Comprehensive Image Quality Evaluation and Motion Phantom Studies of an Ultra-Fast (6-Second) Cone-Beam Computed Tomography Imaging System on a Ring Gantry Linear Accelerator.

Purpose: To evaluate the image quality of an ultrafast cone-beam computed tomography (CBCT) system-Varian HyperSight.

Methods And Materials: In this evaluation, 5 studies were performed to assess the image quality of HyperSight CBCT. First, a HyperSight CBCT image quality evaluation was performed and compared with Siemens simulation-CT and Varian TrueBeam CBCT.

Validation of Acuros for total body irradiation at extended distance.

Purpose: Standardized and accurately reported doses are essential in conventional total body irradiation (TBI), especially lung doses. This study evaluates the accuracy of the Acuros algorithm in predicting doses for extended-distance TBI.

Methods: Measurements and calculations were done with both 6 and 18 MV.

Development of Magnetizable, Nickel-Ferrite-Decorated Carbon Nanocomposites as Hydrogenation Catalyst for Aniline Synthesis.

Catalysts with magnetic properties can be easily recovered from the reaction medium without loss by using a magnetic field, which highly improves their applicability. To design such systems, we have successfully combined the magnetic properties of nickel ferrite nanoparticles with the positive properties of carbon-based catalyst supports. Amine-functionalized NiFeO nanoparticles were deposited on the surfaces of nitrogen-doped bamboo-like carbon nanotubes (N-BCNT) and carbon nanolayers (CNL) by using a coprecipitation process.

Intraoral and maxillofacial abnormalities in patients with autosomal dominant hyper-IgE syndrome.

Autosomal dominant hyper-IgE syndrome (AD-HIES) is an inborn error of immunity (IEI) caused by a dominant-negative mutation in the signal transducer and activator of transcription 3 (STAT 3). This disease is characterized by chronic eczematoid dermatitis, recurrent staphylococcal skin abscesses, pneumonia, pneumatoceles, and extremely high serum IgE levels. Loss-of-function STAT3 mutations may also result in distinct non-immunologic features such as dental, facial, skeletal, and vascular abnormalities, central nervous system malformations and an increased risk for bone fractures.

Initial clinical evaluation of a novel combined biometric, radio-frequency identification, and surface imaging system.

Purpose: To evaluate and characterize the overall clinical functionality and workflow of the newly released Varian Identify system (version 2.3).

Methods: Three technologies included in the Varian Identify system were evaluated: patient biometric authentication, treatment accessory device identification, and surface-guided radiation therapy (SGRT) function.

Technical note: Clinical evaluation of a newly released surface-guided radiation therapy system on DIBH for left breast radiation therapy.

Background: It has been shown that a significant reduction of mean heart dose and left anterior descending artery (LAD) dose can be achieved through the use of DIBH for left breast radiation therapy. Surface-guided DIBH has been widely adopted during the last decade, and there are mainly three commercially available SGRT systems. The reports of the performance of a newly released SGRT system for DIBH application are currently very limited.

An evaluation of the use of DirectSPR images for proton planning in the RayStation treatment planning software.

An important source of uncertainty in proton therapy treatment planning is the assignment of stopping-power ratio (SPR) from CT data. A commercial product is now available that creates an SPR map directly from dual-energy CT (DECT). This paper investigates the use of this new product in proton treatment planning and compares the results to the current method of assigning SPR based on a single-energy CT (SECT).

Surface-Guided Patient Setup Versus Traditional Tattoo Markers for Radiation Therapy: Is Tattoo-Less Setup Feasible for Thorax, Abdomen and Pelvis Treatment?

Purpose: In this study, patient setup accuracy was compared between surface guidance and tattoo markers for radiation therapy treatment sites of the thorax, abdomen and pelvis.

Methods And Materials: A total of 608 setups performed on 59 patients using both surface-guided and tattoo-based patient setups were analyzed. During treatment setup, patients were aligned to room lasers using their tattoos, and then the six-degree-of-freedom (6DOF) surface-guided offsets were calculated and recorded using AlignRT system.

Evaluation of the dosimetric impact of changes in shoulder position on target coverage for spine SBRT to metastases in the lower cervical spine region.

For patients treated with SBRT for spinal metastases in the cervical area, a thermoplastic mask is the usual immobilization technique. This project investigates the impact of shoulder position variability on target coverage for such cases. Eight HN patients treated in a suite equipped with a CT-on-rails system (CTOR) were randomly chosen.

[The importance of patient reported outcome measures in Pompe disease].

Background And Purpose: In recent decades it has become increasingly important to involve patients in their diagnostic and treatment process to improve treatment outcomes and optimize compliance. By their involvement, patients can become active participants in therapeutic developments and their observations can be utilized in determining the unmet needs and priorities in clinical research. This is especially true in rare diseases such as Pompe disease.

Seismic reinforcement of a linac installation.

The local building requirements to secure medical equipment in seismically active areas in the United States are based on recommendations of the American Society of Civil Engineers. In our institution we have recently acquired new linear accelerators, one of which had to be installed in an existing vault and one in a new vault. Since we are in a seismic active area, changes in the local code required us to start placing the new linacs seismically stable.

Evaluation of the effects of implementing a diode transmission device into the clinical workflow.

Purpose: This work investigated effects of implementing the Delta Discover diode transmission detector into the clinical workflow.

Methods: PDD and profile scans were completed with and without the Discover for a number of photon beam energies. Transmission factors were determined for all beam energies and included in Eclipse TPS to account for the attenuation of the Discover.

FMEA occurrence values for four failure modes occurring using look-up tables for dose calculations.

Purpose: For a number of different treatment types [such as Total Body Irradiation (TBI), etc.] most institutions utilize tables from commissioned databooks to perform the dose calculations. Each time one manually looks up data from a large table and then copies the numbers for a manual calculation, there is potential for errors.

Comparison of transperineal ultrasound image guidance technique to transabdominal technique for prostate radiation therapy.

Introduction: Ultrasound (US) guidance of the prostate has long been conducted using a transabdominal (TA) approach. More recently, a transperineal (TP) approach has been made available for image guidance. Our aim was to determine if both methods produced similar alignments within the same patients.

Prevention of Radiation Therapy Treatment Deviations by a Novel Combined Biometric, Radiofrequency Identification, and Surface Imaging System.

Purpose: To evaluate the impact of Varian Identify, a novel combined radiofrequency identification, biometric and surface-matching technology, on its potential for patient safety and prevention of radiation therapy treatment deviations.

Methods And Materials: One hundred eight radiation therapy treatment deviation reports at our facility over the past 8 years were analyzed. Three major categories were defined based on the time point of occurrence: physician order deviations (19.

Using failure mode and effects analysis (FMEA) to generate an initial plan check checklist for improved safety in radiation treatment.

Purpose: To apply failure mode and effect analysis (FMEA) to generate an effective and efficient initial physics plan checklist.

Methods: A team of physicists, dosimetrists, and therapists was setup to reconstruct the workflow processes involved in the generation of a treatment plan beginning from simulation. The team then identified possible failure modes in each of the processes.

Preliminary clinical experience with Calypso anchored beacons for tumor tracking in lung SBRT.

Purpose: To present our preliminary experience with the recently released Calypso lung beacons to track lung tumor location during stereotactic body radiation therapy (SBRT).

Materials/methods: Five recent lung SBRT patients had Calypso lung beacons implanted for tumor tracking during treatment. Beacons were placed by a pulmonologist using fluoroscopic navigation within 1 week prior to planning four-dimensional computed tomography (4DCT) acquisition.

A systematic evaluation of the error detection abilities of a new diode transmission detector.

Transmission detectors meant to measure every beam delivered on a linear accelerator are now becoming available for monitoring the quality of the dose distribution delivered to the patient daily. The purpose of this work is to present results from a systematic evaluation of the error detection capabilities of one such detector, the Delta Discover. Existing patient treatment plans were modified through in-house-developed software to mimic various delivery errors that have been observed in the past.

Calculation of delivered composite dose from Calypso tracking data for prostate cancer: And subsequent evaluation of reasonable treatment interruption tolerance limits.

Purpose: In this study we calculate composite dose delivered to the prostate by using the Calypso tracking -data- stream acquired during patient treatment in our clinic. We evaluate the composite distributions under multiple simulated Calypso tolerance level schemes and then recommend a tolerance level.

Materials And Methods: Seven Calypso-localized prostate cancer patients treated in our clinic were selected for retrospective analysis.

An evaluation of the consistency of shifts reported by three different systems for non-coplanar treatments.

Treatment of intra-cranial lesions sometimes requires a non-coplanar beam configuration. One of the most commonly used IGRT modalities, kV conebeam CT, cannot typically be used when large couch rotations are introduced. However, multiple other systems allow for imaging/tracking the patient for such situations.

[Oral manifestations in patients with primary immunodeficiencies].

Characteristic lesions of the oral cavity in primary immunodeficiencies are commonly found in the form of periodontal disease, tooth decay and disorders of the oral mucosa. Humoral immunodeficiencies may cause tooth decay, while severe forms of plaque-induced periodontal disease are common in phagocytic deficiencies. The structural abnormalities of the teeth can occur in immunodeficiencies associated with apoptosis defect.

The European challenges of funding orphan medicinal products.

Background: Funding of orphan medicinal products (OMPs) is an increasing challenge in the European Union (EU).

Objectives: To identify the different methods for public funding of OMPs in order to map the availability for rare disease patients, as well as to compare the public expenditures on OMPs in 8 EU member states.

Methods: Information on the reimbursement status of 83 OMPs was collected in 8 countries by distinguishing standard and special reimbursements.

A Ballistics Examination of Firearm Injuries Involving Breast Implants.

This ballistics study examines whether saline breast implants can decrease tissue penetration in firearm injuries. We hypothesize that the fluid column within a saline breast implant can alter bullet velocity and/or bullet pattern of mushrooming. The two experimental groups included saline implants with 7.

Comparison of 2 transabdominal ultrasound image guidance techniques for prostate and prostatic fossa radiation therapy.

Purpose: Our clinic is a long-term user of a first-generation transabdominal (TA) biplanar (2.5-dimensional [2.5D]) ultrasound image guidance (USIG) system for prostate cancer treatments.