Dosimetric Evaluation and Verification of Respiratory Motion Management System in Radiation Oncology

Dosimetric Evaluation and Verification of Respiratory Motion Management System in Radiation Oncology

Bibliographic Details
Main Author: Liu, Chenguang CL
Language:English
Published: University of Toledo Health Science Campus / OhioLINK 2017
Subjects:
Radiology
Physics
Medicine
Online Access:http://rave.ohiolink.edu/etdc/view?acc_num=mco1497974052016369
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spelling ndltd-OhioLink-oai-etd.ohiolink.edu-mco14979740520163692021-08-03T07:02:55Z Dosimetric Evaluation and Verification of Respiratory Motion Management System in Radiation Oncology Liu, Chenguang CL Radiology Physics Medicine Respiratory caused intra-fraction motion is an important factor that can affect radiation treatment accuracy. Although the major effect of respiratory motion is in lung tumors, other tumor sites in thoracic and abdomen such as esophagus and liver cancer can also move significantly depending on patient’s geometry. This thesis explains dosimetric discrepancy caused by respiratory motion during radiotherapy, describes different types of respiratory management system, and specifically discusses the clinical implementation of respiratory gating system including Varian RPM system commissioning, machine quality assurance, patient specific quality assurance, and dosimetric evaluation of gating Intensity Modulated Radiation Therapy (IMRT) treatment. In order to verify gated treatment plan, dynamic quality assurance phantoms have been developed to simulate patient’s specific respiratory motion modifying traditional quality assurance devices. A Quasar respiratory motion phantom has been used to commission the Varian RPM system on CT simulator, Edge linear accelerator, and TrueBeam linear accelerator. An in-house developed breathing feedback system has been implemented at University of Toledo Dana Cancer Center to improve patient’s breathing regularity within the defined threshold. This device increases patent’s breathing management especially in breath hold treatment. Raystation Robust Photon planning has also been studied as a method of respiration motion management. Treatment plans were generated for free breathing gating technique, breath-hold gating technique, and Raystation robust technique. In this work, we studies 4D-CT scan utilizing MIM software and recorded patients’ specific breathing waveform by Varian RPM system. This research work also presents analysis of ROI volumes, dose distributions, and the normal tissue dose for patients with RPM in contrast to conventional treatment delineating advantages in sparing healthy normal tissue.During the work for this thesis, multiple tests were designed and performed on the Edge and Truebeam linear accelerators in order to commission the Varian RPM system. A monthly quality assurance and an annual quality assurance tasks have been designed for Varian PRM system implementing TG-142. The objective of quality assurance is to verify the beam output constancy, temporal accuracy, gating interlock, and in-room respiratory monitoring system. An existing respiratory motion phantom has been modified to simulate patient’s intra-fraction organ motion on ArcCheck. The measured data was analyzed using the SNC software. The result of this work indicates that among RPM possibilities, the breath-hold gating techniques (DIBH and EEBH) has the potential advantage of treating patient whom respiratory motion is a concern. 2017 English text University of Toledo Health Science Campus / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=mco1497974052016369 http://rave.ohiolink.edu/etdc/view?acc_num=mco1497974052016369 unrestricted This thesis or dissertation is protected by copyright: some rights reserved. It is licensed for use under a Creative Commons license. Specific terms and permissions are available from this document's record in the OhioLINK ETD Center.
collection NDLTD
language English
sources NDLTD
topic Radiology
Physics
Medicine
spellingShingle Radiology
Physics
Medicine
Liu, Chenguang CL
Dosimetric Evaluation and Verification of Respiratory Motion Management System in Radiation Oncology
author Liu, Chenguang CL
author_facet Liu, Chenguang CL
author_sort Liu, Chenguang CL
title Dosimetric Evaluation and Verification of Respiratory Motion Management System in Radiation Oncology
title_short Dosimetric Evaluation and Verification of Respiratory Motion Management System in Radiation Oncology
title_full Dosimetric Evaluation and Verification of Respiratory Motion Management System in Radiation Oncology
title_fullStr Dosimetric Evaluation and Verification of Respiratory Motion Management System in Radiation Oncology
title_full_unstemmed Dosimetric Evaluation and Verification of Respiratory Motion Management System in Radiation Oncology
title_sort dosimetric evaluation and verification of respiratory motion management system in radiation oncology
publisher University of Toledo Health Science Campus / OhioLINK
publishDate 2017
url http://rave.ohiolink.edu/etdc/view?acc_num=mco1497974052016369
work_keys_str_mv AT liuchenguangcl dosimetricevaluationandverificationofrespiratorymotionmanagementsysteminradiationoncology
_version_ 1719452418963406848

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