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Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists

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https://www.readbyqxmd.com/read/30396725/radiographic-predictors-of-imrt-for-treating-regional-lymph-nodes-in-breast-cancer
#1
Mary K Dean, William Amestoy, Cristiane Takita, Stuart E Samuels
Regional nodal irradiation (RNI) is an essential part of the treatment of high risk early stage (Stage IIb) and locally advanced (Stage III) breast cancer. Acceptable radiation plans can usually be achieved using 3-dimensional conformal radiation therapy with deep-inspiration breath hold to limit dose to the heart, although in some cases intensity-modulated radiation therapy produces superior results. The goal of this study is to identify radiographic parameters that predict the need for IMRT when delivering RNI...
November 2, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30389413/optimal-selection-of-optimization-bolus-thickness-in-planning-of-vmat-breast-radiotherapy-treatments
#2
Maija Rossi, Eeva Boman, Mika Kapanen
The aim of this study was to find an optimal optimization skin flash thickness in volumetric modulated arc radiotherapy of the breast in consideration of soft tissue deformations during the treatment course. Ten breast radiotherapy patients with axillary lymph node inclusion were retrospectively planned with volumetric modulated arc radiotherapy technique. The plans were optimized with the planning target volume (PTV) extending outside the skin contour by 0, 5, 7, and 10 mm; and with optimization boluses of 3 or 5 mm on the extended PTV...
October 30, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30366620/nasopharyngeal-carcinoma-radiotherapy-with-hybrid-technique
#3
Ugur Akbas, Canan Koksal, Nazmiye Donmez Kesen, Kubra Ozkaya, Hatice Bilge, Musa Altun
The aim of the study was to investigate the effect of the Hybrid technique which was created by combining of intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) for the treatment of nasopharyngeal cancer (NPC) patients. 7 to 9 field IMRT, triple arc VMAT, and Hybrid plans were generated for 10 advanced stage NPC patients. The homogeneity index (HI) and the conformity index (CI) of planning target volumes (PTVs) were calculated for each technique to evaluate the plan quality. The techniques were compared in terms of plan quality, sparing of organs at risk (OARs), monitor units (MUs), and delivery time...
October 23, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30366619/radiation-treatment-to-a-postresection-primary-mucoepidermoid-carcinoma-mec-of-the-conjunctiva-with-positive-margins-at-the-tenon-s-fascia-a-case-study
#4
Leland Muller, Christina Henson, Brian Firestone, Salahuddin Ahmad, Terence S Herman, Tania De La Fuente Herman
The primary occurrence of mucoepidermoid carcinoma (MEC) of the conjunctiva is extremely rare, aggressive, and easily mistaken for squamous cell carcinoma. With fewer than 50 cases reported in the literature, there is no consensus on the most effective treatment. Radiation is an alternative to enucleation or orbital exenteration with the potential of eye preservation. We investigated several radiation approaches for a case with postresection positive margins at Tenon's fascia, and reported the patient's clinical course during the treatment and for a short time thereafter...
October 23, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30360940/a-novel-dynamic-arc-treatment-planning-solution-to-reduce-dose-to-small-bowel-in-preoperative-radiotherapy-for-rectal-cancer
#5
Victoria S Brennan, Brendan Curran, Christina Skourou, Emma McVeigh, Mary Dunne, Lydia O'Sullivan, Brian D P O'Neill
Preoperative radiotherapy or combined chemoradiotherapy for locally advanced rectal cancer (LARC) can cause acute and late gastrointestinal (GI) side-effects. There is thought to be a dose-volume relationship between small bowel irradiation and the development of these effects. A planning study was undertaken to compare small bowel sparing for a range of 3D conformal and dynamic arc planning solutions. A planning study was carried out for 20 LARC patients. Organs at risk (OAR) contoured included bowel loops and peritoneal space (PS)...
October 22, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30336971/dosimetric-impact-of-interfractional-organs-at-risk-variation-during-high-dose-rate-interstitial-brachytherapy-for-gynecologic-malignancies
#6
Peter G Hawkins, Ming Tang, Karen A Vineberg, Lisa Young, Kelly Kovach, Choonik Lee, Katherine E Maturen, Shitanshu Uppal, Dawn Owen, Matthew J Schipper, Joann I Prisciandaro, Shruti Jolly
We sought to develop a framework for the identification and management of patients at risk for organs at risk (OARs) overdosing due to interfractional anatomic variation during high-dose rate interstitial brachytherapy for gynecologic malignancies. We analyzed 40 high-dose rate interstitial brachytherapy fractions from 10 patients. Planned OAR doses were compared to delivered doses, which were calculated from computed tomography scans obtained prior to each treatment fraction. Doses were converted to equivalent doses in 2 Gy fractions (EQD2) and doses to the most exposed 2 cm3 (D2cc ) were reviewed...
October 15, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30274874/retrospective-dosimetric-analysis-of-brain-lesions-planned-in-pinnacle-9-8-via-a-hdmlc-linac
#7
Justin M Leasure, Vincent Ulizio, David Pearson
The University of Toledo Medical Center's Eleanor N. Dana Cancer Center located in northwest Ohio currently utilizes the Edge Radiosurgery System (Varian Medical Systems Inc., Palo Alto, CA) to deliver stereotactic radiosurgery for the treatment of brain lesions. The purpose of this study is to determine the quality of conformal arc radiotherapy in treating patients with brain lesions at The University of Toledo Medical Center and to provide more data for conformity and gradient indices (due to a lack of current data) to hopefully improve national standards by allowing centers to compare among each other...
September 28, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30268345/cochlea-sparing-with-a-stratified-scheme-of-dose-limitation-employed-in-intensity-modulated-radiotherapy-for-nasopharyngeal-carcinoma-a-dosimetry-study
#8
Chao Zhang, Ling-Xiang Liu, Wei-Zhan Li, Wen Liang, Zhao-Hui Chen, Xian-Hai Huang, Juan Qi, Xiao-Hua Chen, Jian-Gang Liang, Xiao-Long Cao
Hearing loss is 1 of the major complications after radiotherapy in nasopharyngeal carcinoma (NPC) patients, how to minimize dose to cochlea in order to reduce the incidence of sensorineural hearing loss is a critical task. This study is to investigate a stratified scheme of cochlea sparing based on T stage in intensity-modulated radiotherapy. We designed a comparison between 2 plans of cochlea sparing plan (C-Plan) and regular noncochlea sparing plan (R-Plan) from 19 NPC patients with 2, 3, 8, and 6 cases of T1, T2, T3, and T4 stage, respectively...
September 26, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30236506/use-of-electronic-portal-images-to-evaluate-setup-error-and-intra-fraction-motion-during-free-breathing-breast-imrt-treatment
#9
Jing-Min Hwang, Jing-Yin Hung, Yi-Han Tseng, You-Kang Chang, Yu-Nong Wang, Chiou-Shiung Chang
Before delivering of intensity-modulated radiotherapy, kilo-voltage image-guidance radiotherapy is widely used in setup error correction and monitoring intra-fraction motion effectively. Accordingly, this study proposes and tests an image integration technique for observing intra-fraction motion during beam delivery, with the wider objective of reducing both image-guidance time and the dose delivered to normal breast tissue. The study sample comprised 33 female patients with breast cancer, and 241 sets of portal images acquired using a VARIAN aSi-1000 electronic portal imaging device...
September 17, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30197035/varian-halcyon-dosimetric-comparison-for-multiarc-vmat-prostate-and-head-and-neck-cancers
#10
LETTER
Catalina Riley, Christopher Cox, Sasha Graham, Holly Havran, Bethany Kramer, Tucker Netherton, Christine Peterson, Tyler Williamson, Laurence Court
The Varian Halcyon linear accelerator is designed for faster treatment time and fewer treatment errors than conventional linear accelerators. Its increased gantry speed (4 rpm), dose rate (800 MU/min), and leaf speed (5 cm/s) reduce treatment time. The 2 multileaf collimator banks of 1 cm leaf width could cause planning difficulties, but utilizing many arcs could address this challenge. While 3 or more arcs are often avoided due to the increased treatment time, the Halcyon can deliver 5 arcs in under 3 minutes...
September 6, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30193991/imrt-planning-parameter-optimization-for-spine-stereotactic-radiosurgery
#11
LETTER
Gabriel B Ayala, Kieu A Doan, Hie Ji Ko, Peter K Park, Edwin D Santiago, Shirly J Kuruvila, Tina M Briere, Zhifei Wen
Spine stereotactic radiosurgery (SSRS) is a noninvasive treatment for metastatic spine lesions. MD Anderson Cancer Center reports a quality assurance (QA) failure rate approaching 15% for SSRS cases, which we hypothesized is due to difficulties in accurately calculating dose resulting from a large number of small-area segments. Clinical plans typically use 9 beams with an average of 10 segments per beam and minimum segment area of 2 to 3 cm2 . The purpose of this study was to identify a set of intensity-modulated radiation therapy (IMRT) planning parameters that attempts to optimize the balance among QA passing rate, plan quality, dose calculation accuracy, and delivery time for SSRS plans...
September 4, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30170990/dosimetric-evaluation-of-right-coronary-artery-in-radiotherapy-for-breast-cancer
#12
Ayşe Altınok, Orbay Askeroğlu, Mine Doyuran, Mustafa Çağlar, Emir Cantürk, Cengiz Erol, Nuran Beşe
Comparison with control groups of untreated patients suggests that right-breast-cancer patients who receive radiotherapy have a higher rate of heart disease. Dose constraint for heart has been established to minimize radiotherapy-induced cardiotoxicity during left breast cancer treatment. Additionally, it is suggested to minimize the dosage on left anterior descending (LAD) artery. Right coronary artery (RCA), is the second largest artery, after left main coronary artery, supplying the heart. A dose evaluation study is not present for RCA; the proximal part of which is included in the irradiation field during breast cancer treatment of right breast...
August 28, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30166077/the-implementation-of-rapidplan-in-predicting-deep-inspiration-breath-hold-candidates-with-left-sided-breast-cancer
#13
Aubrie Rice, Ian Zoller, Kevin Kocos, Dannyl Weller, Dominic DiCostanzo, Ashley Hunzeker, Nishele Lenards
The aim of this study is to determine if RapidPlan (RP) can be used as a prediction method to determine which left-sided supine breast cancer patients would benefit from the deep inspiration breath-hold (DIBH) technique. An RP model database was created with 72 clinically approved 3D conformal radiation therapy (3D-CRT) treatment plans. This model was validated by introducing 10 new patient data sets, creating RP-generated plans and comparing the clinically approved plan for the corresponding patient. The prediction ability of the model was then tested on the free-breathing (FB) scans of patients with clinically approved DIBH plans totaling 29 patients and results were then compared to the FB clinical plan attempts...
August 28, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30153966/accuracy-and-efficiency-of-graphics-processing-unit-gpu-based-acuros-xb-dose-calculation-within-the-varian-eclipse-treatment-planning-system
#14
Trent Aland, Anthony Walsh, Mark Jones, Angelina Piccini, Aimee Devlin
To evaluate, in terms of dosimetric accuracy and calculation efficiency, the implementation of a graphic processing unit (GPU)-based Acuros XB dose calculation engine within version 15.5 of the Varian Eclipse treatment planning system. Initial phantom based calculations and a range of 101 clinical cases were analyzed on a dedicated test system. Dosimetric differences, based on dose-volume histrogram parameters and plan comparison, were compared between central processing unit (CPU) and GPU based calculation...
August 25, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30153965/dose-uncertainty-from-calculation-grid-resolution-and-its-alignment-with-mlc
#15
Jinkoo Kim, Archie Chu, Zhigang Xu
The aims are (1) to present a clinical brain case where the dose distribution calculated at 2.5-mm grid resolution was significantly different from that of 1.0 mm with Varian HD120 multileaf collimator (MLC; 2.5-mm central leaf width), and (2) to present our analysis results to better understand the influence of dose calculation grid resolution and its spatial alignment with MLC. A simulation using a static MLC pattern with 10 open strips was conducted to demonstrate the possibility that the characteristics of MLC dose profiles can be completely hidden...
August 25, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30135024/a-robust-volumetric-arc-therapy-planning-approach-for-breast-cancer-involving-the-axillary-nodes
#16
LETTER
Gijs J van der Veen, Tomas Janssen, Amber Duijn, Simon van Kranen, Rob J de Graaf, Geert Wortel, Terry G Wiersma, Eugène Damen
We quantify the robustness of a proposed volumetric-modulated arc therapy (VMAT) planning and treatment technique for radiotherapy of breast cancer involving the axillary nodes. The proposed VMAT technique is expected to be more robust to breast shape changes and setup errors, yet maintain the improved conformity of VMAT compared to our current standard technique that uses tangential intensity-modulated radiation therapy (IMRT) fields. Treatment plans were created for 10 patients. To account for anatomical variation, planning was carried out on a computed tomography (CT) with an expanded breast, followed by segment weight optimization (SWO) on the original planning CT (VMAT + SWO)...
August 19, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30119882/avoidance-sectors-to-reduce-dosimetric-impact-of-an-irreproducible-pannus-on-setup-uncertainty-in-prostate-sbrt-vmat-a-case-study
#17
Emily Hubley, Gaurav Shukla, Yelena Vakhnenko, Robert B Den, Amy S Harrison
This work investigates whether the use of an avoidance sector in a two-arc volumetric modulated arc therapy (VMAT) prostate stereotactic body radiotherapy (SBRT) plan reduces dosimetric variations due to an irreproducible pannus. A morbidly obese patient with favorable-risk prostate cancer elected treatment with SBRT. The patient was treated with the avoidance arcs across the pannus to eliminate reproducibility issues created by daily pannus variability in set up. For post-treatment assessment, the case was planned using Varian Eclipse™ treatment planning system (TPS) with two VMAT arcs with and without 100° avoidance sectors across the pannus...
August 14, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30115539/mri-based-treatment-planning-for-brain-stereotactic-radiosurgery-dosimetric-validation-of-a-learning-based-pseudo-ct-generation-method
#18
Tonghe Wang, Nivedh Manohar, Yang Lei, Anees Dhabaan, Hui-Kuo Shu, Tian Liu, Walter J Curran, Xiaofeng Yang
Magnetic resonance imaging (MRI)-only radiotherapy treatment planning is attractive since MRI provides superior soft tissue contrast without ionizing radiation compared with computed tomography (CT). However, it requires the generation of pseudo CT from MRI images for patient setup and dose calculation. Our machine-learning-based method to generate pseudo CT images has been shown to provide pseudo CT images with excellent image quality, while its dose calculation accuracy remains an open question. In this study, we aim to investigate the accuracy of dose calculation in brain frameless stereotactic radiosurgery (SRS) using pseudo CT images which are generated from MRI images using the machine learning-based method developed by our group...
August 14, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30097226/the-dosimetric-differences-in-calculating-lung-sbrt-plans-on-different-image-data-sets-comparison-of-the-free-breathing-scan-to-both-the-average-intensity-projection-scan-and-to-the-sum-of-calculations-on-each-respiratory-phase-of-the-4dct-scan
#19
LETTER
Francesco Gaetani Liseo, Tim Lautenschlaeger, Marvene Ewing, Mark Langer
The purpose of this study is to evaluate the dosimetric differences to the lung internal target volume (ITV) in stereotactic body radiation therapy (SBRT) when calculated on the free breathing (FB) scan in comparison to calculations on the average intensity projection (AIP) scan as well as the sum of dose calculated on each of the treated respiratory phases. The clinical treatment plan data for 16 SBRT lung patients were retrospectively chosen for this study, 5 of which were 30% to 70% respiratory phase gated...
August 7, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/30078605/dosimetric-comparison-of-deep-inspiration-breath-hold-and-free-breathing-treatment-delivery-techniques-for-left-sided-breast-cancer-using-3d-surface-tracking
#20
Winston Vuong, Rupen Garg, Daniel J Bourgeois, Suhong Yu, Varun Sehgal, Parima Daroui
INTRODUCTION: While radiation therapy has been shown to increase local control and overall survival for breast cancer, late cardiac toxicity remains a concern. Morbidity and mortality have been shown to increase proportionally to the mean heart dose. Deep inspiration breath-hold (DIBH) can reduce heart dose compared to free-breathing (FB) by increasing the heart-to-chest wall distance, especially in left-sided breast cancer. We present our clinical experience with DIBH in left breast and chest-wall irradiation using 3D optical surface tracking...
August 2, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
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