Optimized scoring of end-to-end dosimetry audits for passive motion management - A simulation study using the IROC thorax phantom.

Dosimetry audits for passive motion management require dynamically-acquired measurements in a moving phantom to be compared to statically calculated planned doses. This study aimed to characterise the relationship between planning and delivery errors, and the measured dose in the Imaging and Radiation Oncology Core (IROC) thorax phantom, to assess different audit scoring approaches. Treatment plans were created using a 4DCT scan of the IROC phantom, equipped with film and thermoluminescent dosimeters (TLDs).

A model for estimating peak skin dose in CT.

In interventional radiology patient care can be improved by accurately assessing peak skin dose (PSD) from procedures, as it is the main predictor for tissue-reactions such as erythema. Historically, high skin dose procedures performed in radiology departments were almost exclusively planar fluoroscopy. However, with the increase in use of technologies involving repeated or adjacent computed tomography (CT) such as CT fluoroscopy and multi-modality rooms, the peak skin dose delivered by CT needs to be considered.

Deep Learning Auto-Segmentation Network for Pediatric Computed Tomography Data Sets: Can We Extrapolate From Adults?

Purpose: Artificial intelligence (AI)-based auto-segmentation models hold promise for enhanced efficiency and consistency in organ contouring for adaptive radiation therapy and radiation therapy planning. However, their performance on pediatric computed tomography (CT) data and cross-scanner compatibility remain unclear. This study aimed to evaluate the performance of AI-based auto-segmentation models trained on adult CT data when applied to pediatric data sets and explore the improvement in performance gained by including pediatric training data.

A Data-Driven Variance Reduction Technique for Efficiently Modelling Astronaut Radiation Doses in Spacecraft in High-Energy Isotropic Radiation Fields.

The ionizing radiation exposure to crew on current and future space missions can significantly increase their health risks for cancers, degenerative diseases, and other acute and late effects. A common approach for estimating risk to crew is by completing stochastic (e.g.

Evaluating synthetic computed tomography images for adaptive radiotherapy decision making in head and neck cancer.

Background And Purpose: Adaptive radiotherapy (ART) decision-making benefits from dosimetric information to supplement image inspection when assessing the significance of anatomical changes. This study evaluated a dosimetry-based clinical decision workflow for ART utilizing deformable registration of the original planning computed tomography (CT) image to the daily Cone Beam CT (CBCT) to replace the need for a replan CT for dose estimation.

Materials And Methods: We used 12 retrospective Head & Neck patient cases having a ground truth - a replan CT (rCT) in response to anatomical changes apparent in the daily CBCT - to evaluate the accuracy of dosimetric assessment conducted on synthetic CTs (sCT) generated by deforming the original planning CT Hounsfield Units to the daily CBCT anatomy.

Magnetic resonance biomarker assessment software (MR-BIAS): an automated open-source tool for the ISMRM/NIST system phantom.

To provide an open-source software for repeatable and efficient quantification ofandrelaxation times with the ISMRM/NIST system phantom. Quantitative magnetic resonance imaging (qMRI) biomarkers have the potential to improve disease detection, staging and monitoring of treatment response. Reference objects, such as the system phantom, play a major role in translating qMRI methods into the clinic.

Inhibition of mutant IDH1 promotes cycling of acute myeloid leukemia stem cells.

Approximately 20% of acute myeloid leukemia (AML) patients carry mutations in IDH1 or IDH2 that result in over-production of the oncometabolite D-2-hydroxyglutarate (2-HG). Small molecule inhibitors that block 2-HG synthesis can induce complete morphological remission; however, almost all patients eventually acquire drug resistance and relapse. Using a multi-allelic mouse model of IDH1-mutant AML, we demonstrate that the clinical IDH1 inhibitor AG-120 (ivosidenib) exerts cell-type-dependent effects on leukemic cells, promoting delayed disease regression.

Oxidative Damage to Mitochondria Enhanced by Ionising Radiation and Gold Nanoparticles in Cancer Cells.

Gold nanoparticles (AuNP) can increase the efficacy of radiation therapy by sensitising tumor cells to radiation damage. When used in combination with radiation, AuNPs enhance the rate of cell killing; hence, they may be of great value in radiotherapy. This study assessed the effects of radiation and AuNPs on mitochondrial reactive oxygen species (ROS) generation in cancer cells as an adjunct therapeutic target in addition to the DNA of the cell.

Inhibition of pyrimidine biosynthesis targets protein translation in acute myeloid leukemia.

The mitochondrial enzyme dihydroorotate dehydrogenase (DHODH) catalyzes one of the rate-limiting steps in de novo pyrimidine biosynthesis, a pathway that provides essential metabolic precursors for nucleic acids, glycoproteins, and phospholipids. DHODH inhibitors (DHODHi) are clinically used for autoimmune diseases and are emerging as a novel class of anticancer agents, especially in acute myeloid leukemia (AML) where pyrimidine starvation was recently shown to reverse the characteristic differentiation block in AML cells. Herein, we show that DHODH blockade rapidly shuts down protein translation in leukemic stem cells (LSCs) and has potent and selective activity against multiple AML subtypes.

Please Place Your Seat in the Full Upright Position: A Technical Framework for Landing Upright Radiation Therapy in the 21 Century.

Delivering radiotherapy to patients in an upright position can allow for increased patient comfort, reduction in normal tissue irradiation, or reduction of machine size and complexity. This paper gives an overview of the requirements for the delivery of contemporary arc and modulated radiation therapy to upright patients. We explore i) patient positioning and immobilization, ii) simulation imaging, iii) treatment planning and iv) online setup and image guidance.

MaxiCalc: A tool for online dosimetric evaluation of source-tracking based treatment verification in HDR brachytherapy.

Purpose: Source tracking is becoming a more widely used approach in HDR brachytherapy treatment verification. While it provides a sensitive method to detect deviations from the treatment plan during delivery, it does not show the clinical significance of any detected changes. By incorporating a tool that calculates volumetric doses and DVH indices from measurements, source tracking systems can be expanded to assess dosimetric significance of any deviations from the plan.

Out-of-field dose in stereotactic radiotherapy for paediatric patients.

Background And Purpose: Stereotactic radiotherapy combines image guidance and high precision delivery with small fields to deliver high doses per fraction in short treatment courses. In preparation for extension of these treatment techniques to paediatric patients we characterised and compared doses out-of-field in a paediatric anthropomorphic phantom for small flattened and flattening filter free (FFF) photon beams.

Method And Materials: Dose measurements were taken in several organs and structures outside the primary field in an anthropomorphic phantom of a 5 year old child (CIRS) using thermoluminescence dosimetry (LiF:Mg,Cu,P).

A validation framework to assess performance of commercial deformable image registration in lung radiotherapy.

Introduction: Deformable image registration (DIR) can play an important role in the context of adaptive radiotherapy. The AAPM Task Group 132 (TG-132) has described several quantitative measures for DIR error assessment but they can only be accurately defined when there is a ground-truth present in high-contrast regions. This work aims to set out a framework to obtain optimal results for CT-CT lung DIR in clinical setting for a commercially available system by quantifying the DIR performance in both low- and high-contrast regions.

Dewatering Green Sapwood Using Carbon Dioxide Undergoing Cyclical Phase Change between Supercritical Fluid and Gas.

Conventional kiln drying of wood operates by the evaporation of water at elevated temperature. In the initial stage of drying, mobile water in the wood cell lumen evaporates. More slowly, water bound in the wood cell walls evaporates, requiring the breaking of hydrogen bonds between water molecules and cellulose and hemicellulose polymers in the cell wall.

Nanoparticle dose enhancement of synchrotron radiation in PRESAGE dosimeters.

The physical absorbed dose enhancement by the inclusion of gold and bismuth nanoparticles fabricated into water-equivalent PRESAGE dosimeters was investigated. Nanoparticle-loaded water-equivalent PRESAGE dosimeters were irradiated with superficial, synchrotron and megavoltage X-ray beams. The change in optical density of the dosimeters was measured using UV-Vis spectrophotometry pre- and post-irradiation using a wavelength of 630 nm.

Dose response and stability of water equivalent PRESAGE dosimeters for synchrotron radiation therapy dosimetry.

This research investigated the dose response and post-irradiation stability of water-equivalent PRESAGE dosimeters exposed to synchrotron radiation. Water-equivalent PRESAGE dosimeters were irradiated up to 1000 Gy in a synchrotron x-ray beam with a mean energy of 95.3 keV.

Assessment of leakage dose in patients undergoing radiotherapy for breast cancer.

Background And Purpose: Accurate quantification of the relatively small radiation doses delivered to untargeted regions during breast irradiation in patients with breast cancer is of increasing clinical interest for the purpose of estimating long-term radiation-related risks. Out-of-field dose calculations from commercial planning systems however may be inaccurate which can impact estimates for long-term risks associated with treatment. This work compares calculated and measured dose out-of-field and explores the application of a correction for leakage radiation.

Water equivalent PRESAGE for synchrotron radiation therapy dosimetry.

Purpose: Synchrotron Radiation Therapy techniques are currently being trialed and commissioned at synchrotrons around the world. The patient treatment planning systems (TPS) developed for these treatments use simulated data of the synchrotron x-ray beam to produce the dosimetry in the treatment plan. The purpose of this study was to investigate a water equivalent PRESAGE dosimeter capable of 3D dosimetry over an energy range suitable for synchrotron x-ray beams.

Commissioning of a PTW 34070 large-area plane-parallel ionization chamber for small field megavoltage photon dosimetry.

Purpose: This study investigates a large-area plane-parallel ionization chamber (LAC) for measurements of dose-area product in water (DAP ) in megavoltage (MV) photon fields.

Methods: Uniformity of electrode separation of the LAC (PTW34070 Bragg Peak Chamber, sensitive volume diameter: 8.16 cm) was measured using high-resolution microCT.

An integrated system for clinical treatment verification of HDR prostate brachytherapy combining source tracking with pretreatment imaging.

Purpose: High-dose-rate (HDR) prostate brachytherapy treatment is usually delivered in one or a few large dose fractions. Poor execution of a planned treatment could have significant clinical impact, as high doses are delivered in seconds, and mistakes in an individual fraction cannot be easily rectified. Given that most potential errors in HDR brachytherapy ultimately lead to a geographical miss, a more direct approach to verification of correct treatment delivery is to directly monitor the position of the source throughout the treatment.

The trans-continental distributions of pentachlorophenol and pentachloroanisole in pine needles indicate separate origins.

The production and use of pentachlorophenol (PCP) was recently prohibited/restricted by the Stockholm Convention on persistent organic pollutants (POPs), but environmental data are few and of varying quality. We here present the first extensive dataset of the continent-wide (Eurasia and Canada) occurrence of PCP and its methylation product pentachloroanisole (PCA) in the environment, specifically in pine needles. The highest concentrations of PCP were found close to expected point sources, while PCA chiefly shows a northern and/or coastal distribution not correlating with PCP distribution.

3D catheter reconstruction in HDR prostate brachytherapy for pre-treatment verification using a flat panel detector.

Purpose: High dose rate prostate brachytherapy is a widely-practiced treatment, delivering large conformal doses in relatively few treatment fractions. Inter- and intra-fraction catheter displacements have been reported. Unrecognized displacement can have a significant impact on dosimetry.