The most

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• The most
• Comprehensive, Reliable, Economical and Simple
• GAFCHROMIC film based IMRT QA system
• Updated on 6/22/06

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Presentation Outline

• Company Profile
• Advanced Materials Group
• Product lines
• Goals and objectives
• Overview of GAFCHROMIC products in medical
  applications.
• Discuss about most comprehensive, reliable,
  economical and simple GAFCHROMIC film based IMRT
  QA system
• Exclusive look at GAFCHROMIC EBT film
• Digitization of GAFCHROMIC EBT film
• Analyzing GAFCHROMIC EBT film using FilmQA
• Properties and features of FilmQA
• GAFCHROMIC EBT based system solution
• GAFCHROMIC QD Dosimetry system package for
  on-site implementation.
• GAFCHROMICRTQA film dosimetry
• Conclusion
• References

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International Specialty Products
Specialty Chemicals

• Privately held
• - Annual revenue gt USD 1.2 Billion

Personal Care
Pharm/Special Chem/BevFood
Performance
Advanced Materials Group
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Major Sales Technical Service Facilities
Advanced Materials Group have their own
distributors that are specialized in film
dosimetry
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Advanced Materials Group

• A business unit of ISP
• 20 years of innovation in Radiochromic film
• Started with applications for US military
• Direct sales in USA
• Distributor network in Europe and Asia-Pacific
  regions
• Manufacturing location USA

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Advanced Materials Groups Functions

• Designs, develops and markets radiochromic film.
• Self developing films for radiation measurement.
• Currently two product lines.
• Qualitative devices
• RAD-SURE blood irradiation indicators
• STERIN insect irradiation indicators
• Dose Map - service
• Quantitative devices
• GAFCHROMIC dosimetry films

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Advanced Materials Groups Mission

• Continue striving for higher cost-performance
  benefits of radiochromic dosimetry film
• Produce high quality products with the medical
  physicists objectives in mind .
• Keep it simple - Offer simple (to minimize
  training time thus more time for treating
  patients), affordable but valuable solutions to
  ensure high data integrity.

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GAFCHROMIC Dosimetry Films in medical
applications
Expected launch schedule, 3rd quarter of 2006
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• Features and Characteristics
• Of
• GAFCHROMICEBT dosimetry film

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GAFCHROMIC EBT
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GAFCHROMIC EBT Dosimetry Films Lamination
Structure
Spatial resolution better than 0.1mm
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Energy Response of EBT in Comparison with EDR-2
Chui-Tsao, et al., Med. Phys., Vol. 32, No. 11,
November 2005
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Features of GAFCHROMIC EBT Film

• Convenient and easy to use
• 8 x 10 sheets
• Can be cut into shapes
• Water resistant
• Compatible with water phantoms
• Stable and uniform
• Low post exposure density growth
• Over 95 develops upon exposure

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GAFCHROMICEBT dosimetry film

• Particularly designed and optimized for IMRT QA
• Ideal for processor-less environment
• Eliminates processor noise and drift artifacts
• Energy independent/dose fractionation independent
  high data integrity
• Near tissue equivalent
• No over response due to low energy x-ray
  scatter
• Very competitive in price
• Eliminates 10 overhead expense/use of film

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GAFCHROMICEBT dosimetry film

• Handle in room light
• No dark room or light proof packaging needed
• More efficient workflow
• Wide dose range 1cGy to 800cGy
• Very stable and uniform
• Low post exposure density growth Over 95
  develops upon exposure
• Excellent results using professional flat bed
  (w/16 bit response) color film scanners
• Does not require 20,000 scanner

Easy drop in replacement for a processor-less
environment without any capital investment
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• Digitization
• of
• GAFCHROMICEBT dosimetry film

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Recommended transmission flat-bed color scanner
works best for EBT
With peak absorption at 635nm, EBT film is best
scanned in the red channel of a flatbed scanner
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Easy Film Digitization with Low Cost Flatbed
Scanner
Red channel offers the best contrast
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Film Orientation

• Laminating generates an orientation to the fibers
• Light scatters perpendicular to fiber orientation
• Films should be scanned so that scatter is away
  from detector

Better signal to noise ratio in the portrait
direction for a 8x10 film
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Dose Response ofGAFCHROMIC EBT Dosimetry Film
Epson 1680 consistently provides better results
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Easy Film Digitization with Low Cost Flatbed
Scanner

• Flatbed color scanner
• 48-bit
• Transmission mode
• Preferred scanners
• Epson 4990 8 x 10
• Epson 1680 A4
• Epson 10000XL A3

Have several options to suit your needs
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Optimum solution

• Epson Expression 1680 is a 48 bit professional
  color film scanner with transparency adapter
• Scan format 210mm x 297mm
• Spatial resolution 0.02mm
• Scan mode Transparent and reflective

However, our EBT-Vidar protocol can assist you in
getting a good result with Vidar
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• Analyzing
• GAFCHROMICEBT dosimetry film
• with FilmQA - a verification software
• from 3COGNITION

www.3cognition.com
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TM

• Simplifies, streamlines, and
• lowers the cost of film analysis

For free downloads and video tutorials go to
www.3cognition.com
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FilmQA from 3COGNITION

• Highlights
• FAST!!!
• Analyze multiple films simultaneously
• 7-field IMRT case can be analyzed in under 5
  min.
• FLEXIBLE
• Works with any film EBT, EDR2,
• Work with any scanner Flatbed, VIDAR,
• Works with any phantom.
• Can learns any fiducial mark pattern registers
  multiple films with 1-click
• Optimized for use with GAFCHROMIC EBT film
• ACCURATE
• Calibrates for scanner field flatness and
  processor drift
• Quantitative evaluation
• Dynamic profiles and isodose maps
• Gamma, DTA and dose difference
• Histograms
• Integrated Database
• Customizable site-specific WEB-based reports

Imports all major treatment plans and works with
EDR2 and Vidar
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Full Analysis in 6 Easy Steps

• Import Calculations
• From treatment planning system
• Import Films
• Using flat-bed color scanner
• Register
• Synchronize orientation of films
• Calibrate
• Convert to dose images
• Evaluate
• Compare calculations to dose images
• Create Reports
• Customizable in HTML Format

TM
Complete data analysis in just 6 easy steps in
less than 5 minutes
www.3cognition.com
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Why background correction extremely necessary

• Concern
• Possibilities of significant inaccuracies in scan
  measurements
• Cause
• Images from both conventional processed films and
  radiochromic films are composed of particles
  dispersed in a matrix having different refractive
  index.
• Hence both films scatter light.
• Response from scanned films varies in a direction
  parallel to the light source.
• Hence conventional film scanners with longer
  diffuse light source (relative to flat-bed
  scanners that has light source closer to the film
  produce) produce greater artifacts from scattered
  light than many flat bed scanners.
• Solution
• Background correction
• Scan an unexposed EBT film
• Measure mean pixel value (scanner response value)
  of the unexposed film
• Create a Flat field correction Image by
  dividing all pixel values by mean pixel value
  also called pixel by pixel arithmetic
• Flatten all images in a set of images using pixel
  by pixel division of the image by the flattening
  correction image to correct the effect of light.

This correction can be done manually using our
protocol or can be done automatically by
3Cognitions Software FilmQA just with a click
of a button
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System Performance Example 2
Brainlab case with MLC EBT on Vidar VXR-16 with
background correction
Brainlab case with MLC EBT on Vidar VXR-16
without background correction
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System Performance Example 3
Brainlab case with MLC EBT on Epson 1680 with
background correction
Brainlab case with MLC EBT on Vidar VXR-16 with
background correction
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• GAFCHROMICEBT dosimetry film based
• IMRT QA System solution

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Lowest system cost and operating expense

Entry price of EBT based IMRT QA system ltltlt price
of any other currently available IMRT QA
dosimetry system
Alternately

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Purchase a GAFCHROMIC QD Quickstart package
from ISP (Includes 4 boxes of EBT FILM, w/ 1680
Epson Scanner, and 1 on-site hands on training)
with unlimited FilmQA license from 3COGNITION
Epson 1680 professional transmission color
scanner
IMRT Plan verification software
Very high absolute dose accuracy can be achieved
with our recommended measurement protocol
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Summary of GAFCHROMIC Film Based IMRT QA
System

• GAFCHROMIC EBT Dosimetry Films
• Self-developing, energy-independent, inexpensive
  radiochromic film designed for IMRT QA.
• Epson 1680 professional flat-bed color scanner
  with transparent adapter
• FILMQA IMRT Verification Software
• Simplifies, streamlines, and lowers the cost of
  film analysis.
• ------------------------------------------------
  
• A fast, easy, and reliable QA system with the
• lowest start-up operating costs

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• GAFCHROMIC RTQA dosimetry film for Qualitative
  application only

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What is GAFCHROMIC RTQA and how is it
different from EBT?

• It is a radiochromic film for QA and
  commissioning of radiotherapy modalities.
• Use is qualitative as oppose to quantitative
• Beam alignment, star-shot, etc
• Has single active layer vs. double
• Reflective vs. transparent
• Lower price than EBT dosimetry film
• Comes in two different format
• 10 x 10
• 1.25 x 11 for HDR source verification

Developed for qualitative application only
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In Conclusion..

• Cautionary notes
• It is estimated that between 46K to 100 K deaths
  occur each year in US as a result of medical
  errors. (ref MPW Vol. 21 (1) 2005).
• Of this large portion, 17 billion is associated
  with preventable errors.
• Conventional films and processors are being
  abandoned (in particular for IMRT applications)
  for various scientific reasons one being they
  are prone to inaccuracies.
• New imaging technology, record and verification
  systems, planning systems, etc allows for more
  complex RT but brings with them even greater
  risks.
• Too much dependency on technology.
• Complacency
• Lack of adequate training.
• Insufficient training time.
• Complex QA procedures are susceptible to errors.
• Expensive QA tools are not necessarily the best
  solution.

Hon on your old techniques to minimize training
time and also minimize error
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For more Information
Please visit
www.gafchromic.com
click on Gafchromic
look under Films for Radiotherapy
Application

• Recommended topics under IMRT QA Dosimetry system
• Media files
• Effects of Light scattering on CCD scanners.
• Importance of systematic background corrections
• Scanner consistency and noise
• QAI 365 Scanner Flatness correction
• QAI 366 Conversion from image data to dose
  space
• QAI 367 - Image Evaluation using FilmQA software
• QAI 367A Image Evaluation using FilmQA and
  Vidar Scanner
• For FilmQA tutorial and download
• Click on www.3cognition.com

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Contacts

• US Contact
• Sales Support
• Wanda Simon - 973-628-3688
• Place order 1-877-591-7884
• System support
• Sarah Walsh- 973-628-4287
• Robert Rogers- 973-628-3138
• International contact
• Sales Support
• Local distributor. Please visit our website for
  the info
• System support
• Tejas Telivala ttelivala_at_ispcorp.com (631)
  675-0417

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• BACKUP

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Import Calculations step
Multiple Treatment Plan Options
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Import Films step
Three Channel Output Red, Green, Blue Channels
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Register films step
Learns any pin-prick arrangement
Multiple tools to register films
Tell the program this is a background film
Detects all films with one-click
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Calibrate step (part a)
Smooth curve as a result of background correction
Apply Background correction
Step for film dose conversions
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Calibrate films (part b)
Step for film dose conversions
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Evaluate (step a)
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Evaluate (step b)
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Evaluate (step c)
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Evaluate (step d)
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Evaluate (step e)
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Evaluate (step f)
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Evaluate (step g)
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Reports step