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Radiotherapy error

Seyyed Mostafa Anjam, Nooshin Banaee, Hojjat Rahmani, Hassan Ali Nedaie
The purpose of this study is to determine and verify the exact location of radiation therapy fields by using port-film and digital reconstruction radiograph (DRR) as a low-cost tool. Initially, an appropriate algorithm was written for the application of port film in the megavoltage beam irradiation. Detectable contrast was created for the image and then by using appropriate markers and developed written program by MATLAB as DRrPortRegistartion. Semi-automatic and automatic registration between port-film and DRR images were performed for pelvic and chest phantoms...
August 9, 2018: Medical & Biological Engineering & Computing
Georgia Santos Joana, Maria Socorro Nogueira, Emmily Sandrini, Guilherme Bittencourt, Helio Salmon, Leandro Fairbanks, Saulo Santos Fortes, Camila Salata, Flavia Cristina Teixeira, Marcello Gomes Gonçalves
Risk assessment deals with processes, accident initiating events, barriers and risk rating to unveil the fragility and weakness of some processes as presented specifically to radiation therapy facilities within this study. Barriers are technical or organizational safety measures put in place to avoid, prevent, detect, control, reduce or mitigate the consequences of an accident once an initiating event has occurred. In this work a radiological risk analysis was performed for a set of twenty Brazilian radiotherapy facilities making use of the freeware sevrra risk management software...
August 9, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Daniel L Saenz, Nestor Rodrigo Astorga, Neil Kirby, Mohamad Fakhreddine, Karl Rasmussen, Sotirios Stathakis, Niko Papanikolaou
PURPOSE: While external beam radiotherapy treatment planning determines nearly every mechanical and dosimetric parameter of the linear accelerator (LINAC), the table coordinates in all three dimensions are generally unknown until initial patient setup at the LINAC. Knowing these parameters in advance could help verify the direction of patient shifts and prevent wrong-site errors. This study aims to determine the feasibility and accuracy of table coordinate prediction for indexed immobilization devices...
August 7, 2018: Journal of Applied Clinical Medical Physics
Karin M Andersson, Christina Vallhagen Dahlgren, Johan Reizenstein, Yang Cao, Anders Ahnesjö, Per Thunberg
PURPOSE: To evaluate two commercial CT metal artifact reduction (MAR) algorithms for use in proton treatment planning in the head and neck (H&N) area. METHODS: An anthropomorphic head phantom with removable metallic implants (dental fillings or neck implant) was CT-scanned to evaluate the O-MAR (Philips) and the iMAR (Siemens) algorithms. Reference images were acquired without any metallic implants in place. Water Equivalent Thickness (WET) was calculated for different path directions and compared between image sets...
August 4, 2018: Medical Physics
Helen Frewen, Elizabeth Brown, Michael Jenkins, Anita O'Donovan
INTRODUCTION: The international move towards digital healthcare record keeping has seen an increase in the number of radiotherapy departments moving towards a paperless framework. With the recent transition to a paperless radiation oncology framework at the Princess Alexandra Hospital Brisbane, it was crucial to perform a prospective risk assessment to quantify the most significant sources of risk in the electronic environment. METHODS: A failure mode and effects analysis (FMEA) was performed using a web-based three-round Delphi technique...
July 27, 2018: Journal of Medical Imaging and Radiation Oncology
Steven Michiels, Bram Mangelschots, Robin De Roover, Cédric Devroye, Tom Depuydt
Electron beam collimators for non-standard field sizes and shapes are typically fabricated using Styrofoam molds to cast the aperture cut-out. These molds are often produced using a dedicated foam cutter, which may be expensive and only serves a single purpose. An increasing number of radiotherapy departments, however, has a 3D printer on-site, to create a wide range of custom-made treatment auxiliaries, such as bolus and dosimetry phantoms. The 3D printer can also be used to produce patient-specific aperture cut-outs, as elaborated in this note...
July 26, 2018: Journal of Applied Clinical Medical Physics
Yoshihiro Ueda, Naamit K Gerber, Indra J Das
OBJECTIVE: To develop a mathematical model for cardiac dose estimation for patients who have been treated for left-sided breast cancer without CT data. METHODS: After obtaining institutional review board approvals, 147 patients with left-sided breast cancer were selected that were treated supine with opposed tangents. The heart blocks from the tangential fields were removed and dose calculations were performed with 6 MV beams using an advanced algorithm. This study was performed with CT data with DRR to represent a radiographic simulator image of yesteryear treatments...
July 25, 2018: British Journal of Radiology
Raanan Marants, Eric Vandervoort, Joanna E Cygler
PURPOSE: The Synchrony respiratory motion tracking of the CyberKnife system purports to provide real-time tumor motion compensation during robotic radiosurgery. Such a complex delivery system requires thorough quality assurance. In this work, RADPOS applicability as a dose and position quality assurance tool for CyberKnife treatments is assessed quantitatively for different phantom types and breathing motions which increase in complexity to more closely resemble clinical situations. METHODS: Two radiotherapy treatment experiments were performed where dose and position were measured with the RADPOS probe housed within a Solid Water phantom...
July 25, 2018: Medical Physics
David Cibula, Richard Pötter, François Planchamp, Elisabeth Avall-Lundqvist, Daniela Fischerova, Christine Haie-Meder, Christhardt Köhler, Fabio Landoni, Sigurd Lax, Jacob Christian Lindegaard, Umesh Mahantshetty, Patrice Mathevet, W Glenn McCluggage, Mary McCormack, Raj Naik, Remi Nout, Sandro Pignata, Jordi Ponce, Denis Querleu, Francesco Raspagliesi, Alexandros Rodolakis, Karl Tamussino, Pauline Wimberger, Maria Rosaria Raspollini
Regrettably, the author metadata used for the previous correction (doi: ) contained an error in the tagging of W. Glenn McCluggage's name; this has been corrected. No further adjustments have been made to the Correction, or the original Guideline paper (doi: ).
July 25, 2018: Virchows Archiv: An International Journal of Pathology
J B Farr, V Moskvin, R C Lukose, S Tuomanen, P Tsiamas, W Yao
PURPOSE: To invent, design, construct, and commission an intensity modulated minibeam proton therapy system (IMMPT) without the need for physical collimation and to compare its resulting conformity to a conventional IMPT system. METHODS: A proton therapy system (Hitachi, Ltd, Hitachi City, Japan; Model: Probeat-V) was specially modified to produce scanned minibeams without collimation. We performed integral depth dose acquisitions and calibrations using a large diameter parallel-plate ionization chamber in a scanning water phantom (PTW, Freiburg, Germany; Models: Bragg Peak ionization chamber, MP3-P)...
July 15, 2018: Medical Physics
Sonja Stieb, Michelle Malla, Shaun Graydon, Oliver Riesterer, Stephan Klöck, Gabriela Studer, Stephanie Tanadini-Lang
OBJECTIVE: Pitch, the rotation around the transversal axis of the patient during radiotherapy has little impact on the dose distribution of small spherical treatment volumes; however it might affect treatment of long volumes requiring a correction with a six degree of freedom couch. METHODS: We included 10 patients each with nasopharyngeal carcinoma (NPC) and esophageal cancer, treated with volumetric modulated arc therapy. Pitch was simulated by tilting the planning CT in ventral and dorsal direction by ± 1...
July 25, 2018: British Journal of Radiology
Fan-Tu Kong, Yan-Hua Mai, Meng-Ke Qi, Ai-Qian Wu, Fu-Tong Guo, Qi-Yuan Jia, Yong-Bao Li, Ting Song, Ling-Hong Zhou
OBJECTIVE: To establish the association between the geometric anatomical characteristics of the patients and the corresponding three-dimensional (3D) dose distribution of radiotherapy plan via feed-forward back-propagation neural network for clinical prediction of the plan dosimetric features. METHODS: A total of 25 fixed 13-field clinical prostate cancer intensity-modulated radiation therapy (IMRT)/stereotactic body radiation therapy (SBRT) plans were collected with a prescribed dose of 50 Gy...
June 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Michele Riva, Elia Arturo Vallicelli, Andrea Baschirotto, Marcello De Matteis
Clinical ions beams for cancer treatment provide maximum energy deposition (Bragg peak (BP)) at the end of their range and practically no dose behind. This enables a more efficient therapeutic option comparing with classical photon-based radiotherapy where maximum energy is deposited at the body interface. Obviously, minimum-error BP detection is, thus, a key aspect of this treatment. This paper investigates a promising detection technique, based on the so-called ionoacoustic effect. The BP energy deposition causes a small (millikelvin) heating of the surrounding volume that in turn induces a pressure variation...
June 15, 2018: IEEE Transactions on Biomedical Circuits and Systems
Avinash H Udayashankar, Shibina Noorjahan, Nirmala Srikantia, K Ravindra Babu, Sandeep Muzumder
Aim: To identify the most reproducible technique of patient positioning and immobilization during pelvic radiotherapy. Background: Radiotherapy plays an important role in the treatment of pelvic malignancies. Errors in positioning of patient are an integral component of treatment. The present study compares two methods of immobilization with no immobilization with an aim of identifying the most reproducible method. Materials and methods: 65 consecutive patients receiving pelvic external beam radiotherapy were retrospectively analyzed...
July 2018: Reports of Practical Oncology and Radiotherapy
Oliver E Holmes, Julie Gratton, Janos Szanto, Eric Vandervoort, Janice Doody, Elizabeth Henderson, Scott C Morgan, Joseph O'Sullivan, Shawn Malone
Purpose: Ultra-hypofractionated radiotherapy with SBRT is an established technique for treating localized prostate cancer. CyberKnife based SBRT requires implantation of fiducial markers for soft tissue target tracking by the orthogonal KV X-ray imaging system. The spatial distribution of fiducial markers must allow accurate calculation of a 3D transformation that describes the position of the prostate within the reference frame of the planning CT scan. Accuray provides a fiducial implantation guideline for tracking soft tissue lesions...
2018: Journal of Radiosurgery and SBRT
Seung Hyuck Jeon, Jin Ho Kim
PURPOSE: To investigate positional uncertainty and its correlation with clinical parameters in spine stereotactic body radiotherapy (SBRT) using thermoplastic mask (TM) immobilization. Materials and. METHODS: A total of 21 patients who underwent spine SBRT for cervical or upper thoracic spinal lesions were retrospectively analyzed. All patients were treated with image guidance using cone beam computed tomography (CBCT) and 4 degrees-of-freedom (DoF) positional correction...
June 2018: Radiation Oncology Journal
Maija Rossi, Eeva Boman, Tanja Skyttä, Mikko Haltamo, Marko Laaksomaa, Mika Kapanen
AIM: Traditional radiotherapy treatment techniques of the breast are insensitive for deformations and swelling of the soft tissue. The purpose of this study was to evaluate the dose changes seen with tissue deformations using different image matching methods when VMAT technique was used, and compare these with tangential technique. METHODS: The study included 24 patients with breast or chest wall irradiations, nine of whom were bilateral. In addition to planar kV setup imaging, patients underwent weekly cone-beam computed tomography (CBCT) imaging to evaluate soft tissue deformations...
July 5, 2018: Journal of Applied Clinical Medical Physics
Johannes Tran-Gia, Michael Lassmann
Quantitative SPECT/CT imaging forms the basis for internal dosimetry in molecular radiotherapies. While the conversion from counts to activity is typically performed based on conversion factors individually measured by each site, a recently introduced commercially available reconstruction (xSPECT Quant) offers a standardized and traceable calibration of SPECT/CT systems. The aim of this work was to assess the characteristics of xSPECT Quant in combination with 177 Lu as one of the most important radionuclides used in molecular radiotherapies and to compare it to a widely used ordered subset expectation maximization reconstruction (Flash3D)...
July 5, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Fu Jin, Huan-Li Luo, Juan Zhou, Ya-Nan He, Xian-Feng Liu, Ming-Song Zhong, Han Yang, Chao Li, Qi-Cheng Li, Xia Huang, Xiu-Mei Tian, Da Qiu, Guang-Lei He, Li Yin, Ying Wang
Modern radiotherapy (RT) is being enriched by big digital data and intensive technology. Multimodality image registration, intelligence-guided planning, real-time tracking, image-guided RT (IGRT), and automatic follow-up surveys are the products of the digital era. Enormous digital data are created in the process of treatment, including benefits and risks. Generally, decision making in RT tries to balance these two aspects, which is based on the archival and retrieving of data from various platforms. However, modern risk-based analysis shows that many errors that occur in radiation oncology are due to failures in workflow...
2018: Cancer Management and Research
Christian Baues, Simone Marnitz, Andreas Engert, Wolfgang Baus, Karolina Jablonska, Antonella Fogliata, Andrés Vásquez-Torres, Marta Scorsetti, Luca Cozzi
BACKGROUND: The benefits of proton therapy in the treatment of patients with Hodgkin lymphoma (HL) are controversially discussed. Therefore we compared intensitiy modulated proton therapy (IMPT) with intensity modulated radiotherapy (IMRT), in the form of volumetric modulated arc therapy (VMAT) in patients with Hodgkin lymphoma (HL), through a comparative treatment planning study. METHODS: Radiation plans for 21 patients with Hodgkin Lymphoma (HL) were computed for IMPT and deep inspiration breath hold (DIBH) VMAT...
July 3, 2018: Radiation Oncology
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