Abstract：
:Treatment planning for breast cancer has been traditionally based on clinical landmarks. The Radiation Therapy Oncology Group (RTOG) published consensus guidelines on contouring target volumes (TV) for the breast/chest wall and draining lymphatics. The effect of these guidelines on dosimetric parameters in surrounding organs at risk (OAR) and TVs is unknown. Fourteen patients treated with clinically derived plans from 2007-2011 (Group I) and fourteen patients treated with target volume-based plans from 2011-2012 were selected for comparison (Group II). Treatment plans were constructed based on clinical landmarks (Group I) or TVs (Group II) to a median dose of 50.4 Gy to the breast/chest wall, axilla (Ax), supraclavicular (SCV), and internal mammary (IMN) lymph nodes. The RTOG TVs were then contoured in Group I patients by a single investigator blinded to the dose distributions. Dose-volume histograms (DVH) were computed for the RTOG TVs and OARs in both groups, and DVH parameters were compared. In Group II, coverage improved for the SCV (V90 = 78.0% versus 93.6%, p = 0.02) and intact breast (V95 = 95.6% versus 99.3%, p = 0.007). The dose to the cord, the lung (V20Gy and V30Gy), and contralateral breast (V5Gy) were the same. Finally, the low dose to the heart and lung was decreased in Group II (heart V5Gy= 48.7% versus 27.3%, p= 0.02, heart V10Gy = 33.5% vs. 17.5%, p = 0.01, and ipsilateral lung V5Gy = 84.5% vs. 69.3%, p = 0.001). Overall, our study supports that treatment planning using the RTOG consensus guidelines can improve coverage to certain target volumes compared to treatments based solely on clinical landmarks. Additionally, treatment planning using these target volumes does not increase dose to the contralateral breast, cord, heart, or lungs. Longer follow-up is needed to determine if using these target volumes will affect clinical outcomes.
journal_name
J Appl Clin Med Physjournal_title
Journal of applied clinical medical physicsauthors
Rudra S,Al-Hallaq HA,Feng C,Chmura SJ,Hasan Ydoi
10.1120/jacmp.v15i2.4547subject
Has Abstractpub_date
2014-03-06 00:00:00pages
4547issue
2issn
1526-9914journal_volume
15pub_type
杂志文章abstract：:A patient with a cardiac ventricular assist device (VAD) with computer-controlled driver presented to our department for radiation therapy. The treatment plan was 4500 cGy to the rectum over 25 fractions with 15MV photon beams. All beams avoided the pump and leads. The response to electromagnetic interference (EMI) wa...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v9i4.2851
更新日期：2008-10-29 00:00:00
abstract：PURPOSE:To investigate the effect of the marker placement on the correlation relationship between the motions of external markers and the internal target under different breathing patterns for several lung cancer patients. METHOD AND MATERIAL:To monitor and record simultaneous motions of internal target and associated...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v9i2.2758
更新日期：2008-04-16 00:00:00
abstract：PURPOSE:We conducted this dosimetric analysis to evaluate the feasibility of a multi-center stereotactic body radiation therapy (SBRT) trial for renal cell carcinoma (RCC) using different SBRT platforms. MATERIALS/METHODS:The computed tomography (CT) simulation images of 10 patients with unilateral RCC previously trea...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1002/acm2.12308
更新日期：2018-03-14 00:00:00
abstract：:External beam radiation therapy (RT) is often offered to breast cancer patients after surgical mastectomy followed by breast reconstruction with silicone implants. In some cases, the RT is administered while the patient is still implanted with a temporary tissue expander including a high-density metallic port, which i...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v12i2.3295
更新日期：2011-01-19 00:00:00
abstract：:The aim of this study is to compare the dosimetric characteristics of robotic and conventional linac-based SBRT techniques for lung cancer, and to provide planning guidance for each modality. Eight patients who received linac-based SBRT were retrospectively included in this study. A dose of 60 Gy given in three fracti...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v11i3.3223
更新日期：2010-06-29 00:00:00
abstract：:This study evaluated unexpected dosimetric errors caused by machine control accuracy, patient setup errors, and patient weight changes/internal organ deformations. Trajectory log files for 13 gynecologic plans with seven- or nine-beam dynamic multileaf collimator (MLC) intensity-modulated radiation therapy (IMRT), and...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1002/acm2.13163
更新日期：2021-01-10 00:00:00
abstract：:Documentation is a required component of a residency program, but can be difficult to collect and disseminate, resulting in minimal utilization by residents and faculty. The purpose of this work is to adapt a commercially-available Web-based medical residency management system to improve the learning experience by eff...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v15i6.4866
更新日期：2014-11-08 00:00:00
abstract：:The purpose of this study was to perform comprehensive measurements and testing of a Novalis Tx linear accelerator, and to develop technical guidelines for com-missioning from the time of acceptance testing to the first clinical treatment. The Novalis Tx (NTX) linear accelerator is equipped with, among other features,...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v13i3.3729
更新日期：2012-05-10 00:00:00
abstract：:We retrospectively generated IMRT plans for 14 NSCLC patients who had experienced grade 2 or 3 esophagitis (CTCAE version 3.0). We generated 11-beam and reduced esophagus dose plan types to compare changes in the volume and length of esophagus receiving doses of 50, 55, 60, 65, and 70 Gy. Changes in planning target vo...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v14i4.4248
更新日期：2013-07-08 00:00:00
abstract：:Magnetic Resonance Imaging (MRI) is increasingly being used for improving tumor delineation and tumor tracking in the presence of respiratory motion. The purpose of this work is to design and build an MR compatible motion platform and to use it for evaluating the geometric accuracy of MR imaging techniques during resp...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1002/acm2.12274
更新日期：2018-03-01 00:00:00
abstract：:True 3D CT dataset for treatment planning of an oversized patient is difficult to acquire due to the bore size and field of view (FOV) reconstruction. This project aims to provide a simple approach to reconstruct true CT data for oversize patients using CT scanner with limited FOV by acquiring double partial CT (left ...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v13i2.3629
更新日期：2012-03-08 00:00:00
abstract：:Hypofractionated treatments generally increase the complexity of a treatment plan due to the more stringent constraints of normal tissues and target coverage. As a result, treatment plans contain more modulated MLC motions that may require extra efforts for accurate dose calculation. This study explores methods to min...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v17i2.4989
更新日期：2016-03-08 00:00:00
abstract：:A new version of progressive resolution optimizer (PRO) with an option of air cavity correction has been implemented for RapidArc volumetric-modulated arc therapy (RA). The purpose of this study was to compare the performance of this new PRO with the use of air cavity correction option (PRO10_air) against the one with...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v14i6.4382
更新日期：2013-11-04 00:00:00
abstract：:Remote afterloading devices used for high-dose-rate (HDR) brachytherapy may be supplied with different sources, and these sources typically have differing initial source strengths. In addition, the proposed frequency for source changes may also vary, depending upon the source type. Dosimetric parameters unique to each...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v14i6.4239
更新日期：2013-11-04 00:00:00
abstract：:The purpose of this study was to investigate amplitude gating combined with a coached breathing strategy for 10 MV flattening filter-free (FFF) volumetric-modulated arc therapy (VMAT) on the Varian TrueBeam linac. Ten patient plans for VMAT SABR liver were created using the Eclipse treatment planning system (TPS). The...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v16i4.5350
更新日期：2015-07-08 00:00:00
abstract：:Stereotactic body radiotherapy (SBRT) of lung tumors via the ring-mounted Halcyon Linac, a fast kilovoltage cone beam CT-guided treatment with coplanar geometry, a single energy 6MV flattening filter free (FFF) beam and volumetric modulated arc therapy (VMAT) is a fast, safe, and feasible treatment modality for select...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1002/acm2.13146
更新日期：2020-12-20 00:00:00
abstract：:Shewhart control charts have previously been suggested as a process control tool for use in routine linear accelerator (linac) output verifications. However, a comprehensive approach to process control has not been investigated for linac output verifications. The purpose of this work is to investigate a comprehensive ...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v14i1.4032
更新日期：2013-01-07 00:00:00
abstract：:Prostate cancer radiotherapy workflows, solely based on magnetic resonance imaging (MRI), are now in clinical use. In these workflows, intraprostatic gold fiducial markers (GFM) show similar signal behavior as calcifications and bleeding in T2-weighted MRI-images. Accurate GFM identification in MRI-only radiotherapy w...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1002/acm2.12478
更新日期：2018-11-01 00:00:00
abstract：:The purpose of this study was to develop and validate cardiac computed tomog-raphy (CT) quantitative analysis software with a patient-specific, 17-segment myocardial model that uses electrocardiogram (ECG)-gated cardiac CT images to differentiate between normal controls and severe aortic stenosis (AS) patients. ECG-ga...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v17i5.6237
更新日期：2016-09-08 00:00:00
abstract：:We investigate the role of adaptive radiation therapy in pediatric patients with diffuse pontine glioma and the impact of steroid-related weight gain on treatment parameters utilizing cone-beam CT. Fifteen patients with diffuse pontine glioma were treated with three-dimensional conformal radiation therapy and enrolled...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：
更新日期：2011-01-30 00:00:00
abstract：:Our institution performs in vivo verification measurement for each of our total body irradiation (TBI) patients with optically stimulated luminescent dosimeters (OSLD). The lung block verification measurements were commonly higher than expected. The aim of this work is to understand this discrepancy and improve the ac...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v17i3.6128
更新日期：2016-05-08 00:00:00
abstract：:Significant controversy surrounds the 2012 / 2014 decision announced by the Trustees of the American Board of Radiology (ABR) in October of 2007. According to the ABR, only medical physicists who are graduates of a Commission on Accreditation of Medical Physics Education Programs, Inc. (CAMPEP) accredited academic or ...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v11i2.3005
更新日期：2010-04-12 00:00:00
abstract：PURPOSE:To present an open-source software (https://github.com/CHUSRadOncPhys/FluoMV) for monitoring intrafraction motion that is based on the visualization of superimposed contours of projected region-of-interests from DICOM RTSTRUCT files on cine-MV images acquired and displayed in real-time during radiation therapy ...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1002/acm2.12940
更新日期：2020-08-01 00:00:00
abstract：:Small field dosimetry is a challenging task. The difficulties of small field measurements, particularly stereotactic field size measurements, are highlighted by the large interinstitution variability that can be observed for circular cone collimator commissioning measurements. We believe the best way to improve the co...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v14i6.4493
更新日期：2013-11-04 00:00:00
abstract：:Many head-and-neck cancer (HNC) patients treated with radiotherapy suffer significant anatomical changes due to tumor shrinkage or weight loss. The purpose of this study was to assess dose changes over target volumes and organs at risk during intensity-modulated radiotherapy for HNC patients. Sixteen HNC IMRT patients...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v13i6.3723
更新日期：2012-11-08 00:00:00
abstract：:The purpose of this study was to develop and evaluate filmless quality assurance (QA) tools for helical tomotherapy by using the signals from the on-board megavoltage computed tomography (MVCT) detector and applying a dedicated step-wedge phantom. The step-wedge phantom is a 15 cm long step-like aluminum block positio...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v13i1.3585
更新日期：2012-01-05 00:00:00
abstract：:Using a plane-parallel advanced Markus ionization chamber and a stack of water-equivalent solid phantom blocks, percentage surface and build-up doses of Elekta 6 MV flattening filter (FF) and flattening-filter-free (FFF) beams were measured as a function of the phantom depth for field sizes ranging from 2 × 2 to 10 × ...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1002/acm2.13094
更新日期：2020-12-01 00:00:00
abstract：:This study aimed to verify the accuracy of half-value layer (HVL) measured using the new copper pipe method with the CT ionization chamber while the X-ray tube is rotating and to compare it with the conventional nonrotating method and Monte Carlo simulation method based on the actual measurement and geometry of the ne...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1002/acm2.12780
更新日期：2019-12-01 00:00:00
abstract：:The aim of this study was to assess the performance of a gantry-mounted detector system and a couch set detector system using a systematic multileaf collimator positional error manually introduced for volumetric-modulated arc therapy. Four head and neck and esophagus VMAT plans were evaluated by measurement using an e...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v15i3.4495
更新日期：2014-05-08 00:00:00
abstract：:Doses in Leksell GammaPlan (Elekta, Stockholm, Sweden) are calculated for each shot by summing the contribution from the 201 radiation beams emitted by the Gamma Knife (Elekta), weighted for attenuation in the tissue traversed. The patient's head is modeled based on 24 skull measurements, from which the depth to the c...
journal_title：Journal of applied clinical medical physics
pub_type： 杂志文章
doi：10.1120/jacmp.v8i3.2377
更新日期：2007-07-17 00:00:00
