Development and clinical characterization of a novel 2041 liquid-filled ionization chambers array for high-resolution verification of radiotherapy treatments.

Purpose: The aim of this study was to present a novel 2041 liquid-filled ionization chamber array for high-resolution verification of radiotherapy treatments.

Materials And Methods: The prototype has 2041 ionization chambers of 2.5 × 2.

Failure mode and effects analysis of skin electronic brachytherapy using Esteya unit.

Purpose: Esteya (Nucletron, an Elekta company, Elekta AB, Stockholm, Sweden) is an electronic brachytherapy device used for skin cancer lesion treatment. In order to establish an adequate level of quality of treatment, a risk analysis of the Esteya treatment process has been done, following the methodology proposed by the TG-100 guidelines of the American Association of Physicists in Medicine (AAPM).

Material And Methods: A multidisciplinary team familiar with the treatment process was formed.

A two-dimensional liquid-filled ionization chamber array prototype for small-field verification: characterization and first clinical tests.

In this work we present the design, characterization and first clinical tests of an in-house developed two-dimensional liquid-filled ionization chamber prototype for the verification of small radiotherapy fields and treatments containing such small fields as in radiosurgery, which consists of 2 mm × 2 mm pixels arranged on a 16×8 rectangular grid. The ionization medium is isooctane. The characterization of the device included the study of depth, field-size and dose-rate dependences, which are sufficiently moderate for a good operation at therapy radiation levels.

Modulated electron radiotherapy treatment planning using a photon multileaf collimator for post-mastectomized chest walls.

Background And Purpose: To evaluate the feasibility of using a photon MLC (xMLC) for modulated electron radiotherapy treatment (MERT) as an alternative to conventional post-mastectomy chest wall (CW) irradiation. A Monte Carlo (MC) based planning system was developed to overcome the inaccuracy of the 'pencil beam' algorithm. MC techniques are known to accurately calculate the dose distributions of electron beams, allowing the explicit simulation of electron interactions within the MLC.

Clinical comparative study of dose-volume and equivalent uniform dose based predictions in post radiotherapy acute complications.

Background: Single points placed on Dose-Volume Histograms (DVHs) for treatment plan acceptance are still widely used compared to the Equivalent Uniform Dose (EUD). The aim of this work is to retrospectively measure and compare the ability of both criteria in correctly predicting two clinical outcomes, RTOG grade 2 acute gastrointestinal (GI) and genitourinary (GU) complications in 137 patients treated for prostate cancer.

Material And Methods: For both complications,the best predictions have been achieved by fitting the EUD parameter and a tolerance dose (for a varying DVH point) by maximization of the Area Under the Receiver Operating Curve (AUROC).

Micro ionization chamber dosimetry in IMRT verification: clinical implications of dosimetric errors in the PTV.

Background And Purpose: Absolute dose measurements for Intensity Modulated Radiotherapy (IMRT) beamlets is difficult due to the lack of lateral electron equilibrium. Recently we found that the absolute dosimetry in the penumbra region of the IMRT beamlet, can suffer from significant errors (Capote et al., Med Phys 31 (2004) 2416-2422).

Additional dose constraints for analytical beam weighting optimization in IMRT.

This work presents an improvement to an algorithm for analytical beam weighting optimization where a flexible objective function, which considers 'importance factors' for each anatomical region and 'allowed deviations' from the prescribed dose, is defined. This upgrading allows forcing the mean value of the dose distribution to be the desired value, by using Lagrange multipliers. A real case is presented to show the effect of this change.

Microionization chamber for reference dosimetry in IMRT verification: clinical implications on OAR dosimetric errors.

Intensity modulated radiotherapy (IMRT) has become a treatment of choice in many oncological institutions. Small fields or beamlets with sizes of 1 to 5 cm2 are now routinely used in IMRT delivery. Therefore small ionization chambers (IC) with sensitive volumes 0.

MLC leaf width impact on the clinical dose distribution: a Monte Carlo approach.

Purpose: The influence of the multileaf collimator (MLC) leaf width on the dose distribution in patients treated with conformal radiotherapy and intensity-modulated radiotherapy has been analyzed. This study was based on the Monte Carlo simulation with the beams generated by a linac with the double-focused MLC.

Materials And Methods: The transmission through the leaves and the exact shape of the penumbra regions are difficult to model by treatment planning system algorithms.

Computer optimization of class solutions designed on a beam segmentation basis.

Background And Purpose: A method for analytically solving the optimization of beam weighting in radiotherapy treatments using beam segmentation is presented.

Patients And Methods: A technique has been elaborated permitting the optimization of a flexible objective function which is defined by considering 'importance factors' for each anatomical region and 'allowed deviations' from the prescribed dose. As any change in these importance factors may lead to very different solutions, a statistical tool has been developed which varies the objective function automatically and iteratively to get the best possible results compatible with the chosen class solution.

Cyclooxygenase-1 inhibition corrects endothelial dysfunction in cirrhotic rat livers.

Background/aims: Cirrhotic livers exhibit endothelial dysfunction that contributes to the increased hepatic vascular resistance. The present study evaluates the role of cyclooxygenase (COX)-derived prostanoids, implicated in the pathogenesis of endothelial dysfunction in other settings, in the pathogenesis of endothelial dysfunction in cirrhotic livers.

Methods: Endothelial dysfunction was evaluated by performing concentration-effect curves to acetylcholine after precontracting the liver with methoxamine in groups of control and CCl(4)-cirrhotic rat livers preincubated either with vehicle, indomethacin, the COX-1 selective inhibitor, SC-560, the COX-2 selective inhibitor, SC-236, the thromboxane A(2) receptor antagonist, SQ 29,548 or the nitric oxide (NO) synthase inhibitor N(G)-nitro-L-arginine.

Routine IMRT verification by means of an automated Monte Carlo simulation system.

Purpose: A tool to simulate complete intensity-modulated radiation therapy (IMRT) treatments with the Monte Carlo (MC) method has been developed. This application is based on a distribution model to employ as short processing times as possible for an operative verification.

Materials And Methods: The Clinical Primus-Siemens Linac beam was simulated with MC, using the EGS4 OMEGA-BEAM code package.