Medical Dosimetry最新文献

{"title":"New Members List & Corporate Members List, Spring 2025","authors":"","doi":"10.1016/j.meddos.2025.01.004","DOIUrl":"10.1016/j.meddos.2025.01.004","url":null,"abstract":"","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":"50 1","pages":"Page 103"},"PeriodicalIF":1.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose verification of 2 targets simultaneously for single-isocenter stereotactic radiation therapy and radiosurgery plans.","authors":"Guoqiang Cui, Jun Duan, Fang-Fang Yin","doi":"10.1016/j.meddos.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.meddos.2024.12.006","url":null,"abstract":"<p><p>Most of conventional 2-dimensional (2D) methods verify dose of multiple targets separately one-by-one for Single-isocenter Multiple-target (SIMT) brain plans, which are inefficient and sub-optimal. This study presented a practical method to verify the dose of 2 targets simultaneously for improved efficiency and accuracy. Fifteen Stereotactic Radiation Therapy (SRT) and sixteen Stereotactic Radiosurgery (SRS) plans were used for this study. Each plan has 2 targets coincide with a plane through the plan isocenter. All plans were created in the Eclipse Treatment Planning System (TPS) using a 6 MV flattening filter free photon beam. A 2D detector array, myQA SRS was used for measurements. It has a spatial resolution of 0.4 mm and an active area of 120 × 140 mm². It can be rotated along the longitudinal axis with a cylindrical phantom with one-degree precision. All plans were delivered with the detector array centered at the plan isocenter and rotated to intersect 2 targets. Six plans with target separations less than 70 mm were crosschecked with the SRS MapCHECK, which has an active area of 77 × 77 mm². The measured 2D dose distributions were compared with those calculated from the TPS. Gamma-index analysis was performed using 3%/1 mm criteria and a 10% dose threshold. For all 31 SIMT brain plans measured with myQA SRS, the average and standard deviation of the gamma-passing rate was (96.8 ± 2.2)%. For 15 SRT plans and 16 SRS plans, that was (96.6 ± 2.4)% and (97.0 ± 2.1)%, respectively. For 6 plans crosschecked, the average gamma-passing rates were 96.8% vs. 94.8% with myQA SRS and SRS MapCHECK, respectively. A practical method to verify the dose of 2 targets simultaneously was demonstrated. It offers an efficient way for pretreatment verification of SIMT SRT and SRS plans with improved accuracy.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case study on postoperative radiation therapy of the big toe.","authors":"Chelse D Hollis, Jose L Olmos, Nishele Lenards, Ashley Hunzeker, Matt Tobler","doi":"10.1016/j.meddos.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.meddos.2024.12.004","url":null,"abstract":"<p><p>Sweat gland cancers, particularly eccrine sweat gland carcinomas, are rare and challenging to treat due to their aggressive nature and inconspicuous clinical presentation. Aggressive digital papillary adenocarcinoma, a rare subtype, frequently presents with delays in diagnosis, increasing the risk of metastasis and recurrence. Surgical excision remains the standard treatment, but the role of postoperative radiation therapy is not well-established due to the paucity of data. This case study explores the use of radiotherapy in treating a 50-year-old female with digital papillary adenocarcinoma of the great toe. A custom three-dimensional (3D) printed bolus was utilized to improve dose distribution and reproducibility in radiation treatment using Volumetric Modulated Arc Therapy (VMAT). The comparative analysis of VMAT and 3D conformal radiation plans demonstrated superior target coverage, dose homogeneity, and reduced exposure to adjacent healthy tissue with VMAT. The findings contribute valuable insight into the use of 3D-printed bolus and advanced radiotherapy techniques in the management of rare sweat gland cancers, particularly in complex anatomical regions like the toe.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing precision in lacrimal sac tumor management through integration of multimodal imaging and intensity modulated proton therapy.","authors":"Xue-Ying Ren, Zi-Shen Wang, Jun-Xiao Jia, Xue-Qi Chen, Feng Lyu, Chao Liu, Yan Gao, Si-Wei Liu, Ming-Wei Ma, Xian-Shu Gao","doi":"10.1016/j.meddos.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.meddos.2024.12.002","url":null,"abstract":"<p><p>This study presents a patient with a PET-CT detected residual lacrimal sac tumor who was treated with intensity modulated proton therapy (IMPT) and concurrent chemotherapy. The patient a 49-year-old male diagnosed with squamous cell carcinoma of the left lacrimal sac had under-went endoscopic surgery. Postoperative PET-CT implied tumor residual in the left lacrimal sac. Given the tumor's proximity to optic organs, IMPT was employed to provide optimal dose painting. The precise delineation of the target volumes using multimodal imaging modalities (CT, MRI, and PET-CT), coupled with daily cone-beam CT technology for accurate positioning during radiotherapy contributed to an adequate dose coverage of the target. In comparison to helical tomotherapy (TOMO) and volumetric modulated arc therapy (VMAT), IMPT reduces doses to most ocular structures. With a follow-up period of 21 months after IMPT, the patient exhibited no evidence of disease recurrence and experienced only mild toxicity. This report highlights the critical role of multimodal imaging in diagnosis and radiotherapy planning. Furthermore, a literature review of proton therapy for malignant lacrimal sac tumors reveals that the scarcity of reports and emphasizes the importance of this case as a significant contribution to medical literature. This highlights the potential benefits of optimal tumor control and reducing toxicities by the integration of multimodal imaging and IMPT.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of clearcalc for efficient patient specific QA.","authors":"Ignatius Komakech, Denis Okello, Awusi Kavuma, Bonny Abal, Annette Wygoda","doi":"10.1016/j.meddos.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.meddos.2024.12.003","url":null,"abstract":"<p><p>Uganda's only radiotherapy center is a very busy facility treating about 210 patients daily on three linear accelerators making it sometimes hard to have machine time for pretreatment QAs. This study was aimed at validating an independent calculation software, ClearCalc (ICS) for second checks of the treatment planning system (TPS) calculations. The validation of ICS started with simple phantom test plans consisting of square, irregular, open and wedged fields designed in the TPS and measured in phantoms. Doses and monitor units (MUs) calculated by ICS were compared with TPS calculated doses and with measured doses. ICS was then validated on clinically approved treatment plans: comparison with TPS calculations and with pretreatment QA measurements performed with electronic portal imaging devices (EPIDs) and analyzed using Gamma passing criteria of 3%/3 mm and 3%/2 mm. Results for test plans were within the passing level of 3.0% except for 2 outliers (-3.1% and 3.1%). As for the clinically approved treatment plans, they show good agreement between MUs (0.2 ± 1.8%), reference point doses (0.2 ±1.5%) and mean PTV doses (0.5 ± 1.4%). ICS calculated (3D) mean gamma pass rates were 98.1±1.6% and 98.4±1.0% for 3%/2 mm and 3%/3 mm criteria. No correlation was seen between gamma analysis results from ICS and EPID. This study validated ClearCalc on phantom and clinically approved plans. The result show that ICS based patients specific QA is quick, promising and potentially allows significant time saving that can be utilized for patient treatments.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of axillary dose restriction on plan quality and acute radiation dermatitis in breast cancer radiotherapy.","authors":"Meizhen Shen, Meizhu Shen, Ying Mo, Chunming Lin, Jian Qin","doi":"10.1016/j.meddos.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.meddos.2024.12.005","url":null,"abstract":"<p><p>Axillary dose restriction (ADR) is rarely implemented in breast cancer radiotherapy by radiation oncologists to minimize exposure to organs at risk (OARs), particularly the axilla. This prospective randomized controlled study aims to evaluate the efficacy of ADR in improving plan quality (PQ) and its impact on acute radiation dermatitis (ARD) in breast cancer radiotherapy. The study recruited breast cancer patients who required postoperative radiotherapy but did not have an indication for axillary irradiation. Delineation and dosimetric assessment of the axilla (Axilla Levels I-III and Axillary Cavity) were performed in all cases, with ADR implemented randomly. ADR involved restricting the mean axilla dose to 40-45 Gy during radiotherapy. The outcomes assessed included the ARD grades (both overall and axillary) and dose-volume parameters of PQ including skin V35. The study enrolled 87 patients, who were randomly divided into two groups: Group I (50 patients) received ADR, while Group C (37 patients) did not. ADR was found to be significantly associated with reduced exposure doses to the axilla and ipsilateral lung, specifically in patients with modified radical mastectomy (MRM). Results of other PQ parameters, such as D95, V93, V95, V100, V107 for the planning target volume (PTV), V30, Dmean for the heart, Dmax for the spinal cord, and V5 for the ipsilateral lung, demonstrated potential benefits in alleviating doses to these OARs while maintaining optimized PQ, although these results were not statistically significant. However, no statistically significant correlation between ADR and severe ARD (≥ Grade 2) or skin V35 was established, either in the total patient population or in subgroups. Additionally, a multivariable logistic regression for severe ARD was conducted, with ADR and skin V35 included as predictive factors. Only older age was found to be significantly associated with severe ARD. Implementing ADR in breast cancer radiotherapy not only protects the axilla and ipsilateral lung but also maintains optimized PQ, specifically in MRM patients, though it shows no evidence of alleviating ARD. Adopting ADR may be considered a valuable option in breast cancer radiotherapy.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does extending the body contour into air enhance surface dose calculation accuracy?","authors":"Joshua N Wancura, Olga M Dona Lemus, Sean M Tanny, Jihyung Yoon, Matthew J Webster, Louis S Constine, Dandan Zheng","doi":"10.1016/j.meddos.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.meddos.2024.12.001","url":null,"abstract":"<p><strong>Purpose: </strong>In radiotherapy treatment planning systems, modelling of superficial dose may be aided by a body contour that is, by default, placed at the outermost air-tissue interface. Here we investigate the accuracy of superficial dose calculated using either the default body contour (DBC) or an extended body contour (EBC) compared to radiochromic film measurements made on a slab phantom and an anthropomorphic phantom.</p><p><strong>Methods: </strong>Depth dose curves in the superficial region of the slab phantom were measured using stacked radiochromic films and irradiated using static beams delivered from varying incident angles. Surface doses on the anthropomorphic phantom were measured using films taped to the outside and irradiated with dynamic beams targeting the skin. No intervening immobilization devices were between the incident beams and films. Measurements were compared with dose calculations performed with Eclipse 15.6 Acuros XB using both the DBC and EBC. The EBC was generated by extending the DBC out into air by 1 cm.</p><p><strong>Results: </strong>Differences between the DBC- and EBC-calculated dose were largest within the region ranging from the surface to a depth of 2 mm. Beyond 2 mm, calculations agreed to within 5%. For the slab phantom, the DBC- and EBC-calculated surface doses for 0-degree incident angle were 26% and 44% respectively, while measured dose was 24 ± 3%. At 60-degrees incident angle, DBC- and EBC-calculated surface doses were 33% and 66% respectively, while the measured dose was 43 ± 3%. For the anthropomorphic phantom, the DBC- and EBC-calculated surface doses were 65% and 99% of the prescription dose respectively, while the measured surface dose was 76 ± 3%.</p><p><strong>Conclusions: </strong>Calculating with the EBC overestimated surface dose, while the DBC underestimated surface dose under conditions of oblique delivery. Overall, the default method of placing the body contour at the air-tissue interface produced a more accurate estimation of surface dose for bare skin.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of 4-dimensional maximum intensity projection (4D-MIP) for respiratory motion management with uncertain interobserver delineation.","authors":"Satoki Hinai, Keisuke Usui, Yusuke Obara, Toshiya Maebayashi, Satoshi Ookubo, Atsushi Ichikawa, Yoshihisa Sasaki, Kazuo Ozawa","doi":"10.1016/j.meddos.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.meddos.2024.11.001","url":null,"abstract":"<p><p>This study was conducted to evaluate the use of 4-dimensional (4D) maximum intensity projection (4D-MIP) to compensate for the disadvantages of average intensity projection (AIP), which is used to determine the internal target volume (ITV) in lung tumors. A respiratory motion phantom with a simulated tumor was imaged using 4D computed tomography (4D-CT). AIP and 4D-MIP were generated based on 10 phases of 4D-CT, followed by contouring of the ITV_AIP and ITV_MIP; these were compared with the ITV contoured in 10 phases of 4D-CT (ITV₁₀). Additionally, the profile curves of the ITV_AIP and ITV_MIP were obtained, and the full width at half maximum (FWHM) was measured. There was no significant difference between the ITV₁₀ and ITV_MIP; however, the ITV_AIP demonstrated a lower value. The FWHM values of the ITV_AIP were smaller than those of ITV_MIP owing to decreased CT values in the superior-inferior margin. 4D-MIP may contribute to improving the consistency of the ITV delineation.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An assessment of the influence of trade-off optimization in commercial knowledge based planning library creation for tongue cancer patients.","authors":"Subhra S Biswal, Biplab Sarkar, Monika Goyal, Tharmarnadar Ganesh, Tanweer Shahid, Jibak Bhattacharya","doi":"10.1016/j.meddos.2024.10.006","DOIUrl":"https://doi.org/10.1016/j.meddos.2024.10.006","url":null,"abstract":"<p><p>This article aims to compare the dosimetric performance between knowledge-based plan (KBP) libraries with and without trade-off (TO) exploration using multicriterial optimization (MCO) for tongue cancer patients. The trade-off optimized library (KBP_MCO) contains a minimal number of constituent plans, whereas two nontrade-off optimized libraries contain a minimal and a large number of treatment plans, respectively. Three KBP libraries were created: KBP_100 and KBP_20, each comprising of 100 and 20 manually optimized plans, respectively. Additionally, another KBP library (KBP_MCO_20) was created by reoptimizing the constituent plans from KBP_20 using MCO techniques. A total of 70 tongue plans were validated through these libraries. Validation plans were evaluated for PTV and organ at risk (OAR) doses. Greenhouse-Geisser analysis (ANOVA) and the Bonferroni procedure (t-test) were used for statistical evaluation. The mean PTVD95% for KBP_100, KBP_20, and KBP_MCO_20 was 98.4% ± 0.3%, 98.9% ± 0.2%, and 98.7% ± 0.2%, respectively. The statistical significance of PTVD95% for the 3 possible combinations-KBP_100 vs KBP_20, KBP_100 vs KBP_MCO_20, and KBP_20 vs KBP_MCO_20 were statistically significant with p < 0.001. Spinal cord doses for KBP_100, KBP_20, and KBP_MCO_20 were 29.6 ± 1.8 Gy, 31.2 ± 2.5 Gy, and 26.8 ± 1.9 Gy, respectively, with p(KBP_100 vs KBP_20) = 0.14, p(KBP_100 vs KBP_MCO_20) = 0.001, and p(KBP_20 vs KBP_MCO_20) < 0.001. Only the first comparison showed a statistically insignificant variation. A trade-off optimized plan library with a minimal number of patients (20) yields better performance for serial structures (spinal cord and brainstem) compared to large manually optimized KBP libraries. For other organs at risk (OARs) and target dose coverage, although statistical differences were significant in most instances, the differences in physical dose were small and probably will not yield any significant clinical differences.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel application of an adapted virtual cone technique for the radiosurgical treatment of a 3 mm brain metastasis with a standard multileaf collimator.","authors":"Eric Lobb","doi":"10.1016/j.meddos.2024.10.005","DOIUrl":"https://doi.org/10.1016/j.meddos.2024.10.005","url":null,"abstract":"<p><p>The virtual cone is an innovative MLC-based technique for generating dose distributions comparable to those of physical stereotactic cones. Initially designed for functional radiosurgery applications using a high-definition multileaf collimator (MLC) with 2.5 mm leaf width, this technique has been adapted to a standard 5 mm MLC system for treating small brain metastases. The adapted technique uses preconfigured location-specific control point sequences to produce spherical dose distributions with sharp dose gradients, and facilitates efficient planning through parallelizable template-based workflows. This report highlights the use of the adapted virtual cone technique for treating a 57-year-old patient with a 3 mm brain metastasis from metastatic papillary thyroid carcinoma using a standard multileaf collimator.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}