Abstract:
:We assessed interfraction positional variation in pancreatic tumors using daily breath-hold cone-beam computed tomography at end-exhalation (EE) with visual feedback (BH-CBCT). Eleven consecutive patients with pancreatic cancer who underwent BH intensity-modulated radiation therapy with visual feedback were enrolled. All participating patients stopped oral intake, with the exception of drugs and water, for > 3 hr before treatment planning and daily treatment. Each patient was fixed in the supine position on an individualized vacuum pillow. An isotropic margin of 5 mm was added to the clinical target volume to create the planning target volume (PTV). The prescription dose was 42 to 51 Gy in 15 fractions. After correcting initial setup errors based on bony anatomy, the first BH-CBCT scans were performed before beam delivery in every fraction. BH-CBCT acquisition was obtained in three or four times breath holds by interrupting the acquisition two or three times, depending on the patient's BH ability. The image acquisition time for a 360° gantry rotation was approximately 90 s, including the interruption time due to BH. The initial setup errors were corrected based on bony structure, and the residual errors in the target position were then recorded. The magnitude of the interfraction variation in target position was assessed for 165 fractions. The systematic and random errors were 1.2 and 1.8 mm, 1.1 and 1.8 mm, and 1.7 and 2.9 mm in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions, respectively. Absolute interfraction variations of > 5 mm were observed in 18 fractions (11.0%) from seven patients because of EE-BH failure. In conclusion, target matching is required to correct interfraction variation even with visual feedback, especially to ensure safe delivery of escalated doses to patients with pancreatic cancer.
journal_name
J Appl Clin Med Physjournal_title
Journal of applied clinical medical physicsauthors
Nakamura M,Akimoto M,Ono T,Nakamura A,Yano S,Nakata M,Itasaka S,Mizowaki T,Shibuya K,Hiraoka Mdoi
10.1120/jacmp.v16i2.5123subject
Has Abstractpub_date
2015-03-08 00:00:00pages
5123issue
2issn
1526-9914journal_volume
16pub_type
杂志文章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...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v15i2.4547
更新日期:2014-03-06 00:00:00
abstract:BACKGROUND AND PURPOSE:Along with the increasing demand for high-quality radiotherapy and the growing number of high-precision radiotherapy devices, precise radiotherapy workflow management and accurate time evaluation of the entire radiotherapy process are crucial to providing appropriate, timely treatment for cancer ...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1002/acm2.12959
更新日期:2020-09-01 00:00:00
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
doi:10.1120/jacmp.v14i2.4111
更新日期:2013-03-04 00:00:00
abstract:PURPOSE:The weighted CT dose index (CTDIw ) has been extended for a nominal total collimation width (nT) greater than 40 mm and relies on measurements of CTDIfreeair. The purpose of this work was to compare three methods of measuring CTDIfreeair and subsequent calculations of CTDIw to investigate their clinical appropr...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1002/acm2.12363
更新日期:2018-07-01 00:00:00
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
doi:10.1002/acm2.12474
更新日期:2018-11-01 00:00:00
abstract::A Histogram Analysis in Radiation Therapy (HART) program was primarily developed to increase the efficiency and accuracy of dose-volume histogram (DVH) analysis of large quantities of patient data in radiation therapy research. The program was written in MATLAB to analyze patient plans exported from the treatment plan...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:
更新日期:2010-01-28 00:00:00
abstract::The purpose of this study was to assess treatment margins in free-breathing irradiation of pancreatic cancer after bone alignment, and evaluate their impact on conformal radiotherapy. Fifteen patients with adenocarcinoma of the head of the pancreas underwent implantation of single fiducial marker. Intrafraction uncert...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v14i4.4152
更新日期:2013-07-08 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::The image-guided radiotherapy technique (IGRT) makes use of imaging devices to verify the positions of the target volume and organs at risk during the treatment sessions. In this work we evaluate the image quality provided by an imaging system based on a kilovoltage cone-beam CT, and explore its ability to perform IGR...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v14i1.3888
更新日期:2013-01-07 00:00:00
abstract::We examined the dose distributions generated by Pinnacle3 (Philips Radiation Oncology Systems, Milpitas, CA) for intensity-modulated radiotherapy (IMRT) plans using a cubic-block-piled compensator as the intensity modulator for 4-MV and 10-MV photon beams. The Pinnacle treatment planning system (TPS) uses an algorithm...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v8i1.2323
更新日期:2006-06-16 00:00:00
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
doi:10.1002/acm2.12942
更新日期:2020-08-01 00:00:00
abstract::A new method of generating wedge-shaped dose distributions through dynamic multileaf collimator dose delivery rather than computer-controlled jaw motion is presented. The method starts with the calculation of a wedge-shaped beam profile for the desired wedge angle. The resultant wedge beam profile is then passed to th...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v6i3.2060
更新日期:2005-07-01 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::A patient specific quality assurance (QA) should detect errors that originate anywhere in the treatment planning process. However, the increasing complexity of treatment plans has increased the need for improvements in the accuracy of the patient specific pretreatment verification process. This has led to the utilizat...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1002/acm2.12114
更新日期:2017-07-01 00:00:00
abstract::Chest wall radiation therapy treatment delivery was monitored using a 5 mm thick radiochromic poly(vinyl alcohol) cryogel that also provided buildup material. The cryogels were used to detect positioning errors and measure the impact of shifts for a chest wall treatment that was delivered to a RANDO phantom. The phant...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v17i5.6148
更新日期:2016-09-08 00:00:00
abstract::Intraoperative electron radiation therapy (IOERT) cannot usually benefit, as conventional external radiotherapy, from software systems of treatment planning based on computed tomography and from common dose verify procedures. For this reason, in vivo film dosimetry (IVFD) proves to be an effective methodology to evalu...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v16i1.5065
更新日期:2014-01-08 00:00:00
abstract::The main purposes of this study are to: 1) evaluate the accuracy of XiO treatment planning system (TPS) for different dose calculation grid size based on head phan-tom measurements in uniform scanning proton therapy (USPT); and 2) compare the dosimetric results for various dose calculation grid sizes based on real com...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v16i5.5510
更新日期:2015-09-08 00:00:00
abstract:OBJECTIVES:To compare the effectiveness of two different patient size metrics based on water equivalent diameter (Dw ), the mid-scan water equivalent diameter Dw_c , and the mean (average) water equivalent diameter in the imaged region, Dw_ave , for automatic detection of accidental changes in computed tomography (CT) ...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1002/acm2.12240
更新日期:2018-01-01 00:00:00
abstract::The longitudinal coverage of a LINAC-mounted CBCT scan is limited to the corresponding dimensional limits of its flat panel detector, which is often shorter than the length of the treatment field. These limits become apparent when fields are designed to encompass wide regions, as when providing nodal coverage. Therefo...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v13i4.3796
更新日期:2012-07-05 00:00:00
abstract::The dosimetry of very small electron fields can be challenging due to relative shifts in percent depth-dose curves, including the location of dmax, and lack of lateral electronic equilibrium in an ion chamber when placed in the beam. Conventionally a small parallel plate chamber or film is utilized to perform small fi...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v12i1.3267
更新日期:2010-10-04 00:00:00
abstract::The purpose of this study was to implement full/half bowtie filter models in a com-mercial treatment planning system (TPS) to calculate kilovoltage (kV) cone-beam CT (CBCT) doses of Varian On-Board Imager (OBI) kV X-ray imaging system. The full/half bowtie filter models were created as compensators in Pinnacle TPS usi...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v17i2.5988
更新日期:2016-03-08 00:00:00
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
doi:10.1120/jacmp.v4i2.2530
更新日期:2003-04-01 00:00:00
abstract:INTRODUCTION:A previous pilot study has demonstrated the feasibility of a novel image-based approach for remote dosimetric auditing of clinical trials. The approach uses a model to convert in-air acquired intensity modulated radiotherapy (IMRT) images to delivered dose inside a virtual phantom. The model was developed ...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1002/acm2.12521
更新日期:2019-01-01 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::The accuracy of the CyberKnife Synchrony Respiratory Tracking System (SRTS) is considered to be patient-dependent because the SRTS relies on an individual correlation between the internal tumor position (ITP) and the external marker position (EMP), as well as a prediction method to compensate for the delay incurred to...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v16i1.5049
更新日期:2015-01-08 00:00:00
abstract:PURPOSE:To assess the impact of isocenter shifts due to linac gantry and table rotation during cranial stereotactic radiosurgery on D98 , target volume coverage (TVC), conformity (CI), and gradient index (GI). METHODS:Winston-Lutz (WL) checks were performed on two Elekta Synergy linacs. A stereotactic quality assuranc...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1002/acm2.12854
更新日期:2020-05-01 00:00:00
abstract::A low-energy (50 kV) X-ray tube used for the stereotactic irradiation of intracranial lesions has been in use since 1999. The unit is calibrated prior to every procedure and during periodic quality assurance (QA) tests. The unit uses an internal and an external scintillation detector to monitor dose as well as a conve...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v7i3.2238
更新日期:2006-08-24 00:00:00
abstract::Traditional quality assurance checks of a patient's radiation therapy plan involve printing out treatment parameters from the treatment planning system and the "record and verify" (R&V) system and visually checking the information for one-to-one correspondence. In a paperless environment, one can automate this process...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v10i1.2905
更新日期:2009-01-27 00:00:00
abstract::A new calculation algorithm has been developed for independently verifying doses calculated by the TomoTherapy Hi.Art treatment planning system (TPS). The algorithm is designed to confirm the dose to a point in a high dose, low dose-gradient region. Patient data used by the algorithm include the radiological depth to ...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1120/jacmp.v10i1.2772
更新日期:2009-02-05 00:00:00
abstract::Modern three-dimensional image-guided intracavitary high dose rate (HDR) brachytherapy is often used in combination with external beam radiotherapy (EBRT) to manage cervical cancer. Intrafraction motion of critical organs relative to the HDR applicator in the time between the planning CT and treatment delivery can cau...
journal_title:Journal of applied clinical medical physics
pub_type: 杂志文章
doi:10.1002/acm2.12462
更新日期:2018-11-01 00:00:00