Pérez Cruz, Daniel (2021) Controles de calidad en nueva plataforma Halcyon / Quality controls in the new Halcyon plataform. Maestría en Física Médica, Universidad Nacional de Cuyo, Instituto Balseiro.
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Resumen en español
Halcyon™ (Varian, Palo Alto, CA) es un acelerador lineal (AL) de última generación, que incorpora nuevas tecnologías en su diseño de colimación y gantry, cuenta con una única energíaa de fotones de 6 MV sin ltro aplanador FFF (Flattening Filter Free). Es un equipo diseñado exclusivamente para tratamientos guiados por imágenes IGRT ( Image Guided Radiotherapy), mediante la obtención diaria de imágenes portales de megavoltaje MV-MV o tomográcas de CBCT-MV en las modalidades de baja dosis o alta calidad, haciendo uso del EPID (Electronic Portal Imaging Device). El objetivo de este trabajo es implementar un programa de Garantía de Calidad (GC) en Halcyon, tomando como referencia protocolos internacionales como el AAPM [TG-142], OIEA [TECDOC-1151], entre otros, y mediante el desarrollo de software programados en Python crear herramientas que simpliquen el análisis de algunas de las pruebas de Control de Calidad (CC) relacionadas con aspectos mecánicos, disimétricos y de calidad de imagen. Respecto al rendimiento del equipo se observó que las pruebas de CC relacionadas a aspectos mecánicos y geométricos cumplen ampliamente los criterios de aceptación, evaluadas mediante las pruebas de star shoot, Winston Lutz y picket fence. Las pruebas de CC relacionadas a aspectos dosimétricos como PDD, perles y factores de campo se encuentran dentro de las tolerancias establecidas. El desarrollo de una herramienta en programación creada en Python, mostró tener sensibilidad submilimétrica para detectar cambios en el movimiento de las láminas, la cual puede ser implementada en la clínica, para detectar cambios en la exactitud del posicionamiento de las láminas. Las pruebas de CC implementadas, con relación a la calidad de las imágenes del EPID, se utilizaron para establecer valores de referencia. La dosimetría para la adquisici ón de las imágenes de posicionamiento diario, sugiere que es necesario un análisis más profundo sobre las implicancias relacionadas con el aporte de dosis en los órganos de riesgo, especialmente en la modalidad de alta calidad. Pruebas end to end llevadas a cabo con diferentes cámaras de ionización y películas EBT3 en fantoma antropomórfico, en las modalidades de IMRT y VMAT, muestran resultados que se encuentran dentro de los valores de referencia establecidos en el protocolo de la AAPM [TG-119]. Por otro lado, pruebas end to end realizadas con la modalidad RTC3D, y que son propuestas en el protocolo del IAEA [TECDOCxv 1583], cumplen con las tolerancias establecidas, en la mayoría de los puntos analizados. Se observó que los puntos medidos que superan las tolerancias, están relacionados con incidencias de campos laterales, con irradiación parcial del fantoma, o donde la trayectoria del haz atraviesa heterogeneidades como pulmón con una sobrestimación de la dosis mayor al 3 %. Los puntos analizados en seno de pulmón por el contrario muestran una subestimación de la dosis. Se analizó la sensibilidad del EPID para realizar dosimetría en vivo, a través de evaluaciones de índice gamma, tomando como referencia la fluencia de los diferentes campos el primer día de tratamiento, los resultados muestran poder detectar cambios anatómicos, errores de posicionamiento y variaciones en los dispositivos de inmovilizaci ón en tecnicas de RTC3D e IMRT. Halcyon incorpora un módulo de controles de calidad MPC (Machine Performance Check), el cual debe ser ejecutado diariamente antes de comenzar los tratamientos, se avaluó la sensibilidad de detección ante variaciones en el rendimiento y uniformidad del haz, como así también ante desplazamientos milimétricos del fantoma en las direcciones longitudinal, lateral, transversal y de rotación. Los resultados muestran una sensibilidad sub milimétrica para detectar cambios en la posición del fantoma.
Resumen en inglés
Halcyon, by Varian (Palo Alto, CA) is a new generation linear accelerator (LINAC), which incorporates advanced technologies in its collimator system and gantry. It has only one beam quality of 6 MV without the use of a attening lter. This LINAC is designed for image-guided radiation therapy only, by obtaining daily portal images, either MV-MV or tomographic MV-CBCT with low-dose or high-quality modalities. This work implements a Quality-Assurance (QA) program for Halcyon, taking as reference international protocols like AAPM Task Group number 142. Python´s software were developed to be used as tools for Quality Controls (QC) of mechanical and dosimetry aspects. Quality Controls about mechanical and geometric aspects, evaluated by star-shot, Winston-Lutz and picket-fence tests, satisfy the accepting criteria. Quality Controls about dosimetry aspects, such as PDD, proles and output factors, are inside the established tolerances. Tests about image quality of EPID are used for establishing baseline values. Dosimetry of daily image positioning acquisition suggests that a deeper analysis about the implications related with increased imparted dose in risk organs is needed, especially in high-quality modality. End to end tests done with ionization chambers and EBT3 lms in an anthropomorphic thorax phantom (CIRS) with IMRT and VMAT modalities are within the reference values established in the AAPM's [TG-119] protocol. Most of the end to end tests done with RTC3D modality proposed in the IAEA protocol (TECDOC- 1583) satisfy the established tolerances. The causes of the tests that are out of the tolerance values are related to lateral incidence by partial irradiation of the phantom or where the beam goes through heterogeneities such as lung with an overestimation of the dose higher than 3%. Conversely, the tests analyzed inside the lung show a underestimation of the dose. EPID's sensibility was analyzed to perform in-vivo dosimetry, using the evaluation of the gamma index. The uence of all beams on the rst day of treatment were taken as reference. The results show that anatomic changes, positioning errors, and the changes on immobilization devices (used in RTC3D and IMRT) can be detected. The detection sensibility for changes beam´s output and uniformity, and the milxvii limeter displacements on phantom were evaluated with the daily quality control of the Halcyon (MPC)
| Tipo de objeto: | Tesis (Maestría en Física Médica) |
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| Palabras Clave: | Quality control; Control de calidad; Dosimetry; Dosimetría; Phantoms; [Halcyon Accelerator; Acelerador Halcyon; Dosiemetry in Vivo; Dosimetría en Vivo; Multileaf colimator; Colimador multiláminas] |
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| Materias: | Medicina > Radioterapia |
| Divisiones: | FUESMEN |
| Código ID: | 958 |
| Depositado Por: | Marisa G. Velazco Aldao |
| Depositado En: | 02 Aug 2021 10:53 |
| Última Modificación: | 02 Aug 2021 10:53 |
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