Technical note: A small animal irradiation platform for investigating the dependence of the FLASH effect on electron beam parameters.

Background: The recent rediscovery of the FLASH effect, a normal tissue sparing phenomenon observed in ultra-high dose rate (UHDR) irradiations, has instigated a surge of research endeavors aiming to close the gap between experimental observation and clinical treatment. However, the dependences of the FLASH effect and its underpinning mechanisms on beam parameters are not well known, and large-scale in vivo studies using murine models of human cancer are needed for these investigations.

Purpose: To commission a high-throughput, variable dose rate platform providing uniform electron fields (≥15 cm diameter) at conventional (CONV) and UHDRs for in vivo investigations of the FLASH effect and its dependences on pulsed electron beam parameters.

Practitioner characteristics, diagnostic accuracy metrics and discovering-individual with respect to 637 melanomas documented by 27 general practitioners on the Skin Cancer Audit Research Database.

Background And Objective: Knowledge of accuracy for melanoma diagnosis and melanoma discovering-individual in primary care is limited. We describe general practitioner (GP) characteristics and analyse defined diagnostic accuracy metrics for GPs in the current study comparing this with a previous study for GPs common to both, and we analyse the individual first discovering each melanoma as a lesion of concern.

Methods: The characteristics and diagnostic accuracy of 27 Australasian GPs documenting 637 melanomas on the Skin Cancer Audit Research Database (SCARD) in 2013 were described and analysed.

Analysis of CyberKnife intracranial treatment plans using ICRU 91 dose reporting: A retrospective study.

ICRU 91, published in 2017, is an international standard for prescribing, recording, and reporting stereotactic treatments. Since its release, there has been limited research published on the implementation and impact of ICRU 91 on clinical practice. This work provides an assessment of the recommended ICRU 91 dose reporting metrics for their use in clinical treatment planning.

Compensation for radiotherapy treatment interruptions due to a cyberattack: An isoeffective DVH-based dose compensation decision tool.

Unscheduled interruptions to radiotherapy treatments lead to decreased tumor control probability (TCP). Rapid cell repopulation in the tumor increases due to the absence of radiation dose, resulting in the loss of TCP. Compensation for this loss is required to prevent or reduce an extension of the patient's overall treatment time and regain the original TCP.

Characteristics, treatment and outcomes of 589 melanoma patients documented by 27 general practitioners on the Skin Cancer Audit Research Database.

Background And Objective: General practitioners manage more melanomas than dermatologists or surgeons in Australia. Previously undescribed, the management and outcomes of melanoma patients treated by multiple Australasian general practitioners are examined.

Methods: The characteristics, management and outcomes of 589 melanoma patients, managed by 27 Australasian general practitioners and documented on the Skin Cancer Audit Research Database (SCARD), were analysed.

Characteristics of 637 melanomas documented by 27 general practitioners on the Skin Cancer Audit Research Database.

Background And Objective: Most melanomas (including melanomas in situ), in Australasia, are treated by general practitioners (GPs). Previously undescribed, the characteristics of a series of melanomas treated by multiple GPs are examined.

Patients And Methods: Six hundred and thirty-seven melanomas treated by 27 Australasian GPs during 2013 and documented on the Skin Cancer Audit Research Database (SCARD) were analysed by anatomical site, subtype, Breslow thickness, diameter, associated naevi and linked adverse outcomes.

A comparison of treatment planning techniques for low-dose-rate (LDR) prostate brachytherapy.

Purpose: The purpose of this study was to compare low-dose-rate prostate brachytherapy treatment plans created using three retrospectively applied planning techniques with plans delivered to patients.

Methods And Materials: Treatment plans were created retrospectively on transrectal ultrasound (TRUS) scans for 26 patients. The technique dubbed 4D Brachytherapy was applied, using TRUS and MRI to obtain prostatic measurements required for the associated webBXT online nomogram.

RESEARCH ON PASSIVE SOIL DEPRESSURIZATION SYSTEMS: STATE OF THE ART AND LAB TEST ON-GOING.

There is strong evidence both internationally and in Ireland that the correct installation of passive prevention systems in new buildings is the most cost-effective way of protecting the population against radon. Previous work considering membranes, granular fill material in the aggregate layer beneath the slab and sump system has been conducted in Ireland to improve the protection of buildings from radon. The implications of research on passive sumps potential to reduce radon concentrations are significant, as if it can be shown that the installation of passive sumps in Irish building is effective; this could constitute a low-cost, passive, sustainable method for minimizing radon levels in buildings.

An investigation of a passive opened top-end pipe as an alternative solution for passive soil depressurisation systems for indoor radon mitigation.

This study carried out a series of large-scale experimental tests and numerical simulations to investigate the performance of a passive opened top-end pipe as an alternative solution for passive soil depressurisation systems for indoor radon mitigation. Measurements were conducted in terms of wind velocity, extracted air velocity and negative pressure at the sump-end inside the pipe. Investigations were performed with controlled and natural wind conditions.

Benchmarking a novel inorganic scintillation detector for applications in radiation therapy.

Purpose: The aim of this study was to investigate the contribution of Cerenkov radiation to the overall signal measured with a novel inorganic scintillating detector (ISD).

Methods: An ISD based on terbium doped gadolinium oxysulphide (GdOS:Tb) was used. A hyperspectral technique separated the Cerenkov signal from the radioluminescence (RL) signal of the ISD.

Off-axis dose distribution with stand-in and stand-off configurations for superficial radiotherapy treatments.

Current practice when delivering dose for superficial skin radiotherapy is to adjust the monitor units so that the prescribed dose is delivered to the central axis of the superficial unit applicator. Variations of source-to-surface distance due to patient's anatomy protruding into the applicator or extending away from the applicator require adjustments to the monitor units using the inverse square law. Off-axis dose distribution varies significantly from the central axis dose and is not currently being quantified.

Optimal tumour control for early-stage non-small-cell lung cancer: A radiobiological modelling perspective.

A fully heterogeneous population tumour control probability (TCP) model, based on the linear-quadratic (LQ) cell survival concept combined with the Poisson statistic, was established to predict local tumour control after one, two and three years. This TCP model was created using data from 16 publications that reported on early-stage non-small-cell lung cancer (NSCLC) treated using either three-dimensional conformal radiation therapy (3D-CRT), continuous hyperfractionated accelerated radiotherapy (CHART) or stereotactic ablative body radiotherapy (SABR). The TCP model was fitted to the clinical outcome data using optimised radiosensitivity values produced by the Nelder-Mead simplex algorithm.

Pituitary Adenoma on 18F-Fluciclovine PET/CT.

A 69-year-old man presented with lower urinary tract symptoms and prostate biopsy showed prostate cancer. F-Fluciclovine PET/CT revealed abnormal increased radiotracer uptake within the prostate gland, and multiple osseous structures, suspicious for tumoral involvement. Incidentally, an expansile soft tissue density mass arising from sella turcica demonstrated increased radiotracer activity.

Radon mitigation by soil depressurisation case study: Radon concentration and pressure field extension monitoring in a pilot house in Spain.

A one-year monitoring study was conducted in a pilot house with extremely high radon levels to investigate the ability and efficiency of radon mitigation by soil depressurisation (SD) both active and passive. The study included monitoring of radon concentration, pressure field extension (PFE) under the slab and some atmospheric parameters for different testing phases. Periods in which the house remained closed to foster radon accumulation were alternated with phases of active and passive soil depressurisation under different conditions.

Large-scale experimental investigations of specified granular fill materials for radon mitigation by active and passive soil depressurisations.

A series of large-scale experimental tests were performed to examine the flow behaviour of the T1 Struc and T2 Perm specified granular fill materials with active and passive depressurisations. Granular materials were compacted and tested at various compacted thicknesses. Compaction works were performed using a field compactor and compaction degrees of the materials were found to be higher than those induced by a standardised small-scale compactor.

Axitinib plus pembrolizumab in patients with advanced sarcomas including alveolar soft-part sarcoma: a single-centre, single-arm, phase 2 trial.

Background: VEGF promotes an immunosuppressive microenvironment and contributes to immune checkpoint inhibitor resistance in cancer. We aimed to assess the activity of the VEGF receptor tyrosine-kinase inhibitor axitinib plus the anti-PD-1 immune checkpoint inhibitor pembrolizumab in patients with sarcoma.

Methods: This single-centre, single-arm, phase 2 trial was undertaken at a tertiary care academic medical centre in Miami, FL, USA, and participants were recruited from all over the USA and internationally.

Investigation of gas flow through soils and granular fill materials for the optimisation of radon soil depressurisation systems.

The purpose of this study is to investigate gas flow through different types of granular fill materials and soil by means of a series of experimental laboratory tests, in relation to soil depressurisation systems for radon reduction under buildings and the soil surrounding the foundation. Gas permeability characterisation of materials used as granular fill material beneath the slab in buildings is a key parameter for the optimum performance of soil depressurisation systems to mitigate radon. A test apparatus was developed, adapted from previous studies, to measure the gas permeability of the samples and Finite Element Method numerical simulations were validated to simulate the flow behaviour through them.

Performance of radon monitors in a purpose-built radon chamber.

The purpose of this paper is to benchmark several different radon monitors, by quantifying their accuracy and response time. Radon monitors with different characteristics were tested in a purpose-built radon chamber under reference conditions. The radon concentration in the chamber was controlled and maintained at a stable radon concentration of (2648 ± 85) Bq m to evaluate the accuracy and precision of these monitors.

Investigation of sub-slab pressure field extension in specified granular fill materials incorporating a sump-based soil depressurisation system for radon mitigation.

Design of bearing layers (granular fill material layers) is important for a house with a soil depressurisation (SD) system for indoor radon mitigation. These layers should not only satisfy the bearing capacity and serviceability criteria but should also provide a sufficient degree of the air permeability for the system. Previous studies have shown that a critical parameter for a SD system is the sub-slab pressure field extension in the bearing layers, but this issue has not been systematically investigated.

A Monte Carlo study of the effect of an ultrasound transducer on surface dose during intrafraction motion imaging for external beam radiation therapy.

Purpose: The aim of this study was to estimate changes in surface dose due to the presence of the Clarity Autoscan™ ultrasound (US) probe during prostate radiotherapy using Monte Carlo (MC) methods.

Methods: MC models of the Autoscan US probe were developed using the BEAMnrc/DOSXYZnrc code based on kV and MV CT images. CT datasets were converted to voxelized mass density phantoms using a CT number-to-mass density calibration.

Functional imaging for regenerative medicine.

In vivo imaging is a platform technology with the power to put function in its natural structural context. With the drive to translate stem cell therapies into pre-clinical and clinical trials, early selection of the right imaging techniques is paramount to success. There are many instances in regenerative medicine where the biological, biochemical, and biomechanical mechanisms behind the proposed function of stem cell therapies can be elucidated by appropriate imaging.

Monte Carlo investigation of collapsed versus rotated IMRT plan verification.

IMRT QA requires, among other tests, a time-consuming process of measuring the absorbed dose, at least to a point, in a high-dose, low-dose-gradient region. Some clinics use a technique of measuring this dose with all beams delivered at a single gantry angle (collapsed delivery), as opposed to the beams delivered at the planned gantry angle (rotated delivery). We examined, established, and optimized Monte Carlo simulations of the dosimetry for IMRT verification of treatment plans for these two different delivery modes (collapsed versus rotated).

A SPECT imager with synthetic collimation.

This work outlines the development of a multi-pinhole SPECT system designed to produce a synthetic-collimator image of a small field of view. The focused multi-pinhole collimator was constructed using rapid-prototyping and casting techniques. The collimator projects the field of view through forty-six pinholes when the detector is adjacent to the collimator.

An investigation into the use of MMCTP to tune accelerator source parameters and testing its clinical application.

This paper presents an alternative method to tune Monte Carlo electron beam parameters to match measured data using a minimal set of variables in order to reduce the model setup time prior to clinical implementation of the model. Monte Carlo calculations provide the possibility of a powerful treatment planning verification technique. The nonstandardized and nonautomated process of tuning the required accelerator model is one of the reasons for delays in the clinical implementation of Monte Carlo techniques.