initial results from multiple irradiations of an
TRANSCRIPT
![Page 1: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/1.jpg)
Initial Results from Multiple Irradiations of an Anthropomorphic Spine Phantom
Andrea Molineu, Nadia Hernandez, Paola Alvarez, David Followill, Geoffrey Ibbott
![Page 2: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/2.jpg)
lung
lung
heart
Spine phantom
PTV
bonespinal cord
esophagus
![Page 3: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/3.jpg)
Treatment Plan• 6 Gy to at least 90% of PTV
• Min PTV dose at least 5.25 Gy
2.781000 ccWhole Lung
9.758.63<10 ccSkin
6.004.46<5 ccEsophagus
8.256.00<15 ccHeart
5.253.752.63
<0.35 cc<1.2 ccSpinal Cord
Max Point Dose (Gy)
Volume Max (Gy)
VolumeNormal structure
![Page 4: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/4.jpg)
Representative Treatment Plan
![Page 5: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/5.jpg)
Criteria
• TLD±7%
• Film (axial and sagittal planes)85% meet 5%/3mm
• Plan DVHmust comply with protocol
![Page 6: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/6.jpg)
Good Agreement
PlanMeasurement
PTV
Cord/boneOAR
![Page 7: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/7.jpg)
Good Agreement
Gamma
Measurement100%
passing
![Page 8: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/8.jpg)
Poor AgreementPTV
Cord/boneOAR
Measurement Plan
![Page 9: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/9.jpg)
Poor Agreement
Gamma
Measurement100%
passing26%
passing
![Page 10: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/10.jpg)
Overall results
• 41 irradiations at 35 institutions
• 17 irradiations failed
• 1 failed TLD criteria only
• 8 failed gamma criteria only
• 8 failed both TLD and gamma
![Page 11: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/11.jpg)
All Results
42 - 9922 - 1000.67 - 1.510.88 - 1.15range
14.616.40.170.05std dev
86851.020.99mean
Sagittal Gamma
Axial GammaHeartPTV
![Page 12: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/12.jpg)
Passing Results
85 - 9985 - 1000.67 - 1.180.93 - 1.03range
5.14.60.120.03std dev
94941.020.99mean
Sagittal Gamma
Axial GammaHeartPTV
![Page 13: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/13.jpg)
Results by Machine
8812441total
230813Varian
01012TomoTherapy
01012Siemens
2101013Novalis
22026Elekta
20125CyberKnife
Dose and GammaGammaTLD Dose
Criteria FailedPassesIrradiationsMachine Manufacturer
![Page 14: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/14.jpg)
Results by TPS
8812441total
11013superpositionXiO
11035convolutionPinnacle
10078pencil beam
11024Monte CarloiPlan
01012superpositionHi-Art
10012pencil beam
140712AAAEclipse
20114raytracing
00011Monte CarloCyberKnife
Dose and GammaGammaTLD
Dose
Criteria FailedPassesIrradiationsAlgorithmTPS
![Page 15: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/15.jpg)
Results by Algorithm
8812441total
20114raytracing
200810pencil beam
11035Monte Carlo
230510superposition/convolution
140712AAA
Dose and GammaGammaDose
Criteria FailedPassesIrradiationsAlgorithm
![Page 16: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/16.jpg)
Conclusions
•Challenging credentialing process
•Treatment couch should be considered in these treatments
•Cannot make generalizations with regard to machine, TPS, or algorithm
![Page 17: Initial Results from Multiple Irradiations of an](https://reader033.vdocument.in/reader033/viewer/2022060610/6296b65de60b8c281225b3c5/html5/thumbnails/17.jpg)
Thank you.
The investigation was supported by PHS grants CA10953 and CA81647
awarded by the NCI, DHHS.