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Clinical application of an institutional fractionated stereotactic radiosurgery (FSRS) program for brain metastases delivered with MRIdianⓇ BrainTx™ Med. Dosim. (IF 1.2) Pub Date : 2024-03-02 Alonso La Rosa, Kathryn E. Mittauer, Nema Bassiri, D Jay J. Wieczorek, Yongsook C. Lee, Amy E. Rzepczynski, Michael D. Chuong, Tugce Kutuk, Nicole C. McAllister, Matthew D. Hall, Alonso N. Gutierrez, Ranjini Tolakanahalli, Minesh P. Mehta, Rupesh Kotecha
Single-fraction stereotactic radiosurgery (SRS) or fractionated SRS (FSRS) are well established strategies for patients with limited brain metastases. A broad spectrum of modern dedicated platforms are currently available for delivering intracranial SRS/FSRS; however, SRS/FSRS delivered using traditional CT-based platforms relies on the need for diagnostic MR images to be coregistered to planning CT
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Novel multileaf collimator designs with tongues and grooves in leaf end and Monte Carlo simulations Med. Dosim. (IF 1.2) Pub Date : 2024-02-23 Weijie Cui, Yuan Tian, Jianrong Dai
In this study, we proposed 2 new multileaf collimator leaf designs to eliminate leaf gaps for closed leaf pairs so that radiation leakage can be avoided. In the new designs, multi tongues and grooves were added to the conventional multileaf collimators leaf ends. Thus, when a pair of leaves closed, tongues of a leaf can enter grooves of its opposing leaf. Consequently, there would be no radiation leakage
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Plan complexity metrics for head and neck VMAT competition plans Med. Dosim. (IF 1.2) Pub Date : 2024-02-17 Hiroyuki Okamoto, Akihisa Wakita, Kensuke Tani, Satoshi Kito, Masahiko Kurooka, Takumi Kodama, Naoki Tohyama, Yukio Fujita, Satoshi Nakamura, Kotaro Iijima, Takahito Chiba, Hiroki Nakayama, Miyuki Murata, Tomonori Goka, Hiroshi Igaki
Previous plan competitions have largely focused on dose metric assessments. However, whether the submitted plans were realistic and reasonable from a quality assurance (QA) perspective remains unclear. This study aimed to investigate the relationship between aperture-based plan complexity metrics (PCM) in volumetric modulated arc therapy (VMAT) competition plans and clinical treatment plans verified
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Radiation Oncology Peer Review in a Community Setting: The Value of Prospective Review Med. Dosim. (IF 1.2) Pub Date : 2024-02-16 Irena Dragojević, David Hoopes, Gina Mansy, Douglas Rahn
Peer review is an important component of any radiation oncology continuous quality improvement program. While limited guidelines exist, there is no consensus about how peer review should be performed, and large variations exist among different institutions. The purpose of this report is to describe our experience with peer review at a busy Radiation Oncology clinic and to evaluate the difference between
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Efficacy of flattening filter-free beams with the acuros XB algorithm in thoracic spine stereotactic body radiation therapy Med. Dosim. (IF 1.2) Pub Date : 2024-02-08 Islam Tarek, Abdelrahman Hafez, Mohamed M. Fathy, Heba M. Fahmy, Dina M. Abdelaziz
This study aimed to determine the dosimetric value of flattening filter-free (FFF) beams compared to flattening filter (FF) beams using different algorithms in the treatment planning of thoracic spine stereotactic body radiation therapy (SBRT). A total of 120 plans were created for 15 patients using the Anisotropic Analytical Algorithm (AAA) and the Acuros External Beam (AXB) algorithm with FF and
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Performance assessment of the surface-guided radiation therapy system: Varian Identify Med. Dosim. (IF 1.2) Pub Date : 2024-02-05 Oğuzhan Ayrancıoğlu, Ceren Ayrancıoğlu, Şerife Ceren Arıkan, Lütfiye Zümre Arıcan Alıcıkuş
Image-guided radiotherapy (IGRT) systems using ionizing radiation may increase the risk of secondary cancer and normal tissue toxicity due to additional radiation exposure caused by large field sizes or repeated scans during X-ray imaging. As an alternative to these modalities, surface-guided radiotherapy (SGRT) systems which do not employ ionizing radiation have been developed. This study presents
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Assessing dosimetric advancements in spatially fractionated radiotherapy: From grids to lattices Med. Dosim. (IF 1.2) Pub Date : 2024-01-29 Bhagyalakshmi AT, Ramasubramanian Velayudham
Spatially fractionated radiotherapy (SFRT) techniques have undergone transformative evolution, encompassing physical GRID therapy, MLC-based grids, virtual TOMO GRIDs, and 3-dimensional high-dose lattices. Historical roots trace back to Alban Köhler's pioneering Spatially fractionated grid therapy (SFGRT), utilizing physical grids for dose modulation. Technological innovations introduced multi-leaf
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An introduction to low dose radiation therapy for shoulder osteoarthritis Med. Dosim. (IF 1.2) Pub Date : 2024-01-23 Madeleine Booth, Joseph M. Bryant, Meshan C. Curry, Nishele Lenards, Ashley Hunzeker, Ashley Cetnar
Osteoarthritis (OA) is a painful, degenerative disease that affects the tissues of the joint spaces, such as the shoulder. Conventional medical treatment options, such as corticosteroid injections and anti-inflammatory medications, are not always sufficient to alleviate the symptoms from this disease. Low dose radiotherapy is a newer treatment option for patients with shoulder osteoarthritis and has
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Dosimetric comparison of glioblastoma radiotherapy treatment plans on a low-field MRI-guided linear accelerator compared to conventional C-arm linear accelerator Med. Dosim. (IF 1.2) Pub Date : 2024-01-16 Emily Moats, M. Salim Siddiqui, Parag Parikh, Karen Chin Snyder
Introduction Magnetic resonance imaging (MRI)-guided radiation therapy has proven to provide many benefits such as real-time tracking, dose escalation, and the ability to perform online adaptive therapy. The objective of this study is to compare curative treatment plans for glioblastoma tumors on a low-field MR-guided linac vs a C-arm linac and evaluate if they are comparable in terms of coverage,
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Dosimetric significance of manual density overrides in oropharyngeal cancer Med. Dosim. (IF 1.2) Pub Date : 2024-01-11 Thomas G. Lo Greco, Kristen Vu
Kilovoltage computed tomography plays a crucial role in radiotherapy planning. However, the presence of high-density metallic objects can introduce streaking artifacts in CT scans, resulting in inaccurate dose calculations by the treatment planning software. Previous studies have explored manual density overrides and artifact reduction algorithms individually to enhance dose calculation accuracy, but
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Planning target volume margin in head and neck cancer patients undergoing radiation therapy: Estimations derived from own data and literature Med. Dosim. (IF 1.2) Pub Date : 2024-01-08 Pratik Aher, Madhuri Chirkute, Pournima Kale, Rupesh Sonawane, Ashok Singh, Niloy Ranjan Datta
Planning target volume (PTV) to deliver the desired dose to the clinical target volume (CTV) accounts for systematic (∑) and random (σ) errors during the planning and execution of intensity modulated radiation therapy (IMRT). As these errors vary at different departments, this study was conducted to determine the 3-dimensional PTV (PTV) margins for head and neck cancer (HNC) at our center. The same
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Evaluation of the utility of rescans in the treatment of prostate and pelvic nodes with pencil beam scanning protons Med. Dosim. (IF 1.2) Pub Date : 2023-12-15 Linnae E. Campbell, Steven J. Laub, Jennifer A. Smith, William F. Hartsell
To determine the necessity of the first week CT simulation rescan of pencil beam scanning (PBS) prostate patients requiring treatment to the pelvic lymph nodes. Patients were treated on a prospective registry trial sponsored by the Proton Collaborative Group (PCG—NCT01255748). A total of 42 patients with high-risk prostate cancer requiring treatment to the pelvic lymph nodes were evaluated in a single
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Editorial for the proton therapy special issue Med. Dosim. (IF 1.2) Pub Date : 2023-12-16 Stacey Schmidt
Abstract not available
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Whole-brain radiotherapy with hippocampus sparing and simultaneous integrated boost to metastases: A plan quality comparison study between Ethos, HyperArc, VMAT and Tomotherapy Med. Dosim. (IF 1.2) Pub Date : 2023-12-14 Yucel Akdeniz, Burcin Ispir
This study provides a concise and structured overview of a dosimetric comparison study conducted to assess the feasibility and effectiveness of 4 advanced radiotherapy techniques in treating brain metastases with hippocampus sparing and simultaneous integrated boost (HS-WBRT+SIB). Eleven patients with brain metastases previously treated with radiotherapy were included in the study. Planning CT scans
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Dosimetric evaluation of dose shaping by adaptive aperture and its impact on plan quality Med. Dosim. (IF 1.2) Pub Date : 2023-12-11 Aaron Silvus, Jonathan Haefner, Michael B. Altman, Tianyu Zhao, Stephanie Perkins, Tiezhi Zhang
Mevion's single-room HYPERSCAN proton therapy system employs a proton multileaf collimator called the adaptive aperture (AA), which collimates individual spots in the proton delivery as determined by the Treatment Planning System (TPS). The purpose of this study is to assess the dosimetric benefits of the AA, specifically in the dynamic aperture (DA) mode, and evaluate its impact on proton treatment
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Patient specific quality assurance of volumetric modulated arc therapy of synchronous bilateral breast cancer Med. Dosim. (IF 1.2) Pub Date : 2023-12-09 Francis C. Djoumessi Zamo, Christopher F. Njeh, Anthony Colliaux, Valérie Blot-Lafond, M. Ndontchueng Moyo
Synchronous bilateral breast cancers (SBBC) present a considerable issue in external beam radiotherapy because of large fields size and large target volumes. Mono-isocentric volumetric modulated arc therapy (VMAT) appears as an appropriate irradiation technique for these types of tumors. The aim of this study was to demonstrate the utility of a 3D DVH pretreatment quality assurance program in VMAT
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A novel lung SBRT treatment planning: Inverse VMAT plan with leaf motion limitation to ensure the irradiation reproducibility of a moving target Med. Dosim. (IF 1.2) Pub Date : 2023-12-06 Julien Darréon, Sree Bash Chandra Debnath, Mohamed Benkreira, Pierre Fau, Hugues Mailleux, Marjorie Ferré, Ahcene Benkemouche, Agnès Tallet, Pierre Annede, Claire Petit, Naji Salem
This study exposed the implementation of a novel technique (VMATLSL) for the planning of moving targets in lung stereotactic body radiation therapy (SBRT). This new technique has been compared to static conformal radiotherapy (3D-CRT), volumetric‐modulated arc therapy (VMAT) and dynamic conformal arc (DCA). The rationale of this study was to lower geometric complexity (54.9% lower than full VMAT) and
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Clinical evaluation of deep learning and atlas-based auto-segmentation for organs at risk delineation Med. Dosim. (IF 1.2) Pub Date : 2023-12-06 Ryohei Yamauchi, Tomoko Itazawa, Takako Kobayashi, Shiho Kashiyama, Hiroyoshi Akimoto, Norifumi Mizuno, Jiro Kawamori
Manual delineation of organs at risk and clinical target volumes is essential in radiotherapy planning. Atlas-based auto-segmentation (ABAS) algorithms have become available and been shown to provide accurate contouring for various anatomical sites. Recently, deep learning auto-segmentation (DL-AS) algorithms have emerged as the state-of-the-art in medical image segmentation. This study aimed to evaluate
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Proton pencil beam scanning craniospinal irradiation (CSI) with a single posterior brain beam: Dosimetry and efficiency Med. Dosim. (IF 1.2) Pub Date : 2023-11-30 Lei Hu, Anna Zhai, Qing Chen, Vandana Puri, Chin-Cheng Chen, Francis Yu, Jana Fox, Suzanne Wolden, Jonathan Yang, Charles B. Simone, Haibo Lin
This study explores the feasibility and potential dosimetric and time efficiency benefit of proton Pencil Beam Scanning (PBS) craniospinal irradiation with a single posterior-anterior (SPA) brain field. The SPA approach was compared to our current clinical protocol using Bilateral Posterior Oblique brain fields (BPO). Ten consecutive patients were simulated in the head-first supine position on a long
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Dosimetric comparison of coplanar and noncoplanar volumetric modulated arc therapy for hippocampal-sparing whole-brain radiation therapy Med. Dosim. (IF 1.2) Pub Date : 2023-11-27 Bo Yang, Yongguang Liang, Shumeng He, Yinglong Liu, Kang Zhang, Jie Qiu
Whole brain radiation therapy with hippocampal-sparing (HS-WBRT) is a novel treatment of brain metastases, which can relieve symptoms reduce recurrence in the central nervous system, and spare the hippocampus without compromising target coverage. This study aims to find out the superior combination of the treatment planning system and linear accelerator between Eclipse (version 15.6) with TrueBeam
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Dosimetric comparison of magnetic resonance-guided radiation therapy, intensity-modulated proton therapy and volumetric-modulated arc therapy for distal esophageal cancer Med. Dosim. (IF 1.2) Pub Date : 2023-11-23 Andrew R. Barsky, Jerry George, Andrew J. Wroe, Kathryn E. Mittauer, Adeel Kaiser, Roberto Herrera, Jen Yu, Alonso N. Gutierrez, Diane Alvarez, James McCulloch, Michael E. Kasper, Minesh P. Mehta, Michael D. Chuong
Advances in radiotherapy (RT) technologies permit significant decreases in the dose delivered to organs at risk (OARs) for patients with esophageal cancer (EC). Novel RT modalities such as proton beam therapy (PBT) and magnetic resonance-guided radiotherapy (MRgRT), as well as motion management techniques including breath hold (BH) are expected to further improve the therapeutic ratio. However, to
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Treatment planning of scanned proton beams in RayStation Med. Dosim. (IF 1.2) Pub Date : 2023-11-22 Martin Janson, Lars Glimelius, Albin Fredriksson, Erik Traneus, Erik Engwall
The use of scanned proton beams in external beam radiation therapy has seen a rapid development over the past decade. This technique places new demands on treatment planning, as compared to conventional photon-based radiation therapy. In this article, several proton specific functions as implemented in the treatment planning system RayStation are presented. We will cover algorithms for energy layer
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Treating recurrent metastatic breast cancer to the skin with proton therapy Med. Dosim. (IF 1.2) Pub Date : 2023-11-21 Christopher Brown, Valerie Coffman, Floyd J. Stamper, Allen G. Meek, Samantha Hedrick
Proton therapy offers unique physical properties that make it an excellent choice for treating metastatic breast cancer, particularly when recurrent disease occurs near previously irradiated tissues. This case study demonstrates the dosimetric benefits of proton therapy in patients with metastatic breast cancer to the skin. The case consists of one patient with 5 separate areas treated with Pencil
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A feasibility study of adaptive radiation therapy for postprostatectomy prostate cancer Med. Dosim. (IF 1.2) Pub Date : 2023-11-18 Sandra M. Meyers, Jeff D. Winter, Yazan Obeidi, Peter Chung, Cynthia Menard, Padraig Warde, Heng Fong, Andrew McPartlin, Saibishkumar Parameswaran, Alejandro Berlin, Andrew Bayley, Charles Catton, Tim Craig
Postoperative prostate radiotherapy requires large planning target volume (PTV) margins to account for motion and deformation of the prostate bed. Adaptive radiation therapy (ART) can incorporate image-guidance data to personalize PTVs that maintain coverage while reducing toxicity. We present feasibility and dosimetry results of a prospective study of postprostatectomy ART. Twenty-one patients were
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It's the little THANGS: Recording frequently unreported errors for dosimetry quality improvement Med. Dosim. (IF 1.2) Pub Date : 2023-11-14 Christopher J. Moore, Badal R. Juneja, Leonard H. Kim
The reporting of errors resulting in dose deviations are well-studied. Less studied is the amount of inconsequential errors that will not harm the patient but could lead to inefficiency. This paper reports an institutional effort to quantify and reduce these less significant errors. Dosimetry items discovered during physicist plan/record and verify (R&V) check prior to treatment were recorded in a
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Dose-volume comparisons of proton therapy for pencil beam scanning with and without multi-leaf collimator and passive scattering in patients with lung cancer Med. Dosim. (IF 1.2) Pub Date : 2023-11-06 Yuki Tominaga, Masaki Suga, Mikuni Takeda, Yuki Yamamoto, Takashi Akagi, Takahiro Kato, Sunao Tokumaru, Michinori Yamamoto, Masataka Oita
This study evaluated the dose distributions of proton pencil beam scanning (PBS) with/without a multileaf collimator (MLC) compared to passive scattering (PS) for stage I/II lung cancers. Collimated/uncollimated (PBS+/PBS-) and PS plans were created for 20 patients. Internal-clinical-target-volumes (ICTVs) and planning-target-volumes (PTVs) with a 5 mm margin were defined on the gated CTs. Organs-at-risk
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Comparative dosimetric study of spot-scanning proton therapy versus volumetric-modulated radiation therapy for extrahepatic bile duct cancer Med. Dosim. (IF 1.2) Pub Date : 2023-11-02 Toshiyuki Ogata, Norihiro Aibe, Takuya Kimoto, Tadashi Takenaka, Gen Suzuki, Kei Yamada, Hideya Yamazaki
This study aimed to compare the dose distributions and clarify the dosimetric characteristics of spot-scanning proton therapy (SSPT) and photon volumetric modulated arc therapy (VMAT) for extrahepatic bile duct cancer (EBDC). This retrospective study included 10 patients with EBDC treated with real-time image-gated SSPT. Using the simultaneous integrated boost technique, the 2 prescription dose levels
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Implementation and evaluation of an iterative-based algorithm for automatic beam angle optimization in breast cancer treatment planning Med. Dosim. (IF 1.2) Pub Date : 2023-11-03 Ying Guo, Yang Zhong, Lei Yu, Kang Zhang, Jiazhou Wang, Weigang Hu
Introduction A beam angle optimization (BAO) algorithm was developed to evaluate its clinical feasibility and investigate the impact of varying BAO constraints on breast cancer treatment plans. Materials and Methods A two-part study was designed. In part 1, we retrospectively selected 20 patients treated with radiotherapy after breast-conserving surgery. For each patient, BAO plans were designed using
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Predictive modeling of dose-volume parameters of carcinoma tongue cases using machine learning models Med. Dosim. (IF 1.2) Pub Date : 2023-10-31 Mani Prasannakumar, Velayudham Ramasubramanian
The aim of this study is to create a single institution-based machine learning model for a dose prediction generation tool for post-operative carcinoma of the tongue cases prospectively. Intensity-modulated radiotherapy (IMRT) plans for 20 patients with carcinoma of the tongue were generated using the Eclipse treatment planning system. A machine learning model was generated using a Python 3.10 computer
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A generalized fit index for evaluating treatment plans of multiple target volumes with different prescribed dose: Generalized dose distribution fit index Med. Dosim. (IF 1.2) Pub Date : 2023-10-31 Lingling Yan, Yingjie Xu, Jianrong Dai
Background and Purpose The differential fit index (dFI) and cumulative fit index (cFI) were defined in our previous study to evaluate the fit of isodose surfaces to the target volume. They were only applicable to plans for a single target volume. Therefore, this study aimed to generalize these indices for evaluating plans for multiple target volumes and different prescribed doses. Materials and Methods
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Advancing knowledge-based intensity modulated proton planning for adaptive treatment of high-risk prostate cancer Med. Dosim. (IF 1.2) Pub Date : 2023-10-30 Casey L. Johnson, Shaakir Hasan, Sheng Huang, Haibo Lin, Daniel Gorovets, Andy Shim, Thomas Apgar, Francis Yu, Pingfang Tsai
To assess the performance of a knowledge-based planning (KBP) model for generating intensity-modulated proton therapy (IMPT) treatment plans as part of an adaptive radiotherapy (ART) strategy for patients with high-risk prostate cancer. A knowledge-based planning (KBP) model for proton adaptive treatment plan generation was developed based on thirty patient treatment plans utilizing RapidPlanTM PT
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Two novel stereotactic radiotherapy methods for locally advanced, previously irradiated head and neck cancers patients Med. Dosim. (IF 1.2) Pub Date : 2023-10-20 Damodar Pokhrel, Josh Misa, Shane McCarthy, Eddy S. Yang
To determine the feasibility and utility of conebeam CT-guided stereotactic radiotherapy for locally recurrent, previously irradiated head and neck cancer (HNC) patients on the Halcyon, a ring delivery system (RDS). This research aims to quantify plan quality, treatment delivery accuracy, and overall efficacy by comparing against novel clinical TrueBeam HyperArc method. Ten recurrent HNC patients who
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Hypoglossal nerve delineation in nasopharyngeal carcinoma patients may reduce the radiation dose and damage to the nerve Med. Dosim. (IF 1.2) Pub Date : 2023-10-17 Fen Chen, Yee-Min Jen, Kui He, Zhao-sheng Yin, Jih-Chin Lee, Wen-Yen Huang, Yong-Hong Tang
This study aims to establish a delineation guideline for the contouring of the hypoglossal nerve by dividing the nerve into different segments, and to test the possibility of a radiation dose reduction to the hypoglossal nerve in NPC patients receiving radiotherapy. Twenty NPC patients were selected arbitrarily. The hypoglossal nerves were delineated using anatomic landmarks and divided into the cisternal
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Integrated feathering for craniospinal irradiation improves patient safety and departmental efficiency Med. Dosim. (IF 1.2) Pub Date : 2023-10-05 Amy S. Harrison, Angelia Landers, Virginia Nettleton, Katelyn Palermo, Yelena Vakhnenko, Wenyin Shi
This paper presents to the dosimetrist audience an integrated feathering technique for craniospinal irradiation which improves dosimetry, physics, physician and therapist efficiencies while increasing patient safety and decreasing portal imaging time. This technique has been presented by other authors in physics journals stressing technical and quality assurance aspects, this article is presented to
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Novel hybrid treatment planning approach for irradiation a pediatric craniospinal axis Med. Dosim. (IF 1.2) Pub Date : 2023-10-03 Christian Ziemann, Florian Cremers, Laura Motisi, Dirk Albers, Miller MacPherson, Dirk Rades
This study presents a new treatment planning approach merging 3D-CRT and VMAT fields into a hybrid treatment plan (HybTP), in order to achieve an optimum dose coverage of the planning target volume (PTV) and protection of OAR. Craniospinal axis irradiation (CSI) treated with 3D conformal radiotherapy (3D-CRT) is associated with high doses to the heart and eye lenses but provides better sparing of lungs
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Technical Report: Efficient constancy evaluation of the Eclipse treatment planning system's photon and electron dose calculation algorithms aided by the third-party ClearCheck software Med. Dosim. (IF 1.2) Pub Date : 2023-09-23 Eric Lobb
Our institutional approach to performing periodic constancy checks on dose calculations for the Varian Eclipse treatment planning system is described, including details of how the Radformation ClearCheck software is leveraged for highly efficient results analysis. Photon- and electron-specific synthetic phantoms are created which allow all modality-specific fields to be spatially separated and calculated
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Dosimetric comparison between RapidArc and HyperArc in hippocampal-sparing whole-brain radiotherapy with a simultaneous integrated boost Med. Dosim. (IF 1.2) Pub Date : 2023-09-16 Jeongho Kim, Tae Gyu Kim, Byungdo Park, Hyunjung Kim, Yun Gyu Song, Hyoun Wook Lee, Young Zoon Kim, Jun Ho Ji, Seok-Hyun Kim, Sung Min Kim, Jun Ho Lee, Haeyoung Kim
The HyperArc technique is known for generating high-quality radiosurgical treatment plans for intracranial lesions or hippocampal-sparing whole-brain radiotherapy (WBRT). However, there is no reported feasibility of using the HyperArc technique in hippocampal-sparing WBRT with a simultaneous integrated boost (SIB). This study aimed to compare dosimetric parameters of 2 commercially-available volumetric-modulated
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Proton versus photon comprehensive nodal breast irradiation Med. Dosim. (IF 1.2) Pub Date : 2023-09-15 Kelly McKenna
Comprehensive nodal breast irradiation is traditionally treated utilizing 3DCRT planning with a three or four field technique. While the three or four field photon technique may be the standard of care for comprehensive nodal breast treatment, the ipsilateral lung dose and heart mean can often be of concern dependent on patient's anatomy. Standard dose constraints (200cGy x25) per the Alliance A221505
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Dosimetric characterization of foam padding with posterior fields in palliative radiation therapy Med. Dosim. (IF 1.2) Pub Date : 2023-09-04 Jessica M. Fagerstrom
Patients undergoing external beam radiation therapy for the palliative treatment of painful bony metastases may have difficulty maintaining a still position on a rigid uncovered couch top, both during CT simulation as well as during patient setup, image guidance, and treatment on the linear accelerator. For these patients, a thin foam pad or mattress is sometimes used to mitigate patient discomfort
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From protons to Picasso: recreating famous paintings using proton beams as a “Paintbrush” Med. Dosim. (IF 1.2) Pub Date : 2023-09-04 Lee Xu
In pencil-beam-scanning proton therapy, the dose is painted spot-by-spot, layer-by-layer, allowing for significantly more control compared to conventional radiation. This work intends to showcase the impressive ability of intensity-modulated proton therapy (IMPT) to shape complex dose distributions by recreating some of history's most renowned artworks as treatment plans. Five (5) well-recognized paintings
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From organ at risk to target organ: Dosimetric comparison of myocardial stereotactic ablative body radiotherapy between helical tomotherapy and volumetric arc therapy for refractory ventricular tachycardia Med. Dosim. (IF 1.2) Pub Date : 2023-09-04 Hüseyin Furkan Öztürk, Suheyla Aytaç Arslan, Zerrin Gani, Dursun Aras, Yılmaz Tezcan
Ventricular tachycardia (VT) is an important type of arrhythmia with a risk of sudden death. Although implanted cardiac defibrillation and radiofrequency ablation are used together with medical treatments for VT, the treatment options are limited in cases that do not respond to them. Stereotactic ablative body radiotherapy (SABR) applied to VT substrates in resistant cases is an emerging treatment
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Vertebral artery sparing volumetric modulated arc therapy in nasopharyngeal carcinoma Med. Dosim. (IF 1.2) Pub Date : 2023-09-04 Szu-Huai Lu, Hao-Ting Lan, Yi-Chun Tsai, Ya-Fang Chen, Shih-Fan Lai, Hsiang-Kuang Liang, Bing-Shen Huang, Wan-Yu Chen, Chun-Wei Wang
Vascular stenosis is a late radiation complication that develops in long-term survivors of nasopharyngeal carcinoma. Vertebral arteries (VAs) are major vessels responsible for posterior circulation. In this study, we evaluated the feasibility of VA-sparing volumetric modulated arc therapy (VMAT) techniques. A total of 20 patients with nasopharyngeal carcinoma treated by a TrueBeam linear accelerator
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Quality rectal hydrogel placement allows for gel-enabled dose-escalated EBRT (GEDE-EBRT) without rectal interference in prostate cancer Med. Dosim. (IF 1.2) Pub Date : 2023-09-02 Jamie S.K. Takayesu, Paul Heckman, Eric Short, Patrick Hurley, Vrinda Narayana, Patrick W. McLaughlin
Multiple trials have shown that dose-escalation of radiation for prostate cancer provides a biochemical progression-free survival benefit (bPFS); however, rectal constraints are often limiting. In this dosimetric study, we hypothesized that a well-placed rectal hydrogel (RH) would permit improved dose-escalation and target coverage. We selected patients with good-quality RH and created plans with and
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Risk evaluation of secondary malignancies after radiotherapy of breast cancer in light of the continuous development of planning techniques Med. Dosim. (IF 1.2) Pub Date : 2023-08-31 Savino Cilla, Francesco Deodato, Carmela Romano, Gabriella Macchia, Milly Buwenge, Mariangela Boccardi, Donato Pezzulla, Antonio Pierro, Alice Zamagni, Alessio Giuseppe Morganti
Secondary cancer risk is a significant concern for women treated with breast radiation therapy due to improved long-term survival rates. We evaluated the potential of new advanced automated planning algorithms together with hybrid techniques to minimize the excess absolute risk (EAR) for secondary cancer in various organs after radiation treatment for early staged breast cancer. Using CT data set of
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Regional nodal irradiation in breast cancer patients: Effects of deep inspiration breath hold on the internal mammary chain location Med. Dosim. (IF 1.2) Pub Date : 2023-08-28 Felix Völk, Kai Joachim Borm, Mathias Düsberg, Stephanie Elisabeth Combs, Stefan Knippen, Marciana Nona Duma
The purpose of this study was to investigate the impact of deep inspiration breath hold (DIBH) on the positioning of thoracic structures and provide treatment planning recommendations for internal mammary chain (IMC) irradiation in breast cancer patients. Thirty-two breast cancer patients from our database underwent both DIBH and free breathing (FB) treatment planning. Contouring of the axillary lymph
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Breaking barriers: Stereotactic ablative proton and photon radiation therapy for renal cell carcinoma with extensive metastases: A case report Med. Dosim. (IF 1.2) Pub Date : 2023-08-08 Ming-Wei Ma, Zi-Shen Wang, Hong-Zhen Li, Xian-Shu Gao, Chao Liu, Xue-Ying Ren, Wei-Li Zhang, Kai-Wei Yang
Patients with advanced renal cancer (RCC) often have limited success with systemic therapy due to tumor heterogeneity. However, stereotactic ablative radiotherapy (SABR) has been shown to have a beneficial therapeutic effect for oligometastatic disease when used early. Despite this, current guidelines recommend the use of tyrosine kinase inhibitors (TKIs) as the first-line therapeutic agent for patients
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A planning-based feasibility study of MR-Linac treatment for anal cancer radiation therapy Med. Dosim. (IF 1.2) Pub Date : 2023-07-26 Drew Smith, Kellie Knight, Jenny Sim, Daryl Lim Joon, Farshad Foroudi, Vincent Khoo
The hybrid magnetic resonance image (MRI) scanner and radiation therapy linear accelerator (MR-Linac) has the potential to enhance clinical outcomes for anal cancer (AC) patients with improved soft tissue visualization and daily plan adaption but has planning and delivery limitations due to the incorporation of MRI. We aimed to identify if Elekta Unity MR-Linac-based radiation therapy is feasible for
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Evaluating Pareto optimal tradeoffs for hippocampal avoidance whole brain radiotherapy with knowledge-based multicriteria optimization Med. Dosim. (IF 1.2) Pub Date : 2023-07-24 Tsegawbizu Gebru, Kirk Luca, Jonathan Wolf, Oluwatosin Kayode, Xiaofeng Yang, Justin Roper, Jiahan Zhang
The goal of this study is to investigate the Pareto optimal tradeoffs between target coverage and hippocampal sparing using knowledge-based multicriteria optimization (MCO). Ten prior clinical cases were selected that were treated with hippocampal avoidance whole brain radiotherapy (HA-WBRT) using VMAT. A new, balanced plan was generated for each case using an in-house RapidPlan model in the Eclipse
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Verification of Qfix Encompass™ couch modeling using the Acuros XB algorithm and HypeArc™ using a high-spatial-resolution two-dimensional diode array Med. Dosim. (IF 1.2) Pub Date : 2023-07-16 Takumi Yamada, Hisashi Nakano, Satoshi Tanabe, Tatsuya Sakai, Shunpei Tanabe, Tetsuya Oka, Hironori Sakai, Tomoya Oshikane, Toshimichi Nakano, Atsushi Ohta, Tsutomu Kanazawa, Motoki Kaidu, Hiroyuki Ishikawa
We modeled the Qfix Encompass™ immobilization system and further verified the calculated dose distribution of the AcurosXB (AXB) dose calculation algorithm using SRS MapCHECKⓇ (SRSMC) in the HyperArc™ (HA) clinical plan. An Encompass system with a StereoPHAN™ QA phantom was scanned by SOMATOM go.Sim and imported to an Eclipse™ treatment planning system to create a treatment plan for Encompass modeling
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Robust VMAT treatment planning for extremity soft tissue sarcomas Med. Dosim. (IF 1.2) Pub Date : 2023-07-16 Joshua Barrus, Katelyn Fernando, Mark Addington, Nishele Lenards, Ashley Hunzeker, David J Konieczkowski
Volumetric modulated arc therapy (VMAT) is a frequently employed and guideline-recommended radiotherapy (RT) modality for extremity soft tissue sarcomas (eSTS). Prior studies have demonstrated that significant tumor volume changes during treatment result in loss of target volume coverage with highly conformal techniques such as VMAT, but few solutions exist to these issues aside from adaptive replanning
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Evaluation of the applicability of the lattice radiotherapy technique at the National Cancer Institute - INCA Med. Dosim. (IF 1.2) Pub Date : 2023-07-04 Fernanda Pedroso Partichelli, Marina de Arruda Botelho
Lattice is a 3-dimensional spatially fractionated radiotherapy that uses a distribution of high-doses, similar to spheres at vertices of a 3D network or matrix. These vertices that receive the high-dose are called peaks, while the rest of the target volume that receives a lower dose, is called the valley. This study aims to verify the technical feasibility for Spatially Fractionated Radiation Therapy
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Dosimetry implications of VMAT delivery angles and intra-fraction motion for SBRT prostate treatments Med. Dosim. (IF 1.2) Pub Date : 2023-06-30 Dimitrij Dimiskovski, Trent Aland
For a cohort of retrospectively treated patients with prostate carcinoma using a Stereotactic body radiation therapy (SBRT) technique and with implanted localization fiducials, this study determined whether there were any correlations between theoretical fiducial visibility using intra-fraction megavoltage imaging and intra-fraction motion induced dosimetric effects. Treatment planning data for 20
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Accelerated hypofractionated magnetic resonance-guided adaptive radiotherapy for oligoprogressive non-small cell lung cancer Med. Dosim. (IF 1.2) Pub Date : 2023-06-15 Alonso La Rosa, Kathryn E. Mittauer, Michael D. Chuong, Matthew D. Hall, Tugce Kutuk, Nema Bassiri, James McCulloch, Diane Alvarez, Robert Herrera, Alonso N. Gutierrez, Ranjini Tolakanahalli, Minesh P. Mehta, Rupesh Kotecha
Given the positive results from recent randomized controlled trials in patients with oligometastatic, oligoprogressive, or oligoresidual disease, the role of radiotherapy has expanded in patients with metastatic non-small cell lung cancer (NSCLC). While small metastatic lesions are commonly treated with stereotactic body radiotherapy (SBRT), treatment of the primary tumor and involved regional lymph
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Improved planning efficiency in multiple brain lesion SRS VMAT cases using Eclipse scripting Med. Dosim. (IF 1.2) Pub Date : 2023-06-02 Rebecca Barrett, Rob Hale, Nishele Lenards, Ashley Hunzeker, Sabrina Zeiler
Though dosimetry has a multitude of treatment modalities, software, and workflows to aid in the treatment planning process, treatment planners are still responsible for several tedious and monotonous tasks that could decrease their planning efficiency. The purpose of this study was to determine if scripting could improve treatment planning efficiency for multiple brain lesion stereotactic radiosurgery
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Diversity of medical dosimetry applicants and graduates Med. Dosim. (IF 1.2) Pub Date : 2023-05-23 Nishele Lenards
Diversity is a critical component in the advancement of human endeavor in science. Students who complete their education and training at diverse schools can serve patients from a wide range of ethnic backgrounds and promote cross-cultural competence. However, developing a diverse environment of professionals is a long-term effort which often takes generations to complete. Increasing awareness of underrepresented
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Improvement of target coverage using automated non-coplanar volumetric modulated arc therapy planning in stereotactic radiotherapy for cervical metastatic spinal tumors Med. Dosim. (IF 1.2) Pub Date : 2023-05-16 Shingo Ohira, Toshiki Ikawa, Shoki Inui, Naoyuki Kanayama, Yoshihiro Ueda, Masayoshi Miyazaki, Teiji Nishio, Masahiko Koizumi, Koji Konishi
This study aimed to compare dosimetric parameters for targets and organs at risk (OARs) between volumetric modulated arc therapy (VMAT) and automated VMAT (HyperArc, HA) plans in stereotactic radiotherapy for patients with cervical metastatic spine tumors. VMAT plans were generated for 11 metastases using the simultaneous integrated boost technique to deliver 35 to 40 and 20 to 25 Gy for high dose
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Delivery of a VMAT technique with flattening filter (FF) and flattening filter free (FFF) mode for whole breast irradiation with five fractions (FAST-Forward trial) Med. Dosim. (IF 1.2) Pub Date : 2023-05-13 Md Akhtaruzzaman, Md Jobairul Islam, Md Abdul Mannan, Mostafa Aziz Sumon, Martin Ebert
To investigate the feasibility of volumetric modulated arc therapy (VMAT) delivery for whole breast irradiation with a 5-fraction regimen according to the FAST-Forward trial. Recently, we treated 10 patients with carcinoma of the left breast after breast conserving surgery. The dose prescription to the PTV was 26 Gy in 5 fractions. Treatment plans were produced using a VMAT technique with the Eclipse
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Assessing the impact of intrafraction motion correction on PTV margins and target and OAR dosimetry for single-fraction free-breathing lung stereotactic body radiation therapy Med. Dosim. (IF 1.2) Pub Date : 2023-05-08 Clara J. Fallone, Clare Summers, Wladyslawa Cwajna, Alasdair Syme
The objective of this research is to investigate intrafraction motion correction on planning target volume (PTV) margin requirements and target and organ-at-risk (OAR) dosimetry in single-fraction lung stereotactic body radiation therapy (SBRT). Sixteen patients (15 with upper lobe lesions, 1 with a middle lobe lesion) were treated with single-fraction lung SBRT. Cone-beam computed tomography (CBCT)