Systematizing the risk management process in clinical radiotherapy practice: Recommendations of the working group on risk management of the DGMP.

Purpose: The Deutsche Gesellschaft für Medizinische Physik [German Society of Medical Physics] has recently published two coherent reports, No. 25 and No. 28, detailing the design and implementation of a risk management (RM) process for German radiotherapy (RT) departments.

Risk management patterns in radiation oncology-results of a national survey within the framework of the Patient Safety in German Radiation Oncology (PaSaGeRO) project.

Purpose: Risk management (RM) is a key component of patient safety in radiation oncology (RO). We investigated current approaches on RM in German RO within the framework of the Patient Safety in German Radiation Oncology (PaSaGeRO) project. Aim was not only to evaluate a status quo of RM purposes but furthermore to discover challenges for sustainable RM that should be addressed in future research and recommendations.

Retrospective evaluation of patients with uveal melanoma treated by stereotactic radiosurgery with and without tumor resection.

Importance: The present study intended to analyze the suitability of single-dose stereotactic radiotherapy in the treatment of uveal melanoma that cannot be handled with ruthenium-brachytherapy and therefore is a challenge for ophthalmologists concerning local tumor control, as well as preservation of the eye and visual function.

Objectives: To evaluate local tumor control, eye preservation, visual course, radiation complications, metastases, and death after single-dose stereotactic radiotherapy (SDRT) applied exclusively or combined with tumor resection in uveal melanomas that are neither suitable nor favorably located for ruthenium brachytherapy.

Design: Retrospective, observational case series.

High-pitch computed tomography coronary angiography-a new dose-saving algorithm: estimation of radiation exposure.

Purpose. To estimate effective dose and organ equivalent doses of prospective ECG-triggered high-pitch CTCA. Materials and Methods.

Image quality of two different mobile cone beam computed tomographs for maxillofacial surgery.

Purpose: We evaluated two mobile cone beam computed tomographs (mCBCT) comparing image quality with respect to radiation dosage. Image quality was analyzed by using different scanning modes.

Materials And Methods: The skulls of three human cadavers were scanned by use of conventional Computed Tomography (CT) as well as with two mobile cone beam computed tomographs (Siemens Arcadis Orbic 3D and Ziehm Vision Vario 3D).

Automated computed tomography dose-saving algorithm to protect radiosensitive tissues: estimation of radiation exposure and image quality considerations.

Purpose: To evaluate radiation exposure and image quality in thoracic computed tomography (CT) using a new dose-saving algorithm to protect radiosensitive organs.

Materials And Methods: For dose measurements, an Alderson RANDO phantom equipped with thermoluminescent dosimeters was used. The effective dose was calculated according to the International Commission on Radiologic Protection 103.

Estimation of radiation exposure of retrospective gated and prospective triggered 128-slice triple-rule-out CT angiography.

Background: CT has become an important role in the differential diagnosis of acute chest pain to exclude an aortic dissection, pulmonary embolism and acute coronary artery syndrome. However, the additional radiation exposure is a cause of concern and dose saving strategies should be applied, if possible.

Purpose: To estimate effective dose of retrospective gated and prospective ECG-triggered triple-rule-out computed tomography angiography (TRO-CTA).

Estimation of radiation exposure of different dose saving techniques in 128-slice computed tomography coronary angiography.

Purpose: To estimate the effective dose of cardiac CT with different dose saving strategies dependent on varying heart rates.

Materials And Methods: For dose measurements, an Alderson-Rando-phantom equipped with thermoluminescent dosimeters was used. The effective dose was calculated according to ICRP 103.

Estimation of radiation exposure of 128-slice 4D-perfusion CT for the assessment of tumor vascularity.

Objective: We aimed to estimate the effective dose of 4D-Perfusion-CT protocols of the lung, liver, and pelvis for the assessment of tumor vascularity.

Materials And Methods: An Alderson-Rando phantom equipped with thermoluminescent dosimeters was used to determine the effective dose values of 4D-Perfusion-CT. Phantom measurements were performed on a 128-slice single-source scanner in adaptive 4D-spiral-mode with bidirectional table movement and a total scan range of 69 mm over a time period of nearly 120 seconds (26 scans).

Cyclo-oxygenase-2 expression in photon-radiated and non-radiated uveal melanomas.

Purpose: To determine and compare cyclo-oxygenase-2 (COX-2) expression in photon-radiated and non-radiated malignant uveal melanomas and to analyse the correlation between COX-2 expression and prognosis.

Methods: Immunohistochemical staining for COX-2 was performed on 21 uveal melanomas that were endoresected after prior stereotactic radiotherapy with photons and on 22 tumours that were treated by endoresection without prior radiotherapy. COX-2 staining was further analysed in respect to cell type, maximal prominence, time interval between radiotherapy and surgery, apoptotic index (AI), proliferative index (PI) and the development of metastatic disease.

Dual-source computed tomography: estimation of radiation exposure of ECG-gated and ECG-triggered coronary angiography.

Purpose: The aim of the study was to estimate radiation exposure of coronary calcium scoring and angiography using ECG-gated and ECG-triggered dual-source computed tomography.

Materials And Methods: An Alderson Rando phantom equipped with thermoluminescent dosimeters was used for all dose measurements. Effective dose was calculated according to ICRP 103.

Estimation of the radiation exposure of a chest pain protocol with ECG-gating in dual-source computed tomography.

The aim of the study was to evaluate radiation exposure of a chest pain protocol with ECG-gated dual-source computed tomography (DSCT). An Alderson Rando phantom equipped with thermoluminescent dosimeters was used for dose measurements. Exposure was performed on a dual-source computed tomography system with a standard protocol for chest pain evaluation (120 kV, 320 mAs/rot) with different simulated heart rates (HRs).

[A special radiation shielding for the radiotherapy of a pregnant patient].

Purpose: Measurement of the radiation dose of different radiotherapy techniques with a phantom at the position of the uterus of a pregnant patient with and without a special radiation shielding.

Material And Methods: A special radiation shielding for the radiation therapy of a pregnant patient was constructed in the shape of a tunnel over the abdomen from 1 cm thick lead to reduce scatter radiation to the uterus and the fetus therein. The reduction of the scatter radiation to the lower abdomen was measured for three typical cases (cerebrum with lateral opposed fields, 6-MV photons; tangential fields for mamma irradiation, 6 MV; and anteroposterior-posteroanterior [AP-PA] opposed fields of 15 MV for treatment of the mediastinum) at an anthropomorphic Alderson phantom with thermoluminescence dosimeters in different depths and with an ionization chamber positioned in an RW3 solid water phantom.

A new fixation aid for the radiotherapy of eye tumors.

A modified swim goggle holding a light spot as an optical guide for actively aligning the eye in a reproducible orientation has been constructed to perform radiotherapy of ocular tumors. This device is compatible with computed tomography (CT) and magnetic resonance imaging systems. Image fusion of these data sets yielded clinically acceptable results.

Stereotactic fractionated radiotherapy in patients with optic nerve sheath meningioma.

Purpose: To evaluate the effectiveness of stereotactic fractionated radiotherapy (SFRT) in the treatment of optic nerve sheath meningioma (ONSM). METHODS AND MARERIALS: Between 1994 and 2000, a total of 39 patients with either primary (n = 15) or secondary (n = 24) ONSM were treated with SFRT and received a median total tumor dose of 54 Gy using 1.8 Gy/fraction.

[Results of the DGMP survey on radiotherapy planning systems].

The present paper presents the results of a survey on radiotherapy-treatment planning systems conducted in the summer of 2000. A total of 263 questionnaires of 108 German, 6 Austrian, and 4 Swiss radiotherapy clinics or practices have been evaluated. Most treatment planning systems are used for teletherapy, with nearly all sites using at least one commercial system.

Radiosurgery for brain metastases: the Tuebingen experience.

Purpose: To retrospectively investigate the effectiveness of linear accelerator based radiosurgery (RS) in the treatment of brain metastases (BM).

Material And Methods: Of 55 patients with a total of 72 BM, 41 patients had a single brain metastasis and 14 patients had two or three metastases. Median tumour dose of 15Gy (range 8-20Gy) was prescribed to a median isodose surface of 90% (range 70-100%) encompassing the target volume.