Abstract
Treatment verification plays a vital role in the management of patients receiving radiation treatment. As part of the overall quality assurance program, it is designed to detect a variety of mistakes, errors, and inaccuracies that can occur during a protracted course of fractionated therapy. Mistakes are due to human misjudgments or performance failures, and may have serious implications if not detected and corrected promptly. Treatment errors arise when calculations or procedures are less accurate than expected and can occur in all the stages of the planning and treatment process. They can be divided into two main categories: those associated with the prescription, computation, and specification of target doses and dose distributions, and those that occur during the delivery phase and involve the treatment machine or the patient. Portal verification, in which a transmission image of the patient is acquired just prior to or during teletherapy, is used to verify that such errors are within acceptable limits.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Amols H, Lowinger T (1987) An inexpensive microcomputer based portal film image enhancement system. Med Phys 14:483
Amols H, Reinstein L, Lagueux B (1986) A quantitative assessment of portal film contrast as a function of beam energy. Med Phys 13: 711–716
Andrews J, Swain R, Rubin P (1958) Continuous visual monitoring of 2 MEV Roentgen therapy. Am J Roentgenol 73: 74–78
Antonuk L, Yorkston J, Boudry J (1991) Large area amorphous silicon photodiode arrays for radiotherapy and diagnostic imaging. Nucl Instr Meth Phys Res A310: 460–464
Antonuk L, Boudry J, Huang W et al. (1992) Demonstration of megavoltage and diagnostic x-ray imaging with hydrogenated amorphous silicon arrays. Med Phys 19: 1455–1466
Baily N, Horn R, Kampp T (1980) Fluoroscopic visualization of megavoltage therapeutic x-ray beams. Int J Radiât Oncol Biol Phys 6: 935–939
Baiter J, Pelizzari C, Chen T (1992) Correlation of projection radiographs in radiation therapy using open curve segments and points. Med Phys 19: 329–334
Barrett H, Swindell W (1981) Radiological imaging, vol 1. Academic press, New York, p 137
Bel A, Bartelink H, El-Gayed A, van Herk M, Vijlbrief R, Lebesque J (1992) Portal imaging and decision rules for correcting patient setups. Radiother Oncol 24 (Suppl):S33
Benner S, Rosengren B, Wallman H, Netteland O (1962) Television monitoring of a 30 MV X-ray beam. Phys Med Biol 7: 29–33
Biggs P, Goitein M, Russell M (1985) A diagnostic X-ray field verification device for a 10 MV linear accelerator. Int J Radiât Oncol Biol Phys 11:635–643
Bijhold J, van Herk M, Vijlbrief R, Lebesque J (1991) Fast evaluation of patient set-up during radiotherapy by aligning features in portal and simulator images. Phys Med Biol 36: 1665–1679
Bijhold J, Gilhuijs K, van Herk M (1992a) Automatic verification of radiation field shape using digital portal images. Med Phys 19: 1007–1014
Bijhold J, Lebesque J, Hart A, Vijlbrief R (1992b) Maximizing setup accuracy using portal images as applied to a conformal boost technique for prostatic cancer. Radiother Oncol 24: 261–271
Bissonnette J-P, Jaffray D, Fenster A, Munro P (1992) Physical characterization and optimal magnification of a portal imaging system. SPIE 1651: 182–188
Boesecke R, Bruckner T, Ende G (1990) Landmark based correla- ation of medical images. Phys Med Biol 35: 121–126
Boyer A, Antonuk L, Fenster A, et al. (1992) A review of electronic portal imaging devices (EPIDs). Med Phys 19: 1–16
Brahme A (1984) Dosimetric precision requirements in radiation therapy. Acta Radiol Oncol 23: 379–391
Brahme A (1988) Accuracy requirements and quality assurance of external beam therapy with photons and electrons. Acta Oncol (Suppll)
Buchanan R, Sklensky A, Maple T, Bailey H (1947) Metal-phosphor intensifying screens for high energy imaging applications. IEEE Trans NS-21: 692–694
Cohen G, Wagner L, Amtey S (1981) Contrast-detail-dose and dose efficiency analysis of a scanning digital and a screen-film-grid radiographic system. Med Phys 8: 358–367
Creutzberg C, Visser A, De Porre P, Meerwaldt J, Althof V, Levendag P (1992) Accuracy of patient positioning in mantle field irradiation. Radiother Oncol 23: 257–264
Crooks I, Fallone B (1991) PC-based selective histogram equalization for contrast enhancement of portal films. Med Phys 18:618
Cumberlin R, Rodgers J, Fahey F (1989) Digital image processing of radiation therapy portal films. Comput Med Imaging Graph 13: 227–233
Dally M, Hunter K, Wheat J, Leslie G, Fahey P, Hamilton C Denham J (1992) Objective decision making following a portal film: the results of a pilot study. Radiother Oncol 24 (Suppl): S45
De Neve W, Van den Heuvel F, De Beukeleer M et al. (1992) Routine clinical on-line portal imaging followed by immediate field adjustment using a tele-controlled patient couch. Radiother Oncol 24: 45–54
Droege R, Bjarngard B (1979a) Influence of metal screens on contrast in megavoltage X-ray imaging. Med Phys 6: 487–493
Droege R, Bjarngard B (1979b) Metal screen-film detector MTF at megavoltage X-ray energies. Med Phys 6: 515–518
Droege RT, Stefanakos TK (1985) Portal film technique charts. Int J Radiât Oncol Biol Phys 11: 2027–2031
Dutreix A, van der Schueren E, Leunens L (1992) Quality control at the patient level: action or retrospective introspection? Radiother Oncol 25: 146–147
El-Gayed A, Bartelink H, Bel A, Vijlbrief R, Lebesque J (1992) Evaluation of the time trend of setup deviations during the course of pelvic irradiation using an electronic portal imaging device. Radiother Oncol 24 (Suppl): S45
Evans P, Gildersleve J, Morton E et al. (1992) Image comparison techniques for use with megavoltage imaging systems. Br J Radiol 65: 701–709
Ezz A, Munro P, Porter A, Battista J, Jaffray D, Fenster A, Osborne S (1992) Daily monitoring and correction of radiation field placement using a video-based portal imaging system: a pilot study. Int J Radiât Oncol Biol Phys 22: 159–165
Faermann S, Krutman Y (1992) Generation of portal film charts for 10-MV x-rays. Med Phys 19: 351–353
Galbraith D (1989) Low-energy imaging with high-energy brems-strahlung beams. Med Phys 16: 734–746
Galkin B, Wu R, Suntharalingam N (1978) Improved technique for obtaining teletherapy portal radiographs with high-energy photons. Radiology 127: 828–830
Gildersleve J, Dearnaley D, Evans P, Law M, Rawlings C, Swindell W (1992) A randomised trial of patient repositioning during pelvic radiotherapy. Presented at Megavoltage Portal Imaging, London
Goer D (1983) Radiation therapy treatment: the role of treatment aids and accessories IEEE Trans NS-30: 1784–1787
Gonzalez RC, Wintz P (1987) Digital image processing, 2nd edn. Addison-Wesley, Reading
Graham ML, Cheng AY, Geer LY, Binns WR, Vannier MW, Wong JW (1991) A method to analyze 2-dimensional daily radiotherapy portal images from an on-line fiber-optic imaging system. Int J Radiât Oncol Biol Phys 20: 613–619
Griffiths S, Pearcey R, Thorogood J (1987) Quality control in radiotherapy: The reduction of field placement errors. Int J Radiât Oncol Biol Phys 13: 1583–1588
Griffiths S, Khoury G, Eddy A (1991) Quality control of radiotherapy during pelvic irradiation. Radiother Oncol 20:203–206
Gur D, Deutsch M, Fuhrman C, Clayton P, Weiser J, Rosenthal M, Bukovitz A (1989) The use of storage phosphors for portal imaging in radiation therapy: therapists perception of image quality. Med Phys 16: 132–136
Halverson K, Leung T, Pellet J, Gerber R, Weinhous M, Wong J (1991) Study of treatment variation in the radiotherapy of head and neck tumors using a fiber-optic on-line radiotherapy imaging system. Int J Radiât Oncol Biol Phys 21: 1327–1336
Hammoudah M, Henschke U (1977) Supervoltage beam films. Int J Radiât Oncol Biol Phys 2: 571–577
Haus A, Pinsky S, Marks J (1970) A technique for imaging patient treatment area during a therapeutic radiation exposure. Radiology 97: 653
Haus A, Marks J, Griem M (1973) Evaluation of an automatic rapid- processable film for imaging during the complete radiotherapeutic exposure. Radiology 107: 697–698
Heukelom S, Lanson J, Mijnheer B (1992) In vivo dosimetry during pelvic treatment. Radiother Oncol 25: 111–120
Huizenga H, Levendag P, De Porre P, Visser A (1988) Accuracy in radiation field alignment in head and neck cancer: A prospective study. Radiother Oncol 11: 181–187
ICRU (1976) Errors in clinical dosimetry. Report 24: 45
Jaffray D, Battista J, Fenster A, Munro P (1993) X-ray sources of medical linear accelerators: Focal and extra-focal radiation. Med Phys 20: 1417–1427
Jakobsen A, Iversen P, Gadeberg C, Lindberg Hansen J, Hjelm-Hansen M (1987) A new system for patient fixation in radiotherapy. Radiother Oncol 8:145–151
Johns HE, Cunningham JR (1983) The physics of radiology, Charles C. Thomas, Springfield, 111.
Jones S, Boyer A (1991) Investigation of an FFT-based correlation technique for verification of treatment setup. Med Phys 18: 1116–1125
Kartha P, Chung-Bin A, Wachtor T, Hendrickson F (1977) Accuracy in radiotherapy treatment. Int J Radiât Oncol Biol Phys 2: 797–799
Kihlen B, Cederlund T, Lagergren C, Nordeil B, Rüden B (1991) Improved portal film image quality in radiation therapy with high energy photons. Acta Oncol 30: 1–5
Kotre C, Marshall N, Faulkner K (1992) An alternative approach to contrast-detail testing of X-ray image intensifier systems. Br J Radiol 65: 686–690
Lam K, Ten Haken R (1991) Improvement of precision in spatial localization of radio-opaque markers using the two-film technique. Med Phys 18: 1126–1131
Lam K, Partowmah M, Lam W (1986) An on-line electronic portal imaging system for external beam radiotherapy. Br J Radiol 59: 1007–1013
Lam W, Herman M, Lam K, Lee D (1991) On-line portal imaging: computer-assisted error measurements. Radiology 179: 871–873
Lebesque J, Bijhold J, Hart A (1992) Detection of systematic patient set-up errors by portal film analysis. Radiother Onco l23: 198
Leong J (1984) A digital image processing system for high energy X-ray portal images. Phys Med Biol 29: 1527–1535
Leong J (1986) Use of digital fluoroscopy as an on-line verification device in radiation therapy. Phys Med Biol 31: 985–992
Leong J, Stracher M (1987) Visualization of internal motion within a treatment portal during a radiation therapy treatment. Radiother Oncol 9: 153–156
Leszczynski K, Shalev S (1989) A robust algorithm for contrast enhancement by local histogram modification. Image and Vision Computing 7: 205–209
Leszczynski K, Shalev S (1993) Verification of radiotherapy treatments: Computerized analysis of the size and shape of radiation fields. Med Phys 20: 687–694
Leszczynski K, Shalev S, Cosby S (1990) A digital video system for on-line portal verification. SPIE 1231: 401–405
Leszczynski K, Shalev S, Cosby S (1992a) The enhancement of radiotherapy verification images by an automated edge detection technique. Med Phys 19: 611–622
Leszczynski K, Shalev S, Ryder S (1992b) A study on the efficacy of digital enhancement of on-line portal images. Med Phys 19: 999–1005
Leunens G, Verstraete J, Van den Bogaert W, Van Dam J, Dutreix A, van der Schueren E (1992) Human errors in data transfer during the preparation and delivery of radiation treatment affecting the final result: “garbage in, garbage out”. Radiother Oncol 23: 217–222
Loewenthal E, Loewinger E, Bar-Avraham E, Barnea G (1992) Measurement of the source size of a 6- and 18-M V radiotherapy linac. Med Phys 19: 687–690
Marks J, Haus A (1976) The effect of immobilisation on localisation error in the radiotherapy of head and neck cancer. Clin Radiol 27: 175–177
McGee K, Shalev S (1993) Reduction of interpolation artifacts introduced by MHE in digital on-line portal images. Phys Med Biol 38: 601–614
Meertens H, van Herk M, Weeda J (1988) An inverse filter for digital restoration of portal images. Phys Med Biol 33: 687–702
Meertens H, Bijhold J, Strackee J (1990) A method for the measurement of field placement errors in digital portal images. Phys Med Biol 35: 299–323
Mitine C, Leunens G, Verstraete J, Blanckaèrt N, Van Dam J, Dutreix A, van der Schueren E (1991) Is is necessary to repeat quality control procedures for head and neck patients? Radiother Oncol 21: 202–210
Mok E, Feldmeier J (1988) Digital enhancement of treatment verification films using a low cost video digitizer with a personal computer. Phys Med Biol 33 (Suppl 1): 47
Morton E, Swindell W, Lewis D, Evans P (1991) A linear array, scintillation crystal-photodiode detector for megavoltage imaging. Med Phys 18: 681–691
Muller-Runkel R, Watkins S (1991) Introducing a computerized record and verify system: Its impact on treatment errors. Med Dosim 16: 19–22
Munro P, Rawlinson J, Fenster A (1988) Therapy imaging: source sizes of radiotherapy beams. Med Phys 15: 517–524
Munro P, Rawlinson J, Fenster A (1990) A digital fluoroscopic imaging device for radiotherapy localization. Int J Radiât Oncol Biol Phys 18: 641–649
Pizer SM, Amburn EP, Austin JD, et al. (1987) Adaptive histogram equalization and its variations. Comput Vision Graphics Image Process 9: 355–368
Pratt WK (1991) Digital image processing. Wiley, New York
Rabinowitz I, Broomberg J, Goitein M, McCarthy K, Leong J (1985) Accuracy of radiation field alignment in clinical practice. Int J Radiât Oncol Biol Phys 11: 1857–1867
RCA (1974) Electro-optics handbook. RCA, New Jersey, pp 216–217
Reinstein L (1986) Radiotherapy portal imaging quality. In: Kereiakes J, Elson H, Born C (eds) Radiation oncology physics. American Institute of Physics, New York, p 627 (AAPM medical physics monograph no. 15)
Reinstein LE, Orton CG (1979) Contrast enhancement of high-energy radiotherapy films. Brit J Radiol 52: 880–887
Reinstein LE, Durham M, Tefft M, Yu A, Glicksman AS (1984) Portai film quality: A multiple institutional study. Med Phys 11: 555–557
Reinstein L, Alquist L, Amols H, Lagueux B (1987a) Quantitative evaluation of a portal film contrast enhancement technique. Med Phys 14: 309–313
Reinstein L, Amols H, Biggs P, Droege R, Filimonov A, Lutz W, Shalev S (1987b) Radiotherapy portal imaging quality. American Institute of Physics, New York (AAPM report no.24)
Reinstein L, Shalev S, Leszczynski K, Cosby S, Meek A (1988) Megavoltage movies. Int J Radiât OncolBiol Phys 15 (Suppl 1): 200
Roehrig H, Lutz W, Barnea G, Pond G, Dallas W (1990) Use of computed radiography for portal imaging. Proc SPIE 1231: 492–497
Schonemann PH, Carroll RM (1970) Fitting one matrix to another under choice of a central dilation and a rigid motion. Psychometrika 35: 247–255
Sephton R, Green M, Fitzpatrick C (1989) A new system for port films. Int J Radiât Oncol Biol Phys 16: 251–258
Shalev S (1992) The design and clinical application of digital portal imaging systems. Int J Radiât Oncol Biol Phys 24 (Suppl 1): 104
Shalev S, McGee K (1992) Evaluation of image processing techniques by ROC analysis. Med Phys 19: 822
Shalev S, Arensqn J, Stewart M (1984) Digital enhancement of treatment verification films. Radiology 153(P): 154
Shalev S, Cheng CW, Arenson J (1985) Port film enhancement by digital processing. SPIE 555: 103–108
Shalev S, Leszczynski K, Cosby S, Reinstein L, Meek A (1988) Online verification of radiation treatment portals. Proc IEEE/ EMBS New Orleans: 382–383
Shalev S, Lee T, Leszczynski K, Cosby S, Chu T, Reinstein L, Meek A (1989) Video techniques for on-line portal imaging. Comput Med Imaging Graph 13: 217–226
Shalev S, Leszczynski K, Cosby S, Agbay H (1990) Clinical implementation of on-line portal imaging. Med Phys 17: 554
Sherouse GW, Rosenman J, McMurry HL, Pizer SM, Chaney EL (1987) Automatic digital contrast enhancement of radiotherapy films. Int J Radiât Oncol Biol Phys 13: 801–806
Sherouse G, Bourland D, Reynolds K, McMurry H, Mitchell T, Chaney E (1990) Virtual simulation in the clinical setting: Some practical considerations. Int J Radiât Oncol Biol Phys 19:1059–1065
Shiu A, Hogstrom K, Janjan N, Fields R, Peters L (1987) Technique for verifying treatment fields using portal images with diagnostic quality. Int J Radiât Oncol Biol Phys 13: 1589–1594
Smith V (1987) Routines for enhancement for radiation therapy images. In: Bruinvis I (ed) The use of computers in radiation therapy. Elsevier Science, North Holland, pp 37–40
Soffen E, Hanks G, Hwang C, Chu J (1991) Conformai static field therapy for low volume low grade prostate cancer with rigid immobilization. Int J Radiât Oncol Biol Phys 20: 141–146
Svensson G (1984) Quality assurance in radiation therapy: physics efforts. Int J Radiât Oncol Biol Phys 10 (Suppl 1): 23–29
Tait W, Hanson M (1989) Microcomputer processing of film radiographs. Br J Radiol 62: 613–619
Thornton A, Ten Haken R, Gerhardsson A, Correll M (1991) Three-dimensional motion analysis of an improved head immobilization system for simulation, CT, MRI, and PET imaging. Radiother Oncol 20: 224–228
van Dam J, Vaerman C, Blanckaert N, Leunens G, Dutreix A, van der Schueren E (1992) Are port films reliable for in vivo exit dose measurements? Radiother Oncol 25: 67–72
van Herk M, Meertens H (1988) A matrix ionisation chamber imaging device for on-line patient setup verification during radiotherapy. Radiother Oncol 11: 369–378
van Herk M, Bijhold J, Hoogervorst B, Meertens H (1992) Sampling methods for a matrix ionization chamber system. Med Phys 19: 409–418
van Tienhoven G, Lanson J, Crabeels D, Heukelom S, Mijnheer B (1991) Accuracy in tangential breast treatment set-up: a portal imaging study. Radiother Oncol 22: 317–322
Verhey L, Goitein M, McNulty P, Munzenrider J, Suit H (1982) Precise positioning of patients for radiation therapy. Int J Radiât Oncol Biol Phys 8: 289–294
Visser A, Huizenga H, Althof V, Swanenburg B (1990) Performance of a prototype fluoroscopic radiotherapy imaging system. Int J Radiât Oncol Biol Phys 18: 43–50
Webb S (1988) The physics of medical imaging. Adam Hilger, Bristol, pp 26–32
Weinhous M (1990) Treatment verification using a computer workstation. Int J Radiât Oncol Biol Phys 19:1549–1554
Weiser J, Gur D, Gennari R (1990) Evaluation of analog contrast enhancement and digital unsharp masking in low-contrast portal images. Med Phys 17: 122–125
Wilenzick R, Merritt C (1987) Megavoltage portal films using computer radiographic imaging with photostimulable phosphors. Med Phys 14: 389–392
Wong J, Binns R, Cheng A, Greer L, Epstein J, Purdy J (1990a) On-line radiotherapy imaging with an arrary of fiberoptic image reducers. Int J Radiât Oncol Biol Phys 18: 1477–1484
Wong J, Slessinger E, Hermes R, Offutt C, Roy T, Vannier M (1990b) Portal dose images. I. Quantitative treatment plan verification. Int J Radiât Oncol Biol Phys 18: 1455–1463
Wowk B, Radcliffe T, Shalev S, Rajapakshe R (1994) Optimization of metal/phosphor screens for on-line portal imaging. Med Phys 21: 227–235
Ying X, Geer L, Wong J (1990) Portal dose images. II. Patient dose estimation. Int J Radiât Oncol Biol Phys 18: 1465–1475
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1995 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Shalev, S. (1995). Treatment Verification Using Digital Imaging. In: Smith, A.R. (eds) Radiation Therapy Physics. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-03107-0_8
Download citation
DOI: https://doi.org/10.1007/978-3-662-03107-0_8
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-03109-4
Online ISBN: 978-3-662-03107-0
eBook Packages: Springer Book Archive