QA for helical tomotherapy: report of the AAPM Task Group 148.

Helical tomotherapy is a relatively new modality with integrated treatment planning and delivery hardware for radiation therapy treatments. In view of the uniqueness of the hardware design of the helical tomotherapy unit and its implications in routine quality assurance, the Therapy Physics Committee of the American Association of Physicists in Medicine commissioned Task Group 148 to review this modality and make recommendations for quality assurance related methodologies. The specific objectives of this Task Group are: (a) To discuss quality assurance techniques, frequencies, and tolerances and (b) discuss dosimetric verification techniques applicable to this unit.

IMRT commissioning: multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119.

AAPM Task Group 119 has produced quantitative confidence limits as baseline expectation values for IMRT commissioning. A set of test cases was developed to assess the overall accuracy of planning and delivery of IMRT treatments. Each test uses contours of targets and avoidance structures drawn within rectangular phantoms.

Helical tomotherapy superficial dose measurements.

Helical tomotherapy is a treatment technique that is delivered from a 6 MV fan beam that traces a helical path while the couch moves linearly into the bore. In order to increase the treatment delivery dose rate, helical tomotherapy systems do not have a flattening filter. As such, the dose distributions near the surface of the patient may be considerably different from other forms of intensity-modulated delivery.

Verification of helical tomotherapy delivery using autoassociative kernel regression.

Quality assurance (QA) is a topic of major concern in the field of intensity modulated radiation therapy (IMRT). The standard of practice for IMRT is to perform QA testing for individual patients to verify that the dose distribution will be delivered to the patient. The purpose of this study was to develop a new technique that could eventually be used to automatically evaluate helical tomotherapy treatments during delivery using exit detector data.

Image-guided helical tomotherapy for localized prostate cancer: technique and initial clinical observations.

The purpose of the present study was to implement a technique for daily computed tomography (CT)-based image-guided radiation therapy and to report observations on treatment planning, imaging, and delivery based on the first 2 years of clinical experience. Patients with previously untreated stage T1-T3 biopsy-proven adenocarcinoma of the prostate were considered eligible for treatment with daily CT-guided helical tomotherapy. The prostate was targeted daily using megavoltage CT (MVCT) images that were fused with treatment-planning CT images based on anatomic alignments.

A model for predicting lung cancer response to therapy.

Purpose: Volumetric computed tomography (CT) images acquired by image-guided radiation therapy (IGRT) systems can be used to measure tumor response over the course of treatment. Predictive adaptive therapy is a novel treatment technique that uses volumetric IGRT data to actively predict the future tumor response to therapy during the first few weeks of IGRT treatment. The goal of this study was to develop and test a model for predicting lung tumor response during IGRT treatment using serial megavoltage CT (MVCT).

The management of respiratory motion in radiation oncology report of AAPM Task Group 76.

This document is the report of a task group of the AAPM and has been prepared primarily to advise medical physicists involved in the external-beam radiation therapy of patients with thoracic, abdominal, and pelvic tumors affected by respiratory motion. This report describes the magnitude of respiratory motion, discusses radiotherapy specific problems caused by respiratory motion, explains techniques that explicitly manage respiratory motion during radiotherapy and gives recommendations in the application of these techniques for patient care, including quality assurance (QA) guidelines for these devices and their use with conformal and intensity modulated radiotherapy. The technologies covered by this report are motion-encompassing methods, respiratory gated techniques, breath-hold techniques, forced shallow-breathing methods, and respiration-synchronized techniques.

A topographic leaf-sequencing algorithm for delivering intensity modulated radiation therapy.

Topographic treatment is a radiation therapy delivery technique for fixed-gantry (nonrotational) treatments on a helical tomotherapy system. The intensity-modulated fields are created by moving the treatment couch relative to a fan-beam positioned at fixed gantry angles. The delivered dose distribution is controlled by moving multileaf collimator (MLC) leaves into and out of the fan beam.

A technique for adaptive image-guided helical tomotherapy for lung cancer.

Purpose: The gross tumor volume (GTV) for many lung cancer patients can decrease during the course of radiation therapy. As the tumor reduces in size during treatment, the margin added around the GTV effectively becomes larger, which can result in the excessive irradiation of normal lung tissue. The specific goal of this study is to evaluate the feasibility of using image-guided adaptive radiation therapy to adjust the planning target volume weekly based on the previous week's CT image sets that were used for image-guided patient setup.

Evaluation of image-guided helical tomotherapy for the retreatment of spinal metastasis.

Introduction: Patients with vertebral metastasis that receive radiation therapy are typically treated to the spinal cord tolerance dose. As such, it is difficult to successfully deliver a second course of radiation therapy for patients with overlapping treatment volumes. In this study, an image-guided helical tomotherapy system was evaluated for the retreatment of previously irradiated vertebral metastasis.

Technical note: output and energy fluctuations of the tomotherapy Hi-Art helical tomotherapy system.

The output and energy calibrations for the first clinical Hi-Art 2.0 helical tomotherapy system have been reviewed. Fixed-gantry/fixed-couch and rotational-gantry/fixed-couch measurements were made on a daily basis over a period of 20 weeks to investigate system stability.