LPS), the expression of TNF-alpha gene was induced, and the LPS-induced TNF-alpha seemed to selectively enhance the TNF-R2 gene expression. Collectively, our results suggest that the TNF-alpha or LPS-induced expression of both TNF-R2 and TNF-alpha may provide a positive control mechanism to further enhance the proliferative effect of TNF-alpha in astrocytes.

Animals↗