bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technical Note: Out‐of‐field dose measurement at near surface with plastic scintillator detector
Authors: Bourgouin Alexandra , Varfalvy Nicolas , Archambault Louis 
Published: February 2017

Out‐of‐field dose depends on multiple factors, making peripheral dosimetry complex. Only a few dosimeters have the required features for measuring peripheral dose. Plastic scintillator dosimeters (PSDs) offer numerous dosimetric advantages as required for out‐of‐field dosimetry. The purpose of this study is to determine the potential of using PSD as a surface peripheral dosimeter. Measurements were performed with a parallel‐plate ion chamber, a small volume ion chamber, and with a PSD. Lateral‐dose measurements (LDM) at 0.5 cm depth and depth‐dose curve (PDD) were made and compared to the dose calculation provided by a treatment planning system (TPS). This study shows that a PSD can measure a dose as low as for photon beam and for electron beam with a difference of 0.2 and 0.1 cGy compared to a parallel‐plate ion chamber. This study demonstrates the potential of using PSD as an out‐of‐field dosimeter since measurements with PSD avoid averaging over a too‐large depth, at 1 mm diameter, and can make precise measurement at very low dose. Also, electronic equilibrium is easier to reach with PSD due to its small sensitive volume and its water equivalence.PACS number(s): 87.55.N, 87.55.km
Dosimetric validation for an automatic brain metastases planning software using single‐isocenter dynamic conformal arcs
Authors: Liu Haisong , Li Jun , Pappas Evangelos , Andrews David , Evans James , Werner‐Wasik Maria , Yu Yan , Dicker Adam , Shi Wenyin 
Published: February 2017

An automatic brain‐metastases planning (ABMP) software has been installed in our institution. It is dedicated for treating multiple brain metastases with radiosurgery on linear accelerators (linacs) using a single‐setup isocenter with noncoplanar dynamic conformal arcs. This study is to validate the calculated absolute dose and dose distribution of ABMP. Three types of measurements were performed to validate the planning software: 1, dual micro ion chambers were used with an acrylic phantom to measure the absolute dose; 2, a 3D cylindrical phantom with dual diode array was used to evaluate 2D dose distribution and point dose for smaller targets; and 3, a 3D pseudo‐in vivo patient‐specific phantom filled with polymer gels was used to evaluate the accuracy of 3D dose distribution and radiation delivery. Micro chamber measurement of two targets (volumes of 1.2 cc and 0.9 cc, respectively) showed that the percentage differences of the absolute dose at both targets were less than 1%. Averaged GI passing rate of five different plans measured with the diode array phantom was above 98%, using criteria of 3% dose difference, 1 mm distance to agreement (DTA), and 10% low‐dose threshold. 3D gel phantom measurement results demonstrated a 3D displacement of nine targets of (range 0.2 ~ 1.1 mm). The averaged two‐dimensional (2D) GI passing rate for several region of interests (ROI) on axial slices that encompass each one of the nine targets was above 98% (5% dose difference, 2 mm DTA, and 10% low‐dose threshold). Measured , the minimum dose that covers 95% of the target volume, of the nine targets was 0.7% less than the calculated . Three different types of dosimetric verification methods were used and proved the dose calculation of the new automatic brain metastases planning (ABMP) software was clinical acceptable. The 3D pseudo‐in vivo patient‐specific gel phantom test also served as an end‐to‐end test for validating not only the dose calculation, but the treatment delivery accuracy as well.PACS number(s): 87.53.Lv, 87.55.km, 87.55.Qr
Comparison of automatic image registration uncertainty for three IGRT systems using a male pelvis phantom
Authors: Barber Jeffrey , Sykes Jonathan R. , Holloway Lois , Thwaites David I. 
Published: February 2017

A series of phantom images using the CIRS Virtual Human Male Pelvis was acquired across available dose ranges for three image‐guided radiotherapy (IGRT) imaging systems: Elekta XVI CBCT, Varian TrueBeam CBCT, and TomoTherapy MV CT. Each image was registered to a fan‐beam CT within the XVI software 100 times with random initial offsets. The residual registration error was analyzed to assess the role of imaging hardware and reconstruction in the uncertainty of the IGRT process. Residual translation errors were similar for all systems and . Over the clinical dose range for prostate IGRT images (10–25 mGy), all imaging systems provided acceptable matches in of registrations when incorporating residual rotational error using a dual quaternion derived distance metric. Outside normal dose settings, large uncertainties were observed at very low and very high dose levels. No trend between initial offset and residual registration error was observed. Patient images may incur higher uncertainties than this phantom study; however, these results encourage automatic matching for standard dose settings with review by treatment staff.PACS number(s): 87.55.km, 87.55.ne, 87.56.Da
A methodology for on‐board CBCT imaging dose using optically stimulated luminescence detectors
Authors: Mail Noor , Yusuf Muhammad , Alothmany Nazeeh , Kinsara A. Abdulrahman , Abdulkhaliq Fahad , Ghamdi Suliman M. , Saoudi Abdelhamid 
Published: February 2017

Cone‐beam computed tomography CBCT systems are used in radiation therapy for patient alignment and positioning. The CBCT imaging procedure for patient setup adds substantial radiation dose to patient's normal tissue. This study presents a complete procedure for the CBCT dosimetry using the InLight optically‐stimulated‐luminescence (OSL) nanoDots. We report five dose parameters: the mean slice dose (); the cone beam dose index (); the mean volume dose (); point‐dose profile, D(FOV); and the off‐field Dose. In addition, CBCT skin doses for seven pelvic tumor patients are reported. CBCT‐dose measurement was performed on a custom‐made cylindrical acrylic body phantom (50 cm length, 32 cm diameter). We machined 25 circular disks (2 cm thick) with grooves and holes to hold OSL‐nanoDots. OSLs that showed similar sensitivities were selected and calibrated against a Farmer‐type ionization‐chamber (0.6 CT) before being inserted into the grooves and holes. For the phantom scan, a standard CBCT‐imaging protocol (pelvic sites: 125 kVp, 80 mA and 25 ms) was used. Five dose parameters were quantified: , , , D(FOV), and the off‐field dose. The for the central slice was mGy, and was mGy at 16 cm FOV. The was mGy. The off‐field dose was 10.5 mGy. For patients, the anterior and lateral skin doses attributable to CBCT imaging were and mGy, respectively.OSL nanoDots were convenient to use in measuring CBCT dose. The method of selecting the nanoDots greatly reduced uncertainty in the OSL measurements. Our detailed calibration procedure and CBCT dose measurements and calculations could prove useful in developing OSL routines for CBCT quality assessment, which in turn gives them the property of high spatial resolution, meaning that they have the potential for measurement of dose in regions of severe dose‐gradients.PACS number(s): 87.57.‐s, 87.57.Q, 87.57.uq
Anatomy‐based definition of point A utilizing three‐dimensional volumetric imaging approach for high‐dose‐rate (HDR) intracavitary brachytherapy dose prescription when treating cervical cancer using limited resources
Authors: Goyal Manish K. , Rai D.V. , Kehwar Than S. , Manjhi Jayanand , Heintz Bret H. , Shide Kathleen L. , Barker Jerry L. 
Published: February 2017

This study was designed to determine whether volumetric imaging could identify consistent alternative prescription methods to Manchester/point A when prescribing radiation dose in the treatment of cervical cancer using HDR intracavitary brachytherapy (ICBT). One hundred and twenty‐five treatment plans of 25 patients treated for carcinoma of the cervix were reviewed retrospectively. Each patient received 5 fractions of HDR ICBT following initial cisplatin‐based pelvic chemoradiation, and radiation dose was originally prescribed to point A (ICRU‐38). The gross tumor volume (GTV) and high‐risk clinical target volume (HR‐CTV) were contoured in three dimensions on the CT datasets, and inferior–superior, anterior–posterior, and left–right dimensions HR‐CTV were recorded along with multiple anatomic and skeletal dimensions for each patient. The least square–best fit regression lines were plotted between one half of the HR‐CTV width and pelvic cavity dimension at femoral head level and at maximum cavity dimension. The points in both plots lie reasonably close to straight lines and are well defined by straight lines with slopes of 0.15 and 0.17; intercept on y‐axes of and , point A, at the same level as defined based on applicator coordinates, is defined using this correlation, which is a function of distance between femoral heads/dimensions of maximum pelvic cavity width. Both relations, defined by straight lines, provide an estimated location of point A, which provides adequate coverage to the HR‐CTV compared to the point A defined based on applicator coordinates. The point A defined based on femoral head distance would, therefore, be a reasonable surrogate to use for dose prescription because of subjective variation of cavity width dimension. Simple surrogate anatomic/skeletal landmarks can be useful for prescribing radiation dose when treating cervical cancer using intracavitary brachytherapy in limited‐resource settings. Our ongoing work will continue to refine these models.PACS number(s): 87.55.D‐, 87.55.ne
Evaluation of digital radiography practice using exposure index tracking
Authors: Scott Alexander W. , Zhou Yifang , Allahverdian Janet , Nute Jessica L. , Lee Christina 
Published: February 2017

Some digital radiography (DR) detectors and software allow for remote download of exam statistics, including image reject status, body part, projection, and exposure index (EI). The ability to have automated data collection from multiple DR units is conducive to a quality control (QC) program monitoring institutional radiographic exposures. We have implemented such a QC program with the goal to identify outliers in machine radiation output and opportunities for improvement in radiation dose levels. We studied the QC records of four digital detectors in greater detail on a monthly basis for one year. Although individual patient entrance skin exposure varied, the radiation dose levels to the detectors were made to be consistent via phototimer recalibration. The exposure data stored on each digital detector were periodically downloaded in a spreadsheet format for analysis. EI median and standard deviation were calculated for each protocol (by body part) and EI histograms were created for torso protocols. When histograms of EI values for different units were compared, we observed differences up to 400 in average EI (representing 60% difference in radiation levels to the detector) between units nominally calibrated to the same EI. We identified distinct components of the EI distributions, which in some cases, had mean EI values 300 apart. Peaks were observed at the current calibrated EI, a previously calibrated EI, and an EI representing computed radiography (CR) techniques. Our findings in this ongoing project have allowed us to make useful interventions, from emphasizing the use of phototimers instead of institutional memory of manual techniques to improvements in our phototimer calibration. We believe that this QC program can be implemented at other sites and can reveal problems with radiation levels in the aggregate that are difficult to identify on a case‐by‐case basis.PACS number(s): 87.59.bf
Treatment planning for metals using an extended CT number scale
Authors: Mullins John P. , Grams Michael P. , Herman Michael G. , Brinkmann Debra H. , Antolak John A. 
Published: February 2017

Metal implants which saturate the CT number scale may require dosimetrist and physicist involvement to manually contour and assign an appropriate value to the metal for accurate dose calculation. This study investigated dose calculation based directly on extended CT scale images for different metals and geometries. The aim was to evaluate extended CT accuracy as a suitable alternative to standard CT methods in the presence of high‐Z materials and artifacts, despite the reduced HU resolution of extended CT. Gafchromic film measurements were made for comparison to calculated doses. The method of direct dose calculation on extended CT scale was compared to our institution's standard method of manually contouring and assigning metal values on saturated CT images for each of the metal samples. Clinical patient plans with metal implants were investigated and DVHs were compared between standard CT and extended CT dose calculations. Dose calculations showed agreement within 2% between the two methods of metal characterization and the film measurement in the case of the strongest metal attenuator, cobalt‐chromium. In the clinical treatment plans, the greatest dose discrepancy between the two methods was 1.2%. This study suggests that direct dose calculation on an extended scale CT image in the presence of metal implants can produce accurate clinically viable treatment plans, thereby improving efficiency of clinical workflow and eliminating a potential source of human error by manual CT number assignment.PACS number(s): 87.55.dk
The dosimetric impact of control point spacing for sliding gap MLC fields
Authors: Zwan Benjamin J. , Hindmarsh Jonathan , Seymour Erin , Kandasamy Kankean , Sloan Kirbie , David Rajesakar , Lee Christopher 
Published: February 2017

Dynamic sliding gap multileaf collimator (MLC) fields are used to model MLC properties within the treatment planning system (TPS) for dynamic treatments. One of the key MLC properties in the Eclipse TPS is the dosimetric leaf gap (DLG) and precise determination of this parameter is paramount to ensuring accurate dose delivery. In this investigation, we report on how the spacing between control points (CPs) for sliding gap fields impacts the dose delivery, MLC positioning accuracy, and measurement of the DLG. The central axis dose was measured for sliding gap MLC fields with gap widths ranging from 2 to 40 mm. It was found that for deliveries containing two CPs, the central axis dose was underestimated by the TPS for all gap widths, with the maximum difference being 8% for a 2 mm gap field. For the same sliding gap fields containing 50 CPs, the measured dose was always within of the TPS dose. By directly measuring the MLC trajectories we show that this dose difference is due to a systematic MLC gap error for fields containing two CPs, and that the cause of this error is due to the leaf position offset table which is incorrectly applied when the spacing between CPs is too large. This MLC gap error resulted in an increase in the measured DLG of 0.5 mm for both 6 MV and 10 MV, when using fields with 2 CPs compared to 50 CPs. Furthermore, this change in DLG was shown to decrease the mean TPS‐calculated dose to the target volume by 2.6% for a clinical IMRT test plan. This work has shown that systematic MLC positioning errors occur for sliding gap MLC fields containing two CPs and that using these fields to model critical TPS parameters, such as the DLG, may result in clinically significant systematic dose calculation errors during subsequent dynamic MLC treatments.PACS number(s): 87.56.nk
An innovative method to acquire the location of point A for cervical cancer treatment by HDR brachytherapy
Authors: Chang Liyun , Ho Sheng‐Yow , Yeh Shyh‐An , Lee Tsair‐Fwu , Chen Pang‐Yu 
Published: February 2017

Brachytherapy of local cervical cancer is generally accomplished through film‐based treatment planning with the prescription directed to point A, which is invisible on images and is located at a high‐dose gradient area. Through a standard reconstruction method by digitizing film points, the location error for point A would be 3 mm with a condition of 30° curvature tandem, which is 10° away from the gantry rotation axis of a simulator, and has an 8.7 cm interval between the flange and the isocenter. To reduce the location error of the reconstructed point A, this paper proposes a method and demonstrates its accuracy. The Cartesian coordinates of point A were derived by acquiring the locations of the cervical os (tandem flange) and a dummy seed located in the tandem above the flange. To verify this analytical method, ball marks in a commercial “Isocentric Beam Checker” were selected to simulate the two points A, the os, and the dummies. The Checker was placed on the simulator couch with its center ball coincident with the simulator isocenter and its rotation axis perpendicular to the gantry rotation axis. With different combinations of the Checker and couch rotation angles, the orthogonal films were shot and all coordinates of the selected points were reconstructed through the treatment planning system and compared with that calculated through the analytical method. The position uncertainty and the deviation prediction of point A were also evaluated. With a good choice of the reference dummy point, the position deviations of point A obtained through this analytical method were found to be generally within 1 mm, with the standard uncertainty less than 0.5 mm. In summary, this new method is a practical and accurate tool for clinical usage to acquire the accurate location of point A for the treatment of cervical cancer patient.PACS number(s): 87.55.km
The dose penumbra of a custom‐made shield used in hemibody skin electron irradiation
Authors: Rivers Charlotte I. , AlDahlawi Ismail , Wang Iris Z. , Singh Anurag K. , Podgorsak Matthew B. 
Published: February 2017

We report our technique for hemibody skin electron irradiation with a custom‐made plywood shield. The technique is similar to our clinical total skin electron irradiation (TSEI), performed with a six‐pair dual field (Stanford technique) at an extended source‐to‐skin distance (SSD) of 377 cm, with the addition of a plywood shield placed at 50 cm from the patient. The shield is made of three layers of standard 5/8” thick plywood (total thickness of 4.75 cm) that are clamped securely on an adjustable‐height stand. Gafchromic EBT3 films were used in assessing the shield's transmission factor and the extent of the dose penumbra region for two different shield‐phantom gaps. The shield transmission factor was found to be about 10%. The width of the penumbra (80%‐to‐20% dose falloff) was measured to be 12 cm for a 50 cm shield‐phantom gap, and reduced slightly to 10 cm for a 35 cm shield‐phantom gap. In vivo dosimetry of a real case confirmed the expected shielded area dose.PACS number(s): 87.53.Bn
The feasibility of using Microsoft Kinect v2 sensors during radiotherapy delivery
Authors: Edmunds David M. , Bashforth Sophie E. , Tahavori Fatemeh , Wells Kevin , Donovan Ellen M. 
Published: February 2017

Consumer‐grade distance sensors, such as the Microsoft Kinect devices (v1 and v2), have been investigated for use as marker‐free motion monitoring systems for radiotherapy. The radiotherapy delivery environment is challenging for such sensors because of the proximity to electromagnetic interference (EMI) from the pulse forming network which fires the magnetron and electron gun of a linear accelerator (linac) during radiation delivery, as well as the requirement to operate them from the control area. This work investigated whether using Kinect v2 sensors as motion monitors was feasible during radiation delivery. Three sensors were used each with a 12 m USB 3.0 active cable which replaced the supplied 3 m USB 3.0 cable. Distance output data from the Kinect v2 sensors was recorded under four conditions of linac operation: (i) powered up only, (ii) pulse forming network operating with no radiation, (iii) pulse repetition frequency varied between 6 Hz and 400 Hz, (iv) dose rate varied between 50 and 1450 monitor units (MU) per minute. A solid water block was used as an object and imaged when static, moved in a set of steps from 0.6 m to 2.0 m from the sensor and moving dynamically in two sinusoidal‐like trajectories. Few additional image artifacts were observed and there was no impact on the tracking of the motion patterns (root mean squared accuracy of 1.4 and 1.1 mm, respectively). The sensors’ distance accuracy varied by 2.0 to 3.8 mm (1.2 to 1.4 mm post distance calibration) across the range measured; the precision was 1 mm. There was minimal effect from the EMI on the distance calibration data: 0 mm or 1 mm reported distance change (2 mm maximum change at one position). Kinect v2 sensors operated with 12 m USB 3.0 active cables appear robust to the radiotherapy treatment environment.PACS number(s): 87.53 JW, 87.55 N‐, 87.63 L‐
Accuracy of automatic matching of Catphan 504 phantom in cone‐beam computed tomography for tube current–exposure time product
Authors: Won Hui‐Su , Chung Jin‐Beom , Choi Byung‐Don , Park Jin‐Hong , Hwang Do‐Guwn 
Published: February 2017

The purpose of this study is to evaluate the accuracy of automatic matching in cone‐beam computed tomography (CBCT) images relative to the reduction of total tube current–exposure time product (mAs) for the X‐ray imaging (XI) system. The CBCT images were acquired with the Catphan 504 phantom various total mAs ratios such as 1.00, 0.83, 0.67, 0.57, and 0.50. For studying the automatic matching accuracy, the phantom images were acquired with a six‐dimensional shifting table. The image quality and correction of automatic matching were compared. With a decreasing total mAs ratio, the noise of the images increased and the low‐contrast resolution decreased, while the accuracy of the automatic matching did not change. Therefore, this study shows that a change of the total mAs while acquiring CBCT images has no effect on the automatic matching of Catphan 504 phantom in XI system.PACS number(s): 87.57.C‐, 87.57.Q‐
Volumetric‐modulated arc therapy using multicriteria optimization for body and extremity sarcoma
Authors: Young Michael R. , Craft David L. , Colbert Caroline M. , Remillard Kyla , Vanbenthuysen Liam , Wang Yi 
Published: February 2017

This study evaluates the implementation of volumetric‐modulated arc therapy (VMAT) using multicriteria optimization (MCO) in the RayStation treatment planning system (TPS) for complex sites, namely extremity and body sarcoma. The VMAT‐MCO algorithm implemented in RayStation is newly developed and requires an integrated, comprehensive analysis of plan generation, delivery, and treatment efficiency. Ten patients previously treated by intensity‐modulated radiation therapy (IMRT) with MCO were randomly selected and replanned using VMAT‐MCO. The plan quality was compared using homogeneity index (HI) and conformity index (CI) of the planning target volume (PTV) and dose sparing of organs at risk (OARs). Given the diversity of the tumor location, the 10 plans did not have a common OAR except for skin. The skin D50 and was directly compared between VMAT‐MCO and IMRT‐MCO. Additional OAR dose points were compared on a plan‐by‐plan basis. The treatment efficiency was compared using plan monitor units (MU) and net beam‐on time. Plan quality assurance was performed using the Sun Nuclear ArcCHECK phantom and a gamma criteria of 3%/3 mm. No statistically significant differences were found between VMAT‐ and IMRT‐MCO for HI and CI of the PTV or D50 and to the skin. The VMAT‐MCO plans showed general improvements in sparing to OARs. The VMAT‐MCO plan set showed statistically significant improvements over the IMRT‐MCO set in treatment efficiency per plan MU () and net beam‐on time (). The VMAT‐MCO plan deliverability was validated. Similar gamma passing rates were observed for the two modalities. This study verifies the suitability of VMAT‐MCO for sarcoma cancer and highlighted the comparability in plan quality and improvement in treatment efficiency offered by VMAT‐MCO as compared to IMRT‐MCO.PACS number(s): separated by commas 87.55.D, 87.55.de, 87.55.Qr