Medicine and Health Sciences Commons^™

Post-Modeling Adjustments And Delivered Dose Verification Of The 6fff Beam Model Commissioned For The Monaco Treatment Planning System, Grant C. Debevec

LSU Master's Theses

External beam radiation therapy has been shown to be an effective treatment method for tumors and abnormalities of the spine and vertebral region. Treating the spine using a stereotactic body radiation therapy (SBRT) technique can reduce toxicity to the spinal cord. The 6 MV flattening filter free (6FFF) beam model is currently used to plan and calculate dose for SBRT treatment plans, and the treatment plans are delivered using a linear accelerator (LINAC).

The commissioned beam model represents an invariant component of a LINAC. For volumetric modulated arc therapy (VMAT) treatment plans, the multileaf collimator (MLC) positions are changing throughout …

In-Phantom Film Measurements Of Two Treatment Planning Systems For Single-Fraction Spine Sbrt, Michael J. Taylor

LSU Master's Theses

Purpose: Treatment planning accuracy for spine stereotactic body radiation therapy (SBRT) varies depending on the dose calculation algorithm utilized in the treatment planning system (TPS). This project compared the end-to-end accuracy between spine SBRT plans calculated in a convolution-superposition based TPS (TPS_CS) and Monte Carlo based TPS (TPS_MC) with radiochromic film measurements. The hypothesis was that TPS_MC would calculate the dose gradient in the critical region between the vertebral body and the spinal cord more accurately than TPS_CS.

Methods: Single-fraction spine SBRT treatments following RTOG 0631 and local institutional guidelines were planned in …

Structural Shielding Considerations For Vmat, Ana Lucia Dieguez

LSU Master's Theses

Introduction: As noted in National Council on Radiation Protection and Measurements (NCRP) Report 151, the medical physicist or other qualified expert has the responsibility to keep abreast of any new technology or treatment method that could potentially impact structural shielding design. Volumetric arc therapy (VMAT) became prevalent after the publication of Report 151 and thus was not explicitly addressed in Report 151. If the shielding-related characteristics of VMAT differ enough from the expectations of Report 151, especially in the circumstance of a vault utilized exclusively for VMAT, a shielding design based on Report 151 could potentially be inadequate. The …

Validation Of A Respiratory Gating System For Automated Delivery Of The Deep Inspiration Breath-Hold Technique, Michael G. Stock

LSU Master's Theses

Purpose: To validate the performance of a respiratory gating system for the automated delivery of the deep inspiration breath-hold (DIBH) technique.

Methods: The gating system utilized an automatic gating interface (Elekta Response) which connected a marker-based respiratory motion monitoring system to the linear accelerator control system. The gating system was characterized dosimetrically and temporally using two distinct approaches. Central-axis output and energy constancy were evaluated across 8 beam-matched linear accelerators. Additionally, a representative set of 5 treatment plans were delivered both non-gated and gated to a 2D diode array (MapCHECK). The respiratory motion monitoring system optically tracked a reflective marker …

Modeling Anatomic Changes For Adaptive Radiotherapy In Locally Advanced Lung Cancer Patient Population, James Alexander Kavanaugh

LSU Doctoral Dissertations

Anatomic changes occurring mid-treatment for patients undergoing radiation therapy for locally advanced lung cancer can degrade the quality of the intended treatment plan. These changes include tumor regression, geometric misalignment, and lung density changes (atelectasis and pleural effusion), and are visible on the daily 3D cone beam CT (CBCT). To maintain the intended treatment quality, adaptive radiotherapy (ART) can be employed to modify the treatment plan to account for these anatomic changes. However, the evaluation on when to adapt is currently completed manually by the treating clinicians, resulting in a subjective and inconsistent application. To address these limitations, a series …

Visualization Of Brown Fat Using X-Ray Dark Field Imaging, Troy D. Jacobs

LSU Master's Theses

Introduction: Obesity has become a major societal issue. Many researchers are looking for ways to combat this growing epidemic. Brown adipose tissue (BAT) might be a way to help individuals overcome the challenges associated with weight loss and maintenance of weight loss, but a better understanding of BAT and how to control and utilize it is needed. BAT differs from white adipose tissue (WAT) in that BAT is rich with mitochondria and therefore is metabolically active. BAT is a source of non-shivering thermogenesis and can be activated both by cold exposure and pharmacologically. Current methods of assessing BAT activity are …

Analytical Setup Margin For Spinal Sbrt Based On Measured Errors, Audrey Copeland

LSU Master's Theses

Purpose: No consensus currently exists in the radiotherapy community about the correct margin size to use for spinal SBRT. Margins have been proposed to account for various errors individually, but not with all errors combined to result in a single margin value. The purpose of this work was to determine a setup margin for spinal SBRT based on known and measurable errors during radiotherapy to achieve at least 90% coverage of the clinical target volume (CTV) with the prescription dose for at least 90% of patients and not exceed a 30 Gy point dose or 23 Gy to 10% of …

Stray Radiation Dose From X-Ray And Proton Beam Radiation Therapies, Christopher William Schneider

LSU Doctoral Dissertations

The growing population of cancer survivors at risk of radiation induced side-effects is a public health concern. These side-effects include serious conditions such as second cancers, the majority of which occur outside of the primary treatment volume. Radiotherapy treatment planning systems systematically underestimate the dose to tissues out-of-field. Attempts to predict and reduce the risks of radiogenic side effects require accurate and personalized knowledge of the out-of-field radiation dose to patients. The long-term goal of this research is to provide clinical and research tools necessary to reduce the risk of radiotherapy side effects and improve the health outcomes of radiotherapy …

Determination Of Scatter Fractions, Albedos, And Tenth Value Layers For Shielding Of Synchrotron Beamline Hutches, Bethany Lynn Broekhoven

LSU Master's Theses

Synchrotron facilities require substantial amounts of shielding to protect facility staff and researchers. To meet mandatory exposure limits, the traditional combination of time, distance, and shielding of the radiation source are utilized. Because of continuous 24-7 operation of most synchrotrons, time is the least useful tool. The experimental stations for synchrotron x-ray beamlines, called hutches, enforce a minimum distance from the source, but shielding provided by hutch walls is still the principal tool for a synchrotron facility. Currently there is no single resource for synchrotron beamline hutch shielding design in the literature; most hutch shielding is designed through either over-simplified …

Framework For Algorithmically Optimizing Longitudinal Health Outcomes: Examples In Cancer Radiotherapy And Occupational Radiation Protection, Lydia Joyce Wilson

LSU Doctoral Dissertations

Background: Advancements in the treatment of non-infectious disease have enabled survival rates to steadily increase in recent decades (e.g., diabetes, heart disease, and cancer). Epidemiological studies have revealed that the treatments for these diseases can have life-threatening and/or life–altering effects. Thus, realizing the full beneficial potential of advanced treatments necessitates new tools to algorithmically consider all major components of the health outcome, including benefit and detriment. The goal of this dissertation was to develop a framework for improving projected health outcomes following planned radiation exposures in consideration of all beneficial and detrimental, early and late, and fatal and non-fatal …

Evaluation Of Ventilation Assistance For Improving Respiratory Reproducibility In Radiation Therapy, Cameron J. Sprowls

LSU Master's Theses

Background: Respiratory motion affects all tumor sites in the thorax and abdomen. Variations of the respiratory pattern cause variations of the tumor motion which can result in differences between the planned and delivered dose distributions. Previous breathing guidance techniques have been investigated to improve respiratory reproducibility; however, ventilation assistance has not been investigated. We evaluated using bi-level positive airway pressure (BIPAP) ventilation assistance for improving respiratory reproducibility in patients with tumor sites impacted by respiratory motion.

Methods: Written informed consent was obtained for 10 patients currently undergoing radiation therapy treatment. Patients participated in sessions over their course of treatment, which …

Analytical Models Of Neutron Spectral Fluence, Kerma And Absorbed-Dose For Proton Therapy, Suman Shrestha

LSU Master's Theses

Abstract

Purpose: The accurate prediction of stray neutron dose has become increasingly important as it increases the risk of second cancer development after proton therapy. Previously reported analytical models predicted the quantity dose equivalent, which includes physical and biological considerations but does not explicitly take into account material dependence and variation in the radiation quality. The purpose of this study was to investigate the feasibility of an analytical model of absorbed dose to water from stray neutrons in proton therapy.

Methods: To calculate neutron absorbed dose and kerma in water, the authors developed analytical models of neutron spectral fluence and …

Investigation Of Stereotactic Body Radiation Therapy Delivery Accuracy On An Elekta Linear Accelerator, Addie Barron

LSU Master's Theses

Purpose: This work investigated the delivery accuracy of high-dose lung and spine stereotactic treatments delivered with the Elekta Infinity and Versa HD platforms. The accuracy of these platforms will be used for consideration in implementing a spine stereotactic radiosurgery (SSRS) program at Mary Bird Perkins Cancer Center.

Methods: A geometric phantom was used to perform Winston-Lutz type tests that assessed the relevant degrees of freedom (gantry, collimator, and couch) of the delivery system. A lung stereotactic body radiation therapy (SBRT) and spine SRS treatment plan were generated for use in end-to-end testing. Delivery accuracy was tested using a novel diode …

Endorectal Digital Prostate Tomosynthesis, Joseph Robert Steiner

LSU Doctoral Dissertations

Several areas of prostate cancer (PCa) management, such as imaging permanent brachytherapy implants or small, aggressive lesions, benefit from high image resolution. Current PCa imaging methods can have inadequate resolution for imaging these areas. Endorectal digital prostate tomosynthesis (endoDPT), an imaging method that combines an external x-ray source and an endorectal x-ray sensor, can produce three-dimensional images of the prostate region that have high image resolution compared to typical methods. This high resolution may improve PCa management and increase positive outcomes in affected men.

This dissertation presents the initial development of endoDPT, including system design, image quality assessment, and examples …

Benefit Of Intensity Modulated Bolus Electron Conformal Therapy For Post Mastectomy Chest Wall Irradiation, John Doiron

LSU Master's Theses

Purpose: The delivery of post-mastectomy radiotherapy (PMRT) with bolus electron conformal therapy (BECT) for patients with left-sided breast cancer can reduce second cancer complication probability (SCCP) compared to modern rotational intensity modulated x-ray (IMXT) techniques such as volumetric modulated arc therapy (VMAT) or Tomotherapy. However, rotational IMXT yields superior levels of dose homogeneity compared to BECT. This study investigates the use of intensity modulated (IM) BECT (IM-BECT) to improve dose homogeneity in the chest wall (CW) region of the PMRT planning target volume (PTV) abutted to parallel opposed IMXT tangents for the remaining PTV for a clinically-representative set of patients, …