All plans adopted 6-MV X-ray and Elekta VERSA HD accelerator (Stockholm, Sweden, 5 mm MLC), with prescription doses all set to 2.0Gy * 25 fractions. Monaco TPS (Elekta. Inc, V 5.40.03). was adopted for plan optimization, which utilized Monte Carlo for the dose calculation 1 arc, 150∼260 degree was designed, and according to the shape of target region, corresponding collimator angles were set, table angles all 0°, maximum dose rate 600 MU/min. After providing some optimizing constraints (shown in Table 1 ), distribution of dose curves was automatically optimized, and through repeated parameters adjustment, the ideal distribution of dose curves was achieved.
Versa hd accelerator
Manufactured by Elekta
Sourced in Sweden, United Kingdom
The Versa HD accelerator is a radiation therapy system designed for precise and efficient delivery of radiation treatments. It provides advanced imaging and treatment capabilities to support various cancer treatment modalities.
Automatically generated - may contain errors
8 protocols using versa hd accelerator
1
Optimized 6-MV X-ray VMAT Protocol
2
Pinnacle VMAT Treatment Planning System
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The Pinnacle treatment planning system (version 9.1, Philips Healthcare, Eindhoven, Netherlands) redesigned all plans using a 6 MV X-ray delivered using an Elekta Versa HD accelerator (Elekta Oncology Systems, Crawley, UK). The optimization algorithm for VMAT planning was SmartArc. The multi-leaf collimator (MLC) module was Agility with 80 pairs of leaves and leaf width was 5 mm at the isocenter. The dose calculation grid was 0.4 cm × 0.4 cm × 0.4 cm. P-VMAT had seven full arcs with a collimator rotating to 45° and a couch angle of 0° using dynamic jaws. As shown in Fig. 2 , the maximum field width was limited to 2.5 cm for each arc, similar to HT. The target volume was covered by seven piecewise arcs from the top to the bottom with 0.5 cm overlap regions between every two adjacent arcs to ensure uniform dose coverage in the overlap regions.![]()
Illustration of the layout of 7 arcs for P-VMAT
3
Photon Irradiation Protocol for In Vitro Studies
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Photon irradiations were carried out at the medical linear accelerator (LINAC) of Virgen de las Nieves Hospital (HVN) in Granada. The Elekta Versa HD™ accelerator delivered a flattened 6 MV high energy photon beam [19 (link)]. The irradiation zone was adapted in order to carry out in vitro irradiations. The electronic equilibrium was secured by immersing the flasks in distilled water and placing under these 14 cm of solid water (see Figure 3 ). Two flasks were simultaneously irradiated at room temperature (23–25 °C), both within the field of the beam, and then receiving the same dose. Irradiations of 0.5–6 Gy were performed at 1 Gy/min. dose rate.
4
VMAT Photon Beam Dosimetry
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This study was approved by the institutional review ethical board and informed consent was waived. A total of 207 patients (head and neck: 25; thorax: 61; abdomen: 121) were enrolled retrospectively in this study. All patients were treated with a 6-MV photon beam delivered by an Elekta Versa HD accelerator (Elekta AB, Stockholm, Sweden) in flattering filter-free mode. The VMAT technique was used for optimization with the Pinnacle TPS (version 16.2, Philips Healthcare, Eindhoven, Netherlands). The dose calculation algorithm was set as an adaptive convolve dose engine in the TPS.
5
Beam Modeling and Validation for Elekta Versa HD
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Specific beam modeling was carried out for the Elekta Versa HD accelerator using data measured with a water tank phantom (PDD, profiles, output factors, etc.). The details for beam modeling was introduced before (28 (link), 29 ). The modeling was also commissioned and validated with phantom measurement results. Forty-two phantom verification plans were recalculated with ArcherQA and the RT dose files were imported to the SNC patient software to compare with ArcCHECK measurement results. The commissioning aimed to improve the gamma passing rates between ArcherQA and ArcCHECK measurement for all these plans.
6
Single-Fraction SBRT vs. Fractionated 3DCRT for Spinal Metastases
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CT simulation was carried out with custom immobilization using Aquaplast® head masks, vacuum mattresses, and/or Wingstep® arm abduction framework. OARs (including the spinal cord) and the clinical target volume (CTV) were delineated on the planning CT with MRI co-registration. The planning target volume (PTV) was to be covered by the 80% isodose, and 24 Gy in a single fraction was prescribed to this isodose line. OAR tolerance doses were per the RTOG 0631 trial [13 (link)]. SBRT techniques included helical Tomotherapy, step-and-shoot intensity-modulated radiotherapy, or volumetric-modulated arc therapy. Treatment was delivered by an Elekta Versa HD accelerator. Image guidance was performed in all patients by means of megavoltage CT and/or TomoTherapy platforms.
For the 3DCRT arm, treatment was performed as irradiation of the involved vertebral body as well those immediately above and below to a total dose of 30 Gy in 10 fractions, most commonly delivered with 3/4 anteroposterior/posteroanterior beams. Position verification was carried out weekly before radiotherapy by kilovoltage cone-beam CT (kV-CBCT) and before each fraction by orthogonal portal images being compared with digitally reconstructed radiographs (DRR) from the planning CT.
For the 3DCRT arm, treatment was performed as irradiation of the involved vertebral body as well those immediately above and below to a total dose of 30 Gy in 10 fractions, most commonly delivered with 3/4 anteroposterior/posteroanterior beams. Position verification was carried out weekly before radiotherapy by kilovoltage cone-beam CT (kV-CBCT) and before each fraction by orthogonal portal images being compared with digitally reconstructed radiographs (DRR) from the planning CT.
7
N-VMAT Plan Design and Collision Assessment
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The design of the N-VMAT plan was primarily divided into 2 steps. Step 1: set
6 couch angles of 30°, 60°, 90°, 330°, 330°, and 360° referring to Yuan
et al22 (link)
to better compare with the N-VMAT-Cage, and Step 2: design arc size
and ensure that the gantry angle can reach the maximum range without
collision (all arcs are dual arcs). To determine the range of the gantry
angle with different couch angles, the thermoplastic mask of an HCC patient
was buckled on the couch plate of the Elekta Versa HD accelerator (Elekta
Oncology Systems). The gantry was rotated at 6 couch angles. The range of
the gantry angle without collision between the gantry, couch, or
thermoplastic mask is shown inTable 2 . All operations conformed
to clinical practice.
6 couch angles of 30°, 60°, 90°, 330°, 330°, and 360° referring to Yuan
et al22 (link)
to better compare with the N-VMAT-Cage, and Step 2: design arc size
and ensure that the gantry angle can reach the maximum range without
collision (all arcs are dual arcs). To determine the range of the gantry
angle with different couch angles, the thermoplastic mask of an HCC patient
was buckled on the couch plate of the Elekta Versa HD accelerator (Elekta
Oncology Systems). The gantry was rotated at 6 couch angles. The range of
the gantry angle without collision between the gantry, couch, or
thermoplastic mask is shown in
to clinical practice.
8
FFF X-ray Radiotherapy Planning Protocol
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All plans were designed using the Pinnacle3 (link)
treatment planning system (version 16.2, Philips Healthcare) with
Collapsed Cone Convolution Superposition algorithm and delivered using an Elekta
Versa HD accelerator (Elekta Oncology Systems). All plans used 6-MV FFF X-rays
and were calculated on a dose grid with 4-mm3 voxels using a
collapsed cone convolution algorithm. The prescribed dose was 2 Gy delivered per
fraction for all patients.
treatment planning system (version 16.2, Philips Healthcare) with
Collapsed Cone Convolution Superposition algorithm and delivered using an Elekta
Versa HD accelerator (Elekta Oncology Systems). All plans used 6-MV FFF X-rays
and were calculated on a dose grid with 4-mm3 voxels using a
collapsed cone convolution algorithm. The prescribed dose was 2 Gy delivered per
fraction for all patients.
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