Publications by authors named "Naoki Tohyama"

The current research on staffing models is primarily focused on conventional external photon beam therapy, which predominantly involves using linear accelerators. This emphasizes the need for comprehensive studies to understand better and define specific particle therapy facilities' staffing requirements. In a 2022 survey of 25 particle therapy facilities in Japan with an 84% response rate, significant insights were obtained regarding workload distribution, defined as the product of personnel count and task time (person-minutes), for patient-related tasks and equipment quality assurance and quality control (QA/QC).

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We developed the "Itappachi" universal motion platform for measuring radiation doses under simulated respiratory motion in radiation therapy. The interplay effect, resulting from respiratory motion, degrades dose delivery precision in advanced treatments such as volumetric modulated arc therapy. The Itappachi platform is designed for precise dose measurement in dynamic scenarios through its ability to simulate respiratory motion.

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  • Brachytherapy (BT), particularly high dose rate (HDR) BT, has become more complex due to advanced techniques, necessitating significant training for radiotherapy technologists and medical physicists (RTMPs).
  • A survey conducted across 837 radiation treatment facilities in Japan revealed varying working times for HDR procedures and low quality control (QC) implementation rates for BT compared to external beam radiation therapy (EBRT).
  • The findings underscore a need for improved training and education for RTMPs to enhance the quality and safety of BT practices in Japan.
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  • This study examined how the quality of calibration beams affects the calibration coefficients for measuring absorbed doses to water in an ionization chamber during on-site dosimetry audits.
  • It compared dose measurements of 200 photon beams and 184 electron beams taken before and after the calibration of the ionization chamber.
  • Results showed that the differences between institution-measured doses and audit-measured doses were minimal for photon beams, but the electron beam measurements indicated a larger discrepancy, highlighting that the calibration using linac beams was most consistent for electron reference dosimetry.
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In this study, we aimed to conduct a survey on the current clinical practice of, staffing for, commissioning of, and staff training for online adaptive radiotherapy (oART) in the institutions that installed commercial oART systems in Japan, and to share the information with institutions that will implement oART systems in future. A web-based questionnaire, containing 107 questions, was distributed to nine institutions in Japan. Data were collected from November to December 2023.

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  • FMEA (Failure Mode and Effects Analysis) is gaining traction in radiotherapy for its effectiveness in preventing errors and can be carried out by individuals or groups online.
  • A web-based FMEA risk analysis worksheet was developed using Google tools to make it more accessible and user-friendly for various purposes.
  • The worksheet proved effective for both individual and group settings, allowing simultaneous online editing and automation to streamline the analysis process, ultimately enhancing collaboration and safety.
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  • Previous plan competitions primarily assessed dose metrics, but the actual quality assurance (QA) aspects of submitted plans were uncertain.
  • This study aimed to explore the relationship between plan complexity metrics (PCMs) in volumetric modulated arc therapy (VMAT) competition plans and clinically verified treatment plans through patient-specific QA.
  • The findings indicated that while there was a weak correlation between dose distribution quality and PCMs, high-quality competition plans showed increased complexity, suggesting that the submitted plans can be considered realistic and reasonable from a QA perspective.
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  • - This study is the first to investigate imaging doses in radiotherapy planning computed tomography (RTCT) in Japan, aiming to establish baseline data for national diagnostic reference levels (DRLs).
  • - A survey sent to RT institutions collected data on various imaging parameters and techniques, resulting in 328 responses that highlight differences in imaging doses among different treatments.
  • - The findings indicate that institutions using auto exposure image control (AEC) or image-improving reconstruction options (IIRO) report lower dose values, and specific techniques for lung treatments show varying dose lengths, contributing to future efforts to reduce imaging doses in Japan.
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  • * A CT number calibration audit phantom was scanned by 24 Japanese therapy institutes, and the resulting calibration curves were analyzed to assess their effectiveness compared to theoretical standards.
  • * The evaluation focused on mass density and relative electron density differences across various CT number calibration phantoms and TPSs, with particular attention to how Tomotherapy TPSs differed from other systems.
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The purpose of this study was to investigate the status of remote-radiotherapy treatment planning (RRTP) in Japan through a nationwide questionnaire survey. The survey was conducted between 29 June and 4 August 2022, at 834 facilities in Japan that were equipped with linear accelerators. The survey utilized a Google form that comprised 96 questions on facility information, information about the respondent, utilization of RRTP between facilities, usage for telework and the inclination to implement RRTPs in the respondent's facility.

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  • * It reported a response from 579 facilities, revealing a median annual patient volume of 369 in designated cancer care hospitals and an average RTMP staffing of 4.6 FTE, with a 69.4% QA implementation rate for equipment.
  • * Findings indicate larger facilities faced staff shortages relative to established models, while very small facilities may not need a full-time physicist, highlighting the importance of efficient resource allocation to maintain radiotherapy quality.
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  • * The survey revealed that only a small percentage of institutions offered their own educational systems or on-the-job training for both qualified and non-qualified RTMP, while most encouraged attendance at educational lectures and workshops.
  • * JASTRO-accredited hospitals provided a better educational environment compared to general hospitals, indicating a need for more systematic training and support from academic and professional organizations to maintain RTMP skills.
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Purpose: The Medical Physics Working Group of the Radiation Therapy Study Group at the Japan Clinical Oncology Group is currently developing a virtual audit system for intensity-modulated radiation therapy dosimetry credentialing. The target dosimeters include films and array detectors, such as ArcCHECK (Sun Nuclear Corporation, Melbourne, Florida, USA) and Delta4 (ScandiDos, Uppsala, Sweden). This pilot study investigated the feasibility of our virtual audit system using previously acquired data.

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In recent years, MR-Linac, a radiotherapy linear accelerator (linac) equipped with magnetic resonance (MR) imaging, has been deployed in clinical facilities across Japan. Because of the magnetic field of MR-Linac, which can affect the dose distributions and dose response of ionization chambers, conventional reference dosimetry for absorbed dose to water using an ionization chamber becomes impractical. Consequently, the magnetic field effect should be considered in the reference dosimetry for MR-Linac.

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Background And Purpose: Quality indicators (QIs) for radiotherapy have been proposed by several groups, but no study has been conducted to correlate the implementation of indicators specific to patient safety over the course of the clinical process with an institution's background. An initial large-scale survey was conducted to understand the implementation status of QIs established for quality assurance and patient safety in radiotherapy and the relationship between implementation status and an institutions' background.

Materials And Method: Overall, 68 QIs that were established by this research team after a pilot survey were used to assess structures and processes for quality assurance and patient safety.

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We compared the dose distributions of carbon-ion pencil beam scanning (C-PBS), proton pencil beam scanning (P-PBS) and Volumetric Modulated Arc Therapy (VMAT) for locally recurrent rectal cancer. The C-PBS treatment planning computed tomography (CT) data sets of 10 locally recurrent rectal cancer cases were randomly selected. Three treatment plans were created using identical prescribed doses.

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The questionnaire survey was conducted in 2020 to investigate the working conditions of qualified medical physicists in Japan. We developed a web-based system for administering the questionnaire and surveyed 1,228 qualified medical physicists. The number of received responses was 405.

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The first magnetic resonance (MR)-guided radiotherapy system in Japan was installed in May 2017. Implementation of online MR-guided adaptive radiotherapy (MRgART) began in February 2018. Online MRgART offers greater treatment accuracy owing to the high soft-tissue contrast in MR-images (MRI), compared to that in X-ray imaging.

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Purpose: We experimentally determined the radiophotoluminescent glass dosimeter (RPLD) dose responses for TomoTherapy, CyberKnife, and flattening-filter-free (FFF) linear accelerator (linac) outputs for dosimetry audits in Japan.

Methods: A custom-made solid phantom with a narrow central-axis spacing of three RPLD elements was used for output measurement to minimise the dose-gradient effect of the non-flattening filter beams. For RPLD dose estimation, we used the ISO 22127 formalism.

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Institutional imaging protocols for the verification of brachytherapy applicator placements were investigated in a survey study of domestic radiotherapy institutions. The survey form designed by a free on-line survey system was distributed via the mailing-list system of the Japanese Society for Radiation Oncology. Survey data of 75 institutions between August 2019 and October 2019 were collected.

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This study investigates the quality indicators (QIs) of medical care that are expected to be introduced to radiotherapy departments in Japan and evaluates whether the QIs reflect the characteristics of the treatment facilities. For this purpose, a questionnaire survey was administered to radiotherapy treatment facilities in Japan. A consensus of early QI candidates was obtained from the panel members.

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The Japan Clinical Oncology Group-Radiation Therapy Study Group (JCOG-RTSG) has initiated several multicenter clinical trials for high-precision radiotherapy, which are presently ongoing. When conducting multi-center clinical trials, a large difference in physical quantities, such as the absolute doses to the target and the organ at risk, as well as the irradiation localization accuracy, affects the treatment outcome. Therefore, the differences in the various physical quantities used in different institutions must be within an acceptable range for conducting multicenter clinical trials, and this must be verified with medical physics consideration.

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Purpose: The beam model in radiation treatment planning systems (RTPSs) plays a crucial role in determining the accuracy of calculated dose distributions. The purpose of this study was to ascertain differences in beam models and their dosimetric influences when a golden beam dataset (GBD) and multi-institution measured beam datasets (MBDs) are used for beam modeling in RTPSs.

Methods: The MBDs collected from 15 institutions, and the MBDs' beam models, were compared with a GBD, and the GBD's beam model, for Varian TrueBeam linear accelerator.

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Over the last several decades, there have been great advances in radiotherapy with the development of new technologies and modalities, and radiotherapy trends have changed rapidly. To comprehend the current state of radiotherapy in Japan, the QA/QC 2016-2017 Committee of the Japan Society of Medical Physics set up an intensity-modulated radiotherapy/image-guided radiotherapy (IMRT/IGRT) working group and performed a Web-based survey to show the current status of radiotherapy in Japan. The Web-based questionnaire, developed using Google Forms, contained 42 items: 7 on stereotactic radiotherapy implementation, 4 on IMRT, 24 on IGRT, and 7 on respiratory motion management.

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Purpose: The ICRU has published new recommendations for ionizing radiation dosimetry. In this work, the effect of recommendations on the water-to-air and graphite-to-air restricted mass electronic stopping power ratios (s and s ) and the individual perturbation correction factors P was calculated. The effect on the beam quality conversion factors k for reference dosimetry of high-energy photon beams was estimated for all ionization chambers listed in the Addendum to AAPM's TG-51 protocol.

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