Measuring foetal dose from tomotherapy treatments.

Treating pregnant women in the radiotherapy clinic is a rare occurrence. When it does occur, it is vital that the dose received by the developing embryo or foetus is understood as fully as possible. This study presents the first investigation of foetal doses delivered during helical tomotherapy treatments.

Impact of radiopacified bone cement on radiotherapy dose calculation.

Background And Purpose: Radiopacifiers are introduced to bone cements to provide the appearance of bone in kilovoltage (kV) radiographic images. For higher energy megavoltage (MV) radiotherapy treatment beams, however, these radiopacifiers do not cause a bone-like perturbation of dose. This study therefore aimed to determine the impact of the barium-contrasted plastic-based cement materials on radiotherapy dose calculations.

In vivo monitoring of total skin electron dose using optically stimulated luminescence dosimeters.

Aim: This study retrospectively analysed the results of using optically stimulated radiation dosimeters (OSLDs) for in vivo dose measurements during total skin electron therapy (TSET, also known as TSEI, TSEB, TSEBT, TSI or TBE) treatments of patients with mycosis fungoides.

Background: TSET treatments are generally delivered to standing patients, using treatment plans that are devised using manual dose calculations that require verification via in vivo dosimetry. Despite the increasing use of OSLDs for radiation dosimetry, there is minimal published guidance on the use of OSLDs for TSET verification.

Tomotherapy treatment site specific planning using statistical process control.

Background: This study investigated planned MLC distribution and treatment region specific plan parameters to recommend optimal delivery parameters based on statistical process techniques.

Methods: A cohort of 28 head and neck, 19 pelvic and 23 brain pre-treatment plans were delivered on a helical tomotherapy system using 2.5 cm field width.

Characterisation of radiological properties of a brachytherapy moulding material.

The use of a non-water-equivalent personalised mould for gynaecological brachytherapy treatments can result in a substantial dose reduction at the treatment site, compared to calculated dose, in lieu of a dose calculation algorithm capable of modelling non-water-equivalent materials. This study describes the characterisation of the radiological properties of a brachytherapy applicator moulding material. Simple line source correction factors for an Ir source are obtained through Monte Carlo simulations and verified by film measurements.

Photon optimizer (PO) vs progressive resolution optimizer (PRO): a conformality- and complexity-based comparison for intensity-modulated arc therapy plans.

This study aimed to provide guidance on the advantages and limitations of a new optimizer, "photon optimizer" (PO), when compared with its predecessor, "progressive resolution optimizer" (PRO), for intensity-modulated arc therapy (IMAT) plans. Eleven study plans that included a cohort of prostate, head and neck, and brain treatment sites were optimized using both PRO and PO algorithms. A plan template using the same objectives for the same number of iterations was used for each optimized plan to obtain hypothetical treatment plans that would be comparable with a clinical plan.

Statistical process control and verifying positional accuracy of a cobra motion couch using step-wedge quality assurance tool.

This study utilizes process control techniques to identify action limits for TomoTherapy couch positioning quality assurance tests. A test was introduced to monitor accuracy of the applied couch offset detection in the TomoTherapy Hi-Art treatment system using the TQA "Step-Wedge Helical" module and MVCT detector. Individual X-charts, process capability (cp), probability (P), and acceptability (cpk) indices were used to monitor a 4-year couch IEC offset data to detect systematic and random errors in the couch positional accuracy for different action levels.

Investigating output and energy variations and their relationship to delivery QA results using Statistical Process Control for helical tomotherapy.

The aims of this study were to investigate machine beam parameters using the TomoTherapy quality assurance (TQA) tool, establish a correlation to patient delivery quality assurance results and to evaluate the relationship between energy variations detected using different TQA modules. TQA daily measurement results from two treatment machines for periods of up to 4years were acquired. Analyses of beam quality, helical and static output variations were made.

Monitoring Daily QA 3 constancy for routine quality assurance on linear accelerators.

The purpose of this study was to evaluate the suitability of the Daily QA 3 (Sun Nuclear Corporation, Melbourne, USA) device as a safe quality assurance device for control of machine specific parameters, such as linear accelerator output, beam quality and beam flatness and symmetry. Measurements were performed using three Varian 2300iX linear accelerators. The suitability of Daily QA 3 as a device for quality control of linear accelerator parameters was investigated for both 6 and 10MV photons and 6, 9, 12, 15 and 18MeV electrons.

Investigating the use of image thresholding in brachytherapy catheter reconstruction.

This study evaluated the accuracy of image thresholding in the reconstruction of catheters in brachytherapy treatment planning systems. Six test cases including four planar catheter configurations, an interstitial prostate and an intracavitary treatment plan were made use of in this study. The four planar CT scanned catheter arrangements included; catheters placed approximately 1, 0.

Effects of changing modulation and pitch parameters on tomotherapy delivery quality assurance plans.

This study was aimed at investigating delivery quality assurance (DQA) discrepancies observed for helical tomotherapy plans. A selection of tomotherapy plans that initially failed the DQA process was chosen for this investigation. These plans failed the fluence analysis as assessed using gamma criteria (3%, 3 mm) with radiographic film.

First experiences in using a dose control system on a TomoTherapy Hi·Art II.

The purpose of this study was to investigate the impact of a dose control system (DCS) servo installed on two fully commissioned TomoTherapy Hi·Art II treatment units. This servo is designed to actively adjust machine parameters to control the output variation of a tomotherapy unit to within ± 0.5% of the nominal dose rate.

The influence of the dwell time deviation constraint (DTDC) parameter on dosimetry with IPSA optimisation for HDR prostate brachytherapy.

To investigate how the dwell time deviation constraint (DTDC) parameter, applied to inverse planning by simulated annealing (IPSA) optimisation limits large dwell times from occurring in each catheter and to characterise the effect on the resulting dosimetry for prostate high dose rate (HDR) brachytherapy treatment plans. An unconstrained IPSA optimised treatment plan, using the Oncentra Brachytherapy treatment planning system (version 4.3, Nucletron an Elekta company, Elekta AB, Stockholm, Sweden), was generated for 20 consecutive HDR prostate brachytherapy patients, with the DTDC set to zero.

A unique approach to high-dose-rate vaginal mold brachytherapy of gynecologic malignancies.

Purpose: Patients with cervical and vaginal cancer sometimes have a less straightforward approach for choice of brachytherapy treatment owing to the tumor's location and clinical presentation. The staff at Royal Brisbane & Women's Hospital in Queensland, Australia, is trying to solve this problem by the use of an old technique in a new approach called vaginal molds. With a patient-specific vaginal mold, the appearance of the applicator and the dose distribution can be customized to provide an optimal treatment for each patient.

Constituent components of out-of-field scatter dose for 18-MV intensity modulated radiation therapy versus 3-dimensional conformal radiation therapy: a comparison with 6-MV and implications for carcinogenesis.

Purpose: To characterize and compare the components of out-of-field dose for 18-MV intensity modulated radiation therapy (IMRT) versus 3-dimensional conformal radiation therapy (3D-CRT) and their 6-MV counterparts and consider implications for second cancer induction.

Methods And Materials: Comparable plans for each technique/energy were delivered to a water phantom with a sloping wall; under full scatter conditions; with field edge abutting but outside the bath to prevent internal/phantom scatter; and with shielding below the linear accelerator head to attenuate head leakage. Neutron measurements were obtained from published studies.

A comparison of out-of-field dose and its constituent components for intensity-modulated radiation therapy versus conformal radiation therapy: implications for carcinogenesis.

Purpose: To investigate differences in scatter and leakage between 6-MV intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3DCRT); to describe the relative contributions of internal patient scatter, collimator scatter, and head leakage; and to discuss implications for second cancer induction.

Methods And Materials: Dose was measured at increasing distances from the field edge in a water bath with a sloping wall (1) under full scatter conditions, (2) with the field edge abutting but outside the bath to prevent internal (water) scatter, and (3) with the beam aperture plugged to reflect leakage only.

Results: Internal patient scatter from IMRT is 11% lower than 3DCRT, but collimator scatter and head leakage are five and three times higher, respectively.