Radiation field edge detection in portal images.
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Humans↗
Biomedical subjects
H Meertens
Publications and source records attributed to H Meertens.
In-phantom calibration of Selectron-LDR sources.
Source strength measurements were performed for cesium-137 spherical sources of nine Selectron-LDR remote afterloading systems in The Netherlands. The mean reference air kerma rate of a set of sources was obtained from air kerma rate measurements in a phantom at a distance of about 5.5 cm from a large number (24 to 30) of sources. The results were compared with the source strengths specified by the manufacturer. Discrepancies between measured and manufacturers data ranging from -2.3% to +3.9% were observed. The frequency distribution of the strength of the sources within a set was measured by the use of a well-type ionisation chamber. The root mean square deviations of the nine source sets ranged from 1.0 to 3.2%. Application of the in-phantom calibration method would improve the precision of source strength measurements and therefore reduce the differences in dose delivery between institutes. The uncertainty of the in-phantom method, which could be estimated by statistical methods, was 0.3% (one standard deviation). That part of the uncertainty, which could not be evaluated by statistical methods, was estimated to be about 1.2% (one effective standard deviation). This latter part in the uncertainty needs further investigation in order to reduce the overall uncertainty.
Brachytherapy↗
First clinical experience with a newly developed electronic portal imaging device.
In our institute an electronic portal imaging device (PID) has been developed and it recently became available for routine clinical practice. Images are available within 3 to 6 seconds after the start of irradiation; they are displayed on a video monitor next to the control console of the accelerator. The image quality is similar to the quality of images obtained with films. Because of its cassette-like shape and its low weight, the PID can easily be handled by technicians. An important advantage of the PID over conventional films is its pseudo-real time viewing facility. Typically, 5 to 10 images of each field can be made during one treatment session. In case a high accuracy in setup is demanded, the field edges of the first image, obtained with about 10% of the fraction dose, can be studied for acceptability before the rest of the dose is delivered. Using two prototype PID's first clinical experience has been obtained with patients treated for malignant tumors at various sites. Intra-treatment motion as a result of breathing, swallowing, or patient motion in a cast was seen. Motion of high contrast objects, for example, a field edge during irradiation, can be followed. This feature is important for future applications in computer controlled radiotherapy. Another advantage of the PID over film is that the image is digitally available. Therefore it can be further processed for quality improvement and quantitative analysis. Simple processing is done within seconds on the PID unit. A local network for the transfer of images from the accelerators to the evaluation room, where a detailed analysis of the field placement is performed, is under installation. Simulator film images are digitized in this room and are sent to the PID at the accelerator for a quick comparison with portal images during irradiation. We conclude that our device can replace the conventional film detector for portal imaging, that useful images are obtained within seconds during irradiation, and that the position of the field outline relative to the patient anatomy can be followed during dose delivery.
Electronics↗
A method for the measurement of field placement errors in digital portal images.
Correct placement of radiation fields relative to patient anatomy is essential in radiotherapy in order to minimise serious side effects to reduce the probability of recurrence of the tumour. One way to determine patient setup accuracy is to analyse portal images obtained in the therapy beam distal to the patient. A field placement analysis (FPA) method has been developed for detailed evaluation of patient setup by comparing positions of corresponding radiation field edges in digitised simulator and portal images. A simulator image is matched to a portal image using similar anatomical landmarks in both images and mapping these landmarks against each other applying a least squares minimisation approach. Discrepancies between the simulator field edge (reference) and a portal field edge are determined by comparing the distances between the central axis of the beam and corresponding edge segments and the angles of these segments with a reference line. Uncertainties in these distances and angles are to a large extent determined by the magnification, rotation and translation procedure. Uncertainties due to the FPA method itself are of about 1.0 mm and 0.5 degrees in portal images of head and neck fields. These FPA uncertainties are in general smaller than the variations due to patient setups. Matching of simulator and portal images of lateral pelvic fields revealed larger uncertainties: 1.7 mm and 1.1 degrees. Setup variations in this kind of pelvic radiation field are usually also larger, and therefore meaningful results can be obtained with the new FPA method.
Computer Simulation↗
A comparison of dose calculations at points around an intracavitary cervix applicator.
An intercomparison was made between dose-rate calculations performed in 10 institute in The Netherlands for intracavitary applications with the Selectron-LDR remote afterloading machine. The results of 11 computer planning systems of five different manufacturers were compared with reference dose-rate calculations. The difference in clinically relevant dose-points like rectum and bladder, were less than 2% if the values of the coordinates of source and dose-points were given, except for one type of planning system, that showed differences up to 10%. The errors observed for the latter system were probably due to a coarse calculation grid, which becomes important in regions with a high dose gradient. If the reconstruction process of source and dose-point positions from radiographs was included as it usually is in practice, then the accuracy became worse and the planning system that showed large errors before, gave unacceptable errors of 30% to 40% in the rectal area. This is due to additional errors introduced in the reconstruction. The intercomparison showed that it is very important that computer treatment planning systems for brachytherapy calculations are tested before clinical use. The reconstruction technique for source and dose-point positions should be part of this test. Radiographs should be made of a phantom that simulates the cervix application, and the radiography technique should be similar to the one that is clinically employed.
Brachytherapy↗
A matrix ionisation chamber imaging device for on-line patient setup verification during radiotherapy.
It is very important to have a daily verification of patient setup during radiotherapy. Therefore, we have developed an on-line imaging device for high energy photons. It consists of a matrix of 128 x 128 liquid filled ionisation chambers and has a field of view of 320 mm x 320 mm. This device has an extremely flat cassette-like housing for easy handling and for application with existing radiotherapy equipment. A dedicated microcomputer is used to measure the currents of the 16384 ionisation chambers at high speed. The same computer is used to restore and process the images. With an imaging time of 3.1 s, an image quality comparable to film is obtained. Images of high and low contrast phantoms and of patients are presented. With this device, high quality portal images will be available within only a few seconds after the start of the treatment. This allows an almost instantaneous decision on the approval of patient setup. In addition, it enables observation of organ or patient motion during a single treatment. Analysis of these images at high speed will be an interesting new area of research.
Computers↗
First clinical experience with a remote afterloading system for low dose rate interstitial breast implants.
A new remote afterloading system, developed for low or medium dose rate brachytherapy has been clinically evaluated. With this apparatus, the Micro-Selectron, up to 15 192Ir wires or seeds encapsulated in a plastic tubing can be loaded simultaneously into implants. Improved radiological protection for the medical staff has now been achieved with this apparatus. One hundred and sixty patients have been treated so far with breast implants using remote afterloading. The mean error frequency over the last year was about one error every 10 treatments of which about half could be considered as machine failures. All treatments could, however, be finished by using spare channels of the afterloader. We have found that a set of 45 source assemblies is adequate for the loading of the breast-needle implants performed in our institute. Every 6 to 8 weeks a new set of 192Ir sources is prepared.
Brachytherapy↗
An inverse filter for digital restoration of portal images.
Portal images obtained of patients during irradiation with high energy photon beams have a poor sharpness and contrast due to the physical limitations of the equipment forming these images. Consequently, improvement of the images is desirable. An inverse filter method was investigated for this purpose and values of the parameters of the filter have been determined for various clinical irradiation conditions. Data on the line spread function (LSF) were obtained from the image of a 0.2 mm wide slit between tungsten blocks that were positioned at the isocentre in front of a polystyrene phantom. Slit images were made in a 60Co beam and in a number of 8 and 16 MV x-ray beams with a copper screen-film detector. These images were made for various isocentre to detector distances, field sizes and phantom thicknesses. All slit images and a number of clinical images were digitised both with a TV camera system and a densitometer which were connected to a computer. The main factors that affect the LSF are the radiation source size and the isocentre to film distance. The photon energy had only a minor influence. The thickness of the phantom and the field size, however, did influence the contrast in the image and therefore they determined, together with the digitising system, the noise to signal ratio parameter of the inverse filter to a great extent. Application of the inverse filter improved significantly the visual appearance of anatomical details in the portal images. In addition to image restoration, the contrast was enhanced by the application of a low frequency cut-off filter.
Filtration↗
A comparison of build-up and depth dose characteristics of different photon beams for the treatment of Hodgkin's disease.
Measurements have been performed of build-up and depth-dose characteristics of photon beams under Hodgkin's disease treatment conditions as applied in two hospitals (AVL, Amsterdam and IGR, Villejuif). Although different types of accelerators, photon energies, field sizes and SSD are employed, similar dose distributions along the beam axis have been obtained in both centers. In order to explain this unexpected good agreement, the influence of the geometrical conditions of irradiation on the build-up and depth-dose distribution has been studied in detail for five photon beams (8 MV-25 MV) of three types of accelerators.
Evaluation Studies as Topic↗
Screens in ovoids of a Selectron cervix applicator.
The addition of screens in the vaginal source holders of a cervix applicator for intracavitary brachytherapy reduces the dose to rectum and bladder and therefore diminishes the number of rectal and vesical complications. Shielding properties of tungsten rectal and bladder screens of a Selectron cervix applicator, loaded with spherical cesium sources, were determined for verification of dose calculations. Transmission characteristics of half-disk shaped tungsten screen segments in a single ovoid were measured in a water phantom. The minimum transmission ratios are 60, 70 and 80% for segment thickness of 5.0, 3.5 and 2.0 mm, respectively. The accuracy of the new screen correction algorithm of the Selectron Planning System was assessed by comparing measured and calculated dose rates and was found to be better than +/- 4%. The correction algorithm provides a method to analyse the efficacy of screens in the ovoids for various segment geometries and orientations without extensive phantom measurements. Isotransmission and isodose calculations were made for a typical clinical applicator set-up and source distribution. The dose reduction to rectum and bladder, near the bottom and top of the ovoids was analysed in detail. A 3.5 mm thick rectum and bladder screen in each ovoid reduces the dose approximately by 20% to the rectum and by 15% to the bladder. A distance enlargement of about 5 mm between ovoid and rectum or bladder, e.g. by packing, results in a comparable dose reduction. Shielding properties of a Selectron cervix applicator, provided with screens, were compared with those of some Fletcher-type applicators. Significant differences between the transmission ratios and shielded areas of the screens of both systems near rectum and bladder were observed.
Brachytherapy↗
A liquid ionisation detector for digital radiography of therapeutic megavoltage photon beams.
Experiments with an ionisation detector were performed in order to determine whether it was possible to obtain high energy photon beam images for radiotherapy treatment verification. A small prototype detector with a field of view of 78 mm X 78 mm and constructed from printed circuit boards was used. The imaging area was a matrix ionisation chamber, filled with air or liquid (2,2,4-trimethylpentane). A minicomputer was used to control the data acquisition electronics and to reconstruct and restore the images. The images were displayed on a viewing console for computed tomography images. The liquid filled detector with a front-rear board separation of 1.0 mm gave the best results. The spatial resolution was about 3.8 mm with a density resolution of 0.5% for a data acquisition time of 120 s. Comparison of the liquid detector images with corresponding metal screen-film detector images showed that the image qualities were the same. An important advantage of the ionisation detector image is that grey scale modification, sharpening and smoothing by digital processing can easily be performed.
Humans↗
Extracellular potential recordings by means of a field effect transitor without gate metal, called OSFET.
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Action Potentials↗
Digital processing of high-energy photon beam images.
The potentialities of digital megavoltage radiation field images for image quality improvement and evaluation of patient treatment setup errors are investigated. A treatment verification film is digitized with a densitometer and a treatment planning computer. The 256 X 256 picture matrix is displayed on a viewing console of a computer tomograph. The results of some processed pictures show an improved visibility of anatomical structures, which is of importance for comparison of the treatment beam images with the corresponding localization radiograph made on the simulator. In addition, automated techniques for comparison of irradiation and simulation setup are now possible.
Computers↗
Sampling methods for a matrix ionization chamber system.
To achieve increased image acquisition speed or better image quality, several read-out methods for a matrix ionization chamber system have been investigated. In this device, which is applied for portal imaging in radiation therapy, 256 x 256 small liquid-filled ionization chambers are scanned by switching the polarizing voltage applied to rows of chambers. The ionization current of each column is measured by a separate amplifier. In this approach, instead of measuring row by row, more complex switching schemes can be applied for the polarizing voltage. These schemes are useful either for varying speed and spatial resolution of the imaging device or for coded sampling of the ionization signal. The former option allows for doubling or quadrupling the acquisition speed with a small loss in image quality, or for obtaining a large improvement in signal-to-noise ratio at the cost of image resolution. In the latter option, coded sampling, the image is reconstructed mathematically from the measured signals. It is shown that in this case the application of Hadamard or derived matrices for sampling leads, under certain circumstances, to a noise reduction in the reconstructed image.
Humans↗
A review of electronic portal imaging devices (EPIDs).
On-line electronic portal imaging devices are beginning to come into clinical service in support of radiotherapy. A variety of technologies are being explored to provide real-time or near real-time images of patient anatomy within x-ray fields during treatment on linear accelerators. The availability of these devices makes it feasible to verify treatment portals with much greater frequency and clarity than with film. This article reviews the physics of high-energy imaging and describes the operation principles of the electronic portal imaging devices that are under development or are beginning to be used clinically.
Humans↗