Gafchromic EBT (EBT) films are becoming increasingly popular due to their advantageous properties. When flatbed colour scanners are used for film dosimetry, a good quality control of the scanning device is a crucial step for accurate results. The proposal of this work was to fully assess the performance of the scanner Epson Expression 10000XL in order to quantify all parameters and needed corrections to minimize dose uncertainties. A standard step tablet, with 32 steps and optical densities from 0.06 to 3.8, was used to check the scanner linearity. The scanner warming-up effect and reproducibility were evaluated by performing 30 consecutive scans plus 20 scans in 15 min intervals. The scanning colour modes: 24 and 48 bits and scanning resolutions from 50 to 300 dpi were tested. A Wiener filter with different pixels regions was applied with the purpose of reducing the film noise. All scans were made in transmission mode with a constant film orientation. The red colour channel was posteriorly extracted from the images to maximize readout sensitivity. Two EBT films were irradiated, perpendicularly and parallel to beam incidence, with a 6 MV photon beam with doses that ranged from 0.2 to 3 Gy. A polynomial expression was used to convert optical density into dose. Dose uncertainty was quantified applying error propagation analysis. A correction for the non-uniform response of the scanner was determined using five films irradiated with a uniform dose. The scanner response was linear until an optical density of approximately 1 which corresponds to doses higher than those of clinical interest for EBT films. The scanner signal stabilized after seven readings. Scanner reproducibility around 0.2% was obtained either with the scanner warm or cold. However, reproducibility was significantly reduced when comparing images digitized with the scanner at different temperatures. Neither the colour depth mode, the scanning resolution, the multiscan option nor the Wiener filter had a significant effect on the shape of the calibration curve. However, a reduction in dose uncertainty was possible by selecting appropriate reading parameters. These are a 48 bit colour depth, a 75 dpi resolution and repeating the scan four times. Finally, the two dimensional Wiener filter applied to a 3 x 3 pixel region to the red component of the image reduced the experimental scan uncertainty to about 0.5% for doses higher than 0.5 Gy. Total scan uncertainty was less than 2% for a perpendicular calibration and reduced to less than 1% for a parallel calibration. A dose over-estimation of around 5% for clinical doses may be made if the image acquired is not corrected for the non-uniform response of the scanner. A protocol to read EBT films using the Epson Expression 10000XL scanner was established for IMRT verification. The contribution for the overall uncertainty in film dosimetry coming from the scanning process was estimated to be around 0.5% for doses higher than 0.5 Gy when reading parameters are optimized. Total scan uncertainty achieved is about 2% when using a perpendicular calibration. It can further be reduced if a parallel calibration is used.

Generally, the inverse planning of radiation therapy consists mainly of the fluence optimization. The beam angle optimization (BAO) in intensity-modulated radiation therapy (IMRT) consists of selecting appropriate radiation incidence directions and may influence the quality of the IMRT plans, both to enhance better organ sparing and to improve tumor coverage. However, in clinical practice, most of the time, beam directions continue to be manually selected by the treatment planner without objective and rigorous criteria. The goal of this paper is to introduce a novel approach that uses beam's-eye-view dose ray tracing metrics within a pattern search method framework in the optimization of the highly non-convex BAO problem. Pattern search methods are derivative-free optimization methods that require a few function evaluations to progress and converge and have the ability to better avoid local entrapment. The pattern search method framework is composed of a search step and a poll step at each iteration. The poll step performs a local search in a mesh neighborhood and ensures the convergence to a local minimizer or stationary point. The search step provides the flexibility for a global search since it allows searches away from the neighborhood of the current iterate. Beam's-eye-view dose metrics assign a score to each radiation beam direction and can be used within the pattern search framework furnishing a priori knowledge of the problem so that directions with larger dosimetric scores are tested first. A set of clinical cases of head-and-neck tumors treated at the Portuguese Institute of Oncology of Coimbra is used to discuss the potential of this approach in the optimization of the BAO problem.

Aim: In this work, a graphical method for radiotherapy treatment plan assessment and comparison, named SPIDERplan, is proposed. It aims to support plan approval allowing independent and consistent comparisons of different treatment techniques, algorithms or treatment planning systems. Background: Optimized plans from modern radiotherapy are not easy to evaluate and compare because of their inherent multicriterial nature. The clinical decision on the best treatment plan is mostly based on subjective options. Materials and methods: SPIDERplan combines a graphical analysis with a scoring index. Customized radar plots based on the categorization of structures into groups and on the determination of individual structures scores are generated. To each group and structure, an angular amplitude is assigned expressing the clinical importance defined by the radiation oncologist. Completing the graphical evaluation, a global plan score, based on the structures score and their clinical weights, is determined. After a necessary clinical validation of the group weights, SPIDERplan efficacy, to compare and rank different plans, was tested through a planning exercise where plans had been generated for a nasal cavity case using different treatment planning systems. Results: SPIDERplan method was applied to the dose metrics achieved by the nasal cavity test plans. The generated diagrams and scores successfully ranked the plans according to the prescribed dose objectives and constraints and the radiation oncologist priorities, after a necessary clinical validation process. Conclusions: SPIDERplan enables a fast and consistent evaluation of plan quality considering all targets and organs at risk. (C) 2016 Greater Poland Cancer Centre. Published by Elsevier Sp. z o.o. All rights reserved.