Automated survey of 8000 plan checks at eight facilities.

Purpose: To identify policy and system related weaknesses in treatment planning and plan check work-flows.

Methods: The authors' web deployed plan check automation solution, PlanCheck, which works with all major planning and record and verify systems (demonstrated here for mosaiq only), allows them to compute violation rates for a large number of plan checks across many facilities without requiring the manual data entry involved with incident filings. Workflows and failure modes are heavily influenced by the type of record and verify system used.

Tomotherapy and multifield intensity-modulated radiotherapy planning reduce cardiac doses in left-sided breast cancer patients with unfavorable cardiac anatomy.

Purpose: For patients with left-sided breast cancers, radiation treatment to the intact breast results in high doses to significant volumes of the heart, increasing the risk of cardiac morbidity, particularly in women with unfavorable cardiac anatomy. We compare helical tomotherapy (TOMO) and inverse planned intensity modulated radiation therapy (IMRT) with three-dimensional conformal radiotherapy using opposed tangents (3D-CRT) for reductions in cardiac volumes receiving high doses.

Methods And Materials: Fifteen patients with left-sided breast cancers and unfavorable cardiac anatomy, determined by a maximum heart depth (MHD) of >or=1.

Application of holographic display in radiotherapy treatment planning II: a multi-institutional study.

We hypothesized that use of a true 3D display providing easy visualization of patient anatomy and dose distribution would lead to the production of better quality radiation therapy treatment plans. We report on a randomized prospective multi-institutional study to evaluate a novel 3D display for treatment planning.The Perspecta Spatial 3D System produces 360 degrees holograms by projecting crosssectional images on a diffuser screen rotating at 900 rpm.

A dosimetric analysis comparing treatment of low-risk prostate cancer with TomoTherapy versus static field intensity modulated radiation therapy.

Objectives: Static field intensity modulated radiation therapy (IMRT) has demonstrated dosimetric and clinical benefits over 3-dimensional conformal radiation therapy. TomoTherapy is a unique form of IMRT that may offer further improvements.

Methods: The study population consisted of 15 patients with low-risk prostate cancer treated at Rush University with TomoTherapy (n = 7) or IMRT (n = 8).

A virtual matching technique for three-field breast irradiation using 3-D planning.

Patients with breast cancer are often treated with radiation to the breast (or chest wall) and draining regional lymph nodes. This is typically performed with a three-field technique in which an anterior supraclavicular field is matched to opposed tangent fields. A single isocenter technique is not always possible.

Upright 3D treatment planning using a vertical CT.

In this report, we describe a novel technique used to plan and administer external beam radiation therapy to a patient in the upright position. A patient required reirradiation for thymic carcinoma but was unable to tolerate the supine position due to bilateral phrenic nerve injury and paralysis of the diaphragm. Computed tomography (CT) images in the upright position were acquired at the Northern Illinois University Institute for Neutron Therapy at Fermilab.

A dosimetric comparison of MammoSite and ClearPath high-dose-rate breast brachytherapy devices.

Purpose: A new form of partial breast irradiation (PBI), ClearPath (CP) breast brachytherapy, has been introduced. We present our results of a dosimetric comparison of MammoSite (MS) and CP PBI.

Methods And Materials: The dimensions of the CP device were reconstructed onto the MS planning CT scans for 15 previously treated patients.

A dosimetric comparison of Xoft Axxent Electronic Brachytherapy and iridium-192 high-dose-rate brachytherapy in the treatment of endometrial cancer.

Purpose: This analysis was undertaken to dosimetrically compare iridium-192 high-dose-rate brachytherapy (IB) and Xoft Axxent Electronic Brachytherapy (XB; Xoft Inc., Sunnyvale, CA) in the treatment of endometrial cancer.

Methods And Materials: The planning CT scans from 11 patients previously treated with IB were used to construct hypothetical treatment plans using the source characteristics of the XB device.

Case report and dosimetric analysis of an axillary recurrence after partial breast irradiation with mammosite catheter.

Partial breast irradiation (PBI) was designed in part to decrease overall treatment times associated with whole breast radiation therapy (WBRT). WBRT treats the entire breast and usually portions of the axilla. The goal of PBI is to treat a smaller volume of breast tissue in less time, focusing the dose around the lumpectomy cavity.

A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy.

Purpose: Over 20,000 patients have been treated with partial breast irradiation (PBI) using the MammoSite balloon brachytherapy applicator (IBB). Recently, a new form of balloon-based PBI, Xoft Axxent electronic brachytherapy (KVB), which uses a 50-kV x-ray source, has been introduced. This analysis was undertaken to dosimetrically compare the results of treatment using these two methods of PBI.

A dosimetric comparison of three-dimensional conformal, intensity-modulated radiation therapy, and MammoSite partial-breast irradiation.

Purpose: Limited information is available comparing target volume and normal tissue dosimetry with the different techniques of partial breast irradiation (PBI). We present results of a dosimetric comparison of single catheter, balloon-based brachytherapy using the MammoSite catheter (BRT), 3D conformal radiation therapy (3DCRT), and intensity-modulated radiation therapy (IMRT).

Methods And Materials: Fifteen patients were treated using the BRT device.

Cosmetic outcome and incidence of infection with the MammoSite breast brachytherapy applicator.

We present our results regarding the cosmetic outcome achieved and the rate of infection using the MammoSite breast brachytherapy applicator to treat patients with partial breast irradiation. In addition, factors associated with cosmetic outcome and infection are analyzed. The study population consisted of 30 patients with early stage breast cancer treated using the MammoSite device from October 28, 2002, to February 13, 2004.

Limited accuracy of dose calculation for large fields at deep depths using the BrainSCAN v5.21 treatment planning system.

The Varian 120 multileaf collimator (MLC) has a leaf thickness of 5 mm projected at the isocenter plane and can deliver a radiation beam of large field size (up to 30 cm) to be used in intensity-modulated radiotherapy (IMRT). Often the dose must be delivered to depths greater than 20 cm. Therefore, during the commissioning of the BrainSCAN v5.

The MammoSite breast brachytherapy applicator: a review of technique and outcomes.

The MammoSite breast brachytherapy device was designed to overcome the potential scheduling problems associated with external beam radiotherapy (EBRT) and the technical difficulties of multi-catheter-based interstitial brachytherapy. The device consists of a silicone balloon connected to a catheter which contains an inflation channel and a port for passage of a high-dose-rate brachytherapy source. The American Brachytherapy Society and American Society of Breast Surgeons have published partial breast irradiation (PBI) patient selection guidelines.

Dosimetric characteristics of the Leipzig surface applicators used in the high dose rate brachy radiotherapy.

The nucletron Leipzig applicator is designed for (HDR) 192Ir brachy radiotherapy of surface lesions. The dosimetric characteristics of this applicator were investigated using simulation method based on Monte Carlo N-particle (MCNP) code and phantom measurements. The simulation method was validated by comparing calculated dose rate distributions of nucletron microSelectron HDR 192Ir source against published data.

Dose perturbation induced by radiographic contrast inside brachytherapy balloon applicators.

Phantom measurements and Monte Carlo calculations have been performed for the purpose of characterizing the dose perturbation caused by radiographic contrast inside the MammoSite breast brachytherapy applicator. Specifically, the dose perturbation is quantified as a heterogeneity correction factor (HCF) for various balloon radii and contrast concentration levels. The dose perturbation is larger for larger balloon radii and higher contrast concentrations.