Preventative maintenance and unscheduled downtime from an economic perspective.


:A spreadsheet-based model for economically characterizing the operation of a radiation treatment program has been used to perform a quantitative financial analysis of scheduled and unscheduled downtime. The incremental cost of downtime is broken down into three categories: remuneration of in-house or third party service technologists, decreased patient capacity, and local operating procedures for dealing with downtime. Different service arrangements and operating procedures are simulated to demonstrate the financial cost of treatment machine unavailability due to either preventative maintenance or unexpected breakdown. Depending on the service arrangement and operating policies for accommodating downtime, the combined cost of scheduled and unscheduled downtime (at 5%) can exceed 10% of the total cost of the radiation treatment program. It has also been demonstrated that the greatest cost component of downtime is decreased patient capacity, which can exceed $400,000 (CAN) when unscheduled downtime reaches 5%. The interpretation of this cost depends on the funding environment. Although the emphasis of this study has been the financial consequences of downtime, there are other factors which must be considered when developing policies and procedures for accommodating downtime such as effects on treatment, patient convenience and quality of life for staff. Even though the numerical results are strictly valid only within the context of the simulations performed, they do provide a broad framework within which medical physicists can make recommendations regarding service support and downtime.


J Appl Clin Med Phys


Dunscombe P,Roberts G,Valiquette L





Has Abstract


2000-04-01 00:00:00










  • Image texture and radiation dose properties in CT.

    abstract::The aim of this study was to compare image noise properties of GE Discovery HD 750 and Toshiba Aquilion ONE. The uniformity section of a Catphan 600 image quality assurance phantom was scanned with both scanners, at different dose levels and with extension rings simulating patients of different sizes. 36 datasets were...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Mozejko D,Andersen HK,Pedersen M,Waaler D,Martinsen AC

    更新日期:2016-05-08 00:00:00

  • Clinical and imaging characteristics of breast ductal carcinoma in situ with microinvasion.

    abstract:BACKGROUND:We analyzed the clinical and imaging characteristics of patients with breast ductal carcinoma in situ with microinvasion (DCISM) and breast ductal carcinoma in situ (DCIS). METHODS:We analyzed the records of 40 patients diagnosed with DCISM and 61 patients with DCIS who were hospitalized at Shengjing Hospit...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Han S,Qiu F,Han Y,Xu Y,Yin J,Xing F,Bian X,He G

    更新日期:2020-12-17 00:00:00

  • Evaluation of an electron Monte Carlo dose calculation algorithm for treatment planning.

    abstract::The purpose of this study is to evaluate the accuracy of the electron Monte Carlo (eMC) dose calculation algorithm included in a commercial treatment planning system and compare its performance against an electron pencil beam algorithm. Several tests were performed to explore the system's behavior in simple geometries...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Chamberland E,Beaulieu L,Lachance B

    更新日期:2015-05-08 00:00:00

  • A review of patient questions from physicist-patient consults.

    abstract:PURPOSE:To provide insight into the types of questions asked to medical physicists by patients during one-on-one physicist-patient consults at one institution. MATERIALS AND METHODS:Medical physicists trained in patient communication techniques met with patients to provide an overview of the treatment planning and del...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Atwood TF,Brown DW,Juang T,Moore KL,McConnell KA,Steers JM,Murphy JD,Mundt AJ,Pawlicki T

    更新日期:2020-08-01 00:00:00

  • Dose perturbation in the radiotherapy of breast cancer patients implanted with the Magna-Site: a Monte Carlo study.

    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


    authors: Chatzigiannis C,Lymperopoulou G,Sandilos P,Dardoufas C,Yakoumakis E,Georgiou E,Karaiskos P

    更新日期:2011-01-19 00:00:00

  • Independent review of 4DCT scans used for SABR treatment planning.

    abstract::Four-dimensional computerized tomography (4DCT) is required for stereotactic ablative body radiotherapy (SABR) of mobile targets to account for tumor motion during treatment planning and delivery. In this study, we report on the impact of an image review quality assurance process performed prior to treatment planning ...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Antony R,Lonski P,Ungureanu E,Hardcastle N,Yeo A,Siva S,Kron T

    更新日期:2020-03-01 00:00:00

  • A clinical 3D/4D CBCT-based treatment dose monitoring system.

    abstract::To monitor delivered dose and trigger plan adaptation when deviation becomes unacceptable, a clinical treatment dose (Tx-Dose) reconstruction system based on three-dimensional (3D)/four-dimensional (4D)-cone beam computed tomograpy (CBCT) images was developed and evaluated on various treatment sites, particularly for ...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Qin A,Gersten D,Liang J,Liu Q,Grill I,Guerrero T,Stevens C,Yan D

    更新日期:2018-11-01 00:00:00

  • Utilization of a 3D printer to fabricate boluses used for electron therapy of skin lesions of the eye canthi.

    abstract::This work describes the use of 3D printing technology to create individualized boluses for patients treated with electron beam therapy for skin lesions of the eye canthi. It aimed to demonstrate the effectiveness of 3D-printed over manually fabricated paraffin boluses. The study involved 11 patients for whom the const...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Łukowiak M,Jezierska K,Boehlke M,Więcko M,Łukowiak A,Podraza W,Lewocki M,Masojć B,Falco M

    更新日期:2017-01-01 00:00:00

  • Role of adaptive radiation therapy for pediatric patients with diffuse pontine glioma.

    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


    authors: Beltran C,Sharma S,Merchant TE

    更新日期:2011-01-30 00:00:00

  • An algorithm for automated modulation transfer function measurement using an edge of a PMMA phantom: Impact of field of view on spatial resolution of CT images.

    abstract:PURPOSE:The purpose of this study was to introduce a new algorithm for automated measurement of the modulation transfer function (MTF) using an edge of a readily available phantom and to evaluate the effect of reconstruction filter and field of view (FOV) on the spatial resolution in the CT images. METHODS:Our automat...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Anam C,Fujibuchi T,Budi WS,Haryanto F,Dougherty G

    更新日期:2018-11-01 00:00:00

  • Effect of ROI filtering in 3D cone-beam rotational angiography on organ dose and effective dose in cerebral investigations.

    abstract::The assessment of intracranial aneurysms is increasingly performed using three-dimensional cone-beam rotational angiography (3D CBRA). To reduce the dose to the patient during 3D CBRA procedures, filtered region-of-interest imaging (FROI) is presented in literature to be an effective technique as the dose in regions o...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Göpfert F,Schmidt R,Wulff J,Zink K

    更新日期:2015-03-08 00:00:00

  • Dosimetric characterization and use of GAFCHROMIC EBT3 film for IMRT dose verification.

    abstract::Radiochromic film has become an important tool to verify dose distributions in highly conformal radiation therapy such as IMRT. Recently, a new generation of these films, EBT3, has become available. EBT3 has the same composition and thickness of the sensitive layer of the previous EBT2 films, but its symmetric layer c...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Casanova Borca V,Pasquino M,Russo G,Grosso P,Cante D,Sciacero P,Girelli G,La Porta MR,Tofani S

    更新日期:2013-03-04 00:00:00

  • Development of a stereoscopic CT metal artifact management algorithm using gantry angle tilts for head and neck patients.

    abstract::Dental amalgams are a common source of artifacts in head and neck (HN) images. Commercial artifact reduction techniques have been offered, but are substantially ineffectual at reducing artifacts from dental amalgams, can produce additional artifacts, provide inaccurate HU information, or require extensive computation ...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Branco D,Kry S,Taylor P,Rong J,Zhang X,Peterson C,Frank S,Followill D

    更新日期:2020-08-01 00:00:00

  • Dose calculation for hypofractionated volumetric-modulated arc therapy: approximating continuous arc delivery and tongue-and-groove modeling.

    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


    authors: Yang J,Tang G,Zhang P,Hunt M,Lim SB,LoSasso T,Mageras G

    更新日期:2016-03-08 00:00:00

  • A dosimetric comparison of stereotactic body radiation therapy techniques for lung cancer: robotic versus conventional linac-based systems.

    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


    authors: Ding C,Chang CH,Haslam J,Timmerman R,Solberg T

    更新日期:2010-06-29 00:00:00

  • Statistical process control and verifying positional accuracy of a cobra motion couch using step-wedge quality assurance tool.

    abstract::This study utilizes process control techniques to identify action limits for TomoTherapy couch positioning quality assurance tests. A test was introduced to monitor accuracy of the applied couch offset detection in the TomoTherapy Hi-Art treatment system using the TQA "Step-Wedge Helical" module and MVCT detector. Ind...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Binny D,Lancaster CM,Trapp JV,Crowe SB

    更新日期:2017-09-01 00:00:00

  • Deriving detector-specific correction factors for rectangular small fields using a scintillator detector.

    abstract::The goal of this study was to investigate small field output factors (OFs) for flat-tening filter-free (FFF) beams on a dedicated stereotactic linear accelerator-based system. From this data, the collimator exchange effect was quantified, and detector-specific correction factors were generated. Output factors for 16 j...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Qin Y,Zhong H,Wen N,Snyder K,Huang Y,Chetty IJ

    更新日期:2016-11-08 00:00:00

  • Using an onboard kilovoltage imager to measure setup deviation in intensity-modulated radiation therapy for head-and-neck patients.

    abstract::The purpose of the present study was to use a kilovoltage imaging device to measure interfractional and intrafractional setup deviations in patients with head-and-neck or brain cancers receiving intensity-modulated radiotherapy (IMRT) treatment. Before and after IMRT treatment, approximately 3 times weekly, 7 patients...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Mechalakos JG,Hunt MA,Lee NY,Hong LX,Ling CC,Amols HI

    更新日期:2007-09-24 00:00:00

  • Accelerated tomotherapy delivery with TomoEdge technique.

    abstract::TomoEDGE is an advanced delivery form of tomotherapy which uses a dynamic secondary collimator. This plan comparison study describes the new features, their clinical applicability, and their effect on plan quality and treatment speed. For the first 45 patients worldwide that were scheduled for a treatment with TomoEdg...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Katayama S,Haefner MF,Mohr A,Schubert K,Oetzel D,Debus J,Sterzing F

    更新日期:2015-03-08 00:00:00

  • A fast, independent dose check of HDR plans.

    abstract::High dose rate (HDR) brachytherapy often involves optimization routines to calculate the dwell times and positions of a radioactive source along specified applicator paths. These routines optimize the dwells in such a way as to deliver the prescribed dose at one or more points while satisfying various constraints. The...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Lachaine ME,Gorman JC,Palisca MG

    更新日期:2003-04-01 00:00:00

  • An open-source software for monitoring intrafraction motion during external beam radiation therapy based on superimposition of contours of projected ROIs on cine-MV images.

    abstract:PURPOSE:To present an open-source software ( 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


    authors: Lessard R,Tremblay NM,Plourde MÉ,Guillot M

    更新日期:2020-08-01 00:00:00

  • Hepatic encephalopathy: a neurochemical, neuroanatomical, and neuropsychological study.

    abstract::Hepatic encephalopathy (HE) is normally diagnosed by neuropsychological (NP) tests, which are not very specific and do not reveal the underlying pathology. Magnetic resonance imaging (MRI) and spectroscopy (MRS) of the brain offer alternative and possibly more specific markers for HE. These methods were applied in con...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Binesh N,Huda A,Thomas MA,Wyckoff N,Bugbee M,Han S,Rasgon N,Davanzo P,Sayre J,Guze B,Martin P,Fawzy F

    更新日期:2006-01-01 00:00:00

  • Treatment of cervical cancer with electronic brachytherapy.

    abstract:PURPOSE:We report the first cervical cancer cases treated with interstitial electronic brachytherapy (eBT) at our hospital and compare them with plans made with high-dose-rate interstitial brachytherapy based on Ir192 (HDR-BT). MATERIALS AND METHODS:Eight patients with cervical cancer were treated with the Axxent eBT ...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Lozares-Cordero S,Font-Gómez JA,Gandía-Martínez A,Miranda-Burgos A,Méndez-Villamón A,Villa-Gazulla D,Alba-Escorihuela V,Jiménez-Puertas S,González-Pérez V

    更新日期:2019-07-01 00:00:00

  • Development of a treatment planning protocol for prostate treatments using intensity modulated radiotherapy.

    abstract::We have developed a treatment planning protocol for intensity-modulated radiation therapy of the prostate using commercially available inverse planning software. Treatment plans were developed for ten patients using the Corvus version 3.8 planning system, testing various prescription options, including tissue types, d...

    journal_title:Journal of applied clinical medical physics

    pub_type: 临床试验,杂志文章


    authors: Ezzell GA,Schild SE,Wong WW

    更新日期:2001-04-01 00:00:00

  • A novel and clinically useful dynamic conformal arc (DCA)-based VMAT planning technique for lung SBRT.

    abstract:PURPOSE:Volumetric modulated arc therapy (VMAT) is gaining popularity for stereotactic treatment of lung lesions for medically inoperable patients. Due to multiple beamlets in delivery of highly modulated VMAT plans, there are dose delivery uncertainties associated with small-field dosimetry error and interplay effects...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Pokhrel D,Visak J,Sanford L

    更新日期:2020-07-01 00:00:00

  • Evaluating the positional uncertainty of intrafraction, adjacent fields, and daily setup with the BrainLAB ExacTrac system in patients who are receiving craniospinal irradiation.

    abstract:PURPOSE:To investigate the daily setup, interfraction motion, variability in the junction areas, and dosimetric effect in craniospinal irradiation (CSI) patients. METHODS:Fifteen CSI patients who had undergone split-field IMRT were followed in the study. Previous, middle, and posttreatment, each target volume position...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Duan X,Zhou Y,Dai H,Zhao L,Qian J,Yang D,Zhang L,Luo C,Li G

    更新日期:2020-08-01 00:00:00

  • Generation and verification of QFix kVue Calypso-compatible couch top model for a dedicated stereotactic linear accelerator with FFF beams.

    abstract::This study details the generation, verification, and implementation of a treatment planning system (TPS) couch top model for patient support system used in conjunction with a dedicated stereotactic linear accelerator. Couch top model was created within the TPS using CT simulation images of the kVue Calpyso-compatible ...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Gardner SJ,Gulam M,Song K,Li H,Huang Y,Zhao B,Qin Y,Snyder K,Kim J,Gordon J,Chetty IJ,Wen N

    更新日期:2015-07-08 00:00:00

  • Using C-Arm X-ray images from marker insertion to confirm the gold fiducial marker identification in an MRI-only prostate radiotherapy workflow.

    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


    authors: Gustafsson C,Persson E,Gunnlaugsson A,Olsson LE

    更新日期:2018-11-01 00:00:00

  • Dependence of intrafraction motion on fraction duration for pediatric patients with brain tumors.

    abstract::The purpose of this study was to quantify the intrafraction motion of pediatric patients with brain tumors during radiation therapy and investigate any correlation between motion, use of general anesthesia, and daily treatment duration. 100 pediatric patients with a mean age of 8.5 years (range: 1.0 to 17.8) were incl...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Beltran C,Merchant TE

    更新日期:2011-11-15 00:00:00

  • Dosimetric comparison of three intensity-modulated radiation therapies for left breast cancer after breast-conserving surgery.

    abstract:PURPOSE:This study aimed to evaluate dosimetric differences of intensity-modulated radiation therapy (IMRT) in target and normal tissues after breast-conserving surgery. METHODS:IMRT five-field plan I, IMRT six-field plan II, and field-in-field-direct machine parameter optimization-IMRT plan III were designed for each...

    journal_title:Journal of applied clinical medical physics

    pub_type: 杂志文章


    authors: Zhang HW,Hu B,Xie C,Wang YL

    更新日期:2018-05-01 00:00:00