ORCID Profile
0000-0001-9647-3889
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Publisher: Public Library of Science (PLoS)
Date: 09-01-2019
Publisher: Informa UK Limited
Date: 29-08-2017
Publisher: IEEE
Date: 10-2018
Publisher: Wiley
Date: 31-07-2014
DOI: 10.1118/1.4890602
Abstract: The authors present a hybrid direct multileaf collimator (MLC) aperture optimization model exclusively based on sequencing of patient imaging data to be implemented on a Monte Carlo treatment planning system (MC-TPS) to allow the explicit radiation transport simulation of advanced radiotherapy treatments with optimal results in efficient times for clinical practice. The planning system (called CARMEN) is a full MC-TPS, controlled through aMATLAB interface, which is based on the sequencing of a novel map, called "biophysical" map, which is generated from enhanced image data of patients to achieve a set of segments actually deliverable. In order to reduce the required computation time, the conventional fluence map has been replaced by the biophysical map which is sequenced to provide direct apertures that will later be weighted by means of an optimization algorithm based on linear programming. A ray-casting algorithm throughout the patient CT assembles information about the found structures, the mass thickness crossed, as well as PET values. Data are recorded to generate a biophysical map for each gantry angle. These maps are the input files for a home-made sequencer developed to take into account the interactions of photons and electrons with the MLC. For each linac (Axesse of Elekta and Primus of Siemens) and energy beam studied (6, 9, 12, 15 MeV and 6 MV), phase space files were simulated with the EGSnrc/BEAMnrc code. The dose calculation in patient was carried out with the BEAMDOSE code. This code is a modified version of EGSnrc/DOSXYZnrc able to calculate the beamlet dose in order to combine them with different weights during the optimization process. Three complex radiotherapy treatments were selected to check the reliability of CARMEN in situations where the MC calculation can offer an added value: A head-and-neck case (Case I) with three targets delineated on PET/CT images and a demanding dose-escalation a partial breast irradiation case (Case II) solved with photon and electron modulated beams (IMRT + MERT) and a prostatic bed case (Case III) with a pronounced concave-shaped PTV by using volumetric modulated arc therapy. In the three cases, the required target prescription doses and constraints on organs at risk were fulfilled in a short enough time to allow routine clinical implementation. The quality assurance protocol followed to check CARMEN system showed a high agreement with the experimental measurements. A Monte Carlo treatment planning model exclusively based on maps performed from patient imaging data has been presented. The sequencing of these maps allows obtaining deliverable apertures which are weighted for modulation under a linear programming formulation. The model is able to solve complex radiotherapy treatments with high accuracy in an efficient computation time.
Publisher: Public Library of Science (PLoS)
Date: 13-02-2017
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.EJMP.2017.04.005
Abstract: To develop a new optimization algorithm to carry out true dose painting by numbers (DPBN) planning based on full Monte Carlo (MC) calculation. Four configurations with different clustering of the voxel values from PET data were proposed. An optimization method at the voxel level under Lineal Programming (LP) formulation was used for an inverse planning and implemented in CARMEN, an in-house Monte Carlo treatment planning system. Beamlet solutions fulfilled the objectives and did not show significant differences between the different configurations. More differences were observed between the segment solutions. The plan for the dose prescription map without clustering was the better solution. LP optimization at voxel level without dose-volume restrictions can carry out true DPBN planning with the MC accuracy.
Publisher: IOP Publishing
Date: 02-02-2018
Abstract: Independent verification of complex treatment delivery with megavolt photon beam radiotherapy (RT) has been effectively used to detect and prevent errors. This work presents the validation and uncertainty analysis of a model that predicts 2D portal dose images (PDIs) without a patient or phantom in the beam. The prediction model is based on an exponential point dose model with separable primary and secondary photon fluence components. The model includes a scatter kernel, off-axis ratio map, transmission values and penumbra kernels for beam-delimiting components. These parameters were derived through a model fitting procedure supplied with point dose and dose profile measurements of radiation fields. The model was validated against a treatment planning system (TPS Eclipse) and radiochromic film measurements for complex clinical scenarios, including volumetric modulated arc therapy (VMAT). Confidence limits on fitted model parameters were calculated based on simulated measurements. A sensitivity analysis was performed to evaluate the effect of the parameter uncertainties on the model output. For the maximum uncertainty, the maximum deviating measurement sets were propagated through the fitting procedure and the model. The overall uncertainty was assessed using all simulated measurements. The validation of the prediction model against the TPS and the film showed a good agreement, with on average 90.8% and 90.5% of pixels passing a (2%,2 mm) global gamma analysis respectively, with a low dose threshold of 10%. The maximum and overall uncertainty of the model is dependent on the type of clinical plan used as input. The results can be used to study the robustness of the model. A model for predicting accurate 2D pre-treatment PDIs in complex RT scenarios can be used clinically and its uncertainties can be taken into account.
Publisher: Public Library of Science (PLoS)
Date: 21-11-2016
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.BRACHY.2019.06.005
Abstract: The Bravos afterloader system was released by Varian Medical Systems in October of 2018 for high-dose-rate brachytherapy with The system was evaluated after three sets of experiments: (1) The CamScale was used to verify inter- and intra-channel dwelling variability and system calibration (2) A high-speed camera was used to verify the source simulation cable movement inside a transparent quality assurance device, where dwell positions, dwell times, transit times, speed profiles, and accelerations were measured (3) The source movement inside clinical applicators was captured with an imaging panel while being exposed to an external kV source. Measured and planned dwell positions and times were compared. Maximum deviations between planned and measured dwell positions and times for the source cable were 0.4 mm for the CamScale measurements and 0.07 seconds for the high-speed camera measurements. Mean dwell position deviations inside clinical applicators were below 1.2 mm for all applicators except the ring that required an offset correction of 1 mm to achieve a mean deviation of 0.4 mm. Features of the Bravos afterloader system provide a robust and precise treatment delivery. All measurements were within manufacturer specifications.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.EJMP.2022.03.017
Abstract: Image guided radiotherapy (IGRT) strategies allow detecting and monitoring anatomical changes during external beam radiotherapy (EBRT). However, assessing the dosimetric impact of anatomical changes is not straightforward. In current IGRT strategies dose volume histograms (DVH) are not available due to lack of contours and dose recalculations on the cone-beam CT (CBCT) scan. This study investigates the feasibility of using automatically calculated DVH parameters in CBCTs using an independent dose calculation engine and propagated contours. A prospective study (NCT03385031) of thirty-one breast cancer patients who received additional CBCT imaging (N = 70) was performed. Manual and automatically propagated contours were generated for all CBCTs and an automatic dose recalculation was performed. Differences between planned and CBCT-derived DVH parameters (mean and maximum dose to targets, 95% volume coverage to targets and mean heart dose (MHD)) were calculated using the dose verification system with manual and propagated contours and, in both cases, benchmarked against DVH differences quantified in the TPS using manually contoured CBCTs. Differences in DVH parameters between the TPS and dose verification system with propagated contours were -1.3% to 0.7% (95% CI) for mean dose to the target volume, -0.3 to 0.2 Gy (95% CI) in MHD and -3.9% to 2.9% (95% CI) in target volume coverage. The use of an independent fully automatic dose verification system with contour propagation showed to be feasible and sufficiently reliable to recalculate CBCT based DVHs during breast EBRT. Volume coverage parameters, i.e. V95%, proved to be especially sensitive to contouring differences.
Location: Sweden
No related grants have been discovered for Jose Antonio Baeza Ortega.