Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols.

Background: Radical radiotherapy for muscle-invasive bladder cancer (MIBC) is challenging due to large variations in bladder shape, size and volume during treatment, with drinking protocols often employed to mitigate geometric uncertainties. Utilising adaptive radiotherapy together with CBCT imaging to select a treatment plan that best fits the bladder target and reduce normal tissue irradiation is an attractive option to compensate for anatomical changes. The aim of this retrospective study was to compare a bladder empty (BE) protocol to a bladder filling (BF) protocol with regards to variations in target volumes, plan of the day (PoD) selection and plan dosimetry throughout treatment.

Evaluation of six TPS algorithms in computing entrance and exit doses.

Entrance and exit doses are commonly measured in in vivo dosimetry for comparison with expected values, usually generated by the treatment planning system (TPS), to verify accuracy of treatment delivery. This report aims to evaluate the accuracy of six TPS algorithms in computing entrance and exit doses for a 6 MV beam. The algorithms tested were: pencil beam convolution (Eclipse PBC), analytical anisotropic algorithm (Eclipse AAA), AcurosXB (Eclipse AXB), FFT convolution (XiO Convolution), multigrid superposition (XiO Superposition), and Monte Carlo photon (Monaco MC).

The influence of MRI scan position on patients with oropharyngeal cancer undergoing radical radiotherapy.

Background: The purpose of this study was to demonstrate how magnetic resonance imaging (MRI) patient position protocols influence registration quality in patients with oropharyngeal cancer undergoing radical radiotherapy and the consequences for gross tumour volume (GTV) definition and radiotherapy planning.

Methods And Materials: Twenty-two oropharyngeal patients underwent a computed tomography (CT), a diagnostic MRI (MRI(D)) and an MRI in the radiotherapy position within an immobilization mask (MRI(RT)). Clinicians delineated the GTV on the CT viewing the MRI(D) separately (GTV(C)); on the CT registered to MRI(D) (GTV(D)) and on the CT registered to MRI(RT) (GTV(RT)).

Quantitative comparison of volumetric modulated arc therapy and intensity modulated radiotherapy plan quality in sino-nasal cancer.

The aim of this study was to compare various dosimetric parameters of dynamic mlc intensity modulated radiotherapy (IMRT) plans with volumetric modulated arc therapy (VMAT) plans for sino-nasal cancers, which are rare and complex tumors to treat with radiotherapy. IMRT using five fields, coplanar in the sagittal plane and VMAT employing two coplanar arc plans were created for five patients. The plans were assessed by comparing Conformity Index and Sigma Index (dose homogeneity) in the Planning Target Volume (PTV) and through comparison of dose-volume characteristics to the following organs at risk (OARs): Spinal cord, brainstem, eye, ipsilateral and contralateral optic nerve and the volume of brain receiving 10% of the prescribed dose (V(10%)).

Calculation of exit dose for conformal and dynamically-wedged fields, based on water-equivalent path length measured with an amorphous silicon electronic portal imaging device.

In this study, we use the quadratic calibration method (QCM), in which an EPID image is converted into a matrix of equivalent path lengths (EPLs) and, therefore, exit doses, so as to model doses in conformal and enhanced dynamic wedge (EDW) fields. The QCM involves acquiring series of EPID images at a reference field size for different thicknesses of homogeneous solid water blocks. From these, a set of coefficients is established that is used to compute the EPL of any other irradiated material.

A novel method for patient exit and entrance dose prediction based on water equivalent path length measured with an amorphous silicon electronic portal imaging device.

In vivo dosimetry is one of the quality assurance tools used in radiotherapy to monitor the dose delivered to the patient. Electronic portal imaging device (EPID) images for a set of solid water phantoms of varying thicknesses were acquired and the data fitted onto a quadratic equation, which relates the reduction in photon beam intensity to the attenuation coefficient and material thickness at a reference condition. The quadratic model is used to convert the measured grey scale value into water equivalent path length (EPL) at each pixel for any material imaged by the detector.

Assessment of dosimetrical performance in 11 Varian a-Si-500 electronic portal imaging devices.

Dosimetrical characteristics of 11 Varian a-Si-500 electronic portal imaging devices (EPIDs) in clinical use for periods ranging between 10 and 86 months were investigated for consistency of performance and portal dosimetry implications. Properties studied include short-term reproducibility, signal linearity with monitor units, response to reference beam, signal uniformity across the detector panel, signal dependence on field size, dose-rate influence, memory effects and image profiles as a function of monitor units. The EPID measurements were also compared with those of the ionization chambers' to ensure stability of the linear accelerators.

Acute small bowel toxicity and preoperative chemoradiotherapy for rectal cancer: investigating dose-volume relationships and role for inverse planning.

Purpose: The relationship between volume of irradiated small bowel (VSB) and acute toxicity in rectal cancer radiotherapy is poorly quantified, particularly in patients receiving concurrent preoperative chemoradiotherapy. Using treatment planning data, we studied a series of such patients.

Methods And Materials: Details of 41 patients with locally advanced rectal cancer were reviewed.

Electron dose calculations: a comparison of two commercial treatment planning computers.

The accuracy of electron dose calculations performed by two commercially available treatment planning systems, Varian Cadplan and MDS Nordion Helax-TMS, were assessed. Three tests designed to reproduce clinical treatments likely to result in dose nonuniformity have been carried out. The tests examined oblique incidence of the electron beam; incidence on a surface containing a step shape; and incidence on a phantom containing a small air cavity.