To investigate the daily setup, interfraction motion, variability in the junction areas, and dosimetric effect in craniospinal irradiation (CSI) patients.

The coauthors, Mary Beth Allen, MBA, PhD and Mehdi Mirsaeidi, MD, MPH, are my former colleagues from the University of Louisville and both have significant experience and expertise regarding infectious disease. Dr. Allen is a healthcare research consultant and former senior program manager for infectious disease at the University of Louisville. Dr. Mirsaeidi is currently an Associate Professor at the

Throughout the last years, carbon‐fibre‐reinforced PEEK (CFP) pedicle screw systems were introduced to replace standard titanium alloy (Ti) implants for spinal instrumentation, promising improved radiotherapy (RT) treatment planning accuracy. We compared the dosimetric impact of both implants for intensity modulated proton (IMPT) and volumetric arc photon therapy (VMAT), with the focus on uncertainties

To compare tumor motion amplitudes measured with 2D fluoroscopic images (FI) and with an inhale/exhale CT (IECT) technique

Peripheral lung lesions treated with a single fraction of stereotactic ablative body radiotherapy (SABR) utilizing volumetric modulated arc therapy (VMAT) delivery and flattening filter‐free (FFF) beams represent a potentially high‐risk scenario for clinically significant dose blurring effects due to interplay between the respiratory motion of the lesion and dynamic multi‐leaf collimators (MLCs). The

To develop a practical method for predicting patient‐specific collision during the treatment planning process.

Three‐dimensional (3D) printing is recognized as an effective clinical and educational tool in procedurally intensive specialties. However, it has a nascent role in radiation oncology. The goal of this investigation is to clarify the extent to which 3D printing applications are currently being used in radiation oncology through a systematic review of the literature.

Independent calculations of proton therapy plans are an important quality control procedure in treatment planning. When using custom Monte Carlo (MC) models of the beamline, deploying the calculations can be laborious, time consuming, and require in‐depth knowledge of the computational environment. We developed an automated framework to remove these barriers and integrate our MC model into the clinical

PURPOSE To investigate the dosimetric impact of magnetic (B) field on varying air cavities in rectum patients treated on the hybrid 1.5 T MR-linac. METHODS Artificial air cavities of varying diameters (0.0, 1.0, 1.5, 2.0, 2.5, 3.0, and 5.0 cm) were created for four rectum patients (two prone and two supine). A total of 56 plans using a 7 MV flattening filter-free beam were generated with and without

PURPOSE The PTW microDiamond has an enhanced spatial resolution when operated in an edge-on orientation but is not typically utilized in this orientation due to the specifications of the IAEA TRS-483 code of practice for small field dosimetry. In this work the suitability of an edge-on orientation and advantages over the recommended face-on orientation will be presented. METHODS The PTW microDiamond

PURPOSE A recently introduced commercial tool is tested to assess whether it is able to reduce the complexity of a treatment plan and improve deliverability without compromising overall quality. METHODS Ten prostate and ten oropharynx plans of previously treated patients were reoptimized using the aperture shape controller (ASC) tool recently introduced in Eclipse TPS (Varian Medical Systems, Palo

PURPOSE To accomplish the 3D dose verification to IMRT plan by incorporating DVH information and gamma passing rates (GPs) (DVH_GPs) so as to better correlate the patient-specific quality assurance (QA) results with clinically relevant metrics. MATERIALS AND METHODS DVH_GPs analysis was performed to specific structures of 51 intensity-modulated radiotherapy (IMRT) treatment plans (17 plans each for

MR image-guided radiotherapy has the potential to improve patient care, but integration of an MRI scanner with a linear accelerator adds complexity to the commissioning process. This work describes a single institution experience of commissioning an Elekta Unity MR-linac, including mechanical testing, MRI scanner commissioning, and dosimetric validation. Mechanical testing included multileaf collimator

PURPOSE The COVID-19 pandemic has led to disorder in work and livelihood of a majority of the modern world. In this work, we review its major impacts on procedures and workflow of clinical physics tasks, and suggest alternate pathways to avoid major disruption or discontinuity of physics tasks in the context of small, medium, and large radiation oncology clinics. We also evaluate scalability of medical

PURPOSE To identify causes of error, and present the concept of an automated technique that improves efficiency and helps to reduce transcription and manual data entry errors in the treatment planning of total body irradiation (TBI). METHODS Analysis of incidents submitted to incident learning system (ILS) was performed to identify potential avenues for improvement by implementation of automation of

PURPOSE The purpose of this work is to develop machine and deep learning-based models to predict output and MU based on measured patient quality assurance (QA) data in uniform scanning proton therapy (USPT). METHODS This study involves 4,231 patient QA measurements conducted over the last 6 years. In the current approach, output and MU are predicted by an empirical model (EM) based on patient treatment

PURPOSE Accurate liver tumor delineation is crucial for radiation therapy, but liver tumor volumes are difficult to visualize with conventional single-energy CT. This work investigates the use of split-filter dual-energy CT (DECT) for liver tumor visibility by quantifying contrast and contrast-to-noise ratio (CNR). METHODS Split-filter DECT contrast-enhanced scans of 20 liver tumors including cholangiocarcinomas

COVID-19 is an unprecedented pandemic that has already reached over 2 million confirmed cases globally, with at least 140,000 deaths as reported by the World Health Organization (WHO) as of April 16, 2020 1 . More than 662,000 cases have been reported in the United States with more than 29,000 deaths2 . The overall crude mortality rate now stands at 6.6% (may possibly be lower due to under-testing

This study aimed to investigate the feasibility of independent calculation-based verification of volumetric-modulated arc therapy (VMAT)-stereotactic body radiotherapy (SBRT) for patients with lung cancer using a secondary treatment planning system (sTPS). In all, 50 patients with lung cancer who underwent VMAT-SBRT between April 2018 and May 2019 were included in this study. VMAT-SBRT plans were devised

PURPOSE Prior in silico simulations propose that Temporally Feathered Radiation Therapy (TFRT) may reduce toxicity related to head and neck radiation therapy. In this study we demonstrate a step-by-step guide to TFRT planning with modern treatment planning systems. METHODS One patient with oropharyngeal cancer planned for definitive radiation therapy using intensity-modulated radiation therapy (IMRT)

Certain models of cone beam computed tomography (CBCT) image-guided radiotherapy (IGRT) systems require manually placing the appropriate bowtie filter according to the relevant imaging protocol. Inadvertently using a wrong bowtie filter or no bowtie filter could cause unexpected image artifacts. In this work, CBCT image artifact patterns caused by different bowtie filter placement were evaluated. CBCT

INTRODUCTION The tracheostomy site and adjacent skin is at risk for recurrence in head/neck squamous cell cancer patients. The tracheostomy tube is an in situ device located directly over the tracheostomy site and may have clinical implications on the radiation dose delivered to the peristomal region. This study aimed to investigate this effect by comparing the prescribed treatment planning dose with

PURPOSE To perform a comprehensive validation of plans generated on a preconfigured Halcyon 2.0 with preloaded beam model, including evaluations of new features and implementing the patient specific quality assurance (PSQA) process with multiple detectors. METHODS A total of 56 plans were generated in Eclipse V15.6 (Varian Medical System) with a preconfigured Halcyon treatment machine. Ten plans were

PURPOSE The personalized setting of plan parameters in the Auto-Planning module of the Pinnacle treatment planning system (TPS) using the PlanIQ feasibility tool was evaluated for lung cancer conventional fractionated radiotherapy (CFRT). MATERIALS AND METHOD We reviewed the records of ten patients with lung cancer who were treated with volumetric modulated arc therapy (VMAT). Three plans were designed

PURPOSE Multiple metrics are proposed to characterize and compare the complexity of helical tomotherapy (HT) plans created for different treatment sites. METHODS A cohort composed of 208 HT plans from head and neck (105), prostate (51) and brain (52) tumor sites was considered. For each plan, 14 complexity metrics were calculated. Those metrics evaluate the percentage of leaves with small opening times

PURPOSE To investigate the impact of interfractional anatomical changes and setup correction methods on dose distributions in pancreatic cancer patients under breath-hold conditions. METHODS Three intensity-modulated proton therapy (IMPT) plans with different beam arrangements and one volumetric-modulated arc therapy (VMAT) plan prescribing 54 Gy in 30 fractions were created for 10 patients who underwent

PURPOSE To create a snapshot of common practices for 3D-CRT and intensity-modulated radiation therapy (IMRT) QA through a large-scale survey and compare to TG-218 recommendations. METHODS A survey of 3D-CRT and IMRT QA was constructed at and distributed by the IROC-Houston QA center to all institutions monitored by IROC (n = 2,861). The first part of the survey asked about methods to check dose delivery

1 Introduction Pioneers in the open access movement are gratified, and more than a little relieved, to see the world moving in our direction. Over the past several years, several consortiums of national research institutions and libraries, notably Sweden, the Netherlands, Norway, Hungary, and Germany, have initiated negotiations with the leading electronic journal publishing houses including Wiley

The outbreak of novel coronavirus, named as severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), has caused a global pandemic. The number of cases who are infected with COVID‐19, the disease that SARS‐CoV‐2 causes, grew rapidly in China in late January and early February 2020, but has since plunged significantly owing to tremendous containment efforts by the government and health‐care professionals

PURPOSE To investigate the impact of breath-hold reproducibility on liver motion using a respiratory motion management device. METHODS Forty-four patients with hepatic tumors, treated with SBRT with breath-hold, were randomly selected for this study. All patients underwent three consecutive computed tomography (CT) scans using active breath-hold coordinator (ABC) with three repeated single breath-hold

PURPOSE This article presents a solution for continuing radiation therapy without interruption in the event of a cyberattack to the radiation oncology information systems (ROIS). This process could be easily deployed to any radiation oncology practice, with little clinical overhead or burden. METHODS AND MATERIALS The solution automatically retrieves all essential information from the clinical ROIS

PURPOSE The novel scintillator-based system described in this study is capable of accurately and remotely measuring surface dose during Total Skin Electron Therapy (TSET); this dosimeter does not require post-exposure processing or annealing and has been shown to be re-usable, resistant to radiation damage, have minimal impact on surface dose, and reduce chances of operator error compared to existing

PURPOSE Volumetric modulated arc therapy (VMAT) is gaining popularity for stereotactic treatment of lung lesions for medically inoperable patients. Due to multiple beamlets in delivery of highly modulated VMAT plans, there are dose delivery uncertainties associated with small-field dosimetry error and interplay effects with small lesions. We describe and compare a clinically useful dynamic conformal

PURPOSE To describe a custom-built, web-based MR Quality Control (QC) database, and to assess its impact on the QC workflow and outcomes in a large U.S. academic medical center. METHODS The MR QC database was built with Microsoft Access 2010 and published on a Microsoft Sharepoint website owned and maintained by the authors' institution. Authorized users can access the database remotely with mainstream

PURPOSE Daily online adaptive plan quality in magnetic resonance imaging guided radiation therapy (MRgRT) is difficult to assess in relation to the fully optimized, high quality plans traditionally established offline. Machine learning prediction models developed in this work are capable of predicting 3D dose distributions, enabling the evaluation of online adaptive plan quality to better inform adaptive

In medical image processing, image fusion is the process of combining complementary information from different or multimodality images to obtain an informative fused image in order to improve clinical diagnostic accuracy. In this paper, we propose a two-stage fusion framework for computed tomography (CT) and magnetic resonance (MR) images. First, the intensity and geometric structure features in both

The AAPM is comprised of members with great diversity and with origins from many parts of the globe. There are some things about the culture in the United States that are no doubt unique and bewildering to those who have not grown up in the United States. One such peculiarity is the way hospital and other healthcare costs are paid. Many of us who are US natives will freely admit we can offer no logical

In this study, we assess a developed novel dynamic moving phantom system that can reproduce patient three‐dimensional (3D) tumor motion and patient anatomy, and perform patient‐specific quality assurance (QA) of respiratory‐gated radiotherapy using SyncTraX. Three patients with lung cancer were enrolled in a study. 3D printing technology was adopted to obtain individualized lung phantoms using CT images

To develop and test a three‐dimensional (3D) deep learning model for predicting 3D voxel‐wise dose distributions for intensity‐modulated radiotherapy (IMRT).

PURPOSE Daily flood-field uniformity evaluation serves as the central element of nuclear medicine (NM) quality control (QC) programs. Uniformity images are traditionally analyzed using pixel value-based metrics, that is, integral uniformity (IU), which often fail to capture subtle structure and patterns caused by changes in gamma camera performance, requiring visual inspections which are subjective

This study investigated the use of high spatial resolution solid‐state detectors (DUO and Octa) combined with an inclinometer for machine‐based quality assurance (QA) of Volumetric Modulated Arc Therapy (VMAT) with flattened and flattening filter‐free beams.

This study focused on determining risks from stereotactic radiotherapy using flattening filter‐free (FFF) beams for patients with cardiac implantable electronic device (CIEDs). Two strategies were employed: a) a retrospective analysis of patients with CIEDs who underwent stereotactic radiosurgery (SRS)/SBRT at the Peter MacCallum Cancer Centre between 2014 and 2018 and b) an experimental study on the

To develop and validate a robust template for VMAT SBRT of lung lesions, using the multicriterial optimization (MCO) of a commercial treatment planning system.

To evaluate the dosimetric differences between photon intensity‐modulated radiation therapy (IMRT) plans, 3D conformal proton therapy (3DCPT), and intensity‐modulated proton therapy (IMPT) plans and to investigate the dosimetric impact of different beam spot size and beam apertures in IMPT for pediatric Ewing sarcoma of the chest wall.

In this study, we developed a simple but useful computer program, called TomoMQA, to offer an automated quality assurance for mega‐voltage computed tomography (MVCT) images generated via helical tomotherapy.

PURPOSE We compare the effect of tube current modulation (TCM) and fixed tube current (FTC) on size-specific dose estimates (SSDE) and image quality in lung cancer screening with low-dose CT (LDCT) for patients of all sizes. METHODS Initially, 107 lung screening examinations were performed using FTC, which satisfied the Centers for Medicare & Medicaid Services' volumetric CT dose index (CTDIvol ) limit

To treat multiple targets separated in the craniocaudal direction within a short time, we invented a new technique using multiple static‐port tomotherapy with the dynamic‐jaw mode and named it the pseudo‐DJDC (pDJDC) technique. We compared the pDJDC plans and helical tomotherapy plans using the dynamic‐jaw mode (HDJ) for multiple targets. In the pDJDC plans, we used a beam set with 2–7 ports to the

Surface guided radiation therapy (SGRT) is increasingly being adopted for use in radiation treatment delivery for Head and Neck (H&N) cancer patients. This study investigated the improvement of patient setup accuracy and reduction of setup time for SGRT compared to a conventional setup. A total of 60 H&N cancer patients were retrospectively included. Patients were categorized into three groups: oral

Prostate cancer external beam radiation therapy can result in toxicity due to organ at risk (OAR) dose, potentially impairing quality of life. A polyethylene glycol‐based spacer, SpaceOAR© hydrogel (SOH), implanted between prostate gland and rectum may significantly reduce dose received by the rectum and hence risk of rectal toxicity. SOH implant is not equally effective in all patients. Determining

Due to multiple beamlets in the delivery of highly modulated volumetric arc therapy (VMAT) plans, dose delivery uncertainties associated with small‐field dosimetry and interplay effects can be concerns in the treatment of mobile lung lesions using a single‐dose of stereotactic body radiotherapy (SBRT). Herein, we describe and compare a simple, yet clinically useful, hybrid 3D‐dynamic conformal arc

The assessment of the coincidence of imaging and radiation isocenters is an important task of regular quality assurance of medical linear accelerators (linacs) as recommended in national and international quality assurance guidelines. A previously reported investigation of the accuracy of the Elekta XVI software to localize the linac radiation isocenter, by comparing statistically with other independent

PURPOSE To characterize key plan quality metrics in multi-target stereotactic radiosurgery (SRS) plans treated using single-isocenter volumetric modulated arc therapy (VMAT) in comparison to dynamic conformal arc (DCA) plans treating single target. To investigate the feasibility of quality improvement in VMAT planning based on previous planning knowledge. MATERIALS AND METHODS 97 VMAT plans of multi-target

Accurate quantification of absorbed radiation dose is important for safe and effective delivery of radiation therapy. An important aspect to this is reference dosimetry, which is performed under reference conditions specified by international codes of practice. Such measurements are usually performed in a water phantom. In the Sun Nuclear Corporation (SNC) three-dimensional (3D) scanner water tank

The objective of this study was to investigate the effect of field output factors (FOFs) according to the current protocol for small‐field dosimetry in conjunction to treatment planning system (TPS) commissioning. The calculated monitor unit (MU) for intensity‐modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans in Eclipse™ TPS were observed. Micro ion chamber (0.01

To investigate planning time and number of optimizations in routine clinical lung cancer plans based on the plan quality improvements following each optimization.

To evaluate the accuracy of a commercial optical surface tracking (OST) system and to demonstrate how it can be implemented to monitor patient positioning during non‐coplanar single isocenter stereotactic treatments of brain metastases. A 3‐camera OST system was used (Catalyst HD™, C‐RAD) on a TruebeamSTx with a 6DoF couch. The setup accuracy and agreement between the OST system, and CBCT and kV‐MV

The authors have previously shown the feasibility of using an artificial neural network (ANN) to eliminate the volume average effect (VAE) of scanning ionization chambers (ICs). The purpose of this work was to evaluate the method when applied to beams of different energies (6 and 10 MV) and modalities [flattened (FF) vs unflattened (FFF)], measured with ICs of various sizes.

The purpose of this study was to address the dosimetric accuracy of synthetic computed tomography (sCT) images of patients with brain tumor generated using a modified generative adversarial network (GAN) method, for their use in magnetic resonance imaging (MRI)‐only treatment planning for proton therapy.

Megavoltage computed tomography (MVCT) image quality metrics were evaluated on an Accuray Radixact unit to recommend scan settings for the implementation of a consistent adaptive radiotherapy program. Megavoltage computed tomography image quality was evaluated and compared to a kilovoltage CT (kVCT) simulator using a commercial cone beam computed tomography image quality phantom. Megavoltage computed

With the recent CyberKnife treatment planning system (TPS) upgrade from Precision 1.0 to Precision 2.0, the new VOLO optimizer was released for plan optimization. The VOLO optimizer sought to overcome some of the limitations seen with the Sequential optimizer from previous TPS versions. The purpose of this study was to investigate the clinical impact of the VOLO optimizer on treatment plan quality