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4º Congresso da Sociedade Portuguesa

de Radioterapia Oncologia

VMAT TREATMENTS VERIFICATION


WITH
IBA MATRIXX DETECTOR AND OP’IMRT

Juan Carlos Mateos

Servicio Radiofísica. Hospital Universitario Virgen Rocío. Sevilla.


Depto. Fisiología Médica y Biofísica. Universidad de Sevilla.
España.
CONTENT

• Introduction
• Verification with Matrixx and OP’IMRT
• Initial operations
• Normal workflow
INTRODUCTION:
TREATMENT VERIFICATION SYSTEMS

1. IONIZATION CHAMBER : 1D  POINT

2. FILM : 2D  PLANE

3. MATRIXX in MultiCube or Holder + OmniPro-IMRT:2D  PLANE

4. MATRIXX in Holder + COMPASS: 3D  VOLUME


INTRODUCTION:
MATRIXX DETECTOR

4.5 mm
Physical Characteristics:
5 mm

 Air-vented pixel ionization


7.62 mm
chambers: φ=4.5 mm, d=5 mm,
V=0.07 cm³
 Fast readout down to 20 msec
 1020 detectors in matrix 32x32
 Active area 24 cm x 24 cm
 Spatial resolution: 7.62 x 7.62 mm
M MatriXX Detector
Verification with Matrixx and OP’IMRT

INITIAL OPERATIONS VERIFICATION WORKFLOW

• Scanning of Matrixx in • Treatment plan design in TPS


CT • Plan export and recalculation in
• Matrixx calibration the Phantom Matrixx+Multicube.
Planar dose calculation.
• Directional sensitivity
• Detector and Multicube setup
correction
• Treatment execution to the
phantom
• Analysis of results : TPS vs Meas.
Verification with Matrixx and OP’IMRT
Initial Operations 1: Scanning of Matrixx in CT

Scan matrixx position,


identical to the treatment
Verification

Images to TPS
Verification with Matrixx and OP’IMRT
Initial Operations 1: Scanning of Matrixx in CT

Matrixx
and
Multicube
TC images
acquired

Definition
of a QA
Phantom in
TPS
Verification with Matrixx and OP’IMRT
Initial Operations 2: Matrixx Calibration

Dij = (M-B)ij ·NDW(60Co) · Kuni ij · Koff i,j · kpT · kUser

Measurement Detector factor


Bacground
Calibration factor and P,T correction
Uniformity: (Production site)
Off-axis Calib factor

Dij = Absolute dose in chamber/pixel “ij”


Verification with Matrixx and OP’IMRT
Initial Operations 2: Matrixx calibration

Kuser
Irradiate with 10x10 cm field, with known dose at chambers plane
Verification with Matrixx and OP’IMRT
Initial Operations 2: Matrixx Calibration
Verification with Matrixx and OP’IMRT
Initial Operations 2: Matrixx Calibration
Koff-axis calibration factor

Irradiate with field 27x27, 100 mu


Verification with Matrixx and OP’IMRT
Initial Operations 2: Matrixx Calibration
Koff-axis calibration factor
Verification with Matrixx and OP’IMRT
Initial Operations 3: Angular dependence correction

•Irradiate from -90º to +90º gantry angle CW :

•Interval 5º  -90º to -5º and + 5º to + 90º


•Interval 1º  -5º to + 5º
•Field: 10x10 cm
•MU = 100
•Compare TPS isocenter dose with average
dose measured in 4 central pixels
Verification with Matrixx and OP’IMRT
Initial Operations 3: Angular dependence correction
Verification with Matrixx and OP’IMRT
Initial Operations 3: Angular dependence correction
Verification with Matrixx and OP’IMRT
Initial Operations 3: Angular dependence correction

Angular correction factor

Nij = Dmeas(0)/Dref(0) Cij(0) = 1

Generate a table with Cij in csv format and


import it to OP’IMRT
Verification with Matrixx and OP’IMRT
WORKFLOW

a. Clinical VMAT plan design in TPS


b. Plan export and recalculation in the
Phantom Matrixx+Multicube
c. Detector and Multicube setup
d. Treatment verification with OP’MRT
Verification with Matrixx and OP’IMRT
Plan export and recalculation in the Phantom Matrixx+Multicube (1-5)
Verification with Matrixx and OP’IMRT
Plan export and recalculation in the Phantom Matrixx+Multicube (3-5)
Verification with Matrixx and OP’IMRT
Plan export and recalculation in the Phantom Matrixx+Multicube (4-5)
1. Verification with Matrixx and OP’IMRT
Plan export and recalculation in the Phantom Matrixx+Multicube (5-5)
Verification with Matrixx and OP’IMRT
WORKFLOW

a. Clinical plan design in TPS


b. Plan export and recalculation in the
Phantom Matrixx+Multicube
c. Detector and Multicube setup
d. Treatment verification with OP’MRT
Verification with Matrixx and OP’IMRT
Detector and Multicube setup (1-4)

no

yes
Verification with Matrixx and OP’IMRT
Detector and Multicube setup (2-4)

Align lasers
with marks in
MCube
Verification with Matrixx and OP’IMRT
Detector and Multicube setup (3-4)

1. Sensor angle calibration


• Gantry 0º
• Gantry 90º

2. Matrixx Preirradiation:

• Field 27 x 27 cm
• 600 MU  10 Gy
• Gantry at 0º
• Mode: “online”, 500 ms

3. Background substraction
Verification with Matrixx and OP’IMRT
Matrixx preirradiation (4-4)
Verification with Matrixx and OP’IMRT
WORKFLOW

a. Clinical plan design in TPS


b. Plan recalculation and export to Phamtom
(Matrixx+Multicube) and Mosaiq
c. Detector and Multicube setup
d. Treatment verification with OP’MRT
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (1-12)

Parameters selection:

Meas. Mode: MOVIE


Samp. Time: 300 ms
Nºimages: 1000
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (1-13)
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (2-13)
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (3-13)
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (4-13)
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (5-13)
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (6-13)

Measurements
7.62  1 mm resol
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (7-13)
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (8-13)
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (9-13)
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (10-13)

Measurements

TPS Planar dose Gamma

3% / 3mm
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (11-13)
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (12-13)
Verification with Matrixx and OP’IMRT
Treatment verification with OP’MRT (13-13)

DISCUSSION
If regions with out of tolerance gamma levels:

- Are there in PTV, OAR’s or other places?


- Have that regions infra or over doses?

Can the linac execute the VMAT treatment as


ordered by the TPS?
Moito obrigado
4º Congresso
da Sociedade Portuguesa
de Radioterapia Oncologia

VMAT TREATMENTS VERIFICATION


WITH
IBA MATRIXX DETECTOR and COMPASS

Juan Carlos Mateos


Servicio Radiofísica.HU Virgen Rocío.
Universidad de Sevilla.
CONTENT

1. Introduction: Verification methods


2. Plan export TPS to Mosaiq and OP’IMRT or
COMPASS
3. Comisionado detector
4. Información suministrada por el sistema
5. Análisis de la información
COMPASS- the total concept

Transmission Detector Beam model Dose engine

Detector Beam
Comissioning Comissioning

LINAC QA MLC QA 2D Plan eval Online Surv Patient 3D dos

Dose tracking Plan adaptation


Workflow

Verify, visualize, validate


2. Colocación del MatriXX
Sensor de ángulos
3. Exportación del plan a Mosaiq y
Compass
 Para exportar: FILE → Export → Dicom (en Pinnacle)
− A Mosaiq,
 seleccionar RT Plans completo (Pinnacle)
 Destination: IMPAC_DCM_SCP

− A Compass,
 seleccionar, RT Plans, RT Structure, RT Dose y DICOM
images (Pinnacle)
 Destination: COMPASS
 Ojo: conectar cable de red a PC, activar Compass y pulsar
en Patient 3D Dosimetry → Importar
4. Comisionado del detector

 Calentar acelerador,
− Modo servicio, 27x27 cm, 200 um, 120 um/min
 Conectar MatriXX a PC
 Seguir instrucciones para verificar rotación,
offsetts y dosis absoluta (100 um, campo 10x10)
 Al final, pulsar en icono BD ratón → comisionar
el detector
4. Comisionado del detector

 Medir Background y Pre-irradiar


 Irradiar el MatriXX con tres campos,(10, 15 y 20
cm), con 50 um a 500 um/min
 Colocar dos láminas de agua sólida de 1 cm
 Seguir instrucciones para verificar rotación,
offsetts y dosis absoluta (100 um, campo 10x10)
 Al final, pulsar en icono BD ratón → comisionar
el detector
4. Comisionado del detector
4. Comisionado del detector
4. Comisionado del detector
4. Comisionado del detector
4. Comisionado del detector
4. Comisionado del detector
5. Información suministrada
(respuesta)

Respuesta
Measured response
de las cámaras

Datos-máquina
+ Predicted response
Modelo Pinnacle
5. Información suministrada
(dosis)
Datos-Máquina
+ TPS Dose
Modelo Pinnacle

Datos-Máquina
+ Computed Dose
Modelo Compass
Respuesta detector
+ Indirectly Measured Dose
Modelo Compass
5. Información suministrada
(otras herramientas)

Histogramas Dosis Volumen

Diferencias de dosis TPS vs Indirectly Measured Dose

Diferencias de dosis TPS vs Computed Dose

Análisis Gamma TPS vs Indirectly Measured Dose

Análisis Gamma TPS vs Computed Dose


6. Análisis de la información
Medida de la respuesta
6. Análisis de la información
Medida de la respuesta
6. Análisis de la información
2D Diferencia Dosis Pinnacle e Indirecta
6. Análisis de la información
2D Gamma Pinnacle-Dosis Indirecta
6. Análisis de la información
3D Dosis Pinnacle
6. Análisis de la información
3D Dosis Indirecta
6. Análisis de la información
3D Diferencia Pinnacle-Dosis Indirecta
6. Análisis de la información
3D Gamma Pinnacle-Dosis Indirecta
6. Análisis de la información
Estadística e HDV Pinnacle y Dosis Indirecta
6. Análisis de la información
2D Diferencia Dosis Pinnacle y Computed Dose
6. Análisis de la información
2D Gamma Dosis Pinnacle y Computed Dose
6. Análisis de la información
3D Dosis Pinnacle
6. Análisis de la información
3D Computed Dose
6. Análisis de la información
3D Diferencia Pinnacle y Computed Dose
6. Análisis de la información
3D Gamma Pinnacle y Computed Dose
6. Análisis de la información
Estadística e HDV Pinnacle y Computed Dose
Reports

Hoja 1
Reports

Hoja 2
Reports

Hoja 3
Reports

Hoja 4
Detector de Transmisión